Objective:We successfully treated a patient suffering from pain and numbness in the waist and lower limbs with phobia. Sedative acupuncture treatment was performed in addition to somatic treatment.
Case:A 64-year-old woman complained mainly of pain and numbness in the right waist and the lower limbs and had a sense of fear. Following the postoperative pain of lumbar disk herniation (L4-L5) in X-14 year, dorsal positioning without grasping anything frequently triggered a sense of fear with a scary feeling that her body was suspended in midair, which could not be alleviated by medication. As the symptoms in the waist and lower limbs recurred due to a fall in January of X year, she consulted an orthopedist in April. She was given a diagnosis of lumbar disk hernia (L5-S1) and hospitalized. Since the symptoms sustained, she consulted the department of acupuncture attached to the Kansai University of Health Sciences Clinic in November. The sense of fear triggered by dorsal position in the acupuncture treatment interfered with the treatment. When she was referred to the department of psychosomatic medicine, the diagnosis of "Other types"of the DSM-IV "300.29 specific phobia"was given. While low-frequency acupuncture electrotherapy on the same side and the same level as the hernia was provided, we applied sedative acupuncture treatment once a week 30 times using the following acupuncture points:GV23;PC6;CV17;and CV6. Before and after every acupuncture treatment after the 10th, the symptoms were evaluated with Finger Floor Distance (FFD), Visual Analogue Scale (VAS) of pain and mood (feelings) and State-Trait Anxiety Inventory (STAI).
Results:The sense of fear during the acupuncture treatment slowly decreased after the 14th treatment. Decreases in FFD, VAS for pain and mood (feelings), and state anxiety score of STAI were observed. The pain and the numbness in the waist and the lower limbs decreased in parallel with the sense of fear. Furthermore, the dosage of hypnotic agent decreased gradually as sleep improved.
Conclusion:Pain and numbness in the waist and the lower limbs with phobia were relieved by sedative acupuncture treatment.

BACKGROUND AND OBJECTIVES: There are few reports on renal dysfunction in the remote period after biventricular repair, and biomarkers for early detection of renal dysfunction are not well understood. We examined whether early fluctuation of biomarkers of renal function occurs in the remote period after biventricular repair in patients with congenital heart disease (CHD). METHODS: Fourteen patients with CHD after biventricular repair were included. The examination values obtained by cardiac catheterization test and renal function indices based on blood and urine sampling were compared. RESULTS: The median estimated glomerular filtration rate (eGFR) of creatinine was 113 mL/min/1.73 m2, and the median eGFR of cystatin C was 117 mL/min/1.73 m2. A urine albumin-to-creatinine ratio (UACR) ≥10 mg/gCr was considered a risk factor for cardiovascular disease in 6 (43%) patients. There was a significant difference in right ventricular ejection fraction and deviation in right ventricular end-diastolic volume from the normal value between the 2 groups divided by UACR. Cyanosis before biventricular repair was noted in 2 (25%) patients with UACR < 10 mg/gCr and in 4 (67%) patients with UACR ≥10 mg/gCr. CONCLUSIONS: Increased UACR was noted in 43% of patients. In patients with UACR ≥10 mg/gCr, right heart system abnormality was observed, and several patients had cyanosis before radical treatment. Measurement for UACR may be able to detect renal dysfunction early in the postoperative remote period.
Biomarkers ; Cardiac Catheterization ; Cardiac Catheters ; Cardiovascular Diseases ; Creatinine ; Cyanosis ; Cystatin C ; Glomerular Filtration Rate ; Heart ; Heart Defects, Congenital ; Humans ; Kidney ; Reference Values ; Risk Factors ; Stroke Volume

BACKGROUND AND OBJECTIVES: There are few reports on renal dysfunction in the remote period after biventricular repair, and biomarkers for early detection of renal dysfunction are not well understood. We examined whether early fluctuation of biomarkers of renal function occurs in the remote period after biventricular repair in patients with congenital heart disease (CHD). METHODS: Fourteen patients with CHD after biventricular repair were included. The examination values obtained by cardiac catheterization test and renal function indices based on blood and urine sampling were compared. RESULTS: The median estimated glomerular filtration rate (eGFR) of creatinine was 113 mL/min/1.73 m2, and the median eGFR of cystatin C was 117 mL/min/1.73 m2. A urine albumin-to-creatinine ratio (UACR) ≥10 mg/gCr was considered a risk factor for cardiovascular disease in 6 (43%) patients. There was a significant difference in right ventricular ejection fraction and deviation in right ventricular end-diastolic volume from the normal value between the 2 groups divided by UACR. Cyanosis before biventricular repair was noted in 2 (25%) patients with UACR < 10 mg/gCr and in 4 (67%) patients with UACR ≥10 mg/gCr. CONCLUSIONS Increased UACR was noted in 43% of patients. In patients with UACR ≥10 mg/gCr, right heart system abnormality was observed, and several patients had cyanosis before radical treatment. Measurement for UACR may be able to detect renal dysfunction early in the postoperative remote period.