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Mitsuhiro Tozaki Kunihiko Fukuda Masafumi Suzuki 《Magnetic resonance in medical sciences》2006,5(3):137-146
PURPOSE: The purpose of this study was to assess the relationship between the amount of scirrhous component in invasive ductal carcinoma and its MR characteristics. MATERIALS AND METHODS: We retrospectively reviewed 71 consecutive patients with invasive ductal carcinoma smaller than 25 mm (average, 16.6 mm) in diameter. The scirrhous component was defined as invasive foci in small clusters of cancer cells showing desmoplasia. Invasive ductal carcinoma was subclassified into 3 groups in accordance with the amount of the scirrhous component (scirrhous component degree; SCD): SCD I (scirrhous component less than 20%), SCD II (intermediate), and SCD III (more than 80%). Dynamic magnetic resonance (MR) imaging was performed using volumetric interpolated sequence. Prior to dynamic study, T2*-weighted first-pass perfusion images were obtained before, during, and after bolus injection of 0.1 mmol Gd-DTPA/kg. RESULTS: Twenty-eight lesions were classified as SCD I, 14 as SCD II, and 29 as SCD III. Mass margin and signal intensity loss in the perfusion study were significantly different among the 3 SCD groups (P<0.001). The kinetic patterns were significantly different among the 3 SCD groups (P=0.04), and between SCD I/II and SCD III (P=0.03). The presence of enhancing internal septations was significantly different between SCD I/II and SCD III carcinomas (P=0.05). Central enhancement was only observed in SCD I carcinoma (4%; 3/71). CONCLUSION: The histological predominance of the scirrhous component in invasive ductal carcinoma may be one explanation for the differences in morphologic and kinetic patterns on MR imaging. 相似文献
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Kengo Maeda Shinji Kume Yoshihiko Nishio Shiro Maeda Yasuhiro Nishida Mikio Suzuki Takahiro Nakaguchi Toru Kawabata Osamu Hashimoto Takashi Hisanaga Atsunori Kashiwagi Hitoshi Yasuda 《Clinical neurology》2006,46(4):266-269
We report a 53-year-old woman with severe Graves' ophthalmopathy accompanied by uncontrolled myasthenia gravis. She presented remarkable exophthalmos, chemosis, and restriction of eye movement. Despite plasma exchange, steroid pulse therapy, local injection of steroid, and irradiation, ocular symptoms did not ameliorate. Since optic neuropathy was seen, orbital decompression surgery was performed in the left eye. Bilateral chemosis was improved after the surgery. Five years after surgery, there was no ocular palsy in the operated left eye, but in the contralateral eye. For the good prognosis of the eye movement, orbital decompression might be recommended in the severe Graves' ophthalmopathy accompanied by the optic neuropathy and/or ophthalmoplegia with proptosis. 相似文献
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Endoscopic anterior cruciate ligament reconstruction using a computer-assisted fluoroscopic navigation system 总被引:3,自引:0,他引:3
Hisatada Hiraoka Sou Kuribayashi Akira Fukuda Naoshi Fukui Kozo Nakamura 《Journal of orthopaedic science》2006,11(2):159-166
Background During anterior cruciate ligament (ACL) reconstruction, placement of the reconstructed ligament affects the clinical results.
To accomplish accurate and reproducible placement of the tibial bone tunnel, we employed a fluoroscopic navigation system
for endoscopic ACL reconstruction. In this study, preciseness of the tibial tunnel placement was evaluated, and the advantages
and disadvantages of this navigation system for endoscopic ACL reconstruction are discussed.
Methods Altogether, 16 knees of 16 patients who had undergone ACL reconstruction using this system (navi group) were evaluated regarding
the positioning of the tibial tunnel against Blumensaat's line using X-p and the route of the graft by magnetic resonance
imaging (MRI). Another 16 knees of 16 patients who underwent endoscopic ACL reconstruction without the navigation system were
the controls (control group).
Results At the 1-year follow-up, maximally extended lateral knee X-p revealed that the anterior edge of the tibial tunnel and Blumensaat's
line were almost aligned and that roof impingement was avoided; the T2-weighted MR images showed that the graft was placed
close to and parallel to the intercondylar roof in all the knees of the navi group. The ratio of the distance between Blumensaat's
line and the anterior edge of the tibial tunnel at the level of the tibial plateau to the anteroposterior width in fully extended
true lateral radiographs was 2.7% ± 3.4% in the navi group and 8.4% ± 7.4% in the control group.
