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41.
Shuro Yoshino Takayuki Matsumoto Koichi Kurahara Hiroyuki Kobayashi Mitsuo Iida Tadahiko Fuchigami 《Digestive endoscopy》2006,18(1):59-61
We present a 70‐year‐old man who had two episodes of melena during the preceding 8‐year period. He had a Dieulafoy‐like lesion in a diverticulum in the third portion of the duodenum. While emergency endoscopy revealed neither apparent blood nor clots around the diverticular orifice, there was a non‐bleeding vessel in the fundus of the diverticulum. The vessel ceased bleeding after argon plasma coagulation and, since then, the patient has not experienced bleeding. In cases of gastrointestinal bleeding of obscure origin, duodenal diverticulum should be considered as a possible source of bleeding, even when endoscopy discloses no apparent bleeding. 相似文献
42.
A rare case of osteochondritis dissecans (OCD) occurring in the humeral head is presented. As there are only six available records in the literature concerning OCD in the humeral head, clinical features, treatment, and etiology of OCD involvement of this anatomical part remains unclear. These points are discussed on the basis of the previous cases and ours. Osteochondritis dissecans of the humeral head commonly affects middle-aged and young males rather than females. The prevalent location of involvement is the anterosuperior aspect of the humeral head. We propose that repetitive microtrauma is one of the important causes of OCD in the humeral head. Moreover, we suggest that the most authentic treatment for OCD with a partial detached osteochondral fragment is removal of this fragment and drilling. 相似文献
43.
Clinical evaluation of a potassium nitrate dentifrice for the treatment of dentinal hypersensitivity
Toshihiko Nagata Hiroshi Ishida Hiroyuki Shinohara Seiji Nishikawa Shinji Kasahara Yoichi Wakano Shusaku Daigen Emanuel S. Troullos 《Journal of clinical periodontology》1994,21(3):217-221
Abstract The effectiveness of a 5% potassium nitrate dentifrice as a daily home treatment for dentinal hypersensitivity was evaluated in a double-blind study in 36 Japanese subjects who complained of cold and/or tactile hypersensitivity. The subjects were divided into 2 groups, with 18 being given a 5% potassium nitrate dentifrice (treated group) and the other 18 a vehicle paste (control group). Both groups were instructed to brush their teeth 2 × a day. The hypersensitivity levels of the affected teeth were assessed by 2 stimuli, one tactile and the other cold air, and by the perception of pain. The results of all 3 assessment methods indicated that the potassium nitrate dentifrice significantly decreased the level of hypersensitivity at weeks 4, 8, and 12. In the treated group, a rapid decrease of positive scores for both the cold air stimulus and the subjective symptoms appeared from week 2. Although a significant decrease of the assessment score was also observed in the control group, the reduction rate of the score was much greater in the treated group by ail 3 assessment methods at weeks 4, 8, and 12. Complete relief of subjective symptoms throughout the 12 weeks’examination was noted in 67% of the subjects in the treated group, but in only 6% in the control group. These results suggest the usefulness of a 5% potassium nitrate dentifrice in Japanese patients with dentinal hypersensitivity. 相似文献
44.
Hiroyuki Yamashita MD Katsuhiko Kawakami Eiichirou Murakami Syoji Kuroki 《Surgery today》1990,20(2):229-233
A rare case of primary linitis plastica carcinoma of the colon seen in a 44 year old Japanese man is described herein. The
patient had a complete obstruction of the descending colon and was treated with a loop colostomy followed shortly afterward
by a left hemicolectomy. At the time of the second operation, the entire thickness of the colonic wall was found to be infiltrated
by cancer cells, however, the other intraabdominal organs were free of cancerous involvement. The histopathological diagnosis
made at this time was primary linitis plastica carcinoma of the descending colon. Nine months later, the patient developed
an intestinal obstruction and relaparotomy revealed diffuse peritoneal dissemination. Two years after the first operation,
upper GI films and a gastrofiberscopic examination revealed gastric involvement. The patient died 28 months after his initial
operation, and autopsy revealed widespread metastases in the peritoneal surface, paraaortic lymph nodes, small intestine,
remaining colon and stomach. 相似文献
45.
