检索结果-南通市图书馆

World Journal of Gastroenterology 2007年第8期13卷 1271-1274页

作者： Soo Ryang Kim Hirotsugu Ikawa Kenji Ando Keiji Mita Shuichi Fuki Michiie Sakamoto Yoshihiro Kanbara Toshiyuki Matsuoka Masatoshi Kudo yoshitake Hayashi Department of Gastroenterology Kobe Asahi Hospital Japan Department of Pathology Keio University School of Medicine Japan Department of Surgery Hyogo Medical Center for Adults Japan Department of Radiology Osaka City University Medical School Japan Department of Gastroenterology Kinki University School of Medicine Japan Division of Molecular Medicine & Medical Genetics International Center for Medical Research and Treatment Kobe University Graduate School of Medicine Japan

We describe a rare case of the transformation of a dysplastic nodule into well-differentiated hepato- cellular carcinoma (HCC) in a 56-year-old man with alcoholrelated liver cirrhosis. Ultrasound (US) disclosed a 10 mm hypoechoic nodule and contrast enhanced US revealed a hypovascular nodule, both in segment seven. US-guided biopsy revealed a high-grade dysplastic nodule characterized by enhanced cellularity with a high N/C ratio, increased cytoplasmic eosinophilia, and slight cell atypia. One year later, the US pattern of the nodule changed from hypoechoic to hyperechoic without any change in size or hypovascularity. US-guided biopsy revealed well-differentiated HCC of the same features as shown in the first biopsy, but with additional pseudoglandular formation and moderate cell atypia. Moreover, immunohistochemical staining of cyclase- associated protein 2, a new molecular marker of well- differentiated HCC, turned positive. This is the first case of multistep hepatocarcinogenesis from a dysplastic nodule to well-differentiated HCC within one year in alcohol-related liver cirrhosis.

关键词：酒精性硬化褪变结节高度分化肝细胞癌肝癌发病步骤

Well to moderately differentiated HCC manifesting hyperattenuation on both CT during arteriography and arterial portography

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2007年第43期13卷 5775-5778页

作者： Soo Ryang Kim Susumu Imoto Hirotsugu Ikawa Kenji Ando Keiji Mita Shuichi Fuki Michiie Sakamoto Yoshihiro Kanbara Toshiyuki Matsuoka Masatoshi Kudo yoshitake Hayashi Department of Gastroenterology Kobe Asahi Hospital Kobe 653-0801 Japan Department of Pathology Keio UniversitySchool of Medicine Tokyo 160-8582 Japan Department of Surgery Hyogo Cancer Center Akashi 673-0021 Japan Department of Radiology Osaka CityUniversity Medical School Osaka 545-8586 Japan Department of Gastroenterology Kinki University School of Medicine Osaka-Sayama 589-8511 Japan Division of Molecular Medicine & MedicalGenetics International Center for Medical Research andTreatment Kobe University Graduate School of Medicine Kobe650-0017 Japan

We present a rare case of well-to moderately-differentiated hepatocellular carcinoma (HCC) in a 71-year-old woman with hepatitis C virus-related cirrhosis and unusual radiologic features. A 20-mm hypoechoic nodule disclosed by ultrasound in segment two showed hyperattenuation on both computed tomography hepatic arteriography and computed tomography during arterial portography. Contrast-enhanced ultrasound revealed hypervascularity in the early vascular phase and defect in the post-vascular phase, with the same pattern detected by the two imaging techniques. SPIO-MRI revealed a hyperintense nodule. These findings were compatible with those of moderately-differentiated HCC. An ultrasound-guided biopsy showed histological features of well-to moderately-differentiated HCC characterized by more than two-fold the cellularity of the non-tumorous area, fatty change, clear cell change and mild cell atypia with a thin to mid-trabecular pattern. Further studies may provide insights into the correlation between tumor neovascularity in multistep hepatocarcinogenesis and dual hemodynamics, including the artery and the portal vein.

