We report on a rare case of a left subclavian artery aneurysm concomitant with Loeys-Dietz Syndrome (LDS) which required us to operate in childhood. A 12-year-old female, who had been diagnosed with LDS by genetic examination one year eariler, was revealed to be suffering from a left subclavian artery aneurysm (25 mm in diameter) by follow up chest MRI scan. Hybrid surgery consisting of coil embolization of aneurysm and surgical revascularization of the left subclavian artery and left vertebral artery was performed successfully. The patient was discharged on postoperative day 8.

The venerable drug colchicine has garnered significant recent attention due to its endorsement by the United States Food and Drug Administration as an anti-inflammatory medication for cardiovascular diseases. However, the administration of this drug at its minimal available dose of 0.5 mg has been associated with certain adverse reactions.Once colchicine is administered, the drug disappears from blood in a short time and distributes in the leukocytes for a certain period of time that elicits anti-inflammatory effect.Consequently, an in-depth comprehension of the pharmacokinetics of lower dosages within leukocytes assumes important for its broader application in routine clinical contexts. In this study, we present a comprehensive analysis of the pharmacological disposition of colchicine in the plasma, polymorphonuclear leukocytes, and mononuclear leukocytes among healthy Japanese male subjects, following both single and multiple oral administrations of 0.5 mg and 0.25 mg doses of colchicine. Our investigation reveals that colchicine persists within leukocyte populations even when administered at reduced dosages. The findings herein hold promise for mitigating the adverse effects associated with its use in the treatment of inflammatory cardiovascular disorders.

Community-based clinical clerkship, which involves travel outside the university or prefecture, was restricted or reduced due to the outbreak of the new coronavirus infection. What kind of shortage of learning this caused and how the shortage was compensated for were discussed in a special symposium at the 53rd Annual Meeting of the Japanese Society for Medical Education. As a result, two “essences” of community-based medical education emerged: 1) to recognize one’s role and responsibility in the future in the context of interprofessional practice, and 2) to look beyond the framework of medical institutions and view the whole scope of medicine with the patient at the center. It was concluded that online supplementary education should be utilized to enhance the value of practical training experience even in the post-Corona era. It was also supposed that this would lead to the “evolution” of community-based medical education itself.

A 65-year-old woman was referred for progressive dyspnea and leg edema. Physical examination revealed a continuous murmur along the right sternal border. Enhanced computed tomography showed an aneurysm that extended to the right atrium. Aortic angiography confirmed the rupture of the valsalva aneurysm into the right atrium. The patient underwent emergency surgery to close the aneurysm ostium and suture closure of the right atrial fistula. The patient's postoperative course was uneventful.

BACKGROUND: Listeria monocytogenes (L. monocytogenes) is a rare causative pathogen of brain abscess that is often found in immunocompromised patients. Although patients with supratentorial listerial abscesses showed a longer survival with surgical drainage, the standard therapy for patients with subtentorial lesions has not been established. CASE REPORT: We report herein a patient with supra- and subtentorial brain abscesses caused by L. monocytogenes infection. These abscesses did not respond to antibiotics, and his symptoms gradually worsened. Drainage was not indicated for subtentorial lesions, and the patient was additionally treated with hyperbaric oxygen therapy, which dramatically reduced the volume of abscesses and improved the symptoms. CONCLUSIONS: This is the first report of drastic therapy for a patient with listerial brain abscesses involving combined antibiotics and hyperbaric oxygen therapy. The findings suggest that hyperbaric oxygen therapy is a good option for treating patients with deep-seated listerial abscesses and for who surgical drainage is not indicated.
Abscess ; Anti-Bacterial Agents ; Anti-Infective Agents* ; Brain Abscess* ; Drainage ; Humans ; Hyperbaric Oxygenation* ; Immunocompromised Host ; Listeria monocytogenes

