Flammulina velutipes culture is a flourishing agriculture in Nakano city. People who are 7.5% in all family are employed in flammulina velutipes culture. They use many kinds of machines therefor occasionally they are injured by them. We pick up the patients who were involved in agricultural accidents from 1978 to 1987 and analyzed statistically.
Results obtained are as follows.
1. Patients in accidents of flammulina velutipes culture account for 40% in all agricultual accidents.
2. The compression machine's accident is a lot of the cause of flammulina velutipes culture's accident.
3. The agricultural accidents appeared chiefly in 40 years and 50 years persons.
4. The accidents were observed most frequently in winter-season, but rare in summer-season.
5. The hand injuries are 90% in all part of injuries, rt. hand is 65% in hand jnjuries.

We evaluated the efficacy of sternal coaptation pins used to improve the fixation of the transected sternum after coronary artery bypass grafting (CABG) with the internal thoracic artery (ITA). The subjects were 37 patients who underwent scheduled single CABG with ITA in our department and they were classified into two groups, i. e., Group A, without sternal pins (18 patients), and Group B, with sternal pins (19 patients). The efficacy was assessed by the following measurements : drain bleeding volume up to 12 and 24 h after ICU admission, the time until the removal of drain, surgical site infection (SSI) and the maximum split level between the sternal body and manubrium after surgery. Drain bleeding volume up to 12 and 24 h after ICU tended to be less in Group B. The time until the removal of drain was significantly shorter in Group B. SSI was 17% in Group A but 0% in Group B. The use of sternal coaptation pins reduced misalignment of the coapted sternum, and we belive that the use of sternal coaptation pins contributed to the early removal of drain, and SSI reduction.

A 51-year-old man, with an abnormal shadow on chest X-ray film, was found to have a right-sided aortic arch with mirror-image branching and Kommerell's diverticulum. Neither congenital heart anomalies nor vascular ring was observed. We performed descending aorta replacement with a Hemashield^TM 24-mm graft, because the trachea and esophagus were compressed by the diverticulum, and to eliminate the risks of aneurysmal change or rupture. The operation was performed through right thoracotomy, and with total CPB under deep hypothermic circulatory arrest. The patient was discharged on the 18th postoperative day. This is rare adulthood case of right aortic arch with Kommerell's diverticulum and no anomalies in the heart.

Background : Endovascular treatment of the thoracic aorta (TEVAR) for type B aortic dissection is reported to be effective if the interval between the onset and the procedure is relatively short. However, the optimal timing for TEVAR is still controversial. Method : From December 2008 to April 2015, we experienced 46 TEVARs for type B aortic dissection. The interval between onset and TEVAR was within 3 months in 15 cases (Group A), from 3 months to 1 year in 10 cases (Group B), and more than 1 year in 21 cases (Group C). Result : Primary success was obtained in all cases, and no new intimal tear was formed during the procedure. There was no hospital death. At the time of discharge, disappearance of ULP or thrombosed thoracic false lumen occurred significantly more frequently in Group A (93%) than in Group B (50%) and Group C (43%) (p<0.05). At 6 months, the rate of the patients with reduced aneurysm diameter more than 5 mm was significantly higher in Group A (87%) and Group B (70%) than in Group C (19%) (p<0.05). Three cases of Group C had enlargement of the aneurysm despite of TEVAR, and graft replacement of thoracoabdominal aorta was performed in one of the cases. Conclusion : For type B aortic dissection, TEVAR is more effective if performed within 3 months from the onset.

Hybrid techniques to enable endovascular treatment of complex aortic pathology have been previously described. A staged endograft repair of a complex, chronic Stanford type B aortic dissection with atherosclerotic occlusion of bilateral iliac arteries is reported in a 66-year-old man. The patient also had chronic obstructive lung disease as well as chronic renal dysfunction. The aneurysmal portion of the dissection extended from the distal arch to the entire thoracic aorta. Bilateral femoral arteries were bypassed from the abdominal aorta using open techniques. Then, total arch replacement with a frozen elephant trunk was performed through median sternotomy. Finally, the aneurysmal portion was completely covered with an endograft from the frozen elephant trunk to the upper abdominal aorta, just proximal to the celiac trunk. The patient had no neurologic complications. This case report illustrates the feasibility of the hybrid technique in selected high-risk patients when confronted with complex aortic pathology.

The electrogenic sodium/bicarbonate cotransporter 1 (NBCe1) on the basolateral side of the renal proximal tubule plays a pivotal role in systemic acid-base homeostasis. Mutations in the gene encoding NBCe1 cause severe proximal renal tubular acidosis accompanied by other extrarenal symptoms. The proximal tubule reabsorbs most of the sodium filtered in the glomerulus, contributing to the regulation of plasma volume and blood pressure. NBCe1 and other sodium transporters in the proximal tubule are regulated by hormones, such as angiotensin II and insulin. Angiotensin II is probably the most important stimulator of sodium reabsorption. Proximal tubule AT(1A) receptor is crucial for the systemic pressor effect of angiotensin II. In rodents and rabbits, the effect on proximal tubule NBCe1 is biphasic; at low concentration, angiotensin II stimulates NBCe1 via PKC/cAMP/ERK, whereas at high concentration, it inhibits NBCe1 via NO/cGMP/cGKII. In contrast, in human proximal tubule, angiotensin II has a dose-dependent monophasic stimulatory effect via NO/cGMP/ERK. Insulin stimulates the proximal tubule sodium transport, which is IRS2-dependent. We found that in insulin resistance and overt diabetic nephropathy, stimulatory effect of insulin on proximal tubule transport was preserved. Our results suggest that the preserved stimulation of the proximal tubule enhances sodium reabsorption, contributing to the pathogenesis of hypertension with metabolic syndrome. We describe recent findings regarding the role of proximal tubule transport in the regulation of blood pressure, focusing on the effects of angiotensin II and insulin.
Acidosis, Renal Tubular ; Angiotensin II ; Blood Pressure* ; Diabetic Nephropathies ; Homeostasis ; Humans ; Hypertension ; Insulin ; Insulin Resistance ; Kidney Tubules, Proximal ; Plasma Volume ; Rabbits ; Rodentia ; Sodium ; Sodium-Bicarbonate Symporters