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Biomedical subjects

K Tajima

Publications and source records attributed to K Tajima.

At least 181 records · Page 10Linked to original sources

Everting closure for interrupted aortic arch, ventricular septal defect, and severe subaortic stenosis.

Interrupted aortic arch with ventricular septal defect in the neonate is sometimes complicated by severe subaortic stenosis from posterior deviation of the infundibular septum. We have developed a novel approach to the treatment of this condition. The infundibular septum is penetrated from the right-ventricular side to the left-ventricular outflow tract. It is compressed with patch fixation. The lower margin of the infundibular septum is everted. Three consecutive neonates were treated. The smallest diameters of the left-ventricular outflow tract were 3,4, and 2.5 mm. All patients survived the operation and were discharged from the hospital. They remained well 2 to 7 years after the repair and were in normal sinus rhythm without a left bundle branch block or any significant pressure gradient between the upper and lower extremities. Follow-up two-dimensional and Doppler echocardiography demonstrated no residual shunt, no left-ventricular outflow-tract pressure gradient, and no aortic regurgitation. This technique provides effective widening of the left-ventricular outflow tract, and is more safely and easily performed than conventional methods.

Aorta↗

Evaluation of the death certificate follow-up method for the analysis of survival rate: data from Aichi Prefecture, Japan.

To evaluate the use, for studies on survival, of death certificates from population-based cancer registries in Japan, we compared 5-year survival rates by two different methods: passive, derived from death certificates, and active, using family register systems. Registered cancer cases from Aichi Prefectural Cancer Registry were used as a model. The study subjects comprised 9244 cancer patients (3830 males and 5414 females) newly diagnosed at the Aichi Cancer Center Hospital and recorded in the Aichi Prefectural Cancer Registry between 1983 and 1991. The passive follow-up method, using death certificates, identified 87-89% of deaths among the study subjects. The proportion of deaths which were not identified by the passive follow-up method did not vary greatly with age or gender, but was higher among patients in the earlier rather than the later stages of cancer. Overall, the absolute and relative effects of unregistered deaths on apparent survival rate vary with the absolute survival rate. The absolute and relative differences between the survival rates calculated by the two methods are explained more clearly when data are analyzed by cancer site. The results of the present study provide useful information for interpreting the survival rate following diagnosis of cancer estimated by the passive follow-up method, i.e. using death certificates from a population-based cancer registry.

Aged↗

Nested consent design for clinical trials.

BACKGROUND: Since random treatment allocation is hardly understood by the majority of patients, a new 'nested consent design' for clinical trials is proposed. PROPOSED DESIGN: The design consists of a two-step enrollment of study subjects. The first step is the enrollment of participants into a follow-up study, where consent to be subjects involved in the follow-up is obtained. The second step is the enrollment of randomly sampled eligible participants into a new treatment group. After the explanation of (1) treatment mode, (2) additional burdens associated with the proposed treatment and (3) expected effects and possible adverse events, written informed consent is obtained. Those who reject participation and those who are not allocated into the new treatment are treated by standard care. Endpoints are set to be the same for all follow-up study participants whether allocated into the new treatment or not, and follow-up is carried out in the same manner. Analyses are performed between those allocated to the new treatment and those non-allocated on an intent-to-treat basis. EXAMPLE: Although not a clinical trial, this design was applied in a smoking cessation program at Aichi Cancer Center Hospital for first-visit patients who answered in a questionnaire survey that they were smokers. Out of 1330 necessary participants, 324 were enrolled in the follow-up study during the first three months of enrollment. CONCLUSIONS: The design was found to be feasible for prevention trials, and possibly for clinical trials to compare a new treatment with a standard treatment. There seems to be no ethical difference between this design and the one-arm study design.

Clinical Trials as Topic↗

Vibrio halioticoli sp. nov., a non-motile alginolytic marine bacterium isolated from the gut of the abalone Haliotis discus hannai.

Six alginolytic, facultatively anaerobic, non-motile marine bacteria were isolated from the gut of abalone Haliotis discus hannai. DNA-DNA hybridization data showed that the six strains constituted a single genospecies. Phylogenetic analyses of 16S rDNA sequences indicated that the isolates should be assigned to the genus Vibrio. The phenotypic features of the isolates were closely related to Vibrio fischeri and Vibrio pelagius biovar I, but 13 traits (motility, luminescence, alginase production, lipase production, lysine decarboxylase, indole production, growth in 1 and 6% NaCl and assimilation of five carbon compounds) distinguished these strains from V. fischeri, and 17 traits (motility, growth at 37 degrees C, lipase production, indole production, growth in 1 and 6% NaCl, acid from sucrose and D-sorbitol, and assimilation of nine carbon compounds) distinguished these strains from V. pelagius. The G + C content of the isolates was 41.6-43.1 mol%. According to DNA-DNA hybridization data and 16S rDNA phylogenetic analyses, it was concluded that the six isolates constitute a new species different from any other Vibrio species. The name Vibrio halioticoli sp. nov. (type strain IAM 14596T) is proposed. A set of phenotypic features which enables differentiation of the new species from other species of the Vibrionaceae family is described.

