1.Genealogical Study of a Married Couple from Two Families with Hereditary Spherocytosis.
Tadashi ARAI ; Yo YASUDA ; Yuji ITOU ; Kazuyoshi HAYAKAWA ; Tadatake TAKAYA ; Satoshi TOSHIMA ; Chiken SHIBUYA ; Shigeko SATOU ; Tokie NAKAGAWA ; Yoshitomo KASHIKI
Journal of the Japanese Association of Rural Medicine 1996;44(5):676-679
Hereditary spherocytosis (HS) is a condition characterized by jaundice, hepato-splenomegaly tumors, and the presence of spherocytes. It accounts for about 70% of the reported cases of congenital hemolytic anemia in Japan. Many researchers state that this pathologic condition primarily arises from an abnormality of the red blood cell membrane. We have encountered a familiy, all the members (23-year-old daughter, 20-year-old son, 53-year-old-father, and 46-year-old-mother) of which had their cases diagnosed as HS by peripheral blood examination and electron microscopy. Excluding the farher, the peripheral blood examination also revealed anemia in the other family members. Moreover, the common HLA was found in all the members of these two families including the one on the mother's side, but human parvovirus B19 was not detected at all. We are providing the socalledprophylactic visiting care for the two families, while giving them information about HS which is arelatively easily-misunderstood hereditary disease. We did not find any report about married coupleswith hereditary spherocythosis. In this paper, we report our findings so far obtained through visiting care with some bibliographic discussion on HS.
2.Study on Telomerase Activity in Bronchoalveolar Lavage Fluid.
Tadashi ARAI ; Yo YASUDA ; Yuji ITO ; Kazuyoshi HAYAKAWA ; Tadatake TAKAYA ; Satoshi TOSHIMA ; Chiken SHIBUYA ; Naoki YOSHIMI ; Yoshitomo KASHIKI
Journal of the Japanese Association of Rural Medicine 1997;46(4):679-682
Telomerase has been reported to increase its activity in more than 80% of human pulmonary cancer tissue samples, thus potentially contributing to cancer diagnosis. This led us to try the measurement of telomerase activity in bronchoalveolar lavage fluid in cases clinically suspected to be primary pulmonary cancer. Methodologically, the measurement was made by means of TRAP (telometric repeat amplification protocol) assay, a high-sensitivity assay system using the technique known as polymerase chain reaction (PCR). The resultsshowed that telomerase activity in all the 6 cases, diagnosed as primary lung cancer histologically, was positive. On the other hand, on cytologic examination, 4 out of these 6 cases were positive, and the remaining 2 cases (squamous cell carcinoma and adenocarcinoma) were negative. Histologic examination revealed that of these 4 cases, 2 and 2 were pulmonary cancers and pulmonary tuberculoses, respectively. The above results suggested that examination of telomerase activity in bronchoalveolar lavage fluid may be useful for cancer diagnosis clinically.
3.Three Cases of Myelodysplastic Syndrome. Importance of Microscopic Examination of Hemogram.
Kazuko KAWASHIMA ; Yo YASUDA ; Tadashi ARAI ; Yuji ITO ; Kazuyoshi HAYAKAWA ; Tadatake TAKAYA ; Chiharu MIYADA ; Satoshi TOJIMA ; Momoe DOI ; Masanobu NAGAI ; Chiken SHIBUYA ; Yoshitomo KASHIKI
Journal of the Japanese Association of Rural Medicine 1996;45(1):24-27
During the one-year period from April 1992 through March 1993, we measured 25, 498 blood samples by the use of a sequential multichannel autoanalyzer, which our hospital installed in August 1991. Of the total, 4, 707 samples were thoroughly examined under the microscope. They included those from the patients for which physicians indicated laboratory testing, those samples whose white cell counts were less than 3, 000/μlor more than 10, 000/μl, the cases in which the amount of hemoglobin was less than 10.0g/dl, and the samples which defied blood typing. The result was that three cases of myelodysplastic syndrome were detected, although the autoanalyzer failed to find any abnormalities in these three cases.
Laboratory technicians in hospital are so busy that they hardly have time enough for thoroughgoing examination of hemogram. Nevertheless, the recent experience has brought home to us the importance of a microscopic scrutiny, into hemogram and its application to diagnosis.
4.Histopathological Case of Uterine Carcinoid Tumor Metastasized to the Lung.
Satoshi TOSHIMA ; Yo YASUDA ; Tadashi ARAI ; Yuji ITO ; Kazuyoshi HAYAKAWA ; Tadatake TAKAYA ; Momoe DOI ; Chiken SHIBUYA ; Toshiya ITO ; Yoshitomo KASHIKI ; Naoki YOSHIMI
Journal of the Japanese Association of Rural Medicine 1999;48(1):48-53
With the diagnosis of metastatic tumor of the lung suspected, we had a chance to experience a histopathological case of carcinoma of the uterine cervix (adenoid squamous cell carcinoma), which was thought to coexist with carcinoid tumor. In this paper, we report the results of cytological as well as histological examinations of the case.
