The consumption and export of material and immaterial commodities based upon Japanese popular culture is rapidly growing and continually finds new fans all around the world. In this article, it is ...suggested that some of the competitiveness of these unique cultural phenomena can be traced to the very dense and vivid area of Akihabara in Tokyo. Its long history as an electronic retail district and a more recent influx of firms and shops focused on popular culture has created a strong place brand that continues to mark Akihabara as the capital of Japanese cultural industries. It is a space where different consumers, specialist subcultures and firms and their products can interact. The area functions as a hub were ideas and values are exchanged, tested and promoted. The article argues that research on innovation milieus must take account of the role of users and their relation to place.
A case of agenesis of the left internal carotid artery with an aneurysm of the anterior communicating artery was reported in detail. The patient was a 48-year-old man who had an episode of ...subarachnoid hemorrhage about 10 years ago. This time left heminumbness and motor weakness of the left lower extremity occured and he was brought our hospital. Right common carotid angiography, left retrograde brachial serial angiography and aortography demonstrated an agenesis of the left internal carotid artery, an aneurysm of the anterior communicating artery, tortuous megadolic hobasilar artery and anomalies on the circle of Willis such as absence of supra optic portion of the right anterior cerebral artery, and large left posterior communicating artery. We confirmed latter findings by operation. After successful neck clipping of the aneurysm, his clinical findings were remarkably improved.
Pancreatic tumorigenesis of azaserine by a single intraperitoneal (i.p.) injection after partial pancreatectomy in male Wistar rats was studied. Pancreatic lesions developed in all rats 52 weeks ...after the administration of azaserine at doses of 50 mg (Group 1) or 100 mg/kg body wt (Group 2). Histologically, there were hyperplastic nodules in 4 of 12 rats and 4 of 7 rats, in Groups 1 and 2, respectively, adenomas 100% in both groups, and adenocarcinomas 2 of 7 rats of Group 2. It appears that pancreatic regeneration induced by partial pancreatectomy enhances the azaserine tumorigenesis.
The objectives of this review were to summarize systematic reviews with meta-analysis of balneotherapy (BT) and spa therapy (ST) based on randomized controlled trials, and to provide a perspective ...for future research.
Eligible studies were systematic reviews based on randomized controlled trials with meta-analysis that included at least one group treated with BT or ST. We searched the following databases for articles published in English from the year 2000 to 20 November 2019: Cochrane Database Systematic Review, MEDLINE, CINAHL, Web of Science, and Ichushi-Web.
Eighteen studies met all inclusion criteria. Based on the International Classification of Diseases (ICD)-11, among these 18 studies, 8 (44%) were about "#15 Diseases of the musculoskeletal system or connective tissue", 5 (28%) were about "#21 Symptoms, signs or clinical findings, not elsewhere classified", 4 (22%) were about "#11 Diseases of the circulatory system", and 1 study (6%) was about "#8 Diseases of the nervous system". Both BT and ST provided significant pain relief and improved quality of life in chronic diseases of the musculoskeletal system and connective tissues. Additionally, BT and ST with exercise under water improved physical fitness and function in patients across diseases.
Researchers need to conduct studies on the treatment of many kinds of potential diseases using the keywords of pain relief and QoL. In addition, depending on patients' symptoms, physical fitness, and disabilities, performing exercise under water may improve treatment effects on physical function and fitness.
