2016-06 http://hdl.handle.net/10564/3295 2026-04-09T03:55:35Z 2026-04-09T03:55:35Z 上原, 彰允 菅生, 裕輝 横内, 剛 立石, 恵実 中川, 陽子 石神, 賢一 神古, 智子 杉本, 雅史 濱野, 一將 http://hdl.handle.net/10564/3301 2017-05-29T06:09:31Z 2016-06-29T15:00:00Z

タイトル: コハク酸シベンゾリンにより遷延する低血糖症を来した維持透析患者の一例 著者: 上原, 彰允; 菅生, 裕輝; 横内, 剛; 立石, 恵実; 中川, 陽子; 石神, 賢一; 神古, 智子; 杉本, 雅史; 濱野, 一將 抄録: Cibenzoline succinate (Cibenzoline, CZ) may cause hypoglycemia as a side effect. Because CZ is mainly excreted by kidney, it is contraindicated in patients who are on hemodialysis. We experienced a case of prolonged hypoglycemia induced by CZ in a dialysis patient. He was prescribed CZ as medication to be taken as needed for palpitations related to atrial fibrillation attacks. Approximately 9 months later, he was brought to our hospital by ambulance due to chest oppression and general fatigue. He developed hypoglycemic coma on the third hospital day. The high serum concentration of immunoreactive insulin and serum C-peptide immunoreactivity suggested enhanced insulin secretion. The toxic plasma concentration of CZ (2,140 ng/ml) indicated that his hypoglycemic coma was induced by CZ. He needed intravenous hypertonic glucose injection for about 20 days to prevent the recurrence of hypoglycemia. The hypoglycemia induced by CZ may be prolonged over a few weeks in patients with reduced renal function, including patients on hemodialysis.

2016-06-29T15:00:00Z 梶本, 衣里奈 浪崎, 正 竹田, 惣一 澤田, 保彦 高谷, 広章 北出, 光輝 田原, 一樹 吉治, 仁志 山尾, 純一 沢井, 正佳 http://hdl.handle.net/10564/3300 2017-05-29T06:09:36Z 2016-06-29T15:00:00Z

タイトル: 硬膜外膿腫からMSSA菌血症となり食道静脈癌破裂にいたったアルコール性肝硬変の一例 著者: 梶本, 衣里奈; 浪崎, 正; 竹田, 惣一; 澤田, 保彦; 高谷, 広章; 北出, 光輝; 田原, 一樹; 吉治, 仁志; 山尾, 純一; 沢井, 正佳 抄録: Here we present a case of variceal hemorrhage induced by methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia with epidural abscess in alcoholic cirrhosis. A 65-year-old man with a prior diagnosis of alcoholic cirrhosis, type 2 diabetes mellitus, and hypertension presented with hematemesis to the community hospital He was referred to our hospital for further examination and treatment because sources of bleeding were not identified, despite the existence of esophageal varices during the endoscopic examination at the community hospital. Laboratory examination revealed hemoglobin of 10g/dl, total leukocyte count of 8000 with 76% of neutrophils, platelet count of 470,000/μ1, and prothrombin time of 64%. An emergency endoscopy in our hospital revealed esophagogastric varices (LmF2CbRC2-Lg-cfF2RC0) without active hemorrhage. EIS was performed with 5% ethanolamine oleate to treat esophageal varices on days 2 and 14 of his hospital stay. Follow-up esophagogastroduodenoscopy after EIS demonstrated improvement of esophageal varices graded as LiCwF1RC0. He was admitted with a temperature of 40.0℃ and a complaint of severe back pain. He was identified as being positive for MSSA, and severe back pain remained unchanged. Magnetic resonance imaging revealed a spinal epidural abscess and pyogenic spondylodiscitis at L3-L4 on day 9 of his hospital stay. He was intravenously administered antibiotics for 5 weeks during admission. His temperature returned to normal, and blood tests for markers, such as white blood count and C-reactive protein level, were completely normalized on the day 16 of his stay. He was discharged on oral antibiotics on the day 36 in good condition.

