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91.
Kyoji Yamamoto M.D. Keiichi Fujimoto Takashi Matsushiro Keisuke Ota 《Journal of gastroenterology》1990,25(6):758-761
A case of lymphoepithelial cyst in the pancreas was reported. A 64-year-old man without any specific compalints was found
to have a cystic lesion in the anterior portion of the pancreas, as revealed by ultrasonography of the abdomen at an annual
medical examination in 1988. This was dissected easily from the pancreas. Histologically, it was diagnosed to be a benign
lymphoepithelial cyst in the pancreas. Cysts of this type are rare, and their histogenesis is also not well understood. 相似文献
92.
Teiichi Yamane Taro Date Yasuko Kanzaki Keiichi Inada Seiichiro Matsuo Kenri Shibayama Satoru Miyanaga Hidekazu Miyazaki Ken-ichi Sugimoto Seibu Mochizuki 《Circulation journal》2007,71(5):753-760
BACKGROUND: The limited efficacy and complications of segmental ostial pulmonary vein isolation (PVI) for treating atrial fibrillation (AF) have been discussed so, in the present study the feasibility and efficiency of performing segmental pulmonary vein (PV) antrum isolation to treat AF were assessed. METHODS AND RESULTS: A total of 187 patients with drug-refractory AF (paroxysmal 120, persistent 67) underwent segmental PVI guided by circumferential 20-electrode catheters (Lasso). Radiofrequency (RF) current was delivered either at the ostium using a regular Lasso (15-20 mm in diameter, 70 patients: Group 1) or at the antrum using a larger Lasso (25-30 mm in diameter, 117 patients: Group 2). A significantly wider region had to be ablated, with a longer RF application time, to isolate all 4 PVs in Group 2 patients than in Group 1 patients. Although the rate of recurrence of AF after the initial session was equal in both groups, a significantly greater number of patients were free from AF after a mean of 1.4 procedures in Group 2 than in Group 1 (93% vs 76% for paroxysmal AF, 78% vs 48% for persistent AF). CONCLUSIONS: Segmental antral PVI using large-sized Lasso catheters was found to be more effective and safer than ostial PVI for the treatment of AF. 相似文献
93.
Ozaki K Oda H Suzuki T Ohno Y Tsuchida K Takahashi K Miida T 《Journal of cardiology》2008,51(1):70-73
A 69-year-old woman underwent percutaneous coronary intervention for a severe stenotic lesion in the bifurcation of the mid-left anterior descending artery and first diagonal branch. A single stent was implanted into the left anterior descending artery. After the stent strut was dilated by balloon inflation in the diagonal branch, dissection occurred at the ostium of the diagonal branch and resulted in side branch occlusion due to hematoma. Bailout stenting was performed in the diagonal branch, but thrombus projection occurred in the left anterior descending artery. Aspiration, balloon inflation and thrombolytic therapy were performed, but distal embolism developed. This case illustrates that thrombus projection caused by stenting in a side branch may occur as a rare complication in percutaneous coronary intervention. 相似文献
94.
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96.
Yukihiro Tsuchiya Fumitake Ishihara Goro Kajiyama Saburo Nakazawa Masao Otho Hiroshi Tanimura Yoshikazu Akura Minoru Harada Masabumi Hihara Yukio Kawai Yukihiro Kono Hajime Koshiyama Masahiro Morita Michiko Nakajima Kyoichiro Nishina Hiroshi Sagawa Terufumi Sakai Mitsuo Shoji Kayoko Sone Yoshihiro Sugimoto Keiichi Sugiyama Osamu Takahara Tomoo Takamura Susumu Tazuma Hideki Wakamatsu 《Journal of gastroenterology》1995,30(6):768-774
The use of bile acid dissolution therapy in extracorporeal shockwave lithotripsy of gallstones, remains controversial. Our
study examined whether chemolitholysis after sufficient disintegration enhanced stone clearance within 6 months of the first
lithotripsy. A total of 143 patients who developed one to three radiolucent stones measuring⪯30 mm in diameter were randomly
separated into two treatment groups: 47% were given lithotripsy alone, and 53% lithotripsy plus ursodeoxycholic acid (UDCA).
