著者

瀧澤 俊広 野口 隼矢 瀧澤 敬美

出版者

日本医科大学医学会

雑誌

日本医科大学医学会雑誌 (ISSN:13498975)

巻号頁・発行日

vol.19, no.2, pp.90-95, 2023-04-20 (Released:2023-05-27)

参考文献数

28

著者

石野 孔祐 大橋 隆治

出版者

日本医科大学医学会

雑誌

日本医科大学医学会雑誌 (ISSN:13498975)

巻号頁・発行日

vol.19, no.2, pp.78-83, 2023-04-20 (Released:2023-05-27)

参考文献数

13

著者

菊地 伊豆実 田沼 弘之 川名 誠司

出版者

日本医科大学医学会

雑誌

日本医科大学医学会雑誌 (ISSN:13498975)

巻号頁・発行日

vol.9, no.1, pp.6-13, 2013 (Released:2013-03-11)

参考文献数

70

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In hyperkeratotic type tinea pedis, a sufficient curative effect is generally not obtained with topical antimycotic agents alone, because the main symptom is plantar keratosis. Oral antifungal drugs, such as itraconazole and terbinafine, are useful for treating hyperkeratotic tinea pedis in patients who can orally ingest drugs. In patients who do not respond to oral antifungal agents, we recommend the combination of an oral antifungal agent (such as itraconazole or terbinafine) and a topical antifungal agent, although problems may be encountered in obtaining reimbursement under the Japanese health insurance system. If oral administration is impossible, various topical application methods, such as concurrent use of urea ointments and the use of occlusive dressing technique, can be tried. In any case, it is important to continue treatment without losing hope. Combination therapy with oral and topical antimycotics is considered the most effective treatment. I generalized including domestic and foreign reports, and I pointed out problems, mainly regarding the cure for disease in consideration of the pharmacokinetics in the stratum corneum. In the future, we hope to see the development of more oral and topical antifungal agents that have fewer systemic adverse effects (in particular, hepatic disorders), have interactions with other drugs, and are transferred to the skin at higher concentrations. Treatment regimens (including dosage and treatment period) for existing drugs will also have to be reviewed in multicentre clinical trials.

著者

吉村 明修

出版者

日本医科大学医学会

雑誌

日本医科大学医学会雑誌 (ISSN:13498975)

巻号頁・発行日

vol.8, no.1, pp.18-21, 2012 (Released:2012-03-08)

参考文献数

5

被引用文献数

1 1

著者

中村 有希 四倉 寛子 加藤 雅彦 中田 淳 田中 啓治 林 宏光

出版者

日本医科大学医学会

雑誌

日本医科大学医学会雑誌 (ISSN:13498975)

巻号頁・発行日

vol.3, no.1, pp.25-29, 2007 (Released:2007-03-23)

参考文献数

16

被引用文献数

1

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Adult autosomal dominant polycystic kidney disease (ADPKD) is a common hereditary disorder responsible for 8% to 10% of cases of end-stage chronic renal failure. The extrarenal complications of ADPKD kidney include cardiovascular disorders (such as mitral valve prolapse syndrome, bicuspid aortic valve, aortic coarctation, aortic aneurysm, and aortic dissection), intracranial aneurysms, diverticulum of colon, hepatic cysts, inguinal hernia, and urinary calculus. Acute aortic dissection (AAD) associated with ADPKD is life-threatening. There are few reports of ADPKD with AAD. To the best of our knowledge, only 9 cases have been found, including at autopsy, in Japan. We have treated 121 patients with AAD in the last 5 years, and 3 of these 121 patients also had ADPKD in the intensive care unit of Nippon Medical School. We report clinical features of cases of ADPKD with AAD on the basis of 12 cases, including 9 previously reported cases and our 3 cases. AAD requires urgent antihypertensive therapy, which often aggravates renal function. Priority should be given to antihypertensive therapy in emergent cases. In fact, 2 of our patients required hemodialysis owing to antihypertensive therapy for AAD. Close cooperation between cardiologists and nephrologists is essential.

著者

毛塚 淳子

出版者

日本医科大学医学会

雑誌

日本医科大学医学会雑誌 (ISSN:13498975)

巻号頁・発行日

vol.18, no.3, pp.230-242, 2022-08-25 (Released:2022-08-27)

参考文献数

11

著者

中村 哲子

出版者

日本医科大学医学会

雑誌

日本医科大学医学会雑誌 (ISSN:13498975)

巻号頁・発行日

vol.8, no.1, pp.22-25, 2012 (Released:2012-03-08)

参考文献数

14

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Trauma studies, as consolidated in the 1990s from a trans-disciplinary perspective, have come to attach fresh significance to narrative production by trauma sufferers. William Trevor's The Story of Lucy Gault, a novel featuring a girl injured during the Irish War of Independence, describes the difficulties trauma sufferers have to face in constructing their own narrative for recovery and apprises the reader of their long suffering from a medical point of view.

