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Volume 53, Issue 1
Displaying 1-16 of 16 articles from this issue
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Hajime TAKAGI, Hidehiko OHTUKA, Susumu SHIMIZU, Hajime SUZUKI, Eisei N ...1993 Volume 53 Issue 1 Pages 1-7
Published: February 28, 1993
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSThe effectiveness of mass survey was evaluated in 705 cases that were studied concerning the reason for detection in relation to cell type, the site of origin, the stage, the rate of operability, and any reasons for delay in diagnosis. The rate of cases detected by mass screening was 33.0% (233/705cases) . In the screening detection group, stage O and I cases accounted for 40.3% of all cases. The group detected as a result of symptoms accounted for 9.3%. Absolutely curative operations were performed in 46.8% of the screening detected group, and in 18.4% of the group detected as a result of symptoms. Mass survey was usefull for the detection of early lung cancer, but the screening detection group spent up to 37.9 weeks to begin therapy, and 52.9% of all patients were detected 39 weeks of diagnostic delay. Therefore improvement is still necessary.View full abstractDownload PDF (767K) -
Yasuyuki ABE, Takashi IGUCHI, Itsuo TADAMA, Takeshi OOCHI, Tsunenori I ...1993 Volume 53 Issue 1 Pages 8-18
Published: February 28, 1993
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESS -
Yoshihiro SUZUKI, Hiroshi TAKAHASHI, Rikiya FUZITA, Fumio SUGATA1993 Volume 53 Issue 1 Pages 19-24
Published: February 28, 1993
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSEsophageal and gastric functions were assessed in patients who reported chronic unidentified upper abdominal complaints despite the absence of evidence of any organic disease in examinations and tests, including endoscopy, CT scan, and ultrasound. Determination of gastric emptying by the acetaminophen method, 24-hour esophageal pH monitoring were determined, and lower esophageal sphincter pressure (LESP) was measured in these patients. In the determination of gastric emptying, blood concentrntaios after acetaminophen administration were significantly lower in NUD patients than in normal volunteers. In 24-hour esophageal pH monitoring, postprandial gastric pH in the daytime remained above 4 significantly longer in NUD patients than in normal volunteers. Esophageal pH values decreased to less than 4 in normal volunteer, but remained at 4 or lower for min in NUD patients, and the length of time during which esophageal pH values remained below 4 was correlated with heat-burn symptoms. LESP was significantly lower in NUD patients than in normal volunteers. These finding suggest that NUD is caused by impaired gastro-esophageal function assosciated with decrease in gastric emptying and LESP. Therapy for NUD is corrects the esophageal and gastric function.View full abstractDownload PDF (602K) -
Kazuo ABE, Makoto YOSHIBA, Fumio SUGATA1993 Volume 53 Issue 1 Pages 25-30
Published: February 28, 1993
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSThe authors measured serum bile acid concentrations in 16 patients with fulminant hepatitis (FH) and 12 patients with liver cirrhosis (LC) and studied their correlation with disease status. HPLC was employed to measure 15 serum bile acid fractions. 1) Total serum bile acid (TBA) concentration of 15 fractions measured by HPLC was significantly elevated in PH patients. 2) Among 15 fractions of bile acid, glycochenodeoxycholic acid (GCDC) and glycocholic and (GC) levels were significantly higher in FH than LC, and no intergroup differences were noted among other groups. 3) In FH, the primary bile acid/secondary bile acid ratio was higher than in LC, but the glycine (G) /taurine (T) ratio, the cholic acid (C) / chenodeoxycholic acid (CDC) ratio and the conjugation rate had no significant intergroup differences. These result probably reflect differences about liver damage by PH and LC: The former was characterized by dramatic hepatolysis and caused severe hepatic failure, but liver damage by the latter was not so severe. Study of serum bile acid fractions was therefore useful in characterizing the pathological status of FH and LC.View full abstractDownload PDF (607K) -
