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991.
Yoshitaka T Abe N Minagawa H Date H Sakoma Y Nishida K Ozaki T 《Modern rheumatology / the Japan Rheumatism Association》2008,18(4):359-365
We prospectively evaluated the disease-specific features of the early postoperative plasma D: -dimer value and the relationship with deep venous thrombosis and/or pulmonary thromboembolism (DVT/PE) in 95 patients following total knee arthroplasty. Patients in whom DVT/PE was highly suspected were diagnosed by high-resolution multi-detector row computed tomography scanning (MDCT). Forty-nine knees in 46 patients with rheumatoid arthritis (RA, 24 knees) or osteoarthritis (OA, 25 knees) were finally recruited. DVT/PE was detected in 28 (57.1%) of the 49 cases examined by diagnostic MDCT: 12 (50.0%) of the 24 cases of RA, and 16 (64.0%) of the 25 cases of OA. Of these, PE was found in 11 cases (39.2%), but none of them showed clinical symptomatic signs of dyspnea or chest pain. In both RA and OA cases, there were statistically significant differences in the D: -dimer value on postoperative day 3 (P = 0.027) and after day 28 (P = 0.037) between the groups with and without DVT/PE. In OA cases, there were significant differences between the two groups on postoperative days 1 (P = 0.034), 3 (P = 0.020), 5 (P = 0.005), and 7 (P = 0.045), respectively. At the baseline, perioperative D: -dimer levels in the RA group without DVT/PE were higher than in the OA group. However, multivariate logistic regression analysis showed that RA was not a significant risk factor of DVT/PE in comparison with OA. In conclusion, individual evaluation of the D: -dimer level between RA and OA should provide a more precise predictive indicator of early postoperative DVT/PE. 相似文献
992.
Acute myocardial infarction caused by "malignant" anomalous right coronary artery detected by multidetector row computed tomography. 总被引:4,自引:0,他引:4
Minoru Ichikawa Sei Komatsu Hiroshi Asanuma Akio Iwata Tamayo Ishiko Atsushi Hirayama Young-Jae Lim Kazuhisa Kodama Masayoshi Mishima 《Circulation journal》2005,69(12):1564-1567
Anomalous coronary arteries are usually identified incidentally by angiography or autopsy, but some "malignant" coronary anomalies are associated with a high incidence of syncope, arrhythmia, myocardial infarction, and sudden death. So far, the pathogenesis of the coronary events in such cases has only been revealed by autopsy. In the present case report, a patient with anomalous origin of the right coronary artery from the left sinus of Valsalva developed acute myocardial infarction, and visualization of the anomaly and assessment of the culprit plaque in the artery were done by multidetector row computed tomography and intravascular ultrasound. 相似文献
993.
Kitayama D Yoshidome H Mitsuhashi N Ito H Kimura F Shimizu H Ohtsuka M Miyazaki M 《Hepato-gastroenterology》2004,51(59):1326-1329
We describe a 66-year-old man having hepatocellular carcinoma with tumor thrombus extending into the inferior vena cava and synchronous pulmonary metastasis. He was referred to Chiba University Hospital on May, 2000, complaining of emaciation. Radiological findings showed a huge hepatocellular carcinoma in the entire right lobe and tumor thrombus extended into the intrapericardial inferior vena cava. He also had a solitary pulmonary metastasis in the left pulmonary lobe (stage IVB). Right hemihepatomy was performed under total hepatic vascular exclusion without cardiopulmonary bypass, and tumor thrombus was completely removed. Thoracoscopic wedge resection of pulmonary metastasis was also performed. The patient had an uneventful postoperative course. Histopathological examination revealed that the tumor was moderately differentiated hepatocellular carcinoma The patient is still alive after 26 months with pulmonary recurrence, but without hepatic recurrence. To our knowledge, there has been no reported case of resection for both hepatocellular carcinoma invading the inferior vena cava and synchronous pulmonary metastasis. In conclusion, aggressive surgical resection for advanced hepatocellular carcinoma concomitant with pulmonary resection may bring about better prognosis in highly selected patients. 相似文献
994.
