Journal of Nippon Medical School最新文献

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Unilateral Vocal Cord Paralysis in a Patient with Anti-Galactocerebroside Antibodies: A Case Report. 抗半乳糖脑苷脂抗体患者的单侧声带麻痹:病例报告
IF 1.2 4区 医学
Journal of Nippon Medical School Pub Date : 2024-01-01 DOI: 10.1272/jnms.JNMS.2024_91-402
Masaru Yanagihashi, Ryuichi Okamoto, Ayano Matsuoka, Harumi Morioka, Akira Fukuo, Kota Wada, Osamu Kano
{"title":"Unilateral Vocal Cord Paralysis in a Patient with Anti-Galactocerebroside Antibodies: A Case Report.","authors":"Masaru Yanagihashi, Ryuichi Okamoto, Ayano Matsuoka, Harumi Morioka, Akira Fukuo, Kota Wada, Osamu Kano","doi":"10.1272/jnms.JNMS.2024_91-402","DOIUrl":"10.1272/jnms.JNMS.2024_91-402","url":null,"abstract":"<p><p>Anti-galactocerebroside (Gal-C) antibodies are present in patients with conditions such as Guillain-Barré syndrome and mycoplasma pneumonia. We report a rare case of left vocal cord paralysis in a patient with anti-Gal-C IgG antibodies that improved after administeration of antivirals and steroids.</p>","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":"91 4","pages":"422-424"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Organizing Pneumonia Associated with Pneumocystis jirovecii in a Patient Receiving Dose-Dense Chemotherapy for Breast Cancer: A Case Report. 在接受剂量密集化疗的乳腺癌患者中,组织性肺炎与乙氏肺囊虫相关:1例报告。
IF 1.2 4区 医学
Journal of Nippon Medical School Pub Date : 2024-01-01 DOI: 10.1272/jnms.JNMS.2024_91-605
Mio Yagi, Toshihiko Yoneto, Keiko Yanagihara, Koji Nagata, Satoru Matsuki, Hiroyuki Takei
{"title":"Organizing Pneumonia Associated with Pneumocystis jirovecii in a Patient Receiving Dose-Dense Chemotherapy for Breast Cancer: A Case Report.","authors":"Mio Yagi, Toshihiko Yoneto, Keiko Yanagihara, Koji Nagata, Satoru Matsuki, Hiroyuki Takei","doi":"10.1272/jnms.JNMS.2024_91-605","DOIUrl":"https://doi.org/10.1272/jnms.JNMS.2024_91-605","url":null,"abstract":"<p><p>In patients not infected by HIV, Pneumocystis jirovecii pneumonia (PCP) is characterized by rapid disease progression, difficulty in confirming the diagnosis, and poor prognosis. PCP has also been reported in immunocompromised patients receiving chemotherapy, most often for hematologic tumors, although some patients receiving treatment for breast cancer have been affected. Dose-dense chemotherapy (DDC) which is performed with shorter dosing intervals than standard chemotherapy and is now widely used in clinical practice. However, adverse events have been reported, including infections associated with decreased immune status. PCP infection is considerably more challenging to diagnose and treat than bacterial or viral infections. Furthermore, organizing pneumonia (OP), a pulmonary lesion of PCP, is infrequent and requires caution on the part of clinicians, as protozoan infections require different forms of treatment. Although we initially suspected bacterial, viral, and drug-induced pneumonia in our patient and started treatment with antibiotics, antifungals, and prednisolone, the final diagnosis was OP. The pulmonary lesion of PCP was treated with systemic corticosteroids, leading to recovery. There have been no similar reports of PCP during chemotherapy for malignant disease; however, the possibility of OP should be considered during chemotherapy. Herein, we report a case of PCP during preoperative DDC for advanced breast cancer.</p>","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":"91 6","pages":"567-573"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prognostic Factors for Mortality in Maintenance Hemodialysis Patients Infected with SARS-CoV-2. SARS-CoV-2感染维持性血液透析患者死亡的预后因素分析
IF 1.2 4区 医学
Journal of Nippon Medical School Pub Date : 2024-01-01 DOI: 10.1272/jnms.JNMS.2024_91-611
Takehisa Yamada, Yukinao Sakai, Tetsuya Kashiwagi, Masato Iwabu
