Hirosaki Medical Journal
Online ISSN : 2434-4656
Print ISSN : 0439-1721
Volume 68 , Issue 2-4
Showing 1-20 articles out of 20 articles from the selected issue
Review
  • Takashi Kachi, Hitomi Kachi
    2018 Volume 68 Issue 2-4 Pages 91-103
    Published: 2018
    Released: April 26, 2021
    JOURNAL FREE ACCESS
    We surveyed the references relevant to the effects of mother's pineal gland on the prenatal development of pups, including our own results. Following items were described and interpreted: 1. Details of events from the accumulation of basic experimental data making clues to discovery of developmental abnormality in pups induced by mother's pinealectomy, and the distribution and relationships to ontogeny and phylogeny of the pineal hormones, i.e. serotonin and melatonin. 2. The Brachyury gene, which is involved in the developmental abnormality, and its relationships with the development or differentiation, the expression in murine and normal man and tumor patients, and researches in which the gene was used as the target of tumor therapy. 3. Pineal relationships to blood glucose regulatory mechanisms or diabetes mellitus: 1) The relationships between blood glucose regulatory mechanisms and pregnancy: On regulatory hormones of the blood glucose level, especially on prolactin and the peripheral serotonin. 2) The relationship between the developmental abnormality due to diabetes mellitus and that induced by maternal pinealectomy: (1) mother's diabetes mellitus and developmental abnormality; (2) reduction of developmental abnormality by the activation of immune functions. 3) blood glucose regulatory hormones and endocrine organs influenced by pinealectomy.
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Original Article
  • Masakazu Murakami, Akiyoshi Takami, Ai Shimaya, Misato Makino, Hideki ...
    2018 Volume 68 Issue 2-4 Pages 104-111
    Published: 2018
    Released: April 26, 2021
    JOURNAL FREE ACCESS
    The purpose of this interdisciplinary and longitudinal study was to clarify the factors influencing the burden on caregivers of patients at one month after their hospitalization in the convalescent ward. The study participants were 25 pairs of family caregivers and care receivers who were living at home under their family's care. Basic characteristics, cognitive function, and activities of daily living (ADL) were evaluated in the care receivers, Characteristics, ADL, burden, and the difference between the expected and actual amount of care provided at one month after hospitalization were evaluated in caregivers. The results suggested that the factors affecting caregiver burden are sleeping hours per day, which is consistent with findings in previous studies, and the difference between the expected and actual amount of care provided, which to our knowledge, is reported here for the first time. Therefore, to reduce caregiver burden, caregivers should get adequate sleep and be given a concrete framework regarding patient care.
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  • Akemi Fujita, Seiko Kudo
    2018 Volume 68 Issue 2-4 Pages 112-122
    Published: 2018
    Released: April 26, 2021
    JOURNAL FREE ACCESS
      We examined the factors influencing subjective quality of life (QOL) at different postoperative stages in 62 patients with rectal cancer who had undergone intersphincteric resection (ISR) or low anterior resection (LAR). I also examined nursing interventions aimed at improving the patients' subjective QOL. Subjective QOL was analyzed by using the Schedule for the Evaluation of the Individual Quality of Life – Direct Weighting (SEIQoL-DW).
      In all patients (ISR and LAR groups combined), the mean SEIQoL-DW index values were 57.7 (patients less than 1 year after surgery), 66.6 (patients 1 to less than 2 years after surgery), and 68.7 (patients 2 or more years after surgery); the SEIQoL-DW index was significantly lower in patients in the first postoperative year than in those 2 or more years after surgery. These results suggest that subjective QOL is lowest during the first postoperative year and improves with time.
      Analysis of components of QOL and their indices, as measured by SEIQoL-DW, revealed that family, hobbies (outdoor), health, friends, and hobbies (indoor) were the primary determinants of subjective QOL. Analysis of cues with low levels of satisfaction despite high importance in the SEIQoL-DW revealed that, to provide nursing interventions to improve subjective QOL, it is important to focus on interventions that 1) manage the dyschezia affecting the postoperative health of patients who have undergone LAR; and 2) provide lifestyle counseling to increase fulfillment in work or hobbies among patients who have undergone LAR.
