A binary vector was invented soon after it had been elucidated that crown gall tumorigenesis was caused by genetic transformation of plant cells with a piece of DNA, T-DNA for transferred DNA, from a Ti plasmid (tumor-inducing plasmid) harbored by the soil bacterium Agrobacterium tumefaciens ([
Home oxygen therapy (HOT), also known as long-term oxygen therapy, is prescribed to patients with chronic respiratory failure (CRF) due to advanced respiratory diseases, as it has been shown to improve the prognosis of patients with chronic obstructive pulmonary disease (COPD). However, the therapeutic impact of HOT does not fully reflect the "socialization" of patients, which is one of the final goals of "comprehensive pulmonary rehabilitation", proposed by the Japanese Respiratory Society. Since working is one form of socialization, we evaluated a 55-yr-old worker prescribed with HOT for the management of advanced COPD to elucidate and assess the social barriers experienced by HOT users. This case demonstrates a variety of factors affecting patients, respiratory physicians, occupational physicians, and management teams, which prevents patients from working. By elucidating these factors and seeking solutions, the promotion of the "harmonization of work with treatment and prevention" will both improve working environments and encourage CRF patients to continue working, leading to better socialization. Thus, the "harmonization of working with treatment and prevention" for CRF patients is a core goal for the promotion of both "health and productivity management" and "comprehensive pulmonary rehabilitation."
We defined respiratory sarcopenia as a coexistence of respiratory muscle weakness and decreased respiratory muscle mass. Although respiratory muscle function is indispensable for life support, its evaluation has not been included in the regular assessment of respiratory function or adequately evaluated in clinical practice. Considering this situation, we prepared a position paper outlining basic knowledge, diagnostic and assessment methods, mechanisms, involvement in respiratory diseases, intervention and treatment methods, and future perspectives on respiratory sarcopenia, and summarized the current consensus on respiratory sarcopenia. Respiratory sarcopenia is diagnosed when respiratory muscle weakness and decreased respiratory muscle mass are observed. If respiratory muscle mass is difficult to measure, we can use appendicular skeletal muscle mass as a surrogate. Probable respiratory sarcopenia is defined when respiratory muscle weakness and decreased appendicular skeletal muscle mass are observed. If only respiratory muscle strength is decreased without a decrease in respiratory function, the patient is diagnosed with possible respiratory sarcopenia. Respiratory muscle strength is assessed using maximum inspiratory pressure and maximum expiratory pressure. Ultrasonography and computed tomography are commonly used to assess respiratory muscle mass; however, there are insufficient data to propose the cutoff values for defining decreased respiratory muscle mass. It was jointly prepared by the representative authors and authorized by the Japanese Society for Respiratory Care and Rehabilitation, Japanese Association on Sarcopenia and Frailty, Japanese Society of Respiratory Physical Therapy and Japanese Association of Rehabilitation Nutrition. Geriatr Gerontol Int 2023; 23: 5-15.
BackgroundExclusive breastfeeding (EBF) can reduce illnesses and death in infants. Globally, there has been a slow uptake in EBF despite 30 years of evidence on the benefits of breastfeeding for both infants and mothers. The Royal Government of Bhutan has committed to rising the EBF rate, which was 51.4 % in 2015. Therefore, we seek to investigate the current situation of EBF in Bhutan and identify the underlying factors that influence breastfeeding practices.MethodsThis cross-sectional survey was conducted on mothers with children aged 0–6 months, who visited one of the participating referral hospitals. Participants were divided into the EBF group if they fed their infant only breast milk, or the non-EBF group if their infant was fed other liquids or solids in addition to breast milk. The nutrition-related knowledge, attitude, and practice questionnaire; the Iowa infant feeding attitude scale; and the Breastfeeding Self-Efficacy Scale - Short Form were used to assess breastfeeding practices.ResultsOf the 483 mothers included, 324 (67 %) exclusively breastfed their babies. The EBF and non-EBF groups displayed significant differences for referral hospitals (p = 0.002) and for the duration of maternity leave (p = 0.002). Although knowledge of EBF was significantly lower in the EBF group (p = 0.040), self-efficacy was significantly higher (p = 0.028).ConclusionThis study revealed an increase in the EBF rate compared to the 2015 report. Further propagation and strengthening of EBF practices might be accomplished through improvements in the self-efficacy of the mother.
Although many imaging modalities have developed in the area of pulmonary medicine, information about the condition of pleural surface is limited. In this study, we carried out contrast pleurography under negative pleural pressure in dogs and humans to evaluate the condition of the pleural space including adhesion between the two pleural layers, incomplete fissure and features of the pleural surface. After insertion of a flower-type catheter into the pleural space under ultrasonic guidance, contrast material (60% Meglumine iotalamate, Conray 60, 0.5-1.0 ml/kg) was injected into the pleural space through the catheter. In dogs with intact pleura, contrast material distributed to the pulmonary surface, including interlobar spaces, rapidly. In dogs with pleural adhesion which was induced artificially with talc, affected areas were visualized as defects of contrast material. In humans, this contrast pleurography provided information about pleural adhesion, pulmonary lobulation, extent of cancer to neighbouring lobes, irregular pleural surface due to bullae formation and pleural indentation by cancerous lesion. There was no serious complication in dogs and human studies. This contrast pleurography is unique because it is possible to evaluate the pleural space physiologically under negative pressure condition. It may be concluded that this method of pleurography is useful for the clinical evaluation of the condition of the pleura in various lung diseases.
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