Rocuronium has a suppressive effect on platelet function via the p2y12 receptor pathway in vitro that is not reversed by sugammadex

Rocuronium is an aminosteroid nondepolarizing neuromuscular blocker that is widely used for anesthesia and intensive care. In this study, we investigated the effect of rocuronium on human platelet functions in vitro. The effects of rocuronium on platelet aggregation, P-selectin expression, and cyclic adenosine monophosphate (cAMP) levels in platelets were measured using an aggregometer, an enzyme immunoassay, and flow cytometry, respectively. Rocuronium inhibited ADP-induced platelet aggregation, P-selectin expression and suppression of cAMP production. These effects were not antagonized by equimolar sugammadex, a synthetic γ-cyclodextrin derivative that antagonizes rocuronium-induced muscle relaxation by encapsulating the rocuronium molecule. Morpholine, which constitutes a part of the rocuronium molecule but is not encapsulated by sugammadex, inhibited ADP-induced platelet aggregation. Vecuronium, which has a molecular structure similar to that of rocuronium but does not possess a morpholine ring, had no significant effect on ADP-induced platelet aggregation. These results indicate that rocuronium has a suppressive effect on platelet functions in vitro that is not reversed by sugammadex and suggest that this effect is mediated by blockade of the P2Y12 receptor signaling pathway via the morpholine ring of rocuronium

ゴルフ ト ヨウツウ : ロコモティブ シンドローム ト セキツイ シッカン

Lumbar spinal disease is one of the“locomotive syndrome”. Most common disease for advanced people is lumbar spinal canal stenosis（LSCS）, on the other hand, most common disease for young adult people is lumbar disc herniation（LDH）. Both LSCS and LDH can cause low back pain and severe sciatica of lower extremities. Golf is one of the most favorite sports for any generation worldwide. Sometimes golf can cause low back pain, however we can prevent the injuries of lumbar from playing golf. The achievement of the special positioning based on“Tai chi chuan”, so called Taikyokuken, upward of the hip and knee joint flexed without lordosis of lumbar spine can induce best posture for golf. We can enjoy playing golf with prevention of locomotive syndrome for whole life

Agreement between continuous cardiac output measured by the fourth-generation FloTrac/Vigileo system and a pulmonary artery catheter in adult liver transplantation

In liver transplantation for end-stage liver failure, monitoring of continuous cardiac output (CCO) is used for circulatory management due to hemodynamic instability. CCO is often measured using the minimally invasive FloTrac/Vigileo system (FVS-CCO), instead of a highly invasive pulmonary artery catheter (PAC-CCO). The FVS has improved accuracy due to an updated cardiac output algorithm, but the effect of this change on the accuracy of FVS-CCO in liver transplantation is unclear. In this study, we assessed agreement between fourth-generation FVS-CCO and PAC-CCO in 20 patients aged ≥ 20 years who underwent scheduled or emergency liver transplantation at Kyoto University Hospital from September 2019 to June 2021. Consent was obtained before surgery and data were recorded throughout the surgical period. Pearson correlation coefficient (r), Bland–Altman and 4-quadrant plot analyses were performed on the extracted data. A total of 1517 PAC-CCO vs. FVS-CCO data pairs were obtained. The mean PAC-CCO was 8.73 L/min and the mean systemic vascular resistance was 617.5 dyne·s·cm⁻⁵, r was 0.48, bias was 1.62 L/min, the 95% limits of agreement were − 3.04 to 6.27, and the percentage error was 54.36%. These results show that agreement and trending between fourth-generation FVS-CCO and PAC-CCO are low in adult liver transplant recipients

Compensatory Thrombopoietin Production from the Liver and Bone Marrow Stimulates Thrombopoiesis of Living Rat Megakaryocytes in Chronic Renal Failure

Background/Aims: Decreased thrombopoiesis has been ascribed a role in the pathogenesis of uremic bleeding in chronic renal failure (CRF). However, serum thrombopoietin (TPO) levels are usually elevated in CRF patients, suggesting increased thrombopoiesis. The aim of this study was to determine the thrombopoietic activity in CRF. Methods: Male Sprague-Dawley rats that underwent 5/6 nephrectomy were used as the model of CRF. Age-matched sham-operated rats were used as controls. Single megakaryocytes were isolated from the rat bone marrow, and their size distribution was examined. Megakaryocyte membrane invaginations were monitored by confocal imaging of di-8-ANEPPS staining, and patch clamp whole-cell recordings of membrane capacitance. TPO gene expression was assessed in various tissues. Results: Circulating platelet counts and the number of large megakaryocytes were increased in the bone marrow of CRF rats. Massive di-8-ANEPPS staining and increased membrane capacitance in large megakaryocytes demonstrated increased membrane invaginations. Unaffected Kv1.3-channel currents per cell surface area demonstrated unaltered channel densities. TPO transcription was decreased in the renal cortex but increased in the liver and bone marrow of CRF rats. Conclusion: Increased thrombopoiesis in CRF was thought to be a reactive mechanism to platelet dysfunction. Increased TPO production from the liver and bone marrow compensated for decreased production from damaged kidneys

