32 results on '"Yoshihiko Onishi"'
Search Results
2. Cost-effectiveness of TAS-102 plus bevacizumab versus TAS-102 monotherapy in patients with metastatic colorectal cancer
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Kiyoaki Sugiura, Yuki Seo, Takayuki Takahashi, Hideyuki Tokura, Yasuhiro Ito, Motomu Tanaka, Norihiro Kishida, Yusuke Nishi, Yoshihiko Onishi, and Hikaru Aoki
- Subjects
Colorectal cancer ,TAS-102 ,Bevacizumab ,Cost-effectiveness ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Abstract Background TAS-102 plus bevacizumab is an anticipated combination regimen for patients who have metastatic colorectal cancer. However, evidence supporting its use for this indication is limited. We compared the cost-effectiveness of TAS-102 plus bevacizumab combination therapy with TAS-102 monotherapy for patients with chemorefractory metastatic colorectal cancer. Method Markov decision modeling using treatment costs, disease-free survival, and overall survival was performed to examine the cost-effectiveness of TAS-102 plus bevacizumab combination therapy and TAS-102 monotherapy. The Japanese health care payer’s perspective was adopted. The outcomes were modeled on the basis of published literature. The incremental cost-effectiveness ratio (ICER) between the two treatment regimens was the primary outcome. Sensitivity analysis was performed and the effect of uncertainty on the model parameters were investigated. Results TAS-102 plus bevacizumab had an ICER of $21,534 per quality-adjusted life-year (QALY) gained compared with TAS-102 monotherapy. Sensitivity analysis demonstrated that TAS-102 monotherapy was more cost-effective than TAS-102 and bevacizumab combination therapy at a willingness-to-pay of under $50,000 per QALY gained. Conclusions TAS-102 and bevacizumab combination therapy is a cost-effective option for patients who have metastatic colorectal cancer in the Japanese health care system.
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- 2021
- Full Text
- View/download PDF
3. Bridge to Surgery for Obstructing Colonic Cancer: A Comparison between Right- and Left-sided Lesions
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Kiyoaki Sugiura, Yuki Seo, Hikaru Aoki, Yoshihiko Onishi, Yusuke Nishi, Norihiro Kishida, Motomu Tanaka, Yasuhiro Ito, Hideyuki Tokura, and Takayuki Takahashi
- Subjects
colon cancer ,obstruction ,right-sided ,left-sided ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Objectives: Few studies have compared management and outcomes of bridge to surgery (BTS) for obstructive colonic cancer according to the location of the tumor. Additional information is needed about this procedure's characteristics and short-term and long-term outcomes. We aimed to compare patient and tumor characteristics, and outcomes of BTS for obstructive right-sided versus left-sided colonic cancers. Methods: This was a retrospective, single center, cohort study. The study cohort comprised 149 patients, including 48 with right-sided and 101 with left-sided obstructive colonic cancers, who were treated with BTS between January 2007 and December 2017. Data on medical history, investigations, treatments, and prognosis were collected from an electronic database of a single hospital. The primary end points were overall (OS) and disease-free (DFS) survival and short-term surgical outcomes. Results: Significantly more patients with right-sided cancers had postoperative complications (29.2% vs. 14.9%, p = 0.039). Additionally, postoperative chemotherapy was administered to a marginally significantly greater proportion of patients with left-sided cancers (29.2% vs 45.5%, p = 0.057). The long-term outcomes were comparable between the two groups (the 5-year OS rates were 67.6% and 80.9% [p = 0.117] and the 5-year DFS rates were 62.2% and 58.6% [p = 0.671]). Multivariate analyses using all studied variables showed that lymphovascular invasion, advanced T stage, and adjuvant chemotherapy were independent poor prognostic factors. Conclusions: The long-term outcome was not different between the right- and left-sided groups. In a BTS setting, postoperative complications may reduce the compliance of adjuvant chemotherapy in right-sided cancers and affect long-term outcomes.
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- 2021
- Full Text
- View/download PDF
4. Usefulness of Transesophageal Echocardiography in Diagnosing the Cause of Circulatory Collapse During Reoperation for an Inferior Vena Cava-Left Atrium Shunt After Atrial Septal Defect Closure: A Case Report.
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Kaori Matsumura, Takuma Maeda, Akiyuki Kotoku, and Yoshihiko Onishi
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- 2024
- Full Text
- View/download PDF
5. Outcomes after Rivaroxaban Treatment of Extensive Deep Vein Thrombosis
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Shunichiro Fujioka, Tadashi Kitamura, Fumiaki Shikata, Toshiaki Mishima, Yoshihiko Onishi, Haruna Araki, Hiroshi Goto, Akihiro Sasahara, Masaomi Fukuzumi, Shinzo Torii, and Kagami Miyaji
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Venous Thrombosis ,Treatment Outcome ,Rivaroxaban ,Anticoagulants ,Humans ,Thrombolytic Therapy ,Thrombosis ,Surgery ,General Medicine ,Iliac Vein ,Cardiology and Cardiovascular Medicine ,Retrospective Studies - Abstract
Regression of thrombus in response to treatment with direct oral anticoagulants (DOACs) in patients with extensive deep vein thrombosis (DVT) has not been fully evaluated. This study aimed to determine the therapeutic efficacy of rivaroxaban in the treatment of extensive DVT.We retrospectively evaluated 76 patients treated with rivaroxaban among 728 new DVT patients, at our hospital from January 2018 to March 2021. Extensive DVT was defined as thrombus connecting to 2 or more segments of the inferior vena cava (IVC), iliac vein, femoral vein, or popliteal vein. Localized DVT was defined as a thrombus confined to 1 segment of the inferior vena cava (IVC), iliac vein, femoral vein, or popliteal vein. We compared the changes in thrombus between the extensive DVT group (36 patients) and the localized DVT group (40 patients).In the localized DVT group, 14 (37%) had total recanalization within 3 weeks after DOAC initiation, and 30 (79%) had total recanalization within 3 months. In the extensive DVT group, only 3 (9%) had total recanalization within 3 weeks after starting DOAC, and even after 3 months, only 5 (15%) had total recanalization. Symptoms (P = 0.01) and extensive DVT (P 0.01) were significantly associated with the risk for failure of total recanalization.Rivaroxaban was highly effective for total recanalization of localized DVT but not for symptomatic or extensive DVT. In patients with symptomatic extensive DVT, catheter-based thrombolysis may be considered in selected cases.
