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91.
High plasma fibrinogen level is associated with poor clinical outcome in DIC patients 总被引:1,自引:0,他引:1
Wada H Mori Y Okabayashi K Gabazza EC Kushiya F Watanabe M Nishikawa M Shiku H Nobori T 《American journal of hematology》2003,72(1):1-7
We measured the plasma level of fibrinogen in 560 patients with disseminated intravascular coagulation (DIC) and evaluated its relationship with outcome and with other hemostatic markers. Forty-seven percent of patients had >200 mg/dL of plasma fibrinogen and 24% had <100 mg/dl of plasma fibrinogen, suggesting that plasma fibrinogen level is not a sensitive marker for DIC. In our analysis of outcome and plasma fibrinogen levels, the rate of death was high in leukemia/lymphoma patients with high fibrinogen concentration, but no significant difference in outcome was observed in relation to plasma fibrinogen concentration in non-leukemia/lymphoma patients with DIC. Among patients with leukemia/lymphoma, the frequency of organ failure was markedly high in patients with high plasma levels of fibrinogen. Among patients without leukemia/lymphoma, the frequency of organ failure increased concomitantly with the increase in plasma fibrinogen levels. The international normalized ratio was significantly increased in leukemia/lymphoma patients with low fibrinogen. FDP levels were slightly increased in patients with low fibrinogen. Platelet count was significantly low in patients without leukemia/lymphoma with high fibrinogen. DIC score increased concomitantly with the reduction in plasma fibrinogen levels. Plasma levels of thrombomodulin and tissue factor were significantly high in patients with high fibrinogen levels. Plasma levels of antiplasmin and plasminogen were significantly decreased in patients with low fibrinogen. Plasma levels of plasmin plasmin-inhibitor complex and tissue type plasminogen activator/plasminogen activator inhibitor-1 complex (PAI-I) were significantly higher in patients with low fibrinogen than in those with high fibrinogen. Plasma levels of PAI-I and IL-6 were significantly higher in patients with high fibrinogen than in those with low fibrinogen. Patients with high fibrinogen levels showed less activation of secondary fibrinolysis, which might explain the occurrence of organ failure and poor outcome. 相似文献
92.
Shoichiro Hirose M.D. Hideo Honjou Hikohito Nakagawa Keigo Nishimura Yoshitaka Kuroda Masahiko Tsuji Atsuo Miwa Masanobu Kitagawa 《Journal of gastroenterology》1989,24(5):481-487
Clinical and pathological characteristics of scirrhous carcinoma of the stomach were studied in 106 cases treated by gastrectomy
between 1973 and 1983. The male to female ratio was 0.58. The percentage of scirrhous carcinomas to all gastric carcinomas
resected in the same period was three times higher in females than males. The age distribution of the patients suggested that
there were two peaks in the forties and sixties in the male, and in the thirties and fifties in the female. The incidence
of scirrhous carcinoma in all types of gastric carcinoma was significantly higher in the twenties, thirties and forties compared
to the lowest incidence in the seventies. In the female group the primary lesion had a tendency to be adjacent to the fundic
gland area and to avoid intestinal metaplasia. In the male the opposite was recognized. Cancer nests with single cells or
only several cells were common in this type of carcinoma. These findings suggest that there might be two biologically different
scirrhous carcinomas both in the male and the female, the appearance of single carcinoma cells might be favored by female
sex hormones and young ages, and not only the original gastric mucosa but also mucosa with intestinal metaplasia could be
precursors of single carcinoma cells. 相似文献
93.
94.
