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Volume 50 (2001 - 200･･･
- Issue 6 Pages 753-
- Issue 5 Pages 683-
- Issue 4 Pages 555-
- Issue 3 Pages 194-
- Issue 2 Pages 79-
- Issue 1 Pages 1-
Volume 50, Issue 2
Displaying 1-10 of 10 articles from this issue
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Michio TAKAMATSU, Makoto TAMURA2001 Volume 50 Issue 2 Pages 79-84
Published: July 20, 2001
Released on J-STAGE: August 11, 2011
JOURNAL FREE ACCESSUsing the method specified in the WHO-MONICA Project, we monitored the incidence of myocardial infarction (MI) in the Saku district. When it comes to the trends over a period of 10 years from 1989, we did not observe significant changes, nor did we witness an increase in the incidence, which is ascribable to the aging of population. The average age of women with MI remained unchanged, whereas there were signs of a slight rise for men. Sudden death is more likely to occur in patients with the severest case of MI, so that community based studies in which the local public health center takes the lead are required to come to grips with the full particulars. In the meantime, there is the need for studies in which whether farm workers are involved is spotlighted, and it would be significant if the trends in MI mortality and morbidity in the farming populace were taken up as a research theme for our Association.View full abstractDownload PDF (807K) -
Nobuyuki HORIUCHI2001 Volume 50 Issue 2 Pages 85-95
Published: July 20, 2001
Released on J-STAGE: August 11, 2011
JOURNAL FREE ACCESSThe incidence of tick bites is not rare in the farming and mountain villages in this country. The bite often makes a swelling as big as a large soybean. After the tick attached to the skin is removed, a small red spot appears at the very site of the bite. Then the red lesion starts expanding distally.
In 1987, we reported seven such cases of erythema migrans (formerly called erythema chronicum migrans) in a paper entitled “Statistics of Ixodid Tick Bitesand Ixodiasis.” Incidentally, Baba et al. came up with a report of a case of Lyme disease which was developed after bites of Ixodes persulcatus in Myoko Heights. This report attracted attention becauseit was the first case ever reported in Japan. Since then, we have continued to investigate the incidence of the tick bites and Lyme disease in this country. The following is a summary of our findings thus far.
Up until 1999, there were a total of 165 cases of ixodiasis, of which 16 were diagnosed as Lyme disease marked by erythema migrans. The year 1994 saw the largest number of victims of tick bites with 18. June was the peak month in which the largest 135 cases was registered. Age-wise, those aged 10 years or under were most proneto tick bites, accounting for 33 cases, followed by those in their 50s with 32 cases. The most common site of the bite was the abdomen with 99 cases. The back and the breast came second with 39 cases each. In 56 cases, the ticks were extracted by physicians; in 94 other cases, the removal was done by picking ticks out of the skin by the victims themselves or their family members; and in seven other cases, the ticks simply dropped off before the victims realized it. The species of ticks identified include Ixodes persulcatus in 56 cases and Ixodes ovatus in 26 cases.
We also report here the results of a questionnaire survey of employees at district forestry offices, a cohort at high risk of tick bites, and measurements of anti-Lyme disease Borrelia antibodies in serum.View full abstractDownload PDF (5232K) -
Shoji KUMAKI, Hideki KURIBAYASHI2001 Volume 50 Issue 2 Pages 96-101
Published: July 20, 2001
Released on J-STAGE: August 11, 2011
JOURNAL FREE ACCESSNonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used agents for backache and various joint pains. We suspected that a continuous administration of NSAIDs might suppress bone formation and/or promote bone loss in patients with low bone mineral density (BMD) because the biosynthesis of prostagrandins is inhibited by these drugs. In this study we surveyed the effect of NSAIDs on the bone metabolism in patients with low BMD by comparing a group with NSAIDs administered every day over a period of 1 year and a control group with NSAIDs only occasionally used.
