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1.
Yohei Mizuta Fuminao Takeshima Saburo Shikuwa Satoshi Ikeda Shigeru Kohno 《Digestive endoscopy》2006,18(2):88-97
Obstructive sleep apnea syndrome (OSAS) is a common condition characterized by repetitive sleep‐induced collapse of the upper airways. It is associated with increased risk for hypertension, ischemic heart disease, cerebral stroke, and traffic accidents. In contrast, gastroesophageal reflux disease (GERD) is a very common disorder defined as various symptoms or esophageal mucosal damage generated by the abnormal reflux of gastric contents into the esophagus. Patients with OSAS have been reported to have a high prevalence of gastroesophageal reflux (GER) symptoms. The increase of transdiaphragmatic pressure in parallel with the large negative intrathoracic pressure produced during apnea events may directly lead to GER. In addition, some studies have demonstrated improvement in GERD with the application of continuous positive airway pressure, most consistently effective treatment for OSAS. However, GER dose not occur with every apnea. Moreover, the common conditions observed in patients with OSAS, including obesity or alcohol ingestion, are also predisposing factors for GER. A more recent investigation in over 1000 subjects failed to show a causal link between both diseases. Thus, the potential relationship between OSAS and GERD remains controversial. Inconsistencies in definitions of both diseases or sampling biases may contribute to the confusing results. 相似文献
2.
A 62-year-old woman with rheumatoid arthritis, Basedow's disease and arrhythmia has been treated with antirheumatic, antiarrhythmic drugs and so on. She developed pruritic diffuse erythema with papules on the trunk and extremities 2 days after taking hydroxyzine pamoate for asteatotic eczema. Laboratory data showed increased levels of eosinophils. Histopathological examination revealed a infiltrate of inflammatory cells in the upper dermis. Patch tests with hydroxyzine pamoate and hydroxyzine hydrochloride were positive. From these findings, we diagnosed this case as drug eruption due to hydroxyzine. Her eruption subsided after she discontinued hydroxyzine pamoate and other drugs which were started within 5 days before the onset of the eruption and was treated with systemic steroid, systemic antiallergic drug and topical steroid. 相似文献
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Yasunori Cho Satoru Suzuki Masakazu Yokoi Muneaki Shimada Saburo Kuwabara Akira Murayama 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2004,52(10):476-479
Lymphoblastic lymphoma, an aggressive mediastinal mass, is recognized as serious threat to the patient in developing cardiac
tamponade or airway obstruction. Surgical procedure is often required to relieve clinical emergency and to establish prompt
pathological diagnosis. However, in such a patient, acute respiratory occlusion in the spine position can be a life-threatening
complication during general anesthesia. We describe a 17-year-old man whose cardiac tamponade was treated by pericardial-pleural
window through a left anterior thoracotomy in the lateral position. The patient recovered from hemodynamic compromise without
showing respiratory occlusion during general anesthesia and remained in the lateral position until extubation. Pathological
diagnosis was precursor T-lymphoblastic lymphoma. There were no complications attributable to the operative procedure. Further
chemotherapy reduced the mediastinal mass in size after two weeks when the patient developed sepsis and died. Lateral position
prevents respiratory occlusion during surgical procedure under general anesthesia in the patient of huge anterior mediastinal
tumor with airway obstruction. 相似文献
6.
