Hiroshima journal of medical sciences最新文献_第5页

Clinical Significance of Pharmacological Prophylaxis based on the Original Risk Classification of Venous Thromboembolism after Lower Abdominal Surgery. 基于下腹部手术后静脉血栓栓塞原始危险分级的药物预防的临床意义。

Hiroshima journal of medical sciences Pub Date : 2016-12-01

Manabu Shimomura, Masatoshi Kochi, Takao Hinoi, Hiroyuki Egi, Tomohiro Adachi, Tsuyoshi Kobayashi, Hirotaka Tashiro, Hideki Ohdan

{"title":"Clinical Significance of Pharmacological Prophylaxis based on the Original Risk Classification of Venous Thromboembolism after Lower Abdominal Surgery.","authors":"Manabu Shimomura, Masatoshi Kochi, Takao Hinoi, Hiroyuki Egi, Tomohiro Adachi, Tsuyoshi Kobayashi, Hirotaka Tashiro, Hideki Ohdan","doi":"","DOIUrl":"","url":null,"abstract":"Pharmacological prophylaxis was not routinely administrated following gastroenterological surgery because of concerns about bleeding complications. We tried to establish the original risk classification to determine the indication for pharmacological prophylaxis for selected patients at high risk of venous thromboembolism (VTE). One hundred and fifty-six consecutive patients who underwent lower abdominal elective surgery were divided into three groups (highest, high, and low risk groups) based on the original risk classification. Pharmacological prophylaxis was indicated for patients in the highest and high risk groups. We investigated safety and efficacy of the pharmacological prophylaxis based on this classification. Sixteen patients were classified in the highest, 50 in the high, and 90 in the low risk groups. Pharmacological prophylaxis was used for 59 cases (37.8%). There was no symptomatic pulmonary embolism or major bleeding complications. There were no significant differences in the occurrence of postoperative complications, analgesia use, and median postoperative pain scores for the three groups. In the highest and high risk groups administrated pharmacological prophylaxis, fibrin degradation products (FDP) and D-dimer did not change between postoperative day 1 and day 7. These data suggested the clinical significance of the pharmacological prophylaxis based on the original risk classification.","PeriodicalId":12860,"journal":{"name":"Hiroshima journal of medical sciences","volume":"65 3-4","pages":"53-59"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36299482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

High Excess Risk of Heart Disease Mortality among Hiroshima Atomic Bomb Male Survivors Exposed Near the Hypocenter. 广岛原子弹爆炸后暴露在震源中心附近的男性幸存者心脏病死亡率高。

Hiroshima journal of medical sciences Pub Date : 2016-09-01

Noriyuki Hara, Kenichi Satoh, Keiko Otani, Hideshi Kawakami, Megu Ohtaki

{"title":"High Excess Risk of Heart Disease Mortality among Hiroshima Atomic Bomb Male Survivors Exposed Near the Hypocenter.","authors":"Noriyuki Hara, Kenichi Satoh, Keiko Otani, Hideshi Kawakami, Megu Ohtaki","doi":"","DOIUrl":"","url":null,"abstract":"Heart disease (HD) mortality is the second leading cause of death in Japan. The HD mortality risk among Atomic bomb survivors is slightly positive but shows a statistically significant dose-response relationship with initial radiation dose, as reported by the Radiation Effects Research Foundation. In that report, dosimetry was based on initial radiation only, with the effect of indirect radiation dose not taken into consideration. The atomic bomb radiation, however, consisted of both initial and residual radiation. We reevaluated the dose-response relationship for HD mortality using exposure distance (ground distance between the location where exposed and the hypocenter) as a surrogate indicator of radiation dose. At Hiroshima University, a cohort study has been conducted with Hiroshima Atomic Bomb Survivors (ABS) since 1970. We selected 29605 subjects from the ABS who were exposed at 3.5 km or less from the hypocenter and alive on January 1, 1970. These subjects, referred to as \"Hiroshima hibakusha\" in this paper, were followed until December 31, 2010. We stratified the cohort data with respect to sex and age at the time of bombing (ATB) into 10-year age groups. For each stratum, by applying an extended Cox regression model with time-dependent covariates, we analyzed the risk of HD mortality using either initial radiation dose or exposure distance as an explanatory variable. The results indicate a high excess risk in males and older age ATB females who were exposed near the hypocenter. This difference may be explained by the effect of female sex hormone on the circulatory system among young age ATB females. Some unknown risk factor related to exposure distance was also implicated in the elevated risk of HD among the Hiroshima hibakusha, especially in males. This necessitates further study.","PeriodicalId":12860,"journal":{"name":"Hiroshima journal of medical sciences","volume":"65 2","pages":"45-51"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36299096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Assessment of Outcome of Hepatic Arterial Infusion Chemotherapy in Patients with Advanced Hepatocellular Carcinoma by the Combination of RECIST and Tumor Markers. RECIST联合肿瘤标志物评价晚期肝癌肝动脉输注化疗疗效。

