2.Effect of controlled freezing-point storage of hearts.
Asatoshi MIZUNO ; Michihiko MATSUI ; Tatsuumi SASAKI ; Yoshihiko MOCHIZUKI ; Yuji YATA ; Hiroshi OKUYAMA ; Tatsuta ARAI
Japanese Journal of Cardiovascular Surgery 1990;19(5):843-848
Controlled Freezing-point Storage (CF Storage) is a new method of preserving foods in minus non-frozen temperature range. So, we tried to apply this method to entrails preservation and investigated the effect of controlled freezing-point storage of hearts on ventricular function in isolated perfused rat heart (male, Sprague dawley strain, in body about 300g weight). The hearts were perfused by working heart mode for 10min, and received infusion of cardioplegic solution which was followed by 4 hours of cardiac arrest at a myocardial temperature 4°C (4°C group) or minus non-frozen temperature (CF storage group). Then, the aerobic reperfusion by working heart mode was continued for an additional 30min. The recovery rate of cardiac output was 33.5% and 62.5% respectively of the preischemic value in 4°C group and CF storage group, which was statistically significant (p<0.01). ATP activity after 4 hours of cardiac arrest in 4°C group was significantly lower than that in CF storage group (p<0.05). These data suggest that CF storage of hearts might have a protective effect against an ischemic insult upon myocardial cell during hypothermic cardiac arrest.
3.Genealogical Study of a Married Couple from Two Families with Hereditary Spherocytosis.
Tadashi ARAI ; Yo YASUDA ; Yuji ITOU ; Kazuyoshi HAYAKAWA ; Tadatake TAKAYA ; Satoshi TOSHIMA ; Chiken SHIBUYA ; Shigeko SATOU ; Tokie NAKAGAWA ; Yoshitomo KASHIKI
Journal of the Japanese Association of Rural Medicine 1996;44(5):676-679
Hereditary spherocytosis (HS) is a condition characterized by jaundice, hepato-splenomegaly tumors, and the presence of spherocytes. It accounts for about 70% of the reported cases of congenital hemolytic anemia in Japan. Many researchers state that this pathologic condition primarily arises from an abnormality of the red blood cell membrane. We have encountered a familiy, all the members (23-year-old daughter, 20-year-old son, 53-year-old-father, and 46-year-old-mother) of which had their cases diagnosed as HS by peripheral blood examination and electron microscopy. Excluding the farher, the peripheral blood examination also revealed anemia in the other family members. Moreover, the common HLA was found in all the members of these two families including the one on the mother's side, but human parvovirus B19 was not detected at all. We are providing the socalledprophylactic visiting care for the two families, while giving them information about HS which is arelatively easily-misunderstood hereditary disease. We did not find any report about married coupleswith hereditary spherocythosis. In this paper, we report our findings so far obtained through visiting care with some bibliographic discussion on HS.
4.Study on Telomerase Activity in Bronchoalveolar Lavage Fluid.
Tadashi ARAI ; Yo YASUDA ; Yuji ITO ; Kazuyoshi HAYAKAWA ; Tadatake TAKAYA ; Satoshi TOSHIMA ; Chiken SHIBUYA ; Naoki YOSHIMI ; Yoshitomo KASHIKI
Journal of the Japanese Association of Rural Medicine 1997;46(4):679-682
Telomerase has been reported to increase its activity in more than 80% of human pulmonary cancer tissue samples, thus potentially contributing to cancer diagnosis. This led us to try the measurement of telomerase activity in bronchoalveolar lavage fluid in cases clinically suspected to be primary pulmonary cancer. Methodologically, the measurement was made by means of TRAP (telometric repeat amplification protocol) assay, a high-sensitivity assay system using the technique known as polymerase chain reaction (PCR). The resultsshowed that telomerase activity in all the 6 cases, diagnosed as primary lung cancer histologically, was positive. On the other hand, on cytologic examination, 4 out of these 6 cases were positive, and the remaining 2 cases (squamous cell carcinoma and adenocarcinoma) were negative. Histologic examination revealed that of these 4 cases, 2 and 2 were pulmonary cancers and pulmonary tuberculoses, respectively. The above results suggested that examination of telomerase activity in bronchoalveolar lavage fluid may be useful for cancer diagnosis clinically.
