Feasibility study of immediate pharyngeal cooling initiation in cardiac arrest patients after arrival at the emergency room

AIM: Cooling the pharynx and upper oesophagus would be more advantageous for rapid induction of therapeutic hypothermia since the carotid arteries run in their vicinity. The aim of this study was to determine the effects of pharyngeal cooling on brain temperature and the safety and feasibility for patients under resuscitation. METHODS: Witnessed non-traumatic cardiac arrest patients (n=108) were randomized to receive standard care with (n=53) or without pharyngeal cooling (n=55). In the emergency room, pharyngeal cooling was initiated before or shortly after return of spontaneous circulation by perfusing physiological saline (5 °C) into a pharyngeal cuff for 120 min. RESULTS: There was a significant decrease in tympanic temperature at 40 min after arrival (P=0.02) with a maximum difference between the groups at 120 min (32.9 ± 1.2°C, pharyngeal cooling group vs. 34.1 ± 1.3°C, control group; P<0.001). The return of spontaneous circulation (70% vs. 65%, P=0.63) and rearrest (38% vs. 47%, P=0.45) rates were not significantly different based on the initiation of pharyngeal cooling. No post-treatment mechanical or cold-related injury was observed on the pharyngeal epithelium by macroscopic observation. The thrombocytopaenia incidence was lower in the pharyngeal cooling group (P=0.001) during the 3-day period after arrival. The cumulative survival rate at 1 month was not significantly different between the two groups. CONCLUSIONS: Initiation of pharyngeal cooling before or immediately after the return of spontaneous circulation is safe and feasible. Pharyngeal cooling can rapidly decrease tympanic temperature without adverse effects on circulation or the pharyngeal epithelium

A nine-year clinical case study of a resin-bonded fixed partial denture seated on the maxillary anterior teeth.

PATIENT: This report describes the longevity of a resin-bonded fixed partial denture (RBFPD). This denture was seated on the maxillary anterior teeth with minimal tooth preparation. The RBFPD was cast from a silver-palladium alloy (Castwell M.C. 12), and the pontic was veneered with an indirect composite material (Estenia). The retainers were primed with a metal conditioner (V-Primer) and seated with a tri-n-butylborane initiated adhesive resin (Super-Bond C&B). After an observation period of eight years, a fracture occurred in the incisal edge of the central incisor abutment. The fractured area was restored with light-polymerizing composite resin and the anterior guidance was re-adjusted. DISCUSSION: RBFPD abutment teeth with deep vertical overlap should be carefully prepared to avoid abutment tooth fracture. CONCLUSION: The clinical performance of the RBFPD made from a silver-palladium-copper-gold alloy was sufficient when seated with tri-n-butylborane initiated adhesive resin after surface modification using vinyl-thiol primer. CLINICAL SIGNIFICANCE: The use of vinyl-thiol primer and tri-n-butylborane initiated adhesive resin is a clinically reliable bonding system for seating resin-bonded fixed partial denture (RBFPD) made from a silver-palladium-copper-gold alloy. The RBFPD, based on a reliable bonding system, can clinically function for a long time, even if the vertical overlap of the abutment teeth is excessive

Deep internal tides near steep topographies southeast of Kyushu, Japan observed by the lowered acoustic Doppler current profiler (LADCP)

Abstract AOGS/AGU (WPGM) Joint Assembly at Singapore, 13-17 August, 201

A Multicenter Phase 2 Trial Evaluating the Efficacy and Safety of Preoperative Lenvatinib Therapy for Patients with Advanced Hepatocellular Carcinoma (LENS-HCC Trial)

Introduction: The phase III REFLECT trial demonstrated that lenvatinib was superior to sorafenib in terms of progression-free survival (PFS), time to progression, and objective response rate (ORR) for patients with unresectable hepatocellular carcinoma (HCC). This study assessed the efficacy and safety of preoperative lenvatinib therapy for patients with oncologically or technically unresectable HCC. Methods: In this multicenter single-arm phase II trial, patients with advanced HCC and factors suggestive of a poor prognosis (macroscopic vascular invasion, extrahepatic metastasis, or multinodular tumors) were enrolled. Patients with these factors, even with technically resectable HCC, were defined as oncologically unresectable because of the expected poor prognosis after surgery. After 8 weeks of lenvatinib therapy, the patients were assessed for resectability, and tumor resection was performed if the tumor was considered technically resectable. The primary endpoint was the surgical resection rate. The secondary endpoints were the macroscopic curative resection rate, overall survival (OS), ORR, PFS, and the change in the indocyanine green retention rate at 15 min as measured before and after lenvatinib therapy. The trial was registered with the Japan Registry of Clinical Trials (s031190057). Results: Between July 2019 and January 2021, 49 patients (42 oncologically unresectable patients and 7 technically unresectable patients) from 11 centers were enrolled. The ORR was 37.5% based on mRECIST and 12.5% based on RECIST version 1.1. Thirty-three patients underwent surgery (surgical resection rate: 67.3%) without perioperative mortality. The surgical resection rate was 76.2% for oncologically unresectable patients and 14.3% for technically unresectable patients. The 1-year OS rate and median PFS were 75.9% and 7.2 months, respectively, with a median follow-up period of 9.3 months. Conclusions: The relatively high surgical resection rate seen in this study suggests the safety and feasibility of lenvatinib therapy followed by surgical resection for patients with oncologically or technically unresectable HCC

