Demonstration experiment of telemedicine using ultrasonography and telerehabilitation with 5G communication system in aging and depopulated mountainous area.

Objective: The challenges of an aging population worldwide are the increased number of people needing medical and nursing care and inadequate medical resources. Information and communication technologies have progressed remarkably, leading to innovations in various areas. 5G communication systems are capable of high-capacity, high-speed communication with low latency and are expected to transform medicine.

A series of seton techniques involving "top-down therapy" for patients with Crohn's disease who initially presented with perianal fistulas.

Objectives: We determined the outcomes of seton treatment through a series of techniques using biological agents (BIOs) in 18 patients with Crohn's disease (CD) who initially presented with perianal fistulas.

Methods: The patients underwent seton drainage using three seton types: a Penrose tube for fistulas with massive purulent discharge, a vessel loop for a small amount of discharge, and a rubber band for unproductive fistulas. If the distal end of the fistula extended more than 4 cm from the anal orifice, the skin and subcutaneous tissue were dissected along the outer edge of the anal sphincter to divide the fistulous tract into two portions.

Proposal for Endoscopic Ultrasonography Classification for Small Pancreatic Cancer.

Backgrounds: Endoscopic ultrasonography (EUS) is used to observe the stricture of the main pancreatic duct (MPD) and in diagnosing pancreatic cancer (PC). We investigate the findings on EUS by referring to the histopathological findings of resected specimens.

Materials And Methods: Six patients with carcinoma in situ (CIS) and 30 patients with invasive carcinoma of 20 mm or less were included.

Pulmonary Reinfection by Nocardia in an Immunocompetent Patient with Bronchiectasis.

Pulmonary reinfection by Nocardia has been rarely reported. We describe a case of pulmonary reinfection by Nocardia in an immunocompetent patient. An 82-year-old immunocompetent woman with bronchiectasis presented with exacerbation of cough.

Fatal fulminant herpes simplex hepatitis following surgery in an adult.

We present a case of a healthy 72-year-old man with herpes simplex hepatitis (HSVH) development soon after ordinary surgery for biliary stones. A sudden onset of hepatitis associated with high fever and leukopenia emerged on postoperative day 5, followed by a rapid and lethal course (died on day 9), despite an acyclovir therapy on day 8. Postmortem liver biopsy revealed positive immunostaining for herpes simplex virus (HSV) type-1.

Dual drainage using a percutaneous pancreatic duct technique contributed to resolution of severe acute pancreatitis.

A 66-year-old man was admitted for severe acute alcoholic pancreatitis with infected pancreatic necrosis (IPN). Abdominal computed tomography revealed an inflamed pancreatic head, a dilated main pancreatic duct (MPD), and a large cavity with heterogeneous fluid containing gas adjacent to the pancreatic head, and extending to the pelvis. The cavity was drained percutaneously near the pancreatic head on admission; another tube was inserted into the pelvic cavity on hospital day 3.

Early dual drainage combining transpapillary endotherapy and percutaneous catheter drainage in patients with pancreatic fistula associated with severe acute pancreatitis.

Background: The development of pancreatic fistula (PF) associated with pancreatic necrosis is of great concern in the management of severe acute pancreatitis (SAP). We expected that early recognition and intervention of PF combined with percutaneous catheter drainage (PCD) for pancreatic infection may improve SAP outcomes.

Methods: Fifteen consecutive patients with SAP were enrolled.

Inflammatory pseudotumour-like follicular dendritic cell tumour of the spleen.

We describe an unusual case of a 73-year-old woman presenting with a solitary splenic mass 8 cm in diameter and an elevation of serum soluble interleukin-2 receptor level. The preoperative diagnosis was primary malignant lymphoma of the spleen. Splenectomy was conducted.

Pancreatic mass as an initial manifestation of polyarteritis nodosa: a case report and review of the literature.

Classic polyarteritis nodosa (PAN) that targets medium-sized muscular arteries and microscopic polyangiitis (MPA), characterized by inflammation of small-caliber vessels and the presence of circulating myeloperoxidase anti-neutrophil cytoplasmic antibodies (MPO-ANCA), are distinct clinicopathological entities of systemic vasculitis. A 66-year-old woman presented with fever, cholestasis and positive MPO-ANCA. Radiological examination showed a pancreatic mass compressing the bile duct.

Evaluating patient self-assessment of health as a predictor of hospital admission in emergency practice: a diagnostic validity study.

Background: Emergency departments deal with large patient loads on a day-to-day basis. The importance of patient self-assessment in the triage process has not been fully considered when determining the need for hospital admission.

Objective: To determine the validity of a series of self-administered triage questions in determining the need for hospitalisation in the emergency setting.

Surgical treatment for osteochondromas in pediatric digits.

Purpose: Osteochondromas in pediatric digits occasionally require surgical treatment due to restricted finger motion and/or angulatory deformity. However, the patients are growing children, and the indication for surgical treatment is controversial. We reviewed our cases in order to clarify characteristics of tumors and to report surgical outcomes.

[Continuous treatment with S-1, an effective strategy for an older adult with unresectable advanced pancreatic cancer with peritoneal dissemination-a case report].

