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Volume 57, Issue 2
Displaying 1-11 of 11 articles from this issue
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Toyohiko SAITO1997 Volume 57 Issue 2 Pages 97-107
Published: April 28, 1997
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSRecently, noninvasive methods, such as percutaneous nephrolithotripsy, transurethral ureter lithotripsy, and extracoporeal shockwave lithotripsy ( ESWL), have been widely accepted for the treatment of stone diseases. Among them, ESWL is a completely innovative method of stone treatment.
From April 1990 to March 1996 567 patients visited our urological clinic at Showa University on an outpatient basis. Patients were treated for kidney and ureter stones with a MPL 9000, a second-generation lithotripter provided by Dornier Medizintechnik of Germany.
Examination focused on efficacy, safety and treatment-related problems during 833 sessions for 623 stones. The male-to-female ratio of patients was 2.3 : 1.0, and the highest numbers of patients of both sexes were in the in 40s and 50s. Stones were eliminated in 82.3% of patients and fragmentated in 92.0% of patients.
Stone localization by ultrasound was superior to that by radiography. The required number of treatment sessions and the number of shockwaves seemed to be related to the volume of stones rather than to their character.
No severe side effects were observed during or after treatment. We conclude that ESWL is a safe and effective treatment for kindney and ureteral stones.View full abstractDownload PDF (2668K) -
Takashi TOKUMARU1997 Volume 57 Issue 2 Pages 108-118
Published: April 28, 1997
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSThe significance of caloric testing in patients with acoustic neuroma or sudden deafness was studied in regard to changes due to aging, canal paresis, and clinical course. Caloric testing was performed in 17 patients (19 ears) with acoustic neuroma and 33 patients (33 ears) with sudden deafness. No effects of aging on the maximal slow-phase velocity or duration of nystagmus were recognized on caloric testing of normal ears. Patients with a maximal slow-phase velocity of at least 20 degress/second and of a duration of 100 seconds were regarded as normal. Unilateral canal paresis was diagnosed when the maximal show-phase velocity on the affected side was less than 50% of that on the normal side or when the duration on the affected side was less than 60% of that on the normal side. Among the parameters of caloric testing, the maximal slow-phase velocity was considered to be most suitable for assessing function of the semicircular canal. It is believed that acoustic neuromas larger than 20mm produce canal paresis whereas those smaller than 10mm produce various symptoms according to, for example, the origin of the tumor. Although there was no clear correlation between the size of an acoustic neuroma and hearing, all patients with neuromas smaller than 10mm had only a slight hearing loss. Cancal paresis was recognized in all patients with acoustic neuroma who suffered from dizziness. On the other hand, some patients had canal paresis but no dizziness. No obvious hearing loss or difference in the maximal slow-phase velocity and duration between the right and left sides was seen in the observation period of 3 to 31 months in 3 of 4 patients treated with a gamma knife. No canal paresis was recognized in any patients with sudden deafness but without dizziness, and no canal paresis was seen in half the patients with dizziness. Perhaps dizziness is a temporary and reversible symptom of a cochlear lesion of the vestibular system. The probability of recovery of hearing in cases of sudden deafness was recognized to be related to caloric nystagmus reactions and hearing types, but no clear relation to the presence or absence of dizziness was observed.View full abstractDownload PDF (1241K) -
Toshiyuki SAKAI1997 Volume 57 Issue 2 Pages 119-124
Published: April 28, 1997
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSThe dopamine D3 receptor gene is a candidate locus that may confer susceptibility to shizophrenia. I examined a Ser-9-Gly polymorphism in the D3 receptor protein for an allelic association in 78 Japanese schizophrenia patients and 90 controls. Polymerase chain reaction and digestion by the restriction enzyme Bal I were used for genotyping. There was no significant difference between the two groups in allele frequencies or genotype distribution. When the clinical variables of history of admission to a psychiatric hospital, dosage of antipsychotics, and ase of onset were examined in relation to the genotype and allele frequencies, homozygosity for the Ser-9 allele was found to be less common among patients younger at onset (≤21 year) than among those older at onset (p<0.05) . The clinical variables did not show any significant association with genotype or allele frequency. The present results suggest that the variation in the dopamine D3 receptor gene may have an effect on the age of onset in schizophrenia, although further studies with larger numbers of patients are required.View full abstractDownload PDF (724K) -
—Frontal Lobe Ratios—Susumu ONAGI, Junhui DUAN, Kazumasa SUZUKI1997 Volume 57 Issue 2 Pages 125-131
Published: April 28, 1997
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSWe studied whether differences exist regarding age - related changes of the telencephalic pallium, especially in the volume ratio of the frontal lobe to the total pallium. To measure volume, an electrical planimeter was used to trace magnetic resonance images from 327 asymptomatic persons whose ages ranged from infancy to the 90s. Our most striking finding was that the volume decrease of the frontal lobe started earlier than previously thought and is more rapid, especially in patients in their 90s. We suggest that the frontopallium volume ratio can be used to evaluate brain development and cerebral atrophy, espcially in the frontal lobe. Our results reveal that the human brain develops quickly from birth to the teenage years. There after brain volume gradually decreases with fluctuations untill the early 50s, followed by a constant, gradual decrease after the 60s and by a rapid decrease in frontal volume ratios after the 70s. We conclude that the frontopallium volume ratio will be useful for evaluation investigation of brain development and cerebral atrophy.View full abstractDownload PDF (957K) -
—Correlation between Mutations in the NS 5A Region and Response to Interferon Treatment—Toshiyuki BABA, Makoto ISHII, Keiichiro MITAMURA, Keiji YONEYAMA1997 Volume 57 Issue 2 Pages 132-138
Published: April 28, 1997
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSBackgrounds : Mutations in the nonstructural protein 5A (NS 5A) of HCV are related to the efficacy of interferon (IFN) treatment for patients with chronic hepatitis infected with hepatitis C virus (HVC) of genotype 1b/ II . We studied the relation between the amino acid sequence of the NS 5A 2209-2248 and response to IFN.
