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71.
Akiomi Ogawa Masahiro Takano Kouichi Takagi Osamu Tokunaga Kohji Miyazaki 《Surgery today》1997,27(12):1167-1169
We describe herein a rare case of primary malignant melanoma of the rectum in an 85-year-old woman. The patient presented
with intermittent rectal bleeding, and a colonoscopy revealed an ulcerated polypoid mass in the rectum, located 5 cm from
the anal verge. The lesion was histologically characterized by solid growths of small round cells with scanty cytoplasm and
prominent nucleoli. Although no melanin pigment was found in the tumor cells, they were immunohistochemically positive for
HMB-45, a monoclonal antibody highly specific for malignant melanoma. Thus, HMB-45 proved very useful to establish a diagnosis
of amelanotic malignant melanoma of the rectum. 相似文献
72.
Hajime Kazamatsuri M.D. Tetsuya Hirose M.D. Osamu Kanno M.D. Nobumasa Kato M.D. Hiromoto Yasuda 《Psychiatry and clinical neurosciences》1994,48(4):869-879
Abstract: Two autopsied female sibling cases of sudanophilic leukodystrophy are reported. Case A and case B were the second and third of seven siblings, and a sister and a brother died from severe progressive neurological disease with similar symptoms. Consanguineous marriages were noted in the family of both cases through the past three generations. Case A gradually developed intellectual deterioration and tetraplegia at the age of 29, progressed to akinetic mutism within one year and thereafter survived for 14 years. Neuropathologically, a severe atrophy and degeneration were noted in the white matter of the whole cerebrum, sparing the subcortical U-fibers. Myelin and axons were severely damaged with peripheral astrocytic gliosis. Case B developed similar clinical symptoms at the age of 20 and survived for 7 years in the state of akinetic mutism. Similar postmortem findings as those of case A were found in the white matter of the cerebrum with formation of sudanophilic breakdown products and with thick fibrillary gliosis. The pyramidal tract was completely degenerated. There was no accumulation of abnormal lipid in the brains of both cases. 相似文献
73.
Yasunori Utsunomiya Toshiyuki Imasawa Aya Abe Keita Hirano Tetsuya Kawamura Ryuji Nagasawa Tetsuya Mitarai Naoki Maruyama Osamu Sakai 《Clinical and experimental nephrology》1997,1(2):83-91
Background The purpose of this study was to examine the effects of bacterial suporantigens, which can derange the immune response and
contribute to the renal lesions of immunoglobulin A (lgA) nephropathy.
Methods Twenty-five micrograms of a bacterial superantigen, staphylococcal enterotoxin B (SEB), was injected into IgA nephropathy-prone
ddY mice intrathymically when they reached 6 weeks of age. Evaluation included measurement of albumin excretion in urine,
immunoglobulin concentration, and lymphokine production in vitro, as well as analysis of T-cell receptor expression in splenic
T-cell subsets and examination of renal histology by light and fluorescence microscopy.
Results At 40 weeks of age, the serum level of IgA in these mice was substantially increased and the number of Vβ8+ CD4+splenic T-cells was significantly decreased compared with measurements in untreated controls. Both control and SEB-treated
mice excreted less than 30 μg/mL of urinary albumin. In mice given SEB, the amount of interleukin 2 (IL-2) and tumor necrosis
factor-α (T helper 1 [Th1]-type cytokines) produced by the in vitro-stimulated lymphocytes significantly decreased. whereas
that of interleukin 4 (IL-4) and interleukin 6 (IL-6) (Th2-type cytokines) markedly increased compared with measurements in
control mice. At 40 weeks of age, mice given SEB showed marked glomerular hypercellularity and enhanced glomerular C3 deposition
by renal histology, compared with control mice.
Conclusion These results suggest that bacterial superantigen SEB may modify glomerular lesions through activating Th2 cells, while inducing
deletion of Th1 cells in this experimental model. 相似文献
74.