著者

菅野 淳平

出版者

日本医科大学医学会

雑誌

日本医科大学医学会雑誌 (ISSN:13498975)

巻号頁・発行日

vol.12, no.2, pp.61-63, 2016-04-15 (Released:2016-05-16)

参考文献数

2

著者

松元 秀次

出版者

日本医科大学医学会

雑誌

日本医科大学医学会雑誌 (ISSN:13498975)

巻号頁・発行日

vol.15, no.4, pp.201-209, 2019-10-15 (Released:2019-12-03)

参考文献数

18

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Stroke is clinically characterized by hemiplegia and exercise intolerance, both of which not only interfere with the ability to perform activities of daily living (ADL), but also significantly reduce quality-of-life (QOL). Neurological and functional recovery occurs mainly within the first 6 weeks after onset of stroke, but the process continues for several months, with maximal functional recovery usually achieved within 6 months. In Japan, convalescent rehabilitation wards play an important role in the rehabilitation of post-stroke patients who have impaired ADL and health status after the acute phase. Various physiotherapies have been developed to improve functional recovery in patients with hemiplegia due to stroke, including the facilitation technique with proprioceptive neuromuscular facilitation, and constraint-induced movement therapy. A novel facilitation technique is repetitive facilitative exercises (RFE), which promote the functional recovery of the hemiplegic limbs to a greater extent than conventional rehabilitation sessions.Functional electrical stimulation (FES) is a technique used to produce contractions in paralyzed muscles by the application of small pulses of electrical stimulation to the nerves that supply the paralyzed muscle. FES is used as an orthosis to assist walking, and also as a means of practicing functional movements for therapeutic benefit. New training technologies involving the use of robots have recently been developed to help in the rehabilitation of post-stroke patients.Robot-assisted rehabilitation therapy provides functional training of the upper and lower limbs in an effective, easy and comfortable manner. Furthermore, the robot-assisted training paradigm offers intensive, repetitive, sufficient, and accurate kinematic feedback along with symmetrical practice while reducing the workload for the therapist, thus reducing the cost of post-stroke rehabilitation. Exoskeleton-type robotic devices have robot axes aligned with the anatomical axes of the wearer. These robots provide direct control over individual joints, which can minimize abnormal posture or movement. Robot-assisted gait training is effective in the long term in improving balance and walking ability, and it has a positive impact on patients' QOL. Several well-designed studies have provided evidence that robot-assisted training promotes motor recovery and functional improvement in post-stroke patients. However, the evidence is insufficient to draw conclusions about the effectiveness because of small samples sizes, methodological flaws, and heterogeneous training procedures. More well-designed randomized controlled trials are needed.

出版者

日本医科大学医学会

雑誌

日本医科大学医学会雑誌 (ISSN:13498975)

巻号頁・発行日

vol.6, no.4, pp.204-206, 2010 (Released:2012-10-12)

著者

金田 誠

出版者

日本医科大学医学会

雑誌

日本医科大学医学会雑誌 (ISSN:13498975)

巻号頁・発行日

vol.18, no.1, pp.113, 2022-02-20 (Released:2022-03-15)

著者

仁藤 智香子

出版者

日本医科大学医学会

雑誌

日本医科大学医学会雑誌 (ISSN:13498975)

巻号頁・発行日

vol.17, no.4, pp.226, 2021-10-30 (Released:2021-11-27)

著者

鈴木 康友 齋藤 友香 近藤 幸尋

出版者

日本医科大学医学会

雑誌

日本医科大学医学会雑誌 (ISSN:13498975)

巻号頁・発行日

vol.6, no.3, pp.130-134, 2010 (Released:2010-06-28)

参考文献数

5

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The lower urinary tract symptoms in elderly men are composed of from voiding symptoms and storage symptoms. The representative disease with voiding symptoms is benign prostatic hyperplasia, and the representative syndrome with storage symptoms is overactive bladder and nocturia. Diagnosis by asking questions that use International Prostate Symptom Score and the overactive bladder symptom score is important. The first-line drugs for the treatment of the lower urinary tract symptoms are α1-blockers. Behavior therapy and anticholinergic drugs are also useful for treating storage symptoms.