Methods : We investigated 22 patients with chronic hepatitis C who were treated with IFN for 6 months. The total doses of IFN were 486 to 780 MU. The amino acid sequence of NS 5A 2209 -2248 was deduced from direct sequencing of the HCV genome amplified by reverse-transcription polymerase chain reaction and was compared with the established sequence of prototype HCV-J. Complete response was defined as normalization of serum levels of alanine aminotransferase and clearance of HCV from serum tested by reverse-transcription polymerase chain reaction 6 months after completion of IFN treatment.
Results : Complete responses were observed in 6 of 22 patients. Complete responses were achieved in 3 (23.1%) of 13 patients positive for wild-type HCV without changes in the amino acids of NS 5A 2209-2248, in 1 (16.7%) of 6 patients positive for intermediate-type HCV having 1 to 3 changes, and in 2 (66.7%) of 3 patients positive for mutant-type HCV having more than 4 changes in the amino acids of the NS 5A region.
Conclusion : In patients with chronic hepatitis infected with HCV of genotype 1b/ II, mutations in the NS 5A region of the HCV genome correlated well with response to IFN treatment.View full abstractDownload PDF (596K) -
Takao SUZUKI, Tohru HASHIMOTO1997 Volume 57 Issue 2 Pages 139-148
Published: April 28, 1997
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSAmbulatory electrocardiography (Holter ECG) is commonly used ; however, it is unreliable when used for automated diagnosis of arrhythmia, especially supraventricular arrhythmia. Automated detection of the P wave is required to improve diagnostic precision. Paroxysmal atrial fibrillation (PAf) is a common arrhythmia, and its clinical management is of great importance. Automated diagnosis of PAf with Holter ECG would be extremely useful in clinical practice. We investigated a PAf detection algorithm, compared the results with diagnoses made by cardiologists, and investigated the precision and other problems associated with PAf diagnosis. We examined 36, 754 sinus P waves obtained from 12 subjects. Sensitivity was 94.3% and the positive predictive value was 98.5%. Some P waves could not be detected owing to low amplitude, noise interference, or swamping by the preceding T wave. False detection of the P wave also occurred in cases with high noise and low amplitude. The subjects were 15 patients in whom lasting 30 seconds or longer had been detected with Holter ECG ; 101 PAfs diagnosed by cardiologists were investigated by means of automated diagnosis. Sixtythree percent (64 of 101) of PAfs showed consistent start and end points, 23.7 % (24 of 101) of PAf s showed discrepancies in end points within several heart beats, and correct diagnosis using both methods was 87.1% (88 of 101) . Cases of PAfs which were not detected showed marked arrhyhmia of R-R intervals due to bigeminy or trigeminy or short runs of premature atrial complexes, with no detection of the P wave. Eight of 101 PAfs could not be recognized as PAf because the f wave was mistaken for the P wave. Automated detection successfully determined PAf start and end points, and allowed clinical evaluation of several parameters, including total heart rates, duration, recovery time, maximal R-R interval, and mean, maximal, and minimal heart rates during PAf, for which information was previously insufficient. This system was found to be useful for PAf automated diagnosis.View full abstractDownload PDF (1020K) -
Tomohisa YOKOKAWA1997 Volume 57 Issue 2 Pages 149-154
Published: April 28, 1997
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSBy means of impedance audiometry, the stapedial reflex was recorded and analyzed in 10 patients with Parkinson's disease to determine whether the reflex shows changes. Eight young and eight elderly normal subjects were also as controls.
