Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 31
Filtrar
Mais filtros

Base de dados
Tipo de documento
País de afiliação
Intervalo de ano de publicação
1.
Fish Physiol Biochem ; 47(2): 487-498, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33515395

RESUMO

Although myoglobin (Mb) has been considered to be one of the well-characterized proteins, screening of post-genomic era databases revealed the lack of adequate information on teleost Mbs. The present study was aimed to investigate stability and functional features of Mbs from three teleosts of the same family. To unfold how primary structure influences the stability and function of proteins, Mbs were purified from the dark muscles of three carangids, namely, yellowtail, greater amberjack, and silver trevally. Thermostabilities measured by circular dichroism (CD) spectrometry revealed species-specific thermal denaturation pattern, i.e., silver trevally > yellowtail > greater amberjack Mbs. On the other hand, autoxidation rate constants of the ferrous forms of those three carangid Mbs showed positive correlation between the ferrous state of the heme iron and rising temperature. The order of autoxidation rate was in the order of greater amberjack > yellowtail > silver trevally Mbs. The finding of the present study denotes that the thermal stability is not necessarily correlated with the functional stability of carangid Mbs even though their primary structures shared high homology (84-94%).


Assuntos
Peixes/metabolismo , Mioglobina/química , Mioglobina/metabolismo , Animais , Oxirredução , Desnaturação Proteica
2.
Biochem Biophys Res Commun ; 498(1): 119-124, 2018 03 25.
Artigo em Inglês | MEDLINE | ID: mdl-29496452

RESUMO

Ingestion of marine invertebrates often causes food allergy, where the major allergens have been reported to be derived from tropomyosin (TM). Intact or the digestive fragments of food allergens generally show resistance to digestion, which is usually attributable to the structural stability (or rigidity). The difference in the structural and dynamical characteristics between the epitope and the non-epitope regions in TM has not yet been well understood. In the present study, molecular dynamics simulation was performed at constant pHs for shrimp TM. By analyzing the main-chain dihedral angle fluctuations and local α-helix contents, we found that the epitope regions are more stable than the non-epitope counterparts, providing a possible physical reason for the resistance to digestion in the epitopes regions. The difference of the structural stability between the epitope and the non-epitope regions was largest at low pHs, even though pH dependence of the structural stability in itself was not significant in both regions. The lower content of the Ala cluster in the epitope region is considered to cause the higher stability of the epitope region.


Assuntos
Alérgenos/química , Epitopos/química , Penaeidae/química , Tropomiosina/química , Sequência de Aminoácidos , Animais , Concentração de Íons de Hidrogênio , Estrutura Secundária de Proteína , Temperatura
3.
Int Neurourol J ; 27(2): 124-128, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37401023

RESUMO

PURPOSE: This is the first report to compare 3-dimensional computed tomography (3D-CT) images between pediatric patients with enuresis and children without lower urinary tract symptoms who underwent pelvic CT for other reasons. METHODS: Forty-seven children (33 boys and 14 girls) with primary enuresis underwent 3D-CT of sacrococcygeal bones. The control group consisted of 138 children (78 boys and 60 girls) who underwent pelvic CT for other reasons. First, we determined the presence or absence of unfused sacral arches at the L4-S3 levels in both cohorts. Subsequently, we compared the fusion of sacral arches in age- and sex-matched children from these 2 groups. RESULTS: Dysplastic sacral arches, characterized by lack of fusion at 1 or more levels of the S1-3 arches, were observed in nearly all patients in the enuresis group. In the control group (n=138), 54 of 79 children over 10 years old (68%) exhibited fused sacral arches at 3 S1-3 levels. All 11 control children under 4 years old displayed at least 2 unfused sacral arches at the S1-3 levels. In a comparative study of age- and sex-matched patients with enuresis and control children aged 5 to 13 years (n=32 for each group, with 21 boys and 11 girls; mean age, 8.0±2.2 years [range, 5-13 years]), only 1 patient (3%) in the enuresis group exhibited fusion of all S1-3 arches. In contrast, 20 of 32 control group participants (63%) had 3 fused sacral arches (P<0.0001). CONCLUSION: Sacral vertebral arches typically fuse by the age of 10 years. However, in this study, children with enuresis exhibited a significantly elevated prevalence of unfused sacral arches, suggesting that dysplastic development of sacral vertebral arches may play a pathological role in enuresis.

