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61.
Shoichiro Hirose M.D. Hideo Honjou Hikohito Nakagawa Keigo Nishimura Yoshitaka Kuroda Masahiko Tsuji Atsuo Miwa Masanobu Kitagawa 《Journal of gastroenterology》1989,24(5):481-487
Clinical and pathological characteristics of scirrhous carcinoma of the stomach were studied in 106 cases treated by gastrectomy
between 1973 and 1983. The male to female ratio was 0.58. The percentage of scirrhous carcinomas to all gastric carcinomas
resected in the same period was three times higher in females than males. The age distribution of the patients suggested that
there were two peaks in the forties and sixties in the male, and in the thirties and fifties in the female. The incidence
of scirrhous carcinoma in all types of gastric carcinoma was significantly higher in the twenties, thirties and forties compared
to the lowest incidence in the seventies. In the female group the primary lesion had a tendency to be adjacent to the fundic
gland area and to avoid intestinal metaplasia. In the male the opposite was recognized. Cancer nests with single cells or
only several cells were common in this type of carcinoma. These findings suggest that there might be two biologically different
scirrhous carcinomas both in the male and the female, the appearance of single carcinoma cells might be favored by female
sex hormones and young ages, and not only the original gastric mucosa but also mucosa with intestinal metaplasia could be
precursors of single carcinoma cells. 相似文献
62.
Kami M Tanaka Y Kanda Y Ogawa S Masumoto T Ohtomo K Matsumura T Saito T Machida U Kashima T Hirai H 《Haematologica》2000,85(7):745-752
BACKGROUND AND OBJECTIVES: Blood and radiologic tests are frequently used for diagnosis of invasive pulmonary aspergillosis, but it remains unknown which is more useful for its early diagnosis. Aim of the study was to compare usefulness of computed tomographic (CT) scan of chest, latex agglutination (LA) test and determination of plasma (1-->3)-beta-D-glucan (BDG) levels for early diagnosis of invasive pulmonary aspergillosis (IPA). DESIGN AND METHODS: We treated 215 consecutive patients who underwent cytotoxic chemotherapy. From initiation of chemotherapy until death or discharge, blood samples were taken weekly and subjected to LA and BDG tests. We performed chest CT scans when patients had any signs of pulmonary infection or an antibiotic-resistant fever. RESULTS: Of the 215 patients, 30 (14. 0%) were diagnosed as having IPA. In sixteen cases the diagnosis was definite and in 14 it was suspected. In patient-based analysis, sensitivities of LA and BDG were 44% and 63%, respectively. Sensitivity tended to be lower in patients with IPA localized to the lung than those with disseminated invasive aspergillosis. Specificities were 93% and 74%, respectively. Either a halo or an air-crescent was observed in 7 of the 16 patients with IPA, and all of the IPA patients showed some abnormal signs on chest CT scans. On average, CT scan signs preceded a positive LA test by 7.1 days and a positive BDG assay by 11.5 days. In 6 of the 11 patients who became positive for either LA or BDG assay, CT scan signs preceded the positive results by more than seven days. INTERPRETATION AND CONCLUSIONS: Chest CT scan is more beneficial than the blood tests and X-ray for early diagnosis of IPA. 相似文献
63.
64.