{"title":"Prognostic Factors for Mortality in Maintenance Hemodialysis Patients Infected with SARS-CoV-2.","authors":"Takehisa Yamada, Yukinao Sakai, Tetsuya Kashiwagi, Masato Iwabu","doi":"10.1272/jnms.JNMS.2024_91-611","DOIUrl":"10.1272/jnms.JNMS.2024_91-611","url":null,"abstract":"<p><strong>Background: </strong>Maintenance hemodialysis patients are immunosuppressed, which increases their mortality risk if they contract coronavirus disease 2019 (COVID-19).</p><p><strong>Methods: </strong>We studied data from 36 consecutive patients undergoing maintenance hemodialysis who were diagnosed as having COVID-19 from January 2020 to September 2023. Clinical data such as age and sex, laboratory data, radiological findings, modalities for blood purification therapy, and outcome at the time of discharge were collected from their hospital records. Binomial logistic regression analysis was used to predict risk factors for mortality and continuous hemodiafiltration (CHDF).</p><p><strong>Results: </strong>After analyzing the correlation of outcomes with each prognostic factor, we identified 6 significant factors (P < 0.05). Age and initiation of CHDF were both associated with mortality. COVID-19 severity, steroid treatment, and serum lactate dehydrogenase level at admission were positively correlated with risk for CHDF initiation, while a greater number of vaccine doses was associated with lower risk.</p><p><strong>Conclusions: </strong>Elderly hemodialysis patients have a higher mortality risk if they develop COVID-19 and require CHDF. More attention is warranted for vulnerable older patients with COVID-19 if they require hemodialysis. Risk reduction strategies, such as appropriate vaccination, are necessary.</p>","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":"91 6","pages":"520-526"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Reconstruction Using Negative Pressure Wound Therapy with a Cotton Filler for Fixation of Male Genital Skin Grafts in Cases of Fournier's Gangrene. 负压创面及棉填充物修复男性生殖器皮肤移植固定富尼耶坏疽病例。
IF 1.2 4区 医学
Journal of Nippon Medical School Pub Date : 2024-01-01 DOI: 10.1272/jnms.JNMS.2024_91-610
Yuki Ideguchi, Shimpei Ono, Shintaro Kaneyuku, Taishi Murakami, Rei Ogawa
{"title":"Reconstruction Using Negative Pressure Wound Therapy with a Cotton Filler for Fixation of Male Genital Skin Grafts in Cases of Fournier's Gangrene.","authors":"Yuki Ideguchi, Shimpei Ono, Shintaro Kaneyuku, Taishi Murakami, Rei Ogawa","doi":"10.1272/jnms.JNMS.2024_91-610","DOIUrl":"https://doi.org/10.1272/jnms.JNMS.2024_91-610","url":null,"abstract":"<p><p>The reliable engraftment of skin grafts into areas with complex shapes can be challenging. Here, we report a case of successful fixation of a genital skin graft using negative pressure wound therapy (NPWT) with RENASYS<sup>®</sup> Cotton Filler. A 44-year-old male with no relevant medical history underwent split-thickness skin grafting for a genital skin defect caused by Fournier's gangrene. A 0.4-mm sheet graft was applied for the penile skin defect, while 0.4-mm 1.5 times mesh grafting was applied for the testis and spermatic cord. NPWT with a cotton filler was used for seven days of fixation. No postoperative pain or stool contamination was observed. Although a small area of partial necrosis developed, the lesion healed with conservative treatment. Six months after surgery, there was no scar contracture, urination disorder, or pain during erection. Cotton fillers are highly malleable and adaptable, allowing for simple and reliable fixation of skin grafts in complex areas. Moreover, NPWT for genital graft fixation avoids contamination from stools. Therefore, we recommend fixation using NPWT with a cotton filler for genital skin grafting.</p>","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":"91 6","pages":"595-599"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Changes in Cerebrospinal Fluid Interleukin-6 Levels after Surgical Treatment of Subarachnoid Hemorrhage. 蛛网膜下腔出血手术治疗后脑脊液白细胞介素-6水平的变化
