PubMed | Satou Memorial Hospital, Fueki Naika Clinic, Obata Medicine Clinic, Sanyo and 4 more.
Type: Journal Article | Journal: Clinical and experimental nephrology | Year: 2016
The prevalence of gastroesophageal reflux disease (GERD) symptoms has not been investigated in patients on maintenance hemodialysis in Japan, and few studies have reported the effect of proton pump inhibitors (PPIs) in hemodialysis patients with GERD symptoms. Here, we investigated the prevalence of GERD symptoms and the effects of the PPI esomeprazole on the quality of life related to reflux and dyspepsia in patients on maintenance hemodialysis.This was a cross-sectional/cohort study of hemodialysis outpatients implemented in 10 Japanese medical facilities from October 2012 to March 2014. The trial was registered in the UMIN Clinical Trial Registry (UMIN000009124).Forty-one of 385 patients (11%) reported GERD symptoms on the Global Overall Symptom (GOS) questionnaire. Multivariate logistic regression analysis identified the independent prognostic factors for GERD symptoms as a history of gastric ulcer and use of sevelamer hydrochloride or calcium polystyrene sulfonate. Participants with GERD symptoms completed the Quality of Life in Reflux and Dyspepsia, Japanese version (QOLRAD-J) questionnaire and were assigned to receive 4-week esomeprazole treatment (20 mg/day). This PPI therapy significantly improved all QOLRAD-J domains in the full analysis set (n = 28) and improved the GERD symptoms listed in the GOS questionnaire. Significantly impaired disease-specific quality of life (QOL) in the QOLRAD-J domains was observed in 44.4-74.1% of patients who had symptoms before treatment. The mean GOS and QOLRAD-J scores correlated significantly.Therapy with 20 mg/day esomeprazole appears to be efficacious for improving disease-specific QOL and GERD symptoms in Japanese patients on maintenance hemodialysis.
Ohura T.,Hokkaido University |
Ohura T.,Wound Healing Research Center Kojin kai |
Nakajo T.,University of Tokyo |
Nakajo T.,Aoba Hospital Aobakai |
And 6 more authors.
Wound Repair and Regeneration | Year: 2011
A basic fibroblast growth factor (bFGF) case and a control case whose total scores of Pressure Ulcer Healing Process-Ohura (PUHP-Ohura) and risk factors for pressure ulcers, and level of care for pressure ulcers were equivalent were paired. Twenty-three such eligible pairs were enrolled in this study. Both cases in each pair were treated under conditions in which extrinsic factors such as the use of a pressure-relief mattress and the frequency of postural change were equivalent. The efficacy of bFGF was assessed by analyzing the data obtained over time as the scores of PUHP-Ohura for nine observation items using the SAS MIXED procedure. Treatment of pressure ulcers with bFGF accelerated wound healing over time more significantly than the control in six observation items (exudate volume, ulcer depth, granulation formation, wound edge, epithelialization, total score of the PUHP-Ohura). These data suggest that it may be possible to evaluate drugs for the treatment of pressure ulcers using the PUHP-Ohura wound-assessment tool. © 2011 by the Wound Healing Society.
Arita S.,Kansai Medical University |
Arita S.,Kasaoka Daiichi Hospital |
Hashshizume H.,Kasaoka Daiichi Hospital |
Honda M.,Okayama University
2014 Joint 7th International Conference on Soft Computing and Intelligent Systems, SCIS 2014 and 15th International Symposium on Advanced Intelligent Systems, ISIS 2014 | Year: 2014
Accurate medical diagnosis is very important for patient treatment. The diagnostic framework is to connect the patient's information, X, such as clinical findings of pain, with the outcome of diagnosis, Y, such as cancer. The outcome Y sometimes includes both a decision regarding the disease and the classification of its grade. Moreover, some clinical indicators of X play important roles in the decision about disease and other indicators in the classification of disease. There is some uncertainty regarding information X and the outcome Y in the diagnosis and this is an aspect of 'fuzziness' in medical diagnosis. As a new trial to clarify the fuzziness of diagnosis, we analyzed the clinical data on patients with Carpal Tunnel Syndrome (CTS) by the method of multivariate analysis. From the analytical results, we propose a new diagnostic system with two layers of diagnostic filters: A first Layer (for the decision about CTS) by the clinical indicators of Phalen's test and Ring sensory splitting and a second Layer (for the classification of CTS) by the indicators of Thenar muscle atrophy and Pinch disturbance. © 2014 IEEE.