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- 2022
6. Bridge to Surgery for Obstructing Colonic Cancer: A Comparison between Right- and Left-sided Lesions
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Yasuhiro Ito, Yusuke Nishi, Yoshihiko Onishi, Takayuki Takahashi, Hikaru Aoki, Hideyuki Tokura, Yuki Seo, Norihiro Kishida, Kiyoaki Sugiura, and Motomu Tanaka
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medicine.medical_specialty ,right-sided ,left-sided ,Multivariate analysis ,Lymphovascular invasion ,Colorectal cancer ,business.industry ,Single Center ,medicine.disease ,obstruction ,colon cancer ,Internal medicine ,Cohort ,medicine ,T-stage ,Medical history ,lcsh:Diseases of the digestive system. Gastroenterology ,Original Research Article ,lcsh:RC799-869 ,business ,Cohort study - Abstract
Objectives Few studies have compared management and outcomes of bridge to surgery (BTS) for obstructive colonic cancer according to the location of the tumor. Additional information is needed about this procedure's characteristics and short-term and long-term outcomes. We aimed to compare patient and tumor characteristics, and outcomes of BTS for obstructive right-sided versus left-sided colonic cancers. Methods This was a retrospective, single center, cohort study. The study cohort comprised 149 patients, including 48 with right-sided and 101 with left-sided obstructive colonic cancers, who were treated with BTS between January 2007 and December 2017. Data on medical history, investigations, treatments, and prognosis were collected from an electronic database of a single hospital. The primary end points were overall (OS) and disease-free (DFS) survival and short-term surgical outcomes. Results Significantly more patients with right-sided cancers had postoperative complications (29.2% vs. 14.9%, p = 0.039). Additionally, postoperative chemotherapy was administered to a marginally significantly greater proportion of patients with left-sided cancers (29.2% vs 45.5%, p = 0.057). The long-term outcomes were comparable between the two groups (the 5-year OS rates were 67.6% and 80.9% [p = 0.117] and the 5-year DFS rates were 62.2% and 58.6% [p = 0.671]). Multivariate analyses using all studied variables showed that lymphovascular invasion, advanced T stage, and adjuvant chemotherapy were independent poor prognostic factors. Conclusions The long-term outcome was not different between the right- and left-sided groups. In a BTS setting, postoperative complications may reduce the compliance of adjuvant chemotherapy in right-sided cancers and affect long-term outcomes.
- Published
- 2021
7. Cost-effectiveness of TAS-102 plus bevacizumab versus TAS-102 monotherapy in patients with metastatic colorectal cancer
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Norihiro Kishida, Yoshihiko Onishi, Yuki Seo, Yusuke Nishi, Hikaru Aoki, Kiyoaki Sugiura, Hideyuki Tokura, Takayuki Takahashi, Motomu Tanaka, and Yasuhiro Ito
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Oncology ,medicine.medical_specialty ,Pyrrolidines ,animal structures ,Bevacizumab ,Combination therapy ,Cost effectiveness ,Colorectal cancer ,Cost-Benefit Analysis ,RC799-869 ,Trifluridine ,03 medical and health sciences ,0302 clinical medicine ,Primary outcome ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,In patient ,030212 general & internal medicine ,health care economics and organizations ,business.industry ,Research ,Gastroenterology ,General Medicine ,Diseases of the digestive system. Gastroenterology ,Hepatology ,TAS-102 ,medicine.disease ,Drug Combinations ,Regimen ,030220 oncology & carcinogenesis ,Cost-effectiveness ,Quality-Adjusted Life Years ,Colorectal Neoplasms ,business ,Thymine ,medicine.drug - Abstract
Background TAS-102 plus bevacizumab is an anticipated combination regimen for patients who have metastatic colorectal cancer. However, evidence supporting its use for this indication is limited. We compared the cost-effectiveness of TAS-102 plus bevacizumab combination therapy with TAS-102 monotherapy for patients with chemorefractory metastatic colorectal cancer. Method Markov decision modeling using treatment costs, disease-free survival, and overall survival was performed to examine the cost-effectiveness of TAS-102 plus bevacizumab combination therapy and TAS-102 monotherapy. The Japanese health care payer’s perspective was adopted. The outcomes were modeled on the basis of published literature. The incremental cost-effectiveness ratio (ICER) between the two treatment regimens was the primary outcome. Sensitivity analysis was performed and the effect of uncertainty on the model parameters were investigated. Results TAS-102 plus bevacizumab had an ICER of $21,534 per quality-adjusted life-year (QALY) gained compared with TAS-102 monotherapy. Sensitivity analysis demonstrated that TAS-102 monotherapy was more cost-effective than TAS-102 and bevacizumab combination therapy at a willingness-to-pay of under $50,000 per QALY gained. Conclusions TAS-102 and bevacizumab combination therapy is a cost-effective option for patients who have metastatic colorectal cancer in the Japanese health care system.
