Questionnaire results completed by Kansai University attending physicians of the first department of internal medicine regarding subsequent confirmation of hematologic malignancies and lung cancer diagnosis with thier inpatients indicated such discussions were conducted with 59% of those with hematologic malignancies, whereas only 10% of those with lung cancer were informed of their aliments seriousness. The main reason for the disparty between the two categories was that the prognosis for lung cancer patients was much worse than the hematologic malignancies patients.

View full abstract

This investigation is done, with a questionnaire in twenty five doctors of the department of OB-GY, Kansai Medical University. The range of the age of the doctors is 30-40years old, and eighteen docters (72%) have their careers of more than 5 years. The Tumors which ten doctors treat about 10patients in a year (40%), are mainely diagnosed of ovarinan cancer (49%). Most of the doctors (80%) notified the patients (48%)and their family (16%). The clinical stage of the patient an the time of the notification which is andicated case by case (56%), are early (34%) and advansed (29%) and both (11%). A almost all doctors gone, it is much the time when the patient took CR from the therapy. However many patients (76%) have known the malignancy of their disease befor the doctor's notification.
In conclusion, many doctors have not grieved for the notifications, but think it is suited at the case may be.
The results of this invastigation is almost the same as that in others in Japan.

View full abstract

The phrase of“informed consent”is common and many people have much information about cancer now. And in Japan, informing patients the true they have concer is one of the most important problems during the therapeutic course of cancer patients. We surveyed the doctors in our department on how to get the informed consent from the patients with cancer and discussed what is the best way for the patients to understand their disease enough.

View full abstract

In contrast to organs in other site of the body, brain has special functional structures. Damages to these sructures cause neurological and neuropsychological deficits. Therefore, there are many regulations in the surgical treatment of brain tumors which affect surrounding brain. Surgeons must consider the extent of resection in benign tumors as well as in malignant tumors to avoid worsening neurological status. In terms of patients, they frequently are deteriorated mentally and unable to discuss due to brain tumors affecting the brain. Accordingly, informed consent is made between surgeons and patients's family in many occasions. Fortunately, we think, Japanese neurosurgeons have a less chance to tell the patients directly about poor prognosis. However, we must be in mind to avoid hurting patients's heart with careless words.

View full abstract

Informing a patient of his or her condition on getting a cancer is not widely practiced in japan while the patient's famyly is almost always informed, although this situation seems to be changing rapidly.
To learn the present status a questionnaire was sent to practicing doctors from The Medical Association of Kadoma-city (MAK) asking if they inform their patient when cancer are found. MAK is an association of practicing docters in Kadoma city, a suburban city of Osaka, Japan, where the mean and mode of the members'age groups are both in 60s. MAK has 95 members specializing in internalmedicine (59), surgery (23), ophthalmology and otorhinolaryngology (13), of which 36 members answered the questionnaire. The questionnaire also asked if the doctors wish to be informed when thmselves get cancers.
(1)44% of the doctos inform their patients when the patients get early cancers.
(2)3% inform the patients of progressive cancers.
(3)97% of the doctors wish to be informed when they get early cancers.
(4)89% wish to be informed of progressive cancers.
In both early and progressive cases, the rates of the doctors wishing to be informed are far higher than the rates they inform the patients. Considering that the patient's familiies are informed, this may suggest that the docors regard the patients not so much as individuals with their own and right, but as mere part of the families they belong. The doctors, however, appear to consider themselves as being such individuals.

View full abstract

For relief of the cancer pain we usually use not only oral or parenteral analgesics, but regional nerve blocks including epidural, intrathecal phenol, permanent celiac plexus block. To evaluate these analgesic effectiveness we reviewed cancer pain treatments of 57 patients in our pain clinic.
Almost of the patients complained severe pain at the low back hip, lower extrimities, chest and abdomen. One of the main causes of the pain was bone metastasis. Various nerve blocks were performed to all the patients except for 8 patients who were not treated with any nerve block therapies. Incases of vertebral column metastasis, potent nerve blocks could not be used because of occurence of severe complications.
Satisfactory pain reduction was obtained in 51% of the patients. For the patients with poor effects, more sufficient oral or parenteral analgesics was needed to decrease the total amount of pain.
We conclude the nerve block therapies were the useful method for relief of the cancer pain, in conbination with suitable application of opioids.

