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71.
Keiko Imamura Kenji Wada Kenichi Yasui Kazuhiro Nakaso Yasuhiro Watanabe Hisanori Kowa Kenji Nakashima 《Clinical neurology》2004,44(7):446-449
A 61-year-old man had been treated for malignant fibrous histiocytoma with the pulmonary and the lymph node metastasis in the department of orthopedics in our hospital. He was admitted to our department because of an acute onset of conscious disturbance and non-fluent aphasia. Diffusion-weighted imaging (DWI) showed high signal intensity areas in the bilateral cerebella, thalami and posterior lobes. T2WI did not show any mass effects. Enhanced CT did not reveal any enhanced lesion. He was diagnosed as having cerebral embolism, and his conscious disturbance was improved after medication. Eight weeks later, he presented dysphagia, dysarthria, and ataxia in his extremities. DWI showed multiple lesions of low signal intensity located at the identical place where had showed high signal intensity in the initial DWI. T2WI showed high signal intensity area with mass effect. It was indicated that cerebral metastasis might grow after tumorgenic embolism. This is a rare case that tumor emboluses were developed to the metastatic brain tumors. 相似文献
72.
Toshihisa Inoue MD Shigeru Watanabe MD Yoshiaki Masuda MD Katsuya Yoshida MD Hitoshi Imai MD Yasuo Imazeki MD Yoshiaki Ishizuya MD Masashi Koga MD Hirotoshi Kato MD Hiroo Ikehira MD Yukio Tateno MD 《Clinical imaging》1996,20(4):262-268
The magnetic resonance phase-contrast technique for the measurement of flow velocity and volume in true and false lumens was studied in six patients with chronic dissecting aneurysms. Phase-contrast images were obtained at a level perpendicular to the dissecting aneurysms of the descending aorta. As the maximum diameter of aneurysms increased, the ratio of the cross-sectional area of the false to the true lumen increased and the peak average velocity in the true lumen during systole was decreased. This technique proved invaluable for determining prognosis and operability for this condition. 相似文献
73.
M Kohjiro J Miyake K Koga K Miyamoto T Fukutome 《Masui. The Japanese journal of anesthesiology》1990,39(12):1664-1668
A new benzodiazepine-type drug, midazolam, was administered intramuscularly as a premedicant to 155 patients aged from 16 to 81 years with ASA status 1 or 2. The hypnotic action and the effect on the upper airway tract of midazolam were evaluated. Hypnosis appeared 5 minutes after the administration of midazolam, reached its plateau after 20 minutes and started to decline after 30 minutes. The hypnotic effect showed dose-dependent increase in doses ranging from 0.05 to 0.20 mg.kg-1. No age-dependent differences in hypnosis were observed except for teenage group which showed stronger hypnosis than the other age groups. There was no problem on the upper airway tract for all age groups at the dosage of 0.05 mg.kg-1, but in the patients over 40 years increasing dosage tended to obstruct the upper airway tract. Along with the appearance of hypnosis, cough and breath holding, suggesting retention and aspiration of saliva, were observed. The appropriate dosage of midazolam for premedication was considered to be 0.05 mg.kg-1. 相似文献
74.
Primary leiomyosarcoma of the thyroid gland 总被引:1,自引:0,他引:1
Osamu Ozaki Kiminori Sugino Takashi Mimura Kunihiko Ito Seiichi Tamai Yasuhiro Hosoda 《Surgery today》1997,27(2):177-180
Primary leiomyosarcoma of the thyroid gland is extremely rare, and to the best of our knowledge only five well-documented
cases have been reported in the world literature. We herein report a 58-year-old female patient with primary leiomyosarcoma
of the thyroid who was successfully treated by total thyroidectomy with a modified neck dissection. Immunohistochemically,
the tumor cells showed positive reactivity to α-smooth muscle actin and vimentin. Radical surgery was thus considered to be
essential in the treatment of this rare but rather aggressive malignancy. 相似文献
75.
