Utilization of automated external defibrillators installed in commonly used areas of Japanese hospitals

Objective. Since July 2004, it has become legal in Japan for laypersons to use automated external defibrillators (AEDs). We investigated the effect of AED installation in commonly used areas of Japanese Association for Acute Medicine accredited training (JAAM) hospitals. Methods. In 2008, we sent questionnaires to 419 JAAM hospitals enquiring about the systems, operations, outcome and characteristics of AED usage. Results. Valid responses were received from 271 hospitals (64.7%). A total of 251 (92.8%) hospitals installed AEDs, mostly in the outpatient departments. These AEDs could also be used by laypersons. Operational responsibility was mostly assumed by the medical emergency center staff. The Engineering Department was in charge of AED maintenance. Of the surveyed hospitals, 65.5% reported having guidelines for usage. The percentages of hospitals which kept records of AED use and outcomes were low. A total of 66.2% reported having a rapid response team and 98.1% provided a non-standardized resuscitation education program. In 68.3% of hospitals, an AED had been used. AEDs were used not only by medical doctors but also by other health professionals. Among the patients who received AED defibrillation, 42.5% survived without neurological deficit. Conclusion. The utilization of AEDs, installed in commonly used areas of JAAM hospitals, has shown beneficial and effective outcomes for improving the resuscitation and survival of patients who experience in-hospital cardiac arrest. AEDs can be used not only by doctors but also by laypersons, making them more accessible and useful. The strategic installation of AEDs can make hospitals safer

Principle and clinical usefulness of the infrared fluorescence endoscopy

Since there is no infrared fluorescence materials in the living body, infrared fluorescence labeling materials are very useful for making a diagnosis of a micro cancer. We have developed an infrared fluorescence endoscope (IRFE) and indocyanin green (ICG)-derivative as infrared fluorescence labeling materials to evaluate gastrointestinal neoplastic lesions. The study aims were to apply an IRFE and to demonstrate its usefulness in detecting cancerous tissue using an antibody coupled with ICG-derivative. IRFE consisted of an infrared endoscope equipped with excitation (710-790nm) and barrier (810-920nm) filters and an intensified CCD camera. We have developed ICG N-hydroxy sulfo succinimide ester (ICG-sulfo-OSu) and 3-ICG-acyl-1, 3-thiazolidine-2-thione (ICG-ATT) as an infrared fluorescent-labeling reagent. ICG-derivative-labeled mouse anti-human carcinoembryonic antigen (CEA)antibodyandMUC1 antibody were employed in this study. Moreover, we examined the ability of a reinforcement agent, octylglucoside, to intensity fluorescence from the labeled antibody. Biopsy specimens of gastric cancer were stained with anti-CEA antibody by the avidin-biotinylated peroxidase complex method. Among the positive specimens, freshly resected stomach from three cases were used for the infrared (IR) imaging analysis. The incubation of freshly resected stomach specimens with ICG-anti-CEA antibody-complex resulted in positive staining of the tumor sites by IRFE, and the IR fluorescent images correlated well with the tumor sites. The immunohistochemical studies suggested that the intensity of IR fluorescence of ICG-ATT-MUC1was stronger than that of ICG-sulfo-OSu. In tumor sections, the reinforcement agent intensified fluorescence, ever at low antibody concentrations. Therefore, we conclude that an anti-CEA (and/orMUC1) antibody with affinity for cancerous lesions and labeled with ICG-derivative can be imaged with this IRFE. Specific antibodies tagged with ICG-derivative with the reinforcement agent can label cancer cells and generate a strong enough fluorescent signal to detect small cancers when examined with an IR fluorescence endoscope

Optimal labeling condition of antibodies available for immunofluorescence endoscopy

