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We monitored arterial blood gases during thoracoscopic (TR) and open repair (OR) of congenital diaphragmatic hernia (CDH) to assess the safety of intraoperative hypercapnia and acidosis.We reviewed 30 neonatal CDH cases (OR = 10, TR = 20) diagnosed prenatally or within 6 h of birth at out institution from 2002 to 2014 not requiring inhaled nitric oxide (NO) intraoperatively. OR, routine until 2006 was replaced by TR in 2007. All subjects were managed identically.Five TR cases requiring conversion to OR were excluded. Prenatal diagnosis, gestational age at birth, gender, birth weight, and side of CDH were similar. Preoperative PaCO2 and pH were not significantly different. However, while intraoperative increase in mean PaCO2 (38.8-62.8 mmHg; p0.01) and decrease in mean pH (7.44-7.25; p0.01) were significant in TR, intraoperative PaCO2 was70 mmHg in 12/15 cases and intraoperative pH was7.20 in 11/15 cases. Both PaCO2 and pH reverted to normal on completion of surgery; pre- and postoperative results were comparable. There were no postoperative complications.It would appear that neonatal cases of CDH not requiring NO can tolerate TR, despite transient reversible deterioration in acid/base balance, indicating that TR is safe for the treatment of selected cases of CDH.

During surgery for choledochal cyst (CC), any intrapancreatic CC (IPCC) must also be excised to prevent postoperative pancreatitis and stone formation. We report our technique for laparoscopic total IPCC excision (n = 16; mean age 6.0 years). We insert a fine ureteroscope with a light source into the opened CC through an extra 3.9-mm trocar placed in the epigastrium through a minute incision to identify the pancreatic duct orifice. By pulling the end of the ureteroscope emerging from the trocar gently to withdraw the tip from the pancreatic duct to where distal dissection was ceased under laparoscopic view, the IPCC can be measured. If longer than 5 mm, the distal CC is dissected further caudally until it is less than 5 mm. For accuracy, the distal CC is elevated with a suture that is exteriorized and clamped to provide constant traction. The IPCC was able to be measured in 11/16 (68 %). Initial lengths measured were 3–10 mm (5.2 ± 2.7 mm). Final IPCC were all 5 mm or less. Surgery was uncomplicated without any pancreatic duct injury and postoperative recovery was unremarkable. Follow-up MRI at 32 months showed no IPCC in any case. Measuring the IPCC enables total CC excision, thus reducing the potential for postoperative complications.

Background In 2007, we began using the anorectal line (ARL) as the landmark for commencing rectal mucosal dissection (RMD) instead of the dentate line (DL) during laparoscopy-assisted transanal pull-through (L-TAPT) for Hirschsprung's disease (HD). We conducted a medium-term prospective comparison of postoperative fecal continence (POFC) between DL and ARL cases to follow our short-term study. Methods POFC is assessed by scoring frequency of motions, severity of staining, severity of perianal erosions, anal shape, requirement for medications, sensation of rectal fullness, and ability to distinguish flatus from stool on a scale of 0 to 2 (maximum: 14). Results Patient demographics were similar for ARL (2007–2014: n = 33) and DL (1997–2006: n = 41). There were no intraoperative complications and 2 cases of postoperative colitis in both ARL (6.1%) and DL (4.9%). Mean annual medium-term POFC scores for the 4–7 term of this study were consistently better in ARL: 9.7 ± 1.4*, 10.1 ± 1.6*, 10.6 ± 1.6, and 11.3 ± 1.4* in ARL and 8.6 ± 1.5, 9.1 ± 1.6, 9.8 ± 1.9, 10.0 ± 1.6 in DL (*: p Conclusions Medium-term POFC is better when the ARL is used as the landmark for RMD during L-TAPT for HD.

