The number of patients with diabetes mellitus (DM) in Japan is increasing. Progression of DM leads to the development of diabetic peripheral neuropathy, which causes foot sensory disturbances. This study examined the effect of DM on plantar tactile point pressure sensitivity (TPPS) and identified the site with the highest threshold of plantar TPPS. The subjects were 42 DM patients (aged 71.7±8.2 years) and 122 local elderly residents (aged 72.6±4.8 years). TPPS of eight sites, including the right and left halluces, hallux and fifth toe metatarsal heads, and heels was measured using the Semmes-Weinstein monofilament test. The measurement was performed three times at each site. The results were adopted when all repeated measurements were valid. The Friedman test was used for comparison among the four sites within the same group. The Mann-Whitney U test was used for comparison of sites between groups. A significance level of 5% was adopted. The ages of the DM patients were not significantly different, but the patients had significantly higher TPPS threshold for halluces, and hallux and fifth toe metatarsal heads, compared to the local elderly residents. The TPPS threshold was highest in the heels in both the DM patients and local elderly residents. The threshold of plantar TPPS increases in DM. It is important to evaluate both the forefoot and the heels.

Increase in dermal blood flow by the artificial CO₂-bathing was confirmed by means of a Thermocouple flow meter and by a Laser doppler velocimeter.
The artificial CO₂-bath was prepared with 50g tablet, made from sodium bicarbonate and succinic acid, putting simply in plain water at 38°C.
Dermal blood flow was increased nearly 5-fold by the simple bathing, and was further enhanced 1.3-fold by the artificial CO₂-bathing.
It has been definitely shown by the artificial CO₂-bathing that an increase in oral, finger tip, and forehead temperature and transepidermal water loss is significant compared to the plain bathing, so that the thermal effect equivalent to carbon-dioxated spring will be obtained.

It was found that no effect of increase in dermal blood flow depended solely on HCO₃^- or CO₃^2-, but on CO₂ gas dissolved in water.
The artificial CO₂ bath was prepared with sodium bicarbonate and citric acid, mixing simply in plain water at 38-40°C.
Thermal efficacy was confirmed by a rise in temperature of oral, finger tip and forehead respectively, and by a high transepidermal water loss (TWL) in consequence of increase in dermal blood flow, compared to a plain bathing.
A remarkable effect in artificial CO₂ bathing of 400-800ppm has been well-known clinically, however, a substantial increase in dermal blood flow has observed with artificial CO₂-bathing of 59.8ppm or greater in this study, so that a CO₂-bathing using the preparation would be popularized.

It has been well recognized that no known method can produce as strong or as effective a bath as can be given with natural waters.
The method of bubbling gas through the bath water is thought to be almost entirely ineffective; the solubility of CO₂-gas in water at 40°C is about 10%, but is much further enhanced about 50% by bubbling through an airstone, making fine bubbles.
Tablet form of the CO₂-bath preparation, made from bicarbonate and succinic acid, produces fine CO₂ bubbles so that about 80% of water solubility at 40°C can be obtained.
A CO₂-bath preparation, 50g tablet, can produce 100ppm in maximum concentration in a bath of 150 liter at 40°C, maintaining the level of more than 60ppm for 2 hours.
In order for the safety to estimate the escaped CO₂, a large quantity of the CO₂-bath preparation, 20 and 50 tablets, was used in a relatively air tight room; CO₂ concentration reached the maximum level of 1.9 and 6.6% respectively with a tendency of rapid falling, so that the critical complications could rarely be happened.

We reviewed 24 cases of patchplasty for true thoracic aortic aneurysm performed in our hospital up to July 2001. The size of the aneurysm in the ascending aorta was 6.0cm (1 case), and the mean size in the aortic arch was 2.5±0.5cm (4 cases), that in the distal arch was 4.7±1.7cm (11 cases), and that in the descending aorta was 3.7±0.5cm (8 cases). The hospital mortality rate was 12.5% (3 patients out of 24). The causes of death were multiple organ failure, cerebral bleeding and sepsis. In the long-term results, 2 patients had recurrence, but there were no late deaths in relation to the aneurysmal recurrence. We performed open stent operations for severe adhesion and pulmonary dysfunction in the aneurysmal recurrence cases. The postoperative course of these cases was uneventful. The open stent was useful for the treatment of the aneurysmal recurrence in the distal arch.

BACKGROUND: Cutaneous malignant melanoma has a poor prognosis. The detrimental effect of incisional biopsies on the outcome of malignant melanoma has been debated. The aim of this study was to determine the effect of the presence and type of biopsy on the prognosis of malignant melanoma. METHODS: The medical records of 109 malignant melanoma patients treated at Tokushima University Hospital from 1983 to 2007 were reviewed. After excluding 28 cases with stage 0 disease or incomplete data, 81 cases were analyzed in detail with respect to patient sex, age, tumor site, clinical stage at diagnosis, presence of ulceration or lymph node metastasis, and prognosis. The five-year survival and five-year disease-free survival rates of patients who underwent incisional or excisional biopsies were compared with those who did not undergo a biopsy. RESULTS: The male-to-female ratio was 1:1.19. The mean age was 61.3 years (range, 19-93 years). The most common site was a lower extremity, and the most common clinical stage was stage II. No significant differences in clinicopathological features, five-year survival rates, and five-year disease-free survival rates were observed among the three groups. CONCLUSIONS: The presence and type of biopsy neither affected the metastatic rate nor the prognosis of malignant melanoma. The use of incisional biopsies is not encouraged because tumor thickness cannot be measured accurately. However, they may be helpful for confirming the diagnosis if an excisional biopsy cannot be performed.
Biopsy* ; Diagnosis ; Disease-Free Survival ; Humans ; Lower Extremity ; Lymph Nodes ; Medical Records ; Melanoma* ; Neoplasm Metastasis ; Prognosis ; Survival Rate* ; Ulcer

BACKGROUND/AIMS: Fundic gland polyps (FGPs), hyperplastic polyps (HPs), and xanthomas (XTs) are common benign gastric lesions that can be diagnosed by endoscopic appearance alone in most cases. The aim of this study was to evaluate associations between gastric cancer and these benign lesions. METHODS: Two expert endoscopists reviewed a series of gastroscopy images. FGPs, HPs, and XTs were diagnosed by endoscopic appearance, whereas all gastric cancers were confirmed pathologically. RESULTS: Of the 1,227 patients reviewed, 114 (9.3%) had a concurrent or past history of gastric cancer. The overall prevalences of FGPs, HPs and XTs were 9.4%, 6.3% and 14.2%, respectively. HPs and XTs coexisted in 1.6% of patients, whereas other combinations were rarer. XTs were observed in 39.3% and 11.5% of patients with and without gastric cancer, respectively (p<0.001). In contrast, no gastric cancer patients had FGPs, whereas 10.4% of patients without cancer had FGPs (p<0.001). The prevalence of HPs was similar between the two groups (8.8% and 6.0% of patients with and without cancer, respectively, p=0.29). Multivariate and Mantel-Haenszel analyses demonstrated that XTs were positively associated and FGPs were negatively associated with gastric cancer. CONCLUSIONS: XTs and FGPs might be useful as endoscopic risk indicators for monitoring gastric cancer.
Gastroscopy ; Humans ; Polyps ; Prevalence ; Stomach Neoplasms ; Xanthomatosis