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11.
We investigated the clinical background of patients at Shin-Kokura Hospital who showed a positive culture of pleural effusion
during the period from January 1998 through December 2002. Microorganism cultures of the pleural effusions of 127 patients
were performed in this 5-year period. Seventeen patients showed a positive microorganism culture from a pleural effusion,
and 12 of these patients (70.6%) were 60 years old or more. Ten patients were diagnosed with thoracic empyema. Thirteen patients
had an underlying disease such as malignancy (5 cases), diabetes mellitus (4 cases), etc. A purulent effusion and a high concentration
of lactic dehydrogenase (LDH) in the pleural fluid were more frequently recognized in the positive-culture group. A total
of 21 strains of microorganism were isolated from the 17 patients, including 10 strains of Gram-positive cocci, 6 strains
of Gram-negative bacilli, 3 strains of anaerobes, 1 strain of mycobacterium (Mycobacterium tuberculosis), and 1 strain of fungus. Susceptibility to antimicrobial agents was generally good for most of the microorganisms isolated.
Of the 17 patients, chest-tube drainage was performed in 13, and 6 needed a surgical operation. Twelve patients improved,
but 5 died. In this study, thoracic empyema accounted for 58.8% of the 17 cases with a positive culture of pleural effusion.
Of the 10 thoracic empyema patients, 5 patients needed surgical treatment in spite of adequate antimicrobial treatment and
chest-tube drainage. Our data indicate that thoracic empyema is still difficult to treat, and thus adequate and rapid treatment
is needed for any pleural infection. 相似文献
12.
Severe myoclonic epilepsy (SMEI) or Dravet syndrome is caused by mutations of the SCN1A gene that encodes voltage-gated sodium channel alpha-1 subunit. Recently, we generated and characterized a knock-in (KI) mice with an SCN1A nonsense mutation that appeared in three independent SMEI patients. The SCN1A-KI mice well reproduced the SMEI disease phenotypes. Both homozygous and heterozygous knock-in mice developed epileptic seizures within the first postnatal month. In heterozygous knock-in mice, trains of evoked action potentials in inhibitory neurons exhibited pronounced spike amplitude decrement late in the burst but not in pyramidal neurons. We further showed that in wild-type mice the Nav1.1 protein is expressed dominantly in axons and moderately in somata of parbalbumin (PV) – positive inhibitory interneurons. Our immunohistochemical observations of the Nav1.1 are clearly distinct to the previous studies, and our findings has corrected the view of the Nav1.1 protein distribution. The data indicate that Nav1.1 plays critical roles in the spike output from PV interneurons and further, that the specifically altered function of these inhibitory circuits may contribute to epileptic seizures in the mice. These information should contribute to the understanding of molecular pathomechanism of SMEI and to develop its effective therapies. 相似文献
13.
Tetsuya Nomura Tatsuya Kawasaki Takuji Tanabe Akihiro Azuma Hiroaki Matsubara 《Annals of thoracic and cardiovascular surgery》2007,13(2):118-121
Mediastinal cystic tumors are well-marginated round lesions that comprise 12% to 18% of all mediastinal masses. These lesions include a variety of diseases with overlapping radiologic appearances and variable prognoses. Pathological examinations are almost always required for differential diagnosis. We encountered a case of anterior mediastinal tumor discovered in the process of investigation of Raynaud's phenomenon. Taking into account the tumor location, a pericardial cyst was initially suspected. However, the tumor was surgically resected and histopathological examinations demonstrated thymus-like tissue in the cyst walls. Raynaud's phenomenon greatly improved after surgery. These findings suggested that cystic thymoma originated from ectopic thymic tissue and is accompanied by paraneoplastic syndrome. 相似文献
14.
15.
Tatsurou Tanaka Yasuhiro Morimoto Hiroshi Takano Kazuhiro Tominaga Shinji Kito Sachiko Okabe Tetsu Takahashi Jin-ichi Fukuda Takeshi Ohba 《Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics》2005,100(5):609-613
OBJECTIVE: To evaluate a proposed technique for the 3-dimensional (3D) detection of hemangiomas, including vascular malformation and their feeding arteries, in the head and neck. The new technique combines phase-contrast magnetic resonance angiography (PCMRA) without contrast medium and 3D fast asymmetric spin-echo (FASE) sequences. METHODS: The technique was applied to 3 patients having hemangiomas in the head and neck region. In 1 patient the image obtained with the proposed technique was compared to that obtained by standard contrast angiography. RESULTS: In all 3 patients, the 3D presence of the hemangiomas and the feeding arteries were well defined in images created by the proposed technique. Additionally, the characterization of the hemangioma's 3D structure and distribution of the feeding arteries coincided with those observed using contrast angiography in the case for which contrast angiography was also performed. CONCLUSIONS: Preliminary experience shows that the proposed technique combining 3D-FASE and 3D-PCMRA is useful to visualize both the 3D structure of hemangiomas and to identify the 3D distribution of the feeding arteries without using contrast medium. 相似文献
16.
