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BACKGROUND: It has recently been reported that simultaneous multisite atrial pacing, Bachmann's bundle (BB) pacing, and coronary sinus (CS) pacing are useful for preventing the induction of atrial fibrillation (AF). HYPOTHESIS: We investigated whether a simple pacing approach via BB could reduce the induction of AF by extrastimuli (S2) from the right atrial appendage (RAA). METHODS: Programmed electrical stimulation was performed from the RAA and the area of BB at the superior aspect of the atrial septum, and bipolar recordings were obtained from the RAA, BB, and CS in 14 patients. RESULTS: In five patients, AF was induced with critically timed RAA-S2 delivered during RAA pacing. However, AF was not induced in any patient when RAA-S2 was delivered during BB pacing. The duration of the P wave during BB pacing was significantly shorter than that during RAA pacing and sinus rhythm (BB 80 +/- 16 ms vs. RAA 106 +/- 36 ms vs. sinus rhythm 100 +/- 24 ms, p < 0.05). The intra-atrial conduction time to the distal coronary sinus (CSd) caused by early S2 at the RAA was significantly reduced by BB pacing (BB 114 +/- 22 ms vs. RAA 157 +/- 35 ms, p < 0.001). CONCLUSION: Bachmann's bundle pacing reduces atrial conduction time caused by RAA-S2 and may be useful for preventing the induction of AF. 相似文献
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Noboru Takayanagi Kenichiro Hara Daidou Tokunaga Youtaro Takaku Shunsuke Minagawa Yutaka Tsuchiya Naoya Hijikata Tomohisa Yamaji Hiroo Saito Mikio Ubukata Kazuyoshi Kurashima Tsutomu Yanagisawa Yutaka Sugita 《Nihon Kokyūki Gakkai zasshi》2006,44(12):906-915
The aim of this study was to determine the etiology and outcome of community-acquired pneumonia (CAP) in relation to age and severity in hospitalized patients. Overall, 652 consecutive patients with CAP were studied retrospectively during a 4-year period from 2002. Severity of pneumonia was classified according to the guidelines of the Japanese Respiratory Society (JRS 2005) and American Thoracic Society (ATS 2001). The etiology was identified in 401 of 652 (61.5%) cases. The four most frequent pathogens were Streptococcus pneumoniae (26.2%), influenza virus (12.4%), Mycoplasma pneumoniae (10.9%), and Haemophilus influenzae (5.9%). The most common pathogen in the younger (15-44 years) group and very severe patients (JRS) was Mycoplasma pneumoniae (38.4%) and influenza virus (28.6%), respectively. The three most frequent pathogens in severe CAP patients (ATS) were Streptococcus pneumoniae (29.0%), influenza virus (17.4%), and Legionella species (13.0%). The overall mortality was 6.4%. The mortality of CAP patients among aged 1544, 45-64, 65-74, and 75 years or older was 1.4%, 3.3%, 6.9% and 9.3%, respectively. The mortality of mild, moderate, severe, and very severe patients (RS) was 0%, 4.1%, 15.5%, and 53.6%, respectively. The mortality of non-severe and severe patients (ATS) was 1.8% and 23.9%, respectively. Age and severity had influence on the prevalence of the main microbial pathogens. Streptococcus pneumoniae remained the most important pathogen that needs consideration in initial antibiotic therapy in patients with CAP of all ages and severities. Pathogens identified in patients with severe CAP in Japan were similar to those of Western countries, except for the high incidence of the influenza virus. 相似文献
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Shinji Tanaka Hiroshi Kashida Yutaka Saito Naohisa Yahagi Hiroo Yamano Shoichi Saito Takashi Hisabe Takashi Yao Masahiko Watanabe Masahiro Yoshida Yusuke Saitoh Osamu Tsuruta Ken-ichi Sugihara Masahiro Igarashi Takashi Toyonaga Yoichi Ajioka Masato Kusunoki Kazuhiko Koike Kazuma Fujimoto Hisao Tajiri 《Digestive endoscopy》2020,32(2):219-239
Suitable lesions for endoscopic treatment include not only early colorectal carcinomas but also several types of precarcinomatous adenomas. It is important to establish practical guidelines wherein preoperative diagnosis of colorectal neoplasia and selection of endoscopic treatment procedures are appropriately outlined and to ensure that actual endoscopic treatment is useful and safe in general hospitals when carried out in accordance with guidelines. In cooperation with the Japanese Society for Cancer of the Colon and Rectum, the Japanese Society of Coloproctology, and the Japanese Society of Gastroenterology, the Japan Gastroenterological Endoscopy Society compiled colorectal endoscopic submucosal dissection/endoscopic mucosal resection guidelines by using evidence-based methods in 2014. The first edition of these guidelines was published 5 years ago. Accordingly, we have published the second edition of these guidelines based on recent new knowledge and evidence. 相似文献
66.
Yoko Hiraki Satoko Miyatake Michiko Hayashidani Yutaka Nishimura Hiroo Matsuura Masahiro Kamada Takuji Kawagoe Keiji Yunoki Nobuhiko Okamoto Hiroko Yofune Mitsuko Nakashima Yoshinori Tsurusaki Hirotomo Satisu Akira Murakami Noriko Miyake Gen Nishimura Naomichi Matsumoto 《American journal of medical genetics. Part A》2014,164(1):231-236
67.
