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Volume 61 (2012)
- Issue 6 Pages 783-
- Issue 5 Pages 683-
- Issue 4 Pages 582-
- Issue 3 Pages 153-
- Issue 2 Pages 69-
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Volume 61, Issue 2
Displaying 1-10 of 10 articles from this issue
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ORIGINALS
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Miki FUKUMA, Kuninori SHIWAKU2012 Volume 61 Issue 2 Pages 69-76
Published: July 31, 2012
Released on J-STAGE: November 21, 2012
JOURNAL FREE ACCESSLifestyle-related diseases among the elderly have been brought to light by many investigaters. However, it remains unclear whether age-related frailty in the basic activities of daily living (ADLs) affects mortality independently of lifestyle. To clarify the relationship of lifestyle and frailty to elderly mortality, we conducted a three-year prospective study on 66 elderly people with reduced vital functions newly certified as requiring nursing care (frail elderly) and 72 elderly people living on their own (independent elderly) in Unnan City, Shimane Prefecture. The mortality rate for the frail elderly tended to be higher than for the independent elderly. However, this difference was not statistically significant. Gender was the only factor related to mortality in the frail elderly, who had advanced frailty. Furthermore, mortality rates were significantly higher for men than women. No relationship was observed between lifestyle and frailty. In the independent elderly, smoking and unstable gait, respectively, were significantly related to mortality. The present findings indicate that lifestyle and frailty are independently related to elderly mortality.View full abstractDownload PDF (271K) -
Rumi MANIWA, Mamiko IWAMOTO, Masayuki YAMASAKI, Kuninori SHIWAKU2012 Volume 61 Issue 2 Pages 77-87
Published: July 31, 2012
Released on J-STAGE: November 21, 2012
JOURNAL FREE ACCESSAs the abilitiesof physical and daily life tend to fall by aging, and nutrition improvementis importantin elderly. Effects of nutrition improvement for elderly has verified on the seriously malnutrition elderly in a hospital, but there is little evidencefor elderly in community. We conducted the intervention by milk ingestion based on physical activities program for the frail elderly in community. Subjects were 45 elderly people (73.7±5.7 years old) who participated in the preventive program for three months in Izumo City, and were divided into two groups of 22 milk intervention subjects and 23 controlsubjects. The milk intervention group was provided with milk (180 ml/day) by door-to-door delivery, and the parameters of nutrition and anthropometricwere investigated before and after intervention. BMI, HDL-cholesterol and hemoglobinwere significantly improved in the milk intervention group, but no significant effects in the control. The intervention group had significant health-effects of BMI, albumin, HDL-cholesterol, hemoglobin, HbA1c and essential amino acids/nonessential-amino-acid ratio, compared with the control group. Asphysical activities in the control groupbefore intervention was poorer than the intervention group, the control group improvedsignificantlyby the physical activities program.In conclusion, daily milk ingestion based on physical activities program makes an improvement of nutrient state in frail elderly in community.View full abstractDownload PDF (355K) -
Hirohito NANBU, Miyuki NANBU, Hideyuki SASAKI, Yuko KIRIHARA, Keiko TS ...2012 Volume 61 Issue 2 Pages 88-96
Published: July 31, 2012
Released on J-STAGE: November 21, 2012
JOURNAL FREE ACCESSIn view of the situation where an increasing number of old women as well as old men have health problems associated with drinking, some measures should be taken in terms of setting sensible limits of alcoholic intake for these people to keep to, the Report of Kenko (Health) Nippon 21 for 2011 warned. It also suggested that further studies be made to amass necessary data in order to introduce effective measures and give a right assessment to the situation.
The present study was carried out with the aim of providing fundamental pieces of information usable in primary prevention of alcohol-related health problems among the aged. For this purpose, we looked into the drinking habits as well as the numerical data of vital and liver functions tests of old people in a rural area in Yokote, Akita Prefecture. A total of 448 old people (206 men, 242 women) were involved in this study. Nineteen items out of 25 in the Kihon-Checklist, which was designed to reduce the need for nursing care, revealed notable decreases in vital functions in those men who took in over 21 grams of alcohol per day. Of those men specially categorized as individuals who are 65 and older and who are regarded as very likely to need nursing care in the near future, 88.9% took in 21 grams of alcohol. In women, there was no relation between drinking habits, BMI and liver functions. However, it was found that daily alcoholic consumption was greater in those specially categorized group of women at high risk for institutional care than in the other women.
