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1.
Hiroki Teragawa Chikage Oshita Yuichi Orita Kunihiro Hashimoto Hirofumi Nakayama Yuto Yamazaki Hironobu Sasano 《World Journal of Clinical Cases》2021,9(5):1119-1126
BACKGROUNDAdrenal incidentaloma (AI) has been frequently encountered in the clinical setting. It has been shown that primary aldosteronism (PA) or subclinical Cushing’s syndrome (SCS) are the representative causative diseases of AI. However, the coexistence of PA and SCS has been reportedly observed. Recently, we encountered a case of AI, in which PA and SCS coexisted, confirmed by histopathological examinations after a laparoscopic adrenalectomy. We believe that there were some clinical implications in the diagnosis of the present case.CASE SUMMARYA 58-year-old man presented with lower right abdominal pain with a blood pressure of 170/100 mmHg. A subsequent computed tomography scan revealed right ureterolithiasis, which was the cause of right abdominal pain, and right AI measuring 22 mm × 25 mm. After the disappearance of right abdominal pain, subsequent endocrinological examinations were performed. Aldosterone-related evaluations, including adrenal venous sampling, revealed the presence of bilateral PA. In addition, several cortisol-related evaluations showed the presence of SCS on the right adrenal adenoma. A laparoscopic right adrenalectomy was then performed. The histopathological examination of the resected right adrenal revealed the presence of a cortisol-producing adenoma, while CYP11B2 immunoreactivity was absent in this adenoma. However, in the adjacent non-neoplastic adrenal, multiple CYP11B2-positive adrenocortical micronodules were detected, showing the presence of aldosterone-producing adrenocortical micronodules. CONCLUSIONCareful clinical and pathological examination should be performed when a patient harboring AI presents with concomitant SCS and PA. 相似文献
2.
Rika Yoshimatsu Takuji Yamagami Miki Nishimori Kenta Ogi Yoriko Murata Hitomi Iwasa Kenji Kajiwara Tomoaki Yamanishi Hiroki Minamiguchi Takashi Karashima Keiji Inoue 《Journal of vascular and interventional radiology : JVIR》2019,30(3):460-465
Purpose
To evaluate the influence of percutaneous cryoablation for renal cell carcinoma on function of the affected kidney.Materials and Methods
Between June 2016 and September 2017 at our institution, 12 inoperable patients underwent 15 cryoablation sessions for 17 small renal tumors. Of these, 9 patients who underwent 11 sessions of cryoablation were the focus of this study. For those patients, time-dependent changes in postoperative renal function were investigated by a retrospective review of clinical records. Evaluated were the estimated glomerular filtration rate (eGFR) and scintigraphy using 99m technetium-mercaptoacetyltriglycine (99mTc-MAG3) before and 1 week, 1–2 months, and more than 6 months after cryoablation.Results
Mean baseline eGFR was 76.88 ± 29.82 mL/min/1.73 m2 (mean ± standard deviation; range, 23.4–112.5). Mean eGFR 1 week, 1–2 months, and more than 6 months after cryoablation were 74.56 ± 26.68 mL/min/1.73 m2 (21.0–101.1), 69.5 ± 25.28 mL/min/1.73 m2 (24.1–105.6), and 75.08 ± 26.25 mL/min/1.73 m2 (29.0–107.3), respectively. Changes were statistically insignificant (P = .6044, P = .6699, and P = .9038, respectively). Regarding split renal function, the mean baseline contribution of the affected kidney determined by 99mTc-MAG3 was 47.27% ± 6.14 (38.8%–57.0%). Mean contributions of the affected kidney 1 week after, 1–2 months after, and more than 6 months after cryoablation were 44.40% ± 5.37 (38.3%–53.6%), 44.57% ± 6.52 (34.35%–55.0%), and 45.41% ± 7.77 (34.4%–56.5%), respectively. Differences from baseline were significant for the earliest 2 periods (P = .0473 and P = .0334, respectively) but not the later period (P = .2532).Conclusions
Results suggested that total renal function does not worsen after cryoablation; however, function of the affected kidney worsened after cryoablation but later partially recovered. 相似文献3.
Taisuke Inada Satoshi Fukushima Masayuki Murai Masatoshi Jinnin Azusa Miyashita Satoshi Nakahara Junji Yamashita Jun Aoi Shinichi Masuguchi Hironobu Ihn 《The Journal of dermatology》2015,42(2):198-201
miRNA‐221 (miR‐221) is known to be abnormally expressed in many human cancers. The serum levels of miR‐221 have been reported as a tumor marker for malignant melanoma (MM). We hypothesized that the hair shaft miR‐221 levels may be increased in patients with MM. We therefore assessed the possibility that hair shaft miR‐221 levels could be a marker for MM. The hair shaft miR‐221 levels were significantly higher in patients with MM than controls. The rates of increased hair shaft miR‐221 levels above the cut‐off value were comparable to those of serum 5‐S‐CD, which is a tumor marker commonly used for MM. Measurements of the hair shaft miR‐221 levels could have potential clinical value in the detection of MM. This is the first report investigating the hair shaft levels of an miRNA in patients with MM. Our investigations offer new insight into the relationship between miR‐221 and MM, and may provide a new, non‐invasive way to screen for melanoma. 相似文献
4.
