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Masaru Sasaki Tsuyoshi Takahashi Soichiro Funaki Koji Tanaka Yasuhiro Miyazaki Naoko Ose Tomoki Makino Yukinori Kurokawa Makoto Yamasaki Kiyokazu Nakajima Yasushi Shintani Masaki Mori Yuichiro Doki 《Asian journal of endoscopic surgery》2021,14(1):116-119
We report a case of a diaphragmatic hernia after a heart transplant operation. A 43-year-old woman, who underwent orthotropic heart transplantation for hypertrophic cadiomyopathy two year earlier, presented with vomiting and epigastric pain. A computed tomography scan showed that the stomach and transverse colon were dislocated in the left thoracic cavity. We diagnosed left diaphragmatic hernia incarceration and performed laparoscopic repair of the diaphragmatic hernia. A 12 × 8 cm diaphragmatic defect was found intraoperatively on the ventrolateral aspect of the left diaphragm, and the stomach with volvulus had herniated into the thorax through the defect. The hernia was considered to be iatrogenic. The diaphragmatic defect was large, and the diaphragm was thinning. We closed the defect by mesh repair. Laparoscopic mesh repair of the diaphragmatic hernia could be performed safely and with minimal invasiveness. 相似文献
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Hiroto Kinoshita Hitomi Nishioka Aya Ikeda Kyoko Ikoma Yoichi Sameshima Hidehisa Ohi Mizuki Tatsuno Junka Kouyama Chiaki Kawamoto Tomohiro Mitsui Yuko Tamura Yu Hashimoto Masashi Nishio Tsuyoshi Ogashiwa Yusuke Saigusa Shin Maeda Hideaki Kimura Reiko Kunisaki Kazuhiko Koike 《Journal of gastroenterology and hepatology》2019,34(11):1929-1939
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Koji Matsumoto Masahiro Hoshino Keita Omori Hidetoshi Igarashi Hiromi Matsuzaki Yasuaki Tokuhashi 《Journal of orthopaedic science》2021,26(4):538-542
BackgroundAdjacent vertebral fracture (AVF) is a major complication following Balloon Kyphoplasty (BKP). There is no scoring system for predicting AVF using only preoperative elements. The purposes of this study were to develop a scoring system for predicting early AVF after BKP based on preoperative factors and to investigate the appropriate surgical indication for BKP.MethodsOf 220 patients who underwent BKP at a single institution since 2011, 65 patients over the age of 60 who had undergone a standing whole spine X-ray preoperatively were enrolled. Factors affecting the occurrence of early AVF were examined. A scoring system was created consisting of the factors exhibiting significant differences, and the correlation between the total score and the incidence of early AVF was investigated.ResultsTwenty of the 65 patients (30.8%) had early AVF. In a univariate analysis, age, previous vertebral fracture, pelvic tilt, and Local kyphosis significantly influenced early AVF. In a multivariate logistic regression analysis, age had an odds ratio of 1.136 (95% CI 1.001–1.289), previous vertebral fractures 4.181 (1.01–17.309), and Local kyphosis 1.103 (1.021–1.191). The scoring system was set as follows: ①Age (<75 years: 0 points(P), 75years≦: 1P), ②The number of previous vertebral fractures (0: 0 P, 1: 1P, 2: 2P, 3 or more: 3P), and ③Local kyphosis (<10°: 0P, 10°≦: 1P). There was a correlation between the total score and the incidence of early AVF (r = 0.812, 1P = 0.05). The incidence of early AVF was 6.4% (2 cases/31 cases) for a score of ≦1P and 54.5% (18 cases/33 cases) for a score of ≧2P.ConclusionsThere was a correlation between the total score and the incidence of early AVF. A score of 1 point or less may represent the appropriate surgical indication for BKP. 相似文献
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Ichiro Yasuda Takuji Iwashita Takaya Ohnishi Tsuyoshi Mukai Masamichi Enya Eiichi Tomita Hisataka Moriwaki 《Digestive endoscopy》2006,18(Z1):S92-S95
Endoscopic nasobiliary drainage (ENBD) is a well established mode of biliary decompression. Although ENBD is certainly an uncomfortable procedure with the potential risk of spontaneous dislocation or removal of the drainage catheter by disoriented patients, it has several advantages over endoscopic biliary drainage (EBD) using an indwelling stent. The current indications for ENBD are: (i) temporary drainage to treat obstructive jaundice and cholangitis caused by malignant or benign biliary stricture; (ii) urgent drainage to treat suppurative cholangitis primarily caused by common bile duct stones; (iii) temporary drainage after stone removal in patients with suspected incomplete clearance and/or with cholangitis; and (iv) biliary leaks that occur primarily after surgery, as well as other indications. Different types of nasobiliary catheters are currently available that have been designed with various diameters, shapes, and materials. However, the current catheters are not considered by most endoscopists to be sufficient. Further improvements are needed to achieve better drainage and better maneuverability. 相似文献
9.
