Search

Coronavirus disease 2019 (COVID-19) is a recently-emerged infectious disease that has caused millions of deaths, where comprehensive understanding of disease mechanisms is still unestablished. In particular, studies of gene expression dynamics and regulation landscape in COVID-19 infected individuals are limited. Here, we report on a thorough analysis of whole blood RNA-seq data from 465 genotyped samples from the Japan COVID-19 Task Force, including 359 severe and 106 non-severe COVID-19 cases. We discover 1169 putative causal expression quantitative trait loci (eQTLs) including 34 possible colocalizations with biobank fine-mapping results of hematopoietic traits in a Japanese population, 1549 putative causal splice QTLs (sQTLs; e.g. two independent sQTLs at TOR1AIP1), as well as biologically interpretable trans-eQTL examples (e.g., REST and STING1), all fine-mapped at single variant resolution. We perform differential gene expression analysis to elucidate 198 genes with increased expression in severe COVID-19 cases and enriched for innate immune-related functions. Finally, we evaluate the limited but non-zero effect of COVID-19 phenotype on eQTL discovery, and highlight the presence of COVID-19 severity-interaction eQTLs (ieQTLs; e.g., CLEC4C and MYBL2). Our study provides a comprehensive catalog of whole blood regulatory variants in Japanese, as well as a reference for transcriptional landscapes in response to COVID-19 infection., 「コロナ制圧タスクフォース」COVID-19患者由来の血液細胞における遺伝子発現の網羅的解析 --重症度に応じた遺伝子発現の変化には、ヒトゲノム配列の個人差が影響する--. 京都大学プレスリリース. 2022-08-23.

In the field of respiratory clinical practice, the importance of measuring carbon dioxide (CO2) concentrations cannot be overemphasized. Within the body, assessment of the arterial partial pressure of CO2 (PaCO2) has been the gold standard for many decades. Non-invasive assessments are usually predicated on the measurement of CO2 concentrations in the air, usually using an infrared analyzer, and these data are clearly important regarding climate changes as well as regulations of air quality in buildings to ascertain adequate ventilation. Measurements of CO2 production with oxygen consumption yield important indices such as the respiratory quotient and estimates of energy expenditure, which may be used for further investigation in the various fields of metabolism, obesity, sleep disorders, and lifestyle-related issues. Measures of PaCO2 are nowadays performed using the Severinghaus electrode in arterial blood or in arterialized capillary blood, while the same electrode system has been modified to enable relatively accurate non-invasive monitoring of the transcutaneous partial pressure of CO2 (PtcCO2). PtcCO2 monitoring during sleep can be helpful for evaluating sleep apnea syndrome, particularly in children. End-tidal PCO2 is inferior to PtcCO2 as far as accuracy, but it provides breath-by-breath estimates of respiratory gas exchange, while PtcCO2 reflects temporal trends in alveolar ventilation. The frequency of monitoring end-tidal PCO2 has markedly increased in light of its multiple applications (e.g., verify endotracheal intubation, anesthesia or mechanical ventilation, exercise testing, respiratory patterning during sleep, etc.).

To elucidate the host genetic loci affecting severity of SARS-CoV-2 infection, or Coronavirus disease 2019 (COVID-19), is an emerging issue in the face of the current devastating pandemic. Here, we report a genome-wide association study (GWAS) of COVID-19 in a Japanese population led by the Japan COVID-19 Task Force, as one of the initial discovery GWAS studies performed on a non-European population. Enrolling a total of 2,393 cases and 3,289 controls, we not only replicated previously reported COVID-19 risk variants (e.g., LZTFL1, FOXP4, ABO, and IFNAR2), but also found a variant on 5p35 (rs60200309-A at DOCK2) that was significantly associated with severe COVID-19 in younger (-8 (odds ratio = 2.01, 95% confidence interval = 1.58-2.55). This risk allele was prevalent in East Asians, including Japanese (minor allele frequency [MAF] = 0.097), but rarely found in Europeans. Cross-population Mendelian randomization analysis made a causal inference of a number of complex human traits on COVID-19. In particular, obesity had a significant impact on severe COVID-19. The presence of the population-specific risk allele underscores the need of non-European studies of COVID-19 host genetics.

