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71.
Chie Shimizu Takayuki Fujita Yoshinobu Fuke Minako Yabuki Mamiko Kajiwara Seiichiro Hemmi Atsushi Satomura Masayoshi Soma 《International urology and nephrology》2013,45(3):803-808
Purpose
Cyclosporine (CsA) is often prescribed to patients with glucocorticoid (GC)-dependent nephrotic syndrome. Although it is well known that long-term administration of GC causes osteoporosis, the effects of CsA on bone metabolism are not fully established. Therefore, we examined the effects of CsA on bone metabolism in patients with GC-dependent nephrotic syndrome in remission.Methods
We followed 23 patients treated with prednisolone alone (GC alone group) and 17 patients treated with CsA in combination with prednisolone (GC + CsA group). Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry, and biochemical markers of bone metabolism were simultaneously measured in serum and urine samples.Results
BMD decreased significantly in the GC group from 752 to 623 mg/cm2 but non-significantly in the GC + CsA group from 751 to 684 mg/cm2. Although the cumulative dose of GC increased in both groups, there were no significant differences in biochemical markers at either the start or the end of the study. Vertebrate bone fracture and other side effects associated with CsA treatment did not occur in our study.Conclusions
Our results indicate that CsA does not accelerate GC-induced osteoporosis in patients with nephrotic syndrome. We conclude that CsA is appropriate for the treatment of GC-dependent nephrotic syndrome, because it does not adversely affect bone metabolism and has favorable glomerular effects. 相似文献72.
Enooku K Tateishi R Kanai F Kondo Y Masuzaki R Goto T Shiina S Yoshida H Omata M Koike K 《Journal of gastroenterology》2012,47(1):71-78
Background
We evaluated the usefulness of tumor marker doubling time (DT) as an efficacy indicator of a molecular targeted anticancer agent. 相似文献73.
74.
Takeshita Y Takamura T Inoue O Okumura M Kato K Sunagozaka H Arai K Misu H Nakamura M Nakanuma Y Kaneko S 《Internal medicine (Tokyo, Japan)》2012,51(1):79-82
A 73-year-old woman had previously been diagnosed with CREST syndrome, PBC and diabetes. Hepatic fibrosis was not evident, in spite of the transudative ascites and active esophageal varices. ACA were positive, whereas AMA and anti-gp210 antibodies were negative. She showed low urinary excretion of C-peptide and was weakly positive for anti-GAD antibody. She was diagnosed with a form of PBC that progresses via portal hypertension rather than liver failure and with SPIDDM. Her HLA type did not contain risk allele for IDDM or PBC. SPIDDM should be considered when patients with PBC with portal hypertension-type progression develop diabetes. 相似文献
75.
In this study, we focused on the effect of pressure on the crystal structures of dioxides of group 14 elements, i.e. SiO2, GeO2, and CO2. Systematic searches for their crystal structures using the artificial force induced reaction method generated 219 and 147, 102 and 63, and 148 and 76 structures for SiO2, GeO2, and CO2, respectively, at 1 and 106 atm. At 1 atm, cristobalite-like, quartz, anatase-like, and stishovite were stable structures for SiO2 and GeO2. At 106 atm, structures of stishovite and CaCl2 type were relatively stable for SiO2 and GeO2. At 1 atm of CO2, molecular crystals were the most stable, whereas, quartz-like and cristobalite-like structures were obtained as stable structures at 106 atm. We discuss these pressure dependent structural variations systematically using the obtained structural dataset.In this study, we focused on the effect of pressure on the crystal structures of dioxides of group 14 elements, i.e. SiO2, GeO2, and CO2. 相似文献
76.
Satoshi Ogiso MD Claudius Conrad MD PhD Kenichiro Araki MD PhD Valeria Basso MD Brice Gayet MD PhD 《Annals of surgical oncology》2013,20(9):3120-3120
Background
Laparoscopic pancreaticoduodenectomy (PD) has become more popular despite its complexity and tendency for higher morbidity.1 Replaced right hepatic artery (RRHA) and replaced common hepatic artery (RCHA), both originating from the superior mesenteric artery (SMA), are the most significant and relatively common vascular anomalies in patients undergoing PD, occurring in 8.6–21 and 0.4–4.5 % of cases, respectively.2 , 3 An inadvertent injury to theses arteries may result in an intra- or postoperative bleeding, hepatic or bile duct ischemia, and consequent leakage or delayed stricture in the bilioenteric anastomosis.2 – 4 Therefore, preservation of these aberrant hepatic arteries is essential unless their resection is oncologically indicated.2 We describe a posterior approach that can be advantageous in laparoscopic PD for patients with a RRHA or RCHA.Methods
The posterior approach was used in 81 laparoscopic PDs at the Institute Mutualiste Montsouris between 1994 and 2012.5 In brief, retropancreatic dissection is performed to complete kocherization and expose the posterolateral aspect of the SMA. The origin of the RRHA or RCHA can then be identified and dissected. After division of the pancreatic neck, the portal vein and RRHA or RCHA are separated off the pancreatic neck. In case of the RCHA, the gastroduodenal artery originating from the RCHA is divided during this dissection.Results
The video shows a secure procedure to preserve a RCHA in laparoscopic PD by early identification and dissection of the aberrant artery via the posterior approach.Conclusions
The posterior approach can help to prevent inadvertent RRHA or RCHA injury in laparoscopic PD. 相似文献77.
