小腸カプセル内視鏡による肝硬変患者における門脈圧亢進症性小腸症増悪予測因子の検討 1)肝硬変患者における小腸絨毛浮腫の臨床的意義 2)食道静脈瘤硬化療法後に門脈圧亢進症性小腸症は増悪する

内容の要旨, 審査の要旨広島大学(Hiroshima University)博士(医学)Doctor of Philosophy in Medical Sciencedoctora

Accuracy of Length of Virtual Stents in Treatment of Intracranial Wide-Necked Aneurysms.

Background and purposePrecise stent deployment is important for successful treatment of intracranial aneurysms by stent-assisted coiling (SAC). We evaluated the accuracy of virtual stents generated using commercial stent planning software by comparing the length of virtual and actually deployed intracranial laser cut stents on three-dimensional digital subtraction angiography (3D-DSA) images.MethodsWe retrospectively analyzed the data of 75 consecutive cases of intracranial wide-necked aneurysms treated with the SAC technique using laser cut stents. Based on 3D-DSA images acquired by C-arm CT, stent sizing and placement were intraoperatively simulated by a commercial software application. The difference in length of the stents was estimated by measuring proximal discrepancies between the end points of the virtual and actually deployed stents on fused pre-procedural and post-procedural 3D-DSA images. Discrepancies between distal stent end points were manually minimized. The Kruskal-Wallis test was applied to test whether stent location, type, and length had an effect on difference in length between virtual and real stent.ResultsThe median difference in length between virtual and real stents was 1.58 mm with interquartile range 1.12-2.12 mm. There was no evidence for an effect of stent location (p = 0.23), stent type (p = 0.33), or stent length (p = 0.53) on difference in length between virtual and real stents.ConclusionsStent planning software allows 3D simulation of laser cut stents overlain on 3D-DSA images of vessels and may thus be useful for stent selection and deployment of laser cut stents during stent-assisted coiling of intracranial aneurysms

Combination of high-resolution cone beam computed tomography and metal artefact reduction software: a new image fusion technique for evaluating intracranial stent apposition after aneurysm treatment.

We introduce a new imaging technique to improve visualisation of stent apposition after endovascular treatment of brain aneurysms employing high-resolution cone beam CT and three-dimensional digital subtraction angiography. After performing a stent-assisted coil embolisation of brain aneurysm, the image datasets were processed with a metal artefact reduction software followed by the automated image fusion programmes. Two patients who underwent aneurysm coiling using a Neuroform stent were evaluated. The reconstructed 3D images showed a detailed structure of the stent struts and identified malappositions of the deployed stents. Case 1 showed good apposition on the outer curvature side of the carotid siphon, while the inner curvature side showed prominent malapposition. Case 2, with multiple aneurysms, showed good apposition on both outer and inner curvature sides, although inward prolapse of the struts was observed. This new imaging technique may help evaluate stent apposition after the endovascular aneurysm treatment

Molecular Breeding of Sweetpotato Carotenoids

Sweetpotato [sweet potato; Ipomoea batatas (L.) Lam.] is the seventh most valued food crop of the world. It has an inherent ability to grow under diverse agro-ecological and microclimatic zones ranging from tropical and subtropical zones to temperate areas with its tuberous roots enriched with the secondary metabolites of immense nutritional value. Among these, carotenoids are the most conspicuous one for having their use in nutritional, pharmaceutical, food, feed, aquaculture, and cosmetic industries. In food industries, carotenoids are used as food additives being antioxidants with attractive colors. Despite the immense economic importance, sweetpotato has received lesser attention in terms of its breeding with improved varieties. The conventional method of breeding by crossing has not been much successful due to the complexity of genome sterility and cross-incompatibility. Hence, the modern molecular breeding approaches, e.g. genetic, genomic, and metabolic (pathway) engineering, have been applied to this crop by some of researchers in Japan, Korea, and China to generate various cultivars with improved quantities and qualities of carotenoids. This has also opened a new gate for molecular breeders to engineer new sweetpotato cultivars enriched with carotenoids under current global scenario of dramatically rising climatic changes where novel food resources are bitterly needed, especially under alarmingly growing world population, the majority of which suffers from malnutrition