Low pulmonary retinol levels and disrupted retinoid signaling pathway (RSP) have been implicated in the pathogenesis of congenital diaphragmatic hernia (CDH) and associated pulmonary hypoplasia (PH). It has been demonstrated that nitrofen disturbs the main retinol-binding protein (RBP)-dependent trophoblastic retinol transport. Several studies have demonstrated that prenatal treatment with retinoic acid (RA) can reverse PH in the nitrofen-induced CDH model. We hypothesized that maternal administration of RA can increase trophoblastic RBP-dependent retinol transport in a nitrofen model of CDH. Pregnant rats were treated with nitrofen or vehicle on gestational day 9 (D9) and sacrificed on D21. RA was given i.p. on D18, D19, and D20. Retinol and RA levels were measured using high-performance liquid chromatography. Immunohistochemistry was performed to evaluate trophoblastic expression of RBP. Expression levels of the primary RSP genes were determined using quantitative real-time PCR and immunohistochemistry. Markedly increased trophoblastic RBP immunoreactivity was observed in CDH+RA compared to CDH. Significantly increased serum and pulmonary retinol and RA levels were detected in CDH+RA compared to CDH. Pulmonary expression of RSP genes and proteins were increased in CDH+RA compared to CDH. Increased trophoblastic RBP expression and retinol transport after antenatal administration of RA suggest that retinol-triggered RSP activation may attenuate CDH-associated PH by elevating serum and pulmonary retinol levels.

Bronchogenic cysts are congenital cystic lesions of foregut origin, usually intrapulmonary or mediastinal, while esophageal cysts generally originate within the esophagus. To the best of our knowledge, this is the first report of a case of a completely intramural bronchogenic cyst of the cervical esophagus in a neonate.

Radiofrequency ablation(RFA)and transcatheter arterial chemoembolization (TACE) are widely enforced as a standard combined therapy for liver cancer. Liver abscess occurs occasionally as a complication. This clinical study was conducted to determine risk factors for liver abscess. We investigated the clinical background of 10 cases complicated by liver abscess in 957 cases of patients who underwent TACE or RFA for liver cancer at Minoh City Hospital between April 2002 and March 2012. Risk factors for liver abscess were analyzed statistically in comparison to a control group without liver abscess. Diabetes and a history of biliary tract organic disease were statistically significant independent risk factors determined by multivariate analysis. We consider patients with a history of biliary tract organic disease, or who have a potential biliary tract infection, and diabetes, to be susceptible to infection. A case presenting with diabetes and a history of biliary tract disease is in a high-risk group, so treatment with TACE or RFA for such cases should be considered carefully.

The reductive dimerization α,β-unsaturated aldehydes to give saturated ketones was achieved using RuHCl(CO)(PPh 3 ) 3 as a catalyst in the presence of secondary alcohols as hydrogen source. The reaction is likely to proceed via the hydroruthenation of α,β-un-saturated aldehydes followed by aldol reaction of the resultant ruthenium enolates with α,β-unsaturated aldehydes to give unsaturated α-hydroxymethyl ketones, which undergo transfer hydrogenation to give α-hydroxymethyl ketones.

Ion-exchange chromatography using a high-capacity anion exchanger with UV detection was applied to the determination of nitrate in seawater. Major ions in seawater samples did not affect the peak shape and the retention time of the nitrate when an alkaline metal cation-chloride solution was used as an eluent at high concentrations (0.5 - 2 mol/l). At a wavelength of 220 nm, the peak of bromide was very small because of low absorption, while its separation from the nitrate peak was good at high concentrations. Among the eluents tested, lithium chloride gave the best separation of nitrate from bromide. It was estimated that the lithium ion had the least potential for ion-pair formation with nitrate, and its retention time was prolonged compared with the retention times when using other cations; with bromide and nitrite, such an effect was not observed. The results of shipboard seawater nitrate determination by our method in the South Pacific Ocean and Antarctic Sea showed good agreement with those by the conventional photometric method using continuous flow.

The highly chemoselective transfer-hydrogenation of α,β-unsaturated ketones to give saturated ketones was achieved using RuHCl(CO)(PPh 3 ) 3 as a catalyst. In addition to α,β-unsaturated ketones, other enones, containing a remote C=C bond, were also reduced to give saturated ketones in good to excellent yields with high selectivity.

