Disintegration of urinary calculi by laser beam: drilling experiment in extracted urinary stones

Disintegration of urinary calculi was attempted by the use of laser beam. As a first step, drilling of extracted urinary stones was attempted using a continuous wave CO2 laser and a pulse ruby laser. Stones were drilled easily by either laser beam. The power around 10 W of continuous CO2 laser beam was sufficient to drill through the stone.

Effect of the autonomic blockade on the automaticity of the A-V junctional pacemaker in awake dogs

The effect of the autonomic blockade on the automaticity of the A-V junctional pacemaker was evaluated in 15 awake dogs with experimentally induced A-V junctional rhythm. The duration of asystole after overdrive (D.A.O.) in these dogs was prolonged significantly in accordance with increase in the drive rate, and the mean +/- SD of the D.A.O. reached 4.7 +/- 1.1 seconds (N = 15) after overdrive at 2.5 times the spontaneous heart rate. After administration of atropine (0.4 mg/kg; i.v.) to eight dogs, the mean +/- SD of the D.A.O. at the same rate decreased from 4.5 +/- 0.9 to 3.4 +/- 1.2 seconds. After administration of practolol (0.5 mg/kg; i.v.) to the seven other dogs, the mean +/- SD of the D.A.O. at the same rate increased remarkably from 4.9 +/- 1.3 to 9.4 +/- 3.0 seconds. Intravenous injection of practolol (0.5 mg/kg) had no effect upon the D.A.O. in the five dogs with sinus rhythm. Thus, it is suggested that (1) the sympathetic nerve might play a more important role in regulating the automaticity of the A-V junctional pacemaker than the vagus and (2) it physiologically might take over 5.0 seconds for the A-V junctional pacemaker to initiate an escape beat during longstanding sinus arrest, if a marked dysfunction of the A-V junctional pacemaker occurs due to a decrease in tension of the sympathetic nerve.

[An experimental study on canine A-V junctional pacemaker--evaluation of the automaticity by overdrive suppression and autonomic blockade by practolol and atropine]

1. The automaticity of the A-V junction was evaluated in 15 awake dogs with experimentally induced A-V junctional rhythm. 2. The spontaneous heart rate of these dogs ranged from 54 to 112 beats a minute, showing about 1.5-2.5 times slower than that of control dogs with sinus rhythm. The duration of asystole after overdrive in these dogs prolonged significantly in accordance with an increase in the frequency of stimulation for overdrive, and its mean +/- SD attained 4.7 +/- 1.1 seconds after overdrive at a rate of 2.5 times the spontaneous heart rate. 3. By administration of atropine (0.04 mg/kg, i.v.) to 8 dogs, the duration of asystole after overdrive, at a rate of 1.5 times the spontaneous heart rate, decreased from 2.6 +/- 0.8 to 1.5 +/- 0.4 seconds. By administration of practolol (0.5 mg/kg, i.v.) to 7 other dogs, the duration of asystole after overdrive increased from 3.0 +/- 1.1 to 6.4 +/- 2.2 seconds. 4. It should be suggested that, (1) about 5 seconds of asystole might physiologically occur before the initiation of the A-V junctional escape beat during the long-standing sinus arrest, and (2) the sympathetic nerve might play a more important role in regulating the automaticity of the A-V junction than the vagus nerve.

Mass screening program for prostatic diseases with transrectal ultrasonotomography

A special chair-type apparatus for transrectal ultrasonotomography was developed in our laboratory 3 years ago. We did a mass screening program for prostatic disease, using this equipment as the primary study in the system. The 132 apparently normal men evaluated ranged in age from 40 to 76 years (mean 55.0). The 48 patients suspected of having prostatic disease underwent secondary studies, consisting of the usual urological examinations. Prostatic disease was detected in 24 cases, including 18 cases of benign prostatic hyperplasia. Thus, the model program revealed an extraordinarily high prevalence of latent prostatic disease among apparently normal older men.

Xanthoma secondary to reticulo-histiocyte infiltration

Three cases of xanthomas occurring secondarily are reported: The primary dermatoses were erythroderma, actinic reticuloid and histiocytosis X. Although a slight elevation of pre-beta-lipoprotein was recognized, xanthomas occurring in these particular 3 cases were assumed to be due to the proliferation or hyperplasia of reticulohistiocytes in the skin. The foam cells found in the xanthoma case with erythroderma and actinic reticuloid appeared different from those with histiocytosis X in their fine structures. The lipid constituents of the xanthoma lesion were found to be quite dissimilar from those of serum lipids.

