1.Studies on Therapeutic Effects and Pathological Features of an Antithrombin Preparation in Septic Disseminated Intravascular Coagulation Patients.
Yuichiro SAKAMOTO ; Satoshi INOUE ; Takashi IWAMURA ; Tomoko YAMASHITA ; Atsushi NAKASHIMA ; Yoichi NISHIMURA ; Hiroyuki KOAMI ; Hisashi IMAHASE ; Akiko GOTO ; Kosuke Chris YAMADA ; Kunihiro MASHIKO ; Hiroyuki YOKOTA
Yonsei Medical Journal 2013;54(3):686-689
PURPOSE: Few reports have been made on the therapeutic effects as well as pathological features of an antithrombin preparation in patients diagnosed with septic disseminated intravascular coagulation (DIC) by the diagnostic criteria for acute DIC. MATERIALS AND METHODS: A total of 88 sepsis patients who had received inpatient hospital care during the period from January 2000 through December 2008 were divided into two groups, an antithrombin group and a non-antithrombin group, to study the outcomes. Furthermore, the relationship between sepsis-related factors and DIC in 44 patients was studied. RESULTS: The antithrombin group contained 34 patients, and the non-antithrombin group contained 54 patients. The outcomes were significantly better in the antithrombin group. The levels of protein C were low in DIC patients. CONCLUSION: Our results suggest that early administration of antithrombin might improve outcomes of septic DIC patients in the diagnostic criteria for Japanese Association for Acute Medicine acute DIC.
Aged
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Disseminated Intravascular Coagulation/complications/diagnosis/*drug therapy
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Female
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Fibrinolytic Agents/*therapeutic use
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Humans
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Male
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Middle Aged
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Sepsis/complications/diagnosis/*drug therapy
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Time Factors
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Treatment Outcome
2.A Case of Poor Eating of Elderly Due to Stomach Yin Deficiency Successfully Treated with Bakumondoto
Yuzo FUKUSHIMA ; Hiroko FUKUSHIMA ; Ryosuke FUJITA ; Hidefumi MIYAGAWA ; Kazumasa ITASAKA ; Tomoko NAKASHIMA
Kampo Medicine 2020;71(4):338-343
Poor eating is a life-threatening condition in senior citizens. Herein, we report a case of poor eating due to stomach yin deficiency (wei yin xu), which was successfully treated with bakumondoto. The patient was a 91-year-old woman who expected treatment for her poor food intake. She was diagnosed as poor eating with stomach yin deficiency and was administered with bakumondoto, which increased her food intake and weight. To treat poor eating with Kampo medicine, rikkunshito and various other Kampo drugs are commonly used. In this case, bakumondoto, which is usually used for respiratory diseases such as dry cough, was effective. Bakumondoto is useful for stomach yin deficiency of poor eating.
3.Usefulness of the Endotoxin Activity Assay to Evaluate the Degree of Lung Injury.
Yuichiro SAKAMOTO ; Satoshi INOUE ; Takashi IWAMURA ; Tomoko YAMASHITA ; Atsushi NAKASHIMA ; Hiroyuki KOAMI ; Toru MIIKE ; Mayuko YAHATA ; Hisashi IMAHASE ; Akiko GOTO ; Showgo NARUMI ; Miho OHTA ; Chris Kosuke YAMADA
Yonsei Medical Journal 2014;55(4):975-979
PURPOSE: It has been reported that the Pulse Contour Cardiac Output (PiCCO) is very useful mainly in the field of intensive care and treatment to grasp the pathophysiological conditions of pulmonary edema because of its capability of obtaining data such as Pulmonary Vascular Permeability Index (PVPI) and Extra Vascular Lung Water (EVLW). Furthermore, a high degree of usability of various markers has been reported for better understanding of the pathological conditions in cases with septicemia. MATERIALS AND METHODS: The correlation between the cardiorespiratory status based upon the PiCCO monitor (EVLW and PVPI) and inflammatory markers including C reactive protein, procalcitonin (PC), and Endotoxin Activity Assay (EAA) were evaluated in 11 severe cases that required treatment with a respirator in an intensive care unit. RESULTS: The EAA values were significantly higher in patients with abnormal EVLW at 0.46+/-0.20 compared to the normal EVLW group at 0.21+/-0.19 (p=0.0064). In a similar fashion, patients with abnormal PVPI values tended to have higher PC levels at 18.9+/-21.8 compared to normal PVPI cases at 2.4+/-2.2 (p=0.0676). On the other hand, PVPI was significantly higher in the abnormal EAA group at 3.55+/-0.48 in comparison with the normal EAA group at 1.99+/-0.68 (p=0.0029). The abnormal EAA group tended to have higher PVPI values than the normal EAA group. CONCLUSION: The EAA is a measurement method designed to estimate the activity of endotoxins in the whole blood. Our results suggest that the EAA value, which had the greatest correlation with lung disorders diagnosed by the PiCCO monitoring, reflects inflammatory reactions predominantly in the lungs.
Adult
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Aged
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Aged, 80 and over
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Cardiac Output/physiology
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Endotoxins/*blood
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Female
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Humans
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Lung Injury/*blood/*diagnosis/physiopathology
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Male
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Middle Aged
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Pulmonary Edema/blood/*diagnosis/physiopathology