In vivo anti-osteoporotic activity of isotaxiresinol, a lignan from wood of Taxus yunnanensis.

Isotaxiresinol, the main lignan isolated from the water extract of wood of Taxus yunnanensis, was investigated for its effect on bone loss, on serum biochemical markers for bone remodeling and on uterine tissue, using ovariectomized (OVX) rats as the model of postmenopausal osteoporosis. After oral administration of isotaxiresinol (50 and 100mg/kg/d) for 6 weeks, bone mineral content (BMC) and bone mineral density (BMD) in total and cortical bones were increased as compared to those of OVX control rats, and decreases of three bone strength indexes induced by OVX surgery were prevented. Serum biochemical markers for bone remodeling revealed that isotaxiresinol slightly increased bone formation and significantly inhibited bone resorption without side effect on uterine tissue. These results suggest that isotaxiresinol may be useful for treatment of postmenopausal osteoporosis, especially for prevention of bone fracture induced by estrogen deficiency.

A study of Japan's emergency medical care system--emergency transportation and medical care service areas for tuberculosis patients.

Since 1988, there has been a noted increase in the use of emergency transportation by tuberculosis patients in Japan. Therefore it is necessary to build a suitable emergency medical care system for these patients. We evaluated the present emergency medical care system available to them in Tokyo. We also studied emergency medical care service areas (MCSAs) to further aid in the revision of the emergency medical care system for tuberculosis. We used data from tuberculous patients who required the use of the emergency medical care system in Tokyo. The data was collected by the Tokyo Fire Department's emergency care information system from 1978 to 1990. We investigated and analyzed data regarding transportation and patient data. We also analized transportation data from the point of view of municipal districts (wards, cities, towns, villages), MCSAs and the Tokubetsuku region. We concluded that the number of emergency transports for tuberculosis patients has gradually been increasing and that the currently MCSA regions were not ideal for use in developing a transportation system for these patients. Using larger areas such as Tokubetsu-ku and Tokyotoka would be more practical emergency medical care system for tuberculosis patients in Tokyo, it will be necessary to take into account the Tokubetsu-ku area, the vagrant population within it, and the time required to transport the patients from this area to the Tokyotoka area.

A review of the present emergency medical care system in Japan.

EMT's in the United States initiate emergency treatment including patient resuscitation at accident locations. Such treatment has only recently become available in Japan. In 1992, Emergency Life Support Technicians (ELT's) became available in Japan. ELT's can now implement emergency treatment similar in scope to that of EMT's in the United States. We expect the rate of lifesaving resuscitation and subsequent rehabilitation will improve dramatically. The triage decision making process is designed to aid in choosing appropriate health care facilities. The highest available level of medical expertise should be brought into the triage decision making process. Throughout Japan, improvements in the emergency medical care system are being made in an ongoing process. The Tokyo Fire Department in particular has made great progress in updating and improving its system. It continues to investigate possible innovations which could lead to further improvements.

A study of evaluation methods for hospital medical care systems.

When we seek to evaluate hospital medical care services, we first collect data regarding the existing system in order to gather information and to develop a method of analysis that we can use for evaluation. We took the OPD system as an example, taking into account systematic OPD services based on queuing theory and computer simulation. As a result of the computer simulation model based on experimental conditions, we were able to offer recommendations for modifications of the present system that could improve patient service. The hospital manager can use this information to aid him in the decision making processes concerning the hospital. A study of the methods for the evaluation of hospital medical care services is important. It is necessary to develop a regional medical care information system as well as a hospital medical care information system.