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Volume 70, Issue 1
Displaying 1-13 of 13 articles from this issue
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ORIGINALS
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Yasuo TANAKA2021 Volume 70 Issue 1 Pages 1-12
Published: 2021
Released on J-STAGE: June 30, 2021
JOURNAL FREE ACCESSThe purpose of this study was to clarify the relationship between turnover rates of regular care staff and education or training at conventional and unit-type welfare facilities for the elderly. A questionnaire survey was conducted by mail at a total of 1180 randomly selected facilities of both types nationwide. The relationship between turnover rates of the regular care staff and education or training was analyzed by multiple regression analysis. The results revealed relationships between turnover rates and leader training for regular care staff with less than 1 year of service and between turnover rates and documentation or reporting training for regular care staff with 1 or more years of service at conventional facilities. Furthermore, the results revealed relationships between turnover rates and care skills or knowledge training and between turnover rates and training officers for regular care staff with less than 1 year of service and between turnover rates and functional training or low back pain prevention measures for regular care staff with 1 or more years of service at unit-type facilities.View full abstractDownload PDF (836K) -
Yuko OTSUKI, Yoshiko NAKANE2021 Volume 70 Issue 1 Pages 13-21
Published: 2021
Released on J-STAGE: June 30, 2021
JOURNAL FREE ACCESSThe purpose of this study was to investigate implementation of tablet-based remote support for female in-home caregivers in sparsely populated rural areas and to determine the effectiveness of that support. Remote support was delivered to 2 women providing in-home care through counseling sessions about caregiving conducted over the Hangouts app on a 10.5-inch ipad Pro® for 1 year. The topics on which caregivers were counseled during this year of remote support were “excretion management for the care recipient,” “responding to the care recipient’s words and actions,” “confusion about the care recipient’s symptoms,” “selection of a long-term care service,” and “cooperative family caregiving programs.” Semi-structured interviews about the tablet-based remote support were conducted after the support period ended. Participants were asked about (1) operating the tablet and (2) whether the sessions changed their caregiving practices. Interviews were recorded with a digital voice recorder and transcribed verbatim. Data were analyzed qualitatively using the approach of Mayring (2000). The 4 categories developed were “expectations for instantaneous support methods,” “adaptation to using a tablet,” “changes in perception of caregiving,” and “getting time to talk about their own caregiving.” Participants’ perception of caregiving changed through tablet-based remote support because they could receive professional support with reassurance that comes from seeing the person’s face. In addition, participants were quick to adapt to using a tablet because the application was simple to use even for older caregivers, and they had expectations for instantaneous support methods.View full abstractDownload PDF (854K)
RESEARCH REPORTS
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Takayuki KUGA, Yuka YANO, Masatoshi SHIGETA, Ryunosuke SAKAMOTO, Mayu ...2021 Volume 70 Issue 1 Pages 22-31
Published: 2021
Released on J-STAGE: June 30, 2021
JOURNAL FREE ACCESSCoronavirus disease 2019 (COVID-19) has spread rapidly in Japan. The purpose of this study was to report the clinical experience of our COVID-19 patients early in the pandemic and lessons from our experience. An outpatient fever clinic was established on April 7. Admission of COVID-19 patients was started on July 23. Between April 7 and September 30, there were 364 walk-in outpatients and emergency patients with fever. Polymerase chain reaction test for SARS-CoV-2 RNA or COVID-19 antigen test were performed in all patients, and all results were negative. Twenty patients with COVID-19 were admitted to a newly established dedicated COVID-19 ward. They were discharged well. There were no cases of nosocomial infection at our hospital. Length of hospitalization was correlated with serum ferritin level at admission, serum CRP level at admission, and age. More than half the patients experienced psychological stress, and COVID-19 specialized nurses experienced some stress. It is essential to set up the medical system for COVID-19 according to the trends of the disease. Creation of our original database and our “problem notebook” were useful for treatment and care of COVID-19 patients as well as for mental care of nurses.View full abstractDownload PDF (1864K) -
Satoshi OYAMADA, Naoki HISAMATSU, Junko KOJIMA, Shoichi ISAKA, Akihiro ...2021 Volume 70 Issue 1 Pages 32-37
Published: 2021
Released on J-STAGE: June 30, 2021
