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71.
Koichi Okamoto Itasu Ninomiya Shogo Maruzen Hiroto Saito Tomoya Tsukada Jun Kinoshita Isamu Makino Keishi Nakamura Katsunobu Oyama Tomoharu Miyashita Hidehiro Tajima Hiroyuki Takamura Hirohisa Kitagawa Sachio Fushida Takashi Fujimura Tetsuo Ohta 《Esophagus》2014,11(2):89-98
Background
Tachyarrhythmia after esophagectomy is a severe complication that should not be underestimated because of its negative impact. The aims of this study were to clarify the cause and impact of postoperative tachyarrhythmia after thoracoscopic esophagectomy. Additionally, we analyzed the usefulness of landiolol administration for postoperative tachyarrhythmia.Methods
We evaluated the predictive factors for tachyarrhythmia onset after surgery and its clinical impact in 127 patients who underwent thoracoscopic esophagectomy with extended lymphadenectomy. Moreover, we analyzed the efficacy of landiolol for postoperative tachyarrhythmia.Results
Tachyarrhythmia developed in 38 of the 127 patients. Multivariate analysis showed that advanced age, heart disease, and hyperlipidemia were associated with postoperative tachyarrhythmia. Hyponatremia, hypoalbuminemia, and leukocytosis on postoperative day 3 were significantly associated with tachyarrhythmia onset. The incidence of all complications and respiratory complications, including pneumonia, was significantly higher in patients with than in those without tachyarrhythmia. The mortality rate in the tachyarrhythmia group tended to be higher than that in the nontachyarrhythmia group. Landiolol as a treatment for tachyarrhythmia immediately decreased heart rate and safely reduced subsequent respiratory complications.Conclusion
In elderly patients with cardiac disease or hyperlipidemia, surgeons should be alert for the occurrence of tachyarrhythmia after esophagectomy. Postoperative tachyarrhythmia is a marker of morbidities with particular emphasis on respiratory complications. However, it can be adequately managed by landiolol, resulting in fewer respiratory complications. Landiolol might be a safe and convenient agent for managing postoperative tachyarrhythmia after thoracoscopic esophagectomy, resulting in lower mortality and morbidity rates. 相似文献72.
73.
Case series of 17 patients with cholangiocarcinoma among young adult workers of a printing company in Japan
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Shoji Kubo Yasuni Nakanuma Shigekazu Takemura Chikaharu Sakata Yorihisa Urata Akinori Nozawa Takayoshi Nishioka Masahiko Kinoshita Genya Hamano Hiroaki Terajima Gorou Tachiyama Yuji Matsumura Terumasa Yamada Hiromu Tanaka Shoji Nakamori Akira Arimoto Norifumi Kawada Masahiro Fujikawa Hiromitsu Fujishima Yasuhiko Sugawara Shogo Tanaka Hideyoshi Toyokawa Yuko Kuwae Masahiko Ohsawa Shinichiro Uehara Kyoko Kogawa Sato Tomoshige Hayashi Ginji Endo 《Journal of hepato-biliary-pancreatic sciences》2014,21(7):479-488
74.
Aizawa Y Jastrzebski M Ozawa T Kawecka-Jaszcz K Kukla P Mitsuma W Chinushi M Ida T Aizawa Y Ojima K Tagawa M Fujita S Okabe M Tsuchida K Miyakita Y Shimizu H Ito S Imaizumi T Toba K 《Journal of electrocardiology》2012,45(3):252-259
Background and PurposeSome de- and re-polarization patterns can reflect an increased risk of ventricular tachyarrhythmias. We studied whether some electrocardiographic (ECG) patterns are able to predict the development of ventricular fibrillation (VF) during acute myocardial infarction (MI).MethodsWe compared the patterns of ST-T segment of 78 patients who developed VF during acute MI (patient with VF) vs 170 comparable patients with acute MI but with no VF complications.ResultsOf the VF group, 47 developed out-of-hospital VF and 31 developed VF after their admission to the hospital. A steep downsloping ST segment toward a negative T wave with or without a short, flat, or rising portion at the initial portion was observed in 69.2% of the 78 patients: 61.3% in patients with pre-VF and 74.5% in patients with post-VF, vs 9.4% of patients who did not develop VF (P < .0001). In 90.6% of the latter, a typical upward-concave or convex “ischemic” pattern of the ST segment was observed. Thus, the characteristic ST-T patterns were highly associated with VF with a specificity greater than 90%.ConclusionsA steep downsloping ST segment may characterize the ECGs of patients who develop VF during acute MI. 相似文献
75.
