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51.
TOMOHIRO UEDA MASAHIRO TAMAKI SUSUMU KAGEYAMA NAOKI YOSHIMURA OSAMU YOSHIDA 《International journal of urology》2000,7(3):95-103
Background : Urinary incontinence (UI) is a common problem in adults, especially among the elderly. We examined the prevalence and risk factors of UI and potential factors hindering individuals from seeking treatment for UI among a community‐dwelling population aged over 40 years. Methods : Data were collected by mailing a 23‐item urinary incontinence questionnaire to a random sample of community‐dwelling individuals aged 40–75 years (n = 3500) in seven towns of Shiga Prefecture, Japan. Collected data were then used to estimate the prevalence of UI and to provide information regarding subtypes of UI, knowledge and self‐perception about UI. Results : The overall response rate was 52.5%. Prevalence of UI for male and female respondents were 10.5% and 53.7%, respectively. The incidence of urge incontinence increased as age increased in the male group. In women, stress incontinence was prevalent at all ages and the incidence of urge incontinence increased over 70 years of age. Urinary incontinence was more likely as activities of daily living limitations and cystitis increased. Women with a history of hysterectomy or diabetes mellitus and men who had stroke were at increased risk for UI. Of those who reported UI, only 3% had ever consulted doctors or other health care professionals concern‐ ing it, 25% recognized their condition as a disease and 38% considered it curable by appropriate treatments. In addition, 63% regarded UI as an unavoidable consequence of aging, 63% con‐ sidered their condition was embarrassing and 54% were reluctant to seek treatment from a health professional. Conclusions : Although UI is common among community‐dwelling individuals over 40 years of age, the majority of affected individuals remained untreated due to lack of knowledge and/or a negative perception of UI. Thus, community education on UI may be needed to increase the number of UI patients who receive treatment. 相似文献
52.
SHINICHIRO SAIHARA HIROSHI INDUE IKU TODA MASAHIRO USUI TSUNEAKI SUGIMOTO 《Pacing and clinical electrophysiology : PACE》1990,13(1):52-58
A subthreshold stimulus was reported to become effective in producing a propagated ventricular response when preceded by another subthreshold stimulus or stimuli, a phenomenon that is known as summation of excitation but has not been studied systematically. Effect on summation of current intensity and coupling interval of a conditioning stimulus (Sc, protocol #1) and that of stimulation site of Sc (protocol #2) were determined in anesthetized, open-chest dogs. Effective refractory period (ERP) was determined with an extrastimulus (S2) at a ventricular pacing cycle length (S1S1) of 500 msec. Pulse width of S1, S2 and Sc was 2 msec. For pacing protocol #1 (12 dogs), current intensity of S1 and S2 was equal (twice diastolic threshold, 2, 5, or 15 mA), and that of Sc was equal to or lower than that of S1. S1S2 interval was fixed 1 msec shorter than ERP, and Sc was delivered 5 msec prior to S2. The S1Sc interval was shortened in 2 msec steps. Summation was present if Sc plus S2 evoked a propagated response. Prevalence of summation increased along with an increase in current intensity of Sc (P less than 0.01). For pacing protocol #2 (7 dogs), current intensity of S1, S2 and Sc was equal (twice diastolic threshold, 5 or 10 mA). As the distance between site of Sc and that of S2 increased, prevalence of summation decreased (P less than 0.01). Summation did not occur when Sc was delivered at a site only 5 mm away from the site of S2. In conclusion, summation of excitation with a single conditioning stimulus was both time and strength dependent, and limited in development spatially. 相似文献
53.
Interventional Catheterization in Kawasaki Disease 总被引:1,自引:0,他引:1
HIROHISA KATO M.D. FACC MASAHIRO ISHII M.D. TEIJI AKAGI M.D. GENZYU ETO M.D. MOTOHUMI IEMURA M.D. TAKAHIRO TSUTSUMI M.D. TAKAFUMI UENO M.D. 《Journal of interventional cardiology》1998,11(4):355-361
The experiences of catheter interventional treatment in Kawasaki disease are quite limited. In this article, we report our experiences of catheter intervention. We performed the percutaneous transluminal coronary revascularization (PTCR) in 18 cases, the percutaneous transluminal coronary angioplasty (PTCA) in 12, the stent implantation in 7, and the percutaneous transluminal coronary rotational ablation (PTCRA) in 7, which resulted in success in 55.5%, 75%, 100%, and 100%, respectively. In this article, we discuss the indications and methods for coronary artery lesions of long-term Kawasaki disease. PTCR is useful for treatment of acute myocardial infarction and for prevention of massive thrombus formation, particularly within 2 years from the onset of Kawasaki disease. PTCA is effective in many instances, particularly in patients without severe calcification of the coronary artery. However, neoaneurysm had developed in a certain number of the patients. Stent implantation is more preferable than PTCA, because it may potentially prevent neoaneurysmal formation and restenosis. Rotational ablation is effective for the stiff stenotic lesions with severe calcification, particularly for ring calcification, which frequently develops in the long-term Kawasaki disease patients. The intravascular ultrasound is very useful in evaluating the tissue characterization of the coronary artery and to select the treatment strategy, and to evaluate the catheter interventional treatment. 相似文献
54.
