著者

鈴木 紀子

雑誌

Otsuma Review

巻号頁・発行日

vol.48, pp.39-49, 2015-07

著者

中西 真一 藤原 純一 加賀谷 結華 高橋 久美子 澤邉 淳 三浦 勉 粕谷 孝光 福岡 岳美 小野 剛

出版者

一般社団法人 日本プライマリ・ケア連合学会

雑誌

日本プライマリ・ケア連合学会誌 (ISSN:21852928)

巻号頁・発行日

vol.37, no.3, pp.233-237, 2014 (Released:2014-09-26)

参考文献数

13

被引用文献数

1

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目的 : 大腿静脈カテーテル留置時に上行腰静脈へ迷入すると, 後腹膜血腫等の合併症を引き起こす可能性がある. しかし, カテーテルの迷入についてはあまり認識されていない.方法 : 2011年4月から2013年3月の間に当院で大腿静脈カテーテルを留置した患者107名を対象とし後ろ向きに検討した.結果 : 上行腰静脈への迷入は11/110回 (10.0%) で認め, 左側で5/34回 (14.7%) , 右側で6/76回 (7.9%) だった. 位置確認の腹部レントゲン検査で, カテーテルが側方へ変位している場合, 頭側に急峻に立ち上がる場合に迷入の可能性があった.結論 : カテーテル迷入は稀では無く, 迷入が疑われれば積極的に腹部CT, 側面レントゲン等の追加の検査が必要である.

著者

Teruhiko Imamura Koichiro Kinugawa Minoru Ono Osamu Kinoshita Norihide Fukushima Akira Shiose Yoshiro Matsui Kenji Yamazaki Yoshikatsu Saiki Akihiko Usui Hiroshi Niinami Goro Matsumiya Hirokuni Arai Yoshiki Sawa

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-18-1215, (Released:2019-04-24)

参考文献数

35

被引用文献数

7

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Background:Hemocompatibility-related adverse events (HRAEs) are substantial issues in patients with left ventricular assist devices (LVADs). Atrial fibrillation (AF) is associated with worse prognosis in patients with heart failure (HF), but its effect on HRAEs following LVAD implantation remain uncertain.Methods and Results:Data from the Japanese Mechanically Assisted Circulatory Support registry of consecutive patients who received HeartMate II LVADs and were followed for 1 year were retrospectively reviewed. Among 190 patients, 23 had AF and 167 had sinus rhythm. The AF group had comparable baseline characteristics with the non-AF group except for their higher age (53 vs. 42 years, P<0.001). Following LVAD implantation, most cases of AF (73%) persisted. Antiplatelet therapy, anticoagulation therapy, and LVAD speed following LVAD implantation were comparable between groups (P>0.05 for all). The 1-year survival free from HRAEs was comparable between groups (83% vs. 76%, P=0.52). Event rates of the breakdown of HRAEs were comparable between groups except for a relatively higher rate of surgically managed pump thrombosis in the AF group (0.16 vs. 0.04, incidence rate ratio 3.75, 95% confidence interval 0.87–16.1, P=0.075). These trends still remained with propensity score-matched comparison.Conclusions:Existence of AF had no effect on the development of HRAEs following LVAD implantation. The need to aggressively treat AF before or after LVAD implantation needs further investigation.

著者

山縣禎 編

巻号頁・発行日

vol.[7], 1846

著者

Shiro Uemura Hiroshi Okamoto Michikazu Nakai Kunihiro Nishimura Yoshihiro Miyamoto Satoshi Yasuda Nobuhiro Tanaka Shun Kohsaka Kazushige Kadota Yoshihiko Saito Hiroyuki Tsutsui Issei Komuro Yuji Ikari Hisao Ogawa Masato Nakamura

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-19-0004, (Released:2019-04-24)

