1.A Survey on Incidence of Cerebral Apoplexy in Saku District, Nagano Prefecture, and Follow-up Study (Report I)
Koji Isomura ; Atsushi Takahashi ; Takako Yokoyama ; Michiko Iide ; Sawa Tanaka ; Reiko Tajima ; Mieko Nakazawa ; Taeko Usui
Journal of the Japanese Association of Rural Medicine 1975;24(2):69-76
A survey has been under way on the incidence of cerebral apoplexy among the inhabitants (pop. 105, 185, National Census, 1970) of the Saku district of Nagano Prefecture since April 1972.
This survey, which constitutes a WHO cooperative study, has been under way with cooperation rendered by the local Medical Association, Association of Public Health Nurses in Saku District and Saku Public Health Center with the Saku Central Hospital acting as the survey center.
In the period of two years till March 1974, 585 persons were registered as having been seized with cerebral apoplexy. The annual incidence rate stood at 265 per 100, 000 population. Classified by types of cerebral apoplexy, cerebral hemorrhage accounted for 26%, cerebral thrombosis for 57%, cerebral embolism for 3%, subarachnoid hemorrhage for 9%, and other types for 5%.
By sexes, the incidence rate among males was 1.3 times higher than among females. By ages, the incidence was highest in the seventies.
When the prognosis of cerebral apoplexy is viewed in terms of deaths in the early period of less than three weeks after the onset, the mortality rate stood at 45%.
The hospitalization rate of patients seized with cerebral apoplexy was 55%. There was a significant difference in the mortality rate between inpatients (with 28%) and outpatients (65%).
The ratio of concurrence of autopsy and clinical diagnosis stood at 83% with Okinaka's criteria and 79% with Ikeda's CVD index.
The incidence of hypertension before the onset of cerebral apoplexy was extremely high among the patients seized with cerebral hemorrhage and cerebral infarction.With respect to the treatment of hypertension, the discontinuance of treatment and the failure to undergo it are high in percentage among the patients seized with cerebral hemorrhage. With reference to cerebral infarction patients of 70 years and older in age, there is little defference between the group who discontinued or failed to undergo treatment and the group who underwent it.
The recurrence of cerebral apoplexy stood at 11% for cerebral hemorrhage, 19% for cerebral infarction, and 11% for subarachnoid hemorrhage.
2.Clinical Effects of Beamtherapy "Xe" for Low Back Pain.
Taeko TAKAHASHI ; Kenichi MIHARA ; Toshifumi TARAHARA ; Hiroshi ENDO ; Cai Yuan WANG
Journal of the Japan Society of Acupuncture and Moxibustion 1993;43(2):87-92
Xenon beam wide wave-length including ultraviolet, visible and ultrared rays.
What effects are produced for the human body by using xenon beam effective on the removal of the living body pain?
After patients suffering from low back pain were radiated by xenon beam, their finger-floor distances were measured.
It was examined and compared with the results after using micro wave therapy.
As a result, in xenon beam therapy group, the more the number of times of stimulation was, the shorter the finger-floor distances became gradually, and after more than five times of stimulation, shortening of them was apparent (p<0.01).
Moreover it was known that shortening could be kept in xenon beam therapy group.
3.Treatment of Scapulohumeral Arthropathy with Impairment of ROM using Xenon rays.
Kenichi MIHARA ; Taeko TAKAHASHI ; Cai Yuan WANG ; Hiroshi ENDO ; Toshifumi TARAHARA
Journal of the Japan Society of Acupuncture and Moxibustion 1993;43(2):93-97
Xenon photorays are incoherent waves like the sun rays, but it shows a bright line spectrum. Each bright line exhibits a form similar to the laser spectrum waves. The microwaves have been conventionally used to deliver stimulation to the deep tissues. The effects of the xenon photorays and microwaves on the range of motion in scapulohumeral periarthritis were compared.
Our findings indicated that xenon photorays were superior to the conventional microwaves in bringing about improvement of the range of motion in scapulohumeral arthropathy.
