頸動脈狭窄に対する自己拡張型ステント留置後フォローアップ時のステント径と内腔の検討

Purpose: We examined postoperative stent and lumen expansions after carotid artery stenting (CAS) in patients with carotid artery stenosis. Furthermore, we investigated factors influencing the stent and lumen expansions in a follow-up period. Subjects: 134 cases (128 patients) who underwent CAS and performed follow-up cerebral angiography 12 months after CAS were enrolled into this study. The stenosis rate based on the stent and lumen diameters on follow-up angiography as a percentage of that immediately after CAS was evaluated. Results: Both the stent and lumen diameters were significantly dilated 12 months after CAS (p <0.001). There were no significant stent-type-related differences in the stent expansion rate. In the symptomatic stenosis group, this expansion rate was significantly higher than in the asymptomatic stenosis group (p = 0.02). With respect to the presence or absence of a high signal intensity on time of flight (TOF) magnetic resonance (MR) images, the stent expansion rate was significantly higher in the high signal intensity group (p = 0.006). In patients with a plaque/sternocleidomastoid muscle signal intensity ratio of ≥1.50 on plaque images, it was significantly higher than in those with a value of <1.50 (p = 0.006). However, there were no significant differences in the lumen expansion rate among the groups. Conclusion: Both the stent and vascular lumen were dilated 12 months after CAS. Plaque fragility influenced the stent expansion rate; however, there were no significant factor-related differences in the vascular lumen expansion rate.博士（医学）・乙第1414号・平成30年3月15日©2017 The Editorial Committee of Journal of Neuroendovascular Therapy. All rights reserved. This is an open access article distributed under the terms of Creative Commons Attribution License(CC BY-NC-ND 4.0) https://creativecommons.org/licenses/by-nc-nd/4.0/

ニホンザルにおけるロコモーション発達

京都大学0048新制・論文博士博士(理学)乙第10157号論理博第1363号新制||理||1126(附属図書館)UT51-99-M277(主査)教授 石田 英實, 教授 西田 利貞, 教授 米井 脩治学位規則第4条第2項該当Doctor of ScienceKyoto UniversityDA

DECREASE IN THE BODY MASS OF WILD RINGTAILED LEMURS AT BERENTY RESERVE IN MADAGASCAR WITH ENVIRONMENTAL CHANGES

We measured the body mass of 76 (in 2006) and 73 (in 2011) wild ringtailed lemurs (Lemur catta) inhabiting the Berenty Reserve in Madagascar. Compared with the data recorded in 1999 (Koyama et al., 2008), the mean body mass of the adults had decreased significantly. In 2006, the adult females had decreased from 2.27 kg to 1.98 kg, and the adult males from 2.22 kg to 2.03 kg. In 2011, the body mass of both adult males and females was still 1.99 kg. In 2011, the group variations in body mass may have expanded. No sexual difference was observed in body mass, similar to the data from 1999. Despite their reduced body mass, adult females maintained a high birth rate (73.0% annually), but infant mortality was very high (86.2%) from 2006 to 2011. We discuss these phenomena with reference to environmental changes in this reserve

Edoxaban for 12 Months Versus 3 Months in Cancer Patients With Isolated Distal Deep Vein Thrombosis (ONCO DVT study): An Open-label, Multicenter, Randomized Clinical Trial

Background: The optimal duration of anticoagulation therapy for isolated distal deep vein thrombosis (DVT) in patients with cancer is clinically relevant, but the evidence is lacking. The prolonged anticoagulation therapy could have a potential benefit for prevention of thrombotic events, however, it could also increase the risk of bleeding. Methods: In a multicenter, open-label, adjudicator-blinded, randomized clinical trial at 60 institutions in Japan, we randomly assigned cancer patients with isolated distal DVT, in a 1-to-1 ratio, to receive either a 12-month or 3-month edoxaban treatment. The primary endpoint was a composite of a symptomatic recurrent venous thromboembolism (VTE) or VTE-related death at 12 months. The major secondary endpoint was major bleeding at 12 months, according to the criteria of the International Society on Thrombosis and Hemostasis. The primary hypothesis was that a 12-month edoxaban treatment was superior to a 3-month edoxaban treatment with respect to the primary endpoint. Results: From April 2019 through June 2022, 604 patients were randomized, and after excluding 3 patients who withdrew consent, 601 patients were included in the intention-to-treat population: 296 patients in the 12-month edoxaban group and 305 patients in the 3-month edoxaban group. The mean age was 70.8 years, 28% of the patients were men, and 20% of the patients had symptoms of DVT at baseline. The primary endpoint of a symptomatic recurrent VTE event or VTE-related death occurred in 3 of the 296 patients (1.0%) in the 12-month edoxaban group and in 22 of the 305 (7.2%) in the 3-month edoxaban group (odds ratio, 0.13; 95% CI, 0.03 to 0.44). The major secondary endpoint of major bleeding occurred in 28 of the 296 patients (9.5%) in the 12-month edoxaban group and in 22 of the 305 (7.2%) in the 3-month edoxaban group (odds ratio, 1.34; 95% CI, 0.75 to 2.41). The prespecified subgroups did not affect the estimates on the primary endpoint. Conclusions: In cancer patients with isolated distal DVT, 12 months was superior to 3 months for an edoxaban treatment with respect to the composite outcome of a symptomatic recurrent VTE or VTE-related death

Edoxaban for 12 Months Versus 3 Months in Cancer Patients With Isolated Distal Deep Vein Thrombosis (ONCO DVT study): An Open-label, Multicenter, Randomized Clinical Trial

Background: The optimal duration of anticoagulation therapy for isolated distal deep vein thrombosis (DVT) in patients with cancer is clinically relevant, but the evidence is lacking. The prolonged anticoagulation therapy could have a potential benefit for prevention of thrombotic events, however, it could also increase the risk of bleeding. Methods: In a multicenter, open-label, adjudicator-blinded, randomized clinical trial at 60 institutions in Japan, we randomly assigned cancer patients with isolated distal DVT, in a 1-to-1 ratio, to receive either a 12-month or 3-month edoxaban treatment. The primary endpoint was a composite of a symptomatic recurrent venous thromboembolism (VTE) or VTE-related death at 12 months. The major secondary endpoint was major bleeding at 12 months, according to the criteria of the International Society on Thrombosis and Hemostasis. The primary hypothesis was that a 12-month edoxaban treatment was superior to a 3-month edoxaban treatment with respect to the primary endpoint. Results: From April 2019 through June 2022, 604 patients were randomized, and after excluding 3 patients who withdrew consent, 601 patients were included in the intention-to-treat population: 296 patients in the 12-month edoxaban group and 305 patients in the 3-month edoxaban group. The mean age was 70.8 years, 28% of the patients were men, and 20% of the patients had symptoms of DVT at baseline. The primary endpoint of a symptomatic recurrent VTE event or VTE-related death occurred in 3 of the 296 patients (1.0%) in the 12-month edoxaban group and in 22 of the 305 (7.2%) in the 3-month edoxaban group (odds ratio, 0.13; 95% CI, 0.03 to 0.44). The major secondary endpoint of major bleeding occurred in 28 of the 296 patients (9.5%) in the 12-month edoxaban group and in 22 of the 305 (7.2%) in the 3-month edoxaban group (odds ratio, 1.34; 95% CI, 0.75 to 2.41). The prespecified subgroups did not affect the estimates on the primary endpoint. Conclusions: In cancer patients with isolated distal DVT, 12 months was superior to 3 months for an edoxaban treatment with respect to the composite outcome of a symptomatic recurrent VTE or VTE-related death