記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：日本語   出版者・発行元：(一社)日本脈管学会  

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記述言語：日本語   出版者・発行元：(NPO)日本血管外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：日本語   出版者・発行元：日本静脈学会  

2004年の新潟県中越地震(中越地震)では10万人以上が車中泊避難を行ったことから被災地では深部静脈血栓症(deep vein thrombosis;DVT)が遷延し慢性化していることが判明している。中越地震6年後のDVT検診を小千谷市と十日町市で行い867人(平均年齢65.9±11.2歳)が受診した(292人が初めて検診を受診)。その結果、下腿DVTを85人に認め、17人(5.8%)が初めて検診を受けた人であり中越地震6年後のDVT頻度は5.8%と推定された。また高血圧、高脂血症、糖尿病のうち高血圧のみDVTが有意に関連していた(p<0.001)。また震災後発症の脳梗塞または一過性脳虚血発作(TIA)は下腿静脈のDVT有りでは7人(8.2%)、DVT無しでは28人(3.6%)であり、年齢と性別を層別化したMantel-Haenszel検定においてDVT保有者でオッズ比2.73(95% CI;1.11-6.68)で有意に脳梗塞が多かった(p<0.01)。以上より震災後のDVTは遷延しやすく高血圧と関連することが示唆された。また震災後のDVTは慢性期の脳梗塞・TIAと関連することも示唆された。(著者抄録)

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2012&ichushi_jid=J02365&link_issn=&doc_id=20121128170001&doc_link_id=%2Feo4jjoph%2F2012%2F002304%2F001%2F0315-0320%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Feo4jjoph%2F2012%2F002304%2F001%2F0315-0320%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：(公社)日本医学放射線学会  

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記述言語：日本語   出版者・発行元：(一社)日本脳神経超音波学会  

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記述言語：日本語   出版者・発行元：(一社)日本検査血液学会  

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記述言語：日本語   出版者・発行元：(一社)日本脳神経超音波学会  

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記述言語：日本語   出版者・発行元：(一社)日本脳神経超音波学会  

脳・神経疾患による臥床入院患者における下肢深部静脈血栓症(DVT)の発生頻度と予測因子について検討した。対象は平成18年6月〜19年3月までに入院し、48時間以上の臥床となった脳・神経疾患患者108例であった。疾患内訳は脳梗塞48例、脳梗塞以外の神経筋疾患(パーキンソン症候群や筋ジストロフィー等)60例で、下肢静脈超音波検査と凝血学的検査が行なわれた。その結果、1)108例中21例(19.4%)にDVT(うち2例に肺塞栓症)が認められ、発生部位は大腿静脈6例、ヒラメ筋静脈14例(他下腿2分枝併存例を含む)等であった。2)DVT有群と無群の平均D-dimerは7.5 vs 2.8g/μml、平均年齢は72.3 vs 63.8歳といずれも有意差が確認された。3)D-dimerは脳梗塞例のDVT有群と無群では5.8 vs 3.2、神経筋疾患では9.6 vs 2.5と有意差がみられなかったが、神経筋疾患ではD-dimerがDVTの確定診断に結び付く可能性が示唆された。

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2009&ichushi_jid=J02558&link_issn=&doc_id=20100514280001&doc_link_id=%2Fcn7neuro%2F2009%2F002201%2F001%2F0001-0003%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcn7neuro%2F2009%2F002201%2F001%2F0001-0003%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：ライフサイエンス出版(株)  

72歳男。患者は呼吸困難を主訴とした。38歳時に統合失調症を発症し、内服加療で症状は安定していた。その後、69歳時に交通事故で外傷性くも膜下出血を発症し、精神症状の悪化で入退院を繰返し、身体拘束を3回実施された。3回目の身体拘束は肺炎の加療のために行われ、抗生剤治療により炎症所見は改善した。だが、SpO2の低値が続き、D-dimer値は著明に上昇、もしくは低下、再上昇を繰り返した。一方、造影CTでは左下肺静脈に造影欠損がみられ、肺血流シンチグラフィーでは左肺に欠損像が確認された。更に下肢静脈エコーが実施されたが、血栓は指摘されなかった。治療としてIVCフィルターを挿入し、抗凝固療法を開始した結果、肺血流シンチグラフィーを再検すると、右肺に明らかな欠損像を認められるも、再発時もD-dimerの上昇は認めなかった。尚、身体拘束期間中はヘパリンカルシウム静注を行っていた。

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記述言語：日本語   出版者・発行元：(一社)日本医療検査科学会  

バイダスDダイマー2を用いて、日本人においても高感度D-ダイマーによる深部静脈血栓症(DVT)除外診断が可能か検討した。入院後48時間以上の床上安静を必要とした75例を対象とした。比較のため健常者28例についても高感度D-ダイマーを測定した。下肢DVTの診断は下肢静脈エコー検査を基準検査として行った。最低検出限界は、45ng/mlまでの測定が可能であった。健常者群のD-ダイマー値は248.8±125.1ng/mlで、1例を除いて500ng/ml未満であった。下肢静脈エコー検査で、患者75例中22例がDVTと診断された。血栓の存在部位はいずれもヒラメ静脈で、D-ダイマーの平均値はDVT陰性群1133.3±997.7ng/ml、DVT陽性群2013.3±1232.5ng/mlであった。500ng/mlをカットオフ値とした場合の感度は100%、特異度は30.1%、陰性的中率は100%であった。

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記述言語：日本語   出版者・発行元：(一社)日本臨床検査医学会  

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記述言語：日本語   出版者・発行元：日本胸部外科学会-関東甲信越地方会  

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記述言語：日本語   出版者・発行元：The Japan Society of Ultrasonics in Medicine  

DOI： 10.3179/jjmu.35.S525

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その他リンク： http://search.jamas.or.jp/link/ui/2008248780

記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：日本語   出版者・発行元：(一社)日本臨床化学会  

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記述言語：日本語   出版者・発行元：(一社)日本医療検査科学会  

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記述言語：日本語   出版者・発行元：日本胸部外科学会-関東甲信越地方会  

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記述言語：日本語   出版者・発行元：The Japanese Society of Extra-Corporeal Technology in Medicine  

経頭蓋超音波検査(TCD)では脳動脈内の気泡,血栓などの微小栓子がHigh Intensity Transient Signals(HITS)として検出することが可能である。CPB中に脱血回路から空気が混入した症例で,脳動脈内でHITSが多数検出され,術後の覚醒遅延や痙攣などの合併症を経験した。今回,TCDを用いて3種類の静脈貯血槽(VR)の気泡捕捉能力を検討したので報告する。3種類のVRを用いて模擬回路を作製し,静脈回路に設けた空気の注入口から1mLの空気を注入し,VR出口,人工肺出口,動脈Filter出口にてHITSの検出を行った。灌流液には豚血を用い,灌流温36℃,灌流量は4L/minとした。3種類のVRから出る気泡数に有意差は認められなかったが,気泡径はVRのFilterサイズが150μmのA-VRから流出する気泡径が大きい傾向にあった。人工肺前後では気泡数に有意差が認められたが,動脈Filter前後では有意差が認められず,10μm以下のマイクロバブルみら捕捉はできないことが示唆された。マイクロバブルの捕捉には人工肺のほかにVRの除泡能が大きく関与することが示唆された。

DOI： 10.7130/hokkaidoshakai.31.71

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その他リンク： http://search.jamas.or.jp/link/ui/2004162391

記述言語：英語   出版者・発行元：The Japan Academy of Neurosonology  

Background and Purpose: With recent transcranial Doppler ultrasonography (TCD) techniques, high intensity transient signals (HITS) can be detected automatically. However, the significance of automatically detected HITS without associated sound is unclear. We attempted to determine whether HITS detected automatically during veno-arterial extracorporeal membrane oxygenation (V-A ECMO) reflect the state of blood coagulability. Methods : In an animal study, V-A ECMO was performed in 11 adult pigs by aortic and pulmonary cangulation using a roller pump and membrane oxygenator. HITS were counted automatically during bypass before and after administration of anticoagulants. In a clinical study of 6 patients with V-A ECMO after cardiac surgery, HITS were detected during and after removal of ECMO. Results: In the animal study, the majority of HITS recorded during V-A ECMO had no associated sound. The HITS count before and after ECMO was 0 and 49±35/10-min (n=11), respectively. The HITS count after administration of heparin was 4±4/10-min (n=5), and that after administration of argatroban was 7±7/10-min (n=6) . HITS counts were significantly reduced after administration of either anticoagulant (p<0.001) . In the clinical study, HITS were detected frequently during ECMO (158±99/15-min (n=6) ), but no HITS were detected after its removal. The HITS count rate was negatively correlated with activated clotting time. Conclusions: Automatically detected HITS without associated sound may reflect the degree of coagulation during V-A ECMO. Therefore, inaudible HITS may be a useful indicator of the level of anticoagulation during V-A ECMO.

DOI： 10.2301/neurosonology.12.120

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記述言語：日本語   出版者・発行元：The Japan Academy of Neurosonology  

Purpose: High-intensity transient signals (HITS) are commonly detected during cardiopulmonary bypass (CPB) . However, the clinical significance of HITS during CPB is still controversial. Micro-bubbles are reported to produce HITS of more than 400-500 Hz. We attempted to elucidate the incidence of HITS exceeding 400 Hz during CPB. Methods: The subjects were 6 patients who underwent open heart surgery using CPB. HITS were detected by TC2020, PIONEER (Nicolet /EME) with a 2.0-MHz pulsed Doppler probe at the middle cerebral artery. Transesophageal echocardiography (TEE) was undertaken during the operation. Results: The total number of HITS during CPB was 1707±1392 (n=6) . Of the total HITS, 88.1±6.8% had a frequency of more than 400 Hz. On the other hand, HITS of less than 400 Hz were frequently detected at aortic cannulation, aortic decannulation and aortic cross-clamping. HITS of more than 400 Hz were detected in cases showing cardiac or aortic micro-bubbles in TEE. Conclusion: The present findings suggest that the majority of HITS during CPB reflect micro-bubbles, and that aortic manipulation may be related to the formation of solid micro-emboli. HITS frequency analysis may be useful for differentiating between micro-bubbles and solid micro-emboli formed during CPB.

DOI： 10.2301/neurosonology.12.64

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その他リンク： http://search.jamas.or.jp/link/ui/2000087438

記述言語：日本語   出版者・発行元：The Japan Academy of Neurosonology  

Recently, high-intensity transient signals (HITS) obtained by transcranial Doppler ultrasonography (TCD) were reported to reflect micro-emboli in cerebral arteries. Frequent detection of HITS in patients with mechanical valve replacement has been reported for many years. However, the mechanism and significance of these signals has remained unclear. We attempted to elucidate whether HITS indicate a risk of cerebral infarction in patients with mechanical valve (St. Jude Medical valve: SJM) replacement, and also carried out an animal experimental study to clarity the mechanism of HITS formation.<BR>HITS was frequently detected in patients with SJM valves. The HITS count after surgery in patients with cerebral infarction (83 ± 66/15 min) was significantly higher than that in patients without a history of stroke (7 ± 7/15 min) (p<0.001) . The HITS count in patients with mechanical valve replacement appeared to increase with time after surgery. Thus, the HITS count appeared to indicate the risk of cerebral infarction after mechanical valve replacement. In the experimental study, injection of clotted blood into the aorta produced low-frequency and small-intensity HITS. Introduction of micro-bubbles into the aorta produced high-frequency and large-signal-intensity HITS. These two kinds of HITS were detected in patients with SJM valves. Thus, HITS in patients with SJM valves may be produced by both gaseous and solid micro-emboli.

DOI： 10.2301/neurosonology.12.7

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その他リンク： http://search.jamas.or.jp/link/ui/1999195240

記述言語：日本語   出版者・発行元：The Japan Academy of Neurosonology  

High intensity transient signals (HITS) were detected in patients with a high risk of stroke. The signals were detected in the middle cerebral artery for 15-30 min by a TC2020 or Multi-Dop DX4. HITS were never detected in young healthy volunteers (n=20) . The HITS count in patients with cerebral infarction (16-20/30 min, n-42) was significantly higher than that in patients without cerebrovascular disease (0.5±0.7/30 min, n17) (p<0.01) . In the cerebral infarction group, the HITS count in patients without antiplatelet (20±29/30 min, n=20) was significantly higher than that in patients with antiplatelet (9±6/30 min, n=22) (p<0.01) . HITS were frequently detected in patients fitted with mechanical valves (St. Jude Medical valve) (14.3±34.5/15 min, n=51), and the count was significantly higher than that in open heart surgery patients without mechanical valves (0.05+0.08/15 min, n=11) (p<0.01) . In the mechanical valve replacement group, the HITS count in patients with cerebral infarction after surgery (88±66/30 min, n=43) was significantly higher than that in patients without a historyof stroke (7±7, n-8) (p<0.01) . The HITS intensity in the mechanical valve replacement group (15.1+4.3 dB, n=31) was significantly greater than that in the cerebral infarction group (10.8+1.1dB, n-32) (p<0.05) . In the mechanical valve replacement group, the HITS intensity in patients with post-surgical cerebral infarction (18±3.5 dB, n8) was significantly greater than that in patients without a history of stroke (14.5±5.6 dB, n=23) (p<0.0001) . During veno-arterial extracorporeal membrane oxygenation (V-A ECMO), HITS were frequently detected (124±60/15 min, n=6), and the HITS count was negatively correlated with activated coagulation time (ACT) . HITS may therefore reflect the presence of microemboli and indicate the risk of stroke or the state of blood coagulation.

