Correlation of fasting blood glucose and haemoglobin A1c measured with an automated analyser

A subtype of glycohaemoglobin, haemoglobin (Hb) A1c, in specimens of whole blood was assayed on a new automated analyser that makes use of high-pressure liquid chromatography. The analyser provided precise and reproducible values. The mean of the HbA1c values was lower than that with an older instrument. The mean tended to increase with the age of the subjects, who were undergoing routine health examinations. No sex difference was found. When measurement was made 1 h after the subjects drank 50g of glucose, the value of HbA1c was unaffected. Correlation was strong between the HbA1c value and the fasting blood glucose value, which suggested that fasting blood glucose could be estimated from the HbA1c value

Effects of the increase in co-payments from 20 to 30 percent on the compliance rate of patients with hypertension or diabetes mellitus in the Employed Health Insurance System

Objectives: How to contain medical expenditures is a universal problem. The Japanese government has increased patient co-payments to control it. The purpose of this study is to clarify whether the increase in co-payments to 30 percent prevented patients with hypertension or diabetes mellitus from receiving necessary care in the Employee Health Insurance System. Methods: The subjects were 211 patients with hypertension and 66 patients with diabetes mellitus who regularly visited physicians from October 2001 to March 2002 and were defined as a cohort that needed health care, and their medical indicators were examined between April and September 2002 (prestage) and between April and September 2003 (poststage). Results: In the hypertensive patients with no complications, the compliance rate was 89.9 percent and 88.0 percent in the prestage, and poststage, respectively, showing no significant change. In the hypertensive patients with complications, the compliance rate was 90.5 percent and 92.1 percent in the prestage and poststage, respectively, showing no significant change. In the diabetic patients with complications, the compliance rate was 77.5 percent and 79.2 percent, in the prestage and poststage, respectively, with no significant change. In the diabetic patients with no complications, however, the compliance rate was 83.7 percent and 66.7 percent, in the prestage and poststage, respectively. A significant decrease was observed among diabetic patients without complications. Conclusions: Increasing co-payments reduced necessary preventive care in diabetic patients without complications.</p

Effects of an increase in patient copayments on medical service demands of the insured in japan

Objectives:To examine quantitatively the effects of an increase in patient copayments from 10% to 20% on the demand for medical services in Japan. Methods: The subjects of the study were the employees insured by the 1,797 health insurance societies, belonging to the National Federation of Health Insurance Societies, in 1996 and 1998. Indicators of medical service demands analyzed include the inpatient, outpatient, and dental case rates, the number of serviced days per case, the medical cost per day and the medical cost per insured. Results: When the effects of an increase in patient copayments from 10% to 20% were evaluated, taking into account the average age, the average monthly salary, the total number, the gender (male-tofemale) ratio and the dependent ratio of the insured, the estimated change in the case rate was &#8722;6.96% for inpatient, &#8722;4.79% for outpatient, and &#8722;5.77% for dental care. The estimated change in the number of serviced day per case was &#8722;4.66% for inpatient, &#8722;5.67% for outpatient, and &#8722;1.82% for dental care. The estimated change in the medical cost per day was &#8722;3.15% for inpatient, &#8722;13.00% for outpatient, and &#8722;11.48% for dental care. The estimated change in the medical cost per insured was &#8722;14.08% for inpatient, &#8722;21.54% for outpatient, and &#8722;18.11% for dental care. Conclusions: The increase in patient copayments from 10% to 20% enabled insurers to substantially reduce medical costs by cost shifting from the insurer to the insured, with resultant changes in the case rate and the number of service days per case.</p

Effects of a self-management program on antiemetic-induced constipation during chemotherapy among breast cancer patients: a randomized controlled clinical trial.

