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Biomedical subjects

Y Nose

Publications and source records attributed to Y Nose.

At least 19 recordsLinked to original sources

Comparison of diagnostic methods for diabetes mellitus based on prevalence of retinopathy in a Japanese population: the Hisayama Study.

AIMS/HYPOTHESIS: The aims of this study were to compare the ability of tests measuring fasting plasma glucose, 2-h plasma glucose and HbA1c levels in predicting specific diabetic retinopathy, and to determine the cut-off level of each measurement for diagnosing diabetes in a Japanese population. METHODS: In a total of 1637 subjects, fasting plasma glucose, 2-h plasma glucose and HbA1c levels were measured in a 75-g oral glucose tolerance test, and diabetic retinopathy was assessed by ophthalmic examination. We calculated receiver operating characteristic (ROC) curves as well as the prevalence of diabetic retinopathy by deciles of the distribution of these glycaemic measurements. RESULTS: Of the subjects, 37 (2.3%) had diabetic retinopathy. The prevalence of retinopathy dramatically increased in the tenth decile of each variable. Analysis with ROC curves showed that the optimal cut-off levels for diagnosis of diabetes were 6.4 mmol/l for fasting plasma glucose, 11.1 mmol/l for 2-h plasma glucose, and 5.7% for HbA1c. The sensitivities for the cut-off point of the three measurements were identical (86.5%), and the specificities were similar (fasting plasma glucose 87.3%; 2-h plasma glucose 89.6%; HbA1c 90.1%). The area under the ROC curve for 2-h plasma glucose (96.1%) was slightly but not significantly larger than that for fasting plasma glucose (90.0%) and that for HbA1c (94.5%). CONCLUSIONS/INTERPRETATION: . Our findings suggest that measuring fasting plasma glucose or HbA1c is just as useful as measuring 2-h plasma glucose for the diagnosis of diabetes, and that the cut-off point for diagnostic fasting plasma glucose level is lower than that of the current diagnostic criteria.

Blood Glucose↗

Clinical dose and adverse effects of topical steroids in daily management of atopic dermatitis.

BACKGROUND: Topical steroids are used as the first-line therapy for atopic dermatitis. OBJECTIVES: To determine the clinical doses of topical steroids for the daily treatment of atopic dermatitis in clinics and to elucidate their adverse effects. PATIENTS AND METHODS: A multicentre retrospective analysis of a series of 1271 patients (210 infants, 546 children, and 515 adolescents and adults) with atopic dermatitis. RESULTS: Less than 89.5 g, 135 g and 304 g of topical steroid were applied in 90% of the patients in the infant, childhood, and adolescent and adult AD groups, respectively, on the entire body during the 6-month treatment period. The majority of patients were controlled well; however, 7% of infant, 10% of childhood and 19% of adolescent and adult patients remained in a very severe or severe state or experienced exacerbation even though they applied larger amounts of topical steroids. With regard to adverse effects, the incidence of telangiectasia on cheeks tended to increase in patients who had a longer duration of disease and who applied more than 20 g to the face during the 6-month treatment period. The steroid-induced atrophy of the antecubital and popliteal fossae was more frequently observed in males than in females. CONCLUSIONS: Topical steroids are useful for treating atopic dermatitis, but a substantial percentage of patients cannot be satisfactorily treated with topical steroids. For such patients, adjustments of dose and rank of topical steroids and other therapeutic adjuncts are necessary.

Administration, Topical↗

Chemical peeling with salicylic acid in polyethylene glycol vehicle suppresses skin tumour development in hairless mice.

