1.Successful Surgical Treatment of Ruptured Abdominal Aortic Aneurysm Following Stanford Type B Acute Aortic Dissection
Toshiro Kobayashi ; Kensuke Sakata ; Kenji Hayashi ; Yurio Kobayashi
Japanese Journal of Cardiovascular Surgery 2004;33(3):220-223
A 72-year-old man presented with back pain and 3 days after admission, chest and abdominal CT scanning revealed the existence of infrarenal abdominal aortic aneurysm with Stanford type B acute aortic dissection and hemorrhage in the retroperitoneal space. The maximum diameter of the abdominal aortic aneurysm was 60mm. After treating with anti-hypertensive therapy under restrictive observation because of the patient's stable general condition, surgery was performed 45 days after admission. The dissection extended into the abdominal aortic aneurysm and all visceral arteries branched from the true lumen. The presence of thrombus in the preperitoneal space suggested a ruptured abdominal aortic aneurysm. Abdominal aortic aneurysm was replaced with a Y shaped graft and proximal anastomoses was performed with fenestration to prevent rupture of the proximal dissecting aorta. We report a rare case of ruptured abdominal aortic aneurysm following Stanford type B acute aortic dissection, which was operated on in the chronic stage. The patient is doing well.
2.Correction of Severe Ebstein's Anomaly in a Neonate with Pulmonary Atresia
Toshiro Kobayashi ; Kenji Hayashi ; Kensuke Sakata ; Yurio Kobayashi
Japanese Journal of Cardiovascular Surgery 2006;35(3):151-154
We report the successful surgical treatment of severe Ebstein's anomaly in a female neonate with pulmonary atresia. Soon after birth, a heart murmur was audible and the baby became cyanotic. Echocardiography showed Ebstein's anomaly with pulmonary atresia. We started a LipoPGE 1 infusion for the open ductus arteriosus, but her uncontrollable heart failure necessitated surgery. Thus, when she was 8 days old, she was placed on cardiopulmonary bypass and we performed a triuspid valve orifice closure with right atrium plication and enlargement of the interatrial communication. She received a modified Blalock-Taussig shunt at the age of 60 days, but a prolonged mirulinone infusion was needed for her persistent heart failure. When she was 10 months old, we inserted a bidirectional Glenn shunt and she was discharged. Finally, when she was 30 months old, she had a total cavopulmonary connection. The patient is now asymptomatic, 18 months after her last operation.
3.Dialyzer Blood Flow Less Affects Access Recirculation in Hemodialysis Patients with Higher Access Blood Flow.
Gen KURAMOCHI ; Kenji SHIMA ; Isao KOBAYASHI
Journal of the Japanese Association of Rural Medicine 1999;48(2):96-101
It has been known that access recirculation is positively related to dialyzer blood flow and is negatively related to access blood flow in the vascular access in hemodialysis patients. The present study was designed to examine whether an increase in access recirculation generated by an increase in dialyzer blood flow is related to access blood flow. All patients had native end-to-side arteriovenous anastomoses at the radial site. We measured access recirculation at two different dialyzer blood flow rates (85 and 170 ml/min) using a three-needle technique. Access blood flow rates (mean 668 ml/min ranging from 493 to 1038 ml/min) were measured using Doppler ultrasound sonography. We confirmed that an increase in dialyzer blood flow rate led to an increase in access recirculation (5.4±1.1 vs. 9.9±1.9%, p<0.05), and that access recirculation was negatively related to the access blood flow rate (y=-30.78x+972.20, r=-0.79, p<0.05). We further found a negative correlation between the increase in access recirculation generated by the increase in dialyzer blood flow rate and access blood flow rate (y=-33.88x+821.57, r=-0.75, p<0.05). These results suggested that dialyzer blood flow less affects access recirculation when access blood flow is higher.
