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61.
Toshimichi Hasegawa Yuko Tazuke Yasuhiro Iwasaki Osamu Monta Junichi Sumimura Hiroshi Koyama Toru Dezawa 《Surgery today》1997,27(12):1191-1194
We report herein the case of a premature infant with esophageal atresia (EA) and a tracheoesophageal fistula (TEF) associated
with cardiac anomalies who was successfully treated by an early ligation of the TEF following gastrostomy, and delayed repair
of the esophagus. A 1212-g male was born prematurely at 31 gestational weeks, at which time he was diagnosed as having EA
with TEF and patent ductus arteriosus (PDA), ventricular septal defect (VSD), and atrial septal defect (ASD). A gastrostomy
was initially performed but following extubation he gradually became tachypneic. A chest roentogenogram revealed atelectasis
and ground-glass appearance, and reintubation was required. Ligation of the TEF was performed 53h after his birth. Following
the improvement of his respiratory condition through ventilatory support and the intratracheal administration of pulmonary
surfactant, he underwent repair of the esophagus on the 6th day of life. Postoperatively, he suffered from heart failure,
but was treated with peritoneal dialysis and pharmacological closure of the PDA. Weaning the infant from the ventilator proved
difficult, but it was finally achieved when he had reached a weight of 2268g at 3 months of age by enteral feeding. Our experience
of this case demonstrates that early ligation of TEF should be performed for a premature infant with EA and TEF before respiratory
distress syndrome (RDS) has developed. If a gastrostomy is required to prevent gastric distention, it should be followed by
simultaneous or immediate ligation of the TEF. 相似文献
62.
Yoshihiko Tsuji Hiroaki Ohue Hiroshi Ikuta Osamu Kinoshita Fumio Shibagaki 《Surgery today》1997,27(5):387-391
Between January 1985 and September 1994, 21 patients with psychiatric disorders underwent various forms of surgery at our
hospital. There were 12 men and 9 women with an average age of 57.6 years. The coexisting psychiatric disorders were schizophrenia
in 15 patients, depression in 2, dementia in 2, mental retardation with epilepsy in 1, and Parkinson's disease in 1. All the
patients had been receiving neuroleptic medications for a long period. The indications for surgery were: cholelithiasis in
6 patients, acute appendicitis in 4, perforation of the small intestine in 3, incarceration of an inguinal hernia in 2, and
esophageal cancer, stomach cancer, bleeding from a gastric ulcer, perforation of a duodenal ulcer, strangulating ileus, and
burns in 1 patient each, respectively. All of the patients who underwent elective surgery were given epidural anesthesia with
or without general anesthesia. Antipsychotic medications were given until just prior to surgery and recommenced concurrent
with the first meal. Abnormal behavior was observed in 11 patients (52.4%) postoperatively, but all the patients were discharged
in accordance with recovery from their surgical disorder. Intra- and postoperative hypotension resistant to intravenous catecholamine
administration was recognized in 9 patients (42.9%), and this peculiar complication should be borne in mind when patients
with psychiatric disorders require surgical management.
Presented at the 94th annual meeting of the Japanese Surgical Society, held in Tokyo in March, 1994 相似文献
63.
Osamu Nakamura 《Brain and nerve》2005,57(12):1043-1049
64.
65.
Toshifumi Gabata Masumi Kadoya Osamu Matsui Masashi Yamashiro Tsutomu Takashima Donald G. Mitchell Yasutaka Nakamura Kazuo Takeuchi Yasuni Nakanuma 《Journal of magnetic resonance imaging : JMRI》1998,8(2):503-504
We reported a case of the biliary cystadenoma of the liver. The cystic mass had labulation and septation and showed marked hyperintensity on T1-weighted images and hypointensity on T2-weighted images; MR findings were very unusual for cystadenoma. The content of the cystic mass was jelly-like, thick mucinous fluid without intracystic hemorrhage. We concluded that these unusual signal intensities of the cyst were due to hyperproteinous mucinous fluid. 相似文献
66.
Yoshiro Tanizaki Hikaru Kitani Morihiro Okazaki Takashi Mifune Fumihiro Mitsunobu Ikuro Kimura 《The Journal of asthma》1993,30(4):309-318
The effects of long-term glucocorticoid therapy on airway inflammation were examined in 84 asthma patients. The proportion of lymphocytes in bronchoalveolar lavage (BAL) fluid was significantly decreased in patients with steroid-dependent intractable asthma (SDIA) compared to results in non-SDIA patients, while BAL neutrophils were significantly increased in SDIA patients compared to results in non-SDIA patients. Regarding age, in patients under the age of 69 (except those between 30 and 39), BAL lymphocyte number was significantly decreased in SDIA compared with non-SDIA subjects, and in patients between 50 and 69, BAL neutrophils were significantly increased in SDIA compared with non-SDIA subjects. The number of BAL lymphocytes was significantly lower in patients with serum cortisol levels of less than 5.0 μg/dl than in those with levels of more than 5.1 μg/dl. BAL lymphocyte number was also significantly lower in patients who had received glucocorticoid therapy for more than 6 years than in those who had received such therapy for 2 years. These results show that long-term glucocorticoid therapy decreases the number of lymphocytes and increases neutrophil numbers in the airways. 相似文献
67.
