Image of psychiatric patients' competency to give informed consent to treatment in Japan. I. A factor analytic study.
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Adult↗
Biomedical subjects
T Kitamura
Publications and source records attributed to T Kitamura.
Image of psychiatric patients' competency to give informed consent to treatment in Japan. II. A case vignette study of competency judgements.
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Humans↗
Early parental separation experiences among patients with bipolar disorder and major depression: a case-control study.
BACKGROUND: Although the association between childhood parental loss and later development of mood disorder has received much research interest in the past, the results obtained and conclusions drawn have been various, and inconsistent with each other. The present study aims to examine this old, yet unresolved, question among the Japanese. METHODS: Patients with bipolar disorder (n = 73) and unipolar depression (n = 570) and community healthy controls (n = 122) were examined as to their psychopathology and childhood parental loss experiences with semi-structured interviews. RESULTS: Stratified for sex and age, no statistically significant difference was observed in the incidence of paternal or maternal death or separation before age 16 between bipolar patients and healthy controls. Female patients with unipolar depression under the age of 54 experienced significantly more maternal loss than the corresponding controls. This excess in loss appeared to be largely due to the patients experiencing separation from their mothers. CONCLUSION: Our findings concerning bipolar disorder have replicated the previous two studies reported in the literature. Those concerning unipolar depression appear to be in line with several recent studies on the subject but, as stated, many discrepant findings can also be found in the literature.
Adolescent↗
Lack of carcinogenicity of thiamphenicol in F344 rats.
The carcinogenicity of thiamphenicol (TAP), an antibiotic drug, was examined in Fischer 344 rats of both sexes. TAP was given ad lib. in drinking water at levels of 0 (control), 125 or 250 ppm to groups of 50 male and 50 female rats for 2 yr. The treatment did not affect mortality and no toxic lesions were specifically induced. Furthermore, the incidence of tumours in the treated groups did not show any significant dose-related increase as compared with the control group. The results thus indicate that TAP is neither toxic nor carcinogenic, for any organs or tissues of F344 rats when given continuously at levels of 125 or 250 ppm in drinking water for 2 yr.
Administration, Oral↗
Brachial plexus stretching injuries: microcirculation of the brachial plexus.
This study was undertaken to investigate the pathogenesis of brachial plexus stretching injuries at an intensity level not severe enough to cause avulsion injury. While we performed traction on 64 forelegs of 32 rats, we evaluated changes in the blood flow in the extrinsic and intrinsic microvascular systems of the brachial plexus. While we laterally stretched the brachial plexus during 80 degree shoulder abduction, we measured the blood flow at the bifurcation of the brachial plexus and at the median nerve with the hydrogen washout technique. During weak traction the blood flow decreased markedly in the extrinsic system, causing an imbalance in the two systems. In the median nerve, however, no such imbalance occurred. On histologic examination the axon and myelin in the brachial plexus and the median nerve showed no morphologic change. However, in parts of the brachial plexus we noted hypertrophic connective tissue or granulomatous inflammation in tissue surrounding the extrinsic system. The extrinsic system's apparent susceptibility to injury by acute traction may be a factor in the pathogenesis of the brachial plexus stretching injuries.
Animals↗
Apophysitis of the acromion.
We treated three patients with apophysitis of the acromion. These patients were two male athletes 12 and 14 years of age, respectively, and one female athlete 13 years of age. They reported pain at the top of the shoulder during and after shoulder movement while playing sports but had no rest pain or disturbance of daily activities. Physical examination demonstrated marked local tenderness at the acromion and slight warmth. X-ray films showed sclerosis and irregularity of the secondary ossification center of the acromion. Bone scintigraphy carried out on one patient demonstrated increased uptake in that region. Conservative treatment was used for these patients. Recovery was gradual but satisfactory.
Acromion↗
High dose rate intracavitary brachytherapy for recurrent or residual lesions in the vaginal cuff: results in post-hysterectomy patients with carcinoma of the cervix.
