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71.
Yoshimi Otani Ichiro Yoshida Satoshi Ohki Motoi Kano Osamu Kawashima Masao Suzuki Yasushi Sato Toru Takahashi Akio Ohtaki Susumu Ishikawa Yasuo Morishita 《Surgery today》1997,27(9):812-815
Pulmonary aspergillosis associated with old tuberculosis is generally resistant to treatment. Thus, if patients are treated
only with conservative therapy, their condition continues to deteriorate due to repetitive hemoptysis, and may even become
critical. Surgical treatment is required for these patients; however, it is extremely difficult to resect the lesion due to
severe adhesions to the chest wall and vascular proliferation surrounding the lesion. We performed preoperative arterial embolization,
achieving good results in three patients with hemoptysis caused by pulmonary aspergillosis. The feeding arteries were embolized
using microcoils and/or gelatin sponges, and a lobectomy was safely carried out in all patients. We concluded that preoperative
arterial embolization is a safe and effective technique to prevent massive hemorrhage occurring at the time of surgery.
This work was presented at the 11th Annual Meeting of the Japanese Association for Chest Surgery, held in Kyoto, Japan, May
13–14, 1994 相似文献
72.
M Fujimoto Y Kataoka A Guidotti I Hanbauer 《The Journal of pharmacology and experimental therapeutics》1987,243(1):195-199
Chromaffin cells of the adrenal medulla are known to store and release catecholamines, Met5-enkephalin (ME)-like peptides and gamma-aminobutyric acid (GABA). The present study documents that stimulation of GABAA receptors located on chromaffin cell membranes of canine adrenal glands, eliciting depolarization of chromaffin cell membranes, modulates the responsiveness of chromaffin cells to splanchnic nerve stimulation. 4,5,6,7-Tetrahydroisoxazolo[5,4-c]pyridin-3-ol (0.143 mmol/2 ml/min), a selective GABAA receptor agonist infused into the aortic pouch, increases the release of ME-like peptides and catecholamines into the adrenal effluent blood. Prior infusion into the aortic pouch of the GABAA receptor blocker, bicuculline (0.05 mmol/2 ml/min), prevents the 4,5,6,7-tetrahydroisoxazolo[5,4-c]pyridin-3-ol-elicited release of both substances. A stoichiometric relationship exists between the release of both substances; 1 nmol/ml of plasma of catecholamines was coreleased with 2 pmol/ml of plasma of ME-like peptides. The chromatographic profile on a Sephadex G-75 column indicates that, after injection of 4,5,6,7-tetrahydroisoxazolo[5,4-c]pyridin-3-ol, various MW forms of ME-like peptides are released into the adrenal effluent blood. A similar profile for the release of ME-like peptides was obtained when electrical stimulation (10 V/6 Hz) of the splanchnic nerve was used as a stimulus. These data suggest that direct stimulation of GABAA receptors causes depolarization of chromaffin cell membranes by a burst of Cl- channel opening and triggers neurotransmitter release.(ABSTRACT TRUNCATED AT 250 WORDS) 相似文献
73.
S Shinozaki Y Matsuzawa S Yoshikawa K Fujimoto S Yamaguchi K Harada K Kubo T Kobayashi M Sekiguchi 《Nihon Kyōbu Shikkan Gakkai zasshi》1991,29(8):954-962
The authors studied the effects of natural panting frequency (NF) and the cheek support on the plethysmographic measurement of thoracic gas volume (TGV) in 8 normal subjects (non-smokers) and 46 patients with chronic obstructive pulmonary disease (COPD). The patients were divided into 2 groups according to the degree of airway obstruction (group I; specific airway conductance (SGaw) greater than 0.1 (n = 18), group II; SGaw less than 0.1 (n = 28)). TGV was measured with a pressure-type body plethysmograph (BP). NF was 2.00 +/- 0.43 Hz (mean +/- SD) in control subjects, 1.92 +/- 0.78 Hz in group I, and 1.39 +/- 0.59 Hz in group II, respectively, indicating lower NF in the patients with severe airway obstruction. In control subjects and group I, the differences between TGV at NF and at 0.5-1.0 Hz (TGVNF-TGV1.0) were -0.01 +/- 0.07L, and -0.06 +/- 0.16L, respectively, and cheek support did not alter the difference. On the other hand, in group II, the difference was slightly larger than other groups in spite of the lower NF, and this overestimation was abolished by cheek support (0.13 +/- 0.25L-----0.06 +/- 0.27L, p less than 0.05). These results suggest that, in patients with severe airway obstruction, TGVNF may be overestimated even if NF is relatively low. This overestimation may be mainly due to the extrathoracic airway compliance including the cheek. 相似文献
74.
