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11.
Takanobu Anai M.D. Isao Miyakawa M.D. Ph.D. Hiromi Ohki M.D. Teruyuki Ogawa M.D. Ph.D. 《Pediatrics international》1992,34(3):324-327
There have been only 2 previous reports of nonimmunologic hydrops fetalis (NIHF) caused by fetal Kasabach-Merritt syndrome, both of which were pathological studies. This is the first clinical case report of NIHF due to fetal Kasabach-Merritt syndrome that was prenatally diagnosed by sonography, computerized tomography, and percutaneous umbilical blood sampling. 相似文献
12.
Toshiharu Yamagishi Susumu Ishikawa Ichiro Yoshida Akio Ohtaki Toru Takahashi Satoshi Ohki Shuji Sakata Yasuo Morishita 《Surgery today》1997,27(9):874-875
We describe our technique for performing direct thoracoscopic closure of a congenital partial pericardial defect, which was
successfully employed in a 15-year-old boy. This is the first such report of a procedure that is noninvasive and may therefore
become the treatment of choice for patients with a small congenital pericardial defect. 相似文献
13.
Japan Pancreatoduodenectomy Study Group Ryo Hosotani Masafumi Kogire Tadahiro Takada Hiroyuki Kato Takahiko Funabiki Masumasa Horisawa Takeshi Morimoto Takukazu Nagakawa Toshimichi Nakayama Itsuo Miyazaki Masayuki Imamura 《Journal of Hepato-Biliary-Pancreatic Surgery》1997,4(3):295-303
Endocrine tumor of the pancreas is potentially malignant. A multicenter analysis of these tumors was conducted to clarity
the present status of their surgical management and the subsequent long-term surgical results. The Japan pancreatoduodenectomy
(JPD) study group carried out the study; 368 patients were enrolled and variables related to tumor characteristics, surgery,
and survival were retrospectively analyzed. There were 222 patients with functioning tumor and 143 patients with nonfunctioning
tumor. Malignant tumor was found in 140 of 368 (38%) of the patients, and 63/140 (45%) of these patients had metastatic lesion;
the most common site of the metastasis was liver 34/136 (25%), followed by regional lymph nodes 26/136 (19%). Pancreatic resection
was performed in 91% of patients with nonfunctional tumor and in 83% of those with malignant tumor, and 73% of the pancreatic
resections were done with lymph node dissection. The overall 5-year actuarial survival rate was 76% in patients with malignant
tumor. The actuarial 5-year survival rate was 93% in the patients without metastasis and 83% in patients who received curative
resection. Multivariate analysis showed that the presence or absence of synchronous metastasis was the sole significant prognostic
factor. The results suggest that: (i) malignant endocrine tumor of the pancreas is a curable malignancy when pancreatic resection
with lymph node dissection is adopted and (ii) that synchronous metastasis is the dominant prognostic factor.
This study was carried out as a group project. The authors' institutions are as follows 相似文献
14.
Susumu Ishikawa M.D. Akio Ohtaki M.D. Toru Takahashi M.D. Tetsuya Koyano M.D. Yutaka Hasegawa M.D. Satoshi Ohki M.D. Yukitaka Isa M.D. Kennichi Arai M.D. Fumio Kunimoto M.D. Yasuo Morishita M.D. 《Journal of cardiac surgery》1997,12(3):176-179
A bstract The purpose of this study was to assess the efficacy of nasal mask bi-level positive airway pressure (BiPAP) support in managing respiratory failure following cardiovascular surgery. A total of 20 patients requiring postoperative prolonged respiratory support of 72 hours or longer were studied. BiPAP support was used for eight patients (BiPAP group); the other 12 patients were managed using ordinary oxygen mask treatment (control group). The mean age of the BiPAP group and control group was 65 and 58 years of age, respectively. The mean period of postoperative endotracheal intubation of the BiPAP group and control group was 12 ± 5 days and 7 ± 1 days, respectively. Reintubation was necessary in two patients of the control group. The BiPAP group patients required no reintubation. BiPAP support was discontinued within 48 hours in 6 out of 8 patients. The respiratory rates of control group increased (p < 0.1) 24 hours after extubation, however, the respiratory rates of the BiPAP group remained unchanged. The values of the respiratory index of the BiPAP group improved significantly (p < 0.01) after BiPAP management (from 1.5 ± 0.2 to 0.9 ± 0.2). The values of the control group, however, remained unchanged. A-aDO2 and Qs/Qt decreased (p < 0.1) in the BiPAP group. There were no significant differences in central venous pressure or circulatory status between the two groups. In conclusion, BiPAP support is a noninvasive management technique for postoperative respiratory failure and may also prevent prolonged endotracheal intubation. 相似文献
15.