参考文献数

33

被引用文献数

17

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Background:Primary percutaneous coronary intervention (pPCI) is strongly recommended by guidelines for patients presenting with acute myocardial infarction (AMI), but its applications in elderly patients are less clear.Methods and Results:The JROAD-DPC is a Japanese nationwide registry for patients with cardiovascular diseases combined with an administrative claim-based database. Among 2,369,165 records from 2012 to 2015, data for 115,407 AMI patients were extracted for this study. Elderly patients (≥75 years) comprised 45,645 subjects (39.6%), and received pPCI less frequently (62.2%) than younger patients (79.2%, P<0.001). Clinical variables such as higher age, female sex, higher Killip class, and renal dysfunction, but not functional status on admission, were predictors of non-application of pPCI. Endpoint 30-day mortality increased with aging, and was significantly higher in elderly patients (10.7%) than in younger patients (3.8%, P<0.001). Indeed, pPCI was independently associated with lower 30-day mortality only in subgroups of patients aged ≥60 years. Propensity score-matching analysis confirmed a similar reduction in endpoint 30-day mortality with pPCI in elderly patients. Duration of hospitalization was significantly shorter and functional ability on discharge was significantly better in elderly patients who underwent pPCI.Conclusions:Elderly patients with AMI underwent pPCI less frequently, but it was consistently associated with better clinical outcome in these patients. Our findings support the proactive application of pPCI for elderly AMI patients when they are eligible for an invasive strategy.

出版者

写

巻号頁・発行日

vol.[386],

著者

Do Jung Kim Seung Hyun Lee Hyun-Chel Joo Kyung-Jong Yoo Young-Nam Youn

出版者

International Heart Journal Association

雑誌

International Heart Journal (ISSN:13492365)

巻号頁・発行日

pp.17-283, (Released:2019-04-25)

参考文献数

37

被引用文献数

5

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Severe aortic atherosclerosis is a risk factor for stroke during coronary artery bypass grafting (CABG). The purpose of this study was to evaluate the incidence of postoperative neurologic complications after off-pump CABG (OPCAB) with a proximal seal system (Heartstring).From January 2011 to December 2014, 729 patients underwent isolated OPCAB. The cohort was divided into two groups (Heartstring [HS] and aortic no-touch [NT]). The severity of aortic atherosclerosis (Katz grade) was evaluated by intraoperative epiaortic ultrasonography (EUS). The primary endpoints were postoperative neurologic complications (early stroke and minor events (delirium, transient ischemic attack, and syncope) ), and the secondary endpoints were late major adverse cardiac and cerebrovascular events (MACCEs) and death.The mean age of all patients was 65.1 ± 9.5 years, and a severe Katz grade (IV or V) was demonstrated to be an independent risk factor of long-term mortality (HR 3.53; 95% CI 1.06-11.75; P = 0.04) and MACCEs (HR 2.41; 95% CI 1.19-4.92; P = 0.02), but no significant differences were found for early stroke (0.9% versus 1.7%; P = 0.53) and minor neurologic complications (14.6% versus 9.9%; P = 0.05) between the groups regardless of the Katz grade. The 5-year overall survival rate did not differ significantly between the groups (90.9% versus 87.6%; P = 0.61).Although a higher Katz grade was identified as an independent risk factor of death and MACCEs, the HS group was not inferior in terms of neurologic complications regardless of the Katz grade. Therefore, the Heartstring system might be safely and efficiently used with EUS to decrease the incidence of neurologic complications.

著者

Min Chen Yu-Feng Jiang Hua-Jia Yang Nan-Nan Zhang Qing Rui Ya-Feng Zhou

出版者

International Heart Journal Association

雑誌

International Heart Journal (ISSN:13492365)

巻号頁・発行日

pp.17-293, (Released:2019-04-25)

参考文献数

46

被引用文献数

4

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The issue that genetic polymorphism of tumor necrosis factor-α (TNF-α) is associated with dilated cardiomyopathy (DCM) is debatable. We sought to investigate the potential role of TNF-α gene polymorphism (G-308A) in the susceptibility to dilated cardiomyopathy.We retrieved PubMed, EMBASE, and CNKI to collect all articles which reported on the association between TNF-α G-308A polymorphism and dilated cardiomyopathy. Two authors used the Newcastle-Ottawa Scale (NOS) checklist to assess the quality of the included studies. The odds ratio (OR) with 95% confidence intervals (CI) were pooled in a specific genetic model to assess the association and Stata version 14.0 software was used.A total of 9 studies with 1338 patients and 1677 controls were included in this study. The results from this meta-analysis indicated that TNF-α G-308A polymorphism significantly increased the risk of dilated cardiomyopathy in heterozygous comparison (GA versus GG: OR = 1.87; 95%CI = 1.03-3.40; P < 0.05). The increased risk of DCM was also found in Asian populations using a dominant model and heterozygous comparison (GA+AA versus GG: OR = 2.00, 95%CI = 1.02-3.92, P < 0.05; GA versus GG: OR = 1.94, 95%CI = 1.23-3.06, P < 0.05).The current meta-analysis revealed that TNF-α gene polymorphism (G-308A) may be associated with the susceptibility to DCM.