- Published
- 2021
8. Risk Factors for Progression of Distal Deep Vein Thrombosis
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Kazuki Yakuwa, Tadashi Kitamura, Yoshihiko Onishi, Yuki Tadokoro, Kagami Miyaji, Haruna Araki, Toshiaki Mishima, Shinzo Torii, Shunichiro Fujioka, Takuya Matsushiro, Hirotoki Ohkubo, and Takashi Miyamoto
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Male ,medicine.medical_specialty ,medicine.medical_treatment ,Deep vein ,Compression stockings ,030204 cardiovascular system & hematology ,Treatment results ,Bed rest ,Conservative Treatment ,Fibrin Fibrinogen Degradation Products ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Neoplasms ,Medicine ,Humans ,cardiovascular diseases ,030212 general & internal medicine ,Thrombus ,Vein ,Ultrasonography, Interventional ,Aged ,Retrospective Studies ,Aged, 80 and over ,Venous Thrombosis ,Leg ,business.industry ,Cancer ,Anticoagulants ,General Medicine ,Middle Aged ,medicine.disease ,Thrombosis ,Surgery ,medicine.anatomical_structure ,Treatment Outcome ,Disease Progression ,Female ,Sedentary Behavior ,Cardiology and Cardiovascular Medicine ,business ,Pulmonary Embolism ,Stockings, Compression ,Follow-Up Studies - Abstract
Background There is insufficient evidence regarding the optimal treatment method for distal deep vein thrombosis (DVT), including indications for anticoagulation therapy. Treatment results of patients with distal DVT were evaluated to clarify the risk factors that result in extension of distal DVT to the proximal vein and indications for anticoagulation therapy.Methods and Results:Among 430 patients with DVT between January 2018 and December 2019, 253 were diagnosed with distal DVT; 41 patients who had already started anticoagulation therapy were excluded, and the remaining 212 were included as study subjects. Anticoagulation therapy was not started immediately; conservative treatment with compression stockings was performed. Ultrasonography after 2 weeks revealed thrombus disappearance in 39 patients (21%), and thrombus reduction in 38 patients (20%). In contrast, extension of thrombus to the proximal vein was noted in 12 patients (6.3%) and anticoagulation therapy was commenced. After 3 months, the thrombus had disappeared in 75 patients (52%). No patient developed pulmonary thromboembolism during follow-up. With respect to the risk factors for extension to proximal vein during conservative treatment, active cancer (P=0.03), prolonged bed rest (P 8µg/mL (P=0.01) were identified. Conclusions It is reasonable to consider anticoagulation therapy in distal DVT patients with active cancer, prolonged bed rest or high D-dimer level.
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- 2020
9. Long-term and short-term outcomes of laparoscopic versus open resection following tube decompression for obstructive colorectal cancer: a single-center retrospective study
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Kiyoaki Sugiura, Yuki Seo, Hikaru Aoki, Yoshihiko Onishi, Yusuke Nishi, Norihiro Kishida, Motomu Tanaka, Yasuhiro Ito, Hideyuki Tokura, and Takayuki Takahashi
- Subjects
Decompression ,Treatment Outcome ,Humans ,Surgery ,Laparoscopy ,General Medicine ,Colorectal Neoplasms ,Retrospective Studies - Abstract
The benefits of laparoscopic surgery over open surgery are well documented; however, the suitability of laparoscopic surgery for obstructive colorectal cancer is still controversial. The aim of this retrospective study was to compare the clinical benefits of laparoscopic surgery vs. open surgery for obstructive colorectal cancer after tube decompression.We analyzed the outcomes of patients who underwent laparoscopic surgery vs. open surgery for curative resection after tube decompression for obstructive colorectal cancer at our hospital between January, 2007 and March, 2018.This study comprised 67 patients: 29 patients who underwent open surgery and 38 patients who underwent laparoscopic surgery. The morbidity within 30 days after surgery was comparable between the groups. The 3-year overall survival rates of the open and laparoscopic groups were 83.3 and 79.4%, respectively (p = 0.6244), and the 3-year disease-free survival rates were 59.3 and 71.2%, respectively (p = 0.3200). Multivariate analysis showed that nodal stage (p = 0.021) was an independent prognostic factor for OS and sex (p = 0.010) and side-ness (p = 0.048) were independent prognostic factors for DFS.If adequate decompression is achieved, laparoscopic resection following tube decompression for obstructive colorectal cancer can be a safe alternative to open surgery.
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- 2020
10. Watch-and-wait strategy for type A intramural haematoma and acute aortic dissection with thrombosed false lumen of the ascending aorta: a Japanese single-centre experience
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Tadashi Kitamura, Haruna Araki, Hirotoki Ohkubo, Yuki Tadokoro, Shin Kondo, Toshiaki Mishima, Takashi Miyamoto, Shinzo Torii, Shunichiro Fujioka, Kazuki Yakuwa, Yoshimi Tamura, Yoshihiko Onishi, and Kagami Miyaji
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Pulmonary and Respiratory Medicine ,Male ,medicine.medical_specialty ,False lumen ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Japan ,medicine.artery ,Cardiac tamponade ,Ascending aorta ,medicine ,Humans ,Aorta ,Aged ,Retrospective Studies ,Aortic dissection ,Hematoma ,Aortic Aneurysm, Thoracic ,business.industry ,General Medicine ,medicine.disease ,Thrombosis ,Surgery ,Intramural haematoma ,Aortic Dissection ,030228 respiratory system ,Female ,Aortic diameter ,Cardiology and Cardiovascular Medicine ,business - Abstract
OBJECTIVES In this study, we investigated the early and midterm outcomes of initial watch-and-wait strategy for Stanford type A intramural haematoma and acute aortic dissection with thrombosed false lumen of the ascending aorta in patients with a maximum aortic diameter of ≤50 mm, pain score of ≤3/10 and no ulcer-like projection in the ascending aorta. METHODS Inpatient and outpatient records were retrospectively reviewed. RESULTS Of the 81 patients with type A intramural haematoma and acute aortic dissection with the thrombosed false lumen of the ascending aorta between April 2011 and April 2019, a watch-and-wait strategy was selected in 46 patients. The mean age of the patients was 68 years, and 22 (48%) patients were female. Ten patients underwent emergency pericardial drainage for cardiac tamponade at the time of presentation and 8 patients underwent aortic repair during hospitalization for new ulcer-like projection, re-dissection or rupture. In-hospital mortality occurred in 2 (4%) patients. During follow-up, survival at 1 and 2 years was 95% and 92%, respectively. There was no significant difference in survival or aortic events between patients in whom the watch-and-wait strategy and emergency surgical treatment were indicated. CONCLUSIONS The early and midterm outcomes of the initial watch-and-wait strategy were favourable for type A intramural haematoma and acute aortic dissection with the thrombosed false lumen of the ascending aorta in Japanese patients with a maximum aortic diameter of ≤50 mm, pain score of ≤3/10 and no ulcer-like projection. Further study is required to show the safety of this strategy.
