Search

Purpose: Japan, with an increasing number of elderly people needing long-term care in a super-aged society, urgent needs to develop the clinical guidelines on implant maintenance for elderly people with declining independence. The purpose is to categorize the troubles encountered in the care of patients with dental implants and to indicate actual practices and points of note., Methods: From the members of the Japanese Society of Oral Implantology, 12 expert panelists who were experienced with many problems of implant maintenance during dental visits and were familiar with their solutions were selected. Through repeated discussions in the many panel meetings, the problems of implant maintenance during dental visits were distilled., Results: During a dental visit, the oral cavity, general conditions, and background of elderly patients who cannot orally care for themselves must be grasped, and medical staff, care managers, and patients should understand the changes in these factors as time goes by. The solutions and responses that can be made differ greatly depending on the medical care facilities, the environment, differences in the experience of medical staff, and the patient's background. Thus, it is necessary to select safe treatments appropriate to each situation., Conclusions: This paper features many opinions based on clinical experiences. However, clinical guidelines on implant management during dental visits should be formulated in the future based on the accumulation of evidence through the implementation of clinical research., (© 2022. The Author(s).)

Purpose: Because of the recent innovative growth in computer technology, digital imaging, and the Internet, we can take advantage of these facilities for education and clinical work in nuclear medicine. We developed a tele-nuclear medicine conference system with electronic mail (e-mail) on the Internet., Methods: Twenty-one physicians (20 radiologists, 1 neurologist), 6 technologists and 2 medical students in six university hospitals (Japan 5, Canada 1), 5 local hospitals in Japan participated in this project. We used digital still cameras (330 k pixels) equipped with a floppy disk drive and 10 x optical zoom to digitize images with JPEG compression (640 x 480 matrix). The images were attached to e-mail messages (containing a brief description of each case). The mail was sent simultaneously to all members on the mailing list. Scintigram and SPECT images as well as other radiological images were sent by e-mail. Reply mails about each case were sent to all members via the mailing list., Results: During a period of 6 months, 18 cases (tumor/infection: 7, bone: 6, cardiovascular: 1, neurology; 3, endocrine: 1) with 144 e-mails (average 5.6/case) were submitted to the conference. The average period of discussion was 15.6 days. The number of attached images was 1 to 9 (average, 4.2/e-mails). JPEG compression rate was 1/10 to 1/20. The quality of the images was good enough for discussion. Some cases required additional images for further discussion., Conclusion: Our tele-nuclear medicine conference with an electronic mailing list and digital camera was simple and low-cost. The conference system was useful for education and clinical work.

Sixty-one patients with carcinoma of the remnant stomach after distal gastrectomy were admitted by the end of 1982. Twenty-six of them were gastrectomized for benign disease such as peptic ulcer and 35 for malignant disease such as gastric carcinoma. The age of the benign group was 58, and the average interval from the first operation was 19 years. The corresponding figures for the malignant group were 63 and 8 years, respectively. In the malignant group, the methods of anastomosis at the first operation were 18 cases of Billroth-I (B-I) and 17 of B-II. The lesion was located at the surgical stump in 7 patients and distant from the stump in 14 patients in this group. In the benign group, there were 10 cases of B-I and 16 of B-II, and no differences were seen in the location. Early carcinoma was noted in 11 patients, and 34 were advanced. Differentiated adenocarcinoma was observed in 25 cases and undifferentiated in 20 in the resected specimen. Although no metastases were seen in early cases, the rate of lymph node metastasis was 70%, and the five-year survival rate was 21% in advanced cases, and 80% in early cases.