5.Study on Effective and Safe Cancer Chemotherapy for Outpatients (Part1): Influence of Establishment of the Outpatient Cancer Chemotherapy Unit on Effective Usage of Hospital Beds
Eiji YONEYAMA ; Satoru MASE ; Hiroshi YOSHIDA ; Yuji OHIRA ; Hironobu NIINOMI ; Kazuhisa TSUZUKI ; Mizuho MURAKOSHI ; Kazuyuki NAKAMURA ; Makiko ARAI ; Kazuhisa SAWADA ; Akio KATSUMI
Journal of the Japanese Association of Rural Medicine 2008;57(1):1-7
Although the Outpatient Cancer Chemotherapy (OCC) Unit was established with in Anjo-Kosei Hospital in 2006, its real worth remains to be elucidated. To address this, the following subjects were examined;effective usage of hospital beds changes in the number of outpatients given to chemotherapy, length of hospitalization, the number of patients transferred by ambulance to the hospital, hospital occupancy rate, and the number of frequently used chemotherapy regimens.Since the establishment of the OCC Unit, the number of patients transferred by ambulance has increased and length of hospitalization has gradually decreased, accompanied by the increase in the number of outpatients treated at the OCC Unit. Additionally, no significant change was observed in the hospital occupancy rate. Furthermore, of the frequently used chemotherapy regimens, nine regimens were available for 62.4% of the total number of outpatients of the OCC Unit.These results indicated the useful effect of the establishment of the OCC Unit on the usage of hospital beds, and provided significant information helpful in promoting the effective and safe chemotherapy for outpatients in the OCC Unit.
Chemotherapy-Oncologic Procedure
;
Unit
;
seconds
;
Outpatients
;
Malignant Neoplasms
6.Three Cases of Myelodysplastic Syndrome. Importance of Microscopic Examination of Hemogram.
Kazuko KAWASHIMA ; Yo YASUDA ; Tadashi ARAI ; Yuji ITO ; Kazuyoshi HAYAKAWA ; Tadatake TAKAYA ; Chiharu MIYADA ; Satoshi TOJIMA ; Momoe DOI ; Masanobu NAGAI ; Chiken SHIBUYA ; Yoshitomo KASHIKI
Journal of the Japanese Association of Rural Medicine 1996;45(1):24-27
During the one-year period from April 1992 through March 1993, we measured 25, 498 blood samples by the use of a sequential multichannel autoanalyzer, which our hospital installed in August 1991. Of the total, 4, 707 samples were thoroughly examined under the microscope. They included those from the patients for which physicians indicated laboratory testing, those samples whose white cell counts were less than 3, 000/μlor more than 10, 000/μl, the cases in which the amount of hemoglobin was less than 10.0g/dl, and the samples which defied blood typing. The result was that three cases of myelodysplastic syndrome were detected, although the autoanalyzer failed to find any abnormalities in these three cases.
Laboratory technicians in hospital are so busy that they hardly have time enough for thoroughgoing examination of hemogram. Nevertheless, the recent experience has brought home to us the importance of a microscopic scrutiny, into hemogram and its application to diagnosis.
7.Histopathological Case of Uterine Carcinoid Tumor Metastasized to the Lung.
Satoshi TOSHIMA ; Yo YASUDA ; Tadashi ARAI ; Yuji ITO ; Kazuyoshi HAYAKAWA ; Tadatake TAKAYA ; Momoe DOI ; Chiken SHIBUYA ; Toshiya ITO ; Yoshitomo KASHIKI ; Naoki YOSHIMI
Journal of the Japanese Association of Rural Medicine 1999;48(1):48-53
With the diagnosis of metastatic tumor of the lung suspected, we had a chance to experience a histopathological case of carcinoma of the uterine cervix (adenoid squamous cell carcinoma), which was thought to coexist with carcinoid tumor. In this paper, we report the results of cytological as well as histological examinations of the case.
The patient was as 43-year-old woman. She visited our hospital, complaining about abnormally prolonged uterine bleeding (metrorrhagia). Cytodiagnosis was performed with a Papanicolaou smear. A microscopic examination revealed squamous cell carcinoma occurring together with adenocarcinoma. A similar finding was obtained by cervical biopsy. Thus, the case was diagnosed as adenoid squamous cell carcinoma.
Then the patient underwent radical hysterectomy and lymphadenectomy, followed by chemotherapy. After leaving the hospital, she was put under doctor-monitored observation. About 4 years after the surgery, a chest x-ray examination found abnormal shadows. For inspection, bronchoscopy was performed. Carcinoid of the lung was diagnosed through histopathological as well as electron microscopic examination of specimens taken from bronchial polyps during bronchoscopy. At the same time a cytologic study was conducted. It also revealed neoplasms strongly suspected of caricinoid tumors. Retrospective studies of cytological and histopathological images of the uterine cervix when the patient first visited us found only adenocarcinoma and squamous cell carcinoma, but no signs of carcinoid tumors. However, the immunohistological staining of NSE and chromoganins A, both neuroendocrine markers, showed positive findings in some adenocarcinomatous parts of the tissues of the unterine cervix. Therefore, we considered that the cervical cancer is compounded of adenoid squamous cell carcinomas and tumors having properties of neuroendocrine cells.