著者

松下 宗洋 原田 和弘 荒尾 孝

出版者

日本健康教育学会

雑誌

日本健康教育学会誌 (ISSN:13402560)

巻号頁・発行日

vol.22, no.1, pp.30-38, 2014 (Released:2015-01-13)

参考文献数

17

被引用文献数

1

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目的:運動行動を促進する技法の1つとして,インセンティブを用いて動機づけを高める技法が注目されている.インセンティブを効果的に用いるには,インセンティブの内容(種類,金額)や,対象者の運動行動に対する準備性を考慮する必要がある.本研究の目的は,対象者の運動行動変容ステージとインセンティブの内容によって,運動行動を動機づける強さが異なるかを検討することである.方法:40~69歳のモニターを対象(N=1,290)にインターネット調査による横断研究を実施した.測定項目は,インセンティブの種類による運動行動の動機づけの強さ(以下,動機強化得点),インセンティブとして希望する相当額,運動行動変容ステージであった.結果:動機強化得点は,インセンティブの種類(p<0.01),運動の行動変容ステージ(p<0.01)により有意に異なり,両者の交互作用も有意であった(p<0.01).しかし,各行動変容ステージにおける動機強化得点の高いインセンティブは,現金,商品券,旅行券であり,順位に大きな変動はなかった.各行動変容ステージの運動取組動機率が50%に達するインセンティブ希望金額は,前熟考期が2,000円,熟考期が1,000円,準備&実行期が1,500円,維持期が500円であった.結論:運動行動を動機づける強さは,インセンティブの内容(種類,金額)や運動の行動変容ステージによって異なることが明らかとなった.今後は,本研究を基にしたインセンティブによる運動実践率向上の検証が課題となる.

著者

Tien-Yu Chen Wen-Jung Chung Chien-Ho Lee Po-Jui Wu Shu-Kai Hsueh Tzu-Hsien Tsai Chien-Jen Chen Chiung-Jen Wu Cheng-I Cheng

出版者

International Heart Journal Association

雑誌

International Heart Journal (ISSN:13492365)

巻号頁・発行日

pp.18-377, (Released:2019-04-25)

参考文献数

19

被引用文献数

1

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We investigated the accuracy of various bleeding risk scores to estimate the bleeding risk in patients with acute myocardial infarction (AMI) managed with percutaneous coronary intervention (PCI) access via the radial artery.We retrospectively enrolled 1,651 patients who were definitively diagnosed with ST-elevation myocardial infarction (STEMI) or non-STEMI (NSTEMI). We assessed the predictive validities of 30-day bleeding events in various scoring systems using receiver operating characteristic curves.Overall, ACUITY-HORIZONS exhibited the highest area under the curve to predict 30-day bleeding, followed by ACTION and CRUSADE; HAS-BLED displayed the lowest score. With a cut-off of 17, ACUITY-HORIZONS demonstrated the best discrimination for the Thrombolysis in Myocardial Infarction (TIMI) 30-day serious bleeding rate. We observed significant differences among all-cause death, cardiovascular death, and major adverse cardiac events between the ACUITY-HORIZONS groups with a score of ≤ 17 and > 17. ACUITY-HORIZONS score > 17, initial systolic blood pressure (SBP) < 90 mmHg, and Killip III and IV upon admission positively predicted the 30-day bleeding risk, whereas myocardial infarction (MI) and TIMI major bleeding within 30 days, heart failure at admission, and initial SBP < 90 mmHg positively predicted the 30-day mortality.Comparatively, ACUITY-HORIZON is the most reliable system in predicting 30-day bleeding for patients with AMI via transradial PCI. In the transradial scenario, bleeding and MI within 30 days are substantially related to 30-day mortality.

著者

(漢) 司馬遷 撰

巻号頁・発行日

vol.[2], 1000

著者

Karam Nam Eun Jin Jang Ga Hee Kim Hannah Lee Dal Ho Kim Ho Geol Ryu

出版者

International Heart Journal Association

雑誌

International Heart Journal (ISSN:13492365)

巻号頁・発行日

pp.18-428, (Released:2019-04-25)

