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141.
142.
Mitsui Takahiko Kira Satoru Ihara Tatsuya Sawada Norifumi Nakagomi Hiroshi Miyamoto Tatsuya Shimura Hiroshi Tsuchiya Sachiko Kanda Mie Takeda Masayuki 《International urology and nephrology》2020,52(2):233-238
International Urology and Nephrology - The present study was conducted to identify metabolites using a metabolomics approach and investigate the relationship between these metabolites and urgency... 相似文献
143.
Junya Fujita Shuji Takiguchi Kazuhiro Nishikawa Yutaka Kimura Hiroshi Imamura Shigeyuki Tamura Chikara Ebisui Kentaro Kishi Kazumasa Fujitani Yukinori Kurokawa Masaki Mori Yuichiro Doki 《Surgery today》2014,44(9):1723-1729
Purpose
LigaSure, a bipolar electronic vessel sealing system, has become popular in abdominal surgery but few clinical studies have been conducted to evaluate its effectiveness in radical gastrectomy for gastric cancer.Methods
In this multicenter, prospective, randomized controlled trial, patients with curative gastric cancer were randomly assigned to undergo gastrectomy either with LigaSure or a conventional technique.Results
Of the 160 patients enrolled, 80 were randomized to the LigaSure group and 78 to the conventional group. Patient characteristics were well balanced in the two groups. There were no significant differences between the LigaSure and conventional groups in blood loss (288 vs. 260 ml, respectively; P = 0.748) or operative time (223 and 225 min, respectively; P = 0.368); nor in the incidence of surgical complications or duration of postoperative hospital stay. In a subgroup analysis of patients who underwent gastrectomy that preserved the distal part of the greater omentum, the use of LigaSure significantly reduced blood loss (179 vs. 245 ml; P = 0.033), and the duration of the operation (195 vs. 221 min; P = 0.039).Conclusions
LigaSure did not contribute to reducing intraoperative blood loss, operative time, or other adverse surgical outcomes. The usefulness of the device may be limited to a specific part of the surgical procedure in open gastrectomy. 相似文献144.
Hiroaki Niitsu Junya Taomoto Koji Mita Masanori Yoshimitsu Yoichi Sugiyama Naoki Hirabayashi Wataru Takiyama 《Surgery today》2014,44(5):897-901
Purpose
We evaluated the safety and efficiency of using the mesh plug method (MP) to repair inguinal hernias in patients with a history of radical retropubic prostatectomy (RRP). We also investigated how RRP influences the development of inguinal hernias and impacts their repair.Methods
Among 488 adult male patients who underwent inguinal hernia repair during a recent 5-year period, 37 had a history of RRP. We compared the characteristics and surgical outcomes of the patients who had undergone RRP (post-RRP group) with those who had not (non-RRP group).Results
All post-RRP hernias were treated by MP. The 37 post-RRP patients had a collective 41 hernias, 40 of which were of the indirect type. The side affected by the hernia did not differ significantly between the groups. We compared the short-term surgical outcomes of the indirect post-RRP hernias vs. the indirect non-RPP hernias without recurrence and incarceration. The operation times, postoperative hospital stay, and mobility rates did not differ significantly between the two groups. The blood loss was almost equal in both groups.Conclusion
Inguinal hernia repair after RRP may be difficult because of inflammatory changes in the preperitoneal cavity, but the surgical outcomes of MP were equivalent in patients with or without a history of RPP in this study. MP is a safe and effective method for post-RPP hernia repair. 相似文献145.
