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1.
2.
We experienced one necropsy case of brainstem encephalitis of Iizuka type (BSE) and one necropsy case of the brain-stem syndrome (BSS) of typical neuro-Beh?et's disease, and compared them clinically and neuropathologically. Clinically both of these cases showed chronic progressive mental disturbance, pseudobulbar paresis, spastic tetraparesis, cerebrospinal fluid pleocytosis, increased protein, and brainstem atrophy observed by X-CT. Neuropathologically, irregular, boundary-indistinct demyelinating lesions and obsolete softening lesions were sporadically found, associated with perivascular lymphocytic infiltration and gliosis centering on the brainstem. In this way, both cases were similar in many points except for the presence or absence of cutaneo-muco-ocular signs specific for Beh?et's disease. Also BSE and BSS reports in the literature showed that both diseases were similar not only in clinical findings consisting of mental disturbance and brainstem signs but also in neuropathological findings with similar topographical distribution of the same histopathological changes, including the variations and diversity of these characteristics. Especially of much interest is their similarity in characteristic mental disturbance. In discriminating BSE from multiple sclerosis and other diseases with exclusive involvement of the brainstem, it is important to understand their clinical characteristics. The characteristic mental disturbance includes damage to memory and sentiment, a change in personality, and lowering in spontaneity, but calculation ability and orientation are comparatively preserved. Of course the similarity in clinical and neuropathological findings does not necessarily mean the identical etiopathogenesis. However, it is possible to consider that neuro-Beh?et's disease (syndrome) may form a wide spectrum with BSE and typical neuro-Beh?et's disease at the both ends, regarding the time and spatial diversity of the appearance of cutaneo-muco-ocular signs. 相似文献
3.
Shinhiro Takeda Kazuhiro Nakanishi Teruo Takano Gen Ishikawa Ryo Ogawa 《Journal of anesthesia》1997,11(2):83-87
Effective gas exchange can be maintained in animals without endotracheal intubation using external high-frequency oscillation
(EHFO). The aim of this study was to evaluate the effect of EHFO in patients with respiratory failure due to severe cardiogenic
pulmonary edema. Seven patients were ventilated with EHFO for 2h at 60 oscillations·min−1, with a cuiras pressure of 36 cmH2O (−26 to +10) and an inspiratory to expiratory ratio of 1:1, with EHFO. Blood gas values and hemodynamic parameters were
measured. Significant increases were noted in cardiac index (2.3±0.5 to 2.5±0.5 l·m−2;P<0.05), stroke volume index (24±7 to 28±8 ml·m−2;P<0.05), and arterial O2 pressure (Pao2) (70±4 to 95±23 mmHg;P<0.01) without a change in pulmonary artery wedge pressure at 1 h after EHFO. The respiratory rate decreased from 28±3 to
22 ±3 breaths·min−1 at 5 min after the termination of EHFO (P <0.01). Arterial CO2 pressure (Paco2) did not, however, decrease. Increased stroke volume without a change in pulmonary artery wedge pressure (preload) suggests
either improved inotropic function of the left ventricle or reduced left ventricular afterload with EHFO. The use of EHFO
may be effective not only for gas exchange but also for left ventricular function in patients with severe cardiogenic pulmonary
edema. 相似文献
4.
M Tsujihata I Kinoshita M Mori K Mori S Shirabe A Satoh S Nagataki 《Journal of the neurological sciences》1987,81(2-3):197-213
The motor end-plate fine structure was studied in 3 patients with type A botulism and compared with that in 4 patients with Lambert-Eaton myasthenic syndrome (LES). In the botulism cases a biopsy of the biceps brachii muscle was performed at the chronic stage. The skeletal muscle showed a neurogenic change. The nerve terminal area had decreased and the postsynaptic regions had been denuded of their nerve terminals in 16% of the regions (9.8% in control). No highly simplified postsynaptic regions were observed. The findings are consistent with those observed at the motor end-plates in motoneuron diseases. By contrast, in LES no changes were observed in the presynaptic region. In the postsynaptic region, the postsynaptic membrane length and membrane density decreased and hypertrophy of the junctional folds was not observed. 相似文献
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A technique for reducing the morbidity and mortality of pancreatoduodenectomy by using an omental flap to protect the anastomoses and splanchnic vessels exposed during dissection is described herein. 相似文献
8.
Teruo Iwasaki Katsuhiro Nakagawa Motoaki Yasukawa Hiroyuki Shiono Teruaki Nagano Kunimitsu Kawahara 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2006,54(1):35-39
Ectopic cervical or cervico-mediastinal thymomas are very rare and most of them are asymptomatic, except for the presence
of a cervical mass. We present the case of a 71-year-old man with an ectopic cervico-mediastinal thymoma threatening superior
vena cava syndrome. He had a slight headache and presented with venous dilatation on the chest wall. A computed tomographic
scan and magnetic resonance, imaging of the chest demonstrated a mass extending from the right neck to the hilum, that indented
the trachea and compressed and displaced the brachiocephalic veins anteriorly. Under a right hemicollar incision and median
sternotomy, the mass was resected en bloc together with the thymus. The resected specimen was an encapsulated mass measuring 11×7×4 cm. The pathological diagnosis
was type AB, non-invasive thymoma, confirmed by 3-color flow, cytometry of tumor-derived lymphocytes. Flow cytometry using
biopsy material may contribute to the preoperative diagnosis of ectopic thymoma. 相似文献
9.
Itsuro Tomita Katsuya Sato Susumu Shirabe Kunihiko Nagasato Akira Satoh Mitsuhiro Tsujihata 《Clinical neurology》2004,44(3):182-186
Serial DWIs were performed in a patient with CJD who developed symptoms acutely and progressed rapidly. DWI discloed an increased signal in the frontal and parietal inner cortical areas, and in the caudate nuclei and putamina 20 days after the onset of symptoms. T2-weighted images showed only signal abnormality in the caudate nuclei and putamina, but not in the cerebral cortex. In the CSF obtained 15 days after the onset of symptoms, total tau protein was markedly elevated and 14-3-3 protein was positive. Measurement of these proteins are highly specific and sensitive for the diagnosis of CJD, but not available as a rapid routine examination at present. DWI is not specific, but useful for making the diagnosis of CJD in the early stage of the disease. 相似文献
10.
Kenji Yamao Atsushi Irisawa Hiroyuki Inoue Koji Matsuda Mitsuhiro Kida Shomei Ryozawa Yoshiki Hirooka Teruo Kozu 《Digestive endoscopy》2007,19(Z1):S180-S205
Standard imaging techniques using a curved linear array echoendocope are summarized to facilitate the attainment of expertise in endoscopic ultrasonography and endoscopic ultrasound‐guided fine needle aspiration, and to promote the widespread use of this diagnostic and therapeutic tool. Typical images of the mediastinal organs, the bilio‐pancreatic systems and neighboring organs by scanning from the esophagus, stomach, duodenal bulb, and descending portion of the duodenum, are shown in a sequential manner. The basic techniques of endoscopic ultrasound‐guided fine needle aspiration are also presented. 相似文献