The Significance of Gastric Juice Analysis for a Positive Challenge by a Standard Oral Challenge Test in Typical Cow's Milk Protein-Induced Enterocolitis

This study was performed to investigate the significance of gastric juice analysis (GJA) as a diagnostic criterion of a positive challenge in a standard oral cow's milk challenge (OCC) to confirm typical cow's milk protein-induced enterocolitis (CMPIE). Data from 16 CMPIE patients (aged 14 to 44 days) were analyzed. A standard OCC was openly executed using 0.15 g/kg of protein. Three symptoms (vomiting, lethargy, and bloody or pus-like stool), and four laboratory findings (GJA [3 hr], changes in peripheral blood absolute neutrophil count [ANC] [6 hr], C-reactive protein [6 hr], and stool smear test for occult blood or leukocytes) were observed after OCC. Before OCC, baseline studies were conducted; a stool smear test, blood sampling, and GJA. Positive OCC results were; vomiting (87.5%) (observed 1-3 hr after OCC), lethargy (62.5%) (1-3 hr), bloody or pus-like stool (43.8%) (6-10 hr), abnormal GJA (93.8%), an ANC rise >3,500 cells/µL (93.8%), and an abnormal stool smear test (75.0%). A single GJA test after a standard OCC is a sensitive diagnostic criterion of a positive challenge, and may provide an early confirmatory diagnosis of CMPIE. An investigation of positive OCC outcomes helps to find out a diagnostic algorithm of criteria of a positive challenge in CMPIE

Effect of neck extension on the advancement of tracheal tubes from the nasal cavity to the oropharynx in nasotracheal intubation: a randomized controlled trial

Background Clinicians sometimes encounter resistance in advancing a tracheal tube, which is inserted via a nostril, from the nasal cavity into the oropharynx during nasotracheal intubation. The purpose of this study was to investigate the effect of neck extension on the advancement of tracheal tubes from the nasal cavity into the oropharynx during nasotracheal intubation. Methods Patients were randomized to the neck extension group (E group) or neutral position group (N group) for this randomized controlled trial. After induction of anesthesia, a nasal RAE tube was inserted via a nostril. For the E group, an anesthesiologist advanced the tube from the nasal cavity into the oropharynx with the patients neck extended. For the N group, an anesthesiologist advanced the tube without neck extension. If the tube was successfully advanced into the oropharynx within two attempts by the same maneuver according to the assigned group, the case was defined as success. We compared the success rate of tube advancement between the two groups. Results Thirty-two patients in the E group and 33 in the N group completed the trial. The success rate of tube passage during the first two attempts was significantly higher in the E group than in the N group (93.8% vs. 60.6%; odds ratio = 9.75, 95% CI = [1.98, 47.94], p = 0.002). Trial registration: ClinicalTrials.gov Identifier NCT03377114, registered on 13 December 2017

Long-Term Outcome of Single-Chamber Atrial Pacing Compared with Dual-Chamber Pacing in Patients with Sinus-Node Dysfunction and Intact Atrioventricular Node Conduction

∙The authors have no financial conflicts of interest. Purpose: The optimal pacing mode with either single chamber atrial pacemaker (AAI or AAIR) or dual chamber pacemaker (DDD or DDDR) is still not clear in sinus-node dysfunction (SND) and intact atrioventricular (AV) conduction. Materials and Methods: Patients who were implanted with permanent pacemaker using AAI(R) (n = 73) or DDD(R) (n = 113) were compared. Results: The baseline characteristics were comparable between the two groups, with a mean follow-up duration of 69 months. The incidence of death did not show statistical difference. However, the incidence of hospitalization for congestive heart failure (CHF) was significantly lower in the AAI(R) group (0%) than the DDD(R) group (8.8%, p = 0.03). Also, atrial fibrillation (AF) was found in 2.8 % in the AAI(R) group, which was statistically different from 15.2 % of patients in the DDD(R) group (p = 0.01). Four patients (5.5%) with AAI(R) developed AV block, and subsequently switched to DDD(R) pacing. The risk of AF was lower in the patients implanted with AAI(R

Long-Term Efficacy of Prophylactic Cavotricuspid Isthmus Ablation during Atrial Fibrillation Ablation in Patients Without Typical Atrial Flutter: a Prospective, Multicentre, Randomized Trial

