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81.
Ten‐year long‐term results after non‐surgical management of hepatolithiasis,including cases with choledochoenterostomy 下载免费PDF全文
82.
Kazunari Nakahara Chiaki Okuse Nobuyuki Matsumoto Keigo Suetani Ryo Morita Yosuke Michikawa Shun-ichiro Ozawa Kosuke Hosoya Shinjiro Kobayashi Takehito Otsubo Fumio Itoh 《World journal of gastroenterology : WJG》2015,21(24):7589-7593
We present three cases of self-expandable metallic stent (SEMS) placement using a balloon enteroscope (BE) and its overtube (OT) for malignant obstruction of surgically reconstructed intestine. A BE is effective for the insertion of an endoscope into the deep bowel. However, SEMS placement is impossible through the working channel, because the working channel of BE is too small and too long for the stent device. Therefore, we used a technique in which the BE is inserted as far as the stenotic area; thereafter, the BE is removed, leaving only the OT, and then the stent is placed by inserting the stent device through the OT. In the present three cases, a modification of this technique resulted in the successful placement of the SEMS for obstruction of surgically reconstructed intestine, and the procedures were performed without serious complications. We consider that the present procedure is extremely effective as a palliative treatment for distal bowel stenosis, such as in the surgically reconstructed intestine. 相似文献
83.
Anri Sawada Kohei Unagami Shigeru Horita Kunio Kawanishi Masayoshi Okumi Sekiko Taneda Hideki Ishida Motoshi Hattori Kazunari Tanabe Kazuho Honda Keiko Uchida Akira Shimizu Junki Koike Kosaku Nitta Yoji Nagashima 《Pathology international》2019,69(11):655-660
Here, we report the case of a patient with renal allograft with full‐house immunofluorescence staining in the zero‐hour biopsy. Full‐house immunofluorescence staining is a well‐known characteristic of lupus nephritis. Previous studies have reported patients with full‐house immunofluorescence staining, but without other symptoms or serological findings; this condition is referred to as full‐house nephropathy. We identified only one case out of 2203 zero‐hour biopsies over 13 years. Zero‐hour biopsy presented no glomerular changes but showed full‐house immunofluorescence staining. Electron microscopy revealed a nonorganized electron‐dense deposit mainly in the mesangial lesion. Systemic lupus erythematosus (SLE)‐associated antibodies were negative, and complement deficiency was not observed in the donor patients. Deposition of immunoglobulin and complement levels markedly decreased within 1–3 years post transplantation. Neither donor nor recipient developed clinical or biological features of SLE; they showed good renal prognosis. 相似文献
84.
Flowcharts for the diagnosis and treatment of acute cholangitis and cholecystitis: Tokyo Guidelines 总被引:2,自引:0,他引:2
Miura F Takada T Kawarada Y Nimura Y Wada K Hirota M Nagino M Tsuyuguchi T Mayumi T Yoshida M Strasberg SM Pitt HA Belghiti J de Santibanes E Gadacz TR Gouma DJ Fan ST Chen MF Padbury RT Bornman PC Kim SW Liau KH Belli G Dervenis C 《Journal of Hepato-Biliary-Pancreatic Surgery》2007,14(1):27-34
Diagnostic and therapeutic strategies for acute biliary inflammation/infection (acute cholangitis and acute cholecystitis),
according to severity grade, have not yet been established in the world. Therefore we formulated flowcharts for the management
of acute biliary inflammation/infection in accordance with severity grade. For mild (grade I) acute cholangitis, medical treatment
may be sufficient/appropriate. For moderate (grade II) acute cholangitis, early biliary drainage should be performed. For
severe (grade III) acute cholangitis, appropriate organ support such as ventilatory/circulatory management is required. After
hemodynamic stabilization is achieved, urgent endoscopic or percutaneous transhepatic biliary drainage should be performed.
For patients with acute cholangitis of any grade of severity, treatment for the underlying etiology, including endoscopic,
percutaneous, or surgical treatment should be performed after the patient's general condition has improved. For patients with
mild (grade I) cholecystitis, early laparoscopic cholecystectomy is the preferred treatment. For patients with moderate (grade
II) acute cholecystitis, early laparoscopic or open cholecystectomy is preferred. In patients with extensive local inflammation,
elective cholecystectomy is recommended after initial management with percutaneous gallbladder drainage and/or cholecystostomy.
