A Retrospective Study in the Diagnosis of 301 Jaundiced Cases

In the past 12 years, 301 patients with a total serum bilirubin over 2 mg/dl (reference interval 0.2-0.8 mg/dl) were admitted to the Second Department of Surgery, Nagasaki University School of Medicine, Japan. The purpose of this paper is to analyse the jaundiced cases and to evaluate the diagnostic accuracy of the following imaging techniques: Computed Tomography (CT), Ultrasonography (US), Drip Infusion Cholangiography (DIC), Endoscopic Retrograde Cholangio- pancreatography (ERCP), Percutaneous transhepatic Cholangiography (PTC) and Selective Celiac Angiography (SCAG). Of the 301 patients, 63 had carcinoma of the bile duct, 48 carcinoma of the pancreas, 26 carcinoma of the gallbladder, 16 hepatoma, 8 carcinoma of the ampulla of Vater, 83 cholelithiasis, 27 parenchymal liver disease, 9 congenital bile duct disease, 5 chronic pancreatitis, 14 other diseases, and 2 had no final diagnosis. CT was attempted in 33 of 170 patients with malignancy, and 22 of 129 patients with benignancy. A correct finding was obtained in 23 (69.7%) of the 33 patients and 18 (81.8%) of the 22 patients, respectively. US gave a correct finding in 28 (59.6 %) of 47 patients with malignancy, and 36 (69.2%) of 52 patients with benignancy. DIC gave a correct finding in 1 (5.6%) of 18 patients with malignancy, and 16 (42.1%) of 38 patients with benignancy. ERCP gave a correct finding in 33 (76.7%) of 43 patients with malignancy, and 38 (74.5%) of 51 patients with benignancy. PTC gave a correct finding i

Pacing Therapy for Prevention of Atrial Fibrillation

Nonpharmacological therapy is being evaluated for the prevention of atrial fibrillation (AF). Pacing has been proposed as a one of the option to prevent AF. In patients with bradycardia and requiring pacemaker, physiological pacing such as dual chamber pacing or atrial pacing has an advantage against ventricular pacing in prevention AF. Pacing from novel site like the dual-site atrium, biatrial, Bachman, and low sepatl pacing may reduce AF burden and new anti-AF pacemakers with atrial prevention algorithm may decrease AF further. However, selecting the appropriate patients and adopting tailored-therapy for individual patient is likely to remain one of the difficulties in achieving an advantage. This review discusses the current status of pacing therapy for the prevention of AF. It also discusses the some of merits and limitations of pacing therapy for the treatment of AF