1.Experimental Study of Microvascular Anastomosis Using GRF Glue.
Katsuhiko MATSUDA ; Nobushige TAMURA
Japanese Journal of Cardiovascular Surgery 1993;22(1):26-29
The GRF glue consists of mixture of gelatine and resorcine. The mixture is hardened by the addition of medical formaldehyde. Resorcine is diphenole which reacts with formaldehyde, creating tridimentional network. We performed microvascular anastomosis of abdominal aorta of the rat using GRF glue and the histologial study by the light microscope and the scanning electron microscope. Re-endoterization began from two days after anastomosis and completed at ten days to two weeks after anastomosis. From scanning electron microscopic study the invasion of macrophages and platelets in the case of anastomosis using GRF glue was less than in the case of manual or laser anastomosis. We revealed that GRF glue is very useful for bonding of micro vessels.
2.The Recognition by Medical Students for General Medicine and Japanese Oriental (Kampo) Medicine.
Toshiaki KOGURE ; Katsuhiko ITO ; Naoki MANTANI ; Junichi TAMURA
Kampo Medicine 2003;54(6):1103-1108
We assessed the understanding of Japanese Oriental Medicine, as well as the connection between General Medicine and Japanese Oriental Medicine, among medical students, to improve the effectiveness of clinical practice and lectures. The questionnaires were sent to fifth-year medical students (n=66), and the responses were collected anonymously. Although 22.4% of the responding students were “very” interested in Japanese Oriental Medicine and 68.7% were “slightly” interested, the students who understood Japanese Oriental Medicine even “slightly”comprised only 23.9%. The majority of students considered that the system of Japanese Oriental Medicine was most useful in combination with Western Medicine for practicing General Medicine. Nine (60%) of 15 students who understood Japanese Oriental Medicine considered that the system of Japanese Oriental Medicine was most useful for practicing general medicine. In contrast, among students who did not understand Japanese Oriental Medicine, only 8 of 42 (19%) showed the same response. Similarly, more of the students who understood General Medicine showed this response than students who did not understand General Medicine.
These results permit us to speculate that medical students consider that understanding both General Medicine and Japanese Oriental Medicine might contribute to the development of a medical service.
3.A Case of Prolonged Post-Herpetic Neuralgia Successfully Treated with Uyaku-jyunki-san-ryou
Ayami HOSHINO ; Toshiaki KOGURE ; Katsuhiko ITOH ; Naoki MANTANI ; Jun'ichi TAMURA
Kampo Medicine 2004;55(5):649-653
We present a case of prolonged post-herpetic neuralgia (PHN), successfully treated by Uyaku-junki-san-ryo. A 76-year-old woman was referred for PHN for 5 months. Her pain was confined to the area of the maxillary nerve, and waving smart pains trouble her greatly, all day long. The stellate block or the administration of carbamazepine did not avail against her pain at a nearby hospital. She visited our hospital on ******, the degree of her pain was expressed as 7.0cm/10.0cm in visual analogue scale (VAS). We utilized Uyaku-junki-san-ryo three times a day. The therapy of Uyaku junki-san-ryo resulted in the improvement of her pain, as well as the increase of her quality of life (QOL). Additionally, her VAS score was diminished from 7cm to 2cm, after two months.
This case demonstrates that Uyaku-junki-san-ryo may be a useful agent for the treatment of PHN.
4.Use of CAPD on Articular Rheumatism Patient Unable to Exchange Dialysis Bags Because of Joint Deformity of Fingers: A Case Report
Keiko AKASHIO ; Midori MIYASHITA ; Keiko HAYASHI ; Katsuhiko TAMURA ; Masaki NAGASAWA
Journal of the Japanese Association of Rural Medicine 2005;54(4):667-671
Along with hemodialysis, continuous ambulatory peritoneal dialysis (CAPD), which performs the work of the kidneys, is used in treating chronic renal failure. CAPD (hereafter referred to as PD) can be conveniently done at the patient's home.Other advantages of it include less adveres effects on the cardiovascular system as homeostasis of body fluid is maintained;less dietary restriction;reduction in the frequency of outpatient treatment;availability of a system suited to the patient's lifestyle;and being comparatively easy to return to work. Nonetheless, home PD patients remain at risk of peritonitis, exit-site infection, and undernutrition due to protein-losing enteropathy. Moreover, patients may feel that they have gotten wary of taking care of themselve. Recently, we have come upon a case of end-stage renal failure in a 59-year-old articular rheumatic who was unable to exchange dialysis bags because her finger joints were deformed. So, we applied a PD system using the SMAP method to the patient with the result that she became able to manage to operate the PD by herself.Our patient wished to take it upon herself to perform PD using a UV-F twin-bag system. Ordinarily, bags have to be exchanged four times a day and every time bags are exchanged, several clamping procedures are required. It was impossible for her to exchange bags because of deformed finger joints. To make the impossible possible, a supplementary device for exchanging bags had to be fixed. It was also necessary for her to learn how to manipulate the newly attached device in addition to the existing device. With the SMAP method, there is plenty of time before PD gets started. So it was possible to examine the self-management method thoroughly and learn the trick of operating the new device. Our experience showed that PD by the SMAP method is useful to articular rheumatic patients with finger joint deformities.
