LIVIVO - The Search Portal for Life Sciences

zur deutschen Oberfläche wechseln
Advanced search

Search results

Result 1 - 6 of total 6

Search options

  1. Article ; Online: Preliminary Report

    Jiro Akimoto / Shinjiro Fukami / Megumi Ichikawa / Kenta Nagai / Michihiro Kohno

    Journal of Clinical Medicine, Vol 10, Iss 5375, p

    Rapid Intraoperative Detection of Residual Glioma Cell in Resection Cavity Walls Using a Compact Fluorescence Microscope

    2021  Volume 5375

    Abstract: Objective: The surgical eradication of malignant glioma cells is theoretically impossible. Therefore, reducing the number of remaining tumor cells around the brain–tumor interface (BTI) is crucial for achieving satisfactory clinical results. The ... ...

    Abstract Objective: The surgical eradication of malignant glioma cells is theoretically impossible. Therefore, reducing the number of remaining tumor cells around the brain–tumor interface (BTI) is crucial for achieving satisfactory clinical results. The usefulness of fluorescence–guided resection for the treatment of malignant glioma was recently reported, but the detection of infiltrating tumor cells in the BTI using a surgical microscope is not realistic. Therefore, we have developed an intraoperative rapid fluorescence cytology system, and exploratorily evaluated its clinical feasibility for the management of malignant glioma. Materials and methods: A total of 25 selected patients with malignant glioma (newly diagnosed: 17; recurrent: 8) underwent surgical resection under photodiagnosis using photosensitizer Talaporfin sodium and a semiconductor laser. Intraoperatively, a crush smear preparation was made from a tiny amount of tumor tissue, and the fluorescence emitted upon 620/660 nm excitation was evaluated rapidly using a compact fluorescence microscope in the operating theater. Results: Fluorescence intensities of tumor tissues measured using a surgical microscope correlated with the tumor cell densities of tissues evaluated by measuring the red fluorescence emitted from the cytoplasm of tumor cells using a fluorescence microscope. A “weak fluorescence” indicated a reduction in the tumor cell density, whereas “no fluorescence” did not indicate the complete eradication of the tumor cells, but indicated that few tumor cells were emitting fluorescence. Conclusion: The rapid intraoperative detection of fluorescence from glioma cells using a compact fluorescence microscope was probably useful to evaluate the presence of tumor cells in the resection cavity walls, and could provide surgical implications for the more complete resection of malignant gliomas.
    Keywords intraoperative photodiagnosis ; malignant glioma ; fluorescence–guided surgery ; intraoperative cytology ; fluorescence microscope ; Medicine ; R
    Subject code 610
    Language English
    Publishing date 2021-11-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

    Full text online

    More links

    Kategorien

    Inter-library loan at ZB MED

    Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

  2. Article ; Online: P68 Usefulness of an Optimal Cut-off in Central Augmentation Pressure for the Detection of Left Ventricular Hypertrophy in Men

    Masakazu Obayashi / Shigeki Kobayashi / Hirotaka Yamamoto / Yoriomi Hamada / Takumi Nanno / Michihiro Kohno / Masafumi Yano

    Artery Research, Vol 25, Iss

    2020  Volume 1

    Abstract: Background: Recently, we showed an age-related increase in augmentation pressure (AP) measured using Mobil-O-Graph (MOG) in normotensive Japanese individuals. However, AP might be a poor index of wave reflection due to the overlap between the forward ... ...

