Caregiver psychological characteristics predict discontinuation of care for disabled elderly at home.

OBJECTIVE: This study sought to determine the predictors of discontinuation of care for the disabled elderly at home using multivariate regression analysis. METHODS: In January to February 2005, using a self-administered questionnaire, data were collected from 193 caregivers of frail elderly listed on a roster for utilization of day service or short stay service from two Home Visit Nursing Care Stations. Family caregivers were defined as co-resident family members who provided a minimum of 1 h of daily care for at least 3 months. Multiple stepwise logistic regression analysis was performed to detect predictors of a discontinuation for the disabled elderly at home. RESULTS: The mean age of caregivers was around 59.0 years, accounting for about 80% of the women among caregivers. Of those caregivers, the proportion of desire to institutionalization (high DI) (56.8%) was higher than that of desire to care at home (low DI) (43.2%). Among the following three factors selected by multivariate stepwise logistic regression analysis, the strength of the relationship was stronger in frequent mood swings and irritability as carerecipient characteristic (adjusted OR = 5.93; 95% CI, 2.09-16.8) than in no advanced or skilled care (adjusted OR = 3.13; 95% CI, 1.41-7.14) and a high caregiver burden (adjusted OR = 1.12; 95% CI, 1.03-1.23) as caregiver's one. CONCLUSIONS: Our results suggest that the carerecipients' psychological characteristics may be more strongly related to the decision to continue care for disabled elderly at home than that of the caregivers'.

[Percutaneous cryosurgery for liver tumors].

A new cryoprobe developed in our department makes it possible to perform percutaneous cryoablation for small liver tumors. This cryoprobe is placed into each lesion using an ultrasonic guidance technique. In this study there were 10 patients with hepatocellular carcinoma and 5 patients with liver metastases from colorectal carcinoma. In 6 cases the tumor size was below 2 cm, in 6 cases between 2 and 3 cm, and in 3 cases over 3 cm. Using a cryoprobe of 3 mm in diameter, each lesion was frozen using liquid nitrogen for 15 or 20 minutes then thawed for 10 minutes, and repeated. The ice ball was found to enlarge to 3 cm in 20 minutes and 5 cm in 60 minutes experimentally. Six cases were CR, 5 PR, 2 NC and 2 PD. After cryoablation, liver function did not change and there were no complications. However, as the size of the ice ball was small (about 3 cm), this method was insufficiently effective in some cases. Percutaneous cryoablation using this probe should be performed for tumors smaller than 3 cm.

Initial fermentation of sea sludge using aerobic and thermophilic microorganisms in a mangrove soil.

As sea sludge has the potential to cause eutrophication and red tide resulting in the death of shellfish and offensive odors, an effective method to treat it is needed. It was found that adding soil taken from a mangrove swamp to sea sludge promoted an initial fermentation of the sludge constituents. The result suggested that certain microorganisms that were thought to inhabit the sub-tropical mangrove soil had the potential to play a significant role in the fermentation and that the use of the microorganisms in the mangrove soil might be useful for composting sea sludge.

Pleasant odors attenuate the blood pressure increase during rhythmic handgrip in humans.

We have investigated the effects of inhaling odors of preference on physiological responses to physical exercise in college students. Rhythmic handgrip, maintaining a mercurial pressure by repetitive compression, increased blood pressure. In the participants exercised with inhaling odors of their choice, such as rose, jasmine and lavender, the increase in diastolic blood pressure during exercise was reduced by 24%. In contrast, the blood pressure increase during static handgrip, maintaining the power 30-40% of maximum, was not affected by the existence of favorite odors. Since the blood pressure increase during static handgrip is a lower brainstem reflex, the present result shows that the inhalation of favorite odors suppresses the muscle sympathetic vasoconstrictor activity and attenuates the blood pressure increase by affecting the central nervous system higher than the midbrain.

Pentoxifylline inhibition of vasculogenesis in the neonatal rat retina.