Shimamura Y.,Okayama University of Science |
Nishida K.,Okayama University of Science |
Imatani J.,Okayama Saiseikai General Hospital |
Noda T.,Okayama University of Science |
And 3 more authors.
Acta Medica Okayama | Year: 2010
We biomechanically evaluated the bone fixation rigidity of an ONI plate (Group I) during fixation of experimentally created transcondylar humerus fractures in cadaveric elbows, which are the most frequently observed humeral fractures in the elderly, and compared it with the rigidity achieved by 3 conventional fixation methods: an LCP reconstruction plate 3.5 using a locking mechanism (Group II), a conventional reconstruction plate 3.5 (CRP) with a cannulated cancellous screw (Group III), and a CRP with 2 cannulated cancellous screws (CS) in a crisscross orientation (Group IV). In the axial loading test, the mean failure loads were: Group I, 98.9 ± 32.6; Group II, 108.5 ± 27.2; Group III, 50.0 ± 7.5; and Group IV, 34.5 ± 12.2 (N). Group I fixations failed at a significantly higher load than those of Groups III and IV (p < 0.05). In the extension loading test, the mean failure loads were: Group I, 34.0 ± 12.4; Group II, 51.0 ± 14.8; Group III, 19.3 ± 6.0; and Group IV, 14.7 ± 3.1 (N). Group IV fixations showed a significantly lower failure load than those of Group I (p < 0.05). The fixation rigidities against mechanical loading by the ONI plate and LCP plate were comparable. These results suggested that an ONI system might be superior to the CRP and CS method, and comparable to the LCP method in terms of fixation rigidity for distal humerus fractures. © 2010 by Okayama University Medical School.
Miyashita N.,Kawasaki Medical School |
Kawai Y.,Kawasaki Medical School |
Yamaguchi T.,Kawasaki Medical School |
Ouchi K.,Kawasaki Medical School |
And 16 more authors.
European Journal of Clinical Microbiology and Infectious Diseases | Year: 2011
The purpose of the present study was to evaluate the accuracy and usefulness of three rapid diagnostic methods, ImmunoCard Mycoplasma kit, chest high-resolution computed tomography (HRCT) findings, and the Japanese Respiratory Society (JRS) scoring system (including six parameters), for the early presumptive diagnosis of Mycoplasma pneumoniae pneumonia in adults. We performed three rapid diagnostic methods at the same time in four pneumonia groups: 68 cases with M. pneumoniae pneumonia, 133 cases with Streptococcus pneumoniae pneumonia, 30 cases with Haemophilus influenzae pneumonia, and 20 cases with Legionella pneumonia. The sensitivity and specificity were 35% and 68% for ImmunoCard, 73% and 85% with HRCT, and 83% and 90% with the JRS scoring system, respectively. Among the three rapid diagnostic methods, the JRS scoring system was the most useful tool for initiating the administration of adequate antibiotic therapy for probable M. pneumoniae pneumonia. We suggest that M. pneumoniae pneumonia should be suspected when there is a correlation of more than five parameters in the JRS scoring system (99% specificity). If there is a correlation of three or four parameters in the JRS scoring system, chest computed tomography (CT) findings are helpful for the presumptive diagnosis of M. pneumoniae pneumonia. © 2010 Springer-Verlag.
Miyashita N.,Kawasaki Medical School |
Kawai Y.,Kawasaki Medical School |
Akaike H.,Kawasaki Medical School |
Ouchi K.,Kawasaki Medical School |
And 13 more authors.