Background and Objectives: Cavotricuspid isthmus (CTI) block is easily achieved, and prophylactic ablation can be performed during atrial fibrillation (AF) ablation. However, the previous study was too small and short-term to clarify the efficacy of this block. Methods: Patients who underwent catheter ablation for paroxysmal AF were enrolled, and patients who had previous or induced atrial flutter (AFL) were excluded. We randomly assigned 366 patients to pulmonary vein isolation (PVI) only and prophylactic CTI ablation (PVI vs. PVI+CTI). Results: There was no significant difference in procedure time between the two groups because most CTI blocks were performed during the waiting time after the PVI (176.8 +/- 72.6 minutes in PVI vs. 174.2 +/- 76.5 minutes in PVI+CTI, p=0.75). All patients were followed up for at least 18 months, and the median follow-up was 3.4 years. The recurrence rate of AF or AFL was not different in the 2 groups (25.7% in PVI vs. 25.7% in PVI+CTI, p=0.92). The recurrence rate of any AFL was not significantly different in the 2 groups (3.3% in PVI vs. 1.6% in PVI+CTI, p=0.31). The recurrence rate of typical AFL also was not different (0.5%in PVI vs. 0.5% in PVI+CTI, p=0.99). Conclusions: In this large and long-term follow-up study, prophylactic CTI ablation had no benefit in patients with paroxysmal AF without typical AFL.11Nsciescopu

ジデシルジメチルアンモニウム テトラフルオロボレイト ノ ジセダイ モクザイ ホゾンザイ ト シテ ノ ケンショウ

京都大学0048新制・課程博士博士(農学)甲第13096号農博第1601号新制||農||938(附属図書館)学位論文||H19||N4222(農学部図書室)UT51-2007-H369京都大学大学院農学研究科森林科学専攻(主査)教授 今村 祐嗣, 教授 梅澤 俊明, 教授 東 順一学位規則第4条第1項該当Doctor of Agricultural ScienceKyoto UniversityDA

Water absorption of boron-treated and heat-modified wood

Heat treatments change the chemical and physical properties of wood and dimensional stability and hygroscopicity are affected as a result of modifications of wood cell components. This study evaluated the water absorption of wood specimens treated with boron compounds followed by heat treatment. Sugi (Cryptomeria japonica D. Don) sapwood specimens treated with either boric acid (BA) or disodium octoborate tetrahydrate (DOT) solutions were heat-modified at either 180 degrees or 220 degrees C for 2 or 4 h. Carbohydrate composition and water absorption of the specimens were then measured and compared with those of untreated and unheated specimens. Wood carbohydrates were significantly degraded in the specimens after heat treatment. The heat treatment evidently decreased the water absorption and the heat-modified specimens absorbed less water than unheated specimens. The higher the treatment temperature and the longer the treatment time, the lower the amount of absorbed water. The boron-treated and heat-modified specimens, however, showed increased water absorption due to the hygroscopic properties of BA and DOT

Evaluation of effect of leaching medium on the release of copper, chromium, and arsenic from treated wood

There is increasing public concern about environmental contamination from preservative treated wood due to release of toxic preservative components to the environment. Leaching of wood preservatives from treated wood in service can be affected by a number of factors such as wood and preservative treatment characteristics and properties of water and soil substrate in which treated wood is placed i.e. salinity, pH, and temperature. Laboratory leaching tests usually require distilled or deionized water for leaching procedure however treated wood is generally exposed to different types of water and soil conditions. This study evaluates the release of copper, chromium and arsenic elements from chromated copper arsenate (CCA)-treated wood exposed to either distilled water, tap water, sea water or humic acid. Leaching tests were conducted in laboratory conditions using wood blocks treated with CCA wood preservative at either low or high retention levels. Results showed that tap water resulted in less preservative release when compared to the other leaching media used in the study. Humic acid was the most effective medium causing more element leaching. The percentage of components leached was always higher in wood blocks treated at the high retention in comparison with the low retention level. Our results from the leaching tests can be important in developing more realistic standard leaching methods to evaluate preservative components to be released from treated wood. (c) 2006 Elsevier Ltd. All rights reserved