参考文献数

32

被引用文献数

9

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The relationship between lower institutional case-volume and higher mortality after complex high-risk procedures has been shown. The aim of this study is to examine the effect of institutional volume on patient outcome after heart transplantation (HT) in the entire Korean population.We analyzed all adult HTs performed in Korea between 2007 and 2016 using data from the National Health Insurance Service. The association between case-volume and in-hospital mortality after HT was analyzed after categorizing hospitals performing HT into low-, medium-, or high-volume centers depending on the number of HTs performed. The effect of case-volume on long-term mortality was also assessed.A total of 833 adult HTs were performed in 17 centers. In-hospital mortality was 3.7% (13/356), 10.1% (38/375), and 18.6% (19/102) in high-, medium-, and low-volume centers, respectively. Medium-, and low-volume centers showed increased risk of in-hospital mortality (odds ratio [95% confidence interval]; 2.11 [1.42-3.13] and 3.68 [2.16-2.27], respectively.). Long-term survival of up to 10 years was worse in lower-volume centers compared to high-volume centers (P < 0.001).In conclusion, lower case-volume was associated with increased in-hospital mortality and long-term mortality after HT. A minimum case-volume mandate may be required for hospitals performing HT to ensure the best patient outcome and effective resource allocation.

著者

加藤 剛 湊 真一

雑誌

研究報告アルゴリズム(AL) (ISSN:21888566)

巻号頁・発行日

vol.2019-AL-171, no.7, pp.1-7, 2019-01-22

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7 次対称方陣とは,中心に関して対称な位置にある 2 マスの和が常に一定であるような 7 × 7 の魔方陣である.現在知られている 6 次の半魔方陣 (斜めの和の条件を持たない魔方陣) の数え上げの方法を参考にして,方陣を 2 つに分割して数え上げる手法を用いて計算した結果,7 次対称方陣の解の総数は,回転や鏡像で同じ形になるものを除いて,1,125,154,039,419,854,784 通りであることを初めて明らかにした.本稿ではその計算方法について述べる.

著者

津曲 茂久 東野 利忠 高木 香 大場 茂夫 佐藤 昌介 武石 昌敬

出版者

社団法人日本獣医学会

雑誌

日本獣医学雑誌 (ISSN:09167250)

巻号頁・発行日

vol.53, no.5, pp.797-801, 1991-10-15

被引用文献数

1

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妊娠馬10頭を用いて妊娠1から11ヶ月まで, 血漿中estrogen, gestagen, cortisol (F), 13, 14-dihydro, 15-keto-PGF_2α(PGFM)および妊馬血清性性腺刺激ホルモン(PMSG)を測定した. estron (E_1)とestradiol-17β(E_2)は妊娠8ヶ月前後にピークを示し, progesterone (P)は妊娠3と11ヶ月で増加し, 17α-OH-progesterone (17α-OHP)は妊娠3ヶ月に明瞭なピークを形成した. 20α-OH-progesterone (20α-OHP)は妊娠6ヶ月より急激に上昇した. PGFMは妊娠2と11ヶ月にピークを示し, FとPMSGは妊娠2と3ヶ月にそれぞれピークを示した. 因子分析において, 妊娠月齢, E_1, E_2, 20α-OHPは妊娠進行に伴い増加する変数として第一因子に含まれた. PMSG, 17α-OHP, Pは副黄体に関係する変数として第二因子に, PGFMとFは妊娠2ヶ月における変化により, 第三因子に区分された. Pは第二因子に含まれたが, 第一と第三因子にも影響を受け, PGFMとは対立的な関係性を示した. 結論的には, 第一因子に含まれたE_1, E_2および20α-OHPは妊娠6ヶ月以降の胎盤機能の指標として有用であることが示唆された.

著者

豊国

出版者

平のや

雑誌

吾妻にしき絵

巻号頁・発行日

1862

著者

寺井順一

出版者

財務省

雑誌

ファイナンス

巻号頁・発行日

no.461, 2004-04

著者

坪内 博仁 大重 彰彦 宇都 浩文

出版者

一般社団法人 日本肝臓学会

雑誌

肝臓 (ISSN:04514203)

巻号頁・発行日

vol.56, no.7, pp.313-323, 2015-07-20 (Released:2015-07-29)

参考文献数

98

被引用文献数

2

著者

黒木三郎 [ほか] 著

出版者

法律文化社

巻号頁・発行日

1965

著者

森山 真次

出版者

公益社団法人 日本不動産学会

雑誌

日本不動産学会誌 (ISSN:09113576)

巻号頁・発行日

vol.26, no.4, pp.29-30, 2013

著者

山本 博一

出版者

国際日本文化研究センター

雑誌

武器の進化と退化の学際的研究―弓矢編― = Interdisciplinary Research of Evolution and Degeneration of Arms: A Volume on Bow and Arrows (ISSN:13466585)

巻号頁・発行日

vol.27, pp.141-151, 2002-12-25