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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 2
Displaying 1-11 of 11 articles from this issue
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ORIGINALS
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Satoru TAKEUCHIArticle type: Others
Subject area: Others
2004 Volume 53 Issue 2 Pages 103-109
Published: 2004
Released on J-STAGE: March 29, 2005
JOURNAL FREE ACCESSThe purpose of this study was to review the outcome and recurrence pattern of patients operated on for endometrial cancer with regard to its prognostic factors.
Forty-two patients who underwent surgery for primary endometrial cancer at the Kochi Municipal Hospital from January 1996 to August 2002 (6 years 8 months) were retrospectively reviewed. The Kaplan-Meier survival plot was used to draw disease-free survival.
Five of 42 patients had the events in which one patient died of the disease three months after the operation and four had recurrence. All recurrence parts were vaginal stump. Four of 32 patients who underwent pelvic lymphadenectomy had lymph node metastasis in which one patient in stage IV had a recurrence. The estimated 3-year disease-free survival rates of patients in stages I, II and III were 87.4%, 75.0% and 100%, respectively. The disease-free survival rate of patients in stage IV was 0% at 6 months.
In Patients with endometrial cancer especially in stages I and II, prevention of the vaginal stump recurrence might have improved the disease-free survival.View full abstractDownload PDF (73K) -
Junichi TAZAWA, Katsuhiro SANADA, Yoshinori SAKAI, Michio YAMANE, Fumi ...Article type: Others
Subject area: Others
2004 Volume 53 Issue 2 Pages 110-117
Published: 2004
Released on J-STAGE: March 29, 2005
JOURNAL FREE ACCESSThe whole spectrum of patients infected with hepatitis C virus (HCV) who visited hospitals has not been fully clarified. It is also unknown whether such patients have visited the hospitals regularly thereafter for a long period. We studied 844 consecutive patients with liver diseases who visited our outpatient clinic located in the southern region of Ibaraki Prefecture. Five hundred eighty-three patients were HCV-infected. Among them, three patients were HBsAg-positive and another patient was IgM anti-HAV positive. Thus, 579 patients (68.6%) were considered to have HCV solely as a hepatotropic virus.
Of these HCV patients, 60 were asymptomatic carriers and 15 others were unclassified because of the absence of either biopsy or imaging test records of the liver. As to the rest of the HCV patients, acute hepatitis was diagnosed in one patients, chronic hepatitis in 332 patients, cirrhosis in 130 patients and cancer of the liver in 41 patients.
About half of the patients undergoing liver biopsy showed F1 in the degree of liver fibrosis. The rate of virological response to interferon mono-therapy in patients infected with genotype 2 was worse than the national average. The poor response was considered to be due to high viral load. It was suggested that the distribution of patients with each genotype was uneven in this region. After five years, the rate of patients still visiting our clinic were 68.1% for those with chronic hepatitis, and 50% for the healthy carriers. We deemed that it was important to clarify whether patients not visiting our clinic are followed up closely in other hospitals.View full abstractDownload PDF (84K) -
—For Prevention of Hospital Floors from getting Stained—Kaoru OHE, Takao OZAKI, Naoko NISHIMURA, Kenichi MORISHITA, Yukio KATOArticle type: Others
Subject area: Others
2004 Volume 53 Issue 2 Pages 118-122
Published: 2004
Released on J-STAGE: March 29, 2005
JOURNAL FREE ACCESSIn August 2001 we began to use WELPAS (a benzalkonium chloride solution) as part of our cost-containment drive, replacing self-made glycerol-added ethanol, which had been used for a long time to prevent nosocomial infections. Since then, blackish stains have become particularly noticeable here and there on the floorboards of the passageways in the hospital wards. The newly adopted quick-drying hand disinfectant was suspected as the culprit. To find the real cause of the dirt, we built a hallway similar to the real passageway for experiment. The disinfectant agents used were WELPAS, WELLUP (chlorhexidine gluconate), HIBISOFT (chlorhexidine gluconate), medicinal ethanol, cationic detergent solution, HIBITANE solution (chlorhexidine hydrochioride) and glycerol solution. These agents and distilled water were dropped on a limited area of the floor respectively for comparison of the degrees of dirt. The cationic detergent solution and WELPAS containing cationic detergent left blackish stains that were hardest to remove. From this finding, it was inferred that the cationic detergent solution was responsible for the dirt on the floor. So we decided to switch to a quick-drying hand disinfectant which does not contain cationic detergents. After considering economic benefit, we chose WELLUP which contains medicinal alcohol plus chlorhexidine gluconate and put it into actual use in October 2003. Since then, the hospitall floors have become unmistakalbly clean.View full abstractDownload PDF (56K)
REPORTS
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Hiroshi NAGAMI, Nobuki YAJIMA, Shinji ASANUMA, Makoto USUDA, Miwako HI ...Article type: Others
Subject area: Others
2004 Volume 53 Issue 2 Pages 123-130
Published: 2004
Released on J-STAGE: March 29, 2005
JOURNAL FREE ACCESSIn japan, pesticides have been used increasingly after World War II and pesticide poisoning has been a major issue of rural medicine. In other Asian countries, pesticide poisoning also seems to be a great concern of rural medicine and occupational and environmental medicine as well. We reviewed the results of research on the prevention of pesticide poisoning in Asia with the reports of international organizations and articles which appeared in medical journals.
