Definite ECRS diagnosis with systemic steroid

According to JESREC criteria, definite eosinophilic chronic rhinosinusitis (ECRS) is postoperatively diagnosed based on over 70 eosinophils in high power magnification fields of the resected nasal polyps in patients with probable ECRS. Preoperative systemic administration with steroid is a standard practice, because it reduced intraoperative bleeding during endoscopic sinus surgery (ESS) in patients with ECRS. However, it was recently reported that systemic administration with steroid decreased the number of eosinophils in the nasal polyps, leading to a false negative diagnosis of definite ECRS. To overcome the risk, we have adopted short-term pre-operative systemic administration with low-dose of steroid and examined if our steroid administration makes a false-negative diagnosis. We performed a retrospective chart review of 42 patients with probable ECRS. Eleven patients were administered with 0.5 mg of bethametasone for 7 days before ESS, and other 31 patients were not administered. The average number of eosinophils in nasal polyps in patients who were administered with steroid was 188 ± 167, which was not different from 199 ± 149 in the patients who were not administered. These findings suggest that short-term preoperative administration with low-dose of steroid has few risk of a false-negative diagnosis of definite ECRS

Carnitine for Body Composition in Hemodialysis Patients

Background: Authors and colleagues have continued clinical research for hemodialysis patients. Currently, a pilot study presents intervention of carnitine for changes of the body composition. Subjects and Methods: Subjects were six patients on hemodialysis with intervention of carnitine (group 1). Average data were 74.3 years, 65.4 kg, 22.6 in BMI. As levocarnitine, L-Cartin FF injection 1000 mg was administered three times a week for six months. Group 2 has six control patients for age-, sex-, body weight, BMI-matched (group 2). Body composition of muscle and fat tissues were measured by InBody 770 on 0 and 6 months. Results: In group 1, muscle volume and skeletal muscle showed increasing tendency without statistical significance. In contrast, there were significant decreases of body fat volume (22.3 kg vs 20.5 kg, 39.0% vs 35.8%) (p<0.05). No significant differences were found in hemoglobin, total protein, albumin and Cardio-Thoracic Ratio (CTR) of chest X-ray. Group 2 showed no significant changes. Discussion and Conclusion: Hemodialysis patients often have muscular reduction. Previous reports showed improved lean body mass by carnitine administration, which may support our result. These results from current pilot study would be expected to become useful reference data in the pathophysiological investigation in patients on hemodialysis

Sequential therapies after atezolizumab plus bevacizumab or lenvatinib first-line treatments in hepatocellular carcinoma patients

Introduction: The aim of this retrospective proof-of-concept study was to compare different second-line treatments for patients with hepatocellular carcinoma and progressive disease (PD) after first-line lenvatinib or atezolizumab plus bevacizumab.Materials and methods: A total of 1381 patients had PD at first-line therapy. 917 patients received lenvatinib as first-line treatment, and 464 patients atezolizumab plus bevacizumab as first-line.Results: 49.6% of PD patients received a second-line therapy without any statistical difference in overall survival (OS) between lenvatinib (20.6 months) and atezolizumab plus bev-acizumab first-line (15.7 months; p = 0.12; hazard ratio [HR] = 0.80). After lenvatinib first-line, there wasn't any statistical difference between second-line therapy subgroups (p = 0.27; sorafenib HR: 1; immunotherapy HR: 0.69; other therapies HR: 0.85). Patients who under-went trans-arterial chemo-embolization (TACE) had a significative longer OS than patients who received sorafenib (24.7 versus 15.8 months, p &lt; 0.01; HR = 0.64). After atezolizumab plus bevacizumab first-line, there was a statistical difference between second-line therapy subgroups (p &lt; 0.01; sorafenib HR: 1; lenvatinib HR: 0.50; cabozantinib HR: 1.29; other therapies HR: 0.54). Patients who received lenvatinib (17.0 months) and those who under-went TACE (15.9 months) had a significative longer OS than patients treated with sorafenib (14.2 months; respectively, p = 0.01; HR = 0.45, and p &lt; 0.05; HR = 0.46).Conclusion: Approximately half of patients receiving first-line lenvatinib or atezolizumab plus bevacizumab access second-line treatment. Our data suggest that in patients progressed to atezolizumab plus bevacizumab, the systemic therapy able to achieve the longest survival is lenvatinib, while in patients progressed to lenvatinib, the systemic therapy able to achieve the longest survival is immunotherapy

