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Volume 63, Issue 1
Displaying 1-12 of 12 articles from this issue
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ORIGINAL
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Akihiro KARUBE, Fumiko SAITO, Daisuke NAGAO, Daisuke TAMURA, Natsuki O ...2014 Volume 63 Issue 1 Pages 1-8
Published: 2014
Released on J-STAGE: July 24, 2014
JOURNAL FREE ACCESSThis study was conducted to clarify the benefits of using cervical cytological examinations and human papilloma virus (HPV) testing in our cervical cancer screening program, which was carried out during the period from April 2012 through March 2013 in the Yuri-Honjo district of Akita Prefecture. A total of 772 women underwent this screening. About 11.3% (87/772) of the examinees tested positive for HPV, and of these 87 women, 64 were also positive for HPV DNA in the examinations subsequently conducted in the outpatient clinic. Of the HPV DNA-positive women who showed no sign of abnormalities in cytology, 67.6% had lesions cervical intraepithelial neoplasia (CIN) 1 and above, and five women had l CIN 2/3. Compared with the conventional cytology which detected nine women with CIN 2/3, our screening method with a combination of cytology and HPV testing found 14 women with CIN 2 or 3. To upgrade the cervical cancer screening, we recommend HPV testing should be used in combination with cervical cytology.View full abstractDownload PDF (320K) -
Iwao YOSHIOKA, Shigeru KOSHIBA, Hiroshi MATSUMIYA, Hiroshi TAGUCHI2014 Volume 63 Issue 1 Pages 9-18
Published: 2014
Released on J-STAGE: July 24, 2014
JOURNAL FREE ACCESSLaryngeal cancer is a malignant disease that occurs at a high incidence rate as compared with other forms of cancer of the head and neck, and its treatment is commonly conducted at a regional central hospital from diagnosis to recovery. In this study, we summarized the outcomes of first-line treatment for laryngeal cancer over the past 10 years at our hospital. The subjects consisted of 121 patients who received a first-line treatment for squamous cell carcinoma of the larynx between January 2000 and April 2010. Of these, 115 were male and six were female, with a mean age of 67.9 years. There were 56 cases of stage I laryngeal cancer, 30 of stage II, 14 of stage III, and 21 of stage IVa. Cases of stage IVc cancer with distal metastasis were excluded. The disease-specific 5-year survival rate was 100% in stage I, 81.8% in stage II, 100% in stage III, and 72.5% in stage IVa, respectively. Moreover, the laryngeal preservation rates was 93.7% in stage I, 69.4% in stage II, 34.2% in stage III, and 42.6% in stage IVa, respectively. Although the disease-specific 5-year survival rate in stage III was 100%, the laryngeal preservation rate was the lowest at 34.2%. In cases of stage III cancer, although the survival rate was certainly high when total laryngectomy was performed, we believe that in the future, radiation therapy and partial laryngectomy should be introduced to preserve the larynx. There were only three cases of stage II subglottic cancer in which both the laryngeal preservation rate and survival were low.View full abstractDownload PDF (377K) -
Kazuyuki NAKAMURA, Toshiyuki KUBOTA, Hiroyuki MANSHIO, Yuichi DOI, Mak ...2014 Volume 63 Issue 1 Pages 19-28
Published: 2014
Released on J-STAGE: July 24, 2014
JOURNAL FREE ACCESSSince February, 2012, Anjo Kosei Hospital has embarked upon a new scheme for efficiently handling narcotics during surgical operations. For the purpose pharmacists are allowed to enter the operating room for a while. At the same time, the implementation of digital record keeping for narcotics management tasks has started, making it possible to simplify the handling of a great number of patients. By reviewing the effects on narcotics handling and hours billed, we could determine the effectiveness of operating room pharmacist-led narcotics management at Anjo Kosei. Out of narcotics prescriptions (n＝647) handled in the operating room for one month, 84.7% (548/647) was accounted for by prepared narcotics and 99.8% (646/647) by post-operation management. The introduction of the digital record system resulted in a reduction from 53.3±9.6 minutes to 39.6±6.3 minutes for narcotics preparation, and a reduction from 66.8±16.1 minutes to 41.1±13.5 minutes for post-operation management (p<0.01). It has added to the work efficiency and simplification of operations. Moreover, due to the intervention of pharmacists in the operating room, 92.3% of narcotics prescriptions was performed using the new management system within a relatively short time (80.8±18.4minutes). These data show that the introduction of the new scheme has resulted in more efficient management of narcotics at Anjo Kosei.View full abstractDownload PDF (437K) -
