All issues
Volume 45, Issue 8
Displaying 1-20 of 20 articles from this issue
- |<
- <
- 1
- >
- >|
-
Motonobu MIYAZAKI1991 Volume 45 Issue 8 Pages 721-727
Published: August 20, 1991
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESSThe acquired immunodeficiency syndrome (AIDS) leaped to the forefront of medical and public health attention after an unusual constellation of pneumocystis carinii pneumonia and Kaposi's sarcoma was recognized in homosexual men in mid-1981. As of January 31, 1991, more than 320, 000 AIDS cases are reported by World Health Organization (WHO). Epidemiological studies were carried out in epidemic areas, and it was suggested that most of the modes of human immunodeficiency virus (HIV) transmission were homosexual contact, heterosexual contact, mother to child transmission, blood transfusion and medical injection. The modes of HIV transmission were, however, different in each country. Homosexual transmission and intravenous drug use (IVDU) were recognized as major modes of spread of HIV in the United States, while heterosexual transmission and IVDU were dominant in Thailand, and most of the HIV infection occurred among heterosexuals in Africa. Therefore, HIV/AIDS is now a worldwide problem, but its epidemiological characteristics are clearly different in each country.View full abstractDownload PDF (804K) -
Eiichi IWANAMI, Keisuke HAMASAKI, Nobuyuki MATSUMURA, Naoyuki YAMAGUCH ...1991 Volume 45 Issue 8 Pages 728-733
Published: August 20, 1991
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESS
We analyzed the factors related to the severity of acute viral hepatitis. Subjects were thirty-nine patients consisting of thirteen cases who underwent the severe form with the depression of hepaplastin test less than 30% during the acute phase and twentysix cases of fulminant hepatitis and subacute hepatitis in 408 cases with acute viral hepatitis (type A: n=66, sporadic type B: n=113, post-transfusion type B: n=17, sporadic non-A, non-B: n=91, post-transfusion non-A, non-B: n=121), Prevalence of the severe form in type A, sporadic type B, post-transfusion type B, sporadic non-A, non-B and post-transfusion non-A, non-B was 4.5% (n=3), 11.5% (n=13), 29.4% (n=5), 19.8% (n=18) and 0% (n=0), and mortality was 0%, 30.8%, 100%, 72.2% and 0%, respectively. Anti-HCV was not detected in sera of type A and type B, nor was anti-HDV in sera of type B, so mechanism for the severity was not likely to be the cumulative damage of the two viruses. In sera of the severe form of sporadic non-A, non-B hepatitis anti-HCV was not detected, so the infection of HCV was unknown. As a serological marker for severity in acute viral hepatitis type B, anti-HBV surface to be positive from early phase was especially meaningful, whereas anti-preS2 was not useful. The findings of liver biopsy or necropsy specimens in fatal cases revealed submassive or massive necrosis, so for survival it was thought that an intensive treatment for hepatic failure should be done as soon from the onset of hepatitis as possible.View full abstractDownload PDF (732K) -
Seiki NAMBU, Atsumi SAKAE, Kiyoshi MATSUYAMA, Masako MIYAKE, Kaori CHI ...1991 Volume 45 Issue 8 Pages 734-743
Published: August 20, 1991
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESSA comparison was performed between dietary counseling (guidance) and Burg therapy in patients with essential hypertension consulting the outpatient clinic. The comparison was conducted for 12 weeks in order to compare the antihypertensive effectiveness, side effects and costs for these two treatments. Sixty-eight patients were randomly assigned to either the dietary guidance group (44 patients) or the antihypertensive drug therapy group (24 patients) by selecting an envelope indicating the therapeutic group. In the dietary group, the systolic blood pressure was measured immediately following deep breath. A nutritional screening was performed by measuring the fasting serum insulin. Nutritional guidance was then given based on these results with emphasis on important aspects. The patient's attending physician selected the antihypertensive drug.
