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51.
Proliferation, Vascular Endothelial Growth Factor Expression and Cavernous Sinus Invasion in Growth Hormone Secreting Pituitary Adenomas 总被引:4,自引:0,他引:4
Summary Surgical cure of growth hormone producing pituitary adenomas (GHomas) becomes difficult when they invade the cavernous sinus
(CS). Tumour proliferative activity and angiogenesis are thought to be required for tumour growth and invasion, and vascular
endothelial growth factor (VEGF) activates neovascularization around tumours. In this study, the mechanism and clinical significance
of CS invasion is analysed. In 25 surgically treated GHomas, the extent of CS invasion was classified as high (Knosp's grade
3 and 4), and low (grade 0, 1 and 2) MR grades, and the MR grades were compared with tumour proliferative potential (Ki-67
expression), angiogenetic demand (VEGF expression), volume of adenomas and serum hormone levels.
The Ki-67 index of high MR grade adenomas (1.17±0.62%) was significantly higher than that of low MR grade adenomas (0.55±0.42%,
p=0.027), whereas VEGF expression showed no significant correlation with MR grades (p>0.999). Tumour volume also showed a
significant correlation with MR grade (p=0.002). VEGF expression was not correlated with serum hormone level and volume, but
was correlated with tumour proliferative potential. Proliferative potential and tumour volume were two independent factors
related to CS invasion. Although VEGF expression was not a direct factor related to CS invasion, it may indirectly play a
role in activation of tumour aggressiveness, which is required in CS invasion.
Our results show that high MR grade adenomas have higher proliferative ability. In order to improve the surgical outcome,
pre-operative medical debulking is indicated, particularly, in such adenomas. 相似文献
52.
Pigmented poroma on the temporal region dermoscopically mimicking basal cell carcinoma: A report of two cases
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53.
Chizuko Yano Hidehisa Saeki Takaoki Ishiji Yozo Ishiuji Junko Sato Yukari Tofuku Hidemi Nakagawa 《The Journal of dermatology》2013,40(9):736-739
Atopic dermatitis (AD) is a common inflammatory skin disease that is characterized by chronic and persisting pruritic and eczematous lesions. There has been no study of work productivity and activity in AD patients in relation to disease severity. The purpose of this study was to examine the impact of disease severity on work productivity and activity impairment (WPAI) in adult AD patients using the Japanese version of the questionnaire. Data were collected from 112 AD patients who visited the Jikei University Hospital. Outcomes as measured by the questionnaire included employment status, total work productivity impairment (TWPI) and total activity impairment (TAI). We investigated the correlation between TWPI or TAI scores and severity scoring of AD (SCORAD) for disease severity and dermatology life quality index (DLQI) for quality of life impairment. Both TWPI and TAI scores were significantly correlated with the SCORAD and DLQI scores (P < 0.001), indicating disease severity is significantly associated with WPAI in Japanese adult AD patients. Further studies are necessary to evaluate the effects of treatments on WPAI for severe AD patients. 相似文献
54.
Tomoyoshi Shibuya Keiichi Haga Michio Saeki Mayuko Haraikawa Hitoshi Tsuchihashi Koki Okahara Osamu Nomura Hirofumi Fukushima Takashi Murakami Dai Ishikawa Shigaku Ikeda Akihito Nagahara 《Journal of clinical apheresis》2020,35(5):488-492
Pyoderma gangrenosum (PG) is an extra-intestinal skin lesion in inflammatory bowel disease (IBD) as is erythema nodosum. Vedolizumab (VED) is a monoclonal antibody that targets α4β7 integrin and has an intestinal selective mechanism. Despite good therapeutic effects on colitis, the effect on extra-intestinal manifestations (EIMs) remains unclear. Here we report a case of ulcerative colitis complicated by PG during treatment with VED, which was successfully treated with prednisolone in combination with adsorptive granulocyte and monocyte apheresis (GMA). The patient was a 50-year-old woman with a past medical history of extensive ulcerative colitis managed by golimumab (GLM). She developed flare symptoms due to loss of response to GLM, and treatment was switched to VED. Her gastrointestinal symptoms were improved with VED treatment with less frequent bowel movements. However, infiltrative erythema with pain appeared on the right lower leg and right knee, and expanded and gradually ulcerated. Her skin lesions were treated with corticosteroid, but showed poor improvement. Therefore, granulocyte and monocyte apheresis (GMA) treatment was administered in combination with prednisolone. After 3 months, the ulcer gradually improved, and at the time of this writing, the eruptions were nearly replaced by epithelial tissue. This case study showed that patients with UC and EIMS may respond well to combination therapy of VED and GMA. GMA has a very favorable safety profile. On the other hand, the causal connection between VED and PG is still unclear. We believe that a combination therapy involving VED and GMA in IBD patients with EIMs warrants consideration. 相似文献
55.
Toshihiko luchi Yasuo Iwadate Hiroki Namba Katsunobu Osato Naokatsu Saeki Akira Yamaura 《Neurological research》2013,35(7):640-644
AbstractDespite similar benign histological appearances, proliferative activity of meningiomas varies tumor to tumor, and even region to region in a tumor. To predict proliferative potential before surgery, we compared regional uptake of2-[18F]fluoro-2-deoxyglucose ([18F]FDC) and L-fmethyl-11 CJmethionine ([71C]MET) with histological indices of tumor proliferative activity in 17 specimens from six patients with meningioma obtained by PET guided stereotactic biopsies. Uptake of I11C]MET', an index of protein synthesis rate, significantly correlated not only with the count of nucleolar organizer regions (NORs), a histological index of protein synthesis, but also with Ki-67 index, a histological index of proliferative activity. On the other hand, [18F]FDC uptake showed no significant correlation with Ki-67 index or clinical malignancy. These results suggest that [11 C]MET-PET is a useful tool for predicting tumor proliferative potential in meningiomas. [Neurol Res 1999; 21: 640-644] 相似文献
56.
