[Successful Two-stage Surgical Treatment of Acute Type A Aortic Dissection with Mesenteric Ischemia].

We report the case of a patient with acute type A aortic dissection associated with mesenteric ischemia who underwent superior mesenteric artery (SMA) bypass grafting prior to aortic repair, and obtained a satisfactory outcome. A 70-year-old man presented with sudden chest pain. Computed tomography( CT) revealed acute type A aortic dissection with occlusion of the celiac artery and severe stenosis of the SMA.

Randomized clinical trial comparing long-term quality of life for Billroth I versus Roux-en-Y reconstruction after distal gastrectomy for gastric cancer.

Background: Patients' quality of life (QoL) deteriorates remarkably after gastrectomy. Billroth I reconstruction following distal gastrectomy has the physiological advantage of allowing food to pass through the duodenum. It was hypothesized that Billroth I reconstruction would be superior to Roux-en-Y reconstruction in terms of long-term QoL after distal gastrectomy.

The treatment of femoral neck fractures: results using cephalocervical screws with sliding mechanism.

Background: A new device for the treatment of femoral neck fractures that uses 2 cephalocervical screws in a sliding mechanism allowing linear intraoperative and postoperative compression has been developed. The purpose of this retrospective study was to determine the results using this device for the treatment of stable and unstable femoral neck fractures.

Methods: Between November 2007 and November 2011, 61 consecutive skeletally mature patients with femoral neck fractures were treated with a new cephalocervical screw (Dual SC screw; KISCO DIR Co.

[A case of gastric cancer with peritoneal dissemination and massive ascites successfully treated with S-1/docetaxel therapy].

A 49-year-old woman who complained of abdominal bloating and numbness in the bilateral lower limbs was diagnosed as advanced scirrhous gastric cancer with massive ascites. The biopsy specimen showed a poorly-differentiated adenocarcinoma. She was therefore treated with combined chemotherapy of tri-weekly docetaxel(40mg/m2, day 1, 22)and S-1(60mg/m2, day 1-14 with 1-week rest)for unresectable gastric cancer.

Recent advances in cytokines in cutaneous and systemic lupus erythematosus.

Lupus erythematosus (LE) includes a broad spectrum of diseases from a cutaneous-limited type to a systemic type. Systemic lupus erythematosus (SLE) is a systemic autoimmune disease which affects multiple organs. Cutaneous lupus erythematosus (CLE) includes skin symptoms seen in SLE and cutaneous-limited LE.

[Use of transport medium in sputum bacterial culture examination of lower airway infection].

Our medical institution does not have a bacterial culture facility, requiring outsourcing of bacterial culture tests. Due to the time elapsed from the time of specimen collection to culturing, the identification of causative bacteria in respiratory tract infections tends to be difficult. We therefore used transport medium for sputum bacteria examinations.

Helicobacter pylori infection in children with chronic idiopathic thrombocytopenic purpura.

Background: Recently a high prevalence of Helicobacter pylori infection has been reported in adult patients with chronic idiopathic thrombocytopenic purpura (cITP). Furthermore, after H. pylori eradication therapy in such patients, their platelet counts have been observed to increase, suggesting that H.

[Psoas compartment block for surgery of the femoral neck (trochanteric) fracture in a patient with severe heart failure due to rheumatoid myocarditis].

A 72-year-old female with severe heart failure due to rheumatoid myocarditis underwent open reduction of the left femoral neck (trochanteric) fracture. We performed psoas compartment block (PCB) at L3/4 level in the lateral position with the fractured side up, using a 22 G Tuohy needle to inject 10 ml of normal saline and 20 ml of 2% mepivacaine. Anesthesia was maintained with propofol (1-2 mg.

End colostomy using stapling device.

Our experiences concerning the end colostomy using the stapling method are reported. The anvil which has been inserted to the proximal end of the colon and purse string suture with the skin is engaged the anvil shaft, and then, is fired. This operative procedure is simple, safe and convenient, and we can expect a uniform and satisfactory outcome.

A case of primary intrahepatic sclerosing cholangitis (PISC) complicated with atypical biliary epithelial proliferation.

A 70-yr-old woman was admitted to our hospital with duodenal ulcer and anemia. The result of liver function test was abnormal and showed persistent elevated alkaline phosphatase levels. Thus, after recovery from duodenal ulcer, endoscopic retrograde cholangiopancreatography (ERCP) was performed; the characteristic "beaded" appearance with band-like strictures and saccular outpouchings affecting the intrahepatic biliary system were found.

Primary torsion of the greater omentum.

A case with primary torsion of the greater omentum is reported. This pathological condition is an uncommon cause of acute abdominal emergency and it is very difficult even for general surgeons to differentiate this from other acute abdomen. The etiology remains unknown and the treatment of choice is resection of the affected organ.

A case of traumatic intramural hematoma of the duodenum effectively treated with ultrasonically guided aspiration drainage and endoscopic balloon catheter dilation.

A 52-year-old man was admitted on February 15, 1990, with hiccups and vomiting. He had been well until 13 days before admission when he stumbled and fell when intoxicated, striking his abdomen. A diagnosis of intramural hematoma was made with computerized tomography and sonography of the abdomen after admission, revealing a mass that was intimately related to the duodenum.

[A case of Akiyami C disease, infected in the area of Yoshino].

A 47-year-old male was admitted because of persistent jaundice. Akiyami C disease was diagnosed by serological tests using the microscopic agglutination tests. The source was considered to be a water contaminated with leptospiras which he had drunk while working at a civil engineering job.

Side-to-side choledochoduodenostomy: a reappraisal based on a study of 70 patients.

We experienced a total of 70 side-to-side choledochoduodenostomy cases and 80% of them were indicated for gallstone disease patients. There were no early postoperative complications, but intrahepatic gallstones developed in 2 cases. The size of the stoma and the width of the common duct were reduced about 30% within 3 postoperative months.