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51.
52.
Yukihiro Yokoyama Masato Nagino Hideki Nishio Tomoki Ebata Tsuyoshi Igami Yuji Nimura 《Journal of hepato-biliary-pancreatic sciences》2007,14(5):447-454
The clinical application of portal vein embolization (PVE) has contributed to improving the postoperative outcome of hilar cholangiocarcinoma. The enlarged nonembolized lobe after PVE protects the patient from postoperative hepatic failure, due to the increased functional reserve, and shortens the hospital stay. Although numerous reports have shown beneficial effects of PVE on postoperative outcome after extended hepatectomy, no randomized controlled study has been performed so far. It is urgent to establish a “gold standard” of PVE, because the indications, approach to the portal vein, types of embolic materials, and methods used to evaluate the function of the future liver remnant are variable among institutions. The indications and procedures of PVE for hilar cholangiocarcinoma may be different from those for hepatocellular carcinoma or colorectal metastasis, because, in many patients with hilar cholangiocarcinoma, biliary cancer is associated with biliary obstruction and cholangitis. This review article summarizes the contribution of PVE to the outcome of postoperative management in patients with hilar cholangiocarcinoma needing extended hepatectomy. We also describe our PVE procedure, which has been established from our experience of more than 240 cases of biliary cancer. Furthermore, the drawbacks of PVE, which may reduce the pool of candidates for surgery, are also discussed. 相似文献
53.
In purpose of identifying thyroid tissue in patients with congenital hypothyroidism during childhood, ultrasonography is usually used as a screening examination, and scintigraphy is performed secondarily. Though these methods are useful, it is not easy to identify the accurate location of thyroid tissue by these methods. We previously reported the utility of computed tomography (CT) in identifying thyroid tissue in four cases of congenital hypothyroidism. The purpose of this study is to investigate whether CT is useful in identifying thyroid tissue, compared to ultrasonography or scintigraphy. Nineteen cases (0 month to 18 years of age) that were suspected to have ectopic thyroid tissue or thyroid agenesis on ultrasonography were examined by CT. CT was useful in diagnosing ectopic thyroid tissue or thyroid agenesis in all the cases, whereas ultrasonography or scintigraphy was less accurate in this purpose in seven cases. Plain CT had a difficulty in identifying thyroid tissue in two cases, in which contrasted image was required. This study showed that CT, especially an enhanced CT, is useful in identifying thyroid tissue, when the gland is not identified in the normal position by ultrasonography. 相似文献
54.
Living-related liver transplantation (LRLT) is a relatively new surgical modality that has developed, in part, to overcome the shortage of available cadaveric livers for transplantation and as a method to provide liver graft implants from living donors for patients end-stage with liver disease in areas where the use of cadaveric livers is not yet practiced or permitted. Since 1988 almost 500 LRLTs have been performed globally. The safety of donors who provide a portion of their liver for grafting is of utmost concern, and only one donor death from this procedure has been reported in the literature. Postoperative survival in recipients depends on their pretransplant physical status, but emergency patients in rapid need of a liver have a poorer survival than elective LRLT patients for whom survival is about 80%. Children and infants are the main recipients of LRLTs, but adult patients particularly in Japan, are increasing in number, and present indications for LRLT surgery include not only cholestatic end-stage liver diseases but also metabolic disorders affecting the liver and emergency LRLTs for fulminant hepatic failure. Many ethical problems relating to the concept of liver transplantation, donor liver source, recipient selection, and reimplantation have yet to be resolved. But we believe that LRLTs and cadaveric liver transplantations are saving lives and that the practice should be continued. 相似文献
55.
Hiroaki Shikano Hidenori Ohnishi Hisashi Fukutomi Kimiko Ito Masahiro Morimoto Takahide Teramoto Mitsuhiro Aoki Takezumi Nishihori Yukihiro Akeda Kazunori Oishi Toshiyuki Fukao 《Pediatrics international》2015,57(6):1192-1195
Mondini dysplasia is rare, but has an important association with recurrent bacterial meningitis. We herein describe the case of a 3‐year‐old girl with unilateral sensorineural hearing loss who presented with three independent episodes of bacterial meningitis within 8 months. Temporal bone computed tomography indicated the characteristic features of Mondini dysplasia in the right inner ear. This was treated by surgical closure of the inner ear defect via oval window and additional vaccination was administered. Appropriate vaccination might prevent the recurrent bacterial meningitis associated with Mondini dysplasia. 相似文献
56.
Yukihiro Tsuchiya Fumitake Ishihara Goro Kajiyama Saburo Nakazawa Masao Otho Hiroshi Tanimura Yoshikazu Akura Minoru Harada Masabumi Hihara Yukio Kawai Yukihiro Kono Hajime Koshiyama Masahiro Morita Michiko Nakajima Kyoichiro Nishina Hiroshi Sagawa Terufumi Sakai Mitsuo Shoji Kayoko Sone Yoshihiro Sugimoto Keiichi Sugiyama Osamu Takahara Tomoo Takamura Susumu Tazuma Hideki Wakamatsu 《Journal of gastroenterology》1995,30(6):768-774
The use of bile acid dissolution therapy in extracorporeal shockwave lithotripsy of gallstones, remains controversial. Our
study examined whether chemolitholysis after sufficient disintegration enhanced stone clearance within 6 months of the first
lithotripsy. A total of 143 patients who developed one to three radiolucent stones measuring⪯30 mm in diameter were randomly
separated into two treatment groups: 47% were given lithotripsy alone, and 53% lithotripsy plus ursodeoxycholic acid (UDCA).