4.Osteoinduction with HA/TCP Ceramics of Different Composition and Porous Structure in Rabbits
Zhiyong Zhang ; Hiroshi Kurita ; Hiroichi Kobayashi ; Kenji Kurashina
Oral Science International 2005;2(2):85-95
To determine the effect of material factors on Ca-P biomaterial-induced osteogenesis, six kinds of biphasic calcium phosphate (BCP) ceramics with different HA to TCP ratio (HA/TCP 2-8, 7-3) and different porous structure (micro-, macro- and micro/macro- porous structures) were implanted intramuscularly in rabbits. Different tissue response was detected histologically and microradiographically after the ceramic samples were implanted in the dorsal muscles of rabbits for 3 and 6 months. Obvious bone formation was found in two kinds of ceramics with the same micro/macro-porous structure at both 3 and 6 months. In contrast, no bone formation or host tissue invasion was detected in two other kinds of ceramics with only micro-porous structure, even after 6 months implantation. Some bone formation was found occasionally in two kinds of ceramics with only macro-porous structure at 6 months. Bone tissue was usually formed in direct contact with the pore surface and was only located in non-dissolved porous regions. Osteocyte lacunae were seen and no pathological calcifications were observed. These results indicate that micro- and macro-porous structure play an important role in the osteoinduction with Ca-P ceramics. Furthermore, the results showed that the osteoinductive capacity of BCP ceramics was influenced by the different dissolution rate through changing HA/TCP ratio.
5.Effect of single moxibustion on platelet aggregation and ATP-release in mice.
Masako OKAZAKI ; Mayumi YAMAUCHI ; Koji SAKAMOTO ; Shigekatsu AIZAWA ; Kenji KOBAYASHI
Journal of the Japan Society of Acupuncture and Moxibustion 1988;38(2):188-194
Effects of single moxibustion on platelet aggregation and ATP-release in mice have been studied. Male ddY mice (6 weeks old) were used as experimental animals. 15mg and 5mg of moxa were divided into 6 cones and mice were treated by each 3 cones at right and left LV-14. The electronic aggregometer was used for measuring platelet aggregation and ATP-release using whole blood. Platelet aggregation and ATP-release activities were determined by collagen (final concentration; 2μg/ml) and ADP (final concentration; 20μM) as inducers.
No significant changes on platelet and red blood cell numbers were found after the moxibustion with 15mg of moxa. However, white blood cell numbers were decreased at 1hr and increased at 24hr after the moxibustion.
After the moxibustion with 15mg of moxa, platelet aggregation activity induced by collagen showed no change, but the mild shortness of lag time was observed from 1 to 5hr. While, the mild suppressive effect on platelet aggregation induced by collagen was observed at 1 and 5hr after the moxibustion with 5mg of moxa.
After the moxibustion with 15mg of moxa, mild increase in platelet aggregation activity at 24hr and in ATP-release activity from 1 to 5hr was found. After the moxibustion with 5mg of moxa, an apparent increase in ATP-release activity was observed at 1 and 3hr.
These results suggested that the mild changes in platelet functions were closely related with the response of the coagulation and the fibrinolytic activity in mice.
6.Therapeutic results in elderly patients with prostate cancer: chronologicalcomparison in a single community hospital
Takehiko Okamura ; Hidetoshi Akita ; Kenji Yamada ; Daichi Kobayashi ; Yasuhiko Hirose ; Takahiro Kobayashi ; Yutaro Tanaka ; Taku Naiki ; Takahiro Yasui
Journal of Rural Medicine 2016;11(2):59-62
Objective: There are few reports of the long-term outcomes of elderlypatients with prostate cancer. We analyzed data from our institution from the past 12years, including the patient history, treatment methods, and prognosis of patients withprostate cancer aged 80 years or more.
Patients and Methods: A total of 179 cases of prostate cancer in patientsaged 80 years or more were retrospectively evaluated. We divided them chronologically intogroups A, B, C, and D: Group A included 40 cases from 2002–2004; Group B, 48 cases from2005–2007; Group C, 46 cases from 2008–2010; and Group D, 45 cases from 2011–2013.
Results: Sixty-one (30%) patients changed treatment course. Interestingly,no cancer deaths occurred in the patients who changed treatment course. Although 14 (7.8%)cancer deaths occurred (A: B: C: D = 4: 4: 6: 0, respectively), all occurred in 2011 orlater.
Conclusion: In our study, over 50 patients who underwent treatment survivedfor 5 years or more. By treating prostate cancer in elderly patients when appropriate, wecan lower the mortality rate due to prostate cancer. Our results support the activetreatment of prostate cancer in elderly patients.
7.A Case of Celiac Artery Aneurysm with Type IIIb Aortic Dissection.
