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Preoperative Exercise Testing Is a Better Predictor of Postoperative Complications than Pulmonary Function Testing for Patients with Lung Cancer  [PDF]
Atsushi Hata, Yasuo Sekine, Eitetsu Koh, Nobuyuki Yamaguchi
Open Journal of Thoracic Surgery (OJTS) , 2015, DOI: 10.4236/ojts.2015.51004
Abstract: Objective: The aim of this preliminary study was to evaluate the feasibility of exercise testing (ET) for predicting postoperative complications in patients with impaired pulmonary function. Methods: Thirteen patients were prospectively enrolled. The enrollment criteria were FEV1.0% < 70% and emphysema score > 8 by the Goddard classification or interstitial pneumonia on chest computed tomography. Patients underwent testing for pulmonary function, six-minute walking test (6MWT), and stair-climbing test (SCT). Postoperative cardiopulmonary complications (PCPCs) were recorded. Results: Four patients developed PCPCs. There were no significant differences between the patients with PCPCs (n = 4) and those without PCPCs (n = 9) for background data and PFT. The distances achieved in the 6MWT were 503 ± 72.7 m for patients without PCPCs and 369 ± 50.7 m for patients with PCPCs (p = 0.011). The SCT climbing heights were 20.4 ± 5.3 m for patients without PCPCs and 14.9 ± 4.0 m for patients with PCPCs (P = 0.187). Cut-off points, including a 6MFT distance of less than 400 m, SCT height lower than 15 m, and SCT climbing speed less than 8.5 m/min, were predictive of CPCP. Conclusions: Exercise testing is more feasible for predicting postoperative cardiopulmonary complications than stationary pulmonary function testing.
Severe Renal Hemorrhage in a Pregnant Woman Complicated with Antiphospholipid Syndrome: A Case Report
Shohei Kawaguchi,Kouji Izumi,Takahiro Nohara,Tohru Miyagi,Hiroyuki Konaka,Atsushi Mizokami,Eitetsu Koh,Mikio Namiki
Advances in Urology , 2011, DOI: 10.1155/2011/791094
Abstract: Antiphospholipid syndrome is a systemic autoimmune disease with thrombotic tendency. Consensus guidelines for pregnancy with antiphospholipid syndrome recommend low-dose aspirin combined with unfractionated or low-molecular-weight heparin because antiphospholipid syndrome causes habitual abortion. We report a 36-year-old pregnant woman diagnosed with antiphospholipid syndrome receiving anticoagulation treatment. The patient developed left abdominal pain and gross hematuria at week 20 of pregnancy. An initial diagnosis of left ureteral calculus was made. Subsequently abdominal-pelvic computed tomography was required for diagnosis because of the appearance of severe contralateral pain. Computed tomography revealed serious renal hemorrhage, and ureteral stent placement and pain control by patient-controlled analgesia were required. After treatment, continuance of pregnancy was possible and vaginal delivery was performed safely. This is the first case report of serious renal hemorrhage in a pregnant woman with antiphospholipid syndrome receiving anticoagulation treatment and is an instructive case for urological and obstetrical practitioners. 1. Introduction Antiphospholipid syndrome (APS) is a systemic autoimmune disease characterized by the presence of venous or arterial thromboembolism and/or pregnancy morbidity in association with antiphospholipid antibody (aPL). Consensus guidelines for cases of pregnancy with APS without a history of thrombosis recommend administration of low-dose aspirin in combination with unfractionated or low-molecular-weight heparin [1] because APS causes habitual abortion, intrauterine growth retardation, and severe toxemia of pregnancy at high rates. On the other hand, renal hemorrhage as an initial symptom of adverse events in administration of antiplatelet and anticoagulant drugs is very rare. Accordingly, it is difficult to assume that antiplatelet or anticoagulant drugs cause gross hematuria with severe flank pain. Here, we report a pregnant woman with APS who had severe renal hemorrhage during anticoagulation treatment. 2. Case Report A 36-year-old pregnant woman who had previously been diagnosed with APS had received anticoagulation treatment with 100?mg/day of aspirin and 12000?U/day of unfractionated heparin and had experienced abortion twice. She presented with gross hematuria at 20 weeks of pregnancy and discontinued aspirin administration. However, hematuria did not resolve, and lower left abdominal pain developed. Although hydronephrosis was not detected by ultrasound, left ureteral calculus was suspected from the
Male Infertility and Its Causes in Human
