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Keita Odashiro,Kazuyuki Saito,Takeshi Arita,Toru Maruyama,Takehiko Fujino,Koichi Akashi 대한고혈압학회 2015 Clinical Hypertension Vol.21 No.19
Introduction: Hypertension is associated with microcirculatory disturbance, and erythrocyte deformability is a major determinant of the microcirculation. However, impairment of erythrocyte deformability in hypertensive patients in relation to antihypertensive treatment is unclear. The present study aimed to investigate this impairment in hypertensive patients under treatment using a highly sensitive and quantitative nickel mesh filtration technique. Methods: Deformability was evaluated by filterability, defined as the flow rate of a hematocrit-adjusted erythrocyte suspension relative to that of saline under a specific filtration pressure in a pressure-flow curve obtained by continuous filtration. Baseline characteristics of hypertensive patients (n = 101) and age-matched normotensive subjects (n = 14) were obtained from medical records, and diabetic patients were excluded. Results: Erythrocyte deformability in the hypertensive group was significantly (p = 0.010) lower (87.8 ± 2.2 %) than that of the normotensive group (89.4 ± 1.7 %) and inversely proportional (r = −0.303, p = 0.002) to the mean blood pressure (BP) measured on blood sampling for the filtration study. Stepwise multiple regression analysis demonstrated that this impairment was mostly attributable to the mean BP (p = 0.001), whereas current smoking and episodes of stroke or coronary artery disease were not contributors. Discussion: These findings indicate that erythrocyte deformability is impaired in the hypertensive patients, which depends on the current BP control rather than target organ damage.
Takashi Mitsui,Kazuyuki Saito,Yuhei Hakozaki,Yoshiyuki Miwa,Takuji Noro,Emiko Takeshita,Taizen Urahashi,Yasuyuki Seto,Takashi Okuyama,Hideyuki Yoshitomi 대한위암학회 2023 Journal of gastric cancer Vol.23 No.4
Purpose: Intra-abdominal infection is a common postoperative complication of laparoscopic pylorus-preserving gastrectomies (PPGs). Many studies have reported that intra-abdominal infectious complications after gastrectomy adversely affect patient survival outcomes. To prevent gastric fluid leakage into the abdominal cavity, we developed a novel anastomosis method in which the stomach lumen is not opened (termed the non-opened clean end-to-end anastomosis method [NoCEAM]) and evaluated its feasibility. Materials and Methods: Subsequent to lymphadenectomy, the oral and anal resection lines were sutured using an intraoperative endoscope. After closing the stomach circumferentially with clips, the specimen was rolled outward like a “donut.” We resected the specimen circumferentially using a linear stapler, and anastomosis was completed simultaneously. We examined the feasibility of this procedure ex vivo, using three porcine stomachs, and in vivo, using one pig. Subsequently, we applied the procedure to 13 consecutive patients with middle-third early gastric cancer utilizing laparotomic, laparoscopic, and robotic PPG. Results: NoCEAM was completed in all porcine models and human cases. In the human cases, the mean operation time (±standard deviation) was 279±51 minutes, and mean blood loss volume was 22±45 mL. The mean number of linear staples used was 5.06±0.76. None of the patients had complications, and all were discharged on the eighth postoperative. The serum total protein, serum albumin, and hemoglobin levels did not change significantly after surgery. Conclusions: NoCEAM is feasible and safe for performing totally laparoscopic or robotic PPG. It may reduce postoperative complications, such as intra-abdominal infections.
김형진,Kumiko Takata,Katsunori Tanaka,Ryoji Yamashima,Jun Matsumoto,Kazuyuki Saito,Toshihiko Takemura,Tetsuzo Yasunari 한국기상학회 2014 Asia-Pacific Journal of Atmospheric Sciences Vol.50 No.4
A series of 60-year numerical experiments starting from 1851 was conducted using a global climate model coupled with an aerosol-cloud-radiation model to investigate the response of the Asian summer monsoon to variations in the secondary organic aerosol (SOA) flux induced by two different estimations of biogenic volatile organic compound (BVOC) emissions. One estimation was obtained from a pre-existing archive and the other was generated by a next-generation model (the Model of Emissions of Gases and Aerosols from Nature, MEGAN). The use of MEGAN resulted in an overall increase of the SOA production through a higher rate of gasto- particle conversion of BVOCs. Consequently, the atmospheric loading of organic carbon (OC) increased due to the contribution of SOA to OC aerosol. The increase of atmospheric OC aerosols was prominent in particular in the Indian subcontinent and Indochina Peninsula (IP) during the pre- and early-monsoon periods because the terrestrial biosphere is the major source of BVOC emissions and the atmospheric aerosol concentration diminishes rapidly with the arrival of monsoon rainfall. As the number of atmospheric OC particles increased, the number concentrations of cloud droplets increased, but their size decreased. These changes represent a combination of aerosol-cloud interactions that were favorable to rainfall suppression. However, the modeled precipitation was slightly enhanced in May over the oceans that surround the Indian subcontinent and IP. Further analysis revealed that a compensating updraft in the surrounding oceans was induced by the thermally-driven downdraft in the IP, which was a result of surface cooling associated with direct OC aerosol radiative forcing, and was able to surpass the aerosolcloud interactions. The co-existence of oceanic ascending motion with the maximum convective available potential energy was also found to be crucial for rainfall formation. Although the model produced statistically significant rainfall changes with locally organized patterns, the suggested pathways should be considered guardedly because in the simulation results, 1) the BVOC-induced aerosol direct effect was marginal; 2) cloud-aerosol interactions were modeldependent; and 3) Asian summer monsoons were biased to a nonnegligible extent.