第22回 仮説・推論を提示する2
- 106. 実験結果は次のように解釈できます。
The experimental results can be [ ] as follows. - 107. 前述のすべての観察結果から……と推測できます。
Taking all the aforementioned observations together, we can [ ] that … - 108. 中心となる前提が3つあります。
There are three central [ ] . - 109. この回復の有意な差は生着率の差と深く関係があると思われます。
The significant difference in recovery might be [ ] related to the difference of survivability. - 110. ……を認めた場合には、悪性転化を常に念頭に置く必要があると考えられます。
We think that malignant transformation should always be [ ] when we recognize ….
解答を見る
- 106. The experimental results can be interpreted as follows.
- 107. Taking all the aforementioned observations together, we canspeculate that …
- 108. There are three central premises .
- 109. The significant difference in recovery might be closely related to the difference of survivability.
- 110. We think that malignant transformation should always besuspected when we recognize ….
第21回 仮説・推論を提示する1
- 101. しかし、頭蓋頚椎移行部の動静脈瘻は再出血率が低い可能性が考えられます。
It [ ] possible that the ratio of rebleeding is lower in the AVF of craniocervical junction. - 102. ……の予防に関してはステロイドが有効である可能性が十分あります。
It is [ ] possible that steroids are effective for preventing … - 103. われわれが観察した宿主のドーパミン線維の回復は、栄養因子が生着したクロマフィン細胞から分泌されたことによる可能性が強いと考えられます。
It is [ ] possible that the recovery of host dopaminergic fibers we observed was due to the trophic factors secreted from the surviving chromaffin cells. - 104. 多くの患者が高齢であることを考えると、剖検例にて生着細胞がほとんど認められないのも納得できるところです。
It is [ ] that there are almost no surviving cells in autopsy cases considering that most of the patients are elderly. - 105. 虚血症状がない場合には、側副血行が形成されていると考えるのが妥当です。
When there is no sign of ischemia, it is [ ] to assume that collateral circulation is established.
解答を見る
- 101. It remains possible that the ratio of rebleeding is lower in the AVF of craniocervical junction.
- 102. It is quite possible that steroids are effective for preventing …
- 103. It is highly possible that the recovery of host dopaminergic fibers we observed was due to the trophic factors secreted from the surviving chromaffin cells.
- 104. It is natural that there are almost no surviving cells in autopsy cases considering that most of the patients are elderly.
- 105. When there is no sign of ischemia, it is reasonable to assume that collateral circulation is established.
第20回 明らかになったことを示す
- 96. 類上皮腫は非常に増殖が遅い腫瘍であることが明らかとなりました。
It [ ] clear that epidermoid was a very slowly growing tumor. - 97. 年齢については特定の傾向はないと考えられました。
No specific [ ] was seen regarding age of the patient. - 98. 次に……に関する新たな発見をお示しします。
The [ ] are some of the new findings regarding … - 99. 今回の研究からコイル塞栓術の適応症例が拡大していることが判明しました。
In this study, we found that the number of patients [ ] for coil embolization has been increasing. - 100. 本研究により、副腎髄質移植が線条体ドーパミン線維の回復に強く影響することが明らかとなりました。
The present study demonstrated that adrenal medullary grafting had a strong influence [ ] the recovery of dopaminergic fibers in the striatum.
解答を見る
- 96. It became clear that epidermoid was a very slowly growing tumor.
- 97. No specific tendency was seen regarding age of the patient.
- 98. The following are some of the new findings regarding …
- 99. In this study, we found that the number of patients suitable for coil embolization has been increasing.
- 100. The present study demonstrated that adrenal medullary grafting had a strong influence on the recovery of dopaminergic fibers in the striatum.
第19回 問題点を提起する
- 91. そのメカニズムについてはよくわかっていません。
The mechanism is still [ ] . - 92. しかしながら、我々の知るかぎり、……と結論づけられています。
However, to our [ ] , it has been concluded that … - 93. 剖検例において生着細胞がわずかしか認められていないことが最大の問題点です。
The biggest [ ] is that very little cell survival has been observed in autopsy cases. - 94. 安易に血管内治療が行われていることも懸念されています。
There are [ ] that endovascular therapy is performed without careful consideration. - 95. 病理学的分類に関する統一した診断基準がなく、病理医の経験によるところが大きいのです。
Because there is no unified diagnostic standard for pathological classification, the experience of the pathologist may largely [ ] diagnosis.
