Use of a modified early warning score system to reduce the rate of in-hospital cardiac arrest.

Background: Physiological abnormalities are often observed in patients prior to cardiac arrest. A modified early warning score (MEWS) system was introduced, which aims to detect early abnormalities by grading vital signs, and the present study investigated its usefulness.

Methods: Based on previous reports, the Chubu Tokushukai Hospital-customized MEWS was developed in Okinawa, Japan.

Synchronous quadruple multiple primary cancers of the tongue, bilateral breasts, and kidney in a female patient with a disease-free survival time of more than 5 years: a case report.

Background: Reports of synchronous multiple primary cancers in patients with oral cancer have recently been increasing because of progress in radiographic diagnostic techniques. Multiple primary cancers in patients with oral cavity cancer mainly occur in the head and neck region, lung, and esophagus. 2-[18F]-fluoro-2-deoxy-D-glucose positron emission tomography is usually used to identify synchronous multiple primary cancers.

Transplantation of Restored Kidneys From Unrelated Donors After Resection of Renal Cell Carcinoma: Results From 10 Patients.

Purpose: To relieve the chronic shortage of donor kidneys, we conducted a prospective kidney transplantation trial using kidneys removed from 10 unrelated patients (51 to 79 years of age) who had undergone nephrectomy for small renal cell carcinoma (1.5 to 3.9 cm) of low-to-moderate complexity based on RENAL (radius, exophytic/endophytic properties, nearness of tumor to the collecting system or sinus in millimeters, anterior/posterior location relative to polar lines) nephrometry (objective description helpful for operative indication and planning).

A case of tuberous sclerosis complex with concomitant primary hyperparathyroidism due to parathyroid adenoma: a case report.

The patient was a 27-year-old woman who was clinically diagnosed with tuberous sclerosis complex (TSC). She developed hypercalcemia and hypophosphatemia at age 23. In a detailed examination at age 26, she was diagnosed with primary hyperparathyroidism due to parathyroid adenoma.

[A rare case report of incarceration of Lambl's excrescence of aortic valve resulting in myocardial infarction].

We report a rare autopsy case of Lambl's excrescence of the aortic valve resulting in myocardial infarction. A 50-year-old female patient was referred to our hospital, but she died 4 hours after admission due to myocardial infarction. Autopsy disclosed Lambl's excrescence of the aortic valve, which obstructed the main branch of the left coronary artery.

Long-term outcome of angioplasty or stent placement for stenosis of the cavernous or petrous portion of the internal carotid artery.

Percutaneous transluminal angioplasty (PTA) and stent placement are effective in patients with stenosis of the cavernous or petrous portion of the internal carotid artery (ICA), but the long-term outcomes remain unclear. The present study evaluated long-term outcomes in 54 patients treated by PTA or stent placement for stenotic lesions involving more than 50% of the cavernous or petrous portion of the ICA with ischemic symptoms or without ischemic symptoms if cerebral blood flow on single photon emission computed tomography images was decreased by 20% compared with the contralateral side. Follow-up magnetic resonance, three-dimensional computed tomography, and conventional angiography were performed.

Nonsurgical treatment of scalp arteriovenous malformation using a combination of ultrasound-guided thrombin injection and transarterial coil embolization.

Scalp arteriovenous malformations are treated by surgical excision in many patients. We report a patient with a scalp arteriovenous malformation who was successfully treated by a combination of ultrasound-guided thrombin injection (UGTI) and transarterial coil embolization. This patient was a 52-year-old man with a subcutaneous mass in the left retroauricular region.

[Rare case report of solitary ganglioneuroma of the transverse colon].

We report herein a rare case of solitary ganglioneuroma occurring in the transverse colon with a brief literature review. A 45-year-old man was diagnosed as having hemorrhoids by a local medical practitioner and referred to our hospital for further examination. He showed neither signs nor symptoms of neurofibromatosis and multiple endocrine neoplasia.

