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Volume 64, Issue 5
Displaying 1-16 of 16 articles from this issue
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ORIGINAL
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Kazuhiko NAKAYA, Noriko KASHIWAKURA, Satoru KUROKI, Tadashi ENDO, Akih ...2016 Volume 64 Issue 5 Pages 789-797
Published: January 30, 2016
Released on J-STAGE: March 16, 2016
JOURNAL FREE ACCESSUrine tests, which are performed routinely as specimens can be collected without inflicting pain on patients at all, give plenty of information about health conditions quickly thanks to the recent advances in techniques for urinalysis. Nonetheless, the constituents of urine are liable to change, and so prompt examination is necessary. In the case of inpatients, it sometimes happens that examinations begin several hours after specimen collection. Behind this, there is no time frame set for collecting urine specimens which makes it difficult to deliver specimens to the examination room without delay. In this study, we investigated longitudinal changes in the contents of urine specimens voided by inpatients under some specific conditions. Furthermore, we examined the effects of those intestinal bacteria (E.coli, Proteus), which are often detected in urine, on glycosuria, and the changes in nitrite reduction reaction. Our findings showed that urine specimens containing such physiological and pathological factors as to influence urine tests were particularly subject to change with the passage of time. Therefore, when there is a need to preserve the specimens, chilled storage using a lidded container is required. It was slso found that between E -coli and Proteus in the urine a considerable difference was noted in time-dependent change of glycolysis and nitrite reduction reaction.View full abstractDownload PDF (914K) -
Kiyotaka OHTANI, Noriko MATSUMOTO, Mayu FUJIMOTO, Hitomi INAGAKI, Yuic ...2016 Volume 64 Issue 5 Pages 798-807
Published: January 30, 2016
Released on J-STAGE: March 16, 2016
JOURNAL FREE ACCESSIn Japan, few reports have discussed adverse events and safety after simultaneous vaccination during infancy. The purpose of this study was to elucidate adverse events after simultaneous vaccination of inactivated vaccines in infants in comparison with those after single vaccination. Selected for this study were infants aged ≥2 months who received subcutaneous injections of inactivated vaccines between July 2012 and June 2013. These subjects were divided into two groups: a single-vaccination group (46 subjects) and simultaneous-vaccination group (42 subjects). The presence or absence of severe adverse events that required hospitalization was investigated. We also checked up on subject background and systemic [fever (transitional and highest body temperature)] and local (dermatological, respiratory, gastrointestinal, neurological, and other organs’ symptoms) adverse events. Questionnaires to investigate if adverse events occurred during one week after simultaneous vaccination, questionnaires were distributed to the parents of all the subjects. “We performed vaccination in 162 subjects, and the collect rate of questionnaires was 57% (97/162).” The percentage of effective answers to the questionnaire survey was 91% (88/97). Among simultaneous-vaccination group subjects, 14 (32%) received Haemophilus influenzae type b (Hib) + 7-valent pneumococcal vaccine (PCV7) and 12 (27%) received Hib + PCV7 + Diphtheria-Pertussis-Tetanus vaccine. No subject developed severe adverse events that required hospitalization. The body temperatures taken on the day following the injection in the simultaneous-vaccination group were significantly higher than those in the single-vaccination group (p=0.049). However, the incidence of other systemic and local adverse events in the simultaneous-vaccination group was not significantly different from that in the single-vaccination group. Compared with single vaccination, simultaneous vaccination of inactivated vaccines in infants resulted in a significant rise in body temperature on the day following vaccination; however, no severe adverse events occurred.View full abstractDownload PDF (606K) -
Jinwoo LEE, Yoriko KOBAYASHI, Kazuyuki NAKAMURA, Hiromi KURODA2016 Volume 64 Issue 5 Pages 808-814
Published: January 30, 2016
Released on J-STAGE: March 16, 2016
