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Biomedical subjects

Noriko Yoshimura

Publications and source records attributed to Noriko Yoshimura.

At least 19 recordsLinked to original sources
PubMed2006

Prevalence and clinical features of Paget's disease of bone in Japan.

The present study aimed to evaluate the prevalence and clinical presentation of Paget's disease of bone (PDB) in Japan. As PDB is a very rare disease in Japan, a nationwide mail survey was conducted targeting doctors in the specialty most frequently diagnosing and treating PDB patients in Japan. First, the literature for all case reports in Japan published between January 1990 and December 2002 was reviewed to determine who was diagnosing and treating PDB in Japan. This literature review for all case reports in Japan revealed that 72.1% of cases in Japan were reported from departments of orthopedic surgery. A nationwide two-phase mail survey was conducted for the departments of orthopedic surgery of 2,320 general hospitals accredited by the Japanese Orthopaedic Association. Phase 1 involved determining how many patients with PDB were followed at each hospital. If the answer was one or more, phase 2 of the survey gathered information on the clinical presentation of current patients. The mail survey yielded a final response rate of 75.4% for phase 1 and 87.6% for phase 2. Phase 1 indicated that the prevalence of PDB in Japan is about 2.8 cases per million capita. Phase 2 revealed a slight female predominance, lower frequency of familial clustering, higher frequency of femoral fracture in the affected femur, and a higher ratio of symptomatic PDB in Japan compared with findings in countries displaying a higher prevalence of PDB. The present epidemiological study revealed that the disorder is extremely rare in Japanese individuals, and that some differences exist with regard to the clinical features of PDB between Japanese patients and patients from high-prevalence countries.

Adult↗
PubMed2006

Decreased activities of daily living and associations with bone loss among aged residents in a rural Japanese community: the Miyama Study.

The present study aimed to clarify frequencies of decreased activities of daily living (ADL) and associations with rate of bone loss among inhabitants more than 60 years old in Miyama, a rural community in Japan. A cohort of 1543 inhabitants aged 40-79 years was established according to Miyama resident registrations in 1989. Men (n = 50) and women (n = 50) from each of two age strata between 60 and 79 years (N = 200) were selected from this cohort, and bone mineral density (BMD) of the lumbar spine and proximal femur was measured using dual-energy X-ray absorptiometry in 1990 (initial survey) and again in 1993, 1997, and 2000. Difficulties involving ADL were surveyed at every follow-up study. Of the 200 initial participants, 124 (57 men, 67 women; 62.0%) completed all BMD measurements and answered all items about ADL in the follow-up survey. The following items were investigated as a general indication of changes to ADL: reaching objects on a high shelf or cupboard (reaching); washing and drying the body (washing body); washing hair over a washbasin (washing hair); sitting for 1 h on a hard chair (sitting); raising the torso from a lying position in bed (raising); standing continuously for 30 min (standing); taking socks on and off the feet (taking socks); bending down from a seated position and picking up a small object at the side of the chair (bending); lifting heavy objects (lifting); and running 100 m without stopping (running). Among ADL items, the most frequent difficulties in men involved running (50.0%), followed by raising (30.6%), standing (27.1%), sitting (24.7%), and reaching (16.5%). In women, difficulties involved running (67.0%), followed by lifting (36.3%), standing (33.1%), reaching (30.8%), and sitting (23.6%). To evaluate relationships between decreased ADL and changes in BMD, annual rates of change for BMD at the lumbar spine and femoral neck were compared to changes for each ADL item (2 grade decrease; 1 grade decrease; or no change). Analysis of covariance (ANCOVA) was then performed on decreased ADL and annual bone changes after adjustment for age, concomitant disease (previous fractures, gastrectomy, diabetes mellitus, and renal dialysis at initial survey). In men, annual rates of change in BMD at the femoral neck over 10 years were significantly correlated with decreased abilities in bending (P = 0.046; R2 = 0.10). In women, annual rates of change in BMD at the lumbar spine over 10 years were significantly correlated with decreased abilities in reaching (P = 0.007; R2 = 0.25), and lifting (P = 0.014, R2 = 0.27), and those at the femoral neck were significantly correlated with decreased abilities in lifting (P = 0.001, R2 = 0.33).