Hiroshima journal of medical sciences Pub Date : 2016-09-01

Masahiro Hatooka, Tomokazu Kawaoka, Hiroshi Aikata, Fumi Honda, Yuki Nakamura, Norihito Nakano, Kei Morio, Takayuki Fukuhara, Tomoki Kobayashi, Yuko Nagaoki, Masataka Tsuge, Akira Hiramatsu, Michio Imamura, Yoshiiku Kawakami, Kazuo Awai, Kazuaki Chayama

{"title":"Assessment of Outcome of Hepatic Arterial Infusion Chemotherapy in Patients with Advanced Hepatocellular Carcinoma by the Combination of RECIST and Tumor Markers.","authors":"Masahiro Hatooka, Tomokazu Kawaoka, Hiroshi Aikata, Fumi Honda, Yuki Nakamura, Norihito Nakano, Kei Morio, Takayuki Fukuhara, Tomoki Kobayashi, Yuko Nagaoki, Masataka Tsuge, Akira Hiramatsu, Michio Imamura, Yoshiiku Kawakami, Kazuo Awai, Kazuaki Chayama","doi":"","DOIUrl":"","url":null,"abstract":"To assess the outcome of stable disease (SD) patients with advanced hepatocellular carcinoma (HCC) by tumor markers after the first course of hepatic arterial infusion chemotherapy (HAIC). The study subjects were 156 HCC patients treated with HAIC and classified as Child Pugh A, with no extrahepatic metastasis, and no history of sorafenib treatment. In the study and validation cohorts, the AFP and DCP ratios of patients who were considered SD to the first course of HAIC were analyzed by AUROC for a prediction of response to the second course of HAIC. The imaging response to the first course of HAIC was classified as partial response (PR), SD and progressive disease (PD) in 29 (18.8%), 80 (51.9%), and 44 (28.6%) patients respectively. For SD patients, the a-fetoprotein (AFP) and des-y-carboxy prothrombin (DCP) ratios of patients who were considered SD to the first course of HAIC were analyzed by the receiver operating characteristic curve for prediction of response to the second course of HAIC in the study cohorts. The area under the curve of AFP ratio was 0.743. The area under the curve of DCP ratio was 0.695. The cut-off values of AFP and DCP ratios were 1.3 and 1.0, respectively. In the validation cohort, the accuracy of the prediction of response in this validation cohort (71.4%) showed no significant difference compared to that in the study cohort (72.4%) (p = 1.0). The results suggested that patients with a high tumor marker ratio could be switched to alternative therapeutic regimens despite the SD response to HAIC.","PeriodicalId":12860,"journal":{"name":"Hiroshima journal of medical sciences","volume":"65 2","pages":"25-33"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36299093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

High Initial-dose Dependency of Cerebrovascular Disease Mortality among Female Survivors of the Hiroshima Atomic Bomb Exposed in Teens: A Cohort Study, 1970-2010. 广岛原子弹爆炸后青少年女性幸存者脑血管疾病死亡率的高初始剂量依赖性:1970-2010年队列研究

