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Do changes in intracoronary pressure aid coronary spasm diagnosis using the spasm provocation test?

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World Journal of Cardiology 2024年第1期16卷 16-26页

作者： Hiroki Teragawa Chikage Oshita yuko Uchimura Department of Cardiovascular Medicine JR Hiroshima HospitalHiroshima 732-0057Japan

BACKGROUND Although the spasm provocation test(SPT)can diagnose coronary spasms,it would be helpful if it could also predict their *** To investigate whether coronary spasms can be predicted using changes in intracoronary artery pressure measured using a pressure wire during the *** Seventy patients underwent SPTs with pressure-wire measurement of intracoronary artery *** each SPT,the pressure wire was advanced into the distal portion of the right coronary artery(RCA)and left anterior descending coronary artery,and the ratio of intracoronary pressure to aortic pressure(Pd/Pa)was *** spasm was defined as an arterial narrowing of>90%in response to the administration of acetylcholine(ACh),with chest symptoms and/or ischemic electrocardiographic *** was administered to the RCA at low,moderate,or high doses of 20,50,or 80μg,respectively,and to the left coronary artery(LCA)at low,moderate,or high doses of 50,100,or 200μg,*** arteries with coronary spasms at low doses of ACh were defined as group L,and those with coronary spasms at moderate or high doses were defined as group *** who did not occur coronary spasms at any ACh dose were designated as group *** Among the 132 coronary arteries assessed using a pressure wire,there were 49 in group N,25 in group L,and 58 in group *** Pd/Pa was the lowest in group L(P=0.001).The decrease in the Pd/Pa between baseline to low doses of ACh was lower in group MH than in group N(P<0.001).A receiver-operating characteristics analysis showed that the cutoff baseline Pd/Pa value for predicting group L was 0.95,with a sensitivity of 0.600(15/25)and a specificity of 0.713(76/107)and that the cutoff value of Pd/Pa from baseline to low doses of ACh for predicting group MH was−0.04,with a sensitivity of 0.741(43/58)and a specificity of 0.694(34/49).CONCLUSION These findings suggest that indices of intracoronary pressure during SPT may be useful means for

关键词： Acetylcholine Coronary spasm Intracoronary pressure Pressure wire Spasm provocation test Vasospastic angina

Early response of cytokines in nervous system of DA rats after MBP immunization

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Acta Pharmacologica Sinica 1999年第5期 91-91页

作者： Satoru NUWA,Takeyasu HOMMA,yuko TAKAOKA,Hiroyuki tanaka,Koichi SHUDC,Hiroichi NAGAI Department of Pharmacology Gifu Phannaceutical University Gifu Japan Department of Pharmacology Gifu Phannaceutical University Gifu Japan Department of Pharmacology Gifu Phannaceutical University Gifu Japan Department of Pharmacology Gifu Phannaceutical University Gifu Japan Faculty of Pharmaceutical Sciences Tokyo University Tokyo Japan Department of Pharmacology Gifu Phannaceutical University Gifu Japan

Cytokines (such as IL-6, TNF-α, and IFN-γ) were considered as important factors during the onset of atuoimmune disease, such as rheumatoid arthritis and multiple sclerosis, but the early response of cytokines after immunization is still unclear. In the present experiment, we examined the changes of mRNA levels of several cytokines, inducible nitric-oxide synthase (iNOS) in hypothalamus, pituitary and spinal cord of DA rats 3 d after MBP immunization to analysis the early cytokines response

关键词： MBP iNOS mRNA Early response of cytokines in nervous system of DA rats after MBP immunization DA

Effects of Direct Switching Dual Bronchodilators between Dry Powder and Soft Mist Inhalers in COPD Patients

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Open Journal of Respiratory Diseases 2020年第1期10卷 11-19页

作者： Taisuke Akamatsu Toshihiro Shirai Hiromasa Nakayasu Kanami Tamura Toshihiro Masuda Shingo Takahashi yuko tanaka Hirofumi Watanabe Yutaro Kishimoto Kyohei Oishi Mika Saigusa Akito Yamamoto Satoru Morita Kazuhiro Asada Department of Respiratory Medicine Shizuoka General Hospital Shizuoka Japan

