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91.
Shingen Nakamura Momoyo Azuma Tomoko Maruhashi Kimiko Sogabe Ryohei Sumitani Munenori Uemura Masami Iwasa Shiro Fujii Hirokazu Miki Kumiko Kagawa Takashi Hiraga Noriyasu Kondo Hiromi Fujita Fumihiko Mahara Masahiro Abe 《Journal of infection and chemotherapy》2018,24(5):389-392
Severe fever with thrombocytopenia syndrome (SFTS) is a tick-borne infectious disease caused by the SFTS virus (SFTSV). Clinical symptoms of SFTS often involve encephalopathy and other central neurological symptoms, particularly in seriously ill patients; however, pathogenesis of encephalopathy by SFTSV is largely unknown. Herein, we present case reports of three patients with SFTS, complicated by encephalopathy, admitted to Tokushima University hospital: one patient was a 63-year-old man, while the other two were 83- and 86-year-old women. All of them developed disturbance of consciousness around the 7th day post onset of fever. After methylprednisolone pulse therapy of 500 mg/day, all of them recovered without any neurological sequelae. SFTSV genome was not detected in the cerebrospinal fluid of 2 out of the 3 patients that were available for examination. In these patients, disturbance of consciousness seemed to be an indirect effect of the cytokine storm triggered by SFTSV infection. We propose that short-term glucocorticoid therapy might be beneficial in the treatment of encephalopathy during early phase of SFTSV infection. 相似文献
92.
Yukiko Kato Mao Hagihara Ai Kurumiya Tomoko Takahashi Miki Sakata Yuichi Shibata Hideo Kato Arufumi Shiota Hiroki Watanabe Nobuhiro Asai Yusuke Koizumi Yuka Yamagishi Hiroshige Mikamo 《Journal of infection and chemotherapy》2018,24(1):31-35
Background
Central line-associated bloodstream infections (CLABSIs) are among the most serious complications especially in blood cancer patients. In January 2013, Centers for Disease and Prevention (CDC) introduced a new surveillance definition of mucosal barrier injury-associated laboratory-confirmed bloodstream infection (MBI-LCBI). This study was to determine the impact of MBI-LCBI on CLABSIs and compare the clinical characteristics of MBI versus non-MBI-LCBI cases.Patients and methods
We retrospectively reviewed the records of 250 consecutive patients. They were admitted in department of hematology at Aichi Medical University Hospital. We applied the revised 2013 CLABSI surveillance protocol to all CLABSI cases identified during the 47-months period from May 2012 through June 2016.Results
A total of 44 CLABSIs were identified. The median patient age was 65 years (range, 12 to 89). Among 44 patients, 31 patients were diagnosed as leukemia (70.5%) and 12 patients as lymphoma (27.3%). Six patients underwent bone transplantation for leukemia or myelodysplastic syndrome (13.6%). A total of 20 patients (45.5%) were classified as MBI-LCBI and 24 (54.5%) were classified as non-MBI-LCBI. The primary disease type (P = 0.018), neutropenic within 3 days before CLABSI (MBI-LCBI vs. non-MBI-LCBI: 95.0% vs. 26.3%, P = <0.0001), line(s) removed owing to CLABSI (15.0% vs. 54.2%, P = 0.011) and Gram-negative organisms cultured (70.0% vs. 37.5%, P = 0.004) showed significantly difference between the groups.Conclusion
Our data showed that MBI-LCBI cases account for 45.5% of the CLABSI cases identified in blood cancer patients, and constituted a significant burden to this high-risk patient population. 相似文献93.
Daisuke Katsura Yuichiro Takahashi Shigenori Iwagaki Rika Chiaki Kazuhiko Asai Masako Koike Shunsuke Yasumi Madoka Furuhashi Akira Hara Hitoshi Iwata 《Journal of Medical Ultrasonics》2018,45(4):629-632
Acute funisitis is characterized by the infiltration of fetal neutrophils from the umbilical vessels into Wharton’s jelly and presents as fetal inflammation. However, no reports about its prenatal diagnosis using ultrasonography have been published. We encountered one case of oligohydramnios at 26 weeks and another case of threatened premature delivery at 27 weeks of gestation with ultrasonographic findings of non-uniform thickening of Wharton’s jelly, a heterogeneous internal echo, and a high echoic line of the umbilical vessel wall. Acute funisitis was diagnosed, and the postpartum histopathological examination revealed severe funisitis in both cases. To our knowledge, this is the first case report of prenatal diagnosis of funisitis determined using ultrasonography. When we find such ultrasonographic features under the circumstances of intrauterine infection, severe funisitis should be included in the differential diagnosis. 相似文献
94.
