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Background Low back pain (LBP) and poor subjective sleep quality (SSQ) are major risk factors for presenteeism. However, no studies have investigated whether combined LBP and poor SSQ are associated with presenteeism. Aims We aimed to examine whether a combination of LBP and poor SSQ is associated with presenteeism. Methods This cross-sectional study included 936 workers (median age, 38 years; men, 89%), with evaluated presenteeism using the work limitations questionnaire. We divided them into ‘no presenteeism’ and ‘presenteeism’ categories. The presence of LBP was defined as a numerical rating scale (NRS) score of ≥1 in current pain intensity. SSQ was assessed using a single question regarding whether the participants typically got enough sleep. We categorized the participants into four groups: (i) LBP + poor SSQ, (ii) non-LBP + poor SSQ, (iii) LBP + good SSQ and (iv) non-LBP + good SSQ. Logistic regression analysis was used to investigate the association between presenteeism and the presence of LBP and poor SSQ, adjusting for age, sex, work type, education, marital status, smoking status, body mass index and weekly working hours. Results The data from 533 participants were used for analysis (median age, 38 years; men, 90%, response rate, 66%). Combined LBP and poor SSQ were significantly associated with presenteeism (non-LBP + poor SSQ: adjusted odds ratio = 0.56, 95% CI 0.32–0.96; LBP + good SSQ: 0.33, 0.20–0.56; non-LBP + good SSQ: 0.29, 0.18–0.48). Conclusions Evaluating both LBP and SSQ may be beneficial in considering presenteeism.

Background Triglyceride (TG) deposit cardiomyovasculopathy (TGCV) is a novel cardiovascular disorder and was recently encoded as an orphan disease in Europe (ORPHA code: 565612). Defective intracellular lipolysis results in TG accumulation in the myocardium and coronary arteries in TGCV. The myocardial washout rate (WR) of iodine-123-β-methyl-p-iodophenylpentadecanoic acid (BMIPP) is an essential indicator to evaluate myocardial lipolysis in vivo, and decreased WR ( Purpose To clarify clinical findings of TGCV including comorbid conditions and laboratory findings. Methods We enrolled 234 patients who underwent BMIPP scintigraphy between September 2015 and July 2019. The distributions of TGCV in each comorbidity, cardiac functions and laboratory findings were investigated. Results In total, 104 patients were diagnosed with definitive TGCV. The BMIPP WR of TGCV patients was −1.37±10.6%. TGCV patients had various comorbid conditions, including coronary artery disease (75%), diabetes mellitus (56%), and heart failure (21%). Left ventricular ejection fraction (LVEF) of TGCV patients was significantly lower than that of non-TGCV patients (38.1±18.0% vs. 43.6±18.9%, p-value=0.026). Moreover, among those who did not take lipid-lowering drugs, there was no difference in the serum TG level between TGCV and non-TGCV patients (TGCV: n=44, 127±84.6 mg/dL, non-TGCV: n=66, 133±70.7 mg/dL, p-value=0.73). Conclusions TGCV patients showed multiple coexistence of coronary artery disease, diabetes mellitus, or heart failure with lower LVEF. Serum TG level was not significantly different between TGCV and non-TGCV patients. Serum TG did not affect the intracellular TG accumulation in TGCV patients directly, and this result was consistent with the pathophysiological hypothesis that the TG accumulation in the myocardial cytoplasm is due to intracellular lipase dysfunction. Funding Acknowledgement Type of funding sources: None.

Impaired glucose metabolism reflects neuronal/synaptic dysfunction and cognitive function decline in patients with obstructive sleep apnea (OSA). The study investigated the extent to which exercise training (ET) improves cerebral metabolic glucose rate (CMRgl) and cognitive function in patients with OSA. Patients with moderate to severe OSA were randomly assigned to ET (3 times/week, n = 23) or no intervention (control, n = 24). Echocardiography and apolipoprotein ε4 (APOEε4) genotyping were obtained at baseline. Both groups underwent cardiopulmonary exercise testing, polysomnography, cognitive tests, brain magnetic resonance imaging, and 18F-fluoro-2-deoxy-d-Glucose positron emission tomography (18FDG-PET) at baseline and study end. Compared with control, exercise-trained group had improved exercise capacity, decreased apnea–hypopnea index (AHI), oxygen desaturation and arousal index; increased attention/executive functioning, increased CMRgl in the right frontal lobe (P P P 2 saturation during sleep and non-rapid eye movement sleep (r = − 0.43, P P P Trial registration: NCT02289625 (13/11/2014).