Hiroshima journal of medical sciences Pub Date : 2016-09-01

Junji Matsuba, Keiko Otani, Kenichi Satoh, Hideshi Kawakami, Megu Ohtaki

{"title":"High Initial-dose Dependency of Cerebrovascular Disease Mortality among Female Survivors of the Hiroshima Atomic Bomb Exposed in Teens: A Cohort Study, 1970-2010.","authors":"Junji Matsuba, Keiko Otani, Kenichi Satoh, Hideshi Kawakami, Megu Ohtaki","doi":"","DOIUrl":"","url":null,"abstract":"Several studies have been conducted on cerebrovascular disease mortality in Atomic bomb survivors. Previous studies have investigated the relationship between mortality and initial radiation dose after adjusting for the effects of sex and age at the time of the bombing (ATB), and detected a weak (but statistically significant) dose-response relationship was detected. The objective of the present study was to examine whether the sex- and age ATB-specific cerebrovascular disease mortality among Hiroshima atomic bomb survivors can be explained by the initial radiation dose. At Hiroshima University, a cohort study has been conducted with Hiroshima Atomic Bomb Survivors (ABS) since 1970. We selected 30,378 subjects from the ABS who were exposed at 3.5 km or less from the hypocenter and still alive on January 1, 1970. These subjects were followed up until December 31, 2010. The cohort data were stratified with respect to sex and age ATB into 10-year age groups. For each stratum, using Cox regression, we performed survival analyses of the risk of cerebrovascular mortality using the initial radiation dose and the exposure distance (the ground distance between the exposure location and the hypocenter) as explanatory variables. The results indicated that the risks to females exposed at 10 to 19 years old were highly dependent on the initial radiation dose (hazard ratio: 1.51, p < 0.001), while the risks to males were not. There might exist some radiation exposure effects limited to women who were in their teens at the time of exposure. However, the background mechanisms remain unclear, necessitating further study.","PeriodicalId":12860,"journal":{"name":"Hiroshima journal of medical sciences","volume":"65 2","pages":"35-43"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36299091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Surgical Resection of Thoracic Esophageal Cancer with Interstitial Lung Disease: A Case Report. 胸段食管癌合并间质性肺疾病手术切除1例。

Hiroshima journal of medical sciences Pub Date : 2016-03-01

Yuta Ibuki, Yoichi Hamai, Jun Hihara, Junya Taomoto, Takaoki Furukawa, Ichiko Yamakita, Morihito Okada

{"title":"Surgical Resection of Thoracic Esophageal Cancer with Interstitial Lung Disease: A Case Report.","authors":"Yuta Ibuki, Yoichi Hamai, Jun Hihara, Junya Taomoto, Takaoki Furukawa, Ichiko Yamakita, Morihito Okada","doi":"","DOIUrl":"","url":null,"abstract":"Patients with esophageal cancer often have various comorbidities, and these sometimes limit treatment choices. We describe a patient with stage IA esophageal cancer accompanied by interstitial lung disease (ILD). Endoscopic resection and radiotherapy were not appropriate because of clinically diagnosed submucosal invasion and the patient was at high risk of ILD exacerbation. We therefore selected transhiatal esophagectomy without a thoracotomy considering the risk of postoperative respiratory complications, and administered methylprednisolone and sivelestat in the perioperative period for the reduction of surgical stress. To our knowledge, this is the first report of surgical treatment for esophageal cancer with ILD. The patient was discharged without postoperative complications. Transhiatal esophagectomy is an appropriate choice for patients with early-stage esophageal cancer without lymph node metastasis who are at high risk for postoperative respiratory complications. The appropriate selection of treatment is important for patients with esophageal cancer considering the risk of complications.","PeriodicalId":12860,"journal":{"name":"Hiroshima journal of medical sciences","volume":"65 1","pages":"19-23"},"PeriodicalIF":0.0,"publicationDate":"2016-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34614543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Case of Cutaneous Meningioma in the Rudimentary Meningocele. 原发性脑膜膨出的皮肤脑膜瘤1例。

Hiroshima journal of medical sciences Pub Date : 2016-03-01

Junichiro Ochiai, Satoshi Yamaguchi, Masaaki Takeda, Rupendra Bahadur Adhikari, Manish Kolakshyapati, Vega Karlowee, Kazuhiko Sugiyama, Kaoru Kurisu

