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Background : Cardio-ankle vascular index (CAVI) is a marker that reflects the overall stiffness of the aorta, femoral artery, and tibial artery. Several previous reports have shown the usefulness of CAVI for coronary artery disease (CAD) presence and severity. According to coronary angiography (CAG) and intracoronary imaging such as optical coherence tomography (OCT), coronary plaque burden and morphology as predictors of all-cause and cardiovascular mortality were previously evaluated. The aim of our study was to assess the correlation between CAVI value and Gensini's score for the coronary plaque burden as well as CAVI value and plaque morphology by using OCT. / Methods : A total of 548 consecutive patients who underwent CAG were enrolled in this study. CAVI value was evaluated in all patients, and OCT was performed in 89 of the 548 patients. CAVI ratio is calculated as CAVI/CAVIex (expected normal value of CAVI, which is calculated using patient age and sex)....

Background : The presence of cardiac involvement in sarcoidosis, a multisystem granulomatous disease of unknown etiology, is associated with very poor prognosis. Therefore, early detection of cardiac sarcoidosis (C-sar) is very important for effective treatment. Recently, the value of late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR), which allows visualization of even minute amounts of myocardial damage, has been emphasized in diagnosing C-sar. Although the presence of LGE has been added as a minor criterion for diagnosing C-sar in the most recent Japan Ministry of Health and Welfare (JMHW) guidelines, its clinical utility remains unknown....

Background : Histopathological examination is not suitable for sequential in vivo analysis of arterial healing after stenting because it can be performed only after the animals are killed. Optical coherence tomography (OCT) provides higher resolution than intravascular ultrasound (IVUS). The aim of this study was to compare arterial healing images after stenting on the basis of the findings of histopathological examination, IVUS, and OCT. / Methods : We examined 12 vessels; 12 bare-metal stents were implanted in 6 miniature swine. Histopathological examination, IVUS, and OCT imaging were performed at 1 and 4 weeks after stenting. For quantitative analysis of IVUS and OCT images, we examined cross-sectional frames at 1-mm intervals....

application/pdf, 論文(Article), Among the changes in medical practices in recent years, the low level of proficiency in nursing skills and other practical abilities of new nursing graduates has become an issue. In order to resolve this problem, 79 students participated voluntarily in (1) taking venous blood samples (students drew each other's blood), (2) oronasal suction, (3) preparing an intravenous drip, and (4) handling sterile items. After the completion of training, the participants completed an anonymous questionnaire. Many responded that they had achieved their respective goals, and all responded that the training would be useful after graduation. Responses such as I know what knowledge and skills I am lacking, and I know what it means to be a responsible nurse showed that the students had also clarified future issues for themselves. However, we also identified a need to look into the selection of nursing skills and how to implement them, time available for acquiring these skills, evaluation methods, and student motivation., 近年、医療を取りまく状況の変化の中、看護技術の未熟さなど、新卒看護師の実践能力が課題であるとされている。その解決策のひとつとして、卒業直前に学生が自主的に取り組むという方法で看護技術のトレーニングを実施した。参加学生は79名で、(1)静脈血採血（学生同士での採血）、(2)口鼻腔内吸引、(3)点滴の準備、(4)滅菌物の取り扱いについて実施した。トレーニング終了後、参加学生を対象として無記名によるアンケート調査を行った。その結果、それぞれの目標が達成できたとする回答が多く、全員が「卒業後に役立つ」と回答していた。また、「知識と技術の不足を再確認した」や「看護師として責任を実感した」というように、学生は、今後の自己課題についても明確にすることができていた。したがって、本取り組みが有効であったことが示唆された。しかし、実施する看護技術の選定や時間、評価方法、学生の動機づけなどの検討が必要であることも明らかになった。

Background : HMG-CoA reductase inhibitors (statin) have been reported to decrease coronary artery events in several angiographic studies. However, the mechanism by which statin achieve this is still unclear. The purpose of this study was to identify the effect of statin on coronary plaque using serial intravascular ultrasound analysis. / Methods and Results : In this study, 48 patients with 48 lesions were divided into the prescribed group (statin group, n=22) or the non-prescribed group (control group, n=26) after successful coronary artery stenting. IVUS images were obtained at consecutive 5 mm segments, 5 mm from the proximal stent edge, immediately after stenting and at 6 months follow up....

BACKGROUND: Coronary artery disease (CAD) often occurs concurrently in patients with severe aortic stenosis (AS). However, the influence of concomitant CAD on the presence of atherosclerotic complex plaques in the aortic arch, which is associated with increased stroke risk, has not been fully assessed in patients with severe AS. HYPOTHESIS: We hypothesized that concomitant CAD would be associated with the presence of complex arch plaques in patients with severe AS. METHODS: The study population consisted of 154 patients with severe AS who had undergone transesophageal echocardiography (TEE) and coronary angiography (71 male; mean age, 72 ± 8 years; mean aortic valve area, 0.67 ± 0.15 cm(2)). Aortic arch plaques were assessed using TEE, and complex arch plaques were defined as large plaques (≥4 mm), ulcerated plaques, or mobile plaques. RESULTS: The prevalence of aortic arch plaques (87% vs 70%; P = 0.03) and complex arch plaques (48% vs 20%; P

Clinical and Research Applications of Optical Coherence Tomography Imaging in Coronary Artery Disease

本研究では水道用湖沼原水を対象にした一年間のパイロットプラントを用いた実証試験で、ポリシリカ鉄凝集剤(PSI)の凝集沈澱処理能力をポリ塩化アルミニウム(PAC)および塩化鉄と比較、評価した。PSIの濁度除去能は同じ鉄系凝集剤である塩化鉄と比べて水温の影響を受けにくく、水質変動に対してもPACと同様に安定した処理能力を示した。PSIの藻類除去能はPAC、塩化鉄より高いと考えられた。これはPSIが鉄系凝集剤であることに起因していることと、重合ケイ酸の効果により低水温期でも塩化鉄のように処理能力が悪化することが無かった為と考えられた。ろ過水の残留濁度および全藻類数はPSI、塩化鉄、PACの3つの凝集剤による違いはほとんどなかったが、PSIを使用した場合にはアンスラサイト層で特異的な損失の増加が起こり、PACや塩化鉄を使用した場合に比べてろ過塔の総損失水頭が高くなった。この損失の増加の原因としては、凝集沈殿処理水に残留したPSI由来の溶存の重合ケイ酸が、アンスラサイト表面に吸着して蓄積することにより、アンスラサイト層の空隙を閉塞することが考えられた。, The objective of this study is to evaluate polysilicate-iron (PSI) coagulant in comparison with polyaluminum chloride (PAC) and ferric chloride coagulants on turbidity and algae removal. The evaluation was carried out using a pilot scale plant for a lake water in a year. Turbidity removal by PSI was not affected by water temperature, whereas that by ferric chloride deteriorated in winter. PSI showed higher removal efficiency for algae than PAC in all seasons and ferric chloride in winter. This higher removal efficiency by PSI might be explained by the fact that PSI was a ferric coagulant and contained polysilicate. The water quality of filtrated water with rapid filtration, was almost the same. The total head loss of rapid filtration in PSI was developed quicker than that in PAC and ferric chloride due to high head loss in the anthracite layer. The adsorption and accumulation of dissolved polysilicate remaining from the water coagulated by PSI onto the anthracite would cause the high head loss development.