In order to assess the prevalence of carotid artery disease in patients with arteriosclerosis obliterans (ASO) or aortic aneurysm, 142 patients underwent screening for the presence of carotid atherosclerosis (plaque) with B-mode ultrasonography. Seventy-four (87.1%) of the 85 patients with ASO and 37 (64.9%) of the 57 patients with aortic aneurysm had carotid artery lesions. Of these patients, about half had bilateral lesions. The differences in the prevalence of carotid lesions were not significantly related to age or sex. Prevalence did not differ in relation to the severity or location of the primary lesions. The majority of the carotid lesions were located in the internal carotid arteries. The prevalence of carotid lesions was higher among patients with cerebral infarction than in those without any lesions on computed tomography. These results showing high prevalence of carotid lesions in ASO and aortic aneurysm suggest the usefulness of routine carotid ultrasonographic screening and also that it is important in order to determine the correct treatment for these cases.

Before the introduction of high density barium for contrast studies of the upper gastrointestinal tract, we conducted a survey concerning the adverse reactions to a swallow of barium and barium concentration.
The incidence of side effects rose as the density of barium increased but the effects were transient. There were no cases requiring medical treatment.
Furthermore, the constipation group and the normal group were examined separately.
The ratio of adverse reactions was high in the constipation group even when the barium density was low. In this group stool hardening and delayed excertion were also noticed.
The constancy of barium stool excretion was basically normal, and the barium density had little effect.
The effects of a laxative on the excretion consistency were investigated. The administration of a laxative did not always have a positive affect on excretion. The timing of the administration of the laxative and the amount of water intake should be examined in the future.
We also investigated how the patients feel when they are swallowing barium. We found that whether feel uncomfortable or not depended on the properties of barium rather than its density.
From these results it appears that appropriate guidance is necessary about the use of high density barium, in order to supress the occurrence of side effects, especially in the constipation group.

Objective: The aim of this study is to explore the factors associated with the burden of home care for doctors. Methods: In July 2013 a survey was mailed to a cross-section of clinics and hospitals in Kobe City. Results: Questionnaires were sent to 1,589 clinics and hospitals and 899 (57%) responded. Of these, data from 807 respondents were available for analysis. The burden of home care was felt to be considerable for 30% and slight for 31% of respondents. Determinants associated with the burden of home care were; 80 years and older doctors (P=0.05), particular medical measures (P=0.036), building links with other medical facility or care staff (P=0.002), and ensuring the sufficient time and staff (P<0.001). Conclusion: The majority of doctors reported a burden associated with home care.

Objective：The aim of this study was to investigate the current status of home care provided by hospitals and clinics in Kobe City. Methods：In July 2013 a survey was mailed to a cross-section of all clinics and hospitals in Kobe City. Results：Questionnaires were sent to 1,589 clinics and hospitals and 899（57％）responded. Regular and urgent home visits by doctors were provided by 50％ and 65％ of respondents, respectively. End-of-life care for dying patients at home and in nursing homes was provided by 31％ and 18％ of respondents, respectively. The average time spent on home visits was 2.3±1.7 days per week. Care for cancer patients, participation in national palliative care lectures, and holding a discussion at the admitting hospital before discharge for home care, were performed by 23％, 7.0％, and 6.9％ of respondents, respectively. Conclusion：The majority of hospitals and clinics in Kobe City provided home care.

The aim of this study was to investigate the end of life care provided by long-term care facilities and nursing homes. A cross-sectional survey of all long-term care facilities and nursing homes in Kobe was performed in July 2013. Questionnaires were sent to 350 facilities with an 89.7％ response rate. In total, 121（39％）of respondents stated that end of life care was available, and 151（48％）responded that facilities were willing to provide end of life care for terminally ill residents. One hundred fifty-two（48％）and 183（58％）of respondents answered that facilities were available for managing residents with percutaneous endoscopic gastrostomy, and transfusion, respectively. Seventy-two（23％）of respondents reported that facilities for managing the use of narcotics were available. In conclusion, a minority of long-term care facilities and nursing homes ware available for providing end of life care for residents, though approximately 50％ were willing to do so.