Evaluation of a surgical instrument with right-triangle mounts for diathermic conization of the uterine cervix.
Objective: The purpose of this study was to evaluate a surgical diathermic instrument with right-triangle mounts for conization of the uterine cervix.
Method: Twenty-five patients who received conization with the surgical instrument were enrolled for this study. Conization feasibility, complications, histopathologic interpretability and therapeutic outcome were assessed.
Results: The mean operating time and amount of bleeding were 10.6±4.1 minutes and 6.8±9.0g, respectively.
There were two cases of post-operative stenosis of the uterine cervical canal. Another two cases had positive margins in cone biopsies. Post-operative smears were postive in still another two cases.
The mean follow-up period was 9.4±11.6 months.
Conclusion: A surgical instrument with right-triangle mounts for diathermic conization of the uterine cervix proved to be usefull.

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Rosa duvurica pall (Rdp) is a kind of rose berries which came from the northern part of China originally. In the present paper, we examined whether or not Rdp exerts a neuronal protective action on cultured cells using the crude extracts from Rdp. When hippocampal neurons derived from a rat fetus were cultured in a serum-free medium supplemented with a reduced concentration of transferin, they began to die within a few days. Both vitamin E and K stimulated their survival at physiological concentrations of 10^-8M to 10^-6M. Rdp also showed similar activities like several other plants. However, none of these extracts did inhibit degeneration of glioma cells overxpressing an amyloid precursor protein (ARP), which are induced to die by chloroquine treatment and therefore regarded as one of AD degenerative model cells. Interestingly, only Rdp exerted some kind of action for repairing their damage caused by choloquine and stimulated their proliferation. It also prolonged the life of aged Chinese hamsters by about 15% on average. These data, taken together, suggest that Rdp contained some of the functional molecules that act on both neuron and glial cells from the central nervous system (CNS), probably enhancing neuronal activities in vitro and/or in vitro. Thus, this line of experiments my contribute to the promotion of the health of Japanese as well as the development of domestic agriculture in the 21' century when Japan is expected to be the most aged society.

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Since 1995, Matsukawa Town in Nagano Prefecture has started regular visits by health workers to the homes of persons with hyperglycemia found in annual health examinations. The aim of the present study was to investigate the effects of the visits by health workers. Of those persons with hyperglycemia found in 1994 or 1995 who had undergone health examinations every year from 1992 through 1997, 30 persons were visited by health workers and 35 were not. In 1997, laboratory findings showed that blood sugar levels returned to nomal in a significant 90% of those persons visited by health workers compared with 69% of those who were not. Positive rates in urine sugar test among those visited decreased from 20% to 10%. Additionally, those receiving the home care service tended to lose weight, while those not visited were likely to gain weight. These findings suggested that visits by health workers for health care of persons with hyperglycemia were effective in leading them to maintain a healthy daily life. Such home health care measures for persons with hyperglycemia are important for the prevention of diabetes in a community.

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We examined the rates of sudden death to ordinary deaths of the patients in two hospitals in Obihiro. A total of 130 sudden death cases (89 men and 41 women) out of 1, 088 ordinary deaths were listed (11.9%) during the period of two years from 1992 through 1993.
We also looked into the cause of sudden death in 86 autopsied cases over a 15-year period from 1985 through 1999 from a pathological stand point. Cardiac diseases underlay 49 cases of sudden death. Myocardial infarction (42 cases), cardiomyopathy (2), sarcoidosis (1), amyloidosis (2) and valvular disease (2) were regarded as the causes of death in the 49 cases. Myocardial infarction occurred more frequently in men than in women (27: 15). Next to cardiac diseases came aortic diseases such as ruptured aortic aneurysm (7 cases) and dissecting aneurysm (6). Cardiac diseases (49 cases) and aortic diseases (13) combined to account for 62 of 86 (72.1%) autopsied cases. Among noncardiovascular diseases, respiratory diseases (18 cases) topped the list, followed by alimentary diseases (3) and cerebral bleeding (2). The major cause of respiratory diseases was pulmonary embolism (16). Pulmonary embolism more often occurred in women than in men (14: 2). There was one case of unidentifiable sudden death, namely Pokkuri disease. A decreased incidence of sudden death on Sunday should be noted. A circadian rhythm was evident. The incidence of sudden death started rising from 6: 00 and peaked at 15: 00. Sudden death occurred during rest (42 cases), during routine daily activity (14), during sleep (11), during bathing (1), during defecation (8), during surgery (2), during physical exercise (6) and during agricultural work (2).

