Medical Cooperation System for Acute-Sub Acute Care and Post-ICU as Long-Term Ventilation Unit in The Community Care System / 日本農村医学会雑誌

　　From 2008 to 2014, we experienced 40 respiratory failure cases which required long-term ventilation in the post-ICU in Kakeyu Hospital. They had been referred to our hospital from acute care hospitals and most of them had been transferred on our regional medical cooperation system. Initially, we used long-term care beds for them, but as the number of serious cases increased, we moved them to acute care beds. As regards main causes of respiratory failure, post cardiac arrest syndrome topped the list with 12 cases, followed by chronic obstructive pulmonary disease, intractable neurological diseases and cervical cord injury. All these cases combined, the number came to 30 cases, accounting for 75% of all. The shortest stay in hospital was made by a patient with brain stem lymphoma. It was only 12 days, but the longest was made by a patient with post meningoencephalitis 6 years. Our care consisted not only ventilation and medical care but also giving a bath, walking with a type of wheelchair, and sunbathing at the rooftop of our hospital. In May 2014, we renovated the post-ICU from an acute care division to a physical disability patient ward. As the elderly population will increase, it is expected that the need for acute care will augment in parallel with an increase to the number of post cardiac arrest syndrome and the demand of long-term ventilation. Therefore, the community care system will need the post-ICU for cooperation with acute care hospitals.

A Epidemiological Study on Pseudocholinesterase in Citrut Fruit Area with Special Reference to the Relationship on Serum Lipids / 日本農村医学会雑誌

Based on previous anther's obsarbations of pseudocholinesterase (PCE) activity correlated with total cholesterol, fluctuation of this enzyme was epidemiologically studied in connection with changes of serum lipids on 225 sprayers of pesticides in citrut fruit area, and results are as follows;<BR>1. PCE activity was slightly correlated with serum triglyceride (γ=0.277) and total cholesterol (γ=0.431) in females but not correlated in males.<BR>2. PCE activity was significantly higher (P<0.05) in hyperlipemic subjects than normolipemic, and obviously higher (P<0.001) in hyperlipemic over weight subjects than hyperlipemic normal weight.<BR>3. The enzyme activity was significantly higher (P<0.05) in hypertriglyceridemic subjects than in normolipemic, and highest (P<0.01) in subjects with hypertriglyceridemia and hypercholesteremia.<BR>4. Serum triglyceride values in males and serum cholesterol values in females were obviously higher (P<0.05) in the high level group of PCE activity than in the low level group.<BR>5. PCE activity was exhibited a tendency of elevation in hypertensive females than in normal blood pressure, and slightly correlated with systoric blood pressure (γ=0.286) and diastoric blood pressure (γ=0.358) in females.<BR>6. PCE activity was found to be lower (P<0.05) in arterioslerotic subjects than nonsclerotic subjects with ocular funduscopic findings.<BR>These epidemiological findings suggested that PCE might play a role in lipid metabolism and reduction of this enzyme might cause disturbances of lipid metabolism.