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21.
Shoko Nakajima Hiroaki Umebayashi Rumiko Kurosawa Tomoyuki Imagawa Shigeki Katakura Masaaki Mori Yuko Aihara Shumpei Yokota Tuyoshi Sogo Ayano Inui Tomoo Fujisawa Norio Hanzawa 《Nihon Rinshō Men'eki Gakkai kaishi》2005,28(3):154-158
A 10-year-old girl with autoimmune hepatitis (AIH) was reported. She was admitted to our hospital because of cholestasis and elevation of liver enzymes for 2 months. Laboratory examination revealed that EBV-DNA copy number in the PBMNC (peripheral mononuclear cells) was 1.2 x 10(3) copies/microg of DNA, hypergammaglobulinemia, and positive antinuclear antibody, positive anti-smooth muscle antibody. The histology of her liver biopsy specimen revealed interface hepatitis, dense mononuclear cell infiltrates, mild fibrosis, and negative for EBV in situ hybridization assay indicating AIH and not EBV-associated hepatitis. She was treated firstly with methylprednisolone pulses, then will prednisolone p.o.+azathioprine p.o.. Intravenous cyclophosphamide pulse therapy was introduced because of her abnormal immune pathology. All abnormal laboratory parameters improved to normal levels within 2 months, and EBV-DNA copy number in the PBMNC became negative after 4 months. The histology of liver biopsy specimen was useful for the diagnosis of AIH in such a difficult case needed to be differentiated from EBV hepatitis. 相似文献
22.
Akira Marumoto Yasushi Ashida Hiroaki Kuroda Takafumi Hamasaki Satoshi Kamihira Shingo Ishiguro Shigetsugu Ohgi 《Annals of thoracic and cardiovascular surgery》2005,11(1):48-50
A 63-year-old woman with an 18-year history of idiopathic thrombocytopenic purpura (ITP) was admitted with a persistent fever of unknown cause. Blood culture was positive for alpha-Streptococcus and echocardiography revealed severe mitral regurgitation and vegetation on the mitral valve. After antimicrobial therapy for six weeks, she underwent mitral valve repair using a Cosgrove ring. The platelet count increased and remained stable by perioperative treatment with intravenous high-dose gamma-globulin and platelet transfusion without steroids therapy or splenectomy. The hospital course was uneventful. Perioperative high-dose gamma-globulin therapy and platelet transfusion for the cardiac operation were useful to increase and maintain the platelet count for an ITP patient complicated with infective endocarditis. 相似文献
23.
Yasuhiro Takikawa Yuki Yasumi Akihiro Sato Ryujin Endo Kazuyuki Suzuki Yasuki Mori Hidetoshi Akasaka Yasuhiro Miura Takashi Sawai Hiroaki Okamoto 《Hepatology research》2007,37(2):158-165
A 65-year-old Japanese man was hospitalized because of acute hepatitis and severe cholestasis due to hepatitis E virus (HEV) infection combined with a drug reaction to a cold preparation. He died of disseminated intravascular coagulation and severe intestinal bleeding due to systemic cytomegalovirus reactivation following the development of severe eruptions with marked eosinophilia due to drug hypersensitivity to taurine and ursodeoxycholate preparations. The close interaction between viral infection or reactivation and drug hypersensitivity was considered as a pathophysiology in this case, which emphasizes the need for further study of the immunological mechanism of the interaction. 相似文献
24.
Masashi Takemura Harushi Osugi Masayuki Higashino Nobuyasu Takada Sigeru Lee Hiroaki Kinoshita 《Annals of thoracic and cardiovascular surgery》2005,11(5):293-300
BACKGROUND: The oncologic benefit of avoiding allogenic blood transfusion in oesophageal cancer resection has not been studied. METHODS: The medical records of 68 patients (Auto group) who underwent a potentially curative oesophageal cancer resection without allogenic blood transfusion from 1996 to 1999 receiving 800 g of autologous blood donated preoperatively, and 97 patients (Allo group) who underwent the same operation with allogenic blood transfusion from 1990 to 1995 were compared. RESULTS: There were no differences in age, gender, stage of disease, number of retrieved nodes, or perioperative hemoglobin concentration between the two groups. The survival of the 45 patients with nodal involvement in the Auto group was better than that of the 59 patients in the Allo group (p=0.0435), and the survival of the 35 patients with T3 or T4 lesions in the Auto group was better than that of the 61 patients in the Allo group (p=0.0408). According to logistic regression analysis, allogenic blood transfusion correlated with tumour recurrence in patients with either nodal involvement or a T3-4 lesion. The natural killer cell activity remained higher in the Auto group than in the Allo group (p<0.05). CONCLUSION: Avoidance of allogenic blood transfusion favorably effected the survival of patients with oesophageal cancer at risk for recurrence. 相似文献
25.
26.
