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排序方式: 共有1105条查询结果,搜索用时 15 毫秒
111.
112.
Keiji Matsuda Yoshihisa Fukushima Kentaro Asako Toshiya Miyata Kensuke Kaneko Tamuro Hayama Keijiro Nozawa Hiroki Ochiai Yuko Sasajima 《Asian journal of endoscopic surgery》2023,16(4):790-794
Cancer occurrence in a blind loop is extremely rare. An 86-year-old Japanese woman underwent colonoscopy for tarry stools and weight loss; it revealed a bypass of the transverse colon and small intestine, cecal cancer, and a polyp. She had suffered from acute appendicitis and had undergone two surgeries at age 25: an appendectomy and then a bypass surgery between the transverse colon and the small intestine. We performed a laparoscopy-assisted ileocecal resection for the cancer and polyp in the blind loop with an end-to-side instrumental anastomosis. The pathological examination demonstrated that the cancer was medullary carcinoma (T2, N0, M0, Stage I) and the polyp was tubular adenoma. Two months have passed since the patient's discharge, and she is free of abdominal complaints. Our literature search identified 10 cases of cancer in a blind loop. Laparoscopy-assisted surgery may be possible in patients who have undergone blind-loop surgery. 相似文献
113.
N. Segami T. Nishimura K. Miyaki H. Adachi 《International journal of oral and maxillofacial surgery》2018,47(8):1065-1069
A retrospective study was performed to determine the efficacy of a tethering procedure developed to achieve a more rigid fixation and more reliable outcome in patients with refractory dislocation of the temporomandibular joint. The cases of eight patients with dementia and systemic diseases who underwent this technique were reviewed. In these eight patients, the condyles of 13 joints were ligated using wire between screws placed in the eminence and condylar head. Additional screw–wire ligations were applied to reinforce the restraint of movement in five of the 13 joints with suspected uncontrolled dislocation. The procedure was performed successfully, and the patients were followed-up for an average of 25 months. In one patient, dislocation recurred 1 year postoperatively due to wire breakage. The five joints in which a double set of screw–wire tethering was applied showed no recurrence or wire disturbance. This technique may, therefore, have short-term efficacy in cases that are refractory to standard procedures, although the material used for ligation should be investigated further. This approach can contribute to the quality of life of patients, particularly those with a short life-expectancy. 相似文献
114.
115.
Satoshi Ebata Ayumi Yoshizaki Takemichi Fukasawa Asako Yoshizaki-Ogawa Yoshihide Asano Kosuke Kashiwabara Koji Oba Shinichi Sato 《The Journal of dermatology》2022,49(1):179-183
The benefit of rituximab (RTX) for systemic sclerosis-associated interstitial lung disease (SSc-ILD) has been shown in previous clinical trials. However, predictors of RTX efficacy have not been clarified. We investigated whether B-cell responsiveness to RTX is related to therapeutic effect. Ten SSc-ILD patients treated with RTX in an independent clinical trial (Japan Registry of Clinical Trials, jRCTs031180373) were included in this analysis. Peripheral B-cell counts were examined retrospectively before RTX administration (baseline) and at 2, 4, 12, and 24 weeks after the first RTX administration, along with percent-predicted forced vital capacity (%FVC) before and 24 weeks after RTX treatment. Relative to baseline, the percentage of residual peripheral blood B cells at 2 weeks after RTX was negatively correlated with the %FVC improvement at the 24-week assessment (r = ?0.41, p = 0.04). In the subgroup with less than 5% B-cell persistence at week 2, %FVC at the 24-week assessment was significantly improved compared to baseline (p = 0.02). In another subgroup with more than 5% residual B cells, %FVC was not significantly different after 24 weeks compared to baseline (p = 0.41). In conclusion, the removal rate of B cells after 2 weeks of RTX treatment may be a useful surrogate marker of subsequent SSc-ILD improvement. 相似文献
116.
