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Biomedical subjects

K Kanagawa

Publications and source records attributed to K Kanagawa.

At least 19 recordsLinked to original sources
PubMed2002

Serum pepsinogen can predict response to H2-receptor antagonist in patients with functional dyspepsia.

BACKGROUND: Therapy for the relief of symptoms of functional dyspepsia is unpredictable. AIM: To identify which patients may benefit from antisecretory therapy. METHODS: Twenty-seven patients with functional dyspepsia were selected to receive H2-receptor antagonist (H2RA) treatment for 4 weeks. Serum pepsinogen A, pepsinogen C and gastrin were measured, and Helicobacter pylori status was determined. Symptoms were assessed at baseline and after H2RA treatment. RESULTS: Fourteen patients were identified as H2RA responders and the remaining patients were non-responders. No differences were found between responders and non-responders with regard to serum pepsinogen A, pepsinogen C, gastrin and H. pylori status. However, the pepsinogen A/C ratio was significantly higher in responders than in non-responders. Ten of the 13 functional dyspepsia patients (77%) with a high value of the pepsinogen A/C ratio (> or = 4.5) achieved symptom resolution by H2RA, compared with only one of the eight patients (13%) with a low value of the pepsinogen A/C ratio (< or = 3.0). CONCLUSIONS: The serum pepsinogen A/C ratio seems to identify those functional dyspepsia patients for whom acid control provides benefit. This ratio may be a practical tool for the management of functional dyspepsia patients.

Adult↗
PubMed2002

Increased gastric acid secretion in cholecystokinin-1 receptor-deficient Otsuka Long-Evans Tokushima fatty rats.

BACKGROUND: It is hypothesized that cholecystokinin stimulates acid secretion directly and indirectly by binding to CCK-2 (CCK-B/gastrin) receptors on both parietal and enterochromaffin-like cells. At the same time, however, it inhibits acid responses by stimulating the paracrine secretion of somatostatin from D cells and thereby exerts a tonic inhibition on the parietal cells. To test the validity of this hypothesis, we determined gastric acid secretion in the CCK-1 (CCK-A) receptor-deficient Otsuka Long-Evans Tokushima fatty (OLETF) rats. METHODS: Gastric acid secretion was determined in the acute fistula OLETF and the control Long-Evans Tokushima Otsuka (LETO) rats. Plasma concentrations of gastrin, CCK, somatostatin and histamine were determined by radioimmunoassay. The levels of CCK-2 receptor mRNA in the mucosa of the glandular stomach were determined by Northern blot analysis. RESULTS: Pentagastrin- and CCK-8-stimulated as well as basal acid outputs in OLETF rats were significantly higher than those in LETO rats. CCK-2 receptor antagonist reduced basal acid outputs and completely suppressed CCK-8-stimulated acid secretion in both strains. CCK-8 enhanced the pentagastrin-stimulated gastric acid output in OLETF rats, but not in LETO rats. In LETO rats, CCK-1 receptor antagonist increased CCK-8-stimulated gastric acid secretions to those in OLETF rats. The level of CCK-2 receptor mRNA in the stomach in OLETF rats was 2-fold higher than that in LETO rats. In OLETF rats, plasma concentrations of CCK and histamine were higher, whereas somatostatin concentrations were lower than those in LETO rats, with no change in basal plasma gastrin concentrations. CONCLUSIONS: These results in the CCK-1 receptor-deficient OLETF rats confirmed that CCK stimulates acid secretion by binding to CCK-2 receptors, but at the same time inhibits acid responses by stimulating the paracrine secretion of somatostatin from D cells in the gastric mucosa.

Animals↗
PubMed2001

Characteristics of housebound elderly by mobility level in Japan.

