Nakata M.,Tokuyama Central Hospital
Donald School Journal of Ultrasound in Obstetrics and Gynecology | Year: 2011
Multiple pregnancies have a higher risk of both maternal and fetal prognosis. Accurate diagnosis of chorionicity and amnionicity plays an important role for optical perinatal management. In monochorionic pregnancies, there may be several unique pathological complications derived from vascular anastomoses on monochorionic placentation. Twin-twin transfusion, twin-reversed arterial perfusion sequence and single fetal demise have several issues on both perinatal prognosis and management. Recent investments of medical instruments have allowed intervention during prenatal period, such as fetoscopic laser photocoagulation of communicating vessels. These interventions provide more favorable perinatal prognosis. Another risk in multiple pregnancies is congenital anomaly, which is apparently higher than in singleton pregnancy. Therefore, detailed ultrasound examination is necessary for optical management.
Ikenaga S.,Tokuyama Central Hospital
Kyobu geka. The Japanese journal of thoracic surgery | Year: 2010
BACKGROUND AND OBJECTIVE: Ventricular septal rupture (VSR) is a lethal complication of acute myocardial infarction, and its operative results are far from good. SUBJECTS: Six patients who underwent operations for VSR in our department between 2001 and 2008. All these patients received coronary angiography, which showed 1-vessel disease in 4 patients, 2-vessel disease in 1, and 3-vessel disease in 1. The sites of myocardial infarction were the anteroseptal region in 3 patients and the inferoseptal region in 3. RESULTS: Infarct exclusion was conducted in the 3 patients with anteroseptal infarction. Of the 3 patients with inferoseptal infarction, 1 underwent infarct exclusion and 2 Daggett operation. The number of in-hospital deaths was 3 (50%). Residual shunts were observed in 3 out of the 4 patients (75%) who had received infarct exclusion. Two of these 3 patients needed reoperation. The 2 patients with inferoseptal infarction who had undergone Daggett operation presented no residual shunts, and could be easily weaned from the cardiopulmonary bypass. CONCLUSIONS: Because the infarct exclusion method frequently shows residual shunts, its technical modifications are required to improve the operative results. The Daggett method can be considered useful in patients with VSR after inferior myocardial infarction.
Murakami K.,Yamaguchi University |
Tsujino K.,Yamaguchi University |
Sase M.,Yamaguchi Grand Medical Center |
Nakata M.,Tokuyama Central Hospital |
And 2 more authors.
Nursing and Health Sciences | Year: 2012
Because there are few published studies from Eastern countries concerning women's experiences of prenatal ultrasound scans, this study investigated this topic in 238 Japanese women in three different prenatal settings. A cross-sectional questionnaire of 33 items was administered to 261 women at 14-37 weeks gestation with no known obstetrical risk, after their ultrasounds. The main reasons for the ultrasounds were evaluation of fetal growth (100%, n=238); obstetrical conditions (n=228, 96%); and fetal abnormalities (91%, n=217). With increasing maternal age, participants worried more about obstetric problems or fetal abnormalities. Many were interested in fetal viability in early pregnancy, and obstetric problems or fetal abnormality in late pregnancy. While most (n=234, 98%) looked forward to having scans, the majority (n=235, 99%) wanted to know if their baby had an anomaly, and 72% (n=171) worried about the detection of abnormalities. Only 50% (n=118) had obtained information from their care provider. To assist with women's decision-making, prenatal care providers should provide quality information and understand the factors that influence women's concerns. © 2012 Blackwell Publishing Asia Pty Ltd.
Okada M.,Yamaguchi University |
Nakashima Y.,Yamaguchi Grand Hospital |
Nomura T.,Yamaguchi University |
Miura T.,Tokuyama Central Hospital |
And 4 more authors.
Journal of Cardiology | Year: 2015
Background: Sublingual nitroglycerin capsules or spray is routinely used to treat anginal attacks and to maximally dilate the epicardial coronary arteries during coronary angiography. These dilated coronary vessels have an advantage, but increased heart rates were disadvantageous for coronary computed tomography angiography (CTA). Purpose: The influence of applying nitroglycerin was analyzed regarding the coronary diameter, coronary luminal attenuation, evaluable number of coronary segments, heart rate (HR), HR variability, the optimal reconstruction phase, and image scoring of CTA in the same patients using a 64-slice dual-source CT. Methods and subjects: Fifty-two patients with atypical chest pain underwent coronary CTA before and after the administration of sublingual nitroglycerin without heart rate control. The coronary diameter and luminal attenuation were measured on short-axial images in each coronary segment. The coronary vasodilation ratios (VRs) were calculated from the coronary diameters at the same location before and after the use of nitroglycerin. The local institutional review board approved this study and written informed consent was obtained from all the patients. Results: No significant differences were noted in the HR variability or optimal reconstruction phase, despite an increase in HR after the use of nitroglycerin. Nitroglycerin significantly enlarged the coronary artery diameter, and VRs of each coronary segment ranged from 7.54% to 22.26%. As compared with baseline coronary diameter, VRs of minor segments (16.91%) were significantly larger than those of major segments (11.35%), and the magnitude of VR correlated with the baseline coronary diameter (. r=. -0.48, p<. 0.001). Coronary luminal attenuation significantly increased due to additional administration of contrast material after the use of nitroglycerin (. p<. 0.01), but no significant difference was noted in the image quality after the use of nitroglycerin. Conclusion: Sublingual nitroglycerin significantly enlarged the coronary diameters, especially in peripheral small coronary arteries, and increased the evaluable number of coronary segments on coronary CTA. © 2014 Japanese College of Cardiology.
Kubo H.,Tokuyama Central Hospital
Kyobu geka. The Japanese journal of thoracic surgery | Year: 2013
We report a case of solitary ectopic thymoma at the ligamentum arteriosum, which was resected with thoracoscopic surgery. A 62-year-old male patient received chemoradiation therapy for laryngeal cancer approximately 1 year before. The present computed tomography scan indicated a mass (diameter, 2 cm) at the ligamentum arteriosum. Furthermore, positron emission tomography showed an abnormal accumulation on the mass. Malignant lymphoma and laryngeal cancer with lymph node metastasis were suspected, and thoracoscopic surgery was performed. The tumor had a clear margin;therefore, it could be extirpated easily. The results of the postoperative pathological examination indicated that the tumor was an ectopic thymoma. The patient was discharged 3 days after the surgery because he showed good clinical course and was kept under careful observation.