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Biomedical subjects

Y Naruse

Publications and source records attributed to Y Naruse.

At least 55 records · Page 3Linked to original sources

The comparative study on occupational mortality, 1980 between Japan and Great Britain.

Age-adjusted standardized mortality ratios (SMRs) and life tables in male occupational groups for all causes and major diseases such as malignant neoplasm of stomach and lung, cerebrovascular disease, ischemic heart disease, traffic accidents and suicide was compared between Japan and Great Britain. Except for traffic accidents and suicide, males in higher employment grades had lower SMRs which had also been found to be related to other social class indicators such as perinatal death rate, the frequency of work absence and current smoker's rate. Occupational differences in mortality rates for major diseases became smaller with advancing age in Great Britain but not necessarily in Japan. The present authors concluded that inequalities in socio-economical factors were more likely to be the primary factors for survival, and that selection such as occupation and occupation-related lifestyle might still be an important factor for the inequalities. These inequalities were more obvious in Japan, where a life expectancy was, however, best in the world.

Adult↗

[Emergent coronary artery bypass grafting in patients with acute coronary syndrome].

The incidence of emergent CABG in patients with acute coronary syndrome has been decreasing, because thrombolytic therapy and/or catheter intervention have proved to be done faster and more efficient. The present indication of CABG is mostly limited to patients with left main trunk lesion or severe triple vessel disease, whose PTCA is failed with persistent chest pain or unstable hemodynamic condition. The factors associated with an increased hospital mortality are ejection fraction < 30%, age > 70 years, presence of cardiogenic shock, and cardiac index < 1.5. The interval between operation and AMI is not a significant risk factor. The prognosis of the operative survivors is relatively good. The use of the internal thoracic artery graft does not influence on the early outcome as far as the preoperative hemodynamic condition is stable. To get better surgical results, improvements in intraoperative myocardial protection and in postoperative cardiac support are imperative.

Acute Disease↗

Risk indicators of low back pain among workers in Japan. Association of familial and physical factors with low back pain.

STUDY DESIGN: A questionnaire was given to 3,042 Japanese workers at a factory in 1992. It surveyed age, gender, weight, height, job classification, and work environment, as well as the perceived causes, onset age, and characteristics of low back pain. Family history of low back pain among first-degree relatives and perception of physical condition also were assessed. OBJECTIVES: To investigate the risk indicators of low back pain in Japanese workers with various kinds of job classifications in a manufacturing company. SUMMARY OF BACKGROUND DATA: Risk indicators of low back pain in Japanese patients have not been fully investigated in previous studies. METHODS: Prevalence rates and characteristics of low back pain were examined among 3,042 factory workers (2,517 men and 525 woman) with jobs with varying physical demands. In the analysis of risk indicators of low back pain, the odds ratios and 95% confidence intervals were computed. In addition, a multiple logistic analysis was performed to evaluate risk indicators of low back pain. RESULTS: Point and lifetime prevalence of low back pain were correlated with the physical demands of the job. The perceived cause found to be most associated with low back pain were lifting in workers with jobs requiring moderate to heavy work and sports activity in sedentary workers. Family history of low back pain in parents, siblings, and children was a risk indicator of low back pain. The average age of the first attack of low back pain in workers with a family history of it in their parents was significantly younger than that in workers with no family history in a multiple logistic analysis in male workers, the physical work demands, age, and family history of low back pain in their parents were risk indicators; however, obesity was not a risk indicator. Physical and mental conditions of workers also were associated with low back pain. CONCLUSIONS: The physical job demands show a clear association with the point and lifetime prevalence of low back pain, and improvements in work conditions may decrease low back symptoms among workers. It is likely that a family history of low back pain and physical and mental conditions of workers also should be considered in the management of low back pain.

Adult↗

Elevation of platelet activating factor, inflammatory cytokines, and coagulation factors in the internal jugular vein of patients with subarachnoid hemorrhage.

