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151.
152.
Naotaka Fujita Yutaka Noda Go Kobayashi Katsumi Kimura Akio Yago Shinji Okaniwa 《Journal of gastroenterology》1997,32(4):566-569
A 60-year-old woman was admitted to our department for detailed examination of a polypoid lesion of the gallbladder detected
at the time of a mass survey by ultrasound. Endoscopic ultrasonography (EUS) demonstrated a broad-based mass lesion, about
10 mm in size, with an irregular surface, at the peritoneal side of the body of the gallbladder. The layer structure of the
gallbladder wall had not been destroyed by the mass. Computed tomography showed no direct invasion of the liver or other evidence
of metastasis. Type-IIa (superficial elevated-type) early gallbladder cancer was suspected and laparoscopic cholecystectomy
was performed. Histologically, the tumor proved to be a papillo-tubular adenocarcinoma, 9×8 mm in size, confined to the mucosa
and without lymphatic permeation, vascular involvement, perineural invasion, or other signs of metastasis. Laparoscopic cholecystectomy
for gallbladder cancer can be indicated only when a lesion is a pedunculated protruded-type (type-Ip) cancer, or a broad-based
cancer 10 mm or less in size located on the peritoneal side with no destruction of the layer structure of the wall demonstrated
by EUS. This strategy is justified only with precise evaluation of the lesion by EUS. 相似文献
153.
Left ventricular regional relaxation and its nonuniformity in hypertrophic nonobstructive cardiomyopathy 总被引:4,自引:0,他引:4
W Hayashida T Kumada F Kohno M Noda N Ishikawa J Kojima Y Himura C Kawai 《Circulation》1991,84(4):1496-1504
BACKGROUND. Regional nonuniformity has been suggested to be closely related to left ventricular (LV) relaxation in diseased heart. The purpose of the present study was to assess LV global and regional relaxation in patients with nonobstructive hypertrophic cardiomyopathy (HCM). METHODS AND RESULTS. Left ventriculography was conducted simultaneously with pressure micromanometry in 10 normal control subjects and 11 patients with nonobstructive HCM. LV silhouettes in the right anterior oblique projection were divided into eight regions, and regional wall stress during isovolumic relaxation was computed for six regions from the midventricle to the apex. In HCM patients, isovolumic relaxation time (IRT) and the time constant of LV pressure decrease (Tp) were greater than in control subjects (IRT, 84 +/- 13 versus 66 +/- 6 msec; Tp, 51 +/- 8 versus 36 +/- 5 msec, respectively; p less than 0.01). In HCM patients, the (-)dP/dt upstroke pattern was convex-downward, and dP/dt(20/60), the ratio of dP/dt values 20 and 60 msec after peak (-)dP/dt, was less than in control subjects (1.46 +/- 0.16 versus 2.15 +/- 0.14, p less than 0.01). These findings suggest that there is impaired LV relaxation in HCM patients. End-systolic regional wall stress was lower, and the time constant of regional stress decrease (Tst) was prolonged for each region in HCM patients compared with control subjects. In the HCM group, Tst tended to be more prolonged in regions with increased wall thickness than in regions with normal wall thickness (60 +/- 15 versus 50 +/- 11 msec, p less than 0.01). The coefficient of variation for Tst values in six areas of the left ventricle was calculated in each subject and was greater in HCM patients than in control subjects (13 +/- 7% versus 7 +/- 3%, p less than 0.05), indicating regional nonuniformity in Tst during isovolumic relaxation in HCM patients. CONCLUSIONS. Significant correlations existed between the coefficients of variation for Tst and Tp (r = 0.80, p less than 0.01), IRT (r = 0.79, p less than 0.01), and dP/dt(20/60) (r = -0.67, p less than 0.05) in the HCM group. Thus, regional nonuniformity is closely related to the impairment of LV relaxation in HCM. 相似文献
154.
