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钢结构(中英文) 2009年第6期 85-85页

作者： naohiro nakamura Naohiko Tsunashima Tomio Nakano Eizaburo Tachibana

采用非线性有限元方法,对循环荷载下圆柱和Ⅰ型钢筋混凝土剪力墙进行试验,通过能量消耗分析评估其损伤。首先,通过对荷载-位移关系、裂缝情况的研究以及经过分析所得的总应变能与试验加载能量的比较,验证分析方法的有效性。其次,对能量... 详细信息

采用非线性有限元方法,对循环荷载下圆柱和Ⅰ型钢筋混凝土剪力墙进行试验,通过能量消耗分析评估其损伤。首先,通过对荷载-位移关系、裂缝情况的研究以及经过分析所得的总应变能与试验加载能量的比较,验证分析方法的有效性。其次,对能量消耗分布以及钢筋和混凝土的配置进行研究。研究表明:能量消耗是评估剪力墙损伤的有效方法。

关键词：钢筋混凝土剪力墙能量消耗三维有限元方法非线性分析

Patient-Reported Outcomes of Surgery of Non-Small Cell Lung Cancer: Evaluation Based on the Questionnaires of Anti-Aging Quality of Life and the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire

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Surgical Science 2017年第5期8卷 203-219页

作者： Takanori Ayabe Masaki Tomita naohiro Nose Takashi Asada Kunihide nakamura Division of Thoracic and Breast Surgery Department of SurgeryFaculty of MedicineUniversity of MiyazakiMiyazakiJapan Division of Cardiovascular Surgery Department of SurgeryFaculty of MedicineUniversity of MiyazakiMiyazakiJapan

Background: Patient-reported outcomes of the quality of life (QOL) after an open thoracotomy have not been studied. To determine the physical and mental changes in surgical patients is very important for medical staffs. The surgical patient’s satisfaction and overall healthy changes were evaluated by the patient-self assessment questionnaires. Materials and Methods: From July 2007 to April 2008, 26 patients with non-small cell lung cancer (NSCLC) underwent surgical resection. The outcome of the QOL was evaluated by using two kinds of questionnaire surveys from the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and the anti-aging QOL assessment (AA-QOL). The EORTC QLQ-C30 consisted of five domains (physical, role, cognitive, emotional, and social functionings) and global QOL. The AA-QOL contained 51 items;30 physical and 21 mental symptoms regarding the elderly and the aging population. The patients replied to the two questionnaires at two different times, i.e., at pre-surgery (baseline) and at post-surgery (2 weeks after the operation). The obtained data of these scores were averaged and compared between the two points of the pre-surgery and post-surgery. Results: Regarding the outcomes of the EORTC QLQ-C30, the physical and social functioning became significantly worse after the surgery. In contrast, the global QOL significantly became better after the surgery. For the symptom at post-surgery, three of which were “nausea and vomiting”, “pain”, and “appetite loss”, became significantly worse compared to those at pre-surgery. Regarding the outcomes of the AA-QOL, the physical symptoms (muscular pain/stiffness, palpitations, dyspnea, no feeling of good health, anorexia, and coughing and sputum) became significantly worse after the surgery. Regarding the mental symptoms, there were no significant differences. Conclusions: Regarding the outcomes based on the changes in the QOL after surgery, the physical symp

关键词： Patient-Reported Outcome Surgery Quality of Life Non-Small Cell Lung Cancer

A new diagnostic feasibility for cardiomyopathy utilizing acoustic microscopy

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World Journal of Cardiovascular Diseases 2013年第1期3卷 22-30页

作者： Yoichi nakamura Kengo Fukushima Kusano Kazufumi nakamura Kazuto Kobayashi naohiro Hozumi Yoshifumi Saijo Tohru Ohe Biomedical Imaging Laboratory Graduate School of Biomedical Engineering Tohoku University Sendai Japan Department of Cardiology Sakakibara Heart Institute of Okayama Okayama Japan Department of Cardiovascular Medicine Matsuyama Shimin Hospital Matsuyama Japan Department of Research and Development Honda Electronics Co. Ltd. Toyohashi Japan epartment of Cardiovascular Medicine Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences Okayama Japan Toyohashi University of Technology International Cooperation Center for Engineering Education Development Toyohashi Japan

