The present study was carried out to elucidete whether the accumulation of triglyceride (TG) in rat liver during fasting was stimulated by swimming. Male Wistar rats were divided into three groups; C: control, 24 F: 24 hour-fasted and 48 F: 48 hour-fasted. These animals were required to swim for 120 min.
In rats with both 24F and 48F, the liver glycogen contents did not change during swimming. The level of TG in rat liver was higher in 24 F and 48 F rats than the control group, and the exercise significantly affected the liver TG in each group. There was significant correlation betweem the level of TG in rat liver and the plasma free fatty acid (FFA) concentration (r=0.681, p<0.01) . However, although plasma TG did not change during exercise in each group, the TG secretion rate (TGSR) of the 48 F group was significantly lower than that of the C and 24F groups (p<0.01) .
These results provide evidence that exercise may result in the accumulation of TG in liver during fasting and suggest that the process not only depends on the surplus supply of FFA, but also inhibits very low density lipoprotein-TG secretion from liver.

The purpose of this study was to clarify difficulties and countermeasures in nursing practice for foreign patients with COVID-19 who were non-English native speakers. A questionnaire was collected from 16 nurses in a COVID-19 ward. They cared for 13 non-English-speaking foreign patients from admission to discharge in the ward between May 2021 and June 2021. All nurses reported difficulties in communication related to collecting information from patients and explaining hospital care. For example, they could have simple conversations using a two-way translation device (POKETALK®) but could not understand detailed symptoms or complaints without an interpreter. Not much meaning could be inferred from a patient’s response of “OK”. The nurses reported that it was difficult to explain details of treatments, Japanese customs, and hospital rules. With the help of interpreters, they made hospital manuals and question cards in the patients’ native languages. In nursing care for foreign patients with COVID-19, it was helpful to provide explanations of Japanese customs and hospital rules before admission and to prepare hospital manuals and question cards in patients’ native languages.

Objective : The mainstream strategy for blunt traumatic thoracic aortic injuries (BTAI) has been shifting from conventional open repair (OR) to thoracic endovascular aortic repair (TEVAR). Accordingly, we reviewed the short- and mid-term outcomes following surgical procedures of BTAI, comparing OR with TEVAR. Methods : We retrospectively collected data of consecutive cases of BTAI in a single institution from March 2001 to August 2019. Results : Eighteen cases were identified. Of these, 7 patients (38.9%, mean age 62.0±15.2 years) were treated with OR and 11 (61.1%, mean age 61.8±21.3 years) were treated with TEVAR. There was significant reduction in the mean operative duration (OR 444±145 vs TEVAR 65±14 min ; p＜0.001), the mean intraoperative blood loss (OR 2,787±1,578 vs TEVAR 210±376 ml ; p＜0.001), the volume of blood transfusions (OR 5,042±2,219 vs TEVAR 929±751 ml ; p＜0.001), and the mean dose of heparin infusion (OR 20.3±4.1 vs TEVAR 7.9±8.5 ml ; p＜0.01). Postoperative 30-day mortality of OR and TEVAR were 28.6 and 0% (p＝0.14), respectively. There was no endoleak, 1 case of paraparesis, and 1 case of bilateral cerebellar infarction in the TEVAR group. There was no significant difference in the length of stay in the intensive care unit, the duration of hospital stay, the rate of home discharge, or the mid-term mortality and re-intervention rate (average follow-up period of 42.0±56.9 months). Conclusions : Compared with OR, TEVAR took less operative time with less bleeding, and required less blood transfusions and heparin. The short- and mid-term outcomes following TEVAR for BTAI was favorable and TEVAR appears to be applicable as a first-line treatment for BTAI.

The patient in this case was a boy aged 2 years and 9 months. The patient was transferred to our hospital with ductal shock, and bilateral pulmonary artery banding was performed on the 9th day after the diagnosis of interruption of the aortic arch, ventricular septal defect, subaortic stenosis, and bicuspid aortic valve. Left ventricular outflow tract stenosis due to aortic annulus diameter and subaortic stenosis after repair was suspected. Damus-Kaye-Stansel (DKS) anastomosis, extended aortic arch anastomosis, and a right modified Blalock-Taussig operation were performed. Preoperative examination of the intracardiac repair showed growth of the aortic annulus and confirmed that biventricular repair was possible after DKS take-down. The patient's native aortic and pulmonary valves were preserved, and an intracardiac repair was performed without using an extracardiac conduit. The postoperative course was uneventful, and the patient is currently in a good condition at the age of 6 years. Three and a half years after surgical intervention, echocardiography and cardiac catheterization showed improvement of subaortic stenosis and enlargement of the aortic annulus. Our findings indicate that the most appropriate surgical procedure can be selected by detailed examination of the preoperative condition at each stage of the staged operation.

Purpose: To determine how nurses perceive the need for advance care planning (ACP) for chronic heart failure with patients and their families. Methods: A questionnaire survey was administered with 427 nurses who were affiliated with implantable cardioverter-defibrillators and resynchronization therapy. The survey included 13 items related to the need for ACP for simulated advanced heart failure cases with patients and their families. Results: Valid Responses were obtained from 207 nurses. On out of all items, the least proprtion of participants (51%) responded “giving predictions about functional prognosis and life expectancy” should be performed with patients. The participants’ perceptions regarding 8 items, which included the items on communication about prognosis, reflected their belief that ACP should be performed with family members rather than the patient. It was found that participants with certification in chronic heart failure nursing were more likely to respond in favor of ACP being performed with the patients in relation to 7 items, which included “ask about what has been important in one’s life”, and being performed with the family in relation to 10 items that included “ask the family what kind of life you want the patient to have hereafter”, as compared to other nurses. Conclusion: Regarding ACP, it is suggested that nurses are careful in discussing prognosis with patients, and certified nurses tend to attach importance to the individualities and values of patients and their families.