2.Safety Assessment of Peripherally Inserted Central Venous Catheter: A Retrospective Single-center Study to Compare Cancer and Non-cancer Patients
Nozomi Maruta ; Toyoaki Maruta ; Toshiyuki Takahashi ; Tetsuya Wada
Palliative Care Research 2017;12(1):169-174
Objectives: Peripherally inserted central venous catheter (PICC) is widely used, because the incidence of complications and bloodstream infection in patients receiving PICC was lower than that in patients receiving central venous catheter. We compared PICC between cancer patients and non-cancer patients. Methods: This retrospective single-center study included 157 patients receiving PICC from May 2012 to September 2015. Patients were separated into cancer and non-cancer groups. Results: Cancer patients were 88 and non-cancer patients were 69. The most common causes of PICC were intravenous hyperalimentation (Cancer vs. non-cancer: 45 vs. 51) and difficult peripheral venous access (40 vs. 12) (p=0.0022). The duration of catheterization was 15 (6-39) vs. 21 (12-40) days (p<0.0001). The causes of catheter removal were death (50 vs. 14), remission (9 vs. 26), redness on insertion site or infection suspicion (10 vs. 11), and Some kind of catheter trouble (8 vs. 4) (p=0.0002). Complications occurred in 8 vs. 9 patients (p=0.429), and infection occurred in 0.9 vs. 2.0/1000 catheter days (p=0.041). Discussion: End-stage cancer patients have a weakened immune system. In this study, the incidences of PICC-related infection and other complications were not different between cancer and non-cancer patients, suggesting PICC was a safer method.
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.Training and Detraining Effects on Satellite Cell Response after Exhaustive Exercise in Thoroughbred Horses
Youko Imaoka ; Minako Kawai ; Kazutaka Mukai ; Hajime Ohmura ; Toshiyuki Takahashi ; Atsushi Hiraga ; Hirofumi Miyata
Japanese Journal of Physical Fitness and Sports Medicine 2014;63(1):177-187
We investigate the effects of training and detraining on the satellite cell activation in thoroughbred horse muscles after an exhaustive exercise. Six horses were subjected to conventional training for 18 weeks and detraining for 6 weeks. Before training (Pre), after 10-week and 18-week training (10Tr and 18Tr), and after 6-week detraining (DTr), an incremental exercise test (IET) was performed on inclined treadmill to measure VO2max and the velocity at a plasma lactate of 4 mmol/l (VLA4). Biopsy samples from gluteus medius muscle was obtained before and at 1 minute (1min), 3 hour (3hr), 6 hour (6hr) and 1 day after each IET. Number of muscle satellite cell were counted in type identified muscle fibers by immuno-histochemical stain images. The levels of mRNA expressions were determined using real time RT-PCR system. The number of satellite cells in 10Tr was significantly higher in type IIa fibers (0.31±0.10) than Pre (0.15±0.06). As compared to each value before IET, IL-6 mRNA expression (fold change) increased remarkably at 6hr after IET in 10Tr (x 2290.2) and 18Tr (x 2304.2), but not in both Pre (x 260.0) and DTr (x 853.3). IGF-I and Myogenin mRNA expressions were significantly increased at 1 day after IET in 18Tr (x 6.6 and x 3.3), but not in both Pre and DTr. These results suggested that the increased reactivity of satellite cells by training for 18 weeks is almost disappeared after detraining for 6 week, as well as VO2max and VLA4.
8.A web-based survey of attitudes toward sales system for OTC drugs specified by the revised Pharmaceutical Affairs Act effective since June 2009
Yasuhiko Tsujino ; Toshiyuki Iio ; Rieko Hayashi ; Sigekazu Arai ; Kazuko Iwata ; Atsushi Eto ; Yoshihiko Saeki ; Katsuhito Danjo ; Yutaka Nakamura ; Naoki Oshiro ; Hiroshi Takahashi ; Futoshi Toda
Japanese Journal of Drug Informatics 2010;12(2):77-84
Objective: To examine how best to provide information on over-the-counter (OTC) drugs in the future, the Japan Self-Medication Industry (JSMI) conducted an online survey on public attitudes toward changes in the system for controlling the sales of OTC drugs specified by the revised Pharmaceutical Affairs Act effective since June 2009.
