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排序方式: 共有1912条查询结果,搜索用时 15 毫秒
71.
Kazunori Masahata Noriaki Usui Kouji Nagata Keita Terui Masahiro Hayakawa Shoichiro Amari Kouji Masumoto Tadaharu Okazaki Noboru Inamura Naoto Urushihara Katsuaki Toyoshima Keiichi Uchida Taizo Furukawa Manabu Okawada Akiko Yokoi Hiroomi Okuyama Tomoaki Taguchi 《Pediatric surgery international》2020,36(6):669-677
This study aimed to elucidate the clinical characteristics of neonates with congenital diaphragmatic hernia (CDH) associated with pneumothorax and evaluate the risk factors for the development of pneumothorax. A retrospective cohort study was conducted in the 15 institutions participating in the Japanese CDH Study Group. A total of 495 neonates with isolated CDH who were born between 2011 and 2018 were analyzed in this study. Among the 495 neonates with isolated CDH, 52 (10.5%) developed pneumothorax. Eighteen (34.6%) patients developed pneumothorax before surgery, while 34 (65.4%) developed pneumothorax after surgery. The log-rank test showed that the cumulative survival rate was significantly lower in patients with pneumothorax than in those without pneumothorax. Univariate analysis revealed significant differences between patients with pneumothorax and those without pneumothorax with regard to the best oxygenation index within 24 h after birth, mean airway pressure (MAP) higher than 16 cmH2O, diaphragmatic defect size, and need for patch closure. Multiple logistic regression analysis indicated that only the MAP was associated with an increased risk of pneumothorax. The cumulative survival rate was significantly lower in isolated CDH patients with pneumothorax than in those without pneumothorax. A higher MAP was a risk factor for pneumothorax in CDH patients. 相似文献
72.
T. Yokoi Norio Hirabayashi Masafumi Ito Yutaka Uno Toyonori Tsuzuki Yasushi Yatabe Yoshihisa Kodera 《Virchows Archiv : an international journal of pathology》1997,431(4):275-282
We identified eight patients with bronchiolitis obliterans (BO) in the autopsies of 81 bone marrow transplant (BMT) recipients.
Rapidly progressive dyspnoea and cough were the main presenting symptoms in all eight patients, associated with overinflation
and/or infiltrative opacity seen on chest X-ray and obstructive disorder revealed by pulmonary function tests. Early lesions
were characterized by epithelial loss and an inflammatory infiltrate containing foamy histiocytes with mild luminal narrowing.
Partial or total occlusion of the bronchiolar lumina by fibrous connective tissue was the feature of late lesions. Both changes
were coexistent in all cases. In one case, small bronchi with cartilage were also affected by the obstructive process, showing
bronchitis obliterans. All eight patients showed non-obstructive broncho-bronchiolitis characterized by denuding of respiratory
epithelium, mural oedema and an inflammatory infiltrate in addition to BO, and these changes were also seen in 18 patients
without BO. The submucosal glands of large bronchi and the trachea showed mucous retention and a mild inflammatory infiltrate
in four of the eight patients. Coexistent infectious processes were seen in all cases, cytomegalovirus and Aspergillus being
the most frequent organisms. BO probably develops as an immunopathological event related to graft-versus-host disease (GVHD)
during the impaired immune status phase of the post-BMT period, possibly initiated by infection. Bronchial gland involvement
in chronic GVHD is one of the factors responsible for this abnormal immune status.
Received: 14 January 1997 / Accepted: 5 March 1997 相似文献
73.
74.
