Biomedical subjects

Yuko Ohno

Publications and source records attributed to Yuko Ohno.

11 recordsLinked to original sources

PubMed2006

[The effects of various factors on cerebrovascular disease mortality rates in the 20th century and future trends in Japan].

PURPOSES: To analyze the outcomes of measures designed to decrease cerebrovascular diseases (CVDs) in Japan and to project CVD mortality trends into the 21st century based on an analysis of rates observed in the 20th century. METHODS: The numbers of CVD deaths and population sizes from 1920 to 2003 (excluding 1940 to 1946) by sex, year, and 5-year age group (from 20 to 79 years old) were used and effects of various factors on CVD mortality rates were estimated using Nakamura's Bayesian age-period-cohort model. The numbers of CVD deaths up to the year 2050 were projected based on estimates of age, cohort, and future period effects under three scenarios: (i) values remaining constant after year 2003; (ii) linearly extrapolated values; and (iii) quadratically extrapolated values, we obtained using a regression line for period effects from 1995 to 2003. RESULTS: The age, cohort, and period effects on CVD mortality rates were large and in order of the magnitude of their ranges. There were small differences between males and females. The age effect increased with aging and the period effect started decreasing after 1970. The cohort effect was high for birth cohorts born from the 1840s to the 1890s and low for those born from the 1920s to the 1970s. There were some differences in the cohort effect between males and females for birth cohorts born after 1940s; for females there was a gradual decrease, while for males there was a slight increase, after which it remained almost constant. According to the three scenarios, CVD deaths: (i) had upward trends through the projected period and peaked at around 2025 and 2045; (ii) remained almost constant at the present level for males, and decreased slightly for females; (iii) decreased for both males and females. CONCLUSIONS: The outcomes of measures designed to decrease CVDs were observed as period effects after 1970. Exposure to these measures is associated with prevention of CVD deaths. Nevertheless, in the first half of the 21st century, the number of CVD deaths is projected to increase due to the aging of the baby boomers and upward trends in the cohort effect for males. It would be necessary to adopt and develop both population strategies to decrease future period effects and high-risk strategies to decrease cohort effects for younger males who are currently in their twenties and thirties.

Adult↗

PubMed2005

Statistical estimation of the number of breast cancer patients with disabilities resulting from surgery.

BACKGROUND: The prolongation of the post-operative life of cancer patients brings new medical demands. The purpose of this paper is to estimate the total number of women patients with breast cancer who will have disability resulting from surgical treatment from 2000 to 2020 in Japan. METHODS: The estimation was carried out using four indices: the number of cases of women diagnosed with breast cancer, the proportion of surgical operations, the frequency of disability from surgical treatment, and the crude survival rate of the patient group. The crude survival rates of surgically-treated breast cancer patients were estimated by the Weibull model. The frequencies of iatrogenic disabilities were calculated from several reports of complaints of pain in the chest wall or axilla and lymphedema of the arm, and 95% confidence intervals were calculated by the Monte Carlo simulation. RESULTS AND DISCUSSION: The number of women patients with disability from breast cancer treatment from 2000 to 2020 was estimated to be 42,016 (95% CI: 41,236, 42,796) people in 2000 and 72,514 (95% CI: 71,196, 73,832) people in 2020 for pain in the chest wall or axilla, and 22,486 (95% CI: 22,148, 22,823) people in 2000 and 38,692 (95% CI: 38,094, 39,290) people in 2020 for lymphedema of the arm. Treatment supports required for the disability are medication and social support. Cancer patients with disability after treatment need long-term support in their daily life.

Breast Neoplasms↗

PubMed2004

Benefits of surgery for patients with pulmonary metastases from colorectal carcinoma.

BACKGROUND: A pulmonary metastasectomy for colorectal carcinoma is a generally accepted procedure, although several prognostic predictors have been reported. The aim of this study is to define the patients who benefit from pulmonary metastasectomy for colorectal carcinoma. METHODS: Retrospective survival analysis was performed using 128 patients who underwent curative pulmonary resection. RESULTS: The overall 5-year survival rate was 45.3%. Univariate analysis showed the number of metastases, location (unilateral or bilateral), prethoracotomy carcinoembryonic antigen (CEA) level, hilar or mediastinal lymph-node metastasis, and Dukes' stage to be considerable prognostic factors. Among these, Dukes' A for the primary lesion and unilateral pulmonary metastasis were shown to be independent predictors of longer survival by multivariate analysis (p = 0.0093 and p = 0.0182, respectively). In patients treated with both pulmonary and hepatic metastastasectomies, a better prognosis was observed in those who received metachronous resection. Recurrence after a pulmonary metastasectomy frequently occurred in the thorax and the 3-year survival rate was 44.6% in patients who underwent a repeat thoracotomy. CONCLUSIONS: Patients with unilateral metastasis and Dukes' A for the primary tumor benefit most from the resection of pulmonary metastasis from colorectal carcinoma. Further, the number of metastases, prethoracotomy CEA level, and hilar or mediastinal lymph-node involvement should be considered to determine the operative indication. Finally, periodic follow-up examinations for thoracic recurrence should be carefully performed as these patients may have a heightened risk of requiring a repeat thoracotomy.