SHINSAKU IMASHUKU SHIGEYOSHI HIBI SHINGO MORINAGA KAZUTAKA TAKAGI JIMING CHEN HIDEO MUGISHIMA TAKEFUMI ISHII MASAHIRO SAKO HIROKAZU ARAKAWA & MASAHIKO KATO 《British journal of haematology》1997,96(4):708-714
Five paediatric cases of haemophagocytic lymphohistiocytosis (HLH) which showed proliferation of granular atypical lymphocytoid cells in bone marrow are reported. All cases were girls aged 8 months to 4 years who had marked hepatosplenomegaly. Marker analysis on peripheral blood mononuclear cells revealed an increase in the CD3+ HLADR+ subset in three cases and the CD3− CD56+ subset in one case. An Epstein-Barr virus genome was detected in three cases, and monoclonality was confirmed in two cases. A characteristic morphology of large granular lymphocytes (LGL) was identified, with elongated bizarre features that resembled horsetail-, tadpole-, cucumber- or shooting star-type configurations on the bone marrow smear. Serum concentrations of soluble interleukin-2 receptor and interferon-gamma were elevated in all cases. All five cases required multi-agent chemotherapy which resulted in two complete remissions, two partial remissions and one no response. Refinement of treatment is required for these paediatric GLPD cases which probably comprise a specific high-risk subgroup among secondary HLH patients which had previously escaped notice. 相似文献
55.
Therapeutic results of endoscopic variceal ligation for acute bleeding of oesophageal and gastric varices 总被引:1,自引:0,他引:1
TOSHIYA HARADA TOMOHARU YOSHIDA TOSHINORI SHIGEMITSU YOSHIFUMI TAKEO MASAHIRO TADA KIWAMU OKITA 《Journal of gastroenterology and hepatology》1997,12(4):331-335
Endoscopic variceal ligation (EVL) using 'O' rings is widely accepted as a treatment of oesophageal varices that is at least as effective as endoscopic injection sclerotherapy but which produces fewer complications. Endoscopic variceal ligation using detachable snares has attracted attention as a safe and easy method of endoscopic treatment for gastric varices. Nineteen patients with acute bleeding from oesophageal or gastric varices were treated in the present study. Of these, 14 patients were treated with EVL using 'O' rings and five patients were treated with EVL using detachable snares and the treatment results were evaluated. Haemostasis was achieved in all patients. No serious complications of the procedures were observed. However, recurrences and rebleeding were observed in some patients during the maximum follow-up period of 24 months. Endoscopic variceal ligation using 'O' rings and detachable snares is useful for achieving haemostasis in cases of acute bleeding from oesophageal or gastric varices. However, additional endoscopic sclerotherapy may be needed to eliminate the variceal feeding vessels to further improve the long-term prognosis of these patients. 相似文献
56.
KENICHI CHATANI M.D. TOSHIYA MURAMATSU M.D. REIKO TSUKAHARA M.D. YOSHIAKI ITO M.D. HIROSHI ISHIMORI M.D. KEISUKE HIRANO M.D. MASATSUGU NAKANO M.D. MASAHIRO YAMAWAKI M.D. MOTOHARU ARAKI M.D. MASAYUKI SAKURAI M.D. KAZUYUKI IUCHI M.D. TAKASHI NOZAWA M.D. HIROSHI INOUE M.D. 《Journal of interventional cardiology》2009,22(4):354-361
Sirolimus-eluting stent (SES) is established to be effective in reducing restenosis. Repeat revascularization, however, is still required in up to 5–8% of patients. In this study, we analyzed clinical and angiographic variables that might be related with SES re-restenosis and variables related with re-restenosis after repeat SES implantation for SES restenosis. We also assessed clinical outcomes at 2-year follow-up after percutaneous coronary intervention (PCI) for SES restenosis. Repeat revascularization for SES restenosis was performed in 113 patients with 140 lesions. Of the 140 lesions, follow-up coronary angiography (CAG) was performed on 117 lesions (101 patients) and revealed 46 SES re-restenotic and 71 non-re-restenotic lesions. In multivariate analysis, SES-in-SES-strategy and reference diameter before the second PCI were independent predictors of re-restenosis after PCI for SES restenosis. However, the reference diameter was the only independent predictor of re-restenosis after SES-in-SES. Major adverse cardiac events (MACE) at 2 years were found in 44 patients (43.5%), and target lesion revascularization (TLR) was performed in 33.7% of patients after SES restenosis. In conclusion, the incidence of MACE and TLR was relatively high in patients with SES restenosis, but the placement of another SES on larger-diameter vessels may be an effective strategy for the second PCI . 相似文献
57.
