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101.
N. Motoi Tsuyoshi Ishida Imaharu Nakano Nobu Akiyama Kinuko Mitani Hisamaru Hirai Yoshio Yazaki Rikuo Machinami 《Acta neuropathologica》1997,93(3):301-305
A 64-year-old man in a severely immunocompromised state due to acute myelogenous leukemia died, respirator-unaided, about
10 h after the abrupt onset of coma. An earlier blood culture had yielded Bacillus cereus. The autopsy, performed 2 h after death, demonstrated diffuse subarachnoid hemorrhage without berry aneurysms, and the formalin-fixed
brain was tinged with gray-brownish discoloration. The sections of the brain presented a whitish tint of the surface layer
of all portion of the cerebral cortices, even those in the sulci. Histological examination of the brain revealed leptomeningeal
B. cereus dissemination, and widespread necrosis of the leptomeninges and arachnoid vessels without inflammatory cell reaction. The
grossly recognizable whitish surface layer of the cerebral cortex showed overt hyperchromatism, and contained neurons more
degenerative than those located in the deeper cortical layer. The total absence of inflammatory reaction may be explained
by a combination of the immunocompromised state of the patient and the character of B. cereus infection, which in itself induces little inflammatory reaction. The prominent lesions were confined to the cerebral surface
layer and leptomeningeal tissue including the arachnoid vessels, which were all bathed in the cerebrospinal fluid, suggesting
that some necrotizing toxins had been secreted into the fluid by the B. cereus. The necrosis of arachnoid vessels is thought to have in turn caused diffuse subarachnoid hemorrhage and marked disturbance
of the cerebral blood flow, resulting in the terminal coma.
Received: 4 April 1996 / Revised, accepted: 8 September 1996 相似文献
102.
Tsunehiko Nishimura Masayoshi Sago Koichi Kihara Hisashi Oka Tsuyoshi Shimonagata Tetsuro Katabuchi Makoto Hayashi Toshiisa Uehara Kohei Hayashida Hiroyuki Noda Hisateru Takano 《European journal of nuclear medicine and molecular imaging》1989,15(7):341-345
To evaluate the relationship between myocardial perfusion and fatty acid metabolism in canine myocardial infarction, 16 dogs were studied using thallium and 123I--methyl-iodophenyl pentadecanoic acid (BMIPP). Eight dogs (group A) had left anterior coronary arterial occlusion (6 h ligation), 6 dogs (group B) had reperfusion (3 h ligation and 1 h reperfusion) and 2 dogs served as the normal control. Myocardial imaging with BMIPP was excellent, owing to its higher uptake and longer retention in myocardium and rapid blood disappearance in addition to diminished liver and lung uptake. The mean half time value which was generated from the BMIPP myocardial washout curve, was significantly larger in the reperfused myocardium. The gamma camera imaging showed uncoupling of BMIPP and thallium (BMIPP uptake greater than thallium uptake) in five dogs in group B. On the other hand, all dogs in group A had a persistent defect in BMIPP and thallium uptake. Our findings indicate that the combination of BMIPP and thallium for myocardial imaging supply different information about the zone of infarction and ischemia, which may be useful for the assessment of myocardial viability. 相似文献
103.
Nara S Sakamoto Y Shimada K Sano T Kosuge T Takahashi Y Onaya H Yamamoto J 《World journal of surgery》2005,29(7):885-889
Celiac axis stenosis is found at an incidence of 2%–24% in the general population. During pancreatoduodenectomy in patients
with celiac axis stenosis, division of the gastroduodenal artery from the common hepatic artery may cause acute ischemia of
the upper abdominal organs, such as the liver, stomach, or spleen. Under these circumstances, the clinical indications of
arterial reconstruction remain controversial. Between 1994 and 2003, seven patients with celiac axis stenosis (n = 4) or occlusion (n = 3) underwent pancreatoduodenectomy at our hospital. Arterial reconstruction, including division of the median arcuate ligament,
was conducted in two patients; the replaced right hepatic artery was preserved in one patient, and no vascular refinement
was undertaken in the remaining four of the seven patients. In two of the four patients without arterial reconstruction or
preservation, the serum levels of liver enzymes were markedly elevated (> 800 IU/l) on postoperative day 1, and these patients
subsequently developed liver abscesses. Two patients who underwent arterial reconstruction and three patients who showed no
decrease in intrahepatic arterial flow under Doppler ultrasonography after clamping of the gastroduodenal artery developed
no ischemic complications. Although our experience is limited, when intraoperative Doppler ultrasonography indicates a decrease
in the hepatic arterial signals, we believe that reconstruction of the hepatic artery will be necessary to minimize ischemic
complications in the liver in patients with celiac axis stenosis. 相似文献
104.
