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Kyoto international consensus report on anatomy, pathophysiology and clinical significance of the gastro-oesophageal junction.（最新研究の紹介）
Get PDFGut. 2022 Aug;71(8):1488-1514.
DOI: 10.1136/gutjnl-2022-327281.othe
Isolated Diastolic Hypertension and Risk of Cardiovascular Disease : Controversies in Hypertension - Pro Side of the Argument.
Get PDFpdfIsolated diastolic hypertension (IDH), defined as diastolic blood pressure in the hypertensive range but systolic blood pressure not in the hypertensive range, is not uncommon (<20%) among adults with hypertension. IDH often manifests in concurrence with other cardiovascular risk factors. Individuals with IDH tend to have lower awareness of their hypertension compared with those with both systolic and diastolic hypertension. IDH appears to be a largely underrated risk factor for cardiovascular disease events, which may be explained by inconsistent association of IDH with cardiovascular disease events. The inconsistency suggests that IDH is heterogeneous. One size does not seem to fit all in the clinical management of individuals with IDH. Rather than treating IDH as a monolithic low-risk condition, detailed phenotyping in the context of individual comprehensive cardiovascular risk would seem to be most useful to assess an individual's expected net benefit from therapy. In this review, we highlight that the clinical relevance of IDH differs by individual clinical characteristics, and elucidate groups of individuals with IDH that should be wary of cardiovascular disease risks.Journal Articlejournal articl
ヒス束内縦解離によるtriple pathwayが疑われた間欠性完全右脚ブロックおよび間欠性軸右方シフトの1症例
Get PDFpdf症例は83歳男性、高血圧症、脂肪肝で通院。初診時は53歳、30年間にわたる心電図経過の中で、5種類のQRS波形を呈した間欠性完全右脚ブロック、間欠性軸右方シフトを呈した。71歳時には洞調律で完全右脚ブロック型、QRS軸は+15°[C15]であったが、74歳時には洞調律で完全右脚ブロック型のまま、QRS軸が+60°と右方にシフトした[C60]。76歳時に心房細動が初発したが、[C60]は不変であった。78歳時、先行RR間隔が1.01秒以上では間欠性ながら[C15]に戻った。79歳時には、先行RR間隔が0.98秒以上では間欠性に不完全右脚ブロック型を呈したが、QRS軸は+60°[I60]のまま不変であった。80歳時には、[C60]、[C15]、不完全右脚ブロック型でQRS軸+15°[I15]の3種類のQRS波形を認め、83歳時には[I60]に加え、さらに先行RR間隔が0.44〜0.48秒と極端に短い状況では、QRS幅0.08秒でQRS軸+70°の過常期伝導と考えられる正常QRS波形[N70]を認めた。このように、QRS波形が右脚ブロック型のままでQRS幅とQRS軸のそれぞれが異なる臨界先行PR間隔で変化する現象は、右脚の伝導障害のみでは説明困難であり、ヒス束内縦解離によるtriple pathwayを想定することにより、はじめて説明可能と考えられた。Journal Articlejournal articl
Regional Differences in Kawasaki Disease Incidence Reduction Before and After the Onset of the Coronavirus Disease 2019 Pandemic.
No full textObjective:
To assess regional differences in reduction of the incidence of Kawasaki disease during the mitigation period for the coronavirus disease 2019 pandemic, with a hypothesis that more sparsely populated regions have fewer opportunities for human-to-human contact, resulting in a greater reduction in the incidence of Kawasaki disease.Study design:
A retrospective ecological study was conducted using data from patients hospitalized for Kawasaki disease as well as infectious diseases surveillance reports in Shiga Prefecture, Japan, during 2015-2020. We defined the periods before and after the onset of pandemic as January 2015-March 2020 and as April 2020-December 2020, respectively. We compared the reductions in the incidence of Kawasaki disease among 6 administrative regions in the prefecture according to the density of the populations.Results:
A total of 1290 patients with Kawasaki disease were identified. The incidence of Kawasaki disease (per 100 000 person-years) was significantly reduced after the coronavirus disease 2019 pandemic onset (period before pandemic onset, 105.6 [95% CI 99.8-111.8]; period after pandemic onset, 68.6 [95% CI 56.7-83.0]). During the period after pandemic onset, the incidence of Kawasaki disease was significantly reduced in May, compared with the corresponding period in previous years. The number of patients aged 2-4 years was significantly reduced after the pandemic onset. Notably, greater reductions in the incidence of Kawasaki disease were found in regions with lower population densities.Conclusions:
Assuming that there were fewer opportunities for human-to-human contact in more sparsely populated regions during the pandemic mitigation period, our findings support the hypothesis that human-to-human contact may be associated with development of Kawasaki disease.Journal Articlejournal articl
Involvement of strawberry notch homologue 1 in neurite outgrowth of cortical neurons.
