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Volume 71, Issue 1
Displaying 1-10 of 10 articles from this issue
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ORIGINALS
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Yoshio HISATA, Takashi SUGIOKA2022 Volume 71 Issue 1 Pages 1-11
Published: 2022
Released on J-STAGE: June 23, 2022
JOURNAL FREE ACCESSWe conducted a questionnaire survey to examine the association between loneliness and health with consideration of lifestyle and social relationships in a mountainous rural area of Japan. We used the Japanese versions of the short-form University of California, Los Angeles Loneliness Scale (UCLA score: 3-9 points) and the 12-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS score: 12-48 points). Among 108 respondents (47 men, 61 women), mean age was 74.1 years, 30 (28%) were obese, 40 (37%) had a smoking habit, and 38 (35.1%) had an alcohol habit. Negative social relationships were reported by5 (4.6%) respondents. Mean UCLA score was 4.08 ± 1.34 and mean WHODAS score was 7.68 ± 8.84. Respondents were classified into the loneliness group if the UCLA score was greater than 4 points (58/108, 53,7%) and into the healthy group if the WHODAS score was 7 points or less (66/108, 61.1%). In univariable analysis, lower health status was significantly associated with age > 75 years (odds ratio [OR] 0.29, 95% confidence interval [CI] 0.11-0.73, p = 0.003), female sex (OR 2.82, 95%CI 1.15-7.09, p = 0.01), living alone (OR 0.44, 95%CI 0.14-1.33, p = 0.01), divorce, separation, or bereavement (OR 0.24, 95%CI 0.09-0.60, p < 0.001), ≤ 9 years of education (OR 0.18, 95%CI 0.07-0.46, p < 0.001), unemployed/looking for work (OR 0.9, 95%CI 0.26-0.27, p < 0.001), no alcohol habit (OR 2.66, 95%CI 1.05-7.05, p = 0.02), and loneliness (OR 0.29, 95%CI 0.11-0.72, p = 0.003). On multivariable analysis, loneliness was identified as an independent risk factor for poorer health status (OR 0.11, 95%CI 0.02-0.43, p =0.002) after adjusting for the other significant items on univariable analysis.View full abstractDownload PDF (781K) -
Hiromi KIMURA, Kayoko KOGA, Hiroko KUKIHARA, Midori NISHIO2022 Volume 71 Issue 1 Pages 12-21
Published: 2022
Released on J-STAGE: June 23, 2022
JOURNAL FREE ACCESSThe purpose of this study was to evaluate the stress accompanying behavioral and psychological symptoms of dementia (BPSD) and to validate the care that brings eustress through physical and emotional interventions. The participants were 57 elderly people with BPSD who used or lived in long-term care facilities, group homes, small-scale multifunctional home care services, and community-based specified facilities in prefecture X. The study included a 2-week control period and a 12-week intervention period in which square-stepping exercise (SSE) was introduced and the validation method was used for communication. Results showed that stress levels were higher when BPSD appeared. After SSE, amylase activity levels decreased in 70% of the participants, although the decrease was not statistically significant, and facial expression significantly improved in Face Scale (FS) assessment. Also, after validation communication, amylase activity levels showed a significant decrease and facial expression significantly improved in the FS assessment. Even though most of the participants in this study were elderly people with moderate dementia, SSE appeared effective for enjoying physical activity and making friends, and validation can be expected to have the effect of sharing time and relieving stress.View full abstractDownload PDF (809K) -
Yuko OKAWA, Yoshiichi ABE, Masayoshi SUZUKI2022 Volume 71 Issue 1 Pages 22-30
Published: 2022
Released on J-STAGE: June 23, 2022
JOURNAL FREE ACCESSOrthostatic dysregulation (OD) is mainly caused by circulatory dysregulation by the autonomic nervous system, but it can be psychosomatic and may be associated with school refusal. Here, we investigated the causes of school refusal and problems specific to the COVID-19 pandemic in pediatric patients meeting the diagnostic criteria for psychosomatic OD. This study involved 67 patients with OD (20 boys, 47 girls) who visited the pediatric outpatient department from April 1, 2020 to October 31, 2021. Mean age was 13.7 ± 2.4 years. The subtypes of OD included postural tachycardia syndrome (POTS) in 43 cases, delayed orthostatic hypotension (delayed OH) in 15 cases, instantaneous orthostatic hypotension (INOH) and vasovagal syncope (VVS) with INOH in 1 case each , and 7 other cases that met the conventional diagnostic criteria. Of the 67 patients, 37 met the diagnostic criteria for psychosomatic OD and 22 had a history of long-term school refusal. The COVID-19 pandemic, school closures, and suspected school infections have completely changed the living environment for children. As a result, these children could not rest at school and were forced to return home early. They had worsening of symptoms that was thought to be due to disruptions of daily rhythms caused by staying at home and getting insufficient exercise. At this hospital, we explain the pathophysiology of the autonomic nervous system, provide lifestyle guidance to patients and their families, cooperate with schools with consideration of school refusal and each child’s mental and physical condition, and cooperate with psychiatry. This paper discusses problems and countermeasures specific to the COVID-19 pandemic.View full abstractDownload PDF (895K) -
