Long-term oxygen therapy in Japan: history, present status, and current problems

Historically, the progress of long term-oxygen therapy (LTOT) in Japan has been characterized by collaboration among academicgroups, policy makers, and industrial companies. The public health insurance program has covered the cost of LTOT since 1985.Thomas Petty’s group in Denver enthusiastically carried out the public implementation of LTOT and conveyed the concept of pulmonaryrehabilitation for the processing with LTOT. Although the target diseases of LTOT in Japan tended to be chronic obstructivepulmonary disease or sequelae of primary lung tuberculosis, it was soon applied for cardiac diseases as well as other pulmonarydiseases. Together with increasing medical costs for geriatric patients, the political conversion from hospital based care ofa traditional style to home care system has been performed, with two background reasons: the improvement of quality of life ofpatients and the reduction of the medical expense. Presently, LTOT plays a pivotal role in the successful implementation of homerespiratory care for elderly patients. In addition, this promotes comprehensive pulmonary rehabilitation, a team approach, andclose liaisons between primary care and hospitals. Currently, the total number of patients using LTOT exceeds 150,000. In Japan,LTOT resulted in an advancement in the medical care as well as in administrative decision to introduce it as a nationwide systemafter analyzing the results of opinion polls of patients with respiratory failure. However, the recent great earthquake in East Japanrevealed that many unresolved problems remain for these patients, and these issues are of great concern.Historically, the progress of long term-oxygen therapy (LTOT) in Japan has been characterized by collaboration among academicgroups, policy makers, and industrial companies. The public health insurance program has covered the cost of LTOT since 1985.Thomas Petty’s group in Denver enthusiastically carried out the public implementation of LTOT and conveyed the concept of pulmonaryrehabilitation for the processing with LTOT. Although the target diseases of LTOT in Japan tended to be chronic obstructivepulmonary disease or sequelae of primary lung tuberculosis, it was soon applied for cardiac diseases as well as other pulmonarydiseases. Together with increasing medical costs for geriatric patients, the political conversion from hospital based care ofa traditional style to home care system has been performed, with two background reasons: the improvement of quality of life ofpatients and the reduction of the medical expense. Presently, LTOT plays a pivotal role in the successful implementation of homerespiratory care for elderly patients. In addition, this promotes comprehensive pulmonary rehabilitation, a team approach, andclose liaisons between primary care and hospitals. Currently, the total number of patients using LTOT exceeds 150,000. In Japan,LTOT resulted in an advancement in the medical care as well as in administrative decision to introduce it as a nationwide systemafter analyzing the results of opinion polls of patients with respiratory failure. However, the recent great earthquake in East Japanrevealed that many unresolved problems remain for these patients, and these issues are of great concern

Factors Affecting Home Care of Elders Report 1. Support Expected by the Elderly and Family

For the rapid increase of the elders in population in Japan after the 2nd world war, the arrangement of medical care for aged persons, both therapeutic and preventive, has become the serious social problem. To estimate the possibility of care at home and needs of elders and their family for public and volunteer services, questionnaire survey was carried out at Konko town in Okayama prefecture, Japan, in August 1990. More than half of the 105 elders older than 65 years and living alone (group A, 9 males and 96 females) replied to want to be cared for at home and 178 families with elders (group B) wanted to care for them at home. As for services they would wish to be offered when they would become bedridden at home, while group A wished to be visited and cared for by 'physician', 'home helper' and 'neighbor' in order of high rate group B 'physician', 'public health nurse' and 'nurse'. As for facility or assistance services, the former wanted 'purchasing, sweeping and washing', food delivery' and 'calling on' and the latter 'care consultation', 'assist of body bath' and 'economic aid'. Other supports or cares were also hopefully expected by both groups. The results shows that well-arrangement and promotion of a variety of constitional and personal support for home cares for elders in the community must be urged

STERNOCLAVICULAR JOINT MOVEMENT DURING BACKSWING IN BASEBALL PITCHING MAY BE A GOOD INDICATOR OF SHOULDER INJURY

The purpose of this study was to demonstrate the characteristics of joint movements performed by the pitchers who suffered from throwing shoulder injuries. Fourteen semiprofessional baseball pitchers participated in our longitudinal study. We captured their pitching using an optical motion capture system. We investigated their disease history once a year, for 5 years, in order to investigate the relationship between baseball-related throwing injuries and pitching mechanics. T w of the players suffered from shoulder pain and had to take a "no throw" rest for several weeks during the season. Both pitchers had a reduced range of motions for retraction at the sternoclavicular joint during backswing. However, they presented the same range of motions for shoulder horizontal abduction, as the other healthy pitchers

Hybridization Mechanism for Cohesion of Cd-based Quasicrystals

Cohesion mechanism of cubic approximant crystals of newly discovered binary quasicrystals, Cd$_6$M (M=Yb and Ca), are studied theoretically. It is found that stabilization due to alloying is obtained if M is an element with low-lying unoccupied $d$ states. This leads to conclusion that the cohesion of the Cd-based compounds is due to the hybridization of the $d$ states of Yb and Ca with a wide $sp$ band. %unlike known stable quasicrystals without transition elements %such as Al-Li-Cu and Zn-Mg-RE (RE:rare earth). Although a diameter of the Fermi sphere coincides with the strong Bragg peaks for Cd-Yb and Cd-Ca, the Hume-Rothery mechanism does not play a principal role in the stability because neither distinct pseudogap nor stabilization due to alloying is obtained for isostructural Cd-Mg. In addition to the electronic origin, matching of the atomic size is very crucial for the quasicrystal formation of the Cd-based compounds. It is suggested that the glue atoms, which do not participate in the icosahedral cluster, play an important role in stabilization of the compound.Comment: 4 pages, 2 figure

Serologic Markers in Relation to Parasite Exposure History Help to Estimate Transmission Dynamics of Plasmodium vivax

Plasmodium vivax infection has been gaining attention because of its re-emergence in several parts of the world. Southeastern Turkey is one of the places in which persistent focal malaria caused exclusively by P. vivax parasites occurs. Although control and elimination studies have been underway for many years, no detailed study has been conducted to understand the mechanisms underlying the ineffective control of malaria in this region. Here, for the first time, using serologic markers we try to extract as much information as possible in this region to get a glimpse of P. vivax transmission. We conducted a sero-immunological study, evaluating antibody responses of individuals living in Sanliurfa to four different P. vivax antigens; three blood-stage antigens (PvMSP119, PvAMA1-ecto, and PvSERA4) and one pre-erythrocytic stage antigen (PvCSP). The results suggest that a prior history of malaria infection and age can be determining factors for the levels and sustainability of naturally acquired antibodies. Significantly higher antibody responses to all the studied antigens were observed in blood smear-negative individuals with a prior history of malaria infection. Moreover, these individuals were significantly older than blood smear-negative individuals with no prior history of infection. These data from an area of sole P. vivax-endemic region may have important implications for the global malaria control/elimination programs and vaccine design