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排序方式: 共有7796条查询结果,搜索用时 93 毫秒
1.
2.
Shinjiro Mizuguchi MD Kiyotoshi Inoue MD Takashi Iwata MD Nobuhiro Izumi MD Takuma Tsukioka MD Ryuhei Morita MD Tatsuya Nishida MD Noritoshi Nishiyama MD Taichi Shuto MD Shigefumi Suehiro MD 《General thoracic and cardiovascular surgery》2006,54(3):103-108
Objective: Impacts of mediastinal lymph node dissection on a patient’s course after pulmonary resection is unclear in octogenarians with non-small cell lung cancer. Methods: Retrospectively identified subjects included 39 octogenarians and 1 nonagenarian, with grades according to the Charlson Comorbidity Index ranging from only 0 to 2. We performed mediastinal lymph node dissection in 19 patients (D group), and just lymph node sampling biopsy in the other 21 (S group). We compared clinicopathologic features and outcome after surgery between both groups. Results: Deterioration of performance status at the time of discharge, evident in 17 patients overall, was significantly more frequent in the D group. Postoperative complications occurred in 27 patients overall and there was no significant difference between the two groups. Survival rates in younger patients at 1, 3, and 5 years were 86, 59, and 49%, respectively; in octogenarians these were 83, 58, and 42% (no significant difference). Nor did survival differ significantly by surgical management of mediastinal lymph nodes; 1-, 3-, and 5-year survival rates were 94, 63, and 40%, respectively in the D group and 78, 66, and 43%, respectively in the S group. Conclusion: Octogenarians with non-small cell lung cancer should be treated by urgent pulmonary resection whenever possible. Since mediastinal lymph node dissection has little effect on long-term survival or the carried risk of worsening performance status at discharge, pulmonary resection without complete mediastinal lymph node dissection should be considered. 相似文献
3.
Nobuyuki Inoue Kouji Nagaike Shinichi Ishihara Mitsuhiko Nakamura Toshio Kuroshima 《Digestive endoscopy》2006,18(2):134-137
Background: For management of bowel obstruction due to colorectal cancer, endoscopic trans‐anal decompression technique has been first reported by Lelcuk et al. in 1986 using balloon dilatation technique. Since then, various types of trans‐anal decompression tubes have been clinically used for patients suffering from left side obstructing colorectal cancer as an emergent decompressing device. At present, two types of trans‐anal ileus tube (trans‐anal decompression tube) have been available for clinical use, but they have two main problems that are late colon perforations caused by the tip of the tube and tube obstruction by stool. Methods: Analysis on three late colon perforations experienced with the use of conventional devices drew possible improvements to make a trans‐anal ileus tube less harmful. To overcome the pitfalls inherent to conventional tubes, the author has developed an improved trans‐anal ileus tube with a balloon installed at the very end of the tube (‘balloon‐tipped type’) made of silicone, measuring 1200 or 1700 mm in total length and 22 Fr in outer diameter. It has been used for 12 cases with obstructing colorectal cancer etc. and its outcomes were compared with those obtained by the use of conventional trans‐anal ileus tube. Results: No late perforations have been encountered, but tube obstruction did occur in one of 12 cases. Conclusion: The new trans‐anal ileus tube with a balloon installed at the tip of ileus tube is considered to be safer and especially effective in preventing late colon perforation and tube obstruction. 相似文献
4.
Kazuhiko Tsuruya Atsumi Harada Shinji Kubo Kouji Mitsuiki Kazuhito Takeda 《Clinical and experimental nephrology》1997,1(2):131-135
A 69-year-old man was admitted to our kidney center with endstage renal failure. We started intermittent peritoneal dialysis
immediately because of severe azotemia, hyperkalemia, and metabolic acidosis. Two weeks after admission, he developed uremic
pericarditis with frequent ventricular premature contractions and supraventricular premature contractions. The intermittent
peritoneal dialysis was then replaced by intensive hemodialysis, and oral administration of 300 mg/d of cibenzoline was started.
Four days later, he developed thirst, weakness, and dyspnea due to respiratory muscular paralysis. We initiated respiratory
support with a respirator because analysis of his blood gases revealed marked hypercapnia and hypoxia. He also developed hypoglycemia
and prolonged PQ and QRS intervals on the electrocardiogram, which we believed were due to cibenzoline intoxication; we discontinued
the cibenzoline immediately. All symptoms improved, and he was extubated 5 days later. After 2 months, his pericardial effusion
disappeared. He now continues maintenance hemodialysis as an outpatient. We suspect that the cibenzoline induced the respiratory
muscular paralysis for 2 reasons: 1) the patient experienced the respiratory muscular paralysis, at the same time he also
experienced thirst, weakness, hypoglycemia, and prolonged PQ and QRS intervals on electrocardiogram, and all of these symptoms
improved after the discontinuation of cibenzoline, and 2) his plasma concentration of cibenzoline became remarkably elevated,
to 20 times above the standard therapeutic level. This patient's clinical course indicates that hemodialysis might be superior
to intermittent peritoneal dialysis for treatment of cibenzoline intoxication. 相似文献
5.
