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Biomedical subjects

N Heki

Publications and source records attributed to N Heki.

15 recordsLinked to original sources
PubMed1991

[A manual for community mental health activities for a public health center in Japan].

A system for treatment of persons with chronic mental disease such as schizophrenics in the present structure of the Japanese public Health Center is proposed. Presently, while cases are handled by responsible staff members, incorporation into the health center system with full utilization of its personnel and resources is seldom accomplished. There is a necessity for a systems approach in order to organize essential programs that would provide care for the mentally diseased. Health centers would have three main roles in this system: as a coordinator of mental health resources in the community, as a specialized agency for case management, and responsibility for public relations in its service area. For proper administration of its system, health centers should follow a team concept. The team would consist of a director of health centers, physicians, part-time psychiatrists, public health nurses, psychiatric social workers and clerical staff. At case conferences discussion of whether a prospective case should be registered, assessment of the needs, and development of management plans for all of the registered cases would be conducted. The files and documents of each case would be deleted or re-registered 5 years after initial registration. Cases would have a case-manager to coordinate public health care, including home visits, family care, psycho-educational consultation and crisis intervention. Health centers would be responsible for bringing together available social resources such as sheltered workshops and transient residential programs. The goal of health centers' mental health activities would be to facilitate the normalization of the mentally diseased within the community.

Community Health Centers↗
PubMed1990

[Factors affecting activity of daily living (ADL) in stroke patients at home].

To examine the effects of housing conditions, health care, age, functional status and other demographic factors on the Activity of Daily Living (ADL), an interview survey of the caregivers of 68 cerebral stroke patients was performed. All patients received care at home for 6-128 (mean 40) months after discharge from hospitals and were 56-91 (mean 79) years old at the time of the survey. During the home care, ADL improved in 28 patients (improved ADL group), and did not change or deteriorated in 26 patients (unchanged/deteriorated ADL group). Three variables, i.e. reconstruction of bathroom (bathing facility and not toilet) in the patient's house after starting the home care, the patient whose main caregiver was his or her spouse, and consultation with a physician at a hospital (not a clinic), were significantly more frequent in the improved ADL group than in the unchanged/deteriorated ADL group. Similarly, the ADL level at the start of home care and age at the time of survey were significantly lower in the improved ADL group. The results of multiple logistic regression analysis indicates that the level of ADL when home care was started (p less than 0.01) and reconstruction of the bathroom (p less than 0.05) were major factors affecting the improvement in ADL.

Activities of Daily Living↗
PubMed1983

[2 cases of Hashitoxicosis with histological features of adenomatous goiter].

Two male patients with 'Hashitoxicosis', who revealed histologic pictures of adenomatous goiter in addition to findings of chronic thyroiditis, are described. Case 1. A 55-year-old man was admitted on May 7, 1981, for evaluation of hyperthyroidism. He had exophthalmos with positive Moebius and von Graefe's signs, and a firm, asymmetrically enlarged non tender thyroid gland with multiple cysts. The BMR was +60%, T4 26.4 micrograms/dl, free T4 7.2 ng/dl, T3 5.62 ng/ml and 24 hr radioiodine uptake 49.5%. TSH was undetectable and did not respond to TRH. 123I scan showed multiple defects in the bilateral upper poles of the thyroid gland. Antithyroglobulin and antimicrosomal antibodies were positive. He then underwent a total thyroidectomy with removal of multinodular goiter. The mutinodular goiter was associated with cystic degeneration which contained the thyroid hormone-rich fluid. Histologic examination revealed multiple adenomatous nodules and lymphocytic infiltration and degeneration in the surrounding tissues of the nodules. Case 2. A 43-year-old man was admitted on May 14, 1975, because of an 8 month history of hand tremor, weight loss (5 kg), facial and upper palpebral edema and an enlarged thyroid. He had mild exophthalmos and a firm, asymmetrically enlarged thyroid gland with multiple nodules. The BMR was +35%, T4 20.0 micrograms/dl, T3(Resomat) 0.78 ng/ml and PBI 20.0 micrograms/dl. TSH was 1.0 muU/ml and responded slightly to TRH. 24 hr radioiodine uptake was 84.4% and did not respond to T3 administration. Antithyroglobulin and antimicrosomal antibodies were positive. 123I scan showed diffusely increased uptake and no defects. Histologic examination of the biopsy specimen of the thyroid gland showed multiple adenomatous nodules in addition to typical findings of chronic thyroiditis in the surrounding tissues of the nodules. From the above observations, it is suggested that multiple adenomatous nodules accompanying chronic thyroiditis show clinical features resembling Basedow's disease rather than Plummer's disease.

