著者

Tsuyoshi Shimizu Makoto Sakamoto Hideki Kamitani Masamichi Kurosaki

出版者

The Japanese Society for Neuroendovascular Therapy

雑誌

Journal of Neuroendovascular Therapy (ISSN:18824072)

巻号頁・発行日

pp.cr.2022-0055, (Released:2022-12-22)

参考文献数

13

被引用文献数

1

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Objective: Marfan’s syndrome (MFS) is a systemic connective tissue disorder with autosomal dominant inheritance. Cardiovascular complications of MFS such as aortic root or valve disease and aortic aneurysm or dissection are potential cause of access route problems of mechanical thrombectomy (MT) for acute ischemic stroke (AIS). Here, we report a case of a patient with MFS who underwent MT for AIS.Case Presentation: A 58-year-old woman with MFS presented with a sudden onset of consciousness disturbance and right hemiparesis, and was referred to our hospital. After the infusion of tissue plasminogen activator, CTA showed a type III arch in the aortic arch and severe tortuosity of the thoracoabdominal aorta; thus, angiography was performed using the transbrachial approach. Left common carotid angiogram showed complete recanalization of the left middle cerebral artery. On the sixth day, the patient presented a sudden consciousness disturbance and left hemiparesis. MRA showed right internal carotid artery occlusion. MT was performed by the transbrachial approach, and complete recanalization was achieved on the first pass.Conclusion: MT via the transbrachial approach is a treatment option that should be considered, especially in MFS, where the transfemoral approach is difficult due to anatomical problems.

著者

Hidefumi Amisaki Hirochika Takeuchi Makoto Sakamoto Hisashi Shishido

出版者

The Japanese Society for Neuroendovascular Therapy

雑誌

Journal of Neuroendovascular Therapy (ISSN:18824072)

巻号頁・発行日

pp.cr.2022-0070, (Released:2023-03-18)

参考文献数

9

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Objective: Complications of mechanical thrombectomy (MT) should be identified and managed because they often worsen clinical outcomes. Here we present a case of post-MT embolization of the artery supplying the oculomotor nerve, which has not previously been reported as a complication of MT.Case Presentation: An 81-year-old woman visited our hospital within 2 hours of the sudden onset of left hemiparesis and impaired awareness. MRA showed right middle cerebral artery (MCA) M1 segment occlusion and a possibly salvageable penumbra. We performed thrombectomy for right MCA occlusion with successful recanalization. In the final angiography view, the marginal tentorial artery was almost invisible. Ten hours after thrombectomy, the patient developed complete right oculomotor nerve palsy. Subsequent MRI showed ischemic lesions, but none in the oculomotor nucleus, and there were no lesions compressing the oculomotor nerve. We presume that embolization of the marginal tentorial artery caused oculomotor nerve palsy. The intracranial middle and distal portions of the oculomotor nerve are supplied by the superior branches of the inferolateral trunk and by the marginal tentorial artery.Conclusion: Occlusion of the marginal tentorial artery can cause oculomotor nerve palsy, although this has not previously been reported. Our case suggests that neurointerventional surgeons should evaluate patency of branches of the inferolateral trunk and the meningohypophyseal trunk during the procedure of MT.

著者

Tsuyoshi Shimizu Makoto Sakamoto Hideki Kamitani Masamichi Kurosaki

出版者

The Japanese Society for Neuroendovascular Therapy

雑誌

Journal of Neuroendovascular Therapy (ISSN:18824072)

巻号頁・発行日

vol.17, no.2, pp.68-72, 2023 (Released:2023-02-20)

参考文献数

13

被引用文献数

1

---

Objective: Marfan’s syndrome (MFS) is a systemic connective tissue disorder with autosomal dominant inheritance. Cardiovascular complications of MFS such as aortic root or valve disease and aortic aneurysm or dissection are potential cause of access route problems of mechanical thrombectomy (MT) for acute ischemic stroke (AIS). Here, we report a case of a patient with MFS who underwent MT for AIS.Case Presentation: A 58-year-old woman with MFS presented with a sudden onset of consciousness disturbance and right hemiparesis, and was referred to our hospital. After the infusion of tissue plasminogen activator, CTA showed a type III arch in the aortic arch and severe tortuosity of the thoracoabdominal aorta; thus, angiography was performed using the transbrachial approach. Left common carotid angiogram showed complete recanalization of the left middle cerebral artery. On the sixth day, the patient presented a sudden consciousness disturbance and left hemiparesis. MRA showed right internal carotid artery occlusion. MT was performed by the transbrachial approach, and complete recanalization was achieved on the first pass.Conclusion: MT via the transbrachial approach is a treatment option that should be considered, especially in MFS, where the transfemoral approach is difficult due to anatomical problems.

