1.Three Cases of Cerebral Venous Thrombosis with Rehabilitation
Fuminobu SUGAI ; Futoshi AOIKE ; Kazuo ABE
The Japanese Journal of Rehabilitation Medicine 2007;44(1):40-45
Cerebral venous thrombosis(CVT)is a rare cerebrovascular disorder. However, many reports have suggested that the prognosis of CVT is better than arterial ischemic infarction accompanied with cytotoxic edema. In this report, we present three cases of CVT to explain the possible effectiveness of using a rehabilitation approach. Case 1 was a 51-year-old female oculist with amnestic aphasia and mild right hemiparesis. MRI revealed a massive edematous lesion in the left basal ganglia and thalamus, due to thrombus in the vein of Galen. Speech therapy to facilitate word recall showed remarkable benefit, sufficient enough for her to return to work. Case 2 was a 68-year-old male tax accountant with fluent aphasia. MRI showed multiple contrast-enhanced lesions in his left temporal lobe, due to a lack of venous flow in the left transverse sinus. Speech therapy was also effective enough for him to return to work at 35 days after onset. Case 3 was a 57-year-old male pilot. He suddenly presented severe generalized convulsions controlled by venous anesthetic under mechanical ventilation, due to CVT in the superior sagittal sinus with bilateral frontal hemorrhagic infarction. After extubation, he was transferred to our hospital at 38 days after the disease onset, presenting frontal lobe dysfunction, including apathy, emotional incontinence, and grasp reflexes. During 43 hospitalization days, physical and occupational therapy resulted in drastic improvement in this patient's Barthel index score, from 0 to 50. In conclusion, an early rehabilitation approach should be recommended for CVT, since a better prognosis can be anticipated than in arterial ischemic infarction, regardless of the severity of original brain damage.
2.Successful Management in the Case of Mesenteric Ischemia Following EVAR for Ruptured Abdominal Aortic Aneurysm
Kazunori Ishikawa ; Azumi Hamasaki ; Kazuo Abe ; Gen-ya Yaginuma
Japanese Journal of Cardiovascular Surgery 2013;42(3):193-196
We report a case of successfully treated mesenteric ischemia following emergency endovascular aortic repair (EVAR) for ruptured abdominal aortic aneurysm (r-AAA). A 79-year-old man, who had received hemodialysis for 5 years for diabetic nephropathy, presented with sudden onset abdominal pain. Contrast-enhanced computed tomography revealed an rAAA with a 60-mm diameter in the infrarenal abdominal aorta. Emergency EVAR was performed. After completion of stent graft placement, intraoperative angiogram revealed serious imaging delay of the superior mesenteric artery. An emergency saphenous vein bypass was performed from the right external iliac artery to the ileocolic artery. The postoperative course was uneventful, and there has been no evidence of endoleak or enlargement of aneurysm diameter during the follow-up period of 2 years.
3.Practical Cardiopulmonary Bypass Circuit in Surgery of the Thoracic Aorta.
Gen-ya Yaginuma ; Kazuo Abe ; Yoshiyuki Okada ; Michitoshi Ottomo
Japanese Journal of Cardiovascular Surgery 1999;28(1):13-18
When performing surgery of the thoracic aorta, several supporting methods must be easily available to facilitate various grafting procedures which are selected as the most suitable method for each case. We report on a practical cardiopulmonary bypass (CPB) circuit which can be used in the surgical treatment of any thoracic aortic disease: aortic dissection, true aneurysm involving the aortic arch, descending aortic aneurysm or thoraco-abdominal aortic aneurysm. The circuit design is based on a percutaneous cardiopulmonary support system. We added some modifications to the system for managing CPB simply. The improved bypass circuit was applied in operations on 26 patients and yielded excellent clinical results. The advantages of the circuit are listed as follows: 1) If massive bleeding occurs during closed-circuit CPB, the blood can be sucked into a built-in hard shell reservoir on the venous side of the bypass, and can immediately be returned back into the bypass circuit. 2) Using clamping forceps it is possible to easily switch between closed-circuit CPB and conventional CPB using gravitational venous return. 3) Selective cerebral or other organ perfusion can be done by a built-in roller pump distal to the oxygenator. The perfusion line using the roller pump diverges from the main line using the centrifugal pump kept in a spinning state. If the hypothermic method is used, the lower body is perfused via a femoral arterial cannulation by the centrifugal pump, and the upper body by the roller pump with right subclavian arterial cannulation. When the cardiac rhythm changes to ventricular fibrillation in cooling the patient, the flow ratio of the lower body to the upper body must be 1:1, since retrograde perfusion from the femoral artery may cause cerebral infarction due to embolism of dislodged debris or thrombi from the aneurysm.