Adenoma↗
PubMed1978

[A simple method for the simultaneous analysis of r-T3 and 33'-T2 by mass fragmentography using GC-MS. (Part II. Mass fragmentographic identification of 33'-T2 and r-T3 in biological fluids) (author's transl)].

In view of the previous report of the possibility of 33'-T2 and r-T3 measurements, the identification of these iodinated compounds was performed by mass fragmentography. The peaks at m/e 218, 624 (33'-T2) and m/e 218, 750 (r-T3) were applied to establish the precise qualitative evaluation of unknown peaks. The base peak at m/e 218 (thyroid analogues) was applied to avail itself of simultaneous multiple ion analyses by GC-MS. The following results were obtained. 1) Mass fragmentography makes possible the simultaneous measurements of 33'-T2, r-T3 and other thyroid analogues with 1 ml of serum and urine samples obtained from rats or human beings. 2) This method is very convenient for extracting the compounds from biological fluids, and the procedure can be carried out easily in a short time. The specificity of this method surpasses and cannot be compared to any other existing quantitative methods.

Animals↗
PubMed1978

[Clinical evaluation of thyroid functions in chronic hemodialysis patients (author's transl)].

In order to obtain more precise information on thyroid functions in renal failure, attempts were made to analyze the Hypothalamo-hypophyseal axis in the regulation of thyroid function. TRH levels and other thyroidal function tests were carried out on sera and urine from patients with renal failure and thyroid diseases. Analysis of TRH in serum and urine was performed by mass fragmentography using a GC-MS combined method. Fifteen out of 28 patients had enlarged thyroid glands, goiter in high prevalence. Thyroid function studies showed low serum thyroxine and triiodothyronine, and high serum thyrotropic hormone levels. Serum and urinary TRH in chronic renal failure were strikingly higher than the other thyroid diseases. There were negative correlations between RIA-T3, Resomat-T4 and serum and urinary TRH levels respectively. There was a negative correlation between serum TSH and serum TRH, but no significant correlation was noticed between serum TSH and urinary TRH levels. There was a high positive correlation between serum TRH and urinary TRH levels. From these findings, it is thought that serum and urinary TRH level values are a more reliable index for the clinical evaluation of thyroid functions in renal failure than the other sample under laboratory data. In patients with chronic hemodialysis, the prevalence of goiter is relatively high, and their thyroid functions are abnormal. However, the cause of the abnormalities is not clear. It is postulated that the possibility of a breakdown of compensation in the Hypothalamo-hypophyseal axis for the regulation of the thyroid function may be seen in chronic renal failure.

Adult↗
PubMed1977

[A simple method for the simultaneous analysis of urinary homovanillic acid, vanilmandelic acid and 3, 4-dihydroxy mandeli acid by mass fragmentography (author's transl)].

Gas chromatography-mass spectrometry makes possible the simultaneous measurement of homovanillic acid (HVA), vanilmandelic acid (VMA) and 3, 4-dihydroxy mandelic acid (DOMA) in 2ml urine samples. The equipment used was the Shimadzu LKB 9000 GC-MS (MID-PM). The TMSi derivatives of the compounds were analysed by the GC-MS system equipped with a 3ft. X 3mm column packed with 1.5% OV-1 and the temperature was programed from 130 degrees to 260 degrees C at 10 degrees C/min increments. The mass spectrum showed molecular ions at m/e 326, 414, and 472 which correspond to the TMSi derivatives of HVA, VMA AND DOMA respectively. The peaks at m/e 326 (HVA), 297 (VMA) and 355 (DOMA) were applied to avail themselves of simultaneous multiple ion analyses by GC-MS. As little as 1pg of the compounds injected into the column could be measured reproducibly. The sensitivity is of the order of pg or ng, and the linearity of the response is maintained up to at least 200ng. The procedure was simpler and less time consuming than previous methods. It consists of extraction of the free acid into ether followed by complete silylation of the phenolic, alcoholic and carboxylic acid group with bis (trimethylsilyl) acetamide. Recoveried of HVA, VMA, DOMA added to urine were 93.8%, 71.2% and 23.6% respectively. The specificity of this method surpasses and cannot be compared to any other existing quantitative methods.