著者

Takashi KAMEDA Shunya OKA Jun-ichi IGAWA Makoto SAKAMOTO Kazuto TERADA

出版者

The Japanese Society for Dental Materials and Devices

雑誌

Dental Materials Journal (ISSN:02874547)

巻号頁・発行日

vol.41, no.1, pp.167-183, 2022-01-25 (Released:2022-02-01)

参考文献数

26

被引用文献数

1

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Coronavirus disease pandemic has led to a shortage of disinfectant alcohol (DA; 76.9–81.4% ethanol solution) in Japan. This study investigated the availability of hypochlorous acid (HA) as an alternative disinfectant to DA in clinical environment. HA is a safe and economical disinfectant with a broad antibacterial spectrum and low risk of hand irritation, which is used worldwide. In this study, HA and sodium hypochlorite solution (SH) were degraded over time and the degradation was accelerated by temperature and lighting. Results of bactericidal effects of HA revealed that the realistic effective concentration should be 200 ppm. Compared with DA, the dental carbon steel burs were more severely rusted by SH and HA. These results indicated that high concentration of HA generated on-site could be an effective and safe disinfectant for use immediately after generation with consideration of object materials in clinical environment, as an alternative to DA.

著者

Takashi KAMEDA Shunya OKA Jun-ichi IGAWA Makoto SAKAMOTO Kazuto TERADA

出版者

The Japanese Society for Dental Materials and Devices

雑誌

Dental Materials Journal (ISSN:02874547)

巻号頁・発行日

pp.2021-146, (Released:2021-10-22)

参考文献数

26

被引用文献数

1

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Coronavirus disease pandemic has led to a shortage of disinfectant alcohol (DA; 76.9–81.4% ethanol solution) in Japan. This study investigated the availability of hypochlorous acid (HA) as an alternative disinfectant to DA in clinical environment. HA is a safe and economical disinfectant with a broad antibacterial spectrum and low risk of hand irritation, which is used worldwide. In this study, HA and sodium hypochlorite solution (SH) were degraded over time and the degradation was accelerated by temperature and lighting. Results of bactericidal effects of HA revealed that the realistic effective concentration should be 200 ppm. Compared with DA, the dental carbon steel burs were more severely rusted by SH and HA. These results indicated that high concentration of HA generated on-site could be an effective and safe disinfectant for use immediately after generation with consideration of object materials in clinical environment, as an alternative to DA.

著者

Ichinose Yoshio Cesar Monges A. Centurion Maria G. Medina Dorita Alborno Rose M. Bestard Juan J. Makoto Sakamoto Ricardo Moreno A.

出版者

日本熱帯医学会

雑誌

日本熱帯医学会雑誌 (ISSN:03042146)

巻号頁・発行日

vol.19, no.1, pp.39-47, 1991-03-15

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1990年5月から7月までの3カ月間,パラグアイ・アスンシオン市の医療施設において,5歳以下の下痢症例患者を対象に,下痢便の細菌学的検査を行った。53症例から34名(64.1%) に下痢原因菌を検出したが,その結果は病原性大腸菌の19株(35.8%)を筆頭に,サルモネラ8株(15.1%),毒素原性大腸菌3株(5.7%),赤痢菌とカンピロパクターがそれぞれ2株(3.8%)が検出され,このうち混合感染が3例あった。診断用抗血清による凝集試験で,病原性大腸菌では11種に型別され,O18型が最も頻度が高かった。血清学的抗原構造で毒素原性大腸菌に属するものからは,易熱性毒素(LT)は検出できなかったが,乳のみマウスによる耐熱性毒素(ST)の検査で,毒素原性大腸菌から1株が陽性を示し,病原性大腸菌も2株が陽性を示した。河川水や飲料水の細菌学的検査において,病原性大腸菌,組織侵入性大腸菌,サルモネラ,ビプリオ属などの病原菌の他に,腸内細菌科の細菌も検出された。特にパラグアイ川からは,下痢便で最優先であったものと同型の, O18型病原性大腸菌が検出されたことは,この地域住民に水系感染の危険性があることが推察された。またディスク法によって,抗生物質7種類に対する薬剤感受性試験を行ったが,同一菌種間においても,その感受性パターンは多様性を示した。パラグアイにおける細菌性下痢症の調査は,従来,サルモネラや赤痢菌などの古典的下痢症については行われてきた。しかしカンピロパクターについては,1989年において,初めて4症例の報告がなされた状況であり,腸管病原性大腸菌やピプリオ属の調査については,まったくなされていない。パラグアイでの下痢症の疫学的・病因的調査は不十分な状況であるので,この調査を機会に,今後も継続して行っていく必要性を強調したい。An etiological study of bacterial diarrhea in infants under five years of age in Paraguay from May to July of 1990 was done. Enteropathogenic E. coli (EPEC) strains of known serogroups were isolated from 35.8% of the patients with diarrhea, Salmonella spp. were isolated from 15.1%, enterotoxigenic E. coli (ETEC) strains were isolated from 5.7%, and Shigella and Campylobacter spp. were isolated from 3.8% respectivery. No enteroinvasive E. coli (EIEC) or Vibrio spp. was isolated. Out of 53 diarrheal patients, 34 cases (64.1%) had bacterial diarrheal diseases. The infants under one year of age with diarrhea were predominant among inpatient and outpatient children under five years of age and the total number of male diarrheal cases was greater than that of female cases. Enteropathogenic organisms were isolated from nine out of 12 water samples taken from the Paraguay River. The major serotype (O18) of the EPEC isolated from the water samples of the Paraguay River corresponded to the major serotype isolated from patients with diarrhea.