BACKGROUND: Chemical peeling with salicylic acid in polyethylene glycol (PEG) vehicle is used clinically to improve the cosmetic appearance of skin that has been damaged by exposure to the sun. It is well known that cancers of the skin such as basal cell carcinoma and squamous cell carcinoma may be induced by the sun. However, the carcinogenic potential of chemical peeling agents has not been studied. OBJECTIVES: To evaluate the effects of chemical peeling with 30% salicylic acid in PEG on skin tumour formation in treated vs. control mice. METHODS: To serve as a model of sun-damaged skin, hairless SKH/hr1 mice were irradiated with ultraviolet (UV) B for 14 weeks, with or without treatment every 2 weeks with 30% salicylic acid in PEG for a total of 18 weeks. RESULTS: Not only was the total number of tumours greatly reduced in the treated vs. the control mice, but skin tumour development was also slower in the treated vs. the control mice. At the final treatment, the fractions of T and B lymphocytes and natural killer cells from spleens of both groups of mice were comparable, and interferon-gamma production did not differ. CONCLUSIONS: Our findings suggest that chemical peeling with salicylic acid in PEG may help to prevent as well as to reduce the number of UVB-induced skin tumours.

Animals↗

Risk factors for age related maculopathy in a Japanese population: the Hisayama study.

AIMS: To examine the risk factors for age related maculopathy (ARM) in a sample Japanese population. METHODS: In 1998, a cross sectional community survey was conducted among residents of Hisayama. A total of 596 men and 886 women living in Hisayama, Japan, aged 50 years or older consented to participate in the study. Each participant underwent a comprehensive examination that included an ophthalmic examination. The presence of ARM was determined by grading from fundus examination by indirect ophthalmoscopy, slit lamp examination, and colour fundus photographs. Using these cross sectional data, logistic regression analyses were performed to determine the risk factors for ARM. The following 10 possible risk factors were used: age, cataract, hypertension (history), hypertension (history or examination), diabetes, hyperlipidaemia, current smoker, alcohol intake, BMI, and WBC. RESULTS: ARM was detected in 19.5% of men and 14.9% of women. Men were found to have a significantly higher prevalence of ARM than women. Multiple logistic regression analysis showed that age and hypertension (history or examination) were significantly associated with ARM in men, whereas only age was a significant risk factor for ARM in women. CONCLUSIONS: This study suggests that higher age and male sex are relevant risk factors for ARM in Japan. In addition, hypertension is a relevant risk factor in men.

Age Distribution↗

Definitive high resolution typing of HLA-E allelic polymorphisms: Identifying potential errors in existing allele data.

A set of robust PCR-SSP reactions were developed for each of the five polymorphic sites that define the five alleles of the HLA class Ib gene, HLA-E. This method was developed using 28 homozygous cell lines and further tested in a sample of African-Americans, a sample of Japanese, and a core panel of cell lines compiled for the 13th International Histocompatibility Workshop. Three alleles were found in each of these four sample groups, HLA-E*0101 (64.29, 50.00, 32.00 and 56.58%, respectively), *01031 (5.36, 20.65, 39.00 and 18.42%) and *01032 (30.35, 29.35, 29.00, and 25.00%). HLA-E*0102 was not detected in any of these samples nor in the cell line, LCL 722.221, in which this allele was originally described. HLA-E*0104 was not found either. This latter allele was originally reported in Japanese at a frequency of 1/22 (4.5%), which should have been high enough to have resulted in multiple occurrences of the *0104 allele in the samples tested in this study. We propose that the existence of the HLA-E*0102 and E*0104 alleles should be questioned.

Alleles↗

Clinical value of dilatation and curettage for abnormal uterine bleeding.

Dilatation and curettage was performed under anesthesia in outpatients in 1,837 patients aged over 26 with a history of abnormal uterine bleeding not associated with pregnancy or ovulation. Fifty-one (2.8%) patients were found to have malignant disease. Of these, 47 patients had endometrial carcinoma. An additional 111 (6.0%) patients were found to have endometrial hyperplasia. The incidence of either malignant disease or endometrial hyperplasia was 9.7% in patients over the age of 40. Complications of this method were noted in 12 (0.7%) patients; only three patients needed to stay in hospital.

Adenocarcinoma↗

Natural history of endometrial hyperplasia. Study of 77 patients.

