1.Exposure assessment of Organophosphate Pesticide(DDVP) Based on the Aerial Concentration in the Greenhouse.
Tetsuhito FUKUSHIMA ; Nobumasa HOJO ; Akio ISOBE ; Kuninori SHIWAKU ; Yosuke YAMANE
Journal of the Japanese Association of Rural Medicine 1994;42(5):1056-1060
The exposure to the organophosphate pesticide (DDVP) by sprayers was assessed based on the measurements of concentration in the greenhouse. The serum concentrations of DDVP were examined 1 hour after spraying in two men who worked in the greenhouse with gas masks. Their serum concentration level was 21.2 ng/ml and 15.0 ng/ml, respectively, while serum cholinesterase was within normal level in both men. Changes in aerial DDVP concentrations in the greenhouse were examined. The result showed a higher concentration at the lower point (0.7 m high from the ground) than at the higher point (1.4 m high from the ground). The aerial concentration remained high (0.5ppm-2.0 ppm) for two days after spraying and started to decline thereafter to 0.5 ppm or less. On the seventh day, it was undetectable.
From these results, we suggest that the following precautions should be taken toprevent pesticide exposure in the greenhouse. 1. Wearing only a gas mask but also goggles are recommended when pesticides are being sprayed. 2. The work in the greenhouse should be postponed until the second day after spraying because of the aerial residue of pesticide. 3. The frequent ventilation and gas mask are necessary till the seventh day after spraying. 4. Ventilation of the zone near the ground should be done sufficiently when the workers take the half-sitting posture like “buds gathering, ” because they are exposed to higher aerial concentrations of pesticide than when they are working in a standing posture.
2.Living Conditions of the Solitary Elderly and Their Community Health Problems with Reference to Local Characteristics.
Tetsuhito FUKUSHIMA ; Akio ISOBE ; Nobumasa HOJO ; Kuninori SHIWAKU ; Yosuke YAMANE
Journal of the Japanese Association of Rural Medicine 1994;42(5):1061-1066
To investigate the problems confronting the present health care system for the elderly in depopulated areas of Japan, we examined the living conditions of solitary aged people in two rural communities, Sada and Koryo, Shimane Prefecture, where the percentage of aged population is the highest among all the prefectures in Japan. Just as community characteristics ofthe two areas are different from each other, so are the features of the elderly's health needs.
Sada is a mountainous agricultural community, where the acreage of cultivated land per household is relatively large. As many families are composed of three generations, only a small number of aged people are living by themselves.
Koryo is a urbanized agricultural community on the outskirts of Izumo City. As the acreage of cultivated land per household is narrower, the average number of family members is smaller, and the percentage of the elderly, especially female, living alone is remarkable.
In Sada as well as Koryo the solitary life of the elderly mostly resulted from the death of their spouse. Their daily contact with their children is scarce, because most childrenlive in big cities far away from their parent's home. The rate of the solitary elderly whose children and their family will return home in future is 27.0% in Sada and 43.4% in Koryo.
Most of the social problems the solitary elderly face are derived from strained household economy. The rate of the elderly whose living expenses are less than 60, 000 yen a month is 41.2% in Sada and 31.6% in Koryo. As the economic resources of the solitary elderly are generally meager, the community should gear up to meet their economic needs.
4.Healthy Town Planning Friendly to Natural Ecosystems. Environmental Network Formation Model in a River-Lake Basin.
Tetsuhito FUKUSHIMA ; Iwao SAKAMOTO ; Toshio HARA ; Akio ISOBE ; Kuninori SHIWAKU ; Yosuke YAMANE
Journal of the Japanese Association of Rural Medicine 1998;47(2):83-89
The activities of the community based environmental forum over the past 7 years to maintain the Hii River-Shinji Lake ecosystem were reviewed. The network formation model for environmental safeguard developed in local communities in Shimane and the action targets of a healthy city project were evaluated.
1. Interaction between the development of theme and the increased participation of people from all walks of life.
In 1991, the communities launched “The Chironomidae-outbreak counterplan” named “Shinji Lake Forum” with the participation of various classes of inhabitants around Shinji Lake, including fishermen, biologists and environmental health researchers. The participatory action spread from residents around Shinji Lake to other communities along Hii River, resulting in the formation of an enlarged community network and inter disciplinary research network. The action targets developed as follows:
(1) the Chironomidae-outbreak counterplan, (2) water quality preservation of Shinji Lake, (3) community class for ecology, (4) a community network encompassing the river-lake basin, (5) a healthy city project aimed at cultural development.
2. The objective of the healthy city project
Now the participatory action is developing into the movement of “The Harmony of natural ecosystems”. With linkages between development and ecosystem protection, the healthy city project aimed at cultural development could be pursued in harmony with natural environment.
