1.Residue of Organochlorine Pesticide and PCB in Humans
Takeshi Sugaya ; Kazuhiro Watanabe ; Shiro Sasaki
Journal of the Japanese Association of Rural Medicine 1984;33(2):140-146
Organochlorine insecticides (BHC, DDT, etc) have been used in massive quatities in Japan. But in 1971, the goverment put a ban on their use as insecticides. We continued the residue analyses of organochlorine insecticide in human bodies from 1971 to 1982. This paper deals with the results of our residue analyses from 1980-1982. In paralel, We have also continued to analyze the residue of PCB.
(1) A total of 264 specimens have been analyzed for human mother milk, the adipose tissue, the liver, the kidney and the spleen.
(2) β-BHC and pp'-DDE were detected from all of these specimens.
(3) Over a span 12 years, the decrease of total-DDT was smaller than that of β-BHC.
(4) In the adipose tissue, there were no signs of a decrease in total DDT.
(5) PCB was detected from all specimens of mother milk, the adipose tissue and the liver.
It is conceivable that the pollution of human bodies by BHC, DDT. PCB, and other chemicals will last for a long time.
There is a need to keep constant surveillance over the tendency of these chemicals in the environment and human bodies.
2.Dose conversion ratio for continuous intravenous infusion of fentanyl and fentanyl transdermal patches (reservoir-type)
Masakazu Kuroyama ; Chihiro Kawano ; Takeshi Hirayama ; Genki Iwasa ; Toru Sasaki
Palliative Care Research 2012;7(2):218-224
Objectives: At present, the dose conversion ratio for a continuous intravenous infusion of fentanyl (CIV) and fentanyl transdermal patches (TP), which are widely used in Japan, is not based on the results of clinical studies in Japanese patients. Studies comparing serum fentanyl concentrations in patients with cancer pain treated by TP showed large differences between Japanese patients and those in other countries. We therefore studied the dose conversion ratio in Japanese patients. Methods: From October 2003 through October 2008, we extracted information on all patients with gastrointestinal cancer who underwent rotation from CIV to TP in the gastrointestinal ward of Kitasato University East Hospital. We selected patients in whom the daily dose of CIV or TP (i.e., the basic dose) was unchanged for 10 days after rotation and the difference in the number of rescue doses (per day) as compared with immediately before rotation was 1 or less on at least 3 consecutive days. All TP preparations used in this study were reservoir-type. Regression lines were plotted on the basis of the relation of “the basic released dose of TP” to “the basic prescribed dose of CIV,” and the dose conversion ratio was calculated. Results: 47 patients underwent opioid rotation, and 11 of them satisfied the eligibility criteria. Eleven patients were studied. The following regression equation was obtained: Y=1.0227X+1.0103, r²=0.9188, indicating a strong correlation. The dose conversion ratio of CIV to TP (released dose) derived by regression analysis was 1:1. Conclusions: Our results obtained in Japanese patients will allow dose conversion at the time of opioid rotation from CIV to TP to be more appropriately performed.
3.A clinical study of gastric cancer cases in Mie prefecture.
Yoshihiro OKABAYASHI ; Takeshi SHIMIZU ; Yoshiyuki ANDO ; Seiho NISHIDA ; Jun KITAMURA ; Masataka OTA ; Toshiya SASAKI
Journal of the Japanese Association of Rural Medicine 1990;39(4):921-926
Between September 1972 and December 1987, 808 gastric cancer patients were treated at our hospital. The male/female ratio was 1.7. Gastric resection was performed on 88% of the patients, while curative resection was performed on 59.2%. The operative mortarity rate was 1.8%.
In patients undergoing surgery, the cumulative 5-year survival rates according to stage were 96.4% for stage 1, 68.6% for stage 2, 48.7% for stage 3 and 4.5% for stage 4.
With the spread of a mass screening, many cases of early gastric cancer have been detected recently. However, the incidence of advance cancer increased with age. This suggests the necessity of encouraging the aged to participate in the mass screening. Though gastrectomy is safety procedure of encouraging the aged to participate in the mass screening. Though gastrectomy is safety procedure in old patients over 75 years of age, its indications should be evaluated taking into consideration the quality of the patient's life.
4.A clinical study of colorectal cancer cases in Mie prefecture.
Yoshihiro OKABAYASHI ; Takeshi SHIMIZU ; Yoshiyuki ANDO ; Seiho NISHIDA ; Jun KITAMURA ; Masataka OTA ; Toshiya SASAKI
Journal of the Japanese Association of Rural Medicine 1990;39(4):927-932
We reviewed 338 cases of colorectal cancer treated in our clinic since 1973. On these patients, 62% were aged 60 years or older.