Satoshi IKEDA, Chigusa NAGATA, Koji SHIMABUKURO, Keiko SUZUKI2014 Volume 63 Issue 1 Pages 29-34
Published: 2014
Released on J-STAGE: July 24, 2014
JOURNAL FREE ACCESSIt is known that uterine cervical cancer is caused by persistent infection with high-risk type of HPV (human papilloma virus). We have run HPV genotyping tests on patients since November, 2011. In 111 cases so far examined, HPV types 16, 52 and 58 were detected with high frequency, but type 18 was with low frequency. This trend was comparable to nationwide tendency. Type 52, 56 and 58 were detected from the patients of advanced age frequently. There were differences in HPV infection rate between cytology-negative cases and positive cases, but there was not the difference in HPV typing by cytology-negative and positive patients. Furthermore, it was made clear that the superinfection of HPV who significantly related to the development of tumor. In the cytology negative patients who were followed up because of dysplasia, there are many who are negative for high risk HPV. Therefore, HPV genotyping examination may help physicians determine the relative priority for treatment.View full abstractDownload PDF (290K)
RESEARCH REPORT
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Noriyuki NAKAMURA, Kohei OKI2014 Volume 63 Issue 1 Pages 35-40
Published: 2014
Released on J-STAGE: July 24, 2014
JOURNAL FREE ACCESSThis paper describes the results of a questionnaire survey on the facts about rehabilitation treatment of peripheral facial nerve palsy given by facilities affiliated with the Aichi Prefectural Federation of Agricultural Cooperatives for Health and Welfare. Self-administered questionnaires were sent by mail to seven hospitals (excluding our hospital) affiliated with the prefectural Koseiren in order to check up on whether they are actually providing rehabilitation programs for peripheral facial nerve palsy or not; patient occupation (specialty of rehab providers?), departments from which the patients were referred for rehabilitation, the time when rehabilitation began, frequency, finishing time, yardstick for terminating rehab, program contents, etc. The survey found that four hospitals are giving treating and training for rehabilitation such as massaging, stretching and toning of facial muscles. For pathologic synergic control, one hospital had a feedback training program. None of these four hospitals provided low-frequency current therapy. In view of the facts that any treatment methodology was yet to be established for pathologic synergic control and there are three facilities without any rehabilitation program, we felt keenly the need to put a greater emphasis on the importance of rehabilitation intervention and encourage many more health facilities to rehabilitative care.View full abstractDownload PDF (281K) -
Hiroshi NAGAMI, Takajiro SUENAGA, Mineko NAKAZAKI, Fumio MAEJIMA, Yosh ...2014 Volume 63 Issue 1 Pages 41-48
Published: 2014
Released on J-STAGE: July 24, 2014
JOURNAL FREE ACCESSSoil fumigants are used to control pests, fungi, and weeds before planting crops. As they are highly volatile and acutely toxic, farmers are often exposed to serious risks of poisoning by inhalation and contact. We investigated the use of soil fumigants and subjective symptoms of cut flower farmers by interviewing them. The subjects of this study consisted of 69 male farmers who came to health check, and we asked them about the names of soil fumigants they used in recent years, whether or not they wore the gas mask and the goggle, and whether they had had any subjective symptoms, and many other questions. Of the subjects, 68% said they used Chloropicrin and 64% gave D-D. Chloropicrin tablet and carbam were used by 15% of them, respectively. It was found that 38% of the chloropicrin users put on the gas mask, and that 32% put on the goggle. The occurrences of subjective symptoms differed with whether the farmer put on gas mask or goggle. The farmers without gas mask or goggle complained about watery eye (72%), couch (31%), runny nose (31%), breathing difficulties (21%), and eye irritation (19%). The farmers put into practice some measures to prevent chloropicrin exposure, as follows: Using the machine with injector crawls under the ground, working when gentle wind is blowing, working when the temperature of soil is low, and using the refrigerated chloropicrin. Some farmers and their wives informed that they had runny eye, sneeze when covering fumigated hillings with plastic films. The workers are recommended to put on the gas mask on working this process. The use of low-permeable film, developed in recent years, could economize on soil fumigants for cultivating some corps. It is hoped that the use of this new material will spread in cut flower farming and reduce risks of fumigant exposure.View full abstractDownload PDF (368K)
