Activated carbon particles are taken selectively up by lymphatics when injected into the tissues and visualize regional lymph nodes colored black. Furthermore, carbon particles adsorb a large amount of the anticancer agent mitomycin C (MMC) on their surface and release the drug reversibly. Using these properties of activated carbon particles, we have applied it for lymph node dissection and chemotherapy of lymph node metastasis. After injection of carbon particles, regional lymph nodes of the stomach were found to be black; blackened lymph nodes extending widely from perigastric to para-aortic nodes were identified from other structures. Four hundred and twenty-four patients with gastric cancer were treated with this method for lymph node metastasis during 1984-1988. Involved nodes were generally colored in high incidence, about 70% of involved ones except for highly positive nodes, which was the same as noninvolved nodes. In highly positive nodes, the colored incidence was decreased to about 48%. The cumulative 5-year survival rate of the patients treated with this series was 74.6%, which was significantly higher than the figures without this method.

Informal care by family members still plays an important role in home care after acute stroke. This study determined the clinical and demographic factors, such as family structure, that predict discharge to home and length of hospital stay (LOS) after acute stroke hospitalization. We reviewed the sex, age, family structure before stroke, type of stroke, size of the lesion, activities of daily living (ADL) function at discharge, discharge destination, and LOS of stroke patients (114 cerebral infarctions and 44 intracerebral hemorrhages) admitted to a neurosurgical hospital. Patients with cerebral infarction were older than those with intracerebral hemorrhage (median 75 vs 66 years). Ninety-eight were discharged to home (62%). In the logistic regression analysis, low ADL function, medium or large infarction, and intracerebral hemorrhage (vs lacunar infarction) were significantly associated with discharge to a destination other than home. Of the patients discharged home, low ADL function was strongly associated with LOS in the multiple regression analysis. In addition, living with a spouse only had the opposite effect on LOS in men and women ( p = 0.050 and 0.071, respectively). LOS tended to be shorter for men with a wife, but longer for women with a husband. The structure and gender roles in a stroke patient's household may need further attention for the efficient use of hospital resources.gender; family; stroke outcome; hospitalization © 2005 Tohoku University Medical PressStroke remains the third highest cause of mortality in Japan, resulting in 130,000 deaths per year (Ministry of Health, Labour and Welfare 2004). Although the fatality rate has decreased in the last few decades, a large number of acute survivors still suffer functional disabilities that lead to institutionalization and a consequent economic burden on the patient's household and society as a whole. With the rapid increase in the population of elderly, it is even more important to identify stroke patients who are at risk of a prolonged hospital stay in order to enhance their return home.

No abstract

No abstract

No abstract