Norihiko Matsutani Hiroto Furuta Shohei Matsuno Yoshimasa Oku Shuhei Morita Shinsuke Uraki Asako Doi Machi Furuta Hiroshi Iwakura Hiroyuki Ariyasu Masahiro Nishi Takashi Akamizu 《Journal of diabetes investigation.》2020,11(2):333-336
Activating mutations in the ABCC8 gene cause diabetes and inactivating mutations usually cause hyperinsulinemic hypoglycemia in infancy. Patients with hypoglycemia in infancy due to a heterozygous inactivating mutation have been reported to occasionally progress to diabetes later in life. We explored the gene responsible for diabetes in two brothers, who were suspected to have diabetes at 15 and 18 years‐of‐age, respectively, with whole exome sequencing, and identified a compound heterozygous ABCC8 gene mutation (p.Arg168Cys and p.Arg1421Cys). Although their father and mother were heterozygous carriers of the p.Arg168Cys and the p.Arg1421Cys mutation, respectively, neither parent had diabetes. These mutations have been reported to be responsible for hypoglycemia in infancy and function as an inactivating mutation. Our results suggest that the inactivating ABCC8 gene mutation is also important in the etiology of diabetes. 相似文献
117.
Masahiro Waza Keisuke Maeda Chihiro Katsuragawa Atsuko Sugita Ryotarou Tanaka Asako Ohtsuka Tomo Matsui Keiko Kitagawa Taiki Kishimoto Hiroko Fukui Katsuhisa Kawai Masahiko Yamamoto Michio Isono 《Journal of the American Medical Directors Association》2019,20(4):426-431
Objective
To determine the influence of the Kuchi-kara Taberu (KT) index on rehabilitation outcomes during hospitalized convalescent rehabilitation.Design
A historical controlled study.Setting and Participants
A rehabilitation hospital.Participants
Patients who were admitted to a convalescent rehabilitation ward from June 2014 to May 2017.Measures
Patients’ background characteristics included age, sex, nutritional status, activities of daily living (ADL) assessed using the Functional Impedance Measure (FIM), dysphagia assessed using the Functional Oral Intake Scale (FOIS), and reasons for rehabilitation. The following values before (control group) and after initiation of the KT index intervention period (intervention group) were compared: gain of FIM, length of stay, accumulated rehabilitation time, discharge destination, gain of FOIS, gain of body weight (BW), and nutritional intake (energy and protein).Results
Mean age was 76.4 ± 12.3 years (n = 233). There were no significant differences in the baseline characteristics of the patients at admission between the control and intervention groups, except for reason of rehabilitation. The intervention group demonstrated statistically higher values for the total (P = .004) and motor FIM gain (P = .003), total (P = .018) and motor FIM efficiency (P = .016), and FOIS gain (P < .001), compared with values in the control group. The proportion of patients returning home was statistically more frequent in the intervention group compared with that in the control group (73.4% vs 85.5%, odds ratio 2.135, 95% confidence interval [CI] 1.108-4.113, P = .022). Multivariate analyses indicated that intervention using the KT index was a significant independent factor for increased FIM gain (β coefficient = 0.163, 95% CI 1.379-8.329, P = .006) and returning home (adjusted odds ratio 2.570, 95% CI 1.154-5.724, P = .021).Conclusions/Implications
A rehabilitation program using the KT index may lead to improvement of inpatient outcomes in post-acute care. Further prospective research is warranted to confirm the efficacy of this program. 相似文献118.
The Impact of the Macroeconomy on Health Insurance Coverage: Evidence from the Great Recession 下载免费PDF全文
This paper investigates the impact of the macroeconomy on the health insurance coverage of Americans using panel data from the Survey of Income and Program Participation for 2004–2010, a period that includes the Great Recession of 2007–2009. We find that a one percentage point increase in the state unemployment rate is associated with a 1.67 percentage point (2.12%) reduction in the probability that men have health insurance; this effect is strongest among college‐educated, white, and older (50–64 years old) men. For women and children, health insurance coverage is not significantly correlated with the unemployment rate, which may be the result of public health insurance acting as a social safety net. Compared with the previous recession, the health insurance coverage of men is more sensitive to the unemployment rate, which may be due to the nature of the Great Recession. Copyright © 2013 John Wiley & Sons, Ltd. 相似文献
119.
