Some dental patients have histories of adverse reactions to local anesthesia. The aim of the present study was to investigate the frequency of allergy to local anesthetics of dental patients who had histories of adverse reactions to local anesthesia based on the results of allergy tests in our institute over a period of 5 years. We investigated the past medical records of dental patients retrospectively, and twenty patients were studied. Three of the 20 showed a positive or false-positive reaction in the intracutaneous test, and one patient showed a false-positive reaction in the challenge test. Our results suggest that the frequency of allergy to local anesthetics is low even if patients have histories of adverse reactions to local anesthesia. However, allergy tests of local anesthetics should be performed in patients in whom it is uncertain whether they are allergic.
A detailed investigation was carried out on the schizophrenics who committed suicide at the Tokyo Metropolitan Hospital Matsuzawa during the last 30 years. Of these 58 schizophrenics, 52 cases (male 25, female 27) were studied in this report. The mean age of suicide patients was 38.6 years (male: 34.3 years, female: 42.6 years); in males the suicide occurred between 20 and 39 years (80%), while females showed a wider distribution with two peaks in the 25 to 34 years group (26%) and the 40 to 54 years group (41%). 88% (22/25) of males were unmarried, whereas only 33% (9/27) of the women were unmarried. Suicide methods were comprised of hanging (51.9%-27 cases), being run over by a streetcar (28.8%-15 cases), drowning (6 cases), jumping off a high building (3 cases) and intoxication by creosol liquid soap (1 case). In case of male patients hanging was most frequent (72%), followed by jumping into a streetcar to get run over (24%). Likewise, hanging and jumping into a streetcar were most frequent in females (33.3%, respectively), followed by drowning (22.2%), a method selected by females only. From 1951 to 1960 (right before and after the introduction of psychopharmacotherapy) hanging ranked first, but the suicide methods were shifted to the jumping into a streetcar and drowning after installation of the Open-Door-System (around the years 1961-1970). During the last 10 years (from 1971 to 1980) suicide by jumping from a high building increased. Suicide committed in the open ward occurred 9 times only (17.3%); it was, therefore, a much rarer occurrence than had been expected. This fact may show that such an open ward system would be associated with a relatively low risk of suicide. After introduction of psychiatric pharmacotherapy and as social rehabilitation continued, the incidence was relatively stable and no increase was found in our data. Only 4 patients (7.7%) left suicide notes, which made it difficult to draw a clear conclusion on the motivations. Twenty-six cases (50%) died by the first attempted suicide, but in 13 cases (25%) suicide was finally accomplished after the second trial or more. Women performed several repeated suicide attempts (37%), whereas the male patients died at the first or second attempt (88%). Hospitalization lasted on an average for 5 years and 8 months (male: 3 years and 8 months, female: 7 years and 6 months); the shortest stay was 2 days and the longest was 25 years and 11 months.(ABSTRACT TRUNCATED AT 400 WORDS)
Background and Aim. It is difficult to master the skill of discriminating gastric adenoma from early gastric cancer by conventional endoscopy or magnifying endoscopy combined with narrow-band imaging, because the colors and morphologies of these neoplasms are occasionally similar. We focused on the surrounding gastric mucosa findings in order to determine how to discriminate between early gastric cancer and gastric adenoma by analyzing the characteristics of the gastric background mucosa. Methods. We retrospectively examined 146 patients who underwent endoscopic submucosal dissection for gastric neoplasm between October 2009 and January 2015. The boundary of atrophic gastritis was classified endoscopically according to the Kimura-Takemoto classification system. Of 146 lesions, 63 early gastric cancers and 21 gastric adenomas were ultimately evaluated and assessed. Results. Almost all gastric adenomas were accompanied by open-type gastritis, whereas 47 and 16 early gastric cancers were accompanied by open-type and closed-type gastritis, respectively (p = 0.037). Conclusions. The evaluation of the boundary of atrophic gastritis associated with gastric neoplasms appears to be useful for discrimination between early gastric cancer and gastric adenoma. When gastric neoplasm is present in the context of surrounding localized gastric atrophy, gastric cancer is probable but not certain.
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