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排序方式: 共有1865条查询结果,搜索用时 9 毫秒
1.
Yosuke Homma Takashi Shiga Hiraku Funakoshi Dai Miyazaki Atsushi Sakurai Yoshio Tahara Ken Nagao Naohiro Yonemoto Arino Yaguchi Naoto Morimura 《The American journal of emergency medicine》2019,37(2):241-248
Objective
This study assessed the association between the timing of first epinephrine administration (EA) and the neurological outcomes following out-of-hospital cardiac arrests (OHCAs) with both initial shockable and non-shockable rhythms.Methods
This was a post-hoc analysis of a multicenter prospective cohort study (SOS-KANTO 2012), which registered OHCA patients in the Kanto region of Japan from January 2012 to March 2013. We included consecutive adult OHCA patients who received epinephrine. The primary result included 1-month favorable neurological outcomes defined as cerebral performance category (CPC) 1 or 2. Secondary results included 1-month survival and return of spontaneous circulation (ROSC) after arrival at the hospital. Multivariable logistic regression analysis determined the association between delay per minute of the time from call to first EA in both pre- or in-hospital settings and outcomes.Results
Of the 16,452 patients, 9344 were eligible for our analyses. In univariable analysis, the delay in EA was associated with decreased favorable neurological outcomes only when the initial rhythm was a non-shockable rhythm. In multivariable analyses, delay in EA was associated with decreased ROSC (adjusted odds ratio [OR] for one minute delay, 0.97; 95% confidence interval [CI], 0.96–0.98) and 1-month survival (adjusted OR, 0.95; 95% CI, 0.92–0.97) when the initial rhythm was a non-shockable rhythm, whereas during a shockable rhythm, delay in EA was not associated with decreased ROSC and 1-month survival.Conclusions
While assessing the effectiveness of epinephrine for OHCA, we should consider the time-limited effects of epinephrine. Additionally, consideration of early EA based on the pathophysiology is needed. 相似文献2.
Yosiaki Yajima Nobutaka Takahashi Atsusi Miyazaki Ryosuke Kikuchi Keisuke Kakisaka Keisuke Oikawa Kazuhiko Sugawara Yoshiki Eda Hiroshi Naganuma Masamitsu Unagami 《Nihon Shokakibyo Gakkai zasshi》2006,103(5):515-522
From April 1989 to December 2004, we performed liver biopsy on 475 patients and obtained biopsy proven 35 cases of non-alcoholic fatty liver. Among them, 18 cases were diagnosed as non-alcoholic steatohepatitis (NASH). During the last three years, we have tried to detect NASH using ultrasonography and elevated value of serum ferritin (> 300 ng/ml). All of the eligible 7 cases biopsied during the course were diagnosed as NASH. In these 7 cases, ALT levels improved after the body weight loss accompanied by the parallel decrease of serum ferritin levels. Measurement of serum ferritin is useful in the detection of NASH but the normal value of ferritin cannot rule out the possibility of NASH. 相似文献
3.
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5.
Portsite and intraabdominal metastases of unsuspected gallbladder carcinoma after laparoscopic cholecystectomy: Report of a case 总被引:1,自引:0,他引:1
Nobuhiro Shibata Katsumi Kagotani Sadao Noguchi Masamitsu Tamai 《Surgery today》1996,26(12):1014-1016
We herein report a rare case of portsite metastasis of gallbladder carcinoma which occurred after laparoscopic cholecystectomy. A 64-year-old man underwent laparoscopic cholecystectomy at another hospital for symptomatic cholecystolithiasis. The histological examination revealed an adenocarcinoma of the gallbladder infiltrating the entire wall. Despite the physician's advice the patient refused any additional treatment. Thirteen months after surgery he visited our hospital because of a palpable mass at the scar of the right trocar incision. The nodule was removed and histological examination confirmed metastasis from the gallbladder carcinoma. 相似文献
6.
Hidemi Yamauchi MD Kikuo Miyagawa Masamitsu Maeda Seiki Matsuno Toshio Sato 《Surgery today》1986,16(1):8-15
The findings in twenty-two patients with insulinoma were reviewed, as continuous efforts should be made to establish preoperative
localization of the tumor. Superselective arteriography and percutaneous, transhepatic portal vein and pancreatic venous catheterization
are highly recommended approaches. At the time of surgical intervention, a cautious exploration of the pancreas after thorough
mobilization is most important. Recent use of intraoperative ultrasonography increases the likelihood of finding these occult
tumors which locate deeply in the head of the pancreas. Apart from the diagnostic problems, we wish to emphasize the high
incidence of malignancy (7/22, 31.8 per cent) in our series. Althout patients with malignant isulinoma had a much better prognosis
compared to those with a pancreatic ductal malignancy, pancreatic resection with regional lymphnode dissection seems to be
a rational procedure. Enucleation can be done when intraoperative findings of the tumor and regional lymphonode indicate no
malignant features and no multiple lesions. However, at the first operation, enucleation is still a procedure of choice, even
for the malignant insulinoma in the head with a well-defined capsule and no metastatic lesions, the objective being to avoid
a duodenopancreatectomy or total pancreatectomy.
