1.Nontuberculous Mycobacterial Peritonitis in a Patient Undergoing Continuous Ambulatory Peritoneal Dialysis
Yoshitaka Maeda ; Tomomi Uno ; Akiko Yoshida ; Akiko Takahashi ; Naoto Inaba ; Tatsuo Shiigai
Journal of Rural Medicine 2008;4(2):75-79
Non-tubercuous mycobacterial (NTM) infection in peritoneal dialysis (PD) patients has been rarely reported. We report a case of a 55-year-old female on continuous ambulatory peritoneal dialysis (CAPD). After a 2-year-history of recurrent exit-site infection of a PD catheter caused by Mycobacterium abscessus (M. abscessus), the patient was admitted to the hospital with signs of peritonitis. Since the same species, M. abscessus, was isolated from the CAPD effluent, multiple antibiotics were administered. However, the treatments could not relieve the symptoms of her infection. Consequently, the PD catheter was removed. Her condition gradually recovered over the course of subsequent, long-term, empirical antimicrobial therapies. NTMs, especially a rapidly growing NTM infection, have rarely been reported in PD patients and are commonly resistant to a variety of antimicrobial agents. Routine acid-fast staining is most likely helpful in promptly initiating treatment against NTM infection in PD patients. Moreover, an appropriate treatment regimen for a rapidly growing NTM infection should be established by accumulating data from cases as reported here.
Infection as complication of medical care
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PUPILLARY DISTANCE
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Peritoneal Dialysis, Continuous Ambulatory
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Peritonitis
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Patients
2.Relationships between self-efficacy on health behavior and patient's assessment of rheumatoid arthritis conditions
Akiko Aoki ; Akiko Suda ; Syohei Nagaoka ; Mitsuhiro Takeno ; Yoshiaki Ishigatsubo ; Takako Kawai ; Sachiko Ohde ; Osamu Takahashi ; Sadayoshi Ohbu
An Official Journal of the Japan Primary Care Association 2013;36(4):308-314
Objective : The purpose of this study was to examine the relationships between levels of self-efficacy on health behavior of outpatients with rheumatoid arthritis (RA) and patient's assessment of RA conditions.
Methods : A cross-sectional study was performed using a self-administered anonymous questionnaire between October and December 2010 on 406 RA outpatients who consecutively visited 3 urban hospitals in Japan. The following variables were investigated ; (1) the scale of self-efficacy on health behavior in chronic disease patients (CD-SES), which has 2 subscales : active coping behavior with disease (14 items) and controllability for health (10 items). (2) The demographic data ; age, gender, duration of disease, treatment. (3) patient's assessment of RA conditions : painful joint count, swollen joint count, serum C reactive protein (CRP), patient estimate of global status (PGS) which was measured on a 100-mm visual analogue scale (0=best score), functional disability according to Japanese version of modified Health Assessment Questionnaire.
Results : CD-SES data were obtained from 191 patients. 80% was female with mean age 64.4 yr. Total CD-SES scores significantly correlated with age, PGS and functional disability. The scores of active coping behavior with disease correlated with age, and the scores of controllability for health correlated with PGS. The other variables such as painful joint counts, swollen joint counts, and serum CRP showed no relationship with the scores of self-efficacy.
Conclusion : Self-efficacy on health behavior of RA patients related to PGS and functional disability. The longitudinal study is necessary to ascertain whether the psychological support enhances self-efficacy, and affects clinically important outcome measures such as PGS.
3.Epithelial Mesenchymal Transition in Drug Resistance and Metastasis of Lung Cancer.
Fariz NURWIDYA ; Fumiyuki TAKAHASHI ; Akiko MURAKAMI ; Kazuhisa TAKAHASHI
Cancer Research and Treatment 2012;44(3):151-156
Among all types of cancer, incidence of lung cancer remains the highest with regard to cancer-related mortality. Problems contributing to recurrence of the disease include metastasis and drug resistance. Mounting evidence has demonstrated involvement of epithelial mesenchymal transition (EMT) in cancer progression. EMT is a critical mechanism ensuring tissue remodeling during morphogenesis of multicellular organisms. Therefore, understanding of the biology of this process for identification of potential EMT-targeted therapeutic strategies for the benefit cancer patients is necessary. This review describes recent evidence of EMT involvement in drug resistance and metastasis of cancers, with an emphasis on lung cancer.
