137 research outputs found

    Pulmonary function after segmentectomy for small peripheral carcinoma of the lung

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    AbstractObjective: The aim of this study is to compare the pulmonary function after a segmentectomy with that after a lobectomy for small peripheral carcinoma of the lung. Patients And Methods: Between 1993 and 1996, segmentectomy and lobectomy were performed on 48 and 133 good-risk patients, respectively. Lymph node metastases were detected after the operation in 6 and 24 patients of the segmentectomy and lobectomy groups, respectively. For bias reduction in comparison with a nonrandomized control group, we paired 40 segmentectomy patients with 40 lobectomy patients using nearest available matching method on the estimated propensity score. Results: Twelve months after the operation, the segmentectomy and lobectomy groups had forced vital capacities of 2.67 ± 0.73 L (mean ± standard deviation) and 2.57 ± 0.59 L, which were calculated to be 94.9% ± 10.6% and 91.0% ± 13.2% of the preoperative values (P = .14), respectively. The segmentectomy and lobectomy groups had postoperative 1-second forced expiratory volumes of 1.99 ± 0.63 L and 1.95 ± 0.49 L, which were calculated to be 93.3% ± 10.3% and 87.3% ± 14.0% of the preoperative values, respectively (P = .03). The multiple linear regression analysis showed that the alternative of segmentectomy or lobectomy was not a determinant for postoperative forced vital capacity but did affect postoperative 1-second forced expiratory volume. Conclusion: Pulmonary function after a segmentectomy for a good-risk patient is slightly better than that after a lobectomy. However, segmentectomy should be still the surgical procedure for only poor-risk patients because of the difficulty in excluding patients with metastatic lymph nodes from the candidates for the procedure. (J Thorac Cardiovasc Surg 1999;118:536-41

    脳梗塞モデルラットにおける虚血後の時期依存的な抗炎症性M2マクロファージ活性化変調の役割

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    Cerebral ischemia triggers inflammatory changes, and early complications and unfavorable outcomes of endovascular thrombectomy for brain occlusion promote the recruitment of various cell types to the ischemic area. Although anti-inflammatory M2-type macrophages are thought to exert protective effects against cerebral ischemia, little has been clarified regarding the significance of post-ischemic phase-dependent modulation of M2-type macrophages. To test our hypothesis that post-ischemic phase-dependent modulation of macrophages represents a potential therapy against ischemic brain damage, the effects on rats of an M2-type macrophage-specific activator, Gc-protein macrophage-activating factor (GcMAF), were compared with vehicle-treated control rats in the acute (day 0–6) or subacute (day 7–13) phase after ischemia induction. Acute-phase GcMAF treatment augmented both anti-inflammatory CD163+M2-type- and pro-inflammatory CD16+ M1-type macrophages, resulting in no beneficial effects. Conversely, subacute-phase GcMAF injection increased only CD163+ M2-type macrophages accompanied by elevated mRNA levels of arginase-1 and interleukin-4. M2-type macrophages co-localized with CD36+ phagocytic cells led to clearance of the infarct area, which were abrogated by clodronate-liposomes. Expression of survival-related molecules on day 28 at the infarct border was augmented by GcMAF. These data provide new and important insights into the significance of M2-type macrophage-specific activation as post-ischemic phase-dependent therapy

    Electrocatalytic activity and volatile product selectivity for nitrate reduction at tin-modified Pt(100), Pd(100) and Pd–Pt(100) single crystal electrodes in acidic media

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    We prepared Sn-modified Pt(100), Pd(100) and Pd–Pt(100) single crystal electrodes and investigated the nitrate reduction reaction (NO3RR) activity and the product selectivity for them using online electrochemical mass spectroscopy (OLEMS), also known as differential electrochemical mass spectroscopy (DEMS). OLEMS measurements allowed us to quantify volatile products of N2, N2O and NO and confirm the production of N2 at Sn/Pd(100) but not at Sn/Pt(100). Pd-doping to Pt(100) with a 3 atomic % increased the product selectivity for the NO3RR to N2. These results indicate that the presence of Pd in the (100) surface is the key to produce N2, which seems to be related to the hydrogen adsorption energy to the metal surface. The suppression of hydrogenation of intermediate species at the electrode surface could lead to the production of N2. This work will guide us to understand N2 production mechanism for the NO3RR and develop highly selective electrocatalysts for denitrification

