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Biomedical subjects

M Kiyama

Publications and source records attributed to M Kiyama.

At least 37 records · Page 2Linked to original sources
PubMed1998

[Characteristics and outcome of stroke patients discharged from hospitals in an urban area of Japan].

The purpose of this study was to obtain the overall characteristics and outcome in stroke patients in an urban area of Japan, in order to develop some strategies for a community-based care system for improvement of the prognosis and activities of daily life in stroke patients. The present study, based on 4 hospitals in Yao city in Osaka, showed results as follows: 1) The number of stroke patients discharged from 4 hospitals during a recent one year period was 377 (216 men and 161 women). 2) The proportion of patients who died was 27%. Of the living patients, the proportions of patients who had motor paralysis or speech disturbance at discharge were 54% and 27%, respectively. 3) The proportion of patients who were to return to their home was 77% for all living patients. The proportion of patients who were not able to walk by themselves, or needed assistance in at least one of the activities of daily life was 31% and 28%, respectively, for all living patients who were to return to their home. This study showed that stroke registry from major hospitals in an urban area is useful for obtaining the overall characteristics of stroke patients in the area and promote community-wide programs in the prevention and home care of stroke.

Activities of Daily Living↗
PubMed1997

Reduction of insulin resistance attenuates the development of hypertension in sucrose-fed SHR.

We examined the effect of pioglitazone, a thiazolidinedione derivative that increases insulin sensitivity without increasing insulin secretion, on the development and maintenance of hypertension in sucrose-fed SHR. Nine-week-old male SHR received 12% sucrose dissolved in tap water as drinking water. For 5 weeks, half of the rats were given regular rat chow, and the rest were fed with rat chow containing 0.03% pioglitazone. In week 6, blood glucose and plasma insulin levels were examined before and after oral glucose administration by gavage. Sucrose treatment elicited a significant elevation of systolic blood pressure 3 weeks after the beginning of treatment; pioglitazone treatment attenuated this elevation. The insulin resistance and hyperinsulinemia observed in sucrose-fed SHR were prevented by pioglitazone treatment. Pioglitazone treatment also significantly reduced the urinary excretion of catecholamines and plasma renin activity, both of which were significantly greater in sucrose-fed SHR than in control SHR. Along with improving insulin sensitivity, pioglitazone treatment also attenuated the development of hypertension in SHR fed the regular rat chow, but not in WKY rats. These results indicate that insulin resistance and hyperinsulinemia play an important role in the development of hypertension in SHR probably through the activation of the renin-angiotensin system and sympathetic nervous outflow. This study also shows that chronic sucrose treatment exacerbated the development of hypertension through these mechanisms, precipitating insulin resistance.

Animals↗
PubMed1997

[Trends for left ventricular echocardiographic findings and their related factors--a ten-year follow-up study in rural and urban Japanese populations].

There has been a substantial decline in physical activity in Japan due to mechanization and motorization, and also a decline in blood pressure levels. These trends are more evident in rural populations than in urban. The potential effects of these changes on left ventricular echocardiographic findings were studied among Akita men (rural area) and Osaka men (urban area). Results of a ten-year follow-up study performed between 1975-85 and 1988-1994 on 296 men aged 30-65 without antihypertensive medication use at base line were as follows: Among Akita men, left ventricular diastolic dimension did not change but mean wall thickness decreased, resulting in a decline in mean left ventricular mass. Among Osaka men, there was a small increase in mean left ventricular diastolic dimension, but no significant changes in either mean wall thickness or mean left ventricular mass. A decline in mean wall thickness and mean left ventricular mass among Akita men was primarily observed in men who were involved in heavy manual work at baseline. Among Osaka men, mean wall thickness or mean left ventricular mass did not change in either men involved in heavy manual work or men not involved. Among Akita men, decline in mean wall thickness and mean left ventricular mass was seen in both hypertensives and normotensives. Among Osaka men, mean wall thickness or mean left ventricular mass did not change in either subgroup. According to multiple regression analysis controlling for age, body mass index, alcohol intake, and diastolic blood pressure, heavy manual work was significantly associated with ventricular mass among Akita men in 1975-85, but no more significant in 1988-94, while heavy manual work was not related to left ventricular mass among Osaka men in either time period. These results indicate that a decline in physical activity caused a decline in mean wall thickness and mean left ventricular mass among Akita men.

Adult↗
PubMed1996

Detection of Actinomyces species using nonradioactive riboprobes coupled with polymerase chain reaction.

