慢性静脈不全に対する弁作成術の基礎的研究

金沢大学医学部研究課題/領域番号:62770929, 研究期間(年度):1987出典：研究課題「慢性静脈不全に対する弁作成術の基礎的研究」課題番号62770929（KAKEN：科学研究費助成事業データベース（国立情報学研究所）） （https://kaken.nii.ac.jp/ja/grant/KAKENHI-PROJECT-62770929/）を加工して作

移植された人工血管における治癒過程の免疫組織学的検討

金沢大学医学部附属病院人に移植された人工血管の免疫組織学的検索を再手術や剖検時に取り出されたDacronやPolytetrafluoroethyleneを用いて行った。H-E染色、elastica Van Gieson染色、アザン染色に加えて、細胞とマトリックスの同定のためにα-アクチン、マクロファージ、von Willebrand因子、フィブリン、エラスチン、コラーゲンI-V、プロコラーゲン、CD3、CD20に対する免疫染色を行った。また、増殖因子(PDGF,FGF,TGFβ)、サイトカイン(IFNγ)、プロテアーゼ(u-PA,MMP1,MMP2,MMP9)および細胞増殖マーカーであるKi-67に対する抗体を用いて免疫染色を行った。増殖因子等に対して陽性である細胞は二重染色により細胞の同定を行った。移植後5-24日の人工血管吻合部内面は血栓で覆われ、吻合部以外の内面は所々に血栓の付着を認めた。血栓にはマクロファージが進入し、PDGF、MMP、Ki-67に対して免疫染色陽性であった。移植後11-148カ月の人工血管吻合部はいわゆる内膜肥厚を呈しており、平滑筋細胞とコラーゲンが主たるものであった。吻合部内面は一層の内皮細胞が覆っているか、もしくはフィプリンの薄い層にて覆われていた。内膜肥厚の厚さは移植後11-36カ月のものと移植後94-148カ月もので差は認められなかった。吻合部位外の内面は血栓やコラーゲンと線維芽細胞に覆われているが、所々では人工血管の線維が露出していた。平滑筋細胞、線維芽細胞にはMMP陽性のものを認めたが、PDGF、Ki-67に対して陽性のものは認めなかった。コラーゲンは主としてIII型であり、また、吻合部にはエラスチンも認めた。人工血管周辺の組織にマクロファージやT cellを認めたがB cellは認めなかった。研究課題/領域番号:08671346, 研究期間(年度):1996出典：研究課題「移植された人工血管における治癒過程の免疫組織学的検討」課題番号08671346（KAKEN：科学研究費助成事業データベース（国立情報学研究所）） （https://kaken.nii.ac.jp/ja/grant/KAKENHI-PROJECT-08671346/）を加工して作

腹部大動脈高位遮断時における腎保護(特に破裂性大動脈瘤手術に関して)

金沢大学医学部研究課題/領域番号:58770826, 研究期間(年度):1983出典：研究課題「腹部大動脈高位遮断時における腎保護(特に破裂性大動脈瘤手術に関して)」課題番号58770826（KAKEN：科学研究費助成事業データベース（国立情報学研究所）） （https://kaken.nii.ac.jp/ja/grant/KAKENHI-PROJECT-58770826/）を加工して作

Topographic representation of an occluded object and the effects of spatiotemporal context in human early visual areas.

モノの背後を見る脳の仕組みを解明 -視対象の部分像から全体像を復元する第1次視覚野の活動をfMRIで観察-. 京都大学プレスリリース. 2013-10-23.Occlusion is a primary challenge facing the visual system in perceiving object shapes in intricate natural scenes. Although behavior, neurophysiological, and modeling studies have shown that occluded portions of objects may be completed at the early stage of visual processing, we have little knowledge on how and where in the human brain the completion is realized. Here, we provide functional magnetic resonance imaging (fMRI) evidence that the occluded portion of an object is indeed represented topographically in human V1 and V2. Specifically, we find the topographic cortical responses corresponding to the invisible object rotation in V1 and V2. Furthermore, by investigating neural responses for the occluded target rotation within precisely defined cortical subregions, we could dissociate the topographic neural representation of the occluded portion from other types of neural processing such as object edge processing. We further demonstrate that the early topographic representation in V1 can be modulated by prior knowledge of a whole appearance of an object obtained before partial occlusion. These findings suggest that primary "visual" area V1 has the ability to process not only visible or virtually (illusorily) perceived objects but also "invisible" portions of objects without concurrent visual sensation such as luminance enhancement to these portions. The results also suggest that low-level image features and higher preceding cognitive context are integrated into a unified topographic representation of occluded portion in early areas

Neurological Analysis Based on the Terminal End of the Spinal Cord and the Narrowest Level of Injured Spine in Thoracolumbar Spinal Injuries

This study aimed to clarify neurological differences among the epiconus, conus medullaris, and cauda equina syndromes. Eighty-seven patients who underwent surgery for acute thoracolumbar spinal injuries were assessed. We defined the epiconus as the region from the terminal end of the spinal cord to the proximal 1.0 to 2.25 vertebral bodies, the conus medullaris as the region proximal to < 1.0 vertebral bodies, and the cauda equina as the distal part of the nerve roots originating from the spinal cord. On the basis of the distance from the terminal end of the spinal cord to the narrowest level of the spinal canal, the narrowest levels were ordered as follows: the epiconus followed by the conus medullaris and cauda equina. The narrowest levels were the epiconus in 22 patients, conus medullaris in 37 patients, and cauda equina in 25 patients. On admission, significantly more patients had a narrowed epiconus of Frankel grades A-C than a narrowed cauda equina. At the final follow-up, there were no significant differences in neurological recovery among those with epiconus, conus medullaris, or cauda equina syndrome. Anatomically classifying the narrowest lesion is useful for clarifying the differences and similarities among these three syndromes

