ケイ酸/亜鉛置換ストロンチウムアパタイトコーティングによるβ-リン酸カルシウムの骨誘導能促進効果

Background: β-Tricalcium phosphate (β-TCP) is a popular synthetic bone graft substitute with excellent osteoconductive properties and bioabsorbability. However, its osteoinductive properties are inferior to those of autologous or allogeneic bone. Trace elements such as strontium (Sr), silica (Si), and zinc (Zn) have been reported to promote osteogenesis in materials. In this study, we aimed to determine whether a Si/Zn-substituted Sr apatite coating of β-TCP could enhance osteoinductive properties. Methods: The apatite-coated β-TCP disks were prepared using nanoparticle suspensions of silicate-substituted Sr apatite (SrSiP) or silicate- and Zn-co-substituted Sr apatite (SrZnSiP). Bone marrow mesenchymal cells (BMSCs) from rat femur were cultured and subsequently seeded at a density of 1.0 × 106/cm2 onto apatite-coated and non-coated β-TCP disks. In vitro, the β-TCP disks were then placed in osteogenic medium, and lactate dehydrogenase (LDH) activity was measured from supernatants after culture for 2 days. Additionally, after culture for 14 days, the mRNA expression of genes encoding osteocalcin (OC), alkaline phosphatase (ALP), bone morphogenetic protein-2 (BMP-2), and vascular endothelial growth factor (VEGF) was evaluated by qRT-PCR. In vivo, the β-TCP disks were transplanted subcutaneously into rats that were sacrificed after 4 weeks. Then, the harvested disks were evaluated biochemically (ALP activity, OC content, mRNA expression of OC, ALP, BMP-2, and VEGF measured by qRT-PCR), radiologically, and histologically. Results: Significantly higher mRNA expression of almost all evaluated osteogenic and angiogenic genes was observed in the SrZnSiP and SrSiP groups than in the non-coated group, with no significant cytotoxicity elicited by the apatite coating in vitro. Moreover, in vivo, the SrZnSiP and SrSiP groups showed significantly higher osteogenic and angiogenic gene expression and higher ALP activity and OC content than the non-coated group (P < 0.05). Radiological and histopathological findings revealed abundant bone formation in the apatite-coated group. Conclusions: Our findings indicate that apatite coating of β-TCP improves osteoinductive properties without inducing significant cytotoxicity.博士（医学）・甲第805号・令和3年12月21日© 2021. The Author(s).Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data

骨欠損再建における培養細胞シートを併用した培養人工骨移植の有用性

AIM: To determine the effects of transplanting osteogenic matrix cell sheets and beta-tricalcium phosphate (TCP) constructs on bone formation in bone defects. METHODS: Osteogenic matrix cell sheets were prepared from bone marrow stromal cells (BMSCs), and a porous TCP ceramic was used as a scaffold. Three experimental groups were prepared, comprised of TCP scaffolds (1) seeded with BMSCs; (2) wrapped with osteogenic matrix cell sheets; or (3) both. Constructs were implanted into a femoral defect model in rats and bone growth was evaluated by radiography, histology, biochemistry, and mechanical testing after 8 wk. RESULTS: In bone defects, constructs implanted with cell sheets showed callus formation with segmental or continuous bone formation at 8 wk, in contrast to TCP seeded with BMSCs, which resulted in bone non-union. Wrapping TCP constructs with osteogenic matrix cell sheets increased their osteogenic potential and resulting bone formation, compared with conventional bone tissue engineering TCP scaffolds seeded with BMSCs. The compressive stiffness (mean ± SD) values were 225.0 ± 95.7, 30.0 ± 11.5, and 26.3 ± 10.6 MPa for BMSC/TCP/Sheet constructs with continuous bone formation, BMSC/TCP/Sheet constructs with segmental bone formation, and BMSC/TCP constructs, respectively. The compressive stiffness of BMSC/TCP/Sheet constructs with continuous bone formation was significantly higher than those with segmental bone formation and BMSC/TCP constructs. CONCLUSION: This technique is an improvement over current methods, such as TCP substitution, and is useful for hard tissue reconstruction and inducing earlier bone union in defects.博士（医学）・乙第1366号・平成27年11月27日Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved. This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license,which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/ licenses/by-nc/4.0

