Akathisia Occurrence Induced by Haloperidol Injection and Effectiveness of Biperiden Injection Against Delirium in Cancer Patients / 日本農村医学会雑誌

　　When we use haloperidol (HP) parenterally to treat delirium in cancer patients, sometimes akathisia appears. So, we are pressed to give treat this symptom. The aim of this study was to investigate the occurrence rate of akathisia after HP injection and the effectiveness of biperiden injection in the treatment of akathisia. 　　We retrospectively worked out the rate of the use of Hp injection, the rate of the occurrence of akathisia by using Hp and the effectiveness of biperiden injection in the treatment for delirium in 67 patients out of 100 patients who died in the palliative care unit (PCU) and 10 patients with delirium out of 23 patients who were under care of our palliative care team (PCT) in the sections other than the PCU from August to December of 2012. In the PCU, Hp injections were used in 52 patients (78%) out of 67 with delirium, and akathisia was suspected in 23 patients. Biperiden was injected into all of them and it was effective in 21 patients (91%). Our palliative care team gave Hp injections to seven patients (70%) out of 10 with delirium, and akathisia was suspected in one patient. At that time Hp injection was suspended but biperiden was not used. To sum up, Hp was administered to a total of 59 patients (76%) out of 77 with delirium, and akathisia was suspected in 24 patients (40%). Biperiden was used in 23 patients, all of whom were PCU patients, and effective in 21 (91%). 　　When Hp was used to treat cancer patients with delirium, the onset of akathisia was suspected in 40% of them, but biperiden was considerably beneficial in patients with delirium.

A Case of Abdominal Aortic Aneurysm Associated with Horseshoe Kidney / 日本心臓血管外科学会雑誌

Horseshoe kidney is a common renal anomalies, but coexistence with abdominal aortic aneurysm (AAA) is rare. Horseshoe kidney may cause various technical difficulties of aneurysm repair. A 76-year-old man was referred to our hospital for treatment of AAA with a horseshoe kidney. Preoperative 3-dimensional computed tomography (3D-CT) scans showed a pair of normal renal arteries and 3 accessory renal arteries from the anterior wall to abdominal aorta just proximal to an aneurysm. At operation, the aneurysm was exposed through a transperitoneal approach, and artificial graft replacement was performed with a woven Dacron bifurcated graft preserving the renal isthmus. The accessory renal arteries were not reconstructed. The postoperative course was uneventful. Postoperative 3-D CT showed minor infarction of renal isthmus, but renal function was not impaired.