1.Serum Mineral Levels among Nepalese Living in the Southern Agricultural Terai Region
Yoshimi OHNO ; Kazuko HIRAI ; Kumiko NAGATA ; Toshihide TAMURA ; Mathura P. SHRESTHA
Environmental Health and Preventive Medicine 2000;5(1):1-5
The physical status and serum mineral concentrations for people aged 10 to 68 years living in an agricultural southern region of Nepal were determined. Systolic (SBP) and diastolic blood pressure (DBP) for both sexes in the 10−14 year age group were low (p<0.05, vs the other age groups) and those for the over 50−year−olds tended to be higher than the other age groups. The mean values of total proteins (TP) (8.6±0.5 g/dl for males and 8.7±0.6 g/dl for females) were high due to an increase of globulin (3.9±0.4 g/dl for males and 4.1±0.5 g/dl for females). More than three−fourths of the subjects of both sexes showed calcium (Ca) levels of 9.0−11.2 mg/dl and about 65% of them showed potassium (K) Ievels of 4.8−5.4 mEq/l. A significant positive correlation between DBP and serum K was observed (p<0.05). Serum inorganic phosphorus (IP) correlated with age (p<0.001) and body mass index (BMI) (p<0.001). The serum Ca levels correlated with TP (r=0.31, p<0.001), albumin (Alb) (r=0.50, p<0.001), IP (r=0.31, p<0.001), K (r=0.32, p<0.001) and chlorine (Cl)(r=−0.37, p<0.001). Cl was associated with TP (r=−0.21, p<0.05), Alb (r=−0.36, p<0.001) and IP (r= −0.21, p<0.05). These results suggested that Ca intake for the subjects seemed to be insufficient although their serum Ca level was within normal.
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2.Clinical Evaluation of the Finger Tissue Blood Volume during Shuchi-Bushi Powder Administration
Kampo Medicine 2008;59(6):809-812
In order to evaluate the effect of shuchi-bushi, a powder form of the aconite tuber, we examined changes in finger temperature (FT) and tissue blood flow (TBF). No significant differences were observed in FT between pre-administration and 90 min post-administration, however, FT at 72 min was significantly higher than that at the pre-administration (p=0.0736and p=0.0219, respectively). The FT at 72 h was also significantly higher than that at 90 min (p=0.0253). No significant differences were observed in TBF between pre-administration and 90 min, nor between the 90 min and 72 h. However, the TBF at 72 h was significantly higher than that at pre-administration (p=0.0219). A significant correlation was observed between the FT and TBF (p=0.0052). Our results suggest that shuchi-bushi may play a role in warming and increasing tissue blood flow in human.
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3.Validation of nutritional screening tools against anthropometric and functional assessments among elderly people in Selangor.
Suzana Shahar ; Siti Saifa Hussain
Malaysian Journal of Nutrition 2007;13(1):29-44
This cross sectional study was conducted to determine the validity of three screening tools, Mini Nutritional Assessment Short Form (MNA-SF), Malnutrition Risk Screening Tool for Community (MRST-C) and Malnutrition Risk Screening Tool for Hospital (MRST-H) among elderly people at health clinics. The screening tools were validated against anthropometric and functional assessments. The anthropometric assessments that were carried out included body weight, height, arm span, body mass index (BMI), calf circumference (CC) and mid upper arm circumference (MUAC). A set of questionnaire on manual dexterity, muscular strength, instrumental activities daily living (IADL) and cognitive status was used to assess functional abilities. A total of 156 subjects were recruited from rural (38 subjects) and urban (118 subjects) health clinics at Sabak Bernam and Cheras respectively. Subjects’ age ranged from 60 to 83 years old, with 44.2% were men and 55.8% women. The prevalence of muscle wasting among the subjects assessed from MUAC and CC were both 7.0%. MNA-SF had the highest correlation with BMI (r = 0.497, p<0.001), followed by MUAC (r = 0.398, p<0.001), CC (r = 0.473, p<0.001), cognitive assessment (r = 0.229, p<0.001) and handgrip strength (r = 0.209, p<0.001). Whilst MRST-C had the highest correlation with IADL score (r = -0.320, p<0.001) and MRST-H had the highest correlation with the lock and key test (r = -0.325, p<0.01). Sensitivity was the highest for MNA-SF (93.2%), followed by MRST-H (52.5%) and MRST-C (25.8%). Specificity was the highest for MRST-H (97.3%), followed by MRST-C (90.8%) and MNA-SF (79.4%). Positive predictive value (PPV) for MRST-H, MNA-SF and MRST-C was 55.5%, 18.2% and 14.1%, respectively. In conclusion, among the screening tools being validated, MNA-SF is considered the most appropriate tool to be used in health clinics for identification of elderly individuals who are at high risk of malnutrition.