JOURNAL FREE ACCESSAlthough programmed cell death-ligand 1 (PD-L1) is a prognostic biomarker for nivolumab therapy, it is not very reliable due to its low accuracy. The pharmacological effect of nivolumab involves the cancer immunity cycle, a process that involves T cells, which are strongly associated with nutrition. In this study, we retrospectively investigated whether two measures of nutrition, namely, the Glasgow Prognostic Score (GPS) and the Prognostic Nutritional Index (PNI), could predict response to nivolumab as evaluated in terms of survival time. The subjects were 37 patients treated with nivolumab in the Department of Respiratory Medicine at our hospital between January 2017 and December 2018. Patients were classified into 2 PNI risk groups (low and high risk) and 3 GPS groups (0, 1, and 2), with lower GPS indicating better nutrition. Kaplan-Meier analysis was used to compare differences between the PNI groups and between each possible pairing of GPS groups. Survival time was significantly longer for the low-risk PNI group compared with the high-risk PNI group and for a GPS score of 0 versus 2 and 1 versus 2, but there was no significant difference for a GPS score of 0 versus 1. These results show that GPS and PNI may be potential predictors of response to nivolumab in non-small cell lung cancer.View full abstractDownload PDF (751K) -
Hidefumi FUJITA, Masahito MIURA2021 Volume 70 Issue 1 Pages 38-42
Published: 2021
Released on J-STAGE: June 30, 2021
JOURNAL FREE ACCESSTo expand the role of medical technologists in response to legal reforms made in 2015, our hospital devised a system where all laboratory staff would support physicians in clinical tasks and engage in team medicine. To secure staffing for this system, we had all our laboratory staff participate in a seminar specified by the Ministry of Health, Labour and Welfare, which allowed us to place staff in rotating shifts and thus have dedicated staff for influenza testing continually available in the emergency department on days when the hospital is closed for appointments. We decided that these medical technologists would be responsible for all influenza testingrelated tasks beginning with collecting samples from patients with fever suspected of having influenza to reporting test results. This change significantly improved work efficiency and testing turnaround time, and was viewed favorably by physicians, nurses, and hospital administrators.View full abstractDownload PDF (1200K)
CASE REPORTS
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Koji TAKAHASHI2021 Volume 70 Issue 1 Pages 43-46
Published: 2021
Released on J-STAGE: June 30, 2021
JOURNAL FREE ACCESSA 77-year-old woman was referred to our hospital because of general malaise and appetite loss for 3 months. Contrast-enhanced computed tomography showed a gallbladder tumor and multiple tumors in the liver. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) was performed for the gallbladder tumor. Histopathologically, the tumor was diagnosed as poorly differentiated adenocarcinoma. There were no complications of EUS-FNA. While waiting for the histopathological results of EUS-FNA, her appetite loss gradually became severe, so she declined systemic chemotherapy. She was discharged from the hospital 15 days after EUS-FNA. EUS-FNA for gallbladder lesions is useful when pathological diagnosis is required.View full abstractDownload PDF (1554K) -
Fumitake KOBAYASHI, Sachiei TAKAHASHI, Jiro IMURA2021 Volume 70 Issue 1 Pages 47-52
Published: 2021
Released on J-STAGE: June 30, 2021
JOURNAL FREE ACCESSScrotal hematocele is defined as retention of blood in the tunica vaginalis. Although it is usually an acute change, it can also have a chronic course. A 55-year-old man was being treated for hypertension and diabetes in the Department of Internal Medicine at our hospital. He visited the hospital’s Department of Urology because 3 months earlier he had noticed enlargement of the right scrotum without trauma to the perineum. The right scrotum was swollen to the size of a small child’s head. Imaging examination showed no testicular tumor. Puncture yielded 550 ml of bloody fluid. Surgery was performed to find and treat the source of bleeding. The tunica vaginalis was highly irregular and thickened. Considering the possibility of mesothelioma or other malignancy, we removed the testis after transection of the spermatic cord as proximally as possible. The histopathological diagnosis was encapsulated hematoma with cholesterin granuloma, which was diagnosed as chronic scrotal hematocele.View full abstractDownload PDF (2602K) -
Keisuke INOUE, Yuma NAKAMURA, Masaki HAKOMORI, Kazunori TOYODA, Tomoyu ...2021 Volume 70 Issue 1 Pages 53-61
Published: 2021
Released on J-STAGE: June 30, 2021
JOURNAL FREE ACCESSFew reports have described assessment methods or exercise interventions in detail for patients isolated with COVID-19. Here, we report our experience of providing physical therapy to these patients based on motor assessment with consideration of infection control. This study involved 4 patients with COVID-19 who needed physical therapy due to a fall or frailty during isolation. The assessment method used was intended to minimize physical contact, to be easily performed, and to reflect muscle strength and balance. Based on the assessment, we created exercise programs and provided exercise intervention to the patients in cooperation with nurses. One patient was discharged early; the other 3 patients showed improved motor function and activities of daily living as a result of the intervention in the acute ward. However, they needed ongoing rehabilitation in the rehabilitation ward. No physical therapists showed signs of COVID-19 infection. Performing motor assessments and providing exercise intervention to these patients isolated with COVID-19 contributed to motor improvement and enabled us to promptly determine whether they needed ongoing rehabilitation.View full abstractDownload PDF (1371K) -
Akio YASUI, Takeshi WAKITA, Yoshihito MATSUI, Daiki KOIDE, Hisanobu MA ...2021 Volume 70 Issue 1 Pages 62-68
Published: 2021
Released on J-STAGE: June 30, 2021