We used Acetylcholinesterase (AchE) staining and neural cell adhesion molecule (NCAM) immunoreactivity to examine such resected lengths to determine the complete innervation profile of resected bowel in Hirschsprung’s disease (HD). Resected specimens of colon obtained at pull-through surgery from 15 patients with HD [short type (S-type: n=5), recto-sigmoid type (RS-type: n=5), long type (L-type: n=5)] were sectioned at 1.5 cm intervals and stained conventionally with AchE histochemistry and NCAM immunohistochemistry. The number of positive nerve fibers (PNFs) in the lamina propria and smooth muscle layers was assessed on a scale of 0 to 3 where 0 meant no PNF and 3 meant many PNFs. The three types of HD had different AchE and NCAM innervation profiles, especially the L-type. There were also different AchE and NCAM innervation patterns seen within the same aganglionic or transitional segments of bowel depending on the site of sampling. The mean proportion of transitional segment in resected specimens from RS-type HD was significantly larger than that of S-type HD (P

症例は48歳の女性. 2002年11月に右乳癌に対して右胸筋温存乳房切除術(Bt+Ax)を施行された.組織学的所見はpapillo-tubular carcinoma, T2, N0, M0, Stage IIA, ER(-), PgR(-), Hercep Test 3(+)であった.経過中他の腫瘍マーカーは正常であったが2004年4月に血清HER-2/neu蛋白値の上昇を認め腹部CTにて肝外側区域に腫瘍性病変を指摘された.乳癌肝転移の診断で2004年6月肝外側区域切除術を施行,術後補助療法としてTrastuzumabおよびDocetaxel併用療法を施行した.術後1年を経ても再発の所見を認めていない. 血清HER-2/neu蛋白値はHER-2陽性乳癌に対しては既存の腫瘍マーカーより特異度や感度が高く,術後局所再発などの検出や, Trastuzumabに対する治療効果も予測できる可能性がある.また,乳癌肝転移は肝切除のみでの転移巣制御は困難で,血清HER-2/neu蛋白高値の場合にはTrastuzumabを中心とした術後補助療法が適応になるものと思われた.

We describe a novel system that achieves intuitive retrieval of 3D meshes from a database of 3D models based on the shape geometry and its functionality. By using a point-sampled representation of a 3D shape both for a query and models, our system allows user to physically and interactively express a geometrical and content-based query by simply assembling a set of ActiveCubes. The user can retrieve 3D models from the database based on their shape and can physically integrate functional annotated blocks in the query. The user intuitively defines an interactive spatial query that has geometrical and functional aspects.

症例は60歳の男性.排尿時重苦感を主訴に当院受診,腹部超音波検査および腹部CT検査で右水腎症および回盲部腫瘤を指摘され精査加療目的で当科入院となった.入院時には腹部に圧痛を認めず,血液検査所見でも異常所見を認めなかった.大腸内視鏡検査では盲腸に表面平滑で粘膜下腫瘍様の隆起性病変を,腹部CT検査では回盲部に辺縁不明瞭な腫瘤を認めこの部位で右尿管を圧迫しており右水腎症の状態であった.以上の所見より虫垂原発の悪性腫瘍と診断し結腸右半切除術およびS状結腸部分切除術を施行した.病理組織検査では腫瘍と思われた部分は線維性肉芽組織で,虫垂開口部の隆起性病変は間質の線維化による非腫瘍性病変と診断された.回盲部腫瘤性病変の良悪性の鑑別に際しては虫垂入口部の隆起性病変や水腎症は虫垂炎の一つの所見であることを念頭に置き,術中迅速組織診を積極的に施行して術式を決定する必要があると思われた.

The tree cover (TC) problem is to compute a minimum weight connected edge set, given a connected and edge-weighted graph G, such that its vertex set forms a vertex cover for G. Unlike related problems of vertex cover or edge dominating set, weighted TC is not yet known to be approximable in polynomial time as well as the unweighted version is. Moreover, the best approximation algorithm known so far for weighted TC is far from practical in its efficiency. In this paper we consider a restricted version of weighted TC, as a first step towards better approximation of general TC, where only two edge weights differing by at least a factor of 2 are available. It will be shown that a factor 2 approximation can be attained efficiently (in the complexity of max flow) in this case by a primal-dual method. Even under the limited weights as such, the primal-dual arguments used will be seen to be quite involved, having a nontrivial style of dual assignments as an essential part, unlike the case of uniform weights.