关键词： CT 血液动力学动脉造影术肝脏疾病

Prospective Consensus Building-Ethical Consideration on History of Reason and List of Risks＊

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Journal of Philosophy Study 2013年第6期3卷 443-455页

作者： Kumiko yoshitake Juntendo University

In consensus building process in medicine, it is said that it is crucial for its participants to understand why each stakeholder, patient, his/her family, physician, nurse, etc., in decision-making has his/her own opinion. In order to understand this condition more deeply, I develop the notion of "reason of opinion" to characterize the process as "prospective consensus building." This prospective consensus building should satisfy the requirements of having "history of reason" and "list of risks." The former requirement, history of reason, can be characterized by making clear when one started to form the reason of an opinion, how one formed the reason, what kind of relationship is supposed to be between the present opinion and its reason, and what kind of result is expected to come out after a decision making. The latter requirement, the list of risks, should display what kind of outcomes are supposed to come out in each alternative of the decision making. Prospective consensus building makes it possible, firstly, for the stakeholders to understand the patient"s needs more deeply. For the patient, secondly, the each stakeholder would be able to become aware of his/her own sense of value and to confirm what he/she expects from the result of his/her decision-making. For all the stakeholders, thirdly, it would make it possible to decrease the amount of risks of misunderstanding and to share their expectations for their well-being. Finally, the stakeholders can reach a satisfactory consensus and find a way to the better solution.

关键词：原因风险清单历史利益相关者伦理备选方案价值观念

Safety and Feasibility of the Venous Access via Internal Jugular Vein Puncture Approach for Totally Implantable Venous Access Device Placements Compared with Subclavian Vein Puncture

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Journal of Cancer Therapy 2013年第1期4卷 161-164页

作者： Shinichiro Koketsu Shinichi Sameshima Yawara Kubota Kosuke Hirano Asami Suzuki Nana Makino yoshitake Sugamata Hidemaro Yoshiba Takanori Kakihara Miwako Nozaki Masatoshi Ooya Department of Radiology Koshigaya Hospital Dokkyo Medical University Koshigaya Japan Department of Surgery Koshigaya Hospital Dokkyo Medical University Koshigaya Japan

Background: The aim of this study was to evaluate the safety and feasibility of venous access via the internal jugular vein (IJV) for totally implantable venous access device (TIVAD) placements. In Japan, TIVADs are generally placed in position by the percutaneous subclavian vein puncture approach (SVPA). However, this approach causes infrequent intraoperative or postoperative complications. Using the internal jugular vein puncture approach (IJVPA), TIVADs could be placed more easily and safely. Materials and Methods: Fifty-six patients who received TIVADs for chemotherapy of colorectal carcinomas were enrolled in this study. The choice of approach (IJVPA or SVPA) was adopted at the discretion of each doctor in charge of the patient. The operation time, success rate and complications of the two approaches were compared and evaluated. Results: TIVAD placement was successful in all patients. Thirty patients received the device via IJV puncture, but 1 patient required conversion to SVPA. Twenty-six patients underwent SVPA for device placement, but 3 of these patients required conversion to IJVPA. Mean operation time was 34.3 min in IJVPA and 35.2 min in SVPA. The success rate was 96.6% in IJVPA and 88.5% in SVPA. No severe perioperative complications were observed. However, long-term complications were observed in five cases, 3 by IJVPA and 2 by SVPA, but no significant difference in the rate of complications was observed between these two approaches. A catheter-related thrombosis was found by CT scan in 3 patients, two of whom underwent IJVPA (6.7%) and one case underwent SVPA (3.8%). Two patients received simultaneous administration of bevacizumab. Catheter infections occurred in 1 patient who underwent IJVPA (3.3%) and 1 patient who underwent SVPA (3.8%). Conclusions: The IJVPA is a safe and feasible method for TIVAD placement.

关键词： Totally Implantable Venous Access Device (TIVAD) Internal Jugular Vein Chemotherapy Colorectal Carcinoma

The Effect of Treatment Position on Rectal and Bladder Dose-Volume Histograms for Prostate Radiotherapy Planned with 3-Dimensional Conformal Radiotherapy, Intensity-Modulated Radiotherapy and Volumetric Modulated Arc Therapy

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

International Journal of Medical Physics, Clinical Engineering and Radiation Oncology 2014年第2期3卷 88-97页