For the patient with severe (grade III) acute cholecystitis, multiorgan support is a critical part of management. Biliary
peritonitis due to perforation of the gallbladder is an indication for urgent cholecystectomy and/or drainage. Delayed elective
cholecystectomy may be performed after initial treatment with gallbladder drainage and improvement of the patient's general
medical condition. 相似文献
85.
Nobuyuki Nishikawa Rie Yago Yuichiro Yamazaki Hiromitsu Negoro Mari Suzuki Masaaki Imamura Yoshinobu Toda Kazunari Tanabe Osamu Ogawa Akihiro Kanematsu 《BMC urology》2015,15(1)
Background
To investigate the expression of parathyroid hormone (PTH)/PTH-related peptide (PTHrP) receptor 1 (PTH1R) in clinical specimens of normal and diseased bladders. PTHrP is a unique stretch-induced endogenous detrusor relaxant that functions via PTH1R. We hypothesized that suppression of this axis could be involved in the pathogenesis of bladder disease.Methods
PTH1R expression in clinical samples was examined by immunohistochemistry. Normal kidney tissue from a patient with renal cancer and bladder specimens from patients undergoing ureteral reimplantation for vesicoureteral reflux or partial cystectomy for urachal cyst were examined as normal control organs. These were compared with 13 diseased bladder specimens from patients undergoing bladder augmentation. The augmentation patients ranged from 8 to 31 years old (median 15 years), including 9 males and 4 females. Seven patients had spinal disorders, 3 had posterior urethral valves and 3 non-neurogenic neurogenic bladders (Hinman syndrome).Results
Renal tubules, detrusor muscle and blood vessels in normal control bladders stained positive for PTH1R. According to preoperative urodynamic studies of augmentation patients, the median percent bladder capacity compared with the age-standard was 43.6% (range 1.5–86.6%), median intravesical pressure at maximal capacity was 30 cmH2O (range 10–107 cmH2O), and median compliance was 3.93 ml/cmH2O (range 0.05–30.3 ml/cmH2O). Detrusor overactivity was observed in five cases (38.5%). All augmented bladders showed negative stainings in PTH1R expression in the detrusor tissue, but positive staining of blood vessels in majority of the cases.Conclusions
Downregulation of PTH1R may be involved in the pathogenesis of human end-stage bladder disease requiring augmentation. 相似文献86.
Differences in cerebral metabolic impairment between early and late onset types of Alzheimer's disease 总被引:19,自引:0,他引:19
Sakamoto S Ishii K Sasaki M Hosaka K Mori T Matsui M Hirono N Mori E 《Journal of the neurological sciences》2002,200(1-2):27-32
Hypercortisolemia is thought to be a marker of the stress response following stroke. The aim of this study was to investigate the prevalence and prognostic significance of hypercortisolemia. The circadian variation of cortisol level and the relationship between serum cortisol levels and other stress, inflammatory, and haemostatic markers were also investigated. Seventy consecutive patients with their first ischemic stroke and 24 age- and sex-matched controls were included in the study. Serum cortisol levels (at 6:00 AM, 10:00 AM, 6:00 PM, and 10:00 PM), 24-h urine catecholamine excretion, beta-thromboglobulin levels, and other standard biochemical and haematological parameters were measured on the first day of hospitalisation and in control subjects. Outcome measures used the Barthel Index at Day 30, as well as 30- and 90-day mortality rates. Hypercortisolemia, defined as at least two of the four measurements above the normal range of serum cortisol levels (i.e. >618 nmol/l from the morning samples and >460 nmol/l from the evening samples) was found in 25 (35.7%) of the acute stroke patients and in 3 (12.5%) of the controls (p<0.05). Hypercortisolemia was associated with older age, greater severity of neurological deficit, larger ischemic lesions on CT, and worse prognoses (p<0.05). The study did not find a correlation between serum cortisol levels and other markers of the stress response such as catecholamines excretion and glucose levels. A significant correlation between serum cortisol levels and some markers of the inflammatory response, such as fever, fibrinogen level, white blood cell (WBC) count, and beta-thromboglobulin level, was established in stroke patients. Prognostic significance of hypercortisolemia in acute stroke patients seems to be related to the inflammatory response rather than to the stress response. 相似文献
87.
