Juntendo Medical Journal
Online ISSN : 2188-2134
Print ISSN : 0022-6769
ISSN-L : 0022-6769
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Volume 41, Issue 4
Displaying 1-18 of 18 articles from this issue
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Contents
  • Analysis of prognostic factors of patient with non-small cell lung cancer
    KOHEI MIKAMI
    1996 Volume 41 Issue 4 Pages 444-454
    Published: February 20, 1996
    Released on J-STAGE: November 18, 2014
    DOIhttps://doi.org/10.14789/pjmj.41.444
    JOURNAL FREE ACCESS
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    We analyzed the background factors affecting the prognosis of resected primary lung cancer. A total of 156 cases of non-small cell lung cancer were surgically treated between 1984 and 1994 at Juntendo University Hospital. The histological types were as follows : adenocarcinoma 97 (62.2%), squamous cell carcinoma 50 (22.1%), adenosquamous carcinoma 5 (3.2%) and large cell carcinoma 4 (2.6%). The cumulative survival rate after operation was 79.9% in 1 year, 57.4% in 3 years and 50.0% in 5 years. The factors included in the present analysis were age, sex, performance status (PS), smoking history, history of double cancer, hemoglobin level, CEA level, histological type, T category, N category, M category, operative curability, type of resection, perioperative homologous blood transfusion and adjuvant chemotherapy using CDDP or CBDCA. Univariate analysis showed significant differences in survival in relation to PS, T category, N category, operative curability and type of resection. Multivariate analysis using Cox's proportional hazards model indicated that strong prognostic factors were N category, PS, histological type, age, T category and sex. These 6 features had a p-values less than 0.05. The type of resection and perioperative transfusion were marginally significant (0.05<p<0.1). The relationship between N 2 disease and prognosis was also discussed. Of the 38 patients showed evidence of mediastinal lymph node involvement (N2 disease), 25 patients were dead and the median survival time was 17.5 months. The couse of death was recurrent lung cancer in 22 patients. The c-N staging had an influence on prognosis. Extensive and complete mediastinal lymph node dissection should be performed. It is concluded that it is important to predict the high-risk group using prognostic factors. Postsurgical adjuvant therapy and careful follow-up is recommended to improve the survival rate especially in advanced cases.
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  • Reproducibility of signal-averaged electrocardiography
    YASUHIKO OHNO
    1996 Volume 41 Issue 4 Pages 455-465
    Published: February 20, 1996
    Released on J-STAGE: November 18, 2014
    DOIhttps://doi.org/10.14789/pjmj.41.455
    JOURNAL FREE ACCESS
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    To evaluate the reproducibility of results with signal-averaged ECG (SAECG), three recordings (initial, 10 minutes later and 1 week later) were compared in 20 healthy male subjects. Subsequently, two recordings (initial and 10 minutes later) in 50 healthy male subjects (Group N) and 42 patients with myocardial infarction (Group M 1) were also compared. All healthy male subjects showed normal ECG. In Group M 1 which consisted of 37 males and 5 females, SAECG was recorded at least 4 weeks after the first attack. The recording system was ART1200EPX (Arrhythmia Research Technology : USA) which showed superior reproducibility to VCM-3000 (Fukuda Denshi : Tokyo) on preliminary studies. SAECG was obtained from orthogonal XYZ leads and analyzed by the time domain method (TDM) and frequency domain with fast Fourier transformation (FFT) technique. In TDM, diagnostic criteria were f QRS > 114msec, LAS > 38msec and RMS40 < 20μV, and the definition of late potential (LP) was the presence of more than 2 abnormal indices. In FFT, when the area ratio (AR : 20-50Hz/ 10-50Hz) was greater than 107, LP was considered positive. In 20 healthy male subjects, the diagnostic concordance ratio (positive and positive, or negative and negative) was 90% between the two initial and the second recording or the initial and third recording by TDM. It was 100% between the two initial and the second recording or the initial and third recording by FFT. In Group N, the concordance ratio was 92% by TDM and 100% by FFT. In Group M 1, the concordance ratio was 93% by TDM and 90% by FFT. In conclusion, the reproducibility of the diagnostic results on SAECG by TDM and FFT were excellent despite variation in individual measurements in both healthy subjects and patients with myocardial infarction.
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  • Radiation therapy for lung cancer
    YUTAKA NAOI, TERUYUKI MIYAUTI, OKITO MINOWA, YUJI YAMASHITA, HIDEKI TO ...
