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991.
Endoscopic gastrojejunostomy with survival in a porcine model 总被引:35,自引:0,他引:35
Kantsevoy SV Jagannath SB Niiyama H Chung SS Cotton PB Gostout CJ Hawes RH Pasricha PJ Magee CA Vaughn CA Barlow D Shimonaka H Kalloo AN 《Gastrointestinal endoscopy》2005,62(2):287-292
BACKGROUND: We have previously reported the feasibility and the safety of an endoscopic transgastric approach to the peritoneal cavity in a porcine model. We now report successful performance of endoscopic gastrojejunostomy with survival. METHODS: All procedures were performed on 50-kg pigs, with the pigs under general anesthesia, in aseptic conditions with sterilized endoscopes and accessories. The stomach was irrigated with antibiotic solution, and a gastric incision was performed with a needle-knife and a sphincterotome. A standard upper endoscope was advanced through a sterile overtube into the peritoneal cavity. A loop of jejunum was identified, was retracted into the stomach, and was secured with sutures while using a prototype endoscopic suturing device. An incision was made into the jejunal loop with a needle-knife, and the filet-opened ends of the jejunal wall were secured to the gastric wall with a second line of sutures, completing the gastrojejunostomy. OBSERVATIONS: Two pigs survived for 2 weeks. Endoscopy and a radiographic contrast study performed after gastrojejunostomy revealed a patent anastomosis with normal-appearing gastric and jejunal mucosa. Postmortem examination demonstrated a well-healed anastomosis without infection or adhesions. CONCLUSIONS: The endoscopic transgastric approach to create a gastrojejunostomy is technically feasible and can be performed, with survival, in a porcine model. 相似文献
992.
Zen Kobayashi Kuniaki Tsuchiya Mafuyu Takahashi Osamu Yokota Kazuhiro Taki Hideki Ishizu Tetsuaki Arai Haruhiko Akiyama Hidehiro Mizusawa 《Neuropathology》2010,30(1):76-83
A 57‐year old man with chronic alcoholism presented with apraxia of speech and disturbance of consciousness. He had a history of gastrectomy and had been drinking alcohol. The symptoms improved with administration of thiamine, but he later developed diarrhea and delirium, and died approximately 40 days after the onset. Autopsy findings were consistent with Wernicke's encephalopathy and pellagra encephalopathy. Furthermore, laminar cortical necrosis with vacuoles and astrocytosis was found in the second and third layers of the bilateral frontal cortices, suggesting Morel's laminar sclerosis. The lesions were mainly located in the bilateral primary motor cortices. Involvement of the lower part of the left primary motor cortex may be associated with apraxia of speech in our case. 相似文献
993.
Furukawa-Hibi Y Nitta A Fukumitsu H Somiya H Furukawa S Nabeshima T Yamada K 《Neuroreport》2010,21(18):1177-1181
Piccolo is one of the components of the active zone at chemical synapses and regulates the transport of synaptic vesicles. The piccolo C2A domain is an important calcium sensor and binds with phosphatidylinositol or synaptotagmin-1. Recently, clinical studies suggested that a single nucleotide polymorphism in the piccolo C2A domain might be a causal risk factor for major depression. To clarify the association of piccolo with depression, we produced a transgenic mouse overexpressing the C2A domain of piccolo, and investigated the behavior of these mice. The mice exhibited depression-like behavior in both forced swim and tail suspension tests, suggesting that piccolo might regulate the depressive behavior. 相似文献
994.
