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41.
K. Kohri T. Umekawa Y. Ishikawa Y. Katayama M. Kodama M. Takada Y. Katoh K. Kataoka M. Iguchi T. Kurita 《International urology and nephrology》1990,22(1):13-23
Factors relating alterations in plasma and urine composition to recurrence of urinary stones during drug therapy were investigated
by using a multiple regression analysis technique. These factors were influenced not only by the efficacy of the drugs but
also by other factors (plasma or urinary constituents and overall health of the patients, etc.). In order to study the effect
of drug therapy or other treatment on the alteration of plasma and urine constituents, multiple regression analysis is more
appropriate than Student's pairedt-test which has been used by some workers. These two analytical methods yield different results even if used on the same data. 相似文献
42.
Preliminary results of intermittent retrograde cerebral perfusion during proximal aortic arch surgery. 总被引:1,自引:0,他引:1
Shinpei Yoshii Okihiko Akashi Masahiro Kobayashi Atsuo Kojima Samuel J K Abraham Shunya Shindo Yusuke Tada Hiroji Higuchi 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2003,51(11):588-593
OBJECTIVE: Continuous retrograde cerebral perfusion during aortic arch surgery is associated with cerebral edema. In this report, we describe the clinical use of a new type of intermittent retrograde cerebral perfusion. SUBJECTS AND METHODS: Fourteen patients with a Stanford type A dissection were included in this study. With the usual method of retrograde cerebral perfusion, about 2,500 mL venous blood is drained from bicaval cannulae into a hard-shell reservoir, and oxygenated blood is perfused through the superior vena caval cannula. The flow rate is 300 mL/min. After about 15 min, retrograde perfusion is discontinued, and drainage from the bicaval cannulae is restarted. When a bloodless field is necessary, perfusion also is discontinued. RESULTS: Two to seven cycles of intermittent retrograde cerebral perfusion were administered (average, 3.1+/-0.4, mean+/-SD). The total retrograde perfusion time was 36.0+/-1.9 min which was equivalent to 74.8% of the circulatory arrest time. No patient developed edema of the upper body. The time to wake-up was 3 to 14 h (average, 6.5+/-1.0 h). No patient suffered any neurologic complications even though the time of circulatory arrest was greater than 60 min in four cases. Head magnetic resonance imaging or computed tomography was performed in 12 cases, and no evidence of hypoxic brain injury was detected. CONCLUSIONS: Our clinical experience using a moderate amount of intermittent retrograde cerebral perfusion is superior to continuous retrograde cerebral perfusion for protecting the brain during aortic arch surgery. 相似文献
43.
β2-glycoprotein-I (β2GPI) is a phospholipid-binding plasma protein that consists of five homologous domains. Domain V is distinguished from others by bearing a positively charged lysine cluster and hydrophobic extra C-terminal loop. β2GPI has been known as a natural anticoagulant regulator. β2GPI exerts anticoagulant activity by inhibition of phospholipid-dependent coagulation reactions such as prothrombinase, tenase, and factor XII activation. It also binds factor XI and inhibits its activation. On the other hand, β2GPI inhibits anticoagulant activity of activated protein C. According to the data from knockout mice, β2GPI may contribute to thrombin generation in vivo. Phospholipid-bound β2GPI is one of the major target antigens for antiphospholipid antibodies present in patients with antiphospholipid syndrome (APS). Binding of pathogenic anti-β2GPI antibodies increases the affinity of β2GPI to the cell surface and disrupts the coagulation/fibrinolysis balance on the cell surface. These pathogenic antibodies activate endothelial cells via signal transduction events in the presence of β2GPI. Impaired fibrinolysis has been reported in patients with APS. Using a newly developed chromogenic assay, we demonstrated lower activity of intrinsic fibrinolysis in euglobulin fractions from APS patients. Addition of monoclonal anti-β2GPI antibodies with β2GPI also decreased fibrinolytic activity in this assay system. β2GPI is proteolytically cleaved by plasmin in domain V (nicked β2GPI) and becomes unable to bind to phospholipids, reducing antigenicity against antiphospholipid antibodies. This cleavage occurs in patients with increased fibrinolysis turnover. Nicked β2GPI binds to plasminogen and suppresses plasmin generation in the presence of fibrin, plasminogen, and tissue plasminogen activator (tPA). Thus, nicked β2GPI plays a role in the extrinsic fibrinolysis via a negative feedback pathway loop. 相似文献
44.
Takashi Ishimori Satoru Nakano Masahiro Kagawa Koiku Yokoe Tarou Togami Hirofumi Asakura Toshiaki Kusuhara Motoomi Ohkawa Syeigo Nagao Yuichi Yamashita Satoshi Sugiura 《Magnetic resonance in medical sciences》2003,2(3):145-149
Three-dimensional fast asymmetric spin echo (3D FASE) cisternography provides high spatial resolution and excellent contrast as a water image acquisition technique. It is also useful for the evaluation of various anatomical regions. This study investigated the usefulness and limitations of virtual endoscopic images obtained by 3D FASE MR cisternography in the preoperative evaluation of patients with neurovascular compression. The study included 12 patients with neurovascular compression: 10 with hemifacial spasm and two with trigeminal neuralgia. The diagnosis was surgically confirmed in all patients. The virtual endoscopic images obtained were judged to be of acceptable quality for interpretation in all cases. The areas of compression identified in preoperative diagnosis with virtual endoscopic images showed good agreement with those observed from surgery, except in one case in which the common trunk of the anterior inferior cerebellar artery and posterior inferior cerebellar artery (AICA-PICA) bifurcated near the root exit zone of the facial nerve. The veins are displayed in some cases but not in others. The main advantage of generating virtual endoscopic images is that such images can be used for surgical simulation, allowing the neurosurgeon to perform surgical procedures with greater confidence. 相似文献
45.
