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991.
Yukiko Aono Hisashi Hasegawa Yuji Yamazaki Takashi Shimada Toshiro Fujita Takeyoshi Yamashita Seiji Fukumoto 《Journal of bone and mineral research》2011,26(4):803-810
Fibroblast growth factor 23 (FGF‐23) plays causative roles in the development of several hypophosphatemic rickets/osteomalacia such as X‐linked hypophosphatemic rickets/osteomalacia (XLH) and tumor‐induced rickets/osteomalacia. Patients with hypophosphatemic rickets/osteomalacia often complain of muscle weakness and bone pain that severely affect daily activities of these patients. The purpose of this study was to examine whether anti‐FGF‐23 antibodies, which have been shown to improve hypophosphatemia and rachitic changes of juvenile Hyp mice in a murine model of XLH, also ameliorate hypophosphatemic osteomalacia and affect muscle force and spontaneous motor activity in adult Hyp mice. Repeated injections of anti‐FGF‐23 antibodies increased serum phosphate and 1,25‐dihydroxyvitmain D levels and enhanced mineralization of osteoid in adult Hyp mice, whereas bone length did not change. We found that grip strength was weaker and that spontaneous movement was less in adult Hyp mice than in wild‐type mice. In addition, FGF‐23 antibodies increased grip strength and spontaneous movement. These results suggest that the inhibition of excess FGF‐23 action not only ameliorates hypophosphatemia and impaired mineralization of bone but also improves muscle weakness and daily activities of patients with FGF‐23‐related hypophosphatemic rickets/osteomalacia. © 2011 American Society for Bone and Mineral Research. 相似文献
992.
In patients in whom a tracheal tube cannot be inserted through the nostrils due to multiple facial trauma or hypoplasty of
the nose, submental orotracheal intubation (SOI) is performed to avoid tracheostomy. We report a new modification for SOI
to minimize the risk of apnea. A 20-year-old man was scheduled for sagittal split ramus osteotomy. As the patient had severe
hypoplasia of the nose, SOI was planned. Following orotracheal intubation with a spiral tube (first tube), a submental tunnel
was surgically created. A second tube that had been confirmed, in advance, to snugly fit into the proximal end of the first
tube was passed into the submental tunnel via a polypropylene cylinder and connected between the first tube and the breathing
circuit. After careful withdrawal of the second tube through the submental tunnel, the first tube was directly connected to
the breathing circuit after removal of the second tube. Although this technique requires additional time, apnea time is minimal
even in patients in whom withdrawal of the tracheal tube through the submental tunnel takes time, because the second tube
forms a link between the first tube and the breathing circuit, making it possible to ventilate the patient throughout the
procedure. 相似文献
993.
Purpose
Ventricular fibrillation (VF) is a common cardiac arrest rhythm that can be terminated by electrical defibrillation. During cardiopulmonary resuscitation, there is a strong need for a prompt and reliable predictor of successful defibrillation because myocardial damage can result from repeated futile defibrillation attempts. Continuous wavelet transform (CWT) provides excellent time and frequency resolution of signals. The purpose of this study was to evaluate whether features based on CWT could predict successful defibrillation. 相似文献994.
A diagnosis of narcolepsy requires pharmacologic treatment in more than 90% of patients. Wake-promoting compounds are used
to treat excessive daytime sleepiness (EDS), and anticataplectics are used for cataplexy. The treatment of EDS includes the
use of amphetamine-like CNS stimulants (such as dextroamphetamine and methylphenidate), modafinil, and its R-enantiomer, armodafinil.
Because of its high safety and low side-effect profiles, modafinil has become the first-line treatment of choice for EDS associated
with narcolepsy. However, wake-promoting compounds do not improve cataplexy and dissociated manifestation of REM sleep, and
so antidepressants (monoamine uptake inhibitors) are additionally used for the treatment of cataplexy and REM sleep abnormalities.
