Biomedical subjects

Izumi Kondo

Publications and source records attributed to Izumi Kondo.

8 recordsLinked to original sources

PubMed2005

[An estimation chart for the possibility of aspiration in patients with severe motor and intellectual disabilities: its reliability and accuracy].

Although the most common cause of death in patients with severe motor and intellectual disabilities (SMID) is aspiration pneumonia, there are no criteria to detect aspiration. We have been making an evaluation tool to detect aspiration in patients with SMID easily, in cooperation with the project of comprehensive study of disability, social health, and welfare, supported by the Ministry of Health, Labor and Welfare, Japan. Here we studied the reliability and accuracy of the 2001 edition of the "questionnaires for functions of eating and swallowing" and "estimation chart for the possibility of aspiration" in 20 patients with risk of aspiration (13 with cerebral palsy, six with acquired cerebral palsy and one with muscle disease). Family members or nursing staffs taking care of them answered the questionnaires. A pediatrician and an occupational therapist or speech therapist checked the chart. Reliability was checked by the agreement between the estimation of the two professionals, and accuracy was determined by comparing the results of the chart and videofluolography. The results showed good reliability (kappa 0.63) and accuracy (kappa 0.47). Based on these results and additional analysis of the check items, the new edition of the chart was established.

Cerebral Palsy↗

PubMed2004

Effectiveness of selective muscle-release surgery for children with cerebral palsy: longitudinal and stratified analysis.

The purpose of this study was to determine the effectiveness of muscle-release surgery for children with cerebral palsy (CP) using longitudinal and stratified analysis. Twenty-five children with CP (15 females, 10 males; age range 4 to 16 years; mean age 8 years 2 months, SD 3 years 2 months) were selected from five treatment centres in Japan. Twenty-two children had spastic diplegia, two had spastic quadriplegia, and one had athetospastic quadriplegia. Motor function for each child was assessed using the Gross Motor Function Measure (GMFM). Assessment was conducted on eight separate occasions: 1 month and 1 week before surgery, and 1, 2, 4, 6, 9, and 12 months after surgery. Participants' motor function before surgery was classified using the Gross Motor Function Classification System (GMFCS). Six children were classified at level I, three at level II, six at level III, and 10 at level IV. A significant difference was found after surgery in the GMFCS levels III and IV groups (p<0.05). Improvement in GMFM scores between 1 week before surgery and 12 months after surgery were 1, 5, 8.5, and 8.5 for GMFCS levels I to IV respectively. Results indicate that this treatment is advantageous for improving motor function in children within GMFCS levels III and IV.

Adult↗

PubMed2003

An ankle-foot orthosis with inhibitor bar: effect on hemiplegic gait.

OBJECTIVE: To test whether an inhibitor bar attached to an ankle-foot orthosis (AFO) improves walking ability in hemiplegic stroke patients with tonic toe flexion reflex (TTFR). DESIGN: Before-after trial. SETTING: Rehabilitation hospital in Japan. PARTICIPANTS: Nine patients with TTFR were assigned to the TTFR group, and 8 patients without TTFR were assigned to the control group. INTERVENTION: Inhibitor bar attached to an AFO. MAIN OUTCOME MEASURE: Gait was analyzed by measuring the number of steps and the time required to walk 10m at a maximal walking speed. RESULTS: In the TTFR group, use of an inhibitor bar for 2 weeks significantly increased the maximal walking speed, stride length, and cadence by 13.8% (P=.0045), 8.0% (P=.0398), and 6.1% (P=.0056), respectively. There were no significant changes in the control group. CONCLUSION: An inhibitor bar improved walking ability of hemiplegic patients with TTFR, and its use with an AFO is recommended.

Ankle↗

PubMed2003

Gross motor function classification system: preliminary study for Japanese children.

OBJECTIVE: The purpose of the study was to produce a version of the Gross Motor Function Classification System with the same construct as the original one that would be applicable to Japanese children with cerebral palsy. DESIGN: The reliability studies were performed twice with a convenience sample (first study, 76 children with cerebral palsy; second study, 225 children with cerebral palsy). The first version of the translated Gross Motor Function Classification System was used in the first reliability study. It was revised based on the findings of the study and used in the second reliability study. Two examiners classified each child's level of gross motor function independently. We calculated kappas for individual levels and across all levels to study interrater reliability. RESULTS: The individual kappa for level V changed from 0.59 in the first reliability study to 0.87 in the second reliability study, whereas the overall kappa changed from 0.64 to 0.66. In the second reliability study, the factors that seemed to affect the reproducibility were the unfamiliar words used in the system, partial agreement of the children's status, and thinking of future levels. CONCLUSIONS: Explanation of words and a note stressing the importance of the introduction part should be added to the system for Japanese clinicians.

Age Factors↗

PubMed2003

[Papillary adenocarcinoma of the prostate: report of 4 cases].

