CHDF was applied to 8 patients who developed acute renal failure following cardiogenic shock. Four of 8 patients also underwent PCPS (percutaneous cardiopulmonary bypass) and all were weaned from PCPS. Five patients were weaned from CHDF. CHDF was very effective to control the concentration of serum potassium, creatinine, blood urea nitrogen and diuresis.

Studies on the effects of heating as well as the mineral components of hot spring water have been conducted to investigate the effects of balneotherapy. However, few studies have been conducted on the effects of hydrostatic pressure and buoyancy during water immersion. Therefore, we investigated the effect of water immersion up to the neck at thermoneutral temperature on hemostatic activity.
Nine healthy men aged 22 to 34 were immersed up to the neck in the standing position in thermoneutral water (34.0±0.5°C) for two hours. The heart rate decreased immediately after starting water immersion and remained low during the immersion. Hematocrit values (Ht) of the blood samples taken from the ante-cubital vein decreased by 3.4% in average. The decrease in Ht was more prominent in the blood samples taken from the earlobe (4.0%), suggesting that hemodilution due to fluid shift was stronger in the upper part of the body. The time until euglobulin clot lysis shortened immediately after starting the immersion. Although fibrinolytic activity was enhanced, the concentration of tissue plasminogen activator (t-PA) antigen in the blood decreased gradually during the immersion and tended to return to the original level 30 minutes after immersion. A larger decrease in the concentration of plasminogen activator inhibitor-1 (PAI-1) antigen in the blood was observed immediately after starting the immersion, and it remained low for 30 minutes after immersion. An increase in fibrinolytic activity due to the decrease in PAI-1, not in t-PA, was observed during water immersion at thermoneutral temperature and the activation of fibrinolytic system without activation of the coaguration system was also observed.

Objective: In the intensive care unit (ICU), drugs are administered in sequence as the conditions of the patient change rapidly, and there are often cases where many injections are administered simultaneously.  For this reason, it is important to quickly select the appropriate administration route.  In this study, we prepared a quick reference table for incompatibilities of frequently used and highly important injections in the ICU (referred to as the “quick reference table”) that will enable selection of the appropriate administration route, and we investigated the status of use and usefulness of this quick reference table.
Methods: The drugs included in the quick reference table were extracted from prescription records from May to October 2009, and these were finalized by discussions with the nurses in the ICU.  Three reference materials were used: Manual on the Supervision of Injection Preparation (3rd Edition), Data Search on Injection Incompatibilities 2009, and MICROMEDEX®.  The survey was conducted with all 12 nurses in the ICU after 4 months of distributing the quick reference table.
Results: The quick reference table included 57 pharmaceutical items, and compatibility was classified into 10 categories.  The quick reference table was prepared as one A3 page for convenience.  The retrieval rate of the survey was 100%.  The average number of years of practical experience as a nurse was 12.2 years, and 11 out of 12 nurses used the quick reference table.  Of the 11 nurses who used the table, 6 answered that it was “very useful,” while 4 answered that it was “useful.”  All 11 nurses who used the quick reference table answered that they “consulted the pharmacists less frequently.”
Conclusion: Satisfactory evaluations were obtained with regard to the details included in the quick reference table, and the table was estimated to be highly useful and important even for ICU nurses with many years of experience.  Furthermore, it was suggested that the quick reference table was also useful in reducing the workloads of the pharmacists.

Effects of 38°C 30-minute bathing on hemostatic function and autonomic nervous function were studied in 15 48-to-72-year-old patients with cerebral infarction. Blood samples were collected three times: immediately before the bathing, at the end of 30 minutes of bathing, and 30 minutes after the bathing. Hematocrit values and fibrinogen concentrations decreased during bathing and returned to the pre-bathing levels 30 minutes after bathing. This indicates that bathing caused hemodilution due to the fluid shift. During bathing, noradrenaline decreased at a rate significantly higher than that of hemodilution while the sympathetic nervous function, which was evaluated by spectral analysis of sequential variation in arterial blood pressure, was not suppressed. The autonomic nervous system seemed to be inactive in these patients. Coagulation time (PT and APTT) and platelet factor (β-TG and PF4) showed few changes. In the fibrinolytic system, however, tissue plasminogen activator (t-PA) antigen levels increased and plasminogen activator inhibitor type-1 (PAI-1) levels decreased after 30 minutes of bathing. This suggests that fibrinolytic activity was enhanced by 38°C bathing for 30 minutes. Thus, subthermal bathing with comfort may be useful in preventing cerebral infarction.

OBJECTIVES: The prevalence of chronic low back pain (CLBP) increases with age and several mechanisms are involved in the development of CLBP, including osteoporosis; however, no associations with sarcopenia have yet been identified. METHODS: In total, 100 patients with CLBP and 560 patients without CLBP (nCLBP) aged over 65 years were studied. Skeletal muscle mass index (SMI) and percentage of body fat were evaluated using wholebody dual-energy X-ray absorptiometry. Sarcopenia was diagnosed when the relative SMI was more than 2 standard deviations below the mean in young adults. Thus, the cutoff value for sarcopenia was defined according to Sanada's Japanese population data. Paraspinal muscle cross-sectional areas of the lumbar multifidus and the erector spinae muscles were calculated using magnetic resonance imaging. RESULTS: Forty patients (40.0%) from the CLBP group and 149 (26.6%) from the nCLBP group met the criteria of sarcopenia. SMI was significantly lower and the body fat ratio was significantly higher in the CLBP group compared with the nCLBP group. Sarcopenic obesity was significantly observed in the CLBP group. Lumbar multifidus and the erector spinae muscle cross sectional area were significantly lower in the CLBP group. CONCLUSIONS: Elderly patients with CLBP have significantly lower skeletal muscle mass, and age-related mechanisms in sarcopenia are considered to be associated with chronic pain. Therapeutic procedures that are used to treat elderly aging muscle, including muscle strengthening and performance training, can possibly be a treatment for or used to prevent elderly CLBP.
Absorptiometry, Photon ; Adipose Tissue ; Aged* ; Aging ; Asian Continental Ancestry Group ; Chronic Pain ; Humans ; Low Back Pain* ; Magnetic Resonance Imaging ; Muscle, Skeletal ; Muscles ; Obesity ; Osteoporosis ; Paraspinal Muscles ; Prevalence ; Sarcopenia* ; Young Adult

