1.Effects of hot bathing on blood viscosity, clotting and fibrinolytic system in patients of cerebral thrombosis
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 1979;42(3-4):81-87
The changes of blood viscosity, clotting and fibrinolytic system after hot bathing at 42°C and 39°C were studied on old patients admitted to the hospital for more than one year because of cerebral thrombosis.
The following results were obtained.
1) The blood and plasma viscosity as well as hematocrit value increased markedly immediately after taking a bath at 42°C. On the other hand, they slightly decreased after bathing at 39°C. Partial thromboplastin time, antithrombin III, plasminogen, α2-macroglobulin and α1-antitrypsin were also elevated just after bathing at 42°C, though they showed no significant alteration after bathing at 39°C.
2) 30 minutes after bathing at 42°C, blood and plasma viscosity and hematocrit returned to the level before bathing, while they were reduced 30 minutes after bathing at 39°C. 30 minutes after bathing at 42°C, various examinations on clotting and fibrinolytic system described above returned to the range before bathing. Prolonged prothrombin time and reduced fibrinogen were observed 30 minutes after bathing at 39°C when compared to the condition before bathing or immediately after bathing. 30 minutes after bathing, α2-macroglobulin level was found to be lower than the level before bathing, but not different from the level just after bathing.
3) The effects of bathing at 39°C and 42°C on the hepaplastin test, fibrin or fibrinogen degradation products and plasma platelets were not recognized.
4) The changes of clotting and fibrinolytic system were prominent immediately after bathing and 30 minutes after bathing at 42°C. In contrast, such changes were slight and limited after bathing at 39°C.
2.Efficacy of Shakuyaku-kanzo-to Extract Granules in Cramp in the Calf with Cerebrovascular Disease.
Tsugio SAKAMOTO ; Masanori HOSHINO
Kampo Medicine 1995;45(3):563-568
We asked 50 ambulatory patients with cerebrovascular disease whether their sleep had been disturbed due to cramp in the calf while they were sleeping soundly at night. Their age ranged from 32 to 81 years. Eleven patients (22%) gave an affirmative answer, and eight of these answered that they had cramp from one to three times a week or more. These eight patients received Syakuyaku-kanzo-to extract granules (2.5g) daily for two weeks. Those who responded sufficiently remained on the same dose, and those who did not received double the dose for further two weeks before the efficacy was evaluated.
All five patients who were able to comply with the treatment for four weeks improved either markedly or slightly. The onset of its action was rapid. These results are comparable to those of muscle relaxants and minor tranquilizers and suggest that Syakuyaku-kanzo-to extract granules are beneficial for spasm of the calf in patients with cerebrovascular disease.
With regard to its side-effects, one patients who received the treatment for more than two weeks developed pseudoaldosteronism. This was the only negative point of the treatment, but this disappeared rapidly after treatment was discontinued.
3.Treatment of Acute Renal Failure Following Cardiovascular Operation Using Extracorporeal Circulation. Comparison between Continuous Peritoneal Dialysis(CPD) and Continuous Arterio-Venous Hemofiltration(CAVH).
Ichiya YAMAZAKI ; Jiroh KONDOH ; Kiyotaka IMOTO ; Hirokazu KAJIWARA ; Kazumi HOSHINO ; Akira SAKAMOTO ; Shin-ichi SUZUKI ; Susumu ISODA ; Masanori ISHII ; Akihiko MATSUMOTO
Japanese Journal of Cardiovascular Surgery 1993;22(1):14-20
There were 16 patients who developed acute renal failure (ARF) follwing cardiovascular operation using extracorporeal circulation. They were treated by either CPD or CAVH because their ARF were resistant to medical treatment. These patients were divided into three groups according to their treatment; 7 patients treated by CPD (Group A), 5 patients treated both CPD and CAVH (Group B), 4 patients treated by CAVH (Group C). The survival rate was 33% in Group A, 20% in Group B, and 0% in Group C. The prognosis of the each group was poor. CPD and CAVH were effective to control the concentration of serum potasium and water removing. But CPD and CAVH were not very effective to control the concentrations of serum creatinine and blood urea nitrogen. There were three patients who developed low proteinemia which was one of the side effects of CPD. Seven of nine patients treated by CAVH, developed bleeding. The side effects of CAVH were seemed to be more severe than those of CPD.
