1.Infected Thoracic Pseudoaneurysm Associated with Congenital Bronchoesophageal Fistula
Hideki Tsubota ; Takaaki Mochizuki ; Kazunori Yamada ; Masaki Funamoto ; Toshihiko Ban
Japanese Journal of Cardiovascular Surgery 2008;37(1):44-47
A 74-year-old man with chronic renal failure complained of back pain. Computed tomography revealed an infected thoracic pseudoaneurysm at the descending thoracic aorta. An endovascular stent graft was repaired with exclusion of a false aneurysm. After surgery, he complained of post-prandial cough, minor hemoptysis and deglutition with difficulty. Esophagoscopy and bronchoscopy showed a fistula between the left main bronchus and the esophageal diverticulum. Fistulectomy was planned after his general condition became stabilized, but the patient died of rebleeding on day 64 after stent grafting. The histological examination revealed a congenital bronchoesophageal fistula.
2.Effects of maximal exercise on blood leukocyte counts and neutrophil activity in athletes.
KATSUHIKO SUZUKI ; HIDEKI SATO ; TETSU ENDO ; HIROKO HASEGAWA ; MITSUKUNI MOCHIZUKI ; SHIGEYUKI NAKAJI ; KAZUO SUGAWARA ; MANABU TOTSUKA ; KOKI SATO
Japanese Journal of Physical Fitness and Sports Medicine 1996;45(4):451-460
Twenty endurance-trained athletes (five male speed-skaters, eleven male and four female cross-country skiers, 16-18 years) ran on a treadmill by a protocol of incremental graded increase in workload until exhaustion during an endurance training period in off-season summer. Immediately after exercise, all developed peripheral leukocytosis (1.9 times; p<0.01) due mainly to lymphocytosis (2.6 times; p<0.01) with a predominant effect on large granular lymphocyte (natural killer cell) count (5.9 times ; p<0.01) . Monocyte count was also enhanced 2.3 times (p<0.01) . These increases were transitory and returned to the pre-exercise levels 1 h later. Peripheral neutrophilia was also observed by 43% (p<0.01) immediately after exercise and remained elevated by 25% (p<0.01) 1 h after exercise, but a shift to the left did not take place. The capacity of isolated neutrophils to produce reactive oxygen species was assessed by luminol-dependent chemiluminescence which detects mainly myeloperoxidase (MPO) -mediated formation of such hyperreactive oxidants as HOCl. The maximum intensity of chemiluminescence (peak height) upon stimulation with opsonized zymosan was significantly enhanced following exercise (p<0.05) . Similar results were obtained when phorbol myristate acetate was employed as nonphagocytic soluble stimulus (p<0.01), suggesting that the capacity of neutrophils to degranulate MPO rather than phagocytosis was enhanced following exercise. In addition, the enhancements of chemiluminescence were positively correlated with the increase in segmented neutrophil count. These data indicate that maximal exercise not only mobilized mature neutrophils from the marginated pool into the circulation, but also augmented their capacity to generate reactive oxygen species of higher reactivity.
3.Efficacy of scheduled intravenous acetaminophen administration for catheter-related bladder discomfort in patients after transurethral resection of bladder tumors: A prospective randomized pilot study
Tomoya HATAYAMA ; Koji MITA ; Yuki KOHADA ; Kenta FUJIYAMA ; Ryo TASAKA ; Akihiro GORIKI ; Hideki MOCHIZUKI ; Nobuyuki HINATA
Investigative and Clinical Urology 2025;66(2):144-151
Purpose:
Scheduled administration of intravenous acetaminophen improves catheter-related bladder discomfort (CRBD) after urological surgery. However its efficacy for patients undergoing transurethral resection of bladder tumors (TURBT) remains unclear.This study aimed to investigate the efficacy of scheduled administration of intravenous acetaminophen after TURBT.
