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Biomedical subjects

S Yasumura

Publications and source records attributed to S Yasumura.

At least 19 recordsLinked to original sources
PubMed2002

Assessment by bioimpedance of forearm cell mass: a new approach to calibration.

OBJECTIVE: Changes in skeletal muscle mass are involved in several important clinical disorders including sarcopenia and obesity. Unlike body fat, skeletal muscle is difficult to quantify in vivo, particularly without highly specialized equipment. The present study had a two-fold aim: to develop a regional (40)K counter for non-invasively estimating cell mass in the arm, mainly skeletal muscle cell mass, without radiation exposure; and to test the hypothesis that cell mass in the arm is highly correlated with electrical impedance after adjusting for the arm's length. METHODS: Forearm cell mass was estimated using a rectangular lead-shielded (40)K counter with 4-NaI crystals; impedance of the arm was measured at multiple frequencies using a segmental bioimpedance analysis (BIA) system. The system's within- and between-day coefficient of variation (CV) for (40)K-derived elemental potassium averaged 1.8+/-1.3 and 5.8+/-1.2%, respectively. The corresponding BIA system's CVs were 1.0+/-0.4 and 2.1+/-1.0%, respectively. SUBJECTS AND RESULTS: Participants in the study were 15 healthy adults (eight females, seven males; age 39+/-2.8 y, BMI 22.9+/-4.5 kg/m(2)). The right arm's K (5.2+/-1.7 g) was highly correlated with length-adjusted impedance (r(2)=0.81, 0.82, and 0.83 for 5, 50 and 300 kHz, respectively; all P<0.001); multiple regression analysis showed no additional improvement by adding age or sex to the prediction models. CONCLUSION: These results demonstrate the feasibility of calibrating BIA-measured electrical properties of the arm against estimates of arm cell mass, mainly of skeletal muscle, obtained by regional (40)K counting. This simple and practical approach should facilitate the development of BIA-based regional cell mass prediction formulas

Adult↗
PubMed2001

Long-term prognosis after recovery from myocardial infarction: a community-based survey in Yamagata, Japan.

OBJECTIVE: To assess the long-term prognosis after recovery from acute myocardial infarction (AMI) in the general population in Japan. PATIENTS AND METHODS: Among the 575,000 inhabitants of the Yamagata metropolitan area, a total of 117 patients suffered from first their AMI from April to December 1993. Thirteen patients (11%) died within four weeks after the onset. Of the remaining 104 patients, 101 (mean age, 69+/-12 years) were followed for an average of 65+/-5 months. RESULTS: Twenty-seven of the 101 patients (27%) died during the follow-up period. Compared with survivors, the patients who died were significantly older at the onset of AMI (74+/-12 vs. 67+/-12 years, p<0.01). More diabetic patients than non-diabetic patients died (42 vs. 21%, p<0.05) because of the higher frequency of non-cardiac deaths (29 vs. 11%, p<0.05). The total number of deaths of cardiac origin, including sudden deaths, was 11 (40%) and was lower than the number of definite non-cardiac deaths (n=15). The time from the onset of AMI to death was significantly shorter in cases of cardiac death than in cases of non-cardiac death (median, 16 vs. 45 months, p<0.01). Among non-cardiac deaths, deaths due to lung cancer and cerebral infarction were notable in men (standardized mortality ratio 278) and women (571), respectively. CONCLUSION: Non-cardiac death during long-term follow-up after AMI was more frequent than death of cardiac origin. Thus, preventive measures, including early treatment of complicating diseases, must be implemented to improve the long-term prognosis of patients with myocardial infarction.

Age Factors↗
PubMed2001

The prevalence and psychosocial characteristics of the frail elderly in Japan: a community-based study.

