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951.
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953.
Hinohara H Kadoi Y Takahashi K Saito S Kawauchi C Mizutani A 《Journal of anesthesia》2011,25(3):409-414
We observed an increase in mean middle cerebral artery blood flow velocity (V
mca) after tourniquet deflation during orthopedic surgery under sevoflurane anesthesia in patients with diabetes mellitus or
previous stroke. Eight controls, seven insulin-treated diabetic patients, and eight previous stroke patients were studied.
Arterial blood pressure, heart rate, V
mca, arterial blood gases, and plasma lactate levels were measured every minute for 10 min after tourniquet release in all patients.
V
mca was measured using a transcranial Doppler probe. V
mca in all three groups increased after tourniquet deflation, the increase lasting for 4 or 5 min. However, the degree of increase
in V
mca in the diabetic patients was smaller than that in the other two groups after tourniquet deflation (at 2 min after tourniquet
deflation: control 58.5 ± 3.3, previous stroke 58.4 ± 4.6, diabetes 51.7 ± 2.3; P < 0.05 compared with the other two groups). In conclusion, the degree of increase in V
mca in diabetic patients is smaller than that in controls and patients with previous stroke. 相似文献
954.
Takahiro Ota Ryoko Yamaguchi Takashi Tanigawa Kenichiro Otuka Yusuke Hayashi Hiroyoshi Nishiyama Takara Tsumori Kimio Kamimori Shiro Yanagi Isao Ishikawa 《Journal of Echocardiography》2011,9(1):30-32
We report the case of acquired left ventricle (LV) to right atrial (RA) communication through an aneurysm of the atrioventricular
septum caused by infectious endocarditis. A severe aortic valve regurgitation and destruction of the aortic valve was detected
by echocardiography. Transesophageal echocardiography revealed a flail aortic valve with vegetation and abnormal shunt flow
from the LV to RA with ruptured aneurysm of the membranous septum. An abscess cavity of the aortic ring was introduced. Because
of worsening congestive heart failure, the patient underwent emergency aortic valve replacement and patch closure of the communication
of the membranous septum. The patient’s postoperative course was uneventful. 相似文献
955.
956.
Tomoeda M Yuki M Kubo C Yoshizawa H Kitamura M Nagata S Hamada K Joyama S Araki N Tomita Y 《Orthopedics》2011,34(11):e768-e771
A 70-year-old woman developed a malignant mixed tumor of the soft tissue 2 years after total knee arthroplasty. A 5×3×3-cm elastic hard tumor at the lateral side of the surgical scar was resected. The tumor showed focal infiltration into surrounding adipose and fibrous tissues, focal necrosis, and vascular infiltration. It was diagnosed as malignant. Mixed tumor, or myoepithelioma, of the soft tissue is a relatively rare tumor that was recently recognized as a disease entity; the vast spectrum of myoepithelial cell differentiation and the resultant morphologic diversity might increase the difficulty of the histological diagnosis. Postoperatively, the patient did not receive adjuvant therapy and no recurrence of the tumor was observed for 6 years. Range of motion of her left knee is -5° extension and 90° flexion; however, her activities of daily living are restricted because of general fatigue, partly due to hepatoma and chemotherapy.Despite the increase of artificial implant use worldwide, reports of peri-implant tumor formation are rare. Although we do not know the exact mechanism of tumor genesis, we consider the fibroblast formation in the routine healing process to be a possible mechanism. Further investigation is necessary to identify coexisting factors that increase the risk of tumor formation after implantation. 相似文献
957.
Shimoyama T Kimura K Iguchi Y Shibazaki K Watanabe M Sakai K Sakamoto Y Aoki J 《Journal of the neurological sciences》2011,310(1-2):40-43
PET and SPECT are very sensitive techniques to detect in-vivo nigrostriatal degeneration in Parkinson's disease, even in the pre-motor phase of the disease. Furthermore, these techniques are able to measure disease progression. However, caution must be used in the interpretation of studies in which therapeutic effects in Parkinson's disease were also monitored by serial imaging of nigrostriatal neurons, as disparity between imaging and clinical outcomes has been reported in several clinical studies. 相似文献
958.
959.
960.
Fumihiko Miura Takehide Asano Hodaka Amano Masahiro Yoshida Naoyuki Toyota Keita Wada Kenichiro Kato Eriko Yamazaki Susumu Kadowaki Makoto Shibuya Sawako Maeno Shigeru Furui Koji Takeshita Yutaka Kotake Tadahiro Takada 《Journal of Hepato-Biliary-Pancreatic Surgery》2009,16(1):56-63
Background/Purpose Intra-abdominal arterial hemorrhage is still one of the most serious complications after pancreato-biliary surgery. We retrospectively
analyzed our experiences with 15 patients in order to establish a therapeutic strategy for postoperative arterial hemorrhage
following pancreato-biliary surgery.
Methods Between August 1981 and November 2007, 15 patients developed massive intra-abdominal arterial bleeding after pancreato-biliary
surgery. The initial surgery of these 15 patients were pylorus-preserving pancreatoduodenectomy (PPPD) (7 patients), hemihepatectomy
and caudate lobectomy with extrahepatic bile duct resection or PPPD (4 patients), Whipple’s pancreatoduodenectomy (PD) (3
patients), and total pancreatectomy (1 patient). Twelve patients were managed by transcatheter arterial embolization and three
patients underwent re-laparotomy.
Results Patients were divided into two groups according to the site of bleeding: SMA group, superior mesenteric artery (4 patients);
HA group, stump of gastroduodenal artery, right hepatic artery, common hepatic artery, or proper hepatic artery (11 patients).
In the SMA group, re-laparotomy and coil embolization for pseudoaneurysm were performed in three and one patients, respectively,
but none of the patients survived. In the HA group, all 11 patients were managed by transcatheter arterial embolization. None
of four patients who had major hepatectomy with extrahepatic bile duct resection survived. Six of seven patients (85.7%) who
had pancreatectomy survived, although hepatic infarction occurred in four.
Conclusions Management of postoperative arterial hemorrhage after pancreato-biliary surgery should be done according to the site of bleeding
and the initial operative procedure. Careful consideration is required for indication of interventional radiology for bleeding
from SMA after pancreatectomy and hepatic artery after major hepatectomy with bilioenteric anastomosis. 相似文献