1.Natural Temperature Decrease Extracorporeal Circulation for Cases at High Risk of Brain Damage.
Saihou Hayashi ; Shuji Kohata ; Yasushi Hashimoto
Japanese Journal of Cardiovascular Surgery 2000;29(4):254-259
Clinical cases of normothermic extracorporeal circulation (ECC) are increasing, but the possibility of brain damage is not clear.In emergencies, the brain protective effects of mild (33-34°C) hypothermic therapy have been clearly confirmed. Natural Temperature decrease ECC was conducted in this study, hoping to obtain the advantages of both normothermic ECC and brain protection by mild hypothermia. These were 12 cases at high risk of brain damage (10 cases of brain infarction and 2 cases of severe carotid artery stenosis). In all cases, coronary artery bypass grafting operation with natural temperature decrease ECC was performed. The average laryngeal temperature dropped to 33.0±0.3°C. There was no brain infarction or ICU syndrome. Evaluation of post-operative brain condition by the patients themselves and their families was good. The possibility of natural temperature decrease ECC for high risk cases of brain damage was demonstrated.
2.Surveys to assess the attitudes of medical students about learning
Akira NAKASHIMA ; Akiko OSADA ; Shin ISHIHARA ; Masatsugu OHTSUKI ; Shuji HASHIMOTO ; Yuichiro ONO ; Toshikazu MATSUI
Medical Education 2010;41(6):429-434
In the present study, surveys regarding the philosophy of learning were administered just after the entrance ceremony to all students entering the Fujita Health University School of Medicine in 2005 and then, once more, to the same students during the last term of the fourth year, so that the data could be subsequently analyzed. The 87 fourth-year students who completed the surveys were divided into 3 groups(top, middle, and bottom thirds)on the basis of their examination scores in the previous years.
1) Results of the fourth-year survey suggested that students in the middle or bottom third did not develop a "learning-centered campus lifestyle" during their 4 years of medical studies, although the first-year survey indicated that most students in all 3 thirds had desired such a lifestyle.
2) The image of a physician had changed somewhat for students in middle or bottom third but not for students in the top third.
3) Attendance rates in all years of medical study were lower for students in the bottom third than for students in the middle or top third. Moreover, the motivation to study and attend lectures showed a downward trend over time for students in the bottom third.
3.What factors affect examination results after admission?: Research at the Fujita Health University School of Medicine
Akira NAKASHIMA ; Akiko OSADA ; Shin ISHIHARA ; Masatsugu OHTSUKI ; Shuji HASHIMOTO ; Yuichiro ONO ; Takahide NOMURA ; Toshikazu MATSUI
Medical Education 2008;39(6):397-406
At the Fujita Health University School of Medicine, about 30% of medical students are admitted on the basis of recommendations.To evaluate the performance of these students after admission, a placement test was given to all new students just after the entrance ceremony to examine basic academic abilities.The scores were compared with the number of absences from lectures and with examination results for the first and second years.
1) The 398 students admitted from 2002 through 2005 were classified into three populations: 126 recommended students, 137 students who scored in the top half on the entrance examination, and 135 students who scored in the bottom half.
2) Scores on the placement test were highest for the top-half students, intermediate for the bottom-half students, and lowest for the recommended students.Scores on examinations in the first and second years were highest for the top-half students, intermediate for the recommended students, and lowest for the bottom-half students.
3) The average number of absences from lectures in the first and second years tended to be lower for recommended students than for the top-half or bottom-half students.
4) The examination scores in the second year were correlated with scores in the first year, and the average number of absences in the second year correlated with those in the first year.
5) These results indicate that the motivation of students in each classification to study in the 1st year is, in addition to their basic academic abilities obtained in high school, an important factor affecting their performance in the second year and beyond.
4.An estimation of the number of cancer patients who wanted home death based on the bereaved family survey
Tatsuya Morita ; Mitsunori Miyashita ; Yoko Inoue ; Kazuki Sato ; Ayumi Igarashi ; Miyuki Igarashi ; Takuhiro Yamaguchi ; Shuji Hashimoto
Palliative Care Research 2012;7(2):403-407
The primary aim of this study was to estimate the number of cancer patients who wanted home death based on the bereaved family survey.A postal survey performed on 1,137 bereaved family members in 4 regions to clarify the degree what they believed that the patient actually died where s/he had wanted on the Good Death Inventory, and to explore the preferred place of death. We calculated estimated number of patients who had wanted home death as a total of (1) the actual number of home death × the percentages of the family members who agreed that the patient actually died where s/he had wanted, and × the actual number of hospital death × the percentages of the family members who disagreed that the patient actually died where s/he had wanted and home was the preferred place of death. Estimated number of cancer patients who wanted home death was 32.8%[95%C.I., 31.7, 33.9] in the surveyed regions, and 31.2%[95%C.I., 31.1, 31.4] for national data.