Tanvir Chowdhury Turin Yoshikuni Kita Nahid Rumana Nayouki Takashima Masaharu Ichikawa Hideki Sugihara Yutaka Morita Kunihiko Hirose Katsuyuki Miura Akira Okayama Yasuyuki Nakamura Hirotsugu Ueshima 《Journal of clinical neuroscience》2010,17(7):869-873
We explored the circaseptan variation in 28-day case-fatalities for patients with subarachnoid hemorrhage (SAH) across days of the week. Data were obtained from the Takashima Stroke Registry, which covers approximately 50 000 residents of central Japan. There were 169 first-ever SAH cases registered during the period 1988–2003 (68 in males, 101 in females). We divided the SAH cases into two groups according to the day on which the SAH occurred: “weekend” and “weekday”. The 28-day case-fatality rate and 95% confidence interval (CI) were calculated. Multiple logistic regression analysis was used to calculate the adjusted odds ratio (95% CI) for weekday fatalities by entering all relevant patient-level variables into the model. The 28-day case-fatality rate for SAH was higher on weekdays (51.7%) than on weekends (32.6%; odds ratio 2.19; 95% CI: 1.10–4.49). The differences in fatality rate persisted after adjustment for age, sex, severity, family history of stroke and patient history of hypertension, diabetes mellitus, dyslipidemia, drinking and smoking. We observed a circaseptan variation in fatalities from SAH, with higher fatality rates during weekdays in our study population. 相似文献
995.
Takehito Hananouchi Takashi Nishii Seung Bak Lee Kenji Ohzono Hideki Yoshikawa Nobuhiko Sugano 《The Journal of arthroplasty》2010
The purpose of this study was to determine whether femoral neck fracture after cemented resurfacing hip arthroplasty (RHA) arises from intraosseous vascularity around the femoral head-neck junction. We implanted a replica of the femoral head component into osteoarthritic femoral heads and compared the intraosseous vascularity network between the femoral heads with and without the RHA procedure using microangiography through a retinacular artery with micro–computed tomography. Our results showed no significant difference in the vascularity around the femoral head-neck junction between the groups with and without the RHA procedure. These results suggest that deterioration of the intraosseous vascular network around the head-neck junction after RHA was not severe enough to induce complete avascularity. 相似文献
996.
Daiki Morimoto Tetsuya Tomita Shoko Kuroda Chikahisa Higuchi Shinichi Kato Toshikazu Shiba Hironori Nakagami Ryuichi Morishita Hideki Yoshikawa 《Journal of bone and mineral metabolism》2010,28(4):418-423
The existence of inorganic polyphosphates [poly(P)] in human cells has been demonstrated. In osteoblasts, it is suggested
that the concentration of cellular poly(P) is relatively high. In this study, we examined whether poly(P) accelerates the
differentiation of human mesenchymal stem cells (hMSCs) from patients with osteoarthritis (OA) and rheumatoid arthritis (RA)
into osteoblastic cells. Alkaline phosphatase (ALP) activity was induced by poly(P) in hMSCs from both OA and RA. In Alizarin
Red S and osteocalcin EIA, there was a significant difference between the control and poly(P) group. In real-time PCR, there
was a significant difference in ALP, collagen type 1A, osteocalcin, and bone sialoprotein between the control and poly(P)
group. Our findings suggest that poly(P) have the potent role of differentiating hMSCs into osteoblastic cells at the early
and later stages of osteoblastic differentiation. 相似文献
997.
Hideki Sudo Manabu Ito Kuniyoshi Abumi Yoshihisa Kotani Masahiko Takahata Yoshihiro Hojo Akio Minami 《European spine journal》2010,19(6):907-915
The number of reports describing osteoporotic vertebral fracture has increased as the number of elderly people has grown.
Anterior decompression and fusion alone for the treatment of vertebral collapse is not easy for patients with comorbid medical
problems and severe bone fragility. The purpose of the present study was to evaluate the efficacy of one-stage posterior instrumentation
surgery for the treatment of osteoporotic vertebral collapse with neurological deficits. A consecutive series of 21 patients
who sustained osteoporotic vertebral collapse with neurological deficits were managed with posterior decompression and short-segmental
pedicle screw instrumentation augmented with ultra-high molecular weight polyethylene (UHMWP) cables with or without vertebroplasty
using calcium phosphate cement. The mean follow-up was 42 months. All patients showed neurologic recovery. Segmental kyphotic
angle at the instrumented level was significantly improved from an average preoperative kyphosis of 22.8–14.7 at a final follow-up.
