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Changes in C-Reactive Protein, Albumin, and Hemoglobin in Breast Cancer Patients at the End-of-Life
No full textJournal Article目 的：乳癌患者の死亡前12カ月間におけるCRP，Alb，Hbの経時的な変化を後方視的に検討した．
方 法：2005年12月から2014年4月に乳癌治療を行った1,411例の内，乳癌で死亡した女性22例を対象とした．各検査日毎に，死亡前1カ月以内，死亡2─3カ月前，4─6カ月前，7─9カ月前，10─12カ月前に分類し，各期間の平均検査値を比較した．
結 果：死亡10─12カ月前を基準に，CRPは死亡前1カ月以内の間に有意な増加（p<.0001）を認め，Albは死亡2─3カ月前，死亡前1カ月以内の間にそれぞれ統計学的に有意な減少（p<.0001，p<.0001）を認めた．Hbは死亡前1カ月以内（p＝0.001）の間に統計学的に有意な減少を認めた．
結 語：終末期の乳癌患者は，死亡前3カ月以降にCRP，Alb，Hbが明らかな変化を示した．journal articl
The Influence of Attenuation and Scatter Corrections on Quantitative Analysis of 123I-FP-CIT SPECT Brain Imaging
No full textJournal ArticleObjective: [123I] N-ω-fluoropropyl-2β-carbomethoxy-3β-(4-[123I]iodophenyl) nortropane (123I-FP-CIT) or dopamine transporter (DAT) SPECT scan quantitatively depicts striatum dopamine transporter density. The specific binding ratio (SBR) is important for Parkinson's disease (PD) diagnosis. Correction techniques may improve 123I-FP-CIT image quality, but they are currently not standardized. We aim to determine attenuation correction (AC) and scatter correction (SC) influence on 123I-FP-CIT quantitative analysis.
Methods: We preformed SPECT imaging on a striatal phantom representing striatum-to-background ratios ranging from 10:1 to 1:1. We used the Chang method for AC and triple energy window for SC. Commercially available software semi-automatically calculated SBR. We performed correlation analysis between SBR and the actual concentration ratio in four groups: no correction (NC), SC, AC, and combined correction (CC), paying particular attention to SBR values below the clinical cut-off (4.5). We applied the same imaging conditions, reconstruction, and corrections on 49 human 123I-FP-CIT SPECT studies. Asymmetric index values (AI) were also analyzed. Receiver operating characteristic (ROC) analysis provided AI diagnostic cut-off values in PD patients. PD patient population whose AI values were above these cut-off value were subject to a correlation study to confirm the association between their clinical symptoms and 123I-FP-CIT SPECT.
Results: Phantom study. AC or CC increased SBR 123I-FP-CIT SPECT, making them very close to the standard ratios (AC: y=1.19x - 0.7; R2=0.98; CC: y=1.4x - 1.2; R2=0.98), while NC and SC underestimated SBR at lower values (1 to 4). Clinical study. There was no difference in SBR between NC and SC, while AC and CC produced significantly higher SBR than NC (p<0.0001). Only SC affected AI values (p<0.05). The association between clinical symptoms and 123I-FP-CIT imaging results were maintained only when either NC (n=12, p<0.05) or CC (n=14, p<0.05) was applied.
Conclusions: AC increased SBR more than other corrections, while SC increased AI value more than other corrections. The association between clinical symptom and SPECT findings were maintained when either NC or CC was applied. These correction methods should be carefully selected for 123I-FP-CIT SPECT brain imaging.journal articl
Otitis Media with Effusion Treated by Subannular Tube
No full textJournal Article難治の滲出性中耳炎に対し，鼓膜への換気チューブ留置（鼓膜チューブ）が行われるが，短期間でのチューブ脱落や，鼓膜穿孔の合併症が問題になる．近年，外耳道皮膚を経由してチューブを挿入する，subannular tube（SAT，外耳道チューブ）留置が報告された．鼓膜チューブより長期間の留置が可能で，鼓膜を介さないため穿孔の心配がない．外耳道チューブで良好な結果が得られた，難治の滲出性中耳炎の治療経験を報告し，外耳道チューブの適応と，鼓膜チューブとの比較について考察する．journal articl
Factors Influencing Bone Healing after Extirpation with Endodontic Microsurgery-Microscopic Apicoectomy for Extensive Radicular Cysts
No full textJournal ArticleBackground & Aims: The purpose of this study is to identify the clinical and immunohistological factors that inhibit bone healing after extirpation of extensive radicular cysts and endodontic microsurgery-microscopic apicoectomy, and utilize these factors as predictors of treatment outcome. Methods: Endodontic microsurgery-microscopic apicoectomy was performed in 26 patients. Outcomes were evaluated based on clinical signs and radiographs. Expression levels of cytokines (IL-1β, TNF-α, RANKL) in the cyst epithelium and subepithelial connective tissue were also investigated. Results: The success rate was 88.5%. The radiological reduction rate was ≥75% in 16 patients (good bone healing) and <75% in 10 (poor bone healing). In clinical analysis, penetrating bone defects and the site (maxilla) showed significant differences between the two groups (P<0.05). In immunohistochemical analysis, expression of IL-1β and TNF-α showed significant differences between the two groups (P<0.05). Conclusions: Penetrating bone defects, inflammation, and a maxillary site are prognostic factors for a poor outcome after treatment of extensive radicular cysts. Endodontic microsurgery-microscopic apicoectomy is a new technique for treatment of an extensive radicular cyst, and this study is the first to identify factors that influence the outcome after extirpation of the cyst.journal articl
Laparoscopic Resection of Gastric Duplication Cyst: A Case Report
No full textJournal Article症例は41歳，男性．呼吸器疾患の経過観察のCT検査で胃病変を偶然発見された．CT/MRI検査で胃噴門部小弯側に径40 mmの境界明瞭で内部造影効果のない嚢胞性腫瘤を指摘された．腫瘤は超音波内視鏡検査で胃壁筋層より連続したhypoechoic massとして認められ，術前診断として胃重複症を第一に考え，腹腔鏡下に手術治療を行った．病理組織学的検査所見では腫瘍内腔が多列円柱上皮で覆われた嚢胞性病変で胃固有筋層に連続した病変であり胃重複症と診断した．悪性所見は認められなかった．術後経過は良好で術後第9病日に退院した．胃重複症は稀な疾患で，さまざまな鑑別診断により術前診断が困難であることが多く，確定診断には特徴的な病理組織学的所見を要する．今回，腹腔鏡下に手術治療を行った胃重複症の1例を経験したので報告する．journal articl
Fibronectin on extracellular vesicles from microvascular endothelial cells is involved in the vesicle uptake into oligodendrocyte precursor cells.
No full text群馬大学博士（医学）Thesis or Dissertation学位記番号：医博甲1752doctoral thesi