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1.
J Gastrointestin Liver Dis ; 28(4): 397-404, 2019 Dec 09.
Artigo em Inglês | MEDLINE | ID: mdl-31826062

RESUMO

BACKGROUND AND AIMS: Endoscopic submucosal dissection (ESD) has become a standard treatment for early gastric neoplasia. However, as the upper and middle body of the greater curvature has a rich vasculature and submucosal fibrosis, ESD of neoplasia in these locations requires a specific strategy. We aimed to investigate the efficacy and safety of the J-shaped superficial cutting and splashed submucosal dissection (JSCS) technique for neoplasia of the greater curvature by comparing ESD using JSCS with conventional ESD. METHODS: Twenty-two patients who underwent ESD for gastric neoplasia affecting the upper and middle body of the greater curvature were divided into two groups for retrospective analysis. Nine patients underwent conventional ESD (c-Group), while 13 underwent ESD with JSCS (j-Group). Primary outcome was the en bloc resection rate. Secondary outcomes included complete resection (R0) rate, procedure time, perforation rate, total bleeding time, and the total number of massive bleeding events and of hemostatic forceps times applied during ESD. RESULTS: There were no significant differences between both groups (c-Group vs j-Group) in en bloc resection rate, or R0 resection rate. Compared with the c-Group, the j-Group tended to have a decreased mean procedure time (mean 133 minutes vs 74 minutes, p=0.11) and perforation rate (11% vs 0%, p=0.41). Compared with the c-Group, the j-Group had significantly fewer bleeding incidents (13.4 times vs 6.6 times, p=0.0095), shorter total bleeding time (17.6 min vs 7.4 min, p=0.036), and fewer usages of hemostatic forceps (6.3 times vs 2.4 times, p=0.026) during ESD. CONCLUSION: Endoscopic submucosal dissection with JSCS is superior to conventional ESD, as it reduces intraprocedural bleeding. This technique has the potential to become the standard strategy for neoplasia affecting the upper and middle body of the greater curvature.

2.
Case Rep Orthop ; 2018: 3182643, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30147976

RESUMO

Pseudoaneurysm is one of the most serious complications of femoral trochanteric fracture surgery. Since the rupture of pseudoaneurysm may lead to death, early detection is important. We report the case of an 80-year-old male who developed pain in the proximal thigh and severe swelling after internal fixation of a femoral trochanteric fracture with a hip nail. Angiography revealed a pseudoaneurysm of a branch of the deep femoral artery near the interlocking screw. The vascular lesion was immediately treated by transcatheter embolization, and the vascular leakage was completely resolved with catheter embolization. After embolization, the patient's clinical state improved rapidly, and the laboratory values improved to normal after several weeks. The current case study reminds us that pseudoaneurysm can occur after intramedullary nail placement to treat a femoral trochanteric fracture.

3.
Rinsho Byori ; 61(10): 955-60, 2013 Oct.
Artigo em Japonês | MEDLINE | ID: mdl-24372001

RESUMO

A large number of clinical laboratory technologists are qualified as diabetes educators; however, few of them actually participate in teaching patients. This is partially because it is difficult to balance their routine laboratory tasks and the work of a diabetes educator. We have introduced ultrasonic examinations of the ophthalmic artery, inspection of the R-R interval and current perceptual-threshold inspection for the early diagnosis of diabetic complications, and we have been contributing to the good medical care for diabetes. Furthermore, to care for diabetic foot lesions, clinical laboratory technologists have participated in checking diabetic patients' feet since 2007. In concrete terms, we examine the feet of diabetic patients, take digital pictures of the feet, and write a report, while preparing for thermographic examination of the patient. At the same time, we give simple guidance about foot care. Technologists cannot perform medical treatment; however, this has been accepted by medical staff because we only check foot lesions. We make use of existing medical imaging and reporting systems in the physiological laboratory, so doctors and nurses on the diabetic care team can always obtain information about the patients. Such actions have a good reputation not only among medical staff but also among diabetic patients.