Background The high dose (20mg/day) of apixaban is used for the initial treatment of venous thromboembolism for the first week. Although patients taking direct oral anticoagulants do not require routine coagulation monitoring, the correlations between anti-factor Xa activity (AXA) and routine coagulation markers such as prothrombin time (PT) and activated partial thromboplastin time (APTT) at peak and trough times especially when using high dose of apixaban have not been reported so far. Purpose The purpose is to assess the correlations between AXA values and PT/APTT at peak and trough times in patients with venous thromboembolism using high dose of Apixaban. Methods Twenty-six patients (10 male; 71±15 years) with proximal venous thromboembolism or pulmonary embolism using high dose (20mg/day) of apixaban were enrolled. We measured AXA, using chromogenic assay with the HemosIL Liquid Heparin kit, PT and APTT at peak and trough times. The peak time was defined as 3 hours after the intake of apixaban, and the trough time was defined as that immediately before the intake of apixaban. Results A significant and strong positive correlation was observed between AXA and PT at both peak and trough times (R=0.795, p Conclusion Our findings reveal the relationship between AXA and PT at peak and trough times has a significant strong correlation. These results suggest measuring of PT may be alternative and effective way of monitoring of AXA values when using high dose of apixaban. Figure 1 Funding Acknowledgement Type of funding source: None

Background Although patients taking direct oral anticoagulants (DOACs) do not require routine coagulation monitoring, the distribution of anti-factor Xa activity (AXA) values, prothrombin time (PT), PT-international normalized ratio (INR) and activated partial thromboplastin time (APTT) in patients on apixaban, edoxaban and rivaroxaban therapy is still not clear. Purpose The aim is to set the standard values of AXA values, PT, PT-INR and APTT in patients using DOACs. Methods We measured AXA, using chromogenic assay with the HemosIL Liquid Heparin kit, PT, PT-INR and APTT at trough and peak times in 224 patients with non-valvular atrial fibrillation and venous thromboembolism, of whom 90 received apixaban, 100 received edoxaban and 34 received rivaroxaban. The peak time was defined as 3 hours after the intake of apixaban or rivaroxaban, and 2 hours after the intake of edoxaban. The trough time was defined as that immediately before the intake. The AXA values, PT, PT-INR and APTT were measured at least 72 hours after the start of treatment. The dosage of DOACs is defined according to the prescribing information in Japan. Results (The order of results below is apixaban, edoxaban and rivaroxaban, respectively.) The average AXA values were 2.29, 0.23 and 0.39 (IU/mL) at trough time, and 3.04, 1.01 and 1.70 (IU/mL) at peak time. The average PT values were 17.9, 12.9 and 13.1 (s) at trough time, and 19.7, 15.5 and 17.5 (s) at peak time. The average PT-INR values were 1.49, 1.07 and 1.08 at trough time, and 1.65, 1.29 and 1.45 at peak time. The average APPT values were 34.5, 31.3 and 32.0 (s) at trough time, and 39.5, 35.9 and 39.8 (s) at peak time. Conclusion Our findings reveal the standard values of AXA, PT, PT-INR and APTT in patients using apixaban, edoxaban and rivaroxaban in each dosage. The DOACs should be changed if the measured value is out of those standard values in 90% confidence interval. Funding Acknowledgement Type of funding source: None