- Published
- 2019
11. Association Between Motor-Evoked Potentials and Spinal Cord Damage Diagnosed With Magnetic Resonance Imaging After Thoracoabdominal and Descending Aortic Aneurysm Repair
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Yoshiteru Mori, Shinya Kato, Yusuke Yoshikawa, Yoshitsugu Yamada, Kazuko Hasegawa, Manabu Kakinohana, Mikito Kawamata, Michiaki Yamakage, Masahiko Kawaguchi, Yoshihiko Onishi, Kimitoshi Nishiwaki, Kohshi Hattori, Shunsuke Izumi, and Kenji Yoshitani
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Male ,medicine.medical_specialty ,Spinal mri ,03 medical and health sciences ,0302 clinical medicine ,030202 anesthesiology ,medicine ,Humans ,Spinal cord injury ,Aged ,Retrospective Studies ,Aged, 80 and over ,medicine.diagnostic_test ,Aortic Aneurysm, Thoracic ,business.industry ,Medical record ,Magnetic resonance imaging ,Retrospective cohort study ,Vascular surgery ,Middle Aged ,Spinal cord ,medicine.disease ,Evoked Potentials, Motor ,Magnetic Resonance Imaging ,Anesthesiology and Pain Medicine ,medicine.anatomical_structure ,Logistic Models ,Spinal Cord ,Infarction ,Female ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,030217 neurology & neurosurgery ,Descending aortic aneurysm - Abstract
The authors investigated the association between intraoperative motor-evoked potential (MEP) changes and the severity of spinal cord infarction diagnosed with magnetic resonance imaging (MRI) to clarify the discrepancy between them, which was observed in patients with postoperative motor deficits after thoracic and thoracoabdominal aortic surgery.A multicenter retrospective study.Motor-evoked potential25% of control values was deemed positive for spinal cord ischemia. The severity of spinal cord infarction was categorized into grades A to D based on previous studies using the most severe axial MRI slices. The associations between MRI grade, MEP changes, and motor deficits were examined using logistic regression.Twenty-three of 1,245 patients (from 1999 to 2013, at 12 hospitals in Japan) were extracted from medical records of patients who underwent thoracic and thoracoabdominal aortic repair, with intraoperative MEP examinations and postoperative spinal MRI.No intervention (observational study).Motor-evoked potential25% of control value was associated significantly with motor deficits at discharge (adjusted odds ratio [OR], 130.0; p = 0.041), but not with severity of spinal cord infarction (adjusted OR, 0.917; p = 0.931). Motor deficit at discharge was associated with severe spinal cord infarction (adjusted OR, 4.83; p = 0.043), MEP25% (adjusted OR, 13.95; p = 0.031), and combined deficits (motor and sensory, motor and bowel or bladder, or sensory and bowel or bladder deficits; adjusted OR, 31.03; p = 0.072) in stepwise logistic regression analysis.Motor-evoked potential25% was associated significantly with motor deficits at discharge, but not with the severity of spinal cord infarction.
- Published
- 2018
12. Initial experience using Excimer laser for the extraction of chronically implanted pacemaker and implantable cardioverter defibrillator leads in Japanese patients
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Teruyuki Hayashi, Yusuke Shimahara, Junjiro Kobayashi, Yoshihiko Onishi, Shiro Kamakura, Ikutaro Nakajima, Hideo Okamura, Koji Ogawa, Hisao Ogawa, Satoshi Yasuda, Shunsuke Sato, Takashi Noda, and Wataru Shimizu
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Adult ,Male ,medicine.medical_specialty ,Pacemaker, Artificial ,medicine.medical_treatment ,Laser ,Body Mass Index ,Defibrillator ,Asian People ,Internal medicine ,medicine ,Humans ,Device Removal ,Implanted pacemaker ,Aged ,Retrospective Studies ,Aged, 80 and over ,Infectious disease ,Lead extraction ,Excimer laser ,Venous occlusion ,business.industry ,Age Factors ,Retrospective cohort study ,Middle Aged ,Implantable cardioverter-defibrillator ,Left behind ,Surgery ,Defibrillators, Implantable ,Pacemaker ,Treatment Outcome ,Cardiology ,Equipment Failure ,Female ,Lasers, Excimer ,Implant ,business ,Cardiology and Cardiovascular Medicine - Abstract
Background Given the exponential growth in cardiac device implantations, the need for less invasive lead extraction is increasing. The Excimer laser was approved for lead removal in Japan in 2010. The present study reports the initial experience using this novel technique to extract chronically implanted pacemaker and implantable cardioverter defibrillator (ICD) leads from Japanese patients. Methods and results We performed a retrospective study of consecutive patients undergoing lead extraction using the laser sheath at a single Japanese center. Patient and lead characteristics, indications, and outcomes were analyzed. From August 2010 to September 2012, a total of 70 leads, including 14 ICD leads, were removed using the laser sheath from 40 patients (26 male, 14 female; age 65.5 ± 18.3 [mean ± SD] years; body mass index 21.8 ± 3.5 kg/m2). The median implant duration was 87 months (range 13–328 months). Indications were infection (n = 35), venous occlusion (n = 4), and pain (n = 1). The femoral approach was used in combination with the laser technique in five cases. Complete procedural success was achieved with 68 leads (97.1%). Although the electrode tip was left behind in the remaining two leads, the desired clinical outcomes could be achieved; which were defined as clinical success. No cases resulted in failure. There were no major complications, including death and bleeding requiring open-chest surgery. Conclusions Laser sheaths appear to provide a feasible and effective means of extracting chronically implanted pacemaker and ICD leads in Japanese patients.
