Biomedical subjects

N Hamajima

Publications and source records attributed to N Hamajima.

At least 19 recordsLinked to original sources

PubMed1997

Myelodysplastic syndrome and acute myelogenous leukemia as a late clonal complication in children with acquired aplastic anemia.

The improved outcome of acquired aplastic anemia (AA) has revealed later complications, such as myelodysplastic syndrome (MDS) and acute myelogenous leukemia (AML). We retrospectively analyzed 167 children with severe acquired AA. Eleven of 50 children treated with cyclosporin (CSA) and recombinant human granulocyte colony-stimulating factor (rhG-CSF) developed MDS/AML; 8 of these were within 36 months of the diagnosis of AA, much earlier than previous reports. Six of the 11 children received rhG-CSF exceeding 10 microg/kg/d, and 9 received rhG-CSF therapy for over 1 year. Ten children showed monosomy 7 at diagnosis of MDS. All of the 11 children were administered both CSA and rhG-CSF. There was no development of MDS/AML among 41 children treated with either CSA or rhG-CSF or among 48 children who underwent bone marrow transplantation. A well-controlled clinical trial is warranted to determine whether therapeutic modalities affect the development of MDS/AML in children with severe acquired AA.

Acute Disease↗

PubMed1997

Epidemiological features of first-visit outpatients in Japan: comparison with general population and variation by sex, age, and season.

To evaluate the methodological issues in using first-visit outpatients as controls in epidemiological studies, the features of general lifestyles of non-cancer outpatients at Aichi Cancer Center Hospital (ACCH) were compared with those of the general population, and their variation by sex, age, and season was determined by using a self-administered questionnaire. The study included 1231 subjects randomly selected from the Nagoya electoral roll (CRG), and three groups of non-cancer ACCH outpatients living in Nagoya; 800 from the period September to December 1992 (OPG1), 2326 from January to December 1992 (OPG2), and 12,243 from January 1991 to December 1992 (OPG3). In the younger age group, the proportion of current smokers was higher in the CRG than in the OPGs. In the older age groups, the proportion of those who consumed fresh vegetables and fruit everyday was higher in the OPGs than in the CRG. For other items, the features of the OPGs were not significantly different from those of the CRG. Among the OPG3, there were differences in the features of general lifestyles between sexes and consumption of several food items varied with age. Seasonal variation, however, was only observed in the specific food items where supply varied seasonally. It was concluded that, with due consideration of age, sex, and season in the analysis, it is feasible to use non-cancer outpatients as controls in epidemiological studies.

Adult↗

PubMed1997

Case-control study of leukemia and diagnostic radiation exposure.

A case-control study of leukemia and diagnostic X-ray exposure was conducted by a multi-institution co-operative study group. The subjects were 134 patients with acute myelogenous leukemia, 57 with chronic myelogenous leukemia, 56 with acute lymphocytic leukemia and 50 with myelodysplasia syndrome, who were between 15 and 79 years old, and diagnosed at one of 27 hospitals between September 1993 and August 1995. The controls were 479 first-visit patients seen at eight of these 27 hospitals. History of diagnostic X-ray tests between 1982 and 1991 was determined by an anonymous self-administered questionnaire. The total relative dose of radiation exposure was calculated by summing the products of given weights and frequencies of each test. The relative risk was 0.83 (95% confidence interval (C.I.), 0.58-1.19) for relative dose of 10-30 (equivalent to 4-11 times of UGI series), 0.76 (0.48-1.20) for relative dose of 30 or more (more than 12 times of UGI series), when compared with relative dose of 0-10 (0-3 times of UGI series). Analysis according to type of leukemia revealed that only acute myelogenous leukemia had an estimated relative risk above unity (1.08, 95% C.I. 0.69-1.69, for relative dose 10-30). This study did not support the hypothesis that diagnostic X-ray tests increases leukemia risk.

Adolescent↗

PubMed1997

Estimation of adult T-cell leukemia incidence in Kyushu District from vital statistics Japan between 1983 and 1982: comparison with a nationwide survey.