昭和53年 (1978年) 1月から, 平成14年 (2002年) 12月までの25年間に白河厚生総合病院において808例の大腸癌の手術を施行した。切除数は, 713例 (切除率88.25%), 治癒切除数593例 (治癒切除率73.4%) であった。内訳は結腸癌446例, 直腸癌369例 (7例は多発癌) で, 男女別では, 男性429例, 女性379例であった。臨床的病期および組織学的病期による進行程度はそれぞれ, stage IIIa, stage IIが多かった。切除例の5年生存率は67.2%, 治癒切除例は79.5%であった。

This review discusses the regulation of the intestinal and hypothalamic apolipoprotein A-IV (apo A-IV) gene and protein expression. Apo A-IV is a glycoprotein secreted together with triglyceride-rich lipoproteins by the small intestine. Intestinal apo A-IV synthesis is stimulated by fat absorption, probably mediated by chylomicron formation. This stimulation of intestinal apo A-IV synthesis is attenuated by intravenous leptin infusion. Chronic ingestion of a high-fat diet blunts the intestinal apo A-IV in response to dietary lipid. Intestinal apo A-IV synthesis is also stimulated by members of the pancreatic polypeptide family, including peptide YY (PYY), neuropeptide Y (NPY), and pancreatic polypeptide (PP). Recently, apo A-IV was demonstrated to be present in the hypothalamus as well. Hypothalamic apo A-IV level was reduced by food deprivation and restored by lipid feeding. Intracerebroventricular administration of apo A-IV antiserum stimulated feeding and decreased the hypothalamic apo A-IV mRNA level, implying that feeding is intimately regulated by endogenous hypothalamic apo A-IV. Central administration of NPY significantly increased hypothalamic apo A-IV mRNA levels in a dose-dependent manner. Exp Biol Med 228:1181– 1189, 2003

Apolipoprotein AIV (apo AIV) is a circulating signal released from intestinal cells in response to lipid feeding and contributes to the anorectic effect of a lipid meal. We have demonstrated that apo AIV is also synthesized in the hypothalamus, and that hypothalamic apo AIV gene expression is regulated physiologically. Neuropeptide Y (NPY) is a hypothalamic neuropeptide with broad regulatory actions in the central nervous system. In the present studies, the effects of intracerebroventricular (i.v.t.) administration of NPY and of intraduodenal lipid infusion on hypothalamic apo AIV gene expression were determined using competitive RT-PCR in fasted rats. I.v.t. injection of NPY alone significantly increased apo AIV mRNA levels in the hypothalamus in a dose-dependent manner. Intraduodenal infusion of lipid also stimulated the gene expression of hypothalamic apo AIV, but no further significant increment occurred when i.v.t. injection of NPY was combined with lipid infusion. These results suggest that NPY and lipid may regulate apo AIV gene expression in the rat hypothalamus.

福島県県南地域を診療圏とする白河厚生総合病院外科における胃癌手術例の臨床的検討を行った。昭和56年 (1981年) 1月から, 平成12年 (2000年) 12月までの20年間に1,132例の胃癌の手術を施行した。切除数は1,023例 (切除率90.4%), 治癒切除数894例 (治癒切除率79.0%) であり, 切除例の5年生存率は68.3%, 治癒切除例は75.6%であった。20年間の症例の前期10年間と, 最近の10年間での比較では, 切除数は減少しているが, 切除率は上昇した。進行程度, 組織分類, 深達度, リンパ節転移などで早期のものが増え, 5年生存率も次第に向上してきた。

Corrosion products (rust) formed on a steel surface during atmospheric exposure with repetitive wet and dry environments are generally composed of iron oxy-hydroxides and oxide such as i-FeOOH, ¢-FeOOH, £-FeOOH and Fe3O4. Evans1,2) has indicated that the corrosion products strongly influence the corrosion of a steel since the anodic dissolution of iron is balanced by the reduction of the oxy-hydroxide within the rust layer. The cathodic reduction behavior of rusts, therefore, have been studied from various points of views.3­6) The X-ray diffraction method is a powerful tool for the structural analysis of rusts, but it has usually been applied for ex-situ analysis.4) On the other hand, recent in-situ XRD measurements using synchrotron radiation has enabled us to provide structural investigations in the electrolyte/electrode interface.7­10) However, in-situ XRD technique is hardly adapted for investigating the electrochemical cathodic reduction behavior of rusts because the rust reduction behavior can be investigated only in the presence of a large volume of electrolyte for avoiding the large ohmic resistance. The purpose of this study is to establish in-situ XRD technique for investigating the rust reduction behavior. The electrochemical cell and the optical conditions for XRD measurements are investigated under the condition of a large volume of electrolyte around a sample.

