巻号一覧
55 巻 (2008)
- 3+4 号 p. 37-
- 1+2 号 p. 1-
55 巻, 3+4 号
選択された号の論文の5件中1～5を表示しています
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Original Contribution
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HIDEAKI SUZUKI, TSUYOSHI INABA, NOBUAKI HIRAKI, KOICHI HASHIDA, TETSUR ...2008 年 55 巻 3+4 号 p. 37-41
発行日: 2009/03/31
公開日: 2009/07/01
ジャーナル フリーOrganized hematoma is a benign and non-neoplastic lesion, however, differential diagnosis from neoplastic diseases is always problematic, and patients are often forced to sustain excessive surgical invasion. We retrospectively studied the characteristics of imaging findings of organized hematoma of the maxillary sinus, and estimated the validity and effectiveness of endoscopic sinus surgery for the treatment of this disease. Three patients (2 men and a woman, ranging in age from 50 to 62 years) with organized hematoma of the maxillary sinus who underwent endoscopic sinus surgery were retrospectively analyzed. The diagnosis was provisionally made based on the findings of preoperative computed tomography (CT) and magnetic resonance imaging (MRI), and was confirmed by histopathological examinations of surgical specimens. CT revealed a well-defined expansile mass in the unilateral sinus associated with thinning and expansion of the medial sinus wall in all the cases. On contrast-enhanced images, patchy heterogeneous enhancement was observed. Intermingled low/intermediate/high signal intensity was seen on both T1- and T2-weighted MRI. The lesions were curetted via an endoscopic middle meatal antrostomy with the assistance of a microdebrider. None of the patients received arterial embolization or blood transfusion. Histopathological findings were consistent with those of organized hematoma. Their postoperative courses were uneventful, and all the patients are currently free from disease. We conclude that organized hematoma of the maxillary sinus can be successfully treated by endoscopic sinus surgery under accurate preoperative diagnosis and careful surgical planning.抄録全体を表示PDF形式でダウンロード (1290K) -
ATSUSHI YOSHIDA, KOJI OKUDA, HISAMUNE SAKAI, HISAFUMI KINOSHITA, SHIGE ...2008 年 55 巻 3+4 号 p. 43-53
発行日: 2009/03/31
公開日: 2009/07/01
ジャーナル フリーTo achieve a safer living related liver transplantation (LRLT) using the right lateral sector, anatomical variations of the portal vein, hepatic artery and bile duct for the right lateral sector and their three dimentional (3D) relationship were assessed by integrated 3D-CT images. 52 patients who underwent contrast enhanced multi-detector row CT (MD-CT) and MD-CT cholangiography were enrolled. Data from contrast enhanced MD-CT were used to reconstruct the 3D images of the hepatic artery and portal vein. 3D images reconstructed from MD-CT data of the hepatic artery, portal vein and bile duct were integrated into a single image. The dual branching of the right lateral portal vein was observed in 22 (42.3%) patients. Three (5.8%) had dual right lateral ducts and 14 (26.9%) had dual right lateral arteries. Among them, “south-turning” artery and “north-turning” bile duct was observed in 22 (42.3%). “South-turning” artery and “south-turning” bile duct were 3 (5.8%). “North-turning” artery and “north-turning” bile duct were 2 (7.4%). Only 27 (51.9%) had single portal vein, bile duct and artery for the right lateral sector, those were preferable as candidates for right lateral sector graft transplantation. 3D anatomical variations of portal vein, artery and bile duct for the right lateral sector were complexed, and only half of the donor candidates had preferable hepatic structures for right lateral sector graft transplantation. Understanding of the 3D hepatic structures by 3D-CT may contribute to a better definition of anatomical contraindications for LRLT which may further results in more safe and widely applied right lateral sector graft LRLT.抄録全体を表示PDF形式でダウンロード (1549K) -
KOHJU ETOH2008 年 55 巻 3+4 号 p. 55-62
発行日: 2009/03/31
公開日: 2009/07/01
ジャーナル フリーThe aim of this study was to evaluate of the quantification of Pneumocystis jiroveci using a real-time PCR assay. We tried to verify whether quantification was really effective in differentiating between carriage and Pneumocystis pneumonia (PCP) using real-time PCR with or without sample species normalization for classifying each sample species (sputum, bronchoalveolar lavage : bronchoalveolar lavage (BAL), and total samples). Twenty-two positive samples previously examined by conventional qualitative PCR were subjected to real-time PCR. Of these 22 lower respiratory tract specimens, 10 were BAL samples and 12 were (induced) sputum samples. According to our clinical diagnostic criteria, 17 were PCP and 5 were non-PCP. In the 12 sputum samples the concentrations of Pneumocystis-specific DNA detected in the non-PCP patients did