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Volume 51, Issue 11
Displaying 1-12 of 12 articles from this issue
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Hisamichi BABA1997 Volume 51 Issue 11 Pages 503-507
Published: November 20, 1997
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESSHistorically, open heart surgery was attempted since 1950 and unfortunately the incidence of post-transfusion hepatitis (PTH) after open heart surgery was over 50% in Japan.
Since 1970 open heart surgery without homologous blood transfusion has been attempted under simple deep hypothermia or hypothermia with Pump-Oxygenator in order to prevent various complications caused by homologous blood transfusion, especially PTH. The lowest weight patient upon whom this method was performed hypothermia with Pump-Oxygenator was 5.0kg with reducing in priming volume and using auto-blood transfusion system.
Recently the incidenence of PTH, such as Non-A, non-B type hepatitis, so called C type hepatitis has been reduced to 0.16% by progressive screening method.
However open heart surgery without homologous blood transfusion should be still continued to prevent human immunodeficiency virus infection (HIV) or graft-versus-host disease (GVHD) after fresh blood transfusion.View full abstractDownload PDF (857K) -
Hiroshi ASAJIMA, Taeko YOSHIMURA, Tomoo FURUMOTO, Teisuke ANZAI, Masah ...1997 Volume 51 Issue 11 Pages 508-511
Published: November 20, 1997
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESSBackground; Deterioration of native vessels and graft lumina after coronary artery bypass graft (CABG) results in an increasing need for repeat revascularization procedures. Percutaneous coronary intervention strategies are favored because of high operative risk and difficulty of complete revascularization of reoperation. Methods; We evaluated 14 patients (12 men and 2 women) who underwent coronary interventions with prior coronary artery bypass grafts; 31 interventions (elective 30, emergency 1), 41 procedures (POBA 34, cutting balloon 1, stent 6). Target lesions were assigned 27 native vessels (LAD 1, LCX 5, RCA 20, LMT 1) and 14 grafts (SVG 12, LITA 1, RITA 1). The procedures and lesions per patient were 2.1 and 2.9, respectively. Results; Initial procedual success rate was 93% (native 96%, graft 86%). Restenosis and reocclusion rates were 35% (native 48%, graft 17%) and 16% (native 0%, graft 42%), respectively. There was no major complications (death, Q-AMI, emergency CABG). Final clinical success rate was 62% (8/13). Conclusions; Coronary intervention after CABG was effective in high initial success rate, but the strategies for target lesions were important in procedures because of high restenosis and reocclusion rates.View full abstractDownload PDF (464K) -
RESULTS AND ASSESSMENT OF BREAST CONSERVING SURGERY AND IMMEDIATE BREAST RECONSTRUCTIONTsunehiro ISHIDA, Teruo KUSABA, Kazuhiro SAKATA, Masahiko TOKUMINE, Ke ...1997 Volume 51 Issue 11 Pages 512-517
Published: November 20, 1997
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESSThe annual change of operation methods on 504 primary breast cancers in Takasaki National Hospital was showed for the 13-year period from 1984 to 1996. The radical mastectomy (Halsted) was replaced by the modified radical mastectomy in 1991. A breast conserving surgery (BCS) has been performed since 1992 and increased to be 25% of all cases in 1996. A subcutaneous mastectomy has been done since 1993 and there were 14 cases. In these surgeries all patients have no recurrence. An immediate breast reconstruction has been practiced to be 55 patients (32% in all) since 1994. The procedure was 47 of latissimus dorsi musculocutaneous flap (LDMC), 6 latissimus dorsi muscular flap and one rectus abdominis myocutaneous flap. The LDMC method was technically easy and safe without major complications. According to the postoperative questionnaire of QOL, immediate breast reconstruction showed to improve significantly the patients' QOL concerning a body image more than modified radical mastectomy. The choice of surgical procedure shoud be decided by each patient under the practice of informed consent in consideration of clinical stage, prognosis in disease and a better QOL.View full abstractDownload PDF (2678K) -
Hisanao OHKURA, Mikio OSADA1997 Volume 51 Issue 11 Pages 518-531
Published: November 20, 1997
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESSDownload PDF (3529K) -
Kenji MIYAMURA, Yoshiko HIROTA, Akira MIZUSHIMA, Kiyohisa HIRAKA, Taka ...1997 Volume 51 Issue 11 Pages 532-535
Published: November 20, 1997
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESSA 27 year-old woman, gravida 1, para 1, was admitted at 25 weeks' gestation for macroscopic hematuria and fever. Her white blood cell count was 25, 190/mm3, red blood cell count was 250±104/mm3, and hemoglobin was 7.0g/dl. Ultrasonographic examination and MRI images presented hemorrhagic tumor of the right kidney. As conservative therapies were ineffective, an angiography was operated. First angiography revealed a right sided renal arteiovenous malformation. A TAE with sponzel was performed, but it failed and rebleeding from residual fistulas was occured.