著者

鈴木 達也 野呂瀬 準 須田(二見) 章子 鈴木 一成 関水 憲一 大内 基司 猪狩 吉雅 渡邊 健太郎 中野 博司 大庭 建三

出版者

日本医科大学医学会

雑誌

日本医科大学医学会雑誌 (ISSN:13498975)

巻号頁・発行日

vol.6, no.3, pp.135-139, 2010 (Released:2010-06-28)

参考文献数

7

被引用文献数

1

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In recent years, elderly patients with dementia have been increasing in Japan. It is currently estimated that behavioral and psychological symptoms of dementia (BPSD) occur in approximately 80% of the elderly patients with dementia. As BPSD occur more frequently in elderly patients with dementia, the caregivers burden increases. Although non-pharmacological interventions can reduce BPSD in patients with dementia, antipsychotic medications have been used to treat severe BPSD. Physicians should be particularly careful in the use of antipsychotic medications in the elderly, which have been associated with dangerous adverse effects. Donepesil not only improves the cognitive dysfunction of Alzheimer disease patients, but may also relieve BPSD in these patients. Moreover, the effects on BPSD of yokukan-san, Kampo medicine, have been reported in elderly patients with dementia. A multicenter randomized crossover study, which we participated in, confirmed that yokukan-san is effective in the treatment of BPSD and that no rebound related deterioration occur after withdrawal of yokukan-san. The effects of yokukan-san on BPSD have been reported to influence gamma-amino-n-butyric acid and serotonin receptors.

著者

野村 俊明

出版者

日本医科大学医学会

雑誌

日本医科大学医学会雑誌 (ISSN:13498975)

巻号頁・発行日

vol.16, no.2, pp.46-52, 2020-04-25 (Released:2020-05-18)

著者

本田 一文

出版者

日本医科大学医学会

雑誌

日本医科大学医学会雑誌 (ISSN:13498975)

巻号頁・発行日

vol.17, no.4, pp.146-157, 2021-10-30 (Released:2021-11-27)

参考文献数

41

被引用文献数

1

著者

横田 裕行

出版者

日本医科大学医学会

雑誌

日本医科大学医学会雑誌 (ISSN:13498975)

巻号頁・発行日

vol.16, no.2, pp.102-109, 2020

著者

横田 裕行

出版者

日本医科大学医学会

雑誌

日本医科大学医学会雑誌 (ISSN:13498975)

巻号頁・発行日

vol.16, no.2, pp.102-109, 2020-04-25 (Released:2020-05-18)

著者

金涌 佳雅

出版者

日本医科大学医学会

雑誌

日本医科大学医学会雑誌 (ISSN:13498975)

巻号頁・発行日

vol.14, no.3, pp.100-112, 2018

被引用文献数

4

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<p><i>Koritsu</i>-<i>shi</i> (solitary death) refers to cases of death in which the deceased was living in a one-person household. In Japan, <i>koritsu</i>-<i>shi</i> cases have received significant attention as a major social problem because the aging population has led to an increase in single-person households. However, because the definition of <i>koritsu</i>-<i>shi</i> is unclear and carrying out a national level survey of households where the occupant has died is difficult, the actual situation surrounding <i>koritsu</i>-<i>shi</i> has not been elucidated. As <i>koritsu</i>-<i>shi</i> is legally treated as an unnatural death, statistics on <i>koritsu</i>-<i>shi</i> have been reported in many areas (Tokyo, Osaka, Kobe) under the medical examiner system. Of these areas, statistics from the Tokyo ward area have revealed the most information and show that the proportion of unnatural deaths involving <i>koritsu</i>-<i>shi</i> has been increasing year after year, with 36% of cases being <i>koritsu</i>-<i>shi</i> in 2016. Each year showed that <i>koritsu</i>-<i>shi</i> was higher in men than women. Although the deceased were predominantly male in cases of middle-aged <i>koritsu</i>-<i>shi</i>, both sexes are affected more evenly in single-elderly cases. However, the overall incidence was higher in men when the numbers of middle aged and elderly people are tallied against the higher numbers of elderly women. In men, the characteristic cause of death is chronic alcoholic liver injury with other cases mostly being categorized as unknown due to postmortem damage. Even within the densely populated Tokyo ward area, spatial clustering was detected with regard to the incidence of <i>koritsu</i>-<i>shi</i> per ward. There are many points that are consistent between reports of <i>koritsu</i>-<i>shi</i> in the Tokyo ward area and other areas. However, it is not easy to compare results among different regions due to the unclear definition of <i>koritsu</i>-<i>shi</i> and insufficient bias exclusion. <i>Koritsu</i>-<i>shi</i> cases are expected to increase in Japan in the future. Future efforts should focus on finding the deceased as soon as possible after death, or even pursuing the possibility of preventing <i>koritsu</i>-<i>shi</i> in cases when an individual living in a one-person household suddenly collapses at home. In addition, to reduce the effect of loneliness and social isolation among those living in single-person households to improve health outcomes, it is important that medicine and public health efforts address the problem of <i>koritsu</i>-<i>shi</i>.</p>

著者

高橋 秀実

出版者

日本医科大学医学会

雑誌

日本医科大学医学会雑誌 (ISSN:13498975)

巻号頁・発行日

vol.13, no.3, pp.140-144, 2017