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Volume 53 (2004)
- Issue 6 Pages 873-
- Issue 5 Pages 775-
- Issue 4 Pages 631-
- No.3
- Issue 2 Pages 103-
- Issue 1 Pages 1-
Volume 53, Issue 1
Displaying 1-13 of 13 articles from this issue
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REVIEW
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—A Forecast Based on Our Long-Time Experience—Hidehiko ICHIKAWA, Sumako HANAOKAArticle type: Others
Subject area: Others
2004 Volume 53 Issue 1 Pages 1-10
Published: 2004
Released on J-STAGE: March 29, 2005
JOURNAL FREE ACCESSIn January 2004, a panel of experts (chairman : Satoshi Ueda) commissioned by the Health and Welfare Bureau for the Elderly, the Ministry of Health, Labor and Welfare, came up with an idea suggesting a direction the nation’s rehabilitation project for the aged should take in the future. This has rekindled the debate over the way the rehabilitation work for the old people should be carried out the inevitable subject of discussion that had been taken place on and off since the nursing care insurance system came into being.
We have been involved in the rehabilitation of those people mainly with the after-effects of strokes since the early 1960’s when the Japanese government embarked on the rehabilitation project for the elderly.
In this paper, we examined our ways of grappling with the task of rehabilitation for the aged people in retrospect. At the same time, from the standpoint of the philosophy that the rehabilitation work for the aged should be aimed at recovering their mental and physical functions to improve their quality of life, we envisioned the future of the rehabilitation project for the old people with stress placed on the following two points :
(1) the working on a rehabilitation program for the aged after the model of the international classification of functioning, disability and health ; and
(2) the building up of a community-based rehabilitation system interlocked with an overall program for the promotion of health care, welfare and security in the local community.View full abstractDownload PDF (54K)
ORIGINAL
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—Incidence and Outcome—Kenji KIKUCHI, Yoshitaka SUDA, Hitoshi SHIOYA, Kenjiro SHINDOArticle type: Others
Subject area: Others
2004 Volume 53 Issue 1 Pages 11-22
Published: 2004
Released on J-STAGE: March 29, 2005
JOURNAL FREE ACCESSPurpose : The purpose of this study was to analyze the incidence if subarachnoid hemorrhage (SAH) in residents of Honjo City and its vicinity in northen Japan with a total population of 123,000 during the 8-year period from 1995 through 2002, and to evaluated the overall management outcome of the patients with SAH. Methods : All patients suspected of having SAH are referred to our hospital, which plays a crucial role as a “core” hospital in the region. Computed tomography (CT) scan was indicated for all the patients to verify the occurrence of SAH, and subsequently three dimensional (3D) CT angiography and/or catheter angiography were performed to confirm rupture of aneurysms. Results : During the period under review a total of 327 patients were diagnosed as having aneurysmal SAH, and ruptured aneurysms were confirmed in 276 cases (84%). The cruse annual incidence was 33.0 per 100,000 population for all ages during the entire 8-year period. However, the annual incidence has gradually decreased in contrast to an increasing number of operations for unruptured aneurysms performed during the same period. The age ranged from 21 to 92 years with the mean age of 64.5, and the incidence reached a peak in the 70-79 age group. Women far exceeded men in the incidence at the ratio of 1.8 to 1. The high grade patients with severe SAH as evaluated as grade 4 and 5 according to Hunt & Kosnik’s classification consisted of 45%, and 50% of this group were the patients 70 and older. Overall management outcome was assessed 6 months after the onset of SAH with the use of Glasgow Outcome Scale, and favorable outcome such as good recovery and moderate disability was obtained in 42% of the total 327 patients and death occurred in 39%. Conclusion : The high incidence of SAH was confirmed, and it was also noted that the number of elderly patients with severe SAH has increased in this region. Preventive treatment for unruptured aneurysms may be one clue to the solution of this devastating medical problem.View full abstractDownload PDF (228K)
REPORTS
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Nobuyuki HORIUCHI, Yosio NISHIGAKI, Kuninori SHIWAKU, Takeshi MATSUNAG ...Article type: Others
Subject area: Others
2004 Volume 53 Issue 1 Pages 23-37
Published: 2004
Released on J-STAGE: March 29, 2005
JOURNAL FREE ACCESSThis paper describes the results of clinical and epidemiological studies of pathogen-carrying madani tick bites and the vector-borne diseases. The studies were conducted by a group of researchers specially organized by the Japanese Association of Rural Medicine.