Assuntos
Diabetes Mellitus/diagnóstico , Equipe de Assistência ao Paciente , Diabetes Mellitus/terapia , Diagnóstico Precoce , Humanos , Laboratórios Hospitalares , Pessoal de Laboratório Médico , Fatores de Risco
4.
Invest Ophthalmol Vis Sci ; 53(11): 6964-71, 2012 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-22969072

RESUMO

PURPOSE: To elucidate the correlation between visual threshold of optokinetic tracking (OKT), visual evoked potential (VEP), and histopathology at different time points after induction of experimental autoimmune optic neuritis (EAON). METHODS: EAON was induced in C57BL/6 mice by subcutaneous immunization with an emulsified mixture of myelin oligodendrocyte glycoprotein (MOG)(35-55) peptide. OKT and VEP were measured on days 7, 14, 21, 28, and 42 postimmunization. After VEP measurements, the mice were killed and their eyes were enucleated for histopathological studies. Immunohistochemical staining was performed using cell-specific markers for characterization of cells in the optic nerve: CD3 (T cells), Iba-1 (microglia), MBP (myelin basic protein), and neurofilament (axons). RESULTS: Functionally, OKT threshold decreased as early as day 7, and VEP latency was significantly prolonged on day 21. Axon degeneration was observed as early as day 14. Activated microglia infiltration was also observed on day 14, before T cell infiltration, which peaked on day 21. Demyelination, confirmed by MBP staining, was observed on day 21. CONCLUSIONS: Microglial infiltration in the optic nerve coincided with decline in OKT threshold and preceded VEP latency prolongation, while VEP latency prolongation coincided with T cell infiltration and demyelination of the optic nerve. These findings may contribute to understanding of the pathophysiology of optic neuritis and future development of more effective therapeutic strategy for refractory optic neuritis.


Assuntos
Potenciais Evocados Visuais/fisiologia , Neurite Autoimune Experimental/fisiopatologia , Nistagmo Optocinético/fisiologia , Nervo Óptico/fisiopatologia , Neurite Óptica/fisiopatologia , Animais , Axônios/metabolismo , Axônios/patologia , Complexo CD3/metabolismo , Proteínas de Ligação ao Cálcio/metabolismo , Técnicas Imunoenzimáticas , Camundongos , Camundongos Endogâmicos C57BL , Proteínas dos Microfilamentos/metabolismo , Microglia/metabolismo , Microglia/patologia , Proteína Básica da Mielina/metabolismo , Glicoproteína Mielina-Oligodendrócito , Neurite Autoimune Experimental/imunologia , Neurite Autoimune Experimental/metabolismo , Neurite Óptica/imunologia , Neurite Óptica/metabolismo , Fragmentos de Peptídeos , Linfócitos T/imunologia
5.
Exp Eye Res ; 91(5): 685-90, 2010 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-20723542

RESUMO

Regarding the process of uveitis development, many past studies have used the experimental autoimmune uveoretinitis (EAU) and other animal models to observe histologically the infiltration of inflammatory cells and the process of lesion progression. However, no detailed study of the process of clearance of infiltrated inflammatory cells from the eye has been reported. The purpose of this study was to investigate the process of clearance of polymorphonuclear leukocytes (PMNs) using an experimental hypopyon model. PMNs obtained from ascites of SD rat were injected into the anterior chamber of SD rats. The process of PMNs clearance was evaluated by serial photography and 3D optical coherence tomography (3D-OCT), and histological changes were observed simultaneously. The hypopyon heights regressed from 1.04±0.06 mm at 1h (day 0) to 0.45±0.07 mm at day 1, and 0 mm at day 3 after PMNs injection. When the hypopyon heights at the three time points were compared, significant differences were found between groups (P<0.05). The hypopyon volumes also decreased from 1.46±0.07 mm(3) at 1h to 1.16±0.09 mm(3) at 2h, and 0.83±0.04 mm(3) at 3h after PMN injection. When the hypopyon volumes at the three time points were compared, significant differences were found between groups (P<0.05). Light micrographs of inferior segment of the eyeball revealed dense PMNs in the chamber angle at 1h after PMNs injection and many PMNs in the iris stroma and vessels, as well as at the episcleral and subconjunctival tissues around limbus at 3h and day 1 after PMNs injection. Light micrographs of superior segment of the eyeball at 3h after injection revealed PMNs in the episcleral and subconjunctival vessels. Electron micrographs of inferior segment of the eyeball at 3h after PMNs injection revealed dense PMNs with slightly condensed nuclei in the anterior chamber, as well as in the iris stroma and vessels. In conclusion, in the experimental hypopyon model, PMNs injected into the anterior chamber were cleared from the eye mainly through the iris stroma and vessels, as well as the episcleral and subconjunctival tissues around limbus.