The author, currently professor at the School of Human Cultures, University of Shiga Prefecture, Hikone, Japan, teaches house design, carries out research leading to a theory on the spatial structure of human settlements in Japan, and parallely acts as a design advisor for human settlements as well as a practicing architect. Dr Doi, who was born in Yokohama, took his degrees as an architect-engineer - Bachelors, Masters, and Ph. D in engineering - from Kyoto University. He completed the Education Program provided by the Graduate School of Ekistics of the Athens Technological Organization, Greece, and studied at the Department of Urban Studies and Planning of the Massachusetts Institute of Technology (M.I.T.), where his advisor was Professor Kevin Lynch. Prior to his present position, he was a member of the teaching staff, Department of Architecture, Kyoto University and a Professor of Architecture at the Akashi National College of Technology. Dr Doi has been a member of the World Society for Ekistics since 1986. The text that follows is a slightly edited and revised version of a paper presented at the WSE Symposion "Defining Success of the City in the 21st Century," Berlin, 24-28 October, 2001.

55歳女性。1998年夏頃,左鼠径部の腫瘤に気づいた。生検で悪性黒色腫と診断され,近医病院皮膚科で腫瘤を摘出。精査するも原発巣は不明。左鼠径部腫瘤とほぼ同時期に頭部の白毛に気づいた。その後右眼の視力障害出現し,陳旧性ぶどう膜炎·視神経炎と診断。頭部の白毛は認めるものの白斑は認められなかった。悪性黒色腫に伴う白毛,ぶどう膜炎について悪性黒色腫に対する自己免疫的機序の関与を考えた。

Carbon steels with ferrite-pearlite structures are widely used in industry because of their high mechanical strength and low cost. While carbon steels exhibit excellent mechanical properties, their pitting corrosion resistance is relatively low, because the boundaries between the different phases act as initiation sites for localized corrosion in chloride environments. To prolong their service life and improve their reliability, it is necessary to elucidate the initiation mechanism of pitting. The specimens were AISI 1045 carbon steel (0.47%C, 0.19%S, 0.85%Mn, 0.015%P, 0.015%S, 0.02%Ni, 0.18%Cr, 0.01%Mo, 0.01%Cu, 3C) and the dark areas were ferrite lamellae. The distributions of the alloying elements were analyzed by a field emission electron probe micro analyzer (FE-EPMA). Figures 1b-d show the EPMA mappings of carbon, sulfur, and manganese. As seen from these figures, local accumulations of manganese and sulfur were observed in the pearlite as indicated by blue and yellow allows. The positions of manganese segregation were consistent with those of the cementite lamellae. Sulfur-concentrated points were observed in the ferrite lamellae. The macro-scale anodic polarization curves were measured in boric-borate buffer solutions with and without NaCl (pH 8.0) under deaerated conditions at 298 K. Figure 2 shows the anodic polarization curves of the specimen with the ferrite-pearlite structure. In the solution with 1 mM NaCl, a large increase in current density was observed at approximately 0 V. It indicated that the chloride-induced breakdown of the passive film on the ferrite-pearlite steel occurred above this potential. The comparison of the micro-scale anodic polarization behavior of the primary ferrite and pearlite were performed in the boric-borate buffer solution with 100 mM NaCl (pH 8.0) under naturally aerated conditions at 298 K. As indicated in Figure 3, the pits were initiated only in the pearlite and not in the primary ferrite. It was found that the primary ferrite phase exhibited higher pitting corrosion resistance than the pearlite. In this case, the pits were thought to be initiated in the ferrite lamellae because cementite has higher corrosion resistance than ferrites1. In addition to this, it was known that elemental sulfur causes localized corrosion on carbon steels.2 The segregation of sulfur seemed to cause the pit initiation on the ferrite lamellae in the pearlite. From the in situ observation during the micro-scale polarization for the pearlite in the boric-borate buffer solution with 100 mM NaCl, the relationships between the direction of the ferrite lamellae and the growth behavior of the pits were analyzed using digital image processing. For the in situ real-time optical microscopy observation, a system similar to that developed by Chiba et al. 3 was used. Figure 4 shows the CLSM (confocal laser scanning microscopy) reflectance image of the microstructure and the changes in the outlines of the pit mouth. As given in Figure 4, the pit growth and the lamellar directions were almost the same. The pits seemed to be initiated in the ferrite lamellae and proceeded along the lamellar structure of the pearlite with the selective dissolution of the ferrite lamellae. References; 1. N. Ochoa, C. Vega, N. Pébère, J. Lacaze, and J. L. Brito, Mater. Chem. Phys., 156, 198(2015). 2. W. Lee, Z. Lewandowski, P. H. Nielsen, and W. A. Hamilton, Biofouling, 8, 165 (1995). 3. A. Chiba, I. Muto, Y. Sugawara, and N. Hara, J. Electrochem. Soc., 159, C341 (2012). Figure 1

