Résumé
<b>Background</b><br>The Pacific Islands is an area with one of the world's highest prevalence of obesity and diabetes. The Republic of the Marshall Islands (RMI) is an independent country of the Micronesian that extends along latitude 4 to 18 degrees north. In the past, several studies reported regarding the prevalence of diabetes among the people of the Pacific Islands. However, there is no report yet with respect to diabetes in Majuro, the capital of RMI. In RMI, diabetes and obesity are also recognized to be a serious problem, but the present state of affairs prevents an understanding of the situation.<br><b>Objectives</b><br>The purpose of the present study was to investigate the present situation and the prevalence of diabetes and obesity in Majuro. <br><b>Methods</b><br>The participants were Marshallese visited our thyroid cancer-screening program. Among those participants who undertook thyroid cancer screening, the Body Mass Index (BMI) and hemoglobinA1c (HbA1c) levels were taken of 850 participants. Participants with an HbA1c level of 6.5% or more were put into the diabetes group and participants with a BMI of 30 and over were the obese group. Prevalence was adjusted using the Majuro population based on 1999 national census and using world standard population of Segi. <br><b>Results</b><br>The age-adjusted prevalence of diabetes in aged 20 years and over in Majuro was 22.1%. After standardization, the prevalence was 31.0%.<br><b>Conclusion</b><br>The results suggest there is a high rate of diabetes in RMI similar to other pacific islands. It could be concluded, based on this research, that there is a crisis situation with regards to diabetes in the RMI. There is also a need for epidemiological research to be on a random sample of the population.
Résumé
Unkei-to was used successfully to treat three patients with primary Sjögren's syndrome (pSjS). The first case was a 67-year-old woman. In April 1993, she visited Tonami General Hospital with the symptom of dry eyes. Her condition was diagnosed as pSjS from being antinuclear antibody (ANA) positive, dry eye, and decrease of saliva secretion. She used eye drops, but her dry eye did not improve, she visited our department in June 1995. Administration of Unkei-to improved her symptoms after 6 months of treatment.<br>The second case was a 73-year-old woman. In 1987, she was treated in our hospital for lumbago based on spondylosis. In 1991, she began to suffer from pain and swelling of the right sterno-clavicular joint (RSCJ) and was admitted. She was anti-SS-A/Ro ANA positive, schirmer's test was positive, lymphocyte infiltration was observed by lip biopsy, and thus pSjS was diagnosed. Treatment with Unkei-to resulted in the improvement of pain and swelling of RSCJ, as well as a decrease in serum C-reactive protein. But a favorable effect on dry mouth was not attained in this case.<br>The third case involved a 39-year-old woman who began to experience polyarthralgia and dry mouth in June 1991. She visited a neighborhood hospital and was diagnosed as pSjS from hyper γ-globulinemia, anti SS-A ANA positivity, and decrease of saliva secretion. She first visited our hospital in March 1994. We administered Keishikaryojutubu-to and improvement of polyarthralgia was observed. Subsequently, she suffered from symptoms of dry eye and dry mouth. We treated her with Unkei-to, which improved the symptoms of dryness, but not polyarthralgia in this case.<br>These observations suggest that Unkei-to might be a useful agent for the treatment of pSjS.