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Biomedical subjects

Takeo Nakayama

Publications and source records attributed to Takeo Nakayama.

At least 19 recordsLinked to original sources
PubMed2007

Analysis of news of the Japanese asbestos panic: a supposedly resolved issue that turned out to be a time bomb.

BACKGROUND: Asbestos-linked public health problems were widely reported in Japan, in 2005. The objective is to apply text mining with network analysis to characterize these problems. METHODS: Text mining with network analysis of newspaper headlines including the word 'asbestos' published in 1987 and 2005 was conducted. Outcome measures are occurrence of the words and simultaneous occurrence of two words in the newspaper headlines. RESULTS: In 36 headlines, which contained the word 'asbestos' in 1987, the word 'pollution' (40%) appeared most frequently, followed by 'removal' (31%) and 'campaign' (29%). For combinations of words, the following occurred most frequently: 'campaign and expulsion' (26%) followed by 'removal and campaign' (14%). Of 293 headlines in 2005, the following words appeared: 'hazard' (31%), 'person' (16%) and 'death' (13%). For combinations, the following appeared: 'person and death' (9%). Asbestos pollution and removal campaigns were reported in 1987, but the death of citizens was reported in 2005. CONCLUSIONS: Text mining with network analysis, which presents one of the methods for visualization of text data, suggests the following insight. Insufficient steps against asbestos had been taken for 20 years, which is compatible with the latency period. It has resulted in widespread exposure to asbestos and more severe asbestos-related public health problems among citizens. This methodology suggests that analyzing text data by this method can serve future surveillance and efficient use of epidemiological knowledge.

Asbestos↗
PubMed2006

Dopamine agonists and cardiac valvulopathy in Parkinson disease: a case-control study.

OBJECTIVE: To determine the frequency of cardiac valvulopathy in patients with Parkinson disease (PD) treated with or without dopamine agonists. METHODS: We obtained transthoracic echocardiography and EKG in 210 consecutive patients with PD admitted to our hospital between September 2004 and September 2005. We analyzed the frequency according to the type of dopamine agonist. A case-control design was adopted with dopamine agonist nontreated group as the reference group, and multiple logistic regression analysis was conducted considering age, sex, and duration of illness to examine the relationships between each dopamine agonist and the presence of valvular abnormalities. RESULTS: The frequency of valvulopathy was significantly higher in the cabergoline-treated group (68.8%, 11/16; affected patients/total) than in the dopamine agonist nontreated control group (17.6%, 15/85). The frequency was not different between the pergolide group (28.8%, 19/66) and the pramipexole group (25%, 4/16). The adjusted odds ratio was significantly higher in the cabergoline group (12.96, 95% CI = 3.59 to 46.85), compared with the pergolide group (2.18, 95% CI = 0.90 to 5.30) and pramipexole group (1.62, 95% CI = 0.45 to 5.87). The mean daily dose was 3.8 mg for cabergoline, 1.4 mg for pergolide, and 1.7 mg for pramipexole. The cumulative dose and treatment duration of cabergoline in the valvulopathy subgroup were significantly higher than in the nonvalvulopathy subgroup. CONCLUSION: The frequency of valvulopathy was significantly increased in the cabergoline group. Our results indicate that high cumulative dose and long-term treatment with cabergoline are risk factors for valvulopathy in patients with Parkinson disease.

Aged↗
PubMed2006

Psychological process from hospitalization to death among uninformed terminal liver cancer patients in Japan.

