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Biomedical subjects

Yoshiyuki Ohno

Publications and source records attributed to Yoshiyuki Ohno.

At least 19 recordsLinked to original sources

Nutritional factors and risk of pancreatic cancer: a population-based case-control study based on direct interview in Japan.

BACKGROUND: Few epidemiologic studies have examined the role of nutrient intake in the development of pancreatic cancer in Japan. We addressed this association in a population-based case-control study. METHODS: The cases were 109 patients who were newly diagnosed with pancreatic cancer between January 2000 and March 2002, and controls were selected by a random procedure from the general population. Data on dietary intake were collected by in-person interview, with the use of a food-frequency questionnaire. The risk of pancreatic cancer associated with nutrient intake was estimated by using the odds ratios (ORs) and 95% confidence intervals (CIs) derived from a conditional logistic model. RESULTS: A statistically positive trend in risk was observed with increasing cholesterol intake, with subjects in the highest tertile experiencing a two fold increased risk (OR, 2.06; 95% CI, 1.11-3.85; Ptrend = 0.02). Vitamin C intake was negatively associated with risk of pancreatic cancer. The OR was 0.45 (95% CI, 0.22-0.94) for subjects in the highest tertile compared to the lowest tertile (Ptrend = 0.04). CONCLUSIONS: Our study indicates that high cholesterol intake is significantly associated with an increased risk of pancreatic cancer and that high vitamin C intake decreases the risk of pancreatic cancer.

Adult↗

Pharmacokinetic and pharmacodynamic analysis of systemic effect of topically applied timolol maleate ophthalmic gelling vehicle (Rysmon TG).

PURPOSE: The objective of this study was to evaluate the degree of systemic absorption and the systemic side effect after instillation of timolol maleate ophthalmic gelling vehicle in human. METHODS: A volunteer study was employed, and a randomized crossover design with the two phases was used. In one phase, the volunteers instilled a single drop of the 0.5% timolol maleate ophthalmic gelling vehicle; in the other phase, the volunteers instilled a single drop of the 0.5% timolol maleate ophthalmic solution. The plasma concentration of timolol and the heart rates were studied during the following 120 min and 60 min, respectively. RESULTS: The area under the blood concentration time curve (AUC) in timolol maleate ophthalmic gelling vehicle was lower than that in timolol maleate ophthalmic solution (p < 0.05). No differences were observed in heart rates between ophthalmic gelling vehicle and ophthalmic solution. The correlation between the calculated occupancy of beta-adrenergic receptors and the systemic side effects after instillation could be successfully analyzed with a pharmacokinetic and pharmacodynamic model, showing the predictability of the model for the systemic side effects of timolol. CONCLUSIONS: The result of our analysis clearly shows that timolol maleate ophthalmic gelling vehicle reduced the systemic absorption below that of ophthalmic solution, but the degree in difference of systemic effects was negligible.

Absorption↗

Prospective study of transfusion history and thyroid cancer incidence among females in Japan.

A link between hepatitis C virus (HCV) infection and thyroid cancer was recently reported in a series of case-control studies in southern Italy. A prospective study could reinforce these findings. However, cohort studies that began before 1990 rarely assessed serological HCV infection. In addition, thyroid cancer is rare and generally has a good prognosis. Therefore, incidence outcome data are required, rather than mortality data, to evaluate the risk of thyroid cancer. Blood transfusion history might be a possible substitute measure to evaluate the cancer risks associated with HCV infection because blood transfusions were the major HCV transmission route in Japan until 1992. The purpose of our study was therefore to examine the association between transfusion history and thyroid cancer. A baseline survey of members of the JACC Study was conducted from 1988 until 1990, which involved 110,792 participants from 45 areas throughout Japan. Data were collected from a total of 37,983 women with no history of cancer at the baseline (337,906 person-years) and 79 cases of thyroid cancer were identified among this group. A history of blood transfusion marginally increased the risk of thyroid cancer [risk ratio (RR)=1.77, 95% confidence interval (CI)=0.95-3.30], and a history of transfusion and/or liver disease significantly increased the thyroid cancer risk (RR=1.84, 95% CI=1.07-3.16). These results indirectly support an association between HCV and thyroid cancer. In addition, our data reveal an association between blood transfusion and thyroid cancer, which might be facilitated by transfusion-associated immunomodulation.

Adult↗

Serum insulin-like growth factor-I, insulin-like growth factor binding protein-3, and the risk of pancreatic cancer death.

Recent epidemiological studies have shown that high serum levels of insulin-like growth factor-I (IGF-I) are associated with an increased risk of lung, colon, breast and prostate cancer. Since very few studies have addressed the role of serum levels of IGF-I in the development of pancreatic cancer, we conducted a nested case-control study to examine this association. The analysis involved 69 case subjects who died from pancreatic cancer during the follow-up period of the study, and 207 control subjects matched for sex, age(+/-1 year) and study area, selected randomly from a cohort of 10364 individuals. Serum levels of IGF-I and IGF binding protein-3 (IGFBP-3) were measured by immunoradiometric assay, using commercially available kits. The odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using conditional logistic models. The levels of IGF-I were positively correlated with IGFBP-3 (r=0.55). There was a positive, but statistically insignificant association between serum levels of IGF-I and risk of death from pancreatic cancer, with subjects in the highest quartile having an OR of 2.31 (95% CI=0.70-2.64) compared to those in the lowest quartile. The risk of pancreatic cancer death increased significantly with increasing serum levels of IGFBP-3 (trend p=0.03). Further adjustment for IGFBP-3 or IGF-I slightly attenuated the positive associations. This nested case-control study showed that high serum levels of IGF-I and IGFBP-3 may be associated with an increased risk of death from pancreatic cancer.

