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Biomedical subjects

Toshio Kobayashi

Publications and source records attributed to Toshio Kobayashi.

At least 19 recordsLinked to original sources
PubMed2006

Serotonin syndrome caused by minimum doses of SSRIS in a patient with spinal cord injury.

There have been only a few reports of serotonin syndrome developing after mono-therapy with a selective serotonin reuptake inhibitor (SSRI). We report a case of serotonin syndrome caused by long-term therapy with fluvoxamine prior to treatment with paroxetine. An 18-year-old man with spinal cord injury (SCI) at thoracic level 2-3 presented with onset of serotonin syndrome after taking fluvoxamine (50 mg per day) for 8 weeks prior to treatment with paroxetine (10 mg per day) for 6 days. He had confusion, agitation, severe headache, tachycardia (124 beats/minute), hypertension (165/118 mmHg), high fever (39.1 degrees C), and myoclonus. All of the symptoms disappeared within 24 hours after discontinuation of administration of paroxetine. This is an interesting case of serotonin syndrome that developed after minimum doses of single therapy with an SSRI in a patient with SCI.

Adolescent↗
PubMed2005

Dementia-specific risks of scabies: retrospective epidemiologic analysis of an unveiled nosocomial outbreak in Japan from 1989-90.

BACKGROUND: Although senile dementia patients in long-term care facilities are at leading risk of scabies, the epidemiologic characteristics of this disease have yet to be fully clarified. This study documents the findings of a ward-scale nosocomial outbreak in western Japan from 1989-90, for which permission to publish was only recently obtained. METHODS: A retrospective epidemiologic study was performed to identify specific risk factors of scabies among patients with dementia. Analyses were based on a review of medical and nursing records. All inpatients in the affected ward at the time of the outbreak were included in the study. Observational and analytical approaches were employed to assess the findings. RESULTS: Twenty of 65 inpatients in the ward met the case definition of scabies. The outbreak lasted for almost 10 months and as a result, the spatial distribution of infections showed no localized patterns in the latter phase of the outbreak. The duration of illness significantly decreased after initiation of control measures (P = 0.0067). Movement without assistance (Odds Ratio [OR] = 11.3; 95% Confidence Interval [CI]: 2.9, 44.8) and moving beyond the room (but within the ward) (OR = 4.1; 95% CI: 1.4, 12.5) were significantly associated with infection, while types of room (Western or Japanese) and sleeping arrangement (on beds or futons laid directly on the floor) appeared not to be risk factors. CONCLUSION: Univariate analysis demonstrated the importance of patients' behaviours during daily activities in controlling scabies among senile dementia patients. The findings also support previous evidence that catching scabies from fomites is far less common. Moreover, since cognitive disorders make it difficult for individuals to communicate and understand the implications of risky contacts as well as treatment method, and given the non-specific nature of individual contacts that are often unpredictable, real-time observations might help improve control practices.

Aged↗
PubMed2005

Effects of simulated high altitude on event-related potential (P300) and auditory brain-stem responses.

OBJECTIVE: This study investigated the effect of hyobaric hypoxia on cognitive function. METHODS: We recorded the auditory brain-stem response (ABR) and auditory-evoked event-related potentials (ERP) in 7 male subjects during a rapid ascent to a simulated 4500 m altitude from their acclimatized altitude of 610 m. The amplitude and latency of each component of ABR and of ERP were assessed. RESULTS: Compared with the values at 610 m, at 4500 m the latencies of both waves I and V of ABR significantly increased, with no change in I-V interpeak latency; and the amplitude of wave I decreased, with no change in the amplitude of wave V. The increase in altitude affected neither the amplitude nor the latency of N100. The P300 latency was prolonged significantly after exposure to hypobaric-hypoxic conditions for 2h, with no significant change in amplitude. At 4500 m, the P300 latency returned to the baseline value after oxygen was inhaled. CONCLUSIONS: Our results suggest it is possible to boost cognitive processing by supplying oxygen even when auditory stimulus intensity decreases under hypobaric and hypoxic conditions, and that P300 latency is affected by hypoxic more than hypobaric conditions. SIGNIFICANCE: This study demonstrated that each component of ABR and the latency of both N100 and P300 are important to record when the effects of hypobaric hypoxia on cognitive function are investigated.

Acoustic Stimulation↗
PubMed2005

Consensus statement on chronic and subacute high altitude diseases.

