Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 30
Filtrar
1.
Front Psychiatry ; 14: 1104222, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37415686

RESUMO

Introduction: Perinatal women tend to have difficulties with sleep along with autonomic characteristics. This study aimed to identify a machine learning algorithm capable of achieving high accuracy in predicting sleep-wake conditions and differentiating between the wake conditions before and after sleep during pregnancy based on heart rate variability (HRV). Methods: Nine HRV indicators (features) and sleep-wake conditions of 154 pregnant women were measured for 1 week, from the 23rd to the 32nd weeks of pregnancy. Ten machine learning and three deep learning methods were applied to predict three types of sleep-wake conditions (wake, shallow sleep, and deep sleep). In addition, the prediction of four conditions, in which the wake conditions before and after sleep were differentiated-shallow sleep, deep sleep, and the two types of wake conditions-was also tested. Results and Discussion: In the test for predicting three types of sleep-wake conditions, most of the algorithms, except for Naïve Bayes, showed higher areas under the curve (AUCs; 0.82-0.88) and accuracy (0.78-0.81). The test using four types of sleep-wake conditions with differentiation between the wake conditions before and after sleep also resulted in successful prediction by the gated recurrent unit with the highest AUC (0.86) and accuracy (0.79). Among the nine features, seven made major contributions to predicting sleep-wake conditions. Among the seven features, "the number of interval differences of successive RR intervals greater than 50 ms (NN50)" and "the proportion dividing NN50 by the total number of RR intervals (pNN50)" were useful to predict sleep-wake conditions unique to pregnancy. These findings suggest alterations in the vagal tone system specific to pregnancy.

2.
Dalton Trans ; 52(26): 9026-9031, 2023 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-37334563

RESUMO

Unlike perovskite oxides, antiperovskites M3HCh and M3FCh (M = Li, Na; Ch = S, Se, Te) mostly retain their ideal cubic structure over a wide range of compositions owing to anionic size flexibility and low-energy phonon modes that promote their ionic conductivity. In this study, we show the synthesis of potassium-based antiperovskites K3HTe and K3FTe and discuss the structural features in comparison with lithium and sodium analogues. It is shown experimentally and theoretically that both compounds maintain a cubic symmetry and can be prepared at ambient pressure, in contrast to most of the reported M3HCh and M3FCh which require high pressure synthesis. A systematic comparison of a series of cubic M3HTe and M3FTe (M = Li, Na, K) revealed that telluride anions contract in the order of K, Na, Li, with a pronounced contraction in the Li system. This result can be understood in terms of the difference in charge density of alkali metal ions as well as the size flexibility of Ch anions, contributing to the stability of the cubic symmetry.

3.
Tohoku J Exp Med ; 259(3): 177-188, 2023 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-36543243

RESUMO

Russia's invasion of Ukraine (February 24, 2022) has begun and there are concerns about the impact on health care supply and mental health. This study analyzed tweets in the Ukrainian language to capture the medical needs and mental health conditions in wartime Ukraine by focusing on ostensibly relevant words. The number of tweets containing the keywords and their overall proportion was compared before and after the Russian invasion of Ukraine. The survey period was divided into four phases-the pre-2022 Russian invasion, acute phase (4 weeks), subacute phase (12 weeks), and the chronic phase (8 weeks) up to August 10, 2022. The analysis targeted tweets sent in Ukrainian. The tweets were screened using a set of six classes with 75 key groups and 303 Ukrainian (204 original Japanese) keywords. Overall, 98,526,440 tweets were analyzed, with a pre-invasion and post-onset average of 1,096,976 and 3,328,243 tweets/week (a 3.0-fold increase), respectively. Of these, 3,197,443 tweets contained the keywords, with a pre-invasion and invasion average of 26,241 and 114,640 tweets/week (a 4.4-fold increase), respectively. The post-onset phase witnessed a considerable increase in all classes-medical services, treatment, medical resources, medical situations, and special situations-but not in the symptom class. Keywords related to psychological distress and anxiety immediately increased during the acute phase; those related to depression and post-traumatic stress reactions continued increasing as the invasion persisted, which may have reflected the mental state of those impacted. Analyzing tweets is useful for predicting people's real-time physical and mental health needs during wartime.


