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Dexmedetomidine suppresses serum syndecan-1 elevation and improves survival in a rat hemorrhagic shock model
Get PDF浜松医科大学博士（医学）doctoral医学系研究科thesi
Pre-administration of a carboxypeptidase inhibitor enhances plasminogen accumulation and thrombolysis after tPA infusion: Demonstration by real-time intravital imaging analysis of microthrombi in mice
Get PDF浜松医科大学博士（光医工学）doctoral医学系研究科thesi
MIHARI project, a preceding study of MID-NET, adverse event detection database of Ministry Health of Japan-Validation study of the signal detection of adverse events of drugs using export data from EMR and medical claim data
Get PDF浜松医科大学博士（医学）doctoral医学系研究科thesi
A subpopulation of agouti-related peptide neurons exciting corticotropin-releasing hormone axon terminals in median eminence led to hypothalamic-pituitary-adrenal axis activation in response to food restriction
Get PDF浜松医科大学博士（医学）doctoral医学系研究科thesi
Term newborns with relatively low tissue oxygen saturation levels soon after birth are predisposed to neonatal respiratory disorders in low-risk, elective cesarean sections
Get PDF浜松医科大学博士（医学）doctoral医学系研究科Background: Neonatal respiratory disorders, such as transient tachypnea of the newborn and respiratory distress syndrome, occur frequently after an elective cesarean delivery. Although conventional pulse oximetry is recommended for neonatal resuscitation, it often requires several minutes after birth to obtain a reliable signal. In a previous study, we used novel tissue oximetry equipment to detect fetal and neonatal early tissue oxygen saturation (StO2) before and immediately after vaginal delivery. Therefore, we hypothesized that low neonatal StO2 levels measured by tissue oximetry may lead to neonatal respiratory disorder after a scheduled cesarean delivery. Hence, this study aimed to evaluate the StO2 levels measured by tissue oximetry in neonates with or without a respiratory disorder subsequently diagnosed after an elective cesarean delivery.
Materials and methods: We enrolled 78 pregnant Japanese women who underwent an elective cesarean section at ?36 weeks’ gestation. After combined spinal and epidural anesthesia were administered to the mother, fetal StO2 levels were measured by tissue oximetry using an examiner’s finger-mounted sensor during a pelvic examination immediately before the cesarean section. We measured the neonatal StO2 levels at 1, 3, and 5 minutes after birth and retrospectively compared the fetal and neonatal StO2 levels with the incidence of subsequent diagnoses of neonatal respiratory disorders.
Results: The data of StO2 levels in 35 neonates were collected. Seven neonates (respiratory disorder (RD) group) were subsequently diagnosed with respiratory disorders by neonatal medicine specialists, whereas the 28 remaining neonates (NR group) were not. The median fetal StO2 (interquartile range) of the RD and NR groups was 52.0% (41.8%-60.8%) and 42.5% (39.0%-52.5%), respectively (P=0.12). The median neonatal StO2 (interquartile range) of the RD and NR groups at 1 minute after birth was 42.0% (39.0%-44.0%) and 46.0% (42.0%-49.0%), respectively (P=0.091). At 3 minutes after birth, the median neonatal StO2 (interquartile range) of the RD and NR groups was 41.0% (39.0%-46.0%) and 47.0% (44.3%-53.5%), respectively (P=0.004). Finally, at 5 minutes after birth, the median neonatal StO2 (interquartile range) of the RD and NR groups was 45.0% (44.0%-52.0%) and 54.0% (49.3%-57.0%), respectively (P=0.007).
