JOURNAL OF THE JAPANESE ASSOCIATION OF RURAL MEDICINE
Online ISSN : 1349-7421
Print ISSN : 0468-2513
ISSN-L : 0468-2513
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Volume 55, Issue 1
Displaying 1-9 of 9 articles from this issue
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ORIGINAL
  • A Retrospective Study of 25 Cases of Thymic Epithelial Tumors Treated in Tsuchiura Kyodo General Hospital
    Takuya ONUKI, Kesato IGUCHI, Masaharu INAGAKI, Keiko SUZUKI, Ekapot BH ...
    2006 Volume 55 Issue 1 Pages 1-6
    Published: 2006
    Released on J-STAGE: July 11, 2006
    DOIhttps://doi.org/10.2185/jjrm.55.1
    JOURNAL FREE ACCESS
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      Thymic epithelial tumors are treated with reference to the Masaoka staging system. In 1999, the World Health Organization published a histologic classification of thymomas. The WHO classification was revised in 2004. There is a general consensus that it is as important a prognostic factor in primary thymoma and thymic carcinoma patients as the Masaoka staging system. In the present study, a total of 25 cases of thymic epithelial tumors (21 thymoma cases and 4 thymic carcinoma cases) treated from 1991 through 2005 in our hospital were reclassified based on the new WHO classification. The thymoma cases consisted of four at Masaoka's stage I, 11 cases at stage II and six cases at stage III, whereas according to the WHO classification they were categorized into seven B1 type tumors, eight B2 type, four B3 type and two unclassifiable cases. Of the four thymic carcinoma cases, one belonged under Masaoka's stage II, another under stage III and two under stage IV. One thymic carcinoma case resulted in death. There were no fatalities from thymomas. Most of the thymomas at Masaoka's stage III came under WHO type B2 and B3, showing a high incidence of local infiltration. Since either the WHO classification or the Masaoka staging system is an important factor for determining the course of treatment, we concluded that both should be utilized clinically.
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REPORT
  • The Changes of Duties after the Introduction of Electronic Chart System and Its Usefulness
    Naoya TAJITSU, Takeshi YOKOI, Takahiro TAKEI, Hiroaki YAMADA, Kousuke ...
    2006 Volume 55 Issue 1 Pages 7-17
    Published: 2006
    Released on J-STAGE: July 11, 2006
    DOIhttps://doi.org/10.2185/jjrm.55.7
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      Anjo Kosei General Hospital is a large-scale hospital having 692 beds and located in the central part of Aichi. When the hospital moved into the present adress in April 2002, we introduced an electronic chart system that was not common in Japan at that time. Hospital management changed dramatically because until then we were using exclusively papers, and had not possessed even an electronic ordering system. It was also true in the field of medical office work. We hereby report the changes in routines after the introduction of the electronic chart system and its usefulness.
      The characteristics of our medical work system are as follows.
    (1)Data refrieval function (Data Ware House)
    (2)Credit control system
    (3)Receipt imaging function
      We are evaluating the various effects of the system from seven points of view as follows.
    (1)Basic data of medical care
    (2)Staff placement and personnel expenses
    (3)Work accuracy and efficiency
    (4)Patients service
    (5)Storage space reduction
    (6)Paper reduction
    (7)In-house questionnaire survey
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CASE REPORTS
  • A Case of Legionella Pneumonia Complicated by ARDS, Acute Renal Failure and Shock
    Kazuhisa ITOH, Hideyuki KOBAYASHI, Satoshi HASEGAWA, Ken YOSHIDA, Osam ...
    2006 Volume 55 Issue 1 Pages 18-24
    Published: 2006
    Released on J-STAGE: July 11, 2006
    DOIhttps://doi.org/10.2185/jjrm.55.18
    JOURNAL FREE ACCESS
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      A 55-year-old man visited his neighborhood general practitioner complaining of headache, fever and wet cough on July 7, 2003, but there were no sigins that his symptoms would subside. Since an abnormal shadow was found on chest X-ray on July 11, he was referred to our department and hospitalized on the same day. We started to treat him on the assumption that he had community-acquired pneumonia due-to common pathogens. However, he developed severe hypoxemia, and abnormal shadows rapidly progressed to affect both lungs, which led us to suspect that he had acute respiratory distress syndrome (ARDS). We identified the pathogen by examining urinary antigens and serum antibodies and diagnosed of his case as Legionella pneumonia. Although he suffered complications of acute renal failure and shock, the respirator was withdrawn after 11 days of controlled mechanical ventilation, as he was steadily recovering from his illness. The patient was discharged from the hospital on September 9. Although the mortality of legionella pneumonia, when complicated by ARDS, acute renal failure and shock as in the present case, has been reported to be as high as 50 to 80%, we consider that the administration of neutrophil elastase inhibitors and steroids was effective against this disorder.