DOI： 10.2301/neurosonology.10.16

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その他リンク： http://search.jamas.or.jp/link/ui/1997205194

記述言語：日本語   出版者・発行元：特定非営利活動法人 日本小児外科学会  

DOI： 10.11164/jjsps.30.3_552_2

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記述言語：英語   出版者・発行元：OXFORD UNIV PRESS  

Background: While there is a concern about the increase in the occurrence of acute aortic dissection (AAD) caused by the worsening of hypertension, mental stress, etc., there is a lack of data regarding the influence of disasters on this event. The aim of this study was to address this issue in the acute-subacute phase after the Kumamoto Earthquake occurred on 14 April 2016. Methods: We retrospectively investigated the impacts of the Kumamoto Earthquake on various cardiovascular diseases, including AAD, utilizing the medical records of patients in 16 hospitals in Kumamoto Prefecture during the period from 14 April to 30 June (78 days) in 2014, 2015, 2016, and 2017. Results: The occurrence of heart failure and venous thromboembolism increased significantly in the acute-subacute phase after the earthquake. When comparing the earthquake year (2016) to the non-earthquake years (2014, 2015, and 2017), the difference in the occurrences and mortalities of AADs were not significant. When other characteristics of the patients were compared between the earthquake year and the non-earthquake years, there were no differences. Conclusions: It might be possible that the Kumamoto Earthquake did not affect the incidence of AAD or deaths from AAD, possibly because the climate was mild and the preventive efforts based on previous experience were successful.

DOI： 10.1093/ajh/hpz183

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記述言語：日本語   出版者・発行元：ぎょうせい  

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記述言語：日本語   出版者・発行元：農山漁村文化協会  

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記述言語：日本語   出版者・発行元：農山漁村文化協会  

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記述言語：日本語   出版者・発行元：消防防災科学センター  

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記述言語：日本語   出版者・発行元：イマジン出版  

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記述言語：英語   出版者・発行元：IEEE  

Repair of dissected aorta requires remodeling the structure of the media. Modeling approaches specific to endovascular stenting for aortic dissection have been reported. We created a goat model of descending thoracic aortic dissection and reproduced its morphological characteristics in a mock circulatory system. The purpose of this study was to examine a newly developed aortic stent which was capable of installing to the aortic dissected lesion for biomedical hemodynamics point of view. In this study, we examined the changes in hemodynamics of dissected lesions and the amelioration by endovascular stent intervention. Firstly, we performed animal experiments with the dissected aorta and examined the effects of stenting on volumetric changes in the false lumen. Secondly, we made several types of 3-D stereolithographic dissected aortic models with silicone rubber membrane between the false and the true lumens. Then, the hemodynamic characteristics in each model were evaluated in the pulsatile flow conditions in a mock circulatory system. These modelling approaches enabled the quantitative examination of post-therapeutic effects of stenting followed by elucidating of hemodynamic changes in the vicinity of stents, which may follow the management of clinical amelioration of interventional treatment with aortic stenting.

DOI： 10.1109/EMBC44109.2020.9176423

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その他リンク： https://dblp.uni-trier.de/conf/embc/2020

記述言語：英語   出版者・発行元：VIA MEDICA  

Introduction: Tsunami victims of the Great East Japan Earthquake were screened for deep-vein thrombosis (DVT) in order to compare the DVT incidence rates between temporary and non-temporary housing resident groups.Material and methods: Lower extremity venous ultrasonography was performed on 290 subjects (64 men and 226 women; mean age = 71.9 +/- 7.9 years) at 44 months after the disaster. All subjects completed questionnaires to gather information about their background factors which included the Kessler Psychological Distress Scale: K6.Results: The DVT detection rate was 10.7% in the temporary group. In the non-temporary group, it was 11.3% among the subjects who previously lived in temporary housing. For the subjects who were living in their own homes, it was 9.2%. Psychological distress levels measured by K6 were significantly higher in the temporary housing group than in the non-temporary housing group. The multivariate analysis showed that the background factor associated with DVT risk was SV (soleal vein) dilatation in all subjects as well as in the non-temporary housing group, while hypertension and use of sleeping pills were found to be the factors in the temporary housing group.Conclusions: DVT detection rates were similar between the temporary and non-temporary housing groups, and were higher than that in the Japanese general population. The psychological distress level of the tsunami victims measured by K6 was also higher in the temporary housing group than in the non-temporary housing group. It is necessary to establish a long-term and awareness-raising disaster victim support system.

DOI： 10.5603/AA.2020.0025

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

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記述言語：英語   出版者・発行元：SPRINGER JAPAN KK  

To ensure that experiences and lessons learned from the unprecedented 2011 Great East Japan Earthquake are used to improve future disaster planning, the Japan Diabetes Society (JDS) launched the Research and Survey Committee for Establishing Disaster Diabetes Care Systems Based on Relevant Findings from the Great East Japan Earthquake under the supervision of the Chairman of the JDS. The Committee conducted a questionnaire survey among patients with diabetes, physicians, disaster medical assistance teams (DMATs), nurses, pharmacists, and nutritionists in disaster areas about the events they saw happening, the situations they found difficult to handle, and the needs that they felt required to be met during the 2011 Great East Japan Earthquake. A total of 3,481 completed questionnaires were received. Based on these and other experiences and lessons reported following the 2011 Great East Japan Earthquake and the 2004 Niigata-Chuetsu Earthquakes, the current Manual for Disaster Diabetes Care has been developed by the members of the Committee and other invited authors from relevant specialties. To our knowledge, the current Manual is the world's first to focus on emergency diabetes care, with this digest English version translated from the Japanese original. It is sincerely hoped that patients with diabetes and healthcare providers around the world will find this manual helpful in promoting disaster preparedness and implementing disaster relief.

DOI： 10.1007/s13340-019-00397-7

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記述言語：日本語   出版者・発行元：建築ジャーナル  

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記述言語：日本語   出版者・発行元：建設政策研究所  

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記述言語：日本語   出版者・発行元：環境新聞社  

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その他リンク： http://search.jamas.or.jp/link/ui/2019166224

記述言語：日本語   出版者・発行元：一般社団法人 日本血栓止血学会  

DOI： 10.2491/jjsth.30.81

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記述言語：日本語   出版者・発行元：一般社団法人日本脳神経超音波学会  

A 21-year-old Indonesian woman came to hospital with severe headache and vomiting. Brain MRI showed multiple subcortical lesions. High-intensity transient signals (HITS) was detected in the carotid artery and transesophageal echocardiography (TEE) was performed to search for embolic sources. Mobile string-like structures were found in the aortic arch. We started anticoagulation therapy. One month later, TEE reexamination revealed that the aortic arch cord had shrunk, but numerous cords were found in the pulmonary artery. She was suspected with <i>Angiostrongylus cantonensis</i> infection and treated with antiparasitic agent and steroids. One month later, the TEE was performed again, and the cord-like structure in the aortic arch almost disappeared, and the abnormal structure in the pulmonary artery also disappeared. It is known that <i>A. cantonensis</i> can cause eosinophilic meningoencephalitis, but its prognosis is good, and it is thought that it may be mild. In this case, although the definitive diagnosis has not been made, the possibility was considered to be high because antiparasitic agent was effective. HITS detection for investigating the cause of multiple subcortical lesions was considered to be useful in determining the embolic mechanism.

DOI： 10.2301/neurosonology.32.129

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記述言語：日本語   出版者・発行元：公益社団法人 日本生体医工学会  

<p>【背景】解離性大動脈瘤では解離偽腔内に流入する血流がもたらす乱流による複雑な圧流量特性が観察される。治療効果と安全性を評価する上では血管内治療用の解離性大動脈瘤内の血圧血流速の医工学的モデリングが重要となっている。【目的】これまで解離性大動脈瘤の動物実験モデルを作成し血行動態の再現を行ってきた。本研究では動物実験から得られた超音波画像を基に解離性大動脈瘤血行動態のモデリングを目的としてそれらの解析手法に関して評価を進めた。【方法】〔動物解離モデル〕健常成山羊を麻酔下にて開胸し、下行大動脈の中枢側外膜を切開後、中膜を外科的に剥離し、血管開口部を切開し大動脈解離を作成した。〔モデル化手法・解析〕下行大動脈の超音波短軸像を血管長軸に沿って1mm毎の断層像とし、データの数値的再構成により形状モデルを構築した。作成したモデルを用いて模擬循環回路による流れ可視化と数値流体解析を行った。【まとめ】動物モデルでは臨床に近い形態と血流を再現できる一方、血管内治療の血行力学的評価については血流形態の差や計測誤差の課題がある。解離性大動脈瘤治療ではさまざまな医工学モデリング方法論で安全性評価が可能である。</p>

DOI： 10.11239/jsmbe.Annual57.S220_2

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記述言語：英語   出版者・発行元：WILEY  

To ensure that experiences and lessons learned from the unprecedented 2011 Great East Japan Earthquake are used to improve future disaster planning, the Japan Diabetes Society (JDS) launched the “Research and Survey Committee for Establishing Disaster Diabetes Care Systems Based on Relevant Findings from the Great East Japan Earthquake” under the supervision of the Chairman of the JDS. The Committee conducted a questionnaire survey among patients with diabetes, physicians, disaster medical assistance teams (DMATs), nurses, pharmacists, and nutritionists in disaster areas about the events they saw happening, the situations they found difficult to handle, and the needs that they felt required to be met during the 2011 Great East Japan Earthquake. A total of 3,481 completed questionnaires were received. Based on these and other experiences and lessons reported following the 2011 Great East Japan Earthquake and the 2004 Niigata-Chuetsu Earthquakes, the current “Manual for Disaster Diabetes Care” has been developed by the members of the Committee and other invited authors from relevant specialties. To our knowledge, the current Manual is the world’s first to focus on emergency diabetes care, with this digest English version translated from the Japanese original. It is sincerely hoped that patients with diabetes and healthcare providers around the world will find this manual helpful in promoting disaster preparedness and implementing disaster relief.

DOI： 10.1007/s13340-019-00397-7

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記述言語：英語   出版者・発行元：JAPANESE CIRCULATION SOC  

Background: After previous earthquakes, a high prevalence of deep vein thrombosis (DVT) has been reported. We examined DVT prevalence and risk factors in evacuees of the Kumamoto earthquakes by performing mobile DVT screening at various evacuation centers around the epicenter. Methods and Results: For 1 month after the Kumamoto earthquake on 14 April 2016, mobile DVT screening using portable ultra-sonography (US) was performed at 80 evacuation centers. Questionnaires, physical examination, and US of the lower limb were carried out, and simple D-dimer measurements were undertaken for DVT-positive examinees. The total number of examinees was 1,673, of whom 178 (10.6%) had DVT. The prevalence of DVT seemed to be gradually decreasing in the screening period, but age, use of sleep medication, prevalence of hypertension, dyslipidemia, leg edema, and lower leg varix were significantly higher in the DVT positive group than in the negative group. On multivariable logistic regression analysis, high age (≥70 years old), use of sleep medication, lower leg edema, and lower leg varix were significant predictors of DVT. In examinees with these 4 predictors, the DVT positive rate was 71.4%. Conclusions: In the first month after the Kumamoto earthquakes, DVT prevalence and severity, evaluated on D-dimer level, decreased with the passage of time. Mobile DVT screening indicated significant factors stratifying DVT risk in the evacuees.

DOI： 10.1253/circj.CJ-18-1369

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記述言語：英語   出版者・発行元：ANNALS VASCULAR DISEASES EDITORIAL OFFICE  

A right-sided aortic arch, associated with an aberrant left subclavian artery and a Kommerell's diverticulum, is a rare congenital anomaly. Case 1: A 53-year-old man, complaining of dysphasia, underwent a two-stage hybrid operation. Total arch replacement with the reconstruction of supra-aortic vessels was performed via a median sternotomy. Thoracic endovascular aortic repair was subsequently completed with the femoral approach. Case 2: A 81-year-old man, complaining of syncope and dizziness, underwent thoracic endovascular aortic repair after endovascular aneurysm repair for a common iliac artery aneurysm. Treatment strategies for Kommerell's diverticulum should be individually determined depending on the clinical situation and anatomical features.

