1.A Successfully Treated Case of Crawford Type I Thoracoabdominal Aortic Aneurysm with Supra-renal Abdominal Aorta Occulusion by Endovascular Repair and Debranching Visceral Arteries
Ikuo Katayama ; Masashi Tanaka ; Hidemitsu Ogino ; Satoshi Ito ; Tadahiro Shimada ; Kazunori Hashimoto ; Yoshikazu Ooshiro ; Miyo Shirouzu
Japanese Journal of Cardiovascular Surgery 2013;42(3):228-231
A 64-year-old man under dialysis was referred for surgical treatment of Crawford type I thoracoabdominal aortic aneurysm. He had a history of idiopathic portal hypertension and chronic total occulusion of supra-renal abdominal aorta and appeared to have massive development of collateral arteries and veins in the abdomen. We chose endovascular repair with debranching of visceral arteries and bypass grafting to bilateral superficial femoral artery considering bleeding from collateral arteries and veins by conventional open surgery. Postoperative CT scan revealed no endoleak and all debranched and bypass grafts were patent. He was discharged with no postoperative complications including paraplegia.
2.Review of the Auricular Acupuncture Effects
Akihiro OZAKI ; Kenji IMAI ; Kazunori ITO ; Yoshito MUKAINO ; Takemasa SHIRAISHI ; Naoto ISHIZAKI ; Taro TAKEDA
Journal of the Japan Society of Acupuncture and Moxibustion 2006;56(5):779-792
A seminar was held with “the development of research on auricular acupuncture” as the main theme. In this seminar, the recent development of auricular acupuncture in Japan and abroad, its action mechanism, and clinical effects were reviewed, and the findings were comprehensively evaluated.
Concerning basic research on the effects of auricular acupuncture on obesity, the relationship between the auricle and hypothalamo-autonomic system and individual variation associated with differences in the condition of patients receiving the treatment were reported. As for the action mechanism, leptin expressed in white adi-pose tissue (WAT) due to acupuncture stimulation of the auricle was reported to bind to leptin receptors (Ob-R) in both peripheries and the center and suppress food intake.
Concerning clinical effects of auricular acupuncture, the results reported in Japan indicating its effectiveness for the treatment of obesity were presented. However, no overall conclusion was reached, because papers published abroad were not consistent in the therapeutic procedure or evaluation parameters. Auricular acupuncture appeared to be clinically effective for analgesia and the treatment of drug addiction but ineffective as an anti-smoking treatment.
3.Introducing the Objective Structured Clinical Examination to Evaluate Students' Interviewing and Physical Examination Skills.
Nobutaro BAN ; Tsukasa TSUDA ; Yoshikazu TASAKA ; Hiroki SASAKI ; Ryuki KASSAI ; Mitsuru WAKUNAMI ; Satoru AZUMA ; Kazunori Aoi ; Noriaki OCHI ; Yasuhiro YAMAMOTO ; Katsuhiro ITO ; E. K. Kachur
Medical Education 1994;25(6):327-335
4.Caffeine intoxication as a result of excessive consumption of bottled coffee products: a case report
Mayuko ITO ; Taishi ANDO ; Kazunori YAMAMOTO ; Aki ISHIDO
Journal of Rural Medicine 2023;18(3):200-204
Objectives: Most cases of caffeine intoxication result from the excessive intake of over-the-counter drugs and energy drinks. However, few cases of caffeine intoxication due to the excessive consumption of bottled coffee products have been reported. Herein, we present a case report of caffeine intoxication.Patient: A 39-year-old man experienced numbness and weakness in the extremities for three nights over five days.Results: Blood tests revealed hypophosphatemia and low 25-OH vitamin D concentration. The symptoms disappeared the next day without any additional treatment. A lifestyle interview revealed that he regularly consumed bottled coffee like it was water and had approximately 1 L of it from evening to night. He was diagnosed with weakness in the extremities due to hypophosphatemia caused by caffeine intoxication. Upon investigating some bottled coffee products, we found that only a few of them had labels disclosing caffeine content and warnings of the risks of excessive caffeine intake.Conclusion: We encountered a case of caffeine intoxication via coffee. Although rare in the past, caffeine intoxication might increase owing to the widespread use of bottled coffee products. The caffeine content of coffee products should be indicated on labels to warn consumers.
5.Evaluation of the results of oral food challenges conducted in specialized and general hospitals
Kazunori SAKAI ; Kemal SASAKI ; Tomoko FURUTA ; Shiro SUGIURA ; Yukari WATANABE ; Takae KOBAYASHI ; Takashi KAWABE ; Masashi MORISHITA ; Kumiko NAKANISHI ; Komei ITO
Asia Pacific Allergy 2017;7(4):234-242
BACKGROUND: Oral food challenge (OFC) tests are conducted in both specialized institutions and general hospitals. We aimed to compare the severity of the conditions of the patients between these 2 types of institutions in order to consider the role of such institutions in society. OBJECTIVE: We evaluated the results of OFC tests for hen's egg, cow's milk, and wheat that were conducted in a specialized institution (Aichi Children's Health and Medical Center [ACHMC], n = 835) and in 4 general hospitals (n = 327) in Aichi prefecture, Japan. METHODS: The symptoms provoked were scored using the total score (TS) of the Anaphylaxis Scoring Aichi scoring system in combination with the total ingested protein dose (Pro) before the appearance of allergic symptoms. RESULTS: The total ingested dose of the challenge-positive patients in ACHMC was significantly less than that in the general hospitals (p < 0.01). The median TS of the provoked symptoms in ACHMC and the general hospitals did not differ to a statistically significant extent in the hen's egg or cow's milk challenges; however, the median TS in ACHMC was significantly lower than that in the general hospitals for the wheat challenge (p = 0.02). The median TS/Pro values in ACHMC were almost identical to the upper 25% of the TS/Pro values in the general hospitals, suggesting that the specialized institution usually managed more severe patients. CONCLUSION: The specialized institution performed OFC tests at a lower threshold dose, but provoked similar TSs to the general hospitals. This evaluation may help in optimizing the distribution of patients to general hospitals and specialized institutions.