Materials and Methods:
At the end of surgery, patients in both the control (n=39) and the scheduled administration (n=45) groups received analgesics at the discretion of the anesthesiologists. In the scheduled administration group, intravenous acetaminophen was administered every 4 hours for 12 hours after the surgery. Both groups were administered on-demand analgesics as needed. The primary outcome was CRBD scores, and the secondary outcomes were the face rating scale for lower abdominal pain, administration rates of additional analgesics, durations of bladder catheterization, lengths of postoperative hospital stay, and postoperative complication rate.
Results:
The scheduled administration group had significantly lower CRBD scores than those of the control group at 8 hours postoperatively (p=0.014), and lower administration rates of additional analgesics 4–8 hours (p=0.029) and 8–12 hours (p=0.027) postoperatively compared to those of the control group. Other secondary outcomes were not significantly different between the groups (all p>0.05). The scheduled administration group did not have postoperative complications related to the scheduled administration of intravenous acetaminophen.
Conclusions
Scheduled intravenous acetaminophen administration alleviated postoperative CRBD and reduced the need for additional analgesics in patients who underwent TURBT. These findings can be utilized to improve the quality of postoperative care.
4.Phenotypic characteristics of pediatric inflammatory bowel disease in Japan: results from a multicenter registry
Katsuhiro ARAI ; Reiko KUNISAKI ; Fumihiko KAKUTA ; Shin-ichiro HAGIWARA ; Takatsugu MURAKOSHI ; Tadahiro YANAGI ; Toshiaki SHIMIZU ; Sawako KATO ; Takashi ISHIGE ; Tomoki AOMATSU ; Mikihiro INOUE ; Takeshi SAITO ; Itaru IWAMA ; Hisashi KAWASHIMA ; Hideki KUMAGAI ; Hitoshi TAJIRI ; Naomi IWATA ; Takahiro MOCHIZUKI ; Atsuko NOGUCHI ; Toshihiko KASHIWABARA ; Hirotaka SHIMIZU ; Yasuo SUZUKI ; Yuri HIRANO ; Takeo FUJIWARA
Intestinal Research 2020;18(4):412-420
Background/Aims:
There are few published registry studies from Asia on pediatric inflammatory bowel disease (IBD). Registry network data enable comparisons among ethnic groups. This study examined the characteristics of IBD in Japanese children and compared them with those in European children.
Methods:
This was a cross-sectional multicenter registry study of newly diagnosed Japanese pediatric IBD patients. The Paris classification was used to categorize IBD features, and results were compared with published EUROKIDS data.
Results:
A total of 265 pediatric IBD patients were initially registered, with 22 later excluded for having incomplete demographic data. For the analysis, 91 Crohn’s disease (CD), 146 ulcerative colitis (UC), and 6 IBD-unclassified cases were eligible. For age at diagnosis, 20.9% of CD, 21.9% of UC, and 83.3% of IBD-unclassified cases were diagnosed before age 10 years. For CD location, 18.7%, 13.2%, 64.8%, 47.3%, and 20.9% were classified as involving L1 (ileocecum), L2 (colon), L3 (ileocolon), L4a (esophagus/stomach/duodenum), and L4b (jejunum/proximal ileum), respectively. For UC extent, 76% were classified as E4 (pancolitis). For CD behavior, B1 (non-stricturingon-penetrating), B2 (stricturing), B3 (penetrating), and B2B3 were seen in 83.5%, 11.0%, 3.3%, and 2.2%, respectively. A comparison between Japanese and European children showed less L2 involvement (13.2% vs. 27.3%, P< 0.01) but more L4a (47.3% vs. 29.6%, P< 0.01) and L3 (64.8% vs. 52.7%, P< 0.05) involvement in Japanese CD children. Pediatric perianal CD was more prevalent in Japanese children (34.1% vs. 9.7%, P< 0.01).
Conclusions
Upper gastrointestinal and perianal CD lesions are more common in Japanese children than in European children.