The purpose of the present study was to describe characteristics of the housebound elderly by their mobility levels. Disabled elderly people in Japan were interviewed at home by nurses. Housebound status was defined as people who left the house less than once a week. Characteristics of housebound elderly were compared with non-housebound elderly by three mobility levels: (i) Non-walking group (n=72); 5 m-walking group (n=153); going-by-bus group (n=96). Housebound elderly were not found in the going-by-bus group. Among the elderly in the non-walking group, the cognitive function of the housebound elderly was significantly lower and the housebound elderly were less well cared for; however, their caregivers rated their caregiving burden significantly lower than did caregivers of the non-housebound elderly. Among those in the 5 m-walking group, the autonomy and social networks of the housebound elderly were significantly less than for the non-housebound. The characteristics of housebound elderly showed differences by mobility levels.

Activities of Daily Living↗
PubMed2001

[Positive perceptions encouraging continued caregiving at home among family caregivers].

PURPOSE: Few data are available on factors encouraging continued caregiving at home, especially in relation to positive perceptions of caregiving and the care burden. This study was conducted to explore this question. METHODS: We collected data from forty caregivers using Visiting nursing station, with structured interviews conducted at home. RESULTS: 1. Sixty-five percent of caregivers had positive perceptions of the worth and enjoyment of their work in caregiving. 2. Encouraging continued caregiving was associated with positive perceptions and these are relatively independent of the care burden. 3. Caregivers who had high encouraging continued caregiving were spouses or children of the clients. They had positive attitude to caregiving, an intention to use social services and satisfaction in caregiving. 4. Events from which caregivers felt worth and enjoyment in their work were improvement of client's health conditions, gratitude in client response, learning of care skills and strengthening bonds of family relationship. CONCLUSION: The findings suggest it is important to approach caregivers for the positive perceptions, rather than simply by decreasing burden.

Adult↗
PubMed2001

[Complete remission of brain metastases from prostate cancer by gamma knife radiosurgery: a case report].

A 59-year-old male visited us with a chief complaint of dysuria. The serum prostate specific antigen (PSA) level was within normal limits, and intravenous pyelography and urethrocystography showed no abnormal findings. Because of his urinary retention, transurethral resection of prostate was performed under a clinical diagnosis of benign prostatic hyperplasia. The pathological diagnosis was poorly differentiated adenocarcinoma of the prostate. Not only combination hormone therapy with goserelin acetate and flutamide, but also intermittent arterial infusion chemotherapy with cisplatin (CDDP) and pirarubicin (THP) using a reservoir system was administered. Additionally total pelvic irradiation was delivered. Magnetic resonance imaging (MRI) demonstrated that his prostate was reduced to less than 50% in size and he had no difficulty in voiding. He suddenly developed dysarthria and hemiplegia 3 months later. MRI and computed tomography (CT) revealed multiple brain metastases. After the gamma knife radiosurgery, neurological findings disappeared and MRI showed dramatic shrinkage of metastatic brain tumors. Metastasis to the pancreas was recognized on CT and he died of multiple organ failure 30 months after his first visit.

Adenocarcinoma↗
PubMed2000

A psychosocial group intervention for Japanese women with primary breast carcinoma.

BACKGROUND: To the authors' knowledge, there had been no evidence for the efficacy of psychosocial intervention among Japanese cancer patients. The objective of this study was to determine the effect of a psychosocial group intervention in reducing psychologic distress and enhancing coping in this population in a randomized controlled trial. METHODS: The patient selection criteria were age younger than 65 years, lymph node metastasis positive and/or histologic or nuclear Grade 2-3, and surgery undergone within the previous 4-18 months as of the start of the study. We conducted a 6-week, structured, psychosocial group intervention. The intervention consisted of health education, coping skills training, stress management, and psychologic support. Subjects were assessed for psychologic distress and coping by administering the Profile of Mood States (POMS), Mental Adjustment to Cancer (MAC) scale, and Hospital Anxiety and Depression (HADS) scale at the baseline, at 6 weeks, and at 6 months. RESULTS: Fifty (33%) of the 151 patients participated and were randomized, and 46 (30%) completed the study. The experimental group had significantly lower scores than the controls for total mood disturbance and significantly higher scores for vigor on the POMS, and significantly higher scores for fighting spirit on the MAC at the end of the 6-week intervention. These improvements were sustained over 6 months of follow-up. CONCLUSIONS: The results of this study suggest that a short term psychosocial group intervention produces significant long term improvement in the quality of life of Japanese patients with primary breast carcinoma.

