ABSTRACT
Objective：We identified the factors that influenced the effect of the Wearable Cyborg Hybrid Assistive Limb (HAL) in patients with amyotrophic lateral sclerosis (ALS).Methods：The subjects were patients with ALS who were admitted to our hospital, and all of them underwent HAL intervention. The changes in 2-minute walking distance (2 MD) before and after 1 course of HAL intervention were investigated. Next, we examined the factors that influence the degree of 2 MD improvement using patient attributes and indices of body composition, nutritional status, respiratory function, and ADL (Activities of Daily Living) before HAL intervention.Results：Thirteen subjects showed significant improvement in 2 MD measured before and after the HAL intervention (median 2 MD [quartile] before intervention－median 2 MD [quartile] after intervention：36.0 [32-94.49] m－74.1 [32.75-117.8] m, p＝0.001). The Barthel Index (BI) and phase angle were identified as the factors that influenced the degree of 2 MD improvement (ANOVA：p＝0.004).Conclusion：The results suggest that the degree of improvement in 2 MD by HAL intervention in patients with ALS was the most affected by their BI and phase angle before the intervention. Thus, BI and phase angle may be useful as predictors in the degree of 2 MD improvement by HAL intervention in patients with ALS.
ABSTRACT
In recent years, arteriosclerosis obliterans (ASO) has become one of the most common diseases with obesity, high blood pressure and other lifestyle-related diseases such as hyperlipemia. Westernization of the eating habits of the Japanese and progress of the aging society accounts for the increasing occurrence of these health problems. Early detection and early treatment of ASO help not only improve the quality of life of the patients but also get off without amputation of lower limbs and better the prognosis for survival. It is necessary to evaluate the narrowing of blood vessels or the form of occlusion for treatment of ASO. It is particularly important to know the state of the peripheral arteries below the obstructed region in cases with the complete occlusion. Lately, with the addition of many lines to multislice CT (MSCT) and the improvement of the performance of the workstation, angiography for diagnostic purposes has gradually been replaced by MSCT. In this paper, we report two cases of ASO and the successful application of MSCT using 64 Data Acquisition System (DAS) in the examination prior to ASO bypass surgery.
Subject(s)
Tomography, X-Ray ComputedABSTRACT
Abdominal aortic aneurysm and cystic kidneys are both common diseases that have been increasingly detected due to the development of medical screening instruments, such as computed tomography and ultrasonography. We occasionally intraoperatively encounter abdominal aortic aneurysms accompanying cystic renal lesions. However, there have been extremely few reports about abdominal aortic aneurysms complicated by cystic renal disease. Large renal cysts or polycystic kidneys are at risk of rupture or intraoperative hemorrhage, and can hinder the surgical treatment of abdominal aortic aneurysm. Therefore, there is a significant need for surgeons to be able to preoperatively determine the potential of an interruption of the procedure, for example, due to a cystic lesion. In this paper, we report a case of a 77-year-old man with abdominal aortic aneurysm who complained of abdominal fullness due to the presence of large cystic lesions in both kidneys. Preoperatively we aspirated 1, 550ml percutaneously from bilateral renal cysts under ultrasonographic guidance, but did not instill sclerosing agents, such as ethanol. Three days after the percutaneous aspiration, surgical treatment of the abdominal aortic aneurysm (5.2cm in diameter), the left common iliac arterial aneurysm and the right common iliac arterial aneurysm (3.0 and 2.6cm in diameter) was performed through a median abdominal incision with a retroperitoneal approach. The arterial prosthesis used was a Y-shaped woven double velour vascular graft. The postoperative course was uneventful and the patient was discharged 14 days after the vascular reconstruction procedure. Our experience suggests that percutaneous aspiration of large renal cysts that might hinder the surgical procedure for abdominal aortic aneurysm is useful.