1.Hydrocephalus Associated with Minor Intraventricular Hemorrhage in Patient Undergoing Maintenance Hemodialysis
Eriko Eguchi ; Shinsui Tatsumi ; Atsuo Tanaka ; Takashi Kuwahara
General Medicine 2014;15(1):63-67
A 72-year-old woman on dialysis acutely developed disturbed consciousness and severe hypertension. Head computed tomography (CT) demonstrated only ventriculomegaly without bleeding. Her consciousness level further deteriorated after dialysis using heparin, and subsequent head CT revealed a new, minor intraventricular hemorrhage. Hemorrhage-associated hydrocephalus was diagnosed, and the installation of a ventriculoperitoneal shunt resulted in good recovery. The patient might have experienced minor repeated bleeding and developed latent post-hemorrhagic hydrocephalus. Even minor bleeding could cause acute exacerbation of hydrocephalus; therefore, clinicians should be alert to hydrocephalus when a dialysis patient develops disturbed consciousness without any evidence of stroke on head CT.
2.A prototype interactive seminar on pediatric emergency practice in Yokohama
Atsuo Sato ; Atsushi Isozaki ; Hideyasu Oto ; Wataru Kubota ; Yoshinori Kobayashi ; Tsuyoshi Sogo ; Fumiko Tanaka
Medical Education 2013;44(4):261-263
We describe a prototype seminar, inspired by the problem-based learning tutorial system, on pediatric emergency practice for young physicians working in 7 pediatric emergency centers in Yokohama. The seminar was received favorably by the participants, especially as an opportunity for individual learning. We expect that the seminar will contribute to the standardization of emergency practice in these pediatric centers and the establishment of an interhospital network.
3.Two Stage Operation for Chronic Dissecting Thoracic Aortic Aneurysm Associated with True Lumen Obstruction of the Abdominal Aorta
Yasuaki Shimada ; Keisuke Tanaka ; Yoshimori Araki ; Yuji Narita ; Atsuo Maekawa ; Hideki Oshima ; Akihiko Usui ; Yuichi Ueda
Japanese Journal of Cardiovascular Surgery 2011;40(1):22-26
A 64-year-old man who had chronic aortic dissecting aneurysm with true lumen obstruction of the abdominal aorta was referred to our hospital for surgery. He underwent total aortic arch replacement with the elephant trunk technique using an aortofemoral artery bypass as a first-stage operation. Reconstruction of the thoracic aortic descending aneurysm using the previous elephant trunk graft in a second-stage operation was feasible. His perioperative course was uneventful and he had no neurologic complications.