  The purpose of this study was to clarify the effects of ingesting chloridquellen and bicarbonate spring waters on electrogastrography and heart rate variability in humans. The subjects were ten young adults (average age 21.9 years old). Three and six cycles per minute (cpm) frequency of electrogastrography (EGG) were measured, as well as the high-frequency (HF: 0.15-0.40Hz) components, and the ratio of low-frequency (LF: 0.04-0.15Hz) components to HF components in heart rate variability (HRV) during 90 minutes. The taste of the water and pain or abnormalities in the stomach were also assessed by having the subjects answer a questionnaire. The subjects ingested the spa water or purified water and were asked to respond to the questionnaire after thirty minutes, and they also ingested no water on a different day and were questioned. The EGG-6 cpm frequency, presumably reflecting intestinal activity, did not change under any conditions. The EGG-3 cpm frequency, presumably reflecting stomach activity, significantly increased with bicarbonate spring waters immediately after ingestion and decreased after 30 min. Additionally, the 3 cpm frequency significantly increased with ingestion of purified water over the course of 30 min. The HF components in HRV, presumably reflecting cardiac parasympathetic activity, did not change under any conditions. The ratio of LF to HF components in HRV, presumably reflecting cardiac sympathetic activity, significantly increased with ingestion of purified water immediately and after 15 min, and bicarbonate spring waters after 30 min. There was a difference between ingestion of chloridquellen and purified water in the answers concerning the taste of the water in the questionnaire. These findings suggest that the constituent parts of chloridquellen water and other factors activate stomach and autonomic nervous activities in humans.

Objectives: Radon (222Rn) is a noble gas and a component of water in many hot spring spas. The Hot Springs Law and the Guideline of Analytical Methods of Mineral Springs (revised edition) of Japan classify springs containing 74 Bq/kg or more of radon as “hot springs” and those with radon levels exceeding 111 Bq/kg as “medical springs”, also called “radioactive springs”. Komono Town, one of the foremost spa and health resort destinations in Mie Prefecture, is the site of many radioactive springs. For the purpose of regional vitalization of this area through radioactive springs, it is necessary to confirm the safety and effectiveness of their use. To evaluate the exposure dose due to radioactive spring usage, it is important to measure radon concentration in air, especially in high-humidity air such as in bathing rooms. Methods: The concentration of radon in air was analyzed using an activated charcoal detector (PICO-RAD; AccuStar Labs) with a desiccant (Drierite; 8-mesh anhydrous calcium sulfate; W.A. Hammond Drierite Company, Ltd.) and a liquid scintillation counter (LSC LB-5; Hitachi Aloka Medical, Ltd.). A DPO (2,5-diphenyloxazole) + POPOP (1,4-bis- (5-phenyl-2-oxazolyl)-benzene) toluene solution (Wako Pure Chemical Industries, Ltd.) was used as a liquid scintillator. Activated charcoal detectors were set up in and around the radioactive spring facilities. Results and Discussion: In a radioactive spring facility, radon concentration in air in the bathing room and changing room were relatively high at about 50 Bq/m3. In the corridor on all floors and at the entrance, these values were approximately 10-30 Bq/m3, indicating that radon in hot spring water diffuses into the air and spreads within the facility. Outdoors, radon concentration was 12.5 Bq/m3 at a campsite near the discharge point of the radioactive spring.   Exposure dose is calculated under the assumption of a two-day stay, during which the visitor will use the bath for several hours. The results obtained show that the exposure dose at the hot spring facility is lower than the exposure dose from daily environmental radiation or medical devices. These conclusions are considered sufficient to confirm the safety of the hot spring facility.

