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11.
Sojun Hoshimoto Junichi Matsui Ryohei Miyata Yutaka Takigawa Jun Miyauchi 《World journal of gastroenterology : WJG》2016,22(38):8631-8637
We report a case of a 64-year-old woman with anaplastic carcinoma of the pancreas (ACP) with cyst formation and review 60 ACP cases reported in Japan. In 20% of cases, laboratory tests revealed severe anemia (hemoglobin level < 10.0 g/dL) and elevated leucocyte counts (> 12000/mm3), which were likely attributable to rapid tumor growth, intratumoral hemorrhage, and necrosis. Elevated serum CA19-9 levels were observed in 55% of cases. Cyst-like structures were observed on imaging in 47% of cases, and this finding appears to reflect subsequent cystic degeneration in the lesion. Macroscopically, hemorrhagic necrosis was observed in 77% of cases, and cyst formation was observed in 33% of cases. ACP should be considered when diagnosing pancreatic tumors with a cyst-like appearance, especially in the presence of severe anemia, elevated leucocyte counts, or elevated serum CA19-9 levels. 相似文献
12.
Therapy of gastroesophageal reflux disease and functional dyspepsia overlaps with symptoms after usual‐dose proton pump inhibitor: Acotiamide plus usual‐dose proton pump inhibitor versus double‐dose proton pump inhibitor
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Toshihisa Takeuchi Yoshiaki Takahashi Shinpei Kawaguchi Kazuhiro Ota Satoshi Harada Yuichi Kojima Hiroki Sakamoto Takanori Kuramoto Keishi Kojima Makoto Sanomura Masahiro Hoshimoto Takeshi Higashino Tsukasa Itabashi Ko Takada Masahiro Sakaguchi Kazunari Tominaga Motoyasu Kusano Kazuhide Higuchi 《Journal of gastroenterology and hepatology》2018,33(3):623-630
13.
Osamu Nagayama Akira Koike Masayo Hoshimoto Kaori Yamaguchi Akihiko Tajima Ayumi Goda Tokuhisa Uejima Haruki Itoh Tadanori Aizawa 《Circulation journal》2007,71(5):782-787
BACKGROUND: Although it is assumed that cerebral oxygenation during exercise is influenced by both cardiopulmonary function and cerebrovascular arteriosclerosis, the latter factor has not been fully clarified. In the present study the relationship between the degree of cerebrovascular arteriosclerosis and cerebral oxygenation during exercise was investigated. METHODS AND RESULTS: A total of 109 patients (69 patients with coronary artery disease, 40 patients with hypertensive heart disease) (61.7+/-9.7 years) performed a symptom-limited exercise test with respiratory gas measurements (CPX). From the respiratory gas analysis, peak O(2) uptake (VO(2)), the slope of the increase in VO(2) to the increase in work rate (DeltaVO (2)/DeltaWR), and the slope of the increase in ventilation to the increase in CO(2) output (VE/VCO(2) slope) were calculated. Oxyhemoglobin (O(2)Hb) at the forehead was monitored using near-infrared spectroscopy. The brain ischemic score was counted based upon fluid-attenuated inversion recovery images of magnetic resonance imaging and expressed from 0 to 4. When compared with patients with a lower ischemic score (<2, n=67), those with a higher ischemic score (> or =2, n=42) had a lower increase in brain O(2)Hb during exercise (-1.08 +/-2.7 vs 0.77+/-4.1 micromol/L, p=0.011). Of brain ischemic score, left ventricular ejection fraction, peak VO(2), DeltaVO(2)/DeltaWR, and the VE/VCO(2) slope, DeltaVO(2)/ DeltaWR was found to be the sole independent index determining cerebral O(2)Hb during exercise. The CPX parameters were also significantly related to the degree of cerebrovascular arteriosclerosis. CONCLUSIONS: Although cerebral oxygenation during exercise is mainly related to cardiopulmonary function, the degree of cerebrovascular arteriosclerosis partly influences cerebral oxygenation in patients with risk factors for atherosclerosis. 相似文献
14.