CASE REPORT
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Momotaro MUTO, Mizue MUTO, Chisato ISHIKAWA, Mitsutaka INOUE, Akio MAS ...2014 Volume 63 Issue 1 Pages 49-56
Published: 2014
Released on J-STAGE: July 24, 2014
JOURNAL FREE ACCESSCase I was a 85-year-old woman. She was referred to us as her serum CEA level was found as high as 9.2ng/ml at a clinic in her neighborhood. CT and ultrasound scans revealed a cystic tumor in the appendix area. A barium enema examination showed a tubercular lesion in the subcecal area. The surface of the lesion was flat and smooth. The vermiform appendix was not scanned with the contrast medium. She was diagnosed with mucinous cystadenoma of the appendix. Partial cecotomy was performed. The postoperative serum CEA fell to a normal level of 4.7ng/ml. Case II was also a woman . The 74- year-old inpatient was being treated for high blood pressure and hyperlipemia when her serum CEA level was found elevated to 12.3ng/ml. CT and ultrasonograph examinations revealed a cystic tumor in the appendix area. A barium enema examination showed a mucocele-like tubercle in the appendix. The patient was diagnosed with mucinous cystadenoma of the appendix and partial cecotomy was performed. The CEA level was normalized postoperatively with 1.5ng/ml. The pathologic tests confirmed either of these two cases was mucinous cystadenoma of the appendix. Immunohistochemical staining showed a CEA positive.View full abstractDownload PDF (329K) -
A Case of Cerebral Infarction Associated with Japanese Mamushi (Gloydius blomhoffii blomhoffii) biteYosuke KAWAMURA, Mutsumi NAGAI, Natsuki KURAISHI, Masaaki TAMURA2014 Volume 63 Issue 1 Pages 57-60
Published: 2014
Released on J-STAGE: July 24, 2014
JOURNAL FREE ACCESSThe incidence of Gloydius blomhoffii blomhoffii bite is one of the notable public health issues from the standpoint of rural medicine. The majority of the cases occur incident in the mountains and fields. The mortality of the snakebite is approximately 1%. We report a case of cerebral infarction that occurred 11 days after Gloydius blomhoffii blomhoffii bite. The patient was male. Almost all kinds of the snake venom contain the factor in causing blood coagulation and anticoagulation. We assumed that the snakebite induced cerebral infarction in him because he had no major risk factors for stroke. We reported here a very rare case of cerebral infarction associated with Gloydius blomhoffii blomhoffii bite.View full abstractDownload PDF (256K)
NURSING RESEARCH REPORT
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Shizuka KOBAYASHI, Tomomi KUROSAWA2014 Volume 63 Issue 1 Pages 61-69
Published: 2014
Released on J-STAGE: July 24, 2014
JOURNAL FREE ACCESSFour surgical operations were going on in our hospital when the 9.0-magnitude earthquake hit northeast Japan on March 11, 2011. To work out effective disaster prevention measures, we investigated how did nurses in the operating room acted immediately after the earthquake, and their psychological state. We distributed questionnaires to 17 nurses who had been in the operating room at that time. Our study showed that most nurses formed cool judgments on the safety and helped allay the anxiety of the patients, despite the fact that they themselves felt anxiety or were terrified at heart. On the other hand, several actions such as the protection from contamination of the operative field were not taken properly as prescribed in the Emergency Manual of the operating room. Full awareness of role-sharing flowcharts of emergency evacuation of the patient under operation, and periodical disaster drills are needed to plan for a crisis.View full abstractDownload PDF (343K) -
Yuka NAGAI, Hitomi MAENO, Yoko HOSHI, Mayumi SATO, Satomi YUHARA2014 Volume 63 Issue 1 Pages 70-75
Published: 2014
Released on J-STAGE: July 24, 2014