Murakami T Nobukawa Y Tabata M Ueda M Yasuda Y Suzuki H Shigemi K 《Masui. The Japanese journal of anesthesiology》2007,56(10):1214-1216
We report two cases of atraumatic iliopsoas hematoma. First patient was a 76-year-old man admitted to our hospital from appetite loss. Blood transfusion did not improve his anemia. Five days after admission, suddenly he went into shock. CT scan revealed ileopsoas hematoma. He died from hemorrhagic shock in spite of conservative therapy. Second patient was a 70-year-old man admitted because of acute heart failure. Continuous hemodiafiltration was required to relieve anuria. The next day, he developed left leg and hip pain. CT scan revealed ileopsoas hematoma and he received CT guided aspiration drainage for decompression, but almost 7 days were needed to achieve successful pain control. In a case of iliopsoas hematoma, early diagnosis and adequate choise of therapy are necessary to improve prognosis of patients. 相似文献
105.
Ayuko Yamashita Mineaki Kitamura Yohei Tateishi Kenta Torigoe Kumiko Muta Yasushi Mochizuki Tsuyoshi Izumo Takayuki Matsuo Akira Tsujino Hideki Sakai Hiroshi Mukae Tomoya Nishino 《Internal medicine (Tokyo, Japan)》2022,61(8):1133
Objective The quality of life and activities of daily living (ADL) are generally poor among dialysis patients after intracerebral hemorrhaging, and their precise clinical course remains unclear. In addition, the association between the severity of cerebral hemorrhaging and the long-term prognosis in these patients has not been fully elucidated. This study aimed to evaluate the subsequent prognosis of hemodialysis patients who survived the acute phase of intracerebral hemorrhaging. Methods We included hemodialysis patients who were admitted to Nagasaki University Hospital between 2007 and 2015 for intracerebral hemorrhaging treatment. After excluding cases of in-hospital death, survivors were classified using the 5-point modified Rankin Scale (mRS), which specifically measures the ADL in patients with cerebrovascular diseases. The patients were followed up at the medical facilities to which they were transferred in the same medical zone until 2017. Results Out of 91 patients with cerebral hemorrhaging (65±11 years old, 66% men, hemodialysis duration 108±91 months), 62 survived until discharge. Twenty-one patients died during observation, largely due to infectious diseases, such as sepsis and pneumonia (n=16, 76%). Compared to patients with mRS 0-4 (n=31), those with mRS 5 (n=31) showed a significantly poorer prognosis. The hazard ratio adjusted for age and antiplatelets was 13.7 (95% confidence interval: 3.88-63.7, p<0.001). Conclusion Hemodialysis patients with intracerebral hemorrhaging who were bedridden showed poor outcomes. The major causes of death were infections. Therefore, these patients should be carefully monitored for infections in order to improve their prognosis. 相似文献
106.
Asako Kitahara Akinori Ebihara Shohei Obayashi Yukihiro Horio Yoshitaka Ono Tomohiro Yoshikawa Naoki Okada Jun Tanaka Hiroto Takiguchi Naoki Hayama Yoko Ito Tsuyoshi Oguma Ichiro Kuwahira Koichiro Asano 《Internal medicine (Tokyo, Japan)》2022,61(8):1219
A 44-year-old man developed coronavirus disease 2019 (COVID-19) pneumonia during immunochemotherapy consisting of carboplatin, paclitaxel, and pembrolizumab for non-small cell lung cancer. Low-grade fever, followed by mild hypoxemia, and febrile neutropenia, were observed, and granulocyte colony-stimulating factor (G-CSF) was administered until the recovery of neutropenia, when he developed a high fever, severe hypoxemia, and hypotension accompanied by consolidation in the bilateral lungs. His conditions promptly improved after treatment including hydrocortisone and the primary and metastatic tumors remained regressed for 10 months without further treatment. Post-COVID-19 organizing pneumonia during cancer immunochemotherapy can be aggravated by immune-checkpoint inhibitors and G-CSF. 相似文献
107.