This is the second report of the findings of the clinical and epidemiological studies on pathogen-carrying madani tick bites (ixodiasis) and the vector-borne diseases conducted by a study group of researchers specially organized by the Japanese Association of Rural Medicine. The report covers the period from January 1 through December 31, 2004.The same questionnaires that had been prepared in the previous survey were sentto 80 JARM-affiliated medical facilities and 11 non-member medical institutions to collect information about tick bites and resultant infections.It was found that during 2004 there were 134 cases (67 for men and 67 for women) of skin lesions caused by ixodid tick bites, 14 cases of Lyme disease (7 for men and the same for women), and none for Japanese spotted fever. These ixodiasis cases did not show any speciffic difference from those reported previously. All the Lyme disease patients developed erythema migrans which characterize stage 1 infection.As there is still plenty of catching up to do in terms of coping with the tick bite problems in Japan, we referred to some literature on the control of ixodid ticks, serologic testing techniques for Lyme disease, administration of prophylactic antibiotics and therapeutic methods.
Ticks ; Clinical ; Lyme Disease ; seconds ; Japanese language

Quercetin, a flavonoid, widely distributed in many fruits and vegetables, is well known to have an anti-tumor effect despite its mutagenicity. In this study, we examined the effect of dietary quercetin on duodenum-tumorigenicity of mice induced by a chemical carcinogen, N-ethyl-N'-nitro-N-nitrosoguanidine (ENNG). Eight-week-old male C57BL/6 mice were divided into 4 groups; ENNG without quercetin (group A), ENNG with 0.2% quercetin (group B), ENNG with 2% quercetin (group C), and 2% quercetin without ENNG (group D). ENNG was given in drinking water for the first 4 weeks, and thereafter quercetin was given in a mixed diet. At week 20, the average number of duodenal tumors per mouse was significantly higher in group C (mean±SE, 7.26±1.75, p<0.05) than in group A (2.32±0.31). The size of the duodenal tumors increased significantly in group B (1.79±0.09 mm, p<0.001) compared with group A (1.43±0.09 mm). In contrast, no duodenal tumor was induced in group D. The present findings suggest that excessive intake of quercetin occasionally is a risk factor for carcinogenesis of some specific organs such as the upper intestine.
Quercetin ; Upper Case En ; ENNG ; week ; Laboratory mice

Purpose: Despite widespread adoption of open abdominal management (OAM), there is currently no threshold criterion for OAM duration for non-trauma patients. Moreover, there is a positive relationship between morbidity and the duration of OAM, but an uncertain relationship with patients’ age. Therefore, a novel clinical index for the duration of open abdominal management (IDOM) was developed based on the patient’s age and risk of severe complications following OAM to indicate the maximum tolerable number of days of OAM based on the individual’s age. The utility of this new index was evaluated. Methods: This retrospective study included 65 non-trauma patients managed with an open abdomen (OA) from August 2015 to August 2018. The IDOM was developed based on the patient’s age. The result indicated the maximum number of OA days. Patients’ demographic and operative variables were examined and patient data was assigned to one of two groups according to whether the actual number of OA days was above or below the calculated IDOM. Prevalence of complications between these groups was compared. Measures of validity were employed to assess the utility of the IDOM for patient complications. Results: Sixty-five patients were included. The above-the calculated IDOM group exhibited a significantly longer OA and higher rates of wound complications and postoperative respiratory complications compared with the below the calculated IDOM group. The IDOM predicted the incidence of OA-related complications with a sensitivity of 72.4%, and a specificity of 80.6%. Conclusion The IDOM is a potentially useful tool for appropriate duration at the outset of OA.

Methods: We included 62 patients who underwent combined LLIF surgery and PPS fixation for degenerative lumbar spondylolisthesis with spinal canal stenosis. We compared the patient demographics and the accuracy of fluoroscopy-guided PPS placement between two groups: patients who remained in the lateral decubitus position for the pedicle screw fixation (single-position surgery [SPS] group) and those who were turned to the prone position (dual-position surgery [DPS] group). Results: There were 40 patients in the DPS group and 22 in the SPS group. Of the 292 PPSs, only 12 were misplaced. In other words, 280/292 screws (95.9%) were placed correctly in the pedicle’s cortical shell (grade 0). PPS insertion did not cause neurological, vascular, or visceral injuries in either group. The breach rates for the DPS and SPS groups were 4.1% (grade 1, 5 screws; grade 2, 3 screws; grade 3, 0 screw) and 4.1% (grade 1, 2 screws; grade 2, 2 screws; grade 3, 0 screw), respectively. Although there were no statistically significant differences, the downside PPS had more screw malpositioning than the upside PPS. Conclusions We found that PPS insertion with the patient in the decubitus position under fluoroscopic guidance might be as safe and reliable a technique as PPS insertion in the prone position, with a misplacement rate similar to that previously published.