76.
Nambu T Mori K Shinoto Y Izumi R Matsuo K Kanai Y Kanamoto N Miura M Yonemitsu S Yasoda A Muro S Arai H Oki S Nakao K 《Diabetes research and clinical practice》2012,96(3):326-330
Diabetic ketoacidosis (DKA) is an acute, life-threatening complication of diabetes mellitus and is caused by insulin insufficiency. Hypothermia is defined as a core temperature of less than 35°C and is sometimes accompanied by DKA. We report two patients with diabetes who were admitted for DKA accompanied by hypothermia. 相似文献
77.
Ryosuke Kita Mika Seto Hiromasa Takahashi Yumiko Sakamoto Toshihiro Kikuta 《Oral Science International》2013,10(1):40-43
Wiskott–Aldrich syndrome (WAS) is a condition with variable expression, which causes persistent thrombocytopenia and, in its complete form, also causes small platelets and humoral immunodeficiency. A 14-year-old boy, diagnosed with WAS but never treated, presented with symptoms of heart and renal failure. His right buccal region was swollen and his right first molar showed a cyst-like image on dental X-ray films. The boy's symptoms were attributed to an infected cyst, greatly aggravated by WAS-related immunodeficiency. The boy was sedated and the affected tooth and cyst were enucleated. Invasive treatment was safely achieved by paying close attention to whole-body management. 相似文献
78.
Takatsugu Yamamoto Yukiko Kurashima Chie Watanabe Kazunori Ohata Ryoya Hashiba Shogo Tanaka Takahiro Uenishi Koichi Ohno 《International surgery》2013,98(4):412-415
A 75-year-old woman with a history of myocardial infarction, gallstones, and right renal cancer was referred to our department because of right flank pain. She had a surgical scar on the right abdomen between the 10th and 11th ribs; computed tomography demonstrated intercostal herniation of the colon. Recognizing the possibility of adhesions of the hernia and colon, we used a median skin incision and patched a polyester mesh coated with absorbent collagen. The patient had an uneventful postoperative course, with no pain for 6 months postoperatively. Transdiaphragmatic intercostal hernias with abdominal contents commonly develop after trauma or thoracic surgery. Incisional intercostal hernias seldom develop after nephrectomy; the present case is only the fourth report. We conjecture that a costochondral incision can induce subluxation of the costotransverse joint, intercostal nerve injury, and atrophy of the intercostal and abdominal oblique muscles. Surgeons must therefore recognize the potential, albeit rare, for intercostal hernia after nephrectomy. 相似文献
79.
80.
Ngoma AM Ikeda K Hashimoto Y Mochizuki K Takahashi H Sano H Matsumoto H Noji H Saito S Kikuta A Ogawa K Ohtsuka M Abe M Nollet KE Ohto H 《International journal of hematology》2012,95(1):86-94
To elucidate the correlation between regulatory T cells (Tregs) and acute graft-versus-host disease (aGVHD) or cytomegalovirus infection following allogeneic bone marrow transplantation (allo-BMT), we evaluated either CD4?CD25(high) or FOXP3? Treg-enriched cells in peripheral blood (PB) from 20 patients who received allo-BMT, and in biopsies of skin with aGVHD. Proportions of CD4?CD25(high)FOXP3? cells in total lymphocytes, but not other types of T cells, were lower in patients who eventually developed grades II-IV aGVHD (n = 13) than in others (n = 7, P < 0.001). Proportions of CD62L? cells in CD4?CD25(high) cells at day +30 were lower (P < 0.01) in patients who eventually showed cytomegalovirus viremia (n = 6) than in others (n = 14). Incidence of aGVHD (P < 0.05) or cytomegalovirus viremia (P < 0.05) was higher in patients without these complications, but with lower proportions of PB CD4?CD25(high)FOXP3? cells at day +30 (n = 8) than in others (n = 8). However, in skin with aGVHD (n = 5), there was marked or slightly increased infiltration of CD8? cells (P < 0.001) or CD3?FOXP3? cells (P < 0.05), respectively, when compared with control (n = 5), resulting in threefold higher ratio of CD8?/CD3?FOXP3? cells in aGVHD relative to controls (P < 0.05). Thus, impaired reconstitution of Tregs may be associated with aGVHD and CMV infection. Moreover, imbalance of Tregs and CD8? cells may play a role in aGVHD tissue. 相似文献