On 2nd April 2007, at 7:40 local time (20:40 GMT 1 April), a massive earthquake, the epicenter of which was 10 km deep and 45 km south-southeast of Gizo, the provincial capital of the Western Province, struck the Solomon Islands, killing 52 people and displacing approximately 5,000. This study, based on field research in May 2007, reports on the result of the cross-sectional assessment of the bacterial contamination (E. coli, Vibrio spp. and total bacteria) of drinking water and water sources and the longitudinal comparison of dietary intake and epidemiology in six earthquake- and tsunami-affected villages in the Western Province, Solomon Islands. The test-paper method revealed that 92.0% of drinking-water was unsafe in four camps of evacuated people. Only 3 out of 11 drink-water samples collected from safe water sources were free from contamination throughout the study villages. The reported occurrence of diarrhea, while only 7.6 per mil in 2001 and 4.8 per mil in 2003 in one of the study villages, was 12.7 person-days per mil after the disaster in 2007. Deterioration of dietary intakes was not observed. Although further studies are expected to follow up on the changes in water, diet, and health in mid- and long-term recovery operations, the rapid assessment suggested the need to provide safe water or purifiers and education regarding water and hygiene-related management in order to minimize health risks in devastated villages.

The main purpose of the introductory education programs designed for newly-hired employees at Anjo Kosei Hospital is to acquaint them with basic knowledge to live as members of society. In recent years, our training and development committee has been drawing up and implementing some introductory education programs about hospital regulations and philosophy for the new employees. The present study was carried out to evaluate the effects of the introductory education programs and the role played by our committee in the programs. Those who signed up for the introductory education programs were the subjects of this study. They were included composed of 154, 140, and 150 new coners in 1997, 1998, and 1999, respectively. Questionnaire surveys were conducted on them when they completed the programs. The training and development committee encouraged all of the new mployees, belonging to different occupational categories, to attend to the programs. Great emphasis who placed on education of the basic philosophy in our hospital. The surveys found that the education program about how to receive visitors was valuable to them, but they reduced education time about it clearly decreased their satisfaction level. The education program about the safety of medical treatment poorly contributed to their satisfaction even though the education time was extended. Among the programs, experience-oriented education programs, such as the in-house tour, the training of infection control, and the training of customer support, were accepted by them with enough satisfaction. These results suggested that the intervention to each program by the training and development committee is needed to satisfy the new employees by improving each program from an educational point of view.

It is said that retrospection therapy is effective in stabilizing emotional states of the aged and alleviating or holding in check symptoms associated with senile dementia. In recent years, the extended care facility of Asuke General Hospital has become so crowed with old people with dementia that it has become increasingly difficult to hold annual events on schedule. With the aim of improving the inmates' mental as well as psychological conditions, we more recently tried a retrospection therapy on a group of eight old people consisting of one emotionally unstable person and seven persons suffering from senile dementia.The group therapy was performed after ushering the old people into a private room with soft BGM played. In such a relaxing atmosphere, the session began along with a certain theme. For assessing the effectiveness of the therapy, 1) DMAS, 2) MOSES and3) NM scale were used. Apparently it produced some desired effects in every participant. Thus, the retrospection therapy proved to be useful. However, the results obtained varied depending on the kind of assessment methods. From this, we have also learned that there would be a risk of making an error of judgment with one assessment table.
Therapeutic procedure ; Knowledge acquisition using a method of assessment ; Effective ; Senile dementia ; Elderly

Objective: To identify the clinical and epidemiological characteristics of pernicious anemia (PA) in patients treated at Miyagami hospital on Tokunoshima Island.

Methods: We evaluated 14 patients with PA who were enrolled and treated from March 2009 to May 2014.

Results: The majority of patients were older than 50 years of age and primarily consisted of elderly women. Routine medical examinations revealed macrocytic anemia in 6 of the 14 patients (43%), although they were clinically asymptomatic and subsequently diagnosed with PA. The average number of patients per year was reported to be 3 (95% confidence interval [CI]: 1.25-3.42).

Conclusions: The annual incidence of PA per 100,000 individuals on Tokunoshima Island is possibly much higher than that previously reported in Japan. An increase in the elderly population, a negligence of the disease, and an ethnic and regional diversity may explain this discrepancy. As the annual incidence of PA may be higher than that previously reported, anemia must be carefully evaluated in the differential diagnosis of PA.

  This research was carried out to review the current state of thinga involving trainees (students and business workers) accepted by Anjo-Kosei Hospital and to clarify the role the Education Center in our hospital is expected to play in supporting trainees. The subjects were medical and non-medical students and business workers who signedup for our internship program and junior and senior high school students who paticipated in the hands-on training program at Anjo-Kosei Hospital between April 2006 and March 2009. A total of about 1,300 students and business workers had experienced the actual hands-on work each year. The number of medical students accepted was 289, 289, and 339 in 2006, 2007, and 2008, respectively. Besides, the number of non-medical students also increased from 847 to 1,045 in the period of three years. The business workers accepted came from 15 different types of occupation. It was found that junior and senior high school students were interested in the nursing-care field and this seemed to help them consider seriously their life as students and members of society, leading to the increased number of students who joined our program. In addition, unfortunately, two-fifths of the program were unfavorable for trainees because of poor management. The present research suggested that the Education Center take on a signification role in managing the internship and the hands-on training programs to accelerate the potential of students and business workers.

