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Clinical Feature of Japanese Patients with Fulminant Myocarditis—Myocarditis in Japanese Patients

International Journal of Clinical Medicine 2011年第3期2卷 260-263页

作者： Hiroaki Kawano Yasuhiro Nagayoshi Sunao Kojima Nahoko Kakihara satoshi sakuma Masumi Uchino Aiko Komatsu Machiko Asaka Mitsuhiro Shimomura Hiroshige Yamabe Hisao Ogawa Koichi Node Department of Cardiovascular Medicine Saga University Saga Japan

Fulminant myocarditis is commonly recognized as an acute myocarditis with cardiogenic shock requiring mechanical support systems. Before the development of mechanical assist devices, previous study described that most of patients with fulminant myocarditis die at acute phase because of rapidly progressive cardiac decompensation. To investigate the feature of myocarditis, we checked consecutive 18 patients (10 men, 8 women, 12yr-80yr) from April in 2001 to September 2008 in University. Of these patients 3 needed intraaortic balloon pumping (IABP) (2 men, 1 woman), 6 did both IABP and percutaneous cardiopulmonary support (PCPS) (2 men, 4 women). Three patients who need both IABP and PCPS died (2 men, 49yr and 65yr, 1 woman, 54yr) because of uncontrolled bacterial infection. No patients whose age was under 40yr (5 men, 4 women) died although a man needed IABP and 3 women did both IABP and PCPS. Sixteen patients were able to resume a normal life although 1 male patient needed permanent pacemaker, 1 female did cardiac resynchronization therapy, and a male and a female had left ventricular systolic dysfunction. In conclusion, the young patients had better prognosis than older even if mechanical assist is needed. Although half of patients needed mechanical assist, the prevention of multi-organ complications including bacterial infection is one of the most important keys in the treatment of fulminant myocarditis.

关键词： Myocarditis Mechanical Support Immunosuppressive Therapy Immunomodulation Therapy

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Cochlear Implantation in Patients with Eosinophilic Otitis Media

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International Journal of Otolaryngology and Head & Neck Surgery 2015年第1期4卷 32-37页

作者： Masahiro Takahashi Yasuhiro Arai Naoko sakuma Daisuke Sano Goshi Nishimura Takahide Taguchi Nobuhiko Oridate satoshi Iwasaki Shin-Ichi Usami Department of Otorhinolaryngology Head and Neck Surgery Yokohama City University School of Medicine Yokohama Japan Department of Otorhinolaryngology International University of Health and Welfare Mita Hospital Tokyo Japan Department of Otorhinolaryngology Shinshu University School of Medicine Nagano Japan

It is known that cochlear implantation for deaf patients with eosinophilic otitis media (EOM) is safe and can provide good speech perception. However, the best timing of implant surgery in patients with EOM is not yet known. The aim of this case report is to suggest the appropriate timing of the surgery in EOM patients with deaf. Cochlear implantation was indicated in two patients with EOM. One underwent cochlear implantation in the absence of any ear discharge. In the other case, implant surgery was delayed for three years due to persistent ear discharge. No complications related to implant device or skin flap were observed in either case. The speech recognition score after implantation was good in the first case and poor in the second case. Perioperative complications were manageable even in the patient with persistent ear discharge. However, the delay in implant surgery due to the persistent ear discharge resulted in a poor speech recognition score. Early implantation should be considered even in EOM patients with ear discharge, although the presence of active middle ear inflammation is regarded as one of the contraindications for implantation according to the current Japanese guidelines.

关键词： Eosinophilic Otitis Media Cochlear Implantation Speech Recognition

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