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41.
Matsuo K Nagano Y Sugimori K Taniguchi K Gorai K Kunisaki C Ike H Tanaka K Imada T Kamijo S Nozawa A Nakatani Y Miura Y Tanaka K Endo I Sekido H Togo S Shimada H 《Journal of gastroenterology》2005,40(3):306-311
Primary malignant peripheral nerve-sheath tumors of the common bile duct are extremely rare. To our knowledge, the published literature contains no previous case report of this disease. Here we report on a 58-year-old Japanese woman with a primary malignant peripheral nerve-sheath tumor of the common bile duct, which was completely resected. A hypoechoic mass was identified in the hepatic hilus, using ultrasonography and computed tomography. Endoscopic retrograde cholangiography revealed a smooth stricture and deviation of the common bile duct. Laparotomy exposed a firm mass around the common bile duct that had not invaded the surrounding tissues. Partial resection of the common bile duct and cholecystectomy were performed as the treatment of choice. The final histopathological diagnosis was malignant peripheral nerve-sheath tumor arising from the wall of the common bile duct. 相似文献
42.
Costa JM Tsutsui JM Nozawa E Morhy SS Andrade JL Ramires JF Mathias W 《Echocardiography (Mount Kisco, N.Y.)》2005,22(5):389-394
Patients in an intensive care unit (ICU) under mechanical ventilation (MV) are very difficult to image by transthoracic echocardiography, diminishing the beneficial information that could be obtained by this noninvasive approach. The objective of this study is to assess whether the addition of a contrast agent to fundamental imaging (FI) can improve or change the initial diagnosis in cardiac postoperative patients under mechanical ventilation by enhancing endocardial border delineation and Doppler flow signal. Thirty mechanically ventilated post-cardiac surgery patients (20 men, mean age 61 +/- 13 years) were evaluated with FI before and after intravenous injection of contrast. Left ventricular endocardial border delineation score index (EBDSI), estimated left ventricular ejection fraction (LVEF), and color and spectral Doppler were analyzed. The use of contrast resulted in a significant increase in the number of well-delineated segments, with a salvage rate of 77% of nondiagnostic studies. EBDSI was 1.62 +/- 0.61, before contrast, increasing to 2.05 +/- 0.53 after it (P < 0.001). There was a change in the LVEF estimation in 5 exams, and a new wall motion abnormality was detected in other 4 exams, after the use of contrast. Moreover, a significant change was observed in the quantification of mitral regurgitation in 5 patients, in the aortic transvalvular peak gradient in 1 patient, and measurement of tricuspid regurgitation peak flow velocity in 8 patients. It is concluded that in cardiac postoperative patients under mechanical ventilation, intravenous injection of a contrast agent using FI resulted in a high salvage rate of studies and changed the initial diagnosis in a significant number of patients. 相似文献
43.
Case series of 17 patients with cholangiocarcinoma among young adult workers of a printing company in Japan 下载免费PDF全文
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
44.
Sasaki K Kazama S Sunami E Tsuno NH Nozawa H Nagawa H Kitayama J 《Diseases of the colon and rectum》2012,55(1):72-78
45.
Shimizu H Kimura F Yoshidome H Ohtsuka M Kato A Yoshitomi H Nozawa S Furukawa K Mitsuhashi N Takeuchi D Takayashiki T Suda K Miyazaki M 《Hepato-gastroenterology》2012,59(116):1023-1025
Interventional procedure via percutaneous transhepatic route is often performed, as an initial treatment, in patients with benign bilioenteric anastomotic stricture. However, surgical management is required in most cases in which radiological intervention is unsuccessful. In this report, we describe a case of a 67-year-old woman with recurrent bilioenteric anastomotic stricture, accompanying bilateral hepatolitiasis after several times of transhepatic interventions. The patient underwent intrahepatic cholangiojejunostomy (Longmire procedure) and cholangioscopic lithotomy after resection of an atrophic left lateral segment resulting from hepatolithiasis. Although the damaged hilar bile duct had to be isolated and divided from the corresponding vasculature for re-anastomosis, it was quite impossible due to severe inflammatory change at the hepatic hilus. We, therefore, anastomosed the intact biliary stump on the cut surface of the left lateral segment to the jejunal loop with a stent tube. The patient's postoperative course was uneventful and she exhibited no evidence of cholangitis during follow-up period of 1 year after surgery. At present, the indications for intrahepatic cholangiojejunostomy for biliary obstruction, are quite limited, but biliary surgeons should keep this procedure in mind at the time of biliary reconstruction for benign proximal bile duct stricture, particularly in cases of multiply operated hilum. 相似文献
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48.
