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31.
Silent cerebral lesions are increasingly found in mass screenings using MRI and magnetic resonance angiography (MRA). The purpose of this paper is to assess the usefulness of two non-invasive clinical tests-carotid ultrasound examination and brachial-ankle pulse wave velocity (baPWV) measurement-for predicting silent cerebral infarction (SCI) and silent intracranial arterial stenosis. Data were collected on 480 asymptomatic adult subjects who participated in a brain screening program at a single hospital between April 2003 and March 2006. All participants underwent baPWV measurement, B-mode ultrasonography of carotid arteries, MRI, and MRA. Data on 476 (99.1%) subjects were included in the analysis. Among these, 273 (57.4%) were male and the mean age was 51.5 years; 161 (33.8%) had carotid plaque; 33 (6.9%) had increased intima-media thickness (IMT); 99 (20.8%) had SCI; and 7 (1.5%) had intracranial arterial stenosis. The multivariate analysis showed that age (odds ratio [OR]: 1.12; 95% confidence interval [CI]: 1.08-1.17), carotid plaque (OR: 2.69; 1.59-4.56), increased IMT (OR: 2.40; 1.02-5.65), and a history of hypertension treatment (OR 2.22; 1.11-4.43) were significantly associated with SCI. Also, increased IMT (OR 9.70: 1.48-63.71) was related to intracranial arterial stenosis. Brachial-ankle PWV was related to SCI (p<0.01) and intracranial stenosis (p=0.01) in univariate analysis but not in multivariate analysis. The presence of carotid plaque and that of increased IMT on ultrasound examination are useful for assessing the risk of SIC. Increased IMT is also predictive of intracranial arterial stenosis. 相似文献
32.
Mitsuru Masaki Tadashi Kuroda Naoki Hosen Hisao Hirota Kazuo Terai Yuichi Oshima Yoshikazu Nakaoka Shoko Sugiyama Ryusuke Kimura Satoshi Yoshihara Manabu Kawakami Norishige Iizuka Yasuhiko Tomita Hiroyasu Ogawa Ichiro Kawase Keiko Yamauchi-Takihara 《Journal of the American Society of Echocardiography》2004,17(4):397-398
A 57-year-old man with a history of renal cell carcinoma presented with presyncope. He underwent nephrectomy years earlier followed by HLA-matched allogeneic peripheral-blood stem-cell transplantation. Echocardiographic investigation revealed a solitary right ventricle mass without contiguous vena caval or right atrial involvement. The mass was pathologically confirmed to be metastatic carcinoma in the right ventricular cavity. This case highlights the need to consider an underlying neoplastic syndrome in patients presenting isolated right ventricle mass by echocardiography. 相似文献
33.
Shigeki Yamagishi Kiyoshi Koizumi Tomomi Hirata Kyoji Hirai Jiro Kurita Kazuo Shimizu 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2005,53(6):313-316
We report a 59-year-old woman who underwent thoracoscopic extirpation of the intrapulmonary cystic lymphangioma which was located in the subpleural space of the left upper lobe. A chest X-ray showed a solitary round nodule in the left pulmonary hilum. A computed tomography scan revealed a mass shadow at the interlobar region surrounding the interlobar pulmonary artery. A round nodule was recognized as low signal intensity on T1-weighted images by magnetic resonance imaging. There was biphasic signal intensity on T2-weighted images as well. Radiologically, we diagnosed this lesion as a benign cystic tumor in the lung. Thoracoscopic observation revealed a cystic lesion just beneath the visceral pleura of the upper lobe adjacent to the interlobular pulmonary artery. As this suggested a benign bronchogenic cyst, we performed extirpation of the cyst under thoracoscopy. After this operation, the cyst was diagnosed as an intrapulmonary cystic lymphangioma pathologically. 相似文献
34.
Tomomi Iwashita Kazuo Kitazawa Jun-Ichi Koyama Hisashi Nagashima Toru Koyama Yuichiro Tanaka Kazuhiro Hongo Hiroshi Okudera Kazufumi Okamoto 《Journal of clinical neuroscience》2007,14(1):68-71
A patient with cerebral deep sinus thrombosis, which was not diagnosed on the first examination, is reported. A 46-year-old woman presented with headache and vomiting. Neurological examination and a brain computed tomography (CT) scan showed no obvious abnormal findings. The patient suffered disturbed consciousness on the day after the examination, and was admitted to our emergency centre. A CT scan and magnetic resonance imaging revealed an ischaemic lesion in the left basal ganglia, suggesting deep sinus occlusion. Anticoagulant therapy was administered. One day after admission, a CT scan showed a haematoma and severe brain swelling in the same region. Cerebral angiography demonstrated a straight sinus occlusion. Intracranial pressure was not controlled with hypothermia, and the patient died 25 days after admission. Review of the initial CT scan revealed subtle, early findings of deep venous thrombosis that were missed on first examination. 相似文献
35.
Takashi Yamauchi Takafumi Masai Koji Takeda Satoshi Kainuma Yoshiki Sawa Kazuo Abe 《Annals of thoracic and cardiovascular surgery》2007,13(6):410-412
We report a rare case of constrictive pericarditis that stimulated a large mediastinal tumor obstructing the right ventricular inflow tract. A 58-year-old woman was referred to our hospital because of a recent increase of dyspnea and facial edema. Computed tomography revealed severely thickened calcification, including a low-density area, presenting as a mediastinal tumor, compressing the right ventricular inflow tract. A complete resection was performed, and her symptoms dramatically improved. Idiopathic constrictive pericarditis was diagnosed pathologically. 相似文献
36.
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
37.
