A 53-year-old man underwent aortic and mitral valve replacement, but postoperative cardioangiograms unexpectedly demonstrated aneurysms that had developed right-anteriorly and exactly anteriorly to the ascending aorta. They were initially thought to be pseudoaneurysms formed at the sites of aortotomy for valve replacement and of the aortic hole made by the needle puncture for air-venting. Operative findings, however, strongly suggested that it was a DeBakey type II dissecting aneurysm with two entries at the same sites as described. It was found that almost all distal parts of the aneurysmal cavity, probably a pseudolumen, had been occluded with clots, leaving two round cavities at the entries, which were preoperatively observed as pseudoaneurysms. The entries were successfully closed with approximation of the aortic walls using cardiopulmonary bypass, and the patient survived the operation.

No abstract available.
Early Detection of Cancer* ; Japan*

1）To learn the techniques required immediately after the start of clinical practice, new residents were introduced to the skills laboratory during their orientation period.
2）We attempted to establish the Yanegawara style, which is an overlapping teaching style in which the second–year residents plan the entire training schedule and simultaneously teach the first–year residents while being supported in their teaching by more senior physicians.
3）Training with the new system resulted in greater rapport among all residents as well as a greater feeling of security among first–year residents.

AIMTo investigate possible correlation factors for prostate cancer by a population-based case-control study in China.

METHODSWe carried out a mass screening of prostate cancer in Changchun, China, using a prostate-specific antigen assisted by Japan International Cooperation Agency. From June 1998 to December 2000, 3 940 men over 50 years old were screened. Of these, 29 men were diagnosed with prostate cancer. We selected 28 cases and matched them with controls of low prostate-specific antigen value (< 4.1 ng/mL) by 1:10 according to age and place of employment. A case-control study of diet and prostate cancer was then carried out.

RESULTSAfter adjustment for education, body mass index (BMI), smoking, alcohol consumption, marriage and diet, intake of soybean product was discovered to be inversely related to prostate cancer. Men who consumed soybean product more than twice per week on different days had a multivariate odds ratio (OR) of 0.38 (95% confidence interval [CI], 0.13-1.12). In addition, men who consumed soybean products more than once per day had a multivariate OR of 0.29 (95% CI, 0.11-0.79) compared with men who consumed soybean products less than once per week. The P for trend was 0.02, which showed significant difference. There was no significant difference in P trend for any dairy food. Even when we matched the cases and controls by other criteria, we found that soybean food was the only preventive factor associated with prostate cancer.

CONCLUSIONOur study suggests that consumption of soybeans, one of the most popular foods in Asia, would decrease the risk of prostate cancer.

Aged ; Aged, 80 and over ; Case-Control Studies ; China ; epidemiology ; Diet ; Humans ; Incidence ; Male ; Mass Screening ; methods ; Middle Aged ; Multivariate Analysis ; Prostate-Specific Antigen ; blood ; Prostatic Neoplasms ; diagnosis ; epidemiology ; prevention & control ; Soybeans