Repeated piezoelectric lithotripsy was given, with no limit on the total number of treatment sessions, to pulverize or disintegrate
stones into fragments<3 mm. Stones were disintegrated in 97% of all patients, and the fragments were ⪯2 mm in 50% of these
patients. According to an intention-to-treat analysis, 52% in the lithotripsy alone group and 58% in the UDCA group were free
of stones 6 months after the first lithotripsy (P=0.61). Of the patients with fragments⪯2 mm, 71% in the former and 86% in the latter group were free of stones 6 months after
the first lithotripsy, with no significant difference between the groups. Biliary pain occurred in 25% of all patients, including
3 with acute cholecystitis. We concluded that the sufficient disintegration of gallstones achieved with repeated lithotripsy
enhanced the early clearance of fragments, regardless of whether chemolitholysis was employed. 相似文献
57.
Hiroyoshi Machida Yoko Shibata Sumito Inoue Akira Igarashi Yoshikane Tokairin Keiko Yamauchi Tomomi Kimura Kento Sato Hiroshi Nakano Michiko Nishiwaki Maki Kobayashi Sujeong Yang Yukihiro Minegishi Kodai Furuyama Tomoka Yamamoto Tetsu Watanabe Tsuneo Konta Yoshiyuki Ueno Isao Kubota 《Respiratory investigation》2018,56(1):34-39
Background
Diabetes has been reported as a comorbidity of chronic obstructive pulmonary disease (COPD) in Western countries, but it has not been demonstrated in epidemiological reports in Japan. The purpose of this study was to clarify whether the relationship between airflow obstruction and diabetes can be confirmed in a Japanese general population.Methods
From 2004 to 2006, blood sampling and pulmonary function tests were performed on 3045 people over the age of 40 years in annual health check-ups held in Takahata, Yamagata Prefecture, Japan. Pulmonary function was re-evaluated in 2009 and 2011.Results
The prevalence of diabetes did not differ between subjects with and without airflow obstruction. Furthermore, although body mass index decreased, no increase in the prevalence of diabetes was observed with the progression of airflow obstruction. The annual changes in forced expiration volume in 1 s (FEV1) did not differ depending on the presence or absence of diabetes in the study population.Conclusion
There was no difference in the prevalence of diabetes between subjects with airflow obstruction and those without. As patients with COPD in Japan are thinner than in the West, diabetes may not be a common comorbidity in Japanese patients with COPD. 相似文献58.
Myocardial bridging increases the risk of coronary spasm 总被引:2,自引:0,他引:2
Teragawa H Fukuda Y Matsuda K Hirao H Higashi Y Yamagata T Oshima T Matsuura H Chayama K 《Clinical cardiology》2003,26(8):377-383
BACKGROUND: Myocardial bridging (MB) has been associated with cardiac events. Whether coronary spasm is one factor contributing to those events is unknown. HYPOTHESIS: This study investigated whether the likelihood of coronary spasm is increased in patients with MB. METHODS: A spasm-provocation test was performed by infusing acetylcholine into the left coronary artery in 114 Japanese patients with chest pain. The test result was defined as positive when the diameter of the coronary artery was reduced by > or = 50% and ST-segment changes were documented. Myocardial bridging was defined as a > 15% reduction in coronary arterial diameter during systole after intracoronary injection of nitroglycerin. RESULTS: Myocardial bridging was identified in 41 patients (36%) and was located in the mid-segment of the left anterior descending coronary artery (LAD) in all patients. Patients with MB experienced coronary spasm more frequently than patients without MB (MB+: 73%; MB-: 40%, p = 0.0006). Furthermore, among patients with a positive spasm-provocation test, coronary spasm occurred more frequently in the mid-segment of the LAD in patients with MB than in those without MB (MB+: 73%; MB-: 45%, p = 0.0259). Multivariate regression analysis demonstrated that MB was a predictor of coronary spasm (odds ratio: 3.478, p = 0.0088). CONCLUSIONS: These results suggest that MB increases the risk of coronary spasm and that coronary spasm may be the proximate etiology of cardiac events associated with MB. 相似文献
59.
We report on a Japanese boy with Noonan syndrome who had short stature, bilateral cryptorchidism, poor pubertal development, mild mental retardation, complex cardiac lesions consisting of hypertrophic cardiomyopathy, mitral valve stenosis and insufficiency, subvalvular aortic stenosis, and single coronary artery, and various dysmorphic features including hypertelorism, epicanthic folds, low set malrotated ears, high arched palate, micrognathia, webbed neck, low posterior hairline, shield chest, pectus excavatum, cubitus valgus, borderline short metatarsals, lymphedema, redundant skin, and nail dysplasia. Because of marked lymphedema in the bilateral lower legs, lymphatic scintigraphy was carried out at 13.3 years of age, indicating extreme lymphstasis in the lower extremities, severe lymphstasis in the forearm, the elbow, and the axillary regions, moderate lymphstasis around the ascending aorta, and mild lymphstasis in the bilateral lungs. The results, in conjunction with those suggested in Turner syndrome, imply that lymphatic hypoplasia/dysplasia and resultant distended lymphatics and lymphedema are relevant to the development of not only soft tissue and visceral anomalies but also skeletal anomalies in Noonan syndrome. 相似文献
60.
Satoshi Nozaki Aya Mawatari Yuka Nakatani Emi Hayashinaka Yasuhiro Wada Yukihiro Nomura Takahito Kitayoshi Kouji Akimoto Shinji Ninomiya Hisashi Doi Yasuyoshi Watanabe 《Molecular imaging and biology》2018,20(6):1001-1007