57.
M Shimada Y Saeki S Matsumoto Y Uemura T Kotani S Ohtaki M Sakata H Koike J Kawano T Sasaki 《Kansenshōgaku zasshi. The Journal of the Japanese Association for Infectious Diseases》1991,65(5):612-615
A 26-year-old housewife was admitted to our hospital with a history of high fever after previous cesarean delivery. She had premature rupture of the membrane on the 41st week of pregnancy and the amniotic fluid was found to be cloudy on the fourth day after rupture. Therefore, cesarean delivery was performed. On the first day of operation, her body temperature increased up to 38 degrees C in spite of the treatment with Latamoxef (LMOX), 3 g/day. A sample of intrauterine material yielded M. hominis in pure culture. After administration of Minocycline (MINO) with antimycoplasmal activity, the clinical symptoms improved by the 11th day of operation. Sera obtained after the infection showed antibodies to M. hominis in ELISA study. These results suggested that the cause of this postpartum fever was M. hominis infection. 相似文献
58.
T Yamagishi M Ozaki Y Furutani K Yamamoto A Saeki S Satoh R Kusukawa 《Japanese circulation journal》1990,54(4):361-372
Contributions of rapid filling, slow filling and atrial systole to the left ventricular (LV) filling volume were analyzed with the use of radionuclide ventriculography at rest, both globally and regionally, in 34 patients with isolated disease of the left anterior descending coronary artery. The patients included 17 with a normal ejection fraction (EF greater than or equal to 50%; group 1) and 17 with a depressed EF (less than 50%; group 2), and the data were compared with those obtained from 13 normal subjects. A computer program subdivided the LV image into 4 regions, and time-activity curves were constructed globally and regionally by reverse-gating from the R wave. In both groups the contribution of rapid filling to the LV filling volume was decreased significantly in the affected septal and apical regions, and in the global left ventricle compared with that in normal subjects. In group 1, the contribution of atrial systole showed an increase in these affected regions and in the global left ventricle. In contrast, in group 2, the atrial contribution was not increased globally or regionally as much as was expected. However, the contribution of slow filling was either increased significantly or tended to increase in the affected regions and in the global left ventricle. There were negative correlations between the contribution of rapid filling and that of slow filling in the global left ventricle (r = -0.73, p less than 0.001) and in each of the septal, apical and lateral regions (r greater than or equal to -0.60, p less than 0.001), which suggested that the contribution of slow filling as well as of atrial systole undergoes an increase as rapid filling is impaired. Thus, in patients with coronary artery disease, the left ventricle relies on slow filling as well as atrial systole to affect diastolic LV filling in the affected regions and in the global left ventricle in the presence of LV systolic dysfunction. 相似文献
59.
BACKGROUND: Based on 10 years of experience with chromoendoscopy, our hypothesis was that colonic adenomas can be differentiated from hyperplastic polyps by use of a high-pressure spray-jet of dye (pressure dye-spray). To test the accuracy of pressure dye-spray, classification of colonic polyps as adenomas and hyperplastic polyps by pressure dye-spray and ordinary colonoscopic findings (shape, size, and color surface appearance) were compared. METHODS: Pressure dye-spray chromoendoscopy was performed by using 0.035% indigo carmine, a spray-type cannula, and a water pump. Polyps were first classified as adenomas or hyperplastic polyps by ordinary colonoscopic findings. One or more pressure dye-spray bursts were then focused on the polyp from a distance of 1 to 2 cm. Polyps were classified as adenomas only if oozing of blood was evident; otherwise, they were classified as hyperplastic polyps. A histologic diagnosis was obtained for all polyps, and the results of ordinary colonoscopic findings and pressure dye-spray were compared. RESULTS: This study examined 1468 polyps (1201 adenomas, 267 hyperplastic polyps; mean diameter 4 mm). The sensitivities for polyp differentiation with pressure dye-spray and ordinary colonoscopic findings were, respectively, 97.9% and 73.4% (p < 0.0001); specificities were, respectively, 96.6% and 92.1% (p = 0.077). CONCLUSIONS: Pressure dye-spray was found to be a reliable technique for differentiation between adenomas and hyperplastic polyps. 相似文献
60.
Systemic capillary leak syndrome 总被引:2,自引:0,他引:2
Kawabe S Saeki T Yamazaki H Nagai M Aoyagi R Miyamura S 《Internal medicine (Tokyo, Japan)》2002,41(3):211-215
A 40-year-old woman was referred to our hospital with severe hypovolemic shock and anasarca. The laboratory findings showed marked hemoconcentration and a decrease in total serum protein with the presence of monoclonal IgG-lambda. She had had a similar episode of generalized edema 2 years previously. We diagnosed the patient as having typical systemic capillary leak syndrome (SCLS) and she improved gradually after infusion of albumin-containing fluid. SCLS is a very rare condition caused by unexplained episodic capillary hyperpermeability. Its treatment has remained largely supportive and the prognosis is generally poor. Awareness of SCLS is necessary for improvement of the outcome. 相似文献