Quantitative assessment of coronary stenosis by harmonic power Doppler with a simple pulsing sequence and vasodilator stress in patients

AbstractObjectivesWe examined whether myocardial contrast echocardiography (MCE) with harmonic power Doppler (HPD) employing a simple ultrasound pulsing sequence enables estimation of the severity of coronary artery stenosis in patients.BackgroundContrast intensity (CI) during MCE with intravenous microbubble infusion is dependent on the myocardial blood flow velocity (MBFV) and pulsing interval (PI).MethodsBased on an in vitro experiment, we devised the MBFV index calculated as the reciprocal of the magnitude of CI decay produced by abrupt PI shortening during intermittent imaging. In 68 coronary artery territories from 49 patients, myocardial HPD images were acquired during intravenous infusion of Levovist, while the long PI with 1:10 electrocardiographic gating was shortened to 1:1, both at baseline and during adenosine triphosphate infusion. The MBFV index in each coronary territory and MBFV reserve as the ratio between hyperemia and baseline were compared with the severity of corresponding coronary artery stenosis assessed by quantitative coronary angiography (QCA) or by pressure guide wire as the fractional flow reserve (FFR).ResultsBoth the MCE-derived MBFV index during hyperemia and MBFV reserve exhibited significant negative correlations with the QCA-derived stenosis severity (r = −0.56 and r = −0.64, respectively). The MBFV reserve positively correlated with FFR (r = 0.89). By combining the cutoff values of the MBFV index during hyperemia and MBFV reserve, ≥75% of stenoses defined by QCA were determined, with a sensitivity of 77.3%, specificity of 93.4%, and accuracy of 88.3%.ConclusionsShortening of PI during intravenous MCE with intermittent HPD imaging under vasodilator stress enables assessment of coronary artery stenoses in patients

Two cases of mandibular and masticatory reconstruction with vascularized fibra bone flaps and implants

　Defects of the jawbone have conventionally been repaired using free bone grafts and metallic plates, but patients undergoing reconstruction using these materials experience difficulty using dentures and restoring masticatory function. The use of vascularized bone grafts, which has recently been enabled, has improved bone graft survival rates, and its combination with dental implants has enabled both morphological and functional reconstruction, leading to a higher quality of life. 　We experienced two patients with tumors of the jaw that were treated by resecting and reconstructing it using a vascularized bone graft with the cooperation of the Department of Plastic Surgery in the School of Medicine. We subsequently inserted dental implants, and the superstructure was created by the Department of Prosthetics. We report the course of these patients, who achieved sufficient jaw morphology as well as masticatory function and who are presently satisfied overall three years to three years and nine months postoperatively

Urinary excretion of 3-phenoxybenzoic acid in middle-aged and elderly general population of Japan

Nagoya University, Department of Medical Technology金沢大学附属病院薬剤部Limited data are available on the background levels of exposure to synthetic pyrethroid (PYR) in Japan, despite their frequent application for agriculture and indoor extermination and possible effects of chronic and/or low-dose PYR exposure on human health. This study was conducted to describe the level and distribution of one of the major PYR metabolites, 3-phenoxybenzoic acid (3-PBA), in urine samples collected from a general population in Japan. The subjects were 535 individuals (184 men and 351 women; 61.5±9.8 years of age, mean±S.D.) residing in a town in Hokkaido, a dairy and agricultural area. Urinary 3-PBA was found detectable in 98% of samples above the limit of detection of 0.02 μg/l. The geometric mean values of urinary 3-PBA in occupationally exposed farmers (n=87) and the remaining general group without occupational exposure (n=448) were 0.38 and 0.29 μg/l, respectively, ranging from <LOD to 17.09 μg/l. No significant differences in urinary 3-PBA concentrations were shown between these two groups. Moreover, 3-PBA concentrations were found comparable to those reported in some countries. The present study is, to our knowledge, the first report of a biological monitoring study of urinary 3-PBA, which elucidated the background environmental exposure level of PYR in the Japanese general population without occupational exposure. Further nationwide studies covering different seasons and age distribution are needed to monitor the urinary 3-PBA levels in Japan

The Idea of a Socially Responsible Global Citizen and its Ethical and Philosophical Basis

An idea of a socially responsible global citizen is required to the emerging global community in order to make it with diversity, sustainability, prosperity, equity and justice. The ethical basis and qualities of a socially responsible global citizen could be provided through introducing some ideas and philosophy consisting of responsible well-being by R. Chambers and philosophy of value creation, global citizenship and creative coexistence by D. Ikeda. Ultimately a comprehensive framework for understanding a socially responsible global citizen is provided, which consist of the four domains: the view of the world and human life, core values and principles, qualities of a global citizen, and an envisioned and realized global community.departmental bulletin pape