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A study on respiratory management in acute postoperative period by nasal high flow for patients undergoing surgery under general anesthesia
Full text linkIn head and neck surgery where the oropharyngeal area is the operative field, postoperative respiratory depression and upper airway obstruction are common. Therefore, supplemental oxygen is administered to prevent severe postoperative early hypoxemia. However, a high concentration of oxygen increases the likelihood of secondary complications, such as carbon dioxide (CO2) narcosis.
Nasal high-flow (NHF) therapy generates high flows (≤60 L/min) of heated and humidified gas delivered via nasal cannula and provides respiratory support by generating positive airway pressure, clearance of dead space and reduction of work of breathing. This study aims to determine whether the postoperative hypoxemia and hypercapnia can be prevented by NHF without the requirement
of supplemental oxygen. The study will recruit adult patients undergoing planned oral surgery under general anesthesia
at Nagasaki University Hospital. It is a randomized parallel group comparative study with 3 groups: NHF with room air only and no supplemental oxygen, no respiratory support, and face mask oxygen administration. The study protocol will begin at the time that the patient is returned to the general ward and will finish 3 hours later. The primary endpoint is the time-weighted average of transcutaneous O2 over the 180 minutes
and secondary endpoints are the time-weighted average of transcutaneous CO2 (tcpCO2), SpO2, and respiratory rate,
incidence rate of marked hypercapnia (tcpCO2 ≥60 mm Hg for 5 minutes or longer), incidence rate of moderate hypercapnia
(tcpCO2 ≥50 mm Hg for 5 minutes or longer) and the percentage of time that SpO2 is <90%. Included also is a group in which the postoperative management is performed only by spontaneous breathing without performing respiratory support such as oxygen administration, to investigate the efficacy and necessity of conventional oxygen administration. This exploratory study will investigate the use of NHF without supplemental oxygen as an effective respiratory support during the acute postoperative period. TRIAL REGISTRATION::
The study was registered the jRCTs072200018. URL https://jrct.niph.go.jp/latest-detail/jRCTs072200018
Efficacy of nasal high flow therapy on the coordination between breathing and swallowing of saliva during daytime nap in chronic obstructive pulmonary disease patients
Full text linkBACKGROUND: There are some clinical reports on dysphagia in patients with chronic obstructive pulmonary disease(COPD);however, its pathophysiology remains largely unknown.Changes in respiratory function occur in patients with COPD causing a decrease in tidal volume and an increase in respiratory rate (tachypnea). In addition, it leads to lack of coordination between respiration and swallowing.A new treatment called nasal high flow (NHF) has been introduced for patients with COPD, replacing the traditional non-invasive ventilation (NIV) procedure. The NHF therapy involves
inhalation of high flow of humidified air, which reduces respiratory effort in patients with COPD. Furthermore,NHF therapy facilitates swallowing of saliva even during respiratory management. A recent clinical study reported that high-flow nasal cannula oxygen therapy for 6 weeks improved the health-related quality of life and reduced
hypercapnia in patients with stable COPD. Taken together, NHF therapy is gaining attention in the clinical management
of patients with COPD.Therefore, in this study, we aim to examine the efficacy of NHF therapy on the coordination between breathing and swallowing of saliva during daytime nap in patients with COPD. METHODS/DESIGN: This open-label,investigator-initiated, single center study will evaluate the efficacy of NHF therapy on the coordination between breathing and swallowing of saliva during the daytime nap in COPD patients with forced expiratory volume in 1 second (FEV1%) of <70% during treatment at the Nagasaki University Hospital Respiratory Rehabilitation Center.
Evaluations will be performed during the 90 to 180 minute "daytime nap" in the measurement room of the hospital.The primary endpoint will be the rate of appearance of the expiratory phase after swallowing of saliva and the frequency of swallowing during the measurement period. DISCUSSION: The purpose of this study is to obtain evidence regarding the utility of NHF as a potential therapeutic device for COPD patients to prevent aspiration of saliva
during the sleep stage of daytime nap. The utility will be assessed by comparing the decrease in incidence rates of the expiratory phase after swallowing of saliva in the NHF device group and the control group, wherein this device was not used
Effect of tank shape on survival and growth of Pacific bluefin tuna Thunnus orientalis larvae
No full textWe examined the effect of rearing tank shape on survival and growth of Pacific bluefin tuna Thunnus orientalis larvae. Cylindrical (1.7 × 103 cm2 water surface area; 30 cm deep) and rectangular (1.8 × 103 cm2 water surface area; 28 cm deep) tanks (n = 3 each) were filled with 50 l of seawater. One air stone with a 100 ml/min aeration rate was set at the bottom center of each tank. Light intensity at the water surface was 2000 lx with a photoperiod of 24 L:0D. Larvae were introduced into each tank at a rate of 10 individuals/l at 2 days post-hatching (dph). Rotifers were fed at 10 individuals/ml and their distribution in tanks was measured. Survival of larvae in cylindrical tanks (CT; 52.7 ± 5.1%) at 8 dph was higher than that in rectangular tanks (RT; 0.8 ± 0.7%, p < .01). Meanwhile, larvae growth was not significantly different between tank shapes either in body length (CT: 4.23 ± 0.26 mm; RT: 4.09 ± 0.20 mm) or dry weights (CT: 95.1 ± 17.6 μg; RT: 67.7 ± 10.9 μg). The swimbladder inflation rate of larvae also did not differ significantly between tank shapes (CT: 16.5 ± 14.5%; RT: 56.9 ± 3.47%). Rotifer distribution was higher at tank bottom in both shapes (p < .05). Two-phase bubbly flow simulations in the tanks revealed that the low-flow area was larger in the RT. The low-flow area at tank bottom varied by tank shape, occurring at the edge of the tank wall on the bottom in the CT, and from the center of the tank (air stone) to the tank wall in the RT. These low-flow areas at tank bottom coincided with areas of higher rotifer distribution, which may be a cause of sinking syndrome in fish larvae. Our results indicate that small-scale (50-l) PBT larviculture experiments can be conducted using a CT with the present aeration system, and that an RT requires an improved aerator in place of the single air stone
