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Keiichi Nakahara,Satoshi Yamashita,Katsumasa Ideo,Seigo Shindo,Tomohiro Suga,Akihiko Ueda,Shoji Honda,Tomoo Hirahara,Masaki Watanabe,Taro Yamashita,Yasushi Maeda,Yasuhiro Yonemochi,Tomohiro Takita,Yuk 대한신경과학회 2014 Journal of Clinical Neurology Vol.10 No.4
Background Listeria monocytogenes (L. monocytogenes) is a rare causative pathogen ofbrain abscess that is often found in immunocompromised patients. Although patients with supratentorial listerial abscesses showed a longer survival with surgical drainage, the standardtherapy for patients with subtentorial lesions has not been established. Case Report We report herein a patient with supra- and subtentorial brain abscesses causedby L. monocytogenes infection. These abscesses did not respond to antibiotics, and his symptoms gradually worsened. Drainage was not indicated for subtentorial lesions, and the patientwas additionally treated with hyperbaric oxygen therapy, which dramatically reduced the volume of abscesses and improved the symptoms. Conclusions This is the first report of drastic therapy for a patient with listerial brain abscesses involving combined antibiotics and hyperbaric oxygen therapy. The findings suggestthat hyperbaric oxygen therapy is a good option for treating patients with deep-seated listerialabscesses and for who surgical drainage is not indicated.
Toyota Kazuhiro,Mori Masayuki,Hirahara Satoshi,Yoshioka Shoko,Kubota Haruna,Yano Raita,Kobayashi Hironori,Hashimoto Yasushi,Sakashita Yoshihiro,Yokoyama Yujiro,Murakami Yoshiaki,Miyamoto Katsunari 대한위암학회 2022 Journal of gastric cancer Vol.22 No.1
Purpose: Nutritional problems after gastrectomy affect continuation of postoperative chemotherapy. There have been no studies limited to total gastrectomy, which is particularly prone to nutritional problems. In this study, we aimed to investigate the factors that predict the continuation of postoperative chemotherapy. Materials and Methods: We included 101 patients who underwent curative total gastrectomy and postoperative chemotherapy at Hiroshima Memorial Hospital. The effects of 37 factors, including perioperative inflammatory, nutritional, and tumor status, on the persistence of postoperative chemotherapy were analyzed. Results: In univariate analysis of preoperative factors, age, carbohydrate antigen 19-9, platelet-to-neutrophil ratio, Onodera's prognostic nutritional index (PNI), controlling nutritional status score, and nutritional risk screening (NRS-2002) score were significantly associated with the duration of postoperative chemotherapy. In multivariate analysis of preoperative factors, age (≥74 years) was an independent factor for a shorter duration of postoperative chemotherapy (hazard ratio [HR], 5.24; 95% confidence interval [CI], 2.19–12.96; P<0.01). In univariate analysis of factors before postoperative chemotherapy, intraoperative blood loss, perioperative weight loss rate, postoperative performance status, PNI, albumin-to-bilirubin index, and NRS-2002 score were significantly associated with the duration of postoperative chemotherapy. In multivariate analysis of factors before postoperative therapy, age (≥74 years) (HR, 5.75; 95% CI, 1.90–19.49; P<0.01) and PNI (<39) (HR, 3.29; 95% CI, 1.26–8.56; P=0.02) were independent factors for a shorter duration of postoperative chemotherapy. Conclusions: Age and PNI are useful predictors of postoperative chemotherapy intolerance after total gastrectomy and may determine the treatment strategy and timing of chemotherapy initiation.