In western countries, left-sided diverticular disease (LDC) is very common, but right-sided diverticular disease (RDC) is rare. On the other hand, in Oriental countries including Japan, RDC is more common than LDC. In the pathogenesis of diverticular diseases, RDC has been considered among those diseases with anomaly of colonic motility. It is well known that the genesis of pressure-induced diverticula related to the increased tension which causes blow-out of the mucosa in the colon haustrum located between two successive segments of spastic circular muscle (i.e., colonic segmentation). Peristalsis is very important in the transport of intestinal contents from the mouth to the anus and is mainly controlled by the enteric nervous system (ENS). Physiological, pharmacological and histochemical investigations have indicated that non-adrenergic, non-cholinergic (NANC) excitatory and inhibitory nerves, in addition to adrenergic and cholinergic components, play an important role in the regulation of intestinal peristalsis. However, there have been few reports in regard to the physiologic function of the ENS in patients with diverticular disease. In particular, physiologic functional differences of the ENS between the RDC and the LDC remain unknown. Recently, it has been reported that the ENS contains excitatory and inhibitory nerves and that the former, especially cholinergic nerves, are dominant in both RDC and LDC. Furthermore, there are no functional differences of the ENS between the RCD and LDC. These observations may be related to the high intraluminal pressure due to colonic segmentation in colonic diverticular disease, including RCD and LDC.
The ventricular assist device (VAD) is implanted as an effective treatment for end-stage heart failure and has been widely used as a bridge to cardiac transplantation or in destination therapy. In Japan, however, there are problems with the heart transplantation system, i.e., an extreme shortage of donors and limited availability of VAD. Until recently, only one paracorporeal ventricular assist device (NIPRO VAD) was approved for coverage by national health insurance. In this study, we investigated the results obtained using the NIPRO VAD at our institution. From 2006 to 2009, 8 patients underwent NIPRO VAD implantation (left VAD: LVAD) at Nihon University Itabashi Hospital. Three patients were be weaned from LVAD, and it was used as a bridge to heart transplantation in two patients who underwent transplantation in Germany. Four patients have since achieved long-term survival with LVAD without complications. All four patients with cardiogenic shock due to acute myocardial infarction died despite the use of LVAD. Although the outcome of LVAD therapy was poor for patients with cardiogenic shock due to acute myocardial infarction, it was effective in patients with fulminant myocarditis and as a bridge to transplantation.
Following traumatic brain injury (TBI), inflammatory cells including activated microglia and blood-derived leukocytes, infiltrate into the contusion, and the subsequent inflammatory response may contribute to secondary degenerative brain damage. Thus, treatment strategies designed to inhibit the secondary inflammatory response may be of value in the treatment of TBI patients. Therapeutically, the beneficial effects of minocycline, a derivative of the antibiotic tetracycline, have been shown in various models of central nervous system disorders through inhibition of the inflammatory reactions. This study investigated whether minocycline could ameliorate traumatic brain injury in a rat model. The inflammatory reaction, as represented by morphological changes in microglia and the infiltration of macrophages, persisted for 2 weeks after induction of a controlled cortical impact (CCI) injury. Thus, post CCI, the rats were treated with minocycline or vehicle intraperitoneally every 24 hours until sacrifice at 2 weeks, and the infiltration of inflammatory cells into the contusion, and the lesion size were measured.
Before Nihon University School of Medicine opened utilizing our problem-based learning (PBL) tutorials combined with lectures, low attendance to lectures was identified as one of the justifications for adopting the hybrid PBL. To date, no studies have examined the effects of hybrid PBL on lecture attendance. We used our evaluation of the lectur’s performance conducted by the students and faculty, and compared the data from the four years prior to starting the PBL program with the data from the two years after starting the program. Not only was there a significant improvement of PBL student attendance (p < 0.01), but the attendance of other students improved as well (p < 0.01). Student attendance in lectures improved significantly as an unforeseen consequence of the PBL program. The positive effects of active learning spread beyond the PBL students themselves.
We report a case for which we proposed combination treatment with botulinum toxin A (BTXA) injection and rehabilitation with a specially equipped therapeutic electrical stimulator (TES). The patient was a 66-year-old male patient with right hemiplegia secondary to cerebral infarction ten years prior. He could not hold or release objects since he was unable to extend his fingers or his wrist due to increased flexor muscle tone in the upper extremity. Before therapeutic exercises of his right hand were initiated, BTXA was injected into the flexor muscles of the right arm, which resulted in reduced effort when opening his hemiplegic hand. Thus, TES with newly-developed equipment was successfully introduced to the hemiplegic hand. The equipment stimulates the target muscle (i.e., extensor digitorum communis in this case) in response to the patient’s control detected from the target muscle.