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Biomedical subjects

Y Nose

Publications and source records attributed to Y Nose.

At least 91 records · Page 5Linked to original sources

Patient registration and treatment allocation in multicenter clinical trials using a FAX-OCR system.

This article describes the design and results of implementation of an automated patient registration and treatment allocation system (RETAS) used in multicenter clinical trials. RETAS was developed using a FAX-OCR system by which handwritten Japanese and English characters, as well as numericals and forms with check boxes, are sent from participating institutions by Fax, processed using an optical character reader, and then transmitted to a host computer at a statistical center. Based on the facsimile data, RETAS can automatically review eligibility, collect patient identification data and provide a randomized treatment allocation. RETAS permits uninterrupted, unattended operation at a statistical center, 24 hours a day, 7 days a week. Therefore, it drastically decreases the workload of personnel at the statistical center needed to support central telephone registration coverage. Consequently, staff members are free to focus on patient registration, treatment allocation, and follow-up of patients. The treatment allocation procedure in this system is based on Pocock and Simon's minimization method combined with Zelen's method for institution balancing. By this system it was possible to balance treatment numbers for each level of various prognostic factors over an entire trial and, at the same time, balance the allocation of treatments within an institution. The system currently supports the protocol of a clinical trial for Adjuvant Chemo-Endocrine Therapy for Breast Cancer in West Japan.

Computer Systems↗

A comparison of the logistic regression and the Cox proportional hazard models in retrospective studies on the prognosis of patients with gastric cancer.

To define the independent prognostic factors reducing survival time for gastric cancer, we compared the logistic regression and the Cox proportional hazard models applied to patients who underwent curative gastrectomy. All patients were evaluated after being followed for long fixed periods. Of 1,019, 269 (26.4%) died of tumor recurrence within a 5-year period and 36 (3.5%) died over 5 years after the original surgery. With regard to survival time, multivariate analyses using the Cox proportional hazard model in a stepwise manner adjusted for the sex, age, and 10 other factors, suggested that size of tumor (P < 0.01, relative risk [rr] = 1.0962), degree of gastric wall invasion (P < 0.01, rr < 1.3520), and status of lymph node metastasis (P < 0.01, rr = 1.6572) were the most independent prognostic factors. As well as, using the stepwise logistic regression model, size of tumor, (P < 0.01, odds ratio [or] = 1.115), degree of gastric wall invasion (P < 0.01, or = 1.428), and status of lymph node metastasis (P < 0.01, or = 2.182) were also the most independent risk factors for recurrence within 5 years after surgery. Although regression coefficients are not all the same, these three factors proved significant in both multivariate analyses. This equation for risk factors for prognosis is approached when searching for an appropriate method of retrospective studies using multivariate analyses.

Female↗

Relationship between age and the time of surgery and prognosis after gastrectomy for gastric cancer.

We did a retrospective study to assess the influence of age on the prognosis in 1,537 patients with gastric cancer and who underwent gastrectomy. The patients were classified into 7 groups by age at the time of surgery, and the relative survival rates were calculated after correcting for each patient's sex, age, and the operative calendar year, based on the life table data for the general Japanese population. The overall prognoses in patients under age 30 and over age 80 years were poor (for ages under 30 years, 30-39, 40-49, 50-59, 60-69, 70-79, and over 80 years, the 5-year survival rates were 32.1%, 55.9%, 54.8%, 54.3%, 48.6%, 50.8%, and 31.5%, respectively). The poor prognoses in the youngest patients could be attributed to a high frequency of aggressive stage of the tumor. After curative gastrectomy, although the prognoses were excellent for every category in the first and second postoperative year, patients over age 80 years had a relatively poor prognosis after the third postoperative check-up. The poor prognoses in the oldest patients were attributed to the number of deaths due to other diseases. We conclude that for the very young or old subjects, age is a significant prognostic factor for those treated by gastrectomy for gastric cancer.

Adult↗

Prognostic significance of electrocardiographic findings in patients with dilated cardiomyopathy.