There is insufficient epidemiological data about frail elders in Japan. Few studies concerning the relationship between psychosocial characteristics and frailty exist in the literature. The purpose of this study was to assess the prevalence and to explore the characteristics of the frail elderly in a community of Japan by cross-sectional and case-control studies. Data were collected from a total of 2,310 non-institutionalized persons aged 65 years or older, by mail survey and interview. We defined frailty as a precursor of disability. The prevalence of frail elders was estimated at 6.1%. After controlling for age and gender, multiple logistic regression analyses disclosed that frail elders displayed significantly higher emotional reliance on another person, worsening self-efficacy, fair or poor subjective health, and poor functional ability than independent elders, and significantly higher self-efficacy than bedridden elders. The most noticeable finding in this study was the significant association of psychosocial factors with frailty among the community-dwelling elderly. Based on our study results, we suggest that when controlling physical variables, psychosocial variables might strongly affect the frail status among elderly persons.

Aged↗
PubMed2000

Factors relating to place of death of Japanese people from a small town in a rural area.

The objective of our retrospective study was to clarify factors relating to place of death of Japanese people from a small town in a rural area who had been bedridden for at least one week before dying. The caregivers of subjects aged 40 and above who died during a three-year period were surveyed by trained interviewers. Of 352 subjects who died, 312 caregivers responded and agreed to a face-to-face interview. A total of 213 subjects were considered as an eligible sample. The main outcome measures were odds ratios for death at home in relation to age, pain, cause of death, and home visit service. One hundred and two people died at home, while 112 people died in a hospital. Multivariate logistic regression analysis showed that the probability of home death increased with age of the bedridden, lack of pain during the bedridden period, not having cancer as a cause of death, having senility as a cause of death, and receiving regular home visits by a Public Health Nurse. In conclusion, expansion of the home visit programs by Public Health Nurses may enable people to die at home as they so desire. Further prospective research is needed to explore the association between the attitude toward terminal care and the place of death.

Adult↗
PubMed2000

Circulating levels of soluble Fas ligand and soluble Fas in patients with chronic obstructive pulmonary disease.

Fas- and tumour necrosis factor (TNF) receptor-mediated apoptosis are known to be two principal apoptotic mechanisms in humans. Although there are several distinctions between these two systems, in vitro studies have demonstrated similar hypoxic activation and a functional relationship. Since patients with chronic obstructive pulmonary disease (COPD) show chronic hypoxaemia and the activation of the TNF-alpha system, we investigated whether these pathophysiological changes influence the Fas-Fas ligand system. We measured the circulating soluble Fas ligand (sFas-L) level, an inducer of apoptosis, and the soluble Fas receptor (sFas) level, an inhibitor of apoptosis, in 34 COPD patients and 35 age-matched healthy controls. In addition, we investigated the relationships between the levels of sFas-L or sFas and clinical variables including the TNF-alpha system; circulating TNF-alpha and soluble TNF-receptor (sTNF-Rs: sTNF-R55 and R75) levels, in the COPD patients. Although circulating TNF-alpha, sTNF-R55 and R75 levels were significantly higher in the COPD patients than in the healthy controls, serum level of sFas-L (Fisher's exact probability test; P = 0.26) and plasma level of sFas [COPD patients vs. controls; mean (SD); 3.74 (0.63) vs. 3.67 (0.48) ng/ml; P = 0.89) were not increased in the COPD patients. There was no significant correlation between the levels of sFas-L or sFas and clinical variables in COPD patients. These results suggest that the Fas-Fas ligand system does not independently play an important role in the pathophysiology of patients with COPD.

Aged↗
PubMed2000

Calibration of the Brookhaven National Laboratory delayed gamma neutron activation facility to measure total body calcium.

Differences in body size and shape can cause large variances in the in vivo results of neutron activation analysis. To introduce corrections for body size for the delayed gamma neutron activation facility at Brookhaven National Laboratory, "reference man"-sized and "reference woman"-sized phantoms were constructed. Simulation results using the Monte Carlo Neutron and Photon Transport code also provided correction factors for people of different sizes. For individuals with a body mass index (BMI = weight (kg)/height (m)2) between 20 and 30, no correction was required. At BMIs greater than 30, the effects of neutron attenuation were significant and a correction factor of CF = -0.0192 x BMI + 1.5635 can be applied.

Body Composition↗
PubMed2000

Gamma resonance absorption. New approach in human body composition studies.

