著者

小野 健一郎 田之上 俊介 吉浦 徹 大川 英徳 松下 芳太郎 瀬野 宗一郎 城谷 寿樹

出版者

一般社団法人 日本脳神経外傷学会

雑誌

神経外傷 (ISSN:24343900)

巻号頁・発行日

vol.46, no.1, pp.6-11, 2023-06-30 (Released:2023-06-30)

参考文献数

12

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Background: The purpose of this study was to clarify the criteria for initial treatment of chronic subdural hematoma (CSDH) by com­paring the backgrounds and post–treatment courses of patients who underwent drainage or middle meningeal artery (MMA) emboliza­tion for CSDH.Methods: We performed a retrospective investigation of 23 and 21 patients who underwent drainage and MMA embolization, respec­tive­ly, performed between April 2020 and July 2022 as initial treatment for unilateral CSDH.Results: There was no significant difference between the drainage and embolization groups in terms of age (78 vs 76 years), gender, lateral­ity of lesion, maximum diameter of hematoma (21 vs 19 mm), pretreatment Markwalder grading system (MGS) score (1 vs 1), or length of hospital stay (5 vs 17 days) between the groups. Pretreatment midline shift was greater in the drainage group than the MMA embolization group (8.8 vs 6.6 mm). Operative time was shorter in the drainage group (32 vs 79 min). Recurrence occurred in 2/23 (8.7%) of the drain­age group, in whom addi­tional MMA embo­lization was per­formed. Additional drainage was required due to exacerbation of symptoms in 4/21 (19%) of the MMA embo­lization group. No perioperative complications occurred in either group. There was no significant difference in median pre­operative MGS score (1 vs 1) or mean maximum hematoma diameter (18 vs 19 mm) in the 17 patients who showed resolution of CSDH by MMA embolization alone or in the 4 patients who required additional drain­age. Mean midline deviation was 6.1 and 8.9 mm in the embo­lization alone and additional drainage groups, respec­tively, and was significantly greater in those who required additional drainage (p=0.002).Conclusions: The postoperative course between patients who under­went drainage or embolization for CSDH showed no significant difference in the case of very mild preoperative neurological findings (MGS score of about 1). Patient selection for MMA embolization as the initial treatment for CSDH should be clarified based on clinical symptoms and the radiological findings.

著者

吉野 潔 岩崎 達行 小野 健一郎 町田 三一 木下 忍 松原 淳 室谷 正次 西尾 紀昭 安井 俊彦

出版者

JAPAN TECHNICAL ASSOCIATION OF THE PULP AND PAPER INDUSTRY

雑誌

紙パ技協誌 (ISSN:0022815X)

巻号頁・発行日

vol.53, no.10, pp.1345-1352, 1999 (Released:2009-11-19)

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To control the generation of “(*slime*)” which became a problem when the papermaking process drain was reused, we examined sterilization tests by using ultraviolet (UV) radiation and hydrogenperoxide (HP) together. It was confirmed general bacilli was able to be sterilized by changing the amount of the UV radiation and the amount of the addition HP at an arbitrary level and the proliferation control was effective.Next, we examined the number of general bacilli which existed together on the household papers, such as toiletpapers and tissues. Hundreds of general bacilli a piece in toiletpapers detected and tens of it a piece in tissues. When the UV radiation was irradiated to these papers, it was understood not to detect a general bacillus by one side 30 (mj/cm2) level if both sides were irradiated. When UV radiation was irradiated after HP do atomization, it was confirmed to be able to sterilize even with the HP a low density and the amount of the UV radiation of a low level. Sterilization and the water processing technology by UV radiation and HP using together are thought to be a technology which can be used by various scenes of the papermaking process.