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YUKO UCHIMURA‐MAKITA M.D. YUKIKO NAKANO M.D. Ph.D. TAKEHITO TOKUYAMA M.D. MAI FUJIWARA M.D. YOSHIKAZU WATANABE M.D. AKINORI SAIRAKU M.D. HIROSHI KAWAZOE M.D. HIROYA MATSUMURA M.D. NOZOMU ODA M.D. HIROKI IKANAGA M.D. CHIKAAKI MOTODA M.D. KENTA KAJIHARA M.D. Ph.D. NOBORU ODA M.D. Ph.D. RICHARD L. VERRIER Ph.D. YASUKI KIHARA M.D. Ph.D. 《Journal of cardiovascular electrophysiology》2014,25(9):1021-1027
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Susumu SHIOMI Nohumitsu SASAKI Hirokazu KADOYA. Chulyoo LEE Masaru ENOMOTO Nohuyuki TATSUMI Hiroyasu MORIKAWA Masayuki OGAMI Hideo MASUICHI Kazuki NAKATANI Akihiro TAMORI Daiki HABU Hiroki SAKAGUCHI Shuhei NISHIGUCHI Shuichi SEKI Tetsuo KUROKI 《Digestive endoscopy》1999,11(2):174-178
Abstract: We describe a 56-year-old woman with congenital hepatic fibrosis. Blood tests and liver scanning with Tc-99m-labelled galactosyl human serum albumin revealed mild liver dysfunction. Per-rectal portal scintigraphy with iodine-123 iodoamphetamine showed severe abnormalities in the portal circulation, and the portal pressure measured during percutaneous transhepatic portography was high (350 mmH2O). Idiopathic portal hypertension was suspected. Laparoscopy disclosed diffuse, intense dendritic white markings around the liver. Congenital hepatic fibrosis was confirmed on histologic examination of a biopsy specimen obtained during laparoscopy. In summary, we report a rare and relatively elderly case of CHF, in which laparoscopy was useful in the diagnosis. (Dig Endosc 1999; 11: 174–178) 相似文献
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Masanori MATSUSHITA Osamu SHIROEDA Hideto INOKUCHI Makoto HIROTA Yasuki HABU Keisuke KIYOTA Kiyoshi HIRAI Takashi YOKOTA Kyoichi INOUE 《Digestive endoscopy》1994,6(3):269-274
Abstract: Gastric cancer manifesting as a submucosal tumor (SMT) is not common. A gastric barium meal and endoscopic studies performed on a 49-year-old male with epigastric pain, revealed an elevated lesion with bridging folds and central depression on the posterior wall of the lower body. An endoscopic ultrasonography (EUS) revealed a hypoechoic mass lesion within the submucosal layer. Due to an increase in the size of the tumor and its central depression during the subsequent year and a half, the patient was admitted for closer examination. Endoscopic biopsy material from the deeper layer, obtained by mucosal resection, revealed a poorly differentiated adenocarcinoma. Microscopic examination of the resected stomach showed a poorly differentiated adenocarcinoma within the submucosal layer, with considerable lymphocyte infiltration. Immunohistological examination disclosed marked T cell infiltration adjacent to the cancer cells. We suggest that considerable lymphocyte infiltration, particularly T cells, may have some role in the protective reaction against cancer cells. Our case was diagnosed as being cancer 18 months after the first endoscopic study. The biopsy material taken from the depression at the time of the first examination showed benign findings and a EUS revealed typical SMT. In the case of SMT shown by EUS to be a hypoechoic mass lesion in the submucosal layer, it is recommended that biopsy material be obtained from the deeper layer using methods available such as artificial ulcer formation. 相似文献
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AKINORI SAIRAKU M.D. YUKIHIKO YOSHIDA M.D. HIROKI KAMIYA M.D. YASUSHI TATEMATSU M.D. MAMORU NANASATO M.D. HARUO HIRAYAMA M.D. YUKIKO NAKANO M.D. YASUKI KIHARA M.D. 《Journal of cardiovascular electrophysiology》2012,23(12):1289-1294
AF Ablation in HD Patients . Introduction: It is not common for patients on chronic hemodialysis (HD) to undergo catheter ablation of atrial fibrillation (AF). We aimed to show the outcomes of AF ablation in the HD patients. Methods and Results: Thirty HD patients who underwent pulmonary vein (PV) isolation for drug refractory paroxysmal AF were retrospectively studied, and their AF recurrence free rate and frequency of periprocedural complications were compared to 60 age‐ and gender‐matched control patients not requiring HD. A nonirrigated ablation catheter was used in both patient groups. During a mean follow‐up period of 821 ± 218 days, 16 (54%) of the HD patients remained free from AF recurrence without any antiarrhythmic agents versus 47 (78%) of the control patients with an initial ablation (P = 0.013). A second ablation procedure was performed in 12 patients with an AF recurrence, and consequently 20 (67%) of the HD patients were in sinus rhythm compared to 53 (88%) of the controls during a follow‐up duration of 747 ± 221 after the last ablation (P = 0.012). Bleeding from the venipuncture site requiring a prolonged hospital stay was identified in 2 HD patients and 1 control subject, while no life‐threatening complications were observed in either patient group. Conclusion: Although the success rate of the PV isolation in HD patients was far from satisfactory, it may be considered as one of the therapeutic options for them. (J Cardiovasc Electrophysiol, Vol. 23, pp. 1289‐1294, December 2012) 相似文献