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- 2013
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13. Anesthetic Management of Pregnant Women with Stroke
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Kenji Yoshitani and Yoshihiko Onishi
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- 2015
14. [Untitled]
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YOSHIHIKO ONISHI
- Published
- 2001
15. Diagnosis and treatment of myocardial ischemia in the cardiac surgery. Sutra gullet echo and mechanical support
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Yoshihiko Onishi
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medicine.medical_specialty ,Myocardial ischemia ,business.industry ,Internal medicine ,Echo (computing) ,medicine ,Cardiology ,Radiology ,business ,Cardiac surgery - Published
- 1998
16. Preoperative evaluation of heart failure patients and anesthetic planning. Preoperative evaluation of dilated cardiomyopathy
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Yoshihiko Onishi
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medicine.medical_specialty ,business.industry ,Heart failure ,Anesthesia ,Internal medicine ,Anesthetic ,medicine ,Cardiology ,Dilated cardiomyopathy ,medicine.disease ,business ,medicine.drug - Published
- 1997
17. [Undiagnosed hereditary angioedema in a patient undergoing emergency caesarean section]
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Yukihiko, Tomita, Masataka, Kamei, Satoshi, Jyujou, Chinami, Horiuchi, Shinji, Katsuragi, and Yoshihiko, Onishi
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Adult ,Cesarean Section ,Angioedemas, Hereditary ,Humans ,Female ,Emergencies ,Complement C1 Inhibitor Protein - Abstract
Hereditary angioedema (HAE) is characterized by acute, recurrent attacks of localized edema. Surgical procedures, trauma, and infections have been considered as potential triggers of HAE. Although HAE is a rare genetic disorder, approximately 50-60% of all HAE patients are involved with at least one occurrence of upper airway obstruction. The airway trouble is the most life-threating complication in HAE patients because HAE-related edema does not respond to typical treatment, such as administration of epinephrine, antihistamines, or glucocorticoids. Indeed, mortality rates of laryngeal attack are estimated around 25% to 40%. Here we describe a case of undiagnosed HAE patient undergoing emergency caesarean section under neuraxial blockade. A 31-year-old woman showed multiple regions at her lip margin during surgery and rapidly developed lip swelling after admission to the ward. Neither respiratory nor hemodynamic instability was found during and after surgery. Immediately, in order to assess whether HAE caused these dermatological manifestations, we measured values of both complement component 4 (C4) and functional activity of C1-esterase inhibitor (C1-inh), a protein of the complement system. These laboratory data showed low levels, which were compatible with HAE definition. After commencement of C1-inhibitor replacement therapy, her lip swelling and erythema gradually disappeared without adverse drug reactions. The patient was finally discharged from our institution 10 days after surgery.
- Published
- 2013
18. [Bladder temperature versus tympanic temperature in patients undergoing abdominal aortic aneurysm surgery]
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Yukihiko, Tomita, Masataka, Kamei, Ken, Kuwajima, Yuzuru, Inatomi, Takuma, Maeda, and Yoshihiko, Onishi
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Adult ,Tympanic Membrane ,Urinary Bladder ,Humans ,Aortic Aneurysm, Abdominal ,Body Temperature ,Retrospective Studies - Abstract
Inaccurate measurements of body temperature might be associated with complications during the perioperative period. We conducted a retrospective cohort study to compare the bladder temperature and the tympanic membrane temperature in patients undergoing open repair of abdominal aortic aneurysm.Fifteen adult patients who had undergone general anesthesia with/without epidural anesthesia were included in the present cohort. The bladder and the tympanic temperatures were simultaneously recorded at 6 points during surgery. One-way repeated measures ANOVA and Bland-Altman analysis were performed to assess statistical significance. The two-tailed P values less than 0.05 were considered statistically significant.No difference was found between the bladder and the tympanic temperatures before abdominal aortic cross-clamping. However, during and after cross-clamping, the bladder temperature values were likely to be lower compared with the tympanic values. The average temperature difference (+/- 2 SD) was 0.4 degrees C (+/- 1.1 degrees C) (95% CI: -1.21-0.78).The tympanic membrane might be a reliable site for core body temperature measurement in abdominal aortic aneurysm surgery patients.
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- 2012
19. [Effectiveness of underbody type forced-air warming blanket during endovascular aneurysm repair]
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Masafumi, Idei, Kenji, Yoshitani, Takuma, Maeda, and Yoshihiko, Onishi
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Heating ,Male ,Intraoperative Care ,Endovascular Procedures ,Bedding and Linens ,Humans ,Female ,Stents ,Hypothermia ,Intraoperative Complications ,Aged ,Aortic Aneurysm, Abdominal - Abstract
Intraoperative hypothermia is frequently observed during endovascular aneurysm repair (EVAR), leading to postoperative serious sequelae. We evaluated the effectiveness of underbody type forced-air warming blanket against hypothermia during EVAR.Medical records of 144 patients who had undergone EVAR, were reviewed to investigate the body temperature and whether patients had been extubated in operating rooms.Seventy nine patients used underbody type forced-air warming blanket (blanket group) and 64 patients no warming system (NW group). The intraoperative lowest core temperature and core temperature at the end of the operation were higher in the blanket group (36.0 degrees C vs 35.6 degrees C, P0.001, 36.4 degrees C vs 35.6 degrees C, P0.001). In the blanket group extubation was performed in all patients, although five patients could not be extubated in the NW group.Underbody type forced-air warming blanket is effective to prevent intraoperative hypothermia during EVAR.
