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41.
Atsushi Nakahira Hitoshi Ogino Hiroaki Sasaki Nobuyuki Katakami 《European journal of cardio-thoracic surgery》2007,32(2):388-390
Malignant pulmonary artery tumors represented by sarcomas are rare, but fatal. Early diagnosis and radical surgical resection offer the only chance for survival. However, surgical intervention has some challenging aspects, and prognosis is poor even after tumor resection. We report a case of a pulmonary artery sarcoma between the right ventricular outflow tract and the pulmonary artery branches. The tumor was aggressively extracted with reconstruction using a cryopreserved pulmonary valved allograft, followed by adjuvant chemoradiotherapy. At 56 months after surgery, the patient is well without any evidence of recurrence, demonstrating that aggressive surgical resection with adjuvant chemoradiotherapy can prolong survival. 相似文献
42.
Hiroaki Yoshikawa 《Clinical neurology》2007,47(11):880-882
MGTX Study is a multi-center, international, single-blinded, randomized trial to determine whether extended transsternal thymectomy (ETTX) for patients with myasthenia gravis receiving the prednisone protocol confers added benefits to the prednisone protocol alone. The aims of the study are answering following three questions. 1) Does ETTX combined with prednisone result in a greater improvement in myasthenic weakness, compared to prednisone alone? 2) Does ETTX combined with prednisone result in a lower total dose of prednisone, thus decreasing the likelihood of concurrent and long-term toxic effects, compared to prednisone alone? 3) Does ETTX combined with prednisone enhance quality of life by reducing adverse events and symptoms associated with the therapies, compared to prednisone alone? Primary outcome measure is consists with 1) Comparison of the prednisone protocol alone to prednisone protocol plus ETTX, based on the clinical response to therapy measured over the 3 year trial period by the Area Under the Quantitative Myasthenia Gravis (QMG) Weakness Score (AUQMG), and 2) Testing the difference in the total prednisone used over the 3 year trial period measured by pill count from blister packs (Area Under the Prednisone Dose Time Curve, AUDTC), conditional on the results of comparing AUQMG. 相似文献
43.
Yusuke Narita Katsuhiko Naoki Naoya Hida Hiroaki Okamoto 《Nihon Kokyūki Gakkai zasshi》2007,45(1):13-20
A 78-year-old woman was admitted with dyspnea. She had caught a cold and took an over-the-counter drug (Nospole G) for 2 weeks before admission. Chest radiography and CT scanning showed bilateral diffuse and interstitial shadows, and arterial blood gas analysis demonstrated severe hypoxemia. Withdrawal of Nospole and treatment with both corticosteroid and sivelestat sodium resulted in improvement of clinical findings and successful recovery from mechanical ventilation. A drug lymphocyte stimulation test for Nospole G was positive. Based on these findings, we determined that this patient had drug-induced pneumonitis caused by Nospole G. Finally, she died of sepsis caused by multidrug-resistant Staphylococcus aureus (MRSA) infection. In summary, we report here an elderly case of drug-induced pneumonitis successfully weaned from mechanical ventilation by early treatment with corticosteroid and sivelestat sodium, monitored by changes of markers for interstitial pneumonitis (KL-6, SP-A, SP-D). 相似文献
44.
Masaaki Kohta Hiroaki Minami Kazuhiro Tanaka Keiichi Kuwamura Takeshi Kondoh Eiji Kohmura 《Journal of clinical neuroscience》2007,14(2):167-170
A 52-year-old man fell from standing and a computed tomography (CT) scan revealed traumatic intracerebral haematoma and subarachnoid haemorrhage in the temporal cortex. He was treated without surgery and discharged. On day 30 after the accident, he had no neurological deficit. On day 37 he complained of headache and urinary incontinence, and on day 39 he was hospitalized due to progressive neurological deterioration (reduced conciousness, dilated pupils, and left hemiplegia). A CT scan revealed a diffuse low-density in the right cerebral hemisphere with marked midline shift. Emergency decompressive craniectomy and right temporal lobectomy were performed. Angiography after surgery revealed moderate vasospasm in the right middle and anterior cerebral arteries. The patient remained severely disabled. Delayed onset neurological deterioration can be caused by brain oedema and vasospasm after traumatic brain injury, despite an intervening period of improvement. 相似文献
45.