Activities of Daily Living↗
PubMed2006

Guidelines for diagnosis and management of Paget's disease of bone in Japan.

We here propose guidelines for the diagnosis and management of Paget's disease of bone (PDB) in Japan. These guidelines provide basic information on the epidemiology, pathophysiology, clinical signs and symptoms, diagnosis, indications for treatment, and available therapy, including orthopedic surgery. PDB is a chronic disorder characterized by focal abnormalities of bone turnover. The characteristic feature of PDB is excessive osteoclastic bone resorption coupled to increased and disorganized bone formation. The most common symptom of PDB is pain in involved bones. The most serious complication of PDB is malignant bone or soft-tissue tumor. PDB is uncommon in Japan; our survey in 2003 found 169 patients with PDB. The prevalence of PDB in Japan is 0.15/100 000; in patients aged 55 years or more, the proportion reaches 0.41/100 000. A careful medical history and physical examination are essential for the diagnosis. The diagnosis of PDB is based on finding the typical features on radiographs. Bone scintigraphy and measurement of serum alkaline phosphatase are sensitive means of screening for PDB. Since PDB is a rare disease in Japan, bone biopsy is quite often used to exclude bone metastases. The only evidence-based indication for treatment of PDB is pain in involved bones. In Japan, etidronate and calcitonin are approved by the Ministry of Health, Labour and Welfare for treating PDB, but currently risedronate is also under development for treating PDB in Japan. Indications for surgical intervention in PDB include unstable fractures, osteoarthritis, malignant soft-tissue tumor, osteosarcoma, and bone deformity.

Humans↗
PubMed2006

Risk factors for knee osteoarthritis in Japanese men: a case-control study.

Risk of knee osteoarthritis (OA) was assessed in a population-based case-control study of Japanese men. The study covered three health districts in Wakayama and Osaka prefectures, Japan. Subjects were male individuals >or=45 years old diagnosed radiographically with knee OA, and who did not display any established causes of secondary OA. Controls selected randomly from the general population were individually matched to cases for age, sex, and residential district. Subjects were interviewed using structured questionnaires to determine medical history, physical activity, socio-economic factors, and occupation. Interviews were obtained from 37 cases and 37 controls. In univariate analysis, heaviest weight in the past and physical work such as factory, construction, agricultural, or fishery work as the principal occupation significantly raised the risk of male knee OA (P<0.05). Odds ratios (OR) were determined using conditional logistic regression analysis mutually adjusted for potential risk factors using the results of univariate analysis. Heaviest weight in the past (OR 6.01, 95% confidence interval (CI) 1.18-30.5, P<0.05), past knee injury (OR 6.25, 95% CI 1.13-34.5, P<0.05), and physical work as the principal occupation (OR 6.20, 95% CI 1.40-27.5, P<0.05) represented independent factors associated with knee OA after controlling for other risk factors. Physical work is associated with knee OA, demonstrating the influence of working activity on the development of OA. The present study suggests that risk factors for knee OA in men resemble those in women.

Aged↗
PubMed2006

[Osteoporosis and nutrition: trends of calcium intake and bone mineral densities].