JOURNAL FREE ACCESSWhen we use haloperidol (HP) parenterally to treat delirium in cancer patients, sometimes akathisia appears. So, we are pressed to give treat this symptom. The aim of this study was to investigate the occurrence rate of akathisia after HP injection and the effectiveness of biperiden injection in the treatment of akathisia. We retrospectively worked out the rate of the use of Hp injection, the rate of the occurrence of akathisia by using Hp and the effectiveness of biperiden injection in the treatment for delirium in 67 patients out of 100 patients who died in the palliative care unit (PCU) and 10 patients with delirium out of 23 patients who were under care of our palliative care team (PCT) in the sections other than the PCU from August to December of 2012. In the PCU, Hp injections were used in 52 patients (78%) out of 67 with delirium, and akathisia was suspected in 23 patients. Biperiden was injected into all of them and it was effective in 21 patients (91%). Our palliative care team gave Hp injections to seven patients (70%) out of 10 with delirium, and akathisia was suspected in one patient. At that time Hp injection was suspended but biperiden was not used. To sum up, Hp was administered to a total of 59 patients (76%) out of 77 with delirium, and akathisia was suspected in 24 patients (40%). Biperiden was used in 23 patients, all of whom were PCU patients, and effective in 21 (91%). When Hp was used to treat cancer patients with delirium, the onset of akathisia was suspected in 40% of them, but biperiden was considerably beneficial in patients with delirium.View full abstractDownload PDF (451K) -
Koji SHIMABUKURO, Tamami ODAI, Takanori YOSHIDA, Takafumi TSUKADA, Yuk ...2016 Volume 64 Issue 5 Pages 815-818
Published: January 30, 2016
Released on J-STAGE: March 16, 2016
JOURNAL FREE ACCESSWe have developed a new surgical procedure for uterine prolapse of round ligament suspension to the psoas minor tendon by the use of a laparoscope. Here, we describe the new technique and report the outcome of surgery in three cases. Operative procedure: The fundus of the uterus is lifted back up to its natural position by fixing the round ligament of the uterus to the psoas minor tendon after incising the peritoneum covering psoas. It is important to use the tendon as a stronger reattachment site in addition to the psoas major muscle. The round ligament is tacked to the tendon by a 2-0 nonabsorbable suture on bilateral sides. The second suture may be added if the uterus is not appropriately lifted up by the first suture. The retroperioneum is closed by a continuous 3-0 absorbable suture after fixation. Cases: Two patients with severe uterine prolapse and one patient with a mild condition went through the operation safely and have experienced no recurrence for 10 to 24 months. One severely ill patient complained about post -operative right inguinal pain early and another with the severe condition complained that something felt wrong with the right thigh. We propose the operation of laparoscopic round ligament psoas minor tendon-hitching as a safe and effective surgical treatment for uterine prolapse.View full abstractDownload PDF (264K)
RESEARCH REPORT
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Ryuichi INAGI, Takahiro IWAGAKI, Atsushi OGIHARA2016 Volume 64 Issue 5 Pages 819-826
Published: January 30, 2016
Released on J-STAGE: March 16, 2016
JOURNAL FREE ACCESSThis study was carried out to look into the effects of farm work on the amount of physical activity and mood of four university students who participated in farm work in May and October 2013. The number of steps, metabolic equivalents (METs), and amount of physical activity (Ex) of each student were assessed by the use of a physical activity level meter. In addition, the mood of the subjects was assessed before and after farm work by the use of the Profile of Mood States (POMS) Short Form. In May, the number of steps ranged from 11,386 steps to 25,341 steps. At 3-4 METs, the amount of physical activity ranged from 5.0 Ex to 16.9 Ex. At over 4 METs, the range was 0.5 Ex to 9.0 Ex. In October, the number of steps ranged from 4,975 to 21,965. At 3-4 METs, the range was 5.0 Ex to 17.0 Ex. At over 4 METs, the range was 0.8 Ex to 5.2 Ex. In POMS scoring, the measure of Vigor tended to increase, and negative factors such as Tension and Depression tended to decrease after farm work. A greater number of subjects need to be analyzed to assess the influence of differences in the type of farm work.View full abstractDownload PDF (457K) -
Hironao TANAKA, Shunya TAKENO, Chiho KURUMAZUKA, Yasutaka INOUE, Kunih ...2016 Volume 64 Issue 5 Pages 827-832
Published: January 30, 2016
Released on J-STAGE: March 16, 2016