BACKGROUND: Although the attitude among doctors toward disclosing a cancer diagnosis is becoming more positive, informing patients of their disease has not yet become a common practice in Japan. We examined the psychological process, from hospitalization until death, among uninformed terminal cancer patients in Japan, and developed a psychological model. METHODS: Terminal cancer patients hospitalized during the recruiting period voluntarily participated in in-depth interviews. The data were analyzed by grounded theory. RESULTS: Of the 87 uninformed participants at the time of hospitalization, 67% (N = 59) died without being informed of their diagnosis. All were male, 51-66 years of age, and all experienced five psychological stages: anxiety and puzzlement, suspicion and denial, certainty, preparation, and acceptance. At the end of each stage, obvious and severe feelings were observed, which were called "gates." During the final acceptance stage, patients spent a peaceful time with family, even talking about their dreams with family members. CONCLUSION: Unlike in other studies, the uninformed patients in this study accepted death peacefully, with no exceptional cases. Despite several limitations, this study showed that almost 70% of the uninformed terminal cancer patients at hospitalization died without being informed, suggesting an urgent need for culturally specific and effective terminal care services for cancer patients in Japan.

Journal Article↗
PubMed2006

Periodontal disease and atherosclerosis from the viewpoint of the relationship between community periodontal index of treatment needs and brachial-ankle pulse wave velocity.

BACKGROUND: It has been suggested that periodontal disease may be an independent risk factor for the development of atherosclerosis. However, the relationship between periodontal disease and atherosclerosis has not been fully elucidated. This study aimed to assess the effects of periodontal disease on atherosclerosis. METHODS: The study design was a cross-sectional study. Subjects were 291 healthy male workers in Japan. We used the Community Periodontal Index of Treatment Needs (CPITN) score, average probing depth and gingival bleeding index (rate of bleeding gums) to assess the severity of periodontal disease. We also used the Brachial-Ankle Pulse Wave Velocity (baPWV) as the index for the development of atherosclerosis. RESULTS: The unadjusted odds ratio (OR) of atherosclerosis in relation to the CPITN score was 1.41 [95% CI: 1.16-1.73]. However, after adjustment for age, systolic blood pressure and smoking, the CPITN score had no relationship with atherosclerosis (adjusted OR: 0.91 [0.68-1.20]). CONCLUSION: Our results show no relationship between mild periodontal disease and atherosclerosis after appropriate adjustments.

Adult↗
PubMed2006

An epidemiological study on anemia among institutionalized people with intellectual and/or motor disability with special reference to its frequency, severity and predictors.

BACKGROUND: To examine the type, frequency, severity, and predictors of anemia and its relationship with co-morbid conditions among institutionalized people with intellectual and/or motor disability. METHODS: We conducted a cross-sectional study at a public facility for people with intellectual and/or motor disability in Ibaraki prefecture, Japan. Health checkup data obtained in 2001 from 477 people with intellectual disability (male: 286, average age 40.6 +/- 12.3; female: 191, average age 45.1 +/- 11.6) were retrospectively reviewed. RESULTS: The prevalence of anemia among male participants was higher than in female participants for each disability category (intellectual disability, 41.1%, 4.2%; cerebral palsy, 37.5%, 4.8%; Down's syndrome, 15.0%, 0%; severe motor and intellectual disabilities, 61.9%, 16.7%). Most participants with anemia (93.8 - 100%) showed a normocytic normochromic anemia pattern. Multivariate analysis revealed that factors related to an increase in frequency included sex (male), low body mass index (BMI), use of anticonvulsants or major tranquilizers, and a high zinc sulfate turbidity test (ZTT) value. No clinically diagnosed co-morbid condition was found to be related to the presence of anemia. CONCLUSION: A high frequency of mild normocytic normochromic anemia in institutionalized people with intellectual and/or motor disability was observed, particularly among males. Medications and chronic inflammation may increase the risk of anemia.

Adult↗
PubMed2006

Effectiveness and safety of ritodrine hydrochloride for the treatment of preterm labour: a systematic review.