95.
Akane Anai Kimiyo Ueda Koichi Harada Takahiko Katoh Kumiko Fukumoto Chang-Nian Wei 《Environmental health and preventive medicine》2015,20(6):447-454
Objectives
To assess the difference between self-reported and measured weight values in Japanese men and women and to determine the underlying determinants of the differences between self-reported and measured values.Methods
The data were collected from 363 general Japanese individuals aged 16–88 years living in Kumamoto prefecture. Participants completed a self-administered questionnaire designed for this study with self-reported weight and height values. Measured weight and height were measured immediately after questionnaire completion. Paired t-tests identified differences between self-reported and measured values by sex. Multiple-stepwise regression analysis examined the independent variables’ effects on the differences between self-reported and measured weights.Results
Significant differences were found between self-reported and measured values for both sexes (p < 0.001). There was a significant negative relationship between the difference in an individual’s self-reported and measured weight in each sex, with higher measured weight individuals more likely to underestimate their weight. Multiple-stepwise regression analysis models explained 12.1 % (p < 0.01), 11.3 % (p < 0.01), and 5.6 % (p < 0.01) of the variance in all participants, men, and women, respectively. Significant effects were found for age, weight measurement frequency, and measured weight in total participants, weight measurement frequency, and measured weight for men, and age for women.Conclusions
In this study, the mean absolute value of the weight and height variances proved the unreliability of self-reported weight and height values. This study’s findings suggest self-reported weight inaccuracy especially for obese populations. This should be adjusted when using it in epidemiological studies and healthcare planning.96.
Takuya Tsujimura Takayuki Ishihara Shota Okuno Osamu Iida Naoya Kurata Mitsutoshi Asai Masaharu Masuda Shin Okamoto Kiyonori Nanto Takashi Kanda Yasuhiro Matsuda Yosuke Hata Toshiaki Mano 《Journal of cardiology》2021,77(5):457-464
BackgroundPolymer-free biolimus A9-coated coronary stent (DCS) has novel features which lead to the expectation of better arterial healing. However, comparisons of intravascular status between DCS and drug-eluting stents (DES), and robust real-word clinical assessments of DCS have been lacking to date.MethodsFrom September 2017 to September 2018, we evaluated the intra-vascular status of 74 DCS implanted in 55 lesions from 43 patients using coronary angioscopy (CAS) approximately one year after implantation from a cohort of 219 lesions in 158 patients. We set 239 second-generation durable-polymer DES (DP-DES) implanted in 211 lesions from 180 patients from a cohort of 2652 lesions in 1914 patients as the control. Angioscopic images were analyzed to determine (1) the dominant degree of neointimal coverage (NIC) over the stent; (2) the heterogeneity of NIC; (3) yellow color grade of the stented segment; and (4) the presence of intra-stent thrombus. The primary outcome was the incidence of thrombus and secondary outcomes were the other CAS findings, and the 1-year clinical outcomes which included target lesion revascularization (TLR) and major adverse cardiac events (MACE). To minimize inter-group differences in baseline characteristics, propensity score matching was performed for clinical outcomes.ResultsIncidence of thrombus adhesion was similar in DCS and DP-DES groups (28.4% versus 22.6%, p = 0.31). However, the dominant NIC grade was significantly higher in DCS (p < 0.001), while NIC was more heterogeneous in DCS than in DP-DES (p = 0.001). Maximum yellow color grade was similar (p = 0.22). After propensity score matching, 202 lesion pairs from 146 patient pairs were retained for analysis. The cumulative incidence of TLR (4.6% versus 3.8%, p = 0.38) and MACE (11.6% versus 11.7%, p = 0.84) was similar for DCS and DP-DES.ConclusionsDCS showed thrombus adhesion and clinical outcomes at 1 year similar to DP-DES. DCS can thus be used with similar safety and efficacy as DP-DES. 相似文献
97.
