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In 2013, the European Union expanded the list of hazardous substances contained in the RoHS Directive. In addition, certain phthalate esters, such as dibutyl phthalate (DBP), butyl benzyl phthalate (BBP), di-2-ethylhexyl phthalate (DEHP) and diisobutyl phthalate (DIBP), will be categorized as RoHS-prohibited substances starting from July 2019. Although pyrolysis–gas chromatography–mass spectrometry (Py-GC-MS) is a promising analytical method for the screening of phthalate esters, we have developed a novel soft-ionization MS method that is quantitative as well as faster and more convenient for this purpose. The sample was measured three times, after providing the calibration curve using a powdery standard material of SPEX. The data collection time is 5 min, and continuous measurements are completed within 8 min per sample. The mass spectrum was corrected by dividing the intensity by the sample weight. For the coefficient of variation, DBP was 2.9%, BBP was 3.4%, DEHP was 3.6%, and good reproducibility was observed. Precise analyses of phthalate esters using traditional methods can require solvent extraction times of up to 24 h as well as special techniques. Therefore, a screening method that can be easily carried out by anyone within ten minutes is very attractive.

本研究では, 一般廃棄物焼却施設から採取した飛灰および主灰について各種の溶出試験と化学物質のリスクに関わる優先度を決定するスコアリングを組み合わせることにより, 焼却灰中に含有されるCr, Cd, Pb, Sbの『溶出されやすく, 生体内に曝露されやすく, しかも有害な影響をおこしやすさ』を浸出水へ与えるインパクトの強さとして定量的に評価した。その結果, 焼却灰の浸出水への影響を評価するためには, 二段階バッチ試験とアベイラビリティー試験を組み合わせる必要があることと, 埋立て初期のCd, 長期間にわたるPb溶出によるインパクトが強いという結論を得た。

A 51-year-old man presented with a chief complaint of constipation. Rectal cancer was detected up to 13 cm proximal to the anal verge. The cancer was a fully circumferential type II tumor that was accompanied by prostate invasion and lymph node metastasis. After sigmoid colostomy, preoperative chemoradiotherapy with S-1/irinotecan (CPT-11; total 50 Gy) was administered, resulting in tumor volume reduction. However, because of residual invasion in some parts of the prostate, therapy with capecitabine and oxaliplatin (XELOX) plus bevacizumab was added to avoid pelvic exenteration. Because magnetic resonance imaging revealed no invasion prostate after 7 courses of the therapy, abdominoperineal resection of the rectum was performed. Pathological examination revealed no residual tumor cells, and a pathological complete response was thus confirmed. The addition of chemotherapy to preoperative chemoradiotherapy was considered to be an effective strategy for locally advanced rectal cancer in this case.

患者は65歳,土木作業員の男性.突然の腹痛を主訴に受診.汎発性腹膜炎の診断で緊急手術を施行した. Treitz靱帯から1.6mの空腸腸間膜対側に径5mmの小穿孔を認めた.他の腸管に異常は認めなかった.魚骨による穿孔を疑い楔状切除し縫合閉鎖した.約10カ月後,全く同様の所見で当科受診.再度,開腹術を施行した.前回穿孔部の約10cm口側に前回同様の小穿孔が存在した.約8cmの腸管を切除し端々吻合した. 2度の穿孔時の血液検査の共通点は, CPKとLDHの異常高値で,きつい肉体労働によるものと推察された.繰り返す腸穿孔であり基礎的疾患の存在を念頭に諸検査を行ったが,小腸造影にて空腸に憩室が数個存在し,憩室の穿孔と診断した.病理的にも特異性潰瘍疾患は否定され,憩室で矛盾のない所見とされた.小腸憩室は比較的稀な疾患で短期間に穿孔を繰り返した報告は渉猟されない.しかも,きつい肉体労働による腹圧の上昇が穿孔の誘因と思われ興味深かった.

Road sediment is collected by road sweepers, however, it will be flushed because of rainfall. We investigated to determine the collected amount of road sediment and the harm substances attached on the sediment originated from mobile exhaust gases. The correlation analysis was conducted between the environmental factors, such as traffic numbers, species, amount of precipitation and sunny period.TOC attached on the sediment has the positive correlation with the total traffic numbers, especially Large Freight Vehicles and Large-sized Special Motor Vehicles. On the other hands, the amount of precipitation has the negative correlation with TOC. It will be assumed that the organic carbon originated from exhaust gas can be washed by rainfall and move to road run-off. Some of poly aromatic hydrocarbons are found to have same correlation with environmental factors. Ferric compound has the relation with traffic number because the metal will come from car bodies. Zinc and cadmium have also correlation with the numbers.

ISHIBASHI, S., NAMIKI, K., ABE, M., SHIRAHATA, Y., OHNISHI, K., TOYODA, T. and OHUCHI, K. Cystic Adventitial Disease of the Popliteal Artery-A Case of Young Boy. Tohoku J. Exp. Med., 1995, 176 (3), 173-180-Cystic adventitial disease (CAD) of the popliteal artery (PA) is rare but one of the well-recognized causes of intermittent claudication. Now more than 200 case reports are available in the world, but there are only 6 cases younger than 15 years old. In this paper, we report a case of 14-year-old boy with CAD of the PA found by intermittent claudication. On examination, the pulses were not palpable below the right popliteal artery, and the angiography demonstrated about 1.5 cm-long obstruction of the right PA. We operated a resection of a cyst with artery, and replaced the autovein graft (V. saphena magna). Cyst contained mucoid degeneration-like ganglion. Two weeks after operation, the angiography showed no stenotic lesion, and follow-up at 4 years showed no symptoms.

