Divergent effects of unilateral and subtotal nephrectomy on insulin sensitivity in rats.

Objectives: Insulin resistance is associated with chronic renal failure, which may amplify its cardiovascular pathologic manifestations. We previously showed the presence of insulin resistance in mild renal insufficiency due to chronic glomerulonephritis. These observations may be explained by a decrease in insulin sensitivity due to renal dysfunction.

[Rapid prototyping of the larynx for laryngeal frame work surgery].

A detailed understanding of the three-dimensional (3D) structure of the larynx is important for determining appropriate methods and approaches for laryngeal frame work surgery. In this study, a 3D laryngeal model was constructed based on postoperative helical CT data obtained after lateral cricoarytenoid muscle (LCA) pull surgery (Iwamura) for the treatment of unilateral vocal fold paralysis. The anatomical configurations of the arytenoid cartilages and the optimal approaches for laryngeal frame work surgery were then examined.

[Susceptibilities of bacteria isolated from patients with lower respiratory infectious diseases to antibiotics (2002)].

From October 2002 to September 2003, we collected the specimen from 476 patients with lower respiratory tract infections in 16 institutions in Japan, and investigated the susceptibilities of isolated bacteria to various antibacterial agents and patients' characteristics. Of 584 strains that were isolated from specimen (mainly from sputum) and assumed to be bacteria causing in inflammation, 578 strains were examined. The breakdown of the isolated bacteria were: Staphylococcus aureus 77, Streptococcus pneumoniae 103, Haemophilus influenzae 95, Pseudomonas aeruginosa (non-mucoid) 61, P.

[ENT manifestations of gastroesophageal reflux disease (GERD)].

Gastroesophageal reflux disease (GERD) has been associated increasingly with ear, nose, and throat (ENT) signs and symptoms. However, the cause and effect relationship between these two clinical entities are far from established. Many patients diagnosed initially with GERD as the cause of laryngeal signs do not symptomatically or laryngoscopically respond to aggressive acid suppression and do not have abnormal esophageal acid exposure by pH monitoring.

[The successful anesthetic management of a patient with pheochromocytoma using prostaglandin E1 and a novel, short-acting beta-adrenergic blocker: landiolol hydrochloride].

A 48-year-old male with a history of hypertension was scheduled to undergo resection of a tumor in the upper region of the left kidney. However, his operation was postponed once because pheochromocytoma was suspected from the tumor location, sweating, and insomnia in addition to hypertension. The measurement of plasma catecholamines confirmed the presence of pheochromocytoma.

[Susceptibilities of bacteria isolated from patients with lower respiratory infectious diseases to antibiotics (2001)].

From October 2001 to September 2002, we collected the specimen from 370 patients with lower respiratory tract infections in 16 institutions in Japan, and investigated the susceptibilities of the isolated bacteria to various antibacterial agents and antibiotics and patients' characteristics. Of 458 strains that were isolated from specimen (mainly from sputum) and assumed to be bacteria causing in inflammation, 456 strains were investigated. The breakdown of the isolated bacteria were: Staphylococcus aureus 69, Streptococcus pneumoniae 72, Haemophilus influenzae 85, Pseudomonas aeruginosa (non-mucoid) 44, P.

[A case of serious aspiration pneumonia associated with multiple cerebral infarctions and Alzheimer's disease followed by hospital and home care service team].

A 81-year-old man, who had been diagnosed in multiple cerebral infarction and Alzheimer's disease, was followed up in his local clinic since 1997. He had been bedridden before admission, but could eat. He was admitted with severe aspiration pneumonia in December 1999.

[Recent findings based on the results of the post-marketing surveillance of vancomycin hydrochloride for intravenous infusion].

Vancomycin Hydrochloride for Intravenous Infusion (VCM) was launched as a therapeutic agent for infections caused by Methicillin-Cephem Resistant Staphylococcus aureus (MRSA) in October 1991. The results of the post-marketing surveillance conducted in accordance with GPMSP for 6 years after the launch are as follows. The population studied included 3,037 patients administered this drug intravenously at 1,099 institutions across Japan from October 1991 through September 1997, and among which, 28 patients were excluded because the follow-up was impossible.

A comparison of voice quality ratings made by Japanese and American listeners using the GRBAS scale.

The GRBAS scale is a widely used method for perceptual evaluation of voice quality. Two linguistically diverse groups of listeners (Japanese and American) rated 35 voice samples using the GRBAS scale. The ratings obtained from the two groups were compared to determine if the different linguistic background affected the use of the GRBAS scale.

[Septic shock associated with pyogenic liver abscess rescued with percutaneous transhepatic abscess drainage].

We report a case of septic shock associated with pyogenic liver abscess rescued with percutaneous transhepatic abscess drainage (PTAD). A 70-year-old male patient was admitted to our outpatient department of internal medicine with general fatigue, dullness of bilateral shoulders and extremities, appetite loss, weight loss, headache, and vertigo. Laboratory tests showed severe inflammatory indications, anemia, and high values of hepatobiliary enzymes and blood sugar.

[Susceptibilities of bacteria isolated from patients with lower respiratory infectious diseases to antibiotics (2000)].

From October 2000 to September 2001, we collected the specimen from 410 patients with lower respiratory tract infections in 16 institutions in Japan, and investigated the susceptibilities of isolated bacteria to various anti-bacterial agents and antibiotics and patients' characteristics. Of 499 strains that were isolated from specimen (mainly from sputum) and assumed to be bacteria causing in inflammation, 493 strains were investigated. The breakdown of the isolated bacteria were: Staphylococcus aureus 78, Streptococcus pneumoniae 73, Haemophilus infiuenzae 99, Pseudomonas aeruginosa (non-mucoid) 64, P.

