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991.
Nobuyoshi Takashima Shogo Yazawa Akira Ishihara Sei-ichiro Sugimoto Kazutaka Shiomi Kenji Hiromatsu Masamitsu Nakazato 《Clinical neurology》2008,48(1):30-35
We report a 49-year-old man who was a human T-cell leukemia virus type 1 (HTLV-1) carrier, born in Okinawa prefecture where both strongyloidiasis and HTLV-1 are endemic. He presented with fever, headache and urinary retention. On the basis of CSF examination and MRI findings, his condition was diagnosed as myelitis. He received methylprednisolone pulse therapy. He was transferred to our hospital due to severe paralytic ileus. Strongyloides stercoralis (S. stercoralis) was found in the duodenal stained tissue of a biopsy specimen. Ivermectin applied both orally and through enema were ineffective because of severe ileus and intestinal bleeding. Nine mg (200 microg/kg) of ivermectin solution was administered subcutaneously every other day for five days (total amount 45 mg). The S. stercoralis burden in the stool decreased and paralytic ileus gradually resolved. Three weeks after the resolution of S. stercoralis infection, purulent meningitis developed and acute obstructive hydrocephalus appeared. The hydrocephalus improved by ventricular drainage. Approximately three months after drainage, he died of incidental aspiratory pneumonia. Autopsy showed neither eggs nor larvae of S. stercoralis in the organs. In this case, the fourth reported case in the world, subcutaneous ivermectin injection was dramatically effective. We should consider a diagnosis of strongyloidiasis for any patient from Okinawa prefecture who was an HTLV-1 carrier presenting with unknown origin ileus after treatment of steroid therapy. 相似文献
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Masayoshi Yamamoto Kinji Kamiya Tatsuo Tanaka Tomohiko Setoguchi Toshiki Kawabata Yoshihiro Hiramatsu Kenji Kondo Manabu Ohta Hiroyuki Konno 《Esophagus》2008,5(2):99-103
A 64-year-old man presented with dysphagia and heartburn. Upper gastrointestinal endoscopy showed an irregular type 2 tumor
of the lower esophagus. Histological examination of the biopsy specimen revealed undifferentiated carcinoma, small cell type.
Subtotal esophagectomy was performed. Two months after the initial surgery, an intradural extramedullary metastasis was found,
and tumorectomy was performed. Eight months after the initial surgery, lymph node metastases were found, and alternate-week
administration of CPT-11 was begun. Thirteen months after the initial surgery, an oropharyngeal metastasis was identified
for which he received radiation therapy with a total dose of 45 Gy. One month later, abdominal CT scan showed multiple liver
metastases and a left adrenal metastasis. He received CPT-11 for another 12 months, but eventually succumbed to his disease
30 months after the initial diagnosis. Our case suggests that controlling each of the recurrent lesions with various treatment
modalities might lead to prolonged survival. 相似文献
995.
The purpose of this study was to evaluate the biological features of gastric cancer of the remnant stomach (RSC). Twenty-one patients underwent resection of the remnant stomach for RSC and were divided into two groups: the RSCB group consisted of 11 patients who underwent distal gastrectomy for benign disease and the RSCM group consisted of 10 patients who underwent gastrectomy for primary gastric cancer. The interval between primary surgery and the appearance of gastric cancer in the remnant stomach was significantly shorter in the RSCM group than in the RSCB group. Invasion of adjacent organs was more frequent in the RSCM group than in the RSCB group and the Ki-67 labeling index of the tumors was significantly higher in the former group. Furthermore, p53 overexpression by tumors was almost twice as common in the RSCM group as in the RSCB group. Although there was no significant difference of the H. pylori positivity between the two groups, the rate for both groups was higher than reported in previous studies. Mutation of p53 may play an important role in the high proliferative activity of tumors in the RSCM group and H. pylori infection may be closely related to carcinogenesis in patients with RSC. 相似文献
996.