46.
Y C Park H Kiwamoto T Nishioka H Tsujihashi S Mitsubayashi T Matsuura T Akiyama T Kurita T Miyamoto 《Hinyokika kiyo. Acta urologica Japonica》1987,33(6):883-888
Combined measurement of serum prostate-specific antigen (PA) and prostatic acid phosphatase (PAP) was performed in 235 patients with various urologic diseases including 55 patients with prostatic cancer. A PA level of over 24.7 ng/ml and a PAP level of over 3.1 ng/ml were considered to be positive. The positive rate of PA was 57% in the patients with untreated prostatic cancer and 3% in the patients without prostatic cancer. The positive rate of PAP was 52% in the patients with untreated prostatic cancer and 1% in the patients without prostatic cancer. PA and PAP were considered to be equally sensitive and specific serum markers of prostatic cancer. However, the positive rate increased to 65% without increasing the false positive rate when the PA and PAP were both measured simultaneously. The combined assay of PA and PAP is recommended for screening prostatic cancer. The cross-over titer of PA and gamma-Sm using standard samples in each kit revealed linearity, which suggested that PA and gamma-Sm possess the same antigenicity. 相似文献
47.
A total of 260 patients underwent treatment with extracorporeal shock wave lithotripsy (ESWL). Staghorn calculi were found
in 32 cases. In carrying out ESWL for staghorn calculi, double pigtail stent was previously retained in principle. When the
ureter was occluded by stone street in case a fever of more than 38° C lasted for 4–5 days after the first treatment with
ESWL, percutaneous nephrostomy (PNS) was performed. In ESWL treatment alone a large number of shock waves were required, but
double pigtail stent and PNS were used in combination individually, and larger stones were treated by the same waves. When
combination therapy was used, hospital stay was short and the rate of remaining stones was low. Our therapeutic conclusions
are discussed. 相似文献
48.
Noriaki Tsubota Masahiro Myoshimura Akihiro Murotani Yoshifumi Miyamoto Yasumi Matoba 《Surgery today》1994,24(11):978-981
The results of 101 consecutive bronchoplasties performed between 1979 and 1993, including 8 cases of pneumonectomy, 88 cases of lobectomy, 3 cases of segmentectomy, and 2 cases of bronchial resection, are herein reported. Squamous cell carcinoma was the most common disease (59%) followed by adenocarcinoma (30%) and other diseases (11%). Anastomosis was satisfactory in 96 cases. Among the five stenosed cases, local recurrence was found in two cases, and there were three benign strictures. Two of the three benign strictures were treated with bouginage. The pulmonary artery was concomitantly reconstructed in seven cases with satisfactory results. Preoperative chemoradiotherapy was performed in 15 advanced cases and was followed by acceptable surgical results. The 5-year survival rate, according to the post-operative staging of the 86 patients without induction therapy, was 86% in stage I (19 patients), 49% in stage II (21 patients), and 27% in stage IIIA (40 patients). The overall survival rate was 46% at 5 years. There were two indications for this procedure i.e., a positive resection margin in 59 cases and positive hilar nodes in 42 cases. Better survival was noted in patients with squamous cell carcinoma, stage I, and surgery was thus selected for a positive resection margin, and not for a positive node. 相似文献
49.
Yamamoto Kazuhiko; Nakajima Akira; Eimoto Hiroyuki; Tsutsumi Masahiro; Maruyama Hiroshi; Denda Ayumi; Nii Hiroaki; Mori Yukio; Konishi Yoichi 《Carcinogenesis》1989,10(9):1607-1611
The carcinogenic activity of endogenously synthesized N-nitrosobis(2-hydroxypropyl)amine(BHP) was investigated in male Wistar rats administered bis(2-hydroxypropyl)amine(BHPA) mixed in powder diet at a concentration of 1%, and sodiumnitrite (SN) dissolved in distilled water at concentrationsof 0.15 and 0.3%, for 94 weeks. Urinary excretion of BHP wasdetected in rats given 1% BHPA and 0.3% SN but not in the groupsreceiving either of these precursors alone. Nasal cavity, lung,esophagus, liver and urinary bladder tumors were found in animalstreated with combinations of 1% BHPA and 0.15 or 0.3% SN, suggestingthat the target organs of the endogenously synthesized BHP aresimilar to those affected when the carcinogen is administeredexogenously. The incidences of nasal cavity and lung tumorsreached 74 and 58% in rats given 1% BHPA and 0.3% SN, respectively.Tumors at sites other than target organs were only found atlevels similar to those previously reported for spontaneoustumors in male Wistars. The present results clearly indicatedthe tumor inducibility of a nhrosatable amine, BHA, throughan endogenous nitrosation by feeding to rats in conjunctionwith nitrite, and provide further suggestive evidence that endogenousnitrosations of environmental nitrosatable amines can be a potentialrisk factor in human cancer development. 相似文献
50.
Junya Katoh Shunya Shindo Satsuki Kina Seiichiro Katahira Hiroshi Osawa Masahiro Kobayashi Osamu Suzuki Kihachiro Kamiya Yusuke Tada 《Surgery today》1995,25(6):554-556
Aneurysmal rupture into the intestinal tract is a rare but disastrous complication of an internal iliac artery aneurysm. We report herein the successful surgical repair of a fistula between a huge aneurysm of the right internal iliac artery and the rectum in an 81-year-old man. After a femoro-femoral cross-over bypass had been performed, the aneurysm was opened and its patent arterial branches were ligated with sutures. The fistula was then intra-aneurysmally sutured and covered with an omental flap. The diagnostic and therapeutic approaches to this severe complication are discussed with a review of the literature following the presentation of this case. 相似文献