BMC Infectious Diseases | Year: 2012
Background: Although the prevalence of macrolide-resistant Mycoplasma pneumoniae isolates in Japanese pediatric patients has increased rapidly, there have been no reports concerning macrolide-resistant M. pneumoniae infection in adolescents aged 16 to 19 years old. The purpose of this study was to clarify the prevalence and clinical characteristics of macrolide-resistant M. pneumoniae in adolescent patients with community-acquired pneumonia.Methods: A total of 99 cases with M. pneumoniae pneumonia confirmed by polymerase chain reaction (PCR) and culture were analyzed. Forty-five cases were pediatric patients less than 16 years old, 26 cases were 16 to 19-year-old adolescent patients and 28 cases were adult patients. Primers for domain V of 23S rRNA were used and DNA sequences of the PCR products were compared with the sequence of an M. pneumoniae reference strain.Results: Thirty of 45 pediatric patients (66%), 12 of 26 adolescent patients (46%) and seven of 28 adult patients (25%) with M. pneumoniae pneumonia were found to be infected with macrolide-resistant M. pneumoniae (MR patients). Although the prevalence of resistant strains was similar in pediatric patients between 2008 and 2011, an increase in the prevalence of resistant strains was observed in adolescent patients. Among 30 pediatric MR patients, 26 had an A-to-G transition at position 2063 (A2063G) and four had an A-to-G transition at position 2064 (A2064G). In 12 adolescent MR patients, 10 showed an A2063G transition and two showed an A2064G transition, and in seven adult MR patients, six showed an A2063G transition and one showed an A2064G transition.Conclusions: The prevalence of macrolide-resistant M. pneumoniae is high among adolescent patients as well as pediatric patients less than 16-years old. To prevent outbreaks of M. pneumoniae infection, especially macrolide-resistant M. pneumoniae, in closed populations including among families, in schools and in university students, physicians should pay close attention to macrolide-resistant M. pneumoniae. © 2012 Miyashita et al.; licensee BioMed Central Ltd.
Yamaguchi M.,Tokyo Institute of Technology |
Murakami Y.,Tokyo Institute of Technology |
Hashizume H.,Kasaoka Daiichi Hospital |
Haneishi H.,Chiba University |
And 2 more authors.
Progress in Biomedical Optics and Imaging - Proceedings of SPIE | Year: 2010
The video capture of surgery is becoming widely used but the colors reproduced by conventional RGB-based video systems differ from the original. In this work, 6-band multispectral video was applied to the open surgery for highfidelity color reproduction, and medical doctors visually evaluated the reproduced image quality. As a result, 1) the 6- band video system was rated significantly higher in "color reproducibility," "fidelity," and "material appearance." 2) The perceived color differences between 6-band/RGB and 6-band/3-band were significant. 3) Color videos from 6-band data were transmitted via network, and approximately enough quality was obtained with 15Mbps bit rate. These results show the potential of multispectral technology for the improvement of surgical video quality. © 2010 Copyright SPIE - The International Society for Optical Engineering.
PubMed | Kasaoka Daiichi Hospital, Jichi Medical University and Moka Hospital
Type: | Journal: Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy | Year: 2016
The aim of this study was to evaluate the profile of dialyzability of an oral penem antibiotic, faropenem (FRPM), in hemodialysis (HD) patients with infections. Eight patients took one tablet of FRPM (200mg) every 12h during an inter-dialysis period, and another tablet at 1-5h before the beginning of the HD session. Blood samples were obtained during the HD session (3-4h). Plasma FRPM concentrations in the arterial side were 4.82.5 and 2.81.0g/mL before and at the end of HD session, respectively, which are above the 50% minimal inhibitory concentrations of FRPM against the major pathogen (0.015-2g/mL). Dialyzer clearance and elimination fraction of FRPM were 14.96.8mL/min per m
Imai H.,Oita University |
Watanabe M.,Showa University |
Fujita T.,Kitasato University |
Watanabe H.,Hamamatsu University School of Medicine |
And 2 more authors.