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4.Investigation of the nurse and co-medical worker ; a basis of writing a scientific paper using the concept mapping
Kuninori SHIWAKU ; Yosuke YAMANE
Journal of the Japanese Association of Rural Medicine 2003;52(6):975-977
Methods of writing a scientific paper and forming a working hypothesis were lectured. The concept mapping method has the possibility of evaluating learners' organization of knowledge in research. We tried an application of concept mapping to the research process of nursing. Concept mapping would clarify the conceptual framework, and develop research ability and problem-solving capability.
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5.Quazepam Improves Health-related Quality of Life and Nocturia in Elderly Japanese Patients with Chronic Insomnia
Journal of Rural Medicine 2008;4(1):1-6
Aim and background: Chronic insomnia in elderly patients significantly affects their health and quality of life (QOL). Nocturia also worsens sleep condition. The aim of this study was to evaluate the improvement effects of quazepam, a long-term acting benzodiazepine, on insomnia and nocturia in elderly patients. Method: Forty-one elderly outpatients (mean age 77.1 ± 5.6 yr) suffering from chronic insomnia while on regular a short- or ultra-short-acting hypnotic treatment were enrolled. We prescribed 7.5-15 mg of quazepam, which was administered regularly by the subjects before bedtime. A questionnaire was used to compared changes in quality of sleep and frequency of nocturia for before treatment and at 2 and 4 weeks after initiation of treatment. QOL was also examined using the 36-item Short Form Health Survey of the Medical Outcomes Study (SF-36). Results: Thirty-seven subjects (90.2%) completed the study. All subscales of the sleep quality questionnaire improved significantly (p<0.001) after 2 weeks, as did the total scores (p<0.001) after 4 weeks. Frequency of nocturia decreased significantly from 3.6 ± 1.7 times to 1.5 ± 0.8 (p<0.001) and 1.2 ± 1.0 times (p<0.001) after 2 and 4 weeks, respectively. Every SF-36 subscale also showed significant improvement after 4 weeks. The total SF-36 scores of the group showing a decrease in the frequency of nocturia (>/= 2 times) improved significantly compared with that with a frequency of < 2 times (p=0.016). Conclusion: Quazepam significantly improves sleep, QOL and nocturia in elderly patients that respond poorly to short-acting or ultra-short-acting hypnotics.
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6.Chronic Effect of Training on Neutrophil Functions in Humans
Kazumasa TSUKAMOTO ; Katsuhiko SUZUKI ; Kazuhiko MACHIDA
Environmental Health and Preventive Medicine 2001;6(1):22-26
We performed this study to evaluate the chronic effect of training on neutrophil functions in humans. Twenty-six university students (14 males and 12 females) with a mean age of 19.1±0.8 years were divided into the athlete group and the control group based on answers given to a written questionnaire. The capacity of circulating neutrophils to ingest bacteria (phagocytosis) and to produce superoxide (nitroblue tetrazolium reduction) was measured under resting conditions in the absence of training activities. In addition, we measured hematological and serum biochemical parameters. The present analyses revealed that the frequency of subjective symptoms concerning susceptibility to infections (sum of males and females) was higher in the athlete group than in the control group (p<0.05). In the investigation of males, hemoglobin and serum protein levels of the athlete group were lower than that of the control group (p<0.01, p<0.05, respectively). Although total and differential leukocyte counts, and phagocytic activity of neutrophils were not significantly different between the groups, superoxide productivity of neutrophils in the male athlete group was higher than that in the control group (p<0.05). Since significant differences were observed in hemoglobin and serum protein levels in the male athletes, the training is considered to have been intense. An increase was noted in the neutrophil superoxide production along with these changes, but no significant difference was observed in the phagocytic activity. Therefore, there is the possibility of superoxide overproduction, which may lead to tissue damage.
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7.Experimental production of clinical-grade dendritic cell vaccine for acute myeloid leukemia.