Biology
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Drug Resistance
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Epithelial-Mesenchymal Transition
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Humans
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Incidence
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Lung
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Lung Neoplasms
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Morphogenesis
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Neoplasm Metastasis
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Recurrence
4.A successful case of Denver shunt from the right chest cavity to right femoral vein in the patient with right massive pleural effusion
Toshio Hashimoto ; Toshiyuki Takahashi ; Ikuko Nasu ; Souju Kimura ; Katsuya Yamaguchi ; Miho Suzuki ; Toshiko Endou ; Akiko Abe
Palliative Care Research 2010;6(1):301-307
We experienced a case that right massive pleural effusion was successfully controlled with Denver shunt from the right chest cavity to right femoral vein. A 80-years-old woman had received hemodialysis due to chronic renal failure twice in a week. She was diagnosed as right breast cancer and underwent right breast conserving surgery at December, 2008. In postoperative follow-up duration, she had difficulty in breathing and visited to the emergency room in our hospital. She was diagnosed as respiratory failure due to right massive pleural effusion from the X-ray result and the blood gas analysis. There was no pleural effusion within the left chest space. No malignant cell was detected in the effusion. We thought that diuretics and shunt tube from the right chest cavity to the abdominal cavity would be ineffective because of her chronic renal failure, and for that reason, we placed the shunt tuve from the chest cavity to the right femoral vein. Respiratory failure and the quality of life were successfully improved for about 7 months by using it. Palliat Care Res 2011; 6(1): 301-307
5.Characteristics and influencing factors of sleep during a pre-hospitalization period in liver cancer survivors with frequent recurrences : Actigraph objective sleep measures and PSQI subjective sleep measures
Ayako Ura ; Natumi Okuzono ; Youko Ishibashi ; Akiko Matsunaga ; Ikuko Miyabayashi ; Hiromi Takahashi
Palliative Care Research 2013;8(2):388-395
Objective: To assess the characteristics and influencing factors of sleep during a prehospitalization period in liver cancer survivors with frequent recurrences. Methods: A sleep pattern and mental health were analyzed in 12 patients who had recurrences of hepatocellular carcinoma during a pre-hospitalization period. Subjective sleep quality was assessed by PSQI-J, and objective sleep quality was measured with a actigraphic method. Results: The mean age of the subjects was 74.1 years and the mean number of recurrence episodes was 3.7. The mean PSQI total score was 6.7. The subjective assessment showed that 50% of the patients had a poor sleep pattern, required more time to fall asleep, had a shorter duration of sleep, and had poor sleep quality. The objective assessment showed that 50% of the patients slept for less than 360 minutes and that the patients did not have disturbance of sleep induction with a sleep latency of 3 to 29 minutes. The mean time of awakening episodes was 3.3. The hypnotic agent, severe fatigue, and poor mental health were identified as factors of the poor sleep pattern, as assessed by the subjective measures, and the hypnotic agent shortened and influenced the time spent awake after falling asleep. The subjective evaluation of sleep demonstrated inconsistency with the objective evaluation of sleep. Namely the patients with poor sleep pattern had higher sleep efficiency and significant short awakening times. Conclusion: The sleep pattern in liver cancer survivors was influenced by the hypnotic agent, mental health, and fatigue.
6.End-of-life care by expert clinical nurses for non-malignant chronic illness patients in genelral hospitals
Mariko Tanimoto ; Yoshiyuki Takahashi ; Tomoko Hattori ; Yoshiyuki Tadokoro ; Akiko Sakamoto ; Mai Sudoh ; Harue Masaki
Palliative Care Research 2015;10(2):108-115
This study clarified practices in end-of-life care for non-malignant chronic illness patients by expert nurses in general hospitals. Interviews with 7 chronic illness specialist nurses on practice cases were conducted, and final labels were elicited using a qualitative synthesis method(KJ method). As patients’ conditions deteriorated, nurses defined the necessary interactions to support patients’ decision-making for living their own way of life and accompany patients and families based on their experience, and using patients’ restoration of self-esteem, sense of satisfaction, and acceptance as indices. In general hospitals, measures to cope with pain for patients not receiving life-prolonging treatment were insufficient;and while it was difficult to agree on care between medical professionals and to maintain care in other facilities, expert nurses grasped patients’ wishes on a daily basis and made arrangements for them to permeate through family and community care systems. In end-of-life care in treatment settings, it is necessary to be supportive so that the family and medical professionals can continue the patient’s care. Medical professionals who have been involved from the initial diagnosis stage need to improve their awareness and support skills as medical professionals to be involved purposefully from an early stage to the final stage.
