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Biomedical subjects

K Kanagawa

Publications and source records attributed to K Kanagawa.

At least 37 records · Page 2Linked to original sources
PubMed1998

[Prevalence of pressure ulcers of patient in home visiting nursing service].

PURPOSE: To determine prevalence and risk factors for pressure ulcers of subjects in visiting nursing service stations. METHOD: Descriptive cross-sectional study. Data were collected by a mail survey questionnaire from 934 visiting nursing service stations that were listed in "Visiting nursing service stations list" in September 1995. RESULTS: Responses from 620 visiting nursing service stations were obtained (collection rate 66.4%). The sample consisted of 23,500 subjects, with a pressure ulcer prevalence rate of 14.6% (n = 3,441). Furthermore, the prevalence was 15.1% (n = 3,177) in the elderly of 65 years and older (n = 21,020). The observed prevalence among visiting nursing service stations ranges from 4.8% to 24.1%. In subjects with pressure ulcers, there were high rates of cerebral vascular diseases, dementia, Alzheimer's disease, urinary organ system diseases, and senility. On the other hand, subjects without pressure ulcers, had high rates of ischemic heart diseases, chronic respiratory organ diseases, and mental disease. The total number of pressure ulcers that were observed in 3,441 subjects was 5,158 and the number of the pressure ulcers per person was 1.64. The level of depth of I, II were observed at around 40%. CONCLUSION: The number of elderly people who necessitate medical treatment or nursing care in homes will be increasing in the future. A survey is needed to develop a program that will be efficient in early detection and care of pressure ulcers.

Aged↗
PubMed1997

Experience with revascularizing renal artery aneurysms: is it feasible, safe and worth attempting?

PURPOSE: We retrospectively evaluated the feasibility and efficacy of surgical revascularization for renal artery aneurysms. MATERIALS AND METHODS: Beginning in 1984, 12 patients with renal artery aneurysm underwent renal revascularization regardless of clinical features. Postoperative results were analyzed regarding split renal function, patency of the revascularized arteries, blood pressure control and surgical complications. RESULTS: Postoperative renal function was stable or improved in all but 1 case and patency in branched arteries was preserved in 86%. Hypertension in 8 patients was cured in 7 (88%), including 2 with renovascular hypertension, and improved in 1 (12%). Complications were minimal with only 1 ureteral stricture that required reoperation. CONCLUSIONS: The majority of renal artery aneurysm cases are amenable to surgical repair. Carefully performed renal revascularization is rewarding in that high blood pressure is better controlled, renal function is improved and the potential risk of rupture is obviated.

Adult↗
PubMed1997

[Required manpower for health care and nursing services for the aged at home public health nurses, visiting nurses, dental hygienists, dietitians, physical therapists, and occupational therapists].

The purpose of this study was to estimate the manpower required for the health care and nursing services for the aged at home. For prefectural health care and welfare planning for the aged, data such as the proportion of the aged who need help, service demand, and required frequency of services were obtained. The means and "mean +/- 2 x standard deviations" were calculated to obtain various parameters. Calculated figures were those which can be obtained with some effort. The results are as follows (middle level estimation (low level estimation-high level estimation)): requirements are 1.9 (0.61-5.7) public health nurses, 2.6 (0.63-14) visiting nurses, 0.20 (0.084-0.42) dental hygienists, 0.35 (0.17-0.66) dietitians, and 0.25 (0.014-1.27) physical and occupational therapists per population 10,000. For the national total, requirements are 23 (7.3-67) thousand public health nurses, 31 (7.5-160) thousand visiting nurses, 2.4 (1.0-5.0) thousand dental hygienists, 3.9 (2.0-7.8) thousand dietitians, and 3.0 (0.17-15) thousand physical and occupational therapists. By population sizes, for example in the municipalities which has 10-30 thousand people, required are 4.2 (1.7-11) public health nurses, 5.3 (1.3-27) visiting nurses, 0.4 (0.2-0.8) dental hygienists, 0.5 (0.3-0.9) dietitians, and 0.5 (0.0-2.5) physical and occupational therapists. Comparison of the present numbers with estimated manpower needs show that, the present number of public health personnel is almost the same as the low level estimation. But the present numbers of other manpower is lower than the low level estimation. Considering other services such as maternal and child health, it seems that the municipalities which has 10+ thousand population should employ full-time dietitians and dental hygienists. For policy making in a municipality, the policies of other municipalities should be considered. Because it is based on means for municipalities, the results of this study should be useful for application by other municipalities.