Obstructive sleep apnea (OSA) patients are at risk for increased blood pressure and carotid intima-media thickness (IMT), with pulmonary hypertension and right-sided heart failure potentially developing as well. Chronic intermittent hypoxia (IH) has been used as an OSA model in animals, but its effects on vascular beds have not been evaluated using objective unbiased tools. Previously published and current experimental data in mice exposed to IH were evaluated for IMT in aorta and pulmonary artery (PA) after IH with or without normoxic recovery using software for meta-analysis, Review Manager 5. Because IMT data reports on PA were extremely scarce, atherosclerotic area percentage from lumen data was also evaluated. IH significantly increased IMT parameters in both aorta and PA as illustrated by Forest plots (P < 0.01), which also confirmed that IMT values after normoxic recovery were within the normal range in both vascular beds. One-sided scarce lower areas in Funnel Plots were seen for both aorta and PA indicating the likelihood of significant publication bias. Forest and Funnel plots, which provide unbiased assessments of published and current data, suggest that IH exposures may induce IMT thickening that may be reversed by normoxic recovery in both aorta and PA. In light of the potential likelihood of publication bias, future studies are needed to confirm or refute the findings. In conclusion, OSA may induce IMT thickening (e.g., aorta and/or PA), but the treatment (e.g., nasal continuous positive airway pressure) will likely lead to improvements in such findings.

IntroductionThe rapid spread of COVID-19 posed a global burden. Substantial number of people died of the disease in the acute phase of infection. In addition, a significant proportion of patients have been reported to suffer from post-acute phase symptoms, sequelae of COVID-19, which may negatively influence the quality of daily living and/or socioeconomic circumstances of the patients. However, no previous study has comprehensively and objectively assessed the quality of life of patients by using existing international scales. Further, evidence of socioeconomic consequences among patients with COVID-19 is scarce. To address the multidimensional issues from sequelae of COVID-19, evidence from comprehensive surveys beyond clinical perspectives is critical that investigates health, and social determinants of disease progression as well as socioeconomic consequences at a large scale.Methods and analysisIn this study, we plan to conduct a nationwide and comprehensive survey for the sequelae of COVID-19 in a total of 1000 patients diagnosed at 27 hospitals throughout Japan. This study will evaluate not only the health-related status of patients from clinical perspectives but also the Health-related Quality of Life (HRQoL) scores, socioeconomic status and consequences to discuss the sequelae of the disease and the related risk factors. The primary endpoint is the frequency of long-term complications of COVID-19 infection. The secondary endpoints are risk factors for progression to sequelae of COVID-19 infection. The study will provide robust and important evidence as a resource to tackle the issues from the sequelae of COVID-19 from the multi-dimensional perspectives.Ethics and disseminationThis trial was approved by the Keio University School of Medicine Ethics Committee (20200243, UMIN000042299). The results of this study will be reported at a society meeting or published in a peer-reviewed journal.

Although the incidence of postbulbar duodenal ulcers is low, many complications occur, such as hemorrhage, stenosis and perforation, and there are many points to be paid attention to with regard to its pathology. A high acid level has been pointed out as a cause, but this is not conclusive, and its association with Helicobacter pylori (Hp) infection is also unclear. We investigated chronic cases excluding acute cases such as acute duodenal mucosal lesion we encountered between 2001 and 2015. Five cases corresponded, accounting for 1.4% of all chronic duodenal ulcer cases, and there were more male patients (four patients were male), as previously reported. All cases were solitary punched-out ulcer on the medial side near the superior duodenal flexure, and many complications were observed such as melena in all patients, narrowing in 2, and penetration in 1. No specific pathology, such as Crohn’s disease, vasculitis, or Zollinger-Ellison syndrome, was noted, no patient was previously medicated with NSAIDs or low dose aspirin, and 3 patients were infected with Hp. All cases were healed by proton pump inhibitor administration or gastric acid secretion-suppressing treatment with selective proximal vagotomy. Recurrence after Hp eradication occurred in all of the 3 Hp-infected patients, suggesting that involvement of Hp in the cause of disease is unlikely.

