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91.
92.
Nobuyoshi Takeshita Takayuki Tohma Hideaki Miyauchi Kazufumi Suzuki Takanori Nishimori Gaku Ohira Kazuo Narushima Shunsuke Imanishi Takeshi Toyozumi Hisahiro Matsubara 《International surgery》2015,100(4):604-607
A 61-year-old woman who had undergone total hysterectomy 16 years previously exhibited a pelvic tumor on computed tomography (CT). F-18 fluorodeoxyglucose (FDG) combined positron emission tomography (PET)/CT imaging revealed a solitary small focus of increased FDG activity in the pelvis. A gastrointestinal stromal tumor originating in the small intestine or another type of tumor originating in the mesentery (desmoid, schwannoma, or foreign body granuloma) was suspected; therefore, laparoscopic resection was conducted. A white, hard tumor was found to originate from the mesentery of the sigmoid colon and adhered slightly to the small intestine. The tumor was resected with a negative margin, and the pathologic diagnosis was suture granuloma. The possibility of suture granuloma should be kept in mind in cases of tumors with positive PET findings and a history of surgery close to the lesion. However, it is difficult to preoperatively diagnose pelvic tumors using a biopsy. Therefore, considering the possibility of malignancy, it is necessary to achieve complete resection without exposing the tumor.Key words: Suture granuloma, Laparoscopy, Positron emission tomography (PET)It is very difficult to diagnose suture granulomas preoperatively. F-18 fluorodeoxyglucose (FDG) combined positron emission tomography (PET)/computed tomography (CT) imaging is often used to differentiate benign from malignant tumors that are difficult to diagnose on other modalities, such as ultrasound (US), CT, and magnetic resonance imaging. However, it is not easy to differentiate tumors associated with inflammation or malignancy using FDG-PET/CT. Suture granulomas are known to be benign; however, false-positive findings were observed on PET/CT in our case. In the literature, there are few reports of suture granulomas showing false-positive findings on PET/CT.1–5 We report here a case in which it was not possible to rule out the potential for malignancy using CT or FDG-PET/CT and the lesion was confirmed to be a suture granuloma based on a pathologic examination following laparoscopic resection. 相似文献
93.
A Left Anterior Extrapleural Approach to Adjust Right Ventricle–Pulmonary Artery Shunt Flow Using Hemostatic Clips After the Norwood Operation
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95.
Varicose bleeding after liver transplantation in a patient with severe portosystemic shunts 总被引:1,自引:0,他引:1
Nosaka T Teramoto K Tanaka Y Igari T Takamatsu S Kawamura T Inoue Y Goseki N Arii S Iwai T Inomata Y Tanaka K 《Journal of gastroenterology》2003,38(7):700-703
Recipients for liver transplantation often have portosystemic shunts due to portal hypertension. It is an important problem whether such shunts should be ligated during operations. Ligating the shunts seems of benefit for increasing portal blood flow to the liver, but it is sometimes difficult technically, and it is invasive to the patient. We experienced a recipient with huge portosystemic shunts and no esophageal varices before living-related liver transplantation. Some shunts were ligated during operation to increase portal blood flow to the graft. Unfortunately, the patient suffered severe bleeding from esophagogastric varices after he underwent retransplantation owing to accidental liver failure. Based on our experience, extreme care should be exercised to avoid varicose bleeding after ligating the portosystemic shunts of liver transplantation patients. 相似文献
96.
Yu Sato Akiomi Yoshihisa Yusuke Kimishima Takatoyo Kiko Shunsuke Watanabe Yuki Kanno Satoshi Abe Makiko Miyata Takamasa Sato Satoshi Suzuki Masayoshi Oikawa Atsushi Kobayashi Takayoshi Yamaki Hiroyuki Kunii Kazuhiko Nakazato Takafumi Ishida Yasuchika Takeishi 《The Canadian journal of cardiology》2018,34(1):80-87
Background
It is widely recognized that overt hyper- as well as hypothyroidism are potential causes of heart failure (HF). Additionally it has been recently reported that subclinical hypothyroidism (sub-hypo) is associated with atherosclerosis, development of HF, and cardiovascular death. We aimed to clarify the effect of sub-hypo on prognosis of HF, and underlying hemodynamics and exercise capacity.Methods
We measured the serum levels of thyroid stimulating hormone (TSH) and free thyroxine (FT4) in 1100 consecutive HF patients. We divided these patients into 5 groups on the basis of plasma levels of TSH and FT4, and focused on euthyroidism (0.4 ≤ TSH ≤ 4 μIU/mL and 0.7 ≤ FT4 ≤ 1.9 ng/dL; n = 911; 82.8%) and sub-hypo groups (TSH > 4 μIU/mL and 0.7 ≤ FT4 ≤ 1.9 ng/dL; n = 132; 12.0%). We compared parameters of echocardiography, cardiopulmonary exercise testing, and cardiac catheterization, and followed up for cardiac event rate and all-cause mortality between the 2 groups.Results
Although left ventricular ejection fraction did not differ between the 2 groups, the sub-hypo group had lower peak breath-by-breath oxygen consumption and higher mean pulmonary arterial pressure than the euthyroidism group (peak breath-by-breath oxygen consumption, 14.0 vs 15.9 mL/min/kg; P = 0.012; mean pulmonary arterial pressure, 26.8 vs 23.5 mm Hg, P = 0.020). In Kaplan-Meier analysis (mean 1098 days), the cardiac event rate and all-cause mortality were significantly higher in the sub-hypo group than those in the euthyroidism group (log rank, P < 0.01, respectively). In Cox proportional hazard analysis, sub-hypo was a predictor of cardiac event rate and all-cause mortality in HF patients (P < 0.05, respectively).Conclusions
Sub-hypo might be associated with adverse prognosis, accompanied by impaired exercise capacity and higher pulmonary arterial pressure, in HF patients. 相似文献97.