4.
Arch Biochem Biophys ; 502(2): 96-103, 2010 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-20646991

RESUMO

Fast skeletal muscle tropomyosin (TM) of tunas is composed of nearly equimolar amount of two isoforms designated alpha-TM and beta-TM expediently based on their migration behavior in SDS-PAGE, whereas corresponding TMs from the other fish species are homogenous (alpha-type). The presence of beta-TM is thus specific to tunas so far. The amino acid sequence of beta-TM from bluefin tuna Thunnus thynnus orientalis, which has not been revealed to date unlike alpha-TM, was successfully obtained in this study by cDNA cloning. The coding region of beta-TM cDNA comprised of an open reading frame of 855bp encoding 284 amino acid residues, like most of the TMs. Unexpectedly, the sequence of beta-TM showed high similarity to those of other vertebrate alpha-type TMs including tuna alpha-TM. Phylogenetic analysis also showed that beta-TM has the closest relationship with alpha-TM of tuna. This fact was quite unlike the relation of mammalian alpha- and beta-TMs. Based on the distribution of amino acid substitutions, it was suggested that tuna TM isoforms are the products of different genes. By thermodynamic analysis of native and reconstituted TMs, it was demonstrated that beta-TM is less thermostable than alpha-TM. Proteolytic digestion also supported the lower stability of the former.


Assuntos
Músculo Esquelético/metabolismo , Tropomiosina/química , Sequência de Aminoácidos , Animais , Sequência de Bases , DNA Complementar/genética , DNA Complementar/metabolismo , Eletroforese em Gel de Poliacrilamida , Peixes/genética , Peixes/metabolismo , Perciformes/genética , Perciformes/metabolismo , Isoformas de Proteínas/genética , Isoformas de Proteínas/metabolismo , Tropomiosina/genética , Tropomiosina/metabolismo , Atum/genética , Atum/metabolismo
5.
Biosci Biotechnol Biochem ; 74(8): 1673-9, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20699570

RESUMO

Myoglobin (Mb) purified from fast skeletal muscle of bluefin tuna Thunnus thynnus orientalis was subjected to thermal treatment, and the denaturation profiles were examined by thermodynamic analysis. Based on the ellipticity or helical content obtained by circular dichroism (CD) spectrometry, it was found that denaturation of tuna Mb consisted of three steps, and that slight structural changes of Mb started below 20 degrees C. However, major structural changes were observed at around 58 and 72 degrees C. Differential scanning calorimetry (DSC) analysis revealed a similar but somewhat different thermal denaturation profile of Mb. In comparison with the denaturing profiles of whale Mb under the same conditions, the thermal stability of tuna Mb was found to be much lower. In the modeled tertiary structures of these Mbs, they were roughly similar to each other, though minor conformational differences were recognized and the total energy was found to be lower for tuna Mb.


Assuntos
Mioglobina/química , Desnaturação Proteica , Temperatura , Atum , Sequência de Aminoácidos , Animais , Varredura Diferencial de Calorimetria , Dicroísmo Circular , Modelos Moleculares , Dados de Sequência Molecular , Músculo Esquelético , Estrutura Terciária de Proteína , Termodinâmica
6.
Int J Urol ; 17(3): 241-9, 2010 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-20132362

