ABSTRACT
We experienced a clinical case of a patient with psychotic depression who ingested the residual saponated cresol solution from a 500ml bottle of cresol, a disinfectant, with the intention of committing suicide. Through this experience, we felt it neccessary to investigate the present commercial situation of cresol for domestic use, and to come up with some safty measares.All the 128 drugstores and pharmacies in four cities located in the Tohno area of Gifu Pref. (Mizunami, Toki, Tajimi and Ena) were queried by telephone about the sale and stock of cresol.Almost 80% of the drugstores in these four cities, excluding pharmacies, were found to deal in saponated cresol solutions. They carried a little more than two 500ml bottles of cresol on average. This volume exceeds an estimated adult lethal dose of 250ml.Although it is unlikely that an ordinary household will use the whole of 500ml bottle of the disinfectant at a time, the residual saponated cresol solution could increase the risk of accidental cresol poisoning at home.So, it would be desirable not to sell 500ml bottles in ordinary drugstores. Furthermore, before selling a bottle of cresol, the pharmacists, who have a specialized knowledge about it, should kindly explain to the user about its toxicity and usage.
Subject(s)
Solutions , DisinfectantsABSTRACT
A survey was carried out on how the To-no District is coping with the need of first aid for patients requiring life-supporting treatment before hospitalization. Although there were cities in this district where statistics on first aid were not available, the survey found that, during the 4-year period from 1994 through 1997, bystander CPR (cardiopulmonary resuscitation) saved 11.2% of the lives of patients with CPA (cardiopulmonary arrest). Incidentally, 11.3% of the population attended CPR courses offered by public institutions. Gifu Prefecture has helicopters for use in rescue work, but the survey found that some cities had not ever sponsored drills using helicopters in life-saving operations. Our findings revealed the indifference of the general public as well as administrators in this district toward emergency care. Public recognition of the importance of the care of suddenly ill or injured patients must be gained. Furthermore, acquisition of skills required for first aid by lay people and technical improvement of these skills in professional rescuers are necessary. The authors think that these are the community educational responsibility of hospitals and other medical institutions.
ABSTRACT
A 73-year-old man visited our hospital with complaints of fever, epigastric painand jaundice. Laboratory examinations showed elevation of GOT, GPT, ALP, LAP and amylase. Abdominal ultrasonography revealed gall bladder stones. Endoscopic findings showed parapapillary diverticulum, but the common bile duct stone was not revealed by endoscopic retrograde cholangiography. He was conservatively treated and then discharged. Two months after, the patient was readmitted for cholecystitis and underwent cholecystectomy. After further 2 months, he was again admitted for the same symptoms as those on first admission. We diagnosed this case as Lemmel's syndrome and performed emergency endoscopy. Endoscopic findings revealed the meal rest inside the parapapillary diverticulum. After we removed the meal rest obstructing the orifice of the papilla of Vater using grasping forceps, we performed EST. Purulent bile gushed out from the orifice. Two years have elapsed since them. Cholangitis has not recurred during this period. Therefore, we concluded that EST is effective in treating Lemmel's syndrome.
ABSTRACT
A study was conducted to determine the minimum quantity of leg exercise required to prevent disuse atrophy of the quadriceps femoris muscle during bed rest. The subjects were 10 normal young university students with a mean age of 21.1 years. First, analysis of rectified filtered electromyography (RFEMG) was performed on the rectus femoris and vastus medialis during walking with cadences of 100 steps/min and 150 steps/min. Then, the effects of straight leg raising (SLR), patella setting (PS), knee extension-flexion in a supine position (KEF) and knee extension in a sitting position (KE) were analysed for each muscle using the same method. Based on the value of RFEMG for each muscle during walking, the repetition number for each exercise was calculated. For the rectus femoris, the repetition number for each exercise corresponding to 10000 steps with a cadence of 100 steps/min was 289 for SLR, 466 for PS, 1255 for LEF and 1663 for KE. For the vastus medialis, the corresponding numbers were 1223, 381, 6367 and 2170, respectively. When the cadence increased to 150 steps/min, the repetition number of each exercise for each muscle also increased. These results indicate that high repetition exercise is recommendable to prevent disuse atrophy of the quadriceps femoris muscle. Therefore, the activity of patients should be increased to stimulate weakened muscles such as the quadriceps femoris during hospitalization.