Repeated piezoelectric lithotripsy was given, with no limit on the total number of treatment sessions, to pulverize or disintegrate
stones into fragments<3 mm. Stones were disintegrated in 97% of all patients, and the fragments were ⪯2 mm in 50% of these
patients. According to an intention-to-treat analysis, 52% in the lithotripsy alone group and 58% in the UDCA group were free
of stones 6 months after the first lithotripsy (P=0.61). Of the patients with fragments⪯2 mm, 71% in the former and 86% in the latter group were free of stones 6 months after
the first lithotripsy, with no significant difference between the groups. Biliary pain occurred in 25% of all patients, including
3 with acute cholecystitis. We concluded that the sufficient disintegration of gallstones achieved with repeated lithotripsy
enhanced the early clearance of fragments, regardless of whether chemolitholysis was employed. 相似文献
97.
Comparison of laparoscopic Toupet and laparoscopic Nissen fundoplications in neurologically normal children
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Go Miyano Masaya Yamoto Hiromu Miyake Masakatsu Kaneshiro Keiichi Morita Hiroshi Nouso Mariko Koyama Manabu Okawada Takashi Doi Hiroyuki Koga Geoffrey J Lane Koji Fukumoto Atsuyuki Yamataka Naoto Urushihara 《Asian journal of endoscopic surgery》2018,11(2):129-132
Introduction
We compared laparoscopic Toupet fundoplication (LTF) and laparoscopic Nissen fundoplication (LNF) in neurologically normal children.Methods
Forty neurologically normal children who were followed up for more than 3 years after LTF (n = 22) or LNF (n = 18) were reviewed retrospectively. LTF and LNF were performed between 2006 and 2012.Results
There were no significant differences in gender (LTF, 15 male and 7 female patients; LNF:, 12 male and 6 female patients), mean age at surgery (LTF vs LNF: 2.5 vs 2.3 years), mean weight at surgery (LTF vs LNF: 9.6 vs 8.9 kg), preoperative symptoms, preoperative pH monitoring (pH <4) (LTF vs LNF: 26.7% vs 21.8%), mean operative time (LTF vs LNF: 117 vs 126 min), postoperative recommencement of enteral feeding (LTF vs LNF: 3.7 vs 3.8 days), or duration of hospitalization (LTF vs LNF: 5.5 vs 6.3 days). Intraoperative complications were esophageal trauma (LTF; n = 1; 4.5%) and liver trauma (LNF; n = 1; 5.6%) (P = 0.70). Post‐LTF complications were wrap stenosis (n = 1; 4.5%), and post‐LNF complications were wrap stenosis (n = 1; 5.5%) and gastric outlet obstruction (n = 1; 5.5%) (P = 0.43); all were managed conservatively. No case required conversion to open repair. There was no recurrence after LTF, but there were three cases (16.7%) after LNF (P = 0.08). Reoperation was performed at 4, 11, and 13 months, respectively.Conclusion
Despite LTF and LNF appearing to be equally effective, three LNF cases required reoperation. 相似文献98.
Nobuyasu Hirai Kei Kasahara Hiroyuki Fujikura Shingo Yoshihara Taku Ogawa Yoshihiko Ogawa Naokuni Hishiya Yuki Suzuki Ryuichi Nakano Hisakazu Yano Masahide Yoshikawa Keiichi Mikasa 《Journal of infection and chemotherapy》2018,24(7):570-572
Mycotic aneurysm is a rare but life-threatening disease that warrants an integrated therapeutic approach involving surgical intervention and prolonged antibiotic use. However, the causative organisms are often unidentified because antibiotics started empirically render blood and tissue cultures negative. Molecular diagnosis has been reported to be useful in such culture-negative cases. We report a case of a culture-negative mycotic aortic aneurysm due to Haemophilus influenzae, diagnosed by direct 16S rRNA polymerase chain reaction (PCR) and sequencing of the resected aneurysm tissue. PCR for serotype revealed type b, and PCR and sequencing of the ftsI gene revealed alterations in penicillin-binding protein 3, suggesting resistance to ampicillin. Multilocus sequence typing demonstrated that the isolate belonged to sequence type 54. 相似文献
99.