IF 1.2 4区 医学
Journal of Nippon Medical School Pub Date : 2024-01-01 DOI: 10.1272/jnms.JNMS.2024_91-410
Hidetaka Onda, Takahiro Kanaya, Yutaka Igarashi, Ryuta Nakae, Akira Fuse, Shoji Yokobori
{"title":"Changes in Cerebrospinal Fluid Interleukin-6 Levels after Surgical Treatment of Subarachnoid Hemorrhage.","authors":"Hidetaka Onda, Takahiro Kanaya, Yutaka Igarashi, Ryuta Nakae, Akira Fuse, Shoji Yokobori","doi":"10.1272/jnms.JNMS.2024_91-410","DOIUrl":"10.1272/jnms.JNMS.2024_91-410","url":null,"abstract":"<p><strong>Background: </strong>We measured postoperative changes in cerebrospinal fluid (CSF) interleukin (IL)-6 levels in subarachnoid hemorrhage (SAH) due to aneurysm rupture and examined factors associated with outcomes and cerebral vasospasm. We used physiologic saline or artificial CSF as the intraoperative irrigation fluid and examined the differences.</p><p><strong>Methods: </strong>The participants were 16 men and 41 women who were transported to our facility for SAH and underwent surgical treatment during the period from February 2012 through March 2015. In terms of severity, 31 cases were World Federation of Neurological Surgeons (WFNS) grade I-III and 26 cases were grade IV-V. All cases underwent clipping. Physiologic saline and artificial CSF were used as intraoperative irrigation fluid. We placed a ventricular drainage tube intraoperatively and collected CSF daily from postoperative day (POD) 1 through 10 or until drain removal.</p><p><strong>Results: </strong>IL-6 level varied from 74 pg/mL to 407,936 pg/mL and peaked on PODs 1 and 5. Patients with favorable outcomes had significantly lower postoperative IL-6 levels. POD 1 IL-6 level significantly differed in relation to the presence of cerebral vasospasm but was not associated with its timing or severity. Use of artificial CSF was associated with a significantly lower incidence of cerebral vasospasm. Age and WFNS grade were significantly associated with outcome, and use of artificial CSF had a tendency toward favorable outcomes.</p><p><strong>Conclusions: </strong>Artificial CSF is a potentially useful intervention when managing subarachnoid hemorrhage.</p>","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":"91 4","pages":"402-409"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
RNF213-Related Vasculopathy: Various Systemic Vascular Diseases Involving RNF213 Gene Mutations: Review. RNF213相关血管病:涉及 RNF213 基因突变的各种系统性血管疾病:回顾。
IF 1 4区 医学
Journal of Nippon Medical School Pub Date : 2024-01-01 DOI: 10.1272/jnms.JNMS.2024_91-215
Yasuo Murai, Fumihiro Matano, Asami Kubota, Yohei Nounaka, Eitaro Ishisaka, Kazutaka Shirokane, Kenta Koketsu, Ryuta Nakae, Tomonori Tamaki
{"title":"RNF213-Related Vasculopathy: Various Systemic Vascular Diseases Involving RNF213 Gene Mutations: Review.","authors":"Yasuo Murai, Fumihiro Matano, Asami Kubota, Yohei Nounaka, Eitaro Ishisaka, Kazutaka Shirokane, Kenta Koketsu, Ryuta Nakae, Tomonori Tamaki","doi":"10.1272/jnms.JNMS.2024_91-215","DOIUrl":"10.1272/jnms.JNMS.2024_91-215","url":null,"abstract":"<p><p>Moyamoya disease (MMD) is a cerebrovascular disorder that is predominantly observed in women of East Asian descent, and is characterized by progressive stenosis of the internal carotid artery, beginning in early childhood, and a distinctive network of collateral vessels known as \"moyamoya vessels\" in the basal ganglia. Additionally, a prevalent genetic variant found in most MMD cases is the p.R4810K polymorphism of RNF213 on chromosome 17q25.3. Recent studies have revealed that RNF213 mutations are associated not only with MMD, but also with other systemic vascular disorders, including intracranial atherosclerosis and systemic vascular abnormalities such as pulmonary artery stenosis and coronary artery diseases. Therefore, the concept of \"RNF213-related vasculopathy\" has been proposed. This review focuses on polymorphisms in the RNF213 gene and describes a wide range of clinical and genetic phenotypes associated with RNF213-related vasculopathy. The RNF213 gene has been suggested to play an important role in the pathogenesis of vascular diseases and developing new therapies. Therefore, further research and knowledge sharing through collaboration between clinicians and researchers are required.