握力は、糖尿病患者の心血管イベントの独立した予測因子である

Diabetes mellitus (DM) is associated with an increased incidence of cardiovascular events and an elevated prevalence of sarcopenia. However, the relationship between cardiovascular events and sarcopenia in patients with DM remains unclear. This study examined this relationship and investigated the predictors of cardiovascular events in this population.This study enrolled 161 patients with DM and no history of cardiovascular diseases who were admitted to our hospital for the treatment of DM between September 2012 and December 2015. Patients were divided into sarcopenia and non-sarcopenia groups, and were followed until March 2019. The primary endpoint was major adverse cardiovascular events (MACE).The mean age was 65.9 ± 1.8 years old and the mean follow-up period was 4.1 ± 0.8 years. The log-rank test indicated that MACE differed significantly between the two groups (P < 0.0001). Multivariate Cox hazard analysis identified the cardio-ankle vascular index (CAVI) and handgrip strength as independent predictors of MACE (hazard ratio [HR] = 1.18, P = 0.039; and HR = 0.70, P = 0.016, respectively).Handgrip strength is an indicator of sarcopenia in diabetic patients, and together with CAVI it was independently associated with the incidence of MACE. This suggests that the handgrip strength test might be useful in the management of patients with DM at high risk of cardiovascular outcomes.博士（医学）・乙第1493号・令和3年3月15日© 2021 by the International Heart Journal Association発行元であるインターナショナル・ハート・ジャーナル刊行会の許諾を得て登録（2021年6月23日付）ジャーナル公式サイト（J-STAGE内）：https://doi.org/10.1536/ihj.20-67

骨髄間葉系細胞シートはラット脊髄離断損傷後にグリア瘢痕形成を抑制し、軸索再生と後肢運動機能改善を促進する。

OBJECTIVE Transplantation of bone marrow stromal cells (BMSCs) is a theoretical potential as a therapeutic strategy in the treatment of spinal cord injury (SCI). Although a scaffold is sometimes used for retaining transplanted cells in damaged tissue, it is also known to induce redundant immunoreactions during the degradation processes. In this study, the authors prepared cell sheets made of BMSCs, which are transplantable without a scaffold, and investigated their effects on axonal regeneration, glial scar formation, and functional recovery in a completely transected SCI model in rats. METHODS BMSC sheets were prepared from the bone marrow of female Fischer 344 rats using ascorbic acid and were cryopreserved until the day of transplantation. A gelatin sponge (GS), as a control, or BMSC sheet was transplanted into a 2-mm-sized defect of the spinal cord at the T-8 level. Axonal regeneration and glial scar formation were assessed 2 and 8 weeks after transplantation by immunohistochemical analyses using anti-Tuj1 and glial fibrillary acidic protein (GFAP) antibodies, respectively. Locomotor function was evaluated using the Basso, Beattie, and Bresnahan scale. RESULTS The BMSC sheets promoted axonal regeneration at 2 weeks after transplantation, but there was no significant difference in the number of Tuj1-positive axons between the sheet- and GS-transplanted groups. At 8 weeks after transplantation, Tuj1-positive axons elongated across the sheet, and their numbers were significantly greater in the sheet group than in the GS group. The areas of GFAP-positive glial scars in the sheet group were significantly reduced compared with those of the GS group at both time points. Finally, hindlimb locomotor function was ameliorated in the sheet group at 4 and 8 weeks after transplantation. CONCLUSIONS The results of the present study indicate that an ascorbic acid-induced BMSC sheet is effective in the treatment of SCI and enables autologous transplantation without requiring a scaffold.博士（医学）・甲第656号・平成28年11月24日© Copyright 2016 American Association of Neurological SurgeonsThe definitive version is available at " http://dx.doi.org/10.3171/2016.8.SPINE16250

高齢の非代償性心不全患者において、非心血管疾患、特に感染症は重要な死因である

BACKGROUND:Despite marked improvements in treatment strategies for heart failure (HF), the mortality rate of elderly patients with HF is still high. Detailed causes of death have not been fully understood.METHODS AND RESULTS:We studied 459 consecutive patients with acute decompensated HF (ADHF) emergently admitted to our hospital from 2007 to 2011. Patients were divided into 2 groups: <75 years old (younger group; n = 225) and ≥75 years old (elderly group; n = 234). All-cause death, cardiovascular death, and noncardiovascular death were assessed as adverse outcomes. Compared with the younger group, the elderly group was characterized by a higher proportion of women and hypertensive patients and higher left ventricular ejection fraction. During a mean follow-up of 20.7 months, a total of 174 patients (37.9%) died. All-cause death was significantly higher in the elderly group than in the younger group (46.6% vs 28.9%; P < .0001), and this difference was caused by an increase in noncardiovascular deaths (20.9% vs 9.3%; P < .001), especially deaths due to infection (10.7% vs 4.0%; P < .01). Cardiovascular deaths did not differ between the 2 groups.CONCLUSIONS:Noncardiovascular deaths, most of which were caused by infection, were frequent among elderly patients with ADHF.博士（医学）・甲第629号・平成27年3月16日Copyright © 2014 Elsevier Inc. All rights reserved