Made available in DSpace on 2020-12-12T02:42:20Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-07-01 The present study aims to verify possible changes in the functional feeding group (FFG) structure of benthic macroinvertebrates related to changes in headwater streams riparian vegetation. Streams with this vegetation fully present (forested), present only on one bank (intermediate) and absent (pasture) were studied. In general, there was low abundance of shredders in all streams, a typical pattern found in neotropical streams. The FFG abundance analysis indicated differences only for the gathering collectors’ group, with the abundance in the forested streams significantly smaller than in the other two profiles. The FFG richness analysis did not indicate significant differences. The RDA analysis made with the environmental and FFG abundance data showed a strong relationship of some habitat characteristics related to environmental quality loss, such as higher values of fine substrate and vegetation on the banks, with the abundance of gathering collectors, filtering collectors and predators in streams with the riparian vegetation partially or totally removed. The initial premise of higher FFG complexity in streams with riparian vegetation was not confirmed. In addition, the results showed a high predators richness, probably favored by the high prey and ambush shelter availability, and the latter represented by vegetal debris and coarse substrate at the forested streams bottom or herbaceous vegetation on the altered streams banks. The functional approach of the present study allowed to verify the advantage of benthic macroinvertebrates use as habitat quality ecological indicators, when analyzed together with environment variables directly or indirectly related to feeding mechanisms. Department of Zoology Unesp - Univ Estadual Paulista, C.P. 510 Department of Zoology Unesp - Univ Estadual Paulista, C.P. 510

Made available in DSpace on 2020-12-12T02:40:12Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-04-01 Many studies assess the impact of anthropogenic activities in water bodies using methods that focus on physical, chemical and microbiological characteristics of water. The use of benthic invertebrates as tools for biomonitoring protocols helps the understanding of those impacts, when these modifications cannot be explained only by the water characteristics. We analyzed the environmental characteristics and invertebrate fauna structure in an 80 m extension of streams located in four micro-basins. This reach-scale analysis included streams of three riparian vegetation conservation states: preserved in both riverbanks (forested), removed in both riverbanks for pasture (pasture), and one riverbank with riparian vegetation and another with pasture (intermediate). The environmental data analysis indicated a clear separation between the forested and pasture streams, emphasizing the interaction of the state of riparian vegetation’s preservation with some habitat characteristics, such as width, substrate type and shelter for the fauna. Our initial hypothesis about the benthic invertebrates’ structure was to find in streams with conserved riparian vegetation a benthic fauna composed mainly by groups more specialized and dependent on coarse substrate and plant material imported from the forest and used as shelter and food resource. This hypothesis was confirmed, with higher abundance of groups sensitive to pollution, such as Plecoptera and Trichoptera, mainly in preserved streams. However, when analyzed together the environmental characteristics and the OTUs that best explained the land uses’ differences (RDA analysis), in two micro-basins there was more fauna’s similarity between intermediate and pasture profiles, and in the other two the three profiles differed from each other. These differences may be related not only to reach-scale physical characteristics, but also to catchment-scale attributes of each micro-basin, as the invertebrate distribution and abundance are influenced by a variety of physical/biological factors at different scales. Thus, the study of the possible influence of riparian vegetation conservation states on habitat characteristics and benthic invertebrate structure seems to be dependent on the spatial scale analyzed. Department of Zoology Institute of Bioscience UNESP - Univ Estadual Paulista Department of Zoology Institute of Bioscience UNESP - Univ Estadual Paulista

