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Biomedical subjects

K Akazawa

Publications and source records attributed to K Akazawa.

At least 163 records · Page 9Linked to original sources
PubMed1991

Problems of protocol practice in Japan.

With progress in medical knowledge and in the technology of medical care, the contents of medical practice have become increasingly complicated year by year. The protocol practice (clinical algorithms or scheduled care) has been experimentally employed as one of medical-practice systems aimed at providing better medical care and maintaining its high standards. In the protocol practice the criteria for decision-making, which are clinically employed, are precisely made up in advance so that practice will be performed systematically. The WHO has recommended this protocol practice as a medical-care system appropriate for realizing clinical experiments. In recent years a number of clinical studies have been born from the protocol practice and, thus, it has been considered to be a formula for conducting clinical experiments tolerant of scientific criticism. The protocol practice, however, since it is difficult to conduct smoothly, has not yet been settled. This study aims at considering what we should do to make the protocol practice system settled through the observation of pitfalls in the course of its application.

Clinical Medicine↗
PubMed1991

A 24-hour ordering system for clinical examinations.

We have developed a 24-hour ordering system for clinical examinations, making use of the features of multi-function workstation (IBM5550) which performs two functions both in an on-line terminal and in a personal computer. It is used as an on-line terminal for the host computer (IBM4381) in day time. At night or on holiday, it is used as a stand-alone type personal computer to order clinical examinations. For this purpose, basic information of the inpatients (patient number, name, sex, date of birth, clinic, ward) are transferred from the host computer to the disket in the workstation in the evening when host computer finished on-line service. A physician can input the patient number followed by examination items using the touch panel according to the dialogue type guides written in Chinese character. Then, specimen label, list of ordered tests and an order form are printed out instantly. The date (patient number, examination items, identification number of the specimen, etc.) stored in the disket in the workstation at night are transferred from workstation to the host computer next morning. The host computer merges the information ordered in day time and at night and supplies working documents for examination (worksheets, master log, etc.) to technicians. Thus physicians can order examinations all day long using workstation, which make it possible to spare the time.

Clinical Laboratory Information Systems↗
PubMed1991

[Clinico-statistical study on pyometra in high-aged outpatients].

We clinico-statistically studied outpatients with pyometra aged 60 or older who visited our outpatient clinic during the past four years. 1. Pyometra was diagnosed in 48 cases (13.6%) of 353 in which the uterine cavity could be examined. The incidence became significantly higher with age (p less than 0.01). 2. Thirty-two patients with pyometra were found to require a wheelchair or to be in an immobilized state (bedridden). These patients with poor activity in daily living amounted to 76.2% of 42 cases which were not a complication of malignant uterine tumor or tuberculous endometritis. 3. Pyometra was diagnosed in 29 patients of 96 with urinary and/or rectal incontinence (30.2%). This incidence was significantly higher than that in our patients without incontinence (5.5%) (p less than 0.01). 4. Hematological and blood chemistry study revealed abnormality of the peripheral leucocyte count in 34.5% and CRP abnormality in 70.4% of all the cases of pyometra. 5. Mixed infection by both aerobic and anaerobic bacteria was observed in 16 cases of 36 in which strain could be determined by pus culture. Streptococcus sp. and Bacteroides sp. were predominant as aerobic and anaerobic bacteria, respectively. The present study on pyometra cases of aged people demonstrated that poor activity in daily living and incontinence were significant factors causing this disease. It also revealed the various features of pyometra in aged people.

Aged↗
PubMed1991

Serum interleukin-1 and tumor necrosis factor activities in febrile children with acute leukemia.