- Published
- 2012
20. [Brain protection in aortic surgery]
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Kenji, Yoshitani and Yoshihiko, Onishi
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Extracorporeal Circulation ,Aortic Aneurysm, Thoracic ,Hypothermia, Induced ,Cerebrovascular Circulation ,Humans ,Vascular Surgical Procedures - Published
- 2012
21. [Cytokine]
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Koichi, Matsumoto, Terumi, Higuchi, Yoshihiko, Onishi, Masanori, Abe, Erina, Okawa, and Noriaki, Maruyama
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Membrane Glycoproteins ,Micropore Filters ,Antigen-Presenting Cells ,Biocompatible Materials ,Membranes, Artificial ,Hemodiafiltration ,T-Lymphocytes, Helper-Inducer ,Hemodialysis Solutions ,CD28 Antigens ,Antigens, CD ,Renal Dialysis ,Cytokines ,Humans ,Kidney Failure, Chronic ,B7-2 Antigen ,Inflammation Mediators - Published
- 2004
22. Sclerosing encapsulating peritonitis: regional changes of peritoneum
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Yuji Nagura, Masayoshi Soma, Katsuo Kanmatsuse, Yoshihiko Onishi, Satoshi Saito, Susumu Takahashi, Toshinori Oinuma, and Kazuyoshi Okada
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Adult ,medicine.medical_specialty ,Pathology ,Ileus ,medicine.medical_treatment ,Peritonitis ,Peritoneal dialysis ,Peritoneum ,Peritoneal Dialysis, Continuous Ambulatory ,Renal Dialysis ,medicine ,Humans ,Sclerosis ,Ossification ,business.industry ,Continuous ambulatory peritoneal dialysis ,medicine.disease ,Surgery ,Bowel obstruction ,medicine.anatomical_structure ,Kidney Failure, Chronic ,Female ,Stress, Mechanical ,medicine.symptom ,business ,Calcification - Abstract
Sclerosing encapsulating peritonitis (SEP) is characterized by the diffuse appearance of marked sclerotic thickening of the peritoneal membrane. We experienced a case with SEP accompanied by regional changes of peritoneum. A 37-year-old woman with end-stage renal failure was started on continuous ambulatory peritoneal dialysis in 1985 and was transferred to hemodialysis in 1997. She was admitted because of ileus in 1998 with SEP and died of septicemia. The diagnosis of SEP was confirmed via the autopsy. The root of the mesentery was retracted and shortened. Since the peritoneal change was marked in the regions with free margin of mesentery and was less apparent in the regions not adhered to mesentery, it is indicated that mechanical stress also contributes to the occurrence of SEP. Since calcification and ossification were only seen in a free margin of small bowel from mesentery, it is suggested that there is a close relationship between calcification and ossification. Since fibrosis invaded into the muscle layer, dysfunction of bowel movement as well as bowel obstruction contributed to the appearance of ileus. It is suggested that mechanical stress by the root of mesentery which is retracted and shortened also contributes to the appearance of SEP.
- Published
- 2002
23. Co-based alloy media with a high coercivity prepared by heat treatment after sputtering
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M. Sate, Yoshihiko Onishi, and A. Nakaue
- Subjects
Materials science ,Alloy ,Analytical chemistry ,Energy-dispersive X-ray spectroscopy ,Sputter deposition ,engineering.material ,Coercivity ,Grain size ,Electronic, Optical and Magnetic Materials ,Sputtering ,Scanning transmission electron microscopy ,engineering ,Grain boundary ,Electrical and Electronic Engineering - Abstract
The effects of heat treatment on magnetic properties of Co-based alloy thin-film media using newly developed carbon substrates is discussed. High coercivity (Hc) can be obtained by heat treatment after sputtering using a Zr thin-film as a protective layer. In the case of Zr/Co/sub 62.5/Ni/sub 30/Cr/Cr thin-film media, Hc of 3500 Oe was obtained after heat treatment at 650 degrees C for one minute. No significant change was found in the grain size after heat treatment. From the results of a compositional analysis using X-ray energy dispersive spectroscopy (EDS) in high resolution scanning transmission electron microscopy (HRSTEM), it was found that Cr was segregated from the Cr underlayer to the grain boundary of the Co-based alloy with increasing heat treatment temperature. >
- Published
- 1993
24. Co alloy media made on amorphous carbon substrate
- Author
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Hidetoshi Inoue, Hidetaka Hayashi, Motoharu Sato, Mark R. Visokay, Yoshihiko Onishi, Masago Kuwabara, and Kazuo Muramatsu
- Subjects
Materials science ,Alloy ,General Physics and Astronomy ,chemistry.chemical_element ,Mineralogy ,Substrate (electronics) ,engineering.material ,Coercivity ,Amorphous solid ,Amorphous carbon ,chemistry ,Chemical engineering ,engineering ,NIP ,Thin film ,Carbon - Abstract
Co‐based alloy media were made on recently developed ultra densified amorphous carbon (UDAC) substrates which have several advantages over NiP/Al, glass, and ceramics substrates. It was found that the coercivity (Hc) of media made on UDAC substrates was higher than that on NiP/Al substrates, as was the adhesion performance. The latter is a result of the formation of Cr–C compound at the interface.