3. “The network formation model that has gone through processes of opposition and sharing” and participatory action research
In this paper we discuss the formation process of environmental safeguard network. At first, opposition structure such as the fishermen and the agriculturalists, the citizens and the administration, the upperstream area residents and the downstream area residents, was made obvious by making clear differences in interest concerning the environment and living well-being. And the common goals to achieve and roles individuals have to play become clear through the process of sharing a thought on the natural ecosystem and the process of recognizing the different standpoints again. The importance of the cooperation of residents, administrations and researchers, together with participatory action research using the network formation model, was emphasized in order to settle variously complicated problems of ecosystems.
5.Urination Trouble in Middle Aged and Elderly People and Need of Medical or Health Care.
Hisae NAKATANI ; Tetsuhiro FUKUSHIMA ; Akio ISOBE ; Kuninori SHIWAKU ; Tsutomu NISHIYAMA ; Kazunori SUGIYAMA ; Yosuke YAMANE
Journal of the Japanese Association of Rural Medicine 1999;47(5):701-707
Loss of bladder control has a significant psychological and social impact on the well-being of affected individuals. In the present study, a questionnaire survey regarding the incidence of urination trouble was conducted on individuals aged 40-86 years from a selected community.
A total of 281 individuals (137 males and 144 females) responded to our survey. In this study, urination trouble was categorized into: painful urination, retension and a decreased daily activity due to loss of bladder control. Of the 281 respondents, 122 (43.4%) said they had one or more symptoms of dysuria, 89 (31.7%) had irritative symtoms, 67 (23.8%) had obstructive symtoms, and 53 (18.9%) experienced a decrease in daily activities due to loss of bladder control.
The cases of abnormal urination showed no relationship to age, disease, or exercise. However, urinary abnormalities appeared to be related to frequent nocturnal and diurncl urination.
Loss of bladder control showed a positive correlation with the individual's perception concerning the quality of life. Thus, it was made clear that urinary trouble should be grappled with in earnest in the field of community health care.
7.The educational practice and the evaluation of health care for the elderly in a commnuity where the aged population has been increasing.
Yosuke Yamane ; Kuninori Shiwaku ; Kenji Abe ; Tetsuhito Fukushima ; Tsutao Okamoto ; Akio Isobe ; Manabu Tada ; Yoichiro Fukuzawa ; Takuji Kishimoto ; Miyoko Abe
Medical Education 1991;22(2):71-76
8.Subtype of Achalasia and Integrated Relaxation Pressure Measured Using the Starlet High-resolution Manometry System: A Multicenter Study in Japan
Tetsuya TATSUTA ; Hiroki SATO ; Yusuke FUJIYOSHI ; Hirofumi ABE ; Akio SHIWAKU ; Junya SHIOTA ; Chiaki SATO ; Masaki OMINAMI ; Yoshitaka HATA ; Hisashi FUKUDA ; Ryo OGAWA ; Jun NAKAMURA ; Yuichiro IKEBUCHI ; Hiroshi YOKOMICHI ; Shinsaku FUKUDA ; Haruhiro INOUE
Journal of Neurogastroenterology and Motility 2022;28(4):562-571
Background/Aims:
ManoScan and Sandhill high-resolution manometry (HRM) systems are used worldwide; however, the diagnosis of achalasia on the Starlet HRM system is not fully characterized. Furthermore, the impact of calcium channel blockers and nitrites in treating achalasia has not been investigated using HRM. Management of recurrent cases is a priority issue, although few studies have examined patient characteristics.
Methods:
We conducted a multicenter, large-scale database analysis. First, the diagnosis of treatment-naive achalasia in each HRM system was investigated. Next, patient characteristics were compared between type I-III achalasia, and the impact of patient characteristics, including calcium channel blocker and nitrite use for integrated relaxation pressure (IRP) values, were analyzed. Finally, patient characteristics with recurrent achalasia were elucidated.
Results:
The frequency of type I achalasia with Starlet was significantly higher than that with ManoScan and Sandhill HRM systems. In achalasia, multivariate analysis identified male sex, advanced age, long disease duration, obesity, type I achalasia, and sigmoid type as risk factors related to normal IRP values (< 26 mmHg). Calcium channel blockers and nitrites use had no significant impact on the IRP values, although achalasia symptoms were indicated to be alleviated. In recurrent cases, the IRP value was significantly lower, and advanced age, long disease duration, and sigmoid type were more common than in treatment-naive patients.
Conclusions
We should cautiously interpret the type of achalasia and IRP values in the Starlet HRM system. Symptoms of recurrent cases are related to disease progression rather than IRP values, which should be considered in decision making.