Aim We compared the effectiveness of two sampling devices, the Surber sampler and the D-frame net, commonly used in the analysis of invertebrate fauna structure in biomonitoring programs. These programs use the response of benthic invertebrates to assess changes in aquatic ecosystems because they respond quickly to spatial and temporal variations. However, the lack of consensus on the best method of sampling the fauna may reduce the quality of these studies. Methods We evaluated both devices in four structurally different reaches of streams, two in places with preserved riparian vegetation and two occurring in places with many anthropic disturbances. We repeated the analysis at the dry season of two consecutive years. Results The two samplers were equally effective in analyzing the benthic fauna and sensitive enough to identify spatial and temporal variation in the structure of this fauna, influenced by the presence or absence of riparian vegetation, by the position of the reach with this vegetation (upstream or downstream of the reach without vegetation) and the characteristics of the substrate. Conclusions The analyzed fauna structure was similar for the two samplers, but we consider the use of Surber more advantageous and effective because it collects a smaller number of individuals, reducing the time of processing and identifying in the laboratory, and allows a better definition of the area sampled. Resumo Objetivo Comparamos a eficácia de dois dispositivos de amostragem, o amostrador Surber e a Rede-D, comumente utilizados na análise da estrutura da fauna de invertebrados em programas de biomonitoramento. Esses programas utilizam a resposta dos invertebrados bentônicos para avaliar as mudanças nos ecossistemas aquáticos porque respondem rapidamente às variações espaciais e temporais. No entanto, a falta de consenso sobre o melhor método de amostragem da fauna pode reduzir a qualidade desses estudos. Métodos Avaliamos ambos os dispositivos em quatro trechos estruturalmente diferentes de riachos, dois em locais com vegetação ripária preservada e dois ocorrendo em locais com várias alterações antrópicas. Repetimos a análise na estação seca de dois anos consecutivos. Resultados Os dois amostradores foram igualmente eficazes na análise da fauna bentônica e sensíveis o suficiente para identificar variações espaciais e temporais na estrutura desta fauna, influenciada pela presença ou ausência de vegetação ripária, pela posição do trecho com essa vegetação (a montante ou jusante do trecho sem vegetação) e pelas características do substrato. Conclusões A estrutura da fauna analisada foi semelhante para os dois amostradores, mas consideramos o uso do Surber mais vantajoso e efetivo por amostrar um menor número de indivíduos, reduzindo o tempo de processamento e identificação no laboratório, e por permitir uma melhor definição da área amostrada.

Albinism is a genetic condition caused by an autosomal recessive gene that affects normal pigmentation in animals. In Neotropical freshwater fish fauna, albinism cases are extremely rare, with only 14 species recorded among more than 6000 described. Here, we describe the first reported case of albinism in the South American catfish Imparfinis mirini. The albino fish was collected in July 2016 with a seine net in a stream in southeast Brazil. Although albinism can decrease the chance of fish survival, the cryptic and nocturnal habits of this species and the low amount of piscivorous fish and birds in the stream may have favored its growth. Two possible explanations for the appearance of the albino fish are discussed: a genetic disorder caused by heavy metal contamination and the high endogamy rate in the fish population which could increase the chances of appearing deleterious genes.

Made available in DSpace on 2018-12-11T17:32:55Z (GMT). No. of bitstreams: 0 Previous issue date: 2017-04-01 We studied a benthic invertebrate assemblage of a stream that passes through pristine, rural, suburban and urban areas of a municipality located in southeastern Brazil to investigate a possible relationship between this assemblage structure and urbanization. The environmental variables and fauna structure were analyzed in a spatial and temporal scale, sampling the four sites in a dry and wet season. We found a clear spatial pattern, with higher similarity between sites from rural and suburban area that presented intermediate environmental characteristics. The pristine site showed in both seasons the lowest values of alkalinity and fecal coliform. On the other hand, the site located in the urban area showed the lowest concentration of dissolved oxygen and higher of suspended solids, ammonia and fecal coliform. The extreme values of these three variables occurred in the wet season, probably related to the high rainfall values. The benthic invertebrate fauna structure followed the same longitudinal and seasonal pattern found for the environmental variables. The site in urban area showed the lowest richness, diversity and evenness, with a dominance of two groups resistant to adverse environmental conditions (Oligochaeta and Orthocladiinae) and absence of more sensitive groups (Coleoptera, Ephemeroptera and Trichoptera). The increase drag of the substrate and associated invertebrates can be responsible for the lower abundance and richness observed in the wet season. The environmental variables that best defined the differentiation between sites (dissolved oxygen, organic suspended solids and fecal coliform) related directly to urbanization effects, like dump effluents and removal of riparian vegetation. Department of Zoology Unesp - Univ Estadual Paulista, C.P. 510 Department of Zoology Unesp - Univ Estadual Paulista, C.P. 510

