Mamushi is a species of pit viper distributed throughout Japan excluling the Ryukyu Islands and sighted from spring to autumn. It is estimated that about ten people dies in a year. It is important in the rural medicine because a lot of people are bitten in mountains and fields. A total of 35 cases of mamushi viper bite were treated from 1999 to 2006 in our hospital. The patients were 17 men and 18 women ranging in age from 7 to 80 years old (average: 60). Local swelling and pain were manifest in all the cases. Sixteen patients had systemic symptoms, and toxic effects commonly appeared in the eyes. The blood tests revealed elevated CPK levels in 24 patients (69%). The elevation correlated to the seriousness of the clinical symptoms. In accordance with our manual for mamushi viper bites, all patients were hospitalized after incision for exclusion of the toxin. The median length of time before the worst symptoms began to subside was 3 days. The median length of hospitalization stays was 7 days. It took long before the patients fully recovered. The severity of envenomation was different from patient to patient and one case needed intensive care. The median of treatment period was 31 days. The quick and appropriate primary care for the mamushi viper bits is important to prevent serious complications.
Median Statistical Measurement ; symptoms <1> ; Agkistrodon halys blomhoffi ; Clinical ; Cases

Recently the evaluation of health-related quality of life (QOL) in cancer patients has become important in carrying out a treatment strategy. During a period between June and August 2004, we studied the QOL in 16 breast cancer patients with or without chemotherapy. The regimens of chemotherapy were EC (n=6), AT (n=1) and CMF (n=1). We made the Functional Assessment of Cancer Therapy Scale-General (FACT-G) in all patients. The patients treated without chemotherapy were superior to those with chemotherapy with respect to physical and emotional well-being (p<0.05). There were no differences in social well-being and relationship to families between the two groups. The patients treated without chemotherapy made significantly higher scores in the basic activities of daily living than those with chemotherapy (p<0.05). Compared with patients receiving chemotherapy, patients treated without chemotherapy had better quality of life (p<0.05). We concluded that it was important for us to assist in decision making about treatment and supportive care needs.
Chemotherapy-Oncologic Procedure ; lower case pea ; Lower case en ; Malignant neoplasm of breast ; Pulmonary evaluation

Recently, the incidence of pulmonary embolism (PE) after surgery began to increase in Japan and to prevent PE has become essentially important. During the period between July 2003 and August 2004, we placed 203 general surgical patients under our perioperative management using intermittent pneumatic compression (IPC) and compression stockings (CS). We evaluated the effect of our management on the prevention of postoperative PE in those patients. The incidence of PE, prognosis, complications, patient's complaints, cost-benefit were examined. No fatal PE occurred. One patient with low SpO2 had a chest pain and dyspnea but pulmonary scintigrams revealed no PE. Two other patients had contact dermatitis by CS and another patient using an epidural catheter suffered temporary paraplegia after heparin injection. The government has approved a fee for PE prophylaxis since April 2004. Our management using IPC and CS for PE prophylaxis after surgery proved to be an effective in reducing the risk of PE. However, we must take the atmost care in injecting heparin into patients with epidural catheters.
cisplatin/etoposide protocol ; Pulmonary Embolism ; Postoperative Period ; Patients ; Cesium

Hemodialysis patients need to acquire exercise habits because physical inactivity in hemodialysis patients is associated with increased mortality. However, factors associated with exercise habits in hemodialysis patients are unknown. The purpose of this study was to investigate the factors related to exercise habits in hemodialysis patients. We measured 104 hemodialysis patients' exercise habits (transtheoretical model：TTM), laboratory data, self-efficacy (SE), short physical performance battery and grip strength, nutritional index, dialysis vintage, fluid removal, and Kt/V. Multiple linear regression analysis was carried out to assess the association of the aforementioned factors with TTM. As a result, in multiple linear regression analysis, SE, age, and Kt/V were associated with TTM (R2＝0.34, p＜0.05). hemodialysis patients may require mental support, such as SE and adequate dialysis dose, to acquire exercise habits.

Hemodialysis patients need to acquire exercise habits because physical inactivity in hemodialysis patients is associated with increased mortality. However, factors associated with exercise habits in hemodialysis patients are unknown. The purpose of this study was to investigate the factors related to exercise habits in hemodialysis patients. We measured 104 hemodialysis patients' exercise habits (transtheoretical model：TTM), laboratory data, self-efficacy (SE), short physical performance battery and grip strength, nutritional index, dialysis vintage, fluid removal, and Kt/V. Multiple linear regression analysis was carried out to assess the association of the aforementioned factors with TTM. As a result, in multiple linear regression analysis, SE, age, and Kt/V were associated with TTM (R2＝0.34, p＜0.05). hemodialysis patients may require mental support, such as SE and adequate dialysis dose, to acquire exercise habits.