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Identifying bereaved grievers with greatest medical or social service needs in Japan

Family Medicine and Community Health 2022年第1期10卷 1-9页

作者： carl becker Yozo Taniyama Megumi Kondo-Arita Noriko Sasaki Shinya Yamada Kayoko Yamamoto Policy Science Unit School of MedicineKyoto UniversityKyotoJapan Department of Religious Studies Tohoku UniversitySendaiJapan Nakayama International Center Osaka Medical CollegeTakatsukiJapan Department of Healthcare Economics and Quality Management Graduate School of MedicineKyoto UniversityKyotoJapan Department of Ethnology National Museum of Japanese HistorySakuraJapan Department of Nursing Tenri Health Care UniversityTenriJapan

Objective Severe grief adversely affects the health of bereaved families,potentially burdening medical and community health *** for effective community health maintenance must identify the people likely to face severe effects of *** present study identified characteristics of mourners who experience severe grief within a year of bereavement to confirm whether this grief increased their reliance on Japanese medical and social *** We conducted a nationwide postal survey of Japanese bereaved within the previous year,to compare those reporting daily or overwhelming‘heavy’grief to those with less heavy grief,in terms of demographic and socioeconomic details,daily work and non-work activity,frequency of medical and social service ***/participants In 2019,with the support of the Ministry of Education and the All Japan Funeral Co-Operation,we distributed approximately 5500 questionnaires to Japanese who had presided at funerals within the past year for anonymous *** January of 2020,we received 1078 complete voluntary responses from bereaved *** Half of the‘heavy grief’group(n=143)reported adverse effects on health and daily life,including needs for pharmacological,medical or welfare *** of husbands or children were particularly connected to severe grief;‘unexpected’death from cancer caused the greatest ***(even part-time)buffered against severe grief;grief was greater for the unemployed and substantially worse for those who lost significant income at the same time as they lost loved *** These findings suggest that prior counselling should reduce the shock of bereavement and economic loss,which increases subsequent medical *** professionals and community health workers can use the above factors to target in advance the family members in greatest danger of heavy grief,to intervene lest grief adversely affect their physical and psychological health after ber

关键词： service sided return

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Medieval & Renaissance art

Medieval & Renaissance art

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作者： (author..1794-1859 )becker carl (writer of added commentary )Warncke Carsten-Peter (author..1811-1903 )Hefner-Alteneck Jakob Heinrich von

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Last line therapy with sorafenib in colorectal cancer: A retrospective analysis

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World Journal of Gastroenterology 2016年第23期22卷 5400-5405页

作者： Ksenia Martchenko Irene Schmidtmann Thomas Thomaidis Verena Thole Peter R Galle Marc becker Markus Mohler Thomas C Wehler carl C Schimanski Department of Internal Medicine Marienhospital 64285 Darmstadt Germany Institute of Medical Biostatistics Epidemiology and Informatics Johannes Gutenberg University Hospital of Mainz 55131 Mainz Germany First Department of Internal Medicine Johannes Gutenberg University Hospital of Mainz 55131 Mainz Germany Department of Internal Medicine Katholische Kliniken Mainz 55131 Mainz Germany Institute of Pathology Saarland University Medical Center 66421 Homburg Germany Third Department of Internal Medicine Johannes Gutenberg University Hospital of Mainz 55131 Mainz Germany

AIM: To analyze the efficacy of last line sorafenib treatment in colorectal cancer patients. METHODS: All patients receiving chemotherapy for colorectal cancer in the outpatient clinic of the University of Mainz since 2006 were retrospectively analyzed for last line sorafenib exposure. Charts of identified patients were analyzed for clinic-pathological parameters, like data on gender, age, date of initial diagnosis, UICC stage, number and kind of the pretherapies, therapy start and end of sorafenib, sorafenib mediated treatment cessation, side effects, response rates, time to progression and overall survival. RESULTS: Ten patients with a median of 3.0 prior chemotherapy lines had received a last line sorafenib therapy either alone(10%) or in combination with 5-fluorouracil derivates(90%). All patients suffered from colorectal cancer stage UICC 4 and were routinely seen in 2-wk intervals in the oncology outpatient clinic. Median duration of treatment was 142.0 d. At 8 wk 80% of patients showed stable disease but we did not observe any remissions. Median time to progression was 140.5 d(4.7 mo), while median overall survival reached 176.5 d. One patient ceased treatment due to side effects. Reason for treatment stop was bleeding complication in one case and non-specified sorafenib intolerance in another case. Due to the retrospective approach we did not further quantify side ***: This retrospective analysis encourages further investigation of sorafenib in colorectal cancer last line therapy.