International Journal of Clinical Pharmacology and Therapeutics | Year: 2014
Background and objective: Teriparatide acetate was developed in the form of a synthetic analogue of the Nterminal peptide (1-34) of human parathyroid hormone for the treatment of osteoporosis; it is administered subcutaneously once weekly. However, it is not known whether the pharmacokinetics (PK) of this drug is affected by renal impairment, and this study was conducted to look into this question. Methods: A multi-center study was conducted at six hospitals in Japan. Subjects were enrolled and grouped on the basis of renal function stratified as: normal function to mild renal impairment (estimated GFR(e-GFR): = 60.0 mL/min/1.73 m2) (8 subjects), moderate impairment (eGFR: 30.0 - 59.9 mL/min/1.73 m2) (5 subjects), and severe impairment (eGFR: 15.0 - 29.9 mL/min/1.73 m2) (5 subjects). The PK parameters, blood and urine electrolytes concentrations, and safety profiles were assessed following a single subcutaneous injection of teriparatide acetate (56.5 μg as teriparatide). Results: The elimination half-life (t1/2) and the mean residence time extrapolated to infinity were significantly prolonged in the group with severe renal impairment (t1/2: 5.0 hours) compared with normal to mild and moderate impairment groups (t1/2: 1.5 hours and 1.2 hours, respectively). However, virtually all of the teriparatide was eliminated from the blood after 24 hours. Given that the drug is administered once weekly, it appeared highly unlikely that accumulation of the drug in the body would become a problem even with repeated administration. There were no particular problems with safety or tolerability. Conclusions: In treatment with teriparatide acetate once-perweek formulation, prescription at the usual dosage appears to be appropriate even in renally impaired patients. © 2014 Dustri-Verlag Dr. K. Feistle.
PubMed | Kasaoka Daiichi Hospital
Type: Journal Article | Journal: Electromyography and clinical neurophysiology | Year: 2010
Although bicycle ergometer exercise and walking are recommended as aerobic exercise for patients with lumbago, little research has been done to examine the muscular activities and circulatory dynamics during these exercises. In this study, we aimed at obtaining basic information on aerobic exercises effective for patients with lumbago by investigating the activities and circulatory dynamics of their lumbar muscles during bicycle ergometer exercise and walking. As subjects, we selected 10 healthy adults (23.7 +/- 3.4 years old) with no anamnestic history of lumbago. The measurement conditions were 4 types of exercise: walking (4.0 km/h); 25W, 50W and 75W bicycle ergometer exercises. The activities of the lumbar muscles during the exercises were measured by a surface electromyograph, and percent of MVC was calculated from the maximal voluntary contraction (MVC). With regard to the circulatory dynamics of the lumbar muscles, we measured oxygenated hemoglobin (Oxy-Hb) and deoxygenated hemoglobin (Deoxy-Hb) before and after the exercises with near infrared spectroscopy (NIRS). The change rates during the exercises were calculated based on the values before the exercises. Paired t test was employed to analyse the comparison of the circulatory dynamics of the lumbar muscles between, before and during the exercises. With respect to the comparison of the change rates of the muscular activities and circulatory dynamics among each of the exercises, we employed the one-way analysis of variance (ANOVA) (p < .05). The lumbar muscular activities during the walking were significantly higher than those during the bicycle ergometer exercise were at each load level. The Oxy-Hb increased significantly during the 25W and 50W bicycle ergometer exercises, as opposed to before the exercises. It showed a tendency to decrease during the 75W bicycle ergometer exercise and walking, but not significant. The change rate of the Oxy-Hb during the 25W bicycle ergometer exercise indicated a higher value than that of the other exercises. The Deoxy-Hb, on the other hand, declined significantly in every exercise compared with those before the exercises, with no significant differences in the change rates between each of the exercises. Bicycle ergometer exercise has been suggested as an aerobic exercise permitting as much oxygen uptake as walking does, with fewer loads on lumbar muscles and less likelihood of inducing a hypoxic state on lumbar muscles.