BackgroundUsual clinical practice for arterial blood gas analysis (BGA) in conscious patients involves a one-time arterial puncture to be performed after a resting period of 20–30 min. The aim of this study was to evaluate the use of transcutaneous BGA for estimating this gold standard arterial BGA.MethodsSpontaneously breathing Asian adults (healthy volunteers and respiratory patients) were enrolled (n = 295). Transcutaneous PO2(PtcO2) and PCO2(PtcCO2) were monitored using a transcutaneous monitor (TCM4, Radiometer Medical AsP, Denmark) with sensors placed on the chest, forearm, earlobe or forehead. Transcutaneous BGA at 1-min intervals was compared with arterial BGA at 30 min. Reasonable steps to find severe hypercapnia with PaCO2 > 50 mmHg were evaluated.ResultsSensors on the chest and forearm were equally preferred and used because of small biases (n = 272). The average PCO2bias was close to 0 mmHg at 4 min, and was almost constant (4–5 mmHg) with PtcCO2being higher than PaCO2at ≥8 min. The limit of agreement for PCO2narrowed over time: ± 13.6 mmHg at 4 min, ± 7.5 mmHg at 12–13 min, and ± 6.3 mmHg at 30 min. The limit of agreement for PO2also narrowed over time (± 23.1 mmHg at 30 min). Subgroup analyses showed that the PaCO2and PaO2levels, gender, and younger age significantly affected the biases. All hypercapnia subjects with PaCO2 > 50 mmHg (n = 13) showed PtcCO2 ≥ 50 mmHg for until 12 min.ConclusionsAlthough PtcCO2is useful, it cannot completely replace PaCO2because PCO2occasionally showed large bias. On the other hand, the prediction of PaO2using PtcO2was unrealistic in Asian adults. PtcCO2 ≥ 50 mmHg for until 12 min can be used as a screening tool for severe hypercapnia with PaCO2 > 50 mmHg.

A 42-year-old Japanese man developed Churg–Strauss syndrome 7 years after being diagnosed with chronic eosinophilic pneumonia. Prominent eosinophilia, subcutaneous nodules, and neuropathy in the left leg were seen. A pathological diagnosis of necrotizing vasculitis was determined by a biopsy of a subcutaneous nodule. The leg pain was severe and there was prominent atrophy of the thigh and calf, but the muscle weakness was mild. Serum anti-myeloperoxidase anti-neutrophil cytoplasmic antibody was positive. Because the initial treatment with an intravenous methylprednisolone pulse at 1 g/day for 3 days was not sufficient, a onetime treatment with intravenous cyclophosphamide at 15 mg/kg and intravenous immunoglobulin therapy (IVIG) at 400 mg/kg/day for 5 days were administered. Peripheral eosinophilia improved and the leg pain significantly improved. IVIG was repeated 1 month later and symptoms gradually improved further. The early diagnosis of Churg–Strauss syndrome and the early initiation of IVIG with cyclophosphamide were thought to be important.

