Biomedical subjects

Kazuo Maeda

Publications and source records attributed to Kazuo Maeda.

6 recordsLinked to original sources

PubMed2006

Fetal behavior analyzed by ultrasonic actocardiogram in cases with central nervous system lesions.

AIMS: This study examined whether analysis of fetal behavioral states by monitoring fetal heart rate and movement using an actocardiogram (ACG), could provide prognostic information related to fetal central nervous system (CNS) lesions. METHODS: The ACG simultaneously records fetal heart rate (FHR) and fetal movement bursts composed of spikes of ultrasonic Doppler signals. Durations of FHR accelerations and fetal movement bursts were measured manually. Five actocardiographic indices were studied in 12 fetuses with CNS lesions and in 14 normal pregnancies of 28-38 weeks. RESULTS: Severity of the fetal CNS lesions was estimated from the acceleration/burst (A/B) duration ratio, which correlated with the rank of the sonographic fetal functional test in cases with CNS lesions. Severity of a fetal lesion may also be estimated by the regression equation of the A/B duration ratio and behavioral ranking. CONCLUSION: The severity of fetal CNS lesions may be estimated by quantitative analysis of ACG usings the measurement of A/B duration ratio to provide a prognosis. An ACG may demonstrate a loss of CNS control in cases with severe brain damage.

Case-Control Studies↗

PubMed2005

"Proton-pump inhibitor-first" strategy versus "step-up" strategy for the acute treatment of reflux esophagitis: a cost-effectiveness analysis in Japan.

BACKGROUND: Gastroesophageal reflux disease (GERD) is a common condition, and acid-suppressing agents are the mainstays of treatment. For the acute medical management of GERD, two different strategies can be proposed: either the most effective therapy, i.e., proton-pump inhibitors (PPIs), can be given first, or histamine H2-receptor antagonists (H2RAs) can be attempted first (the "step-up" approach). METHODS: A clinical decision analysis comparing the PPI-first strategy and the H2RA-first "step-up" strategy for the acute treatment of reflux esophagitis in Japan was performed, using a Markov chain approach. RESULTS: The PPI-first strategy was consistently superior to the step-up strategy with regard to clinical outcomes for the patient and with regard to cost-effectiveness (direct cost per patient to achieve clinical success). This superiority was robust within the plausible range of probabilities according to the sensitivity analyses. CONCLUSIONS: The PPI-first strategy is superior to the H2RA-first "step-up" strategy with regard to both efficacy and cost-effectiveness and therefore, the PPI-first strategy is the preferred therapeutic approach for the acute medical treatment of reflux esophagitis.

2-Pyridinylmethylsulfinylbenzimidazoles↗

PubMed2005

Quantitative studies on fetal actocardiogram.

AIM: To quantitatively analyze actocardiography as a method to differentiate between active and resting fetal states. METHODS: We established five new quantitative parameters for actocardiogram; they include duration, occupancy, and frequency of movement bursts, and fetal heart rate acceleration to movement ratio (A/B ratio) in duration and number. These parameters were analyzed and compared in 14 normal late pregnancies and in non-hypoxic sinus bradycardia due to fetal cardiac sick sinus syndrome (n=1), hypoxic non-reactive non-stress test (n=3), hypoxic fetal distress (n=1), and that ensuing in death (n=1). RESULTS: Fetal hypoxic disorders differed from non-hypoxic states in the significant reductions of burst frequency (normal pregnancy mean was 0.65-/+0.22 cpm and fetal distress 0.24 cpm), occupancy (32.67% and 10.00%, respectively), and the ratio of durations of acceleration to movement burst (1.03 and 0, respectively). CONCLUSION: Our study of quantitative actocardiogram parameters in normal pregnancy and various hypoxic fetal disorders demonstrated new characteristics of fetal movement and its relation to fetal heart rate. The results are promising for further analysis of fetal behavior and abnormalities.

Cardiotocography↗

PubMed2002

[Factors associated with self-rated health for non-institutionalized aged persons].

