ABSTRACT
The tsunami triggered by the Great East Japan Earthquake of March 2011, the strongest quake ever recorded in Japan, deposited tsunami sediments along the coastline of the affected area. Because the sediments contained a wide variety of hazardous chemicals, including organic micropollutants, a method for rapidly evaluating the environmental and human health risks of such chemicals is necessary. For this purpose, we propose a novel three-step scheme designated "rapid screening for environmental micropollutants in emergency situations (REPE)". In the first step, samples are subjected to target screening analysis using an automated identification and quantification system (TSA-AIQS) involving gas chromatography mass spectrometry (GC-MS). In the second step, the chemicals detected by TSA-AIQS analysis are quantified precisely by conventional target analysis. The third step is risk assessment of the target chemicals. TSA-AIQS analysis of the tsunami sediments detected 63 substances, including polycyclic aromatic hydrocarbons (both native and alkylated PAHs) at high concentrations. These PAHs were precisely quantified by target analysis, and the concentrations were used to assess the health risks posed by oral intake, which were found to be negligible. Our results suggest that the REPE scheme will be useful for rapid, comprehensive screening and risk assessment in emergency situations.
Subject(s)
Earthquakes , Environmental Monitoring/methods , Environmental Pollutants/analysis , Geologic Sediments/analysis , Tsunamis , Emergencies , Gas Chromatography-Mass Spectrometry , Geologic Sediments/chemistry , Humans , Japan , Polycyclic Aromatic Hydrocarbons/analysis , Risk Assessment , Time FactorsSubject(s)
Adenocarcinoma, Mucinous/diagnosis , Gallbladder Neoplasms/diagnosis , Adenocarcinoma, Mucinous/diagnostic imaging , Adenocarcinoma, Mucinous/secondary , Aged , Gallbladder Neoplasms/diagnostic imaging , Gallbladder Neoplasms/pathology , Humans , Lymphatic Metastasis , Magnetic Resonance Imaging , Male , Tomography, X-Ray Computed , UltrasonographyABSTRACT
The use of percutaneous endoscopic gastrostomy (PEG) has widely spread in recent years, even in Japan. In our hospital, we have performed this procedure in over 20 patients per year recently. In this study, we investigated the usefulness of PEG in home health care from the view point of cost effectiveness. We found that medical expenses decreased remarkably when patients underwent PEG because they could switch from hospital care to home health care, shortening there by the period of hospital care. The role of PEG in home health care will be more important also from cost effectiveness.
Subject(s)
Gastroscopy , Gastrostomy/economics , Home Care Services/economics , Parenteral Nutrition, Home , Adult , Aged , Aged, 80 and over , Cost-Benefit Analysis , Female , Gastrostomy/methods , Humans , Male , Middle Aged , Nutritional SupportABSTRACT
The use of percutaneous endoscopic gastrostomy (PEG) has widely spread in recent years, even in Japan. In our hospital, we have performed this procedure in over 20 patients per year recently. In this study, we investigated the usefulness of PEG in home health care from the view point of cost effectiveness. We found that medical expenses decreased remarkably when patients underwent PEG because they could switch from hospital care to home health care, shortening there by the period of hospital care. The role of PEG in home health care will be more important also from cost effectiveness.
Subject(s)
Gastroscopy , Gastrostomy/economics , Health Care Costs , Home Care Services, Hospital-Based/economics , Aged , Aged, 80 and over , Cost-Benefit Analysis , Costs and Cost Analysis , Female , Gastrostomy/methods , Humans , Long-Term Care/economics , Parenteral Nutrition, HomeSubject(s)
Cysts/pathology , Fibromatosis, Abdominal/pathology , Mesentery , Peritoneal Neoplasms/pathology , Adult , Female , HumansABSTRACT
The patient was a 68-year-old woman. She was referred to our hospital because of advanced gastric cancer. Endoscopic examination showed that the tumor was located in the Subcardia, with its oral margin invading the esophagus. Histologic examination of biopsy specimen led to a diagnosis of moderately to poorly differentiated adenocarcinoma. Apparent lymph node swellings (No. 7, No. 11) on enhanced CT examination indicated the metastasis of the gastric cancer. Consulting with her family, we decided to treat the cancer with chemotherapy using the peroral carcinostatic "UFT", and started it on November 18, 1997. Follow-up endoscopic examination confirmed that the tumor was reduced in size immediately after starting chemotherapy, and then finally disappeared on December 10, 1999. Since then, there has been no recurrence of the tumor. This is a rare case of gastric cancer showing complete response to chemotherapy using a peroral carcinosatatic alone.