Thermal behavior of vacancy-type defects in polycrystalline ZnO was studied by the positron annihilation lifetime spectroscopy. Two-component analysis of the PALS spectra revealed that the defect-related longer-lifetime component decreases as the annealing temperature is raised, and almost disappears within 15 min when annealed at 1,273 K. We also found that the intensity of this component decreases with increasing density of the annealed ZnO pellets; however, little density dependence was seen in its lifetime. These observations evidently suggest that this component having long lifetime of about 400 ps corresponds to the positrons trapped in grain boundaries in the polycrystalline ZnO.

The influence of crystal defects on bulk laser damage and UV absorption in CsLiB 6 O 10 (CLBO) crystals was investigated. A CLBO crystal grown by the solution stirring method had a 2.5-fold higher laser-induced damage threshold (maximum) than conventional CLBO crystals. This highly damage-resistant CLBO crystal had a lower dislocation density (best value, 6.6×10 3 /cm 2 ) than conventional CLBO crystals (best value, 15.0×10 3 /cm 2 ). The temperature increase during UV generation on the output surface of highly damage-resistant CLBzO crystal was lower than that detected in conventional CLBO crystal.

Positron-emission tomography/computed tomography (PET/CT) has improved cyst infection (CI) management in autosomal dominant polycystic kidney disease (ADPKD). The determinants of kidney and/or liver involvement, however, remain uncertain. In this study, we evaluated clinical and imaging factors associated with CI in kidney (KCI) and liver (LCI) in ADPKD. A retrospective cohort study was performed in hospital-admitted ADPKD patients with suspected CI. Clinical, imaging and surgical data were analyzed. Features of infected cysts were evaluated by PET/CT. Total kidney (TKV) and liver (TLV) volumes were measured by CT-derived multiplanar reconstruction. CI was detected in 18 patients who experienced 24 episodes during an interval of 30 months (LCI in 12, KCI in 10 and concomitant infection in 2). Sensitivities of CT, magnetic resonance imaging and PET/CT were 25.0, 71.4, and 95.0%. Dysuria (P

As an archetype of convergence, Internet telephony has been questioning the continuing appropriateness of the current telecommunications policy and regulation. This article examines how policy makers and regulators in the US, the EU, Japan and Singapore have responded to the challenges brought about by Internet telephony. Their common approach seems to apply the existing regulatory framework to this new service. The authors argue that those responses will not be aligned with the dynamically changing communications environment and explain two key shifts taking place in the communications industry that should be taken into account to form more appropriate regulatory frameworks.

In order to increase quickly pulverized coal injection at the modernized No. 3 blast furnace of Kakogawa, various investigations of burden distribution at high ore to coke ratio were performed prior to the start-up during the filling operation.The results of these investigations have clarified the fact that the O1 armor stroke position can be utilized to control the gas permeability and to acquire the optimum burden distribution.Applying the results, the No. 3 blast furnace is being operated steadily. The PC rate reached 125 kg/thm a month after the blow-in and 170 kg/thm in May 1997.

Postoperative pulmonary complications (PPCs) after esophagectomy have been reported to occur in 15.9-30% of patients and lead to increased postoperative morbidity and mortality, prolonged duration of hospital stay, and additional medical costs. The purpose of this retrospective cohort study was to investigate the possible prevention of PPCs by intensive preoperative respiratory rehabilitation in esophageal cancer patients who underwent esophagectomy. The subjects included 100 patients (87 males and 13 females with mean age 66.5 ± 8.6 years) who underwent esophagectomy. They were divided into two groups: 63 patients (53 males and 10 females with mean age 67.4 ± 9.0 years) in the preoperative rehabilitation (PR) group and 37 patients (34 males and 3 females with mean age 65.0 ± 7.8 years) in the non-PR (NPR) group. The PR group received sufficient preoperative respiratory rehabilitation for7 days, and the NPR group insufficiently received preoperative respiratory rehabilitation or none at all. The results of the logistic regression analysis and multivariate analysis to correct for all considerable confounding factors revealed the rates of PPCs of 6.4% and 24.3% in the PR group and NPR group, respectively. The PR group demonstrated a significantly less incidence rate of PPCs than the NPR group (odds ratio: 0.14, 95% confidential interval: 0.02~0.64). [Correction added after online publication 25 June 2012: confidence interval has been changed from -1.86~ -0.22] This study showed that the intensive preoperative respiratory rehabilitation reduced PPCs in esophageal cancer patients who underwent esophagectomy.