Osamu Ozaki M.D. Kunihiko Ito M.D. Kaoru Kobayashi M.D. Akira Suzuki M.D. Yoshitaka Manabe M.D. Yasuhiro Hosoda M.D. 《World journal of surgery》1988,12(4):565-571
Familial occurrence of differentiated, nonmedullary thyroid carcinoma in 23 patients from 11 families is reported. Five patients were male and 18 were female. The familial relationship of patients was parent and child in 12 cases from 6 families, and siblings in 11 cases from 5 families. Carcinoma of other organs was noted in other members in 8 families. Histological examination revealed 18 papillary, 2 follicular, and 2 anaplastic carcinomas (the 2 anaplastic carcinomas were considered to be transformed from preexisting differentiated carcinoma). In 1 case, the histological type was unknown. The average diameter of the primary lesion was 29.9 mm. Cervical lymph node metastasis was found in 77.8% and local recurrence in 28.6% of the patients. Solid and invasive growth was dominant. On HLA typing, phenotypes of B7 and DR1 were significantly redominant in familial patients compared with nonfamilial patients and normal Japanese. Moreover, the haplotype of B7-Cw7-DR1 was observed in 5 of 13 patients tested.
It is suggested from these observations that some types of differentiated, nonmedullary thyroid carcinoma may show familial occurrence and that they may have common factors with regard to the genetic and immunologic basis of the disease.
Presented at the International Association of Endocrine Surgeons in Sydney, Australia, September, 1987. 相似文献
Resumen Se informa la ocurrencia familiar de carcinoma bien diferenciado, no medular, de tiroides en 23 pacientes provenientes de 11 familias, 5 hombres y 18 mujeres. La relación familiar fue padre e hijo en 12 casos de 6 familias, y hermanos en 11 casos de 5 familias. Se observé la presencia de carcinoma de otros órganos en otros miembros de 8 familias. El examen histopatológico reveló 18 carcinomas papilares, 2 foliculares, y 2 anaplásicos (los 2 fueron considerados como transformación de carcinomas diferenciados preexistentes). En un caso no fue conocido el tipo histológico. El diámetro promedio de la lesión primaria fue 29.9 mm. Se hallaron metástasis en ganglios cervicales en 77.8% de los pacientes y recurrencia local en 28.6%. El crecimiento sólido e invasivo apareció como característica dominante. En la tipificación HLA aparecieron como significativamente predominantes los fenotipos de B7 y DR1 en pacientes familiares en comparación con pacientes no familiares y japoneses normales. Por otra parte, el halotipo de B7-CW7-DR1 fue observado en 5 de 13 pacientes investigados.Como resultado de estas observationes se sugiere que algunos tipos de carcinomas diferenciados, no medulares, pueden demostrar ocurrencia familiar y que pueden poseer factores comunes relacionados con las bases genéticas e inmunológicas de la enfermedad.
Résumé On a étudié les caratéristiques du cancer de la thyroïde, dans sa variété différenciée non médullaire, survenu chez 23 patients provenant de 11 familles. Cinq patients étaient des hommes, 18 des femmes. La relation familiale était parent/enfant dans 12 cas provenant de 6 familles, et frère/soeur dans 11 cas provenant de 5 familles. Des membres de 8 autres familles présentaient un cancer d'un autre organe. Il y avait 18 cancers papillaires, 2 cancers folliculaires, et 2 cancers anaplasiques (on a considéré que les 2 cancers anaplasiques étaient des transformations à partir de cancers différenciés préexistants). Dans un cas, le type histologique était inconnu. Le diamètre moyen de la lésion primitive était de 29.9 mm. On a retrouvé des métastases ganglionnaires cervicales chez 77.8% des patients et une récidive locale chez 28.6%. Les tumeurs étaient principalement solides et invasives. Par rapport aux cancéreux non familiaux et à la population japonaise normale, il y avait plus de phénotypes B7 et DR1 au système HLA. L'haplotype B7-CW7-DR1 était observé chez 5 des 13 patients testés.On suggère que certains types de cancer différenciés, non médullaires, ayant des facteurs communs génétiques et immunologiques, peuvent survenir dans une même famille.