4.Delayed Neuro-Toxicity of Organophosphorous Agents As Demonstrated by Use of Hens
Eishiro Abe ; Kiichiro Sasaki ; Kazuo Kurosawa ; Shinji Asanuma ; Akira Suzuki ; Shosui Matsushima ; Kazuhiro Kawahara
Journal of the Japanese Association of Rural Medicine 1984;33(2):190-197
To demonstrate delayed neuro-toxicity of organophosphate, we administered 13 types of organophosphorous pesticide to hens. Initially, a screening test was performed with nine varieties of the chemical product. Later, four types were given to the fowls. Those hens dosed with S-Seven and Surecide developed ataxia and other neurophatic symptoms in the lower limbs.
After 50 days of observation, all the hens were killed and anatomized. Phathohistological examination revealed various changes in the hens that developed neuropathic symptoms: atrophy, diminution and disappearance of nerve cells in the anterior horn of the spinal cord ; edematous changes in the myelin; swelling of the neuroglia ; atrophy and vaculolar degeneration of liver cells; and necrobiosis of nepaticlobures.
It was found that these changes are closely related with the development of ataxia and doses of the chemical.
It was also found that the pathotistological changes occurred to a less extent in those hens which did not develop toxicoses.
5.Survey of Content of Nitrate in Well Water of Rural Areas
Shinji Asanuma ; Akira Suzuki ; Kazuo Kurosawa ; Kiichiro Sasaki ; Eishiro Abe ; Masahiko Sakurai ; Hidesato Ide ; Shosui Matsushima
Journal of the Japanese Association of Rural Medicine 1984;33(2):173-182
We investigated the content of NO3-N in the well water of the eastern, middle and nothern districts of Nagano Prefecture. The NO3-N content seasonally changes and takes on the pattern of a high in summer and a low in winter.
Rain is considered to dilute the contaminated well water, but it lets NO3-N flow from the soil into the.well water, when the rain is poured by a typhoon. As a result, a high content of NO3-N is measured in the well water.
The water sample of 25 out of 85 wells in Matsukawa Town exceeded the tolerance level of NO3-N (10 ppm, but 44.3 ppm in terms of NO3-).
By crop area, the amount of NO3-N was highest in the fruitgrowing area, which was followed in order of the vegetable-growing area, the flower-growing and the rice planting area.
We consider that the contamination of well water is caused both by chemical fertilizers and the less absorbility of the soil.
6.The Effects of Lactic Fermenting Beverage ANP71 on Defecation-An Open Clinical Trial-
Hoko KYO ; Kazuo UEBABA ; Tetsuro ABE ; Shintaro HASHIMOTO ; Tomihisa OHTA ; Nobutaka SUZUKI
Japanese Journal of Complementary and Alternative Medicine 2017;14(1):39-44
Objectives: The aim of this study is to examine the effects of lactic fermenting beverage ANP71 on defecation, blood pressure, immune function, constitution of Traditional Chinese Medicine (TCM) and safety.Methods: An open Clinical study was conducted on 15 healthy adults (female 11, male 4). ANP71 150ml per day was administrated for 4 weeks. At week 0, 1 and 4, blood samples were collected. blood pressure, immune function and constitutionwere measured.Results:① Defecation amount and exhilarating feeling increased. Abdominal feeling of fullness decreased.② Decrease of blood pressure was observed. ③ The change of parameters of blood biochemistry was in normal range. ④ Humoral immunity was predominant(Th1/Th2 decreased). ⑤ In constitution of TCM, Gentleness type, Yang-deficiency type, Yin-deficiency type, Phlegm-wetness type, wet-heat type and Qi-depression type were improved. ⑥ No significant adverse events were observed.Conclusion: Lactic fermenting beverage ANP71 appears to have benefits in improving defecation and constitutional problems. Various other biological effects of ANP71 were also observed.
