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61.
Furumoto K Miura K Nagashima D Kojima H Mori T Ito D Kajimura K Kogire M 《International journal of surgery case reports》2012,3(7):322-326
INTRODUCTIONSkeletal muscle metastases from carcinomas, especially to intercostal muscles, are rare. Most metastatic chest wall tumors from hepatocellular carcinoma (HCC) result from disseminations through needle tracts of intrahepatic HCC treatments.PRESENTATION OF CASEWe report the case of a 65-year-old man with chronic viral hepatitis B whose intrahepatic lesions were stabilized by repeated radiofrequency ablations and transcatheter arterial chemoembolization. Follow-up computed tomography demonstrated a well-enhanced mass in the right chest wall. Because α-fetoprotein and des-γ-carboxy prothrombin levels were elevated and no other tumors were detected, we diagnosed the mass as an extrahepatic metastasis from the HCC and resected it along with the surrounding ribs. There was no involvement of the bone, pleura, and lung.DISCUSSIONThe tumor was microscopically diagnosed as an intercostal muscle tumor metastasized from HCC, which has not been documented previously. The resection rate of extrahepatic tumors of HCC is low in literature. No other apparent extrahepatic recurrence has been observed for more than 20 months after the surgery.CONCLUSIONWe report the case of HCC patient who underwent surgical resection of an intercostal muscle tumor that had metastasized from HCC. Pathological examination of the tumor revealed the tumor cells in the blood vessels, and we speculate it hematogeneous metastasis. 相似文献
62.
Yoshikawa T Aoki S Abe O Hayashi N Masutani Y Masumoto T Mori H Satake Y Ohtomo K 《Radiation Medicine》2008,26(8):481-487
Purpose The aim of the study was to estimate the effect of distortion correction with correspondence to numbers of encoding directions
to acquire diffusion tensor imaging (DTI) of improved quality.
Materials and methods Ten volunteers underwent DTI of the head using echo planar imaging with 6, 13, 27, and 55 encoding directions. Fractional
anisotropy (FA) maps and apparent diffusion coefficient (ADC) maps were created before and after distortion correction. Regions
of interest were placed in the corpus callosum on each map, and standard deviations of FA and ADC were calculated. FA maps
were also evaluated visually by experienced neuroradiologists.
Results Dispersion of standard deviations tended to be reduced after distortion correction, with significant differences found in
FA maps with 6 encoding directions, ADC maps with 6 directions, and ADC maps with 13 directions (P < 0.001, P < 0.005, and P < 0.05, respectively). Visual image quality was improved after distortion correction (P < 0.01 for all of the visual comparisons).
Conclusion Distortion correction is effective in providing DTI of enhanced quality, notwithstanding the number of encoding directions.
This article was presented at a Japan Radiological Society meeting in 2002 相似文献
63.
The surgical techniques and clinical results of quadrantectomy as a form of breast-conserving surgery are described. A quadrantectomy is a breast-conserving technique including wide resection and tumorectomy. A quadrantectomy is designed to remove an anatomic segment of breast tissue (duct-lobular system). It has the advantage of greater surgical curability than other conserving techniques in cases with ductal spread, because breast cancer arising in the terminal duct often spreads in the duct-lobular system. However, quadrantectomy poses some cosmetic problems due to the large volume of breast tissue excised. Additionally, quadrantectomy has failed to show better results in local recurrence rates compared with wide resection. Therefore quadrantectomy should be limited to breast cancer with segmental and wide ductal spread. It is important to determine the surgical technique that compromises between local curability and cosmetic results for each patient with breast cancer. 相似文献
64.
Detrusor instability with equivocal obstruction: A predictor of unfavorable symptomatic outcomes after transurethral prostatectomy 总被引:2,自引:0,他引:2
Machino R Kakizaki H Ameda K Shibata T Tanaka H Matsuura S Koyanagi T 《Neurourology and urodynamics》2002,21(5):444-449
AIMS: To elucidate whether preoperative urodynamic findings can predict outcomes of transurethral resection of the prostate (TUR-P). METHODS: Sixty-two patients with symptomatic benign prostatic hyperplasia were categorized in three different ways based on findings of preoperative pressure-flow study (PFS) and cystometry: urodynamic obstruction (determined by the Abrams-Griffiths nomogram), detrusor instability (DI), and combination of both. Outcomes of TUR-P regarding symptom, function, and quality of life (QOL) were analyzed by changes in the International Prostate Symptom Score (I-PSS), maximum flow rate in uroflowmetry, and QOL index before and after TUR-P, respectively. Overall outcome was defined as success when all of the three categories showed successful improvement. RESULTS: Neither urodynamic obstruction alone nor DI alone predicted outcomes of TUR-P. However, symptomatic and overall outcomes were significantly worse in patients who were not obstructed but had DI. Postoperative persistent DI was more frequently noted in patients without clear obstruction (60%) than in those with obstruction (27%). Patients with equivocal obstruction showed less satisfactory symptomatic outcomes of TUR-P when DI was accompanied. Persistent DI might be the principle cause of unfavorable outcomes. CONCLUSIONS: Preoperative evaluation of DI is of benefit because it enhances predictive value of the PFS. 相似文献
65.