PURPOSE: To analyse the available data on the effectiveness and safety of ritodrine hydrochloride in delaying delivery and in decreasing the incidence of preterm birth. METHODS: Systematic review of randomised controlled trials (RCTs) that compared the effectiveness and safety of ritodrine hydrochloride with a placebo or with no treatment. Main outcome measures were relative risks (RRs) for perinatal mortality, neonatal respiratory distress syndrome (RDS), delivery within 48 hours or 7 days, preterm birth before 37 weeks gestation and low birth weight. We searched computerised databases (MEDLINE, CENTRAL, Ichushi Web) from their inception to October 2004, and searched the references of eligible trials. RESULTS: Seventeen RCTs were included and meta-analysis was conducted. Pooled RRs relative to placebo for delivery within 48 hours or 7 days for parenteral ritodrine hydrochloride were 0.74 (95%CI (confidential interval): 0.56, 0.97), 0.85 (95%CI: 0.74, 0.97). There was no significant decrease in perinatal mortality, the proportion of RDS, preterm birth and low birth weight infants. Maternal side-effects significantly increased in patients receiving ritodrine with respect to those receiving a placebo. Pooled RRs relative to placebo for oral ritodrine hydrochloride showed no significant decrease in primary and secondary endpoints. CONCLUSIONS: The effectiveness of parenteral ritodrine hydrochloride for tocolysis in preterm labour is limited to short-range prolongation of gestation. The effectiveness of maintenance tocolytic therapy with oral ritodrine hydrochloride was not proved.

Administration, Oral↗
PubMed2006

Gender differences in effects of physical activity on quality of life and resource utilization.

BACKGROUND: Physical activity is associated with health-related quality of life (HRQOL) in the general population, but the effects may be different between sexes. In addition, the effects on resource utilization are not well elucidated. METHODS: A population-based cross-sectional survey was conducted in a rural town, and follow-up data were obtained after 1 year. Physical activity was measured in two ways: amount and maximum intensity. The association between physical activity and the MOS Short Form-36 (SF-36) at baseline, and hospitalization, sick days, and medications in the following year were assessed by multiple regression models. RESULTS: Among 4018 adult residents eligible, 3529 (62.4%) had completed the follow-up questionnaire. A greater amount of exercise was positively correlated with all domains of the SF-36: 2.4-9.5 increase in 100-scale at baseline, but association between maximum intensity and SF-36 was observed in only women. It was also associated with a 20-50% higher utilization of over-the-counter drugs in the following year in both sexes, but the effects of maximum intensity on sick days had different directions for men (relative risk, 2.0-2.4) and women (relative risk, 0.3-0.5). CONCLUSION: The amount of physical activity had positive effects on HRQOL for both men and women, but women had more preferable effects of maximum intensity on HRQOL and resource utilization than men.

Adult↗
PubMed2006

Comparison of effects in randomized controlled trials with observational studies in digestive surgery.

OBJECTIVES: To compare the results of randomized controlled trials versus observational studies in meta-analyses of digestive surgical topics. SUMMARY BACKGROUND DATA: While randomized controlled trials have been recognized as providing the highest standard of evidence, claims have been made that observational studies may overestimate treatment benefits. This debate has recently been renewed, particularly with regard to pharmacotherapies. METHODS: The PubMed (1966 to April 2004), EMBASE (1986 to April 2004) and Cochrane databases (Issue 2, 2004) were searched to identify meta-analyses of randomized controlled trials in digestive surgery. Fifty-two outcomes of 18 topics were identified from 276 original articles (96 randomized trials, 180 observational studies) and included in meta-analyses. All available binary data and study characteristics were extracted and combined separately for randomized and observational studies. In each selected digestive surgical topic, summary odds ratios or relative risks from randomized controlled trials were compared with observational studies using an equivalent calculation method. RESULTS: Significant between-study heterogeneity was seen more often among observational studies (5 of 12 topics) than among randomized trials (1 of 9 topics). In 4 of the 16 primary outcomes compared (10 of 52 total outcomes), summary estimates of treatment effects showed significant discrepancies between the two designs. CONCLUSIONS: One fourth of observational studies gave different results than randomized trials, and between-study heterogeneity was more common in observational studies in the field of digestive surgery.