Akira Koike Osamu Nagayama Ayumi Goda Masayo Hoshimoto Kaori Yamaguchi Akihiko Tajima Tokuhisa Uejima Haruki Itoh Tadanori Aizawa 《Circulation journal》2007,71(9):1418-1423
BACKGROUND: It has been recently reported that cerebral oxyhemoglobin (O(2)Hb) decreases during exercise in nearly 50% of patients with dilated cardiomyopathy. The present study evaluated whether the inhalation of supplemental O(2) diminishes the decrease in cerebral O(2)Hb during exercise. METHODS AND RESULTS: Ten patients with a left ventricular ejection fraction <50% and a clearly observable decrease in cerebral O(2)Hb during preliminary exercise testing underwent 2 additional symptom-limited incremental exercise tests: 1 while breathing room air (control) and the other while breathing 50% O(2). In the latter test, the switch from room air to 50% O(2) was performed, on average, at 43.0+/-14.2 W. Cerebral O(2)Hb was continuously monitored during exercise using near-infrared spectroscopy. In the control exercise test, cerebral O(2)Hb gradually decreased as the work rate increased in all the subjects. When the subjects breathed 50% O(2), this decrease in cerebral O(2)Hb was diminished. The change in cerebral O(2)Hb from rest to peak exercise during the test under 50% O(2) was significantly higher than that during the control test (-0.23 +/-1.89 vs -2.47+/-1.57 micromol/L, p=0.002). Similarly, the change in the cerebral tissue oxygenation index was significantly higher in the test under 50% O(2) (0.45 +/-4.46 vs -3.33+/-3.06%, p=0.023). CONCLUSIONS: Impaired cerebral oxygenation during moderate to heavy intensity exercise in patients with left ventricular dysfunction can be offset by breathing supplemental O(2). 相似文献
15.
Sojun Hoshimoto Zenichi Morise Keiichi Suzuki Yoshinao Tanahashi Masahiro Ikeda Tadashi Kagawa Yoshizumi Mizoguchi Atsushi Sugioka 《Journal of Hepato-Biliary-Pancreatic Surgery》2009,16(4):566-570
Peliosis hepatis is a rare lesion histologically characterized by multiple cavities representing dilated sinusoids filled
with blood in the liver. Although it has been observed in the liver parenchyma in association with several diseases and medications,
there are few reports of nodules of hepatocellular carcinoma (HCC) showing extensive peliotic change. We describe a case of
HCC showing extensive peliotic change in the cancer nodule. A 73-year-old man with a liver tumor was referred to our hospital
for further investigation. Abdominal ultrasonography revealed an 8-cm hyperechoic lesion with a halo and mosaic pattern in
segment 8 (S8) of the liver. Dynamic magnetic resonance imaging of the liver showed early irregular enhancement of the peripheral
part of the lesion, and the effect persisted into the late phase, spreading into the central part of the nodule. Hepatic arteriography
showed the “cotton–wool” sign, usually observed in cavernous hemangiomas. Fine-needle aspiration biopsy revealed the diagnosis
of HCC. Anterior sectionectomy of the liver was conducted. Histological examination of the resected specimen showed that the
tumor was a well-differentiated HCC with extensive dilated sinusoid-like structures in the main portion of the nodule, suggestive
of peliotic change. 相似文献
16.
Escherichia coli isolates associated with uncomplicated and complicated cystitis and asymptomatic bacteriuria possess similar phylogenies, virulence genes, and O-serogroup profiles
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Takahashi A Kanamaru S Kurazono H Kunishima Y Tsukamoto T Ogawa O Yamamoto S 《Journal of clinical microbiology》2006,44(12):4589-4592
The genetic and serological characteristics of Escherichia coli isolates from patients with uncomplicated cystitis (UC), complicated cystitis (CC), and complicated asymptomatic bacteriuria (CASB) were determined. Phylogenetic group B2 was predominant in all categories. The prevalences of 14 out of 18 virulence factor genes were similar among the three categories, while pap, iha, ompT, and PAI were more frequently seen in isolates associated with UC than CC or CASB. 相似文献
17.
Yamamoto S Kanamaru S Ogawa O Monden K Kumon H Ishikawa K Hoshinaga K Egashira T Naito S Iwamura M Satoh T Baba S Tanaka K Arakawa S Kamidono S Matsukawa M Takeyama K Tsukamoto T Yasuda M Ishihara S Deguchi T Kiyota H Onodera S Egawa S Yamada Y Muratani T Matsumoto T 《Hinyokika kiyo. Acta urologica Japonica》2004,50(11):779-786
In order to establish an acceptable guideline for prevention of perioperative infection following urologic surgery, a questionnaire survey on the theory of antimicrobial prophylaxis (AMP) was conducted among urologists in Japan in February 2004. A reply was obtained from 149 urologists working for institutes located all over Japan from Hokkaido to Kyushu areas. Ninety-two percent of the urologists agreed that AMP should be administered 30 min before an incision, and 44% replied that an additional dose of AMP is required in the case of prolonged intervention. Penicillins or the 1st or 2nd generation cephems were used by 89 to 93% of the urologists in operations not including bowel segments, while 78% preferred such AMP agents in the procedures including bowel segments. AMP was terminated within 3 days in 87% for genital operations, in 70 to 76% for laparoscopic operations, in 54 to 65% for other clean or clean-contaminated operations, and in 24% for operations without the bowel segments. Especially, 58% of the urologists continued AMP for more than 5 days after operations with urinary diversion using the intestine. When compared with the previous questionnaire survey by Shinagawa et al, our survey demonstrated that standard consensus of AMP has spread widely among urologists in Japan, although the recommendations published in Europe and United States are still controversial in Japan. Thus, further well-designed clinical trials are required to establish original guidelines in Japan. 相似文献
18.
