JOURNAL OF THE JAPANESE ASSOCIATION OF RURAL MEDICINE

Show abstractHide abstract

Obesity is a major risk factor for lifestyle-related diseases and its prevention is essential in terms of public health. Body weight is influenced by a genetic predisposition as well as food intake, and exercise. In about 30% of the Japanese, a specific mutation [codon 64 TGG (Trp) →CGG (Arg)] of β3-adrenergic receptor gene is observed. The basal metabolic rate is about 200 kcal/day lower in the individuals with this type of mutation than in those without. We conducted a weight loss program which included analysis of β3-adrenergic receptor gene polymorphism, monitoring of eating behavior, and promotion for lifestyle modifications by public health nurses. The subjects for analyses were 39 Japanese men (mean age 37.8±8.6 years) and six Japanese women (46.8±6.4 years), with body mass index (BMI) over 24. They had not been receiving medical treatment for lifestyle-related diseases. The ratio of the normal group (no mutation at the specific site of β3-adrenergic receptor gene) to the mutation group were 73% to 27%. After we explained the results of the genetic testing to the participants, public health nurses encouraged them to change their lifestyle and provided dietary guidance. After 3 and 8 months intervention, reductions in BMI were observed 75% and 57% of the subjects in the normal group, and 92% and 67% of the subjects in the mutation group, respectively. At any time point, the changes were not statistically significant between the normal and mutation groups. Behavior modification was observed 49% of the subjects in the normal group and 75% in the mutation group. More than 80% of the participants were of the opinion that the genetic testing had been useful for them to reconsider their health status.

View full abstract

Download PDF (405K)

Mamushi is a species of pit viper distributed throughout Japan excluling the Ryukyu Islands and sighted from spring to autumn. It is estimated that about ten people dies in a year. It is important in the rural medicine because a lot of people are bitten in mountains and fields. A total of 35 cases of mamushi viper bite were treated from 1999 to 2006 in our hospital. The patients were 17 men and 18 women ranging in age from 7 to 80 years old (average: 60). Local swelling and pain were manifest in all the cases. Sixteen patients had systemic symptoms, and toxic effects commonly appeared in the eyes. The blood tests revealed elevated CPK levels in 24 patients (69%). The elevation correlated to the seriousness of the clinical symptoms. In accordance with our manual for mamushi viper bites, all patients were hospitalized after incision for exclusion of the toxin. The median length of time before the worst symptoms began to subside was 3 days. The median length of hospitalization stays was 7 days. It took long before the patients fully recovered. The severity of envenomation was different from patient to patient and one case needed intensive care. The median of treatment period was 31 days. The quick and appropriate primary care for the mamushi viper bits is important to prevent serious complications.

View full abstract

Register with J-STAGE for free!