4569 research outputs found
Sort by
Should the upper end vertebra be selected as the upper instrumented vertebra in patients with Lenke type 5C adolescent idiopathic scoliosis?
Get PDFStudy Design
Retrospective study
Purpose
The upper end vertebra (UEV) is often selected as the upper instrumented vertebra (UIV) in patients with adolescent idiopathic scoliosis (AIS) with Lenke type 5C curves; however, the effect of adjusting UIV selection one level toward the cranial side (UEV+1) is unknown. Therefore, this study aimed to assess the effect of UIV extension on scoliosis correction and global alignment in patients with the UIV as the UEV and UEV+1.
Methods
Data of 52 patients with AIS with Lenke type 5C curves who underwent selective thoracolumbar/lumbar (TL/L) fusion with a minimum follow-up period of 2 years were retrospectively analyzed. The patients were divided according to the UIV in relation to the UEV: the UEV and UEV+1 groups. Radiographic parameters and clinical outcomes were compared between the two groups.
Results
Among the 52 patients, 24 and 28 were included in the UEV and UEV+1 group. Baseline data showed no intergroup differences except for the UIV level. While the UEV+1 group showed a significantly greater TL/L curve correction (72.9% vs. 62.8%, p<0.05) and a lower UIV tilt, it showed a significantly greater absolute value of radiographic shoulder height (RSH) (-7.9 vs. -0.9mm, p<0.05) and coronal balance (-11.0mm vs -4.8mm, p<0.05) at 2 years postoperatively. The rate of post-operative shoulder imbalance (RSH≥2cm) was significantly higher in the UEV+1 than in the UEV group. 23 No intergroup differences were observed in the sagittal alignment and patient outcomes between the two groups.
Conclusion
When the UIV was selected as the UEV+1, correction of the TL/L curve improved; however, it increased the risk of shoulder and coronal imbalance. There is no clinical benefit observed in terms of extending the UIV to the UEV+1; therefore, the UIV should be selected as the UEV to maintain harmonious global alignment.journal articl
Long-term prognosis of familial adenomatous polyposis with or without mucosectomy
Get PDFPurpose: This study primarily aimed to compare the long-term prognosis of patients who underwent total colectomy/proctocolectomy with or without mucosectomy to the dentate line for the diagnosis of familial adenomatous polyposis (FAP).
Methods: Patients who underwent total colectomy/proctocolectomy for FAP between January 1979 and December 2020 and were followed up at Hamamatsu University Hospital were included in this study. Those who underwent total proctocolectomy with hand-sewn ileal pouch–anal anastomosis were defined as the mucosectomy group. Those who underwent total colectomy or total proctocolectomy using the stapled ileal pouch–anal anastomosis approach were defined as the no mucosectomy group.
Results: A total of 61 individuals (37 families) were diagnosed during the surveillance period (median, 191 months). Between the mucosectomy (n=24) and no mucosectomy groups (n=34), metachronous rectal cancer was significantly more common in the no mucosectomy group (21% in no mucosectomy vs. 0% in mucosectomy, P=0.02). Overall survival in the no mucosectomy group was worse than that in the mucosectomy group (84.5% in no mucosectomy vs. 100% in mucosectomy at 120 months, 81.1% vs. 90.0% at 240 months, 50.6% vs. 75.0% at 360 months, P=0.09). Cox regression analysis revealed an independent effect of not performing mucosectomy on overall survival (P=0.03).
Conclusion: Long-term surveillance revealed that colectomy or total proctocolectomy without mucosectomy had a negative impact on the overall survival of patients with FAP. Therefore, we recommend total proctocolectomy with mucosectomy, i.e., hand-sewn ileal pouch–anal anastomosis, for FAP.journal articl
Changes of mass spectra patterns on a brain tissue section revealed by deep learning with imaging mass spectrometry data
Get PDFThe characteristic patterns of mass spectra in imaging mass spectrometry (IMS) strongly reflect the tissue environment. However, the boundaries formed where different tissue environments collide have not been visually assessed. In this study, IMS and convolutional neural network (CNN), one of the deep learning methods, were applied to the extraction of characteristic mass spectra patterns from training brain regions on rodents’ brain sections. CNN produced classification models with high accuracy and low loss rate in any test datasets of mouse coronal sections measured by desorption electrospray ionization (DESI)-IMS, and mouse and rat sagittal sections by matrix-assisted laser desorption (MALDI)-IMS. Based on the extracted mass spectra pattern features, the histo-logically plausible segmentation and classification score imaging of the brain sections were obtained. The boundary imaging gener-ated from classification scores showed the extreme changes of mass spectra patterns between the tissue environments, with no sig-nificant buffer zones for the intermediate state. The CNN-based analysis of IMS data is a useful tool for visually assessing the changes of mass spectra patterns on a tissue section, and it will contribute to a comprehensive view of the tissue environment.journal articl
