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Biomedical subjects

M Ikeda

Publications and source records attributed to M Ikeda.

At least 235 records · Page 13Linked to original sources
PubMed2001

[Utilization of Maternal and Child Health handbook in Japan].

OBJECTIVES: In Japan, Maternal and Child Health (MCH) handbook have been widely used for more than fifty years. However, there has been no evaluation research from the users' point of view. We therefore conducted a questionnaire survey of guardians to evaluate how they utilize MCH handbooks. METHODS: A well-structured questionnaire survey was carried out in 231 municipalities, towns and villages of four prefectures (Gifu, Hiroshima, Niigata and Shizuoka) and one city (Yokohama) in November and December 1999. The targets were 13,271 guardians who visited health stations for 18-month examinations of their children and agreed to participated in our research. The questionnaire covered situation of usage and loss by guardians, utility from the users' perspective, and suggestions for improvement. RESULTS: We obtained answers from 10,900 guardians. As for reading rate and writing rate, 98.3% of respondents had read and 97.8% of them had written down something in relation. Only 0.9% of respondents had lost this MCH handbook. Generally, 87.0% of respondents answered that MCH handbook was helpful for child bearing and 81.6% of them said the record for immunization was useful. However, 34.1% of respondents answered it was not simple to utilize MCH handbook and 60.6% of them requested more detail on child bearing. As for dental health, the completion rate for information was low and only 21.3% of respondents reported for the dental record was useful. CONCLUSIONS: The research shows MCH handbook are highly utilized in Japan by almost all guardians. However, there are still problems to be solved; many guardians feel that they are not simple to use and the section on dental health is not highly particularly helpful. Improvements should be made in future in light of the viewpoints of guardians and parents.

Child Rearing↗
PubMed2001

Application of resampling techniques to the statistical analysis of the Brier score.

We investigated the application of resampling techniques to the statistical analysis of the Brier score (B), and extended them to the statistical comparison of two Bs derived from the same set of patients. The resampling techniques are helpful in the statistical analysis of B, and there are almost no differences between the jackknife method and the bootstrap method in this analysis. Thus, we believe that B should be used more often as an index to evaluate probabilistic judgments in the case in which the data sets for the assessment are "degenerate" as the "receiver operating characteristic data sets."

Case-Control Studies↗
PubMed2001

[A case of suprasellar hemangioblastoma with thoracic meningioma].

Supratentorial hemangioblastoma is encountered very rarely, with only about 110 cases reported. This report concerns a case of a suprasellar hemangioblastoma associated with thoracic meningioma. A 62-year-old man was admitted with visual disturbance of the left eye. T2-weighted magnetic resonance imaging (MRI) showed a high signal intensity mass in the suprasellar region without perifocal edema. T1-weighted MRI with gadolinium showed a homogeneously enhanced mass. The angiogram revealed remarkable tumor staining originating from the right and left internal carotid arteries (ICA) and the left external carotid artery (ECA). On the basis of the pre-operative diagnosis of tuberculum sellae meningioma, total tumor removal was performed. Photomicrographs of the specimen showed numerous capillaries divided by stroma cells. Positive immunostaining for factor VIII related antigen (F VIII RAg) was observed in endothelial cells, but immunostaining for epithelial membrane antigen (EMA) was not observed in any cells. A diagnosis of suprasellar hemangioblastoma was made on the basis of these findings. The patient suffered paraparesis on the postoperative seventh day. Since MRI showed a thoracic tumor, a second total tumor removal was performed. The tumor was diagnosed as a meningothelial meningioma. The patient was discharged without evidence of new neurological deficits. Our experience shows that, when a mass is vascularized in the cerebral hemisphere, the possibility of hemangioblastoma needs to be taken into consideration.

Hemangioblastoma↗
PubMed2001

[Usefulness of epidural administration of ketamine for relief of postherpetic neuralgia].

Four patients with postherpetic neuralgia had their pain alleviated by epidural administration of ketamine. No oral non-steroidal anti-inflammatory drugs and anti-depressant drugs were effective in all cases. Lidocaine or bupivacaine was administered epidurally to all four patients. When these patients stated that they did not feel pain reduced, they received epidural infusion of ketamine at doses from 5 mg to 20 mg with lidocaine or bupivacaine and their postherpetic neuralgia was controlled. Therefore with these cases, we suspect that epidural administration of ketamine, an antagonist for N-methyl-D-aspartic acid receptor, could be an effective and useful alternative treatment in a patient with refractory postherpetic neuralgia.

Aged↗
PubMed2001

Prevalence of hepatitis B and C virus infection among women in Jeju Island, Republic of Korea.

