1.Simulium (Gomphostilbia) taitungense, a new species of black fly (Diptera: Simuliidae) from Taiwan, with description of the male of Simulium (Gomphostilbia) tuenense Takaoka
Yao-Te Huang, ; Hiroyuki Takaoka* ; Yasushi Otsuka ; Chiharu Aoki
Tropical Biomedicine 2011;28(3):577-588
Simulium (Gomphostilbia) taitungense sp. nov. is described on the basis of
reared adult, pupal and mature larval specimens collected from Taitung, Taiwan. This new
species is placed in the ceylonicum species-group within the subgenus Gomphostilbia and is
distinguished from related known species by the characteristic colour markings on the ventral
surface of the head capsule and on the dorsal surface of the abdomen in the larva. The male
of Simulium (Gomphostilbia) tuenense Takaoka, which was originally described from a
pharate pupa and a larva, is described for the first time; the association of the adult stage
with the larval stage was confirmed by the comparison of the sequences of the mitochondrial
16S rRNA gene; this species is also placed in the ceylonicum species-group.
2.Popliteal Artery Adventitia Cyst
Shohei Yoshida ; Shinichi Hiromatsu ; Kentaro Sawada ; Takahiro Shojima ; Ryo Kanamoto ; Shinichi Imai ; Hiroyuki Otsuka ; Hiroyuki Tanaka
Japanese Journal of Cardiovascular Surgery 2017;46(4):182-185
A 60 year old man presented with a history of right leg claudication which occurred after walking a distance of 200 m. He had no history of cardiovascular risk factors or trauma in the lower extremities. Palpation disclosed no right popliteal or pedal pulse. Ankle-brachial pressure index (ABI) was 0.60 on the affected side. Computed tomography (CT) demonstrated the presence of a highly stenotic lesion in the right popliteal artery due to compression from periarterial polycystic masses. Magnetic resonance imaging (MRI) revealed no communication to the knee joint bursa. Further, angiography showed a beak-like severe stenosis on the knee of the right popliteal artery. Based on the results of these three imaging techniques we confirmed the diagnosis of cystic adventitial disease (CAD). The patient underwent a surgical exploration of his popliteal artery through a posterior approach. Evacuation of all cysts by longitudinal incision of his adventitia yielded yellow mucoid gelatinous material. The popliteal artery was replaced using the great saphenous vein because the previous imaging showed thrombus formation at the cyst site. He had an uneventful postoperative recovery with ABI of 1.10.
3.A Case of One-Stage Surgical Treatment for Chronic Mesenteric Ischemia Associated with Severe Aortic Valve Regurgitation and Stenosis
Ryo Kanamoto ; Takahiro Shojima ; Kanako Sakurai ; Mau Amako ; Hiroyuki Otsuka ; Satoru Tobinaga ; Seiji Onitsuka ; Shinichi Hiromatsu ; Hidetoshi Akashi ; Hiroyuki Tanaka
Japanese Journal of Cardiovascular Surgery 2017;46(6):334-338
We report a case of chronic mesenteric ischemia associated with severe aortic valve regurgitation and stenosis (ASR). The patient was a 76-year-old man who had been given a diagnosis of ASR in his 40s. He gradually developed heart failure and chronic kidney disorder due to deterioration of ASR. He had started hemodialysis 1 year before admission and had complained of abdominal pain after meals and weight loss during that period. He was admitted to the Department of Cardiology in our hospital for evaluation of ASR. Severe ASR with low output syndrome (C. I. 2.00 L/min/m2) were confirmed by cardiac catheter examination. In addition, abdominal angiography revealed total occlusion of the superior mesenteric artery (SMA) and severe stenosis of the celiac artery (CA). We considered that low cardiac output due to severe ASR had exacerbated the mesenteric ischemia. We performed AVR and abdominal aorta-SMA bypass at the same time to prevent acute mesenteric ischemia in the perioperative period. The combination of valvular disease and CMI is very rare. This is the first report in Japan of simultaneous valve replacement and mesenteric artery revascularization.
4.A Survey of Patients' Understanding of Drowsiness as Side Effect of 2nd Generation Antihistamines
Hideki NAOI ; Hiroyuki OHBAYASHI ; Kyoko MATSUMOTO ; Masashi SHIGEYAMA ; Hiroyuki NAGAKI ; Gaku YAMADA ; Michiko ITO ; Tetsuo HATTORI ; Moritoshi OTSUKA ; Masanori NISHIO
Journal of the Japanese Association of Rural Medicine 2007;56(5):719-724
Purpose: Many types of antihistamines used for the treatment of allergic rhinitis induce drowsiness as a side effect. Whether or not patients taking the internal drugs know of this untoward effect is a matter of importance. Recently we conducted a questionnaire survey to know how many patients are aware of this.Method: The subjects were 257 patients who visited our hospital for treatment of alergic rhinitis and took the prescription from February through March this year. The patients filled in a questionnaire given at the window of the dispensary. All the participants in this survey gave their informed consent.Results: Effective replies (90.3%) were obtained from 232 patients (mean age: 53.5±17.5; sex: 85 males and 147 females). Of those respondents, 45 individuals (19.9%) said they did not know that the antihistamines produce drowsiness. Furthermore, the survey found that 24 out of the 45 individuals were actually taking the type of antihistamine that caused drowsiness and 21 individuals were not given any explanation of the side effect by their doctors. The patients said that if they knew of the side effect they would not have taken the medicine. Moreover, it was found that 10 out of the 21 patients drove their cars while they felt drowsy.Conclusions: The survey revealed the hard fact that the drowsiness as side reaction the patients might have after taking antihistamines was made light of. The findings brought home to us the importance of giving clear directions to the patients about the medicine and the precaution against the side effects.
