京都大学 / 0048 / 新制・課程博士 / 博士(工学) / 甲第19237号 / 工博第4072号 / 新制||工||1628(附属図書館) / 32236 / 京都大学大学院工学研究科航空宇宙工学専攻 / (主査)教授 泉田 啓, 教授 藤本 健治, 教授 松野 文俊 / 学位規則第4条第1項該当 / Doctor of Philosophy (Engineering) / Kyoto University / DFAM

Sarcoidosis is a multisystem, inflammatory granulomatous disease that rarely involves breast tissue. The pathophysiology of this chronic granulomatous condition is not well understood but is thought to be multifactorial, involving environmental influences causing an amplified immune response. A key histomorphology feature in sarcoidosis is the presence of non-necrotizing granulomas. In this case, we report a 41-year-old African-American man with a known history of sarcoidosis of the lung who presented with gynecomastia and bilateral breast tenderness with palpable nodules. Subsequent biopsy and microscopic examination of the breast nodules revealed diffuse involvement with non-necrotizing granulomas in both breasts. A final diagnosis of extensive sarcoidosis involving breast tissue was rendered after excluding other causes of non-necrotizing granulomas. The patient underwent a bilateral mastectomy to remove the breast nodules. This case discusses sarcoidosis involving an unusual site.

<p> The present study was undertaken to investigate the mechanism underlying the observation that the maximal voluntary strength of the two legs acting together or bilaterally in isometric leg extension was less than the summed unilateral (sum of the left and right legs tested separately) strength. Observations were made on this phenomenon under both isometric and concentric contraction conditions by testing young adult males performing unilateral and bilateral leg press contractions on a modified isokinetic dynamometer. </p> <p> Electromyographical evidence indicated that there was a lesser activation of motor units in bilateral contraction as compared to unilateral, under isometric conditions and at a low and high concentric velocity. To determine whether a particular type of motor unit was being activated to a lesser extent in bilateral contractions, two physiological parameters of unilateral and bilateral contractions were compared: the strength-velocity relation and fatigability. This investigative method was based on the known physiological differences between the motor unit types; namely fast-twitch (FT), type two motor units have a faster twitch contraction time, greater force output at high velocities of shortening and lesser resistance to fatigue than the slow-twitch (ST), type one units. </p> <p> Results showed a greater relative decline in the strength of bilateral contractions as the velocity of contraction was increased through a range from 0°/s to 424°/s (0 to 7.40 radians/s). The bilateral to summed unilateral strength ratio (B/U-ratio) decreased from 0.91 under isometric conditions to 0.51 at the highest test velocity. Lesser fatigability was found in the bilateral condition in a 100 consecutive concentric contraction fatigue test. These results provided complementary evidence for the conclusion that FT motor units were active to a lesser degree in bilateral contractions. </p> / Thesis / Master of Science (MSc)

This research focuses on the integration of Eye Movement Desensitization and Reprocessing therapy (EMDR) and Virtual Reality (VR). EMDR is a therapeutic approach using bilateral stimulation to process distressing memories, emotions, and experiences. It is widely employed for conditions like PTSD, anxiety, and depression. The study involves the development of a proof-of-concept virtual reality tool tailored for EMDR therapy sessions. The tool comprises a bilaterally moving sphere within the user's VR environment, controllable by the therapist through a graphical interface on a computer. The therapist can dynamically adjust the sphere's color, speed, and sound to enhance the therapeutic process. The study's findings affirm the feasibility of creating a VR tool that supports therapists in conducting effective EMDR therapy sessions.

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Introduktion: Avsikten med denna studie var att undersöka och beskriva de olika komplikationer som kan uppkomma vid och efter en bilateral sagittal split osteotomi samt fastställa deras incidens och påverkan på slutresultatet.Metod: Vi har använt oss av 4 läroböcker för att få förståelse för tillvägagångssättet vid en BSSO. Vår artikelsökning gav totalt 49 artiklar som vi läste i sin helhet genom inklusions- och exklusionskriterier. Vi valde sedan ut 34 artiklar av dessa som vi sedan använde oss av i arbetet gällande komplikationer vid BSSO.Resultat: Direkt postoperativt hade skador på nervus alverolaris inferior högsta incidens (91%) av komplikationerna. Incidens av skador på nervus lingualis var 19,4%, bad splits 6,49%, blödning 1,2%, nervskador på nervus facialis 0,67% samt non-union 0,47%. Av de komplikationer, som sågs 1 år postoperativt, hade recidiv vid posterior flyttning högst incidens på 28% och recidiv vid anterior flyttning 21%. Vid skador på n. lingualis låg incidensen 13,44%, skador på n. alveolaris inferior 10,75% och tempromandibulära dysfunktioner 3,7%.Slutsats: Permanenta komplikationer vid BSSO sker sällan och de komplikationer som uppkommer kan oftast lösas med reoperation. Skador på n alveolaris inferior har högst incidens vid BSSO. Detta är en komplikation som dock inte går att korrigera i efterhand och som kan påverka patienten under en längre tid. Därför bör patienten preoperativt vara informerad om de olika komplikationer som kan uppkomma.