2016-06-29T15:00:00Z 田原, 一樹 四宮, 敏章 山﨑, 正晴 高橋, 正裕 井川, 大輔 http://hdl.handle.net/10564/3299 2017-05-29T06:09:36Z 2016-06-29T15:00:00Z

タイトル: がんによる神経障害性疼痛の背景とその制御に影響する要因の分析 著者: 田原, 一樹; 四宮, 敏章; 山﨑, 正晴; 高橋, 正裕; 井川, 大輔 抄録: We analyzed the background of neuropathic pain due to cancer and the factors that affect its control among 241 patients with cancer pain who were referred to our department from 2007 to 2012. The patients were divided into neuropathic pain (NP: 94 cases) and other pain groups (OP: 147 cases) for comparison of background factors and treatment interventions. There was no significant difference between the numerical rating scale (NRS) scores of the NP and OP groups both at the time of intervention at our department, and 3 weeks after the intervention at our department. In the study of treatment intervention, both groups had increased opioid and adjuvant analgesic usage, with analgesic usage increasing from the time of initial consultation at our department to the time of the intervention three weeks later. In particular, adjuvant analgesic usage had increased markedly from 24.5% to 91.5% in the NP group. The causative site of pain had been included in the irradiation area in all cases in which radiation therapy (RT) had been commenced within three weeks of the intervention. The RT enforcement rate was significantly higher in the NP vs. the OP group (36.1% vs. 19.7%; P=0.007). Our results suggest that neuropathic pain, which is generally intractable, can also be controlled by adjuvant analgesic usagec ombined with RT, as with other types of pain.

2016-06-29T15:00:00Z Fukuoka, Atsuhiko Ueda, Masahide Ariyama, Yutaka Iwai, Kazunori Kai, Yoshiro Kunimatsu, Mikikazu Yoshikawa, Masanori Uyama, Hiroki Tomoda, Koichi Kimura, Hiroshi http://hdl.handle.net/10564/3298 2017-06-11T23:20:26Z 2016-06-29T15:00:00Z

タイトル: Effect of Laughter Yoga on Pulmonary Rehabilitation in Patients with Chronic Obstructive Pulmonary Disease. 著者: Fukuoka, Atsuhiko; Ueda, Masahide; Ariyama, Yutaka; Iwai, Kazunori; Kai, Yoshiro; Kunimatsu, Mikikazu; Yoshikawa, Masanori; Uyama, Hiroki; Tomoda, Koichi; Kimura, Hiroshi 抄録: Objective: To evaluate the clinical usefulness of laughter yoga for patients with chronic obstructive pulmonary disease (COPD) in a pulmonary rehabilitation setting. Design: Pilot study, with randomization of participants. Setting: This study was conducted by the Yoshino-cho National Health Insurance Yoshino Hospital Department of Internal Medicine. Participants: Stable outpatients with COPD (7 men and 1 woman, age 64 to 84 years) participated in the pulmonary rehabilitation program during a 2-week period. Intervention : The patients were divided into two groups based on a sealed envelope randomization method. The laughter yoga group had a 10-min laughter yoga session before exercise training. Patients in both groups had exercise training, educational programs, lung physiotherapy, and nutrition counseling. Outcome Measures: Health-related quality of life using the St. George's Respiratory Questionnaire (SGRQ) and the Medical Research Council (MRC) Health Survey Short Form 36-item (SF-36), depression scores using the Self-rating Depression Scale (SDS), anxiety scores using State-Trait Anxiety Inventory (STAI), and spirometry, the 6-minute walk test and mMRC dyspnea scale results were evaluated before and at 2 weeks after the program in both groups. Results: There were significant improvements in the SGRQ impacts domain and the SF-36 general health domain in the laughter yoga group, while the SF-36 physical functioning domain significantly improved in the control group. SDS and STAI result did not significantly change in either group. Spirometry, the 6-minute walk test, and MRC dyspnea scale results did not significantly change in either group. Conclusion: Laughter yoga may improve the psychological quality of life in patients with COPD.

2016-06-29T15:00:00Z