Rinsho byori. The Japanese journal of clinical pathology
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Exercise testing plays a major role in evaluation of visceral impairments in disabled patients. We introduced recently-developed exercise testing and a newly-developed instrument for monitoring cardiopulmonary and postural parameters. We also evaluated the effects of cardiac phase II rehabilitation, pulmonary rehabilitation, and lung volume reduction surgery (LVRS) in patients with cardiopulmonary diseases. ⋯ The ratio of ischemic heart disease (IHD) in stroke patients was 18%. Our hospitalized phase II cardiac rehabilitation program improved the management of cardiac risk factors and the physical status in patients with MI. The physical status of the patient with idiopathic interstitial pneumonia was markedly improved after pulmonary rehabilitation, and she did not need to undergo lung transplantation. The physical status and lung function of PE was significantly improved 3 months after LVRS. MCPP was made and used in the field of rehabilitation medicine. MCPP shows the picture and cardiopulmonary and postural parameters at the same time on a monitor, and is a very useful tool to evaluate the activities of daily living of the patients undergoing rehabilitation. MCPP may provide useful information to develop more efficient strategies for rehabilitation planning and patients' education.
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Some patients developed Guillain-Barré syndrome after the administration of bovine brain ganglioside. Patients with Guillain-Barré syndrome subsequent to Campylobacter jejuni enteritis frequently have IgG antibody to GM1 ganglioside. ⋯ My colleagues and I showed the existence of molecular mimicry between GM1 and lipopolysaccharide of C. jejuni isolated from a patient with Guillain-Barré syndrome, and that between GQ1b and C. jejuni lipopolysaccharides from patients with Miller Fisher syndrome. The glycotope mimicry between infectious agents and gangliosides may function in the production of antiganglioside antibodies and the development of Guillain-Barré syndrome and Miller Fisher syndrome.
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We investigated factors of daytime sleepiness in 22 middle-aged male patients with sleep apnea syndrome (SAS) using the Epworth sleepiness scale (ESS) and polysomnography. The subjects were classified into two groups according to ESS score as follows; low ESS group: ESS score < 10, and high ESS group; ESS score > or = 10. ⋯ Time of SpO2 < 90% and percent of movement arousals at the termination of apnea/hypopnea (number of movement arousal/total number of apnea/hypopneas x 100) were significantly higher in high ESS group than in low ESS group. Our findings suggest that the severity of oxygen desaturation and sleep fragmentation caused by arousal response at the termination of apnea/hypopnea may be important factors of daytime sleepiness in patients with SAS.
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Lactate can be viewed as a metabolic dead end in that it can only be produced or utilized via pyruvate. Lactate production is determined primarily by pyruvate concentration and to a lesser extend by the redox state. Increased lactate production may result from tissue hypoxia, alkalosis, catecholamine and alanine transamination to pyruvate. ⋯ In these cases, laboratory data showed prominent hyperlactatemia, hyperglycemia and acidemia and elevated anion gap. The mortality rate in these cases was 36% and higher in cases with organ failure. Treatment of lactic acidosis consists of alkalization by sodium bicarbonate with carbicarb, insulin-glucose-infusion, dichloroacetate therapy, tham administration, bicarbonate-buffered peritoneal dialysis and high bicarbonate-containing dialysis.
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Viral hemorrhagic fevers include Ebola hemorrhagic fever, Marburg disease and Lassa fever. The etiologic agents of the diseases, Ebola virus, Marburg virus and Lassa virus, respectively, are categorized as viruses with biosafety level 4, because of their high mortality, high transmissibility and the lack of effective vaccines and therapeutic measures. Ebola and Marburg viruses are members of the Filoviridae family and easily distinguishable from viruses of other families by the characteristic morphology of the virion. ⋯ Ebola, Marburg and Lassa viruses exist almost exclusively in Africa, with a minor fraction of Ebola virus being present in southeast Asia and possibly other tropical areas. However, these viruses can be imported to any part of the world industrialized countries. When attending patients with viral hemorrhagic fevers, "barrier nursing" using face shields (or goggles), masks, rubber gloves, etc., is recommended to avoid direct contact with blood and other body fluids of the patients.