Circulating CD34+ cells and active arterial wall thickening among elderly men: A prospective study
Full text linkAge-related physical changes, such as low-grade inflammation and increased oxidative stress, induce endothelial repair and cause active arterial wall thickening by stimulating the production of CD34+ cells (the principal mediators of atherosclerosis). Despite this, aggressive endothelial repair (progressing atherosclerosis) might cause a wasting reduction in CD34+ cells, which could result in a lower capacity of endothelial repair and hypertension. As yet, no prospective study has clarified the association of circulating CD34+ cells with active arterial wall thickening. We conducted a prospective study of 363 men aged 60–69 years who participated in a general health check-up at least twice from 2014–2017. The circulating CD34+ cell count was significantly positively associated with active arterial wall thickening among subjects without hypertension (n = 236), but not among subjects with hypertension (n = 127). The fully adjusted odds ratios (ORs) of active arterial wall thickening for the logarithmic circulating CD34+ cell count were 1.83 (1.19, 2.84) and 0.69 (0.36, 1.32) for subjects without and with hypertension, respectively. Circulating CD34+ cells are positively associated with active arterial wall thickening in subjects without hypertension. This study demonstrates a means to clarify the mechanisms of endothelial repair in elderly subjects
Stereoselective synthesis of (+)-5-thiosucrose and (+)-5-thioisosucrose
Full text link+)-5-Thiosucrose 1, a novel isosteric sulfur analog of sucrose, was synthesized stereoselectively for the first time via indirect β-d-fructofuranosidation involving selective β-d-psicofuranosidation, followed by stereo-inversion of the secondary hydroxy group at the C-3 position on the furanose ring. Glycosidation of protected 5-Thio-d-glucose with a d-psicofuranosyl donor provided β-d-psicofuranosyl 5-Thio-α-d-glucopyranoside and that with d-fructofuranosyl donor gave α-d-fructofuranosyl 5-Thio-α-d-glucopyranoside. Two anomeric stereocenters of the glycosyl donor and acceptor were controlled correctly to provide a single disaccharide among four possible anomeric isomers in the glycosylation. Conversion of the resulting disaccharides afforded (+)-5-Thiosucrose 1 and (+)-5-Thioisosucrose 2 in excellent yields, respectively. Inhibitory activities of 1 and 2 against α-glucosidase in vitro were also examined
Ceramics in Guadalajara, Mexico
Full text linkWe will introduce some collection of ceramics in Guadalajara and a ceramic workshop in Tonalá near Guadalajara. Tokugawa shogunate banned Christianity and completed sakoku system that was a kind of sea ban system in Japan in 1639. As a result, the exchange between Japan and the Catholic countries, such as Spain and Portugal, officially discontinued. However we can find some evidence of material exchange between Japan and New Spain. For example, many pieces of Japanese porcelains were exported from Nagasaki to New Spain in the second half of 17th century and the first half of 18th century. One pair of jar colored with enamel in the cathedral church in Guadalajara is one of the evidences. They were jars that were produced in the first half of 18th century in Arita, Japan. Under the sakoku system, they were imported from Nagasaki to Mexico. Chinese porcelain and Japanese porcelain had crossed the Pacific Ocean. On the other hand ceramic production technology came from Europe to New Spain. Tonala ware near Guadalajara is ceramic made by introducing European technology
軟質リライン材およびティッシュコンディショナーの粘弾性性質、硬さおよびガラス転移温度の評価
No full textSoft denture liners and tissue conditioners are widely used for the denture patients to cushion masticatory force and condition abused tissues, respectively. This study assessed methods for the evaluation of the viscoelasticity and glass transition temperature (Tg) of the silicone permanent soft liner, acrylic permanent soft liner, and tissue conditioner. Three rheological parameters of storage modulus (E′), loss modulus (E′′), and loss tangent (tanδ), Tg, and hardness were determined using dynamic mechanical analysis (DMA), differential scanning calorimetry (DSC), and the Shore A0 hardness test. Five specimens were measured for each material. The time–temperature superposition principle was applied to produce master curves of E′, E′′, and tanδ for the tested materials at a reference temperature of 37 °C. The acrylic permanent soft liner and tissue conditioner exhibited viscoelastic behavior and sensitivity to frequency, especially at lower frequencies. The silicone permanent soft liner showed elastic behavior and was frequency-independent. Tg for the acrylic permanent soft liner was higher than that for the tissue conditioner, which in turn was higher than that for the silicone permanent soft liner for both DMA and DSC. In DMA, a higher frequency led to higher Tg values. A positive linear relationship was found between Shore A0 hardness and E′ values, but not E′′ and tanδ values. Shore hardness reflects elasticity, but not viscosity. The results of the present study can be used to improve methods for evaluating the viscoelasticity and Tg of soft denture liners and tissue conditioners.長崎大学学位論文 学位記番号:博(医歯薬)甲第1211号 学位授与年月日:令和2年3月4
Efficient Synthetic Reactions Utilizing Hybrid Catalysts Composed of Hydrolases and Inorganic Nanosheets
No full text長崎大学学位論文 学位記番号:博(工)甲第83号 学位授与年月日:令和2年3月19