- 著者
- Takashi Ueno Tokuya Omi Eiji Uchida Hiroyuki Yokota Seiji Kawana
- 出版者
- 日本医科大学医学会
- 雑誌
- Journal of Nippon Medical School (ISSN:13454676)
- 巻号頁・発行日
- vol.81, no.1, pp.4-11, 2014 (Released:2014-03-10)
- 参考文献数
- 23
- 被引用文献数
- 7 20
Background: Treating chronic wounds is challenging. Despite standard wound care, some chronic wounds fail to heal. Therefore, hyperbaric oxygen therapy (HBOT) was developed as an adjunct to standard wound care. Objective: To evaluate the efficacy of HBOT for treating chronic wounds due to a variety of causes at our institution. Methods: We reviewed the medical records of patients with chronic wounds treated with HBOT in addition to standard wound care at the Department of Dermatology, Nippon Medical School Hospital, from 2009 through 2012. Twenty-nine patients were reviewed (14 men and 15 women; mean age, 64.1±14.4 years). The cause of chronic wounds was diabetes mellitus (DM) in 13 patients, venous stasis in 10, polyarteritis nodosa cutanea in 2, and livedoid vasculopathy, pyoderma gangrenosum, chronic renal failure, and systemic sclerosis in 1 patient each. The patients underwent HBOT for 60 minutes with 100% oxygen delivered via a mask in a hyperbaric chamber pressurized to 2.8 atmospheres of absolute pressure. The response of the chronic wounds to HBOT was evaluated according to the following criteria: "excellent": more than 90% wound healing; "good": a greater than 30% reduction in wound size, and wound healing was confirmed on follow-up visits within 6 weeks; "fair": wound healing was achieved with a combination of further invasive interventions; and "poor": the wound showed a less than 30% reducion or worsened during HBOT, or wound healing had not been completed by follow-up visits within 6 weeks. Results: The response to HBOT was "excellent" in 6 patients, "good" in 8, "fair" in 11, and "poor" in 4. All 4 patients with a "poor" response had DM and had undergone hemodialysis. Conclusions: HBOT is an effective treatment for patients with chronic wounds, due to a variety of causes, when used in combination with conventional standard therapy or further interventions. However, HBOT is less effective in patients with DM than in patients with venous stasis because hemodialysis, which is more common in patients with DM, has negative effects on wound healing.
- 著者
- Hayato HIRASHIMA Naoki UCHIDA Ichiro FUKAZAWA Seiichiro ISHIGAKI Eiji UCHIDA Hajime YASUHARA
- 出版者
- The Japanese Society of Clinical Pharmacology and Therapeutics
- 雑誌
- 臨床薬理 (ISSN:03881601)
- 巻号頁・発行日
- vol.37, no.3, pp.127-133, 2006-05-31 (Released:2010-06-28)
- 参考文献数
- 33
- 被引用文献数
- 2 3
There are many reports on grapefruit juice (GFJ) increasing the apparent oral bioavailability of several clinically important drugs metabolized by the most abundant isoform of cytochrome P450, i. e. CYP 3A4. Azelnidipine (Calblock ®) is a long-lasting 1, 4-dihydropyridine calcium antagonist currently used in the treatment of hypertension in Japan. In a drug interaction study using human liver microsomes, several CYP3A4 inhibitors and substrates inhibited the oxidative metabolism of azelnidipine to the same extent as nifedipine and felodipine. In order to evaluate the possible interaction of azelnidipine with GFJ in humans, a randomized, two-way crossover study was conducted in eight Japanese healthy volunteers.A single oral dose of 8mg azelnidipine was administered orally with either 250mL water or GFJ after overnight fasting. Blood samples were drawn periodically up to 24hours after dosing. Plasma concentrations of azelnidipine were measured by liquid chromatography-tandem mass spectrometry (LC/APCI-MS/MS).Concomitant administration of azelnidipine with GFJ increased the mean Cmax of azelnidipine by 2.5-fold and the AUC by 3.3-fold compared with water; moreover, the time to reach Cmax (tmax) and the mean residence time (MRT) were slightly delayed. No serious adverse events were observed except one subject described mild symptoms of drug-related headache and flushing accompanied with orthostatic hypotension at 4hrs after administration in the GFJ phase.The results demonstrated the pharmacokinetic interaction between azelnidipine and a single glass of GFJ.
- 著者
- Takuma Iwai Hiroshi Yoshida Tadashi Yokoyama Hiroshi Maruyama Seiji Suzuki Takeshi Matsutani Akira Matsushita Atsushi Hirakata Koji Sasajima Eiji Uchida
- 出版者
- 日本医科大学医学会
- 雑誌
- Journal of Nippon Medical School (ISSN:13454676)
- 巻号頁・発行日
- vol.78, no.3, pp.189-193, 2011 (Released:2011-06-30)
- 参考文献数
- 17
- 被引用文献数
- 3 5 3
We describe a patient in whom a fish bone penetrated the duodenum and migrated into the right renal vein. The bone was successfully removed with surgery. The 75-year-old man was admitted to Nippon Medical School Tama Nagayama Hospital because of right upper abdominal pain persisting for 7 days. The patient's medical history was not relevant to the current disorder. Plain radiography showed no abnormalities. Computed tomography revealed a linear object of high intensity that had penetrated the duodenum and migrated into the right renal vein with thrombus. The object was surrounded by a low-density area, suggesting severe inflammation. The patient had eaten fish 1 day before the onset of abdominal pain. We diagnosed duodenal penetration caused by an ingested fish bone. Endoscopic examination showed erosion, but no fish bone or ulceration was detected in the duodenum. The patient was treated conservatively with fasting, peripheral parental nutrition, and intravenous antibiotics. Three days after admission, non-contrast-enhanced computed tomography showed no movement of the foreign body. The patient continued to have pain, and the decision was made to surgically explore the abdomen. Intraoperative ultrasonography showed that the foreign body had migrated completely into the right renal vein with thrombus. Severe inflammation of the right renal vein was observed. Because we could not remove the foreign body without seriously injuring the right renal vein, right nephrectomy was performed. Macroscopic examination of the surgical specimen confirmed the presence of a fish bone with thrombus in the right renal vein. The patient was discharged 9 days after operation, with no complications.