Abstract Background Exercise capacity is helpful in the management of patients with mitral regurgitation (MR). However, the determinants of exercise capacity reduction in MR have remained unclear. ...This study was designed to objectively assess exercise capacity, identify the echocardiographic predictors of exercise capacity, and investigate its impact on development of symptoms in asymptomatic degenerative MR. Methods A total of 49 consecutive asymptomatic patients (age, 58.9 ± 13.1 years; 82% males) with at least moderate degenerative MR (effective regurgitant orifice area = 0.40 ± 0.14 cm2 ; regurgitant volume = 60.9 ± 19.6 mL) underwent the symptom-limited cardiopulmonary exercise testing for assessing exercise capacity (peak oxygen uptake, peak V ˙ O 2 ; the minute ventilation/carbon dioxide production, V ˙ E / V ˙ CO 2 slope). All patients also underwent exercise stress echocardiography for detecting exercise-induced pulmonary hypertension (EIPH) defined by systolic pulmonary arterial pressure (SPAP) ≥60 mmHg. Results The mean peak V ˙ O 2 was 22.6 ± 5.1 mL/kg/min (86.7 ± 14.1% of age, gender-predicted); peak V ˙ O 2 widely varied (48–121% of predicted), and was markedly reduced (<80.4% of predicted) in 24% of the study patients. The patients with EIPH had lower 2-year symptom-free survival than those without EIPH ( p = 0.003). The multivariable analysis demonstrated that EIPH was an independent echocardiographic determinant of peak V ˙ O 2 ( p = 0.001) and V ˙ E / V ˙ CO 2 slope ( p = 0.021). Furthermore, the area under curve of age- and gender-adjusted exercise SPAP was 0.88 (95% confidence interval: 0.78–0.97) for reduced exercise capacity. Conclusions In asymptomatic moderate to severe degenerative MR, EIPH was independently associated with exercise capacity and predicted the occurrence of symptoms. Exercise stress echocardiography is an important tool in managing patients with asymptomatic degenerative MR.
Summary Background Speckle tracking echocardiography (STE)-derived mitral annular displacement (MAD) utilizes the speckle tracking technique to measure strain vectors, which provides accurate ...estimates of left ventricular ejection fraction (LVEF). Here, we investigated a link between STE-derived MAD and LVEF in patients with different heart diseases and evaluated its clinical usefulness. Methods This study included 266 outpatients and 84 controls. Of the study patients, 52 patients had ischemic heart disease (IHD), 37 patients had dilated cardiomyopathy (DCM), 34 patients had hypertrophic cardiomyopathy (HCM), 74 patients had valvular heart disease (VHD), and 69 patients had hypertensive heart disease (HHD). STE continuously tracked annular motion throughout the cardiac cycle in the apical 4- and 2-chamber views. Results In all participants, the curvilinear relationship was found between STE-derived MAD and LVEF ( R2 = 0.642). The strong correlation between STE-derived MAD and LVEF was also found in the patients with IHD ( R2 = 0.733, p = 0.001) and in those with DCM ( R2 = 0.614, p = 0.008). However, such a correlation was not found in the patients with HCM, VHD, or HHD. Conclusion The specificity in the correlation between STE-derived MAD and LVEF was found in patients with each heart disease, which should be taken into account when assessing these parameters.
Background
Secondary mitral regurgitation (MR) remains a challenging problem in the diagnosis and treatment of patients with heart failure. Although it is well known that secondary MR is dynamic, the ...impact of the severity of MR during exercise on long-term outcome has not been fully evaluated. The aim of the present study was to investigate the prognostic value of exercise stress echocardiography (ESE) in patients with secondary MR.
Methods
This prospective study included 118 consecutive patients with secondary MR and left ventricular dysfunction (mean ejection fraction at rest: 38 ± 14%) who underwent semi-supine ESE. Their major cardiovascular events (MACE) including cardiac death were followed up for a median of 41.7 (range: 6–128) months.
Results
MR significantly increased from rest to exercise (effective regurgitant orifice: 0.18 ± 0.09 vs. 0.25 ± 0.12 cm
2
,
P
< 0.001). The prevalence of severe MR was higher during exercise than those at rest (37% vs. 56%,
P
< 0.001). During follow-up, MACE occurred in 49 patients (41.5%) including 12 cardiac deaths. Cox proportional-hazard multivariate analysis revealed that older age and MR severity during exercise were significantly associated with increased risk of MACE (hazard ratio: 1.04 and 8.4, respectively, both
P
< 0.05).
Conclusions
ESE provides prognostic information in patients with secondary MR that is useful for predicting long-term outcome.
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