YANG Shi-Ming Doi Tadashi Kaneko Toshihiko Cai Shu-Ping Wu Wen-Ming Matsumoto Ayumi Asako Mikiya Yamashita Toshio 《中华耳科学杂志(英文版)》2009,4(2):106-114
Objective Using optical imaging in brainstem slices, we studied evoked responses in the mouse cochlear (CN) and vestibular (VN) nuclei. Methods The use of optical imaging allowed us to visualize the.spa-tiotemporal patterns of excitatory propagation in the CN and VN. Optical recordings can differentiate excitatory propagation in the ventral CN(VCN) from that in the dorsal CN(DCN). Furthermore, we assessed the relative dis-tribution of NMDA and non-NMDA receptors in these regions using the glutamate antagonists APV (NMDA recep-tor antagonist) and CNQX (non-NMDA receptor antagonist) in mouse brainstem slices during postnatal days 1 to 3. Results The average sensitivity to APV was 99.1% in the VCN, 76.0% in the DCN and 64.9% in the VN. The average sensitivity to CNQX was 0.9% in the VCN, 24.0% in the DCN and 35.1% in the VN. These results indi-cate that the effect of APV dominated in the VCN, while both APV and CNQX were effective antagonists in the DCN and VN. In the VN, the distribution of APV-and CNQX-sensitive cells was almost completely uniform. However, in the DCN the distribution of APV- and CNQX-sensitive cells was highly complex. The area that was more sensitive to CNQX was located in the superficial layer of the DCN while the area with a higher sensitivity to APV was located progressively in the deep layer. Conclusion This optical recording data suggests that there is a differential distribution of NMDA and non-NMDA receptor mediated neurotransmission in the VCN, DCN and VN. 相似文献
120.
APC gene mutations in a jejunal adenoma causing intussusception in a patient with familial adenomatous polyposis 总被引:2,自引:0,他引:2
Ishida H Iwama T Inokuma S Takeuchi I Hashimoto D Miyaki M 《Journal of gastroenterology》2002,37(12):1057-1061
Adenomatous polyps of the jejunum/ileum in patients with familial adenomatous polyposis (FAP) are usually small (<5 mm) and
are considered to be of little clinical importance. Genetic alterations in these polyps have not previously been analyzed.
We herein report an extremely rare case of FAP presenting with intussusception caused by jejunal adenomas. Both somatic and
germline mutations of the APC gene were detected in one of the polyps. A 40-year-old man with FAP was admitted for closure
of an ileostomy that had been created because of an anastomotic leak after subtotal proctocolectomy with ileo-anal-canal anastomosis.
During the follow-up after that surgery, he had occasionally complained of colicky abdominal pain, but it had quickly subsided.
At the second laparotomy, for closure of the ileostomy, jejuno-jejunal intussusception was incidentally found, and segmental
resection of the jejunum, including the leading point of the intussusception, was performed. There were five polyps clustered
in the resected jejunum. Histologically, the polyps, ranging from 5 to 26 mm in diameter, were adenomas with moderate to severe
atypia. Genetic examinations of one of the largest polyps, using polymerase chain reaction single-strand conformation polymorphism
(PCR-SSCP) and direct sequencing methods, revealed somatic (T insertion at codon 1557) and germline mutations (4 base-pair
deletion at codons 181–182) of the APC gene. This is the first evidence that the coexistence of somatic and germline alterations in the APC gene is involved in the development of a jejunal adenoma causing small-bowel intussusception.
Received: April 3, 2001 / Accepted: July 20, 2001 相似文献