We have been focusing our attention on the detection and identification of oral bacteria which are frequently associated with periodontal disease. In previous studies, Actinomyces species-specific riboprobes were generated and used to identify this microorganism. However, problems lie in the low sensitivity of this method. We have developed a novel system for the detection of Actinomyces species using nonradioactive riboprobes coupled with polymerase chain reaction (PCR) in this study. This system employs two procedures; initially, DNA fragments specific for the target microorganism are amplified by PCR, and these specific fragments are further hybridized with nonradioactive riboprobes. PCR analysis using chromosomal DNA isolated from Actinomyces species including laboratory strains, clinical isolates, and Actinomyces naeslundii (ATCC 12104) indicated the presence of the predicted common 756-bp fragment, a portion of the sialidase gene. These amplified DNA fragments were effectively visualized by hybridization with the digoxigenin-labeled riboprobes corresponding to the internal region of the amplified sialidase gene. With this system, approximately three orders of magnitude less chromosomal DNA was sufficient for the detection of specific microorganisms compared to the conventional riboprobe systems.

Actinomyces↗
PubMed1996

Plasma fibrinogen and its correlates in urban Japanese men.

BACKGROUND: The intention of the study was to examine determinants of plasma fibrinogen concentrations in Japanese men. METHODS: A cross-sectional study was conducted in 1991 among 995 male employees aged 40-59 years in two urban companies. RESULTS: The overall mean value (standard deviation) of plasma fibrinogen concentration was 257 (57) mg/dl. There was a strong dose-response relationship between cigarette smoking and plasma fibrinogen concentration. Plasma fibrinogen was positively associated with age and serum total cholesterol, and inversely associated with ethanol intake, dietary intake of sea foods such as squid, octopus or shrimp. Intake of other major protein and lipid resources such as meat, eggs and milk, or intake of vegetables was not related to plasma fibrinogen. An effect of dietary intake of sea foods on plasma fibrinogen was small but significant after controlling for the other covariates; an 80 g/week larger intake of sea foods was associated with a 3.9 mg/dl (95% confidence interval: 0.5, 7.3) lower fibrinogen concentration. CONCLUSIONS: This study confirms the relation of known coronary risk factors to plasma fibrinogen in Japanese men, and suggests that dietary intake of sea foods affects plasma fibrinogen concentrations.

Adult↗
PubMed1996

High-throughput asymmetric-PCR SSCP analysis using well-controlled temperature conditions.

Single-stranded conformational polymorphism (SSCP) analysis is useful for mutation detection and polymorphism identification. To realize high-throughput SSCP analysis using a high-intensity electric field, the gel temperature must be well-controlled. We have developed an electrophoretic system having a pair of glass plates with an efficient temperature-controlling apparatus on each side of the gel. The gel temperature is controlled by estimating the temperature difference between the gel and the glass plates, based on a heat-transfer model. Distinctive patterns of asymmetric-PCR SSCP gel electrophoresis were obtained with this system. The patterns showed high reproducibility for an electric field ranging from 40 V/cm to 160 V/cm, as long as the same gel temperature was used. Electric-field strength had little effect on the SSCP patterns. Use of the highest electric field reduced the run time to about 100 min.

HLA-DQ Antigens↗
PubMed1996

A case-reference study on plasma fibrinogen concentrations and coronary atherosclerosis in Japanese.

To examine contribution of plasma fibrinogen concentrations to coronary atherosclerosis in Japanese, a cross-sectional study was conducted from 1991 to 1993 for 169 myocardial infarction cases and 1 : 1 matched references. All cases had one to three coronary vessels with 50 percent or more stenosis. References were chosen out of Osaka residents who had no cardiac event by matching sex and age ((+)-3 years) with cases. Mean (SD) values of plasma fibrinogen concentration were 322 (81) mg/dl in men and 377 (77) mg/dl in women for cases, and were 282 (56) mg/dl in men and 277 (48) mg/dl in women for references; mean plasma fibrinogen was significantly higher in cases than in references for both men and women. Furthermore, mean plasma fibrinogen was progressively higher as the number of stenotic vessels increased for men, and similar trend was seen for women. The case-reference difference remained significant even after adjusting smoking status, hypertension, serum total cholesterol, serum HDL cholesterol. Although plasma fibrinogen concentration was reported lower in Japanese than in American Caucasians, plasma fibrinogen is suggested to be a risk factor for myocardial infarction among Japanese as so among Caucasians.

Adult↗
PubMed1996

[The relation of alcohol intake to constitutional and biochemical variables in Japanese populations].