Ryohei Sumitani Taiki Hori Jumpei Murai Shiyori Kawata Masahiro Oura Kimiko Sogabe Mamiko Takahashi Takeshi Harada Shiro Fujii Hirokazu Miki Kumiko Kagawa Masahiro Abe Shingen Nakamura 《Internal medicine (Tokyo, Japan)》2021,60(11):1753
A 33-year-old man was admitted to our hospital for fever and abdominal pain. A blood analysis revealed pancytopenia and increased serum pancreatic enzymes with disseminated intravascular coagulation. A detailed examination revealed acute pancreatitis, with diffuse swelling of the pancreas and diffuse beaded dilatation of the main pancreatic duct, which mimicked autoimmune pancreatitis complicated by acute myeloid leukemia. Systemic cytotoxic chemotherapy led to the remission of leukemia and pancreatitis. We hypothesized that the etiology of acute pancreatitis was invasion of leukemia cells. Acute pancreatitis is rare as a symptom of leukemia; however, we should consider the possibility of leukemia during the differential diagnosis of acute pancreatitis. 相似文献
98.
The high- and low-avoidance animal (HAA and LAA respectively) strains of Hatano rats were originally selected and bred from Sprague-Dawley rats for their performance in the shuttle-box task. The present study focused on the activity of the hypothalamo-pituitary-adrenocortical (HPA) axis of HAA and LAA rats in response to restraint stress. The restraint stress induced an elevation in plasma concentrations of ACTH, prolactin, corticosterone and progesterone. Peak levels of plasma ACTH during stress conditions were significantly higher in HAA rats than in LAA rats, while peak levels of prolactin were significantly lower in HAA rats than in LAA rats. Under stress conditions, ACTH and prolactin synthesis in the anterior pituitary glands was significantly higher in HAA rats compared with LAA rats. The peak plasma concentrations of corticosterone, during restraint stress, were significantly higher in LAA rats compared with HAA rats. These results indicate that the response of the hypothalamo-pituitary axis to acute restraint stress is greater in HAA rats than in LAA rats, whereas the ACTH-induced adrenal response of corticosterone release is higher in LAA rats than in HAA rats. On the other hand, prolactin secretory activity is higher in LAA rats compared with HAA rats. These differences in endocrine responses to stress may be involved in the regulation of the avoidance responses in the shuttle-box task. 相似文献
99.
Michitaka Naito Toshio Hayashi Chiaki Funaki Masafumi Kuzuya Kanichi Asai Fumio Kuzuya 《Heart and vessels》1988,4(2):100-103
Summary We studied the effect of acetoacetylated low-density lipoprotein (LDL), which is recognized by the scavenger receptor, on the migration of fetal bovine aortic smooth muscle cells in culture, using a Neuro Probe 48-well microchemotaxis chamber. Acetoacetylated LDL is chemotactic and chemokinetic for the smooth muscle cells, and the effect is maximal with 50µg/ml of protein, while native LDL has no significant chemotactic activity. These results suggest that denatured LDL might play an important role in the recruitment of smooth muscle cells from the media into the intima in atherosclerosis. 相似文献
100.
We encountered a rare case of pulmonary granulomatous lesion accompanied with severe chest pain and hemoptysis. A 42-year-old man visited our hospital complaining of hemosputum. A chest radiograph showed a nodular shadow in the left lower lung field. Further examinations including fiberoptic bronchoscopy, bronchoalveolar lavage and transbronchial lung biopsy did not suggest a diagnosis. During the course of his illness, he suffered an episode of severe chest pain which could be controlled only by intravenous morphine chloride (10 mg). The chest radiograph at the time showed a broad infiltration in the left lower lung field. However, the lung perfusion scintigram taken 2 days before demonstrated decreased blood flow in the same field. We waited for the infiltration in the chest radiograph to diminish and then performed partial resection of the left lower lobe, thus terminating both hemosputum and chest pain. Histological examination showed a cavitary lesion in the periphery of the lung, surrounded by large numbers of infiltrating plasma cells and lymphocytes, among which were many hemosiderinladen macrophages. A small amount of mycelium, considered to be Nocardia or fungus, was seen in the cavity wall. These findings may indicate that an infection had contributed to the formation of a hemorrhagic granulomatous lesion, and that this lesion caused chest pain mainly because of the pleuritis and the decrease in the local pulmonary circulation. 相似文献