Hiroyuki Noda Hiroyasu Iso Hideaki Toyoshima Chigusa Date Akio Yamamoto Shogo Kikuchi Akio Koizumi Takaaki Kondo Yoshiyuki Watanabe Yasuhiko Wada Yutaka Inaba Akiko Tamakoshi 《Journal of the American College of Cardiology》2005,46(9):1761-1767
OBJECTIVES: We aimed to examine the impact of exercise on mortality from cardiovascular disease (CVD) in Asian populations. BACKGROUND: Few data have been available in Asian countries, where job-related physical activity is higher than that in Western countries. METHODS: Between 1988 and 1990, 31,023 men and 42,242 women in Japan, ages 40 to 79 years with no history of stroke, coronary heart disease (CHD), or cancer, completed a self-administered questionnaire. Systematic mortality surveillance was performed through 1999, and 1,946 cardiovascular deaths were identified. We chose the second lowest categories of walking and sports participation as the reference to reduce a potential effect of ill health. RESULTS: Men and women who reported having physical activity in the highest category (i.e., walking > or =1 h/day or doing sports > or =5 h/week) had a 20% to 60% lower age-adjusted risk of mortality from CVD, compared with those in the second lowest physical activity category (i.e., walking 0.5 h/day, or sports participation for 1 to 2 h/week). Adjustment for known risk factors, exclusion of individuals who died within two years of baseline inquiry, or gender-specific analysis did not substantially alter these associations. The multivariate-adjusted hazard ratios (95% confidence interval) for the highest versus the second lowest categories of walking or sports participation were 0.71 (0.54 to 0.94) and 0.80 (0.48 to 1.31), respectively, for ischemic stroke (IS); 0.84 (0.64 to 1.09) and 0.51 (0.32 to 0.82), respectively, for CHD; and 0.84 (0.75 to 0.95) and 0.73 (0.60 to 0.90), respectively, for CVD. CONCLUSIONS: Physical activity through walking and sports participation might reduce the risk of mortality from IS and CHD. 相似文献
155.
To evaluate the therapeutic efficacy of a new calcium antagonist, nicardipine in hypertension, the cardiovascular effects of chronic therapy were determined by echocardiography in 10 patients with uncomplicated mild to moderate hypertension. Significant declines were recorded in mean blood pressure (average; 11.7 +/- 0.8%) and total peripheral resistance (22.0 +/- 2.0%), accompanied by an increase in cardiac index (13.6 +/- 2.2%). In spite of the considerable degree of blood pressure reduction, heart rate and body weight were unchanged. The magnitude of the decline in total peripheral resistance was directly correlated to both the decrease in mean blood pressure (r = 0.701, p less than 0.02) and the increase in cardiac index (r = -0.953, p less than 0.01). These findings suggest that the hypotensive effect of this new calcium antagonist is due to peripheral vasodilation, and it appears to represent an effective adjunct for the treatment of mild to moderate hypertension. 相似文献
156.
Fujita N Noda Y Kobayashi G Ito K Obana T Horaguchi J Takasawa O Sugawara T 《Journal of gastroenterology》2008,43(8):637-640
Endosonography-guided biliary drainage (ESBD) is now gaining acceptance as a useful alternative for the management of obstructive jaundice.(1) At present, ESBD is used mainly to establish an anastomosis between the biliary tree and the duodenum, stomach, jejunum, or esophagus by placing a stent so as to bridge the bile duct and alimentary tract. We herein report a new application of ESBD, that is, its temporary use for gaining access to the bile duct in order to deploy a self-expandable metallic stent (SEMS) via the transhepatic route. In a patient with pylorus stenosis due to advanced gastric cancer with extrahepatic bile duct obstruction caused by nodal metastasis, a plastic stent was placed temporarily by ESBD to bridge the esophagus and the left hepatic duct. Ten days later, the stent was retrieved, leaving a guidewire in the bile duct, and a delivery unit of a SEMS was introduced into the bile duct over the guidewire via the sinus tract. The SEMS was then successfully deployed through the stenosis. No stent was left in the sinus tract. This procedure yields a mature fistula through which a delivery unit can be safely introduced into the bile duct followed by uneventful deployment of a SEMS. 相似文献
157.
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160.
Yuya Matsue Makoto Suzuki Wataru Nagahori Kazuki Yoshida Yuko Onishi Yasuhiro Satoh Yuichi Ono Toshihiko Nishioka Makoto Noda Kaoru Sugi Sho Torii Tamotsu Tejima Harumizu Sakurada Satoshi Yamaguchi Kaoru Okishige Hiroyuki Fujii Atsushi Takahashi 《Cardiovascular drugs and therapy / sponsored by the International Society of Cardiovascular Pharmacotherapy》2014,28(1):73-77