    Abstract Background: Recently, we showed an age-related increase in augmentation pressure (AP) measured using Mobil-O-Graph (MOG) in normotensive Japanese individuals. However, AP might be a poor index of wave reflection due to the overlap between the forward wave and reflected wave. Methods: We enrolled untreated hypertensive patients and patients currently on antihypertensive treatment. For 70 patients (median age, 70.5 years; 34 men), M-mode echocardiography was performed for determination of left ventricular hypertrophy (LVH), while hemodynamic measurements were taken using MOG. We investigated the influence of central hemodynamic parameters on LVH. Results: Spearman correlation coefficients between various parameters [age, height, systolic blood pressure (SBP), mean BP, diastolic BP, central systolic BP (cSBP), and AP] were calculated for LV mass indexed to body surface area (LVMI; g/m2). In men, age (r = 0.600, p = 0.0002), height (r = −0.495, p = 0.003), SBP (r = 0.423, p = 0.013), cSBP (r = 0.454, p = 0.007), and AP (r = 0.661, p < 0.0001) were correlated to LVMI. In women, cSBP (r = 0.334, p = 0.044) and AP (r = 0.480, p = 0.003) were correlated to LVMI. In men, LVMI (R2 = 0.578, p = 0.0001) was significantly associated with AP (β = 1.32 ± 0.56, p = 0.027) in multivariate regression analysis. In women, no significant independent parameter for LVMI was observed. ROC curve analysis was performed to estimate the utility of AP for the detection of LVH (LVMI >115 g/m2) in men. Area under the ROC curve was 0.83 (95% CI: 0.68–0.99). The optimal cut-off point of 12.5 mmHg produced 79.0% sensitivity and 86.7% specificity. Conclusion: Higher AP showing >12.5 mmHg calculated by MOG was a significant independent predictor of LVH in male hypertensive patients.
    Keywords Specialties of internal medicine ; RC581-951 ; Diseases of the circulatory (Cardiovascular) system ; RC666-701
    Subject code 610
    Language English
    Publishing date 2020-02-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

    Full text online

    More links

    Kategorien

    Inter-library loan at ZB MED

    Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

  3. Article ; Online: P128 COMPARISON OF AUGMENTATION INDEX OBTAINED FROM HEM-9000AI AND MOBIL-O-GRAPH IN JAPANESE NORMOTENSIVE INDIVIDUALS

    Masakazu Obayashi / Michihiro Kohno / Shigeki Kobayashi / Michiaki Kohno / Masafumi Yano

    Artery Research, Vol

    2017  Volume 20

    Abstract: Background: HEM-9000AI (HEM) is an established device for measurement of radial augmentation index (rAIx) used by applanation tonometry in Japan. Mobil-O-Graph (MOG) is a cuff-based oscillometric device for assessment of central aortic AIx (cAIx) and the ...

    Abstract Background: HEM-9000AI (HEM) is an established device for measurement of radial augmentation index (rAIx) used by applanation tonometry in Japan. Mobil-O-Graph (MOG) is a cuff-based oscillometric device for assessment of central aortic AIx (cAIx) and the usefulness to Europeans has been reported. We compared the AIx between HEM and MOG in Japanese normotensive subjects. Methods: We enrolled 106 normotensive volunteers (47 male, 21 to 79 years). The left radial arterial waveform was recorded with the HEM. MOG were taken on the left arms, which arm circumferences (ACs) were measured to allow the correct choice of cuff (two sizes available; 20–24 and 24–32 cm). We performed multiple regressions for AIx and key variables in HEM and MOG. Results: The ACs in M and F were 25.7±1.9 (mean±SD) cm and 23.5±2.1cm, respectively. Both rAIx (70.5±15.3% vs 83.6±11.9%, p < 0.001) and cAIx (17.2±7.3% vs 29.7±9.8%, p < 0.001) in M were smaller than those in F. Multiple regression analysis revealed that cAIx in M (R2 = 0.5176) was significantly associated with age (β = 0.17, p = 0.004) and cuff size (p = 0.001). cAIx obtained using the smaller cuff was significantly increased compared to the larger cuff (25.1±5.9% vs 14.8±5.9%). In F, cAIx (R2 = 0.2245) tended to be associated with age (β = 0.16, p = 0.072) and was significantly associated with height (β = −0.62, p = 0.007) and heart rate (β = −0.26, p = 0.0029). Conclusions: The brachial cuff-based waveform recordings are useful for Japanese normotensive individuals. However, the mean AC is close to the bound of two cuff sizes and the measurement of lower cAx using the larger cuff is less sensitive.
    Keywords Specialties of internal medicine ; RC581-951 ; Diseases of the circulatory (Cardiovascular) system ; RC666-701
    Subject code 616
    Language English
    Publishing date 2017-12-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

