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101.
Repair of an Abdominal Aortic Aneurysm with a Remarkably Dilated Meandering Artery: Report of a Case
Sakamoto S Yamauchi S Yamashita H Imura H Maruyama Y Ochi M Shimizu K 《Surgery today》2007,37(2):133-136
A 73-year-old man on dialysis for chronic renal dysfunction was referred to our hospital for surgical treatment of an abdominal
aortic aneurysm (AAA). Preoperative angiography showed a remarkably developed meandering artery branching from the inferior
mesenteric artery (IMA). The superior mesenteric and celiac arteries were occluded at the origin, and all blood flow to the
abdominal organs was apparently supplied by collateral circulation from the IMA. Considering the risk of mesenteric ischemia
after aortic clamping in conjunction during surgery, we used a perfusion catheter with a 12-F balloon to create a shunt to
the IMA from the subclavian artery. The operation was successful and the patient recovered uneventfully. We describe this
surgical procedure for its effectiveness in preventing postoperative mesenteric ischemia in a rare case of an AAA with complex
branching lesions. 相似文献
102.
Shuichiro Uchiyama Kazuo Chijiiwa Masahide Hiyoshi Motoaki Nagano Jiro Ohuchida Koki Nagaike Masahiro Kai Kazuhiro Kondo 《Journal of gastrointestinal surgery》2007,11(11):1570-1572
Mucin-producing tumor in the bile duct is referred to clinically as mucin-producing bile duct tumor (MPBT). Intraductal papillary
neoplasm of the biliary tract that resembles an intraductal papillary mucinous neoplasm (IPMN) of the pancreas is a rare category
of MPBT and is not well characterized. We, herein, report a case of MPBT of the caudate lobe of the liver that showed papillary
growth and communicated with the bile duct of the caudate lobe and protruded into the common hepatic duct. Histologically,
MPBT cells showed papillary overgrowth with abundant mucinous secretions, resembling an IPMN of the pancreas. The MPBT cells
showed the same immunostaining pattern as that of cells from IPMN of the pancreas. 相似文献
103.
Purpose “Juci”, one of the traditional acupuncture techniques, means contralateral acupuncture; i.e., implanting a needle into an acupoint
to treat a given disease or disorder, but on the side of the body opposite to the diseased side. The aim of this study was:
(1) to assess acupuncture effects on formalin-induced nociceptive behavior in the orofacial region in the rat, and (2) to
evaluate the efficacy of Juci in the orofacial formalin test.
Methods Forty-four adult male Wistar rats were used in the present study. A 1.0% formalin solution (25 μl s.c., diluted in saline)
was injected into the right upper lip. The rats were randomly assigned to five groups. (1) The control group (n = 9), which received formalin injection without acupuncture pretreatment; (2) the ipsilateral Ho-ku (see note below) acupuncture
group (n = 10); (3) the contralateral Ho-ku acupuncture group (n = 11); (4) the acupuncture plus naloxone group (n = 9), where intraperitoneal naloxone (1.0 mg·kg−1) was injected immediately before acupuncture pretreatment; and (5) the sham acupuncture group (n = 5). “Ho-ku” is the term used for the “Large Intestine 4” acupoint, located between the first and second metacarpal bones.
Results The injection of formalin produced the characteristic biphasic behavioral response. Acupuncture significantly inhibited the
response in the early and late phases. Naloxone significantly reversed these effects. There were no statistically significant
differences between the ipsilateral and Juci acupuncture groups. Sham acupuncture did not exert any significant effect on the formalin-induced behavior.
Conclusion Our results showed that the degree of effectiveness of Juci was similar to that of the ipsilateral acupuncture technique. Therefore, the Juci technique is also useful for the treatment of orofacial pain. 相似文献
104.
Fukushima K Sato T Mitsuhashi S Kaneko K Yazaki M Matsuda M Hashimoto T Hamanaka K Yoshida K Ikeda S 《Neuromuscular disorders : NMD》2006,16(11):763-765
We report a patient with Isaacs' syndrome associated with myasthenia gravis and pleural recurrence of thymoma, who showed severe limb pain attributed to hyperexcitability of sensory nerves. Myokymia and severe pain were successfully treated with cytoreductive surgery and intraoperative hyperthermic intrathoracic perfusion chemotherapy, but neither pharmacotherapy nor plasma exchange showed obvious clinical effects. Pleural thymoma in our patient may have caused Isaacs' syndrome, probably by unconfirmed humoral immune mechanisms. Cytoreductive treatment for recurrent thymoma should be actively considered as a potent therapeutic option in refractory patients with disabling neuromyotonia symptoms. 相似文献
105.
The efficiency of hepatocyte transplantation into the liver varies with the method of administration. This study investigated whether retrograde infusion via the hepatic vein provides a sufficient number of donor cells for the liver. Donor hepatocytes were isolated from dipeptidyl peptidase IV (DPPIV(+)) rats and transplanted into DPPIV(-) rat livers either by antegrade portal vein infusion or retrograde hepatic vein infusion. Hepatocyte engraftment ratios and localization were evaluated by histological DPPIV enzymatic staining at 1 week and 8 weeks after the transplantation. No significant differences in engraftment efficiency were observed at either 1 week or 8 weeks after transplantation by either route. However, the localization of the transplanted hepatocytes differed with the administration route. Portal vein infusion resulted in predominantly periportal engraftment, whereas hepatic vein infusion led to pericentral zone engraftment. Immunohistochemical analysis showed that the transplanted hepatocytes engrafted in the pericentral zone after retrograde infusion displayed intense CYP2E1 staining similar to the surrounding native hepatocytes. CYP2E1 staining was further enhanced by administration of isosafrole, an inducing agent for various cytochrome P450 enzymes, including CYP2E1. This study demonstrates a novel approach of transplanting hepatocytes into the liver through retrograde hepatic vein infusion as the means to target cell implantation to the pericentral zone. 相似文献
106.