Cytologic findings and differential diagnoses of primary thyroid MALT lymphoma with striking plasma cell differentiation and amyloid deposition
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Yuri Nobuoka C.T. Mitsuyoshi Hirokawa M.D. F.I.A.C. Seiji Kuma M.D. Nozomi Takagi C.T. I.A.C. Miyoko Higuchi C.T. I.A.C. Hiroo Masuoka M.D. Akihiro Miya M.D. Sumihisa Kubota M.D. Akira Miyauchi M.D. 《Diagnostic cytopathology》2014,42(1):73-77
We report two cases of thyroid mucosa‐associated lymphoid tissue (MALT) lymphoma with associated amyloid protein deposition. While other primary thyroid neoplasms sush as medullary carcinoma and plasmacytoma with associated amyloid protein are known to occur and have been previously described by fine‐needle aspiration cytology (FNAC), to our knowledge, the current cases are the first of thyroid MALT lymphoma with amyloid deposition to be detailed in the cytopathology literature. Case 1 was a 73‐year‐old female with chronic thyroiditis. FNAC suspected MALT lymphoma. The amyloid material was not noticed, nevertheless it existed. Case 2 was a 71‐year‐old female with a nodule of the thyroid. Malignant lymphoma and medullary carcinoma were suspected by FNAC. The possibility of medullary carcinoma was excluded by a measurement of serum calcitonin and carcinoembryonic antigen. After follow‐up for two years, the nodule was diagnosed as MALT lymphoma associated with plasma cell differentiation and amyloidosis by the fourth FNAC. When we encounter small round cell tumors associated with amyloid in thyroid FNAC, we should consider not only medullary carcinoma but also MALT lymphoma. Diagn. Cytopathol. 2014;42:73–77. © 2013 Wiley Periodicals, Inc. 相似文献
68.
Alex M DAngelo Samantha Nemeth Catherine Wang Alexander P Kossar Koji Takeda Hiroo Takayama Vinayak Bapat Yoshifumi Naka Michael Argenziano Craig R Smith James Beck Jessica Spellman Paul Kurlansky Isaac George 《Interactive Cardiovascular and Thoracic Surgery》2022,34(4):556
Open in a separate window OBJECTIVESFew data exist on the use of del Nido cardioplegia in adults, specifically during operations requiring prolonged aortic cross-clamp. In this pilot study, we evaluate outcomes of patients undergoing surgery with cross-clamp time >3 h based on re-dosing strategy, using either full dose (FD; 1:4 blood to crystalloid ratio) or dilute (4:1 blood to crystalloid ratio) solution.METHODSConsecutive adult patients (>18 years) undergoing cardiac surgery from 2012 to 2018 with cross-clamp time >3 h were reviewed. Patients were excluded if del Nido cardioplegia was not used. Patients were categorized into FD or dilute groups based on re-dosing solution. Propensity score matching was used to control for baseline differences between groups. The primary endpoint was in-hospital mortality. Other outcomes examined included: postoperative mechanical support, arrhythmia, stroke, dialysis and cardiac function.RESULTSIncluded for analysis were 173 patients (115 male) with median age of 63.8 (interquartile range 53.9–73.1). Major comorbidities included diabetes (45), cerebrovascular disease (34), hypertension (131), atrial fibrillation (52) and previous cardiac surgery (83). There were 108 patients (62%) who received FD re-dosing, while 65 (38%) received dilute. A greater proportion of patients in the dilute group received retrograde delivery, for both induction (32/108 vs 39/65, P < 0.001) and re-dose (50/108 vs 53/65, P < 0.001). After propensity score matching, in-hospital mortality was not different between groups (6/48 vs 1/48, P = 0.131). There were no differences in rates of postoperative mechanical circulatory support, stroke, left ventricular ejection fraction or right ventricle dysfunction.CONCLUSIONSDel Nido cardioplegia has been used in complex cardiac surgery requiring prolonged cross-clamp. Re-dosing can be performed with either FD or dilute del Nido solution with no statistical difference in outcomes. 相似文献
69.
Atsuo Kitano Kenzo Kobayashi Hiroo Furukawa Yasutake Yamamoto Keiichi Kawai Susumu Morikawa Yoshiaki Maeda Tsuyoshi Tajima Haruki Wakasa Tadashi Yamazaki Tetsuichiro Muto Isamu Kino Hikaru Watanabe Nobuo Hiwatashi Hikoo Shirakabe Kyoichi Nakamura Noritsugi Ikeda Takanori Matsumura Moriya Yamashiro Shuji Tsuchiya Hiroshi Takemura Takeo Miyake Masami Oishi Tsuyoshi Suzaki Nobuhiro Sakaki Yukinori Okazaki Tokio Ono Michio Tanaka Shigeru Suzuki Masahiro Tada Yoshimasa Suto Shigeo Kobayashi Mamoru Nishizawa 《Journal of gastroenterology》1978,13(5):401-410
70.