Hiroshima journal of medical sciences最新文献_第4页

Antimicrobial Resistance of Breakthrough-Urinary Tract Infections in Children under Antimicrobial Prophylaxis 抗菌药物预防下儿童突破性尿路感染的耐药性

Hiroshima journal of medical sciences Pub Date : 2017-08-01 DOI: 10.24811/HJMS.66.2_39

Toshihito Nomura, K. Hisata, Y. Toyama, K. Sakaguchi, Naru Igarashi, Akihiro Nakao, N. Matsunaga, Mitsutaka Komatsu, K. Obinata, Toshiaki Shimizu

引用次数: 2

Spontaneous Celiac and Splenic Artery Dissection. 自发性腹腔和脾动脉夹层。

Hiroshima journal of medical sciences Pub Date : 2017-03-01

Takahiro Zenda, Ichiro Araki, Naomichi Hamano, Hiroto Nishida, Masatoshi Ikeda, Hisashi Bunko, Tetsuya Aoki

{"title":"Spontaneous Celiac and Splenic Artery Dissection.","authors":"Takahiro Zenda, Ichiro Araki, Naomichi Hamano, Hiroto Nishida, Masatoshi Ikeda, Hisashi Bunko, Tetsuya Aoki","doi":"","DOIUrl":"","url":null,"abstract":"Dissection of the splanchnic artery unrelated to an aortic lesion is extremely rare. We describe a patient with dissection of the celiac and splenic arteries causing splenic circulatory impairment. A 55-year-old Japanese man was referred to our hospital for left back pain that suddenly occurred 3 days previously and spread to the left flank. He had complicated sleep apnea syndrome well controlled with continuous positive airway pressure, and had been prophylactically taking aspirin (100 mg/day) because of asymptomatic cerebral lacunar infarcts. Contrast-enhanced computed tomography (CT) in the arterial phase revealed dissection from the celiac root extending to the entire splenic artery, the caliber of which was irregularly narrowed, causing malperfusion in the spleen. Because of hemodynamic stability and lack of impending sequelae, the patient was carefully observed with rest, strict blood pressure control, and aspirin administration. One month later, CT revealed restoration of the caliber of the dissected arteries and regression of the organizing false lumen, which confirmed the patient's recovery. Despite the extreme rarity or nonspecific symptoms, splanchnic artery dissection should be considered a potentially life-threatening emergency. This case supports the possible benefit of starting antithrombotic treatment early to prevent thrombotic sequelae such as organ infarction and aneurysmal formation.","PeriodicalId":12860,"journal":{"name":"Hiroshima journal of medical sciences","volume":"66 1","pages":"21-25"},"PeriodicalIF":0.0,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36296018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Portosystemic Encephalopathy without Liver Disease Masquerading as Dementia. 伪装成痴呆的无肝脏疾病的门系统性脑病。

Hiroshima journal of medical sciences Pub Date : 2017-03-01

Yohji Honda, Masami Kubo, Shintaro Takaki, Nami Mori, Masaki Ishikawa, Hideaki Kakizawa, Keiji Tsuji, Yoshinari Furukawa

引用次数: 0

Hybrid Surgery for Portosystemic Encephalopathy in a Patient with Liver Cirrhosis: a case report. 混合手术治疗肝硬化门系统性脑病1例报告。

Hiroshima journal of medical sciences Pub Date : 2017-03-01 DOI: 10.24811/HJMS.66.1_11