The purpose of this study was to assess the long-term survival, disease control, and complication rates of high dose rate intracavitary brachytherapy (HDR-ICR) alone or combined with external beam irradiation (HDR-ICR + EBRT) in patients with pathologically involved or close surgical margin in the vagina (Group 1) and recurrent lesions in the vaginal cuff (Group 2) following hysterectomy for cervical carcinoma. In Group 1, 10 patients received HDR-ICR only, and 11 patients received HDR-ICR + EBRT with or without paravaginal shielding. In Group 2, 8 patients received HDR-ICR only, and 11 patients received HDR-ICR + EBRT with or without paravaginal shielding. The HDR-ICR dose per fraction planned at the Apical Vaginal Point was 5-6 Gy per week. In Group 1, the 5-year absolute survival rates (AS), disease-free survival rates (DFS), and vaginal control rates (VC) were 81.0%, 76.2%, and 100%, respectively. The 5-year AS was lower in patients with parametrial infiltration or adenocarcinoma. In Group 2, the 5-year AS, DFS, and VC were 73.3%, 77.4% and 88.8%, respectively. The 5-year AS was lower when tumors were larger than 3 cm or infiltrated. Late complications occurred in 10 patients. In all but one patient, the complications were acceptable. All patients with cystitis, ileus, or leg edema received EBRT + HDR-ICR. We recommend a treatment regimen of 25-30 Gy of HDR-ICR alone for Group 1 patients without pathologically high risk of recurrence or Group 2 patients with superficial recurrent lesions, and a treatment regime of 50 Gy whole pelvis EBRT combined with 10-15 Gy HDR-ICR for Group 1 patients with pathologically high risk of recurrence or Group 2 patients with infiltrated recurrent lesions.
Adult↗
Marked retention of indocyanine green and sulfobromophthalein with chronic persistent hepatitis.
A hepatitis B virus (HBV) carrier with marked retention of indocyanine green (ICG) and sulfobromophthalein (BSP) was admitted to our hospital for assessment of liver function. On admission, he was asymptomatic and blood chemistry tests showed normal values for transaminases and bilirubin. Serum hepatitis B surface antigen (HBsAg) and antibody to hepatitis B e antigen (anti-HBe) were positive. A history of drug abuse or alcoholism was denied. Dye excretion tests revealed marked retention of ICG (R15 = 70%) and BSP (R45 = 23%). Histopathological examination of a liver biopsy specimen obtained during laparoscopic observation showed chronic persistent hepatitis (CPH). Familial research of the patient failed to prove the existence of dye excretory defect in his siblings. Usual cases of CPH due to continuous HBV infection do not show such severe disturbance of organic anion transport. This pattern of the dye excretory defect with CPH has not been reported. Although the relationship between this dye excretory defect and HBV infection is unclear, the existence of the constitutional dye excretory defect due to abnormal organic anion transport in the liver might be considered.
Carrier State↗
Basic fibroblast growth factor accelerates gastric mucosal restoration in vitro by promoting mesenchymal cell migration and proliferation.
It has been generally accepted that basic fibroblast growth factor is a potent stimulator of duodenal ulcer healing. However, the detailed mechanism and mode of action of growth factor on gastric ulcer healing is still controversial. Therefore, in the present study, the effects of basic fibroblast growth factor on gastric mucosal repair were studied using an in vitro cultured cell system. Artificial wounds were made in confluent monolayer rabbit gastric fibroblast and epithelial cell sheets by mechanical denudation. Changes in the size of the cell-free area were analysed quantitatively. Cell proliferation was assessed by BrdU staining. For both cell types, mucosal restoration involved cell migration and proliferation. Although the speed of restoration of epithelial cells was not affected by the addition of basic fibroblast growth factor, it was much faster for epithelial cells than for fibroblasts. Basic fibroblast growth factor accelerated wound repair of fibroblasts but not epithelial cells. Basic fibroblast growth factor accelerated wound repair by stimulating both cell migration and proliferation. Therefore, the effects of basic fibroblast growth factor in peptic ulcer diseases may be mainly due to the stimulation of mesenchymal cells.
