In April, 2006, we made and distributed the pamphlet entitled “Declaration for safety measures in medical services.” Because we thought that sharing with patients in the safty target could lead to create a safe environment in the hospital.To make certain whether inpatients and nurses understood and practiced the declaration, we took a questionnaire survey. The results showed that about 90% of the medical staff and inpatients understood the declaration and thought it worked out well. However some of the medical staff answered that they thought it did not work out. We felt the necessity to educate the medical staff thoroughly. Moreover, we found out differences in the recognition between medical staff and patients. For example, medical staff wonders if they mistake the contents of injections. But most of patients worry about pain.The medical staff is always working nervously and anxiously. However, there arequite a few cases in which complaints or disputes result from insufficient understanding by patients although medical staff thought that it was checked and explained.We are now working on safety measures reflecting patient's opinions.
Safety ; seconds ; Work ; Patients ; participation

Objective : To examine the association between the combination therapy of calcium antagonists with angiotensin converting enzyme (ACE) inhibitors and underlying diseases for hypertensive patients.
Design : Cross-sectional survey of the drug utilization.
Methods : This survey included 603 hypertensive patients who had visited Toyama Medical and Pharmaceutical University Hospital, Toyama, Japan more than twice from January to June in 1996 and received the prescriptions of calcium antagonists and/or ACE inhibitors. Main outcome measure was the combined medication of calcium antagonists with ACE inhibitors. Underlying diseases under consideration were diabetes mellitus (DM), hyperlipidemia (LIPID), ischemic heart disease (IHD), chronic heart failure (CHF), and ischemic stroke (STROKE).
Results : Out of 603 hypertensive patients, 57.5% received only calcium antagonists, 23.7% received only ACE inhibitors, and 18.7% received both of them. Patients with either IHD or CHF tended to receive the combination therapy as compared to DM or LIPID. Although men tended to receive the combination therapy, a gender effect might be a confounder for the association. Logistic regression showed a 33% increase (P=0.265) in frequency of the combination therapy in patients with IHD after adjusting for age and gender.
Conclusion : Some underlying diseases were associated with more frequent prescriptions of the combination therapy for hypertensive patients, especially with ischemic heart diseases. This result should be regarded as an exploratory stage although the pattern of antihypertensive drug use could be reasonably explained from the pharmacological sense.

We performed dietary guidances for 15 male elite athletes (23±3 years of age) participating a training program for vigorous endurance run. Nutrient allowances for the athletes were determined by the guidelines of Japanese Dietary Allowances (5 th ed.), considering their physical activities at the highest level IV; total energy 3, 500 kcal, protein 140g, lipid 100g, carbohydrate 510g, calcium 1, 500 mg, iron 25 mg, vitamin A 8, 000 IU, thiamine 4.0 mg, riboflabin 5.0 mg and vitamin C 200 mg per day. We also developed food group allowances for the athletes based on their nutrient allowances and current young-aged Japanese dietary styles ; cereals 400 g, potatoes and starches 60 g, sugars 20 g fats and oils 30g, pulses 120g, meats 150g, fishes and shellfishes 150g, eggs 80g, milks 600g, green and yellow vegetables 300 g, the other vegetables 350 g, fruits 400 g and algae 20 g per day. For the experimental period of 45 days, daily diets adjusted to approximate 120% of the dietary allowances were served to the athletes who were free taking snacks and drinks. Dietary guidances for the athletes were assessed by monitors of their dietary intakes, physical constitution and clinical examinations in blood. Means of the dietary intakes of the athletes were 96-99% of the dietary allowances, determined by a nutritional survey with the 24 hrs recall method. There were less changes in the physical constitution of the athletes before, during and after the experimental period; body weight 57±2 kg and body fat 8.8 ± 2.4%. Values of the clinical marks in the blood of the athletes were maintained normally for a half year including the experimental period; red blood cells 507±9×104 cells/mm3, hemoglobin 15±0.4g/dl and hematocrit 46.6±0.7%.
It is concluded that suitable nutritional guidances and managements for young-aged male vigorous endurance runners lead good in their health and physical maintenances, which may have important consequences for their physical development as elite athletes.