Urethrocutaneous fistula (UCF) complicating hypospadias surgery is associated with compromised tissue and perfusion at the UCF site, especially if recurrent. We report our technique for UCF repair.Between 1997 and 2014, we treated 35 UCF in 26 postoperative hypospadias patients; 12 UCF were recurrent (mean 2.5; range 1-5). Mean age at UCF repair was 9.3 years (range 2-22). Our repair involves making a superficial incision 3-5 mm around the fistula orifice, placing multiple stay sutures in the outer edge of this incision and dissecting only the epidermis under traction for 7-10 mm. This technique does not compromise underlying connective tissue or tissue perfusion. The skin layer of the inner edge of the circumferential incision is trimmed completely and the fistula closed using 7/0 absorbable interrupted sutures. A pedicled external spermatic fascia, or tunica vaginalis flap is then mobilized to cover the repair site through a subcutaneous tunnel and the skin closed. A urethral catheter is placed and removed the next day. Duration of follow-up was calculated as the period from discharge home until the last outpatient clinic attendance.Repair was successful in all cases. Penile cosmesis was acceptable to good without any testicular complications or scrotal deformity. At mean follow-up of 7.4 years (range 0.4-17.3) there have been no recurrences.Our technique allows UCF to be repaired effectively and is also indicated for recurrences.

We assessed the effect of high partial pressure of arterial carbon dioxide (PaCO2) due to pneumoperitoneum (PP) on growth (height/weight) and development (gross/fine motor function, receptive/expressive communication, and social interaction), by comparing outcome after portoenterostomy (PE) for biliary atresia (BA) using laparoscopic PE (LPE: n = 13) and open PE (OPE: n = 13) cases performed between 2005 and 2014. Our PE is based on Kasai’s original PE. All data were collated prospectively. Differences in duration of follow-up (LPE: 38.8 months; OPE: 38.1 months), jaundice clearance (LPE: 12/13 = 92.3 %; OPE: 9/13 = 69.2 %), survival with the native liver (LPE: 10/13 = 76.9 %; OPE: 9/13 = 69.2 %), incidence of cholangitis, hypersplenism, and incidence of esophageal varices were not significant. Mean intraoperative PaCO2 was significantly higher in LPE (LPE: 50.1 mmHg; OPE: 40.7 mmHg, p

There are few reports about postoperative outcome of penoplasty (PP). We present the results of mid- to long-term follow-up of PP performed for congenital megaprepuce (CMP). Data from 65 CMP cases treated by PP performed by a single surgeon from 2000 to 2014 were collected prospectively. All cases were treated using the technique reported by Cuckow (Pediatric surgery. Springer, Berlin, pp 543–554, 2006). Mean age at PP was 5.9 years (range 0.4–13.9). All cases presented as infants and some 12 cases (18.5 %) had PP when 10 or more years old. There were no intra- and postoperative complications. Mean duration of follow-up was 3.6 years (range 0.1–17.5). Duration of follow-up was 4 years or less in 48 (73.8 %), 5–9 years in 13 (20.0 %), and 10 or more years in 4 (6.2 %). While postoperative penile cosmesis was good in 63/65 (96.9 %) cases without scrotal deformity, 2/65 (3.1 %) had redundant penile skin excised upon the recommendation of the treating surgeon even though the patients and parents were unconcerned. Mid- to long-term follow-up of our PP cases shows that outcome is cosmetically acceptable and stable.

isolation and structure elucidation of Schoepfiajasmin A (Ia), B (Ib), C (Ic), D (II), E (IIIa), F (IIIb); G and H are not shown

This paper deals with H 2 optimal control problem in a behavioral framework. Here, a modified image representation of a plant is proposed in order to describe exogenous disturbances. Based on this representation, a condition under which a control law is H 2 optimal for behavioral systems is derived via calculus of variations.

