飲泉による身体効果

温泉療法の一つである「飲泉」の身体への効果について既報文献をもとにレビューした。医学中央雑誌ならびにPubMedを用いて12編の原著文献を収集した。主として、胃腸、胆膵、糖代謝に関する検討がみられた。これに基づくと、飲泉は消化器系や代謝系に好ましい効果を持つ可能性があった。報告数の過少さや研究方法の限界から、飲泉の効果を確立するためにはさらに検証していく必要があると考えられた

Successful Treatment of Long-Term Severe Progressive Interstitial Pneumonia with Low-Dose Corticosteroid and Azathioprine in a Patient with Diffuse Systemic Sclerosis

For progressive interstitial pneumonia (progressive IP) that accompanies diffuse systemic sclerosis (diffuse SSc), no treatment guidelines have yet been established, and it is a complication with a poor prognosis. We herein report a case in which combination therapy of a low-dose corticosteroid and low-dose azathioprine was performed for progressive SSc-IP in a 64-year-old female whose respiratory function was severely damaged for a long period of time and for whom improvement was achieved. The beneficial effect has continued for 3 years with no side effects being observed during the course

FORMATION OF CARBON INTERPHASE ON POLYCRYSTALLINE AND AMORPHOUS SiC FIBERS IN SiC/SiC COMPOSITES BY ELECTROPHORETIC DEPOSITION

Continuous silicon carbide fiber-reinforced silicon carbide matrix (SiC/SiC) composites have been recognized as key materials for aerospace industries, high-temperature gas turbines and future nuclear and fusion applications because they show a pseudo-ductile fracture behavior and excellent fracture tolerance. Fiber/matrix interfaces act as an important role for toughening and strengthening SiC/SiC composites. Currently, carbon or hexagonal-boron nitride has been formed on SiC fibers as the interphases, and these interphases have been generally formed by chemical vapor infiltration (CVI), chemical vapor deposition (CVD) or solution-coating/pyrolysis process. However, these processes generally require long manufactuiring time and complicated apparatuses, and they use toxic, flammable or combustible reactant gases, resulting in much higher production cost and an increase in environmental load. Present authors paid attention to EPD process to form interphases on SiC fibers in SiC/SiC composites and demonstrated that EPD process was effective to form homogeneous C-interphase on SiC fibers [1-5]. In this study, EPD was applied for carbon interphase formation on polycrystalline (electric conductive) and amorphous (low electric conductive) SiC fibers in SiC/SiC composites, and microstructure and mechanical properties of the SiC/SiC composites were evaluated. From TEM micrograph of carbon interphase on the polycrystalline SiC fiber in the SiC/SiC composite formed by EPD, it was observed that flaky carbon particles were deposited parallel to the SiC fiber. Carbon has a layered structure and the layers bonded by weak van der Waals forces enable a low friction coefficient. As a result, the SiC/SiC composites with carbon interphases showed excellent mechanical properties with a pseudo-ductile fracture behavior. For amorphous SiC fibers, thin electric conductive polymer was coated on the amorphous SiC fibers, and carbon interphase formation was successfully achieved by EPD. The SiC/SiC composites reinforced with the carbon-coated amorphous SiC fibers also showed pseudo-ductile fracture behavior. References [1] K. Yoshida et al., Key Eng. Mater., 352 (2007) 133. [2] K. Yoshida et al., J. Nucl. Mater., 386-388 (2009) 643. [3] K. Yoshida et al., Mater. Sci. Eng. B, 161 (2009) 188. [4] K. Yoshida, J. Ceram. Soc. Japan, 118 (2010) 82. [5] K. Yoshida et al., Compos. Sci. Technol., 72 (2012) 1665. [6] K. Yoshida et al., Key Eng. Mater., 617 (2014) 213. [7] K. Yoshida, Chapter 18, in “MAX Phases and Ultra-High Temperature Ceramics for Extreme Environments” (2013)

Intravenous infusion of cardiac progenitor cells in animal models of single ventricular physiology

