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991.
992.
Shigeki Kushimoto Tomoyuki Endo Satoshi Yamanouchi Teruo Sakamoto Hiroyasu Ishikura Yasuhide Kitazawa Yasuhiko Taira Kazuo Okuchi Takashi Tagami Akihiro Watanabe Junko Yamaguchi Kazuhide Yoshikawa Manabu Sugita Yoichi Kase Takashi Kanemura Hiroyuki Takahashi Yuuichi Kuroki Hiroo Izumino Hiroshi Rinka Ryutarou Seo Makoto Takatori Tadashi Kaneko Toshiaki Nakamura Takayuki Irahara Nobuyuki Saito 《Critical care (London, England)》2013,17(4):R132
Introduction
The Berlin definition divides acute respiratory distress syndrome (ARDS) into three severity categories. The relationship between these categories and pulmonary microvascular permeability as well as extravascular lung water content, which is the hallmark of lung pathophysiology, remains to be elucidated. The aim of this study was to evaluate the relationship between extravascular lung water, pulmonary vascular permeability, and the severity categories as defined by the Berlin definition, and to confirm the associated predictive validity for severity.Methods
The extravascular lung water index (EVLWi) and pulmonary vascular permeability index (PVPI) were measured using a transpulmonary thermodilution method for three consecutive days in 195 patients with an EVLWi of ≥10 mL/kg and who fulfilled the Berlin definition of ARDS. Collectively, these patients were seen at 23 ICUs. Using the Berlin definition, patients were classified into three categories: mild, moderate, and severe.Results
Compared to patients with mild ARDS, patients with moderate and severe ARDS had higher acute physiology and chronic health evaluation II and sequential organ failure assessment scores on the day of enrollment. Patients with severe ARDS had higher EVLWi (mild, 16.1; moderate, 17.2; severe, 19.1; P <0.05) and PVPI (2.7; 3.0; 3.2; P <0.05). When categories were defined by the minimum PaO2/FIO2 ratio observed during the study period, the 28-day mortality rate increased with severity categories: moderate, odds ratio: 3.125 relative to mild; and severe, odds ratio: 4.167 relative to mild. On independent evaluation of 495 measurements from 195 patients over three days, negative and moderate correlations were observed between EVLWi and the PaO2/FIO2 ratio (r = -0.355, P<0.001) as well as between PVPI and the PaO2/FIO2 ratio (r = -0.345, P <0.001). ARDS severity was associated with an increase in EVLWi with the categories (mild, 14.7; moderate, 16.2; severe, 20.0; P <0.001) in all data sets. The value of PVPI followed the same pattern (2.6; 2.7; 3.5; P <0.001).Conclusions
Severity categories of ARDS described by the Berlin definition have good predictive validity and may be associated with increased extravascular lung water and pulmonary vascular permeability.Trial registration
UMIN-CTR ID UMIN000003627 相似文献993.
Margaret McFall-Ngai Michael G. Hadfield Thomas C. G. Bosch Hannah V. Carey Tomislav Domazet-Lo?o Angela E. Douglas Nicole Dubilier Gerard Eberl Tadashi Fukami Scott F. Gilbert Ute Hentschel Nicole King Staffan Kjelleberg Andrew H. Knoll Natacha Kremer Sarkis K. Mazmanian Jessica L. Metcalf Kenneth Nealson Naomi E. Pierce John F. Rawls Ann Reid Edward G. Ruby Mary Rumpho Jon G. Sanders Diethard Tautz Jennifer J. Wernegreen 《Proceedings of the National Academy of Sciences of the United States of America》2013,110(9):3229-3236
In the last two decades, the widespread application of genetic and genomic approaches has revealed a bacterial world astonishing in its ubiquity and diversity. This review examines how a growing knowledge of the vast range of animal–bacterial interactions, whether in shared ecosystems or intimate symbioses, is fundamentally altering our understanding of animal biology. Specifically, we highlight recent technological and intellectual advances that have changed our thinking about five questions: how have bacteria facilitated the origin and evolution of animals; how do animals and bacteria affect each other’s genomes; how does normal animal development depend on bacterial partners; how is homeostasis maintained between animals and their symbionts; and how can ecological approaches deepen our understanding of the multiple levels of animal–bacterial interaction. As answers to these fundamental questions emerge, all biologists will be challenged to broaden their appreciation of these interactions and to include investigations of the relationships between and among bacteria and their animal partners as we seek a better understanding of the natural world. 相似文献
994.