Surgery information reduces anxiety in the pre-operative period

PURPOSE: Patients preparing to undergo surgery should not suffer needless anxiety. This study aimed to evaluate anxiety levels on the day before surgery as related to the information known by the patient regarding the diagnosis, surgical procedure, or anesthesia. METHOD: Patients reported their knowledge of diagnosis, surgery, and anesthesia. The Spielberger State-Trait Anxiety Inventory (STAI) was used to measure patient anxiety levels. RESULTS: One hundred and forty-nine patients were selected, and 82 females and 38 males were interviewed. Twenty-nine patients were excluded due to illiteracy. The state-anxiety levels were alike for males and females (36.10 ± 11.94 vs. 37.61 ± 8.76) (mean ± SD). Trait-anxiety levels were higher for women (42.55 ± 10.39 vs. 38.08 ± 12.25, P = 0.041). Patient education level did not influence the state-anxiety level but was inversely related to the trait-anxiety level. Knowledge of the diagnosis was clear for 91.7% of patients, of the surgery for 75.0%, and of anesthesia for 37.5%. Unfamiliarity with the surgical procedure raised state-anxiety levels (P = 0.021). A lower state-anxiety level was found among patients who did not know the diagnosis but knew about the surgery (P = 0.038). CONCLUSIONS: Increased knowledge of patients regarding the surgery they are about to undergo may reduce their state-anxiety levels.PROPÓSITO: Pacientes que vão ser operados não devem sofrer ansiedade. Este estudo tem por objetivo comparar o grau de ansiedade no dia anterior à cirurgia entre pacientes que têm informação sobre seu diagnóstico, cirurgia e anestesia. MÉTODOS: Pacientes referiram seu conhecimento sobre o diagnóstico, a cirurgia e a anestesia. O inventário de Spielberger, State-Trait Anxiety Inventory (STAI), mediu a ansiedade. RESULTADOS: Cento e quarenta e nove pacientes foram selecionados, 82 mulheres e 38 homens foram entrevistados. Vinte e nove pacientes foram excluídos do estudo por analfabetismo. A ansiedade-estado foi semelhante para homens e mulheres, (36,10 ± 11,94 vs. 37,61 ± 8,76) (mean ± SD). A ansiedade-traço foi maior entre mulheres (42,55 ± 10,39 vs. 38,08 ± 12,25, P = 0,041). O nível de educação não influenciou a ansiedade-estado mas mostrou-se inversamente relacionado à ansiedade-traço. O diagnóstico fora claro para 91,7% dos pacientes entrevistados, cirurgia para 75% e anestesia para 37,5%. O desconhecimento da cirurgia elevou a ansiedade-estado (P = 0,021) cujo menor índice foi encontrado entre pacientes que não conheciam seu diagnóstico, mas sabiam sobre a cirurgia (P = 0,038). CONCLUSÕES: O conhecimento sobre a cirurgia a ser realizada pode reduzir o estado de ansiedade

ORIGINAL RESEARCH SURGERY INFORMATION REDUCES ANXIETY IN THE PRE-OPERATIVE PERIOD

PURPOSE: Patients preparing to undergo surgery should not suffer needless anxiety. This study aimed to evaluate anxiety levels on the day before surgery as related to the information known by the patient regarding the diagnosis, surgical procedure, or anesthesia. METHOD: Patients reported their knowledge of diagnosis, surgery, and anesthesia. The Spielberger State-Trait Anxiety Inventory (STAI) was used to measure patient anxiety levels. RESULTS: One hundred and forty-nine patients were selected, and 82 females and 38 males were interviewed. Twentynine patients were excluded due to illiteracy. The state-anxiety levels were alike for males and females (36.10 ± 11.94 vs. 37.61 ± 8.76) (mean ± SD). Trait-anxiety levels were higher for women (42.55 ± 10.39 vs. 38.08 ± 12.25, P = 0.041). Patient education level did not influence the state-anxiety level but was inversely related to the trait-anxiety level. Knowledge of the diagnosis was clear for 91.7% of patients, of the surgery for 75.0%, and of anesthesia for 37.5%. Unfamiliarity with the surgical procedure raised state-anxiety levels (P = 0.021). A lower state-anxiety level was found among patients who did not know the diagnosis but knew about the surgery (P = 0.038). CONCLUSIONS: Increased knowledge of patients regarding the surgery they are about to undergo may reduce their state-anxiety levels