Animals↗
The curative role of radiotherapy in patients with isolated para-aortic node recurrence from cervical cancer and value of squamous cell carcinoma antigen for early detection.
The objective of this study was to examine the clinical benefits of routine squamous cell carcinoma antigen (SCC-ag) monitoring of patients with locally advanced cervical cancer. Recurrent disease occurred in 99 uterine cervical cancer patients with elevated pretreatment SCC-ag before primary radiotherapy. Elevated SCC-ag levels persisted in 23 patients after primary radiotherapy (group 1), and SCC-ag was normalized in 76 patients after primary radiotherapy (group 2). The overall survival (OS) rate was higher for patients with SCC-ag elevation as the first sign than for patients with recurrence predicted by other modalities for group 2 patients (P = 0.033). The prediction of isolated para-aortic node recurrence significantly correlated with SCC-ag elevation as an initial sign (P = 0.001). The SCC-ag level before primary radiotherapy (> or = 10.8 ng/mL) significantly affected recurrence predicted by SCC-ag elevation as an initial sign (P = 0.002). For multivariate analysis, the presence of para-aortic node recurrence was statistically significant in OS (P < 0.0001). Routine SCC-ag monitoring of patients with carcinoma of the uterine cervix can lead to the early diagnosis of isolated para-aortic lymph node recurrence, and prolonged survival can be achieved by applying radiation therapy to the para-aortic region. To reduce the number of patients monitored for SCC-ag, we recommend monitoring group 2 patients with pretreatment SCC-ag level before primary radiotherapy > or = 10.8 ng/mL.
Adult↗
The role of pretreatment squamous cell carcinoma antigen level in locally advanced squamous cell carcinoma of the uterine cervix treated by radiotherapy.
The purpose of this study was to determine the pretreatment serum squamous cell carcinoma antigen (SCC-ag) level as a generally applicable measurement in predicting and estimating the treatment outcome of patients with locally advanced SCC of the cervix. Three hundred fifty-two patients with stage IIB-IVA SCC of the cervix were managed with both external irradiation and high-dose rate intracavitary brachytherapy. A significantly higher median SCC-ag was seen in association with increasing stage, tumor size, and lymph node involvement. The difference in disease-free survival (DFS) between stages IIB and III patients was not statistically significant with SCC-ag level <2 ng/mL. In multivariate analysis, median SCC-ag level (> or =6.0 ng/mL) and lymph node metastases had significant independent effects on absolute survival and DFS. A direct linear relationship (y=-2.932x+ 84.896) existed between the median SCC-ag of groups distributed by pretreatment prognostic factors and the 5-year DFS rate. The 5-year DFS rate as a function of SCC-ag level defined by cervix size, lymph node status, and hydronephrosis was obtained from a formula combining risk scores and the baseline survival function. From the obtained formulas, we can objectively estimate the treatment outcome in patients with locally advanced squamous cell cervical cancer.
Adult↗
Endoscopic ultrasonography of the pancreas in the dog.
Endoscopic ultrasonography was done in 12 normal adult dogs to investigate its efficacy in visualization of the pancreas. The endoscopic ultrasonographic device used in the present study had a curved-array ultrasound transducer mounted in front of the objective lens. The tip of the ultrasonic endoscope was inserted into the stomach, and all examinations of the pancreas were performed from within the stomach. Endoscopic ultrasonography provided good images of most parts of the pancreas except for the ends of each lobe. Useful information about the pancreatic parenchyma, including pancreatic lobular structure, pancreatic duct, and vessels of the pancreas was obtained by endoscopic ultrasonography. Blood flow within vessels was detected using color Doppler and pulsed-wave Doppler examination. These results suggest that endoscopic ultrasonography is available as an effective diagnostic modality in small animal practice.