    Full text online

    More links

    Kategorien

    Inter-library loan at ZB MED

    Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

  4. Article: Disseminated cerebellar hemangioblastoma in two patients without von Hippel-Lindau disease.

    Akimoto, Jiro / Fukuhara, Hirokazu / Suda, Tomohiro / Nagai, Kenta / Hashimoto, Ryo / Michihiro, Kohno

    Surgical neurology international

    2014  Volume 5, Page(s) 145

    Abstract: Background: Two patients who had received a total resection of cerebellar hemangioblastoma developed cerebrospinal fluid dissemination during a long-term follow-up period. We present this rare disease with discussion based on the literature.: Case ... ...

    Abstract Background: Two patients who had received a total resection of cerebellar hemangioblastoma developed cerebrospinal fluid dissemination during a long-term follow-up period. We present this rare disease with discussion based on the literature.
    Case description: The patients were two women aged 45 and 57 years. In the cerebellar hemisphere, one patient had cystic hemangioblastoma of mural nodule type and the other had solid type. Both the patients successfully underwent total resection by craniotomy. They presented no mutations in the von Hippel-Lindau disease (VHL) gene or lesions in the other organs. One patient developed local recurrence 38 months after the initial surgery, and received stereotactic radiosurgery. Three spinal cord tumors developed 91 months later, and the tumors were disseminated to the entire cerebrospinal cavity 107 months later. The other patient developed hydrocephalus 53 months after the initial surgery with tumor tissues disseminated in the intracranial subarachnoid space. The conditions of the two patients gradually aggravated despite treatment with ventriculo-peritoneal shunt and irradiation to the whole brain and whole spinal cord.
    Conclusion: Cerebrospinal fluid dissemination of cerebellar hemangioblastoma was found dominantly in non-VHL patients. The diagnosis was made 10 years after the initial surgery. Irradiation therapy was performed, but the patients died about 2 years after the diagnosis was given. Molecular targeted therapies including vascular proliferation suppression have been attempted lately, but no effective therapy has been established. Early diagnosis of dissemination as well as combination of aggressive excision and stereotactic radiosurgery are considered to be appropriate for current interventions.
    Language English
    Publishing date 2014-10-07
    Publishing country United States
    Document type Case Reports
    ISSN 2229-5097
    ISSN 2229-5097
    DOI 10.4103/2152-7806.142321
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

    Inter-library loan at ZB MED

    Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

  5. Article ; Online: Endovascular treatment of ruptured intracranial aneurysms in patients 70 years of age and older

    Daisuke Watanabe / Takao Hashimoto / Shunichi Koyama / H Tomoo Ohashi / Hirohumi Okada / Norio Ichimasu / Michihiro Kohno

    Surgical Neurology International, Vol 5, Iss 1, Pp 104-

    2014  Volume 104

    Abstract: Background: An increasing number of elderly patients present with intracranial aneurysms. In addition to female gender, an older age is associated with a higher risk of developing a subarachnoid hemorrhage (SAH), and these patients often fare poorly in ... ...