引用次数: 0

The Selective Arterial Calcium Injection Test is a Valid Diagnostic Method for Invisible Gastrinoma with Duodenal Ulcer Stenosis: A Case Report. 选择性动脉钙注射试验是诊断隐性胃原质瘤合并十二指肠溃疡狭窄的有效方法。

Hiroshima journal of medical sciences Pub Date : 2016-03-01

Kenjiro Okada, Takeshi Sudo, Katsunari Miyamoto, Yujiro Yokoyama, Yoshihiro Sakashita, Yasushi Hashimoto, Hironori Kobayashi, Hiroyuki Otsuka, Takuya Sakoda, Fumio Shimamoto

{"title":"The Selective Arterial Calcium Injection Test is a Valid Diagnostic Method for Invisible Gastrinoma with Duodenal Ulcer Stenosis: A Case Report.","authors":"Kenjiro Okada, Takeshi Sudo, Katsunari Miyamoto, Yujiro Yokoyama, Yoshihiro Sakashita, Yasushi Hashimoto, Hironori Kobayashi, Hiroyuki Otsuka, Takuya Sakoda, Fumio Shimamoto","doi":"","DOIUrl":"","url":null,"abstract":"The localization and diagnosis of microgastrinomas in a patient with multiple endocrine neoplasia type 1 is difficult preoperatively. The selective arterial calcium injection (SACI) test is a valid diagnostic method for the preoperative diagnosis of these invisible microgastrinomas. We report a rare case of multiple invisible duodenal microgastrinomas with severe duodenal stenosis diagnosed preoperatively by using the SACI test. A 50-year-old man was admitted to our hospital with recurrent duodenal ulcers. His serum gastrin level was elevated to 730 pg/ml. It was impossible for gastrointestinal endoscopy to pass through to visualize the inferior part of the duodenum, because recurrent duodenal ulcers had resulted in severe duodenal stenosis. The duodenal stenosis also prevented additional endoscopic examinations such as endoscopic ultrasonography. Computed tomography did not show any tumors in the duodenum and pancreas. The SACI test provided the evidence for a gastrinoma in the vascular territory of the inferior pancreatic-duodenal artery. We diagnosed a gastrinoma in the peri- ampullary lesion, so we performed Subtotal Stomach-Preserving Pancreatico- duodenectomy with regional lymphadenectomy. Histopathological findings showed multiple duodenal gastrinomas with lymph node metastasis and nonfunctioning pancreatic neuroendocrine tumors. Twenty months after surgery, the patient is alive with no evidence of recurrence and a normal gastrin level. In conclusion, the SACI test can enhance the accuracy of preoperative localization and diagnosis of invisible microgastrinomas, especially in the setting of severe duodenal stenosis.","PeriodicalId":12860,"journal":{"name":"Hiroshima journal of medical sciences","volume":"65 1","pages":"13-7"},"PeriodicalIF":0.0,"publicationDate":"2016-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34614542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Sarin-like Organophosphorus Agent bis (isopropyl methyl)phosphonate Induces Apoptotic Cell Death and COX-2 Expression in SK-N-SH Cells. 沙林样有机磷剂甲基膦酸异丙酯诱导SK-N-SH细胞凋亡和COX-2表达

Hiroshima journal of medical sciences Pub Date : 2016-03-01

Yosuke Arima, Kanji Yoshimoto, Akira Namera, Ryosuke Makita, Kazuhiro Murata, Masataka Nagao

引用次数: 0

Additional Value of Diffusion-weighted MRI to Gd-EOB-DTPA-enhanced Hepatic MRI for the Detection of Liver Metastasis: the Difference Depending on the Experience of the Radiologists. 弥散加权MRI对gd - eob - dtpa增强肝脏MRI检测肝转移的附加价值:基于放射科医师经验的差异。

Hiroshima journal of medical sciences Pub Date : 2015-06-01

Wataru Fukumoto, Yuko Nakamura, Toru Higaki, Fuminari Tatsugami, Makoto Iida, Kazuo Awai

