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21.
Resolution of homonymous visual field loss documented with functional magnetic resonance and diffusion tensor imaging. 总被引:5,自引:0,他引:5
Masaki Yoshida Masahiro Ida Thien Huong Nguyen Marie-Therese Iba-Zizen Luc Bellinger Jean Louis Stievenart Takehiko Nagao Shinsuke Kikuchi Takaaki Hara Takuya Shiba Kenji Kitahara Emmanuel Alain Cabanis 《Journal of neuro-ophthalmology》2006,26(1):11-17
A 68-year-old man developed right homonymous hemianopic paracentral scotomas from acute infarction of the left extrastriate area. He was studied over the ensuing 12 months with visual fields, conventional MRI, functional MRI (fMRI), and diffusion tensor imaging (DTI). As the visual field defect became smaller, fMRI demonstrated progressively larger areas of cortical activation. DTI initially showed that the lesioned posterior optic radiations were completely interrupted. This interruption lessened in time and had disappeared by one year after onset. fMRI and DTI are innovative measures to follow functional and structural recovery in the central nervous system. This is the first reported application of these imaging techniques to acute cerebral visual field disorders. 相似文献
22.
Kenji Tsukada Shigeru Kobayashi Tatsuya Gotoh Naoki Asakage Masayuki Sekine Morio Sasaki Eiji Miyazaki Takahisa Suzuki Toshio Yamada Shu Hirai Shigetaka Yamazaki 《Digestive endoscopy》2006,18(1):55-58
A case of early gastric carcinoma accompanied by Dieulafoy ulcer is presented. The patient, a 26‐year‐old female, visited our emergency room with chief complaints of massive hematemesis and tarry stool. The initial endoscopic examination revealed a superficial depressed lesion with a faded color accompanied by a tiny ulcer with converging folds at the anterior wall of the middle gastric body. Although no active bleeding vessel was found at that time, the patient was admitted to our hospital for further check‐ups and treatment. On the 6th hospital day, she developed massive hematemesis resulting in shock. Urgent endoscopy, this time, disclosed an exposed bleeding vessel at the small ulcer floor previously mentioned, and endoscopic hemostasis was achieved. Since, however, a biopsy at initial examination from the surrounding depressed area proved carcinoma, a partial distal gastrectomy was subsequently carried out. Histological examination of the resected specimen confirmed the diagnosis of carcinoma limited to the mucosa and submucosa along with findings consistent with Dieulafoy ulcer. This is a rare case of combination of early cancer and Dieulafoy ulcer particularly in such a young patient. A review of the literature is also presented. 相似文献
23.
Ryo Hattori MD Tateki Kubo MD Kenji Yano MD PhD Atsushi Tanemura MD Yuji Yamaguchi MD PhD Satoshi Itami MD PhD Ko Hosokawa MD PhD 《Dermatologic surgery》2003,29(10):1071-1072
BACKGROUND: Nevus lipomatosus cutaneous superficialis (NLCS) is a relatively rare condition. Although NLCS can affect any region of the entire body, no case of NLCS in the clitoris has ever been reported. OBJECTIVE: To report a case of NLCS of the clitoris that presented manifestations that were similar to female pseudohermaphrodism. METHODS: This is a case report and review of the literature. RESULTS: A congenital, soft, skin-colored lesion of the clitoris in a 1-year-old girl resembled female pseudohermaphrodism. It was resected, and the histologic diagnosis was NLCS. Postoperatively, there was no subsequent change in the lesion during the 3-year follow-up period. CONCLUSION: We reported a case of congenital solitary NLCS of the clitoris. Although NLCS might be a relatively rare condition, we should consider it in the differential diagnosis of female pseudohermaphrodism. 相似文献
24.
25.
Tetsuhiko Nagao Seizo Sadoshima Takao Ishitsuka Kenji Kusuda Osamu Shiokawa Setsuro Lbayashi Masatoshi Fujishima 《Clinical and experimental pharmacology & physiology》1992,19(7):489-493
1. The effects of acute bilateral superior cervical ganglionectomy on cerebral blood flow and metabolism were investigated in stroke-prone spontaneously hypertensive rats (SHRsp), before and during cerebral ischaemia. 2. The resting cerebral blood flow was comparable between the control and denervated animals. 3. There was no significant difference in cerebral blood flow or concentration of tissue energy metabolites (adenosine triphosphate [ATP], lactate and pyruvate) between the sham-operated control and denervated animals during ischaemia. 4. The results suggest that sympathetic innervation of cerebral vessels originating from superior cervical ganglia may not play a major role in the progression of cerebral ischaemia in SHRsp. 相似文献
26.
27.
Makoto Kamada Kenji Ohsaka Susumu Nagamine Hidemitsu Kakihata 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2003,51(10):552-556
Acute aortic dissection complicated with acute myocardial infarction (AMI) is the most fatal situation. We experienced the
successful treatment for acute type A aortic dissection complicated with inferior AMI following aortic valve replacement (AVR).
