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Volume 44 (1995 - 199･･･
- Issue 6 Pages 769-
- Issue 5 Pages 663-
- Issue 4 Pages 565-
- Issue 3 Pages 188-
- Issue 2 Pages 65-
- Issue 1 Pages 1-
Volume 44, Issue 4
Displaying 1-14 of 14 articles from this issue
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Kenji OGIHARA, Tadahisa TAKIZAWA, Masaaki ITIMURA, Satosi YOSHIDA, Tet ...1995 Volume 44 Issue 4 Pages 565-568
Published: November 30, 1995
Released on J-STAGE: August 11, 2011
JOURNAL FREE ACCESSSince MR angiography (MR) can demonstrate the whole brain arterial system without introduction of contrast medium, it is very useful in screening for aneurysm, AVM and vascular occlusion in outpatients.
There are two methods in MRA-subtraction and non-subtraction methods (time of flight, TOF).
The magnetization transfer contrast (MTC) technique can demonstrate smaller vessels and slower blood flow than any conventional TOF-MRA.
Compared with the subtraction MRA, the MTC-TOF-MRA demonstrates smaller vessels clearly in a shorter time. By Gd-enhancement, the image of the arterial system can be also improved on the MTC method.View full abstractDownload PDF (6483K) -
Experience in the Preoperative OrientationAtsuko ITOH, Etsuko WAKAMATSU, Kiyo SUZUKI, Kiyomi ARAKAWA, Chikako YA ...1995 Volume 44 Issue 4 Pages 569-572
Published: November 30, 1995
Released on J-STAGE: August 11, 2011
JOURNAL FREE ACCESSA total of 78 patients were operated on for senile cataract in our hospital in 1985. The number almost doubled to 142 in 1992, more than 90 percent of whom received the intraocular lens. We asked each patient postoperatively to submit a questionnaire, and found the greatest inconvenience suffered before surgery was the difficulty in reading the letters. Patients with senile cataract have anxiety due to extremely weak eyesight, therefore, we believe it is very important for them to receive orientation before the operation. Until recently, we used the B5-sized (10.12″×7.17″) leaflet for a guide to the operation, but the type was too small for them to read. We renewed the guide by using a F8-sized (17.95″× 14.96″) sketch book. We put them in the sickrooms Just before they patients left our hospital, we asked them for their opinion about the guide. 90 percent of the patients said that they were satisfied with the size of the type, all of them said that the contents are easy to understand, and 50 percent said they read the guide more than twice.
In conclusion, we found that the sketch book, full of illustrations, was quite convenient for senile patients and read repeatedly. It was also a great help to them, because it gave them encouragement and made it easy for them to prepare themselves for the operation.View full abstractDownload PDF (455K) -
Investigation into DOA and Autopsy RecordsHideomi FUJIWARA, Hiroshi AMEMIYA, Yoshito YASAKA, Naoki MATSUMIYA1995 Volume 44 Issue 4 Pages 573-577
Published: November 30, 1995
Released on J-STAGE: August 11, 2011
JOURNAL FREE ACCESSSudden death (SD), which unexpectedy occurs in the middle aged and the elderly, is a subject worth studying. Much about the cause of the demise remains shrouded in mystery from the standpoint of medicine and has a significantly great impact on the community.
We conducted a fact-finding survey of SD by gathering data on dead-on-arrival (DOA) cases stored by five general hospitals affiliated with the National Welfare Federation of Agricultural Cooperatives. Examined were 292 DOAs that were registered between January 1993 and December 1993 and autopsy findings of 45 cases obtained from one of the hospitals over the past eight years. The results are summed up as follows:
(1) The largest number of DOA cases was found in the age group of 70 to 79 years. About half of the total number was accounted for by people older than 70.
(2) Cardiovascular disease topped the list of causative and basal ailments that might have led to SD. Especially ischemic heart disease was evident in many cases.
(3) In many cases, death occurred during sleep or at rest.
(4) Cardiopulmonary resuscitation was performed according to rule on most of the victims, but the priamry resuscitation ratio came out at 26%.