The following results were obtained from analysis of 59 cases after excluding 9 cases. A reduction in blood pressure was achieved in 78.4% of the dietary guidance group and in 77.3% of the drug therapy group. A reduction in blood pressure was obtained in as much as 82.6% of those who strictly observed their diet.
In terms of side effects, abnormal liver function tests developed in 3 of the patients in the drug therapy group (13.6%).
For calculation of the medical cost, it was possible to reduce the total medical fee by 5740×(n-l)-610 yen when the hypertension was treated with diet alone on n visits. The medical fee was shown to be reducted by 68, 270 yen per year by diet therapy with antihypertensive results similar to those obtained with drug therapy.View full abstractDownload PDF (1026K) -
Toshihisa MIYAZAKI, Shigetaka NOMA, Yasuo HOSODA, Tsuyoshi KUROKAWA, M ...1991 Volume 45 Issue 8 Pages 744-750
Published: August 20, 1991
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESSEffects of the autonomic nervous system on inducibility of A-V nodal reentrant tachycardia (AVNR) were studied in 5 patients. In 4 of 5 patients, AVNR which used slow pathway (SPW) for antegrade and fast pathway (FPW) for retrograde conduction was induced following a sudden jump in A-H interval (100-200 cosec) by programmed right atrial stimulation during control state. Intravenous propranolol (4mg) prevented induction of AVNR by selectively suppressing antegrade SPW conduction in 2 of these 4 patients, whereas intravenous atropine (1mg) or intravenous infusion of isoproterenol (1μg/min) prevented induction of AVNR by selectively augmenting antegrade FPW conduction in another 2 patients. One patient developed a sudden jump and inducible AVNR only after atropine administration.
These results suggest that change in autonomic tone does not always affect selectively the antegrade conduction via SPW, and sympathetic stimulation does not always facilitate induction of AVNR in patients with dual A-V nodal pathways.View full abstractDownload PDF (5424K) -
Satoshi NISHINO, Takao HAYASHI, Shogen MATUSHITA, Tomoyoshi YOSHIDA, A ...1991 Volume 45 Issue 8 Pages 751-755
Published: August 20, 1991
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESSThe advent of home oxygen therapy (HOT) has led to drastic modification of the management system for the patients with chronic rspiratory insufficiency.
Management by long-term hospitalization is replaced by home management on HOT. As a result, medical institutions which have introduced HOT are now faced with the necessities of not only enlightening the patients on the nature of the diseases and the methods of the treatment but also providing them a full guidance on the management of daily living.
In November 1989, our hospital organized a homev-isiting team composed of a physician, pharmacist and nurse, and started a home-visiting care of the patients on HOT. To get acquaintance with the customary living conditions of the patients by home visit was useful for the supplementation of the inadequate hospital care. The experience of home visit was also considered very helpful to obtain the understanding and cooperation of their family members for the correct application of HOT.View full abstractDownload PDF (3370K) -
Hideya NISIMURA, Makoto SAITO, Keiko ONO1991 Volume 45 Issue 8 Pages 756-760
Published: August 20, 1991
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESSHasegawa's dementia rating scale (HDS) composed of 5 items (I-V) was studied in 100 stroke patients without aphasia. It was evaluated on admission and discharge. The results were analyzed in terms of each item score and a total score. A discharge mark minus an admission mark (an improved mark) of each score was also investigated.
1. The patients were classified into two groups by sex, three by disease, two by age, three by work, or four by school career. The scores were compared among the groups in each case. When there was a significant difference for a total score, all item scores were not the same.
2. The patients were classified by an improved mark of each score into two groups; the group with the improved mark above the average (the improved group) and the other group (the non-improved group). Improvement of paralysis, ADL, and so on was compared between the two of each score. In the score of the IV th item, the improved gronp had significant improvement of ADL compared with the non-improved group (p<0.01).