A 60-year-old man had had AVR for aortic regurgitation. Sixteen months after the AVR, he had a sudden onset of severe chest
pain with complete atrioventricular block. Immediately, temporary pacing and cardiac catheterization were conducted, showing
the occlusion of the right coronary artery due to acute type A aortic dissection. On his way to our hospital, direct current
shock was conducted 3 times for ventricular fibrillation. We replaced the ascending aorta combined with coronary artery bypass
grafting and the postoperative course was uneventful. The key to treat acute aortic dissection complicated with AMI is early
accurate diagnosis, prompt temporary pacing for bradycardia, defibrillation for lethal arrhythmia and insertion of a perfusion
catheter if possible. These preoperative hemodynamic stabilization gives us the chance to save these patients. 相似文献
28.
Yusuke Kishikawa Daiki Masaki Yurinosuke Kitabayashi Naosuke Tani Akira Hirogane Kenji Fukui 《Nihon Arukōru Yakubutsu Igakkai zasshi》2003,38(5):434-439
In order to find useful information for the establishment of new treatment method to alcohol dependence, we investigated the change of the body image of patients with alcohol dependence before and after the treatment. HABIT (Haga Body Image Test), a questionnaire about body image developed in department of psychiatry in Kyoto Prefectural University of Medicine, was used to examine the change of body image between pre- and post-3-month conventional treatment program in 46 patients with alcohol dependence hospitalized into special institutions for treatment of the disease in Kyoto. Patients with poor outcome of the treatment showed improvement of body image on visceral function, feeling of appetite and outward appearance, while patients with good outcome indicated no significant change in these aspects. This finding likely suggests that the treatment would result in good outcome in patients having stable feeling of physical health, and the cognitive treatment approach about these aspects of body image should be performed on the patients with poor treatment outcome. On the other hand, the body image about motor function showed significantly higher score in the patients approach for the patients with poor outcome to become aware of their physical activity would be effective. 相似文献
29.
Aortic arch replacement with proximal first technique. 总被引:2,自引:0,他引:2
Yuji Miyamoto Kenji Onishi Masataka Mitsuno Koichi Toda Masao Yoshitatsu Kazuo Abe 《Annals of thoracic and cardiovascular surgery》2003,9(6):389-393
BACKGROUND: Deep hypothermic circulatory arrest (DHCA) without retrograde cerebral perfusion (RCP) has a strict time limit. We modified a surgical technique for anastomosis to shorten the period of DHCA and unilateral cerebral perfusion (UCP). METHODS: Between March 1993 and August 2001, retrospective analysis was done on 23 consecutive patients, who underwent aortic arch replacement with branches. The patients were divided into two groups: DHCA group and UCP group. The DHCA group, in which DHCA alone and without additional cerebral perfusion was performed, comprised of nine patients. Proximal aortic anastomosis was performed first during systemic cooling; then both the brachiocephalic artery and left carotid artery were reconstructed with the branches of the artificial graft during circulatory arrest; thereafter, cerebral and coronary perfusions were resumed. The UCP group, in which DHCA was not used but right hemisphere perfusion during deep hypothermia was performed when the origin of brachiocephalic artery was safely clamped, consisted of 14 patients. RESULTS: Mean time of DHCA was 18.8+/-4.2 minutes and that of right hemisphere perfusion time was 11.0+/-3.8 minutes, respectively. Twenty-one patients survived the surgery (91.3%), and two (8.7%) died during hospitalization. Transient cerebral complication occurred in four patients in the DHCA group and all recovered. Logistic regression analysis revealed that DHCA was the only parameter to significantly influence temporary neurological dysfunction. There was no other significant difference between the two groups. CONCLUSION: With our modified and simple surgical technique for aortic arch repair, we were able to successfully shorten the DHCA time and right hemisphere perfusion time. However, because DHCA was the only parameter to significantly influence temporary neurological dysfunction, some form of continuous cerebral perfusion at deep hypothermia may be a safer method to preserve cerebral function. 相似文献
30.
Masahito Minakawa Kenji Takahashi Norihiro Kondo Masaharu Hatakeyama Toshihiko Kuga Ikuo Fukuda 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2003,51(11):582-587
Objective: Reoperative coronary bypass grafting is at high risk. Particularly in redo cases where the patent graft is running near
the midline of the sternum, the graft may be exposed to injury by a median sternotomy and subsequent dissection. Whereas,
off-pump bypass grafting from the left axillary artery or descending thoracic artery by a left thoracotomy approach is safe
for preventing graft damage.Methods: From March 1998 to February 2002, we performed off-pump coronary artery bypass grafting by a left thoracotomy approach in
9 patients. The left axillary artery was used as the inflow vessel in 4 cases, and the descending thoracic, aorta in 5.Results: The radial artery was anastomosed proximally to the axillary artery in 4 cases and the descending thoracic aorta in one
case. The saphenous vein graft was anastomosed, proximally to the descending thoracic aorta in 4 cases. Transdiaphragmatic
minimally invasive bypass grafting for the right coronary artery was simultaneously performed in 3 cases. Postoperative cardiac
events were ventricular arrhythmia in 6 cases and supraventricular arrhythmia in 3 cases. There was no damage to the patent
grafts. Postoperative coronary angiography performed, in 8 cases revealed all the grafts to be patent without stenosis. Cardiac
symptoms were not found after the operation in any of the cases.Conclusions: These procedures can prevent the injury to patent grafts caused by a median sternotomy, and will be one of the useful strategies
for reoperative off-pump coronary artery bypass grafting. 相似文献