This study was undertaken to evaluate the effect of increasing the dialysate sodium concentration on myocardial ischemia assessed by EKGs taken immediately before and after dialysis in 43 hemodialysis patients. An increase in the R wave (V5 + V6) by more than 5 mm was seen in 26 patients with standard sodium dialysate, while only 12 cases showed the same changes after a high sodium dialysis. These was a positive correlation between an increase in R wave amplitude and the weight loss/dry weight ratio of patients only after standard sodium dialysis (r = 0.74, p < 0.001). Relative high sodium dialysate is beneficial during dialysis and reduce the incidence of myocardial ischemia and unpleasant disequilibrium syndrome.
A rare case of follicular dendritic cell (FDC) sarcoma is reported. A 71-year-old womanwas admitted for evaluation of constipation. Computerized tomography showed cervical, supradavicular, retroperitoneal, and paraaortic lymphadenopathies. Histological findings from a cervical lymph node revealed Hodgkin's disease at first. But tumors that arose both in the cervical and the left interscapular regions during the chemotherapy were immunohistochemically confirmed to be of follicular dendritic cell origin. The ultrastructural findings were consistent with those of FDC sarcoma. FDCsarcoma is a rare nonlymphoid cell-derived malignant tumor originating from the lymphoid tissue. The diagnosis of FDCsarcoma is most accurately established by immunohistochemical methods, using its specific markers. (Internal Medicine 39: 950-955, 2000)
Vibrio vulnificus infection often causes serious or fatal disease. Recently, in Japan there have been numerousreports of Vibrio vulnificus infection. Here, wereport a successfully treated case of Vibrio vulnificus septicemia with shock, disseminated intravascular coagulation (DIG) and necrotizing cellulitis in a middleaged heavy drinker with chronic alcoholic liver disease. On reviewing 38 cases in Japan including ours, the overall mortality rate was 68%. Although the incidence is relatively low, it is recommendedto warn patients in the high risk category, such as liver disease patients, to avoid raw fish and shellfish and limit sea water exposure.
suMMARY The best way to record the right ventricular wall by echocardiography was investigated in 40 consecutive adult subjects with normal hearts and with various congenital and acquired cardiac disorders.The right ventricular wall echo was recorded by (1) (1) to find out the optimal method for recording the right ventricular wall; (2) to determine the normal range of the right ventricular wall thickness; and (3) to examine the usefulness for the diagnosis of right ventricular hypertrophy.
Background: Basic clinical skills training in the Japanese medical education system has traditionally incorporated on-the-job training with patients. Recently, the complementary use of simulation techniques as part of this training has gained popularity. It is not known, however, whether the participants view this new type of education program favorably; nor is the impact of this program known. In this study we developed a new simulation-based training program in phlebotomy for new medical residents and assessed their satisfaction with the program
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