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RISS 인기검색어
- 검색키워드
- 저자 : Takeshi Aoyama (검색결과 3 건)
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Clinical Factors for Prognosis and Treatment Guidance of Spinal Cord Astrocytoma
Toshitaka Seki,Kazutoshi Hida,Shunsuke Yano,Takeshi Aoyama,Izumi Koyanagi,Toru Sasamori,Shuji Hamauchi,Kiyohiro Houkin 대한척추외과학회 2016 Asian Spine Journal Vol.10 No.4
Study Design: Retrospective study. Purpose: To obtain information useful in establishing treatment guidelines by evaluating baseline clinical features and treatment outcomes of patients with spinal cord astrocytoma (SCA). Overview of Literature: The optimal management of SCA remains controversial, and there are no standard guidelines. Methods: The study included 20 patients with low-grade and 13 with high-grade SCA surgically treated between 1989 and 2014. Patients were classified according to the extent of surgical resection. Survival was assessed using Kaplan–Meier plots and compared between groups by log-rank tests. Neurological status was defined by the modified McCormick scale and compared between groups by Mann–Whitney U tests. Results: Surgical resection was performed for 19 of 20 low-grade (95%) and 10 of 13 high-grade (76.9%) SCA patients. Only nine patients (27.3%) underwent gross total resection, all of whom had low-grade SCA. Of all patients, 51.5% showed deteriorated neurological status compared to preoperative baseline. Median overall survival was significantly longer for low-grade SCA than that for high-grade SCA (91 months, 78% at 5 years vs. 15 months, 31% at 5 years; p =0.007). Low-grade SCA patients benefited from more aggressive resection, whereas high-grade SCA patients did not. Multivariate analysis revealed histology status (hazard ratio [HR], 0.30; 95% confidence interval [CI], 0.09–0.98; p <0.05) and postoperative neurological status (HR, 0.12; CI, 0.02–0.95; p <0.05) as independent predictors of longer overall survival. Adjuvant radiotherapy had no significant impact on survival rate. However, a trend for increased survival was observed with radiation cordotomy (RCT) in high-grade SCA patients. Conclusions: Aggressive resection for low-grade and RCT for high-grade SCA may prolong survival. Preservation of neurological status is an important treatment goal. Given the low incidence of SCA, establishing strong collaborative, interdisciplinary, and multiinstitutional study groups is necessary to define optimal treatments.
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Surgical Outcomes of High-Grade Spinal Cord Gliomas
Toshitaka Seki,Kazutoshi Hida,Syunsuke Yano,Takeshi Aoyama,Izumi Koyanagi,Kiyohiro Houkin 대한척추외과학회 2015 Asian Spine Journal Vol.9 No.6
Study Design: A retrospective study. Purpose: The purpose of this study was to obtain useful information for establishing the guidelines for treating high-grade spinal cord gliomas. Overview of Literature: The optimal management of high-grade spinal cord gliomas remains controversial. We report the outcomes of the surgical management of 14 high-grade spinal glioma. Methods: We analyzed the outcomes of 14 patients with high-grade spinal cord gliomas who were surgically treated between 1989 and 2012. Survival was charted with the Kaplan-Meier plots and comparisons were made with the log-rank test. Results: None of the patients with high-grade spinal cord gliomas underwent total resection. Subtotal resection was performed in two patients, partial resection was performed in nine patients, and open biopsy was performed in three patients. All patients underwent postoperative radiotherapy and six patients further underwent radiation cordotomy. The median survival time for patients with high-grade spinal cord gliomas was 15 months, with a 5-year survival rate of 22.2%. The median survival time for patients with World Health Organization grade III tumors was 25.5 months, whereas the median survival time for patients with glioblastoma multiforme was 12.5 months. Both univariate and multivariate Cox proportional hazards models demonstrated a significant effect only in the group that did not include cervical cord lesion as a factor associated with survival (p =0.04 and 0.03). Conclusions: The surgical outcome of patients diagnosed with high-grade spinal cord gliomas remains poor. Notably, only the model which excluded cervical cord lesions as a factor significantly predicted survival.
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A System Concept for EFD/CFD Integration
Shigeya Watanabe,Shigeru Kuchi-ishi,Hiroyuki Kato,Takeshi Aoyama,Keiichi Murakami,Atsushi Hashimoto,Naoyuki Fujita,Yuichi Matsuo 한국항공우주학회 2008 한국항공우주학회 학술발표회 논문집 Vol.- No.-
A trail towards integration of EFD (Experimental Fluid Dynamics) and CFD (Computational Fluid Dynamics), that is. the development of a system called Digital/Analog Hybrid Wind Tunnel, is introduced. The aim of the system is to improve efficiency, accuracy, and reliability of aerodynamic characteristics evaluation in aerospace vehicle developments through mutual support between EFD and CFD. The function of the system consists of optimization of test planning utilizing pretest CFD calculations, an accurate correction of the wind tunnel wall and support interaction effects through CFD, CFD data refinement based on EFD data, the most probable aerodynamic characteristics estimation based on both EFD and CFD data, database including EFD and CFD data at an identical condition, and so forth. Key technical challenges in the system development, such as an automatic grid generation and high-speed solver development for CFD, a highly efficient data reduction technique for image measurement data. and techniques integrating EFD and CFD. are addressed.
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