Ohnishi H Saitoh S Takagi S Ohata J Isobe T Kikuchi Y Takeuchi H Shimamoto K 《Atherosclerosis》2002,164(1):167-170
We investigated the relationship between insulin-resistance (IR) and remnant-like particle cholesterol (RLP-C) using 472 subjects (174 men and 298 women) randomly selected from inhabitants of two rural communities in Japan, Tanno and Sobetsu. The level of fasting immunoreactive insulin (FIRI), fasting blood glucose (FBS), total cholesterol (TC), triglyceride (TG), HDL cholesterol, LDL cholesterol, and RLP-C were measured in each subject. Homeostasis model assessment (HOMA-R) was used as an indicator of IR. The subjects were divided into two groups according to the value of HOMA-R: an IR group of subjects with HOMA-R > approximately equal to 1.73 and a normal (NR) group of subjects with HOMA-R <1.73. There was a significant positive correlation between HOMA-R and RLP-C. The value of RLP-C was higher in the IR group than in the NR group (7.1 vs. 3.9 mg/dl in men and 5.3 vs. 3.6 mg/dl in women). The frequency of hyper RLP cholesterolemia (RLP-C > approximately equal to 7.5 mg/dl) was higher in the IR than in the NR group (23.7 vs. 6.6% in men and 20.3 vs. 6.6% in women). The results of multiple regression analysis showed that HOMA-R was closely related to RLP-C. The results of this study suggest that RLP-C is closely associated with IR syndrome. 相似文献
995.
Yulin Liao Hui Zhao Akiko Ogai Hisakazu Kato Masanori Asakura Jiyoong Kim Hiroshi Asanuma Tetsuo Minamino Seiji Takashima Masafumi Kitakaze 《Hypertension research》2008,31(2):335-344
The aim of this study was to investigate whether atorvastatin inhibits epidermal growth factor receptor (EGFR) activation in cardiomyocytes in vitro and slows the progression of cardiac remodeling induced by pressure overload in mice. Either atorvastatin (5 mg/kg/day) or vehicle was orally administered to male C57BL/6J mice with transverse aortic constriction (TAC). Physiological parameters were obtained by echocardiography or left ventricular (LV) catheterization, and morphological and molecular parameters of the heart were also examined. Furthermore, cultured neonatal rat cardiomyocytes were studied to clarify the underlying mechanisms. Four weeks after TAC, atorvastatin reduced the heart/body weight and lung/body weight ratios (8.69+/-0.38 to 6.45+/-0.31 mg/g (p<0.001) and 10.89+/-0.68 to 6.61+/-0.39 mg/g (p<0.01) in TAC mice with and without atorvastatin, respectively). Decrease of LV end-diastolic pressure and the time constant of relaxation, increased fractional shortening, downregulation of a disintegrin and metalloproteinase (ADAM)12, ADAM17 and heparin-binding epidermal growth factor genes, and reduction of the activity of EGFR and extracellular signal-regulated kinase (ERK) were observed in the atorvastatin group. Phenylephrine-induced protein synthesis, phosphorylation of EGFR, and activation of ERK in neonatal rat cardiomyocytes were all inhibited by atorvastatin. These findings indicated that atorvastatin ameliorates cardiac remodeling in mice with pressure overload, and its actions are associated with inhibition of the EGFR signaling pathway. 相似文献
996.
Aoyama T Shimizu T Matsuo T Sakamoto H Kamata K Higashihara M Tsuji H Shigematsu H Kobayashi Y 《Internal medicine (Tokyo, Japan)》2002,41(6):458-462
A 37-year-old woman had been found to have proteinuria in October 1996. About 8 months later, the first renal biopsy was performed, revealing focal segmental necrotizing and crescentic glomerulonephritis. At that time, serum creatinine was 1.0 mg/dl and urinary protein 3+. In October 1999, laboratory tests revealed positivity for MPO-ANCA and a serum creatinine level of 1.42 mg/dl, anemia and proteinuria of 2+. A second renal biopsy showed almost the same histological findings. Accordingly, a diagnosis of MPO-ANCA positive glomerulonephritis was made. This patient was thought to be a rare case of MPO-ANCA-positive slowly progressive glomerulonephritis presenting focal segmental tuft necrosis and crescents. 相似文献
997.
Tetsutaro Nagaoka Yasuhiro Setoguchi Masashi Muramatsu Noriyuki Honma Takashi Danbara Hideaki Miyamoto Hiroshi Izumi Toshimasa Uekusa Yoshinosuke Fukuchi 《Nihon Kokyūki Gakkai zasshi》2002,40(6):525-529
A 71-year-old man was referred to our hospital complaining of cough. Chest radiography revealed a mass opacity in the right upper lung field. A transbronchial biopsy specimen revealed non-specific inflammatory changes. Percutaneous lung aspiration biopsy under ultrasound guidance demonstrated gram-positive rods, suggesting actinomyces. On the diagnosis of pulmonary actinomycosis, the patient was treated with penicillin-G and his symptoms were relieved. In a three-month follow-up, the mass shadow in the right upper lung field was found to have increased in size. Squamous cell lung cancer was diagnosed on the basis of repeated transbronchial tumor biopsies, and right upper lobectomy was performed. Most cases of pulmonary actinomycosis have been diagnosed from post-surgical tumor specimens taken on suspicion of the presence of lung cancer. However, the lung cancer in this case was difficult to diagnose because the lung cancer was co-existent with pulmonary actinomycosis. 相似文献
998.
