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121.
122.
MAI TOMIOKA KEIJU HIROMURA TORU SAKAIRI SHIGERU TAKEUCHI AKITO MAESHIMA YORIAKI KANEKO TAKASHI KUROIWA TOSHIYUKI TAKEUCHI YOSHIHISA NOJIMA 《Nephrology (Carlton, Vic.)》2010,15(5):568-574
Aim: Nestin, an intermediate filament originally identified as a marker of neural progenitor cells, is transiently expressed in endothelial cells and tubuloepithelial cells during kidney development. However, in adult kidneys, podocytes are the only cells that express nestin. In this study, we examined tubulointerstitial nestin expression in human glomerulonephritis. Methods: Renal biopsy specimens obtained from 41 adult patients with immunoglobulin (Ig)A nephropathy were studied. Nestin expression was determined by immunohistochemical staining and estimated by digital image analysis. To identify the phenotype of nestin‐positive cells, a double immunofluorescent study was performed for nestin and CD34 (a marker for endothelial cells) or α‐smooth muscle actin (α‐SMA, a marker for myofibroblasts). Results: In normal kidney, nestin expression was restricted to the podocytes and was not detected in tubular cells and tubulointerstitial cells. In contrast, increased nestin expression was observed at tubulointerstitial areas of IgA nephropathy. The degree of tubulointerstitial nestin expression was positively correlated with tubulointerstitial fibrosis (r = 0.546, P < 0.001). The double immunofluorescent study showed that most nestin‐positive cells in the interstitium were co‐stained with CD34 or α‐SMA, suggesting that peritubular endothelial cells and tubulointerstitial myofibroblasts express nestin during the progression of tubulointerstitial injury. In addition, strong nestin expression was associated with deterioration of renal function. Conclusion: Nestin expression is associated with tubulointerstitial injury and predicts renal prognosis in IgA nephropathy. Nestin could be a new marker for peritubular endothelial cell injury and tubulointerstitial fibrosis. 相似文献
123.
ERIKO YOKOYAMA M.D. † TOSHIYUKI OSAKA M.D. Ph .D. YOSHIO TAKEMOTO M.D. TOMOYUKI SUZUKI M.D. ATSUSHI ITO M.D. Ph .D. KAICHIRO KAMIYA M.D. Ph .D.† ITSUO KODAMA M.D. Ph .D.† 《Journal of cardiovascular electrophysiology》2009,20(6):630-636
Introduction: Increasing evidence suggests that high-frequency excitation in the pulmonary vein (PV) plays a dominant role in the maintenance of paroxysmal atrial fibrillation (AF). However, in a certain population of patients, AF remains inducible after PV isolation (PVI). We sought to clarify whether dominant frequency (DF) analysis of atriopulmonary electrograms can predict paroxysmal AF maintained by non-PV sources.
Methods and Results: Sixty-one patients with paroxysmal AF (aged 59 ± 12 years) were studied. Before PVI, bipolar electrograms during AF were recorded simultaneously from three PV ostia, the coronary sinus (CS), and the septum and free wall of the right atrium (RA). DF was obtained by fast Fourier transform (FFT) analysis. AF was rendered noninducible after PVI in 39 of the 61 patients (noninducible group), but was still inducible in the remaining 22 (inducible group). Among the six recording sites, the highest DF was documented in the PV in all of the patients in the noninducible group; the maximum DF among the three PVs (PV-DFmax ) was higher than that among the CS and two RA sites (atrial DFmax ; 7.2 ± 1.0 Hz vs 5.8 ± 0.7 Hz, P < 0.0001). In contrast, the highest DF was documented in the CS or RA in 45.5% of the patients in the inducible group; PV-DFmax was comparable with atrial DFmax (6.6 ± 0.8 Hz vs 6.6 ± 0.6 Hz). AF inducibility after PVI was predicted by a PV-to-atrial DFmax gradient of <0.5 Hz, with a sensitivity of 90.9% and a specificity of 89.7%.
Conclusion: Paroxysmal AF maintained by non-PV sources can be predicted by the PV-to-atrial DF gradient. 相似文献
Methods and Results: Sixty-one patients with paroxysmal AF (aged 59 ± 12 years) were studied. Before PVI, bipolar electrograms during AF were recorded simultaneously from three PV ostia, the coronary sinus (CS), and the septum and free wall of the right atrium (RA). DF was obtained by fast Fourier transform (FFT) analysis. AF was rendered noninducible after PVI in 39 of the 61 patients (noninducible group), but was still inducible in the remaining 22 (inducible group). Among the six recording sites, the highest DF was documented in the PV in all of the patients in the noninducible group; the maximum DF among the three PVs (PV-DF
Conclusion: Paroxysmal AF maintained by non-PV sources can be predicted by the PV-to-atrial DF gradient. 相似文献
124.
