著者

Naoyuki Nakamura Yutaka Inaba Shinya Kato Takako Momose Shunsuke Yamada Yoko Matsuda Jiro Machida Yoichi Aota Tomoyuki Saito

出版者

The Japanese Society for Spine Surgery and Related Research

雑誌

Spine Surgery and Related Research (ISSN:2432261X)

巻号頁・発行日

vol.1, no.4, pp.185-190, 2017-10-20 (Released:2017-11-27)

参考文献数

15

被引用文献数

1 1

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Introduction: This study aimed to assess treatment outcomes and caregivers' satisfaction regarding scoliosis surgery for handicapped children.Methods: Handicapped children are, by definition, noncommunicatory and/or nonambulatory. We recruited 26 handicapped children who were followed-up for >1 year after a scoliosis surgery. We recruited 40 patients with adolescent idiopathic scoliosis (AIS) who underwent a surgery during the same period as controls. We used a posterior approach in all the children. We determined preoperative body mass index (BMI), main Cobb angle, Cincinnati correction index (CCI), and fusion level; intraoperative time and blood loss per level; and postoperative complications. We also assessed caregivers' satisfaction with surgical treatments for these patients using the modified Bridwell's questionnaire.Results: We have described the results as handicapped children/AIS. Median preoperative BMI was 16.1/18.6 kg/m2. Preoperative and final Cobb angles were 94.2°/59.7° and 39.7°/17.0°, respectively and CCI was 2.0/1.7. The number of fusion levels was 14.6/9.0. The operative time and blood loss per level were 40.1/44.1 minutes and 264/138 ml, respectively. Postoperative complications in handicapped children were adynamic ileus in 8 cases, dysphagia in 5, pneumonia in 3, urinary tract infection in 2, and superior mesenteric artery syndrome (SMA), surgical site deep infection, infectious enteritis, agitation, and liver dysfunction in 1 each. However, in the AIS group, there was only 1 case of SMA. Median caregivers' satisfaction score on the 0-10 visual analog scale was 9. Caregivers for 19 of the 26 handicapped cases (73%) recommended surgical treatment to caregivers of other children with the same disease.Conclusions: Surgical treatment for neuromuscular and syndromic scoliosis was associated with a high rate of postoperative complications. However, the caregivers' satisfaction score after surgery was high.

著者

Keisuke Nonaka Yoko Matsuda Mototsune Kakizaki Shoichiro Takakuma Akihiko Hamamatsu Yasuhiro Sakashita Tomoyasu Matsubara Shigeo Murayama Toshiyuki Ishiwata Noriko Yamanaka Mitsuyo Itabashi Takashi Takei Noriko Nakajima Hideki Hasegawa Tomio Arai

出版者

National Institute of Infectious Diseases

雑誌

Japanese Journal of Infectious Diseases (ISSN:13446304)

巻号頁・発行日

vol.72, no.5, pp.347-349, 2019 (Released:2019-09-19)

参考文献数

10

被引用文献数

7 8

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An 84-year-old man with chronic renal failure, anemia, and diabetes was admitted for hemodialysis initiation. His vital signs were stable until the eighteenth hospital day, before acquiring an influenza A virus infection. Three days later, he died of septic shock with severe liver impairment. His leukocyte count, prothrombin time (PT-INR), and liver enzyme levels such as aspartate transaminase and alanine aminotransferase, were significantly increased. Hypercytokinemia was also observed. Autopsy revealed bilateral diffuse pneumonia with neutrophil infiltration. The liver showed extensive centrilobular hepatocyte necrosis. Immunohistochemistry for influenza A nucleoprotein revealed positivity in the ciliated columnar epithelium of the bronchi and negativity in the trachea, lungs, and liver. Hypoxic hepatitis is characterized by an abrupt and massive increase in aminotransferase levels (> 20 times upper normal limit) due to anoxic centrilobular hepatocyte necrosis. The occurrence of hypoxic hepatitis requires a pre-existing, chronic condition, such as anemia, causing reduced oxygen supply to the liver, followed by an acute decrease in hepatic oxygen supply, such as septic shock. Therefore, this report suggests that hypoxic hepatitis can be an important causative factor for acute liver failure associated with influenza virus infection.

著者

久米 昭元 松田 陽子 クメ テルユキ マツダ ヨウコ Teruyuki Kume Yoko Matsuda

出版者

立教大学異文化コミュニケーション学部

雑誌

ことば・文化・コミュニケーション : 異文化コミュニケーション学部紀要 (ISSN:18838197)

巻号頁・発行日

vol.5, pp.153-167, 2013