Juntendo Medical Journal
Online ISSN : 2188-2134
Print ISSN : 0022-6769
ISSN-L : 0022-6769
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Volume 38, Issue 4
Displaying 1-14 of 14 articles from this issue
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Contents
  • Analysis of dissecting aneurysms of the aorta
    HITOSHI TOMIHARA
    1993 Volume 38 Issue 4 Pages 522-532
    Published: 1993
    Released on J-STAGE: November 21, 2014
    DOIhttps://doi.org/10.14789/pjmj.38.522
    JOURNAL FREE ACCESS
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    We have examined the 75 bedside and clinical cases of the dissecting aneurysms treated by the intensive drug therapy at Izu-Nagaoka Juntendo Hospital. Age distribution has shown clinically twin peaks of the middle-aged and the old-aged. High blood pressure (hypertension) was detected in 55 cases (73% of all), and we encount ered in 13 cases (17%) movements such as wriggling of the body as causal factors of the disease, which seemed to be an important clue to our clinical diagnosis. Mortality rates corresponding to elapse of time were 25% in 48 hours after the attack, 36% in 14 days. and 49% in the final. The outcome as a whole was relatively favorable, but the mortality rate at an early stage was high. Cardiac tamponade was the largest cause of death (19 cases or 51% of all), and arrhythmia was seen to appear at a high rate of 77% during cardiac tamponade. Hematoma was detected in the atrioventricular junctional area and its neighboring areas, and this seemed to have caused arrhythmia. We have classified the cases into three categories according to the degrees of visual extension of hematoma, and examined the interrelation between those categories and various types of hematoma. However, there was no specific cause-and-effect to be found. In conclusion, it would be more reasonable to regard this type of arrhythmia as a consequence appearing immediately after the cardiac tamponade, rather than as a forerunning sign of aneurysmic rupture in the aortic area.
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  • Differential diagnosis of uterine myoma and adenomyosis using conventional ultrasound and transvaginal color doppler technique
    CHIZUKO KAWAMATA, MASAHIRO MACHIDA, MAMIKO NAKAJO, HISAYA TAKEUCHI, MI ...
    1993 Volume 38 Issue 4 Pages 533-540
    Published: 1993
    Released on J-STAGE: November 21, 2014
    DOIhttps://doi.org/10.14789/pjmj.38.533
    JOURNAL FREE ACCESS
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    Even with present day advances in ultrasono-tomography, differential diagnosis of uterine adenomyosis is difficult. We conducted this study to improve the results of differential diagnosis. During the 2 year period since 1987, in regard to a total of 116 cases including 81 cases of uterine myoma and 35 cases of uterine adenomyosis whose uterus was extirpated and underwent a definite histopathological diagnosis, we retrospectively studied the diagnostic accuracy rate of preoperative ultrasound diagnosis. Although the diagnostic sensitivity was favorable for uterine myoma, it was low for uterine adenomyosis, showing a sensitivity of 34.1%, specificity of 98.8%, and accuracy of 78.4%, so that the difficulty of correctly diagnosing uterine adenomyosis became increasingly evident. Looking at the images of these same cases stored on optical disks, we studied in detail the readings of the nodular images important in differential diagnosis, and found that we were able to pick up these characteristic findings, but the establishment of differential diagnostic criteria was difficult. Therefore, from September through December, 1990 in cases whose histopathological diagnosis was confirmed following extirpation of the uterus we used an extremely new ultrasound diagnostic technique, namely, the transvaginal color doppler method. We detected the blood flow rate wave form of the radial arteries as the afferent blood vessels of the nodules, and calculated their resistence index (RI). The RI of 28 uterine myoma cases averaged 0.54±0.11 and it averaged 0.78±0.07 for 8 cases of uterine adenomyosis, so that at a risk rate of 0.1 % a significant difference was observed, thus suggesting that this index will be of assistance in the differential diagnosis.
