Glaucomatous Visual Field Defect Severity and the Prevalence of Motor Vehicle Collisions in Japanese: A Hospital/Clinic-Based Cross-Sectional Study

Purpose. This study examined the association between the severity of visual field defects and the prevalence of motor vehicle collisions (MVCs) in subjects with primary open-angle glaucoma (POAG). Methods. This is a cross-sectional study. Japanese patients who have had driver’s licence between 40 and 85 years of age were screened for eligibility. Participants answered a questionnaire about MVCs experienced during the previous 5 years. Subjects with POAG were classified as having mild, moderate, or severe visual field defect. We evaluated associations between the severity of POAG and the prevalence of MVCs by logistic regression models. Results. The prevalence of MVCs was significantly associated with the severity of POAG categorized by worse eye MD (control: 30/187 = 16.0%; mild POAG: 17/92 = 18.5%; moderate POAG: 14/60 = 23.3%; severe POAG: 14/47 = 29.8%; P=0.025, Cochran-Armitage trend test). Compared to the control group, the adjusted OR for MVC prevalence in subjects with mild, moderate, or severe POAG in the worse eye was 1.07 (95% CI: 0.55 to 2.10), 1.44 (95% CI: 0.68 to 3.08), and 2.28 (95% CI: 1.07 to 4.88). Conclusions. There is a significant association between the severity of glaucoma in the worse eye MD and the prevalence of MVCs

遠隔教育の実施と大学での教育に関する一考察 ―建学の精神を伝える授業のオンラインでの実施をもとに―

2019年末に端を発した新型コロナ感染症（COVID-19）の拡大によって、多くの大学は2020年度の新学期から遠隔教育の実施に踏み切った。本学においても遠隔教育の採用が決定され、ホスピタリティ概論も IT 機器を活用したオンラインでの実施となった。この中で大学教育の将来像に大きな影響を与えると考えられるオンライン授業の在り方を探る基礎調査を実施した。その結果、次のことが明らかになった。1）受講生の IT 環境の整備には、差がみられること、2）受講生の使用する機器は、パソコン、タブレット、スマートフォンに分かれること、3）オンライン授業に関しては、肯定する意見がある一方、改善を要望する意見も見られること、4）スマートフォンのみでの受講者とパソコンおよびタブレットでの受講者を比較分析した結果、画面の明瞭度や授業の進行、及び授業の理解などにおいて両者に差がみられ、スマートフォンのみでの受講者の方が有意に低い結果であったこと、5）遠隔授業に関する要望等の中には、遠隔教育の利点を述べている受講生の他に、授業以外の大学が持つ機能、つまり、友人獲得や相互啓発に関する不安も多くみられたこと。この結果等を踏まえ、オンライン授業のあり方、及び、将来社会における大学教育のあり方に関する提案を行った

Indocyanine Green Fluorescence Imaging for Evaluation of Uterine Blood Flow in Cynomolgus Macaque

<div><p>Background</p><p>Uterine blood flow is an important factor in uterine viability, but the number of blood vessels required to maintain viability is uncertain. In this study, indocyanine green (ICG) fluorescence imaging was used to examine uterine hemodynamics and vessels associated with uterine blood flow in cynomolgus macaque.</p><p>Methods</p><p>The uterus of a female cynomolgus macaque was cut from the vaginal canal to mimic a situation during trachelectomy or uterine transplantation surgery in which uterine perfusion is maintained only with uterine and ovarian vessels. Intraoperative uterine hemodynamics was observed using ICG fluorescence imaging under conditions in which various nutrient vessels were selected by clamping of blood vessels. A time-intensity curve was plotted using imaging analysis software to measure the T_max of uterine perfusion for selected blood vessel patterns. Open surgery was performed with the uterus receiving nutritional support only from uterine vessels on one side. The size of the uterus after surgery was monitored using transabdominal ultrasonography.</p><p>Results</p><p>The resulting time-intensity curves displayed the average intensity in the regions of the uterine corpus and uterine cervix, and in the entire uterus. Analyses of the uterine hemodynamics in the cynomolgus macaque showed that uterine vessels were significantly related to uterine perfusion (P = 0.008), whereas ovarian vessels did not have a significant relationship (P = 0.588). When uterine vessels were clamped, ovarian vessels prolonged the time needed to reach perfusion maximum. Postoperative transabdominal ultrasonography showed that the size of the uterus was not changed 2 months after surgery, with recovery of periodic menstruation. The cynomolgus macaque has got pregnant with favorable fetus well-being.</p><p>Conclusion</p><p>Uterine vessels may be responsible for uterine blood flow, and even one uterine vessel may be sufficient to maintain uterine viability in cynomolgus macaque. Our results show that ICG fluorescence imaging is useful for evaluation of uterine blood flow since this method allows real-time observation of uterine hemodynamics.</p></div

T_max and T_1/2 values in time-intensity curves for perfusion of the entire uterine region with different patterns of blood vessels.

<p>T_max and T_1/2 values in time-intensity curves for perfusion of the entire uterine region with different patterns of blood vessels.</p

Time-intensity curves for different patterns of vessels for uterine perfusion.

<p>A Bilateral uterine + ovarian + vaginal vessels. B Bilateral uterine + ovarian vessels. C Bilateral uterine vessels. D Bilateral ovarian vessels. E Right uterine vessel + right ovarian vessel. F Right uterine vessel + left ovarian vessel. G Right ovarian vessel, H right uterine vessel. Red: uterine corpus, yellow: uterine cervix, blue: average of uterine corpus and cervix.</p

Temporal distribution of uterine blood flow observed by ICG fluorescence imaging after (a) 5 s, (b) 8 s, (c) 12 s, (d) 35 s, (e) 45 s, and (f) 60 s.

<p>Upper: ICG fluorescence imaging; lower: Regions with fluorescence intensity ≥100 are shown in red. Uterine artery/vein (yellow arrow) and ovarian artery/vein (red arrow).</p

Time-intensity curves prepared by ROI software to show temporal changes in ICG fluorescence intensity (Pattern A).

<p>(a) Temporal changes in intensity in 5 specified regions (red: right uterine corpus, yellow: left uterine corpus, green: right uterine cervix, blue: left uterine cervix, pink: uterine isthmus) (b) Temporal changes in average intensity in the uterine corpus (red), uterine cervix (yellow) regions, and the whole uterine region including the corpus and cervix regions (blue).</p

Preparation for intraoperative observation of uterine hemodynamics with ICG fluorescence imaging.

<p>(a) The ICG fluorescence imaging system, including the main body, camera unit, and remote controller. (b) CCD camera unit of a PDE installed at the site of surgery. (c) The uterus with a separated vaginal canal. The uterus was connected by the uterine artery/vein (yellow arrow) and ovarian artery/vein (red arrow).</p

Patterns of selected blood vessels used for uterine perfusion observed by ICG fluorescence imaging.

<p>Patterns of selected blood vessels used for uterine perfusion observed by ICG fluorescence imaging.</p