<臨床>胃癌術後に肺転移巣を切除した2例

It is said that the prognosis is poor in cases with recurrent pulmonary metastasis after operation for gastric cancer. In this article, 2 cases with nodular type of pulmonary metastasis resected after operation for gastric cancer and surviving well are reported by the authors. Case 1: 57year-old female. The patient underwent a total gastrectomy for the 3'type of cardiac cancer. As the serum levels of tumor markers increased and the chest X-ray examination revealed a mass lesion in the right lung (S_10), the operation for the lesion under the diagnosis of metastatic lung cancer was performed 1 year and 2 months after gastrectomy. The patient died of pulmonal and pleural metastasis 4 years and 7 months after the first operation. Case 2: 65-year-old male. The patient underwent a subtotal gastrectomy for the 5'type of gastric cancer. Chest X-ray examination for follow-up study revealed a mass lesion in the left lung (S_5). The patient underwent a left pulmonary superior lobe resection 2 years and 9 months after gastrectomy. The patient is still alive 6 years after the first operation. Surgical treatment must be actively considered for nodular type of metastatic lung cancer after operation for gastric cancer.胃癌術後に肺転移をきたした症例の予後は不良とされている. 今回, 胃切除術後に結節型肺転移巣を切除し, 良好な結果を得た胃癌の2例を経験したので、報告する. 症例 1 は57歳, 女性. 噴門部 2'型胃癌の診断のもと, 胃全摘術を受けている. 腫瘍マーカーの上昇があり, 胸部X線写真で右肺 S_10 に腫瘤陰影を認めた. 胃癌術後1年2カ月目に肺部分切除術を施行した. 患者は胃癌切除後4年7カ月で肺転移および癌性胸膜炎のため死亡した. 症例2は65歳, 男性. 胃体部 5'型胃癌の診断のもと, 胃亜全摘を受けている. 術後経過観察中, 胸部X線写真で左肺 S_5 に腫瘤陰影を認め, 胃癌術後2年9カ月目に左肺上葉切除切除術を施行した. 患者は胃癌切除術後6年で健在である. 結節型の肺転移例に対しては積極的な外科手術を考慮すべきである

Comparison of early outcomes after primary stenting in Japanese patients with acute myocardial infarction between clopidogrel and ticlopidine in concomitant use with proton-pump inhibitor

SummaryBackgroundRecent studies have reported that concomitant use of clopidogrel with proton-pump inhibitors (PPIs) might decrease antiplatelet effects and increase the risk of adverse outcomes after coronary stenting. However, little is known about the difference between clopidogrel and ticlopidine in concomitant use with PPIs, especially within the Asian population.MethodsWe retrospectively analyzed 302 consecutive patients (248 males, mean age 66±12 years) undergoing primary stenting for acute myocardial infarction from July 2006 to June 2010. PPIs were administered to 92% (278/302) of the patients. The patients were divided into two groups on the basis of clopidogrel (clopidogrel group, n=187) or ticlopidine (ticlopidine group, n=91) with PPI. Their characteristics, medications, and 30-day clinical outcomes were examined.ResultsThere were no significant differences in 30-day major adverse cardiac events (cardiac death, non-fatal myocardial infarction, and definite stent thrombosis), bleeding events, and stroke between the two groups. The discontinuation of clopidogrel due to side effects was significantly less frequent than that of ticlopidine (1.1% vs 7.7%, p=0.003, respectively).ConclusionOur findings suggest that concomitant use of clopidogrel with PPIs might be safer than ticlopidine with PPIs in patients undergoing primary stenting for acute myocardial infarction

Multi-scale MHD analysis of LHD plasma with background field changing

The mechanism of the partial collapse observed in the experiment with the background magnetic field changing in the Large Helical Device (LHD) is numerically investigated with a nonlinear magnetohydrodynamics (MHD) simulation. Since the different timescales of the perturbations and the background field changing have to be treated simultaneously for the analysisof this plasma, a multi-scale simulation scheme is developed. The effect of the perturbation dynamics on the equilibrium pressure and rotational transform is taken into account in this scheme. The result indicates that the collapse is caused by the destabilization of an infernal-like mode due to the magnetic hill enhanced by the change of the background field. The mechanismof the reduction of the central beta observed after the partial collapse in the experiment is also analysed in relation to the effect of the background field changing

Impact of Energetic Ion Driven Global Modes on Toroidal Plasma Confinements

Excitation of energetic-ion-driven Alfv6n eigenmodes (AEs) and their impact on energetic ion confinement are widely and intensively studied in helical devices such as CHS and LHD as well as major tokamaks. The excitation of AEs sensitively depends on the parameter space defined by the averaged beam beta and the velocity ratio V6nlV6 (V611 : injected beam ion velocity, Va: Alfv6n velocity). In LHD, these two relevant parameters are widely scanned without suffering from current disruptions. So far, toroidicity induced AE (TAE), global AE (GAE) and energetic particle mode (EPM) or resonant TAE (R-TAE) were identified during tangential neutral beam injection (NBI) in CHS and LHD. Moreover, a new coherent mode with the frequency by about 8 times higher than the TAE frequency was observed in NBI heated plasmas of LHD at low magnetic field (<0.6T). This mode may be induced by helical field components of the confinement field. Nonlinear phenomena of bursting amplitude modulation and fast frequency chirping are clearly seen for TAEs and EPMs in CHS and LHD. EPMs in CHS and bursting TAEs in LHD enhance radial transport of energetic ions in certain plasma conditions