HDS should be evaluated not only as a total score but as item scores.View full abstractDownload PDF (492K) -
Kazuo MURAYAMA, Tetsuo KATSUMI, Kishichiro WATANABE, Akira TADA1991 Volume 45 Issue 8 Pages 761-765
Published: August 20, 1991
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESSTen cases with primary parahyperthyroidism were operated from 1982 to 1990. Bone changes was recognized in two cases and urolithiasis in nine cases. Histological examination of resected parathyroid glands revealed adenoma in six cases, hyperplasia in two, cyst in one and normal findings in one. Preoperative localization of enlarged gland was evaluated by CT, ultrasonography or RI-scintigraphy. All of 4 patients with adenoma of greater than 1cm and only one of 5 patients with enlarged gland from 0.5 to 1cm in size were accurately localized preoperatively. Postoperative follow-up study revealed no evidence of recurrence in nine cases, but the serum calcium level of one case with hyperplasia has remained upper limit of normal value for 5 years after the operation.View full abstractDownload PDF (535K) -
-INFORMATION OBTAINED THROUGH A QUESTIONNAIRE-Masayoshi YOSHIMORI1991 Volume 45 Issue 8 Pages 766-769
Published: August 20, 1991
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESSIn order to clarify the problems associated with anticancer chemothrapy at outpatient clinics, the author obtained information through a questionnaire. The questionnairing was conducted on 117 patients who underwent chemotherapy at the outpatient clinic of Natinal Cancer Center Hospital, Tokyo. Eighty out of the 117 patients (68.4%) filled out the questionnaire.
Not a few patients came to hospital regularly from a relatively long distance. In spite of traffic inconvenience, howewver, they preferred to be treated as outpatients rather than as inpatients.
One of the most important problems related to being outpatients was how to cope with an emergency at home. Many patients did not have their home doctors who took care of them in case of emergency. In order to enrich the home care of cancer patients, this problem should be solved.
Patients had a relatively good relation with their doctors. Most patients had been informed of their diseases. So-called informed consent was thought to be important for continuation of cancer chemotherapy with side effects. Doctors could easily tell the truth about disease itself, treatment and side effects of chemotherapy, but not about the patients prognosis.View full abstractDownload PDF (428K) -
Taiichiro OKAJIMA1991 Volume 45 Issue 8 Pages 770-773
Published: August 20, 1991
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESSEffects of very low calorie diet (VLCD) on the subpopulation of peripheral lymphocytes and natural killer (NK) cells were observed in twelve obese subjects to study whether the restriction of calorie intake influences on immune functions in human. The changes in the subpopulation of lymphocytes (OKT4/OKT8 ratio, B-1) and NK cells (Leu-11a, Leu-7) in peripheral blood were investigated before and 14 days after starting VLCD, using monoclonal antibodies and flow cytometry, 14 days of VLCD (420 Cal/day) caused a significant reduction of body weight as well as an increase of Leu-11a positive NK cells, whereas OKT4/OKT8 ratio, ratio of B-1 or Leu-7 positive cells were unchanged. These results suggest that restriction of calorie intake possibly influences on immune functions in human.View full abstractDownload PDF (339K) -
1. STUDY OF TESTING CONDITIONSKatsuhiro YAMAWAKI, Mikako TSUJITA, Miho HASHIMOTO, Akiyo YONEDA, Tomo ...1991 Volume 45 Issue 8 Pages 774-778
Published: August 20, 1991
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESSThe purpose of this research was to evaluate granulocyte function rapidly with small amount of heparinized blood under the condition close to biological response. The asaay of hydrogen peroxide (H2O2) generation of granulocyte stimulated by S. aureus FDA 209P JC-1, and E. coli, NIHJ J C-2, using a flowcytometer has been developed.
Magnitude of H2O2 generation of granulocyte which was incubated for 24 hours at room temperature, was similar to that of those treated just after bleeding.
