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11.
Mikihiko Kudo Takahiko Misumi Kiyoshi Koizumi Hankei Shin 《Annals of thoracic and cardiovascular surgery》2005,11(2):121-124
A 78-year-old woman with diagnosis of acute myocardial infarction (AMI) in the anteroseptal area fell into cardiogenic shock suddenly just before starting percutaneous coronary intervention (PCI). Echocardiography showed left ventricular free wall rupture, then an emergent operation was performed by sutureless patch repair using collagen fleece with fibrinogen-based impregnation. Eight days later from the initial operation, the onset of ventricular septal perforation (VSP) was recognized. Fifteen days after, the infarct exclusion technique with endocardial patch was performed. She has been doing well 4 months after the operation without residual shunt. To our best knowledge, this is the first surgical case report that free wall rupture of left ventricle and VSP which are serious complications after myocardial infarction happened in succession. 相似文献
12.
13.
We report a 82-year-old woman who developed difficulty in standing and sitting in the morning. She had no other complaints and stayed in the bed. The next day, she was admitted to the hospital and neurological examination revealed that she was alert, with no other motor or sensory abnormalities. Finger to nose test, and knee to heel test were normal. No dysdiadochokinesia was seen. Astasia was the only observed abnormal finding. MRI showed a small infarction (14 x 8mm) in the posterolateral portion of the left thalamus (VPL-LP nucleus). During the following 15 days, her imbalance has gradually improved and then disappeared. We diagnosed the patient as astasia occurring from a small unilateral infarction in the thalamus. It is thought that thalamic astasia is caused by the disruption of afferent pathway from the vestibulocerebellum; however, this case is based on just clinical and MRI study, so physiological and pathological studies will be necessary in the future. 相似文献
14.
Hitoshi Taguchi Koh Yamada Hideo Matsumoto Akira Kato Toshihiro Imanishi Koh Shingu 《Journal of anesthesia》1997,11(3):173-178
Purpose Several case reports indicate critical respiratory complications in relation to the double-lumen endobronchial tube (DLT).
A prospective survey for the airway problems in using the DLT is presented.
Methods One hundred adult patients undergoing thoracotomy for lung cancer were investigated. Tube malposition and airway obstruction
were searched using a fiber-optic scope. The endobronchial cuff was positioned just below the trachcal carina while the trachea
was intubated with a DLT (Rüsch). The distances of displacement, from the tracheal carina to the bronchial cuff, were measured
during anesthesia using an epidural catheter, which had marks every 5 mm. The distances for correcting the tube position were
measured at both the bronchial cuff and the level of the teethPaO2,PaCO2 andSPO2 were also measured.
Results Malposition (displacement over 5 mm from the correct position) was found in 42 patients, and 40 of them were in a withdrawal
direction, occurring at the postural change and during one-lung ventilation, especially during manipulation of the lung hilum.
Correcting distances at the level of the teeth were 15.3–3-times longer than those at the bronchial cuff. Airway deformities
and gradual withdrawal of the bronchial cuff were found in association with surgical manipulation. Obstruction occurred at
the tips of the tracheal tube in four patients and the bronchial tube in six patients, and at the tip of both in two patients.
Hypoxemia (PaO2<60 mmHg) occurred in four patients and hypercapnea (PaCO2>60 mm Hg) in two patients.
Conclusion Most of the DLT obstructions were associated with withdrawal malposition. Great attention to DLT displacement and airway deformity
is advised. 相似文献
15.
Yoshinori Yamashita Toshihiro Hirai Hidenori Mukaida Takashi Iwata Tetsuya Toge Hong Jae Hoon 《Surgery today》1990,20(6):671-676
This report presents the effect of repeated heating every 24 hrs using bleomycin (BLM) which, although seemingly contrary
to the usual agreement that hyperthermia should be carried out with a long interval due to thermotolerance, holds many possibilities.
FM3A cells on the foot pad of C3H mouse were immersed in a heated water bath at 43 and 44°C for 30 min. The effect of repeated
heating was appreciated by an improved growth curve and 50 day survival compared to mice which received heating twice with
a 96-hr interval. Repeated heating every 24 hrs 5 times with BLM suppressed tumor growth significantly as compared to heating
twice with a 96-hr interval without BLM. The longest survival time was obtained by the repeated heating with BLM among all
protocols. There is therefore a good possibility that more effective results could be obtained clinically by repeated heating
over a short period. 相似文献
16.
17.
