1.Fate of the Communicated False Lumen Following Surgical Treatment for Aortic Dissection.
Shigeru Hosaka ; Kihachiro Kamiya ; Shoji Suzuki ; Osamu Suzuki ; Shinpei Yoshii ; Ryoichi Hashimoto ; Yusuke Tada
Japanese Journal of Cardiovascular Surgery 1996;25(2):99-104
The purpose of this study was to estimate the postoperative growth of untreated segments of the dissected aorta with non-thrombotic communicating false lumen, and also to evaluate the clinical outcome in relation to the aortic enlargement after surgery. Nineteen patients who underwent surgical treatment of aortic dissection were studied with enhanced CT scans and angiograms during the postoperative follow-up period. In Stanford type A patients, mean aortic dilatation rate calculated at the segment showing maximal dilatation was 5.1mm/year during 13-82 months (average, 41 months) after surgery, as a sequela of enlargement of the false lumen. Differences in the aortic dilatation rates between the different segments of the aorta were observed and these were per annum 4.8mm in the ascending aorta, 5.4mm in the transverse aortic arch, 4.3mm in the proximal descending aorta, 2.7mm in the distal descending aorta and 2.4mm in the abdominal aorta. In all patients, major communications were detected at the perianastomotic sites on angiography. In Stanford type B patients, false lumens with small communications were observed to show gradual thrombotic occlusion, but no significant aortic dilatation was detected during the follow-up period (13-70 months, average: 44 months), except three cases of sudden death who had major communications. Nine late events related to dissection, consisting of 4 sudden deaths suspected to be due to aortic rupture, 2 intestinal necroses and 3 cerebral infarctions, occured in 6 patients (32%), among which three patients had undergone arterial fenestration, one of whom had double barrel anastomosis. In the remaining two, major leakages were recognized at distal aortic anastomotic sites on postoperative angiography. The results of this study, we stress the importance of periodic check-ups using enhanced CT scan and if necessary, angiography after surgery of the patients having communicating false lumen. Early detection of progressive aneurysm formation and timely surgical reintervention can yield a good prognosis.
2.Consciousness survey on the effect of acupuncture moxibustion treatment.
Kazuhiro MORIKAWA ; Tatsuyo ISHIGAMI ; Akezo OKADA ; Shuichi KATAI ; Toshikatsu KITADE ; Shigeru KINOSHITA ; Yasuzo KURONO ; Futoshi SUZUKI ; Shigeru HORI ; Nakazoh WATARI
Journal of the Japan Society of Acupuncture and Moxibustion 1992;42(2):199-207
3.A Case of Hepatitis and Interstitial Pneumonitis Induced by Hangeshashin-to and Shosaiko-to.
Yumi OKADA ; Kenji WATANABE ; Yukio SUZUKI ; Kunihiko SUZUKI ; Go ITO ; Akihiko MURANUSHI ; Shigeru KURAMOCHI ; Kanji TSUCHIMOTO ; Shogo ISHINO ; Toshihiko HANAWA
Kampo Medicine 1999;50(1):57-65
A 60-year-old male patient visited the Oriental Medicine Research Institute of the Kitasato on ***** because of abdominal discomfort. Hangeshashin-to was administered to him and the abdominal discomfort was relieved. He continued to take Hangeshashin-to from June to August 1997. He had chills, high fever, and fatigue from ********. He stopped Hangeshashin-to and took Shosaiko-to for five days because of liver dysfunction. He was admitted to our hospital on ********. Antibiotics and stronger neo-minophagen C were administered to him. A chest roentgenogram revealed a ground-glass shadow on the left upper lung, and Shosaiko-to was discontinued. The patient began to complain of dyspnea and had fine crackles on the chest. A chest roentgenogram and chest CT showed interstitial pneumonitis. Oral predonisolone therapy was started for hypoxemia and the patient improved. A drug lymphocytes stimulation test revealed that lymphocytes were stimulated by Shosaiko-to and its components, Saiko and Ogon. A chest roentgenogram just before ingesting Hangeshashin-to revealed the interstitial change of the lung. Taken all together, this patient suffered from druginduced hepatitis and pneumonitis as a result of ingesting Hangeshashin-to and Shosaiko-to.