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Objectives: This study was carried out to verify the usefulness of the Japanese version of the Hearing and Disability and Handicap Scale (HDHS) in the self-evalution of hearing disorders and to clarify the relationships between the hearing disability/handicap scores and such QOL components as life satisfaction, self-rated health conditions and social support networks, etc.
Methods: A questionnaire survey was conducted in Soyo village in Kumamoto Prefecture. The subhects were 136 residents aged 40 years or older who had received health check-ups in accordance with the Health and Medical Service Law for the Aged and who had complained of mild to profound hearing loss in one or both ears. The questionnarie was composed of three parts; back-ground question, the HDHS, and question regarding QOL components. Evalution of language adequacy regarding the Japanese translation of HDHS was carried out with the assistance of four bilinguals.
Results: Data from 123 respondents who completed the questionnaire were analyzed. The results were as follows:
1) Chronbach's alpha coefficients for the three subscales of HDHS ranged from 0.873 to 0.899-all within satisfactory levels.
2) Maximum likelihood factor analysis with varimax roataion suggested that 20 items of HDHS could be categorized according to three factors: Fl-handicaps; F2-detection of such verbal sound as the TV or radio or daily conversation; F3-detection of such nonverbal sound as door chimes or the sound of boiling water.
3) The response rates of “Always or Sometimes” for five questions regarding verbal sounds ranged from 65.8% to 82.1% compared with 47.9% to 58.6% for those questions regarding nonverbal sounds. Those for 10 questions regarding handicaps showed a great disparity; 25.2% for Q15 and 60.1% for Q4.
4) Analysis of covariance structures suggested that increases in hearing disability and handicap scores were indirectly related, through the lowering of self-rated health levels, to a perceived deterioration of QOL.
Conclusion: To ensure high QOL levels among middle aged and elderly residents, the creation of supportive environments that contribute to the alleviation of the affects of communication disorders induced by age-related hearing impairments is extremely important.

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Questionnaire survey were conducted three times to evalute the social life and functional problems in patients with orthotopic neobladder after cystectomy. A total of 34 responses were collected froml9 patients with a mean age of 66 years at diagnosis. The patients with orthotopic neobladder were found to be troubled with prolonged urinary incontinence such as nocturnal enuresis and stress incontinence. The problems was deteriorating the quality of life of the patients.

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Recently, varieties of medical instruments have been developed and improved upon rapidly along with the progress of medicine. However, the advent of many types of new devices sometimes creates confusion on the clinical scene. The central supply system of medical instruments may be effective in reducing medical troubles and accidents, through centralized maintenance, check and repair stuff education and enlightenment.
In our hospital, the central supply room of medical instruments was established in April 1993 to try to reduce the costs and troubles. We have somehow managed our system by trail and error for eight years. Recently, many people who have any relationship with us have come to rate our system highly. We will try to make a further effort to establish a better supply system.

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A 59-year-old man was admitted to our hospital, complaining of fever and left lumbago. He was diagnosed with primary left iliopsoas abscess and treated with draining the abscess percutaneously and antibiotics. Chest x-rays taken on admission showed multiple round nodules in both lung fields. CT scans of the chest revealed a wedgeshaped lesion abutting the pleura in the left lower lung field and multiple nodules of various sizes in both peripheral lung fields. Some nodules had cavities with thin walls and feeding vessels. Follow-up CT scans to the chest demonstrated that some old nodules had vanished and new nodules developed in both lung fields. The diagnosis of septic pulmonary embolism secondary to iliopsoas abscess was established, because organized pneumonia was detected in the transbronchial lung biopsy specimens and the cultures of the pus from the abscess and the sputum on admission showed Enterococcus faecium.

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The patient was a 63-years-old female with early gastric cancer in her upper stomach. Widely spreading on the mucous membrane, the cancer was too big to remove by endoscopical mucosal resection, although she wanted minimal invasive treatment. Therefore, we adopted total gastrectomy with hand-assisted laparoscopic surgery (HALS) after obtaining “informed consent” from her. Five small skin-incisions were necessary to perform it-one 7cm' for hand-port and four 1.2cm' for trocars.
The dissection was started from greater omentum and proceeded counterclockwise to remove primary lymphnodes. The abdominal esophagus and the duodenum were devided with a single or double application of Endo GIA stapler (linear stapler). All these steps were accomplished safely and securely with the effective support of the left hand of the operator. After extraction of the whole stomach through the 7cm-incision, Roux-en Y reconstruction was performed laparoscopically (esophago-jejunostomy) followed by hand sewing through the 7cm-incision (jejuno-jejunostomy). The anvil of 21mm circular stapler (EEA) was inserted orally in order to anastomose the esophagus to the jejunum. The patient had acceptable results intra-operatively as well as postoperatively by HALS total gastrectomy, which had been considered to be very hard to perform up to present time.

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