Paul Fischer Kazutaka Sugimoto David Y Chung Isra Tamim Andreia Morais Tsubasa Takizawa Tao Qin Carlos A Gomez Frieder Schlunk Matthias Endres Mohammad A Yaseen Sava Sakadzic Cenk Ayata 《Journal of cerebral blood flow and metabolism》2021,41(6):1264
Recurrent waves of spreading depolarization (SD) occur in brain injury and are thought to affect outcomes. What triggers SD in intracerebral hemorrhage is poorly understood. We employed intrinsic optical signaling, laser speckle flowmetry, and electrocorticography to elucidate the mechanisms triggering SD in a collagenase model of intracortical hemorrhage in mice. Hematoma growth, SD occurrence, and cortical blood flow changes were tracked. During early hemorrhage (0–4 h), 17 out of 38 mice developed SDs, which always originated from the hematoma. No SD was detected at late time points (8–52 h). Neither hematoma size, nor peri-hematoma perfusion were associated with SD occurrence. Further, arguing against ischemia as a trigger factor, normobaric hyperoxia did not inhibit SD occurrence. Instead, SDs always occurred during periods of rapid hematoma growth, which was two-fold faster immediately preceding an SD compared with the peak growth rates in animals that did not develop any SDs. Induced hypertension accelerated hematoma growth and resulted in a four-fold increase in SD occurrence compared with normotensive animals. Altogether, our data suggest that spontaneous SDs in this intracortical hemorrhage model are triggered by the mechanical distortion of tissue by rapidly growing hematomas. 相似文献
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999.
Sakyo Hirai Yoji Tanaka Hirotaka Sato Koichi Kato Yongson Kim Toshihiro Yamamura Kazutaka Sumita Toshinari Arai 《Journal of stroke and cerebrovascular diseases》2021,30(7):105797
ObjectivesCollateral status (CS) is considered a predictor of clinical outcome after reperfusion therapy (RT) in patients with acute ischemic stroke (AIS). We proposed a quantitative assessment of CS using cerebral blood volume (CBV) measured by computed tomography perfusion (CTP) imaging.Materials and MethodsThis retrospective study was approved by the Institutional Review Board. Between February 2019 and September 2020, 60 patients with anterior circulation large-vessel occlusion who presented to our institution within 8 h after stroke onset were included. The ratio of the average CBV values in the affected middle cerebral artery (MCA) territories to the unaffected side was defined as the CBV ratio. CS was assessed by scores from previously reported qualitative scoring systems (Tan & regional leptomeningeal collateral (rLMC) scores).ResultsThe CBV ratio was an independent factor contributing to a good functional outcome (P<0.01) and was significantly correlated with the Tan score (ρ=0.73, P<0.01) and the rLMC score (ρ=0.77, P<0.01). Among the patients with recanalization, the CBV ratio was a useful parameter that predicted both a good functional outcome (area under the receiver operating characteristic curve (AUC-ROC), 0.76; 95% CI, 0.55–0.89) and a good radiological outcome (AUC-ROC, 0.90; 95% CI, 0.72–0.97), and it was an independent predictor for good radiological outcome (OR: 4.38; 95% CI:1.29–14.82; P<0.01) in multivariate models.ConclusionsThe CBV ratio is a suitable parameter for evaluating CS quantitatively for patients with AIS that can predict patient response to recanalization. 相似文献
1000.
Shin-ei Kudo Katsuro Ichimasa Benjamin Villard Yuichi Mori Masashi Misawa Shoichi Saito Kinichi Hotta Yutaka Saito Takahisa Matsuda Kazutaka Yamada Toshifumi Mitani Kazuo Ohtsuka Akiko Chino Daisuke Ide Kenichiro Imai Yoshihiro Kishida Keiko Nakamura Yasumitsu Saiki Kensaku Mori 《Gastroenterology》2021,160(4):1075-1084.e2
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