Hiromi Tateno MD PhD Ryuji Sakakibara MD PhD Shunsuke Shiina BSci Hirokazu Doi PhD Fuyuki Tateno MD PhD Mitsutoshi Sato PhD Tohru Masaka PhD Masahiko Kishi MD PhD Yohei Tsuyusaki MD Yosuke Aiba MD Tsuyoshi Ogata MSc Yasuo Suzuki MD PhD 《Journal of the American Geriatrics Society》2015,63(11):2416-2418
98.
Yoshiyuki Tamura Shunsuke Orino Yoshiaki Saijyo Tetsuo Nishimoto Norio Nagase Hiroyoshi Mori 《Heart and vessels》1986,2(4):202-207
Summary The relations of the light chains of myosins of the atria, ventricles, and atrioventricular conducting tissue (specialized myocardial tissue) and the distribution of the light chains of myosin in different regions of the atrioventricular conducting tissue in bovine heart were examined. Two-dimensional gel electrophoresis showed that the atrial and ventricular myosins each had two light chains (LC1 and LC2). Ventricular LC1 differed from atrial LC1, but ventricular LC2 corresponded to atrial LC2. The specialized myocardial tissue myosin had three light chains (named here SL1, SL2, and SL3). SL1 comigrated with ventricular LC1, SL2 with atrial LC1, and SL3 with ventricular LC2 and atrial LC2. The compositions of the three light chains of myosins in various regions of the atrioventricular conducting tissue were determined by sodium dodecyl sulfate (SDS)-polyacrylamide gel electrophoresis. The percentage proportion of SL1 decreased in the order—atrioventricular node (AVN), right and left bundle branches (RLBB), His bundle (HIS), false tendon (FT) myosin; while the percentage proportion of SL2 decreased in the order—FT and HIS, RLBB, AVN myosin. The percentages of SL3 in these four regions were similar. The Ca2+-activated ATPase activity of myosin was highest in the AVN and lowest in the FT. The activities in the HIS and RLBB were intermediate between those in the AVN and FT. Thus, the composition of the light chains and the Ca2+-activated ATPase activity were different in various regions of the atrioventricular conducting tissue. 相似文献
99.
Relation of aortic wall thickness and distensibility to cardiovascular risk factors (from the Multi-Ethnic Study of Atherosclerosis [MESA]) 总被引:1,自引:0,他引:1
Malayeri AA Natori S Bahrami H Bertoni AG Kronmal R Lima JA Bluemke DA 《The American journal of cardiology》2008,102(4):491-496
To determine the relation between aortic wall thickness (WT) and aortic distensibility (AD) with traditional cardiovascular risk factors in the Multi-Ethnic Study of Atherosclerosis (MESA) cohort, 1,053 participants in MESA who underwent cardiac magnetic resonance imaging were consecutively selected for the measurement of aortic WT and AD. Double inversion-recovery fast spin-echo images of the thoracic aorta were obtained to measure average and maximum WT. AD was measured at the same level using a gradient-echo cine sequence. Average and maximum WT were positively correlated with increasing age, and AD was inversely related to age (p <0.01). Compared with normotensive participants, those with hypertension had significantly greater mean average WT (2.45 vs 2.23 mm, p <0.01) and maximum WT (3.61 vs 3.41 mm, p <0.01) and lower AD (0.15 vs 0.2 mm Hg(-1), p <0.01). In multiple regression analysis, older age and hypertension were significantly associated with higher mean average WT, while older age, male gender, and higher blood pressure were associated with higher mean maximum WT. AD was inversely related to older age, hypertension, current smoking, African American ethnicity, and lower high-density lipoprotein cholesterol level. In conclusion, in the MESA cohort, older age and higher blood pressure were associated with higher aortic WT and lower AD. Decreased AD was further associated with current smoking, African American ethnicity, and higher high-density lipoprotein cholesterol level. 相似文献
100.