Junji Takaya Yuri Fujii Hirohiko Higashino Shoichiro Taniuchi Makiko Nakamura and Kazunari Kaneko 《Pediatric diabetes》2009,10(7):484-486
Abstract: The WHIM syndrome is a rare immunological disorder characterized by warts, hypogammaglobulinemia, infections, and myelokathexis. We hypothesized that immunological or genetic mechanisms may link WHIM syndrome and type 1 diabetes. We report that the young girl with WHIM syndrome developed diabetes and transient hypothyroidism. A nonsense mutation (C→T) truncating the CXC chemokine receptor 4 (CXCR4) C-terminal cytoplasmic tail domain occurred at nucleotide position 1000(R334X) of the CXCR4 gene in one allele of the patient was identified, and the person was diagnosed as having WHIM syndrome. Recent observation suggested that the CXCR4, a G-protein-coupled receptor with a unique ligand, CXCL12, might be involved in the pathogenesis for type 1 diabetes. Taken into consideration the concurrent prevalence of the two disorders and the speculated common pathogenesis associated with the CXCR4, our patient may enable us to understand the genetic damage related to accelerated apoptosis. 相似文献
88.
89.
Yoshihide Kanno MD Dai Hirasawa MD Naotaka Fujita MD Yutaka Noda MD Go Kobayashi MD Kazuhiko Ishida MD Kei Ito MD Takashi Obana MD Takashi Suzuki MD Toshiki Sugawara MD Jun Horaguchi MD Osamu Takasawa MD Kazunari Nakahara MD Tetsuya Ohira MD Kengo Onochi MD Yoshihiro Harada MD Wataru Iwai MD Masatake Kuroha MD 《Gastrointestinal endoscopy》2009,69(7):1363-1368
90.
Shigeaki Yasaka Kazunari Murakami Takashi Abe Juro Anan Kazuhiro Mizukami Jin Tanahashi Tadayoshi Okimoto Masaaki Kodama Yoshikuni Kudo Hisanori Kawasaki Toshio Fujioka 《Journal of gastroenterology and hepatology》2009,24(10):1677-1682
Background and Aims: To investigate the utility of a new method of carrying out esophageal manometry using a narrow gauge manometry catheter via a transnasal endoscope.
Methods: The Frequency Scale for the Symptoms of gastroesophageal reflux disease (GERD) (FSSG), a GERD-specific questionnaire, was given to 45 subjects. Subjects
underwent transnasal endoscopy with three dry and three wet (3 mL water) swallows. Direct observations of the primary peristaltic wave and peristaltic pressure measurement were conducted simultaneously.
Results: Endoscopic observation of lower esophageal motility associated with swallowing revealed dilatation of the esophageal lumen after swallowing, followed by contraction in association with the primary peristaltic wave. The peristaltic pressure was significantly lower with increased FSSG scores for dry swallows ( r = −0.347, P = 0.0212), but no significant correlation was seen for wet swallows.
Conclusions: The significant negative correlation between reflux symptoms and peristaltic pressure in dry swallows was thought to be that reduced pressure immediately rostral to the lower esophageal sphincter leads to decreased clearance following gastric acid reflux, playing a large part in the onset of symptoms. 相似文献
Methods: The Frequency Scale for the Symptoms of gastroesophageal reflux disease (GERD) (FSSG), a GERD-specific questionnaire, was given to 45 subjects. Subjects
underwent transnasal endoscopy with three dry and three wet (3 mL water) swallows. Direct observations of the primary peristaltic wave and peristaltic pressure measurement were conducted simultaneously.
Results: Endoscopic observation of lower esophageal motility associated with swallowing revealed dilatation of the esophageal lumen after swallowing, followed by contraction in association with the primary peristaltic wave. The peristaltic pressure was significantly lower with increased FSSG scores for dry swallows ( r = −0.347, P = 0.0212), but no significant correlation was seen for wet swallows.
Conclusions: The significant negative correlation between reflux symptoms and peristaltic pressure in dry swallows was thought to be that reduced pressure immediately rostral to the lower esophageal sphincter leads to decreased clearance following gastric acid reflux, playing a large part in the onset of symptoms. 相似文献