The patient was as 43-year-old woman. She visited our hospital, complaining about abnormally prolonged uterine bleeding (metrorrhagia). Cytodiagnosis was performed with a Papanicolaou smear. A microscopic examination revealed squamous cell carcinoma occurring together with adenocarcinoma. A similar finding was obtained by cervical biopsy. Thus, the case was diagnosed as adenoid squamous cell carcinoma.
Then the patient underwent radical hysterectomy and lymphadenectomy, followed by chemotherapy. After leaving the hospital, she was put under doctor-monitored observation. About 4 years after the surgery, a chest x-ray examination found abnormal shadows. For inspection, bronchoscopy was performed. Carcinoid of the lung was diagnosed through histopathological as well as electron microscopic examination of specimens taken from bronchial polyps during bronchoscopy. At the same time a cytologic study was conducted. It also revealed neoplasms strongly suspected of caricinoid tumors. Retrospective studies of cytological and histopathological images of the uterine cervix when the patient first visited us found only adenocarcinoma and squamous cell carcinoma, but no signs of carcinoid tumors. However, the immunohistological staining of NSE and chromoganins A, both neuroendocrine markers, showed positive findings in some adenocarcinomatous parts of the tissues of the unterine cervix. Therefore, we considered that the cervical cancer is compounded of adenoid squamous cell carcinomas and tumors having properties of neuroendocrine cells.
From this, we concluded that it is necessary to take into account a differential diagnosis of neuroendocrine tumors including carcinoid of the uterine cervix when less differentiated adenocarcinoma and squamous cell carcinoma are suspected in histological and cytological examinations. Furthermore, we thought it important to make a definite diagnosis after meticulous examinations by immunohistological staining and electron microscopy.
5.Fluctuations in Blood Pressure in Hemiplegic Patients Measured by Using Digital Compact Wrist Blood Pressure Monitor.
Norifumi WADA ; Yo YASUDA ; Tadashi ARAI ; Yuji ITO ; Kazuyoshi HAYAKAWA ; Tadatake TAKAYA ; Yukie NISHIOKA ; Sakiko TANIGUCHI ; Maki TSUJIMOTO ; Masaru IWAKOSHI ; Koichi MORII ; Yoshitomo KASHIKI
Journal of the Japanese Association of Rural Medicine 1999;48(2):152-155
With household digital compact wrist blood pressure monitors, blood pressure was measured in hemiplegic patients who were receiving kinesitherapy.
During the training program routinely worked out by physical therapists, most patients had shown elevated levels of both systolic and diastolic blood pressure. There were some patients whose blood pressure went up so high as to call doctors' attention.
As changes in blood pressure are affected by various factors, we cannot say at once that doing exercise alone adds to blood pressure. Nonetheless, by using a household blood pressure monitor, it would be easy to know the extent to which blood pressure rises in accordance with the amount of exercise, so that it would be possible to make patients and their family aware of the importance of blood pressure readings. We thought it possible to obtain an index of the amount of exercise at home.
6.What should we bear in mind when hosting webinars? Lessons learnt by the “Kansai Global Health” Friends of WHO Japan
Soichiro SAEKI ; Sayako YANAGISAWA ; Rie OGASAWARA ; Tadashi YASUDA ; Yasuhide NAKAMURA ; “Kansa Global Health” Friends of WHO Japan
Journal of International Health 2021;36(2):63-72
Introduction The Novel Coronavirus Disease 2019 (COVID-19) outbreak forced social events to be cancelled, and academic meetings were no exception. This has increased the need for online seminars (webinars), although, lack of knowledge or experience for hosting such events were prominent. We, “Kansai Global Health”, began preparing a series of webinars from March 2020 under the theme “COVID-19 and the Sustainable Development Goals (SDGs)”. We hereby report our experience and tips on what hosts should bearing in mind for academic webinars. Our Event Participants of Kansai Global Health were required to register prior to the webinar on Google Forms, where characteristics of the participants were subsequently obtained. Zoom software was used to create a YouTube livestreaming video for viewing. An online questionnaire was used to obtain feedback from the participants. Data analysis of the livestreaming was conducted with YouTube Analytics. The cumulative total of participants was 2083. Most were Japanese residents, but 69 participants registered from overseas such as Tunisia and Zambia. The majority of the participants were health professionals, with some non-health professionals and students. 85.7% of the participants rated the webinar satisfaction above four on a scale out of five. Comments from the participants were mostly positive, while some participants claimed some errors of the host members prior to and during the webinar. Lessons Learnt The satisfaction of webinars consisted not only of the contents but also of the quality of the hosts. These accidents could be avoided, or kept under control, with thorough preparations and rehearsals of the hosts discussing possible protocols under such circumstances and making good use of communication tools such as message applications. Adequate hosting techniques are essential for feasible discussions online. Global health webinars should improve hosting skills, as well as its contents, to create a future platform to conduct fruitful discussions.