Takahiro Shoji Takehiko Tarui Takashi Igarashi Yuki Mochida Hiroyuki Morinaga Yasuhiko Miyakuni Yoshitaka Inoue Yasuhiko Kaita Hiroshi Miyauchi Yoshihiro Yamaguchi 《The Journal of emergency medicine》2018,54(4):410-418
Background
Bleeding from hemorrhagic shock can be immediately controlled by blocking the proximal part of the hemorrhagic point using either resuscitative thoracotomy for aortic cross-clamping or insertion of a large-caliber (10–14Fr) resuscitative endovascular balloon occlusion of the aorta (REBOA) device via the femoral artery. However, such methods are very invasive and have various complications. With recent progress in endovascular treatment, a low-profile REBOA device (7Fr) has been developed.Objective
The objective of this study was to report our experience of this low-profile REBOA device and to evaluate the usefulness of emergency physician?operated REBOA in life-threatening hemorrhagic shock.Methods
Ten patients with refractory hemorrhagic shock underwent REBOA using this device via the femoral artery. All REBOA procedures were performed by emergency physicians. The success rate of the insertion, vital signs, and REBOA-related complications were evaluated.Results
Median age was 54 years (interquartile range 33–78 years). The causes of hemorrhagic shock were trauma (n = 4; 1 blunt and 3 penetrating), ruptured abdominal aortic aneurysm (n = 3), and obstetric hemorrhage (n = 3). Two patients had cardiopulmonary arrest upon arrival. REBOA procedure was successful in all patients, and all became hemodynamically stable to undergo definitive interventions after REBOA. There were no REBOA-related complications. The mortality rate within 24 h and 30 days was 40%.Conclusions
This REBOA device was useful for emergency physicians in life-threatening hemorrhagic shock because of its ease in handling and low invasiveness. 相似文献95.
Sakamoto Kazumasa Ito Kiyoaki Yotsuyanagi Hiroshi Yatsuhashi Hiroshi Tanaka Yasuhito Hige Shuhei Takikawa Yasuhiro Ueno Yoshiyuki Yamamoto Kazuhide Imazeki Fumio Inoue Jun Kurosaki Masayuki Umemura Takeji Toyoda Hidenori Mita Eiji Michitaka Kojiro Maeshiro Tatsuji Yamada Norie Suetsugu Atsushi Kawanaka Miwa Seko Yuya Matsuura Kentaro Okumura Akinori Fukuzawa Yoshitaka Sugiyama Masaya Mizokami Masashi Yoneda Masashi 《Journal of gastroenterology》2022,57(12):971-980
Journal of Gastroenterology - Hepatitis B virus (HBV) is one of the most prevalent chronic viral infections that causes chronic hepatitis B (CHB). In Japan, genotypes B and C account for most of... 相似文献
96.
Shingo Nasu Kunimitsu Kawahara Yuki Han Norio Okamoto Yoshitaka Tamura Hidekazu Suzuki Takayuki Shiroyama Yumiko Samejima Tomohiro Kanai Yoshimi Noda Ayako Tanaka Naoko Morishita Kayo Ueda Shoji Hashimoto Tomonori Hirashima Takayuki Nagai 《Internal medicine (Tokyo, Japan)》2021,60(3):445
Miliary tuberculosis is a potentially lethal type of tuberculosis that results from the hematogenous dissemination of Mycobacterium tuberculosis bacilli. We herein describe the case of a 34-year-old man that presented with a one-month history of cough and fever, while his sputum smear results were negative. Chest computed tomography revealed bilateral centrilobular ground-glass opacification (GGO), suggestive of hypersensitivity pneumonitis; thus, bronchoscopy was performed. Cryobiopsy specimens revealed necrotic granulomas. A re-examination of sputum after bronchoscopy identified Mycobacterium tuberculosis, and miliary tuberculosis was diagnosed. A cryobiopsy might be useful for diagnosing miliary tuberculosis pathologically, particularly when miliary nodules may be masked by GGO. 相似文献
97.
Junya Makiyama Yoshitaka Imaizumi Haruka Watanabe Machiko Fujioka Masahiko Chiwata Hideaki Kitanosono Jun Nakashima Yasushi Miyazaki Shinichiro Yoshida 《Internal medicine (Tokyo, Japan)》2021,60(5):709
Objective Classic Hodgkin lymphoma (CHL) has been regarded as a curable disease when treated appropriately, especially in younger patients, and ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) has been regarded as the standard regimen. However, a relatively poor prognosis has been reported in older patients with CHL, and the efficacy and tolerability of the ABVD regimen has not been fully elucidated. We retrospectively investigated the outcomes in patients with CHL treated with ABVD at our institute. Methods Twenty-five patients were evaluated; 14 were ≤60 years of age, and 11 were >60 years of age (older group). Results The ABVD doses were reduced in all patients in the older group; the median average relative dose intensity was 0.58. In the older group, the 5-year overall survival (OS) and median OS were 100% and not reached, respectively, for patients with early-stage CHL and 66.7% and not reached, respectively, for those with advanced-stage CHL. No patients died of CHL, and only one treatment-related death was observed in the older group. Conclusion ABVD with dose attenuation may represent a feasible and effective strategy for the treatment of older patients with CHL in clinical practice, particularly in those with early-stage disease, although the optimal degree of attenuation remains unclear. 相似文献
98.
