Although it is ideal that a hospital has full-time radiologists for image diagnosis, it is quite difficult to retain a full-time radiologist in a small hospital because of a shortage of radiologists. In our hospital, CT films were formerly sent to the hospital that had full-time radiologists by mail and diagnostic information was obtained a few days later. Since May 2003 we have introduced teleradiology using SECOM HOSPI-NET system. We transmit a diagnostic request form and CT images using ISDN line. We receive a diagnostic message on the following day. We are able to gain diagnostic information timely. Therefore, we report the usage, reliability, and user-friendliness of this system in comparison with the mailing system from the aspect of responsiveness, economical efficiency, and operating efficiency.
Hospitals ; NET questionnaire ; System ; Teleradiology ; X-Ray Computed Tomography

A 6-year-old boy was admitted with infective endocarditis and aortic regurgitation. Clinical signs of infection were severe. The leukocyte count was 13, 100/μl and the C-reactive protein (CRP) was elevated to 17.2mg/dl. Blood culture was positive for Staphylococcus aureus. Echocardiography showed a vegetation 3mm in diameter on the aortic valve, and a perforation of the right coronary cusp with moderate aortic regurgitation. With antibiotic therapy, clinical signs and laboratory data of infection improved at an early stage. We decided to operate after his complete recovery from infection. Laboratory data normalized completely in 6 weeks, but echocardiography demonstrated aneurysmal change of the right coronary sinus and severe aortic regurgitation. The Ross operation was performed on the 44th day. At operation, it was noted that the non-coronary cusp was destroyed completely leaving only strings of fibrous tissue. A perforation of 3mm in diameter was also found on the right coronary cusp. There was a mural aneurysm near the right coronary orifice without abscess formation in the surrounding structure. A pulmonary autograft was transplanted to the aortic root after resection of the destroyed aortic cusps, aortic root and the mural aneurysm. The right ventricular outflow tract was reconstructed using an autologous pericardium as a posterior wall and the Monocusp ventricular outflow patch (MVOP) #22 as an anterior transannular patch. The postoperative course was uneventful. Postoperative echocardiography revealed no aortic regurgitation.

Seventy patients with rheumatic valvular disease were evaluated with preoperative CT scanning. The correlation of the obtained CT images to the operative findings were examined. Left atrial thrombi were found in 24 cases at the operation. CT scan had detected thrombi in 19 cases (79.2%) and echocardiography in 15 (62.5%). CT failed to find them in 5 cases in which the left atrial thrombi were less than 3g. Echocardiogram, however, failed to detect thrombi in 9 cases, the largest being 14g. There were 15 cases with left atrial calcification, in which 10 cases had left atrial thrombi. Nine cases out of these 10 cases had rough left atrial surface after thrombectomy. Early postoperative CT of 10 with left atrial calcification showed recurrent left atrial thrombi in 4 (40%) cases. Mitral valve calcification was found in 42 cases during operation. CT scan was able to detect it in 40 (95.2%), while echocardiogram detected in 34 cases (81.0%) (p<0.05). All mitral valves with calcification required replacement. Out of 30 cases with non calcified mitral valves, 9 underwent OMC, and the other 21 underwent mitral valve replacement. Aortic valve calcification was found in 9 out of 11 cases with aortic stenosis. All has been diagnosed by CT scan. In conclusion, 1. In detecting the left atrial thrombi, CT scan was superior to echo-cardiography, and provided useful information for planning the operative procedure including atrial approach and valvular manipulation. 2. CT scan could detect calcification of left atrial wall which had high incidence of thrombus formation and rough left atrial surface. 3. CT scan could detect calcification of both mitral and aortic valve, and showed the severity of valvular structural changes.

Background/Aims: Although certain allergic diseases have been reported to be associated with the prevalence of functional dyspepsia (FD) and irritable bowel syndrome (IBS), it is unclear whether the presence of multiple allergic diseases further increases the prevalence of FD and IBS.The aim of this study is to determine this issue in young people. Methods: A cohort of 8923 Japanese university students was enrolled and diagnoses of FD and IBS were confirmed using Rome III criteria.Allergic disorders diagnosed at medical institutions were obtained by means of a self-administered questionnaire. Results: The prevalence of FD, IBS, and their overlap was found to be 1.9%, 6.5%, and 1.1%, respectively. Pollen allergy was independently positively correlated with FD, IBS, and overlap of FD and IBS. Allergic rhinitis was positively linked to IBS. Drug allergy was positively associated with FD. The presence of multiple allergic diseases was positively correlated with FD and IBS (FD: adjusted OR for 2 allergic diseases: 1.95 [95% CI, 1.24-2.98], P for trend = 0.003; and IBS: adjusted OR for 1 allergic disease: 1.40 [95% CI, 1.15-1.69], 2 allergic diseases 1.47 [95% CI, 1.12-1.91], and 3 or more allergic diseases: 2.22 [95% CI, 1.45-3.28], P for trend = 0.001). Additionally, the concomitant existence of multiple allergic diseases was also demonstrated to have a trend that correlated with the overlap of FD and IBS (P for trend = 0.018). Conclusion Allergic disease multimorbidity is positively correlated with the prevalence of FD and IBS in a young population.