Assuntos
Mídias Sociais , Humanos , Ucrânia , Idioma , Inquéritos e Questionários , Nível de Saúde
4.
Intern Med ; 62(2): 187-199, 2023 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-36328579

RESUMO

Objective Patients in whom coronavirus disease 2019 (COVID-19) was suspected or confirmed between January 1, 2020, and October 31, 2021, were enrolled from Japanese hospitals in this multicenter, retrospective, observational study. Methods Data on the treatment administered (including conventional and Kampo medicine) and changes in common cold-like symptoms (such as fever, cough, sputum, dyspnea, fatigue, and diarrhea) were collected from their medical records. The primary outcome was the number of days without a fever (with a body temperature <37°C). The secondary outcomes were symptomatic relief and the worsening of illness, defined as the presence of a condition requiring oxygen inhalation. The outcomes of patients treated with and without Kampo medicine were compared. Patients We enrolled 962 patients, among whom 528 received conventional and Kampo treatment (Kampo group) and 434 received conventional treatment (non-Kampo group). Results Overall, after adjusting for the staging of COVID-19 and risk factors, there were no significant between-group differences in the symptoms or number of days being afebrile. After performing propensity score matching and restricting the included cases to those with confirmed COVID-19 who did not receive steroid administration and initiated treatment within 4 days from the onset, the risk of illness worsening was significantly lower in the Kampo group than in the non-Kampo group (odds ratio=0.113, 95% confidence interval: 0.014-0.928, p=0.0424). Conclusion Early Kampo treatment may suppress illness worsening risk in COVID-19 cases without steroid use. Further randomized controlled studies are needed to confirm the clinical benefit of Kampo medicine for COVID-19.


Assuntos
COVID-19 , Humanos , SARS-CoV-2 , Estudos Retrospectivos , Medicina Kampo , Japão/epidemiologia , Esteroides
5.
Tohoku J Exp Med ; 255(3): 183-194, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34853210

RESUMO

Disaster response procedures have been developed and improved following the Great East Japan Earthquake. Innovative services have also been created through digital transformation, including an acceleration and deepening of artificial intelligence technology. Things that were once technically impossible are now possible. These innovative technologies will spread across various fields, and disaster response will not be an exception. The Ministry of Health, Labour and Welfare is promoting the use of personal health records in a way that effectively supports the management of treatments by using data from wearable devices and specific applications. During the COVID-19 pandemic, the trade-off between protecting personal information and enabling social benefits, such as in the use of digital tracking, and infodemics, including misinformation, have become new social challenges. Reviewing past disaster preparedness and the services and value provided by digital transformation indicates what new disaster preparedness should be. Digital transformation does not require literacy (ability to collect, analyze, and use information) but competence (beneficial behavioral traits derived from experience). Understanding behavior through data and enabling rational behavior are crucial. By increasing human productivity, we can save time and improve self- and mutual-help in times of disaster. Medical information and digital services must be properly used in normal times. A society that uses such services will be more disaster resilient.


Assuntos
Inteligência Artificial , Planejamento em Desastres , Informática Médica , COVID-19 , Comunicação , Empoderamento , Humanos , Infodemia , Japão , Pandemias
6.
J Am Chem Soc ; 143(28): 10668-10675, 2021 Jul 21.
Artigo em Inglês | MEDLINE | ID: mdl-34228923

RESUMO

To improve ionic conductivity, solid-state electrolytes with polarizable anions that weakly interact with mobile ions have received much attention, a recent example being lithium/sodium-rich antiperovskite M3HCh (M = Li, Na; Ch = S, Se, Te). Herein, in order to clarify the role of anions in antiperovskites, the M3FCh family, in which the polarizable H- anion at the octahedral center is replaced by the ionic F- anion, is investigated theoretically and experimentally. We unexpectedly found that the stronger attractive interaction between F- and M+ ions does not slow down the M+ ion diffusion, with the calculated energy barrier being as low as that of M3HCh. This fact suggests that the low-frequency rotational phonon modes of the octahedron of cubic M3FCh (and M3HCh) are intrinsic to facilitate the fast ionic diffusion. A systematic analysis further reveals a correlation between the tolerance factor t and the ionic transport: as t decreases within the cubic phase, the rotational mode becomes softer, resulting in the reduction of the migration energy. The cubic iodine-doped Li3FSe has a room-temperature ionic conductivity of 5 × 10-5 S/cm with a bulk activation energy of 0.18 eV.

