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71.
Hidenori Kamiyama Nobuyuki Toyama Yasuaki Mori Kunihisa Miyazaki Makoto Nagano Shigeki Yamada Yoshihisa Suminaga Fumio Konishi 《Journal of hepato-biliary-pancreatic sciences》2002,9(6):759-763
We report a successfully managed case of far‐advanced hepatocellular carcinoma (HCC) by intraarterial infusion therapy. A 55‐year‐old man was admitted to our hospital with abdominal pain and subileus. Abdominal ultrasonography, computed tomography, and angiography revealed HCC with obstruction of the main portal vein due to tumor thrombus. Serum levels of α‐fetoprotein (AFP) and protein induced by vitamin K absence or antagonist‐II (PIVKA‐II) were elevated. Neoadjuvant chemotherapy was tried with a course of low‐dose cisplatin (CDDP) +5‐fluorouracil (5‐FU) intrahepatic arterial infusion through the indwelling catheter via the subcutaneous reservoir port. After 7 weeks of administration (total dose CDDP 370 mg/5‐FU 18.5 mg), the main tumor size was effectively reduced. Serum levels of AFP and PIVKA‐II decreased markedly. Adverse effects were tolerated. Following the chemoinfusion therapy, posterior segmentectomy and thrombectomy were performed. Reconstruction of the portal vein was not necessary because we removed the tumor thrombus without resecting the portal vein. The postoperative course was uneventful, and the patient has been doing well more than 2 years after surgery, with no evidence of recurrence or metastasis. Preoperative low–dose CDDP +5‐FU intrahepatic arterial infusion therapy in combination with hepatic resection may be an effective treatment for advanced HCC with portal vein tumor thrombus. 相似文献
72.
Hiroshi Hosono Chikatoshi Katada Koichi Kano Akari Kimura Shohei Tsutsumi Syunsuke Miyamoto Masaaki Ichinoe Yasuaki Furue Satoshi Tanabe Wasaburo Koizumi Taku Yamashita 《Auris, nasus, larynx》2021,48(2):265-273
ObjectiveThe aim of this retrospective study is to evaluate the usefulness of upper gastrointestinal endoscopy and the Valsamouth? by an otolaryngologist in patients with hypopharyngeal cancer to assess the risk.MethodsThe study group comprised 41 patients with untreated hypopharyngeal cancer that was precisely diagnosed by an otolaryngologist using upper gastrointestinal endoscopy and the Valsamouth? at our hospital from January 2016 to December 2017. With upper gastrointestinal endoscopy and the Valsamouth?, the oral cavity, oropharynx, larynx, hypopharynx, and esophagus were observed in this order. Narrow-band imaging, and subsequently, white-light observation were performed. At the hypopharynx, vocalization, and subsequently, the Valsalva maneuver were performed. After observing the esophagus, Lugol chromoendoscopy of the esophagus was performed.ResultsThe mean age of the 38 men and 3 women included in the study was 69.7 ± 10.0 years (range, 51–94 years). As for the T category of hypopharyngeal cancer, T1 cancer was observed in 9 patients, T2 cancer in 14, T3 cancer in 11, and T4 cancer in 7. With vocalization, the grade of visualization in the hypopharynx was 1 in 30 patients (73.2%), 2 in 11 patients (26.8%), and 3 or more in 0 patients (0.0%). With the Valsalva maneuver, the grade of visualization in the hypopharynx was 1 in 1 patient (2.4%), 2 in 15 patients (36.6%), 3 in 8 patients (19.5%), 4 in 11 patients (26.8%), and 5 in 6 patients (14.6%). The grade of visualization in the hypopharynx on average was 1.27 after vocalization and 3.15 after the Valsalva maneuver (p < 0.001). With vocalization, the percentage of patients in whom the entire image of hypopharyngeal cancer could be observed was 0.0% for grade 1 and 18.2% for grade 2. With the Valsalva maneuver, the percentage of patients in whom the entire image of hypopharyngeal cancer could be observed was 0.0% for grade 1, 40.0% for grade 2, 50.0% for grade 3, 86.1% for grade 4, and 100% for grade 5. Synchronous esophageal cancers were detected in 17.1% (7/41) of the patients. The grade of Lugol-voiding lesions was A in 5.6%, B in 52.8%, and C in 41.7%.ConclusionThe examination with upper gastrointestinal endoscopy and the Valsamouth? by an otolaryngologist is feasible in patients with hypopharyngeal cancer. This procedure can detect synchronous esophageal cancer, allowing the risk of metachronous cancer in the head and neck or the esophagus to be recognized after the treatment. 相似文献
73.
