All issues
Volume 49 (2000 - 200･･･
- Issue 6 Pages 799-
- Issue 5 Pages 711-
- Issue 4 Pages 553-
- Issue 3 Pages 202-
- Issue 2 Pages 79-
- Issue 1 Pages 1-
Volume 49, Issue 4
Displaying 1-12 of 12 articles from this issue
- |<
- <
- 1
- >
- >|
-
Shinichi GOTO, Yoshikazu CHIBA, Naoki KINTO, Satoshi NAKAMURA, Atsumi ...2000 Volume 49 Issue 4 Pages 553-557
Published: November 30, 2000
Released on J-STAGE: August 11, 2011
JOURNAL FREE ACCESSThere are many published studies on postoperative deep venous thrombosis (DVT) which can develop after hip joint arthroplasty, but very few reports are available on the incidence of thigh DVT following or thopedic treatment of transcervical fractures. In this study, therefore, we tried to find out a screening method just right for the early detection of clots that develop in the deep femoral veins after treatment of the feactures in the neck of femurs. Between March and September 1999, a total of 24 patients were operated on for fractures on the cervix of thighbone in our hospital. Of the total, 19 were recruited for this study. The five cases were excluded because some of them were on medication that could affect the coagulation/ fibrinogenolysis factors and some were under management of other departments. After surgery, a series of blood biochemical tests were performed, and changes in the partial pressure of arterial blood oxygen and D-dimer (??) level were examined with the passage of time. In the cases which were suspected to have thrombosis in the veins in the lower extremities by ultrasonography performed six to 18 days after surgery, definitive diagnosis was made by the aid of venography. DVT was found in three in the 19 cases. Routine blood biochemical tests and measurements of oxygen partial pressure in the artery were not so much helpful as were expected in the early detection of thrombosis, whereas measurements of D-dimer levels were considered useful because the levels were well over 20μg/ml one week after surgery in the positive-DVT cases.View full abstractDownload PDF (3576K) -
Predictable from the Severity of Osteoporosis?Shoji KUMAKI, Hideki KURIBAYASHI2000 Volume 49 Issue 4 Pages 558-564
Published: November 30, 2000
Released on J-STAGE: August 11, 2011
JOURNAL FREE ACCESSProximal femur fractures (PFFs) are a major cause of disability in the elderly. Some reports say that osteoporosis is a factor contributing to PFFs and values of bonemineral density (BMD) can be used to predict PFFs. In this study we investigated thepossibility of using BMD monitoring to predict the risk of PFFs.
This study compares a PFF group with a nonfracture control group. The selection criteria for both groups were female patients, age 60 and over, on whom dual energy xray absorptiometry (DXA) was performed. The PFF group was composed of 52 patients who were treated between Feb. 1997 and Nov. 1998 and DXA was performed within two weeks postoperatively. The nonfracture control group was made up of 27 patients who were treated for total knee replacement between April 1998 and Dec. 1998 and DXA was performed within two weeks preoperatively.
Histograms were made using BMD data from lumbar and proximal femor measuring sites. The histograms were used to produce receiver-operating characteristic (ROC) curves. After analysing the histograms and ROC curves, two ranges of interest in each DXA report, neck and Wards were selected as the best sites to use when comparing the PFF and control groups.
The two groups were compared to determine cut-off levels for PFFs. For the assessment of fracture risk of the patients with osteoporosis, we would like to propose for neck, 0.600g/cm2 BMD in which sensitivity is 76% and specificity is 80%. And for Wards, 0.400g/cm2 BMD in which sensitivity is 71% and specificity is 81%.View full abstractDownload PDF (715K) -
Tomio KAMETANI, Hideo KOSHIDA, Kiyomori HASHIZUME, Kazuhiko SHIBATA, K ...2000 Volume 49 Issue 4 Pages 565-572
Published: November 30, 2000
Released on J-STAGE: August 11, 2011
JOURNAL FREE ACCESSTo determine risk factors for progression of diabetic retinopathy, a study was conducted in 92 patients with diabetes whose HbA1c levels were more than 9.5% when they were admitted to our hospital.
The progression of retinopathy was observed in 50% of the patients during 12 months after admission. Their cases were diagnosed as preproliferative retinopathy. The duration of no-treatment, serum cholesterol level, blood pressure and proteinuria were significantly greater in the deterioration group of retinopathy than in the no-deterioration group. Nerve conduction velocity was significantly lower in the deterioration group of retinopathy than in the no-deterioration group. The reduction of HbA1c level during the period of 3 months after admission was significantly higher in the deterioration group than in the improved group. In the patients whose initial levels of HbA1c were less than 10%, the deterioration of retinopathy was not observed. In conclusion, these findings suggest that the duration of no-treatment, serum cholesterol level, blood pressure, proteinuria, nerve conduction velocity, retinopathy severity, the HbA1c level at admission and the reduction of HbA1c level during the 3-month period are risk factors for the progression of retinopathy.View full abstractDownload PDF (981K) -
Hiroyuki OHBAYASHI, Hideyuki ICHIOKA, Chie TAKEUCHI, Masanori MIYACHI, ...2000 Volume 49 Issue 4 Pages 573-581
Published: November 30, 2000
Released on J-STAGE: August 11, 2011
JOURNAL FREE ACCESS[Introduction] Fluticasone propionate (FP), an inhaled corticosteroid, has almost twice as much clinical efficacy as Beclomethasone dipropionate (BDP) in the management of asthma. The inhalation of FP dry powder by using a handy and portable inhalator is effective for young and middle-aged patients with bronchial asthma. However, the inhalator are not always easy for elderly patients to operate because it requires some manual dexterity and a knack for quick inhalation.