Adaptation, Psychological↗
PubMed2000

Polypoid metastatic hepatocellular carcinoma of the esophagus occurring after endoscopic variceal band ligation.

This report describes a rare case of metastatic hepatocellular carcinoma (HCC) presenting as a polypoid mass in the lower esophagus after endoscopic variceal band ligation (EVL). A 56-year-old man underwent EVL for variceal bleeding in September 1993. He presented with dysphagia and tarry stool in December 1993. An endoscopic examination revealed a semipedunculated polypoid mass at the lower part of the esophagus, where EVL had been performed 3 months previously. The histologic examination at autopsy revealed that the polypoid mass consisted of metastatic HCC that had spread via the retrograde portal flow.

Biopsy↗
PubMed2000

[Functional changes in one-year and related factors among community-dwelling frail elderly].

PURPOSE: The purpose of this study was to investigate physical and psychosocial characteristics together with life activities related to functional changes among frail elderly, including J-rank individuals able to walk outdoors and take a bus as well as people of A-rank capable of moving around inside the house but incapable of going outside. METHODS: The study design was of longitudinal type. Participants were community-dwelling frail elderly, 61 J-rank and 90 A-rank individuals aged over 65-years and caregivers. Nurses conducted home interviews as Wajima City, Ishikawa Prefecture in Japan, in 1998 at the baseline and 1999 at follow-up, and evaluated the degree of independence of the frail elderly. With the baseline survey, physical function, psychosocial characteristics, and life activities were assessed. RESULTS: At the follow-up survey, 3.3% people of J-rank elderly had died and 83.6% were at home. Among the A-rank elderly, 11.1% had died and 80.6% were at home. Functional change in one-year was as follows: 31.4% people of J-rank had declined and 68.6% remained the same. 19.4% people of A-rank improved, 65.3% unchanged, and 15.3% declined. Among J-rank elderly, functional decline was significantly related to low ADL level and less verbal contact with their caregivers. Life activities such as getting out to the garden or around the house, worshipping at a temple, doing house chores, shopping, and gardening, related to maintained function. Among A-rank elderly with the low ADL, function similarity declined. Life activities such as visiting friends, gardening, and performing self-care chores were significantly linked to improvement. CONCLUSIONS: The results suggest that the degree of independence of frail elderly may easily change. ADL is related to functional change among frail elderly of both A and J rank. It is recommended that facilitating activities like house chores or getting out the house for J-rank individuals and self-care for A-rank elderly is important to prevent functional decline. Preventive community-based care for frail elderly should therefore be directed of supporting their active life.

Activities of Daily Living↗
PubMed1999

[A review of methodology on community health nursing diagnosis].

PURPOSE: To develop a systematic method and model for community health nursing diagnosis to be used in teaching and in community practices. METHOD: From searching the databases of Medline (from Jan. 1966 to May 1997) and the Japana Centra Revuo Medicina (from Jan. 1987 to Jan. 1997), literature on community diagnosis, community health nursing, diagnosis, assessment and analysis were classified into keywords, purposes, subjects, health problems and methods. RESULTS: 1. As an explanation of the process of nursing diagnosis the community-as-partner model (Anderson and McFarlane; 1995) is useful for understanding the target community and the use of the community health nursing diagnosis process. 2. The methodology of the community health nursing diagnosis is based on three strategies of public health diagnosis. The method of interview surveys was strengthened by incorporating the ethnographic method. 3. Several case studies in the partnership between communities and universities in USA were introduced. CONCLUSION: Changes in community health policy require that public health nurses develop specialized and comprehensive practices in their communities. The authors presented the model of the community health nursing diagnosis process and proposed a partnership between communities and universities. The construction of community health nursing diagnosis process in this paper is based on the public health diagnosis framework consisting of three strategies, to which analysis of existing data, a social survey utilized in epidemiological community diagnosis, and free interviewing from ethnographic methods are incorporated. Developing this systematic diagnosis process of facilitates the search for potential or actual community health problems or concerns, the practice of applying data from surveys and the discussion of concrete strategies toward problem solving. It is useful for educational and research processes and in practice in the community.