Objectives: Recent reports on venous blood gas analysis have shown that venous bicarbonate concentration is useful in the evaluation of the body acid-base status. Most of these reports have been based on the Bland-Altman analysis comparing arterial and venous blood gas values. We intended to elucidate any factors that decrease the agreement between venous and arterial bicarbonate concentrations, which might impair the usefulness of venous blood gas analysis. Methods: Healthy volunteers and patients with various diseases (n = 141) were evaluated by simultaneous arterial and venous blood sampling and Bland-Altman analysis. The venous-arterial bicarbonate concentration difference was compared between healthy volunteers and untreated respiratory alkalosis patients. Intentional hyperventilation (30 or 60 breaths/min, for 3 min) was also performed on 6 healthy volunteers and the venous-arterial bicarbonate concentration difference was evaluated. Results: The relative average bias in bicarbonate concentration was 2.00 mEq/l with venous bicarbonate higher than arterial bicarbonate with 95% limits of agreement of ±4.15 mEq/l. Hyperventilation challenges increased the venous-arterial bicarbonate concentration difference in an intensity-dependent manner. The venous-arterial bicarbonate concentration difference was higher in untreated respiratory alkalosis patients than in healthy volunteers (P Conclusion: Although venous bicarbonate may be useful to evaluate the body acid-base status, hyperventilation increases the venous-arterial bicarbonate concentration difference. Physicians should keep this phenomenon in mind.

Objective: The Japanese drug use system allowed the “once-daily use” of inhaled corticosteroid (ICS) fluticasone furoate (FF) combined with a long acting beta-2 agonist (LABA) vilanterol (VI) against asthma for the first time in 2013. Until then, patients with asthma had to use ICS at least twice-daily. We investigated the real-world efficacy and problems of this drug (FF/VI). Methods: This was an open-label, uncontrolled, within-group time-series (before-after) design. Prior treatments of asthma (twice-daily use of ICS with or without LABA) were switched to once-daily use of FF/VI (200 μg/25 μg). Subjects were evaluated by lung function tests prior to, and 2–3 months after, the initiation of FF/VI. Questions on the asthma control test (ACT) and preference of drugs were asked to patients. Results: One hundred and twenty-eight Japanese asthma outpatients were enrolled from 2014–2018 and 107 subjects completed the study. Peak flow, instantaneous flow at 75% of the forced vital capacity (V75), V50, maximum mid-expiratory flow rate, forced expiratory volume in 1 s, and ACT score in FF/VI-using subjects were significantly increased (all p

A 55-year-old man visited our department because of epigastric pain. Upper gastrointestinal endoscopy revealed a small, undermined ulcer in the gastric cardia. He had no history of taking NSAIDs, and was positive for Helicobacter pylori (Hp) infection. After Hp eradication therapy followed by 8 weeks of proton pump inhibitor (PPI) administration, re-endoscopy showed that the ulcer had slightly shrunk without scarring, and the surrounding mucosa was markedly elevated, like in a submucosal tumor. Endoscopic ultrasonography, performed at the same time, showed thickening of the submucosal and muscular layers around the ulcer. After continuous PPI administration, the mucosal elevation disappeared, and the ulcer shrunk and later scarred. However, when the dose of PPI was reduced with the aim of discontinuing it after the confirmation of successful Hp eradication, the ulcer recurred. We report this case of gastric ulcer because of its peculiar clinical presentation.

A man taking antithrombotic agents was admitted because of melena. Upper gastrointestinal endoscopy revealed a large, pedunculated polyp bleeding from erosions on its top. The polyp was endoscopically resected, and histopathologically diagnosed as Brunner ’ s gland hyperplasia. It is commonly encountered as a small, raised lesion, but may enlarge or bleed. We report this case, with a review of the Japanese literature and discussion of the mechanism of bleeding. doi: http://dx.doi.org/10.4021/gr532e

Microplasma technology was used in many applications from biomedical to surface treatment of polymers. A new application could be the surface treatment of glass panels for the electronic industry in order to improve the surface wettability. The remote microplasma method is proposed for the surface treatment of glass. It can be easily applied as an industrial process due to the relatively low discharge voltage around 1 kV and small size of the reactor. This paper presents the surface treatment of glass by microplasma using Ar and mixtures of Ar with N2 and O2. A microplasma process was analyzed by the emission spectroscopy method. A Marx generator with MOSFET switches, a neon transformer, and a pulsed power supply were used to energize the electrodes. The emission spectrum was measured by an intensified charge-coupled device camera and a spectrometer. An optic fiber was used to have an accurate measurement of a small part of the microplasma discharge. Surface wettability of glass was confirmed, measuring the contact angle before and after the microplasma treatment. The surface of glass was modified due to the action of the radicals and active species generated by microplasma. The emission spectrum of the microplasma discharge in Ar and mixtures of Ar with and showed ArI peaks, OH peaks, second positive band system peaks, and first positive band system peaks.