Keiko Goto Yutaka Fujiwara Takeshi Isobe Naoko Chayahara Naomi Kiyota Toru Mukohara Yukari Tsubata Takamasa Hotta Kenji Tamura Noboru Yamamoto Hironobu Minami 《Cancer science》2019,110(6):1987-1994
Although dose reduction of S‐1 is recommended for patients with impaired renal function, dose modification for such patients has not been prospectively evaluated. The aim of the present study was to investigate the pharmacokinetic parameters of 5‐fluorouracil, 5‐chloro‐2,4 dihydroxypyridine and oteracil potassium, and to review the recommended dose modification of S‐1 in patients with renal impairment. We classified patients receiving S‐1 into 4 groups according to their renal function, as measured using the Japanese estimated glomerular filtration rate (eGFR) equation. The daily S‐1 dose was adjusted based on the patient's eGFR and body surface area. Blood samples were collected for pharmacokinetic analysis. A total of 33 patients were enrolled and classified into 4 groups as follows: 10 patients in cohort 1 (eGFR ≥ 80 mL/min/1.73 m2), 10 patients in cohort 2 (eGFR = 50‐79 mL/min/1.73 m2), 10 patients in cohort 3 (eGFR = 30‐49 mL/min/1.73 m2), and 3 patients in cohort 4 (eGFR < 30 mL/min/1.73 m2). Those in cohorts 3 and 4 treated with an adjusted dose of S‐1 showed a similar area under the curve for 5‐fluorouracil (941.9 ± 275.6 and 1043.5 ± 224.8 ng/mL, respectively) compared with cohort 2 (1034.9 ± 414.3 ng/mL). Notably, while there was a statistically significant difference between cohort 1 (689.6 ± 208.8 ng/mL) and 2 (P = 0.0474) treated with an equal dose of S‐1, there was no significant difference observed in the toxicity profiles of the cohorts. In conclusion, dose adjustment of S‐1 in patients with impaired renal function using eGFR is appropriate and safe. 相似文献
5.
Atsushi Hata Takahiro Nakajima Keisuke Matsusaka Masaki Fukuyo Junichi Morimoto Takayoshi Yamamoto Yuichi Sakairi Bahityar Rahmutulla Satoshi Ota Hironobu Wada Hidemi Suzuki Hisahiro Matsubara Ichiro Yoshino Atsushi Kaneda 《International journal of cancer. Journal international du cancer》2020,146(2):388-399
6.
Regional fractional ventilation mapping in spontaneously breathing mice using hyperpolarized 129Xe MRI 下载免费PDF全文
Hirohiko Imai Hironobu Matsumoto Erika Miyakoshi Shintaro Okumura Hideaki Fujiwara Atsuomi Kimura 《NMR in biomedicine》2015,28(1):24-29
The feasibility of ventilation imaging with hyperpolarized (HP) 129Xe MRI has been investigated for quantitative and regional assessment of ventilation in spontaneously breathing mice. The multiple breath ventilation imaging technique was modified to the protocol of spontaneous inhalation of HP 129Xe delivered continuously from a 129Xe polarizer. A series of 129Xe ventilation images was obtained by varying the number of breaths before the 129Xe lung imaging. The fractional ventilation, r, was successfully evaluated for spontaneously breathing mice. An attempt was made to detect ventilation dysfunction in the emphysematous mouse lung induced by intratracheal administration of porcine pancreatic elastase (PPE). As a result, the distribution of fractional ventilation could be visualized by the r map. Significant dysfunction of ventilation was quantitatively identified in the PPE‐treated group. The whole‐lung r value of 0.34 ± 0.01 for control mice (N = 4) was significantly reduced, to 0.25 ± 0.07, in PPE‐treated mice (N = 4) (p = 0.038). This study is the first application of multiple breath ventilation imaging to spontaneously breathing mice, and shows that this methodology is sensitive to differences in the pulmonary ventilation. This methodology is expected to improve simplicity as well as noninvasiveness when assessing regional ventilation in small rodents. Copyright © 2014 John Wiley & Sons, Ltd. 相似文献
7.
