1.Current Characteristics of Emergency Operations in Patients Aged 70 and Over.
Hideo TERASHIMA ; Tomio MATSUOKA ; Osamu USUBA
Journal of the Japanese Association of Rural Medicine 1993;42(1):11-15
In this study, disease aspects and background factors affecting prognosis were reviewed and analyzed in a total of 45 aged patients (≥70 years old) who had undergone emergency operations for acute abdomen.
1) Colorectal cancer accounted for 70 per cent of malignant disorders. All the colorectal cancer patients but one had non-curative operations.
2) The incidence of perforated appendicitis was high (58.7%) as in the past. But no great difference was found in clinical course between aged patients and younger patients.
3) Incarcerated hernia occurred only in females advanced in years (mean age: 80.6 years). All the patients with incarcerated hernia have been suffering from prolapse long since but they had not been informed that they were at risk.
4) Preoperative complications were found in 81.8% of all the cases. Arrythmia, hypertension, and diabetes were observed most frequantly.
5) The most common postoperative complication was pneumonia. Preoperative complications were well controllable and causead no serious postoperative complications.
6) The one-year uneventful survival rate was 93.5% in the patients without malignacy. We concluded that this percentage was satisfactory, considering that their mean age was 76.8 years. On the other hand, in the patients with malignancy, the establishment of medical check-ups for early detection of colorectal cancer would have resulted in better prognosis.
2.Clinical Study of Gastric Cancer Cases in the Southern Area of Akita Prefecture.
Tomio MATSUOKA ; Akira SUZUKI ; Hideo TERASHIMA
Journal of the Japanese Association of Rural Medicine 1991;40(2):89-97
A total of 1, 236 cases of gastric cancer operated at Hiraka general hospital during the 14 years from 1975 to 1988, were analyzed and the following results were obtained.
1. There was a distinct tendency to increase in the numbers of early-staged cancer cases and patients over 70 years of age.
Any decrease in the number of operated gastric cancers could not be obeseverd during this period.
2. The ratio of patients aged over 70 years increased to reach 26.4% recently and the ratio of early staged cancer increased to 59.3% in 1988.
3. The over all resection rate was 90.8% and curative resection was performed in 85.2% of resected cases.
4. The cumulative 10-year survival rate in curative resected cases was 74.0%.
5. The rate of the multiple cancer cases was as high as 5.0%.
3.Clinical Study of Colorectal Cancer Cases in the Southern Area of Akita Prefecture.
Tomio MATSUOKA ; Akira SUZUKI ; Hideo TERASHIMA
Journal of the Japanese Association of Rural Medicine 1991;40(2):98-106
A total of 417 operated cases of colorectal cancer at Hiraka General Hospital during the 15-year period from 1974 to 1988 were analyzed and the following results were obtained.
1. There was a distinct tendency to increase in the numbers of resectable cases. By region, cases of cancers in sigmoid colon and upper third of rectum (S+Rs) and right side colon (C+A) were on the rise.
2. The ratio of patients aged over 70 years increased to reach 36 % recently. But the ratio of early stage cancer cases was 7.1 % on the average.
3. The over all resection rate was 90.6 %, and curative resection was performed in 78.5 % of colon cancer cases and 82.0 % of rectal cancer cases respectively.
4. The cumulative 10-year survival rate in curative resected cases was 74.7 % for colon cancer and 70.8 % for rectal cancer.
5. The rate of multiple cancer cases was as high as 13.4 %.
4.A Study of Health Problems and Different Types of Agricultural Production
Takeshi Sugaya ; Shigeki Hayashi ; Masato Hayashi ; Tomio Matsuoka ; Shunji Okubo ; Akira Kotanagi
Journal of the Japanese Association of Rural Medicine 1983;32(2):65-71
A study was made to elucidate growing health problems confronting women in rural communities today amidst drastic changes in agriculture.
From the standpoint of production structure, the area covered by our survey was divided into single-crop (paddy-rice), paddy-rice and fruits (apple), paddy-rice and water melon, and fishing village districts. In each of these districts, we conducted a survey by the use of a questionnaire and a health examination.
1, About 45 to 70 % of women engaged in farming complained that they could not take enough time to sleep. Especially in the paddy-rice and water melon producing district, the percentage was high.
2. Female farmers who complained of pains in the legs and the lower part of the back accounted for 40-60 % of the total. The rates were high in the rice producing district, and the paddy-rice and water melon producing district. This is probably due to the nature of farm work. However, the cause of the complaints was not always clear in the paddy-rice district.
3. Depending on the working postures (work on the stepladden in the orchard, work on hillsides, work in the supine position, etc.), the ailing region they complained about differed.
4. Those women who take care of supplementary work when machines are employed said that they feel they are subordinate to mechnization.
5. When pesticides are used, 10-20 % of the subjects showed toxic symptoms. In the paddy-rice and apple growing district, high ratios were recorded.
6. Of the total, 52.7 % were found negative in the mass health screening. The rate was the highest in the paddy-rice and water melon producing district.
7. The obesity rate rose in proportion to the rise in age.
8. The incidence of hypertension (WHO criteria) was the lowest in the fishing community, followed by the paddy-rice and apple district, and the rice producing district in that order.
9. As regards the hemoglobin level, those who showed less than 12.0 g/dl accounted for 11 to 32%. The level was lowest in the paddy-rice and apple producing district, followed by the paddy-rice district and the fishing village. There were few who need medical treatment immediately.