7.Visual Recognition of the Elderly Concerning Risks of Falling or Stumbling Indoors in the Home
Toshiki Katsura ; Norio Miura ; Akiko Hoshino ; Kanae Usui ; Yasuro Takahashi ; Seiichi Hisamoto
Journal of Rural Medicine 2011;6(2):71-80
Objective: The objective of this study was to verify the recognition of dangers and obstacles within a house in the elderly when walking based on analyses of gaze point fixation.Materials and Methods: The rate of recognizing indoor dangers was compared among 30 elderly, 14 middle-aged and 11 young individuals using the Eye Mark Recorder.Results: 1) All of the elderly, middle-aged and young individuals showed a high recognition rate of 100% or near 100% when ascending outdoor steps but a low rate of recognizing obstacles placed on the steps. They showed a recognition rate of about 60% when descending steps from residential premises to the street. The rate of recognizing middle steps in the elderly was significantly lower than that in younger and middle-aged individuals. Regarding recognition indoors, when ascending stairs, all of the elderly, middle-aged and young individuals showed a high recognition rate of nearly 100%. When descending stairs, they showed a recognition rate of 70-90%. However, although the recognition rate in the elderly was lower than in younger and middle-aged individuals, no significant difference was observed. 2) When moving indoors, all of the elderly, middle-aged and young individuals showed a recognition rate of 70%-80%. The recognition rate was high regarding obstacles such as floors, televisions and chests of drawers but low for obstacles in the bathroom and steps on the path. The rate of recognizing steps of doorsills forming the division between a Japanese-style room and corridor as well as obstacles in a Japanese-style room was low, and the rate in the elderly was low, being 40% or less.Conclusion: The rate of recognizing steps of doorsills as well as obstacles in a Japanese-style room was lower in the elderly in comparison with middle-aged or young individuals.
8.From tumor hypoxia to cancer progression: the implications of hypoxia-inducible factor-1 expression in cancers.
Fariz NURWIDYA ; Fumiyuki TAKAHASHI ; Kunihiko MINAKATA ; Akiko MURAKAMI ; Kazuhisa TAKAHASHI
Anatomy & Cell Biology 2012;45(2):73-78
Hypoxia, defined as a decrease of tissue oxygen levels, represents a fundamental pathophysiological condition in the microenvironment of solid tumors. Tumor hypoxia is known to be associated with radio/chemo-resistance and metastasis that eventually lead to cancer progression contributing to poor prognosis in cancer patients. Among transcription factors that accumulated under hypoxic conditions, hypoxia-inducible factor-1 (HIF-1) is a master transcription factor that has received the most intense attention in this field of research due to its capacity to modulate several hundred genes. With a clearer understanding of the HIF-1 pathway, efforts are directed at manipulation of this complex genetic process in order to ultimately decrease cellular HIF-1 levels. Some novel agents have been shown to have HIF-1 inhibition activity through a variety of molecular mechanisms and have provided promising results in the preclinical setting.
Anoxia
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Genetic Processes
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Humans
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Neoplasm Metastasis
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Oxygen
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Prognosis
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Transcription Factors
9.From tumor hypoxia to cancer progression: the implications of hypoxia-inducible factor-1 expression in cancers.
Fariz NURWIDYA ; Fumiyuki TAKAHASHI ; Kunihiko MINAKATA ; Akiko MURAKAMI ; Kazuhisa TAKAHASHI
Anatomy & Cell Biology 2012;45(2):73-78
Hypoxia, defined as a decrease of tissue oxygen levels, represents a fundamental pathophysiological condition in the microenvironment of solid tumors. Tumor hypoxia is known to be associated with radio/chemo-resistance and metastasis that eventually lead to cancer progression contributing to poor prognosis in cancer patients. Among transcription factors that accumulated under hypoxic conditions, hypoxia-inducible factor-1 (HIF-1) is a master transcription factor that has received the most intense attention in this field of research due to its capacity to modulate several hundred genes. With a clearer understanding of the HIF-1 pathway, efforts are directed at manipulation of this complex genetic process in order to ultimately decrease cellular HIF-1 levels. Some novel agents have been shown to have HIF-1 inhibition activity through a variety of molecular mechanisms and have provided promising results in the preclinical setting.
Anoxia
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Genetic Processes
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Humans
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Neoplasm Metastasis
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Oxygen
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Prognosis
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Transcription Factors
10.Intralymphatic Histiocytosis with Massive Interstitial Granulomatous Foci in a Patient with Rheumatoid Arthritis.
Mayuri TANAKA ; Yoko FUNASAKA ; Kyoko TSURUTA ; Akiko KANZAKI ; Kenji TAKAHASHI ; Hidehisa SAEKI
Annals of Dermatology 2017;29(2):237-238
No abstract available.
Arthritis, Rheumatoid*
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Histiocytosis*
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Humans