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Minoru Sugita

Publications and source records attributed to Minoru Sugita.

At least 19 recordsLinked to original sources

Long-term physiologic changes of intraocular pressure: a 10-year longitudinal analysis in young and middle-aged Japanese men.

OBJECTIVE: Although the intraocular pressure (IOP) is the most important factor related to the onset and progression of glaucoma, there is little evidence on long-term aging effects on IOP. This article examines the changes of IOP over 10 years in normal eyes to assess physiologic changes related to aging. DESIGN: Population-based long-term longitudinal study. STUDY POPULATION AND OBSERVATION PROCEDURE: Two thousand nine hundred eighty-seven Japanese male aircraft crew members underwent IOP measurement by Goldmann apparatus and received physical and complete ophthalmologic examinations every year for 10 years. A total of 2330 healthy persons (21-49 years; mean age, 35.9+/-6.8 [standard deviation]) who had no history of treatment for ophthalmic diseases, current illnesses, and no missing data for 10 consecutive years were analyzed. MAIN OUTCOME MEASURES: For analysis of the longitudinal index (trend), the linear regression coefficients for 11 points of measurement were determined. Ophthalmologic and physiologic factors affecting the 10-year mean values and a trend of IOP were examined by multivariable linear regression analysis. RESULTS: Intraocular pressure tended to decrease with age in all age groups. The mean linear regression coefficient (right eye/left eye) = -0.076/-0.060 (95% confidence interval [CI]: (-0.094 to -0.057)/(-0.078 to -0.041), -0.073/-0.060 [95% CI: (-0.084 to -0.062)/(-0.071 to -0.049)], and -0.060/-0.050 [95%CI: (-0.075 to -0.046)/(-0.064 to -0.036)] (mmHg/year) in the 20s, 30s, and 40s, respectively). In investigating correlations between the 10-year mean values of IOP and factors examined in this study, multivariate analysis showed a significantly inverse correlation with spherical power (partial regression coefficient [B] = -0.155/-0.144) and positive correlation with esophoria (B = 0.536/0.521), systolic blood pressure (B = 0.021/0.022), heart rate (B = 0.024/0.024), and hematocrit (B = 0.041/0.043) with IOP. The trend of IOP was significantly positively associated with the trends of systemic factors: body mass index (BMI) (B = 0.117/0.119), blood pressure (systolic) (B = 0.020/0.020), and hematocrit (B = 0.057/0.045), but not with any ophthalmologic factor. CONCLUSIONS: The long-term observation clearly demonstrated that, in normal eyes, the IOP decreased with aging. The IOP value was negatively associated with spherical power and positively with esophoria, blood pressure, heart rate, and hematocrit. The change of IOP could be affected mainly by the change of body mas index, blood pressure, and hematocrit.

Adult↗

Possible association between heavy computer users and glaucomatous visual field abnormalities: a cross sectional study in Japanese workers.

STUDY OBJECTIVE: To study the association between computer use and visual field abnormalities (VFA) and to assess whether heavy computer users have an increased risk of glaucoma. DESIGN: Cross sectional multicentre study. Subjects and observation procedures: A total of 10 202 randomly selected Japanese workers (mean (SD) age 43.2 (9.8) years) were screened for VFA using the frequency doubling technology perimetry (FDT-VFA), in addition to undergoing a general medical check up, and then ophthalmologically examined. Information about their computer use and refractive errors was obtained from a questionnaire and interview, respectively. MAIN RESULTS: As a result of FDT test, 522 and 8602 subjects were positive and negative for FDT-VFA, respectively. A significant (p = 0.004) interaction was found between computer use and refractive errors regarding the risk of FDT-VFA. In stratified analysis, heavy computer users with refractive errors showed a significant positive association with FDT-VFA (odds ratio (OR) = 1.74, 95% confidence interval (CI) 1.28 to 2.37), while those without refractive errors did not. Comparison of 165 subjects with an ophthalmological diagnosis of glaucoma and 2918 controls showed that the OR for glaucoma of heavy computer users with refractive errors was 1.82 (95% CI 1.06 to 3.12). Of 165 subjects with glaucoma, 141 had refractive errors, especially myopia (96.4%, 136 of 141). CONCLUSIONS: Although there are limitations to this study, such as its cross sectional design, heavy computer users with refractive errors seem to have an increased risk of FDT-VFA. Glaucoma might be involved in an underlying disease and myopia in a risk factor for FDT-VFA.