Conclusions The computer-assisted fluoroscopic navigation system improves accuracy and decreases dispersion of the tibial tunnel placement
against Blumensaat's line in single-bundle ACL reconstruction. This innovative device renders the reconstruction procedure
more reliable, eliminating the problem of skeletal variation among patients. However, the function of this navigation system
for femoral tunnel placement is insufficient at present. Further refinement of the system is necessary, and the method of
application requires improvement. 相似文献
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Yasuyuki Suzuki Kazuyuki Daitoku Masahito Minakawa Kozo Fukui Ikuo Fukuda 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2006,54(1):44-46
We report the case of a 4-year-old girl who had quadricuspid aortic valve regurgitation with tetralogy of Fallot and pulmonary
atresia. This combination is very uncommon. Aortic valve replacement was performed successfully due to aortic regurgitation
which had progressed one year after the total repair. The dilated aortic annulus plus quadricuspid aortic valve may result
in progressive aortic regurgitation for a short period. 相似文献
9.
Haruhito Adam Uchida Yoshio Nakamura Masanobu Kaihara Hisanao Norii Yoshihisa Hanayama Hitoshi Sugiyama Yohei Maeshima Yasushi Yamasaki Hirofumi Makino 《Nephrology, dialysis, transplantation》2006,21(12):3475-3480
BACKGROUND: Decreased plasma adiponectin is associated with impaired endothelial function and, thereby, increased risk for cardiovascular events. Glucocorticoid (GC) affects vascular endothelial cells either favourably or harmfully depending upon the dosages and duration. We examined the effect of GC pulse therapy on vascular endothelial function. METHODS: Fourteen young patients with IgA nephropathy were evaluated for flow-mediated vasodilation (FMD), plasma levels of adiponectin both in high molecular weight (HMW adiponectin) form and in single molecular form (total adiponectin), hepatocyte growth factor (HGF), asymmetric dimethylarginine (ADMA), and high-sensitive C-reactive protein, before and after a course of GC pulse therapy. RESULTS: GC pulse therapy significantly decreased FMD (from 7.2 +/- 2.6 to 5.7 +/- 2.5%, P < 0.01). Meanwhile, plasma adiponectin levels were significantly augmented (total adiponectin: from 10.2 +/- 4.0 to 12.1 +/- 6.3 microg/ml, P < 0.05; HMW: from 6.5 +/- 3.2 to 7.7 +/- 3.3 microg/ml, P < 0.05). In parallel, elevated concentrations of serum HGF (from 0.28 +/- 0.12 to 0.63 +/- 0.38 ng/ml, P < 0.01) and plasma ADMA (from 0.45 +/- 0.07 to 0.53 +/- 0.04 nmol/ml, P < 0.05) were observed. CONCLUSIONS: GC pulse therapy impaired endothelial function while increasing plasma adiponectin levels, which may in turn restore the endothelial function in patients with IgA nephropathy. 相似文献
10.
Hitoshi Tajiri M.D Kosuke Kozaiwa M.D Tokuzo Harada M.D Yoshikazu Ozaki M.D Kazunori Miki M.D Kazuo Shimizu M.D Shintaro Okada M.D. 《Pediatrics international》1991,33(3):323-326
We assessed the efficacy of a government-sponsored mass protection program in Osaka, Japan, for perinatal HBV infection in infants born to HBeAg positive HBV carrier mothers. We also evaluated the impact of optional follow-up procedures in such infants, including an evaluation of anti-HBs response and a booster dose of HBV vaccine for poor responders. The results demonstrated that this mass protection program protected 94.4% of the infants from perinatal HBV infection in the Osaka area. However, the proportion of infants with an unprotective level of anti-HBs was higher in the standard group than in the follow-up group both at 1.0 and 1.5 years of age, which was also the case for HBV events. Furthermore, the present study showed that a booster dose of vaccine in poor responders was very effective in promoting an anti-HBs response. In conclusion, we recommend that a follow-up blood test to confirm a response of anti-HBs to HBV vaccine should be performed at 4–8 weeks after the third injection of HBV vaccine in infants born to HBeAg positive HBV carrier mothers. We also recommend that a booster injection of HBV vaccine should be immediately given to poor responding infants who otherwise are at a considerable risk of developing HBV infection in late infancy. 相似文献