1.Two Patients with Ophthalmic Symptoms due to Post Herpetic Infection Dramatically Improved with Chotosan
Satoru FUKUDA ; Takashi NAMBU ; Hidenori TAKAHASHI ; Kanako KUROKI ; Hiroshi NISHIYAMA ; Tadamichi MITSUMA
Kampo Medicine 2010;61(7):912-916
We successfully treated 2 patients with ophthalmic symptoms due to post herpetic infection using chotosan. Case1was a 78-year-old woman who had been suffering from ophthalmic symptoms such as foreign body sensation and irritation pain due to post herpetic infection for almost 20 years, and had a history of hypertension. We treated her with stellate ganglion block every week and orally administered keishikajutsubuto, amitriptyline, and later mexiletine. Initially, stellate ganglion block was very effective, but its effect gradually decreased over about one month. Considering the same action of stellate ganglion block and chotosan, both of which might increase intracranial blood flow, we administered chotosan instead of keishikajutsubuto. Her ophthalmic symptoms subsided for 5 days, and had completely disappeared almost two and half months after initiating chotosan. Case 2 was a 65-year-old man who had also complained of foreign body sensation due to post herpetic infection for 11 months. He also had a history of hypertension. Initial stellate ganglion block was also effective for relieving his symptom, but the effect was transient as in Case 1. Taking into consideration of our experience in Case 1,we administered chotosan. His foreign body sensation gradually subsided for 2 weeks, and had almost disappeared 2 months after initiating chotosan. Our experiences suggest that chotosan may be an optimal formulation for the patients suffering from ophthalmic disorders due to post herpetic inflammation and hypertension.
2.Postgraduate Clinical Experience and the Diagnostic Usefulness of History-taking, Physical Examination and Stat Laboratory Testing.
Tsuguya FUKUI ; Shunichi HORIKAWA ; Masashi SHIRAHAMA ; Hiroshi KOHNO ; Masanori NISHIYAMA ; Shingo ONOHARA ; Yuzoh KATAFUCHI ; Tatsuhiko KOBAYASHI ; Naoaki HIGUCHI ; Toshinobu TAKASHIMA ; Reiki KATAFUCHI ; Yukio MATSUI ; Masahiro YOSHIHARA ; Shigemi KONDOH
Medical Education 1991;22(3):139-145
3.Points requiring attention in primary-care settings in the treatment of patients with acute drug intoxication
Yoshinori Masui ; Naonori Tsuda ; Takeshi Nishiyama ; Junwa Kunimatsu ; Tomonori Mizutani ; Sumie Moriyama ; Reo Yoshikawa ; Hiroki Adachi ; Hidetaka Hamasaki ; Hirohisa Morikawa ; Kazuhiro Honda ; Hiroshi Kaneko ; Shuichi Mishima ; Atsuto Yoshizawa ; Hidekatsu Yanai
An Official Journal of the Japan Primary Care Association 2011;34(2):115-123
Objective: To develop an effective and safe therapeutic strategy, we studied the effect of the clinical characteristics of patients with acute drug intoxication on the duration of hospitalization.
Subjects and Methods: The subjects were 89 patients hospitalized for acute drug intoxication. They were divided into two subgroups; the short hospitalization group (duration of hospitalization < 7 days) and the long hospitalization group (duration of hospitalization ≥ 7 days). We compared age, sex, vital signs, drugs, and therapy between the two groups.
Results: There were no significant differences in sex or severity of consciousness disturbance between the short- and long-hospitalization groups. Age in the latter group was higher than that in the former, and age was significantly and positively correlated with the duration of hospitalization. Prolongation of hospitalization in patients with Japan Coma Scale (JCS) I or II is associated with psychiatric disease, and in patients with JCSIII, with physical disease. We used direct hemoperfusion (DHP) to treat patients with severe acute drug intoxication. The duration of hospitalization in patients treated by DHP tended to be shorter than those not so treated.
Conclusions: The present results suggest that aging is associated with prolongation of hospitalization and the onset of physical disease among patients with acute drug intoxication. When elderly patients with acute drug intoxication are treated in a primary-care setting, the question of whether or not physical diseases are present as complications should be considered. The appropriate use of DHP for the treatment of patients with severe acute drug intoxication requires further study.