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991.
Nosocomial BK Polyomavirus Infection Causing Hemorrhagic Cystitis Among Patients With Hematological Malignancies After Hematopoietic Stem Cell Transplantation 下载免费PDF全文
J. Kato T. Mori T. Suzuki M. Ito T. C. Li M. Sakurai Y. Yamane R. Yamazaki Y. Koda T. Toyama N. Hasegawa S. Okamoto 《American journal of transplantation》2017,17(9):2428-2433
BK polyomavirus (BKPyV) is recognized as a pathogen that causes diseases such as hemorrhagic cystitis and nephritis after allogeneic hematopoietic stem cell transplantation (HSCT) or renal transplantation. BKPyV‐associated disease is thought to occur through reactivation under immunosuppression. However, the possibility of its nosocomial transmission and the clinical significance of such transmission have not been elucidated. During a 6‐month period, nine adult patients (median age: 47 years) who had hematological disorders and who were treated with HSCT (n = 7) or chemotherapy (n = 2) in a single hematology department developed hemorrhagic cystitis due to BKPyV infection. The polymerase chain reaction products of BKPyV DNA obtained from each patient were sequenced. Of the nine patients, six had subtype I, 2 had subtype IV, and 1 had subtype II or III. In the alignment of sequences, four and two of the six subtype I strains were completely homologous (100%). These results strongly suggest that BKPyV has the potential to cause nosocomial infection within a medical facility, especially among recipients of HSCT. Further studies are clearly warranted to elucidate the route(s) of BKPyV transmission in order to establish optimal infection control. 相似文献
992.
Tomoko Sonoda Junichi Takada Kousuke Iba Sumiyo Asakura Toshihiko Yamashita Mitsuru Mori 《Journal of orthopaedic research》2012,30(10):1529-1534
We hypothesized that environmental factors might affect the relationship between genetic predisposition and the risk of bone mineral density (BMD) loss. Cases were 114 Japanese women with a confirmed diagnosis of postmenopausal osteoporosis and controls were 171 general Japanese women. Genetic risk of SNPs in the estrogen receptors was analyzed by a case–control study. The interaction between gene and environmental factors for osteoporosis were assessed by a case‐only design. Significant increases in osteoporosis risk were observed with minor alleles of rs2077647 located in the first exon and rs2234693 located in the first intron of estrogen receptor α (ESRα). Haplotype CC at these risk SNPs was strongly associated with osteoporosis risk (odds ratio [OR] = 3.15, 95% confidence interval [CI] = 1.83–5.41). There was a statistically significant interaction between haplotype CC and alcohol drinking; moderate alcohol consumption decreased genetic risk of osteoporosis (OR = 0.22, 95%CI = 0.05–0.83). © 2012 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 30:1529–1534, 2012 相似文献
993.
994.
Responses of plasma adrenocorticotropic hormone, cortisol, and cytokines during and after upper abdominal surgery. 总被引:31,自引:0,他引:31
Y Naito S Tamai K Shingu K Shindo T Matsui H Segawa Y Nakai K Mori 《Anesthesiology》1992,77(3):426-431
There is currently accumulating evidence for bidirectional communication between the neuroendocrine and immune systems. Various cytokines have been suggested to be involved in the stimulation of stress hormone secretion during the times of infection and inflammation. To assess the possible involvement and pathophysiologic significance of cytokines in the mechanisms responsible for the perioperative stress response of the hypothalamo-pituitary-adrenal axis, we observed the changes of plasma adrenocorticotropic hormone and cortisol levels together with those of plasma endotoxin and cytokine levels. In patients undergoing pancreatoduodenectomy, perioperative stimulation of adrenocorticotropic hormone and cortisol secretion was accompanied by a significant elevation of plasma cytokine levels. Application of epidural block up to the upper thoracic levels failed to suppress this stress response effectively. In patients undergoing unilateral total hip replacement, the response of plasma hormone levels was smaller and briefer with no significant increase of plasma cytokine levels. Application of epidural block up to the lower thoracic levels suppressed this hormonal response almost completely. In patients undergoing pancreatoduodenectomy, a significant elevation of plasma endotoxin level was followed by a gradual but significant elevation of plasma tumor necrosis factor alpha and interleukin-6 levels. It seems likely that the stimulatory effects of these cytokines on the secretion of adrenocorticotropic hormone and cortisol might be involved in the development of the greater and more prolonged stress response of hypothalamo-pituitary-adrenal axis. Our present study suggests that not only neural input from the surgical wound but also stimulation of cytokine production were responsible for the development of the stress response of the hypothalamo-pituitary-adrenal axis during and after upper abdominal surgery.(ABSTRACT TRUNCATED AT 250 WORDS) 相似文献
995.
