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31.
N Motomura K Kitaura S Shirakata K Ohga T Oka 《[Zasshi] [Journal]. Nihon Kyōbu Geka Gakkai》1992,40(11):2057-2060
The size of a thoracic aortic aneurysm (TAA) is an important factor of the operative indication. We experienced a ruptured TAA the diameter of which was only 4 cm. A 71 years old man was admitted due to the severe back pain under the shocked condition. We diagnosed him a ruptured TAA by CT scan. Because he had no progressive anemia and the hemodynamics was very stable, we followed him conservatively. Two months later, the operation was performed. We resected the aneurysm and inserted an aortic prosthetic graft. From the operative findings, the aneurysm was certified as a true aneurysm, and the maximal diameter was only 4 cm. First choice for the treatment of ruptured TAA is the emergent operation. But when the hemodynamics is extremely stable and the anemia does not progress at all, a conservative therapy can be selected. Even if the aneurysm is very small, the control of hypertension is quite important. 相似文献
32.
H. Oka T. Yamamoto T. Kawazoe K. Saratani Y. Hikida 《Medical & biological engineering & computing》1988,26(3):260-266
A new impact response method using a fracture of a pencil-lead to produce an excitation pulse is proposed. Impact excitations
(rectangular pulse, triangular pulse and half-sine pulse) are strictly given in physical and mathematical definitions and
complete solutions to the impact excitations are provided for Noyes' model of the human tooth. When a relatively long triangular
pulse is applied to Noyes' model, which can express the physical characteristic of periodontal tissues, a sinusoidal damped
vibration of a single degree-of-freedom model is approximately obtained. The acceleration response is characterised by the
physical parameters (T, δ and Ao) and mechanical elements (m1, c1 and k) of which a single degree-of-freedom model is composed. By means of this method, the values of the parameters and elements
in the cases of healthy maxillary, healthy mandibular and pathological mandibular incisors are obtained. The single degree-of-freedom
model can express the high-frequency spectra of Noyes' model. The pathological tooth is characterised by a longer damped time
constant and a larger acceleration maximum. This impact response method can effectively be applied to clinical diagnosis in
view of the physical parameters and mechanical elements which have been derived. 相似文献
33.
Kuniaki Nakahara Satoru Shimizu Satoshi Utsuki Sachio Suzuki Hidehiro Oka Kiyotaka Fujii 《Child's nervous system》2007,23(8):863-865
Objects We evaluated whether the presence of lacunar skull deformity (LSD) with myelomeningocele is a predictive factor for subsequent
hydrocephalus development.
Materials and methods We reviewed the clinical and radiological records of 18 infants with myelomeningocele, divided the patients into groups with
(group A, n=9) and without (group B, n=9) ventriculomegaly at birth and assessed whether the presence of LSD was predictive of the necessity for ventriculoperitoneal
shunt (VPS) placement.
Results LSD was present in five group A patients. All nine group A patients underwent VPS placement. Among the group B patients, five
had LSD; they underwent VPS placement. A significantly higher proportion of those with ventricle enlargement or LSD at birth
required VPS placement (p=0.0001).
Conclusion Adding to the ventriculomegaly at birth, the presence of LSD alerts to the necessity to monitor these infants closely to determine
the necessity for VPS placement. 相似文献
34.
Hisayoshi Oka Masayuki Yoshioka Kenji Onouchi Masayo Morita Soichiro Mochio Masahiko Suzuki Toshiaki Hirai Mitsuyoshi Urashima Kiyoharu Inoue 《Movement disorders》2007,22(10):1510-1514
We assessed the relations of visual hallucinations (VH) to cardiovascular autonomic dysfunction in patients with Parkinson's disease (PD). The subjects were 37 patients without VH (VH(-)) and 31 with VH (VH(+)). Autonomic function was evaluated on the basis of cardiac 123-radioiodinated metaiodobenzylguanidine (123I-MIBG) uptake and hemodynamic testing with Valsalva maneuver. Systolic blood pressure (SBP) and plasma norepinephrine concentrations (NE) were measured by tilt-table testing. 123I-MIBG uptake was lower in VH(+) than VH(-). Hemodynamic studies showed that VH(-) had only cardiac sympathetic and parasympathetic dysfunction, while VH(+) additionally had reduced vasomotor sympathetic functions. The fall in SBP during tilt-table testing was greater in VH(+) than VH(-). NE and its difference in the supine and upright positions were decreased in VH(+). We conclude that cardiac and vasomotor sympathetic dysfunction is more severe in VH(+) than in VH(-). Severe dysfunction in PD with VH is probably attributed to Lewy-body lesions or neuronal loss in sympathetic ganglia, the central autonomic system, or both. 相似文献
35.
36.
Hiroyuki Oka Taiji Kondoh Atsushi Seichi Takahiro Hozumi Kozo Nakamura 《Journal of orthopaedic science》2006,11(1):13-19
Background Few previous studies have analyzed the incidence of bone metastases in a defined population of Japanese breast cancer patients
and their prognosis after chemotherapy.
