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2.
Self-expandable metallic stent for unresectable malignant strictures in the esophagus and cardia 总被引:2,自引:0,他引:2
Shigeru Lee Harushi Osugi Taigo Tokuhara Masashi Takemura Masahiro Kaneko Yoshinori Tanaka Yushi Fujiwara Satoshi Nishizawa Hiroshi Iwasaki Shigefumi Suehiro 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2005,53(9):470-476
Objective Self-expandable metallic stent (EMS) placement has been the first choice for dysphagia because of the certainty over its safety,
low invasiveness, and immediate efficacy. However, there still remain some problems in relation to the EMS placement site
and anticancer therapies before and after EMS placement. Methods: Consecutive 78 patients in whom EMS was placed due to the unresectable malignant stricture in the esophagus or cardia from
July 1995 to August 2003 in our department were studied. Results: Gastroesophageal reflux was found in 5 of 8 patients after placement of conventional EMS for the stricture in the gastroesophageal
junction. Meanwhile, acid and bile reflux into the esophagus were not detected by pH and bilirubin monitoring, respectively,
in 6 patients after placement of the EMS with an anti-reflux mechanism for the stricture in the gastroesophageal junction.
The median survival period of all patients after EMS placement was 123 days. The median survival period of 7 patients with
radiotherapy only after EMS placement was 138 days and that of 17 patients with radiotherapy before EMS placement was 60 days,
which was shorter than that of the former (p<0.05). On the other hand, the median survival period after hospital admission
due to dysphagia of these 7 patients was longer than that of 17 patients with radiotherapy only before EMS placement, although,
the difference was not significant. Conclusion: EMS with an antireflux mechanism is not commercially available in Japan and approval is urgently required. The indication
of radiotherapy associated with EMS placement is to be studied further. 相似文献
3.
Shuichi Umeoka Koichi Baba Kiyohito Terada Kazumi Matsuda Takayasu Tottori Naotaka Usui Keiko Usui Fumihiro Nakamura Yushi Inoue Tateki Fujiwara Tadahiro Mihara 《Epileptic Disord》2007,9(4):443-448
We report a patient manifesting seizures with bilateral symmetric tonic posturing, which were markedly reduced after resection of the left precuneus. A 16-year-old man had sudden onset, complex partial seizures with bilateral symmetric tonic posturing since the age of eight years. Magnetic resonance fluid-attenuated inversion-recovery imaging revealed a hyperintense lesion in left precuneus. In almost all focal seizures recorded during an invasive EEG evaluation, ictal onset was detected from the inferomesial aspect of the lesion, but fast paroxysmal discharges from the ipsilateral supplementary motor area (SMA) were observed just before the clinical onset. After surgical excision of the EEG onset zone, including the lesion, seizure frequency was markedly (> 95%) reduced. By the 20th month after surgery, there were only brief nocturnal seizures involving slight elevation of both shoulders and slight abduction of both arms, with preservation of consciousness occurring once every few days. Invasive EEG findings and surgical outcome suggested that the epileptic activity originating from the epileptogenic zone may have propagated to the symptomatogenic zone including mainly the ipsilateral SMA. In summary, we report an interesting case of bilateral symmetric tonic posturing suggesting propagation to the SMA. MRI and invasive EEG confirmed the epileptogenic focus as a precuneate cortical dysplasia lesion.[Published with video sequences]. 相似文献
4.
Yushi Uetera Keiichi Hiramatsu Takeshi Yokota Katsuhiro Sato Masatoshi Ogawa 《Journal of infection and chemotherapy》1995,1(2):147-151
Electron microscopy and bacteriological culture revealed viable bacteria covered with a glycocalyx (biofilm) in choledochal
stones recovered from two patients with acute cholangitis. On the cut surface of the choledochal stones, the cholesterol stone
component was surrounded with a layer of brown pigment stone. In each case, bacterial culture of the choledochal stone recoveredPseudomonas aeruginosa. Since alginate is the main component of the glycocalyx produced byP. aeruginosa, serum IgM, IgG and IgA anti-alginate antibodies were measured in each patient. The present study is the first to demonstrate
acute and transient IgM seroconversion to alginate in cases of acute cholangitis. In one case, the elevation of anti-alginate
IgM preceded the elevation of anti-alginate IgG. The authors propose that the bacterial glycocalyx may play a significant
role in acute cholangitis. 相似文献
5.
目的:探讨妊娠早期人巨细胞病毒(HCMV)感染和妇女自然流产的关系。方法:采用ELISA和PCR分别为40例自然流产妇女和40例人工流产妇女和血清中人巨细胞病毒IgM抗体(HCMV-IgM)胎盘组织中人巨细胞病毒核酸(HCMV-DNA)进行检测。结果自然流产组妇女HCMV-IgM检出率为55%(22/40),人工流产组妇女为25%(10/40),自然流产组妇女胎盘组织HCMV-DNA检出率为10% 相似文献
6.