Masafumi Yamaguchi Shinsuke Mii Takashi Kai Hisanobu Sakata Akira Mori 《Surgery today》1997,27(9):863-867
Two elderly women complaining of intermittent claudication complicated with persistent sciatic artery are herein reported.
A direct femoral arteriogram showed hypoplasty of the superficial femoral artery and an unnatural anatomical relationship
between the distal superficial femoral artery and the proximal popliteal artery, thus suggesting the presence of persistent
sciatic artery. The diagnosis of persistent sciatic artery was finally made based on the aortography findings including the
iliac arterial system and computed tomography (CT) scan. Magnetic resonance imaging (MRI) was helpful to demonstrate the entire
image of this anomaly in cases with non-thrombolized sciatic artery. These diagnostic methods were useful in designing the
optimal surgical strategy. The first case with a gluteal pulsating mass underwent exclusion of the persistent sciatic artery
including the aneurysm through a retroperitoneal approach with a combination of femorotibial bypass, while the second case
with thrombosed persistent sciatic artery only underwent femoropopliteal bypass. To recognize such a rare lesion, awareness
of the differential diagnosis is important, and to provide appropriate treatment, an accurate whole image including adequate
angiography, a CT scan, and magnetic resonance imaging is necessary. 相似文献
16.
17.
Y. Nako Y. Ohki A. Harigaya T. Tomomasa A. Morikawa 《Acta paediatrica (Oslo, Norway : 1992)》1997,86(10):1105-1109
Objective: Plasma soluble thrombomodulin level reflects endothelial damage. The plasma thrombomodulin level at birth is increased in asphyxiated full-term infants. There is no report of plasma thrombomodulin level in premature infants. To determine the thrombomodulin level in premature infants and whether it might reflect endothelial damage, we examined the plasma thrombomodulin level in very low birthweight (VLBW) infants at birth. Methods: Forty-five VLBW infants, of whom 14 had perinatal asphyxia complications, were recruited. As a control, 50 full-term infants wimout complications were also studied. Plasma thrombomodulin concentration, pH, base deficit, serum creatinine and D-dimer concentration, platelet count and fibrinogen concentration were measured within 1 hour after birth. Results: There were significant differences in plasma pH, creatinine concentration, platelet count, antithrombin in activity and D-dimer concentration between VLBW infants and full-term infants. Plasma thrombomodulin concentration (39. 0 (16. 6–93. 7) vs 27. 0 (16. 6–39. 1) μg/L, p < 0. 0001) and plasma taombomodulin-to-serum creatinine ratio (0. 82 (0. 19–2. 65) vs 0. 47 (0. 24–0. 70) μg/μmol, p < 0. 0001) were significantly higher in VLBW infants than those in full-term infants. By univariate analyses for all neonates, there were significant relations between plasma thrombomodulin concentration and gestational age, birthweight, plasma pH, creatinine concentration, platelet count and antithrombin in activity. A stepwise multiple linear regression model using the above variables as dependent factors showed only birthweight contributed significantly to plasma thrombomodulin concentration (plasma thrombomodulin concentration (μg/1) = 45. 677–0. 006 (birthweight; g), r2= 0. 323, p < 0. 0001, n= 94). Plasma thrombomodulin concentration and plasma thrombomodulin-to -serum creatinine ratio in VLBW infants with asphyxia were higher than in those without asphyxia, but not significantly different (43. 2 ± 17. 7 vs 38. 3 ± 8. 5 μg/1 and 0. 92 ± 0. 60 vs 0. 83 ± 0. 37 μg/μmol). Conclusion: Plasma thrombomodulin level in VLBW infants shows a high value at birth, and we consider the main factor responsible for this elevation may be endothelial damage or low clearance rate of thrombomodulin, which may be related to early gestational age. 相似文献
18.
