PubMed Health⌕ Search

Biomedical subjects

S Tonouchi

Publications and source records attributed to S Tonouchi.

At least 19 recordsLinked to original sources
PubMed1993

Developments in the delivery of emergency care in Japan and the present state of our hospital's emergency care.

Japan is far behind Western nations in emergency care, such as the United States where paramedics are placed under the M-ICU system and France in which the SAMU system is in force. This paper is an attempt to introduce developments in the delivery of emergency care in the Japanese rural setting and the present state of emergency care delivered at our hospitals, while checking them against national policy.

Ambulances↗
PubMed1992

Morphometrical analysis of nuclear abnormality of tubular tumors of the stomach with image processing.

Nuclear size and shape on histological specimens were used to quantify nuclear abnormality in gastric tubular tumors. A valid technique for this morphometrical analysis by image processing was developed. Furthermore, the present study examined the nuclear size and shape to determine if they were reliable criteria to be used for differential diagnosis. Nuclear area, maximum diameter and maximum width on the histological specimens were defined as factors to represent nuclear size. Nuclear aspect ratio represented nuclear shape. Histological features revealed varied degrees of condensation of nuclei; this was due to different protocols for preparing the histological specimens. This finding indicated that the size of intermediate lymphocytes on the same specimens should be measured as a control in order to estimate the degree of nuclear condensation. The present study also demonstrated that at least 200 nuclei should be measured on the histological specimens to obtain accurate nuclear size and shape. Histologically, the nuclei in benign tubular adenoma and borderline lesions tended to be spindle-shaped, while those in well-differentiated type tubular adenocarcinoma tended to be round and swollen. The nuclei in borderline lesions were larger than those in benign tubular adenoma and smaller than those in well-differentiated type tubular adenocarcinoma. Our results for the above 4 factors corresponded well with these histological findings. The nuclear size and shape on histological specimens were concluded to be reliable criteria for assessing nuclear abnormality in gastric tubular tumors and useful ones for differential diagnosis.

Adenocarcinoma↗
PubMed1991

Morphometrical analysis of structural abnormality of tubular tumors of the stomach with image processing.

Four indices, index of tubular density, index of dispersion of tubular size, degree of complexity of tubular shape and frequency of complex-shaped tubuli, were defined to quantify the structural abnormalities of gastric tumors in morphometrical analysis by image processing. The values of each index corresponded well with the degree of each structural abnormality found pathologically. These indices were considered to be valid for representing their respective structural factors. There were significant differences among the mean values of the scores calculated by a formula using all 4 indices of benign tubular adenoma, borderline lesion and well-differentiated type tubular adenocarcinoma (P less than 0.05). Therefore, the discriminant formula was considered to be valid for integrating these indices and for representing structural abnormality of gastric tubular tumors.

Adenocarcinoma↗
PubMed1988

Alcoholic liver injury in rural Japan.

As regards causes to liver cirrhosis in the latest survey, HB viral cirrhosis accounted for 20.9% and alcoholic cirrhosis 33%, going up to 46.8% in some highly prevalent areas. In Japanese rural areas, there are many occasions for people to drink according to custom like districts in the West where wine is consumed in large quantities, and there are signs of a rise in the prevalence of alcoholic cirrhosis. Besides, the more important thing is that about half of the cases with HB viral cirrhosis and 20% or so of those with alcoholic cirrhosis are complicated with liver cancer, and 31.7% of all types of hepatocirrhosis were complicated with liver cancer. The subject diseases in the present survey, i.e. liver cirrhosis and primary liver cancer, are difficult to diagnose early and poorly responsive to treatment as has been reported in many proceedings of medical societies. Medical institutions that are situated in rural areas of Japan, such as ours, are as yet inadequately staffed and poorly equipped with medical appliances. Moreover, in rural countries an effective educational movement against liver diseases does not seem to be raised yet. All told, we medical workers engaged in the delivery of medical care to rural populations, must do everything in our power for the prevention, early detection, diagnosis and treatment of diseases in the rural communities.

Hepatitis B↗
PubMed1988

[Surgical treatment of the left main trunk and left main equivalent coronary artery disease].

The comparative studies on operative and hemodynamic results following aorto-coronary bypass grafting were performed in 9 patients with left main trunk (LMT) stenosis and 20 with left main equivalent (LME). One of 20 LME had bypass grafts occluded on the postoperative angiogram. There were two operative deaths, one in LMT, another in LME, and one late death. Following results were obtained in 8 LMT (Group I) and 15 LME (Group II) whose all bypass grafts were patent. There were significantly higher operative mortality rate and the incidence of perioperative myocardial infarction in Group I (11.1% versus 5.0%). Cardiac index and left ventricular ejection fraction significantly increased postoperatively in both groups. Mean Vcf and PLVSP/LVESV significantly increased postoperatively in Group II, but not in Group I. Left ventricular anterior segmental wall motion significantly increased in both groups and apical in Group I, whereas it did not in the postero-inferior segment. The completely revascularized patients had a better postoperative left ventricular function comparing with the incompletely revascularized patients. Angina disappeared postoperatively in all patients in Group I and 12 (75%) in Group II. In both groups, NYHA classification was improved from class III or IV preoperatively to class I or II postoperatively. Postoperative 8 years actuarial survival rate was 88.2% in Group I and 84.6% in Group II. In conclusion, it was suggested that much more strict perioperative management and complete revascularization were needed in the patient with LMT.