Digestive System Surgical Procedures↗
PubMed2006

Promoting measles vaccination in attendees not yet immunized at day-care centers in Kyoto City.

BACKGROUND: Due to the low measles vaccination rate, localized measles epidemics occasionally occur in Japan with the majority of sufferers being children under 2 years of age. Despite an increased risk of infection at day-care centers, the measles vaccination coverage for day-care attendees is lower than children who are reared-at-home or attend kindergartens. This study aims to describe the current state of measles prevention policy at day-care centers and to examine factors associated with vaccine promotion. METHODS: A cross-sectional study using anonymous self-administered questionnaires were distributed to the director or person-in-charge at 250 all licensed day-care centers in Kyoto City, Japan, in 2004. The preventive measures against measles at day-care centers and factors related to carrying out the promotion of measles vaccination were examined. Descriptive statistics and odds ratios (OR) using a logistical model were presented. RESULTS: Out of 250 day-care centers, 187 questionnaires were returned (response rate, 74.8%). Measles vaccination history was taken at 161 day-care centers (86.1%) at the time of enrollment; only 61 day-care centers (32.6%) took a history during the school year. A total of 101 day-care centers (54.0%) promoted measles vaccination in day-care attendees who had not yet been immunized. Day-care centers which promoted it were more likely to be 'public facility' (OR, 3.09) and 'having opportunities to learn about vaccination' (OR, 5.55). After adjustment, 'having opportunities to learn about vaccination' and 'having knowledge that measles vaccination is best under the age of 15 months' were significantly related to carrying out the promotion of measles vaccination (OR, 6.47; 95% confidence interval, 2.52-18.61; OR, 3.12; 95% confidence interval, 1.45-6.95, respectively). CONCLUSION: Preventive measures for measles at day-care centers are currently insufficient. Increasing opportunities to learn about vaccination may encourage promotional behavior.

Adult↗
PubMed2006

Linguistic adaptation and validation of the General Oral Health Assessment Index (GOHAI) in an elderly Japanese population.

OBJECTIVES: This study sought to develop a Japanese version of the General Oral Health Assessment Index (GOHAI) and validate its use in an elderly Japanese population. METHODS: The GOHAI scale was translated in a standardized way consisting of forward translation, pilot study, and backward translation. Psychometric properties of the final version were assessed on 175 participants (mean age: 70.0 years, SD 6.4). RESULTS: The response rate was more than 98% for each item. The reliability in terms of a Cronbach's alpha value was 0.89. The mean GOHAI scores were significantly lower for participants with poor perceived oral health (P<0. 001) or poor perceived general health (P<0.01). Significant correlations were observed between the GOHAI scores and the general health or physical functioning scores of the Medical Outcome Study Short Form 36 (P<0.01). CONCLUSIONS: The present study showed that the Japanese version of the GOHAI was psychometrically valid in an elderly sample population.

Aged↗
PubMed2006

Two new criteria of the metabolic syndrome: prevalence and the association with brachial-ankle pulse wave velocity in Japanese male workers.

In 1998 and 2001, The World Health Organization and the National Cholesterol Education Program Adult Treatment Panel III proposed working criteria for the metabolic syndrome (MS), but they are not perfect for use in diverse ethnicities. In 2005, the International Diabetes Federation (IDF) and eight societies in Japan respectively proposed new criteria. However, there has been no report regarding the application of these new criteria in Japanese workplaces. We conducted a cross-sectional study of 377 healthy Japanese men aged 20-64 yr who worked in a chemical factory in Kanagawa, Japan. Participants completed a self-reported questionnaire, underwent a physical examination including waist measurements and brachial-ankle pulse wave velocity (baPWV), and provided overnight fasting blood samples. The prevalence of MS in Japanese men was 17.0% and 13.5% according to the new IDF and Japanese criteria respectively. In both of the new criteria, baPWV was significantly higher in those with MS than those without MS (1,563 +/- 264.2 vs 1,362 +/- 204.6 cm/sec, p<0.001 in the new IDF criterion; 1,574 +/- 265.2 vs 1,368 +/- 209.1 cm/sec, p<0.001 in the Japanese criterion). In the analysis of the 5 or 6 subgroups stratified according to the number of MS components, baPWV increased significantly with increasing number of MS components (p for trend<0.01 in both criteria). The new IDF and Japanese criterion are both good for diagnosing MS among Japanese because a linear increase in baPWV occurred with increasing MS components after adjustment for potential confounding factors. Further studies are expected using these new criteria.