Optimum concentration of bacterial solution was OD 0.6 at 620nm with a spectrophotometer. The asaay was performed as follows; after 60 minutes, incubation of the mixture at 37°C containing of 50μl of heparinized whole blood and 50μl of bacterial solution, the mixture was put into cold water at 4°C to suspend the reaction and measured H2O2 using a flowcytometer within six hours after suspension.View full abstractDownload PDF (431K) -
-WITH ANALYSIS OF 104 CASES UNDERGOING ENDOSCOPIC POLYPECTOMY-Hisataka KOBAYASHI, Yukio KAJITANI, Takama MAEKAWA, Tsuyoshi ITOH, Mas ...1991 Volume 45 Issue 8 Pages 779-784
Published: August 20, 1991
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESSA case of gastric hyperplastic polyp (HP) with focal carcinoma was reported. Before polypectomy, endoscopic finding and biopsy specimen revealed that this polyp was a HP with focal well-differentiated tubular adenocarcinoma at a part of the head of the polyp. The head and stalk of the polyp was removed completely by endoscopic polypectomy.
Endoscopic polypectomy was performed in 104 lesions (96 cases) at Kyoto National Hospital from 1976 to 1990. Histological study revealed that 85 of these lesions were HPs, but one case was a HP with focal carcinoma (1.20). Only large-sized polyps with focal or total malignant tissue or with some complications were removed, but others were followed up by endoscopic and histological examination. The incidence of HPs with focal carcinoma should be lower than 196 of all HPs in Japan.
At present, two opinions on the therapy of gastric HPs exist. One is that all gastric polyps should be removed and the other is that the resection of HPs without any complications and malignant tissues will not be necessary. However endoscopic apperances of HPs with focal carcinoma were not characteristic in our case and other reported cases. If a polyp is not removed and just followed up, then a careful biopsy and a histological study are necessary to demonstrate that the polyp has no malignant tissues.View full abstractDownload PDF (3747K) -
Toyofumi NAKANISHI, Shuji HASHIMOTO, Haruko ISHII, Ushio TSUJI, Hirona ...1991 Volume 45 Issue 8 Pages 785-788
Published: August 20, 1991
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESSWe have quantitatively analyzed organic acids in urine and plasma from a patient with acute encephalopathy. The patient was a 10-month-old boy, good psychomotor developement until 9 months of life, who developed a common cold and fever, unconsciousness, tonic convulsion, and was admitted to the Department of Pediatrics at Osaka National Hospital. The analysis of organic acids by gas chromatography/mass spectrometry revealed abnormal excretion of fumaric acid and other metabolites of tricarboxylic acid cycle at onset. The profiles of organic acids from acute encephalopathy were usually lactic acidemia, ketotic dicarboxylic acidurias.
But the profiles of this patient showed an unusual pattern and would be the same as fumarase deficiency although we did not measure the activities of mitochondrial or cytoplasmic fumarase.View full abstractDownload PDF (406K) -
Norihiko TSUCHIYA, Tokuo TAKAHASHI, Youichirou AMINO, Takashi SOMENO, ...1991 Volume 45 Issue 8 Pages 789-792
Published: August 20, 1991
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESSWe used the permanent magnet MRI system (MRP-20) for diagnosis of patients with pheochromocytoma and primary aldosteronism. The gradient echo with rephasing method was used to avoid the artifacts due to respiration. The images obtained using this method clearly showed adrenal tumors and were useful for abnormalities of the organs with respiratory movement Though we could not perform 13'I-MIBG scintigraphy for the patient with pheochromocytoma, we obtained coronal images of MRI along the retroperitoneal ganglions, and these images were useful for the search of ectopic tumors. Adenoma of the adrenal gland was slightly enhanced by contrast Gd-DTPA. The relative tumor-to-liver signal intensities with the T2* weighted sequence were 0.96 and 0.58 in pheochromocytoma and adenoma, respectively. However, to evaluate this method for the possibility of the tumor characterization, more discussions in many cases were considered to be needed.View full abstractDownload PDF (4093K) -
Yoshihiro HADA, Hideo ASAKURA, Kouji ONODA, Akio SAITOU, Ikuo TATSUNO, ...1991 Volume 45 Issue 8 Pages 793-799
Published: August 20, 1991
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESSA co-operative study was carried out to evaluate effects of radiation alone and in combination with 5'-deoxy-5-fluorouridine (5'-DFUR), a 5-FU derivative. Patients with various cancers were treated. Nine national hospitals participated in the study and number of subjects amounted to 177 patients. The results indicated that no significant differences were observed between the patients treated with either therapies based on local effects but such excellent effects were obtained in the patients treated with the combination therapy especially in patients with breast cancer metastases, recurrent cancers, local effects and survival rates.