    Abstract Background: An increasing number of elderly patients present with intracranial aneurysms. In addition to female gender, an older age is associated with a higher risk of developing a subarachnoid hemorrhage (SAH), and these patients often fare poorly in terms of long-term outcome. It is often thought that elderly patients would especially benefit from endovascular aneurysm treatment. We assessed the clinical outcomes in elderly patients with ruptured intracranial aneurysms (RIAs) who were treated by endovascular procedures. Methods: We performed a retrospective review of a prospective database of elderly patients treated with coil embolization for RIAs. The clinical outcomes were assessed using the modified Glasgow Outcome Scale. The rates of procedural complications and adverse events were also recorded. Results: During a period of 5 years, 162 patients with 183 intracranial aneurysms were treated in our hospital by means of an endovascular approach. Among them, 51 patients (31.5%) with a ruptured aneurysm were aged 70 years or older. These patients aged 70-91 years (mean age, 74 years) were treated by coil embolization for RIAs. Among them, seven had a Hunt and Hess (HH) grade of I or II, 42 had an HH grade of III or IV, and 2 had an HH grade of V. Endovascular treatment resulted in 32 complete occlusions (62.7%), 15 neck remnants (22%), and 4 body fillings (7.9%). Procedural complications occurred in five patients (9.8%). The outcomes were good or excellent in 17 patients (33.3%). Three patients (5.8%) who died had an HH grade of IV or V. Rebleeding occurred during follow-up in one patient (1.9%). Conclusions: Coil embolization of intracranial aneurysms is safe and effective in the elderly. However, the morbidity and mortality rates are higher in patients with high HH grades. This finding suggests that the timing of treatment should be based on the patient′s initial clinical status.
    Keywords Coil embolization ; elderly ; intracranial aneurysm ; ruptured ; Medicine ; R ; Surgery ; RD1-811 ; Internal medicine ; RC31-1245 ; Neurosciences. Biological psychiatry. Neuropsychiatry ; RC321-571 ; Neurology. Diseases of the nervous system ; RC346-429
    Subject code 616 ; 610
    Publishing date 2014-01-01T00:00:00Z
    Publisher Medknow Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

    Full text online

    More links

    Kategorien

    Inter-library loan at ZB MED

    Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

  6. Article ; Online: National trends in the outcomes of subarachnoid haemorrhage and the prognostic influence of stroke centre capability in Japan