To predict the future incidence and prevalence of osteoporosis in Japan, bone mineral densities (BMDs) in the same age ranges, but attained by different birth cohorts in 1990 or in 2000, were compared. In men, the mean value of BMD at the lumbar spine in the birth cohort of 1930-1939, when they reached the age stratum 60-69, was significantly higher than that of the older cohort born in 1920-1929 when in the same age stratum (p<0.05). The same tendency was observed in BMD of the femoral neck. In women ,the mean value of BMD of the lumbar spine L2-4 in the birth cohort of 1940-1949, when they reached the age stratum 50-59, was significantly higher than that of the cohort born in 1930-1939 when in the same age stratum (p<0.05). Again, the same tendency was observed in BMD at the femoral neck. The comparatively higher levels of BMD observed in women in the 1940-1949 birth cohort when they reached their fifties, may reflect nutritional improvements in Japan. The nationwide nutritional survey reports mean values of calcium intake as 253 mg/day in 1946 (1st survey), 338 mg/day in 1955, 465 mg/day in 1965 and 552 mg/day in 1975 , a dramatic increase. These nutritional improvements might be expected to increase BMD in all age groups;but nevertheless, for females born in 1940-1949 calcium intake per life year would be the highest among the birth cohorts of the present study. The improvement observed in men in their sixties, rather than their fifties as in women, might be attributed to differences in the timing of growth spurts in younger generations. It is encouraging that both men and women in later birth cohorts showed higher BMDs in middle-age, for this may predict a decrease in the incidence and prevalence of osteoporosis in the near future in Japan.

Age Distribution↗
PubMed2006

[Incidence of and prognosis for osteoporotic fracture].

As the population rapidly ages, osteoporosis has been a serious problem. The incidence of hip fracture, which is the most serious complication for osteoporosis, is increasing and over 1,000 thousands per year, while, the incidence of vertebral fracture is still five times more than that of hip fracture. The incidence of hip fracture, vertebral fracture and proximal humeral fracture increases with ages, however, that of distal radial fracture does not. Fracture, especially hip fracture and vertebral fracture, is associated with mortality. Thus, prevention for fracture in the elderly is very important issue.

Age Factors↗
PubMed2006

[Steroids as a risk factor for osteoporotic fracture].

Glucocorticoid is effective medicines for the treatment of, such as, collagen diseases, pulmonary diseases, skin diseases, organ transplantation, however, glucocorticoid induced osteoporosis have been a serious problem. Glucocorticoid is not only associated with decreased bone mineral density (BMD), but also with deteriorated bone quality, so osteoporotic fracture can occur even at slightly lower BMD. Recent studies have shown that long-term use of inhaled glucocorticoid at high doses is also associated with increased risk for fracture. Osteoporotic fracture decreases not only the abilities of daily living and the quality of life, but also to increase mortality, so earlier prevention for glucocorticoid induced osteoporosis is necessary at administration of glucocorticoid.

Activities of Daily Living↗
PubMed2005

Estrogen-metabolizing enzymes in breast cancers from women over the age of 80 years.

CONTEXT: Aromatase, steroid sulfatase, and 17beta-hydroxysteroid dehydrogenase type 1 (HSD-1) peripherally up-regulate, whereas estrogen sulfotransferase (EST) and HSD-2 down-regulate, the synthesis of active and more potent estrogens. These estrogen-metabolizing enzymes (EMEs) are important in postmenopausal breast cancers, but have never been systematically examined in breast cancers of the elderly. OBJECTIVE AND DESIGN: mRNA levels of EMEs in cancerous and normal breast tissues from 39 elderly patients (age, 80-99 yr) were compared with those from 39 controls (age, 37-70 yr) or compared according to estrogen (ER)/progesterone (PR) receptor status. RESULTS: Aromatase levels were higher in cancers of the elderly (EldCa) than in normal tissue of the elderly (P = 0.0008) or cancers of controls (P = 0.0033). In contrast, levels of steroid sulfatase and EST were higher in cancers of controls than normal tissue of controls (P = 0.0046 and P < 0.0001, respectively) or EldCa (P = 0.0001 and P < 0.0001, respectively). Levels of HSD-1 and HSD-2 did not differ significantly between any two of the categories. Among EldCa, HSD-1 levels were higher in ER/PR-positive than in ER/PR-negative carcinomas, whereas EST and HSD-2 exhibited opposite results. CONCLUSIONS: The importance of aromatase is relatively increased in EldCa. ER/PR-positive EldCa exhibited a pattern of EMEs more beneficial to the production of estrogen than did ER/PR-negative EldCa. The specific pattern exhibited in EldCa may elucidate the role of EMEs in the absence of ovarian estrogens in the pathogenesis of breast cancer.

