キュウセイ コキュウ アッパク ショウコウグン ニタイスル サイシン ノ コキュウ カンリ

The mortality rate of acute respiratory distress syndrome (ARDS) has been still high.　A many kinds of strategies for ARDS are being tried in the world. The important factors which influence for pathological-physiology of ARDS during the mechanical ventilation are gravity consolidation, atelectasis, and ventilator induced lung injury (VILI). VILI is caused by shear stress that is induced by the repeated collapse and recruit of alveolus. Alveolar over-distention caused by large tidal volume also induces VILI. To prevent the VILI, the open lung strategy (The lung protective strategies for ARDS) is recommended. The high positive end expiratory pressure (PEEP) that prevents the shear stress and a small tidal volume are necessary for ARDS treatment.　The concept of the open lung strategy is re-open of alveolus and keeping the recruited alveolus. Recruitment maneuver, preventive therapy by PEEP, and prone positioning are lately proposed in the world. Recruitment maneuver is likely to inspire the gas at the level of vital capacity. Preventive PEEP is useful for the secondary lung injury of sepsis, burn and trauma. Prone position in Intensive Care Unit that is recognized to increase the oxygenation for lung injury patients may improve the mortality of severe ARDS patients.　Key words ： Acute Respiratory Distress Syndrome, acute lung injury, recruitment maneuver, pressure volume curve, prone positio

The influence of size, specific gravity, and head position on the swallowing of solid preparations

AbstractAimTo clarify the influence of size and specific gravity of solid preparations, and the position of healthy volunteers when swallowing, for the purpose of practical use in patient consultation regarding the taking of medicines.Materials and methodsThe paper reports three studies. Volunteers were asked to swallow four different capsules (A, large and heavy; B, large and light; C, small and heavy; D, small and light) in Study 1, two preparations with different positions (upright, horizontal, and chin-down) in Study 2, and two preparations before and after anesthetization of the bilateral lingual and inferior alveolar nerve in Study 3. The oral transit time (OTT) and pharyngeal transit time (PTT) were evaluated with videofluoroscopy.ResultsThe mean OTT became longer in the order of C, D, B, A. The mean PTT showed no statistically significant differences. The swallowing preference of the four preparations ranked by the subjects showed that difference in size but not the difference in specific gravity is a significant factor. In the chin-down position, OTT was shorter for two preparations, compared with the other two positions. The mean OTT for both the A and B preparations was significantly longer after the bilateral lingual and inferior alveolar nerves were anesthetized.ConclusionWhen swallowing solid preparations, a consideration of size and the position will enable ease of swallowing of medicines. This would especially be the case when delivery of the medicines to be taken by the aged suffering from oral hypoesthesia caused by an underlying disease

Out-of-hospital endotracheal intubation experience, confidence and confidence-associated factors among Northern Japanese emergency life-saving technicians: a population-based cross-sectional study

OBJECTIVE: Clinical procedural experience and confidence are both important when performing complex medical procedures. Since out-of-hospital endotracheal intubation (ETI) is a complex intervention, we sought to clarify clinical ETI experience among prehospital rescuers as well as their confidence in performing ETI and confidence-associated factors. DESIGN: Population-based cross-sectional study conducted from January to September 2017. SETTING: Northern Japan, including eight prefectures. PARTICIPANTS: Emergency life-saving technicians (ELSTs) authorised to perform ETI. OUTCOME MEASURES: Annual ETI exposure and confidence in performing ETI, according to a five-point Likert scale. To determine factors associated with ETI confidence, differences between confident ELSTs (those scoring 4 or 5 on the Likert scale) and non-confident ELSTs were evaluated. RESULTS: Questionnaires were sent to 149 fire departments (FDs); 140 agreed to participate. Among the 2821 ELSTs working at responding FDs, 2620 returned the questionnaire (response rate, 92.9%); complete data sets were available for 2567 ELSTs (complete response rate, 91.0%). Of those 2567 respondents, 95.7% performed two or fewer ETI annually; 46.6% reported lack of confidence in performing ETI. Multivariable logistic regression analysis showed that years of clinical experience (adjusted OR (AOR) 1.09; 95% CI 1.05 to 1.13), annual ETI exposure (AOR 1.79; 95% CI 1.59 to 2.03) and the availability of ETI skill retention programmes including regular simulation training (AOR 1.31; 95% CI 1.02 to 1.68) and operating room training (AOR 1.44; 95% CI 1.14 to 1.83) were independently associated with confidence in performing ETI. CONCLUSIONS: ETI is an uncommon event for most ELSTs, and nearly half of respondents did not have confidence in performing this procedure. Since confidence in ETI was independently associated with availability of regular simulation and operating room training, standardisation of ETI re-education that incorporates such methods may be useful for prehospital rescuers

Genotoxic Stress Abrogates Renewal of Melanocyte Stem Cells by Triggering Their Differentiation

SummarySomatic stem cell depletion due to the accumulation of DNA damage has been implicated in the appearance of aging-related phenotypes. Hair graying, a typical sign of aging in mammals, is caused by the incomplete maintenance of melanocyte stem cells (MSCs) with age. Here, we report that irreparable DNA damage, as caused by ionizing radiation, abrogates renewal of MSCs in mice. Surprisingly, the DNA-damage response triggers MSC differentiation into mature melanocytes in the niche, rather than inducing their apoptosis or senescence. The resulting MSC depletion leads to irreversible hair graying. Furthermore, deficiency of Ataxia-telangiectasia mutated (ATM), a central transducer kinase of the DNA-damage response, sensitizes MSCs to ectopic differentiation, demonstrating that the kinase protects MSCs from their premature differentiation by functioning as a “stemness checkpoint” to maintain the stem cell quality and quantity

Genotoxic stress abrogates renewal of melanocyte stem cells by triggering their differentiation.