JOURNAL FREE ACCESSWe worked out TTR values in patients receiving warfarin treatment in Abashiri-Kosei General Hospital. The patients were divided into two groups - those with satisfactory TTR values and those with poor TTR values - and associations between patient factors and average dosing interval were examined in the two groups. A total of 178 patients joined this study. The average TTR value worked out at 65.1±24.8%. It was found that the average TTR value for those patients aged at 70 and above came to 72.7±21.4%, which was significantly high as compared with 51.06plusmn;24.6% for those under 70 years of age. When the average TTR value was calculated after the optimal PT-range for the group of those below the age of 70 was changed from 2.0～3.0 to 1.6～2.6, it rose from 51.0% to 74.9%. These findings made it clear that PT-INR, regardless of age, was under control within the range from 1.6 to 2.6 in this hospital in accordance with the results of the J-RHYTHM Registry analysis.View full abstractDownload PDF (306K) -
Analysis of Survey Results and Their Commitment to AgricultureTomihiro HAYAKAWA, Masashi SUGIURA, Shinya KOBAYASHI, Sachiko SUZUKI, ...2016 Volume 64 Issue 5 Pages 833-846
Published: January 30, 2016
Released on J-STAGE: March 16, 2016
JOURNAL FREE ACCESSAs part of the special study project of the Japanese Association of Rural Medicine (JARM), a questionnaire survey was conducted to probe into the attitude of rural people toward their eating habits and health. Most of the people surveyed had received health checkups carried out by medical facilities affiliated with the JARM. Questionnaires were distributed to a total of 5,397 people (2,588 men; 2,809 women) living in and around provincial cities. Mean age was 53.4 for men and 53.8 for women. More than half of those questioned were farmers or had experienced in farming. The people aged 80 and older accounted for 3.2% of the total. Eighty percent of the total said they felt happy, and those who felt short of exercise also represented 80%, but with advancing age, the ratio decreased. Those over the age of 70 who said they had a habit of taking exercise made up as high as 60%. Many said they were satisfied with food in terms of quantity, but not a few people expressed uneasiness about food safety, dietary life and supply of food. Regarding favorite foodstuffs, many gave rice, vegetables and dairy products. There was a tendency for older people to eat meat less. It was found that, with increasing age, people took to eat dairy products, soybeans, vegetables, fruits and fish were ranked among the most popular foodstuffs. A study of factors related to local production for local consumption and commitment to agriculture found that a significantly large number of people were interested in social participation, eating breakfast, securing food supply and purchasing foodstuffs at outlet stores run by local agricultural cooperatives. From these findings, it was suggested that many residents in and around provincial cities oriented themselves to healthy eating habits and lifestyle, and were very interested in social participation, local economy, agricultural production and consumption of local farm produce.View full abstractDownload PDF (1574K) -
Chizuru MISAWA, Mikiyo TAKASHIMA, Ikuya NAKANE, Masami SHIBATA, Yasuji ...2016 Volume 64 Issue 5 Pages 847-852
Published: January 30, 2016
Released on J-STAGE: March 16, 2016
JOURNAL FREE ACCESSUnder the Handicapped Person’s Employment Promotion Law, it is obligatory for employers to raise the hiring rate of physically or mentally challenged persons up to a certain level. The Ministry of Health, Labor and Welfare raised the legal employment rate of handicapped people to 2.0% from 1.8% in April 2013. Contrary to the increasing responsibilities of hiring the handicapped people, many private enterprises hane yet to attain the legal employment rate. A survey conducted in June 2013 about the situation of handicapped people employment showed that the hiring rate of handicapped people in Toyota Kosei Hospital was as low as 0.99%. To deal with this stark reality, the Department of Office Management in our hospital started to carry out a series of activities to increase the employment rate of the handicapped. As a result, a mentally challenged person got a position for the first time in the Department of Clinical Laboratory. The Department of Office Management sought cooperation is demanded from the department of clinical laboratory. This paper reports, our activities and the present situation surrounding the new employee, and dwells on the prospect of employing the handicapped.View full abstractDownload PDF (448K) -
Masanobu ARIMITSU, Hideya SASSA, Kousaku UCHIYAMA, Makoto SUZUKAWA, Ka ...2016 Volume 64 Issue 5 Pages 853-859
Published: January 30, 2016
Released on J-STAGE: March 16, 2016