The aim of the present study was to examine the changes of inflammatory and coagulation factors in blood of the internal jugular vein, not of peripheral vein, in patients with subarachnoid hemorrhage (SAH). The results show that while interleukin-6 (IL-6) and platelet activating factor (PAF) concentrations increased within first 4 days after SAH and remained elevated up to 14 days, interleukin-1 beta (IL-1 beta) showed a transient increase between 5-9 days after SAH and tumor necrosis factor-alpha (TNF-alpha) remained unchanged. Also different coagulation factors were increased between 5-9 days after SAH. Moreover, patients with delayed ischemic neurological deficits (DIND) displayed the highest levels of PAF and the coagulation factors, von Willebrand factor (vWF) and thrombin-antithrombin III complex (TAT). These results suggest that elevation of PAF and other inflammatory cytokines following SAH may cause the hypercoagulation state that is associated with cerebral vasospasm and internal jugular vein may be more adequate vessel for sampling blood to examine these factors.

Adult↗

[Reduction of alcohol consumption and its effect on Na(+)-K(+)-ATPase activity of red blood cell membrane].

Fifty-four untreated, mildly hypertensive men who were civil servants and were aged 30-59 years reduced their alcohol consumption as much as possible for three weeks. Then blood pressure and serum gamma GTP decreased significantly, but Na(+)-K(+)-ATPase activity of the red blood cell membrane did not change significantly. The enzyme activity in twenty subjects (45.5% of total subjects) increased and that in twenty-four subjects (54.5%) decreased or was unchanged. No significant relationship between the ratio of the change of Na(+)-K(+)-ATPase activity and that of blood pressure or serum gamma GTP was observed.

Adult↗

[Health care needs of the elderly in long-term care facilities and their suitable placements for care].

In order to obtain information on the elderly cared for in long-term facilities, regarding their needs and the actual services received in these facilities, and to determine which facility could provide the most suitable service, elderly in two areas, urban S area and rural N area, were surveyed. The results were as follows. (1) The proportion of elderly placed in hospitals where the suitable care placements were hospitals was 84.6% in S area, and 66.6% in N area. (2) In elderly cared for in long-term facilities, the proportion of persons where the suitable care placement was in-home care was 11.7% in S area, and 14.1% in N area. (3) Therefore estimates for the elderly that would be for at home increases by 21.1% in S area and 27.2% in N area than the estimated figures used in plan for Elderly-Health Welfare in 2,000 AD.

Aged↗

Ischaemic heart disease deaths in a Japanese rural area evaluated by clinical records.

A community-based survey to examine the actual number of ischaemic heart disease (IHD) deaths was undertaken in the western area of Toyama, a rural area with a population of 209,000. IHD deaths (International Classification of Diseases [ICD], ninth revision, codes 410-414) and heart failure (HF) deaths (ICD code 428) according to the death certificate aged 15 to 74 in 1987 to 1990 were reevaluated from medical records using the criteria of the multinational monitoring of trends and determinants in cardiovascular disease (MONICA). Of 97 subjects with IHD and of 170 subjects with HF according to the death certificate, 85 cases (87.6%) and 143 cases (84.1%) could be examined, respectively. Using the MONICA criteria, of 85 subjects with IHD, 18 (21.2%) were reevaluated as "definite acute myocardial infarction (AMI)" and 30 (35.3%) as "possible AMI". On the other hand, of 143 subjects with HF, 1 (0.7%) were reevaluated as "definite AMI" and 12 (8.4%) as "possible AMI". From these results, the number of deaths as reevaluated IHD was estimated 104.5 in the study period, and it was 7.7% increase at least compared with the number of deaths judged from the death certificate.

Adolescent↗

[Clinical analysis of infective endocarditis with aneurysmal formation of the mitral or aortic valve].

Echocardiographic findings, clinical features, and pathophysiology of mitral and aortic valve aneurysms were evaluated in four patients with pathologically proven aneurysms of the mitral and/or aortic valves associated with infective endocarditis. These four were selected from 20 patients hospitalized in our institute from April 1990 to May 1995 because of infective endocarditis. All four patients had received repeated, inadequate antibiotic treatments at other medical institutions prior to admission, and underwent surgical repair because of acute hemodynamic exacerbation associated with aneurysmal perforation. Six aneurysms (three mitral and three aortic valve aneurysms) were detected before surgery, including two by transthoracic echocardiography and four by transesophageal echocardiography. The echocardiographic findings typical of aortic valve aneurysm were: ringed echo at the level of the aortic annulus in the short-axis view; turbulent flow within the ringed echo; and dome formation of the aortic valve that persisted throughout the cardiac cycle. All mitral valve aneurysms were true aneurysms without active inflammatory changes or significant destructive lesions, and were associated with severe infective aortic regurgitation. Histologic examination of the aortic valve in these patients showed active inflammation and extensive destruction, suggesting that these valves were the primary focus of infection. One patient had an aortic valve aneurysm without apparent mitral involvement, indicating that another mechanism had mediated aneurysmal formation. We conclude that: diagnosis of mitral or aortic valve aneurysms in patients with infective endocarditis has important therapeutic implications, and therefore, transesophageal echocardiographic examination should be done in such patients: there are three key echocardiographically diagnostic findings of aortic valve aneurysm as mentioned above; and several unknown factors may contribute to aneurysmal formation of the mitral or aortic valve in patients with infective endocarditis.

