Video-assisted Thoracic Surgery with a Kirschner Wire Traction for an Anterior Mediastinal Tumor : A Case Report

Article信州医学雑誌 67(3): 205-208(2019)journal articl

Complete Response of Advanced Invasive Mucinous Adenocarcinoma of the Lung with Gemcitabine and Pemetrexed

Article信州医学雑誌 64(2): 79-83(2015)journal articl

Outcomes of Surgically Treated Pneumothorax in Patients with Interstitial Pneumonia

Article信州医学雑誌 65(3): 163-170(2017)journal articl

An intrathoracic scapular prolapse with hemorrhagic shock after a thoracotomy

We herein present a case in which an emergency operation was performed for an intrathoracic hemorrhage resulting from a scapular prolapse after a thoracotomy, a rare complication of this procedure. A 59-year-old man had undergone a right upper lobectomy with an extended resection of the posterior chest wall including the second to fourth ribs due to a direct invasion by a lung cancer. On postoperative day 80, we performed an emergency operation as the patient had gone into shock due to an intrathoracic hemorrhage with a right scapular prolapse. The scapula protruded through the enlarged fourth intercostal space. The prolapsed scapula was reduced and the defect in the chest wall was covered with Marlex mesh.ArticleINTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY. 12(2):326-327 (2011)journal articl

Bingham fluid simulations using a physically consistent particle method

The Bingham fluid simulation model was constructed and validated using a physically consistent particle method, i.e., the Moving Particle Hydrodynamics (MPH) method. When a discrete particle system satisfies the fundamental laws of physics, the method is asserted as physically consistent. Since Bingham fluids sometimes show solid-like behaviors, linear and angular momentum conservation is especially important. These features are naturally satisfied in the MPH method. To model the Bingham feature, the viscosity of the fluid was varied to express the stress-strain rate relation. Since the solid-like part, where the stress does not exceed the yield stress, was modeled with very large viscosity, the implicit velocity calculation was introduced so as to avoid the restriction of the time step width with respect to the diffusion number. As a result, the present model could express the stopping and solid-like behaviors, which are characteristics of Bingham fluids. The proposed method was verified and validated, and its capability was demonstrated through calculations of the two-dimensional Poiseuille flow of a Bingham plastic fluid and the three-dimensional dam-break flow of a Bingham pseudoplastic fluid by comparing those computed results to theory and experiment

新しい微小血管半自動吻合デバイスを用いた内視鏡下血管吻合に関する研究

学位の種別: 課程博士審査委員会委員 : （主査）東京大学教授 光嶋 勲, 東京大学教授 岡崎 仁, 東京大学准教授 平田 康隆, 東京大学講師 犬塚 亮, 東京大学講師 平田 陽一郎University of Tokyo(東京大学

Surgical outcomes in patients with small cell lung cancer: comparative analysis of computed tomograpy-detected patients with others

Background: It is shown that low-dose computed tomography (CT) screening is useful for a reduction in lung-cancer- specific mortality in heavy smokers. However, the information about effectiveness according to the histological types of lung cancer has not been adequately investigated especially small cell lung cancer (SCLC). The present study was performed to see the clinical benefit of CT screening in patients with SCLC following thoracotomy. Methods: We retrospectively reviewed the outcome in patients with early stage SCLC who initially underwent thoracotomy. The clinical stages and actuarial survival were estimated according to the three means of detection of SCLC: chest CT, radiographic screen, and symptomatically prompted cases. Results: Sixty-nine patients (men/women, 63/6; mean age, 70 years) with SCLC underwent thoracotomy between 1991 and 2010 including chest CT (n = 13), radiographic screening (n = 39), and symptomatically prompted cases (n = 17). Pathological staging information included stage IA (n = 25), IB (n = 8), IIA (n = 13), IIB (n = 5), IIIA (n = 11), and IIIB (n = 7). Median survival time was 30.0 (95% confidence interval (CI): 22.0 to 57.0) months, with overall survival at 5 years of 34.3% (95% CI, 23.47 to 47.3). Nine patients (69%) with stage I were detected by CT which was significantly higher than those in other detection arms. However, there were no significant differences in the survival between CT and other detection arms. Conclusions: CT examination may be useful for detection in early stage SCLC potentially suitable for surgery, but the contribution to better clinical outcome in patients with SCLC remains unclear.ArticleWORLD JOURNAL OF SURGICAL ONCOLOGY. 11:61 (2013)journal articl