RESUMO

A totally non-invasive transperineal urodynamic technique using Doppler ultrasonography has been developed. Normal urine doesn't have blood cells so urine was thought not to produce Doppler effects. However, basic studies confirmed that the decrease of pressure at high velocity (Bernoulli effects) caused dissolved gas to form microbubbles, which are detected by Doppler ultrasonography. Subjects sat and a probe was advanced via remote control to achieve gentle contact with the perineal skin. The digital uroflow data signals and the color Doppler ultrasound video images were processed on a personal computer. This method was viable to diagnose the degree of bladder outlet obstruction. The advantage of being rapid, effective, and equipped with no special attachments allows it to surpass any other non-invasive urodynamic methods. The difference between the echocardiogram and the ultrasound urodynamic system is only the frequency of obtaining velocity information: more than 50 times per minute vs once every several hours, respectively. Although the ultrasound urodynamic system is more difficult to develop than the echocardiogram, one principle is shared by both methods. The patient can void freely without interruptions, there is no contact between the penis and the equipment and it is specifically directed toward non-invasive diagnosis. The development of non-invasive Doppler ultrasound videourodynamics will dramatically expand understanding of voiding function.


Assuntos
Ultrassonografia Doppler/tendências , Obstrução do Colo da Bexiga Urinária/diagnóstico por imagem , Urodinâmica , Gravação de Videoteipe/tendências , Criança , Humanos , Pediatria , Urologia
7.
Int J Urol ; 16(1): 49-57, 2009 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-19120526

RESUMO

Spina bifida and anencephaly, the common form of neural tube defects, affect approximately 300 000 newborns each year worldwide. The effectiveness of folic acid supplementation in preventing their occurrence or recurrence has been unambiguous since 1991. In general, the prevalence of these abnormalities has decreased in the past 20 to 30 years because of periconceptional folate supplementation, food fortification in several countries, avoiding exposure to environmental factors, and increased accuracy of prenatal screening for fetal anomalies. Women who are planning to conceive should be informed about the importance of folic acid in fetal development and advised to take 400 microg/day of folic acid supplements. Food fortification with folic acid will ultimately be necessary to reduce the number of patients. Primary prevention of neural tube defects by the periconceptional intake of folic acid is a major public health opportunity and has wide implications in reducing the mortality and morbidity of offspring.


Assuntos
Defeitos do Tubo Neural/etiologia , Defeitos do Tubo Neural/prevenção & controle , Suplementos Nutricionais , Feminino , Ácido Fólico/administração & dosagem , Alimentos Fortificados , Humanos , Defeitos do Tubo Neural/epidemiologia , Cuidado Pré-Concepcional , Gravidez , Prevalência
8.
Indian J Urol ; 25(1): 110-5, 2009 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-19468440

RESUMO

OBJECTIVES: A totally non-invasive transperineal urodynamic technique using Doppler ultrasonography has been developed. METHODS: Since normal urine does not have blood cells, urine was thought not to produce the Doppler effects. However, basic studies confirmed that the decrease of pressure at high velocity (Bernouilli effect) caused dissolved gas to form microbubbles, which are detected by Doppler ultrasonography. Subjects sat and the probe was advanced via remote control to achieve gentle contact with the perineal skin. The digital uroflow data signals and the color Doppler ultrasound video images were processed on a personal computer. The flow-velocity curves from two sites; the distal prostatic urethra just above the external sphincter (V1) and the sphincteric urethra (V2) were plotted against time. The parameters of both the pressure-flow studies and the Doppler ultrasound urodynamic studies were compared in men who had various degrees of obstruction. RESULTS: Functional cross-sectional area at prostatic urethra (A1), calculated by Q(max)/V1, was lower in the group of bladder outlet obstruction (BOO) vs. control group. Velocity ratio (VR), which was calculated by V1/V2, was the parameter having the best correlation with BOO index, though A1 had a similar correlation. This method is viable to diagnose the degree of BOO. CONCLUSIONS: The development of non-invasive Doppler ultrasound videourodynamics (Doppler UDS) will dramatically expand the information on voiding function.