Animals↗

Pseudoalteromonas bacteriolytica sp. nov., a marine bacterium that is the causative agent of red spot disease of Laminaria japonica.

An aerobic, polarly flagellated marine bacterium that produces a prodigiosin-like pigment was isolated from the red-spotted culture beds of Laminaria japonica. Five isolates had unique bacteriolytic activity for both Gram-positive and -negative bacteria, which had never been observed among Alteromonas or related species. The isolates were identified as the causative agent of red spot disease of L. japonica seeds. The phenotypic features of the isolates were similar to these of Pseudoalteromonas rubra ATCC 29570T, but they could be differentiated using 10 traits (growth at 37 degrees C, requirement for organic growth factors, bacteriolytic activity, utilization of sucrose, N-acetylglucosamine, fumarate, succinate, D-galactose, L-proline and acetate). The G+C content of DNAs from the isolates was 44-46 mol%. The isolates constitute a new species, distinct from the other Alteromonas and Pseudoalteromonas species, as shown by DNA-DNA hybridization experiments and phylogenetic clustering of 16S rRNA gene sequences, for which the name Pseudoalteromonas bacteriolytica sp. nov. (type strain = IAM 14595T) is proposed. A set of phenotypic features which differentiate this new species from closely related Pseudoalteromonas and Alteromonas species is provided.

Base Sequence↗

Patients' views on residual blood use for research purposes.

In order to document patients' views on residual blood use for research purposes, a questionnaire survey was conducted at Aichi Cancer Center Hospital in October 1997. Subjects were patients who had undergone blood tests at a central blood sampling room in the morning during the week of the study enrollment. The questionnaire was handed out and collected at a waiting area in front of the blood sampling room. Of the 583 patients to whom we tried to hand out the questionnaire, 558 participated (258 males, 294 females, and 6 of sex unknown) and 25 refused. Those who regarded research to improve health care as important were 76.7% of those sampled. Only 28 patients (5.0%) answered that they would not permit the use of their residual blood for research purposes. Although logistic analysis did not detect significant factors influencing the giving of permission, the percentage who would not permit the use of their residual blood for research purposes was significantly higher in cancer outpatients (6.7%) than in inpatients (1.0%). It seems desirable for hospitals to establish an open policy concerning residual blood use for research purposes.

Blood↗

Multiple inflammatory pseudotumors of the liver associated with acute myeloblastic leukemia.

A 26-year-old man, diagnosed with acute myelogenous leukemia had multiple inflammatory pseudotumors (IPT) in the liver. The patient presented complete remission after remission induction therapy, and then showed right upper quadrant discomfort and intermittent fever. An ultrasonography disclosed multiple hypoechoic nodules in the liver. A biopsy of the nodules showed focal liver cell necrosis with scant inflammatory cells, compatible with IPT. After several courses of chemotherapy, the nodules in the liver increased. The second liver biopsy of the nodule showed fibrosis. Multiple IPTs in the liver should be distinguished from abscess and metastatic nodules.

Adult↗

Smoking and dietary risk factors for cervical cancer at different age group in Japan.

The importance of the major risk and protective factors for cervical cancer in women by age group was evaluated with the use of data from the Hospital-based Epidemiologic Research Program at Aichi Cancer Center (HERPACC), Japan. This study included 416 cervical cancer cases and 20,985 referents confirmed as free of cancer. Cases and referents were divided into three age groups: the younger, middle and older age groups (30-44, 45-54 and 55-69 years old, respectively). Logistic model was applied separately to the three groups to estimate odds ratios (ORs) of smoking, beverage and dietary habits with adjustment for marital and reproductive factors. The elevated OR of current smokers was observed consistently in all age groups, while alcohol intake did not show any increased ORs. Dietary control for health lowered ORs for all three age groups, and the effect appeared to be more pronounced among the older age group (OR = 0.49, 95% confidence interval: 0.30-0.80). Higher frequency intake of green-yellow vegetables consistently afforded lower ORs among all three age groups. This risk increment of smoking and risk reduction by dietary control were consistent in all age groups. These findings suggested practicable prevention strategy for the cervical cancer by modifying general life style.

Acculturation↗

The estimation of cancer incidence in Aichi Prefecture, Japan: use of degree of completeness of registration.