Yuko Takeyama Keiki Ogino Hiroyuki Segawa Haruo Kobayashi Taizo Uda Tatsuya Houbara 《Basic & clinical pharmacology & toxicology》1995,76(1):50-55
Abstract: The effects of zinc on the production of active oxygen species were investigated in rat neutrophils by chemilumi-nescence and spectrophotometric assays. The luminol-dependent chemiluminescence in unstimulated neutrophils showed a single peak. Zinc at concentrations lower than 0.1 mM augmented the intensity of chemiluminescence and showed a bimodal pattern, the first peak of which was inhibited by superoxide dismutase and catalase, while the second peak disappeared in the presence of catalase, but was unaffected by superoxide dismutase. At the same concentrations of zinc, O2? and H2O2 production increased, but secretion and activity of myeloperoxidase were not affected. Zinc at 0.1 mM enhanced the second peak of luminol-dependent chemiluminescence, and concomitantly O2? and H2O2 production of neutrophils stimulated with formyl-methionyl-leucyl-phenylalanine. Homogenized neutrophils showed a bimodal pattern on induction by zinc, the second peak of which was inhibited slightly by catalase and completely by sodium azide, but was not inhibited by superoxide dismutase. Zinc-induced O2? production was inhibited by pertussis toxin, but was not significantly inhibited by a protein kinase C inhibitor, 1-(5-isoquinolinesulfonyl)-2-methylpiperazine dihydrochloride (H-7), or a calmodulin antagonist, N-(6-aminohexyl)-5-chloro-1-naphthalenesulfonamide (W-7). These results suggest that zinc can augment luminol-dependent chemiluminescence by increasing O2? production through the classical signal transduction pathway, and by increasing H2O2 not via O2?. 相似文献
46.
Kentaro Yamashita Hiroyuki Tsukuda Yasuyo Mizukami Jun Ito Shigeo Ikuta Yoshihiro Kondo Hiroshi Kinoshita Yasunori Fujisawa Kohzoh Imai 《Journal of gastroenterology》1997,32(5):684-688
A case of hepatic infarction with portal thrombosis is reported. A 63-year-old woman with liver cirrhosis and esophageal varices
was admitted for treatment of the esophagel varices. Endoscopic variceal ligation (EVL) and endoscopic injection sclerotherapy
(EIS) were performed. Two months later, she experienced right hypochondralgia and right flank pain. Serum transaminase levels
were suddenly elevated, and computed tomography scans of the liver showed multiple small nodular lesions. Her condition worsened,
and she died of hepatic failure. Autopsy revealed splenic and portal vein thrombosis, multiple hepatic infarction, and evidence
of chronic pancreatitis. We believe that liver cirrhosis and chronic pancreatitis were the main risk factors for the portal
thrombosis, and the treatment for esophageal varices appeared to have triggered the thrombosis. The hepatic infarction was
caused by the portal thrombosis. 相似文献
47.
Tsutomu Saito Hiroyuki Horimi Tsuguo Hasegawa Toshiro Kamoshida 《Surgery today》1993,23(12):1081-1084
We report herein the case of a 42-year-old man in whom dyspnea on exertion was found to be caused by isolated tricuspid stenosis. Two-dimensional echocardiogram showed thickening of the tricuspid valve with a markedly enlarged right atrium. A color-flow Doppler examination-revealed severe tricuspid stenosis without regurgitation and a Doppler-derived tricuspid diastolic pressure gradient of 23 mmHg. At the time of surgery, the patient was noted to have a stenotic tricuspid valve with thickened leaflets, fused commissures, and almost normal chorda tendineae. The valve leaflets were teased apart to the scattered specimen, and tricuspid valve replacement was successfully performed. Microscopic examination of the specimen demonstrated infective endocarditis. Isolated acquired tricuspid stenosis is extremely rare and, to our knowledge, this is the first case of infective endocarditis being involved as the primary cause. 相似文献
48.
