【 Introduction】 We examined the current situation and problems of treatment for acute cerebral infarction in our hospital. 【Method】 The targets were acute cerebral infarction patients who were hospitalized from September 2014 to July 2017 with t-PA and endovascular treatment or endovascular treatment alone. In all cases, we measured the time from arrival to CT, to MRI, to t-PA injection, to enter the angiography room, to puncture femoral artery, and to re-perfusion.【RESULTS】Among 31 patients, 21 patients underwent t-PA and endovascular treatment and 10 cases were performed only endovascular therapy. Twenty-seven cases （87.1％） were able to obtain effective re-perfusion of TICI grade 2b or more. The median score of NIHSS at the time of discharge was 11.8. The time from arrival to start t-PA was 102 minutes, the time from arrival to re-perfusion was 245 minutes. It exceeded the recommended target time.【Conclusion】It is necessary for each department to cooperate firmly. And it is important to treat patients with common recognition of rapid recanalization.
Lymphocytic adenohypophysitis in pregnant or postpartum women occurs with an initial symptom like headache or visual disturbance. The definitive diagnosis depends on pituitary gland biopsy, but, it is increasing to administer steroid without biopsy due to invasiveness. Here, we report postpartum lymphocytic adenohypophysitis patient suspected by clinical findings（nausea, vomiting, malaise） , Magnetic Resonance Imaging（MRI）, endocrinological examination. It is necessary to keep in mind lymphocytic adenohypophysitis for the diagnosis. In addition, it is important to keep in mind that lymphocytic adenohypophysitis occurs with an initial symptom like vomiting, malaise, anorexia other than headache and visual disturbance. It is useful to perform MRI and endocrinological examination for the early diagnosis if lymphocytic adenohypophysitis is suspected.
A 52-year-old female case. A Patient with chronic nephropathy due to diabetic nephropathy was taken to our hospital by ambulance because of hypothermia and consciousness disturbance. Body temperature was 25.3 ℃, systolic blood pressure was 70 mmHg, diastolic blood pressure was 40 mmHg, sinus bradycardia with a heart rate of 40 beats/minute, and J wave in the electrocardiogram were observed at the time of visit. UN: 121.6 mg/dl, Cr: 13.2 mg/dl, due to uremia caused by acute exacerbation of chronic renal failure, it was diagnosed as having difficulty in body movement, hypothermia. It was necessary to remove uremic toxin and recover temperature at the same time, and it was possible to recover efficiently using hemodialysis.
Forty-six man was undergone replacement of ascending aorta for acute aortic dissection six years ago. A follow up CT showed an aneurysm of aortic root and also moderate aortic valve regurgitation was detected on echocardiography. We performed valve sparing aortic root replacement（remodeling technique） . Postoperative course was uneventful. Valve sparing aortic root replacement is fascinate technique for young patients and women who desire to bear children because of unnecessary to anticoagulant therapy.