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21.
Takehiko Shimoyama Katsuo Yoshiya Yasushi Yamato Teruaki Koike Keiichi Honma 《General thoracic and cardiovascular surgery》2009,57(6):310-314
Malignant peripheral nerve sheath tumors (MPNSTs; malignant schwannomas) rarely occur in the anterior mediastinum, and their
prognosis is poor. A 75-year-old man was referred to our hospital for examination of an anterior mediastinal tumor. A computed
tomography-guided percutaneous needle biopsy revealed only fibrosis. The tumor was completely excised via a median sternotomy
with partial resection of the pericardium and right upper lobe of the lung. Thereafter, the tumor was diagnosed as a storiform-pleomorphic
type of malignant fibrous histiocytoma. At 1 year after the surgery, a distant metastasis was found in the interlobular space
between the right middle and lower lobes. The tumor was completely excised via a right posterolateral thoracotomy. Reexamination
of the primary and secondary tumors revealed an MPNST. No recurrence was found up to 5 years after the second surgery without
adjuvant chemotherapy or radiation therapy. However, he died from multiple lung metastases after 6 years. 相似文献
22.
Takao Kamezaki Kiyoyuki Yanaka Keishi Fujita Kazuhiro Nakamura Yasushi Nagatomo Tadao Nose 《Journal of clinical neuroscience》2004,11(3):311-313
Subdural hygroma is a frequent delayed complication of head trauma. Most hygromas are clinically 'silent' and a few cases have shown slow deterioration in the chronic stage. We report a case of subdural hygroma showing unique radiological findings and rapid deterioration. A 74-years-old female presented with a mild headache and consciousness disturbance after head injury. Computed tomography showed a midline shift as a result of two components piling up in the subdural space; the outer components showed low density, the inner components high density. Magnetic resonance imaging demonstrated that these two subdural components were subdural hygroma and subarachnoid hematoma. Simple burr hole irrigation, rather than large craniotomy, was thought to be more appropriate treatment to reduce the mass effect. Simple burr hole irrigation was performed to remove the subdural hygroma and the patient showed an excellent recovery. Careful examination of the radiological findings prevented an unnecessary procedure in this case. A possible mechanism of this phenomenon is discussed. 相似文献
23.
24.
Tokio Yamaguchi Masahiko Miyata Wataru Kamiike Yasushi Kobayashi Hikaru Matsuda 《Surgery today》1997,27(5):420-428
To clarify the histological status of the pancreas tail after pancreatoduodenectomy (PD), fibrosis, islets of Langerhans,
and A, B, and D cells were examined histometrically in surgical cases of pancreatic cancer. The same investigations were also
performed during an autopsy examination of the pancreas tail of survivors of surgery who had received either PD or total pancreatectomy
with segmental autotransplantation (SAT). In the surgical cases, fibrosis and the islet percentage compared with nonpancreatic
cancer cases were significantly higher while the B cell ratio was significantly lower. In addition, in pancreatic cancer patients,
the fibrosis and islet ratio in the group with a blocked pancreatic duct were higher while the B cell ratio was lower than
in the group with an open pancreatic duct. A direct relationship between the islet ratio and the degree of fibrosis, and an
inverse relationship between the B cell ratio and the degree of fibrosis, were thus found. From the autopsy cases, the fibrosis
progressed and the islet ratio increased following PD, but after SAT only the islet ratio increased compared to the time of
surgery. The progression of fibrosis after PD thus suggests the presence of some problems in both the surgical method and
postoperative management. 相似文献
25.
Chinori Kurata MD PhD Sakae Shouda MD Tadashi Mikami MD Yasushi Wakabayashi MD Tomoyasu Nakano MD Tsuyoshi Sugiyama MD Kei Tawarahara MD PhD Kazuyuki Sakata MD PhD 《Journal of nuclear cardiology》1997,4(6):515
Background. [123I]Metaiodobenzylguanidine (MIBG) imaging has been used to assess cardiac sympathetic nerve abnormalities. We evaluated the clinical significance of myocardial MIBG imaging as a measure of cardiac sympathetic nervous system function by comparing it to heart rate variability and plasma norepinephrine level.Methods and Results. In 211 subjects, we analyzed heart rate variability with 24-hour electrocardiography, performed scintigraphy with MIBG, and measured plasma norepinephrine levels. Time and frequency domain measures of heart rate variability were calculated with the Marquette heart rate variability program (Marquette Electronics, Milwaukee, Wis.). Early and late myocardial MIBG uptakes were measured at 15 and 150 minutes after injection, respectively. MIBG clearance rate from the heart and heart-to-lung and heart-to-mediastinum ratios of MIBG activities were calculated. On the whole, heart rate variability, including low-frequency power, correlated positively, but modestly so, with late MIBG uptake and negatively with MIBG clearance rate. The plasma norepinephrine level correlated negatively with late MIBG uptake and with heart rate variability, including low-frequency power, and positively with MIBG clearance rate. Similar correlations were also observed in patient subgroups with coronary artery disease, diabetes mellitus, and renal failure, but these correlations were weak (R2 < 0.5).Conclusions. Increased cardiac sympathetic nervous system activity may be associated with increased myocardial MIBG clearance and decreased heart rate variability, including low-frequency power. Because these associations were not strong, however, the combination of heart rate variability with MIBG may allow an interactive assessment of the cardiac autonomic nervous system. 相似文献
26.
