ノウソッチュウ ノ イリョウ レンケイ : ケンナンブ イリョウ ノ カイゼン オ メザシテ

Background : Cerebrovasucular disease have been known as“brain attack”since introduction of the treatment with recombinant tissue plasminogen activator against cerebral infarction. Emergent transport of apoplexy patients to hospitals with stroke care unit is needed. But nowadays, shortage of doctors appeared in Kaifu county of Tokushima Prefecture. Objectives : The aim of this study was to clarify problems on patients with apoplexy in this district. Methods : Three representative clinical cases are presented. Results : They were suffered from acute cerebral infarction, subarachnoid hemorrhage, or chronic cerebral infarction complicated with aspiration pneumonia and bed-sores. Conclusions : In order to treat patients with cerebrovasucular diseases effectively in this district, organic and friendly co-operation among doctors of stroke care units, physicians belonging to the Tokushima Medical Association, and staffs of the geriatric health service facilities is needed

Squamous Cell Carcinoma of the Descending Colon: Report of a Case and Literature Review

It is very rare that squamous cell carcinoma (SCC) arises from colorectal epithelium. An 89-year-old man was treated in 2001 with chief complaints of anorexia, abdominal pain, and low grade fever. The histological diagnosis as SCC was determined by biopsy during a colonoscopy. We diagnosed primary SCC of the colon because except in the colon no malignant lesions were found by systemic CT. Surgical complete resection was performed. However, he died three months after surgical resection because of hepatic metastasis and cachexia. The prognosis of this disease seems to be worse than that of adenocarcinoma

GSRS ガ リックンシトウ ニヨル ショウカキ ショウジョウ ノ QOL カイゼン ノ ヒョウカ ニ ユウヨウ デアッタ 1レイ

We report here an effective case of Rikkunshi-to（TJ-43）for who had gastrointestinal symptoms,nausea and diarrhea, and a usefulness of GSRS for evaluation of quality of life（QOL）ingastrointestinal symptoms. A 78 year-old male developed nausea and vomitting, and was foundwith a well to moderately differentiated adenocarcinoma of the rectum（Ra, type2, cT2, cN0, cM0,cStageⅡ）. He would be done with neoadjuvant chemoradiotherapy following transverse colostomy.However, he had heart burn and diarrhea after colostomy. Rikkunshi-to improved thesesymptoms. In GSRS, pre-and post-treatment of the total score decreased 3.9 to 2.0. The GSRS isa good relationship to QOL in gastrointestinal symptoms

Vitamin K deficiency, evaluated with higher serum ucOC, was correlated with poor bone status in women

BACKGROUND: An increase in serum undercarboxylated osteocalcin concentrations suggests vitamin K deficiency. Clinical intervention studies suggested that the vitamin K supplementation might contribute to preventing bone loss in postmenopausal women. Evidence on the relationship between serum undercarboxylated osteocalcin (ucOC) levels and bone parameters of quantitative ultrasound (QUS) is limited. We examined the correlation between serum ucOC concentrations and bone status as measured by QUS among middle-aged and older Japanese men and women. METHODS: The subjects were community-dwelling men (n = 358) and women (n = 503) aged ? 40?years in Japan. Heel QUS parameters, including the stiffness index, speed of sound, and broadband ultrasound attenuation, were measured. Serum ucOC concentrations were measured by electrochemiluminescence immunoassay. Grip strength was measured in the dominant hand. Information on alcohol drinking, current smoking, exercise, and menopause in women was collected. RESULTS: Serum ucOC concentrations were significantly associated with age in both sexes. Serum ucOC concentrations in men were higher at ? 80?years than those in the age groups of 40-49, 50-59, and 60-69?years. Serum ucOC concentrations in women were higher in the age groups of 50-59 and 60-69?years than those at 40-49?years. Partial correlation analysis adjusting for covariates (age, body mass index, grip strength, alcohol drinking, current smoking, and exercise in men; age, body mass index, grip strength, alcohol drinking, current smoking, exercise, and menopause in women) showed that serum ucOC concentrations were negatively significantly correlated with all QUS parameters in women. Serum ucOC concentrations were not correlated with them in men. CONCLUSIONS: Vitamin K deficiency, evaluated with higher serum ucOC, was correlated with poor bone status in women

新刊紹介

p.106, p.112, p.119, p.128, pp.135-136, p.148, p.15