Our study made it clear that drinking habits, which were found to bear on liver and vital functions, could serve as a yardstick for judging whether the old people are at high risk for institutional care. We concluded that it is necessary to spread the knowledge about the adverse effects of alcohol among the elderly and advise them to act their age and drink in moderation even before they enter advanced age.View full abstractDownload PDF (351K)
REPORTS
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Miho MATSUMURA2012 Volume 61 Issue 2 Pages 97-101
Published: July 31, 2012
Released on J-STAGE: November 21, 2012
JOURNAL FREE ACCESSRecently, the care of patients with Latex- allergy (LA) has become one of the challenges to operation room staffers of many hospitals. To cope with the situation, an LA prevention team was established in our hospital in January 2010.
[Method] It's main tasks include: ①Making a list of all medical materials including latex; ②Accumulation of all allergic information for preoperative patients; ③Making the medical carts laden with latex-free materials; and ④Making the manual for LA prevention.
[Results] ①The components of medical supplies have been clarified; ②Preventive measures could be taken on the basis of the information of LA; ③The latex-frec wagons have been prepared for emergency situations; and ④A better understanding of LA has been brought about by the manual.
[Future problems] The safety of patients in our operating room has been secured, but not in many other parts of the wards. This problems should be resolved by the whole hospital with our anti-LA team playing a leading role.View full abstractDownload PDF (329K) -
Hiroya ITOU, Yoshihito MIYOSHI, Tomomi INOUE, Masayosi SUGITANI2012 Volume 61 Issue 2 Pages 102-108
Published: July 31, 2012
Released on J-STAGE: November 21, 2012
JOURNAL FREE ACCESSA new radiation system known as the TomoTherapy Hi-ART system was introduced into our hospital in October 2010. This system combines helical intensity-modulated radiotherapy (IMRT) with an integrated image guidance system by means of a megavoltage-CT. This image-guided IMRT enables us to deliver appropriate doses to tumors with good conformality while avoiding sensitive structures in an accurate manner. Patients having tumors in the head, neck, abdomen and pelvis would be good candidates for this treatment. In our hospital, a total of about 150 patients were treated with the helical tomotherapy in 2011.
However, in the helical tomotherapy, low-dose areas would be spread wide, compared with conventional radiotherapy. Low dose irradiation to large volumes of the lung would increase the risk of radiation pneumonitis, thus planning for thoracic regions such as chest wall and mediastinum might be difficult. In such cases, another strategy “TomoDirect” might be more useful. That allows us to create treatment plans just like conventional radiotherapy using static gantry positions, combined with simultaneous couch movement. Over 20 patients were treated with TomoDirect in 2011.View full abstractDownload PDF (347K) -
Hiroshi NAGAMI, Toru YAOSAKA, Fumio MAEJIMA, Yoshio NISHIGAKI, Shusuke ...2012 Volume 61 Issue 2 Pages 109-112
Published: July 31, 2012
Released on J-STAGE: November 21, 2012
JOURNAL FREE ACCESSMass poisoning with an organo-phosphate insecticide occurred at a junior high school in Japan. We collected clinical data from four hospitals, which treated the patients, and investigated this poisoning.
In late July, the janitor of the school dropped an undiluted solution of 40% methidathion insecticide into the nest of ant near the classroom between 10:00 and 11:00 a.m.. The volatilized gas spread into the classroom, and many students presented some symptoms of poisonig, 16 students were taken to neighborhood hospitals around noon.
Of the 16 patients, 13 complained of headache, 11 of nausea, and 4 of dizziness. One patient vomited twice. The serum cholinesterase activities, the pupil diameters and the light reflexes of the patients were normal. Three patients were hospitalized one night for observation. All patients did not get sever poisoning, and recovered and had no sequela.