Matsushima Y Kinoshita Y Fukui H Maekawa T Yazumi S Okada A Nakase H Kawanami C Iwano M Hashimoto K Takeda Z Okazaki K Chiba T 《Journal of gastroenterology》2002,37(6):428-433
Background:
Background: Although Helicobacter pylori eradication is effective in treating low-grade gastric mucosa-associated lymphoid tissue (MALT) lymphoma, the condition in
some patients deteriorates even after the eradication. Therefore, it is important to predict the disease outcome before starting
H. pylori eradication. We investigated the usefulness of flow cytometry, quantifying CD19- and CD20-positive B lymphocytes in MALT lymphoma
tissue, for predicting the disease outcome after H. pylori eradication.
Methods: Tissue specimens from 14 patients with H. pylori-positive low-grade gastric MALT lymphoma were examined by histology, Southern blotting, and flow cytometry before therapy.
Serum levels of soluble interleukin (IL)-2 receptor were also measured. The relationship between the data and the prognosis
after H. pylori eradication was analyzed.
Results: Remission occurred in 10 of the 14 patients. The condition in the 4 remaining patients deteriorated even after H. pylori eradication. The percentages of CD19- and CD20-positive cells in MALT lymphoma tissue from the patients in remission were
both significantly lower than those in the tissue from patients not in remission. Indeed, 4 of the 5 patients in whom both
CD19- and CD20-positive cells accounted for more than 50% of the total number of lymphocytes had gastrectomy, whereas all
patients in whom both CD19- and CD20-positive cells accounted for less than 50% of the total number of lymphocytes achieved
remission. Although immunoglobulin gene rearrangement was present in all patients operated on, there were also 6 patients
whose MALT lymphoma was ameliorated in spite of the presence of gene rearrangement. The serum level of soluble IL-2 receptor
was in the normal range in all patients tested.
Conclusions: Analysis of mature B-cell markers in MALT lymphoma tissue is more useful than the examination of immunoglobulin gene rearrangement
or serum levels of soluble IL-2 receptor in predicting the outcome of low-grade gastric MALT lymphoma after H. pylori eradication.
Received: January 5, 2001 / Accepted: November 2, 2001 相似文献
999.
Nakamura Nobuo Nonogi Hiroshi Miyazaki Shunichi Nakanishi Norifumi Yoshioka Kimio Haze Kazuo Hiramori Katsuhiko 《Heart and vessels》1993,8(1):23-32
Summary To assess left ventricular diastolic properties in response to dynamic exercise, mitral inflow velocity integrals were measured
by pulsed-wave Doppler echocardiography in ten patients with myocardial infarction and in ten normal subjects, and simultaneous
left ventricular pressure was obtained with micromanometry in the patients. Early filling velocity integrals were maintained
in the patients during exercise. Late filling velocity integrals were not augmented during exercise in the patients, but were
increased in the normal subjects. In the patients, there was an increase in mitral valve opening pressure, left ventricular
end-diastolic pressure, and the time constant of left ventricular isovolumic pressure decay. The lowest diastolic pressure
and the number of time constants that had elapsed before the lowest diastolic pressure remained unchanged.
These results show that in patients with myocardial infarction, early filling is maintained by an increase in driving pressure
during exercise, despite incomplete relaxation. Augmentation of late filling, seen in normal subjects, is impaired in patients
with myocardial infarction, probably due to an increase in left ventricular stiffness. 相似文献
1000.
Hasegawa D Fukushima M Hosokawa Y Takeda H Kawasaki K Mizukami T Nunoi H Ochiai H Morio T Kosaka Y 《International journal of hematology》2008,87(1):88-90
Allogeneic hematopoietic stem-cell transplantation (HSCT) for chronic granulomatous disease (CGD) with a reduced-intensity
conditioning regimen can be expected to lead to less therapy-related mortality and late-onset impairment, whereas it has also
been reported to increase the risk of unsustained mixed donor chimerism and late rejection after transplantation. Herein,
we report a 4-year-old boy with CGD who was successfully treated with unrelated bone marrow transplantation with a reduced-intensity
conditioning regimen (RIC). Fludarabine-based RIC, 4 Gy of total body irradiation, 120 mg/kg of cyclophosphamide, and 125 mg/m2 of fludarabine, was adopted for transplantation, followed with 8.9 × 108/kg mononucleated donor cells infused without T-cell depletion. Although hematopoietic engraftment was rapidly obtained by
day +17, he developed unstable donor chimerism. After tacrolimus withdrawal, the patient showed grade III acute graft-versus-host
disease (GVHD), and subsequently reached full donor chimerism by day +61. Twelve months post-transplant, the patient has remained
well with stable and durable engraftment, 100% donor chimerism, and normal superoxide production, without the requirement
of donor lymphocyte infusions (DLI). 相似文献