[Medication reduction in a convalescent rehabilitation ward].

Background: Senior citizens who have multiple diseases often receive multiple medications (polypharmacy). Because of the increased risk of adverse drug reactions with polypharmacy, trying to minimize the number of medications is important to medical care. Some rehabilitation physicians often treat multiple diseases alone, and hospitalization for rehabilitation provides a good opportunity to improve prescription practices.

Elective single-vessel percutaneous coronary intervention in a vegetative state patient.

A 73-year-old male in a persistent vegetative state underwent percutaneous coronary intervention (PCI) for unstable angina with multiple-vessel stenosis. The maximum dose pharmaceutical therapy was ineffective in controlling his symptoms. The goal of the procedure was to alleviate the patient's severe chest pain and vomiting with minimal invasion and risk.

[Terminal care education and consultation activities in advance of the critical stage of disease by attending physicians at a rehabilitation unit].

Aim: We aimed to examine the effectiveness of information provided by a physician to patients and their family in a geriatric rehabilitation unit for facilitating terminal care decision-making process.

Method: The subjects were 338 patients who entered our rehabilitation unit between July 2005 and June 2007. Of the 338 patients, we provided terminal care consultation for 224 upon admission.

[A case of polypoid type ganglioneuroma of the decsending colon].

A 32-year-old woman came to our hospital with purpose of careful examination for anemia. Colonoscopy was revealed a solitary protrusion with irregular shape covered with red and discolored mucosa of the descending colon. Surface of this lesion was smooth, which had flexibility in dynamic study with infusion of the air and water.

Optimal noninvasive assessment of diastolic heart failure in patients with atrial fibrillation: comparison of tissue doppler echocardiography, left atrium size, and brain natriuretic peptide.

Objective: The aim of this study was to evaluate whether the ratio of early diastolic transmitral velocity to early diastolic mitral annular velocity (E/E') can be applied to identify diastolic heart failure (HF) noninvasively rather than using brain natriuretic peptide (BNP) or enlargement of left atrium (LA) in patients with atrial fibrillation (AF) by comparing the severity of HF symptoms. Moreover, we investigated the relationship between the changes in E/E' and the severity of HF or LA remodeling in the follow-up period.

Methods: We examined 73 patients with nonvalvular AF disease and preserved left ventricular ejection fraction (>50%), ie, patients with diastolic HF accompanied with New York Heart Association (NYHA) functional class I to IV (n = 32, HF group) and those without HF (n = 41, non-HF group).

[Persistent left ventricular systolic dysfunction in a patient with ampulla cardiomyopathy: a case report].

An 81-year-old woman was admitted for treatment of diastolic heart failure. Two weeks after admission, she suffered sudden chest pain without somatic and/or psychological stress. Electrocardiography showed ST elevation in leads V2- V5.

Endoscopic classification of chronic gastritis based on a pilot study by the research society for gastritis.

Background:  Various types of classification of gastritis have been proposed, but no plausible classification has been available until now. The Research Society for Gastritis performed a pilot study to establish an endoscopic classification, taking into consideration the following: (i) ease of use; (ii) permitting everyone the common image; and (iii) presence of histopathological evidence.

Methods:  One hundred and fifty-five patients were enrolled and underwent gastroscopy.