The prognostic significance of electrocardiographic variables was retrospectively investigated in 88 patients with dilated cardiomyopathy and with normal coronary arteriograms. During an average follow-up of 3.7 +/- 2.9 years, 43 patients died, 26 of progressive heart failure, 15 patients with sudden death, and one due to cerebral embolism. Excluding one patient, who died of esophageal cancer, the cumulative survival rate was 73% at 2 years and 60% at 5 years. By univariate life table analysis, abnormal Q-waves, a QRS duration > or = 0.12s, a cardiothoracic ratio > or = 60%, systolic blood pressure < 110mmHg, and left ventricular end-diastolic pressure > or = 15mmHg were significantly associated with increased mortality within 5 years. Multivariate analysis using Cox's proportional hazards model determined the major independent risk factors in the following order: (1) for all patients; the presence of abnormal Q-waves, left bundle branch block or intraventricular conduction disturbances, left ventricular end-diastolic pressure, systolic blood pressure and the cardiothoracic ratio; (2) for patients without left bundle branch block or intraventricular conduction disturbances; abnormal Q-waves, left ventricular end-diastolic pressure and systolic blood pressure. The present study thus demonstrated that the electrocardiogram could provide independent prognostic predictors in patients with dilated cardiomyopathy, possibly reflecting the severity of myocardial damage.

Cardiomyopathy, Dilated↗

A visual field quantification system for the Goldmann Perimeter.

We have developed a visual field quantification system that can accurately quantify the measurement results by the Goldmann Perimeter (GP). This system calculates the plural indexes introduced in published papers. In recent years, several isopter quantification methods have been proposed. In these methods, the isopters are digitized and the data are input into a computer, after which a computer program evaluates the changes in the isopters quantitatively. However, each program is only able to evaluate private indexes. We have developed a system that quantifies data using multiple methods. This system used five methods that have been introduced in published papers. With this system, a physician can analyze GP data with multiple methods and can diagnose diseases accurately. We have already input about 2500 GP recording papers into the computer by this system. We then calculated the plural indexes, and visualized the temporal changes in the perimetry.

Humans↗

The effect of a multiple literature database search--a numerical evaluation in the domain of Japanese life science.

In literature database searching, we show that it is necessary to use plural databases for a more improved search. We also compare the results of a single database search with that of multiple database search in the domain of Japanese life sciences. We searched the MEDLINE and EMBASE using the same search terms. There were some differences in the results, owing to differences in the journals and recording methods. We herein show some of the differences in the journals contained in both databases. Furthermore, we show the differences in the number of papers derived from the same journal. Next, as an example of a practical search, we selected some universities in Japan, searched both databases regarding papers published from these universities and then merged the results by hand. According to our results, only 63% of all papers were common to both databases.

Biological Science Disciplines↗

Experimental and clinical evaluation of a noninvasive reflectance pulse oximeter sensor.

The objective of this study was to evaluate a new reflectance pulse oximeter sensor. The prototype sensor consists of 8 light-emitting diode (LED) chips (4 at 665 nm and 4 at 820 nm) and a photodiode chip mounted on a single substrate. The 4 LED chips for each wavelength are spaced at 90-degree intervals around the substrate and at an equal radial distance from the photodiode chip. An optical barrier between the photodiode and LED chips prevents a direct coupling effect between them. Near-infrared LEDs (940 nm) in the sensor warm the tissue. The microthermocouple mounted on the sensor surface measures the temperature of the skin-sensor interface and maintains it at a present level by servoregulating the current in the 940-nm LEDs. An animal study and a clinical study were performed. In the animal study, 5 mongrel dogs (weight, 10-20 kg) were anesthetized, mechanically ventilated, and cannulated. In each animal, arterial oxygen saturation (SaO2) was measured continuously by a standard transmission oximeter probe placed on the dog's earlobe and a reflectance oximeter sensor placed on the dog's tongue. In the first phase of the experiment, signals from the reflectance sensor were recorded while the dog was immersed in ice water until its body temperature decreased to 30 degrees C. In the second phase, the animal's body temperature was normal, and the oxygen content of the ventilator was varied to alter the SaO2. In the clinical study, 18 critically ill patients were monitored perioperatively with the prototype reflectance sensor. The first phase of the study investigated the relationship between local skin temperature and the accuracy of oximeter readings with the reflectance sensor. Each measurement was taken at a high saturation level as a function of local skin temperature. The second phase of the study compared measurements of oxygen saturation by a reflectance oximeter (SpO2[r]) with those made by a co-oximeter (SaO2[IL]) and a standard transmission oximeter (SpO2[t]). Linear regression analysis was used to determine the degree of correlation between (1) the pulse amplitude and skin temperature; (2) SpO2(r) and SaO2(IL); and (3) SpO2(t) and SaO2(IL). Student's t test was used to determine the significance of each correlation. The mean and standard deviation of the differences were also computed. In the animal study, pulse amplitude levels increased concomitantly with skin temperature (at 665 nm, r = 0.9424; at 820 nm, r = 0.9834; p < 0.001) and SpO2(r) correlated well with SaO2(IL) (r = 0.982; SEE = 2.54%; p < 0.001).(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