DOI： 10.3400/avd.cr.18-00170

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記述言語：日本語   出版者・発行元：消防防災科学センター  

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記述言語：日本語   出版者・発行元：一般社団法人日本脳神経超音波学会  

<b>Purpose:</b> We attempted to detect high intensity transient signals (HITS) at common carotid artery (carotid HITS) by paste type Doppler probe in residents at Kashiwazaki City where big earthquake occurred in 2008. Calf deep venous thrombosis (DVT) has been detected frequently in the residents due to earthquake. It was examined whether it relates to DVT, cerebro-cardiovascular diseases (CCVDs), etc. <br><b>Subjects and Methods:</b> We conducted screening for 522 residents in Kashiwazaki City in 2016–2017. HITS were detected by using 2.0MHz paste type probe at carotid artery for 5min.<br> <b>Results:</b> Carotid HITS was detected in 39 (7.5%). Statistically significant risk factors in the carotid HITS positive group were arterial velocity pulse index (AVI), CCVDs and atrial fibrillation. Univariate analysis of cerebro-cardiovascular disease indicated an odds ratio of 3.8 (95% CI: 1.8–7.9, <i>p</i> = 0.001) in the carotid HITS positive, and furthermore odds ratio 3.6 (95% CI: 1.6–7.9, <i>p</i> = 0.001) was found in the same group in multivariate analysis.<br><b>Conclusion:</b> Carotid HITS was a significant risk factor for CCVDs and atrial fibrillation in the general population. Therefore, it was suggested that detection of HITS at carotid artery by paste type probe may be useful for prevention of embolic disease.

DOI： 10.2301/neurosonology.32.46

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記述言語：英語   出版者・発行元：SPRINGER  

Background: An increase in cardiovascular diseases has been reported following major disasters. Previous work has shown that ultrasonographic findings from ultrasound cardiography examination (UCG) increased until the 44th month after the tsunami caused by the Great East Japan Earthquake. The present study conducted UCG among victims in the tsunami disaster area and investigated the frequency of disaster-related cardiovascular diseases and changes over time until the 55th month after the disaster. Methods: The subjects were residents of temporary housing complexes and neighboring housing in Watari-gun, Miyagi Prefecture, Japan. There were 207 subjects in the 18th month, 125 in the 30th month, 121 in the 44th month, and 106 in the 55th month after the disaster. Data were collected through UCG and self-report questionnaire. Results: Significant changes were observed among subjects with clinical findings from the UCG, which increased over the study period-from 42.0 to 60.8, 72.7, and 73.6% beginning in the 18th month after the disaster (p<0.0001). Conclusions: It is possible that the UCG can become a useful examination to visualize the potential impact of a major disaster on the cardiac function of victims. Victims with clinical findings continued increasing not only during the acute phase after a disaster but also in the long term. We therefore need to keep this in mind, and note that it is important to establish a support system to control cardiovascular diseases from the early stage of disaster.

DOI： 10.1186/s12199-018-0721-4

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記述言語：日本語   出版者・発行元：(NPO)日本血管外科学会  

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記述言語：英語   掲載種別：速報，短報，研究ノート等（学術雑誌）   出版者・発行元：ELSEVIER SCIENCE INC  

DOI： 10.1016/j.cjca.2018.01.014

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記述言語：日本語   出版者・発行元：東京法規出版  

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記述言語：日本語   出版者・発行元：東京法規出版  

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その他リンク： http://search.jamas.or.jp/link/ui/2019264151

記述言語：英語   出版者・発行元：ELSEVIER SCIENCE INC  

Introduction: A prospective study was designed to elucidate incidence and predictors of deep venous thrombosis (DVT) in patients undergoing craniotomies. Materials and Methods: Ninety-two patients who underwent craniotomies received pre- and postoperative venous ultrasonography and/or contrast-enhanced spiral computed tomography for diagnosis of DVT. The primary endpoint was DVT occurrence. Serial levels of serum D-dimer, soluble fibrin, and thrombin–antithrombin complex (TAT) were analyzed. Results: Twenty-four of 92 patients (26.1%) had DVT, of whom 10 (41.7%) were diagnosed preoperatively. In patients with preoperative DVT, age, incidence of decreased performance status and leg paresis, levels of D-dimer, soluble fibrin, and TAT were significantly greater. In patients with postoperative DVT, length of surgery, incidence of decreased postoperative performance status, levels of D-dimer on postoperative days (POD) 3, 7, and 14, and TAT on POD7 were significantly greater. Patients with postoperative DVT had elevated D-dimer levels on POD 7 compared with POD 3. The D-dimer cutoff of 2.65 μg/mL at POD 7 could be used to identify DVT with 85.7% sensitivity and 72.3% specificity. A cutoff of 5.25 μg/mL at POD 7 yielded a specificity of 96.9%. Decreased performance status and elevated D-dimer were independent predictors for preoperative DVT, prolonged operation time, and elevated D-dimer on POD 7 for postoperative DVT. Conclusions: DVT frequently was observed in patients before and after undergoing craniotomies. Patients with decreased performance status should be preoperatively screened for DVT by checking D-dimer levels. Elevated D-dimer levels on POD 7 compared with POD 3 and D-dimer levels greater than 2.65 μg/mL at POD7 suggest the presence of DVT.

DOI： 10.1016/j.wneu.2017.12.139

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記述言語：日本語   出版者・発行元：一般社団法人 日本繊維製品消費科学会  

DOI： 10.11419/senshoshi.59.7_510

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記述言語：日本語   出版者・発行元：一般社団法人 日本血栓止血学会  

<p><b>要約：</b>東日本大震災ではワルファリンが届くのが1 週間後になった避難所もあった．今後の首都直下地震，東南海地震では薬剤が避難所に届くのがもっと遅れる可能性もある．また通常の避難所診療所ではPT-INR 測定は困難でありワルファリンのコントロールは不可能である．そこで大規模災害が予測される地域ではワルファリンをできるだけDOAC に変更することが必要である．またワルファリンに変えられない患者も少なくないことから，平時からPT-INR をPOCT で測定できるようにDMAT や災害拠点病院では準備すること，PT-INR 測定できるPOCT がどこにあるかを医療機関で情報共有しておくことが必要である．さらに災害後にワルファリンが4 日以上届かない場合にワルファリン服用者に対してDOAC 処方するかどうかなどを本学会が中心になって提言し，可能ならガイドライン作成が必要と考えられる．</p>

DOI： 10.2491/jjsth.29.370

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記述言語：日本語   出版者・発行元：メジカルビュー社  

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その他リンク： http://search.jamas.or.jp/link/ui/2018060328

記述言語：日本語   出版者・発行元：新潟医学会  

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その他リンク： http://search.jamas.or.jp/link/ui/2018235908

記述言語：日本語   出版者・発行元：メディカルレビュー社  

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記述言語：日本語   出版者・発行元：国立病院総合医学会  

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記述言語：英語   出版者・発行元：WILEY  

Background. To evaluate the diagnostic performance of ultrasonography for screening of a population at risk for deep vein thrombosis (DVT) in a post-disaster setting. Methods. Ultrasonography was applied as a screening technique to the residents of a temporary housing facility who were displaced following the Great East Japan Earthquake. Thirty DVT screening sessions were held from April 2013 to June 2015. Individuals were invited to participate if they were identified as “high risk” for DVT, defined as those with low activity levels, a history of lower limb trauma, baseline lower limb pain or swelling, a cancer-bearing status, or a history of venous thromboembolic event. Ultrasonographic examinations were performed from the calf to the popliteal veins using portable devices. Results. Of the 3,316 subjects screened (682 men and 2,634 women) with a mean age of 71 ± 9.7 years, DVT was diagnosed in 382 (11.5%). DVT was more likely in older, symptomatic, or female patients with a history of venous thromboembolism and attempting to perform daily exercise. The rate of DVT diagnosis increased from 9.9% in 2013 to 13.5% in 2015. Conclusions. Ultrasonography is efficient for screening at-risk populations in challenging settings.

DOI： 10.1002/jcu.22505

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記述言語：日本語   出版者・発行元：日本医事新報社  

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その他リンク： http://search.jamas.or.jp/link/ui/2017325507

記述言語：日本語   出版者・発行元：日本医事新報社  

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その他リンク： http://search.jamas.or.jp/link/ui/2017325506

記述言語：日本語   出版者・発行元：新潟医学会  

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その他リンク： http://search.jamas.or.jp/link/ui/2018063725

記述言語：日本語   出版者・発行元：新潟医学会  

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その他リンク： http://search.jamas.or.jp/link/ui/2018020183

記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

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記述言語：日本語   出版者・発行元：(一社)日本血栓止血学会  

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記述言語：英語   出版者・発行元：SPRINGEROPEN  

Background: Severe aortic tortuosity of the access route often prevents successful complete exclusion of an aneurysm in thoracic endovascular aortic repair (TEVAR).Case presentation: We performed antegrade TEVAR on a 79-year-old man with right hemiparesis. We deployed the stent graft from the ascending aorta with a tube graft conduit to treat a descending thoracic aortic aneurysm associated with rickets and multiple comorbidities. Although the application of a ministernotomy diminished the potential advantages of endovascular treatment in view of less invasive surgery, antegrade TEVAR using an ascending aortofemoral through-and-through wire technique was a good option in this patient because a conventional retrograde approach was not feasible due to his severely tortuous aorta.Conclusions: To avoid device-related complications, it is crucial to make a prudent preoperative decision on a patient-by-patient basis, taking into account the appropriate access site, adjuvant guidewire technique, and adjunctive surgical interventions.

DOI： 10.1186/s40792-017-0324-0

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記述言語：日本語   出版者・発行元：東京法規出版  

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記述言語：日本語   出版者・発行元：一般社団法人日本脳神経超音波学会  

For a period of 4 years, we conducted deep vein thrombosis (DVT) examinations among people living in temporary homes and those living in their own homes in areas affected by the Great East Japan Earthquake. We divided those with positive results for DVT after receiving numerous examinations into a DVT disappeared group and a DVT remained group. The thrombus formation sites were the soleus muscle veins for both groups. In terms of characteristics, multiple organized thrombi were recognized, and there was no spread to the central side. In addition, the DVT remained group exhibited an increased maximum diameter of the soleal vein. We believe that stasis of blood flow due to the extension of the soleal veins contributed to the continued formation of thrombi.

DOI： 10.2301/neurosonology.30.43

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記述言語：日本語   出版者・発行元：日本静脈学会  

<p>周辺住民に甚大な被害をもたらした平成27年9月関東・東北豪雨による茨城県常総市鬼怒川決壊による水害ならびに，最大18万名にのぼる被災者が避難生活を余儀なくされた平成28年熊本地震においては，ともに指定避難所が発災後速やかに開設されている．平成16年新潟県中越地震の際に避難生活と震災関連死としての静脈血栓塞栓症の関係が指摘されて以降，さまざまな災害の避難所で深部静脈血栓症の検診が行われており，今回両災害の避難所でも血管エコーを用いた検診が行われた．各避難所を巡回し，希望者を集い生活スペースもしくは場所を借り，問診・血圧などの測定・血管エコー検査・弾性ストッキング配布を行った．災害大国と呼ばれる日本において避難所生活を必要とする大災害発生リスクは大変高く，減災の視点に立てば災害関連死の原因となる肺塞栓症を予防するための避難所検診は非常に意義深いと考えられた．</p>

DOI： 10.7134/phlebol.16-38

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記述言語：日本語   出版者・発行元：日本胸部外科学会-関東甲信越地方会  

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記述言語：日本語   出版者・発行元：新潟医学会  

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2017&ichushi_jid=J00990&link_issn=&doc_id=20171214040017&doc_link_id=%2Fdg3nigta%2F2017%2Fs13108%2F008%2F0514-0514%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdg3nigta%2F2017%2Fs13108%2F008%2F0514-0514%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：新潟医学会  

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2017&ichushi_jid=J00990&link_issn=&doc_id=20180425070009&doc_link_id=%2Fdg3nigta%2F2017%2Fs13112%2F005%2F0715-0716%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdg3nigta%2F2017%2Fs13112%2F005%2F0715-0716%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：新潟医学会  

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2017&ichushi_jid=J00990&link_issn=&doc_id=20170707030030&doc_link_id=%2Fdg3nigta%2F2017%2Fs13103%2F024%2F0197-0197%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdg3nigta%2F2017%2Fs13103%2F024%2F0197-0197%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：英語   出版者・発行元：EDIZIONI MINERVA MEDICA  

A quadricuspid aortic valve (QAV) is a rare congenital aortic valve anomaly. Here we describe a case of a patient with a QAV associated with severe aortic, mitral, and tricuspid regurgitations that were treated surgically. Transesophageal echocardiography clearly demonstrated a QAV. The aortic vlave was excised and replaced with an 18-mm ATS AP360 valve (ATS Medical Inc., Minneapolis, MN), and the mitral valve was replaced with a 29-mm St. Jude valve (St. Jude Medical Inc., St. Paul, MN). Subsequently, tricuspid annuloplasty was performed with a 30-mm MC3 ring (Edwards LifeSciences, Irvine, CA) for annular enlargement. The patient's postioperative course was uneventful. Despite the widespread use of cardiac echocardiography, some cases of a QAV are incidentally detected during surgery. As a QAV can be associated with other congenital malformations, it is crucial to diagnose a QAV accurately using a combination of available imaging modalities, prior to surgery.