ヤマダ デンキ ト ヨドバシカメラ ノ センリャク ヒカク : カデン リョウハンテン ノ サバイバル センリャク

現在、家電量販業界では、熾烈な戦いが繰り広げられている。本稿ではその中でマーケットリーダーのヤマダ電機と人材教育に定評があるヨドバシカメラを採りあげる。ヤマダ電機とヨドバシカメラの戦略はマイケル・E・ポーターの3 つの基本戦略に照らし合せると、現在のところ、それぞれコストリーダーシップ戦略、差別化戦略を採って成功している。本論文では、両社のそれぞれの戦略について詳述し、さらに今後の激変する環境の中で両社が採っている戦略をどのような変化させていくのかを検討する。Recently there is a cutthroat battle among electronic stores in Japan. In this paper, we will look at two companies. One is Yamada Denki, the market leader in the industry, and the other is Yodobashi Camera, the leader in terms of Human Resources Management(HRM). We argue that Yamada Denki\u27s success is due to their implementation of the Cost Leadership Strategy as stated in Michael E. Porter\u27s three generic strategies while on the other hand, Yodobashi Camera has achieved positive results using Porter\u27s Differentiation Strategy. In this paper, We discuss each of the two strategies as utilized by Yamada and Yodobashi

胎盤増殖因子の可溶性Fms様チロシンキナーゼ-1に対する血中濃度比の上昇は安定冠動脈疾患患者における有害事象発症の予測因子である

OBJECTIVE: To investigate the predictive values of placental growth factor (PlGF) and its endogenous antagonist, soluble fms-like tyrosine kinase-1 (sFlt-1), for the long-term prognosis of patients with stable coronary artery disease (CAD). Both PlGF and sFlt-1 play important roles in the pathological mechanisms of atherosclerosis. We recently demonstrated that the plasma levels of these molecules are correlated with the severity of coronary atherosclerosis. METHODS: We enrolled 464 patients with stable CAD who consecutively underwent coronary angiography. Baseline blood samples were collected from the femoral artery immediately before coronary angiography (after the administration of 20 units of heparin), and the plasma levels of PlGF and sFlt-1 were measured. A Cox proportional hazard regression analysis was performed to evaluate the relationship between these parameters and the occurrence of all-cause death (ACD) and total cardiovascular events (TCVE) during a median follow-up of 3.3 years. RESULTS: A total of 31 ACDs and 51 TCVEs occurred. Patients with higher PlGF/sFlt-1 ratios (>4.22×10(-2)) had a significantly higher risk of both ACD and TCVE than patients with lower ratios (<4.22×10(-2)) (hazard ratio [HR]: 3.32, 95% confidence interval [CI]: 1.43 to 7.72, p=0.005, and HR: 2.23, 95% CI: 1.23 to 4.03, p=0.008, respectively). A multivariate analysis showed the PlGF/sFlt-1 ratio to be an independent predictor for ACD, but not TCVE.博士（医学）・甲615号・平成26年3月17日発行元の規定により、本文の登録不可。本文は以下のURLを参照 "http://dx.doi.org/10.2169/internalmedicine.52.9073

Postoperative Urinary Retention in Japanese Elderly Males with a Femoral Neck or Trochanteric Fracture

We assessed risk factors for postoperative urinary retention (UR) in elderly males with femoral bone fractures: 169 Japanese males (mean age 81.95 ± 1.19 years) who had undergone hip surgery at a municipal hospital (Toyama, Japan). A multiple logistic regression analysis was used to test possible risk factors for UR: age, body mass index, serum albumin, cognitive impairment, activities of daily living (ADL), and history of diabetes mellitus (DM). UR occurred in 24 (14.2%) of the 169 patients. A multivariate logistic regression analysis with age adjustment showed that ADL (odds ratio [OR] 3.88; 95% confidence interval [CI]: 1.2-12.5, p=0.023) was significantly associated with the development of UR, and a history of DM showed marginal significance for UR occurrence (OR 0.36, 95%CI: 0.11-10, p=0.064). These results suggests that ADL is a risk factor for UR development in elderly males who have undergone surgery for femoral neck or trochanter fractures