Aims: Dilated cardiomyopathy often shows left ventricular systolic dysfunction, although histologically it always exhibits non-specific abnormality. We hypothesized that myocyte sound speed might be altered due to incomplete protein accumulation in cells. Methods and Results: Ninety eight biopsied samples were obtained from 49 patients comprising 43 with clinical dilated cardiomyopathy and 6 with hypertrophic cardiomyopathy. Sound speed was evaluated in deparaffinized 10 μm thick sections using an acoustic microscope (frequency range: 50 - 105 MHz). Conventional histology revealed 7 cases of persistent myocarditis derived from clinical dilated cardio- myopathy samples. Histology of the remaining dilated cardiomyopathy patients indicated non-specific abnormality. All hypertrophic cardiomyopathy cases exhibited myocardial disarray. Ten normal autopsied hearts were compared as controls. The sound speed of controls was 1627 ± 30m/sec. The sound speed in dilated cardiomyopathy samples (1700 ±51m/sec) was 1.045-fold faster compared to controls. The sound speed in hypertrophic cardiomyopathy samples (1734 ±51m/sec, 1.066-fold compared to controls) was faster than that of the myocarditis group (1672 ±30m/sec, 1.028-fold) (P = 0.0218). Furtheremore, desmin expression was evaluated as extent of emergence (grading 0 - 4). The desmin expression score in hypertrophic cardiomyopathy samples (2.7 ± 0.8) was significantly higher than in other groups (dilated 2.0 ± 1.4, myocarditis 1.6 ± 1.5 vs., controls 0, P ≤ 0.0001, 0.0001, 0.0129, respectively). Conclusion: Cardio-myopathy enhanced the sound speed, which correlated with the elasticity of myocytes, following the impaired compliance of left ventricle, despite the absence of histological changes. The elevation of sound speed of myocytes may be linked to cytoskeletal changes. Myocyte sound speed may be a new diagnostic tool for diagnosis of idiopathic cardiomyopathy independently of conventional histological diagnosis.

关键词： Cardiomyopathy Acoustic Microscopy Heart Failure Myocytes Sound Speed Diagnosis

Unexpected Intraoperative Resecting of Common Trunk of Pulmonary Vein Resulted in an Incidental Pneumonectomy from Left Upper Lobectomy

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Open Journal of Thoracic Surgery 2016年第3期6卷 18-24页

作者： Takanori Ayabe Masaki Tomita naohiro Nose Eiichi Chosa Kazuhiro Higuchi Kunihide nakamura Division of Thoracic and Breast Surgery Department of Surgery Faculty of Medicine University of Miyazaki Miyazaki Japan

There is a wide range of anatomical variations in the pulmonary vessels. Some of these variations may cause surgical morbidity during general thoracic surgery. We intended to perform a left upper lobectomy for a 73-year-old male with suspected left lung cancer (lt.U, S3, 20 × 20 mm, P0, E0, D0, PM0, N0, T1aN0M0, c-stage IA). Preoperatively, we did not recognize the existence of the common trunk of the left pulmonary vein. After the open thoracotomy, due to a severe intrathoracic adhesion, we omitted releasing the adhesion of the lower lobe. We did not exactly confirm the location of the inferior pulmonary vein (IPV). After cutting the interlobular pulmonary arterial branchies, we resected the superior pulmonary vein (SPV) using auto sutures. After division of the lung parenchyma and incomplete fissures using auto sutures, we intended to resect the upper bronchus. However, we could not find an IPV at the normal IPV site. A thin IPV was found to be returned to the peripheral site of the resected SPV. The SPV and IPV formed a common trunk at the normal site of the SPV. Although we considered reconstructing the resected common trunk, we finally made a decision of performing an incidental pneumonectomy in order to prevent any postoperative complications on the reconstruction of the IPV such as thrombus occlusion at the anastomosis site and venous return congestion. Retrospectively, we confirmed the preoperative images of the computed tomographic scanning, which showed a narrow IPV that returned to the peripheral site of the SPV. It is important to confirm both accurate locations of the SPV and IPV when performing a lobectomy.

