Abdominal Vacuum-Assisted Closure for Secondary Abdominal Fascial Closure into Open Abdomen after Surgical Repair for Ruptured Abdominal Aortic Aneurysm / 日本心臓血管外科学会雑誌

Secondary abdominal fascial closure by abdominal vacuum-assisted closure (VAC) therapy is required for abdominal organ protection and prevention of infection due to abdominal compartment syndrome (ACS) developing after the surgery. In this paper, we present our experience with abdominal VAC therapy for two cases that required open abdominal management after surgical repair for ruptured abdominal aortic aneurysm, with favorable outcomes. Case 1 involved a 72-year-old man who underwent endovascular aortic repair for ruptured abdominal aortic aneurysm. Abdominal VAC therapy was started after decompression laparotomy because he developed ACS immediately after surgery. Secondary abdominal fascial closure was performed on day 4 postoperatively, and he had no complications. Case 2 involved a 71-year-old man who underwent emergency Y-graft replacement for ruptured abdominal aortic aneurysm. We considered secondary abdominal fascial closure necessary because of prominent intestinal edema and massive retroperitoneal hematoma, and performed abdominal VAC therapy. We changed the VAC system on day 4, postoperatively and performed secondary abdominal fascial closure on day 7, postoperatively. Abdominal VAC therapy is considered effective and safe for patients requiring secondary abdominal fascial closure after abdominal surgery.

Central nervous system infection following allogeneic hematopoietic stem cell transplantation

Objective / background: Here, we described the clinical characteristics and outcomes of central nervous system [CNS] infections occurring after allogeneic hematopoietic stem cell transplantation [allo-HSCT] in a single institution over the previous 6 years

Methods: Charts of 353 consecutive allogeneic transplant recipients were retrospectively reviewed for CNS infection

Results: A total of 17 cases of CNS infection were identified at a median of 38 days [range, 10- 1028 days] after allo-HSCT. Causative pathogens were human herpesvirus-6 [n = 6], enterococcus [n = 2], staphylococcus [n = 2], streptococcus [n = 2], varicella zoster virus [n = 1], cytomegalovirus [n = 1], John Cunningham virus [n = 1], adenovirus [n = 1], and Toxoplasma gondii [n = 1]. The cumulative incidence of CNS infection was 4.1% at 1 year and 5.5% at 5 years

Conclusion: Multivariate analysis revealed that high-risk disease status was a risk factor for developing CNS infection [p = .02], and that overall survival at 3 years after allo-HSCT was 33% in patients with CNS infection and 53% in those without CNS infection [p = .04]

Aortic Arch Aneurysm 7 Years after Aortic Root Replacement in a Patient of Loeys-Dietz Syndrome / 日本心臓血管外科学会雑誌

<p>A 14-year-old women who had a history of aortic root replacement at 7 years old admitted our hospital due to dilatation of aortic arch aneurysm. Loeys-Dietz syndrome was diagnosed when she was 10 years old. Computed tomography showed 70 mm proximal arch aneurysm. Operative findings revealed brachiocephalic artery and left common carotid artery branched from aneurysm. Partial arch replacement was performed and distal anastomosis was made between left common carotid artery and left subclavian artery. Close observation by CT regularly is necessary and undergo aortic repair not to miss the timing of surgery.</p>

Psoriatic Arthritis That Responded Dramatically When Infliximab Was Switched to Adalimumab

No abstract available.

Development of standard on acupuncture and moxibustion in Japan: current status and thinking / 中国针灸

The current development situation of acupuncture and moxibustion standard in Japan is introduced from three aspects including State Standard, Industry Standard and Enterprise Standard. Now there are one State Standard (Standard of Acupuncture Needle for Single Use), nine Industry Standards and several Enterprise Standards in Japan. Yet there are some problems in the current standardization research, such as inadequate numbers, no related standards in some important fields, moreover, because Japanese government does not give enough attention, supports from the state is also less. In a word, the standardization of acupuncture and moxibustion in Japan has just started, and it needs further development.

Relationship between the family composition and medical expenses of diseases of the circulatory system. An analysis on medical expenses for the elderly people in national health insurance / 日本農村医学会雑誌

To examine relationship between the family composition and medical expenses for circuration diseases in the elderly people who were 65 or more, we analysed the 1982 and 1983 data of medical expenses of national health insurance in the rural area of Fukuoka Prefecture.<BR>The elderly people were classified into five groups according to whether they were living with their children and whether their spouse was alive.<BR>The results were as follows:<BR>1) In the elderly people who were living with their children, the medical expenses were low among those living with their spouses and high among those living without.<BR>2) In the elderly people who were not living with their children, the medicalexpenses were low among the elderly men with their spouses and high among the eldrly women without.<BR>3) In the elderly people who were living alone, the elderly men and women had low medical expenses in hospital services and ambulatory services.<BR>4) The medical expenses for circulation diseases were more influenced by the presence of spouses than living with their children.