Adenocarcinoma↗

PubMed2004

Improvement in cognitive impairment after cataract surgery in elderly patients.

PURPOSE: To evaluate whether cognitive impairment improves in elderly patients who have cataract surgery with intraocular lens (IOL) implantation. SETTING: Kouki Hospital, Yamaguchi, Japan. METHODS: A prospective observational study evaluated patients' scores on the Revised Hasegawa Dementia Scale (HDS-R) and the HDS-R minus 1 item regarding immediate regeneration (ie, function of vision and memory). Twenty patients (6 men, 14 women) with cognitive impairment had cataract surgery in 1 eye between March 1996 and July 2001 at Kouki Hospital, Japan. The mean age of the patients was 81.8 years (range 61 to 90 years). Twenty patients (4 men, 16 women) with cognitive impairment who did not have cataract surgery were selected as a control. The mean age in the control group was 84.3 years (range 70 to 93 years). The HDS-R was administered twice between March 1996 and July 2001. RESULTS: The mean HDS-R scores in the cataract surgery group improved from 12.5 points +/- 5.3 (SD) preoperatively to 16.6 +/- 6.2 points postoperatively; the improvement was significant (t = -5.02; P<.0001). After cataract surgery, the grade of cognitive impairment improved in 12 patients (60%), was unchanged in 7 (35%), and was worse in 1 (5%). CONCLUSION: Cataract surgery improved cognitive impairment in elderly Japanese patients.

Aged↗

PubMed2004

Results of surgical intervention for p-stage IIIA (N2) non-small cell lung cancer: acceptable prognosis predicted by complete resection in patients with single N2 disease with primary tumor in the upper lobe.

OBJECTIVES: Non-small cell lung cancer with mediastinal lymph node involvement is a heterogeneous entity different from single mediastinal lymph node metastasis to multiple nodes or extranodal disease. The objective of this study was to identify the subpopulation of patients with N2 disease who can benefit from surgical intervention. METHODS: We reviewed 219 consecutive patients with N2 non-small cell lung cancer treated with a thoracotomy between November 1980 and June 2002 and retrospectively analyzed 154 of those who had p-stage IIIA disease and underwent a complete resection. Age, sex, side (right or left), histology, location (upper or middle-lower lobe), tumor size, c-N factor, and N2 level (single or multiple) were used as prognostic variables. RESULTS: The 3- and 5-year survivals were 45.3% and 28.1%, respectively, in patients with p-stage IIIA (N2) disease. Survival for those with single N2 non-small cell lung cancer was significantly better than in those with multiple N2 disease (P =.0001), and patients with a tumor in the upper lobe showed a significantly longer survival than those with middle-lower lobe involvement (P =.0467). The 3- and 5-year survivals for patients with single N2 disease with a primary tumor in the upper lobe were 74.9% and 53.5%, respectively. A multivariate analysis with Cox regression identified 5 predictors of better prognosis: younger age, squamous cell carcinoma as determined by histology, primary tumor location in the upper lobe, c-N0 status, and a single station of mediastinal node metastasis. CONCLUSION: Our results suggest that of the heterogeneity of N2 diseases, patients with single N2 disease with non-small cell lung cancer in the upper lobe are good candidates for pulmonary resection.

Adenocarcinoma↗

PubMed2003

The Patterns of Care Study and Regional Cancer Registry for non-small-cell lung cancer in Japan.