Third-Generation Capsule Endoscopy Outperforms Second-Generation Based on the Detectability of Esophageal Varices

Background and Aim. The third-generation capsule endoscopy (SB3) was shown to have better image resolution than that of SB2. The aim of this study was to compare SB2 and SB3 regarding detectability of esophageal varices (EVs). Methods. Seventy-six consecutive liver cirrhosis patients (42 men; mean age: 67 years) received SB3, and 99 (58 men; mean age, 67 years old) received SB2. All patients underwent esophagogastroduodenoscopy within 1 month prior to capsule endoscopy as gold standard for diagnosis. The diagnosis using SB3 and SB2 for EVs was evaluated regarding form (F0–F3), location (Ls, Lm, and Li), and the red color (RC) sign of EVs. Results. SB2 and SB3 did not significantly differ on overall diagnostic rates for EV. Sensitivity, specificity, positive predictive value, and negative predictive value of SB2/SB3 for EV diagnosis were, respectively, 65%/81%, 100%/100%, 100%/100%, and 70%/62%. However, the diagnostic rates for EV form F1 were 81% using SB3 and 52% using SB2 (P=0.009). Further, the diagnostic rates for Ls/Lm varices were 79% using SB3 and 81% using SB2, and, for Li, varices were 84% using SB3 and 52% using SB2 (P=0.02). Conclusion. SB3 significantly improved the detectability of EVs compared with SB2

Coronary angioscopic findings 9 months after everolimus-eluting stent implantation compared with sirolimus-eluting stents

AbstractObjectivesWe assessed angioscopic findings after everolimus-eluting stents (EES) implantation, compared with sirolimus-eluting stents (SES).BackgroundCoronary angioscopy (CAS) provides an opportunity to assess neointimal coverage over stent struts, thrombus, and plaque color by direct visualization. CAS is a useful tool for evaluating stent struts after drug-eluting stent implantation. Angioscopic findings after EES implantation have not been reported before.MethodsWe performed CAS in 23 patients who were treated with EES and 41 patients with SES. CAS was performed 8.5 months after stent implantation. We assessed neointimal coverage, thrombus, and plaque color. We classified neointimal coverage in 4 grades: grade 0=struts were completely exposed; grade 1=struts were visible with dull light reflexion; grade 2=there was no light reflexion from slightly visible struts; grade 3=struts were completely covered.ResultsThere was no significant difference in minimum, maximum, dominant grade of neointimal coverage, and heterogeneity index between EES and SES. Thrombus was less frequently observed in EES than SES (4% vs 29%, p=0.02). When we divided study patients into acute coronary syndrome (ACS) or stable angina pectoris (SAP), there was a tendency toward less thrombus in EES than SES, in both ACS and SAP. Maximum color grade of the plaques was less advanced in EES than SES (p<0.01). Yellow plaques of grade 2 or 3 were less frequent in EES than SES (35% vs 76%, p<0.01).ConclusionsThis study suggested that EES were associated with lower risk of thrombus formation than SES