Hiroaki Shiba Takeyuki Misawa Susumu Kobayashi Tokuyasu Yokota Kyonsu Son Katsuhiko Yanaga 《Journal of gastrointestinal surgery》2007,11(4):549-551
A 41-year-old Chinese woman was admitted to our hospital with epigastric pain. Computed tomography detected a heterogeneous
enhancement tumor fed by the left gastroepiploic artery in the left lower quadrant and cholelithiasis. Excision of the tumor
in the greater omentum and cholecystectomy were performed laparoscopically. Histological findings confirmed a diagnosis of
hemangiopericytoma with low-grade malignancy. To our knowledge, hemangiopericytoma of the greater omentum is very rare, and
only 12 cases were reported in English literature. We report a case of hemangiopericytoma arising in the greater omentum and
review the literature. 相似文献
46.
47.
Hiroaki Nakamura Marie Yamada Makoto Fukae Hidehiro Ozawa 《Journal of bone and mineral metabolism》1997,15(4):184-192
We investigated the immunohistochemical localization of CD44, hyaluronate receptor, and moesin, of the ezrinradixin-moesin
(ERM) family, in osteoclasts after calcitonin adminstration using confocal laser scanning microscopy and transmission electron
microscopy to clarify the role of CD44 and moesin in their cytoskeletal organization and cell polarity. We also elucidated
the localization of osteopontin (OPN) to confirm its possible role in cell-matrix recognition via CD44. In untreated mice,
intense immunoreactivities for CD44 and moesin were detected on the basolateral plasma membrane of osteoclasts. Rhodamine-phalloidin
reactivity was seen in a bandlike pattern on the region of contact between osteoclasts and bone and was also detected moderately
along their basolateral plasma membrane. At 30 min after calcitonin administration, osteoclasts did not show either clear
zones or ruffled borders. The bandlike reactivity of rhodamine-phalloidin in the contact region was diminished, although labeling
was seen along osteoclasts. CD44 and moesin were colocalized along their plasma membranes, including the region facing the
bone surface. Electron microscopic observation revealed that the microvillus processes in the contacting region with bone
surface, as well as the basolateral plasma membrane, showed immunoreactivities to CD44 and moesin. At 60 min, some osteoclasts
attached to bone and showed a bandlike pattern of rhodamine-phalloidin. On the other hand, OPN was localized under CD44-positive
cytoplasmic processes and the clear zone of osteoclasts. These findings suggest that calcitonin effects on the cell polarity
of osteoclasts and the CD44-moesin-actin filament system in osteoclasts plays an imporant role in cell polarity and cell-matrix
recognition. 相似文献
48.
Analysis of T Cell Receptor Variability in Fresh Tumor-infiltrating Lymphocytes from Human Head and Neck Cancer 总被引:1,自引:1,他引:0
Kazuaki Chikamatsu Masao Eura Koji Nakano Yuichi Kanzaki Hiroaki Matsuoka Keisuke Masuyama Takeru Ishikawa 《Cancer science》1994,85(6):626-632
In this study, we analyzed T cell receptor (TCR) gene rearrangements in tumor-infiltrating lymphocytes (TIL) freshly obtained from 15 patients with head and neck cancer using the reversely transcribed polymerase chain reaction (RT-PCR) method. These TILs showed preferential expression of Vα10, Vα8 and Vα1, detected in 13 (87%), 11 (73%), and 9 cases (60%), respectively. The TCRVβ gene revealed diversity without preferential usage. The head and neck region is exposed to bacteria and viruses, so it is possible that the tumor site can become infected and accumulate T cells involved in infection and inflammation. Therefore, we also investigated TCR gene usage in T cells infiltrating in chronic sinusitis mucosa to address the question of whether the Vα1, Vα8, and Vα10 subfamilies are characteristic in TIL from squamous cell carcinoma of head and neck. TCR Vα10 gene usage was also the most common in Vα segment in T cells infiltrating the sinus mucosa, but Vα and Vα8 were not detected in the T cells in sinusitis. These results indicate that the Vα10 subfamily, the preferred T cell population in both TIL and T cells in inflammatory disease, might he involved mainly in inflammation or infection. On the other hand, Vα1 and Vα8 appear to be relatively specific populations for antitumor immunity in head and neck cancer. 相似文献
49.
