1 0 0 0 OA コーニス症候群と救命治療後合併症の内胸動脈損傷にTAEが有効であった一例
- 著者
- 朱 佐木 木曽原 昌也 深谷 有 三宅 庸介 河合 辰哉 樋渡 昭雄
- 出版者
- 一般社団法人 日本放射線科専門医会・医会
- 雑誌
- 日本放射線科専門医会・医会学術雑誌 (ISSN:27586499)
- 巻号頁・発行日
- vol.3, pp.90-93, 2023 (Released:2023-12-06)
- 参考文献数
- 5
In recent years, there has been an increase in reported cases of acute coronary syndrome, as-sociated with allergic reactions, namely Kounis syndrome. In this report, we present a case of suspected Kounis syndrome that occurred after the administration of contrast media.A female patient in her 60s with a medical history of paroxysmal atrial fibrillation, lower limb arteriosclerosis obliterans, and end-stage renal failure underwent contrast-enhanced CT using iodinated contrast media for the evaluation of lower limb arteriosclerosis obliterans. Imme-diately after administration of the contrast media, she experienced itchiness and rash on the right lower-back, followed by difficulty breathing and intense neck pain. Subsequently, she experienced cardiopulmonary arrest and was treated with cardiopulmonary resuscitation. Electrocardiogram revealed ST elevation in the II, III, and aVF leads. Subsequent coronary angiography revealed complete occlusion of the right coronary artery. The patient underwent successful percutaneous coronary intervention. The day after treatment, contrast-enhanced CT showed extravasations at the bilateral internal mammary arteries which were treated with transcatheter arterial embolization. The patient's condition improved, and she was discharged.Kounis syndrome is classified into three types. Type I is caused by coronary artery spasm, type II is caused by rupture of a coronary artery plaque and subsequent thrombus formation, and type III is caused by stent thrombosis. Our case was likely diagnosed as type II based on her cardiovascular risk factors and complete occlusion of the right coronary artery. It appears to be important to recognize the symptoms and physical findings suggestive of acute coronary syndrome during the management of anaphylactic reactions and to consider Kounis syndrome as a potential diagnosis.
1 0 0 0 OA ためこみ症と強迫症・不安症の生物学的差異の検討
ためこみ症17名と、年齢・性別をマッチさせた強迫症患者、健常対照群それぞれ17名が本研究に参加した。3群の灰白質体積に差が存在するかを調査した。3群の平均年齢はそれぞれためこみ症:43.9±11.5歳、強迫症:39.9±9.0歳、健常対照群:42.4±10.4歳だった。分散分析において、右前頭前野で3群の間に有意な体積の差異を認めた。OCDと同様に、HDは認知機能障害をその基礎として有すると考えられている。 この結果は、HDの臨床的特徴を考慮した上で説得力があり、前頭前野領域の構造異常がHDの病態生理学に関連する可能性が示唆された。