Kakogawa No. 1 blast furnace has increased its pulverized coal (PC) injection rate from 100 kg/thm, after the enlargement of the PC injection system which was completed in October 1992. And the PC injection rate reached more than 180 kg/thm in October 1993 and this stable operation is being maintained.

Crohn病に合併する痔瘻病変への外科治療を検討するため自験手術例32例に検討を加えた.肛門病変を初発としたものは手術例の34.4%(11/32例)を占め,痔瘻術後の難治創からCrohn病発見となった例が18.8%(6/32例)にみられた,Crohn病に合併する痔瘻の特徴としては病変の多発するものが21.9%(7/32例)に,原発口を裂肛とするものが18.8%(6/32例)にみられた.また痔瘻の型の頻度は通常の痔瘻と同様であったが,瘻管走行の特異なものが43.8%(14/32例)にみられた.括約筋温存術式は低位筋間痔瘻8例,高位筋間痔瘻2例,坐骨直腸窩痔瘻12例に行われたが再発や治癒の遅れは坐骨直腸窩痔瘻の各1例に認めただけであった.痔瘻術後も予期せぬ難治の経過を示す例にはCrohn病を疑う必要がある.またCrohn病に伴う痔瘻にはCrohn病と直接関係ある痔瘻以外は積極的に愁訴改善のために手術を行うべきで術式としては積極的に括約筋温存術式を選択すべきであるである.

We have measured absorption spectra, luminescence spectra and the time response of luminescence intensity in σ – π conjugated polymers of silylene–biphenylene copolymers in tetrahydrofuran solution at room temperature. In order to investigate the σ -conjugated length dependence of optical properties, we have prepared the three copolymers which have different silylene chain lengths of m =1, 2 and 6. It is found that the excitations are strongly localized at biphenylene units for m =1 and that a strong lattice relaxation occurs for m =2. For m =6, the charge transfer excitation from silylene units to biphenylene units is indicated.

Tinnitus is a frequent disorder which is very difficult to treat and there is compelling evidence that tinnitus is associated with functional alterations in the central nervous system. Targeted modulation of tinnitus-related cortical activity has been proposed as a promising new treatment approach. We aimed to investigate both immediate and long-term effects of low frequency (1 Hz) repetitive transcranial magnetic stimulation (rTMS) in patients with tinnitus and normal hearing.Using a parallel design, 20 patients were randomized to receive either active or placebo stimulation over the left temporoparietal cortex for five consecutive days. Treatment results were assessed by using the Tinnitus Handicap Inventory. Ethyl cysteinate dimmer-single photon emission computed tomography (SPECT) imaging was performed before and 14 days after rTMS.After active rTMS there was significant improvement of the tinnitus score as compared to sham rTMS for up to 6 months after stimulation. SPECT measurements demonstrated a reduction of metabolic activity in the inferior left temporal lobe after active rTMS.These results support the potential of rTMS as a new therapeutic tool for the treatment of chronic tinnitus, by demonstrating a significant reduction of tinnitus complaints over a period of at least 6 months and significant reduction of neural activity in the inferior temporal cortex, despite the stimulation applied on the superior temporal cortex.

The Kakogawa No. 2 blast furnace held the monthly world record of low coke rate : 298 kg/ (lump coke : 280 kg/t, small coke : 18 kg/t) with pulverized coal : 123 kg/t and oil : 62 kg/t. The lowest rate achieved is 289 kg/t.The paper describes the low coke rate operation, with center coke charging and movable armor and discusses the phenomena observed and the results achieved.