Introduction: Tramadol (TRM) has been included as a weak opioid at the second step of the WHO analgesic ladder and has been widely used in palliative medicine. Here we report a case of amelioration of cancer pain by TRM therapy in a female patient with myasthenia gravis (MG). Case:The patient was a 70’s woman who was diagnosed with advanced endometrial carcinoma and suffered from chest pain caused by chest metastasis. 25 mg of a TRM capsule was orally administered three times a day. The dose was increased to 50 mg twice a day. It was resulted in sound pain relief with transient muscle weakness but without a myasthenic crisis.

Objective: We conducted a questionnaire survey to comprehend the situation regarding the collection, provision, and utilization of drug safety information at hospitals.  In addition, we asked pharmaceutical companies how they select medical institutions to provide drug safety information.  We also investigated the current situation of information provision to Tokyo Medial Center by pharmaceutical companies.
Method: A questionnaire was mailed to all hospitals in Japan.  The survey was conducted between January 13 and February 10, 2011.  Moreover, we asked thirteen pharmaceutical companies by telephone and e-mail about the implementation status of the provision of information and performed a survey at Tokyo Medical Center on the current situation of information provision by pharmaceutical companies regarding revisions to precaution sections in package inserts.
Results: The results of the questionnaire survey (response rate: 41.2%) showed that the major information sources for hospitals were medical representatives (77.8%), Drug Safety Update (50.3%) and direct mails (49.3%).  Furthermore, in the case of drugs prescribed exclusively for extramural dispensing, fewer hospitals responded that medical representatives of the pharmaceutical companies provided drug safety information and more hospitals responded that they did not obtain any drug safety information at all, compared with drugs listed in the hospital formularies.
Conclusion: To minimize the risks of drugs, healthcare professionals must collect a wide range of drug safety information and must utilize this information in their medical practice.  Therefore, it is important that pharmaceutical companies and regulatory authorities make an effort to provide suitable information dissemination to medical institutions.  Furthermore, medical institutions must also strengthen their systems for collecting drug safety information and providing such information to healthcare professionals.

BACKGROUND: IgA nephropathy (IgAN) is the most common form of primary glomerulonephritis worldwide. Tonsillectomy plus steroid pulse therapy has been able to induce clinical remission in early-stage IgAN. However, its possible effect on systemic and local cytokines and tubular markers has not been fully investigated. METHODS: We obtained serum and urine samples from 38 patients just before renal biopsy and third steroid pulse therapy. Markers of tubular damage such as N-acetyl-β-d-glucosaminidase, and kidney injury molecule-1 and inflammation such as interleukin (IL)-6, monocyte chemotactic protein (MCP)-1, intercellular adhesion molecule (ICAM)-1, and vascular cell adhesion molecule (VCAM)-1 were measured by immunoassay. RESULTS: Before renal biopsy, only urinary inflammatory markers, except MCP-1, were associated with glomerular (proteinuria) and/or tubular damage markers. Proteinuria, hematuria, and estimated glomerular filtration rate dramatically improved after therapy. In addition, levels of serum IL-6 and ICAM-1 and all urinary markers declined significantly; however, serum MCP-1 and VCAM-1 levels did not. None of the urinary markers correlated with the serum inflammatory markers. CONCLUSION: Tonsillectomy plus steroid pulse therapy for patients with IgAN might be useful for improving not only glomerular damage marker but also tubular damage markers through the improvement of local renal inflammation.
Biopsy ; Cytokines ; Glomerular Filtration Rate ; Glomerulonephritis ; Glomerulonephritis, IGA* ; Hematuria ; Humans ; Immunoassay ; Immunoglobulin A* ; Inflammation ; Intercellular Adhesion Molecule-1 ; Interleukin-6 ; Interleukins ; Kidney ; Monocytes ; Proteinuria ; Tonsillectomy* ; Vascular Cell Adhesion Molecule-1

STUDY DESIGN: Retrospective case series. PURPOSE: To elucidate the impact of postoperative occiput-C2 (O-C2) angle change on subaxial cervical alignment. OVERVIEW OF LITERATURE: In the case of occipito-upper cervical fixation surgery, it is recommended that the O-C2 angle should be set larger than the preoperative value postoperatively. METHODS: The present study included 17 patients who underwent occipito-upper cervical spine (above C4) posterior fixation surgery for atlantoaxial subluxation of various etiologies. Plain lateral cervical radiographs in a neutral position at standing were obtained and the O-C2 angle and subaxial lordosis angle (the angle between the endplates of the lowest instrumented vertebra (LIV) and C7 vertebrae) were measured preoperatively and postoperatively soon after surgery and ambulation and at the final follow-up visit. RESULTS: There was a significant negative correlation between the average postoperative alteration of O-C2 angle (DO-C2) and the average postoperative alteration of subaxial lordosis angle (Dsubaxial lordosis angle) (r=-0.47, p=0.03). CONCLUSIONS: There was a negative correlation between DO-C2 and Dsubaxial lordosis angles. This suggests that decrease of mid-to lower-cervical lordosis acts as a compensatory mechanism for lordotic correction between the occiput and C2. In occipito-cervical fusion surgery, care must be taken to avoid excessive O-C2 angle correction because it might induce mid-to-lower cervical compensatory decrease of lordosis.
Animals ; Follow-Up Studies ; Humans ; Lordosis* ; Occipital Bone ; Retrospective Studies ; Spinal Curvatures ; Spinal Fusion ; Spine ; Walking