Yasuaki Hayashino Jeffrey L. Jackson Takumi Hirata Norio Fukumori Fumiaki Nakamura Shunichi Fukuhara Satoru Tsujii Hitoshi Ishii 《Metabolism: clinical and experimental》2014
Objective
C-reactive protein (CRP), inflammatory cytokines, and adipokines contribute to atherosclerosis, insulin resistance, and development of late-onset complication in patients with type 2 diabetes. We performed a systematic review to assess effects of exercise interventions on inflammatory markers/cytokines and adipokines.Materials/Methods
We searched electronic databases (MEDLINE, EMBASE, and Cochrane Controlled Trials Registry) and reference lists in relevant papers for articles published in 1966–2013. We selected studies that evaluated the effects of exercise intervention on inflammatory markers/cytokines and adipokines in adult patients with type 2 diabetes. Weighted mean differences of exercise on outcomes were derived using fixed or random effect models; factors influencing heterogeneity were identified using meta-regression analysis.Results
Fourteen randomized controlled trials (824 patients) were included in our meta-analysis. Exercise was associated with a significant in CRP = − 0.66 mg/l (95% CI, − 1.09 to − 0.23 mg/l; − 14% from baseline) and interleukin-6 (IL-6) = − 0.88 pg/ml (95% CI, − 1.44 to − 0.32 pg/ml; − 18% from baseline) but did not alter adiponectin or resistin levels; aerobic exercise program was associated with a significant change in leptin = − 3.72 ng/ml (95% CI, − 6.26 to − 1.18 ng/ml; − 24% from baseline). For IL-6, exercise was more effective in those with a longer duration in the program and larger number of sessions during study (p = 0.001).Conclusions
Exercise decreases inflammatory cytokine (CRP and IL-6) in patients with type 2 diabetes. Exercise could be a therapeutic option for improving abnormalities in inflammation levels in patients with diabetes. 相似文献74.
75.
Fengshi Chen Aya Miyagawa‐Hayashino Kimiko Yurugi Naomi Chibana Tetsu Yamada Masaaki Sato Akihiro Aoyama Shunji Takakura Toru Bando Hiroshi Date 《Transplant international》2014,27(2):e8-e12
Living‐donor lobar lung transplantation (LDLLT) is an established therapy for patients with end‐stage lung disease, but living‐donor lobar lung retransplantation (re‐LDLLT) is rarely reported. We previously reported a case of unilateral antibody‐mediated rejection after LDLLT in the presence of newly formed donor‐specific antibodies against a right‐lobe donor. The same patient developed contralateral bronchiolitis obliterans, resulting in bilateral bronchiolitis obliterans, but re‐LDLLT was successful. Pathological findings of the explanted lungs were consistent with the clinical course of the patient. One year after re‐LDLLT, the patient is doing well without any anti‐human leukocyte antigen antibodies. Four lobes from four different donors were transplanted in this patient. The first two lobes were rejected eventually, but the two lobes implanted later presented no signs of rejection at least for 1 year after the transplant. Herein, we report this rare case and compare the clinical course and pathological findings. 相似文献
76.
77.
Yuichiro Ueda Tatsuo Nakagawa Yasuaki Tomioka Toshiya Toyazaki Masashi Gotoh 《Asian journal of endoscopic surgery》2020,13(1):121-123
Chest wall resection is traditionally performed via open thoracotomy, a procedure that increases surgical morbidity and reduces postoperative quality of life. Conversely, thoracoscopic chest wall resection may minimize invasiveness but the optimal procedure remains uncertain. We previously reported rib resection using a pneumatic high‐speed power drill during video‐assisted thoracoscopic surgery for selected lung cancer patients. In this report, we present two cases of chest wall tumor resected using the drill via the thoracoscopic approach. We also report thoracoscopic chest wall reconstruction in one patient using a patch sheet. 相似文献
78.