Dual energy x-ray absorptiometry (DXA) was performed on a total of 272 female at our department from April 1999 to September 1999. As a result, 163 cases were found to have BMD less than 80% of the nation's young adult mean values and considered non-secondary in nature. Out of the 163, we chose 14 cases for the NSAID group, and 51 cases for the control group.
The average age, height and body weight were 73.6 years, 149.1cm and 52.1kg for the NSAID group and 71.7 years, 146.7cm and 48.0kg for the control group. There were no statistical differences in all these items. For the treatment of low BMD, 64.9% of the patients in the NSAID group and 52.9% in the control group had anti-osteoporotic medication. In the NSAID group, the relative changes in BMD between the values of the first measurements and those after a 1-year interval were 2.7% decrease at 2nd lumbar vertebra (L2), 12.4% decrease at 3rd lumbar vertebra (L3), 3.9% decrease at 4th lumbar vertebra (L4) and 4.4% decrease at 2nd-4th lumbar vertebra (L2-4). In the control group these were at each site 2.9% increase, 3.6% increase, 2.3% increase and 2.8% increase, respectively. In the NSAID group, BMD changes at neck, Wards, trochanter and shaft of the femur were 3.6% decrease, 4.6% decrease, 4.2% decrease and 3.9% decrease, respectively in the control group, they were 1.0% decrease, 2.2% increase, 1.6% increase and 0.1% increase, respectively. A comparison between the two groups showed thaf the percent changes in BMD of L3, L2-4, Wards, trochanter and shaft of the femur were statistically significant in the NSAID groups.
The present data suggest that the regular use of NSAIDs enhances bone loss in patients with low bone density detected by DXA examination.View full abstractDownload PDF (2353K) -
Tomio KAMETANI, Hideo KOSHIDA, Kiyomori HASHIZUME, Kazuhiko SHIBATA, K ...2001 Volume 50 Issue 2 Pages 102-107
Published: July 20, 2001
Released on J-STAGE: August 11, 2011
JOURNAL FREE ACCESSThe self-monitoring of blood glucose is a recommendable method for control of diabetes mellitus. But few reports of the prospective insulin sliding scale for outpatients were available in Japan. To elucidate the efficacy of the prospective insulin sliding scale for outpatients with diabetes mellitus, 14 insulin-treated patients who usedwith the prospective insulin sliding scale (scale group) and 14 insulin-treated patients who did not use with the prospective insulin sliding scale (control group) were studied over a period of 6 months.
The control group showed no significant change of Hb Aic level. But the scale group showed a significant reduction in Hb Aic level at 5 months (8.37 ± 1.14% to 7.50 ±1.42%, p<0.008). The scale group had an almost two fold increase in the frequency in hypoglycemia. However, there was no severe hypoglycamia. There were weight gains in the control group and scale group, but there was no difference between control group and scale group.
