JOURNAL OF THE JAPANESE ASSOCIATION OF RURAL MEDICINE
Online ISSN : 1349-7421
Print ISSN : 0468-2513
ISSN-L : 0468-2513
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Volume 59, Issue 6
Displaying 1-20 of 20 articles from this issue
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——Special Issue on the 59th General Assembly of the Japanese Association of Rural Medicine——
LECTURE BY ASSEMBLY CHAIRMAN
  • Agriculture of Iwate as Seen from a Hygienic Viewpoint
    Masanobu TATSUMI
    2011 Volume 59 Issue 6 Pages 660-666
    Published: March 30, 2011
    Released on J-STAGE: May 30, 2011
    DOIhttps://doi.org/10.2185/jjrm.59.660
    JOURNAL FREE ACCESS
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      I started to study health problems in dairy farming in the Kitakami mountain district during the latter half of the1970's. Fields were located mostly in steep slopes and pastures were limited in area. In this district a survey of dairy farmers, time budget was carried out by the direct time-study method. And the energy consumption of farmers for their dairy farming activities was measured using the Douglas bag method.
      Working hours were prolonged because grass grew thick from early May to late October (the busy farming season). In this season, many farmers worked 13-14 hours per day. Grass harvesting that was done on the steep slope consumed a lot of energy. There was a close correlation between gradient and energy consumption for mowing.
      Various other kinds of agriculture were researched in Iwate Prefecture. And we pointed out some problems in each study.
      In recent years, the most serious problem in farm work is a high rate of accident occurence. About 400 farmers died in accidents every year for the past 40 years, and there is not a sign to decrease at all. This is the big problem that the Japanese Association of Rural Medicine should wrestle with.
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SPECIAL LECTURE I
  • ‘What Should We Discuss from Now On?’
    : Tracing Miyazawa Kenji's Life of “Failure and Resurrection”
    Yoshitsugu MOCHIZUKI
    2011 Volume 59 Issue 6 Pages 667-677
    Published: March 30, 2011
    Released on J-STAGE: May 30, 2011
    DOIhttps://doi.org/10.2185/jjrm.59.667
    JOURNAL FREE ACCESS
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      The title of this lecture, ‘What should we discuss from now?’ is taken from the first paragraph in the introduction of “General Theory of Farmers' Arts” written by Miyazawa Kenji. It can be said the life of Miyazawa was marked by “failure and resurrection.” He suffered his setback five times in his life, and was not able to recover from the last frustration until he closed his life at the age of 37. From the fact that the manuscript fee was received only once throughout his whole life, it could be difficult to say that his life ‘in this world’ was successful. However, thousands of people have been touched by his awkward, but earnest, way of life, and it will give many suggestions to the prospect of JARM.
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SPECIAL LECTURE II
EDUCATIONAL LECTURE I
EDUCATIONAL LECTURE II
EDUCATIONAL LECTURE III
SYMPOSIUM I
SYMPOSIUM II
WORKSHOP I
WORKSHOP II
  • Present State of “Tokutei Kensin and Tokutei Hoken Sidoh” as a Metabolic Syndrome-Specific Health Check-up and Counseling System and Proposal to Improve It
    Hiromiti OBUCHI, Kazuhira MAEHARA
    2011 Volume 59 Issue 6 Pages 710-713
    Published: March 30, 2011
    Released on J-STAGE: May 30, 2011
    DOIhttps://doi.org/10.2185/jjrm.59.710
    JOURNAL FREE ACCESS
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      Two years and six months have passed since the national health care system “Tokutei Kensin and Tokutei Hoken Sidoh”, which is a metabolic syndrome-specific health check up and counseling system, was enforced on April in 2008. It is high time for us to review it and make a proposal for a future improvement of the system. We would like to discuss the present problems and how we can increase the efficiency of the system in the workshop.
      Tokutei Hoken Sidoh, which is six month counseling and instruction for health-promoting lifestyle behavior, has significant effects not only on an improvement of lifestyle, i.e., physical activity and energy intake, but also on the reduction in body weight, waist circumference and blood pressure. Particularly, initial counseling and instruction after health check-up has a great importance for realization of future risks of cardiovascular diseases, and motivation for reducing abdominal obesity and other risk factors. However, the effects are lost in time after the accomplishment of the six-month program. Therefore, how to maintain the motivation and actual lifestyle change should be sought. At present, the cost effectiveness of Tokutei Hoken Sidoh appears to be low, because we tend to expend a lot of time in counseling. To increase efficiency, standardized group counseling would be needed. In addition, the stratification of individuals may be necessary for attending group counseling, because there are large differences in realization and motivation among subjects regarding metabolic syndrome.