A case of primary leiomyosarcoma of the ureter 总被引:1,自引:0,他引:1
Shirotake S Sumitomo M Asakuma J Asano T Aiko S Hayakawa M 《Hinyokika kiyo. Acta urologica Japonica》2006,52(1):41-45
A 60-year-old woman was admitted to our hospital with pain in the left flank. Retrograde pyelography, computed tomographic scan, and magnetic resonance imaging demonstrated left hydronephrosis due to a 7 cm retroperitoneal mass involving the left ureter. Left nephroureterectomy and partial resection of the mesentery revealed a primary ureteral leiomyosarcoma. Three months postoperatively, the patient received systemic chemotherapy (CYVADIC; cyclophosphamide, vincristine, adriamycin and DTIC) for a recurrent tumor. Two courses of chemotherapy reduced the tumor by nearly 60%. Then we performed surgery in an attempt to resect the residual disease. However, the tumor continued to progress and the patient died approximately one year after diagnosis. 相似文献
66.
Kuroki T Tajima Y Tsutsumi R Mishima T Kitasato A Adachi T Kanematsu T 《American journal of surgery》2006,191(6):823-826
Intraductal papillary mucinous neoplasm (IPMN) of the pancreas showed significantly less aggressive pathologic features compared with common pancreatic cancer. Therefore, several organ-preserving techniques, including duodenum-preserving pancreatic head resection, have been advocated in surgical procedures for IPMN. We describe a surgical technique of superior head resection of the pancreas with inferior branch preservation followed by a gastric wall-covering method for the prevention of pancreatic leakage in patients with IPMN of the pancreas head. 相似文献
67.
Takeshi?Namekawa Takanobu?UtsumiEmail author Tomoaki?Tanaka Mayuko?Kaga Hidekazu?Nagano Takashi?Kono Koji?Kawamura Naoto?Kamiya Takashi?Imamoto Hiroyoshi?Suzuki Tomohiko?Ichikawa 《World journal of surgery》2017,41(4):986-990
Background
Laparoscopic adrenalectomy has been established as a standard surgical method for unilateral primary aldosteronism. Meanwhile, the background characteristics of the patients undergoing adrenalectomy have changed over the last 20 years. The aim of this study was to investigate the changes in hypertension cure rates after laparoscopic adrenalectomy during the last two decades.Methods
This retrospective clinical study included 176 patients who underwent unilateral laparoscopic adrenalectomy for primary aldosteronism from 1995 to 2015. The patients were divided into two groups by decade. The patients’ baseline characteristics and the hypertension cure rates were compared between the two groups. Additionally, the values were re-examined based on predictive model predicting postoperative hypertension cure.Results
The hypertension cure rate decreased significantly from 51.8 to 31.1%. The following variables were significantly different between the two groups: age, sex, body mass index, history of diabetes mellitus, preoperative systolic and diastolic blood pressures, potassium level, and plasma renin activity.Conclusions
This study showed that the number of patients with unfavorable conditions for hypertension cure after adrenalectomy has recently increased. The treatment goal for primary aldosteronism is not only to cure the hypertension but also to prevent organ disorders due to inappropriate aldosterone levels. Therefore, we recommend laparoscopic adrenalectomy for unilateral primary aldosteronism, even if hypertension is not always cured postoperatively. However, clinicians need to fully explain the postoperative hypertension outcomes to primary aldosteronism patients.68.
Tomohiko Hirose 《European journal of orthopaedic surgery & traumatology : orthopedie traumatologie》2008,18(1):55-57
This article will describe the incidence of a low-energy hip dislocation, due to a fall from a standing height, in a 64-year-old female with hereditary multiple exostosis (HME). The dislocated left hip was reduced under spinal anesthesia, and the patient was restricted to 3 weeks of bed rest with skeletal traction of the affected limb. The post-reduction CT scan revealed a tangential fracture in the apex of the exostosis on the posteroinferior aspect of the femoral neck. The exostosis was assumed to impinge on the ischium and that the lever mechanism led to the dislocation. The 3 month follow-up MRI revealed no evidence of subluxation or avascular necrosis of the femoral head. 相似文献
69.
