フククウキョウ カ チュウスイ セツジョ ジュツ オ シコウ シタ チュウスイ ケイシツ エン ノ 1レイ

本邦では虫垂憩室炎は比較的稀な疾患であり臨床的に診断が困難である.虫垂炎が疑われる症例の中にも本症例のように虫垂憩室炎が存在する可能性がある.しかしそのような場合でも腹腔鏡下手術が有用と考えられる.慢性に経過し画像上虫垂憩室炎の診断に苦慮したが,治療に鏡視下手術が有用であった一例を経験し文献的な考察を加えて報告した.虫垂の炎症疾患を疑い外科的治療を施行する際には腹腔鏡下手術が望ましいと考えられた.Diverticulum of the vermiform appendix is rarely encounteredin Japan. It is difficult to diagnose diverticulum ofthe appendix preoperatively. A 37-year-old male patientcame to our hospital with presentation of acute abdominalpain in the right lower quadrant. We performed laparoscopicappendectomy under the diagnosis of the suspicion ofacute appendicitis. It showed severe adhesion between thetip of appendix and retroperitoneum with local inflammatoryreaction. Pathological examination revealed severalchronic diverticulitis and acute diverticulitis in the appendix.Laparoscopic surgery is very useful to dissect severeadhesion of appendix. Laparoscopic surgery for diverticulumof the appendix is an effective procedure

Is the fatty raised lesion a pre-atheromatous lesion? - A preliminary study

Traditionally, atherosclerosis has been evaluated macroscopically from the presence of fatty streaks (FS), fibrous plaques (FBP), and complicated lesions (CL). In this preliminary study, employing aortas from autopsied middle-aged or older persons we investigated the fatty raised lesion (FRL) to elucidate its significance and histological features. The FRL is determined macroscopically from its distinctive intimal elevation with a yellowish surface, so displaying mixed characteristics of the FS and the FBP. The FRL was identified macroscopically in 50% of 10 cases in the thoracic part of the aorta, and in 30% of the cases, in the abdominal part. When present, it occupied 6.4% and 5% of the intimal area in the thoracic and abdominal parts, respectively. These data were comparable to those of other lesions. Microscopically, the FRL exhibited different histological types, depending on the presence of a necrotic core and the degree of fibrous tissue development in the cap region. One predominant type had a clearly recognizable necrotic core, similar to the FBP, and an active fatty cap region, resembling that of fatty plaque. The presence of FRLs may be an important characteristic to be examined during the progress of atherosclerosis

Job Shop Scheduling Focusing on Role of Buffer

A scheduling problem is formulated in order to consistently manage each manufacturing resource, including machine tools, assembly robots, AGV, storehouses, material shelves, and so on. The manufacturing resources are classified into three types: producer, location, and mover. This paper focuses especially on the role of the buffer, and the differences among these types are analyzed. A unified scheduling formulation is derived from the analytical results based on the resource\u27s roles. Scheduling procedures based on dispatching rules are also proposed in order to numerically evaluate job shop-type production having finite buffer capacity. The influences of the capacity of bottle-necked production devices and the buffer on productivity are discussed.・rights：日本機械学会・rights：本文データは学協会の許諾に基づきCiNiiから複製したものである・relation：isVersionOf：http://ci.nii.ac.jp/naid/110004781798

A Case of Early Stage Bladder Carcinosarcoma in Late Recurrence of Urothelial Carcinoma after Transurethral Resection

Carcinosarcomas of the urinary bladder are rare biphasic neoplasms, consisting of both malignant epithelial and malignant mesenchymal components, and the prognosis of this tumor is unfavorable in most patients with even possibility of resection of disease. A 77-year-old male with a history of transurethral resection (TUR) of urothelial carcinoma (UC) of the bladder and adjuvant intravesical chemotherapy with pirarubicin 10 years ago revisited our department with a gross hematuria. Cystoscopy demonstrated an approximately 2.5 cm nonpapillary tumor on the right wall of the bladder. Pelvic MRI showed the tumor without extending the base of the bladder wall. The tumor could be completely removed with TUR. The malignant epithelial elements consisted of high-grade UC and the majority of mesenchymal components were fibrosarcomatous differentiation based on immunohistochemical studies. The tumor could be pathologically also suspected to be an early stage on TUR specimens. Although he has received no additional intervention due to the occurrence of myocardial infarction at three weeks after the TUR, he has been alive with no evidence of recurrence of the disease 27 months after the TUR. Some early stages of bladder carcinosarcoma might have a favorable prognosis without aggressive treatments