These data suggest that the prospective insulin sliding scale is useful for the better control of diabetes mellitus.View full abstractDownload PDF (658K) -
Gen KURAMOCHI2001 Volume 50 Issue 2 Pages 108-113
Published: July 20, 2001
Released on J-STAGE: August 11, 2011
JOURNAL FREE ACCESSIt is known that the cerebral circulation is regulated spontaneously and always keep blood flow constant despite changes in perfusion pressure. This phenomenon has been called the autoregulation of cerebral blood flow. However, there is still considerable controversy regarding the influence of blood viscosity upon cerebral blood flow. Several studies have reported that in hemodialysis patients, the velocity of middle cerebra artery (MCA) blood flow decreased after hemodialysis, resulting from the decrease in body fluid and the increase in blood viscosity. In the present study, we evaluated changes in MCA blood flow velocity by hemodialysis in the patients with end-stage re -nal disease referred for hemodialysis due to chronic glomerulonephritis (CGN group) and diabetic nephropathy (DN group). No stenoses of the carotid artery were comfi rmed by ultrasonography in all subjects. We measured MCA blood flow velocity before and after hemodialysis using a 2-MHz pulsed-wave transcranial Doppler instrument with on-line spectrum analysis. Additionally, the measurements of mean blood pressure, body weight, hematocrit levels and arterial blood gas were made simultaneously. In the CGN and DN groups, mean MCA blood flow velocity was 52-56cm/sec and 49-53 cm/sec before hemodialysis and 51-53cm/sec and 51-53cm/sec after hemodialysis, respectively. No significant decreases in MCA blood flow velocity after hemodialysis were found in both groups, though body weight in both groups and mean blood pressure in the DN group alone decreased while pH, HCO3-, and Ht levels in both groups increased significantly. PCO2 and pO2 levels remained unchanged. Also, no significant differences were found between both groups in the changes in MCA blood flow velocity. Pulsatility and resistive indices in the DN group were relatively higher than those in the CGN group. This result suggests the more progression of arteriosclerotic changes in MCA in the DN group compared with those in the CGN group.View full abstractDownload PDF (816K) -
Yoshito MOMOSE, Hiroshi UNE2001 Volume 50 Issue 2 Pages 114-124
Published: July 20, 2001
Released on J-STAGE: August 11, 2011
JOURNAL FREE ACCESSBackground: Behavior modification approaches involve various strategies of cognitive therapy. There is increasing interest in adopting such approaches in order to achieve more modest and sustainable weight control and also prevent the prevalence of hypercholesterolemia.
Objective: To better understand the risk factors associated with the development of hypercholesterolemia, we examined the relationship between changes in eating behavior based on cognitive therapy and serum low density lipoprotein cholesterol (LDLC) levels. In addition, the outlook for such individuals, lifestyle improvement was also examined based on a behavior modification approach.
Research methods: Data were obtained during regular medical checkups in 1999 from subjects. They consistied of 611 males and females ranging from 40 to 65 years of age in Kyushu, Japan. A co-variance analysis was performed to examine the independent relationship between eating behavior and the LDL-C levels.
Results: “Overeating” when not related to cognitive restraint showed a considerably strong correlation with the LDL-C levels among male subjects. In contrast, both “unplanned eating” and “pessimistic thoughts concerning dieting” were strongly associated with the LDL-C levels among female subjects. Regarding lifestyle improvement, the need to lose weight and exercise was accepted by 40-50% of the subjects.
Discussion: Male subjects need to better recognize their overeating behavior: for example, they need to understand the influence of advertising for many high-calorie fast foods. In addition, they should limit their intake of high-calorie foods and try to only eat at regular meal times. Female subjects should prepare only as much food as will be eaten at one meal. Moreover, female subjects also need to modify their pessimistic thoughts concerning dieting: for example, if they become fat, they often do not try to improve their eating habits because they assume that getting fat is unavoidable because of their innate constitution. These features of cognitive eating behavior provide both barriers and opportunities for changing LDL-C levels. Accordingly, future research needs to focus on the relationship between such cognitive behavior and the LDL-C levels.View full abstractDownload PDF (1265K) -
Toshikazu MATSUNO, Akihiro OTA, Takako SUGITA, Yuichi OZEKI, Takehiro ...2001 Volume 50 Issue 2 Pages 125-129
Published: July 20, 2001
Released on J-STAGE: August 11, 2011
JOURNAL FREE ACCESSMagnetic resonance imaging (MRI) for diagnostic evaluation of the breast was performed in 61 patients who visted the Breast Clinic of our hospital and were suspected to have malignant tumors by physical examination and mammography between January and December 1999. In 58 patients undergoing histological diagnostic tests (8 with benignancy and 50 with breast cancer), we compared the imaging characteristics and the time-signal intensity curves acquired by dynamic imaging between benign and malignant lesions, and evaluated the usefulness of analyzing enhancement patterns on contrast MRI. Contrast MRI revealed strong tumor enhancement in all patients; the mean time required for the signal intensity to reach a peak was about 7 min in patients with benign tumors and about 2 min in those with breast cancer. Peripheral ring enhancement was observed in 40 of the 50 patients with breast cancer (80.0%), while such enhancement was not noted in any of the patients with benign tumors.