解答を見る
- 91. The mechanism is still unknown .
- 92. However, to our knowledge , it has been concluded that …
- 93. The biggest issue is that very little cell survival has been observed in autopsy cases.
- 94. There are concerns that endovascular therapy is performed without careful consideration.
- 95. Because there is no unified diagnostic standard for pathological classification, the experience of the pathologist may largely affectdiagnosis.
第18回 所見・病態を説明する
- 86. 流出静脈の方向が下行性であったにもかかわらず、くも膜下出血を来していました。
Although the direction of draining vein was downward, the patient [ ] subarachnoid hemorrhage. - 87. 脳の各部位におけるドーパミン濃度について、MPTPの影響は老齢マウスにおいてより広汎で顕著でした。
As for the dopamine concentration in each brain location, the influence of MPTP was more [ ] and prominent in aging mice. - 88. 関節リウマチは多くの組織や器官に影響を及ぼしますが、特に可動性（滑膜）関節が侵されます。
Rheumatoid arthritis may affect many tissues and organs, but [ ] attacks flexible (synovial) joints. - 89. 2型糖尿病はインスリン抵抗性の結果として起こり、時にインスリンの完全欠乏を伴います。
Type 2 diabetes mellitus results from insulin resistance, sometimes [ ] with an absolute insulin deficiency. - 90. 過量投与に伴い頭痛、血圧低下、尿失禁などの症状が出現します。
Excessive administration [ ] various symptoms such as headache, hypotension, and urinary incontinence.
解答を見る
- 86. Although the direction of draining vein was downward, the patientdeveloped subarachnoid hemorrhage.
- 87. As for the dopamine concentration in each brain location, the influence of MPTP was more widespread and prominent in aging mice.
- 88. Rheumatoid arthritis may affect many tissues and organs, butprincipally attacks flexible (synovial) joints.
- 89. Type 2 diabetes mellitus results from insulin resistance, sometimes combined with an absolute insulin deficiency.
- 90. Excessive administration causes various symptoms such as headache, hypotension, and urinary incontinence.
第17回 治療法を紹介する
- 81. 正確な術前内視鏡診断が必須です。
Accurate preoperative endoscopic diagnosis is [ ]. - 82. 症状が不可逆的になる前に、外科的治療が行われるのが望ましいです。
It is [ ] to perform surgical therapy before the symptoms become irreversible. - 83. 母血管閉塞の結果予想される神経脱落症状などを勘案して治療法を決定します。
We determine the therapy [ ] the neurological deficit presumed by parent artery occlusion. - 84. 放射線治療については即効性がないので、緊急治療が必要な例に適応はありません。
Because radiation therapy brings no [ ] effect, it has no indication for patients who need immediate treatment. - 85. 放射線治療は、エビデンスが少なく、現時点では治療の第一選択にはなっていません。
At the moment, radiation therapy is not the first-line treatment due to [ ] of evidence.
解答を見る
- 81. Accurate preoperative endoscopic diagnosis is essential.
- 82. It is desirable to perform surgical therapy before the symptoms become irreversible.
- 83. We determine the therapy considering the neurological deficit presumed by parent artery occlusion.
- 84. Because radiation therapy brings no prompt effect, it has no indication for patients who need immediate treatment.
- 85. At the moment, radiation therapy is not the first-line treatment due to lack of evidence.
第16回 従来の定説を紹介する
- 76. このタイプはミエロパシー を発症しやすいと言われています。
It has been reported that this type [ ] develops myelopathy. - 77. 脊髄硬膜外電気刺激療法（SCS）は、びまん性軸索損傷に対して有効であるとされています。
Spinal cord stimulation (SCS) is [ ] effective for diffuse axonal injury. - 78. 意識障害は大まかに2群に大別されます。
Consciousness disturbance is divided [ ] into 2 groups. - 79. 脳は必ずしも免疫租界ではないと考えられるようになりました。
Now we have [ ] that the brain is not necessarily immunologically privileged. - 80. …は…に対する治療法として確立しつつあります。
…is becoming an [ ] therapy for …
解答を見る
- 76. It has been reported that this type often develops myelopathy.