We investigated biochemical and morphological changes in electrically stimulated gastrocnemius muscle of rats fed normal (20% casein) and low-protein (5% casein) diets. Tissue weight and protein content per tissue weight of gastrocnemius muscle were significantly decreased in rats fed 5% casein diet than in rats fed 20% casein diet. Immunohistochemically, cathepsin B antigen was detected in inflammatory cells, and injured sites determined immunological intensity of anti-cathepsin B were lower in 5% casein diet group than 20% casein diet group. Electron microscopically, there was delayed repairment of muscle components (sarcometric units) in 5% casein diet as compared with that in 20% casein diet group.

BACKGROUND: The prognosis of recovery following microneurosurgery for injured lingual nerves varies among individual cases. This study aimed to investigate if recovery ratios of sensory and taste functions are improved by the microneurosurgery within 6 months after lingual nerve injury. METHODS: We retrospectively assessed 70 patients who underwent microneurosurgery at the Wakayama Medical University Hospital for lingual nerve injuries between July 2004 and December 2016. Sensory and taste functions in lingual nerves were preoperatively evaluated using a static two-point discrimination test, an intact superficial pain/tactile sensation test, and a taste discrimination test. They were evaluated again at 12 and at 24 months postoperatively. The abundance ratio of Schwann cells in the excised traumatic neuromas was analyzed with ImageJ software following immunohistochemistry with anti S-100β antibody. RESULTS: In early cases (microneurosurgery within 6 months after the injury), recovery ratios of sensory and taste functions were not significantly different at 24 months after microneurosurgery compared with later cases (microneurosurgery more than 6 months after the injury). Meanwhile, the ratio of patients with taste recovery within 12 months after microneurosurgery was significantly decreased in late cases compared with early cases. The abundance ratio of Schwann cells in traumatic neuroma was also significantly lower in later cases. CONCLUSION Microneurosurgery more than 6 months after lingual nerve injury did not lead to decreased recovery ratio of sensory and taste functions, but it did lead to prolonged recovery of taste. This delay may be associated with a decrease in the abundance ratio of Schwann cells in traumatic neuromas.

Purpose：A new simple and noninvasive stretch sensor (STR) has been developed to detect chest wall motion for respiratory rehabilitation. The purpose of this study was to investigate the validity of chest wall motion measurements obtained using the new stretch sensor.Methods：Twelve healthy male volunteers wore three different sensors (STR, respiratory inductance plethysmography [RIP], and flowmeter) while they performed the testing protocol, which included natural breathing (120 s), deep breathing (60 s), and polypneic (60 s) and apneic (30 s) conditions in the upright stance. The STR was implemented in two bands for the participant's chest and abdominal measurements. The ability of the three sensors to measure respiration and chest wall motion was analyzed.Results：The output signals from the STR showed significant correlation with the flow and RIP signals (r＝0.5-1.00, p＜0.05). The total number of breaths obtained from the STR signals showed no significant difference from the reference values obtained from the flowmeter signals (p＞0.05). The amplitude of the STR output signals changed significantly according to the respiratory maneuver used. Specifically, it increased from apnea, polypnea, and natural breathing to deep breathing (p＜0.05).Conclusion：The newly developed stretch sensor is capable of measuring chest wall motion in various breathing maneuvers in young men.

Objective: In order to ensure the safety of nursing home residents, it is very important to implement appropriate assistance to ensure compliance with necessary medication. The purpose of this study is to identify issues and to plan solutions for medication assistance.Design: We conducted a workshop involving care workers (CWs), nurses and pharmacists together.Methods: Using the KJ method, participants extracted problems related to medication assistance and planned solutions in a mixed group of CWs, nurses and pharmacists. Questionnaire surveys were conducted for the participants before, immediately after, and 3 months after the workshop.Results: A number of important and urgent issues related to medication assistance were identified. There were differences in the recognition patterns of the importance and urgency of the issues among the three categories of participants. In addition, many possible solutions were proposed. Among these solutions, 25% had been implemented by at least two participants. More than 75 % of participants felt that their awareness of the value of cooperation in medication assistance had been improved by participating in the workshop.Conclusion: These results suggest that a workshop with a group of CWs, nurses and pharmacists in one place is a useful approach for extracting problems and planning effective solutions related to cooperation in medication assistance.