1.A Case of Chronic Nasal Obstruction Treated with Kampo Medicine and Acupuncture.
Akinori SHINOHARA ; Hiroshi SHIMIZU
Kampo Medicine 1995;46(2):315-318
A 78-year-old female patinet complained of chronic nasal obstruction. The purulent and occasionally blood-streaked nasal discharge continued for three years. Kakkon-to-ka-senkyushin-i was administered according to the traditional Chinese medical diagnosis and acupuncture was applied bilaterally to Rekketsu (L7) and Geiko (LI20) once a week, After this combination therapy involving administration of Kampo extract and acupunctute was continued for seven months her clinical complaint had disappeared completely.
This case demonstrated the efficacy of traditional Chinese medicine in mountainous rural areas where commuting to a otorhinolaryngologist is not feasible.
2.Changes in the sagittal plane spinal alignment at the time of the cross-leg sitting position
Yukio Urabe ; Hiroshi Shinohara ; Takuya Takeuchi ; Shogo Tsutsumi
Japanese Journal of Physical Fitness and Sports Medicine 2017;66(5):363-367
Cross-leg sitting is locus posture performed well in Asian area, and a lifestyle and culture are thought to affect it. It is usually essential to cross-leg sitting carried out in the case of Zen meditation to maintain cross-leg sitting locus in a relaxed state to perform locus posture in floor, and to perform it in hip joint flexion of bilateral feet, abduction, and lateral rotation position in the meditation for a long time. The spinal column of cross-leg sitting was intended that aligning it confirmed backbone in lumbar vertebrae being displaced than rest standing position in the kyphosis direction or raising a bearing surface whether aligning it changed into lordotic projection from the lumbar vertebrae kyphosis direction. The thoracic vertebra angle and the lumbar vertebrae angle measured it using SpinalMouse®. We decided to measure a thoracic vertebra angle, a lumbar vertebrae angle when we changed the height of the target rest standing position and the bearing surface of cross-leg sitting. The thoracic vertebra angle did not change by raising the bearing surface of cross-leg sitting, however the lumbar vertebrae angle changed. It showed a significant correlation between hip joint flexion, abduction, an external rotation angles and the change of the lumbar vertebrae angle. Results of this study suggested that lumbar, aligning it changed to lordosis in the high cross-leg sitting thing that we changed. The quantity that aligning it biases into lordosis of the lumbar part is related to the flexion of the hip joint, abduction, external rotation flexibility.
3.Surgical Reconstruction with Autologous Tissue in a Case of Isolated Unilateral Absence of the Right Pulmonary Artery
Yoshimasa Uno ; Kiyozo Morita ; Masahito Yamashiro ; Gen Shinohara ; Hiroshi Kagawa ; Kazuhiro Hashimoto
Japanese Journal of Cardiovascular Surgery 2009;38(2):156-159
Isolated unilateral absence of the right pulmonary artery without any intracardiac anomaly is a rare congenital cardiovascular disorder. We performed a successful surgical reconstruction with autologous tissue of this anomaly. The patient was a 1-month-old boy who had been transferred to our center at 3 days of age because of tachypnea and heart murmur. Multi-detector CT and radial angiography imaging revealed isolated unilateral absence of the right pulmonary artery and left patent ductus arteriosus. Conservative treatment did not help his progressive heart failure and pulmonary hypertension due to an acute increase of pulmonary blood flow. Therefore surgical correction was determined to avoid the worsening of those symptoms. Under cardiopulmonary bypass, the right pulmonary artery branching off from the brachiocephalic artery was removed and anastomosed to the main pulmonary artery with an autologous pericardium roll. Symptoms improved postoperatively and he was discharged in good condition on the 21st of postoperative day. Cardiac catheterization, 3 months later, showed excellent results.
4.Report of 2009 WFAS University Cooperation Working Committee and WFAS Standard Working Committee
Ikuro WAKAYAMA ; Naomi TAKAZAWA ; Naoto ISHIZAKI ; Hiroshi TSUKAYAMA ; Shoji SHINOHARA ; Shuichi KATAI
Journal of the Japan Society of Acupuncture and Moxibustion 2010;60(2):255-260
The WFAS University Cooperation Working Committee and WFAS Standard Working Committee were held during 2009 WFAS World Acupuncture Congress at European Parliament in Strasbourg, France on 6 November 2009. Publishing an International Textbook of Acupuncture and Moxibustion was proposed in the WFAS University Cooperation Working Committee. Also establishing Making WFAS standards on acupuncture needles, nomenclature and location of auricular points, manipulation of moxibustion, and manipulation of scalp acupuncture were discussed and proposed in the WFAS Standard Working Committee.
5.A Case of Giant Coronary Artery Aneurysm in the Right Atrium Associated with a Right Coronary-Right Atrial Fistula
Motohiro Oshiumi ; Kazuhiro Hashimoto ; Hiroshi Okuyama ; Ryuichi Nagahori ; Gen Shinohara ; Masamichi Nakano
Japanese Journal of Cardiovascular Surgery 2004;33(5):352-355
Coronary artery fistula is an unusual congenital anomaly, particularly in association with coronary aneurysm. In the present case, a right coronary fistula leading to the right atrium was associated with a giant coronary aneurysm. There have only been 3 such cases reported in the literature. Since both the aneurysm and the fistula were completely thrombosed, no heart murmur was detected and the patient was initially diagnosed as having an intracardiac tumor by echocardiography.