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  • Spiritual Pain Inferred From Terminally Ill Patient's Word and Deed
    Yukari YASUDA, Yoshiko OTSU, Masako SHIBATA, Mayumi SATO, Kaoru HIRAYA ...
    2006 Volume 55 Issue 1 Pages 25-29
    Published: 2006
    Released on J-STAGE: July 11, 2006
    DOIhttps://doi.org/10.2185/jjrm.55.25
    JOURNAL FREE ACCESS
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      We encountered a terminally ill patient, who had resigned as hospital nurse soon after she had fallen ill. As a former health professional, she was acting the good patient and performing her part as a member of the family. The patient was suffering social pain, so much so that she seemed to be unable to express what was really on her mind. One day, the ex-nurse gave us her precious nurse pin. It was when it occurred to us that what the patient had said and behaved was an expression of spiritual pain. Then, we started exploring the meaning of what she had said and done and tried to get at the structure of her spiritual pain referring to Murata's three structures of the spiritual pain of terminally ill patients: “time existence,” “relational existence” and “autogenic existence.” Eventually, we found that her behavior to respond to the wish of her family and to keep a good relationship with her physicians, which she herself regarded as social pain, was to sweep away uneasiness about and fear of being left alone, that is, the spiritual pain associated with “relational existence.” We also found that the spiritual pain associated with “time existence” intermingled with her wish to continue to be a nurse as expressed in the handing over of her nurse's pin.
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  • Two Cases of Xanthogranulomatous Pyelonephritis
    Manabu OKANO, Naruyasu MASUE, Shigeaki YOKOI, Yukimichi KAWADA, Masaya ...
    2006 Volume 55 Issue 1 Pages 30-34
    Published: 2006
    Released on J-STAGE: July 11, 2006
    DOIhttps://doi.org/10.2185/jjrm.55.30
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      Two conservatively treated cases of xanthogranulomatous pyelonephritis are reported here. The first case was a 31-year-old diabetic woman. She was referred to our department. Examinations for gross hematuria were made. US, CT and MRI revealed a renal tumor in the upper pole of the left kidney. The second case was an 86-year-old man with ileal conduit. He complained about pain in the right back. A mass of fist size was found. US, CT and MRI revealed right hydronephrosis connected to the subcutaneous tumor on the right back, and DIP revealed no-functioning right kidney. Because both cases showed some signs of inflammation in laboratory findings, we performed biopsy. Either of the two cases were pathologically diagnosed as xanthogranulomatous pyelonephritis. For this reason, Antibiotic therapy was continued. As a result, reduction of the tumors was seen. The prognosis was good.
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NURSING RESEARCH REPORT
  • Implementation of Kangaroo Care Immediately After Childbirth
    Kyoko KISAKA, Tomomi UENO, Mayumi ASHIDA, Kayoko ISHIKAWA, Chizuru OGA ...
    2006 Volume 55 Issue 1 Pages 35-40
    Published: 2006
    Released on J-STAGE: July 11, 2006
    DOIhttps://doi.org/10.2185/jjrm.55.35
    JOURNAL FREE ACCESS
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      Nowadays, the merits of early mother-child contact are being recognized once again. In expectation of beneficial effects on mother-infant relationships, our hospital has launched a kangaroo care program for mothers and their healthy infants immediately after birth. This study was conducted to elucidate the positive impact this postpartal care had produced on mothers. For this purpose, questionnaires were mailed to the women who had given birth to children in our hospital and their impressions were heard about the experience during the first hours or days after delivery. Many said that they were deeply impressed because they could realize what it is like to be a mother. It was also found that there are an increasing number of women who wish to make physical contact with newborn children soon after delivery and stay close as long as possible, bringing their infants to their chest. Mother-child interaction seemed to create a sense of security and a feeling of trust. From the present study, we concluded that our kangaroo care program could influence mothers' mental health and behavior very favorably.
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REGIONAL MEETINGS
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