Background/Objectives: Since April 2006, smoking cessation treatment has been included in public health insurance coverage, although conditionally. The tobacco control program usually takes 12 weeks or so. When it comes to the form of treatment, most medical care facilities adopt nicotine replacement therapy (NRT) at their outpatient ward. The cessation success rates are considered not so high as before. In stead of treating nicotine-addict outpatients individually, our hospital has been offering a stop-smoking program all its own since 1999. This study was designed to examine the results of our efforts in the last six years retrospectively.
Subjects/Methods: Enrolled for this study were 232 patients who had participated in our six-month smoking cessation program between 1999 and 2005. A non-smokingsupport team made up of a physician, pharmacist(s), nurses, dietitian(s) and physical therapist(s) takes care of groups of participating patients, each group consisting of 10 or less. The patients undergo behavior therapy throughout the 6-month period and NRT in the first eight weeks. Under the program, nutrition guidance is offered regularly by dietitians for weight control and physical exercises by physical therapists for relief from the stress due to abstinence from smoking. We took a questionnaire survey of all the subjects and worked out the ratios of those persons who had remained abstinent up to one year after they stopped smoking to the total.
Results: The rates of abstinence maintained eight weeks, six months and one year after the start of cessation were 78.4%, 70.3% and 64.7%, respectively. Of those who were still abstinent, 78.0% replied that they found it easy to resist the urge to smoke cigarette thanks to the smoking cessation program.
Conclusion: Our six-month participatory tobacco control program was found effective as high cessation rates were maintained.

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We investigated the system of emergency medical service in the Chuno area in Gifu prefecture.
It was found that about 20,000 emergency cases were carried into the Emergency Medical Center (EMC) in Chuno Kosei Hospital annually. About 90% were patitents with mild disease or injury. During the past four years an increasing number of severely ill patients such as those acute myocardial infarction and cerebral apoplexy were transfered to our EMC from other hospitals in the Chuno area.
We found that many emergency patients came to our EMC, which was not staffed with so many emergency care specialists nor equiped with so many beds for emergency patients. Therefore, we requested residents, family doctors, primary care clinics, common hospitals and administrators in the Chuno area, to contribute their share to emergency medical care together with EMC.
In conclusion, we thought it necessary to build a better system of emergency medical care in this area promptly.

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  Nosocomial infection management is one of the most important subjects in terms of risk management in a hospital. To achieve the nosocomial infection management appropriately, both public relations and information gathering are important. When it comes to publicity, it is desirable that information is offered quickly and efficiently and the personnel are able to access the information easily anytime and wherever they are. As for information gathering, it is also important to collect the information concerning the nosocomial infection promptly, and to tell it quickly to infection management persons including infection control team members. The infection control committee of our hospital has engaged in both publicity and information gathering by using the committee web site established in the LAN of the hospital since January 2004. The web site carries notifications, organization chart, list of committee members, various manuals, guidance of educational activities, infection management, etc. It is also used for questions and answers, and gathering information concerning nosocomial infection. The number of times the web site was accessed was about 200 every month, and was considerable at night and on holidays. This method of using the web site seems to be useful to promote nosocomial infection management.

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  The purpose of this report was to evaluate the effect of oral appliances (ORAP) on patients with obstructive sleep apnea syndrome (OSAS) patients and to examine problem with ORAP therapy.
  Five patients (3 men and 2 women) who had OSAS were treated by ORAP therapy. Each patient underwent polysomnography before and after ORAP therapy. Percutaneous arterial oxygen saturation (SpO₂) and Apnea Hypopnea Index (AHI) were measured and were compared.
  SpO₂ levels were decreased and AHI figures were increased after ORAP therapy. The results indicated ORAP therapy was an effective treatment for OSAS.

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  A questionnaire survey was taken on the subjects administered an investigational new drug in order to look into their attitude toward a clinical testing and assessment of the work of the pharmacists clinical research coordinating the testing. Questionnaires were sent to 75 outpatients who were tested on with a new drug between January 2001 and March 2006. 55 individuals responded to the inquiry. All the subjects were taken care of by the coordinators by turns. The major concerns to the testees when they participated in the trial were the adverse reactions and efficacy of the new drug. Of the subjects who felt uneasy, 79.4% cited the adverse reactions and 50% about the efficacy. Some 80% of the respondents said they were satisfied with the explanation given beforehand about the nature of the clinical testing. The majority of the subjects, when they were in a fix, turned to pharmacist clinical reave coordinators for advice, not the physician nor nurses. The guidance given by the clinical reave coordinators about medication was generally received favorably. From the above-mentioned findings, it was made clear that the pharmacists clinical research coordinating the clinical trial played an important role as consultants in alleviating the anxiety of the testees during the trial. In the future, pharmacists will do the best to measure up to the expectations as coordinators in the clinical trial of new drugs by improving care of the testees individually while taking into their backgrounds and wishes into full consideration.

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  Sound management of hospital in Japan in general has become more and more difficult with frequent reductions in the fees officially paid to medical institutions for medical examinations and treatments, and this current situation obviously necessitates a more efficient way of hospital management and ardent efforts at improvement on the part of our hospital as well. The Division on Nursing has set the goals to implement thoroughgoing cost-management strategies and to strengthen cooperation with other divisions. For this purpose we visited the hospital wards jointly with other personnel from the Divisions of Medical Materials and Dispensary to check inventories of medical materials and to make them optimum. As a result, it was found that medical materials were often improperly placed, stored excessively, or returned inaccurately. The instructions for redefining the proper quota of the medical materials per ward, putting them in order and returning them properly in case of excess facilitated direct communication and cooperation between divisions, and resulted in inventory reduction and thus the annual costs of returning them. These efforts successfully inspired each staff member to participate voluntarily in the management of our hospital, which eventually led to reasonable inventory control of medical materials. It would be important for each division, while demonstrating its specialty, to realize the importance of cooperation to reach far greater achievements.

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  Basal ganglia are an area where cerebral haemorrhage occures frequenthy. Recently our knowledge of the brain and its function increases rapidly, but this knowledge is not much used in rehabilitation yet. Parallel neural networks (Hikosaka, 1999) are a model of sequential procedures learning, and basal ganglia perform an important function in it. Using this model, we designed a rehabilitation approach and applied it to a patient with left putamen hemorrhage. In the early stage, we promoted passive movement of her paralysed arm and fingers in the spatial coordinates with her eyes opened. Afterwords, we guided her to motor leaning in the motor coordinates with somatic sensation with her eyes closed. We intended to integrate the spatial coordinates and motor coordinates, by which we encouraged her to move her arm and fingers with her eyes opened after her recognition of motion perception improved. Her motor paralysis of fingers in particular improved by rehabilitation, which lasted about 1.5 month. We recognized some improvement in her arm, but it was slightly insufficient than her fingers. We considered that a difference in the degree of improvement occurred because she could not confirm enough on her shoulder in the early stage.

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