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YOUSAKU OKUBO AKINORI SAIRAKU NOBUYUKI MORISHIMA HIROSHI OGI TAKESHI MATSUMOTO HIROKI KINOSHITA YASUKI KIHARA 《Journal of cardiac failure》2018,24(8):520-524
Background
Urinary liver-type fatty acid–binding protein (L-FABP) is a potential biomarker for acute kidney injury, and it in turn increases cardiovascular mortality. We tested whether the urinary L-FABP level predicted short- and mid-term outcomes in patients with acute heart failure.Methods and Results
We enrolled consecutive patients with acute heart failure, and measured their urinary L-FABP levels before acute treatment. Worsening renal function (WRF), defined as both an absolute increase in the serum creatinine level of ≥0.3mg/dL and a ≥25% relative increase in its level from baseline, occurred in 37 (26.8%) of 138 patients. Patients with a urinary L-FABP level above the upper normal limit (8.4 µg/g creatinine) (n = 49; 35.5%) were more likely than those with a urinary L-FABP level within normal limits (n = 89; 64.5%) to develop WRF (n?=?26 [53.1%] vs n?=?11 [12.4%]; P < .001). A urinary L-FABP level above the upper limit was independently associated with WRF (hazard ratio 1.8; P?=?.01). During 1 year of follow-up, 12 patients (8.7%) died, and urinary L-FABP level had no association with all-cause mortality. There was, however, a tendency toward a higher readmission rate in patients with a urinary L-FABP level above the upper normal limit who survived the index hospitalization (n = 46) than in those without an abnormal L-FABP level (n = 88; n = 13 [28.3%] vs n?=?13 [14.8%]; log-rank P?=?.06).Conclusions
Increased urinary L-FABP level before treatment may predict WRF in patients with acute heart failure. Further investigation is warranted for its predictive ability of adverse outcomes. 相似文献9.
KATSUMI TORIGOE OSAMU NUMATA MASAMITI MATSUNAGA YASUKI TANAKA CHIHAYA IMAI HAJIME YAMAZAKI 《Pediatrics international》1997,39(1):28-33
The intra-abdominal visceral fat to subcutaneous fat ratio (V/S ratio) has been reported to be strongly related to disorders of glucose and lipid metabolism, and hypertension. It is a matter of concern as to whether weight loss causes an improvement of the V/S ratio or not in obese children. Changes in body fat distribution during weight loss in 23 obese children were quantified by weight, bioelectrical impedance analysis (BIA) and computed tomography (CT scan of the abdomen). Twenty-three patients were divided into two groups; six were in the inpatient group and 17 were in the outpatient group. Bodyweight, body fat percentage, subcutaneous fat and visceral fat were significantly higher in the inpatient group than in the outpatient group before weight loss. Whereas the V/S ratio was almost equal between the two groups before weight loss. Bodyweight, body fat percentage, subcutaneous fat and visceral fat were found to decrease significantly during weight loss in the two groups. The V/S ratio of the outpatient group did not change after weight loss. In contrast, the V/S ratio of the inpatient group decreased significantly during weight loss. These preliminary findings suggest that a large amount of body fat and a high obesity rate are not always accompanied by a high V/S ratio in obese children. The fat pattern changes during weight loss with strict dietary therapy and therapeutic exercise. A larger sample of obese children should be studied to test this conjecture. 相似文献
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YASUKI MAENO YUMI KIYOMATSU NORIKO RIKITAKE ON TOYODA TAKUMI MIYAKE TEIJI AKAGI MASAHIRO ISHII TERUHIRO KAWANO TAKEYO KAZUE JUNJI ISHIMATU HIROHISA KATO 《Pediatrics international》1995,37(4):431-436
Fetal echocardiography can provide useful information for the evaluation of fetal arrhythmias. Between 1980 and 1993, 44 fetuses with arrhythmias were diagnosed in utero at 12 and 40 weeks of gestation in Kurume University Hospital. Fetal bradycardia, tachycardia and ectopic beats were revealed in 17, seven and 20 fetuses, respectively, and their clinical features and prognosis were evaluated. In the 17 fetuses with bradycardia, eight were associated with congenital heart defect, and six of these developed to fetal hydrops. Of the 17 fetuses, four died in utero, one was terminated, and six died after birth. The other six cases survived. Three of these had a pacemaker implanted after birth. In the seven fetuses with tachycardia, transplacental anti-arrhythmic drugs were administered in five cases and conversion of the arrhythmia was achieved in four. None of the cases was associated with any congenital heart defect, and none died. Three infants had paroxysmal tachycardia postnatally. In the 20 fetuses with ectopic beats, arrhythmia was observed postnatally in 10, but all of these were resolved within 3 months after birth. Fetal bradycardias carried a poor prognosis in most cases and further studies are required to establish effective treatment. Some cases of fetal tachycardia developed recurrent tachycardia postnatally. Close follow-up of the newborn is therefore necessary. 相似文献