Questionnaires were sent out to JARM-affiliated 108 medical institutions to collect information about cases of ixodiasis, Lyme disease and Japanese spotted fever. It was found that during 2002, there were 151 cases of Ixodes tick bites (67 males and 84 females) and 17 cases of Lyme disease (13 males and 4 females). The incidence of Japanese spotted fever was zero.
The survey also found that before that year, 24 out of the 108 medical institutions had treated tick bite cases and 13 handn’t. No reply came from the rest. As to Lyme disease, six hospitals had experienced in treating this vector-borne disease, 31 hadn’t and the rest did not reply. Japanese spotted fever was confirmed by one hospital. Thirty-three hospitals said they had not encountered this disease. The remaining 74 facilities did not respond. It was regrettable that more than a half of the 108 institutions did not respond to the survey. Considering that new types of infectious diseases caused by new forms of pathogens are raging nowadays, we, professionals affiliated with the Japanese Association of Rural Medicine, must keep careful watch on these diseases.View full abstractDownload PDF (338K) -
Masanori NISHIO, Hirotsune ITATSU, Izumi TSUYAMA, Michiko ITO, Hiroko ...Article type: Others
Subject area: Others
2004 Volume 53 Issue 1 Pages 38-45
Published: 2004
Released on J-STAGE: March 29, 2005
JOURNAL FREE ACCESSIyaku Bungyo means separation of dispensing from medical practice. Under this system, physicians provide outpatients with prescriptions, if need be, after examinations. The patients visit neighborhood drugstores and produce the prescriptions to pharmacists, who are authorized to accept patients covered by health insurance and to make up prescriptions. The prescribed medicines will be given to the patients in exchange for the payment. The pharmacists will also instruct the customers how to take in the prescribed medicines properly. The system has been so designed as to improve the quality of health care services with the physicians and pharmacists performing their respective roles as the specialists. However, the government office is promoting the Iyaku Bungyo system in favor of the pharmacies outside the hospitals in the name of the containment of medical costs, charging that the medical institutions prescribe and dispense so many kinds and quantities of medicines the patients can hardly take in, simply to make large profits from a comfortable margin between the market price for each pharmaceutical and the price at which it is actually purchased. Ministry of Health, Labor and Welfare officials and insurers have trumpeted the system as if it were an ideal scheme to curb health care costs. In reality, however, medical expenses have been boosted up. It can be taken for granted that the expenditure on national health care is increasing year after year with the population of the elderly on the rise and progress in medical technology. Notwithstanding, it is an important task to hold down increases in the cost of health care with the advent of an era of an aging population.View full abstractDownload PDF (54K) -
—Tabulated for First and Second Years—Osamu NOGUCHIArticle type: Others
Subject area: Others
2004 Volume 53 Issue 1 Pages 46-52
Published: 2004
Released on J-STAGE: March 29, 2005
JOURNAL FREE ACCESSIn recent years, spiral computed tomography has played an increasingly significant role in mass health screenings for lung cancer. Given this development, the Specialists’Committee for Lung Cancer Mass Screening in Nagano-Ken Koseiren (Nagano Prefectural Federation of Agricultural Cooperatives for Health and Welfare) came out with a van of its own suitable for mass screening by use of a spiral CT scanner and organized a caravan team of lung cancer screenings in 2001. With the collaboration of 11 general hospitals affiliated with Nagano-Ken Koseiren and its Health Care Center, our program includes films reading, guidance based on findings, workups, treatment and prognostic management. We examined 6,633 people in the first year and another 6,639 in the second year. In the two years, 55 examinees were found to have lung cancer. In the two years, we had 11,140 initial examinees, 54 of whom were found to