To investigate the change in adult T-cell leukemia incidence between 1983 and 1992 and to evaluate the sensitivity of the nationwide adult T-cell leukemia survey, we estimated adult T-cell leukemia incidence in the Kyushu district, southern Japan, where adult T-cell leukemia is endemic. The incidence of adult T-cell leukemia was calculated from the difference between Kyushu and the rest of Japan in mortality from malignant lymphoid neoplasms, i.e., Kyushu's excess rate was assumed to be due to adult T-cell leukemia. In Kyushu, average annual adult T-cell leukemia cases aged > or = 20 years were estimated for men as 252 during the period 1983-87 and 341 during 1988-92, and for women as 201 and 246 respectively. The age-adjusted mortality rate tended to be higher in the latter period [6.29 per 100000 (95% confidence interval 5.59-7.00) vs. 5.25 (4.60-5.90) in men, and 3.33 (2.85-3.80) vs. 3.18 (2.71-3.66) in women]. By contrast, the registered number of adult T-cell leukemia cases nationwide during 1988-93 was only 35% (203/587) of the estimated number, and the number of registered versus estimated cases decreased with age, especially when cases were > 60 years old. In conclusion, the estimated adult T-cell leukemia incidence for 1983-92 increased in the latter half of the period. The estimation suggests that 65% of adult T-cell leukemia cases might be missed by a nationwide survey, and older cases were more likely than younger ones to be missed.

Adult↗

PubMed1997

A new macroscopic classification predicts prognosis for patient with liver metastases from colorectal cancer.

OBJECTIVE: The authors defined a new macroscopic classification of liver metastases from colorectal cancer. SUMMARY BACKGROUND DATA: There were different prognostic results after the same operative procedure for liver metastases with similar background factors. METHODS: Eighty-one resected liver metastases were classified into simple nodular (SN) or confluent nodular (CN) types according to the characteristics of the cut surface of the tumor. RESULTS: The 5-year survival rates after hepatectomy were 41.7% for the SN lesions (n = 39) and 23.1% for the CN lesions (n = 42). The difference between the survival curves was statistically significant (p = 0.0307). Multivariate analysis using Cox's proportional hazards model revealed that the macroscopic type (p = 0.023), the tumor diameter (p = 0.0001), and the presence of lymph node metastases (p = 0.0016) were statistically significant independent prognostic factors. CONCLUSION: The new macroscopic classification may be valuable as a prognostic factor reflecting the biologic behavior of liver metastases.

Colorectal Neoplasms↗

PubMed1997

Patients' views on reference to clinical data.

In order to survey patients' views on reference to clinical data for research purposes, an anonymous self-administered questionnaire was distributed to Aichi Cancer Center Hospital patients in 1995. All eligible first-visit outpatients (97 persons), randomly selected revisit outpatients (99 persons), and all eligible inpatients in a good condition at discharge except six cases (97 persons), responded to the questionnaire. Out of 293 patients (115 males, 174 females and 4 unspecified), 85.3% (standard error 2.1%) considered that hospitals should make active efforts to improve their health care and treatment skills. And 88.1% (standard error 1.9%) answered that reference to their own clinical data to improve health care and treatment skills was "preferable" or "don't mind".

Adult↗

PubMed1997

[A nonparametric estimation of survival curve with interval censored data].

Although survival analysis dealing with right-censored data has enjoyed wide use, analysis of data with left-censored and interval censored cases is available only to a very limited number of clinical researchers because of the difficulty in understanding the concepts and performing the calculations. This paper applies Turnbull's self-consistency algorithm, which he applied in his paper on survival data with only left-censored cases, for nonparametric estimation of survival curve including both left and interval censored data. A difference in the estimates of survival rate among different modes of calculation was demonstrated using the data from the Hematopoietic Cell Transplantation Registry of the Japan Society for Hematopoietic Cell Transplantation, which illustrated the necessity of a correct analysis.

Algorithms↗

PubMed1996

A novel gene family defined by human dihydropyrimidinase and three related proteins with differential tissue distribution.