In order to determine whether a relationship exists between levels of serum interleukin-1 (IL-1) and tumor necrosis factor (TNF) and the incidence of fever in malignant disease and infection, IL-1 and TNF levels in 60 children with acute leukemia, 18 children with bacterial infection, and 10 children with viral infection were compared with those of 20 healthy children. IL-1 levels greater than 100 pg/ml were seen in two febrile leukemic patients and six bacteria-infected patients, and the bacteria-infected group as a whole had IL-1 levels significantly higher than those of healthy children (p less than 0.05). TNF levels greater than 50 pg/ml were noted in six febrile leukemic patients and two bacteria-infected patients (both of whom were complicated by septic shock). No single group showed significantly higher levels when compared to healthy children. All patients showing high IL-1 or TNF levels had fevers at the time of diagnosis. These findings suggest that fever in bacterial infection is associated with the production of IL-1 but not TNF (except in cases of septic shock), whereas fever in acute leukemia may be associated with the production of either IL-1 or TNF. Monitoring patients with acute leukemia for IL-1 and TNF levels throughout the clinical course of disease may help clarify the causes of febrile episodes.

Child↗
PubMed1990

Lack of relationship between perioperative blood transfusion and survival time after curative resection for gastric cancer.

To better comprehend the relationship between perioperative blood transfusion and survival time after curative gastrectomy for advanced gastric cancer, the authors reviewed retrospectively data on 568 patients treated in their clinics from 1965 to 1983. Of these 568, 195 (34.3%) required no blood transfusion and 373 (65.7%) required transfusions within the perioperative period. Univariate analysis indicated that the survival time of the transfusion recipients was significantly less than that of the patients who had no transfusions (P less than 0.01). In subgroups of the authors' patients stratified to adjust for stage of disease, there was, however, no significant difference between the survival rates. Subsequently, multivariate analysis, using the Cox regression analysis, which adjusted for sex, age, and other covariates, indicated that perioperative blood transfusion was not a useful factor for predicting survival time. Multivariate analysis suggested that tumor size (P less than 0.01), degree of invasion into the gastric wall (P less than 0.01) and status of lymph node metastasis (P less than 0.01) were the most important covariates after curative gastrectomy for advanced gastric cancer. The authors' findings revealed the lack of any relationship between perioperative blood transfusion and survival time of patients who underwent curative resection for advanced gastric cancer.

Blood Transfusion↗
PubMed1990

Inverse correlation between expression of multidrug resistance gene and N-myc oncogene in human neuroblastomas.

Genomic amplification of N-myc is an important prognostic indicator in neuroblastoma. The tumors with amplified N-myc are initially sensitive to chemotherapy but often acquire resistance to therapy, recur, and ultimately kill the patients. We measured amplification and expression of N-myc and expression of mdr-1 in 35 surgically resected neuroblastomas, before acquisition of drug resistance and in 4 recurrent tumors resistant to chemotherapy. The mdr-1 mRNA expression was found to be inversely correlated with the N-myc expression. The mdr-1 gene expression was at a low level in advanced stage and histologically undifferentiated neuroblastomas, the same group of tumors in which N-myc expression is elevated. A significantly better prognosis was noted in those patients whose tumors had a high level of mdr-1 expression and a low level of N-myc expression. The role, if any, of increased expression of mdr-1 in the acquisition of multidrug resistance in neuroblastoma remains unclear. However, the aggressive clinical behavior associated with N-myc amplification and/or expression appears to be linked to down-regulation of mdr-1 expression.

Cell Differentiation↗
PubMed1990

Risk of gastric cancer in patients with non-surgically treated peptic ulcer.

We followed up 2072 patients with unoperated gastric and duodenal ulcer, diagnosed from 1963 to 1975, and evaluated the risk of development of gastric cancer. During the follow-up period of 9-23 years 38 patients had a gastric cancer or died of gastric cancer. The number of gastric cancers in patients with duodenal ulcer (observed/expected = 3:12) was statistically low (p less than 0.01) compared with the number expected from the sex- and age-matched general population. On the other hand, the number of patients with gastric ulcer and the number of those with both gastric and duodenal ulcers was 29 and 6, neither of which differed significantly from the expected occurrence. These results suggest that in peptic ulcer patients the risk of developing gastric cancer is equal to or low compared with that of the general population.

Adolescent↗
PubMed1990

Development of an automatic medical summary report system.