We report a case of corticobasal degeneration (CBD) presenting with visual hallucination. A 65-year-old woman showed clumsiness of the left hand. Clinical symptoms slowly progressed to include rigidity, which was left side dominant, limb-kinetic apraxia of the left hand, disorder of construction and dressing, unilateral spatial neglect, cortical sensory loss and alien limb phenomenon. Cranial MRI showed atrophy of the parietal and medial aspect of the frontal lobes, which was more severe on the right than on the left. SPECT images showed hypoperfusion in the parietal, frontal and temporal lobes, which were similarly more severe on the right than on the left. We diagnosed the patient as having CBD based on the clinical symptoms. Two years' later, she developed recurrent visual hallucinations that were typically well formed and detailed. Since patients with CBD generally do not experience visual hallucination, this case is considered the very rare and indicates the possibility that visual hallucination may be one of the clinical symptoms of CBD. 相似文献
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The effects of pulsatile cardiopulmonary bypass on the renin-angiotensin-aldosterone system and tissue metabolism, especially
those which occur soon after surgery, were studied in 26 patients who required total cardiopulmonary bypass for longer than
60 minutes. These patients comprised 11 who underwent open heart surgery utilizing nonpulsatile cardiopulmonary bypass (Group
I) and 15 who underwent open heart surgery utilizing pulsatile cardiopulmonary bypass (Group II). Plasma angiotensin II and
serum aldosterene levels were significantly increased one and 5 hours postoperatively in Group I when compared with the preoperative
values, whereas no significant elevations were observed in Group II. Plasma angiotensin II and serum aldosterone levels one
hour postoperatively in Group II were significantly lower than those in Group I. Lactate levels in the arterial blood were
significantly elevated, one and 5 hours postoperatively in both Groups I and II. Moreover, no significant difference was observed
in the lactate levels between Groups I and II, one hour postoperatively. In the nonpulsatile group (Group I), plasma angiotensin
II levels one hour postoperatively were correlated significantly with the duration of total cardiopulmonary bypass. In conclusion,
pulsatile cardiopulmonary bypass offers significant advantages in terms of lower plasma angiotensin II and serum aldosterone
levels, when compared with nonpulsatile cardiopulmonary bypass soon after open heart surgery requiring total cardiopulmonary
bypass for longer than 60 minutes, however, it does not offer a definite advantage for tissue metabolism. 相似文献
9.
Shun'Ichi Abe Hiroshi Yoshimura Hideki Tabara Mitsuo Tachibana Naomi Monden Teruhisa Nakamura Saburou Nagaoka 《Journal of surgical oncology》1995,59(4):226-229
Patients with stage T3N0~2M0 gastric carcinoma (n = 108) were studied for relevant prognostic factors. Peritoneal lavage cytology (PLC) was performed in all. In univariate analysis, 5-year survival rates were better with smaller serosal invasion (diameter <3.0 cm vs. ≥3.0 cm, 61% vs. 37%, P < 0.05) and fewer metastatic nodes (≤5 vs. ≥6, 57% vs. 29%, P < 0.05). In multivariate analyses, only these two factors were significant. The predictive value of PLC was not shown in both univariate and multivariate analyses. Peritoneal recurrence occured in 14 (22%) of 77 patients with negative PLC, and in 3 (18%) of 17 with positive PLC, the difference being not significant. Our results indicate that PLC is insensitive in predicting the development of peritoneal recurrence. Its role in the estimation of survival is limited, as many will die of visceral or locoregional recurrence if not of peritoneal dissemination. 相似文献
10.
Tadahito Kanda Takashi Onda Soichi Zanma Toshiharu Yasugi Akemi Furuno Sumie Watanabe Takashi Kawana Motoyasu Sugase Kuniaki Ueda Takahiko Sonoda Saburo Suzuki Takenobu Yamashiro Hiroyuki Yoshikawa Kunito Yoshiike 《Virology》1992,190(2)
The E4 open reading frame (ORF) of human papillomaviruses (HPVs) is transcribed in abundant mRNAs encoding an
fusion gene during the productive infection, and the HPV 16 E7 ORF encodes an oncoprotein detectable in the cell lines derived from cervical carcinoma. We examined 421 human sera, which included 108 samples from the patients with cervical carcinoma, for the presence of IgG antibodies against the HPV 16 E4 and E7 proteins by enzyme-linked immunosorbent assay. Bacterially expressed fusion protein lac-
and nonfusion protein E7 were purified and used as antigens. All of the 22 serum samples positive for anti-E7 antibody and the 11 out of 15 samples positive for anti-
antibody were from the patients with cervical carcinoma, but only one sample was found to contain both anti-
and anti-E7 antibodies. These findings show specific and independent association of these antibodies with cervical carcinoma. 相似文献