Community Health Nursing↗
PubMed1996

Case report: primary CD30 (Ki-1)-positive anaplastic large cell lymphoma of the duodenum.

As recently described, Ki-1 anaplastic large cell lymphoma is a distinctive subtype of non-Hodgkin's lymphoma. We report a Ki-1 anaplastic large cell lymphoma of the duodenum in a 62-year-old man. He received modified CHOP therapy and was in complete remission at 18 months. To our knowledge, this is the first report of primary Ki-1 anaplastic large cell lymphoma of the duodenum.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1996

Correlates of participation in adult day care and quality of life in ambulatory frail elderly in Japan.

The purpose of this study was to explore the correlates of participation in adult day care programs and the quality of life (QOL) of ambulatory frail elderly in Japan. The study was conducted through questionnaires administered to 95 elderly participants at two adult day care centers in a prefecture in Japan. Participation in adult day care had positive correlations with QOL for female participants. However, for male elderly subjects, there was no significant correlation between participation and QOL. Results imply the need for additional research on factors influencing negative self-esteem in the male elderly, including an identification of the mechanisms by which their self-esteem was affected. The reliability of the Graham Global Well-Being Scale was supported for the first time in a domestic study in Japan.

Activities of Daily Living↗
PubMed1996

Defect in pancreatic exocrine and endocrine response to CCK in genetically diabetic OLETF rats.

Clinical as well as experimental studies in insulinopenic diabetes mellitus have demonstrated abnormal pancreatic exocrine responses to cholecystokinin (CCK). In the present study, we examined pancreatic exocrine and endocrine function in the recently developed genetically diabetic Otsuka Long-Evans Tokushima fatty (OLETF) rats and compared them with those in the control Long-Evans Tokushima Otsuka (LETO) rats of the same age. Stepwise increasing doses of CCK octapeptide (CCK-8; 0.027-7.0 nmol.kg-1.h-1) evoked a characteristic biphasic dose-response curve for pancreatic juice and protein output in the LETO rats, whereas the OLETF rats were totally insensitive to CCK-8 stimulation. However, the responsiveness and the sensitivity to both carbamylcholine and secretin were similar in the two groups. Intraduodenal infusion of casein (500 mg/h) failed to stimulate pancreatic exocrine secretion in the OLETF rats despite a greater CCK response than in the LETO rats (peak response: 8.43 +/- 0.97 vs 5.12 +/- 0.30 pmol/l in LETO, P < 0.01). Intravenous infusion of CCK-8 (4.4 nmol.kg-1.20 min-1) caused a significant increase in serum insulin concentrations and a concomitant decrease in glucose levels in the LETO rats but not in the OLETF rats. On the other hand, an intravenous bolus injection of 1.1 mmol/kg glucose caused a greater insulin release in the OLETF rats than in the LETO rats. In contrast, gastric acid secretion in the OLETF rats was significantly high in basal and in response to intravenous infusion of CCK-8 compared with that in the LETO rats. Four subcutaneous injections of 20 micrograms/kg caerulein at hourly intervals over 3 h induced acute pancreatitis in the LETO rats but did not elicit any significant increase in serum amylase or lipase activities and pancreatic wet weight or histological evidence of acute pancreatitis in the OLETF rats. These results indicate that the exocrine and endocrine pancreas of the recently developed genetically diabetic OLETF rats are totally and specifically insensitive to exogenous and endogenous CCK stimulation, whereas parietal cells in these rats are sensitive to CCK stimulation.

