Effective prevention of lifestyle-related diseases requires establishment of a healthy lifestyle during earlier life. Planning and evaluation of interventions for lifestyle-related diseases should include suitable assessment and monitoring of health-related lifestyle. This study evaluated the feasibility of a survey on health-related lifestyle at coming-of-age celebrations. We conducted a survey in participants aged 18 to 20 years old at coming-of-age celebrations in three municipalities of Yamaguchi prefecture in January 2010. Questionnaires including basic characteristics, self-rated health, and health-related lifestyle, such as diet, exercise, alcohol consumption, and smoking, were disseminated at the ceremony and collected by mail. Among 1761 questionnaires disseminated, 328 (18.6%) were collected and 324 (18.4%) were analyzed. The percentages of poor self-rated health, missing breakfast frequently, insufficient exercise, drinking alcohol, and smokers were 6.8%, 32.1%, 74.1%, 84.6% and 8.8%, respectively. Compared with students, workers had a significantly higher smoking rate (odds ratio=3.6). The low response rate and possibility of underestimation of smoking rate are limitations of this survey. The higher smoking rate among workers suggested that lower education attainment and early socialization promote starting smoking. Methods of efficient and accurate survey and effective intervention based on the survey results should continue to be discussed.

View full abstract

We present a rare case of tuberculous aneurysm of which formed the aortoduodenal fistula. A 63-year-old man was admitted to our hospital with massive hematoemesis and melena on emergency. He had no history of lung tuberculosis. An urgent endoscopic examination revealed the bleeding from the third portion of the duodenum. A CT scan demonstrated a saccular type of abdominal aortic aneurysm. The patient fell into hemorrhagic shock with re-bleeding,so emergency laparotomy was performed and revealed an abdominal aortic aneurysm with aortoduodenal fistula at the level of third portion. The aneurysm was resected and replaced by a graft. Pathological examination showed that the aneurysm was caused by tuberculosis. After the surgery, anti-tuberculosis drugs had been given for about forty days. He was admitted again with sudden massive hematoemesis and fell into hemorrhagic shock and died. We should consider the possibility of an aneurysm-intestinal fistula in patients with hematoemesis and melena of unknown origin. Despite of no history of active tuberculosis, we should consider that tuberculosis cause an aortic false aneurysm.

View full abstract

A 42-year-old woman visited our hospital complaining lightheadedness and foot edema. Blood examination indicated severe anemia and hypoalbuminemia. The abdominal CT showed a transverse colon cancer directly invading the liver. The colonoscopy showed a type 3 cancer in the transverse colon, suggested moderately differentiated tubular adenocarcinoma by histological examination. The “en bloc” resection of the right side transverse colon and the invaded liver was performed. On histopathology, moderately differentiated adenocarcinoma (SI, N1, M0, ly3, v1, Stage III B) was diagnosed. Currently, she has no signs of recurrence after 5 years from operation. The “en bloc” resection at the operation for colorectal cancer with other organs invasion is important.

View full abstract