PURPOSE: The zeta isozyme of protein kinase C (PKC) is essential for activation of the transcription factor nuclear factor (NF)kappaB and transcription of vascular endothelial growth factor (VEGF). This study examined the antiangiogenic potential of an existing drug, pentoxifylline (PTX), which inhibits PKC-dependent activation of NFkappaB and is reported to prevent hypoxia-induced expression of VEGF. METHODS: Neovascularization was induced by maintaining neonatal rats for 10 full days in 80% oxygen, interrupted daily by 30 minutes in room air followed by a progressive return to 80% oxygen. On experimental day 11, they were placed in room air until they were killed on day 17. Daily intraperitoneal injections of PTX in saline (25 or 75 mg/kg per day), or saline alone, were administered from day 6 through day 16. Retinal neovascularization was scored, and avascular areas (AVAs) were measured in ADPase stained retinas. RESULTS: PTX inhibited radial extension of retinal vessels, causing increases in AVA of 65% (P < 0.01) and 33% (P < 0.15) at the lower and upper doses, respectively. A significant increase in mean neovascular score was seen at the lower dose (P < 0.0001), but analysis of variance indicated that neovascularization was strongly and positively influenced by the AVA (P < 0.0001) and only weakly stimulated by PTX (P < 0.05). CONCLUSIONS: Systemic PTX significantly inhibited VEGF-mediated retinal vasculogenesis, but was not effective in reducing neovascularization in the oxygen-exposed neonatal rat.

A comparison of distilled water and normal saline as diluents for endobronchial administration of epinephrine in the dog.

UNLABELLED: We compared the effects of distilled water and normal saline as diluents for the endobronchial administration of epinephrine in anesthetized dogs by using a cross-over design. Six dogs received 2 mL of either normal saline or distilled water into the bronchus, and the other solution was administered 1 wk later. Eight dogs received 0.02 mg/kg epinephrine diluted in either distilled water (E + water) or normal saline (E + saline) to a total volume of 2 mL into the bronchus, and the other solution was administered 1 wk later. Normal saline or distilled water without epinephrine did not affect the plasma epinephrine concentration, mean arterial pressure (MAP), and PaO(2). The peak plasma epinephrine concentration was significantly larger after treatment with E + water (26.5 +/- 7.9 ng/mL) than after E + saline (2.1 +/- 0.7 ng/mL). E + water caused an increase in MAP of 91 +/- 24 mm Hg, whereas E + saline did not affect MAP. The maximal decrease in PaO(2) after the administration of E + water (14 +/- 5 mm Hg) was significantly greater than after E + saline (7 +/- 2 mm Hg). In conclusion, distilled water as the diluent for endobronchially administered epinephrine to a total volume of 2 mL allowed better absorption of epinephrine compared with normal saline without a serious detrimental effect on PaO(2). IMPLICATIONS: Using a small volume of distilled water as the diluent for endobronchial epinephrine administration significantly increased epinephrine absorption and arterial pressure in comparison with normal saline, without having a serious detrimental effect on PaO(2), in an anesthetized, noncardiopulmonary, resuscitation dog model.

Eicosapentaenoic acid release from the red alga Pachymeniopsis lanceolata by enzymatic degradation.

Forty-eight species of seaweeds from Japanese waters were screened for the valuable polyunsaturated fatty acids eicosapentaenoic acid (EPA). The eight species that contained the highest levels of these compounds were analyzed in detail. Of all species tested the red alga Pachymeniopsis lanceolata contained the highest EPA concentration, and it was present as both the free and bound forms. EPA constituted 38.7% of total fatty acids, and polar lipids were the main constituent of the total lipids in P. lanceolata. EPA was obtained from the marine algae P. lanceolata by enzymatic hydrolysis of the total lipids extract using phospholipase A2 (PLA2). The release of EPA reached a plateau after 10 min of enzymatic treatment. These results suggest that P. lanceolata is a useful natural source of EPA and that PLA2 treatment is a convenient method for obtaining EPA from the red alga.

Dorsal specification in blastoderm at the blastula stage in the goldfish, Carassius auratus.