Purpose: In recent years, labeled antibodies have been used for diagnostic imaging in many studies. In this study, we investigated the mode of binding in antibodies labeled with ICG derivatives newly developed for the diagnosis of microcarcinomas, and evaluated the optimal binding molar ratio between the labeling compounds and antibody. Methods: MUC1 antibody and ICG derivatives (ICG-ATT and ICG-sulfo-OSu) were used. ICG derivatives noncovalently bound to the antibody were removed with ethyl acetate, and the ratio of ICG derivatives covalently bound to the labeled antibody was confirmed. During purification of the labeled antibody, the amount of each labeling compound reacting with 1molecule of the antibody varied as follows: 4, 8, 16, and 32molar equivalents. Subsequently, the intensity of fluorescence was evaluated by spectroscopy and infrared fluoroscopy. Results : The ratio of residual ICG derivative labeling the antibody was 67.4% for ICG-ATT and 65.0% for ICG-sulfo-OSu. When fluorescent antibody labeled with ICG-ATT at anF/Pratio of 2.94or 4.18wasused, specific and clear fluorescent images of the antigen were obtained. When ICG-ATT-labeled antibody at an F/P ratio of 6.50 or 6.75 was used, the fluorescence intensity decreased and the fluorescent images of antigen became unclear. Conclusions: It was found that the ICG-ATT-labeled antibody was a more specific and sensitive marker than ICG-sulfo-OSu-labeled antibody, and that lower binding molar ratios of ICG-ATT were more useful for labeling the antibody

HSP47 levels determine the degree of body adiposity

Shin J., Toyoda S., Okuno Y., et al. HSP47 levels determine the degree of body adiposity. Nature Communications 14, 7319 (2023); https://doi.org/10.1038/s41467-023-43080-x.Adiposity varies among individuals with the influence of diverse physiological, pathological, environmental, hormonal, and genetic factors, but a unified molecular basis remains elusive. Here, we identify HSP47, a collagen-specific chaperone, as a key determinant of body adiposity. HSP47 expression is abundant in adipose tissue; increased with feeding, overeating, and obesity; decreased with fasting, exercise, calorie restriction, bariatric surgery, and cachexia; and correlated with fat mass, BMI, waist, and hip circumferences. Insulin and glucocorticoids, respectively, up- and down-regulate HSP47 expression. In humans, the increase of HSP47 gene expression by its intron or synonymous variants is associated with higher body adiposity traits. In mice, the adipose-specific knockout or pharmacological inhibition of HSP47 leads to lower body adiposity compared to the control. Mechanistically, HSP47 promotes collagen dynamics in the folding, secretion, and interaction with integrin, which activates FAK signaling and preserves PPARγ protein from proteasomal degradation, partly related to MDM2. The study highlights the significance of HSP47 in determining the amount of body fat individually and under various circumstances

EMPRESS. XI. SDSS and JWST Search for Local and z~4-5 Extremely Metal-Poor Galaxies (EMPGs): Clustering and Chemical Properties of Local EMPGs

We search for local extremely metal-poor galaxies (EMPGs), selecting photometric candidates by broadband color excess and machine-learning techniques with the SDSS photometric data. After removing stellar contaminants by shallow spectroscopy with Seimei and Nayuta telescopes, we confirm that three candidates are EMPGs with 0.05--0.1 $Z_\odot$ by deep Magellan/MagE spectroscopy for faint {\sc[Oiii]}$\lambda$4363 lines. Using a statistical sample consisting of 105 spectroscopically-confirmed EMPGs taken from our study and the literature, we calculate cross-correlation function (CCF) of the EMPGs and all SDSS galaxies to quantify environments of EMPGs. Comparing another CCF of all SDSS galaxies and comparison SDSS galaxies in the same stellar mass range ($10^{7.0}-10^{8.4} M_\odot$), we find no significant ($>1\sigma$) difference between these two CCFs. We also compare mass-metallicity relations (MZRs) of the EMPGs and those of galaxies at $z\sim$ 0--4 with a steady chemical evolution model and find that the EMPG MZR is comparable with the model prediction on average. These clustering and chemical properties of EMPGs are explained by a scenario of stochastic metal-poor gas accretion on metal-rich galaxies showing metal-poor star formation. Extending the broadband color-excess technique to a high-$z$ EMPG search, we select 17 candidates of $z\sim$ 4--5 EMPGs with the deep ($\simeq30$ mag) near-infrared JWST/NIRCam images obtained by ERO and ERS programs. We find galaxy candidates with negligible {\sc[Oiii]}$\lambda\lambda$4959,5007 emission weaker than the local EMPGs and known high-$z$ galaxies, suggesting that some of these candidates may fall in 0--0.01 $Z_\odot$, which potentially break the lowest metallicity limit known to date