Hiroyuki Takamatsu Yoshiyasu Ogawa Noriko Kobayashi Kazue Obata Tadashi Narisawa Kouji Nakayama Saori Munemoto Go Aoki Kinya Ohata Yoshihisa Kumano Jun Ozaki Ryoichi Murata Yukio Kondo Yasushi Terasaki Toshiro Kurokawa Toshihiro Miyamoto Naomi Shimizu Toshihiro Fukushima Akira Yoshida Takanori Ueda Takashi Yoshida Shinji Nakao 《Experimental hematology》2013
995.
Masaya Iwamuro Masato Okuda Eiichiro Yumoto Seiyuu Suzuki Atsuko Shirakawa Katsuyoshi Takata Tadashi Yoshino Hiroyuki Okada Kazuhide Yamamoto 《Gut and liver》2013,7(2):258-261
The representative endoscopic features of primary intestinal follicular lymphoma are well known as small whitish polypoid nodules, but a magnified view has only been described in a few case reports. Herein, we report a case with intestinal follicular lymphoma in which magnifying endoscopy with narrow band imaging was helpful for prompt diagnosis. A 57-year-old Japanese woman underwent surveillance esophagogastroduodenoscopy. The endoscopic examination revealed confluent whitish granules in the duodenum, distinct from the nodules or polyps that are typical findings of intestinal follicular lymphoma. Magnifying endoscopy visualized whitish enlarged villi, and narrow band imaging emphasized an elongated and coiled vascular pattern. Based on these features, intestinal follicular lymphoma was highly suspected, and subsequent histological study confirmed the diagnosis. This case demonstrates that magnifying endoscopy with narrow band imaging was useful for the detection and prompt diagnosis of intestinal follicular lymphoma. The pathological features of intestinal follicular lymphoma are also discussed. 相似文献
996.
Miho Shimizu Kengo Furuichi Tadashi Toyama Shinji Kitajima Akinori Hara Kiyoki Kitagawa Yasunori Iwata Norihiko Sakai Toshinari Takamura Mitsuhiro Yoshimura Hitoshi Yokoyama Shuichi Kaneko Takashi Wada The Kanazawa Study Group for Renal Diseases Hypertension 《Diabetes care》2013,36(11):3655-3662
OBJECTIVE
We evaluated the structural-functional relationships and the prognostic factors for renal events, cardiovascular events, and all-cause mortality in type 2 diabetic patients with biopsy-proven diabetic nephropathy.RESEARCH DESIGN AND METHODS
Japanese type 2 diabetic patients with biopsy-proven diabetic nephropathy (n = 260) were enrolled. Patients were stratified by albuminuria (proteinuria) and estimated glomerular filtration rate (eGFR) at the time of renal biopsy. The outcomes were the first occurrence of renal events (requirement of dialysis or a 50% decline in eGFR from baseline), cardiovascular events (cardiovascular death, nonfatal myocardial infarction, coronary interventions, or nonfatal stroke), and all-cause mortality.RESULTS
The factors associated with albuminuria (proteinuria) regardless of eGFR were hematuria, diabetic retinopathy, low hemoglobin, and glomerular lesions. The factors associated with low eGFR regardless of albuminuria (proteinuria) were age and diffuse, nodular, tubulointerstitial, and vascular lesions. The glomerular, tubulointerstitial, and vascular lesions in patients with normoalbuminuria (normal proteinuria) and low eGFR were more advanced compared to those in patients with normoalbuminuria (normal proteinuria) and maintained eGFR. In addition, compared to patients with micro-/macroalbuminuria (mild/severe proteinuria) and low eGFR, their tubulointerstitial and vascular lesions were similar or more advanced in contrast to glomerular lesions. The mean follow-up period was 8.1 years. There were 118 renal events, 62 cardiovascular events, and 45 deaths. The pathological determinants were glomerular lesions, interstitial fibrosis and tubular atrophy (IFTA), and arteriosclerosis for renal events, arteriosclerosis for cardiovascular events, and IFTA for all-cause mortality. The major clinical determinant for renal events and all-cause mortality was macroalbuminuria (severe proteinuria).CONCLUSIONS