From these observations, we concluded that for the prediction and prevention of SD and DOA it is necessary to work on measures to help prevent and cure ischemic heart disease.View full abstractDownload PDF (603K) -
Kenji TAMURA1995 Volume 44 Issue 4 Pages 578-585
Published: November 30, 1995
Released on J-STAGE: August 11, 2011
JOURNAL FREE ACCESSThe national health insurance record is an important source of information regarding the trend of morbidity throughout Japan. Using the record, we clarified the characteristics and annual trends of morbidity for main diseases in municipalities in Ibaraki Prefecture.
Age-adjusted morbidity rates in each municipality were calculated from the number of patients actually covered by the national health insurance and the number of the insured population from 1980 to 1992. To classify municipalities by the degree of urbanization, the proportions of farming population were used. Eighty-seven municipalities were classified into the three groups; urban group (UG), middle group (MG) and rural group (RG).
According to the pattern of annual morbidity in the three groups (UG, MG, RG) from 1980 to 1992, main diseases were classified as follows. The diseases for which the rates in UG were always higher than that in RG during the study period: Total morbidity rate in UG was about 10% higher than other two groups. Diabetes, heart disease and liver disease were included in this category, and especially, morbidity rate for allergic rhinitis in UG was nearly twice as much as that in other groups. The diseases for which the rates in RG are higher than UG during the study period: Only hypertension was included in the category. The diseases for which the rates in RG were higher than that in UG in the beginning while the rate intersected in the study period: Cerebral hemorrhage and cerebral infarction were included in this category.
There were no differences between UG and RG in morbidity rates for gastric cancer, intestinal cancer and lung cancer.
The results were confirmed by classifying the maps of municipalities into the three categorieswith 12-year average morbidity rates for main diseases.View full abstractDownload PDF (1111K) -
Hiroko HORI, Michiko MORIWAKI, Isuzu TANAKA, Keiko MITSUHASHI, Hiroshi ...1995 Volume 44 Issue 4 Pages 586-591
Published: November 30, 1995
Released on J-STAGE: August 11, 2011
JOURNAL FREE ACCESSBased on the assessment of the home health care services provided by our hospital over the past five years and the results of a survey of the people concerned, we studied the problems of home care and dwelt on what it should be in the future. An alarming fact was brought to light: Many of those who look after patients in their homes are stress-ridden. Even among those who said they are satisfied with the present care system, not a few expressed uncertainty about the future. Many were of the opinion that without option of putting the patients in hospitals or nursing homes if need be, the home health care system would not hold water.
Our hospital admits only those patients who are badly in need of hospital treatment, and technically many cases cannot be referred to general practitioners. To add to the development of home health care, it is necessary to establish a coll aborative system between hospitals and neighborhood clinics. Under the system, patients will be screened according to the degree of their need for medical care, and visiting nurses will be able to show their skill fully and provide care confidently while keeping close contact with physicians.View full abstractDownload PDF (712K) -
Tsuneo OHNO, Keisuke ITOH, Wataru MURAMATSU, Tomomitsu TANI, Fuminori ...1995 Volume 44 Issue 4 Pages 592-596
Published: November 30, 1995
Released on J-STAGE: August 11, 2011
JOURNAL FREE ACCESSIn patients with the visceral fat type obesity, there is a high incidence of glucose and lipid metabolic abnormalities and hypertension. We obtained the following results from a study of the relationship between the degree of visceral fat obesity and metabolic and vascular complications in 98 obese patients with various complications.
1. Viceral fat obesity (V/S ratio ≥ 0.4) was found in 74% of the subjects. The incidence was higher in males than females. The highest incidence was observed in both men and women in thier 40s, and there was no increase with age.
2. The V/S ratio was high in patients with hyperlipidemia, diabetes, and fatty liver in that order. In the V/S ≥ 0.4 group, there was a higher incidence of hyperlipidemia and ischemic heart disease than in the V/S<0.4 group.
3. The V/S ratio was higher in the patients with two or more metabolic and vascular complications than in those with only one complication.
4. A questionnaire survey showed that there were many individuals who did almost no exercise and had a long history of obesity in the V/S ≥ 0.4 group.