<p> The performance index in teleoperation, transparency, is often defined as linear scaling of force and position between the master/ operator and slave/ environment. Motivated by applications involving soft tissue manipulation such as robotic surgery, the transparency objective is generalized in this thesis to include static nonlinear and linear-time-invariant filter mappings between the master I slave position and force signals. Lyapunov-based adaptive motion/ force controllers are proposed to achieve the generalized transparency objectives. Using Lyapunov stability theory the mapped position and force tracking errors are shown to converge in the presence of dynamic uncertainty in the master I slave robots and user I environment dynamics. Given a priori known bounds on unknown dynamic parameters, a framework for robust stability analysis is proposed that uses stability of Lur'ePostinkov systems and Nyquist/Bode envelopes of interval plant systems. Methods for finding the required Nyquist/Bode envelopes are presented in this thesis. A comprehensive stability analysis is performed under different sets of generalized mappings. For nonlinear mapping of either position or force, robust stability depends on stability of an equivalent Lur'e-Postinikov system. Stability results of such systems are discussed in this thesis. In particular, the on and off-axis circle theorems are utilized. Using these theorems, sufficient teleoperation stability regions are obtained that are far less conservative than those obtained from passivity. In the special case of LTI filtered force and position mappings the exact robust stability regions are obtained by showing stability of the relevant closed-loop characteristic polynomial. The proposed robust stability test uses the phase values of a limited set of extremal polynomials. </p> <P> To demonstrate the utility of the generalized performance measures, a stiffness discrimination tele-manipulation task is considered in which the user compares and contrasts the stiffness of soft environments via haptic exploration in the presence and absence of visual feedback. Using adaptive psychophysical perception experiments a nonlinear force mapping is shown to enhance stiffness discrimination thresholds. The design guidelines for this enhanced nonlinear force mapping are reported in this thesis. Generalized nonlinear and linear filtered mappings are achieved in experiments with a two-axis teleoperation system where the details of implementation are given. </p> / Thesis / Master of Applied Science (MASc)

Bilateral art is a neurologically-based therapeutic intervention that engages both dominant and non-dominant hands in the creation of images in response to polarized beliefs, cognitions, or feelings. Advances in neuroscience that integrate attachment theory and experience with neuronal development argue for use of the intervention. Retrospective case studies using enhancements of the bilateral art intervention protocol for individuals support these arguments. These case studies demonstrate clinical application of the intervention to a range of presenting problems including differentiation from family of origin, parenting problems, loss, trauma, and self-esteem concerns and provide the first documented evidence of the effectiveness of the bilateral art intervention. Additional case studies reflect development of two different bilateral art intervention protocols that facilitate exploration of relationships. The first protocol adapts the use of bilateral art with individuals to use with couples and it has a dual purpose: to facilitate both openness and integration of polarized thoughts or feelings in one member of a couple and to increase empathy in the other. The second protocol facilitates exploration of and reflection upon a relationship and is applied in the case study to the supervisor-supervisee dyad that is an integral part of the training of marriage and family therapists. Experiences reveal possible contraindications as well as indications for the use of these protocols. / Ph. D.

