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Journal of Iwate Medical Assiociation
Online ISSN : 2434-0855
Print ISSN : 0021-3284
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Displaying 1-4 of 4 articles from this issue
Original
  • Tetsuro Kiyokawa, Kazumasa Oura, Takayuki Chiba, Shunrou Fujiwar, ...
    2023 Volume 75 Issue 5 Pages 169-180
    Published: December 01, 2023
    Released on J-STAGE: December 27, 2023
    DOI
    JOURNAL OPEN ACCESS
    The purpose of this study was to compare the quantitative data of superb microvascular imaging (SMI) and contrast-enhanced ultrasonography (CEUS) as a method of identifying intraplaque neovascularization (IPN) in tissue specimens obtained by carotid endarterectomy. We enrolled 25 patients who underwent carotid endarterectomy because of ≧ 70% ipsilateral carotid stenosis. We evaluated intraplaque microvascular flow (IMVF) signals within carotid plaques by SMI and calculated the ratio of the difference between the maximum and minimum IMVF signal intensities (IDIMVF) to that of the lumen (IDl). We also measured contrast effects by CEUS and calculated the ratio of the difference between maximum and baseline intraplaque intensities (EIp) to that of intraluminal curves (EIl). IPN number and area were measured on histological sections immunostained with anti-CD34 antibody. We identified IMVF signals in 8 patients and contrast effects in 12 patients. The EIp/EIl ratio was significantly correlated with IPN area (ρ= 0.50, p =0.01) but not with IPN number (ρ= 0.11, p = 0.60). The IDIMVF/IDl ratio was not correlated with either IPN number (ρ= -0.27, p = 0.20) or area (ρ= 0.04, p = 0.84). There was a significant correlation between CEUS results and IPN in carotid plaques, but not between SMI and IPN. Further studies are needed to confirm these findings.
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Case Report
  • Hiroyuki Oshima, Hiroshi Katagiri, Satoshi Ogasawara, Daijiro Kuro ...
    2023 Volume 75 Issue 5 Pages 181-186
    Published: December 01, 2023
    Released on J-STAGE: December 27, 2023
    DOI
    JOURNAL OPEN ACCESS
    Orbital cellulitis is characterized by a severe, purulent inflammation of the soft tissues within the orbit, caused by pathogenic microorganisms. In this case, a 72-year-old man presented to an ophthalmologist with a complaint of eyelid swelling. He exhibited a visual acuity of 0.7 and 0.125 in his right and left eyes, respectively, along with erythema surrounding the left eyelid and marked conjunctival hyperemia. A systematic examination including the patient's body temperature (37.6°C), blood tests, and imaging studies revealed a diagnosis of septic pulmonary embolism. Antibiotic therapy was initiated to treat periodontitis around or the left upper molars. Streptococcus constellatus was identified in the blood culture, and the pulmonary embolism was mitigated using antibiotics to which the organism was sensitive. Magnetic resonance imaging initially revealed multiple abscesses in the left orbital region, resulting in forward compression of the eyeball and optic neuropathy, which led to a reduction in the left visual acuity to 0.01. With systemic improvement, the abscesses decreased in size and the patient’s visual acuity improved to 0.2. This case highlights how prompt systematic examination and judicious use of antibiotics are crucial in the management of orbital cellulitis.
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  • Yawara Kikuchi, Yuichiro Akasaka, Kazuhiro Yoshikawa, Yuki Matsuur ...
    2023 Volume 75 Issue 5 Pages 187-194
    Published: December 01, 2023
    Released on J-STAGE: December 27, 2023
    DOI
    JOURNAL OPEN ACCESS
    An 82-year-old woman with congestive heart failure (CHF) and chronic kidney disease (CKD) stage G5 due to diabetic kidney disease was admitted to our hospital with refractory CHF. She was subsequently diagnosed with severe aortic stenosis, which did not recover with pharmacologic treatment, and transcatheter aortic valve implantation (TAVI)was performed on the 25th day of admission. Due to decreased urine volume and worsening kidney function in the perioperative period, continuous hemodiafiltration was required from the 27th day. Although she could not be withdrawn from hemo-dialysis (HD), her hemodynamics stabilized following TAVI, which was performed before the initiation of HD. At that time she had not experienced intra-dialytic hypotension, and an arteriovenous fistula (AVF) was safely created without concern for cardiac overload. TAVI will contribute to both stable HD induction and safe AVF creation in patients with CKD G5 due to its minimal invasiveness and rapid stabilization of hemodynamics.
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  • 2023 Volume 75 Issue 5 Pages 195-196
    Published: 2023
    Released on J-STAGE: December 27, 2023
    DOI
    JOURNAL OPEN ACCESS
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