Yasuyuki FUJITA, Rikiya FUJITA, Nobuto HIRATA, Fumio SUGATA1993 Volume 53 Issue 1 Pages 31-38
Published: February 28, 1993
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSThe aim of this report is clarification of the usefulness of endoscopic sphincterotomy (EST) in therapy for choledocholithiasis. A total of 667 patients with choledocholithiasis treated by EST in our department and related hospitals from November 1975 to May 1992 were analyzed for success rate, incidence of complications, and long term prognosis. In the initial phase up to 1985, successful stone removal was accomplished in 430 out of 465 patients (92.5%) with complications in 32 patients (6.9%), including 9 patients of hemorrhage (1.9%), 8 pancreatitis (1.7%), 5 perforation (1.1%), 5 cholangitis (1.1%), 3 cholecystitis (0.6%), and 2 basket impaction (0.4%) . Of these, surgical management was required in 8 cases (1.7%) . Two patients died of cholangitis and one of hemorrhage (0.6%) . Since about 1986, transduodenal lithotripsy techniques, such as mechanical lithotripsy, electrohydraulic lithotripsy (EHL) and laser irradiation under peroral choledochoscopy (PCS) have been available. Such techniques have created great improvements in therapeutic capability. The incidence of complications, laparotomy and mortality have decreased significantly to 3.5%, 0.5% and 0%, respectively, compared to the initial phase. In long term follow-up, 226 patients were analyzed. Among them, 51 patients had been cholecystectomized before EST and 46 after, and 129 had gallbladder with stone (65 patients) or without stone (64) . Common bile duct stones recurred in 13 patients (5.8%) and cholecystitis occured in 6 patients (4.7%) with gallbladder stones. From our clinical experiences, we concluded as follows: (1) EST for choledocholithiasis is becoming a safer and more reliable lithotomy technique due to improvement of both instruments and skill. (2) Stone recurrence and incidence of cholecystitis in long term follow-up are at acceptable rates.View full abstractDownload PDF (981K) -
Hiroyuki TAJIMA, Mitsuru ADACHI, Teruaki KIMURA, Yasuro KOHNO, Terumi ...1993 Volume 53 Issue 1 Pages 39-46
Published: February 28, 1993
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSThe sulphidopeptide leukotriene C4 and D4 (LTC4, LTD4) are potent bronchoconstrictors. To investigate the role of LTs in allergic asthma, time related changes in urinary LTE4, a stable urinary end-product of LTC4 and LTD4, was evaluated after BPT with HD in 29 patients with bronchial asthma whose skin tests and radioallergosorbent test (RAST) were positive. The following results were obtained: 1) The levels of urinary LTE4 did not change in 12 hours in patients who had no response to BPT with HD. 2) The levels of urinary LTE4 increased significantly (p<0.01) 3 hours after inhalation by patients who had immediate single asthmatic responses (IAR) . 3) The levels of urinary LTE4 increased significantly (p<0.01) 3 hours after inhalation by patients who had dual asthmatic responses (DAR) . However, there were no significant changes from 3 to 12 hours. 4) The levels of urinary LTE4, measured during the first 3 hours after inhalation were not correlated with the maximal decreases in FEV1.0, PER, V50, or V25 in 0 to 3 hours after inhalation. These results suggest that the LTE4 precursors, LTC4 and LTD4, are important bronchoconstrictive mediators that cause IAR after allergen inhalation.View full abstractDownload PDF (760K) -
Shinobu NOZAKI1993 Volume 53 Issue 1 Pages 47-56
Published: February 28, 1993
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSA clinico-statistical survey was carried out on 154 patients (secondary repair of bilateral cleft lip: 144 cases, primary repair of bilateral cleft lip: 10 cases) who had been undergone Onizuka's One-Scar-Line procedure at the Department of Plastic and Reconstructive Surgery, School of Medicine, Showa University from March, 1975 to December, 1990. 1. Hypertrophic scar formation occurred in 40 cases (27.8%) after this procedure as secondary repair of bilateral cleft lip, and was the most common in the nostril floor area. 2. Hypertrophic scar occurred more on the complete bilateral cleft lip than on the incomplete type, and more on bilateral cleft lip in conjunction without cleft palate than with cleft palate. 3. Hypertrophic scar was more frequent in young patients than elderly patients. 4. Modification of the procedure, such as insertion of a skin flap into the nostril from the alar base of the upper lip, decreased the incidence of hypertrophic scar to 19.0% in 1990. 5. We evaluated the effect of radiation and Tranilast, and found that they were not effective in preventing hypertrophic scar formation after the One-Scar-Line procedure.View full abstractDownload PDF (1118K) -
