Journal of The Showa Medical Association
Online ISSN : 2185-0976
Print ISSN : 0037-4342
ISSN-L : 0037-4342
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Volume 69, Issue 1
Displaying 1-16 of 16 articles from this issue
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  • PERIOPERATIVE COMPLICATIONS IN PATIENTS UNDERGOING HEPATECTOMY AFTER HEPATIC ARTERIAL INFUSION CHEMOTHERAPY
    Ken HAYASHI, Mitsuo KUSANO
    2009 Volume 69 Issue 1 Pages 69-75
    Published: February 28, 2009
    Released on J-STAGE: May 12, 2011
    DOIhttps://doi.org/10.14930/jsma.69.69
    JOURNAL FREE ACCESS
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    The purpose of this study was to investigate perioperative complications in patients receiving hepatic arterial infusion chemotherapy (HAI) prior to hepatectomy and hepatic toxicity associated with HAI. A retrospective review of 15 patients undergoing hepatectomy for colorectal liver metastases initially unresectable downstaged by HAI to the point that operation was performed. HAI consists of 5FU alone in 6 patients, 5FU with cisplatin in 7 patients, and 5FU with mitomycin C in 2 patients. We classified the patients into 2 groups by the total amount of 5FU (Group A > 15.0g/m2, B≤15.0g/m2). We investigated perioperative parameters and pathological findings of hepatic toxicity in the non-neoplastic liver in both groups. The average age of patients was 62.5 years old (group A = 8, group B = 7). There were significant differences in the amount of 5FU and the frequency of HAI between both groups (P < 0.05). However no significant differences were seen in other parameters of HAI, patients back ground, tumor parameters, and operative and perioperative parameters between both groups. Regarding pathological findings of the non-neoplastic liver, steatohepatitis more than Kliner score 4 was all in the group A (3 patients), and there were no sinusoidal dilatations of more than grade 2 in both groups. Pathological findings indicated 3 patients with hepatic injury, all in group A (37.5%). We conclude that there are some risks of pathological hepatic injury with steatohepatitis after HAI when the total amount of 5FU is more than 15g/m2. However HAI prior to hepatectomy is not associated with an increase of perioperative mortality and morbidity.
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  • Usefulness of choline-PET for the head and neck cancer
    —Comparative analysis of FDG-PET and choline-PET—
    Akihiro Kono, Harumi Suzaki, Junichi Ishitoya, Hisayo Fukuoka, Yuzuru ...
    2009 Volume 69 Issue 1 Pages 76-83
    Published: February 28, 2009
    Released on J-STAGE: May 12, 2011
    DOIhttps://doi.org/10.14930/jsma.69.76
    JOURNAL FREE ACCESS
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    We assessed the usefulness of 11C-choline positron emission tomography (choline-PET) for head and neck cancer as compared with 18F-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (FDG-PET). Both FDG-PET and choline-PET were carried out in 14 patients with squamous cell carcinoma of the head and neck. The accumulation patterns of FDG-PET and choline-PET in relatively large tumors were different due to the difference of biological characteristics between FDG and choline in tumor tissues. For the detection of small size carcinoma, choline-PET was more sensitive than FDG-PET. Because choline-PET was affected by cell growth activity, choline-PET was superior for the evaluation of the effect of therapy and recurrence. In conclusion, choline-PET for head cancer is very useful from the different standpoint of FDG-PET.
