1.Health and living conditions of Hamachi (yellowtail fish) breeders.
Yasuo CHUMA ; Yasuo SESHITA ; Keiko SHIRAHATA ; Ikuko MAEDA ; Chieko KAMO ; Ken KUSANO ; Kazuhiko MIYAHARA
Journal of the Japanese Association of Rural Medicine 1985;34(1):34-42
With an aim at making future community health services more effective, the authors have attempted surveys of the living and health conditions of yellowtail fish breeders for Tarumi Fishermen's Cooperative Association over the past three years.
1st February 25, 1982 54 persons
2nd January 31, 1983 70 persons
3rd January 30, 1984 55 persons
In the last survey, 21 persons out of 55 were the same persons who had taken part in the 1982 and 1983 surveys.
Conclusion
(1) Fishermen get up earlier in the morning and set to work, many skipping breakfast. In the afternoon, they are relatively free. However, none use their leisure hours for promoting physical wellbeing.
(2) Many are liable to catch cold and suffer from lower back pain. Obesity, byperlipemia and liver dysfunction due to excessive alcohol intake are notable.
(3) Compared with farmers, they are youg, but many are out of condition.
(4) Health conditions of those who have undergone medical checkups for the therr years running showed some improovement in obesity and high blood pressure, but the cases of ECC disorder and liver dysfunction have increased.
(5) Bad health conditions derived from personal habtis could be rectified if long-term educational measures and others were implemented.
2.Successful Surgical Repair of Impending Rupture of a Pseudoaneurysm of the Brachiocephalic Artery with Prior Reconstruction of the Carotid Artery.
Ken Miyahara ; Masanobu Maeda ; Yoshimasa Sakai ; Hajime Sakurai ; Hiroomi Murayama ; Hiroki Hasegawa
Japanese Journal of Cardiovascular Surgery 2003;32(1):52-55
We report the successful repair of impending rupture of a pseudoaneurysm of the brachiocephalic artery (BCA) in a 70-year-old man. He had undergone a mediastinal tumor resection through a median sternotomy in 1995. Pathological examination revealed non-Hodgkin's lymphoma. Two years later, he underwent radiation therapy of 65 Gray for metastasis to the supraclavicular lymph nodes. On January 18, 2000, plastic surgeons planned to perform a pectoralis major musculocutaneous flap to repair a radiation skin ulcer. During the operation, the BCA was lacerated, possibly in an area of radiation tissue damage. We performed a prosthetic graft (10-mm GelsealTM) replacement of the BCA. The right subclavian artery had to be ligated. Postoperative digital subtraction angiography (DSA) showed excellent reconstruction of the artery. Magnetic resonance angiography of the brain showed a deficit in the anterior communicating artery and stenosis of the posterior communicating artery, which indicated that the reconstruction procedure was reasonable. Seven months later, on August 18, 2000, the patient was transferred to our hospital because of swelling of the right neck and oozing from the previous cutaneous wound. CT scan and DSA demonstrated the presence of a pseudoaneurysm of the proximal anastomosis site, which required emergency surgery. Before this third sternotomy, a saphenous vein graft was interposed between both external carotid arteries. Removal of the prosthetic graft and resection of the pseudoaneurysm were performed under mild hypothermia and cardiopulmonary bypass with left common carotid arterial perfusion. Then, the wound was closed completely using a left pectoralis major musculocutaneous flap. The postoperative course was uneventful and DSA showed good patency of the graft and intracranial arteries. The patient was discharged without neurological complications. We conclude that prior reconstruction of the carotid artery is a safe and effective procedure for patients with aneurysmal changes in the BCA, especially in the case of re-operation.
3.Questions Predicting Severe Disease in Patients with Abdominal Pain at a General Outpatient Department
Ken Kimura ; Masatomi Ikusaka ; Yoshiyuki Ohira ; Tomoko Tsukamoto ; Kazutaka Noda ; Toshihiko Takada ; Masahito Miyahara ; Ayako Basugi ; Kaori Sakatsume
General Medicine 2012;13(1):11-18
Background: Taking a good history is important for the diagnosis of abdominal pain. We investigated questionnaire items that were significantly correlated with causes of abdominal pain requiring hospitalization. We also studied the combination of responses that could exclude severe disease.
Method: Between February 2006 and December 2007, 296 of 317 patients with abdominal pain who attended our Outpatient Department completed a questionnaire for their abdominal pain. They included 32 patients requiring hospitalization (severe group) and 264 other patients (mild group). The percentage of positive responses to each questionnaire item was compared between the two groups, and those showing a significant difference were employed for logistic regression analysis.
Results: The following 4 responses were selected: “It is less than 7 days since the onset of pain” (odds ratio [OR], 2.8; 95% confidence interval [95% CI], 1.2-6.4); “The pain is exacerbated by walking” (OR, 2.8; 95% CI, 1.3-6.2); “The pain is accompanied by weight loss” (OR, 3.8; 95% CI, 1.5-9.8); and “The pain wakes me at night” (OR, 2.3; 95% CI, 1.1-5.2). If a patient had none of these responses, the predictive value was 0.03 for severe disease.
Conclusions: Our findings suggested that pain reported within 7 days, exacerbation by walking, nocturnal awakening, and associated weight loss are features of abdominal pain that predict severe disease. Conversely, severe disease can be almost completely excluded in patients negative for all 4 features.