Journal of The Showa University Society
Online ISSN : 2188-529X
Print ISSN : 2187-719X
ISSN-L : 2187-719X
Volume 74, Issue 1
Feature Articles: Less Invasive Therapy for Adult Cardiac Aortic and Vascular Surgery
Displaying 1-17 of 17 articles from this issue
Feature Articles: Less Invasive Therapy for Adult Cardiac Aortic and Vascular Surgery
Invited Review
Special Lecture
Educational Material
Original
  • Ai TAYAMA, Hiromasa YAMASHITA, Tomoo SATO, Gontaro KITAZUMI, Toshio CH ...
    2014Volume 74Issue 1 Pages 60-66
    Published: 2014
    Released on J-STAGE: September 27, 2014
    JOURNAL FREE ACCESS
    The importance of compact-size medical equipment which is capable of wireless monitoring of human patients to evaluate their clinical condition has been growing in recent years. To achieve this goal, we have been striving to develop an earphone-type small and wireless sensor which could enable non-invasive measurement of human vital signs, including heart rates. We developed such a sensor, and compared its precision with a conventional monitor in our study. Using anesthesized rabbits (white Japanese cross-bred female rabbits, weighing approximately 3kg) with the earphone sensors mounted on their external auditory canal, we evaluated their heart rate by measuring the changes in pressure as well as the vibratory dynamics within the canal. The heartbeat and pressure changes could be obtained as heart pressure signals within a range of approximately 2Hz to 20Hz by means of sealing the canal using our earphone sensors. Theoretically, the heart pressure signals are thought to represent the small changes in pressure generated from the ear drum and the ear canal in association with their heartbeat. The rabbits underwent general anesthesia and a conventional monitor or the earphone-type sensor was mounted on the rabbits in our experiments. Subsequently, the rabbits were placed in an environment with a progressively reduced oxygen concentration (reduced by 5% every 10minutes); thereafter, the heart rate results based on both sensors were compared for reference. Our earphone-type sensor was capable of measuring the heart rate by analyzing the heart pressure signals based on a data processing program. The data obtained by the earphone-type sensor could be successfully validated by these animal experiments. When the heart rate values were plotted with the data obtained by conventional monitors on the horizontal axis and the data by the earphone-type sensor on the vertical axis, both data showed statistically significant relationships. When the heart rate was changed by decreasing the oxygen concentration, the root mean squared error of more than 5% oxygen concentration was less than 11. The earphone-type vital sign (heart rate) sensor is definitely useful in terms of its tiny size, wireless and non-invasive nature and its measurement accuracy as well.
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  • Masayuki MAEDA, Yuji OTO, Jun-Ichiro MURAYAMA, Atsuko MINEMURA, Toshiy ...
    2014Volume 74Issue 1 Pages 67-72
    Published: 2014
    Released on J-STAGE: September 27, 2014
    JOURNAL FREE ACCESS
    To study the risk factors for antibiotic selective pressure in carbapenem-treated patients, we analyzed the data for inpatients at Showa University Hospital, Tokyo, Japan. We performed univariate and multivariate analysis of two risk factors: patient background information and amount of antibiotic used in carbapenem-treatment patients with or without carbapenem-resistant organisms. Multiple logistic regression analysis was performed for factors with P < 0.20 in the univariate analysis. Multivariate analysis showed significant differences with three variables: age > 70 years, hospital inpatient days, and hemodialysis. These results suggest that appropriate antibiotic use and infection control are important for the management of antibiotic-resistant organisms in carbapenem-treated patients. In addition, there was no significant difference between the antibiotic quantitative factors and carbapenem-resistant organism detection. Therefore, when evaluating the correlation between detection of antibiotic-resistant bacteria and usage of antibiotics in hospitals, it is necessary to pay attention to the interpretation of results.