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WORKSHOP III
WORKSHOP IV
WORKSHOP V
  • Obesity and Diabetes
    Isao KAWAMURA, Tsuneo OHNO
    2011 Volume 59 Issue 6 Pages 722-725
    Published: March 30, 2011
    Released on J-STAGE: May 30, 2011
    DOIhttps://doi.org/10.2185/jjrm.59.722
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      Health education provided by a group of professionals from different disciplines, so-called “team medical care”, is considered essential for the treatment of diabetes. When each specialized professional educates diabetic patients on how to manage their condition, patient-centered medical care is realized, and it becomes possible to provide appropriate support to individual patients. The treatment of obesity is somewhat similar to that of diabetes. Diet therapy and exercise are the basic therapies, and diabetes in many obese patients can simply be improved by weight loss. Metabolic syndrome has been reported to be associated with visceral fat-type obesity. In order to prevent the development of atherosclerotic occlusive diseases due to weight loss, individual counseling after each medical checkup is provided by public health nurses or registered dietitians.
      Behavior modification is necessary to improve lifestyle. Helpful education and advice by various professionals help patients to modify their behavior, and thus patient-centered medical care can be achieved.
      Recently, for the treatment of diabetes, new oral hypoglycemic agents and insulin preparations as well as incretin preparations have become available, indicating that diabetes treatment strategies are increasing. This has allowed better glycemic control in diabetes than was possible before. Nonetheless, diet therapy and exercise remain the basic treatment methods, and they should not be made light of.
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KANAI PRIZE WINNER'S LECTURE
ORIGINAL
  • Retrospective Study of Advanced Ovarian Cancer Cases Treated in Our Hospital
    Masaaki KAWASHIMA, Hajime KONDO
    2011 Volume 59 Issue 6 Pages 730-736
    Published: March 30, 2011
    Released on J-STAGE: May 30, 2011
    DOIhttps://doi.org/10.2185/jjrm.59.730
    JOURNAL FREE ACCESS
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    Objective: To investigate unfavorable prognostic factors in advanced ovarian cancer.
    Materials and Methods: The medical records of 15 women diagnosed with advanced ovarian cancer between January 2003 and December 2009 were examined. We compared some factors between the complete first-line chemotherapy group and the incomplete first-line chemotherapy group, and between the complete SLO/SDS group and the incomplete SLO/SDS group. Moreover, we performed multivariate analysis of prognostic factors.
    Results: The mean age of women in the incomplete first-line chemotherapy group was significantly advanced than that in the complete first-line chemotherapy group. The CA125 value for the complete SLO/SDS group was significantly lower than that for the incomplete SLO/SDS group. Multivariate analysis, found that advanced age, incomplete first-line chemotherapy and poor declined CA125 value were unfavorable prognostic factors in advanced ovarian cancer.
    Discussion: From advanced aged women with advanced ovarian cancer, it is necessary to obtain informed consent. As the case may be, we should consider providing neoadjuvant chemotherapy and palliative medicine.
      To those patients with incomplete first-line chemotherapy and poor declined CA125 value, we should tell them that they could choose second-line chemotherapy and palliative medicine.
    Conclusion: It was found that advanced age, incomplete first-line chemotherapy and poor declined CA125 value, were unfavorable prognostic factors. In cases with these three factors, we should supply them with adequate information and treatment cautiously.
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CASE REPORT
  • Two Survived Cases of Necrotizing Fasciitis Caused by Sacral Decubitus
    Takeshi HASEGAWA, Takashi MIYAKE
    2011 Volume 59 Issue 6 Pages 737-743
    Published: March 30, 2011
    Released on J-STAGE: May 30, 2011
    DOIhttps://doi.org/10.2185/jjrm.59.737
    JOURNAL FREE ACCESS
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      Necrotizing fasciitis has a very high acute mortality. Diabetes mellitus often underlies the disease. In this paper, we report two cases of necrotizing fasciitis caused by sacral decubitus, which were successfully treated with withdrawal of pus through radical excision, cleansing and debridement. The patients were: a 74-year-old man with a history of diabetes and depression (case 1) and a 82-year-old man with a history of diabetes and spinal injury which resulted in paraplegia (case 2). In either case, a wide area extending from the buttocks to lower back was cut open for drainage, washing and debridement at an early stage after the onset of necrotizing fasciitis, and broad-spectrum antibiotics were administered. Due to preoperative general health conditions, underlying diseases such as diabetes mellitus and postoperative diapedesis of protein, the patients' nutritional status critically deteriorated after surgery. Consequently, measures were taken to control diabetes and provide nutritional care. These efforts were crowned with success. It was found that early healing of surgical wound necessitated using pressure dispersion type mattresses and turning, on a regular basis, of the bed-ridden patients with decreased mobility, in addition to putting them in rehabilitation.
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REGIONAL MEETING
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