    Satoshi Suzuki / Kenji Yamamoto / Hiroaki Tanaka / Hiroshi Ozawa / Yuji Okamoto / Tatsuya Abe / Hidenori Suzuki / Akiko Kada / Shigeki Nishino / Nobuyuki Sakai / Kunihiro Nishimura / Tomoyoshi Oikawa / Takanari Kitazono / Hiroshi Tanaka / Daisuke Onozuka / Akihito Hagihara / Hiroshi Ooyama / Akira Watanabe / Shinichi Yoshimura /
    Toru Iwama / Hiroki Sato / Satoshi Ushikoshi / Kiyohiro Houkin / Nobuhiro Mikuni / Naoyuki Nakao / Michio Nakamura / Nanako Tamiya / Naofumi Isono / Koji Iihara / Yutaka Yamaguchi / Kuniaki Ogasawara / Osamu Onodera / Yusaku Nakamura / Naoki Hayashi / Akira Takada / Hiroyuki Arai / Masayuki Ezura / Akio Hyodo / Shigeru Miyachi / Susumu Miyamoto / Yuji Matsumaru / Ichiro Nakahara / Tomoaki Terada / Kazunari Yoshida / Ai Kurogi / Ataru Nishimura / Yoshiaki Shiokawa / Koichi Arimura / Kaoru Kurisu / Fusao Ikawa / Kenji Ohata / Kyoichi Nomura / Nobuhito Saito / Hiroaki Fujiwara / Susumu Suzuki / Masanori Isobe / Soshiro Ogata / Takeshi Matsuoka / Junichiro Satomi / Takashi Matsumoto / Hiroyuki Nakase / Yasunari Niimi / Manabu Kinoshita / Mamoru Murakami / Masaaki Uno / Junichi Iida / Takashi Matsuoka / Tatsuya Sasaki / Shinichi Wakabayashi / Hiroki Toda / Hideki Sakai / Hajime Ohta / Osamu Yamamura / Hideyuki Ohnishi / Hiroko Oyama / Junichi Ono / Izumi Nagata / Hiroharu Kataoka / Ryota Kurogi / Hajime Arai / Atsuo Yoshino / Tsuyoshi Ohta / Hiroshi Sugimori / Hidehiro Hirabayashi / Hiroyuki Masaoka / Satoshi Yamamoto / Hideki Murakami / Kazuhiko Nozaki / Hiroyuki Matsumoto / Yuichiro Tanaka / Takahisa Mori / Keizo Yasui / Akira Takahashi / Ichiro Suzuki / Sachio Suzuki / TAKASHI YOSHIDA / Masanori Morimoto / Tetsuya Ueba / Hiromu Hadeishi / Masaki Chin / Michihiro Kohno / Hitoshi Fukuda / Toru Nishi / Kazunari Koga / Toshihiko Wakabayashi / Hiroki Ohkuma / Kazuhiro Hongo / Hiroshi Nakane / Kazumi Nitta / Satoshi Utsuki / Toshihiko Iuchi / Nice Ren / Hidefuku Gi / Kensuke Kawai / Masayuki Ishihara / Eiji Kohmura / Yoshihiro Nishiura / Kazutaka Yatsushiro / Kensaku Yoshida / Atsushi Tominaga / Masayuki Sumida / Hidenori Yoshida / Atsushi Sato / Takashi Inoue / Hiroaki Shimizu / Eiichiro Kamatsuka / Makoto Ichinose / Naoya Takeda / Tsuyoshi Inoue / Hidekazu Takahashi / Satoshi Kuroda / Toshiaki Osato / Nobutaka Horie / Isao Date / Yoichiro Hashimoto / Haruhiko Hoshino / Takafumi Shimogawa / Koji Yoshimoto / Teiji Tominaga / Isao Sasaki / Kazuo Kitazawa / Minoru Saitoh / Hitoshi Saito / Minoru Asahi / Makoto Goda / Atsuhito Takemura / Masaaki Shibukawa / Isao Fuwa / Saburo Watanabe / Seiko Kataoka / Koji Takasaki / Kouji Shiga / Kensuke Hayashida / Ryunosuke Uranishi / Chiaki Ito / Kenji Wakui / Takashi Saegusa / Isao Kitahara / Yasushi Ejima / Satoru Hayashi / Kazuyoshi Hattori / Shinji Okita / Toshikazu Ichihashi / Tsugumichi Ichioka / Shinichi Shirakami / Teruo Kimura / Tomonori Kobayashi / Kanehisa Kohno / Kazunori Yamanaka / Akira Morooka / Nozomi Mori / Hideo Kunimine / Masahiro Satoh / Syougo Imae / Hirochiyo Wada / Masanori Kabuto / Katsuyuki Hirakawa / Isao Inoue / Kiyoshi Kazekawa / Masani Nonaka / Kouzou Fukuyama / Shigenari Kin / Kiyoshi Saito / Yoichi Watanabe / Tadashi Arisawa / Kou Takahashi / Tetsuya Tanigawara / Junki Ito / Kei Hisada / Makoto Takeda / Jun Niwa / Mikio Nishiya / Shuji Hayashi / Ichiro Fujishima / Teiji Nakayama / Yoshihiko Watanabe / Koichirou Matsukado / Takamichi Yuguchi / Tadahisa Shono / Hiroyuki