Y. Imaoka, M. Ohira, S. Kuroda, H. Tahara, K. Ide, K. Ishiyama, Tsuyoshi Kobayashi, Masaki Ishikawa, K. Awai, H. Ohdan

{"title":"Hybrid Surgery for Portosystemic Encephalopathy in a Patient with Liver Cirrhosis: a case report.","authors":"Y. Imaoka, M. Ohira, S. Kuroda, H. Tahara, K. Ide, K. Ishiyama, Tsuyoshi Kobayashi, Masaki Ishikawa, K. Awai, H. Ohdan","doi":"10.24811/HJMS.66.1_11","DOIUrl":"https://doi.org/10.24811/HJMS.66.1_11","url":null,"abstract":"Regarding the treatment for a portosystemic shunt, surgical or interventional radiological closure of the shunt was established. Interventional radiology including balloon-occluded retrograde transvenous obliteration can worsen portal hypertension and create a large thrombus close to the major venous system in the case of a huge portosystemic shunt. In contrast, it is also difficult to treat some cases through surgery alone when huge complicated shunts exist very deep in the body. Herein, we report a successful case of surgical shunt ligation for portosystemic encephalopathy in a hybrid operation room that enabled intraoperative angiography and computed tomography. A 62-year-old woman with chronic hepatitis C was referred to our hospital due to high levels of serum ammonia and hepatic encephalopathy. She had a massive, complicated portosystemic shunt from the inferior mesenteric vein to the left renal vein but did not have esophageal or gastric varices. It was difficult to occlude the portosystemic shunt by interventional radiologic techniques because the shunt had an extremely large amount of blood flow and many collateral routes. We performed the shunt ligation in the hybrid operation room. Intraoperative angiography provided detailed information about the portosystemic shunt, such as direction or volume of blood flow and collateral routes in real time. Her encephalopathy disappeared completely and she remains healthy with improved liver functional reserve to date. In conclusion, this is a successful case of a hybrid operation for an extremely large and complicated portosystemic shunt, providing for intraoperative angiography as a safe and reliable surgical treatment for portosystemic encephalopathy in patients with liver cirrhosis.","PeriodicalId":12860,"journal":{"name":"Hiroshima journal of medical sciences","volume":"66 1 1","pages":"11-15"},"PeriodicalIF":0.0,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45175774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hybrid Surgery for Portosystemic Encephalopathy in a Patient with Liver Cirrhosis: a case report. 混合手术治疗肝硬化门系统性脑病1例报告。

Hiroshima journal of medical sciences Pub Date : 2017-03-01

Yuki Imaoka, Masahiro Ohira, Shintaro Kuroda, Hiroyuki Tahara, Kentaro Ide, Kohei Ishiyama, Tsuyoshi Kobayashi, Masaki Ishikawa, Kazuo Awai, Hideki Ohdan

{"title":"Hybrid Surgery for Portosystemic Encephalopathy in a Patient with Liver Cirrhosis: a case report.","authors":"Yuki Imaoka, Masahiro Ohira, Shintaro Kuroda, Hiroyuki Tahara, Kentaro Ide, Kohei Ishiyama, Tsuyoshi Kobayashi, Masaki Ishikawa, Kazuo Awai, Hideki Ohdan","doi":"","DOIUrl":"","url":null,"abstract":"Regarding the treatment for a portosystemic shunt, surgical or interventional radiological closure of the shunt was established. Interventional radiology including balloon-occluded retrograde transvenous obliteration can worsen portal hypertension and create a large thrombus close to the major venous system in the case of a huge portosystemic shunt. In contrast, it is also difficult to treat some cases through surgery alone when huge complicated shunts exist very deep in the body. Herein, we report a successful case of surgical shunt ligation for portosystemic encephalopathy in a hybrid operation room that enabled intraoperative angiography and computed tomography. A 62-year-old woman with chronic hepatitis C was referred to our hospital due to high levels of serum ammonia and hepatic encephalopathy. She had a massive, complicated portosystemic shunt from the inferior mesenteric vein to the left renal vein but did not have esophageal or gastric varices. It was difficult to occlude the portosystemic shunt by interventional radiologic techniques because the shunt had an extremely large amount of blood flow and many collateral routes. We performed the shunt ligation in the hybrid operation room. Intraoperative angiography provided detailed information about the portosystemic shunt, such as direction or volume of blood flow and collateral routes in real time. Her encephalopathy disappeared completely and she remains healthy with improved liver functional reserve to date. In conclusion, this is a successful case of a hybrid operation for an extremely large and complicated portosystemic shunt, providing for intraoperative angiography as a safe and reliable surgical treatment for portosystemic encephalopathy in patients with liver cirrhosis.","PeriodicalId":12860,"journal":{"name":"Hiroshima journal of medical sciences","volume":"66 1","pages":"11-15"},"PeriodicalIF":0.0,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36296051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Case of Holocord Leptomeningeal Dissemination from Cerebellar Hemangioblastoma without von Hippel-Lindau Disease. 无希佩尔-林道病的小脑血管母细胞瘤完全性小脑膜播散1例。

