The term breech trial (TBT) has brought about radical changes but it is debatable whether it provides unequivocal evidence regarding the practice of breech deliveries. There is a need to publish the data of a study that was performed before the era of the TBT in a hospital where there was a high rate of breech vaginal delivery. The objectives were to ascertain the incidence, mode of delivery and fetal outcome in singleton breech deliveries. The study design was a retrospective cohort study where 165 consecutive breech and 165 controls (cephalic) were included. Statistical analysis, used were Chi squared and Fischer’s exact test. P<0.05 is taken as the level of significance. The incidence of breech deliveries was found to be 3% and has remained fairly constant but the rate of breech vaginal delivery has fallen and the CS rates have increased. Even though more breech compared to controls were significantly sectioned, majority of the breeches {n=137 (83%)} were planned for vaginal delivery and in these patients two-thirds attained vaginal delivery. There was 1 fetal death in the CS group compared to 12 deaths in the vaginally delivered breech. However, most death in the breech delivered vaginally are unavoidable. In conclusion, there is a high rate of breech vaginal delivery in this series of patients and most perinatal deaths were not related to the mode of delivery.
Delivery ; Hospitals ; Foetal ; incidence of cases ; Cessation of life

A strong earthquake (magnitude 6.8) off the Sea of Japan struck the Chuetsu area of Niigata Prefecture on July 16, 2007. By way of investigating the impact of the earthquake on the health of maintenance hemodialysis patients, we examined several biochemical parameters including nutritional markers and psychological stress markers and checked up on the incidence of earthquake-induced complications (heart failure and shunt obstruction). Blood samples were collected and the values of several biochemical parameters were measured. Incidences of clinical complications one, three and six months after the quake were scrutinized. Significant decreases in the nutritional markers and a significant increase in the incidence of complications were found one month after the quake. During this period, the supplies of electricity, city gas and water were completely recovered one after another. The significant changes in the nutritional levels and the incidence of complications coincided with the time of the complete recovery of these utilities. The levels of these parameters recovered and the incidence of complications reduced three months after the quake. However, the serum albumin level did not recover and remained significantly lower even six months after. The psychological stress markers increased significantly three months after. These suggested that there was the time lag between the decrease in the nutritional markers, the increase in the incidence of complications (1 month after earthquake) and the increases in the psychological stress markers (3 months after earthquake). We concluded that these findings provided important information for the total medical plan to maintain the physical and psychological states of hemodialysis patients in an earthquake- stricken district.
month ; Complications Specific to Antepartum or Postpartum ; Earthquakes ; incidence of cases ; Hemodialysis

A clinico-epidemiological analysis was performed of 2,414 consecutive stroke patients who were treated in our hospital during the 6-year period from 1997 through 2003. All the patients were neurologically examined and diagnostic studies were made by use of computed tomography. Cerebral infarction, cerebral hemorrhage, and subarachnoid hemorrhage accounted for 68%, 22%, and 10% of the stroke cases, respectively. The incidence of these subtypes of stroke in this region during the past 20 years was characterized by a singnificant decrease in cerebral hemorrhage, and an increased proportion of cerebral infarction. Men exceeded women in the incidences of both cerebral infarction and hemorrhage, whereas characteristically women far exceeded men in subarachnoid hemorrhage. The incidence reached a peak in the 70-79 age group regardless of the subtypes of stroke, and 64% of the entire stroke patients were those 70 and older. Women were found to suffer from stroke at much older age than men. As to the site of hemorrhage, putaminal hemorrhage was the most frequent, experienced by 36% of the patients, followed by thalamic hemorrhage in 34% of the patients. Putaminal and pontine hemorrhages predominated in the age groups younger than 60;thalamic, cerebellar and subcortical hemorrhages were predominant in the age groups older than 70. The incidence of these subtypes of hemorrhage during the past 20 years was characterized by a dramatic decrease in putaminal hemorrhage in a younger population, and a significant increase in thalamic, cerebellar, and subcortical hemorrhages in an older population.
Cerebrovascular accident ; Hemorrhage ; seconds ; Age Group Unspecified ; incidence of cases