Yoshifumi Kawarada M.D. F.A.C.S. Shuji Isaji M.D. Hiroki Taoka M.D. Masami Tabata M.D. Bidhan Chandra Das M.B.B.S. Hajime Yokoi M.D. 《Journal of gastrointestinal surgery》1999,3(4):369-373
Recently we have been performing S4a + S5 with total resection of the caudate lobe (SI) by using a dome-like dissection along
the root of the middle hepatic vein at the pinnacle, which we refer to as the Taj Mahal liver parenchymal resection, for carcinoma
of the biliary tract. This procedure offers the following advantages: (1) It allows total resection of the caudate lobe, including
the paracaval portion (S9), and (2) because the cut surface of the liver is large, it allows intrahepatic jejunostomy to be
performed more easily with a good field of view. The indications for this procedure include hilar bile duct carcinoma, gallbladder
carcinoma, and choledochal cyst (type IVA). Because of the high rate of hilar liver parenchyma and caudate lobe invasion associated
with hilar bile duct carcinoma, the liver must be resected. The Taj Mahal procedure is indicated in cases where extended liver
resection is impossible. The dissection limits of this procedure are, on the left side, the B2 + 3 bifurcation at the right
margin of the umbilical portion of the portal vein and, on the right side, the B8 of the anterior branch and the B6+7 bifurcation
of the right posterior branch. This procedure could also be described as a reduced form of extended right hepatectomy and
extended left hepatectomy. For gallbladder carcinoma, this procedure is indicated to ensure an adequate surgical margin and
eradicate transvenous liver metastasis, particularly in cases of pT2 lesions. Hilar and caudate lobe invasion also occurs
in liver bed-type gallbladder carcinoma, and bile duct resection and caudate lobe resection are required for the surgery to
be curative. We performed this procedure in four cases of hilar bile duct carcinoma, five cases of gallbladder carcinoma,
and one case each of choledochal cyst (type IVA) with carcinoma of the bile duct and gallbladder adenomyomatosis. Curative
resection was possible in all except the patient with adenomyomatosis, and all of the patients are alive and recurrence free
10 to 37 months postoperatively. This procedure, in addition to preserving liver function, provides a wide field of view and
facilitates reconstruction of multiple intrahepatic bile ducts. Thus it can be said to be a curative operation not only in
patients considered high risk but also in those whose hilar bile duct carcinoma is limited to the bifurcation area (Bismuth
type IIIa and IIIb) and in gallbladder carcinoma up to pT2 with slight extension on the hepatic side.
Presented at the Thirty-Ninth Annual Meeting of The Society for Surgery of the Alimentary Tract, New Orleans, La., May 17–20,
1998 (poster presentation). 相似文献
75.
Isao Yokoi Hidehiko Komatsu 《Experimental brain research. Experimentelle Hirnforschung. Expérimentation cérébrale》2010,202(1):247-251
Previous studies have shown that neurons in layer 6 of V1 are activated by visual stimuli that induce perceptual filling-in at the blind spot (BS). As the main target of layer 6 neurons is the lateral geniculate nucleus (LGN), we speculate that the cortico-geniculate projection is involved in mediating filling-in at BS. To begin to test that hypothesis, we examined whether there is an anatomical basis for integration of visual signals from both sides of BS by cortico-geniculate feedback neurons in V1. We injected an anterograde tracer into a site adjacent to the region representing BS. We observed that numerous axons traverse the neuron-free gap that retinotopically corresponds to BS within LGN. This indicates that visual signals from one side of BS are conveyed to the opposite side via a feedback connection. Cortico-geniculate feedback projection may integrate visual signals from around BS and contribute to perceptual filling-in at BS. 相似文献
76.
Shingo Komura Tatsuo Yokoi Yasushi Suzuki 《Journal of orthopaedics and traumatology》2011,12(1):65-68
We describe a patient with palmar-divergent dislocation of the scaphoid and lunate. After successful closed reduction, the
scapholunate and lunotriquetral ligaments were sutured through the dorsal approach, and the anterior capsule was sutured through
the palmar approach. The scapholunate and lunotriquetral joints were fixed with Kirschner wires for 7 weeks. At the 1-year
follow-up, magnetic resonance imaging showed no evidence of avascular necrosis of the scaphoid or lunate, and radiographs
showed no evidence of the dorsal and volar intercalated segment instability patterns associated with carpal instability. However,
flexion of the scaphoid and a break in Gilula’s line remained. To our knowledge, this is the first report showing treatment
of palmar-divergent dislocation of the scaphoid and lunate by suturing the carpal interosseous ligaments. 相似文献
77.
