Heat and moisture exchangers (HME) are used to prevent a loss of heat and moisture in the anesthetized patients. We compared the efficiency of HME (Gibeck Humid-Vent 1 Port, Gibeck Humid-Vent Filter ...Compact, DAR Hygrobac "SM", PALL HME 15-22, PORTEX FILTERD HEAT & MOISTURE EXCHANGER). Gibeck Humid-Vent Filter Compact is most efficient in maintaining temperature and humidity in inhaling anesthetic gas. However, the measured values were lower than the ideal values (airway temperature 32-34°, humidity 30-35mg•l-1), suggesting that the ability of available HME has limitation.
Surgery remains the treatment of choice for patients with resectable biliary tract cancer, enhancing the chance of cure and increasing long-term survival. Early recurrence, however, is frequent in ...patients who have undergone curative resection. To date, no randomized controlled trials have assessed adjuvant chemotherapy in patients with biliary tract cancer. The aim of this study was to evaluate the outcomes of surgical management followed by adjuvant chemotherapy in patients with biliary tract cancer.
This study enrolled 100 patients with Union for International Cancer Control (UICC) stages I-IV biliary tract cancer who underwent surgical resection, including 16 who received sequential adjuvant chemotherapy with gemcitabine or S-1. Overall survival (OS), disease-free survival (DFS), and prognostic factors were analyzed.
The median duration of follow-up was 12.6 months. Forty-one patients had lymph node metastasis and 81 underwent RO resection. The 1-, 3-, and 5-year OS rates were 80.9%, 48.6%, and 38.3%, respectively, and the 1-, 3-, and 5-year DFS rates were 59.8%, 39.9%, and 24.9%, respectively. Five-year OS rates were similar in patients who did (40.4%) and did not (32.4%) receive adjuvant chemotherapy. The morbidity and mortality rates were 59% and 3%, respectively. Multivariate analysis showed that only lymph node metastasis (p = 0.042) was independently associated with long-term survival.
The presence of lymph node metastasis significantly affected long-term survival, whereas adjuvant chemotherapy did not affect outcomes in our patients with resectable biliary tract cancer.
Blockage by ice floes and freezing of the seawater in ports along the coast of Hokkaido, theonly coastal sea area in Japan that freezes over in winter, have serious direct and indirecteconomic ...impacts on various industries such as shipping and fishing industries. In order to devise strategies todeal with the problem of port closure in winter, the mechanism by which the water in the ports freezes mustbe elucidated. Elucidation of this mechanism and the establishment of measures to resolve theproblem of freezing in ports would be very beneficial for industries operating in such ports. The aim of this study was to elucidate the mechanism of freezing in Otsu Fishing Port, aexcavatedtype fishing port in which the water freezes almost every winter, and to try to establisheffective measures for dealing with the problem of port closure due to freezing.
Ice Scour is a phenomenon that occurs when ice comes into contact with seabed. Ice Scour has been reported to have caused damage to communication cables and water intake pipelines. It will be very ...important to acknowledge the mechanisms. We have performed a series of small-scale (1-g) model experiments. Furthermore, we performed a series of medium-scale model experiments on ice scour events at a sandy beach in order to try to determine the effect of scale. The model ridge-keel was placed in the sea and pulled at a constant velocity toward the shore by a crane, and the bulldozing force and the motion of the model keel were measured, Furthermore, a model pipeline to which a strain gauge had been attached was buried at a depth of 15-20 cm from the predicted scour surface, and stress and strain acting on the model pipeline during a gouging event were measured. We showed our mechanical model could be applied to scour events not only on a small scale but also on a medium scale. We also discuss similarity law between medium-scale test results and small-scale test results, stress and deformation acting on the model pipeline.
This is a report on the results of experiments aimed to clarfy the optimal section form of sink-and-float type ice boom (SFIB) which may prevent SFIB from becoming buried in send when it sinks and on ...the results of in site tests at Saroma Lagoon which is located on the Okhotusk sea coast of Hokkaido.