Adult↗
PubMed2006

Evidence-based healthcare and health informatics: derivations and extension of epidemiology.

Epidemiology provides extremely valid information and evidence regarding human health. Epidemiologic findings with regard to major illnesses must be amassed, enhanced, and expanded further into related areas as a foundation for evidence-based medicine that is based on clinical practice, as well as for evidence-based healthcare that includes public health-related issues. Epidemiology should be recognized not only by epidemiologists but also by a variety of people, including specialists in other areas for healthcare and medicine, people in law and media, policy makers, and the general public. A system is needed that can create information for facilitating appropriate decision-making with issues related to clinical medicine and public health. The principles and methodology of epidemiology are used as a base for developing a field of health informatics. The objective of health informatics is to establish a system for facilitating the flow and circulation of health and medical information. Health informatics has potential applications for the creation, communication, and use of information, and the discipline is being expanded as a practical applied science in search of solutions. This report represents an effort to expand the scope of health informatics and extend the applications of epidemiology by working with individuals in other disciplines and the public.

Decision Support Techniques↗
PubMed2006

Oral health status and health-related quality of life: a systematic review.

This study was conducted in order to identify the literature on oral health status and health-related QOL, review the findings systematically, and assess the association between them. We performed a literature search of reports published between January 1973 and June 2004, using five databases including MEDLINE. Only studies that used validated generic health-related QOL instruments were selected. The reviewers evaluated selected articles independently and resolved disagreements by consensus. A total of 1,726 articles were retrieved and seven were selected for the review; five observational studies and two intervention studies. Four studies showed significant associations between oral health status and health-related QOL. Temporomandibular disorders were highly associated with reduced health-related QOL. Poor oral status linked to both craniomandibular and cervical spinal pain was associated with increased impairment of health-related QOL. Dissatisfaction with the teeth and mouth, and a sensation of dry mouth contributed to reduce health-related QOL. Providing edentulous patients with implant-supported full dentures contributed to improve health-related QOL. Assessment of health-related QOL in relation to oral health with validated instruments remains insufficient. The present findings suggest that oral health status could affect health-related QOL in some settings; however, further evidence is needed to support this interpretation.

Craniomandibular Disorders↗
PubMed2005

Measles vaccine coverage and factors related to uncompleted vaccination among 18-month-old and 36-month-old children in Kyoto, Japan.

BACKGROUND: Due to low vaccine coverage, Japan has not only experienced outbreaks of measles but has also been exporting it overseas. This study aims to survey measles vaccine coverage and the factors uncompleted vaccination among community-living children. METHODS: Subjects were the parents whose children had undergone either an 18-month or a 36-month checkup publicly provided by Kyoto City during November 2001 to January 2002. An anonymous self-administered questionnaire survey was conducted. RESULTS: The coverage was 73.2% among the 18-month-old children (n = 2707) and 88.9% among the 36-month-old children (n = 2340), respectively. The following characteristics of mothers were related to uncompleted measles vaccination: aged below 30, working, concerned about the adverse events of the vaccine, and had insufficient knowledge. Similarly, the following characteristics among children were related to uncompleted measles vaccination: not the first-born child, interacting with other children in group settings. The coverage was the lowest among the children whose mothers were concerned about the adverse events of the vaccine without proper knowledge of measles and its vaccination. CONCLUSION: To increase vaccine coverage among children, parents' awareness about measles and vaccination against it should be promoted, especially for working mothers. Efforts to enhance access to vaccination services and to communicate with parents about changing vaccination schedules are necessary.

