超常磁性体を用いたMRリンフォグラフィーによる口腔癌患者のセンチネルリンパ節同定

The purpose of this study was to examine the feasibility of interstitial MR lymphography using Superparamagnetic Iron Oxide (SPIO) to detect sentinel lymph nodes (SLNs) in head and neck cancer. For two patients with cT2N0 squamous cell carcinoma of the tongue, the submucosal injection of SPIO as well as sentinel lymph node navigation surgery (SLNNS) was performed before undergoing surgical treatment. SPIO was used for MR lymphography and Tc-99m phytate for SPECT. We compared the images by both modalities. Berlin blue stain was also performed postoperatively if SLNs had the uptake of SPIO. The lymph nodes with MR signal attenuation and those with hot spots were probed to be anatomically identical. All the lymph nodes detected as a SLN by a gamma-probe contained the blue granules from SPIO. These data suggest that SPIO can be a novel tracer for performing SLNNS and SLN biopsy in oral cancer patients with cN0 neck.博士（医学）・甲622号・平成26年3月17

Activity Based Costing / Activity Based Managementを用いた院外持ち込み画像データの効果的な取り込み方法

Background: With filmless operation becoming widespread in Japanese hospitals, medical images provided for referral purposes are frequently stored using portable media such as compact discs. Few facilities import brought-in data into their own Picture Archiving and Communication Systems (PACS) with a clearly defined responsible creator at the time of data storage. Currently, no literature analyzing this series of tasks exists. Objective: This study aimed to determine the best workflow for importing brought-in images into PACS in order to optimize management and costs. Methods: We created three different importation operational workflows (post-medical examination importation, pre-medical examination importation, and pre-medical examination importation using Temporary PACS for storage), and clarified the decision maker, who decides when to lock and prevent further image modifications, and the responsible creator of the image. Task analysis of each operation was carried out using Activity-Based Costing and Activity-Based Management, methodologies used in the field of management accounting. Results: Task analyses revealed that post-examination importation increased the burden on physicians, in addition to increasing operational costs. It was also shown that an explicit responsible creator did not exist with pre-examination importation. When pre-examination importation was conducted using Temporary PACS, physicians were both decision makers and responsible creators. Moreover, the burden on physicians was low and the costs could also be kept low. Conclusion: We analyzed importation tasks involved in bringing external images into PACS. Our results indicate that, from the perspective of management and costs, it is most efficient to import images using Temporary PACS servers

Effect of a Domain Wall on the Conductance Quantization in a Ferromagnetic Nanowire

The effect of the domain wall (DW) on the conductance in a ballistic ferromagnetic nanowire (FMNW) is revisited by exploiting a specific perturbation theory which is effective for a thin DW; the thinness is often the case in currently interested conductance measurements on FMNWs. Including the Hund coupling between carrier spins and local spins in a DW, the conductance of a FMNW in the presence of a very thin DW is calculated within the Landauer-B\"{u}ttiker formalism. It is revealed that the conductance plateaus are modified significantly, and the switching of the quantization unit from $e^2/h$ to ``about $2e^2/h$'' is produced in a FMNW by the introduction of a thin DW. This accounts well for recent observations in a FMNW.Comment: 5 pages, 2 figures, Corrected typos and added reference

Case of an unusual clinical and radiological presentation of pulmonary metastasis from a costal chondrosarcoma after wide surgical resection: A transbronchial biopsy is recommended

Chondrosarcomas are the most frequently occurring primary malignant chest wall tumors. Furthermore, the lungs serve as the most frequent sites for metastases. Pulmonary metastases from sarcomas usually appear as round nodules of varying sizes on roentgenograms. Here, we report an unusual clinical and radiographic presentation of pulmonary metastasis from a costal chondrosarcoma. Bilateral pulmonary metastases developed soon after wide surgical resection. Thoracic computed tomography revealed unusual radiological findings: consolidation accompanied with ground-glass opacity. To confirm the metastasis, we recommend a transbronchial biopsy in cases where unusual pulmonary findings are detected