By location, the malignant tumor was found most frequenty in the rectum, followed by the sigmoid colon.
Resection was perforoed in 94.3%, of the patients with curative resection accounted for 68.3%. In the curative resection group the cumulative 5-year and 10-year survival rates were 77% and 65, 9%, respectively.
Early colorectal cancer was detected in only 26 patients. Mass screening for colorectal cancer using occult blood tests of feces had just recently started in our communities. Thus, further efforts to detect early colorectal cancer are needed.
5.Assessment of Cardiac Function Using Echocardiography in Long-Term Hemodialysis Patients.
Takeshi ISHIYAMA ; Yoshiaki MIURA ; Masami OKADA ; Tsukasa NAKAMARU ; Yoshifumi ASANO ; Hitoshi MURAYAMA ; Wataru SASAKI
Journal of the Japanese Association of Rural Medicine 1995;44(1):27-31
Echocardiography was performed in two gruops of patients with impaired renal function excluding those with diabetic renal failure. Group A was comprised of 19 patients who had recieved hemodialysis from 1 year to 5 years, and Group B, of 32 patients who had been undergoing hemodialysis for more than 10 years. Significant reductions in left ventricular diastolic dimensions and cardiac output were found in Group B. In these two groups, there were no statistically significant differences in left ventricular wall thickness and left ventricular ejection fraction. Left ventricular diastolic function was assessd by the ratio of the peak atrial velosity (A) to early diastolic velosity (E). 15 patients (83%) in Group A and 19 patients (76%) in Group B had left ventricular diastolic dysfunction. A high incidence of left ventricular diastolic dysfunction was revealed. Moreover, dilated and hypertrophic cardiomyopathy like patterns were observed in both groups. In Group B, significantly increased left ventricular wall thickness in patients with hypertension and reduced left ventricular systolic function in patients with dialysis hypotension were found.
6.Kampo Therapy for Graves' Disease Associated with Psychological Disorders
Takeshi ARISHIMA ; Ichiro SASAKI ; Mami YOSHIDA ; Atsushi FUKAO ; Nakaaki OHSAWA ; Toshiaki HANAFUSA ; Shogo ISHINO ; Toshihiko HANAWA
Kampo Medicine 2007;58(1):69-74
We report 2 patients with Graves' disease and psychological disorders. In these patients, treatment did not relieve psychological disorders despite normalization of thyroid function, but kampo therapy was effective. Patient 1 was a 24-year-old female. In 2000, she was diagnosed as having Graves' disease. Treatment with an antithyroid drug normalized thyroid function, but did not relieve psychological disorders such as irritation, anxiety, or despair. In February 2005, the patient consulted our hospital. Patient 2 was a 26-year-old female. After graduating from a high school, she developed Graves' disease. Treatment with an antithyroid drug was started. However, thyroid function was unstable ; mild hyperthyroidism and hypothyroidism repeatedly occurred. During this period, irritation, fatigue, malaise, and alopecia deteriorated, and she consulted our hospital in January 2005. In the two patients, keishikanzoryukotsuboreitogohangekobokuto was prescribed (the regimen was changed during follow-up in Patient 1), and their conditions markedly subsided after 16 and 9 weeks of administration, respectively, suggesting the usefulness of kampo therapy in the treatment of Graves' disease associated with psychological disorders.
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7.Heterogeneity of Islet Cells during Embryogenesis and Differentiation
Shugo SASAKI ; Takeshi MIYATSUKA
Diabetes & Metabolism Journal 2023;47(2):173-184
Diabetes is caused by insufficient insulin secretion due to β-cell dysfunction and/or β-cell loss. Therefore, the restoration of functional β-cells by the induction of β-cell differentiation from embryonic stem (ES) and induced-pluripotent stem (iPS) cells, or from somatic non-β-cells, may be a promising curative therapy. To establish an efficient and feasible method for generating functional insulin-producing cells, comprehensive knowledge of pancreas development and β-cell differentiation, including the mechanisms driving cell fate decisions and endocrine cell maturation is crucial. Recent advances in single-cell RNA sequencing (scRNA-seq) technologies have opened a new era in pancreas development and diabetes research, leading to clarification of the detailed transcriptomes of individual insulin-producing cells. Such extensive high-resolution data enables the inference of developmental trajectories during cell transitions and gene regulatory networks. Additionally, advancements in stem cell research have not only enabled their immediate clinical application, but also has made it possible to observe the genetic dynamics of human cell development and maturation in a dish. In this review, we provide an overview of the heterogeneity of islet cells during embryogenesis and differentiation as demonstrated by scRNA-seq studies on the developing and adult pancreata, with implications for the future application of regenerative medicine for diabetes.