ニンシンキ ニ オケル ボシ ノ セッショク ト シテノ タイドウ : タイドウ ニッキ ニ オケル タイドウ オ アラワス オノマトペ ノ ブンセキ カラ

妊婦が胎動をどのような感覚としてとらえているか。本研究では,胎動そのものの変化に対して,妊婦がどのような感受性を示すかを検討する。妊婦の胎動への感受性の指標として,妊娠中に記録された胎動日記において,胎動を表現するために用いられたオノマトペに着目した。妊婦38 名から得られた胎動日記1032 を分析した結果,妊娠期には,実にさまざまなオノマトペが用いられていることがわかった。オノマトペに用いる音が豊富であり,語基の変形だけでなく,臨時のオノマトペの使用も認められた。また,胎動を表すオノマトペと胎児への意味づけとの関連について週齢変化を検討した結果,3 つの時期に整理することができた。第一期(～ 28 週)は胎動のオノマトペが多様性を帯び,第三期(35 ～ 40 週)に向けて,オノマトペの多様性より,胎児への意味づけの多様性が増すように変化することを見いだした。最後に,母子の身体接触としての胎動という観点から考察した。How sense does a pregnant woman have at fetal movement? The present study examined how pregnant women (N=38) described fetal movement in order to consider women\u27s perceptions of relationships with their fetuses. Especially, it focused on how onomatopoeia they use to express their sense at fetal movement. Participants kept a pregnancy diary about fetal movement. Analysis of the 1032 diary entries found out that pregnant women used very different kinds of idiomatic onomatopoeia, and also produced temporary onomatopoeia. Further, it also found out that in each of three periods (e.g., before 28th week, 29th &#8211; 34th week, and 35th &#8211; 40th week), pregnant women used different onomatopoeia for fetal movement. Finally, this paper discussed the meaning of the fetal movement as touch between fetus and mother

The influence of the blocking of autonomic nerves upon the anaphylactic phenomenon. Part Ⅳ. The investigation of Arthus phenomenon in the area with blocking of autonomic nerves by means of fluorescein-labelled protein

Histochemical investigations were made upon the allergic reaction having the sympathectomy by means of fluorescein-labelled active protein conjugate. 1. On Arthus phenomenon at 24 hours after the provocating injection, although the fluorescence was observed in swollen connective tissue, the range of the fluorescence was narrow and weak on the operated side. This is considered to be based on the differences of the accumulated amounts of the tissue and blood antibodies. 2, The fluorescence was more instinctive and its range and strength were concentrated on the 3 rd day, but they were much weaker on the operated side than the control side. This is considered to be depending on the amounts of antibodies and, moreover, it regards to less necrotic products and weak autofluorescence. 3. The swollen connective tissue showed the coagulating necrosis and the fluorescence showed an yellow-red colour on the 7 th day, and the fluorescent cells appeared at the same time. Because of the weak reaction, the fluorescent cells were much less and straggled. These fluorescent cells are considered to be the plasma cells, which concerned to the antibody production

The influence of the blocking of autonomic nerves upon the anaphylactic phenomenon. Part 1. The influences of the blocking of autonomic nerves by medicines upon the general anaphylaxy

The influences of Ravonal, Procaine, Promethazine and Chlorpromazine upon the general anaphylaxy on rabbits were investigated. 1. Ravonal showed the definite inhibitory reaction upon the general anaphylaxy, which depended upon the depth of anesthesia. It did not show any marked effect in light anesthesia, while, in deep, it showed the prominent inhibitory effect. That is, the inhibitory effects varried markedly with the depth of the anesthesia. 2. As soon as the anesthetic effects reached to hypothalamus, the marked inhibitory effects were shown. This is considered to be caused by the mechanism based on the anesthetic effect on the autonomic nerve center. 3. Although Procaine showed an inhibitory reaction, the effects were slight. 4. Either Promethazine or Chlorpromazine showed the strong inhibitory reaction. 5. The excellent inhibitory effects of these phenothiazine derivatives upon the general anapylaxy are regarded to have much factors on central anesthetic reactions against the autonomic nerve system than their reactions against antihistamine and antiacetylcholine effects

The influence of the blocking of autonomic nerves upon the anaphylactic phenomenon. Part Ⅱ. The influences of the blocking of autonomic nerves by medicines upon the local anaphylactic phenomenon

The influences of Ravonal, Procaine, Promethazine and Chlorpromazine upon the local anaphylactic phenomenon on rabbits were investigated. 1. Ravonal anesthesia as well as general and local administration of Procaine have no influences upon the manifestation of the Arthus phenomenon. This is considered to be based on their temporary actions. 2. The general and local administration of Promethazine and Chlorpromazine showed the significant inhibition to the Arthus phenomenon and their effects were shown markedly by the administration of Chlorpromazine. This inhibitory effects are considered to be based on the antagonistic actions against the accentuation of vessel permeabilities through the autonomic nerves. 3. The influences of the anesthesia and artificial hibernation upon the aquiring of the anaphylaxy were investigated by the Arthus phenomenon and the precipitin value in blood and there were no significant differences against the control. This is considered to be based on the incomplete blocking of autonomic nervous function through over the antibody producing periods. 4. Ravonal anesthesia as well as general and local administration of Procaine showed a slight inhibition to the Shwartzman phenomenon. This is, also, considered to be caused by their temporary action, but the manifestation is much earlier than the Arthus phenomenon. 5. The general and local administration of Promethazine or Chlorpromazine showed significant inhibition to the Shwartzman phenomenon. This is considered to be based on the antagonistic action against the accentuation of vessel permeability through the antonomic nerves