2.Effectiveness of a group seminar on opioids for lung cancer patients
Makoto Nakashima ; Hiromitsu Kato ; Takuya Goto ; Syuichi Matsumoto ; Sayo Ishii ; Toshitaka Suzuki ; Kimiyasu Sano ; Tatsuo Kato ; Masumi Suzui ; Tadashi Sugiyama
Palliative Care Research 2010;6(1):109-118
Purpose: We conducted a group seminar for lung cancer patients. The purpose of the group seminar was to eliminate the negative notions about opioids and to impart the right knowledge about these drugs. Further, we investigated the notions about opioids and the effectiveness of the group seminar. Methods: A pharmacist conducted a group seminar on opioids for lung cancer inpatients who agreed to participate in the group seminar. Moreover, we performed a questionnaire survey before and after the delivery of the group seminar. Results: Sixty patients answered the questionnaire. After completion of the group seminar, the understanding and knowledge about opioids increased, as indicated by the responses of the patients to all of the questions. Conclusion: Complete elimination of the negative notion about opioids could not be achieved through the group seminar. However, the group seminar was thought to be one of the useful methods of educating patients. If a patient resists treatment with opioids, control of pain may be delayed. This in turn would hamper improvement of the quality of life. Therefore, we consider that it is necessary that a patient has the right knowledge about opioids beforehand. Palliat Care Res 2011; 6(1):109-118
3.Case of Success in Halting the Progression of Renal Failure among Patients with Low Protein Diets.
Tatsuo SHIIGAI ; Toshihiko HATA ; Koji HATTORI ; Hitoshi IWAMOTO ; Yoshitaka MAEDA ; Akira OOWADA ; Kunihiko KATO
Journal of the Japanese Association of Rural Medicine 1995;44(1):16-21
Seven years ago, we began the “Toride Project” which aimed at organized care, mainly on based a low-protein diet (LPD), for chronic renal failure patients. This project cumulatively involved 486 patients, and 219 of them have been followed up at our hospital.
In this paper, we report the 12 patients who had before shown progressive deterioration of renal function and turned out stable (less than 5% change) in creatinine clearance (Ccr) for 12-54 months after involved in the project. Their diseases were chronic glomerulonephritis (CGN; 10 cases) and nephrosclerosis (NSC; 2 cases), and the mean Ccr was 20.9±1.3 (SE) ml/min (16-32 ml/min). All of them carried out the well maintained LPD (0.62±0.02 g/kg/day), and showed relatively low urinary protein excretion (UPE; 0.4±0.2g/day). In contrast, 10 other cases (CGN; 9, NSC; 1) showed persistent deterioratiom of renal function even if they continued the LPD (0.60±0.02 g/kg/day). They significantly showed higher UPE (1.6±0.3 g/day, p<0.05) than the 12 cases mentioned above. Moreover, frequent examination revealed that the day-to-day change in their protein intake was more widely distributed (coefficient of variation; 19.5±1.3% vs 10.8±0.6%, p<0.05).
4.Four Cases of Eosinophilic Gastroenteritis.
Koji HATTORI ; Miho TAMURA ; Akira KATO ; Shinkan YO ; Yukihito MINATO ; Tatsuo SHIIGAI
Journal of the Japanese Association of Rural Medicine 2002;50(5):715-720
Eosinophilic gastroenteritis (EG) is characterized by infiltration of eosinophils into the wall of the digestive tract, and the clinical spectrum seems to depend on the predominant site of eosinophilic infiltration of the wall.
We experienced four cases of EG, and two of them (Cases, 1 and 2) manifested massive ascites, suggesting the principal lesion is located on the serous coat. Case 3 manifested abdominal pain and vomiting, and muscle layer involvement of the duodenum was detected by ultrasonography and CT scan. In case 4, epigastralgia was a main symptom. An endoscopic examination revealed marked redness and erosion of the gastric mucosa associated with massive infiltration of eosinophils. In this case, mucosal involvement seemed to be the main lesion because hypertrophy of the gut wall thickness was not found by ultrasonography and CT scan.
Although the pathogenesis of this disease is obscure, allergic mechanism may play an important role. Three cases had histories of allergic diseases, and steroid therapy resulted in prompt disappearance of symptoms.
5.Determination of Bone Mass for Diagnosis of Osteoporosis: Comparison of Computed X-Ray Densitometry(CXD) with Quantitative Computed Tomography(QCT).
Shigeo TOMURA ; Kimika KAWANAMI ; Miwa HOSOKAWA ; Kimiko TANAKA ; Hisako YANAGI ; Shigeru TSUCHIYA ; Hitoshi AMAGAI ; Kunihiko KATO ; Tatsuo SHIIGAI
Journal of the Japanese Association of Rural Medicine 1997;46(2):142-147
Measurement of bone mass (BM), especially in the lumbar vertebrae, is very important for diagnosis of osteoporosis. In this study, we compared BM values measured by computed X-ray densitometry (CXD) with those by quantitative computed tomography (QCT), and discussed differences between the two methods.
The subjects were 90 women and 3 men, aged 42-86 years, who visited our outpatient department of osteoporosis. Metacarpal bone density (ΣGS/D) and metacarpal index (MCI) in the second metacarpal bone were measured by CXD. QCT was uesd for measurement of bone mineral density (BMD) in the lumbar trabecular bone, where pronounced osteoporotic changes occur early. The mineral values of L3 were expressed as mineral equivalent of CaCO3 in mg/ cm3, and≤75 mg/cm3 of L3 values were judged to be loss of lumbar BMD.
There were negative correlations between age and ΣGS/D, MCI or L3 value, and positive correlations were found between ΣGS/D or MCI and L3 value. Based on the above criterion of lumbar BMD loss, sensitivity and specificity of ΣGS/D for lumbar bone loss were examined. If ΣGS /D of 2.30 (T score -2.7) was used as the cut-off point, the sensitivity was 69.8% and the specificity was 75.0%, and if ΣGS/D of 2.37 (T score -2.3) and 2.40 (T score -2.1) were employed, the sensitivity was 79.1% and 79.1%, while the specificity was 64.5% and 62.5%, respectively. We concluded that BM values of cortical bone and trabecular bone decrease with age, and that sensitivity and specificity of GS/D for diagnosis of lumbar BMD loss are not very high.