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81.
Tsuneharu Kosuga Kimiaki Komukai Satoru Miyanaga Takeyuki Kubota Kotaro Nakata Kenichiro Suzuki Takayuki Yamada Jun Yoshida Haruka Kimura Michihiro Yoshimura 《Heart and vessels》2016,31(5):671-676
In patients with heart failure, coronary artery disease is the most common underlying heart disease, and is associated with increased mortality. However, estimating the presence or absence of coronary artery disease in patients with heart failure is sometimes difficult without coronary imaging. We reviewed 155 consecutive patients hospitalized with heart failure who underwent coronary angiography. The patients were divided into two groups: patients with (N = 59) and without (N = 96) coronary artery stenosis. The clinical characteristics and blood sampling data were compared between the two groups. The patients with coronary artery stenosis were older than those without. The prevalence of diabetes mellitus (DM), dyslipidemia and a history of revascularization was higher in the patients with coronary artery stenosis. Patients with coronary artery stenosis tended to have wall motion asynergy more frequently than those without. On the other hand, the prevalence of atrial fibrillation (AF) was lower in patients with coronary artery stenosis. The serum hemoglobin level and estimated glomerular filtration rate were lower in patients with coronary artery stenosis than in those without. In the multivariate analysis, DM (odds ratio 3.517, 95 % CI 1.601–7.727) was found to be the only the predictor of the presence of coronary artery stenosis in patients with heart failure. In conclusion, coronary imaging is strongly recommended for heart failure patients with DM to confirm the presence of coronary artery stenosis. 相似文献
82.
Yuko Kitagawa Hitoshi Idani Haruhiro Inoue Harushi Udagawa Ichiro Uyama Harushi Osugi Natsuya Katada Hiroya Takeuchi Yasunori Akutsu Shinya Asami Ken Ishikawa Akihiko Okamura Taiki Ono Fumihiko Kato Toshiki Kawabata Koichi Suda Tomoko Takesue Tsuyoshi Tanaka Mai Tsutsui Kei Hosoda Satoru Matsuda Tatsuo Matsuda Mariko Mani Tatsuya Miyazaki 《Asian journal of endoscopic surgery》2015,8(2):114-124
83.
A 52-year-old man presented with vomiting, general fatigue and hyponatremia. His symptoms and signs were consistent with the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). Endocrine studies revealed hypopituitarism and administration of hydrocortisone resulted in a marked polyuria. The patient was diagnosed as masked diabetes insipidus. The lymphocytic hypophysitis was also diagnosed on the basis of MRI findings and anti-pituitary antibody. Six months later, these abnormalities disappeared. Diabetes insipidus may exist in a case of hyponatremia due to contrastive SIADH. Such patients may recover spontaneously and careful follow-up is required, avoiding a long-term treatment by monotonous continuation of hormonal replacement. 相似文献
84.
Mayumi Ishida Hideki Onishi Tatsuya Morita Yosuke Uchitomi Megumi Shimizu Satoru Tsuneto Yasuo Shima Mitsunori Miyashita 《Journal of pain and symptom management》2018,55(4):1061-1067.e1
Context
The importance of communication between the cancer bereaved and others has been emphasized, but little is known about the more problematic aspects of this communication such as “unhelpful communication.”Objectives
The aim of this study was to establish which types of communication are perceived by the bereaved to be unhelpful.Methods
We conducted a cross-sectional, anonymous, nationwide survey at 103 certified hospice facilities/palliative care units in Japan.Results
A total of 630 (63%) bereaved responded. Over 60% of the bereaved experiencing such communication considered it to be unhelpful, with the most unhelpful communication being “They emphasized the positive aspects of death.” Thirteen items related to communication were separated into two factors (“advice for recovery” and “comments on cancer”) by factor analysis. “Comments on cancer” were more unhelpful to them and were more often provided by those around them. With regard to “advice for recovery,” losing a spouse was a stronger predictor with a higher odds ratio for communication distress than losing a parent (odds ratio, 5.34; 95% CI, 1.63–17.57).Conclusion
A number of the bereaved have experienced unhelpful communication regarding advice on dealing with bereavement and cancer. To prevent putting an unnecessary burden on the bereaved with such unhelpful communication, it is essential to understand problematic aspects. Even when people have no intention of hurting the bereaved, some communication may do so. Communication with the bereaved is also a core clinical skill required by health professionals, and further efforts are required to support the grieving process. 相似文献85.
Taito Kitano Yuki Nishikawa Satoru Sueyoshi Noriko Horikawa Hiroyuki Nakagawa Sayaka Yoshida 《Journal of infection and chemotherapy》2018,24(3):224-227
Hepatic abscess in chronic granulomatous disease (CGD) is very refractory and frequently requires multiple surgeries with frequent morbidities. Although surgical interventions are often required, patients are often not able to have surgery for various reasons. We present the case of a 21-year-old man with recurrent hepatic abscess in CGD. We could not provide surgical interventions due to the lack of a fluid cavity and the patient's refusal, and therefore we administered transcatheter arterial antimicrobial and steroid therapy. He did not have any exacerbation for more than 18 months after the final transcatheter treatment. This is the first reported case of successful transcatheter arterial antimicrobial and steroid therapy for refractory hepatic abscess in CGD. Although the patient's burden and medical cost were not inconsequential, this case shows that the transcatheter arterial antimicrobial and steroid therapy may be a treatment option for patients who are not candidates for surgical interventions. 相似文献
86.
