The prevalence of obese and thin status based on body mass index (BMI) in Gunma Prefecture were compared to averages in Japan. These results showed that there were more overweight class, but fewer obese class in Gunma females.
The prevalence of obese and thin status varied from area to area within Gunma Prefecture. The findings indicate that with regard to background, per capita annual income in each region may relate to men's physics' status, while on the other hand, population density may have a greater influence on female's status. However, the prevalence of obese and thinness, showed no close relation to either advanced-age ratio or life-style related diseases.
Therefore, the prevalence and/or status of obesity and thinness can not be evaluate in the same manner in Gunma Prefecture as in western society because of food and life style differences.

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The recovery of motor function in 18 patients with hemiplegia due to cerebrovascular diseases (13 with cerebral infarction and 5 with cerebral hemorrhage ; 64.8±11.2 years of age) were assessed by Brunnstrom classification and compared with the transcutaneous oxygen tensions, and arterial and venous oxygen tensions of the lower limbs. The patients with severe hemiplegia showed a significant increase in the difference between the transcutaneous oxygen tensions of the affected and the healthy limbs, though no significant changes in the transcutaneous, arterial and venous oxygen tensions of affected limbs among light to severe hemiplegia patients were noted. These results suggest that the difference between transcutaneous oxygen tensions of affected and healthy limbs is useful in evaluating the grade of hemiplegia. This difference may be derived from vasomotor dysfunction, autonomic nerve palsy, opening of an arterio-venous shunt, and disorder of muscle and fatty tissue metabolisms in an affected limb.

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A clinical investigation of bladder cancer was conducted in the Department of Urology at Gunma University Hospital, from January 1982 through December 1996. The patients studied were 229 males and 85 females (ratio, 2.7 : 1) with bladder cancer. They ranged in age from 17 to 97 years old with an average age of 68.2 years.
The 5 year survival rate was 94.8% for superficial bladder cancer, and 48.2% for invasive bladder cancer. In the multivariative analysis of the tumor shape, base configuration, size, number of tumors, pathological grade, and clinical stage, papillary involvement, a peduncle, less than 1 cm diameter in size, grade 1, and pTa were the significant dominant factors for patient survival.
An ileal conduit was performed and was followed by radical cystectomy as standard urinary diversion, however, other methods, such as a continent reservoir or orthotopic bladder replacement (neobladder) are now being employed.
The development of treatment for invasive bladder cancer should consider the patient's quality of life.

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The association of thrombocytopenia with insulin-dependent diabetes mellitus (IDDM) has rarely been reported. We observed thrombocytopenia in four out of the ten diabetic children newly diagnosed within the past five years. Thrombocytopenia in these patients was not so severe clinically as to cause bleeding and thus did not draw attention of the endocrinologists. It was postulated that immune mechanisms are involved in the pathogenesis of thrombocytopenia on the basis of elevated levels of platelet-associated IgG (PAIgG) in three of the three patients on whom it was measured. Our observation suggests that mild thrombocytopenia may be a rather frequent association with IDDM. A prospective study is required in order to determine the incidence of thrombocytopenia and to clarify the significance of PAIgG in relation to other immunological abnormalities observed in IDDM.

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Introduction : Nakazato village is located in the far-southwest region of Gunma prefecture. It takes at least one hour to go to the nearest general hospital. Author's clinic does not have a CT scanning device. Until that time, every patient went to far hospitals by oneself, when CT scan was necessary for further examination. This study adverted to the usefulness of Mobile CT in a rural clinic. Patients and Methods : Between June 1995 and October 1997, 20 patients needed CT scanning because of further examination. The mean age was 72 years old, and the ratio of male to female was 9 to 11. Results : Seven patients had surgical treatment for cancer, and we had suspected recurrence of primary cancer. Four patients needed CT scanning in following various diseases. Nine patients had an abnormal shadow on chest roentgenogram. The disease was detected in 8 patients (40 %) out of 20 patients. Of 7 postoperative cancer patients, 2 had primary cancer recurrence, each of which was lung cancer and breast cancer. Of the remaining 9, 6 patients had a disease, which was chronic bronchitis in 2 patients, and bronchoectasia, emphysema, lung abscess and pleuritis in 1 each. Conclusion : Using the mobile CT makes it easy for patients to take further examination. We deliberate that this device is useful and recommends for rural clinics or hospitals, which do not have a CT scanning device.