7.
Keio J Med ; 70(2): 44-50, 2021 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-33853975

RESUMO

SARS-CoV-2 whole-genome sequencing of samples from COVID-19 patients is useful for informing infection control. Datasets of these genomes assembled from multiple hospitals can give critical clues to regional or national trends in infection. Herein, we report a lineage summary based on data collected from hospitals located in the Tokyo metropolitan area. We performed SARS-CoV-2 whole-genome sequencing of specimens from 198 patients with COVID-19 at 13 collaborating hospitals located in the Kanto region. Phylogenetic analysis and fingerprinting of the nucleotide substitutions were performed to differentiate and classify the viral lineages. More than 90% of the identified strains belonged to Clade 20B, which has been prevalent in European countries since March 2020. Only two lineages (B.1.1.284 and B.1.1.214) were found to be predominant in Japan. However, one sample from a COVID-19 patient admitted to a hospital in the Kanto region in November 2020 belonged to the B.1.346 lineage of Clade 20C, which has been prevalent in the western United States since November 2020. The patient had no history of overseas travel or any known contact with anyone who had travelled abroad. Consequently, the Clade 20C strain belonging to the B.1.346 lineage appeared likely to have been imported from the western United States to Japan across the strict quarantine barrier. B.1.1.284 and B.1.1.214 lineages were found to be predominant in the Kanto region, but a single case of the B.1.346 lineage of clade 20C, probably imported from the western United States, was also identified. These results illustrate that a decentralized network of hospitals offers significant advantages as a highly responsive system for monitoring regional molecular epidemiologic trends.


Assuntos
COVID-19/virologia , Genoma Viral , SARS-CoV-2/genética , Sequenciamento Completo do Genoma/métodos , Humanos , Filogenia
8.
Preprint em Inglês | medRxiv | ID: ppmedrxiv-21250798

RESUMO

ObjectivesWhole SARS-CoV-2 genome sequencing from COVID-19 patients is useful for infection control and regional trends evaluation. We report a lineage data collected from hospitals in the Kanto region of Japan. MethodsWe performed whole genome sequencing in specimens of 198 COVID-19 patients at 13 collaborating hospitals in the Kanto region. Phylogenetic analysis and fingerprinting of the nucleotide substitutions underwent to differentiate and classify the viral lineages. ResultsMore than 90% of the strains belonged to Clade 20B and two lineages (B.1.1.284 and B.1.1.214) have been detected predominantly in the Kanto region. However, one sample from a COVID-19 patient in November 2020, belonged to the B.1.346 lineage of Clade 20C, which has been prevalent in western United States. The patient had no history of overseas travel and no contact with anyone who had travelled abroad, suggesting that this strain appeared likely to have been imported from western United States, across the strict quarantine barrier. ConclusionB.1.1.284 and B.1.1.214 have been identified predominantly in the Kanto region and B.1.346 of clade 20C in one patient was probably imported from western United States. These results illustrate that a decentralized network of hospitals can be significantly advantageous for monitoring regional molecular epidemiologic trends. Highlights{middle dot} Whole SARS-CoV-2 genome sequencing is useful for infection control {middle dot} B.1.1.284 and B.1.1.214 have been identified predominantly in the Kanto region {middle dot} B.1.346 of Clade 20C was detected in one COVID-19 patient in November {middle dot} Molecular genomic data sharing provides benefits to public health against COVID-19

9.
Vascular ; 29(6): 826-831, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33478338

RESUMO

OBJECTIVE: We investigated the outcomes of extended coverage of the descending thoracic aorta by thoracic endovascular aortic repair (TEVAR) for residual chronic type B aortic dissection after type A aortic dissection (TAAD) repair. METHODS: From November 2015 to August 2020, 36 patients underwent extended TEVAR for residual intimal tear after TAAD repair. We specifically investigated the methods and outcomes of this procedure. RESULTS: TEVAR consisted of isolated TEVARs (n = 29), single-vessel debranching TEVAR (6), and two-vessel debranching TEVAR (1). The mean time from TAAD repair to TEVAR was 27 ± 33 months (2-86 months). The TEVAR devices used were Valiant (28 cases), GORETAG (4), Relay plus (2), and TX2 (2). Technical success of TEVAR was 100%. The distal ends of the stent grafts were T 8 (1 case), T 9 (5), T 10 (6), T 11 (9), and T 12 (15), with an average of T 11 ± 1. The average length of hospital stay after TEVAR was 9 ± 3 days (5-17 days). There were no surgical/hospital deaths or complications. The average postoperative follow-up period was 21 ± 15 months without death or reintervention. CONCLUSIONS: The short-term outcomes of extended TEVAR for residual chronic type B aortic dissection after TAAD repair were acceptable without perioperative SCI. Aggressive descending thoracic aorta coverage may prevent aortic events, and extended TEVAR may be a preemptive treatment for the downstream aorta. Mid- to long-term results should be clarified.


