Recently, people are interested in visceral obesity and metabolic syndrome (MS). The Japanese Ministry of Health, Labor and Welfare has decided to introduce a new MS screening system and health promotion guidance on the prevention of type 2 diabetes mellitus (diabetes) and cardiovascular disease from 2008. We analyzed the prevalence of MS and estimated the number of candidates for MS in a rural community based on the new criteria provided by the Japanese Association of Internal Medicine and the Ministry of Health, Labor and Welfare. Data obtained from 393 males and 526 females aged over 20 years were studied for the prevalence of MS and diabetes. The prevalence of MS was 14% for males and 6% for females. It was a remarkable lower prevalence than the reported prevalence in urban communities. We calculated again the prevalence of MS with the exclusion of diabetes, because diabetes was usually preceded by MS. The prevalence of diabetes and MS was 10% and 10% for males and 8% and 6% for females, respectively. Diabetes increased with age, but MS prevailed among younger people aged 20-59 years. We think that countermeasures against MS should be taken targeted on younger people, and those against diabetes on elder people. We also estimated the member of people with MS using the Ministry of Health, Labor and Welfare criteria. In 2012, the health organizations, both public and private, will be providing service to 3,470 thousand adults with MS and encouragement to 3,950 thousand adults to have a motivation for healthy lifestyle.

View full abstract

  Percutaneous endoscopic gastrostomy (PEG) is a common procedure for placing a feeding tube in the stomach to provide fluids and nutrition to patients who have difficulty in swallowing or in taking enough noutrishment through the mouth. Thought the procedure is simple and easy, PEG is not without its risks. The reported complication ratio is not low-, -between 5.7% and 33.3%. This is probably because the patients are lacking in reserves of physical faculties.
  The present study was conducted to work out measures to reduc the incidence of PEG complications by reviewing the complications cases treated in our hospital.
  From March 1997 to December 2005, we performed PEG on 110 patients, of which 11 patients (9.6%) had complications. In some cases, we inadvertently perforated the colon. From our experience, we have learned that it is not safe to perform PEG with the aid of radiography alone on cases in which the intervention of the transverse colon between stomach and abdominal wall was suspected by CT scan, and concluded PEG should be done using gastrography of the transverse colon, to guide the placement of a feeding tube in the stomach. In view of the systemic condition of the patients, we thought it necessary to take safety measures by all possible means.

View full abstract

  Purpose: Many types of antihistamines used for the treatment of allergic rhinitis induce drowsiness as a side effect. Whether or not patients taking the internal drugs know of this untoward effect is a matter of importance. Recently we conducted a questionnaire survey to know how many patients are aware of this.
  Method: The subjects were 257 patients who visited our hospital for treatment of alergic rhinitis and took the prescription from February through March this year. The patients filled in a questionnaire given at the window of the dispensary. All the participants in this survey gave their informed consent.
  Results: Effective replies (90.3%) were obtained from 232 patients (mean age: 53.5±17.5; sex: 85 males and 147 females). Of those respondents, 45 individuals (19.9%) said they did not know that the antihistamines produce drowsiness. Furthermore, the survey found that 24 out of the 45 individuals were actually taking the type of antihistamine that caused drowsiness and 21 individuals were not given any explanation of the side effect by their doctors. The patients said that if they knew of the side effect they would not have taken the medicine. Moreover, it was found that 10 out of the 21 patients drove their cars while they felt drowsy.
  Conclusions: The survey revealed the hard fact that the drowsiness as side reaction the patients might have after taking antihistamines was made light of. The findings brought home to us the importance of giving clear directions to the patients about the medicine and the precaution against the side effects.

View full abstract

  In recent years, arteriosclerosis obliterans (ASO) has become one of the most common diseases with obesity, high blood pressure and other lifestyle-related diseases such as hyperlipemia. Westernization of the eating habits of the Japanese and progress of the aging society accounts for the increasing occurrence of these health problems. Early detection and early treatment of ASO help not only improve the quality of life of the patients but also get off without amputation of lower limbs and better the prognosis for survival. It is necessary to evaluate the narrowing of blood vessels or the form of occlusion for treatment of ASO. It is particularly important to know the state of the peripheral arteries below the obstructed region in cases with the complete occlusion. Lately, with the addition of many lines to multislice CT (MSCT) and the improvement of the performance of the workstation, angiography for diagnostic purposes has gradually been replaced by MSCT. In this paper, we report two cases of ASO and the successful application of MSCT using 64 Data Acquisition System (DAS) in the examination prior to ASO bypass surgery.

View full abstract

  In April, 2006, we made and distributed the pamphlet entitled “Declaration for safety measures in medical services.” Because we thought that sharing with patients in the safty target could lead to create a safe environment in the hospital.
  To make certain whether inpatients and nurses understood and practiced the declaration, we took a questionnaire survey. The results showed that about 90% of the medical staff and inpatients understood the declaration and thought it worked out well. However some of the medical staff answered that they thought it did not work out. We felt the necessity to educate the medical staff thoroughly. Moreover, we found out differences in the recognition between medical staff and patients. For example, medical staff wonders if they mistake the contents of injections. But most of patients worry about pain.
  The medical staff is always working nervously and anxiously. However, there arequite a few cases in which complaints or disputes result from insufficient understanding by patients although medical staff thought that it was checked and explained.
  We are now working on safety measures reflecting patient's opinions.

View full abstract

[in Japanese]

View full abstract