关键词： Incidental Pneumonectomy Common Trunk Lobectomy Unexpected Lung Cancer

Severity of Chronic Obstructive Pulmonary Disease and the Prognosis of Non-Small Cell Lung Cancer Patients

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Advances in Lung Cancer 2016年第2期5卷 13-20页

作者： Masaki Tomita Takanori Ayabe Eiichi Chosa naohiro Nose Kazuyo Tsuchiya Kunihide nakamura Department of Thoracic and Breast Surgery Faculty of Medicine University of Miyazaki Miyazaki Japan Department of Cardiovascular Surgery Faculty of Medicine University of Miyazaki Miyazaki Japan

Objectives: We retrospectively analyzed whether the severity of Chronic Obstructive Pulmonary Disease (COPD) affected disease-specific survival in Non-Small-Cell Lung Cancer (NSCLC) patients after surgical resection. Methods: We enrolled 210 NSCLC patients who underwent curative surgery between 2009 and 2011. Classification of COPD severity was based on guidelines of the Global Initiative for Chronic Obstructive Lung Disease (GOLD). Results: A total of 55 patients were diagnosed with COPD. The 5-year disease-specific survival of patients with COPD was not different compared with that of patients without COPD. Among the COPD patients, 40 were classified as GOLD 1, 13 as GOLD 2, and 2 as GOLD 3. Although the number of patients with GOLD 2 - 3 was small, the 5-year disease-specific survival of patients with GOLD 2 - 3 was significantly poorer. We found the prognostic significance of GOLD 2 - 3 in univariate analysis, but failed to find this in multivariate analysis. Conclusions: There is a possibility that the severity of COPD might be useful to predict the prognosis of NSCLC patients. Further studies with large study population are needed.

关键词： Non-Small Cell Lung Cancer COPD GOLD Prognosis

Study on Walking Ability after Surgery for Proximal Femoral Fracture in Elderly Patients Aged 75 Years or Older

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Open Journal of Orthopedics 2013年第2期3卷 94-96页

作者： Tsuyoshi Nakai Atsunori Onishi Kunihiko Hashimoto Toshiyuki nakamura naohiro Yasuda Akira Miyama Department of Orthopaedic Surgery Itami City Hospital Itami Japan

Background: Fractures of the hip are the cause of hospitalization in the geriatric population. In many cases, hip fractures are a sentinel event signaling a systemic decline in the patient’s health. Methods: A retrospective review of the cases of 88 patients aged 75 years or older with proximal femoral fracture was performed. Fracture types, surgical procedures, walking ability before the injury and at discharge, and waiting time from injury to surgery were obtained. Results: No significant difference was observed in walking ability before injury among patients with femoral neck fracture treated with bipolar hip arthroplasty (BHA) or open reduction and internal fixation (ORIF) and those with trochanteric fracture. The degree of deterioration of walking ability was 0.6 in patients treated with BHA, 1.2 in those with neck fracture treated with ORIF, and 1.1 in those with trochanteric fracture. Deterioration was significantly less severe in patients who received BHA, compared with those who received ORIF. Conclusions: Among the patients aged 75 years or older with femoral neck fracture, those who received BHA had a shorter time interval to the start of walking with parallel assist bars or with walking aids, and also had a higher rate of regaining walking ability.

关键词： Walking Ability Proximal Femur Fracture Elderly Patients

Analysis of Perioperative Complications of Surgery for Proximal Femur Fracture in Elderly Patients Older than 75 Years

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Open Journal of Orthopedics 2013年第2期3卷 90-93页

作者： Tsuyoshi Nakai Kunihiko Hashimoto Atsunori Onishi Toshiyuki nakamura Akira Miyama naohiro Yasuda Department of Orthopaedic Surgery Itami City Hospital Itami Japan

Background: In elderly patients with femoral neck fracture, functional recovery is affected largely by preoperative underlying diseases and postoperative complications. The present study was designed to analyze the relationship between preoperative underlying diseases and perioperative complications of surgery for proximal femur fracture. Methods: The study involved 86 patients aged 75 years or older, who underwent surgery for proximal femur fracture. Each patient was examined for the presence of preoperative underlying diseases and preoperative biochemical test data. Moderate and severe complications, which were life-threatening and necessitated treated, were investigated during the perioperative period. A retrospective analysis was conducted on the relationship of preoperative underlying diseases and preoperative biochemical data with the moderate or severe complications that developed during the perioperative period. Results: Eighty-one patients developed a preoperative underlying disease, with hypertension being most frequent (42 cases). Complications during the perioperative period were observed in 58 patients, with anemia develops most frequently (23 cases). Moderate or severe complications during the perioperative period were observed in 16 patients, and infection was the most frequent complication (8 cases). In the statistical analysis, a significant difference in the incidence of moderate or severe perioperative complications was observed only in the users of anticoagulants/antiplatelet drugs. Discussion: Patients of preoperative use of anticoagulants/antiplatelet drugs should be closely managed medically so that perioperative medical complications can be managed.

关键词： Perioperative Complications Proximal Femur Fracture Elderly Patients