2.Successful Off-Pump Coronary Artery Bypass Grafting for a Renal Transplant Patient
Yoshio Hayashida ; Noritsugu Morishige ; Hidehiko Iwahashi ; Masaru Nishimi ; Kazuma Takeuchi ; Nobuhisa Ito ; Go Kuwahara ; Yuta Sukehiro ; Tadashi Tashiro
Japanese Journal of Cardiovascular Surgery 2008;37(5):281-284
This paper reports the findings of off-pump coronary artery bypass grafting (OPCAB) for a 56-year-old man who had undergone a renal transplantation. Coronary angiography (CAG) revealed triple-vessel coronary disease. OPCAB was therefore performed. The patient was discharged 20 days after surgery without any subsequent rejection, infection or renal dysfunction. At two years after the operation the patient is doing well without any cardiac events. Cardiac disease, especially coronary artery disease is a common cause of death in renal transplant patients. Cardiac surgery in renal transplant patients is expected to increase. OPCAB for renal transplant patients with ischemic heart disease is therefore expected to reduce the incidence of myocardial infarction, thereby prolonging patient survival.
3.Tranexamic Acid Reduces Bleeding during Off-Pump Coronary Artery Bypass Grafting in a Patient on Clopidogrel
Hidehiko Iwahashi ; Tadashi Tashiro ; Noritsugu Morishige ; Yoshio Hayashida ; Nobuhisa Ito ; Kazuma Takeuchi ; Masaru Nishimi ; Go Kuwahara ; Yuta Sukehiro
Japanese Journal of Cardiovascular Surgery 2009;38(6):389-393
A 72-year-old man was admitted to a local hospital with symptoms of unstable angina pectoris. He was given Clopidogrel for acute coronary syndrome. Coronary angiography showed left main trunk and three-vessel disease. He was then admitted to our hospital due to a sudden onset of unstable angina following shock during the PCI procedure. We performed emergency off-pump coronary artery bypass grafting (OPCAB). He received 10 mg/kg/h tranexamic acid during the operation. He also received 2,000 U ascorbic acid at the start of surgery and 2,000 U after undergoing anastomoses of the coronary artery. Postoperatively, only some minor bleeding was observed. Tranexamic acid and Ascorbic acid reduce bleeding, and transfusion requirements of packed red blood cells, platelets, and the total blood units in patients on Clopidogrel who undergo emergency OPCAB.
4.Trans-Thoracic Aortic Insertion of Intra-Aortic Balloon Pumping for the Patient of Ischemic Cardiomyopathy with Severe Arteriosclerotic Disease
Go Kuwahara ; Tadashi Tashiro ; Noritsugu Morishige ; Hidehiko Iwahashi ; Masaru Nishimi ; Yoshio Hayashida ; Kazuma Takeuchi ; Noritoshi Minematsu ; Nobuhisa Ito ; Yuta Sukehiro
Japanese Journal of Cardiovascular Surgery 2011;40(2):62-65
A 58-year-old man with diabetic nephropathy had been on hemodialysis for 15 years. He had lost his left leg below the knee and whole right leg due to atherosclerotic necrosis. During the past 3 years, his cardiac function had also gradually deteriorated. For the past 2 years, echocardiography showed progressively worsening mitral valve regurgitation. Coronary angiography showed severe stenosis in the left main trunk and left descending artery. Ischemic cardiomyopathy with mitral regurgitation were diagnosed. He underwent coronary artery bypass grafting and mitral valve annuloplasty. Because of difficulty in weaning him from cardiopulmonary bypass, he required intra-aortic balloon-pump (IABP) support. An IABP was inserted through the ascending aorta via a tube graft. It was removed on the 4th postoperative day with a small skin incision, under local anesthesia. The postoperative course was uneventful. This IABP insertion technique was useful for a patient with severe arteriosclerotic disease.
5.The Policy of Full Subsidy for Six Voluntary Vaccinations and Community Education in Horokanai Town ; Effects on Vaccine Coverage
Yuta Sakanishi ; Takashi Sugioka ; Masaki Hyakutake ; Tatsuro Morisaki ; Kazuhiko Ohyama ; Hiromi Mizutani ; Norio Fukumori ; Yayoe Kinoshita ; Satoko Miyauchi ; Rika Ito ; Shunzo Koizumi
An Official Journal of the Japan Primary Care Association 2011;34(4):323-328
In Horokanai town, Hokkaido, the policy of full subsidies for voluntary vaccinations against influenza, haemophilus influenzae type b (Hib), varicella, mumps, pneumococcal for children and human papillomavirus (HPV) was introduced between 2008 and 2010. A campaign for community education about vaccination was initiated.