To investigate associations of alcohol intake to constitutional and biochemical variables, cross-sectional studies of men aged 40-59 years from six geographical and occupational populations with varied lifestyles were conducted in the 1990's. Systolic and diastolic blood pressures, glutamic oxaloacetic transaminase, gamma glutamyl transpeptidase, HDL-cholesterol, and uric acid were linearly associated with alcohol intake in all six populations. Drinkers of 2+ drinks (46 g ethanol or more) per day showed higher levels of triglyceride, glutamic pyruvic transaminase than never-drinkers. In two urban occupational populations, men who mainly drank beer had higher uric acid levels; men mainly drinking sake had higher blood pressures and lower serum total cholesterol; men mainly drinking whiskey had higher obesity indices. These differences in constitutional and biochemical variables related to type of alcoholic beverage consumed may be due to differences in lifestyles such as diet and physical activity.

Adult↗
PubMed1995

Alcohol intake and the risk of cardiovascular disease in middle-aged Japanese men.

BACKGROUND AND PURPOSE: Understanding the effects of alcohol intake on stroke and other cardiovascular diseases is an important issue for public health. METHODS: A 10.5-year prospective study of the relationship between alcohol intake and cardiovascular disease incidence was conducted in 2890 men, aged 40 to 69 years and free of a history of stroke and coronary heart disease, in three rural communities of Japan. RESULTS: One hundred seventy-eight strokes (40 intracerebral hemorrhages, 18 subarachnoid hemorrhages, 104 nonhemorrhagic strokes, and 16 unclassified strokes), 34 coronary heart disease events, and 19 sudden unclassified deaths occurred. Drinkers of > or = 70 g/d ethanol had an approximately 2.5 times higher age-adjusted risk of all stroke than never-drinkers; the excess risk was more evident for hemorrhagic stroke than nonhemorrhagic stroke. When hypertension category, serum total cholesterol level, cigarette smoking, and diabetes mellitus were taken into account, these excess risks were reduced but remained significant for all stroke (2.0; 95% confidence interval, 1.3 to 3.1) and hemorrhagic stroke (3.4; 95% confidence interval, 1.2 to 9.2). A J-shaped relationship was suggested between alcohol intake and risk of nonhemorrhagic stroke; drinkers of < 42 g/d ethanol had a slightly lower risk and heavy drinkers had a higher risk than never-drinkers. Current drinkers had a slightly lower risk of coronary heart disease than never-drinkers, although the risk difference was not statistically significant. The age-adjusted risk of sudden death was 10 times higher in heavy drinkers than never-drinkers, and the excess risk did not change when the covariates were controlled for. Total cardiovascular disease showed a similar pattern as did all stroke. CONCLUSIONS: Heavy drinking appeared to increase the risk of hemorrhagic stroke, in part due to hypertension, and to increase the risk of sudden death, which was probably due to drinking per se. Light or moderate alcohol consumption seemed to protect against nonhemorrhagic stroke and coronary heart disease.

Age Factors↗
PubMed1995

Spontaneous dissection in the common carotid artery--case report.

A 60-year-old female presented with a very rare spontaneous dissection in the common carotid artery manifesting as disturbance of consciousness and left dense hemiparesis immediately after swimming. Cerebral angiography showed complete obstruction of the right common carotid artery. Endarterectomy was performed to remove the subintimal thrombus and dissected intima. Blood flow was re-established 4 hours after onset of symptoms. Her disturbance of consciousness was resolved and left dense hemiparesis disappeared completely 12 hours after onset.

Aortic Dissection↗
PubMed1995

[Characteristics of participants in community-based rehabilitation programs and their levels of independence in activities of daily living].

To clarify characteristics of participants in community-based rehabilitation programs provided by local municipalities (cities, towns, and villages) and effect of the program on their levels of independence in activities of daily living (ADL), a cross-sectional study was performed on 422 participants in 49 municipalities in Kochi Prefecture. 1. Mean age of participants was 68.3 +/- 9.0, and 77.7% of them were stroke patients. 2. The mean interval between disease onset and program participation was 40.4 months, and the mean duration of program participation was 54.5 months. 3. At the start of rehabilitation programs and at the time of the investigation (December 1993), about 90% of the participants had good levels of independence in ADL (Rank A and over according to the standard of the Ministry of Health and Welfare). 4. The frequency of rehabilitation programs and the presence of occupational therapists were positively associated with the improvement of levels of independence in ADL. In particular, the frequency of rehabilitation programs was associated with improvement of quality of life in self-supporting participants (Rank J2), and the presence of occupational therapists was associated with the improvement of ADL in semi-bed-ridden participants (Rank A). 5. After adjusting for age and sex, using multiple logistic regression analysis, type of diseases (non-stroke), hospital rehabilitation immediately after onset, higher levels of independence in ADL at the start of rehabilitation programs, and higher frequency of rehabilitation programs were significantly associated with improvements in levels of independence in ADL. Shorter interval between disease onset and program participation, and the presence of occupational therapists were also associated with improvements in levels of independence in ADL, although the relation did not reach statistical significance.

