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991.
Okawada M Okazaki T Yamataka A Yanai T Kato Y Kobayashi H Lane GJ Miyano T 《Pediatric surgery international》2006,22(11):925-930
A review of 100 consecutive cases of congenital diaphragmatic hernia (CDH) treated at our institute focusing on the efficacy of protocolized management (PM) was conducted. Of the 100 cases, 14 who became symptomatic more than 24 h after birth, and seven with fatal anomalies (four cardiac and three chromosomal) were excluded, leaving 79 subjects for this study. Of these, 41 were diagnosed prenatally (PD). Subjects were divided into four groups. Group I: No PD, no PM (n = 34), Group II: No PD, PM (n = 4), Group III: PD, no PM (n = 21), and Group IV: PD, PM (n = 20). PM includes criteria for planned delivery, use of high frequency oxygenation, nitric oxide, echocardiography (EC), and a medication schedule. Overall survival rates for Groups I, II, III, and IV were 73.5% (25/34), 75% (3/4), 38.1% (8/21), and 70.0% (14/20), respectively. Survival rates were higher when PM was used: 70.8% (Groups II, IV) versus 60.0% (Groups I, III). Survival rates were significantly lower if diagnosed prenatally (PD+): 53.7% (Groups III, IV) versus 73.7% (Groups I, II) (P < 0.01). However, in PD+ groups, survival was significantly higher if PM was used (P < 0.05). PM significantly reduced length of hospital stay (35.5 vs. 52.0 days: P < 0.05). EC was found to be a predictor for survival while post-ductal AaDO2 was not. In 17 cases with cardiac anomalies, PM did not affect survival. Our study suggests that use of PM for prenatally diagnosed CDH cases is associated with improved outcome, although the components of PM need to be tested in prospective trials to determine their true value. 相似文献
992.
Yoshifumi Kotake MD Takashige Yamada MD Hiromasa Nagata MD Takeshi Suzuki MD Ryohei Serita MD Nobuyuki Katori MD Junzo Takeda MD Hideyuki Shimizu MD 《Journal of clinical monitoring and computing》2009,23(3):149-155
Objective This study investigated the accuracy of the NICO monitor equipped with the newer software. Additionally, the effects of the
increased dead space produced by the NICO monitor on ventilatory settings were investi- gated.
Methods Forty-two patients undergoing elective aortic reconstruction participated in this prospective, obser- vational study at a
university hospital. Cardiac output was continuously monitored using both the NICO monitor and continuous cardiac output (CCO)
measured by a pulmonary artery catheter. A NICO monitor equipped with ver. 4.2 software was used for the first 21 patients
while a NICO monitor equipped with ver. 5.0 software was used for the rest of␣the patients. Cardiac output measured by bolus
thermo- dilution (BCO) at 30 min intervals was used as a reference.
Results The bias ± precision of the NICO monitor was 0.18 ± 0.88 l/min with ver. 4.2 software (n = 182) and 0.18 ± 0.83 l/min with 5.0 software (n = 194). The accuracy of the NICO monitor is comparable to CCO, whose bias ± &!hairsp;precision against BCO is 0.19 ± 0.81 l/min
(n = 376). At the␣same level of CO2 production and minute ventilation, PaCO2 was lower in the patients monitored by NICO with ver. 5.0 software than patients with ver. 4.2 software.
Conclusions This study demonstrated the improved perfor- mance of the NICO monitor with updated software. The performance of the NICO
monitor with ver. 4.2 or later software is similar to CCO. However, the cardiac output measurement did not fulfill the criteria
of interchangeability to the cardiac output measurement by bolus thermodilution. Updates to ver. 5.0 attenuated the effects
of rebreathing introduced by the NICO monitor without compromising the accuracy of the cardiac output measurement.
This study was presented at the Annual Meeting of the American Society of Anesthesiologists, 2004.10.26, Las Vegas, NV, USA.
Kotake Y, Yamada T, Nagata H, Suzuki T, Serita R, Katori N, Takeda J, Shimizu H. Improved accuracy of cardiac output estimation
by the partial CO2 rebreathing method. 相似文献
993.
Yuki Ogasawara Tadaharu Okazaki Yoshifumi Kato Geoffrey J. Lane Atsuyuki Yamataka 《Pediatric surgery international》2009,25(11):973-976
Purpose
We report our experience of using a commercial wound protector and retractor system to allow spontaneous sutureless closure of the abdominal wall defect in gastroschisis. 相似文献994.
