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排序方式: 共有1869条查询结果,搜索用时 703 毫秒
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Kenichi Okubo Masashi Kobayashi Hiromasa Morikawa Eiichi Hayatsu 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2006,54(7):268-272
Objective: Induction chemoradiotherapy followed by anatomical resection is a current therapeutic strategy for non-small-cell lung cancer
with mediastinal node involvement. Dense peritracheal fibrosis and sclerosis after chemoradiotherapy cause difficult mediastinal
node dissection. We evaluated a novel technique to make the mediastinal node dissection easier after induction therapy. Methods: At the end of mediastinoscopic node biopsy for staging of lung cancer, cotton-type collagen was inserted anterior and lateral
to the trachea in patients with pathologically confirmed mediastinal node involve-ment (n=45). The induction therapy consisted
of concurrent use of platinum-based chemotherapy and hyperfractionated radiotherapy. After the chemoradiotherapy all patients
underwent a pulmonary resection with complete mediastinal node dissection 7–12 weeks after the collagen insertion. Surgical
findings of the mediastinum and the time for node dissection were compared with those without collagen insertion at mediastinoscopy
after chemoradiotherapy (n=5). Results: All five patients without collagen insertion showed sclerotic and fibrotic change of mediastinal nodes with severe adhesion
to the trachea. In 42 of 45 patients with collagen insertion (93.3%) the collagen remained unabsorbed and separated the mediastinal
nodes from the trachea. Mediastinal node dissection was easily accomplished by removing mediastinal tissues lateral and anterior
to the collagen. The rate of mediastinal node separation was significantly higher with collagen insertion than without (p<
0.0001). The times for node dissection in patients with and without collagen insertion showed no significant difference. Conclusion: Cotton-type collagen insertion at staging mediastinoscopy for lung cancer separates the mediastinal nodes from the trachea
and makes the node dissection easier after induction chemoradiotherapy. 相似文献
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Abstract: A prospective study was performed to determine whether low-density lipoprotein (LDL) apheresis, when performed only immediately before and after percutaneous transluminal coronary angioplasty (PTCA), is effective in preventing restenosis of coronary artery lesions following PTCA. Thirty-six patients with coronary heart disease (CHD) and hypercholesterolemia were divided into 2 groups. The 9 patients in the LDL group underwent LDL-apheresis 1 day before and 5 days after PTCA while the 27 patients of the control group underwent PTCA but did not undergo LDL-apheresis. Follow-up coronary angiography (CAG) was performed 4 months after PTCA. The rate of restenosis of coronary artery lesions was significantly lower in the LDL group (0%) than in the control group (30%). These findings suggest that LDL-apheresis, when performed before and after PTCA, is effective in preventing restenosis of coronary artery lesions in patients with CHD and hypercholesterolemia. 相似文献
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Soichi Hotta Hiromasa Kashimura Shinji Hirai Akira Nakahara Hisayuki Fukutomi Toshiaki Osuga Yasuo Uchiyama 《Lasers in surgery and medicine》1995,16(3):262-271
Background and Objective: To further understand the precise process of the tumor cell degeneration after photodynamic therapy (PDT), laser hyperthermic therapy (LH), and combined treatments using an Nd:YAG laser. It is important to examine initial morphological alteration of tumor cells after these treatments. Study Design/Materials and Methods: In this study, nude mice bearing HeLa cell tumors were treated with PDT, LH, and combined treatments of the two. Tumor tissues obtained immediately after these treatments were analyzed using electron microscopy and morphometry. Results: In the combined treatments, which produced more severe effects on tumor cells, morphological features of apoptosis such as cytoplasmic condensation, blebs, and apoptotic bodies appeared in the cells, although the typical alteration in the nuclear chromatin was not seen. Conclusion: Cytoplasmic alterations may proceed more rapidly than nuclear alterations in the cellular degeneration induced by the single or combined treatments of PDT and LH. 相似文献
8.