Vaccination coverage improved after the subsidy as follows : influenza vaccination increased from 57.4% to 60.1%, Hib from 2.9% to 52.2%, varicella from 0% to 30.0%, mumps from 2.8% to 38.2%, pneumococcal for children from 1.3% to 50.6%, and HPV from 0% to 81.3%.
6.The Application and Pitfalls for Registering New Japanese Board of Cardiovascular Surgery
Hironobu NISHIORI ; Takahiro ITO ; Kohei TONAI ; Rihito TAMAKI ; Yukika KAMEDA ; Yuta KITAGATA ; Taisuke SHIBUYA ; Takao MIKI ; Go MIYAZAKI ; Kaori MORI ; Misato TOKIOKA
Japanese Journal of Cardiovascular Surgery 2023;52(6):6-U1-6-U6
The first examination of the new board of the Japanese cardiovascular surgery took place in 2022. As it is a transitional period for the new system, many doctors are not familiar with the changes and details of the new system, and some have their concerns. Here, we held a round-table discussion with doctors who actually took the new board of the Japanese cardiovascular surgery under the new system, and we summarized their opinion.
7.Similar Drug Proposals Based on Package Inserts Using Latent Semantic Analysis
Misa KIKUCHI ; Rie ITO ; Yuta TANAKA ; Yohsuke SHIMADA ; Satoru GOTO ; Rie OZEKI ; Masayo KOMODA
Japanese Journal of Drug Informatics 2018;20(2):111-119
Objective:The topic model is a well-known method used in the field of natural language processing (NLP)that defines adocument as constructed of topics that combine specific t erms. This method is used to model topic co-occurrencemathematically. In this study,we extracted topics from featu re vectors of explicit documents called medical package insertsby using cluster analysis. Methods:We counted the terms(nouns)recognized by the morphological analysis engine MeCab and created a documentterm matrix. A value of“tf・idf”was calculated in this matrix for term weighting to avoid the effect of term frequency. We reduced the dimensionality of the matrix using singular v alue decomposition,which removed unnecessary data,and weextracted feature vectors attributed to each medical package insert. The distance between feature vectors was calculatedusing cosine distance,and cluster analysis was performed based on the distance between the vectors.Results:Cluster analysis on our document-term matrix show ed that medical package inserts of drugs that have the sameefficacy or active ingredient were included in the same cl uster. Moreover, using term weighting and dimensionalityreduction,we could extract topics from medical package inserts.Conclusion:We obtained a foothold to apply our findings t o the recommendation of similar drugs. Cluster analysis ofmedical package inserts using NLP can contribute to the pro per application of drugs. In addition,our study revealed thesimilarities of drugs and suggested possibilities for new applications from several points of view.
8.Attitudes and Barriers of Physicians toward Palliative Care in Critical Care Setting:Qualitative Content Analysis Using Open-ended Data from Nationwide Self-administrated Questionnaire Survey in Japan
Yuta TANAKA ; Akane KATO ; Kaori ITO ; Yuko IGARASHI ; Satomi KINOSHITA ; Yoshiyuki KIZAWA ; Mitsunori MIYASHITA
Palliative Care Research 2023;18(2):129-136
Purpose: Palliative care implementation should take into account the perceptions and acceptability of healthcare providers. This study aimed to identify physicians’ perceptions of palliative care and barriers to palliative care practice in the critical care setting. Methods: A nationwide, self-administered questionnaire was distributed to physicians working in intensive care units, and free-text data were qualitatively analyzed. Results: The questionnaire was sent to 873 respondents, and 436 responded (50% response rate). Of these, 95 (11%) who responded to the open-ended sections were included in the analysis. Conclusion: Japanese physicians working in ICUs recognized that palliative care was their role and practiced it as part of their usual care. They felt, however, that the practice was difficult and not sufficient. Barriers to practice included the lack of human resources and availability of palliative care teams, and the lack of uniformity in the perception of palliative care in the critical care setting.