</p>","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":"91 2","pages":"140-145"},"PeriodicalIF":1.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141081383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Use of Fever Duration to Guide Management of Urinary Tract Infection. 利用发热持续时间指导尿路感染的治疗。
IF 1 4区 医学
Journal of Nippon Medical School Pub Date : 2024-01-01 DOI: 10.1272/jnms.JNMS.2024_91-208
Takeshi Yanagihara, Koichi Kobayashi, Emi Yanai, Hikaru Takeshita, Yujiro Tanabe, Yasuhiko Itoh
{"title":"Use of Fever Duration to Guide Management of Urinary Tract Infection.","authors":"Takeshi Yanagihara, Koichi Kobayashi, Emi Yanai, Hikaru Takeshita, Yujiro Tanabe, Yasuhiko Itoh","doi":"10.1272/jnms.JNMS.2024_91-208","DOIUrl":"https://doi.org/10.1272/jnms.JNMS.2024_91-208","url":null,"abstract":"<p><strong>Background: </strong>The appropriate duration of antimicrobial therapy for febrile urinary tract infection (fUTI) in children has not been established. This study examined the optimal duration of treatment for fUTI in children.</p><p><strong>Methods: </strong>We created a protocol that used fever duration to determine the duration of antibiotic administration. Transvenous antibiotics were administered until 3 days after resolution of fever, followed by oral antibiotics for 1 week. Diagnosis of fUTI was based on a fever of 37.5°C or higher and a quantitative culture of catheterized urine yielded a bacteria count of ≥5 × 10<sup>4</sup>. Acute focal bacterial nephritis (AFBN) and pyelonephritis (PN) were diagnosed on the basis of contrast-enhanced computed tomography (eCT) findings. We retrospectively reviewed treatment outcomes.</p><p><strong>Results: </strong>Of the 78 patients treated according to our protocol, data from 58 were analyzed-49 children (30 boys) had PN and nine (three boys) had AFBN. Blood test results showed that patients with AFBN had significantly higher white blood cell counts and C-reactive protein levels than did those with PN; however, urinary findings and causative bacteria did not differ between groups. Time to resolution of fever and duration of intravenous antibiotic administration were significantly longer in patients with AFBN than in those with PN. However, average duration of AFBN treatment was 14.2 days, which was shorter than the previously reported administration period of 3 weeks. No recurrence was observed in AFBN patients.</p><p><strong>Conclusions: </strong>A protocol that used fever duration to determine the duration of antimicrobial treatment was useful. Invasive examinations, such as eCT, were not required.</p>","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":"91 2","pages":"190-197"},"PeriodicalIF":1.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141081445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Usefulness of the Palliative Prognostic Index in Predicting Prognosis when Considering the Transition from Hospital to Home Care in Patients with Terminal Stage Cancer. 在考虑癌症晚期患者从医院向家庭护理过渡时,姑息预后指数在预测预后方面的实用性。
IF 1 4区 医学
Journal of Nippon Medical School Pub Date : 2024-01-01 DOI: 10.1272/jnms.JNMS.2024_91-107
Shiho Sakaguchi, Masahiro Sakaguchi, Shunsuke Honma, Tomohiro Yagi, Gakuji Osawa, Akira Hirano, Hiroki Yamaguchi, Takayuki Hisanaga, Shunichi Shiozawa