This is an international consensus statement of an ad hoc committee formed by the International Society for Mountain Medicine (ISMM) at the VI World Congress on Mountain Medicine and High Altitude Physiology (Xining, China; 2004) and represents the committee's interpretation of the current knowledge with regard to the most common chronic and subacute high altitude diseases. It has been developed by medical and scientific authorities from the committee experienced in the recognition and prevention of high altitude diseases and is based mainly on published, peer-reviewed articles. It is intended to include all legitimate criteria for choosing to use a specific method or procedure to diagnose or manage high altitude diseases. However, the ISMM recognizes that specific patient care decisions depend on the different geographic circumstances involved in the development of each chronic high altitude disease. These guidelines are established to inform the medical services on site who are directed to solve high altitude health problems about the definition, diagnosis, treatment, and prevention of the most common chronic high altitude diseases. The health problems associated with life at high altitude are well documented, but health policies and procedures often do not reflect current state-of-the-art knowledge. Most of the cases of high altitude diseases are preventable if on-site personnel identify the condition and implement appropriate care.

Acclimatization↗
PubMed2005

Cholesterol intake is associated with lecithin intake in Japanese people.

Many dietary recommendations for the prevention of heart disease and hyperlipidemia include restriction of cholesterol intake. However, limiting cholesterol intake might also affect the intake of other nutrients. The daily intakes of cholesterol, lecithin, total fatty acids, and SFAs by 388 Japanese subjects (ages 6-59 y) were analyzed directly using the duplicate portion sampling technique. Intakes were 266.1 +/- 146.5 mg/d, 1.6 +/- 0.9 g/d, 39.3 +/- 16.8 g/d, and 12.8 +/- 6.9 g/d, respectively. There was a strong positive correlation between cholesterol and lecithin intakes (r = 0.864, P < 0.001), and when food intake was adjusted to 1 kg/d, the correlation remained high (r = 0.881, P < 0.001). In contrast, the correlation between total fatty acid and lecithin intakes was lower (r = 0.423, P < 0.001), and when food intake was adjusted to 1 kg/d, the correlation coefficient remained stable (r = 0.448, P < 0.001). These results strongly indicate that limiting cholesterol intake decreases lecithin intake. Lecithin intake can be estimated from the following regression equation: lecithin intake (g/d) = 0.005 x cholesterol intake (mg/d) + 0.16 (R2= 0.747, P < 0.001). Furthermore, the intake of choline derived from lecithin can be estimated by the following equation: choline (mg/d) = 0.724 x cholesterol (mg/d) + 21.5.

Adult↗
PubMed2005

Associations of sleep problems and recent life events with smoking behaviors among female staff nurses in Japanese hospitals.

For the purpose of examining the relation of sleep problems and other possible correlates with smoking among staff nurses in hospitals, the cross-sectional data of a self-administered questionnaire survey for 522 Japanese female staff nurses were reanalyzed. Registered nurses or licensed practical nurses were 82%, while nursing assistants were 18%. The prevalence of current smoking (PCS) was 29%, being higher than that in the general population of Japanese women. The current smokers exhibited a high tendency toward tobacco dependence. Multivariate analyses revealed that PCS was associated with recent frequent night shifts and a large amount of support from coworkers, while the association of a large amount of job control and a feeling of light overnight sleep with PCS was also suggested. The tobacco-dependent tendency was associated with recent life events and the presence of insomnia. It is possible that smoking is a countermeasure against sleepiness caused by the disadaptation to shift-work, or that tobacco-intake pharmacologically disturbs sleep. For decreasing PCS in staff nurses, further research should focus on the relation of smoking with their sleepiness and shift-working system, and also on the process in which major life events develop smoking behaviors.

Adult↗
PubMed2004

Polymorphisms of renin-angiotensin system genes with high-altitude pulmonary edema in Japanese subjects.

STUDY OBJECTIVES: The renin-angiotensin system (RAS), including angiotensin-converting enzyme (ACE) and angiotensin II type 1 receptor (AT(1)R), plays an important role in the pathogenesis of pulmonary hypertension, which is suggested to be critical in the development of high-altitude pulmonary edema (HAPE). Investigating the associations of the polymorphisms in the genes of RAS with HAPE is to elucidate the genetic background underlying this disease. DESIGN: A cross-sectional, case-control study. SETTING: Shinshu University Hospital, Matsumoto, Japan. PARTICIPANTS: Forty-nine HAPE-susceptible (HAPE-s) subjects with a history of HAPE, and 55 healthy climbers with HAPE resistance (HAPE-r). INTERVENTIONS: Twenty-one of 49 HAPE-s subjects underwent right cardiac catheterization. MEASUREMENTS AND RESULTS: The insertion/deletion polymorphism in the ACE gene (ACE-I/D) was investigated by polymerase chain reaction (PCR). There was no significant difference of the distribution of the ACE-I/D polymorphism between the HAPE-s and HAPE-r groups. The A(1166)C and G(1517)T single-nucleotide polymorphisms (SNPs) in AT(1)R gene were investigated by the PCR following digested by corresponding restricted endonuclease enzymes. The distribution of the G(1517)T SNP was significantly different between the two groups (p = 0.012). The pulmonary hemodynamics of the 21 HAPE-s subjects were retrospectively examined. The pulmonary artery pressure (PAP), pulmonary vascular resistance (PVR), and PVR index (PVRI) were all significantly increased on hospital admission. Moreover, the PVR and PVRI were significantly higher in the HAPE-s subjects with D positivity than in the HAPE-s subjects with I positivity (PVR, p = 0.015; PVRI, p = 0.028), while the PAP did not show any significant difference between the two subgroups. CONCLUSIONS: The ACE-I/D polymorphism is not associated with HAPE susceptibility in Japanese subjects. The AT(1)R gene polymorphisms may likely associate with HAPE susceptibility. The D allele of the ACE-I/D polymorphism probably contributes to the hyperresponsive PVR and PVRI to acute hypoxia.