作者： Kotaro Terashima Katsumasa Nakamura Tomonari Sasaki Saiji Ohga Tadamasa yoshitake Kazushige Atsumi Makoto Shinoto Kaori Asai Keiji Matsumoto Hidenari Hirata Yoshiyuki Shioyama Akihiro Nishie Hiroshi Honda Department of Clinical Radiology Graduate School of Medical Sciences Kyushu University Fukuoka Japan Department of Radiology Kyushu University Hospital at Beppu Beppu Japan Kyushu International Heavy Ion Beam Therapy Center Tosu Saga Japan

Purpose: To compare target coverage and organ at risk (OAR) sparing in the supine and prone positions with 3-dimensional conformal radiotherapy (3DCRT), intensity-modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) in low- and high-risk prostate radiotherapy cases. Materials and Methods: Using magnetic resonance images of five healthy volunteers, six treatment plans (supine 3DCRT, prone 3DCRT, supine IMRT, prone IMRT, supine VMAT and prone VMAT) were generated. Planning target volume 1 (PTV1) was defined as the prostate gland plus the seminal vesicles with adequate margins in a high-risk setting, while PTV2 was defined as prostate only with margins in a low-risk setting. The mean dose for both PTV1 and PTV2 was set at 78 Gy. Plans generated by each of the 3 techniques were compared between the supine and prone positions using dose-volume histograms (DVHs). Results: For PTV1, prone 3DCRT provided a significantly higher D98% than did supine 3DCRT, and its homogeneity index (HI) was significantly better. IMRT and VMAT values did not differ significantly between the prone and supine positions. For PTV2, no values differed significantly between the supine and prone positions under any treatment plan. With respect to OAR, the rectal D mean, D2%, V50, and V60 values of PTV1 were statistically higher in supine 3DCRT than in prone 3DCRT, while there were no significant differences in rectal values between the supine and prone positions with IMRT or VMAT. The rectal Dmean, V50, V60, V70, and V75 values of prone 3DCRT were significantly higher than those of supine IMRT or supine VMAT. There were no significant differences in any values for the rectum and bladder for PTV2. Conclusion: Although prone 3DCRT was found to be superior to supine 3DCRT in terms of rectal sparing in high-risk prostate cancer, IMRT and VMAT techniques could possibly cover this disadvantage.

关键词： Prostate Radiotherapy Dosimetric Comparison 3DCRT IMRT VMAT

Experimental Study on a Cascade Flapping Wing Hydroelectric Power Generator

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Journal of Energy and Power Engineering 2012年第9期6卷 1429-1436页

作者： Hisanori Abiru Akira yoshitake Department of Intelligent Mechanical Engineering Fukuoka Institute of Technology Fukuoka 811-0295 Japan Department of Marine Systems Engineering Kyushu University Fukuoka 819-0395 Japan

A hydroelectric power generator, which is able to extract the water flow energy from the hydroelastic response of an elastically supported rectangular wing, is experimentally investigated. An electric motor is used to excite pitching oscillations of the wing. Both the wing and the electric motor are supported by leaf springs which are designed to work both as a linear guide for the sway oscillations and as elastic elements. The wing mass in sway direction necessary to achieve a hydroelastic response is obtained by utilizing a mechanical snubber mechanism. The appropriate load to generate electricity is provided by magnetic dampers. In the previous paper, the generating power rate and the efficiency were examined through the experiments with a single wing model, and the feasibility of the flapping wing hydroelectric power generator was verified. In this paper, the influence of the neighboring wings is examined by using two experimental apparatuses, with the intention of achieving a practical cascade wing generator. Tests revealed that the cascade moving in-phase with the neighboring wings at narrower intervals has a higher rate of electric power generation.

关键词：实验装置发电机水电站级联扑翼机翼模型弹性支承弹性响应

偶然发现的左室心尖部"铲形"FDG摄取可能提示心尖肥厚性心肌病

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

中华核医学与分子影像杂志 2018年第1期38卷 72-73页

作者：唐军 215021 上海交通大学医学院附属苏州九龙医院核医学科

目的心尖部心肌"黑桃A"样的增厚是心尖肥厚性心肌病(AHCM)的独特征象。该研究调查了日常肿瘤脱氧葡萄糖(FDG) PET显像中偶然发现的左心室心尖部位"铲形"FDG摄取增高影(SSUA)。方法进行回顾性分析,选出具有左心室心尖部位SSUA的患者。将S... 详细信息