not differ significantly from those in the PCP patients. The data were normalized using glyceraldehyde-3-phosphate dehydrogenase (GAPDH) as the housekeeping gene to exclude differences due to the number of human cells in collected samples. After normalization, the Pneumocystis-specific DNA/GAPDH-DNA ratio in the non-PCP patients was higher than that in the PCP patients. In the BAL samples (10 samples), the mean concentration of Pneumocystis-specific DNA detected in the PCP patients was 9.6 times higher than that in the non-PCP patients (P=0.058), and after normalization, the Pneumocystis-specific DNA/GAPDH-DNA ratio in the PCP patients did not differ significantly (P=0.19) from that in the non-PCP patients. Although the present study indicated that normalization using GAPDH might be not helpful but BAL specimens are recommended over sputum specimens for the diagnosis of Pneumocystis Pneumonia by quantification with real-time PCR.抄録全体を表示PDF形式でダウンロード (1033K) -
MAKOTO NAKIRI, MASANORI NOGUCHI, TATSUYA ISHITAKE, KEI MATSUOKA2008 年 55 巻 3+4 号 p. 63-69
発行日: 2009/03/31
公開日: 2009/07/01
ジャーナル フリーThe influence of the presence or absence of the neurovascular bundles on patient QOL were examined using the UCLA Prostate Cancer Index (UCLA-PCI) in patients who underwent radical retropubic prostatectomy. The study was performed in 105 patients who were histopathologically diagnosed with prostate cancer and underwent radical retropubic prostatectomy (During prostatectomy, the bilateral neurovascular bundles were preserved in 45 patients (42.8%), unilateral neurovascular bundle preservation was achieved in 24 (22.9%), and no neurovascular bundles were preserved in 36 (34.2%)). The QOL was evaluated before and after surgery using the Japanese edition of the UCLA-PCI, which examines 6 items. Our findings suggested that ‘urinary function, ‘urinary bother’, ‘bowel function’, and ‘bowel bother’ deteriorated early after surgery, and recovered to the preoperative levels in the late phase after surgery, but no significant difference was noted in the time-course among the three groups. In contrast, ‘sexual function’ was significantly improved in the late postoperative phase only in the bilateral nerve-spared group, but not in the unilateral nerve-spared and non-nerve-spared groups. Patients complaining of ‘Sexual bother’ were more prevalent in the unilateral nerve-spared group in the late postoperative phase, but the difference was not significant. On multiple regression analysis of factors associated with sexual function in the late postoperative phase, only bilateral nerve preservation of was significantly associated with sexual function in the late postoperative phase (p<0.0001). In order to maintain sexual function following radical retropubic prostatectomy, the bilateral neurovascular bundles should be preserved, as far as practicable.抄録全体を表示PDF形式でダウンロード (987K) -
AKIRA ISHIBASHI, YOSHITAKE YOKOKURA, HISASHI ADACHI2008 年 55 巻 3+4 号 p. 71-75
発行日: 2009/03/31
公開日: 2009/07/01
ジャーナル フリーTo examine whether antiplatelet therapy contributes to the unfavorable prognosis of intracerebral hemorrhage, we enrolled 253 consecutive patients (120 men and 133 women; 72.9±11.7 years) hospitalized in our institution within 24 hrs after onset of intracerebral hemorrhage. The location and size of intracerebral hemorrhage were determined from computed tomography (CT). Hematoma enlargement was identified on the basis of a second computed tomography scan performed on the day after admission. An unfavorable prognosis was defined as an outcome of worsening or death using the modified Rankin Scale (mRS). Locations of intracerebral hemorrhage (ICH) determined from CT were the thalamus in 92 patients (36.3%), putamen in 79 (31.2%), subcortex in 35 (13.8%), cerebellum in 20 (7.9%), brainstem in 18 (7.1%), and caudate nucleus in 9 (3.5%). Sizes of ICH were small and moderate in 153 patients (60%) and large in 100 (40%). Seventeen patients (6.7%) received antiplatelet therapy for stroke prevention. Hematoma enlargement was identified in 39 patients (15.4%). Overall outcomes at the time of discharge were unfavorable (modified Rankin Scale score 5-6) in 64 patients (25.2%) and favorable mRS score (0-1∼4) in 189 (74.8%). Univariate analysis demonstrated that age ≥75 years (odds ratio: 2.78; 95%CI: 1.54-5.04) and presence of a large hematoma (odds ratio: 19.28; 95%CI: 8.84-42.1) were significantly related to the unfavorable prognosis. Using multiple logistic regression analysis after adjustments for age and sex, the presence of a large hematoma was still judged unfavorable; however, antiplatelet therapy was not related to unfavorable prognosis. Antiplatelet therapy may be unrelated to the unfavorable prognosis of ICH.抄録全体を表示PDF形式でダウンロード (960K)
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