Hiroshima journal of medical sciences Pub Date : 2017-03-01

Hideo Ohba, Satoshi Yamaguchi, Takuro Magaki, Masaaki Takeda, Manish Kolakshyapati, Takashi Sadatomo, Kaoru Kurisu

{"title":"A Case of Holocord Leptomeningeal Dissemination from Cerebellar Hemangioblastoma without von Hippel-Lindau Disease.","authors":"Hideo Ohba, Satoshi Yamaguchi, Takuro Magaki, Masaaki Takeda, Manish Kolakshyapati, Takashi Sadatomo, Kaoru Kurisu","doi":"","DOIUrl":"","url":null,"abstract":"Hemangioblastoma disseminated along leptomeninges from the solitary cranial lesion without von Hippel-Lindau (VHL) disease is a quite rare instance with 23 cases reported in 40 years. We add a new case and discuss these rare instances. A 55-year-old female underwent surgery for total removal of cerebellar hemangioblastoma. Twenty months later, magnetic resonance (MR) images of the spinal cord revealed a tumor compressing the thoracic cord at T3-4 level which was removed en bloc by emergent spinal surgery. However, paraplegia and bowel bladder dysfunction recurred 5 months after the spinal surgery. Spine MR images showed diffuse enhancement of subarachnoid space. Exploratory surgery disclosed that the enhanced lesion was disseminated hemangioblastoma. After whole spinal irradiation, she was transferred to a palliative care hospital. Even after complete removal, possibility of leptomeningeal dissemination demands continuous follow-up. The mechanism of seeding of hemangioblastoma remains unclear, but attention must be paid to avoid spreading tumor cells during surgery because all the disseminated cases had precedent cranial surgery.","PeriodicalId":12860,"journal":{"name":"Hiroshima journal of medical sciences","volume":"66 1","pages":"7-10"},"PeriodicalIF":0.0,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36296050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Application of Compound Action Potential of Facial Muscles Evoked by Transcranial Stimulation as a Reference Waveform of Motor-evoked Potential in Spinal Surgery. 经颅刺激诱发面部肌肉复合动作电位作为脊柱外科运动诱发电位参考波形的应用。

Hiroshima journal of medical sciences Pub Date : 2017-03-01

Mizuki Morishige, Masaaki Takeda, Satoshi Yamaguchi, Kazuhiko Sugiyama, Kaoru Kurisu