4.Successful elimination of intractable anal pain associated with rectal cancer by combination of subarachnoid phenol block with sacral nerve root thermocoagulation
Tomoharu Funao ; Ichiro Hase ; Yuriko Kodani ; Motoko Shimizu ; Taketo Nakamura ; Ryota Takahashi ; Taeko Miyata ; Akira Asada
Palliative Care Research 2010;5(2):314-316
Purpose: We report a case whose anal pain accompanied by rectal cancer was remarkably eliminated by subarachnoid phenol block and sacral nerve root thermocoagulation. Case Report: The subject was a sixty-one-year old male. His anal pain failed to respond to opioid whereas his pain was alleviated by subarachnoid phenol block, but was exacerbated a few weeks later. This relapsing pain was completely eradicated by sacral nerve root thermocoagulation. Conclusion: Anal pain associated with rectal cancer recurrence of pelvic space is sometimes hard to be controlled only by subarachnoid phenol block, but there is a possibility of pain control by combination use with sacral nerve root thermocoagulation. Palliat Care Res 2010; 5(2): 314-316
5.Use of One-step Nucleic Acid Amplification® and ultrasonography to predict metastasis in non-sentinel lymph node in breast cancer
Taeko KANAMORI ; Satoru FURUTA ; Youko SANADA ; Sho YAGI ; Kazuhiro ISHIHARA ; Harumi TAKAHASHI ; Atsuko YAMADA ; Hidenori TANAKA ; Satoru YAMAMOTO
Journal of the Japanese Association of Rural Medicine 2016;64(6):1049-1053
Although axillary lymph node dissection (ALND) is conventionally indicated for metastasis in the sentinel lymph node (SLN), the omission of ALND is being discussed more often in recent years. However, because of the lack of specific guidelines, it is unclear which cases should be treated without ALND. In this study, we performed one-step nucleic acid amplification of the SLN with metastasis to determine the total tumor load (TTL), that is, the number of cytokeratin (CK) 19 mRNA copies. After ultrasonography (US) of ALN, the ultrasonographic findings were combined with TTL to rate SLN metastasis. In the rating, a total score was obtained by assigning 1 point each for (a) TTL of ≥15000 copies/μL, (b) US findings of a long-to-short LN diameter ratio of ≤2, and (c) US findings of no echogenic hilus. We then investigated the association between the total score and metastasis in the non-SLN. Results showed that while 87.5% (5/6) of patients with positive non-SLN scored ≥2 points, only 3.1% (1/34) of patients with negative non-SLN did so, suggesting that a total copy number of CK19 mRNA, US findings of a long-to-short LN diameter ratio, and the presence/absence of echogenic hilus are important predictors for non-SLN metastasis. This novel scoring system is expected to help determine which patients need ALND or what postoperative therapy is necessary.
6.In Search of a Way of Obtaining Informed Consent Inpatients' Replies to a Qestionnaire on Medical Care.
Tokuko Ito ; Michiko Migiya ; Ayako Konda ; Kyoko Matsui ; Keiko Sato ; Mitsuko Terui ; Sakuko Kume ; Taeko Sasaki ; Hamako Kato ; Ritsuko Takahashi ; Kimi Suzuki ; Shunji Ohkubo ; Shigeru Matsumoto
Journal of the Japanese Association of Rural Medicine 1994;43(1):33-35
High-quality terminal care cannot be given without good communication and understanding among patients, their family members and health as well as medical professionals.Recently, we have taken a questionnaire survey on new inpatients in our hospital to sound them out on their thinkings about hospital care, and examined the findings along with the validity of survey.Many respondents including those contracting either benign or malignant diseases wished to be keptposted on what they are really up against and to partake in the decision-making process before treatment plans are put into practice. The recent questionnaire survey has proved to be worthwhile as a tool to know the wishes of hospitalized patients and suggested an effective way to promote the practice of obtaining informed consent before specific test and therapautic procedure.
7.Clinical Efficacy and Safety of Arbekacin against Pneumonia in Febrile Neutropenia: A Retrospective Study in Patients with Hematologic Malignancies
Takashi OHASHI ; Yukiyoshi FUJITA ; Hiroyuki IRISAWA ; Hidemasa NAKAMINAMI ; Takahiro ARAI ; Masumi TAKAHASHI ; Emi MOMIYAMA ; Naoya MURATA ; Kayoko MURAYAMA ; Taeko SAITO
Infection and Chemotherapy 2022;54(1):80-90
Background:
Arbekacin (ABK) is an aminoglycoside that exhibits anti-methicillin-resistant Staphylococcus aureus (MRSA) and anti-Pseudomonas aeruginosa activities. Therefore, for patients with febrile neutropenia (FN) and concurrent pneumonia suspected to be caused by MRSA, ABK may be sufficiently effective even as a single agent.
Materials and Methods:
Patients with hematologic malignancies treated with ABK who met the following criteria were included: 1) fever during neutropenia or functional neutropenia, 2) FN complicated by pneumonia, and 3) possible infection by antimicrobial-resistant Grampositive cocci.
Results:
This study encompassed 22 episodes involving 19 patients, of which, 15 (68.2%) were successfully treated with ABK. Of the nine episodes showing inadequate response to other anti-MRSA drugs, eight were successfully treated with ABK. Grade 2 or worse adverse events included acute kidney injury (13.6%) and increased transaminase levels (9.1%).
Conclusion
The present study demonstrated that ABK is effective and safe in patients with FN and concurrent pneumonia caused by antimicrobial-resistant Gram-positive cocci. ABK may also be effective in patients who are unresponsive to other anti-MRSA drugs. Therefore, ABK may be beneficial in the treatment of pneumonia caused by antimicrobial-resistant Gram-positive cocci in patients with FN.