Objective: Dual bronchodilation with long-acting muscarinic antagonist and long-acting β2-agonist combinations are available worldwide in COPD patients. However, the choice of agents remains under debate. We hypothesized that switching devices between dry powder and soft mist inhalers without a wash-out period to mimic clinical practice would improve clinical symptoms and lung function. The aim of this study was to examine the effects of switching between once-daily glycopyrronium/indacaterol (GLY/IND) or umeclidinium/vilanterol (UMEC/VI), dry powder inhalers, and tiotropium/olodaterol (TIO/OLO), a soft mist inhaler, in COPD patients. Methods: This was a prospective, open-label, 8-week, observational study with follow-up. Subjects included 57 COPD patients, who attended outpatient clinics at Shizuoka General Hospital for routine check-ups between February and December 2015, receiving GLY/IND (50/110 μg) or UMEC/VI (62.5/25 μg). After an 8-week run-in period, medications were switched to TIO/OLO (5/5 μg). Study outcomes included patient’s global rating (PGR), modified MRC (mMRC), COPD assessment test (CAT), and spirometric and forced oscillatory parameters after 8 weeks. PGR used in this study was a 7-point scale ranging from 1 to 7, with 4 in the middle. Patients who consented to switch from TIO/OLO to GLY/IND or UMEC/VI were followed-up thereafter. Results: In total, 53 patients completed the study (mean age, 75 years;48 males and 5 females;GOLD 1/2/3/4 = 19/27/6/1;mMRC 0/1/2/3/4 = 14/22/12/4/1;UMEC/VI 26, GLY/IND 27). PGR, mMRC, and CAT improved in 20 (38%), 9 (17%), and 15 patients (28%), respectively. Respiratory system resistance at 5 Hz (R5), 20 Hz (R20), and the difference between R5 and R20 (R5 - R20) significantly improved. In a follow-up of 16 patients after switching from TIO/OLO to UMEC/VI (9) or GLY/IND (7), PGR, mMRC, and CAT improved in 5 (31%), 3 (12%), and 4 patients (25%), respectively, and R20 significantly improved (p = 0.011). Conclusions: Switc

关键词： Device Dry Powder Inhaler Dual Bronchodilator Soft Mist Inhaler Switching

Usefulness of Fractional Exhaled Nitric Oxide-Guided Treatment in Patients with Asthma-Chronic Obstructive Pulmonary Disease Overlap

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Open Journal of Respiratory Diseases 2018年第1期8卷 1-12页

作者： Taisuke Akamatsu Toshihiro Shirai yuko tanaka Hirofumi Watanabe Yoshinari Endo Yukiko Shimoda Takahito Suzuki Rie Noguchi Mika Saigusa Akito Yamamoto Yuichiro Shishido Takefumi Akita Satoru Morita Kazuhiro Asada Department of Respiratory Medicine Shizuoka General Hospital Shizuoka Japan

Background: Some patients present clinical features of both asthma and chronic obstructive pulmonary disease (COPD), which has led to the recent proposal of asthma-COPD overlap (ACO) as a diagnosis. Fractional exhaled nitric oxide (FeNO) is a candidate biomarker to diagnose ACO. We assessed the effect of an add-on treatment with budesonide/formoterol (BUD/FM) combination in patients with ACO, which was diagnosed by FeNO. Methods: This was a prospective, single-arm, open-label, before and after comparison study. Subjects included 83 patients with COPD who attended outpatient clinics for routine checkups at Shizuoka General Hospital between June and November 2016. All patients fulfilled the GOLD definition of COPD and were receiving long-acting muscarinic antagonist (LAMA) or LAMA/long-acting β2 agonist (LABA) combinations. After an 8-week run-in period, BUD/FM was added to the patients with FeNO levels of ≥35 ppb, defined as having ACO. For patients receiving LAMA/LABA, BUD/FM was added after the discontinuation of LABA. The modified British Medical Research Council (mMRC) score, COPD assessment test (CAT) score, spirometric indices, forced oscillation parameters, and FeNO were assessed before and after 8 weeks of BUD/ FM add-on treatment. Results: Twenty-four patients (28.9%) had FeNO levels ≥ 35 ppb, and 17 patients completed the study (mean age: 73 years and GOLD I/II/III/IV, 5/10/1/1). The mean CAT scores significantly improved (9.2 to 5.4, p = 0.015) and 10 patients (58.8%) showed ≥2 points improvement, a minimal clinically important difference. The mean FeNO levels significantly decreased from 63.0 to 34.3 ppb (p Conclusions: FeNO-guided treatment with BUD/FM improves symptoms in patients with ACO.