The purpose of this study was to clarify the outcomes of preoperative CDDP/5-FU chemotherapy (FP therapy) followed by surgery for patients with clinical Stage II/III thoracic esophageal cancer.
...Seventeen patients with clinical Stage II/III thoracic esophageal cancer who underwent FP therapy followed by esophagectomy were investigated with regard to the perioperative clinical results and postoperative outcomes.
Grade 3 or 4 adverse effects associated with FP therapy were recognized in 2 of the 17 (11.8%) cases, and 16 patients completed 2 cycles of FP therapy (94.1%). Complications after surgery occurred in 7 cases (41.2%). There were 7 patients with postoperative recurrences (41.2%), 6 of whom had clinical Stage III disease. Similarly, 4 out of the 5 patients who died of cancer had clinical Stage III disease. All recurrences and cancer-related deaths were recognized in histological effectiveness of Grade 0/1 cases.
Preoperative FP therapy was found to be safe for patients with clinical Stage II/III thoracic esophageal cancer. However, the treatment seemed to be less beneficial for Stage III patients than for Stage II patients, thus suggesting that a more powerful preoperative treatment may be necessary for clinical Stage III patients.
Total pharyngo-laryngo-esophagectomy (TPLE) is indicated for either cervical esophageal cancer or synchronous double cancer of the thoracic esophagus and head and neck and this operation is extremely ...invasive. We adopted minimally invasive surgery for three patients who underwent this operation: VATS (video-assisted thoracoscopic surgery) esophagectomy was undergone in left semi-prone position and laparoscopic approach was also applied to reconstruction with gastric tube. After pharyngo-laryngectomy and gastric tube pull-up through post-mediastinal route, cervical anastomosis was performed. Free jejunal interposition was added in a case, while microvascular venous anastomosis between short gastric vein and cervical vein in another two cases. All patients recovered well without any postoperative complications. This is the first report, which describes minimally invasive TPLE using both VATS and laparoscopic technique in addition with plastic surgery.
The purpose of this study is to clarify the characteristics of moored ship motions at fishing ports in Hokkaido by using the results of questionnaire asking forfishing ports users. It is considered ...that the characteristics of ship motions depend on geographical features, shape of ports and mooring conditions. The results of questionnaire demonstrate that the troubles in cargo handling caused by ship motions occur to nearly all of investigated fishing ports, and the troubles are caused by long period waves. So, it is effective to avoid the troubles bychanging the shape of harbor and mooring conditions. The allowable ship motions of fishing boats are ±0.5m for surging, +0.5m for swaying and ±0.5m for heaving. These values are smaller than values of large size ships.
Previous studies have demonstrated that oxidative stress by mediating the excessive production of reactive oxygen species is involved in tissue damage and organ failure during and after surgery. The ...impact of the preoperative immunonutrition including antioxidants on the postoperative course of patients undergoing hepatic surgery was investigated in this pilot study.
Twenty-three living donor liver transplantation (LDLT) donors were randomly assigned to either an experimental (AO) group, received a commercial supplement enriched with antioxidant nutrients for each of the 5 days immediately prior to surgery while maintaining normal food intake, or a control (CT) group, administered no supplement. Antioxidative capacity was measured by spectrophotometry of patient serum using a free-radical analytical system.
The antioxidative capacity of 90.9% patients in the AO group increased after immunonutrition. Compared to the CT group, the AO group was found to have higher antioxidant capacity and transferrin levels; lower WBC, lymphocyte, and neutrophil counts; and briefer duration of postoperative fever during the postsurgical period. No significant differences were found between the 2 groups regarding the nutritional parameters; liver functioning parameters; immunological parameters; intraoperative factors; postoperative outcomes.
Preoperative immunonutrition including antioxidants might play a beneficial role in improving postsurgical immunological response but the modest biological advantage was not associated with any significant clinical outcome.
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