Objective : To examine the relation between psychoactive drugs and the outcome of dysphagia in patients with psychiatric disorders. Methods : We examined 53 inpatients who were prescribed speech therapy in the psychiatry ward of our hospital from January 2011 to April 2012. We categorized the patients into a poor outcome group and a good outcome group by the necessity for alternative nutrition at discharge and analyzed the number and kind of typical antipsychotic, atypical antipsychotic, hypnotic, antidepressant and mood stabilizer, total amount of typical antipsychotic, atypical antipsychotic used at admission and at discharge, sex, psychiatric disorder, central nervous system disease, aspiration pneumonia, duration of hospitalization, psychiatric disorder disease period, speech therapy intervention period and GAF scale at admission. Results : The outcome of dysphagia had a significant relation with the number and kind of antipsychotic used, especially typical antipsychotic used at admission. The good outcome group had a higher total amount of antipsychotic use, especially atypical antipsychotics. Conclusion : Long-term practical oral intake should not comprise antipsychotic polypharmacy, especially typical antipsychotics before onset of dysphagia, but should instead consist of a monopharmacy approach with atypical antipsychotics.

The evaluation of coronary arteries has become easier, with regard to postoperative coronary artery bypass grafting (CABG) evaluation through the development of multidetector computed tomography (MDCT). In this study, MDCT and coronary angiography (CAG) were performed for graft assessment after CABG, and the usefulness and assessment capability of MDCT were examined. We examined the morphology of graft stenosis and obstruction in 63 cases (51 men, 12 women, mean age 66 years old) in whom comparison by MDCT and CAG was possible. We used 49 grafts for LITA and 65 grafts for SVG (mean number of anastomoses 2.8). The graft evaluation was possible in all cases in CAG, but it was difficult to evaluate due to artifacts in 5 cases in MDCT. MDCT is less invasive than CAG and is useful for early postoperative assessment of CABG. Also, MDCT allows evaluation of the anastomotic region which can be difficult to evaluate from many directions in CAG, by building an image by the VR, MIP and MPR method. It was particularly useful for evaluation of the form of the whole graft and anastomotic region form by the curved MPR method. Further advance in the evaluation of coronary and bypass graft will depend on future developments in scaning methods and instrument improvements.

Introduction : This study aimed to clarify the relationship between the presence of someone to care for and the subjective QOL (quality of life) of local elderly people.
Methods : Data for 7,728 residents aged 65 and above was obtained from the everyday life sphere needs survey implemented by the government of Nanto City, Toyama Prefecture, between May to July, 2014. Multiple logistic regression analysis was conducted to evaluate the relationship between two sets of variables : first, the presence (or absence) of “something to live for”, “sense of fulfillment”, and “self-esteem” as indicators of the respondents'subjective QOL ; and second, a set of explanatory variables (common to all models) including the presence of someone to care for, indicators of the personal attributes, health, and life style of the respondents.
Results : The presence of someone to care for was positively related to the presence of “something to live for,” “sense of fulfillment,” and “self-esteem,” which were indicators of subjective QOL, even after several indicators of personal attributes, health, and life style were accounted for.
Conclusion : Promoting mutual help in local areas has a positive significance for those elderly who take care of others, as well as for those who accept care. The results also suggest the social importance of being the recipient of care in the elderly.

Background: Urosepsis is a potentially fatal syndrome that is sometimes difficult to diagnose. Thus, the aim of the present study was to clarify the clinical and laboratory characteristics and pitfalls in the diagnosis of urosepsis.
Methods: We enrolled the study participants based on clinical records of patients with urosepsis treated between January 2009 and April 2012 inclusive, in the Department of General Internal Medicine, Toyama University Hospital and retrospectively surveyed underlying diseases, clinical symptoms, physical findings, and laboratory data, respectively.
Results: Ten definitive patients were selected (nine females and one male; age, 55–86 years). Fever was the most frequent symptom followed by nausea. Lower back pain was the chief complaint in only two patients. One patient complained of dysuria, and on examination half of the patients lacked costovertebral angle (CVA) tenderness. Five patients showed elevated liver enzymes without evidence of hyperbilirubinemia.
Conclusions: There were no specific clinical characteristics of urosepsis, and symptoms in some patients resembled digestive diseases such as cholangitis. Our results demonstrate that use of dipstick urinalysis and microscopic urinalysis are essential for the diagnosis in patients with sepsis. Abdominal ultrasonography and/or computed tomography should also be considered to rule out false negative results of urinalysis related to urinary tract obstruction, and to detect other focal infections when appropriate.