- Published
- 1993
25. Relationship between insulin resistance and uremic toxins in the gastrointestinal tract
- Author
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Terumi Higuchi, Kyoko Aoki, Katsuo Kanmatsuse, Erina Okawa, Chihiro Hagi, Hiroshi Shibahara, Kazuyoshi Okada, Yoshihiko Onishi, Yoshiko Takahashi, Yuji Nagura, and Susumu Takahashi
- Subjects
Blood Glucose ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Renal function ,Blood Urea Nitrogen ,Diabetic nephropathy ,Rats, Sprague-Dawley ,Enterotoxins ,Insulin resistance ,Internal medicine ,Medicine ,Animals ,Insulin ,Diabetic Nephropathies ,Blood urea nitrogen ,Uremia ,Gastrointestinal tract ,business.industry ,Body Weight ,Oxides ,medicine.disease ,Nephrectomy ,Carbon ,Rats ,Disease Models, Animal ,Proteinuria ,Endocrinology ,Creatinine ,Adsorption ,Insulin Resistance ,business ,Digestive System ,Kidney disease - Abstract
The relationship between insulin resistance and local uremic toxins was examined using an oral adsorbent. Fourteen rats demonstrating a diabetic state underwent two-thirds, nephrectomy and were divided into two groups. The control group was fed standard rat chow, and the test group was fed standard rat chow containing 5% AST-120. The target level of blood glucose was achieved by controlling the dosage of exogenous insulin. All rats were sacrificed at week 6. Body weight, blood glucose level, and renal function at week 6 were not significantly different between both groups. However, the mean blood glucose level and the mean dose of exogenous insulin in the AST-120-fed group were significantly reduced as compared with the control group. The results of the present study indicate that administration of an oral adsorbent in diabetic nephropathy decreases the doses of exogenous insulin and improves insulin resistance, and that uremic toxins which exist in the gastrointestinal tract play important roles.
- Published
- 2001
26. Ultra densified amorphous carbon (UDAC) substrate for hard disks
- Author
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Motoharu Sato, Kazuo Muramatsu, Yoshihiko Onishi, Yoshihiro Hara, and Masakazu Nakao
- Subjects
Materials science ,Amorphous carbon ,NIP ,Substrate (printing) ,Coercivity ,Composite material - Abstract
An ultra-high temperature HIP method was applied for amorphous carbon to eliminate micro pores, which amorphous carbon generally has. Ultra densified amorphous carbon (UDAC) substrate has many favourable characteristics for hard disk substrates, and mechanical texturing methods, which are generally used in texturing of NiP/AI substrates, can be applied. High coercivity can be obtained by using a circumferentially textured UDAC substrate.
- Published
- 1994
27. Heat Treatment Effects On Magnetic Properties Of Co Alloy Media Using Carbon Substrate
- Author
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M. Sate, A. Nakaue, Yoshihiko Onishi, K. Muramatsu, and H. Hayashi
- Subjects
Materials science ,Sputtering ,Chromium Alloys ,Alloy ,Metallurgy ,engineering ,Magnetic films ,Carbon substrate ,engineering.material - Published
- 1993
28. Subject Index Vol. 88, 2001
- Author
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Hiroko Yamasaki, David A. Sampson, Aydan Ikinciogullari, Janice Green, Gavin J. Becker, Cüneyt Ensari, Hassane Izzedine, Hiroshi Shibahara, Yoshihiko Kawarada, Yuji Nagura, Masahiro Hiraoka, F. Grases, Kazuo Fujisawa, Seiki Ito, Chikahide Hori, Katsuo Suyama, Mitsufumi Mayumi, Yusei Ohshima, D. Grekas, Norishige Yoshikawa, Tim D. Hewitson, Kazuo Tsuzuki, Muhammad Salmanullah, Masatomo Yashiro, Tadashi Kamata, Nigel Wardle, Takuma Narita, O. Söhnel, Z. Wang, Koichi Matsumoto, Adrian Williams, Michael K. Hise, Toshiko Yaginuma, Hiroki Fujita, Hirofumi Makino, Yoshihiko Onishi, Kathleen M. Nicholls, D. Stratakis, Eri Muso, Olivier Pajot, Sydney Benchetrit, Terumi Higuchi, Gilbert Deray, Toshihiro Sugiyama, Shigetake Sasayama, Masami Kawagoe, Jacques Bernheim, Hiroyuki Ohi, Eugenia Pedagogos, Donald Richardson, A. Makedou, H. Schiffl, Hélène Beaufils, Erina Okawa, Yoshiyuki Yoshida, A. Tourkantonis, Richard B. Parsons, Mariko Tamano, Arzu Ensari, E. Kassimatis, Kazuyoshi Okada, Mesiha Ekim, Shigeki Miyawaki, Fumiaki Nogaki, Chihiro Hagi, Kazuo Yoshioka, G. Bamichas, Sahare Fongoro, Haruyoshi Yoshida, Atsushi Oyama, Kyoko Aoki, Katsuo Kanmatsuse, Richard M. Rohan, D. Bacharaki, David B. Ramsden, S.M. Lang, Bernard Katz, A. Costa-Bauzá, Ikei Kobayashi, Necmiye Tümer, M. Ramis, Yoshio Nagake, Hurokazu Tsukahara, Susumu Takahashi, Velibor Tasic, Takahiko Ono, Eduardo Podjarny, Gloria S. Tannenbaum, Petar Korneti, Hiroyuki Matsushima, Yoshiko Takahashi, Rosemary H. Waring, and Cerys C. Huggins
- Subjects
Index (economics) ,business.industry ,Statistics ,Medicine ,Subject (documents) ,business - Published
- 2001
29. Contents Vol. 88, 2001
- Author
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Kazuo Yoshioka, Katsuo Kanmatsuse, D. Grekas, Tadashi Kamata, D. Stratakis, Mesiha Ekim, Masami Kawagoe, Takuma Narita, Donald Richardson, Sydney Benchetrit, Terumi Higuchi, Adrian Williams, Bernard Katz, Koichi Matsumoto, Hirofumi Makino, Yoshihiko Onishi, Norishige Yoshikawa, Takahiko Ono, Yoshihiko Kawarada, Atsushi Oyama, Shigeki Miyawaki, Eduardo Podjarny, Chikahide Hori, Seiki Ito, Shigetake Sasayama, Eugenia Pedagogos, Erina Okawa, Kazuyoshi Okada, Olivier Pajot, Hiroyuki Matsushima, M. Ramis, H. Schiffl, Hurokazu Tsukahara, Hiroshi Shibahara, Eri Muso, Yusei Ohshima, Haruyoshi Yoshida, Nigel Wardle, Hiroyuki Ohi, Hiroko Yamasaki, David A. Sampson, Jacques Bernheim, Gloria S. Tannenbaum, Kathleen M. Nicholls, Mitsufumi Mayumi, G. Bamichas, Kyoko Aoki, A. Tourkantonis, Richard B. Parsons, D. Bacharaki, Kazuo Fujisawa, Masahiro Hiraoka, O. Söhnel, David B. Ramsden, Chihiro Hagi, Toshiko Yaginuma, S.M. Lang, Yoshio Nagake, Yoshiyuki Yoshida, Cerys C. Huggins, Toshihiro Sugiyama, F. Grases, E. Kassimatis, Rosemary H. Waring, Hiroki Fujita, Masatomo Yashiro, Hélène Beaufils, A. Makedou, Richard M. Rohan, Petar Korneti, Tim D. Hewitson, Kazuo Tsuzuki, Gavin J. Becker, Katsuo Suyama, Gilbert Deray, Hassane Izzedine, Z. Wang, Mariko Tamano, Janice Green, Aydan Ikinciogullari, Fumiaki Nogaki, Cüneyt Ensari, Velibor Tasic, A. Costa-Bauzá, Necmiye Tümer, Arzu Ensari, Ikei Kobayashi, Susumu Takahashi, Yuji Nagura, Muhammad Salmanullah, Michael K. Hise, Sahare Fongoro, and Yoshiko Takahashi
- Subjects
Traditional medicine ,business.industry ,Medicine ,business - Published
- 2001
30. Initial experience using Excimer laser for the extraction of chronically implanted pacemaker and implantable cardioverter defibrillator leads in Japanese patients.