The main stream of body elemental analysis is based on the delayed, prompt, and inelastic neutron interactions with the main elements found in the human body, and subsequent analysis of the measured delayed or prompt gamma ray spectra. This methodology traditionally was, and still is, applied for whole body analysis and requires relatively high radiation doses. A new method, based on gamma nuclear resonance absorption (GNRA), is being established at Brookhaven National Laboratory as part of its body composition program. The method is element specific with a high tomographic spatial-resolution capability, at a small fraction of the radiation dose used in the current system. The new system, with its components and capabilities, is described below.

Adult↗
PubMed2000

A reproductive health survey on unintended pregnancy in Yamagata, Japan: feasibility of the survey and test-retest reliability and validity of a questionnaire.

We have designed a survey to investigate factors related to unintended pregnancy using a newly devised questionnaire. This pilot study was conducted to examine the feasibility of the study and the test-retest reliability and the validity of the questionnaire. Samples were 107 cervical and breast cancer screening participants aged 35-49 year-old in 1999 in Yamagata, Japan. The same questionnaires were mailed twice to examine the test-retest reliability. Women's medical records for cancer screening were used to examine the validity of the questionnaire. Ninety-six women agreed to participate in the study and 89.6% of them responded to the first survey. The agreements between two surveys were substantial to perfect for the nominal and ordinal data, and for the continuous data, the standard deviations (SDs) were less than 1 and the correlation coefficients were over 0.6. The comparison between medical record and questionnaire derived data showed perfect agreements for reproductive items except age at last birth (SD: 0.71, correlation coefficient: 0.97), and fair agreements for drinking and smoking habits. Obtaining information on unintended pregnancy by questionnaire is feasible, and the test-retest reliability and the validity of the questionnaire are satisfactory. Currently we are conducting a survey with a larger sample.

Adult↗
PubMed2000

[Behavioral competence among community dwelling older people with disability in basic activities of daily living].

This study observed the status of independence in behavioral competence among older people who have any disability in basic activities of daily living (BADL) living in a rural community in Japan. Study participants (N = 76) who were regarded as bedridden were surveyed by means of a questionnaire in July to August 1996. The independence variables were age, sex, BADL status, hearing impairment, visual impairment, history of stroke, and cognitive impairment. The dependent variable was each item of the Tokyo Metropolitan Institute of Gerontology (TMIG) Index of Competence, which is a multidimensional 13-item index of behavioral competence. Percentages of subjects who were independent in each item of the TMIG Index of Competence varied from 1% to 36%. Multiple logistic regression analyses revealed that BADL status was independently associated with independence in using a telephone, being interested in news stories or programs dealing with health, being called on for advice, and initiating conversations with young people, after adjustment for age, sex, hearing impairment, visual impairment, history of stroke, and cognitive impairment. These findings suggest that programs for preventing decline in behavioral competence of older people with BADL disability might be important as well as physical therapy for them.

Activities of Daily Living↗
PubMed2000

[Characteristics of functional training and effects on physical activities of daily living].

PURPOSE: The effects of functional training on physical Activities of Daily Living (ADL) based on the Health and Medical Service Law for the Elderly have been controversial. The aim of the present study was to explore its characteristics and influence with a large sample. SUBJECTS AND METHODS: 669 participants and 1,110 non-participants in functional training were recruited from 54 cities and villages in 1998. The effects of functional training on physical ADL were evaluated by comparing the baseline ADL and 1-year follow-up ADL in the "index of Activities of Daily Living for bedridden elderly (1993)". RESULTS: 1. The change in physical ADL in participants was significantly better than that in non-participants after adjusting for age. 2. Significant effects of functional training were observed in both sexes, in all three age groups, and in ranks J, A and B. 3. There was no significant difference between the sexes in terms of the influence of functional training. Functional training was more effective in the younger group, in stroke subjects, and individuals suffering from any disease within one year prior to the baseline. 4. A total of 16.4% of the participants demonstrated increased physical ADL, while 7.2% of the participants also had increased mobility. CONCLUSION: Functional training has a significant positive effect on increase of physical ADL. Functional training based on the Health and Medical Service Law for the Elderly is an effective program especially for homebound and/or frail people who are at risk of becoming bedridden. Further longitudinal studies are now needed to improve functional training for increasing ADL and QOL.

