1.Occupational health hazards among migrant forestry and construction workers in a mountainous rural area. Part 1. Migrant forestry work.
Akinori HISASHIGE ; Shinichi KONDO ; Hiroshi OHARA ; Masanori GOTO
Journal of the Japanese Association of Rural Medicine 1988;37(1):1-10
High economic growth since the late 1950's has brought about a severe labour shortage in Japan. Japanese industry sought migrant workers as one reliable source of labour. As seasonal and unskilled workers, they were employed in a wide variety of trades ; for example, construction, manufacturing, forestry and transportation. However, some of the migrant work was becoming a principal and nonseasonal occupation, and specialized. Migrant forestry and tunnel-construction work are two examples of such specialized work.
To identify health problems among them, we examined the factors affecting workers' entry into migrant forestry and tunnel-construction work, working conditions, and health care services at the workplace by interviewing 65 migrant wokers identified at Hayama Village in Kochi Prefecture, one of the areas well known for providing migrant wokers. Moreover, we carried out health examinations for vibration disease and pneumoconiosis. In this report, we show the results of analysis on 35 migrant forestry workers.
The main factors affecting their entry into migrant forestry work were unstable and poor socioeconomic conditions in the area and the strong demand for a workforce during the rapid economic growth from the late 1950's in Japan. Most of the wage configuration was for piece and contracted work, which promoted long working hours and above-average consecutive work days. They engaged in cutting down, collecting and transporting trees, using vibrating tools such as chain saws, bush cutters, collecting machines and so on. High levels of vibration-exposure quite exceeded the limit of the Ministry of Labour and lasted continuously over 17 years. A difference in labor conditions and working situations was observed between migrant workers who devoted themselves to migrant forestry work and those who did not. Health care administration including health examinations was inadequate. There had been no case of vibration disease identified at the workplace. However, 68 percent among 25 examinees were diagnosed as suffering from vibration disease. Moreover, 40 percent of the subjects experienced absences of more than 4 days due to occupational accidents.
3.Pneumoconiosis and Vibration Syndrome Among Migrant Workers in Kochi Prefecture
Hiroshi Une ; Hiroji Esaki ; Shunichi Horikawa ; Shinichi Kondo ; Masayuki Nakamura ; Masanori Goto
Journal of the Japanese Association of Rural Medicine 1984;32(5):969-977
About 7, 000 workers migrated from Kochi Prefecture in 1965. Recently the number of patients with pneumoconiosis and vibration syndrome has increased among these persons who worked on constructing tunnels. To investigate the health status of these workers, we interviewed 73 of these workers with regard to history of migration, work situations, health condition and so on in Niyodo Village in Kochi Prefecture. Thirty workers were examined for pneumoconiosis and vibration syndrome. Geographical distribution of the areas from which these workers had migrated were also analysed by using the statistical data of Kochi Prefecture in 1965.
The results were as follows:
1) Numerous migrant workers come from the mountain villages along the Shikoku Mountains. In the middle-northern areas, included Niyodo Village, the number of migrant workers was large.
2) Their working conditions in the tunnel were poor and measures for prevention of pneumoconiosis, such as wearing of a dust respirator and drilling the rock with water, were poorly carried out. Vibrating tools were also used for long periods of time.
3) Of 73 workers, 40 have been given the compensation follwing a diagnosis of pneumoconiosis or vibration syndrome.
4) In 23 examinees, silicosis was detected in the chest X-ray examination. Classifications included 13 of type 1, 7 of type 2, and 3 of type 4. Also examinees had subjective symptoms and/or objective findings of vibration syndrome. Eighty seven percent were classified as Grade III according to the criteria of Andreeva-Galanina. Thus, most of migrant workers involved in tunnel construction work had complications of pneumoconsosis and vibration syndrome.
4.Postoperative Deep Venous Thrombosis and Biochemical Examinations of Blood in Transcervical Fracture Patients.
Shinichi GOTO ; Yoshikazu CHIBA ; Naoki KINTO ; Satoshi NAKAMURA ; Atsumi ANBE ; Rie YATAGAI
Journal of the Japanese Association of Rural Medicine 2000;49(4):553-557
There are many published studies on postoperative deep venous thrombosis (DVT) which can develop after hip joint arthroplasty, but very few reports are available on the incidence of thigh DVT following or thopedic treatment of transcervical fractures. In this study, therefore, we tried to find out a screening method just right for the early detection of clots that develop in the deep femoral veins after treatment of the feactures in the neck of femurs. Between March and September 1999, a total of 24 patients were operated on for fractures on the cervix of thighbone in our hospital. Of the total, 19 were recruited for this study. The five cases were excluded because some of them were on medication that could affect the coagulation/ fibrinogenolysis factors and some were under management of other departments. After surgery, a series of blood biochemical tests were performed, and changes in the partial pressure of arterial blood oxygen and D-dimer (??) level were examined with the passage of time. In the cases which were suspected to have thrombosis in the veins in the lower extremities by ultrasonography performed six to 18 days after surgery, definitive diagnosis was made by the aid of venography. DVT was found in three in the 19 cases. Routine blood biochemical tests and measurements of oxygen partial pressure in the artery were not so much helpful as were expected in the early detection of thrombosis, whereas measurements of D-dimer levels were considered useful because the levels were well over 20μg/ml one week after surgery in the positive-DVT cases.
6.The effect of an intervention of a regional palliative care intervention program on home hospice utilization and hospital staff’s perceptions about home care: an observation from the OPTIM-study
Yutaka Shirahige ; Takatoshi Noda ; Minoru Hojo ; Shinichi Goto ; Shiro Tomiyasu ; Masahiro Deguchi ; Sadayuki Okudaira ; Masakazu Yasunaka ; Mika Hirayama ; Ritsuko Yoshihara ; Taeko Funamoto ; Ayumi Igarashi ; Mitsunori Miyashita ; Tatsuya Morita
Palliative Care Research 2012;7(2):389-394
This study aimed to clarify whether a regional palliative care intervention program, the OPTIM project, increased home hospice utilization, and explore the potential association between the home hospice utilization and the hospital staff's perceptions on home care. A questionnaire survey was conducted involving 154 physicians and 469 nurses. The rate of patients who made the transition to home-based care increased 967% in A Hospital, 295% in B Hospital, and 221% in C Hospital in 2010 compared to 2007, which was assumed to be 100. Staff of a hospital where many patients made the transition to home-based care were more likely to agree with the following statements concerning home care perspectives: “I started to consider that even cancer patients can be treated at home until the last moment of their life”, “I usually ask patients whether they wish to receive home-based care”, “We decided on coping strategies for sudden changes in the course of disease and a place to contact in advance”, and “I started to simplify treatment procedures, such as prescriptions during hospitalization for patients and their families to prepare for home-based care“.
7.Intralesional steroid infusion using a spray tube to prevent stenosis after endoscopic submucosal dissection of esophageal cancer
Atsushi GOTO ; Takeshi OKAMOTO ; Ryo OGAWA ; Kouichi HAMABE ; Shinichi HASHIMOTO ; Jun NISHIKAWA ; Taro TAKAMI
Clinical Endoscopy 2022;55(4):520-524
Background/Aims:
Intralesional steroid injections have been administered as prophylaxis for stenosis after esophageal endoscopic submucosal dissection. However, this method carries a risk of potential complications such as perforation because a fine needle is used to directly puncture the postoperative ulcer. We devised a new method of steroid intralesional infusion using a spray tube and evaluated its efficacy and safety.
Methods:
Intralesional steroid infusion using a spray tube was performed on 27 patients who underwent endoscopic submucosal dissection for superficial esophageal cancer with three-quarters or more of the lumen circumference resected. The presence or absence of stenosis, complications, and the number of endoscopic balloon dilations (EBDs) performed were evaluated after treatment.
Results:
Although stenosis was not observed in 22 of the 27 patients, five patients had stenosis and dysphagia requiring EBD. The stenosis in these five patients was relieved after four EBDs. No complications related to intralesional steroid infusion using the spray tube were observed.
Conclusions
Intralesional steroid infusion using a spray tube is a simple and safe technique that is adequately effective in preventing stenosis Clinical trial number (UMIN000037567).
8.Specificity of the meridians and acupuncture-points. Effects of qiuxu on the gallbladder's form.
Tadashi YANO ; Yoshiki OYAMA ; Nobuyuki YAMADA ; Kazu MORI ; Toshinori YUKIMACHI ; Shinichi FUSHITA ; Kentaro MAEDA ; Ryo KAWAMOTO ; Katsuhiko SHIMOYA ; Takao SHIBATA ; Shigeru IHARA ; Naoto HONTANI ; Katsutoshi GOTO ; Hiroshi NAKATA ; Misao OKIEBISU
Journal of the Japan Society of Acupuncture and Moxibustion 1990;40(4):343-350
Objective:
There have been a few reports on the specificity of the meridians and Acupuncture-points. In order to identify the specific effects of the meridians and Acupuncture-points, the functional relations between “the gallbladder Meridian and gallbladder” were investigated using the gallbladder's form as an index.
Materials and Methods:
Ten healthy male adult volunteers participated in the experiments in fasting conditions. The target organ was the gallbladder, and its form was measured with the ultrasonic diagnostic apparatus (Toshiba SSA-90A). The images of the gallbladder form were taken at the point when the major long axis of the cross-section of the gallbladder reached the peak. The cross-sectional area of the gallbladder was measured with the image analyzer. The measurement of the gallbladder form was conducted after 15 minutes lying on the back, taking images for 10 minutes before stimulation, for 30 minutes during and after stimulation, every two to five minutes. The acupuncture stimulation was given at the points of G34, G36, G37, G40 and G44 on the right side of the body. After getting the deqi, 1 minute of sparrow pecking needle technique and 1 minute of leaving needle technique were conducted three times. The effect of the G40 under the egg yolk loading were also investigated.
Results:
1) The stimulation of the G34, G36, G37, and G44 showed no effects on the gallbladder form. 2) The stimulation of the G40 caused the distension of the gallbladder form. 3) The stimulation of the G40 showed the suppressive effect on the contraction of the gallbladder due to the load of egg yolk.
As described above, the results of this study showed that there is an acupuncture-point on the gallbladder meridian to cause the distension of the gallbladder specifically. It suggests the existence of the specificity of acupuncture-point.