Axonal regeneration after transection is a complex biological process. It is not merely a process of tissue repair, but rather
of cellular repair of a large number of nerve cells. Regeneration involves restoration of the original morphology of each
single cell, rather than proliferation. Techniques in microneurosurgical reconstruction of peripheral nerve injuries have
improved over the last two decades, with subsequent improvement in functional results. Nerve autografts are now routinely
used to guide the regrowth of the proximal nerves to distal nerve segments. However, the limited source of expendable cutaneous
nerves restricts the use of nerve grafting techniques and is associated with significant morbidity. With extensive injuries
there is an insufficient quantity of nerve autograft material to facilitate optimal repair. In future, the use of artificial
conduits or nerve allografts could provide a limitless source of material to reconstruct otherwise irreparable traumatic nerve
injuries. Establishment of appropriate strategies to suppress host-immune reaction or donor antigenicity would facilitate
clinical allogeneic nerve transplantation.
Guest lecture presented at the 69th Annual Meeting of the Japanese Orthopaedic Association in Tokyo on April 13, 1996. 相似文献
27.
Ikuo Konishi M.D. Kanako Nanbu M.D. Masaki Mandai M.D. Yuko Tsuruta M.D. Nobuhiko Kataoka M.D. Yasushi Nagata M.D. Takahide Mori M.D. 《Gynecologic oncology》1998,70(3):365-371
Objective.To identify the clinicopathological and chemoresistant factors predicting the response to neoadjuvant chemotherapy and the patient prognosis in high-risk cervical carcinomas.Methods.We retrospectively reviewed 47 patients with locally advanced or bulky cervical carcinoma treated with two courses of intraarterial infusion of cisplatin, doxorubicin, mitomycin C, and 5-fluorouracil (5-FU), followed by radical hysterectomy at our hospital between 1988 and 1995. Expressions of the chemoresistance-related proteins, such as P-glycoprotein, glutathioneS-transferase π (GST-π), and proliferating cell nuclear antigen (PCNA) in the tumor cells, were examined by immunohistochemistry using pretreatment biopsy specimens. These results were compared with the chemotherapeutic response, which was evaluated by magnetic resonance imaging (MRI) and histopathology. Outcome of the patients was also studied.Results.Chemotherapeutic effect of either complete (CR) or partial (PR) response on MRI was obtained in 36 of the 47 (86%) patients. Poor response to chemotherapy was significantly correlated with P-glycoprotein expression (P< 0.005) and low PCNA labeling (P< 0.05), but not GST-π expression in the tumor cells. Independent prognostic factors for patient survival were parametrial involvement and lymph node metastasis. Neither the expression of GST-π nor PCNA was correlated with the patient survival.Conclusion.Assessment of the expression of P-glycoprotein and PCNA is potentially useful for the prediction of tumor response to neoadjuvant chemotherapy for cervical carcinomas. 相似文献
28.
29.
INAUGURAL ARTICLE by a Recently Elected Academy Member:Characterization of a 34-kDa soybean binding protein for the syringolide elicitors
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Cheng Ji Carol Boyd David Slaymaker Yasushi Okinaka Yoji Takeuchi Sharon L. Midland James J. Sims Eliot Herman Noel Keen 《Proceedings of the National Academy of Sciences of the United States of America》1998,95(6):3306-3311
Syringolides are water-soluble, low-molecular-weight elicitors that trigger defense responses in soybean cultivars carrying the Rpg4 disease-resistance gene but not in rpg4 cultivars. 125I-syringolide 1 previously was shown to bind to a soluble protein(s) in extracts from soybean leaves. A 34-kDa protein that accounted for 125I-syringolide 1 binding activity was isolated with a syringolide affinity-gel column. Partial sequences of internal peptides of the 34-kDa protein were identical to P34, a previously described soybean seed allergen. In soybean seeds, P34 is processed from a 46-kDa precursor protein and was shown to have homology with thiol proteases. P34 is a moderately abundant protein in soybean seeds and cotyledons but its level in leaves is low. cDNAs encoding 46-, 34-, and 32-kDa forms of the soybean protein were cloned into the baculovirus vector, pVL1392, and expressed in insect cells. The resulting 32- and 34-kDa proteins, but not the 46-kDa protein, exhibited ligand-specific 125I-syringolide binding activity. These results suggest that P34 may be the receptor that mediates syringolide signaling. 相似文献
30.
Naoaki Takemoto Hiroaki Kuroda Yoshinobu Nakamura Takashi Ichiba Naruto Matsuda Yasushi Ashida Takafumi Hamasaki Yohichi Hara Shingo Ishiguro Tohru Mori 《Surgery today》1996,26(3):179-183
The effects of calcium (Ca) on a hyperkalemic cardioplegic solution for continuous cardioplegia were examined in an isolated perfused working rat heart model. The coronary arteries were perfused with a modified Krebs-Henseleit bicarbonate buffer (K-H) solution, containing various concentrations of Ca(0.1, 0.6, 1.2, and 2.5 mmol/l) and a high concentration of potassium (20 mmol/l), for 180 min, after which cardiac arrest was induced at 37°C for 180 min. Cardiac function and creatine kinase (CK) were measured. In the control group, K-H solution was infused in place of the cardioplegic solution, and cardiac arrest was not induced. No significant differences were observed between the groups infused with the K-H solution containing Ca concentrations of 0.6, 1.2, and 2.5 mmol/l in the percent recovery of aortic flow (82.1±2.9%, 80.6±2.0%, and 71.5±3.7% (mean±SEM) respectively) or in the recovery of other indices of cardiac function, or in CK leakage. There were also no significant differences in the recovery of cardiac function and CK leakage between these groups and the control group. In the Ca 0.1 mmol/l group, however, the characteristic Ca paradox was observed. These findings suggest that if the Ca concentration in a cardioplegic solution is higher than 0.6 mmol/l during continuous cardioplegia, excellent cardioprotective effects will be achieved. 相似文献