6.A Case of Marfan's Syndrome with Acute Aortic Dissection during Pregnancy
Takahiro Inoue ; Yoshimasa Sakamoto ; Hiroshi Okuyama ; Makoto Hanai ; Noriyasu Kawada ; Gen Shinohara ; Kazuhiro Hashimoto
Japanese Journal of Cardiovascular Surgery 2005;34(2):116-119
We present a case of Marfan's syndrome with acute aortic dissection during the trimester of her pregnancy, who underwent a Bentall operation 2 days after emergency cesarean section. A 24-year-old woman during the 31st week of pregnancy visited our emergency room due to sudden onset of chest and back pain, though she had no abnormality until this event. Because of her tall height, spider fingers, positive wrist sign, visual disorder and scoliosis, she was given a diagnosis of Marfan's syndrome. Enhanced CT and cardiac ultrasonography revealed that she was suffering from acute aortic dissection with annulo-aortic ectasia. Since it was difficult for her to continue with her pregnancy, she underwent emergency cesarean section and gave birth to a male baby weighted 1, 706g. Although there was little likelifood of early thrombus formation in the false lumen or significant aortic regurgitation indicating an emergency operation, fear of massive bleeding from her uterus and the exfoliated surface of the placenta after cesarean section required an observation period of 2 days. We performed a Bentall operation successfully after careful sedation, ventilation and blood pressure control for 2 days.
7.Tricuspid Valve Replacement for a Patient with Corrected Congenital Transposition of the Great Vessels and Protein C Deficiency
Gen Shinohara ; Kazuhiro Hashimoto ; Yoshimasa Sakamoto ; Hiroshi Okuyama ; Makoto Hanai ; Takahiro Inoue ; Ken Nakamura
Japanese Journal of Cardiovascular Surgery 2007;36(4):193-197
Protein C (PC) deficiency is an inherited thrombotic disorder with a prevalence of 0.19% among the general population. PC deficiency is associated with an increased risk of thrombosis when other risk factors are present, such as trauma, surgery, or infection, and is an important cause of mechanical valve thrombosis. We performed tricuspid valve replacement with a 29mm Carpentier-Edwards Perimount valve in a 20-year-old man with PC deficiency. The patient had corrected transposition of the great vessels with severe tricuspid insufficiency, as well as a history of cerebral infarction. In the perioperative period, we used only heparin sodium as the anticoagulant. When we restarted administration of warfarin, changing over from heparin, transient increases of serum plasmin inhibitor-plasmin complex (PIC) and thrombin antithrombin complex (TAT) levels were observed. Despite an increased dose of heparin, an appropriate activated partial thromboplastin time (APTT) was not obtained. This suggested a hypercoagulatory state, but the postoperative course was uneventful. Management of perioperative anticoagulation, prevention of late thrombotic events, and prosthetic valve selection in this particular situation are discussed.
9.Experimental study on the specificity of Jin-yu needling for urinary secretion.
Shoji SHINOHARA ; Eeisou ISIMARU ; Munenori TAWA ; Tosikatsu KITADE ; Hisasi KOUDA ; Sikou GO ; Midori YAMAKAWA ; Hiroshi SUZUYAMA ; Masakazu SAKITA
Journal of the Japan Society of Acupuncture and Moxibustion 1989;39(2):246-251
The specificity of Jin-yu needling for urinary secretion was studied.
1); 15 healthy adult men were subjected to this experiment. After drinking water (500ml), acupuncture needles (No. 2 Seirin Co. Limited) were perpendiculary inserted to the jin-yu point depth of about 2cm, and left there for 10 minutes. The blood samples were collected at 60 minutes after drinking water, and urine volume and amount of Na, K, Cl, BUN, UA and Cre were measured.
As a result, a marked increase was observed in excretion of urine, UA, Cre, K and creatinine clearance. An upward tendency of Na, Cl and BUN excretion were found and it is correlated with urine volume.
2); Subjects were 11 healthy adult men. The group of acupuncture stimulation was divided as follows; a) a group, acupuncture needles were inserted at Jin-yu point [B-23], b) kyouseki point, c) sisitu point [B-52], d) daityou-yu point [B-25], e) I-yu point [B-21] and f) untreated contorol group. Urine were collected at 60 minutes after drinking water (500ml).
As a result, a significant increase of urine volume was observed in the group of stimulation at Jin-yu, Kyouseki, and Sisitu point (p<0.05).
Finally, it was suggested that the increase of urine volume was caused by a somato-visceral reflex.
10.A Case of Mitral Valve Replacement with Rupture of the Left Ventricle
Yoshimasa Sakamoto ; Kazuhiro Hashimoto ; Hiroshi Okuyama ; Kazuaki Shiratori ; Motohiro Oshiumi ; Makoto Hanai ; Takanori Inoue ; Gen Shinohara ; Shouhei Kimura ; Takayuki Abe
Japanese Journal of Cardiovascular Surgery 2004;33(6):391-394
A 56-year-old woman suffering from mitral stenosis had underwent PTMC (percutaneous transvenous mitral commissurotomy) at age 46. After she developed congestive heart failure, mitral valve replacement (MVR) with Carbomedics 29M and tricuspid annuloplasty (TAP) was carried out. Four hours after admission to the ICU, massive bleeding was noticed. Cardiopulmonary bypass was restarted in the operating room. Laceration and hematoma were found at the posterolateral wall of the left ventricle. Under cardiac arrest with removal of the prosthetic valve, an internal tear was detected about 2cm below the anterolateral commissure (Miller Type III). The tear was covered with a horse pericardial patch (2×3cm) using 6-0 running sutures with reinforcement with gelatin-resorcine-formaline (GRF) glue between the laceration and the patch. MVR sutures in the annulus above the ventricular tear were first passed through the annulus, the pericardial patch and then the prosthetic cuff. Additionally, an epicardial tear was covered and reinforced with the fibrin sheet, GRF glue and pericardial patch in turn. Cardiopulmonary bypass was weaned easily without bleeding. The patient was intentionally on respiratory support with sedation for 3 days. The subsequent postoperative course was uneventful.