Pulmonary sarcoidosis with associated bloody pleurisy 总被引:1,自引:0,他引:1
Watarai M Yazawa M Yamanda K Yamamoto H Yamazaki Y 《Internal medicine (Tokyo, Japan)》2002,41(11):1021-1023
A 64-year-old man was admitted to our hospital complaining of non-productive cough and right chest pain. Chest radiographs showed bilateral hilar lymphadenopathy, diffuse granular nodules and right pleural effusion. Serum angiotensin-II-converting enzyme and lysozyme levels were elevated. Since thoracentesis indicated bloody pleurisy, video-assisted thoracoscopy was performed and revealed multiple white nodules on both the visceral and parietal pleura. Resected pleural biopsy specimens showed non-caseous granulomas. Furthermore, some nodules were observed to compress and involve small vessels and capillaries. The bloody pleurisy was assumed to have been derived from the rupture of small vessels that had been compressed and affected by the granuloma with sarcoidosis. 相似文献
99.
Lewis Blood Group-Related Antigen Expression in Normal Gastric Epithelium, Intestinal Metaplasia, Gastric Adenoma, and Gastric Carcinoma 总被引:6,自引:0,他引:6
Kenji Kobayashi M.D. Junichi Sakamoto M.D. Tsuyoshi Kito M.D. Yoshitaka Yamamura M.D. Takashi Koshikawa M.D. Miyuki Fujita Tadashi Watanabe M.D. Hiroaki Nakazato M.D. 《The American journal of gastroenterology》1993,88(6):919-924
The expression of blood group-related antigens of the Lewis system in normal gastric mucosa, intestinal metaplasia, gastric adenoma, and gastric carcinoma was examined. Ninety-five percent of normal foveolar epithelial samples stained positive for Lewisb antigen, whereas only 10.0% expressed Lewisa antigen. In contrast, intestinal metaplasia specimens had increased Lewisa antigen expression and slightly decreased Lewisb antigen expression. A similar pattern of Lewisa and Lewisb expression was observed in gastric adenomas and intestinal type adenocarcinomas. Lewisx and Lewisy were detected in all normal deep glands, but were not expressed in the majority of intestinal metaplasia specimens. In addition, only 20–40% of gastric adenomas and gastric carcinomas expressed Lewisx and Lewisy antigens. These changes in Lewis antigen expression in intestinal metaplasia, adenomas, and intestinal type adenocarcinomas suggest that altered expression of Lewis blood group-related antigens may correlate with cell transformation processes. 相似文献
100.
Koba S Hirano T Murayama S Kotani T Tsunoda F Iso Y Ban Y Kondo T Suzuki H Katagiri T 《Atherosclerosis》2003,170(1):131-140
BACKGROUND: The small dense low-density lipoprotein (LDL) phenotype (pattern B), high concentrations of remnant-like particles (RLPs), and postprandial lipemia are newly recognized risk factors for coronary heart disease (CHD). However, the associations of these lipoprotein abnormalities remain unclear. The aim of this study was to investigate the relationships among LDL phenotype, very-low-density lipoprotein (VLDL) subclasses, and postprandial lipoprotein metabolism in CHD patients. METHOD: We performed an oral fat tolerance test in 32 patients with acute myocardial infarction and compared the following parameters between patients characterized by either large buoyant LDL (pattern A) versus pattern B: lipids and apolipoproteins (apo) in the plasma and Svedberg flotation rates (Sf) >400 (chylomicron), Sf 60-400 (large VLDL), and Sf 20-60 (small VLDL) fractions. RESULT: Fasting levels of triglyceride, RLP-cholesterol and RLP-triglyceride were slightly higher in the pattern B patients. Postprandial increases of RLP-cholesterol and the cholesterol and triglyceride of large VLDL fractions were significantly greater in the pattern B patients. The areas under the curves of cholesterol, triglyceride, and apo-B in large VLDL fractions were significantly higher in pattern B, while those in small VLDL were not. RLP-cholesterol and RLP-triglyceride in fasting and fed states correlated very highly with the corresponding cholesterol and triglyceride concentrations in large VLDL fractions. CONCLUSION: These results suggest that postprandial increase of large VLDL fractions and RLPs contribute to the formation of small dense LDL in CHD patients. 相似文献