4.Clinical Pharmacokinetics of Methadone
Hideya Kokubun ; Shirou Tomiyasu ; Shigeru Tanda ; Yasuhito Uezono ; Hajime Kagaya ; Tsutomu Suzuki ; Motohiro Matoba
Palliative Care Research 2014;9(4):401-411
Methadone oral tablets initially became available on the Japanese market in MAR-2013. Methadone, which has different pharmacological properties from other opioids including morphine, can cause serious adverse drug reactions such as respiratory depression and QT prolongation. One of the causes of these reactions is its extremely complex pharmacokinetics. Methadone is mostly metabolized in the liver, with a variety of metabolic enzymes, including cytochrome P450 (CYP) 3A4, CYP2B6, and CYP2D6, being involved. The characteristics of methadone include self-induction of metabolism, delayed excretion due to alkaline urine, and an extremely long half-life requiring a long time to achieve a steady state. Without a full understanding of its complex pharmacokinetics, the blood concentration of methadone is not maintained at a constant level, and serious adverse events could happen due to an unexpected increase in its blood concentration. Herein, for safe clinical use by physicians and pharmacists, we summarize the pharmacokinetics of methadone.
5.Effects of Moderate-Intensity Endurance Exercise on Reactive Oxygen Species Production and Leukocyte Activation Markers
Masaki TAKAHASHI ; Katsuhiko SUZUKI ; Hideki MATOBA ; Masayuki SATAKE ; Shizuo SAKAMOTO ; Shigeru OBARA
Japanese Journal of Complementary and Alternative Medicine 2011;8(1):25-28
The purpose of this study was to examine effects of moderate-intensity endurance exercise on reactive oxygen species production and leukocyte activation markers in young and middle-aged persons. Blood samples were collected before and after the jogging of 10 km. Although cytokines recruiting and priming neutrophils and monocytes were released into the circulation and functional after the jogging of 10 km, reactive oxygen metabolites-derived compounds (d-ROMs) were not significantly increased. It was indicated that chemokines and leukocyte activation markers at rest were increased with aging, and that might be accompanied by the higher level of d-ROMs in the elderly.
6.A STUDY ON THE BLOOD CONSTITUENTS AND PHYSICAL FITNESS OF UNDER-WEIGHT ELEMENTARY SCHOOLBOYS
SATIO IKAWA ; MASATO SUZUKI ; MASATOSHI SHIOTA ; YOSHIKO IIJIMA ; SHIGERU MATSUBARA ; KUNIHIKO HARADA
Japanese Journal of Physical Fitness and Sports Medicine 1985;34(Supplement):213-221
The present study was done to elucidate the medical problems and physical fitness of under-weight elementary schoolboys. Eighty nine volunteers, ranging in age from 9 to 12 yrs, were divided into five groups based on the grade of obesity, expressed as % of the standard, taking into account height, age and sex.
The mean grade of obesity for under-weight boys was -12 %, and this group was defined as the experimental group (group I; n=15) . The group III, which contained 23 boys of grade 0 %, and the group V made of 13 boys of grade +33.5 % was defined as the normal control and obese control, respectively.
The measurement of blood pressure, EKG recording, and blood sampling were done in the state of fasting before and after exercise. The exercise was a step test of 5 min duration with a temp of 1 step per 2 seconds, jumping over a bench 25 cm high for 9 years old boys, and 33 cm high for boys of 10 to 12 years. The step test score (PFI) and recovery rate of heart rate (RR (HR) ) were calculated from the EKG. The test battery of physical fitness performance was also done on another experimental day.
The serum levels of total cholesterol (TC), triglyceride (TG), total protein (TP) and hemoglobin (Hgb) were lower in experimental group (EG) than in control groups (CG) . The cholesterol-HDL/TC ratio was conversely higher in EG than in CG. There were no significant differences in the other biochemical measurements between the five groups.
Any abnormal EKG was not recorded before and after exercise throughout the subjects. The frequency of hypertension (above the 135/80 mmHg) was 10.2 % at pre-exercise time. But, none of the boys in EG was found to be hypertensive.
The PFI and physical fitness performance test score showed no differences between EG and group III, however, the score of group V was inferior to that of EG and/or group III. The RR (HR) in EG and over-weight group was lower compared to that for the average-weight boys.
Almost all components in blood measured were elevated after exercise in all the groups. The finding of the highest interest of the exercise-induced elevations of blood constituent levels was an increase in WBC measured as an indicator of stress. The magnitude of increase in WBC (ΔWBC) was higher in EG and the over-weight group than in the average-weight group. In normal subjects, ΔWBC was generally proportional to the work intensity, which, in the present exercise, depended upon the stature and body weight, because the height of bench, tempo and duration of exercise were same for all groups. The work intensity in EG was presumed milder, becasue the mean stature was slightly taller and bodyweight was less heavy compared to those in control groups. But, the greater increase of WBC in EG was observed in spite of a lighter work intensity. According to the Selye's literature, the particular WBC reaction to exercise in the under-weight boys was interpreted as a over-reaction to stress in the state of malnutrition.