[Methods] A total of 47 outpatients aged 65 years or above who had achieved a stable asthmatic condition were enrolled for this study, and changed the drugs from BDP to FP. The amount of FP to be taken at one time was equivalent to half the dose of BDP. Twelve check points of inhalation skills were repeatedly taught until patients understoodfully. We checked these points after 2-4 weeks and 8 weeks. We used a questionnaire to survey the patients' impression of FP and its adverse effects. We also evaluated peak flow values (PEF) in the morning and at night, results of pulmonry function tests and asthmatic grades.
[Results] We found clear weak points for the 12 skills in the elderly patients. PEF both in the morning and at night significantly improved after 2-4 week treatment with FP, but pulmonary function tests found no statistically significant change. Eventually 71.4% of the patients in the 65-74 year age range and 50.0% of those of 75 years or above hoped to continue to receive FP therapy. The total number of the patients with adverse effects was 14 (29.8%): These were 7 cases of dryness in the mouth, 5 cases of hoarseness and 2 cases of nausea and vomiting.
[Discussion] Although we confirmed the clinical usefulness of FP in elderly patients with asthma, we must recognize that it requires much time and labor for the eldrely to get used to FP inhalation and that it is important to give them repeated instruction.View full abstractDownload PDF (1073K) -
[in Japanese]2000 Volume 49 Issue 4 Pages 582-592
Published: November 30, 2000
Released on J-STAGE: August 11, 2011
JOURNAL FREE ACCESS -
[in Japanese]2000 Volume 49 Issue 4 Pages 593-606
Published: November 30, 2000
Released on J-STAGE: August 11, 2011
JOURNAL FREE ACCESS -
[in Japanese]2000 Volume 49 Issue 4 Pages 607-617
Published: November 30, 2000
Released on J-STAGE: August 11, 2011
JOURNAL FREE ACCESS -
Shinji SASAKI2000 Volume 49 Issue 4 Pages 618-625
Published: November 30, 2000
Released on J-STAGE: August 11, 2011
JOURNAL FREE ACCESSGiven the outbreak of accidents in which workers, engaged in the management and control of national forests, are stung by wasps, the Forestry Agency has decided to have them carry around and, when anaphylactic shock occurs after a sting, use Epipen, an automatic injector of American makes immediately.
In this paper, we report on the developments that have led to the use of Epipen, the clinical cases for which it was used, and its efficacy. The automatic syringe was used for 10 cases over a period of five years, and the lives of nine of them were saved thanks to its efficacy.
It is hoped that this syringe will be used not just by the Forestry Agency but in a broad range of pre-hospital care sectors.View full abstractDownload PDF (2120K) -
Tomio KAMETANI, Kiyomori HASHIZUME, Kazuhiko SHIBATA, Kuniyoshi SHIMIZ ...2000 Volume 49 Issue 4 Pages 626-630
Published: November 30, 2000
Released on J-STAGE: August 11, 2011
JOURNAL FREE ACCESSA 62-year-old woman was adimitted to our hospital because of thirst and a body weight loss of 9kg. She had a history of vasospastic breast pang 5months before. The level of fasting plasma glucose was 320 mg/dl and the level of HbA1c was 13.0%. The autoantibody to glutamic acid decarboxylase was positive. The level of urine C-peptide was 28.6μg/day. She rejected insulin injections and was treated with glibenclamide. The level of urine C-peptide increased to 70.0μg/day. The disease was controlled with the levels of 6.0% of HbA1c. But her condition became uncontrollable gradually after 6 months and she was treated by insulin therapy.
Insulin secretion in type 1 diabetes mellitus was transiently improved by sulfony 1 urea. This suggests that not only the insulin secretion but also glucotoxicity plays an important role in early stage of type 1 diabetes mellitus.View full abstractDownload PDF (519K) -
Toshio ONO, Hiroaki ABE, Saburo YAMASHITA, Norichika MATSUI2000 Volume 49 Issue 4 Pages 631-636
Published: November 30, 2000
Released on J-STAGE: August 11, 2011
JOURNAL FREE ACCESSDiffuse peritonitis due to perforation of pyometra is relatively rare. We experienced three cases of this type of peritonitis between 1993 and 1999. Three women aged 77, 83 and 91 years had mild abdominal pain, slight fever and defecation for nearly one week. Following these, severe abdominal symptoms developd. These patients underwent emergency laparotomy as they were diagnosed with diffuse peritonitis. At first, intestinal perforation was suspected, but perforation of pyometra was confirmed when lapasortomy was done. On preoperative examinations, physical findings were scanty in comparison with hemological ones, and free air on abdominal X-ray films was not detected. Thus, we failed to establish the preoperative diagnosis. The prognosis was very poor in two of the three patients. One was with advanced cervical cancer and the other was in multiple organ failure on admission. Differential diagnosis of this disease is important for the management of acute abdominal diseases in elderly women.View full abstractDownload PDF (4329K) -
2000 Volume 49 Issue 4 Pages 637-646
Published: November 30, 2000
Released on J-STAGE: August 11, 2011
JOURNAL FREE ACCESSDownload PDF (1339K) -
2000 Volume 49 Issue 4 Pages 647-673
Published: November 30, 2000
Released on J-STAGE: August 11, 2011
JOURNAL FREE ACCESSDownload PDF (3643K)
- |<
- <
- 1
- >
- >|