Adult↗

[A case of tricuspid valve infective endocarditis presenting with multiple nodular shadows in both lungs without known predisposing factors].

A 56-year-old woman was admitted to our hospital with fever, cough, and sputum production. Her chest radiograph and chest computed tomography showed multiple nodules. Laboratory findings revealed leukocytosis and an increased C-reactive protein concentration. Physical examination revealed a systolic murmur. Transesophageal echocardiography demonstrated a 1.5-cm area of vegetation on the tricuspid valve. Blood cultures grew Staphylococcus aureus. Tricuspid valve endocarditis and septic pulmonary embolism were diagnosed. She was treated successfully with intravenous ampicillin/sulbactam. This was a rare case of tricuspid valve infective endocarditis in an adult patient without known predisposing factors.

Ampicillin↗

Estimating cadmium absorption rate in digestive organs calculated from information of studies on cadmium conducted in Japan.

The absorption rate of cadmium (Cd) in the digestive organs is reported to be 0.5-8% in Friberg's textbook. This value was obtained from experimental studies. The object of the present study is to obtain the value from the Cd intake amount by ingestion, the Cd absorption amount by respiration and smoking, and the total Cd absorption amount calculated from the Cd accumulation amount in organs reported in articles including not only experimental but also epidemiologic studies conducted in Japan. The oral intake amounts of Cd in Japan were obtained from a published article to be 48 micrograms/day for males in the 1970s. The total Cd absorption amount that was calculated from the Cd accumulation amount in organs of 223 male subjects autopsied following sudden death was found to be 6.8 micrograms/day for male adults in the 1970s. The Cd exposure before the 1970s reflected the Cd absorption amount calculated from the Cd accumulation amount in the 1970s. The Cd absorption amount by respiration and smoking for males in the 1960s was 1.0 microgram/day, and the difference of 5.8 micrograms/day between the above two corresponds to the Cd absorption amount in digestive organs before the 1970s. The rice intake amount for Japanese in 1955-1965 was reported to be about 1.4 times as much as that in 1975. Therefore the Cd absorption rate in digestive organs was estimated to be about 10% from these values, assuming that most of the change in Cd intake from food is derived from the amount of rice eaten in Japan. This value is somewhat greater than the values published in the literature.

Absorption↗

Postmetamorphic changes in parvalbumin expression in the hindlimb skeletal muscle of the bullfrog, Rana catesbeiana.

Anuran amphibians, animals that spend a terrestrial life after metamorphosis, exhibit a marked development of hindlimbs during and after metamorphosis. In order to see whether changes occur in the muscle protein components in the course of postmetamorphic development, we subjected gastrocnemius muscle extracts from growing froglets to two-dimensional electrophoresis (2DE). As a result, we found two proteins to undergo a change in level. One spot, indicating a molecular mass of approximately 12 kDa and an isoelectric point (pI) of 5.0 first became detectable at 45 days after metamorphosis. Another spot, corresponding to a protein of 11 kDa and pI 4.8, was prominent until the former spot appeared. N-terminal amino acid sequence analysis and comparison of the spots with those of parvalbumin (PA) revealed that these two proteins were PA alpha and PA beta. Northern blot analysis using PA alpha and PA beta cDNAs as probes revealed that the PA beta mRNA level declined whereas that of PA alpha mRNA rose as the frogs grew.

Amino Acid Sequence↗

Inducible nitric oxide synthase activity induced by sodium chloride solution prolongs luminal pH elevation in rat and mouse stomachs.