Takashi Takata Yong Lu Ikuko Ogawa Ming Zhao Zhi Yu Zhou David Mock Hiromasa Nikai 《Pathology international》1998,48(11):877-881
The calcifying odontogenic cyst (COC) presents with diverse hlstologlcal features; thus, several subclasslfl-cations have been proposed. To evaluate the slgnlficance of the various histological features and subtypes of COC from the perspectlve of proliferative activity, the proliferating cell nuclear antigen (PCNA) labellng index (LI; the percentage of positive nuclei) was assessed immunohistochemlcally in 25 cases of COC (21 benign and four malignant). All of the benign cases were of the cystic variety and further subclas-sified into non-proliferative subtype (NPS; four cases); proliferative subtype (PS; eight cases); and COC associated with odontoma (COCaO, nlne cases). The PCNA U of the mallgnant COC (65.2 ± 5.6) was slgnlflcantly higher than that of the benlgn COC (11.6 ± 9.0; P = 0.002). Non-proliferative subtype (6.8 ± 2.8) showed the lowest PCNA LI and PS (17.2 ± 11.2) the highest of among the three subtypes of benign cystic COC (P = 0.028). In nine cases of COCaO, six showed epithelial lining of the non-proliferative type as NPS and the other three had lining wlth proliferative features as PS. The PCNA LI of the latter COCaO group (14.3 ± 6.6) was significantly higher than that of the former (6.1 ± 4.3; P = 0.05), as Seen between PS and NPS. These results demonstrate that PCNA LI is a possible parameter for differentiating mallgnant COC from benign COC and, whatever the subtypes, the proliferative features In the lining are the main factor influencing the prollferatlng actlvity of COC. 相似文献
9.
Hiroko Sasahara Susumu Sueyoshi Toshiaki Tanaka Hiromasa Fujita Kazuo Shirouzu 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2004,52(5):231-239
Objective: The purpose of this experimental study was to investigate whether aortic stent grafting can be applied to the treatment of
an esophageal cancer involving the thoracic aorta. Methods: The canine thoracic aorta was partially resected without aorta being clamped after emplacement of an endovascular stent graft.
Study I; The aortic whole layer of 1 cm in length and 1/4 of the circumference was resected and was covered by a free fascia
patch of the abdominal rectal muscle immediately after stent graft placement. Study II; The aortic adventitia and the outer
half of the media of the same size was resected on day 3, 7,14, 21, and on day 28, after the stent graft placement. The resected
portion was covered by the free fascia patch in half experimental dogs, and was uncovered in the others. Study III; The aortic
adventitia and the outer half of the media of 1 cm in length and 1/2 of the circumference was resected and was uncovered on
day 7 after stent graft placement. Histological examinations were performed on day 28 and at one year after aortic resection.
Results: The aortic wall could be resected in all cases with no complication, except in resection of 1/2 the circumference where the
aorta had become narrow. There was no difference in healing of the resected portion of the aorta between with and without
fascia covering. Conclusion: An aortic endovascular stent graft could be applied to surgery for an esophageal cancer involving the aorta. 相似文献
10.
Hiromasa Yanagi Jiro Kondo Keiji Uchida Michio Tobe Shin-ichi Suzuki Yoshimi Yano 《General thoracic and cardiovascular surgery》1998,46(10):1014-1019
We experienced a case with acute mitral regurgitation caused by complete posterior papillary muscle rupture as complication of acute inferior myocardial infarction, who underwent successfully emergency operation of mital valve replacement and coronary revascularization in acute stage. A 64-year-old woman developed sudden cardiogenic shock shortly after the onset of acute inferior myocardial infarction. The diagnosis of acute inferior myocardial infarction was based on the electrocardiographic findings. Under IABP support, preoperative coronary angiography visualized total occlusion of segment 3 of the right coronary artery, and preoperative left ventriculography showed akinesis of inferior wall and severe mitral regurgitation. At 6 hours after onset of papillary muscle rupture, emergency operation was performed. At operation, posterior papillary muscle was found to be totally ruptured. Coronary artery revascularization and mitral valve replacement were performed. Postoperative course was uneventful, with 4 days of IABP and 5 days of ventilatory support. She was discharged on the twentieth postoperative day in NYHA class I. Reports of successful emergency operation for total papillary muscle rupture following acute myocardial infarction are rare. Early diagnosis and surgical treatment are mandatory to save this group of patients. 相似文献