Comparison between regional lung CT values and lung densities estimated using EIT

In this paper we report the results of our study in which we compared lung density values obtained from EIT and CT values (HU) within a region of interest. The purpose was to verify clinical use of lung density estimation using EIT data. Image resolution of CT images, which was originally 512*512 pixels, was changed to 16*16 pixels, to match that of the EIT images. The CT and EIT images were recorded from eight patients in an intensive care unit and the results showed a correlation coefficient of 0.66 (p<0.05) between the CT values (HU) and the lung density values (kg/m3) obtained from EIT

Effects of early awake prone positioning on changes in oxygenation in non-intubated patients with COVID-19 pneumonia and respiratory failure

北里大学博士（医学）2022(令和4)年度doctoral thesi

呼吸不全を合併したCOVID-19患者に対する早期覚醒下腹臥位療法が酸素化に及ぼす影響

2022(令和4)年

Detailed Changes in Oxygenation following Awake Prone Positioning for Non-Intubated Patients with COVID-19 and Hypoxemic Respiratory Failure&mdash;A Historical Cohort Study

Few studies have reported on the effectiveness of awake prone therapy in the clinical course of coronavirus disease (COVID-19) patients. This study aimed to investigate the effects of awake prone therapy during spontaneous breathing on the improvement of oxygenation over 3 weeks for COVID-19 acute respiratory failure. Data of consecutive COVID-19 patients with lung disorder with a fraction of inspired oxygen (FIO2) &ge; 0.4 and without tracheal intubation were analyzed. We examined changes in SpO2/FIO2, ROX index ((SpO2/FIO2)/respiratory rate) and the seven-category ordinal scale after the initiation of FIO2 &ge; 0.4 and compared these changes between patients who did and did not receive prone therapy. Of 58 patients, 27 received awake prone therapy, while 31 did not. Trend relationships between time course and change in SpO2/FIO2 and ROX index were observed in both groups, although a significant interaction in the relationship was noted between prone therapy and change in SpO2/FIO2 and ROX index. The seven-category ordinal scale also revealed a trend relationship with time course in the prone therapy group. The awake prone therapy was significantly associated with a lower rate of tracheal intubation. In patients with COVID-19 pneumonia treated with FIO2 &ge; 0.4, awake prone therapy may improve oxygenation within two weeks

Interaction Between Methyl CpG-Binding Protein and Ran GTPase during Cell Division in Tobacco Cultured Cells

• Background and Aims Methyl CpG-binding proteins are considered to play critical roles in epigenetic control of gene expression by recognizing and interacting with 5-methylcytosine (m5C) in eukaryotes. However, among 13 corresponding genes in Arabidopsis thaliana, designated as featuring a methyl-binding domain (MBD), only four have so far been shown actually to bind to m5C. One example, AtMBD5, was selected here to screen for interacting proteins

Studies on the variability of the Greenland Ice Sheet and climate

We review major scientific results from Subtheme (1) "Variability of the Greenland Ice Sheet and climate" under Research Theme 2 "Variations in the ice sheet, glaciers, and the environment in the Greenland region" of the Arctic Challenge for Sustainability (ArCS) project. We participated in the international East Greenland Ice Core Project (EGRIP) led by Denmark, conducted snow pit observations near the coring site and reconstructed the surface mass balance over the past 10 years. Analyses of an ice core from Northwest Greenland revealed temporal variability in black carbon concentration over the past 350 years and in mineral dust over the past 100 years. To understand the mechanisms of ice-sheet flow, which is necessary for accurate predictions of sea level rise, we conducted laboratory experiments using artificial ice and derived an improved flow law for ice containing impurities. Ice sheet modeling was improved by including effects of impurities and ice stream dynamics. As part of the Ice Sheet Model Intercomparison Project for the Coupled Model Intercomparison Project Phase 6 (ISMIP6), we simulated ice sheet mass loss and contribution to sea level rise over the 21st century and beyond. Furthermore, we developed a Glacial Isostatic Adjustment model to better constrain ice sheet models

Management of Difficult Bile Duct Stones by Large Balloon, Cholangioscopy, Enteroscopy and Endosonography

Endoscopic management of bile duct stones is now the standard of care, but challenges remain with difficult bile duct stones. There are some known factors associated with technically difficult bile duct stones, such as large size and surgically altered anatomy. Endoscopic mechanical lithotripsy is now the standard technique used to remove large bile duct stones, but the efficacy of endoscopic papillary large balloon dilatation (EPLBD) and cholangioscopy with intraductal lithotripsy has been increasingly reported. In patients with surgically altered anatomy, biliary access before stone removal can be technically difficult. Endotherapy using two new endoscopes is now utilized in clinical practice: enteroscopy-assisted endoscopic retrograde cholangiopancreatography and endoscopic ultrasound-guided antegrade treatment. These new approaches can be combined with EPLBD and/or cholangioscopy to remove large bile duct stones from patients with surgically altered anatomy. Since various endoscopic procedures are now available, endoscopists should learn the indications, advantages and disadvantages of each technique for better management of bile duct stones

A Novel Partially Covered Self-Expandable Metallic Stent with Proximal Flare in Patients with Malignant Gastric Outlet Obstruction

Background/AimsEndoscopic placement of self-expandable metal stents (SEMSs) has emerged as a palliative treatment for malignant gastric outlet obstruction (GOO). Although covered SEMSs can prevent tumor ingrowth, frequent migration of covered SEMSs may offset their advantages in preventing tumor ingrowth.Methods : We conducted this multicenter, single-arm, retrospective study at six tertiary referral centers to evaluate the safety and efficacy of a partially covered SEMS with an uncovered large-bore flare at the proximal end as an antimigration system in 41 patients with symptomatic malignant GOO. The primary outcome was clinical success, and the secondary outcomes were technical success, stent dysfunction, adverse events, and survival after stent placement.Results : The technical and clinical success rates were 100% and 95%, respectively. Stent dysfunctions occurred in 17 patients (41%), including stent migration in nine (23%), tumor ingrowth in one (2%), and tumor overgrowth in four (10%). Two patients (5%) developed adverse events: one pancreatitis and one perforation. No procedure-related death was observed.Conclusion : sA novel partially covered SEMS with a large-bore flare proximal end was safe and effective for malignant GOO but failed to prevent stent migration. Further research is warranted to develop a covered SEMS with an optimal antimigration system