PURPOSE: We examined whether the data registered in the Japanese Patterns of Care Study (PCS) for patients with non-small-cell lung cancer (NSCLC) represent the actual situation of radiotherapy in Japan. The Osaka Cancer Registry (OCR) data, forming the largest database of a regional cancer registry in Japan, were adopted for use as a benchmark against the national condition. PATIENTS AND METHODS: We examined 906 patients of the PCS treated between 1995 and 1997 and 845 patients of the OCR registered between 1988 and 1992. The investigation was made by descriptive statistical methods to measure age, stage, combined treatments, type of treated hospitals, and prognosis. Furthermore, the national averages (NAs) of the PCS process (PCS NA) were also calculated to compensate for the imbalance in the PCS data sampling. RESULTS: The mean age was 67.3 +/- 10.1 in PCS and 64.4 +/- 11.0 in OCR (p < 0.001), 67.2 in PCS NA. The male ratio was 84.2% in PCS and 84.0% in OCR (p = 0.411), 84.1% in PCS NA. The ratio of the patients at the localized stage was 24.2% in PCS and 15.6% in OCR (p = 0.001), 21.1% in PCS NA. The ratio of surgery combined was 24.2% in PCS and 28.9% in OCR (p = 0.026), 25.3% in PCS NA. The ratio of chemotherapy combined was 50.1% in PCS and 67.5% in OCR (p = 0.001), 47.4% in PCS NA. Because the definitions of institution classification and period of prognostic inquiry were different between the two databases, the 3-year survival rates were calculated for reference. In the nonsurgery group, it was 20.3% in PCS and 11.3% in OCR (p = 0.001), and in the surgery group it was 52.5% in PCS and 42.2% in OCR (p = 0.057). RESULTS: Ages in the two databases were inconsistent. Sex distributions were consistent. Surgery and chemotherapy were more frequently performed for the OCR patients, and more patients at more advanced stages were also observed in OCR. The PCS NAs of sex, stage, and ratio of surgery combined were at the midpoints between those of PCS and OCR. The survival rate of NSCLC patients in the OCR was significantly inferior to that in the PCS. The follow-up rate of the PCS was lower than that of the OCR. The general features of PCS data showed similarity to OCR data, and the results of the PCS NAs suggested the effectiveness of this method to adjust the sampling imbalance in PCS.

Aged↗

PubMed2003

Logical checking function increases the accuracy of data entry in the patterns of care study.

BACKGROUND: For clinical studies, the use of a databases combined with a computer is becoming popular for data capturing. Commercially available database software has a logical checking function, which can restrict the type of data and their range. The study presented here quantitatively and prospectively evaluated the effectiveness for data management with this function using the database of Patterns of Care Study (PCS) in Japan. PATIENTS AND METHODS: The first external audit was performed from September 1998 to March 1999 using the PCS database without the function, and the second from April to September 1999 with the function. We analyzed the numbers and patterns of erroneous data for these two periods obtained with and without the function. RESULTS: In the database without the function, the number of incorrect data was 2,812 out of 596,186 (0.47%), while the corresponding number with the function was significantly reduced to 161 out of 533,656 (0.03%, p < 0.0001). CONCLUSIONS: The data accuracy was improved by using the computer database more extensively than the conventional case report form. By adding the logical checking function to the PCS database, significant improvement in the accuracy of data entry was accomplished. This indicates the potential for increasing the accuracy of data capturing with the aid of a computer.

Data Collection↗

PubMed2002

Patterns of Care Study quantitative evaluation of the quality of radiotherapy in Japan.

BACKGROUND: Quality assurance (QA) of clinical practice is important for any medical specialty. Programs based on the Patterns of Care Study (PCS) have been developed to compare the quality of radiotherapeutic care at individual institutions, with the national average representing the process and outcome of radiotherapy. The feasibility of these programs was analyzed. METHODS: Calculation programs for the national average and standard score were developed to evaluate quantitatively the process and outcome of radiotherapy at individual institutions as well as at the national level. The programs were used to evaluate the quality of radiotherapy for 561 esophageal carcinoma patients surveyed in the Japanese PCS. RESULTS: As a representative example of QA measurement, the national average for the 5-year survival rate for these patients in the nonsurgery group was 5%. The regional averages for those in academic and nonacademic institutions were 9% and 1%, respectively (P = 0.0142), showing a significant difference between these two institutional strata. The standard score compared with the national average for institution No.105, for example, was 16.3 (P < 0.0001), with the positive value indicating that the outcome at this institution was significantly higher than the national average. The corresponding figure compared with the regional average was -0.3 (P = 0.7391), with the negative value indicating the outcome is not superior to the regional average of academic institutions. CONCLUSIONS: These programs make it possible to compare quantitatively the quality of radiation therapy at individual institutions with the national and regional averages. They should also be useful for nationwide QA projects in radiation oncology as well as in other medical specialities.

Aged↗

PubMed2002

Properties of perimetric threshold estimates from Full Threshold, SITA Standard, and SITA Fast strategies.