T Yamaguchi S Kikuchi H Doi A Watanabe M Ebuoka 《[Zasshi] [Journal]. Nihon Kyōbu Geka Gakkai》1990,38(9):1538-1542
A 71-year-old woman was admitted to our hospital by ambulance, because of right chest pain and hypotension. Chest X-ray and standard 12-lead ECG showed mirror-image dextrocardia with situs inversus totalis. ECG with right-left reversal of all leads showed acute inferior myocardial infarction. The patient underwent coronary bypass surgery due to postinfarction angina, and she is now doing well 2 years following the operation. Mirror-image dextrocardia with situs inversus totalis is very unusual. But the patients are believed to have normal longevity, and presumably have an incidence of atherosclerotic coronary artery disease similar to the general population. To our knowledge, this is the first case of coronary bypass surgery on a patient with mirror-image dextrocardia in Japan. 相似文献
49.
Hiroyuki Ishizu Masatoshi Takahashi Yukifumi Kondo Akihiko Kataoka Takashi Nakamura Kuniaki Okada Hiroyuki Masuko Yasunori Nishida Hideaki Ogawa Ryoji Yokoyama Yutaka Kimura 《Surgery today》1997,27(3):285-287
Magnetic resonance cholangiopancreatography (MRCP) was performed in 35 patients to evaluate the feasibility of its use as a postsurgical imaging technique after resection of the pancreas. The surgical procedures performed were: pancreatoduodenectomy in 22 patients, segmental pancreatectomy in 1, distal pancreatectomy in 7, and pyroluspreserving pancreatoduodenectomy in 5. The pancreatic duct was shown in its entirety in 24 of the 35 patients (68.6%) and was partially visualized in 8 patients (22.9%), but the intrahepatic and extrahepatic bile ducts were visualized completely in all patients. Furthermore, MRCP was able to demonstrate lesions in 3 of 6 patients who had shown clinical evidence of recurrence. The visualization of the pancreatic and bile duct system was satisfactory despite anatomical changes brought about by resection of the pancreas. Thus, we conclude that MRCP is an appropriate follow-up screening test for patients with suspected abnormalities of the biliary and pancreatic duct system. 相似文献
50.
Japan Pancreatoduodenectomy Study Group Ryo Hosotani Masafumi Kogire Tadahiro Takada Hiroyuki Kato Takahiko Funabiki Masumasa Horisawa Takeshi Morimoto Takukazu Nagakawa Toshimichi Nakayama Itsuo Miyazaki Masayuki Imamura 《Journal of Hepato-Biliary-Pancreatic Surgery》1997,4(3):295-303
Endocrine tumor of the pancreas is potentially malignant. A multicenter analysis of these tumors was conducted to clarity
the present status of their surgical management and the subsequent long-term surgical results. The Japan pancreatoduodenectomy
(JPD) study group carried out the study; 368 patients were enrolled and variables related to tumor characteristics, surgery,
and survival were retrospectively analyzed. There were 222 patients with functioning tumor and 143 patients with nonfunctioning
tumor. Malignant tumor was found in 140 of 368 (38%) of the patients, and 63/140 (45%) of these patients had metastatic lesion;
the most common site of the metastasis was liver 34/136 (25%), followed by regional lymph nodes 26/136 (19%). Pancreatic resection
was performed in 91% of patients with nonfunctional tumor and in 83% of those with malignant tumor, and 73% of the pancreatic
resections were done with lymph node dissection. The overall 5-year actuarial survival rate was 76% in patients with malignant
tumor. The actuarial 5-year survival rate was 93% in the patients without metastasis and 83% in patients who received curative
resection. Multivariate analysis showed that the presence or absence of synchronous metastasis was the sole significant prognostic
factor. The results suggest that: (i) malignant endocrine tumor of the pancreas is a curable malignancy when pancreatic resection
with lymph node dissection is adopted and (ii) that synchronous metastasis is the dominant prognostic factor.
This study was carried out as a group project. The authors' institutions are as follows 相似文献