Evaluation of Exhaled Nitric Oxide in Thoracic Surgery Patients under One Lung Ventilation Using a Newly Designed Online Exhaled Nitric Oxide Measuring System

Measurement of exhaled nitric oxide (NO) has been gaining much interest lately. However, an ideal measuring system is not yet available in the clinical setting. The aims of the present study were to construct an exhaled NO measuring system and to investigate the effects of one lung ventilation (OLV) on exhaled NO output in patients who underwent thoracic surgery. At first, the NO measuring system was constructed with an NO analyzer, a respiratory flowmeter and a data processing computer system in which the algorithm was indwelled for correcting the distorted NO output wave form. Then, accuracy of this system was tested by using a simulator. This simulator was reworked in order to simulate NO production from the lung under both spontaneous respiration and mechanical ventilation. The data of peak NO concentration (pNO) and NO output (VNO) obtained with the NO monitoring system were significantly correlated with "alveolar" NO concentration (aNO) and exhaled NO volume from the simulator. Then, exhaled NO was measured in 12 thoracic surgery patients who underwent OLV using this system. pNO and VNO were significantly decreased by about half during OLV, and returned to baseline 25 min after releasing OLV. These data suggest that the newly designed online exhaled NO measuring system accurately detected aNO and exhaled NO volume in a breath-by-breath manner, and OLV for about 3 h did not influence the NO output from the lung after releasing OLV in thoracic surgery patients

認定介護福祉士達はなぜ養成研修で介護職チームを意識できたのか

研究ノート　本研究ノートは、認定介護福祉士を対象とした縦断研究の一部である。養成研修がカリキュラム目標や、資格取得者の変容から、認定介護福祉士養成が個人としての資質向上を目指すだけではなく、資格創設時の目的であった、介護職チームを牽引する意識づけや、人材確保のための役割を果たす発信力を習得する場になっていることを示した

認定介護福祉士資格取得者における資格取得後の変容 : 資格取得過程の体験に着目して

調査報告　本研究ノートは、認定介護福祉士の資格取得後の変容を明らかにするために3 名にインタビューした内容の報告である。内発的な動機づけや、職場環境の違いに若干の違いがあるものの、研修中は、葛藤や躓きを抱きながらも、受講生仲間と支え合いながらモチベーションの維持をし、資格取得後には、研修本来の目的である地域での介護職チーム作りの実践を継続している。認定介護福祉士が、「介護職という重層的なチーム」の中で、「専門性の明確化・高度化・介護福祉実践の蓄積などの理論化」に期待できる資格であることが示唆された

A Computational Approach To Predict Warp Of Sawn Lumber Due To Residual Growth Stress In A Log

A tree generates a complicated stress distribution inside the stem during its formation, which is called 'residual growth stress (RGS)'. The RGS often induces warp in a sawn lumber such as bow, crook, and other deformation, which causes severe losses of materials and benefits in the sawmill industry. Generally, warp becomes more serious in the lumber 'without pith' than in the lumber 'with pith'. In Japan, 50% of conifer plantations are ready to produce large-diameter logs of which diameter is more than 30 cm. The use of those logs inevitably leads to the production of the lumber 'without the pith', so we are concerned about the problems due to lumber warp in future sawmill industry using largediameter logs. Based on those practical background, this study presents a computational procedure to predict warp of the squared lumber, such as a beam, a bearer, and so forth, when those lumbers are sawn from the log and/or the thick plank. Using the derived procedure, 2-D patterns of the RGSs in the sawn lumbers and their changes during sawing processes are simulated. Simulated results will be experimentally verified by measuring the warp of the sawn lumber, as well as by measuring the RGS distributions in a log

Novel prospective umbrella-type lung cancer registry study for clarifying clinical practice patterns: CS-Lung-003 study protocol