Furthermore, cases of esophageal cancers undergoing preoperative combination therapy of radiation at 52 or 54 Gy with 5'-DFUR demonstrated complete disappearance of the tumor cells. No severe side effects were observed.View full abstractDownload PDF (779K) -
Toshio MATSUOKA, Kenshi SEKINE, Akira MIYAGAWA, Toichi SUGIMOTO1991 Volume 45 Issue 8 Pages 800-803
Published: August 20, 1991
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESSEleven patients with T1 and small T2 breast cancer were treated by a combination of quadrantectomy, axillary dissection and radiotherapy.
The mean age of the patients was 44.6 years. Mean follow-up period was 7.1 months. Six patients had clinical stage I, and five patients had clinical stage II. Four patients had involvement of axillary content (36.3%) on histological examination. There were eight scirrhous carcinomas and three papillotubular carcinomas. The incidence of local and distant recurrence was none in our group.
The multifocality of breast cancer based on pathologic studies had been shown. On the basis of these findings we concluded that the patients undergoing breast conservation should be subjected to postoperative radiotherapy.
Psychological morbidity was compared in 10 patients treated by breast conservation and 23 patients treated by mastectomy. There were no statistically significant differences between two groups in the estimation of adjustment disorder, depression, anxiety and stress. The patients in breast conservation group had a significant excess or nervousness and the patients of the mastectomy group had an anger.View full abstractDownload PDF (432K) -
Takao SUZUKI, Hidehiko KASHIWABARA, Kouichiro OHMORI, Tadashi HACHISU, ...1991 Volume 45 Issue 8 Pages 804-807
Published: August 20, 1991
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESSIt is well known that the patients with chronic renal failure who require long-term hemodialysis are frequently associated with acquired cystic desease of the kidney (ACDK). In this report we present the remarkable regression of ACDK after successful renal transplantation. A 29-year-old male had chronic renal failure and had underwent hemodialysis for 9 years. On 1988 living related kidney transplantation was performed using HLA non-mismatched mother's kidney. Ciclosporin and prednisone were administered as immunosuppressants. After the mild episode of acute tubular necrosis, the patient has been maintaining good renal function with 1.2mg/dl of serum creatinine. Before the transplantation, abdominal CT scan demonstrated bilateral polycystic kidneys, however almost all cysts regressed and kidneys were contracted promptly after the transplantation. No malignant tumor have developed in the kidneys up to the present. We conclude that ACDK is a good indication for renal transplantation.View full abstractDownload PDF (1837K) -
Kiwako WATANABE, Hisaki SAITOH, Akira OHNISHI, Tohru MATSUBARA1991 Volume 45 Issue 8 Pages 808-813
Published: August 20, 1991
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESSTwo cases of retropharyngeal abscess were reported. Case 1 was a 2-month-old male infant caused by upper respiratory infection and case 2 was a 71-year-old man caused by tonsillitis.
We presented 89 cases of retropharyngeal abscess including our two cases, being reported in Japan since 1965. Discussions on this disease were made for age, sex, cause, bacteriological examination, diagnosis and treatment.
The results suggest that adult cases with primary retropharyngeal abscess has been increasing relatively in recent years.View full abstractDownload PDF (2068K) -
8. DILATED CARDIOMYOPATHY, MYOCARDITISMasatsugu IWASE1991 Volume 45 Issue 8 Pages 814-817
Published: August 20, 1991
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESSDownload PDF (5229K) -
1991 Volume 45 Issue 8 Pages 818
Published: August 20, 1991
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESSDownload PDF (140K) -
1991 Volume 45 Issue 8 Pages 818a-819
Published: August 20, 1991
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESSDownload PDF (184K)
- |<
- <
- 1
- >
- >|