PUPILLARY DISTANCE
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Patients
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Peritoneal Dialysis, Continuous Ambulatory
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Fingers
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Joints
5.Pitfalls in Open Stent Grafting for Distal Aortic Arch Aneurysm.
Kentaro Tamura ; Fumikazu Nomura ; Shogo Mukai ; Katsuhiko Ihara
Japanese Journal of Cardiovascular Surgery 2002;31(2):139-142
A 72-year-old woman underwent surgical stent graft implantation for a huge distal arch aneurysm (12×11cm). Axillo-bifemoral bypass was added in order to restore visceral perfusion. Severe metabolic acidosis developed after the operation, and the patient died 6 hours after surgery. Autopsy showed thromboembolism of the superior mesenteric artery and aortic dissection in the descending thoracic aorta because of stent graft insertion into a false lumen. To reduce complications like this case, we should consider the peculiar anatomic features and thoroughly evaluate atheromatous changes in the aortic wall with improvement of the shape of the sheath and delivery system.
6.A Case of Serous Gonarthritis with Nonproductive Cough Successfully Treated with Eppikajutsuto
Ayami HOSHINO ; Takeshi TATSUMI ; Hiroko SATO ; Yuko OKU ; Katsuhiko ITO ; Jun'ichi TAMURA ; Toshiak KOGUR
Kampo Medicine 2008;59(5):733-737
We report a case of serous gonarthritis with nonproductive cough successfully treated with Eppikajutsuto. A 37-year-old Japanese man developed a right genicular arthrocele with nonproductive cough, in October X. Over 100 ml of serous synovial fluid was drained via an arthrocentesis puncture procedure. Although he was treated with nonsteroidal anti-inflammatory agents by an orthopedist, under a diagnosis of serous gonarthritis, his symptoms did not improve. Laboratory findings suggested inflammatory conditions (serum CRP 3.4 mg/dl, ESR 76 mm/h). At the time of his first visit in January X+1, orthopedic examinations revealed that rheumatoid arthritis was unlikely, based on negative physical and laboratory findings. A contrast MRI knee joint scan did not demonstrate any tumor-like mass of synovium which would indicate pigmented villonodular synovitis. And orthopedists found it difficult to specify the cause of his serous gonarthritis. After a common cold in December X, cough stimulated by cold exposure was superimposed on serous gonarthritis.We utilized Eppikajutsuto under the interpretation that both his genicular arthrocele and nonproductive cough were due to a “sui” disturbance. This Eppikajutsuto therapy reduced his genicular arthrocele and nonproductive cough in1month. His symptoms and inflammatory reactions were completely improved in 3 months, regardless of gradual withdrawal of his medication.
Coughing
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Upper case ecks
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symptoms <1>
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Serous
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Treated with
7.Two Cases of Fibromyalgia Syndrome Succesfully Treated with Kampo Medicine
Toshiaki KOGURE ; Takeshi TATSUMI ; Hiroko SATO ; Katsuhiko ITOH ; Nobuyasu SEKIYA ; Takao NAMIKI ; Katsutoshi TERASAWA ; Jun'ichi TAMURA
Kampo Medicine 2007;58(1):61-68
We demonstrated two patients with fibromyalgia syndrome (FMS), successfully treated with Kampo medicine, and considered the resemblance between the clinical manifestation of FMS and SHO for Kanzo-bushi-to.The first case was a 52-year-old women who consulted a local hospital in 2001 due to althralgia and myalgia in the left hand, bilateral elbows, shoulders and foot. Her condition was diagnosed as FMS without abnormal findings in the thorough medical examination. Treatment with NSAIDs was not effective, so she consulted our department in 2004. She was treated with Keishi-ni-eppi-itto-ka-ryojutsu-ka-boi-ogi-kakkon. After two mouths, her symptoms had reduced to 50% by visual analog scale (VAS). By March 2006, her symptoms had significantly decreased to 20% by VAS and NSAIDs became unnecessary.The second case was a 58-year-old woman who had suffered from tolerable pain in her right elbow for 10 years. In 2004, she visited the Department of Orthology at her local hospital due to pain in the neck, bilateral arms and shoulders. There were no findings on cervical X-ray or neurological examination, and NSAIDs were administered. Her symptoms did not resolve, therefore, she consulted our department in 2005. She was diagnosed with FMS, based on fulfilling the diagnostic criteria for FMS of ACR (American college of rheumatology) in 1990. She was treated with Kanzo-bushi-to. After 3 months, her symptoms had reduced to 30% by VAS. By Mar. 2006, her pain had redused to 25% by VAS and she was physically fit enough for a daily life.
