ジンソクナ バイスタンダー シンパイ ソセイホウ ニヨリ トツゼンシ オ マヌガレ シャカイ フッキ デキタ コウコウセイ ノ 2 ショウレイ

Bystander CPR means that people who find cardiopulmonary arrest perform cardiopulmonary resuscitation on the spot. Quick CPR contributes to increase in the rate of returning to the society as well as one-month survival rate and neurological prognosis. We report our experience with two high school students who underwent quick Bystander CPR, avoided sudden death, and returned to the society. ［Case 1］ Eighteen-year-old man : He collapsed suddenly in his home. Bystander CPR was performed by his family until emergency crews arrived there. Automated external defibrillator （AED） worked twice and his heartbeat started again. In electrocardiogram, coved type ST elevation in lead V1 was observed, and he was diagnosed as Brugada syndrome. We implanted an implantable cardioverter-defibrillator. Since his condition was stable, he was discharged on the 19th day. ［Case 2］ Seventeen-year-old woman : She collapsed suddenly walking with her family. Her father confirmed that she had no response, and started Bystander CPR. Her father got AED quickly and AED worked once, and she started to breathe again. She was admitted to our hospital for a work-up. Torsades de pointes （TdP） was observed in monitor electrocardiogram, and her QTc time was 513 msec in 12‐lead electrocardiogram. She was diagnosed as congenital long QT syndrome because genetic test showed that she had LQT2. Her QTc time was improved （approximately 350 msec） by medication, and she was discharged on the 25th day. Utstein-style statistics in Japan shows that the rate of returning to the society can be doubled by performing Bystander CPR on patients with cardiopulmonary arrest. However, performing rate of Bystander CPR is less than 50％ in Japan. In order to increase survival rate of patients with cardiopulmonary arrest for the future, it is important to inform people about CPR and to promote CPR, and in fact, we have been promoting CPR

Complement Factor H Is an Early Predictive Biomarker of the Therapeutic Efficacy of Sublingual Immunotherapy for Japanese Cedar Pollinosis

Sublingual immunotherapy for Japanese cedar pollinosis can improve the symptoms of allergic rhinitis and modify its natural course. However, sublingual immunotherapy requires a long treatment period and some patients do not respond to treatment. In this study, we aimed to identify biomarkers that could predict the efficacy of sublingual immunotherapy at an early stage. In this study, 40 patients from phase III trials were recruited and divided into good and poor response groups. Using peripheral blood mononuclear cells from before and two months after the start of medication, microarray, discriminant analysis, and real-time polymerase chain reaction were performed to extract candidate genes that could be biomarkers. Furthermore, these genes were validated in 30 patients in general clinical practice. Complement factor H was upregulated in the good response group and downregulated in the poor response group. Complement factor H may be a useful biomarker for predicting the efficacy of sublingual immunotherapy for Japanese cedar pollinosis at early time points after treatment initiation