Acute Disease↗
PubMed1996

Surgical revascularization in children with renovascular hypertension.

Two boys, 11 and 10 years of age, respectively, having renovascular hypertension are reported. Diagnostically, captopril test and renal scintigraphy were useful as pharmacologic probes of the renal arterial stenosis and to determine its laterality, as well for examination of the operative outcome. Both children were rendered normotensive after renal revascularization, one by renal autotransplantation and the other by aortorenal bypass procedure. Renovascular hypertension in children is also discussed.

Aortography↗
PubMed1996

Pharmacological profile of a new serine derivative cholecystokinin receptor antagonist TP-680 on pancreatic, biliary and gastric function.

The in vivo pharmacological effects of the newly developed serine derivative [(R)-1-[3-(3-carboxypyridine-2-yl)thio-2-(indol-2-yl) carbonylamino]propionyl-4-diphenyl-methyl-piperazine] (TP-680), a cholecystokinin type-A (CCK-A) receptor antagonist, on pancreatic, biliary and gastric function were examined in rats and mice. The i.v. infusion of TP-680 in rats caused a parallel rightward shift of the entire dose-response curve for cholecystokinin octapeptide (CCK-8)-stimulated pancreatic exocrine secretion without altering the maximal response (ID50 = 480 nmol/kg). TP-680 also antagonized CCK-8-stimulated pancreatic secretion in mice (ID50 = 600 nmol/kg). Secretion of pancreatic juice and protein elicited by intraduodenal infusion of casein was also antagonized by TP-680. The CCK antagonism produced by i.v. TP-680 persisted for 16 h. Specificity for CCK was demonstrated by the inability of TP-680 (1000 nmol/kg) to antagonize either secretin- or bombesin-stimulated pancreatic secretion in rats. Moreover, specificity for CCK-A receptor was also demonstrated by the inability of TP-680 to antagonize pentagastrin-stimulated gastric acid secretion. Administered i.v., TP-680 was highly potent in antagonizing CCK-8-induced inhibition of gastric emptying (ID50 = 40 nmol/kg) but was less potent in antagonizing the contractile effects of CCK-8 on the gallbladder in mice (ID50 = 4000 nmol/kg). TP-680 also antagonized gallbladder contraction elicited by p.o. administered peptone. In the absence of exogenously administered CCK-8, TP-680 had no effect on any of the assay systems studied, which indicates a lack of CCK-like agonist properties. These results indicate that TP-680 is a potent, competitive and specific CCK-A receptor antagonist with long duration of action. The selectivity of TP-680 action depends on anatomical location of the CCK receptors (gastric emptying > pancreatic secretion > gallbladder contraction). This may provide a potentially valuable new tool for evaluating the role of CCK as a physiological mediator of GI function and its possible involvement in pathological states.

Animals↗
PubMed1995

Strain combination-dependent genesis of necrotizing arteritis in anti-ICAM-1 antibody-perfused renal allografts in the rat.

Rat kidneys were perfused with anti-intercellular adhesion molecule-1 (anti-ICAM-1) monoclonal antibody prior to allotransplantation. In the two strain combinations examined, LEF-to-WKAH transplants resulted in accelerated graft loss, and no prolongation of graft survival. The accelerated graft loss was the result of frequent occurrence of necrotizing arteritis within the grafts. In contrast, TO-to-WKAH transplants resulted in no change in graft survival and no arteritis. Necrotizing vasculitis in the LEJ-to-WKAH grafts was characterized by fibrinoid necrosis, collection of cellular infiltrates and serum macromolecular protein entrapment. The F(ab1)2 form of anti-ICAM-1 antibody partially preserved the antibody's capacity to accelerate graft loss. Therefore, although endothelial injury by Fc-mediated cytotoxicity may be involved in vascular damage, other mechanisms also come into play. The amount and distribution pattern of ICAM-1 antigen were identical in both TO and LEJ strains. Intravenous anti-ICAM-1 antibody administration combined with lipopolysaccharide, Poly(I)-Poly(C), warm ischemia to the kidney, or subcutaneous immunization with allogeneic spleen cells, but without renal transplantation, did not generate necrotizing vasculitis or proteinuria. These observations plus our previous data on the rat liver transplantation model clearly show that graft perfusion with anti-ICAM-1 monoclonal antibody invokes extensive vascular damage within allografts by Fc-mediated and Fc-independent mechanisms, depending on the donor-to-host combination.