Activities of Daily Living↗
PubMed1994

Serum total cholesterol and mortality in a Japanese population.

Although the relation between serum total cholesterol and coronary heart disease is well established, the relation with mortality from non-coronary disease is controversial. Inverse relations of serum cholesterol with hemorrhagic stroke and cancer have stimulated the examination of cholesterol-non-coronary mortality associations. The population surveyed is 12,187 men and women aged 40-69 years living in Yao City, a suburb of Osaka, who undertook baseline examinations between 1975 and 1984 and had no history of stroke and coronary heart disease at baseline. The subjects were followed on average 8.9 years until the end of 1988 using systematic mortality surveillance. During the follow-up, there were 343 deaths, comprising 170 cancer deaths (International Classification of Death 9th edition: ICD-9, 140-239), 21 coronary heart disease deaths (ICD-9, 410-414), 67 other cardiovascular deaths (ICD-9, 390-458 excluding 410-414), and 85 non-cardiovascular, non-cancer deaths. There was a significant inverse association of serum cholesterol with total and cancer mortality for men, and no significant association for women. The cholesterol-disease association, although not significant, was positive for coronary heart disease and other cardiovascular disease deaths, and inverse for non-cardiovascular, non-cancer deaths in both sexes. The inverse association of serum cholesterol with total and cancer mortality for men remained significant after controlling for age, job classification, hypertension category, usual alcohol intake, cigarette smoking, and relative weight index.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Left ventricular mass and subsequent blood pressure changes among middle-aged men in rural and urban Japanese populations.

BACKGROUND: It has been suggested that echocardiographically determined left ventricular mass (LVM) is useful in the prediction of hypertension. To examine the relation between LVM and subsequent blood pressure (BP) change, a 6- to 8-year follow-up was conducted in adult Japanese men. METHODS AND RESULTS: LVM was determined by M-mode echocardiography using the American Society of Echocardiography formula among 354 normotensive men aged 30 to 59 years from a rural community (n = 193) and from urban companies (n = 161) in Japan between 1979 and 1983. BP was remeasured 6 to 8 years after baseline in 148 rural men (77%) and 127 urban men (79%). For men whose BP was remeasured, the mean +/- SD LVM index (LVM/body surface area [g/m2]) at baseline was 117 +/- 22 in rural men and 99 +/- 15 in urban men (the difference, P < .001). For both populations, LVM index was positively associated with age and physical activity but not with body mass index. Associations of LVM index with usual alcohol intake and initial BPs were generally weak. According to linear regression analyses after controlling for these covariates at baseline, a 20-g/m2 greater LVM index at baseline was associated with a 5 mm Hg increase in systolic and a 4 mm Hg increase in diastolic BP during the subsequent 6 to 8 years for urban men. A 1-mm greater average ventricular wall thickness was associated with a similar BP increase. For rural men, positive associations of LVM index with BP increase existed but were weak. The weaker association between LVM index and BP increase in rural compared with urban men was probably the result of effects of higher physical activity, leading to a larger left ventricular internal dimension. The increase in systolic and diastolic BPs over the 6 to 8 years of observation was significantly related to baseline LVM index in rural and urban men with a smaller internal dimension (rural men, < or = 49 mm; urban men, < or = 47 mm) but not in those with larger dimensions. CONCLUSIONS: An increased LVM index predicts subsequent BP increase in middle-aged normotensive men in the presence of a normal or small internal dimension.

Adult↗
PubMed1994

High-density lipoprotein cholesterol and premature coronary heart disease in urban Japanese men.