Activities of Daily Living↗
PubMed1999

Bone mineral measurements: a comparison of delayed gamma neutron activation, dual-energy X-ray absorptiometry and direct chemical analysis.

A system in vitro consisting of a femur from a cadaver and soft-tissue equivalent material was used to test the agreement between several techniques for measuring bone mineral. Calcium values measured by delayed gamma neutron activation (DGNA) and bone mineral content (BMC) by Lunar, Hologic and Norland dual-energy X-ray absorptiometers (DXA) were compared with calcium and ash content determined by direct chemical analysis. To assess the effect of soft-tissue thickness on measurements of bone mineral, we had three phantom configurations ranging from 15.0 to 26.0 cm in thickness, achieved by using soft-tissue equivalent overlays. Chemical analysis of the femur gave calcium and ash content values of 61.83 g +/- 0.51 g and 154.120 +/- 0.004 g, respectively. Calcium measured by DGNA did not differ from the ashed amount of calcium at any of the phantom configurations. The BMC measured by DXA was significantly higher, by 3-5%, than the amount determined by chemical analysis for the Lunar densitometer and significantly lower, by 3-6%, for the Norland densitometer (p<0.001-0.024), but only 1% lower (not significant) for the Hologic densitometer. DXA instruments showed a decreasing trend in BMC as the thickness increased from 20.5 to 26.0 cm (p<0.05). However, within the entire thickness range (15.0-26.0 cm), the overall influence of thickness on BMC by DXA was very small. These findings offer insight into the differences in these currently available methods for bone mineral measurement and challenge the comparability of different methods.

Absorptiometry, Photon↗
PubMed1999

Neonatal hyperbilirubinemia and a common mutation of the bilirubin uridine diphosphate-glucuronosyltransferase gene in Japanese.

Neonatal hyperbilirubinemia, which is prevalent among Asian peoples, has been considered as a physiological phenomenon, and its metabolic basis has not been clearly explained. Gilbert syndrome is a common inherited disease of unconjugated hyperbilirubinemia due to decreased bilirubin uridine diphosphate-glucuronosyltransferase (B-UGT), and its role in neonatal jaundice has recently been considered. We have previously reported that the Gly71Arg mutation of the B-UGT gene associated with Gilbert syndrome is prevalent in Japanese, Korean, and Chinese populations and was more frequently detected in neonates with severe hyperbilirubinemia than in control subjects. We have studied 159 Japanese full-term neonates, evaluating the relationship between the B-UGT genotype and the severity of jaundice, as assessed with a transcutaneous bilirubinometer. The gene frequency of the Gly71Arg mutation in these neonates was 0.19, and neonates carrying the Gly71Arg mutation had significantly increased bilirubin levels on days 2-4, manifested in a gene dose-dependent manner. The frequency of the Gly71Arg mutation was 0.47 in the neonates who required phototherapy (i.e., those with more severe hyperbilirubinemia), significantly higher than 0.16 in the neonates who did not require the therapy. The gene frequency of the TA repeat promoter polymorphism, the (TA)7 mutation, was 0.07, and neonates carrying this mutation did not have an increase in bilirubin. These results suggested that the Gly71Arg mutation contributes to the high incidence of neonatal hyperbilirubinemia in Japanese.

Base Sequence↗
PubMed1999

Total body-calcium measurements: comparison of two delayed-gamma neutron activation facilities.

This study compares two independently calibrated delayed-gamma neutron activation (DGNA) facilities, one at the Brookhaven National Laboratory (BNL), Upton, New York, and the other at the Children's Nutrition Research Center (CNRC), Houston, Texas that measure total body calcium (TBCa). A set of BNL phantoms was sent to CNRC for neutron activation analysis, and a set of CNRC phantoms was measured at BNL. Both facilities showed high precision (< 2%), and the results were in good agreement, within 5%.