Research on patient-reported outcomes indicates that constipation is a common adverse effect of chemotherapy, and the use of 5-hydroxytryptamine (serotonin; 5HT3) receptor antagonists aggravates this condition. As cancer patients take multiple drugs as a part of their clinical management, a non-pharmacological self-management (SM) of constipation would be recommended. We aimed to evaluate the effectiveness of a SM program on antiemetic-induced constipation in cancer patients. Thirty patients with breast cancer, receiving 5HT3 receptor antagonists to prevent emesis during chemotherapy were randomly assigned to the intervention or control group. The SM program consisted of abdominal massage, abdominal muscle stretching, and education on proper defecation position. The intervention group started the program before the first chemotherapy cycle, whereas patients in the wait-list control group received the program on the day before their second chemotherapy cycle. The primary outcome was constipation severity, assessed by the constipation assessment scale (CAS, sum of eight components). The secondary outcome included each CAS component (0-2 points) and mood states. A self-reported assessment of satisfaction with the program was performed. The program produced a statistically and clinically significant alleviation of constipation severity (mean difference in CAS, -3.00; P = 0.02), decrease in the likelihood of a small volume of stool (P = 0.03), and decrease in depression and dejection (P = 0.02). With regards to program satisfaction, 43.6 and 26.4 % patients rated the program as excellent and good, respectively. Our SM program is effective for mitigating the symptoms of antiemetic-induced constipation during chemotherapy

Cytochemical studies of the hemoglobin synthesis of erythroblasts

The process of hemoglobin sythesis in erythroid cells have been traced mainly by observing cells under the light of 4,060 &#197;. To scrutinize the theory of hemoglobin synthesis in the nucleus of erythroblasts, several cytochemical and morphological observations were also carried out. The conclusions derived from them are as follows: 1 The absorption at 4,060 &#197; of the cell, which indicates the location of heme, appeared in the nucleus as early as in the develpmental stage of basophilic erythroblasts. The absorption of hcme in cytoplasm likewise appeared in this stage showing nearly the same intensity of the absorption. The absorption picture of heme in the nucleus, which is coincidental with that of interchromatin, increased along with the progess of maturation as well as in the cytoplasm. The absorption in the nucleus disappeared at the orthochromatic stage where the picture of interchromatin disappeared, while the intensity of absorption in the cytoplasm continued to increase till the stage of reticulocyte. 2 The pseudoperoxidase reaction of hemoglobin, the appearance of acidophlic protein and masked lipids detectable in the location of hemoglobin gave an exactly identical picture with that of the absorption of heme in the nucleus as well as in the cytoplasm. 3 Permeability test performed by supravital staining with Nile blue revealed that the nucleus of erythroblasts from the basophilic to the orthorchromatic stages has increased its permeability being stained selectively as in the case of dead cells. 4 The mitochondria and the endoplasmic reticulum proved to be retained well in the entire course of hemoglobin synthesis, even after the denucleation, the reticulocyte stage. From these observations the authors believe that the hemoglobin syntheis will take place in the cytoplasm throughout the life cycle of erythroid cells, pointing out that the absorption picturebf heme appearing in the nucleus will be in all likelihood due to the infusion of the hemoglobin from the cytoplasm.</p

p59fyn is associated with the development of hepatic steatosis due to chronic ethanol consumption

p59fyn, a protein tyrosine kinase belonging to the src-family, is involved in the regulatory mechanism of acute response to ethanol in the central nervous system. A previous report showed an association between src-family kinase activity and fatty acid oxidation, and it also reported that hepatic free fatty acid levels were low in Fyn−/− mice. We examined, using Fyn−/− mice whether Fyn is also involved in fatty acid metabolism and the development of pathological changes in the liver in response to chronic ethanol consumption. C57BL/6J Fyn−/− and Fyn+/+ mice were fed for 8 weeks with either a liquid diet comprising ethanol or one in which the calories from ethanol were replaced with carbohydrates. Chronic ethanol consumption for 8 weeks resulted in remarkable hepatic steatosis in Fyn+/+ mice but not in Fyn−/− mice. Chronic ethanol consumption induced a significant decrease in hepatic FFA and triglyceride levels in Fyn−/− mice. Levels of interleukin-6, which is associated with the enhancement of fatty acid oxidation, was also increased significantly in the livers of ethanol-fed Fyn−/− mice. The results suggest that Fyn is involved in the enhancement of fatty acid oxidation and the development of hepatic steatosis caused by chronic ethanol consumption

Synthesis of a Stimulus-responsive Processing Device and Its Application to a Nucleocytoplasmic Shuttle Peptide

Stimulus-responsive processing (peptide bond cleavage) devices were developed. The processing reaction was triggered by stimulus-induced removal of a PG and the processing products were obtained in good purity. A photo-responsive processing device was successfully applied to develop a nucleocytoplasmic shuttle peptide. (F: fluorophore, NES: nuclear export signal. NLS: nuclear localization signal. PG: stimulusresponsive protective group