1.A Case of Vascular Parkinsonism Treated Mainly at His Home with Thyrotropin-Releasing Hormone(TRH).
Kazuhisa KOBAYASHI ; Aiko KASHIWAGI ; Takenao IDESAWA ; Takeshi KANAI ; Ichiro TAKAYAMA ; Fumiaki KITAHARA ; Yoshioki YODA ; Zenji SHIOZAWA
Journal of the Japanese Association of Rural Medicine 1997;46(2):178-183
We report a case of vascular parkinsonism mainly treated at the patients' home with thyrotropin-releasing hormone (TRH). The patient was a 77-year-old male who had an attack of cerebral bleeding in the left posterior lobe in 1990. Thereafter, dysarthria, dysphagia and gait disturbance gradually developed. He had rigidity in the neck, and upper and lower extremities, but no tremor, and walked with short strides (marche a petit pas). We diagnosed the case as vascular parkinsonism, by his history and those symptomes.
We treated him mainly at his home since 1994. At first, we used combinations of levodopa, bromocriptine, amantadin, and anti-chorinergic drugs, but symptomes and signs of vascular parkinsonism did not disappear.
Finally, we used TRH 0.5 mg by an intravenous or intramuscular injection for 10-14 days a month. Thereafter, he became able to eat, speak and walk a little more, and we continued this therapy for about one year. He died in 1996 of asphyxia at a meal. We think TRH was effective for chronic stage of vascular parkinsonism even if treated at home.
2.How to Decrease the Mortality from Lung Cancer.
Kazuhisa KOBAYASHI ; Tatsuaki TSUKAMOTO ; Jyunya KATO ; Ayako MISAWA ; Masahiko OOTAKA ; Koji MIYAZAKI ; Etsuhide HANAGATA ; Ritsuko MORIYA ; Yoshioki YODA
Journal of the Japanese Association of Rural Medicine 2003;51(5):751-759
Background: Lung cancer screening by chest X-rays and/or cytological tests of sputum has been practiced for many years. Nonetheless the number of deaths from lung cancer was kept increasing all this while. We wanted to find a way to decrease the mortality from lung cancer by investigating the screening methods or lifestyle to prevent the lung cancer.
Methods: I. The detection rate of lung cancer was investigated according to each method of screening-helical CT, chest X-rays or sputum tests, from 1998 to 2000.
II. Seventy-nine cases of lung cancer detected by the screening carried from 1995 to 2000 at our institute were compared with control cases matched with respect to age, sex and seasons of screening.
Results: I. The detection rate by helical CT in 1998, 1999, and 2000 was 0.29%, 0.24%, and 0.19%, respectively, while the detection rate by chest X-rays was 0.01%, 0.02% and 0.2%. There was no detection of lung cancer by sputum tests in those three years.
II. The ingestion of vegetables was the only one statistical difference between the lung cancer group and the control group. A lesser ingestion of vegetables increased the risk for lung cancer.
Conclusions: The detection rate of lung cancer by helical CT is remarkably higher than chest X-rays or cytological tests of sputum. People who eat a lot of vegetables have a lesser chance to suffer from lung cancer.