腎部分切除後に発生した腎偽性動脈瘤の1例

Although intraoperative hemorrhage is a well-recognized complication of open partial nephrectomy, postoperative hemorrhage caused by a renal artery pseudoaneurysm (RAP) after open partial nephrectomy is rare. We presented a case of RAP occurring in an 84-year-old man 3 weeks after right open partial nephrectomy for renal cell carcinoma. The pseudoaneurysmal branch was successfully identified and selectively embolized using percutaneous renal arterial angiography.腎偽性動脈瘤は腎生検, 腎外傷, 腎移植などに起因することが多いが, 腎部分切除術後に発生することは1%以下と稀である。われわれは腎部分切除術後3週間目に発生した, 腎偽性動脈瘤の1例を経験したので若干の文献的考察を加えて報告する。(著者抄録

Surface Circular Photogalvanic Effect in Tl-Pb Monolayer Alloys on Si(111) with Giant Rashba Splitting

We have found that surface superstructures made of "monolayer alloys" of Tl and Pb on Si(111), having giant Rashba effect, produce non-reciprocal spin-polarized photocurrent via circular photogalvanic effect (CPGE) by obliquely shining circularly polarized near-infrared (IR) light. CPGE is here caused by injection of in-plane spin into spin-split surface-state bands, which is observed only on Tl-Pb alloy layers, but not on single-element Tl nor Pb layers. In the Tl-Pb monolayer alloys, despite their monatomic thickness, the magnitude of CPGE is comparable to or even larger than the cases of many other spin-split thin-film materials. The data analysis has provided the relative permittivity $\epsilon^{\ast}$ of the monolayer alloys to be $\sim$ 1.0, which is because the monolayer exists at a transition region between the vacuum and the substrate. The present result opens the possibility that we can optically manipulate spins of electrons even on monolayer materials

Vaginoplasty with a Pudendal-Thigh Flap in Intersexuals

We treated 2 different types of intersexual patients who underwent a vaginoplasty with the pudendal-thigh flap. One was a female with testicular feminization syndrome for whom we reconstructed the total vagina with a pudendal-thigh flap, and the other was a female with an adrenogenital syndrome for whom we enlarged the introitus of the vagina with the same approach. There were no complications such as a flap necrosis. In addition, there was no stricture of the neo-vagina and no urinary problem.</p

High-Dose Corticosteroids for a Pregnant Woman Critically Ill With Coronavirus Disease 2019

Pregnancy was reported to be a risk factor for coronavirus disease 2019 (COVID-19), with an increased risk for premature birth. Corticosteroids and remdesivir are used for patients with COVID-19; however, there is no established treatment for these patients. In particular, the effective management of pregnant, critically ill patients with COVID-19 remains unknown. We describe a 34-year-old, critically ill woman at 30 weeks of gestation with COVID-19, who was successfully treated with remdesivir and combined high-dose betamethasone (12 mg/day for two days) and methylprednisolone (125 mg/day for three days) followed by steroid tapering. During treatment, fetal biophysical profile scores on obstetric ultrasound were normal; her pregnancy course progressed well. Since high-dose corticosteroids improve fetal lung maturation and as well as cytokine storm due to COVID-19, this case provides an insight into the management of pregnant COVID-19 patients

Phantom erectile penis after sex reassignment surgery

Between January 2001 and December 2007, we performed vaginoplasty as sex reassignment surgery in a total of 14 male-to-female transsexual (MTFTS) patients [1]. Several complications occurred such as partial flap necrosis, rectovaginal fistula formation and hypersensitivity of the neoclitoris. Just after the operation, some patients feel that their penises still exist, but by several weeks postoperatively, this sensation has disappeared. Herein we report a case of MTFTS in whom the sensation of a phantom erectile penis persisted for much longer.</p

Vaginoplasty with an M-Shaped Perineo- Scrotal Flap in a Male-to-female Transsexual

To date, many techniques have been reported for vaginoplasty in male-to-female trans-sexual (MTFTS) patients, such as the use of a rectum transfer, a penile-scrotal flap and a reversed penile flap. However, none of these procedures is without its disadvantages. We developed a newly kind of flap for vaginoplasty, the M-shaped perineo-scrotal flap (M-shaped flap), using skin from both sides of the scrotum, shorn of hair by preoperative laser treatment. We applied this new type of flap in 7 MTFTS patients between January 2006 and January 2007. None of the flaps developed necrosis, and the patients could engage in sexual activity within 3 months of the operation. The M-shaped flap has numerous advantages: it can be elevated safely while retaining good vascularity, it provides for the construction of a sufficient deep vagina without a skin graft, the size of the flap is not influenced entirely by the length of the penis, and it utilizes skin from both sides of the scrotal area, which is usually excised.</p

Recommended Instructional Methods for Elementary School English Based on a Survey of First-year Junior High School Students : Focused on 5th and 6th Graders