Harunobu Matsumoto ; Shunya Shindo ; Okihiko Akashi ; Kenji Kubota ; Atsuo Kojima ; Tadao Ishimoto ; Kenji Iyori ; Masahiro Kobayashi ; Yusuke Tada
Japanese Journal of Cardiovascular Surgery 2002;31(5):359-362
Celiac artery aneurysm (CAA) is very rare. We report a case of CAA with type IIIb aortic dissection (DA) which was treated surgically. A 60-year-old man who had an abnormal enlargement of the aorta on abdominal ultrasonography was admitted to our hospital. Angiography and CT scan revealed CAA with type IIIb DA. His general condition was stable and surgery was performed electively. The CAA was exposed through a median laparotomy. It was found to be about 3cm in diameter. As vascular reconstruction seemed difficult and the proper hepatic artery showed good pulsation after clamping the common hepatic artery, we decided to perform celiac artery aneurysmectomy without vascular reconstruction. Except for transient liver dysfunction, there was no other complication and he was discharged on the 24th postoperative day. During surgery for CAA, when collateral perfusion from the SMA to the liver is adequate, it seems that vascular reconstruction is not always necessary as shown by this case.
9.Current Circumstances and Future of the WHO Standard Acupuncture Point Locations
Shuichi KATAI ; Shoji SHINOHARA ; Shunji SAKAGUCHI ; Hisatsugu URAYAMA ; Yasuhiro KAWAHARA ; Toshimitsu KATORI ; Kenji KOBAYASHI
Journal of the Japan Society of Acupuncture and Moxibustion 2007;57(5):576-586
1. Introduction
The Meeting on Development of International Standard Acupuncture Point Locations hosted by WHO/WPRO was held between Oct. 31 th and Nov. 2 nd in 2006 at the International Congress Center in Tsukuba City, Japan. The delegates came from nine countries, e.g. Australia, China, Japan, Korea, Mongolia, Singapore, UK, USA, Vietnam, and two organizations, e.g. WFAS (World Federation of Acupuncture Societies), AAOM (American Association of Oriental Medicine). The total number of delegates was twenty. The draft of Standard Acupuncture Point Locations, which had been discussed between three countries, Japan, China and Korea during the previous three years, was officially decided.
2. Agreement for Acupuncture Point Locations
Three hundred and sixty one Acupuncture Point Locations were decided at the meeting, the number is 7 more than the number that has been taught so far in the educational field of Japanese acupuncture. The points which differ from the current Japanese text book are 7. These points had been considered “extra points” located along meridians as well as points requiring special attention. 6 points had been the subject of debate, and as a result two locations for each point have been decided. These are LI 19, LI 20, CV 24, PC 8, PC 9, and GB 31.
3. Future Plan of WPRO
We attempted to standardize the Acupuncture Point Locations at the official meeting in Tsukuba. Moreover WHO/WPRO intends to standardize (1) Oriental Medical Terminology, (2) Oriental Medical Information, (3) Guidelines for research of Acupuncture and Moxibustion, and general thoughts, points of view, and an outline of Oriental Medicine. Then WHO hopes to encourage application of these standards to research and practice of Oriental Medicine.
4. The themes after deciding the Acupuncture Point Locations
Subjects for further discussion include: (1) Research on acupuncture point locations, (2). Encouraging the use of Standardized locations, (3). Clarifying “Japanese Acupuncture” and its supporting its use all over the world, etc.
10.Commemorative Lecture Meeting for Publication of "WHO Standard Acupuncture Point Locations in the Western Pacific Region"
Shuichi KATAI ; Shoji SHINOHARA ; Shunji SAKAGUCHI ; Hisatsugu URAYAMA ; Yasuhiro KAWAHARA ; Toshimitsu KATORI ; Kenji KOBAYASHI
Journal of the Japan Society of Acupuncture and Moxibustion 2008;58(4):680-683
The (First) Japan Acupuncture Point Committee was established in 1965 and the nomenclature for meridians and acupuncture points was standardized at the meeting in Geneva in 1989. After that the first Informal Consultation on Development of International Standard Acupuncture Points Locations was organized by WHO/WPRO and held in Beijing (2003). In Japan the (second) Japan Acupuncture Point committee started April in 2004. Japan, China and Korea held nine meetings and made a draft for the Locations of Acupuncture Points. According to the draft made at the official meeting of 'the Development of Standard Acupuncture Point Locations'held in Tsukuba, Japan (2006), Acupuncture Point Locations were further standardized. Finaly, the book "WHO Standard Acupuncture Point Locations in the Western Pacific Region"was published on May 16th, 2008. Here, we want to report on the Commemorative Lecture Meeting for Publication of WHO Standard Acupuncture Point Locations held on May 30th, 2008.