Gas Chromatography-Mass Spectrometry↗
PubMed1977

[An improved method for the simultaneous analysis of norepinephrine, epinephrine and dopamine at the picogram level by mass fragmentography (author's transl)].

Gas chromatography-mass spectrometry makes possible the simultaneous measurement of norepinephrine (NE), epinephrine (E) and dopamine (DA) at the picogram level. The equipment used was the Shimadzu LKB 9000 GC-MS (MID-MD. The TFA derivatives of the compounds were analysed by the GC-MS system equipped with a 3ft X 3mm column packed with 1.5%OV-1 and the temperature was programed from 135 degrees to 260 degrees C at 10 degrees C/min increments. The mass spectrum showed molecular ions at m/e 552, 566 and 440 which corresponds to the TFA derivatives of NE, E and DA respectively. The base peaks of NE, E and DA were m/e 109, 140 and 328 respectively. The peaks at m/e 126 (NE and DA) and 140 (E) were applied to avail themselves of simultaneous multiple-ion analyses by mass fragmentography. As little as 4pg of the compounds injected into the column could be measured with good reproducibility, and the linearity of the response was maintained up to 120 pg. The sensitivity was of the order of ng or pg which enable quantitation with 1ml of human serum and urine sample. The procedures were simpler and less time consuming than previously reported methods. Recovery rates of NE, E and DA from serum were 25.7%, 13.7% and 76.1%, whereas those from urine were 100%, 89.6% and 100% respectively. The specificity of this method surpasses and cannot be compared to any other existing quantitative methods.

Catecholamines↗
PubMed1977

[Analysis of estrone, estradiol and estriol in serum and urine by mass fragmentography using GC-MS (author's transl)].

The first successful analysis of estrogens in serum and urine was performed by mass fragmentography using a GC-MS combined system. The equipment used was Shimadzu LKB 9000 GC-MS (MID-PM). The TMSi derivative of the compounds were analyzed using the GC-MS system equipped with a 3 ft x 3mm column packed with 1.5% OV-1 and the temperature was programed from 200 degrees to 260 degrees C at 10 degrees C/min increments. The mass spectrum showed molecular ions at m/e 342, 416 and 504 which correspond to the TMSi derivatives of Estrone (E-1), Estradiol (E-2) and Estriol (E-3) respectively. Molecular ion peak of each compound was applied to establish the precise quantitative evaluation of E-1, E-2 and E-3. 1) The minimum detectable limits of the compounds injected into the column were ca. 2 pg for E-1, E-2 and 5 pg for E-3 respectively. 2) The sensitivity was of the order of ng or pg which enables quantitation with 2 ml of human serum and urine samples obtained from normally ovulating women. 3) This method was very convenient for extracting the compounds from biological fluids, and the procedure can be carried out easily in a short time. 4) Mass fragmentography makes possible the simultaneous measurements of E-1, E-2 and E-3 in samples obtained from pregnant women.

Adult↗
PubMed1976

[Analysis of thyroid hormones in serum and urine by mass fragmentography using GC-MS].

The first successful analysis of iodine compounds in serum and urine by mass fragmentography using GC-MS combined system was performed. The equipment used was Shimadzu LKB 9000 GC-MS (MID-PM). The TMSi derivatives of the compounds were analyzed by GC-MS system equipped with a 3 ft X 3 mm column packed with 1% OV-1 and the temperature was programmed from 200 degrees to 320 degrees C at 10 degrees C/min. The mass specturm showed molecular ions at m/e 523, 649, 741, 867 and 993 which correspond to the TMSi derivatives of MIT, DIT, T2, T3 and T4 respectively. The base peak at m/e 218 was applied to establish the precise quantitative evaluation of T4 and related compounds by mass fragmentography. The following results were obtained: 1) The minimum detectable limits of the compounds injected into the column were ca. 10 pg for MIT, DIT, 20pg for T2, 50pg for T3, and 500 pg for T4 respectively. 2) The sensitivity was of the order of ng or pg which enables quantitation with 1 ml of human serum and urine sample. 3) West's method was very convenient for extracting the compounds from biological fluids, and procedure can be carried out easily in a short time. The recovery rates were ca. 16.0% for MIT, 26.6% for DIT, 61.5% for T2, 71.6% for T3, and 85.1% for T4 respectively. 4) The ability to simultaneously analyze various iodoaminoacids is sure to be effectively utilized in studies to elucidate the relative importance of these hormones and their metabolic changes in various physioloigcal and pathological states of human beings.

Chromatography, Gas↗