Reversible left ventricular dysfunction due to severe stenosis of the elephant trunk graft: A case report.

Acquired coarctation of the aorta (CoA) following total aortic arch replacement (TAR) is a rare complication inducing left ventricular (LV) dysfunction probably due to increased LV afterload and secondary hypertension caused by increased upper body and decreased renal blood flow. We describe a case of a 35-year-old male who developed atypical CoA with severe LV dysfunction with LV ejection fraction of 10%, but without secondary hypertension after TAR using conventional elephant trunk (ET) technique for acute aortic dissection. Computed tomography revealed near-occlusive CoA due to narrowed distal ET.

[Case report--cooperation among medical staff to improve home enteral nutrition and increase hope in a patient with dementia].

Herein, we describe the case of a man in his 70s who had slight dementia. Because of dysphagia, the patient received enteral nutrition by gastrostomy. The patient wished to care for his wife, who had severe dementia and was also receiving enteral nutrition.

[Does the nutritional care plan and report upon discharge under the health care system substitute the nutrition support team summary at patient discharge?].

Our nutrition support team (NST) designed the NST summary for cooperation among personnel providing medical care for nutritional management of high-need patients in our area. After the introduction of the NST fee under the health care system, the number of summary publications decreased. The requested NST fee is necessary for publication of a nutritional care plan and report upon patient discharge.

[Coordination to assist with hospital-to-home discharge after cerebral hemorrhage--perspectives of a patient's family and nurse].

Discharge support, although provided for a limited time, is of vital importance in the acute phase care period. Such support is necessary to ensure continuity of care and treatment even after being discharged from the hospital. I acquired both the viewpoints of the family and the nurse of a patient who was about to be discharged from the hospital after cerebral hemorrhage.

[The trend of nutritional management in a survey of nutrient intake, via gastrostomy, in patients following an acute hospital stay].

In our hospital, the nutrition support team(NST)deepened relations with the local medical institution for sequential nutritional management following patient discharge. We began to process additional reports about patient nutritional management that could be passed onto any other institute for subsequent nutritional therapy. Three months following discharge, the main method of nutritional management was examined in 109 patients who were discharged between April 2008 and July 2010 and who were receiving the majority of nutrients via gastrostomy.

[A survey on nutritional management planning for patients attending an another institute after discharge].

We sent the reports and plans concerning nutritional management to the 81 facilities, such as a hospital, nursing home, or clinic of home care, and carried out the questionnaire to determine their level of understanding and utilization of the reports. Sixty-nine % understood the purpose of the survey, with 74% noting that the report served as a reference. The purpose of the report was relatively well understood in the hospital or nursing home environments, but was not sufficiently understood in the clinics.

[Home-based infusion therapy by Broviac catheter after total parenteral nutrition therapy in a patient with a severe skin condition].

In collaboration between the in-hospital nutrition support team and infection control team, we attempted to standardize the management of infusion therapy. We report on a simple and effective at-home infusion therapy, after total parenteral nutrition(TPN)therapy, by using a Broviac catheter in a discharged patient with a severe skin condition. The patient was a man in his 50s who had amyloidosis.

[A regional alliance in nutritional management-ten years of collaboration with an nutrition support team network].

Ten years has passed since we began the nutrition support team(NST)to make a regional alliance between local institutions for construction of the NST network. The network was formed with the following aims: 1) regional joint conferences for learning about nutrition with family doctors, facilities, and hospitals; 2) open general meetings for information about nutrition within the suburbs of our city; 3) preparing and sending an NST manual about parenteral nutrition(PN)and enteral nutrition(EN); and 4) preparation of an NST summary of patient malnutrition to foster mutual understanding. We produced a questionnaire summarizing the completion of nutritional management in patients.

[Local communalization of clinical records between the municipal community hospital and local medical institutes by using information technology].

We introduced the electronic health record system in 2002. We produced a community medical network system to consolidate all medical treatment information from the local institute in 2010. Here, we report on the present status of this system that has been in use for the previous 2 years.

[The management for safety on Home Parenteral Nutrition(HPN)].

Nutrition support team(NST)continuously leads a safe and effective home nutritional management for a reliable operation. With regard to home parenteral nutrition(HPN), we provided some pamphlets on HPN for the patient and family and nurses. The utilization of the pamphlets was two folds: (1) a teaching instruction can be unified for the patient and family and nurses, (2) to eliminate the gap among nurses for instructional procedures.

[The follow-up study of patients with NST discharge summary for a continuous nutritional management].

The nutritional management of a patient discharged from a primary hospital will not end just there. The nutritional management information issued by the primary hospital is required when a patient moves to a next institute.We,the Nutritional Support Team(NST), make a nutrition summary report in addition to letters written by the doctor and the ward in charge.

[The use of total enteral formula with enriched nutrient in home Low Calorie Diet(LCD)therapy based on regular meal].

We made a low calorie diet(LCD)menu which added two commercial supporting nutritional supplements to a meal. Because a conventional formula food is very expensive, the patient was not able to afford it at home. Those supplements are a total enteral formula with enriched nutrient(ACURE EN800)and vitamin-mineral rich drink(V CRESC).

[A case of severe obese patient complicated with type-2 diabetes--transition from Very Low Calorie Diet(VLCD) therapy to Low Calorie Diet(LCD)therapy].

A 6 0-year-old woman with severe obese and type-2 diabetes was hospitalized due to poorly controlled glycemia by worsening osteoarthritis of both knees. Although a diet therapy(1,200 kcal/day)was initially offered, but the body weight did not decrease. Thus, we changed VLCD therapy to LCD therapy sequentially.

[Two elderly case reports of renal excretion type drug poisoning caused by dehydration that was due to poor eating in home care].

The elderly patients are susceptible to acute renal failure due to dehydration or infection. Therefore, the drug should be administered with caution. We report two cases of acute renal failure from dehydration that led to a subsequent drug poisoning.

[The importance of Dysphagia management during the peri-operative period to home elderly care].

Dysphagia is usually a major problem for the elderly to go home after a surgical treatment for the bone fracture of the thigh bone cervix or trochanter part in the leg. We analyzed each clinical course with regard to a change of the oral intake and the nutritional status, the activity of daily living(ADL)and a nutritional management and the place after the patient was discharged. According to our results, about 20% of the patients among those surgical cases were pointed with dysphagia, and there were many cases that ADL was ultimately gotten worse.

Discrimination of porcine glycogen debranching enzyme isozymes by the ratios of their 4-alpha-glucanotransferase and amylo-alpha-1,6-glucosidase activities.

Glycogen debranching enzyme (GDE) is a single-chain protein containing distinct active sites that exhibit 4-alpha-glucanotransferase and amylo-alpha-1,6-glucosidase activities. The ratios of these two activities in porcine liver and muscle GDEs were compared using a set of homologous fluorogenic branched dextrins. For quantifying 4-alpha-glucanotransferase activity, 6(3)-O-alpha-maltotetraosyl-PA-maltooctaose (B3/84), 6(4)-O-alpha-maltotetraosyl-PA-maltooctaose (B4/84), 6(5)-O-alpha-maltotetraosyl-PA-maltooctaose (B5/84) and 6(6)-O-alpha-maltotetraosyl-PA-maltooctaose (B6/84) were used as substrates and maltohexaose (G6) as the acceptor.