Metastatic Tumor of the Spermatic Cord in Adults: A Case Report and Review

Metastatic spermatic cord (SC) tumor is extremely rare. Recently, we experienced a case of late-onset metastatic SC tumor from cecal cancer. This case is a 68-year-old man presenting with a painless right SC mass. He had undergone a right hemicolectomy for cecal cancer 6 years ago. Radical orchiectomy and adjuvant chemotherapy with S-1 were performed. No recurrence was found after one year of follow-up. We identified a total of 25 cases, including our case, on a literature search via PubMed from January 2000 to April 2015. The most frequent primary sites of the tumors metastasizing to the SC were the stomach (8 cases, 32%) and the colon (8 cases, 32%), next the liver (2 cases, 8%), and kidney (2 cases, 8%). The majority of the cases underwent radical orchiectomy for the metastatic tumors of the SC. Over half of the cases received adjuvant interventions based on the regimens for the primary tumors. Prognosis in the patients with metastatic tumor of the SC was unfavorable except for late-onset metastasis. In patients with a mass in the SC and a history of neoplasm, especially in gastrointestinal tract, the possibility of metastasis from the primary cancer should be considered

Long-term outcomes of an esophagus-preserving chemoradiotherapy strategy for patients with endoscopically unresectable stage I thoracic esophageal squamous cell carcinoma

[Background and purpose] To assess the long-term outcomes of a multimodal approach for maximum esophagus preservation in operable patients with endoscopically unresectable stage I thoracic esophageal squamous cell carcinoma (ESCC). [Materials and methods] The medical records of patients with stage I thoracic ESCC treated with our protocol between 1992 and 2005 were retrospectively reviewed. Our protocol consisted of neoadjuvant concurrent chemoradiotherapy, followed by either additional definitive chemoradiotherapy for good responders (CRT group) or surgery for moderate or poor responders (CRT-S group) after an interim appraisal. [Results] A total of 51 patients were analysed. The median age of the patients was 67 years. The median follow-up period was 124.8 months. After the interim assessment, 49 and 2 cases were assigned to the CRT and CRT-S groups, respectively. In the intent-to-treat analyses, overall survival (OS), disease-free survival (DFS), cumulative incidence for death from esophageal cancer, and that for loss of esophageal function were 78.9%, 53.5%, 10.5%, and 20.4% at 5 years, and 55.2%, 27.8%, 18.2%, and 22.9% at 10 years, respectively. Grade 3 late toxicities occurred with the following incidences: esophageal stenosis in 1 case, esophageal ulcer in 1 case, and pericardial effusion in 2 cases. No grade 4 or higher toxicities were observed. [Conclusion] Long-term survival and esophagus preservation outcomes were favorable, with acceptable toxicities. Our results suggest that CCRT is an alternative treatment for majority of operable patients with endoscopically unresectable stage I thoracic ESCC in combination with salvage therapy

Visualising Martensite Phase Fraction in Bulk Ferrite Steel by Superimposed Bragg-edge Profile Analysis of Wavelength resolved Neutron Transmission Imaging

Bragg-edge neutron transmission imaging, a wavelength-resolved neutron imaging method, is a unique method for materials characterization. This method can quantitatively visualise various crystalline microstructural information in bulk material over several- centimetres with sub-millimetre spatial resolution. In various forms of crystalline information, the martensite phase fraction in ferritic steel is significant for the characterisation of, e.g., contact surface of an induction-hardened gear, dual phase (DP) steel used for automobiles, and the cutting edge of Japanese swords. However, the martensite phase fraction in a ferrite-martensite steel has not been measured using conventional Bragg-edge analysis methods because the entire neutron transmission spectral pattern of the alpha'- martensite phase corresponds to that of the alpha- ferrite phase. However, the Bragg-edge profile of the martensite phase is slightly broader than that of the ferrite phase. For these reasons, we developed a new method for measuring the ferrite/martensite phase fraction from the superimposed Bragg-edge (sBE) profile composed of both sharp alpha{110} Bragg-edge and broad asymmetric a'{110}- a'{101} Bragg-edge. As a result, two-dimensional imaging and computed tomography of the martensite phase fraction in ferrite-martensite steel were reasonably achieved. In addition, we observed the sBE analysis method to have numerous advantages such as reasonable accuracy (similar to 5%), high precision and stability, and easy handling. Furthermore, we identified the suitability of an asymmetric crystal-latticeplane-spacing distribution function for the determination of the alpha'{110}- alpha'{101} Bragg-edge profile, and found the blurred boundary by mixing unquenched and quenched regions in an induction-hardened steel rod