BACKGROUND: The objective of this study was to examine the relation of high-density lipoprotein cholesterol (HDL-C) to coronary heart disease in Japanese men whose serum total cholesterol is low by Western standards. METHODS AND RESULTS: A prospective, observational study based on 7.7 years of follow-up for incidence of coronary heart disease and stroke was conducted. The subjects were 6408 middle-aged male workers aged 40 to 59 years at baseline in urban companies in Osaka, Japan, whose mean serum total cholesterol was 5.10 mmol/L. Mean HDL-C adjusted for age, total cholesterol, systolic blood pressure, alcohol intake, cigarette smoking, and body mass index was 1.27 to 1.28 mmol/L for men who developed coronary heart disease (n = 46) or definite myocardial infarction (n = 21) compared with 1.46 mmol/L for those free of cardiovascular disease (n = 6256; difference, P < .01). There was no significant difference in mean HDL-C between stroke cases (n = 33) and those free of cardiovascular disease. The incidence rates of coronary heart disease and definite myocardial infarction, adjusted for the other risk factors, were three to four times higher in the lowest HDL-C quartile (< 1.24 mmol/L) than the highest quartile (> or = 1.66 mmol/L), and there was a significant dose response for definite myocardial infarction. Serum total cholesterol was positively and significantly associated with coronary heart disease incidence. Furthermore, the inverse association for HDL-C was apparent among men with total cholesterol < 5.69 mmol/L (mean total cholesterol, 4.76 mmol/L) and men with total cholesterol > or = 5.69 mmol/L (mean total cholesterol, 6.26 mmol/L). CONCLUSIONS: Coronary heart disease incidence is inversely related to HDL-C in urban Japanese middle-aged men, whose mean total cholesterol (5.10 mmol/L) is relatively low.

Adult↗
PubMed1993

[A case of metastatic spinal tumor from renal cancer reduced by interferon-alpha].

A case of metastatic spinal tumor from renal cancer reduced by interferon-alpha is reported. A 54-year-old man was admitted to Tane General Hospital on April 12, 1990, with the complaint of difficulty in walking. Abdominal CT scan revealed right renal carcinoma, and MRI demonstrated metastatic spinal tumor at Th6, which was mainly occupying the entire lamina, spinous process and right pedicle of Th6. Nephrectomy was performed and, instead of operating on the spinal lesion, the patient was given follow-up treatment with administration of interferon-alpha (5 million units twice a week) and steroid. 1 year and 6 months later the patient's walking ability began to deteriorate and paraparesis progressed, although the size of the metastatic spinal tumor had gradually reduced. This was thought to be because of atrophy of the legs due to prolonged bed rest and steroid administration. Laminectomy with total removal of the tumor was performed on January 16, 1992. In the 12 months postoperatively, there has been neither recurrence nor remote metastasis seemingly due to the administration of interferon-alpha. This appears to be the first report of metastatic spinal tumor from renal cancer reduced by interferon-alpha.

Carcinoma, Renal Cell↗
PubMed1992

[A nested case-control study of risk factors for intracerebral hemorrhage and cerebral infarction classified by computed tomographic findings].

Risk factors for intracerebral hemorrhage (ICH) and cerebral infarction (CI), were studied by a prospective study of 7,390 men and women aged 40-69 without a history of stroke living in three rural populations in Japan. Baseline examinations were done for populations in Akita-Ikawa and Akita-Ishizawa in 1975-1979, and for Ibaraki-Kyowa in 1981-1987, and followed until 1989 for Akita-Ikawa and Ibaraki-Kyowa and 1987 Akita-Ishizawa. There were 246 stroke cases diagnosed by clinical criteria during the follow-up period in which 74 percent (n = 181) had data from computed tomography (CT) performed within three weeks of the onset. According to these CT-findings, 181 stroke were classified as 48 with ICH, 50 with CI in penetrating artery regions (penetrating artery infarction), 33 with CI in cortical artery regions (cortical artery infarction), and 31 with subarachnoid hemorrhage while there were 19 with stroke without any evident CT abnormality. Cortical artery infarction was further classified as embolic type (n = 17) and thrombotic type (n = 9) according to clinical findings of the onset and presence of possible embolic sources such as atrial fibrillation, congenital heart disease, myocardial infarction and heart valve diseases. Using a nested case-control design, risk variables at baseline examination were compared between 131 stroke cases, 48 ICH and 83 CI, with 655 controls matched for sex, age (+/- 3), and the follow-up year. Univariate analysis showed that high blood pressure was associated with all types of stroke. From conditional logistic regression analysis significant risk variables were found to be high blood pressure for ICH and penetrating artery infarction, while atrial fibrillation and ST-T abnormality in electrocardiogram (ECG) were risk variables for cortical artery infarction. Associations with hypertensive or arteriosclerotic changes in ocular fundus were stronger for penetrating artery infarction than ICH and cortical artery infarction. ST-T abnormality in ECG was associated with embolic type cortical artery infarction and high blood pressure was associated with the thrombotic type, although the number of cases were small. Compared to controls, cortical artery infarction showed a higher mean value of serum total cholesterol for thrombotic type cortical infarction, and lower mean values for embolic type and ICH, but none of them reached statistical significance. The present study also suggests that duration of hypertension varied with type of stroke. ICH may develop due to acute effects of hypertension, while penetrating artery infarction and cortical artery infarction develop by chronic effects of hypertension.

Adult↗