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The author interviewed and observed 14 patients in the neurosurgery ward to elucidate characteristics and factors related to preoperative anxiety of craniotomy patients and obtained the following results :
(1) Six common preoperative anxiety of craniotomy patients are : fear of change and collapse of personality, fear of physical disability due to complications, fear of lost or altered role in the society, fear of change in body image caused by tonsure, fear of postoperative death, fear of ambiguity and something unknown.
(2) These fears are related to their past experience of operations, subjective symptoms, sufferings, triggers of their decision to have operation, expectation from the surgery, awareness of expected complications as well as their understanding of neurology.

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A 62-year-old man was admitted to our hospital in June 1996 with pancytopenia. He was diagnosed with acute myelogenous leukemia (AML) with trilineage dysplasia, and treated with induction therapy including idarubicin and cytosine arabinoside (Ara-C). After complete remission, he was treated with consolidation therapy including mitoxantrone and Ara-C in July 1996. At this time, small red papules with vesicles were observed on the right hand and forearm. In the vesicles, imagines and nits of sarcoptes scabiei were detected. He was diagnosed with scabies, and treated with ointment of hydrocortisone plus crotamiton. Temporarily, eruptions spread throughout his body, however, decreased with same therapy. In September 1996, the scabies infestation was eradicated. Scabies, especially Norwegian scabies, have become an important complication in patients with chronic lymphoid malignancies, AIDS, and recipients of bone marrow transplantation. In patients with AML, scabies is a rare complication, but unforgettable infectious disease.

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Aspergillosis is an uncommon complication of pulmonary carcinoma. A 60-year-old female was performed right lower lobectomy because of adenocarcinoma with pseudocavities. The diagnosis was bronchiolo-alveolar adenocarcinoma, and there was aspergilloma in one of the cysts in the tumor. Cavitation or cystic change in bronchiolo-alveolar adenocarcinoma is rare because of nondestructive growth pattern with an adequate blood supply in this histologic type. Additionally, bronchiolo-alveolar adenocarcinoma associated with pulmonary aspergilloma is rare.

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Two cases of dumbbell tumors occurring at the lumbar spine (both cases were Eden type II) were removed by a posterior approach without facetectomy. No fusions were performed in order to maintain flexibility of the lumbar spine. In both cases, we, performed partial laminectomy and resection of the pars interarticularis.Then the dura and epineurium were incised longitudinally just above the tumor. The tumors were dissected from the nerve, and were removed. After tumor removal, the dura mater was secured and closed. A small bone block from the spinous process was placed at the pars interarticularis with surgical wire. In both cases, tumors sizes complied with the following criteria ; 1) heights were within the size of inter transverse process distance ; 2) lateral margins were not over the tip of transverse process ; 3) and tumors did not extend over the psoas muscle. We concluded that the dumbbell tumor at the lumber spine could be removed by posterior approach without facetectomy if these conditions were satisfied.

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A 22-year-old nulligravida was evaluated at a hospital for persistent vaginal bleeding and malodorous discharge. She was considered to have a foreign body in her vagina, apparently penetrating the uterine cervix with perforation into the peritoneal cavity. By history the object had been present for 6 years. She was transferred to our university hospital for surgical removal. On computed tomography and magnetic resonance imaging, the object was cylindrical and was located in the vaginal vault without evidence of perforation. With both modalities it appeared lucent relative to surrounding tissues. Removal required limited dissection of the vaginal wall, and the object proved to be a plastic container cap. No vesico-vaginal fistula or other complication was present. Precise early diagnosis was difficult in this case, but details of the chief complaint offered valuable clues and imaging was informative.

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During the court journey in 1826, Nagasakiya was the usual inn where the Dutch stayed in Edo. While Siebold was there, a lot of people including the governor of Nagasaki, feudal lords, and imperial doctors visited him alternately. Siebold obtained diverse information from them, and this became the cause of the Siebold Incident later in 1828. In this study, we opened the important materials which could overthrow the established story of the von Siebold Incident. The first one is the letter which Siebold sent to Mamiya on February 25, 1828. So far, the von Siebold Incident has been considered to begin with Mamiya's notice to the government, which stated that Mamiya had received via Takahashi Sakuzaemon a letter from Siebold, a total stranger to him. The second material is the warrant issued by the government against Siebold, who violated the law by writing a letter to Mamiya. Concerning how the government dealt with this case, there still remain many questions. For example, the government did not check the relationship between Siebold and Takahashi at all, even though they knew that it was Takahashi who had given the letter of Siebold to Mamiya. It may be because Mogami had already been under investigation that he could escape the accusation of the government. In any event, the whole story related to the letter and the warrant seems to signal the existence of another intent of the government, something beyond the ban of communication with foreigners.

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[in Japanese]

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