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991.
Naotaka Nishiyama Hiroshi Hotta Atsushi Takahashi Masahiro Yanase Naoki Itoh Hitoshi Tachiki Noriomi Miyao Masanori Matsukawa Yasuharu Kunishima Keisuke Taguchi Hiroshi Kitamura Naoya Masumori 《Urologic oncology》2018,36(6):306.e9-306.e15
Objectives
The aim of this study was to clarify the prognostic indicators for upper tract urothelial carcinoma (UTUC) following intravesical bacillus Calmette-Guérin (BCG) therapy for nonmuscle-invasive bladder cancer (NMIBC).Methods
Data from 402 patients who received intravesical BCG therapy between January 1990 and November 2011 were collected from 10 institutes. The median follow-up interval from transurethral resection of the bladder tumor (TURBT) followed by BCG treatment was 50.0 months (IQR: 31.8–77.0). Of these patients, 186 (46.3%) had intravesical recurrence during the follow-up period after BCG therapy.Results
Thirty patients (7.5%) were diagnosed with UTUC after BCG therapy. The 10-year recurrence-free survival rates for UTUC (RFS-UTUC) was 87.5%. In univariate and multivariate analyses, the independent predicting factors for UTUC were intravesical recurrence (P = 0.016) and tumor morphology at TURBT before BCG (P = 0.045). The 10-year RFS-UTUC of patients with intravesical recurrence and others, were 80.6% and 95.0%, respectively. The 10-year RFS-UTUC of patients with papillary pedunculated tumors and nonpapillary or nonpedunculated were 96.1% and 84.6%, respectively.Conclusions
The frequency of UTUC in patients with NMIBC after BCG therapy is not negligible. Two independent predicting factors (intravesical recurrence and nonpapillary nonpedunculated at TURBT before BCG) were identified for UTUC. These results might be useful to predict UTUC after BCG therapy for NMIBC. 相似文献992.
Hiroaki Takada Toru Hifumi Naoki Nishimoto Takashi Kanemura Hayato Yoshioka Ichiro Okada Nobuaki Kiriu Junichi Inoue Yuichi Koido Hiroshi Kato 《The American journal of emergency medicine》2017,35(2):245-248
Objectives
Several reports have compared the efficacy of linezolid (LZD) in Methicillin-resistant Staphylococcus aureus (MRSA) infections with that of vancomycin (VCM); however, these two antibiotics for the treatment of nosocomial MRSA pneumonia in elderly patients has not been well evaluated. The purpose of this study is to evaluate the efficacy and safety of LZD compared with VCM for the treatment of elderly patients with nosocomial MRSA pneumonia in a retrospective chart review of a cohort.Methods
We included 28 consecutive patients aged ≥ 65 years hospitalized with a confirmed diagnosis of MRSA pneumonia and treated with LZD (n = 11) or VCM (n = 17) between November 2010 and May 2015. We collected patient, disease, and laboratory data. The primary outcome was 30-day mortality. The secondary outcomes were the sequential organ failure assessment (SOFA) total, respiratory, renal, coagulation, hepatic, cardiovascular, and central nervous system scores on days 1, 3, 7, and 14.Results
There were no significant differences between the two groups with regard to baseline characteristics. The 30-day mortality rate was significantly lower in the LZD group than in the VCM group (0% vs. 41%, P = .02). The SOFA total score on days 3, 7, and 14 were significantly lower those at baseline in the LZD group (P < .05). The SOFA respiratory score on days 14 was also significantly lower than baseline in the LZD group (P < .05).Conclusion
LZD may be more efficacious than VCM for treating elderly patients with nosocomial MRSA pneumonia. 相似文献993.
Furuya D Yagihashi A Komatsu M Masashi N Tsuji N Kobayashi D Watanabe N 《Journal of immunotherapy (Hagerstown, Md. : 1997)》2002,25(Z1):S65-S67
Elevated expression of interleukin (IL)-18 mRNA and protein in intestinal mucosa, attributable to activated monocytes and macrophages in that site, has been reported in patients with inflammatory bowel disease (IBD). However, changes in serum IL-18 concentrations in patients with IBD have not been reported. We measured bioactive IL-18 in serum from patients with IBD, using an enzyme-linked immunosorbent assay (ELISA). Mean serum IL-18 concentrations in 5 patients with Crohn disease (CD) were 400 pg/mL, approximately 1.7 times higher than concentrations in 21 control subjects (p < 0.01). However, serum IL-18 was not increased in patients with ulcerative colitis (UC). These results suggest that like other T-helper type 1 (Th1) cytokines IL-18 may play a key pathogenetic role in Th1-mediated disorders, such as CD. Regulation and expression of IL-18 appears to differ between CD and UC, and serum IL-18 may be a useful clinical marker for CD. 相似文献
994.