M. Ito T. F. Lang M. Jergas M. Ohki M. Takada T. Nakamura K. Hayashi H. K. Genant 《Calcified tissue international》1997,61(2):123-128
This study examined trabecular bone mineral density (BMD) in Japanese women with and without spinal fracture, and compared
the results to American women with and without fracture. The quantitative computed tomography (QCT) systems used at the University
of California, San Francisco (UCSF) and at Nagasaki University were cross-calibrated. Normative BMD was assessed with the
K2HPO4 liquid phantom in 538 Americans aged 20–85 years, and with the B-MAS200 phantom in 577 Japanese aged 20–83 years. These BMD
were adjusted for use with the Image Analysis solid phantom using the result of cross-calibration. The trabecular BMD in 111
postmenopausal American women (55 with fracture), and in 185 postmenopausal Japanese women (67 with fracture) were compared
for investigation of the difference in BMD values relative to fracture status. The absolute BMD values in Japanese were lower
than those in Americans, and the differences were greater with advancing age. The magnitude of the BMD difference was 8.6,
20.5, 38.1 mg/cm3 in women aged 20–24 years, 40–44 years, 60–64 years, respectively. In premenopausal women, BMD began to decrease at the age
of 20 in Japanese, whereas the peak bone mass was maintained until the age of 35 in the American women. In immediate postmenopausal
women, BMD significantly decreased in both populations. In later postmenopausal women, BMD significantly decreased with age
in the Japanese women but decreased less rapidly in the American women. The aging decrease of BMD was 1.4% and 2.2% per year
in the later postmenopausal American and Japanese women, respectively. The fracture threshold is considered to be lower in
Japanese women. However, the BMD difference between American and Japanese women with fracture was similar to that without
fracture. The Z-scores of fracture subjects versus controls were 2.9 in American and 1.8 in Japanese women. In conclusion,
Japanese women were found to have a lower BMD and lower fracture threshold than American women. The significant decrease of
spinal trabecular BMD in late postmenopause is potentially responsible for the higher prevalence of spinal fracture in Japanese
women.
Received: 18 December 1995 / Accepted: 23 September 1996 相似文献
19.
M. Ito K. Hayashi Y. Ishida M. Uetani M. Yamada M. Ohki T. Nakamura 《Calcified tissue international》1997,60(1):11-15
For several different bone mineral measurements and various skeletal sites, we compared capability to discriminate between
women in various age decades with and without spinal fracture, and attempted to identify the most effective cutoff level in
discrimination of spinal fracture. The subjects were 88 women aged 50–59 years (including 32 with fracture), 95 women aged
60–69 years (including 54 with fracture), and 34 women aged 70–79 years (including 18 with fracture). Spinal trabecular and
cortical bone mineral density (BMD) were measured using quantitative computed tomography (CT), and spinal, radial (ultra-distal,
10% distal and 33% distal), and calcaneal BMD were measured by dual X-ray absorptiometry. These BMD values were obtained in
each subject on the same day. Three statistical techniques—Student's t-test, the logistic regression analysis, and the receiver operating characteristics (ROC) analysis— were applied and accuracy
was calculated using the various cutoff values. The capability to discriminate between women with and those without fracture
using these BMD values was different among the three age groups. In women aged 50–59 and 60–69 years, all measurements showed
good capabilities for discriminating women with fracture. In women aged 70–79 years, these measurements showed lower capability
than in those aged 50–59 and 60–69 years, but among them, the calcaneal and ultradistal radial BMD showed relatively good
capability. The 10% and 33% distal radial BMD values were not useful in the detection of the high risk women with fracture.
The cutoff BMD values for discrimination of women with fracture varied according to the sites and methods of measurement.
For each specific age group, the most suitable measurement methods and the appropriate skeletal sites should be considered,
and the effective cutoff values to discriminate those with fracture may differ according to the measurement methods, the skeletal
sites examined, and age.
Received: 5 February 1996 / Accepted: 18 June 1996 相似文献
20.
Kazutoshi Hamada Akihito Tomonaga Masafumi Gotoh Hideyuki Yamakawa Hiroaki Fukuda 《Journal of orthopaedic research》1997,15(1):24-32
To determine the healing potential and healing process of torn supraspinatus tendons, in situ hybridization was used to localize cells containing α1 type-I procollagen mRNA. Biopsy specimens of torn supraspinatus tendons from 19 patients with complete-thickness tears and 13 patients with incomplete-thickness tears were obtained during surgery. Four macroscopically normal supraspinatus tendons were obtained to serve as normal controls. Specimens were fixed in 10% buffered formalin and embedded in paraffin. A 22-mer oligonucleotide probe was labeled with digoxigenin and used as an in situ marker. The labeled cells were mainly composed of tenocytes and undifferentiated mesenchymal cells. In complete-thickness tears, the labeled cells at the proximal tendon stumps in the specimens that were obtained less than 4 months after trauma were significantly more abundant than in the specimens obtained 4 months or more after trauma. However, the number of labeled cells was maintained at the torn portion even in long-standing incomplete-thickness tears. The labeled cells at the margins of concomitant intratendinous extensions of the tears were detected even in the long-standing tears. The intratendinous extensions exhibited more labeled cell than were bursal-side or joint-side layers of the tendon substance in the incomplete-thickness tears (p < 0.05). The torn supraspinatus tendon may possess an intrinsic healing capability in the intermediate and late phases of tendon healing. Incomplete-thickness tears and concomitant intratendinous extensions can continue to rupture after the initial injury. 相似文献