The teleost dorsoventral axis cannot be morphologically distinguished before gastrulation. Previous studies by the current authors have shown that localized dorsalizing activity in the yolk cell (YC) induces the dorsal tissues in the overlying blastoderm. In order to examine whether or not dorsal blastomeres are committed to their dorsal fate before the gastrula stage, a variety of transplant operations were performed in goldfish blastoderms at the mid- to late-blastula stages. When the blastoderm was cut from the YC, rotated horizontally at 180 degrees, and recombined with the YC, the blastoderm frequently developed two axes, indicating that dorsal blastomeres of the blastula had already acquired the ability to differentiate into the organizer in the absence of dorsalizing signals from the YC. This result was further confirmed by experiments using ventralized embryos in which no dorsal structures formed: the axis formation was frequently observed in the normal blastoderm combined with the ventralized YC at the blastula stage. However, the axes formed in the absence of dorsal information from the YC exhibited a lower dorso-anterior index. Furthermore, the dorsal specification was not stably maintained when the dorsal cells were located far from the YC. These results suggest that the inductive and permissive influence of the YC may be required for the blastoderm to undergo full dorsal differentiation.

Enzyme-less amperometric biosensor for l-ascorbate using poly-l-histidine-copper complex as an alternative biocatalyst.

A poly-l-histidine(PLH)-copper(II) complex can be used as an alternative biocatalyst in an O(2) detection-type amperometric enzyme-less l-ascorbate (AsA) sensor. The PLH-Cu(II) membrane was simply prepared by entrapping the PLH in polyacrylamide gel and subsequent treatment of the gel with CuCl(2) solution. This enzyme-less biosensor can be used over a relatively wide pH region from 4 to 11 and enables precise determination of AsA (RSD less than 3%, n=10) at pH 7.0. The fundamental performance characteristics (sensitivity, response time, and linear range) of this PLH-Cu(II)-based sensor is comparable to those of a native ascorbate oxidase-based sensor. Unfortunately, the selectivity is inherently rather low and, as a result, the response was degraded in the presence of higher concentrations (more than mM order) of quinones. However, reducing sugars caused no interference and the sensor could be used to detect AsA in some fruits and drinks. This enzyme-less sensor has excellent stability for at least 3 months of repeated analysis (more than 300 samples) without loss of ordinal activity.

Highly sensitive flow detection of uric acid based on an intermediate regeneration of uricase.

The principle of the signal amplification of a uric acid sensor based on dithiothreitol (DTT)-mediated intermediate regeneration of uricase was applied to a flow-injection system with an immobilized uricase reactor and a DTT-containing carrier. Highly sensitive detection for nM to microM order of uric acid was achieved when 10 mM TRIS-HCl buffer (pH 10.0) containing 20 mM DTT was used as a carrier at 0.6 ml min-1 and 37 degrees C. The sensitivity of the uric acid was much improved over a batch method using a uricase membrane-coupling electrode, and the detection limit (ca. peak current 8 nA) of uric acid was found to be down to 3 x 10(-10) M (amplification factor; more than 10,000). This chemically amplified flow-system is very useful for the direct assay of uric acid in highly diluted biological fluids (urine and serum) without complicated pretreatment of the samples, because this sensor has the potential to detect trace amounts (nM to microM) of uric acid in highly diluted body fluids in which the concentration of interfering constituents was decreased to negligible levels. Good correlation was observed between this system and conventional spectrophotometry. The immobilized uricase reactor could be re-used for at least 4 months of repeated analysis without loss of activity and was stable if stored at 4 degrees C in 10 mM TRIS-HCl buffer, pH 9.0.

Specific and amplified current responses to histidine and histamine using immobilized copper-monoamine oxidase membrane electrode, based on novel ascorbate oxidase activity induced by exogenous ligands.

Upon the addition of histidine and histamine, the copper containing monoamine oxidase (MAO) catalyzes the oxidation of L-ascorbic acid (AsA) by dissolved oxygen, in which the consumed oxygen was finally converted to hydrogen peroxide, according to Michaelis-Menten kinetics (Km) = 1.97 mM, upon the addition of 5 x 10(-5) M L-histidine at 35 degrees C and pH 8.5). The amount of oxygen consumption depended on the amount of histidine and histamine added, and specific responses over other amines were observed when the oxygen electrode modified with immobilized MAO membrane was used in the 0.1 M Tris buffer containing AsA. The calibration curves of L-histidine and histamine at 4 mM AsA exhibit linearity in the concentration range from 5 x 10(-7) to 5 x 10(-5) M L-histidine and 5 x 10(-6) to 1 x 10(-8) M histamine, with detection limit of 3 x 10(-7) M L-histidine and 3 x 10(-6) M histamine, respectively. The ESR signal of copper(II) in active site of MAO at 77K was apparently changed upon the addition of L-histidine and histamine indicating that exogenous histidine and histamine bound to the copper site of enzyme and lead to the structural change in active site.