Adult↗
PubMed1987

[Rupture of false aneurysm of the femoral artery caused by blunt trauma].

The successful surgical repair of a ruptured false aneurysm of the left femoral artery in a 44-years-old male is presented. He was admitted to this hospital with the chief compliant of marked swelling accompanied with severe pain of the left thigh and the past history of a blunt trauma 7 years ago on the left groin? He had also severe anemia with hb 4.4 g/dl. An aneurysm measuring 15 by 8 cm was detected on the arteriogram. The aneurysm was treated by resection and implantation of Gore-Tex graft with good result. The pathological findings strikingly suggested that the false aneurysm was caused by the old blunt trauma. A false aneurysm of femoral artery caused by a blunt trauma is very rare and it's complications include acute arterial occlusion, subsequent ischemic change of lower limb and massive bleeding by the rupture. In conclusion, early diagnosis and surgical treatment are essential for a false aneurysm of femoral artery.

Adult↗
PubMed1986

[Influence of aorto-coronary bypass surgery on left ventricular function and prognosis in patients with severe left coronary artery disease].

The effects of aorto-coronary bypass surgery on left ventricular (LV) function and prognosis were studied in 21 patients with severe left coronary artery disease consisted of 8 left main trunk (LMT) stenosis and 17 left main equivalent (LME) that is the combined disease of left anterior descending (LAD) and left circumflex coronary arteries proximal to the origin of their major branches. One of 21 cases had bypass grafts occluded on the postoperative angiogram. The other 20 cases consisted of 10 cases with previous transmural myocardial infarction (PTMI) and 10 without PTMI had all bypass grafts opened including 20 grafts to LAD. In 10 cases without PTMI, all of LV function parameters markedly improved postoperatively. In the other 10 cases with PTMI, LV ejection fraction significantly increased from 0.53 +/- 0.07 preoperatively to 0.67 +/- 0.04 postoperatively (p less than 0.005). PLVSP/LVESV also increased from 1.85 +/- 0.66 to 2.89 +/- 1.16 (p less than 0.05). In both groups, LV segmental wall motion (SWM) increased in the anterior and apical segment, whereas did not in the postero-inferior segment. In the case with occluded grafts LV function was deteriorated postoperatively. Even in the cases which anterior SWM showed less than 30% (the lowest value in the normal subjects), anterior and apical SWM significantly increased postoperatively in both groups. Angina disappeared postoperatively in all cases but one with PTMI. All cases showed NYHA class III to IV preoperatively, then class I to II postoperatively. Postoperative 8 years actuarial survival rate was 91.0%.

Adult↗
PubMed1985

[The effects of aorto-coronary bypass grafting to totally occluded coronary arteries on left ventricular contractility].

The effects of aorto-coronary bypass grafting (ACBG) on totally occluded coronary arteries (TOCA), postocclusion vessels of which were demonstrated angiographically through collaterals and left ventricular contractility were studied in eleven patients consisted of nine with transmural myocardial infarction (TMMI) on ECG in the area perfused by TOCA and without TMMI. Of eleven ACBG consisting of eight left anterior descending coronary arteries (LAD) and three right coronary arteries (RCA), all eight grafts to LAD were patent, whereas two of three to RCA were obstructed on the postoperative angiogram. The following evaluations were undertaken in the cases with patent grafts. In seven cases with TMMI (six LAD, one RCA), left ventricular ejection fraction (EF) increased from 0.56 +/- 0.08 (Mean +/- SD) to 0.65 +/- 0.07 (p less than 0.01). PLVSP/LVESV slightly increased, but not significantly. Mean Vcf increased from 1.07 +/- 0.33 to 1.83 +/- 0.88 circ/sec (p less than 0.02). Left ventricular segmental wall motion also improved from 23.1 +/- 6.8 to 29.5 +/- 7.2% (p less than 0.01), markedly in the anterior and apical segment. In two cases without TMMI, all of EF, PLVSP/LVESV, Mean Vcf and segmental wall motion improved much more than the cases with TMMI. In conclusion, it was suggested that ACBG to TOCA, especially LAD visualized angiographically through collaterals resulted in the excellent graft patency rate and the significant improvement of left ventricular contractility, even in the cases with TMMI.

Adult↗