BACKGROUND: Sodium chloride (NaCl) is a strong promoter of gastric cancer. We hypothesized that inducible nitric oxide synthase (iNOS) induced by NaCl may be involved in its promoting effects. We investigated iNOS expression by hypertonic NaCl solutions and its pathophysiological roles in the gastric mucosa of rats and mice. METHODS: iNOS mRNA and protein expressions were examined in the rat and mouse gastric mucosa after intragastric administration of NaCl solution by northern blot, reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemistry. The effect on luminal pH by iNOS activity was assessed using aminoguanidine, a potent iNOS inhibitor, and iNOS gene deficient (iNOS-/-) mice. RESULTS: iNOS expression was detected at concentrations higher than 1.7 M, mainly in the cells infiltrating the damaged mucosa of rats. Administration of a higher than 3.4 M NaCl solution elevated luminal pH of the rat stomach remarkably, enabling bacterial overgrowth and dramatically increasing iNOS expression (n = 5 per concentration). Pretreatment with ampicillin (p.o), an antibiotic, attenuated the iNOS expression in duplicate experiments. Co-treatment with aminoguanidine (s.q) accelerated recovery of elevated luminal pH at 8 h and 16 h or 24 h after administration of 3.4 M (n = 8) and 5.2 M NaCl solution (n = 5), respectively. iNOS expression and luminal pH elevation were also observed in mice stomachs after administration of 3.4 M NaCl solution. The elevated luminal pH of iNOS-/- mice stomachs after the administration of NaCl solution was significantly lower at 6 h (n = 7) and at 9 h (n = 11), compared to that of wild type mice (n = 9 and 10, respectively). CONCLUSIONS: Hypertonic NaCl solutions induced iNOS expression in the gastric mucosa. iNOS activity prolonged the elevation of the luminal pH, potentially leading to bacterial overgrowth, which in turn enhanced iNOS expression. This vicious cycle might be related to the promoting effect of NaCl.

Animals↗

Laterality of the performance of glaucoma mass screening using frequency-doubling technology.

PURPOSE: This study investigated laterality during the performance of glaucoma mass screening with a frequency-doubling technology perimetry test. MATERIALS AND METHODS: A frequency-doubling technology screening mode (C-20-1, version 2.6) test was performed on both eyes of 14,784 persons. Subjects with visual field abnormalities detected by the frequency-doubling technology test or with fixation error underwent retesting without a specified interval for rest. Consequently, 206 subjects who fulfilled the screening criteria of the frequency-doubling technology-based glaucoma screening protocol [FDT-GSP(+)] were further investigated using the Humphrey visual field analyzer (30-2). As a result, 74 right eyes and 57 left eyes were shown to have definite glaucoma. RESULTS: Frequency-doubling technology data for the left eye demonstrated a significantly (P<0.001) higher rate of artifacts, such as no reproducibility of results between the first and second tests (left/right: 2.4%/1.7%) as well as fixation errors (left/right: 2.8%/1.0%). The false-positive rate of the FDT-GSP for glaucoma was more than 1.5-fold higher in the left eye than in the right eye (16.3%/9.8%). In the case that either eye exhibited FDT-GSP(+), the positive predictive value of the FDT-GSP for definite glaucoma in the left eye was almost half of that in the right eye (28.4% vs. 53.8%). Specificity of the FDT-GSP for detection of definite glaucoma also exhibited a lower trend (P = 0.097) in the left eye (44.6%) than in the right eye (55.3%), but the sensitivity of the test was similar in both eyes (91.2% vs. 90.5%, respectively). CONCLUSIONS: When frequency-doubling technology-based mass screening is performed on the general population, performance is lower for the left eye than for the right eye. This performance disparity is likely to be primarily associated with a difference in specificity.

Adult↗

Roles of inducible nitric oxide synthase in the development and healing of experimentally induced gastric ulcers.

The roles of inducible nitric oxide synthase (iNOS) in the development and healing of gastric ulcers have not been fully characterized. We characterized iNOS expression in experimentally induced ulcers in rat and mouse stomachs and investigated the roles of iNOS using iNOS gene-deficient (iNOS-/-) mice and wildtype mice. Gastric ulcers were induced in rats and mice by the application of acetic acid and cryoinjury, respectively. iNOS expression was detected on days 1-7 and peaked 3 days after ulcer induction in the rat. iNOS-positive cells were distributed mainly among the infiltrating cells and fibroblasts in the ulcer bed. The almost similar courses of healing and iNOS expression were observed in the ulcers of mice. During the course of healing, the iNOS gene status did not affect cell proliferation in the healing zone or vessel formation in the ulcer bed. iNOS deficiency, however, caused larger ulcers and severer inflammation during ulcer healing; the clearance of inflammatory cells in the ulcer bed by apoptosis was also delayed when the ulcer was re-epithelialized in the iNOS-deficient mice. These results indicate that iNOS is expressed in the ulcer bed and that iNOS activity may play beneficial roles in the ulcer repair process, possibly by regulating inflammation.