Toshinobu Miyamoto,Akira Tsujimura,Yasushi Miyagawa,Eitetsu Koh,Mikio Namiki,Kazuo Sengoku
Advances in Urology , 2012, DOI: 10.1155/2012/384520
Abstract: Infertility is one of the most serious social problems facing advanced nations. In general, approximate half of all cases of infertility are caused by factors related to the male partner. To date, various treatments have been developed for male infertility and are steadily producing results. However, there is no effective treatment for patients with nonobstructive azoospermia, in which there is an absence of mature sperm in the testes. Although evidence suggests that many patients with male infertility have a genetic predisposition to the condition, the cause has not been elucidated in the vast majority of cases. This paper discusses the environmental factors considered likely to be involved in male infertility and the genes that have been clearly shown to be involved in male infertility in humans, including our recent findings. 1. Introduction One of the most serious social problems facing developed countries today is the declining birth rate, although it is generally not well recognized that the number of infertile couples is on the rise in these countries. While both social (i.e., social progress for women and the resulting increase in the age at which women marry) and environmental (i.e., pollution and global warming) factors are behind part of the increase in the number of patients with infertility, infertility in the male partner contributes to approximately half of all cases. To date, various techniques, such as in vitro fertilization (particularly, intracytoplasmic sperm injection or ICSI) and so-called TESE-ICSI involving the harvesting of sperm from the testes, have been developed for male infertility. Although these methods are steadily producing results, no technique has proven effective for patients with nonobstructive azoospermia, in which there is an absence of mature sperm in the testes. Evidence suggests that many patients with azoospermia have a genetic predisposition to the condition, although the cause has not been elucidated in the vast majority of cases [1]. Conversely, studies using knockout mouse models have recently linked many genes to spermatogenesis, the mechanisms of which are currently being clarified. These animal findings have yet to be shown applicable to most human cases. This is because identifying the affected genes in humans requires a retrograde genetic approach and because the knockout mouse phenotype is not always faithfully reproduced in humans. This paper discusses the environmental factors considered likely to be involved in male infertility and the genes that have been clearly shown to be involved in male
Two-Way but Asymmetrical Reproductive Interference between an Invasive Veronica Species and a Native Congener  [PDF]
Koh-Ichi Takakura
American Journal of Plant Sciences (AJPS) , 2013, DOI: 10.4236/ajps.2013.43069

Recent studies have suggested that reproductive interference, a deleterious interspecific interaction in the mating process, plays an important role in biological invasions. In the system of plant species, however, the border with the pollen limitation has often been vague in past studies. This study, using field and laboratory experiments and field observations, examined the reproductive success of an endangered native herbaceous plant, Veronica polita lilacina, in the context of the reproductive interference by the alien congener, V. persica. The auto-pollination experiment confirmed that both species can usually produce seeds even without external conspecific pollens. Results of the artificial pollination experiment demonstrated that pollination with the heterospecific pollens significantly decreases the number of seeds in the native species, but not in the alien species. A transplant experiment revealed that the coexistence with the alien species reduced the fruiting success of the native species. Field observations have shown the interaction between two species in the native patch with only one intruding alien species. They demonstrated that native individuals placed closer to the alien individual suffered a greater decrease in fruiting success and the seed production and that the alien intruder produced no seed. These results demonstrate that species that could reproduce via the auto-pollination suffered the reproductive interference and that the native species also exert the resistive reproductive interference slightly. These interactions can explain the displacement pattern of the native species by the alien congener in Japan.