Hiroji Shinkawa Shigekazu Takemura Takahiro Uenishi Masayuki Sakae Kazunori Ohata Yorihisa Urata Kazuhisa Kaneda Akinori Nozawa Shoji Kubo 《Surgery today》2013,43(3):276-283
Purpose
Malnutrition has been considered a risk factor for the development of a surgical site infection (SSI). The aim of this study was to determine the relationship between preoperative nutritional screening scores and the development of SSI after pancreaticoduodenectomy.Methods
We examined 64 patients who had undergone pancreaticoduodenectomy. Their clinical data, nutritional risk index (NRI), and nutritional risk screening 2002 (NRS-2002) score were recorded. SSIs were diagnosed according to the definitions of wound infection established by the Center for Disease Control and Prevention and were confirmed by a microbiological examination. Data were analyzed using the Fisher exact probability method and a multivariate logistic regression analysis.Results
SSIs developed in 21 patients (33 %). Eleven patients had wound infections, and 14 patients had an intra-abdominal abscess. A univariate analysis of perioperative factors revealed that a pancreatic fistula, the NRS-2002, and the NRI were significantly associated with the development of SSI (p < 0.05). The multivariate logistic regression analysis revealed that a pancreatic fistula and the NRI were independent risk factors for SSI. By analyzing the pre- and intra-operative factors after excluding the 11 patients with pancreatic fistulas, the NRI was still an independent risk factor for SSI.Conclusion
The present study showed the NRI to be an independent factor for predicting the risk of SSI after pancreaticoduodenectomy. 相似文献49.
Junko?KishikawaEmail author Shinsuke?Kazama Koji?Oba Kiyoshi?Hasegawa Hiroyuki?Anzai Yuzo?Harada Hiroyuki?Abe Keisuke?Matsusaka Kumiko?Hongo Masaru?Oba Koji?Yasuda Kensuke?Otani Takeshi?Nishikawa Toshiaki?Tanaka Junichiro?Tanaka Tomomichi?Kiyomatsu Keisuke?Hata Kazushige?Kawai Hiroaki?Nozawa Hironori?Yamaguchi Soichiro?Ishihara Eiji?Sunami Tetsuo?Ushiku Joji?Kitayama Masashi?Fukayama Norihiro?Kokudo Toshiaki?Watanabe 《Annals of surgical oncology》2016,23(6):1916-1923
Background
CD133 is a transmembrane protein that is proposed to be a stem cell marker of colorectal cancer (CRC); however, the correlation between CD133 expression and survival of CRC patients with liver metastasis has not been fully examined.Methods
CD133 expression was evaluated immunohistochemically, both in primary tumors and synchronous liver metastases of 88 consecutive CRC patients, as well as recurrent lesions in the remnant liver of 27 of these 88 patients. The relationship between CD133 expression and clinicopathological characteristics, recurrence-free survival, and overall survival (OS) was analyzed.Results
CD133 expression in liver metastases (mCD133) was detected in 50 of 88 patients (56.8 %), and had significant correlation with CD133 expression in primary lesions (pCD133) (p < 0.001). CD133 expression in liver recurrent lesions (recCD133) also had a significant correlation with mCD133 (p < 0.001). mCD133+ patients had significantly longer disease-free survival (p = 0.043) and OS (p = 0.014) than mCD133? patients. In addition, mCD133+ patients had a significantly lower rate of extrahepatic recurrence (p < 0.001).Conclusions
Patients without CD133 expression in liver metastasis had significantly shorter survival, perhaps because mCD133? patients had a significantly higher rate of extrahepatic recurrence.50.
Tsuyoshi Ozawa MD Shinsuke Kazama MD PhD Takashi Akiyoshi MD PhD Koji Murono MD Satomi Yoneyama MD PhD Toshiaki Tanaka MD PhD Junichiro Tanaka MD PhD Tomomichi Kiyomatsu MD PhD Kazushige Kawai MD PhD Hiroaki Nozawa MD PhD Takamitsu Kanazawa MD PhD Hironori Yamaguchi MD PhD Soichiro Ishihara MD PhD Eiji Sunami MD PhD Joji Kitayama MD PhD Teppei Morikawa MD PhD Masashi Fukayama MD PhD Toshiaki Watanabe MD PhD 《Annals of surgical oncology》2014,21(8):2650-2658