Assuntos
Câmara Anterior/metabolismo , Modelos Animais de Doenças , Neutrófilos/metabolismo , Uveíte Supurativa/metabolismo , Animais , Câmara Anterior/patologia , Imagem Tridimensional , Cinética , Neutrófilos/patologia , Ratos , Ratos Sprague-Dawley , Tomografia de Coerência Óptica , Uveíte Supurativa/patologia
7.
Cancer Sci ; 97(9): 854-60, 2006 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-16805824

RESUMO

Esophageal cancer is difficult to treat because of its rapid progression, and more effective therapeutic approaches are needed. The PPARgamma is a nuclear receptor superfamily member that is expressed in many cancers. PPARgamma expression is a feature of esophageal cancer cell lines, and in the present investigation, the PPARgamma antagonists T0070907 and GW9662 could induce loss of invasion but could not induce growth reduction or apoptosis at low concentrations (< 10 mM). A high concentration of antagonists (50 microM) inhibited cell growth and induced apoptosis, but these effects did not explain our result at the low concentration. Morphological change, decreased expression of the cell signaling pathway and inhibition of cancer cell invasion were observed in the low concentration. This suggested that PPARgamma antagonists inhibited esophageal cancer cell invasion as well as cell adherence, most likely due to alteration in the FAK-MAPK pathway, and this was independent of apoptosis. These results suggested that PPARgamma plays an important role in cancer cell invasion and that it might be a novel target for therapy of esophageal cancer.


Assuntos
Neoplasias Esofágicas/metabolismo , Neoplasias Esofágicas/patologia , Invasividade Neoplásica/fisiopatologia , PPAR gama/metabolismo , Actinas/efeitos dos fármacos , Anilidas/farmacologia , Apoptose/efeitos dos fármacos , Apoptose/fisiologia , Benzamidas/farmacologia , Western Blotting , Adesão Celular/efeitos dos fármacos , Adesão Celular/fisiologia , Linhagem Celular Tumoral , Proliferação de Células/efeitos dos fármacos , Relação Dose-Resposta a Droga , Matriz Extracelular/efeitos dos fármacos , MAP Quinases Reguladas por Sinal Extracelular/efeitos dos fármacos , Imunofluorescência , Proteína-Tirosina Quinases de Adesão Focal/efeitos dos fármacos , Humanos , PPAR gama/antagonistas & inibidores , PPAR gama/efeitos dos fármacos , Fosforilação , Piridinas/farmacologia
8.
No Shinkei Geka ; 34(2): 161-7, 2006 Feb.
Artigo em Japonês | MEDLINE | ID: mdl-16485561

RESUMO

We report three cases of frontal meningioma with their pre- and post-operative evaluations of higher brain functions, especially of frontal lobe functions. All of the cases showed the improvement of the frontal lobe functions after the tumor removal. The evaluations of frontal lobe functions in benign brain tumors such as a meningioma are reported only in a few cases. The evaluations of frontal lobe functions in the operative cases of benign brain tumors provide many interesting and valuable informations about frontal lobe functions. So we must be more interest in evaluations in higher brain functions and accumulate cases for the further analysis of higher brain functions.


Assuntos
Lobo Frontal/fisiologia , Meningioma/cirurgia , Feminino , Atividade Nervosa Superior/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade
9.
Surg Neurol ; 65(2): 170-3, 2006 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-16427416

RESUMO

BACKGROUND: Parry-Romberg syndrome or progressive facial hemiatrophy is a rare clinical entity of an unknown etiology. We present the case of a 56-year-old woman with Parry-Romberg syndrome and a giant internal carotid artery aneurysm. CASE DESCRIPTION: The case was a 56-year-old woman with Parry-Romberg syndrome and a giant internal carotid artery aneurysm. Its association was extremely rare. Our report and some other reports of Parry-Romberg syndrome with cerebral aneurysms suggest the hypothesis that Parry-Romberg syndrome could be related to some inflammatory causes such as an autoimmune disease. CONCLUSION: We present the case of a 56-year-old woman with Parry-Romberg syndrome and a giant internal carotid artery aneurysm. Its association is extremely rare and will support the hypothesis that Parry-Romberg syndrome could be related to some inflammatory causes such as an autoimmune disease.