Drowsiness
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Surveys
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Antihistamines
;
adverse effects
;
Effective
6.Arterial embolization for iatrogenic life-threatening bleeding from subcutaneous hypervascular tumor in prone position.
Seiji MORITA ; Tomoatsu TSUJI ; Toru SAWAMOTO ; Hiromichi AOKI ; Naoya MIURA ; Hiroyuki OTSUKA ; Sadaki INOKUCHI
Chinese Journal of Traumatology 2010;13(4):244-246
Performing angiography in the prone position is a difficult technique; however it is useful in some emergency situation. We experienced a 60 years old male who was performed lipoma excision on his back in his family doctor's clinic. Since massive arterial bleeding could not be controlled with manual astriction, he transferred to our hospital in prone position with hemodynamic instability. Operating field was not kept because of massive bleeding; therefore surgical treatment was impossible. We planed emergency arterial embolization (AE) in prone position. Hence we chose the left radial artery for vascular access. The left subclavicle arteriography showed many major and minor feeding arteries from left subclavicular and axillary arteries and a massive extravasation of the contrast medium. Three major feeding arteries were performed AE with gelatin sponge and steel coils. After AE, massive bleeding was controlled. He could discharge from our hospital on the 5th hospital day without any complication. Arterial embolization for life-threatening bleeding from subcutaneous hypervascular tumor in the prone position is first report to our knowledge, and it is extremely rare. However we thought that this technique is useful for patients who could not turn in the supine position, e.g. massive bleeding during renal biopsy and penetrating trauma from back.
Angiography
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Embolization, Therapeutic
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Emergency Medical Services
;
Humans
;
Lipoma
;
blood supply
;
diagnostic imaging
;
surgery
;
Male
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Middle Aged
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Postoperative Hemorrhage
;
therapy
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Prone Position
7.A Case of Axillofemoral Bypass Graft Stump Syndrome Occurring in Both the Upper and Lower Extremities
Shinya NEGOTO ; Ryo KANAMOTO ; Shinichi NATA ; Shinichi IMAI ; Yusuke SHINTANI ; Hiroyuki OTSUKA ; Shinichi HIROMATSU ; Hidetoshi AKASHI ; Hiroyuki TANAKA
Japanese Journal of Cardiovascular Surgery 2019;48(4):277-280
Acute ischemia due to thromboembolism caused by occluded prosthetic graft after axillary-femoral artery bypass has been reported as axillofemoral bypass graft stump syndrome (AxSS). AxSS usually occurs in the upper extremities and it is rare that it occurs in the lower extremities. We encountered a rare case of a 76-year-old woman with acute right upper and lower extremities ischemia 4 years after right axillary-external iliac artery bypass grafting. The graft and the native arteries of the right upper and lower limbs were occluded. In addition, the right axillary artery and proximal anastomotic site were deformed. We diagnosed acute limb ischemia due to AxSS and immediately performed thrombectomy. Because we considered the thrombosis to originate from the axillary-iliac artery bypass graft, we disconnected the occluded graft from the native arteries. Six months after surgery, she was doing well without recurrence of thromboembolism. We report here the successful treatment of a case of AxSS that developed in both the upper and lower extremities.
8.A Case of Aortoesophageal Fistula in Advanced Esophageal Cancer Treated with SB-Tube and TEVAR
Shinya NEGOTO ; Hiroyuki OTSUKA ; Tomoyuki ANEGAWA ; Yasuyuki ZAIMA ; Takanori KONO ; Yusuke SHINTANI ; Eiji NAKAMURA ; Takahiro SHOJIMA ; Tohru TAKASEYA ; Eiki TAYAMA
Japanese Journal of Cardiovascular Surgery 2023;52(3):176-180
The patient is a 71-year-old man. After receiving chemoradiotherapy (CRTx) for an unresectable esophageal cancer, he developed sudden hematemesis during a follow-up examination. Subsequent imaging via contrast-enhanced computed tomography (CT) showed leakage of the contrast medium from the descending aorta into the esophagus. Consequently, an aortoesophageal fistula (AEF) was diagnosed and an emergency thoracic endovascular aortic stent graft repair (TEVAR) was scheduled. However, during the preparation for surgery, the patient vomited a large amount of blood and went into cardiopulmonary arrest. Following the administration of cardiopulmonary resuscitation, a Sengstaken-Blakemore tube (SB-tube) was inserted intranasally to control bleeding and TEVAR was performed to save his life. Although a gastrostomy was necessary after the surgery, the patient was transferred from the hospital on the 32nd day without any complications. Nonetheless, his general condition deteriorated as the cancer progressed and he died on the 103rd postoperative day. It is generally reported that the risk for esophageal perforation is 10-20% in CRTx for unresectable esophageal cancer. Although issues regarding the long-term prognosis of patients treated with TEVAR have been highlighted in recent years, there have also been reports of life-saving cases following its use; in this case, the patient was discharged home after SB-tube insertion and TEVAR with prompt treatment, resulting in his life being prolonged for an estimated 3 months.