Nishimura / Jyunya Hayashi / Keisuke Migita / Kazuhiro Yokoyama / Hirotoshi Ohtaka / Takata Hisashi / Takamitsu Uchizawa / Naoki Shinohara / Mitsunobu Kaijima / Junkoh Yamamoto / Yoshio Sakagami / Hideo Aihara / Takayuki Sakaki / Keishi Fujita / Sumio Kobayashi / Nobuaki Momozaki / Masahito Hara / Akazi Kazunori / Fumitaka Miya / Hisato Minamide / Shinichiro Kurokawa / Syuichi Ishikawa / Naohisa Miura / Shinya Noda / Shoji Mashiyama / Shinji Amano / Takayuki Sugawara / Yukihiko Shimizu / Keiichi Saito / Kazuyuki Miura / Akinori Yabuta / Tatumi Yamanome / Hiroshi Seto / Makoto Hasebe / Hikaru Mizobuchi / Junkoh Sasaki / Shin Tsuruoka / Keiichi Nishimaki / Katsumi Takizawa / Hitoshi Tsugu / Nozomi Suzuki / Takeshi Kohno / Shu Hasegawa / Ken Asakura / Masaki Miyatake / Hiromu Konno / Katsunobu Takenaka / Akira Ikeda / Keizou Yamamoto / Keigo Matsumoto / Satoshi Inoha / Masaki Morisige / Kunihiko Harada / Hirofumi Hiyama / Yasuaki Takeda / Taturou Mori / Takekazu Akiyama / Osamu Okuda / Kazuaki Awamori / Naoki Shirasaki / Kimihiro Yoshino / Atsushi Shindo / Kazuho Hirahara / Shunichi Tanaka / Teruaki Kawano / Kazunori Arita / Hiroaki Sawaura / Yoichi Uozumi / Masahiko Tanaka / Shunsuke Shiraga / Shuji Sato / Mitsutoshi Nakada / Kimihisa Kinoshita / Nakazawa Kazutomo / Yasuhiro Fujimoto / Kunikazu Yoshimura / Masaaki Iwase / Shinichi Yagi / Atsushi Tsuchiya / Junichi Harashina / Sadao Kaneko / Naoto Kuwayama / Junya Hayashi / Masayuki Sasou / Sotaro Higashi / Masakazu Kitahara / Sumio Suda / Amami Kato / Satoshi Magarisawa / Kenji Hashimoto / Hirotoshi Hamaguchi / Tomohiko Satou / Masaru Idei / Haruhisa Tsukamoto / Toshihiro Kumabe / Naoaki Sato / Yasuyuki Toba / Takashi Tominaga / Haruo Yamashita / Toyoaki Shinohara / Kazuyoshi Watanabe / Hidenori Endo / Kenjirou Hujiwara / Toshinori Hasegawa / Hisashi Nitta / Kuroyanagi Takayuki / Nobuhiko Mizutani / Akira Tsunoda / Fumio Suzuki / Tetsuya Morimoto / Takuya Kawai / Mitsuyuki Fujitsuka / Hiromasa Tsuiki / Junichi Kuratsu / Hidemichi Sasayama / Shigehiro Ohmori / Seiko Hasegawa / Kazuhiro Kikuchi / Motohiro Morioka / Masayuki Yokota / Nozomu Murai / Yasumasa Yamamoto / Nobuhito Mori / Minoru Kidooka / Hiroshi Tenjin / Yoshihiro Iwamoto / Hitonori Takaba / Sei Haga / Yoshinori Arai / Toshiyuki Tsukada / Hirohide Karasudani / Masakazu Suga / Kawamoto Yukihiko / Naoto Izumi / Youtarou Takeuchi / Motohiro Arai / Shinji Okumura / Hisashi Tanaka / Yasushi Shibata / Tetsuya Masaoka / Masahiko Kasai / Hitoshi Miyake / Osamu Hamasaki / Misao Nishikawa / Naohiko Kubo / Yosimasa Kinosita / Hiroyuki Kaidu / Tarou Komuro / Hiroaki Shigeta / Yoshikazu Kusano / Shigekazu Takeuchi / Takayuki Matsuo / Yoshiharu Tokunaga / Norimoto Nakahara / Nobukazu Hashimoto / Mitsuhito Mase / Junpei Yoshimoto / Jin Momoji / Kenji Kamiyama / Koji Oka / Hiromichi Koga / Kazuya Morimoto / Tsutomu Kadekaru / Naoki Tokumitsu / Yasuyuki Nagai / Hirokazu Tanno / Takato Kagawa / Masaaki Saiki / Kotaro Ogihara / Junichi Imamura / Katsuhiro Yamashita / Akira Nakamizo / Yoshinari Nakamura / Ei-Ichirou Urasaki / Noriyuki Suzaki / Chiaki Takahashi / Youichirou Namba / Kazuo Hashikawa / Tomonori Yamada / Kazuyuki Kuwayama / Keiichi Sakai / Katsuhiro Kuroda / Hideyuki Kurihara / Masayuki Miyazono / Kosuke Miyahara / Hideaki Takahashi / Akihiko Saito / Igarashi Michitoku / Mitsuo Kouno / Shiro Kobayashi / Shunichi Yoneda / Hiroshi Kusunoki / Hiroji Miyake / Toshio Yokoe / Tatsuya Nakamura / Takayuki Kubodera / Mitsuhiko Hokari / Yasunari Otawara / Cheho Park / Hidemitu Nakagawa / Souichi Obara / Haruki Takahashi / Masafumi Ohtaki / Atsuya Okubo / Katsuhiko Hayashi / Masahisa Kawakami / Yu Takeda / Akihiko Kaga / Ryoichi Hayashi / Koji Tokunaga / Hiroyuki Nakashima / Yasuyuki Miyoshi / Atusi Kimoto / Toshimitsu Uchihara / Tomoaki Nagamine / Masahiro Noha / Hiromichi Sadashima / Toshihiko Kinjo / Osamu Tao / Masayuki Nakajima / Akira Isoshima / Kouichi Kuramoto / Shigeru Daido / Yoshiyasu Iwai / Toshihiko Kuroiwa / Akatsuki Wakayama / Kohsuke Yamashita / Yasunobu Gotou / Kouich Iwatsuki / Yoshida Masahiro / Nobuaki Kobayasi / Yoshimasa Niiya / Syouji Mabuchi / Motohiro Takayama / Kazuo Yamamoto / Junta Moroi / Masato Sugitani / Akio Ookura / Naoko Fujimura / Osamu Nishizaki / Sumio Isimaru / Hiroshi Wanihuchi / Nobukuni Murakami / Hiroto Murata / Naoki Kitagawa / Katsuhiko Kono / Michiya Kubo / Masashi Nakatsukasa / Makoto Inaba / Hidetoshi Ooigawa / Atsuhiro Kojima / Takamitsu Fujimaki / Osamu Fukuda / Yoshikazu Nakajima / Kazuyuki Kouno / Takaaki Yoshida / Reizou Kanemaru / Yohei Kudoh / Toshitaka Nakamura / Masayoshi Takigami / Shogo Nishi / Rokuya Tanikawa / Seisaburo Sakamoto / Makio Kaminogo / Seiichiro Hoshi / Yoshinari Okumura / Shinichi Okabe / Haruhiko Sato / Shiro Miyata / Kotaro Tsumura / Hiroshi Karibe / Noriaki Watabe / Ryuji Nakamura / Norifumi Shimoeda / Tsutomu Hitotsumatsu / Tomoaki Kameda / Hiroshi Ishiguchi / Atsuo Shinoda / Masanobu Hokama / Akinori Yamamura / Takeshi Kondoh / Kenichi Murao / Takafumi Wataya / Seiji Fukazawa / Shinsuke Muraoka / Hirosuke Fujisawa / Tsuneo Shishido / Mayumi Mori / Arai Hiroaki / Shinjitsu Nishimura / Zenichiro Watanabe / Susumu Nakashima / Kazuhito Nakamura / Yukinari Kakizawa / Hiroki Takano / Norihito Shirakawa / Masahiro Kagawa / Eiichiro Mabuchi / Kazusige Maeno / Takayuki Koizumi / Warou Taki / Yusuke Nakagaki / Kazuyuki Tane / Hiromichi Ooishi / Katsuyuki Asaoka / Yoshinori Akiyama / Tadao Kawamura / Atumi Takenobu / Takehisa Tuji / Masami Shimoda / Mitsunori Matsumae / Shinji Noda / Koiti Moroki / Hirofumi Oka / Masahito Agawa / Hajimu Miyake / Masateru Katayama / Shinichi Numazawa / Taketoshi Maehara / Hiroyuki Jimbo / Satoshi Ihara / Koji Matuoka / Oikawa Akihiro / Takahiro Oota / Makoto Noguchi / Takakazu Kawamata / Youichi Hashimoto / Keiichirou Onitsuka / Masahiko Kitano / Jae-Hyun Son / Toru Masuoka / Naoki Koketsu / Keiichi Akatsuka / Masamichi Kurosaki / Miyamori Tadao / Hiroaki Hondo / Kazumasa Yamatani / Hirofumi Oyama / Junji Koyama / Ogura Koichiro / Shinji Yamamoto / Hitoshi Tabata / Kazuya Uemura / Kazuhiko Sato / Hideyuki Yoshida / Takafumi Nishizaki / Hiroshi Egami / Hideo Takeshima / Shogo Ishiuchi / Akira Matsumura / Hiroyuki Kinouchi / Susumu Mekaru / Mikihiko Takeshita / Hitoshi Ozawa / Kiichiro Zenke / Takeshi Matsuyama / Toshikazu Kuwata / Teruyuki Habu / Tomoyoshi Okumura / Seiya Takehara / Rei Kondo / Takashi Kumagai / Keiten So / Sunao Takemura / Sonoda Yukihiko / Manabu Urakawa / Yasuhiro Hamada / Michiyasu Suzuki / Mikito Uchida / Hidehito Koizumi / Masaru Yamada / Takashi Tsuruno / Gen Ishida / Ryouichi Masuda / Makoto Kimura / Shinichirou Ishihara / Masashi Morikawa / Hidetoshi Murata / Katsumi Sakata / Motohiro Nomura / Akihiro Nemoto / Sumio Endou / Nobuo Hirota / Kennji Itou / Hiroaki Minami / Yoshihumi Teramoto