The WHO Glabal Information Network on Chemicals worked out an international protocol to collect and analyze the cases of pesticide poisoning, and is carrying out hospital-based surveys in east and south Asia from 1998. These data were discussed in comparison with the results of our hospital-based survey of pesticide poisoning in 1998-2000.
Also, FAO has been exploring the concept of “community integrated pest management (CIPM)” from 1999, in Asian countries. In a project related to this, farmers were asked to report their pesticide use and symptoms, and researchers analyzed the data and gave advice to the farmers, and these practices produced so fruitful findings that the farmers have come to refrain from using hazardous pesticides of their own accord.
These research projects are expected to complementarily contribute to the prevention of pesticide poisoning. We resumed the hospital-based survey of pesticide poisoning in 1996, and have collected and analyzed several hundreds cases. In order to reduce pesticide poisoning in Japan and other Asian countries, we are interested in rendering cooperation in those projects.View full abstractDownload PDF (64K) -
—Surgical Operation of Psychiatric Patients—Mutsuo SAITO, Tsunehiko ENOMOTO, Kazuhiko TSUNODAArticle type: Others
Subject area: Others
2004 Volume 53 Issue 2 Pages 131-139
Published: 2004
Released on J-STAGE: March 29, 2005
JOURNAL FREE ACCESSNiigata Prefecture is suffering from a chronic shortage of physicians. The 2000 statistics shows the number of physicians in active service is 162.5 for 100,000 population. This ranks the prefecture 40th among all the 47 administrative divisions of Japan (Average : 191.6 physicians). In the area including Ojiya, where our hospital is located, the number of physicians per 100,000 population works out at 124.5. A lack of physicians poses a serious problem. It is extremely difficult to maintain the quality of medical treatment and meet emergencies. As one of the countermeasures, the Niigata Prefectural Federation of Agricultural Cooperatives for Health and Welfare has made a network of seven hospitals in the Chuetsu area. The network is functioning well between our hospital and the surrounding four hospitals-Nagaoka Chuo General Hospital (Nagaoka), Nakajo Hospital and 2nd Nakajo Hospital (Tokamachi) and Kariwa-gun General Hospital (Kashiwazaki) because of favorable geographic conditions. Our hospital accepts psychiatric patients from 2nd Nakajo Hospital who need surgical treatment. Although our hospital does not have a psychiatric department, we accept those patients and have obtained good results.View full abstractDownload PDF (79K) -
—With the Aim of Maintaining No-Fault Record—Tokie MIZUNO, Emi KURASHIMA, Hideyo KAWAI, Yoneko MIURA, Yukitoshi MUR ...Article type: Others
Subject area: Others
2004 Volume 53 Issue 2 Pages 140-144
Published: 2004
Released on J-STAGE: March 29, 2005
JOURNAL FREE ACCESSAs part of community health care services provided by our hospital, there are regular visits by a nurse and/or a physician to patients in their homes. Durin one year from April 2001 to May 2002, we inadvertently skipped 15 visits. It was feared that if nothing were done, such a failure in duty would occur at least once a month. To find the way out of this situation and to reduce the number of skipped cases to zero, we made concerted efforts, turning to the methodology of Total Quality Management (TQM) activities.
We tried to grasp the state of things to begin with, and investigated the root causes of the failure. The causes were analyzed using the fishbone diagram. Based on the results of analysis, preventive measures were adopted. Thanks to this, as of February 2004, there are no cases in which we have been remiss in visiting our patints for care in their homes.View full abstractDownload PDF (66K) -
Souichi FURUHATA, Keiko KATOU, Katsunori YAMAKAWA, Masanari YAMAGOE, T ...Article type: Others
Subject area: Others
2004 Volume 53 Issue 2 Pages 145-147
Published: 2004
Released on J-STAGE: March 29, 2005
JOURNAL FREE ACCESSWe investigated the outcomes of nephron-sparing surgery in patients with small renal cell carcinomas by retrospectively reviewing the records of 20 elective cases of nephron-sparing surgery performed from 1994 to 2003. All patients had low pathologic stage, localized, unilateral tumors smaller than 4 cm and sporadic renal cell carcinomas. There were no significant differences between mean preoperative serum creatinine levels and postoperative levels. Nephron-sparing surgery may be safe and curative treatment for low pathologic stage, localized, unilateral tumors smaller than 4 cm and sporadic renal cell carcinomas.View full abstractDownload PDF (36K) -
Kenichi NOMURA, Yasuko SUZUKI, Takaaki SUZUE, Hiroaki SUITOArticle type: Others
Subject area: Others
2004 Volume 53 Issue 2 Pages 148-155
Published: 2004
Released on J-STAGE: March 29, 2005
JOURNAL FREE ACCESSToday, the circumstances surrounding the medical economy are severer than ever. Therefore, it is vitally important for a hospital to rationalize management and implement a labor-saving system drastically.