金沢大学医薬保健研究域　医学系Somatic stem cell depletion due to the accumulation of DNA damage has been implicated in the appearance of aging-related phenotypes. Hair graying, a typical sign of aging in mammals, is caused by the incomplete maintenance of melanocyte stem cells (MSCs) with age. Here, we report that irreparable DNA damage, as caused by ionizing radiation, abrogates renewal of MSCs in mice. Surprisingly, the DNA-damage response triggers MSC differentiation into mature melanocytes in the niche, rather than inducing their apoptosis or senescence. The resulting MSC depletion leads to irreversible hair graying. Furthermore, deficiency of Ataxia-telangiectasia mutated (ATM), a central transducer kinase of the DNA-damage response, sensitizes MSCs to ectopic differentiation, demonstrating that the kinase protects MSCs from their premature differentiation by functioning as a "stemness checkpoint" to maintain the stem cell quality and quantity. © 2009 Elsevier Inc. All rights reserved

『日本語日常会話コーパス』モニター版の設計・評価・予備的分析

国立国語研究所 音声言語研究領域国立国語研究所 音声言語研究領域 非常勤研究員国立国語研究所 音声言語研究領域 非常勤研究員国立国語研究所 音声言語研究領域 非常勤研究員国立国語研究所 音声言語研究領域国立国語研究所 音声言語研究領域 非常勤研究員国立国語研究所 音声言語研究領域 非常勤研究員千葉大学国立国語研究所 コーパス開発センター 非常勤研究員Spoken Language Division, Research Department, NINJALAdjunct Researcher, Spoken Language Division, Research Department, NINJALAdjunct Researcher, Spoken Language Division, Research Department, NINJALAdjunct Researcher, Spoken Language Division, Research Department, NINJALSpoken Language Division, Research Department, NINJALAdjunct Researcher, Spoken Language Division, Research Department, NINJALAdjunct Researcher, Spoken Language Division, Research Department, NINJALChiba UniversityAdjunct Researcher, Center for Corpus Development, NINJAL国立国語研究所共同研究プロジェクト「大規模日常会話コーパスに基づく話し言葉の多角的研究」では，『日本語日常会話コーパス』（CEJC）の構築を進めている。CEJCは，日常会話の多様性を捉え自然な会話行動が観察できるよう，様々な種類の会話をバランスよく収めることを目標に掲げている。2021年度末に予定している本公開に先立ち，コーパスの利用可能性や問題などを把握するために，目標とする200時間のうち50時間の会話データについて，2018年12月にモニター公開を開始した。本稿ではまず，コーパスの設計について，会話の収録法，データの公開方針，調査協力者の内訳，コーパスの規模や構成などの観点から概観する。次に，収録されているデータが設計通りバランスがとれているかを，話者と会話の両面から検証する。最後に，コーパスを用いた予備的分析を通して，CEJCモニター版を活用した研究の可能性を示す。We have been constructing the Corpus of Everyday Japanese Conversation (CEJC) under the NINJAL collaborative research project since 2016. The CEJC is designed to contain various kinds of everyday conversations in a balanced manner to capture the diversity of everyday conversations and to observe natural conversational behavior. Prior to the publication of the whole corpus, which scheduled for 2022, we published the monitor version of the CEJC in December 2018. In this paper, we first outlined the design of the monitor version of the CEJC, including recording methods, the release policy of the corpus, corpus size, and annotations. Then, we examined whether the speakers and the conversations in the corpus vary in a balanced manner. Finally, we conducted a preliminary analysis on some linguistic aspects of the monitor version of the CEJC, revealing the possible implications of the corpus

Sonodynamic Therapy With Anticancer Micelles and High-Intensity Focused Ultrasound in Treatment of Canine Cancer

Sonodynamic therapy (SDT) is a minimally invasive anticancer therapy involving a chemical sonosensitizer and high-intensity focused ultrasound (HIFU). SDT enables the reduction of drug dose and HIFU irradiation power compared to those of conventional monotherapies. In our previous study, mouse models of colon and pancreatic cancer were used to confirm the effectiveness of SDT vs. drug-only or HIFU-only therapy. To validate its usefulness, we performed a clinical trial of SDT using an anticancer micelle (NC-6300) and our HIFU system in four pet dogs with spontaneous tumors, including chondrosarcoma, osteosarcoma, hepatocellular cancer, and prostate cancer. The fact that no adverse events were observed, suggests the usefulness of SDT