    BMJ Open, Vol 13, Iss

    retrospective cohort study

    2023  Volume 4

    Abstract: Objectives To examine the national, 6-year trends in in-hospital clinical outcomes of patients with subarachnoid haemorrhage (SAH) who underwent clipping or coiling and the prognostic influence of temporal trends in the Comprehensive Stroke Center (CSC) ... ...

    Abstract Objectives To examine the national, 6-year trends in in-hospital clinical outcomes of patients with subarachnoid haemorrhage (SAH) who underwent clipping or coiling and the prognostic influence of temporal trends in the Comprehensive Stroke Center (CSC) capabilities on patient outcomes in Japan.Design Retrospective study.Setting Six hundred and thirty-one primary care institutions in Japan.Participants Forty-five thousand and eleven patients with SAH who were urgently hospitalised, identified using the J-ASPECT Diagnosis Procedure Combination database.Primary and secondary outcome measures Annual number of patients with SAH who remained untreated, or who received clipping or coiling, in-hospital mortality and poor functional outcomes (modified Rankin Scale: 3–6) at discharge. Each CSC was assessed using a validated scoring system (CSC score: 1–25 points).Results In the overall cohort, in-hospital mortality decreased (year for trend, OR (95% CI): 0.97 (0.96 to 0.99)), while the proportion of poor functional outcomes remained unchanged (1.00 (0.98 to 1.02)). The proportion of patients who underwent clipping gradually decreased from 46.6% to 38.5%, while that of those who received coiling and those left untreated gradually increased from 16.9% to 22.6% and 35.4% to 38%, respectively. In-hospital mortality of coiled (0.94 (0.89 to 0.98)) and untreated (0.93 (0.90 to 0.96)) patients decreased, whereas that of clipped patients remained stable. CSC score improvement was associated with increased use of coiling (per 1-point increase, 1.14 (1.08 to 1.20)) but not with short-term patient outcomes regardless of treatment modality.Conclusions The 6-year trends indicated lower in-hospital mortality for patients with SAH (attributable to better outcomes), increased use of coiling and multidisciplinary care for untreated patients. Further increasing CSC capabilities may improve overall outcomes, mainly by increasing the use of coiling. Additional studies are necessary to determine the effect of confounders such as aneurysm ...
    Keywords Medicine ; R
    Subject code 150
    Language English
    Publishing date 2023-04-01T00:00:00Z
    Publisher BMJ Publishing Group
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

    Full text online

    More links

    Kategorien

    Inter-library loan at ZB MED

    Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

To top