R&D Progress of HTS Magnet Project for Ultrahigh-field MRI

Proceedings of the 28th International Symposium on Superconductivity (ISS 2015) November 16-18, 2015, Tokyo, JapanAn R&D project on high-temperature superconducting (HTS) magnets using rare-earth Ba2Cu3O7 (REBCO) wires was started in 2013. The project objective is to investigate the feasibility of adapting REBCO magnets to ultrahigh field (UHF) magnetic resonance imaging (MRI) systems. REBCO wires are promising components for UHF-MRI magnets because of their superior superconducting and mechanical properties, which make them smaller and lighter than conventional ones. Moreover, REBCO magnets can be cooled by the conduction-cooling method, making liquid helium unnecessary. In the past two years, some test coils and model magnets have been fabricated and tested. This year is the final year of the project. The goals of the project are: (1) to generate a 9.4 T magnetic field with a small test coil, (2) to generate a homogeneous magnetic field in a 200 mm diameter spherical volume with a 1.5 T model magnet, and (3) to perform imaging with the 1.5 T model magnet. In this paper, the progress of this R&D is described. The knowledge gained through these R&D results will be reflected in the design of 9.4 T MRI magnets for brain and whole body imaging

弓部大動脈瘤術後の脳障害

金沢大学医薬保健研究域医学系Postoperative brain dysfunction was studied for 18 patients who survived more than 30 days after operations of aortic arch aneurysms. The operative procedures were graft replacement in 12 patients, resection with direct or patch closure in 3, and thromboexclusion in 3. Except for thromboexclusion, adjuncts were used: temporary bypass in 1, partial EPC (extracorporeal circulation) in 2, and selective cerebral perfusion during EPC in 12. As for intra-operative monitoring, the temporal artery blood pressures were more than 50 mmHg in all, but the electroencephalogram changed to flat wave just after clamping the aorta in one patient. Postoperative brain dysfunction occurred in 5 patients, including temporary loss of consciousness in 2, lasting loss of consciousness in 1, and paralysis with loss of consciousness in 2. Postoperative brain dysfunction occurred more often in old aged men with atherosclerotic aneurysms. Patients with temporary brain dysfunction had no remarkable change in CT scan, but patients with lasting brain dysfunction had low density areas. It is recommended to prevent this complication as follows: 1) pre-operative evaluation of cerebral vascular disorders, 2) gentle maneuver of atherosclerotic lesions, 3) bilateral cerebral perfusions and intra-operative monitorings, 4) intensive perioperative care of circulation and respiration.1

弓部大動脈再建における脳保護の検討

金沢大学医薬保健研究域医学系We analyzed cerebral protection of twenty-five patients, 11 of whom underwent ascending-arch aortic replacement and 14 underwent aortic arch replacement, supported with cardiopulmonary bypass. Twenty of patients underwent selective cerebral perfusion (SCP) with moderate hypothermic circulatory support; 12 of single SCP, 8 of double SCPs. Major arch branch reconstruction were performed with 11 patients; 3 of triple branches, 2 of double branches and 6 of single branch reconstruction. Cerebral impairment was found in 7 patients (25%) with SCP; 3 of them died of low output syndrome and major bleeding during perioperative period. Four of 17 patients, who survived more than one month, showed cerebral infarction in 2 patients and temporary neurological deficit in 2 patients. Our strategies for cerebral protection are (1) careful cerebral four vessels study, (2) SCP with perfusion pressure more than 40 mmHg and flow rate of 7-10 ml/kg/min under moderate hypothermia, (3) bilaterally double branches perfusion minimally for arch replacement, (4) intensive cerebral monitoring from multiple aspect, (5) pharmacological support with barbiturate or aprotinin, (6) gentle maneuver and reliable major branch cannulation to prevent debris embolism

大血管再建を伴った肺癌および縦隔腫瘍切除例の検討

金沢大学医薬保健研究域医学系From 1973 to 1998, we resected and reconstructed the great vessels in 44 patients with primary lung cancer or mediastinal tumor. Among them, 39 patients (28 with lung cancer and 11 with mediastinal tumor) and 5 patients (all with lung cancer) underwent reconstruction of the superior vena cava (SVC) and aorta, respectively. The SVC was repaired by expanded polytetrafluoroethylene (EPTFE) graft (n = 8), prosthetic patch (n = 5) or direct suture (n = 26). The aorta was repaired with temporary subclavian artery-descending aorta (n = 3), or left atrium-femoral artery bypass (n = 2). No complication or operative death occurred after surgery. The survival rate of the patients with lung cancer who underwent SVC reconstruction at 3 year and 5 year were 26.2% and 11.2%, respectively. Five of 11 (45.5%) patients with mediastinal tumor are alive at 5 years. We concluded that extended resection for primary lung cancer or mediastinal tumor invading the SVC is acceptable operation method for some patients

T4肺癌に対する一時バイパス法による大動脈合併切除術

金沢大学医薬保健研究域医学系Radical operation for T4 lung cancer is technically difficult. We report here 3 cases of T4N0M0 lung cancer involving aorta or left subclavian artery which was successfully operated on. We could carry out combined aortic resection more safely and speedy under the assistant devices, such as Anthrontube and Biomedicus Centrifugal Pump. Even T4 lung cancer having aortic invasion with N0 disease can be operated on and be expected long-term survival using these assistant devices.1