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The efficacy of non-pharmacological intervention for chronic insomnia has been proven by several meta-analytic reviews, an NIH report, an American Academy of Sleep Medicine review, and numerous clinical trials. Behavior therapy for chronic insomnia consists of relaxation, stimulus control, sleep restriction, cognitive restructuring and sleep hygiene education, which has produced reliable and durable changes in total sleep time, sleep onset latency, number and duration of awakening. These studies also showed that the post-treatment effect of behavior therapy is equal to that of hypnotic therapy, and that these effects were maintained for 6 months on follow-up assessment. Elderly insomniac patients would gain considerable benefit from behavioral treatments because there are no adverse physical effects as there are from pharmacological therapy. The authors present the basic theory, techniques of behavior therapy for insomnia, and the results of two important key meta-analytic reviews. Any behavioral approach such as convenient education, self-care enhancement by bibliotherapy, and individual face-to-face counseling, seem to be fruitful not only for American but also Japanese insomnia patients. Nonetheless, there are no currently actual intervention studies using behavior therapy in Japan. We have discussed the methodology of intervention study and published a behavioral self-help manual for people with sleep problems. Development of a behavioral approach to chronic insomnia seemed to be very beneficial and a useful contribution to mental health services. 相似文献
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The association of MTHFR and CBS variants with the doubling time and responsiveness to several chemodrugs was analyzed in 26 human cancer xenografts. The tumors homozygous for the absence of insertion (NN) for the CBS 844ins68bp were more chemosensitive than those with insertion (NI) to TS-1 (P=0.0048), suggesting a potential effect of this variant on fluoropyrimidine efficacy. Furthermore, the doubling time of tumors with a variant C allele (AC or CC) in MTHFR-A1298C was significantly longer than that of tumors with a normal allele (AA) (P=0.0008). Twenty-nine cellular proliferation-related genes were associated with MTHFR-A1298C genotyping and with the doubling time. 相似文献
5.
T Yamagami S Iida T Kato T Hirota T Nishimura 《Journal of Medical Imaging and Radiation Oncology》2006,50(1):75-78
We present a patient with gastric varices complicating portal hypertension caused by liver cirrhosis related to hepatitis C virus. The patient underwent balloon‐occluded retrograde transvenous obliteration. The gastric varices almost completely disappeared, without any sclerotic agent being used, after iatrogenic injury of the gastrorenal shunt at the time of the interventional procedure. 相似文献
6.
Percutaneous radiofrequency neurotomy of lumbar medial branch (facet rhizotomy)--a report of 6 cases
H Yamagami K Hashizume K Nakahashi T Okuda 《Masui. The Japanese journal of anesthesiology》1990,39(4):491-495
We performed radiofrequency neurotomy of lumbar medial branch as a treatment of facet syndrome. Our six cases had no indication for surgical therapy, such as neuralgia, spinal canal stenosis without neurological deficit except for pain and deformed spines. Facet joint injection with regional anesthetics and steroids could not prevent their recurrent back pain. By facet rhizotomy, they could obtain relief of back pain for several months to a year. We conclude that facet rhizotomy is a more effective method for facet syndrome when a proper indication is present. 相似文献
7.
Tetsuji Kai Yang Il Kim Hirokazu Kitamura Katsunori Kawano Seigo Kitano 《Journal of Hepato-Biliary-Pancreatic Surgery》1997,4(4):423-430
There is a growing body of evidence that the cytokine, tumor necrosis factor-α (TNF-ga), plays an important role in the development
of hepatic ischemia/reperfusion injury. We found that the immunosuppressants, cyclosporine-A (CsA), azathioprine, and FK506,
have protective effects on such injury. The purpose of the present study was to elucidate mechanisms involved in these beneficial
effects of the immunosuppressant, CsA, on liver injury following cold preservation and transplantation, with special reference
to the suppression of TNF-α release. Rat livers were stored in Euro-Collins solution (EC) at 4°C for 6h and orthotopically
transplanted. The animals allotted to two groups: group A (untreated controls) and group B (CsA pretreatment of recipients).
CsA (10 mg/kg, p.o.) was given for 3 consecutive days preoperatively. CsA pretreatment of the recipients significantly improved
the 2-week survival rate (0/6 for group A, 3/6 for group B;P<0.05) and this was associated with a significant decrease in serum TNF-α levels 2h posttransplantation (group A, 69.8±15.7
pg/ml; group B, 22.8±6.8; mean±SEM;n=12 each;P<0.05) and amelioration of sinusoidal endothelial injury, assessed by electron microscopy. Plasma endotoxin levels following
reperfusion of the grafts were not altered by the CsA therapy. Morphologically, CsA pretreatment of the recipients did not
alter activation of Kupffer cells. CsA pretreatment of the recipient aids in preventing cold preservation/reperfusion injury
of the liver graft, possibly by modulating effects of TNF-α. 相似文献
8.
A Hiraoka J Ishikawa H Kitayama T Yamagami H Teshima H Nakamura H Shibata T Masaoka S Ishigami F Taguchi 《Bone marrow transplantation》1991,7(2):107-111
We used a thin-sectioning technique for the electron microscopic detection of viral particles within the cells of urinary sediments in three recipients who developed hemorrhagic cystitis after allogeneic bone marrow transplantation. Results of viral cultures of urine and electron microscopic (EM) observations on urinary sediments were consistent in only one recipient. In this recipient, EM observations revealed many viral particles within the cells of urinary sediments with diameter of about 80 nm corresponding to adenovirus, of which type 11 was produced in viral cultures. In one of the other two recipients many viral particles with a mean diameter of 41.6 nm corresponding to papovavirus were observed, but viral cultures using conventional cells were negative. Re-cultures using HEK cells produced polyomavirus BK. EM observation was a clue to the correct diagnosis. In the remaining recipient, no viral particles were observed within the cells of urinary sediments, suggesting the hemorrhagic cystitis to be of non-viral origin, despite a positive result of viral culture. These results suggest that a thin-sectioning technique on the cells of urinary sediments is important for the differential diagnosis between a viral-induced and non-viral hemorrhagic cystitis. 相似文献
9.
I Matsubara Y Naruse S Sokejima T Yamagami S Kagamimori 《[Nihon kōshū eisei zasshi] Japanese journal of public health》1992,39(11):873-878
A data system which enables utilization of individual patient data by public health nurses, physicians and home helpers, is required both for the continuous and comprehensive monitoring of the various needs of the aged receiving care services at home in the local district and for facilitating welfare services. Therefore, an experimental and comprehensive system for public health, medical services and welfare was put into practice for district public health services for the aging society. The results of this trial system shows that this system is useful indeed for the welfare services, though it also has several problems. 相似文献
10.
Akihiro Hosaka M.D. Tetsuro Miyata M.D. Hiroshi Shigematsu M.D. Jun-o Deguchi M.D. Hideo Kimura M.D. Hirokazu Nagawa M.D. Osamu Sato M.D. Takehiko Sakimoto M.D. Tomoyuki Mochizuki M.D. 《Journal of gastrointestinal surgery》2006,10(4):583-585
The vascular type of Ehlers-Danlos syndrome is a genetic disorder of connective tissue and is frequently associated with catastrophic
arterial complications. Its surgical treatment is extremely difficult because of the fragility of vessels. This article describes
three patients with vascular type of Ehlers-Danlos syndrome who developed mesenteric hemorrhage due to spontaneous arterial
rupture. The clinical and molecular characteristics of the disease are briefly reviewed. 相似文献