{"title":"Usefulness of the Palliative Prognostic Index in Predicting Prognosis when Considering the Transition from Hospital to Home Care in Patients with Terminal Stage Cancer.","authors":"Shiho Sakaguchi, Masahiro Sakaguchi, Shunsuke Honma, Tomohiro Yagi, Gakuji Osawa, Akira Hirano, Hiroki Yamaguchi, Takayuki Hisanaga, Shunichi Shiozawa","doi":"10.1272/jnms.JNMS.2024_91-107","DOIUrl":"10.1272/jnms.JNMS.2024_91-107","url":null,"abstract":"<p><strong>Background: </strong>No accurate prognostic tool is available for patients with cancer who spend their final days at home. In this study, we examined whether performance status (PS) and the palliative prognostic index (PPI), a well-known prognostic tool in palliative care units, could be used to predict prognosis in the home care setting at the time of intervention by home physicians.</p><p><strong>Subjects and methods: </strong>Using medical records, we conducted a retrospective analysis of 132 patients who were referred to the Home Clinic Naginoki for home care for terminal stages of carcinoma in situ. Based on the status at the time of the first visit, the PPI-Low group was defined as those scoring six or below and the PPI-High group as those scoring greater than six.</p><p><strong>Results: </strong>The PPI-high group had a significantly poorer prognosis within 21 days than the PPI-low group (21-day-OS; Low 71.4% vs. High 13.2%; p<0.001). The Eastern Cooperative Oncology Group (ECOG) PS alone predicted better prognosis in the group with PS of one or two (21-day survival 90.1%), and the PPI score further significantly stratified the prognosis for patients with PS three or four, with a trend toward poor prognosis (p ≤ 0.005).</p><p><strong>Conclusion: </strong>ECOG PS 1 or 2 has a favorable prognosis and that using PPI in ECOG PS 3 or 4 leads to a more accurate prognosis prediction. PPI evaluated during the hospital-based treatment of patients with terminal cancer can also be used to predict prognosis if the patient is transitioned to a home care environment.</p>","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":"91 1","pages":"74-82"},"PeriodicalIF":1.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140095224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association between Postoperative Adjuvant Vasodilator Therapy and In-Hospital Mortality for Non-Occlusive Mesenteric Ischemia: A Nationwide Observational Study. 非闭塞性肠系膜缺血术后辅助血管扩张剂治疗与住院死亡率之间的关系:一项全国性观察研究。
IF 1.2 4区 医学
Journal of Nippon Medical School Pub Date : 2024-01-01 DOI: 10.1272/jnms.JNMS.2024_91-310
Toru Takiguchi, Mikio Nakajima, Hiroyuki Ohbe, Yusuke Sasabuchi, Takashi Tagami, Richard H Kaszynski, Hiroki Matsui, Kiyohide Fushimi, Shiei Kim, Shoji Yokobori, Hideo Yasunaga
{"title":"Association between Postoperative Adjuvant Vasodilator Therapy and In-Hospital Mortality for Non-Occlusive Mesenteric Ischemia: A Nationwide Observational Study.","authors":"Toru Takiguchi, Mikio Nakajima, Hiroyuki Ohbe, Yusuke Sasabuchi, Takashi Tagami, Richard H Kaszynski, Hiroki Matsui, Kiyohide Fushimi, Shiei Kim, Shoji Yokobori, Hideo Yasunaga","doi":"10.1272/jnms.JNMS.2024_91-310","DOIUrl":"10.1272/jnms.JNMS.2024_91-310","url":null,"abstract":"<p><strong>Background: </strong>Although several clinical guidelines recommend vasodilator therapy for non-occlusive mesenteric ischemia (NOMI) and immediate surgery when bowel necrosis is suspected, these recommendations are based on limited evidence.</p><p><strong>Methods: </strong>In this retrospective nationwide observational study, we used information from the Japanese Diagnosis Procedure Combination inpatient database from July 2010 to March 2018 to identify patients with NOMI who underwent abdominal surgeries on the day of admission. We compared patients who received postoperative vasodilator therapy (vasodilator group) with those who did not (control group). Vasodilator therapy was defined as venous and/or arterial administration of papaverine and/or prostaglandin E1 within 2 days of admission. The primary outcome was in-hospital mortality. Secondary outcomes included the prevalence of additional abdominal surgery performed ≥3 days after admission and short bowel syndrome.