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For this study, instructors carried out active learning classes using tools to obtain biological information. Due to the constrained conditions for their use, students proposed their own projects and successfully carried them out on their own. The students belonged to two groups: one was for17 year old students and the other was for the students 19 years of age. Both groups displayed good creativity and engineering design capabilities. However, there was a clear difference between the two groups. The older students had more quantitative and application-related capabilities. We could confirm that the age demographic in KOSEN education was very sensitive for the improvement of creative engineering design capability.

An experimental trial was carried out with a problem-based learning (PBL) class for students. They were asked to come up with a plan for applying a glass sensor to determine concentration power. They held a discussion and agreed on a system and process, in which students would focus on memorizing English words. The process had three components. While studying English words, the students listened to music at the same time. As a second component, when the learning time was not long enough, students could concentrate on learning the words without any music. However, when the learning time was prolonged, the combination of learning and outcomes was higher for the case of memorizing 10 words. The students defined a coefficient that was based on the average of memorizing capability and concentration power. The results and the system are a unique case study. We believe the basic concept could be applied to the final trial for mutual non-verbal communication.

This paper introduces and describes a learning system for analyzing devices in a virtual world and points out its significance for current research collaboration. Now we are in Society 5.0, so daily problems should be solved by IoT (Internet of Things) with a mutual collaboration without borders. The authors need to collaborate with each other among remote organizations and different nations. For such situations, we need to establish the learning system for analyzing devices which would lead to an actual sharing system in the future. In this paper, the proposed concept for the learning system in metaverse is explained. The significance of the system is described, too.

We report a case of congenital bronchial atresia resected by the uniportal thoracoscopic approach. A man in his 20s with congenital bronchial atresia diagnosed at 16 years of age visited our hospital with gradually worsening shortness of breath. Chest computed tomography revealed a localized emphysematous area that progressively increased in size, in the left upper lobe and the absence of a left upper division bronchus with mucoid impaction. Surgical treatment was deemed necessary in view of dyspnea and progressively worsening emphysema, and the resection of left upper division was performed by uniportal video-assisted thoracoscopic surgery.

E-learning is a powerful educational tool nowadays. Particularly, it could activate classrooms and enhance the understanding of educational content taught by teachers. However, teachers often have various difficulties for using e-learning. One problem is for them to produce educational tools on their own. Some teachers need support for this type of activity. From the viewpoint, it is very important for us to know the various types of support that teachers need. In this study, we focused on teachers’ mental situations when they produce educational materials for their classrooms. We aimed to establish a model, so that the data of eye blinking could be analyzed and applied to evaluate teachers’ psychological and mental situations. Using a commercial glass-type sensor to observe eye blinking behaviors, we measured them for three teachers (as examinees), while they were producing their own presentation files. The data for the blinking behaviors were compared with the concentration power index and analyzed. And we discussed the possibility of applying the model to determine how teachers could be supported technically.

Students’ psychological responses were evaluated by a commercial electrooculography (EOG) sensor. As psychological responses, we picked up two factors – concentration power and the impression about the simplicity for problem solving. A glass-type EOG sensor detected the electrooculogram and calculated the blink rate (focus), the blink strength (calmness) and the head posture (posture), constituting the final parameter called concentration power. In this study, we investigated the correlation between the two psychological responses and EOG parameters. We could confirm the qualitative correlation between the EOG parameter corresponding to concentration power and the psychological response. At this point, we presume that it could be applied to e-learning in virtual classrooms soon. As for the impression about the simplicity to solve problems, we could not found the reasonable correlation. However, the detailed analyses for all of the parameters and their time-dependent behaviors might make it clearer and also other relations with more psychological response.

