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Future expectations for respiratory disease assessment in dynamic chest radiography
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シガ イカ ダイガク イガクブ フゾクビョウイン ノ シュウジュツキ コウクウ キノウ カンリ ノ リンショウテキ トウケイ 2002ネン
Get PDF滋賀医科大学医学部附属病院歯科口腔外科では2014年より, 周術期患者の口腔機能管理を目的とした「オーラルマネジメントシステム」を稼働した. 2015年には, 患者に快適, 安心, 安全な周術期医療を提供することを目的として, 多職種からなる「周術期チーム」が発足し, 当科はチームの一員として口腔機能管理を担っている. 今回われわれは, 2015年4月１日から2022年3月31日までの７年間の年度毎の全身麻酔手術件数, 周術期口腔機能管理依頼件数の推移と周術期口腔機能管理依頼率(1年間の全身麻酔手術件数に対する周術期口腔機能管理依頼件数の割合), 依頼件数の多かった診療科について臨床的検討を行った. 当院の2021年度の全身麻酔手術件数は4158件, 依頼件数は1931件, 依頼率は46.3%であり, オーラルマネジメントシステムを導入した2015年度より年々増加を認めていた. 診療科毎の依頼件数は消化器外科, 耳鼻咽喉科が多かった. 当科の院内啓蒙活動や周術期口腔機能管理により術後合併症のリスクが低下する報告が増えたことにより, 医科の周術期口腔機能管理の認知が高まり, 依頼件数, 依頼率の増加につながったと考える. 診療科毎の依頼件数に関しては, 歯科口腔領域と関係の深い診療科の依頼が多いと考えられた. 周術期チームが発足してから, 他職種連携は密となり, 依頼件数, 依頼率の増加を認めたが, 周術期口腔機能管理が, 術後合併症の予防を示すエビデンスはまだないため今後の課題と考えている.The Department of Oral Surgery of Shiga University Hospital launched the "Oral Management System" for the purpose of managing oral functions of perioperative patients, in 2014. "Perioperative team" consisting of members from various professions was established in 2015, with the aim of providing comfortable, safe, and secure perioperative care to patients. Our department is responsible for the management of oral functions. In this study, we conducted a clinical review of the number of general anesthesia cases per year, the number of requests for perioperative oral function management, the rate of requests for perioperative oral function management (the ratio of the number of requests for perioperative oral function management to the number of general anesthesia cases per year), and the departments with high number of requests for perioperative oral function management during the seven years from April 1, 2015, to March 31, 2022. The number of general anesthesia surgeries in our hospital in 2021 was 4158, and the number of requests was 1931, for a request rate of 46.3%. The number of requests had been increasing every year since 2015, when the oral management system was introduced. The number of requests per department was higher in the departments of gastroenterological surgery and otorhinolaryngology. The number of requests and the request rate increased. Because we consider that the awareness of perioperative oral functional management in the medical department has increased due to our hospital's educational activities and an increase in the number of reports showing that perioperative oral function management reduced postoperative complications. After the perioperative team was established, the collaboration among other departments became closer, and the number of requests and the request rate increased. However, there is still no evidence that perioperative oral function management prevents postoperative complications, and this is an issue for the future.departmental bulletin pape
Increased Cellular Expression of Interleukin-6 in Patients With Ossification of the Posterior Longitudinal Ligament.
No full textStudy design:
We performed histologic, immunohistochemical, immunoblot examination and suspension array analyses of cytokine expression in cultured cells derived from human cervical ossification of the posterior longitudinal ligament (OPLL).Objective:
To determine the roles of interleukin-6 (IL-6) during the maturation of osteoblasts and chondrocytes associated with the development of OPLL.Summary of background data:
Ectopic OPLL affects ~3% of the general population, with a higher incidence in Asian ethnic groups. Alterations in cytokine profiles may influence osteoblast differentiation, but the mechanisms and signaling pathways associated with the ossification process remain unclear.Methods:
Samples were collected from 14 patients with OPLL who had undergone spinal surgery and seven with cervical spondylotic myelopathy without OPLL. Tissue sections were used for histologic and immunohistochemical studies, and primary cells from ligamentum samples were used for cytokine array and immunoblotting. A suspension array was used to measure the concentrations of 27 inflammatory cytokines or growth factors.Results:
Suspension array and immunoblot analyses revealed significantly elevated levels of IL-6 in OPLL patients. Alterations in IL-6 concentrations were found to alter the expression of the genes Sox9 , Runx2 , and SIRT1 . In addition, immunohistochemical analysis revealed that these factors are present in mesenchymal cells within the degenerative portion of the ligament matrix that is adjacent to the ossification front.Conclusions:
IL-6 plays a profound role in the osteoblast differentiation process along with the induction of chondrocyte hypertrophy and cell apoptosis in the early stages of ossification in OPLL. These changes in cytokine profiles are essential factors for regulation of the ectopic ossified plaque in OPLL.Journal Articlejournal articl
Efficacy of oligodendrocyte precursor cells as delivery vehicles for single-chain variable fragment to misfolded SOD1 in ALS rat model