Enkhbaatar P Cox RA Traber LD Westphal M Aimalohi E Morita N Prough DS Herndon DN Traber DL 《Critical care medicine》2007,35(12):2805-2810
OBJECTIVE: Acute lung injury is a detrimental complication for victims of burn accidents. Airway obstruction plays an important role in pulmonary dysfunction in these patients. In this study, we tested the hypothesis that aerosolized anticoagulants will reduce the degree of airway obstruction and improve pulmonary function in sheep with severe combined burn and smoke inhalation injury by preventing the formation of airway fibrin clots. DESIGN: Prospective, randomized, controlled, experimental animal study. SETTING: Investigational intensive care unit at a university hospital. SUBJECTS: Adult female sheep. INTERVENTIONS: After 7 days of surgical recovery, sheep were given a cutaneous burn (40% of total body surface, third degree) and insufflated with cotton smoke (48 breaths, <40 degrees C) under halothane anesthesia. After injury, sheep were placed on ventilators and resuscitated with lactated Ringer's solution. Sheep were randomly divided into five groups: sham, noninjured and nontreated (n = 6); control, injured and aerosolized with saline (n = 6); recombinant human antithrombin (rhAT) + heparin, injured and aerosolized with rhAT (290 units for each) and heparin (10,000 units for each) (n = 6); rhAT, injured and aerosolized with rhAT alone (290 units for each; n = 5); and heparin, injured and aerosolized with heparin alone (10,000 units for each; n = 5). rhAT and heparin were aerosolized every 4 hrs, starting at 2 hrs postinjury. MEASUREMENTS AND MAIN RESULTS: Cardiopulmonary hemodynamics were monitored during a 48-hr experimental time period. Control sheep developed multiple signs of acute lung injury. This pathophysiology included decreased pulmonary gas exchange and lung compliance, increased pulmonary edema, and extensive airway obstruction. These variables were stable in sham animals. The aerosolization of rhAT or heparin alone did not significantly improve deteriorated pulmonary gas exchange. However, aerosolization of these anticoagulants in combination significantly attenuated all the observed pulmonary pathophysiology. CONCLUSIONS: The results provide definitive evidence that aerosolized rhAT and heparin in combination may be a novel treatment strategy for pulmonary pathology in burn victims with smoke inhalation injury. 相似文献
995.
996.
Kazuhiko Kotani Kokoro Tsuzaki Yoshiko Sano Mizuho Maekawa Shinji Fujiwara Taku Hamada Naoki Sakane 《Clinical chemistry and laboratory medicine》2008,46(10):1434-1437
BACKGROUND: Usual coffee consumption may decrease insulin resistance and type 2 diabetes incidence, and reduce cardiovascular disease risk. As a mechanism, coffee-induced lower levels of C-reactive protein (CRP), a marker for the development of these diseases, can be considered. The associations between coffee consumption and CRP should be established by studies on various populations, yet studies in Japanese people, who do not necessarily consume as much coffee daily, are limited. METHODS: In total, 459 community-living Japanese women, aged 23-83 years, were investigated. Clinical data including age, body mass index, blood pressure, HbA(1c), serum high sensitive CRP (hsCRP) and lifestyle habits, such as coffee consumption, were included in the analyses. All analyses were performed in two groups of the population, i.e., age < 60 and > or = 60 years. RESULTS: Significantly lower levels of hsCRP were observed in the group of > or = 1 cup/day than in that of < 1 cup/day in the respective groups of < 60 years (p = 0.001) and > or = 60 years (p < 0.0001). In multiple regression analysis, coffee consumption was significantly, independently and inversely correlated to log-hsCRP in the respective groups of < 60 years (p = 0.017) and > or = 60 years (p < 0.0001). CONCLUSIONS: It was noteworthy that the benefits of coffee consumption, even if > or = 1 cup/day, on serum hsCRP levels were confirmed in Japanese women, following similarly to other ethnic data. 相似文献
997.
998.
Genotype–phenotype relationships in familial amyotrophic lateral sclerosis with FUS/TLS mutations in Japan 下载免费PDF全文
Tetsuya Akiyama MD Hitoshi Warita MD PhD Masaaki Kato MD PhD Ayumi Nishiyama MD Rumiko Izumi MD PhD Chikako Ikeda MD Masaki Kamada MD PhD Naoki Suzuki MD PhD Masashi Aoki MD PhD 《Muscle & nerve》2016,54(3):398-404
Introduction: We investigated possible genotype–phenotype correlations in Japanese patients with familial amyotrophic lateral sclerosis (FALS) carrying fused in sarcoma/translated in liposarcoma (FUS/TLS) gene mutations. Methods: A consecutive series of 111 Japanese FALS pedigrees were screened for copper/zinc superoxide dismutase 1 (SOD1) and FUS/TLS gene mutations. Clinical data, including onset age, onset site, disease duration, and extramotor symptoms, were collected. Results: Nine different FUS/TLS mutations were found in 12 pedigrees. Most of the patients with FUS/TLS‐linked FALS demonstrated early onset in the brainstem/upper cervical region, and relatively short disease duration. A few mutations exhibited phenotypes that were distinct from typical cases. Frontotemporal dementia was present in 1 patient. Conclusions: This study revealed a characteristic phenotype in FUS/TLS‐linked FALS patients in Japan. FUS/TLS screening is recommended in patients with FALS with this phenotype. Muscle Nerve 54 : 398–404, 2016 相似文献
999.
Prospect of future housing and risk of psychological distress at 1 year after an earthquake disaster 下载免费PDF全文
1000.
The technique of endoscopic submucosal dissection (ESD) needs special skills and involves a long procedure. We therefore developed a new type of dissection knife, the irrigation cap-knife (the Kume cap-knife attachment, which uses a fixed snare), that facilitates ESD by just sliding over the muscle layer with a coagulating current. The ESD procedure using the irrigation cap-knife was performed in seven patients with intramucosal gastric cancer. The tumor was separated from the surrounding normal mucosa using the insulated-tip knife. Submucosal dissection was then performed by pushing our device along the muscle layer while applying a coagulating current, at the same time as a grasping forceps, deployed through the accessory channel, was used to push the lesion away from the muscle layer. The rate of en bloc resection was 100% (7/7). The irrigating cap-knife was extremely useful for ESD of large intramucosal cancers in the stomach. 相似文献