心不全加療における抗凝固剤や造影剤使用による有害事象の軽減を目的とした臨床的研究

学位の種別:課程博士University of Tokyo(東京大学

Prevalence of childhood obstructive sleep apnea syndrome and its role in daytime sleepiness

ObjectivesTo investigate childhood obstructive sleep apnea syndrome (OSAS) and its role in daytime sleepiness among school-age children.MethodsA questionnaire survey was conducted with 25,211 children aged 6–15 (mean, 10.39) years attending 148 elementary and 71 middle schools in 10 prefectures across Japan and their parents. Questions concerned 4 sleep habit items (bedtime, sleep onset latency, wake time after sleep onset, wake-up time) and 4 sleep disorder items (loud snoring, snorts/gasps, breathing pauses, seems very sleepy in the daytime). Total sleep time (TST) was calculated with sleep habits. Severe possible OSAS (p-OSAS) was defined as having loud snoring, snorts and gasps, or breathing pauses “frequently” (≥ 5 times per week), and mild p-OSAS was rated as having any of these “sometimes” (2–4 times per week). Severe daytime sleepiness was defined as seeming very sleepy “frequently” and mild daytime sleepiness as seeming very sleepy “sometimes”.ResultsMean prevalence of mild to severe p-OSAS and severe p-OSAS in children across all grade levels was 9.5% and 1.6%, respectively. p-OSAS was particularly prevalent in children at lower elementary levels, decreasing with advancing grade levels. Prevalence of mild and severe daytime sleepiness was 6.1% and 0.9%, respectively, among all children (7.0%). Prevalence of daytime sleepiness increased with advancing grade levels, particularly in middle-school level. Average TST was 8.4 ± 2.2 h in both elementary and middle-school levels, and decreased as grades advanced, particularly in middle-school levels. Multivariate logistic regression analysis showed that middle-school level, TST < 8 h, and p-OSAS were independent factors for daytime sleepiness. Strong correlations were found between severe daytime sleepiness and severe p-OSAS or TST < 6 h, and between daytime sleepiness and loud snoring or breathing pauses.Conclusionp-OSAS may be an independent factor influencing daytime sleepiness in school-age children. Loud snoring and breathing pauses could be clinical markers for children with severe daytime sleepiness

Prevalence of childhood obstructive sleep apnea syndrome and its role in daytime sleepiness

Objectives To investigate childhood obstructive sleep apnea syndrome (OSAS) and its role in daytime sleepiness among school-age children. Methods A questionnaire survey was conducted with 25,211 children aged 6-15 (mean, 10.39) years attending 148 elementary and 71 middle schools in 10 prefectures across Japan and their parents. Questions concerned 4 sleep habit items (bedtime, sleep onset latency, wake time after sleep onset, wake-up time) and 4 sleep disorder items (loud snoring, snorts/gasps, breathing pauses, seems very sleepy in the daytime). Total sleep time (TST) was calculated with sleep habits. Severe possible OSAS (p-OSAS) was defined as having loud snoring, snorts and gasps, or breathing pauses frequently (>= 5 times per week), and mild p-OSAS was rated as having any of these sometimes (2-4 times per week). Severe daytime sleepiness was defined as seeming very sleepy frequently and mild daytime sleepiness as seeming very sleepy sometimes. Results Mean prevalence of mild to severe p-OSAS and severe p-OSAS in children across all grade levels was 9.5% and 1.6%, respectively. p-OSAS was particularly prevalent in children at lower elementary levels, decreasing with advancing grade levels. Prevalence of mild and severe daytime sleepiness was 6.1% and 0.9%, respectively, among all children (7.0%). Prevalence of daytime sleepiness increased with advancing grade levels, particularly in middle-school level. Average TST was 8.4 +/- 2.2 h in both elementary and middle-school levels, and decreased as grades advanced, particularly in middle-school levels. Multivariate logistic regression analysis showed that middle-school level, TST < 8 h, and p-OSAS were independent factors for daytime sleepiness. Strong correlations were found between severe daytime sleepiness and severe p-OSAS or TST < 6 h, and between daytime sleepiness and loud snoring or breathing pauses. Conclusion p-OSAS may be an independent factor influencing daytime sleepiness in school-age children. Loud snoring and breathing pauses could be clinical markers for children with severe daytime sleepiness

Deep-Sea Robotic Survey and Data Processing Methods for Regional-Scale Estimation of Manganese Crust Distribution

Manganese crusts (Mn-crusts) are a type of mineral deposit that exists on the surface of seamounts and guyots at depths of >800 m. We have developed a method to efficiently map their distribution using data collected by autonomous underwater vehicles and remotely operated vehicles. Volumetric measurements of Mn-crusts are made using a high-frequency subsurface sonar and a 3-D visual mapping instrument mounted on these vehicles. We developed an algorithm to estimate Mn-crust distribution by combining continuous subsurface thickness measurements with the exposed surface area identified in 3-D maps. This is applied to data collected from three expeditions at Takuyo Daigo seamount at depths of ~1400 m. The transects add to ~11 km in length with 12 510 m 2 mapped. The results show that 52% of the surveyed area is covered by Mn-crusts with a mean thickness of 69.6 mm. The mean Mn-crust occurrence is 69.6 kg/m 2 with a maximum of 204 kg/m 2 in the mapped region. The results are consistent with estimates made from samples retrieved from the area, showing more detailed distribution patterns and having significantly lower uncertainty bounds for regional-scale Mn-crust inventory estimation

Symplectic Jacobi diagrams and the Lie algebra of homology cylinders

Let S be a compact connected oriented surface, whose boundary is connected or empty. A homology cylinder over the surface S is a cobordism between S and itself, homologically equivalent to the cylinder over S. The Y-filtration on the monoid of homology cylinders over S is defined by clasper surgery. Using a functorial extension of the Le-Murakami-Ohtsuki invariant, we show that the graded Lie algebra associated to the Y-filtration is isomorphic to the Lie algebra of ``symplectic Jacobi diagrams.'' This Lie algebra consists of the primitive elements of a certain Hopf algebra whose multiplication is a diagrammatic analogue of the Moyal-Weyl product. The mapping cylinder construction embeds the Torelli group into the monoid of homology cylinders, sending the lower central series to the Y-filtration. We give a combinatorial description of the graded Lie algebra map induced by this embedding, by connecting Hain's infinitesimal presentation of the Torelli group to the Lie algebra of symplectic Jacobi diagrams. This Lie algebra map is shown to be injective in degree two, and the question of the injectivity in higher degrees is discussed.Comment: 42 pages, with some figures. Minor changes with respect to the first versio