Hepar lobatum carcinomatosum (HLC) is defined as an acquired hepatic deformity consisting of an irregularly lobulated hepatic contour caused by intravascular infiltration of metastatic carcinoma. To date, only nine ca...Hepar lobatum carcinomatosum (HLC) is defined as an acquired hepatic deformity consisting of an irregularly lobulated hepatic contour caused by intravascular infiltration of metastatic carcinoma. To date, only nine cases of HLC have been reported in the literature. We report a case of a 68-year-old woman showing hepatic metastasis of breast carcinoma in radiologically unidentified form. Initially, she received left partial mastectomy for breast cancer but solid hepatic metastases were identified in S2 and S6, 9 mo after surgery. Then, they responded to chemotherapy and radiologically disappeared. After radiological disappearance of the liver tumors, the patient's blood chemistry showed abnormal liver function. A CT scan demonstrated heterogeneous enhancement effect in the liver in the late phase,suggesting uneven hepatic blood supply. Hepatic deformity was not obvious. Laparoscopy revealed a slightly deformed liver surface with multiple indentations and shallow linear depressions. Furthermore, a wide scar was observed on the surface of S2 possibly at the site where the metastatic tumor existed before chemotherapy. Liver biopsy from the wide scar lesion showed intraportal tumor thrombi with desmoplastic change. Because of its similarity to the histology of the original breast cancer, we concluded that the hepatic functional abnormalities and slightly deformed liver surface were derived from the circulatory disturbance caused by microscopic tumor thrombi. Besides, since the wide scar was located at the site of the pre-existing tumor,it is probable that chemotherapy was an important cause of fibrous scarring as a result of tumor regression. These morphologic findings are compatible with those of HLC.Laparoscopy-assisted liver biopsy was useful to make definite diagnosis, even though the hepatic deformity was radiologically undetectable.展开更多
The thermal hydraulic (TH) behavior of coo- lant water is a key factor in the structural integrity assessments on reactor pressure vessels (RPVs) of pressurized water reactors (PWRs) under pressurized thermal sh...The thermal hydraulic (TH) behavior of coo- lant water is a key factor in the structural integrity assessments on reactor pressure vessels (RPVs) of pressurized water reactors (PWRs) under pressurized thermal shock (PTS) events, because the TH behavior may affect the loading conditions in the assessment. From the viewpoint of TH behavior, configuration of plant equipment and their dimensions, and operator action time considerably influence various parameters, such as the temperature and flow rate of coolant water and inner pressure. In this study, to investigate the influence of the operator action time on TH behavior during a PTS event, we developed an analysis model for a typical Japanese PWR plant, including the RPV and the main components of both primary and secondary systems, and performed TH analyses by using a system analysis code called RELAP5. We applied two different operator action times based on the Japanese and the United States (US) rules: Operators may act after 10 min (Japanese rules) and 30 min (the US rules) after the occurrence of PTS events. Based on the results of TH analysis with different operator action times, we also performed structural analyses for evaluating thermal-stress distributions in the RPV during PTS events as loading conditions in the structural integrity assessment. From the analysis results, it was clarified that differences in operator action times significantly affect TH behavior and loading conditions, as the Japanese rule may lead to lower stresses than that under the US rule because an earlier operator action caused lower pressure in the RPV.展开更多
文摘Hepar lobatum carcinomatosum (HLC) is defined as an acquired hepatic deformity consisting of an irregularly lobulated hepatic contour caused by intravascular infiltration of metastatic carcinoma. To date, only nine cases of HLC have been reported in the literature. We report a case of a 68-year-old woman showing hepatic metastasis of breast carcinoma in radiologically unidentified form. Initially, she received left partial mastectomy for breast cancer but solid hepatic metastases were identified in S2 and S6, 9 mo after surgery. Then, they responded to chemotherapy and radiologically disappeared. After radiological disappearance of the liver tumors, the patient's blood chemistry showed abnormal liver function. A CT scan demonstrated heterogeneous enhancement effect in the liver in the late phase,suggesting uneven hepatic blood supply. Hepatic deformity was not obvious. Laparoscopy revealed a slightly deformed liver surface with multiple indentations and shallow linear depressions. Furthermore, a wide scar was observed on the surface of S2 possibly at the site where the metastatic tumor existed before chemotherapy. Liver biopsy from the wide scar lesion showed intraportal tumor thrombi with desmoplastic change. Because of its similarity to the histology of the original breast cancer, we concluded that the hepatic functional abnormalities and slightly deformed liver surface were derived from the circulatory disturbance caused by microscopic tumor thrombi. Besides, since the wide scar was located at the site of the pre-existing tumor,it is probable that chemotherapy was an important cause of fibrous scarring as a result of tumor regression. These morphologic findings are compatible with those of HLC.Laparoscopy-assisted liver biopsy was useful to make definite diagnosis, even though the hepatic deformity was radiologically undetectable.
文摘The thermal hydraulic (TH) behavior of coo- lant water is a key factor in the structural integrity assessments on reactor pressure vessels (RPVs) of pressurized water reactors (PWRs) under pressurized thermal shock (PTS) events, because the TH behavior may affect the loading conditions in the assessment. From the viewpoint of TH behavior, configuration of plant equipment and their dimensions, and operator action time considerably influence various parameters, such as the temperature and flow rate of coolant water and inner pressure. In this study, to investigate the influence of the operator action time on TH behavior during a PTS event, we developed an analysis model for a typical Japanese PWR plant, including the RPV and the main components of both primary and secondary systems, and performed TH analyses by using a system analysis code called RELAP5. We applied two different operator action times based on the Japanese and the United States (US) rules: Operators may act after 10 min (Japanese rules) and 30 min (the US rules) after the occurrence of PTS events. Based on the results of TH analysis with different operator action times, we also performed structural analyses for evaluating thermal-stress distributions in the RPV during PTS events as loading conditions in the structural integrity assessment. From the analysis results, it was clarified that differences in operator action times significantly affect TH behavior and loading conditions, as the Japanese rule may lead to lower stresses than that under the US rule because an earlier operator action caused lower pressure in the RPV.