Hepatitis B and C virus infection prevalence was investigated in the Island of Jeju (formerly Cheju), the Republic of Korea, by means of a small-scale sero-epidemiological survey in 2000. Adult women in the city of Jeju (the provincial capital) and two fishing-farming villages A and B were invited to offer venous blood samples for immunological examination for infection markers of two virus and serum biochemistry for liver function. In practice, 66 married women (33, 16 and 17 women from the city, Village A and Village B, respectively) volunteered. Sera were separated on site and were assayed for HBsAg, anti-HBs, anti-HBc, and anti-HCV positivities and liver function markers including AST, ALT and gamma-GTP. The serum assay showed that the prevalence of HbsAg+ or anti-HCV+ cases was low (5 and 2%, respectively), whereas that of anti-HBs+ and anti-HBc+ cases were high (71 and 62%) so that the over-all HBV positivity was 82%. There were essentially no urban-rural difference or age-dependent changes in the positivity. Comparison with the prevalence reported in literature shows that prevalence of HBsAg+ and anti-HCV+ is in general agreement with the values reported for the populations in general, but HBV+ prevalence might be somewhat higher than the levels reported for the general populations.

Adult↗
PubMed2001

[A case of corticobasal degeneration of which movemental disturbances were improved by administration of amantadine].

Corticobasal degeneration(CBD) is a neurodegenerative disorder characterised clinically by apraxia, cortical sensory loss, alien limb, dementia, oculomotor abnormalities, dysarthria, postural instability, akinesia, rigidity, and pyramidal signs. Brain imaging may demonstrate greater abnormalities contralateral to the more affected side. We reported a case of corticobasal degeneration of which praxic impairments were improved by administration of amantadine. The patient was a 63-year-old right-handed woman. She showed marked dysfunction including rigidity, limb kinetic apraxia, cortical sensory loss, ideomotor apraxia, and dressing apraxia. A brain MRI scan revealed bilateral cortical atrophy centered in the postcentral gyrus, more pronounced in the left hemisphere than the right. A SPECT scan showed a decrease in blood flow in the temporo-parieto-occipital regions, more pronounced in the left hemisphere than the right. An EEG showed a diffuse slowness. L-dopa had no effect on the symptoms of rigidity, limb kinetic apraxia, cortical sensory loss, ideomotor apraxia, and dressing apraxia. By administration of amantadine, rigidity and cortical sensory loss did not improve, but some praxic impairments, such as dressing apraxia and ideomotor apraxia, and the EEG improved. Upon withdrawal of amantadine, the improved symptoms deteriorated. Amitriptyline did not improve the deteriorated symptoms. After amantadine was re-administered, the same praxic impairments and the EEG improved again. This suggested that administration of amantadine had some effect on certain praxic impairments and the EEG.

Amantadine↗
PubMed2001

Fractal analysis of cerebral blood flow distribution in Alzheimer's disease.

UNLABELLED: This study describes a method for quantifying cerebral blood flow (CBF) distribution in Alzheimer's disease (AD) from SPECT images obtained with (99m)Tc-hexamethylpropyleneamine oxime (HMPAO) by 3-dimensional fractal analysis (3D-FA). METHODS: HMPAO SPECT was performed on 68 patients with probable AD and 14 healthy control subjects. We delineated the CBF images using 4 cutoff levels (35%, 40%, 45%, and 50% of the maximal voxel radioactivity) and measured the total number of voxels in the areas surrounded by the contours obtained with each cutoff level. We calculated fractal dimensions from the relationship between the total number of voxels and the cutoff levels transformed into natural logarithms. RESULTS: The fractal dimensions (mean +/- SD) for patients with probable AD and healthy subjects were 0.74 +/- 0.33 and 0.52 +/- 0.09, respectively. A significant difference in the fractal dimension was found between groups (P = 0.001). Statistically significant correlations were obtained between the fractal dimension and the Mini-Mental State Examination score (r = -0.598; P < 0.0001) and between the fractal dimension and the AD Assessment Scale (r = 0.670; P < 0.0001). The fractal dimensions for subjects with clinical dementia rates (CDRs) of 0, 1, 2, and 3 were 0.52 +/- 0.09, 0.63 +/- 0.21, 0.77 +/- 0.23 (P < 0.05 vs. the group with a CDR of 1), and 1.43 +/- 0.49 (P < 0.0001 vs. the group with a CDR of 2), respectively. CONCLUSION: Quantification of CBF distribution on SPECT images in AD was possible using 3D-FA. The fractal dimension was well correlated with the cognitive impairment, as assessed in neuropsychologic tests. 3D-FA may be a useful method for objectively evaluating the progression of AD.

Aged↗
PubMed2001

Extra-articular avulsion fracture of the distal phalanx of the ring finger--a case report.