CSF1-R
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symptoms <1>
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Medicine, Kampo
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Pain
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Fibromyalgia
8.A Case of Jugular Sense of Discomfort with Dryness and Nonproductive Cough Successfully Treated with Soshikokito
Ayami HOSHINO ; Takeshi TATSUMI ; Yuko OKU ; Hiroko SATO ; Katsuhiko ITO ; Jun'ichi TAMURA ; Toshiaki KOGURE
Kampo Medicine 2007;58(6):1121-1126
We report a case with an intractable jugular sense of discomfort, with dryness and nonproductive cough successfully treated with soshikokito. A 62-year-old Japanese man developed jugular sense of discomfort with dryness and nonproductive cough, after odontotherapy in October. Although he was treated with Western drugs by an otolaryngologist, under the diagnosis of xerostomia with no mechanical problems, his symptoms did not disappear. The symptoms followed a protracted course, and he further developed a loss of appetite. At the time of first visit in October, otorhinolaryngological studies showed no structural lesions or problems, with the exception of minimum salivation in the normal range on a gum test. There was no evidence of dry eyes. With the diagnosis of xerostomia, Bakumondoto-go-hangekobokuto was administered for a month but showed no sign of improvement. Making a shift to bukuryoin-go-hangekobokuto regained his appetite, but did not produce any improvement on dryness. We then utilized soshikokito under the interpretation that both dryness and nonproductive cough is ki-gyaku. The soshikokito therapy reduced his dryness in a month's time. Additionally, his nonproductive cough gradually decreased, and within 11 months after, he had no symptoms, regardless of a gradual medication withdrawal.
Coughing
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symptoms <1>
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seconds
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month
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Peripartum discomfort
9.Effect of Weather on Chief Complaints and Disorders of Outpatients
Ayami HOSHINO ; Jun'ichi TAMURA ; Katsuhiko ITO ; Kazuaki MORIDAIRA ; Hitoshi KURABAYASHI ; Kazuo KUBOTA
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 2005;68(3):150-154
We investigated the effect of season or meteorological phenomena, on chief complaints and disorders of outpatients, by way of clarification of relationship between weather and health. This study covered the new outpatients of our division, and carried out on February '03 and June '03 (February: 72 males, 106 females, aged 49.9±18.5, June: 98 males, 109 females, aged 47.6±19.5). We categorized their clinical data into chief complaints (pain, headache, discomforts, fever, cough, vertigo/stagger, palsy) and disorders (gastrointestinal, mental, inflammatory, orthopedic, infection, respiratory, circulatory, tumorous, urinary, autoimmune/allergic, dental/oral, gynecological), then, compared the clinical data of February with June, in terms of seasonal disease. Additionally, we investigated the relationship between weather data and clinical data of February and June, from a perspective of meteoropathy. The average of meteorological phenomena (air pressure, air temperature, relative humidity, velocity of wind, day length, rainfall level) of a week before first visit, were used as weather data. The main results of analysis about seasonal disease, showed that the complaint of discomfort were more frequent in June than February (p=0.005). The orthopedic disorder was more frequent in June than February (p=0.012). Infection was more frequent in February than June (p=0.011). The analyses in terms of meteoropathy, showed that the complaint of cough were more frequent after cold temperature in February (p=0.014). The gastrointestinal disorders were more frequent after humid (p=0.018) and pluvious days (p=0.016) in February. The complaint of headache was liable to be frequent after pluvious weather in June.
The relationship between weather and health is known in the prior an, and our study anew demonstrated the effect of season or meteorological phenomena, on chief complaints and disorders of outpatients, as statistical evidence.