This study was conducted to estimate true incidence of the total number of cancer cases and of cancers at selected sites in the population of Aichi Prefecture, Japan, using the degree of completeness of registration (CR). Information on incidence (I), death (D), and cases first notified via death certificate (DCN) was based on the data from 1976 to 1993. Using this information, CR for each cancer site was calculated by gender and a 3-year period of diagnosis [CR = (1-PDCN l/D)/(1-PDCN), PDCN: proportion of DCN cases]. The true number of incident cases and incidence rates (estimated incidence rate: EIR) were then estimated from the number of cases observed and from CR. CR for all sites of cancer was 62-78 percent in males and 54-72 percent in females, and CR was higher in cancers with low I/D ratios than those with high I/D ratios. Annually, about 2,500-3,000 cases in each gender were unreported. The EIR of all sites was estimated at 252-280 in males and 213-207 in females compared with the incidence rates observed (observed incidence rate: OIR) as 157.0-218.6 in males and 115.3-149.2 in females. OIR was closer to the EIR for cancers with low I/D ratios than those with high I/D ratios. These values are important for planning and evaluating cancer control strategies in the population.

Death Certificates↗

GB virus C/hepatitis G virus infection among Colombian native Indians.

To elucidate the prevalence of GB virus C/hepatitis G virus (GBV-C/HGV) infection in Colombian native Indians, serum GBV-C/HGV RNA was assayed in 163 native Indians and 67 members of the general population in Colombia. The native Indians (males:females = 40:123) and the members of the general population (males:females = 20:47) were tested by reverse transcription-semi-nested polymerase chain reaction. Of the 163 native Indians, 10 (6.1%) were positive for GBV-C/HGV RNA, compared with one (1.5%) of 67 from the general population. All Indians were negative for hepatitis B surface antigen and antibody to hepatitis C virus. Of 10 Indians with GBV-C/HGV RNA, the genotype of nine subjects was the Asian type. These data indicated that 1) the prevalence of GBV-C/HGV RNA in Colombian native Indians is high, and 2) GBV-C/HGV was probably brought from Asia and inherited for generations in some native Indian groups.

Adolescent↗

[Scrotum exfoliative dermatitis with ulcers associated with treatment of acute promyelocytic leukemia with all-trans retinoic acid].

All-trans retinoic acid (ATRA) induces complete remission (CR) in most cases of acute promyelocytic leukemia (APL). Toxicity of ATRA has been shown to be mild and consist of headache, dry skin, dermatitis, gastrointestinal disorders, and hypertriglyceridemia. We report three patients with APL treated with ATRA in combination with chemotherapy, who developed scrotum exfoliative dermatitis with ulceration. Their age was 33 years (range, 25 to 37). All three cases developed scrotum erosions, and many small ulcers after 9 to 17 days of ATRA treatment. The scrotum exfoliative dermatitis with ulceration occurred repeatedly, but gradually resolved in about 8 weeks time. They developed no dryness of the lip or skin apart from the scrotum. All three cases continued to receive 45 mg/m2 of ATRA daily throughout induction therapy, and achieved CR. We suspected the scrotum exfoliative dermatitis with ulceration to be a side effect of ATRA. The scrotum lesions, which have been already reported may be common in patients receiving ATRA.

Adult↗

Agreement of endoscopic findings and serum pepsinogen levels as an indicator of atrophic gastritis.

Serum pepsinogen I and II levels have recently become popular as indicators of atrophic gastritis in epidemiological studies. Previous studies show a significant association between serum pepsinogen levels and endoscopically diagnosed atrophic gastritis. This study assesses the level of agreement between the degree of atrophic gastritis as assessed by endoscopic examination and by serum pepsinogen assays. Study subjects were 200 outpatients at Aichi Cancer Center Hospital, Nagoya, Japan, who were endoscoped between February and August 1995. Agreement of the degree of atrophic gastritis was assessed by endoscopic examination and by serum pepsinogen levels. Agreement in assessing the extent of atrophic gastritis between the two methods was 57%, and the presence of atrophic gastritis was 79%. Serum pepsinogen assays identify the majority of patients with atrophic gastritis, although they are less useful in assessing the degree of atrophy in detail.

Adult↗

Association of Ile462Val (Exon 7) polymorphism of cytochrome P450 IA1 with lung cancer in the Asian population: further evidence from a case-control study in Okinawa.

