How to promote the stockpiling of medication for disaster preparedness among Parkinson’s disease patients receiving home care services

The purpose of this study was to identify factors, using the Health Belief Model (HBM) associated with Parkinson’s disease (PD) medication stockpiling for disaster preparedness among PD patients receiving home care services. The survey was conducted through an anonymous, self-administered postal questionnaire between March and September 2013, targeting all 1,398 members of Japan Parkinson’s Disease Association in nine prefectures in East Japan including the Hokuriku region. The analysis included 571 valid responses (40.8%). The results of a binary logistic regression analysis indicated that three of the modifying factors in the HBM, “possession of a disability certificate,” “bringing a medicine notebook or information sheet when going out,” and “awareness of the possibility of a future disaster” were significantly associated with stockpiling behavior. The “Cues to Action” factor (“encouragement from others or information promoting the stockpiling of medication”) was also significantly associated. However, the other constructs in the HBM, “Susceptibility,” “Severity,” “Perceived Threat,” “Barriers,” and “Benefits,” did not show significant association. We concluded that encouragement of stockpiling behavior from healthcare professionals and the PD Association, making a habit of always bringing a medicine notebook when going out, and raising awareness of the possibility of a disaster are useful in promoting medication stockpiling among PD patients

Low fat intake is associated with pathological manifestations and poor recovery in patients with hepatocellular carcinoma

BACKGROUND: This study aimed to clarify whether dietary deviation is associated with pathological manifestations in hepatocellular carcinoma (HCC) patients. METHODS: Dietary intake was estimated in 35 HCC cases before and after hospitalization by referencing digital camera images of each meal. Pathological conditions were evaluated in nitrogen balance, non-protein respiratory quotient (npRQ), neuropsychiatric testing and recovery speed from HCC treatment. RESULTS: On admission, nitrogen balance and npRQ were negative and less than 0.85, respectively. Five patients were judged to have suffered from minimal hepatic encephalopathy that tended to be associated with a lowered value of npRQ (p = 0.082). The energy from fat intake showed a tendency of positive correlation with npRQ (p = 0.11), and the patients with minimal hepatic encephalopathy took significantly fewer energy from fat (p = 0.024). The energy difference from fat between diets at home versus those in the hospital showed a significant positive correlation with npRQ change after admission (p = 0.014). The recovery speed from invasive treatments for HCC showed a significant negative correlation with npRQ alteration after admission (p = 0.0002, r = −0.73). CONCLUSIONS: These results suggest the lower fat intake leads to deterioration of energy state in HCC patients, which associates with poor recovery from invasive treatments and various pathological manifestations

The Role of a Brain-specific Splice Variant of Ryanodine Receptor Type 1

The ryanodine receptor type 1 (RyR1) is capable of homotetrameric assembly to form a Ca2+ release channel at intracellular Ca2+ storage sites such as endoplasmic reticulum (ER). The mRNA transcript encoding full-length RyR1 is approximately 16kb and is mainly distributed in excitable cells. A 2.4-kb mRNA splice variant from the 3\u27-terminal region of the RyR1 gene coexists specifically in brain together with the full-length form, although the functions of this brain-specific splice variant remain unclear. To investigate the short form of RyR1 in intracellular Ca2+ signaling in brain at the cellular level, we established an experimental system whereby the green fluorescent protein (GFP) -tagged brain-specific variant of RyR1 is coexpressed with the full-length protein in the same cell. Both forms of RyR1 were localized in the ER. Caffeine-induced Ca2+-release activities in cells expressing both the brain-specific and full-length RyR1 were reduced compared to cells expressing only the full-length form of RyR1. These results suggested that coexpression of the brain-specific splice variant of RyR1 with its full-length counterpart modulates intracellular Ca2+ signaling by acting as a dominant-negative subunit of the Ca2+ release channel in a tissue-specific fashion

An international survey of physicians regarding clinical trials: a comparison between Kyoto University Hospital and Seoul National University Hospital

This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Abstract Background International clinical trials are now rapidly expanding into Asia. However, the proportion of global trials is higher in South Korea compared to Japan despite implementation of similar governmental support in both countries. The difference in clinical trial environment might influence the respective physicians attitudes and experience towards clinical trials. Therefore, we designed a questionnaire to explore how physicians conceive the issues surrounding clinical trials in both countries. Methods A questionnaire survey was conducted at Kyoto University Hospital (KUHP) and Seoul National University Hospital (SNUH) in 2008. The questionnaire consisted of 15 questions and 2 open-ended questions on broad key issues relating to clinical trials. Results The number of responders was 301 at KUHP and 398 at SNUH. Doctors with trial experience were 196 at KUHP and 150 at SNUH. Among them, 12% (24/196) at KUHP and 41% (61/150) at SUNH had global trial experience. Most respondents at both institutions viewed clinical trials favorably and thought that conducting clinical trials contributed to medical advances, which would ultimately lead to new and better treatments. The main reason raised as a hindrance to conducting clinical trials was the lack of personnel support and time. Doctors at both university hospitals thought that more clinical research coordinators were required to conduct clinical trials more efficiently. KUHP doctors were driven mainly by pure academic interest or for their desire to find new treatments, while obtaining credits for board certification and co-authorship on manuscripts also served as motivation factors for doctors at SNUH. Conclusions Our results revealed that there might be two different approaches to increase clinical trial activity. One is a social level approach to establish clinical trial infrastructure providing sufficient clinical research professionals. The other is an individual level approach that would provide incentives to encourage doctors to participate in and conduct clinical trials

Construction and Expression of Ryanodine Receptor Mutants Relevant to Malignant Hyperthermia Patients in Japan

Malignant hyperthermia (MH) is a potentially fatal pharmacogenetic disorder triggered by exposure to commonly used volatile anesthetics. Pharmacological and genetic analyses implicated the type 1 of ryanodine receptor (RyR1) /Ca2+ release channel as the main candidate gene for causing MH. Genetic diagnosis of MH was proposed to replace conventional methods using biopsied muscle samples that are painful for patients and require skillful diagnosticians to interpret. However, more than 250 RyR1 gene variants have now been reported in MH-susceptible patients, although most have yet to be associated with functional abnormalities using exogenous constructs of these mutants expressed in living cells. To directly compare the pharmacological characteristics of some of the MH-related RyR1 mutants, we have established doxycycline -inducible cell lines expressing two of the unconfirmed rabbit RyR1 mutants, Q156K or R534H (corresponding to the Q155K or R533H mutations in human RyR1 reported in MH patients in Japan) and a confirmed mutant, R164C RyR1 (corresponding to the R163C mutation in human). The caffeine sensitivity of Q156K-expressing cells was remarkably enhanced compared to wild-type RyR1 and similarly to previously reported levels for R164C-expressing cells, while that of the R534H mutants was not different from wild-type cells. The resting cytosolic Ca2+ concentrations of cell lines expressing Q156K or R164C were much higher than those expressing R534H or wild-type RyR1. These results indicated that the RyR1 gene mutation causing the Q156K phenotype (Q155K in human) is potentially susceptible to MH, and that screening for this mutation could be useful for the noninvasive genetic diagnosis of MH in humans