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Shinichiro Muro Hironari Kato Etsuji Ishida Toru Ueki Masakuni Fujii Ryo Harada Hiroyuki Seki Ken Hirao Masaki Wato Yutaka Akimoto Masahiro Takatani Hirofumi Tsugeno Jiro Miyaike Tatsuya Toyokawa Mamoru Nishimura Naoko Yunoki Hiroyuki Okada 《Journal of gastroenterology and hepatology》2020,35(1):37-42
33.
Stephen F. Futterer Alexander J. Nemeth Sean A. Grimm Ann B. Ragin James P. Chandler Kenji Muro Maryanne H. Marymont Jeffrey J. Raizer 《Journal of neuro-oncology》2014,118(1):147-153
Bevacizumab has been reported to cause diffusion restriction in the tumor bed of patients with malignant gliomas. This study evaluated prolonged diffusion restriction, in the corpus callosum (CC), of patients with malignant brain tumors treated with bevacizumab. We retrospectively reviewed our database of patients treated with bevacizumab for malignant brain tumors looking for those with restricted diffusion in the CC. CC ADC ratio measurements were obtained prior to and following treatment. Correlation was made with biopsy (n = 3) and MR perfusion (n = 7) and PET (n = 4). The temporal evolution of these changes relative to therapy was examined with mixed effects regression analysis. Nine patients (eight malignant gliomas, one malignant meningioma) out of 146 patients were found to have developed areas of diffusion restriction in the CC. These areas tended to enlarge and coalesce over serial MRIs and persisted for up to 22 months. Hypoperfusion was demonstrated in MR perfusion in 7/7. PET was hypometabolic in all 4. Biopsy of the CC showed no tumor in 3/3. ADC ratio measurements indicated a significant overall effect of time (F(16,60) = 11.2; p < 0.0001), consistent with persistent diffusion restriction over the measured time periods. Bevacizumab causes prolonged diffusion restriction in the CC. The negative MR perfusion, FDG PET and histopathology suggest this is a toxicity of bevacizumab and not active tumor. Awareness of these changes can assist in patient care. 相似文献
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Sabino Puente German Ramirez-Olivencia Mar Lago Mercedes Subirats Eugenio Perez-Blazquez Fernando Bru Teresa Garate Belén Vicente Moncef Belhassen-Garcia Antonio Muro 《Enfermedades infecciosas y microbiología clínica》2018,36(10):633-639
Introduction
Onchocerciasis is caused by Onchocerca volvulus and mainly leads to pruritus and skin and visual disorders, including blindness. Seventeen million people are infected in 38 countries; 31 of these are in sub-Saharan Africa, six in Latin America and one on the Arabian Peninsula. More than 99% of cases occur in sub-Saharan Africa where 120 million people are at risk of infection. Eye disorders have been well-documented; however, skin disorders have not been described accurately. The objective of our study was to describe the epidemiology, main skin manifestations and treatment of imported onchocerciasis.Material and methods
A retrospective study was thus conducted by analysing the main demographic, clinical and treatment data regarding a cohort of 400 patients attending a reference clinical unit over a 17-year period.Results
Most patients were female (55%) with mean age 37.5 ± 16.7 years. All the migrants came from sub-Saharan countries. The most frequently occurring dermatological symptom was pruritus. Ivermectin had been used as first-line therapy and adverse reactions had been described in 11 patients (3.2%).Conclusions
The results indicate the fact that there should be a clinical suspicion of onchocerciasis regarding immigrants from endemic areas having skin lesions compatible with the disease's profile or asymptomatic patients having eosinophilia or unexplained high IgE. Moreover, skin snips from the buttocks region were very fruitful and treatment with ivermectin was seen to be safe. This is the largest case series regarding imported onchocerciasis described up to the present time. 相似文献36.
Masatoshi Masuo Haruhito Takano Satoru Takamoto Jun Tanaka Shigehiro Kitamura Toshikazu Saito 《Circulation journal》2004,68(4):392-395
Pulmonary artery obstruction is a rare complication of acute thoracic aortic dissection. A 74-year-old woman was admitted to hospital with respiratory distress. Computed tomography scan showed right pulmonary artery occlusion and a thoracic aortic dissection of the Stanford A type. Lung perfusion scan revealed a defect in the entire right lung field. These findings mimicked acute pulmonary thromboembolism accompanying aortic dissection. On the other hand, pulmonary angiography revealed a round smooth defect of the right pulmonary artery, indicating an extrinsic compression. The patient finally died of cardiac tamponade. Autopsy disclosed that the right pulmonary artery was compressed by a hematoma in the adventitial space around the pulmonary artery. Such a mechanism of pulmonary artery obstruction caused by acute aortic dissection is unique, and is distinct from that caused by chronic non-dissecting aortic aneurysms, which themselves compress the pulmonary arteries. This complication inevitably follows aortic rupture; therefore, emergency operation to repair the dissected aorta must be performed to avoid the following catastrophic event. 相似文献
37.