In October 2000, Atsumi Hospital moved to a newly built complex. At that time, those sections and departments which do not have any direct relation to medical treatment and care were restructured and established a supply center in order to use human resources effectivily.
Before the establishment of the supply center, we had reviewd simple, routine tasks such as ward nursing assistant services, office work and management itself.
While introducing our hospital supply center in this paper, we compare efficiencies before and after the move to the new building and dwell on advantages of centralization of ward nursing services.
The rearrangement of the personnel, materials and information has made it possible to increase the efficiency of simple work and reduce the number of nursing assistants by 20%. Henceforth, it would be necessary to educate the staff, work on proper personnel changes, carefully make a plan for outsourcing, and choose trustworthy dealers.View full abstractDownload PDF (63K)
CASE REPORTS
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Fukiko MITSUI, Hironori TOKUMO, Kei SHINAGAWA, Yasumasa ASAMOTO, Hiron ...Article type: Others
Subject area: Others
2004 Volume 53 Issue 2 Pages 156-160
Published: 2004
Released on J-STAGE: March 29, 2005
JOURNAL FREE ACCESSA 41-year-old woman liked farm chemical-free (pesticid-free) vegetables. She was admitted for severe upper abdominal pain. Biliary ascariasis was suspected upon abdominal ultrasonographic examination. ERC (Endoscopic Retrograde Cholangiography) was performed and a linear filling defect was shown in the bile duct. We diagnosed her case as biliary ascariasis. And then, we removed a worm from the bile duct using stone extracer basket forceps. After this, she was given pyrantel pamoate.
Abdominal ultrasonographic examination was helpful in diagnostic screening for biliary ascariasis. ERC and basket forceps were useful in removing the parasite.View full abstractDownload PDF (87K)
NURSING RESEARCH REPORTS
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Masayo NOMURA, Hitomi MURAO, Hideko TERADAArticle type: Others
Subject area: Others
2004 Volume 53 Issue 2 Pages 161-166
Published: 2004
Released on J-STAGE: March 29, 2005
JOURNAL FREE ACCESSThe chemotherapy unit of our hospital came into existence in April 2002. Since then, we, nurses, have teamed up together in support of cancer patients who visited us for receiving chemotherapy. We investigated the use of the facilities during the first 12 months since the opening of the unit, and made a questionnaire survey to sound out the degree of the patients’ satisfaction and needs. This paper describes our findings.
The number of patients who used the chemotherapy unit came to 1,213. The questionnaire survey were conducted on 40 outpatients who initially had visited the department of surgery of our hospital. Of the patient supporting tools, the self-help notebooks were utilized by 27 patients. Those patients who said they took nurses into their confidence numbered 34. They expressed their anguish and uneasy feelings in connection with the condition of their disease and treatment. The same number of patients replied that they wanted to receive chemotherapy even if extra charges were involved. From these findings, it could be said that the patients’satisfaction was great. However, it was also suggested that to obtain the informed consent from the patients there should be explanatory leaflet which explain the therapeutic procedure and additional fees in plain language, that repeated instructions about side effects should be given orally, and that nurses are required to occasionally act as moderators between the unit and other departments in accordance with the patients’wishes. These are some of the patients’needs. To fill them, further studies must be made.View full abstractDownload PDF (44K) -
—Present State and Problems to Be Solved—Kyoko NAKAZAWAArticle type: Others
Subject area: Others
2004 Volume 53 Issue 2 Pages 167-171
Published: 2004
Released on J-STAGE: March 29, 2005
JOURNAL FREE ACCESSRegular visits by an NICU nurse to the high-risk pregnant woman (at ahigh risk of complications) are very effective in allaying the anxiety of her family and supporting the family after childbirth as well. To provide the home-visit services that measure up to the needs of such pregnant women and their families, we analyzed the contents of the services and discuss the present state of affairs and problems yet to be solved.
Using the applications presented by 62 families for the home-visit services and their reports, a survey was conducted to find out the family backgrounds, the recipients of the services other than pregnant mothers, and their expectations from the home-visit program.
Of the families of those pregnant women who were admitted later into the Neonate Intensive Care Unit, 19.1% had been visited by NICU nurses while the expectant mothers were in the maternity ward. Of those expectant mothers, 81% were in the 35 weeks or less of gestation. The anxiety of the women who are very likely to be put in the NICU and their family members is great. Pregnant women and their family members who both recieved the home-visit services accounted for 71% of the 62 families. It was found that they were most anxious to know about the growth and developmental disorders of the unborn babies, prognosis, hospital charges and the process of giving birth. From this, we deemed it highly important for visiting nurses to put themselves in their shoes and share in their feeling toward the neonates. This will surely help them strength the ties that bind the family members together. The nurses are required to have leadership qualities with adequate knowledge of NICU and perinatology.View full abstractDownload PDF (43K)
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