Yuji Morimoto Osamu Kemmotsu Koichi Kitami Izumi Matsubara Ichiro Tedo 《Journal of anesthesia》1995,9(1):22-26
We evaluated whether we could predict the neurologic outcome in 55 out-of-hospital cardiac arrest patients using auditory
brainstem responses (ABR). ABR patterns were classified into one of 3 types by evaluation of 5 components: type 1, with all
5 components; type 2, lack of at least one response between the 2nd and 5th components; type 3, with only the first component
or no response. The relation between the ABR patterns on the 3rd day following resuscitation and the neurologic outcome on
hospital discharge was evaluated. The specificity that the 5 awake patients had type-1 ABR was 38%. The sensitivity that the
10 brain dead patients had type-3 ABR was 60%. In the type-1 ABR patients, the negative predictive value that the patients
were awake was 100%. In the type-3 ABR patients, the negative predictive value that the patients became brain dead was 90.9%.
These results suggest that ABR on the 3rd post-resuscitation day may not be useful for predicting if patients are awake or
become brain dead, although the loss of components may be a sign of morbidity, and the presence of the 2nd or later components
indicates possible future prevention of brain death. 相似文献
6.
Tetsushi Tsujimoto Kazushi Daimon Kazuhide Izumi Maki Sawai Tatsuya Iwashige 《Seishin shinkeigaku zasshi》2007,109(4):313-320
Fifty two outpatients, who showed signs of school-refusal-withdrawal at the Shiga Prefectural Psychiatric Institution have been analyzed according to their age, gender, ICD-10 diagnosis, medical evolution, and total number of consultations. A total of 61.5% of the population were male, and they showed a higher average and a wider range of age than female patients. According to the ICD-10 diagnosis, 67.3% were in the group of F40-48 neurotic, stress-related and somatoform disorders, and 11.5% were in the group of F30-39 mood [affective] disorders. Twenty five % of the patients were assumed to have show medical improvement, and 42.3% of the patients continued to have further consultations. This article discusses the possible role of psychiatric medical institutions in supporting cases of school-refusal and social-withdrawal. 相似文献
7.
Objectives To analyze the relationship between lateral displacement of the mandible and scoliosis.
Methods From April 2002 through July 2003, we examined posteroanterior cephalometric radiographs and chest X-rays from 85 patients
with jaw deformities and a control group of 20 patients with no jaw deformities. To measure the lateral shift of the mandible,
we drew a horizontal baseline (X axis) on the cephalogram connecting the intersection of the external margins of the orbits and the most lateral points of
the greater wings of the sphenoid. A vertical baseline (Y axis) was then marked perpendicular to the X axis, intersecting the ethmoid crista galli. Then, we measured the lateral displacement of the mandibular mentum from the
Y axis. Displacement to the right was designated positive; that to the left was designated negative. Cobb's method was used
to measure scoliosis curves on chest X-rays; the direction of the curve was designated similarly.
Results Of the 85 patients with jaw deformity, 23 (27.1%) had a Cobb angle exceeding 10°. None of the control group had scoliosis
exceeding 10°. No correlation was found between the direction of mandibular displacement and the direction of scoliosis.
Conclusion This study suggests a relationship between jaw deformities and scoliosis, as scoliosis was found in 27.1% of the patients
with a main complaint of jaw deformity. 相似文献
8.
9.
Staging of esophageal carcinoma in vitro with 4.7-T MR imaging 总被引:4,自引:0,他引:4
10.
M Noguchi T Taniya K Ueno M Yagi R Izumi K Konishi I Miyazaki 《The Japanese journal of surgery》1990,20(4):448-452
We report herein a rare case of a 26 year old woman with pheochromocytoma complicated by paralytic ileus. She presented with remarkable abdominal distension and respiratory difficulty but was effectively treated by surgical removal of the tumor with preoperative and operative management using alpha and beta adrenergic blocking agents. An excessive and persistent catecholamine production from large tumors or massive metastases characterizes this rare complication, and a review of the English and Japanese literature is given following this report. 相似文献