Tsunenori IDEI, Takashi IGUCHI, Itsuo TADAMA, Takeshi OOCHI, Yasuyuki ...1993 Volume 53 Issue 1 Pages 57-66
Published: February 28, 1993
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSA comparison was made of schizophrenic outpatients visiting Karasuyama Hospital, a hospital affiliated with Showa University (referred to here as the mental hospital group), or the Department of Psychiatry, Showa University Hospital (the general hospital group) . Only those patients who could be observed over a period of more than five years, were evaluated. None had ever had any treatment prior to their first visit to either hospital. The following results were obtained: No difference was noted between the two groups in adaptability to society. Taken as a whole, two-thirds of the patients were well-adapted to society. Based on scored to evaluate mental signs and symptoms, however, the severity of mental signs remained higher in the general hospital group. Compared to the general hospital group, more patients were under long-term observation in the mental hospital group. The latter group had earlier onset of schizophrenia, a higher number of hospitalizations, longer total elapsed time of hospitalization, longer stay per hospitalization, and a longer period between onset of the illness and their first visit to a hospital. The course and prognosis of schizophrenia in outpatients who had not had any treatment until their visit to either hospital, and who could be ovserved over a long period of time were favorable in most patients. However, the results suggest that these patients could be divided into two groups: those who could be mainly observed in a mental hospital; and a mild type that might commonly appear in a general hospital, but would also be present in a mental hospital in more than an insignificant number. The fact that not a few patients displayed this mild type shows in one respect that schizophrenia may be presently becoming milder.View full abstractDownload PDF (1269K) -
Shizuo TAKEYAMA1993 Volume 53 Issue 1 Pages 67-74
Published: February 28, 1993
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSVecuronium has been developed as a more rapidly acting, non-depolarizing, steroidal, neuromuscular blocking agent. Onset time of neuromuscular blockade was measured for increasing doses of vecuronium in 163 patients (ASA class I-II), between 20 and 60 years of age, who had elective surgical procedures. Vecuronium was continuously quantitated by recording the EMG response to stimulation of the ulnar nerve by train of four. Each patients was assigned to one of nine groups to recieve 0.07, 0.1, 0.15, 0.2, 0.25, 0.3, 0.35, 0.4, 0.45 mg·kg-1 of vecuronium. Intubation was performed when the blockade was maximum. Intubation could be satisfactorily carried out in the 0.15 mg·kg-1 dose group. The onset time from the time of vecuronium administration to maximum blockade decreased from 287.5±74.1 to 140.9±25.1 sec when the vecuronium doses increased from 0.07 to 0.2mg·kg-1. Increasing the dose above 0.2mg·kg-1 did not appreciably shorten the time to full neuromuscular blockade. The duration of action of vecuronium from the time of injection to 15% recovery was longer with lager doses, up to a limit of 0.3mg·kg-1. The optimal dose of vecuronium for endotracheal intubation was estimated to be 0.15-0.2mg·kg-1. In the present study there was no obvious side effect associated with the administration of a large dose of vecuronium.View full abstractDownload PDF (848K) -
—EXPERIMENTAL STUDY BY MEASURING TISSUE BLOOD FLOW—Kiyoaki TAMURA, Kazushige ARAI, Tadashi KOIKE1993 Volume 53 Issue 1 Pages 75-83
Published: February 28, 1993