Get PDFpdfWhen the regulation of axonal and dendritic growth is altered, the neuronal network becomes disordered, which may contribute to the development of psychiatric disorders. Some genome analyses have suggested relationships between mutations in strawberry notch homologue 1 (SBNO1) and neurodevelopmental disorders. However, the function of SBNO1 has not yet been reported. Here, SBNO1 expression pattern during the development of the cerebral cortex in mice was examined. SBNO1 was strongly expressed in the cortical plate and its expression was maintained at a low level during the postnatal stage. CRISPR/Cas9-based knockout of Sbno1 in Neuro2A cultured cells showed delayed growth of neurites. A cortical neuron-specific conditional knockout mouse was constructed, which resulted in hypotrophy of axon bundles and dendrites in cortical neurons. Thus, when mutated, SBNO1 is a candidate gene for psychiatric diseases, such as schizophrenia, as suggested by human genome studies.Journal Articlejournal articl
Benefit Profile of Thrombomodulin Alfa Combined with Antithrombin Concentrate in Patients with Sepsis-Induced Disseminated Intravascular Coagulation
Get PDF滋賀医科大学博士（医学）pdfThesis or DissertationClinical and Applied Thrombosis/Hemostasis. 2022 Jan-Dec;28:10760296221077096.令和4年度thesi
Effectiveness of Countermeasures against Technical Alarms in the Dispensing Inspection Support System
Get PDFObjective:
Our previous study reported many technical alarms in the dispensing inspection support system due to setting or operation errors, but not due to dispensing errors, and that countermeasures reduce technical alarms. In this study, we investigated the long-term effects of the countermeasures.
Methods:
The log data of the inspection results were extracted from the dispensing inspection support system and divided into image inspection and weight inspection data. The details and frequency of technical alarms before (April-June 2019), after (April-June 2020), and one year after (April-June 2021) the countermeasures were compared by chi-square test.
Results:
The frequency of technical alarms in image inspection was 13.7, 11.3, and 9.1% in 2019, 2020, and 2021, respectively (p< 0.01). However, the frequency of technical alarms in weight inspection was 3.0, 3.0, and 1.6% in 2019, 2020, and 2021,respectively (p< 0.01). The ratio of technical alarms to all alarms was 98.2% for image inspections and 91.2% for weight inspections in 2021.
Conclusion:
The frequency of technical alarms was reduced by the countermeasures. However, the ratio of technical alarms to all alarms is still high, and further improvements are needed to prevent the loss of reliability due to technical alarms.journal articl
Perivascular mechanical environment: A narrative review of the role of externally applied mechanical force in the pathogenesis of atherosclerosis
Get PDFapplication/pdfAtherosclerosis is promoted by systemic factors, such as dyslipidemia, hypertension, diabetes, and smoking, which cause atherosclerosis in blood vessels throughout the body. However, atherosclerotic lesions are characterized by their frequent occurrence in specific vessels and sites. Blood vessels are exposed to various mechanical forces related to blood pressure and flow. Although shear stress promotes the initiation and progression of atherosclerotic lesions, the pathogenesis of site specificity of atherosclerosis is not sufficiently explained by shear stress. We propose the concept of a perivascular mechanical environment (PVME). Compelling evidence suggests that site specificity in atherosclerotic lesions depends on a distinct local PVME. Atheroprone arteries, such as the coronary artery, are markedly affected by externally applied mechanical force (EMF), whereas atheroprotective arteries, such as the internal thoracic artery, are less affected. Recent studies have shown that the coronary artery is affected by cardiac muscle contraction, the carotid artery by the hyoid bone and the thyroid cartilage, and the abdominal aorta and lower extremity arteries by musculoskeletal motion. We speculate that the thoracic cage protects the internal thoracic artery from EMF owing to a favorable PVME. Furthermore, evidence suggests that plaque eccentricity is provided by EMF; plaques are frequently observed on an external force-applied side. In each vascular tree, site-specific characteristics of the PVME differ substantially, inducing individual atherogenicity. From the perspective of the mechanical environment, hemodynamic stress occurs in an inside-out manner, whereas EMF occurs in an outside-in manner. These inward and outward forces apply mechanical load individually, but interact synergistically. The concept of a PVME is a novel pathogenesis of atherosclerosis and also might be a pathogenesis of other arterial diseases.Journal Articlejournal articl
Effects of different bed heights on the physical burden of physiotherapists during manual therapy: an experimental study
Get PDF滋賀医科大学博士（医学）pdfThesis or DissertationIndustrial Health. 2022 Jun 9.令和4年度thesi
Radical Cyclopolymerization of Isocyanurate Core-Based Bifunctional Monomers Bearing a Hydroxy Group and Their Application to Cross-Linking Reaction
Get PDFapplication/pdfWe report the synthesis of linear polymers having macrocyclic units in the main chain and hydroxy groups in the side chains by radical cyclopolymerization of the isocyanurate core-based bifunctional monomers and their utilization to cross-linking reaction via esterification. The 5% weight loss temperature (Td5) and glass transition temperature (Tg) of the resulting linear polymers have clearly revealed the effect of the introduced macrocyclic unit upon the thermal stability of the polymer. Among the synthesized cross-linked polymers, the rigidity of the incorporated cross-linked structure in the cross-linked polymers also dominates thermal properties of polymers. Such reactive linear polymers including macrocyclic units and hydroxy groups are expected to be applied to various fields of high thermal-resistance materials.Journal Articlejournal articl