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Get PDFObjective: To identify factors influencing the hospital choice of patients who undergo colon cancer surgery. Methods: We conducted a multivariate analysis using micro data from the Patient Survey and the Survey of Medical Institutions conducted by the Statistics and Information Department, Minister's Secretariat, Ministry of Health, Labour and Welfare of Japan, to identify patient and hospital characteristics which influence a patient's decision whether to undergo surgery at a hospital where many colon surgeries have been performed ("high-volume hospital"). Results: Hospitalizations to high-volume hospitals were linked to factors such as referral from nonmedical facilities and the fact that the medical institution was a teaching hospital. Hospitalizations to high-volume hospitals decreased by about 8% for every 1-km increase in distance to the nearest high-volume hospital. Conclusion: Geographic factors and hospital function had an impact on admission to high-volume hospitals that are expected to contribute to functionalization of medical institutions and improvement of medical standards. This suggests that geographic conditions should be considered in planning regional coordination systems for specialized medical care.departmental bulletin pape
Get PDFAlthough the association of two distinct autoimmune diseases, Graves' disease (GD) and myasthenia gravis (MG), is rare, the relationships of clinical and immunological activities between the two diseases remain unknown. In the present study, we investigated whether there exist any relationships between clinical and immunological activities of GD and MG as well as any common characteristics of their HLA antigens in five patients with concomitant association with GD and MG. The present study clearly showed positive relationships between the clinical activities of GD and MG in all five cases. Except for two cases, one with undetectable acetylcholine receptor antibody and another with few sample number, there were positive relationships between two circulating auto-antibodies against TSH receptor and acetylcholine receptor as well as their immunological and clinical activities in the remaining three cases. Furthermore, the present serological HLA typing study revealed that all five cases had common HLA-DQ3. Therefore, our study clearly demonstrates a reverse 'see-saw' relationship between GD and MG based on their clinical and immunological features, and suggests that HLA-DQ3 may play a potential pathogenic role in the concomitant development of the two diseases.departmental bulletin pape
Get PDFPurpose: Aim of this study was to determine patients' preference to acrylic resin major connector analogues (MCA) that simulated strengthened major connector designs formulated for Ti-6Al-7Nb alloy. Materials and methods: Four MCA namely wide design (Wide), design with 2 strengthening ridges (2SR), design with 1 strengthening ridge (1SR), and thick design (Thick) were fabricated using light-polymerizing acrylic resin for 10 patients with Kennedy Class I or II partially edentulous maxillary arches. They were asked to wear each MCA in the mouth for 30 seconds in 6 pairs, and to report their preference for each pair. Using these data the 4 MCA were ranked in a descending preference order for each patient. A within-subject comparison of preferences was performed with the Friedman test and multiple comparisons with Wilcoxon Signed Ranks test. Results: A statistically significant preference order was revealed: Wide, 1SR, 2SR, and Thick (P<0.008). The wide design (P<0.004) and the 1SR (P<0.01) were significantly preferred to the thick design. However, individual data showed that the first preference varied depending upon the subject. Conclusion: Thinner designs tended to be preferred to the thicker design by the subjects, while none of the designs tested were consistently selected as the best design.departmental bulletin pape
Get PDFThis study compares temporomandibular joint dysfunction (TMD) symptoms before and after bilateral sagittal split ramus osteotomy, and identifies predictive factors for the postoperative TMD symptoms by assessing the adjusted odds ratio using multiple logistic regression analysis. A consecutive series of 37 cases treated only with bilateral sagittal split ramus osteotomy were evaluated. New postoperative TMD symptoms appeared in 9 cases, preoperative TMD symptoms disappeared in 6 cases, and TMD symptoms were unchanged in 5 cases. The median period until the interincisal opening range attained 40 mm was 5 months (range, from 2 to 15 months). Age was a positive factor in patients with postoperative TMD symptoms, with an odds ratio of 1.43 (95 percent confidence interval, from 1.05 to 1.93). In addition, the maximum value of the bilateral setback distance of more than 9 mm was a positive factor of 6.95 (95 percent confidence interval, from 1.06 to 45.42). We concluded that surgical correction in skeletal malocclusion may affect temporomandibular joint dysfunction symptoms.departmental bulletin pape
Get PDFPurpose: The aim of this study was to evaluate the expression of cyclooxygenase-2 in human breast cancer using immunohistochemistry and to determine whether the expression of cyclooxygenase-2 is associated with clinicopathological factors in invasive ductal breast carcinoma. Methods: Cyclooxygenase-2 expression was investigated by immunohistochemistry in 30 invasive ductal breast carcinoma specimens and relationships between cyclooxygenase-2 expression and age, histological grade, histological type, nodal status, and hormone receptor status were evaluated. Results: Cyclooxygenase-2 expression was found in 56.7% of the tumor samples and was related to histological grade (P<0.01) and histological type (P<0.001). Conclusions: Our results suggest that cyclooxygenase-2 expression has an important role in tumor differentiation in invasive ductal breast carcinoma.departmental bulletin pape
