7カ月齢のミニチュア・ダックスフントが，重度な尿毒症を呈し，対症療法を中心とした内科治療に反応を示さず，本学獣医臨床センターに上診した．初診時には腎機能低下の原因は確定できなかったが，一般状態の改善を優先し，血液透析を実施した．血液透析により，一般状態は改善し，血液検査上の異常値（BUN，Creなど）は補正された．飼い主の希望により，さらなる精査を実施せず，Quality of ...Life（QOL）の維持を目的とした血液透析を継続した．その結果，短期間ではあったが，良好に経過した．その後，症例は急性感染症が疑われる症状を呈し斃死した．死後剖検ならびに病理組織学的に両腎低形成による末期腎不全と診断された．本症例において，血液透析は腎低形成による尿毒症の管理において高い効果を示し，QOLを向上させることが示された.
A 55-year-old man with advanced gastric cancer underwent total gastrectomy (T3N0M0, stage II , por, sig) in the USA. Following his return to Japan, the patient then suffered from a recurrence with ...ileus, bilateral hydronephrosis and ascites caused by peritoneal dissemination. Systemic chemotherapy of paclitaxel combined with 5-FU was performed, and after four cycles, ileus, bilateral hydronephrosis and ascites disappeared. S-1 monotherapy was started to maintain his QOL, but after five cycles, ileus of the transverse colon recurred. Colostomy was performed and systemic chemotherapy of paclitaxel combined with S-1 was performed. For 13 months, the patient's condition remained stable and he returned to society, but died 30 months after the first recurrence. This case suggests that paclitaxel-based chemotherapy is a promising treatment for gastric cancer with peritoneal dissemination.
INTRODUCTIONWe present a case of laparoscopic repair of vesicovaginal fistula caused by radiation therapy using a perirectal fatty tissue interposition graft.CASE PRESENTATIONA 72-year-old woman was ...diagnosed with vesicovaginal fistula induced by radiation therapy. Repair of the vesicovaginal fistula was achieved via laparoscopic approach. The fistula was exposed, followed by excision of fistula tract, fine dissection to achieve a traction-free approximation of bladder mucosa, then water-tight closure. An interposition graft derived from the perirectal fat was inserted to reduce the risk of repair failure. The patient did not have the incontinence problem at 1-year follow-up.CONCLUSIONThe laparoscopic approach for vesicovaginal fistula repair is minimally invasiveness. Preparation of the interposition graft derived from the perirectal fatty tissue was easy and its mobility to achieve closure of the fistula was acceptable. Thus, this procedure is feasible for the repair of poorly vascularized tissues such as radiation-induced fistulas.
A 246-base pair (bp) retroviral sequence, which was homologous to a long terminal repeat of avian erythroblastosis virus (AEV), was detected and cloned from Md5 strain (Md5) of Marek's disease virus ...type 1 (MDV1) by representational difference analysis (RDA). The retroviral sequence was thought to be located in the border region of short unique region (US) and short terminal repeat (TRS), but did not exist in the border region of US and the inverted short repeat (IRS) of the Md5 genome. A cloned fragment of the US/TRS border region of the Md5 genome showed a construction of U-E'-R-U'-E-TRS with the regions designated as follows: E, expanded TRS reported by Jones et al. Proc. Natl. Acad. Sci. U.S.A. 90, 3855, 1993; E', a partial copy of the expanded TRS; R, the retroviral sequence detected in Md5 genome; U, TRS-end sequence of US; U', a partial copy of TRS-end sequence of US. The sequence unit indicated as E'-R-U' was thought to be heterogeneously repeated in the Md5 genome. Since this retroviral sequence reportedly did not exist in the original stock of Md5, the retroviral sequence is thought to be inserted in the Md5 genome without experimental co-infection of avian cells with retrovirus and MDV1. These results suggest that RDA could be useful for the detection of retroviral sequences in the herpesvirus genome.