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記述言語：日本語   出版者・発行元：南山堂  

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その他リンク： http://search.jamas.or.jp/link/ui/2017051824

記述言語：日本語  

OBJECTIVE: Endovascular repair for retrograde type A aortic dissection with an entry in the descending aorta (RAAD) is challenging. We present early and mid- term results of endovascular repair for acute phase of RAAD by using commercially-available device.

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記述言語：日本語   出版者・発行元：一般社団法人日本脳神経超音波学会  

<b>Introduction:</b> The aim of this study is to clarify the important role of deep venous thrombosis (DVT) in disaster refugees.<br> <b>Methods:</b> We visited the Minami-sanriku Tome shelter in Miyagi Prefecture, one of the areas affected by the Great East Japan Earthquake, to examine the incidence of DVT by using an ultrasound device from March 14 to May 4, 2011. One hundred eighty-seven people, who were aged over 60 years and had lower limb trauma, lower limb symptoms, a history of lengthy periods of resting inside a car, and/or a motionless lifestyle in the shelter, participated in the examination. The ultrasound examination was mainly intended to check for DVT findings below the knee.<br> <b>Results:</b> The incidence of DVT in the participants was 5.3% (10/187). When comparing those with DVT with those without, age, percentage of women, and percentage with lower limb trauma were significantly higher in DVT patients than in non-DVT people. After logistic regression analysis, lower limb trauma was an independent strong risk factor for DVT (<i>p</i> < 0.0001, odds ratio=26.5).<br><b>Conclusion:</b> In conclusion, lower limb trauma is the most important cause of DVT formation in disaster refugees.

DOI： 10.2301/neurosonology.29.104

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記述言語：日本語   出版者・発行元：(NPO)日本心臓血管外科学会  

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DOI： 10.1253/circj.CJ-66-0121

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記述言語：日本語   出版者・発行元：新潟医学会  

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その他リンク： http://search.jamas.or.jp/link/ui/2016020525

記述言語：日本語  

The surgical strategy for coexisting lung cancer and aneurysm is controversial owing to the risk of aneurysm rupture during the perioperative period of pulmonary resection. We performed simultaneous pulmonary resection and endovascular repair in 2 patients with coexisting lung cancer and aneurysm. Case 1:A 74-year-old man presented at our hospital with cT2aN0M0 lung cancer and a 5.0 cm abdominal aortic aneurysm. Because computed tomography indicated the possibility of advanced lung cancer, we decided to perform simultaneous surgery for lung cancer and the aneurysm. Under general anesthesia, endovascular aneurysm repair was performed before right lower lobectomy with lymphadenectomy. The postoperative course was uneventful, and the patient was discharged on postoperative day 12. Case 2:A 72-year-old man presented at our hospital with cT2aN1M0 lung cancer, a 5.0 cm left internal iliac artery aneurysm, and right renal cell carcinoma( RCC). Because the lung cancer was advanced and the patients needed following surgical treatment for RCC, we decided to perform simultaneous surgery for lung cancer and the aneurysm. Under general anesthesia, endovascular aneurysm repair was performed before right upper lobectomy with lymphadenectomy. The postoperative course was uneventful, and the patient was discharged on postoperative day 11.

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記述言語：日本語   出版者・発行元：公益財団法人 日本心臓財団  

DOI： 10.11281/shinzo.47.880

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記述言語：日本語   出版者・発行元：公益財団法人 日本心臓財団  

DOI： 10.11281/shinzo.47.894

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記述言語：日本語   出版者・発行元：公益財団法人 日本心臓財団  

DOI： 10.11281/shinzo.47.930

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記述言語：日本語   出版者・発行元：公益財団法人 日本心臓財団  

DOI： 10.11281/shinzo.47.881

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記述言語：日本語   出版者・発行元：公益財団法人 日本心臓財団  

DOI： 10.11281/shinzo.47.940

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記述言語：日本語   出版者・発行元：公益財団法人 日本心臓財団  

DOI： 10.11281/shinzo.47.939

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記述言語：日本語   出版者・発行元：(一社)日本外科学会  

J-GLOBAL

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記述言語：英語  

We describe a patient with successfully treated giant bilateral internal iliac artery aneurysms that were associated with acute renal failure secondary to bilateral hydronephrosis, lumbosacral plexopathy, and ileus. After hemodialysis for 1 month, the patient underwent graft replacement of the abdominal aorta and iliac arteries, including complete obliteration of the internal iliac artery branches, reconstruction of the inferior mesenteric artery, and ureterolysis. Weaning from hemodialysis was achieved and postoperative renal function improved. Although the patient had serious preoperative co-morbidities, emergency traditional open surgery should be the gold standard for securely releasing compression of the neighboring organs instead of endovascular treatment.

DOI： 10.3400/avd.cr.15-00065

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記述言語：英語  

OBJECTIVE: To estimate the frequency of deep vein thrombosis (DVT) among non-surgical inpatients, and to evaluate the D-dimer assay as a screening tool for DVT. METHODS: Subjects were non-surgical inpatients aged 20 years or older who had been bedridden for at least 24 hours and had moderate-to-high risk factors for DVT. We assessed the presence of DVT by venous ultrasonography. Patients who received a diagnosis of venous thromboembolism (VTE) before admission, who had symptoms or findings of VTE at admission, or who had surgery or trauma within the past 3 months before admission were excluded. RESULTS: DVT was confirmed in 96 of 525 patients (18.3%). In a logistic regression analysis, longer duration of hospitalization, higher D-dimer value, and history of cancer surgery were significantly associated with the occurrence of DVT. The D-dimer assay showed high sensitivity (96.1%) and high negative predictive value (97.6%). CONCLUSION: Non-surgical inpatients with a long-term hospitalization or history of cancer surgery have a risk for DVT, and need to be considered for added DVT preventive measures as recommended in the prevention guidelines. In addition, the D-dimer assay is beneficial for the screening of DVT in medical practice.

DOI： 10.3400/avd.oa.14-00132

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記述言語：日本語   出版者・発行元：(一社)日本人工臓器学会  

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記述言語：日本語   出版者・発行元：日本胸部外科学会-関東甲信越地方会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：日本胸部外科学会-関東甲信越地方会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(NPO)日本血管外科学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：日本胸部外科学会-関東甲信越地方会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：新潟医学会  

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2015&ichushi_jid=J00990&link_issn=&doc_id=20160215140011&doc_link_id=%2Fdg3nigta%2F2015%2Fs12910%2F005%2F0608-0608%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdg3nigta%2F2015%2Fs12910%2F005%2F0608-0608%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：(株)メディカルレビュー社  

2012年に発生したイタリア北部地震(エミリア地震)は群発性地震でマグニチュード5〜6の直下型地震が2ヵ月間に7回、場所を変えて起きた。人々は家が崩壊する恐怖から車中泊や玄関にマットを敷いて寝るなどを数週間から数ヵ月行った。そのため車中泊では肺塞栓症(PE)で死亡者も出た。またPEとDVTは前年よりも増加していた。この状況は新潟県中越地震後と似ていたため調査を行った。被災地の8市と震源地から150km離れたトレント市で下肢静脈エコー検査を地元の医師、NPO、献血団体、スローフード協会などの協力で行った。その結果被災地の447名(男114名、女292名、平均年齢55.0歳)にエコー検査を行い39名に下腿DVTを認めた。トレントでは平均年齢55.8名の40名中2名に下腿DVTを認めた。被災地の被験者全体では年齢とDVT陽性率に相関を認めたが、各市別に被験者の年齢とDVT陽性率は相関せず、逆に若年でDVT陽性率が高い結果であった。また各市別では車中泊率とDVT陽性率に相関を認め、震災後のベッド使用率とDVT陽性率は強い負の相関を認めた。以上の結果から、エミリア地震では車中泊によるDVTが多かったことで若年でもDVTが多く、また震災後のベッド使用でDVTが予防されたものと考えられた。今回の結果はエミリア地震被災地ではDVT陽性率が高いことが示唆され、新潟県中越地震の経験からすると今後脳梗塞、心筋梗塞、肺塞栓症などの二次的健康被害がDVT陽性者で増加する危険性がある。したがって今後も被災者に対する医療的支援、特にDVTの定期的な検査が必要であり、そのためには世界的な支援が必要である。(著者抄録)

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2014&ichushi_jid=J04437&link_issn=&doc_id=20141216260002&doc_link_id=%2Fai1throd%2F2014%2F000904%2F002%2F0206-0212%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fai1throd%2F2014%2F000904%2F002%2F0206-0212%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語  

We report herein a rare case of endocardial blood cyst (EBC) in an adult patient. A 63-year-old asymptomatic woman underwent echocardiography, which incidentally detected a cardiac tumor in the right atrium. On echocardiography, the tumor was revealed to be a 30-mm round mass with thin, hyperechogenic walls and heterogeneously hypoechogenic contents. The lesion was attached to the septum. On computed tomography, the tumor appeared partly calcified and showed poor contrast-enhancement. On magnetic resonance imaging, the lesion appeared isointense or slightly hyperintense in T1 and T2-weighted sequences. Myxoma was strongly suspected based on these preoperative imaging findings. The tumor was successfully excised under cardiopulmonary bypass. Gross examination confirmed that the cyst was filled with blood. The cystic walls comprised thin-layered fibrous tissue lined with endocardial cells. No tumor cells were found. The diagnosis of EBC was confirmed based on histopathological examination, and the postoperative course was uneventful.

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記述言語：日本語   出版者・発行元：新潟医学会  

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その他リンク： http://search.jamas.or.jp/link/ui/2015038160

記述言語：日本語   出版者・発行元：新潟医学会  

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その他リンク： http://search.jamas.or.jp/link/ui/2015038120

Objectives: A retrospective analysis of data collected during subject screening following Japan's March 2011 earthquake and tsunami was performed. We aimed to determine the incidence of deep venous thrombosis (DVT) among screened subjects and to identify risk factors associated with the development of DVT as independent variables. Methods: Calf ultrasonography was undertaken in 269 subjects living in 21 shelters in Miyagi prefecture during the one-month period immediately following the March 2011 disaster. Information regarding the health and risk factors of subjects was collected by questionnaire and assessment of physical signs. Results: Of the 269 evacuees screened, 65 (24%) met the criteria for calf DVT.We found lower limb trauma, reduced frequency of urination and sleeping in a vehicle to be independent positive predictors of DVT. Conclusions: Evacuees had an increased risk of developing DVT, associated with tsunamirelated lower limb injury, immobility and dehydration.

DOI： 10.1177/0268355512474252

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記述言語：日本語   出版者・発行元：新潟医学会  

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その他リンク： http://search.jamas.or.jp/link/ui/2014333894

記述言語：日本語   出版者・発行元：一般社団法人日本外科学会  

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記述言語：日本語   出版者・発行元：一般社団法人日本外科学会  

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記述言語：日本語   出版者・発行元：一般社団法人日本脳神経超音波学会  

Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by acute thunderclap headaches with or without other neurological symptoms, and reversible multi-segmental vasoconstriction of the cerebral arteries. We describe the case of a 49-year-old woman presenting with severe, sudden-onset headaches and multi-segmental vasoconstriction of the cerebral arteries demonstrated on magnetic resonance angiography (MRA). Headaches disappeared within several days, and vasoconstriction of cerebral arteries was markedly improved 6 weeks after the onset. We therefore diagnosed RCVS. In addition to MRA, we repeatedly performed transcranial-color flow imaging (TC-CFI) and transcranial Doppler ultrasonography (TCD) to evaluate cerebral arterial blood flow and risk of cerebral infarction. The first TCD study was performed 6 weeks after the onset; 11 high-intensity transient signals (HITS) were detected in 30 min at the region of vasoconstriction in the right MCA. To the best of our knowledge, this is the first report of HITS-positive RCVS. Ten weeks after the onset, MRA demonstrated disappearance of cerebral arterial vasoconstriction, and TCD detected only 1 HITS in 30 min. Interestingly, TC-CFI still indicated elevated flow velocity in the bilateral MCAs. These findings suggest that TC-CFI may be more sensitive and useful than MRA for diagnosis of RCVS.