Adult↗
PubMed2004

Changes in health habits of female shift workers.

This paper examines the effects of shift work on the lifestyles of female factory workers. As an indicator of healthy lifestyle habits, we used a scoring system (referred to below as the 'health score') based on Lester Breslow's health habits. The 'health score' of the women was higher than that of the men, but the shift workers' score was lower than that of the non-shift workers (p<0.01). In addition, the score of workers who had changed from non-shift work to double-shift work was remarkably low (p<0.01). These results suggest that, while the female shift workers manage to maintain relatively healthy lifestyles in comparison with the males, they have more difficulty maintaining these habits than do female workers who do not perform shift work. It can be concluded that, in addition to heightening women's consciousness of their own health, surrounding entities such as the work environment, the home, and the community in general need to pay due care to Japan's female shift workers.

Adult↗
PubMed2004

[Development of the Brief Scales for Coping Profile (BSCP) for workers: basic information about its reliability and validity].

Coping profile of workers greatly affects the process where job stressors develop health problems, but most of the previously proposed questionnaires for the coping profile are too long to be applied to the program of occupational mental health. In the present study, the authors report the process of developing a new self-rating questionnaire for assessing workers' coping profile which includes only 18 questions. Based on the results of a preparatory study, the 18 questions which provide 6 scales about coping strategies were proposed as the Brief Scales for Coping Profile (BSCP). A self-administered questionnaire including BSCP, Brief Scales for Job Stress (BSJS), and a depression scale (CES-D) was applied to 394 workers in a company, and 328 (83%) responded. Their age was 40.1 +/- 10.0 yr (mean +/- SD), 78% were men, 75% were married, and most of them were white collar workers. Six factors extracted through factor analysis of BSCP closely agreed with the expected 6 scales and also with the results of previous studies. They were named "active solution", "seeking help for solution", "changing a point of view", "changing mood", "emotional expression involving others", and "avoidance and suppression". The Cronbach's reliability coefficients for the scales were from 0.66 to 0.75, showing sufficiently high internal consistency. None of them related to gender or age. Multiple regression analysis revealed that 38% of the variance of the depression score was explained by "workload", "problems in personal relationships", and "reward from work" scores in BSJS, and also with "active solution" and "avoidance and suppression" scores in BSCP. Interaction analysis revealed that the coping profile modifies the relationship between job stressors and depressive symptoms; the "active solution" score was inversely associated with the depression score, particularly for the workers with high "problems in personal relationships" scores and low "reward from work" scores, while "avoidance and suppression" scores were positively associated with the depression score particularly for the workers with high "problems in personal relationships" scores. These results support part of the reliability and validity of BSCP, and also support the feasibility of BSCP as a tool for self-management and health education concerning job stress in the field of occupational mental health. The test-retest reliability and concurrent validity of BSCP should be confirmed in a future study. It also should be confirmed in future whether the coping profile relates with gender, age, job type, or other outcome of job stress in other populations.

Adaptation, Psychological↗
PubMed2004

Effect of shift work on mental state of factory workers.

This paper examines the effects of shift work on the mental state of factory workers. As an indicator of the workers' mental condition, the authors used a scoring system (referred to below as the 'depression tendency score') based on the SRQ-D investigative report. The depression tendency score of the men was higher among the shift worker group than among the regular day worker group (p < 0.01). The depression tendency score of the male back-to-back shift workers was higher than that of the male regular day workers among skilled workers (p < 0.05). Among the women, no notable difference in depression tendency score was observed between the regular day worker group and the shift worker group. However, the depression tendency score of the female two-shift workers was higher than that of the female regular day workers among skilled workers (p < 0.05). We conclude that the mental health of men is easily affected by back-to-back shift work and that of women is affected by two-shift work because of the difference in modern societal/home role between man and woman.

Adult↗
PubMed2003

Distribution of haplotypes derived from three common variants of the NR4A2 gene in Japanese patients with schizophrenia.

