Journal of Nippon Medical School = Nippon Ika Daigaku zasshi
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It is well known that pregnancy reduces anesthetic requirements in response to various noxious stimuli. However, there have been no detailed reports concerning functional changes in nerve fibers during pregnancy. ⋯ A significant difference in CPT values on A fibers was noted between the gravid and the nongravid women, but, no significant difference in CPT values was noted in any of the nongravid women in the follicular or luteal phases. Our results support the current theory that pregnancy changes nerve fiber conduction, as indicated by an increase in CPT values especially on myelinated fibers, but does not cause changes in CPT values across the menstrual cycle.
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An 11-year-old girl with Kostmann syndrome developed refractory pneumonia. Culture of oral discharge, throat-swab specimens, and blood could not identity the causative organism, and systemic antimicrobial therapy failed to achieve improvement. We then performed diagnostic bronchoalveolar lavage (BAL) and culture of BAL fluid (BALF) yielded Pseudomonas aeruginosa. Therapeutic BAL using gentamicin produced a striking improvement of her pneumonia. ⋯ In immunocompromised children with pneumonia, BAL helps to identify the causative organism. If the patient is unresponsive to systemic antimicrobial therapy, BAL using antimicrobial agents is also worth trying.
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Dyspnea is a major clinical symptom of various respiratory diseases. However, no objective assessment of dyspnea on exertion (DOE) in elderly subjects has been established yet. Furthermore, the factors which may influence DOE in healthy elderly subjects have not yet been precisely elucidated. ⋯ The odd ratio increased with advancing age; when the value in the 65~69 year-old group was 1, the odd ratios in the 85~89 year-old and 90~94 year-old groups were in approximately 6 and 8, respectively. Similarly, the odd ratio increased parallel with reduction in MVV. From these results, we conclude that the OCD value is reliable, simple and the best method of evaluating dyspnea in elderly subjects semi-quantitatively, and both the minute ventilatory volume and age are closely related with changes in OCD values.
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The incidence and the distribution of blood vessels were examined in normal and abnormal mitral valve leaflets. ⋯ At the ring area, normal mitral valve leaflets were supplied with nutrition from blood vessels that mainly extended from the left atrium with myocardial tissues. In RVD, the vessels branched from previously existing capillaries, extending to the distal area, and increased in number. Mechanical stress during opening and closing of the leaflets contributes to the arterialization of these vessels. In FMV, the number of capillaries, which is smaller than in normal valves, might be related to the progression of this disorder. In HIE with valvular disease, the number of vessels is related to the preexisting disease.