DOI： 10.2301/neurosonology.27.76

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記述言語：日本語   出版者・発行元：一般社団法人日本脳神経超音波学会  

<b>Background and Purpose</b>: Deep venous thrombosis (DVT) in the upper part of the body is rare, accounting for approximately 1 &ndash; 4% of all DVTs. The incidence and clinical significance of jugular vein thrombosis (JVT) were investigated in consecutive patients with acute ischemic stroke.<br><b>Subjects and Methods</b>: From December 2006 to March 2007, 71 patients (46 men, aged 70.8 &plusmn; 13.2 years) hospitalized within 48 hours after ischemic stroke or TIA onset were retrospectively examined. The presence of JVT was evaluated by ultrasonography. Patients with jugular vein catheterization were not included. Age, sex, hypertension, diabetes mellitus, hyperlipidemia, smoking status, presence of a malignant tumor, and D-dimer were assessed.<br><b>Results</b>: JVT was demonstrated in four patients (5.6%). The rate of a malignant tumor was significantly higher in patients with JVT than in those without (100% vs. 14.9%, p<0.001). The tumors were as follows: esophageal cancer (1); lung cancer (1); and uterine cervical cancer (2). The stroke subtype in three patients was Trousseau syndrome with a high D-dimer value, and that in the other patient was a lacunar stroke with a normal D-dimer value.<br><b>Conclusions</b>: Ultrasonographic evidence of JVT in patients with acute ischemic stroke could be a marker of a coincidental malignant tumor with or without Trousseau syndrome.

DOI： 10.2301/neurosonology.26.139

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記述言語：日本語   出版者・発行元：公益財団法人 日本心臓財団  

DOI： 10.11281/shinzo.46.569

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記述言語：日本語   出版者・発行元：(NPO)日本心臓血管外科学会  

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記述言語：英語   出版者・発行元：MEDICAL TRIBUNE INC  

We describe a case of patent ductus arteriosus (PDA) in a 76-year-old woman with a history of stroke, atrial fibrillation, and chronic obstructive pulmonary disease. Cranial diffusion-weighted imaging (DWI) performed for preoperative assessment showed a hyperintense lesion in the left cerebellum. Preoperative transesophageal echocardiography (TEE) demonstrated two highly mobile masses approximately 5 mm in diameter adherent to the left and non-coronary cusps of the aortic valve. We performed transpulmonary patch closure of PDA under hypothermic circulatory arrest. Subsequently, two frond-like masses were completely shaved off the cusps, preserving the native aortic leaflets. Pathological examination confirmed the diagnosis of papillary fibroelastoma (PFE). To our knowledge, this is the first report of PDA associated with PFE. Perioperative use of TEE is an effective tool for management of cardiovascular patients with suspected cardiogenic embolism.

DOI： 10.5761/atcs.cr.12.02114

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記述言語：英語  

After the Great East-Japan Earthquake, the prevalence of deep vein thrombosis (DVT) in disaster shelters in Ishinomaki (Pacific coast, Miyagi, Japan) was found much higher than that ever reported in Japan. In Ishinomaki, twelve patients were found to have pulmonary thromboembolism for one month since the earthquake and DVT was found in 10 of those patients. The calf DVT was examined using ultrasonography in the shelters (from March to July 2011) and in temporary emergency housings (from August to December 2011). Calf DVT was found in 190 of 701 evacuees. DVT prevalence was higher in the tsunami-flooded shelters (34.2%) than in that in the non-flooded shelters (19.1%). This indicated that deteriorated and crowded condition in the tsunami-flooded shelters might induce thrombogenesis in calf veins. Therefore, evacuees were recommended to leave tsunami-flooded areas. DVT prevalence in the shelters was gradually reduced, however, that was still higher in the temporary emergency housings (8.9%) than in the non-disaster area in Japan (2.2% in Yokohama city). The risk of calf DVT in the temporary emergency housings was increased because of reduced blood flow in the calf veins caused by immobility. The residents of the housings were required to be physically active to avoid calf DVT. (English translation of Jpn J Phlebol 2013; 24: 380-384).

DOI： 10.3400/avd.oa.14-00106

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記述言語：英語  

We describe a successfully treated case of acute type B aortic dissection complicated with lower extremity, visceral, and spinal cord malperfusion. To restore perfusion to both lower extremities, we performed an emergency right axillo-bifemoral bypass. Furthermore, we performed total arch replacement, including primary entry closure, because of delayed visceral organ ischemia. Unexpectedly, delayed paraplegia occurred after hospital discharge; however, the patient recovered without any neurologic sequelae after early introduction of hyperbaric oxygen therapy. Because another episode of organ malperfusion in the long term cannot be anticipated, and even though the previous organ malperfusion episode was treated successfully, close observation is mandatory for detecting clinical manifestations in combination with the availability of imaging modalities.

DOI： 10.3400/avd.cr.14-00059

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記述言語：日本語   出版者・発行元：日本胸部外科学会-関東甲信越地方会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(NPO)日本血管外科学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：日本胸部外科学会-関東甲信越地方会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：メディカルレビュー社  

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その他リンク： http://search.jamas.or.jp/link/ui/2015060356

記述言語：英語   出版者・発行元：ELSEVIER SCIENCE BV  

Background: This study aimed to investigate whether left atrial appendage (LAA) dysfunction evaluated by transesophageal echocardiography (TEE) during sinus rhythm is predictable of paroxysmal atrial fibrillation (PAF) as an embolic source in the acute stage of stroke. Methods and Results: We measured and analyzed LAA flow velocity (LAA-FV) and LAA ejection fraction (LAA-EF) in 300 acute ischemic stroke patients by TEE. We divided the acute ischemic stroke patients into 3 groups. The atrial fibrillation (AF) group (n = 58) comprised patients whose TEE was performed during AF rhythm. The PAF group (n = 42) comprised patients with a history of AF but with normal sinus rhythm when TEE was performed. The normal sinus (sinus) group (n = 200) did not have any history of AF. We found that mean LAA-FV and LAA-EF values in the PAF group were significantly lower than those in the sinus group (P <.001). The diagnostic accuracy of LAA-FV for the diagnosis of PAF calculated as the area under receiver operating characteristic curves was low (.582, 95% confidence interval [CI] =.498-.665) but that of LAA-EF was modest (.721, 95% CI =.653-.789), with an optimal cutoff point of 49.1%. Conclusions: LAA dysfunction as determined by TEE (LAA-EF < 49.1%) in the acute stage of stroke is predictive of PAF with moderate accuracy. Long-term electrocardiographic monitoring is recommended for cryptogenic stroke patients with LAA dysfunction. © 2013 Elsevier B.V. All rights reserved.

DOI： 10.1016/j.jstrokecerebrovasdis.2013.03.020

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記述言語：英語   掲載種別：速報，短報，研究ノート等（学術雑誌）   出版者・発行元：OXFORD UNIV PRESS INC  

DOI： 10.1093/ejcts/ezs610

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記述言語：日本語   出版者・発行元：一般社団法人日本外科学会  

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記述言語：日本語   出版者・発行元：一般社団法人日本外科学会  

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記述言語：日本語   出版者・発行元：新潟医学会  

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その他リンク： http://search.jamas.or.jp/link/ui/2013333120

記述言語：日本語   出版者・発行元：(一社)日本外科学会  

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記述言語：日本語   出版者・発行元：新潟医学会  

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その他リンク： http://search.jamas.or.jp/link/ui/2013320278

記述言語：日本語   出版者・発行元：日本静脈学会  

要約：石巻医療圏において，東日本大震災後の1 カ月間に12 例の肺血栓塞栓症例が発生し，平成23 年7 月までに32 カ所の避難所で701 名に行った下肢静脈エコー検査で，190 名に深部静脈血栓症（DVT）を認めた．DVT 陽性率は震災直後の3 月を最高に徐々に低下傾向であったが，避難所の集約が行われた直後の5 月に一時的に上昇した．津波で浸水した避難所は非浸水避難所に比較して有意にDVT 陽性率が高かったことから（各34.2％，19.1％，P<0.001），避難所環境がDVT 発症に影響したことが推測された．8月以降，仮設住宅団地17 カ所で360 名にエコー検査を行い，32 名にDVT を認めた．非被災地でのDVT 陽性率に比較すると明らかに高く，仮設住宅入居後の住民の活動性の低下が影響していると思われた．以上より，環境の悪い浸水地域からの早期の二次避難と仮設住宅での活動性保持などがDVT 予防に重要と思われた．

DOI： 10.7134/phlebol.409

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記述言語：日本語   出版者・発行元：新潟医学会  

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2013&ichushi_jid=J00990&link_issn=&doc_id=20130812030023&doc_link_id=%2Fdg3nigta%2F2013%2Fs12703%2F018%2F0162-0162%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdg3nigta%2F2013%2Fs12703%2F018%2F0162-0162%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：新潟医学会  

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2013&ichushi_jid=J00990&link_issn=&doc_id=20131128030013&doc_link_id=%2Fdg3nigta%2F2013%2Fs12706%2F008%2F0330-0331%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdg3nigta%2F2013%2Fs12706%2F008%2F0330-0331%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：新潟医学会  

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2013&ichushi_jid=J00990&link_issn=&doc_id=20130724080023&doc_link_id=%2Fdg3nigta%2F2013%2Fs12702%2F016%2F0112-0113%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdg3nigta%2F2013%2Fs12702%2F016%2F0112-0113%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：新潟医学会  

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2013&ichushi_jid=J00990&link_issn=&doc_id=20130612050010&doc_link_id=%2Fdg3nigta%2F2013%2Fs12701%2F002%2F0055-0056%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdg3nigta%2F2013%2Fs12701%2F002%2F0055-0056%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：新潟大学災害・復興科学研究所  

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記述言語：日本語   掲載種別：書評論文，書評，文献紹介等   出版者・発行元：一般社団法人 日本血液学会  

DOI： 10.11406/rinketsu.53.1730

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その他リンク： http://search.jamas.or.jp/link/ui/2012353346

Left atrial free-floating thrombi increase the risk of catastrophic complications such as systemic embolization. We describe the case of a left atrial free-floating thrombus in an octogenarian with a history of stroke and atrial fibrillation; the thrombus was detected unexpectedly by scheduled transesophageal echocardiography. Surgical removal of the thrombus was performed successfully in spite of the patients great age. Routine transesophageal echocardiography therefore is an effective and indispensable tool for individualized management of patients with a history of stroke and atrial fibrillation.

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記述言語：日本語   出版者・発行元：医学書院  

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その他リンク： http://search.jamas.or.jp/link/ui/2012288490

記述言語：日本語   出版者・発行元：メジカルビュー社  

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その他リンク： http://search.jamas.or.jp/link/ui/2012270058

記述言語：日本語   出版者・発行元：メディカルレビュー社  

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その他リンク： http://search.jamas.or.jp/link/ui/2012259954

記述言語：日本語   出版者・発行元：一般社団法人日本外科学会  

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記述言語：日本語   出版者・発行元：(株)南江堂  

86歳男。79歳時にS状結腸癌でS状結腸切除術、81歳時に白内障で手術を受けた。腹痛、背部痛が出現した。その後、食欲低下、体重減少があり、入院した。血小板数減少、フィブリン分解産物(FDP)の上昇を認め、播種性血管内凝固症候群(DIC)が疑われた。CTで解離性胸部大動脈瘤および解離性腹部大動脈瘤を認めた。DICの確定診断にはいたらなかったが、出血傾向を懸念し凝固障害の改善のため、メシル酸ガベキサートの投与を開始した。経時的CTで腹部大動脈瘤の拡大傾向を認めた。腹部大動脈瘤の切迫破裂を疑い、破裂死の予防のため、開腹で腹部大動脈瘤の切除分岐型人工血管置換、胸部下行大動脈ステントグラフト内挿術を一期的に施行した。術後一時的に血小板数は上昇したが徐々に減少し、Dダイマーなど凝固系の検査値は術前と同様であった。全身状態は順調に回復し、24病日に独歩により退院した。

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2012&ichushi_jid=J00349&link_issn=&doc_id=20120113200017&doc_link_id=40019144171&url=http%3A%2F%2Fci.nii.ac.jp%2Fnaid%2F40019144171&type=CiNii&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00003_1.gif

記述言語：日本語   出版者・発行元：公益財団法人 日本心臓財団  

DOI： 10.11281/shinzo.44.957

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記述言語：日本語   出版者・発行元：公益財団法人 日本心臓財団  

DOI： 10.11281/shinzo.44.955

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記述言語：日本語   出版者・発行元：(NPO)日本血管外科学会  

J-GLOBAL

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：KARGER  

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記述言語：英語   出版者・発行元：TOHOKU UNIV MEDICAL PRESS  

High prevalence of deep vein thrombosis (DVT) in disaster shelters has been reported in the aftermath of earthquakes in Japan. Calf DVT was examined using sonography in the shelters after the Great East Japan earthquake on March 11, 2011. By the end of July 2011, 701 out of 8,630 evacuees suspected with calf DVT, judged by inspections or medical interviews, were examined in 32 shelters, and 190 evacuees were confirmed to have calf DVT. The prevalence of DVT was 2.20%, which was 200 times higher than the usual incidence in Japan. The DVT prevalence seemed to decrease with time. By the end of May, a significantly higher prevalence of DVT was found in tsunami-flooded shelters (109 of 3,871 evacuees; 2.82%) than in non-flooded shelters (53 of 3,155 evacuees; 1.68%). After June, its prevalence was still higher (18/541; 3.33%) in tsunami-flooded shelters than in non-flooded shelters (10/1063; 0.94%). The cause of the high prevalence of DVT was supposed to be dehydration due to the delay in supplying drinking water, vomiting, and diarrhea experienced by the evacuees because of a shortage of clean water to wash their hands. Dehydration was especially noticed in women because they restricted themselves of water intake to avoid using unsanitary toilet facilities. Moreover, crowded shelters restricted the mobility of elderly people, which would exacerbate the prevalence of DVT. Those deteriorated and crowded shelters were observed in tsunami-flooded areas. Therefore, long-term shelters should not be set up in flooded areas after tsunami. © 2012 Tohoku University Medical Press.