Anaphylaxis
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Child Health
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Hospitals, General
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Hospitals, Special
;
Humans
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Japan
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Milk
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Ovum
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Severity of Illness Index
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Triticum
6.Effectiveness of administering zinc acetate hydrate to patients with inflammatory bowel disease and zinc deficiency: a retrospective observational two-center study
Kensuke SAKURAI ; Shigeru FURUKAWA ; Takehiko KATSURADA ; Shinsuke OTAGIRI ; Kana YAMANASHI ; Kazunori NAGASHIMA ; Reizo ONISHI ; Keiji YAGISAWA ; Haruto NISHIMURA ; Takahiro ITO ; Atsuo MAEMOTO ; Naoya SAKAMOTO
Intestinal Research 2022;20(1):78-89
Background/Aims:
Inflammatory bowel disease (IBD) patients frequently have zinc deficiency. IBD patients with zinc deficiency have higher risks of IBD-related hospitalization, complications, and requiring surgery. This study aimed to examine the effectiveness of zinc acetate hydrate (ZAH; Nobelzin) in IBD patients with zinc deficiency.
Methods:
IBD patients with zinc deficiency who received ZAH from March 2017 to April 2020 were registered in this two-center, retrospective, observational study. Changes in serum zinc levels and disease activity (Crohn’s Disease Activity Index [CDAI]) before and after ZAH administration were analyzed.
Results:
Fifty-one patients with Crohn’s disease (CD, n = 40) or ulcerative colitis (UC, n = 11) were registered. Median serum zinc level and median CDAI scores significantly improved (55.5–91.0 μg/dL, P< 0.001; 171.5–129, P< 0.001, respectively) in CD patients 4 weeks after starting ZAH administration. Similarly, median serum zinc levels and CDAI scores significantly improved (57.0–81.0 μg/dL, P< 0.001; 177–148, P= 0.012, respectively) 20 weeks after starting ZAH administration. Similar investigations were conducted in groups where no treatment change, other than ZAH administration, was implemented; significant improvements were observed in both serum zinc level and CDAI scores. Median serum zinc levels in UC patients 4 weeks after starting ZAH administration significantly improved from 63.0 to 94.0 μg/dL (P= 0.002), but no significant changes in disease activity were observed. One patient experienced side effects of abdominal discomfort and nausea.
Conclusions
ZAH administration is effective in improving zinc deficiency and may contribute to improving disease activity in IBD.
7.Ongoing increase in measles cases following importations, Japan, March 2014: times of challenge and opportunity
Takuri Takahashi ; Yuzo Arima ; Hitomi Kinoshita ; Kazuhiko Kanou ; Takehito Saitoh ; Tomimasa Sunagawa ; Hiroaki Ito ; Atsuhiro Kanayama ; AyakoTabuchi ; Kazutoshi Nakashima ; Yuichiro Yahata ; Takuya Yamagishi ; Tamie Sugawara ; Yasushi Ohkusa ; Tamano Matsui ; Satoru Arai ; Hiroshi Satoh ; Keiko Tanaka-Taya ; Katsuhiro Komase ; Makoto Takeda ; Kazunori Oishi
Western Pacific Surveillance and Response 2014;5(2):31-33
Since late 2013 through March 2014, Japan experienced a rapid rise in measles cases. Here, we briefly report on the ongoing situation and share preliminarily findings, concerns and challenges and the public health actions needed over the coming months and years.
Measles is a notifiable disease in Japan based on nationwide case-based surveillance legally requiring physicians to report all clinically diagnosed and laboratory-confirmed cases within seven days, but preferably within 24 hours. After a large outbreak in 2007–2008 (more than 11 000 cases reported in 2008 alone) and a goal of elimination by April 2015, a catch-up programme using the bivalent measles-rubella (MR) vaccine was offered for grades seven and 12 (ages 12–13 and 17–18 years) from April 2008 through March 2013. During this period, there was an estimated 97% decline in measles notifications, and the cumulative number of reported cases has been steadily declining over the last five years (732 cases in 2009, 447 cases in 2010, 439 cases in 2011, 293 cases in 2012 and 232 cases in 2013). However, since late 2013 through March 2014, the country experienced a resurgence only a year after a large rubella outbreak.
8.A Case of Popliteal Endarterectomy in a Patient Post CABG
Kazunori HASHIMOTO ; Harunobu MATSUMOTO ; Takayuki YAMAMOTO ; Tetsuya SATO ; Satoshi ITO
Japanese Journal of Cardiovascular Surgery 2022;51(3):183-186
A 74-year-old man having a right refractory foot ulcer was referred to our hospital with a diagnosis of arteriosclerosis obliterans. Angiography of the lower extremities showed occlusive lesions in the middle popliteal artery and lower-leg arteries. Preoperative examination revealed decreased cardiac function and severe stenosis of the left and right coronary arteries. Therefore, we first performed coronary artery bypass grafting, followed by revascularization of the lower limbs at a later date. Owing to the lack of suitable autologous vein grafts, our procedure of choice was popliteal endarterectomy via a posterior approach with short saphenous vein angioplasty. The patient's foot ulcer healed completely following surgery. His postoperative course was uneventful, and he remained symptom-free during a 1-year follow-up.