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101.
102.
Shoji Hirasaki Norio Koide Hiromichi Ogawa Toshihiro Wada Atsuhiko Sato Kozo Ujike Takao Tsuji 《Journal of gastroenterology》1997,32(6):808-811
We report a patient with mixed connective tissue disease (MCTD) associated with idiopathic portal hypertension (IPH) and chronic
thyroiditis. The patient was a 68-year-old Japanese woman who was admitted to our hospital for treatment of bleeding esophageal
varices. She had previously exhibited Raynaud's phenomenon and had had arthritis for about 30 years. She also had had high
titers anti-U1 of ribonucleoprotein (RNP) anti-single strand-DNA autoantibodies for 2 years, and had been diagnosed with MCTD
1 year previously. The bleeding from esophageal varices was successfully stopped by endoscopic injection sclerotherapy. Results
of laboratory examinations, imaging examinations, and laparoscopy, including liver biopsy, indicated that the esophageal varices
were caused by portal hypertension due to IPH. The patient also had a diffusely firm and enlarged goiter and hypothyroidism,
and she exhibited anti-thyroid microsomal antibodies and anti-thyroglobulin antibodies, she was diagnosed as having a complication
of chronic thyroiditis. This association of MCTD, IPH, and chronic thyroiditis is quite rare and provides a unique opportunity
to observe immunological involvement in the pathogenesis of IPH. 相似文献
103.
104.
105.
Seiji Matsukuma Kiyoyuki Eishi Tomayoshi Hayashi Shiro Yamachika Shiro Hazama Tsuneo Ariyoshi Hideaki Takai Tomohiro Odate Daisuke Onohara Makoto Yanatori 《Annals of thoracic and cardiovascular surgery》2004,10(5):307-310
Cardiac transplantation is an established treatment for end-stage heart failure, but its use is very limited. Partial left ventriculectomy has been reported as an alternative treatment for end-stage dilated cardiomyopathy. However, it has been well recognized that emergency partial left ventriculectomy for intractable decompensation is associated with poor survival. We report a case of a 68-year-old man with a left ventricular end-diastolic diameter of 108 mm, who underwent emergency extended partial left ventriculectomy, without papillary muscle resection, and mitral valve replacement with chordae preservation to deal with ongoing cardiogenic shock caused by end-stage dilated cardiomyopathy. The patient's cardiac status and general condition improved after the operation, and he survived the crisis. This operation should be considered as an alternative strategy for patients with septal motion and very large left ventricle. Thus, we report a successful extended partial left ventriculectomy and mitral valve replacement for end-stage dilated cardiomyopathy with very large left ventricular end-diastolic diameter. 相似文献
106.
107.
108.
Kazuyoshi Tanigawa Kiyoyuki Eishi Shiro Yamachika Koji Hashizume Seiichi Tada Kentaro Yamane Kenta Izumi Hideaki Takai Takashi Miura Shun Nakaji 《Annals of thoracic and cardiovascular surgery》2008,14(2):81-87
OBJECTIVE: Short (< or =3 months)- and middle (> or =4 months)-term results of aortic valve replacement (AVR) using 19-mm Carpentier-Edwards Perimount (CEP) bioprosthetic valves and 19-mm Medtronic Mosaic (MM) bioprosthetic valves in patients with small aortic annulus were compared. PATIENTS AND METHODS: At our facility, AVR was performed using bioprostheses in 110 patients from April 1999 to March 2006. Of these patients, 40 were treated using 19-mm CEP (Group C), and 9 using 19-mm MM (Group M). Evaluation by inquiry, physical examination, and echocardiography was performed before, a short term after, and a middle term after surgery, and the effects of AVR were compared. RESULTS: The New York Heart Association (NYHA) functional class grade showed improvements in both groups. The aortic valve peak pressure gradient was 29.8 +/- 10.1 mmHg in Group C and 53.8 +/- 17.3 mmHg in Group M, being higher in Group M, a middle term after surgery. However, the left ventricular mass index (LVMI) showed improvements in both groups compared with the values before surgery, and the left ventricular ejection fraction (LVEF) was maintained. During the middle term after surgery, the frequency of cardiac events showed no significant difference between the two groups. CONCLUSIONS: In the patients treated with 19-mm MM, the aortic valve peak pressure gradient was higher than in those treated with 19-mm CEP, but acceptable improvements in the LVMI, maintenance of the LVEF, and avoidance of cardiac events were observed in both groups. 相似文献
109.
M Ohara M Hirohata T Toshimori H Miyatani R Okamoto S Hirasaki H Kumashiro H Moritani Y Tominaga M Imai 《Internal medicine (Tokyo, Japan)》1992,31(3):397-399
A-39-year-old man was admitted to our hospital because of a markedly decreased level of serum cholinesterase found incidentally by a blood test. Detailed examination did not reveal severe liver disease, malignant tumor, infection or organophosphate compound poisoning. Investigation of three generations of his family revealed two homozygous and five heterozygous family members with the cholinesterase deficiency gene E1s indicating familial serum cholinesterase deficiency. 相似文献
110.
Shoji Hirasaki Junro Kataoka Junichirou Nasu Minoru Matsubara Fusao Ikeda Seiyuu Suzuki 《Nihon Shokakibyo Gakkai zasshi》2007,104(7):1051-1056
The endoscopic examination of a 63-year-old man revealed a IIc lesion, 5 mm in diameter, in the lesser curvature of the gastric body. His serum alpha-fetoprotein (AFP) level was high at 14.3 ng/ml. Immunohistological studies on the biopsy specimens showed a positive reaction for AFP. Endoscopic ultrasonography revealed that the tumor was limited to the second layer of the gastric wall and this tumor was diagnosed as mucosal cancer. The final diagnosis was AFP-producing mucosal gastric cancer (AFPMGC). Cases of AFPMGC are rarely encountered. The present case suggested that even minute mucosal gastric cancer could produce AFP. 相似文献