It has to be admonished against spraying an undiluted solution of high toxic insecticide near the classroom, and it is necessary to take stern measures to prevent another such accident.View full abstractDownload PDF (253K) -
Yoshihisa HIRAKAWA2012 Volume 61 Issue 2 Pages 113-117
Published: July 31, 2012
Released on J-STAGE: November 21, 2012
JOURNAL FREE ACCESSCommissioned welfare volunteers (CWVs), who constitute indispensable part of health resources, play an important role in improving the environment so that those aged with dementia can live comfortably. They give advice to local residents and survey for enhancing their wellbeing voluntarily, while working hand in hand with district welfare offices. They are also expected to have a role-playing ability to support the living of aged people with dementia from a holistic point of view. In this study, we shed light on the needs of study for CWVs in order to mark one step forward toward the development of a dementia workshop program for local people, especially CWVs. Based on the findings, a program was worked out by way of trial and implemented. Lasting two hours and half, it comprises several sessions: “What is the workshop?” “Prevention of dementia,” “Difficulty in treating wih demented old men and experience of their families,” “Affliction case study1” and “Affliction case study 2." A questionnaire survey of the participants revealed that more than 90% of the program contents were understandable.View full abstractDownload PDF (263K)
CASE REPORTS
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Tomonori SATO, Yoshihide KAWASAKI, Shinnosuke KATO2012 Volume 61 Issue 2 Pages 118-123
Published: July 31, 2012
Released on J-STAGE: November 21, 2012
JOURNAL FREE ACCESSThe patient was a 81-year-old woman, who had been carried into our hospital after having been hit by a small truck. The accident occurred when she was crossing a street. Her major complaints were gross hematuria and left abdominal pain. Computerized tomography was performed with contrast medium. In light of the Japanese classification of renal trauma, we diagnosed the case as Type IIIb kidney trauma, which is characterized by deep renal injury in the middle of the kidney. The patient was treated conservatively. Her condition was stable. However, on the 18th day after the traffic accident, hematuria recurred all of a sudden. As anemia progressed, erythrocyte transfusion was done. Radiographs of the arteries in the injured left kidney revealed arteriovenous fistula and psuedoaneurysm. Because of these findings, transcatheter arterial embolism (TAE) was performed using liquid embolic material and a microcoil. After surgery, hematuria ceased and anemia abated. The patient was doing fine for a while. But she suffered from cardiac insufficiency and had to undergo long-term internal treatment. Now, 14 months have elapsed since she met with the accident. There are no recurrence of arteriovenous fistula, no occurrence of renal infarction and no sign of decreased renal functions. This indicates that our TAE operation has been a success. Since there are reports that renal arteriovenous fistula is complicated by cardiovascular diseases, careful watch must be kept on these complications during the long-term management of patients with this type of renal disorder.View full abstractDownload PDF (361K) -
Momotaro MUTO, Masayo YAMAMOTO, Mizue SHIMODA, Akihiro HAYASHI, Senri ...2012 Volume 61 Issue 2 Pages 124-129
Published: July 31, 2012
Released on J-STAGE: November 21, 2012
JOURNAL FREE ACCESSA 86-year-old woman visited us, complaining about sharp abdominal pain she had very morning when she got up. Ultrasound and computer tomography scans of the abdomen revealed notable parietal hypertrophy and swelling of the gallbladder. The old woman was diagnosed with acute cholecystitis and immediately admitted to the hospital. Her condition did not improve on conservative management. Percutaneous transhepatic gallbladder drainage (PTGBD) was performed. The bile thus aspirated was bloody, which led us to suspect necrotizing cholecystitis. Emergency cholecystectomy was done. The abdominal operation found the gallbladder wandering with a torsion of 360 degrees around the gallbladder neck as the axis and the leakage of bile in the abdominal cavity from what could be presumed to be the area where the PTGBD was placed. After the torsion was corrected, the gallbladder was surgically removed. Neither gallstones nor tumors were found in it. There were signs of hemorrhagic necrosis in the mucus membrane. The patient made good progress after the operation and was discharged on the 15th hospital day. Torsion of the gallbladder is a comparatively rare entity and its symptoms are not always specific. Therefore, it defies preoperative diagnosis. In this paper, we report our experience with a case of this disease which presented characteristic radiographic images and discuss the treatment strategies including PTGBD.View full abstractDownload PDF (469K)
REGIONAL MEETING
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2012 Volume 61 Issue 2 Pages 130-141
Published: July 31, 2012
Released on J-STAGE: November 21, 2012
JOURNAL FREE ACCESSDownload PDF (553K)
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