Our study suggests that the characteristic pathological lesions as well as macroalbuminuria (severe proteinuria) were closely related to the long-term outcomes of biopsy-proven diabetic nephropathy in type 2 diabetes.Diabetic nephropathy occurs in 20–40% of patients with diabetes (1). The prevalence of diabetic nephropathy is increasing in proportion to the increase in prevalence of diabetes, and it has been predicted to continue to increase in future (2). Diabetes is a risk factor of cardiovascular disease and death, and diabetic nephropathy further increases these risks (3). In addition, diabetic nephropathy is the leading cause of end-stage renal disease requiring dialysis or transplantation in developed countries (4–6).In recent years, many clinical studies have suggested strict glycemic control and blood pressure management by use of appropriate medication to suppress the onset and progression of diabetic nephropathy. Thus, it is important to identify patients at risk in the early stages to improve prognosis in patients with diabetic nephropathy (1). Albuminuria and glomerular filtration rate (GFR) are recommended for use as clinical markers of diabetic nephropathy (1,7–9). On the other hand, selection of pathological markers is complicated because a variety of renal lesions can be found in diabetic nephropathy in addition to factors such as obesity, hypertension, dyslipidemia, and aging, which are frequently complicated in type 2 diabetes, causing a wide variety of pathological changes (10).We previously reported on the clinical factors related to the development and progression of renal lesions in diabetic nephropathy by the evaluation of serial renal biopsies or autopsy (11). In this report, we demonstrated a significant relationship between the progression of diabetic glomerulosclerosis and clinical factors such as the control of blood glucose, type of diabetes, age at onset, type of treatment, and degree of obesity.After this study, we conducted a long-term retrospective study to evaluate the structural-functional relationships and the predictive impacts of clinicopathological parameters for renal events, cardiovascular events, and all-cause mortality among Japanese patients with biopsy-proven diabetic nephropathy in type 2 diabetes. 相似文献997.
998.
999.
Hayashi Yuki Wagatsuma Kohei Nojima Masanori Yamakawa Tsukasa Ichimiya Tadashi Yokoyama Yoshihiro Kazama Tomoe Hirayama Daisuke Nakase Hiroshi 《Journal of gastroenterology》2021,56(5):421-421
Journal of Gastroenterology - A correction to this paper has been published: https://doi.org/10.1007/s00535-021-01786-z 相似文献
1000.
Tadashi Shiohama Katsunori Fujii Kenji Shimizu Hirofumi Ohashi Tomozumi Takatani Nobuhiko Okamoto Gen Nishimura Mitsuhiro Kato Naoki Shimojo 《Congenital anomalies》2018,58(3):102-104
Pallister‐Killian syndrome (PKS) is rare genetic disorder caused by tetrasomy 12p mosaicism with supernumerary isochromosome 12p that manifests with intellectual disability, craniofacial dysmorphism, and epilepsy. Although PKS presents as a multisystem morphological defect, respiratory system involvement is rare, except for diaphragmatic hernia. We are the first to report a case of PKS with progressive subglottic stenosis. Subglottic stenosis is a potentially lethal condition due to severe respiratory obstruction and difficult intubation; therefore, further accumulation of cases is required to assess the causal link between PKS and subglottic stenosis. 相似文献