Column-Parallel Correlated Multiple Sampling Circuits for CMOS Image Sensors and Their Noise Reduction Effects

For low-noise complementary metal-oxide-semiconductor (CMOS) image sensors, the reduction of pixel source follower noises is becoming very important. Column-parallel high-gain readout circuits are useful for low-noise CMOS image sensors. This paper presents column-parallel high-gain signal readout circuits, correlated multiple sampling (CMS) circuits and their noise reduction effects. In the CMS, the gain of the noise cancelling is controlled by the number of samplings. It has a similar effect to that of an amplified CDS for the thermal noise but is a little more effective for 1/f and RTS noises. Two types of the CMS with simple integration and folding integration are proposed. In the folding integration, the output signal swing is suppressed by a negative feedback using a comparator and one-bit D-to-A converter. The CMS circuit using the folding integration technique allows to realize a very low-noise level while maintaining a wide dynamic range. The noise reduction effects of their circuits have been investigated with a noise analysis and an implementation of a 1Mpixel pinned photodiode CMOS image sensor. Using 16 samplings, dynamic range of 59.4 dB and noise level of 1.9 e− for the simple integration CMS and 75 dB and 2.2 e− for the folding integration CMS, respectively, are obtained

Relationships between the Prediction of Linear MHD Stability Criteria and the Experiment in LHD

We analyze the relationship between the experimentally observed pressure gradients at resonant rational surfaces and the theoretically predicted ideal magnetohydrodynamics (MHD) unstable region of global modes in the large helical device (LHD). According to the stability analysis of the ideal MHD modes with a low toroidal mode number, we find that the ideal MHD mode gives a constraint on the operational regime of the pressure gradients in the core. In the edge, a clear saturation of the pressure gradients due to the ideal MHD instability has not been observed up to the high beta regime around 3% as the volume-averaged toridal beta value, where global ideal MHD modes are predictedto be unstable

Construction of a genetic AND gate under a new standard for assembly of genetic parts

<p>Abstract</p> <p>Background</p> <p>Appropriate regulation of respective gene expressions is a bottleneck for the realization of artificial biological systems inside living cells. The modification of several promoter sequences is required to achieve appropriate regulation of the systems. However, a time-consuming process is required for the insertion of an operator, a binding site of a protein for gene expression, to the gene regulatory region of a plasmid. Thus, a standardized method for integrating operator sequences to the regulatory region of a plasmid is required.</p> <p>Results</p> <p>We developed a standardized method for integrating operator sequences to the regulatory region of a plasmid and constructed a synthetic promoter that functions as a genetic AND gate. By standardizing the regulatory region of a plasmid and the operator parts, we established a platform for modular assembly of the operator parts. Moreover, by assembling two different operator parts on the regulatory region, we constructed a regulatory device with an AND gate function.</p> <p>Conclusions</p> <p>We implemented a new standard to assemble operator parts for construction of functional genetic logic gates. The logic gates at the molecular scale have important implications for reprogramming cellular behavior.</p

Onset of instability with collapse observed in relatively high density and medium beta regions of LHD

Edge MHD instabilities with pressure collapse are found in relatively high beta and low magnetic Reynolds number regions with a magnetic axis torus outward-shifted configuration of the large helical device (LHD), and characteristics and onset conditions of the instability are investigated. The instability has a radial structure with an odd parity around the resonant surface, which is different from that of the interchange instability typically observed in the LHD. The onset condition dependence on the magnetic axis location shows that the onset beta increases as the magnetic axis location moves more torus inwardly, and the instability appears only in limited configurations where the magnetic axis is located between 3.65 and 3.775 m. In such configurations, the resonant surface location is close to an index of the plasma boundary. This fact suggests that the distance between the resonant surface location and the plasma boundary plays an important role in the onset, and a possibility that the instability is driven by an external mode

External RMP effect on locked-mode-like instability in helical plasmas

The slowing-down mechanism of the locked-mode-like instabilities with and without an island structure is investigated through the effects of an external RMP (resonant magnetic perturbation) on the instabilities. For both instabilities, the slowing-down duration decreases with the increase in the external RMP, and the RMP dependence is consistent with the braking model of the j × B force due to the interaction between the instabilities and the external RMP. Moreover, the relationship between the amplitude and the frequency of both locked-mode-like instabilities during the slowing down is consistent with the force balance model between the j × B force due to the external RMP and a viscous force. These results suggest that the slowing down of both locked-mode-like instabilities with finite external RMP occurs due to the j × B force driven by the external RMP

Dependence of the resonant magnetic perturbation penetration threshold on plasma parameters and ions in helical plasmas

We investigate the penetration threshold of resonant magnetic perturbation (RMP) by the external coils in the Large Helical Device (LHD) for various plasma aspect ratio configurations. The qualitative dependence on the collisionality is opposite to that in a high plasma aspect configuration; this is a quite unique property first found in the LHD. We also investigate the threshold dependence on the ion species, and find that the threshold in deuterium discharges is much smaller than that in hydrogen discharges. In all cases the thresholds are higher as the poloidal rotation becomes faster, which shows that poloidal rotation is the dominant driver to the RMP shielding. This is qualitatively consistent with the torque balance model between the electromagnetic and poloidal viscous torques. In a configuration of the LHD, the dependence of the threshold on the density is qualitatively similar to that in Ohmic tokamak plasmas, but the beta dependence is opposite to that of tokamaks. The difference arises from the cause of the viscous torque