A total of 469 hybridomas was generated from a BALB/c mouse immunized with the syngeneic antiidiotypic mAb KO3-34 that recognizes an idiotope within the Ag-combining site of the immunizing syngeneic anti HLA-DQw3 mAb KS13. One of the hybridomas, named S2B154, was shown with a number of serologic and immunochemical assays to mimic the specificity of anti HLA-DQw3 mAb KS13. This result was unexpected, because the antiidiotypic mAb had been classified as gamma because of the lack of detection of anti-HLA-DQw3 antibodies in sera from BALB/c mice immunized with the antiidiotypic mAb KO3-34. The antiidiotypic mAb S2B154, an IgG1, displays a lower affinity constant to HLA-DQw3 Ag-bearing lymphoid cells than mAb KS13, an IgG2b, but a higher one to antiidiotypic mAb KO3-34. Testing with a panel of antiidiotypic mAb elicited with the mAb KS13 showed that both antiidiotypic mAb S2B154 and mAb KS13 express in their Ag-combining site the idiotopes recognized by the antiidiotypic mAb KO3-256, KO3-335, and R1-38. However, the antiidiotypic mAb S2B154 does not react with the mAb R18-9 that recognizes an idiotope outside the Ag-combining site of mAb KS13. The results we have presented question the validity of the classification of antiidiotypic antibodies based on their ability to inhibit the binding of the corresponding antibodies to Ag and on the specificity of antisera elicited with antiidiotypic antibodies. Furthermore, the hybridomas we have developed in this Id cascade provide us the opportunity to analyze the structural basis of idiotypic Ag mimicry and to evaluate the regulatory properties of antiidiotypic antibodies in the immune response to HLA class II Ag.

女性の肛門疾患の特徴をわれわれの施設の統計から検討した.1989年までの外来統計によると男女比の平均は1.6 : 1であるが, 次第に女性の増加傾向が見られた.肛門の3大疾患の頻度は外来, 手術例とも男性では痔核, 痔瘻, 裂肛, 女性では痔核, 裂肛, 痔瘻の順であり, それぞれの疾患の手術率に男女差はない.1987年までの4年間の手術例 (痔核 : 男684例, 女698例, 裂肛 : 男70例, 女101例, 痔瘻 : 男685例, 女161例) の検討によると, (1) 女性の痔核手術の76.5%, 裂肛手術の64.4%, 痔瘻手術の56.7%に出産の既往がある, (2) 手術となる年代には男女差がなく, 痔核, 裂肛は50代, 痔瘻は30代にピークがある, (3) 術前に便秘症状を有したものは女性に多い, (4) 女性には痔核手術例では痔核の4箇所以上の切除を必要とした切除部が多いものが15.5%と多く, 痔瘻手術例では単純なタイプの低位筋間痔瘻が全体の81.4%を占め, 裂肛では肛門ポリープの合併したものが31.7%にみられた.

rectoceleは直腸ヘルニアの一つで, 直腸膣中隔の脆弱化によって直腸壁が腔側にポケット状に突出するような病態であり, 女性の排便障害, ことに便秘, 残便感の原因の一つとなるものである.わが国では排便障害の原因としてとらえられることは少なく, 婦人科において子宮脱に伴う一つの合併症としてとらえられているようである.われわれは直腸に起因する排便障害をとらえるために, defecography (注腸排便造影) を行いrectoceleを診断し治療を行っている.診断は画像診断上容易であり, 努責時に膣側へ突出した直腸前壁をとらえることができる.突出の程度はさまざまであり, 必ずしも訴えと平行しない場合もあり, またいくつかの直腸肛門の合併症を有する揚合が多い.治療はまず保存的に行うこととするが, 改善の見られない揚合は手術的に行っている.手術は脆弱となった直腸膣中隔を経膣的あるいは経肛門的に補強することであり, 術後数箇月は強い “いきみ” を控えさせることが肝要である.

A basic concept is shown of color image processings without destroying the color balance. Applications to the emphasis of endoscopic images and to a color image restoration are presented.