: Health Examination Findings in Tosa Town, Kochi PrefectureMitsuhiro NOSE, Yumi KIMURA, Ryota SAKAMOTO2022 Volume 71 Issue 1 Pages 31-40
Published: 2022
Released on J-STAGE: June 23, 2022
JOURNAL FREE ACCESSAlthough previous studies have investigated the relationship between agricultural work and health conditions in older adults, little attention has been paid to crop handling. In this study, we aimed to clarify the relationship between agricultural work, crop handling/sales, and health. A survey was conducted of older adults attending health examinations in Tosa Town, Kochi Prefecture. To clarify the relationship among comprehensive geriatric assessment items, the t-test was used for comparisons between two groups according to the presence or absence of agricultural work, and one-way analysis of variance with multiple comparisons was used for comparison among three groups according to the presence or absence of crop handling and agricultural work. The analyses were performed separately for men and women. The analysis results showed that male participants who were engaged in agricultural work had significantly better indicators of ability to walk and stand up as well as higher scores for social roles on the Tokyo Metropolitan Institute of Gerontology Index of Competence compared with those who were not engaged in agricultural work. No significant differences were found between the two groups of women. In three-group comparisons, the subjective well-being and social roles of men and women who did agricultural work and distributed their crops were significantly higher than those who did not do agricultural work and those who did agricultural work but did not distribute their crops.View full abstractDownload PDF (752K)
RESEARCH REPORT
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Rina WAKISAKA, Chinari FURUICHI, Hideto FUKUOKA, Masaya HIGUCHI, Chihi ...2022 Volume 71 Issue 1 Pages 41-45
Published: 2022
Released on J-STAGE: June 23, 2022
JOURNAL FREE ACCESSEchocardiographic assessment of wall motion is prone to interrater variability because it requires subjective visual evaluation. Echocardiography technicians were divided into 2 groups by years of experience, and their assessments of left ventricular wall motion on previously recorded echocardiograms were scored and compared. Scores did not differ within the more experienced group but differed significantly between technicians in the less experienced group. However, this difference disappeared after 3 months of training. This suggests that training can eliminate discrepancies between technicians, even inexperienced ones, in a relatively short period of time.View full abstractDownload PDF (856K)
CASE REPORTS
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Takashi MAEDA, Satoshi KOBAYASHI, Takehiro TAKAGI, Kenichi KOMAYA, Shi ...2022 Volume 71 Issue 1 Pages 46-50
Published: 2022
Released on J-STAGE: June 23, 2022
JOURNAL FREE ACCESSA 57-year-old man was admitted to our hospital with adhesive bowel obstruction following pancreaticoduodenectomy performed for cholangiocarcinoma 4 months earlier. After admission, the patient remained nil per os and was closely observed. On the third day of admission, he developed worsening abdominal pain, and computed tomography revealed strangulation of the small intestinal mesentery dorsal to the superior mesenteric artery, with prolapse of the small intestine into the right upper quadrant to form a closed loop. Strangulated bowel obstruction secondary to internal hernia was diagnosed, and he underwent emergency surgery. Intraoperatively, we detected a hernia orifice formed by the mesentery and peritoneum at the site of the defect following resection of the ligament of Treitz, and we observed that approximately 2 m of the small intestine had prolapsed into the right upper quadrant. The herniated intestine was returned to the abdominal cavity, and the hernia orifice was sutured following hernia reduction. Few reports have described an internal hernia after pancreaticoduodenectomy; however, it has been reported that this operation can result in various types of internal hernia because of the complicated reconstructive procedure. Here we report our findings in this unique case together with a literature review.View full abstractDownload PDF (1089K) -
Midori YOKOI, Yuko NAKAMURA, Taku ISHII2022 Volume 71 Issue 1 Pages 51-55
Published: 2022
Released on J-STAGE: June 23, 2022