9.
Nihon Hinyokika Gakkai Zasshi ; 99(5): 638-44, 2008 Jul.
Artigo em Japonês | MEDLINE | ID: mdl-18697470

RESUMO

AIMS: Folic acid is one of water-soluble Vitamin B group and plays an important role in proliferating cells of the fetus. A multicentered, randomized control trial proved in 1991 that folic acid supplements of 4 mg per day periconceptionally administered to 1031 women who were recruited from 7 countries and had afflicted prior pregnancy successfully prevented 72% of recurrence of neural tube defects. As a primary prevention method, the Government has recommended to take 400 microgram of folate supplements per day from 4 weeks before and 12 weeks after conception. Because of huge amount of folate being demanded in the first trimester, this vitamin is called as "vitamin for women" or "vitamin for fetuses". We herewith report results of questionnaire study performed among urologists. MATERIALS AND METHODS: A questionnaire was sent July 2007 to 400 urologists randomly selected from the Membership Directory of the Japanese Urological Association 2006 whether they are aware of the role of folic acid and how they guide young women or pregnant women on their life style. One hundred sixty-one responses were obtained (40%). RESULTS: Thirty-six percent of urologists were aware of the important role of folic acid in the critical stage of fetal development, which was significantly elevated compared to 26% observed in 2002 (p = 0.037). Fifty-seven percent of urologists acquired this information through Japanese Urological Association or medical journals, 17% through mass media, and 7% through internet. Those who guided young women or pregnant women to refrain from smoking, to abstain from alcohol, to take well-balanced meals and to take folate supplements were 73%, 62%, 67% and 7%, respectively. Ninety-two percent of urologists agreed to provide this information to young women or pregnant women. CONCLUSION: Birth incidence of spina bifida has been increasing in Japan. In order to suppress incidence of this congenital anomaly, Urologists are requested to send young women a message that maternal periconceptional intake of folate will suppress the risk of congenital anomalies.


Assuntos
Conscientização , Competência Clínica , Fertilização , Ácido Fólico/administração & dosagem , Defeitos do Tubo Neural/prevenção & controle , Médicos/estatística & dados numéricos , Inquéritos e Questionários , Urologia , Adulto , Idoso , Feminino , Ácido Fólico/fisiologia , Humanos , Pessoa de Meia-Idade , Gravidez , Risco
10.
Nihon Hinyokika Gakkai Zasshi ; 98(1): 3-8, 2007 Jan.
Artigo em Japonês | MEDLINE | ID: mdl-17302288

RESUMO

OBJECTIVES: Improvement of perioperative management for transurethral resection of the prostate (TURP) by revising the common clinical path was investigated in multiple hospitals. METHODS: We discussed perioperative outcomes using the common path in 2002 and revised it for 2003. Changes in perioperative outcomes between 2002 and 2003 and differences among hospitals were compared. RESULTS: There were no statistically significant differences in age, proportion of patients with mildly impaired activity of daily living and/or impaired cognition, general anesthesia, operating duration, resected weight, incidence of intraoperative complications and blood transfusion between 2002 and 2003. Although there were no differences in preoperative hospital stay, re-hospitalization rate and charges for surgery and anesthesia, Foley catheter was removed significantly earlier from postoperative day 2.9 to 2.3 and total medical charge significantly decreased from 43,703 to 39,661 units (1 unit = 10 yen). The incidence of postoperative pyrexia increased from 2.4% to 11.2% in 2003, however, the incidences of epididymitis, postoperative bleeding and postoperative difficulty on micturition remained stable. The average and standard deviation of postoperative hospital stay and total medical charge at each hospital decreased, however, differences among hospitals found in 2002 remained in 2003. CONCLUSION: We found that standardization can be accomplished by discussing perioperative management using a common path in multiple hospitals and revising the path as needed. Common clinical path should be a valid method of advancing standardization in Japan.


Assuntos
Procedimentos Clínicos/normas , Ressecção Transuretral da Próstata , Atividades Cotidianas , Idoso , Procedimentos Clínicos/economia , Custos de Cuidados de Saúde , Humanos , Tempo de Internação , Masculino , Resultado do Tratamento
11.
Nihon Hinyokika Gakkai Zasshi ; 98(6): 770-5, 2007 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-17929459