Highlights • The soft tissue mass at the stump of artery suspected of pseusdoaneurysm. • Embolization and artery bypass are effective for pseudoaneurysm of the iliac artery. • Prophylactic arterial flow block may be safe to avoid recurrence of pseudoaneurysm., Introduction An optimal treatment strategy for a ruptured pseudoaneurysm of the iliac artery must necessarily control bleeding and prevent ischemia in the ipsilateral lower extremity. Presentation of case A 69-year-old man underwent resection of a metastatic lymph node from rectal cancer, which had invaded the sigmoid colon, the left internal iliac artery and vein, and his left ureter. The metastatic lymph node and the organs it invaded were resected together. Owing to postoperative complications, the patient was required to undergo a 2nd and 3rd operation after the initial surgery. During his 3rd surgery, sudden intraoperative bleeding was identified, which was diagnosed as a ruptured pseudoaneurysm of the internal iliac artery. After achieving temporary surgical hemostasis, the lesion was successfully treated using combined therapy comprising catheter embolization and an axillofemoral bypass. Discussion Even after temporary surgical hemostasis has been achieved, it is perhaps safer to block the arterial flow prophylactically to avoid recurrence of a pseudoaneurysm owing to infection. Conclusion Combined therapy using catheter embolization and surgical revascularization is a minimally invasive and effective treatment option for a ruptured pseudoaneurysm of the iliac artery.

The discussion through Skype on research topics between two laboratories were carried out as virtual problem based learning project. During the discussion, the blinking eyes were counted as biological data. After the project, questionnaires were given to the participants. Two series of data, biological data by counting blinking eyes and psychological data derived from questionnaires were compared and analyzed. Both data were compatible reasonably and could be well explained complimentary. If the system could be established systematically, it would be a very powerful educational tools for both teachers and students in the future.

A 67-year-old man presented at the hospital with worsening exertional dyspnea. Echocardiography showed a tumor in the left ventricle (approximately 35 × 48 mm) that protruded into the left atrium and left ventricular outflow tract during systole. These findings suggested a high risk of sudden death resulting from aortic valve obstruction or tumor embolism. Surgical resection was performed. During the operation, the tumor was resected as completely as possible, together with part of the myocardium where it arose. Histopathologic examination showed diffuse large B-cell lymphoma. The patient received systemic chemotherapy and is alive after 1 year.

In the present study, an airship for the fixed point observation of nara withering in village forests was designed and trial manufactured. The airship consists of a helium gas filling envelope of 4.5m in total length, propeller-driven motors, a polymer electrolyte fuel cell (PEFC) in order to achieve longer flight, Ni-H batteries, a CCD camera observation system, and propeller control systems. Automatic charging device was designed to charge the Ni-H battery from the PEFC in the sky automatically. It controlls the power system by using a micro computer in a mannar where the electromagnetic valve supplying hydrogen is open to recover the output voltage of the PEFC when the voltage of Ni-H battery decreased to a certain level, resulting in energy charging to the Ni-H battery and keeping the rotation of the moter. The opened electromagnetic valve is closed when the Ni-H battery full charged. Furthermore, after a certain hours operation when the output voltahge of the PEFC drops due to accumulation of impurities in hydrogen gas, the outlet valve will be opened to exhaust hydrogen containing accumulated impurities. It has been verified that as soon as the Ni-H battery voltage doropped to less than 3.8 [, the hydrogen inlet valve opened then the output of the power source increased suddnly to around 7 [.

Right atrial tumor thrombus is rare in patients with visceral malignant tumors and can cause right heart failure or sudden death. We present 2 cases of right atrial tumor thrombus treated under deep hypothermic intermittent circulatory arrest (DHICA). A 45-year-old man with right heart failure was diagnosed with right renal cancer extending to the right atrium. Computed tomography revealed no metastasis. He underwent right nephrectomy and tumor thrombus resection under DHICA. He was discharged on postoperative day 11 in good clinical course. A 67-year-old woman with hepatitis C virus liver cirrhosis( Child-Pugh A) was diagnosed with hepatocellular carcinoma and right atrial tumor. She underwent S8 and tumor thrombus resection under DHICA. Hemorrhagic diathesis was controlled using fresh frozen plasma transfusion. She was discharged on postoperative day 24 without liver failure. In cases of atrial tumor thrombus resection, DIHCA may be useful to achieve a bloodless operation field because the procedure is relatively simple and the primary disease need not be considered.