We studied mechanism to induce scoliosis in Duchenne muscular dystrophy (DMD) by use of X-ray computed tomography (CT) of paraspinal muscles. CT examination of paraspinal muscles was performed on 15 DMD patients at the following six levels; 1. Th3 vertebrae (upper thoracic spine level) 2. Th6 vertebrate (middle thoracic spine level) 3. Th10 vertebrae (lower thoracic spine level) 4. L1 vertebrae (upper lumbar spine level) 5. L3 vertebrae (middle lumbar spine level) 6. L5 vertebrae (lower lumbar spine level). We evaluated the degeneration of paraspinal muscle by a decrease in radio-density of the muscle which indicates infiltration of fatty tissue. The degeneration of the lateral portion of paraspinal muscle was more marked than that of the medial portion. The muscle was most severely affected at the middle lumbar spine level, showing a tendency to increase degeneration at the lower level of the spine. In cases showing laterality of the degeneration of paraspinal muscle, the less affected muscle on CT was located at the convex site of scoliosis. We speculate that the scoliosis occurs when DMD patients have asymmetrical paraspinal muscle degeneration, leading them to take compensatory posture. 相似文献
75.
Tokio Yamaguchi Masahiko Miyata Wataru Kamiike Yasushi Kobayashi Hikaru Matsuda 《Surgery today》1997,27(5):420-428
To clarify the histological status of the pancreas tail after pancreatoduodenectomy (PD), fibrosis, islets of Langerhans,
and A, B, and D cells were examined histometrically in surgical cases of pancreatic cancer. The same investigations were also
performed during an autopsy examination of the pancreas tail of survivors of surgery who had received either PD or total pancreatectomy
with segmental autotransplantation (SAT). In the surgical cases, fibrosis and the islet percentage compared with nonpancreatic
cancer cases were significantly higher while the B cell ratio was significantly lower. In addition, in pancreatic cancer patients,
the fibrosis and islet ratio in the group with a blocked pancreatic duct were higher while the B cell ratio was lower than
in the group with an open pancreatic duct. A direct relationship between the islet ratio and the degree of fibrosis, and an
inverse relationship between the B cell ratio and the degree of fibrosis, were thus found. From the autopsy cases, the fibrosis
progressed and the islet ratio increased following PD, but after SAT only the islet ratio increased compared to the time of
surgery. The progression of fibrosis after PD thus suggests the presence of some problems in both the surgical method and
postoperative management. 相似文献
76.
We describe the case of a 71-year-old man with calcium pyrophosphate dihydrate crystal deposition disease who developed acute popliteal artery occlusion immediately after total knee arthroplasty. Reperfusion was achieved thanks to the early diagnosis and thrombolytic therapy with urokinase. Arterial occlusion occurring after total knee arthroplasty is a rare but serious complication. Detailed preoperative evaluation of the peripheral arterial circulation and an early diagnosis seem to be important. 相似文献
77.
Chinori Kurata MD PhD Sakae Shouda MD Tadashi Mikami MD Yasushi Wakabayashi MD Tomoyasu Nakano MD Tsuyoshi Sugiyama MD Kei Tawarahara MD PhD Kazuyuki Sakata MD PhD 《Journal of nuclear cardiology》1997,4(6):515
Background. [123I]Metaiodobenzylguanidine (MIBG) imaging has been used to assess cardiac sympathetic nerve abnormalities. We evaluated the clinical significance of myocardial MIBG imaging as a measure of cardiac sympathetic nervous system function by comparing it to heart rate variability and plasma norepinephrine level.Methods and Results. In 211 subjects, we analyzed heart rate variability with 24-hour electrocardiography, performed scintigraphy with MIBG, and measured plasma norepinephrine levels. Time and frequency domain measures of heart rate variability were calculated with the Marquette heart rate variability program (Marquette Electronics, Milwaukee, Wis.). Early and late myocardial MIBG uptakes were measured at 15 and 150 minutes after injection, respectively. MIBG clearance rate from the heart and heart-to-lung and heart-to-mediastinum ratios of MIBG activities were calculated. On the whole, heart rate variability, including low-frequency power, correlated positively, but modestly so, with late MIBG uptake and negatively with MIBG clearance rate. The plasma norepinephrine level correlated negatively with late MIBG uptake and with heart rate variability, including low-frequency power, and positively with MIBG clearance rate. Similar correlations were also observed in patient subgroups with coronary artery disease, diabetes mellitus, and renal failure, but these correlations were weak (R2 < 0.5).Conclusions. Increased cardiac sympathetic nervous system activity may be associated with increased myocardial MIBG clearance and decreased heart rate variability, including low-frequency power. Because these associations were not strong, however, the combination of heart rate variability with MIBG may allow an interactive assessment of the cardiac autonomic nervous system. 相似文献
78.