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  • Masataka Narita
    2018 Volume 68 Issue 2-4 Pages 123-134
    Published: 2018
    Released: April 26, 2021
    JOURNAL FREE ACCESS
      The International Commission on Radiological Protection (ICRP) recommends that the exposure dose from radiological examinations should be as small as possible (as low as reasonably achievable, ALARA). However, some patients transported to the emergency center were subject to multiple radiological examinations such as mobile X-ray, computed tomography (CT) examination and digital subtraction angiography (DSA).
      Increased radiation exposure is a concern for patients. By inserting a thermoluminescent dosimeter (TLD) into a tissue-equivalent phantom, the equivalent dose and effective dose of each radiological examination were determined at each anatomical region. According to the total equivalent doses of radiological imaging (mobile X-ray, head-to-pelvis CT, head DSA), the head equivalent dose was 267.26 mGy. This value is lower than the threshold (3 Gy) for temporary hair loss proposed in ICRP Publication 59. The head dose was 0.05 mSv for head mobile X-ray, 60.43 mSv for head-to-pelvis CT, and 8.42 mSv for head DSA. The total effective dose was 68.9 mSv.
      To optimize ALARA measurements as well as the radiation dose, it is necessary to know the exposure dose of radiological examination. The dose data evaluated in this study will be useful for the estimation of radiation risks for patients of emergency centers who undergo multiple radiation examinations.
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  • Yoshihiro Shoji, Shingo Sasaki, Yuichi Toyama, Kimitaka Nishizaki, Tak ...
    2018 Volume 68 Issue 2-4 Pages 135-141
    Published: 2018
    Released: April 26, 2021
    JOURNAL FREE ACCESS
      Wearable cardioverter-defibrillator (WCD) is an external device capable of automatic detection and treatment of ventricular tachycardia (VT)/ventricular fibrillation (VF). We examined whether WCD use for patients at high risk for VT/VF is associated with shortening the length of stay in the intensive care unit (ICU) and safe management in the general ward until implantable cardioverter-defibrillator (ICD) implantation.
      From June 2012 to May 2014, ICD was implanted in 44 patients for secondary prevention of VT/VF (control group). From June 2014 to May 2016, WCD was prescribed in 50 patients for secondary prevention, of which 29 patients had ICD implantation (WCD group). The median length (25th-75th percentiles) of the ICU stay was 3 (1–7) days in the control and 0 (0-1.5) days in the WCD group (p<0.05). The period until ICD implantation in the general ward was 0 (0–3) days in the control and 10 (5–19) days in the WCD group (p<0.05). No sudden cardiac death and no readmission to the ICU were reported in both groups before ICD implantation.
      In patients with indication for ICD implantation for secondary prevention, WCD use can shorten the length of ICU stay and provide a safe management in a general ward.
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  • Midori Kimura, Shizuka Kurauchi, Itoyo Tokuda, Kaori Sawada, Hitomi Ko ...
    2018 Volume 68 Issue 2-4 Pages 142-156
    Published: 2018
    Released: April 26, 2021
    JOURNAL FREE ACCESS
    The social life activity is a habitual behavior, which involves physical and cognitive functions. Therefore, there is a possibility that the social life activity has an effect on cognitive functions. In this study, we focused on personal interaction and daily schedule as the social life activities, so as to examine the relationship between social life activity and cognitive function. The Subjects of this investigation were 563 adults who participated in the Iwaki Health Promotion Project 2015. Their cognitive functions were measured by MMSE, moreover relationships and influence structure of factors were analyzed by using the multiple regression analysis and graphical modeling. As a result, MMSE in males between 50 to 64 years of age was positively correlated with "sports", "TV · radio · newspaper · magazine" and "rest and relaxation" . However, no correlations were found in 65 years and older. MMSE in females between 50 to 64 years of age showed a positive correlation with "child rearing", however, negative correlations with "meals" and "sleep". For older females (age of 65 years and over), MMSE was positively correlated with "seeing family members more than once a month". Therefore, it is important for males to positively engage in sports and leisure activities from the middle age in order to raise the cognitive reserve power, and for females to have more opportunities for personal interactions in order to improve the psychological well-being and to increase physical activity.
