トウテイイ キフク ヲ トモナウ ロボット シエン シュジュツ ニ オケル ミャクハ デンパン ジカン ヲ モチイタ ヒシンシュウテキ シンハクシュツリョウケイ ノ シヨウ ケイケン

Background: Estimated continuous cardiac output（esCCO）is a non-invasive technique for monitoring continuous cardiac output（CCO）that is based on pulse-wave transit time. In this study, we report the use of CCO monitoring for patients undergoing robot-assisted surgery with pneumoperitoneum in a head-down position. Method: Thirteen patients undergoing radical robot-assisted prostatectomy under general anesthesia were enrolled. Intraoperatively, esCCO and arterial pressure-based cardiac output（APCO）were simultaneously recorded. The association between esCCO and APCO was then evaluated using correlation analysis and Bland-Altman analysis. The trending ability of esCCO was evaluated by 4-quadrant plot analysis. Results: The correlation coefficient between esCCO and APCO was 0.54（P < 0.0001）. According to the Bland-Altman plot, the bias and precision values were 1.38 and 0.79 L/min, respectively. The concordance analysis showed the concordance rate of 92.3%. Conclusion: These results indicate that esCCO is capable of tracking hemodynamic changes associated with pneumoperitoneum in the head-down position

Combination of Diclofenac and Sublingual Nitrates Is Superior to Diclofenac Alone in Preventing Pancreatitis After Endoscopic Retrograde Cholangiopancreatography

BACKGROUND & AIMS: Acute pancreatitis is a major adverse event of endoscopic retrograde cholangiopancreatography (ERCP). Rectal administration of nonsteroidal anti-inflammatory drugs (NSAIDs) decreases the incidence of post-ERCP pancreatitis (PEP). Little is known about the combined effects of sublingual nitrate and NSAIDs. We performed a randomized trial to assess whether the combination of NSAIDs and sublingual nitrate is more effective than NSAIDs alone in preventing PEP. METHODS: In a prospective superiority trial, eligible patients underwent ERCP at 12 endoscopic units in Japan, from March 2015 through May 2018. Patients were randomly assigned to groups given diclofenac suppositories (50 mg) within 15 minutes after the endoscopic procedure alone (diclofenac-alone group, n = 442) or in combination with sublingual isosorbide dinitrate (5 mg) 5 minutes before the endoscopic procedure (combination group, n = 444). The primary endpoint was the occurrence of PEP. RESULTS: PEP developed in 25 patients in the combination group (5.6%), and in 42 patients in the diclofenac-alone group (9.5%) (relative risk 0.59; 95% confidence interval 0.37-0.95; P = .03). Moderate to severe pancreatitis developed in 4 patients (0.9%) in the combination group, and 10 patients (2.3%) in the diclofenac-alone group (relative risk 0.12; 95% confidence interval 0.13-1.26; P = .12). There was no serious adverse event related to the additional administration of sublingual nitrate. CONCLUSIONS: In a randomized controlled trial, we found that prophylaxis with rectal diclofenac and sublingual nitrate significantly reduces the overall incidence of PEP compared with diclofenac suppository alone. ClinicalTrials.gov, no: UMIN 000016274

Current status and outcomes of patients developing PSA recurrence after prostatectomy who were treated with salvage radiotherapy: A JROSG surveillance study

The conditions and outcomes of Japanese patients with prostate cancer who developed PSA failure after radical prostatectomy (RP), and who were treated via salvage radiotherapy (S-RT), were surveyed. Clinical data on S-RT were gathered in questionnaires completed by facilities participating in the Japanese Radiation Oncology Study Group. S-RT was defined as external-beam radiotherapy delivered to the prostate beds of patients with prostate cancer who had eventually developed PSA failure, although their PSA values had at one stage attained levels 0.3 ng/ml (57.5% vs 40.5%, P = 0.027). In Japan, hormonal therapy is combined with S-RT in ∼40% of cases. The 5-year PRFS and CFFS rates of cases treated via S-RT alone were 50.1% and 90.1%, respectively. A PSA value of 0.3 ng/ml served as a significant cut-off for prediction of PRFS

カガク データ カチョウカ プロジェクト プロジェクト タチアゲ ト ショキ データ コウカイ

We report on the current status of our astronomical data sonification project. This project aims to sonify astronomical data, that is, to convert a visual medium into an audio medium for both scientists and the visually impaired. We hope that sonification can lead to a new way of conceptualizing scientific data. The primary sourcesof the data used for this project come from Japanese satellites dedicated to X-ray astronomy and geophysics. This project is performed in collaboration with Nihon Fukushi University and the Center for Planning and Information Systems (PLAIN center) of the Japan Aerospace Exploration Agency (JAXA) Institute of Space andAstronautical Science (ISAS). Our project began in March 2006. Since this time we have sonified astronomical data sets, including data from X-ray pulsars, and have published these results. In this paper we also discuss future plans for the project, as well as its implications for visually impaired scientists and public

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P &lt; 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men