Community Health Nursing↗
PubMed1999

[Three-years changes in disability and mortality associated with daily life patterns among the home frail elderly].

PURPOSE: The purpose of this study was to eximine 3-year changes in disability and mortality in relation to the daily life patterns among the frail elderly living at home. METHODS: Subjects were 50 frail elderly living at home who were interviewed at baseline, in July to September, 1995. By detailed time budgets, five daily life patterns were classified: Lying-rest, Sitting-rest, Hobby, Walking, and Housework. Information on ADL was obtained from visiting nurses or mailed questionnaires in June 1998 (3 years later). RESULTS: Within the 3-year period, 15 people (30%) died. At the follow up, 27 people (54%) were living at home, three (6%) were hospitalized, and four (8%) were institutionalized. In 31 analyzed samples, ADL scores significantly decreased during the 3-year period. As for the ability to perform each activity, it was found that only the elderly in Housework life pattern maintained their ADL. The elderly in Lying-rest life and Sitting-rest life patterns were more likely to die. CONCLUSION: Decline in ADL among home frail elderly was found for the 3 years. It was suggested that community health care for preventing disability progress among home frail elderly were important over a long time. Housework life patterns were seemed to be associated with physical performance.

Activities of Daily Living↗
PubMed1999

[Incidence proportion estimation, prevalence and effective visiting nurse care of pressure ulcers].

PURPOSE: The purpose of this study are as follows: 1. To determine incidence proportion estimations and prevalence of pressure ulcers in home care settings. 2. To clarify the effective nursing care for prevention and treatments of pressure ulcers at visiting nursing service stations. 3. To show whether demographic characteristics are factors in pressure ulcer development. METHODS: This research is a part of the series of studies on prevalence of pressure ulcers in 934 visiting nursing service stations on October 1995 in Japan. This was followed in November 1, 1996 to October 31, 1997, by another investigation for incidence proportion estimation and prevalence of pressure ulcers and their relationship to nursing care facilities, in which questionnaires were mailed to 620 facilities that participated in the first research. Responses from 294 (47.4%) facilities and 1,208 subjects were received. We analyzed the responses from 215 facilities (73.1%) and 864 subjects to the two types of questionnaires. RESULTS: Prevalence of pressure ulcers was found to be 8.0% (95% CI: 7.5-8.6) on July 1, 1997 and incidence proportion estimation was 3.7% (95% CI: 3.3-4.1) from November 1, 1996 to October 31, 1997 for the 10,750 clients in 215 facilities. The number of prescriptions for turning of client sleep position (p = 0.044), and having a standard care assessment procedure (p = 0.015) were significantly higher for no-present pressure ulcer than in facilities with under 5% having present pressure ulcers and facilities with over 5% having present pressure ulcers. Subtracting the prevalence point in 1997 from 1995, the utilization of a primary nursing care plan (p = 0.021), and the number of part-time nurses (p = 0.008) were significantly higher in the groups that had a decrease or no-change compared to the increased groups. 45.6% of the ulcers identified were situated on the sacrum/buttocks and 39.4% of the ulcers were grade 2. The mean total score on the Braden Scale was 12.7. A score of 18 may be considered as the cut-off point in home care settings. DISCUSSION: Prevalence of pressure ulcers was found to be 8.0% and incidence proportion estimation was 3.7%. The present findings concerning incidence proportion estimation and prevalence of pressure ulcers and the practice of nursing care in visiting nursing service stations suggests possibility for improving outcomes for clients with pressure ulcers and for those at risk factors of developing them.

