2.Distribution of Mosquito Larvae on Kosrae Island, Kosrae State, the Federated States of Micronesia
Shinichi Noda ; Sota Yamamoto ; Takako Toma ; Livinson Taulung
Tropical Medicine and Health 2013;41(4):157-161
Surveys of mosquito larvae were carried out in six areas of Kosrae Island, Kosrae State, the Federated States of Micronesia in December 2009 and June 2012. A total of 962 larvae of six species were collected from 106 natural and artificial habitats. They were identified as Aedes aegypti, Ae. albopictus, Ae. marshallensis, Culex quinquefasciatus, Cx. annulirostris, and Cx. kusaiensis. This is the first report from Kosrae Island for three of these species—Ae. marshallensis, Cx. quinquefasciatus, and Cx. annulirostris. The most abundant species was Ae. albopictus, followed by Ae. marshallensis, and these two species were found in all areas. Relatively large numbers of Cx. quinquefasciatus and Cx. kusaiensis were found in five areas. Fewer Cx. annulirostris were found, and only in three areas. Aedes aegypti larvae were collected from a single habitat at Tafunsak in 2009. To prevent the outbreak of dengue fever, environmental management should focus on the destruction, alteration, disposal and recycling of containers that produce larger numbers of adult Aedes mosquitoes.
3.Educating medical students in rural area through a rural medicine experience camp
Takao Wakabayashi ; Shinichi Takeda ; Yoshinobu Fujito ; Wari Yamamoto
An Official Journal of the Japan Primary Care Association 2015;38(3):243-247
A rural medicine experience camp is held every year for medical students of Sapporo Medical University who are obligated to work in rural area after graduation. We organized two method in our camp : 1. the lecture about rural medicine by senior medical students, 2. setting up the learning content in camp by participant before camp. We investigated how these methods make an impact on the participant's motivation about rural medicine. The results suggested that a method 1 enhanced the understanding of rural medicine and method 2 raised an a warenss about rural medicine. We thought that it was important to try various education about rural medicine for increasing the motivation to rural medicine for medical student.
4.Use of Diffusion-Weighted Imaging for Cerebral Infarctions in Kainan General Hospital.
Koji MIZUTANI ; Tomotaka SUMIDA ; Shinichi UMEDA ; Naoto YAMAMOTO ; Toshihiko TANASAWA ; Koji HATTORI ; Tadao SUGATA ; Isao TANIMOTO
Journal of the Japanese Association of Rural Medicine 1996;45(1):28-32
Many reports say that DWI (diffusion-weighted-image) is very useful for the diagnosis of cerebral infarction, especially in the acute phase, but it is difficult to have a fine image because DWI is very sensitive to artifacts caused by the “body-move” of the patient.
About the degree of MPG (motion probing gradient), criteria are yet to be established. Many persons try in their own way. With MPG5, the intensity of CSF and that of the focal lesion are almost equal, so that it is difficult to distinguish infarcts from adjacent ventricles.
The stronger the degree of MPG is, the more artifacts or noises we get, We recommend MPG6 or 7 in the right-left direction.
5.Cervical nerve roots and the dural sheath: a histological study using human fetuses near term
Kei KITAMURA ; Masahito YAMAMOTO ; Yoshinosuke HIROTA ; Noriyuki SATO ; Toshimasa MACHIDA ; Noboru ISHIKAWA ; Hitoshi YAMAMOTO ; Gen MURAKAMI ; Shinichi ABE
Anatomy & Cell Biology 2020;53(4):451-459
We have previously reported that the thoracolumbar posterior nerve root shows a tortuous epidural course, based on studies of human fetuses near term. For comparison with the cervical nerve, examinations were conducted using frontal, sagittal and horizontal sections of cervical vertebrae from 22 fetuses at 30–38 weeks of gestation. The cervical nerve root showed a short, straight and lateral course near the zygapophysial joint. Multiple rather than single bundles of the cervical posterior root seemed to account for the majority of sensory nerve fibers innervating the upper extremity. Fasciculation of rootlets was evident near the thoracolumbar spinal cord, whereas it was seen in the dural pocket at the nerve exit from the dural sac although both sites were subdural. As in the thoracolumbar region, the nerve sheath was continuous with the dura mater and independently surrounded each of the anterior and posterior roots. Radicular arteries were few in the cervical region. In 2 of the 22 fetuses (31 weeks and 33 weeks), there was a segmental, unilateral abnormality of nerve rootlet fasciculation where the dorsal root ganglion was located lateral or peripheral to the intervertebral region. Long nerve roots running inferiorly are a necessary adaptation to the delayed and marked growth of the thoracolumbar vertebral column.In children, the cervical nerve roots are likely to be affected by movement or dislocation of the vertebrae. The segmental abnormality of the cervical nerve root may be linked to rare variations in the brachial plexus.