- 77. Spinal cord stimulation (SCS) is considered effective for diffuse axonal injury.
- 78. Consciousness disturbance is divided roughly into 2 groups.
- 79. Now we have learned that the brain is not necessarily immunologically privileged.
- 80. … is becoming an established therapy for …
第15回 統計学的有意性を述べる／他の報告と比較する
- 71. コイル塞栓術では、高齢群の割合が有意に高いものでした。
Regarding coil embolization, the rate of the aged group was [ ] high. - 72. 生着細胞数は、若年マウスをドナーとした方が有意に多くありました。
Surviving cell number was significantly [ ] in the young donor mice. - 73. MPTPは神経変性疾患と加齢現象の関係を研究する上で重要な神経毒であることが指摘されています。
MPTP is [ ] out to be an important neurotoxin for studying the relationship between neurodegenerative disorder and the aging phenomenon. - 74. Akarらは、必ずしも全摘出例で水頭症が少ないとは言えないと考察しています。
Akar et al. [ ] that it is not always true that total removal cases were less likely to develop hydrocephalus. - 75. これらの結果は……とする従来の研究と一致します。
These results are [ ] with earlier studies showing that …
解答を見る
- 71. Regarding coil embolization, the rate of the aged group wassignificantly high.
- 72. Surviving cell number was significantly larger in the young donor mice.
- 73. MPTP is pointed out to be an important neurotoxin for studying the relationship between neurodegenerative disorder and the aging phenomenon.
- 74. Akar et al. argue that it is not always true that total removal cases were less likely to develop hydrocephalus.
- 75. These results are consistent with earlier studies showing that …
第14回 結果を説明する、数値を挙げて比較する
- 66. 全症例で手術合併症を認めませんでした。
[ ] of the cases had complications from surgery. - 67. 発症時年齢は1例を除いてすべて50歳以上でした。
The age at onset of all cases was more than 50 years old, with one young onset [ ] . - 68. ドーパミン濃度の回復は、同系移植片群で最も顕著です。
The recovery of dopaminergic concentration is most [ ] in the syngeneic graft group. - 69. クロマフィン細胞が神経様に形態変化していることが明らかとなりました。
It has [ ] apparent that chromaffin cells transmute to neuron- like cells. - 70. クロマフィン細胞数は、cograft群ではnon-cograft群に比べて約2倍に向上しました。
The number of chromaffin cells increased about [ ] in the cograft group compared with the non-cograft group.
解答を見る
- 66. None of the cases had complications from surgery.
- 67. The age at onset of all cases was more than 50 years old, with one young onset exception .
- 68. The recovery of dopaminergic concentration is most prominent in the syngeneic graft group.
- 69. It has become apparent that chromaffin cells transmute to neuron- like cells.
- 70. The number of chromaffin cells increased about twofold in the cograft group compared with the non-cograft group.
第13回 図表で示す
- 61. 表1に患者背景を示します。
We [ ] the backgrounds of the patients in Table 1. - 62. 治療法を表1にまとめます。
Therapy is [ ] in Table 1. - 63. 図2が示すように、各グラフはそれぞれS字状のカーブを呈します。
As [ ] in Figure 2, each graph shows a sigmoid curve respectively. - 64. 全症例の詳細を表1に示します。
The [ ] of all the cases are shown in Table 1. - 65. 調査結果を性別ごとに分けました。
The research results were divided by [ ] .
解答を見る
- 61. We describe the backgrounds of the patients in Table 1.
- 62. Therapy is summarized in Table 1.
- 63. As seen in Figure 2, each graph shows a sigmoid curve respectively.
- 64. The details of all the cases are shown in Table 1.
- 65. The research results were divided by gender .