Rectal Lymphoma: A Diagnostic Challenge  [PDF]
Koh Ging Wong
Open Journal of Gastroenterology (OJGas) , 2015, DOI: 10.4236/ojgas.2015.54004
Abstract: Rectal lymphoma is a rare colorectal tumor with incidence of 0.2% - 0.6%. We report a rare case of large rectal lymphoma. Our patient is a 48-year-old man, presented with 2 months history of per rectal bleed, altered bowel habits and weight loss. Clinical examination, computed tomography scan and initial endoscopic mucosal biopsy were indistinguishable from Rectal Carcinoma. With high level of suspicion, we resorted to full thickness punch biopsy in lithotomy position for a good tissue sample. Ultimately, an immunohistochemical study confirmed Diffuse Large B-cells Lymphoma (DLBCL). This case highlighted the importance of high level of suspicion for lymphoma when dealing with a rectal tumor. Accurate diagnosis of rectal lymphoma affects the treatment modalities and prognosis of the patient.
Occupational health for an ageing workforce: do we need a geriatric perspective?
Gerald Koh, David Koh
Journal of Occupational Medicine and Toxicology , 2006, DOI: 10.1186/1745-6673-1-8
Abstract: The world is undergoing unprecedented ageing and in many developed countries, the workforce is contracting due to falling birthrates, longer life expectancies and changing population demographics [1]. Experts have warned that if society continues to reduce the number of people over the age of 50 who are not actively working, economies will suffer a cumulative annual loss of GDP [2]. Some countries like the UK are already introducing anti-age discrimination policies laws and retirement ages are projected to increase in the coming years [3]. Employers now have to face the prospect of having workers in their sixties. In New Zealand, the number of older persons aged 45 to 65 years is expected to increase from 35% to 45% within the working-age population between 2001 and 2051 [4]. The International Labour Organisation estimates that the number of economically active persons aged 65 years and above will increase from 83.2 million persons in the world in 2000 to 136 million persons by 2020 [5]. Occupational physicians are accustomed to managing middle-aged workers and their associated health problems but are we ready to manage elderly-related illnesses that may impact worker performance and health?Geriatrics is the branch of medicine that is devoted to the care of older people [6]. The relatively young discipline addresses the unique needs and circumstances of the elderly and is characterized by recognition of geriatric syndromes. Examples of conditions that affect the elderly include falls, impaired cognition, disability, malnutrition, incontinence and iatrogenesis. At first glance, most of these syndromes are associated with advanced age and it is unlikely that such an old person would still be working and hence be seen by an occupational physician. However, when one considers that many geriatric syndromes can present in fifth decade of life, it becomes apparent that knowledge of geriatric syndromes may be relevant to occupational health. This paper will use 2 common ger
Dongsoo Koh
Acta Crystallographica Section E , 2013, DOI: 10.1107/s1600536813006843
Abstract: In the title molecule, C22H20O5, the C=C bond of the central enone group adopts an E conformation. The dihedral angle formed by the benzene ring and the naphthalene ring system is 12.6 (4)°. The hydroxy group attached to the naphthalene ring is involved in an intramolecular O—H...O hydrogen bond. In the crystal, weak C—H...O hydrogen bonds link the molecules into chains along [010]. In addition, π–π stacking interactions are present, with centroid–centroid distances of 3.6648 (15) and 3.8661 (15) between the benzene and two naphthalene rings.
Dongsoo Koh
Acta Crystallographica Section E , 2012, DOI: 10.1107/s1600536812047319
Abstract: In the title molecule, C11H10O3, the fused dihydropyran ring is in a half-chair conformation with the O atom and the methylene C atom positioned 0.1318 (13) and 0.143 (2) , respectively, on either side of the mean plane formed by the other four atoms. In the crystal, weak C—H...O hydrogen bonds link molecules along [001].
Malaysian Family Physician , 2011,
Malaysian Family Physician , 2008,
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