An 18-year-old female with myelodysplastic syndrome underwent an allogeneic cord blood transplantation in May 2005. The conditioning regimen consisted of total body irradiation, cytarabine and ...cyclophosphamide. The day of the cord stem cell transfusion was counted as Day 0. For acute GVHD prophylaxis, cyclosporine A (CsA) and methotrexate were used. Engraftment was achieved on Day 30, acute GVHD grade II developed on Day 45 and treatment with methylprednisolone for acute GVHD was started. On Day 68 the patient had generalized seizures accompanied by loss of consciousness, hypertension and left hemiparesis, and was intubated. A cranial CT scan showed a mass effect on the right basal ganglia, and high signal intensities on the T2-weighted and FLAIR images of a MR examination were detected in the bilateral basal ganglia and posterior lobes, the findings of which were compatible with a brain tumor or infectious disease. Since an increased level of apparent diffusion coefficient (ADC) values on the bilateral basal ganglia was noted, we suspected that vasogenic edema had caused the mass effect. She went into remission immediately after CsA treatment was discontinued. Therefore, this case was diagnosed as atypical reversible posterior leukoencephalopathy syndrome (RPLS) associated with CsA. CsA-induced encephalopathy presenting a mass effect in clinical imaging findings is very rare, and an ADC map may be useful for the diagnosis of RPLS.
〔Aim〕The purpose of this study was to clarify the differences of experience as a pediatric nursing practical training clinical instructor on recognition of pediatric nursing practical training, job ...stress, and career development.〔Methods〕A total of 1995 nurses from 178 pediatric wards participated in a questionnaire survey. Comparative analysis of differences in recognition of pediatric nursing practical training, job stress, and career development was then conducted.〔Results〕825 Nurses were separated 466 “with instructor experience” and 359 “without instructor experience”. Nurses obtained concerning recognition of pediatric nursing practical training and reported feeling more stress for instructing experience. Nurses in the “with instructor experience” group obtained particularly high scores in recognition of pediatric nursing practical training, job stress, and career development than the “without instructor experience” group.〔Discussion〕Having experience as an instructor related to the effectiveness of recognition of pediatric nursing practical training, job stress, and career development.
Several studies have reported urinary tract infection of felines with LUTD accounting for 2–10% of cases. We performed direct identification of bacteria in urine using pretreatment kits for the ...direct application of positive blood culture bottles to MALDI-TOF MS. Urine samples collected from 43 cats with bacterial cystitis brought to Maeda Veterinary Hospital between August 10, 2015 and March 31, 2016 were used in the study. The MALDI Sepsityper Kit correctly identified 23 enteric gram-negative bacteria (92.0%) and 6 gram-positive cocci (37.5%). This method employing the MALDI Sepsityper Kit for pretreatment is a quick and reliable method for the identification of bacteria from infected urines.
The QRS complex of the pacemaker best resembles a typical left bundle branch block (LBBB) during right ventricle (RV) pacing. The right bundle branch block (RBBB)-like pattern implies an abnormal ...lead position or perforation of the RV. We performed electrocardiogram (ECG) recording and encountered a case of RBBB-like pattern. An abnormal lead position was ruled out by chest X-ray and echocardiogram examinations, confirming the apical right ventricular lead position. It has been reported that an uncomplicated RV produces an RBBB-like pattern. We investigated the position of the lead in one intercostal space lower than the usual space of the chest electrode, and determined the frontal axis and precordial point of transition. Our patient also showed the RBBB-like pattern in one intercostal space lower than the usual space of the chest electrode. The frontal axis was −30°, the precordial point of transition was between V1 and V2, and there was no difference in the reported ECG algorithms. ECG is useful for detecting the abnormal position of the right ventricular lead.
2. Early Childhood Care and Education Forum Abe, Kazuko; Hishitani, Shinko; Oogata, Mika ...
RESEARCH on EARLY CHILDHOOD CARE and EDUCATION in JAPAN,
2016, Letnik:
54, Številka:
3
Journal Article
We examined the bone movement in the forepaw and hind paw in the aardvark (
Orycteropus afer) by using three-dimensional (3D)-computed tomography (CT) techniques and osteometrical methods to confirm ...the functional adaptation of the extremities as a digging system. The four metacarpal bones could be strongly bent from the distal carpal bones. The distal end of the second and third metacarpal bones possessed enlarged smooth articulation surfaces that allowed the proximal phalanx to bend at a sharp angle. However, the articulation surface was not well-developed in the distal end of the fourth and fifth metacarpal bones and the proximal phalanx could bend at smaller angle in these two lateral digits. The proximal phalanges sharply crook from the metatarsal in the first, second, third and fourth digits in the hind paw. We suggest that the medial two digits in the forepaw directly contribute to the crushing, when these proximal phalanges crook in the phase of power stroke. In contrast the lateral third and fourth digits may act as sweeper of the crushed soil. These suggestions regarding the different functional adaptation between medial two digits and lateral two digits are consistent with the anatomical data of the forearm musculature. In the hind paw, we suggest that the second, third and fourth digits are functionally similar and that the hind paw may not act as a crushing apparatus but as a running motor or soil-sweeper similarly using these main three digits.
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