Tranilast is an oral antiallergic agent widely used in Japan. Recently, in Western populations, hyperbilirubinemia induced by tranilast was suspected during clinical trials. Tranilast has been reported to be mainly metabolized to a glucuronide and a phase I metabolite, 4-demethyltranilast (N-3). In the present study, we investigated the in vitro metabolism of tranilast in human liver and jejunum microsomes and recombinant UDP-glucuronosyltransferases (UGTs). The glucuronidation of tranilast was clarified to be mainly catalyzed by UGT1A1 in human liver and intestine. The K(m) values of tranilast glucuronosyltransferase activity were 51.5, 50.6, and 38.0 microM in human liver microsomes, human jejunum microsomes, and recombinant UGT1A1, respectively. The V(max) values were 10.4, 42.9, and 19.7 pmol/min/mg protein in human liver microsomes, human jejunum microsomes, and recombinant UGT1A1, respectively. When the intrinsic clearance was calculated using the in vitro kinetic parameters, microsomal protein content, and weight of tissues, tranilast glucuronosyltransferase activity was 2.5-fold higher in liver than in intestine. Tranilast glucuronosyltransferase activity was strongly inhibited by bilirubin, a typical UGT1A1 substrate, and N-3, indicating that the phase I metabolite could affect the tranilast glucuronosyltransferase activity. In the case of N-3 formation, the K(m) and V(max) values were 37.1 microM and 27.6 pmol/min/mg protein in human liver microsomes. The bilirubin glucuronosyltransferase activity was strongly inhibited by both tranilast and N-3, suggesting that tranilast-induced hyperbilirubinemia would be responsible for the inhibition by tranilast and N-3 of the bilirubin glucuronosyltransferase activity, as would the UGT1A1 genotype. 相似文献
78.
Daniela Medeiros Milhomem Cardoso Paulo Moacir de Oliveira Campoli Chizu Yokoi Flávio Hayato Ejima Paulo Adriano de Queiroz Barreto Alexandre Menezes de Brito Eliane Duarte Mota Ailton Cabral de Fraga Junior Orlando Milhomem da Mota 《Gastric cancer》2008,11(4):226-232
Background Endoscopic resection is an adequate treatment for subgroups of patients with early gastric cancer. Endoscopic submucosal dissection
(ESD) represents a recent advance and leads to good results when adequately indicated. There is great experience with this
technique in Japan and it is gaining acceptance among Western endoscopists. We present the first gastric ESD series performed
in Brazil.
Methods Patients with well-differentiated adenocarcinomas macroscopically classified as early cancer, less than 30 mm with no ulcer
or scar, were included. ESD was performed with an insulated-tip knife and electrosurgical unit with endocut mode. Clinicopathological
aspects and morbidity were evaluated. The study was approved by the local ethics committee and informed consent was obtained
from all participant subjects.
Results From October 2005 to July 2007, 160 patients received surgical treatment for gastric cancer; 44 patients (27.5%) had early
gastric cancer. In this latter group, 15 procedures (ESD) were performed in 12 patients. The mean size of the lesions was
16.8 mm. Almost half of the lesions were located in the proximal third of the stomach and the mean elapsed time for the procedure
was 140 min. In 80% of the cases resection was en bloc and 80% of the resections were considered curative. We had three perforations,
which were managed clinically, and no bleeding.
Conclusion When adequately indicated, ESD is a safe and feasible technique. 相似文献
79.
