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141.
Uchino H Asano T Nakayama N Kuroda S Houkin K 《No shinkei geka. Neurological surgery》2011,39(1):59-63
The authors present the case of a 61-year-old male with a de novo fusiform vertebral artery aneurysm, probably due to non-traumatic dissection. He underwent flow diversion therapy, using a double overlapping technique, because the origin of the contralateral vertebral artery was stenotic. Placement of two stents resulted in marked reduction of blood flow in the aneurysm. Postoperative course was uneventful. Follow-up 3D-CT angiography revealed a patent blood flow in the stent and a gradual progression of intra-aneurysmal thrombosis. Flow diversion therapy can potentially obliterate the complicated cerebral aneurysm with the preservation of blood flow in the parent artery, and would be one of the important therapeutic options in patients with complicated aneurysms in which conventional strategies such as neck clipping, endovascular coiling and parent artery occlusion are not feasible or contraindicated. 相似文献
142.
Nakashima K Shimanuki T Uchino H Nakamura C 《Kyobu geka. The Japanese journal of thoracic surgery》2000,53(10):867-869
We report a successful case of active infective endocarditis due to Methicilin-Resistant Staphylococcus aureus (MRSA). A 2-year-old girl who had a ventricular septal defect (VSD) complained of persistent fever. Echocardiography showeda large vegetation on the tricuspid valve and a small VSD. She underwent vegetectomy, tricuspid valvoplasty and direct closure of VSD. Vancomycin treatment was also effective to abolish infection. She was discharged without any complication. 相似文献
143.
Motoi Uchino Hiroki Ikeuchi Toshie Tsuchida Kazuhiko Nakajima Naohiro Tomita Yoshio Takesue 《World journal of surgery》2009,33(5):1042-1048
Background It is generally believed that the accompanying conditions in patients with inflammatory bowel disease (IBD) are associated
with a high incidence of surgical site infection (SSI), and sometimes these patients are classified as compromised hosts without
definitive clinical evidence. The aim of this study was to clarify the impact of IBD on the occurrence and features of SSI
in patients with clean-contaminated wounds.
Methods We conducted prospective SSI surveillance of 580 patients with clean-contaminated wounds who underwent surgery between March
2006 and December 2007 using the National Nosocomial Infection Surveillance system. Multivariate analyses using stepwise logistic
regression were performed to determine risk factors for SSI.
Results A total of 562 patients with clean-contaminated wounds who underwent surgery for IBD [ulcerative colitis (UC), n = 173; Crohn’s disease (CD), n = 122] or colorectal cancer [(CA), n = 267] were identified for evaluation. SSI was observed in 12.6% of all patients and there was no significant difference
in infection rate by type of disease (UC, 14.5%; CD, 13.9%; CA, 10.9%). Multivariate logistic regression analysis yielded
an ASA score ≥3 [odds ratio (OR) = 2.04; 95% confidence interval (CI) = 1.06–3.93] and rectal surgery (OR = 2.35; 95% CI = 1.28–4.31)
as independent risk factors for SSI. IBD surgery was not an independent risk factor for overall SSI (OR = 1.62; 95% CI = 0.94–2.80).
However, there was a significant difference in the incidence of incisional SSI [IBD, 11.9% (UC, 12.7%; CD, 10.7%); CA, 4.9%,
p = 0.003]. In the analysis of rectal surgery, the incidence of incisional SSI was 5.3% in CA patients, 12.0% in UC patients,
and 26.3% in CD patients. In contrast to overall SSI data, IBD surgery was found to be an independent risk factor for incisional
SSI (OR = 2.59; 95% CI = 1.34–5.03).
Conclusions In patients of surgery restricted to clean-contaminated wounds, IBD was shown to be an independent risk factor for incisional
SSI. With the use of proper operative procedures and techniques, the incidence of organ/space SSI should not be high in patients
who undergo an uncomplicated IBD surgical procedure. 相似文献
144.
Yamashita H Noguchi S Moriyama T Takamatsu Y Sadanaga K Uchino S Watanabe S Ogawa T 《Surgery》2005,137(4):419-425
BACKGROUND: We hypothesized that impaired peripheral sensitivity to parathyroid hormone (PTH) may play a role in reelevation of PTH after successful operation for primary hyperparathyroidism (pHPT). METHODS: Factors affecting reelevation of PTH were determined in 90 patients who underwent parathyroidectomy for pHPT. PTH/nephrogenous cyclic adenosine monophosphate ratio, as an index of renal resistance to PTH, was examined in relation to factors shown to influence reelevation of PTH. RESULTS: Serum PTH levels were elevated above the upper limit of normal in 23 patients (26%) at 1 week and in 39 patients (43%) at 1 month after parathyroidectomy. These 39 normocalcemic patients with elevated serum PTH at 1 month after parathyroidectomy had a higher preoperative serum level of PTH and lower serum phosphate and 25-hydroxyvitamin D (25OHD) concentrations than those with normal PTH (n = 59). Elevated PTH and low 25OHD were shown by multivariate analysis to be significant predictors of reelevation of PTH. Renal resistance to PTH was higher in patients with vitamin D deficiency or renal insufficiency than in patients with normal serum vitamin D concentrations or normal renal function, and it increased according to increases in levels of PTH. CONCLUSIONS: The mechanism of PTH reelevation in patients with pHPT after successful parathyroidectomy appears to be renal resistance to PTH. 相似文献
145.