These data were reported at the 30th Congress of Société Internationale de Chirurgie, Hamburg, Germany, 1983 相似文献
7.
Q-Switched Alexandrite Laser Therapy for Pigmentation of the Lips Owing to Laugier-Hunziker Syndrome 总被引:2,自引:0,他引:2
Ozawa Toshiyuki MD Fujiwara Masao MD † Harada Teruichi MD Muraoka Michinari MD Ishii Masamitsu MD 《Dermatologic surgery》2005,31(6):709-712
BACKGROUND: Laugier-Hunziker (LH) syndrome is a rare benign condition in which hyperpigmentation of the lips and buccal mucosa occurs with no systemic associations. OBJECTIVE: We report the response to treatment with the Q-switched alexandrite laser (QSAL) because there are few reports on therapy for LH syndrome. METHODS: The QSAL was used for pigmentation of the lips in a 63-year-old woman with LH syndrome. Laser irradiation was done at 5.0 J/cm2 with a 3 mm spot size. RESULTS: There was 100% clearance of pigmentation of the lips with a single laser treatment, and recurrence was not observed after 6 months. CONCLUSION: The QSAL is very effective for pigmentation owing to LH syndrome. 相似文献
8.
Distortion and movement of the expander during skin expansion. 总被引:2,自引:0,他引:2
Masamitsu Kuwahara Mitsuo Hatoko Hideyuki Tada Aya Tanaka Satoshi Yurugi Kumi Mashiba 《Nordisk plastikkirurgisk forening [and] Nordisk klubb for handkirurgi》2003,37(1):22-27
Distortion and movement of tissue expanders can cause expansion of the wrong area, such as the naevus or the scar that is to be resected. In 71 rectangular expanders, we examined the incidence of distortion (over 15 degrees) and movement (over 3 cm). We divided the expanders into three anatomical site groups: scalp, body, and extremities, and compared the complication rate between two study groups (distortion or movement, or not). In total, the incidence of distortion was 15/71 (21%) and that of movement 5/71 (7%). Distortion occurred mainly in the extremities (11/33,33%). The implanted expanders tended to move more often in the body part (3/15, 20%). In the extremities, the bigger the angle between the axis of the implanted expander and that of the extremity, the bigger the angle of distortion. Although the incidence of complications between the two groups was not significant, except for alteration in design of the flap, we recommend that these points should be considered when preoperative plans are being made for appropriate patients. 相似文献
9.
Mariko Kobayashi Yukihiro Takahashi Makoto Ando Naoki Wada Masamitsu Murata Toshio Kikuchi 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2005,53(12):635-637
A 6 month-old male infant (weight: 4.5 kg) with congenital aortic stenosis underwent aortic valve replacement with a pulmonary
autograft (Ross procedure). The right ventricular outflow tract (RVOT) was reconstructed with a polytetrafluoroethylene (PTFE)-valved
equine pericardial conduit. At the age of 5, re-RVOT reconstruction with an equine pericardial patch bearing a PTFE monocusp
was required because of severe pulmonary stenosis resistant to 2 attempts of percutaneous transluminal pulmonary valvotomy.
Currently, at the age of 8, the degree of aortic regurgitation is trivial and the pulmonary autograft is free of functional
deterioration despite somatic growth. 相似文献
10.
A case of heparin-induced thrombocytopenia that worsened preexisting cerebral infarction] 总被引:1,自引:0,他引:1
Hiroshi Yaguchi Hidetaka Mitsumura Ritsuko Ozawa Hironori Sato Kiyoharu Inoue 《Clinical neurology》2004,44(9):636-638
A 75-year-old man was admitted to our hospital with dysesthesia of the right lip, dysphagia and gait disturbance. He presented with right Wallenberg syndrome and brain MR image showed a fresh infarction in the right lateral medulla. Therapy with heparin and ozagrel sodium was started. For a time his symptom improved a little, but after 8 days he developed re-infarction, thrombocytopenia and DIC, while being treated with heparin for cerebral infarction. Heparin was discontinued, and these symptoms improved quickly. The clinical course and the positive anti-platelet factor 4-heparin complex antibody suggested that these symptoms were caused by heparin-induced thrombocytopenia (HIT). HIT should be included as a differential diagnosis for progression of ischemic stroke under heparin therapy. 相似文献