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Volume 46 (1997 - 199･･･
- Issue 6 Pages 894-
- Issue 5 Pages 805-
- Issue 4 Pages 665-
- Issue 3 Pages 246-
- Issue 2 Pages 101-
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Volume 46, Issue 2
Displaying 1-15 of 15 articles from this issue
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Shigeki KODA, Hiroshi OHARA1997 Volume 46 Issue 2 Pages 101-107
Published: July 30, 1997
Released on J-STAGE: August 11, 2011
JOURNAL FREE ACCESSAgriculture has been reported as one of the most dangerous industries, but there are a very few statistical reports about agricultural injuries and accidents in Japan. The authors conducted analyses of agricultural injuries and accidents data from 1992 to 1995 (n=333) in Kochi, in order to discuss issues of agricultural safety and health, and the characteristics of agricultural injuries and accidents among aged farmers.
The average age of 333 patients, including 13 deaths, was 57.1 years old, and 174 patients (52.3%) were over 60 years old. One hundred and thirty seven accidents (41.4%) occurred during the period from July to September. Injuries resulting from falls topped the list with 101 patients (30.3%), followed by pinchs and involvements with 58 (17.4%), cuts and lacerations with 54 (16.2%), and slips with 36 (10.8%). The injury causes were agricultural machinery in 134 patients (40.2%), agricultural facilities in 34 (10.2%), motor vehcles in 27 (8.1%), and farm animals in 18 (5.4%). The rate of fall accidents was significantly higher among people over 60 years old than among those under 60 years old (p<0.001). The rate of serious injuries and accidents was significantly higher among people over the age of 60 than among those under the age of 60 (p<0.01).
Considering these results, effective and feasible preventions for agricultural injuies and accidents must be safety education and training, safety procedure manuals, which should be easy to understand for aged farmers, and improvements of agricultural machinery and eqiupments.View full abstractDownload PDF (932K) -
Shigeo TOMURA, Ikuyo MORINAGA, Sumi SHOJI, Tomiko DEI, Emiko AKATSU, A ...1997 Volume 46 Issue 2 Pages 108-116
Published: July 30, 1997
Released on J-STAGE: August 11, 2011
JOURNAL FREE ACCESSWe assessed the relationships between lumbar bone mineral density (BMD) in middle and old-aged women and dietary habits, especially in their youth (about 18-25 years) and physiologic factors (height, weight, menarche, menopause, etc.). The subjects were 90 women at age 45-87 [63.5±9.5 (mean±SD) years] who visited our outpatient clinic of osteoporosis. Of them, 83 women had already ceased menstruation. Quantitave computed tomography (QCT) was used for measurements of the BMD of the trabecular bone in the third lumber vertebra (L3 expressed in mg/cm3 of CaCO3), where pronounced changes associated with osteoporosis occur early.
There were significant negative correlations between age or menarcheal age and BMD of L3. Significant positive correlations were found between height or weight at the present and L3, but there was no correlation between body mass index (BMI) and L3. Significant positive correlations were noted between the values subtracted height at the present from height in the youth and L3. There were no correlations between frequency of pregnancy and delivery or outdoor life hour and L3. High milk-consumers in their youth (milk-drinking≥5 days per week) had higher L3 than low milk-consumers (milk-drinking≤2 days per week), and women, who had ate small fish 3 days or more per week in their youth, showed significantly higher L3 than thoes who had 2 days or less per week. We concluded that there are negative correlations between age or menarcheal age and L3 and positive correlations between height or weight and L3, and that low intake of milk and small fish in the youth may influence BMD in later years, leading to osteoporosis.View full abstractDownload PDF (888K) -
Norio TAKEUCHI, Yoshikatsu MOCHIZUKI, Iwao SUGIMURA, Yuzo FUKUYAMA1997 Volume 46 Issue 2 Pages 117-123
Published: July 30, 1997
Released on J-STAGE: August 11, 2011
JOURNAL FREE ACCESSBased on the community health examination data (1980-1996) for inhabitants of Takasu, a rural town in Central Hokkaido, long-term changes in body mass index and prevalence of anemia were studied.
The results were as follows:
1) Median BMIs increased gradually during the observation period in all age groups in males, whereas in females median BMI did not clearly change in their 50's to 70's and decreased gradually in their 30's and 40's.
2) Median BMIs increased gradually with age in both sexes.
3) Median blood hemoglobin levels did not clearly change during the observation period in both sexes.
4) The rate of iron-deficiency anemia was supposed to increase gradually during the observation period in females in their 30's and 40's.View full abstractDownload PDF (936K) -
Trial of Time-study by Utilizing Container SystemMutsuko TSUBOSAKI, Atsuko TAKEUCHI, Fumi OIKUBO1997 Volume 46 Issue 2 Pages 124-128
Published: July 30, 1997
Released on J-STAGE: August 11, 2011
JOURNAL FREE ACCESSA great change has been made in the work of our operating room since we moved into a newly-built hospital several years ago. The number of operations has been increasing and most of the operations have been getting much more complicated year by year. Furthermore, there is a tendency for one operation to take longer and longer.
