It is often reported that the number of cases of cervical spinal cord injury without fracture resulting from falls have increased in recent years with a aging population.　　We reviewed the cases of cervical spinal cord injury in the patients who were admitted within two days after the injury to our department between January 2006 and December 2012, The subjects of this study numbered 167 cases;129 males and 38 females. The frequency of occurrence of cervical spinal cord injury, according to reports by the fire departments in the southwestern part of Ibaraki Prefecture is 32.0 per million individuals per year. In our cases under review, fractures were noted in 72 individuals, whereas 95 had no fractures. As to the causes of injury, traffic accidents topped the list with 38.9%, followed by falls with 28.7%, stumbles with 20.4%, and other factors with 12.0%. Cervical spinal cord injury account for 75% of all the cases of spinal cord injury with an incident of 30-40 cases per 100 million individuals per year. In 2011, the incidence of cervical spinal cord injuries resulting from traffic accidents decreased, while that of injuries related to falls increased. Six cases of injury resulting from falls happened during repairs on the damaged houses in the aftermath of the Great East Japan Earthquake of March 2013.

We report a case of drug-induced cystitis caused by the administration of two different Kampo medicines containing Scutellariae radix. The patient was prescribed bofutsushosan for weight gain at the age of 55. She visited her primary care physician approximately one month later for micturition pain and other symptoms, and was prescribed antibacterial agents based on a diagnosis of bacterial cystitis. The patient’s symptoms persisted even after she was treated for one month ; therefore, she was referred to the urology department of a general hospital. All medicines including Kampo medicines were discontinued ; her subjective symptoms and urinary findings improved within 2 weeks. Her symptoms of cystitis flared up after a few days of re-administration of bofutsushosan. Four months later, she developed cystitis-like symptoms again after using nyoshinsan for menopausal symptoms. Based on the aforementioned clinical observations, she was diagnosed with drug-induced cystitis due to bofutsushosan and nyoshinsan administration. The components of these two Kampo medicines and past history of Kampo medicine use were reviewed and Scutellariae radix was considered to be the causative agent. Drug-induced cystitis caused by herbal medicines generally takes a long time to develop, and symptoms resolve within a relatively short period following discontinuation of the causative agent. Several reports in the literature implicate Scutellariae radix as the etiological agent in such cases. We believe that it is necessary to pay close attention to the risk of cystitis in patients receiving long-term Kampo therapy.

Background: Laparoscopy-assisted gastrectomy requires a lot of disposable products. So we compared the cost between laparoscopy-assisted gastrectomy and open surgery.Patients and methods: For comparison we used five cases each of open distal gastrectomy (ODG), laparoscopy-assisted distal gastrectomy (LADG), open total gastrectomy (OTG) and laparoscopy assisted total gastrectomy (LATG). In this study, we defined the profit of gastrectomy as below and we used the list price for all products. Profit of gastrectomy=Fee for gastrectomy-(Costs of all single use products-Demandable fee for single-use products)Results: Mean profits of ODG and LADG were 278,756.2 yen and 190,292.8 yen. The difference was 88,463.4 yen. Mean profits of OTG and LATG were 395,922.6 yen and 330,653.6 yen. The difference was 65,269 yen. Mean hospital charges, mean length of hospital stay, mean hospital charges per day of ODG, LADG, OTG and LATG were 1,390,464 yen, 21.4 days, 65,140.0 yen and 1,484,254.0 yen, 18.8 days, 80,805.4 yen and 1,956,664.0 yen, 24.4 days, 82,397.1 yen and 1,686,936.0 yen, 18.4 days, 91,894.8 yen, respectively.Conclusion: The turnover of laparoscopic gastrectomy was higher than open gastrectomy, but, the profit was lower because of high costs of disposable products. Hospital charges were not higher but the charge per day was higher because of a shorter hospital stay.
Gastrectomy ; Laparoscopy ; Hospitals ; Mean ; Financial cost

Objective: The benefits of combining cancer screenings with clinical surveys have become increasingly obvious as cancer morbidity and mortality have steadily increased. This paper discusses a study on the current status of and issues surrounding breast cancer screening in a clinical survey. The study also investigated the patients' awareness of the benefits of breast cancer screening. A secondary aim of the study was to promote mammographic screening.;Subjects and Methods: During the 72 months between April 1999 and March 2005, a total of 36,505 women underwent clinical surveys in our hospital. In October 2002, mammographic examination was included as an optional part of the routine physical examination. We evaluated the results of breast cancer screening with or without mammographic examination and used a questionnaire to investigate the patients' awareness of the benefits of breast cancer screening.;Results: Compared with the pre-2001 results, the detection rate of breast cancer significantly increased after 2003 when physical examination was combined with mammographic examination. Our study also found that both elderly patients and those residing in the suburbs of Sapporo City tended to choose physical examination alone rather than combining it with mammographic examination. An analysis of the questionnaires collected from these patients indicates they had a poor understanding of and lacked awareness of the benefits of mammographic examinations during breast cancer screenings.;Conclusions: The inclusion of mammographic screenings with clinical surveys was found to be significantly useful in the detection of breast cancer. Further continued education is needed for women, particularly the elderly and residents in the suburbs, so they understand the benefits of breast cancer screening by mammographic examination for the early detection of breast cancer and, consequently, decreased mortality of the disease.
Breast neoplasm screen NOS ; Clinical ; benefits ; Awareness ; Surveys