Kenji Wakabayashi Kazuo Kawasaki Daizo Yonemura Kiyohiko Yamazaki 《Documenta ophthalmologica. Advances in ophthalmology》1986,63(4):383-388
We previously reported the hyperosmolarity response (a decrease of the ocular standing potential by hyperosmolarity) as a new clinical test of the retinal pigment epithelium (RPE) activity. In the present study a hypertonic solution (Fructmanit, 1.4 × 103 m0sm/1) was intravenously injected for 20 min in proportion to a subject's total blood volume (TBV). At the injection speed of 5, 10, and 15% of the subjects' TBV per hour the mean amplitude of the hyperosmolarity response in normal subjects was 19.7, 30.1 and 36.4% respectively. The amplitude of the hyperosmolarity response depends on the logarithm of the dose of the hypertonic solution within the range of the dose tested.We previously found that hyperosmolarity suppresses the light rise. The present study investigated this suppressive effect in a quantitative manner. The light rise (a full-field illumination of 1.2 × 103 cdl/m2) was dose-dependently suppressed by Fructmanit. The mean of the light rise to dark trough ratio in normal subjects was 1.81 with no osmotic stress, and 1.64, 1.41 and 1.29 respectively at the injection speeds of 5, 10, and 15%. The suppression of the light rise by hyperosmolarity is compatible with the view that the hyperosmolarity response and the light rise share the basal membrane of the RPE as the main site of their generation. 相似文献
38.
Chojiro Yamashita Satosi Tobe Hidehiro Yamamoto Hidefumi Oobo Hiroomi Nakamura Kazuo Nakamura 《Surgery today》1994,24(10):906-910
This study examines the pulmonary hemodynamics during reimplantation and rejection following unilateral lung transplantation in dogs. Nineteen mongrel dogs were divided into three groups according to the method of treatment used: group 1 (n = 6) underwent modified autotransplantation of the left lung; group 2 (n = 6), allotransplantation without immunosuppression; and group 3 (n = 7), allotransplantation with immunosuppression. The pulmonary arterial blood flow and ventilation scores, assessed by chest X-rays, were measured for 2 weeks postoperatively. Pulmonary blood flow to the transplanted lung decreased slightly in group 1, whereas in group 2, it decreased sharply from the 3rd postoperative day (POD) and was almost completely absent by the 14th POD. In group 3, it decreased by 28% on the 1st POD but recovered gradually to 37% by the 14th POD. Ventilation scores were the same among the three groups on the 1st POD but in group 2, they decreased rapidly from the 3rd POD. This change correlated well with that of the pulmonary arterial (PA) flow, although the ventilation score changed after the PA flow did. In conclusion, rejection was reflected earlier and more distinctly by the changes in PA flow than by chest X-rays. 相似文献
39.
Tadaki Yasumura MD Toshikazu Akami Manabu Mitsuo Takahiro Oka Kazuo Naitoh Takara Yamamoto Hideo Honjyo Hiroji Okada 《Surgery today》1990,20(4):369-375
The ovarian and pituitary functions of 64 operable breast cancer patients undergoing adjuvant therapy with cytotoxic chemotherapy
and/or tamoxifen were investigated. The post menopausal patients, divided into 3 treatment groups, one with tamoxifen alone,
one with tamoxifen and chemotherapy and the other with chemotherapy alone had serum estradiol 17-β (E2) and progesterone levels
lower than the evaluable limits. Although there was no significant difference in the level of estrone sulfate (E1-S) between
these three groups, the level of lutainizing hormone (LH) and follicle stimulating hormone (FSH) in the patients treated with
tamoxifen alone and tamoxifen and chemotherapy were significantly lower than those treated with chemotherapy alone. The decrease
in gonadotropin levels induced by tamoxifen treatment was reversible as it appeared after the initiation of tamoxifen and
recovered after its cessation. In the premenopausal patients, a group treated with tamoxifen and chemotherapy had significantly
higher E1-S, E2 and progesterone levels and significantly lower gonadotropin levels than a group treated with chemotherapy
alone or one treated with a cyclophosphamide regimen. These increases in the levels of estrogen and progesterone were also
reversible, and induced by tamoxifen. Thus, adjuvant endocrinochemotherapy causes profound alteration in the hypothalamo-pituitary-ovarian
axis and therefore, monitoring a variety of hormonal levels is thought to be necessary for assessing the consequences of adjuvant
therapy in breast cancer patients, especially in premenopausal patients using tamoxifen. 相似文献
40.
Hiroko Sasahara Susumu Sueyoshi Toshiaki Tanaka Hiromasa Fujita Kazuo Shirouzu 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2004,52(5):231-239
Objective: The purpose of this experimental study was to investigate whether aortic stent grafting can be applied to the treatment of
an esophageal cancer involving the thoracic aorta. Methods: The canine thoracic aorta was partially resected without aorta being clamped after emplacement of an endovascular stent graft.
Study I; The aortic whole layer of 1 cm in length and 1/4 of the circumference was resected and was covered by a free fascia
patch of the abdominal rectal muscle immediately after stent graft placement. Study II; The aortic adventitia and the outer
half of the media of the same size was resected on day 3, 7,14, 21, and on day 28, after the stent graft placement. The resected
portion was covered by the free fascia patch in half experimental dogs, and was uncovered in the others. Study III; The aortic
adventitia and the outer half of the media of 1 cm in length and 1/2 of the circumference was resected and was uncovered on
day 7 after stent graft placement. Histological examinations were performed on day 28 and at one year after aortic resection.
Results: The aortic wall could be resected in all cases with no complication, except in resection of 1/2 the circumference where the
aorta had become narrow. There was no difference in healing of the resected portion of the aorta between with and without
fascia covering. Conclusion: An aortic endovascular stent graft could be applied to surgery for an esophageal cancer involving the aorta. 相似文献