Source Selection for Cluster Weak Lensing Measurements in the Hyper Suprime-Cam Survey

We present optimized source galaxy selection schemes for measuring cluster weak lensing (WL) mass profiles unaffected by cluster member dilution from the Subaru Hyper Suprime-Cam Strategic Survey Program (HSC-SSP). The ongoing HSC-SSP survey will uncover thousands of galaxy clusters to $z\lesssim1.5$. In deriving cluster masses via WL, a critical source of systematics is contamination and dilution of the lensing signal by cluster {members, and by foreground galaxies whose photometric redshifts are biased}. Using the first-year CAMIRA catalog of $\sim$900 clusters with richness larger than 20 found in $\sim$140 deg$^2$ of HSC-SSP data, we devise and compare several source selection methods, including selection in color-color space (CC-cut), and selection of robust photometric redshifts by applying constraints on their cumulative probability distribution function (PDF; P-cut). We examine the dependence of the contamination on the chosen limits adopted for each method. Using the proper limits, these methods give mass profiles with minimal dilution in agreement with one another. We find that not adopting either the CC-cut or P-cut methods results in an underestimation of the total cluster mass ($13\pm4\%$) and the concentration of the profile ($24\pm11\%$). The level of cluster contamination can reach as high as $\sim10\%$ at $R\approx 0.24$ Mpc/$h$ for low-z clusters without cuts, while employing either the P-cut or CC-cut results in cluster contamination consistent with zero to within the 0.5% uncertainties. Our robust methods yield a $\sim60\sigma$ detection of the stacked CAMIRA surface mass density profile, with a mean mass of $M_\mathrm{200c} = (1.67\pm0.05({\rm {stat}}))\times 10^{14}\,M_\odot/h$.Comment: 19 pages, 4 tables, 12 figures, accepted to PASJ special issu

Guideline from Japanese Society of Echocardiography : 2018 focused update incorporated into Guidance for the Management and Maintenance of Echocardiography Equipment

Echocardiography plays a pivotal role as an imaging modality in the modern cardiology practice. Information derived from echocardiography is definitely helpful for a patient care. The Japanese Society of Echocardiography has promoted echocardiography for a routine clinical and research use. One of the missions of the Society is to provide information that is useful for high-quality examinations. To ensure it, we believe equipment in good conditions and a comfortable environment are important for both a patient and an examiner. Thus, the Committee for Guideline Writing, the Japanese Society of Echocardiography published brief guidance for the routine use of echocardiography equipment in 2015. Recently, the importance of international standardization has been emphasized in the medical laboratories. Accordingly, the committee has revised and updated our guidance for the routine use of echocardiography equipment

New functional polar maps for estimating regional cardiac function using ECG-gated technetium-99m-tetrofosmin SPECT

金沢大学大学院医学系研究科Objective: The purpose of this work was to develop functional parameters to analyze regional cardiac function using ECG-gated 99mTc-tetrofosmin SPECT. Our goal was to develop a methodology that used slice thickness correction, the generation of a time-activity curve and a polar map. Methods: Fourteen normal patients without evidence of coronary artery disease were studied. One hour after intravenous injection of 740-1110 MBq (20-30 mCi) 99mTc-tetrofosmin, ECG-gated SPECT data were acquired by dividing a cardiac cycle into 12 frames. The SPECT data were reconstructed from 11 of 12 frames into 3 views. The reconstruction of these images was repeated after performing slice thickness correction. Excluding the effect of different apex-to-base lengths at any frame during a cardiac cycle, 10 short-axis images with the same slice thickness were obtained. Each short-axis image was divided by 40 radii into 40 segments. The time-activity curve was generated from the total counts included in each segment plus both neighboring segments. Subsequently the curve fitting was performed using the second Fourier function. Results: From fitted curves and their differentials, we calculated end-systolic count, end-diastolic count, percent count increase, uptake, peak contraction rate, peak distention rate and contraction time. Conclusion: The functional polar maps visually demonstrated regional myocardial function. This method is expected to be helpful for assessing regional cardiac function using 99mTc-tetrofosmin