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Minoru Kobayashi,Toshitaka Uematsu,Gaku Nakamura,Hidetoshi Kokubun,Tomoya Mizuno,Hironori Betsunoh,Takao Kamai 대한감염학회 2018 Infection and Chemotherapy Vol.50 No.3
Background Diabetes is considered a risk factor for acquisition of febrile urinary tract infection (f-UTI), but information on the association of diabetes with subsequent course of the disease is lacking. Thus, we investigated the clinical variables including diabetic status which determined the clinical course in patients with community-acquired f-UTI. Materials and Methods Patients hospitalized consecutively for f-UTI between February 2016 and January 2018 were used for this single center study. The routine laboratory tests including blood glucose and glycated hemoglobin (HbA1c) were done and empiric treatment with parenteral antibiotics was commenced on admission. The clinical course such as duration of fever (DOF) and length of hospital stay (LOS) were compared among groups classified by the clinical variables. Results Among the101 patients admitted for f-UTI, 15 patients with diabetes (14.9%) experienced significantly longer febrile period and hospitalization compared to those with hyperglycemia (n = 18, 17.8%) or those without diabetes and hyperglycemia (n = 68, 67.3%). Of the laboratory parameters tested on admission and several clinical factors, the presence of diabetes and risk factors for severe complicated infection (hydronephrosis, urosepsis, and disseminated intravascular coagulopathy) as well as HbA1c and albumin were identified as predictors for LOS by univariate analysis, whereas none of the variables failed to predict DOF. In the subsequent multivariate analysis, HbA1c levels and albumin levels were isolated as independent predictors of LOS. Conclusion Patients with higher HbA1c and lower albumin levels required the longest period of hospitalization. Thus, an evaluation of diabetic and nutritional status on admission will be feasible to foretell the clinical course and better manage the subset of patients at risk of prolonged hospitalization.
( Shiro Nakamura ),( Hirotsugu Imaeda ),( Hiroki Nishikawa ),( Masaki Iimuro ),( Minoru Matsuura ),( Hideo Oka ),( Junsuke Oku ),( Takako Miyazaki ),( Hirohito Honda ),( Kenji Watanabe ),( Hiroshi Nak 대한장연구학회 2018 Intestinal Research Vol.16 No.4
Background/Aims: Noninvasive objective monitoring is advantageous for optimizing treatment strategies in patients inflammatory bowel disease (IBD). Fecal calprotectin (FCP) is superior to traditional biomarkers in terms of assessing the activity in patients with IBD. However, there are the differences among several FCP assays in the dynamics of FCP. In this prospective multicenter trial, we investigated the usefulness of FCP measurements in adult Japanese patients with IBD by reliable enzyme immunoassay using a monoclonal antibody. Methods: We assessed the relationship between FCP levels and disease or endoscopic activity in patients with ulcerative colitis (UC, n=64) or Crohn’s disease (CD, n=46) compared with healthy controls (HCs, n=64). Results: FCP levels in UC patients strongly correlated with the Disease Activity Index (r<sub>s</sub>=0.676, P<0.0001) and Mayo endoscopic subscore (MES; r<sub>s</sub>=0.677, P<0.0001). FCP levels were significantly higher even in patients with inactive UC or CD compared with HCs (P=0.0068, P<0.0001). The optimal cutoff value between MES 1 and 2 exhibited higher sensitivity (94.1%). FCP levels were significantly higher in active UC patients than in inactive patients (P<0.001), except those with proctitis. The Crohn’s Disease Activity Index tended to correlate with the FCP level (rs=0.283, P=0.0565). Conclusions: Our testing method using a monoclonal antibody for FCP was well-validated and differentiated IBD patients from HCs. FCP may be a useful biomarker for objective assessment of disease activity in adult Japanese IBD patients, especially those with UC. (Intest Res 2018;16:554-562)
Fujio Ito,Zenya Ito,Motohide Shibayama,Shu Nakamura,Minoru Yamada,Hideki Yoshimatu,Mikinobu Takeuchi,Kenzo Shimizu,Yasushi Miura 대한척추신경외과학회 2019 Neurospine Vol.16 No.1
Objective: Spinal stenosis is increasingly common due to population aging. In elderly patients with lumbar central canal stenosis (LCCS), minimizing muscle damage and bone resection is particularly important. We performed a step-by-step operation with a newly designed spinal endoscope to obtain adequate decompression in patients with spinal stenosis. Methods: From April 2015 to August 2016, 78 patients (48 males, 30 females) with LCCS (91 segments) underwent endoscopic decompression using a newly designed endoscope system. The inclusion criteria were: (1) neurogenic intermittent claudication with or without radiculopathy, (2) LCCS, and (3) having exhausted conservative treatment (>3 months). The exclusion criteria were: (1) >10° of instability, (2) spondylolisthesis grade II or greater according to the Meyerding criteria, (3) foraminal stenosis, (4) vascular intermittent claudication, (5) infection, and (6) stenosis combined with malignancy. We performed a step-by-step procedure using a newly designed endoscope system for unilateral-approach bilateral decompression. We used the same incision for 2–3 segments, only moving the skin. Results: The mean follow-up was 2.3±1.3 years. Excellent or good results were found according to the MacNab criteria in 85.9% of cases (67 of 78). The visual analogue scale, Japanese Orthopedic Association score, and Oswestry Disability Index showed significant decreases at 1 month, persisting until the 2-year follow-up. Dural tear occurred in 4 cases (5.1%), and patch repair was performed under endoscopy. No patients experienced aggravated instability requiring surgery. Conclusion: We obtained good results with endoscopic decompression surgery using a newly designed instrument that minimized muscle and bone damage in elderly patients with spinal stenosis.
Ultrasound Measurements on the Skutterudite Compound SmOs4P12
Yoshiki Nakanishi,Gen Koseki,Dai Tamura,Kohei Kurita,Takeshi Saito,Minoru Koseki,Mitsuteru Nakamura,Masahito Yoshizawa,Yuya Koyota,Chihiro Sekine,Takehiko Yagi 한국물리학회 2013 THE JOURNAL OF THE KOREAN PHYSICAL SOCIETY Vol.62 No.12
We have investigated the elastic properties of the Sm-based filled skutterudite compoundSmOs4P12 for the first time. The measurements were performed on polycrystalline samples preparedat high temperatures and high pressures by using a wedge-type, cubic anvil, high-pressureapparatus. A clear and steep decrease was observed at an antiferromagnetic transition temperatureof 4.5 K in the temperature dependence of both the longitudinal and the transverse elastic constants. Absence of a precursor behavior reminds us of the multipolar ordering, possibly octupolarordering, observed in the isostructural system SmRu4P12. The transition is robust against an externalmagnetic field. We argue that the low-lying degenerate levels derived from the 4f-multipletground state of the Sm ion is split by the crystalline electric field in SmOs4P12. Furthermore, wediscuss the phononic properties, which include the ionic degrees of freedom for the rattling motion,and compare them with the values for other isostructural systems.