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41.
A 78-year-old woman is described who presented with a diaphragmatic hernia through the foramen of Morgagni. A definitive
diagnosis was confirmed by a sagittal view on magnetic resonance imaging prior to surgery. The hernia was repaired laparoscopically
under an abdominal wall lifting technique without pneumoperitoneum, and her symptoms completely resolved postoperatively with
no evidence of recurrence. The laparoscopic repair was considered a suitable and safe procedure for the treatment of a Morgagni
hernia.
Received: 3 April 1996/Accepted: 3 May 1996 相似文献
42.
Makoto Watanabe Takashi Fujimoto Masayuki Iwano Hideo Shiiki Shinobu Nakamura 《Nihon Rinshō Men'eki Gakkai kaishi》2002,25(2):191-198
We describe the case of a 61-year-old woman diagnosed with primary Sj?gren's syndrome (SS) after an 8-year history of IgA nephropathy and a 3-year history of recurrent purpuric rashes. Her two daughters had previously been diagnosed with other autoimmune diseases. One daughter had Graves' disease and the other had Hashimoto's disease and systemic lupus erythematosus. The diagnosis of SS was made based on dryness of mucous membranes, Shirmer test, and parotid sialography. Thrombocytopenia, high platelet-aggregated IgG (PA-IgG) level, and normal megakaryocytes count in bone marrow suggested that her recurrent purpuric rashes were due to idiopathic thrombocytopenic purpura (ITP). Patients with SS may develop other autoimmune diseases. This case aids understanding of the immune pathogenesis and genetic background of SS. 相似文献
43.
Late Effects of Childhood Acute Leukemia and Its Treatment 总被引:1,自引:0,他引:1
Masao Yamamoto M.D. Yoshitaka Fukunaga M.D. Ichiroh Tsukimoto M.D. Fumio Bessho M.D. Jun-ichi Akatsuka M.D. Ryohta Hosoya M.D. Shinpei Nakazawa M.D. Minoru Sakurai M.D. Kazuhiro Ueda M.D. Sumio Miyazaki M.D. Masaru Yokoyama M.D. Hideo Mugishima M.D. Kohzoh Nishimura M.D. 《Pediatrics international》1991,33(4):573-588
Late effects of childhood acute leukemia and its treatment were studied in 766 patients (684 ALL, 73 ANLL, and 9 others) in Japan who had remained in remission for more than 1 year after their first complete remission. Delayed adverse sequelae involve a wide variety of organs and their functions. Short stature was present in 2.61%, obesity in 3.79%, abnormalities of growth hormone secretion in 1.5%, delayed secondary sex characteristics in 1.5% of males and 0.6% of females, motor disturbances in 1.17%, sensory disturbances in 0.91%, intellectual and learning disabilities in 2.48%, abnormal findings in routine neurologic examinations in 1.31%, EEG abnormalities in 4.30%, brain CT abnormalities in 5.09% and cardiac dysfunction in 1.07%. Various other disorders were seen in 20 patients. Many of these delayed adverse sequelae are caused by or related to central nervous system prophylaxis and systemic combination chemotherapy. The results suggest that it is needed to improve therapeutic methods through the stratification of patients by risk factors and detailed analysis of prognostic factors. Moreover it is important to render medical and psychosocial support to long-term survivors of childhood leukemia through interactions between the patient, parents and medical staff. 相似文献
44.
Hideaki Anai Yoshihiko Maehara Tatsuo Oshiro Hideo Baba Hiroyuki Orita Toshiro Okuyama Keizo Sugimachi 《Journal of surgical oncology》1993,53(3):204-207
In 268 of the 1,115 patients (24.0%) with gastric cancer who underwent a curative resection in our clinics, the tumor was located in the middle third of the stomach. The clinicopathological features and prognosis of these patients were divided into two groups, according to site of the tumor: anterior wall (n = 58) vs. other sites (n = 210). Clinicopathological factors did not differ between the two groups. The survival time for patients with a tumor in the anterior group was shorter than that for patients with a tumor in other areas (P < 0.05). The five-year survival rate was 79.3% for patients with an anterior tumor and 91.9% for those with a tumor at a different site. A multivariate analysis indicated lymph node metastasis, serosal invasion, and anterior wall location to be independent prognostic factors indicative of a poor prognosis when the tumor was located in the middle third of the stomach. For such patients, close follow-up is needed to detect possible recurrences. © 1993 Wiley-Liss, Inc. 相似文献
45.
Mitsuhiro Morita Harumoto Yamada Osamu Hemmi Kyosuke Fujikawa 《Journal of orthopaedic science》2004,9(1):99-102
In acetabular dysplasia of the hip joint accompanied by a giant acetabular bone cyst, rotational acetabular osteotomy may cause serious complications, such as bone necrosis after surgery or fracture of the fragile acetabulum during the operation. In a patient with this condition, we performed a two-stage operation: first, autogenous bone grafting supplemented with hydroxyapatite filling, then rotational acetabular osteotomy (after new bone formation had been assured). Radiographs and CT scans showed favorable fusion of the grafted bone. Some 18 months after the second operation, arthrograms showed no inflow of contrast medium from the articular cavity into the bone cyst region, although this had been observed before treatment. Thus, an effective remodeling of bony congruency was indicated in the mobile acetabulum 5 years after the second operation. This two-stage operation appears to be useful for correcting acetabular dysplasia accompanied by a giant bone cyst and to carry a reduced risk of serious complications, such as deterioration of the articular surface of the acetabulum or necrosis of the translocated acetabulum. 相似文献
46.