Intraoperative ultrasonographic localization of pulmonary ground-glass opacities

ObjectivesGround-glass opacities are typically difficult to inspect and to palpate during video-assisted thoracic surgery. We therefore examined whether ultrasonographic assessments could localize ground-glass opacities and help to achieve adequate resection margins.MethodsAn intraoperative ultrasonographic procedure was prospectively performed on 44 patients harboring ground-glass opacities of less than 20 mm in diameter to localize these lesions and to achieve adequate margins. We also examined whether there were any complications resulting from the intraoperative ultrasonogram, such as lung injury, heart injury, or arrhythmia. We excluded patients with both asthma and chronic obstructive pulmonary disease from this study inasmuch as the intraoperative ultrasonographic procedure is more difficult to interpret when residual air is present in the lung.ResultsA total of 53 ground-glass opacities were successfully identified by intraoperative ultrasonography without any complications. Of the 20 mixed ground-glass opacities that we examined, 15 were found on palpation. However, only 4 (12.1%) of the 33 pure ground-glass opacities could be palpated. In all instances in which complete collapse of the lung was achieved (30/53 of these cases), high-quality echo images were obtained. Additionally, a strong correlation was found between the resection margins measured by ultrasonogram and the margins determined by histologic examination in the resected lung specimens (r2 = 0.954, P < .001).ConclusionsIntraoperative ultrasonography can both safely and effectively localize pulmonary ground-glass opacities in a completely deflated lung. This procedure is also useful for the evaluation of surgical margins in a resected lung. Hence, ultrasonography may assist surgeons to perform minimally invasive lung resections with clear surgical margins during the treatment of solitary lung ground-glass opacity

Application of neutron diffraction technique to industrial materials

金沢大学大学院自然科学研究科As an important industrial problem, the rolling contact fatigue damage is accumulated in rails during the repeated passage of trains over the rails, and rail failures may occur from the cracks grown in the rails. In order to prevent such rail failures, the estimation of the behavior of internal rail cracks is required based on the exact engineering analysis model as well as conducting rail test to search rail defects. The purposes of this paper are to apply the neutron stress measurement to rails, and to obtain residual stress state in the rails for the above purpose. The rail samples used were those that have been used in service line in Japan for about six years (222 million gross tons). The neutron measurement was conducted using the Residual Stress Analyzer (RESA) of the Japan Atomic Energy Agency (JAEA). The present measurement of stresses in rails by the neutron diffraction method was the first attempt in Japan

Fabp7 Maps to a Quantitative Trait Locus for a Schizophrenia Endophenotype

Deficits in prepulse inhibition (PPI) are a biological marker for schizophrenia. To unravel the mechanisms that control PPI, we performed quantitative trait loci (QTL) analysis on 1,010 F2 mice derived by crossing C57BL/6 (B6) animals that show high PPI with C3H/He (C3) animals that show low PPI. We detected six major loci for PPI, six for the acoustic startle response, and four for latency to response peak, some of which were sex-dependent. A promising candidate on the Chromosome 10-QTL was Fabp7 (fatty acid binding protein 7, brain), a gene with functional links to the N-methyl-D-aspartic acid (NMDA) receptor and expression in astrocytes. Fabp7-deficient mice showed decreased PPI and a shortened startle response latency, typical of the QTL's proposed effects. A quantitative complementation test supported Fabp7 as a potential PPI-QTL gene, particularly in male mice. Disruption of Fabp7 attenuated neurogenesis in vivo. Human FABP7 showed altered expression in schizophrenic brains and genetic association with schizophrenia, which were both evident in males when samples were divided by sex. These results suggest that FABP7 plays a novel and crucial role, linking the NMDA, neurodevelopmental, and glial theories of schizophrenia pathology and the PPI endophenotype, with larger or overt effects in males. We also discuss the results from the perspective of fetal programming