Adult↗

[Evaluative indicators for the pre-hospital care system].

Survival factors for out-of-hospital cardiac arrest treated by 80 emergency/critical care centers in Japan were studied. As a result, the following three indicators to evaluate the prehospital care system are proposed. 1) Bystander initiated resuscitation at the scene of collapse 2) Defibrillation by emergency medical technicians 3) Referral system by regional hospitals to emergency/critical care centers These indicators are especially important now, when emergency medical technician services are being expanded in all areas. Also accurate diagnosis of death cause in DOA is important from the sudden death prevention standpoint.

Adolescent↗

Does an allergy skin test on school-children predict respiratory symptoms in adulthood?

BACKGROUND: It is interesting from the correct point of preventive health care whether allergy skin tests at entry have the positive relationship with common respiratory symptoms such as persistent cough, persistent phlegm and wheeze with colds at end point in longitudinal studies. OBJECTIVE: The purpose of this study is to investigate this relationship in subjects followed from when they were school-children until they were young adults. METHODS: Young adults aged 18-31 years who had participated in an allergy skin test and a health survey for common respiratory symptoms during primary and junior high school were asked about their respiratory symptoms at the end-point in the follow-up study. Three cohort groups were employed in the follow-up study. RESULTS: According to a multiple logistic analysis with adjustments made for sex, symptoms at entry in childhood, and age and smoking habits at the end-point, young adults with a positive skin test to an extract of house dust as school-children showed a higher prevalence of wheeze with colds compared with those with a negative skin test. However, this relationship was not found for persistent cough or persistent phlegm, indeed, the latter symptom was significantly associated with negative skin tests in one cohort group. CONCLUSION: The respective symptoms at entry in childhood were also predictors of their occurrence in young adults. The results show that the common respiratory symptoms such as persistent phlegm and wheeze with colds in childhood are related to those in young adults rather than is an allergy skin test to an extract of house dust in childhood.

Adolescent↗

[The clinical value of BMIPP on the evaluation of myocardial ischemia and metabolism before and after CABG].

To evaluate the clinical usefulness of BMIPP (15-(p-[125I]-iodophenyl)-3-R, S-methylpentadecanoic acid), BMIPP and T1 imaging were underwent before and after surgery in 25 CABG patients. Preoperatively the demonstrated lesion on BMIPP scintigram is almost the same as that on rest-T1 scintigram. A month after CABG, the recovery on T1 scintigram was remarkable, however improvement on BMIPP was limited. These results suggest that on the evaluation of myocardial ischemia, the clinical value of BMIPP is almost the same as that of rest-T1 before CABG. The postoperative discrepancy between T1 and BMIPP scintigram suggests that the restoration of myocardial circulation does not directly improve myocardial metabolism.

Coronary Angiography↗

[A case of left ventricular myxoma].

Left ventricular myxoma is very rare. To our knowledge, only 26 cases have been reported in the English and 7 cases in the Japanese literature. A 71-year-old man in our care was being followed due to angina pectoris. Two-dimensional echocardiography revealed a small mass in the left ventricular outflow tract. An operation was performed under cardiopulmonary bypass on July 14, 1992. A small mass located on the anterior wall of the left ventricle was excised en bloc via a transaortic approach. The gelatinous mass measuring 24 x 12 x 3 mm was determined histopathologically to be a myxoma. The postoperative course was uneventful and there has been no sign of recurrence so far. Because recurrent cases have been reported in the past, careful follow-up will be performed periodically.

Aged↗

[A case report of concomitant carotid and coronary artery reconstruction].