In ordes to make our work efficient, we took note of a “Container System”, and investigated the time is required to prepare machines and to tidy up after operations by a time-study method.
As a result, we have succeeded in reducing our working hours by 40%View full abstractDownload PDF (490K) -
Effect of Aging, Menopause and Anthropometric ValuesAtsushi IO, Hidehiro NISHIO, Susumu KAWAMOTO, Kenji TAKESHITA, Makiko ...1997 Volume 46 Issue 2 Pages 129-134
Published: July 30, 1997
Released on J-STAGE: August 11, 2011
JOURNAL FREE ACCESSThree ultrasound parameters-broad band ultrasound attenuation (BUA), speed of sound (SOS) through the heel and average of standardized BUA and SOS (stiffness)-were measured with a LUNAR Achilles system (Lunar Corporation, Madison, WI, USA) in 9459 normal Japanese women (mean±SD 54.7±11.3yr, 15-90 yr) who have no history of ovariectomy, and 260 men (58.1±16.5 yr, 15-86 yr).
The bone mass values peaked in women aged 15-17 years (BUA 116±9, SOS 1572±23 and stiffness 97±11), and in men aged 15-16 (SOS 1590±20, stiffness 107±11) and in the age span 22-29 years (BUA 124±14).
The rates of bone loss were high in women aged 51-55 (stiffness 1.0%/yr), significantly high in the women who had been menopausal for less than 5 years (stiffness 2.0% yr).
We compared the mean values of the parameters in women with early menopause (≤45 yr) and late menopause (≥53 yr) more than 5 years after the menopause. In the early menopausal women, the mean BUA values at age 58-62, and those of BUA, SOS and stiffness at age 63-67 were significantly low (P<0.02) compared with the age-matched values in the late menopausal women, whereas no significant difference was observed between those in either of the two groups after 68 years of age.
There were significantly positive correlations between the 3 ultrasound parameters and height, body weight and obesity index, but SOS was not significantly correlated with body mass index.
These results indicate that the maximal bone mass in the os calcis is attained in very young women aged 17 or less and that loss in the calcaneus bone quality appears to be more dependent on menopause than aging in women 58-67 years old. In the older women, however, the loss of bone seems to be age-related.View full abstractDownload PDF (730K) -
Toru TAKAHASHI, Masato HAYASHI, Akira MIURA1997 Volume 46 Issue 2 Pages 135-141
Published: July 30, 1997
Released on J-STAGE: August 11, 2011
JOURNAL FREE ACCESSWe performed a retrospective study on the clinical data of 13 remission failure cases in 53 patients who had received remission induction therapy for acute leukemia (AL) in our hospital over the past seven years.
The outstanding clinical manifestations of the remission failure cases, as compared with the successful cases, included (a) disseminated intravascular coagulation (DIC) syndrome (b) complex chromosomal abnormalities (c) leukocytosis over 100, 000/μl and (d) markedly elevated seum LDH level and thymidine kinase activitis at the time of initial admission.
The greater majority of these cases (10 out of 13) resulted in death within 90 days after the start of induction therapy.
The causes of death were predominantly hemorrhagic events associated with DIC syndrome, cerebral hemorrhage and severe infectious diseases such as sepsis and pneumonia.
Earlier death within 14 days after therapy was caused from hemorrhagic events and later one was severe infections.
In the G-CSF treated group, the febril term of over 38°C was shorter and the number of days taken for the neutrophil counts to be restored to the 1, 000/μl level was fewer than in the non G-CSF treated group.
Thus, it was suggested that G-CSF was expected to be one of the useful supporting agents to prevent infections in remission induction therapy for acute leukemia.View full abstractDownload PDF (820K) -
Comparison of Computed X-Ray Densitometry (CXD) with Quantitative Computed Tomography (QCT)Shigeo TOMURA, Kimika KAWANAMI, Miwa HOSOKAWA, Kimiko TANAKA, Hisako Y ...1997 Volume 46 Issue 2 Pages 142-147
Published: July 30, 1997
Released on J-STAGE: August 11, 2011
JOURNAL FREE ACCESSMeasurement of bone mass (BM), especially in the lumbar vertebrae, is very important for diagnosis of osteoporosis. In this study, we compared BM values measured by computed X-ray densitometry (CXD) with those by quantitative computed tomography (QCT), and discussed differences between the two methods.