DOI： 10.1620/tjem.227.199

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記述言語：日本語  

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記述言語：日本語   出版者・発行元：日本静脈学会  

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記述言語：日本語   出版者・発行元：へるす出版  

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記述言語：日本語   出版者・発行元：医学書院  

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その他リンク： http://search.jamas.or.jp/link/ui/2011335646

記述言語：日本語   出版者・発行元：一般社団法人 日本血栓止血学会  

DOI： 10.2491/jjsth.22.229

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記述言語：英語  

We present a case of floating thrombus originating from an almost normal thoracic aorta in a 54-year-old man who presented with acute arterial occlusion of his left leg. Transesophageal echocardiography (TEE), computed tomography, and magnetic resonance imaging showed two masses in an almost normal aorta after embolectomy for the acute arterial occlusion. Although the embolus was thrombus histologically, malignant tumors could not be ruled out. The masses did not decrease in size after 7 days of anticoagulant therapy, so they were extirpated under cardiopulmonary bypass (CPB) and TEE guidance. Frozen section examination during CPB indicated that there was no evidence of malignancy in the removed mass. TEE played an important role in the diagnosis and surgery of this condition, and it was useful when deciding on a surgical strategy. Because the treatment strategy for this disease remains controversial, further studies are needed. © 2011 The Japanese Association for Thoracic Surgery.

DOI： 10.1007/s11748-010-0752-2

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記述言語：英語   出版者・発行元：JAPANESE CIRCULATION SOC  

Background: Unfractionated heparin (UFH) is the standard drug for the initial treatment of pulmonary embolism (PE) and deep vein thrombosis (DVT) in Japan, whereas fondaparinux is the standard drug in Europe and the United States. Here, we examine the efficacy and safety of fondaparinux in Japanese patients. Methods and Results: In 2 randomized, open-label, multicenter studies, 80 Japanese patients with acute PE or DVT received either subcutaneous fondaparinux or intravenous UFH as a non-comparative reference, in a 3:1 ratio, for 5-10 days. Concomitant warfarin therapy was continued until Day 90. Multidetector-row computed tomography-based assessment showed that 57.9% and 45.9% of the patients with acute PE and acute proximal DVT had proximal DVT and PE as a complication, respectively. There was no recurrence of symptomatic venous thromboembolism. In the fondaparinux group, the respective improvement rates at the end of the initial treatment and follow-up periods were 71.4% and 86.8% for 42 patients with PE, and 57.8% and 83.3% for 46 patients with DVT; similar results were noted in the UFH group. One patient in the fondaparinux group experienced major bleeding during the initial treatment, but no such episode in the UFH group. Conclusions: Once-daily, subcutaneous fondaparinux is as effective and safe without monitoring as adjusteddose intravenous UFH for the initial treatment of acute PE and DVT in Japanese patients.

DOI： 10.1253/circj.CJ-10-1036

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記述言語：日本語   出版者・発行元：一般社団法人日本外科学会  

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記述言語：日本語   出版者・発行元：時事通信社  

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記述言語：日本語   出版者・発行元：新潟医学会  

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その他リンク： http://search.jamas.or.jp/link/ui/2011220118

記述言語：日本語   出版者・発行元：医療の質・安全学会  

DOI： 10.11397/jsqsh.6.248

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その他リンク： http://search.jamas.or.jp/link/ui/2011249620

記述言語：日本語   出版者・発行元：一般社団法人 日本脳卒中学会  

【背景および目的】急性期脳血管障害患者において，仰臥位で施行した際の下肢静脈径の臨床的意義についての報告は少ない．われわれは，急性期脳血管障害患者の深部静脈血栓症(DVT)発症予測因子としての下肢静脈径の意義を検討した．【方法】急性期脳血管障害患者(クモ膜下出血は除く)122名のうち，入院7日以内に下肢静脈エコーを施行し得た86例を対象とし，DVTの有無と静脈径(膝窩静脈およびヒラメ静脈)を計測した．【結果】DVTは16例(18.6%)に認め，DVT群は非DVT群に比較し，有意に膝窩静脈径が拡張していた (9.1&plusmn;3.4 mm，7.1&plusmn;1.9 mm，p=0.001)．一方，ヒラメ静脈径には有意差は認めなかった．膝窩静脈最大径の第1分位に対する第4分位(8.4–19.3 mm)のodds比は5.54倍と有意に高値であった(p=0.049，95%信頼区間1.01–30.50)．【結論】脳血管障害急性期において，仰臥位で下肢静脈エコーを施行する際，膝窩静脈径の計測が有用である．今後DVT発症予測の意義を含めて検討する価値がある．

DOI： 10.3995/jstroke.33.319

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記述言語：日本語   出版者・発行元：国立病院総合医学会  

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記述言語：日本語   出版者・発行元：公益財団法人 日本心臓財団  

DOI： 10.11281/shinzo.43.932

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記述言語：日本語   出版者・発行元：公益財団法人 日本心臓財団  

DOI： 10.11281/shinzo.43.958

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記述言語：日本語   出版者・発行元：プラネット  

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その他リンク： http://search.jamas.or.jp/link/ui/2010174790

記述言語：日本語   出版者・発行元：新潟医学会  

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その他リンク： http://search.jamas.or.jp/link/ui/2010340053

記述言語：日本語   出版者・発行元：新潟医学会  

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その他リンク： http://search.jamas.or.jp/link/ui/2010340055

記述言語：日本語   出版者・発行元：一般社団法人日本外科学会  

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記述言語：日本語   出版者・発行元：一般社団法人日本外科学会  

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記述言語：日本語   出版者・発行元：金原出版  

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その他リンク： http://search.jamas.or.jp/link/ui/2010110082

記述言語：英語   出版者・発行元：SAGE PUBLICATIONS LTD  

Intraoperative autologous blood predonation is reported to be useful for the prevention of homologous blood transfusion in cardiac operations, especially in on-pump coronary artery bypass grafting (CABG). However, CABG is now performed more often off-pump than on-pump. We analyzed the major factors of homologous blood transfusion in 25 consecutive cases of valvular heart operation with intraoperative autologous blood predonation except those with preoperative autologous blood donation. Homologous blood was not transfused in 18 cases, but was in 7 cases only after cardiopulmonary bypass (CPB). The homologous transfusion was not correlated with body weight, CPB dilution or duration, or preoperative hematocrit level, but was found to correlate with age (R =0.289, p=0.0413), bleeding output (R =0.197, p=0.0485), and predonation blood volume (R =0.436, p=0.0152). In conclusion, suitable intraoperative predonation may reduce the necessity for homologous blood transfusion in valvular heart operations. © 2010 Wichtig Editore. 2 2 2

DOI： 10.1177/039139881003300202

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記述言語：日本語   出版者・発行元：公益財団法人 日本心臓財団  

DOI： 10.11281/shinzo.42.924

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記述言語：日本語   出版者・発行元：公益社団法人 日本超音波医学会  

心臓血管外科術後脳障害の機序は脳循環不全と塞栓である．経頭蓋超音波検査（TCD）を術中に行うことで一度に両者の検出が可能である．しかし，高齢の日本人では，側頭骨から中大脳動脈（MCA）を検出することが難しいため顎下部からの頭蓋外内頸動脈（ICA）でのモニタリングが推奨される．TCDによる脳血流速度は人工心肺や脳分離体外循環時の潅流量の目安になる．術中の微小栓子シグナル（HITS/MES）の殆どは微小気泡を示すが，数が多いと脳障害を起こす．多数のHITS/MESが検出された際には術後の脳保護治療が必要である．

DOI： 10.3179/jjmu.37.305

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記述言語：日本語   出版者・発行元：公益財団法人 日本心臓財団  

DOI： 10.11281/shinzo.42.966

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記述言語：日本語   出版者・発行元：公益財団法人 日本心臓財団  

岩手・宮城内陸地震発生後，新潟大学を主体とする「エコノミークラス症候群予防検査支援会」を中心に，周辺医療機関からのボランティアと栗原市職員から構成される『チーム栗原』として，静脈血栓塞栓症 (venous thromboembolism；VTE) 予防検査活動を行った．地震発生後6カ月目までに，被災者113名に対し下肢静脈エコーを行い，17名 (15％) に深部静脈血栓 (deep vein thrombosis；DVT) を認めた．DVT陽性群とDVT陰性群とで，リスク要因について多変量解析を用いて分析した結果，年齢：高齢 (オッズ比1.090，95％CI 1.029-1.155，p＝0.004)，性別：男性 (odds ratios (OR) 0.150，95％ confidence interval (CI) 0.027-0.818，p＝0.028），症状の有無：有り (OR 3.326，95％CI 1.024-10.805，p＝0.046），喫煙習慣：有り (OR 16.020，95％CI 2.067-124.163，p＝0.008) が統計学的に有意であった．血栓陽性者に対しては，弾性ストッキングを配布し，かかりつけ医に対し診療情報提供書を作成し，基礎疾患治療の継続とともに，血栓治療を依頼した．さらに検診データをもとに栗原市とともに，避難所および仮設住宅の環境改善にも取り組んだ．保健師を中心に，避難所生活内での指導と管理を継続して行った．その結果，避難所および仮設住宅内で1人も肺塞栓症へ進展することなく現在まで経過している．震災後のVTE予防検査活動を行ううえでは，病院の枠組みを越え，行政を巻き込んだ活動が必要である．またこのような活動を支援することは，災害時における循環器科医師の重要な役割の1つと考える．

DOI： 10.11281/shinzo.42.473

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記述言語：日本語   出版者・発行元：日本胸部外科学会-関東甲信越地方会  

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記述言語：日本語   出版者・発行元：(NPO)日本心臓血管外科学会  

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記述言語：日本語   出版者・発行元：国立病院総合医学会  

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記述言語：日本語   出版者・発行元：日本胸部外科学会-関東甲信越地方会  

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記述言語：日本語   出版者・発行元：新潟医学会  

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その他リンク： http://search.jamas.or.jp/link/ui/2009143492

記述言語：英語   出版者・発行元：SPRINGER TOKYO  

Left ventricular assist devices (LVADs) have become more important than ever for patients with terminal heart disease. The chronic shortage of donors for heart transplantation may enhance the importance of LVADs as destination therapy. To prevent cerebral complications, the evaluation of high-intensity transient signals (HITS) of transcranial Doppler (TCD) ultrasound is important. In the present study, HITS were measured on seven occasions in patients supported with LVADs. The high-frequency counts in HITS were greater than the low-frequency counts (47 ± 42 vs. 9 ± 9 in 3 min, P = 0.025), and declined further with oxygen delivery to the patient. The high frequency of signals may imply air microemboli, and the counts may increase with time. © 2008 The Japanese Society for Artificial Organs.

DOI： 10.1007/s10047-008-0430-7

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記述言語：日本語   出版者・発行元：学習研究社  

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その他リンク： http://search.jamas.or.jp/link/ui/2008376835

記述言語：日本語   出版者・発行元：学習研究社  

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その他リンク： http://search.jamas.or.jp/link/ui/2008376834

記述言語：日本語   出版者・発行元：学習研究社  

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その他リンク： http://search.jamas.or.jp/link/ui/2008376836

記述言語：日本語   出版者・発行元：一般社団法人電子情報通信学会  

2004年に起こった新潟県中越地震では,10名の肺血栓塞栓症(Pulmonary embolism:PE)が報告され,そのうち少なくとも3名が亡くなった.また,PEの原因の約80%をしめる下肢深部静脈血栓(Deep vein thrombosis:DVT)は,地震発生から2週間以内に行われた調査において,対象者の30.4%に認められた.これらの背景から,近年ではDVTの早期発見の必要性が高まっている.DVTが生じた場合,流れを阻害された静脈血が表在静脈に集中する.そのため静脈への負担が増大し,血管の拡張が予測される.そこで本研究では,皮膚を透過しやすくデオキシヘモグロビンに吸収されやすい近赤外光(波長:780nm付近)を用いた表在静脈イメージング装置を構築し,深部静脈血栓症リスク評価への利用を検討した.