OBJECTIVE: To determine factors affecting self-rated health among the non-institutionalized elderly in Japan. METHODS: In 20 municipalities in Japan, 6,094 persons aged 65 years and older who were not institutionalized were selected at random. A questionnaire survey was conducted from September through November 2000. The distribution of self-rated health was rated in terms of dependent variables, with odds ratios and their 95% confidence intervals calculated using unconditional logistic models. RESULTS: Of the study population, 5,565 persons (91.8%) responded to the survey. Of the respondents, 64.4% answered that they were healthy, while 28.8% were not. The necessity for periodical visit to hospitals and clinics, and lowering of the activity of daily living greatly lowered self-rated health. Compared with those who were 85 years of age or older, a high health status was observed among those aged between 75 and 84 years, but not those aged 65 to 74 years. Those who tried to have exercise periodically, who had a vice-leadership role in a group, who joined social activities, who lived what they considered a worthwhile life, and who had positive positive activities in daily life, had high levels of self-rated health. Joining social activities for passive reasons elevated the health as well as joining for active reasons such as "because it is fun." CONCLUSION: Even if the reason is passive, joining social activities may elevate the self-rated health levels of elderly people.

Aged↗

PubMedDate not supplied

Evaluation of prolonged fetal monitoring with normal and pathologic outcome probabilities determined by artificial neural network.

OBJECTIVE: The purpose of this study was to objectively evaluate prolonged fetal heart rate (FHR) monitoring, which has been difficult to do with conventional cardiotocogram (CTG). METHODS: FHR was analyzed by an artificial neural network computer that calculates probabilities of normal, pathologic and suspicious outcome. Earlier normal and pathologic outcome probabilities (OPs) recorded during 15-min intervals are averaged every 5 min. Initially, two curves (the averaged normal and pathologic OPs) are compared. Furthermore, a single curve traced for each difference between the averaged normal and pathologic OPs and its value are studied. Our FHR probability data are of 9 cases reported in a previous paper on neural network FHR analysis. RESULTS: In the 4 cases of normal neonatal condition, the trends of the averaged curves and the last averaged values were higher for normal OP than for pathologic OP, and the final values of the difference were >0. On the other hand, in the 5 cases of neonatal depression, the trend of the two curves and the final values were lower for normal than for pathologic OP; and the final difference values of averaged probabilities were <0. For prolonged monitoring, the single parameter is more useful than the comparison of the two curves. CONCLUSION: A useful single parameter is obtained for the accurate and objective evaluation of prolonged FHR monitoring. The present method is promising for prospective studies using the combined system of experts and neural computers.

Female↗

PubMedDate not supplied

Automatic computerized diagnosis of fetal sinusoidal heart rate.

OBJECTIVES: Computerized automatic detection of pathologic fetal sinusoidal heart rate (FSHR) and its differentiation from physiologic FSHR is the purpose of this study. The results will be applied in the objective evaluation of fetal heart rate (FHR) with artificial neural network computer. METHODS: FHR tracings of pathologic FSHR of 9 cases of fetal-neonatal anemia, death, or severe asphyxia, those of 7 physiologic FSHR followed by normal outcome, and those of 5 normal FHR are processed with fast Fourier transform (FFT) analysis after digitization, and their power spectrums are obtained. The peak power spectrum frequency (PPSF), peak power spectrum density (PPSD), the area under the power spectrum of 0.03125-0.1 Hz (La), the area under the whole power spectrum (Ta), and the ratio of La/Ta (%) of pathologic FSHR are compared to those of physiologic FSHR and normal FHR. RESULTS: The La/Ta ratio and PPSD are significantly larger in the pathologic FSHR than those of physiologic FSHR and normal FHR. The true positive rate is 100%, false negative and false positive rates are 0%, respectively, when the pathologic FSHR is diagnosed by such combined criteria as 39% or more of La/Ta ratio and 300 or more of PPSD. CONCLUSION: Pathologic FSHR is clearly separated from physiologic FSHR and normal FHR by the La/Ta ratio and PPSD obtained by FFT frequency analysis of FHR. Consequently, it is capable to automatically diagnose pathologic FSHR, and to apply it to neural network computer evaluation of FHR.

Anemia↗