Assuntos
Aneurisma da Aorta Torácica/cirurgia , Dissecção Aórtica/cirurgia , Implante de Prótese Vascular , Procedimentos Endovasculares , Adulto , Idoso , Dissecção Aórtica/diagnóstico por imagem , Aneurisma da Aorta Torácica/diagnóstico por imagem , Prótese Vascular , Implante de Prótese Vascular/efeitos adversos , Implante de Prótese Vascular/instrumentação , Doença Crônica , Procedimentos Endovasculares/efeitos adversos , Procedimentos Endovasculares/instrumentação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Stents , Fatores de Tempo , Resultado do Tratamento
10.
Nat Commun ; 12(1): 201, 2021 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-33420012

RESUMO

Most solid-state materials are composed of p-block anions, only in recent years the introduction of hydride anions (1s2) in oxides (e.g., SrVO2H, BaTi(O,H)3) has allowed the discovery of various interesting properties. Here we exploit the large polarizability of hydride anions (H-) together with chalcogenide (Ch2-) anions to construct a family of antiperovskites with soft anionic sublattices. The M3HCh antiperovskites (M = Li, Na) adopt the ideal cubic structure except orthorhombic Na3HS, despite the large variation in sizes of M and Ch. This unconventional robustness of cubic phase mainly originates from the large size-flexibility of the H- anion. Theoretical and experimental studies reveal low migration barriers for Li+/Na+ transport and high ionic conductivity, possibly promoted by a soft phonon mode associated with the rotational motion of HM6 octahedra in their cubic forms. Aliovalent substitution to create vacancies has further enhanced ionic conductivities of this series of antiperovskites, resulting in Na2.9H(Se0.9I0.1) achieving a high conductivity of ~1 × 10-4 S/cm (100 °C).

11.
Dalton Trans ; 50(6): 1990-1994, 2021 Feb 16.
Artigo em Inglês | MEDLINE | ID: mdl-33491690

RESUMO

The tetrahedral distortion of iron(ii) centres in the cyanide-bridged framework FePd(CN)4 was recently demonstrated experimentally. Here, we theoretically confirmed the electronically driven tetrahedral distortion of iron(ii) by comparing the density of states and total energies of FePd(CN)4 (d6) and ZnPd(CN)4 (d10). The calculation results suggested that a Jahn-Teller-like effect is caused on the tetrahedral geometry by the electronic effect of unequally occupied non-bonding 3d orbitals in the corresponding structure.

12.
Nihon Hoshasen Gijutsu Gakkai Zasshi ; 76(11): 1152-1162, 2020.
Artigo em Japonês | MEDLINE | ID: mdl-33229845

RESUMO

Computed tomography (CT) is used for the attenuation correction (AC) of [F-18] fluoro-deoxy-glucose positron emission tomography (PET) image. However, acquisition of a CT image for this purpose requires increasing the radiation dose of the patient. To generate a pseudo-image, a generative adversarial network (GAN) based on deep learning is adopted. The purpose of this study was to generate a pseudo-CT image, using a GAN, for the AC of the PET image, with the aim of reducing the dose of the patient. A set of approximately 15,000 no-AC PET and CT images was used as the training sample, and the CycleGAN was employed as the image generation model. The training samples were inputted in the CycleGAN, and the hyperparameters, i.e., the learning rate, batch size, and number of epochs were set to 0.0001, 1, and 300, respectively. A pseudo-PET image was obtained using a pseudo-CT image, which was used for the AC of the no-AC PET image. The coefficient of similarity between the real and generated pseudo-images was estimated using the peak signal-to-noise ratio (PSNR) , the structural similarity (SSIM), and the dice similarity coefficient (DSC). The average values of PSNR, SSIM, and DSC of the pseudo-CT were 31.0 dB, 0.87, and 0.89, and those of the pseudo-PET were 35.9 dB, 0.90, and 0.95, respectively. The AC for the whole-body PET image could be accomplished using the pseudo-CT image generated via the GAN. The proposed method would be established as the CT-less PET/CT examination.