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  • THERAPEUTIC EFFICACY OF ENDOSCOPIC SINUS SURGERY FOR OLFACTORY DISTURBANCE CAUSED BY CHRONIC SINUSITIS
    Takeshi TOKUMARU, Jun UCHIDA, Miki SHINO, Atsuko FURUTA, Harumi SUZAKI
    2009 Volume 69 Issue 1 Pages 84-93
    Published: February 28, 2009
    Released on J-STAGE: May 12, 2011
    DOIhttps://doi.org/10.14930/jsma.69.84
    JOURNAL FREE ACCESS
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    We performed endoscopic sinus surgery on 81 patients with chronic sinusitis complicated by olfactory disturbance, and we conducted a study of its therapeutic efficacy in regard to olfactory disturbance. Both the average detection threshold levels and the average recognition threshold levels as indicated by the standard olfactory acuity test (T & T olfactometry) showed significant postoperative improvement, suggesting the usefulness of surgical treatment by endoscopic sinus surgery. Significantly more cases of improvement in olfaction were observed among patients who were 59 years of age and under at the time of surgery, and there were significantly more cases of improvement in olfaction in the group whose duration of illness between the onset of symptoms and surgery was 6 years or less. No significant differences were observed regarding complication by either allergic rhinitis or bronchial asthma was present. The results of the preoperative intravenous olfaction test (Alinamin® injection test) showed significantly more cases in which a clear response was observed in the group with an improvement in olfaction; there were significantly more cases in which no response was detected in the group in which no improvement was observed. The olfaction of the cases in which postoperative adrenocortical hormone nose drop therapy was performed showed significant postoperative improvement. The findings in this study suggest that greater improvements in olfaction are achieved by performing endoscopic sinus surgery early in patients with olfactory disturbance caused by chronic sinusitis and by performing adrenocortical hormone nose drop therapy postoperatively. In addition, the results suggest that the preoperative intravenous olfaction test is useful for predicting postoperative improvement in olfaction.
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  • A STUDY OF THE APPLICATION OF OPIOID PREPARATIONS FOR CANCER PAIN IN PATIENTS WITH HEAD AND NECK CANCERS
    Kenzaburo OSHIMA, Kenichi KANAI, Jun UCHIDA, Mutsuo KUDO, Yoshiyuki KA ...
    2009 Volume 69 Issue 1 Pages 94-102
    Published: February 28, 2009
    Released on J-STAGE: May 12, 2011
    DOIhttps://doi.org/10.14930/jsma.69.94
    JOURNAL FREE ACCESS
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    Patients with head and neck cancers have various unique physical and functional problems related to the cancer. In the use of opioid preparations for palliative care of these patients, the unique problems associated with head and neck cancers must be taken into consideration. In this study the application of opioid preparations for palliative care of these patients was retrospectively assessed based on the data obtained from the medical charts of 62 patients with head and neck cancers who were treated and attended to in their deathbed by us. Based on results of assessment regarding the methods of introduction of opioid preparations in these patients, the opioid preparations appropriate for palliative care of pain were assessed. Investigation regarding the contents of rotation of opioid preparations and the reasons for such rotation revealed that many patients with head and neck cancers had performed a rotation of opioid preparations and that it is important to take into consideration the unique problems associated with head and neck cancers when selecting appropriate opioid preparations. The results of investigation regarding the routes of administration of opioid preparations at the time of death indicate that because of the unique nature of the problems associated with head and neck cancers, the use of continuous subcutaneous infusion of opioids is needed for the treatment of these patients. In regard to the applications of opioid preparations for cancer pain in patients with head and neck cancers, it is necessary to consider drug selection based on consideration of the unique problems associated with these cancers and employ rotation of opioid preparations. Furthermore, the routes of administration of opioid preparations must be taken into account when the physician attends to such patients in their deathbed.
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Case Report
  • CASES OF ACUTE ABDOMINAL PAIN AFTER EATING JAPANESE ANCHOVIES
    Noriyuki MURAI, Masahiko MURAKAMI, Hiroshi AZUMA, Hirohisa KATO, Mituo ...
    2009 Volume 69 Issue 1 Pages 103-107
    Published: February 28, 2009
    Released on J-STAGE: May 12, 2011
    DOIhttps://doi.org/10.14930/jsma.69.103
    JOURNAL FREE ACCESS
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    Subjects reported abdominal pain and vomiting 5 hours after eating Japanese anchovies. All cases had severe abdominal tenderness, and X-ray images revealed small intestinal gas images. Blood tests showed increased white blood cells. Results of Abdominal ultrasonography and gastro intestinal endoscope were normal. All cases were treated by conservative therapy limiting oral intake. Complaints improved between one to three days after treatment. It is thought that such cases of abdominal pain are a result of eating fish with worms or food poisoning. There was no indication of anisakiasis. Stool Culture tests showed no significant findings. The acute abdominal pain, appearance and progress of the symptoms are characteristic of histamine poisoning. Although the symptoms of histamine poisoning are generally mild, it is important that the medical examination include a careful interview of patients, and histamine poisoning should be considered in cases of acute abdominal pain.
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