We sought to determine whether neonatal complications are less frequent in gestational diabetes mellitus (GDM) than in overt maternal diabetes (DM), and whether these complications are related to degree of maternal glycemic control during pregnancy. Obstetric and diabetic management was provided at a university hospital. Maternal glycemic control was monitored with hemoglobin (Hb) A lc determinations. Neonatal complications were somewhat more frequent in the DM group than in the GDM group, but except for congenital anomalies the difference was not statistically significant. Maternal HbA lc levels ≥6 % were associated with some apparent excess of neonatal complications, again falling short of statistical significance. In conclusions, glycemic control in born GDM and DM is likely to be important in minimizing risk of neonatal complications, since occurrence rates were similarly high in GDM and DM.

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We report clinical statistics on new outpatients in our department in 1999. The total number of new outpatients was 729, 529 males and 200 females. The male to female ratio was 2.65 : 1.62% of outpatients were referred to us by other sources.
Disease diagnosed included 96 malignant tumors, consisting of prostate cancer in 38, renal cell carcinoma in 18, bladder tumors in 17 and testicular tumors in 10. Benign prostatic hypertrophy, in 205 patients, accounted for the majority of benign tumors. Other major disease categories were urinary tract stones patients in 59, dialysis in patients 51, and cystitis in 46 patients. Compared with other hospitals, the percentage of patients with malignant tumors, infertility, dialysis were higher at our hospital than at others. The percentage of phimosis, injury, and sexually transmitted disease was low.

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To clarify the effects of municipal health education and consultation, and the cause of such effects, we distributed a questionnaire targeting public health nurses in 3, 255 municipalities nationwide. Valid responses were received from 2, 884 municipalities, excluding special wards, cities under government ordinance, and core cities. Health education and consultation was evaluated as effective in “progress in the health of citizens” and as being “improved in medical examination”, but evaluated as not so useful in “decreasing incidence rate and prevalence rate” and in “reducing medical costs”. Problems to be overcome in health education and consultation, include “difficulty in judging effect”, “failure of intended targets to show up”, “difficulty in specialist job retention”, and “lack of appropriate skills”. The development and study of evaluation methods and cooperation with other organizations, retention of personnel with appropriate skills, securing targets, and improvement understanding by citizens, personal with are thus important in practicing effective health education and consultation.

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Radiofrequency ablation (RFA) has recently begun being used against liver cancer. Subjects were 5 patients with hepatocellular carcinoma (HCC), 1 with cholangiocellular carcinoma, and 3 with metastatic liver cancer, 1 of whom was treated intraoperatively with RFA and 8 of whom were treated percutaneously. The patient with HCC was additionally treated by intraoperative RFA after percutaneous RFA. RFA was effective in 7 of 9 (77.8%) but not in 2 as determined by computed tomography and serum tumor markers. Post-RFA complication included slight side effects in liver function and 1 patient (11.1%) who had prolonged fever, local pain and right pleural effusion. One of the 7 treated effectively (14.3%) showed Post-REA recurrence. RFA is thus effective in feating liver cancer locally.

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A 70-year-old man who had undergone bilateral STA-MCA bypass was hospitalized with unstable angina pectoris. Coronary angiography revealed triple vessel disease with left main trunk lesion. Selective cerebral angiography showed occlusion of the right common carotid artery, left internal carotid artery, and left vertebral artery. The left external carotid artery was 90% stenotic at its origin. Conventional combination of on-pump CABG and carotid endarterectomy was a high-risk procedure for this patient, so we conducted carotid artery stenting against left external carotid stenosis under local anesthesia 10 days before CABG. Off-pump CABG was done using a LITA graft to the LAD and SVG to the RCA branch. Postoperative coronary angiography confirmed good graft patency. The patient had a stable, uncomplicated postoperative course. Off-pump CABG following carotid artery stenting was less invasive than the conventional procedure and very beneficial to a patient with high-risk cerebral artery disease.

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Anti glomerular basement membrane (GBM) nephritis is reported to have a poor prognosis even with intensive immunosuppressive drug therapy. We present two cases of anti-GBM nephritis, exhibiting progressive renal failure without pulmonary lesions and increased serum anti-GBM antibody. Histological examination of renal samples in both cases indicated severe cellular or fibrocellular crescentic glomerulonephritis with a linear deposition of IgG along glomerular capillary walls. Both patients were diagnosed with anti-GBM nephritis. Therapy with steroid pulse treatment, immunosuppressive agents, or plasma exchange was adopted after diagnosis. Both patients suffered unfavorable outcomes, however indicating that renal damage at therapy may be crucial to prognosis.

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Ovarian hyperstimulation syndrome (OHSS) is almost cases an iatrogenic complication. Severe OHSS is characterised by ovarian enlargement, ascites, electrolyte imbalance, hypovolemia, and hemoconcentration. The pathophysiologic factors of this syndrome are not well known.
It has been observed that paracentesis is efficacious, provided that care is taken to reinfuse protein lost in the peritoneal exudate. For this reason, in two patients with severe OHSS, we used a dialytic technique of reinfusing concentrated ascitic fluid. Here, we report two cases of severe OHSS following IVF with massive ascites in which we reinfused concentrated ascites by ultrafiltration.
Through sonography-guided paracentesis, the ascitic fluid was concentrated by ultrafiltration and reinfused. The concentrated fluid was returned to the peripheral vein. In these patients, a progressive increase of diuresis was evident during treatment and subjective improvement was almost immediate. After treatment, hematologic and biochemical parameters had returned to normal limits. In treating severe OHSS, we have used the technique of reinfusing of concentrated ascitic fluid to avoid protein depletion induced by paracentesis. We were able to successfully restore to normal the hematological and biochemical imbalance with one treatment. Treatment of OHSS with this ultrafiltration and reinfusion method may help to resolve serious cases of OHSS and to treat severe OHSS.

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Extracorporeal shock wave lithotripsy (ESWL) is one of the treatments for sialolithiasis without surgical excision. ESWL applies for a patient who is in primary condition of sialolith internal submandibular gland. As the device of ESWL, there are EDAP LT-01 and EDAP LT-02. LT-01 is a former device and LT-02 is a improved device. These device like LT-01 and LT-02 make ESWL treatment more effective, especially, a improved device LT-02. LT-02 has been already used in urology, but there are not many reported about using LT-02 in silolithiasis case. However, LT-02 gives the operation promptly, makes the angle of focusing exactly, and shows a precise of echo imaging. All the reasons have proven that LT-02 has better effectual device on the lithotripsy than LT-01 in the field of urology.
This report is our experiment about ESWL for sialolith internal submandibular gland using LT-02. We experience with a client who is 26 year-old female. She complains of the pain for swelling in the left side of digastric triangle. She has the treatment of ESWL and is recovered from her chief complain. As a result of our experiment, we think that ESWL using LT-02 has more effectual device for the treatment of sialolith internal submandibular gland than a former device LT-01.

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