Adenocarcinoma, Mucinous↗
PubMed2005

Gene expression profiling of breast cancer in relation to estrogen receptor status and estrogen-metabolizing enzymes: clinical implications.

Interactions between luminal epithelial cells and their surrounding microenvironment govern the normal development and function of the mammary gland. Estradiol plays a key role in abnormal intracellular signaling, which contributes to the development and progression of breast tumors. The present article summarizes the results from a microarray whole genome gene expression analysis as well as a quantitative analysis of the mRNA expression of members of the estradiol metabolic and signaling pathways in the tumors of postmenopausal breast cancer patients. The analysis of the variation in whole genome gene expression resulted in a tumor classification comprising several distinct groups with distinct expression of the estrogen receptor (ER). The parallel study on the expression of only nine mRNA transcripts of members of the estradiol pathways resulted in two main clusters, representing ER- and ER tumors. The mRNA expression of the estradiol-metabolizing enzymes did not follow the expression of the ER in all cases, leading to the recognition of several further subclasses of tumors. When the tumor classes obtained by whole genome gene expression analysis were compared with those obtained by independent quantitation of the estradiol-metabolizing enzymes, a statistically significant association between both classification groups was observed. These findings point to a possible association between development of a tumor with a particular expression profile and its capacity to synthesize estradiol as measured by the expression of the transcripts for the necessary key enzymes. Further, whole genome expression patterns were studied in 12 patients treated with anastrozole. Using significance analysis of microarrays, we identified 298 genes significantly differently expressed between partial response and progressive disease groups.

Breast Neoplasms↗
PubMed2005

Epidemiology of hip fracture in Japan: incidence and risk factors.

Hip fracture is the most serious complication of osteoporosis and has been recognized as a major public health problem. The prevention of hip fractures is an high-priority issue because of the rapid increase of the number of elderly people in Japan. The General Research Committee for the Prevention and Treatment of Osteoporosis in Silver Health Science Researches sponsored by the Ministry of Health and Welfare (Director, Hajime Orimo) first undertook a nationwide survey of femoral neck fracture in 1987. This nationwide survey has been continued every 5 years, in 1992, 1997, and 2002. The total number of new cases was nearly 120,000 in the latest survey, and has been rising in every survey. Total number of new cases was about 1.4 times the baseline 1987 figures in 1992, 1.7 times in 1997, and 2.2 times in 2002. The total number of new female patients was about three times higher than that of new male patients, a finding identical to those of the previous surveys. The incidences of hip fracture (per 10,000) according to sex and age was increased in both men and women, particularly among individuals 80 years old or over. The Epidemiological Research Group on Osteoporosis, Ministry of Health and Welfare (Chairman; Hajime Orimo) undertook a nation-wide case-control study to clarify the risk factors for hip fractures among Japanese in 1994. Cases of hip fracture in people aged 65-89 were selected from 21 hospitals in seven areas of Japan. Two sex- and age-matched controls were selected from the same residential area for each case using resident registration lists. During this 1-year survey, 249 cases of hip fractures (43 men and 206 women) were reported. The following risk factors for hip fractures were identified using multivariate analysis: past history of stroke with hemiplegia, sleep disturbance, sleeping in a Western-style bed, and drinking more than 3 cups of coffee daily.

Age Distribution↗
PubMed2005

Effects of anastrozole on the intratumoral gene expression in locally advanced breast cancer.

