Gen Konemori

Ultrasonography improves diagnostic accuracy of acute appendicitis and provides cost savings to hospitals in Japan.

A cost analysis based on changes in patient care was used to evaluate the utility of abdominal ultrasonography in both the clinical management of patients clinically suspected of having acute appendicitis and in reducing expenditure of hospital resources. Among the 200 patients suspected of having acute appendicitis, 57 actually had acute appendicitis. Interpretation of appendiceal ultrasonographic results was 98.5% accurate. The ultrasonographic result led to changes in the treatment of 103 patients. Moreover, ultrasonography led to the prevention of unnecessary appendectomy in 25 patients, providing a savings to the hospital of about Yen 8,013,450 (

Permanent pacemaker therapy in a community with many elderly people

65,150), and prevented unnecessary hospital admission for 78 patient‐days, thus saving the hospital approximately Yen 1,199,250 (

Application of the box plot to evaluate serum lipid levels and apolipoprotein levels in patients with cerebral infarction and diabetes mellitus

9750). The cost of performing the 200 ultrasonographic examinations was about Yen 1,096,176 (

Lipoprotein(a) and Other Risk Factors for Cerebral Infarction

8912), and thus the overall savings to the hospital was approximately Yen 40,590 (

The effect of smoking habit on aortic pulse wave velocity using a new method for data analysis

330) per patient. Ultrasonography performed in patients with suspected acute appendicitis improves patient diagnostic accuracy, thus leading to more appropriate selection of patient treatment and reduced hospital expenditure.

Indices for Prediction of Coronary Sclerosis with Particular Reference to Apo-B/Apo-AI Ratio

To clarify the utility of permanent pacemakers in a society composed largely of elderly people, clinical characteristics, pacemaker characteristics, outcome, and quality of life in a total of 116 patients in a community with many (19.6%) elderly people were evaluated after permanent pacemaker implantation. Patients above age 65 accounted for 88.8%, while those above 80 years accounted for 24.1%. Syncope was the most common observation before pacemaker implantation and emergency care was needed in 35% of patients. Sick sinus syndrome and complete AV block were seen in a majority, while atrial fibrillation with bradycardia was seen in a minority of patients. Although the physiological pacing and ventricular pacing mode (VVI) were used in about 50% each, recently the physiological pacing mode has markedly increased. During the mean follow-up of 26.1 +/- 16.2 months, only four patients died. NYHA 3 symptom improved to NYHA 1 after pacemaker implantation and 72.5% patients of all cases returned to their jobs. We conclude that the permanent pacemaker is effective in improving symptoms and reducing the death rate in elderly patients.

Clinical Application of Ultrasonographic Diagnosis of Gastrointestinal Disease

Serum levels of lipids and apolipoproteins were determined in patients with cerebral infarction during the chronic stage three months after onset, and these patients were classified into the group with diabetes mellitus and that without diabetes mellitus. These levels were compared with the levels observed in the control group and the diabetes mellitus-only group using the box plot which is a procedure employed in exploratory data analysis. a. Compared to the control group, the levels of T.G., apo B, Apo C-II and Apo C-III were higher, that of HDL-C, was lower, that of LDL-C, tended to be higher and that of Apo A-I tended to be lower in the diabetes mellitus-only group without treatment or under diet treatment alone. b. Compared to the control group, the levels of LDL-C, and Apo B were higher, while those of HDL-C., Apo A-I, and APO A-II were lower in the cerebral infarction-only group. c. Compared to the control group, the level of Apo B was higher, those of T.G. tended to be higher, and that of HDL-C, tended to be lower in the cerebral infarction group with diabetes mellitus, but when compared to the cerebral infarction-only group, the levels of T.G., HDL-C, Apo A-II, Apo C-II and Apo C-III tended to be higher. d. Compared to the control group, the ratio of LDL-C. to Apo B was lower (p less than 0.05) in the cerebral infarction group with diabetes mellitus and tended to be lower even in the diabetes mellitus-only group.