Assuntos
Aprendizado Profundo , Humanos , Processamento de Imagem Assistida por Computador , Imageamento por Ressonância Magnética , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Tomografia por Emissão de Pósitrons , Tomografia Computadorizada por Raios X
13.
Angew Chem Int Ed Engl ; 59(43): 19254-19259, 2020 Oct 19.
Artigo em Inglês | MEDLINE | ID: mdl-32662185

RESUMO

Metal node design is crucial for obtaining structurally diverse coordination polymers (CPs) and metal-organic frameworks with desirable properties; however, FeII ions are exclusively six-coordinated. Herein, we present a cyanide-bridged three-dimensional (3D) CP, FePd(CN)4 , bearing four-coordinate FeII ions, which is synthesized by thermal treatment of a two-dimensional (2D) six-coordinate FeII CP, Fe(H2 O)2 Pd(CN)4 ⋅4 H2 O, to remove water molecules. Atomic-resolution transmission electron microscopy and powder X-ray and neutron diffraction measurements revealed that the FePd(CN)4 structure is composed of a two-fold interpenetrated PtS topology network, where the FeII center demonstrates an intermediate geometry between tetrahedral and square-planar coordination. This four-coordinate FeII center with the distorted geometry can act as a thermo-responsive flexible node in the PtS network.

14.
Nat Commun ; 11(1): 1854, 2020 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-32296064

RESUMO

Quantifying the dependence of thermal conductivity on grain boundary (GB) structure is critical for controlling nanoscale thermal transport in many technologically important materials. A major obstacle to determining such a relationship is the lack of a robust and physically intuitive structure descriptor capable of distinguishing between disparate GB structures. We demonstrate that a microscopic structure metric, the local distortion factor, correlates well with atomically decomposed thermal conductivities obtained from perturbed molecular dynamics for a wide variety of MgO GBs. Based on this correlation, a model for accurately predicting thermal conductivity of GBs is constructed using machine learning techniques. The model reveals that small distortions to local atomic environments are sufficient to reduce overall thermal conductivity dramatically. The method developed should enable more precise design of next-generation thermal materials as it allows GB structures exhibiting the desired thermal transport behaviour to be identified with small computational overhead.

15.
Int Heart J ; 61(2): 397-399, 2020 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-32173698

RESUMO

A 50-year-old man who suffered from dyspnea on effort with hearing loss was referred to our hospital. Computed tomography angiography revealed a giant 90-mm diameter ascending aortic aneurysm with severe calcification and neck vessel occlusion. Transthoracic echocardiography revealed moderate-to-severe aortic regurgitation. His condition was diagnosed as Takayasu arteritis and he underwent aortic valve reimplantation with total arch replacement. Postoperative computed tomography angiography showed complete aneurysm resection and the patient was discharged without any complications and his hearing loss improved. He is currently being followed up as an outpatient.


Assuntos
Aneurisma Aórtico/complicações , Arterite de Takayasu/complicações , Aneurisma Aórtico/cirurgia , Artérias Carótidas/cirurgia , Implante de Prótese de Valva Cardíaca , Humanos , Masculino , Pessoa de Meia-Idade
16.
Gen Thorac Cardiovasc Surg ; 68(8): 780-784, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32002748

RESUMO

OBJECTIVE: We aimed to elucidate the surgical outcomes of aortic valve neocuspidization (AVNeo) in patients under 65 years old. METHODS: From December 2010 to February 2019, we performed AVNeo in a total of 168 patients. Of them, we evaluated 36 patients aged under 65 years. Twenty-three patients had aortic regurgitation (AR) and 13 had aortic stenosis (AS). There were 20 patients who had isolated AVNeo, and the concomitant procedures were coronary artery bypass grafting in 5, mitral valve procedures in 4, ascending aorta replacement in 4, MAZE in 3, closure of atrial septum defect in 1, and tricuspid valve annuloplasty in 1. In the AS series, preoperative echocardiography revealed an average peak pressure gradient of 81 ± 33 mmHg. In the AR series, preoperative echocardiography revealed 15 patients with severe AR and 8 patients with moderate-severe AR. RESULTS: There were no conversions to valve replacement. There were two in-hospital deaths owing to low output syndrome and sepsis in the emergent cases. In the AS series, postoperative echocardiography showed an average peak pressure gradient of 23 ± 15 mmHg 1 week post-procedure and 19 ± 9 mmHg 26 months post-procedure. In the AR series, postoperative echocardiography revealed no AR in 11, trivial in 9, and moderate in 1. Three patients underwent reoperation. The freedom from reoperation rates were 100% and 93% at 36 and 60 months of follow-up, respectively. CONCLUSIONS: AVNeo in patients aged under 65 years appears to be suitable considering its early and midterm outcomes. Verification and follow-up of its long-term outcomes and reliability are indispensable.


