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心拡張機能が肺切除後周術期回復に与える影響
Get PDFBackground/aim: In patients undergoing lung resection, even when lung and ventricular function are normal, there may be a prolonged delay in postoperative recovery. The effect of left ventricular extension disorders on recovery after pulmonary resection was investigated. Materials and methods: The postoperative recovery of ninety patients with normal left ventricular ejection fraction and exercise tolerance who underwent anatomical pulmonary resection was evaluated according to the grade of left ventricular expansion (E/e'). Results: Left ventricular extension was normal (≤8) in 53 cases, moderately restricted (8-12) in 36 cases and severely restricted (>12) in 9 cases. No significant difference was found in the postoperative complication rate. However, the severely restricted group had a significantly higher duration of oxygen administration, intensive care unit stay, and postoperative hospital stay, which were found to be independent predictors of ventricular expansion. Conclusion: Left ventricular expansion dysfunction had a negative effect on postoperative recovery.博士（医学）・乙第1469号・令和2年9月30日Copyright© 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.Articles from In Vivo are provided here courtesy of International Institute of Anticancer Research.The publication is available at International Institute of Anticancer Research via http://dx.doi.org/10.21873/invivo.1169
甲状軟骨形成術Ⅰ型と声帯内自家脂肪注入術との治療成績の検討
Get PDFObjective: Type-I thryroplasty, also known as medialization thyroplasty (MT) and autologous fat injection laryngoplasty (FIL) are one of the main surgical treatments for unilateral vocal fold paralysis (UVFP). Both procedures have the same concept of completing the glottal closure by medializing the vocal fold, although the surgical approaches are quite different. In order to assess these surgical effects, we examined the treatment outcomes and benefits of the two surgeries. Methods: We collected data from the 135 phonosurgeries that we performed out of 375 patients with UVFP at Osaka Voice Center, Osaka Kaisei Hospital from January 2009 to February 2013. After excluding cases with glottal level differences on phonation, either MT or FIL were performed on 80 cases. The inclusion criteria for the present study were: (1) patients had no history of previous phonosurgery, and (2) functional evaluations were available before/after surgery. Consequently, 43 participants (12 for MT and 31 for FIL) were enrolled in this study. Surgical effects were evaluated by means of the maximum phonation time (MPT), pitch period perturbation quotient (PPQ), amplitude perturbation quotient (APQ), and harmonic to noise ratio (HNR) just before, one month, and 6 months after surgery. Results: Both MT and FIL showed significant improvement in MPT (MT, p = 0.005; FIL, p < 0.001) and PPQ (MT, p = 0.047; FIL, p = 0.041) at 1 month postoperation. We also compared the variation of each variable between the two procedures, but there were no significant differences in these parameters. However, MPT, APQ, and HNR at the post-MT after 6 months worsened compared to those at 1 month posttreatment, whereas MPT showed only a slight decrease from the 1st month to the 6th month in those with FIL. Conclusion: Both MT and FIL were effective for the voice recovery in patients with UVFP. Our findings suggest that surgical results in FIL might be better than those in MT 6 months after surgery, although there were no significant differences between these two procedures 1 month postoperation.博士（医学）・乙第1490号・令和2年12月24日Copyright © 2020 Oto-Rhino-Laryngological Society of Japan Inc. Published by Elsevier B.V
Spreading depressionと局所虚血刺激による大脳皮質領域の神経細胞新生
No full textEndogenous neurogenesis can arise from a variety of physiological stimuli including exercise, learning, or “enriched environment” as well as pathological conditions such as ischemia, epilepsy or cortical spreading depression. Whether all these conditions use a common trigger to set off endogenous neurogenesis is yet unclear. We hypothesized that cortical spreading depression (CSD) induces neurogenesis in the cerebral cortex and dentate gyrus after cerebral venous ischemia. Forty-two Wistar rats alternatively underwent sham operation (Sham), induction of ten CSDs or venous ischemia provoked via occlusion of two adjacent superficial cortical vein followed by ten induced CSDs (CSD + 2-VO). As an additional control, 15 naïve rats received no intervention except 5-bromo-2′-deoxyuridine (BrdU) treatment for 7 days. Sagittal brain slices (40 μm thick) were co-stained for BrdU and doublecortin (DCX; new immature neuronal cells) on day 9 or NeuN (new mature neuronal cells) on day 28. On day 9 after sham operation, cell proliferation and neurogenesis occurred in the cortex in rats. The sole induction of CSD had no effect. But on days 9 and 28, more proliferating cells and newly formed neurons in the ipsilateral cortex were observed in rats subjected to CSD + 2VO than in rats subjected to sham operation. On days 9 and 28, cell proliferation and neurogenesis in the ipsilateral dentate gyrus was increased in sham-operated rats than in naïve rats. Our data supports the hypothesis that induced cortical neurogenesis after CSD + 2-VO is a direct effect of ischemia, rather than of CSD alone.博士（医学）・乙第1459号・令和2年6月30日Open access statement: This is an open access article distributed under
the terms of the Creative Commons Attribution-NonCommercial-ShareAlike
3.0 License(https://creativecommons.org/licenses/by-nc-sa/3.0/), which allows others to remix, tweak, and build upon
the work non-commercially, as long as the author is credited and the new
creations are licensed under the identical terms
A Case of delayed diagnosis of congenital candidiasis in a Late preterm infant.
No full textA female infant was vaginally born at 35 weeks and developed respiratory distress. A rash with pustules gradually appeared on her entire body. Her respiratory condition did not improve with antibacterial treatment. Candida albicans was detected in pharynx, urine, stool, and gastric fluid cultures. Therefore, she was diagnosed with congenital candidiasis (CC) and prescribed fiuconazole. Her respiratory condition rapidly improved after the course of treatment. CC is rare but should be considered in infants with rashes and pustules. Rapid diagnosis is important for a prompt treatment because CC has a high mortality rate, particularly in low-birth-weight infants. However, the diagnosis is challenging when the rash is nonspecific. Paying attention to maternal risk factors, such as the use of intrauterine contraceptive devices, cervical suture, and the use of antibiotics, and to infants' symptoms, including respiratory distress and leukocytosis with left shift may help in a faster diagnosis.個人の尊厳に関わる画像が掲載されているため本文PDFの登録はな