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61.
Yasushi Sano Hirohisa Machida Kuang‐I. Fu Hiroaki Ito Takahiro Fujii 《Digestive endoscopy》2004,16(Z1):S93-S96
The goal of endoscopic mucosal resection (EMR) is to allow the endoscopist to obtain tissue or resect lesions not previously amenable to standard biopsy or excisional techniques and to remove malignant lesions without open surgery. In this article, we describe the results of conventional EMR and EMR using an insulation‐tipped (IT) electrosurgical knife (submucosal dissection method) for large colorectal mucosal neoplasms and discuss the problems and future prospects of these procedures. At present, conventional EMR is much more feasible than EMR using IT‐knife from the perspectives of time, money, complication, and organ preservation. However, larger lesions tend to be resected in a piecemeal fashion; and it is difficult to confirm whether EMR has been complete. For accurate histopathological assessment of the resected specimen en bloc EMR is desirable although further experience is needed to establish its safety and efficacy. Further improvements of in EMR with special knife techniques are required to simply and safely remove large colorectal neoplasms. 相似文献
62.
Takehiko Shimoyama Katsuo Yoshiya Yasushi Yamato Teruaki Koike Keiichi Honma 《General thoracic and cardiovascular surgery》2009,57(6):310-314
Malignant peripheral nerve sheath tumors (MPNSTs; malignant schwannomas) rarely occur in the anterior mediastinum, and their
prognosis is poor. A 75-year-old man was referred to our hospital for examination of an anterior mediastinal tumor. A computed
tomography-guided percutaneous needle biopsy revealed only fibrosis. The tumor was completely excised via a median sternotomy
with partial resection of the pericardium and right upper lobe of the lung. Thereafter, the tumor was diagnosed as a storiform-pleomorphic
type of malignant fibrous histiocytoma. At 1 year after the surgery, a distant metastasis was found in the interlobular space
between the right middle and lower lobes. The tumor was completely excised via a right posterolateral thoracotomy. Reexamination
of the primary and secondary tumors revealed an MPNST. No recurrence was found up to 5 years after the second surgery without
adjuvant chemotherapy or radiation therapy. However, he died from multiple lung metastases after 6 years. 相似文献
63.
Satoshi Suzuki Koji Yasuda Yuji Matsumura Takashi Kondo 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2006,54(5):225-227
We present here a rare case of left-side catamenial pneumothorax, in which endometrial tissue pleura was found on the visceral pleura histologically. A chest roentogenogram confirmed the left pneumothorax, but did not reveal bullae or any associated anomalies, in a 41-year-old woman with three documented episodes of left-side pneumothorax occurring every menstruation. Video-assisted thoracoscopic surgery revealed not only tiny holes in the diaphragm, but also a scattered small brown spots on the visceral pleura. Histological examination of the lung sections revealed the existence of endometrial tissue on the visceral pleura with disrupted pleural elastic fibers. Our case suggests that cyclic erosion of the visceral pleura by the implanted endometrial tissue caused air leakage from the lung, in addition to the most accepted concept that air is aspirated into the thoracic cavity via the abdomen through the acquired fenestration of the diaphragm. 相似文献
64.
Shuichiro Uchiyama Kazuo Chijiiwa Masahide Hiyoshi Motoaki Nagano Jiro Ohuchida Koki Nagaike Masahiro Kai Kazuhiro Kondo 《Journal of gastrointestinal surgery》2007,11(11):1570-1572
Mucin-producing tumor in the bile duct is referred to clinically as mucin-producing bile duct tumor (MPBT). Intraductal papillary
neoplasm of the biliary tract that resembles an intraductal papillary mucinous neoplasm (IPMN) of the pancreas is a rare category
of MPBT and is not well characterized. We, herein, report a case of MPBT of the caudate lobe of the liver that showed papillary
growth and communicated with the bile duct of the caudate lobe and protruded into the common hepatic duct. Histologically,
MPBT cells showed papillary overgrowth with abundant mucinous secretions, resembling an IPMN of the pancreas. The MPBT cells
showed the same immunostaining pattern as that of cells from IPMN of the pancreas. 相似文献
65.
Takao Kamezaki Kiyoyuki Yanaka Keishi Fujita Kazuhiro Nakamura Yasushi Nagatomo Tadao Nose 《Journal of clinical neuroscience》2004,11(3):311-313
Subdural hygroma is a frequent delayed complication of head trauma. Most hygromas are clinically 'silent' and a few cases have shown slow deterioration in the chronic stage. We report a case of subdural hygroma showing unique radiological findings and rapid deterioration. A 74-years-old female presented with a mild headache and consciousness disturbance after head injury. Computed tomography showed a midline shift as a result of two components piling up in the subdural space; the outer components showed low density, the inner components high density. Magnetic resonance imaging demonstrated that these two subdural components were subdural hygroma and subarachnoid hematoma. Simple burr hole irrigation, rather than large craniotomy, was thought to be more appropriate treatment to reduce the mass effect. Simple burr hole irrigation was performed to remove the subdural hygroma and the patient showed an excellent recovery. Careful examination of the radiological findings prevented an unnecessary procedure in this case. A possible mechanism of this phenomenon is discussed. 相似文献
66.
Preliminary Report on Teratogenic Effects of Zonisamide in the Offspring of Treated Women with Epilepsy 总被引:4,自引:3,他引:1
Summary: Purpose: We wished to assess the risk of terato-genicity of zonisamide (ZNS) in humans.
Methods: Pregnant epileptic women treated with ZNS and their offspring were prospectively monitored from June 1989 to December 1994. The outcome of pregnancy and status of neonates were examined based on the same standardized protocol.