Manabu Fujimoto Jun Asai Yoshihide Asano Takayuki Ishii Yohei Iwata Tamihiro Kawakami Masanari Kodera Masatoshi Abe Masahiro Amano Ryuta Ikegami Taiki Isei Zenzo Isogai Takaaki Ito Yuji Inoue Ryokichi Irisawa Masaki Ohtsuka Yoichi Omoto Hiroshi Kato Takafumi Kadono Sakae Kaneko Hiroyuki Kanoh Masakazu Kawaguchi Ryuichi Kukino Takeshi Kono Monji Koga Keisuke Sakai Eiichi Sakurai Yasuko Sarayama Yoichi Shintani Miki Tanioka Hideaki Tanizaki Jun Tsujita Naotaka Doi Takeshi Nakanishi Akira Hashimoto Minoru Hasegawa Masahiro Hayashi Kuninori Hirosaki Hideki Fujita Hiroshi Fujiwara Takeo Maekawa Koma Matsuo Naoki Madokoro Sei-Ichiro Motegi Hiroshi Yatsushiro Osamu Yamasaki Yuichiro Yoshino Andres James LE Pavoux Takao Tachibana Hironobu Ihn Japanese Dermatological Association Guidelines 《The Journal of dermatology》2020,47(10):1071-1109
The Japanese Dermatological Association prepared guidelines focused on the treatment of skin ulcers associated with connective tissue disease/vasculitis practical in clinical settings of dermatological care. Skin ulcers associated with connective tissue diseases or vasculitis occur on the background of a wide variety of diseases including, typically, systemic sclerosis but also systemic lupus erythematosus (SLE), dermatomyositis, rheumatoid arthritis (RA), various vasculitides and antiphospholipid antibody syndrome (APS). Therefore, in preparing the present guidelines, we considered diagnostic/therapeutic approaches appropriate for each of these disorders to be necessary and developed algorithms and clinical questions for systemic sclerosis, SLE, dermatomyositis, RA, vasculitis and APS. 相似文献
8.
9.
Takashi Anayama Kentaro Hirohashi Ryohei Miyazaki Hironobu Okada Marino Yamamoto Kazumasa Orihashi 《The Journal of international medical research》2021,49(2)
ObjectiveTo determine the appropriate amount of indocyanine green for bronchial insufflation.MethodsWe enrolled 20 consecutive patients scheduled for anatomical segmentectomy in the Kochi Medical School Hospital. After inducing general anesthesia, 6 to 60 mL of 200-fold-diluted indocyanine green (0.0125 mg/mL) was insufflated into the subsegmental bronchi in the targeted pulmonary segmental bronchus. The volume of the targeted pulmonary segments was calculated using preoperative computed tomography. Fluorescence spread in the segmental alveoli was visualized using a dedicated near-infrared thoracoscope.ResultsThe targeted segment was uniformly visualized by indocyanine green fluorescence in 16/20 (80.0%) cases after insufflating indocyanine green. A receiver operating characteristic curve indicated that the area under the curve was 0.984; the optimal cut-off volume of diluted indocyanine green for insufflation was 8.91% of the calculated targeted pulmonary segment volume.ConclusionsThe setting for indocyanine green insufflation was optimized for near-infrared fluorescence image-guided anatomical segmentectomy. By injecting the correct amount of indocyanine green, fluorescence-guided anatomical segmentation may be performed more appropriately. 相似文献
10.
Cholestatic Liver Injury After Biliary Reconstruction Impairs Transplanted Islet Viability and Function 下载免费PDF全文
T. Hata N. Sakata G. Yoshimatsu H. Tsuchiya M. Fukase M. Ishida T. Aoki Y. Katayose S. Egawa M. Unno 《American journal of transplantation》2015,15(8):2085-2095
Islet autotransplantation following total pancreatectomy differs from allograft transplantation with respect to the requirement of biliary reconstruction. Although it is known that careful consideration should be given to postoperative cholestatic liver injury after biliary reconstruction, its direct effects on transplanted islets have not been completely elucidated. In this study, we developed a murine model of postoperative cholestatic liver injury after biliary reconstruction with islet autotransplantation that involved syngeneic intraportal islet transplantation into chemically induced diabetic mice and common bile duct ligation. We assessed the viability and function of the transplanted islets. The impaired viability of transplanted islets and increased blood glucose levels indicated restoration of the diabetic state after common bile duct ligation in this murine model. Furthermore, impaired islet viability and function occurred earlier in the transplanted islets than in the surrounding liver tissues, which was consistent with the faster and higher expression of oxidative stress markers in the transplanted islets. Transplanted islets may be more vulnerable to oxidative stress caused by cholestatic liver injury than the surrounding liver tissue. Therefore, patients should be intensively managed after total pancreatectomy with islet autotransplantation to preserve viability and function of the transplanted islets. 相似文献