Transport of carbon-bearing dusts from Iraq to Japan during Iraq\u27s War

Rainwater collected during the period of February-April, 2003 in Kanazawa University and Hakui, Ishikawa Prefecture, Japan, was investigated by ion chromatography of the dissolved ions, and Scanning electron microscopy equipped with energy dispersive analyzer (SEM-EDX), electron microprobe analyzer (EPMA), transmission electron microscopy, and X-ray powder diffraction (XRD) analyses of the filtered samples. The pH, Eh, EC, dissolved oxygen (DO) and depleted U (DU) of the rainwater were also measured. The results show a rare case with low pH value of rain and high value of electrical conductivity (EC) in the rainwater during certain period. The NO 3 -, SO 4 2- and NH 4 + concentrations on 26th March, show quite high values after oil field fires on 21st March 2003. The powdery dust and carbon-bearing nm sized particles contained in the rainwater have characteristics different from that of the Asian dust (Kosa). Since 21 March, 2003 the Iraq plunged into the war, the 9 oil field fires were reported on 25 March, 2003 in Rumaylah oil field near the borderline of Kuwait. The first precipitation was caught in Kanazawa on 24 March, 2003. The pH value of the rainwater indicated a strong acid rain (pH 3.6) with black powdery dusts. The acid rain on 27th March to 2nd April (pH 3.4-4.3; 5-17mm) associated with WNW wind (2.7-4.1m/s) has continued to the first 10 days of April in Kanazawa, during the 9 oil fields were burning in Iraq. The EC in rainwater collected from 24 March to 15 April, 2003, shows high concentrations of ions, suggesting high contents of water soluble-carbon particles and soot. In the meantime, it was the highest season of sandstorms at bare dried land in Iraq from the end of March to the beginning of April. Westerly wind blew around 5500m high, and the sandstorm with 2000m wide was transported by strong wind to Zagros 3000m high mountains. The hot wind hit the Zagros Mountains and easily to join and rise to Westerly wind high by a rising air current. The 234U/ 238U activity (around 0.2) in typical depleted uranium (DU) is quite low compared with that (around 1.0) in natural uranium. The contamination of DU from the Iraq conflict may be, if any, negligibly small on undetectable level. On the other hand, the powdery dusts and carbon-bearing particles of rainwater have been produced by combustion of oil field in Iraq and they are directly cycling in our planet by Westerly wind. Black carbon particles are a product of incomplete combustion, and are the principal light-absorbing atmospheric aerosol. The result reminds us of the scientific values of short-term atmospheric environment records during Iraq\u27s War. This has consequences for primary production of powdery dusts coming from Iraq to the atmosphere over half the globe away. © 2004 Elsevier Ltd. All rights reserved

韓国における移民関連施策および支援状況に関する実態調査報告(2)

韓国では近年,移民受入れが進み,それに伴って移民政策も急速に整備されてきている。本稿は2009年10-11月に科研費補助金により,日本語教育保障法研究会で実施した韓国における移民関連施策および移民支援の状況に関する現地実態調査の報告後編で,「韓国移住女性人権センター」(第2章),「緊急支援センター」(第3章),「安山市外国人住民センター」(第4章),「安山市多文化家族支援センター」(第5章),「安山市サハリン永住帰国者の家(コヒャンマウル)」(第6章),「平澤大学校多文化家族センター」(第7章),「チョ・ソンギョン氏」(第8章)に関する調査報告によって構成される。本編で2009年度調査の報告は完了し,次号では,2010年度調査について報告が行われる予定である

Multicenter, single-blind, randomized controlled study of the efficacy and safety of favipiravir and nafamostat mesilate in patients with COVID-19 pneumonia

Objectives: To evaluate the efficacy and safety of nafamostat combined with favipiravir for the treatment of COVID-19. Methods: We conducted a multicenter, randomized, single-blind, placebo-controlled, parallel assignment study in hospitalized patients with mild-to-moderate COVID-19 pneumonia. Patients were randomly assigned to receive favipiravir alone (n = 24) or nafamostat with favipiravir (n = 21). The outcomes included changes in the World Health Organization clinical progression scale score, time to improvement in body temperature, and improvement in oxygen saturation (SpO2). Results: There was no significant difference in the changes in the clinical progression scale between nafamostat with favipiravir and favipiravir alone groups (median, -0.444 vs -0.150, respectively; least-squares mean difference, -0.294; P = 0.364). The time to improvement in body temperature was significantly shorter in the combination group (5.0 days; 95% confidence interval, 4.0-7.0) than in the favipiravir group (9.0 days; 95% confidence interval, 7.0-18.0; P =0.009). The changes in SpO2 were greater in the combination group than in the favipiravir group (0.526% vs -1.304%, respectively; least-squares mean difference, 1.831; P = 0.022). No serious adverse events or deaths were reported, but phlebitis occurred in 57.1% of the patients in the combination group. Conclusion: Although our study showed no differences in clinical progression, earlier defervescence, and recovery of SpO2 were observed in the combination group