Yoshihiko Tsuji Hiroaki Ohue Hiroshi Ikuta Osamu Kinoshita Fumio Shibagaki 《Surgery today》1997,27(5):387-391
Between January 1985 and September 1994, 21 patients with psychiatric disorders underwent various forms of surgery at our
hospital. There were 12 men and 9 women with an average age of 57.6 years. The coexisting psychiatric disorders were schizophrenia
in 15 patients, depression in 2, dementia in 2, mental retardation with epilepsy in 1, and Parkinson's disease in 1. All the
patients had been receiving neuroleptic medications for a long period. The indications for surgery were: cholelithiasis in
6 patients, acute appendicitis in 4, perforation of the small intestine in 3, incarceration of an inguinal hernia in 2, and
esophageal cancer, stomach cancer, bleeding from a gastric ulcer, perforation of a duodenal ulcer, strangulating ileus, and
burns in 1 patient each, respectively. All of the patients who underwent elective surgery were given epidural anesthesia with
or without general anesthesia. Antipsychotic medications were given until just prior to surgery and recommenced concurrent
with the first meal. Abnormal behavior was observed in 11 patients (52.4%) postoperatively, but all the patients were discharged
in accordance with recovery from their surgical disorder. Intra- and postoperative hypotension resistant to intravenous catecholamine
administration was recognized in 9 patients (42.9%), and this peculiar complication should be borne in mind when patients
with psychiatric disorders require surgical management.
Presented at the 94th annual meeting of the Japanese Surgical Society, held in Tokyo in March, 1994 相似文献
50.
Hidehito Matsuoka Wataru Nishio Toshihiko Sakamoto Hiroaki Harada Noriaki Tsubota 《European journal of cardio-thoracic surgery》2004,26(3):480-482
OBJECTIVE: To predict accurate morbidity after lung resection using treadmill exercise test. METHODS: A total of 130 patients (108 men and 22 women, with mean age 67.1+/-11.4 years (range, 34-78 years)) of 1129 patients underwent standard lobectomy were performed both treadmill exercise test and spirometry preoperatively. We measured maximum oxygen uptake/body weight (VO2max/BW) and change in arterial blood oxygen pressure from rest to symptom-limited maximum loading (delta aPaO2) and calculated exercise-induced hypoxemia (delta PaO2/delta VO2/BW), and retrospectively compared these parameters for patients with and without complications. RESULTS: There were five patients with severe postoperative complications, including three requiring use of a respirator, two with home oxygen therapy. %Vital capacity, VC (%, 80.2+/-13.2 vs. 92.5+/-20.9, P=0.026), delta PaO2 (Torr, -29.3+/-4.3 vs. -13.2+/-10.8, P=0.0004), VO2max/BW (ml/min/kg, 16.5+/-2.9 vs. 20.6+/-5.1, P=0.018) and delta PaO2/delta VO2/BW (Torr/ml/min/kg, -1.98+/-0.26 vs. -0.57+/-0.47) were significantly associated with worse outcome. All the five patients with complications had delta PaO2/delta VO2/BW<-1.7. CONCLUSIONS: Treadmill exercise testing is a good method for assessment of cardiopulmonary reserve. Limited resection must be performed if delta PaO2/delta VO2/BW is under -1.7. 相似文献