Extrastriatal dopamine D2/3 receptor binding, functional connectivity, and autism socio-communicational deficits: a PET and fMRI study
Get PDF浜松医科大学博士（医学）doctoral医学系研究科The social motivation hypothesis of autism proposes that social communication symptoms in autism spectrum disorder (ASD) stem from atypical social attention and reward networks, where dopamine acts as a crucial mediator. However, despite evidence indicating that individuals with ASD show atypical activation in extrastriatal regions while processing reward and social stimuli, no previous studies have measured extrastriatal dopamine D2/3 receptor (D2/3R) availability in ASD. Here, we investigated extrastriatal D2/3R availability in individuals with ASD and its association with ASD social communication symptoms using positron emission tomography (PET). Moreover, we employed a whole-brain multivariate pattern analysis of resting-state functional magnetic resonance imaging (fMRI) to identify regions where functional connectivity atypically correlates with D2/3R availability depending on ASD diagnosis. Twenty-two psychotropic-free males with ASD and 24 age- and intelligence quotient-matched typically developing males underwent [11C]FLB457 PET, fMRI, and clinical symptom assessment. Participants with ASD showed lower D2/3R availability throughout the D2/3R-rich extrastriatal regions of the dopaminergic pathways. Among these, the posterior region of the thalamus, which primarily comprises the pulvinar, displayed the largest effect size for the lower D2/3R availability, which correlated with a higher score on the Social Affect domain of the Autism Diagnostic Observation Schedule-2 in participants with ASD. Moreover, lower D2/3R availability was correlated with lower functional connectivity of the thalamus-superior temporal sulcus and cerebellum-medial occipital cortex, specifically in individuals with ASD. The current findings provide novel molecular evidence for the social motivation theory of autism and offer a novel therapeutic target.doctoral thesi
Facile Preparation of Multi-grams of trans-7,8-Dihydro-7,8-dihydroxybenzo[a]pyrene, a Precursor of Benzopyrene Diol Epoxide
Get PDF雑誌掲載タイトル：Facile Multi-gram Preparation of trans-7,8-Dihydro-7,8-dihydroxybenzo[a]pyrene, a Precursor of Benzopyrene Diol EpoxideCarcinogenic benzo[a]pyrene diol epoxide (BPDE) is one of the essential materials in tumor pathological research; however, it is expensive and unstable. In addition, its synthetic intermediates are metabolic intermediates of BPDE; thus, there is a need to reduce the handling of these compounds during the synthesis. Accordingly, a precursor of BPDE (i.e., trans-7,8-dihydro-7,8-dihydroxybenzo[a]pyrene) was prepared in a multi-gram scale by modified procedures. Efficient work-ups (e.g., simple extraction and precipitation) were also improved, which resulted in a crude product with high target compound content in each step of the synthesis.journal articl
Relationship between orthostatic hypotension and body composition in Parkinson's disease
Get PDF通巻571号journal articl
Usefulness of α-Fetoprotein Measurement for the Diagnosis of Fetomaternal Transfusion Syndrome in a Very Low Birth Weight Infant
Get PDF母児間輸血症候群は，胎児血が経胎盤的に母体循環へ移行し胎児貧血をきたす疾患である．今回，出生時Hb値が1.1 g/dLと重症貧血を認めた本疾患を経験した．症例は，在胎31週4日に胎児機能不全のため緊急帝王切開で出生した．Apgarスコアは1分値，5分値ともに2点，全身蒼白であった．出生体重1412g．母体血中のα-フェトプロテイン（AFP）の増加により母児間輸血症候群と診断し，治療介入により急性期の経過は比較的良好であった．日齢44で撮影した頭部MRIでは脳室周囲白質軟化症と小脳の微小出血痕を認めたが，神経症状は認めず日齢63で退院となった．本症例は母児間輸血症候群であっても母体血中のHbFの上昇を認めず，AFPの測定が重要であった．journal articl
Treatment strategy for uterine artery pseudoaneuysm
Get PDF子宮仮性動脈瘤（Uterine Artery Pseudoaneuysm：UAP）は帝王切開術や子宮内膜掻爬術後などに発生し、性器出血を主症状とし破裂後に診断されることが多い。UAPの治療には子宮動脈塞栓術（Uterine artery embolization：UAE）が有効であるが、自然消失する例もあり、明確な管理・治療方針はない。そこで、我々は当院におけるUAP17例を検討し管理方法・治療戦略について考察した。UAEが施行されたのは3例でいずれもUAP径は20mm以上であり、自然消失した14例のUAP径が平均11mmであったの対し、UAP径は大きい傾向を示した。UAEが施行された3例のうち1例は妊娠後期の分娩後に発生したUAPで大量出血をきたし、造影CT検査3D血管構築像でUAPに豊富な側副血行路を認めた。一方、UAE未施行例ではUAPに側副血行路は認めなかった。UAP径の大きさ、および3DCT血管構築像でUAPへの側副血行路の有無を評価することは、UAEなどの治療介入の必要性を評価することに有用な可能性がある。Uterine Artery Pseudoaneuysm (UAP) occurs after cesarean section and endometrial curettage and is often diagnosed after rupture with genital bleeding as a chief complaint. Uterine artery embolization (UAE) is effective in treating UAP, but there is no clear management and treatment strategy for UAP because it can disappear spontaneously. Therefore, we examined 17cases of UAP in our hospital and considered the management and treatment strategy of UAP. The average UAP diameter of 14cases which disappeared spontaneously was 11mm, whereas the UAP diameter of 3cases which underwent UAE was more than 20mm. One of 3case which underwent UAE occurred the massive bleeding due to rupture after delivery in the third trimester, and three-dimensional multislice computed tomographic angiography (3DCTA) showed the rich collateral circulation around UAP. No collateral circulation was found in the cases which did not undergo UAE. Evaluating the size of the UAP diameter and the presence or absence of collateral circulation to the UAP with 3DCTA may help assess the need for therapeutic interventions such as UAE.journal articl