In July 2001, psychiatric wards for acute treatments (PWAT) were investigated in Japan using a questionnaire to clarify current and recent problems in 79 PWAT. The questionnaires were sent to wards, patients and psychiatrists and were returned by 72.2% overall. The number of admissions per ward was calculated as 21 patients per one month, and comprised half of all admissions to the hospital. 50% were schizophrenia, 17% were affective disordes and 16% involved drug abuse. Seventeen patients were discharged from PWAT per one month, and comprised 43% of all patients discharged from the hospital. These results indicate that both 21 patients admitted and 17 patients discharged per month and needs to maintain the essential standard for PWAT and the standard should be come more flexible as admission from the other unit of ward than PWAT. As rate of re-admission within 3 months after discharge was around 10% of the total number of patients in the ward, 3 months was considered suitable length of acute treatment in the field of psychiatry in Japan. There was one psychiatrist working in PWAT, and specialized psychiatrists had 17.4 patients, the most number of patients among types of psychiatrist. Simulations of one psychiatrist to 16 and to 32 patients in PWAT were performed to determine how many psychiatrists were needed for a ward. When the ratio was 32 patients to 1 psychiatrist, it was necessary to increase the number of psychiatrists to a ward by 1, and in the case of 16 patients, 1-3 psychiatrists were needed. These indicate the standard number of psychiatrists for PWAT should be at most one psychiatrist for the ward or all of the psychiatrists working in PWAT should be allowed to work simultaneously in other wards. Preparing wards to treat acute phase psychiatric patients is a very important role of each psychiatric hospital, the standard for PWAT should include not only a high level of medical staff, but also preparing easy criteria for each hospital. 相似文献
10.
High incidence of nitrosamine-induced tumorigenesis in mice lacking DNA repair methyltransferase 总被引:12,自引:4,他引:8
Iwakuma T; Sakumi K; Nakatsuru Y; Kawate H; Igarashi H; Shiraishi A; Tsuzuki T; Ishikawa T; Sekiguchi M 《Carcinogenesis》1997,18(8):1631-1635
The enzyme O6-methylguanine-DNA methyltransferase repairs alkylation-
induced DNA damage, O6-methylguanine and O4-methylthymine, the former being
formed more frequently. Previously, by means of gene targeting, we
generated mice in which alleles for methyltransferase were disrupted. We
now use these mouse lines, which are totally deficient in methyltransferase
activity, to examine protective effects of the enzyme against tumor
formation. In gene-targeted female mice given an i.p. injection of 5 mg/kg
of dimethylnitrosamine, a larger number of liver and lung tumors occurred,
as compared with normal female mice treated in the same manner. In male
mice given a lower dose of carcinogen, the difference between normal and
gene-targeted mice was statistically insignificant although more tumors did
form in the gene-targeted mice. Methyltransferase apparently afforded
protection from nitrosamine- induced tumorigenesis.
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