Tricyclic antidepressants potently reduce REM sleep and thus have been used for the treatment of cataplexy and REM sleep abnormalities,
but these have recently been replaced by more selective serotonin and/or noradrenaline uptake inhibitors with better side-effect
profiles. As sodium oxybate (the approved formula of γ-hydroxybutyrate in the United States), given at night, improves both
EDS and cataplexy, the number of US patients treated with sodium oxybate is increasing, while much progress has been made
in understanding the modes of action of amphetamine-like CNS stimulants. 相似文献
995.
Hirahara N Tanaka T Yano S Yamanoi A Minari Y Kawabata Y Ueda S Hira E Yamamoto T Nishi T Hyakudomi R Inao T 《Surgical laparoscopy, endoscopy & percutaneous techniques》2011,21(1):e11-e15
We report the method of anastomosis based on a hemi-double stapling technique (hereinafter, HDST) using a trans-oral anvil delivery system (EEA OrVil) for reconstructing the esophagus and lifted jejunum following laparoscopic total gastrectomy or proximal gastric resection. As a basic technique, end-to-side anastomosis was used for the cut-off stump of the esophagus and lifted jejunum. After the gastric lymph node dissection, the esophagus was cut off obliquely to the long axis using an automated stapler. EEA OrVil was orally, and a small hole was created at the tip of the obliquely cut-off stump with scissors to let the valve tip pass through. When it was confirmed that the automated stapler and center rod were made completely linear, the anvil and the main unit were connected with each other and firing was carried out. Then, HDST-based anastomosis was completed. The method may safe laparoscopic anastomosis between the esophagus and reconstructed intestine. 相似文献
996.
Seiji Takatsuki MD Hideo Mitamura MD Kojiro Tanimoto MD Yukiko Fukuda MD Masaki Ieda MD Shunichiro Miyoshi MD Kyoko Soejima MD Fabrice Extramiana MD Antoine Leenhardt MD Satoshi Ogawa MD 《Heart rhythm》2006,3(12):173-1418
BACKGROUND: Para-Hisian pacing is an effective method of differentiating between pathways for retrograde conduction over the accessory pathway (AP) and over the atrioventricular node (AVN). When performing para-Hisian pacing, the pacing spike sometimes captures only the His bundle, which we named "pure" Hisian pacing (Hc). OBJECTIVE: We evaluated the significance of pure Hisian pacing for predicting the pathways of ventriculoatrial conduction. METHODS: In 62 patients with supraventricular tachycardia, both para-Hisian and pure Hisian pacing were carried out during the sinus rhythm, resulting in three different types of electrocardiographic complexes with wide (local ventricular myocardial capture), slightly narrow (both local myocardial and His bundle capture), and very narrow QRS widths (Hc). A change of atrial activation sequence as demonstrated by these pacing modes indicated the presence of multiple retrograde pathways. The diagnosis of retrograde pathways by para-Hisian pacing with or without Hc was evaluated. RESULTS: In 22 patients with AVN reentrant tachycardia, para-Hisian pacing alone was able to correctly predict ventriculo-atrial conduction exclusively through the AVN without requiring findings from Hc. In 40 AP patients, para-Hisian pacing showed a pattern of retrograde conduction through the AVN in six, through both the AVN and AP in 10, and through an AP in 24 patients. Four of these 24 patients were diagnosed as having multiple pathways (AP+AVN or dual APs) by the addition of Hc. CONCLUSION: Pure Hisian pacing can help disclose another pathway for retrograde conduction in AP patients, which is unpredicted by ordinary para-Hisian pacing. 相似文献
997.
Rumi Ohata Tadaharu Okazaki Yoichi Ishizaki Junya Fujimura Toshiaki Shimizu Geoffrey J. Lane Atsuyuki Yamataka Seiji Kawasaki 《Pediatric surgery international》2010,26(4):447-450
Pancreatoblastoma (PB) is extremely rare. A 11-year-old boy, who had excision of dilated common bile duct with hepaticoduodenostomy
when 9 years old was referred to our institute for further management of abdominal pain and steatorrhea. Imaging studies showed
a solid 4 cm tumor in the head of the pancreas and two lesions in the liver. Needle biopsies diagnosed PB with liver metastases.