The subjects were 90 women and 3 men, aged 42-86 years, who visited our outpatient department of osteoporosis. Metacarpal bone density (ΣGS/D) and metacarpal index (MCI) in the second metacarpal bone were measured by CXD. QCT was uesd for measurement of bone mineral density (BMD) in the lumbar trabecular bone, where pronounced osteoporotic changes occur early. The mineral values of L3 were expressed as mineral equivalent of CaCO3 in mg/ cm3, and≤75 mg/cm3 of L3 values were judged to be loss of lumbar BMD.
There were negative correlations between age and ΣGS/D, MCI or L3 value, and positive correlations were found between ΣGS/D or MCI and L3 value. Based on the above criterion of lumbar BMD loss, sensitivity and specificity of ΣGS/D for lumbar bone loss were examined. If ΣGS /D of 2.30 (T score -2.7) was used as the cut-off point, the sensitivity was 69.8% and the specificity was 75.0%, and if ΣGS/D of 2.37 (T score -2.3) and 2.40 (T score -2.1) were employed, the sensitivity was 79.1% and 79.1%, while the specificity was 64.5% and 62.5%, respectively. We concluded that BM values of cortical bone and trabecular bone decrease with age, and that sensitivity and specificity of GS/D for diagnosis of lumbar BMD loss are not very high.View full abstractDownload PDF (726K) -
Masahiko SODA, Yasutaka SHIBATA, Keiji FUNAHASHI, Yumiko NODA, Yumika ...1997 Volume 46 Issue 2 Pages 148-153
Published: July 30, 1997
Released on J-STAGE: August 11, 2011
JOURNAL FREE ACCESSThis study investigated whether significant coronary artery stenosis in 231 consecutive unstable angina patients can be diagnosed by thoroughgoing history-taking initial electorocardiography and symptom- or sign-limited treadmill exercise ECG after medication. The unstable angina patients were divided into those with accelerated angina, those with new-onset effort angina and those with angina at rest based on the findings of detailed inquiry. Initial ECG showed that the sensitivity and specificity of detecting significant coronary artery stenosis in all patients were 55.2% and 63.2%, respectively. In accelerated angina, sensitivity and specificity were 52.2% and 50.0%, respectively. In new-onset effort angina, sensitivity and specificity were 46.7% and 57.1%, respectively. In angina at rest, sensitivity and specificity were 69.0% and 68.3%, respectively. Initial ECG provided valuable diagnostic information about angina at rest. Treadmill exercise ECG offered 66.0% sensitivity and 89.2% specificity in all patients, respectively. In accelerated angina, sensitivity and specificity were 80.0% and 66.7%, respectively. In new-onset effort angina, sensitivity and specificity were 70.8% and 87.8%, respectively. In angina at rest, sensitivity and specificity were 48.3% and 91.4%, respectively. Thus, treadmill exercise electrocardiograms provided valuable diagnostic information in the case of unstable angina, especially accelerated angina and new-onset effort angina. For patients with angina at rest, this testing was very useful for excluding significant coronary artery stenosis.
In conclusion, detailed inquiry, initial ECG and symptom- or sign-limited treadmill exercise ECG after medical stabilization proved to be of great value for diagnosing unstable angina patients with significant coronary artery stenosis.View full abstractDownload PDF (762K) -
Mitsuya ONO, Machiko KIKUCHI, Michiko ARAI, Akemi YANAGISAWA, Shigefum ...1997 Volume 46 Issue 2 Pages 154-158
Published: July 30, 1997
Released on J-STAGE: August 11, 2011
JOURNAL FREE ACCESSSince 1994, our clinic has had monthly study meetings for those who looked after bedridden patients in their homes. As of June 1996, we have gotten together 39 times and a total of 168 persons have participated (mean 4.8). We have discussed the welfare system (3 times) and diseases such as bed sore and lumbago (16 times), visited participants' homes and demonstrated medical equipment (4 times each) and talked about general affairs (12 times). In home health care, a role of those who look after bedridden patients in their homes is very important. Social and medical systems should support them. We think ther meetings could continue to support them morally and psyehologically.View full abstractDownload PDF (475K) -
Yasuji TAKANO, Masasi HOSOYA, Hiroyoshi TANAKA1997 Volume 46 Issue 2 Pages 159-163
Published: July 30, 1997
Released on J-STAGE: August 11, 2011
JOURNAL FREE ACCESSA questionnaire survey conducted on the matter concernmg the centralized management of medical electronic (ME) instruments found that 78% of physicians and nurses were in favor of the proposition. According to this result, our hospital began to manage ventilators and low pressure continuous suction instruments under central control at first, and then 13 types of 142 ME instruments. has also The centralization of ME instruments has made it possible to decrease the number of instruments. It has also enabled clinical engineers to find instrument trouble without delay and repair it in our hospital. It saved 62, 220, 000 yen for new instrument cost and 3, 016, 000 yen a year for repair. We concluded that centralized management of ME instruments was efficient, economical and advantageous in terms of safety.View full abstractDownload PDF (528K) -
