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1.
Although mixed venous oxygen saturation ( 相似文献
2.
MASAHIKO KAWAI TOHRU YORIFUJI CHUTARO YAMANAKA AYA MIYAZAKI HARUO HATTORI SHINJI UEMOTO YUKIHIRO INOMATA KOICHI TANAKA KENSH FURUSHO 《Pediatrics international》1998,40(1):96-98
A female infant with hypoproteinemia and coagulopathy associated with hypertyrosinemia was successfully treated with living-related liver transplantation (LRLT). On the 12th day of life plasma amino acid analysis revealed a marked elevation of tyrosine, so the patient was fed on a low-tyrosine and low-phenylalanine diet. However, hepatosplenomegaly. hypotonia, alopecia, eczema and psychomotor delay did not improve and recurrent episodes of disseminated intravascular coagulation (DIC) caused her condition to deteriorate. Liver biopsy on the 230th day revealed marked fatty change accompanied by mild to moderate cholestasis. Therefore. LRLT from her father was performed on the 286th day resulting in improvement of all the aforementioned signs and symptoms. Despite a thorough examination, no diagnosis of a known disorder could be established. However, her elder brother had also been born with severe hypoproteinemia and coagulopathy, and died of DIC on the second day of life. Thus, the disorder is designated as a new entity, namely ‘congenital hypoproteinemia and coagulopathy associated with hypertyrosinemia’. 相似文献
3.
Zen Isobe Tatsuo Suga Toshimitsu Katou Kenichirou Hara Fumiaki Aoki Kana Aoyagi Manabu Ueno Toshitaka Maeno Masahiko Kurabayashi 《Nihon Kokyūki Gakkai zasshi》2008,46(3):226-231
A 54-year old man was admitted with general fatigue, muscle weakness and dyspnea on effort. Medical examinations led to a diagnosis of small cell lung carcinoma (SCLC) with Lambert-Eaton myasthenic syndrome (LEMS). Marked improvement of SCLC and symptoms of LEMS were recognized twice during chemoradiotherapy. On his third admission, he showed muscle weakness, dysaethesia, and neurodysfunction of the bladder and rectum. We initially considered these symptoms to be due to spinal metastasis because MRI findings showed multiple spinal metastases. However, electoromyogram and nerve conduction study demonstrated that his muscle weakness resulted from LEMS though dysethesia and neurodysfunction of bladder and rectum were caused by spinal metastasis. We believe that it is important to perform electomyogram and nerve conduction studies, not only radiographic findings, to detect the "hidden" symptoms of LEMS. 相似文献
4.
Masashi Sakamoto Izumi Yoshi Takahiro Sodeno Kenichirou Aso Ryuya Hashimoto Hidetaka Masahar Takatoshi Maeno 《国际眼科杂志》2021,21(1):15-20
目的:研究并探讨Baerveldt青光眼植入术(BGI)的不同植入部位对眼压(IOP)的影响。方法:对日本Toho大学Sakura医疗中心接受BGI治疗的新生血管性青光眼的病例进行回顾性分析。所有患者分为两组:颞上植入组(16例患者18眼,其中男性13例,女性3例;平均年龄62.9±14.4岁)和鼻下植入组(15例患者17眼,其中男性11例,女性4例;平均年龄56.9±10.7岁)。术后12mo随访复查。比较两组术后12mo与术前相比的眼压降低率。结果:颞上植入组:术前平均IOP为31.1±10.0 mmHg,术后平均IOP为14.4±4.5 mmHg;鼻下植入组:术前平均IOP为34.9±9.7 mmHg,术后平均IOP为15.9±3.7 mmHg。颞上植入组IOP降低率为(50.0±19.0)%,鼻下植入组降低率为(51.2±16.3)%。两组间无显著统计学差异(t-test,P=0.590)。结论:经睫状体平坦部行颞上或鼻下BGI的短期临床疗效无差异。 相似文献
5.
Masashi Sakamoto Izumi Yoshi Takahiro Sodeno Kenichirou Aso Ryuya Hashimoto Hidetaka Masahar Takatoshi Maeno 《国际眼科》2021,2(4):199-205
AIM: To investigate and discover whether different insertion areas for Baerveldt glaucoma implant (BGI) surgery produce different outcomes in terms of the reduction of intraocular pressure (IOP).