The ASTRO-H X-ray Observatory

The joint JAXA/NASA ASTRO-H mission is the sixth in a series of highly successful X-ray missions initiated by the Institute of Space and Astronautical Science (ISAS). ASTRO-H will investigate the physics of the high-energy universe via a suite of four instruments, covering a very wide energy range, from 0.3 keV to 600 keV. These instruments include a high-resolution, high-throughput spectrometer sensitive over 0.3-2 keV with high spectral resolution of Delta E < 7 eV, enabled by a micro-calorimeter array located in the focal plane of thin-foil X-ray optics; hard X-ray imaging spectrometers covering 5-80 keV, located in the focal plane of multilayer-coated, focusing hard X-ray mirrors; a wide-field imaging spectrometer sensitive over 0.4-12 keV, with an X-ray CCD camera in the focal plane of a soft X-ray telescope; and a non-focusing Compton-camera type soft gamma-ray detector, sensitive in the 40-600 keV band. The simultaneous broad bandpass, coupled with high spectral resolution, will enable the pursuit of a wide variety of important science themes.Comment: 22 pages, 17 figures, Proceedings of the SPIE Astronomical Instrumentation "Space Telescopes and Instrumentation 2012: Ultraviolet to Gamma Ray

インソールが片脚着地の床反力の側方成分に与える影響

着地動作は多くのスポーツ障害の要因となる動作の一つである。着地の瞬間に足から全身に衝撃が加わり、その衝撃は床反力から算出することができる。着地の際の床反力を減少させる可能性のある装具として、インソールがあり、実際にインソールを装着することによって床反力の垂直成分が減少することが知られている。他方、床反力の側方成分は左右への衝撃を示す。しかしながらインソールを装着することで床反力の側方成分が減少するかどうかは明らかとなっていない。そこで本研究ではインソールが着地の瞬間の床反力の側方成分に与える影響を検証した。対象は健常な大学生9名とした。対象者には前方に床反力計のある30センチ台上に立たせ、着地させた。着地の条件はインソールあり、なしの2条件で各5回実施させた。各条件は被験者ごとにランダムに実施させた。床反力計から着地直後200msecにおける床反力の垂直成分最大値と外側成分最大値、内側成分最大値を算出した。被験者ごとの条件別の平均値を算出し、2条件間を比較した。また外側成分における荷重変化率を算出し、外側成分最大値との相関関係を検証した。有意水準は5%とした。インソールあり条件にて外側成分最大値は有意に減少した。内側成分最大値は有意に増加した。また外側成分最大値と外側成分荷重変化率は正の相関関係を認めた。インンソールは着地の側方成分を減少させることが明らかとなった。またこの作用にはインソールによる衝撃吸収能が関与している可能性が示唆された。This study was designed to determine whether the use of shoes with insoles changed in ground reaction force during drop jump landing in healthy subjects. Nine subjects performed single leg jumps onto a force platform at a self-selected pace for five trials with and without insoles, and ground reaction forces, were recorded. Magnitudes of forces during the first 200 ms following impact were analysed and compared between with and without insoles. The use of shoes with insoles significantly decreased the lateral force peaks, and increased medial force peaks. The use of shoes with insoles reduce impact forces in healthy subjects. These results suggest that may contribute to disorder prevention by a reduction of impact force while using insoles

高校における部活動内での傷害調査 : 四條畷学園大学リハビリテーション総合研究所の活動報告

四條畷学園大学内にあるリハビリテーション総合研究所ではアスリートサポート相談会(athlete support consultation以下、ASC)を実施している。ASCにおける開設当初の調査が可能であった2005年1月から2014年12月までのASCの利用者の実態について調査・検討を行った。その結果、6月と9月に相談件数が多かった。また、陸上部は下腿と足関節の相談でほぼ過半数を占め、バスケットボール部は足関節が54.1%と多かった。これに対し、水泳部は肩関節が56.1%と多い傾向であった。この結果から、春期を迎える前や長期休業に入る前に、セルフコンディショニングやトレーニングの指導を実施すること、競技特性に合わせたフィジカルチェックを実施する必要性が示唆された。The purpose of this study is to investigate the actual situation of Comprehensive Rehabilitation center in Shijonawate Gakuen University. Subjects were total number of users of the center from January 2005 to December 2014. Survey items are the total number of user number, the number of users per day, belonging club, the affected body part and the medical consultation. Number of the user was greater in June and September. In addition, the affected body parts were closely related with features of the belong club. Therefore, the content of guidance for self-conditioning and training are important before spring and the long-term holiday. The physical examination for each club member will lead to the prevention of injury

Demographic and Clinical Characteristics of Patients with Severe Asthma in the Asian Pacific Region : data from the International Severe Asthma Registry (ISAR)

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