Acetic Acid↗

Allergic bronchial asthma: airway inflammation and hyperresponsiveness.

The international consensus report on diagnosis and treatment of asthma was published in 1992 (Clin Exp Allergy 22: 1-72). According to the report, asthma is a chronic inflammatory disorder of the airways in which many cells play a role, including mast cells and eosinophils. Airway inflammation causes various symptoms of asthma which are usually associated with widespread but variable airflow obstruction and causes an associated increase in airway responsiveness to a variety of stimuli. The definition of asthma, provided in this report, is an epoch-making revision of the conventional recognition of asthma based on respiratory physiology and does not contradict the empirical knowledge that asthma responds well to steroid therapy. One reason, which led airway inflammation to be understood as a major factor in the pathophysiology of asthma is the technological advance and the widespread use of bronchoscopes. The use of bronchoscopy as a research tool has markedly improved the understanding of the pathology of asthma. It became also possible to link biopsy findings to autopsy findings in patients who died of asthma. However, it is relatively difficult to repeat a biopsy of the airway mucosal membranes in individual asthmatic patients. Here, animal models of asthma play a significant role. Findings from animal models can provide a clue for the development of new anti-asthmatic drugs. This paper will deal with the paradigm of allergic asthma and focus on recent topics of interleukin (IL)-4 and IL-5, which seem to play a central role in allergic asthma. The causative relationship between airway inflammation and hyperresponsiveness will be discussed.

Airway Obstruction↗

[Burden of disease in bone and joint diseases].

In order to evaluate the burden of disease in bone and joint diseases, DALY (Disability-adjusted Life Year) values were calculated by using existing medical database. DALY value of rheumatoid arthritis was calculated to 76,038, and the value of arthritis was calculated to 86,783. The sum of value of DALY of these diseases is about half of diabetes mellitus and very large.

English Abstract↗

Relationships between lifestyle factors and neutrophil functions in the elderly.

We investigated the relationships between neutrophil functions and lifestyle factors in the elderly. The subjects (84 males, 73.9+/-5.8 years old; and 63 females, 70.0+/-4.6 years old) belonged to a recreational seniors club in Japan. Investigations of the subjects' stress, exercise habits, smoking habits, and alcohol-drinking habits were performed. The phagocytosis and superoxide productivity of the neutrophils were measured with a nitroblue tetrazolium (NBT) reduction test. In addition, leukocyte counts and serum total protein (TP) levels were determined. The results revealed that aging, high serum levels, and stress-coping factors (e.g., having hobbies, keeping pets, and close links with friends or family) significantly correlated with preferable neutrophil functions. In addition, significant effects of lifestyle factors on the balance between phagocytosis and subsequent superoxide production were observed. Thus, the results of the present study suggest that there are correlations between neutrophil functions and lifestyle factors in the elderly.

Aged↗

Performance of glaucoma mass screening with only a visual field test using frequency-doubling technology perimetry.

PURPOSE: To report the performance of glaucoma mass screening with only a visual field test utilizing frequency- doubling technology (FDT) perimetry in general populations. DESIGN: Hospital and population-based cross-sectional study. METHODS: This study took place in a multicenter setting. One hundred three consecutive glaucomatous patients and 14,814 persons were randomly selected. We had created a glaucoma screening protocol (GSP) using FDT perimetry (FDT-GSP). Frequency-doubling technology-glaucoma screening protocol was tested on consecutive glaucoma patients diagnosed with Humphrey visual field analyzer (30-2 SITA standard), and then FDT-GSP was applied to general populations. Frequency-doubling technology-glaucoma screening protocol positive subjects were ophthalmologically diagnosed. Detection ability of FDT-GSP was determined in consecutive patients, and the positive predictive value (PPV) of FDT-GSP to detect definitive glaucoma was estimated in general populations. RESULTS: Frequency-doubling technique-glaucoma screening protocol detected 83.3% and 100% of definitive glaucoma patients with an early (mean deviation [MD] > -6 dB) and more advanced stage (MD < or = -6 dB), respectively. In the population-based screening, there were 660 (4.5%) subjects who had positive FDT-GSP, including 512 in whom no visual field abnormalities (VFA) had been pointed out previously. Of them, 370 subjects underwent ophthalmologic diagnosis. Then, 266 (71.9%, 266/370) subjects had a glaucomatous disk and 167 had definitive glaucomatous VFA. Fifty-five (14.9%) and 39 (10.5%) subjects were diagnosed as having other diseases and as normal, respectively. The PPV of FDT-GSP ranged from 32.6% (167/512)-45.1% (167/370). CONCLUSIONS: Frequency-doubling technology-based screening with only a visual field test showed reasonable performance on mass screening for detection of definitive glaucoma in this study population, considering the glaucoma prevalence.