Get PDFapplication/pdfSuperoxide dismutase1 (SOD 1) mutation is a leading cause of familial amyotrophic lateral sclerosis (ALS). Growing evidence suggests that antibody therapy against misfolded SOD1 protein can be therapeutic. However, the therapeutic effects are limited, partly because of the delivery system. Therefore, we investigated the efficacy of oligodendrocyte precursor cells (OPCs) as a drug delivery vehicle of single-chain variable fragments (scFv). Using a Borna disease virus vector that is pharmacologically removable and episomally replicable in the recipient cells, we successfully transformed wild-type OPCs to secrete scFv of a novel monoclonal antibody (D3-1), specific for misfolded SOD1. Single intrathecal injection of OPCs scFvD3-1, but not OPCs alone, significantly delayed disease onset and prolonged the lifespan of ALS rat models expressing SOD1 H46R . The effect of OPC scFvD3-1 surpassed that of a 1 month intrathecal infusion of full-length D3-1 antibody alone. scFv-secreting OPCs suppressed neuronal loss and gliosis, reduced levels of misfolded SOD1 in the spinal cord, and suppressed the transcription of inflammatory genes, including Olr1, an oxidized low-density lipoprotein receptor 1. The use of OPCs as a delivery vehicle for therapeutic antibodies is a new option for ALS in which misfolded protein and oligodendrocyte dysfunction are implicated in the pathogenesis.Journal Articlejournal articl
Association between treatment for retinopathy of prematurity and blood monocyte counts
No full textPurpose:
To investigate blood monocyte counts as a risk factor for retinopathy of prematurity (ROP) treatment.Design:
Retrospective cohort study.Methods:
Infants who underwent ROP screening at Shiga University of Medical Science Hospital between January, 2011 and July, 2021 were included in this study. Screening criteria were a gestational age (GA) < 32 weeks or birth weight (BW) < 1500 g. The week with the largest difference in monocyte counts between the infants with and without type 1 ROP determined based on the effect size. Multivariate logistic regression analysis was applied to investigate whether the monocyte counts constituted an independent risk factor for type 1 ROP. The objective variable was type 1 ROP, and the explanatory variables were GA, BW, infants' infection, and Apgar score at 1 min and monocyte counts in the week with the largest monocyte-counts difference between the with- and without type 1 ROP groups.Results:
In total, 231 infants met the inclusion criteria. The monocyte counts in the fourth week after birth (4w MONO) exhibited the largest difference between infants with and without type 1 ROP. The analysis was performed on 198 infants, excluding 33 infants without 4w MONO data. Thirty-one infants had type 1 ROP, whereas 167 infants did not. BW and 4w MONO were significantly associated with type 1 ROP (odds ratio: 0.52 and 3.9, P < .001 and 0.004, respectively).Conclusions:
The 4w MONO was an independent risk factor for type 1 ROP and may be useful in follow-up of infants with ROP.Journal Articlejournal articl
A Trimming Technique : A Case Report of a Novel Surgical Approach for Cesarean Scar Dehiscence During Cesarean Section
No full textCesarean section can lead to residual myometrial thickness thinning and cesarean scar syndrome. We report a novel trimming technique for residual myometrial thickness recovery in women with cesarean scar syndrome. Case 1: A 33-year-old woman who developed cesarean scar syndrome (CSS) and abnormal uterine bleeding post-cesarean scar became pregnant following hysteroscopic treatment. The myometrium at previous scar was dehiscent; therefore, a transverse incision was made above the scar. Post-operative uterine recovery failed owing to lochia retention, and developed cesarean scar syndrome again. Case 2: A 29-year-old woman who developed cesarean scar syndrome post-cesarean section became pregnant spontaneously. The myometrium at the previous scar was dehiscent like case 1. Scar repair was performed using a trimming technique during cesarean section; there were no subsequent complications and she conceived again spontaneously. Performing this novel surgical procedure during cesarean section may contribute to residual myometrial thickness recovery in women with cesarean scar syndrome.journal articl
Dexamethasone palmitate as an etoposide-free treatment for children with hemophagocytic lymphohistiocytosis after hematopoietic cell transplantation
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Randomized controlled trial of olanexidine gluconate and povidone iodine for surgical site infection after gastrointestinal surgery
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Antiseptics used at surgical sites are vital to preventing surgical site infections (SSI). In this study, a comparative investigation of the novel antiseptics olanexidine gluconate (OG) and povidone-iodine (PI) was conducted to determine whether OG is more effective than PI against SSI after gastrointestinal surgery.
Methods:
This prospective, randomized, single-blind, interventional, single-center study was conducted between August 2018 and February 2021. Patients scheduled for large-scale gastrointestinal surgeries were randomized into two groups and administered OG (OG group) or PI (PI group) as preoperative antiseptics. The primary endpoint was the SSI occurrence rate within 30 days after surgery.
Results:
In total, 525 patients were enrolled in this study, of whom 256 and 254 were in the OG and PI groups, respectively. The total SSI occurrence rate in the OG group (10.8%; n = 26) and the PI group (13.0%; n = 33) was not significantly different (p = 0.335). The occurrence rate of superficial incisional SSI and organ/space SSI did not significantly differ between the groups; however, that of deep incisional SSI showed a significant difference, with 0.4% (n = 1) in the OG group and 4.3% (n = 11) in the PI group (p = 0.003).
Conclusion:
OG, as a preoperative skin antiseptic, did not reduce the occurrence rate of total SSI. However, deep incisional SSI may be reduced using OG.journal articl