Assuntos
Doenças das Artérias Carótidas/complicações , Hemiatrofia Facial/complicações , Aneurisma Intracraniano/complicações , Doenças das Artérias Carótidas/diagnóstico por imagem , Angiografia Cerebral , Hemiatrofia Facial/diagnóstico por imagem , Feminino , Humanos , Aneurisma Intracraniano/diagnóstico por imagem , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X
10.
No Shinkei Geka ; 33(10): 979-84, 2005 Oct.
Artigo em Japonês | MEDLINE | ID: mdl-16223176

RESUMO

We have reported a case of chondroma arising from the falx cerebri in a 60-year-old female with no neurological symptom. The tumor was revealed as a round mass, attached to the falx cerebri, with marginally scattered calcification on CT scan and with slight enhancement on MRI images. And cerebral angiogram presented a mass with no tumor stain on the external carotid angiography against our preoperative diagnosis of falx meningioma. A subtotal removal of the mass was performed with the diagnosis of chondroma on pathological examination. The chondroma arising from the falx cerebri is extremely rare with only 15 reported cases in the literature. We have presented the first case in Japan and reviewed the previous reports.


Assuntos
Dura-Máter/patologia , Neoplasias Meníngeas/diagnóstico , Condroma/diagnóstico , Condroma/patologia , Diagnóstico Diferencial , Feminino , Humanos , Imagem por Ressonância Magnética , Neoplasias Meníngeas/patologia , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X
11.
No Shinkei Geka ; 33(4): 377-81, 2005 Apr.
Artigo em Japonês | MEDLINE | ID: mdl-15830545

RESUMO

A 54-year-old woman was admitted to our hospital because of severe headache. CT scan demonstrated subarachnoid hemorrhage (SAH), and cerebral angiography revealed a wide-necked basilar tip aneurysm with a bleb and a small basilar artery-left superior cerebellar artery aneurysm. She was treated with coil embolization using a neck remodeling technique one day after SAH. Guiding catheters were introduced into the bilateral vertebral artery via the transfemoral route. A Hyperform occlusion balloon catheter was introduced into the left posterior cerebral artery (PCA) through the left vertebral artery, and was placed at the neck of the basilar tip aneurysm for neck remodeling. Then, the microcatheter for coil deployment was placed in the dome of the aneurysm through the right vertebral artery. The coil was deployed in the aneurysm while the balloon was inflated across the neck. The inflated Hyperform occlusion balloon was partially herniated into the dome of the aneurysm. The distal part of the balloon was positioned in the left PCA segment, and its proximal part was positioned in the basilar artery. The balloon conformed easily to the aneurysmal neck and its surrounding vessel structure. When the balloon was deflated, the coil did not protrude into the parent artery, and was stable in the aneurysm. Angiography immediately after the procedure showed complete occlusion of the aneurysm with patency of both PCAs. The Hyperform occlusion balloon is very compliant and supple, so it easily changes from its cylindrical shape when inflated to expand into the origin of the arterial branches emerging from the aneurysm neck. We think this balloon is a useful device for treating wide-necked aneurysms located at arterial bifurcation.


Assuntos
Aneurisma Roto/terapia , Oclusão com Balão , Artéria Basilar , Embolização Terapêutica/métodos , Aneurisma Intracraniano/terapia , Embolização Terapêutica/instrumentação , Feminino , Humanos , Pessoa de Meia-Idade
12.
No Shinkei Geka ; 32(7): 735-40, 2004 Jul.
Artigo em Japonês | MEDLINE | ID: mdl-15462364

RESUMO

Direct carotid puncture is an important option in endovascular surgery when a guiding catheter is not advanced into the common carotid artery because of arterial tortuosity. However, hemostasis after the procedure is not easy and hematoma formation from the puncture site sometimes causes serious complications. We present our carotid angioplasty and stenting (CAS) method with a direct carotid puncture and a small incision. An 85-year-old male with transient ischemic attack had severe left carotid artery stenosis. CAS was planned considering his age, but arterial tortuosity prevented a guiding catheter from being introduced into the left common carotid artery. Following this, the left common carotid artery was exposed with a small skin incision under local anesthesia, and a direct carotid puncture was made. A 7-French short sheath was carefully advanced and positioned into the left common carotid artery and a self-expandable stent was delivered through it. Upon completion of the procedure, the puncture point of the vascular wall was sutured with 6-0 proline immediately after withdrawing the sheath, and the skin was closed. A direct carotid puncture with a small incision can be performed safely. This method can reliably stop bleeding from the puncture site and also avoid the need for prolonged manual compression of the carotid artery under systemic anticoagulation and antiplatelet therapy. We think our method is useful for accessing corotid artery stenosis when the transfemoral approach is difficult.


Assuntos
Angioplastia/métodos , Artéria Carótida Primitiva/cirurgia , Estenose das Carótidas/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Punções/métodos , Stents , Idoso , Idoso de 80 Anos ou mais , Humanos , Masculino
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