Animals↗
Acute gastric changes in patients with acute stroke. Part 1: with reference to gastroendoscopic findings.
A gastroendoscopic study was performed on 177 patients with acute stroke. Gastric changes were found in 92 among them (52%), including ten with acute ulcer. A high frequency of gastric changes was found in patients with serious stroke and/or in patients whose cerebral lesions were located close to the hypothalamus or its centrifugal tract. The mortality in patients with gastric changes was high, especially in patients with acute ulcers, multiple erosions and petechiae. The frequency of brown gastric juice and coffee grounds at gastroendoscopic examination (gastric hemorrhage) was three times as high as that of melena and/or hematoemesis. On the other hand, the mortality of patients with gastric hemorrhage differed little from that of patients with melena and/or hematoemesis.
Adult↗
Acute gastric changes in patients with acute stroke. Part 2: gastroendoscopic findings and biochemical observation of urinary noradrenalin, adrenalin, 17-OHCS and serum gastrin.
To investigate the relationships between gastric change accompanying patients with acute stroke and the function of the autonomic nervous system and pituitary-adrenal system, studies on the gastroendoscopic technique and biochemical observations were done in 122 patients. The mean urinary noradrenalin and adrenalin excretions were elevated in patients with acute gastric changes, especially in patients with multiple erosions and acute ulcers. An elevation of the mean fasting serum gastrin concentration was found in patients with acute ulcers and no acute gastric changes. The mean urinary 17-OHCS excretion was increased in patients with multiple erosions, petechiae and acute ulcers. In conclusion, the sympathetic and parasympathetic nervous system and the pituitary-adrenal system have respectively different roles in the production of various types of acute gastric changes in patients.
17-Hydroxycorticosteroids↗
Acute insulin response to intravenous arginine in nonobese healthy cats.
The purpose of this study was to document and characterize insulin response to intravenous administration of arginine, a nonglucose secretagogue, and compare it to insulin response during intravenous glucose tolerance tests (IVGTTs) in clinically healthy nonobese cats. In addition, we examined the influence of plasma glucose level on insulin response to arginine in cats. Five dosages of 10% L-arginine hydrochloride (0.015, 0.025, 0.05, 0.1, and 0.2 g/kg of body weight) were administered to 5 cats. All doses of arginine elicited an abrupt insulin response that peaked at 2-4 minutes and returned to basal concentrations within 30 minutes. Mean insulin peak response (IPR) and mean area under the curve of plasma insulin concentration evaluated for the initial 10 minutes after administration (AUC10) increased with each progressive increase in arginine dosage. An asymptotic maximal response estimated by mean insulin AUC10 reached plateau at 0.1-0.2 g arginine/kg. Arginine at 0.2 g/kg induced hypersalivation in 2 of 4 cats. No adverse effects were evident at lower doses. Mean insulin AUC10 produced by equimolar amount of glucose (0.086 g/kg) was only 42% of that seen in response to 0.1 g arginine/kg, and mean IPR was much lower (18 +/- 7 versus 61 +/- 17 microU/mL). Mild hyperglycemia (211 +/- 6 mg/dL) induced by variable infusion rate of glucose resulted in a significant (P < .05) potentiation of insulin response to arginine; mean insulin AUC10 increased 287 +/- 26 to 551 +/- 167 microU/mL/10 minutes. These findings indicate that the arginine challenge is a more meaningful tool than is the IVGTT for evaluating the insulin secretory capacity in cats.
Animals↗
Role of heat-shock proteins in the induction of thermotolerance in Chinese hamster V79 cells by heat and chemical agents.