JOURNAL FREE ACCESSMany patients carried into the emergency room or intensive care unit are suspected to have risk factors for deep-seated mycosis. Using the Actions Bundle, which itemizes diagnosis and treatment of invasive candidiasis, we carried out investigations into facts about the use of antifungal drugs in the intensive care unit of our hospital. The subjects of this retrospective study were 11 ICU patients who were given antifungal drugs intravenously between April 2013 and March 2014. Their medication records revealed that micafungin was administered to five patients, fosfluconazole to another five patients and fulconazole to the remaining one patient. The ratio of the cases where the dugs were used in compliance with what the Actions Bundle suggested worked out at 71.4±15.9%. When it came to the collection rate of two sets of blood culture and the proper dosage, the compliance rates were the lowest with 36% each. As regards dosage, 18% was excessive, 36% proper and 45% insufficient. As pharmacists in charge of the ICU, we have to use the checklist more effectively and intervene in the care of patients with invasive candidiasis at an early stage.View full abstractDownload PDF (603K)
CASE REPORT
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Takahiro SAKAMOTO, Hikaru KIMURA, Yoshikazu YAZAKI2016 Volume 64 Issue 5 Pages 860-863
Published: January 30, 2016
Released on J-STAGE: March 16, 2016
JOURNAL FREE ACCESSAcute coronary syndrome is a typical life-threatening condition. Nevertheless, 1-8% of patients rushed to the emergency outpatient unit are sent home. One of the reasons for that is the absence of pain in a minority of myocardial infarction cases. It is said that 25% of the patients with acute coronary syndrome visit hospitals without complaining of chest pain, and about 1% of the patients complaining of nausea and vomiting only. In this paper, we present a case diagnosed as anteroseptal myocardial infarction at the outpatient department of internal medicine. The patient had symptoms of queasy feeling and vomiting. Coronary artery bypass grafting was indicated. We examined the case, focusing on the diagnostics with bibliographical consideration. Acute coronary syndrome cannot be ruled out in the elderly, even if they have fewer risk factors. In cases like the present one, when no other accessory symptoms are noted, the condition should be considered in the differential diagnosis. We believe that this will prevent life-threatening acute coronary syndrome from being overlooked.View full abstractDownload PDF (258K) -
Kazumasa AKIKAWA, Takeshi KOSHIYA, Naohide KOYANAGAWA2016 Volume 64 Issue 5 Pages 864-870
Published: January 30, 2016
Released on J-STAGE: March 16, 2016
JOURNAL FREE ACCESSIt is a well-known fact that germline mutations of various genes involved in the synthesis, secretion and action of thyroid hormone causes various abnormalities in serum levels of thyroid hormone and its effect. In this paper, we described two cases of dysthyroidism: thyroid-stimulating hormone (TSH) receptor abnormalities (case1) and resistance to thyroid hormone (case2). In case 1, the patient was woman in her 30s with gain-of-function mutation (p-Asp617Tyr) of TSH receptor genes. Ordinarily, her hyperthyroidism was subclinical, but thyrotoxicosis appeared during the later period of pregnancy. In case 2, the patient was a man in his 60s. His case was diagnosed as inappropriate TSH secretion syndrome complicated with Graves’ disease (Basedow disease) Thyroid hormone receptor β gene mutation (Ala234Thr) was recognized.View full abstractDownload PDF (453K)
NURSING RESEARCH REPORT
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Mitsue YOSHIDA, Hiroko AOTO, Yukie NISHIYAMA2016 Volume 64 Issue 5 Pages 871-876
Published: January 30, 2016
Released on J-STAGE: March 16, 2016
JOURNAL FREE ACCESSWith the participation in a national model project, Hanawa Kousei Hospital, in cooperation with Higashi Shirakawa Medical Association, took it upon itself in 2012 to promote a venture to build up a base for cooperation to provide home medical care within the region. For this purpose, we attended seminars on how to team up with people engaged in different types of business and meetings to exchanges views and ideas. Using summaries for regional cooperation, we also took part in case conferences and leadership conferences for leader-training and case study discussion. By first-hand experience, we realized how important was the role outpatient nurses should play. We conducted an interview with six leaders of outpatient nurses whom we become acquainted with in various meetings and categorization analyses were made of the roles which they said outpatient nurses should play. It was found that what the outpatient nurses should keep in mind includes:gathering information to put it to practical use in home care, working in close cooperation with people engaged in different types of business, and putting themselves in patients shoes with a deep understanding the lifestyle of patients. Furthermore, to perform the part of home care supporters, we realized the matter of cardinal importance was to educate outpatient nurses and consolidate a regional network.View full abstractDownload PDF (507K) -
