ST-segment elevation in leads I and aVL predicts short-term prognosis in acute anterior wall myocardial infarction.

Our study demonstrates that ST-segment elevation in both leads I and aVL noted on admission for an anterior acute myocardial infarction does portend a worse short-term survival. Independent predictors of short-term prognosis in an anterior acute myocardial infarction include ST elevation in both leads I and aVL, advanced age, female gender, left ventricular failure, and malignant arrhythmias.

Pulmonary thromboembolism after surgery for esophageal cancer: its features and prophylaxis.

We attempt to clarify the problems of pulmonary thromboembolism (PTE), which occurs less frequently in Japan than in the West, regarding its special perioperative management and prophylaxis for PTE after esophagectomy. We studied 26 patients with PTE following esophagectomy among 1023 patients with esophageal cancer between 1984 and 1997. The presence of embolism was confirmed by pulmonary perfusion scintigraphy.

Cologastric fistula and colonic perforation as a complication of percutaneous endoscopic gastrostomy.

Cologastric fistula has rarely been reported as a complication of percutaneous endoscopic gastrostomy (PEG). We encountered a patient in whom this problem went unrecognized for 2 years. After the initial PEG tube was changed, the second PEG tube was advanced into the colon, causing severe diarrhea.

Severity of residual stenosis of infarct-related lesion and left ventricular function after single-vessel anterior wall myocardial infarction: implication of ST-segment elevation in lead aVL of the admission electrocardiograms.

Background: The relationship between the severity of chronic-phase stenosis of infarct-related lesions (IRLs) and chronic left ventricular function in anterior acute myocardial infarctions (AMI) has not been adequately investigated.

Hypothesis: This study investigated whether ST elevation in lead aVL of admission electrocardiogram (ECG) would be a determinant factor of the relationship between the severity of stenosis of the IRL and chronic left ventricular function after anterior wall AMI.

Methods: One month after AMI, the IRL was evaluated by coronary angiography in 98 patients with anterior AMI, and left ventricular ejection fraction (LVEF) was determined using multigated radionuclide angiocardiography.

Cardiac rupture and admission electrocardiography in acute anterior myocardial infarction: implication of ST elevation in aVL.

This study determines the usefulness of electrocardiography in the emergency room for assessing the risk of cardiac rupture after acute anterior myocardial infarction (MI). The presence of ST segment elevation on the admission 12-lead electrocardiography was evaluated in 325 consecutive anterior MI patients. A forward-stepwise logistic regression analysis for cardiac rupture was performed with the covariates of age, gender, hypertension, history of MI, reperfusion therapy by coronary angioplasty, and ST segment elevations in leads I, aVL, V1-V6.

Usefulness of autologous blood transfusion for avoiding allogenic transfusion and infectious complications after esophageal cancer resection.

Background: A retrospective investigation was conducted to determine whether autologous blood collection could reduce allogenic transfusion after resection of esophageal cancer and whether allogenic transfusion influenced postoperative infection.

Methods: Patients (n = 100) who met the criteria for hemoglobin, age, body weight, and serum protein donated 800 mL of autologous blood from May 1994 to December 1997. The control group (n = 248) was selected from patients who met the same criteria and did not donate autologous blood over the 10 years before the start of autologous blood collection.

Esophageal cancer and right aortic arch associated with a vascular ring.

We report on the problems of diagnosis and surgical technique from the standpoint of mediastinal anatomy in patients with esophageal cancer and right aortic arch associated with a vascular ring. We propose that left thoracotomy plus sternotomy is the best approach to allow visualization of the bilateral recurrent laryngeal nerves.

[Multicenter evaluation of broth microdilution test, BrothMIC MTB, to determine minimum inhibitory concentrations (MICs) of antimicrobial agents for Mycobacterium tuberculosis--evaluation of interlaboratory precision and interpretive compatibility with agar proportion method].

