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11.
Hironori Abe Hirotsugu Suwanai Nodoka Kambara Koji Sano Junpei Shikuma Hiroaki Akaoka Akira Kanazawa Hideaki Hirai Takashi Miwa Toshitaka Nagao Masato Odawara 《Internal medicine (Tokyo, Japan)》2021,60(1):105
A 40-year-old woman who had a history of recurrent olfactory neuroblastoma presented with full moon face, central obesity, buffalo hump, impaired glucose tolerance and bilateral cervical lymph node swelling. Laboratory tests showed morbidly elevated levels of adrenocorticotropic hormone (ACTH) and cortisol, which were not suppressed by high-dose (8 mg) dexamethasone. Biopsies of the enlarged cervical lymph nodes revealed ACTH-positive metastatic olfactory neuroblastoma, and ectopic ACTH syndrome was diagnosed. Metyrapone was used to suppress cortisol production and resulted in decreased levels of ACTH and cortisol. Bilateral cervical tumor resection further reduced the ACTH and cortisol levels, accompanied by a reduction in the metyrapone dosage. Cushing''s syndrome was alleviated through ACTH-producing tumor removal. 相似文献
12.
目的:探究应用伊曲康唑口服液预防血液肿瘤患者化疗后粒细胞减少期并发真菌感染的效果.方法:将62例化疗后中性粒细胞减少的血液肿瘤患者随机分为真菌感染预防用药组和对照组,其中预防用药组患者预防性地服用伊曲康唑口服液,而对照组患者未接受任何预防性抗真菌药物治疗.观察并比较2组患者真菌感染的发生率和严重程度.结果:31例服用伊曲康唑口服液患者中,仅2例发生真菌感染,真菌感染率仅为6.5%,而对照组31例中,8例并发真菌感染,包括3例深部真菌感染,真菌感染率为25.8%,明显高于预防用药组(P<0.01),而且2组患者并发真菌感染的病原菌存在明显差异.结论:预防性应用伊曲康唑口服液能有效降低血液肿瘤患者化疗后粒细胞减少期真菌感染的概率. 相似文献
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Noriyuki Watanabe Kiyoko Kobayashi Sachie Koyama Mayu Tabira Junpei Matsuno Yoshitada Taji Yu Akuzawa Maho Ishikawa Tomoya Maeda Kazuo Imai Norihito Tarumoto Norio Asou Kotaro Mitsutake Yasuhiro Ebihara 《Transplant infectious disease》2020,22(2)
We reported the case of a patient with leukemia who developed febrile neutropenia after hematopoietic stem cell transplantation. Blood culture results revealed the presence of Streptococcus oralis, while antimicrobial susceptibility testing showed the resistance to penicillin and cephem. Furthermore, isolates were not susceptible to either meropenem or daptomycin but not to vancomycin. S oralis is known to belong to Streptococcus mitis group and be a causative agent of bacteremia in the neutropenic patients, but multidrug resistance of S oralis is rare. Our findings suggest that we might pay attention to the emergence of the microorganisms acquiring multidrug resistance in neutropenic patients. 相似文献
15.
Masanori Aihara Hiroya Fujimaki Ryosuke Shintoku Tadashi Osawa Ken Asakura Mizuho Miyazaki Tetsuyoshi Horiuchi Junpei Nitta 《Acta neurochirurgica》2013,155(4):607-609
Background
Superficial temporal artery-to-middle cerebral artery (STA-MCA) anastomosis is a common procedure for neurosurgeons. The surgery necessarily requires accurate and speedy manipulation of microscope, for which a specific training is needed. Unexpected bypass occlusion sometimes happen during surgery.Objective
Generally, conventional interrupted or continuous suture has been used for vascular anastomosis, despite various ideas have been attempted in the other surgery fields. We propose a horizontal mattress suture technique for intracranial microvascular bypass surgery. This is the first report ever published on intracranial vascular anastomosis.Methods
We had four patients of STA-MCA bypass surgery with “mattress anastomosis” from March to May of 2012.Results
During the procedure, there was no bypass occlusion and good patency was confirmed in all cases.Conclusion
Intimae of the recipient and the donor blood vessel contact each other precisely with this technique. Although a long-term assessment of patency is needed, it is useful for the intracranial bypass surgery. 相似文献16.
Tumor-derived factors affect the stroma of cancer tissue by activating pro-angiogenic signals. One of the key components of
this response is the mobilization of the pro-angiogenic cells from bone marrow (BM), which contribute to the development of
abnormal tumor vasculature. Evidence is accumulating that the pro-angiogenic cells derived from BM are involved in the physiological
processes of tissue repair and wound healing. However, vascular structure in cancer tissue is impaired, resulting in the formation
of chaotic neo-vessels and hypoxic microenvironments. Ultimately, these structural and functional abnormalities result in
the limited delivery of chemotherapeutic agents and create regions of metabolic derangement, both of which enhance resistance
to chemotherapy. In spite of recent advances in targeted therapy using anti-vascular agents, clinical results from studies
using individual agents have unsatisfactory, necessitating the combinatorial use of anti-cancer drugs and a targeting agent.
We suggest the possibility of a new therapeutic approach in which aberrant tumor vessels are normalized by BM-derived pro-angiogenic
cells, and the delivery of anti-cancer drugs is maximized. In this review, we focus on the current understanding of the structure
and function of tumor vessels, and an alternative approach to the repair of abnormal tumor vasculature by the use of BM-derived
pro-angiogenic cells. This approach may improve both the delivery and the efficacy of anti-cancer drugs by restoring aberrant
tumor vascularization and hypoxia. 相似文献
17.
Tetsuyoshi Horiuchi Junpei Nitta Shigetoshi Ishizaka Kohei Kanaya Takao Yanagawa Kazuhiro Hongo 《Neurosurgical review》2013,36(4):559-565
Previous studies have shown that extracranial–intracranial (EC-IC) bypass surgery has no preventive effect on subsequent ipsilateral ischemic stroke in patients with symptomatic atherosclerotic internal carotid occlusion and hemodynamic cerebral ischemia. A few studies have assessed whether an urgent EC-IC bypass surgery is an effective treatment for main trunk stenosis or occlusion in acute stage. The authors retrospectively reviewed 58 consecutive patients who underwent urgent EC-IC bypass for symptomatic internal carotid artery or the middle cerebral artery stenosis or occlusion between January 2003 and December 2011. Clinical characteristics and neuroimagings were evaluated and analyzed. Based on preoperative angiogram, responsible lesions were the internal carotid artery in 19 (32.8 %) patients and the middle cerebral artery in 39 (67.2 %). No hemorrhagic complication occurred. Sixty-nine percent of patients showed improvement of neurological function after surgery, and 74.1 % of patients had favorable outcome. Unfavorable outcome was associated with insufficient collateral flow and new infarction after bypass surgery. 相似文献
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Minami Takayuki Ebata Tomoki Yokoyama Yukihiro Igami Tsuyoshi Mizuno Takashi Yamaguchi Junpei Onoe Shunsuke Watanabe Nobuyuki Nagino Masato 《World journal of surgery》2020,44(3):896-901
World Journal of Surgery - The border between segments VI and VII of the right posterior sector of the liver is controversial owing to lack of anatomical landmarks. This study aimed to examine the... 相似文献