suffer from lung cancer (detection rate : 0.48%). As many as 1,862 persons participated in the annual lung cancer screening two years running. Of them, one examinee was found to have lung cancer in the second year (detection rate : 0.05%). The sex-specific rate of detection in the initial screening was 0.25% for males and 0.80% for females, suggesting that the ratio for women was overwhelmingly higher. A histological check of 55 cases found to have lung cancer reveals that 51 cases (93%) had adenocarcinoma. After the removal of detected carcinomas, the diameters of tumors were found for 54 cases. Of them, there were 24 cases (44%) with a micro-cancer less than 10 mm in diameter and 43 cases (80%) with small-sized lung cancer less than 20 mm. In terms of stages, therefore, as many as 48 cases (87%) were in the IA stage, suggesting that this lung cancer screening is significantly useful in detecting lung cancer in an early phase.View full abstractDownload PDF (90K)
CASE REPORTS
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Koh KANEDA, Yuichi TOKUNAGA, Toru OKAMURAArticle type: Others
Subject area: Others
2004 Volume 53 Issue 1 Pages 53-55
Published: 2004
Released on J-STAGE: March 29, 2005
JOURNAL FREE ACCESSWe report a case of right cervical (C2-C4 area) acute herpetic pain successfully treated by therapeutic selective nerve blocks. A47-year-old man complained of right cervical persistent pain and frequent intermittent pain associated with herpes zoster. This pain was resistant to standard therapies such as satellite ganglion block and epidural block. On the 10th day after onset, the patient was treated by X-ray-guided therapeutic C3 and C4 selective nerve root blocks, resulting in an almost immediate relief of pain. The patient remained pain-free, and postherpetic neuralgia (PHN) was prevented. Although there are various treatments for PHN, none produces definitive effects. Relief of acute herpetic pain and prevention of PHN are important in the treatment of herpes zoster.View full abstractDownload PDF (78K) -
Manabu OKANO, Shigeaki YOKOI, Yukimichi KAWADA, Toshiyuki MIYAHARA, Ta ...Article type: Others
Subject area: Others
2004 Volume 53 Issue 1 Pages 56-59
Published: 2004
Released on J-STAGE: March 29, 2005
JOURNAL FREE ACCESSA case of inguinoscrotal bladder hernia in a 68-year-old man is reported. He was referred from the Department of Internal Medicine to our department because of the presence of occult blood in the urine. On abdominal examination, a goose-egg-sized inguinal hernia was noted extending into the scrotum. Cystography, CT and MRI demonstrated hernia of the bladder into the right side of the scrotum. Although a radical cure operation had been planned, ileocecum excision was enforced, as the symptoms of appendicitis were developed. Postoperatively, the right side of the inguinal swelling disappeared, and the repeated cystgraphy showed the bladder to be in the normal position with a normal contour.View full abstractDownload PDF (101K)
NURSING RESEARCH REPORTS
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Namiko KIKUYA, Seiko HAYASHI, Chisato TAKAHASHI, Kazuko MURAKAMIArticle type: Others
Subject area: Others
2004 Volume 53 Issue 1 Pages 60-64
Published: 2004
Released on J-STAGE: March 29, 2005
JOURNAL FREE ACCESSIntroduction : Every day, patients undergo rehabilitation training under the guidance of a physical therapist person-to-person, but it ends in a short time. A patient who are taking walking exercises in the rehab center is confined to a wheelchair when that patient returns to the hospital ward. Such being the situation, we introduced part of the rehabilitation program into daily routine in the ward life. All the staff of the convalescent ward joined forces to help the patients restore their ability to perform the basic activities if daily living (ADLs) and motivate them to return to normal. The results of our efforts shall be reported here.
Subjects and Methods : A total of 10 patients who were undergoing training in the rehab center were the subjects for this study. The progression of rehabilitation was observed and documented. The target of rehabilitation at the hospital ward was set. Their ability to perform ADLs were assessed.