Papillary adenocarcinoma of the prostate, previously referred to as endometrioid carcinoma, is a variant of prostatic adenocarcinoma. Clinical and pathological evidence of involvement of the periurethral prostatic duct or verumontanum is usually required for definitive diagnosis of papillary adenocarcinoma. However, significant histologic and clinical features of papillary adenocarcinoma overlap with typical acinar carcinoma. Four cases of papillary adenocarcinoma were studied for the clinical features, histologic characteristics and immunohistochemical nature of prostatic specific antigen. In two cases, there were papillary regions, near the verumontanum, but in the other two cases, there were no papillary regions in the urethra. In two cases, acinar adenocarcinoma coexisted with papillary adenocarcinoma. All cases displayed positive immunohistochemical staining for prostatic specific antigen. In accordance with the observations of others, we suggest that papillary adenocarcinoma is one aspect of growth pattern of acinar adenocarcinoma, not a concept of a unique clinical and pathological entity.

Adenocarcinoma, Papillary↗

PubMed2002

Hyperhomocysteinemia in Japanese patients with convalescent stage ischemic stroke: effect of combined therapy with folic acid and mecobalamine.

Hyperhomocysteinemia is considered to be a risk factor for vascular diseases including ischemic stroke. It has been shown that plasma homocysteine level can be lowered by folic acid supplementation. Vitamin B(12) may be also beneficial when included in the supplement regimen with folic acid. We have examined in Japanese patients with ischemic stroke the homocysteine-lowering potential of a combination therapy with folic acid and vitamin B(12). Patients with ischemic stroke were randomized into three groups and each group received vitamin B(12) (1500 microg/day, n = 63), folic acid (5 mg/day, n = 64), or both vitamin B(12) and folic acid (n = 64) for 8 weeks. Plasma levels of homocysteine and these vitamins were followed. Significant reduction in plasma homocysteine was observed in all three groups, and the combination therapy yielded the most remarkable result, i.e., plasma total homocysteine was reduced by 38.5% and this was significantly larger than the reduction in other two groups (22.4% and 10.9% in the groups received folic acid and vitamin B(12), respectively). Vitamin B(12) synergizes with folic acid in reducing plasma homocysteine in Japanese patients with ischemic stroke and the combined therapy may be particularly effective in the secondary prevention.

Aged↗

PubMed2002

Vitamin K deficiency and osteopenia in vitamin D-deficient elderly women with Parkinson's disease.

OBJECTIVE: To assess the influence of vitamin K on bone mineral density (BMD) in vitamin-D-deficient women with Parkinson's disease (PD). DESIGN: Cross-sectional study. SETTING: Neurology department at a university medical center in Japan. PARTICIPANTS: Sixty-two women with PD (mean age, 70.7yr) and 62 age-matched controls. Patients were divided into 2 groups according to their functional capabilities: group A (independent: stages I-II of Hoehn and Yahr stages of Parkinson's disease, n = 26); and group B (dependent: Hoehn and Yahr stages 3-5; n = 36). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Sera were analyzed to relate vitamin K concentrations to bone-related biochemical indices. BMD was measured by computed radiograph densitometry. RESULTS: Group B had significantly lower metacarpal BMD (P <.0001) lower serum concentrations of vitamin K1 (P <.01) and 25-hydroxyvitamin D (25-OHD; P <.0001) than group A. Serum undercarboxylated osteocalcin levels were higher in group B than in group A (P <.0001). The serum concentration of vitamin K1 correlated positively with that of 25-OHD (r =.735, P <.0001), and negatively with undercarboxylated osteocalcin (r = -.751, P <.0001) and Hoehn and Yahr stages (r =.787, P <.0001). Multiple regression analysis identified Hoehn and Yahr stages, vitamin K1, 25-OHD, and undercarboxylated osteocalcin as independent determinants of BMD (P <.0364.0003). CONCLUSION: In functionally dependent women with PD, nutritional vitamin K1 deficiency is believed to reduce production of fully carboxylated osteocalcin, causing reduced BMD.

Aged↗

PubMed2002

Prediction of reflex sympathetic dystrophy in hemiplegia by evaluation of hand edema.

OBJECTIVE: To determine the predictive value of measurements of hand edema for the development of reflex sympathetic dystrophy (RSD). DESIGN: Cohort study. SETTING: Departments of rehabilitation medicine in 3 general hospitals and 1 rehabilitation hospital in Japan. PARTICIPANTS: Thirty-four stroke patients. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Measurement of the circumference of the middle finger was used to evaluate hand edema. The degree of hand edema was expressed by the ratio of circumference of the middle finger (RCMF) in the affected side to that in the uninvolved extremity. RESULTS: Eight of 34 patients developed clinical RSD from 2 to 4 months after stroke. Hand edema showed a significant relationship to the development of RSD (ie, the patients who had an RCMF of above 1.06 at 4 weeks poststroke had significantly higher incidence of RSD than those with a lower RCMF; P=.0127). CONCLUSION: It is possible to predict the development of RSD in hemiplegia by measuring hand edema 4 weeks poststroke.

Adult↗