Impedance changes were recorded on an X-Y plotter by contralateral sound stimulation. Sounds applied were 500Hz and 1000Hz, 10dB above the threshold of the reflex, for 1.5 seconds. Four latencies in the reflex curve were evaluated in normal subjects and in patients with Parkinson's disease. There were no significant differences in the latencies between young and elderly normal subjects. However, one of the four latencies (D50) was significantly longer in patients with Parkinson's disease than in the elderly normal subjects.
We hypothesize that disturbance of the extrapyramidal system causes prolongation of the latency of the stapedial reflex in patients with Parkinson's disease.View full abstractDownload PDF (568K) -
Yoshimi OSAKABE, Shigeru KANESAKA, Kentaro NARIHARA, Yoshiki TAKAHASHI ...1997 Volume 57 Issue 2 Pages 155-160
Published: April 28, 1997
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSAccording to Lyell, drug-induced toxic epidermal necrolysis (TEN) is a potentially fatal skin disorder caused by drug hypersensitivity. It is characterized by the rapid development of clinical symptoms with high grade fever, Nikolsky's sign, vesicle formation, and erosion, and the histologic finding of epidermal loosening and necrosis. A patient is described who died 8 days after onset of drug-induced TEN, which was most likely due to nonsteroidal anti-inflammatory drugs ( NSAIDs) . The patient was a 38-year-old woman with a history of hypersensitivity to several drugs. The patient was simultaneously given a fosfomycin-group antibiotic ; a macrolide, clarithromycin ; and an NSAID by her local physician for the treatment of an upper respiratory infection. Eruptions of the face and trunk and a fever of 39°C developed approximately 3 days after the start of drug therapy (Fig. 1) . The patient was hospitalized owing to the development of severe pain in the epigastrium and increased severity of the skin eruption. Cardiac, pulmonary, and hepatic dysfunction, gastrointestinal bleeding, disseminated intravascular coagulation, and Nikolsky's sign were present on admission. TEN due to NSAIDs was suspected from the clinical course and was confirmed by histologic examination of a biopsy specimen (Fig. 2 and 3) . Diagnosis led to the start of steroid pulse therapy, plasma exchange, hemodialysis, granulocye colony-stimulating factor therapy, and other treatments. The patient died on the 5th hospital day despite these efforts (Table 1) . Findings at autopsy included bleeding in multiple organs. In addition, the mucosa of the gastrointestinal tract had diffusely sloughed and the lumen was filled with blood. Although its incidence is lower (0.4 %) than that of other skin eruptions, drug-induced TEN is potentially fatal. Patients must be observed carefully when drugs, especially NSAIDs, are administered.View full abstractDownload PDF (3780K) -
Toshiaki HATSUMI, Souichirou TAKIGAWA, Masaji TAKEMOTO, Raita AMEMIYA, ...1997 Volume 57 Issue 2 Pages 161-164
Published: April 28, 1997
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSSubtalar dislocation is rare type of trauma. We report a case of subtalar dislocation with fracture dislocation of the ankle. In this case we believe that subtalar dislocation occurred first, followed by fracture dislocation of the ankle due to high energy impact. We performed open reduction and internal fixation immediately after manual reduction.
We acheived a good result with careful rehabilitation.View full abstractDownload PDF (3218K) -
Pei TANG, Yukio TAKASAKI, Akira NITSUMA, Aya MIZUGUCHI, Toshiya SHINGU ...1997 Volume 57 Issue 2 Pages 165-169
Published: April 28, 1997
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSFor lower-extremity amputees it is important to proceed with prosthetic rehabilitation as soon as possible postoperatively. We report on two patients, both of them transf emoral amputees owing to vascular diseases. Patient 1 was a 69-year-old man who had undergone right transfemoral amputation because of arteriosclerosis obliterans and had a history of angina pectoris, hypertension, and diabetes mellitus. Patient 2 was also a 69-year-old man who had undergone left transfemoral amputation because of thromboangiitis obliterans. The patients were successfully rehabilitated and were able to resume walking with prostheses and achieve independence in activities of daily living. In the early weeks after amputation, the patients' stumps changed greatly in both size and shape. Temporary prostheses were used for early ampulation training. Thermoplastics were used in the fabrication of the temporary socket. In this article, we discuss the necessity of using a temporary prosthesis socket and discuss some medical problems associated with early rehabilitation in geriatric amputees.View full abstractDownload PDF (3355K) -
[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...1997 Volume 57 Issue 2 Pages 170-174
Published: April 28, 1997
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSDownload PDF (573K)
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