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81.
Tsutomu Saito Hiroyuki Horimi Tsuguo Hasegawa Toshiro Kamoshida 《Surgery today》1993,23(12):1081-1084
We report herein the case of a 42-year-old man in whom dyspnea on exertion was found to be caused by isolated tricuspid stenosis. Two-dimensional echocardiogram showed thickening of the tricuspid valve with a markedly enlarged right atrium. A color-flow Doppler examination-revealed severe tricuspid stenosis without regurgitation and a Doppler-derived tricuspid diastolic pressure gradient of 23 mmHg. At the time of surgery, the patient was noted to have a stenotic tricuspid valve with thickened leaflets, fused commissures, and almost normal chorda tendineae. The valve leaflets were teased apart to the scattered specimen, and tricuspid valve replacement was successfully performed. Microscopic examination of the specimen demonstrated infective endocarditis. Isolated acquired tricuspid stenosis is extremely rare and, to our knowledge, this is the first case of infective endocarditis being involved as the primary cause. 相似文献
82.
The effect of complete unilateral ureteral obstruction (CUUO) on proximal tubular functions was studied in rats, using the K+-sensitive microelectrode technique and split oil drop method. In the control kidneys peritubular membrane potential (EMperi) and intracellular potassium activity (aKi) were -70.8 +/- 7.0 mV and 81.2 +/- 22.0 mEq/liter (mean +/- SD), respectively. In the CUUO kidneys both EMperi and aKi were progressively reduced with the duration of obstruction. However, in all tubules aKi values were still above the electrochemical equilibrium. In the three days' CUUO kidneys EMperi and aKi were -51.5 +/- 11.7 mV and 53.8 +/- 22.8 mEq/liter, respectively. Rate of fluid absorption (JVL;nl./sec. mm.) across the proximal tubular epithelium from Ringer solution in the control and three days' CUUO kidneys was 0.029 and 0.0065 respectively. In the CUUO kidneys there were wide variations in JVL and EMperi, but there was a clear correlation between these two variables. JVL from choline chloride solution was negligible in both control and CUUO kidneys. From above results, it was suggested that the proximal tubular reabsorption primarily depending on the Na+-K+ pump might be reduced but still working in the CUUO kidney, and thus the proximal tubular reabsorption might take part in preservation of glomerular filtration during the obstruction. 相似文献
83.
84.
85.
Masahiko Saito 《SANGYO EISEIGAKU ZASSHI》2003,45(4):139-143
Although occult urinary blood in health examinations is common in healthy employees, in the majority with occult urinary blood usually no further examination or treatment is necessary, but occult urinary blood could be an early symptom in urinary tract malignancy. In this study the data on health examinations of male employees with occult urinary blood were analyzed from 1999 to 2002 and strategies for them were discussed. The subjects were male employees working in a steel company, 1,135 ('99), 1,077 ('00), 994 ('01) and 945 ('02). The positive ratios of occult urinary blood were 8.6% in '99, 7.6% in '00, 7.8% in '01, 8.3% in '02, respectively. Multiple logistic regression analysis showed that age and urinary protein were significant factors associated positively with occult urinary blood. In general, a man who had urinary tract malignancy would have macroscopic hematuria in the course of the disease. Therefore, in people with recurrent occult urinary blood the risk of urinary malignancy is considered to be rare. The follow-up protocol was set up for employees with occult urinary blood. For four years 6 employees were referred to specialists (5 to a urologist and 1 to a nephrologist). No significant disease, including urinary tract malignancy, was detected. 相似文献
86.
Y Shiokawa M Nobunaga T Saito T Sakita T Miwa K Nakamura A Gunji K Aoki 《Ryūmachi》1991,31(5):554-571
87.