Although diagnosis of breast disease by imaging has primarily relied on mammography and ultrasonography, the pattern of contrast enhancement on dynamic MRI also appears to be useful for determining the treatment method of breast tumors.View full abstractDownload PDF (7990K) -
Yoshihiro OKABAYASHI, Akiyoshi OTA, Hideho HAGA, Yayoi NAKANISHI2001 Volume 50 Issue 2 Pages 130-137
Published: July 20, 2001
Released on J-STAGE: August 11, 2011
JOURNAL FREE ACCESSThe bone density of os calcis were measured with ultrasonic bone densitometry in 6, 680 healthy rural women in Mie Prefecture. Serum BGP and B-ALP levels were measured in 350 and 450 randomly selected cases respectively. The relations between their titers and bone loss with advancing age were also assessed. The BGP and B-ALP values began to rise in those subjects aged around 45 years. The elevated levels seemed to be kept till they became 70 years old. In this period, they might have massive bone loss with a high bone turnover, if they did not have an adequate calcium intake and exercise.
During this longitudinal observation, we measured bone density in 795 women 1, 062 times over a period of five years, with the initial bone mass value set at 100% and all the subsequent values expressed as a percentage of the initial value. Its value increased for about 106% and decreased from 95 to 91% in five years. By age, its numbers increased for 30% to 40% for those in their 40s and 60s, respectively. Overall, the decreases were significant (p<0.05) but the increases were not significant. In the low bone density group with the initial values below 59, only 21 cases of the total 91 had increased values thereafter, but 78% of them had kept the initial values, so they were advised to use caution against bone fracture in daily life and suitable treatments were recommended.
Many factors are associated with osteporosis. Presumably, lifestyle improvements alone would not serve to prevent its outbreak, but the authors believe that the findings of this study may cast light on the issue of osteoporosis for Japan, whose population is rapidly aging.View full abstractDownload PDF (1031K) -
Koh KANEDA2001 Volume 50 Issue 2 Pages 138-142
Published: July 20, 2001
Released on J-STAGE: August 11, 2011
JOURNAL FREE ACCESSCase 1: The patient, a 73-year-old male with early hypopharyngeal cancer, underwent endoscopic mucosal resection (EMR) under general anesthesia. Coming out from under the anesthetic, the patient was extubated in the operating room. Then, he suddenly developed severe inspiratory stridor, followed by tachypnea, and began to complain strongly of dyspnea. Case 2: The patient, a 67-year-old male with early hypopharyngeal cancer, underwent EMR under general anesthesia. Immediately after extubation following successful surgery, the patient developed respiratory distress with vigorous inspiratory efforts. Because severe laryngo-pharyngeal edema was found in both cases, these tracheae were orally re-intubated under direct laryngoscopy. Both patients were transferred to the intensive care unit (ICU). In case 2, chest X-rays immediately after re-intubation revealed bilateral diffuse alveolar infiltration. The diagnosis was interstitial pulmonary edema. The lung edema was considered to be induced by strong inspiratory efforts. The patient required mechanical ventilatory support in ICU for several days. It was strongly recommended that the entire laryngo-pharyngeal space be examined at the completion of hypopharyngeal endoscopic mucosectomy before extubation. If any signs of laryngo-pharyngeal edema exist, the endotracheal tube was to be left in place and the patient carefully observed in the ICU until the next morning.View full abstractDownload PDF (6133K) -
2001 Volume 50 Issue 2 Pages 143-146
Published: July 20, 2001
Released on J-STAGE: August 11, 2011
JOURNAL FREE ACCESSDownload PDF (527K)
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