关键词： Asthma-COPD Overlap Budesonide/Formoterol Combination COPD Assessment Test Fractional Exhaled Nitric Oxide

Novel procedure for hepatic venous outflow block after liver resection:A case report

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World Journal of Clinical Cases 2024年第29期12卷 6320-6326页

作者： Hisanobu Higashi Yuta Abe Kodai Abe Yutaka Nakano Masayuki tanaka Shutaro Hori Yasushi Hasegawa Hiroshi Yagi Minoru Kitago yuko Kitagawa Department of Surgery National Hospital Organization Saitama HospitalWako 351-0102Japan Department of Surgery Keio University School of MedicineTokyo 160-8582Japan

BACKGROUND Postoperative complications like remnant hepatic vein(HV)outflow block and liver torsion can occur after right *** falciform ligament fixation is typically used to prevent liver *** report a novel procedure to manage outflow *** SUMMARY An 80-year-old man developed HV outflow block after remnant right hepatectomy,despite liver fixation and intraoperative HV flow *** had a history of cholangiocellular carcinoma and had undergone posterior segmentectomy and *** falciform ligament fixation was inadequate to maintain liver *** surgery was performed,using an omental flap and mobilized right side colon with ileocecal region to prevent liver dislocation due to intraabdominal *** postoperative course was *** This is the first report providing a novel surgical procedure when the falciform ligament is insufficient for remnant liver fixation.

关键词： Hepatectomy Postoperative complications Budd-Chiari syndrome Hepatic vein outflow block Emergency surgery Case report

The Development of the “Monitoring Application for Inappropriate Expressions in Nursing Records”for PsyNACS^©

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Journal of Computer and Communications 2024年第5期12卷 42-52页

作者： Hirokazu Ito yuko Yasuhara Tetsuya Tanioka Department of Nursing Institute of Biomedical Sciences Tokushima University Graduate School Tokushima Japan

Lengthening periods of hospitalization, increasing numbers of patients with age-related complications, and a shortage of nursing staff have been of great concern in medical psychiatry in Japan. Under these circumstances, countries such as Japan that face a super-aging society and a decline in the working-age population, have been recommended for use of advanced information and communications technology (ICT) to improve the efficiency of medical treatment and care. This study aims to develop the “Monitoring Application for Inappropriate Expressions in Nursing Records” for using PsyNACS©, which will enable psychiatric nursing plans to harness the advantages of ICT. The functions considered necessary are as follows: 1) identification of users who enter information;2) a necessary database for lists of inappropriate expressions;3) development of a matching function to recommend proper writing input and a warning function;and 4) a management function for an inappropriate expression list database. A demonstration experiment for developing the application in this study was conducted at a specialized psychiatric hospital. To introduce them to the application, nurses and nurse managers were informed about the system developed in this study, and a survey regarding their opinions on the functions of the application was conducted with ten nurse managers. The results were evaluated in terms of usefulness for nursing care, documentation, and the education of nurses from an ethical perspective. This study suggests that matching their input with an inappropriate expression database will allow nurses to record more appropriate expressions. From an ethical perspective, the ability to use appropriate expressions makes records more likely to withstand disclosure requests from patients and their families.

关键词： PsyNACS© Monitoring Application Inappropriate Expressions Nursing Records

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Enzyme-linked immunosorbent assay of 3 Screen Islet Cell Autoantibody in patients with autoimmune thyroid disease

Journal of Computer and Communications（电脑和通信） 2024年第5期12卷 42页

作者： Hirokazu Ito yuko Yasuhara Tetsuya Tanioka Department of Nursing Institute of Biomedical Sciences Tokushima University Graduate School Tokushima Japan.

Lengthening periods of hospitalization, increasing numbers of patients with age-related complications, and a shortage of nursing staff have been of great concern in medical psychiatry in Japan. Under these circumstances, countries such as Japan that face a super-aging society and a decline in the working-age population, have been recommended for use of advanced information and communications technology (ICT) to improve the efficiency of medical treatment and care. This study aims to develop the “Monitoring Application for Inappropriate Expressions in Nursing Records” for using PsyNACS©, which will enable psychiatric nursing plans to harness the advantages of ICT. The functions considered necessary are as follows: 1) identification of users who enter information; 2) a necessary database for lists of inappropriate expressions; 3) development of a matching function to recommend proper writing input and a warning function; and 4) a management function for an inappropriate expression list database. A demonstration experiment for developing the application in this study was conducted at a specialized psychiatric hospital. To introduce them to the application, nurses and nurse managers were informed about the system developed in this study, and a survey regarding their opinions on the functions of the application was conducted with ten nurse managers. The results were evaluated in terms of usefulness for nursing care, documentation, and the education of nurses from an ethical perspective. This study suggests that matching their input with an inappropriate expression database will allow nurses to record more appropriate expressions. From an ethical perspective, the ability to use appropriate expressions makes records more likely to withstand disclosure requests from patients and their families.