Animals↗
PubMed1995

[Kidney transplantation].

From March 1986 to August 1994, 110 living-related renal transplants were performed under the cyclosporine combination immunosuppression. Age of the recipients ranged from 4 to 48 years old (mean 29.3), and 81 patients were male and 29 were female. The mean duration on dialysis before the transplants were 39.7 months (0 to 210), and the methods of dialysis were divided with hemodialysis in 94 patients, CAPD in 15 and no dialysis in 1. The donors consisted of 96 parents (87.3%), 66 mothers and 30 fathers, and 14 siblings (12.7%). Age of the donors ranged from 28 to 73 years old (mean 48.7). The number of patients with acute rejection episodes were 48 patients with once, 18 with twice, 10 with 3 times and 34 (30.9%) with no rejection. Patient survival rate was 99.0% after 1 year posttransplantation, 97.9% after 3 years and 95.7% after 5 years. Graft survival rate was 91.5%, 85.1% and 77.8%, respectively. Twenty grafts were lost with the most common causes of graft loss being chronic rejection (55%), acute rejection (20%) and accelerated acute rejection (15%). In cadaveric renal transplants, because of very small number of informations for cadaver donor, only 13 cadaveric renal transplants were performed in Hokkaido, from 1984 to August 1994. There was no case over 5 years follow up postoperatively, so patient survival rate was 100% and 90% after 1 year and 3 years posttransplantation, and graft survival rate was 84.6% and 74.0%, respectively. Two kidneys of 13 cadaveric renal transplants were never functioning grafts. We have to make more efforts for propagation of the donation system.

Adolescent↗
PubMed1994

One-stage repair of hypospadias: is there no simple method universally applicable to all types of hypospadias?

A simple method of hypospadias repair is described. The operative technique consists of 7 steps, including 1) outlining the skin incision and dartos mobilization; 2) artificial erection, harvesting parameatal foreskin flap and release of chordee as needed; 3) glans splitting and creation of glanular wings; 4) 1-stage urethroplasty with parameatal foreskin flap; 5) meatal glanuloplasty; 6) creation of Byars' flaps of the skin, and 7) skin closure. Central to the technique is the feasibility of the choice of 1-stage urethroplasty with meatal based manta-wing flap or with parameatal based and fully extended circumferential foreskin flap even after the skin incision is made, which enables its application to all types of hypospadias. Of 120 patients the 1-stage urethroplasty was performed with meatal based manta-wing flap in 50, and with parameatal based and fully extended circumferential foreskin flap in 70. Primary success was obtained in 82% of the cases with meatal based manta-wing flap, and in 53% with parameatal based and fully extended circumferential foreskin flap. Complications requiring secondary repair occurred in 42 cases (9 with meatal based manta-wing flap, and 33 with parameatal based and fully extended circumferential foreskin flap) but repair was successful in 32. Thus, the overall success rate was 91% (96% with meatal based manta-wing flap, and 87% with parameatal based and fully extended circumferential foreskin flap). Additional repair (10 secondary, 2 tertiary and 1 quaternary) is planned in 13 cases. The technique of 1-stage urethroplasty with parameatal foreskin flap is recommended as a simple and reliable treatment for hypospadias with a reasonable success rate.

Child↗
PubMed1994

Management and outcome of antenatally diagnosed hydronephrosis.