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSAs an operation for esophageal-gastric varix, we have performed the blocking of blood circulation and stitching of the gastric wall in the upper region of the stomach. Twelve adult male dogs were operated on. Blood flow in the mucosa and serous membrane was measured before and after each operation. As a clinical study, the cases of esophageal-gastric varix hospitalized here were divided into an endoscopic injection sclerotherapy (EIS) group, an esophageal transection group, and a group for our type of operation, and a comparative study was made. In the experiment using adult dogs, the blood flow in the upper part of the gastric body decreased about 1/3 from that before the operation on both the mucosal and the serous membrane sides. The mucosal blood flow remained significantly decreased at about 1/2 the preoperation level for up to 12 weeks after the operation. The decrease was greater than in the lower part of the gastric body. In the present experiment, the blood flow blocking effect of this operation was determined by measuring the blood flow, and the effectiveness, safety and universality of the operation was confirmed by studying clinical cases. It is concluded that this operation is one of the more effective types of operation among the prospective and prophylactic cases for which surgery is indicated.View full abstractDownload PDF (1048K) -
Akira GOMI1993 Volume 53 Issue 1 Pages 84-91
Published: February 28, 1993
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSTo investigate the influence of splenectomy under obstructive jaundice, we designed an experimental study by ligating the common bile duct of 4 weeks old male Wistar rats. We observed the histological damage to the liver and effects on the function of the Kupffer cells. The following results were obtained. 1) The liver in splenectomized rats was compared with that in jaundiced rats. 2) The phagocytosis of Kupffer cells in splenectomized rats with jaundice was less than that in jaundiced rats. It is suggested that an inhibitory factor from the spleen might suppress functions of the liver when an animal suffers from obstructive jaundice.View full abstractDownload PDF (4350K) -
Tsutomu KITAMURA1993 Volume 53 Issue 1 Pages 92-102
Published: February 28, 1993
Released on J-STAGE: November 19, 2010
JOURNAL FREE ACCESSNineteen cases with Klinefelter's syndrome were examined by clinical psychology tests (WAIS, Rorschach test, Y-G and TPI) and psychiatric interview (EEG) . Six of these were dosed with testosterone depo, and EEG and W AIS were examined before and after this dosage. After that, changes of the cognitive style were studied. Then some findings were reported as compared with past literatures. The nineteen cases were so-called “subclinical cases”, because they did not suffer from any psychiatric signs. But all psychological tests showed unbalanced IQ profiles and neurotic or organic signs, and EEGs were abnormal or borderline in most cases. (1) The results of the testosterone-depo dosage were as follows: EEG showed the aggravation such as increased θ wave; W AIS showed significant increase in both Total and Performance IQ levels. Thus, paradoxical results were evident. (2) In this way, the effect of the testosterone therapy revealed a good change of the psychological aspects of the disease, and this observation was verified by improvement in character and behavior of these patients. This structural change of the intelligence is extraordinary with Klinefelter's syndrome, and will be further reported after conducting more examinations of the relations between this psychological test and hormonal data. (3) No definite answer can be given yet about the “premorbid character” and the character after the change by the disease. However, this method throws light on the old and new problems of Klinefelter's syndrome. If the Klinefelter's syndrome is a clinical entity, it is possible to pattern the character of the patients, and this approach leads to “a study of Schizophrenia”. In other words, this interdisciplinary study between psychiatry and urology brings out patternization of personality aspects, which in turn leads us to survey of “What is Schizophrenia? ”. (4) On the part of the patients, this medical service develops their ability to understand their disease, so the patients are relieved of unnecessary worry, and can understand the states of their illness more clearly. This approach thus demonstrates that the psychological tests are useful not only in psychiatry per se, but also other fields of medicine.View full abstractDownload PDF (3075K) -