PURPOSE: To evaluate the amount of ultrasound (US) used, best corrected visual acuity (BCVA), and corneal endothelial cell loss in bimanual microincision cataract surgery (MICS) and coaxial phacoemulsification. SETTING: Department of Ophthalmology, Universidade Gama Filho, Rio de Janeiro, Brazil. METHODS: A prospective randomized study included 30 patients (60 eyes) with bilateral cataract. All patients had coaxial phacoemulsification in 1 eye and MICS in the fellow eye. The US time and the effective US time were measured intraoperatively. The BCVA and central endothelial cell loss were evaluated in both groups over a 1-year follow-up. The results between the 2 groups were compared. RESULTS: The total US time was lower in the coaxial phacoemulsification group than in the MICS group; the means were 0.50 minutes +/- 0.33 (SD) and 0.82 +/- 0.39 minutes, respectively. The mean US power was similar between groups (mean 10.1% +/- 3.76% and 10.0% +/- 4.0%, respectively). The BCVA was similar between the groups from 24 hours to 1 year. The mean central corneal endothelial cell loss at 3 months was 4.66% +/- 6.10% in the coaxial phacoemulsification group and 4.45% +/- 5.06% in the MICS group and at 1 year, 6.00% +/- 6.72% and 8.82% +/- 7.39%, respectively. The only significant difference in the postoperative results between the 2 groups was central endothelial cell loss at the 1-year follow-up. CONCLUSIONS: The US time was longer in the MICS group than in the in the coaxial phacoemulsification group, but the mean US power was similar between groups. The BCVA was also similar between groups; however, the MICS group had more central endothelial cell loss at the 1-year follow-up. 相似文献
995.
996.
997.
The aim of this study was to evaluate potential predictive factors in the treatment of limited-disease small cell lung cancer (LD-SCLC). A total of 33 patients with LD-SCLC who underwent definitive chemoradiotherapy at our institute between April 1996 and May 2007 were enrolled in our retrospective study. The relationship between a range of potential predictive factors and the initial response, time to progression and pattern of failure was analyzed. The factors evaluated included the tumor markers Pro-gastrin-releasing peptide (Pro-GRP) and neuron-specific enolase; net tumor size (sum of each lesion mass on computed tomography at 1-cm intervals); total radiation dose; biological effective dose (BED); overall treatment time (OTT); time between the start of any type of treatment and the end of radiation therapy (SER). In addition, the novel factors of radiation dose-intensity (RDI = BED/OTT) and RDI/NTS (= RDI/net tumor size) were defined. Of the 33 patients evaluated in our study, 22 (67%) achieved a complete response (CR) and 27 (82%) experienced treatment failure or recurrence. High RDI/NTS values showed a significant correlation with CR (P=0.043). Prolonged OTT and lower values of RDI and RDI/NTS showed a significant correlation with recurrence within 12 months (P=0.022, 0.033 and 0.015, respectively). The lower values of RDI and RDI/NTS showed a significant correlation with distant metastasis as a first failure site (P=0.038 and 0.044, respectively). Patients with RDI/NTS ≥0.08 had a more favorable prognosis (P=0.045). Thus, RDI and RDI/NTS may become beneficial predictive factors in the treatment of LD-SCLC. However, further studies are required to confirm our preliminary results. 相似文献
998.
Tomohiko Imamura Yuji Tanaka Yumiko Ninomiya Masao Yoshinaga 《Pediatrics international》2015,57(4):716-718
Congenital junctional ectopic tachycardia is a rare tachyarrhythmia with high mortality. A pharmacological approach in early infancy is regarded as the first‐line therapeutic option. Pharmacologically, amiodarone alone or in combination with other drugs is the most commonly reported effective agent for congenital junctional ectopic tachycardia, but it has many adverse effects. Here we report the case of a 40‐day‐old infant. The clinical course suggests that combined oral flecainide and propranolol is an effective alternative therapy for early infants. Esophageal lead electrocardiography may give a clear diagnosis of junctional ectopic tachycardia. 相似文献
999.
Interleukin‐8‐producing primary cardiac undifferentiated sarcoma in a child with sustained fever 下载免费PDF全文
Ryu Yanagisawa Tomohiko Nakamura Yoshifumi Ogiso Akira Hachiya Ikuko Fujihara Daisuke Morita Kazuo Sakashita Masatomo Kitamura Hikoro Matsui Fumie Nishijima Hidetaka Hayashi Eiko Hidaka Kenji Sano Masaaki Shiohara Satoshi Yasukochi 《Pediatrics international》2015,57(4):742-745
We report the case of a 12‐year‐old boy with primary undifferentiated sarcoma of the left atrium. He had sustained fever during the clinical course and multiple lung and brain metastases. Chemotherapy and irradiation were ineffective; he died 41 days after hospitalization. On retrospective analysis, interleukin‐8 (IL‐8) was elevated; this was supported by immunohistochemistry and gene expression analysis of tumor samples. IL‐8 continued to increase with tumor progression accompanied by elevated neutrophil count and C‐reactive protein. IL‐8 is involved in malignant tumor proliferation, migration, and angiogenesis and may have been related to the clinical condition and prognosis in the present case. 相似文献
1000.