Naomi Takeichi Sanae Midorikawa Atsushi Watanabe Banyar Than Naing Hideki Tamura Toshiko Wakakuri‐Kano Akira Ishizaki Hitoshi Sugihara Sumiko Nissato Yuria Saito Yuichi Aita Kiyo‐aki Ishii Takehito Igarashi Yasushi Kawakami Hisato Hara Tatsuhiko Ikeda Kazuo Shimizu Shinichi Suzuki Hitoshi Shimano Masashi Kawamoto Takashi Shimada Tsuyoshi Watanabe Shinichi Oikawa Kazuhiro Takekoshi 《Clinical endocrinology》2012,77(5):707-714
108.
109.
Yukihiro Yokoyama Masato Nagino Hideki Nishio Tomoki Ebata Tsuyoshi Igami Yuji Nimura 《Journal of hepato-biliary-pancreatic sciences》2007,14(5):447-454
The clinical application of portal vein embolization (PVE) has contributed to improving the postoperative outcome of hilar cholangiocarcinoma. The enlarged nonembolized lobe after PVE protects the patient from postoperative hepatic failure, due to the increased functional reserve, and shortens the hospital stay. Although numerous reports have shown beneficial effects of PVE on postoperative outcome after extended hepatectomy, no randomized controlled study has been performed so far. It is urgent to establish a “gold standard” of PVE, because the indications, approach to the portal vein, types of embolic materials, and methods used to evaluate the function of the future liver remnant are variable among institutions. The indications and procedures of PVE for hilar cholangiocarcinoma may be different from those for hepatocellular carcinoma or colorectal metastasis, because, in many patients with hilar cholangiocarcinoma, biliary cancer is associated with biliary obstruction and cholangitis. This review article summarizes the contribution of PVE to the outcome of postoperative management in patients with hilar cholangiocarcinoma needing extended hepatectomy. We also describe our PVE procedure, which has been established from our experience of more than 240 cases of biliary cancer. Furthermore, the drawbacks of PVE, which may reduce the pool of candidates for surgery, are also discussed. 相似文献
110.
Oguma T Asano K Shiomi T Fukunaga K Suzuki Y Nakamura M Matsubara H Sheldon HK Haley KJ Lilly CM Drazen JM Yamaguchi K 《American journal of respiratory and critical care medicine》2002,165(3):382-386
Prostaglandins and thromboxanes are important modulators of airway physiology. The synthesis of these mediators depends on two isoforms of cyclooxygenase (COX), constitutive COX-1 and inducible COX-2. COX-2 expression has been observed in various inflammatory diseases, but not all aspects of the expression and the role of COX-2 in conditions of allergic inflammation such as asthma are clear. In the present study, we examined the 72-h kinetics of the expression of COX-isoform mRNA in ovalbumin-sensitized and -challenged guinea-pig lungs. The sensitized animals showed a robust and transient induction of COX-2 mRNA expression within 1 h after ovalbumin challenge, whereas their COX-1 mRNA levels remained unchanged. Upregulation of the level and activity of COX-2 protein followed the induction of COX-2 mRNA. Lung slices harvested from ovalbumin-challenged animals released more prostaglandin D(2) and prostaglandin E(2) spontaneously or in response to A23187 (10 microM) ex vivo than did those from unchallenged animals. This response was significantly blocked by the COX-2 selective inhibitors, NS-398 and JTE-522. In vivo administration of NS-398 significantly inhibited the accumulation of eosinophils and neutrophils in the lungs. In conclusion, de novo COX-2 expression during allergic inflammation modifies prostanoid synthesis in the lung and airway pathophysiology. 相似文献