Clinical effects of percutaneous cardiopulmonary support in severe heart failure: early results and analysis of complications. 总被引:2,自引:0,他引:2
Shigeru Sakamoto Junichi Matsubara Toshiaki Matsubara Yasuhiro Nagayoshi Shinji Shono Hisateru Nishizawa Masaaki Kanno Katsunori Takeuchi Toshimichi Nonaka Jun Kyosawa 《Annals of thoracic and cardiovascular surgery》2003,9(2):105-110
Between January 1993 and December 2001, we employed percutaneous cardiopulmonary support (PCPS) in 35 patients. PCPS was used for postcardiotomy in 25 of these patients who could not be weaned from cardiopulmonary bypass (CPB) because of severe cardiogenic shock. In the other 10 patients, PCPS was used for a non-surgical disease. Twenty-nine patients (82.9%) were weaned from PCPS, and 28 (80.0%) survived. The other 7 patients (20.0%) died due to postoperative complications. The causes of death were multiple organ failure (MOF) due to wound bleeding, low cardiac output syndrome (LOS), myonephropathic metabolic syndrome (MNMS) with severe lower limbs ischemia, cerebrovascular accident (CVA), and sepsis. The first cause for the complications was postoperative sustained severe heart failure. To improve the survival rate, it was necessary to prevent bleeding and begin PCPS at an earlier stage. 相似文献
76.
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
77.
Isao Iwamoto Hisamichi Baba Yasunori Koga Noriyuki Uchida Kazuhiko Matsuo Kiyoshi Ishii Toshio Onitsuka Kouichirou Shibata 《Surgery today》1990,20(2):158-162
In order to assess the accuracy of electroencephalography (EEG), in children who have undergone cardiac surgery under simple
deep hypothermia, the relation between IQ or schoolwork achievement and the duration of circulatory arrest was investigated
in 75 such children. Abnormal preoperative EEG's were found in 16 per cent of the children while abnormal postoperative EEG's
were found in 17 per cent. The children were divided into 4 groups, according to pre- and postoperative EEG results. Schoolwork
achievement scores ranged between 3.0 and 3.2, the difference among the groups being insignificant. Moreover, no significant
shift in IQ was found among the groups. Finally, regarding the number of children who were able to go on to a higher level
of education, including high school the college or university, again no significant differences were found among the 4 groups.
In a comparison with the number of such children in neighboring Nagasaki prefecture able to continue on to a higher level
of education, no significant differences were seen either. The findings and statistics of this investigation therefore indicate
that pre- and postoperative EEG's are not always a reliable reference for assessing the prognosis of cerebral activity. 相似文献
78.
Traumatic dislocation of the testes 总被引:1,自引:0,他引:1
Traumatic dislocation of the testis is an unusual disorder. A case of bilateral traumatic dislocation of the testes is presented. Ultrasound examination is very useful for determination of the preoperative diagnosis and management of the dislocated testis. 相似文献
79.
T Motohiro Y Yoshinaga H Sasaki K Oda M Aramaki A Kawakami K Tanaka T Koga Y Shimada Y Sakata 《The Japanese journal of antibiotics》1989,42(2):465-494
It has been known that clarithromycin (TE-031, A-56268), a new macrolide antibiotic (ML), achieves higher concentrations in blood, is better excreted into urine and is better distributed into various tissues than conventional MLs. We investigated the pharmacokinetics of TE-031 in children upon oral administration of the drug in the following method. TE-031 granular preparation with a potency of 100 mg/g was given to 6 boys (5 years 4 months-14 years 0 month) with dose levels of 5 mg/kg and 10 mg/kg for each 3 boys. A tablet preparation with each tablet containing 50 mg of TE-031 was administered to 4 boys and 2 girls (8 years 5 months-11 years 6 months) with dose level of 2 tablets (i.e., 100 mg) and 3 tablets (i.e., 150 mg) for each 3 children. All administrations were done at 30 minutes before meal. Then, to conduct a cross-over test, the granule preparation was given orally to the 3 children mentioned