Right ventricular abnormalities assessed by myocardial single-photon emission computed tomography using technetium-99m sestamibi/tetrofosmin in right ventricle-originated ventricular tachyarrhythmias

AbstractOBJECTIVESWe sought to determine whether right ventricular (RV) perfusion imaging with technetium-99m (Tc-99m) sestamibi or tetrofosmin single-photon emission computed tomography has diagnostic benefit for RV-originated ventricular tachyarrhythmias (RVT).BACKGROUNDIdentification of RV abnormalities is clinically important to establish RVT etiology.METHODSForty-seven patients with RVT (23 with idiopathic and 24 with organic RVT due to arrhythmogenic RV or dilated cardiomyopathy, cardiac sarcoidosis or myocarditis) were compared to 25 control subjects. Right ventricular uptake score, as assessed by modified tomographic imaging, and regional RV count relative to peak left ventricular (LV) count (RV/LV count ratio) were compared with RV regional and global function.RESULTSRegional RV uptake score correlated well with the RV/LV count ratio, and segmental abnormality was more frequently (p = 0.001) detected in the organic RVT group (22 [92%] of 24 patients) than in the idiopathic RVT group (4 [17%] of 23 patients) or the control group (8 [32%] of 25 patients). The total RV score (8.4 ± 3.8) in the organic RVT group was significantly lower than that in the idiopathic RVT group (15.6 ± 1.6) or the control group (15.1 ± 1.8). The total RV score correlated with RV EF (r = 0.702, p < 0.001). A total RV score <12 differentiated the organic RVT group from the other two groups, with a sensitivity of 79% and a specificity of 100%. The asynergic RV regions had a significantly lower RV/LV count ratio and RV score as compared with the nonasynergic regions and were identified by RV assessment, with a sensitivity of 76.1% and a specificity of 76.6%.CONCLUSIONSRight ventricular perfusion tomography using a Tc-99m–labeled tracer is clinically useful for the noninvasive detection of RV myocardial damage in patients with RVT and for differentiating organic from idiopathic RVT

アタラシイ エイゾウ キョウザイ ノ カイハツ オ メザシテ : ガクシュウシャ ノ センモン ニ ハイリョ シタ ジュギョウ ノ ココロミ

医学・歯学・薬学系の学部および大学院に所属している日本語学習者を対象にしたクラスで，留学生が専門分野の日本語によりアクセスしやすくなる効果を期待して，医・科学系の映像素材を使った教材を作成し，授業実践を試みた。実施後の調査では，映像を使用した授業に対する興味・関心は高かったものの，内容は必ずしも医・科学系の映像でなくてもよいという反応も見られた。教師の振り返りでは，教材の選定と作成とに多くの手間と時間がかかることがわかった。今後はこの結果を踏まえ，より学生のニーズに合った，日本語の運用能力を伸ばす教材の開発が必要であろう

Nucleophilic allylation of N,O-acetals with allylic alcohols promoted by Pd/Et3B and Pd/Et2Zn systems

Pd/Et3B and Pd/Et2Zn systems promote the nucleophilic allylations of 2-aminotetrahydrofuran and 2-aminotetrahydropyran with allylic alcohols to provide ω-hydroxyhomoallylamines in high yields. The transformation is applicable to the allylation of non-protective carbohydrates, such as ribose and deoxyribose

Application of a First Impression Triage in the Japan Railway West Disaster

On April 25, 2005, a Japanese express train derailed into a building, resulting in 107 deaths and 549 injuries. We used “First Impression Triage (FIT)”, our new triage strategy based on general inspection and palpation without counting pulse/respiratory rates, and determined the feasibility of FIT in the chaotic situation of treating a large number of injured people in a brief time period. The subjects included 39 patients who required hospitalization among 113 victims transferred to our hospital. After initial assessment with FIT by an emergency physician, patients were retrospectively reassessed with the preexisting the modified Simple Triage and Rapid Treatment (START) methodology, based on Injury Severity Score, probability of survival, and ICU stay. FIT resulted in shorter waiting time for triage. FIT designations comprised 11 red (immediate), 28 yellow (delayed), while START assigned six to red and 32 to yellow. There were no statistical differences between FIT and START in the accuracy rate calculated by means of probability of survival and ICU stay. Overall validity and reliability of FIT determined by outcome assessment were similar to those of START. FIT would be a simple and accurate technique to quickly triage a large number of patients