Masaki MORI1997 Volume 46 Issue 2 Pages 164-167
Published: July 30, 1997
Released on J-STAGE: August 11, 2011
JOURNAL FREE ACCESSPleural dissemination of a tumor is one form of the extrapleural involvments of lung cancer. CT images of pathologically proved pleural dissemination of lung cancer in 18 patient were included in this study. CT features of (a) small nodular opacities in the interlobar area and/or thickening of interlobar fissure, and (b) irregular pleural surface of the chest wall were retrospectively reviewed. Fourteen of 18 cases (78%) showed interlobar abnormalities and nine cases (50%) demonstrated irregular pleural surface of the chest wall. We concluded that CT scanning could play an important role in the clinical diagnosis of pleural dissemination of lung cancer.View full abstractDownload PDF (3781K) -
Involvement in Brain Disease ScreeningYukiko MIZUTANI, Terutaka OHHASHI, Naohito YAMAMOTO1997 Volume 46 Issue 2 Pages 168-172
Published: July 30, 1997
Released on J-STAGE: August 11, 2011
JOURNAL FREE ACCESSWith the aim of improving patient compliance with medication regimens, we conducted a questionnaire survey on outpatients who had been diagnosed with asymptomatic cerebrovascular infarction after brain disease screening. Prior to the survey, we gave them instructions to take prescribed medications correctly, using explanatory leaflets. To the question “What do you want to know the most about the drug”, a majority of the respondents said “possible side effects.” “Efficacy” came second. There were some patients who said that they are not much inclined to know about the drug because they entrust the doctor with everything as far as medical treatment is concerned.
Later, to confirm their compliance with prescribed drug regimens, we made a follow-up survery. The results showed that all (almost all?) the patients had a good understanding of the use as well as the dosage of the drug, but that they han not read well the explanatory leaflets.
In this country, medical care services for inpatients have been improved. However, there is still much to be desired about the approach to outpatients who need a proper follow-up. To meet the need of outpatients, we would like to make use of what we have learned from the recent experience.View full abstractDownload PDF (463K) -
Hiroomi NAKATSU, Katsuhiko YASUHARA1997 Volume 46 Issue 2 Pages 173-177
Published: July 30, 1997
Released on J-STAGE: August 11, 2011
JOURNAL FREE ACCESSFrom April 1993 to July 1996, the records of 119 patients (mean age: 69) undergoing urologic surgeries were analyzed to evaluate the influence and efficacy of autologous blood transfusion. The mean total blood volume (TBV) and collected blood volume of these patients were 4, 110 ml and 687.9 ml. The levels of hemoglobin decreased gradually after blood collection. However, they never fell below 10 g/dl. It appears that the use of r-EPO allows the collection of a sufficient volume of autologous blood without the occurrence of anemia associated with phlebotomy.
Allogenic blood transfusion was dupensed with 68% for patients who underwent radical prostatectomy or total cystectomy, and 100% for those who underwent retropubic prostatectomy or transurethral resection of the prostate (TUR-P).
We concluded that autologous blood transfusion is significantly effective for patients undergoing surgeries of benign prostatic hypertrophy, while there is room for further reduction in allogenic blood exposure in patients for surgery of malignancy.View full abstractDownload PDF (749K) -
Kazuhisa KOBAYASHI, Aiko KASHIWAGI, Takenao IDESAWA, Takeshi KANAI, Ic ...1997 Volume 46 Issue 2 Pages 178-183
Published: July 30, 1997
Released on J-STAGE: August 11, 2011
JOURNAL FREE ACCESSWe report a case of vascular parkinsonism mainly treated at the patients' home with thyrotropin-releasing hormone (TRH). The patient was a 77-year-old male who had an attack of cerebral bleeding in the left posterior lobe in 1990. Thereafter, dysarthria, dysphagia and gait disturbance gradually developed. He had rigidity in the neck, and upper and lower extremities, but no tremor, and walked with short strides (marche a petit pas). We diagnosed the case as vascular parkinsonism, by his history and those symptomes.
We treated him mainly at his home since 1994. At first, we used combinations of levodopa, bromocriptine, amantadin, and anti-chorinergic drugs, but symptomes and signs of vascular parkinsonism did not disappear.
Finally, we used TRH 0.5 mg by an intravenous or intramuscular injection for 10-14 days a month. Thereafter, he became able to eat, speak and walk a little more, and we continued this therapy for about one year. He died in 1996 of asphyxia at a meal. We think TRH was effective for chronic stage of vascular parkinsonism even if treated at home.View full abstractDownload PDF (3294K) -
1997 Volume 46 Issue 2 Pages 184-192
Published: July 30, 1997
Released on J-STAGE: August 11, 2011
JOURNAL FREE ACCESSDownload PDF (1092K)
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