above who was given 2 tablets and the 1 of 3 cases that were given 3 tablets at the same dose levels (100 mg and 150 mg) respectively. A bioassay was used to determine concentrations in blood of active antibiotic compounds and an high performance liquid chromatography (HPLC) was used to determine unchanged TE-031 and its main metabolite, M-5. Urinary concentrations of active antibiotic compounds were also determined by the bioassay and the HPLC was used to determine concentrations and proportions of unchanged TE-031 and its metabolites, M-1, M-4, M-5, M-6 and M-7 to figure out the urinary recovery rate in the first 6 hours. The results of these experiments are summarized as follows. 1. As was mentioned above, TE-031 was administered orally to 2 groups of children at dose levels of 5 mg/kg and 10 mg/kg, respectively. Mean serum levels of total active antibiotic compounds reached their maximum in 1 and 2 hours for the 5 mg/kg and the 10 mg/kg dosage groups, respectively, at 1.28 and 3.62 micrograms/ml, respectively. Mean half lives of serum concentrations in the 2 groups were quite similar, with values of at 2.1 and 2.0 hours, respectively. Mean serum concentrations of unchanged TE-031 determined by the HPLC method reached their peaks in 1 hour after administration in either of the 5 and 10 mg/kg dosage groups at peak levels of 0.65 micrograms/ml and 2.67 micrograms/ml, respectively. Thus, dose-response relationships were observed with TE-031 and M-5.(ABSTRACT TRUNCATED AT 400 WORDS) 相似文献
80.
T Motohiro K Tanaka A Kawakami T Koga Y Shimada S Tomita Y Sakata T Fujimoto T Nishiyama N Kuda 《The Japanese journal of antibiotics》1987,40(6):1200-1214
To evaluate pharmacokinetics of amikacin (AMK), one of the aminoglycoside antibiotics, children with ages from 2 days to 11 years were treated with various doses by various administration routes, and both plasma and urinary levels of AMK were determined. The following is a summary of the results obtained: 1. Of 6 children, three were treated with 2.0 mg/kg of AMK by a 30-minute intravenous drip infusion, and the other 3 with 4.0 mg/kg by a 60-minute. Peaks of average plasma levels were observed at the ends of the infusions in both cases, and their levels were 9.23 and 13.67 micrograms/ml, respectively, showing a dose-dependency. Both half-lives and areas under plasma concentration-time curves (AUCs) were similar to those of adults. However, the volume of distribution (Vd) showed a lower value than that of adults. Peaks of average urine levels were 149.3 micrograms/ml with 2.0 mg/kg in 0-2 hours after the start of the infusion and 223.3 micrograms/ml with 4.0 mg/kg in 2-4 hours. Average urinary recovery rates within 6 hours after the start of the infusion were 95.4% with 2.0 mg/kg and 85.7% with 4.0 mg/kg. These recoveries were equal to or higher than that of adults. 2. When 3.0, 4.0 and 6.0 mg/kg of AMK were administered to 3 groups of mature or premature babies by intramuscular injection, average peak levels of AMK in plasma were 6.26, 8.61 and 12.60 micrograms/ml, respectively, at 30 minutes after the injection, showing dose-dependency. In these groups, the younger the day age after birth was, the longer the half-life became. The AUCs were larger as the half-life became longer. The Vd was larger than that in the intravenous drip infusion group, but, any particular was not observed. Average peak levels of AMK in urine were 78.83 micrograms/ml at 4-6 hours with a dose level of 3.0 mg/kg, 99.17 micrograms/ml at 2-4 hours with 4.0 mg/kg and 139.20 micrograms/ml at 0-2 hours with 6.0 mg/kg. Average urinary recovery rates within 6 hours were 36.57% with 3.0 mg/kg, 34.67% with 4.0 mg/kg and 43.77% with 6.0 mg/kg. These recovery rates were markedly lower than those observed in adults and children. One of the causes of this low recovery is that mature and premature babies have immature renal functions. 3. When 3.0 mg/kg of AMK was administered to three premature babies by a 30-minute intravenous drip infusion, the average peak plasma levels was 7.61 micrograms/ml at the end of the drip infusion.(ABSTRACT TRUNCATED AT 400 WORDS) 相似文献