10. Abnormality of liver function was found among some 5 % of the examined. Serum cholesterol levels were lower in the paddy-rice district than in the other districts.
5.Results of mass screening for breast cancer in rural districts of Akita prefecture.
Akira Suzuki ; Hironori Kato ; Susumu Kishibe ; Yuji Ono ; Cho Morooka ; Kazuhiko Takano ; Tadanobu Watanabe ; Tomio Matsuoka ; Toshio Ikeda ; Takeshi Sugaya
Journal of the Japanese Association of Rural Medicine 1985;34(4):803-807
This present study was conducted among the nine centers of Akita prefectural Welfare Federation of Agricultural Cooperatives. This applied to women over 30 years of age, and carried out following to the standard method of the Japan Cancer Society.
The total of women examined by the first screening from April 1983 to January 1985 amounted to 15903, of which the number of women over 60 years of age was only 7 per cent of the total. According to the type of screening, the number of women slightly more in the center screening than in the local screening. However, in both types of screening, the number of women examined by the combination method, for example, anemia or uteric cancer, was much higher than that of the mass screening for breast cancer alone.
The second screening rates indicaded a marked difference of 0.4 to 21.7 per cent depending on the location of the center. The over-all average for the second screening was 3.8 per cent. As a result of the second screening, breast cancers were detected in 12 cases (0.07%). The breast cancer detection rate increased with age. It is notable that the breast cancer detection rate for women over 60 years of age was 5 times higher than for women over 40 years of age. Among other diseases detected in the second screening were mastpathy (233 cases), fibroadenoma (15 cases), mastitis (40 cases) and others.
As far the stage distribution and screening history for detected breast cancers, 60 per cent of all cancer cases were diagnosed as stage I, and 70 per cent were the initial screening. Seven out of 12 cases were aware the breast lump themselves before the first screening. From this point of view, it was suggested that every women should be educated in order to perform selfexamination.
6.Primary health care in a rural district, Akita prefecture.
Takeshi SUGAYA ; Masato HAYAHI ; Shunji OKUBO ; Kimio SAITO ; Kenichi HOSOYA ; Tomio MATSUOKA ; Akira KOTANAGI ; Takashi SATO ; Kenkichi TAKISAWA ; Seiko ISHINARI
Journal of the Japanese Association of Rural Medicine 1987;36(2):79-84
Investigation was made into the health care conditions in a rural district in Akita Prefecture. Topographically, the district is divided into two parts-one characterized by mountain and the other by flat terrain.
1. In remote, depopulated villages, per capita cost of public health is on the increase.
2. The number of health personell, particularly public health nurses, is not enough to carry on various health programs.
3. With the prospect of greater numbers of the aged in society, there is an urgent need for increased medical services along with the consolidation of primary health care. In order to meet the need, it is necessary to establish a regional community health system comprised of a hospital as a nucleus and neighborhood medical instituions such as clinics and health centers.
7.Studies on Low Back Pain Caused by Agricultural Work in Flat Villages of South District in Akita Prefecture and by Work of Fisherman in a Fishing Village in Iwate Prefecture
Takeshi Sugaya ; Shigeki Hayashi ; Masato Hayashi ; Tomio Matsuoka ; Atsuro Yoshizumi ; Shinji Okubo ; Hiroshi Kitahara ; Kazuhiro Watanabe ; Yukio Ito ; Akira Kotanagi
Journal of the Japanese Association of Rural Medicine 1983;32(4):817-826
As regards to low back pain of agricultural worker, there are many problems still as to a syndrom of “Nofusho” in rural medicine, a disease in ocupational medicine and clinic of orthopedic.
Agricultural worker who complained of low back pain varies with their country and farm products, and it tend to increase with adding to their age. Further, the female rate of low back pain showed slightly high tendency than the made rate, 8.5-12.5 % of male, 6.5-13.4 % of female always complained of low back pain.
According to the findings of roentogenographic examination of back bone, the deformed vertebrae was found clearly, especially, low back pain caused by a trauma of soft tissue and iscogenic pain showed in farmers. Therefor, it is necessary to be improved working posture and condition.
In comparrison with non-farmer, it is located in order of truck drivers. bus drivers and repairmen.
8.Health problems of women in mixed-farm households.
Takeshi SUGAYA ; Masato HAYASHI ; Shunji OKUBO ; Kimio SAITO ; Tomio MATSUOKA ; Shunichi OKABE ; Kazuhiro WATABE ; Shiro SASAKI ; Akira KOTANAGI ; Takashi SATO ; Seiko ISHINARI
Journal of the Japanese Association of Rural Medicine 1985;34(2):129-133
Investigations were made into the actual working and living conditions of adults, both men and women, in the families engaged in mixed farming.
The working conditions were analyzed according to the types of crops farmers are growing. The work study was necessary to probe into the causes of farmers' health disturbances.
A questionnaire revealed that farmers are short of sleep during the busiest season. Especially housewives are forced to cut down on their sleeping hours.
It also found that some farmers spray pesticides in quantity and expose themselves to the potentially health injurious chemicals with alarming frequency.
There was evidence to show that some ailments, notably low back pain, had been reduced due to imporovements on farmwork and working environment.
Health checkups showed that the incidences of hypercholesterolemia and obesity remain high. There was imbalance between carolic intake and consumption.