The second angiography, which was operated 2 days after the previous angiography, revealed re-sidual fistulas, and an additional TAE with stainless steel coil was performed. Renal bleeding was stopped and anemia was gradually improved. The fetal growth was not restricted and no anomalies were seen at ultrasonographic examination. The patient deliverd a full-term healthy neonate at 38 weeks' gestation. Her puerperial course was un-eventful and renal function was normal.
As a good result has been achieved, it is assumed that even in the pregnant case, TAE could be the first indication for treatment of renal arteriovenous malformation.View full abstractDownload PDF (4331K) -
Michio YASUZAWA, Taiso TAMURA, Masahiko TAKEMOTO, Nobuo MATSUMOTO, Sor ...1997 Volume 51 Issue 11 Pages 536-539
Published: November 20, 1997
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESSAs for usual early symptoms of the primary vaginal cancer, there are irregular bleeding, abnormal flow, and demarked vaginal tumor. Recently, we experienced a patient with the primary vaginal cancer who complained chiefly anal pain. Pelvic examination revealed a large tumor with ulcerative lesion on the posterior vaginal wall and invasived widely. On admision, she was treated with systematic combination chemotherapy : BPM therapy (Bleomycin 5mg/body for day 1-5. Mitomycin C 6mg/body and Carboplatin 50mg/body on the day 5 in 1 course), for 5 courses and with local administration (Carboplatin 50mg/body once a week) for 16 times. With these chemotherapy the patient turned well with improvement of the anal pain and local visual findings in vagina and it decreased of the tumor marker (serum SCC) These changes were interpreted as effective chemotherapy.View full abstractDownload PDF (4760K) -
Junichi IMAMURA, Yukihide IKEYAMA, Sigenari KIM, Sakae NAGAOKA, Nobuhi ...1997 Volume 51 Issue 11 Pages 540-543
Published: November 20, 1997
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESSThe authors report a case of congenital portal-systemic encephalopathy (PSE) of which symptom developed from focal neurological sign (left hemiparesis) to diffuse encephalopathy (conscious disturbance). The patient was 70 year-old man who was initially diagnosed as transient ischemic attack with hemiparesis and a short term unconsciousness, and thereafter developed repeated attacks of the same pattern. The brain X-CT showed multiple cerebral infarctions, which was not a direct reason for the attacks. Ictal serum anmonia level was abnormally higher than interictal one. Portal systemic shunt was confirmed by percutaneous portal angiography and was occluded by endovascular surgery using coils. Anmonia level was normalized and the symptoms disappeared. But it began to elevated 3 months later when he was attacked by conscious disturbance again, probably because of recanalization or opening of collateral circulation.
We discussed focusing on focal neurological deficits which rarely occurred in the metabolic encephalopathy, and speculated that it depended upon decrease of tolerance of the brain foci to anmonia and metabolites derived from the portal systemic shunt. This decrease of tolerance was thought to be based on senile and ischemic change of the brain foci.View full abstractDownload PDF (4730K) -
Tetsuro KARASAWA, Kanemitsu SHIBATA, Tadashi MIWA, Ryozo TOTANI1997 Volume 51 Issue 11 Pages 544-547
Published: November 20, 1997
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESSBetween 1991 and 1995, para-aortic lymphadenectomy was performed on 17 patients with endometrial carcinoma for having risk factors of the metastases to the posterior abdominal lymph nodes.