The prognosis for advanced pancreatic cancer with peritoneal dissemination is extremely poor, and no effective standard therapy has been established. We present a case of a very old patient whose QOL improved shortly after administration of only S-1 to treat advanced pancreatic cancer with peritoneal dissemination. A 85-year-old man presented to our hospital with anorexia and loss of weight.

Correlations of anatomical parameters in dynamic pelvic CT and conventional defecography for patients with rectal prolapse.

Purpose: To evaluate the correlations of anatomical parameters between dynamic pelvic CT (D-PCT) and conventional defecography (CD) for patients with rectal prolapse.

Material And Methods: Anatomical parameters in multislice CT scanning of the pelvis performed at rest and during simulated defecation (D-PCT) were studied with those of CD to evaluate the correlations in both methods for 10 patients with rectal prolapse.

Result: The correlation coefficients of the pubococcygeal line and the pubosacral line were r=0.

[A case of advanced gastric cancer with peritoneal metastasis that responded to paclitaxel plus 5-FU therapy].

We report a case in which paclitaxel (PTX) plus 5-FU therapy was remarkably effective for advanced gastric cancer with peritoneal metastasis. The patient was a 41-year-old woman who had type 4 gastric cancer with peritoneal metastasis. PTX plus 5-FU therapy was performed.

[Omega-3 fatty acids in mood disorders].

The etiology and treatment of mood disorders has not yet been elucidated. Omega (omega)-3 fatty acids are essential fatty acids, which cannot be synthesized in the human body. Eicosapentanoic acid (EPA) and docosahexaenoic acid (DHA) are representative omega-3 fatty acids which are found in fish (eg.

[Present condition of home care treatment at Shinshiro Municipal Hospital].

Shinshiro Municipal Hospital is situated in a mountainous region of Oku-Mikawa area at the East side of Aichi prefecture. Because of this geographical location, there are relatively higher numbers of elderly patients living alone in comparison to other regions of Japan. Our hospital consists of a general ward (255 beds), recuperation area combined with a medical care ward (46 beds), and a visiting nurse care unit.

Takayasu arteritis with multiple cardiovascular complications.

A 60-year-old Japanese woman first presented in 1990 with effort angina. She underwent coronary angiography and was diagnosed with bilateral coronary ostial stenosis and Takayasu arteritis. Coronary artery bypass graft surgery (CABG) for multiple vessels was attempted, but the blood flow in the bilateral internal thoracic and gastroepiploic arteries was to poor for a donor artery, and the calcification of the ascending aortic wall was too severe for anastomosis of saphenous vein grafts.

Angiographically verified progression of moyamoya disease in an adult. Case report.

The authors present the case of a 37-year-old man with definite moyamoya disease in whom angiographic findings drastically changed. The patient presented with left hemiparesis due to lacunar infarction. Angiography initially disclosed a narrow right carotid artery (CA) siphon and severe stenosis of the horizontal segment of the left middle cerebral artery.

Plasma concentrations of brain natriuretic peptide in patients with subarachnoid hemorrhage.

Background And Purpose: Hyponatremia after subarachnoid hemorrhage (SAH) is commonly associated with diuresis and natriuresis, but the causes are still controversial. We investigated whether brain natriuretic peptide (BNP) was related to such hyponatremia.

Methods: Plasma BNP concentrations were measured by immunoradiometric assay in 18 patients at 0 to 2 days (period 1), 7 to 9 days (period 2), and > 14 days (period 3) after SAH.

Postcontrast magnetic resonance imaging to predict progression of traumatic epidural and subdural hematomas in the acute stage.

Objective: We investigated the possibility of predicting the progression of traumatic epidural hematomas (EDHs) and subdural hematomas (SDHs), in the acute stage, by using postcontrast magnetic resonance imaging (MRI) with gadolinium-diethylenetriaminepentaacetic acid.

Methods: From January 1990 through December 1996, 41 patients with 43 hematomas (21 EDHs and 22 SDHs) underwent postcontrast MRI within 24 hours after injury. T1-weighted MRI was performed by using the spin echo method, after the administration of 0.

[Clinical effects of postoperative immunochemotherapy with a combination of 5-FU, CDDP and lentinan for stage IVb gastric carcinoma and long-term pharmacokinetic studies on CDDP and 5-FU].

Eleven patients with postoperative-stage IVb gastric cancer were treated by combined administration of CDDP, 5-FU and Lentinan. CDDP was given intravenously at 20 mg/body on days one to five. At the same time, 5-FU was continuously administered 250 or 500 mg/body/day via the central venous catheter for more than two weeks, while Lentinan was given at the dose of 2 mg per week.

[Laser prostatectomy--image analysis by transurethral ultrasonography].

Background: Conventional transurethral Nd:YAG laser ablation of the prostate does not significantly reduce the volume of prostate and patients frequently experience post-operative urinary retention. Thus in the present study, prostatic tissue was extensively vaporized with laser fiber to produce a definite cavity during the operation.

Methods: Between August 1993 and April 1995, laser prostatectomy utilizing Ultraline was carried out on 91 patients with BPH, 38 of these patients had histories of urinary retention.