Fast-track surgery has been widely implemented and allows such immediate extubation as in the operating room(OR). We retrospectively investigated the effect of routine ultra-fast-track(UFT) surgery extubating in the OR in patients undergoing cardiovascular operations. Among 333 consecutive patients, 224 (67.3%)were extubated in the OR. Five patients were re-intubated, but none were because of heart or respiratory failure. Independent predictors for failure of OR extubation were preoperative renal failure, pre-existent cerebrovascular disease, emergency surgery, and prolonged operation and/or cardiopulmonary bypass times. In patients extubated in the OR, postoperative pneumonia and delirium were less frequent, oral intake was facilitated, and lengths of stay in the intensive care unit as well as hospital were shortened. UFT in cardiovascular surgery can be safely and effectively performed in a majority of patients.

An 85-year-old man, who had developed right-sided heart failure associated with isolated severe tricuspid regurgitation (TR), was referred to our institution to undergo cardiac surgery. Preoperative echocardiography revealed tricuspid annular dilatation and leaflet tethering, resulting in severe TR. The anterior leaflet was detached from the annulus with 1.5 mm margin for suture incorporation, and an autologous pericardial patch was sutured with 3 5-0 running interlocked sutures to augment the leaflet. Annuloplasty was then performed with an undersized ring. Postoperative echocardiography showed trivial TR with good coaptation of the tricuspid leaflets. This technique may be a therapeutic option for the surgical treatment of severe functional TR due to lack of leaflet coaptation.

A 45-year-old man with acute Type A aortic dissection underwent the ascending aorta replacement with BioGlue (CryoLife Europa, Guildford, Surrey, UK) for anastomotic reinforcement. Postoperatively, he developed descending aortic dilation, a giant mediastinal cyst, Henoch-Schonlein purpura and an anastomotic-site pseudoaneurysm rupture. A BioGlue-induced inflammatory reaction was likely, according to a positive patch test (delayed allergic reaction).

A 45-year-old man had aortic regurgitation with a syphilitic true aneurysm of the ascending to transverse arch aorta and a descending aortic aneurysm from chronic Stanford type B aortic dissection. After antibiotic therapy, two-staged surgical repair was performed and there has been no evidence of recurrence in 12 months since the second stage. We describe the successful management of extensive cardiovascular syphilitic damage.

Six consecutive patients underwent emergency surgical repair of a postinfarction ventricular septal perforation. The principle of this technique is a simple three-dimensional repair with a nontailored square patch beforehand, which provides an adequate-sized pouch and prevents dehiscence of the patch being caused by excessive tension on the suture line. It also prevents a residual shunt. A single equine pericardium was sutured to the viable muscle circumferentially around the infarcted area to be excluded, after which the free edge of the patch was tailored and sutured in a pouch configuration. This technique seems to provide satisfactory early results in the acute phase of myocardial infarction.

Summary Background Although intraoperative transesophageal echocardiography (IOTEE) has been widely used in cardiovascular surgery, the exact incidence of abnormalities detected by IOTEE in each type of surgical procedure is still unclear. The aim of this study was to review our experiences of IOTEE, in patients who underwent different types of cardiovascular surgery and to evaluate the clinical usefulness of IOTEE. Methods and results Our database of 1011 consecutive patients, who underwent cardiovascular surgery and IOTEE monitoring was reviewed. The incidence of abnormal findings was 115 of 1011 patients (11.4%), and the highest incidence was the appearance of new wall motion abnormalities after cardiopulmonary bypass. These findings influenced surgical decision-making in 59 of the evaluated 1011 patients (5.8%). Conclusions IOTEE provides important intraoperative and postoperative information that may influence surgical decision-making in various cardiovascular surgeries.