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81.
Takahiro Nishida Hisanori Mayumi Yoshito Kawachi Shigehiko Tokunaga Yoshiyuki Maruyama Atsuhiro Nakashima Hisataka Yasui Kouichi Tokunaga 《Surgery today》1994,24(7):651-654
A case of active prosthetic valve infective endocarditis (PVE) due toCandida glabrata was successfully treated by the systemic administration of fluconazole. A 66-year-old Japanese man with infective endocarditis of unknown etiology underwent aortic and mitral valve replacement to treat severe aortic and mitral regurgitation associated with multiple organ failure. Postsurgical cultures of arterial blood were repeatedly positive forC. glabrata, and therefore fluconazole was administered either intravenously or orally at a dose of 400 mg/day for 46 days. During that time the signs of inflammation including fever such as an elevated white blood cell count and the presence of C-reactive protein (CRP) all improved while the blood cultures became negative. Fluconazole is thus considered to be effective in treating PVE caused byC. glabrata. When administering this treatment, it is also important to monitor the patient's renal and liver function. 相似文献
82.
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
83.
84.
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
85.
Tadaki Yasumura MD Toshikazu Akami Manabu Mitsuo Takahiro Oka Kazuo Naitoh Takara Yamamoto Hideo Honjyo Hiroji Okada 《Surgery today》1990,20(4):369-375
The ovarian and pituitary functions of 64 operable breast cancer patients undergoing adjuvant therapy with cytotoxic chemotherapy
and/or tamoxifen were investigated. The post menopausal patients, divided into 3 treatment groups, one with tamoxifen alone,
one with tamoxifen and chemotherapy and the other with chemotherapy alone had serum estradiol 17-β (E2) and progesterone levels
lower than the evaluable limits. Although there was no significant difference in the level of estrone sulfate (E1-S) between
these three groups, the level of lutainizing hormone (LH) and follicle stimulating hormone (FSH) in the patients treated with
tamoxifen alone and tamoxifen and chemotherapy were significantly lower than those treated with chemotherapy alone. The decrease
in gonadotropin levels induced by tamoxifen treatment was reversible as it appeared after the initiation of tamoxifen and
recovered after its cessation. In the premenopausal patients, a group treated with tamoxifen and chemotherapy had significantly
higher E1-S, E2 and progesterone levels and significantly lower gonadotropin levels than a group treated with chemotherapy
alone or one treated with a cyclophosphamide regimen. These increases in the levels of estrogen and progesterone were also
reversible, and induced by tamoxifen. Thus, adjuvant endocrinochemotherapy causes profound alteration in the hypothalamo-pituitary-ovarian
axis and therefore, monitoring a variety of hormonal levels is thought to be necessary for assessing the consequences of adjuvant
therapy in breast cancer patients, especially in premenopausal patients using tamoxifen. 相似文献
86.
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
87.
Yoshito Matsui Tomoatsu Kimura Noriyuki Tsumaki Haruhiko Nakahara Nobuhito Araki Natsuo Yasui Takahiro Ochi 《Journal of orthopaedic science》1996,1(2):130-135
Recent DNA studies performed by several groups have detected mutations of the gene encoding fibroblast growth factor receptor
3 (FGFR3) in patients with achondroplasia-group disorders, including achondroplasia (ACH), hypochondroplasia (HCH), and thanatophoric
dysplasia (TD). For this study, we analyzed theFGFR3 gene in 31 Japanese patients with typical ACH, four with HCH, three with a condition intermediate between ACH and HCH (ACH/HCH-intermediate),
and one with TD. Of the 31 typical ACH patients, 29 showed a G1138 to A transition and the other two a G1138 to C transversion,
both resulting in a common Gly380Arg substitution in the transmembrane domain of FGFR3. The one TD and the four HCH patients
did not display any mutations in the transmembrane domain of FGFR3. Of the three ACH/HCH-intermediate cases, one patient showed
the Gly380Arg substitution and one did not, and further analysis of the second patient revealed the presence of Asn540Lys
substitution. The first patient was, therefore, genotypically diagnosed as ACH and the second as HCH. Peripheral blood leukocyte
DNA analysis in the remaining ACH/HCH-intermediate patient indicated an unequal ratio of mutant to normal PCR products, possibly
representing a somatic mosaic for the Gly380Arg mutation. Analysis of the common FGFR3 mutation thus appears to help in the
molecular diagnosis of patients with achondroplasia-group disorders. 相似文献
88.