关键词： Colorectal cancer Sorafenib Regorafenib Chemotherapy Last line

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Split liver transplantation: a reliable approach to expand donor pool

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Hepatobiliary & Pancreatic Diseases International 2005年第3期4卷 339-344页

作者： Ji-Qi Yan, Thomas becker, Cheng-Hong Peng, Hong-Wei Li and Juergen Klempnauer Department of Surgery, Ruijin Hospital Affiliated to Shanghai Second Medical University, Shanghai 200025, China ( Yan JQ, Peng CH and Li HW) Department of Abdominal and Transplant Surgery, Medical School of Hannover, carl-Neuberg-Str. 1 , 30625 Hannover, Germany Department of Surgery Ruijin Hospital Affiliated to Shanghai Second Medical University Shanghai 200025 China. jiqiyan@***

Orthotopic liver transplantation as a successful treatment of end-stage liver disease is hampered by a persistent lack of cadaveric organs. Split liver transplantation, which was first successfully performed by Medical School of Hannover in 1988, has become a mature surgical technique to expand the donor pool. Between 1993 and 1999, split liver transplantation activities have increased in Europe from 1. 2% to 10. 4% in all performed liver transplantations. Current data have strongly supported that the survival rate of patients after split liver transplantation is not significantly different from that of patients after whole-size orthotopic liver transplantation. The most important step of donor graft selection is surgeon' s observation judged by the experience of individual transplant center. The paper aims to provide the guideline of donor selection, hepatic graft splitting, and recipient management as well. DATA SOURCES: Medical School of Hannover has accumulated plentiful experience of split liver transplantation for more than 10 cases ever since 1998. Besides that, we also reviewed a variety of literatures from other famous European and American centers specialized in this field for many years. RESULTS:According to our experience combined with the view points of others, the donor should meet the following criteria as well: (1) age less than 50 years; (2) hemodynamics stable; (3) ICU less than 5 days; (4) Na less than 170 mmol/L or better if less than 150 mmol/L. In 1996 and 1997, the Hamburg group and the UCLA group separately introduced a breakthrough technique performing split liver transplantation in situ. Evidently, the in situ technique has been limited by prolonged time of donor organ procurement , coordination with other organ procurement teams, and even extra burden on donor hospital. Some groups, therefore, have restored the ex situ or bench splitting technique , and fortunately the transplant outcomes of the ex situ technique are equivalent to those of

关键词： donor liver split transplantation

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Surgical experience in splitting donor liver into left lateral and right extended lobes

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World Journal of Gastroenterology 2005年第27期11卷 4220-4224页

作者： Ji-Qi Yan Thomas becker Michael Neipp Cheng-Hong Peng Rainer Lueck Frank Lehner Hong-Wei Li Juergen Klempnauer Department of Surgery Ruijin Hospital Affiliated to Shanghai Second Medical University Shanghai 200025 China Department of Abdominal and Transplant Surgery Medical School of Hannover Carl-NeubergStr. 1 Hannover 30625 Germany

AIM: To outline the surgical experience with donor liver splitting in split liver ***: From March 1 to September 1 in 2004, 10donor livers were split ex situ into a left lateral lobe (segments Ⅱ and Ⅲ) and a right extended lobe (segments Ⅰ, Ⅳ-Ⅷ) in Medical School of Hannover, and thereafter split liver transplantation was performed successfully in 19 cases. The average age, weight and ICU staying period of the donors were 32.7 years (15-51 years), 64.5 kg (45-75 kg) and 2.4 d (1-8 d) ***: The average weight of the whole graft and the left lateral lobe was 1 322.6 g (956-1 665 g) and 281.8 g (198-373 g) respectively, and the average ratio of left lateral lobe to the whole graft was 0.215 (0.178-0.274).The average graft to recipient weight ratio (GRWR) of the left lateral lobe and the right extended lobe reached 2.44% (1.22-5.41%) and 1.73% (1.31-2.30%) *** average it took approximately 105 min (85-135 min)to split the donor liver. Five donor organs showed anatomic variation including the left hepatic vein variation in two cases, the left hepatic artery variation in two cases and the bile duct variation in one ***: Split liver transplantation has become a mature surgical technique to expand the donor pool with promising results. In the process of graft splitting, close attention needs to be paid to potential anatomic variations,especially to variations of the left hepatic vein, the left hepatic artery, and the bile duct.

关键词：手术治疗肝损伤肝移植并发症圆裂片

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