METHODS: This retrospective study involved the review of cases of patients admitted at Toho University Sakura Medical Center, who underwent BGI surgery via the pars plana route for the treatment of neovascular glaucoma. The patients were divided into two groups: the superotemporal insertion group [18 eyes in 16 subjects (13 males, 3 females; mean age 62.9±14.4y)] and the inferonasal insertion group [17 eyes in 15 subjects (11 males, 4 females; mean age 56.9±10.7y)]. The patients were followed up and re-evaluated at 12mo. The IOP reduction rate 12mo after surgery relative to preoperative IOP was compared between the two groups.
RESULTS: The mean preoperative IOP was 31.1±10.0 mm Hg and postoperative IOP was 14.4±4.5 mm Hg in the superotemporal group, whereas for the inferonasal group, the mean preoperative IOP was 34.9±9.7 mm Hg and postoperative IOP was 15.9±3.7 mm Hg. The IOP reduction rate of the superotemporal group was 50.0%±19.0% and that of the inferonasal group was 51.2%±16.3%. There was no significant correlation between the two groups (Student’s t-test, P=0.590).
CONCLUSION: There was no difference in the short-term clinical outcomes between superotemporal and inferonasal BGI performed via the pars plana route. 相似文献
6.
Ikawa H Takeyasu Y Ukichi K Watanabe S Takada A Tonogi M Yamane GY Katakura A 《The Bulletin of Tokyo Dental College》2012,53(2):83-90
Two patients requiring surgical management for leakage of calcium hydroxide paste from a root canal into the infraorbital space are reported. A paste root canal treatment material used at the time of maxillary root canal treatment had leaked out of the root canal in both patients. Computed tomography confirmed displacement of the root canal treatment material into the soft tissue, with extension into the infraorbital space. In both cases, foreign body removal was performed. Root canal treatment using a calcium hydroxide paste should be performed carefully without strong pressure. 相似文献
7.
Ojima H Kato T Araki K Okamura K Manda R Hirayama I Hosouchi Y Nishida Y Kuwano H 《World journal of surgery》2006,30(4):553-559
Background Idiopathic thrombocytopenic purpura (ITP) is an autoimmune disorder for which appropriate diagnostic treatments are uncertain.
The response to splenectomy varies from 60% to 90%, and the remaining patients relapse and require further treatment. Therefore,
it is important to predict the outcome of splenectomy before and after surgery. The objective of this study was to evaluate
the efficacy of splenectomy in patients diagnosed with ITP.
Materials and Methods From 1988 to 2004, we splenectomized 32 patients with ITP; 17 underwent laparoscopic splenectomy (LS) and 15 underwent conventional
open splenectomy (OS). For analysis, patients were separated retrospectively into two groups: the “responding group,” those
who showed good outcomes with splenectomy, and the “non-responding group,” those who did not show good outcomes with splenectomy.
Blood samples were examined before and immediately after surgery (day 0) and on postoperative days (POD) 1, 3, 5, and 7.
Results The median follow-up was 8.3 years (range: 1–16 years). The overall 5- and 10-year survival rates after splenectomy were 96.9%
(one death). The responding group included 24 patients (75%), and the non-responding group included 7 (21.9%). Platelet counts
in the responding group increased gradually until POD 7, and although platelet counts in the non-responding group were almost
constant until POD 5, they subsequently decreased until POD 7. Average platelet counts in the responding and non-responding
groups were 269 and 124 × 109/l on POD 7, respectively (P < 0.05). The pre- to post-surgery ratio of platelet counts were almost the same as the result of the actual data. Platelet
counts during the long-term follow-up for the responding and non-responding groups were related to those noted on discharge.
Conclusions A high platelet count on POD 7 was associated with a good response to splenectomy, but age at surgery, the time interval between
diagnosis and splenectomy, and prior responses to corticosteroid were not. We suggest that long-term outcomes of splenectomy
can easily be predicted by platelet counts on POD 7. 相似文献
8.
