Pulmonary perfusion SPECT-CT fusion image largely contributes to objective and detailed correlation between lung morphologic and perfusion impairment in various lung diseases. However, traditional perfusion SPECT obtained during rest breathing usually shows a significant mis-registration on fusion image with conventional CT obtained during deep-inspiratory phase. There are also other adverse effects caused by respiratory lung motion such as blurring or smearing of small perfusion defects. To resolve these disadvantages of traditional perfusion SPECT, an innovative method of deep-inspiratory breath-hold (DIBrH) SPECT scan is developed in the Nuclear Medicine Institute of Yamaguchi University Hospital. This review article briefly describes the new findings of pulmonary pathophysiology which has been reveled by detailed lung morphologic-perfusion correlation on automated reliable DIBrH perfusion SPECT-CT fusion image.

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Objectives: This study aimed to estimate the required number of physicians in accordance with a limitation on over-time work in hospitals in Yamaguchi prefecture. Methods: We analyzed data from a survey of physicians employed in hospitals in Yamaguchi prefecture. The required number of physicians was estimated by dividing the total number of hours of over-time work (more than 48 hours per week) by 48 hours and extrapolating the result to the total number of physicians in the Survey of Physicians, Dentists, and Pharmacists. Results: The numbers of responders and additional necessary physicians were 868 and 164, respectively. The total number of additional necessary physicians in all hospitals in Yamaguchi prefecture was estimated to be 350. Specialties with large shortages were cardiovascular surgery, emergency medicine, gastrointestinal medicine, gastrointestinal surgery, urology, obstetrics and gynecology, circulatory medicine, and neurosurgery. Discussion: This study estimated the required number of physicians by specialty in Yamaguchi prefecture based on the limitation imposed on the amount of over-time work allowed. Although the results must be carefully interpreted, with consideration of factors such as methodological limitations and the findings of other studies, the estimated numbers will facilitate further discussion of policies designed to increase and allocate physicians and to reduce excessive physician work burdens.

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We evaluated the usefulness of computed tomography (CT) in diagnosing and management acute appendicitis. We studied 133 patients diagnosed with acute appendicitis confirmed by plain CT between March 2004 and November 2008. Sixty-nine of these patients underwent appendectomy, 64 were treated conservatively. Recurrence of acute appendicitis was recognized in 13 out of 64 patients treated conservatively, and appendectomy was done in 8. On the CT findings of 77 patients who underwent appendectomy, appendicoliths were shown in 50 patients. In 64 patients treated conservatively, 14 patients had images of calcified appendicoliths. Eight out of 14 patients with appendicoliths had small calcifications, which were not obstructive in inner lumen of appendix. Inflammatory signs (increased WBC and CRP, and fever) with positive signs on CT, including calcifications, periappendicular infiltration, free fluid etc. , are useful in confirming the clinical diagnosis and directing treatment (operative versus conservative) of patient.

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