Axonal regeneration after transection is a complex biological process. It is not merely a process of tissue repair, but rather
of cellular repair of a large number of nerve cells. Regeneration involves restoration of the original morphology of each
single cell, rather than proliferation. Techniques in microneurosurgical reconstruction of peripheral nerve injuries have
improved over the last two decades, with subsequent improvement in functional results. Nerve autografts are now routinely
used to guide the regrowth of the proximal nerves to distal nerve segments. However, the limited source of expendable cutaneous
nerves restricts the use of nerve grafting techniques and is associated with significant morbidity. With extensive injuries
there is an insufficient quantity of nerve autograft material to facilitate optimal repair. In future, the use of artificial
conduits or nerve allografts could provide a limitless source of material to reconstruct otherwise irreparable traumatic nerve
injuries. Establishment of appropriate strategies to suppress host-immune reaction or donor antigenicity would facilitate
clinical allogeneic nerve transplantation.
Guest lecture presented at the 69th Annual Meeting of the Japanese Orthopaedic Association in Tokyo on April 13, 1996. 相似文献
79.
Ikuo Konishi M.D. Kanako Nanbu M.D. Masaki Mandai M.D. Yuko Tsuruta M.D. Nobuhiko Kataoka M.D. Yasushi Nagata M.D. Takahide Mori M.D. 《Gynecologic oncology》1998,70(3):365-371
Objective.To identify the clinicopathological and chemoresistant factors predicting the response to neoadjuvant chemotherapy and the patient prognosis in high-risk cervical carcinomas.Methods.We retrospectively reviewed 47 patients with locally advanced or bulky cervical carcinoma treated with two courses of intraarterial infusion of cisplatin, doxorubicin, mitomycin C, and 5-fluorouracil (5-FU), followed by radical hysterectomy at our hospital between 1988 and 1995. Expressions of the chemoresistance-related proteins, such as P-glycoprotein, glutathioneS-transferase π (GST-π), and proliferating cell nuclear antigen (PCNA) in the tumor cells, were examined by immunohistochemistry using pretreatment biopsy specimens. These results were compared with the chemotherapeutic response, which was evaluated by magnetic resonance imaging (MRI) and histopathology. Outcome of the patients was also studied.Results.Chemotherapeutic effect of either complete (CR) or partial (PR) response on MRI was obtained in 36 of the 47 (86%) patients. Poor response to chemotherapy was significantly correlated with P-glycoprotein expression (P< 0.005) and low PCNA labeling (P< 0.05), but not GST-π expression in the tumor cells. Independent prognostic factors for patient survival were parametrial involvement and lymph node metastasis. Neither the expression of GST-π nor PCNA was correlated with the patient survival.Conclusion.Assessment of the expression of P-glycoprotein and PCNA is potentially useful for the prediction of tumor response to neoadjuvant chemotherapy for cervical carcinomas. 相似文献
80.
Victor Y. Fujimoto MD J.Heath Miller MD Nancy A. Klein MD Michael R. Soules MD 《American journal of obstetrics and gynecology》1997,177(6):1419-1425
OBJECTIVE: Our aim was to evaluate the clinical course and management of congenital cervical atresia. STUDY DESIGN: This retrospective analysis included 7 patients referred to our clinic and a review of the medical literature. RESULTS: Including this case series, 58 cases of congenital cervical atresia have been reported in the literature. Forty-eight percent of patients had isolated congenital cervical atresia with a normal vagina whereas the remainder had either complete or partial vaginal atresia (“shortened blind vaginal pouches”). Surgical management has included abdominal hysterectomy or uterovaginal cannulation with or without vaginoplasty. In 59% of patients who underwent uterovaginal canalization procedures (23/39), normal menstrual bleeding was achieved. Four of these patients subsequently became pregnant and were delivered at term. CONCLUSION: Surgical canalization in selected patients with congenital cervical atresia can be successfully performed to provide patients an opportunity for conservative management, resulting in normal menstrual bleeding, resolution of cyclic pelvic pain, and some potential (albeit limited) for fertility.(Am J Obstet Gynecol 1997;177:25) 相似文献