脳卒中患者に対するデイケア効果についての報告は極めて少ない. そこで国立療養所福岡東病院のデイケア患者のうち, 評価を行つた脳卒中患者43例についてデイケア開始時及び6カ月後の評価を比較し, デイケア効果を検討したので報告する.
評価項目は身体機能, 行つているADL, 患者の行動範囲, 復職または家庭での役割, 日常の過ごし方, 生活に対する意欲の6項目である. すべての項目において43例の90%以上が維持または改善を示したことから, 現時点においてはデイケア効果があるといえ, 脳卒中患者に対するデイケアの必要性を示唆している.

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A 6-year-old girl was detected hearing loss without subjective complaints by screening audiometry before entering elementary school. The audiogram showed bilateral conductive hearing loss, and repeated pure tone audiometry indicated that right conductive hearing loss was due to ossicular chain abnormality and that left fluctuating conductive hearing loss was due to functional deafness. When she was 11 years old, the audiogram showed bilateral mixed hearing loss, and she was referred to our outpatient clinic due to progressive hearing loss. Bekesy audiometry revealed type V in the right ear. And there was unexplainable discrepancy between the threshold of pure tone audiometry and response threshold of auditory brainstem response. It was considered that the deterioration of the right hearing loss was due to ossicular chain abnormality and functional deafness, and that of the left hearing loss was due to deteriorated functional deafness. Type III-itympanoplasty was performed on the right ear. After operation, bilateral hearing loss was improved.
These observations suggested that a diagnosis of functional deafness with ossicular chain abnormality is difficult, and that various kinds of objective hearing tests are useful for diagnosis of such pathologies.

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Two cases of psychogenic hearing loss in adults are presented with the process of their mental states. Case 1 was a 20-year-old male who complained of unilateral hearing loss and tinnitus on his left side after receiving a “karate” kick on his left temple. Considering the perforation of his left tympanic membrane, his left hearing level was much worse (77.5 dBHL). Later examination of ABR revealed the sensorineural system to be intact, and functional hearing loss was suspected. Further questions about his history disclosed that he was extremely unhappy in his job and wanted to leave his present employment. After discussion with psychiatrists, the diagnosis of psychogenic hearing loss was established.
Case 2 was a 23-year-old male who complained of right tinnitus after hearing rifle shooting during night time maneuvers in the Self Defense Forces. In spite of the normal appearances of his external and middle ear, his hearing level was 72.5dBHL. Being treated as acoustic trauma, ABR was performed and it resulted in a completely normal response. In this case, the diagnosis of psychogenic hearing loss was also established.
Especially in adults, psychogenic hearing loss is regarded as a kind of conversion disorder. In this disease, getting ill brings some “gain” to the patients. Admission to the hospital separates a patient from his unpleasant job and persons (secondary gain). This is almost compatible with the mental state of case 1. When their desires are converted to physical disorders and are appreciated by another person, they don't have to be concerned by their source of annoyance. Thus their mental states are stabilized (primary gain). This is almost compatible with the mental state of case 2.
When assessing patients of Psychogenic hearing loss, their mental states should be considered as there may be various processes involved in the disease.

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Nasal respiratory resistance was measured in twenty five healthy adults by oscillation method using microrhinography (Chest, TUC-5000) for study of nasal cycle and objective diagnosis of nasal provocation test.
Twelve persons (48%) showed the inversion of the dominant side during three hours.
It seemed that this phenomenon were nasal cycle.
Even if nasal cycle was appeared, the bilateral nasal respiratory resistance showed only slight changes.
Considering by the change of the nasal respiratory resistance after fifteen minutes, it was reasonable that positive criterion in nasal provocation test was twice or more rise of the nasal respiratory resistance levels.

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高血圧症のプライマリ・ケアの実態を知る目的で,尼崎市医師会内科医会会員を対象にアンケート調査を行ない以下の結果を得た.患者は加令とともに増加し,各年代とも女性が多かつた.血圧の管理状況をー般内科あるいは循環器科を標傍するものとそれ以外(他科)とで比較すると,他科での管理がやや不十分であつた.降圧薬の選択順位は,第一選択では利尿薬,精神安定薬, β遮断薬で,第二選択ではβ遮断薬, Ca拮抗薬,利尿薬,メチルDOPAで,薬物の使用頻度からみて利尿薬, Ca拮抗薬が重症例の軽症化に寄与している可能性が示唆された.医師の指示や服薬の履行状態からみて医師と患者の信頼関係は良好に保たれていた.後送病院との連携は急を要さない場合は良好であつたが,緊急時には不十分であつた.