Takahiro Shoji Takehiko Tarui Takashi Igarashi Yuki Mochida Hiroyuki Morinaga Yasuhiko Miyakuni Yoshitaka Inoue Yasuhiko Kaita Hiroshi Miyauchi Yoshihiro Yamaguchi 《The Journal of emergency medicine》2018,54(4):410-418
Background
Bleeding from hemorrhagic shock can be immediately controlled by blocking the proximal part of the hemorrhagic point using either resuscitative thoracotomy for aortic cross-clamping or insertion of a large-caliber (10–14Fr) resuscitative endovascular balloon occlusion of the aorta (REBOA) device via the femoral artery. However, such methods are very invasive and have various complications. With recent progress in endovascular treatment, a low-profile REBOA device (7Fr) has been developed.Objective
The objective of this study was to report our experience of this low-profile REBOA device and to evaluate the usefulness of emergency physician?operated REBOA in life-threatening hemorrhagic shock.Methods
Ten patients with refractory hemorrhagic shock underwent REBOA using this device via the femoral artery. All REBOA procedures were performed by emergency physicians. The success rate of the insertion, vital signs, and REBOA-related complications were evaluated.Results
Median age was 54 years (interquartile range 33–78 years). The causes of hemorrhagic shock were trauma (n = 4; 1 blunt and 3 penetrating), ruptured abdominal aortic aneurysm (n = 3), and obstetric hemorrhage (n = 3). Two patients had cardiopulmonary arrest upon arrival. REBOA procedure was successful in all patients, and all became hemodynamically stable to undergo definitive interventions after REBOA. There were no REBOA-related complications. The mortality rate within 24 h and 30 days was 40%.Conclusions
This REBOA device was useful for emergency physicians in life-threatening hemorrhagic shock because of its ease in handling and low invasiveness. 相似文献65.
Shingo Nasu Kunimitsu Kawahara Yuki Han Norio Okamoto Yoshitaka Tamura Hidekazu Suzuki Takayuki Shiroyama Yumiko Samejima Tomohiro Kanai Yoshimi Noda Ayako Tanaka Naoko Morishita Kayo Ueda Shoji Hashimoto Tomonori Hirashima Takayuki Nagai 《Internal medicine (Tokyo, Japan)》2021,60(3):445
Miliary tuberculosis is a potentially lethal type of tuberculosis that results from the hematogenous dissemination of Mycobacterium tuberculosis bacilli. We herein describe the case of a 34-year-old man that presented with a one-month history of cough and fever, while his sputum smear results were negative. Chest computed tomography revealed bilateral centrilobular ground-glass opacification (GGO), suggestive of hypersensitivity pneumonitis; thus, bronchoscopy was performed. Cryobiopsy specimens revealed necrotic granulomas. A re-examination of sputum after bronchoscopy identified Mycobacterium tuberculosis, and miliary tuberculosis was diagnosed. A cryobiopsy might be useful for diagnosing miliary tuberculosis pathologically, particularly when miliary nodules may be masked by GGO. 相似文献
66.
Pulmonary sarcoidosis with associated bloody pleurisy 总被引:1,自引:0,他引:1
Watarai M Yazawa M Yamanda K Yamamoto H Yamazaki Y 《Internal medicine (Tokyo, Japan)》2002,41(11):1021-1023
A 64-year-old man was admitted to our hospital complaining of non-productive cough and right chest pain. Chest radiographs showed bilateral hilar lymphadenopathy, diffuse granular nodules and right pleural effusion. Serum angiotensin-II-converting enzyme and lysozyme levels were elevated. Since thoracentesis indicated bloody pleurisy, video-assisted thoracoscopy was performed and revealed multiple white nodules on both the visceral and parietal pleura. Resected pleural biopsy specimens showed non-caseous granulomas. Furthermore, some nodules were observed to compress and involve small vessels and capillaries. The bloody pleurisy was assumed to have been derived from the rupture of small vessels that had been compressed and affected by the granuloma with sarcoidosis. 相似文献
67.
Shigemoto Yoko Matsuda Hiroshi Kimura Yukio Chiba Emiko Ohnishi Masahiro Nakaya Moto Maikusa Norihide Ogawa Masayo Mukai Yohei Takahashi Yuji Sako Kazuya Toyama Hiroshi Inui Yoshitaka Taki Yasuyuki Nagayama Hiroshi Ono Kenjiro Kono Atsushi Sekiguchi Kenji Hirano Shigeki Sato Noriko 《Annals of nuclear medicine》2022,36(5):460-467
Annals of Nuclear Medicine - Although previous studies have investigated age and gender effects on striatal subregional dopamine transporter (DaT) binding, these studies were mostly based on a... 相似文献
68.
