The Japanese Journal of Rehabilitation Medicine
Online ISSN : 1881-8560
Print ISSN : 1881-3526
ISSN-L : 1881-3526
Volume 47, Issue 5
Displaying 1-9 of 9 articles from this issue
Reports
46th Annual Meeting of the Japanese Association of Rehabilitation Medicine
Symposium
46th Annual Meeting of the Japanese Association of Rehabilitation Medicine
Educational Lectures
4th Annual Meeting of the Japanese Board-certificated Physiatrist Association
Educational Lecture
Short Note
  • Takashi TANAKA, Hitoshi KAGAYA, Michio YOKOYAMA, Eiichi SAITOH, Mikoto ...
    2010 Volume 47 Issue 5 Pages 320-323
    Published: May 18, 2010
    Released on J-STAGE: June 11, 2010
    JOURNAL FREE ACCESS
    Videofluoroscopic examination of swallowing (VF) is widely used for evaluating swallowing function. However, pulmonary complications after VF are seldom evaluated. We checked residual barium sulfate on chest X-rays and early pulmonary complication after VF. One hundred and ninety-eight patients underwent VF and chest X-rays. Eighty-six patients who did not aspirate during VF had no residual barium on their chest X-rays. One hundred and twelve patients aspirated during VF, but only 40 of these patients showed residual barium on their chest X-rays. Ten patients had fever after VF, but no significant relationship was observed between fever and residual barium on chest X-rays or aspiration. Aspiration was not correlated with mobility or cognitive status. One case had pneumonia after VF, but VF did not seem to be the cause of the pneumonia. In conclusion, no severe early pulmonary complications after VF were observed. It is difficult to predict early pulmonary complications from chest X-rays.
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Case Report
  • Ikuno ITO, Junko FUJITANI, Naoko SHINDO, Kohei HAMADA, Fumiko HATTORI, ...
    2010 Volume 47 Issue 5 Pages 324-328
    Published: May 18, 2010
    Released on J-STAGE: June 11, 2010
    JOURNAL FREE ACCESS
    The following report illustrates a rare case of dysphagia caused by secondary adrenal insufficiency in a patient with isolated ACTH deficiency. A 76-year-old man with progressive appetite loss, weight loss and general fatigue was hospitalized due to dehydration, aspiration pneumonia and hypoglycemia. He was unable to stand and walk by himself. His serum cortisol and ACTH levels were both low. An endocrinological examination resulted in a diagnosis of isolated ACTH deficiency. Following the administration of 15mg of glucocorticoids daily, his symptoms diminished without dysphagia. Furthermore, we investigated his swallowing function using a videofluoroscopic examination of swallowing (VF). The VF showed an impaired laryngeal movement as well as an upper esophageal opening and severe aspiration without a delay in his swallowing reflex. Oral intake was judged to be impossible, but his swallowing function gradually improved and he was able to resume eating all of his meals 2 months after treatment. Dysphagia is not a common symptom in ACTH deficient patients but a few similar cases have been reported. The swallowing function of the patients in these cases was not evaluated in detail, so we evaluated this case according to the results of the VF and the patient's process of recovery. Careful monitoring of swallowing function and appropriate treatment for both dysphagia and adrenocortical failure are required for the recovery of such patients. In conclusion, practitioners should be wary of isolated ACTH deficiency in elderly patients with progressive weight loss and dysphagia.
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Regional Meeting
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