Chihaya Maesawa Gen Tamura Yasushi Suzuki Kaoru Ishida Kazuyoshi Saito Ryoichi Satodate 《Cancer science》1992,83(12):1253-1256
For the rapid and sensitive detection of p53 gene mutations in esophageal endoscopic biopsy specimens, we combined cell sorting with the polymerase chain reaction and single-strand conformation polymorphism (PCR-SSCP) analysis. Mutations in exons 5–8 of the p53 gene were investigated by FCR-SSCF analysis using 103 sorted nuclei obtained from each endoscopic biopsy specimen of 16 patients with esophageal cancer. DNAs extracted from their respective surgical specimens were investigated by a conventional method of PCR-SSCP analysis. Mutations in the biopsy specimens were detected in 6 of the 12 aneuploid tumors but in none of the 4 diploid tumors. After tumor cell enrichment by cell sorting, one mutation in exon 8 became apparent, which could not be detected from the surgical specimen by a conventional method of PCR-SSCP analysis. This method should improve the sensitivity of detecting p53 gene mutations, and provides additional information concerning the DNA ploidy pattern in the tumors. 相似文献
88.
89.
Preliminary results of intermittent retrograde cerebral perfusion during proximal aortic arch surgery. 总被引:1,自引:0,他引:1
Shinpei Yoshii Okihiko Akashi Masahiro Kobayashi Atsuo Kojima Samuel J K Abraham Shunya Shindo Yusuke Tada Hiroji Higuchi 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2003,51(11):588-593
OBJECTIVE: Continuous retrograde cerebral perfusion during aortic arch surgery is associated with cerebral edema. In this report, we describe the clinical use of a new type of intermittent retrograde cerebral perfusion. SUBJECTS AND METHODS: Fourteen patients with a Stanford type A dissection were included in this study. With the usual method of retrograde cerebral perfusion, about 2,500 mL venous blood is drained from bicaval cannulae into a hard-shell reservoir, and oxygenated blood is perfused through the superior vena caval cannula. The flow rate is 300 mL/min. After about 15 min, retrograde perfusion is discontinued, and drainage from the bicaval cannulae is restarted. When a bloodless field is necessary, perfusion also is discontinued. RESULTS: Two to seven cycles of intermittent retrograde cerebral perfusion were administered (average, 3.1+/-0.4, mean+/-SD). The total retrograde perfusion time was 36.0+/-1.9 min which was equivalent to 74.8% of the circulatory arrest time. No patient developed edema of the upper body. The time to wake-up was 3 to 14 h (average, 6.5+/-1.0 h). No patient suffered any neurologic complications even though the time of circulatory arrest was greater than 60 min in four cases. Head magnetic resonance imaging or computed tomography was performed in 12 cases, and no evidence of hypoxic brain injury was detected. CONCLUSIONS: Our clinical experience using a moderate amount of intermittent retrograde cerebral perfusion is superior to continuous retrograde cerebral perfusion for protecting the brain during aortic arch surgery. 相似文献
90.
β2-glycoprotein-I (β2GPI) is a phospholipid-binding plasma protein that consists of five homologous domains. Domain V is distinguished from others by bearing a positively charged lysine cluster and hydrophobic extra C-terminal loop. β2GPI has been known as a natural anticoagulant regulator. β2GPI exerts anticoagulant activity by inhibition of phospholipid-dependent coagulation reactions such as prothrombinase, tenase, and factor XII activation. It also binds factor XI and inhibits its activation. On the other hand, β2GPI inhibits anticoagulant activity of activated protein C. According to the data from knockout mice, β2GPI may contribute to thrombin generation in vivo. Phospholipid-bound β2GPI is one of the major target antigens for antiphospholipid antibodies present in patients with antiphospholipid syndrome (APS). Binding of pathogenic anti-β2GPI antibodies increases the affinity of β2GPI to the cell surface and disrupts the coagulation/fibrinolysis balance on the cell surface. These pathogenic antibodies activate endothelial cells via signal transduction events in the presence of β2GPI. Impaired fibrinolysis has been reported in patients with APS. Using a newly developed chromogenic assay, we demonstrated lower activity of intrinsic fibrinolysis in euglobulin fractions from APS patients. Addition of monoclonal anti-β2GPI antibodies with β2GPI also decreased fibrinolytic activity in this assay system. β2GPI is proteolytically cleaved by plasmin in domain V (nicked β2GPI) and becomes unable to bind to phospholipids, reducing antigenicity against antiphospholipid antibodies. This cleavage occurs in patients with increased fibrinolysis turnover. Nicked β2GPI binds to plasminogen and suppresses plasmin generation in the presence of fibrin, plasminogen, and tissue plasminogen activator (tPA). Thus, nicked β2GPI plays a role in the extrinsic fibrinolysis via a negative feedback pathway loop. 相似文献