Mitsuro Kanda Tsutomu Fujii Hideki Takami Masaya Suenaga Yoshikuni Inokawa Suguru Yamada Goro Nakayama Hiroyuki Sugimoto Masahiko Koike Shuji Nomoto Yasuhiro Kodera 《Surgery today》2014,44(9):1692-1701
Purpose
The aim of this study was to detect high-performance prognostic biomarkers of pancreatic cancer which would enable the identification of high-risk patients.Methods
The subjects were 324 patients who underwent radical surgery for pancreatic ductal adenocarcinoma without neoadjuvant therapy. We evaluated the prognostic impact of four perioperative serum tumor markers, including carbohydrate antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA). We also evaluated the indices by multiplying the values of two tumor markers (e.g., CA19-9 × CEA).Results
The preoperative CA19-9 × CEA index had a strong correlation with the prognosis of patients with pancreatic cancer, even when the cut-off was set at the median value. CA19-9 × CEA ≥500 was an independent predictor of mortality (hazard ratio: 1.642, p = 0.021). In the ROC curve analysis of early mortality after surgery, the CA19-9 × CEA index had the highest goodness of fit. The presence of CA19-9 × CEA ≥500 had the largest attributable risk proportion because of its combined high predictive performance and prevalence. The postoperative CA19-9 × CEA index was also a significant predictive marker of mortality.Conclusion
The CA19-9 × CEA index is a strong prognostic biomarker that could help identify pancreatic cancer patients expected to have a poor prognosis so that they can be administered appropriate multidisciplinary treatment. 相似文献146.
Tomoyuki Kakuta MD Shin-ichi Kosugi MD PhD Tatsuo Kanda MD PhD Takashi Ishikawa MD PhD Takaaki Hanyu MD PhD Tsutomu Suzuki MD PhD Toshifumi Wakai MD PhD 《Annals of surgical oncology》2014,21(5):1749-1755
Background
The number of patients cured of esophageal cancer after esophagectomy is gradually increasing owing to advances in surgical techniques, perioperative management, and adjuvant therapies. This study assessed the clinical course and sought to identify the prognostic factors of these patients.Methods
A series of 220 consecutive patients who underwent esophagectomy and survived for more than 5 years with no relapse were enrolled. Survival analysis was performed using 25 variables including patient characteristics and operative and perioperative factors. Potential prognostic factors were identified by univariate and multivariate analyses, and the development of other primary cancers and the causes of death were retrospectively reviewed.Results
The overall 10-, 15-, and 20-year survival rates were 71.6, 50.1, and 32.2 %, respectively, with a median survival time of 180 months (range, 61–315 months). The negative independent prognostic factors identified were age at surgery [hazard ratio (HR), 1.05; P < .01], being male (HR, 2.62; P = .02), pulmonary comorbidities (HR, 2.03; P = .02), synchronous presence of other cancers (HR, 2.35; P < .01), colonic/jejunal interposition (HR, 1.76; P = .03), perioperative blood transfusion (HR, 1.92; P = .02), development of pulmonary complications (HR, 1.71; P = .02), and adjuvant radiotherapy (HR, 2.13; P = .01). Pulmonary diseases and other primary cancers were found to be the most common causes of death.Conclusions
Careful follow-up including the surveillance of other primary cancers is required for long-term survivors of esophageal cancer after esophagectomy. 相似文献147.
Matsuda Yasuhiro Masuda Masaharu Asai Mitsutoshi Iida Osamu Okamoto Shin Ishihara Takayuki Nanto Kiyonori Kanda Takashi Tsujimura Takuya Okuno Shota Hata Yosuke Uematsu Hiroyuki Mano Toshiaki 《Journal of interventional cardiac electrophysiology》2021,61(1):171-179
Journal of Interventional Cardiac Electrophysiology - Cardiac conduction disturbance necessitating pacemaker implantation is common among elderly patients. However, patients often have... 相似文献
148.
Aya Miyazaki Hideki Uemura Yasuyo Takeuchi Junya Tomida Yasuo Ono Yoshifumi Fujimoto Norie Mitsushita Akio Ikai 《Congenital heart disease》2022,17(6):647-652
Appropriate heart rate in a failing pulmonary ventricle remains unknown, particularly in congenital heart disease with unique hemodynamics. A 71-year-old male with repaired tetralogy of Fallot and a pacemaker for a sinus node dysfunction suffered from heart failure symptoms with preserved left ventricular function. Simply changing the pacemaker’s lower rate from 60 to 75 bpm, New York Heart Association classification improved from III to II, and hemodynamic parameters drastically improved. We regarded this case as informative. Appropriate heart rate could be higher in congenital patients with failing right and non-failing left ventricles than in adults with malfunctioning LV. 相似文献
149.