JOURNAL FREE ACCESSIntra-arterial chemoradiotherapy for advanced oral cancer has recently been reported and can preserve the form and function of the tongue by avoiding surgery at the primary site. We report here a case of advanced tongue cancer treated with intra-arterial chemoradiotherapy that preserved phonation and swallowing function. A 71-year-old man presented with an ulcerative mass, 43×28 mm in size, extending from the left lingual margin to the base of the tongue. The pathological diagnosis was squamous cell carcinoma based on biopsy results, and the clinical diagnosis was left lingual carcinoma (cT3N0M0, stage III) based on imaging findings. A polyurethane catheter was inserted into the left lingual artery, and intra-arterial chemotherapy was administered using docetaxel (15 mg/m2/week, total dose 60 mg/m2) and cisplatin (5 mg/m2/ day, total dose 125 mg/m2) with concurrent radiotherapy (2 Gy/day, total dose 50 Gy). Posttreatment biopsy results showed no tumor cells, and complete response was achieved, thus avoiding surgical resection of the primary site. Six years after completing treatment, the patient remains in good health with no recurrence, metastasis, phonation problems, or dysphagia.View full abstractDownload PDF (2239K) -
Kai TAKAYANAGI, Takeshi OKADA, Otone ENDO, Kentaro FUJII, Tomotaka ISH ...2021 Volume 70 Issue 1 Pages 69-75
Published: 2021
Released on J-STAGE: June 30, 2021
JOURNAL FREE ACCESSA 68-year-old woman had unstable angina pectoris with asymptomatic right internal carotid artery and right middle cerebral artery occlusion with impaired cerebral perfusion reserve. The cardiology, cardiovascular surgery, anesthesiology, and neurosurgery departments discussed the treatment plan. We simultaneously performed superficial temporal artery-middle cerebral artery anastomosis and coronary artery bypass grafting to reduce the likelihood of perioperative ischemic stroke. Fortunately, neither cerebral ischemia nor myocardial ischemia occurred. Simultaneous superficial temporal artery-middle cerebral artery anastomosis and coronary artery bypass grafting can be a therapeutic option for patients with unstable angina and impaired cerebral perfusion reserve. However, the risk of bleeding associated with anticoagulation during coronary artery bypass grafting cannot be ignored.View full abstractDownload PDF (1759K) -
Koji TAKAHASHI2021 Volume 70 Issue 1 Pages 76-78
Published: 2021
Released on J-STAGE: June 30, 2021
JOURNAL FREE ACCESSAn 85-year-old man who developed sudden neck pain after ingesting walnuts visited our hospital. Computed tomography showed food impaction in the cervical esophagus. Upper gastrointestinal endoscopy revealed a walnut half that was not chewed at all in the cervical esophagus. The walnut half was pushed into the stomach with the endoscope and removed using a retrieval net. No strictures, neoplastic lesions, or ulcerations were found in the esophagus. The neck pain improved after the procedure.View full abstractDownload PDF (1624K) -
Sota YOSHIMINE, Atsushi SEYAMA, Atsushi SUGA, Masanori HAYASHI, Takash ...2021 Volume 70 Issue 1 Pages 79-84
Published: 2021
Released on J-STAGE: June 30, 2021
JOURNAL FREE ACCESSLaparoscopy is useful for minimally invasive detailed examination of patients with suspected gastrointestinal perforation. Here we report a case of gastrointestinal perforation of unknown cause that was diagnosed laparoscopically as perforation of the sigmoid colon by a toothpick. The patient was a 41-year-old woman. She presented with a chief complaint of left lower abdominal pain and CT showed a small amount of free air in the peritoneal cavity, so emergency surgery was performed. Laparoscopy revealed a foreign body penetrating the sigmoid colon. After mobilization of the sigmoid colon, the surgical technique was switched to minilaparotomy and partial sigmoid colectomy was performed. The foreign body that had penetrated the intestine was identified as a toothpick. We later learned that the patient had become intoxicated while eating at a yakiniku barbecue restaurant 7 days prior to the operation, and she guessed that she had accidentally consumed a toothpick stuck in an onion. Gastrointestinal perforation by a toothpick is rare and is difficult to diagnose preoperatively because toothpicks appear transparent on X-ray imaging. In this case, laparoscopy was useful for identifying the site and cause of perforation as well as the extent of leakage into the peritoneal cavity.View full abstractDownload PDF (2169K)
MATERIAL
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: The Relationship Between Health and Continuing to Farm AloneTakashi YOSHIMURA2021 Volume 70 Issue 1 Pages 85-91
Published: 2021
Released on J-STAGE: June 30, 2021
JOURNAL FREE ACCESSThe purpose of this study was to examine the relationship between the meaning of growing traditional vegetables and the health of elderly people living in rural areas. Data obtained from semi-structured interviews were qualitatively analyzed considering the local social and cultural contexts. The results suggest that cultivating traditional vegetables was related to the following categories: [A means to connect with people], [Facing old age], [A means to maintain physical functions], and [Protecting the community]. Cultivation of traditional vegetables is an activity that uses the five senses and utilizes intellectual functions. Furthermore, it is thought that significance and value will be found in life by building active relationships with people. Therefore, the cultivation of traditional vegetables was considered to be linked to recognizing the existential self and accepting the decline and loss of physical and mental functions to live as oneself.View full abstractDownload PDF (750K)
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