7.Implementation of Glucose Monitor System Following Introduction of Automated Ordering System
Yasuhiro SAIKI ; Fumie HIRASAWA ; Tatsuo ABE ; Kazuo EGUCHI ; Hideo FUKASAWA ; Hironobu KAKUTA
Journal of the Japanese Association of Rural Medicine 2004;53(4):679-684
Aichi Koseiren-Aihoku Hospital has implemented a New Glucose Monitoring System,using Precision PCx and its data management application, QC Manager (both Abbott Japan), for outpatient testing. It utilizes the advantages that have come with the introduction of the Ordering System. The new system has automated a great portion of glucose monitoring workflow and reduced the human work, and consequently, the potential risk of malfunction due to human errors. The system has been designed and developed to meet the following criteria; To be able to fully utilize the potential capabilities of the Ordering System (Barcode recognition of test samples); To be capable of transferring test results automatically to the Laboratory Information System without being handled by human; To improve the productivity as a whole system; To possess the precision and accuracy;and To be handled easily for bed-side use.
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8.A Case of Blow Out Type Left Ventricular Free Wall Rupture after Percutaneous Coronary Intervention with a Diagnosis of Unstable Angina Pectoris
Daizo Tanaka ; Gen-ya Yaginuma ; Kazuo Abe ; Azumi Hamasaki ; Shun-ichi Kawarai
Japanese Journal of Cardiovascular Surgery 2009;38(2):123-125
An 83-year-old woman with unstable angina pectoris underwent percutaneous coronary intervention (PCI) of the left circumflex artery, and her condition improved. However, on the eighth day after PCI, she went into a stated shock, and echocardiogram confirmed a large amount of pericardial effusion. Pericardiocentesis was immediately performed, and bloody pericardial effusion was drained. Cardiac rupture was suspected, although the cause was unknown. Emergency sternotomy was performed, and blow out type cardiac rupture in the center of a thumb-sized infarction was found at the area of the obtuse marginal branch. The ruptured left ventricular wall was successfully closed with 2 mattress sutures because the infarcted area was relatively small. Postoperative course was good, and she was discharged on the 25th postoperative day. In this case, the cause of cardiac rupture was thought to be a small branch of the left circumflex artery, which was occluded during PCI. This is one of the rare but important mechanisms of cardiac tamponade after PCI.
9.Efficacy of Short-Acting β-Blockers after Cardiac Surgery
Haruo Suzuki ; Susumu Ishikawa ; Susumu Kadowaki ; Keisuke Nakamura ; Keiko Abe ; Akio Kawasaki ; Kazuo Neya ; Keisuke Ueda
Japanese Journal of Cardiovascular Surgery 2009;38(3):175-178
The efficacy of Landiolol hydrochloride (Onoact®) for the treatment of arrhythmia was studied in 10 adult patients who underwent cardiovascular surgery. Onoact was continuously infused at a mean rate of 0.018 mg/kg/min initially and followed by 0.01 mg/kg/min. After the initiation of Onoact infusion, supra-ventricular tachycardia was eliminated in 5 out of 6 patients, and ventricular tachycardia disappeared in all 4 patients. The decrease in systemic blood pressure was not significant. Low-dose continuous infusion of Onoact was safe and effective even in patients just after cardiovascular surgery.
10.Endovascular Treatment of Axillofemoral Bypass Graft Stump Syndrome
Kazunori Ishikawa ; Shunichi Kawarai ; Azumi Hamasaki ; Kazuo Abe ; Gen-ya Yaginuma
Japanese Journal of Cardiovascular Surgery 2013;42(1):38-41
The use of axillofemoral bypass grafts (AxFG) has became a widely accepted treatment for high-risk patients with aortoiliac occlusive disease. On the other hand, AxFG has been associated with a variety of complications in the upper extremity. A symptom of upper extremity thromboembolism after AxFG occlusion is reported as axillofemoral bypass graft stump syndrome (AxFSS). We report the case of a 55-year-old man with repeated AxFSS after an AxFG occlusion. He underwent brachial artery exploration and embolectomy. Angiograms showed an embolus floating in the axillary artery, which originated from the occluded graft stump. The stump was obliterated with a metallic stent introduced through the same arteriotomy made for the embolectomy. The endovascular treatment of AxFSS is minimally invasive and is an effective modality in this condition.