8.Drug-induced Cystitis Following Administration of Two Kampo Medicines Containing Scutellariae Radix : A Case Report
Shinichi YAMAMOTO ; Ayako OSAFUNE ; Akira MATSUI ; Kuniaki TANAKA
Kampo Medicine 2023;74(4):331-337
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.
9.Evaluation of the outpatient clinic education of our department by the patient
Daisuke DANNO ; Shinichi FUJIMOTO ; Yuka YAMAMOTO ; Reiko MIZUNO ; Koichi MAEDA ; Masatoshi KANNO ; Masahiko MATSUMURA ; Takashi FUJIMOTO ; Shinobu NAKAMURA
Medical Education 2008;39(1):51-54
1) We investigated the patients'evaluations of the students, our management of the medical training, and the patients' recognition of our outpatient clinic education. We then requested the patients to give their opinions regarding such interviews.
2) The patients'evaluations of the outpatient clinic and the patients'recognition of our outpatient clinic education were relatively good, but some patients complained about the short duration of medical care and also expressed anxiety over the students'medical interview.
3) Many patients expressed the desire to positively participate in medical education because the patients had high expectations of the medical students.In addition, this interview training fulfilled the patients'desire to be listened to and have their concerns acknowledged.
10.Influence of the Patient/Doctor Relationship on the Non-attendance Rate of General Practice, and Investigation of Reasons for Hospital Non-attendance
Daisuke Danno ; Shinichi Fujimoto ; Yuka Yamamoto ; Reiko Mizuno ; Koichi Maeda ; Masatoshi Kanno ; Takashi Fujimoto ; Masahiko Matsumura ; Shinobu Nakamura
General Medicine 2005;6(1):17-21
BACKGROUND: In general practice, though patients often stop visiting ambulatory clinics of their own vo-lition despite the need for ongoing medical treatment, there is little reported research on the reasons for nonattendance in Japan. In this study, we investigated whether the patient/doctor relationship influences nonattendance rates in general practice. In addition, we investigated the reasons why patients stopped visiting the hospital.
METHODS: We collected data from 115 patients (58 males, 57 females; age range: 16 to 94 years old, median age: 52 years old) whose initial diagnoses were made in our department from June to July 2000. We classified the patients into five groups based on the level of their complaints concerning the initial consultation (‘A’ representing the highest degree of complaint, ‘E’ representing the lowest) and determined the relationship between the strength of complaints and the non-attendance rate. Furthermore, we investigated the reasons for non-attendance concerning 28 patients who stopped visiting the hospital from April 2000 to November 2001.
RESULTS: The non-attendance rates were 0% (014) for group A, 14.3% (2114) for group B, 5.6% (5189) for group C, 33.3% (216) for group D, and 50% (1/2) for group E. The rate tended to be higher in groups with fewer complaints. The reasons for non-attendance were the following: remission of symptoms (9 patients), request for another hospital or department (6 patients), relief due to consultation at the university hospital (6 patients), and lack of time to come to the particular hospital (5 patients) . In contrast, the most common reason for satisfaction at the time of consultation was ‘enough explanation and listening to complaints well’ in 7 of 11 patients who were satisfied with the consultation.
CONCLUSIONS: The level of patient's complaints at the time of consultation is related to the non-attendance rate. However, sufficient explanation about symptoms and careful listening to complaints are important for establishing a good patient/doctor relationship.