第12回 臨床研究2：患者の内訳、治療・評価・解析方法
- 56. 対象症例の内訳は、男性10例、女性5例、年齢は56～84歳（平均 69.1歳）です。
The [ ] of the subjects was 10 males and 5 females, and the age ranged between 56 and 84 years (average 69.1). - 57. 最も大切なことは、……の損傷を防ぎつつ、いかに広い術野を確保できるかに尽きます。
The most important point is keeping the operative field as wide as possible [ ] avoiding injury to … - 58. すべての被験者は……検査を受けました。
All the subjects [ ] … exam. - 59. P＜0.05を有意としました。
A P value < 0.05 was considered [ ] . - 60. 術後1週間以内にMRI拡散強調画像で高信号を示したものを急性期梗塞と定義しました。
We [ ] acute cerebral infarction as when postoperative MRI within one week demonstrated high intensity signal in the MRI diffusion-weighted image.
解答を見る
- 56. The breakdown of the subjects was 10 males and 5 females, and the age ranged between 56 and 84 years (average 69.1).
- 57. The most important point is keeping the operative field as wide as possible while avoiding injury to …
- 58. All the subjects underwent … exam.
- 59. A P value < 0.05 was considered significant .
- 60. We defined acute cerebral infarction as when postoperative MRI within one week demonstrated high intensity signal in the MRI diffusion-weighted image.
第11回 臨床研究1：患者の定義、同意の取得
- 51. 重症群はHunt and Kosnik Grade IV、V としました。
The patients with Hunt and Kosnik Grade IV and V were [ ] as ‘Severe’ Group. - 52. 対照群として、年齢・性別・ボディマス指数が一致する健常ボランティア25名を、書面による同意を得て用いました。
We used as a control group 25 healthy volunteers with their written consent [ ] for age, sex and body mass index. - 53. 2000年から2007年の間に当科にて外科治療を行い、組織学的に神経膠芽腫（GBM）と診断された症例で、診断後36ヵ月以上の生存期間を認めた5例を長期生存群としました。
We [ ] long-term survivors as follows:5 patients who were diagnosed as GBM histologically between 2000 and 2007, who then received surgical removal in our department and survived more than 36 month after diagnosis. - 54. 対照群は生理食塩水を投与されました。
The control group was [ ] to normal saline. - 55. 患者は全員、書面によって治療に同意しました。
All patients agreed to treatment with [ ] consent.
解答を見る
- 51. The patients with Hunt and Kosnik Grade IV and V were assessedas ‘Severe’ Group.
- 52. We used as a control group 25 healthy volunteers with their written consent matched for age, sex and body mass index.
- 53. We defined long-term survivors as follows:5 patients who were diagnosed as GBM histologically between 2000 and 2007, who then received surgical removal in our department and survived more than 36 month after diagnosis.
- 54. The control group was exposed to normal saline.
- 55. All patients agreed to treatment with written consent.
第10回 症例報告3：治療の実施、治療効果
- 46. 急性水頭症を併発していたため脳室ドレナージを行いました。
As the patient [ ] complications of acute hydrocephalus, ventricular drainage was performed. - 47. 血管内手術による新たな神経症状の出現はありませんでした。
No additional neurological symptoms [ ] after intravenous surgery. - 48. フォローの脳血管撮影では動脈瘤の再発や新規出現はありませんでした。
We [ ] no recurrence or de novo appearance of aneurysm in the follow-up angiography. - 49. 高次脳機能障害が残存しましたが、麻痺は認められませんでした。
Higher brain dysfunction of the patient [ ] but palsy was absent. - 50. 術後、経過良好でリハビリテーション療法を併用し独歩退院となりました。
The postoperative course went well, and after rehabilitation therapy the patient became [ ] and was discharged.
解答を見る
- 46. As the patient showed complications of acute hydrocephalus, ventricular drainage was performed.
- 47. No additional neurological symptoms appeared after intravenous surgery.
- 48. We found no recurrence or de novo appearance of aneurysm in the follow-up angiography.
- 49. Higher brain dysfunction of the patient persisted but palsy was absent.
- 50. The postoperative course went well, and after rehabilitation therapy the patient became ambulatory and was discharged.
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