A 77-year-old man hospitalized in a bedridden state for cerebral infarction and left hemiparesis experienced the sudden onset of dyspnea and cyanosis. Chest X-ray films detected a foreign object in the hilum of the left lung. Emergency bronchoscopy revealed a dental crown lodged in the second carina. It was not possible to remove the crown with bronchoscopy forceps. The patient suffered severe respiratory failure the following day. Bronchoscopy again was performed, and the foreign object was removed with basket-type forceps. It was the patient's first molar, covered with a crown. The patient's respiratory failure was caused by atelectasis of the left lower lobe and overinflation, of the right lung, both of which resulted from postoperative edema of bronchial mucous membrane. Dental foreign objects do not cause pulmonary atelectasis or pneumonia as easily as other types of bronchial foreign objects. Therefore, there is usually enough time for thorough examination prior to removal procedures. It is important to accurately identify the shape of the foreign object, choose appropriate forceps, and successfully remove the object in the first operation. Moreover, adequate dental treatment of caries and loose teeth is important as a means of preventing dental foreign objects, especially in elderly people and bedridden patients. 相似文献
38.
Normal ultrasonic myocardial reflectivity in athletes with increased left ventricular mass. A tissue characterization study. 总被引:4,自引:0,他引:4
F Lattanzi V Di Bello E Picano M T Caputo L Talarico C Di Muro L Landini G Santoro C Giusti A Distante 《Circulation》1992,85(5):1828-1834
BACKGROUND. Ultrasonic integrated backscatter of myocardial walls is directly related to the morphometrically evaluated collagen content. The integrated backscatter is also increased in hypertrophic cardiomyopathy, probably because of fiber disarray. The purpose of this study was to investigate myocardial tissue reflectivity in subjects with physiological hypertrophy caused by intense physical training and to assess the relation between the acoustic properties of myocardial tissue and left ventricular wall thickness assessed by conventional two-dimensional echocardiography. METHODS AND RESULTS. Twenty-four young male athletes (14 professional cyclists and 10 weight lifters, all in full agonistic activity) were studied together with 10 normal age-matched controls with sedentary life. By means of a commercially available two-dimensional echocardiograph, standard measurements were obtained according to the recommendations of the American Society of Echocardiography. With a prototype implemented in our Institute, an on-line radiofrequency analysis of ultrasound signals was also performed to obtain quantitative operator-independent measurements of the integrated backscatter of the myocardial walls. The integrated values of the radiofrequency signal were normalized for the pericardial interface and expressed in percent integrated backscatter (%IB). Compared with control subjects, athletes showed greater thickness values of septum (controls, 9 +/- 1; cyclists, 14 +/- 2; weight lifters, 15 +/- 1 mm, mean +/- SD; p less than 0.01) and posterior wall (9 +/- 1, 12 +/- 2, and 12 +/- 1 mm, respectively; p less than 0.01) but similar values of %IB for both septum (23 +/- 4%, 21 +/- 7%, and 23 +/- 8%, p = NS) and posterior wall (10 +/- 2%, 9 +/- 2%, and 11 +/- 2%, p = NS). In athletes, no correlation was found between septal and posterior wall thickness and the corresponding regional myocardial reflectivity (r = 0.23, p = NS and r = 0.01, p = NS, respectively). Furthermore, we compared the quantitative ultrasonic data between two subsets of 10 athletes and 10 patients with hypertrophic cardiomyopathy and similar degrees of septal thickness (16 +/- 1 versus 17 +/- 1 mm, respectively, p = NS). Septal and posterior wall %IB results were significantly higher in patients with hypertrophic cardiomyopathy (53 +/- 13% and 36 +/- 9%, respectively) than in athletes (21 +/- 7% and 10 +/- 3%, respectively; p less than 0.01 for both). CONCLUSIONS. We conclude that 1) endurance athletes show a normal pattern of quantitatively assessed ultrasonic backscatter despite of a marked left ventricular hypertrophy and 2) athletes and patients with hypertrophic cardiomyopathy and similar degrees of myocardial wall thickness can be differentiated on the basis of quantitative analysis of backscattered signal. 相似文献
39.
Shimatani T Inoue M Harada N Horikawa Y Nakamura M Tazuma S 《Digestive diseases and sciences》2004,49(5):787-794
In the pathogenesis of gastroesophageal reflux disease (GERD), gastric acid is considered to be one of the most important factors, but little is known about the degree of gastric acid secretion in GERD patients. In this study, we evaluated it in GERD patients and control subjects by 24-h intragastric pH, and serological and histological investigations, in relation to Helicobacter pylori (H. pylori) status. In H. pylori-negative GERD patients gastric acid secretion was similar to that in H. pylori-negative control subjects. In H. pylori-positive GERD patients, in particular, mild GERD patients, it decreased significantly compared to that in H. pylori-negative control subjects, but the degree of decrease was smaller than in H. pylori-positive control subjects. Results of serological and histological evaluation were supportive. In conclusion, in some GERD patients, gastric acid secretion was significantly decreased. Increased or maintained gastric acid secretion was not essential in the pathogenesis of mild GERD. 相似文献
40.