We developed a medical summary report system. In this system, each department can specify the predetermined conditions for issuing the summary report. The summary is made through a hierarchical database in the integrated hospital information system according to the predetermined conditions. The summary automatically issued after reception of the outpatient, or also issued by on-line summary report program with the patient number if requested by doctors. The report is sent to the proper consulting room from the reception desk using an air-shooter. The report contains the patient information such as a patient name, age, sex, birthday, a clinic name, a chart number, a patient number, diagnoses and examinations. The doctors can refer to the points of the clinical history of the patient in his own and other departments, and make a correct diagnoses and avoid the overlaps of the examinations and medications. This system has contributed to the quality-up of the patient care by availability of patient information even in other departments without the medical chart.

Hospital Information Systems↗
PubMed1990

A disposable patient identification card made of a paper.

This paper describes a patient identification system with a disposable paper card. In general, total costs of cards themselves, equipments and personnel are remarkable, not negligible for the hospital management. Therefore, a disposable identification cards made of a paper were issued to out-patients in our hospital. Many order forms were integrated into only one sheet. Patient identification data were printed on this sheet by a computer system when a patient came to the reception desk, and quickly transmitted to physicians. We could save the hospital costs and printing works by physicians, and also shorten the waiting time of patients at reception desks.

Ambulatory Care Information Systems↗
PubMed1990

Drug sensitivity test for acute myeloblastic leukemia by an efficient leukemic blast colony assay using 5637-conditioned medium as a stimulator.

Drug sensitivity of clonogenic leukemic blast cells was measured using the leukemic blast colony formation technique. Each of three chemotherapeutic agents, cytosine arabinoside, daunorubicin and aclarubicin, was added at the start of culture, and sensitivity was measured in terms of numbers of surviving leukemic blast colonies formed under continuous exposure to the drug. A substantial number of colonies was observed in all cases examined when the conditioned medium of human bladder carcinoma cell line 5637 was used as the leukemic blast colony stimulator. Although drug sensitivity varied considerably among the cases examined, sensitivity to administered drugs in clinical non-responders was significantly poorer than that in clinical responders (p less than 0.05).

Aclarubicin↗
PubMed1989

Effect of glucocorticoid replacement on tumor growth after adrenalectomy in mice.

We studied the effects of glucocorticoid replacement on tumor growth after adrenalectomy of Meth A sarcoma in mice. Tumor growth was inhibited in the adrenalectomized mice when a minimum dose of corticosterone, 0.3 mg/day, was given for replacement, and higher doses led to an even greater inhibition. Corticosterone had no effect on tumor growth in the irradiated mice. Sinecomitant immunity in the case of growth of the retransplanted excised tumor was compromised in the adrenalectomized mice. In vivo neutralization and immunosuppressive activities were absent in the spleen cells of the adrenalectomized mice. It would thus appear that adrenalectomy suppresses tumor growth by mechanisms other than glucocorticoid ablation. For optimum tumor control, glucocorticoid replacement after adrenalectomy should be in excess of the minimum daily requirements.

Adrenalectomy↗
PubMed1989

Functional neuromuscular stimulation system using an implantable hydroxyapatite connector and a microprocessor-based portable stimulator.

For developing functional neuromuscular stimulation (FNS) orthoses, percutaneous implants made of sintered hydroxyapatite (HAp) and a microprocessor-based portable stimulator were devised, and related basic studies were carried out. First, a button-shaped HAp was percutaneously implanted up to 23 months in the skin of dogs, and 30 months in human subjects. The HAp was closely contacted with the skin tissue. Then, button-shaped HAp electrical connectors were percutaneously implanted in the skin of rabbits. Sufficient contractions of the calf muscle were elicited by electrical stimuli delivered to intramuscular electrodes through the connector. These results indicated that the HAp electrical connector could be clinically utilized as an implantable skin interface for FNS. The microprocessor-based stimulator capable of processing control command signals and delivering 16-channels of electrical stimuli was developed. Usefulness of the stimulator was demonstrated by applying it to flexor and extensor muscles of the thumb in a C5 quadriplegic patient.

