Lateral–Medial Dissociation in Orbitofrontal Cortex–Hypothalamus Connectivity

The orbitofrontal cortex (OFC) is involved in cognitive functions, and is also closely related to autonomic functions. The OFC is densely connected with the hypothalamus, a heterogeneous structure controlling autonomic functions that can be divided into two major parts: the lateral and the medial. Resting-state functional connectivity has allowed us to parcellate the cerebral cortex into putative functional areas based on the changes in the spatial pattern of connectivity in the cerebral cortex when a seed point is moved from one voxel to another. In the present high spatial-resolution fMRI study, we investigate the connectivity-based organization of the OFC with reference to the hypothalamus. The OFC was parcellated using resting-state functional connectivity in an individual subject approach, and then the functional connectivity was examined between the parcellated areas in the OFC and the lateral/medial hypothalamus. We found a functional double dissociation in the OFC: the lateral OFC (the lateral orbital gyrus) was more likely connected with the lateral hypothalamus, whereas the medial OFC (the medial orbital and rectal gyri) was more likely connected with the medial hypothalamus. These results demonstrate the fundamental heterogeneity of the OFC, and suggest a potential neural basis of the OFC-hypothalamic functional interaction

Impact of a learning health system on acute care and medical complications after intracerebral hemorrhage

Introduction: Patients with stroke often experience pneumonia during the acute stage after stroke onset. Oral care may be effective in reducing the risk of stroke‐associated pneumonia (SAP). We aimed to determine the changes in oral care, as well as the incidence of SAP, in patients with intracerebral hemorrhage, following implementation of a learning health system in our hospital. Methods: We retrospectively analyzed the data of 1716 patients with intracerebral hemorrhage who were hospitalized at a single stroke center in Japan between January 2012 and December 2018. Data were stratified on the basis of three periods of evolving oral care: period A, during which conventional, empirically driven oral care was provided (n = 725); period B, during which standardized oral care was introduced, with SAP prophylaxis based on known risk factors (n = 469); and period C, during which oral care was risk‐appropriate based on learning health system data (n = 522). Logistic regression analysis was performed to evaluate associations between each of the three treatment approaches and the risk of SAP. Results: Among the included patients, the mean age was 71.3 ± 13.6 years; 52.6% of patients were men. During the course of each period, the frequency of oral care within 24 hours of admission increased (P < .001), as did the adherence rate to oral care ≥3 times per day (P < .001). After adjustment for confounding factors, a change in the risk of SAP was not observed in period B; however, the risk significantly decreased in period C (odds ratio 0.61; 95% confidence interval 0.43‐0.87) compared with period A. These associations were maintained for SAP diagnosed using strict clinical criteria or after exclusion of 174 patients who underwent neurosurgical treatment. Conclusions: Risk‐appropriate care informed by the use of learning health system data could improve care and potentially reduce the risk of SAP in patients with intracerebral hemorrhage in the acute stage

ハイ アスペルギローマ ジュツゴ ハイロウ ニ タイシテ PushampSlideホウ ト ロープウェイホウ オ オウヨウ シタ EWS ニヨル キカンシ ジュウテンジュツ ガ ユウヨウ デアッタ 1レイ

Background : Bronchial occlusion using endobronchial Watanabe Spigot（EWS）is reported to be useful for treatment of secondary intractable pneumothorax and thoracic empyema, peripheral bronchial fistula. However, the methods of the bronchial occlusion are sometimes difficult and EWS sometimes fall off from plugged bronchus. Case : A ４４ year old man presented hemosputum. He was diagnosed with Aspergilloma. We performed a resection of the right upper lobe and S６ partial resection. Air leak appeared at postoperative day ３. We performed EWS embolization with an application of push & slide method and the ropeway method, and the persistent air leak disappeared. Conclusion : Our method is useful when the bronchial occlusion is difficult

A variant Philadelphia chromosome (Ph1) positive chronic myelocytic leukemia.

