ABSTRACT
<b><i>Abstract</i></b><br><b>Objective</b> : Laninamivir Octanoate (LO) is a novel anti-influenza drug administered by inhalation only once administration, and with a very simple dosage adjustment regimen. Conversely, inhalation might be expected to fail in some groups of patients, particularly the very young and very elderly because of poor inhalation technique. Therefore, we undertook a study to investigate the success and failure rates of the dry powder inhalation formulation of LO.<br><b>Methods</b> : We observed 159 patients who were prescribed LO. Pharmacists observed the administration technique after explaining how to inhale the drug. Success was defined as patients who could inhale the drug without a problem. Failure was defined as those patients who were judged to have inhaled less than 75％ of the drug. We also examined the success rate between pharmacies and the success and failure rates according to age.<br><b>Results</b> : A 4-years-old patient was the youngest to fail LO therapy whereas a 5-years-old patient was the youngest to succeeded with the therapy. The success rate did not differ significantly between pharmacies. The success rate was 88.9％ in patients under the age of 9 years, but which was significantly lower compared with 97.9％ in the group of patients over 10 years of age.<br><b>Conclusion</b> : This survey revealed that many cases of inhalation failure of LO anti-influenza therapy occur below the age of 9 year.
ABSTRACT
Dacron prostheses are the most widely used grafts in replacement procedures for abdominal aortic aneurysms, but they are not perfect grafts. We encountered a rare case of late graft complication. A 66-year-old man was admitted to our hospital with a pulsatile mass in an abdominal operation scar. He had received placement of a Y-shaped Cooley double velour knitted Dacron graft 18 years previously. Computed tomography and angiography demonstrated graft dilatation and an aneurysm. After resection of the graft aneurysms, the operative findings showed a non-anastomotic aneurysm formation due to longitudinal division near the graft guideline. In this case, this graft failure may have been due to the deterioration of the filter of the Dacron prosthesis itself. Therefore it is important to perform careful long-term follow-up in patients with implanted Dacron arterial prostheses.
ABSTRACT
Bypass grafting from the ascending thoracic aorta to the common iliac artery was performed to manage proximal hypertension in a patient with atypical coarctation of the thoracic aorta. The patient's history was significant for an acute aortic thrombosis at the level of the diaphragm for which she underwent an axillo-bifemoral bypass grafting as an emergency operation. Although she was doing well following the initial bypass grafting, the second bypass grafting was required to treat proximal hypertension refractory to medical management. The axillo-femoral bypass graft had a smaller diameter and a longer subcutaneous distance, and the blood supply to the abdominal viscera may have been insufficient. The proximal hypertension was well controlled following ascending thoracic aorta to common iliac bypass, because the diameter (16mm) of the graft is larger than that of the axillo-bifemoral bypass graft (8mm).