5.Blood pressure, levels of serum lipids, liver enzymes and blood glucose by aldehyde dehydrogenase 2 and drinking habit in Japanese men.
Sayuri NAKAMURA ; Yoshinori ITO ; Koji SUZUKI ; Shuji HASHIMOTO
Environmental Health and Preventive Medicine 2006;11(2):82-88
OBJECTIVESThe association of blood pressure and levels of serum lipids, liver enzymes, blood glucose and aldehyde dehydrogenase 2 (ALDH2) with drinking habit was examined in Japanese men.
METHODSThe subjects were 264 men aged 39 to 80 years who were classified into the ALDH2 deficiency or sufficiency group using the ethanol patch test and the Tokyo University ALDH2 Phenotype Screening Test. A self-administered questionnaire including drinking habit was used. Blood pressure and the levels of biochemical markers in groups with ALDH2 sufficiency, ALDH2 deficiency and drinking habit were compared using multiple regression models for adjusting age, smoking habit, physical exercising habit and body mass index.
RESULTSThe levels of serum high-density lipoprotein cholesterol, triglycerides, aspartate aminotransferase (AST) and gamma-glutamyl transpeptidase (γ-GTP) were significantly higher in current drinkers of 20 g of ethanol or more per day than in nondrinkers of the ALDH2 sufficiency group. The levels of serum AST and γ-GTP in current drinkers of 20 g of ethanol or more per day, and fasting blood sugar in current drinkers of less than 20 g of ethanol per day were significantly higher than those in nondrinkers of the ALDH2 deficiency group.
CONCLUSIONSThese results suggest that alcohol consumption increases the levels of serum lipids and liver enzymes in ALDH2-sufficient individuals and liver enzymes and blood glucose levels in ALDH2-deficient individuals.
6.Endoscopic Findings and Treatment of Gastric Neoplasms in Familial Adenomatous Polyposis
Chihiro SATO ; Kazuya TAKAHASHI ; Hiroki SATO ; Takumi NARUSE ; Nao NAKAJIMA ; Masafumi TAKATSUNA ; Ken-ichi MIZUNO ; Satoru HASHIMOTO ; Manabu TAKEUCHI ; Junji YOKOYAMA ; Masaaki KOBAYASHI ; Shuji TERAI
Journal of Gastric Cancer 2022;22(4):381-394
Purpose:
Gastric neoplasia is a common manifestation of familial adenomatous polyposis (FAP). This study aimed to elucidate the clinical characteristics, endoscopic features including fundic gland polyposis (FGPsis), and treatment outcomes of gastric neoplasms (GNs) in patients with FAP.
Materials and Methods:
A total of 35 patients diagnosed with FAP, including nine patients from four pedigrees who underwent esophagogastroduodenoscopy (EGD), were investigated regarding patient characteristics, GN morphology, and treatment outcomes.
Results:
Twenty-one patients (60.0%) had 38 GNs; 33 (86.8%) and 5 (13.2%) were histologically diagnosed with adenocarcinoma and adenoma, respectively. There were no specific patient characteristics related to GNs.Nodule-type GNs were more prevalent in patients with FGP than without (52.2% vs. 0.0%, P=0.002) in the upper body of the stomach. Conversely, depressed-type GNs were fewer in patients with FGPsis than in those without (13.0% vs. 73.3%, P<0.001). Slightly elevated-type GNs were observed in both groups (34.8% vs. 20.0%, P=0.538). Even within pedigrees, the background gastric mucosa and types of GNs varied. In total, 24 GNs were treated with endoscopic submucosal dissection (ESD) and eight with endoscopic mucosal resection (EMR). EMR was selected for GNs with FGPsis because of the technical difficulty of ESD, resulting in a lower en bloc resection rate (62.5% vs. 100%, P=0.014).
Conclusions
Our study indicates the necessity of routine EGD surveillance in patients diagnosed with FAP. Notably, the morphology and location of GNs differed between patients with and without FGPsis. Endoscopic treatment and outcomes require more attention in cases of FGPsis.