A rare case of variant Philadelphia (Ph1) chromosome positive [46, XX, t (9; 22) (q34; q11), inv (9) (9q22; 22q13)] chronic myelocytic leukemia (CML) was described. The patient, 73 years old female, was hospitalized to our hospital because of leukocytosis. Hematological findings corresponded to those of CMLs. However, this case lacked hepatosplenomegaly. Southern blot analysis using a 3 breakpoint cluster region (bcr) probe revealed a bcr rearrangement. The patient has been in the chronic phase for sixteen months without treatment. Clinical and chromosomal changes are under observation in order to get accumulate data for a pathophysiological analysis of variant Ph1 positive CMLs.</p

A human T cell leukemia virus type-I carrier with recurrent thrombocytopenia and various autoantibodies.

A 34-year-old woman infected with human T cell leukemia virus type-I(HTLV-I) with recurrent thrombocytopenia and various autoantibodies is described. The platelet counts fluctuated between 1.3 x 10(4)/microliters and 14.8 x 10(4)/microliters without any medical treatment, and thrombocytopenia improved with a decrease of platelet-associated IgG (PA-IgG). Autoantibodies such as rheumatoid factor, antinuclear factor, anti-Sm, anti-RNP and anti-SSA antibodies were also recognized. Marker analysis of peripheral mononuclear cells showed an increase in the proportion of CD 25+ cells, CD 3+ HLA-DR+ cells, CD4+ HLA-DR+ cells and CD8+ HLA-DR+ cells. The recurrent thrombocytopenia and development of various autoantibodies in this HTLV-I carrier are speculated to be due to the alteration of B cell functions by T cells infected with HTLV-I.</p

Why do we treat adolescent idiopathic scoliosis? What we want to obtain and to avoid for our patients. SOSORT 2005 Consensus paper

BACKGROUND: Medicine is a scientific art: once science is not clear, choices are made according to individual and collective beliefs that should be better understood. This is particularly true in a field like adolescent idiopathic scoliosis, where currently does not exist definitive scientific evidence on the efficacy either of conservative or of surgical treatments. AIM OF THE STUDY: To verify the philosophical choices on the final outcome of a group of people believing and engaged in a conservative treatment of idiopathic scoliosis. METHODS: We performed a multifaceted study that included a bibliometric analysis, a questionnaire, and a careful Consensus reaching procedure between experts in the conservative treatment of scoliosis (SOSORT members). RESULTS: The Consensus reaching procedure has shown to be useful: answers changed in a statistically significant way, and 9 new outcome criteria were included. The most important final outcomes were considered Aesthetics (100%), Quality of life and Disability (more than 90%), while more than 80% of preferences went to Back Pain, Psychological well-being, Progression in adulthood, Breathing function, Scoliosis Cobb degrees (radiographic lateral flexion), Needs of further treatments in adulthood. DISCUSSION: In the literature prevail outcome criteria driven by the contingent treatment needs or the possibility to have measurement systems (even if it seems that usual clinical and radiographic methods are given much more importance than more complex Disability or Quality of Life instruments). SOSORT members give importance to a wide range of outcome criteria, in which clinical and radiographic issues have the lowest importance. CONCLUSION: We treat our patients for what they need for their future (Breathing function, Needs of further treatments in adulthood, Progression in adulthood), and their present too (Aesthetics, Disability, Quality of life). Technical matters, such as rib hump or radiographic lateral alignment and rotation, but not lateral flexion, are secondary outcomes and only instrumental to previously reported primary outcomes. We advocate a multidimensional, comprehensive evaluation of scoliosis patients, to gather all necessary data for a complete therapeutic approach, that goes beyond x-rays to reach the person and the family