BACKGROUND: There are many published case reports of successful conception following transcervical Fallopian tube recanalization (T-FTR) in patients with bilateral proximally occluded Fallopian tubes. However, no serial trials have been published with respect to successful conception following unilateral tubal recanalization in infertile patients with a unilateral proximally occluded tube and a contralateral patent tube. This study was designated to analyse the success rate of T-FTR and the pregnancy rate due to natural fertilization in the lumen of the recanalized tube in these patients. METHODS: We have encountered only 11 patients with this abnormality in our department in the past 10 years. T-FTR with fluoroscopic guidance was performed in these patients, confirmed by at least two hysterosalpingographies to exclude tubal spasm. The uterine catheter devised by us was used during the procedure. RESULTS: All 11 Fallopian tubes were successfully opened by T-FTR. In the six patients who conceived, a preovulatory follicle was demonstrated on the side of the cannulated tube during the conception. The success rate of recanalization, the pregnancy rate due to fertilization in the lumen of the recanalized tube and the successful delivery rate were 100, 55 and 36% respectively. CONCLUSIONS: Our findings suggest that a functional and/or organic disorder in the patent tube resulted in infertility in patients with unilateral proximal tubal obstruction. Our results further show that recanalization of occluded tubes is an effective treatment. Thus, recognition of successful conception following T-FTR in these patients will be beneficial to our clinical approach to this infertile condition. 相似文献
19.
Macrophage colony-stimulating factor levels in amniotic fluid before and after the onset of labor do not differ in normal pregnancies 总被引:1,自引:0,他引:1
Hayashi M Hoshimoto K Komine F Ohkura T Inaba N 《American journal of reproductive immunology (New York, N.Y. : 1989)》2004,51(5):329-335
PROBLEM: Macrophage colony-stimulating factor (M-CSF) promotes placental growth and maintenance. M-CSF also regulates trophoblast invasion into the placental bed. We evaluated whether M-CSF levels in amniotic fluid during labor contributing to subsequent delivery differed from those before the onset of labor in normal pregnancies. METHOD OF STUDY: This study enrolled 48 Japanese women experiencing normal pregnancies with single fetuses who had no infection. Of these pregnancies, 24 were women during labor: 22 led to subsequent term delivery (labors); two had premature delivery. The other 24 were women without labor underwent cesarean section (controls). These two groups (22 labors and 24 controls) were compared. The average gestational age at entry was 38 weeks of gestation. The women's ages and gestational ages did not differ significantly between the two groups. Amniotic fluid was collected and the M-CSF levels were compared between two groups. The M-CSF level was determined by the sandwich enzyme-linked immunosorbent assay (ELISA) method. RESULTS: The levels of M-CSF in amniotic fluid did not differ significantly between the women during labor and those without labor. CONCLUSIONS: M-CSF in amniotic fluid may not contribute to the onset of labor in term pregnancy and/or labor resulting in subsequent delivery may not induce the production and secretion of M-CSF into amniotic cavity. 相似文献
20.
Okada Y Yamamoto S Akamatsu S Kanamaru S Ito N Kinoshita H Kamoto T Ogawa O 《Hinyokika kiyo. Acta urologica Japonica》2005,51(2):101-103
A case of primary carcinoma of the remaining ureter is reported. A 70-year-old man presented with asymptomatic gross hematuria. Three years ago, he had received right nephrectomy for pyonephrosis. Although drip infusion pyelography (DIP) and cystoscopy showed no abnormal findings, computed tomography (CT) and retrograde ureterography demonstrated the irregular thickening of the right remaining ureteral wall. He underwent right ureterectomy with bladder cuff resection. Pathological examination revealed transitional cell carcinoma of the remaining ureter. He has been free of disease for 3 years. 相似文献