コキュウ キノウ ケンサ ニ オケル ヒマン ノ エイキョウ

肥満が呼吸機能に及ぼす影響に関しては,既に多くの報告がなされているが一定の見解が得られていないのが現状である.今回,われわれは喫煙歴がなく呼吸器疾患を有さない患者を対象とし,男女別にそれぞれ非肥満者群がBody Mass Index (以下BMI) を25未満とし,肥満者群がBMIを25以上として2群に分け,各検査値に対する肥満の影響を基準値との比率 (%) で比較検討した.今回の検討では,特に%予備呼気量 (%Expiratory Reserve Volume;以下%ERV) と%最大呼気口腔内圧(%Maximal mouth Expiratory Pressure;以下%MEP) で男女とも肥満の影響が認められた.%ERVは,非肥満者群に比べ肥満者群が男女ともに有意な低値となった.一方,%MEPでは非肥満者群に比べ肥満者群が男女ともに有意な高値となった.呼吸機能検査の基準値を求める予測式は,体重 (肥満) が考慮されていないため,判読の際には肥満の影響を考慮する必要性が示唆された.Backgrounds:Recently, the number of people with obesity is increasing. It is known that obesity affects respiratory systems including functions of diaphragm. However, the influence of obesity on respiratory function test is not clearly elucidated.Patients and Methods:Subjects who received pulmonary function tests in Department of Laboratory Medicine Dokkyo Medical University Koshigaya Hospital between November 2007 and June in 2008 were enrolled in this study. Smokers and Subjects with respiratory diseases were excluded. Enrolled subjects were divided into 2 groups, obesity group( Body Mass Index( BMI)≧25) and non-obesity( BMI<25) group, and pulmonary function test results were compared.Results:%Expiratory Reserve Volume (ERV) in obesity groups was significantly lower than that in non-obesity group. %Maximal mouth Expiratory Pressure (MEP) in obesity groups was significantly higher than that in non-obesity group. No significant differences were detected between 2 groups in %Vital Capacity, %Forced Expiratory Volume 1.0 % and V50/V25.Conclusion:A body weight value is not included in the predicting formula for calculation of standard value of each pulmonary function data. Therefore, the influence of obesity required to be considered when the pulmonary function test is carried out for patients with obesity

ドッキョウ イカ ダイガク コシガヤ ビョウイン ニオケル, フクブ チョウ オンパ ケンサ ニヨル タンノウ リュウキセイ ビョウヘン ノ ケントウ

腹部超音波検査が施行された3572 例を対象として胆嚢隆起性病変の検討を行った.胆嚢隆起性病変は3572例中791例( 22.1%) に認められ,重複検査例を除いた773例の平均年齢は59.6±13.6歳であり,男性370 例,女性403 例であった.胆嚢隆起性病変の最大径の平均は4.7±5.8 mm で,単発が256 例 (33.1%),多発が517例( 66.9%) であった.773例中,10 mm 以上の病変を有する症例は44 例( 5.6%) であった.これら44例の最終診断は,胆嚢良性ポリープ19例( 43.2%),胆嚢腺筋症2 例( 4.6%),胆泥貯留2 例( 4.6%),胆嚢結石2例( 4.6%) 切除可能胆嚢癌6例( 13.6%),切除不能胆嚢癌6 例( 13.6%),その他の癌2 例( 4.6%),不明5例( 11.3%) であり,胆嚢癌の半数が切除不能であった.今後,超音波検査を用いて切除可能な胆嚢癌をより多く拾い上げるためには,人間ドック等による,より幅広いスクリーニングが必要であると考えられた.The present study investigated the presence and characteristicsof elevated gallbladder lesions in 3572 patients whounderwent abdominal ultrasonography in our hospital betweenApril 2011 and March 2012. Elevated gallbladder lesionswere present in 791 patients (22.1 %). After excludingpatients who underwent repeat examination, 44 of theremaining 773 patients (5.6 %) had lesions &#8805; 10 mm. Finaldiagnoses in these 44 patients were as follows:benign gallbladderpolyp, n=19 (43.2 %);gallbladder adenomyosis,n=2 (4.6 %);biliary sludge accumulation, n=2 (4.6 %);gallbladder stone, n=2( 4.6%);resectable gallbladder cancer,n=6( 13.6%);non-resectable gallbladder cancer, n=6(13.6%);other cancers, n=2( 4.6%);and unknown, n=5(11.3 %). Wider screening during routine medical examinationssuch as annual health checks is required to enable increasedidentification of gallbladder cancer at an early stagewhen resection is still possible

Hitomi (ASTRO-H) X-ray Astronomy Satellite

The Hitomi (ASTRO-H) mission is the sixth Japanese x-ray astronomy satellite developed by a large international collaboration, including Japan, USA, Canada, and Europe. The mission aimed to provide the highest energy resolution ever achieved at E  >  2  keV, using a microcalorimeter instrument, and to cover a wide energy range spanning four decades in energy from soft x-rays to gamma rays. After a successful launch on February 17, 2016, the spacecraft lost its function on March 26, 2016, but the commissioning phase for about a month provided valuable information on the onboard instruments and the spacecraft system, including astrophysical results obtained from first light observations. The paper describes the Hitomi (ASTRO-H) mission, its capabilities, the initial operation, and the instruments/spacecraft performances confirmed during the commissioning operations for about a month