A newly developed microdilution antimycobacterial susceptibility test, BrothMIC MTB (Kyokuto Pharmaceutical Industrial Co., Ltd., Tokyo, Japan) to determine minimum inhibitory concentrations (MICs) was evaluated at multisites.

Severe pulmonary hemorrhage in patients with serious group A streptococcal infections: report of two cases.

Severe pulmonary hemorrhage was observed in two patients who died of serious group A streptococcal infections. These two patients initially presented with fever and sore throat. This was followed by sudden onset of septicemia caused by the bacteria and by the subsequent development of severe pulmonary hemorrhage.

[Evaluation of CO2 condition for antibiotic susceptibility test of Helicobacter pylori on microdilution broth].

We determined the MICs of clarithromycin for 32 Helicobacter pylori strains isolated from gastric mucosa of patients, by using microdilution broth method under different microaerobic conditions (CO2: 5% and 15%). The pH of broth was more acidic at 15% CO2 than that of at 5% CO2. The MICs of clarithromycin for all H.

Serious group A streptococcal infection around delivery.

Objective: To differentiate the features of serious, perinatal, group A streptococcal infection from other types of streptococcal toxic shock syndrome.

Data Sources: Thirty-eight obstetric cases that were fatal or fulfilled the criteria of Centers of Disease Control and Prevention for streptococcal toxic shock syndrome were reviewed. Three cases were from Asahi General Hospital, 26 from MEDLINE (1966-December 1998), four from Japana Centra Revuo Medicina (1987-November 1998) using the search terms "Streptococcus," "Streptococcus pyogenes," "Streptococcal infection," "pregnancy," "labor," "delivery," "sepsis," and "shock," and five from official records of the Ministry of Health and Welfare of Japan.

[Therapeutic strategy for adenocarcinoma in Barrett's esophagus: a study based on a comparison with squamous cell carcinoma].

The therapeutic strategy for adenocarcinoma in Barrett's esophagus is discussed based on a comparison with squamous cell carcinoma. The pattern and range of lymph node metastasis of adenocarcinoma in Barrett's esophagus is similar to that of squamous cell carcinoma, as is the pattern of recurrence. Chemotherapy is less effective, except for some reports on paclitaxel, but chemoradiation therapy is comparable in effect.

[A gastrointestinal radiographic study of 18 patients with esophageal adenocarcinoma arising from Barrett's epithelium].

Gastrointestinal radiographs were reviewed with pathological correlation in 18 patients with histologically proven esophageal adenocarcinoma arising from Barrett's epithelium. Comparison was also made with postoperative radiographs of resected esophageal specimens from 3 of the patients. Esophageal carcinoma could be observed in the gastrointestinal radiographs in 17 of the 18 patients.

p53 gene mutation in 150 dissected lymph nodes in a patient with esophageal cancer.

For thoracic esophageal cancer, we perform extended three field lymph node dissection, and have achieved nearly 50% of overall 5-year survival. However, patients sometimes develop lymph node recurrences in spite of having no lymph node metastases found by conventional histopathologic examination. In a patient with esophageal squamous cell carcinoma, we sequenced all the p53 cDNA translated regions (exon 2-10) of primary carcinoma, and confirmed one p53 nonsense mutation in exon 10.

Carcinosarcoma of the esophagus with metastases showing osteosarcoma: a case report and review of the literature.

Carcinosarcoma of the esophagus includes both carcinomatous and sarcomatous elements. The classification and histogenesis of carcinosarcoma is controversial. In a polypoid carcinosarcoma diagnosed in a resected esophagus the sarcomatous component was composed of dense interlacing bundles of spindle-shaped cells in the submucosa.

A new choleretic effect of folinic acid.

Background/aims: In the chemotherapy of recurrent gastric cancer with 5-fluorouracil and folinic acid, an interesting phenomenon, the reduction of jaundice and improvement of liver function, was observed. The aim of this study was to investigate the mechanism of this phenomenon, and to confirm a choleretic effect of folinic acid.

