Reference blood pressure (BP) values for Japanese children based on a large number of measurements by auscultation have not yet been established.This was a cross-sectional analysis of data from a birth-cohort study. The data from the sub-cohort study conducted for children at the age of 2 years in the Japan Environment and Children's Study from April 2015 to January 2017 were analyzed. BP was measured via auscultation using an aneroid sphygmomanometer. Each participant was measured in triplicate, and the average value of two consecutive measurements with a difference of less than 5 mmHg was recorded. The reference BP values were estimated using the lambda-mu-sigma (LMS) method and compared with those obtained via the polynomial regression model.Data from 3361 participants were analyzed. Although the difference between the estimated BP values by the LMS and the polynomial regression model was small, the LMS model was more valid based on the results of the fit curve of the observed values and regression models for each model. For 2-year-old children with heights in the 50th percentile, the 50th, 90th, 95th, and 99th percentile reference values of systolic BP (mmHg) for boys were 91, 102, 106, and 112, and that for girls were 90, 101, 103, and 109, respectively, and those of diastolic BP for boys were 52, 62, 65, and 71, and that for girls were 52, 62, 65, and 71, respectively.The reference BP values for 2-year-old Japanese children were determined based on auscultation and were made available.
Abstract Time-of-flight neutron and X-ray diffraction as well as Raman spectroscopic measurements were carried out on an aqueous 15 mol% HCOONa solution in order to investigate the hydration structure of both the formate and sodium ions in the concentrated aqueous solution. The intramolecular bond distances of DCOO− (rCD = 1.07 ± 0.01 Å, rCO = 1.272 ± 0.007 Å and rOO = 2.18 ± 0.02 Å) were determined through a least-squares fit of the observed neutron interference term in the high-Q region. The average hydrogen-bond distances between the D2O molecules in the solution (r(O···D) = 1.92 ± 0.02 Å and r(D···D) = 2.42 ± 0.02 Å) were also obtained. The hydration parameters on the formate ion were estimated to be rOformate···H2O = 2.82 ± 0.01 Å and nOformate···H2O = 4.4 ± 0.2 from a least-squares fit of the X-ray intermolecular interference term. A preferred orientation between the formate ion and hydrated water molecules was suggested from the present X-ray data. The hydration number of Na+ in the solution was given to be 4.6 ± 0.2, besides the intermolecular distance (rNa+···H2O = 2.37 ± 0.01 Å). The symmetrical stretching vibrational band of the hydrated sodium ion, Na+(H2O)n, in a 15 mol% HCOONa solution was observed at 225 cm−1 in the present isotropic Raman spectrum.
Abstract Time-of-flight (TOP) neutron diffraction experiments have been carried out for pure liquid D2O and concentrated aqueous deuterochloric acid solutions (DCl)x(D2O)1−x (x = 0.10, 0.23). The errors due to the inelasticity effect on the molecular structure in the solution were markedly reduced by the TOF measurement at the small scattering angle (2θ=44°). From the least square fit of the theoretical intramolecular interference function to the observed one, the internuclear distances, rOD and rDD, and the root mean square displacements, lOD and lDD, in both D3O+ and D2O molecules were determined as follows; rOD = 1.04(4) Å, rDD = 1.63(5) Å, lOD = 0.07(2) Å and lDD = 0.12(6) Å for D3O+, and rOD = 0.983(5) Å, rDD = 1.55(4) Å, lOD = 0.067(8) Å, and lDD = 0.12(4) Å for D2O. The bond angle ∠DOD in D3O+ was also calculated to be 103°. The trigonal pyramidal structure of oxonium ion in the liquid phase has been lead through this investigation.
We describe our experience with a 15-year-old girl receiving anesthesia during one-stage bilateral nephrectomy for treatment-resistant hypertension due to chronic renal failure. Approximately 10 minutes after removal of both kidneys, a reduction in blood pressure associated with decreased cardiac contractile force was observed and this necessitated catecholamine administration. However, blood pressure was sufficiently improved approximately 60 minutes later, and catecholamine administration was not necessary after she awoke from anesthesia. Although administration of an antihypertensive agent as required after surgery, as had been the case before surgery, the dose was gradually tapered and we were able to stop drug administration on postoperative day 31.
We have developed a simple and easy method of estimating the glomerular filtration rate (eGFR) of serum creatinine in Japanese children (eGFRUemura). The eGFR equation is for children aged 2-18 years. Therefore Uemura et al. developed an equation for children younger than 2 years (eGFRunder 2). The aim of the present study was to validate this new equation.We collected the data of 13 patients from previous studies and compared the results of eGFRunder 2, eGFRUemura, and updated eGFR developed by Schwartz (eGFRSchwartz) with measured GFR using mean error (ME), root mean square error (RMSE), P30 and Bland-Altman analysis.The ME of eGFRunder 2, eGFRUemura and eGFRSchwartz were 2.3 ± 15.9, 7.7 ± 14.5, and 16.0 ± 18.2 ml/min/1.73m2, respectively. The RMSEs were 15.5, 15.9, and 49.6, respectively. The P30 values were 76.9%, 76.9%, and 53.8%, respectively. The graph of Bland-Altman bias analysis showed fan-shape. The eGFRunder 2 equation was the most accurate in the three equations.The eGFRunder 2 equation was useful for Japanese children younger than 2 years.