Hitomi X-Ray Studies of Giant Radio Pulses from the Crab Pulsar

To search for giant X-ray pulses correlated with the giant radio pulses (GRPs) from the Crab pulsar, we performed a simultaneous observation of the Crab pulsar with the X-ray satellite Hitomi in the 2300 keV band and the Kashima NICT radio telescope in the 1.41.7 GHz band with a net exposure of about 2 ks on 2016 March 25, just before the loss of the Hitomi mission. The timing performance of the Hitomi instruments was confirmed to meet the timing requirement and about 1000 and 100 GRPs were simultaneously observed at the main pulse and inter-pulse phases, respectively, and we found no apparent correlation between the giant radio pulses and the X-ray emission in either the main pulse or inter-pulse phase. All variations are within the 2 fluctuations of the X-ray fluxes at the pulse peaks, and the 3 upper limits of variations of main pulse or inter-pulse GRPs are 22% or 80% of the peak flux in a 0.20 phase width, respectively, in the 2300 keV band. The values for main pulse or inter-pulse GRPs become 25% or 110%, respectively, when the phase width is restricted to the 0.03 phase. Among the upper limits from the Hitomi satellite, those in the 4.510 keV and 70300 keV bands are obtained for the first time, and those in other bands are consistent with previous reports. Numerically, the upper limits of the main pulse and inter-pulse GRPs in the 0.20 phase width are about (2.4 and 9.3) 10(exp 11) erg cm(exp 2), respectively. No significant variability in pulse profiles implies that the GRPs originated from a local place within the magnetosphere. Although the number of photon-emitting particles should temporarily increase to account for the brightening of the radio emission, the results do not statistically rule out variations correlated with the GRPs, because the possible X-ray enhancement may appear due to a >0.02% brightening of the pulse-peak flux under such conditions

肝門部胆管所見に着目した腹部超音波検査症例の検討

目的：腹部超音波検査にて，肝門部胆管の異常所見が胆膵疾患の拾い上げにどの程度寄与するか明らかにすることを目的として，肝門部胆管の超音波所見と最終診断について検討した．方法：対象は2016 年4 月から2017 年3 月までに当院で腹部超音波検査を施行した4326 例である．肝門部胆管に所見を認めた症例を抽出して超音波所見と最終診断について検討した．超音波所見の判定は日本超音波医学会の腹部超音波検診マニュアルに準じた．結果：肝門部胆管に所見を有する症例は123/4326 例（2.8％）であった．所見の内訳（重複あり）は，①壁肥厚が11 例，②拡張が99 例，③結石または内腔エコーが15 例であった．最終診断は，胆管癌12 例（9.8％），膵臓癌14 例（11.4％），硬化性胆管炎5 例（4.1％），胆管結石29 例（23.6％），その他の胆管疾患14 例（11.4％），その他の膵疾患9 例（7.3％），胆膵以外の癌7 例（5.7％），その他33 例（26.8％）であった．結論：肝門部胆管に所見を有する患者は4326 例中の2.8％であった．そのうち胆管癌が9.8％，膵臓癌が11.4％であった．肝門部胆管の所見に着目することにより，効率的に胆管癌および膵臓癌を拾い上げることが出来ると考えられる．Purpose：A purpose of this study is to determine a utility of the findings of porta hepatis bile duct contribute to a pickup of the bile tract and pancreatic disease.Methods：Subjects were 4,326 patients that underwent abdominal ultrasonography in Dokkyo Medical University Saitama Medical Center by March, 2017 from April, 2016. Patients having findings in the porta hepatis bile duct by abdominal ultrasonography were chosen and ultrasonic findings and final diagnosis were examined. The judgment of ultrasonic findings followed an abdominal ultrasound examination manual of the Japan Society of Ultrasonics in Medicine.Results：The patients with findings in the porta hepatis bile duct were 123/4376 cases （2.8％）. The patients with wall thickness of the bile duct were 11, patients with the dilatation of bile duct were 99 and patients with stones in the bile duct or intraductal lumen echo were 15. The final diagnosis of these patients were 12 cholangiocarcinoma （9.8％）, bile duct stone 29（23.6％）, sclerosing cholangitis 5（4.1％）, other bile duct disease 14 （11.4％）, pancreas cancer 14（11.4％）, other pancreatic disease 9（7.3％）, other cancer 7（5.7％）, others 33（26.8％）.Conclusions：The patients with findings in the porta hepatishepatis bile duct were 2.8 ％ of 4326 patients in this hospital. The authors think that we can diagnose cholangiocarcinoma and pancreas cancer efficiently by paying attention to the findings of the porta hepatis bile duct

Design and performance of Soft Gamma-ray Detector onboard the Hitomi (ASTRO-H) satellite

International audienc