本研究のg的は,2020年度から全面実施された新学習指導要領で,小学校英語の早期化•教科化に対応した指導のあり方を,中学1年生の意識調査から探ることであった。そのため,「外国語活動」から「英語」の授業へという学習過程が同じである旧学習指導要領の中学1年生720人を対象に,2学期の11月下旬に学習経験や学習状況に関する意識調査を実施した。その結果,学習困難の開始時期は中学校入学後,学習困難事項の第1位は「テストで点が取れない」であり,英語の授業や学習を理解するには家庭学署の習慣化が重要であることが分かった。また,幼稚園•保育園時代と小学校時代の学校以外での英語学習の有無は,中学校での英語の理解度に幾分関係はあるが絶対的なものではなかった。小学校での英語の学習時間数と学習内容にも大きな違いはなかったため,今後特に5 - 6年生対象に効果的な英語の指導を展開するには,通常の授業での工夫はもとより,学習事項を定着するために家庭学習を有機的に組み込むことが必要であると示唆された。According to the new Course of Study (Ministry of Education, Culture, Sports, Science and Technology, 2017), which was fully implemented in elementary schools from 2020, “foreign language activities^^ are taught for 35 unit hours in both grade 3 and 4, while 70 unit hours of “English” is taught in both grade 5 and 6. The purpose of this study, therefore, was to explore appropriate instructional methods corresponding to the earlier introduction of "foreign language activities” and “English” in elementary schools, focusing on 5th and 6th graders. To complete the study, a survey of 720 first-year junior high school students was conducted in November 2013 on learning experiences and conditions with the former Course of Study (Ministry of Education, Culture, Sports, Science and Technology, 2008), which had the same curriculum progression from “foreign language activities^^ to “English” classes. The results revealed the ollowing:1) Regarding the degree of understanding of English lessons and studying, 20% were “unable to understand.” 2) The most frequently cited item that first-year junior high school students found difficult in English lessons and studying was “getting a good score on English tests.” 3) The first-year junior high school students who were “able to understand” English lessons and studying had a habit of home study to a significant degree. 4) A relatively high number of students had learned English during kindergarten / nursery school days, but the majority (77%) of “understanding” students had not, suggesting that it is not so important. 5) A significantly higher number of people had learned English outside of school as elementary school students, but this was not absolute, as the majority (55%) of “understanding” students had no such experience. 6) There was no large difference in the number of hours spent learning English in elementary school between the first-year junior high school students who were “able to understand” and “unable to understand’ English lessons and studying. 7) There was almost no difference in the content of English learning experienced at elementary schools between the students of these two groups. From these findings, in order to establish the study items for a class limited to 2 lessons per week under the new Course of Study, it is suggested that “habituation of home study” is an important point to be considered for instruction of 5th and 6th graders.4uetdai-15_03_s_hasegawa.pdfdepartmental bulletin pape

Physical Characteristics of Injection Site Pain After COVID-19 mRNA BNT162b2 Vaccination

Background: BNT162b2, an mRNA COVID-19 vaccine, was launched in many countries as an intramuscular vaccination for COVID-19 infection. Few studies have assessed the physical indications of pain at the immunization site. This study aimed to characterize pain at the injection site and investigate morphological attributes using ultrasound. Methods: Forty-three of 211 healthcare workers who received a second dose of BNT162b2 between February 2021 and March 2021 were enrolled in the study. The mean age of the subjects was 40 years. We evaluated patients’ pain at the injection site using the Numerical Rating Pain Scale (NRPS). We also assessed the thickness of the deltoid muscle fascia at the injection site by ultrasound. Bayesian robust correlation was employed to explore the relationship between the pain intensity scores and ultrasound measurements. Results: All eligible subjects complained of pain at the injection site. A median pain onset of 8 hours post-vaccination and a median peak intensity score of 4 were reported. Onset of relief occurred after 2 days. Ultrasound images demonstrated a 2.5-fold increase in fascia thickness at the injection site without intramuscular echogenicity change in all subjects. A correlation was established between the NRPS score and the non-injection-to-injection-side ratio of fascia thickness at the injection site (rho = 0.66). Conclusion: A sore arm was the most prevalent side effect of BNT162b2 vaccination and could be attributed to temporal fasciitis

Direct Nucleophilic Substitution of Alcohols Using an Immobilized Oxovanadium Catalyst

Direct nucleophilic substitution of alcohols with thiols or carbon nucleophiles was achieved using a mesoporous silica-supported oxovanadium catalyst (VMPS4). Benzyl and allyl alcohols were compatible in this reaction under mild conditions, affording the products in high yields. The VMPS4 catalyst showed excellent chemoselectivity toward alcohols in the presence of acid-labile functional groups, which is in contrast to that observed for the commonly used Lewis acid catalysts, which exhibit poor selectivity. The VMPS4 catalyst could be recycled by simple centrifugation, and the catalytic activity was maintained over seven cycles.This is the pre-peer reviewed version of the following article:Nishio T., Yoshioka S., Hasegawa K., et al. Direct Nucleophilic Substitution of Alcohols Using an Immobilized Oxovanadium Catalyst. European Journal of Organic Chemistry 2021, 4417 (2021), which has been published in final form at https://doi.org/10.1002/ejoc.202100569. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archivin