Dysregulation in dopaminergic neurotransmission might play a role in the pathogenesis of schizophrenia, and therefore genetic components of the dopamine (DA) pathway may confer risk. The NR4A2 (Nurr1) gene is essential for the development and maintenance of mesencephalic DA-synthesizing neurons. Moreover, Nurr1 forms a heterodimer with the retinoid X receptor and disturbances in the retinoid-signaling cascade may be involved in susceptibility to schizophrenia. To investigate the potential genetic contribution of NR4A2, we performed a case-control association study using three common variants in the gene [-2922(C)2-3, IVS6 + 17 approximately +18insG, EX8 + 657(CA)9-10] that were in strong linkage disequilibrium with each other. We did not detect a significant allelic or genotypic association. Haplotypes derived from all three polymorphisms generated similar results. These data do not support the notion that the NR4A2 gene plays a major role in risk for schizophrenia among Japanese individuals.

Adult↗
PubMed2003

Vascular endothelial growth factor in patients with high-altitude pulmonary edema.

To examine the role of VEGF in the pathogenesis of high-altitude pulmonary edema (HAPE), we measured the concentrations of VEGF in venous serum and bronchoalveolar lavage fluid in patients with HAPE and in healthy volunteers. The VEGF in venous serum of the patients was normal at admission and significantly increased at recovery. Similarly, the VEGF in bronchoalveolar lavage fluid of the patients was increased at recovery compared with admission, but values at both admission and recovery were significantly lower than those of the controls. The present finding suggests that VEGF probably is destroyed in the lung of HAPE, and it appears less likely to have a critical part in the pathogenesis of HAPE but has rather an important role in the repair process for the impaired cell layer.

Adult↗
PubMed2003

Polymorphisms of the tyrosine hydroxylase gene in subjects susceptible to high-altitude pulmonary edema.

STUDY OBJECTIVES: A blunted hypoxic ventilatory response (HVR) has been observed in some sufferers of high-altitude pulmonary edema (HAPE), and was proposed as a potential mechanism in its pathogenesis. Tyrosine hydroxylase (TH) is a rate-limiting enzyme in the carotid body responding to hypoxia to synthesize dopamine neurotransmitter to heighten ventilation. The association of constitutional susceptibility to HAPE regarding the blunted HVR aspect with polymorphisms of the TH gene was examined. DESIGN: A cross-sectional case control study. SETTING: Shinshu University Hospital, Matsumoto, Japan. PARTICIPANTS: Forty-three subjects with a history of HAPE (HAPE group) and 51 healthy climbers without a history of HAPE (control group). MEASUREMENTS: The (TCAT)n tetranucleotide microsatellite repeats within intron 1 and Met81Val variant in exon 2 of the TH gene were investigated by polymerase chain reaction following either direct sequencing or restriction fragment length polymorphism. The HVR in 21 subjects among the HAPE group was also measured. RESULTS: No significant frequency differences could be found in terms of either of the two polymorphisms between the HAPE and control groups. Meanwhile, no relationships were observed between the HVR values of HAPE subjects and the individual alleles in both polymorphisms of the TH gene. CONCLUSION: The genetic susceptibility of HAPE, specifically the blunted HVR in HAPE, is probably not associated with the mutations of the TH gene, implying that these two polymorphisms may not be a sufficient genetic marker for predicting a predisposition to the susceptibility to HAPE.

Adolescent↗
PubMed2003

A survey of urinary hippuric acid and subjective symptoms among occupational low toluene exposed workers.

Biological monitoring of toluene exposure by urinary hippuric acid determination and a subjective symptom survey by self-administered questionnaire were performed in 20 workers at low toluene exposure in factories to evaluate the health hazard including dysfunction of nervous system. Environmental monitoring was carried out using toluene gas detection tubes. Urine samples were collected three times a day in order to measure hippuric acid: first before the commencement of work, then at the end of forenoon work, and lastly at the end of afternoon work. Toluene vapor concentrations of throughout the workday ranged from 15.3 to 31.4 ppm. The urinary hippuric acid concentrations correlated with the toluene concentrations of ambient air (r = 0.58, p = 0.01). The subjective symptoms increased in close association with the exposure to toluene; the prevalence rate of subjective symptoms "during work" in the exposed group was 15 times higher than the rate of the non-exposed group (p < 0.0001). The prevalence rate of subjective symptoms "off-work" in the exposed group was 2.4 times higher than the rate of the non-exposed group (p < 0.0001), and also the prevalence rate of "nineteen symptoms off-work which are apparently related to central nervous system (CNS) and autonomic nervous system (ANS)" in the exposed group was 1.8 times higher than the rate of the non-exposed group (p < 0.05). From these results, these subjective symptoms, which have been believed to be complained in high organic solvent exposure should be reassessed and reconsidered in evaluating the nervous system dysfunction and local irritation in relatively low toluene exposed workers.

Adult↗