Their stages at the operation were Ib in 2 cases, Ic in 4, IIIa in 5, and IIIc in 6. Metastases in the para-aortic lymph nodes were found in 6 of the 17 cases (35.3%). Five-year survival rates obtained by the use of Kaplan-heir method were 100% in stage Ib 100% in Ic, 80% in IIIa, and 33.8% in IIIc. The rate of the 17 cases was 65.2%. In order to classify pathological prognostic factors in positive cases for para-aortic lymph node metastases, a study with single variance was made. The factors were significant in cases with 8 or more of lymph node metastases (including pelvic lymph nodes) (P<0.03). The recurrent sites of 4 deceased cases with para-aortic lymph node metastases were cervical lymph nodes in 2, mesentery in one, and vaginal wall in one. Intensive postoperative treatments are considered to be necessary for patients with para-aortic lymph node metastases as their prognoses are generally poor, and 75% of recurrences have occurred not in the operated areas but in other parts of the body.View full abstractDownload PDF (517K) -
Yo KAGEYAMA, Mamoru MIYAIRI, Yuichi NAKAMURA1997 Volume 51 Issue 11 Pages 548-552
Published: November 20, 1997
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESSA case of chronic idiopathic thrombocytopenic purpura (ITP) with an increased platelet count during the course of pulmonay abscess is reported. A 69-year-old woman with ITP was admitted to our hospital because of severe thrombocytopenia and hyperglycemia. The ITP had been diagnosed 2 years previously, splenectomy had been performed, and the platelet count was maintained at around 20, 000-30, 000/mm3 with prednisolone, 10mg/day. Because the platelet count was 6, 000/mm3 on a regular visit, the prednisolone dose was increased to 30mg/day. Two weeks later, the platelet count and fasting blood glucose were 2, 000/mm3 and 212mg/dl, respectively, and she complained of polyuria and thirst. She was then admitted for further evaluation and treatment. After admission, platelet concentrate was infused, the prednisolone dose was reduced and cyclophosphamide was added. On the 18th hospital day, a fever up to 38°C developed with a platelet count of 10, 000/mm3. A cavity and air-fluid level were noted in a chest X-ray and CT scan, and leukocytosis and increased serum C-reactive protein (CRP) were also found. Based on these findings a diagnosis of pulmonary abscess was made. Candida albicans and Klebsiella pneumoniae were cultured from the sputum, and cef azoline sodium and f luconazole were administered intravenously. The fever subsided in a week, and the CRP levels and leukocytosis became normal in 2 weeks. The platelet count increased to38, 000/mm3 by one week, to 86, 000/mm3 by 4 weeks after treatment of the pulmonary abscess, and remained at 50, 000-90, 000/mm3 one year after admission on prednisolone 5mg/day. Cases of ITP exhibiting remission or increases in platelet count during infection are rare, only 12 cases have been reported in Japan to date.View full abstractDownload PDF (3008K) -
Ken-Ichi KANO, Akira YOKOTA, Teizo WATANABE1997 Volume 51 Issue 11 Pages 553-555
Published: November 20, 1997
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESSA study was designed to investigate whether purple urine bag syndrome occurs in the presence of indican (3-indoxyl sulfate) and various kinds of bacteria. Eleven kinds of bacteria were used. and the following treatments were conducted.
1) Urine from a healthy man in eleven test tubes was supplemented with 3-indoxyl sulfate and each kind bacterium, respectively.
2) Physiological saline in the tubes with 3-indoxyl sulfate and each kind of bacterium, respectively.
3) Urine in the tubes without 3-indoxyl sulfate, but with each kind of bacterium, respectively.
4) Physiological saline in the tubes without 3-indoxyl sulfate, but with each bacterium, respectively.
The purple color characteristic of occured only in the test tubes containing 3-indoxyl sulfate and two kinds of bacteria (E. coli and Klebsiella pneumoniae). Thus occurrence of this syndrome seems to be influenced by not only bacteria and indican, but also urine pH and unknown substances in the urine.View full abstractDownload PDF (2573K) -
Hideo MATSUZAKI, Hideki NOMURA, Tsutomu TANAKA, Kyosuke UKAI, Kiyoshi ...1997 Volume 51 Issue 11 Pages 556-559
Published: November 20, 1997
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESSTo assess left ventricular diastolic properties of angina pectoris, 27 patients with angina pectoris (AP group), 7 patients with old myocardial infarction (OMI group) and 20 patients with noramal coronary artery (N group) were studied by ISDN (isosorbide dinitrate) stress echocardiography. Deceleration half time (DHT) and A/E were measured in all of patients before and after ISDN ad-ministration. DHT at rest was longer in AP group than that in OMI grpoup (p=0.0058) and in N group (p=0.0127). After ISDN administration, DHT was longer in AP group than in OMI group (p<0.0001) and in N group (p<0.0001). DHT in AP group was prolonged significantly after ISDN a dnistration (p<0.0001).
A/E at rest was greater in AP group (p<0.0001), and OMI group (p=0.0015) than in N group. after ISDN administration, A/E was greater in OMI Group than in N group (p<0.0001) and AP group (p=0.0006), in AP group than in N group (p<0.0001). A/E of all group increased significantly after ISDN administration (AP group: p<0.0001, OMI group: p=0.0193, N group: p=0.0001).
A prolongation of DHT after ISDN administration in AP group was specific. It was speculated that ISDN stress echocardiography was evaaluated to be usef ull to make diagnosis on angina pectoris.View full abstractDownload PDF (2378K) -
Kazuko MACHIDA1997 Volume 51 Issue 11 Pages 560-562
Published: November 20, 1997
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESSDownload PDF (332K)
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