Seventy-seven patients with endometrial hyperplasia, 48 with simple hyperplasia without atypia (SH), 17 with complex hyperplasia without atypia (CH), one with simple hyperplasia with atypia (SHA), and 11 with complex hyperplasia with atypia (CHA) were prospectively followed-up by total curettage every 12 months for 3 years. Progression to carcinoma occurred in only one of the 77 patients; she showed grade 1 adenocarcinoma. The overall regression rates were 79% for SH, 100% for SHA, 94% for CH, and 55% for CHA, respectively. In patients with CHA whose disease reverted to normal endometrium, regression was most likely to occur within the first year.

Adenocarcinoma↗

A simple computerized program for the calculation of the required sample size necessary to ensure statistical accuracy in medical experiments.

We developed a sample size estimation program (SSEP) with which medical researchers can easily estimate the appropriate sample size for a specific significance level and statistical power using their favorite WWW browsers. SSEP can estimate the sample sizes for six statistical methods by Monte-Carlo simulation: Student's t-test, Welch's t-test, Analysis of variance, Wilcoxon's rank sum test, Kruskal-Wallis test, and the Cochran-Armitage test for linear trends. The SSEP simulation programs were created using the SAS software macro language. Medical researchers can interactively use this program and determine reliable sample sizes when planning new prospective clinical studies and animal experiments.

Computer Simulation↗

Possible electromagnetic interference with electronic medical equipment by radio waves coming from outside the hospital.

Electromagnetic interference (EMI) with electronic medical equipment by radio waves from mobile telephone handsets has been reported and is currently receiving wide attention. The possibility of EMI with electronic medical equipment by radio waves coming into the hospital has also been pointed out. But so far, there are no reports measuring the frequency distribution of electric field intensity induced by incoming radio waves. Therefore, we measured electric field intensity induced by radio waves coming into our 11-floor hospital, which was under construction. The maximum intensity observed was about 200 V/m at 2.79 GHz, from airport surveillance radar waves. The maximum intensity induced by radio waves from cellular phone base stations was 1.78 V/m. These data show that various frequencies of radio waves are common in this urban area, and that they induce strong electricfield intensity. This strong electric field intensity might cause EMI with electronic medical equipment. Measurement of the electromagnetic environment should be done by each hospital in urban areas to prevent EMI with electronic medical equipment.

Electric Power Supplies↗

Merits of duplicate LAN cabling in hospitals.

Our hospital wired three LAN cables separately to improve the data distribution range. One LAN is between the various sections of the hospital (hospital LAN), another is within each section (section LAN), and the other is connected to the Internet (open LAN). The section LAN was connected to the hospital LAN to enable data exchange. Data from the section LAN for common use is collected through the hospital LAN and stored in the central server The duplicate cabling and separate LANs increased the independence of each LAN and the system within each section. The section systems can be changed at anytime without the necessity of reconstructing the whole hospital information system. The data transfer speed of each cable increased. Hospital information processing systems often use a distributed-processing centralized management system. Because of advances in technology, each section can now take responsibility for developing their own system, making the responsibility of the information processing section responsible for hospital information systems more limited than previously. Herein, we show the merits of separate cable installation.

Centralized Hospital Services↗

Association between birthweight and body mass index at 3 years of age.

BACKGROUND: Obesity in children is one of the risk factors for adulthood obesity, which then leads to the development of chronic diseases such as hypertension, hyperlipidemia and diabetes. In this study, we identified significant factors associating with the body mass index (BMI) at 3 years of age from the perinatal characteristics of children. METHODS: A total of 588 children were included in the study. The BMI at 3 years of age was examined in conjunction with the possible variables such as parents' smoking status during pregnancy, parents' age at birth, gestational age, sibling number and live birth order, sex, birthweight, BMI at 1 month of age, weight gain during the first month of life and feeding method at 1 month of age. RESULTS: Univariate analysis showed that birthweight (P<0.0001), weight gain during the first month of life (P=0.0012) and BMI at 1 month of age (P<0.0001) were significantly associated with the BMI at 3 years of age. Of these factors, birthweight and weight gain during the first month of life were the independent factors correlating with the BMI at 3 years by multivariate analysis (P<0.0001 and P=0.0095, respectively). CONCLUSIONS: Infants with higher birthweight and/or greater weight gain during the first month of life may have a risk of being overweight at 3 years of age.