The continual increase in anterior cruciate ligament (ACL) injuries in sports makes it the most common ligament injury and leads the athlete down a difficult road with reconstruction surgery (ACLR) and months of rehabilitation. Specifically, females are at a greater risk of both primary and secondary ACL injuries compared to males. The purpose of this research was to understand the differences in movement and loading variability between ACLR and healthy athletes during unilateral and bilateral landings while utilizing limb symmetry to understand between group differences. It was hypothesized that females with an ACLR would have greater variability compared to males with an ACLR and healthy female athletes. 40 ACLR and 67 healthy athletes were asked to complete seven stop jumps and 25 ACLR and 30 healthy athletes completed seven single hop trials to assess intra-subject variability. The stop jump task utilized embedded force plates and motion capture technology while the single hop task used loadsol® in-shoe force sensors. The measures studied with the stop jump included posterior and vertical ground reaction force (GRF), knee/hip abduction/adduction angles, and loading rate. The single hop measures included peak force, loading rate, and impulse. To assess variability and limb symmetry, coefficient of variation (CV) and the limb symmetry index (LSI) were calculated for each of outcome measure. A linear mixed effects model was completed in JMP (SAS Institute Inc., Cary, NC) with p<0.05 to see the effects of group, sex, and limb. During the stop jump task, the ACLR athletes showed higher variability for both posterior GRF (p<0.001), posterior GRF LSI (p<0.001), and loading rate (p=0.027) compared to controls. Females with an ACLR had higher variability in vertical GRF (p<0.001) and vertical GRF symmetry (p=0.029) compared to HC females. Additionally, females with an ACLR had higher variability in the vertical GRF (p=0.033) when compared to males with an ACLR. Knee abduction angle (p=0.024) showed males with an ACLR to have higher variability compared to females with an ACLR. For the single hop task, there was a significant difference between sex for loading rate (p<0.001), loading rate LSI (p=0.004), impulse (p=0.006), and impulse LSI (p=0.001) with males producing a higher mean CV compared to females in all measures regardless of group. Overall, these results support the hypothesis that group and sex differences exist and that females with an ACLR will have higher variability and asymmetrical movements than male ACLR patients and healthy females during bilateral landings, which could lead to increased injury risk. In unilateral landings, the results suggest that females are landing with less variability compared to males. With increased variability on the surgical limb of an athlete with an ACLR, it is likely that the athlete will have a more successful return to sport as they can react and adapt to changes in landing during sports. Future work should report reinjury rates to investigate the potential role of movement variability in injury risk and potentially determine variability thresholds for injury risk. The evaluation of bilateral and unilateral landings revealed the need to include both landing tasks in return to sport testing as well as a limb symmetry metric to understand an athlete's functional readiness to react to changing conditions during sports related movement. / Master of Science / Anterior cruciate ligament (ACL) injuries continue to rise in all sports and result in athletes having to undergo reconstruction surgery (ACLR) and months of rehabilitation if they want to compete at a high level again. Specifically, females have a greater risk of suffering both a primary and secondary ACL injury compared to males. Movement differences have been previously researched in hopes of decreasing injury risk. Variability, or the differences between one trial to the next, is a way to visualize the athlete's ability to adapt following injury. The ideal level of adaptability is still unclear as too much variability can be seen as unstable while too little can be seen as unforgiving. The purpose of this project was to better understand movement and loading variability between ACLR and healthy athletes during one legged (unilateral) and two legged (bilateral) landings. Differences between limbs were analyzed to understand whether one leg was favored over the other. Every participant completed seven stop jump trials which required them to run forward, jump off one leg and landing with two legs followed by a maximum vertical jump; another different group completed a series of seven single leg hop tasks during which they started on one-leg and jumped forward as far as they could while maintaining their balance. The measures studied with the stop jump included peak vertical and posterior force, frontal plane knee and hip angles, and loading rate. The single hop measures included peak force, loading rate, and impulse. The loading rate is defined as the ratio of peak force divided by the time it takes the athlete to reach peak force following initial contact. Impulse is the area under the force time curve and provides insight into the athlete's ability to dissipate load. The force data from each trial performed were collected using force plate technology and loadsol® shoe inserts. Variability was calculated using the coefficient of variation (CV) which is the ratio between the standard deviation and the mean value across the trails. The limb symmetry index (LSI) was calculated as the ratio between the surgical/non-dominant and the non-surgical/dominant limbs. During a stop jump, female patients with an ACLR showed greater variability in peak force and force LSI revealing asymmetric landing compared to healthy females. Additionally, females with an ACLR had greater variability compared to males with an ACLR in peak force. The ACLR group had greater variability in posterior force, posterior force symmetry, and loading rate compared to the athletes in the healthy group. During a single hop, males had higher greater variability in loading rate, loading rate limb difference, impulse, and impulse limb difference compared to females. These results suggest that all females have a more unstable and asymmetrical landing compared to all males during bilateral landing. However, during a unilateral landing, females had a less forgiving landing compared to males, which could also indicate an increased injury risk. Future work should investigate reinjury rates to determine whether variability impacts injury risk and if differences in injury risk between males and females are associated with differences in variability.

In general, an individual commands a salary in return for their contribution to the production process at their place of employment. In the case of a quarterback for a National Football League team, the salary he commands depends on how much the team's owner expects him to contribute to the team and how unique his talents and services are. The salary of the quarterback is negotiated between the quarterback and the team and will vary greatly depending on the relative strengths of each side's bargaining position. The bilateral oligopoly provides a useful way to view how salaries are determined. This thesis uses an econometric model to explore the bilateral oligopoly framework for determining quarterback salaries. Within this framework, there are a set of on-field performance variables (related to the quarterback and the team) and off-field financial variables (related to the team) that are used to negotiate a quarterback's salary. This paper characterizes the quarterback-team relationship by identifying those variables that effect quarterback salaries. / Master of Arts