The Kobe journal of medical sciences
-
The purpose of this study was to evaluate the usefulness of adding Waters' projection to panoramic imaging compared with panoramic imaging or Waters' projection alone. Maxillary sinusitis in 106 patients (206 sinuses) was retrospectively assessed with panoramic imaging, Waters' projection, and computed tomography imaging by two oral radiologists. The diagnostic performance was assessed with computed tomography imaging as the gold standard. ⋯ Intra-observer agreement was good for Waters' projection (κ, 0.752), and moderate for panoramic imaging (κ, 0.597). Panoramic imaging was equivalent to Waters' projection for diagnosing maxillary sinusitis. Combination imaging comprising panoramic imaging and Waters' projection can contribute to the diagnosis of odontogenic maxillary sinusitis because of its high sensitivity.
-
Total management of chronic kidney disease has been well established, and the screening using dipstick urine test has already been widespread in Japan. Nevertheless, the number of dialysis patients is still rising. While clinical cooperation between general physicians and nephrologists is expected to improve prognoses of chronic kidney disease patients, real situation of the management in general practice has not been obvious. ⋯ For the patients of diabetes without previous diagnosis of nephropathy, only 30.8% of doctors examined urine albumin at least every 6 months. In general practice, there is still much possibility to improve chronic kidney disease management. We have to continue to advocate the significance of clinical cooperation between general physicians and nephrologists, with high level of evidence.
-
Idiopathic pulmonary fibrosis (IPF) is a devastating disease with poor prognosis due to limited clinical treatment options. IPF is characterized by the augmented deposition of extracellular matrix driven by myofibroblasts, and the epithelial-mesenchymal transition (EMT) has been known to play an essential role in the mechanism of pulmonary fibrosis. Previous genome-wide association study identified Fam13a as one of genes that showed genetic link with IPF and chronic obstructive pulmonary disease. ⋯ Of note, genetic deletion of Fam13a exacerbated the lung fibrosis induced by bleomycin in association with enhanced EMT in mice. Moreover, silencing of Fam13a accelerated EMT induced by TGF-β and TNF-α in alveolar epithelial cells, accompanied by increased active β-catenin and its nuclear accumulation. Our data revealed a crucial role of Fam13a in the development of pulmonary fibrosis potentially through inhibiting EMT, and thus Fam13a has a therapeutic potential in the treatment of IPF.
-
Randomized Controlled Trial
Bronchoscopy Using Virtual Navigation and Endobronchial Ultrasonography with a Guide Sheath (EBUS-GS) with or without Fluoroscopy for Peripheral Pulmonary Lesions.
Endobronchial ultrasonography and guide sheath (EBUS-GS) technique has high diagnostic yield in lung nodules. Virtual bronchoscopic navigation (VBN) can lead bronchoscope to the target bronchi. The aim of this prospective study was to compare the diagnostic yield of two bronchoscopic procedures: bronchoscopy under EBUS-GS and VBN with or without x-ray fluoroscopy in small peripheral pulmonary lesions (PPLs, ≤30mm) with apparent CT-bronchus sign. ⋯ There was a possibility that VBN-guided EBUS-transbronchial diagnosis without fluoroscopy might be equivalent to that under fluoroscopy. Further multi-center randomized study may be desired. (UMIN000008592).
-
It has been proposed that anticoagulant activity during continuous renal replacement therapy with nafamostat mesilate can be monitored by using intra-circuit activated clotting time. However, it is still unclear whether activated clotting time would be useful for this purpose. We conducted a retrospective study and included 76 patients who required continuous renal replacement therapy using nafamostat mesilate. ⋯ In sensitive analysis, the duration on continuous renal replacement therapy without bleeding complications was significantly longer for filters with post-tw ACT<262 than for those with post-tw ACT≥262 (p=0.03). This result suggested that post-filter time-weighted average activated clotting time might be a good predictor of bleeding complications during continuous renal replacement therapy with nafamostat mesilate. Further study is required to refute or confirm our findings.