Toshimichi Hasegawa Yuko Tazuke Yasuhiro Iwasaki Osamu Monta Junichi Sumimura Hiroshi Koyama Toru Dezawa 《Surgery today》1997,27(12):1191-1194
We report herein the case of a premature infant with esophageal atresia (EA) and a tracheoesophageal fistula (TEF) associated
with cardiac anomalies who was successfully treated by an early ligation of the TEF following gastrostomy, and delayed repair
of the esophagus. A 1212-g male was born prematurely at 31 gestational weeks, at which time he was diagnosed as having EA
with TEF and patent ductus arteriosus (PDA), ventricular septal defect (VSD), and atrial septal defect (ASD). A gastrostomy
was initially performed but following extubation he gradually became tachypneic. A chest roentogenogram revealed atelectasis
and ground-glass appearance, and reintubation was required. Ligation of the TEF was performed 53h after his birth. Following
the improvement of his respiratory condition through ventilatory support and the intratracheal administration of pulmonary
surfactant, he underwent repair of the esophagus on the 6th day of life. Postoperatively, he suffered from heart failure,
but was treated with peritoneal dialysis and pharmacological closure of the PDA. Weaning the infant from the ventilator proved
difficult, but it was finally achieved when he had reached a weight of 2268g at 3 months of age by enteral feeding. Our experience
of this case demonstrates that early ligation of TEF should be performed for a premature infant with EA and TEF before respiratory
distress syndrome (RDS) has developed. If a gastrostomy is required to prevent gastric distention, it should be followed by
simultaneous or immediate ligation of the TEF. 相似文献
75.
A 51-year-old woman, with progressive gait disturbance and dysarthria, had been diagnosed as Menzel-type spinocerebellar degeneration. Later, she developed dystonic posture of upper limbs and bulging eyes. She was diagnosed as Machado-Joseph disease from neurological findings, which consisted of cerebellar signs, pyramidal tract signs and extrapyramidal tract signs and peripheral neuropathy. She died suddenly of unknown origin. Her illness lasted about 13 years. Neuropathological findings showed moderate neuronal loss with gliosis in the subthalamic nucleus, globus pallidus, substantia nigra, dentate nucleus, oculomotor and hypoglossal nucleus and anterior horn. Positron emission tomography (PET) using 15O steady state inhalation technique revealed reduction of cerebral blood flow and cerebral metabolic rate of oxygen in not only cerebellum but also cerebral cortex. These findings are different from typical PET findings of spinocerebellar degeneration. 相似文献
76.
77.
Hyperthermo-chemo-radiotherapy as a definitive treatment for patients with early esophageal carcinoma. 总被引:1,自引:0,他引:1
H Matsuda S Tsutsui M Morita K Baba K Kitamura H Kuwano K Sugimachi 《American journal of clinical oncology》1992,15(6):509-514
Ten patients with early stage esophageal carcinoma were treated with hyperthermo-chemo-radiotherapy (HCR) without surgery. The reasons for the inoperability of these patients included medically inoperable unresectable cancers, advanced age, and/or refusal to undergo surgery. The diagnosis of early esophageal carcinoma was determined by esophagograms, endoscopy, and ultrasonography. Squamous cell carcinoma was histopathologically confirmed in each case. Each patient underwent four to nine sessions of hyperthermic treatment combined with external irradiation and chemotherapy using bleomycin; eight of these patients received additional radiation, and two terminated treatment after the HCR therapy. The tumors in all patients showed either a complete response (CR) or a partial response (PR) after HCR therapy; in two patients viable cancer cells remained, but later disappeared after additional radiation. Five patients experienced no local recurrence for 12 to 70 months and are now alive and doing well, three died of other medical conditions without any evidence of esophageal cancer, and two died of recurrent esophageal cancer 20 to 27 months after initial admission. All ten patients tolerated the HCR well without any systemic side effects. However, in two patients, esophageal erosion was recognized endoscopically. HCR therapy therefore deserves serious consideration when treating patients with small malignant lesions of the esophagus who, for various reasons, are unable to undergo surgery. 相似文献
78.
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
79.
The authors report four cases of familial pituitary adenomas from two unrelated families. No clinical or biochemical evidence of multiple endocrine neoplasia, type I (MEN-I) was demonstrated. Detailed study of the family trees disclosed no other family members affected by MEN-I. Familial occurrence of pituitary adenomas unassociated with MEN-I is rare. 相似文献
80.
Osamu Nakamura 《Brain and nerve》2005,57(12):1043-1049