EIJIRO NAKAMURA TOSHIRO TERACHI TOSHIYUKI KAMOTO HIROSHI OKUNO AKITO TERAI YOSHIUKI KAKEHI OSAMU OGAWA 《International journal of urology》2002,9(1):60-62
A 71-year-old man who had previously undergone left nephroureterectomy for renal pelvic tumor developed advanced bladder cancer with obstructive uropathy. He complained of severe macroscopic hematuria, dysuria and presented with postrenal failure. To rescue the renal function and improve ease the patient's symptoms, retroperitoneoscopic ureterocutaneostomy was performed. The operation time was 90 min and blood loss was kept to a minimum. He was able to walk and eat on the first postoperative day, and he left the hospital on postoperative day 21 with satisfactory renal function. Retroperitoneoscopic ureterocutaneostomy is simple, less invasive and a reproducible procedure for poor prognostic advanced cancer patients with obstructive uropathy. 相似文献
125.
Critical PQ Interval for the Appearance of Diastolic Mitral Regurgitation and Optimal PQ Interval in Patients Implanted with DDD Pacemakers 总被引:2,自引:0,他引:2
TOSHIYUKI ISHIKAWA SINICHI SUMITA KAZUO KIMURA NAOMITSU KUJI RIICHIRO NAKAYAMA TOSHIRO NAGURA NAOMICHI MIYAZAKI OSAMU TOCHIKUBO TAKASHI USUI MASANOBU KASHIWAGI MASAO ISHII 《Pacing and clinical electrophysiology : PACE》1994,17(11):1989-1994
Diastolic mitral regurgitation (MR) may be induced by prolonging atrioventricular (AV) delay, and a significant negative correhtion has been described between tbe critical PQ interval for the appearance of diastolic MR and pulmonary capillary wedge pressure (PCWP) in patients with DDD pacemakers. We report the relationship between the critical PQ interval for the appearance of diastolic MR and the optimal PQ interval in 11 patients (69.1 ± 12.6 years). Cardiac output (CO) and PCWP were measured by Swan-Ganz catheter and transmitral blood flow was recorded by pulsed-Doppler echocardiography. AV delay was prolonged stepwise by 0.025 seconds starting from 0.065 seconds. The pacing rate was fixed at 70 beats/min. CO was highest when the PQ interval was 0.18 ± 0.04 seconds. There was a significant positive correlation between the critical PQ interval for the appearance of diastolic MR and the PQ interval at which CO was the highest (r = 0.91, P < 0.01). The PQ interval at which CO was the highest was 0.02 ± 0.02 seconds shorter than the critical PQ interval for the appearance of diastolic MR (P < 0.05). When the PQ interval was increased by 0.025 seconds from the critical PQ interval for the appearance of diastolic MR, CO decreased from 4.3 ± 0.6 L/min to 4.1 ± 0.6 L/min and PCWP increased from 7.5 ± 6.4 mmHg to 8.5 ± 7.3 mmHg (P < 0.05). In conclusion, the critical PQ interval for the appearance of diastolic MR may represent the upper limit of the optimal PQ interval and the AV delay should be set to not exceed the critical PQ interval for the appearance of diastolic MR. 相似文献
126.
MICHIKO AKIMOTO ma ISAO FUKUNISHI md MAYO SAKATA ba MAKOTO SATO md YUICHI SAITO md YOICHI AOTA md TOSHIYUKI YAMADA md KEIICHI SASAKI md 《Psychiatry and clinical neurosciences》1995,49(5-6):267-271
Abstract We report a case of Klinefelter's syndrome with multiply operated low back (MOB). Psychological and/or psychosocial problems related to MOB have been of recent interest in the field of orthopedic surgery. Based on psychiatric interviews, this case was diagnosed as a somatoform pain disorder of the DSM-III-R somatoform disorders. In addition to psychological problems, the pain was partly explicable by severe osteoporosis, which was prematurely caused by endocrinological disturbances associated with Klinefelter's syndrome. Patients with this syndrome are more likely to develop severe osteoporosis. In the presenile period of Klinefelter's syndrome with severe osteoporosis, liaison psychiatrists may pay attention to somatoform disorders (e.g. somatoform pain disorder and conversion disorder) linked with the MO. 相似文献
127.
NAOKI SHIMOJO YOICHI KOHNO TOSHIYUKI KATSUKI KIRI HONMA KEN-ICHI YAMAGUCHI HAJIME TSUNOO TAKESHI TAKAHASHI SHUICHI KAMINOGAWA HIROO NIIMI 《Pediatrics international》1997,39(4):416-421
In order to investigate the role of food antigen-specific T cells circulating in the blood of patients with food allergy, we compared T cell response to three casein components (αs-, β- and, K-casein) with specificities of IgG and IgE binding to the casein components in four milk-allergic patients (P1-4) with atopic dermatitis. In all patients, the binding activities of IgG antibodies to αs-casein were most dominant, followed by those to β- and to K-casein. The major component of casein bound by IgE antibodies was αs-casein in P1 and P3, K-casein in P2, and αs-casein as well as K-casein in P4; the order of casein components bound by IgE antibodies was different from that by IgG antibodies. Proliferative responses of peripheral blood mononuclear cells (PBMC) to casein components were so low that the dominance of casein recognition could not be clearly demonstrated. However, short-term T cell lines that specifically respond to casein were successfully established from PBMC of the four patients and the proliferative responses of the T cell lines to the three components of casein were in accord with the IgE antibody specificity to casein components but not with that of IgG antibody specificity. When taken together, these results indicate that casein-specific T cells circulating in the blood are involved in or reflect an allergic reaction against casein. 相似文献
128.