A 44-year-old female was admitted with the complaint of choking. On fiberbronchoscopic examination, multiple, polypoid lesions with a smooth surface were exhibited at the cervical trachea. Histological diagnosis was B-cell malignant lymphoma, diffuse, medium sized cell type (LSG classification). No other lesions were detected in the systemic evaluation. After combined chemotherapy and regional irradiation, the tumor disappeared. The clinical and pathological characteristics of this case are similar to those of malignant lymphoma of mucosa-associated lymphoid tissue (MALT).(Internal Medicine 31 : 655-658, 1992)

To evaluate the outcome of laparoscopic rectopexy for complete rectal prolapse in patients above 70 years of age, compared with that in younger patients.Between October 1997 and September 2001, 14 consecutive patients with complete rectal prolapse underwent laparoscopic rectopexy. Nine patients were aged 70 years or older, and five were aged under 70 years. All of the patients were ambulant and well enough to tolerate surgery under general anesthesia. Each patient was monitored pre- and postoperatively, for fecal incontinence, constipation, recurrent prolapse, morbidity, and mortality.The median follow-up period was 34.5 (range 5-54) months. No significant differences were noted in the hospitalization, incidence of complications, recurrence rate, and functional outcome.The outcome of laparoscopic rectopexy in elderly patients is similar to that in younger patients. Therefore, advanced age alone should not be a contraindication to laparoscopic rectopexy.

We used video-assisted thoracoscopic surgery to successfully treat primary chylopericardium, a very rare disease. A 27-year-old woman was admitted to our hospital for investigation of cardiomegaly and dyspnea on exertion. Echocardiography showed severe peri-cardial effusion. A milky fluid was extracted by pericardiocentesis and diagnosed as being chylous. A computed tomography (CT) scan taken after lymphangiography showed the leakage of contrast solution into the pericardial cavity. Initially, conservative therapy was used to treat the condition, but this proved ineffective and we decided to perform video-assisted thoracoscopic surgery. The thoracic duct was ligated and excised, and partial pericardiectomy was carried out under thoracoscopy. The patient has been in good health with no sign of recurrence since her operation. Thus, video-assisted thoracoscopic thoracic duct ligation and partial pericardiectomy can be effectively used to treat primary chylopericardium.

A 64-year-old man was admitted to the emergency center of Furukawa City Hospital because of common cold-like symptoms and hypotension. He was diagnosed as fulminant myocarditis with cardiogenic shock and arrhythmia elicited by influenza virus subtype A. Cardiac angiography, echocardiography and biopsy also showed myocarditis, and serum antibody titer to influenza virus subtype A was increased to 4-fold in paired serums. Treatments of both percutaneous cardio-pulmonary support (PCPS) and intra-aortic balloon pumping (IABP) were carried out to sustain the general circulation. PCPS treatment was discontinued on the 25th day of the admission, but IABP was continued. Finally, he died of multiple organ failure. The autopsy revealed myocardial necrosis with a slight fibrosis and a small amount of lymphocytic infiltration into the ventricular wall, which were compatible with restrictive myocarditis. Moreover, immunohistochemical analysis also showed the presence of viral antigens in cardiac myocytes. This case clearly showed that PCPS and IABP can be beneficial to sustain the general circulation in fulminant myocarditis, but cardiac pumping function failed completely to recover from myocardial damage.

The bioavailability of cadmium, lead, and chromium leaching from soil was determined by an in vitro experiment utilizing artificial stomach and small intestine solutions. The dissolved concentrations of these metals in the model stomach + small intestine condition was lower than those found in the model stomach as a result of the re-adsorption to the soil by titration from pH 2.0 to 7.0.

In clinical liver transplantation, a venous bypass that rechannels the blood flow from the inferior vena cava and portal vein to the superior vena cava has been used to maintain the venous return. However, the usage of mechanical shunt has given rise to derangements of blood coagulability and fibrinolysis. Therefore, changes of coagulability and fibrinolysis during the venous bypass were examined in dogs using a centrifugal pump (Bio-Pump), and the effect of gabexate mesilate for coagulation were studied. Venous bypass from the inferior vena cava and the portal vein to the external jugular vein was performed in mongrel dogs (group A: bypass without pump, group B: bypass with the Bio-Pump, group C: bypass with the Bio-Pump and the addition of gabexate mesilate). In group A, blood pressure gradually decreased, but in groups B and C it maintained the pre-bypass level. All results of coagulation parameters and fibrinolytic measurements of group B were not significantly different from those of group A; only partial thromboplastin time was prolonged in group B. However, this prolongation was effectively prevented by the addition of gabexate mesilate in group C.

OHKOHCHI, N., SASAKI, T., NAMIKI, K., KATOH, H., KOIZUMI, M., TAGUCHI, Y., FUJIMOTO, H., ENDO, E. and KASAI, M. Liver transplantation in Dogs after 30 Minutes of Warm Ischemia. Tohoku J. exp. Med., 1986, 148 (3), 285-294 - In order to investigate the applicability of liver transplantation after warm ischemia, a partial auxiliary auto-transplantation of the liver after 30min of warm ischemia was carried out in 9 mongrel dogs. Among them, 6 dogs survived longer than 7 days. Liver functions, blood coagulability and histological changes were investigated before and after the transplantation. Serum GOT, LDH, and OPT levels were elevated immediately after transplantation, and returned to normal within a few days. Hemostatic tests also showed significant abnormalities after transplantation. Although PT and thrombotest became normal within a week, PTT and antithrombin III remained slightly abnormal for longer periods. Microscopically, vacuolization and degeneration of hepatocytes were observed after transplantation but they recovered completely within 4 weeks. Based on these results, it could be said that the livers subjected to warm ischemia for 30min ischemia were still acceptable for auxiliary transplantation.