Aged↗

Difference between consciousness of intervention for improving lifestyle by public health nurses and recipients of a company health check.

Improving an unhealthy lifestyle decreases risk of incidence and death of lifestyle-related diseases. Consultation about a healthy lifestyle to recipients of health checkups conducted by public health nurses is one method for such improvement. The objective in the present study was to investigate the difference between consciousness of intervention by (1) the public health nurses who conducted consultations with recipients of health checkups and (2) the recipients who were consulted by the public health nurses. Data on 1,370 male white collar workers who underwent health checks were analyzed. When public health nurses determined that recipients required health consultation regarding lifestyle from the health checkup, they consulted with the recipients regarding improvement of lifestyle. The consultation regarding lifestyle included abstinence from smoking, drinking in moderation, exercise, and eating. The results of the analysis regarding difference in consciousness of the intervention by the public health nurses and the recipients show that (1) most drinkers did not think they were being discouraged to drink despite intervention by the public health nurses and (2) the smokers and the subjects with no habitual physical exercise tend to think that they were being consulted even though the public health nurses did not intervene regarding smoking and exercise.

Adult↗

[A case of desmoplastic malignant mesothelioma with elevated serum CYFRA 21-1].

A 70-year-old woman was admitted to our hospital for medical evaluation of a right side pleural effusion, which was pointed out at another hospital. Chest CT revealed a right pleural effusion with diffuse and irregular pleural thickening. Percutaneous pleural biopsy showed hypocellular collagenous tissue without malignant cells. Though she received antituberculosis therapy, the pleural thickening progressed and the serum CYFRA 21-1 level was elevated. Chest pain and dyspnea appeared, and she was readmitted. However, pneumonia was present as a complication, and she died. At autopsy, the right pleura was thickened and invasion of the lung and the chest wall was observed. Microscopic findings showed increased amounts of hyalinized collagen fibers forming a storiform pattern. At the tumor foci, atypical cells with distinct nucleoli were observed. Desmoplastic malignant mesothelioma, which is rarely reported in Japan, was diagnosed.

Aged↗

[A case of pulmonary sarcoidosis with pneumothorax and pleural effusion after improvement of pulmonary impairment].

A 23-year-old man was admitted to our hospital for a complete medical evaluation of abnormal pulmonary shadows found on a chest radiograph during his annual check-up. Chest radiography and chest CT showed a diffuse spread of micronodules in both lung fields and mediastinal lymphadenopathy. A transbronchial lung biopsy demonstrated evidence of noncaseating epithelioid cell granuloma with multinucleated giant cells, and a diagnosis of sarcoidosis was made. The pulmonary shadows improved without therapy. Twenty months later, the patient was readmitted to the hospital because of chest pain and dyspnea. Pneumothorax appeared on the right in a chest radiograph, but subsided after drainage therapy, and two weeks later, a right side pleural effusion was seen. We determined that the pleura was involved in the sarcoidosis, and the patient was treated with oral prednisolone 20 mg daily. The pleural effusion gradually subsided. This is the first reported case in Japan of pulmonary sarcoidosis with pneumothorax and pleural effusion after improvement of pulmonary impairment.

Adult↗

[Evaluation of intractable diseases].

