1.Review of Spontaneous Pneumothorax Cases in Eastern Hokkaido.
Takashi YOSHIKAWA ; Shuichi INABA ; Shirou MAKIMURA ; Tsugio TERAI
Journal of the Japanese Association of Rural Medicine 1993;42(4):956-961
Fifty cases of spontaneous pneumothorax treated in our hospital between 1988 and 1993 were reviewed. Forty-three cases were males and 7 cases were females. Treatments were broken down into rest cure for 11 cases and chest tube drainage for 39 cases. Of the chest tube drainage therapy cases, 30 could attained complete remission, but the remaining 9 cases required thoracotomy. In either case, the recurrence rates after the first pneumothorax and second attacks were 39% and 36%, respectively.
Stature and roentgenologically determined lung sizes were also examined in 34 male patients with spontaneous pneumothorax in comparison with those of 30 healthy men, who were age-matched control subjects. Among the significant findings was that the patients were much taller than the controls. The lungs were also significantly elevated in the patients compared with those of the controls. These results indicate that the patients liable to spontaneous pneumothorax are tall with their lungs housed high in the thorax compared to the ordinary people.
2.Review of Home Oxygen Therapy Provided by Our Hospital.
Takashi YOSHIKAWA ; Makoto YAMAMOTO ; Shuichi INABA ; Shirou MAKIMURA ; Tsugio TERAI
Journal of the Japanese Association of Rural Medicine 1995;43(6):1241-1246
Prognostic facfors were examined in 71 patients receiving home oxygen therapy under the direction of our hospital between 1984 and 1994. In 25 patients who had undergone right catheterization, relationships between pulmonary hemodynamics and prognosis were also discussed. Mean pulmonary arterial pressure (PPA) were correlated negatively with PaO2. This indicated that hypoxic pulmonary vasoconstriction was the major cause of pulmonary hypertention in these patients. Pulmonary hypertention was revealed in 80% of the patients with PPA ≥20 Torr and in 52% of the patients with PPA ≥25 Torr. Acute hemodynamic effects of low-flow oxygen administration were investigated in 17 patients. PPA decreased significantly from 25.5 Torr to 23.5 Torr after oxygen administration and pulmonary arteriolar resistance (PAR) decreased from 243 dynes ·ses ·cm-5 to 225 dynes·sec·cm-5, but this change was not significant.
In patients with pulmonary fibrosis and sequelae of tuberculosis, the survival rates were lower than that of the patients with pulmonary emphysema. The median survival time (MST) for patients with cor pulmonale was significantly lower than that for those without cor pulmonale. When background factors were compared between the group with % home stay≥90% and % home stay<90%, there were no significant differences in observation periods, arterial blood gases and spirometry. The factors influencing % home stay were considered to be an important subject in addition to improving the survival rate.
3.Review of Early Lung Cancer Cases Treated by Our Hospital in Eastern Hokkaido.
Takashi YOSHIKAWA ; Kenji AKIE ; Jinichi HIROKAWA ; Makoto YAMAMOTO ; Shirou MAKIMURA ; Tsugio TERAI
Journal of the Japanese Association of Rural Medicine 1998;47(4):596-601
We treated 472 patients with lung cancer from 1983 though 1993. Of the total number of the cases, early lung cancer accounted for 31 caces (6.6%), 6 of the hilar and 25 of the peripheral type. Of the 6 hilar type early lung cancer cases, 3 cases were detected by mass screening (2 cases were detected by sputum cytology). On the other hand, of the 25 cases of the peripheral type early lung cancer, 10 cases were detected by mass screening. All the 10 peripheral type early lung cancer cases detected by mass screening were detected by chest roentogenography. The 5-year survival rates for the hilar and peripheral type early lung cancer were 100% and 94.4%, respectively. For the improvement of prognosis of lung cancer, every effort should be made to detect lung cancer at an early stage. Careful lung cancer screening such as sputum cytology and bronchoscopy in a highrisk group and modern techniques such as helical X-ray CT are recommended for the increase in the detection of early lung cancer.
4.High Density Barium Dosage and its Effect on Excretion. A Survey.
Koichi YOSHIZAKI ; Hiroyuki NOSE ; Yuji SUZUKI ; Norio KONDO ; Junichi MAEDA ; Osamu HORII ; Satoko III ; Shirou MAKIMURA ; Tsuguo TERAI ; Hiroshi AZUMA
Journal of the Japanese Association of Rural Medicine 1999;48(4):630-637
Before the introduction of high density barium for contrast studies of the upper gastrointestinal tract, we conducted a survey concerning the adverse reactions to a swallow of barium and barium concentration.
The incidence of side effects rose as the density of barium increased but the effects were transient. There were no cases requiring medical treatment.
Furthermore, the constipation group and the normal group were examined separately.
The ratio of adverse reactions was high in the constipation group even when the barium density was low. In this group stool hardening and delayed excertion were also noticed.
The constancy of barium stool excretion was basically normal, and the barium density had little effect.
The effects of a laxative on the excretion consistency were investigated. The administration of a laxative did not always have a positive affect on excretion. The timing of the administration of the laxative and the amount of water intake should be examined in the future.
We also investigated how the patients feel when they are swallowing barium. We found that whether feel uncomfortable or not depended on the properties of barium rather than its density.
From these results it appears that appropriate guidance is necessary about the use of high density barium, in order to supress the occurrence of side effects, especially in the constipation group.