Isolated rupture of radial collateral ligament of the small finger DIP joint is a rare injury. We treated this lesion using a bone suture anchor with excellent results. 相似文献
17.
Yoshimasa Sakamoto Kazuhiro Hashimoto Hiroshi Okuyama Shinichi Ishii Takahiro Inoue Katsushi Kinouchi Takayuki Abe 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2005,53(9):465-469
Objective The objective of the present study was to compare long-term results of single aortic valve replacement (AVR) with mechanical
(St. Jude Medical valves: standard) and biologic (the Carpentier-Edwards pericardial) prostheses. Method: Between 1995 and 2002, 95 patients who underwent single AVR with mechanical (n=46) or biologic (n=49) prostheses were enrolled
in this study. The mean age at the operation was 54.0±9.6 years (range: 20 to 69 years) with the mechanical and 68.8±7.1 years
(range: 44 to 85 years) with the biologic prosthesis. Results: The 9-year actuarial survival rate, which was calculated by taking perioperative mortality into account, was 90.3±4.6% for
patients with mechanical valves and 87.6 ±4.8% for patients with bioprostheses, with no difference between the two groups
(p=0.342). The 9-year freedom rate from thromboembolism, reoperation, endocarditis was 94.8+3.6%, 100% and 97.8 ±2.2% for
patients with mechanical valves and 98.0 ±2.0%, 97.5 ±3.4% and 95.0 ±3.4% for those with bioprostheses, respectively. After
9 years, freedom from cardiac death averaged 97.8% in the group with mechanical valves compared with 95.3% in those with bioprostheses
(p=0.541). Conclusion: We conclude that the mid-term durability of the Carpentier-Edwards pericardial valve in the aortic position for the elderly
is excellent. Nevertheless, the risk of tissue valve reoperation progressively increases with time, and a longer follow-up
may be necessary to provide its value compared with the mechanical valves in a country like Japan with a high life expectancy.
(Jpn J Thorac Cardiovasc Surg 2005; 53:465-469) 相似文献
18.
Yukio Naya Toyofusa Tobe Takahito Suyama Kazuhiro Araki Akira Komiya Hiroyoshi Suzuki Tatsuo Igarashi Tomohiko Ichikawa 《International journal of urology》2007,14(1):17-20
OBJECTIVES: Laparoscopic surgery for kidney treatment is a common procedure. However, the efficacy of this procedure in patients with several comorbidities has not been well investigated. We conducted a retrospective comparison of results of laparoscopic surgery between patients with several comorbidities and patients with no comorbidity to access the efficacy and safety of this procedure. METHODS: The subjects were 20 patients with three or more comorbidities (group A) and 46 patients with less than three comorbidities (group B). These 66 patients were 48 men and 18 women with a mean age of 62.3 years (age range, 24-83 years). The data from these two groups were compared for American Society of Anesthesiology (ASA) physical status score, previous surgical history, duration of surgery, estimated blood loss, tumor size, complications during and after surgery, conversion rates, time to oral intake, and length of hospital stay. RESULTS: The initial ASA score and age were significantly higher for the patients with comorbidities (P < 0.0001, P = 0.0008, respectively). All other variables before, during, and after surgery were similar for both laparoscopic groups. However, the incidence of atelectasis of laparoscopy was higher than that of open surgery. CONCLUSIONS: Laparoscopic nephrectomy for patients with comorbidities is safe and minimally invasive. Further investigation to prevent atelectasis is necessary. 相似文献
19.
20.
Mitsuru Koizumi Yasuhiko Yamada Etsuji Nomura Maki Amano Yuji Okajima Hiromi Okizuka Keiko Yamada Seishi Sawano Takashi Kitahara Takashi Yamashita Minoru Nakane Toshio Ishikawa 《Annals of nuclear medicine》1995,9(2):101-104
A case of recurrent medullary thyroid cancer (MTC) was evaluated with123I-MIBG,99mTc(V)-dimercaptosuccinic acid (DMSA), and201Tl scintigraphy. This patient had been operated on for MTC in the right thyroid. Recently a left neck mass was noticed, and was suspected of being a. recurrence of MTC based on increased plasma calcitonin (CT) and carcinoembryonic antigen (CEA). He was operated on for the neck mass which revealed MTC, and papillary thyroid cancer was incidentally found in the left thyroid, but the CT and CEA levels remained high, and remaining MTC tumor was suspected. But the location of the tumor was unknown. Although99mTc(V)-DMSA scintigraphy is generally believed to be superior in sensitivity to123I-MIBG scintigraphy, it did not demonstrate the tumor site but201Tl and123I-MIBG did. Furthermore,123I-MEBG scintigraphy has greater specificity for tumors which arise in the neural crest. Judging from the results of this case and cases reported in the literatures, both123I-MIBG and99mTc(V)-DMSA should be performed in the detection of recurrent MTC. 相似文献