Kayo IMAEDA, Keiko NAITO, Nami MATSUDA, Yuko NAGAHAMA, Junko GOTO, Nao ...2016 Volume 64 Issue 5 Pages 877-881
Published: January 30, 2016
Released on J-STAGE: March 16, 2016
JOURNAL FREE ACCESSIn the guidance of technical aspects in the “new nursing staff training guidelines” prepared by the Ministry of Health, Labor and Welfare in December 2009, We were using an e-learning method. We evaluated the achievement of nursing technology item 69 and examined the problems to be solved for the future basic nursing technical guidance. The subjects in the present study were 53 persons who joined the of rookie nursing staff of our hospital in April 2013 (new nurses are all fresh from college). Of the goals indicated in the guidelines, nursing technology item 69 was prepared for the group training course using e-learning. The trainees learned with a focus on simulation. After that each department carried out OJT and evaluation. We aggregated achievement evaluations and carried out questionnaire surveys on the use of e-learning in June, September and March of the following year. We compared and examined the evaluations of achievement in comparison with the previous year evaluations. In March 2014 when the new nursing staff training program ended, it was found that those who attained “a measure of reach 1: can” or “2: as possible under the guidance” accounted for 36.5% of the total number of recruits in 2013, compared to 34.9% in 2012. The ratio of those who highly evaluated “a measure of reach 4: have knowledge” remarkably increased from4.5% to23.4%, and that of inexperienced persons or people who did not evaluate decreased from 29.2% to 4.2%. This showed that the self-learning and utilizing e-learning at their own pace proactively helped them to acquire basic nursing skills. However, a problem remained that too much time was required for evaluation, because it has been actually evaluated over 100 fields due to detailed e-learning items, the limited number of desk-top computers.View full abstractDownload PDF (329K)
MATERIAL
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Mari WAKAMATSU, Naoyuki SUMIYOSHI, Tomohiko YOKOI, Miho SENDA, Maki FU ...2016 Volume 64 Issue 5 Pages 882-885
Published: January 30, 2016
Released on J-STAGE: March 16, 2016
JOURNAL FREE ACCESSWe made some improvements on the in situ hybridization protocol for EB virus (EBV) detection so that many general laboratories in Japan are able to perform the procedure. Using FITC-labeled EBER-PNA probes (DAKO), we examined dilutions of several chemicals and the incubation temperature of the probes in tissue sections. We confirmed the accuracy and reproducibility of our protocol by applying PCR to detect EBV genomes within tissue sections. We applied the technique to 55 laboratory samples which were suspected to be infected with EBV, and eight negative control and successfully ended up with pathological diagnosis. Moreover, coupled with immunohistochemical detection of LMP-1, we could determine the type of EBV infection.View full abstractDownload PDF (313K) -
Takuya SHIRAISHI2016 Volume 64 Issue 5 Pages 886-890
Published: January 30, 2016
Released on J-STAGE: March 16, 2016
JOURNAL FREE ACCESSThe school physical examination is important, because it screens children for scoliosis at an early stage. It occurs most often in children at puberty without subjective symptoms. Scoliosis can be noticed by observing the back of children. Recently, the interview sheets have come to be used in scoliosis school physical examination. In this paper, we examined effects of interview sheets of scoliosis on parents. We conducted a questionnaire survey targeted at parents on the use of interview sheets in scoliosis school physical examination. The survey found that the interview sheets were helpful not only to find out scoliosis children early who need to receive medical attention but also to make parents understand this disorder and concern more about the school physical examination. Scoliosis might be found earlier because parents take care of the back of their children.View full abstractDownload PDF (424K)
REGIONAL MEETING
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2016 Volume 64 Issue 5 Pages 891-914
Published: January 30, 2016
Released on J-STAGE: March 16, 2016
JOURNAL FREE ACCESSDownload PDF (787K)
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