Conclusions: The StO2 values in the RD group were lower than those in the NR group at 3 and 5 minutes after birth, suggesting that neonates with low StO2 levels soon after birth may be predisposed to clinically diagnosed neonatal respiratory disorders.doctoral thesi
Metformin reduces pleural fibroelastosis by inhibition of extracellular matrix production induced by CD90-positive myofibroblasts
Get PDF浜松医科大学博士（医学）doctoral医学系研究科Metformin, an AMP-activated protein kinase activator used to treat diabetes mellitus, has recently attracted attention as a promising anti-fibrotic agent. However, its anti-fibrotic effects on pleural fibroelastosis remain unknown. We induced mouse pleural fibroelastosis by intra-pleural coadministration of bleomycin and carbon and evaluated its validity as a preclinical model for human pleural fibrosis. We assessed the expression of the myofibroblast surface marker CD90 in the fibrotic pleura and the effects of metformin in vivo and in vitro. Finally, we evaluated the effects of metformin on human pleural mesothelial cells stimulated by transforming growth factor β1 (TGFβ1). The fibrotic pleura in mice had collagen and elastin fiber deposition similar to that seen in human fibrotic pleura. Moreover, CD90-positive myofibroblasts were detected in and successfully isolated from the fibrotic pleura. Metformin significantly suppressed the deposition of collagen and elastic fibers in the fibrotic pleura and decreased the expression of extracellular matrix (ECM)-related genes, including Col1a1, Col3a1, Fn1, and Eln, in pleural CD90-positive myofibroblasts. In human pleural mesothelial cells, metformin decreased TGFβ1-induced upregulation of ECM-related genes and SNAI1. Overall, metformin suppresses pleural fibroelastosis by inhibition of ECM production by pleural myofibroblasts, suggesting that this drug has therapeutic potential against human pleural fibrosis, including pleuroparenchymal fibroelastosis.doctoral thesi
Pro-gastrin-releasing peptide as a marker for the Ewing sarcoma family of tumors
Get PDF浜松医科大学博士（医学）doctoral医学系研究科thesi
Usefulness of a temporary shunt by cannulation during superior vena cava combined resection
Get PDFSuperior vena cava invasive thoracic malignancy requires combined resection of the superior vena cava to achieve en bloc resection of the involved structures with negative margins. The superior vena cava combined resection requires the creation of collateral circulation from the head to the heart before performing the combined resection. Even for a short time, total superior vena cava clamping without a procedure is unsafe and should be avoided. We will present a surgical resection with superior vena cava reconstruction, involving a temporary extrathoracic shunt from the left brachiocephalic vein to the right auricle using a venous return cannula. This is an optional technique for convenient and safe superior vena cava combined resection. It provides an excellent intrathoracic surgical view by venous return via the unilateral brachiocephalic vein, with the advantages of being a simple procedure requiring short surgical time.journal articl
Comparison Between the Simultaneous Reconstructions of the Anterior Talofibular Ligament and Calcaneofibular Ligament and the Single Reconstruction of the Anterior Talofibular Ligament for the Treatment of Chronic Lateral Ankle Instability
Get PDF発行年：2022年5-6月This study aimed to evaluate the procedures of reconstruction surgery for chronic lateral ankle instability. We compared single anterior talofibular ligament reconstruction to simultaneous reconstructions of the anterior talofibular and calcaneofibular ligaments. From 2015 to 2019, 14 consecutive patients diagnosed with chronic lateral ankle instability underwent arthroscopic anterior talofibular ligament reconstruction with or without calcaneofibular ligament reconstruction after conservative treatment. Seven patients underwent single anterior talofibular ligament reconstruction (group AT), and seven patients underwent simultaneous reconstructions of the anterior talofibular ligament and calcaneofibular ligament (group AC). The Japanese Society for Surgery of the Foot scale scores and Karlsson scores significantly improved in all patients one year postoperatively. The radiographic measurement of the talar tilt angle and the talar anterior drawer distance at one year after surgery were also significantly improved compared to preoperative values. The postoperative talar tilt angle was significantly greater in group AT (median 6°, range 3° to 7°) than that in group AC (median 3°, range 2° to 5°; p=0.038). The postoperative talar anterior drawer distance, Japanese Society for Surgery of the Foot scale score, and Karlsson score were not significantly different between the two groups.
We found that although the clinical outcomes after the anterior talofibular ligament reconstruction with or without the calcaneofibular ligament reconstruction for chronic lateral ankle instability were good, instability of the talar tilt angle at one year postoperatively 30 in patients who underwent single anterior talofibular ligament reconstruction was greater than that in patients who underwent simultaneous anterior talofibular and calcaneofibular ligament reconstructions.journal articl
肝細胞癌リスク患者をEOB造影MRIとダイナミック造影CTで画像診断するには？
Get PDFEOB造影MRIの普及により、慢性肝炎患者のスクリーニング検査で非多血性病変が指摘される機会が増えている。非多血性病変は進行肝癌発生の重要なリスク因子であることを認識し、経過観察に当たる必要がある。経過観察の間隔はガイドラインに記載されているが、確固たるエビデンスはないのが現状である。journal articl