Presented at the International Association of Endocrine Surgeons in Sydney, Australia, September, 1987. 相似文献
68.
E G Shaw C Daumas-Duport B W Scheithauer D T Gilbertson J R O'Fallon J D Earle E R Laws H Okazaki 《Journal of neurosurgery》1989,70(6):853-861
The records of 167 patients with grade 1 or 2 supratentorial pilocytic astrocytomas (41 patients), ordinary astrocytomas (91 patients), or mixed oligoastrocytomas (35 patients) diagnosed between 1960 and 1982 are retrospectively reviewed. The extent of surgical tumor removal was gross total or radical subtotal in 33 patients (20%) and subtotal or biopsy only in the remaining 134 patients (80%). Postoperative radiation therapy was given to 139 (83%) of the 167 patients, with a median dose of 5000 cGy (range 600 to 6500 cGy). Multivariate analysis revealed that a pilocytic histology was the most significant prognostic variable associated with a good survival. The 5- and 10-year survival rates were, respectively, 85% and 79% for the 41 patients with pilocytic astrocytomas compared to 51% and 23% for the 126 patients with ordinary astrocytomas or mixed oligoastrocytomas. Postoperative irradiation did not appear to be associated with improved survival times in the patients with pilocytic astrocytomas; however, in the 126 patients with ordinary astrocytomas or mixed oligoastrocytomas, those who received "high-dose" radiation (greater than or equal to 5300 cGy) had significantly better survival times than those who received "low-dose" radiation (less than 5300 cGy) or surgery alone. The 5- and 10-year survival rates were, respectively, 68% and 39% for the 35 patients receiving high-dose radiation, 47% and 21% for the 67 receiving low-dose radiation, and 32% and 11% for the 19 treated with surgery alone. The survival rate was poor for the 23 patients with ordinary astrocytomas and oligoastrocytomas who underwent gross total or radical subtotal tumor removal (14 of whom were also irradiated): 52% at 5 years and 21% at 10 years, with 19 of 23 patients developing tumor progression and dying 1 to 12 years postoperatively. In contrast, all 10 patients with pilocytic astrocytomas who had gross total or radical subtotal tumor removal alone were long-term survivors, with follow-up periods of about 4 to 25 years. 相似文献
69.
Bruch's membrane exists between the retinal pigment epithelium and the choriocapillary endothelium. Its structure is very complicated, having five sublayers containing basement membranes of retinal pigment epithelium and choriocapillary endothelium, outer and inner collagenous layers, and a central elastic layer. In the development of Bruch's membrane in normal mice, both basement membranes are created first. Secondarily, collagen fibers are accumulated in the space between these basement membranes and then form a collagenous layer. Finally, the elastic layer elaborated in the collagenous layer separates this into outer and inner collagenous layers. Brachymorphic mice have a disorder in the sulfation pathway, resulting in undersulfation. Consequently, in Bruch's membrane of brachymorphic mice, the expression of decorin, a small proteoglycan containing chondroitin sulfate and an indispensable component in collagen assembly, is at a very low level. It is clear that hypoplasia of the collagenous layer in Bruch's membrane of brachymorphic mice induces a disorder in the following formation of the elastic layer. These findings suggest that the formation of the collagenous layer, regulated with acidic glycoconjugates such as decorin, is important in the development of Bruch's membrane. 相似文献
70.
Murdiastuti K Miki O Yao C Parvin MN Kosugi-Tanaka C Akamatsu T Kanamori N Hosoi K 《Pflügers Archiv : European journal of physiology》2002,445(3):405-412
By Western blot analysis, the expression level of aquaporin (AQP) 5 in the submandibular gland (SMG) was found to be different among individual rats of the Sprague-Dawley (SD) strain. Such differences were observed for AQP5 but not for AQP1 and consequently the SD strain was divided into two groups, one expressing a high level of AQP5 and the other a low one. The difference in average intensity of expression between the two groups was more than twofold. Immunohistochemical analysis of the SMG demonstrated that the AQP5 protein was localized in the basal and apical/lateral plasma membrane of acinar cells in rats expressing the high level of AQP5. In the rat expressing the low level, however, this channel protein was localized strongly in the apical/lateral plasma membrane, but only very weakly in the basal membrane of the acinar cells. Such a diverse localization of AQP5 was confirmed by Western blotting as well. Breeding between brother and sister was repeated for two times within high expressers and low expressers to obtain the third generation progenies (F2); the AQP5 level of the SMG in the third generation (F2 rats) from high expressers was significantly higher than the F2 from low expressers. Our present study suggests the existence of genetic variation in the expression of a water channel protein, AQP5, in rats. 相似文献