産後うつとボンディングの関連の経産による変化: 子どもの健康と環境に関する全国調査からの経時的な結果より

富山大学・富医薬博乙77号・土田 暁子・2020/11/25関連論文Tsuchida A, Hamazaki K, Matsumura K, Miura K, Kasamatsu H, Inadera H; Japan Environment and Children\u27s Study (JECS) Group. Changes in the association between postpartum depression and mother-infant bonding by parity: Longitudinal results from the Japan Environment and Children\u27s Study. J Psychiatr Res. 2019 Mar;110:110-116. doi: 10.1016/j.jpsychires.2018.11.022. Epub 2018 Nov 28. PMID: 30616158.富山大

Gel phantom study of a cryosurgical probe with a thermosiphon effect and liquid nitrogen-cooled aluminum thermal storage blocks

Cryosurgery is a minimally invasive treatment for certain types of cancers. Argon-based cryosurgical devices are available at present, however a large compressed gas cylinder with the pressure of 300 atmospheres is needed. To overcome these drawbacks, we developed a new cryosurgical probe measuring about 50 cm in length with separate lumens inside for liquid and gaseous ethylene to be used as a thermosiphon and liquid nitrogen-cooled aluminum thermal storage blocks. The probe needle was 8 cm in length and 3 mm in outer diameter. To investigate the freezing capabilities of our new cryosurgical system we inserted the needle 5cm into a poly-acrylamide gel phantom warmed to 36.5 °C. Thermal storage blocks made of aluminum, cooled at –196 °C in liquid nitrogen, were attached to the condenser of the probe and replaced with thermal storage blocks every 4 to 5 minutes to compensate for warming. We took digital camera images of the ice ball at the needle and measured the temperature in certain locations of the cryoprobe. Ice ball formation started at one minute after cooling. The sizes (longest diameter × minimum diameter) at 10, 20 and 30 minutes after the start of the procedure were 4.5×2.1, 4.5×3.1 and 4.6×3.7 cm, respectively. During the procedure the minimum temperature of the condenser was –85 °C and the needle was –65 °C. This newly developed compact cryosurgical probe with thermosiphon effect and cooled thermal storage blocks created an ice ball that can be used for cryosurgery within 20 minutes

National trends in the outcomes of subarachnoid haemorrhage and the prognostic influence of stroke centre capability in Japan: retrospective cohort study

Objectives To examine the national, 6-year trends in in-hospital clinical outcomes of patients with subarachnoid haemorrhage (SAH) who underwent clipping or coiling and the prognostic influence of temporal trends in the Comprehensive Stroke Center (CSC) capabilities on patient outcomes in Japan.Design Retrospective study.Setting Six hundred and thirty-one primary care institutions in Japan.Participants Forty-five thousand and eleven patients with SAH who were urgently hospitalised, identified using the J-ASPECT Diagnosis Procedure Combination database.Primary and secondary outcome measures Annual number of patients with SAH who remained untreated, or who received clipping or coiling, in-hospital mortality and poor functional outcomes (modified Rankin Scale: 3–6) at discharge. Each CSC was assessed using a validated scoring system (CSC score: 1–25 points).Results In the overall cohort, in-hospital mortality decreased (year for trend, OR (95% CI): 0.97 (0.96 to 0.99)), while the proportion of poor functional outcomes remained unchanged (1.00 (0.98 to 1.02)). The proportion of patients who underwent clipping gradually decreased from 46.6% to 38.5%, while that of those who received coiling and those left untreated gradually increased from 16.9% to 22.6% and 35.4% to 38%, respectively. In-hospital mortality of coiled (0.94 (0.89 to 0.98)) and untreated (0.93 (0.90 to 0.96)) patients decreased, whereas that of clipped patients remained stable. CSC score improvement was associated with increased use of coiling (per 1-point increase, 1.14 (1.08 to 1.20)) but not with short-term patient outcomes regardless of treatment modality.Conclusions The 6-year trends indicated lower in-hospital mortality for patients with SAH (attributable to better outcomes), increased use of coiling and multidisciplinary care for untreated patients. Further increasing CSC capabilities may improve overall outcomes, mainly by increasing the use of coiling. Additional studies are necessary to determine the effect of confounders such as aneurysm complexity on outcomes of clipped patients in the modern endovascular era