This report describes a rare case of extra-articular avulsion fracture of the flexor digitorum profundus tendon in a 59-year-old man is reported. A large avulsed fragment of bone was localized by radiography on the volar side of the middle phalanx. The avulsed bone fragment had torn the A4 pulley and had been caught by the C2 pulley. The fracture was extra-articular. The avulsed fragment was fixed using a fragment fixation screw. This case was classified as a subtype of type 3 according to Leddy's classification. Only 10 cases of type 3 injury have been reported, and none of them clearly involved an extra-articular fracture.

Cartilage, Articular↗
PubMed2001

[Examination on efficacy and safety of concurrent use of ondansetron hydrochloride and steroid in gynecological cancer patients on cisplatin].

The anti-emetic effect and safety in patients receiving ondansetron hydrochloride (OND group) and ondansetron and dexamethasone (DEX group) concurrently in cases of acute and delayed onset emesis induced by a single high dose of cisplatin, given as a chemotherapy to gynecological cancer patients, were comparatively studied. The study subjects were 139 gynecological cancer patients. The OND group received 4 mg of ondansetron via slow intravenous injection on Day 1, 30 minutes prior to cisplatin, and for Days 2 to 5, the subjects orally received 4 mg ondansetron tablet each day. The DEX group received the same dose regimen of ondansetron as the OND group for Days 1-5, but in addition the subjects received dexamethasone injection in doses of 8 mg twice daily on Day 1 and 4 mg (1 mg QID) daily for Days 2-5. An anti-emetic effect against acute nausea and vomiting was achieved in 47.9% of the OND group and in a higher rate of 84.2% of the DEX group. Significantly better efficacy was seen in the DEX group also in the complete suppression rate of nausea and vomiting and the improvement of food intake. The group also achieved better efficacy in delayed onset of emesis. Adverse reactions were observed in 2 cases (2 reports of headache) in the OND group and 5 cases (2 reports of hiccups, 2 headache, 2 diarrhea, one constipation, one hot facial flushes and one elevation of gamma-GTP) in the DEX group; however, since the symptoms were all mild, we did not consider there was any problem in safety. We conclude from the above findings that concurrent administration of ondansetron hydrochloride and dexamethasone is a clinically useful treatment for acute and delayed onset emesis induced by a single high dose of cisplatin given to gynecological cancer patients.

Antiemetics↗
PubMed2001

[The significance of neoadjuvant intra-arterial chemotherapy for locally advanced breast cancer by different methods].

For neoadjuvant intra-arterial (IA) chemotherapy in locally advanced breast cancer patients, Seldinger's methods were found to be convenient and had the same effect and outcome as conventional methods. The prognosis of the patients in whom IA chemotherapy was locally effective and had fewer than n 1 lymph node metastases was comparatively favorable. However, several patients who underwent IA chemotherapy later experienced local recurrence, and the cause of these patient's death was distant metastases in almost all cases. We recommend neoadjuvant IA and systemic chemotherapy, and systemic adjuvant chemotherapy.

Adult↗
PubMed2001

[Significance of liver resection for multiple hepatic metastases from colorectal cancer].

In colorectal cancer, liver metastasis is the most common and most important prognostic factor. To elucidate the significance of liver resection, we examined 72 cases (H2: 29 cases, H3: 43 cases). The 3-year survival rate for H2 and H3 patients was 71.5% and 4.5%, respectively. The liver resection rate in H2 and H3 patients was 58.6% (17/29) and 16.3% (7/43), respectively. In H2 patients the 3-year survival rate of those with liver resection and non-resection was 71.3% and 9.2%, respectively (p < 0.001). However, in H3 patients the 3-year survival rate in liver resection and non-resection patients was 80.0% and 43.9%, respectively (not significant). Many therapies, such as liver resection, hepatic arterial infusion, and systemic chemotherapy, were attempted for patients with hepatic metastases. Our data show that liver resection can prolong the survival of H2 patients only. On the other hand, hepatic arterial infusion therapy prolongs the survival of H3 patients only. Systemic chemotherapy does not prolong the survival of either H2 or H3 patients.

Adult↗
PubMed2001

[A case of locally advanced breast cancer successfully treated with wide resection and reconstruction of chest wall with A-O metallic plates].

A 63-year-old female with locally advanced breast cancer was treated with preoperative chemotherapy using docetaxel. The therapeutic regimen was comprised of four cycles at 3-week intervals. One cycle consisted of 80 mg of docetaxel which was administered on day 1. A remarkable response was confirmed. The side effects such as leukopenia, general fatigue and alopecia were moderate and had no influence on the patient's QOL. After preoperative chemotherapy, a full thickness chest wall resection was performed. Chest wall defect was reconstructed with orthopedic A-O metallic plates, Marlex mesh and rectus abdominis myocutaneous flap. These metal plates were very useful because it was easy to bend and twist them manually to fit the defect at the time of operation. Moreover, the curved metal plates preserved the cone form of the chest cage. The postoperative course was favourable without frail chest or wound infection.