PURPOSE: To investigate the distributions of threshold estimates with the Swedish Interactive Threshold Algorithms (SITA) Standard, SITA Fast, and the Full Threshold algorithm (Humphrey Field Analyzer; Zeiss-Humphrey Instruments, Dublin, CA) and to compare the pointwise test-retest variability of these strategies. METHODS: One eye of 49 patients (mean age, 61.6 years; range, 22-81) with glaucoma (Mean Deviation mean, -7.13 dB; range, +1.8 to -23.9 dB) was examined four times with each of the three strategies. The mean and median SITA Standard and SITA Fast threshold estimates were compared with a "best available" estimate of sensitivity (mean results of three Full Threshold tests). Pointwise 90% retest limits (5th and 95th percentiles of retest thresholds) were derived to assess the reproducibility of individual threshold estimates. RESULTS: The differences between the threshold estimates of the SITA and Full Threshold strategies were largest ( approximately 3 dB) for midrange sensitivities ( approximately 15 dB). The threshold distributions of SITA were considerably different from those of the Full Threshold strategy. The differences remained of similar magnitude when the analysis was repeated on a subset of 20 locations that are examined early during the course of a Full Threshold examination. With sensitivities above 25 dB, both SITA strategies exhibited lower test-retest variability than the Full Threshold strategy. Below 25 dB, the retest intervals of SITA Standard were slightly smaller than those of the Full Threshold strategy, whereas those of SITA Fast were larger. CONCLUSIONS: SITA Standard may be superior to the Full Threshold strategy for monitoring patients with visual field loss. The greater test-retest variability of SITA Fast in areas of low sensitivity is likely to offset the benefit of even shorter test durations with this strategy. The sensitivity differences between the SITA and Full Threshold strategies may relate to factors other than reduced fatigue. They are, however, small in comparison to the test-retest variability.

Adult↗

PubMed2002

[A report on medication adherence among outpatients].

BACKGROUND: Increase in chronic disease and hospital stays of minimal length have caused a rise in the number of outpatients receiving long-term medication. The authors conducted the present study to examine their adherence to medication. METHODS: Self-administered questionnaires covering 20 items related to adherence were collected from outpatients who received medication from O university hospital on a day in October 1998. The authors examined the relationship between adherence to medication and lifestyle and then analyzed predictors of adherence using discriminant analysis. RESULTS: The rare of adherence to medication for 943 outpatients in O university hospital was 87.9%. The major reasons for non adherence were "forgetting medication", "leaving home without [one's] medication," "suspecting side effects" and "having no symptoms". The patients who made a detailed explanation displayed better understanding and adherence to medication. Although 94.8% of the patients received an explanation about their medications at least once, 76.9% expressed some anxiety about their use. Predictors of poor adherence to medication were "no support to remind the patient to take medicines correctly," "anxiety about medication," "not receiving a detailed explanation about medications," "poor knowledge of medication," and "youth (20-29 years of age)." CONCLUSION: Among outpatients in O university hospital, the medication adherence rate is 87.9%, but most patients had anxieties. The results clarified the need to consider lifestyle in medication management in the outpatient setting, since this was the main predictor of adherence to medication.

Adolescent↗

PubMedDate not supplied

Comparison of the additive effects of nipradilol and carteolol to latanoprost in open-angle glaucoma.

PURPOSE: To compare the effects of nipradilol and carteolol on intraocular pressure (IOP) when added to latanoprost treatment for glaucoma patients. METHODS: Fifty patients with primary open-angle glaucoma were treated with latanoprost 0.005% once daily for 3 months. Then they were assigned to one of two groups randomly. One group received nipradilol 0.25% twice daily (nipradilol preceding group; n = 25), and the other carteolol hydrochloride 2% twice daily (carteolol preceding group; n = 25), for 3 months in addition to latanoprost. Then, nipradilol and carteolol were switched, and the subjects were treated for 3 more months. One eye was selected randomly for analysis. RESULTS: In the nipradilol preceding group, IOP was 21.4 +/- 2.3 mmHg (mean +/- SD) at baseline, and 16.8 +/- 1.9 mmHg at the end of latanoprost monotherapy (P < 0.01). The addition of nipradilol decreased IOP to 15.8 +/- 1.7 mmHg, and the change to carteolol, to 15.3 +/- 2.0 mmHg. In the carteolol preceding group, IOP was 21.2 +/- 2.0 mmHg at baseline, and 17.0 +/- 2.1 mmHg at the end of latanoprost monotherapy (P < 0.01). The addition of carteolol decreased IOP to 15.4 +/- 1.8 mmHg, and the change to nipradilol, to 16.3 +/- 1.9 mmHg. Additional IOP reduction was greater with carteolol than with nipradilol (cross-over analysis of variance; P = 0.0005). CONCLUSIONS: Both nipradilol and carteolol have additive effects when used in combination with latanoprost. Carteolol, however, may have a more potent effect than nipradilol.

Antihypertensive Agents↗