Calcium↗
PubMed1999

A cohort study of hepatitis C virus (HCV) infection in an HCV epidemic area of Japan: age and sex-related seroprevalence of anti-HCV antibody, frequency of viremia, biochemical abnormality and histological changes.

We studied the age- and sex-specific prevalence of hepatitis C virus (HCV) infection and aminotransferase abnormalities as well as histological changes in the liver associated with HCV infection. Of the eligible 3,707 inhabitants aged 6 years and older in an HCV infection epidemic area 2,382 (64.3%) were examined. The anti-HCV positivity rate was 20.7% on average and increased according to age. Age was the most potential risk indicator for anti-HCV positivity by multiple stepwise regression analysis. The HCV RNA positivity rate in females with anti-HCV was significantly lower than that in males. However, as the age of females increased, the HCV RNA positivity rate became higher. The proportion of subjects with aminotransferase abnormalities among HCV RNA-positive subjects was significantly lower in females than males. Aminotransferase abnormalities significantly increased with age in females. In subjects with abnormal aminotransferase levels, nearly half of the HCV RNA-positive females were aged 50 or older and also nearly half of the male subjects showed CAH2B or liver cirrhosis, while most of the HCV RNA-positive females younger than 50 exhibited histological findings consistent with CPH. In conclusion, age was the principal risk indicator for HCV infection in this area. Females, especially those younger than 50, both biochemically and histologically showed less severity of HCV infection than males. Gender and age might have effects on the outcome of HCV related liver disease.

Adolescent↗
PubMed1999

Angioplasty but not thrombolysis improves short-term mortality of acute myocardial infarction. A multicenter survey in Yamagata, Japan.

There are few district-based surveys to investigate the actual effects of thrombolytic therapy and percutaneous transluminal coronary angioplasty (PTCA) on short-term mortality in patients with acute myocardial infarction (AMI) in Japan. The study population comprised 974 patients (319 women and 655 men, aged 69 +/- 12 years) admitted with confirmed AMI to 41 hospitals in Yamagata Prefecture from January 1, 1994 to December 31, 1996. Thrombolysis and PTCA were performed in 262 (27%) and 428 (44%) patients, respectively, and 161 patients died within 28 days after the onset of AMI (short-term mortality 16.5%). Thirteen variables, including risk factors and clinical manifestations, were examined by bivariate and multiple logistic regression analyses to identify the predictors of short-term mortality. Multiple logistic regression analysis, incorporating variables with a p value < 0.05 in a bivariate analysis, demonstrated that advanced age, history of myocardial infarction and Killip class III or IV independently correlated with increased short-term mortality and treatment with PTCA independently correlated with decreased short-term mortality (odds ratio 0.21, 95% confidence interval [CI] 0.11-0.39). Thrombolytic therapy was not an independent predictor of short-term mortality (odds ratio 0.67, 95% CI 0.37-1.20). Treatment with PTCA but not thrombolysis significantly improved the short-term mortality in patients with AMI in our area-based study.

Aged↗
PubMed1999

[Compliance concerning external protectors for hip fractures among the institutionalized elderly in Japan].

An external protector (EHP) which was developed in Europe to protect the femoral neck from direct impact on falling is available but has not been examined sufficiently in Japan. In order to explore the compliance of use of the EHP among the institutionalized elderly with in case of hip fracture who are at high risk of falling, we conducted the four-week intervention study using two types of a EHP. The subjects of a study consisted of 10 elderly people (2 men, 8 women) with a mean age 85.7 living in nursing home in a village. Informed consent was obtained from all participants. At the end of the study, rate of subjects who wore EHP was relatively high for the Finnish EHP (Safety Pants) group compared to the Danish EHP (Hip Protector) group. There were no significant differences between variables in age, sex, fall experience during the previous year, history of diseases etc. The reasons for dropout were first: difficult in wearing EHP and accompanying delay in toilet, secondly: taking much time to wear, thirdly: a sense of incongruity, too small or too tight'. If the EHP is redesigned to suit Japanese elderly, the compliance might increase. Thorough explanation to institutionalized elderly who may have cognitive impairment, physical problems, or both, is required.

Aged↗