RESUMO

PURPOSE: We investigated whether continuous bladder irrigation after Transurethral Resection of the Prostate (TURP) would prevent catheter obstruction by the clot. MATERIALS AND METHODS: We analyzed data from 761 patients registered in "a multi-institutional study of TURP clinical pathway" sponsored by the Ministry of Health, Labor and Welfare between 2001 and 2003. The difference of clinical backgrounds of the cases, resected weight, operating time, risk of being feverish, risk of catheter obstruction and chance of postoperative Transurethral Fulguration (TUF) between each institution were investigated. The risk factor of catheter obstruction is characterized and the significance of continuous bladder irrigation is discussed. RESULTS: The incidence of catheter obstruction in the four institutions, in which 90% or more of patients underwent continuous bladder irrigation, was significantly lower than that in the three institutions, in which continuous bladder irrigation was performed in selected patients whose hematuria was severe (4.4% VS 12.9%, p<0.001). There was no difference in the frequency of either pyrexia or postoperative TUF. Logistic regression analysis showed that significant factors for catheter obstruction are continuous bladder irrigation, resected tissue weight and preoperative urinary infection. CONCLUSIONS: Routine continuous bladder irrigation achieved a lower incidence of catheter obstruction. However, we recommend that urologists should decide whether to perform routine continuous irrigation, considering the frequency of catheter obstruction, safety, labor and cost.


Assuntos
Complicações Pós-Operatórias/prevenção & controle , Ressecção Transuretral da Próstata , Bexiga Urinária , Procedimentos Clínicos , Humanos , Masculino , Período Pós-Operatório , Irrigação Terapêutica/métodos , Cateterismo Urinário/efeitos adversos
12.
Nihon Hinyokika Gakkai Zasshi ; 97(7): 830-4, 2006 Nov.
Artigo em Japonês | MEDLINE | ID: mdl-17154025

RESUMO

OBJECTIVES: We investigated perioperative management for transurethral resection of the prostate (TURP) in Japan. METHODS: The questionnaire survey was conducted in 1,213 educational institutions for urology. RESULTS: The questionnaires were returned from 722 (60%) institutions. Admission to hospital was most frequently scheduled on preoperative day 1; termination of continuous drip infusion, starting meal intake and walking on postoperative day 1; intravenous antibiotics for three days; removal of Foley catheter on postoperative day 4; oral antibiotics for 7 days; and discharge from hospital on postoperative day 7. CONCLUSION: Although hospitalization was 14 days or less at most institutions, several procedures, especially the administration of prophylactic antibiotics, were fairly varied. Discussions from various perspectives might be needed to standardize the perioperative management of TURP in Japan.


Assuntos
Procedimentos Clínicos , Assistência Perioperatória/normas , Inquéritos e Questionários , Ressecção Transuretral da Próstata , Humanos , Tempo de Internação , Masculino
13.
Low Urin Tract Symptoms ; 8(1): 5-29, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26789539

RESUMO

The "Japanese Clinical Guideline for Female Lower Urinary Tract Symptoms," published in Japan in November 2013, contains two algorithms (a primary and a specialized treatment algorithm) that are novel worldwide as they cover female lower urinary tract symptoms other than urinary incontinence. For primary treatment, necessary types of evaluation include querying the patient regarding symptoms and medical history, examining physical findings, and performing urinalysis. The types of evaluations that should be performed for select cases include evaluation with symptom/quality of life (QOL) questionnaires, urination records, residual urine measurement, urine cytology, urine culture, serum creatinine measurement, and ultrasonography. If the main symptoms are voiding/post-voiding, specialized treatment should be considered because multiple conditions may be involved. When storage difficulties are the main symptoms, the patient should be assessed using the primary algorithm. When conditions such as overactive bladder or stress incontinence are diagnosed and treatment is administered, but sufficient improvement is not achieved, the specialized algorithm should be considered. In case of specialized treatment, physiological re-evaluation, urinary tract/pelvic imaging evaluation, and urodynamic testing are conducted for conditions such as refractory overactive bladder and stress incontinence. There are two causes of voiding/post-voiding symptoms: lower urinary tract obstruction and detrusor underactivity. Lower urinary tract obstruction caused by pelvic organ prolapse may be improved by surgery.


