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Volume 57, Issue 10
Displaying 1-8 of 8 articles from this issue
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Kiyoshi KURODA2003 Volume 57 Issue 10 Pages 595-599
Published: October 20, 2003
Released on J-STAGE: October 07, 2011
JOURNAL FREE ACCESSEndoscopy is used in several surgical fields and is now often applied in neurosurgical field. Neuroendoscopic surgery is useful in observation of the ventricle system and has been applied for treatment of hydrocephalus and assisted observation (endoscopic-assisted surgery). Recently, minimal invasive surgery by neuroendoscopy itself has been developed and has shown good results (neuroendoscopic surgery).
A rigid scope and a flexible fiber scope are both used in neurological surgery. One of most important points in neuroendoscopic surgery is to secure the visual field and another one is hemostasis. Therefore, suitable instruments for neuroendoscopy are necessary.
Techniques, methods and instruments are presented in this paper.View full abstractDownload PDF (4937K) -
Teruo SHIRAKI, Hiraku FUJITA, Shunsuke SAITO, Mitsuhiro AKITA, Takayuk ...2003 Volume 57 Issue 10 Pages 600-605
Published: October 20, 2003
Released on J-STAGE: October 07, 2011
JOURNAL FREE ACCESSPatients with acute myocardial infarction admitted to our hospital between 1984 and 1998 were divided into 4 groups by the way of recanalization and clinical characteristics were evaluated. The parameters which showed no change among the 4 groups are as follows: mean age of the onset, distribution of the number of patients in the onset season and time, infarct location, severity of Killip classification, and incidence of fatal arrythmias. The parameters which showed an increase among them are as follows: annual number of patients, age of maximum number of patients, number of patients from local area, extent of coronary artery disease, number of patients admitted within 6 hours, rate of recanalization therapy and its success rate, amount of peak creatin kinase, incidence of ventricular premature beat, rate of revascuralization in delayed stage and occupancy of coronary angioplasty, and percentage of heart failure and shock in the cause of death. Mortality rate decreased gradually, but the prevalence of smoking and hyperlipidemia as coronary risk factors was higher in younger aged people than older and the difference between the 4 groups was small. Parameters which related significantly to in-hospital death were as follows: age, infarct site, reperfusion therapy, heart failure, fatal arrythmia, and hyperlipidemia. Coordination between hospital and clinic, patient education, and progress of treatment improved prognosis of acute myocardial infarction.
Furthermore, it is important to minimize the high prevalence of coronary risk factors in younger age for the primary prevention of acute myocardial infarction.View full abstractDownload PDF (1091K) -
Makoto YONEMARU, Yuka SASAKI, Takefumi SAITO, Atsuyuki KURASHIMA, Fumi ...2003 Volume 57 Issue 10 Pages 606-609
Published: October 20, 2003
Released on J-STAGE: October 07, 2011
JOURNAL FREE ACCESSTo determine the resistant rate of tuberculosis against four first-line anti-tuberculosis drugs, we reviewed the drug-susceptibility results of the patients with tuberculosis who were admitted to the four participating National Hospitals in 1994 and 1999. Among the patients with no prior chemotherapy against tuberculosis, the complete resistance rates in 1994 and 1999 were 1.2% and 2.0% for isoniazid (INH), 0.21% and 1.3% for rifampicin (RFP), 3.9% and 3.9% for streptomycin (SM), 0.41% and 0.34% for ethambutol (EB), and 0% and 0.5% for multiple drugresistant (MDR) tuberculosis. The acquired resistance rates in 1994 and 1999 were 22.4% and 16.7% for INH, 24.0% and 13.9% for RFP, 16.4% and 6.9% for SM, 11.9% and 5.6% for EB, and 14.9% and 5.6% for MDR. Our results indicated that between 1994 and 1999 there were no significant increase in drug-resistant tuberculosis in patients with no prior treatment and a decreasing trend of the resistance rate in the patients with prior treatment of tuberculosis. A multi-drug regimen currently considered as a standard chemotherapy does not seem to induce a significant increase in drug-resistant tuberculosis.View full abstractDownload PDF (753K) -
THE CURRENT STATE AND THE WARD OF NEUROLOGY IN NATIONAL HOSPITALSSonoko NOZAKI, Noriko ICHIHARA, Tatsuhiko YUASA2003 Volume 57 Issue 10 Pages 610-614
Published: October 20, 2003
Released on J-STAGE: October 07, 2011
JOURNAL FREE ACCESSThe purpose of this paper was to clarify the current state and the problems in the swallowing program in the department of neurology in national hospitals. This is a report of the results of a questionnaire given to the neurologist in 36 hospitals.