</p><p><strong>Results: </strong>We identified 928 eligible patients (149 in the vasodilator group and 779 in the control group). One-to-four propensity score matching yielded 149 and 596 patients for the vasodilator and control groups, respectively. There was no significant difference in in-hospital mortality between the groups (control vs. vasodilator, 27.5% vs. 30.9%; risk difference, 3.4%; 95% confidence interval, -4.9 to 11.6; p=0.42) and no significant difference in the prevalences of abdominal surgery, bowel resection ≥3 days after admission, and short bowel syndrome.</p><p><strong>Conclusions: </strong>Postoperative vasodilator use was not significantly associated with a reduction in in-hospital mortality or additional abdominal surgery performed ≥3 days after admission in surgically treated NOMI patients.</p>","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":"91 3","pages":"316-321"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141556035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluation of Coronary Circulation by 13N-Ammonia Myocardial Perfusion Positron Emission Tomography in Patients with Right Coronary Artery Occlusion Due to Kawasaki Disease. 通过 13N-Ammonia 心肌灌注正电子发射断层扫描评估川崎病右冠状动脉闭塞患者的冠状动脉循环。
IF 1.2 4区 医学
Journal of Nippon Medical School Pub Date : 2024-01-01 DOI: 10.1272/jnms.JNMS.2024_91-306
Nobuko Suzuki, Makoto Watanabe, Tomonari Kiriyama, Shogo Imai, Masanori Abe, Ryuji Fukazawa, Yasuhiko Itoh
{"title":"Evaluation of Coronary Circulation by <sup>13</sup>N-Ammonia Myocardial Perfusion Positron Emission Tomography in Patients with Right Coronary Artery Occlusion Due to Kawasaki Disease.","authors":"Nobuko Suzuki, Makoto Watanabe, Tomonari Kiriyama, Shogo Imai, Masanori Abe, Ryuji Fukazawa, Yasuhiko Itoh","doi":"10.1272/jnms.JNMS.2024_91-306","DOIUrl":"https://doi.org/10.1272/jnms.JNMS.2024_91-306","url":null,"abstract":"<p><strong>Background: </strong>Although occlusion of the right coronary artery (RCA) is common in the remote stages of Kawasaki disease, revascularization of the RCA is challenging in children and is usually managed by observation without intervention.</p><p><strong>Methods: </strong>Using adenosine-stress <sup>13</sup>N-ammonia myocardial perfusion positron emission tomography, we evaluated coronary circulation in 14 patients (12 males) with RCA occlusion to identify ischemia (myocardial flow ratio < 2.0) in the RCA region and examined hemodynamics, cardiac function, and coronary aneurysm diameter. These variables were also compared in patients with/without RCA segmental stenosis (SS).</p><p><strong>Results: </strong>There were five cases of ischemia in the RCA region. RCA myocardial blood flow (MBF) at rest was higher in patients with ischemia than in those without ischemia, but the difference was not significant (1.27 ± 0.21 vs. 0.82 ± 0.16 mL/min/g, p = 0.2053). Nine patients presented with RCA SS, and age at onset of Kawasaki disease tended to be lower in those with SS. The maximum aneurysm diameter of RCA was significantly smaller in patients with SS (10.0 ± 2.8 vs. 14.7 ± 1.6, p = 0.0239). No significant differences in other variables were observed between patients with/without ischemia and SS.</p><p><strong>Conclusions: </strong>At rest, MBF in the RCA region was relatively well preserved, even in patients with RCA occlusion, and there was no progressive deterioration in cardiac function. Adenosine stress showed microcirculatory disturbances in only half of the patients, indicating that it is reversible in children with Kawasaki disease.</p>","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":"91 3","pages":"277-284"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141556039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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