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81.
Takashi Ishimori Satoru Nakano Yasutane Mori Reiko Seo Taro Togami Tetsuya Masada Toshiaki Kusuhara Motoomi Ohkawa Seigo Nagao Yuichi Yamashita Satoshi Sugiura 《Magnetic resonance in medical sciences》2007,6(4):225-229
PURPOSE: We assessed the feasibility of utilizing three-dimensional (3D) phase sensitive inversion recovery (IR) images for preoperatively determining deep brain stimulator position. METHODS: We measured geometric distortion with a grid phantom and evaluated images of 3 volunteers to determine optimum imaging parameters for 3D phase sensitive IR. RESULTS: Geometric distortion measured less than 1.0%. Respective inversion and recovery times, which provided high T(1) contrast between the subthalamic nucleus and adjacent tissue, were 200 and 4000 ms. In studies of 3 volunteers and 2 patients, the subthalamic nucleus was clearly depicted in 3D phase sensitive IR images. The measured coordinates of the subthalamic nucleus agreed well with those calculated by conventional estimation from midpoint of the anterior and posterior commissure. CONCLUSION: Three-dimensional phase sensitive inversion recovery was useful in visualizing the subthalamic nucleus for effective deep brain stimulation. 相似文献
82.
Satoshi Suzuki Koji Yasuda Yuji Matsumura Takashi Kondo 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2006,54(5):225-227
We present here a rare case of left-side catamenial pneumothorax, in which endometrial tissue pleura was found on the visceral pleura histologically. A chest roentogenogram confirmed the left pneumothorax, but did not reveal bullae or any associated anomalies, in a 41-year-old woman with three documented episodes of left-side pneumothorax occurring every menstruation. Video-assisted thoracoscopic surgery revealed not only tiny holes in the diaphragm, but also a scattered small brown spots on the visceral pleura. Histological examination of the lung sections revealed the existence of endometrial tissue on the visceral pleura with disrupted pleural elastic fibers. Our case suggests that cyclic erosion of the visceral pleura by the implanted endometrial tissue caused air leakage from the lung, in addition to the most accepted concept that air is aspirated into the thoracic cavity via the abdomen through the acquired fenestration of the diaphragm. 相似文献
83.
Takashi Yamauchi Takafumi Masai Koji Takeda Satoshi Kainuma Yoshiki Sawa Kazuo Abe 《Annals of thoracic and cardiovascular surgery》2007,13(6):410-412
We report a rare case of constrictive pericarditis that stimulated a large mediastinal tumor obstructing the right ventricular inflow tract. A 58-year-old woman was referred to our hospital because of a recent increase of dyspnea and facial edema. Computed tomography revealed severely thickened calcification, including a low-density area, presenting as a mediastinal tumor, compressing the right ventricular inflow tract. A complete resection was performed, and her symptoms dramatically improved. Idiopathic constrictive pericarditis was diagnosed pathologically. 相似文献
84.
Masaaki Kohta Hiroaki Minami Kazuhiro Tanaka Keiichi Kuwamura Takeshi Kondoh Eiji Kohmura 《Journal of clinical neuroscience》2007,14(2):167-170
A 52-year-old man fell from standing and a computed tomography (CT) scan revealed traumatic intracerebral haematoma and subarachnoid haemorrhage in the temporal cortex. He was treated without surgery and discharged. On day 30 after the accident, he had no neurological deficit. On day 37 he complained of headache and urinary incontinence, and on day 39 he was hospitalized due to progressive neurological deterioration (reduced conciousness, dilated pupils, and left hemiplegia). A CT scan revealed a diffuse low-density in the right cerebral hemisphere with marked midline shift. Emergency decompressive craniectomy and right temporal lobectomy were performed. Angiography after surgery revealed moderate vasospasm in the right middle and anterior cerebral arteries. The patient remained severely disabled. Delayed onset neurological deterioration can be caused by brain oedema and vasospasm after traumatic brain injury, despite an intervening period of improvement. 相似文献
85.
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
86.
Takeshiro Fujii Yoshinori Watanabe Noritsugu Shiono Muneyasu Kawasaki Hiroki Yokomuro Tsukasa Ozawa Satoshi Hamada Hiroshi Masuhara Tetsuo Teramoto Masanori Hara Tomonori Katayanagi Yuki Sasaki Nobuya Koyama 《Annals of thoracic and cardiovascular surgery》2006,12(5):324-332
OBJECTIVE: To clarify the position of on-pump beating coronary artery bypass (CAB) and to define preoperative indicators of intentional conversion to the procedure in the era of advancement of off-pump CAB (OPCAB), we assessed on-pump beating CAB performed after the introduction of OPCAB. SUBJECTS AND METHODS: We assessed 130 patients who underwent single CAB [117 (90%) with OPCAB and 13 (10%) with on-pump beating CAB] between August 1999 (when OPCAB was selected as the first-line surgical procedure) and December 2004. RESULTS: No significant differences were seen between the groups in the number of coronary lesions or the prevalence of left main trunk (LMT) lesion. Reduced left cardiac function, cardiac dilatation, and mitral regurgitation (MR) were more remarkable in the on-pump beating CAB group. Preoperative ischemic condition was generally unstable in the both groups. A conversion to on-pump beating CAB occurred at anastomosis for the left anterior descending (LAD) branch in 61% and for the left circumflex (LCX) branch in 15%. LAD patients had more severe left cardiac dysfunction and cardiac dilatation than LCX patients. CONCLUSION: To perform safe and reliable CAB surgery, cardiovascular surgeons should define preoperative indicators of difficult OPCAB and convert OPCAB to on-pump beating CAB intentionally without hesitation when unstable hemodynamics is detected. 相似文献
87.