Objectives: Radon (222Rn) is a noble gas found in the water of hot spring spas (“onsen”). In Japan, the Hot Springs Law and the Guideline of Analytical Methods of Mineral Springs (revised) classify springs containing 74 Bq/kg of radon as “hot springs” and those with levels exceeding 111 Bq/kg as “medical springs”, also called “radioactive springs”. According to the notification article (the Nature Conservation Bureau of the Ministry of the Environment in Japan), bathing in a radioactive springs may alleviate the effects of gout, arteriosclerosis, and hypertension as well as chronic conditions such as cholecystitis, gallstones, and skin and gynecological diseases. Drinking water from these springs may treat gout, chronic digestive disorders, chronic cholecystitis, gallstones, neuralgia, muscle pain, and arthralgia. To determine exposure doses from radioactive springs, it is important to establish an easy and accurate method of measuring radon concentration in water and humid air in bathing areas. Methods: This study measured the concentration of airborne radon using an activated charcoal detector (PICO-RAD: AccuStar Labs), desiccant (Drierite; 8 mesh of anhydrous calcium sulfate: W.A. Hammond Drierite Company, Ltd.), a liquid scintillation counter (LSC LB-5: Hitachi Aloka Medical, Ltd.), and 2,5-diphenyloxazole(DPO) + 1,4-bis (5-phenyl-2-oxazolyl) benzene(POPOP) toluene solution (Wako Pure Chemical Industries, Ltd.) were used as the liquid scintillator. Results and Conclusions: This study evaluated radon exposure doses due to radioactive spring at a spa in Komono town, Mie prefecture. After water was piped from hot spring storage tanks into bathtubs, only 5.3-18.0% of the radon remained in the water. Two days later, only 0.25% remained, likely due to radioactive decay and increased diffusion into the air from bathing and recirculating filters. Thus, we investigated radon levels in the humid bathroom air around the radioactive hot spring and determined the total radon exposure from spa water and air. The total exposure dose was calculated assuming a two-day stay, during which customers used the bath for some number of hours. Our findings confirm the safety and efficacy of the hot spring facility. This study was supported in part by a grant from the Daido Life Welfare Foundation.

  We previously reported that in patients with Alzheimer’s disease (AD), the number of baths that patients report taking at their first evaluation at a memory clinic was significantly decreased in comparison to before the onset of dementia. Based on this research, we thought further longitudinal evaluation was needed regarding the relationship between the number of baths, cognitive impairment and depression state after AD progression. In the present study, we reevaluate the number of baths; cognitive function tests (Hasegawa’s Dementia Scale-Revised [HDS-R], Mini Mental State Examination [MMSE] and Wechsler Adult Intelligence Scale-Revised [WAIS-R]); and the depression assessment (Zung Self-rating Depression Scale [SDS]) 1 year after first evaluation.   At the first evaluation, the average number of baths taken by 65 AD patients (16 male, 49 female; range: 64-90 years, average: 79.5±5.6 years), was 5.6±1.6 bathsweek. At the reevaluation, this number had decreased to 4.9±1.9 bathsweek. In the WAIS-R, a significant positive correlation was found between the score change in number of baths and the change in performance intelligence quotient (PIQ) and total intelligence quotient (TIQ). However, no significant correlation was found between the score change in number of baths and the change in HDS-R, MMSE, or verbal intelligence quotient in WAIS-R or SDS.   We further evaluated the present series by dividing the study population into two subtypes: a group of patients in which the number of baths decreased 1 year after the first evaluation, and a group in which there was no change. There were no significant differences in background factors (e.g. average age at first evaluation) between the groups. Although, no significant difference was observed between the groups in number of baths before dementia onset (both were 6.7 timesweek), a significant difference was found at the first evaluation (5.3 bathsweek vs 5.9 bathsweek, respectively). No significant differences were observed between the groups in cognitive function test or depression assessment at the first evaluation. However, on reevaluation the group with the decreased number of baths showed significantly lower PIQ and TIQ scores in WAIS-R and a significantly higher SDS score.   The results of the present study suggested that number of baths decreased along with the progression of AD and the greatest participating factor was the practical dysfunction reflected by the PIQ score in WAIS-R. Furthermore, we considered the existence of two subtypes: patients in whom the number of baths decreases with AD progression and those in whom there is no change.