Spinal canal occupation was significantly reduced from an average before surgery of 40.4–19.1% at the final follow-up. Two
patients experienced loosening of pedicle screws and three patients developed subsequent vertebral compression fractures within
adjacent segments. However, these patients were effectively treated in a conservative fashion without any additional surgery.
Our results indicated that one-stage posterior instrumentation surgery augmented with UHMWP cables could provide significant
neurological improvement in the treatment of osteoporotic vertebral collapse. 相似文献
998.
Satoshi Kawaguchi Keiko Horigome Hideki Yajima Takashi Oda Yuichiro Kii Mitsunori Yoshimoto Tsuneo Takebayashi Toshihiko Yamashita 《European spine journal》2010,19(6):901-906
To determine the role of percutaneous vertebroplasty (PVP) in bone formation and the union of vertebral pseudarthrosis, we
analyzed 14 patients with an average follow-up duration of 21 months. Evaluation methods included back pain (visual analog
scale: VAS), wedge angle, dynamic mobility, radiographic remodeling including callus and spur formation, and union status.
The Student's t test was used for statistical analysis and a probability of less than 0.05 was determined as a significant difference. Back
pain improved in all 14 patients with a VAS score of 57.8 ± 23.5 mm (average ± standard deviation) preoperatively and 14.7 ± 16.4 mm
at the final follow-up (P < 0.001). The wedge angle decreased from 21.6° ± 8.3° (average ± standard deviation) preoperatively to 13.2° ± 6.9° at the
final follow-up (P < 0.001). Callus formation was seen in four patients. Bony spurs were seen in the affected vertebra in preoperative radiographs
in all patients, and were further developed to a solidified form during follow up after PVP. Dynamic mobility of the affected
vertebrae was 6.9 ± 2.9 mm preoperatively, which decreased to 1.1° ± 0.7° at the final follow-up (P < 0.001). Notably, all patients showed the dynamic vertebral mobility of 2 mm or less. Nevertheless, only two patients exhibited
the dynamic vertebral mobility of 0 mm at the final follow-up, which is referred to as bone union. These findings indicate
that PVP serves as a mechanical stabilizer for vertebral pseudarthrosis, which leads to immediate pain relief and segmental
bony responses. 相似文献
999.
Masataka Sawaki Kazuki Yokoi Tetsuro Nagasaka Reiko Watanabe Chikara Kagawa Hideki Takada Shigenori Sato Tomohiro Yamada Toyone Kikumori Tsuneo Imai Akimasa Nakao 《Surgery today》2010,40(9):831-835
Purpose
To evaluate the frequency and prognostic importance of neuroendocrine differentiation (NED) in Japanese breast cancer patients.Methods
We used standard immunohistochemical techniques to examine 50 patients who underwent resection of breast cancer between 1988 and 1993 at the Department of Surgery II, Nagoya University Hospital, for NED, defined as positive reactivity for four markers: neuron-specific enolase (NSE), synaptophysin, CD57, and chromogranin A (CGA). Neuroendocrine differentiation was defined by the presence of at least one marker including CGA, CD57, and synaptophysin, or at least two markers when one was positive for NSE.Results
Neuroendocrine differentiation was found in 13 (26%) of the 50 patients examined. There were no significant differences in the distribution of patients with positive or negative NED in terms of age, menopausal status, tumor size, lymph node metastasis, histological grade, ER, PgR, and HER2. We calculated the cumulative survival rates of patient groups according to NED status, and found no significant difference in overall or disease-free survival between patients with and those without NED.Conclusion
Neuroendocrine differentiation was identified in a subset (26%) of Japanese breast cancer patients, but this appeared to have no relationship with established prognostic factors or patient outcome. 相似文献1000.