Quantification of simulated corneal haze by measuring back-scattered light.

The Scheimpflug anterior eye segment analysis system EAS-1000 was modified to specifically quantitate the degree of corneal haze. In order to confirm the basic measurement performance of the new system, TSPC-3 hazemeter, in vitro experiments were conducted. Using white latex microsphere solutions, tests were performed for the linearity of the measurements, the influence of slit lamp illuminance and the influence of the length of the light path through the latex solution.

[Susceptibilities of bacteria isolated from patients with lower respiratory infectious diseases to antibiotics (1999)].

From October 1999 to September 2000, we collected the specimen from 430 patients with lower respiratory tract infections in 17 institutions in Japan, and investigated the susceptibilities of isolated bacteria to various antibacterial agents and antibiotics and patients' characteristics. Of 515 strains that were isolated from specimen (mainly from sputum) and assumed to be bacteria causing in inflammation, 506 strains were investigated. The breakdown of the isolated bacteria were: Staphylococcus aureus 78, Streptococcus pneumoniae 101, Haemophilus influenzae 104, Pseudomonas aeruginosa (non-mucoid) 58, P.

[Propofol and sevoflurane--a comparison of anesthesia for laryngomicrosurgery].

Laryngomicrosurgery has some special characteristics. It is under much stress such as intubation and direct laryngoscopy during a short operation time. Therefore both adequate anesthesia and quick recovery are needed.

[Usefulness of 7 day therapy with cefluprenam in the management of respiratory tract infections].

Efficacy and safety of a newer injectable cephalosporin, cefluprenam (CFLP) on cases with bacterial pneumonia and chronic respiratory tract infections were evaluated at a dose of 1g (potency), d.i.d for 7 days.

Total auricular reconstruction with a three-dimensional costal cartilage framework.

Microtia (hypoplasia of the auricle) is known to result from incomplete development of the auricle during embryonic development so that the size and shape of the deformity vary from case to case. Total auricular reconstruction for microtia is dependent on the degree of hypoplasia in comparison to that of the normal auricle on which the specific reconstruction method is based. I have classified microtia into 3 major types: 1) The lobule type.

Secondary reconstruction for unfavorable microtia results utilizing temporoparietal and innominate fascia flaps.

Unfavorable results in reconstruction of the auricle for microtia can be encountered from time to time, in which secondary reconstruction of the auricle is usually performed. One must note that secondary reconstruction is much more difficult than primary reconstruction for the following reasons: (1) all necrotic skin and scar tissue from the primary reconstruction must be removed, thus limiting the surface area of the skin for the secondary reconstruction; (2) the presence of scar tissue and loss of tensility in the subdermal layer makes it difficult to construct a subcutaneous pocket for grafting of the three-dimensional costal cartilage framework; and (3) in patients with full-thickness skin grafts in the conchal and postauricular regions, contraction of the grafted skin was noted. In order to resolve these problems, the temporoparietal fascia flap was used in the first-stage three-dimensional frame grafting operation, and the innominate fascia flap, obtained from the same site as the temporoparietal fascia in the first-stage operation, was used for the second-stage operation.

Modification of the stages in total reconstruction of the auricle: Part IV. Ear elevation for the constructed auricle.

The contour of the constructed structures of the anterior surface of the auricle tends to diminish after ear elevation; thus it is extremely difficult to obtain the proper projection of the constructed ear without destroying the contour of these structures. There have been numerous articles concerned with ear elevation, even though most methods or procedures are plagued with problems. The major factors concerned with ear elevation have been described and stated in a previous article.

Modification of the stages in total reconstruction of the auricle: Part III. Grafting the three-dimensional costal cartilage framework for small concha-type microtia.

The characteristic features of small concha-type microtia are the existence of the remnant ear and lobule and a small indentation representing the concha. Presently, the microtic disorder known as hypoplasia of the middle third of the auricle has the featured characteristics of a well-developed lobule, scapha, and helix and the existence of a small concha. Therefore, from these clinical aspects and features, the major criterion for classification for this particular type of microtia (small concha-type microtia) is the presence of the small concha.

Modification of the stages in total reconstruction of the auricle: Part II. Grafting the three-dimensional costal cartilage framework for concha-type microtia.

Among the microtic disorders, those with the remnant ear, ear lobule, concha, acoustic meatus, tragus, and incisura intertragica are classified as concha-type microtia. From these characteristic factors, concha-type microtia has been thought to be a milder form of microtic disorder in comparison with lobule-type microtia. The constructed modified three-dimensional costal cartilage framework is grafted to the superior portion of the auricle and fixed to the inferior remnant cartilage of the auricle (conchal portion).

Modification of the stages in total reconstruction of the auricle: Part I. Grafting the three-dimensional costal cartilage framework for lobule-type microtia.

Total auricular reconstruction for microtia is dependent on the fabricated three-dimensional costal cartilage framework, with all the auricular features and the skin flaps formed and utilized to cover the three-dimensional framework, in which extreme caution is required. Furthermore, other factors, such as contraction of the skin graft, use of the remnant ear cartilage in construction of the tragus, and the number of surgeries required, all affect the final results of total auricular reconstruction for microtia, especially with reference to the contour of the constructed ear, morphologic locations of the auricular features, contraction, circulatory dysfunction, resorption, etc. The grafting of the three-dimensional framework is the first stage of a two-stage surgical method for total auricular reconstruction without resorting to skin grafts, free composite grafts, and additional surgical procedures.

Pushing exercise program to correct glottal incompetence.

A voice therapy program using pushing exercises to correct glottal incompetence is described. The program utilizes various types of instrumentation to determine whether or not a given patient is likely to benefit from the treatment. The program also provides feedback of target voices.