Kouhei Nishikawa Norihito Soga Kenichiro Ishii Manabu Kato Yoichi Iwamoto Yasuhide Hori Michiru Etoh Takeshi Ohkawara Tomomi Yamada Katsunori Uchida Hideaki Kise Kiminobu Arima Masaaki Narita Taizo Shiraishi Yoshiki Sugimura 《Urologic oncology》2013,31(6):787-795
ObjectivesTo investigate the presence of manserin in human prostate cancers and to correlate manserin expression with pathologic outcomes and progression-free survival.MethodsEighty-seven patients with recent prostate cancer were classified into 4 groups based on Gleason score, and manserin immunohistochemistry was correlated with Gleason sum grade. To investigate the validity of manserin as a prognostic factor, the Cox proportional hazards regression model was performed on 48 patients in our cohort with T3 or T4 prostate cancer who were initially treated with androgen deprivation therapy.ResultsThe manserin-positive rates of patients with Gleason sums of 6, 7, 8, and ≥9 were 0%, 20.0%, 35.0%, and 48.1%, respectively. Manserin-positive rates were positively correlated with Gleason sums (P = 0.0001). Median times to cancer progression in groups with (n = 8) and without (n = 40) manserin expression were 8 months and 28 months, respectively (P = 0.01). Univariate Cox analysis revealed that manserin expression, clinical stage T4, and high Gleason sum were significantly associated with progression. Multivariate analysis revealed that only 2 factors, manserin expression (hazard ratio (HR) 4.99, P = 0.01) and clinical stage T4 (HR 4.77, P = 0.03), were independent risk factors for progression.ConclusionsThis is the first report of manserin expression in human prostate cancers. Manserin may serve as a marker of prostate cancer progression. 相似文献
78.
Yoshiaki Murakami Kenichiro Uemura Takeshi Sudo Yasushi Hashimoto Naru Kondo Naoya Nakagawa Takeshi Muto Hayato Sasaki Kazuhide Urabe Taijiro Sueda 《Journal of gastrointestinal surgery》2013,17(8):1429-1439
Background
The significance of perineural invasion in extrahepatic cholangiocarcinoma has not been fully elucidated. This study aims to determine the prognostic impact of and optimal treatment strategy for perineural invasion in patients with extrahepatic cholangiocarcinoma.Methods
Medical records of 133 patients with extrahepatic cholangiocarcinoma who underwent curative resection were reviewed retrospectively. Ninety-eight patients had perineural invasion and 35 patients did not. Univariate and multivariate survival analyses were performed to clarify the prognostic impact of and optimal treatment strategy for perineural invasion.Results
Only tumor differentiation (P?=?0.024) was independently associated with perineural invasion in the multivariate logistic regression model. Multivariate survival analysis revealed that perineural invasion (P?=?0.002), resection margin status (P?=?0.016), and International Union Against Cancer (UICC) pT factor (P?=?0.015) were independent prognostic factors of overall survival. Overall 5-year survival rates for patients with and without perineural invasion were 28 and 74 %, respectively. Among 98 patients with perineural invasion, the use of adjuvant chemotherapy (P?=?0.003), lymph node status (P?=?0.015), resection margin status (P?=?0.008), and UICC pT factor (P?=?0.016) were independently associated with overall survival by multivariate analysis. Overall 5-year survival rates for patients with perineural invasion who did and did not receive adjuvant chemotherapy were 33 and 21 %, respectively (P?=?0.023).Conclusions
Perineural invasion is a potent prognostic factor in extrahepatic cholangiocarcinoma. Adjuvant chemotherapy may improve the overall survival of patients with perineural invasion. 相似文献79.
Akira Watanabe Hideki Suzuki Norio Kubo Tsutomu Kobayashi Kenichiro Araki Shigeru Sasaki Tatsuo Shimura Tetsunari Oyama Hiroyuki Kuwano 《International journal of surgery case reports》2013,4(2):212-215
INTRODUCTIONWe present a rare case of mesenteric lymphangioma in a middle-aged female.PRESENTATION OF CASEA 56-year-old female was admitted to the hospital with upper abdominal pain. Abdominal computed tomography revealed a multicystic mass surrounding the mesentery. We made the decision to resect the mass, suspecting that was a mesenteric lymphangioma based on additional imaging studies. The tumor adhered strongly to parts of the duodenum and the upper jejunum. In order to preserve the jejunum, we dissected its serosa away from the tumor. Approximately 1 week after surgery the patient experienced a constriction of the third portion of the duodenum. Her symptoms were improved with conservative therapy, and she was discharged from the hospital 62 days after surgery.DISCUSSIONLymphangioma originating from the mesentery may have cause adhesions due to exfoliated tumor cells; it is necessary to be concerned about postoperative obstruction.CONCLUSIONThe preoperative diagnosis of lymphangioma is based on various imaging modalities. 相似文献
80.