Nobuya Kobayashi Hideki Kobara Noriko Nishiyama Masao Fujiwara Keiichi Okano 《Minimally invasive therapy & allied technologies》2018,27(4):203-208
Background: Endoscopic submucosal dissection (ESD) techniques, such as generating an artificial space between digestive tract layers for safer dissection, were thought to be safer for the resection of organs in cholecystectomy. We investigated whether combinations of endoscopic techniques and laparoscopic techniques could be performed more safely and rapidly.Material and methods: Laparoscopic and endoscopic cooperative-cholecystectomy (LEC-chole) and conventional laparoscopic cholecystectomy (Lapa-chole) were performed in six dogs. Operation time was defined as the time from the creation of the first port to the retrieval of the resected gallbladder (GB); and GB bed dissection time was the time from local injection of natural saline to the clipping of the cystic duct. The main roles of the endoscope in LEC-chole were to obtain a sufficient cutting space via local injection of natural saline to the GB bed and to monitor the operative view without laparoscopic camera, thus omitting the umbilical port.Results: The operation times were 60?±?18.3?minutes for LEC-chole and 95?±?7.0 for Lapa-chole (p?=?.036). The GB bed dissection times were 31?±?8.54?minutes in LEC-chole and 50.6?±?7.37?minutes in Lapa-chole (p?=?0.048). There were significant differences in liver damage and bleeding (p?=?0.116), but there were no significant differences in one-month survival.Conclusions: The application of LEC-chole may be expanded to cholecystectomy. 相似文献
100.
Hidenori Moriyama Mitsushige Murata Toshimitsu Tsugu Takashi Kawakami Masaharu Kataoka Takahiro Hiraide Mai Kimura Sarasa Isobe Jin Endo Takashi Kohno Yuji Itabashi Keiichi Fukuda 《The international journal of cardiovascular imaging》2018,34(6):875-882
Chronic thromboembolic pulmonary hypertension (CTEPH) has a poor prognosis because of the associated progressive right heart failure. Accurate evaluation of right ventricular (RV) function would thus be useful to predict prognosis. However, the significance of RV diastolic function remains unclear. We aimed to identify which echocardiographic measures are most accurate, and potentially useful, in assessing RV diastolic function in patients with CTEPH, and to study the effects of balloon pulmonary angioplasty (BPA) on them. We enrolled 53 CTEPH patients who underwent BPA. Echocardiographic parameters, including two-dimensional speckle-tracking echocardiography, were compared to the hemodynamic parameters measured by right heart catheterization before and after BPA. RV strain rate during early diastole (SR_E), tricuspid e′ and right atrial area (RAA) were ameliorated after BPA, concomitant with a decrease in the time constant of the RV pressure curve during diastole (tau), indicating the improvement of RV diastolic function. Among them, SR_E had the strongest correlation with tau (r?=???0.39, p?<?0.001). Furthermore, the receiver operating characteristic analyses revealed that E/SR_E (AUC 0.704) and inferior vena cava diameter (AUC 0.726) had a stronger association with higher mean right atrial pressure than RAA (AUC 0.632). In contrast, RAA had a stronger correlation with 6 min-walk distances than SR_E (r?=???0.39, p?<?0.001 vs. r?=?0.30, p?=?0.005). Taken together, echocardiographic assessment of RV diastolic function might be associated with hemodynamics as well as exercise tolerance in patients with CTEPH, indicating its benefits in evaluating the therapeutic effects of BPA. 相似文献