Biomedical subjects

Kyoichiro Toyoshima

Publications and source records attributed to Kyoichiro Toyoshima.

3 recordsLinked to original sources

PubMed2004

[Potential risk factors aggravating airway allergy--aspects of involvement of airtight housing and passive smoking].

OBJECTIVES: The involvement of tightly insulated housing conditions and passive smoking in atopic sensitization, a major risk factor for airway allergy, was examined with nonsmoking adult women and school-age children. SUBJECTS AND METHODS: The subjects were 382 nonsmoking healthy adult women (housewives) who underwent medical examinations for prevention of adult diseases conducted in a district of Osaka from 1995 to 1997, and 214 elementary school-children 9-12 years old living in an urban district of Osaka who underwent medical examinations at a health center in April, 2000 to prevent allergic diseases. We also examined the correlation between tightly insulated housing conditions and the amount of passive smoking based on family smoking habits with 170 children under 12 years old who had been under the care of a hospital pediatrics department between December, 1993 and May, 1994. A questionnaire was administered to all subjects to survey the housing structure (concrete/wooden housing), family smoking habits and visible mold proliferation in the kitchen in relation to airtight housing conditions, passive smoking and exposure to inhalant allergens. Atopic sensitization was assessed by positivity for serum house dust mite-specific IgE, and passive smoking was defined as a urinary cotinine level of more than 6 ng/mgCr. RESULTS: 1. Among the three factors, indoor mold proliferation and family smoking habits were positively and synergistically related with atopic sensitization to house dust mites. 2. Airtight conditions of concrete housing showed a promotional effect on passive smoking for housewives, but a suppressive effect for school-age children. 3. Taking into account the above results, the promotional effects of passive smoking on atopic sensitization appeared predominantly in the concrete housing-residence group of housewives and the wooden housing-residence group of school-age children. 4. Effects of visible mold proliferation in the kitchen on atopic sensitization appeared predominantly in wooden housing-residence group of housewives. CONCLUSIONS: The results suggest that involvement of the three factors in atopic sensitization is due to increased exposure to indoor inhalant allergens or enhanced IgE-antibody production (adjuvant effects of tobacco smoke) and the extent of their inpact varies depending on the individual life styles of the housewives and school-age children.

Adult↗

PubMed2004

[A strategy for assessing environmental influence on airway allergy using a regression binary tree-based method].

OBJECTIVE: To clarify the living environment factors that increase the risk of allergic sensitization to house dust mites, we applied a regression binary tree-based method (CART, Classification & Regression Trees) to an epidemiological study on airway allergy. The utility of the tree map in personal sanitary guidance for preventing allergic sensitization was examined with respect to feasibility and validity. SUBJECTS AND METHODS: A questionnaire was given to 386 healthy adult women, asking them about their individual living environments. Also, blood samples were collected to measure Dermatophagoides pteronyssinus (Dp)-specific IgE, the presence/absence of Dp-sensitization being expressed as positive/negative. The questionnaire consisted of nine items on (1) home ventilation by keeping windows open, (2) personal or family smoking habits, (3) use of air conditioners in hot weather, (4) type of flooring (tatami/wooden/carpet) in the living room, (5) visible mold proliferation in the kitchen, (6) type of housing (concrete/wooden), (7) residential area (heavy or light traffic area) (8) heating system (use of unventilated combustion appliances), and (9) frequency of cleaning (every day or less often). There also were queries on the past history of airway allergic diseases, such as bronchial asthma and allergic rhinitis. CART and a multivariate logistic regression analysis (MLRA) were performed. The subjects were first classified into two groups, with and without a history of airway allergic diseases (Groups WPH and WOPH). In each group, the involvement of living environment factors in Dp-sensitization was examined using CART and MLRA. RESULTS: In the MLRA study, individual living environment factors showed promotional or suppressive effects on Dp-sensitization with differences between the two groups. With respect to the CART results, the two groups were first split by the factor that had the most significant odds ratio for MLRA. In Group WPH, which had a Dp-sensitization risk of 19.5%, the first split was by the factor of visible mold proliferation in the kitchen into the factor-present group with a risk value of 45.5% and the factor-absent group with 13.5%. The mold proliferation group was split with reference to frequent cleaning, and the risk rose to 75% in the factor-absent group and to 100% when family smoking habits were reported. Group WOPH (the risk: 10.8%) was first split into two groups according to the use of air conditioners in hot weather for more than 6 hours a day or less, which showed risk values of 16.7% and 6.9%, respectively. The risk of the group that intensively used air conditioners fell to 8.3% with tatami as flooring in the living room, and, if others, rose to 20.8%. The risk of the factor-lacking group fell to 4.0% without wooden flooring. CONCLUSIONS: CART analysis enables us to express complex relationships between living environment factors and Dp-sensitization simply by a binary regression tree, pointing to preventive strategies that can be flexibly changed according to the individual living environments of the subjects.

Environment↗

PubMed2002

Video-assisted thoracoscopic bullectomy for spontaneous pneumothorax in a Swyer-James syndrome patient.

We treated a 15-year-old patient with spontaneous pneumothorax associated with Swyer-James syndrome using video-assisted thoracoscopic surgery (VATS). Thoracic computed tomography showed hyperlucent areas in the bilateral lungs. Due to major air leakage continuing for a week, we conducted VATS bullectomy. Because the opposite lung suffered hypoplasia, intermittent bilateral pulmonary ventilation was required to sustain an adequate PaO2 in arterial blood gas analysis during surgery. Because of recurrent pneumothorax, we performed reoperation 10 months later, finding a few newly generated bullae. To the best of our knowledge, this is the first report of VATS used to treat a Swyer-James syndrome patient with pneumothorax.

Adolescent↗