Changes in arrhythmogenic properties and five‐year prognosis after carbon‐ion radiotherapy in patients with mediastinum cancer
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Mari Amino MD PhD Koichiro Yoshioka MD PhD Makiyoshi Shima MD Tohru Okada MD PhD Mio Nakajima MD PhD Yoshiya Furusawa PhD Shigetaka Kanda MD Sadaki Inokuchi MD PhD Teruhisa Tanabe MD PhD Yuji Ikari MD PhD Tadashi Kamada MD PhD 《Annals of noninvasive electrocardiology》2018,23(1)
Introduction
Carbon‐ion irradiation of rabbit hearts has improved left ventricular conduction abnormalities through upregulation of gap junctions. However, to date, there has been no investigation on the effect of carbon‐ion irradiation on electrophysiological properties in human. We investigated this effect in patients with mediastinum extra‐cardiac cancer treated with carbon‐ion radiotherapy that included irradiating the heart.Methods and Results
In April–December 2009, eight patients were prospectively enrolled (including two male, aged 72.5 ± 13.0 years). They were treated with 44–72 Gray equivalent (GyE), with their hearts exposed to 1.3–19.1 GyE. High‐resolution ambulatory electrocardiography was performed before and after radiotherapy to investigate arrhythmic events, late potentials (LPs), and heart rate variability. Five patients had pre‐existing premature ventricular contraction (PVC)/atrial contraction (PAC) or paroxysmal atrial fibrillation (PAF)/AF; after irradiation, this improved in four patients with PVC/PAF/AF and did not deteriorate in one patient with PAC. Ventricular LP findings did not deteriorate and improved in one patient. In eight cases with available atrial LP findings, there was no deterioration, and two patients showed improvements. The low frequency/high frequency ratio of heart rate variability improved or did not deteriorate in the six patients who received radiation exposure to the bilateral stellate ganglions. During the five‐year follow‐up for the prognosis, six of the eight patients died because of cancer; there was no history of hospitalization for cardiac events.Conclusion
Although this preliminary study has several limitations, carbon‐ion beam irradiation to the heart is not immediately cardiotoxic and demonstrates consistent signals of arrhythmia reduction.150.
Hemhongsa P Tasaneeyapan T Swaddiwudhipong W Danyuttapolchai J Pisuttakoon K Rienthong S McCarthy K Varma MJ Whitmore J Varma JK 《Tropical medicine & international health : TM & IH》2008,13(10):1288-1296
Objective To measure the burden and improve management of tuberculosis (TB), HIV‐associated TB and MDR TB in Tak Province, Thailand, which borders Myanmar. Methods From September 2006 to August 2007, we collected uniform data about TB cases and enhanced human immunodeficiency virus (HIV) counselling and testing. We provided mycobacterial culture and drug‐susceptibility testing in public or non‐governmental organization facilities. Patients were classified by nationality and, for non‐Thais, by migration status. Results Of 1662 TB cases in the 12‐month period, 1087 (65%) occurred in non‐Thais. Of non‐Thais, 415 (38%) lived in Myanmar but crossed the border for healthcare. HIV infection was diagnosed in 18% of Thais compared with 12% of non‐Thais (P < 0.01); HIV status was unknown for 22% of Thais and 27% of non‐Thais (P = 0.02). Overall, multidrug‐resistant (MDR) TB was diagnosed in 27 patients, 19 (70%) in non‐Thais. Among TB cases never previously treated for TB, no MDR cases were diagnosed in Thais or in Myanmar refugees, but six cases were diagnosed in migrants from Myanmar. Conclusions In Thailand, TB, HIV‐associated TB and MDR TB in migrants from Myanmar are important public health problems; they need to be resolved in both the countries. 相似文献