Survey on Evacuation Behavior at Nursing Facilities in Ashikita Town due to Heavy Rain in July 2020

The nursing facility C located near the Sashiki River was flooded due to Heavy Rain in July 2020. The survey method was an interview survey on the damage situation and evacuation behavior. In addition, a flood inundation analysis was conducted. Judging from both the execution and the process of flooding, facility C missed the timing of the evacuation action. The main reasons were that the event was beyond one’s expectation, information was not helpful, lack of manpower, flooded water rose fast. The lessons of this experience are action plan using information, nighttime emergency system, evacuation drills with multiple patterns. For the safety of elderly people, both an evacuation security plan and a business continuity plan (BCP) are needed. On the other hand, there are administrative issues related to wide-area evacuation. Deregulation of the long-term care insurance system and simplification of administrative procedures are desirable.令和2年7月豪雨により佐敷川の近くに立地する高齢者施設Cは浸水被害を受けた。高齢者施設Cを対象に，被害状況や避難行動に関するインタビュー調査と氾濫解析を実施した。避難行動と浸水の過程からみて，より安全な避難のタイミングを逃していた。主な理由として，想定外の出来事であったこと，情報が活用されなかったこと，マンパワーが足りなかったこと，浸水の速度が速かったことなどが考えられる。この教訓として，情報を活用した行動計画，夜間の緊急参集体制，複数のパターンによる避難訓練，などが挙げられる。また，高齢者の安全な生活のためには避難確保計画と事業継続計画（BCP）の両方が求められる。一方，広域避難に関する行政上の課題も明らかになった。この課題を解決するためには，自治体や福祉団体による計画策定支援が必要で，介護保険制度の規制緩和，行政手続きの簡略化が望まれる

H2_2 Emission Nebulosity Associated with KH 15D

An H$_2$ emission filament is found in close proximity to the unique object KH 15D using the adaptive optics system of the Subaru Telescope. The morphology of the filament, the presence of spectroscopic outflow signatures observed by Hamilton et al., and the detection of extended H$_2$ emission from KH 15D by Deming, Charbonneau, & Harrington suggest that this filament arises from shocked H$_2$ in an outflow. The filament extends about 15" to the north of KH 15D.Comment: 11 pages, 3 figures, 1 table. Astrophysical Journal Letters, in pres

A surgical case of mitral valve replacement for a patient with Fabry disease complicated with hemodialysis

　Fabry disease is a rare genetic disease, and surgical reports for the patients with Fabry disease are also rarer.　A 58-year-old man presented with chest pain. At the age of 40, he commenced dialysis due to chronic renal failure and at the age of 50, he developed shortness of breath on exertion, and echocardiography showed mitral regurgitation and left ventricular hypertrophy. He was then diagnosed with Fabry disease due to decreased alpha-galactosidase activity. This diagnosis led to enzyme replacement therapy (ERT). The ERT was effective as he had not never experienced further exacerbation of congestive heart failure. While the CHF was put under control, his mitral stenosis gradually worsened, and the patient began to have more chest pain and became hypotensive. He then referred to our section for mitral valve replacement. His mitral annulus was severely calcified and we removed mitral annulus calcification (MAC) at minimum so that we could stich needles and implanted mechanical valve. Paroxysmal atrial fibrillation and bradycardia made his hemodynamics unstable against ERT, which also caused low dialysis efficiency. It took longer than usual to wean him off catecholamines. His hemodynamics became more stable and dialysis efficiency generally improved, so he moved from ICU to ward on postoperative day 11. On day 32, he was transferred back to the referring hospital for his rehabilitation.　We have reported a surgical case of Fabry disease, that are not only rare but have high perioperative risk due to Fabry disease’s specific complications

Case report on a coronary artery bypass graft for a patient with antiphospholipid antibody syndrome associated with systemic lupus erythematosus

　Antiphospholipid antibody syndrome (APS) is an immune disease in which antiphospholipid antibodies cause hypercoagulability and thromboembolic complications. We experienced APS cases associated with systemic lupus erythematosus with three-vessel lesions of the coronary artery. After a below knee amputation on a 60-year-old woman with APS, she complained of chest pain at rest. An electrocardiogram showed an ST depression and a coronary angiography showed complicated three-vessel disease, as a result she was referred to the cardiac surgery department. A coronary artery bypass with arterial grafts was performed along with postoperative anticoagulant and antiplatelet therapy, and the short-term graft patency was good. Case reports of coronary artery bypass grafts for secondary APS are rare, so we report here on our case and our strategy to treat thromboembolic complications

A Subarcsecond Companion to the T Tauri Star AS 353B

Adaptive optics imaging of the bright visual T Tauri binary AS 353 with the Subaru Telescope shows that it is a hierarchical triple system. The secondary component, located 5.6" south of AS 353A, is resolved into a subarcsecond binary, AS 353Ba and Bb, separated by 0.24". Resolved spectroscopy of the two close components shows that both have nearly identical spectral types of about M1.5. Whereas AS 353A and Ba show clear evidence for an infrared excess, AS 353Bb does not. We discuss the possible role of multiplicity in launching the large Herbig-Haro flow associated with AS 353A.Comment: AASTeXv5.0, 21 pages, 5 figures, Astronomical Journal, in pres

Two cases of lymphoepithelial cyst of the pancreas

A 35-year-old man was found to have a cystic mass in the pancreatic body on a routine health examination ; high serum CA19-9 was also detected. The enucleated cyst was diagnosed as a lymphoepithelial cyst (LEC). A 74-year-old man found to have a cystic mass in the pancreatic head by computer tomography as well as high serum CA19-9 was suspected of a cystic neoplasm of the pancreas (IPMN), and pylorus-preserving pancreaticoduodenectomy (PPPD) was performed. Pathologically, the cyst was found to be LEC. It is often difficult to diagnose pancreatic cyst as LEC preoperatively. Care should be taken not to do over-surgery for benign disease LEC