Assuntos
Sintomas do Trato Urinário Inferior/diagnóstico , Sintomas do Trato Urinário Inferior/terapia , Algoritmos , Feminino , Humanos , Sintomas do Trato Urinário Inferior/epidemiologia , Qualidade de Vida , Inquéritos e Questionários
14.
Acta Med Okayama ; 59(3): 109-12, 2005 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-16049564

RESUMO

We report a case in which retroperitoneoscopic pyelolithotomy was the procedure selected to treat a large stone in the upper urinary tract. A 71-year-old woman who had multiple cerebral infarction and dementia was admitted with a persistent high fever unresponsive to antibiotics. The diagnosis was pyelonephritis and urosepsis associated with ureteral calculus. A large calculus(3.0 x 2.0 cm)was found in the left ureter at the L3 level. She underwent nephrostomy of the left side. After the patient's general condition had improved, surgery was performed successfully with an uneventful recovery. The findings in this case confirm that retroperitoneoscopic surgery allows removal of a large stone in a single, minimally invasive procedures.


Assuntos
Laparoscopia/métodos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Pielonefrite/complicações , Cálculos Ureterais/cirurgia , Idoso , Feminino , Humanos , Espaço Retroperitoneal/cirurgia , Cálculos Ureterais/etiologia
15.
Nihon Hinyokika Gakkai Zasshi ; 96(5): 541-7, 2005 Jul.
Artigo em Japonês | MEDLINE | ID: mdl-16083031

RESUMO

OBJECTIVE: To evaluate usefulness and safety of an indwelling contemporary balloon catheter, we compared complication rates among five methods of urinary tract management. PATIENTS AND METHODS: History of febrile episode, bladder stones, pyuria and the miscellaneous urinary tract problems of 114 patients were retrospectively reviewed. The rates of complications were compared among five types of urinary tract management as clean intermittent catheterization dry (not incontinent) (CIC-dry: n = 33), clean intermittent catheterization with incontinence (CIC-wet: n = 16), clean intermittent catheterization with a contemporary balloon catheter indwelling at night (Contemporary catheter: n = 20), a suprapubic cystostomy catheter indwelling (Cystostomy: n = 22) and permanent urethral balloon catheter indwelling (Urethral catheter: n = 24). The contemporary balloon catheter used consisted of a reusable balloon catheter and a reservoir to inflate the balloon. The patients in the Contemporary catheter group self-inserted the catheter every night before sleeping, and then removed it in the next morning. After use, the catheter was washed with tap water, and stored in a special purpose case filled with disinfectant. RESULTS: The mean follow up period was 41 months. The incidence of febrile episode in CIC-wet was 3.36 times/100 months, Urethral catheter was 2.96, Cystostomy was 1.26, Contemporary catheter was 0.57, and CIC-dry was 0.42. The incidence of febrile episode in CIC-wet and Urethral catheter were significantly higher than in CIC-dry (p<0.05). The incidence of bladder stone in Urethral catheter was 1.11 times/100 months, Cystostomy was 1.05, Contemporary catheter was 0.96, CIC-wet was 0.61, and CIC-dry was 0.21. The Urethral catheter group had significantly higher incidence of bladder stone than CIC-dry (p<0.05). CONCLUSIONS: The indwelling contemporary balloon catheter is recommended for long-term use in CIC-wet group.


Assuntos
Cateterismo/instrumentação , Cateterismo/normas , Doenças da Medula Espinal/terapia , Bexiga Urinaria Neurogênica/terapia , Incontinência Urinária/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Transtornos Cerebrovasculares/terapia , Segurança de Equipamentos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Traumatismos da Medula Espinal/terapia
17.
Nihon Hinyokika Gakkai Zasshi ; 95(7): 792-9, 2004 Nov.
Artigo em Japonês | MEDLINE | ID: mdl-15624489