Adult↗
PubMed1989

Developmental retardation in children with refractory epilepsy.

It is controversial whether developmental retardation occurs in children with epilepsy and what causes the retardation if it occurs. The present study aims to reveal the factors associated with the retardation. The patients were 126 children who had been developmentally normal before the onset of epilepsy and had been followed for more than five years. Forty-eight of the 126 children showed mental retardation, and the remaining 78 had normal mental development at the follow-up. Developmental retardation was observed in children with onset before one year, known etiology, diffuse slow spike-wave or hypsarrhythmia on EEG, ingestion of six or more drugs and high blood levels of phenobarbital or phenytoin. Late onset of epilepsy, idiopathic or familial etiology, ingestion of five drugs or less and low blood level of phenobarbital or phenytoin were associated with normal development.

Adolescent↗
PubMed1989

Mathematical model of the frog skeletal muscle--analysis of non-linear mechanical properties.

A mathematical model of the skeletal muscle, consisting of contractile and series elastic components of the contracting muscle as well as viscoelastic components of the resting muscle is presented, in which the contractile component obeying the force-load-velocity relation is expressed by two components, a force generator and a viscous-like component. Since it is one of the most significant properties of the muscle that the mechanical properties depend upon the contractile force (the intensity of the active state), detailed attention is given to the explanation of those non-linear properties. Parameters of the model are determined based on physiological observations obtained from fiber bundles prepared from the frog semitendinosus muscle. While viscoelasticity is constant at the resting state, the series elastic coefficient of the contracting muscle increases with an increase in tension and the viscous-like coefficient also increases linearly with increasing contractile force. This model is checked by digital simulation against responses to ramp stretch of the muscle of the steady and transient contractions. A close agreement is shown between the simulated results and the experimental ones. The model can explicitly account for the non-linear mechanical properties of the contracting muscle.

Animals↗
PubMed1988

Excised human neoplastic tissues are more sensitive to heat than the adjacent normal tissues.

In tissues from patients subjected to gastrectomy or colectomy, the heat sensitivity was determined in the case of 23 neoplastic, 15 gastric, 8 colorectal, and the adjacent normal tissues, using the in vitro succinate dehydrogenase inhibition test. The succinate dehydrogenase (SD) activity of tissue fragments was assayed, following exposure to heat at 43 degrees C (heat treatment) or 37 degrees C (control) for 5, 10, 15 or 20 h. The sensitivity to heat treatment was estimated by the percentage of SD activity of the heat-treated cells, compared to that of control cells. The decrease in SD activity varied in the tumor tissue, following exposure to heat. The SD activity decreased to a greater extent in the tumor tissue than in the adjacent normal tissue, in each case. The mean +/- standard deviation of SD activity, following exposure to heat treatment for 20 h, was 32.1 +/- 14.0% for the tumour tissues and 52.4 +/- 10.4% for the adjacent normal tissues, with a statistically significant difference (p less than 0.01). These results show that the assay of heat sensitivity is meaningful for prediciting the effectiveness of hyperthermia and that hyperthermia has a selectivity for treating a malignant lesion.

Adult↗
PubMed1988

Cancer registration using case history database in hospital information system.

The World Health Organization (WHO) recommendations for hospital cancer registration, although being effective for combating the disease, need heavy manpower for complete implementation. A computer-based method for cancer registration is in use at Kyushu University Hospital as part of the integrated hospital information system. This method needs no manpower for data gathering, and the database includes almost all the core data and half of optional data recommended for cancer registration by the WHO. This database can, therefore, be regarded as a file for hospital cancer registration, and is used for two applications. The prepared form is automatically completed for the regional cancer register by a computer program without involving any physicians' time. In addition, a decision support system for the protocol used for a patient with a cancer was developed. Trendtables and graphs of clinical examination and medication are displayed, with suggestions and warning for physicians to help them make clinical decisions.

Clinical Protocols↗