A 60-year-old male presented with cough and fever (case 1), and a 77-year-old female patient with hemoptysis (case 2) were admitted to IUHW Shioya Hospital. Interferon gamma release assay (IGRA: QFT-3G and T-SPOT. TB) were both performed on each patient; the QFT-3G was positive and T-SPOT.TB was negative in both cases despite different final diagnosis. While case 1 was determined to have active tuberculosis, in case 2 active tuberculosis was eliminated as the diagnosis. The contradictory results in these patients should serve as a reminder to clinicians that they should not rely on the results of IGRA testing for the diagnosis of active tuberculosis. Keywords: Interferon Gamma Release Assay; Negative; Tuberculosis; T-SPOT; QFT

A middle-aged man with no symptom or history visited our hospital due to duodenal abnormality and fecal occult blood detected by health screening. Upper gastrointestinal endoscopy showed marked enlargement of the papilla of Vater surrounded by nodules, and biopsy disclosed non-caseating granuloma. Colonoscopy yielded findings suggestive of intestinal tuberculosis such as annular ulcers. Examination of the biopsy samples failed to make a diagnosis of tuberculosis, and no pulmonary lesion was found, but whole-blood interferon gamma release assay was positive. The duodenal lesion was also suspected to be tubercular, so antitubercular drugs were administered. As this resulted in the resolution of both lesions, a definite diagnosis of tubercular papillitis of Vater was made. Duodenal tuberculosis is rare, and a localized lesion of the major duodenal papilla is extremely rare. However, this case suggests that tuberculosis must be considered in the differential diagnosis of lesions of the papilla of Vater.

Microplasma can be found in many applications. The technology is also used for surface treatment of polymers. The process of surface treatment by microplasma is environmental friendly, and it could be realized at low cost due to the relatively low discharge voltage (around 1 kV) even under atmospheric pressure and the small size of the power supply and reactor. This paper presents the surface treatment by microplasma of polyethylene naphthalate (PEN) film using Ar gas and mixtures of Ar with N2 and O2. The microplasma process was analyzed by the emission spectroscopy method. An experimental Marx generator with MOSFET switches was used as a pulsed high-voltage power supply. The emission spectra were measured by an intensified charge coupled device camera, a spectrometer, and a photomultiplier tube. Surface wettability of the PEN film was confirmed by measuring the contact angle before and after the microplasma surface treatment. It was observed that the contact angle of the PEN film decreased, especially with the O2/Ar mixture. The analysis using an X-ray photoelectron spectrometer showed the decrease of C1s, which correspond to the C-H bond. The emission spectrum of the microplasma discharge in the N2/Ar mixture showed Ar peaks, OH peaks, N2 second positive band system peaks (N2 SPS), N2 first positive band system peaks ( N2 FPS), and decrease in the peak intensities of ArI and OH for microplasma discharge in the O2/Ar mixture. The lifetime emission signals for the N2 SPS for the microplasma discharge in 0.25% N2 in Ar were around 1 μs. The calculation of the microplasma rotational and electron temperatures shows low rotational and high electron temperatures.

This report describes a novel technique for the calibration of accelerometers. The theory is based on acceleration as a vector quantity and the fact that the mathematical function of accelerometers is the projection of a real motion vector space to a signal vector space. The sensitivity should be therefore be defined as a matrix. The definition of the calibration shall be to derive all of the components in the sensitivity matrix. The transverse sensitivity value in the conventional definition can be derived using sensitivities in the sensitivity matrix. Cross sensitivity makes a large influence on the measurement error.