We reported a case of a 70-year-old female who underwent simultaneous carotid endarterectomy and coronary artery bypass surgery. Preoperatively, cardiac catheterization demonstrated three vessel coronary artery disease. Her carotid angiogram revealed a 90% stenosis in the left common carotid artery. The cerebral blood flow scintigram on acetazolamide stress detected severely reduced cerebral blood flow on her left anterior and temporal lobe. Her postoperative course was uneventful. Postoperatively, no reduced cerebral blood flow was detected on the acetazolamide stress image. In patients with significant carotid artery stenosis, the cerearal blood flow scintigraphy on acetazolamide stress was a useful method for the simultaneous carotid endarterectomy and coronary artery bypass surgery.

Acetazolamide↗

Comparison of long-term efficacy of medical treatment versus coronary artery bypass grafting (CABG) in multivessel coronary artery disease.

The long-term results of medical therapy and coronary artery bypass grafting (CABG) were compared in patients with multivessel disease. All patients were confirmed to have > or = 75% luminal narrowing of major coronary arteries by coronary arteriogram. When multivessel disease was stratified into double- and triple- vessel disease, the outcomes varied. In triple-vessel disease, the outcome with CABG was good, but the outcome was unfavorable in those employing medical therapy, particularly in patients with decreased left ventricular (LV) function. In patients with double-vessel disease with good LV function, the long-term results with medical therapy were just as favorable as those with CABG. However, double-vessel disease complicated by reduced LV function (ejection faction < or = 40%) had a clearly less favorable outcome when treated with medical therapy than with CABG. Thus, it is important for patients with multivessel disease to undergo revascularization if indicated, to improve their prognosis. On the other hand, the incidence of cardiac events arising from vein graft occlusions tended to increase in CABG patients after 5 years or more following surgery.

Aged↗

Effects of taurine on depletion of erythrocyte membrane Na-K ATPase activity due to ozone exposure or cholesterol enrichment.

The objective of this study was to investigate the interrelationship between taurine and erythrocyte-membrane Na-K ATPase activity. A comparison was conducted to test whether taurine or uric acid (a water-soluble scavenger of free radicals) prevents or recovers the depletion in membrane ouabain-sensitive Na-K ATPase activity resulting from ozone exposure or cholesterol enrichment of the erythrocyte membrane. A depletion of 44% and 27% in ouabain-sensitive Na-K ATPase activity was respectively caused by ozone exposure and cholesterol enrichment. Taurine as well as uric acid partially prevented the activity loss from ozone exposure. In addition, taurine at high concentrations (from 1.5 to 4.5 mM) restored the depletion of erythrocyte-membrane Na-K ATPase activity due to ozone exposure and prevented the depletion of the enzyme activity due to cholesterol enrichment. In contrast, although the same high concentrations were used, uric acid failed to show either of the above effects. These results suggest that taurine acts (1.5-4.5 mM) polyvalently as not only an antioxidizing agent but also as a membrane stabilizer to maintain the functions of membrane Na-K ATPase, a membrane-bound protein.

Adult↗

[Relationship between intraoperative pleural lavage cytology and recurrence in pleural cavity after resection of lung metastasis from colorectal cancer].

Seventeen patients with lung metastases from colorectal cancer underwent intraoperative pleural lavage cytology immediately after thoracotomy from August 1988 to December 1994. Patients with pleural effusion and/or dissemination were excluded. The median followup period was 34 months (range 3-52 months). Of the 17 patients, 13 were cytologically negative (76%, group A) and 4 were positive (24% group B). Recurrence rate in the pleural cavity was 25% (1/4) in group B and 0% (0/13) in group A. The three-year survival rate was 0% in group B and 78% in group A, respectively. These results indicate that intraoperative pleural lavage cytology is useful in the assessment of prognosis, and locoregional therapy should be considered for cytology positive group.

Colorectal Neoplasms↗

[The clinical value of MIBG myocardial spect before and after CABG--comparison with TI myocardial spect].

To evaluate the clinical usefulness of MIBG scintigraphy, 25 CABG patients underwent myocardial imaging using MIBG and TI. The result of this study indicated that the sensitivity of the MIBG was equivalent to that of the stress TI in detection of ischemic lesions. In spite of successful recanalization, only 14 patients showed improvement of MIBG uptake, indicating that MIBG is not useful for detecting myocardial ischemia just after CABG. The decreased postoperative uptake of MIBG suggests that the CABG procedure may have caused denervation of the region.

3-Iodobenzylguanidine↗