ムショウ シンリョウジョ ノ カンリエイヨウシ ハイチ ニ タイスル セイカツ シュウカンビョウ カンジャ カラ ノ ニーズ ニ ツイテ

【目的】これまで我々は、無床診療所医師を対象とした調査を行い、管理栄養士による栄養指導が普及していない理由として、「患者からのニーズがない」という意見が多くあることを明らかにした。一方、無床診療所の管理栄養士配置に対する患者からのニーズを調査した成績はない。そこで今回、無床診療所の管理栄養士配置に対する生活習慣病患者からのニーズを明らかにすることを目的とした。【方法】東大阪地域の市民祭りや老人クラブの活動拠点に集まった方のうち、糖尿病や高血圧症などの生活習慣病を患い、病院もしくは診療所に通院されていた245 名を対象として、聞き取り式のアンケート調査を行った。【結果】管理栄養士の名称や業務を認知していた者は75.1％（184/245 名）であった。このうち「管理栄養士を無床診療所に配置する必要がある」と回答した者は70.7％（130/184 名）であり、その理由として「食生活について身近に相談できる人がいると嬉しい」「食の専門家である管理栄養士の意見を聞きたい」という意見が多くみられた。一方、「管理栄養士を配置する必要がない」と回答した者は16.3％（30/184 名）であり、その理由として「他の医療従事者による栄養指導で十分」「自分自身で食事管理できる」という意見が多くみられた。また、「どちらでもない」と回答した者は13.0％（24/184 名）であり、その理由として「管理栄養士を置く必要性が分からない」という意見が多くみられた。【結論】今回調査した地域における無床診療所の管理栄養士配置に対する生活習慣病患者からのニーズは、約7 割と高いものであった。今後は無床診療所医師に対する普及活動や、管理栄養士の役割を理解できていない患者に対する啓発活動が必要である。In this study, we aimed to clarify the needs of patients suffering from lifestyle related diseases, to determine the perceived role and importance of a registered dietitian placement in a non bed clinic. A previous survey of non bed clinic physicians suggested that nutritional guidance provided by registered dietitians was not valued in the clinical setting; many physicians felt that “there is no need for the patient” to receive dietary advice from registered dietitians. However, no research has examined patients’ perspectives regarding the placement of a registered dietitian in a non bed clinic.Methods: We conducted a questionnaire with 245 participants suffering from lifestyle related diseases such as diabetes and hypertension. They were recruited from those who gathered in the activity base of a civic festival, and from a seniors club in the Higashi Osaka region. All of the participants had visited the hospital or clinic at one time.Results: Of the 245 participants, 184 (75.1%) had been advised by a registered dietitian. The opinion that “a registered dietitian needs to be placed in a non bed clinic” was expressed by 70.7% (130 of 184) of those surveyed. Many wanted “to hear the opinion of a registered dietitian who is an expert on food” and gave reasons such as, “I’m happy to have people who can consult closely with me about my diet.” By con- trast, 30 of the 184 participants (16.3%) responded that “there is no need to place a registered dietitian” in a non bed clinic. They believed that “the nutritional guidance offered by other health care workers was enough” or that “their own opinion” provided adequate dietary management. Finally, 24 (13.0%) participants answered “Neither,” giving “I do not know whether there is a need to place a registered dietitian” as their reason.Conclusions: It needs from lifestyle related diseases a patient to a registered dietitian placement of the non bed clinic in conclusion was this time the study area were those about 70% and higher. Based on our findings, we suggest that in future dissemination activities, including those provided by non bed clinic doctors, there is a need for awareness raising for patients who do not understand the role of registered dietitians in a non bed clinic setting

Reaction frequency of solvated electrons in water interacting with atmospheric-pressure helium plasma jet

We employed the charge transfer to solvent (CTTS) transition of iodine negative ions to investigate the reactivity of solvated electrons in water interacting with an atmospheric-pressure helium plasma jet. A dye laser pulse at 225 nm was injected into the solution of potassium iodide, which was irradiated with an atmospheric-pressure helium plasma jet, and the reaction frequency of solvated electrons produced by the CTTS transition was measured by optical absorption spectroscopy. We observed the temporal and spatial variations of the reaction frequency of solvated electrons. We found that the reaction frequency of solvated electrons was determined by the concentrations of dissolved oxygen and hydrogen peroxide. We detected a high reaction frequency of solvated electrons in the limited depth region from the solution surface, indicating that hydrogen peroxide is localized near the plasma-liquid interface

Detection of hydrated electrons in water-jet immersed in low-pressure plasma by laser-induced desolvation

We detected hydrated electrons in a micrometer-size water jet immersed in a low-pressure plasma by laser-induced desolvation. When we irradiated the 2nd, 3rd, and 4th harmonics of Nd:YAG laser pulses to the water jet, we detected the pulsed current which indicated the transport of electrons from the water jet to the plasma. We observed a proportional relationship between the amplitude of the pulsed current and the laser energy, which is consistent with the conversion from hydrated to free electrons by laser-induced desolvation. The amplitude of the pulsed current increased with the negative bias voltage between the plasma and the water jet. The most remarkable result was found in the relationship between the photon energy and the quantum yield of the electron transport. The experimental quantum yield was orders of magnitude higher than that predicted by a Monte Carlo simulation in a low photon energy region, suggesting the possibility that hydrated electrons we detected in the present experiment have much lower hydration energies than well-known hydrated electrons