Yokoi N Kinoshita S Bron AJ Tiffany JM Sugita J Inatomi T 《Investigative ophthalmology & visual science》2000,41(12):3748-3753
PURPOSE: To elucidate the effect of the cotton thread test (CT-T) and Schirmer test (S-T) on the tear reservoir by evaluating the radius of tear meniscus curvature. METHODS: The radii (R) of the central lower tear menisci were measured by a newly developed video meniscometer in 11 eyes of 11 normal volunteers (6 men, 5 women; mean age, 27.7 +/- 3.6 years [SD]) and 9 eyes of 9 patients with tear deficiency and severe dry eye in whom the puncta had been therapeutically occluded (9 women; mean age, 50.6 +/- 10.4 years). In this dry eye group, the absence of reflex tearing, coupled with the absence of lacrimal drainage due to punctal occlusion allowed more precise observation of the removal of tears from the meniscus. A 1-minute CT-T was performed, followed after an interval of 10 minutes by a 1-minute S-T. Tear meniscus curvature was documented before (R:(0)) and during the tests at 30 seconds (R(30)) and 60 seconds (R:(60)). RESULTS: In the normal group, respective R values (CT-T; S-T; mean +/- SD mm) were R(0) (0.26 +/- 0.11; 0.26 +/- 0. 07), R(30) (0.27 +/- 0.16; 0.20 +/- 0.13), and R(60) (0.29 +/- 0.15; 0.23 +/- 0.21); and in the dry eye group, respective R: values (CT-T; S-T) were R(0) (0.59 +/- 0.23; 0.51 +/- 0.19), R(30) (0.52 +/- 0.25; 0.22 +/- 0.09), and R(60) (0.51 +/- 0.19; 0.21 +/- 0.08). It was demonstrated in the dry eye group that R was diminished more by the S-T than by the CT-T in the time course of the measurement (P = 0.01). In the dry eye group alteration of R occurred within the first 30 seconds, and in this group significant correlation was found between R(0) and the S-T result (r = 0.67; P = 0.05), and between R(60)- R(0) and the S-T result (r = -0.81; P = 0.01). Also, there was a significant correlation between R(60)- R(0) and the S-T result in the normal group (r = 0.71; P = 0.02). There were no significant correlations between R(0) or R(60)- R(0) and the CT-T results in either group. CONCLUSIONS: These studies afford some insight into the dynamics of the Schirmer test, suggesting that wetting is influenced by the negative hydrostatic pressure within the tear meniscus. With the protocol used, no conclusion could be drawn about the relation between meniscus radius and wetting of the cotton thread. 相似文献
80.
PURPOSE: To investigate the relationship between the radius of tear meniscus curvature (TMR) and tear meniscus height (TMH). METHODS: Twenty-nine eyes of dry-eye patients (all left eyes; two males, 27 females, aged 26 to 85 years [mean +/- SD; 60 +/- 14.4]) were enrolled in the study. TMR was measured at the tear meniscus of the central lower lid with a newly developed videomeniscometer. At the same region of the eye, TMHs were measured without fluorescein (TMH-M) and after 5 minutes with fluorescein (TMH-MF), using a slit lamp equipped with a micrometer. TMHs were also measured on cross-sectional photographs of the fluorescein-stained meniscus (TMH-P). RESULTS: The values of TMR, TMH-M, TMH-MF, and TMH-P (mean +/- SD, mm) were 0.22 +/- 0.09, 0.19 +/- 0.09, 0.21 +/- 0.14, and 0.24 +/- 0.09, respectively. There was significant correlation between TMR and TMH-M, TMH-MF, and TMH-P values (TMR versus TMH-M: r = 0.596, p = 0.0005; TMR versus TMH-MF: r = 0.587, p = 0.0006; TMR versus TMH-P: r = 0.605, p = 0.0003). CONCLUSION: There is a significant correlation between TMR and TMH. Videomeniscometry has some merits over conventional methods for obtaining tear meniscus parameters. 相似文献