5. The V/S ≥ 0.4 group had high triglyceride levels. There was a positive correlation between the V/ S ratio or V value and the trigyceride level, but no correlation between S value and triglyceride level.View full abstractDownload PDF (639K) -
Shuichi MIHARA, Sawako KAWAZU, Michiyo SAWATARI, Sachio HAMADA, Hiroe ...1995 Volume 44 Issue 4 Pages 597-602
Published: November 30, 1995
Released on J-STAGE: August 11, 2011
JOURNAL FREE ACCESSWe have performed mass surveys for colorectal cancer by using an immunological fecal occult blood test (OC Hemodia) since April, 1987. In this report, we evaluated the mass survey protocol, and investigated the upcoming problems and measures.
The total number of examinees for six years until March, 1993 was 172, 474. The persons needed detailed examination amounted to 6, 952 (4.0%) and the persons received the detailed examination, 4, 706 (67.7%). A total of 144 colorectal cancer cases (detection rate: 0.08%, 153 lesions) were discovered, 93 cases (64.6%) were in their early stage. 101 cases (66.0%) of 153 lesions were early cancer, and 71 cases (70.3%) were cured by endoscopic polypectomy.
The detection rate of colorectal cancer was higher in males than females. In particular, the finding rate for males 50 years old and above was extremely high. We strongly recommend that the elderly people should receive a mass survey. Moreover, it is important to offer the opportunity for detailed examination to the persons who don't receive them. That might raise the detection rate.
It was found that detailed examination has left much room for improvement in terms of methodology. Some medical institutions performed only fecal occult blood testing. They are require d to raise the understanding of mass surveys for colorectal cancer. Collaboration with the medical institutions that are capable of detailed examination and care is indispensable to raise the accuracy of examination.
On the basis of the results in 1992, we calculated the diagnostic accuracy of immunological fecal occult blood test. The sensitivity of the one-day-method was 70.8%, the specificity, 97.0%, and the positive predictive value 2.1. The sensitivity of the two-days-method was 86.7%, the specificity, 95. 3%, and the positive predictive value, 2.7, and was better than the one-day-method.
These findings suggest that the carcinomas, negative to the occult blood test, still exist in a high frequency rate. Therefore, we should perform mass surveys by the two-days-method every year, in order to improve the evaluation of the mass survey method for colorectal cancer.View full abstractDownload PDF (793K) -
[in Japanese]1995 Volume 44 Issue 4 Pages 603-608
Published: November 30, 1995
Released on J-STAGE: August 11, 2011
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Tomio KAMETANI, Masaharu NOMURA, Tsukasa YAMAZAKI, Tatsushi MORITA, Is ...1995 Volume 44 Issue 4 Pages 609-612
Published: November 30, 1995
Released on J-STAGE: August 11, 2011
JOURNAL FREE ACCESSWe report a case of reactive hypoglycemic coma in a 77-year-old man. Seven months after partial gastrectomy for early gastric cancer, he presented with syncopal attacks and seizure. His plasma glucose and insulin levels at coma were 18 mg/dl and 27μU/ml. Insulinoma was neglected with computerized tomography, magnetic resonance imaging and angiography. Because dietary control was insufficient, oral diazoxide therapy was done. But diazoxide did not protectthe overresponse of the insulin and reactive hypoglycemia in 75 g GTT. Octreotide (100 micrograms IM) inhibited insulin release and prevented hypoglycemia. Acarbose delayed the response of insulin butdid not inhibited insulin release. However, acarbose also prevented reactive hypoglycemia. We concluded that acarbose is an effective therapy for reactive hypoglycemic coma.View full abstractDownload PDF (493K) -
[in Japanese]1995 Volume 44 Issue 4 Pages 613-619
Published: November 30, 1995
Released on J-STAGE: August 11, 2011
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[in Japanese]1995 Volume 44 Issue 4 Pages 620-622
Published: November 30, 1995
Released on J-STAGE: August 11, 2011
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[in Japanese]1995 Volume 44 Issue 4 Pages 623-624
Published: November 30, 1995
Released on J-STAGE: August 11, 2011
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[in Japanese]1995 Volume 44 Issue 4 Pages 625-634
Published: November 30, 1995
Released on J-STAGE: August 11, 2011
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[in Japanese]1995 Volume 44 Issue 4 Pages 635-639
Published: November 30, 1995
Released on J-STAGE: August 11, 2011
JOURNAL FREE ACCESSDownload PDF (805K)
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