RESUMO

PURPOSE: To investigate the length of hospitalization and medical charges when a common clinical path for TURP (transurethral resection of prostate) was implemented in multiple hospitals. PATIENTS AND METHODS: This study included 310 patients in 2001 and 298 in 2002, who were diagnosed with benign prostatic hyperplasia and who underwent TURP in seven hospitals in Japan. While the patients were treated according to the managing methods of each hospital in 2001, the patients were managed using a common clinical path in 2002, on which we conferred and established in 2001. We investigated the change of various outcome indicators before and after implementation of the common clinical path. RESULTS: The background of patients and surgical outcome in 2002 were equal to those in 2001, except in incidence of preoperative urinary tract infection, general anesthesia and blood transfusion, and number of surgeons. Implementation of a common clinical path shortened the pre- and postoperative hospital stay, duration of bed rest, administration of antibiotics and Foley catheter indwelling, and reduced the standard deviation of these indicators. The total medical charge decreased from 515,439 to 491,935 yen. However, outcomes were considerably different among the seven hospitals. Multivariate analyses identified the hospitals, cognitive impairment, preoperative indwelling catheter and preoperative variance as the factors affecting preoperative hospital stay, and the hospitals, co-existing disease, blood transfusion, postoperative urinary tract infection and postoperative variance as factors affecting postoperative stay. Based on these analyses, we determined four exclusion criteria against using a common clinical path: 1) patients requiring examination or surgery other than TURP simultaneously, 2) patients whose ADL disturbance, cognitive impairment, past history and/or coexisting disease are expected to affect postoperative convalescence, 3) patients with a preoperative indwelling catheter just before operation, and 4) patients with preoperative urinary tract infection. By excluding 122 (39.4%) and 129 (43.3%) patients fulfilling the above criteria in 2001 and 2002, respectively, there were reduction in the length of pre- and postoperative hospital stay, and the total admission fee. Furthermore, there were decrease in their standard deviations. CONCLUSIONS: A common clinical path was valid for reducing variance of the critical indicators affecting the clinical course of TURP and shortening the pre- and postoperative stay in the multiple hospitals. It is mandatory to establish the standard perioperative management for TURP from the viewpoint of urologists, under the circumstances of the impending introduction of the Diagnosis Procedure Combination (DPC).


Assuntos
Procedimentos Clínicos , Implementação de Plano de Saúde , Tempo de Internação , Hiperplasia Prostática/cirurgia , Ressecção Transuretral da Próstata , Idoso , Idoso de 80 Anos ou mais , Hospitalização/economia , Hospitais , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Hiperplasia Prostática/economia , Ressecção Transuretral da Próstata/economia , Resultado do Tratamento
18.
Nihon Hinyokika Gakkai Zasshi ; 95(7): 800-8, 2004 Nov.
Artigo em Japonês | MEDLINE | ID: mdl-15624490

RESUMO

PURPOSE: We conducted a questionnaire survey to elucidate the rating of the patients who underwent transurethral resection of the prostate (TURP) and were managed by a common clinical path during hospitalization. PATIENTS AND METHODS: At the day of discharge from seven hospitals in Japan, the questionnaires were handed to 298 patients who underwent TURP in 2002. In the path, it was determined that the patients should be admitted one day before surgery and discharged on the seventh postoperative day. RESULTS: The questionnaires were returned by 240 (80.5%) patients. Of the 212 patients answering a question regarding the desirable preoperative hospital stay, 58 (27.4%), 85 (40.1%) and 46 (21.7%) considered 1, 2 and 3 days as a desirable preoperative stay, respectively. Of the 206 answering a question about the desirable postoperative hospital stay, 54 (26.2%), 28 (13.6%) and 60 (29.1%) considered 7, 8 and 9-10 days as a desirable postoperative hospital stay, respectively. Of the 240 patients, 229 (95.4%) received the path for the patients, 234 (97.5%) understood the treatment methods well and 229 (95.4%) understood the schedule during hospitalization well. Two hundred thirty-six (98.3%) and 218 (90.8%) patients answered that as scheduled, they started to have meals and started to walk, respectively. Continuous drip infusion was terminated in 219 (91.3%) as scheduled, and indwelling catheters were removed in 215 (89.6%) as scheduled. CONCLUSIONS: This questionnaire survey elucidated that approximately 70% of the patients who underwent TURP wanted to stay 1 or 2 days before surgery and 7 to 10 days after surgery. We consider it very important that patients understand well the treatment methods, complications, schedules during hospitalization and criteria for discharge when they are managed using the clinical path, so they will accept better a length of hospital stay that is shorter than that which they had desired.