Methods: A secure web-based questionnaire system was developed and linked to the JSMI website. The survey was conducted between July 17 and August 31, 2009.
Results: Of the 4,257 people who responded to the questionnaire, 56.8% indicated they understood the provisions of the revised Pharmaceutical Affairs Act. More than half of the responders had positive opinions of the revision. They welcomed the improvement in convenience resulting from the availability of drugs at convenience stores, but “Druggists,” who are responsible for sales of the drugs, were not sufficiently represented among responders. It was inferred that the general public feels that they should be able to purchase OTC drugs for self-medication after receiving sufficient information about the drugs from qualified sources.
9.Analysis of Revision Surgery of Microsurgical Lumbar Discectomy
Taku INADA ; Sei NISHIDA ; Taigo KAWAOKA ; Toshiyuki TAKAHASHI ; Junya HANAKITA
Asian Spine Journal 2018;12(1):140-146
STUDY DESIGN: A retrospective study. PURPOSE: Our objectives were to determine the association between the pathological changes of disc herniation and the interval between primary and revision surgeries and to investigate the frequency and site of the dural laceration in the primary and revision surgeries. OVERVIEW OF LITERATURE: Among 382 patients who underwent microsurgical lumbar discectomy, we investigated 29 who underwent revision surgery to analyze recurrent herniation pathologies and complications to determine the manner in which lumbar disc herniation can be more efficiently managed. METHODS: Of 29 patients, 22 had recurrent disc herniation at the same level and site. The pathological changes associated with compression factors were classified into the following two types depending on intraoperative findings: (1) true recurrence and (2) minor recurrence with peridural fibrosis (>4 mm thickness). The sites of dural laceration were examined using video footage and operative records. RESULTS: The pathological findings and days between the primary and revision surgeries showed no statistical difference (p=0.14). Analysis of multiple factors, revealed no significant difference between the primary and revision surgery groups with regard to hospital days (p=0.23), blood loss (p=0.99), and operative time (p=0.67). Dural lacerations obviously increased in the revision surgery group (1.3% vs. 16.7%, p < 0.01) and were mainly located near the herniated disc in the primary surgery group and near the root shoulder in the revision surgery group, where severe fibrosis and adhesion were confirmed. To avoid dural laceration during revision surgery, meticulous decompressive manipulation must be performed around the root sleeve. CONCLUSIONS: We recommend that meticulous epidural dissection around the scar formation must be performed during revision surgery to avoid complications.
Cicatrix
;
Diskectomy
;
Fibrosis
;
Humans
;
Intervertebral Disc Displacement
;
Lacerations
;
Operative Time
;
Pathologic Processes
;
Pathology
;
Recurrence
;
Reoperation
;
Retrospective Studies
;
Shoulder
10.Randomized Controlled Trials (RCTs) of Acupuncture and Moxibustion in Japan at the Present and the Future Issues.
Etsuko INOUE ; Toshiyuki SHEIKHDOM ; Tomoyuki NABETA ; Eiji SUMIYA ; Takashi UMEDA ; Shigekatsu AIZAWA ; Atsushi NISHIDA ; Norihito TAKAHASHI ; Hideki OCHI ; Syouhachi TANZAWA ; Kenji KAWAKITA
Journal of the Japan Society of Acupuncture and Moxibustion 2003;53(5):635-645
The results of multi-center RCT of acupuncture and moxibustion for the prevention of the symptoms of common cold conducted by the financial support of the foundation for training and licensure examination in anma-massage-acupressure, acupuncture and moxibustion were briefly reviewed. Traditional acupuncture manipulation to the throat induced significant positive effects, however, more common indirect moxibustion to the neck for longer period did not induce the significant effect compared with no-treatment control. Several issues to be resolved were discussed and the shortage of duration of intervention was pointed out as one of the major issues. Then four pilot studies with long-lasting intervention of acupuncture or moxibustion were con-ducted. The effects tended to be more positive, however, they were still unclear. The selection of subjects (students in the acupuncture school) will be the next important issue to be examined.