OBJECTIVE: The aim of this study was to determine priorities for specific intractable disease from the viewpoint of countermeasures. METHODS: A significance evaluation to provide a priority framework for intractable disease was performed with a questionnaire distributed to the staff of preventive medicine and public health departments of medical schools in Japan. To determine the actual conditions of these intractable diseases question were directed at the chairmen of individual clinical study groups. The priority to be assigned countermeasures for such diseases was obtained from the two questionnaires. RESULTS: When the 4 factors "rare nature of diseases," "level of clarity of causes and pathology," "unestablished curative treatment", and "influence on daily life" were evaluated using 100 point as a full score, the mean scores were 14.5, 27.1, 28.5 and 29.9 points, respectively. In attaching importance to the various items, regarding the "rare nature of disease" the elements of "few patients nationwide" and "few specialist doctors nationwide" proved important; for the "level of clarity of causes and pathology," this was the case for the elements of "unclear triggering mechanism" and "diagnostic criteria not established." With the "unestablished curative treatment," the "no efficacious treatment available" and "low 5-year survival rate elements were important; and with the factor of "influence on daily life," the two most significant were "high proportion of patients needing assistance in daily life" and "high percentage of patients impeded from attending school or obtaining a job (playing a role in society)". CONCLUSION: When the priority among the 118 intractable diseases was evaluated by combining the overall results of the questionnaire survey with preventive medicine and public health staffs, and actual condition data from survey investigation of the intractable diseases among chairmen of clinical study groups, it was suggested that some intractable diseases whose medical expenses are covered by the medical aid program have a low ranking.

Activities of Daily Living↗

[An autopsy case of desmoplastic malignant mesothelioma].

On November 15, 2000, a 60-year-old man was admitted to our hospital with progressive dyspnea and right chest pain. He had a 40-year history of occupational asbestos exposure, which began when he was 20 years old. On admission, his chest radiographs showed pleural effusion on the right side, and asbestos bodies were detected in his sputum. Neither a cytological examination of the pleural effusion nor a histological examination of the pleura by percutaneous pleural biopsy revealed malignant cells. In addition, we could not find any other cause for the pleural effusion (such as tuberculosis, collagen disease, or heart failure). In May 2001, the patient also developed pleural thickening and pain in the right hypochondrium, and he was readmitted to our hospital on May 21, 2001. On readmission, an enhanced abdominal CT showed multiple liver tumors, and percutaneous pleural and liver biopsies were performed. The histological findings in the pleura and liver specimens revealed hypocellular collagen tissues without malignant cells. Thus, we could not determine the main cause either of the pleural effusion or of the patient's disease. However, his condition rapidly deteriorated, and he died on August 12, 2001. At the autopsy, bilateral pleural thickening, predominantly on the right side, and invasion of the lungs were observed. The histological findings in the pleural and hepatic tissues revealed hypocellular collagen fibers with a striate pattern and areas of neoplastic spindle cells. He was diagnosed as having malignant desmoplastic mesothelioma with liver metastasis. Cases of malignant desmoplastic mesothelioma have rarely been reported in Japan.

Humans↗

[An autopsy case of protein-losing enteropathy due to gastrointestinal amyloidosis, occurring in empyema].

On August 14, 2001, a 76-year-old woman with a history of rheumatoid arthritis was admitted to our hospital with fever, cough, dyspnea and diarrhea. On admission, her chest radiography showed pleural effusion on the right side, and thoracocentesis was used to diagnose empyema. The patient underwent pleural drainage and received antibiotics. Alpha-Streptococcus was detected in both aerobic and anaerobic cultures of the pleural effusion. After 2 weeks of therapy, her empyema had improved; but her diarrhea, which had started 1 week before admission, had worsened, and her hypoproteinemia had progressed. Examination of the fecal clearance of alpha-1-antitrypsin and biopsied rectal material revealed that the diarrhea was caused by protein-losing enteropathy due to gastrointestinal amyloidosis secondary to rheumatoid arthritis. The patient was treated with steroids, but developed an additional infectious disease and died on September 29, 2001. In this case, she suffered from various infectious diseases including empyema and fungus infections. It has been reported that protein-losing enteropathy accompanies abnormalities in the immune system, by the loss of immunoglobulins and lymphocytes from the gut. We therefore suspect that protein-losing enteropathy due to gastrointestinal amyloidosis caused this patient's empyema.

Aged↗