Masakazu ISEKI, Osamu ARAIDA, Tetsuya KAWAGUCHI, Tadashi KOIKE1993 Volume 53 Issue 1 Pages 103-106
Published: February 28, 1993
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSThe case is a 74 year-old male with a history of shrapnel in his back during World War II, 50 years ago. This was diagnosed by X-P as a foreign body in the abdomen but left it untreated because of the absence of symptoms. With epigastric pain as the chief complaint, he was seen at the Department of Internal Medicine of this hospital. Diagnosed as having malignant lymphoma of the stomach by endoscopic examination of the stomach and biopsy, he was referred to this department for surgery. Subtotal gastrectomy and cholecystectomy were performed and shrapnel pieces were found to form the nucleus of the stone. Reports of cholelithiasis with a foreign body as the nucleus are few. Cholelithiasis with shrapnel as the nucleus, as in our case, is considered rare, so we report our findings together with a review of the literature.View full abstractDownload PDF (3052K) -
Hiroshi NEMOTO, Takashi SUZUKI, Akihiko KITAMI, Mototoshi YAMASHIRO, G ...1993 Volume 53 Issue 1 Pages 107-110
Published: February 28, 1993
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSWe resected a bleb of a spontaneous pneumothorax by thoracoscopic surgery for a 21-year-old man. He had been diagnosed as having aplastic anemia nine years before. During the treatment of this disease, he also had hepatitis, necroses of bilateral femoral heads, and diabetes mellitus. The bone marrow transplant was performed in October 1990, and took a good course. However, during admission for the treatment for diabetes mellitus, left spontaneous pneumothorax occurred. The pneumothorax was improved by the conservative therapy, but it recurred after one month. As operations for necroses of the bilateral femoral heads were planned, curative therapy for the spontaneous pneumothorax was thought to be required to avoid the tension of pneumothorax during the general anesthesia for orthopedic surgery. Since he was considered to be a “poor risk”, resection of the bleb under thoracoscopic surgery using ENDO-GIA was chosen because of its lower invasiveness. He was discharged on the 8th postoperative day. He underwent two orthopedic operations as scheduled, but spontaneous pneumothorax did not recur. Although thoracoscopic surgery has not been discussed completely from the the statistical aspect of safety, it seems likely that this technique will be useful, especially for patients at poor risk.View full abstractDownload PDF (3470K) -
Tatsuro HORINOUCHI, Kazuhiko SOEJIMA, Mikio KANDA, Makoto YOSHIMURA, K ...1993 Volume 53 Issue 1 Pages 111-115
Published: February 28, 1993
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSA case of intra-muscular hemangioma with clinico-pathological study is reported. A 28 year-old man was admitted complaining of left-femoral pain and tumor. CT and MR revealed a tumorous lesion in the middle part of the vastus intermedius muscle of the left femur. Irregular pooling was seen in the venous phase of angiography. From these findings, diagnosed as intra-muscular hemangioma of the left femur, surgical excision was performed. Macroscopically, these were some tumorous lesions in the vastus intermedius muscle, and the cut surfase appeared like dark red coagulation-like tissue. Microscopically, the tumor had intramuscular hemangioma with cavernous and capillart patterns that suggest a mixed type of hemangioma.View full abstractDownload PDF (4351K) -
Yuichirou TSUJI, Toshio OHBA, Hiroshi CHIKAOKA, Kazuo ITABASHI, Seiji ...1993 Volume 53 Issue 1 Pages 116-121
Published: February 28, 1993
Released on J-STAGE: June 23, 2011
JOURNAL FREE ACCESSA 2 year-old boy with hepatomegaly and increased hepatic enzymes was admitted to our hospital. Fernandes tolerance tests were performed, and activities of phosphorylase and phosphorylase b kinase were measured. The results indicated that he had glycogen storage disease type VIII b.View full abstractDownload PDF (560K)
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