目的心尖部心肌"黑桃A"样的增厚是心尖肥厚性心肌病(AHCM)的独特征象。该研究调查了日常肿瘤脱氧葡萄糖(FDG) PET显像中偶然发现的左心室心尖部位"铲形"FDG摄取增高影(SSUA)。方法进行回顾性分析,选出具有左心室心尖部位SSUA的患者。将SSUA的形态或放射性强度与心电图、超声心动图和负荷态心肌灌注SPECT显像结果进行比较。AHCM的诊断基于心电图出现巨大反向T波、超声心动图心尖部"铲形"肥厚的厚度以及静息态心肌灌注SPECT显像时心尖部位的显像剂摄取增加。结果 34例患者36次PET显像中发现有SSUA,17例"铲形"放射性增加较弱,17例增加较强。29例为单独SSUA,5例除SSUA外还伴有弥漫性或局灶性左心室摄取增高,后者中3例证实同时有AHCM和不对称性室间隔肥厚。16例行超声心动图检查的SSUA阳性患者中,13例(81%)诊断为AHCM,另外3例被认为是接近AHCM的患者(心尖室壁厚度14～15 mm)。16例SSUA患者在该研究后的随访中再行PET显像,11例(69%)仍有SSUA,余5例SSUA几乎消失,但伴有左心室心肌弥漫性摄取增加。SSUA的强度与巨大反向T波(P<0.01)、心尖协同不能(P=0.08)、冠状动脉血流储备下降(P<0.05)呈显著或弱显著相关。其他因素未见与SSUA的形态或放射性强度相关。结论肿瘤FDG PET显像中偶然发现的SSUA可能与AHCM有关,尤其在心肌缺血的情况下。在多次FDG PET显像中重复出现的SSUA可能与不明原因的心肌生理性摄取有关。

关键词：肥厚性心肌病心尖肥厚 FDG PET 心电图超声心动图心肌灌注SPECT

同方期刊数据库评论

在线全文

同方期刊数据库

学校读者我要写书评

暂无评论

这是苹果吗?也许是喔

新教育（海南） 2017年第9期 38-页

作者： yoshitake Shinsuke

当我们看到一颗苹果会想到什么?英文是apple?手机?牛顿?华盛顿?(华盛顿砍的是樱桃树啦.)很多小朋友的想象力令父母惊奇,这是创意的猜想、是哲学的思考。《这是苹果吗?也许是喔》这本书里面有小朋友对苹果的上百种的想像。

关键词：日本筑波大学讲谈社想像力

Advanced lower gingival cancer successfully treated by modest doses of radiotherapy and adjuvant chemotherapy with S-1

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

中国口腔颌面外科杂志 2008年第B5期6卷 171-171页

作者： Takuya Tanaka Hideki Nakayama Masashi Nagata Yoshihiro yoshitake Takehisa Obayashi Masanori Shinohara Department of Oral and Maxillofacial Surgery KumamotoUniversity Kumamoto city 860-8556 Japan

We report the case of a 62-year-old man with advanced lower gingival cancer and nodal metastasis who was successfully treated by modest doses of radiotherapy and adjuvant chemotherapy with S-1。The patient was clinically diagnosed with stage IV (T4NIM0) disease and was initially treated by 30 Gy of radiotherapy given over three weeks as preoperative treatment。Since he refused surgery after preoperative treatment, adjuvant chemotherapy with S-I was elected instead。The treatment regimen consisted of S-I administration for 14 consecutive days, followed by a 7-day rest。Three months after the chemotherapy, the primary oral region showed no sign of cancer, whereas the metastatic lymph node showed enlargement。With his informed consent, he underwent submandibular neck dissection, and after the surgery, he was administered S-1 for 20 months。At present, no sign of cancer has been identified by radiological follow-up examinations。

关键词：牙龈癌治疗方法临床分析化学疗法

人心房钠尿肽在患慢性肾病未经透析的患者冠状动脉移植术中的有效性

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

中国心血管病研究 2010年第8期8卷 632-632页

作者： Isamu yoshitake 日本大学医学部心血管外科日本

Chronic kidney disease(CKD)is most important risk factors for cardiac *** this study,the subjects were patients undergoing coronary artery bypass grafting(CABG)with *** only the early postoperative results but also th... 详细信息

关键词：慢性肾病冠状动脉移植术人心房钠尿肽