Management of dysphagia: evaluation of dysphagia was done in 36% of hospitals, feeding training was done in 63%, prefeeding management was done in 47%, diet for dysphagia was done in 83%. The percentages of patients with a feeding tube for a given disease were 41% for amyotrophic lateral sclerosis (ALS), 31% for spinocerebellar degeneration (SCD), 28% for progressive supranuclear palsy (PSP), 17% for Parkinson's disease (PD), 10% for myasthenia gravis (MG) and 19% for cerebrovascular disease in chronic phase CVD (C). The patients with percutaneous endoscopic gastrostomy for a given disease were 39% for ALS, 38% for PSP, 20% for SCD, 14% for PD, 0% for MG, and 14% for CVD (C). Aspiration pneumonia was found in 7% of SCD, 5% of MG, 5% of PD, 3% of ALS, 1% of PSP and 6% of CVD (C). Surgical intervention for dysphagia was done in a few institutes.
Problem to be solved: Poor collaboration with medical staff and poor continuity of the swallowing program (training, diet, suctioning and tube feeding) in the community medical care were pointed out. A medical team for dysphagia and established facilities for evaluation were needed. Also, more payment for management of dysphagia should be discussed.
We need to organize and develop a dysphagia program for neurological disorders.View full abstractDownload PDF (1650K) -
THE CURRENT STATE IN THE DEPARTMENT OF NEUROLOGY IN NATIONAL HOSPITALSSonoko NOZAKI, Noriko ICHIHARA, Tatsuhiko YUASA2003 Volume 57 Issue 10 Pages 615-619
Published: October 20, 2003
Released on J-STAGE: October 07, 2011
JOURNAL FREE ACCESSThis is a report of a questionnaire sent to the neurologists in 36 national hospitals about the management of dysphagia for patients with amyotrophic lateral sclerosis (ALS).
At 21 out of 36 hospitals (58%) management of dysphagia was started when symptoms of dysphagia appeared. When there was inadequate oral intake tube feeding was introduced as a supplemental route in 27 of 36 (76%) hospitals. But in 56% of them percutaneous endoscopic gastrostomy (PEG) was recommended when oral nutrition failed. In 15 (42%) hospitals frequency in complications of PEG placement was more than 5%. The risks of PEG included respiratory failure due to procedural sedation or pain, peritonitis, failure to place PEG tube, and localized infection. Surgical intervention to prevent aspiration, such as laryngeal diversion, was done in 15 (42%) hospitals. Only 5 (14%) of hospitals have swallowing programs.View full abstractDownload PDF (801K) -
MULTI-CENTER COOPERATIVE STUDYTai YAMAGUCHI, Toaki ONO, Yoshinori HIGUCHI, Kimio UCHIYAMA, Yukitada ...2003 Volume 57 Issue 10 Pages 620-624
Published: October 20, 2003
Released on J-STAGE: October 07, 2011
JOURNAL FREE ACCESSThis paper describes the current issues associated with providing dental care to the patients with human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) in regional core hospitals (Kyoten-Byouin) in Japan. In each hospital, safe dental practice was conducted through keeping a good inter-professional relationship with patient's managing doctor and dentist. The total number of HIV-infected dental patients was 295: 274 (92.9%) of these patients were male and 21 (7.1%) were female. 97 (32.9%) patients were hemophilia patients infected with HIV-through clotting factor. 184 (62.4%) were infected through sexual behavior and 14 (4.7%) were from unknown causes. The total number of dental care treatments was 1466 times for those patients: 1007 (68.7%) times of dental work and 459 (31.3%) times for oral and periodontal care.
Post exposure prophylaxisis after needle-stick injury are already adhered to in these hospitals. Dental hygienists are not found in many clinics, so regular oral care programs of preventive oral hygiene are not provided enough. Dental units with check valves were not installed in some of these dental clinics. It is important that the quality of dental care for HIV infected patients improve in these clinics in Japan.View full abstractDownload PDF (742K) -
Tsuyako IWAI, Michiko SONE, Shigeko YAMAMOTO2003 Volume 57 Issue 10 Pages 625-628
Published: October 20, 2003
Released on J-STAGE: October 07, 2011
JOURNAL FREE ACCESSCultured amniotic fluid cells were evaluated cytogenetically in 122 cases. Six cases (4.9%) showed abnormal karyotypes: one trisomy 21, two trisomy 18, two reciprocal translocation and one pseudomosaicism. In addition, we diagnosed aneuploidy for chromosomes 13, 18, 21, X and Y in uncultured amniotic fluid cells using interphase in fluorescence in situ hybridization (FISH) analysis. The same results were obtained in two analyses: conventional cultured method and interphase FISH. Interphase FISH analysis was acceptable for precise rapid preliminary diagnosis for chromosomal aneuploidy in direct amniocyte preparations. A dual-color FISH analysis was also performed in two reciprocal translocation carriers using chromosome-specific telomere probes. The results showed that the method was strongly reliable for rapid exclusion of chromosomally unbalanced segregations in the reciprocal translocation carriers.View full abstractDownload PDF (2892K) -
Tooru INOUE2003 Volume 57 Issue 10 Pages 629-631
Published: October 20, 2003
Released on J-STAGE: October 07, 2011
JOURNAL FREE ACCESSDownload PDF (3518K)
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