T Ozaki J Kondoh T Sohma R Adachi H Kurata K Imoto H Kajiwara M Tobe K Hoshino A Matsumoto 《[Zasshi] [Journal]. Nihon Kyōbu Geka Gakkai》1990,38(8):1248-1254
From 1985 to 1987, we examined relationship between the lesion of tricuspid valve and right ventricular function in 31 patients (male: 9, female: 22) with mitral valve disease. The median age at operation was 52 years (range 37-69 years). Group I consisted of 17 patients (MS: 10, MSR: 5, MR: 2) accompanied with tricuspid regurgitation (TR) and Group II 14 patients (MS: 12, MSR: 2) without TR. In all cases of Group I tricuspid annuloplasty (TAP) were performed correctly. De Vega methods were done in 12 cases and Carpentier rings were used in 5 cases. Cardiac catheterization was done before and after operation. And right ventricular volume was measured by right ventricular angiography. In both groups pulmonary capillary wedge pressure, pulmonary artery pressure and cardiac index were improved postoperatively. Pulmonary artery resistance (PAR) and total pulmonary resistance (TPR) in Group I were significantly higher before operation but there were no difference between two groups postoperatively. Right ventricular end-diastolic volume index (RVEDVI) and right ventricular end-systolic volume index (RVESVI) in Group I were significantly improved postoperatively, but in Group II these were within normal range both pre- and postoperatively. Preoperative PAR was correlated inversely with postoperative right ventricular ejection fraction (RVEF). It means that patients with severe pulmonary vascular lesion had postoperative lower right ventricular function. In both groups, RVESVI was in inverse correlation with RVEF pre- and postoperatively. In both groups, there was an inverse correlation between the per cent change of RVESVI and that of RVEF. This means that RVESVI influenced right ventricular pump function. 相似文献
88.
A CASE OF METASTATIC YOLK SAC TUMOR OF TESTIS IN A CHILD 总被引:1,自引:0,他引:1
Akito Terai Satoshi Ishitoya Takayuki Hashimura Hideo Takeuchi Osamu Yoshida 《International journal of urology》1995,2(2):135-138
We report a case of testicular yolk sac tumor in a child aged 3 years and 6 months with multiple bulky metastases to lung and retroperitoneum (stage 11182). After three courses of chemotherapy with a PV 8 regimen (cisplatin, vinblastine and bleomycin). complete and partial responses were obtained for lung and retroperitoneal lymph node metastases, respectively. The patient was followed-up closely. However, on the basis of a re-elevated alpha-letoprotein (AFP) after 4 months' follow-up, he was treated with three courses of salvage chemotherapy with a modified VAB-6 regimen (cyclophosphamide. etoposide. actinomycin D, bleomycin and cisplatin), lollowed by retroperitoneal lymph node dissection. Histologically, only necrotic tissue was found. There is no evidence of recurrence 24 months after lymphadenectomy. There is very little information in the literature on the appropriate management of postchemotherapy residual mass in pediatric testicular tumors. 相似文献
89.
Yoshimi Otani Ichiro Yoshida Satoshi Ohki Motoi Kano Osamu Kawashima Masao Suzuki Yasushi Sato Toru Takahashi Akio Ohtaki Susumu Ishikawa Yasuo Morishita 《Surgery today》1997,27(9):812-815
Pulmonary aspergillosis associated with old tuberculosis is generally resistant to treatment. Thus, if patients are treated
only with conservative therapy, their condition continues to deteriorate due to repetitive hemoptysis, and may even become
critical. Surgical treatment is required for these patients; however, it is extremely difficult to resect the lesion due to
severe adhesions to the chest wall and vascular proliferation surrounding the lesion. We performed preoperative arterial embolization,
achieving good results in three patients with hemoptysis caused by pulmonary aspergillosis. The feeding arteries were embolized
using microcoils and/or gelatin sponges, and a lobectomy was safely carried out in all patients. We concluded that preoperative
arterial embolization is a safe and effective technique to prevent massive hemorrhage occurring at the time of surgery.
This work was presented at the 11th Annual Meeting of the Japanese Association for Chest Surgery, held in Kyoto, Japan, May
13–14, 1994 相似文献
90.