Methods This is a retrospective cohort study. We investigated 695 patients who underwent surgery for breast cancer. The strategy of
adjuvant therapy was as follows. Patients with both estrogen receptors (ERs) and progesterone receptors (PgRs) had endocrine
therapy as initial adjuvant therapy (n = 239). Patients with neither ERs nor PgRs had chemotherapy. When metastasis to other organs, including bone, was identified,
patients received chemotherapy. The survival rates after surgery and after the onset of bone metastasis, as well as the incidence
of bone metastasis, were calculated. We also evaluated the prognostic and predictive factors.
Results Bone metastases developed in 148 of 695 patients. All 148 received chemotherapy, and 121 of them developed spinal metastases.
The 5-year survival rate after bone metastases was 26.1%. Prognostic factors for bone metastases were visceral metastases
and PgR status. Cord compression was observed in 17 of the 148 patients, with the thoracic spine being the most common. The
1-year survival rate for patients with bone metastases who received chemotherapy was 66.3%, whereas that of patients with
paralysis after spinal metastases was 17.6%. Within 6 months of the development of spinal cord compression, 70.6% of the patients
died.
Conclusions We reported the incidence and prognostic factors for a defined population of Japanese breast cancer patients with bone and
spinal metastases. Our results suggest that the expected survival time for patients with paralysis who received adequate endocrine
therapy or chemotherapy is generally poor. However, to detect a predictive factor of long survival after paralysis and establish
the indications for surgery, a comparative study among large groups of patients with paralysis and with different backgrounds
is necessary. 相似文献
37.
Tadaki Yasumura MD Toshikazu Akami Manabu Mitsuo Takahiro Oka Kazuo Naitoh Takara Yamamoto Hideo Honjyo Hiroji Okada 《Surgery today》1990,20(4):369-375
The ovarian and pituitary functions of 64 operable breast cancer patients undergoing adjuvant therapy with cytotoxic chemotherapy
and/or tamoxifen were investigated. The post menopausal patients, divided into 3 treatment groups, one with tamoxifen alone,
one with tamoxifen and chemotherapy and the other with chemotherapy alone had serum estradiol 17-β (E2) and progesterone levels
lower than the evaluable limits. Although there was no significant difference in the level of estrone sulfate (E1-S) between
these three groups, the level of lutainizing hormone (LH) and follicle stimulating hormone (FSH) in the patients treated with
tamoxifen alone and tamoxifen and chemotherapy were significantly lower than those treated with chemotherapy alone. The decrease
in gonadotropin levels induced by tamoxifen treatment was reversible as it appeared after the initiation of tamoxifen and
recovered after its cessation. In the premenopausal patients, a group treated with tamoxifen and chemotherapy had significantly
higher E1-S, E2 and progesterone levels and significantly lower gonadotropin levels than a group treated with chemotherapy
alone or one treated with a cyclophosphamide regimen. These increases in the levels of estrogen and progesterone were also
reversible, and induced by tamoxifen. Thus, adjuvant endocrinochemotherapy causes profound alteration in the hypothalamo-pituitary-ovarian
axis and therefore, monitoring a variety of hormonal levels is thought to be necessary for assessing the consequences of adjuvant
therapy in breast cancer patients, especially in premenopausal patients using tamoxifen. 相似文献
38.
39.
Yoshito Matsui Tomoatsu Kimura Noriyuki Tsumaki Haruhiko Nakahara Nobuhito Araki Natsuo Yasui Takahiro Ochi 《Journal of orthopaedic science》1996,1(2):130-135
Recent DNA studies performed by several groups have detected mutations of the gene encoding fibroblast growth factor receptor
3 (FGFR3) in patients with achondroplasia-group disorders, including achondroplasia (ACH), hypochondroplasia (HCH), and thanatophoric
dysplasia (TD). For this study, we analyzed theFGFR3 gene in 31 Japanese patients with typical ACH, four with HCH, three with a condition intermediate between ACH and HCH (ACH/HCH-intermediate),
and one with TD. Of the 31 typical ACH patients, 29 showed a G1138 to A transition and the other two a G1138 to C transversion,
both resulting in a common Gly380Arg substitution in the transmembrane domain of FGFR3. The one TD and the four HCH patients
did not display any mutations in the transmembrane domain of FGFR3. Of the three ACH/HCH-intermediate cases, one patient showed
the Gly380Arg substitution and one did not, and further analysis of the second patient revealed the presence of Asn540Lys
substitution. The first patient was, therefore, genotypically diagnosed as ACH and the second as HCH. Peripheral blood leukocyte
DNA analysis in the remaining ACH/HCH-intermediate patient indicated an unequal ratio of mutant to normal PCR products, possibly
representing a somatic mosaic for the Gly380Arg mutation. Analysis of the common FGFR3 mutation thus appears to help in the
molecular diagnosis of patients with achondroplasia-group disorders. 相似文献
40.