{"title":"Application of Compound Action Potential of Facial Muscles Evoked by Transcranial Stimulation as a Reference Waveform of Motor-evoked Potential in Spinal Surgery.","authors":"Mizuki Morishige, Masaaki Takeda, Satoshi Yamaguchi, Kazuhiko Sugiyama, Kaoru Kurisu","doi":"","DOIUrl":"","url":null,"abstract":"Transcranial electrical stimulation motor-evoked potential (TES-MEP) has been widely used to monitor major motor pathways in cranial and spinal surgeries. However, the results of TES-MEP might be strongly influenced by anesthetic agents and muscle relaxants. To compensate for this effect, a technique using compound muscle action potentials of the abductor pollicis brevis (APB-CMAP) evoked by median nerve stimulation has recently been reported. In this article, we adopted the transcranial electrical stimulation motor-evoked potential of facial muscles (TES-FMEP) instead of APB-CMAP as a reference waveform for compensation. Intraoperative monitoring in spinal surgeries using TES-MEP, TES-FMEP and APB-CMAP was performed in 64 patients. We compared with and without compensation methods using TES-FMEP and APB-CMAP to evaluate TES-MEP. The cases which demonstrated postoperative motor disturbance, including transient symptoms, were judged to be positive cases. Postoperative transient paraplegia was shown in one intramedullary tumor case among those 64 cases. Compensation by TES-FMEP exhibited the highest specificity (90.5%) and lowest false-positive rate (9.5%) among the three compensation modalities when evaluated at 80% amplitude decrease. TES-FMEP, being derived from motor cortex stimulation, is not influenced by the original spinal lesion or surgical manipulation of the spine. Therefore, compensation using TES-FMEP is suitable for intraoperative monitoring during spinal surgery. The authors advocate TES-FMEP as a reference waveform for the compensation of intraoperative TES-MEP.","PeriodicalId":12860,"journal":{"name":"Hiroshima journal of medical sciences","volume":"66 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36296049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Case of Spontaneously Reduced Ileoileal Intussusception Caused by a Lipoma. 脂肪瘤致自发性回回肠肠套叠减少1例。

Hiroshima journal of medical sciences Pub Date : 2016-12-01

Satoshi Sueoka, Toshiyuki Itamoto, Koichi Oishi, Tatsuro Ishimoto

{"title":"A Case of Spontaneously Reduced Ileoileal Intussusception Caused by a Lipoma.","authors":"Satoshi Sueoka, Toshiyuki Itamoto, Koichi Oishi, Tatsuro Ishimoto","doi":"","DOIUrl":"","url":null,"abstract":"Intussusception in adulthood is unusual. We describe herein a rare case of adult ileoileal intussusception caused by an ileal lipoma, which was diagnosed preoperatively and was confirmed at the operation to have reduced spontaneously. A 68-year-old woman experienced sudden-onset colicky pain in the upper abdomen accompanied by vomiting and was brought to our hospital by ambulance. Physical examination revealed a distended abdomen and tenderness in the upper abdomen. Laboratory findings showed slightly elevated inflammatory parameters. Abdominal computed tomography (CT) showed a target sign in the ileum, which is a typical sign of intussusception. Additional caudal-side scans showed a homogenous and fatty mass measuring 2.5 cm that was considered to be the leading point for the invagination. These findings led to a pre-operative diagnosis of intussusception induced by a lipoma. The patient underwent emergency surgery. Laparotomy revealed a yellowish, soft ileal tumor measuring 2.5 cm in diameter and that the intussusception had already been reduced at laparotomy. Approximately 15 cm of the ileum's length, including the tumor, was resected, and an end-to-end anastomosis was performed. Adult intussusception caused by an ileal lipoma is a rare condition. However, CT is the most useful tool for making a definite preoperative diagnosis based on its typical findings.","PeriodicalId":12860,"journal":{"name":"Hiroshima journal of medical sciences","volume":"65 3-4","pages":"65-68"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36299485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Russell Body Gastritis Concurrent with Eosinophilia: a case report. 罗素体胃炎并发嗜酸性粒细胞增多1例。

Hiroshima journal of medical sciences Pub Date : 2016-12-01

Takeharu Imai, Kazuhiro Sentani, Kazuomi Yamashita, Naohide Oue, Kazuhiro Yoshida, Wataru Yasui

引用次数: 0

Ganglioneuroma of Spinal Nerve Root: A Rare Case Mimicking Herniated Lumbar Disc and Lumbar Radiculopathy. 脊神经根神经节神经瘤:一例罕见的模拟腰椎间盘突出和腰椎神经根病的病例。

Hiroshima journal of medical sciences Pub Date : 2016-12-01

Prabin Shrestha, Anish M Singh, Rupendra B Adhikari, Geeta Sayami, Satoshi Yamaguchi, Kaoru Kurisu

引用次数: 0