OBJECTIVES: The goal of this study was to identify the practical applications of intravenous cell therapy for single-ventricle physiology (SVP) by establishing experimental SVP models. METHODS: An SVP with a three-stage palliation was constructed in an acute swine model without cardiopulmonary bypass. A modified Blalock–Taussig (MBT) shunt was created using an aortopulmonary shunt with the superior and inferior venae cavae (SVC and IVC, respectively) connected to the left atrium (n = 10). A bidirectional cavopulmonary shunt (BCPS) was constructed using a graft between the IVC and the left atrium with an SVC cavopulmonary connection (n = 10). The SVC and the IVC were connected to the pulmonary artery to establish a total cavopulmonary connection (TCPC, n = 10). The survival times of half of the animal models were studied. The other half and the biventricular sham control (n = 5) were injected intravenously with cardiosphere-derived cells (CDCs), and the cardiac retention of CDCs was assessed after 2 h. RESULTS: All SVP models died within 20 h. Perioperative mortality was higher in the BCPS group because of lower oxygen saturation (P  CONCLUSIONS: Without the total right heart exclusion, stage-specific SVP models can be functionally constructed in pigs with stable outcomes. Intravenous CDC injections may be applicable in patients with SVP before TCPC completion, given that the initial lung trafficking is efficiently bypassed and sufficient systemic blood flow is supplied from the single ventricle

Norwood procedure with right ventricle to pulmonary artery conduit: a single-centre 20-year experience

Objectives: The aim of this study was to evaluate the long-term outcomes of the Norwood procedure with right ventricle-pulmonary artery (RV-PA) conduit for hypoplastic left heart complex (HLHC). Methods: A retrospective observational study was performed in 136 patients with HLHC who underwent a Norwood procedure with RV-PA conduit between 1998 and 2017. The probabilities of survival, reintervention and Fontan completion were analyzed. Results: Stage 1 survival was 91.9% (125/136). Reintervention for pulmonary artery stenosis was needed for 22% and 30% at stage 2 and 3, respectively, while 15% underwent reintervention for aortic arch recoarctation. Among 106 bidirectional Glenn survivors, 93 (68% of the total number of patients) had a Fontan completion, while four were not considered to be Fontan candidates. Risk factors for overall mortality included weighing Conclusions: Probabilities of survival and Fontan completion were acceptable under the current surgical strategy incorporating RV-PA Norwood procedure as the first palliation. Incorporating a strategy to maintain pulmonary artery growth and ventricular function through the staged repair is of prime importance. Further studies are necessary to observe changes in atrioventricular regurgitation as well as in right ventricular function, in patients who require atrioventricular valve interventions during the staged Fontan completion

Staged Repair of Tetralogy of Fallot: A Strategy for Optimizing Clinical and Functional Outcomes

Background This study evaluated the impact of a staged surgical strategy incorporating a modified Blalock-Taussig shunt (BTS) for tetralogy of Fallot (TOF) on pulmonary valve annulus (PVA) growth, the rate of valve-sparing repair (VSR) at the time of intracardiac repair (ICR), and long-term functional outcomes. Methods This retrospective study included 330 patients with TOF who underwent ICR between 1991 and 2019, including 57 patients (17%) who underwent BTS. The mean follow-up period was 15.0±7.3 years. We compared the data of patients who underwent BTS and those who did not undergo BTS before ICR. Results The median age and body weight before BTS were 71 (28–199) days and 4.3 (3.3–6.8) kg respectively. There were no in-hospital or interstage deaths after BTS. The PVA Z-scores of patients with BTS revealed significant growth after BTS (from -4.2±1.8 to -3.0±1.7, P Conclusions A staged surgical strategy incorporating BTS as the first palliation for symptomatic patients resulted in no mortality. BTS may have contributed to the avoidance of primary transannular patch repair (TAP) and facilitated PVA growth; therefore, approximately half of the symptomatic neonates and infants were recruited for VSR. Staged repair may have led to functionally-reliable delayed TAP repair, thereby resulting in less surgical reinterventions