8.Collaboration between Primary Care Physicians and the Local Government for Long-term Care and Prevention Based on Community Diagnosis in Sannohe Town, Aomori Prefecture, Japan
Ryunosuke SHIOYA ; Yasufumi MATSUOKA ; Naoe TANAKA ; Shuko SASAKI ; Junko FUKUDA ; Kumi MATSUOKA ; Yasuaki MATSUO ; Takeshi SAKAMOTO
An Official Journal of the Japan Primary Care Association 2024;47(2):56-59
9.A Case of Early Repair of Ventricular Septal Perforation due to Blunt Chest Trauma.
Takeshi Ikuta ; Shigefumi Suehiro ; Toshihiko Shibata ; Yasuyuki Sasaki ; Hidekazu Hirai ; Tadahiro Murakami ; Mitsuharu Hosono ; Hiromichi Fujii ; Takanobu Aoyama ; Hiroaki Kinoshita
Japanese Journal of Cardiovascular Surgery 2002;31(3):221-223
We report a 25-year-old man with ventricular septal perforation due to blunt chest trauma. He was transferred by ambulance to our hospital following a traffic accident. On admission, he had no cardiac murmur. Two days later, a pansystolic murmur appeared over the left lower sternal border. Doppler echocardiogram revealed a large left-to-right shunt through a ventricular septal perforation. We postponed surgical treatment as long as possible because he also exhibited bronchial bleeding due to a lung contusion. Surgical repair of the ruptured ventricular septum was performed 8 days after the chest trauma, because the pulmonary to systemic flow ratio was elevated to 4.6 and cardiac function had deteriorated. During the operation, the site of the septal perforation was easily detected by epicardial echocardiography. A 4-cm tear in the muscular septum was closed through a right ventriculotomy using a pericardial patch reinforced with a Dacron patch. Postoperative recovery was uneventful with the exception of transient right ventricular failure. There was no residual shunt.
10.Clinical study on the prevention of recurrent tonsillitis by acupuncture (II)
Keishi YOSHIKAWA ; Kazushi NISHIJO ; Kazuhiro YAZAWA ; Hidetoshi MORI ; Tomomi SAKAI ; Kazuo SASAKI ; Akihiro OGATA ; Toshikazu SHIMA ; Katsumi KURIHARA ; Takeshi TOMIYASU ; Shuichi KATAI ; Yoshitsugu OHIRA ; Seiichi KOBAYASHI ; Akemi YAMAMOTO
Journal of the Japan Society of Acupuncture and Moxibustion 1984;34(1):8-14
We have continued a study on the preventive effects of acupuncture on recurrent tonsillitis. Among 239 patients with tonsillitis examined in 1980, 200 were included in the category of recurrent tonsillitis, showing a fever four or more times a year.
The preventive effects of acupuncture in these 200 patients are reported in this paper.
The subjects were 200 patients with recurrent tonsillitis treated in our department in 1980. The frequency, number of days and severity of fever and other symptoms (conditions of the nose and throat, snoring, colds and general condition) were followed for one year after the acupuncture treatment.
Of the 200 patients, 171, excluding the 29 in whom the results of research could not be obtained, were analyzed. With regard to the frequency of fever, the number of patients with a fever 12 or more times a year decreased from 102 before acupuncture therapy to nine after the treatment. The number of patients who did not have any fever and who had a fever one to three times after treatment was 30 and 69, respectively. Thus, 40.4% were not included in the category of recurrent tonsillitis, even though fever was present. In addition, there was a decrease in the severity and number of days of fever.
Favorable effects of the treatment on symptoms other than fever, such as conditions of the nose and throat, snoring, resistance to colds and general condition, were noted in more than 50% of the patients who did not have any fever after treatment or had a fever half as frequently as before treatment.
When the preventive effects on fever were determined according to age, improvement was observed in all age groups. From the viewpoint of the prevention of repetition of a high fever, the best results were obtained in patients 6-11 years of age, followed by those five years old or less.
Acupuncture treatment for recurrent tonsillitis is not so effective as tonsillectomy. However, we consider that acupuncture treatment is worth using prior to tonsillectomy to prevent the relapse of recurrent tonsillitis, taking into account operative stress on the living body and economic and personal problems arising from tonsillectomy.