Comparison of Remifentanil and Landiolol on Hemodynamic and Plasma Catecholamine Responses to Tracheal Intubation

The purpose of this study is to compare remifentanil with landiolol to examine the effects of hemodynamic and plasma catecholamine responses to tracheal intubation. Sixty patients scheduled for elective surgery were randomly divided into three groups, to receive either normal saline( group C), a 1-minute loading infusion of remifentanil 0.5 m g/kg followed by an infusion of remifentanil 0.25/m g/kg/min during the study(group R), or a 1-minute loading infusion of landiolol 0.125 mg/kg followed by an infusion of landiolol0.04 mg/kg/min during the study (group L). After the 1-minute loading infusion of each drug, anesthesia was induced with intravenous injection of propofol 2 mg/kg, and vecuronium 0.1 mg/kg. Five minutes after the administration of each drug, tracheal intubation was performed within 30 seconds. Mean arterial pressure remained below the baseline value after tracheal intubation in group R, but not in groups L and C.Heart rate significantly increased after tracheal intubation in group C, but not in groups R and L. Plasma concentration of adrenaline remained below the baseline value after tracheal intubation in all groups, but it was significantly lower in group R, compared with other groups. Plasma concentration of noradrenaline significantlyincreased after tracheal intubation in groups L and C, but not in group R. Bispectral index in group R remained lower than that in groups L and C after tracheal intubation. Remifentanil may be preferableto landiolol to provide cardiovascular stability after tracheal intubation

ALMA 26 Arcmin2^{2} Survey of GOODS-S at One-millimeter (ASAGAO): Average Morphology of High-zz Dusty Star-Forming Galaxies is an Exponential-Disk (n≃1n \simeq 1)

We present morphological properties of dusty star-forming galaxies at z=1-3 determined with high-resolution (FWHM~0"19) Atacama Large Milllimeter/submilimeter Array (ALMA) 1-mm band maps of our ASAGAO survey covering a 26-arcmin^2 area in GOODS-S. In conjunction with the ALMA archival data, the present sample consists of 42 ALMA sources with a wide rest-frame far-infrared (FIR) luminosity L_FIR range of ~10^11-10^13 Lo. To obtain an average rest-frame FIR profile, we perform individual measurements and careful stacking of the ALMA sources using the uv-visibility method that includes positional-uncertainty and smoothing-effect evaluations through Monte-Carlo simulations. We find that the dusty star-forming galaxies have the average FIR-wavelength Sersic index and effective radius of n_FIR=1.2+/-0.2 and R_e,FIR=1.0-1.3 kpc, respectively, additionally with a point source at the center, indicative of the existence of AGN. The average FIR profile agrees with a morphology of an exponential-disk clearly distinguished from a spheroidal profile (Sersic index of 4). We also examine the rest-frame optical Sersic index n_opt and effective radius R_e,opt with the deep Hubble Space Telescope (HST) images. Interestingly, we obtain n_opt=0.9+/-0.3 (~n_FIR) and R_e,opt=3.2+/-0.6 kpc (>R_e,FIR), suggesting that the FIR-emitting disk is embedded within a larger stellar disk. The rest-frame UV and FIR data of HST and ALMA provide us a radial surface density profile of the total star-formation rate (SFR), where the FIR SFR dominates over the UV SFR at the center. Under the simple assumption of a constant SFR, a compact stellar distribution found in z~1-2 compact quiescent galaxies (cQGs) is well reproduced, while a spheroidal stellar morphology of cQGs (n_opt=4) cannot, suggestive of other important mechanisms such as dynamical dissipation.Comment: 13 pages, 6 figures, ApJ in pres