Get PDFIf the quality and efficiency of medical services are to be ensured, electronic health records (EHR) and EHR-supporting infrastructure must be prevalent. Many hospitals, however, have EHR systems for their internal use only, and the standardization process for the exchange of medical information is still in process. This standardization process addresses information security and is considering public key infrastructure (PKI) as one security measure, but PKI is rarely used by medical practioners because of its poor user-friendliness. Here we propose an effective use of the identitybased encryption (IBE) system as a security measure. This system enables us to send encrypted and signed messages without requiring the receiver to get a public key, and it enables us to deliver secured messages to ambiguous receivers like those to whom letters of reference are sent. We evaluated the feasibility of this technology by using the analytic hierarchy process, which is an effective analysis tool when selection and judgment depend on nonquantitative psychological factors, to analyze the results of an experiment in which medical workers used E-mail agents with and without PKI and IBE. We found that medical practioners and researchers avoid using PKI because of its poor user-friendliness and instead use IBE even though it is harder to install. We therefore think IBE would encourage medical institutions to share patient records.departmental bulletin pape
Get PDFThe purpose of this study was to estimate the coverage and quality of information on dental caries prevention in Japanese newspapers. Newspaper articles were searched using database during 10 years from 1993 to 2002. From five major newspapers, 440 articles concerning dental caries prevention were selected and used for analysis. The number of caries prevention articles was related to National Oral Health Week, which was held in June of each year, and the introduction of new policy or government statements on oral health issues. Major sources of articles came from manufacturing companies (29.3%), staff of universities (27.7%), and other dental specialists (20.2%). Caries prevention articles appeared frequently in the health columns (35.7%) followed by news articles (20.0%) and business columns (17.7%). Dietary control (47.5%) was the most frequently described preventive method. Plaque control was referred to in 40.9% of articles, and information about improvement of host factors was provided in 40.0%. Among them, fluoride information was included in 30.0%. Clearly wrong information against evidence based were found in 24 articles. It is important that newspapers provide accurate information with a supportive evidence base. Dental professionals in Japan should be aware of the importance of media advocacy in order to provide appropriate oral health information to the public.departmental bulletin pape
Get PDFMacaque lumber posterolateral spine fusion (PLF) was performed by using beta-TCP graft combined with bone marrow derived stromal cells (MSCs), to evaluate whether a beta-TCP/MSCs hybrid can be used for PLF instead of autogenous bone graft. Nine crab-eating macaque underwent bilateral PLF at L4-L5. The implants were divided into three groups: 1) beta-TCP/MSCs hybrid, 2) autogenous bone, and 3) beta-TCP. Six monkeys were sacrified at 12 weeks and three monkeys were sacrificed at 24 weeks after implantation. Manual palpation, radiography, micro computed tomography, peripheral quantitative computed tomography (pQCT), and histology were used to assess bone formation. Manual palpation and X-ray showed that 83.3% of hybrid groups and 66.7% of autogenous groups achieved solid spine fusion, whereas none of other groups fused. Histological analysis showed that all of the hybrid groups achieved massive bone formation. Bone mineral density (BMD) evaluated with pQCT in the hybrid groups increased by additional new bone. Beta-TCP/MSCs hybrid can be used for PLF instead of autogenous bone graft. Thus it can be hypothesized that the monkey PLF can simulate human PLF.departmental bulletin pape
Get PDFThe cyclic peptide WP9QY (YCWSQYLCY), which was designed to mimic the most critical tumor necrosis factor (TNF)α recognition loop on type1 TNF receptor, antagonizes the effects of TNFα. In this study, we investigated the effects of WP9QY peptide on collagen- induced arthritis (CIA) mice to evaluate its effects on inflammatory bone destruction. DBA/1J mice were injected intradermally at the base of the tail with bovine type II collagen, emulsified in complete Freund's adjuvant on day 0 and 21. The three sets of WP9QY peptide injections (24 mg/kg×8 times per day) were performed before the onset of paw swelling. Mice were sacrificed at day 38 and thereafter, the arthritis scores as well as radiographical and histological outcomes were assessed. WP9QY peptide inhibited CIA- induced increase in the arthritis score. Furthermore, histomorphometric analysis of the tibial epiphysis region revealed that WP9QY peptide inhibited the increase of synovial pannus infiltration and the decrease of bone volume, which were induced by the CIA. The WP9QY treatment prevented the inflammation as well as bone destruction of the joints in the CIA mice, suggesting that the administration of WP9QY peptide might be useful for developing a drug to prevent inflammatory bone destruction.departmental bulletin pape
Get PDFThe purpose of this study was to investigate the general and oral health status of patients at a dental hospital in Tokyo and examine the correlations between general health and oral health items. One hundred and seventy-four (174) new patients at the Dental Hospital of Tokyo Medical and Dental University participated in this study. The Visual Analog Scale (VAS) was employed to investigate dental demands and symptoms, as well as satisfaction with oral and general health conditions, while SF-36 served an indicator for healthrelated quality of life (HRQOL). The results were statistically analyzed at a significance level of p = 0.05. The results of VAS were further examined using factor analysis. Several VAS items showed significant correlations with SF-36 subscales (p0.05). Emotional elements and esthetic demands on dental status, as well as physical symptoms, influence HRQOL. Dental discomfort proved to be independent of general health status and was considered a dental-specific item that needs to be measured separately from general health status.departmental bulletin pape