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その他リンク： http://search.jamas.or.jp/link/ui/2008376595

記述言語：日本語   出版者・発行元：一般社団法人日本脳神経超音波学会  

DOI： 10.2301/neurosonology.21.4

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記述言語：日本語   出版者・発行元：一般社団法人日本外科学会  

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記述言語：日本語   出版者・発行元：朝日新聞社  

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記述言語：日本語   出版者・発行元：一般社団法人 日本血栓止血学会  

Point<br>1）深部静脈血栓症（DVT），特にヒラメ筋静脈血栓は日本人でも多い．<br>2）DVT検査法のゴールドスタンダードは下肢静エコーと造影CTである．<br>3）大腿静脈は臥位で，下腿静脈は座位でエコー検査する．<br>4）静脈血栓の診断は血栓陰影の有無と圧迫法で確認する．<br>5）ヒラメ筋静脈血栓は非生理的状態で急速進展し肺塞栓症の原因になる．<br>6）器質化したDVTは慢性反復性となり非生理的状態で肺塞栓症の原因になる．<br>

DOI： 10.2491/jjsth.19.39

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記述言語：日本語   出版者・発行元：新潟大学  

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その他リンク： http://search.jamas.or.jp/link/ui/2008208855

記述言語：日本語   出版者・発行元：社団法人日本リハビリテーション医学会  

身体機能や日常生活動作（以下ADL）低下のため，呼吸リハビリテーションの対象として注目されている慢性呼吸器疾患患者に対して，下肢静脈エコーを用いた深部静脈血栓症（以下DVT）のスクリーニング検査を行い，ヒラメ静脈所見の検討を行った．ヒラメ静脈径は，対照群6.1&plusmn;1.5mm，在宅酸素療法（以下HOT）患者群6.8&plusmn;2.1mm，非HOT患者群7.0&plusmn;1.6mm（平均値&plusmn;標準偏差），で，HOT患者群，非HOT患者群のいずれも対照群と比較し有意な拡張が認められた（<i>p</i>=0.003）．HOT患者群では血栓形成率は14.3％と高く，非HOT患者群（2.0％）以上に血栓形成率の上昇が認められ（<i>p</i>=0.027），ADL低下に加え呼吸機能障害，低酸素血症状態の関与も示唆される．慢性呼吸器疾患も深部静脈血栓症の危険因子の1つと考え，スクリーニングとしての下肢静脈エコー検査や生活指導，理学療法などの予防対策が重要と考えられる．

DOI： 10.2490/jjrmc.45.40

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その他リンク： http://search.jamas.or.jp/link/ui/2008109348

記述言語：日本語   出版者・発行元：新潟医学会  

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2008&ichushi_jid=J00990&link_issn=&doc_id=20080811060025&doc_link_id=%2Fdg3nigta%2F2008%2F012205%2F025%2F0288-0288%26dl%3D2&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdg3nigta%2F2008%2F012205%2F025%2F0288-0288%26dl%3D2&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_5.gif

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記述言語：日本語   出版者・発行元：国立病院総合医学会  

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記述言語：日本語   出版者・発行元：一般社団法人日本外科学会  

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記述言語：日本語   出版者・発行元：新潟大学  

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その他リンク： http://search.jamas.or.jp/link/ui/2008111389

記述言語：日本語   出版者・発行元：新潟大学  

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その他リンク： http://search.jamas.or.jp/link/ui/2008111394

記述言語：日本語   出版者・発行元：先端医学社  

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その他リンク： http://search.jamas.or.jp/link/ui/2008039919

記述言語：日本語   出版者・発行元：社団法人日本リハビリテーション医学会  

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記述言語：日本語  

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記述言語：日本語  

We encountered 2 cases of pulmonary thromboembolism developed during refuge for Niigata Chuetsu earthquake in 2004. Case 1 was a 76-year-old woman who moved to the back seat of a car for refuge since the earthquake struck on October 23rd, 2004. When she emerged from the car on the morning of October 25th, she felt sudden dyspnea and lost consciousness. On arrival at the hospital, she had low blood pressure and hypoxemia, hypocapnia, and metabolic acidosis. Based on her clinical history and her symptoms, pulmonary thromboembolism was suspected and heparinization was begun immediately. In our hospital, the chest CT angiography proved the diagnosis. She was transferred to a university hospital for further treatment. Case 2 was a 79-year-old woman. She spent only one night in a car. Fifteen days after the earthquake, chest tightness and dyspnea occurred. Although her symptoms were improved and disappeared, she came to our hospital. Chest CT images confirmed pulmonary thromboembolism, and treatment with heparin was begun. We think this pulmonary thromboembolism was related to the knee-bending position she had assumed in the car and decreased activity during refuge. This is a clinical condition which could happen during disasters in the future. We should recognize the likelihood of pulmonary thromboembolisms in the disasters in the future.

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記述言語：日本語   出版者・発行元：一般社団法人日本外科学会  

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記述言語：日本語   出版者・発行元：一般社団法人日本外科学会  

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記述言語：日本語   出版者・発行元：一般社団法人日本外科学会  

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記述言語：英語   出版者・発行元：社団法人日本循環器学会  

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記述言語：英語   出版者・発行元：社団法人日本循環器学会  

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記述言語：日本語   出版者・発行元：Japan Heart Foundation  

DOI： 10.11281/shinzo1969.39.2_104

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記述言語：日本語   出版者・発行元：日本看護協会出版会  

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その他リンク： http://search.jamas.or.jp/link/ui/2008181652

記述言語：日本語  

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記述言語：英語   掲載種別：書評論文，書評，文献紹介等   出版者・発行元：THIEME MEDICAL PUBL INC  

There have been no reports on acute pulmonary embolism (APE) after earthquakes. Our aim was to clarify the actual the occurrence of APE following the 2004 Mid Niigata Prefecture earthquake in Japan, and to assess the risk factors for APE after the event. We sent questionnaires to 122 hospitals in the Niigata Prefecture after the earthquake. Cities, towns, and villages in the prefecture were classified into two areas (high evacuee rate area, and low evacuee rate area) due to the mean ratio of evacuees to the overall population during 1 week immediately after the earthquake. A rate of 5% and higher was encountered for the high evacuee rate area and a rate of <5% was encountered for the low evacuee rate area. Ten out-of-hospital cases of APE (seven in the high evacuee rate area and three in the low evacuee rate area) were diagnosed within the first month after the earthquake. The relative risk of APE was high in the high evacuee rate area (13.09; p = 0.0002) and also higher in women (8.55; p = 0.04). All patients in the high evacuee rate area had stayed in their automobiles for long periods of time, but none had done so in the low evacuee rate area (p = 0.008). Copyright © 2006 by Thieme Medical Publishers, Inc.

DOI： 10.1055/s-2006-955468

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記述言語：日本語   出版者・発行元：新潟医学会  

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記述言語：日本語   出版者・発行元：新潟大学  

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その他リンク： http://search.jamas.or.jp/link/ui/2006320730

記述言語：日本語   出版者・発行元：社団法人日本リハビリテーション医学会  

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記述言語：日本語   出版者・発行元：一般社団法人日本外科学会  

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記述言語：日本語   出版者・発行元：新潟大学  

新潟中越地震の車中泊では地震による心的ストレス,窮屈な下肢屈曲姿勢,そして脱水により下肢深部静脈に血栓が発生しエコノミークラス症候群(肺塞栓症)が多発した.10/31,11/3,11/7には厚生連佐久総合病院の診療チームと計69名(男性4名)にポータブルエコーで,11/15から12/20までは厚生連魚沼病院に通常のエコー装置を設置しマスコミを通じて呼びかけ82名(男性13名)に下肢静脈エコー検査施行した.2005/2/28から3/31まで再度魚沼病院で検査した方を対象に再度下肢静脈エコーを行った.10/31-11/7に検査した69名中車中泊経験者は60名で,8名にヒラメ静脈浮遊血栓(そのうち1名はCTで肺塞栓症を認めた),14名に壁在血栓を認め,血栓陽性例は全員車中3泊以上であった.11/15-12/20の検査では車中泊は66名(6名は30日以上連泊),そのうち60名が下肢の疼痛や腫脹を訴えヒラメ静脈の充満血栓1名,9名で壁在血栓を含めた血栓を認め,血栓陽性例は全員震災直後から車中4泊以上であった.血栓陽性率は震災後からの経過時間とともに低下し12/20では10%であったが2/28から3/31の診療結果では新たな血栓も認め血栓陽性率は21.9%と上昇を認めた.11/7までの下肢静脈エコーにおける車中泊者のヒラメ筋最大静脈径は8.8±2.5mm(車中泊経験の無いヒラメ筋最大静脈径7.1±2.0mm)より有意に大(n=55,p<0.05),また血栓を認めた被災者のヒラメ静脈最大径10.0±2.6mmで血栓の無い被災者(7.5±4.4mm)より有意に大であった(n=67,p<0.0001).本診療調査により大災害時における車中泊は急性期に肺・静脈血栓塞栓症を起こすだけでなく,静脈の損傷により慢性期に反復性の血栓を生じて血栓後症候群になる危険性も大であることが示唆された.

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その他リンク： http://hdl.handle.net/10191/3443

記述言語：日本語   出版者・発行元：(一社)日本脈管学会  

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記述言語：日本語   出版者・発行元：シュプリンガー・ジャパン(株)  

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記述言語：日本語   出版者・発行元：(一社)日本血栓止血学会  

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記述言語：日本語   出版者・発行元：新潟大学  

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その他リンク： http://search.jamas.or.jp/link/ui/2006091891

記述言語：日本語   出版者・発行元：日本臨床生理学会  

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記述言語：日本語   出版者・発行元：新潟大学  

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その他リンク： http://search.jamas.or.jp/link/ui/2005215005

記述言語：日本語   出版者・発行元：(一社)日本脳卒中学会  

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記述言語：英語   出版者・発行元：社団法人日本循環器学会  

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記述言語：日本語   出版者・発行元：一般社団法人 日本農村医学会  

<B>はじめに</B><BR>平成16年10月23日午後5時56分新潟県中越地震が起こった。ライフラインが断たれ多くの方が避難所生活を余儀なくされた。一向に収まらない余震に、１万人以上といわれる車中生活者が見られたのが特徴であった。車から出た途端に血栓症で倒れて亡くなる、所謂エコノミークラス症候群の疑いの死亡者が報道されるようになった。そこで、新潟大学呼吸循環外科・榛沢医師が各避難所を回り調査した結果30％の高率で血栓が見つかった。それをふまえ定置での検査も必要と考え、被災地のほぼ中心に位置する当院でエコー検査を実施した。より多くの被災者に知ってもらうため避難所にポスターを貼り、メディアの協力を得て呼びかけを行なった。<BR><B>期間</B><BR>前期 平成16年11月15・17・22・24・29日 12月6・13・20・27日の9日間<BR>後期 平成17年2月28日 3月4・7・14・17・22・28日の7日間<BR><B>対象</B><BR>１）前期：車中泊の経験者・足の痛み・腫れ・浮腫のある方<BR>男性16名（40歳から81歳）女性67名（28歳から83歳）の計83名 <BR>平均年齢59.5歳<BR>２）後期：前期被検者で再検を希望した人32名<BR><B>結果</B><BR>前期：症状あり73名（下肢腫脹・疼痛・足がつる・熱感・違和感・関節痛）症状なし10名<BR>慢性血栓（壁在血栓）8名 充満血栓や浮遊血栓2名 <B>12％に血栓を確認</B><BR>車中泊連続20日以上8名（全員症状はあるが血栓なし）車中泊経験者は血栓が消失しても浮腫・疼痛が残る。<BR>後期：症状あり21名（下肢腫脹・下肢疼痛など）<BR>症状なし11名<BR>浮遊血栓を再度確認1名 新たな浮遊血栓2名 壁在血栓3名 静脈瘤血栓1名 <B>21.9％に血栓を確認</B><BR><B>考察</B><BR>11月12月の検査では12％が陽性と診断された。これは、車中生活で長時間同じ姿勢の維持、トイレの回数を減らす為に水分を摂らずにいた為と考えられる。また、2月・3月のフォローアップでは、21.9％に血栓が見られた。前回異常のなかった2名に血栓が見つかり、参考に行ったＤダイマー検査でも陽性を示した。これらのことから、早期発見の重要性とフォローアップの必要性がある。死亡者を出さないためにも車中泊での問題点や注意点を啓蒙していかなければならない。今回、県内各病院の検査技師からボランティア（延べ40名）からエコー検査に協力して貰った。全国各地で地震が起こっている。今回の経験を生かし、検査技師会を通じて下肢静脈エコー検査の有用性を知って貰い、災害時に検査技師として、率先して現地に赴き、エコノミークラス症候群の早期発見に努めるよう提起していきたいと考えている。

