1.Results of Lung Cancer Screening with a Spiral Computed Tomography Van - A Study of Findings
Journal of the Japanese Association of Rural Medicine 2004;53(1):46-52
In recent years, spiral computed tomography has played an increasingly significant role in mass health screenings for lung cancer. Given this development, the Specialists’Committee for Lung Cancer Mass Screening in Nagano-Ken Koseiren (Nagano Prefectural Federation of Agricultural Cooperatives for Health and Welfare) came out with a van of its own suitable for mass screening by use of a spiral CT scanner and organized a caravan team of lung cancer screenings in 2001. With the collaboration of 11 general hospitals affiliated with Nagano-Ken Koseiren and its Health Care Center, our program includes films reading, guidance based on findings, workups, treatment and prognostic management. We examined 6,633 people in the first year and another 6,639 in the second year. In the two years, 55 examinees were found to have lung cancer. In the two years, we had 11,140 initial examinees, 54 of whom were found to suffer from lung cancer (detection rate : 0.48%). As many as 1,862 persons participated in the annual lung cancer screening two years running. Of them, one examinee was found to have lung cancer in the second year (detection rate : 0.05%). The sex-specific rate of detection in the initial screening was 0.25% for males and 0.80% for females, suggesting that the ratio for women was overwhelmingly higher. A histological check of 55 cases found to have lung cancer reveals that 51 cases (93%) had adenocarcinoma. After the removal of detected carcinomas, the diameters of tumors were found for 54 cases. Of them, there were 24 cases (44%) with a micro-cancer less than 10 mm in diameter and 43 cases (80%) with small-sized lung cancer less than 20 mm. In terms of stages, therefore, as many as 48 cases (87%) were in the IA stage, suggesting that this lung cancer screening is significantly useful in detecting lung cancer in an early phase.
Malignant neoplasm of lung
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Lung neoplasm screen
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Van
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Spiral Shape
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seconds
2.The Effects of Acupuncture Therapy on Cold Hands and Feet("Hiesho"). The Relationship between Cold Hands and Feet("Hiesho") and Blood Stagnation "Oketsu".
Shunji SAKAGUCHI ; Makiko TANI ; Rie NISHIGUHI ; Takashi HORIKAWA ; Eitaro NOGUCHI ; Masazumi KAWAMOTO ; Osamu FUJIKAWA
Kampo Medicine 1995;45(4):919-925
The relationship between coldness of the hands and feet (“Hiesho”) and Blood Stagnation (“Oketsu”), a disorder description unique to Oriental Medicine, was examined using the Oketsu score of five Hiesho cases based on the Terasawa Oketsu Diagnostic Criteria. The effects of acupuncture treatment were studied by evaluating Oketsu symptoms and accompanying complaints, the Visual Analogue Scale (VAS) and subjective evaluation of coldness of the hands and feet.
The results were as follows:
1) 100% of the five females with Hiesho were also positive for the Oketsu factor.
2) The Oketsu score showed a significant decrease (P<0.05) upon treatment with acupuncture.
3) An improvement in subjective Hiesho symptoms (VAS) was seen in three of the five cases upon acupuncture treatment.
4) It was suggested that the subjective improvement in Hiesho symptoms, i. e., coldness of the hands and feet, was related to the disappearance of the resistance and pain upon pressure in the ileocecal region that is characteristic of Oketsu, and the improvement in menstrual disorders.
3.Successful Veno-Arterial Bypass Support Using Centrifugal Pump with Membranous Artificial Oxygenator in a Case of Cardiogenic Shock Following Coronary Artery Bypass Surgery for Acute Myocardial Infarction.
Tetsuo HADAMA ; Tatsunori KIMURA ; Hidemi TAKASAKI ; Yoshiaki MORI ; Osamu SHIGEMITSU ; Shinji MIYAMOTO ; Hidenori SAKO ; Takayuki NOGUCHI ; Yuzo UCHIDA ; Joji SHIRABE
Japanese Journal of Cardiovascular Surgery 1992;21(3):314-318
A 54-year-old man developed cardiogenic shock after acute myocardial infarction. Urgent coronary angiogram revealed complete occlusion at proximal portion of the right coronary artery and severe stenosis at just proximal site of the left anterior descending branch. Following thrombolytic therapy was not successful and he was sent to the operating room for coronary artery bypass surgery under external cardiac massage after 6hr from the onset. Three aorto-coronary bypasses were made to left anterior descending branch, first diagonal branch and right coronary artery using saphenous vein grafts by aortic cross-clamping of 67min. He fell into severe low cardiac output syndrome and could not be weaned from the cardiopulmonary bypass even by catecholamine infusions and IABP support. Veno-arterial bypass consisted of centrifugal pump and membranous artificial oxygenator was instituted. Venous blood was drained from the right atrium using percutaneous cannula via the right femoral vein and oxygenated blood was returned to the right subclavian artery. Hemodynamics recovered dramatically and after 71hr of this assisted circulation he was weaned from veno-arterial bypass. Activated coagulation time was maintained within 180-200sec. During this period, the centrifugal pump and oxygenator was not necessary to change and no clot was seen in the bypass system. He discharged from our hospital after 2 mo, postoperatively and now he is doing well as NYHA class-II 8 mo. postoperatively.