JOURNAL FREE ACCESSUrinary tract infections (UTIs) are among the most common entities in hospitals, accounting for about 40% of nosocomial infections. It is said that more than 80% of UTIs are associated with the use of catheters. The discharge opening of the Uro Bag, a type of urine storing bag, is alive with bacteria. The microorganisms can enter the bag and then bladder, causing UTIs. It can also be said that the longer the catheters are used, the greater the risk of catheter-related UTIs becomes. Furthermore, Pseudomonas aeruginosa, Staphylococcus aureas, Serratia mareescens and other kinds of bacteria that have acquired the resistance to drugs are increasing. The incidence of mixed infections with different organisms are on the rise. Such being the present situation, to prevent UTIS we think that the proper management of urinary catheterization and right use of urethral catheters are of the primary importance. Those health providers who handle catheters frequently need to take every precaution against inadvertently acting as intermediaries in the incidence of nosocomial infectious diseases including catheter-related UTIs. Recently, we reviewed the prophylactic measures which had been taken by our hospital, assessed the findings using the checklist made by the Nosocomial Infection Prevention Committee. Later, we held a seminar and discussed the standardization of prophylactic measures. As a result, the assessment items which were rated low in June marked 100% in September and March. Thus, our efforts have led the hospital employees to deepen their knowledge and understanding of the need to watch out nosocomial infection constantly. For the guidance of employees, we included in the educational program on-the-job training, which proved to be helpful for the trainees to have imagery. To maintain the effect of infection prevention and to keep up the interest awakened in the hospital staff, the holding of seminars and meetings for reviewing on a regular basis are called for.View full abstractDownload PDF (266K)
SHORT COMMUNICATION
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Yoshihisa HIRAKAWA2014 Volume 63 Issue 1 Pages 76-82
Published: 2014
Released on J-STAGE: July 24, 2014
JOURNAL FREE ACCESSNagoya has seen various educational activities through workshops to build a large-city- type interprofessional network. In this paper, we reported the depth of 21 people’s feelings toward the activities. They took part in the June, 2013, workshop and were all concerned in eldercare. We invited them to a one-hour meeting and talked freely about a workshop with the participation of people engaged in different type of occupation. The arguments were summed up by KJ method. It was suggested that the workshop not only provided an opportunity to learn a lot but also helped promote exchanges of views and ideas between participants. Some argued that whether a workshop ends in success or not would depend on compatibility with other participants.. The author thinks that how to nurture talented people concerned in the planning and management of the workshop and how to invite as many people as possible from various fields are subjects to be grappled with.View full abstractDownload PDF (302K)
MATERIAL
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Yoshihisa HIRAKAWA2014 Volume 63 Issue 1 Pages 83-85
Published: 2014
Released on J-STAGE: July 24, 2014
JOURNAL FREE ACCESSThe number of geriatric care managers is on the rise. This tendency has given rise to concerns in some quarters over the widening communication gap between care managers and medical professionals. The problem is that already many care managers are taking too much time writing requests to physicians because they do not know how to write them. The situation is such that in concert with care managers we had a workshop to improve in writing to physicians on a case-by-case basis. Cases were presumed by participating care managers. For examples: cases where instructions from doctors concerning home care are needed as bed-ridden patients had serious bedsores;where hard-to-manage behavioral and psychological symptoms of dementia developed in patients have to be reported and at the same time the doctors’ advice is needed as to whether the patients should be referred to clinics specialized in Alzheimer’s disease; and where it becomes necessary to ask permission from doctors for reduction in the number of times of internal use of prescription medicines by reason of forgetfulness on the part of the patients. With these and other hypothetical cases included, a sort of manual was worked out by the first author of this paper in cooperation with two nurses. We hope that this work will help care managers build up their writing skill and facilitate communication between care managers and physicians.View full abstractDownload PDF (170K)
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