This paper describes the system for the calibration of accelerometers using a three-dimensional vibration generator and laser interferometers. The vibration generator is an electrodynamic type, IMV TS-1030 S, which can generate motion with the arbitrary direction in the three-dimensional coordinate system under sinusoidal, random and shock operation mode. It has five actuators in total, two actuators each for X-axis and Y-axis and one for Z-axis motion. Motion of the table is monitored during the operation by the three piezoelectric-accelerometers, BK 4393. The signal from them is used for the control of the table, feed forward and feed back. Motion of the table in three-dimensional space is measured by three laser interferometers, Neoark MLD 301 K. The sensitivity of an accelerometer is defined in the form of a matrix including the cross sensitivity. Size of the matrix is 1×3, 2×3 and 3×3 for one-axis accelerometer, two-axis accelerometer and three-axis accelerometer, respectively. Since acceleration is a vector quantity, input signals and output signals of an accelerometer make a vector space. An accelerometer is mathematically a device executing a projection between two vector spaces. This system is the realization of this concept.

A 61-year-old man took loxoprofen sodium hydrate, a prodrug NSAID, for acute upper respiratory infection for 5 days, developed melena 2 days later, and was admitted to our hospital. Upper gastrointestinal endoscopy revealed a giant and deeply undermined ulcer mainly in the greater curvature of the antrum, which occupied halfway around the lumen. His medical history was unremarkable. He was negative for Helicobacter pylori infection, and was diagnosed with NSAID-induced acute gastric ulcer in the absence of other causes of gastric ulcer. Giant gastric ulcers, as in this patient, are rare. Moreover, deeply undermined or huge gastric ulcers sometimes develop during the long-term administration of NSAIDs, but very rarely after their short-term administration, which prompted us to report this case.

A trend in sintered machine parts is the production of net shaped objects and comprex shaped parts. Correspondingly the machinability of green compacts with a lathe was investigated experimentally. In this regard, the compactibility of a raw powder was also discussed. Beside Fe-40% Cu plated powder with excellent compactibility, Fe-40%Cu, Fe-3%Cu, Fe-3%Cu-1%C and Fe-1%C as mixed powders and Fe powder were used. All these green strengths increase in proportion to the compacting pressure in the range of 98MPa to 686MPa. As the results of cutting test, satisfactory cutting surfaces were obtained for the green compacts with the radial crushing strength above about 60 MPa. Furthermore, the graphite as one of the alloying elements serves to provide lubrication on cutting. Conseqently, both Fe-3%Cu-1%C and Fe-1%C compacts exhibit good machinability in spite of low green strength in comparison with the others.

To study the inflammatory responses of small-airway epithelium in smokers, we harvested enough living epithelial cells (1.97 × 106± 0.74 × 106) with a new ultrathin fiberscope from the very peripheral airways of 22 current smokers and 17 subjects who never smoked after informed consent was obtained. The cells were keratin positive and composed mainly of nonciliated cells. The expression levels of inflammatory markers [interleukin (IL)-8 and intercellular adhesion molecule (ICAM)-1] were evaluated with RT-PCR. The magnitude of the mRNA levels corrected by β-actin transcripts of IL-8 and ICAM-1 was significantly higher in the smokers than in the nonsmokers ( P < 0.001). Furthermore, among current smokers, IL-8 mRNA levels correlated positively with the extent of smoking history [in pack ⋅ years (packs/day × no. of years of smoking); r = 0.754, P < 0.001]. Spontaneously released IL-8 and soluble ICAM-1 levels ( n = 12) from cultured epithelial cells were elevated in subjects with a smoking history than in those without it (IL-8, 1,580 ± 29.6 vs. 354 ± 39.4 pg ⋅ 106cells−1⋅ 24 h−1; P < 0.001; soluble ICAM-1, 356.0 ± 45.9 vs. 112.9 ± 12.9 pg ⋅ 106cells−1⋅ 24 h−1; P < 0.01 by Student's t-test ). In contrast, the epithelial cells from the main bronchi did not show such differences between smokers and nonsmokers. Our study highlighted a close link between smoking and the expression of inflammatory mediators such as IL-8 and ICAM-1 in small airways. Our results also suggested that this new ultrathin bronchofiberscope promised a good approach for the evaluation of cellular changes in the small airways.