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  • Rorschach test study on atypical psychosis
    -Its subcategorization-
    HIROSHI KAKUTOU
    1993 Volume 38 Issue 4 Pages 541-551
    Published: 1993
    Released on J-STAGE: November 21, 2014
    DOIhttps://doi.org/10.14789/pjmj.38.541
    JOURNAL FREE ACCESS
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    To improve our understanding of atypical psychotics, their Rorschach test. results were analyzed. Twenty-one patients diagnosed with atypical psychosis (5 men and 16 women) were given the Rorschach test. Then, they were classified into four subgroups on two criteria of thinking disturbance and affective disturbance. In the Rorschach, the deviant verbalizations and minus form level represent the former disturbance, and the chromatic and achromatic color responses signify the latter disturbance. Group I (n 10) was characterized by the presence of deviant verbalizations in the Rorschach results. Group II (n 4) did not include any deviant verbalizations and gave many human movements, chromatic and achromatic color responses. Group III (n 3) showed no deviant verbalizations or achromatic color responses, but they gave many human movements and chromatic responses. Group IV (n 4) had no deviant verbalizations, and there was at most one human movement response. Group I includes more schizophrenic components, though Group II shows more manic and depressive potentials. Both Group III and IV appear to be more neurotic. There are few signs of good prognosis in Group I and II, whereas Group III and IV are supposed to show better prognosis. These four groups keep adequate intellectual productivity and good interpersonal relations.
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  • Chemotherapy for the management of nocardiosis
    -Susceptibility of Nocardia species isolated from the 6 clinical cases of nocardiosis-
    HIROSHI ISONUMA
    1993 Volume 38 Issue 4 Pages 552-556
    Published: 1993
    Released on J-STAGE: November 21, 2014
    DOIhttps://doi.org/10.14789/pjmj.38.552
    JOURNAL FREE ACCESS
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    Seven Nocardia isolates from six patients were tested for in vitro susceptibility to sulfonamides, trimethoprim (TMP) and minocycline (MINO). Minimal inhibitory concentration (MIC) values against Nocardia species were in the range between 1.56-12.5μg of sulfonamides/ml, 6.25-25μg of TMP/ml, 0.20-3.13μg of MINO/ml, Sulfamethoxazole (SMX) showed lowest MIC values among the five sulfonamides, and synergistic activities between TMP and sulfonamides were observed. A clinical study of these six patients revealed three patients with pulmonary infection, two with skin infection and one with both. Six patients were treated with TMP-SMX, MONO or MINO plus SMX, and all showed improvement. As we have effective drugs against nocardiosis, early diagnosis and early treatment, are essential.
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  • Clinical study on anti-tumor activity of regional lymph-node of the stomach in patients with gastric cancer by analysis of lymphocyte subsets
    KAZUHIKO YASUDA
    1993 Volume 38 Issue 4 Pages 557-566
    Published: 1993
    Released on J-STAGE: November 21, 2014
    DOIhttps://doi.org/10.14789/pjmj.38.557
    JOURNAL FREE ACCESS
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    The population of lymphocyte subsets in 51 regional non-metastatic lymph-node lymphocytes from 31 gastric cancer patients was analyzed using the two-color flow cytometry technique under practical grouping of the regional lymph-nodes. In cases of gastric cancer without lymph-node metastasis, the population of helper T-cells and activated T-cells in the proximal lymph-nodes was increased, but not in the distal lymph-nodes. The same population was also increased in the non-metastatic distal lymph-nodes from the cases with proximal lymph-nodes metastasis. By contrast, the population of helper T-cells, but not activated T-cells was increased in the non-metastatic right cardial lymph-nodes from the cases with cancer lesion at the lower third of the stomach, and in the non-metastatic suprapyloric or infrapyloric lymph-nodes from the cases with cancer lesion at the upper third of the stomach. These findings suggest that antitumor activity may increase in proximal lymph-nodes in patients without cancer metastasis and in non-metastatic distal lymph-nodes in patients with proximal lymph-node metastasis.
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