We have isolated cDNA clones encoding dihydropyrimidinase (DHPase) from human liver and its three homologues from human fetal brain. The deduced amino acid (aa) sequence of human DHPase showed 90% identity with that of rat DHPase, and the three homologues showed 57-59% aa identity with human DHPase, and 74-77% aa identity with each other. We tentatively termed these homologues human DHPase related protein (DRP)-1, DRP-2 and DRP-3. Human DRP-2 showed 98% aa identity with chicken CRMP-62 (collapsin response mediator protein of relative molecular mass of 62 kDa) which is involved in neuronal growth cone collapse. Human DRP-3 showed 94-100% aa identity with two partial peptide sequences of rat TOAD-64 (turned on after division, 64 kDa) which is specifically expressed in postmitotic neurons. Human DHPase and DRPs showed a lower degree of aa sequence identity with Bacillus stearothermophilus hydantoinase (39-42%) and Caenorhabditis elegans unc-33 (32-34%). Thus we describe a novel gene family which displays differential tissue distribution: i.e., human DHPase, in liver and kidney; human DRP-1, in brain; human DRP-2, ubiquitously expressed except for liver; human DRP-3, mainly in heart and skeletal muscle.

Amidohydrolases↗

PubMed1996

Molecular cloning and sequencing of a cDNA encoding dihydropyrimidinase from the rat liver.

A cDNA encoding dihydropyrimidinase has been isolated from a rat cDNA library. The N-terminal and an internal amino acid sequences were determined, and PCR primers were designed based on these sequences. Using a cDNA fragment amplified by RT-PCR with these primers, three cDNA clones were isolated from a rat liver library. The clone with the longest insert of 2129 bp contained a 1557 bp open reading frame encoding a polypeptide of 519 residues with a molecular mass of 56,832 Da.

Amidohydrolases↗

PubMed1996

Patients' expectations of information provided at cancer hospitals in Japan.

In order to survey patients' views on disease and treatment information that should be provided at hospitals, an anonymous self-administered questionnaire was distributed to patients at Aichi Cancer Center Hospital in 1995. All eligible first-visit outpatients (97 persons), randomly selected revisit outpatients (99 persons; about one in ten refused), and all except six eligible inpatients in good condition at discharge (97 persons) responded. Out of 293 patients (115 males, 174 females and 4 unspecified), 74% answered that they wanted to be informed of their diagnosis irrespective of circumstances, 20% answered that they would want to be informed only in certain circumstances, and 2% did not want to be informed at all. There were no significant differences in response among the three sources of patients. Inpatients wanted more (81%) to be explained about recommended therapy than either first-visit outpatients (67%) or revisit outpatients (67%). The majority considered that about a 30-minute explanation was needed using pamphlet-like written materials or video. When asked what information was needed when choosing a cancer hospital, 71% specified information on the specialty of the hospital, 57% the content of the care provided, 23% the name and specialty of the doctors, 20% the waiting period before scheduled admission, 13% the average admission period, 11% the number of patients with the same disease, 10% the waiting time at the outpatient clinic, 6% the meal menu, and 4% the number of private wards. Forty-three percent wanted an information service covering all hospitals in the region through an information center. The results revealed that patients at this cancer hospital required information on their disease, treatment, and hospital specialty.

Adult↗

PubMed1996

Tobacco, alcohol and dietary factors associated with the risk of oral cancer among Japanese.

The mortality rate among Japanese men due to oral cancer is increasing, but risk factors among Japanese other than smoking and drinking have not been examined. To investigate the dietary factors involved in oral cancer, we conducted a hospital-based case-referent study in Aichi, Japan. Cases comprised 189 men and 77 women aged 20-79 years with one of the following cancers: tongue, mouth, oropharynx and hypopharynx. The reference group comprised 9,858 male and 26,669 female out-patients without cancer. Smoking and drinking were highly associated with an increased risk of oral cancer. Japanese sake showed a lower odds ratio (OR) than beer or hard liquor (OR= 3.6, 4.5 and 4.8, respectively). In the cross analysis between smoking and drinking, smoking combined with drinking increased the risk of oral cancer to three times that of smoking only (OR=6.2 vs. 2.2). Frequent intake of raw vegetables (OR = 0.5) and fruit (OR = 0.5) were inversely associated with the risk of oral cancer after adjustment for age, sex, smoking, drinking and year of visit. Western-style breakfast and salty food preference decreased the risk of oral cancer, and salty food preference was still statistically significant by multivariate analysis (OR= 0.7). In conclusion, smoking cessation, drinking control and frequent intake of raw vegetables and fruit among Japanese are likely to be effective preventive measures against oral cancer.