Cu-plated Fe powder by the use of the etching waste solution is produced. Since the amount of plated Cu can be regulated, the composition of plated powder in this study is controlled Fe-50wt%Cu. As the result, there is the excellent compactibity of plated powder and it is possible to sinter at low temperature. For instance, the rattler value of 0.25% was obtained by the compacting pressure of 294MPa and the radial crushing strength was 171MPa at the sintering temperature of 973K for 3.6ks. The sintered compacts of the plated powder in comparison with mixedpowder have the low dimensional change, the uniform in the pore distribution and reasonable mechanical strength. Conseqently this Cu-plated Fe powder appears to be very suitable oil-impregnated bearing. Furthermore, this sintered compact is very superior in roundness and cylindricity which are important from the standpoint of the precision of bearing.

Dynamic response of foil strain gages is investigated in the ranges of up to approximately 300 kHz in frequency, 2000 μe in strain and 750 s−1 in strain rate. Impulsive input is applied to the gages using elastic wave pulses in a circular bar. The input is determined by measuring the velocity of the bar end with a laser interferometer. It was confirmed that deviations from the static gage factors do not exceed−5 percent within the frequency range up to 45 kHz, 110 kHz and more than 290 kHz for 20-mm, 10-mm and 3-mm gages, respectively, and that the gage length is the dominant factor in the gages' frequency characteristics. This paper also mentions self-generated voltages.

Smoking cessation decreases oxidative stress and restores vascular endothelial function. However, a recent meta-analysis suggests that the use of varenicline, a α4β2 nicotinic acetylcholine receptor partial agonist, increases the risk of cardiovascular events. This study was designed to determine the effect of varenicline-assisted smoking cessation on vascular endothelial function. Study subjects were 11 healthy Japanese males (mean age, 54.4 years) without evidence of cardiovascular disease who were eager to quit smoking. Each subject was treated with varenicline titrated up to 1.0 mg twice daily. We evaluated serum derivatives of reactive oxygen metabolites (d-ROMs) as a marker of oxidative stress, and flow-mediated dilation (FMD) of the brachial artery as a marker of vascular endothelial function. Both measurements were performed before and 3 months after completing smoking cessation. All subjects gained weight (average, 1.7 kg) after smoking cessation. However, there were no significant differences in the following parameters before and after smoking cessation: systolic blood pressure, diastolic blood pressure, heart rate, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, glucose and hemoglobin A1c. Serum d-ROM levels significantly decreased from 340.7±70.4 to 300.0±43.2 U.CARR (P=0.012), and FMD significantly increased from 3.36±1.26 to 5.25±1.33% (P=0.00067) after smoking cessation. There was an inverse correlation between FMD and serum d-ROM levels (R=-0.377; P=0.043). Our observations suggest that varenicline-assisted smoking cessation restores vascular endothelial function, and this is associated with decreased oxidative stress, despite an increase in body weight. As varenicline-assisted smoking cessation possibly has beneficial effects on vascular endothelial function, it might also reduce cardiovascular risk.

Objectives: A meta-analysis suggested that the use of varenicline, which is a partial agonist of nicotinic acetylcholine receptors and is effective in smoking cessation, increases the risk of cardiovascular events within 52 weeks of starting treatment. Defining these events as occurring during drug treatment (usually for 12 weeks) or within 30 days of discontinuation, another meta-analysis showed that the risk was statistically insignificant. In the present study, we aimed to clarify the effect of varenicline-assisted smoking cessation on vascular endothelial function assessed by flow-mediated vasodilation (FMD). Design: Before–after and time-series. Setting: Tochigi Prefecture, Japan. Participants: Data of 85 participants who visited nicotine-dependent outpatient services were reviewed. FMD was repeatedly measured in 33 of the 85 participants. Inclusion criteria: 20 years and older, Brinkman index ≥200, Tobacco Dependence Screener ≥5 and stated motivation to quit smoking. Interventions: Each participant was treated with varenicline titrated up to 1.0 mg twice daily (for 12 weeks in total). Primary and secondary outcome measures: Participants were evaluated by FMD prior to, and 3 months after, complete smoking cessation. Follow-up FMD measurements were carried out every 3 months if possible. Changes in FMD during varenicline use were also evaluated. Results: FMD was significantly increased from 4.0±1.8% to 5.5±2.2% (p