Hiroaki Yuasa Koji Kawanishi Jun Watanabe 《The Journal of pharmacy and pharmacology》1995,47(7):576-580
The effects of ageing on the oral (gastrointestinal) absorption of d -xylose were investigated by analysing the gastrointestinal disposition after oral administration to young (9 weeks) and old (53 weeks) rats. A linear model assuming first-order gastric emptying followed by first-order intestinal absorption was fitted to remaining fraction vs time profiles for the stomach and small intestine to estimate the gastric emptying rate constant (kg) and the intestinal absorption rate constant (ka). In young and old rats, kg values were 0·087 ± 0·008 and 0·070 ± 0·007 min?1, respectively, and ka values were 0·020 ± 0·002 and 0·018 ± 0·002 min?1 suggesting an insignificant effect on ageing on the rate of oral absorption. The average intestinal lumen volume (Vav) was unchanged with ageing, and so was the apparent intestinal membrane permeability clearance (CLapp) as the product of ka and Vav. However, the small intestinal transit time (Tsi) was suggested to be twice that in older rats (171 min) than in young rats (78 min) by the analysis of gastrointestinal disposition of inulin, a non-absorbable marker. It was also shown that our preceding finding of an increase in the fraction absorbed of D-xylose with ageing can be solely ascribable to the delay in intestinal transit. Thus, among various determinants of oral absorption, only Tsi was found to be altered with ageing. The CLa,app and ka of passively absorbed drugs such as D-xylose may be generally unchanged, and the fraction absorbed may increase with ageing by the delay in intestinal transit. 相似文献
27.
28.
Hiroaki YOSHIDA Tetsuya KAWAMURA Iekuni ICHIKAWA Osamu SAKAI 《Nephrology (Carlton, Vic.)》1997,3(S2):s719-s723
Summary: Clinical studies revealed that angiotensin converting enzyme (ACE) inhibitor reduces proteinuria and attenuates progressive decline in renal function in IgA nephropathy. Recent studies by us and others have demonstrated that the homozygote of the D allele (DD) of the ACE insertion/deletion (I/D) polymorphism is a potential risk factor for poor prognosis in IgA nephropathy, and that this deletion polymorphism predicts the therapeutic efficacy of ACE inhibition on proteinuria and, potentially, on progressive deterioration of renal function in patients with the nephropathy. 相似文献
29.
Masao Tanaka Hiroyuki Konomi Hiroaki Matsunaga Kazunori Yokohata Naruhiro Utsunomiya Torahiko Takeda 《Journal of Hepato-Biliary-Pancreatic Surgery》1997,4(1):16-19
Technical improvements, such as mechanical lithotripsy, stenting or nasobiliary drainage, and wire-guided cannulation, have reduced the risk of complications in endoscopic sphincterotomy. To determine the extent of this reduction in risk, we assessed the medical records of 1352 patients with common bile duct stones in whom the procedure was conducted. Complications examined were: acute cholangitis and pancreatitis. Stone clearance was achieved in 1256 patients (92.8%), with an overall morbidity rate of 7.7% and a mortality rate of 0.15%. One hundred and forty-two patients had stones with a diameter greater than 20mm; 97 of these patients did not undergo lithotripsy. Cholangitis occurred in 10 of these 97 patients (10.3%), whereas, in the 45 patients who underwent lithotripsy, there were no cases of cholangitis (P=0.02). Stone removal was not immediately accomplished or attempted in 396 patients. In 82 of these patients in whom a stent or a nasobiliary drain was placed in the common bile duct, the incidence of cholangitis was 1.2%, significantly less (P=0.045) than the incidence of 6.4% in the other 314 patients given no stenting or nasobiliary drain. To overcome difficult cannulation, precut sphincterotomy was conducted in 134 patients and wireguided sphincterotomy, a recently introduced procedure, was conducted in 55 patients. When the precutting technique was used, the incidence of acute pancreatitis was significantly higher (8/134; 6.0%) than that in the patients in whom the standard procedure was conducted, i.e., neither the precut technique nor wire-guided ES was used (23/1218; 1.9%) (P=0.008). There were no cases of pancreatitis in the 55 patients in whom wire-guided sphincterotomy was performed, although the difference was not statistically significant because of the small number of patients (P=0.06). Based on these findings, we conclude that improved technologies have led to a significant reduction of complications in endoscopic sphincterotomy. 相似文献
30.
Shoji Kubo Hiroaki Kinoshita Kazuhiro Hirohashi Hiromu Tanaka Tadashi Tsukamoto Taichi Shuto Yoshihiko Morimoto Akishige Kanazawa Shinichi Mikami Chikaharu Sakata 《Journal of Hepato-Biliary-Pancreatic Surgery》1997,4(4):359-364
Hepatocellular carcinoma (HCC) is often associated with chronic liver disease, such as hepatitis or cirrhosis, and this association
may limit the use of surgery as a therapy, and if surgery is pursued, may give rise to postoperative hepatic failure. We evaluated
the outcome in patients with HCC given preoperative portal vein embolization (PVE) before they underwent major hepatectomy.
After PVE, portal pressure increased significantly. Two weeks after PVE, both the volume of the non-embolized lobe and the
15-min indocyamine green retention rate (ICG R15) were significantly increased. The prognostic score, calculated on the basis
of age, ICG R15, and the resection rate, was significantly decreased. The operative mortality rate was significantly lower
in patients who underwent PVE before surgery than in patients who did not receive PVE. The cumulative survival rate of the
PVE patients, even those with cirrhosis of the liver, was significantly higher. Prior PVE appears to allow more extensive
major hepatectomy and to lessen the risk of this invasive surgery. However, patients in whom the portal pressure immediately
after PVE was more than 30cm H2O and/or whose prognostic score exceeded 50 points developed postoperative hepatic failure. These features should be kept
in mind when it is decided whether surgery is indicated. Nevertheless, preoperative PVE appears to be a beneficial procedure
for patients undergoing major hepatectomy, particularly those with chronic liver disease. 相似文献