4.Objective Criteria for Judging Walking Independence in a Convalescent Rehabilitation Ward for Hemiparetic Stroke:A Study Using Decision Tree Analysis
Takashi HOSHINO ; Kazuyo OGUCHI ; Masanori ITO ; Sae OGASAWARA ; Motoki TANAKA ; Haruka MATSUDA
The Japanese Journal of Rehabilitation Medicine 2022;():22005-
Objective:This study aimed to clarify the objective criteria for assessing walking independence using cane in patients with stroke in the convalescent rehabilitation ward.Methods:Participants were in-patients with hemiparetic stroke who could walk with a cane, and they were categorized into the independent (ID) and supervised (SV) walking groups. Stroke impairment assessment set-motor for lower extremity (SIAS-LE), trunk control test (TCT), Berg balance scale (BBS), 10-m walking speed (m/s), and functional independence measure-cognitive (FIM-C) were assessed. ID and SV used the scores at the time of independent walking and at the discharge time, respectively. Additionally, falls after independence were investigated. Statistical analysis was performed using univariate analysis and decision tree analysis.Results:In total, 148 patients (ID:n=101, 68±13 years, SV:n=47, 79±12) were included. Significant differences were observed in walking speed, TCT score, BBS score, and FIM-C score between the groups. Moreover, walking speed, FIM-C score, and BBS score were selected in the decision tree analysis in this order and divided into five groups namely:1) walking speed ≥ 0.42 and FIM-C ≥ 22 (percentage of independent patients 97%/percentage of fallers 5%), 2.) walking speed ≥ 0.42, FIM-C<22, and BBS ≥ 50 (100%/0%), 3.) walking speed ≥ 0.42, FIM-C<22, and BBS<50 (52%/8%), 4.) walking speed<0.42, and BBS ≥ 28 (49%/28%), and 5) walking speed<0.42 and BBS<28 (0%/0%). The overall percentage of fallers was 8.9%, with group 4 having the highest number of fallers.Conclusion:Walking speed, FIM-C, and BBS, in decreasing order, were involved in walking independence. Patients with low walking speed were more likely to fall. Therefore, careful assessment of walking independence is particularly required.
5.Objective Criteria for Judging Walking Independence in a Convalescent Rehabilitation Ward for Hemiparetic Stroke:A Study Using Decision Tree Analysis
Takashi HOSHINO ; Kazuyo OGUCHI ; Masanori ITO ; Sae OGASAWARA ; Motoki TANAKA ; Haruka MATSUDA
The Japanese Journal of Rehabilitation Medicine 2022;59(8):836-846
Objective:This study aimed to clarify the objective criteria for assessing walking independence using cane in patients with stroke in the convalescent rehabilitation ward.Methods:Participants were in-patients with hemiparetic stroke who could walk with a cane, and they were categorized into the independent (ID) and supervised (SV) walking groups. Stroke impairment assessment set-motor for lower extremity (SIAS-LE), trunk control test (TCT), Berg balance scale (BBS), 10-m walking speed (m/s), and functional independence measure-cognitive (FIM-C) were assessed. ID and SV used the scores at the time of independent walking and at the discharge time, respectively. Additionally, falls after independence were investigated. Statistical analysis was performed using univariate analysis and decision tree analysis.Results:In total, 148 patients (ID:n=101, 68±13 years, SV:n=47, 79±12) were included. Significant differences were observed in walking speed, TCT score, BBS score, and FIM-C score between the groups. Moreover, walking speed, FIM-C score, and BBS score were selected in the decision tree analysis in this order and divided into five groups namely:1) walking speed ≥ 0.42 and FIM-C ≥ 22 (percentage of independent patients 97%/percentage of fallers 5%), 2.) walking speed ≥ 0.42, FIM-C<22, and BBS ≥ 50 (100%/0%), 3.) walking speed ≥ 0.42, FIM-C<22, and BBS<50 (52%/8%), 4.) walking speed<0.42, and BBS ≥ 28 (49%/28%), and 5) walking speed<0.42 and BBS<28 (0%/0%). The overall percentage of fallers was 8.9%, with group 4 having the highest number of fallers.Conclusion:Walking speed, FIM-C, and BBS, in decreasing order, were involved in walking independence. Patients with low walking speed were more likely to fall. Therefore, careful assessment of walking independence is particularly required.