Subdural hygroma is a frequent delayed complication of head trauma. Most hygromas are clinically 'silent' and a few cases have shown slow deterioration in the chronic stage. We report a case of subdural hygroma showing unique radiological findings and rapid deterioration. A 74-years-old female presented with a mild headache and consciousness disturbance after head injury. Computed tomography showed a midline shift as a result of two components piling up in the subdural space; the outer components showed low density, the inner components high density. Magnetic resonance imaging demonstrated that these two subdural components were subdural hygroma and subarachnoid hematoma. Simple burr hole irrigation, rather than large craniotomy, was thought to be more appropriate treatment to reduce the mass effect. Simple burr hole irrigation was performed to remove the subdural hygroma and the patient showed an excellent recovery. Careful examination of the radiological findings prevented an unnecessary procedure in this case. A possible mechanism of this phenomenon is discussed. 相似文献
Background. A membrane oxygenator consisting of a microporous polypropylene hollow fiber with a 0.2-μm ultrathin silicone layer (cyclosiloxane) was developed. Animal experimental and preliminary clinical studies evaluated its reliability in bypass procedures.
Methods. Five 24-hour venoarterial bypass periods were conducted on dogs using the oxygenator (group A). In 5 controls, bypass periods were conducted using the same oxygenator without silicone coating (group B). As a preliminary clinical study, 14 patients underwent cardiopulmonary bypass with the silicone-coated oxygenator.
Results. Eight to 16 hours (mean, 12.2 hours) after initiation of bypass, plasma leakage occurred in all group B animals, but none in group A. The O2 and CO2 transfer rates after 24 hours in group A were significantly higher than at termination of bypass in group B (p < 0.005 and p < 0.03, respectively). Scanning electron microscopy of silicone-coated fibers after 24 hours of bypass revealed no damage to the silicone coating of the polypropylene hollow fibers. In the clinical study, the oxygenator showed good gas transfer, acceptable pressure loss, low hemolysis, and good durability.
Conclusions. This oxygenator is more durable and offers greater gas transfer capabilities than the previous generation of oxygenators. 相似文献
p = 0.0007) and tumor necrosis (TN) (HMC:p = 0.0050). Univariate analysis showed that AMC or HMC was a statistically significant predictor of overall survival in all
patients (p = 0.0086 andp = 0.0307, respectively). Multivariate analysis showed that AMC was an independent predictor of node status when we fitted
a model with node status, BVI, and either AMC or HMC; but HMC was not independent. However, when we fitted a model including
all 11 of the other indicators and AMC or HMC, the node status, HG, and LI were independent predictors, but AMC and HMC were
not. Although AMC was a better method than HMC for evaluating angiogenesis, we cannot confirm angiogenesis as a significant
independent prognostic factor associated with long-term survival in Japanese breast cancer patients.相似文献
A simulation study was conducted to compare the cost and performance of various models for population analysis of the steady
state pharmacokinetic data arising from a one-compartment model with Michaelis-Menten elimination. The usual Michaelis-Menten
model (MM) and its variants provide no estimate of the volume of distribution, and generally give poor estimates of the maximal
elimination rate and the Michaelis-Menten constant. The exact solution to the Michaelis-Menten differential equation (TRUE)
requires a precise analysis method designed for estimation of population pharmacokinetic parameters (the first-order conditional
estimation method) and also considerable computational time to estimate population mean parameters accurately. The one-compartment
model with dose-dependent clearance (DDCL), in conjunction with the first-order conditional estimation or Laplacian method,
ran approximately 20-fold faster than TRUE and gave accurate population mean parameters for a drug having a long biological
half-life relative to the dosing interval. These findings suggest that the well-known MM and its variants should be used carefully
for the analysis of blood concentrations of a drug with Michaelis-Menten elimination kinetics, and that TRUE, in conjunction
with a precise analysis method, should be considered for estimating population pharmacokinetic parameters. In addition, DDCL
is a promising alternative to TRUE with respect to computation time, when the dosing interval is short relative to the biological
half-life of a drug.