Aged↗
PubMed1998

Experience with kidney transplantation in children and adolescents.

BACKGROUND: Paediatric kidney transplantation has different aspects in adults in terms of underlying primary renal disease, surgical technique, perioperative care and graft prognosis. Significant urological problems are present in a high percentage of paediatric recipients. This study was undertaken to characterize paediatric kidney transplantation as performed at our institutes. METHODS: Twenty-eight patients (age range 4-17 years, 10 girls, 18 boys) were included in this study. We analyzed (1) urologic procedures performed prior to or simultaneously with transplantation, (2) intraoperative changes in haemodynamics, (3) postoperative complications and (4) acute allograft rejection and graft prognosis. RESULTS: Of 4 patients with lower urinary tract abnormalities (neurogenic bladder in 3, posterior urethral valve in 1), 2 underwent augmentation ileocystoplasty prior to transplantation. The Mitrofanoff procedure as a diversion for neourethra was also performed in 2 of the 4 patients. All these 4 patients were managed with clean intermittent catheterization. Central venous pressure changes before and after graft vessel declamping were much greater in patients with body weight below 25 kg than in those above 25 kg. Five surgical complications and 6 infections were encountered postoperatively and hypertension was lasting in 6. Thirteen patients experienced 19 periods of acute allograft rejection. All of the 24 patients in the cyclosporin era (1986-) overcame rejections and they are all alive with good graft function. CONCLUSIONS: As long as proper pretransplant patient evaluation and management, and intensive perioperative care are undertaken, good prognosis of renal allograft can be achieved in young patients.

Adolescent↗
PubMed1998

Defects of cholecystokinin (CCK)-A receptor gene expression and CCK-A receptor-mediated biological functions in Otsuka Long-Evans Tokushima Fatty (OLETF) rats.

Recent studies in genetically obese and diabetic Otsuka Long-Evans Tokushima Fatty (OLETF) rats suggest defects of cholecystokinin (CCK)-A receptor gene expression and CCK-A receptor-mediated biological functions such as pancreatic juice, protein, and gastric acid secretion. The present studies were undertaken to further examine CCK-A receptor gene expression and CCK-A receptor-mediated biological functions in the pancreas, stomach, and brain of OLETF rats. Expression of the CCK-A receptor gene could not be detected in the stomach, pancreas and brain by the reverse-transcription polymerase chain reaction (RT-PCR) method and Southern blotting of the PCR products. Southern blot analysis of genomic DNA from OLETF and control Long-Evans Tokushima Otsuka (LETO) rats with CCK-A receptor fragment as a probe revealed different restriction bands. Expression of the CCK-B receptor gene was observed in the stomach, pancreas, and brain in both OLETF and LETO rats by the RT-PCR method, with expression of the CCK-B receptor gene markedly enhanced in OLETF rats compared with that in LETO rats. Consistent with the defect of CCK-A receptor gene expression, CCK-A receptor-mediated biological functions were not observed in these organs. Perfused exocrine and endocrine pancreas of OLETF rats were insensitive to CCK stimulation but not to carbamylcholine stimulation. Basal gastric acid and pepsinogen secretions in OLETF rats were higher than in LETO rats. OLETF rats showed a significantly higher average daily food intake, gained body weight faster, and were heavier than LETO rats. The present study confirmed that OLETF rats have CCK-A receptor gene anomalies and demonstrated deficient CCK-A receptor-mediated biological function in the pancreas, stomach, and brain.

Animals↗
PubMed1998

Immunological analysis of rat renal transplant recipients exhibiting long-term survival following treatment with 15-deoxyspergualin in the early postoperative phase.

