On Sanemori

一、 はじめに 世阿弥の修羅能を云々する場合、必ずといってよいほど言及されるのが『風姿花伝』第二篇［物学条々］の「修羅」の条であろう。ここにはまず、「これまた一体の物なり。よくすれども、面白き所稀なり。 ..

An Empirical Study on the factors influencing the utilization and the effectiveness of Enterprise Instant Messenger

Communication technology has been recognized to play an important role in boosting organization’s competitiveness and viability by facilitating efficient communication and information sharing. Lately, many organizations began to actively adopt the self-developed Enterprise Instant Messenger (EIM) as a common organizational communication medium after experiencing security problem with public messengers like MSN. Its utilization and tangible benefits of EIM, however, vary. There’s an urgent need to understand how each organization embraces EIM and to empirically evaluate whether active use of EIM can result in a better communication, eventually leading into better business productivity. In this research we try to investigate those antecedents which may have affected the high use of EIM and a better decision making efficiency. Theoretical justification of research variables and causal relationships of our research model are mainly based on Technology Acceptance Model (TAM), media selection theory, and social influence model. Through a survey data analysis of 171 EIM users, it was found that perceived usefulness, social influence, the externally-orientated organizational culture had a significant effect on the high use of EIM. In addition, the use of EIM was found to have a significant effect on the efficiency in the decision-making process

Intra-abdominal Esophageal Duplication Cyst in an Adult

Esophageal duplication cysts are congenital anomalies of the foregut that are rarely found in the abdomen. An accurate preoperative diagnosis is not always possible, so the definitive diagnosis can be made by histologic examination of the surgical specimen. We experienced a case of Intra-abdominal esophageal duplication cyst in a 52-year-old female, who initially presented with an esophageal submucosal tumor on upper gastrointestinal endoscopy. She did not have any gastrointestinal symptoms. Barium esophagography, chest computed tomography scan and endoscopic ultrasonography demonstrated the cystic lesion in the intra-abdominal esophagus. Transhiatal enucleation of the lesion was performed successfully via the abdominal approach with no postoperative complications. Histologic study showed that the cyst wall contained a two-layered muscle coat and the surface of the lumen was lined by pseudo-ciliated columnar epithelium. The patient has been doing well without any complaints for 3 months of follow-up period

Volumetric analysis and indocyanine green retention rate at 15 min as predictors of post‐hepatectomy liver failure

AbstractObjectivesThe actual future liver remnant (aFLR) is calculated as the ratio of remnant liver volume (RLV) to total functional liver volume (TFLV). The standardized future liver remnant (sFLR) is calculated as the ratio of RLV to standard liver volume (SLV). The aims of this study were to compare the aFLR with the sFLR and to determine criteria for safe hepatectomy using computed tomography volumetry and indocyanine green retention rate at 15 min (ICG R15).MethodsMedical records and volumetric measurements were obtained retrospectively for 81 patients who underwent right hemi‐hepatectomy for malignant hepatic tumours from January 2010 to November 2013. The sFLR was compared with the aFLR, and a ratio of sFLR to ICG R15 as a predictor of postoperative hepatic function was established.ResultsIn patients without cirrhosis, the sFLR showed a stronger correlation with the total serum bilirubin level than the aFLR (R2 = 0.499 versus R2 = 0.239). Post‐hepatectomy liver failure developed only in the group with an sFLR of <25%, regardless of ICG R15. In patients with cirrhosis, the aFLR and sFLR had no correlation with postoperative total serum bilirubin. An sFLR : ICG R15 ratio of >1.9 showed 66.7% sensitivity and 100% specificity.ConclusionsRegardless of ICG R15, an sFLR of ≥25% in patients without cirrhosis, and an sFLR of ≥25% with an sFLR : ICG R15 ratio of >1.9 in patients with cirrhosis indicate acceptable levels of safety in major hepatectomy

Fundamental thickness limit of itinerant ferromagnetic SrRuO3_3 thin films

We report on a fundamental thickness limit of the itinerant ferromagnetic oxide SrRuO$_3$ that might arise from the orbital-selective quantum confinement effects. Experimentally, SrRuO$_3$ films remain metallic even for a thickness of 2 unit cells (uc), but the Curie temperature, T$_C$, starts to decrease at 4 uc and becomes zero at 2 uc. Using the Stoner model, we attributed the T$_C$ decrease to a decrease in the density of states (N$_o$). Namely, in the thin film geometry, the hybridized Ru-d$_yz,zx$ orbitals are terminated by top and bottom interfaces, resulting in quantum confinement and reduction of N$_o$.Comment: 20 pages, 4 figure

Reduced systemic vascular resistance is the underlying hemodynamic mechanism in nitrate-stimulated vasovagal syncope during head-up tilt-table test

AbstractBackgroundNitroglycerin (NTG) challenge during head-up tilt-table testing (HUTT) is often utilized to determine the etiology of unexplained vascular syncope. However, conflicting results concerning nitrate-induced hemodynamic changes during HUTT have been reported. The purpose of this study was to assess the determinants of presyncopal symptoms during NTG-stimulated HUTT.MethodsWe evaluated 40 patients with suspected vasovagal syncope. Beat-to-beat changes in blood pressure, heart rate (HR), cardiac index (CI), and systemic vascular resistance (SVR) during HUTT were measured with thoracic impedance cardiography and a plethysmographic finger arterial pressure monitoring device.ResultsNone of the 40 patients complained of presyncopal symptoms during passive HUTT. However, after the administration of NTG 28 patients showed presyncopal symptoms (NTG+ group) and the remaining 12 patients did not (NTG– group). HR, CI, and the stroke index did not significantly differ between the two groups, whereas mean arterial pressure and SVR were significantly lower in the NTG+ group.ConclusionsPresyncopal symptoms during NTG-stimulated HUTT are SVR mediated, not cardiac output mediated. This study challenges the conventional idea of a decrease in cardiac output mediated by NTG as the overriding cause of presyncopal symptoms during HUTT