Faecal clearance of α1 -antitrypsin reflects disease activity and correlates with rapid turnover proteins in chronic inflammatory bowel disease 总被引:1,自引:0,他引:1
SOICHIRO MIURA MASAHIRO YOSHIOKA SHIN TANAKA HIROSHI SERIZAWA HIROKAZU TASHIRO HITOSHI ASAKURA MASAHARU TSUCHIYA 《Journal of gastroenterology and hepatology》1991,6(1):49-52
Faecal clearance of alpha 1-antitrypsin was measured in patients with ulcerative colitis and Crohn's disease and compared with disease activity and markers of protein-calorie malnutrition. Patients with active ulcerative colitis and Crohn's disease showed elevated clearance of alpha 1-antitrypsin and clearance declined in most patients with induction of remission. However, even with inactive disease, elevated protein loss persisted in some patients, presumably reflecting residual inflammation in the intestinal mucosa. There was a significant correlation between clearance of alpha 1-antitrypsin and serum levels of retinol-binding protein and transferrin in patients with ulcerative colitis and with retinol-binding protein in patients with Crohn's disease. Clearance of alpha 1-antitrypsin reflects disease activity in inflammatory bowel disease and correlates with serum levels of rapid-turnover proteins such as retinol-binding protein and transferrin, which are markers for the presence of protein-calorie malnutrition. 相似文献
58.
SERIAL QUANTIFICATION OF MINIMAL RESIDUAL DISEASE OF t(8;21) ACUTE MYELOGENOUS LEUKAEMIA WITH RT-COMPETITIVE PCR ASSAY 总被引:1,自引:0,他引:1
59.
TATSUO KONO SHIGEKO KUWASHIMA MUTSUHISA FUJIOKA CHIE KOBAYASHI KAZUTOSHI KOIKE MASAHIRO TSUCHIDA ICHIRO SEKI 《Pediatrics international》2007,49(6):923-927
BACKGROUND: The purpose of the present study was to evaluate the incidence of epidural air associated with spontaneous pneumomediastinum in children. METHODS: The subjects consisted of 25 boys and 17 girls with an age range of 3-14 years (mean age: 8.5 years) who underwent chest computed tomography (CT) for evaluation of spontaneous pneumomediastinum. The CT scans and medical records were reviewed retrospectively. RESULTS: Of the 42 patients, four (9.5%) had intraspinal air on CT. The air was interpreted as epidural in every patient. The small number of patients with epidural air meant that there was no significant difference in age, gender, or clinical manifestations between groups with and without epidural air. Subcutaneous emphysema was identified in all four patients with epidural air versus 18 out of 38 patients (47%) without epidural air. The patients with epidural air did not have any neurologic symptoms. Irrespective of the presence or absence of epidural air, every patient had a favorable outcome without any serious complications. CONCLUSION: In patients with spontaneous pneumomediastinum, epidural air may be more common than was previously realized. It is suggested that an air leak may spread from the mediastinum into the epidural space via the cervical fascial planes and neural foramina. 相似文献
60.
HIDEO MUGISHIMA KENSUKE HARADA TAKASHI SUZUKI MOTOAKI CHIN TOSHIAKI SHIMADA MAYUMI TAKAMURA HIROYUKI SHICHINO TAKAHITO FUJISAWA MASATAKA ICHIKAWA MITSUMASA IWATA IKUO OKABE EIICHI SANUKI YOSHIAKI TANAKA NAOMI ONUMA MASAHIRO TANABE TAKAO OKAMATSU SHOICHI KOIZUMI TERUHO KAJIMOTO ISAO SERINE NOBORU OKADA JOTARO YOKOYAMA SYUNICHI KATO MORIHIRO SAEKI JUNICHI AKATSUKA ATSUSHI KIKUTA ICHIRO TSUKIMOTO HIDEYUKI KITO JUNICHI MIMAYA TAKEO FUJIMOTO MUTSURO OHIRA MICHIO KANEKO YOSHIAKI TSUCHIDA 《Pediatrics international》1995,37(4):493-499
Encouraging results are reported with high-dose chemotherapy and total body irradiation followed by autologous bone marrow transplantation in the treatment of advanced neuroblastoma. However, relapse remains a significant problem. We used high-dose chemotherapy, surgery, intraoperative radiation and an autologous bone marrow transplant treated in vitro to remove tumor cells followed by 13-cis-retinoic acid to treat 36 children with advanced neuroblastoma. This comprehensive treatment appears to improve the survival rate of patients with advanced neuroblastoma, including those with N-myc amplification and bony involvement. The disease-free survival rate was 66% (95% confidence interval, 49–84%) at 3 years. All patients who received 13-cis-retinoic acid developed cheilitis, but no bone marrow depression occurred in these patients. Five patients developed hemolytic uremic syndrome (HUS) post-transplant. This may have been related to the procedure used for total body irradiation. Patients who had their kidneys shielded during this procedure did not develop this syndrome. Patients who received local irradiation at the primary site showed no evidence of relapse in this region, indicating that such therapy may help to prevent a relapse. These data suggest a high rate of 3 year disease-free survival with this treatment strategy. The nonrandomized nature of the study and use of multiple modalities precludes analysis of the specific contribution of each. 相似文献