[Pseudohypoaldosteronism type I].
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Biomedical subjects
Publications and source records attributed to Akira Endoh.
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BACKGROUND: With increasing computerization of nursing records in Japan, standardization of nursing terminology is becoming imperative. Although some efforts have been made to formalize description of nursing practice in Japan with the International Classification of Nursing Practice (ICNP), lack of effective description tools has impacted negatively on the initiatives. PURPOSE: To develop and evaluate an ontological approach that could be used to facilitate the description of nursing practice in Japan with the ICNP. METHODOLOGY: An ontology-based support system was developed using Protégé-2000, mainly by the following three steps: (1) representing a standard classification of nursing practice (the Nursing Master) in Japan; (2) representing a Japanese version of the ICNP; (3) designing an ontology-based framework. A heuristic matching algorithm was developed to automatically match the action labels in the Nursing Master with the terms of the eight axes of the ICNP Nursing Actions Classification. A preliminary evaluation was performed to examine the usefulness of the system. RESULTS: High hit rate was shown on the ICNP axes ActionType, Target, and Location. The evaluation indicated that 51.7+/-5.8% (mean+/-S.D.) of the action labels with only one action type were properly matched, and that in 80+/-4% (mean+/-S.D.) of action labels with more than one action type, at least one valid action type was matched correctly. CONCLUSION: The ontology-based approach using a frame-based knowledge representation system (e.g., Protégé-2000) is useful for supporting the formal description of nursing practice in Japan with the ICNP.
In order to establish whether there are differences in DNA-binding proteins between zona fasciculata (ZF) and zona reticularis (ZR) cells of the human adrenal cortex, we prepared nuclear extracts from separated ZF and ZR cells. The formation of DNA-protein complexes was studied using an element in the first intron of the type I and type II 3beta-hydroxysteroid dehydrogenase genes (HSD3B1 and HSD3B2). Using the element in the HSD3B2 gene as a probe, a complex (C1) was formed with extracts from ZF cells but was formed only at a low level with ZR cell extracts. Another pair of complexes (C2/C3) was formed with both ZF and ZR cell extracts. The ZF-specific protein forming C1 was enriched by column chromatography on DEAE-Sepharose and carboxymethyl-Sepharose. Oligonucleotide competition analysis on the enriched fraction gave results consistent with those obtained on the unfractionated material. A further enrichment was brought about by passing the protein over an oligonucleotide affinity column based on the HSD3B2 element. The protein bound to the column was identified as alpha-enolase by mass spectrometry. Although alpha-enolase is a glycolytic enzyme, it binds to specific DNA sequences and has been found to be present in nuclei of various cell types. We performed immunohistochemistry on sections of adult human adrenal cortex and found alpha-enolase to be located in nuclei of ZF cells but to be predominantly cytoplasmic in ZR cells. Transfection of an alpha-enolase expression vector into NCI-H295R human adrenocortical cells increased HSD3B2 promoter activity, suggesting a possible functional role for this protein in regulation of HSD3B2 expression.
The purpose of the study is to develop and evaluate a bottom-up approach to extract the specific nursing terms from textual nursing records using corpora comparison. A nursing records corpus was developed as the target corpus, and a newspaper corpus and a medical literature abstracts corpus were developed as the reference corpora. Two filters were established to extract the technical terms and the relative frequency ratio was used for corpora comparison. The issues related to the improvement of both the algorithms and the evaluation methods were discussed.