View full abstract

Use of postoperative epidural narcotic for pain relief is widespread. We examined the effectiveness and incidence of side effects of an epidural fentanyl-bupivacaine combination for postoperative analgesia.

View full abstract

The woman who underwent radical mastectomy due to breast cancer, is psycho-socially handicapped. In order to re-obtain good QOL, we preferably use V-RAM flap for the breast reconstruction primarilly and secondally. Nipple-areolar complex is reconstructed in following 3 to 6 months. Most of the patients, we carried out the surgery, have expressed satisfactory.

View full abstract

The goal of the reconstruction for enuclated orbits is for the patient to lead good psycho-social lift without wearing eye patch. By means of out post operative evaluations for 6 representative cases who underwent the total eye socket and lids reconstruction, we discussed our philosophy for good QOL by the eye lid and orbital reconstruction due to malingnancy.

View full abstract

Authers investigated the chromosomal aberrations of sixteen astrocytomas in fresh specimens and paraffin blocks by fluorescent in situ hybridization (FISH) and tried to use FISH to investigate paraffin blocks for retrospective study in astrocytomas. Each fresh speciman was divided into two parts. The part of tissue was made in single cell suspension and hybridized with biotined centromeric DNA probes D7Z1, D9Z1, D10Z1 and D17Z1. The other one was embedded with paraffin routinely and made in single cell suspesion. Before hybridization, pretreatment of cells with proteinase K was carried out. Hybridization spots were counted under fluorescence microscope. The results showed that the number of hybridization spots of fresh specimen and paraffin block in a sample was almost same for all the probes. There were eleven cases with trisomy 7, eight cases with monosomy 10, three cases with tetrasomy 17 and two cases with monosomy 9 in this group. Our result suggests: (1)FISH is advantage and simple to analyze chromosome aberration in human astrocytomas. (2)The aberrations of chromosome 7,9,10 and 17 are common in human astrocytomas, including trisomy 7 monsomy 10, tetrasomy 17. (3)The combination of trisomy 7 and monsomy 10 is probly involved with progression of glioblastoma. (4)FISH method can be applied to observe chromosomal numeric changes in paraffin block for retrospbctive studies.

View full abstract

In this study, we investigated the effectiveness of intraluminal thermoradiation therapy for local advanced esophageal cancer. Intraluminal thermoradiotherapy was performed to 10 patients with local advanced esophageal cancer ( 6 T3 and 4 T4). Of three patients, sequential thermoradiotherapy was performed (Goup A). Of seven patients, concurrent thermoradiotherapy was performed (Group B)achieved good response, but complete responese (CR) was obtained in three patients. CR rates in group A and group B were 33.3% and 28.6%, respectively. In group B, all CR cases were administered 60 Gy/6 weeks of external radiotherapy and 8 Gy/2 weeks of intraluminal brachytherapy. Of 10 patients, four had curative resection, three had microscopic carcinoma in the specimen. Pain and vomitig during the thermoradiotherapy were observed in four patients and one patient, respectively. Intraluminal thermoradiotherapy for esophageal cancer is effective treatment. However, in patients who have been treated with intracavitary brachytherapy during heat treatment, this combination was not been determined, the reasonable radiation dose, when is treated with intraluminal brachytherapy during hyperthermia, has to determine.

View full abstract

To evaluate the effect of host, tumor and treatment-related variables on local control and survival in patients

View full abstract

To improve the quality of life (QOL) of patients requiring urinary diversion, various surgical new techniques, such as Kock pouch or Indiana pouch, have been advocated instead of conventional techniques such as ileal conduit or cutaneous ureterostomy. Augmented valved rectum is one of the Kock's new technique of urinary diversion and has unique feature of“stomaless”. In this study we evaluated the post operative QOL of four patients who received angmented valved rectum during the disease-free period. The patients were asked 61 questions regarding physical and mental conditions and their social life using the questionnaire developed by our study group.
All patients were able to take a bath as pre-operative manner and at the point the operation was superior to other continent urinary reservoir, such as Kock pouch and Indiana pouch. But one patient has been suffering from the urinary incontinence at night. And some patients have a tendency of urinary frequency after the operation. There were no significant changes between the patients and the Kock, Indiana pouch patients group with respect to physical and mental conditions after the operation.
Overall, the augmented valved rectum is believed to be one of a few good choices after cysto-urethrectomy because of better QOL after operations.

View full abstract