Atrophie blanche examined with thermography

Atrophie blanche developed in a 25-year-old man with systemic lupus erythematosus is reported. A thermographic examination was applied to estimate skin temperature, and the temperature was low on areas where lesions were distributed.

Non-invasive detection of ultrasonic Doppler signals from renal vessels

We successfully obtained ultrasonic Doppler signals, presumably caused by the renal vessels, through the body surface without invasion. An outline of the method and several results are presented in this preliminary report.

An evaluation of the function of new special equipment for transrectal ultrasonotomography

A new type of equipment for transrectal ultrasonotomography was described in a previous paper. This equipment was evaluated from the data obtained from 205 cases in which examinations were performed. Tomograms were successfully recorded in 94% of cases. Tomograms sufficiently useful for diagnosis and the measurement of organs were obtained in 89% of cases for the prostate, 78% for the urinary bladder, and 80% for the seminal vesicles. No basic problems in the procedure were found, although hypotension of unknown origin was observed during the examination in a few cases.

Cat scratch disease

Cat scratch disease developed on a 40-year-old wife was reported. Umbilicated papules closely resembling those in herpetic skin infection development on the areas which had been scratched by a cat a week ago. Obtained findings in the present case led us to a speculation that this disease was caused by herpes virus. 72 cases of this disease have been reported in Japan, and they were reviewed in the present paper.

Volume estimation of the seminal vesicles by means of transrectal ultrasonotomography: a preliminary report

The volume of the seminal vesicles was estimated in 27 cases by means of transrectal ultrasonotomography. The seminal vesicles of normal subjects were found to be generally larger than in cases of prostatic hypertrophy or cancer. The volume of the seminal vesicles in Klinefelter's syndrome was remarkably small. The correlation between the volume of the seminal vesicles and of the prostate is given.

Transrectal ultrasonotomography of the prostate

New equipment for transrectal ultrasonomography has been developed. Wth this equipment an excellent cross-section picture of various intrapelvic organs is easily obtained. Diagnostic application of the technique is particularly significant for abnormalities of the prostate because the shape of the prostate cannot be revealed by x-ray. Diagnostic criteria for prostatic disease are described, with the demonstration of typical cases. In a test by well trained physicians the diagnostic accuracy of the new technique was more than 80 per cent. Ultrasonotomography provided for precise measurement of prostatic size. Transrectal ultrasonotomography is a promising new diagnostic technique that yeilds abundant information not available with former methods of examination. The procedure is likely to become one of th most important diagnostic tools in the field of urology.

Overdrive suppression in diagnosis of sick sinus syndrome

A criterion to determine the indication for pacemaker implantation in the sick sinus syndrome by overdrive suppression is proposed. Overdrive suppression was performed in 10 patients with the sick sinus syndrome (SSS) and another 10 patients with normal sinus rhythm (NSR) who served as controls. In the SSS group, 9 patients had complained of such severe symptoms as Adams-Stokes attack and/or congestive failure and were referred to our laboratory for pacemaker implantation. One other patient, an apparently robust young man (20 years old) referred for detailed cardiac examination, had no remarkable symptoms except for arrhythmias, but was found dead two months later. Atrial pacing for overdrive suppression was carried out at first at various rates ranging from 60 to 180 beats/min for 15 sec, and then at a rate of 100 beats/min for various durations ranging from 5 to 180 sec. After cessation of the atrial pacing, asystolic pauses were measured and the maximum (maximum pause) among the pauses obtained was used as a parameter indicating depression of cardiac automaticity. The maximum pause in the SSS group ranged from 5.6 to 9.0 sec (mean +/- SD = 7.0 +/- 1.2), WHILE THOSE IN THE NSR group ranged from 0.7 to 1.5 sec (mean +/- SD = 1.2 +/- 0.14). Therefore, the maximum pause was considered not only to reflect the severity of the symptoms necessitating pacemaker implantation in the 9 patients of the SSS group but to have warned us of sudder death in another patient. We concluded that overdrive suppression is useful as a supplementary challenge to determine indications for pacemaker implantation for the sick sinus syndrome, and that prolongation of the maximum pause beyond 5.0 sec is the critical level for pacemaker implantation.