Multi-resolution (MR) molecular dynamics (MD) method is developed for the investigation of nano-scale atomic cluster in collision and coalescence processes. Lennard-Jones interatomic potential for copper crystal is used. Equations of motion both for ordinary MD particles and for clusters treated as rigid bodies are derived from the same Lagrangian, and are solved simultaneously. It is found that ordinary MD regions and rigid body regions should be adequately bounded. To cope with this difficulty, interactive molecular dynamics method using computer graphics is adopted to MRMD algorithm for the selection of adequate MD region. In the interactive simulation, intentional shift of each atom or cluster is also possible. This enables one to set up various initial conditions of calculation and to simulate any possible physical process. It is recognized that real-time nature and interactivity are advantageous and vital to enhance the reality and familiarity in the atomic or molecular simulation. It is concluded that, for more efficient interactive visualization, graphics ability of computer is further required.

From research concerning to atmospheric corrosion, it is understood a little that rust differs with anions in water films, pH, wet-dry conditions, etc. But, there are many unknown parts in the growing process of rust. In order to study the relationship between corrosive factors and corrosion products, wet-dry cycle tests using several kinds of solutions were carried out.Weathering steel was used as a specimen material. Corrosion products were investigated under parameters of the kind of solutions, water film thickness, solution concentration, etc.As a result, it was observed for the easier generation of α-FeOOH than γ-FeOOH in the Na2SO4 solution, which depended on the solution concentration and water film thickness, etc. 1) α-FeOOH was mainly produced under water film which contained the 0.1mol/m3 Na2SO4 or more. 2) γ-FeOOH was produced under water film of less than 0.1mol/m3 Na2SO4 in a solution and in the drying process of water film.

We present a rare case of metastasis to the small intestine of lung cancer causing intussusception after partial lobectomy of the lung and chemotherapy, togethre with a review of the literature. A 46-year-old man was admitted to the hospital because of abnormal shadow of the right lung and a partial lobectomy was performed. Histological diagnosis was large cell carcinoma. After adjuvant chemotherapy, he was admitted again because of intestinal obstruction. Emergency operation was performed, and enteroenteric intussusception about 15cm in length caused by a 5×4cm tumor was found in the ileum 50cm proximal to the terminal ileum. Partial resection of the small intestine was carried out. Histological examination revealed metastatic large cell carcinoma. He died of pneumonia on the 16th postoperative day. When abdominal symptoms occurred during treatment of lung cancer, we should consider a possibility of metastasis to the small intestine. So far 181 cases of metastasis of lung cancer to the small intestine have been reported in Japan, but only few cases of them presented with intussusception. This case is thought to be uncommon.

A monoclonal antibody against histamine has been produced. A histamine-haemocyanin conjugate prepared using 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide as a coupling agent was used for immunizing mice. Immunized mice were sacrificed to prepare monoclonal antibody using a hybridoma technique. On immunospot assay, the hybridoma culture supernatant containing a monoclonal antibody was capable of detecting 50 pmol of histamine. Using this antibody, we examined the cellular localization of histamine-like immunoreactivity in the stomach of normal or alpha-fluoromethylhistidine-treated rats and mice. Immunoreactive cells were abundant in the gastric mucosal layer. These positive cells were often located in the basal half of the fundic gland but were rare in the pyloric gland. The cells, small or medium in size, spindle or cone in shape, were intermingled with immunonegative epithelial cells. In the cytoplasm of the positive cells, granular reaction products were densely deposited. In addition, a few positive cells, identified as mast cells by Toluidine Blue staining, were distributed mainly in the submucosal and muscular layer. The antibody preabsorbed with 10 mM histamine gave no positive immunostaining. For pharmacological study, some rats were injected six times with c-fluoromethylhistidine every 8 h. In these rats, positive cells except mast cells were no longer detected. In conclusion, the monoclonal antibody produced appears to be highly specific for histamine. Its application in immunohistochemistry should provide a powerful tool for analysing the roles of histamine in enterochromaffin-like or mast cells in the stomach.