Hashimoto Y Gotanda Y Ito T Ushijima K 《Masui. The Japanese journal of anesthesiology》2011,60(8):968-971
Motor evoked potential (MEP) monitoring has been employed to detect the spinal cord injury during spinal, neurosurgical and cardiovascular operations. Muscle relaxants diminish the amplitude of MEP because MEP is the picture of electromyogram. In 5 cases undergoing MEP monitoring, we examined the effect of rocuronium followed by the administration of sugammadex on MEP Anesthesia was induced with propofol (target controlled infusion 3.0-3.5 microg x ml(-1)) and remifentanil 0.15-0.3 microg x kg(-1) x min(-1), and the trachea was intubated with the use of rocuronium 0.6 mg x kg(-1) without any muscle rigidity, bucking and laryngospasm. General anesthesia was maintained by total intravenous anesthesia using propofol and remifentanil with no muscle relaxants. Immediately after the tracheal intubation, sugammadex 4 mg x kg(-1) was intravenously given. The amplitude of MEP was measured just before the administration of rocuronium, immediately after the tracheal intubation, and 1, 2, 3, 5 min following the administration of sugammadex. Sugammadex restored the MEP amplitude, deteriorated by rocuronium, in 3 to 5 min to the level of non-paralytic muscles. In one case, it took 8 min to restore the MEP of hemiparetic leg. Taking these findings into consideration, it is likely that rocuronium might not affect the MEP when reversed by sugammadex, and should be safe for smooth tracheal intubation in patients who need MEP monitoring. 相似文献
107.
Mizuno J Morita S Hanaue N Hanaoka K Yokoyama T 《Masui. The Japanese journal of anesthesiology》2011,60(8):908-912
Intravenous patient-controlled analgesia (IV-PCA) using opioids such as morphine and fentanyl can be an effective analgesic method for post-operative pain that is resistant to conventional administration of narcotic analgesics and nonsteroidal anti-inflammatory drugs, and where epidural block and peripheral nerve block are not feasible. In addition to post-operative pain relief, IV-PCA can facilitate early ambulation, reduce respiratory complications, and increase patient satis-faction. However, respiratory and circulatory depression, and post-operative nausea and vomiting (PONV) often occur as side effects of IV-PCA with opioids. Administration of droperidol can be an effective treatment for PON. 相似文献
108.
K. Fukuda Shinichiro Ushigome Takashi Nikaidou Kazuo Asanuma Fumiaki Masui 《Skeletal radiology》1999,28(5):294-297
A case of osteosarcoma arising from a metatarsal bone is reported, focusing on the radiological findings and differential
diagnosis.
Received: 16 November 1998 Revision requested: 17 December 1998 Revision received: 11 January 1999 Accepted: 14 January 1999 相似文献
109.
BACKGROUND: Endoscopic surgery for inner-side breast cancer usually is performed by periareolar approach, but leaves deformation or malposition, and sensory disturbance. We devised an approach of retromammary route without subcutaneous removal, from an axillary skin incision, to treat distant cancers and also to preserve sensation to skin touch. METHODS: We have performed video-assisted breast surgery on 230 patients. The transaxillary retromammary-route approach was performed on 20 patients with early breast cancer. From a 2.5-cm axillary incision, we dissected the major pectoral muscle fascia to detach retromammary tissue. We cut the proximal side of the gland vertically, and dissected the skin flap over the tumor by the tunnel method. Then we cut each side of the gland vertically and removed it through the axillary port. RESULTS: All surgical margins were negative. The surgical time was 45 minutes longer than the conventional video-assisted breast surgery. The postoperative esthetic results were good. CONCLUSIONS: The transaxillary retromammary-route approach leaves no injury on whole breast, and can become a single standard method for breast-conserving surgery wherever a cancer is situated. 相似文献
110.
Kazuhiro Kondo Kazuo Chijiiwa Mayumi Funagayama Masahiro Kai Kazuhiro Otani Jiro Ohuchida 《Journal of gastrointestinal surgery》2008,12(3):468-476
Long-term postoperative survival and prognostic factors were examined retrospectively in patients with hepatocellular carcinoma
(HCC) with serum hepatitis B surface antigen (HBsAg) or hepatitis C antibody (HCVAb) and in those without virus infection.
Subjects were 265 consecutive HCC patients treated surgically at one institution during the period 1990 to 2006. Postoperative
survival was analyzed and compared between HBsAg-positive (B-HCC), HCVAb-positive (C-HCC), and hepatitis B- and C-negative
(NBNC-HCC) patients. Prognostic factors for overall and recurrence-free survival were also analyzed. Overall and recurrence-free
survival rates were significantly higher in the NBNC-HCC group than in the C-HCC group. Significant prognostic factors for
overall survival identified by univariate and multivariate analyses were age, serum alkaline phosphatase (ALP) level, tumor
multiplicity, portal vein invasion (Vp), hepatic vein invasion (Vv), and operative blood loss in the B-HCC group; serum albumin
level, ALP level, tumor size, and Vv in the C-HCC group; and tumor multiplicity in the NBNC-HCC group. Significant factors
for recurrence-free survival were age, ALP level, tumor multiplicity, Vp, and operation time in the B-HCC group; ALP level,
prothrombin time, tumor size, Vv, and width of the surgical margin in the C-HCC group; and age, tumor size, tumor multiplicity,
and Vp in the NBNC-HCC group. Thus, postoperative survival and prognostic factors in cases of HCC differ according to the
presence of serologic viral markers. 相似文献