Age Factors↗

Relationships among bone mineral densities, static alignment and dynamic load in patients with medial compartment knee osteoarthritis.

OBJECTIVE: To investigate the relationships among bone mineral density (BMD), static alignment and the adduction moment of the knee in patients with tibiofemoral osteoarthritis (OA). METHODS: Sixty-nine patients with medial compartment knee OA underwent radiographic evaluation, gait analysis and BMD measurements at the proximal tibia and lumbar spine. RESULTS: The bone mineral distribution of the medial to lateral part of the proximal tibia correlated significantly with the peak knee adduction moment and the mechanical axis. Furthermore, the adduction moment correlated significantly with the mechanical axis. However, the BMD of the lumbar spine and the bone mineral distribution of the posterior to anterior part of the proximal tibia did not correlate with any other measurement. CONCLUSIONS: Our results suggest that the bone mineral distribution of the proximal tibia is directly affected but lumbar BMD is not influenced by the local mechanical stress around the knee with medial compartment OA.

Absorptiometry, Photon↗

The impact of covariate imbalance on the size of the logrank test in randomized clinical trials.

This paper examines the baseline imbalance incidental to stratified random sampling in clinical trials. We assume that patients are randomly sampled from a stratum-specific population and assigned to either treatment or control groups. Prognostic factors not used for the stratification cause within-stratum patient heterogeneity. The patient heterogeneity is investigated with an analysis of the prognostic index, or the log-relative-hazard. An index V, used to measure the degree of baseline imbalance between the groups, is defined using the prognostic index. The degree of baseline imbalance resulting from the stratified random sampling of a population of heterogeneous patients is examined. A method to estimate the exact size of the stratified logrank test is developed and applied to data obtained from a cancer clinical trial.

Adult↗

Amlodipine inhibits the production of cytokines induced by ouabain.

Recent studies have suggested that cytokines are capable of modifying cardiovascular function and that drugs used in the treatment of heart failure have various modulating properties on the production of cytokines. More recently, we have found that ouabain induces the production of cytokines. This study was performed to examine the effects of calcium channel blockers on the production of cytokines induced by a cardiac glycoside. Human peripheral blood mononuclear cells (PBMC) were obtained from healthy volunteers. PBMC were cultured in 0.1, 1, 10, and 30 micromol/l amlodipine, diltiazem, and nifedipine in presence of 1 micromol/l ouabain. After 24 h of incubation, IL-1alpha, IL-1beta, IL-6, and TNF-alpha were measured in the culture supernatants by enzyme-linked immunosorbent assay. Ouabain induced the production of IL-1alpha, IL-1beta and IL-6, but not of TNF-alpha. Induction of IL-1beta was most prominent. The production of IL-1alpha, and IL-6 was inhibited by amlodipine in a concentration-dependent manner and was significantly decreased at a concentration of 10 micromol/l. IL-1beta production was also inhibited by 30 micromol/l amlodipine. In contrast, neither diltiazem nor nifedipine inhibited the production of these cytokines. The unique property of amlodipine to inhibit the production of IL-1alpha, IL-1beta and IL-6 may contribute to its beneficial effects in heart failure patients.

Amlodipine↗

HLA DPB1*0201 gene confers disease susceptibility in japanese with childhood onset type I diabetes, independent of HLA-DR and DQ genotypes.