交通事故軽減のための汎用性と経済的頒布性に優れた蛍光反射材用品の開発

　現在、交通事故死者数に占める高齢者の数は、依然として高い水準で推移している。これに対して官公庁関係は、交通事故軽減のため市民に対して蛍光反射材を使用した安全啓発用品を配布している。しかし、市民の間では必要性の意識が低い、効果が周知されずデザインが服装に合わない等の理由から着用率が低く、啓発活動に至っていない現状がある。　本研究では、大学がコーディネーター役となり、産官学民がそれぞれの役割のもと着用率向上を目指すことを目的とし、本学は日常生活に密着した反射材を活用したデザイン提案を行い、16 点のサンプル制作を行った。そしてそれらの視認性を照射実験にて検証し、交通安全フェアや様々な展示会で市民を対象にアンケート調査を行った。結果、色は白色、アイテムは帽子やバック類、反射球などの立体形で反射材の面積が広いものほど、視認性が高いことが明らかになった。Currently, the number of the elderly citizens in traffic fatalities has moved at a high level. To reduce the number of traffic accident, the Civil Service distributes the reflective material goods to the citizens and advises to wear them to enlighten their conscious of traffic safety. However, due to their low consciousness of necessity, the effect has been unknown, or because the goods are not fashionable enough, the wearing rate of the reflective material goods is still so low that more educational activity is required. In this research, KOBE Design University has coordinated so called “industry-academia-government collaboration” with some business companies and Hyogo Prefectural Police. We worked together from each point of view to increase the wearing rate. KOBE Design University has proposed some designs of the reflective material goods which are close to and easy to wear for daily use and made16 kinds of sample goods. The visibility of the goods was tested under an irradiation experiment. Also we promoted the goods to the citizens at some traffic safety fairs and exhibitions and held a questionnaire survey. As a result, we found out that stereoscopic items with color of white with wide area such as hats and bags are the most visible goods

日本・中国のファッションデザイン学術交流にみるユニバーサルファッションの意義と役割に関する調査研究

　現在、世界で高齢化が進む中、中華人民共和国（以下、中国と称す。）は、2010 年に65 歳以上の高齢人口が1 億人を超える世界で唯一の国となった。さらに、短期間で高齢社会に突入する中、その対応策が急務となる。本研究の目的は、中国のファッションデザイン教育において、高齢社会に対応するデザイン手法が確立されていない現状に対し、「ユニバーサルファッション－国籍や年齢、障害の有無に関わらず、誰もが快適な衣生活を送るデザイン手法」を、教育カリキュラムとして普及し確立することにある。2016 年から本学ファッションデザイン学科と中国上海視覚芸術学院ファッションデザイン学部間で学術交流が始まった。そして2017 年、本学は、第12 回アート＆デザイン教育国際サミットフォーラム、第3 回上海中高齢時尚服飾国際会議、高齢社会に向けてのファッションショーへ参画した。高齢社会は国境を超えての世界的な課題であり、ファッションデザイン分野で解決し推進していくことが重要であると共有認識された。2017 年11 月、両大学の学長面談が行われ、今後の教育・研究・活動に関しての協力体制が約束された。両大学間の取り組みは、始まったばかりではあるが、ファッションデザイン学術交流を深めながら、ユニバーサルファッションの意義と役割を見い出していきたい。The People\u27s Republic of China (hereinafter referred to as China) has become the only country in the world with a 65 and older population in excess of 100 million in 2010. As we enter into a aged/aging society within a relatively short period of time, it is important that efforts be made to deal with the effects. Against China\u27s fashion design education, The objective of this study is to spread and establish a curriculum based on the concept of “Universal Fashion: a design method focused on designing comfortable clothing for everyone, regardless of nationality, age, or ability". Academic exchanges began between the Fashion Design Department of our university and the Shanghai Institute of Visual Arts, School of Fashion Design in 2016. Aging Societies are a global issue which extends beyond national borders; the importance of resolving/ promoting efforts to accommodate these social changes within the fashion design field was collectively acknowledged. Joint university efforts have just begun, but we would like to research the significance and role of universal fashion, while continuing to deepen fashion design academic exchange