    1996 Volume 41 Issue 4 Pages 466-473
    Published: February 20, 1996
    Released on J-STAGE: November 18, 2014
    DOIhttps://doi.org/10.14789/pjmj.41.466
    JOURNAL FREE ACCESS
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    In this study, we examined the effect of radiotherapy on survival rates in lung cancer patients who has been treated in this hospital between February 1989 and April 1994. The data obtained were analyzed for the presence or absence of chemotherapy, radiation dose, area, patients age and lesion site. Life span was significantly prolonged in patients who had undergone chemotherapy after radiation, and patients who had been in radiated at a total dose of 60Gy or more. A comparison of patients aged 65-plus with younger patients showed that the former tolerated and required full doses of radiation at 60Gy. There were no significant differences in radiation area or site between the two age groups. In recent years, there has been a preferance for reducing the length and hazards of therapy, and giving greater consideration to improving the patient's quality of life, rather than striving almost exclusively to prolong the patient's life at any cost. From this perspective, optimal combination of chemotherapy with radiation and shortning treatment time are major issues for future consideration.
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  • Postgastrectomy symptoms and early dumping syndrome after pyloruspreserving gastrectomy or Billroth- I gastrectomy.
    YOZO WATANABE, HIDENORI TSUMURA, FUMIO MATSUMOTO, SHUICHI SAKAMOTO, TA ...
    1996 Volume 41 Issue 4 Pages 474-480
    Published: February 20, 1996
    Released on J-STAGE: November 18, 2014
    DOIhttps://doi.org/10.14789/pjmj.41.474
    JOURNAL FREE ACCESS
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    We usually treat early gastric carcinoma locatted in the M or MA region of the stomach by pylorus-preserving gastrectomy (PPG) to prevent postoperative disturbances (e.g., dumping syndrome, malnutrition). In this study, we compared PPG with Billroth-I gastrectomy (B-IG) with regard to postoperative complaints and early dumping syndrome. Twenty-one PPG patients and 24 B-I G who under went Surgery 1.5 or more years earlier were studied. A standardized questionnaire form containing items related to life activities, food ingestion, body weight, subjective symptoms, early dumping syndrome, and satisfaction with the surgery. Although there was no significant difference between the two surgical techniques with respect to the resumption of life activities or amount eaten, PPG patients generally gave more favorable responses. We found a significant difference in the ratio of the preoperative and standard weight to the current weight. The frequency of a heavy feeling in the stomach was significantly higher for PPG patients (p<0.05), and the frequency of reflux of a bitter fluid tended to be higher for B-I G patients. The frequency of early dumping syndrome was significantly higher for B-I G patients (p<0.05). There was no significant difference in satisfaction with the surgery between the two surgical techniques. These results indicate that despite the disadvantage of postoperative stagnation of gastric contents PPG compares favorably with B-I G from the perspective of preventing reflux esophagitis and early dumping syndtome.
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  • Clinical study of psychiatric symptoms in gynecological patientsin in the climacteric state
    YOSUKE ICHIMIYA, TOSHIAKI MASUMURA, KAZUTAKA FUKAMAUCHI, YOSHINORI KUW ...
    1996 Volume 41 Issue 4 Pages 481-486
    Published: February 20, 1996
    Released on J-STAGE: November 18, 2014
    DOIhttps://doi.org/10.14789/pjmj.41.481
    JOURNAL FREE ACCESS
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    Three hundred twelve patients in the climacteric state, consulted the Division of Gynecology at our hospital for hormone replacement therapy, and were screened by Self-Rating-Questionnare for Depression (SRQ-D). Sixteen patients were referred to our psychiatric out-patient unit because they scored over 10 points on SRQ-D which suggested the presence of depression. Twelve patients actually underwent psychiatric examination. Eight patients were diagnosed with depression and 4 patients were diagnosed with neurosis. The mean value of SRQ-D points in the 12 patients was 19.6±6.2. Neurosis could not be distinguished from depression by SRQ-D. Eight of 312 patients had histories of previous psychiatric illness, 7 patients had depression and one psychogenic reaction. The mean value of SRQ-D points in the 7 patients was 10.9±7.7. These results suggest that consultation liaison service, particularly cooperative treatment by gynecologists and psychiatrists is useful for climacteric patients.
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