Unusual trihydroxy bile acids in the urine of patients treated with chenodeoxycholate, ursodeoxycholate or rifampicin and those with cirrhosis 总被引:1,自引:0,他引:1
T Nakashima A Sano Y Seto T Nakajima T Shima Y Sakamoto T Okuno K Kashima T Hasegawa 《Hepatology (Baltimore, Md.)》1990,11(2):255-260
Urinary bile acids from 20 patients treated with chenodeoxycholate, 18 treated with ursodeoxycholate, 15 treated with rifampicin and 8 patients with advanced cirrhosis were analyzed by gas-liquid chromatography and gas-liquid chromatography-mass spectrometry. Occurrence rates and amounts of three so-called unusual trihydroxy bile acids, hyocholate, ursocholate and omega-muricholate, were increased in patients treated with chenodeoxycholate, ursodeoxycholate or rifampicin and decreased in cirrhotic patients as compared with those in untreated healthy adults. These data suggest that chenodeoxycholate and ursodeoxycholate are hydroxylated to produce unusual trihydroxy bile acids in bile acid-loaded humans and that this metabolism may be related to the induction of hepatic microsomal enzymes by rifampicin. In contrast, the hydroxylation of chenodeoxycholate and ursodeoxycholate may be impaired by severe hepatic damage. Because the urine is a secretory pathway for internal bile acids, the occurrence of unusual trihydroxy bile acids in the urine may be used as an indicator of hepatic ability to metabolize "hydrophobic" dihydroxy bile acids to their secretory forms. 相似文献
69.
Cough variant asthma is known as a major cause of chronic cough. Fundamental features of cough variant asthma are prolonged nonproductive cough responding to bronchodilator therapy, no history of wheezing or dyspnea attack, normal cough sensitivity, and slightly increased bronchial responsiveness. Animal model of cough variant asthma has not been reported. The aim of this study was to establish an animal model for studying detailed pathophysiology of cough variant asthma. Bronchial responsiveness to methacholine and cough reflex sensitivity to capsaicin were measured 72 hours after antigen (ovalbumin, OA) inhalation in actively sensitized guinea pigs. Next, cough number and specific airway resistance (sRaw) were measured during 20 minutes following reinhalation of OA solution, which was carried out 72 hours after the first OA inhalation, and then total cell number and cell differentials in bronchoalveolar lavage fluid (BALE) were measured. Bronchial responsiveness to methacholine, but not cough reflex sensitivity to capsaicin, was significantly increased 72 hours after the first inhalation of OA solution. Number of coughs, sRaw and total cell number in BALF increased significantly by the OA reinhalation, and the cough number and the increase in sRaw were significantly suppressed by beta2 agonist, procaterol. FK224, a specific neurokinin (NK) receptor antagonist, did not significantly influence the OA reinhalation-induced cough and increase in sRaw and total cell number in BALF in this model In conclusion, pathophysiologic feature of this animal model is similar to that of clinical cough variant asthma. Tachykinins may not play an important part in antigen-induced cough associated with bronchoconstriction and airway inflammation in cough variant asthma. 相似文献
70.
Yoshitaka Morimatsu Hiroya Akiyoshi Hisamichi Aizawa 《Kansenshōgaku zasshi. The Journal of the Japanese Association for Infectious Diseases》2003,77(3):174-177
We report a case of septicemia type Vibrio vulnificus infection. The patient was a 74-year-old man who had liver cirrhosis and hepatocelluler carcinoma. He felt a pain in the right femoral lesion after eating raw shellfish (Japanese "Umitake") two days ago. He was admitted to our emergency center due to his shock status and thrombocytopenia two days after the onset. We diagnosed necrotizing fasciitis due to Vibrio vulnificus infection, his life was saved by emergency amputation of the right lower extremity. The culture of the blood and vesicle fluid showed Vibrio vulnificus. There are some reports that the debridement was effective to necrotizing fasciitis due to Vibrio vulnificus infection, but these reports are all about single upper extremity lesion. As far as we know, this is the second report of lower extremity necrotiaong fasciitis due to septicemia type Vibrio vulnificus infection rescued by extremity amputation in Japan. The mortality of septicemia type Vibrio vulnificus infection with necrotizing fasciitis is very high, this is quite a valuable report in making a decision for therapy of septicemia type Vibrio vulnificus infection. 相似文献