OBJECTIVESThe aim of this study was to compare the risk for cancers of A-bomb survivors in the ongoing life span study (LSS) with unexposed groups consisting of the entire populations of Hiroshima prefecture and neighboring Okayama prefecture.

METHODSThe subjects consisted of the Hiroshima group reported in LSS report 12 (LSS-H group) and a control group (the entire populations of Hiroshima and Okayama-HPCG and OPCG, respectively). We estimated the expected number of deaths due to all causes and to cancers of various causes among the exposed survivors of the Hiroshima bombing in the LSS report 12 who died in the follow-up interval at ages similar to those of people in Hiroshima and Okayama prefectures who were aged 0-34 years at the time of the bombing in 1945. We compared the standardized mortality ratio (SMR) of the LSS-H group to that of the HPCG and OPCG (SMR-H and SMR-O, respectively).

RESULTSEven at low and very low dose categories, the SMR-H and SMR-O were significantly high for all deaths, all cancers, solid cancers, and liver cancers in male subjects, and for uterus and liver cancers in female subjects, respectively. The results show that, if the dose estimations of the dosimetry system 1986 (DS86) are correct, there are significantly increased risks of cancer among even survivors exposed to the very low dose level.

CONCLUSIONSThe dose assumptions of DS86 have been criticized for underestimating doses in areas distant from the hypocenter. The contribution of residual radiation, ignored in LSS, and that of neutrons, underestimated by DS86, is suggested to be fairly high.

Methods: Preoperative CT data from 26 patients pertaining to adult spinal deformities were investigated in this study. We applied a 3D image processing method for a detailed investigation. Virtual cylinders were used to mimic SAI screws. These were placed to penetrate the sacral iliac joint without violating the other cortex. We then assessed the trajectory of the longest SAI screw and the ideal entry point of SAI using a color mapping method on the surface of the sacrum. We measured the location of the nerve root at S1 in relation to the foramen at S1 and the sacral surface. Results: As per the results of our color mapping, it was determined that areas that received high scores are located medially and caudally to the dorsal foramen of S1. The mean angle between a horizontal line and a line connecting the medial edge of the foramen and nerve root at S1 was 93.5°. The mean distances from the dorsal medial edge of the foramen and sacral surface to S1 nerve root were 21.8 mm and 13.9 mm, respectively. Conclusions The ideal entry point of the SAI screw is located medially and caudally to the S1 dorsal foramen based on 3D digital mapping. It is also shown that this entry point spares the S1 nerve root from possible iatrogenic injuries.

Japanese version of the Constitution in Chinese Medicine Questionnaire (CCMQ-J) in Chinese consists of 60 items for 9 sub-scales called Gentleness, Qi-deficiency, Yang-deficiency, Yin-deficiency, Phlegm-wetness, Wet-heat, Blood-stasis, Qi-depression, and Special diathesis. Each question is answered by choosing one form 5 grades of a Likert scale where the grades from 1 to 5 corresponding to Never, Rarely, Sometimes, Often and Always, respectively. In the present study, we examined the relationship of scores based on 597 respondents to 60 items. We tentatively classified 60 items into 12 groups by utilizing the Ward’s hierarchical clustering method and discussed similarity of items and 9 body conditions. Body Mass Index (BMI) and age can be explained by the score of 60 items by partial least square model. Significantly high correlation coefficients between real and estimated values were obtained for BMI (0.81 for male and 0.82 for female) and age (0.82 for male and 0.83 for female). Those results indicate that the answers to the 60 items can reflect aging and BMI properties and CCMQ-J can be used to assess the situation of health for evaluating the actual aging conditions in human.