Antineoplastic Agents, Phytogenic↗
PubMed2001

[Successful non-invasive positive pressure ventilation therapy to acute respiratory failure after volume reduction surgery for patient with severe emphysema: report of a case].

A 55-year-old man consulted our hospital because of short of breath. Chest CT showed low attenuation areas and we diagnosed his illness as a chronic respiratory failure by chronic lung empysema. He was perfomed bilateral lung volume reduction surgery (VRS), after a few days who was in serious acute respiratory failure. He was treated by non-invasive positive pressure ventilation (NIPPV) for those. After that general condition and arterial blood gas data was improved. NIPPV may be one of the effective tools for acute respiratory failure after VRS.

Acute Disease↗
PubMed2001

Reconstructing an unstable medial elbow complicated by medial epicondyle non-union: case report.

Reconstruction of the medial support system of the elbow joint was perfomed after dislocation in a 54-year-old man with pseudoarthrosis at the medial epicondyle of the humerus. The patient fell and dislocated the elbow. Although it was manually reduced, the medial side of the elbow remained extremely unstable. The medial epicondyle of the humerus had an old pseudoarthrosis and the bone fragment of the medial epicondyle was dislocated at the level of the humeroulrar joint. Because conservative therapy would result in an unstable medial side of the joint, an unique method for reconstruction of the medial support system of the elbow was performed. The tendon of the palmaris longus muscle was placed between the dislocated bone fragment of the medial epicondyle and it's original position of the humerus. A good result was obtained.

Elbow Joint↗
PubMed2001

The process of cardiorespiratory autoresuscitation in intact newborn rats.

To examine the process of spontaneous autoresuscitation and the recovery of the hypoxic ventilatory response (HVR) after prolonged anoxia, we monitored respiratory frequency (f, by body plethysmography) and heart rate (HR, by ECG) in intact newborn rats (n = 12, day 2-4) before, during, and after 100% N2 exposure. The rat before anoxia showed signs of HVR: f changes at acute hypoxia (10% O2) and hyperoxia (100% O2). During anoxia, the spontaneous respiratory movement "gasping" appeared for 21 min (mean). At O2 restoration (with 100% O2), gasping stopped and no respiratory flow was detected for 1 min. One rat failed to autoresuscitate and had heart arrhythmia during the transient apnea, but 11 rats recovered respiration after the HR acceleration. Despite the successful autoresuscitation, the rats did not show HVR at 10 min into the recovery period and the recovery of HVR required more than 30 min. The results indicate that O2 inhalation is useful to trigger autoresuscitation even when the rat has already been in a state of profound hypoxic depression, but the rat becomes transiently insensitive to HVR after autoresuscitation. We estimate that reform of the respiratory control system in newborn rats is not yet firmly established to track HVR early in the recovery phase after prolonged anoxia.

Animals↗
PubMed2001

[A study of the relation between providing healthcare information and behavior changes of people in Japan. Parental behavior changes after receiving information about the sudden infant death syndrome].

OBJECTIVE: Considering the lack of evidence concerning the relationship between providing healthcare information and behavior of people in Japan, we utilized a questionnaire to survey the parents of infants to evaluate behavior change after receiving information about the Sudden Infant Death Syndrome (SIDS). METHODS: A questionnaire about SIDS information was administered in 234 municipalities in Niigata, Gifu, Shizuoka, and Hiroshima Prefectures and in Yokohama City in November and December of 1999 to 14,879 parents who visited for the 18-month health examination of their children. The questionnaire did not ask for the participants' names. Logistic regression analysis was used to study the connection between behavior change and SIDS information sources. RESULTS: 10,900 parents returned the questionnaire to give a 73.3% response rate, 19.0% of these receiving information about SIDS risk factors from hospitals or clinics, 3.7% from public health centers, and 9.2% from their friends. More received information from the mass media such as TV programs, which provided the main source for 71.1% of the parents. The degree of behavior change was evaluated after adjustment for variables concerning a variety of information sources and other appropriate factors such as the age and sex of parents and the number of their children. We found that receiving information from hospitals or clinics significantly influences behavior changes for all kinds of risk factors. Information from public health centers, baby-care groups, and friends influenced behavior changes relevant to the risk factors for feeding methods, sleeping position, and parents' smoking. There was no relation between receiving information from the mass media and behavior change of parents. CONCLUSIONS: The mass media provide far more information than do medical facilities, public health centers, baby-care groups and personal contacts but the latter played much more effective roles in making parents change their baby care behavior. These results point to an obvious discrepancy between efficiency in providing information and the degree of behavior change elicited. We should thus take the source of information and the target population into consideration when we examine the best way to provide healthcare information for people in the future.

Adult↗