Results: Twenty-six offspring exposed to ZNS with or without other antiepileptic drugs (AEDs) were studied. Malformations were detected in 2 offspring (7·7%) exposed to ZNS polypharmacy. Anencephaly was detected in one case at 16 weeks of gestation (case 1, artificial abortion), and atrial septa1 defect was detected in another case at 37 weeks of gestation (case 2, delivery by cesarean section). Serum concentrations of ZNS during the first trimester of pregnancy were 6·1 μg/ml in case 1 and 6·3μ/ml in case 2; in both cases, the levels were below the therapeutic concentration range of ZNS.
Conclusions: Teratogenic effects of ZNS were not clearly defined from these results since malformations were detected in two polypharmacy cases but not in four monopharmacy cases. The present data do not indicate that the risk of ZNS teratogenicity is greater than that of other conventional AEDs. However, such risk cannot be neglected even at therapeutic dosages or concentrations of ZNS, especially in patients receiving polypharmacy. 相似文献
Methods: Pregnant epileptic women treated with ZNS and their offspring were prospectively monitored from June 1989 to December 1994. The outcome of pregnancy and status of neonates were examined based on the same standardized protocol.
Results: Twenty-six offspring exposed to ZNS with or without other antiepileptic drugs (AEDs) were studied. Malformations were detected in 2 offspring (7·7%) exposed to ZNS polypharmacy. Anencephaly was detected in one case at 16 weeks of gestation (case 1, artificial abortion), and atrial septa1 defect was detected in another case at 37 weeks of gestation (case 2, delivery by cesarean section). Serum concentrations of ZNS during the first trimester of pregnancy were 6·1 μg/ml in case 1 and 6·3μ/ml in case 2; in both cases, the levels were below the therapeutic concentration range of ZNS.
Conclusions: Teratogenic effects of ZNS were not clearly defined from these results since malformations were detected in two polypharmacy cases but not in four monopharmacy cases. The present data do not indicate that the risk of ZNS teratogenicity is greater than that of other conventional AEDs. However, such risk cannot be neglected even at therapeutic dosages or concentrations of ZNS, especially in patients receiving polypharmacy. 相似文献
67.
68.
Masahiro Tsuboi Hisao Asamura Tsuguo Naruke Haruhiko Nakayama Haruhiko Kondo Ryosuke Tsuchiya 《Surgery today》1997,27(11):1074-1076
A video-assisted right upper lobectomy was successfully performed on a 58-year-old man with an anomalnous segmental pulmonary
vein. The tumor was a peripherally located adenocarcinoma. The anomalous vein behind the right main bronchus was identified
and safely divided. This case emphasized that to perform this procedure successfully, (1) a careful preoperative evaluation
of the anatomy, including the presence of any possible vascular and/or bronchial anomalies, is necessary, and (2) if any anatomical
structures cannot be determined intraoperatively, a conversion into an open procedure must immediately be undertaken. 相似文献
69.
Tokio Yamaguchi Masahiko Miyata Wataru Kamiike Yasushi Kobayashi Hikaru Matsuda 《Surgery today》1997,27(5):420-428
To clarify the histological status of the pancreas tail after pancreatoduodenectomy (PD), fibrosis, islets of Langerhans,
and A, B, and D cells were examined histometrically in surgical cases of pancreatic cancer. The same investigations were also
performed during an autopsy examination of the pancreas tail of survivors of surgery who had received either PD or total pancreatectomy
with segmental autotransplantation (SAT). In the surgical cases, fibrosis and the islet percentage compared with nonpancreatic
cancer cases were significantly higher while the B cell ratio was significantly lower. In addition, in pancreatic cancer patients,
the fibrosis and islet ratio in the group with a blocked pancreatic duct were higher while the B cell ratio was lower than
in the group with an open pancreatic duct. A direct relationship between the islet ratio and the degree of fibrosis, and an
inverse relationship between the B cell ratio and the degree of fibrosis, were thus found. From the autopsy cases, the fibrosis
progressed and the islet ratio increased following PD, but after SAT only the islet ratio increased compared to the time of
surgery. The progression of fibrosis after PD thus suggests the presence of some problems in both the surgical method and
postoperative management. 相似文献
70.
Haruhiko Ogawa Masaki Fujimura Motoyasu Saito Tamotsu Matsuda Nobuaki Akao Kaoru Kondo 《Clinical autonomic research》1994,4(1-2):19-28
Eosinophilic bronchitis without asthma can cause a persistent non-productive cough which is resistant to bronchodilator therapy. To understand the mechanism of the cough in this disorder, an animal model of eosinophilic bronchitis was developed. Guinea-pigs were treated with transnasal administration of polymyxin B or saline twice a week for 3 weeks. The number of eosinophils in bronchoalveolar lavage fluid increased in polymyxin B-treated animals when compared with those treated with saline. In addition, histological examination showed that the number of eosinophils infiltrated into the tracheal epithelium increased; injury to the tracheal epithelium was greater in polymyxin B-treated animals. The numbers of coughs induced by saline and each concentration of capsaicin (10–18, 10–16, 10–14M) were greater in the polymyxin B-treated animals. FK-224 (a neurokinin receptor antagonist) decreased the heightened cough reflex in this animal model of eosinophilic bronchitis. These findings suggest that neuropeptides, and particularly neurokinins, are involved in the heightened cough receptor sensitivity in eosinophilic bronchitis without asthma. This has implications for better understanding of this disorder and its treatment. 相似文献