996.
Atsushi Takeno MD Ichiro Takemasa MD Shigeto Seno PhD Makoto Yamasaki MD Masaaki Motoori MD Hiroshi Miyata MD Kiyokazu Nakajima MD Shuji Takiguchi MD Yoshiyuki Fujiwara MD Toshiro Nishida MD Toshitsugu Okayama PhD Kenichi Matsubara PhD Yoichi Takenaka PhD Hideo Matsuda PhD Morito Monden MD Masaki Mori MD Yuichiro Doki MD 《Annals of surgical oncology》2010,17(4):1033-1042
Background
Peritoneal relapse is the most common pattern of tumor progression in advanced gastric cancer. Clinicopathological findings are sometimes inadequate for predicting peritoneal relapse. The aim of this study was to identify patients at high risk of peritoneal relapse in a prospective study based on molecular prediction.Methods
RNA samples from 141 primary gastric cancer tissues after curative surgery were profiled using oligonucleotide microarrays covering 30,000 human probes. Firstly, we constructed a molecular prediction system and validated its robustness and prognostic validity by 500 times multiple validation by repeated random sampling in a retrospective set of 56 (38 relapse-free and 18 peritoneal-relapse) patients. Secondly, we applied this prediction to 85 patients of the prospective set to assess predictive accuracy and prognostic validity.Results
In the retrospective phase, repeated random validation yielded ~68% predictive accuracy and a 22-gene expression profile associated with peritoneal relapse was identified. The prediction system identified patients with poor prognosis. In the prospective phase, the molecular prediction yielded 76.9% overall accuracy. Kaplan–Meier analysis of peritoneal-relapse-free survival showed a significant difference between the “good signature group” and “poor signature group” (log-rank p = 0.0017). Multivariate analysis by Cox regression hazards model identified the molecular prediction as the only independent prognostic factor for peritoneal relapse.Conclusions
Gene expression profile inherent to primary gastric cancer tissues can be useful in prospective prediction of peritoneal relapse after curative surgery, potentially allowing individualized postoperative management to improve the prognosis of patients with advanced gastric cancer. 相似文献997.
Nobutsugu Abe Masanori Sugiyama Yutaka Suzuki Osamu Yanagida Tadahiko Masaki Toshiyuki Mori Yutaka Atomi 《Journal of Hepato-Biliary-Pancreatic Surgery》2009,16(2):184-188
Background/purpose Pancreatic fistula, which is one of the main causes of late postpancreatectomy hemorrhage (PPH), is a common complication
of pancreatoduodenectomy (PD). It may erode the anastomosis site and vascular wall in its vicinity, resulting in pseudoaneurysm
formation and/or the rupture of major vessels. To protect the vessels near the area for pancreaticojejunostomy from potential
pancreatic fistula, we have adopted a surgical option by which such vessels are separated from the pancreaticojejunostomy
using a pedicled falciform ligament. We reviewed 36 patients who underwent PD that included this option.
Methods After the PD was completed (before reconstructions), the pedicled falciform ligament was spread widely on the major vessels
exposed during resection, and was fixed to the surrounding retroperitoneal connective tissue. These procedures enabled the
complete separation of these vessels from the pancreaticojejunostomy.
Results The mobilization and placement of the falciform ligament in the space between the pancreaticojejunostomy and the major vessels
were successfully carried out without any complications. Although ten (28%) patients developed pancreatic fistula and three
(8%) developed intraabdominal infection, none of the patients developed late PPH.
Conclusions The present surgical option is technically simple and easy, and may be an effective prophylactic measure against late PPH
following PD. 相似文献
998.
999.
1000.
Yoshiyuki Kuwabara Masahiro Kimura Akira Mitsui Hideaki Ishiguro Keisuke Tomoda Yoichiro Mori Ryo Ogawa Koshiro Harata Takeyasu Katada Yoshitaka Fujii 《Surgery today》2009,39(9):800-802
A segment of the transverse colon can be used for gastric reconstruction after a total gastrectomy. This report presents the
case of a 68-year-old woman with primary adenocarcinoma of the colon in a segment used for reconstruction after a total gastrectomy.
The interposed colon developed colon carcinoma 9 years after the gastric reconstruction. The possibility of a primary carcinoma
arising in a gastric colon interposition must be considered when employing the transverse colon as a gastric substitute. 相似文献