Those women underwent removal of splenic artery aneurysm. One of them was admitted because of intraperitoneal bleeding. Further examination showed rupture of a splenic artery aneurysm with the delayed rupture phenomenon. Emergency laparotomy was perfomed. Splenic aneurysmectomy and splenectomy were successfully carried out. The two other cases of splenic artery aneurysm were detected accidentally. One was complicated by aortic abdominal aneurysm and the other by cholelithiasis. Each patient received two different types of operations at the same time. Splenic aneurysm is likely to be overlooked because of lack of symptoms. However, even a small aneurysm has the possibility of rupture. Therefore, an early operation is recommended.

We evaluated the efficacy of evoked spinal potential (ESP) monitoring during thoracoabdominal aortic replacement to prevent intra-operative spinal ischemia. Nine patients underwent intraoperative ESP monitoring. The ESP was unchanged in 5 patients and decreased in 4 patients. However, ESP recovered in 2 of them by the following techniques: (1) perfusion of intercostal arteries, (2) elevation of distal bypass perfusion pressure, (3) slight hypothermia. Postoperative paraplegia occurred only 1 patient of the 2 whose ESP was not restored. The sensitivity and specificity of the efficacy of ESP monitoring were 100% and 87.5%, respectively. We concluded that ESP is the most useful monitoring for prevention of operative spinal ischemia during thoracoabdominal aortic replacement.

We studied the status of Kampo preparations at Iizuka Hospital by analyzing the content of doctors' prescriptions outside the department of Japanese Traditional (Kampo) Medicine.
Our method of analysis was to convert the prescription volume (or quantity) of into a number of Kampo packets for every half-year starting from 2003. As a result of this research, we saw that Kampo preparation volume gradually increased from 2003. Furthermore, we reviewed the content and volume of Kampo preparations prescribed by each doctor and department in the second half of 2009. Accordingly, the most prescribed Kampo preparation was daikenchuto, followed by daiokanzoto and goshajinkigan.
Moreover, Kampo preparations were prescribed by 87% of all doctors and departments. The Department of Surgery prescribed more than any other. And similarly characteristic usage patterns were seen for the Departments of Obstetrics & Gynecology, and Urology.
Thus we suggest that Kampo preparations are useful for medical treatment in the Hospital.

BACKGROUND: More than 140 million people drink arsenic-contaminated groundwater. It is unknown how much arsenic exposure is necessary to cause neurological impairment. Here, we evaluate the relationship between neurological impairments and the arsenic concentration in drinking water (ACDW). PARTICIPANTS AND METHODS: A cross-sectional study design was employed. We performed medical examinations of 1867 residents in seven villages in the Thabaung township in Myanmar. Medical examinations consisted of interviews regarding subjective neurological symptoms and objective neurological examinations of sensory disturbances. For subjective neurological symptoms, we ascertained the presence or absence of defects in smell, vision, taste, and hearing; the feeling of weakness; and chronic numbness or pain. For objective sensory disturbances, we examined defects in pain sensation, vibration sensation, and two-point discrimination. We analyzed the relationship between the subjective symptoms, objective sensory disturbances, and ACDW. RESULTS: Residents with ACDW ≥ 10 parts per billion (ppb) had experienced a "feeling of weakness" and "chronic numbness or pain" significantly more often than those with ACDW < 10 ppb. Residents with ACDW ≥ 50 ppb had three types of sensory disturbances significantly more often than those with ACDW < 50 ppb. In children, there was no significant association between symptoms or signs and ACDW. CONCLUSION Subjective symptoms, probably due to peripheral neuropathy, occurred at very low ACDW (around 10 ppb). Objective peripheral nerve disturbances of both small and large fibers occurred at low ACDW (> 50 ppb). These data suggest a threshold for the occurrence of peripheral neuropathy due to arsenic exposure, and indicate that the arsenic concentration in drinking water should be less than 10 ppb to ensure human health.
Adolescent ; Adult ; Arsenic ; analysis ; toxicity ; Cross-Sectional Studies ; Dietary Exposure ; adverse effects ; Dose-Response Relationship, Drug ; Drinking Water ; adverse effects ; chemistry ; Female ; Groundwater ; chemistry ; Humans ; Male ; Middle Aged ; Myanmar ; epidemiology ; Peripheral Nervous System Diseases ; chemically induced ; epidemiology ; physiopathology ; Sensation Disorders ; chemically induced ; epidemiology ; physiopathology ; Water Pollutants, Chemical ; analysis ; toxicity ; Young Adult