From this, we concluded that it is necessary to take into account a differential diagnosis of neuroendocrine tumors including carcinoid of the uterine cervix when less differentiated adenocarcinoma and squamous cell carcinoma are suspected in histological and cytological examinations. Furthermore, we thought it important to make a definite diagnosis after meticulous examinations by immunohistological staining and electron microscopy.
8.Fluctuations in Blood Pressure in Hemiplegic Patients Measured by Using Digital Compact Wrist Blood Pressure Monitor.
Norifumi WADA ; Yo YASUDA ; Tadashi ARAI ; Yuji ITO ; Kazuyoshi HAYAKAWA ; Tadatake TAKAYA ; Yukie NISHIOKA ; Sakiko TANIGUCHI ; Maki TSUJIMOTO ; Masaru IWAKOSHI ; Koichi MORII ; Yoshitomo KASHIKI
Journal of the Japanese Association of Rural Medicine 1999;48(2):152-155
With household digital compact wrist blood pressure monitors, blood pressure was measured in hemiplegic patients who were receiving kinesitherapy.
During the training program routinely worked out by physical therapists, most patients had shown elevated levels of both systolic and diastolic blood pressure. There were some patients whose blood pressure went up so high as to call doctors' attention.
As changes in blood pressure are affected by various factors, we cannot say at once that doing exercise alone adds to blood pressure. Nonetheless, by using a household blood pressure monitor, it would be easy to know the extent to which blood pressure rises in accordance with the amount of exercise, so that it would be possible to make patients and their family aware of the importance of blood pressure readings. We thought it possible to obtain an index of the amount of exercise at home.
9.Arthroscopic Pullout Fixation for a Small and Comminuted Avulsion Fracture of the Posterior Cruciate Ligament from the Tibia
Shuji NAKAGAWA ; Yuji ARAI ; Kunio HARA ; Hiroaki INOUE ; Manabu HINO ; Toshikazu KUBO
The Journal of Korean Knee Society 2017;29(4):316-320
We describe a patient who underwent arthroscopic pullout fixation for a posterior cruciate ligament (PCL) avulsion fracture. A 46-year-old female, injured in a fall while riding a motorcycle, was diagnosed with a right knee PCL tibial attachment avulsion fracture and underwent arthroscopic osteosynthesis. A Kirschner wire was drilled to a point just medial to the medial border of the anterior tibial bony bed. A suture wire was folded into a loop and introduced into the posteromedial compartment via the bone tunnel. A fixation thread was inserted from the posteromedial portal, through the medial and lateral loop wires, and into the posteromedial compartment. The lateral and medial loop wires attached to the thread were pulled to the outside, and the thread was fixed onto the tibia. Three months post-surgery, she returned to her job. This procedure represents a minimally invasive method of treating avulsion fractures of the tibial attachment of the PCL.
Arthroscopy
;
Female
;
Humans
;
Knee
;
Methods
;
Middle Aged
;
Motorcycles
;
Posterior Cruciate Ligament
;
Sutures
;
Tibia
10.Radiologic results of additional single screw fixation with lateral locking plate after hybrid closed-wedge high tibial osteotomy
Nobuyuki HIRAOKA ; Shuji NAKAGAWA ; Eigo OTAKARA ; Hiroaki INOUE ; Kenji TAKAHASHI ; Yuji ARAI
The Journal of Korean Knee Society 2020;32(4):e65-
Background:
Hybrid closed-wedge high tibial osteotomy (hybrid CWHTO) is an effective surgical treatment for medial compartment osteoarthritis of the knee. Our study investigated whether the combination of a lateral locking plate and a single medial screw promoted bone union after hybrid CWHTO.
Methods:
The study cohort consisted of 30 patients (15 men and 15 women) who underwent hybrid CWHTO for medial compartment osteoarthritis or spontaneous osteonecrosis of the knee. Sixteen knees were fixed with a lateral locking plate (LP group), and 17 were fixed with both a lateral locking plate and a cannulated cancellous screw on the medial side of the tibia (LPS group). The times to bone union, radiolucency, and callus formation at the osteotomy site were evaluated radiographically.
Results:
The mean postoperative time to radiographic confirmation of bone union was 5.5 ± 2.6 months in the LP group and 3.4 ± 1.5 months in the LPS group. Radiolucency at the osteotomy site and excess callus formation on the posterior side of the tibia were lower in the LPS group than in the LP group.
Conclusions
This modified hybrid CWHTO combining a lateral locking plate and a cannulated cancellous screw on the medial side of the tibia improves the stability of the osteotomy site and shortens the period of bone union.