This work was supported in part by the Epilepsy Research Foundation, the Nakatomi Foundation, and a Grant-in-Aid for Scientific
Research from the Ministry of Education, Science, and Culture of Japan. 相似文献
Ductus arteriosus aneurysm is rare in adults and preoperative diagnosis has not been usually done. We report 2 cases of adult
type ductus arteriosus aneurysm. In both cases, 3D computed tomographic scanning showed a saccular aneurysm originating from
the distal aortic arch toward the left pulmonary artery, which had a notching in the orifice of the aortic side. They were
successfully treated surgically though one was a ruptured aneurysm to the left pulmonary artery. In these cases, 3D-CT scan
was of great value in the preoperative diagnosis of the ductus arteriosus aneurysm. 相似文献
Here, we present the first report of the molecular cloning of zebrafish protocadherin 10 (Pcdh10, OL-protocadherin) and describe its functional analyses in the development of segmental plate. Epitope-tagged Pcdh10 expressed in embryos was localized on cell peripheries of adjacent cells. In situ hybridization showed that pcdh10 was expressed in the paraxial mesoderm (PAM) and developing somites, and in the pineal body, the diencephalon, and the vicinity of otocysts. Expression in PAM increased in the last few presumptive somites, reached the maximum level in the latest segmenting somites, and decreased thereafter during somite maturation. These expression patterns suggested that Pcdh10 is involved in development of PAM and somites. This was confirmed by morpholino knockdown and dominant-negative inhibition of Pcdh10 in embryos, which disturbed movements of PAM cells and somite segmentation. Comparative studies showed that pcdh10 expression lasted up to approximately three times longer in maturing somites than that of paraxial protocadherin (pcdh8). They also indicated that the adaxial cells expressed pcdh8 but not pcdh10. We propose that Pcdh10 is involved in the morphogenic movements of PAM cells and somite segmentation and that differential adhesion of Pcdh8 and Pcdh10 plays a role in the morphogenic machinery of somites and adaxial cells. 相似文献
SUMMARY: A comparative immunohistological study was performed for the glomerular deposition of complements (C1q and C3c), fibrin/fibrinogen‐related antigen (FRA), the expression of intercellular adhesion molecule‐1 (ICAM‐1), and the infiltration of leucocytes bearing β2 integrins (leucocyte function associated antigen‐1 (LFA‐1), complement receptor 3 (CR3) and complement receptor 4 (CR4)) on renal biopsy specimens from 49 cases with Henoch‐Schoenlein purpura nephritis (HSPN), and 49 age‐matched cases with immunoglobulin A nephropathy (IgAN). the glomerular expression of ICAM‐1 was signifcantly correlated with the glomerular infiltration of leucocyte function associated antigen (LFA)‐1+ leucocytes in both diseases, and with that of CR3+ leucocytes in HSPN. the expression of ICAM‐1 was closely localized with the infiltration of LFA‐1+ leucocytes in the study with double immunostaining. the incidence and intensity of glomerular deposition of FRA were significantly higher in HSPN than in IgAN (P< 0.001), and those of C3c were significantly lower in HSPN than in IgAN (P< 0.001). the glomerular deposition of FRA was significantly correlated with the glomerular infiltration of CR4+ leucocytes in HSPN (P<0.05) but not in IgAN. In contrast, the glomerular deposition of C3c was significantly correlated with the glomerular infiltration of CR4+ leucocytes in IgAN (P<0.05), but not in HSPN. Studies with double immunostaining revealed a close association of CR4+ leucocytes with FRA deposition in HSPN and with C3c deposition in IgAN, respectively. the number of glomerular leucocytes bearing β2 integrins was significantly correlated with urinary protein at the time of renal biopsy in both diseases. These results suggested the differential roles of β2 integrins in the induction of glomerular injury in HSPN and IgAN. the ICAM‐1/LFA‐1 interaction may commonly be involved in the glomerular infiltration of leucocytes in both diseases. the ICAM‐1/CR3 interaction may be involved only in HSPN. Complement receptor 4 may function as a fibrin/fibrinogen receptor in HSPN, while CR4 may function as a complement receptor in IgAN. 相似文献
Transabdominal resection for esophagocardial cancer and reestablishment of alimentary continuity using bypass methods were
performed in 76 patients. Thirteen underwent a bypass with a gastric tube and in 30, a colonic segment was prepared. In the
remaining 33, a jejunal segment was used as a bypass organ, with considerable success. The 5 year survival rates were 68.8
per cent in those with stages (I+II), 16.5 per cent in those with stage III, 12.6 per cent in those with stage IV and 22.5
per cent in all cases, indicating similar results compared to those with cancer located in the upper third of the stomach
with the limited proximal extension within the esophagocardial junction and operated on during the same period. 相似文献