After five courses of chemotherapy, the primary tumor was completely resected with pancreaticoduodenectomy (PD) and Child’s
pancreaticobiliary tract reconstruction. The liver metastases were resected. Postoperative recovery was uneventful. Here,
we present this case and review the literature focusing on management of PB. 相似文献
998.
999.
Chemokines direct the movement of leukocytes, including hematopoietic stem and progenitor cells, and can mobilize hematopoietic cells from marrow to peripheral blood where they can be used for transplantation. In this review, we will discuss the stem cell mobilizing activities and mechanisms of action of GRObeta, a CXC chemokine ligand for the CXCR2 receptor. GRObeta rapidly mobilizes short- and long-term repopulating cells in mice and/or monkeys and synergistically enhances mobilization responses when combined with the widely used clinical mobilizer, granulocyte colony-stimulating factor (G-CSF). The hematopoietic graft mobilized by GRObeta contains significantly more CD34(neg), Sca-1+, c-kit+, lineage(neg) (SKL) cells than the graft mobilized by G-CSF. In mice, stem cells mobilized by GRObeta demonstrate a competitive advantage upon long-term repopulation analysis and restore neutrophil and platelet counts significantly faster than cells mobilized by G-CSF. Even greater advantage in repopulation and restoration of hematopoiesis are observed with stem cells mobilized by the combination of GRObeta and G-CSF. GRObeta-mobilized SKL cells demonstrate enhanced adherence to vascular cell adhesion molecule-1 and VCAM(pos) endothelial cells and home more efficiently to bone marrow in vivo. The marrow homing ability of GRObeta-mobilized cells is less dependent on the CXCR4/SDF-1 axis than cells mobilized by G-CSF. The mechanism of mobilization by GRObeta requires active matrix metalloproteinase-9 (MMP-9), which results from release of pro-MMP-9 from peripheral blood, and marrow neutrophils, which alters the stoichiometry between pro-MMP-9 and its inhibitor tissue inhibitor of metalloproteinase-1, resulting in MMP-9 activation. The efficacy and rapid action of GRObeta and lack of proinflammatory activity make it an attractive agent to supplement mobilization by G-CSF. In addition, GRObeta may also have clinical mobilizing efficacy on its own, reducing the overall time and costs associated with peripheral blood stem cell transplantation. 相似文献
1000.
Ootani H Iwakiri R Shimoda R Nakahara S Amemori S Fujise T Kikkawa A Tsunada S Sakata H Fujimoto K 《Journal of gastroenterology》2006,41(1):41-46
Background Helicobacter pylori infection and nonsteroidal anti-inflammatory drugs (NSAIDs) are well-known major causes of peptic ulcers. This study aimed
to characterize the features of bleeding peptic ulcers in Japan.
Methods This prospective study evaluated 116 patients revealed to have bleeding peptic ulcers from January 2000 to December 2002.
Results Eighty-eight of the 116 patients (75.9%) had H. pylori infection. Seventy (60.3%) patients were positive for H. pylori with no history of NSAID use (group A), and 18 (15.5%) were positive for H. pylori with a history of NSAID use (group B). Among the H. pylori-negative patients, 15 (12.9%) were associated with NSAID use (group C). Thirteen (11.2%) patients had no H. pylori infection or history of NSAID use (group D). Among the 33 patients with a history of NSAID use, 11 were on-demand NSAID users
and 14 took daily low-dose aspirin. The patients in groups B and C were significantly older that those in groups A and D,
and they more frequently had coexisting diseases compared with group A. In group D, 11 patients had atrophic changes revealed
by endoscopic examination, suggesting a past H. pylori infection, and these atrophic changes remained at the time of bleeding. Many of the patients in group D had serious comorbidity.
Compared with healthy control subjects, the concentrations of both phosphatidylcholine and phosphatidylethanolamine were significantly
decreased in the antral gastric mucosa in all patient groups.
Conclusions NSAID use contributed to bleeding ulcers in 28.4% of patients; thus, low-dose aspirin or on-demand NSAID use may cause bleeding
ulcers. There were only two (1.7%) confirmed cases of H. pylori-negative, non-NSAID ulcers. 相似文献