Yuen-Fen Tan ; Geok-Choo Sim ; Aziz Habsah ; Chooi-Fun Leong ; Soon-Keng Cheong
The Malaysian journal of pathology 2008;30(2):73-9
Dendritic cells (DC) are professional antigen presenting cells of the immune system. Through the use of DC vaccines (DC after exposure to tumour antigens), cryopreserved in single-use aliquots, an attractive and novel immunotherapeutic strategy is available as an option for treatment. In this paper we describe an in vitro attempt to scale-up production of clinical-grade DC vaccines from leukemic cells. Blast cells of two relapsed AML patients were harvested for DC generation in serum-free culture medium containing clinical-grade cytokines GM-CSF, IL-4 and TNF-alpha. Cells from patient 1 were cultured in a bag and those from patient 2 were cultured in a flask. The numbers of seeding cells were 2.24 x 10(8) and 0.8 x 10(8), respectively. DC yields were 10 x 10(6) and 29.8 x 10(6) cells, giving a conversion rate of 4.7% and 37%, respectively. These DC vaccines were then cryopreserved in approximately one million cells per vial with 20% fresh frozen group AB plasma and 10% DMSO. At 12 months and 21 months post cryopreservation, these DC vaccines were thawed, and their sterility, viability, phenotype and functionality were studied. DC vaccines remained sterile up to 21 months of storage. Viability of the cryopreserved DC in the culture bag and flask was found to be 50% and 70% at 12 months post cryopreservation respectively; and 48% and 67% at 21 months post cryopreservation respectively. These DC vaccines exhibited mature DC surface phenotypic markers of CD83, CD86 and HLA-DR, and negative for haemopoietic markers. Mixed lymphocyte reaction (MLR) study showed functional DC vaccines. These experiments demonstrated that it is possible to produce clinical-grade DC vaccines in vitro from blast cells of leukemic patients, which could be cryopreserved up to 21 months for use if repeated vaccinations are required in the course of therapy.
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8.Anthropogenic deforestation, El Ni?o and the emergence of Nipah virus in Malaysia.
Kaw Bing Chua ; Beng Hui Chua ; Chew Wen Wang
The Malaysian journal of pathology 2002;24(1):15-21
In late 1998, a novel paramyxovirus named Nipah virus, emerged in Malaysia, causing fatal disease in domestic pigs and humans with substantial economic loss to the local pig industry. Pteropid fruitbats have since been identified as a natural reservoir host. Over the last two decades, the forest habitat of these bats in Southeast Asia has been substantially reduced by deforestation for pulpwood and industrial plantation. In 1997/1998, slash-and-burn deforestation resulted in the formation of a severe haze that blanketed much of Southeast Asia in the months directly preceding the Nipah virus disease outbreak. This was exacerbated by a drought driven by the severe 1997-1998 El Ni?o Southern Oscillation (ENSO) event. We present data suggesting that this series of events led to a reduction in the availability of flowering and fruiting forest trees for foraging by fruitbats and culminated in unprecedented encroachment of fruitbats into cultivated fruit orchards in 1997/1998. These anthropogenic events, coupled with the location of piggeries in orchards and the design of pigsties allowed transmission of a novel paramyxovirus from its reservoir host to the domestic pig and ultimately to the human population.
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10.Clinical Significance of Serum Leptin Levels in the Diagnosis of Fatty Liver
Koji HATTORI ; Nahoko MOCHIZUKI ; Keiji KOSHIBU ; Yukihito MINATO ; Tatsuo SHIIGAI
Journal of the Japanese Association of Rural Medicine 2005;54(5):734-739
We examined the usefulness of serum leptin concentration as an index for the diagnosis of fatty liver. Twenty-two patients diagnosed with fatty liver by abdominal ultrasonography, participated in this study together with 7 indinduels as controls. As laboratory findings showed, body fat percentage (29.5±1.4 vs 19.1±1.6%, P<0.001), BMI (25.7±0.7 vs 20.8±1.0 kg/m2, P<0.005), procollagen III peptide (P III P) (0.58±0.04 vs 0.42±0.04 U/ml, P<0.05), and serum leptin levels (7.3±1.0 vs 2.9±0.5 ng/ml, P<0.001) were significantly higher in the fatty liver group than in the control group. Serum leptin levels were correlated significantly with body fat percentage (r=0.76, P<0.0001) and BMI (r=0.61, P<0.001), though there was a significant correlation between serum leptin levels and liver-kidney contrast (r=0.47, P<0.05) only in males. In addition, when the fatty liver group was classified into two groups by GPT levels, m-GOT (mitochondrial glutamate-oxaloacetate transaminase) (8.6±1.0 vs 5.7±1.0 IU/l/37°C, P<0.05) and P III P (0.65±0.06 vs 0.49±0.04 U/ml, P<0.05) were significantly higher in the elevated GPT group than in the normal GPT group.These results suggest that serum leptin levels may be indicative of fatty liver and that fatty liver is not always a reversible disease.
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