Intratumoral levels of E1 (oestrone), E1S (oestrone sulphate) and E2 (oestradiol) are significantly reduced by treatment with the aromatase inhibitor anastrozole regardless of treatment response. The purpose of the present pilot study was to look for additional markers of biochemical response to aromatase inhibitors on mRNA expression level. Whole genome expression was studied using microarray analysis of breast cancer tissue from 12 patients with locally advanced tumors, both before and following 15 weeks of treatment with the aromatase inhibitor anastrozole (Arimidex). Intratumoral mRNA levels for a subset of genes coding for steroid metabolizing enzymes, hormone receptors and some growth mediators involved in cell cycle control were analysed by quantitative RT-PCR. There was a correlation between the two methods for some but not all genes. The mRNA expression levels of the different genes were correlated to each other and to the intratumoral levels of E1, E2 and E1S, before and after the treatment. Notably, a correlation of the E1/E2 metabolic ratio to the mRNA levels of CYP19A1 was observed before treatment (r=0.745, p<0.005). Whole genome expression analysis of these 12 breast cancer patients revealed similar tumor classification to previously published larger studies. Tumors with no or low expression of ESR1 (oestrogen receptor) clustered together and were characterized by a strong basal-like signature highly expressing keratins 5/17, cadherin 3, frizzled and apolipoprotein D, among others. The luminal epithelial tumor cluster, on the other hand, highly expressed ESR1, GATA binding protein 3 and N-acetyl transferase. An evident ERBB2 cluster was observed due to the marked over-expression of the ERBB2 gene and GRB7 and PPARBP in this patient material). Using significance analysis of microarrays (SAM), we identified 298 genes significantly differently expressed between the partial response and progressive disease groups.

Anastrozole↗
PubMed2005

Gastric cancer screening of a high-risk population in Japan using serum pepsinogen and barium digital radiography.

With the aim of developing more efficient gastric cancer screening programs for use in Japan, we studied a new screening program that combines serum pepsinogen (PG) testing and barium digital radiography (DR). A total of 17 647 middle-aged male subjects underwent workplace screening over a 7-year period using a combination of PG testing and DR. This program's effectiveness, as well as other characteristics of the program, was analyzed. Forty-nine cases of gastric cancer were detected (comprising 88% early cancer cases). The detection rate was 0.28%, and the positive predictive value was 0.85%. The PG test detected 63.3% of cases, DR detected 69.4% of cases, and both tests were positive in 32.7% of cancer cases. The two methods were almost equally effective, and were considerably more effective than conventional screening using photofluorography. Each screening method detected a distinct gastric cancer subgroup; the PG test efficiently detected asymptomatic small early cancer with intestinal type histology, while DR was efficient at detecting cancers with depressed or ulcerated morphology and diffuse type histology. The cost for the detection of a single cancer was much less than that for conventional screening. In fact, it is possible to further reduce the cost of detecting a single cancer to a cost comparable to that of surgically resecting a single gastric cancer. Thus, it is probable that a highly efficient gastric cancer screening system can be implemented by combining the two screening methods. Such a screening program would be beneficial in a population at high risk for gastric cancer.

Barium↗
PubMed2005

[Intervention in lifestyle factors for the prevention of osteoporosis and osteoporotic fractures].

According that osteoporosis is the common condition in an aging society such as in Japan, much progress has been made in understanding the treatment and prevention of osteoporosis. Among potential risk factors, exercise, smoking, and alcohol consumption have been recognised as important lifestyle factors that might influence the risk of osteoporosis and osteoporotic fractures. To assess the relationship between these lifestyle factors and the risk for low bone mass and osteoporosis-related fractures, a systematic literature search over past 13 years was conducted. Accumulating evidence indicates that exercises decrease the risk for hip fractures among middle aged and older men and women. Exercises also help to maintain muscle strength, muscle volume, balance, and joint flexibility, which might prevent falls and fall-related fractures. One randomised controlled trial indicates that high-impact and/or weight-bearing exercise might increase the bone density in the elderly and the peak bone mass among young women. The literature search also address that there is an association between cigarette smoking and the risk of osteoporosis. Smoking cessation is effective to decrease the risk for both osteoporosis and osteoporotic fractures. Future research should be required to evaluate the alcohol consumption and osteoporosis.

Adult↗
PubMed2005

[Risk factors for osteoporosis in Japan].

Risk factors for osteoporosis based on literally analysis were reviewed. For the prevention for the incidence of osteoporosis, the risk factors were low BMI, smoking and low impact exercise. Calcium and Vitamin D intake was the important preventive factor for the disease. Risk factors to assess the prevalent osteoporosis early were also reviewed. Finally, risk assessment for osteoporosis integrated by members of WHO collaborating centre for metabolic bone diseases were stated. They have undertaken a series of meta-analyses to identify clinical risk factors for fracture to determine their dependence upon age and sex. These were based on the individual data from prospective population-based studies. They concluded the risk factors for osteoporosis were age female-sex, low BMI, family history of fracture, current smoking, ever use of systemic corticosteroids, alcohol intake more than two units per day, rheumatoid arthritis and low BMD at the femoral neck or total hip.