In this paper, we propose a novel method for evaluating the frequency response of shock accelerometers using Davies bar and interferometry. The method adopts elastic wave pulses propagating in a thin circular bar for the generation of high accelerations. The accelerometer to be examined is attached to one end of the bar and experiences high accelerations of the order of 103∼105 m/s2. A laser interferometer system is newly designed for the absolute measurement of the bar end motion. It can measure the motion of a diffuse surface specimen at a speed of 10−3 ∼100 m/s. Uncertainty of the velocity measurement is estimated to be±6×10−4 m/s, proving a high potential for use in the primary calibration of shock accelerometers. Frequency characteristics of the accelerometer are determined by comparing the accelerometer's output with velocity data of the interferometry in the frequency domain. Two piezoelectric-type accelerometers are tested in the experiment, and their frequency characteristics are obtained over a wide frequency range up to several ten kilohertz. It is also shown that the results obtained using strain gages are consistent with those by this new method.

胸部X線所見分類で孤立結節性陰影1例, 多発粟粒状結節性陰影1例, 肺炎様陰影3例の細気管支肺胞上皮癌5例を胸部単純X線写真, X線CTと細気管支鏡所見を対比し検討した. 内視鏡所見は肺炎様陰影を呈した症例では細気管支は漿液性の分泌物が多く肺胞の方から湧き出てくる像がみられ, また, 細気管支に粘膜下主体型の腫瘍および閉塞像が認められた. 散在するポリープ様変化も認められ本症の進展形式を示唆した. 孤立結節性陰影の症例では結節隆起型の腫瘍がみられた. 多発粟粒状結節性陰影の症例では細気管支は全般的に狭窄を起こし粘膜面が蒼白に認められた. 初めて本症を内視鏡で観察することが出来た.

Six cases of gastric antral ulcer with an unknown cause encountered at our hospital and related facilities during the last 5 years were evaluated. The frequency of the disease was 1.3% of all gastric ulcers. The lesions were multiple in 3 and solitary in 3. All these lesions were ellipsoidal and small ulcers 1 cm or less in long diameter with mucosal elevations around them, located primarily in the greater curvature, and accompanied by reddened erosions in other areas of the antrum. The patients were middle-aged or older, 5 of them were females, half of them had a history of bleeding, and 4 showed resistance to treatment with proton pump inhibitors. The 6 patients had common clinical features, suggesting that they had the same disease. From the presence of reddened erosion, mutual friction of the antral mucosa was suspected to be a cause of the disease. Similar ulcers are found in the literature, but they have not been described or evaluated in detail. The further accumulation of cases and clarification of details of the disease are desired.

This paper proposes a novel method for evaluating the dynamic characteristics of shock accelerometers under high acceleration levels and a wide frequency bandwidth. High accelerations of 103∼105m/s2 can be generated by the reflection of an elastic wave pulse propagating in a metal bar known as the Davies bar. The elastic wave pulse is produced by the collision of a projectile against one end of the bar, and is detected by straingages. The accelerometer to be characterized is attached to the other end of the bar. The one-dimensional theory of elastic waves enables the derivation of an input acceleration to the accelerometer from the measured strain. The dispersion of the elastic waves caused by the lateral inertia of the bar is compensated for by using a two-dimensional analytical solution. This method was validated by an experiment characterizing a piezoelectric-type accelerometer within the frequency band approximately 1 kHz∼70 kHz.