Role of physical therapists and aromatherapy for fall prevention in older people: A narrative review
Falls among older people are usually the result of several causes combined. Identifying all the fall-related factors that apply to a particular individual and providing comprehensive multifactorial intervention is recommended for the prevention of falls among older people. However, the overall net benefit of multifactorial intervention in preventing falls is small, and it does not appear to improve fall-related outcomes, such as the number of fall-related injuries. Therefore, we might require new perspectives to overcome this situation. Here, we raise two novel strategies for fall prevention among older people. One is using physical therapists more actively. The other is using aromatherapy for stabilization of older people. Physical therapists should carry out detailed gait assessment and caregiver education. Aromatherapy is effective in improving balance and mental stability in older people. To overcome refractory geriatric syndrome, there is no choice but to eliminate all preconceived ideas before choosing the best fall prevention strategies. Geriatr Gerontol Int 2021; 21: 445–450 . 相似文献
87.
88.
Handa H Irisawa H Komatsumoto S Matsushima T Tsukamoto N Nojima Y Murakami H 《[Rinshō ketsueki] The Japanese journal of clinical hematology》2006,47(6):521-525
A 68-year-old woman suffering from a left iliac tumor and severe back pain was admitted to another hospital in May 1999. The bone X-ray, CT scan and MRI demonstrated a 7 cm x 5 cm left iliac tumor with osteolysis and she was transferred to our hospital. Angiography demonstrated multiple hypervascular lesions in the left ilium, lumbar vertebrae, left ischium, left pubis and left rib. The tumor was resected and diagnosed as a plasmacytoma. Immunoelectrophoresis did not show any M-protein in the serum and urine, but the patient was diagnosed as having a non-secretory or low producing multiple myeloma because of the presence of 42.8% of abnormal plasma cells in the bone marrow aspirate. Her symptoms improved following 3 courses of MCNU-VMP therapy and the bone marrow plasma cells decreased to less than 5%. She was discharged and treated as an outpatient but relapsed and died of chemotherapy-resistant myeloma. We report this case because macro-angiogenesis in a multiple myeloma demonstrated by angiography is rare and interesting. 相似文献
89.
ASXL2 mutations are frequently found in pediatric AML patients with t(8;21)/ RUNX1‐RUNX1T1 and associated with a better prognosis 下载免费PDF全文
Genki Yamato Norio Shiba Kenichi Yoshida Yuichi Shiraishi Yusuke Hara Kentaro Ohki Jun Okubo Haruna Okuno Kenichi Chiba Hiroko Tanaka Akitoshi Kinoshita Hiroshi Moritake Nobutaka Kiyokawa Daisuke Tomizawa Myoung‐ja Park Manabu Sotomatsu Takashi Taga Souichi Adachi Akio Tawa Keizo Horibe Hirokazu Arakawa Satoru Miyano Seishi Ogawa Yasuhide Hayashi 《Genes, chromosomes & cancer》2017,56(5):382-393
ASXL2 is an epigenetic regulator involved in polycomb repressive complex regulation or recruitment. Clinical features of pediatric acute myeloid leukemia (AML) patients with ASXL2 mutations remain unclear. Thus, we investigated frequencies of ASXL1 and ASXL2 mutations, clinical features of patients with these mutations, correlations of these mutations with other genetic alterations including BCOR/BCORL1 and cohesin complex component genes, and prognostic impact of these mutations in 369 pediatric patients with de novo AML (0–17 years). We identified 9 (2.4%) ASXL1 and 17 (4.6%) ASXL2 mutations in 25 patients. These mutations were more common in patients with t(8;21)(q22;q22)/RUNX1‐RUNX1T1 (ASXL1, 6/9, 67%, P = 0.02; ASXL2, 10/17, 59%, P = 0.01). Among these 25 patients, 4 (27%) of 15 patients with t(8;21) and 6 (60%) of 10 patients without t(8;21) relapsed. However, most patients with relapse were rescued using stem cell transplantation irrespective of t(8;21). The overall survival (OS) and event‐free survival (EFS) rates showed no differences among pediatric AML patients with t(8;21) and ASXL1 or ASXL2 mutations and ASXL wild‐type (5‐year OS, 75% vs. 100% vs. 91% and 5‐year EFS, 67% vs. 80% vs. 67%). In 106 patients with t(8;21) AML, the coexistence of mutations in tyrosine kinase pathways and chromatin modifiers and/or cohesin complex component genes had no effect on prognosis. These results suggest that ASXL1 and ASXL2 mutations play key roles as cooperating mutations that induce leukemogenesis, particularly in pediatric AML patients with t(8;21), and these mutations might be associated with a better prognosis than that reported previously. 相似文献
90.
Loss of interaction between plectin and type XVII collagen results in epidermolysis bullosa simplex 下载免费PDF全文
Ken Natsuga Wataru Nishie Machiko Nishimura Satoru Shinkuma Mika Watanabe Kentaro Izumi Hideki Nakamura Yoshiaki Hirako Hiroshi Shimizu 《Human mutation》2017,38(12):1666-1670
Plectin is a linker protein that interacts with intermediate filaments and β4 integrin in hemidesmosomes of the epidermal basement membrane zone (BMZ). Type XVII collagen (COL17) has been suggested as another candidate plectin binding partner in hemidesmosomes. Here, we demonstrate that plectin–COL17 binding helps to maintain epidermal BMZ organization. We identified an epidermolysis bullosa (EB) simplex patient as having markedly diminished expression of plectin and COL17 in skin. The patient is compound heterozygous for sequence variants in the plectin gene (PLEC); one is a truncation and the other is a small in‐frame deletion sequence variant. The in‐frame deletion is located in the putative COL17‐binding domain of plectin and abolishes the plectin–COL17 interaction in vitro. These results imply that disrupted interaction between plectin and COL17 is involved in the development of EB. Our study suggests that protein–protein binding defects may underlie EB in patients with unidentified disease‐causing sequence variants. 相似文献