Retrospective study of post-anesthetic mild liver disorder associated with inhalation anesthetics, halothane and enflurane.

The incidence of post-anesthetic mild liver disorder (PAMLD) was compared between 928 patients administered halothane and 1766 patients administered enflurane. They were selected from 19 504 surgical patients administered general anesthesia at Kyushu University Hospital over the past 6 years and 4 months. They had had normal liver function before operation and had no history of blood transfusion. Alanine aminotransferase (ALT) levels exceeding 70 IU. l(-1) within 180 days after operation were found in 226 patients in the halothane group (24.4%), and in 250 patients in the enflurane group (14.2%) ( P < 0.01). Both maximum ALT levels and duration of ALT elevation were higher and longer in the halothane group ( P < 0.01). These results suggest that, not only in the development of fulminant hepatitis but also in PAMLD, enflurane is less hepatotoxic than halothane.

Journal Article↗

Sequence variation in Japanese HLA-DRw8 specificity.

There are four DRw8 haplotypes with different DQ alleles in Japanese: DRw8-DQw6 (w1), DRw8-DQw4, DRw8-DQw8(w3), and DRw8-DQw7 (w3). We previously reported the nucleotide sequence of DRB1 gene of DRw8-DQw6(w1) and it was named DRB1*08032. The nucleotide sequences of the other DRw8 DRB1 alleles and their correspondence to internationally recognized DRw8 subspecificities were still unclear. We have cloned these DRB1 genes and determined the nucleotide sequences. The comparison of the sequences with the published sequences revealed that the differences were occurred at two amino acid positions, and these four haplotypes are classified in two groups: (a) DRw8-DQw6(w1) and DRw8-DQw7(w3), and (b) DRw8-DQw4 and DRw8-DQw8(w3). The DRB1 molecules of DRw8-DQw6(w1) and DRw8-DQw7(w3) have Ser57 and Ile67, and those of DRw8-DQw4 and DRw8-DQw8(w3) have Asp57 and Phe67. The former has the same sequence as that of DRB1*08032, and the latter is same as that of DRB1*0802. The classification corresponds to the serologic subtyping, which divides DRw8 into DR8.1 and DR8.2, reported in the 10th Japan HLA Workshop.

Alleles↗

Risk factors which predict pattern of recurrence after curative surgery for patients with advanced gastric cancer.

The objective of the study was to define risk factors for peritoneal dissemination and haematogenous metastasis after curative resection of patients with an advanced gastric cancer. In retrospective analyses of 405 patients, 168 died of a tumour recurrence. Patients who died of gastric cancer were more likely to have large, invasive tumours which had spread throughout the stomach, metastasized to lymph nodes, and vessel invasion by gastric cancerous cells (P < 0.01 or P < 0.05). Of the 168 deaths, 60 (35.7%) were secondary to haematogenous recurrence, 53 (31.5%) were related to peritoneal dissemination, and 19 (11.3%) were related to a local recurrence. To determine the independent risk factors related to peritoneal dissemination and haematogenous metastasis, multivariate analyses using a stepwise logistic model suggested that serosal invasion (P < 0.01, relative risk = 2.57) and Borrmann type 4 (P < 0.01, relative risk = 1.95) were the greatest risk factors for peritoneal dissemination. The presence of lymph node metastasis (P < 0.01, relative risk = 2.62) and presence of vessel invasion by cancerous cells (P < 0.05, relative risk = 1.59) were the greatest risk factors for a haematogenous metastasis.

Cause of Death↗