S-1 plus cisplatin combination chemotherapy in patients with advanced non-small cell lung cancer: a multi-institutional phase II trial. 总被引:3,自引:0,他引:3
Yukito Ichinose Kozo Yoshimori Hiroshi Sakai Yushi Nakai Takahiko Sugiura Masaaki Kawahara Hisanobu Niitani 《Clinical cancer research》2004,10(23):7860-7864
PURPOSE: To evaluate the efficacy and toxicity of a novel combination chemotherapeutic regimen including cisplatin with an oral anticancer agent, S-1 that consisted of tegafur, 5-chloro-2, 4-dihydroxypyridine, and potassium oxonate, for non-small-cell lung cancer (NSCLC) patients. EXPERIMENTAL DESIGN: In this phase II trial, patients with locally advanced and metastatic NSCLC were treated with the oral administration of S-1 at 40 mg/m(2) twice a day for 21 consecutive days while cisplatin (60 mg/m(2)) was administered intravenously on day 8. This schedule was repeated every 5 weeks. RESULTS: Of 56 patients enrolled in the study, 55 patients were eligible and analyzed. The median number of cycles administered was 3 (range, 1-12 cycles). Among these 55 patients, one complete response and 25 partial responses were observed with an overall response rate of 47% (95% confidence interval, 34-61%). The median survival time was 11 months and the 1-year survival rate was 45%. Hematologic toxicities of grades 3 and 4 included neutropenia (29%) and anemia (22%). No grade 4 nonhematologic toxicity was observed. Grade 3 toxicity included anorexia (13%), vomiting (7%), or diarrhea (7%). CONCLUSIONS: S-1 plus cisplatin combination chemotherapy showed a promising effectiveness with acceptable toxicity rates in patients with advanced NSCLC. These results warrant further investigations of this regimen including a randomized controlled trial for its use as a first line treatment for NSCLC. 相似文献
7.
89锶内照射治疗转移性骨肿瘤骨痛的临床观察 总被引:2,自引:0,他引:2
目的:分析89锶治疗转移性骨肿瘤的临床疗效及其安全性.方法:42例转移性骨肿瘤患者接受了89锶治疗.治疗后定期测定血常规、血生化等指标,随访时间3个月以上.对患者骨痛缓解情况、不良反应和血液学、肝肾功能变化进行观察和评价.结果:42例中有效35例,总有效率83.3%,起效时间2~20 d,缓解持续时间3~14个月.毒性反应主要有轻度可逆性骨髓抑制,血液学毒性小于Ⅱ级.无过敏反应及其他特殊不良反应.对肝肾功能无明显影响.结论:89锶对于转移性骨肿瘤所致的剧烈疼痛有良好的止痛效果,毒副作用小,是提高患者的生存质量的一种有效、安全的治疗方法. 相似文献
8.
目的探讨肾盏憩室去顶术后漏尿的治疗方法及预防措施。方法选择2003年至2013年我院收治的8例术后漏尿的患者,术前均误诊为肾囊肿,术后证实为肾盏憩室。在逆行插入D-J管的基础上,1例漏尿自然愈合;7例行手术治疗,其中1例采取微创顺行切开扩大憩室颈的方法,4例行开放手术,2例行腹腔镜手术,术中缝合憩室颈开口,灼烧憩室腔黏膜。结果所有患者漏尿均愈合,患者无发热,无腰痛,B超显示患肾周围无积液,其中6例憩室完全消失,2例可见憩室较术前明显减小。结论肾盏憩室行去顶减压后出现的漏尿不易自行愈合,应采用手术治疗,预后较好。而术前正确诊断肾盏憩室是减少术后漏尿的关键。 相似文献
9.
Fukuhara K Osugi H Takada N Takemura M Lee S Morimura K Taguchi S Kaneko M Tanaka Y Fujiwara Y Nishizawa S Fukushima S Kinoshita H 《Hepato-gastroenterology》2004,51(59):1515-1518
BACKGROUND/AIMS: Helicobacter pylori infection is known to induce gastritis, oxidative stress, and cyclooxygenase (COX)-2 expression in the gastric mucosa. However, the effect of H. pylori infection on remnant gastritis has not been studied. We investigated whether the severity of remnant gastritis and COX-2 expression were affected by H. pylori infection after distal gastrectomy. METHODOLOGY: The study included 97 patients with gastric cancer who underwent curative distal gastrectomy with lymphadenectomy in our department between May 1999 and April 2001. All patients underwent endoscopic examination 2 weeks before and 12 weeks after surgery. The presence of H. pylori infection was determined by urease activity, hematoxylin-eosin staining, and immunochemical staining. Histologic remnant gastritis was graded based on the degree of neutrophil infiltration using the updated Sydney System. COX-2 expression was estimated immunohistochemically. RESULTS: Both the degree of neutrophil infiltration and the level of COX-2 expression were significantly higher in patients with than without H. pylori (p<0.05). There was a significant correlation between the degree of neutrophil infiltration and the degree of COX-2 expression (p<0.001). CONCLUSIONS: H. pylori eradication may become a treatment for preventing both remnant gastritis as well as remnant gastric carcinoma after distal gastrectomy. 相似文献
10.
目的:针对超声检查在胎儿中枢神经系统畸形诊断中的应用价值进行探讨分析。方法选择于2012年12月—2013年12月在该院进行产前超声诊断的70例单胎孕妇为研究对象,所有孕妇的胎儿经分娩后随访和引产后尸检证实为中枢神经系统畸形,分析超声表现和超声检查的临床符合率。结果所有胎儿中,引产68例,继续妊娠后生产2例。经病理检查证实该组胎儿严重小脑畸形1例,3例脊柱裂,11例脑膜脑膨出和脑膜膨出,23例为脑积水,31例为无脑畸形。通过产前超声检查诊断,胎儿中枢神经系统畸形包括:1例蛛网膜囊肿,3例脊柱裂,11例脑膜脑膨出和脑膜膨出,23例为脑积水,32例为无脑畸形。超声检查与病理检查结果的临床符合率98.9%,误诊率为1.1%。结论超声检查在胎儿中枢神经系统畸形诊断中的应用具有较高的诊断率,并且操作简便,无创伤,可以作为产前排除胎儿中枢神经系统畸形的重要方法。 相似文献