From some biochemical parametors, the leaner subjects were assumed to be in a slight malnutrition. And also a later recovery of HR and over-reaction to exercise stress were shown in the under-weight boys group.
It is emphasized that the malnutrition resulting from excessive effort for preventing obesity was unfavourable for children in the growing stage for their healthy growth and development.
7.Validating a Nutrition Support Team's (NST) Effect in Convalescent Stroke Rehabilitation using the Functional Independence Measure
Wataru USUI ; Shigeru SONODA ; Toru SUZUKI ; Sayaka OKAMOTO ; Takashi HIGASHIGUCHI ; Eiichi SAITOH
The Japanese Journal of Rehabilitation Medicine 2008;45(3):184-192
The aim of this study is to validate the effect of a nutrition support team's (NST) interventions in convalescent stroke rehabilitation using the Functional Independence Measure (FIM). Three hundred and four patients were retrospectively divided into an NST-nourishment group, an NST-losing-weight group and a non-NST group. We then compared the FIM gain, the FIM efficiency and the change of body mass index during admission among these three groups. The FIM gain was 17.3±15.9 in the NST-nourishment group and 16.7±12.5 in the non-NST group and there was no significant difference. The FIM efficiency in the NST-nourishment group (0.20±0.19) was significantly lower than the one in the non-NST group (0.27±0.19). Patients with an FIM of 53 or less showed no significant difference in FIM gain and FIM efficiency between the two groups. Since those patients who received NST intervention would tend to have a poor prognosis in general, we assumed that our “no difference” results indicated the effectiveness of the NST intervention. There was no evident relationship between FIM gains and changes in the body mass index.
8.A Fundamental Study of Water Jet Angioplasty.
Junya Katoh ; Masaru Iwasaki ; Shoji Suzuki ; Shigeru Hosaka ; Kihachiroh Kamiya ; Yusuke Tada
Japanese Journal of Cardiovascular Surgery 1994;23(3):156-160
Water Jet flow was projected at normal human aortic walls and human chronic obstructive iliac arteries in the air or in the ordinary saline solution. Ordinary saline solution was used for the jet, which was projected at a pressure of 10kg·f/cm2 through a nozzle 0.10mm in diameter. When the Water Jet was projected at the normal aortic intima, damage to the wall was more severe with duration of fluid projection, and projection for ten sec ruprured the elastic fiber of the media. But when the fluid jet projected ordinary saline, damage to the aortic wall was slight and projection for 30sec only dissected the surface of the intima. Water Jet projection in air showed slight effect on thrombi of the chronic obstructive iliac arteries, and projection for 60sec only made small irregular holes in the thrombi. When the Water Jet was projected in ordinary saline solution, however, destructive effects on thrombi were stronger and the projection for 40sec could remove almost all the thrombi for a distance of 2cm, while damage to the initima was very slight. This study demonstrated that fluid jet projection using ordinary saline solution could remove thrombi in chronically obstructive artery safely and effectively and suggested the possibility of the Water Jet angioplasty.
9.A Case of Embolomycotic Aneurysm and Mitral Insufficiency Due to Infective Endocarditis.
Shigeru Hosaka ; Shoji Suzuki ; Seiichiro Katahira ; Hidenori Inoue ; Shunya Shindo ; Shinpei Yoshii ; Kihachiro Kamiya ; Yusuke Tada
Japanese Journal of Cardiovascular Surgery 1997;26(3):190-192
A 64-year-old man was admitted with intermittent high fever of 4 months duration and with three episodes of arterial embolism in the previous 2 months. Several investigations revealed evidence that those episodes involving bilateral popliteal arteries and the left external iliac artery originated from mycotic emboli. Severe mitral insufficiency due to infective endocarditis was also recognized. The ischemic symptoms improved after medical treatment. Despite antibiotic therapy for 4 weeks, inflammatory signs did not subside. Since aneurysm formation of the left external iliac artery at the embolized portion was detected on CT, mitral valve replacement and aneurysmectomy with femoro-femoral grafting were done concomitantly. Inflammatory signs disappeared immediately after the operation. Pathological findings indicated organization of the mitral vegetation and evidence of active infection in the aneurysm wall. Though aneurysmal change of a symptomatic embolized site is not common, the preoperative evaluation of possible associated mycotic aneurysm is important to decide on surgical strategy for infective endocarditis complicated by embolism.
10.Workshop for Workshop Planning
Susumu TANAKA ; Shigeru HAYASHI ; Yasuyuki TOKURA ; Masahiko HATAO ; Masako OTAKE ; Junichi SUZUKI
Medical Education 1981;12(6):398-406