EXPERIMENTAL STUDY ON HEMORRHAGE IN THE BRAIN STEM INDUCED BY AN INTRACRANIAL SPACE OCCUPYING LESION
Increased intracranial pressure was experimentally produced in dogs by inserting a rubber balloon epidurally in the left temporal region and then inflating the balloon with water. The animals were killed after a set interval and the hemorrhagic lesion in the brain stem examined in detail. 1. The hemorrhagic lesions in the brain stem could be microscopically classified into three types; arterial, venous and capillary. Massive hemorrhagic lesion was also observed in some animals. 2. Arterial hemorrhage was distributed mostly in the area supplied by the thalamo-perforating artery in the diencephalon and in the area supplied by the paramedian branches of the basilar artery in the lower brain stem. Venous hemorrhage was found mostly in the region of the terminal vein and basal vein in the diencephalon and in the region of the basilar vein in the lower brain stem. Capillary hemorrhage was extensive and the distribution corresponded approximately with that of venous hemorrhage but also in part with that of arterial lesions. 3. A relation was apparent between the hemorrhagic lesion in the brain stem and the amount of water instilled into the rubber balloon, which could be correlated to intracranial pressure. Capillary hemorrhage was observed in most cases in which over 3.5 ml of water was instilled. With instillation of 4.0 ml of water, all types of hemorrhage were observed profusely but venos hemorrhage predominated. With instillation of more than 4.5 ml of water, arterial hemorrhage was dominant. 4. The relation between the hemorrhagic lesions and the survival time after procedure was studied in the animals which had died naturally. Capillary hemorrhage was observed in almost all the animals irregardless of the survival time. Both arterial and venous hemorrhage were observed abundantly in animals which survived for over 10 hours. Arterial hemorrhage, in particular, was dominant in the cases which died within 12 hours and the venous type was dominant in the case surviving over 12 hours. 相似文献
129.
SUGURU MATSUOKA KATSUYOSHI TATARA YURI USHIROGUCHI MASAHIRO KUBO MASAKI NII YOSHIYUKI TAGUCHI YASUHIRO KURODA 《Pediatrics international》1994,36(4):383-386
The objective was to detect chronic hepatitis C virus infection in recipients of blood products using retrospective analysis by recall and enrollment of recipients. 226 patients who received blood products for open heart surgery from January 1983 to June 1992 were examined for HCV antibody by using a second generation assay and liver function test. 22 (14%) of the 161 patients who received blood products before November 1989 had detectable HCV antibody, but none of the 65 recipients receiving blood products after 1990, the year the Japanese blood bank began to screen for HCV-antibody. Abnormal alanine aminotransferase (ALT) levels, more than 25 iu/L, during the chronic phase of HCV infection was recognized in nine of 22 (41%) seropositive patients. The liver function test and second generation HCV antibody in the serum are effective markers to screen for chronic hepatitis C in blood product recipients transfused before 1990. 相似文献
130.
Evoked electromyograms of the orbicularis oculi muscle with repeated stimulation given at frequencies of 5, 10, 20, 50 and 100 c/s were examined in myasthenia gravis; and the following results were obtained. 1. In the normal subject, the amplitude of M-waves showed almost no change by stimulation at frequencies of 5 and 10 c/s, and a mild gradual increase by stimulation at a frequency of 20 c/s. On stimulation with 50 and 100 c/s, the amplitude of M-waves showed a marked gradual increase and maintained nearly the peak value after a maximum had been reached. 2. In a total of 23 patients with myasthenia gravis, the amplitude of M-waves showed several specific changes against the stimulation frequencies employed. The patterns of the amplitude of M-waves appearing with each frequency were classified into 3 types: Type I, which showed an initial gradual decrease in amplitude with all the stimulation frequencies employed, was observed in 13 patients (56.5%). Type II, which showed an initial gradual decrease at frequencies of 5 c/s and 10 c/s, but a gradual increase followed by gradual decrease at frequencies of 50 and 100 c/s, was observed in 8 patients (34.8%). Type III, which showed no obvious difference from the pattern of the normal curve with stimulation given at not more than 50 c/s but a gradual increase followed by gradual decrease at a frequency of 100c/s, was observed in 2 patients (8.7%). 3. No distinct differences were noted in other neuromuscular diseases taken as control, as compared with the normal. 相似文献