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  • Haruka EMORI, Kakei RYU, Katsuji OGUCHI, Shinichi IWAI, Hitoshi AMANO
    2014Volume 74Issue 1 Pages 73-80
    Published: 2014
    Released on J-STAGE: September 27, 2014
    JOURNAL FREE ACCESS
    The decrease in bone density occurs by the increase in bone resorption, due to the breakdown in the balance of resorption of bone by osteoclasts dissolving and bone formation by osteoblasts. Osteoporosis is a representative disease caused by the decrease in the bone density. Therefore, osteoclasts are one of the important target cells for the treatment of osteoporosis. Recently, a real-time cellular analysis system (RTCA) was developed to analyze the quantity of cytomorphology and the cell adhesion in vitro by measuring the electronic impedance (Cell Index; CI) of the electrode in a plate. To date, there was no report on the use of RTCA for osteoclast differentiation until our report. Therefore, we thought that RTCA is useful for the screening of therapeutic drugs for osteoporosis. We reported inhibition of osteoclast differentiation by epigallocatechin gallate (EGCG). In this study, we attempted to quantify the inhibitory effect of EGCG for osteoclast differentiation using a new method. We have taken bone marrow cells from femur and tibia bone of male mice (5-8 weeks of age). We cultured bone marrow cells of 1.0 × 105 cells/well. We added EGCG to culture media of bone marrow cells in 1µM, 10µM and 100µM with CO2 incubator and induced osteoclasts. We cultured osteoclasts for 188 hours in total, and exchanged the culture media and added EGCG after 24 and 72 hours. We counted the cells for osteoclasts which appeared as tartrate-resistant acid phosphatase (TRAP)-positive and had three or more nuclei. The multinuclear osteoclast number by TRAP staining and the CI level were inhibited concentration dependent by EGCG. Furthermore, the CI level and the multinuclear osteoclast number had a strong correlation. In addition, we found that 1µM EGCG of low-concentration inhibited the osteoclast differentiation. There is a report that the highest plasma concentration of EGCG becomes 2µM by drinking one cup of green tea (400mg of catechin components). Therefore, it is strongly suggested that EGCG has an osteoporosis prophylaxis effect. RTCA does not require the staining and the measurement is possible sequentially. RTCA is relatively simple and easy, and the screening of drugs for osteoclasts is enabled. It is suggested that this RTCA system might be useful to determine the appropriate level and the site of action of osteoporotic therapeutic drugs.
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  • Naohiro YAMADA, Hitome KOBAYASHI, Kenichiro IKEDA, Yoshiyuki KYO, Atsu ...
    2014Volume 74Issue 1 Pages 81-90
    Published: 2014
    Released on J-STAGE: September 27, 2014
    JOURNAL FREE ACCESS
    There are many cases of children with cleft palate (CP) who develop intractable otitis media with effusion (OME). Consequently, long-term ventilation tube (VT) placement is necessary for OME in children with CP. However, the appropriate duration of VT placement for OME in children with CP has not been determined. In this study, we investigated the appropriate duration of VT placement based on the results of treatment in children with CP. We were able to observe 206 cases (412 ears) in subjects aged up to 6 years old undergoing palatoplasty at Showa University Hospital between January 2001 and December 2004. VT placement was performed in 93 cases (179 of 412 ears; 45.1%). From the results of clinical course of treatment of OME, we determined that the best result was observed when patients underwent palatoplasty and VT placement simultaneously with a VT placement period of 37 - 42 months. In patients with VT placement after palatoplasty, the VT placement period should be shorter.
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Case Report
  • Yojiro KAWAMURA, Yuko SHIMOTATARA, Taisuke NAKAMURA, Yoichi IKENOYA, T ...
    2014Volume 74Issue 1 Pages 91-95
    Published: 2014
    Released on J-STAGE: September 27, 2014
    JOURNAL FREE ACCESS
    Despite its relatively rare occurrence, mycosis of the larynx developed in an 81-year-old woman with a number of risk factors, including long-term administration of antibiotics, advanced age, xerostomia, and dentures. Topical treatment provided as an initial local treatment was ineffective, and deep-seated mycosis was subsequently diagnosed based on thickening of the vocal cords. After unsuccessful treatment with itraconazole, oral administration of fluconazole improved the patient's symptoms. Mycosis of the larynx can cause airway obstruction if treatment efficacy is not satisfactory. Therefore, it is necessary to determine whether mycosis is superficial or deep-seated and to select antifungal drugs on the basis of drug tissue distribution and drug susceptibility.
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  • Koji OTSUKA, Masahiko MURAKAMI, Tomotake ARIYOSHI, Masahiro KOHMOTO, R ...
    2014Volume 74Issue 1 Pages 96-102
    Published: 2014
    Released on J-STAGE: September 27, 2014
    JOURNAL FREE ACCESS
    A 46-year-old woman with abdominal pain, left shoulder pain, and dyspnea after vomiting was diagnosed with Boerhaave's syndrome at the emergency department of our hospital. A chest computed tomography scan revealed extraluminal air from the mediastinum to the cervical region and widespread pleural contamination. We performed pleural drainage accordingly and observed a 10-mm tear under esophagography. We treated the patient conservatively based on her stable general condition and good drainage. As the inflammatory reaction persisted for 4 days after admission, we performed endoscopic clipping, which effectively closed the tear. The treatment course was uneventful, and the patient was discharged from the hospital after we endoscopically confirmed complete healing of the esophageal ulcer. We present a case of Boerhaave's syndrome with pleural rupture and contamination that was successfully treated with endoscopic clipping.
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Transaction of Showa University Society: The 315th Meeting
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