DOI： 10.14879/nnigss.54.0.146.0

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記述言語：日本語   出版者・発行元：一般社団法人 日本農村医学会  

DOI： 10.14879/nnigss.54.0.336.0

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記述言語：日本語   出版者・発行元：社団法人日本循環器学会  

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記述言語：日本語   出版者・発行元：社団法人日本循環器学会  

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記述言語：日本語   出版者・発行元：社団法人日本循環器学会  

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記述言語：日本語   出版者・発行元：社団法人日本循環器学会  

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記述言語：日本語   出版者・発行元：新潟大学  

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その他リンク： http://search.jamas.or.jp/link/ui/2004216444

記述言語：英語   出版者・発行元：社団法人日本循環器学会  

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記述言語：日本語   出版者・発行元：シュプリンガー・ジャパン(株)  

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記述言語：英語  

Left ventricular unloading and energy charge as effects of transaortic catheter venting (TACV) during venoarterial bypass (VAB) in normal and failing hearts has been reported previously. The aim of this study was to assess the effectiveness and safety of a special multipurpose catheter for TACV during percutaneous cardiopulmonary support (PCPS) in a preclinical setting. Six adult pigs underwent PCPS with or without the TACV. With standard hemodynamic monitoring, LV volume and function were assessed by direct ultrasonic cardiography (UCG) in each condition. PCPS was smoothly established and the TACV catheter was safely introduced in all cases. As compared with isolated PCPS, the TACV combined with PCPS maintained significant blood flow with LV venting and systemic perfusion: the heart rate of the native heart, systemic arterial pressure, and central venous pressure were stable. Also the additional TACV led to a significant reduction of LV preload during PCPS, and the reduction was 25-30% of LVDd and 20-35% of LVAd. The results of this investigation suggest that clinical application of the TACV technique with a clinical PCPS circuit would be feasible and additional TACV might be useful for LV recovery during PCPS in patients with severe heart failure.

DOI： 10.1111/j.1525-1594.2004.47036.x

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記述言語：日本語   出版者・発行元：一般社団法人 日本超音波検査学会  

DOI： 10.11272/jssabst.29.0.240.1

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記述言語：日本語   出版者・発行元：一般社団法人 日本人工臓器学会  

DOI： 10.11392/jsao1972.33.2Supplement_s203

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記述言語：日本語   出版者・発行元：一般社団法人 日本人工臓器学会  

DOI： 10.11392/jsao1972.33.2Supplement_s212

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記述言語：日本語   出版者・発行元：(株)インナービジョン  

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記述言語：日本語   出版者・発行元：社団法人日本循環器学会  

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記述言語：日本語   出版者・発行元：社団法人日本循環器学会  

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記述言語：日本語   出版者・発行元：社団法人日本循環器学会  

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記述言語：日本語   出版者・発行元：社団法人日本循環器学会  

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記述言語：日本語   出版者・発行元：社団法人日本循環器学会  

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記述言語：日本語   出版者・発行元：一般社団法人日本外科学会  

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記述言語：日本語   出版者・発行元：一般社団法人日本外科学会  

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記述言語：日本語   出版者・発行元：社団法人日本循環器学会  

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記述言語：日本語   出版者・発行元：社団法人日本循環器学会  

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記述言語：日本語   出版者・発行元：社団法人日本循環器学会  

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記述言語：日本語   出版者・発行元：社団法人日本循環器学会  

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記述言語：日本語   出版者・発行元：社団法人日本循環器学会  

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記述言語：英語   出版者・発行元：社団法人日本循環器学会  

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記述言語：日本語   出版者・発行元：シュプリンガー・ジャパン(株)  

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記述言語：日本語   出版者・発行元：新潟医学会  

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その他リンク： http://hdl.handle.net/10191/3594

Heparin-induced thrombocytopenia and thrombosis syndrome (HITTS) is a potentially life-threatening side effect of heparin therapy, triggered by an immune response, and has been reported to be related not only to the therapeutic use of heparin but also to heparin-coated catheters. A 45-year-old woman with intrapelvic malignancy developed an acute pulmonary thromboembolism (PE) after hysterectomy despite prophylactic heparin use. Subsequent large doses of heparin for treatment of the PE exacerbated the thrombocytopenia and, moreover, a large thrombus formed around the heparin-coated central venous catheter. Anti-heparin-platelet factor 4 complex antibody and heparin-induced platelet aggregation assay were positive, so the diagnosis was HITTS, and heparin was replaced by argatroban after carrying out thrombectomy. This therapy was successful, and the patient made favorable progress.

DOI： 10.1253/circj.67.96

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記述言語：日本語   出版者・発行元：Japan Heart Foundation  

症例は36歳,男性.咳嗽,喀痰,右腰背部痛を主訴に当科受診. 胸部X 線写真では特記すべき所見はなかったが,肺癌の精査を希望し胸部CTを施行,左横隔膜部に3.5×2.0cmの腫瘤を認め呼吸器外科に紹介された.胸部MRIでは心尖部に心室瘤を疑わせる所見があり縦隔腫瘍も含めた精査目的で同科入院,心精査のため当科紹介受診となった.<BR>心エコーでは前壁心尖部に径約1 c m の瘤を認め,カラードップラーでは収縮期に一致して入口部より左室内腔に向かう異常血流を認めた.エルゴメーター負荷201Tl心筋SPECTでは心尖部より指状に突出する201Tl集積を認めた.確定診断のため心臓カテーテル検査を施行,左室造影では前壁心尖部より左側方へ指状の内腔突出(最大径1.3cm,全長約6cm)を認め,その特異な形態より筋性の先天性左室憩室症と診断した.冠動脈造影では器質的狭窄を認めなかった.<BR>先天性左室憩室症はまれな心奇形で,他の合併奇形により生後早期に診断されることが多く,本症例のように無症状で成人期に診断される例は極めてまれとされる.時に破裂,血栓塞栓症などの重篤な合併症が報告されているが,孤立性の本症の自然予後は不明であり,手術適応も確立されたものはない.本症例では患者の希望もあり慎重に経過観察の方針とした.日常診療のなかで成人の未診断例が存在している可能性を示唆する症例と思われ報告する.

DOI： 10.11281/shinzo1969.35.3_175

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記述言語：日本語   出版者・発行元：一般社団法人日本脳神経超音波学会  

A proposal has been made to introduce a new Japanese guideline for detection of micro-embolic signals using trans-cranial Doppler (TCD). This guideline is in accordance with the Consensus on Micro-Embolus Detection by TCD proposed by the International Consensus Group on Micro-Embolus Detection in 1998. Micro-embolic signals are called HITS or MES. HITS include artifacts in place of MES. Recommended settings are: (1) use of a 2-MHz probe; (2) sample volume within 10 mm; (3) power set as low as reasonably possible; and (4) use of a headband to affix the TCD probe. The characteristics of HITS/MES are: (5) an intensity at least 3 dB higher than the background that reflects the blood stream; (6) a recording time of more than 30 minutes but not more than one hour to maintain the normal brain temperature; and (7) signals without associated sounds or a low emboli-blood ratio (EBR) excluding HITS. Other recommendations include: (8) recording HITS as digital data, using digital audio tape or CD-R; (9) having data double-checked by an expert who is not familiar with the clinical profile of the examinee; and (10) checking all data manually. The results are better than those obtained from an automatically detected HITS/MES system that is not yet at the completion stage.

DOI： 10.2301/neurosonology.16.168

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記述言語：日本語   出版者・発行元：一般社団法人 日本人工臓器学会  

DOI： 10.11392/jsao1972.32.2Supplement_s30

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記述言語：日本語   出版者・発行元：一般社団法人 日本人工臓器学会  

DOI： 10.11392/jsao1972.32.2Supplement_s110

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記述言語：日本語   出版者・発行元：社団法人日本循環器学会  

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記述言語：日本語   出版者・発行元：新潟大学  

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記述言語：日本語   出版者・発行元：新潟大学  

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その他リンク： http://search.jamas.or.jp/link/ui/2003102884

記述言語：日本語   出版者・発行元：新潟大学  

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その他リンク： http://search.jamas.or.jp/link/ui/2003102912

記述言語：日本語   出版者・発行元：新潟大学  

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その他リンク： http://search.jamas.or.jp/link/ui/2003083783

記述言語：日本語   出版者・発行元：新潟医学会  

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その他リンク： http://search.jamas.or.jp/link/ui/2003083784

記述言語：日本語   出版者・発行元：(NPO)日本血管外科学会  

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記述言語：日本語   出版者・発行元：一般社団法人日本外科学会  

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記述言語：日本語   出版者・発行元：医学図書出版  

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その他リンク： http://search.jamas.or.jp/link/ui/2002247147

記述言語：英語   掲載種別：書評論文，書評，文献紹介等  

To clarify special imaging assessment that is useful for minimally invasive cardiac surgery (MICS), we examined 141 cases of MICS operations with ministernotomy or minithoracotomy. In the 141 patients, 62 valve, 42 coronary, 37 congenital heart, and 2 other procedures were successfully completed without conversion to full sternotomy. Preoperative chest x-ray, computed tomography, and/or magnetic resonance imaging were necessary for determining the level of ministernotomy, especially in aortic valve operations. Transthoracic echocardiography was useful for selecting procedures of mitral valve or intracardiac repair through the MICS approach. Intraoperative transesophageal echocardiography was essential for continuous monitoring of cardiac function, intracardiac flow, air bubbles, and so forth. The above results suggest that intensive imaging assessment might be very important for successful MICS operations with ministernotomy or minithoracotomy and that extensive indications for this technique exist for various cardiovascular diseases.

DOI： 10.1046/j.1525-1594.2002.06965.x

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In development of an artificial heart, thrombus formation is still serious problem. However, there is no effective means to detect a thrombus. An optical measurement method is one of the best approaches which realize noninvasive thrombus detection. The purpose of this research is to develop the noninvasive thrombus detection method using NIR (Near Infra-Red) laser, and to apply the method to clinical use. By considering the optical characteristic of a thrombus and blood, we have developed the new thrombus detection system. By using this measurement system, the mockup experiment and the animal experiment were performed to detect a fake thrombus such as plastic beads (r=0.2mm) and celite powder (0.1×0.02mm) in the artificial heart circulatory system. The thrombus detection performance and safety of this method have been confirmed as the result of these experiments. After obtaining informed consent, the measurement examination was performed to the artificial heart (LVAS: Left Ventricular Assist System) use patient as the clinical application, and similar signals (LMES: Laser-detected Micro-Embolus Signals) corresponding to the animal experiment were detected. The proposed noninvasive thrombus detection method using NIR laser would be regarded as effective in the surveillance of the thrombus formation at the time of clinical artificial heart use.

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記述言語：日本語   出版者・発行元：一般社団法人 日本人工臓器学会  

DOI： 10.11392/jsao1972.31.2Supplement_s97

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記述言語：日本語   出版者・発行元：一般社団法人 日本人工臓器学会  

DOI： 10.11392/jsao1972.31.2Supplement_s37

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記述言語：日本語   出版者・発行元：新潟医学会  

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その他リンク： http://search.jamas.or.jp/link/ui/2002181403

A-37-year-old woman in shock condition was transferred to our hospital after cardiopulmonary resuscitation for ventricular fibrillation. She was unconscious and suspected of suffering ischemic brain damage, with pathologic reflexes and weak brain stem reflexes. Brain CT scan showed cerebral edema without hemorrhage or infarction and an electroencephalograph revealed slow alpha-theta waves. Chest CT scan and echocardiogram showed ascending aortic aneurysm with sever aortic regurgitation. An emergent operation was performed for progression of heart failure. There were no distortion or dilatation of the sinus of Valsalva and annuloaortic ectasia and aortic valve leaflets were almost normal. We considered that the aortic valve dysfunction was cause by dilatation of the sinotubular junction. Ascending aortic and aortic valve replacement were carried out to shorten cardiopulmonary bypass time and to prevent the progression of brain damage. Mild hypothermia was employed as a neuroprotective procedure for three days after surgery. The patient's neurological symptoms, which were right hemiparesis, facial apraxia and motor aphasia, improved and she was discharged from the hospital on foot without any neurological complications on the 47th postoperative day and returned to work after two months.

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記述言語：日本語   出版者・発行元：(一社)日本人工臓器学会  

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記述言語：日本語   出版者・発行元：新潟医学会  

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その他リンク： http://search.jamas.or.jp/link/ui/2002153416

記述言語：日本語   出版者・発行元：新潟医学会  

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その他リンク： http://search.jamas.or.jp/link/ui/2002161232