Child, Preschool↗
PubMed2005

Assessment of tailor-made prevention of atherosclerosis with folic acid supplementation: randomized, double-blind, placebo-controlled trials in each MTHFR C677T genotype.

This study aimed at assessing the effect of folic acid supplementation quantitatively in each MTHFR C677T genotype and considered the efficiency of tailor-made prevention of atherosclerosis. Study design was genotype-stratified, randomized, double-blind, placebo-controlled trials. The setting was a Japanese company in the chemical industry. Subjects were 203 healthy men after exclusion of those who took folic acid or drugs known to effect folic acid metabolism. Intervention was folic acid 1 mg/day p.o. for 3 months. The primary endpoint was plasma total homocysteine level (tHcy). In all three genotypes, there were significant tHcy decreases. The greatest decrease was in the TT homozygote [6.61 (3.47-9.76) micromol/l] compared with other genotypes [CC: 2.59 (1.81-3.36), CT: 2.64 (2.16-3.13)], and there was a significant trend between the mutated allele number and the decrease. The tHcy were significantly lowered in all the genotypes, but the amount of the decrease differed significantly in each genotype, which was observed at both 1 and 3 months. Using these time-series data, the largest benefit obtained by the TT homozygote was appraised as 2.4 times compared with the CC homozygote. Taking into account the high allele frequency of this SNP, this quantitative assessment should be useful when considering tailor-made prevention of atherosclerosis with folic acid.

Alleles↗
PubMed2005

Living close to automobile traffic and quality of life in Japan: a population-based survey.

The objective of this study was to evaluate the association between living close to traffic and health related quality of life (HRQOL) that is important to the health outcome. We administered a questionnaire including the Medical Outcome Study Short Form-36-item Health Survey to all 6197 residents living in Naie, aged 20 years and older, and received 5107 (82.4%) responses. The respondents were classified into three groups: those whose bedrooms were located to an arterial road (AR), located to other roads (OR), and not located to any road (NR). We used analysis of covariance to estimate the mean differences among the three groups for each SF-36 domain. HRQOL scores of the AR and the OR group were lower than those of the NR group in all domains. The adjusted mean scores of the AR group on "mental health" and "vitality" domains were significantly lower than those of the NR group. This study suggests that the HRQOL is an effective tool for evaluating the many impacts of road transportation on aspects of health.

Adult↗
PubMed2005

Role of NAD-dependent deacetylases SIRT1 and SIRT2 in radiation and cisplatin-induced cell death in vertebrate cells.

Yeast Sir2 is a nicotinamide adenine dinucleotide (NAD)-dependent histone deacetylase that plays a central role in transcriptional silencing, chromosomal stability, DNA damage response and aging. In mammals, Sir2-like genes constitute a seven-member family whose function is largely unknown. To investigate the role of the Sir2 family in vertebrates, we have disrupted Sir2 homologues SIRT1 and SIRT2 in the p53-deficient chicken cell line DT40. Both SIRT1-/- and SIRT2-/- cells had mild growth defects. Colony survival assays showed moderate and mild sensitivity to cisplatin in SIRT1-/- and SIRT2-/- cells, respectively, while SIRT1-/-, but not SIRT2-/- cells, were sensitive to ionizing radiation (IR). Cells rendered doubly deficient in SIRT1 and SIRT2 exhibited the same levels of IR and cisplatin sensitivity as SIRT1-/- cells. SIRT1-/- cells appeared to be defective neither in DNA double strand break repair nor in G2/M checkpoints, but were more susceptible to cell death induction following IR than wild-type cells. Furthermore, both SIRT1- and SIRT2-deficient cells were more sensitive to pro-apoptotic stimuli including cisplatin and staurosporine. Our results indicate that SIRT1 and SIRT2 regulate stress-induced cell death pathways in a p53-independent manner.

Animals↗