Adult↗

PubMed1996

Subsite (cervix/endometrium)-specific risk and protective factors in uterus cancer.

In Japan the incidence of cervical cancer has been high, but has recently been decreasing gradually, while the incidence of endometrial cancer is running at lower levels but is gradually increasing. To clarify the common and/or specific risk and/or protective factors of cervical cancer(CC) in contrast with endometrial cancer (EC), a comparative case-control study was conducted at the Aichi Cancer Center Hospital, Japan. In total, 556 CC cases and 145 EC cases were included and 26,751 women, confirmed as free of cancer, were chosen as the common control group. Odds ratio and its 95% confidence interval (95%CI) for each exposure variable were estimated by using an unconditional logistic regression model adjusted for age and first-visit year. Habitual smoking and experience of pregnancy increased the risk of CC, while decreasing the risk of EC. Greater body mass index (>20), daily intake of fruit and more frequent intake of boiled or broiled fish (>1-2 times/week) decreased the risk of CC, whereas they increased the risk of EC. Daily intake of milk decreased the risk of CC. The results obtained from this study suggest that several EC-increasing risk factors are in fact CC-decreasing determinants. The observed risk reduction in both CC and EC by physical exercise and dietary control for health is noteworthy from the public health standpoint and warrants further investigation.

Adult↗

PubMed1996

Analysis of 55 transplantations from unrelated volunteer donors facilitated by Tokai Marrow Donor Bank.

In October, 1989, the Tokai Marrow Donor Bank (TMDB) was established through the cooperation of patients' families, the branches of blood centers of Japanese Red Cross and the hematologists' group in Tokai Area (Aichi, Shizuoka, Gifu and Mie Prefectùres) in Japan to facilitate the procurement of suitable marrow from unrelated volunteer donors for patients lacking related donors. The number of human leukocyte antigen (HLA)-A, B typed donors totaled 3,083 and the number of patients registered for donor search totaled 1,415 by June 1992, when the activities of TMDB were transferred to the newly created Japan Marrow Donor Program (JMDP), and 55 transplanations from unrelated donors facilitated by TMDD were performed.

Adolescent↗

PubMed1996

Risk factors of thyroid cancer among women in Tokai, Japan.

To analyze the risk factors of thyroid cancer among Japanese women who generally consume much more iodine than Europeans, we conducted a hospital-based case-referent study at Aichi Cancer Center Hospital (ACCH) in Nagoya, Japan. Ninety-four female patients aged between 20-79 years with papillary or follicular carcinoma of the thyroid, and 22,666 female outpatients without cancer were used. Past history of benign thyroid mass or goiter (odds ratio: OR = 13.9) and hyperthyroidism (OR = 5.0) showed increased ORs of thyroid cancer. Thyroid cancer cases consumed coffee less frequently (OR = 0.5) and had had more experience of delivery than referents (> or = 3 times; OR = 2.5). Western style breakfast (OR = 0.5) also decreased the OR. For the multivariate analysis, past history of thyroid diseases (OR = 4.3) was positively associated with the risk of thyroid cancer and everyday coffee consumption (OR = 0.6) tended to decrease the risk. These results suggest that thyroid hormone-related factors may be involved in the risk of thyroid cancer in Japan, too. To clarify the risk involved in Japanese food, another comparative study including detailed information on iodine intake between countries and individuals is required.

Adenocarcinoma, Follicular↗

PubMed1995

Characterization of the testis-specific gene 'calmegin' promoter sequence and its activity defined by transgenic mouse experiments.

We have cloned the genomic DNA of calmegin [(1992) J. Biol. Chem. 269, 7744-7749] and analyzed its promoter region. It contained GC-rich sequences and potential binding sites for AP 2 and Sp 1, but lacked the TATA sequence. The 330 bp 5' flanking sequence of calmegin genomic DNA fused with the CAT gene was used for the study of promoter activity in transgenic mice. The CAT gene activity was detected exclusively in testes, indicating that the 330 bp calmegin 5' sequence was sufficient for the testis-specific expression. The existence of testicular nuclear factors specifically bound to the putative promoter sequence was also demonstrated.