Assuntos
Estenose da Valva Aórtica/cirurgia , Fatores Etários , Idoso , Estenose da Valva Aórtica/diagnóstico por imagem , Estenose da Valva Aórtica/mortalidade , Ecocardiografia , Feminino , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Reoperação , Análise de Sobrevida
17.
Gen Thorac Cardiovasc Surg ; 68(8): 762-767, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32008187

RESUMO

OBJECTIVE: At our institution, we actively perform aortic valve neocuspidization (AVNeo) for aortic valve stenosis (AS) with a small annulus. In this report, we aimed to evaluate the midterm outcome of AVNeo for AS with a small annulus. METHODS: From February 2011 to May 2017, we performed AVNeo for AS with a small annulus in 34 patients. Their mean age was 77.0 ± 9.1 years. Preoperative transthoracic echocardiography (TTE) revealed a mean peak pressure gradient average of 84.2 ± 31.1 mmHg. The effective orifice area index (EOAi) was 0.45 ± 0.14 cm2/m2. The mean annulus diameter was 18.4 ± 1.1 mm. Our procedure complies with the three cuspid suturing to the aortic annulus with glutaraldehyde-treated autologous pericardium. RESULTS: There were no conversion to aortic valve replacement and no concomitant annulus enlargement. There were two inhospital mortalities resulting from a noncardiac cause. Three patients underwent reoperation owing to aortic regurgitation (n = 2) and infective endocarditis (n = 1). One patient underwent a pacemaker implantation for complete atrioventricular block. The mean follow-up period was 28.0 ± 22.7 months. Postoperative TTE showed a mean peak pressure gradient average of 18.3 ± 9.4 mmHg and a calculated mean EOAi of 1.18 ± 0.35 cm2/m2. The freedom from reoperation rates were 94.1% and 90.8% at 1 year and 5 years of follow-up, respectively. The overall survival rates were 91.2% and 76.8% at 1 and 5 years of follow-up, respectively. CONCLUSIONS: The midterm outcome of AVNeo for AS with a small annulus was excellent. The long-term outcome and reliability of this procedure must be fully clarified.


Assuntos
Estenose da Valva Aórtica/cirurgia , Pericárdio/transplante , Idoso , Idoso de 80 Anos ou mais , Estenose da Valva Aórtica/diagnóstico por imagem , Intervalo Livre de Doença , Ecocardiografia , Feminino , Humanos , Japão , Masculino , Reoperação
18.
Interact Cardiovasc Thorac Surg ; 29(6): 923-929, 2019 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-31365077

RESUMO

OBJECTIVES: We investigated the outcomes of total arch replacement with frozen elephant trunk (FET) for Stanford type A acute aortic dissection and the patterns of postoperative aortic remodelling from computed tomographic (CT) findings. METHODS: From April 2015 to November 2018, we performed total arch replacement with FET for Stanford type A aortic dissection in 30 patients. Postoperative contrast-enhanced CT showed the position of the FET distal end, the number and the site of communications between the lumina and the presence or absence of aortic remodelling. RESULTS: Primary entry tear was found in the ascending aorta (n = 6), proximal arch (n = 6), aortic arch (n = 11) and distal arch (n = 7). The mean diameter and length of FET were 26 ± 2 and 84 ± 18 mm, respectively. Postoperative contrast-enhanced CT was performed in 26 patients. When the number of communications between the lumina was 0, complete aortic remodelling was achieved in all cases (n = 12). In the case of the most proximal tear in the descending aorta (n = 9), aortic remodelling was not recognized in 3 cases, and additional TEVAR was performed because of diameter enlargement. In the remaining 6 patients, neither aortic remodelling nor aortic diameter enlargement was recognized. When the most proximal tear was below the diaphragm (n = 5), aortic remodelling occurred up to the most proximal tear, but not in the periphery. CONCLUSIONS: We investigated the patterns of aortic remodelling after total arch replacement with FET for Stanford type A aortic dissection from postoperative CT findings. Regardless of the position of the most proximal tear in the descending aorta, aortic remodelling did not occur as long as the most proximal tear was located in the descending aorta. When the most proximal tear occurred in the descending aorta, TEVAR as a pre-emptive treatment can be effective in preventing postoperative aortic adverse events.