- Author
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Hideo Okamura, Satoshi Yasuda, Shunsuke Sato, Koji Ogawa, Ikutaro Nakajima, Takashi Noda, Yusuke Shimahara, Teruyuki Hayashi, Yoshihiko Onishi, Junjiro Kobayashi, Shiro Kamakura, Hisao Ogawa, and Wataru Shimizu
- Abstract
Background: Given the exponential growth in cardiac device implantations, the need for less invasive lead extraction is increasing. The Excimer laser was approved for lead removal in Japan in 2010. The present study reports the initial experience using this novel technique to extract chronically implanted pacemaker and implantable cardioverter defibrillator (ICD) leads from Japanese patients. Methods and results: We performed a retrospective study of consecutive patients undergoing lead extraction using the laser sheath at a single Japanese center. Patient and lead characteristics, indications, and outcomes were analyzed. From August 2010 to September 2012, a total of 70 leads, including 14 ICD leads, were removed using the laser sheath from 40 patients (26 male, 14 female; age 65.5 ± 18.3 [mean ± SD] years; body mass index 21.8 ± 3.5kg/m²). The median implant duration was 87 months (range 13-328 months). Indications were infection (n=35), venous occlusion (n = 4), and pain (n = 1). The femoral approach was used in combination with the laser technique in five cases. Complete procedural success was achieved with 68 leads (97.1%). Although the electrode tip was left behind in the remaining two leads, the desired clinical outcomes could be achieved; which were defined as clinical success. No cases resulted in failure. There were no major complications, including death and bleeding requiring open-chest surgery. Conclusions: Laser sheaths appear to provide a feasible and effective means of extracting chronically implanted pacemaker and ICD leads in Japanese patients. [ABSTRACT FROM AUTHOR]
- Published
- 2013
- Full Text
- View/download PDF
31. Substrate effects on the magnetic characteristics of sputtered media
- Author
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H. Matsumura, T. Hase, Yoshihiko Onishi, K. Katsumoto, M. Sato, and Hidetaka Hayashi
- Subjects
Materials science ,Alloy ,Abrasive ,Polishing ,Substrate (electronics) ,Diamond turning ,engineering.material ,Grain size ,Electronic, Optical and Magnetic Materials ,Corrosion ,engineering ,Electrical and Electronic Engineering ,Composite material ,Sheet resistance - Abstract
The magnetic characteristics of C/CoNiCr/Cr longitudinal recording media on NiCuP-plated substrates and various Al-Mg alloy substrates were investigated and compared with the conventional NiP-plated substrates. It was found that the media on the NiCuP-plated substrates had a flatter envelope waveform. The error characteristics of the media directly sputter-deposited on the Al-Mg alloy substrate made from high-purity Al ground metal or by rapid solidification were almost the same as those of the media on the NiP substrates. The Al-Mg alloy substrate finished by electrolytic abrasive polishing exhibited a higher resistance to corrosion than that finished by diamond turning. >
- Published
- 1989
32. Extreme Ultraviolet Spectra of Emission from Plasma Focus. I. Fe Ion Lines from 70 to 210 Å
- Author
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Toshifumi Hasama, Masamitsu Uchiike, Kuniya Fukuda, and Yoshihiko Onishi
- Subjects
Dense plasma focus ,Chemistry ,General Engineering ,General Physics and Astronomy ,Plasma ,Spectral line ,Ion ,Atmosphere ,Physics::Plasma Physics ,Extreme ultraviolet ,Astrophysics::Solar and Stellar Astrophysics ,Emission spectrum ,Atomic physics ,Spectrograph - Abstract
Multiply-ionized Fe atoms were produced by discharges in a plasma focus apparatus with an Fe electrode in an ambient atmosphere of He, and the discharge condition for the most intense emission from Fe ions was found. The extreme ultraviolet spectrum was photographed under this condition with a grazing incidence spectrograph in the wavelength range between 70 and 500 Å. The spectrum has many strong emission lines in the range from 170 to 200 Å and is very similar to the spectrum of the quiet sun. Lines of FeVIII to XVIII ions are identified in the range between 90 and 210 Å and are tabulated together with the measured relative intensities. The results are discussed in relation to the solar and laboratory plasma spectra so far observed in the extreme ultraviolet range.
- Published
- 1981
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