Rebecca A. Campo Bert N. Uchino Julianne Holt‐Lunstad Allison Vaughn Maija Reblin Timothy W. Smith 《Journal of community psychology》2009,37(4):471-486
The Social Relationships Index (SRI) was designed to examine positivity and negativity in social relationships. Unique features of this scale include its brevity and the ability to examine relationship positivity and negativity at the level of the specific individual and social network. The SRI's psychometric properties were examined in three studies. The SRI demonstrated good psychometric properties, including test–retest reliability for the assessment of positivity and negativity, and of relationship classifications across social networks. Additionally, discriminant and convergent validity was established with existing social relationship and personality scales. Finally, the SRI showed some generalizability across different contexts. These studies suggest that the SRI is a reliable and valid alternative measure for use in health studies that require a shorter assessment of relationships. © 2009 Wiley Periodicals, Inc. 相似文献
146.
Isao Kurosaki Masahiro Minagawa Chie Kitami Kabuto Takano Katsuyoshi Hatakeyama 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》2011,396(5):607-613
Purpose
Hepatectomy for liver metastasis from carcinomas of the distal bile duct (BDC) and of the papilla of Vater (PVC) has not been studied in detail. The purpose of this study is to analyze risk factors of liver metastasis and to evaluate outcome of hepatectomy for liver metastasis. 相似文献147.
148.
Yoshiyuki Ikeda Shin-ichi Kosugi Ken Nishikura Manabu Ohashi Tatsuo Kanda Takashi Kobayashi Katsuyoshi Hatakeyama 《Gastric cancer》2007,10(1):63-68
Gastric carcinosarcoma often presents with an elevated lesion or increased thickness of the stomach wall. Histological diagnosis
is achieved using conventional hematoxylin and eosin staining to confirm the coexistence of both epithelial and mesenchymal
elements. We report a case of gastric carcinosarcoma presenting as a large mass in the epigastric region. Specimens obtained
by endoscopic biopsy and surgical excision showed diffuse proliferation of atypical cells in sheet formation. No mucus production
or glandular structures were apparent, but immunoreactivity for both epithelial and mesenchymal markers was noted. These findings
led to a definitive diagnosis of gastric carcinosarcoma. Immunohistochemical analysis is useful for the early diagnosis and
treatment of gastric carcinosarcoma. 相似文献
149.
Yoshinobu Hata M.D. Fumiaki Sasaki M.D. Motomu Igarashi M.D. Tsutomu Namieno M.D. Hiromasa Takahashi M.D. Junichi Uchino M.D. 《Pediatrics international》1990,32(1):27-31
Metabolic disturbances of pancreatic hormones in obstructive jaundice in infancy were evaluated experimentally and clinically. In our experimental study, using young rats, the level of plasma insulin (IRI) gradually increased after ligation of the common bile duct. These levels were a little lower than those in the non-treated controls. The level of plasma glucagon (IRG) incerased remarkably 4 weeks after ligation of the common bile duct. Clinically, there were no significant differnces in the levels of IRI and IRG among normal controls and cases of neonatal hepatitis and congenital biliary atresia (CBA). In CBA patients, these levels can be correlated with the progression of hepatic fibrosis; an increase in IRG and a decrease in teh IRI/IRG mol ratio was noticed in patients with grade III of hepatic fibrosis. These indicate that, in obstructive jaundice in infancy, the more severe the hepatic damage due to obstructive jaundice, the higher the level of plasma glucagon concentration will rise. 相似文献
150.
Yamakawa Y Ishikawa T Uchino K Sumita S Mochida Y Ebina T Kobayashi S Kobayashi T Matsushita K Okusu Y Tanaka Y Kitamura Y Umemura S 《Journal of cardiology》2002,39(4):221-225
A 76-year-old female had undergone implantation of a single chamber pacemaker for sick sinus syndrome 20 years previously. She developed chronic atrial fibrillation and required repeated admission due to congestive heart failure. She had significant mitral and tricuspid regurgitation. Paradoxical movement of the intraventricular septum was severe. Due to right ventricular apical pacing, significant interventricular conduction delay was present with a paced QRS duration of 189 msec. The left ventricular pacing lead was positioned via the coronary sinus. The mode of the previously implanted pacemaker was set at VVT. Biventricular pacing could be achieved even in intrinsic beats by VVT mode. The battery life time was improved. This method is useful in patients with conventional pacemakers. 相似文献