Superior sulcus tumor( SST) is a rare type of lung cancer. Treatment usually consists of surgical resection after chemoradiotherapy. We report a case of a woman in her fifties who underwent carbon ion radiotherapy for SST. The patient complained of left shoulder pain, and imaging studies revealed a 5.2×3.5-cm local solid tumor at the apex of the left lung, invasion to the ribs, and no lymph node swelling. The level of tumor marker, carcinoembryonic antigen (CEA), was 5.7 ng/mL. Needle biopsy specimen revealed adenocarcinoma. The diagnosis was SST, T3N0M0, stage IIB. We did not detect Horner syndrome. Carbon ion radiotherapy at 66 Gy equivalent dose per 10 fractions was administered to the SST site. Subsequently, the tumor size decreased to 4.5×1.9-cm. The adverse effect was Grade 1 skin and pulmonary toxicity. Six months later, Grade 2 left shoulder connective tissue toxicity was observed; it was difficult to differentiate this from tumor recurrence. After 2.5 years from radiotherapy, the patient is free from recurrence. Carbon ion radiotherapy is effective and safe and can be considered as an important treatment option for SST.

Case 1 involved a 74-year-old man. After transcatheter arterial chemoembolization( TACE) for hepatocellular carcinoma (HCC), abdominal computed tomography (CT) revealed a gas-containing lesion in the liver. The patient was diagnosed as having a gas-containing liver abscess, necessitating emergency drainage under laparotomy. Blood culture revealed Clostridium perfringens. He was discharged on day 63 after surgery. Case 2 involved a 70-year-old man who was admitted to our hospital for obstructive jaundice caused by HCC. He was treated with TACE after endoscopic retrograde biliary tract drainage (ERBD). On the second day, he was diagnosed as having a ruptured gas-containing liver abscess with massive hemolysis, necessitating emergency drainage under laparotomy. He died the next day after surgery. The clinical course of liver abscess caused by Clostridium perfringens can be fulminant and fatal with massive hemolysis.

A man in his 40s had a locally advanced pancreatic head cancer invading the portal vein( PV) and common hepatic artery (CHA). He underwent 5 courses of neoadjuvant chemotherapy( gemcitabine+S-1), which reduced the tumor volume and cancer antigen 19-9 (CA19-9) level. R0 resection was performed via sub-stomach preserving pancreatoduodenectomy with combined resection of the PV and CHA. Adjuvant chemotherapy with gemcitabine was administered at 4 weeks after the operation. Relevant neoadjuvant chemotherapy is considered to contribute to R0 resection of locally advanced pancreatic cancer. Here, we report a case of a successful R0 resection after neoadjuvant chemotherapy for locally advanced pancreatic cancer.

The median survival time following chemotherapy for unresectable metastatic colorectal cancer (mCRC) is approximately 2 years. Although palliative care during the chemotherapy period is very important, it has not been reported in detail.Information on the palliative care of 110 patients with Stage IV mCRC, who were treated from September 2007 to March 2011, was retrospectively examined.Following an explanation of their recurrence or metastases of mCRC, all the patients received mental care from nurses or psychiatrists. They also needed care to prevent the side effects of chemotherapy. Some patients experienced pain associated with tumor growth. Thus, they required NSAIDs or opioids to reduce the cancer-related pain. After they could not be taken chemotherapy, 87.5% of these patients consulted medical social workers to discuss where they would live.The patients required palliative care depending on the duration of chemotherapy for mCRC. Thus, we believe that palliative care is an important part of treatment for advanced cancer.

A 70-year-old man with advanced gastric cancer was treated with neoadjuvant chemotherapy consisting of S-1 plus cisplatin( CDDP). He exhibited symptoms of cerebral infarction during the second course of chemotherapy. Distal gastrectomy was performed and the histological diagnosis was pT3N3aM0, pStage IIIB. Adjuvant chemotherapy was administered; however, after the second course, gastric cancer recurred in the lymph nodes. Second-line chemotherapy with irinotecan (CPT-11) and CDDP was initiated. Thereafter, third-line chemotherapy with docetaxel was performed. However, the response to treatment was progressive disease (PD). Subsequently, fourth-line chemotherapy was performed with capecitabine and CDDP (XP chemotherapy). After the fourth course of XP chemotherapy, the response was partial response (PR). Moreover, PR was maintained after 20 courses of chemotherapy.