Akira Komiya Takumi Endo Masayuki Kobayashi Woojin Kim Kazuhiro Araki Yukio Naya Hiroyoshi Suzuki Toyofusa Tobe Tomohiko Ichikawa Hideki Fuse 《International journal of urology》2009,16(11):874-880
Objectives: To examine the pre-emptive analgesic effect of the non-steroidal anti-inflammatory drug zaltoprofen against rigid cystoscopy-associated pain, and compare it with the effect of an anesthetic gel.
Methods: Forty men periodically undergoing follow-up office cystoscopy were enrolled in this prospective study. The effects of lidocaine gel alone or in combination with zaltoprofen, were examined. The following parameters were assessed using an 11-point numerical rating scale: pain during injection of gel into the urethra, insertion of rigid cystoscope, and the endoscopic examination of the urinary bladder, pain at the first urination after cystoscopy, and at the first urination in the following morning at home.
Results: Pain scores with pre-emptive zaltoprofen plus lidocaine gel were significantly lower than the ones with lidocaine gel alone at the time points of inserting rigid cystoscope into the urethra, viewing inside the urinary bladder and the first urination after cystoscopy. The efficacy of zaltoprofen was more significant in the patients with higher baseline pain score. There was no correlation between pain scores and bladder cancer grading, number of tumors, and time from surgery.
Conclusions: Pre-emptive zaltoprofen is able to control cystoscopy-associated pain, which translates into better quality of life for patients. Thus, its use is recommended in the management of these patients. 相似文献
Methods: Forty men periodically undergoing follow-up office cystoscopy were enrolled in this prospective study. The effects of lidocaine gel alone or in combination with zaltoprofen, were examined. The following parameters were assessed using an 11-point numerical rating scale: pain during injection of gel into the urethra, insertion of rigid cystoscope, and the endoscopic examination of the urinary bladder, pain at the first urination after cystoscopy, and at the first urination in the following morning at home.
Results: Pain scores with pre-emptive zaltoprofen plus lidocaine gel were significantly lower than the ones with lidocaine gel alone at the time points of inserting rigid cystoscope into the urethra, viewing inside the urinary bladder and the first urination after cystoscopy. The efficacy of zaltoprofen was more significant in the patients with higher baseline pain score. There was no correlation between pain scores and bladder cancer grading, number of tumors, and time from surgery.
Conclusions: Pre-emptive zaltoprofen is able to control cystoscopy-associated pain, which translates into better quality of life for patients. Thus, its use is recommended in the management of these patients. 相似文献
70.
Hiroshi Kawachi Koichi Suzuki Naoko Miyauchi Taeko Hashimoto Yasuhiro Otaki Fujio Shimizu 《Clinical and experimental nephrology》2009,13(4):275-280
Several recent studies have demonstrated that the slit diaphragm of the glomerular epithelial cell (podocyte) is the structure
likely to be the principal barrier in the glomerular capillary wall. Nephrin identified as a gene product mutated in congenital
nephrotic syndrome located at the outer leaflet of plasma membranes of the slit diaphragm. The anti-nephrin antibody is capable
of inducing massive proteinuria, which indicates that nephrin is a key functional molecule in the slit diaphragm. Expression
of nephrin was reduced in glomeruli of minimal change nephrotic syndrome. Some recent studies demonstrated that podocin, CD2-associated
protein and NEPH1 are also functional molecules in the slit diaphragm, and their expressions are altered in membranous nephropathy
and also in focal glomerulosclerosis. These observations suggested that the alteration of the molecular arrangement in the
slit diaphragm is involved in the development of proteinuria in several kinds of glomerular diseases. Recent studies of our
group have demonstrated that type 1 receptor-mediated angiotensin II action reduced the expression of the slit diaphragm-associated
molecules and that type 1 receptor blockade ameliorated proteinuria by preventing the function of angiotensin II on the slit
diaphragm. By the subtraction hybridization techniques using glomerular cDNA of normal and proteinuric rats, we detected that
synaptic vesicle protein 2B and ephrin B1 are involved in the maintenance of the barrier function of the slit diaphragm.
Presented at the 36th Eastern Regional Meeting of the Japanese Society of Nephrology. 相似文献