Effects of skin surface temperature distribution of thermal manikin on clothing thermal insulation.

Effects of the distribution of skin surface temperature were investigated on thermal insulation of clothing for whole and each body part. The experiments were carried out with a thermal manikin in a climatic chamber. The two types of clothing ensemble were measured. The measurement with nude thermal manikin were also conducted. The three variations of skin temperature distribution were set with the thermal manikin. The values of the thermal insulation of nude skin surface (Ia), the total thermal insulation of clothing (It) and the basic thermal insulation of clothing (Icl) were measured with this thermal manikin under each skin temperature distribution. As a result, the values of Ia and It were not affected by skin temperature distributions of the range of typical experimental conditions. However, It is necessary to carefully use the values of the thermal insulation of clothing for the body parts, because these values were more influenced by the skin temperature distribution than those for the whole body.

Microbial cyanide sensor for monitoring river water.

A microbial cyanide sensor using Saccharomyces cerevisiae for monitoring a river water is described. This sensor is based on the inhibition of S. cerevisiae's respiration by cyanide. This sensor is a reactor type flow system and composed of two oxygen electrodes and a reactor which contains S. cerevisiae immobilized beads. The S. cerevisiae's respiration activity is measured using the oxygen electrodes. The sensor showed a linear response in the range from 0 to 15 microM and maintained stable response for 9 days at ambient temperature. The sensor was optimized for the monitoring of river water and was applied to river water analysis.

Chemically amplified kojic acid responses of tyrosinase-based biosensor, based on inhibitory effect to substrate recycling driven by tyrosinase and l-ascorbic acid.

A tyrosinase-based chemically amplified biosensor, based on the substrate recycling of polyphenols driven by tyrosinase-catalyzed oxidation and chemical reduction by l-ascorbic acid (AsA), has been utilized for the highly sensitive detection of inhibitors of tyrosinase such as kojic acid, benzoic and SCN(-) ion. The amplified current response of immobilized tyrosinase-coupling oxygen electrode due to the recycling was suppressed by the addition of inhibitors, and a highly amplified response to kojic acid over other inhibitors was observed in the presence of 5 mM AsA. The amplification factor (AF) of kojic acid is substantially proportional to the AF of substrates, and the AF for 1 x 10(-7)M kojic acid was increased by up to a factor of 143 when 1 x 10(-5)M dopamine was used as a competitive substrate in the presence of 5 mM AsA. The amplified calibration curve of kojic acid obtained with 5 mM AsA was shifted towards more than a two decades lower concentration range compared with that of the non-amplified response, and the detection limit of kojic acid was lowered to 7 x 10(-8)M.

Usefulness of R-R interval and its variability in evaluation of thermal comfort.

The use of R-R interval and the coefficient of variation in R-R intervals (CVR-R) for the evaluation of thermal comfort was investigated. The experiments were carried out with ten male subjects but data from one were excluded from the analysis. Thermal sensation, comfort, and tolerance of environmental conditions were reported and mean skin temperature, R-R interval and CVR-R were monitored during a 3 h period in a climatic chamber with the operative temperature set at 26, 20, or 30 degrees C. Relative humidity was maintained at ca. 50% in each case. At the operative temperature of 20 degrees C, the mean skin temperature was significantly lower, the cold sensation was significantly more intense, and discomfort was significantly greater than at 26 degrees C and R-R interval was increased significantly. Seven of the nine subjects were unable to tolerate this thermal environment. The R-R interval and CVR-R were increased in five and four of those seven subjects, respectively. At the operative temperature of 30 degrees C, the mean skin temperature was significantly higher, and the sensation of warmth was significantly more intense than at 26 degrees C. Seven of the nine subjects felt discomfort, and four of the seven reported an inability to tolerate this thermal environment. The R-R interval and CVR-R were decreased in four and three of these four subjects, respectively. At the operative temperature of 20 degrees C CVR-R was significantly greater than that at 30 degrees C.(ABSTRACT TRUNCATED AT 250 WORDS)

[Thermal insulation of clothing for seated and standing postures].