Hideki Aragane Hideki Fujii Takaharu You Atuhiro Morita Morimichi Miyazaki Kiyoshi Morita Tohru Ohkawara Shinji Fukumitu Yoshihiko Sawa Yasuo Ohkawara 《Nihon Shokakibyo Gakkai zasshi》2006,103(5):537-542
This report describes our experience with a 60 year old male who suffered from a recrudescence of groove pancreatitis. He had been treated by conservative medication therapy by proton pump inhibitor used for therapy of duodenal ulcer, and was in remission. During a follow-up one year later, endoscopy revealed gastric cancer, for which a proximal gastrectomy and vagotomy were performed. The patient continues to remain in remission for the groove pancreatitis. Our experience with the clinical course of this disease, in which treatment for duodenal ulcer was used effectively, offers new insights into the progression and therapy of groove pancreatitis. 相似文献
47.
S Minohara S Sasaki K Asada H Muraki T Kodama S Hasegawa M Morita E Tsujii A Takeuchi 《Kyobu geka. The Japanese journal of thoracic surgery》1992,45(12):1106-1108
The patient was a one-year-old boy, who underwent surgery with a diagnosis of atrial septal defect (ASD). During operation, aorto-pulmonary window (A-P window) which had not been detected by the preoperative examinations, was found. Therefore, the A-P window was divided prior to closing ASD. The patient is in good condition six months after the operation. The causes of the inaccurate preoperative diagnosis were discussed. 相似文献
48.
The effects of pulsatile cardiopulmonary bypass on the renin-angiotensin-aldosterone system and tissue metabolism, especially
those which occur soon after surgery, were studied in 26 patients who required total cardiopulmonary bypass for longer than
60 minutes. These patients comprised 11 who underwent open heart surgery utilizing nonpulsatile cardiopulmonary bypass (Group
I) and 15 who underwent open heart surgery utilizing pulsatile cardiopulmonary bypass (Group II). Plasma angiotensin II and
serum aldosterene levels were significantly increased one and 5 hours postoperatively in Group I when compared with the preoperative
values, whereas no significant elevations were observed in Group II. Plasma angiotensin II and serum aldosterone levels one
hour postoperatively in Group II were significantly lower than those in Group I. Lactate levels in the arterial blood were
significantly elevated, one and 5 hours postoperatively in both Groups I and II. Moreover, no significant difference was observed
in the lactate levels between Groups I and II, one hour postoperatively. In the nonpulsatile group (Group I), plasma angiotensin
II levels one hour postoperatively were correlated significantly with the duration of total cardiopulmonary bypass. In conclusion,
pulsatile cardiopulmonary bypass offers significant advantages in terms of lower plasma angiotensin II and serum aldosterone
levels, when compared with nonpulsatile cardiopulmonary bypass soon after open heart surgery requiring total cardiopulmonary
bypass for longer than 60 minutes, however, it does not offer a definite advantage for tissue metabolism. 相似文献
49.
H Naruse M Morita J Yamamoto H Kawamoto M Itano N Fukutake M Ohyanagi K Fujitani T Iwasaki M Fukuchi 《Journal of cardiology》1992,22(2-3):295-305
To evaluate the extent and characteristics of infarct areas, we performed indium-111 monoclonal antimyosin Fab (InAM), thallium-201 (TL) and Tc-99m pyrophosphate (PYP) imagings in 17 patients with acute myocardial infarction, and tried to find out the mechanism that causes difference of these imagings. In each study, the extent scores as an index of the infarct area were obtained by single photon emission computed tomography (SPECT), and comparisons were made between the results obtained. The overlap between InAM and TL imagings obtained by SPECT was evaluated. Location, severity, extent and patterns of accumulation were compared between InAM and PYP with both planar image and SPECT. The extent scores of InAM correlated well with those of TL (r = 0.73, p < 0.01). However, the overlap of both methods was recognized in 8 of 17 patients, in whom wall thickness of the infarct area as obtained by echocardiography was well preserved. The left ventricular regional asynergy was mild in 6 of these 8 patients. Coronary angiography showed poor or no collateral circulation in these cases. Although there were generally close correlations of the extent scores between InAM and PYP, discrepancy was noted in 2 cases for location; 2 for severity, 5 for extent, and 3 for patterns of accumulation. These differences may be attributed to the timings of imaging, coronary reperfusion and different mechanisms of accumulation. In conclusion, the extent of acute myocardial infarction obtained by InAM correlates well with those obtained by TL and PYP, with some exceptions. 相似文献
50.
Evaluation of renal first pass blood flow with a functional image technique in hypertensive patients
Masatoshi Ishibashi Seiichiro Morita Noriyoshi Umezaki Hisashi Ohtake 《European journal of nuclear medicine and molecular imaging》1988,14(1):25-27
The renal circulation of patients with essential hypertension and renovascular hypertension was evaluated using 99mTc-DTPA. The first renal peak count (the first Cmax; FCmax), time phase distribution (the first Tmax; FTmax), and blood velocity (the FCmax/FTmax) were calculated by digital imaging. This yields a visual image of the renal circulation. We consider that the increase in the renal first pass blood flow in patients with essential hypertension is best observed pixel by pixel. The FCmax and FCmax/FTmax images before and after treatment by percutaneous transluminal renal angioplasty in patients with renovascular hypertension clearly show its therapeutic effect. The FI technique, therefore, has the advantage that it can be performed at the same time as the conventional routine examinations of renal function. This makes it very useful clinically. 相似文献