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World Journal of Diabetes 2024年第5期15卷 935-944页

作者： Eiji Kawasaki Hidekazu Tamai Takahiro Fukuyama Yoko Sagara Ryutaro Hidaka Aira Uchida Masayuki Tojikubo Narihito Tatsumoto yuko Akehi Yuji Hiromatsu The Diabetes Thyroid and Endocrine CenterShin-Koga HospitalKurume 830-8577Japan

BACKGROUND In recent years,the emergence of multiplex technology that can simultaneously measure multiple anti-islet autoantibodies has become particularly valuable for the staging and early diagnosis of immune-mediated type 1 diabetes(T1D).While it has been established that 20%-30%of T1D patients suffer from autoimmune thyroid disease(AITD),there is limited available data regarding the presence of anti-islet autoantibodies in AITD *** commercially available anti-islet autoantibodies,glutamic acid decarboxylase 65 autoantibodies(GADAs)are often the first marker measured in general clinical *** To investigate the frequency of anti-islet autoantibodies in AITD *** Our study involved four hundred ninety-five AITD patients,categorized into three distinct groups:AITD with T1D(n=18),AITD with phenotypic type 2 diabetes(T2D)(n=81),and AITD without diabetes(n=396),and the enzyme-linked immunosorbent assay(ELISA)was employed to determine the frequencies of 3 Screen Islet Cell Autoantibody(3 Screen ICA),GADA,insulinoma-associated antigen-2 autoantibodies(IA-2As),and zinc transporter 8 autoantibodies(ZnT8As)within these *** The frequency of 3 Screen ICA in AITD patients with T1D,T2D,and those without diabetes were 88.9%,6.2%,and 5.1%,respectively,with no significant difference seen between the latter two ***,the frequency of 3 Screen ICA was 11.1%higher in AITD patients with T1D,1.3%higher in AITD patients with T2D,and 1.1%higher in AITD patients without diabetes compared to GADA,***,12.5%,20.0%,and 20.0%of the 3 Screen ICA-positive patients were negative for ***,1.3%of the AITD patients who tested negative for 3 Screen ICA in both the AITD with T2D and non-diabetic AITD groups were found to be positive for individual *** the 3 Screen ICA-positive patients,there was a significantly higher proportion of individuals with multiple autoantibodies in AITD patients with T1D com

关键词： Anti-islet autoantibodies Autoimmune thyroid disease Real-world practice Retrospective study Type 1 diabetes

Direct visualization of postoperative aortobronchial fistula on computed tomography

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World Journal of Radiology 2024年第8期16卷 337-347页

作者： Nanae Tsuchiya Hitoshi Inafuku Satoko Yogi yuko Iraha Gyo Iida Mizuki Ando Takaaki Nagano Shotaro Higa Tatsuya Maeda Yuya Kise Kojiro Furukawa Koji Yonemoto Akihiro Nishie Department of Radiology Graduate School of Medical ScienceUniversity of the RyukyusOkinawa 903-0215Japan Department of Thoracic and Cardiovascular Surgery Graduate School of Medical ScienceUniversity of the RyukyusOkinawa 903-0215Japan Department of Biostatistics School of Health SciencesFaculty of MedicineUniversity of the RyukyusOkinawa 903-0215Japan

BACKGROUND Postoperative aortobronchial fistula(ABF)is a rare complication that can occur in 0.3%-5.0%of patients over an extended period of time after thoracic aortic *** visualization of the fistula via imaging is *** To investigate the relationship between computed tomography(CT)findings and the clinical signs/symptoms of ABF after thoracic aortic *** Six patients(mean age 71 years,including 4 men and 2 women)with suspected ABF on CT(air around the graft)at our hospital were included in this retrospective study between January 2004 and September *** CT findings included direct confirmation of ABF,peri-graft fluid,ring enhancement,dirty fat sign,atelectasis,pulmonary hemorrhage,and bronchodilation,and the clinical course were retrospectively *** proportion of each type of CT finding was *** ABF detection after surgery was found to have a mean and median of 14 and 13 years,*** signs and symptoms were asymptomatic in 4 patients,bloody sputum was found in 1 patient,and fever was present in 1 *** complications of ABF included graft infection in 2 patients and graft infection with hemoptysis in 2 *** the 6 patients,3 survived,2 died,and 1 was lost to *** locations of the ABFs were as follows:1 in the ascending aorta;1 in the aortic arch;2 in the aortic arch leading to the descending aorta;and 2 in the descending *** were directly confirmed by CT in 4/6(67%)***-graft dirty fat(4/6,67%)and peri-graft ring enhancement(3/6,50%)were associated with graft infection,endoleaks and pseudoaneurysms were associated with hemoptysis(2/6,33%).CONCLUSION Asymptomatic ABF after thoracic aortic surgery can be confirmed on chest *** is useful for the diagnosis of ABF and its complications.

关键词： Peri-graft air Aortobronchial fistula Chest computed tomography Postoperative Thoracic endovascular aortic repair Complication Thoracic aorta surgery