Results : Eight of the 10 subjects achieved the objective. Two persons failed because they got out shape. Two of the eight subjects who could attain the objective became eager to do daily routine.
Discussion : Before this study, we only drove the patients to and from the rehab center, but when the study got started, we came to observe the patients from various angles because we had opportunities to grasp the situation about rehabilitation, to asked physical therapists questions about care and exercises and exchange views with them. We thought that the introduction of part of the program implemented in the rehab center into daily routine in the ward life and the setting of the target of rehabilitation contributed to the enhancement of the levels of the patient’s ability to perform the ADLs. The old people exhibit a peculiar state of mind due to physical inactivity and aging. When they are hindered from performing daily activities, they feel frustrated and plunge into helplessness. We thought that it is important to make them take an interest in what they can do instead of what they cannot do, if we are to uplift their ability to perform ADLs and improve the quality of their life.
Conclusion : Giving the patients rehabilitation training in concert with physical therapists results in the improvement of their ability to do the activities of daily living.View full abstractDownload PDF (34K) -
—How did women who gave birth feel about birth plan?—Yaeko ISHIKAWA, Risako KINOArticle type: Others
Subject area: Others
2004 Volume 53 Issue 1 Pages 65-74
Published: 2004
Released on J-STAGE: March 29, 2005
JOURNAL FREE ACCESSDownload PDF (58K)
MATERIAL
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Nobuyiki KOBAYASHI, Fusakuni KURODA, Takashi DOI, Makoto KINOUCHI, Yas ...Article type: Others
Subject area: Others
2004 Volume 53 Issue 1 Pages 75-79
Published: 2004
Released on J-STAGE: March 29, 2005
JOURNAL FREE ACCESSDuring the period of 25 years from January 1978 through December 2002, a total of 808 colorectal cancer cases were operated on in Shirakawa Kosei General Hospital. The number of sugical resection cases came to 713 (ratio : 88.25%). Curative resection was performed on 593 cases (ratio : 73.4%). The total number of cases was broken down into 446 cases of cancer of the colon and 369 cases of cancer of the rectum (7 multiple cancer cases included). By sex, male cases numbered 329 and female cases 379. Clinically or histologically, many cases were diagnosed as stage IIIa or stage II cancer. The 5-year-survival rate for the resection cases was calculated at 67.2% and that for the cure resection cases, at 79.5%.View full abstractDownload PDF (40K)
SHORT COMMUNICATION
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Tetsuaki SHUMIYA, Yoko KUNIMASA, Chizuru HISHIKAWA, Yoko OBA, Chiemi S ...Article type: Others
Subject area: Others
2004 Volume 53 Issue 1 Pages 80-82
Published: 2004
Released on J-STAGE: March 29, 2005
JOURNAL FREE ACCESSFrom April 1, 2002 through March 31, 2003, 158 accident reports were submitted from 35 staffers of the nutrient Department in Showa Hospital. We analysed the causes of accidents with the aim of preventing future accidents. It was found 90 cases were attributable to errors in paperwork (57%), 56 cases dul to waiting errors (35%), eight cases to foreign body contamination (5%), and four cases to other resons (3%). Most accidents occurred by lack of confirmation, and it seemed that thoroughness of affirmation such as repetitive affirmation by a plural number of staffers prevent accidents. We should feed back both contents and causes of these accidents to all the employees, and should make a new guideline for accident prevention.View full abstractDownload PDF (71K)
REGIONAL MEETING
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Article type: Others
Subject area: Others
2004 Volume 53 Issue 1 Pages 83-91
Published: 2004
Released on J-STAGE: March 29, 2005
JOURNAL FREE ACCESSDownload PDF (54K) -
Article type: Others
Subject area: Others
2004 Volume 53 Issue 1 Pages 92-100
Published: 2004
Released on J-STAGE: March 29, 2005
JOURNAL FREE ACCESSDownload PDF (49K)
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