[in Japanese]

View full abstract

[in Japanese]

View full abstract

Background : The “hall-ward” in Ninosawa Hospital that admits 25 patients all together is rare and precious material.
Methods : We examined merits and demerits of “hall-ward” using a questionnaire given to the nursing staffs.
Results : Most staffs considered “little oppressiveness” and “being well-lighted by broad windows” as patients' merits, and “little concealment during clothes-change” and “noisiness” as patients' demerits. “Well-understanding between patients and staffs” and “easy in observing patients” were considered to be merits affecting the nursing staff.
Conclusions : These merits of the “hall-ward” highlighted the primary importance of an adequate area and capacity for one bed, fairly high ceiling, broad windows, and a well-designed arrangement of wards.

View full abstract

Background and Aims : Activin is a growth factor which belongs to the TGF-β superfamily and it is produced by several tissues including the feto-placental unit. It is also reported that activin is involved in the regulation of insulin secretion. In the light of these facts it is thought that activin may influence organ development in the fetuses of diabetic mothers. There are few papers on activin in diabetic fetopathy, however, and the links between diabetes in the mother and activin in the fetus was studied. Method : Adult Wistar female rats were injected with streptozotocin and those whose blood glucose levels exceeded 200 mg/dl were determined as diabetic. Fetuses of diabetic and non-diabetic mother rats were delivered by cesarean section on the 20th day of pregnancy and blood was collected. The blood of adult rats was also collected. Serum activin A concentrations were measured by ELISA. Result : There was no significant difference in serum activin A concentrations between diabetic and non-diabetic adult rats. In fetuses, serum. activin A concentrations were higher in those of diabetic mother compared to those of non-diabetic mother. Conclusion : It is suggested that maternal diabetes affects the metabolism of activin in fetuses, but further study is required.

View full abstract

Background : It has been documented that the internal thoracic artery yields better long-term patency rates than saphenous vein grafts for coronary artery bypass grafting. The use of the radial artery for coronary artery bypass grafting is controversial. Radial artery has been used as the promising arterial grafts with the quality similar to the internal thoracic artery. The aim of this study was to evaluate the short-term patency rate of radial artery graft.
Methods : From March to December 1999, radial artery graft was used in 15 patients (14 male and one female, mean age, 60.4 years) undergoing myocardial revascularization. Thirteen patients underwent angiographic studies in the early postoperative period (2-42 weeks after surgery).
Results : Of 12 grafts studied, all were patent, however, 2 grafts (13%) showed string sign. The flow characteristics of the grafts were mainly graft dominant flow pattern.
Conclusions : Our results suggest that with proper care, the radial artery may be used for coronary artery bypass grafting with good early results. Long-term follow-up and angiographic studies will be necessary to establish the merit of the radial artery as a graft for coronary artery operation.

View full abstract

Aim : We studied the effects of relaxing breathing exercises in healthy womens prior to enrollment in the present study.
Methods : All of the subjects had never used relaxation technique.
Examination 1 : The pulse and blood pressure of thirty-five healthy women were measured while the women rested or performed relaxing breathing exercises. Examination 2 : Forty-four healthy women were divided into a relaxing breathing group and a rest group. The brain waves of each woman were measured for 3 minutes before, during, and after the experiment.
Results : Examination 1 : In the relaxing breathing group, the pulse rate was lower after the experiment than before the experiment. The pulse rate in the rest group did not change before and after the experiment. Examination 2 : After the experiment, the amplitude of alpha waves increased in the relaxing breathing group and decreased in the rest group. Although the amplitude of beta waves decreased in the relaxing breathing group and increased in the rest group, the difference was not significant.
Conclusions : Relaxing breathing exercises decrease the pulse rate, compared with that in the rest state, and increase the amplitude of alpha waves. Even when relaxing breathing exercises were performed for the first time, they appeared to have the same effect as other relaxation techniques.

View full abstract

Purpose : Mid-term results of intraoperative radiofrequency ablation (RFA) procedure for the treatment of atrial fibrillation (AF) were evaluated. Methods : A total of 87 patients were followed up for longer than three months after RFA. The mean age of them was 67± 11 years old, including 61 males and 26 females. Preoperatively 64 patients were in persistent AF, 21 had paroxysmal AF and two had atrial flutter. Fifty-eight patients underwent mitral valve repair/replacement concomitantly, including combined CABG or aortic valve replacement (AVR). CABG, AVR and CABG + AVR procedures were performed in 13, five and three patients, respectively. The left atrial RFA lesions were created endocardially in patients with mitral procedures, while epicardially created in patients with AVR/CABG. The right atrial epicardial lesions were common to both groups of patients. The mean follow-up period was 6.3 months ranging from three to 24. Results : No heart muscle or esophageal perforation occurred after RFA. The recovery rate to regular sinus rhythm at the time of three, six and 12 months after surgery was 83%, 88% and 93%, respectively. Conclusions : Mid-term results of RFA suggest that it is safe and effective in the treatment of AF, especially in patients without mitral valve disease.

View full abstract

A case of twin pregnancy associated with HELLP syndrome is reported. The case is unique in that the patient lacked the usual symptoms and signs of hypertension, abdominal right upper quadrant pain, and tenderness. A 26-year-old primiparous woman developed preeclampsia during late pregnancy, antithrombin III activity is more likely to decrease in women with twin pregnancies. After giving birth, blood tests suggested that she had developed the HELLP syndrome (decreased platelet count, impaired liver function). The causes of HELLP syndrome were many and varied, with a large proportion having no obvious cause, the monitoring of AT-III activity and platelet count in women who exhibit a gradual decline in these parameters may help to avoid the development of severe HELLP syndrome.

View full abstract

Two mother-child pairs reviewed their disease history with interviewers once a week for four times while in a hospital. Children completed a CMAS (Children's Manifest Anxiety Scale) and took a CAT (Children Apperception Test), and mothers completed a POMS (Profile of Mood Scale) and a TAT (Thematic Apperception Test). Children exhibited mental health since they were nearing hospital release and they were free from limitations in moving. Although both of the children exhibited good relationships, results of the CAT suggest that there may be some problems with those relationships. One of the two mothers had great troubles concerning her family members, as revealed in the TAT, and she reviewed these troubles in early periods. There are relationships where the mother is very patient but the child is not, or vice versa. There was no consistent effect of reviewing their disease history. The factors which affect children's psychology are prospect of getting out of the hospital, limitations of moving, and relationships between the patients' friends or parents. Some help is needed to adjust the relationships between the patients' friends. And mothers need some help, especially during the early period of hospitalization. Although consistent effects of reviewing their disease history were not observed, reviewing their disease history with psychological tests is useful to examine affective factors on their psychology.

View full abstract

We report a 60-year old male hemodialysis patient with intermittent deep coma due to liver cirrhosis. The patient had a clinical history of hemodialysis (HD) due to hepatonephric syndrome resulting from chronic hepatitis C and alcoholic cirrhosis for 5 years. Serum ammonia level gradually increased, despite the alteration from HD to hemodiafiltration (HDF) and administration of lactulose orally and Aminoleban™ intravenously. The rate of ablation in serum ammonia was about 30% and satisfactory. However, the patient was admitted to the hospital 6 times in 8 months for deep coma and died due to respiratory disturbance at home. Advanced alkalosis was more closely correlated with the onset of deep coma than was ammonia level in this case.

View full abstract

[in Japanese]

View full abstract