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We evaluated the correlations between the geometric parameters obtained by acoustic rhinometry (AR) and the sensation of nasal obstruction assessed by Visual Analogue Scale (VAS). Fifty-nine patients (35 males, 24 females) with nasal disease, complaints of stuffy nose, and sixty-seven normal subjects (54 males, 13 females) were selected for this study.
VAS was recorded according to sensation of nasal obstruction at the time AR was measured. An acoustic rhinometry (GM instrument) was used, and each subject were measured in a quiet sitting position.
With regards to the results by AR, no significant difference was seen between the two groups. The results obtained by VAS correlated poorly with the geometric data obtained by AR. However, when the values of VAS were classified in three categories according to severity (mild, moderate, severe), rough correlations between the date by AR and these categories were demonstrated. This tendency was more obvious in single nasal airway breathing than in two nasal airway breathing. In sensation of nasal obstruction, this study revealed that most cases (40/59 cases) felt a difference between each nasal airway. Therefore, to diagnose the sensation of nasal obstruction by AR, evaluation of each nasal cavity separately should be carried out.

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Experimental loading of γ-aminobutyric acid or β-hydroxy-γ-aminobutyric acid ar intravenous injection in rabbits following pretreatment with isonicotinic hydrazide resulted in the production of β-hydroxy-γ-aminobutyric acid in the case of γ-aminobutyric acid and glycine in the case of β-hydroxy-γ-aminobutyric acid. These products however were not obtained when pyridoxine was given concomitantly. A pathway from γ-aminobutyric acid to glycine via the β-hydroxy form was therefore shown to exist but in the normal state, it is believed that a more active metabolic pathway involving vitamin B_6 is present.

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The purpose of the study was to verify the significance of prosthodontic treatment for the elderly patients by our university's dental treatment system at home. Thirty-four patients whose dental practice was based on removable prosthodontic treatment and performed by the staff of our department were given questionnaires on satisfaction with the treatment and denture insertion. The results were as follows:
1. Seventy percent of the patients were in their seventies and eighties and almost half of them were edentulous.
2. ADL scores of the patients were low and most patients needed care.
3. The prevalence of cerebrovascular disease was fifty-six percent in the patients.
4. Ninety-four percent of the chief complaints about dental satisfaction of the patients was masticatory disturbance due to wearing uncomfortable dentures.
5. Forty-seven percent of the patients needed to have their dentures replaced.
6. Almost all patients answered that they were satisfied with the prosthodontic treatments offered at home.
From the results of this study, removable prosthodontic treatment is significant not only for the restoration of stomatognathic function and appearance but also for the improvement of quality of life for the home bound elderly.

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A企業内診療所では30歳代の従業員の受診率が最も高く、受診者ひとりあたりの受診回数は60歳代が最も多かった。傷病分類別にみた受信回数では「循環器系の疾患」が最も多く(36.7%),ついて「呼吸器系の疾患」(20.8%),「尿路性器系の疾患」(9.6%),「消化器系の疾患」(9%),「内分泌,栄養および代謝の疾患」(7.5%)の順であった。一般診療所および病院における外来患者数と比較すると「筋骨格系及び結合組織の疾患」が少なく,これは企業内診療所に共通した特性である可能性がある。医療施設調査によると会社が開設した一般診療所数は平成5年の2,999から平成11年には2,806と7%近く減少した。労働者健康状況調査によると健康診断を事業所の診察室で実施した事業所の割合は平成9年から平成14年にかけて減少しており,この減少は企業内診療所の減少・縮小傾向を反映している可能性がある。

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阪神・淡路大震災の被災者における身体症状を中心とした心身医学的問題を探るため, 震災1カ月前後に神戸市灘区内の避難所にて80名に問診カード調査を行い, 心身の諸症状の出現率を健常者と比較したところ, 「不眠・易疲労・食欲不振・頭痛・動悸・胸痛」が多く, 被災者内要因として慢性疾患が「風邪症状・食欲不振・易疲労・抑うつ気分」に, 近親者死亡が「易疲労」に, 建物全壊が「不眠・抑うつ気分」に影響を与えていた。さらに震災後2週目および5週目に計408名の避難所生活者の血圧測定を行ったところ, 高血圧症の既往のない者の約45%に高血圧状態が認められた。なお本研究所では, 様々な被害状況の互いの交絡因子の影響を除外するために多重ロジスティック回帰分析を使用した。

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