Background and Aims : Brachial-ankle pulse wave velocity (baPWV) and serum inflammatory markers, such as high-sensitive C-reactive protein (hsCRP) and interleukin-6 (IL-6), are non-invasive approaches for evaluating the severity of atherosclerosis. This study was conducted to elucidate the relationship between baPWV and serum inflammatory markers among healthy adults in a community.
Methods : We measured baPWV and serum concentrations of hsCRP and IL-6 in 109 healthy adults who attended health counseling in Yoshioka-town, Gunma, Japan. We statistically analyzed the relationship of baPWV with serum inflammatory markers.
Results : The positive correlation was found between baPWV and the two inflammatory markers, hsCRP and IL-6. The coefficient rates in IL-6 was higher than that in hsCRP. Serum IL-6 concentrations were significantly higher in the adults with baPWV ?? 13.7 m/sec than in those with baPWV < 13.7 m/sec.
Conclusions : Vascular inflammation may cause subclinical atherosclerosis in healthy adults in a community. The serum inflammatory marker, particularly IL-6 may be a useful measure of subclinical atherosclerosis.

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Background and Purpose : Currently, bath towel are often used for transferring bedridden patients. The purpose of this study was to develop a wool bore mat for patient care to transfer from a supine position as an alternative to the bath towel, and evaluate its usefulness comparing with bath towel. Materials and Methods : We assessed the strength, durability and body pressure of the newly developed wool bore mat in both experiment and healthy volunteers and compared them with bath towel. Results : The strength and elasticity were significantly higher in the wool bore mat than in the bath towel. The body pressure was (p<0.05-0.01) lower in the right heel and the left knee joint using the wool bore mat compared with sham treatment no bath towel. Also, the body pressure was (p<0.05) lower in the left knee joint using the wool bore mat compared with the bath towel. More subjects reported that the wool bore mat was better in texture, comfortable, and warmth than the bath towel, as well as the neck stability and body pain. Nurses reported that the wool bore mat was easy to handle but it was more slippery. Conclusion : Wool bore mats are more suitable for patient care and transfer than bath towel.

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Background and Purposes : Maternal mortality, neonatal death and perinatal death rates are high in Bangladesh. To clarify the causes and to improve the rate, maternal health examination were performed in a Bangladesh rural area as a selected model. Materials and Methods : The maternal health records of 1,394 subjects that had been completed by a member of the Japan Overseas Cooperation Volunteers between September 2002 and April 2004 were analyzed. Results : The number of participants who visited the maternal health examination unit changed seasonally and showed a wave pattern, probably because of religious events, climate and farming. More than 80% of the women who visited the maternal health examination unit did so for the first time when they were more than six months pregnent, and approximately 70% of the participants never visited the maternity unit again. In addition, 7.5% of the participants experienced fetal loss and 7.7% of the participants experienced neonatal death. The incidence of participants with high-risk childbirth factors reached 24.2%, and 39.5% of the 162 participants who were followed up until delivery experiemced various abnormalities during the deliveries. Conclusions : The continuity and effects of maternal health examinations did not reduce the high rates of maternal mortality, and perinatal death in Banglodesh.

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Background : This study aimed to examine behavior characteristics of the demented elderly in shopping and financial management. Materials and Methods : Subjects were residents in "B" group home and 22 users in "C" dementia specialty day services. Participants shopped within 2,000 yen for supper at a mimic shop using real vegetables and fruits, and food models of fishes and meats. We developed a checklist for shopping and financial management procedure and made an observation. The checklist consisted of major items such as "preparation", "selection and judgment", and "payment" as well as 30 minor items. Results : The demented elderly achieved 9 of the 30 items, and "selection and judgment" was the most common while they failed only one item, "do shopping with a basket". Conclusions : It is important to repeatedly practice in daily life by emphasizing what the demented elderly can do with their behavior characteristics in shopping and financial management.

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A 56-year-old male underwent a left nephrectomy in 1996. A histological examination resulted in a diagnosis of a clear-renal-cell carcinoma (T3, N1, M0). After undergoing a nephrectomy , he received subcutaneous interferon α for a year. In November 1998, a CT scan showed lung metastases. He received subcutaneous interferon α again. However follow-up CT scans showed progressive disease. In June 2000, the metastases additionally appeared in the right kidney and adrenal gland. As a result, he underwent a partial right kidney and adrenal gland resection. Coxal bone metastases appeared before stem cell transplantation. In March 2001 , he underwent nonmyeloablative allogenic peripheral blood stem cell transplantation (NST) from his HLA-identical sister due to multiple lung metastases. A chimerism analysis of his blood demonstrated 100% donor chimerism in the T-lymphoid lineages on day 28. Acute and chronic graft-versus-host-disease (GVHD) developed and could not be controlled. It was difficult to reduce the steroid dosage. Because we reduced the dosage, thereafter the GVHD developed again. The renal cell carcinoma progressed and on day 793 he died due to cardiac failure and pulmonary hemorrhaging. The effect of NST was a regression of the lung metastases. However, the metastases to the right kidney and coxal bone nevertheless progressed. Differences were observed in the graft-versus-tumor-effect (GVT) between the lung metastases and other metastatic organs.

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We present a rare case of a 26-year old woman with diffuse sclerosing variant of papillary thyroid carcinoma. The patient was referred to our hospital with diffuse enlargement of the thyroid accompanied with palpable bilateral cervical lymph nodes. Ultrasonography showed a heterogeneous pattern with ill-defined hypoechoic areas in both thyroid lobes. There were multiple small punctate echogenic foci. Fine-needle aspiration cytology revealed typical signs of papillary carcinoma. The patient underwent a total thyroidectomy using a bilateral modified neck dissection. Pathological findings demonstrated diffuse involvement and continuous infiltration of the tumors to both thyroid lobes, lymph nodes and cervical soft tissue. Postoperatively, 100 mCi of ¹³¹I was administrated to the small amount of residual thyroid tissue. The patient is free from recurrence one year after the operation.

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Descending necrotizing mediastinitis (DNM) is a rare, however, highly fatal disease originating from odontogenic, pharyngeal, or cervical infectious sources that descend along facial planes into the mediastinum. We report a case who underwent surgical drainage using a mediastinoscope for the treatment of DNM and had successful postoperative course. Cervicothoracic CT should be performed immediately for diagnosis and for evaluating the extent of infection and necrosis, and effective drainage and debridement with suitable approach is required as soon as possible if DNM is suspected.

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