Animals↗

PubMed1995

Subsite-specific risk factors for colorectal cancer: a hospital-based case-control study in Japan.

To investigate the subsite-specific risk factors for colorectal cancer, we conducted a case-control study, using a common questionnaire which inquired about general lifestyles over the past five years (1988-92), at the Aichi Cancer Center Hospital, Nagoya, Japan. This study compared 432 patients with histopathologically diagnosed colorectal cancer (94 proximal colon [cecum, ascending colon, transverse colon]; 137 distal colon [descending colon, sigmoid colon]; 201 rectum [rectosigmoid, rectum]); and 31,782 first-visit outpatient controls who were free from cancer. In both genders, habitual smoking selectively increased the risk for rectum cancer. Soft or loose feces increased the risk for all subsites of colorectal cancer, particularly in female rectum cancer (odds ratio [OR] = 4.5). Among female dietary habits, Japanese-style foods decreased the risk for distal colon cancer, but increased the risk for proximal colon cancer. These results suggested that the risk factors for colorectal cancer differ by subsite among such a low-risk population as the Japanese. It is suggested also that 'irritable bowel' (soft or loose feces) might be associated with distal subsites of colorectal cancer, independently or combined with habitual smoking.

Adult↗

PubMed1995

A large-scale, hospital-based case-control study of risk factors of breast cancer according to menopausal status.

We conducted a large-scale, hospital-based case-control study to evaluate differences and similarities in the risk factors of female breast cancer according to menopausal status. This study is based on a questionnaire survey on life style routinely obtained from outpatients who first visited the Aichi Cancer Center Hospital between January 1, 1988 and December 31, 1992. Among 36,944 outpatients, 1,186 women with breast cancer detected by histological examination were taken as the case group (607 premenopausal women and 445 postmenopausal women) and 23,163 women confirmed to be free of cancer were selected as the control group. New findings and reconfirmed factors of breast cancer were as follows. 1) The risk of at least one breast cancer history among subjects' first-degree relatives was relatively high among pre- as well as post-menopausal women. 2) A protective effect of physical activity against breast cancer was observed among both pre- and post-menopausal women. 3) Dietary control decreased the risk of premenopausal breast cancer. 4) Current smoking and drinking elevated the risk of breast cancer in premenopausal women. 5) Decreasing trends of breast cancer risk were associated with intake of bean curd, green-yellow vegetables, potato or sweet potato, chicken and ham or sausage in premenopausal women, while in postmenopausal women a risk reduction was associated with a more frequent intake of boiled, broiled and/or raw fish (sashimi). Further study will be needed to clarify the age group- and/or birth cohort-specific risk factors for breast cancer among the young generation in Japan.

Adult↗

PubMed1995

A modified landmark method for dealing with an event observed during a follow-up period.

Events observed during a follow-up period are generally more informative when predicting the prognosis of patients than the clinical data available at the start of follow-up. The present paper has aimed to introduce a modified landmark method for estimating a survival curve for patients in whom an event related to their survival had occurred at a given landmark time during the follow-up period. Survival curves were compared graphically by the conventional method, the Mantel-Byar method, the landmark method and the modified landmark method. The subjects were ninety-five patients with myelodysplastic syndrome who had been diagnosed between 1979 and 1992 at Tokyo Medical College Hospital, and followed-up until September, 1993. Disease evolution was used as the event. The survival curves for patients with and without the event, calculated by the conventional method, were biased and not applicable to the actual patients at the start of follow-up before the occurrence of the event. The curves obtained using the Mantel-Byar method were not biased but similarly not applicable to the actual patients. The landmark method gave unbiased curves applicable to patients with and without the event at a given landmark time, but the curve for those with the event included a lead time from the onset of the event to the landmark time. The modified method gave an unbiased estimation of survival for patients in whom the event had just occurred around a given landmark time.

Disease Progression↗