Okinawa, a group of islands that lie between the East China Sea and the Pacific Ocean, 2000 km south of the Japanese main islands, has a different profile of diseases, ethnicities, and cultures than does the rest of Japan. We examined an Ile462Val polymorphism (CYP1A1*2 allele) of cytochrome P450 IA1 in a hospital-based case-control study of lung cancer patients (247 cases and 185 controls) in Okinawa to ascertain the association of this variant with lung cancer. In addition, the distribution of this genotype was studied in populations from different areas of Japan, including Tokyo (n = 69) and Iwate (northern part of Japan; n = 81), as well as in a Chinese group from the Jiangsu province (n = 39) and in an Australian Caucasian group (n = 146). Genotype frequency in controls was not significantly different from area to area in Japan. In Okinawa, however, the genotype encoding Val/Val was associated with a significantly higher risk of lung cancer (odds ratio = 3.32, P = 0.013), especially of squamous cell carcinoma and small cell carcinoma (odds ratio = 4.85 and 9.35, respectively). The Val-encoding allele was less frequent in the Chinese population and was rare in Australian Caucasians. Thus, this study gives support to the value of the cytochrome P450 IA1 Ile462Val polymorphism as a practical high-risk marker of lung cancer in populations, especially those in southeast Asia, in which this variant is more common.

Adult↗

[Estimated prevalence rate of HTLV-I uveitis in Chikugo].

To estimate the prevalence rate of human T-cell lymphotropic virus type 1 (HTLV-I) uveitis, an epidemiological survey was carried out in the Chikugo District of Fukuoka Prefecture between 1 September and 31 October 1995. The survey was done by sending questionnaires on uveitis patients to all ophthalmological institutes in the district and measuring the serum antibody to HTLV-I. The recovery rate of the survey was 39 of 48 institutes (81.3%). A total of 357 patients with uveitis were reported in the survey, of whom 317 (88.8%) were tested for their seropositivity to HTLV-I. Among them, 18 patients were counted as having HTLV-I uveitis (HU) on 1 October 1995. Based on these data together with the age- and sex-specific population of HTLV-I carriers in the Chikugo District, it was estimated that the crude prevalence rates of HU per 100,000 HTLV-I carrier population were 58.6 in males, 152.0 in females, and 112.2 in both sexes. The prevalence rate of HU was slightly higher than that of HTLV-I associated myelopathy.

Adult↗

[Study of the validity of ADL assessment by Minsei-iin of bed ridden elderly cared for at home].

We studied the validity of assessment of activities of daily living (ADL) by minsei-iins of the bed ridden elderly cared for at home. The cases, 66 male and 128 female elderly in a county of Gunma Prefecture, had been registered by minsei-iins (non-professional district welfare commissioners) as bed ridden cared for at home. Minsei-iins interviewed the case and the caregiver at home, asking them about the term of care, the levels of independence in their daily living, and seven items of ADL. Out of the 194 cases registered, PTs or OTs interviewed 136 cases, 42 male and 94 female, and calculated the Barthel index score. The Quantification method of the first type was applied to the data to predict the Barthel index score. The independent variables were five items of ADL assessed by the minsei-iins. The relation was close between the assessment of all items of ADL by the minsei-iins and the Barthel index calculated by the PTs or OTs. The Quantification method of the first type revealed that bathing, excreting and walking contributed most to the measured Barthel index. The multiple correlation coefficient was 0.687. There were three cases who scored 100 in the Barthel index.

Activities of Daily Living↗

Effect of YNS-15P, a new alpha-2 adrenoceptor antagonist, on stress-stimulated colonic propulsion in rats.

We studied effects of a novel alpha-2 adrenoceptor antagonist, YNS-15P (N-[(2R,11bS)-9-methoxy-1,3,4,6,7, 11b-hexahydro-2H-benzoquinolizin-2-yl]-N-methylmethanesulfonami de hydrochloride), on colonic propulsion stimulated by wrap-restraint stress (WRS) or bethanechol, on normal colonic propulsion and on diarrhea induced by castor oil in rats. Alpha-2 adrenoceptor antagonists, rauwolscine and RX821002, decreased the increase in the number and weight of fecal pellets induced by WRS. YNS-15P also inhibited WRS-stimulated fecal excretion in a dose-dependent manner. A 5-hydroxytryptamine3 receptor antagonist, granisetron, trimebutine and diazepam, but not a 5-hydroxytryptamine4 receptor antagonist, GR113808, significantly inhibited WRS-stimulated fecal excretion. YNS-15P inhibited WRS-stimulated colonic transit in a dose-dependent manner. However, YNS-15P had no significant effect on normal fecal excretion and colonic transit or on bethanechol-stimulated fecal excretion. YNS-15P also failed to inhibit castor-oil-induced diarrhea. These results indicate that YNS-15P selectively inhibits WRS-stimulated colonic propulsion, and that alpha-2 adrenoceptors may be involved in stress-induced colonic motor dysfunction in fed rats.

Adrenergic alpha-2 Receptor Antagonists↗