Introduction Conventional cancer registries are suitable for simple surveillance of cancer patients, including disease frequency and distribution, demographics, and prognosis; however, the collected data are inadequate to clarify comprehensively diverse clinical questions in daily practice. Methods We constructed an umbrella‐type lung cancer patient registry (CS‐Lung‐003) integrating multiple related prospective observational studies (linked studies) that reflect clinical questions about lung cancer treatment. The primary endpoint of this registry is to clarify daily clinical practice patterns in lung cancer treatment; a key inclusion criterion is pathologically diagnosed lung cancer. Under this registry, indispensable clinical items are detected in advance across all active linked studies and gathered prospectively and systematically to avoid excessive or insufficient data collection. Researchers are to input information mutually, irrespective of the relevance to each researcher's own study. Linked studies under the umbrella of the CS‐Lung‐003 registry will be updated annually with newly raised clinical questions; some linked studies will be newly created, while others will be deleted after the completion of the analysis. Enrollment began in July 2017. Discussion We successfully launched the umbrella‐type CS‐Lung‐003 registry. Under this single registry, researchers collaborate on patient registration and data provision for their own and other studies. Thus, the registry will produce results for multiple domains of study, providing answers to questions about lung cancer treatment raised by other researchers. Through such analysis of each linked study, this registry will contribute to the comprehensive elucidation of actual daily practice patterns in lung cancer treatment. Key points CS‐Lung‐003 registry directly integrates multiple linked studies created under the umbrella of this cancer registry to solve various clinical questions regarding daily practice patterns of lung cancer treatment

Protocol for a multicentre, prospective observational study of elective neck dissection for clinically node-negative oral tongue squamous cell carcinoma (END-TC study)

Introduction: In early-stage oral tongue squamous cell carcinoma (OTSCC), elective neck dissection (END) is recommended when occult lymph node metastasis is suspected; however, there is no unanimous consensus on the risks and benefits of END in such cases. The management of clinically node-negative (cN0) OTSCC remains controversial. This study, therefore, aimed to evaluate the efficacy of END and its impact on the quality of life (QoL) of patients with cN0 OTSCC. Methods and analysis: This is a prospective, multicentre, nonrandomised observational study. The choice of whether to perform END at the same time as resection of the primary tumour is based on institutional policy and patient preference. The primary endpoint of this study is 3-year overall survival. The secondary endpoint are 3-year disease-specific survival, 3-year relapse-free survival and the impact on patient QoL. Propensity score-matching analysis will be performed to reduce selection bias. Ethics and dissemination: This study was approved by the Clinical Research Review Board of the Nagasaki University. The protocol of this study was registered at the University Hospital Medical Information Network Clinical Trials Registry. The datasets generated during the current study will be available from the corresponding author on reasonable request. The results will be disseminated internationally, through scientific and professional conferences and in peer-reviewed medical journals

Protocol for a multicentre, prospective observational study of elective neck dissection for clinically node-negative oral tongue squamous cell carcinoma (END-TC study)

Introduction In early-stage oral tongue squamous cell carcinoma (OTSCC), elective neck dissection (END) is recommended when occult lymph node metastasis issuspected; however, there is no unanimous consensus on the risks and benefits of END in such cases. The management of clinically node-negative (cN0) OTSCCremains controversial. This study, therefore, aimed to evaluate the efficacy of END and its impact on the quality of life (QoL) of patients with cN0 OTSCC.Methods and analysis This is a prospective, multicentre, nonrandomised observational study. The choice of whether to perform END at the same time as resection of the primary tumour is based on institutional policy and patient preference. The primary endpoint of this study is 3-year overall survival. The secondary endpoints are3-year disease-specific survival, 3-year relapse-free survival and the impact on patient QoL. Propensity score-matching analysis will be performed to reduce selection bias.Ethics and dissemination This study was approved by the Clinical Research Review Board of the Nagasaki University. The protocol of this study was registered at the University Hospital Medical Information Network Clinical Trials Registry. The datasets generated during the current study will be available from the correspondingauthor on reasonable request. The results will be disseminated internationally, through scientific and professional conferences and in peer-reviewed medical journals

カンガクレンケイ ニヨル ジセダイ イクセイシエン ニ カンスル キョウドウ ケンキュウ ニ トリクンデ : カタノシ ジセダイ イクセイ シエン コウキ コウドウ ケイカク サクテイ カテイ ニ オイテ

次世代育成支援対策推進法に基づく、次世代育成支援後期行動計画の作成過程において、官学連携による次世代育成支援に関する共同研究を行った。その活動内容および官学連携に関する一考察について報告する

Red blood cell width (RDW) and C-Reactive Protein (CRP) in dogs with chronic degenerative mitral valve disease