From March 1989 to December 1992, we encountered 25 kidneys in 21 patients with a suspicious ureteropelvic junction (UPJ) obstruction detected only on prenatal ultrasound. In all these patients other urological abnormalities were excluded by voiding cystourethrography and other radiological findings. Diuretic renography (DR) was initially performed at an age ranging from 15 days to 32 months in all patients and repeated a total of 39 times. Both the split renal function (SRF) and diuretic drainage half-time clearance (DT1/2) of radioagent were within their normal ranges in the case of 15 (60%) of the kidneys on initial DR. In these kidneys, there were no aggravated signs on repeated DR. Decreased SRF was found in 3 kidneys (12%) on initial DR. Of these, the renal function spontaneously reverted to normal in 2 cases with bilateral hydronephrosis. Another 1 kidney revealed significant UPJ obstruction assessed by pressure flow study and continuous nephrostomy drainage had brought relief from the obstruction 1 year later. Prolonged DT1/2 with normal SRF was found in 7 (28%) kidneys. The renal function did not deteriorate and the diuretic response improved on repeat DR except for 1 kidney, whose function deteriorated and on which ultimately, pyeloplasty was performed at 7 months of age. Prenatally diagnosed hydronephrosis is usually asymptomatic and clinically significant UPJ obstruction should be always verified. Although even today there is still no examination which can detect a definite obstruction, we can identify one as significant by careful repeat examinations and thus avoid unnecessary surgery without causing any renal deterioration.

Child, Preschool↗
PubMed1994

In vivo effect of a selective endothelin receptor antagonist, BQ-123, on renal function in cyclosporin A-treated rats.

To investigate the possible involvement of endogenous endothelin (ET) in cyclosporin A (CsA) nephrotoxicity, we examined the renal effects of the selective [125I]ET-1 binding to porcine aortic membrane (ETA) receptor antagonist, BQ-123 (BQ), on CsA-treated rats. An osmotic minipump filled with BQ or its vehicle (saline), was subcutaneously implanted and animals were treated with CsA (50 mg/kg/d, i.p.) for 4 d. In both BQ- and its vehicle-treated rats, the 24-hour urine volume, urinary N-acetyl-beta-D-glucosaminidase (NAG) excretion, urinary Ca/creatinine (Cr) and urinary NAG/Cr ratios were significantly increased compared with those before administration of CsA. In contrast, after administration of CsA, urinary Cr excretion was significantly decreased in both rat groups. Although urinary NAG excretion and the NAG/Cr ratio in the rats treated with BQ were significantly increased compared with those treated with saline, the serum Cr levels in BQ-treated rats were significantly lower than those in saline-treated rats. Urinary immunoreactive ET-1 (irET-1) excretion in all animals was significantly increased after administration of CsA. There were no significant differences in urinary irET-1 excretion in both BQ-treated and saline-treated rats with and without CsA. Expression of irET-1 was seen in the cytoplasm of renal tubules, but the degree of expression was similar in the BQ-treated and saline-treated rats on CsA. In the BQ-treated rats, small round areas with high grain densities over the glomeruli in the cortex and vesa recta bundles in the outer medulla were masked by the antagonist action of BQ.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1994

[Bladder calculus after augmentation ileocystoplasty in children].

Of 12 children who had undergone augmentation ileocystoplasty for treatment of neurogenic bladder, 3 developed bladder calculi 9 to 19 months after the operation. All these 3 children had simultaneously undergone procedure to ensure urinary continence together with ileocystoplasty, and postoperative persistent bacteriuria was found in these 3 children. Component of bladder calculi was magnesium-ammonium phosphate in 2 and calcium phosphate in the other child, and all were successfully removed by endoscopic lithotripsy. These data suggest that postoperative persistent bacteriuria as well as procedures to ensure urinary continence might play a role in the formation of bladder calculus after augmentation cystoplasty.

Adolescent↗