It is a big problem to cope with elderly patients who are increasing in a community in Niigata which has already been heavily populated by those people over 65 years of age. Aging is not a disease. However, the actual situation of patients with hematological and solid tumors in the aging community is little known. In this communication, we analyzed 293 patients (AML/ALL: 52, NHL: 112, MDS: 75, MM: 40, and others: 14) and 127 dead with hematological malignancies treated in our hospital for the past 10 years or 80 to clarify the actual changes in the trend of patients with hematological malignancies and compared them with those of patients who died of solid tumors. The population movements over the last 20 years in the Kashiwazaki area were also studied.Our analysis showed that the number of patients who died of solid tumors increased (1.6 times) in step with the increases in the aged population for there 20 years in the Kashiwazaki area. In addition, the incidence of gastric cancer markedly decreased for the past 20 years, while that of colorectal cancer rapidly increased (5 times). The incidence of hematological malignancies also increased with its peak shiftted to the latter haf of the 7th decade of age for the past 10 years. In addition to the increased incidence, patients with NHL and MDS increased in number by 1.5 times over the last 10 years. Especially, patients with MM showed an increase of 3 times, while the incidence of AML was not changed, even decreasing in number.In conclusion, the incidence of hematological malignancies as well as solid tumors has steadily been increasing with the increases in the aged population in the Kashiwazaki area, and the number of the aged patients over 70 years of age also increased. Such aged patients, however, are not available for hematopoietic stem cell transplantation. Therefore, it is urgently necessary for us to cope with the increases in the number of aged patients with hematological malignancies.
Malignant Neoplasms ; incidence of cases ; seconds ; Solid tumor ; Aging

Schools ; incidence of cases ; School Health Services ; Role ; Health Surveys

incidence of cases ; trends ; Sexually Transmitted Diseases ; Papua New Guinea

Upper case tea ; incidence of cases ; United States ; Hospitals ; Malignant Neoplasms

Purpose : The purpose of this study was to analyze the incidence if subarachnoid hemorrhage (SAH) in residents of Honjo City and its vicinity in northen Japan with a total population of 123,000 during the 8-year period from 1995 through 2002, and to evaluated the overall management outcome of the patients with SAH. Methods : All patients suspected of having SAH are referred to our hospital, which plays a crucial role as a “core” hospital in the region. Computed tomography (CT) scan was indicated for all the patients to verify the occurrence of SAH, and subsequently three dimensional (3D) CT angiography and/or catheter angiography were performed to confirm rupture of aneurysms. Results : During the period under review a total of 327 patients were diagnosed as having aneurysmal SAH, and ruptured aneurysms were confirmed in 276 cases (84%). The cruse annual incidence was 33.0 per 100,000 population for all ages during the entire 8-year period. However, the annual incidence has gradually decreased in contrast to an increasing number of operations for unruptured aneurysms performed during the same period. The age ranged from 21 to 92 years with the mean age of 64.5, and the incidence reached a peak in the 70-79 age group. Women far exceeded men in the incidence at the ratio of 1.8 to 1. The high grade patients with severe SAH as evaluated as grade 4 and 5 according to Hunt & Kosnik’s classification consisted of 45%, and 50% of this group were the patients 70 and older. Overall management outcome was assessed 6 months after the onset of SAH with the use of Glasgow Outcome Scale, and favorable outcome such as good recovery and moderate disability was obtained in 42% of the total 327 patients and death occurred in 39%. Conclusion : The high incidence of SAH was confirmed, and it was also noted that the number of elderly patients with severe SAH has increased in this region. Preventive treatment for unruptured aneurysms may be one clue to the solution of this devastating medical problem.
incidence of cases ; X-Ray Computed Tomography ; Japan ; Subarachnoid Hemorrhage, Aneurysmal ; Hospitals