[in Japanese]

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　We reviewed the effects of the treatment of flexion brace for the degenerative lumbar disorders from previous literatures. In our study, one-third of the patients reported substantial improvement, and another third report limited improvement. The remaining one-third of the patients reported no improvement; they tended to have some complications, such as cervical myelopathy, systemic disease, or mental instability. The ideal symptom of the best indication for the flexion brace was typical cauda equina claudication or radicular pain without spastic paraplegia or psychological problems.

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　The primary purpose of this study was to clarify characteristics of the Minnesota Multiphasic Personality Inventory (MMPI) profile in freshmen of university. A total of 1600 freshmen who entered Toyama Medical and Pharmaceutical University, Toyama, Japan, from 1998 to 2003 participated in this study. The mean age of these subjects at the time of testing was 19.2 (SD 2.4) years. All students gave informed consent before entering the study. The new Japanese version of MMPI was administered to students as routine mental health checkup during the orientation following entrance into the university. As a result, 1.9% of students on the hypomanic scale which was the lowest had high score (T>70) and 8.4% of student on the depression scale which was the highest had high score. Three % of students revealed the MMPI code type related to patients with schizophrenia spectrum disorder. The MMPI is a useful tool for identifying university students, who have problems related to mental health. In addition, the interviews for feedback appear to be useful for early diagnosis and early intervention.

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　For prevention of vagal bradycardia, we blocked selective vagal afferent pathway to SA and AV nodes with use of epicardial radiofreqency (RF) ablation in canine hearts. After RF ablation to PVFP, fat pad around right pulmonary vein nearby LA, sinus bradycardia induced by cervical vagal stimulation was diminished, and after RF ablation to triangular fat pad at the junction of the inferior vena-cava inferior LA (IVC-ILA), AV block by vagal stimulation was abolished. Shortening of effective refractory period with vagal stimulation on RA was decreased after PVFP RF ablation. 8 weeks after ablation, sinus bradycardia had not caused by vagal stimulation.

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Backgrounds: Care experience course was set up in 1987 and has been regarded as an effective curriculum for the first-year medical students. The aim of this study was to evaluate whether medical students change their ways of thinking of the care for the elderly and the disabled before and after the course.
Method: Subjects were 90 first-year medical students. Before and after care experience course, the subjects were asked to fill in a11-item questionnaire with 4 response categories. Wilcoxon’s signed rank test was used to evaluate whether the students change their ways of thinking of the care before and after the course. P value of less than 0.05 was considered significant.
Result: In comparison with the item scores before the course, most of the item scores showed significantly higher values after the course, particularly for those who had never visited nursing care institutions.
　While those who had visited nursing care institutions were likely to have higher scores for the importance of experiencing activities of daily living(ADL)assistance, those who had never visited tended to show higher scores for the importance of having opportunity to think of their future as a medical doctor and of experiencing some specific techniques as performed in nursing care institutions.
Conclusions: Care experience course may provide opportunities to think of the significance of nursing care, particularly ADL assistance, and think of their future as a medical doctor.

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　A79-year-old man who ingested low-dose aspirin daily underwent phacoemulsification/aspiration and intraocular lens implantation in the left eye. The intraoperative course was uneventful. Nine days after the surgery, he presented sudden bleeding, and a conjunctival tumorous lesion was observed at the site of the scleral incision in the right eye. The lesion was excised and treated with diathermy. Histopathologic examination of the tumor showed a hematoma. Ophthalmologists should be aware that a subconjunctival hematoma may develop suddenly after an uneventful small-incision cataract surgery in a patient with chronic aspirin intake.

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[in Japanese]

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　We report a case of phrenic nerve pacing with electrical stimulation for the treatment of high cervical spinal cord injury. A sixty-two year-old female patient suffered an atlanto-axial dislocation, high cervical spinal cord injury, lower brain stem injury brain contusion, bilateral lower limb fractures and a mandible fracture as a result of a motor vehicle accident. Consciousness disturbance, respiratory insufficiency and complete tetraplegia resulted. Tracheotomy and artificial ventilation were subsequently performed. Respiratory insufficiency and complete tetraplegia remained unaltered, although consciousness gradually improved to near alertness. In order to allow cessation of daytime use of the respirator, diaphragm pacing was performed 86 days after injury. One month later, the patient was independent of the respirator for up to 11 hours a day. This enabled her to go to the X-ray room, bathe and go outside in a wheelchair without the respirator. Permanent use of a ventilator in patients with respiratory insufficiency secondary to high cervical spinal cord injury results in a great burden of care to family and nursing staff. In the case, diaphragm pacing was effective in reducing nursing and medical effort and improving the patient’s activity field and quality of life.

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　Valacyclovir (VACV) is a prodrug of acyclovir and well known as an effective medicine for the treatment of herpes zoster, however, acyclovir neurotoxicity rarely appears as a side-effect. We wish to report on two cases of neurotoxicity caused by oral VACV administration which they have dealt with, together with several bibliographical comments. Case 1: A 78-year-old female patient, without renal failure, was prescribed VACV at a dose of 3000mg per day. Five days later, disturbance of consciousness appeared, and she came to our hospital the next day. Acyclovir neurotoxicity and acute renal failure were suspected, because disturbance of consciousness and renal failure completely improved within several days after discontinuation of VACV administration. Case 2: A 73-year-old male patient, on hemodialysis third a week, was prescribed VACV at a dose of 3000mg per day. Two days later, psychiatric disorder appeared and he came to our hospital by ambulance. Acyclovir neurotoxicity due to overdosage was suspected. Administration of VACV was discontinued and hemodialysis was performed. A few days later, the symptoms were completely disappeared. It is important to remind acyclovir neurotoxicity when patient has disturbance of consciousness or psychiatric disorder following administration of VACV.

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　The 65th Annual Conference of the Japanese Society for Public Health, chaired by Professor Sadanobu Kagamimori, was held on October 25−27, 2006 in Toyama Kenminkaikan and Toyama International Conference Center. The conference was entitled“Healthy Society”. The total number of participants was more than 3000. Participants consisted mainly of government officials, medical doctors, and public health nurses, and other related specialists. The conference contained presidential lecture, preliminary lecture by Professor Sir Michael Marmot (University College London, the UK), a leading researcher for health inequalities, main symposium, 7 satellite symposia, 6 educational lectures, 7 forums, and 2 special programmes, some of which were opened to the general public. There were approximately 1500 oral and poster presentations. Based on these thought-provoking programmes, we discussed how we should construct our society in this century. The conference has been historically organised by the collaboration of prefectural office for health and welfare and public health department at university. In addition to the academic contents, the effective collaboration with local government, convention company, and travel agency played a crucial role for the success of this conference.

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　The 19 th Annual Meeting of Japan Association of Cerebral Resuscitation & Brain Death. (President: prof. Hiroshi OKUDERA) was held at Toyama international conference center in June2 and 3. In this report, we present the characteristics and result of this meeting.

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　The Donor Coordinator meeting 2006 in Toyama was held at the Toyama International Conference Center from Jun 2nd to 3rd. (Organizer: Asai Tomoko, Japan Organ Transplant Network, Chief coordinator, and Takahashi Kinuyo, Toyama Kidney Bank, Toyama Prefectual Transplant coordinator). This meeting was held associate with the 19th Annual Meeting of Japan Association of Cerebral Resuscitation & Brain Death (President: Prof Okudera Hiroshi, Department of Disaster & Emergency Medicine, Toyama University). We present a report of our meeting.

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