    Natural Course of Pachychoroid Pigment Epitheliopathy

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    PURPOSE: To investigate the natural course of pachychoroid pigment epitheliopathy (PPE). DESIGN: A retrospective cohort study. SUBJECTS: From the Kyoto central serous chorioretinopathy (CSC) cohort consisting of 548 patients with CSC as of September 2020, we included consecutive unilateral patients with acute or chronic CSC between January 2013 and December 2016. METHODS: All patients underwent complete ophthalmic examination, including multimodal imaging such as fundus autofluorescence, spectral-domain optical coherence tomography, and fluorescein angiography/indocyanine green angiography and/or optimal coherence tomography angiography. The fellow eyes of eyes diagnosed with CSC were screened for PPE, and their natural course was evaluated. We also evaluated the association of ARMS2 rs10490924, CFH rs800292, TNFRSF10A rs13278062, and GATA5 rs6061548 genotypes with the natural course. MAIN OUTCOME MEASURES: Incidence of CSC, pachychoroid neovasculopathy, and pachychoroid geographic atrophy (GA). RESULTS: In total, 165 patients with unilateral CSC (mean age, 55.7 ± 12.6 years; female, 22.4%) were included from the Kyoto CSC cohort. Among them, 148 (89.7%) were diagnosed as having PPE in their non-CSC eye. Survival analysis revealed that 16.8% of PPE eyes developed CSC during the 6-year follow up, whereas non-PPE eyes did not. Although genetic factors did not have significant association with CSC development (P > 0.05, log-rank test), choroidal vascular hyperpermeability (CVH) and subfoveal choroidal thickness (SFCT) were significantly associated with CSC incidence (P = 0.001, log-rank test). Survival analysis showed that eyes without CVH and eyes with SFCT < 300 μm did not develop CSC during the 6-year follow-up. Pachychoroid neovasculopathy developed in only 1 eye with PPE during a follow-up of 46.4 months. Pachychoroid GA did not develop in any of the studied eyes. CONCLUSIONS: This study revealed a natural history of PPE in a relatively large Japanese cohort. Choroidal vascular hyperpermeability and SFCT were significant risk factors for the development of CSC in PPE eyes. Although the current results cannot be generalized for all eyes with PPE, these findings present an important clinical implication

    Self-consistent long-time simulation of chirping and beating energetic particle modes in JT-60U plasmas

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    Recurring bursts of chirping Alfvén modes that were observed in JT-60U tokamak plasmas driven by negative-ion-based neutral beams (N-NB) are reproduced in first-principle simulations performed with an extended version of the hybrid code MEGA. This code simulates the interactions between gyrokinetic fast ions and magnetohydrodynamic (MHD) modes in the presence of a realistic fast ion source and collisions, so that it self-consistently captures dynamics across a wide range of time scales (0.01–100 ms). The simulation confirms that the experimentally observed phenomena known as \u27fast frequency sweeping (fast FS) modes\u27 are caused by bursts of energetic particle modes (EPM) with dominant toroidal mode number n  =  1. On the long time scale (1–10 ms), the simulation reproduces the chirping range (40–60 kHz), the burst duration (few ms) and intervals (5–10 ms). On the short time scale (0.01–0.1 ms), it reproduces pulsations and phase jumps, which we interpret as the result of beating between multiple resonant wave packets. Having reproduced at multiple levels of detail the dynamics of low-amplitude long-wavelength Alfvén modes driven by N-NB ions, the next goal is to reproduce and explain abrupt large-amplitude events (ALE) that were seen in the same experiments at longer time intervals (10–100 ms)
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