Influence of a human protease inhibitor on surgical stress induced immunosuppression 总被引:21,自引:0,他引:21
Sato N Endo S Kimura Y Ikeda K Aoki K Iwaya T Akiyama Y Noda Y Saito K 《Digestive surgery》2002,19(4):300-305
BACKGROUND/AIM: Postoperative tissue injury and immunosuppression can occur after major surgery. In this study, we explore the potential benefits of administering a protease inhibitor to treat immunosuppression caused by surgical stress. METHODS: Sixteen patients with esophageal cancer were preoperatively allocated at random into two equal groups. A urinary trypsin inhibitor, ulinastatin (UTI), was intravenously administered to the treatment (UTI) group at a dose of 150,000 U every 12 h from the start of surgery until postoperative day 5, whereas the control group received a placebo. One unit of UTI was defined as the amount of UTI necessary to inhibit the activity of 2 microg of bovine pancreatic trypsin by 50%. We measured the plasma levels of polymorphonuclear neutrophil elastase, interleukin 8, circulating T lymphocyte subsets, and mitogenic activity and in vitro production of tumor necrosis factor alpha in lipopolysaccharide-stimulated whole blood. RESULTS: The postoperative serum value of polymorphonuclear neutrophil elastase was significantly lower in the UTI group, but the interleukin 8 concentrations did not significantly vary between the two groups. On the other hand, the severity of the postoperative immunosuppression was reduced in the UTI group, and immune functions, such as the numbers of T lymphocytes, the mitogenic activity of lymphocytes, and the level of tumor necrosis factor alpha production in whole blood, recovered significantly earlier in the UTI group. CONCLUSION: These data suggest that a protease-modulating therapy may be a new strategy for the treatment of surgical stress induced immune dysfunction. 相似文献
9.
Takagi T Kin S Nakase Y Fukuda K Han L Ito T Fujiyama J Shimomura K Sakakura C Otsuji E Hagiwara A Yamagishi H 《Gan to kagaku ryoho. Cancer & chemotherapy》2002,29(12):2318-2321
Peritoneal recurrence is one of the critical problems that occurs after surgery for gastrointestinal cancers. Since no curative treatment has been established for peritoneal recurrence, many efforts have been made to develop an effective method for preventing such recurrence. We focused on dextran sulfate, an anti-cell-adherence agent, to prevent peritoneal metastasis. Our previous studies in vitro and in vivo clarified that dextran sulfate prevents cancer cells from adhering to plastic flasks and the abdominal wall. In this study, we investigated the effects of dextran sulfate on cancer cells from the viewpoint of the cell cycle. Changes in gene expression caused by dextran sulfate were analyzed by cDNA microarrays. Analysis by cDNA microarray revealed the decreased expression of the genes essential to the progression of G1 and S phases. Our results indicate that dextran sulfate suppresses progression of the cell cycle as well as cell adhesion, suggesting that dextran sulfate could be used as an antimetastatic agent. Anti-cell-adherence agents with such mechanisms of action could be effective drugs for treatment during and after operation to prevent peritoneal metastases induced by surgical operation. 相似文献
10.
Yokouchi J Satani K Kanesaka N Abe K Hasegawa T 《Japanese journal of clinical oncology》2004,34(11):692-695
Case 1: A 14-year-old boy with nasopharyngeal cancer (T4N0M0) was treated with stereotactic radiosurgery (SRS) as a boost therapy after conventional radiotherapy. Persistent residual tumor visible with MR remained after conventional radiotherapy comprising 59.6 Gy in total. We therefore performed SRS to add a further irradiation dose while causing minimal damage to adjacent normal tissue. SRS was performed using multiple non-coplanar arcs delivered to the residual tumor, which was defined to add 2 mm margins to the residual tumor. This was 30 cc as defined by CT and MR images. Twenty Gy were administered to the periphery of the planning target volume (PTV), corresponding to the 80% isodose line. No recurrences or late complications have been observed 4 years and 6 months after the SRS. Case 2: A 27-year-old man with nasopharyngeal cancer (T1N0M0) was treated with SRS as a boost therapy following conventional radiotherapy with 55 Gy. The SRS was performed using multiple non-coplanar arcs delivered to the PTV, which was 10 cc as defined by CT and MR images as in case 1. Sixteen Gy were administered to the periphery of the residual tumor, corresponding to the 80% isodose line. The tumor was not visible on follow-up MR images and no complications have been observed 4 years and 2 months after the SRS. 相似文献