Assuntos
Aorta/fisiopatologia , Aneurisma da Aorta Torácica/cirurgia , Dissecção Aórtica/cirurgia , Implante de Prótese Vascular/métodos , Remodelação Vascular , Doença Aguda , Idoso , Idoso de 80 Anos ou mais , Dissecção Aórtica/diagnóstico , Dissecção Aórtica/fisiopatologia , Aorta/diagnóstico por imagem , Aorta/cirurgia , Aneurisma da Aorta Torácica/diagnóstico , Aneurisma da Aorta Torácica/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Período Pós-Operatório , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
19.
Asia Ocean J Nucl Med Biol ; 7(1): 49-57, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30705911

RESUMO

OBJECTIVES: The latest single-photon emission computed tomography (SPECT)/computed tomography (CT) reconstruction system, referred to as xSPECT Bone™, is a context-specific reconstruction system utilizing tissue segmentation information from CT data, which is called a zone map. The aim of this study was to evaluate the effects of zone-map enhancement incorporated into the ordered-subset conjugated gradient minimization (OSCGM) reconstruction method on SPECT images. METHODS: Image quality with zone-map enhanced OSCGM (OSCGMz) and non-enhanced OSCGM methods was compared using various reconstruction parameters. The compartment phantom had 3 radioactive sections with CT values of about 1000, 250, and 0 HU. SPECT data were acquired using a low-energy high-resolution (LEHR) collimator, with a 256×256 matrix and 2.4-mm pixel size. The performances of the 2 reconstruction methods (OSCGM vs. OSCGMz) were evaluated on the basis of %error, coefficient of variation (%CV), and normalized mean squared error (NMSE), and adequate iterative update numbers were determined. The relative CV representing the ratio of smoothed images to non-smoothed images was calculated to evaluate the effects of the Gaussian filter on each section set with different CT values. RESULTS: On comparing the OSCGM and OSCGMz methods, it was found that the %error of the OSCGMz method tended to show convergence with fewer updates, especially in the high CT value section mimicking bone absorption. In the water section, the %CV of the OSCGMz method was lower than that of the OSCGM method. The NMSE minimum values for the OSCGM and OSCGMz methods were obtained at 30 and 20 updates, respectively. The relative CV for the OSCGMz method in the water section decreased remarkably according to the size of the full width at half maximum (FWHM) of the Gaussian filter. CONCLUSION: The zone-map enhancement contributed to SPECT reconstruction for the reproduction of radioactive concentrations in bone tissues, using a low number of OSCGM updates. Our findings indicated that the incorporation of zone maps into SPECT reconstruction might improve image quality.

20.
J Clin Biochem Nutr ; 63(1): 66-69, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30087546

RESUMO

This study aimed i) to investigate about items with high relevance for aspiration pneumonia during hospitalization among cases evaluated using Diagnosis Procedure Combination data, and ii) to determine whether the concern factors for aspiration pneumonia during hospitalization were exacerbated with the trend of the time. The Diagnosis Procedure Combination data were gathered from 2010 through to 2015 with 63,390 cases at Saga University Hospital. The occurrence of concern factors of aspiration pneumonia during hospitalization were compared in the two time periods set (2010-2012 and 2013-2015). The concern factors included: male, age, dysphagia at admission and during hospitalization, use and days in the emergency care unit or high care unit, use of the intensive care unit, and use of an ambulance. Age, dysphagia, and use of the intensive care unit were time-dependently exacerbated. The incidence of aspiration pneumonia during hospitalization in hospitalized cases did not differ between years 2010-2012 and 2013-2015. Aspiration pneumonia during hospitalization complicated with surgery and number days in the emergency care unit or high care unit diminished in years 2013-2015. Despite an increased concern of aspiration pneumonia during hospitalization, the complication rate of aspiration pneumonia during hospitalization did not increase.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...