O RDW é um índice hematológico utilizado para avaliação quantitativa da anisocitose eritrocitária, sendo útil na diferenciação das causas de quadros anêmicos. Atualmente, na medicina humana, o RDW tem sido considerado como um importante fator prognóstico em quadros de ICC, mesmo na ausência de anemia. A CRP é considerada a principal proteína de fase aguda sendo amplamente utilizada como marcadora de inflamação. O objetivo deste estudo foi determinar se há diferença nos valores do RDW e da concentração da CRP em cães com DVDCM com e sem ICC, bem como nos diferentes estágios (A, B1, B2, C e D) da doença, segundo a classificação da ACVIM, comparados a cães de raças predispostas, mas sem a doença cardíaca, e associações entre as variáveis. Esta pesquisa constituiu um estudo clínico observacional prospectivo transversal de caráter exploratório, realizada em cães com DVDCM. Para tal, foram selecionados 141 cães, de até 20kg, machos e fêmeas. O grupo com ICC e sem ICC apresentaram menor número de hemácias, hemoglobina e hematócrito em relação ao grupo controle (P<0,001). O índice RDW não diferiu entre os grupos estudados quando foram alocados quanto ao estadiamento ACVIM (P= 0,25), quanto à presença de ICC (P= 0,146), ou de remodelamento cardíaco (P=0,078). Quanto à CRP, os grupos C e D (C: 2.251 ng/dL, 962,05-5.292,5 ng/dL e D: 3.628,4 ng/dL, 4.1592,3-6.254,5 ng/dL) apresentaram concentração maior que o grupo controle (1.685,5 ng/dL, 1.045,45-3.795,5 ng/dL). Quanto ao estadiamento da DVDCM os grupos diferiram entre si (P=0,014) porém, não foi possível identificar quais grupos apresentaram diferença. O grupo com ICC (2.939,7-1.304,25-5.908,8 ng/dL) apresentou maior concentração de CRP em relação ao grupo controle (1.685 ng/dL, 1.1015,45-3.795,5 ng/dL) (P=0,03). O grupo com remodelamento (4.916,66±6.102,14) apresentou maior concentração de CRP em relação ao grupo sem remodelamento (2.510,67±3,26) (P=0,009). Houve correlação positiva fraca entre CRP e número total de leucócitos (r=0,197; P=0,019). Conclui-se que apesar de não ter sido detectada diferença significativa para o RDW houve tendência a valores maiores nos cães com remodelamento comparados aos sem remodelamento. A concentração de CRP foi maior nos cães com remodelamento cardíaco em relação àqueles sem remodelamento e nos cães com ICC em relação aos cães sem ICC e àqueles de raças predispostas, mas sem alterações cardíacas. A dosagem sérica de CRP juntamente com outros marcadores e exames complementares já utilizados rotineiramente, poderá ser útil na avaliação e acompanhamento de pacientes portadores de DVDCMRDW is a hematological index used for anisocytosis quantitative assesment, and useful to diferenciate anemic states. In human medicine, it has been considered an important prognostic factor in heart failure (HF), even in the absence of anemia. CRP is considered the main acute phase protein, and it is widely used as a marker of inflammation. An exploratory prospective cross sectional study was conducted aiming to determine whether there is a difference in RDW and CRP concentration in dogs with chronic degenerative mitral valve disease (CDMVD) with and without HF, presence of remodeling, as well as between the different disease stages (A, B1, B2, C e D - ACVIM), compared to dogs of predisposed breeds, but without heart disease. For this study, 141 dogs, up to 20kg, males and females were distributed in groups in order to achieve the main golas. Dogs with and without HF presented smaller number of red blood cells, hemoglobin and hematocrit compared to control group (P<0.001). RDW was not diferente between groups for CDMVD stages (P= 0.25), regarding HF presence (P= 0.146), or cardiac remodeling (P=0.078). Groups C and D (C: 2,251 ng/dL, 962.05-5,292.5 ng/dL e D: 3,628.4 ng/dL, 4,1592.3-6,254.5 ng/dL) presented higher CRP concentration compared to control (1,685.5 ng/dL, 1,045.45-3,795.5 ng/dL). There was a difference in CRP concentration between groups, however, it was not possible to identify the differing groups (P=0.014). CRP concentration was higher in HF group (2,939.7-1,304.25-5,908.8 ng/dL) compared to control (1,685 ng/dL, 1,1015.45-3,795.5 ng/dL) (P=0.03). CRP concentration was higher in cardiac remodeling group (4,916.66±6,102.14) in relation to the group without remodeling (2,510.67±3.26) (P=0.009). There was a weak positive correlation between CRP and total leucocyte count (r=0.197; P=0.019). We conclude that although we could not identify a significative difference for RDW, there was a tendency to increased values in dogs with cardiac remodeling. CRP concentration was higher in cardiac remodeling group and in HF group compared to control. CRP serum together with other markers and auxiliary exames already routinely used may provide useful information for assessment and follow up of dogs with CDMV