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  • Kana Ishihara, Kanji Tanaka, Maika Oishi, Asami Ito, Yoshihito Yokoyam ...
    2018 Volume 68 Issue 2-4 Pages 157-167
    Published: 2018
    Released: April 26, 2021
    JOURNAL FREE ACCESS
    Objectives: This study aimed to clarify the health status of women with gestational diabetes mellitus (GDM) in Tsugaru District, Aomori Prefecture, Japan, and provide information for establishing a long-term follow-up system for women with a history of GDM.
    Methods: Questionnaires were mailed to women diagnosed with GDM who gave birth between 2006 and 2015 at four general hospitals in Tsugaru District. Subjects were grouped according to progression or non-progression of GDM to type 2 diabetes mellitus (DM), and clinical characteristics between both groups during pregnancy were compared. A health survey was performed in women with GDM.
    Results: There were a total of 10,681 deliveries, and 516 women were diagnosed with GDM. Out of those, 452 women were eligible for the study. The questionnaires were mailed to them, and 227 women returned the questionnaire. The number of women with progression of GDM to DM was 14, but only 5 out of those returned the questionnaires. Although the current age of women who developed DM was under 40 years old, women with a history of GDM who had not had health checkups were significantly younger than those who had had health checkups, with a larger proportion being younger than 40 years.
    Conclusions: Women with a history of GDM of less than 40 years old in Aomori Prefecture had less opportunity of their health checkups. Therefore, it is preferable to provide medical checkup recommendation system for the women with a history of GDM even if the current age is under 40 years old.
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  • Masashi Kasuya, Yuki Soma, Yu Ogasawara, Shizuka Kurauchi, Hitomi Koma ...
    2018 Volume 68 Issue 2-4 Pages 168-176
    Published: 2018
    Released: April 26, 2021
    JOURNAL FREE ACCESS
    The purpose of this study was to examine how cognitive function is related to metabolic syndrome and locomotive syndrome in a Japanese general population over the age of 60. The subjects were 101 males and 167 females living in the Iwaki area, Hirosaki city in Aomori Prefecture. The survey parameters were as follows: cognitive function test (Mini-Mental State Examination, MMSE), metabolic syndrome index (abdominal girth, blood pressure, serum lipid and serum glucose level) and the locomotive syndrome index (the 25-question geriatric locomotive function scale, two-step test and stand-up test). As a result, males with locomotive syndrome had significantly lower cognitive function, and the tendency was remarkable as the number of relevant items increased. On the other hand, in the metabolic syndrome index, associations with neither gender nor cognitive function were observed. From the above, it was found that the locomotive syndrome evaluation index was considered useful as a tool for screening cognitive decline in males.
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  • Satoru Tsuruta, Yoshikazu Toyoki, Shinnosuke Yonaiyama, Shingo Sakurab ...
    2018 Volume 68 Issue 2-4 Pages 177-183
    Published: 2018
    Released: April 26, 2021
    JOURNAL FREE ACCESS
    Laparoscopic cholecystectomy (LC) is widely performed because less invasiveness and brings better esthetic outcomes and earlier recovery than open cholecystectomy. It is conceivable that LC is effective therapy in elderly patients. We evaluated its efficacy and safety in elderly patients retrospectively. This study involved a total of 538 cases who went through LC in our hospital from 2010 January to 2015 December (except for patients with tumors or other operations). Thirty patients 80 years of age or older belong to the elderly group, and 508 patients less than 80 years belongs to the non-elderly group. Incidence of hypertension, respiratory diseases and biliary drainage history significantly increased in the elderly group than the non-elderly group. In the elderly group, surgical and non-surgical perioperative complications were more frequency observed, and length of postoperative hospital stay was longer. We considered that cholecystitis in elderly tends to accompany a marked inflammatory response requiring biliary drainage. Through evaluation of the preoperative physical status and meticulous perioperative management are necessary in LC of elderly patients.
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Abstracts of Meeting of Hirosaki Medical Society
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