To examine the involvement of heat shock proteins in the induction of thermotolerance in Chinese hamster V79 cells, thermotolerance was induced by heating of the cells at 42 degrees C for 4 h or at 44 degrees C for 20 min, or by treatment of the cells with 50 microM sodium arsenite for 3 h or 20 micrograms/ml puromycin for 4 h. Under unstressed conditions V79 cells synthesized constitutively three major heat-shock proteins, hsp70, hsp85 and hsp105. On exposure to conditions under which thermotolerance was induced, the synthesis of constitutive hsp70, hsp85 and hsp105 increased, but the inducible form of hsp70 was not synthesized, indicating that this inducible form was not necessary for the induction of thermotolerance. Although the amounts of heat-shock proteins synthesized in the cells that acquired thermotolerance were not always more than those synthesized constitutively in unstressed cells, the stressed cells synthesized heat-shock proteins (especially hsp70) preferentially over other proteins. As the level of hsp70 in the thermotolerant cells was almost the same as that in unstressed cells, the specific accumulation of hsp70 seemed not to be required for the acquisition of thermotolerance. From these findings it seemed likely that, for the induction of thermotolerance in V79 cells, hsp70 preferentially synthesized during or after the stress has an important function. Or the synthesis of heat shock proteins may not be important, and constitutively synthesized heat-shock proteins acquire a specific function during or after the stress.
Animals↗
Characteristic synthesis and redistribution of 70 kd heat shock protein in thermotolerant Chinese hamster V79 cells.
Upon exposure to heat shock the increased rate of hsp70 synthesis decreased more rapidly in thermotolerant V79 cells than in the non-thermotolerant cells. However, the levels of hsp70 in the thermotolerant cells at 12 h after a heat shock were almost the same as those in the non-thermotolerant cells. On the other hand, the migration of hsp70 from cytoplasm to nucleoli after a heat shock was very rapid in both thermotolerant and non-thermotolerant cells, but hsp70 in the nucleoli disappeared faster in the thermotolerant cells than in the non-thermotolerant cells, and this coincided with the faster decline of hsp70 synthesis in the thermotolerant cells. For the characteristic distribution of hsp70, protein synthesis was not required. Furthermore, the induction and expression of thermotolerance by the cells were little affected by the inhibition of protein synthesis. Thus, the synthesis of hsp70 itself seemed not to be essential for the induction and expression of thermotolerance of the cells, although hsp70 may be essential for thermoresistance of cells. The rapid decrease of hsp70 synthesis and the rapid disappearance of hsp70 from the nucleoli after a heat shock may be essential for the expression of thermotolerance of the cells.
Animals↗
A feasibility study of continuous etoposide infusion combined with thoracic radiation for non-small cell lung cancer.
We conducted a feasibility study of continuous etoposide infusion, which was expected to suppress DNA repair after radiation, combined with radiation in patients with advanced non-small cell lung cancer (NSCLC). Between July 1995 and January 1997, 10 patients with NSCLC were registered. Thirty-six mg/m2/day etoposide was infused continuously for a mean of 19 days (range 14-26). Patients tolerated a mean total dose of accelerated hyperfractionated thoracic radiotherapy (1.5 Gy twice per day) of 52.6 Gy (range 33-60). The primary tumors of 7 patients showed partial responses and distant metastasis progression occurred before primary tumor progression in all 7 responders. The hematological adverse effects of chemoradiotherapy were grade 3 or 4 leukopenia in all 10 patients, grade 3 anemia developed in 3, and 2 had grade 3 thrombocytopenia. Six patients contracted infections and one of them died of pneumonia. The major non-hematological adverse effect was esophagitis, which was grade 3 in 3 patients, one of whom died of renal dysfunction. The serum etoposide concentrations were 1.6-2.0 microgram/ml, except in one patient, who had liver dysfunction due to B-type hepatitis. DNA repair gene XRCC1 mRNA expression in peripheral blood mononuclear cells was analyzed, using the reverse transcriptase-polymerase chain reaction, in 8 patients and was suppressed during etoposide infusion in 2. No relationship was observed between serum etoposide concentration and XRCC1 expression and clinical outcome. In conclusion, continuous etoposide infusion combined with thoracic radiation induces severe toxicity and should be given only after careful consideration.
Adult↗