BACKGROUND: Leptin exerts its effects by using both long (OB-Rb) and short (OB-Ra) receptors. Although leptin resistance or insensitivity is reported to be a cause of human obesity, there have not been enough studies to clarify regulation of leptin receptors. METHODS: The authors studied leptin receptor regulation by leptin and dexamethasone in the human hepatocellular carcinoma cell (HepG2). Using a quantitative RT-PCR technique, the authors demonstrate expression of OB-Ra and OB-Rb mRNA after the incubation for 24 h with leptin or dexamethasone at various concentrations (10(-9)-10(-6) M). RESULTS: Leptin (10(-7)-10(-6) M) significantly inhibited expression of OB-Rb mRNA, with maximum inhibition (43% of control) at 10(-6) M. Expression of OB-R219.1 and OB-R219.3, two short isoforms of leptin receptor, were also reduced in cells treated with leptin most remarkably at 10(-7) M for OB-R219.1 (44% of the control) and at 10(-6) M for Ob-R219.3 (49% of the control). In contrast, dexamethasone (10(-8)-10(-6) M) significantly increased OB-Rb mRNA levels, with a maximum increase (204% of the control) at 10(-7) M, and OB-R219.1 and OB-R219.3 mRNA expression was also markedly increased at 10(-9)-10(-6) M. The peak values were 254% of the control for OB-R219.1 and 246% of the control for OB-R219.3 at 10(-7) M. CONCLUSIONS: In HepG2 cells, leptin inhibits and dexamethasone increases OB-Ra and OB-Rb mRNA expression. It is suggested that glucocorticoids as well as leptin itself contribute to regulatory effects of leptin through changes in gene expression of leptin receptors.
OBJECTIVE: Ontology in clinical domains is becoming a core research field in the realm of medical informatics. The objective of this study is to explore the potential role of formal concept analysis (FCA) in a context-based ontology building support in a clinical domain (e.g. cardiovascular medicine here). METHODOLOGY: We developed an ontology building support system that integrated an FCA module with a natural language processing (NLP) module. The user interface of the system was developed as a Protégé-2000 JAVA tab plug-in. A collection of 368 textual discharge summaries and a standard dictionary of Japanese diagnostic terms (MEDIS ver2.0) were used as the main knowledge sources. A preliminary evaluation was taken to show the usefulness of the system. RESULTS: Stability was shown on the MEDIS-based medical concept extraction with high precision. 73+/-14% (mean+/-S.D.) of the compound medical phrases extracted were sufficiently meaningful to form a medical concept from a clinical perspective. Also, 57.7% of attribute implication pairs (i.e. medical concept pairs) extracted were identified as positive from a clinical perspective. CONCLUSION: Under the framework of our ontology building support system using FCA, the clinical experts could reach a mass of both linguistic information and context-based knowledge that was demonstrated as useful to support their ontology building tasks.
BACKGROUND: With the aim of improving the quality of life of children with cancer, this study presents an analysis of one hospital's experience with terminal care. METHODS: Between 1994 and 2000, 28 children died after treatment for cancer at Hamamatsu University Hospital. The circumstances of their deaths were analyzed through medical records and interviews with 8 sets of bereaved parents. We compared results of this analysis with our previous data collected from 1978 to 1993. RESULTS: Of the 28 children, 11 had leukemia/lymphoma (LL group) and 17 had solid tumors (ST group). Six children (21.4%), all of whom were in the LL group, died of treatment-related complications. Twenty children (71.4%) died during terminal care: three (27.3%) were in the LL group and 17 (100%) in the ST group. Eleven children (39.3%) received terminal care at home and eight (28.6%) of these died at home. The number of children who received terminal care and died at home had increased in comparison with the previous period. Among problems with terminal care identified by parents were the lack of opportunity for the child to continue with education and an inadequate support system after the child's death. CONCLUSIONS: Some advances in the quality of life of the children were recognized. However, these advances were extended to a greater percentage of children in the ST group than in the LL group. The psychosocial problems faced by children and their families are now changing for the better.
A portable video transmission system based on a hand-held computer and cellular telephone was developed for use with patients undergoing rehabilitation at home. It was designed to be simple to operate, for use by nurses on home care visits. The whole system can be held in one hand, and video pictures can be recorded and transmitted with the touch of a few buttons. The quality of the transmitted pictures and the feasibility of the system were clinically evaluated by physical therapists and nurses. Three image transmission scenes were used to evaluate the system: turning over in bed; walking; and raising and lowering a shoulder. Nurses reported that the system was easy to carry and simple to use. Physiotherapists found the system to be useful in making a judgement about the patient's condition. The patients were all enthusiastic about the system. The increased interaction had the effect of improving the patients' desire to continue their in-home rehabilitation.
We conducted a survey among 100 clinicians in a university hospital to determine the clinician's attitudes and the relevant computer-based information needs towards the practice of evidence-based medicine in outpatient setting.