Emergency off-pump complete arterial revascularization in a patient with dextrocardia.

We describe complete emergency arterial coronary artery bypass grafting performed on the beating heart of a 73-year-old man with situs inversus totalis and triple-vessel disease. The right internal mammary artery was anastomosed to the left anterior descending artery in situ. The first and second obtuse marginal branches of the circumflex coronary and the posterior descending branch of the right coronary artery were sequentially revascularized using the left internal mammary and radial arteries in situ.

Cerebral mature teratoma with malignant transformation in a 52-year-old man: a case report.

A case of adult teratoma with malignant transformation in a 52-year-old male is reported. We describe characteristic CT, histopathologic features and histogenesis of the tumor. Gradual onset of cerebral signs and symptoms was considered to be due to the tumor originating from the silent area of the frontal lobe of the brain and possessing a slowly progressive growth character.

Left ventricular pseudoaneurysm after sutureless repair of subacute left ventricular free wall rupture: a case report.

A 65-year-old woman presenting with a left ventricular pseudoaneurysm 27 months after sutureless repair of a subacute left ventricular free wall rupture complicating acute myocardial infarction is described. An autologous pericardial patch and gelatin resorcin formaldehyde (GRF) glue were used in the repair. A small pseudoaneurysm bulged out over the true aneurysm of the left ventricle.

Cardiac reoperation in a patient with osteogenesis imperfecta: a case report.

A case of a 40-year-old man with dehiscence of the prosthetic aortic valve and recurrence of mycotic aneurysm of the left ventricular outflow tract with osteogenesis imperfecta is presented. He had an operation of aortic valve replacement and direct closure of the mycotic aneurysm for infective endocarditis twenty-one months ago. We performed reoperation of prosthetic aortic valve, patch closure of the mycotic aneurysm and graft replacement of the ascending aorta.

Acute aortic dissection associated with Sheehan's syndrome.

A 69-year-old woman with Sheehan's syndrome who suffered acute Stanford type A aortic dissection had received corticosteroids and thyroid hormones for over 20 years. The entire ascending aorta was replaced in emergency graft replacement. We administered twice the usual dose of methylprednisolone during cardiopulmonary bypass and twice the patient's usual dose of prednisolone from postoperative day 1 to 6.

Surgical treatment of multiple inflammatory aortic aneurysms of the aortic arch and thoracoabdominal aorta.

A 67-year-old woman hospitalized with pleuritis was treated with antibiotics. Although the inflammation was resolved, saccular aneurysms in the aortic arch and thoracoabdominal aorta enlarged rapidly. We conducted graft replacement of the aortic arch, but despite careful blood pressure control, the thoracoabdominal aneurysm rapidly enlarged even further.

Surgical treatment of spontaneous dissection of the superior mesenteric artery: a case report.

A case of a 46-year-old man with spontaneous dissection of the superior mesenteric artery (SMA) demonstrated by ultrasonography is presented. He was successfully treated by emergency aorto-SMA bypass surgery, but complicated with bilateral internal iliac aneurysm. The patient has remained asymptomatic with full employment.

Sutureless technique for subacute left ventricular free wall rupture: A case report of an 85-year-old.

This case was an 85-year-old female who developed left ventricular free wall rupture (LVFWR) of the anterior wall 13 days after an acute myocardial infarction. She was further complicated with an ascending aortic aneurysm and severe aortic regurgitation. The wall was repaired using a sutureless technique with an autologous pericardial patch and GRF glue without cardiopulmonary bypass.

[A rare case of cranial metastasis from hepatocellular carcinoma].

This is the first reported case of magnetic resonance imaging (MRI) findings of cranial metastasis from hepatocellular carcinoma. A 53-year-old male was admitted to our hospital on August 23, 1994, complaining of severe headache and a subcutaneous mass on the forehead. He was diagnosed as hepatocellular carcinoma in February, 1994, at another hospital.