Strangulation necrosis of the intestine in a patient with giant polycystic kidney disease: a rare cause of acute abdomen.

We recently treated a patient with strangulating intestinal necrosis caused by the enlarged abdominal cysts characteristic of autosomal dominant polycystic kidney disease (ADPKD). A 75-year-old Japanese woman with a 30-year history of ADPKD underwent surgery to treat a diagnosis of acute abdomen. Surgery confirmed that the mesenterium was stretched caudally over the huge cysts that occupied the entire abdominal cavity, and the intestines were necrotic from the jejunum to the transverse colon.

[Prevention of parenchymal air leakage after lung resection; comparison of effectiveness in drug formation of fibrin adhesive].

We investigated the comparative effectiveness of the seat and glue types of fibrin adhesive, to clarify which is more useful in preventing postoperative parenchymal air leaks after lung resection. One hundred sixteen patients received fibrin adhesive to prevent postoperative air leakage after lung resection carried out by the same surgeon. Ninety-two lobectomies and 24 partial resections were assessed.

Increased expression of integrin beta1 is a poor prognostic factor in small-cell lung cancer.

The purpose of this study was to investigate the possible association between the expression of integrin beta1 and response to chemotherapy and survival in patients with small cell lung cancer (SCLC). One-hundred and four patients with SCLC, who had received an initial course of chemotherapy between February 1989 and July 1999, were entered into the study. There were 91 males and 13 females, with a median age of 65 years (range 40-85 years).

[Combined medical and surgical treatment of 74 cases of acute type III aortic dissection].

In the early period up to 1986, our treatment of acute type III dissection was anti-hypertension drug therapy as a rule, and Collins operations were performed in two cases of progressive hemothorax. Among 21 patients receiving medical therapy, five died of rupture, and three operated cases died of multiple organ ischemia, and then the hospital mortality was 40%. Since 1987, we have selected hypotensive treatment of strictly maintaining blood pressure less than 120mmHg for the completely thrombosed type of the dissected lumen, and the emergency operation of ringed intraluminal graft insertion (RIG operation) for the blood-flow type and aneurysm formation type of the dissected lumen, diagnosed by the emergency cine-angiography.

[Clinical study of paragangliomas in the thorax].

Four cases of paraganglioma in the thorax, consisted of 3 cases originating from the mediastinum and a case of pulmonary metastasis from the posterior peritoneum, were clinically investigated. Three were malignant and one was benign with noradrenaline secretion. On surgical excision, preoperative arterial embolization was assumed to be useful for reducing hemorrhage during procedure.

Combined apical hypertrophic cardiomyopathy and left atrial myxoma.

A patient had apical hypertrophic cardiomyopathy and left atrial myxoma. We believe that this is the first description of such a combination.

[Operative risk of splenic repair for isolated but complex splenic injuries due to blunt abdominal trauma].

Surgical repair for complex splenic trauma is often controversial, because the operative risk of splenic salvage may exceed the risk of overwhelming postsplenectomy infection (OPSI). To determine the operative risk of splenic salvage for such injuries, 19 cases of isolated but complex injuries among 73 cases of blunt splenic trauma were examined retrospectively. Shattered spleens were excluded from the study.

[A case of mediastinal teratoma--differentiation from lung abscess and bronchogenic carcinoma].

A 38-year-old man was admitted with persistent productive cough and right anterior chest pain. Chest X-ray showed two large masses connected with each other, one in the right lung field and the other in the anterior mediastinum. A tentative diagnosis of either lung abscess or bronchogenic carcinoma was initially made, because of elevated serum tumor markers (SLX and SCC) and persisting refractory inflammatory sings.

[Influences of irradiation on the anastomotic sites of artificial grafts].

To examine the acute influences of irradiation on the anastomotic sites of EPTFE vascular grafts, an experimental study was performed using dogs. After replacement of superior vena cava and bilateral femoral arteries with EPTFE grafts, a total of 20 to 100 Gy doses were given at the anastomotic sites of superior vena cava and right femoral artery. There was no degradation of grafts themselves or rupture in the anastomoses at cumulative radiation doses of 20 to 100 Gy.

[A case of a 10-year survivor with squamous cell carcinoma of the lung, treated with radiation after an exploratory thoracotomy].

We have experienced a rare case of an unresectable lung cancer in a male patient who has survived 10 years after radiation therapy. The patient was aged 58 at the time of diagnosis. In May 1978, he was hospitalized because of an abnormal shadow in the upper left lung filed, and the diagnosis of squamous cell carcinoma was made by TBLB.

[Diffuse B-cell lymphoma of anterior mediastinum cured by short-term administration of CDDP-containing regimen].

The following report is of a case of diffuse B-cell lymphoma of the anterior mediastinum that was originally treated by resection and radiation in a patient who had pleural and subcutaneous metastases four months after operation. A total dose of 120 mg of CDDP, 60 mg of BLM, and 15 mg of VBL was administered in five weeks. The metastases completely disappeared by this dose alone, and the patient is alive and well seven and a half years after the chemotherapy.

Evaluation of intracardiac thrombus with computed tomography.

Left atrial (LA) and left ventricular (LV) thrombus was evaluated by computed tomography in 56 patients. The patients were divided into 2 groups: Group I, 28 patients with mitral valve disease, and Group II, 28 patients with myocardial infarction. Computed tomography and 2-dimensional echocardiography were performed in all the patients studied.

Comparison of protected isolation techniques between the laminar airflow room and the life island unit.

The use of laminar airflow rooms and a life island unit for comprised patients was evaluated. Six patients spent a total of 170 days in the laminar airflow rooms and 112 days in the life island unit, and none acquired any exogenous infection. Patients were febrile for 7 out of 170 days (4.

Computer assisted medical record retrieval system.

A medical record retrieval system for access to patients' records has been developed as the first step toward constructing a medical record data base. Since retrieval is a logical process, a logical system was used to describe the retrieval conditions. For access to a patient set having a number of medical data of interest, the patients concerned are taken as one set for each data item.

Clinical application of cardiovascular computed tomography.

The application of computed tomography to cardiovascular diagnosis was attempted. One hundred and four consecutive patients with various cardiovascular diseases were studied with a third-generation computed tomographic three-second whole body scanner. Identification and evaluation of abnormalities of the great vessels, atria, ventricles and interventricular septum were possible by cardiac computed tomography.

Evaluation of left atrial thrombus with computed tomography.

Left atrial thrombi were evaluated with computed tomography in 23 patients with mitral valvular diseases. In three of the patients, left atrial thrombi were delineated with computed tomography and were confirmed by cardiac surgery or autopsy. The minimum size of the thrombi detected tomographically was 3.

Septicemia during compromised host treated in a protected isolation unit.

Bacteriological, hematological and immunological data were evaluated in patients with septicemia in a protected isolation unit. Patients were randomly given antimicrobial prophylaxis. Three out of four episodes of septicemia occurred 2 to 4 days after discontinuing oral nonabsorbed antibiotics at the stage of leukopenia and immunodeficiency induced by chemotherapy.