Assuntos
Procedimentos Clínicos , Hospitalização , Inquéritos e Questionários , Ressecção Transuretral da Próstata , Humanos , Tempo de Internação
19.
Nihon Hinyokika Gakkai Zasshi ; 95(4): 663-8, 2004 May.
Artigo em Japonês | MEDLINE | ID: mdl-15198000

RESUMO

OBJECTIVE: The Ministry of Health, Labour and Welfare announced that periconceptional consumption of folic acid will reduce risks of having babies afflicted with Neural Tube Defects (NTDs) in the year of 2000. We assessed awareness of the role of folic acid among urologists and a patient group, how urologists give advices on lifestyle to young women, and what lifestyle the patient group currently maintains. MATERIALS AND METHODS: A postal questionnaire survey was conducted involving 400 urologists randomly selected and a group of 250 female patients afflicted with NTDS and 250 mothers who had given birth to babies having NTDs during the past 7 years. Eighty-four percent of urologists aged 40 years and over and 76% of the patient group aged in their 20s and 30s. Response rates were 56% in the former and 52% in the later. RESULTS: Twenty-six percent of urologists and 92% of the patient group knew an important role folic acid played in prevention of neural tube defects. While 10% of urologists advised to consume multi-vitamins containing folic acid or folic acid supplements, 25% of myelodysplastics and the mothers took them. Sixty-eight percent of doctors advised to take well-balanced food and 82% of the patent group answered that they do. Over 80% of the doctors and the patient group believed that a folic acid campaign is to be organized to inform young women of childbearing age of possible reduction of the risk. CONCLUSION: It is found that proportion of urologists who are aware of a role of periconceptional consumption of folic acid is significantly lower than that of the group of patients (p < 0.0001). Urologists are expected to recognize specific benefits of folic acid in the prevention of NTDs, to advise young women of childbearing age to take well-balanced meals, and to recommend those who wish to be pregnant to consume 400 micrograms of folic acid supplements from 4 weeks before to 12 weeks after conception.


Assuntos
Conscientização , Competência Clínica , Dieta , Ácido Fólico/fisiologia , Urologia , Adulto , Feminino , Ácido Fólico/administração & dosagem , Ácido Fólico/metabolismo , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Defeitos do Tubo Neural/etiologia , Defeitos do Tubo Neural/metabolismo , Gravidez , Recursos Humanos
20.
Comp Biochem Physiol B Biochem Mol Biol ; 160(2-3): 64-71, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21722747

RESUMO

Structural properties of invertebrate muscle tropomyosin (TM) have not been characterized in detail to date. TMs were thus purified from the mantle muscle of Japanese common squid Todarodes pacificus, the foot muscle of tokobushi abalone Haliotis diversicolor and the tail muscle of kuruma prawn Marsupenaeus japonicus, and investigated for their thermodynamic properties by circular dichroism (CD) spectrometry and differential scanning calorimetry (DSC). From the CD spectrometry data, the apparent melting temperature and the apparent free energy of unfolding at 20°C were calculated to be 43.5°C and 14.5 kJ/mol for the squid TM, 43.0°C and 23.9 kJ/mol for the abalone TM, and 47.3°C and 50.2 kJ/mol for the prawn TM, respectively. From the DSC data, the total free energy of unfolding at 20°C was calculated to be 129 kJ/mol, 253 kJ/mol, and 271 kJ/mol for the squid, abalone, and prawn TMs, respectively. These results suggest that the thermal stability was in the order of prawn TM>abalone TM>squid TM.


Assuntos
Invertebrados/química , Termodinâmica , Tropomiosina/química , Sequência de Aminoácidos , Animais , Varredura Diferencial de Calorimetria , Dicroísmo Circular , Invertebrados/anatomia & histologia , Dados de Sequência Molecular , Músculo Esquelético/anatomia & histologia , Músculo Esquelético/química , Desnaturação Proteica , Água do Mar , Alinhamento de Sequência
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA