Introduction
Floods are the most common natural disaster. Although infectious diseases are paid attention in flood settings, public health impact from other diseases has been rarely discussed. In Thailand, a large-scale flood disaster severely affected local people and the societies mainly in the North and Central regions due to unusual heavy rain in 2011. To provide information on health issues from a prolonged flood, we reported the health issues among the patients in several areas of Thailand where a flood lasted more than 1 month.
Methods
Data on the patients were extracted from records of the collaborated activities between two NGOs in Thailand and Japan in three areas of two provinces in the Central region at the end of November, 2011. The data on the venues were also abstracted: main stations for medical care in three areas and mobile clinics at evacuation centers (tent, temple, and school) in two areas. We evaluated distributions of health issues, and examined the characteristics of the distributions stratifying by place and patients' age.
Results
High prevalence was observed for muscle and joint pain, chronic diseases, and acute respiratory infections. Among patients with the infections, 96 % or more was those with upper respiratory infections. In the evacuation centers, the prevalence of acute respiratory infections was high (39 %) at school compared to that at other places. The prevalence of muscle and joint pain sharply increased among patients in their 30's, which was highest among those in their 40's and 50's.
Conclusions
Muscle and joint pain, chronic diseases, and acute respiratory infections were main issues in this flood setting. This study would provide information on potential health issues in the coming floods. Future research is needed to examine whether an occurrence of flood disaster could be associated with increased risk of muscle and joint pain.

The management of influenza has dramatically changed since the introduction of the rapid influenza diagnostic test, or RIDT, and neuraminidase inhibitors (NI). However, it is still far from optimal due to low RIDT sensitivity and problems involving NI such as side effects and the potential emergence of resistant virus.Therefore, we developed a decision-making model for the management of influenza, which includes Kampo medicines in its strategies. First, the severity of patients is evaluated. If a patient is judged at severe or high-risk, intravenous NI would be the main component of treatment. If a patient has neither a severe condition nor is at high-risk, the patient would be asked to choose either NI or Kampo medicine. In the former, RIDT would be used if pretest probability was less than 50%, but it would not be used if it was more than 50%, based on the lack of influence on the post-test probability. For the latter, RIDT would be not used in general as Kampo targets “phenomena”, not the virus per se. This model enables us to optimize the use of RIDT by appropriately selecting patients based on the characteristics of RIDT, and by avoiding unnecessary tests and their misinterpretation.

　　We experienced five cases of male breast cancer for during the past 10 years from 2002 through 2011, and performed the clinicopathologic study. Male breast cancer accounts for as low as 1.59% of all breast cancers, and the average age at occurrence is 70.4 years. In every case of ours the tumor was located around the nipple with its nodular diameter not exceeding 2.0 cm. By histological types, our case consisted of two papillotubular carcinoma, two solid-tubular carcinoma and one scirrhous carcinoma. Pathological findings showed that all cancers had infiltrated into the surrounding fat tissues of the mammary gland and four of them into the overlying skin. One case of papillotubular carcinoma was diagnosed as neuroendocrine carcinoma. Four cancers examined for ER and PgR were all positive, but all cases for HER2 was negative. There was a tendency for the age and clinical history of breast cancer to be older and longer in men than in women. Information about male breast cancer should be disseminated more widely and more effects toward early detection should be made.

We have tried surgical pathologic diagnosis using a still image transmission system. The equipment we used was a medical information network system (Telepathology) developed jointly by Inohara Shokai and NTT. During the 9-month period from April to December in 1995, we performed pathological diagnosis on a total of 63 cases received via this system. The cases included 21 stomach cancers, 13 colorectal cancers, 5 breast tumors, 4 lung tumors, 5 thyroid tumors and 3 ovary tumors. Materials presented for pathologic examination were 44 lymph nodes, 20 stumped sections of the lesions and 13 tumor tissues. The correct diagnosis ratio was as high as 93.7%. Improvement in the specimen-making procedure reduced the time required to arrive at a firm diagnosis. However, the quality of images of low magnification is unsatisfactory. It should also be pointed out that there is much room for improvement in the technical skill and knowledge of the persons concerned. Nevertheless, great expectations could be placed on this system. With progress in data transmissions technology, it will find its use more widely.

This paper describes a clinical review of cases of gastric cancer treated surgically at the Department of Surgery of the Shirakawa Kosei General Hospital, the core medical institution in the southern part of Fukushima Prefecture.
During the period of 20 years from January 1981 through December 2000, a total of 1, 132 cases were operated on for gastric carcinoma. Surgical resection cases totaled 1, 023 (resection ratio: 90.4%); curative resection cases, 894 (curative resection ratio: 79.0%); 5-year survival rate for resection cases, 68.3%; and 5-year survival rate for curative resection cases, 75.6%. When the cases were divided into those treated during the first half of the 20 years nad those treated during the latter half of the 20 years, the number or resection cases was smaller during the latter than during the first half but the resection ratio was larger. The early stomach cancer cases in terms of the degree of progress, histological classification, depth and metastasis to lymph nodes have been increasing and the 5-year survival rate has been on the rise.

During the period of 25 years from January 1978 through December 2002, a total of 808 colorectal cancer cases were operated on in Shirakawa Kosei General Hospital. The number of sugical resection cases came to 713 (ratio : 88.25%). Curative resection was performed on 593 cases (ratio : 73.4%). The total number of cases was broken down into 446 cases of cancer of the colon and 369 cases of cancer of the rectum (7 multiple cancer cases included). By sex, male cases numbered 329 and female cases 379. Clinically or histologically, many cases were diagnosed as stage IIIa or stage II cancer. The 5-year-survival rate for the resection cases was calculated at 67.2% and that for the cure resection cases, at 79.5%.
Excision ; Malignant Neoplasms ; Colorectal Cancer ; Cases ; Review of

Anthropometry measurements, such as height and weight, have recently been used to predict poorer birth outcomes. However, the relationship between maternal height and birth outcomes remains unclear. We examined the effect of shorter maternal height on low birth weight (LBW) among 17,150 pairs of Japanese mothers and newborns. Data for this analysis were collected from newborns who were delivered at a large hospital in Japan. Maternal height was the exposure variable, and LBW and admission to the neonatal intensive care unit were the outcome variables. Logistic regression models were used to estimate the associations. The shortest maternal height quartile (131.0-151.9 cm) was related to LBW (OR 1.91 [95% CI 1.64, 2.22]). The groups with the second (152.0-157.9 cm) and the third shortest maternal height quartiles (158.0-160.9 cm) were also related to LBW. A P trend with one quartile change also showed a significant relationship. The relationship between maternal height and NICU admission disappeared when the statistical model was adjusted for LBW. A newborn's small size was one factor in the relationship between shorter maternal height and NICU admission. In developed countries, shorter mothers provide a useful prenatal target to anticipate and plan for LBW newborns and NICU admission.
Adult ; *Body Height ; Body Mass Index ; Female ; Hospitals ; Humans ; *Infant, Low Birth Weight ; Infant, Newborn ; Intensive Care Units, Neonatal ; Japan ; Logistic Models ; Male ; Mothers/*statistics & numerical data ; Odds Ratio ; Risk Factors ; Weight Gain

This case report describes the effect of exercise therapy on a patient with plasmacytoma diagnosed with chemotherapy-induced peripheral neuropathy (CIPN). A man in his mid 70s was diagnosed with plasmacytoma and received outpatient chemotherapy. He developed glove-and-stocking numbness and balance disorder and underwent 16-week multimodal exercise therapy consisting of resistance and balance training, and aerobic exercise. He attended one session per week of exercise therapy at a hospital under the supervision of a physical therapist and completed five sessions of home-based exercise. His symptoms and physical function were evaluated at baseline and after intervention using the Common Terminology Criteria for Adverse Events version 5.0 (CTCAE), Functional Assessment of Cancer Therapy-Neurotoxicity subscale (FACT-Ntx), modified Total Neuropathy Score (mTNS), Stand-up test, and Berg Balance Scale (BBS). After the 16-week intervention, clinician-assessed CIPN symptoms were stable (CTCAE：Grade 2 at baseline, Grade 2 after intervention), whereas patient-reported CIPN symptoms improved beyond the minimal clinically important difference (FACT-Ntx score increased from 22 to 29 points). Although the components of mTNS such as motor symptoms and strength improved, the total mTNS score remained stable. The Stand-up test and BBS scores improved, and better physical function led to improvements in activities of daily living. Thus, exercise therapy may effectively reduce the symptom burden and improve physical function in patients with CIPN.

This case report describes the effect of exercise therapy on a patient with plasmacytoma diagnosed with chemotherapy-induced peripheral neuropathy (CIPN). A man in his mid 70s was diagnosed with plasmacytoma and received outpatient chemotherapy. He developed glove-and-stocking numbness and balance disorder and underwent 16-week multimodal exercise therapy consisting of resistance and balance training, and aerobic exercise. He attended one session per week of exercise therapy at a hospital under the supervision of a physical therapist and completed five sessions of home-based exercise. His symptoms and physical function were evaluated at baseline and after intervention using the Common Terminology Criteria for Adverse Events version 5.0 (CTCAE), Functional Assessment of Cancer Therapy-Neurotoxicity subscale (FACT-Ntx), modified Total Neuropathy Score (mTNS), Stand-up test, and Berg Balance Scale (BBS). After the 16-week intervention, clinician-assessed CIPN symptoms were stable (CTCAE：Grade 2 at baseline, Grade 2 after intervention), whereas patient-reported CIPN symptoms improved beyond the minimal clinically important difference (FACT-Ntx score increased from 22 to 29 points). Although the components of mTNS such as motor symptoms and strength improved, the total mTNS score remained stable. The Stand-up test and BBS scores improved, and better physical function led to improvements in activities of daily living. Thus, exercise therapy may effectively reduce the symptom burden and improve physical function in patients with CIPN.

Background/Aims: Several studies have assessed the effect of cool temperature on colonic peristalsis. Transient receptor potential melastatin 8 (TRPM8) is a temperature-sensitive ion channel activated by mild cooling expressed in the colon. We examined the antispasmodic effect of cool temperature on colonic peristalsis in a prospective, randomized, single-blind trial and based on the video imaging and intraluminal pressure of the proximal colon in rats and TRPM8-deficient mice. Methods: In the clinical trial, we randomly assigned a total of 94 patients scheduled to undergo colonoscopy to 2 groups: the mildly cool water (n = 47) and control (n = 47) groups. We used 20 mL of 15°C water for the mildly cool water. The primary outcome was the proportion of subjects with improved peristalsis after treatment. In the rodent proximal colon, we evaluated the intraluminal pressure and performed video imaging of the rodent proximal colon with cool water administration into the colonic lumen. Clinical trial registry website (Trial No. UMIN-CTR; UMIN000030725). Results: In the randomized controlled trial, after treatment, the proportion of subjects with no peristalsis with cool water was significantly higher than that in the placebo group (44.7% vs 23.4%; P < 0.05). In the rodent colon model, cool temperature water was associated with a significant decrease in colonic peristalsis through its suppression of the ratio of peak frequency (P < 0.05). Cool temperaturetreated TRPM8-deficient mice did not show a reduction in colonic peristalsis compared with wild-type mice. Conclusion For the first time, this study demonstrates that cool temperature-dependent suppression of colonic peristalsis may be associated with TRPM8 activation.