Methodology: The bile duct of anesthetized rats was catheterized, and bile was collected.

[Difference between Japan and western countries in the treatment strategy for esophageal cancer].

The most conspicuous difference between Japan and Western countries in the treatment strategy for esophageal cancer is the attitude to lymph node dissection. Japanese surgeons have aimed at complete eradication of lymphatic spread of cancer cells and have reached the level of three-field lymph node dissection. In Western countries, however, surgeons rely more on chemotherapy or radiotherapy because they consider that most patients who present with esophageal cancer already have disseminated disease.

ST-segment elevation in right precordial leads implies depressed right ventricular function after acute inferior myocardial infarction.

Background: The prognosis of acute inferior myocardial infarction is worse when it is complicated by right ventricular infarction. ST elevation in the right precordial leads is one of the reliable methods for detecting acute right ventricular infarction. The purpose of the study was to examine the relation between ST elevation in the right precordial electrocardiographic leads during acute inferior infarction and the severity of right ventricular systolic dysfunction.

[Rational extent of lymph node dissection for carcinoma of the lower third of the thoracic ESOP-hagus of T2 or T3 stage with abdominal lymph node metastasis].

We discussed the rational extent of the lymph node dissection for carcinoma of the lower third of the esophagus of T2 or T3 stage with abdominal lymph node metastasis. Lymph node metastasis developed in 89.5% of patients.

Biphasic synovial sarcoma of the peritoneal cavity with t(X;18) demonstrated by reverse transcriptase polymerase chain reaction.

A case of a biphasic synovial sarcoma, arising on the inner surface of the anterior abdominal wall of a 13-year-old girl, is reported. Although the tumor showed rather typical histological and immunohistochemical features for synovial sarcoma, its unusual clinical presentation and anatomical location caused diagnostic difficulty, especially with regard to differentiation from a malignant mesothelioma. Applying reverse transcriptase polymerase chain reaction (RT-PCR) analysis, the SYT-SSX2 chimeric gene transcripts that result from the translocation, t(X;18)(p11.

[Mediastinal lymph node metastasis from esophageal carcinoma: CT assessment with pathologic correlation].

Computed tomographic (CT) scans were performed in 179 patients with esophageal carcinoma to evaluate mediastinal lymph node metastasis. Histopathologic findings were compared with CT findings in a total of 7,218 resected lymph nodes. First, the criterion for lymph node metastasis on CT scans was 10 mm or more in long transverse diameter.

Prognostic factors in adenocarcinoma of the gastric cardia: pathologic stage analysis and multivariate regression analysis.

Purpose: To clarify the pathologic stages of adenocarcinoma of the gastric cardia in which the prognosis is worse than in adenocarcinoma of the middle or distal part of the stomach, and to determine prognostic factors in these stages by multivariate analysis.

Patients And Methods: We analyzed 2,536 cases of surgically resected gastric adenocarcinoma of all pathologic stages. Four hundred seventy-two cases of gastric carcinoma, in which cumulative survival of gastric cardia was poor, were subjected to Cox regression analysis for prognostic factors, and to logistic regression analysis for factors influencing venous or lymphatic invasion.

Changes in PAF (platelet-activating factor) production during cell cycle of yeast Saccharomyces cerevisiae.

Yeast Saccharomyces cerevisiae cells were cultured synchronously and the change of platelet-activating factor (PAF) production during the cell cycle was investigated at each phase of the cycle. The basal PAF contents of diploid AKU4103 cells in G1 and M phases were higher than those of cells in S phase. Both diploid and haploid strains showed the same level of PAF production in response to the calcium ionophore A23187.

A new type of fulminant group A streptococcal infection in obstetric patients: report of two cases.

A new type of fulminant group A streptococcal infection in obstetric patients is described. The illness occurs in late stage of pregnancy, and is preceded by an episode of upper respiratory tract infection. This is followed by sudden onset of septicemia, subsequent hematogenous infection of the myometrium by the bacteria, and development of acute purulent myometritis.