HLA is an important etiologic genetic factor in Type I diabetes and specific HLA-class II genes are closely related to the onset of the disease. Many differences in the patterns of susceptible and resistant DRB1, DQA1, and DQB1 genes have been observed among various ethnic groups. We have previously shown that DRB1*0405, DRB1*0901 and DQA1*0301-DQB1*0302 were the major susceptible alleles or haplotype to Type I diabetes while DR-DQ haplotype studies suggested the important role of DR and DQ alleles in susceptibility and resistance in Japanese patients. Based on the analysis of 90 Japanese patients with childhood onset Type I diabetes and 136 unrelated healthy Japanese controls by polymerase chain reaction-restriction fragment polymorphism method (PCR-RFLP), we report here the association of Type I diabetes with DPB1*0201 (relative risk = 2.29; Pc = 0.027) in this population. Comparison of linkage disequilibrium patterns between patients and controls showed that the significantly high prevalence of DPB1*0201 among patients cannot be attributed simply to linkage disequilibrium with susceptible DRB1 alleles and DQA1-DQB1 haplotypes. Our results suggest that in addition to alleles at the DRB1, DQA1, DQB1 loci, polymorphism at DPB1 locus also influences the risk of Type I diabetes.

Adolescent↗

An easily customized, random allocation system using the minimization method for multi-institutional clinical trials.

In a randomized clinical trial, random allocation of patients to treatment groups should be done to balance in the distribution of prognostic factors. Random allocation in a multi-institutional randomized clinical trial is conducted by a coordinating center, independent of the medical institution the attending doctor uses for his/her practice. This study provides a sophisticated system for doing an exact random allocation of patients to treatment groups. The minimization method proposed by Pocock was applied to this system to balance the distribution of prognostic factors between two treatment groups, even when the number of registered patients is relatively small (S.J. Pocock, Allocation of patients to treatment in clinical trial, Biometrics 35 (1979) 183-197). Furthermore, Zelen's method is used to balance the number of patients allocated to the two groups within each institution (M. Zelen, The randomization and stratification of patients to clinical trials, J. Chron. Dis. 27 (1974) 365-375.). This system was created by the 'PERL&RSQUO; language for writing common gateway interface (CGI) script, and can therefore, be easily extended to include data entry function by attending doctors as well as the random allocation function. This system is being used effectively in thirteen multi-institutional randomized clinical trials for stomach, colon-rectum and breast cancers in Japan.

Clinical Trials as Topic↗

Electromagnetic interference with electronic medical equipment induced by automatic conveyance systems.

Electromagnetic interference (EMI) with electronic medical equipment induced by automatic conveyance systems is estimated. We measured the electric intensities of electromagnetic waves transmitted by three self-controlled electric truck systems. We also observed EMI with an infusion pump and a syringe pump set 1 m from the rail. The maximum electric field intensity was observed at the supplied current frequency in two systems with non-contact power supply mechanisms. The highest value, 137.0 dB microV/m, was measured just beside the rail. This is higher than the international electromagnetic immunity standard limit for electronic medical equipment. EMI may occur if electronic medical equipment is used within 2 m of the rail when the system contains an inductive power supply mechanism. With a contact power supply mechanism, the electric field intensity was much lower than that of the immunity standard. EMI should not occur even when electronic medical equipment is used just beside the rail.

Automation↗

A question and answer E-mail system for responding to query from the general public with which the system manager can identify delayed replies.

We constructed a question and answer system for direct delivery of E-mail queries from the general public to the proper hospital representative and with which the system administrator can monitor E-mail replies. The system consists of two sub-systems; one is an E-mail questionnaire sub-system that automatically delivers E-mail queries to the proper person and an E-mail reply monitor sub-system with which the system administrator can monitor the E-mail replies. The monitor system compares the origin address of the E-mail reply and the destination address on a questionnaire filled out at the time the query is made. In a test of the system, 56 queries were received in 31 days, with 37 replied to. The interval from receipt of an E-mail query to reply was calculated. Nineteen replies were submitted within 2 days.

Administrative Personnel↗