{"title":"Additional Value of Diffusion-weighted MRI to Gd-EOB-DTPA-enhanced Hepatic MRI for the Detection of Liver Metastasis: the Difference Depending on the Experience of the Radiologists.","authors":"Wataru Fukumoto, Yuko Nakamura, Toru Higaki, Fuminari Tatsugami, Makoto Iida, Kazuo Awai","doi":"","DOIUrl":"","url":null,"abstract":"This retrospective study was to investigate whether adding diffusion-weighted imaging (DWI) to Gd-EOB-DTPA-enhanced MRI (EOB-MRI) improved the detection of liver metastasis in radiology resident and board-certified radiologist groups. It was approved by our institutional review board. We selected 18 patients with 35 liver metastases and 12 patients without liver tumors. Five board-certified radiologists and 5 radiology residents participated in the observer performance study. Each observer first interpreted T1- and T2-weighted-, plain-, arterial phase-, and hepatobiliary phase images and specified the location of the liver metastases. The software subsequently displayed the DWI images simultaneously and all participants repeated the reading. We used Jackknife alternative free-response receiver operating characteristic (JAFROC) analysis to compare the observer performance in detecting liver metastases. The mean values for the area under the curve (AUC) for EOB-MRI without and with DWI were 0.78 ± 0.13 [standard deviation: SD] and 0.87 ± 0.09, respectively, for the radiology residents, and the difference was statistically significant (p = 0.045). For the board- certified radiologists these values were 0.92 ± 0.02 and 0.96 ± 0.01, respectively, and the difference was not statistically significant (p = 0.092). EOB-MRI with DWI significantly improved the performance of radiology residents in the identification of liver metastases.","PeriodicalId":12860,"journal":{"name":"Hiroshima journal of medical sciences","volume":"64 1-2","pages":"15-21"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33869086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Logical Method of Selecting an Approach for Amplatzer Septal Occluder Implantation: Using Transesophageal Echocardiography to Reduce Procedure Durations and Avoid Complications. 一种选择Amplatzer鼻中隔封堵器植入术入路的逻辑方法:经食管超声心动图减少手术时间和避免并发症。

Hiroshima journal of medical sciences Pub Date : 2015-06-01

Naomi Nakagawa, Masao Yoshizumi, Masahiro Kamada, Yukiko Ishiguchi

{"title":"A Logical Method of Selecting an Approach for Amplatzer Septal Occluder Implantation: Using Transesophageal Echocardiography to Reduce Procedure Durations and Avoid Complications.","authors":"Naomi Nakagawa, Masao Yoshizumi, Masahiro Kamada, Yukiko Ishiguchi","doi":"","DOIUrl":"","url":null,"abstract":"Percutaneous closure of atrial septal defects using an Amplatzer Septal Occluder (ASO) has recently become the procedure of first choice. However, when ASO deployment is difficult, procedures may be prolonged and complications may occur. We investigated a method for identifying cases in which ASO deployment would be difficult. After retrospectively identifying 70 patients (age: 4.1-70.4 years; body weight: 15.6-77.3 kg) who underwent atrial septal defect closure using an ASO in 2007 or later, we classified them into three groups: Group A, implantation by a conventional approach; Group B, implantation by a right upper pulmonary vein approach, and Group C,. change from a conventional to a right upper pulmonary vein approach. Characteristics of the groups were compared. Individually, none of the investigated characteristics was suitable for identifying difficult cases. Furthermore, we observed no consistent trends between aortic rim deficiency and ASO diameter, or between SG/IAS angle, which is the angle formed by the super stiff guidewire (SG) and the intra-atrial septum (IAS). However, the ASO diameter divided by the diameter of the left atrium (ASO/LA) correlated with the SG/IAS angle in Group C. Using this correlation, ASO implantation is predicted to be difficult in patients with an ASO/LA (%) ratio exceeding the (SG/IAS angle) x 1.44 + 48.1, which represents the 95th percentile of Group C. Graphing the SG/IAS angle and the ASO/LA ratio can identify cases in which ASO implantation may be difficult. We consider this method of selecting an approach to be extremely useful for avoiding various risks.","PeriodicalId":12860,"journal":{"name":"Hiroshima journal of medical sciences","volume":"64 1-2","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34039433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0