JOURNAL FREE ACCESSVascular ring is a congenital anomaly of the aorta and its branches that compresses the trachea and/or esophagus. Infants with vascular ring may have critical dyspnea due to airway obstruction, which is called a dying spell. In addition, vascular ring leads to secondary malacia of the trachea and bronchus. To prevent dying spells and progression of malacia, vascular ring should be diagnosed as soon as possible. We report here a case of a 5-month-old girl with vascular ring affecting the right aortic arch, aortic diverticulum, and ligamentum arteriosum. She had stridor from birth and afebrile convulsions due to dying spells at 5 months of age. Transthoracic echocardiography revealed right aortic arch, and plain computed tomography (CT) revealed severe tracheal stenosis. Finally, we diagnosed vascular ring based on contrast-enhanced CT imaging. We should consider vascular ring when we encounter infants with stridor. Echocardiography is helpful for examining the structure of aorta, and if an aortic anomaly is noted, contrast-enhanced CT should be performed to diagnose vascular ring immediately.View full abstractDownload PDF (1285K) -
Saki ISHIYA, Yasuhiro KURUMIYA2022 Volume 71 Issue 1 Pages 56-62
Published: 2022
Released on J-STAGE: June 23, 2022
JOURNAL FREE ACCESSA 39-year-old woman underwent preoperative chemotherapy and laparoscopic low-anterior resection for rectal cancer (Rab, ypT3, ypN1b, ypStageIIIb). Preoperative examinations and intraoperative macroscopic findings showed no significant abnormality in the ovaries. Two months postoperatively, however, she complained of abdominal distention, and work-up examinations revealed massive ascites and pleural effusion with bilateral nodular-cystic enlargement of the ovaries. She underwent bilateral salpingo-oophorectomy, and histopathological findings revealed bilateral ovarian metastasis of the rectal cancer. The ascites and pleural effusion disappeared soon after the surgery and have not recurred. The pathology was considered to be pseudo-Meigs syndrome. Postoperative chemotherapy was administered for 12 months, and there has been no evidence of no recurrence as of this writing 18 months postoperatively.View full abstractDownload PDF (3081K) -
Yasuhiro KURUMIYA, Tae NIWA, Sakura ONISHI, Shingo OYA, Keisuke MIZUNO ...2022 Volume 71 Issue 1 Pages 63-68
Published: 2022
Released on J-STAGE: June 23, 2022
JOURNAL FREE ACCESSA 66-year-old, postmenopausal woman was referred to our hospital because of abnormal breast cancer screening results. A tumor was found in the upper outer part of the left breast. Biopsy revealed papillotubular carcinoma, ER (Allred score total score [TS] 3 = proportion score [PS] 2 + intensity score [IS] 1), PgR (Allred score TS 3 = PS 2 + IS 1), HER2 (2+), fluorescent in situ hybridization 1.1 (negative), and Ki-67 labeling index 15%. In diagnostic imaging, the tumor size was 35 mm. The diagnosis was T2N0M0 Stage IIA, luminal B-like breast cancer. First, letrozole 2.5 mg/day was administered as preoperative hormone therapy. After 2 months of treatment with letrozole, the tumor size had increased to 44 mm and preoperative hormone therapy was discontinued. She was started on preoperative chemotherapy (4 courses of epirubicin plus cyclophsphamide followed by 4 courses of triweekly docetaxel). The tumor size decreased, becoming undetectable. After these preoperative treatments, nipple-sparing mastectomy, sentinel lymph node biopsy, and breast reconstruction with a primary latissimus dorsi flap were performed. As of 3 years and 6 months after the operation, there has been no recurrence. At first, preoperative hormone therapy is performed for Luminal B-like breast cancer as in this case, if the response is insufficient, preoperative chemotherapy after hormone therapy may be a therapeutic option.View full abstractDownload PDF (2068K) -
Aina OISHI, Shinji TAKAHASHI2022 Volume 71 Issue 1 Pages 69-72
Published: 2022
Released on J-STAGE: June 23, 2022
JOURNAL FREE ACCESSThe patient was a 36 year-old woman with cold sensitivity who had repeated episodes of herpes labialis. Her average sleep time was 13 h, and she experienced problems in her daily life when she could not get enough sleep, so she was diagnosed as having hypersomnia. She gave birth to her first child at the age of 35 years. She had herpes labialis at 1 month after birth, and lochia continued for 3 months. She also experienced repeated episodes of herpes labialis and continuation of lochia after giving birth to her second child at the age of 36 years. In the examination, abdominal tension was low, and because she reported frequent fatigue and infections, she was diagnosed as having Qi deficiency. Hochuekkito was started internally, and after 2 weeks, she had less lochia and the herpes labialis disappeared. In addition, as her symptoms of hypersomnia improved, she became able to maintain her physical strength without excessive daytime sleepiness even after sleeping for only 5 h. Hochuekkito, which is often used to treat Qi deficiency, may improve Qi deficiency-related symptoms and contribute to improving daily life by shortening the sleep time of people with hypersomnia.View full abstractDownload PDF (706K)
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