The purpose of this study is to examine the effects of body posture on thermal insulation of clothing. Clothing ensembles including skirts were mainly investigated. A new thermal manikin was developed for this study. This manikin was able to change her body posture without increasing or decreasing her surface area. By changing posture from standing to seated, the total thermal insulation of clothing (It) was decreased by around 1.4%. The surface thermal resistance at nude (Ia) was increased by 8%. As a result, the basic thermal insulation of clothing (Icl) was decreased by 14%. The main reason for the decrease of basic thermal insulation (Icl) when the posture of thermal manikin changes from standing to seated was the increase of Ia at nude. The total thermal insulation of clothing for each body posture (Iti), when standing and seated, were compared. The parts affected by the changed posture were abdomen, hip and thighs, and especially under the skirt of 61cm length, the knees were most affected.

[Intermittent intra-arterial chemotherapy using subcutaneously implanted reservoir for hepatocellular carcinoma and liver metastasis of colorectal carcinoma].

Hepatectomy has been performed as a treatment for hepatocellular carcinoma (HCC) and metastatic liver carcinoma. The prognosis has improved, but it is not sufficient. In our department hepatic arterial infusion chemotherapy using subcutaneous implanted reservoir has been undertaken in 21 of 66 patients who underwent hepatectomy in hepatocellular carcinoma and 13 of 30 in liver metastasis of colorectal carcinoma since 1986. There was no significant difference between the group with and without arterial infusion chemotherapy in HCC but there was a significant difference in metastasis of colorectal carcinoma. In unresectable cases, intra-arterial chemotherapy was undertaken, but there was no significant difference. On the other hand, 26 of 58 cases receiving arterial infusion chemotherapy have shown complications.

Amphetamine-antagonistic properties of 4-phenyl-1,2,3,4- tetrahydroisoquinoline: inhibition of spinal reflex-enhancing effects of methamphetamine, phenylethylamine and nomifensine.

The antagonistic effects of 4-phenyl-1,2,3,4-tetrahydroisoquinoline (4PTIQ) against S(+)-methamphetamine, phenylethylamine and nomifensine were studied by measurement of spinal monosynaptic reflex potential (MSR). S(+)-Methamphetamine, phenylethylamine and nomifensine enhanced the amplitude of MSR in C1-spinalized rats through release of noradrenaline from the terminals of descending fibers and consequent activation of alpha 1-adrenoceptors. Although 4PTIQ alone did not change the amplitude of the MSR, 4PTIQ inhibited the enhancement of MSR induced by S(+)-methamphetamine and related compounds. The MSR of rats with an intact spinal cord was enhanced by conditioning stimulation of the ipsilateral locus ceruleus. The MSR enhancement produced by the stimulation was blocked by prazosin but unaffected by 4PTIQ, showing that 4PTIQ does not have an alpha 1-blocking action. These results suggest that the antagonistic effects of 4PTIQ on MSR enhancement by S(+)-methamphetamine, phenylethylamine and nomifensine are due to its blocking of noradrenaline release produced by these amphetamine-like agents.

Effects of the new centrally acting muscle relaxant 7-chloro-N,N,3-trimethylbenzo[b]furan-2-carboxamide on motor and central nervous systems in rats.

Effects of KW-6629 (7-chloro-N,N,3-trimethylbenzo[b]furan-2-carboxamide) were studied with special reference to the effect on motor and central nervous systems using rats. The drug effectively reduced the motor coordination (rotarod), the anemic decerebrate rigidity, the crossed extensor reflex, and the gamma-activity indirectly recorded from muscle afferent discharges without showing the direct inhibitory effect on muscle spindles. KW-6629 depressed the polysynaptic and dorsal root reflexes without showing marked effect on the monosynaptic reflex in intact spinal cord rats. KW-6629 produced high-amplitude slow wave in the cerebral cortex in electroencephalogram (EEG). KW-6629 did not reduce the EEG after-discharges and behavioral convulsion (amygdaloid kindling). KW-6629 had no effect on the neuromuscular junction. These results suggest that KW-6629 is a centrally acting muscle relaxant which has a site of action in supraspinal structures.