Accurate diagnosis of fatty liver using ultrasonography was attempted based on the difference between the echo intensities of the liver and kidney determined from ultrasonic histograms. Livers were then classified as having fatty infiltration, normal histology, or intermediate histology based on CT ratios established previously in earlier work comparing non-contrast-enhanced liver and spleen. The hepatorenal difference was significantly greater in the fatty liver group than in the normal liver group (8.9 ± 2.0 dB vs 2.5 ± 4.5 dB, p < 0.001). When a hepatorenal difference of ⩾7.0 dB was taken as the criterion, this method had a sensitivity of 91.3%, a specificity of 83.8%, and an accuracy of 86.7% for the diagnosis of fatty liver. Thus, quantitative ultrasonic diagnosis of fatty liver can be performed using echo intensity histograms. © 1996 John Wiley & Sons, Inc. 相似文献
79.
Mai Katsura Ayako Okuhama Yoshiki Koizumi Naokatsu Ando Yasuaki Yanagawa Daisuke Mizushima Takahiro Aoki Kunihisa Tsukada Katsuji Teruya Yoshimi Kikuchi Shinichi Oka Koji Watanabe 《Internal medicine (Tokyo, Japan)》2022,61(2):257
Cytopenia is a common complication in patients with human immunodeficiency virus (HIV) infection. Identifying the cause is demanding because of the wide range of possible diagnoses. We herein report an HIV-infected patient with disseminated cryptococcosis involving multiple organs including the blood, brain, lungs, and bone marrow, who developed progressive pancytopenia after initiation of anti-fungal treatment with liposomal amphotericin-B (L-AMB) and flucytosine (5FC). The pancytopenia persisted despite early 5FC discontinuation. A bone marrow biopsy revealed cryptococcal infiltration and the blood examination findings recovered quickly after resuming L-AMB. Thus, this HIV-infected patient''s pathological findings and clinical course suggested that the primary cause of the pancytopenia was bone marrow cryptococcosis. 相似文献
80.
Kenichiro Kinoshita MD Shimeru Kamihira Shüichi Ikeda Yasuaki Yamada Takaya Muta Tsutomu Kitamura Michito Ichimaru Takeshi Matsuo 《Cancer》1982,50(8):1554-1562
Cells obtained from malignant lymph nodes and the peripheral blood of 106 patients with non-Hodgkin's lymphomas were examined for T- and B-cell characteristics. Surprisingly, 79 cases were of the T-cell type on the basis of spontaneous rosette formation with sheep erythrocytes (E-rosettes). Of the remaining cases, 15 were B-cell in nature (monoclonal S-Ig positive), seven were non T-, non B-cell and four cases were undetermined. Forty-nine (62.0%) of the T-cell malignancies were of a leukemic variety, characterized by pleomorphism in the peripheral blood cell size, and histological appearance. Most of the leukemic T-cells showed obvious lymphocytic differentiation, with condensed nuclear chromatin and scant cytoplasm, although in many of the cases, the lymphomatous infiltrate was dominated by large or pleomorphic lymphoid cells. All tumors were of a diffuse variety, and on histologic examination included a mixed type (21 cases), PDLL forms (15 cases), a large lymphoid cell type (eight cases), and WDLL forms (five cases). Although the mixed type with a pleomorphic lymphoid infiltrate was distinctive, there has been considerable variation from case to case. Clinically this unusual T-cell, leukemic variety of non-Hodgkin's lymphomas primarily involved middle-aged and elderly subjects, and was characterized by wide spread organ invasion (preferentially to the liver, spleen and skin), resistence to chemotherapy, and a poor prognosis. A mediastinal mass was not observed in all cases. The patients had a median survival of only ten months. 相似文献