BACKGROUND: We previously reported that short-term administration of 15-deoxyspergualin (DSG), 5 mg/kg/day on postoperative days 4 through 7, prolonged survival of rat renal allografts indefinitely. We now report the immunologic environment of DSG-treated recipients in the early postoperative phase. METHODS: TO (RT1u) rat kidneys were transplanted into WKAH (RT1k) rats. Peripheral blood lymphocytes (PBL), splenocytes (SPC) and graft infiltrating lymphocytes (GIL) were harvested from rejecting (untreated) recipients on day 7 (group AR) and from DSG-treated recipients on days 7 (Group DSG7) and 14 (group DSG14). Flow cytometric analysis was done to determine characteristics of these cells. Mixed lymphocyte culture reactions (MLRs) were also studied to examine suppressive activities of sera, SPC, and GIL of each group by adding them to TO/WKAH MLRs. RESULTS: In all groups, the proportions of CD8- and interleukin 2 receptor (IL-2R)-positive cells were higher for GIL than for either PBL or SPC. The CD4/CD8 ratio was lowest in GIL. Comparing groups DSG7 and DSG14, significant decreases in the proportion of CD8- and IL-2R-positive cells were found only in GIL. Sera of all groups nonspecifically suppressed MLRs, independent of DSG-administration. GIL of all groups also nonspecifically suppressed MLRs, while these suppressive activities were not observed with SPC. Suppressive activities of GIL remained unchanged in the first 2 postoperative weeks. CONCLUSIONS: Differences in the immunologic environment were reflected primarily in GIL. DSG seemed to decrease CD8- and IL-2R-positive cells in allografts. In the presence of DSG, this model may feature a predominance of nonspecific suppressor T cells over cytotoxic T cells during the first 2 postoperative weeks.

Animals↗
PubMed1998

Kidney transplantation in a child with posterior urethral valve from a hepatitis B virus-carrier mother. Report of a case with special reference to urinary tract reconstruction for dysfunctionalized uropathies and seroimmunological preparation against viral transmission.

The case of a 7-year-old boy with posterior urethral valve (PUV) who underwent successful kidney transplantation for progressive renal failure is reported. He required complex reconstructive surgery for PUV-related disorders, and also specific serological preparation for hepatitis B (HB) as his living donor mother was a proven carrier. By carefully executing the principles of reconstructive surgery and with well-planned seroimmunological preparation, we have demonstrated that successful kidney transplantation can be done from an HB Ag-positive mother to an HB Ag- and HB Ab-negative son, even when his urinary tract is severely dysfunctional due to PUV.

Carrier State↗
PubMed1998

[Daily life patterns associated with 18-months changes of disability among frail elderly living at home].

The purpose of this study was to investigate daily life patterns associated with changes of disability over 18-months among frail elderly living at home. Subjects were 50 frail elderly living at home who were interviewed at baseline, in July-September 1995. By detailed time budgets among them, five life patterns were classified. Lying-rest life pattern, Sitting-rest life pattern, Hobby life pattern, Walking life pattern, and Houseworking life pattern. Activities of daily living (ADL) measured by Extended ADL Index consisted of 8 items of Barthel Index and 4 items of TMIG Index of Competence. Information for follow-up were obtained from home health nurses or mail-questionnaires February-March in 1997. The results were as follows: All samples were able to be followed. Seven people died within the 18 months follow-up. Overall change of score on ADL was not seen between baseline and follow-up study. ADL improvement was seen in 45.0% and 43.7% had declines. Daily life patterns were not correlated with changes in ADL score. However, analysis of decline in ability to perform each activities, relative associations (not statistically significant) were found for changes in function and daily life patterns. Lying-rest life pattern and Sitting-rest life pattern elderly were more likely to decline in ADL than Walking life pattern and HouseworKing life pattern elderly. Hobby life pattern elderly only declined in walking. These findings support previous studies showing that disability of home frail elderly could be improved. Daily life pattern among them would be a helpful predictor of changes in specific physical performance over years.

Activities of Daily Living↗