Toshihiro Seo Taketoshi Kajihara Toshiro Iijima 《Macromolecular chemistry and physics.》1987,188(6):1295-1304
The catalytic hydrolysis of phenyl esters in systems containing ß-cyclodextrin (ß-CD) and polyelectrolytes was investigated. Poly(methacrylic acid) was found to exhibit an inhibition effect on the hydrolysis, while poly(sodium styrenesulfonate) (NaPSS) shows a pronounced acceleration effect on the hydrolysis: the larger the molecular weight and the lower the degree of substitution, the greater is the acceleration effect. On the other hand, sodium ethylbenzenesulfonate and sodium dodecylbenzenesulfonate inhibit the reaction. The acceleration of the reaction in presence of NaPSS is attributed to the concentration of ß-CD and the substrate esters near to the chain of the macromolecule, through inclusion effects and hydrophobic interactions. 相似文献
18.
Hideyuki Iwai Ryuji Koike Jun Ogawa Takahiko Sugihara Hiroyuki Hagiyama Kenji Nagasaka Yoshinori Nonomura Junko Nishio Toshihiro Nanki Rieko Tsubata Hitoshi Kohsaka Tetsuo Kubota Nobuyuki Miyasaka 《Nihon Rinshō Men'eki Gakkai kaishi》2002,25(3):270-276
A 36-year-old man was admitted to a hospital with complaints of fever, polyarthralgia and dyspnea. Erythema was observed on his face, extensor surface of the fingers and extremities, and a chest X-ray revealed massive bilateral pleural effusion. He had no sign of myopathy at this point. Pleural fluid was proved to be exudative and contained extremely high levels of hyaluronic acid. He was also complicated with interstitial pneumonitis and was given a pulse therapy with methyl prednisolone followed by daily administration of 55 mg prednisolone (PSL). Twenty days after the commencement of the therapy, pleural effusion decreased but muscle weakness gradually appeared, accompanied by elevation of myogenic enzymes. Myogenic changes on electromyogram, and irregularity of the muscle fibers with slight inflammatory cell infiltrates in a biopsy specimen were demonstrated. He was transferred to our hospital, and a diagnosis of dermatomyositis was made. Later, pleural effusion waxed and waned depending on the dosage of PSL, but no other causative disorder was demonstrated by extensive examinations. This case indicates that the pleuritis could be one of the vasculitic manifestations of dermatomyositis. 相似文献
19.
Genetic alteration in carcinoid tumors of the lung. 总被引:1,自引:0,他引:1
Kenji Sugio Toshihiro Osaki Tsunehiro Oyama Mitsuhiro Takenoyama Takeshi Hanagiri Masaru Morita Koji Yamazaki Akira Nagashima Hisashi Nakahashi Yoshihiko Maehara Kosei Yasumoto 《Annals of thoracic and cardiovascular surgery》2003,9(3):149-154
Surgically resected specimens of 13 carcinoid tumors of the lung including nine typical carcinoids and four atypical carcinoids, and eight salivary gland type carcinomas (six mucoepidermoid carcinomas and two adenoid cystic carcinomas) were analyzed regarding p53 expression, loss of heterozygosity (LOH) in chromosome 3p, 9p, and K-ras mutation. The overexpression of p53 was identified in four atypical carcinoid tumors, one mucoepidermoid carcinoma, and one adenoid cystic carcinoma, however, none of typical carcinoids showed p53 immunoreactivity. LOH in 3p14 was demonstrated in three of seven informative cases in all tumors. LOH in 9p was demonstrated in two of five informative cases in all tumors. Two of three cases with LOH at 3p14 had a poor prognosis, one of which also had LOH at 9p. No mutation of the K-ras gene was observed in any of these tumors. These data thus indicate that p53 overexpression might distinguish atypical carcinoid tumors from typical tumors and might therefore be useful as an adjunct modality in the differential diagnosis of pulmonary carcinoid tumors. The presence of LOH at 3p14 or 9p may thus help to identify lung cancer patients with a poor prognosis. 相似文献
20.
Yuzo Kodaira Tetsuo Shibuya Koushi Matsumoto Kiichiro Uchiyama Toshihiro Tenjin Nobutaka Yamada Shigeo Tanaka 《Surgery today》1997,27(8):745-748
A 66-year-old man died of massive gastrointestinal hemorrhage caused by a fistula between the third portion of the duodenum
and the abdominal aorta. An autopsy revealed that duodenal tuberculosis had resulted in the development of a fistula into
the aorta with no pathological changes, and no active pulmonary tuberculosis was found. Duodenal tuberculosis and primary
aortoduodenal fistula (ADF) without an aneurysm are both extremely rare. Thus, we report herein a unique case of primary aortoduodenal
fistula without an abdominal aortic aneurysm, but associated with duodenal tuberculosis, and review the current literature. 相似文献