Aged↗
PubMed2004

Progression of chronic atrophic gastritis associated with Helicobacter pylori infection increases risk of gastric cancer.

We conducted a longitudinal cohort study to determine the association of Helicobacter pylori infection and the progression of chronic atrophic gastritis (CAG) with gastric cancer. A cohort of 4655 healthy asymptomatic subjects was followed for a mean period of 7.7 years. H. pylori infection was established by serum specific antibodies and the presence of CAG was confirmed by serum pepsinogen. During the follow-up period, 45 gastric cancer cases were detected (incidence rate, 126/100000 person-years). A univariate analysis after adjustment for age showed that both H. pylori and CAG were significantly associated with gastric cancer. To clarify the interaction between H. pylori and CAG, an analysis stratified by H. pylori- and CAG-status was performed. No cancer developed in the H. pylori(-)/CAG(-) group during the study period. This supports the theory that it is quite rare for any type of gastric cancer to develop in an H. pylori-free healthy stomach. With the progression of H. pylori-induced gastritis, the risk of gastric cancer increased in a stepwise fashion from CAG-free gastritis [H. pylori(+)/CAG(-) group] (HR=7.13, 95%CI=0.95-53.33) to CAG [H. pylori(+)/CAG(+) group] (HR=14.85, 95%CI=1.96-107.7) and finally to severe CAG with extensive intestinal metaplasia [H. pylori(-)/CAG(+) group] (HR=61.85, 95%CI=5.6-682.64) in which loss of H. pylori from the stomach is observed. Therefore, it is probable that H. pylori alone is not directly associated with stomach carcinogenesis. Instead, H. pylori appears to influence stomach carcinogenesis through the development of CAG. The observed positive correlation between the extent of H. pylori-induced gastritis and the development of cancer was strong, especially for the intestinal type. These results are compelling evidence that severe gastritis with extensive intestinal metaplasia is a major risk factor for gastric cancer, and they confirm the previously described model of stomach carcinogenesis: the gastritis-metaplasia-carcinoma sequence.

Adult↗
PubMed2004

Risk factors for knee osteoarthritis in Japanese women: heavy weight, previous joint injuries, and occupational activities.

OBJECTIVE: Risk of knee osteoarthritis (OA) associated with constitutional factors, history of joint injuries, and occupational factors was assessed in a case-control study among women in Japan. Results were contrasted with a comparable study in Britain. METHODS: The study covered 3 health districts in Japan. Cases were women aged >/= 45 years old, diagnosed with knee OA by orthopedic physicians utilizing radiography. No cases displayed established causes of secondary OA. Controls selected randomly from the general population were individually matched to each case for age, sex, and residential district. Subjects were interviewed using structured questionnaires to determine medical history, including history of joint injury, physical activity, socioeconomic factors, and occupation. Height and weight were measured. RESULTS: Interviews were obtained from 101 female cases and controls. The highest third of heaviest body weight in the past [high (> 62.0 kg) vs low (< 55 kg) odds ratio = 4.42, 95% confidence interval 1.17-16.64], previous injury to the knee (OR 7.11, 95% CI 2.40-21.09), sedentary work during initial employment (OR 0.35, 95% CI 0.15-0.84), and total working years (OR 1.05, 95% CI 1.01-1.08) represented independent factors associated with knee OA, after controlling for other potential risk factors. CONCLUSION: Heavy weight in the past appears to represent a risk factor for knee OA among women in Japan, as reported in Britain. Constitutional factors may represent important determinants for knee OA, regardless of race. Previous injury to the knee and occupational factors are also associated with knee OA in both Britain and Japan, although characteristic activities for work vary.

Aged↗