著者

Sakiko Itaya Zen Kobayashi Kokoro Ozaki Nozomu Sato Yoshiyuki Numasawa Kinya Ishikawa Takanori Yokota Hiroshi Matsuda Shuzo Shintani

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.0068-17, (Released:2018-02-09)

参考文献数

14

被引用文献数

4

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A 58-year-old man consulted our hospital due to a 2-year history of dysarthria and a 1-month history of blepharospasm. In addition to the ataxic dysarthria and blepharospasm, a neurological examination demonstrated slight ataxia of the trunk and lower limbs. Brain MRI demonstrated atrophy of the upper portion of the cerebellar vermis. Gene analysis established a diagnosis of spinocerebellar ataxia type 31 (SCA31). SPECT with the three-dimensional stereotaxic ROI template (3DSRT) software program demonstrated hyperperfusion in the lenticular nucleus and thalamus. Although the association between SCA31 and blepharospasm in our patient remains unclear, we considered that this combination might be more than coincidental.

著者

Miho YOSHIOKA Zen KOBAYASHI Keisuke INOUE Mayumi WATANABE Kaori KATO Kazunori TOYODA Yoshiyuki NUMASAWA Shoichiro ISHIHARA Hiroyuki TOMIMITSU Shuzo SHINTANI

出版者

Japanese Society for Brain Function and Rehabilitation

雑誌

Journal of Rehabilitation Neurosciences (ISSN:24342629)

巻号頁・発行日

vol.19, no.1, pp.33-36, 2019 (Released:2019-10-25)

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The Trail Making Test (TMT) is widely used as a measure of attention impairment. The time needed to complete TMT (TMT score) is prolonged in association with attention impairment in patients with brain diseases. Thus far, however, there have been no reports of serial changes in the TMT score after minor ischemic stroke. We retrospectively investigated serial changes in the TMT score of 19 patients with minor ischemic stroke. We included patients in whom TMT could be performed both 4-11 days after onset (initial evaluation) and 14-47 days after onset (second evaluation). The mean value of the initial TMT-A scores was 58 seconds, and that of the initial TMT-B scores was 144 seconds. The mean value of the second TMT-A scores was 43 seconds, and that of the second TMT-B scores was 119 seconds. The TMT-A and TMT-B scores improved in 89 % and 74 % of patients, respectively. This study demonstrated that most minor ischemic stroke patients showed improvement in the TMT score 14 days or later after onset.

著者

Yoshitaka Maeda Shuzo Shintani

出版者

(社)日本農村医学会

雑誌

Journal of Rural Medicine (ISSN:1880487X)

巻号頁・発行日

vol.10, no.1, pp.29-33, 2015 (Released:2015-06-19)

参考文献数

8

被引用文献数

9

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Objective: Living wills, written types of advanced directives, are now widespread in western countries, but in Japan, their recognition still remains restricted to a small part of the population. As an initial step to introduction of such patient-oriented medicine, we surveyed present recognition and acceptance patterns concerning living wills in a main regional hospital located in a suburban area of Tokyo.Methods: Without any preceding guidance on living wills, the questionnaire on living wills was distributed to all the staff working at JA Toride Medical Center in September 2013, and their responses were collected for analysis within one month.Results: Questionnaires were distributed to all hospital staff, 843 in total, and 674 responses (80.0% of distributed) were obtained. The term of living will was known by 304 (45.1%) of the respondents, and introduction of living wills to patients was accepted in 373 (55.3%) of the respondents, meanwhile, 286 (42.4%) respondents did not indicate their attitude toward living wills. As to styles of document form, 332 respondents (49.3%) supported selection of wanted or unwanted medical treatments and care from a prepared list, and 102 respondents (15.1%) supported description of living wills in free form. As preferred treatment options that should be provided as a checklist, cardiac massage (chest compression) and a ventilator were selected by more than half of the respondents. Based on their responses, we developed an original type of living wills available to patients visiting the hospital.Conclusions: Although not all the respondents were aware of living wills even in this main regional hospital, introduction of living wills to patients was accepted by many of the hospital staff. Awareness programs or information campaigns are needed to introduce living wills to support patient-centered medicine.