Tohru Hashimoto M.D. Hironobu Nakamura Shinichi Hori Kaname Tomoda Katsuyuki Nakanishi Takamichi Murakami Takahiro Kozuka Morito Monden Mitsukazu Gotoh Chikazumi Kuroda Kenichi Wakasa Masami Sakurai 《Cardiovascular and interventional radiology》1995,18(2):82-86
Purpose: To evaluate the efficacy of transcatheter oily chemoembolization (TOCE) for hepatoceliular carcinoma (HCC) on the basis
of microscopic and macroscopic findings postembolization.
Methods: HCCs ranging in size from 0.5 to 13 cm (mean 3.6 cm) were obtained from partial hepatectomies of 100 consecutive patients
who had undergone TOCE between 20 and 246 days (mean 59.5 days) prior to surgery. The efficacy of TOCE was assessed on the
basis of the necrotic to live cell ratio of the tumors. The microscopic pattern of tumor growth was grouped into expanding
type (complete capsule formation) and replacing type (incomplete or no capsule). There were five types of macroscopic groupings:
single nodule, single nodule with extranodular growth (SNE), contiguous and noncontiguous multinodular, and massive growth
type.
Results: Among 79 cases with the expanding type, 29 (37%) had 100% HCC necrosis, but none with 100% necrosis were in the replacing
type. By macroscopic grouping, the efficacy of TOCE decreased from the single nodule type (50% of patients had 100% necrosis)
to the SNE type (21%), and the other types (9%). 相似文献
89.
Hiroshi Wanifuchi Mizuo Kagawa Mikihiko Takeshita Masahiro Izawa Kohichi Kitamura 《Child's nervous system》1988,4(6):361-364
The authors studied 34 patients with juvenile ischemic cerebrovascular disease over a 15-year period. Of the 34 patients, 23 had intracranial occlusions attributed to cerebral thrombosis or embolism and 11 had occlusions resulting from moyamoya disease. Clinicopathological features were evaluated in the 23 cases with ischemic stroke, but not those with moyamoya disease. The cause of the arterial occlusion remained undetermined in 11 patients and was found to be an embolism based on congenital heart disease in 8, on trauma in 3, and on infection in 1. Cerebral angiography was performed in 21 patients. Of these, 17 had stenoses or occlusions corresponding to their symptoms. CT scans were performed in 10 patients; the lesion in question showed no stenosis or occlusion with cerebral angiography. With regard to prognosis, patients with unknown etiology had good outcomes compared with those with congenital heart disease. With respect to acute infantile hemiplegia, 10 patients had convulsive seizures and 4 had a history of an earlier infection. Angiography and CT scans in patients with congenital heart disease demonstrated arterial occlusive sites in the middle cerebral artery region. Three patients had abscesses after their ischemic lesions. 相似文献
90.
Touraine et al reported some cases lacking HLA-class I antigens on the cell surface of their lymphocytes as "Bare lymphocyte syndrome" (BLS). Recently we experienced a case of BLS the clinical features of which are very similar to those of diffuse panbronchiolitis (DPB). Namely, she had chronic pansinusitis, diffuse nodular shadows on her chest X-ray film, obstructive impairment of pulmonary function tests and continuous increase of cold hemagglutinin titer. The pathogenesis of DPB is not confirmed. However, this case and other cases with sino-bronchial syndrome suggest that patients with DPB may have some immunodeficiencies. In addition the immunosuppressive action of erythromycin and its effectiveness on DPB were interesting. From these points of view, we discussed the relationship between this case and DPB, and the pathogenesis of DPB. 相似文献