Aged↗

Self-reported sleep duration as a predictor of all-cause mortality: results from the JACC study, Japan.

BACKGROUND: Epidemiologic studies have shown that habitual sleeping patterns are associated with all-cause mortality risk. However, sleep duration may be affected by physical, mental, or social conditions, and its impact on health may differ depending on the time or place. OBJECTIVES: To examine the effects of sleep duration on all-cause mortality after adjusting for several covariates, mental condition in particular. METHODS: A total of 104,010 subjects (43,852 men and 60,158 women), aged 40 to 79 years, who enrolled in the JACC Study (Japan Collaborative Cohort Study on Evaluation of Cancer Risk Sponsored by Monbusho) from 1988 to 1990 and were followed for an average of 9.9 years. Average sleep duration on weekdays and covariates, including perceived mental stress and depressive symptoms, were used in the analyses. Relative risks were calculated by Cox's proportional hazard model separately by sex. RESULTS: Men tended to sleep longer than women, and the elderly slept longer than younger subjects. Mean sleep duration was 7.5 hours for men and 7.1 hours for women; mode durations were 8 hours (range, 7.5-8.4 hours) and 7 hours (6.5-7.4), respectively. Sleep duration of shorter or longer than 7 hours was associated with a significantly elevated risk of all-cause mortality. However, the significant association with short sleep disappears when adjusted for some covariates among men. CONCLUSIONS: Sleep duration at night of 7 hours was found to show the lowest mortality risk.

Adult↗

Pharmacokinetic/pharmacodynamic analysis of neutrophil proliferation induced by rhG-CSF in patients receiving antineoplastic drugs.

In the present study, we analyzed the effect of recombinant human granulocyte colony-stimulating factor (rhG-CSF) on neutrophil counts in cancer patients undergoing chemotherapy using a previously developed pharmacokinetic/pharmacodynamic model.(7)) The time profiles of neutrophil counts in blood after repeated administration of rhG-CSF to lung cancer patients undergoing chemotherapy could be analyzed by this model by considering the inhibition of neutrophil production by antineoplastic drugs. Although deviation was observed between the predicted and observed neutrophil counts in ovarian cancer patients, it may be possible to use this model for determining a rational dosage regimen of rhG-CSF for patients undergoing chemotherapy.

Antineoplastic Combined Chemotherapy Protocols↗

Environmental factors and risk of idiopathic dilated cardiomyopathy: a multi-hospital case-control study in Japan.

BACKGROUND: Detailed epidemiological investigations on the relationship of environmental factors, especially occupational and microbiological factors, to the development of idiopathic dilated cardiomyopathy (IDC) are scarce. METHODS AND RESULTS: A multi-hospital case-control study was conducted in 38 hospitals throughout Japan in order to survey IDC cases and age, sex-matched outpatient controls at each hospital. Crude and adjusted odds ratios (ORs) by various environmental factors were calculated in 135 pairs of cases and controls. Univariate analyses revealed significantly increased ORs for lower education, passive smoking in the workplace, cold and/or hot workplace, symptoms of fatigue and history of bacterial infection; in contrast, decreased ORs were associated with a history of rubella and gastroduodenal diseases. Based on multivariate adjusted analyses, lower education (OR 1.96, 95% confidence interval (CI) 1.13-3.40), cold or hot workplace (OR 1.84, 95%CI 1.08-3.12) and history of measles (OR 1.78, 95%CI 1.01-3.08) exhibited a significant positive relationship with IDC risk. History of rubella (OR 0.17, 95%CI 0.06-0.52) and gastroduodenal diseases (OR 0.14, 95%CI 0.07-0.29) were inversely related to the risk. CONCLUSIONS: Some occupational and microbiological factors appear to relate independently to the development of IDC and further investigation is required to establish their respective mechanisms.

Adult↗

Out-of-hospital cardiac arrest and survival: an epidemiological analysis of emergency service reports in a large city in Japan.

BACKGROUND: The factors that influence survival of out-of-hospital cardiac arrest in Japan have not been fully investigated. METHODS AND RESULTS: The official emergency service record was used to investigate 1,600 patients for whom cardiopulmonary resuscitation was attempted by the city's emergency personnel. Only 45 (2.8%) patients survived for 1 month. The survival rate was 9.8% in the patients under 20 years of age, with a marked decreasing trend to 0.8% in the patients aged 80 years or older. The rate peaked at 4.8% on Sunday and bottomed out at 0.5% on Thursday, forming a distinct sine curve. The survival rate was 9.9% when an ambulance arrived at the scene within 4 min, with a steep drop to 2.5% when 4-7 min elapsed. However, the rate was not significantly different by the interval to hospital. Although bystander resuscitation did not significantly affect the survival, paramedics on board significantly improved the rate (3.5% vs 1.6%). Multivariate analysis confirmed that age, day of the week, place, interval to ambulance's arrival, and personnel on board were independently associated with the probability of survival. CONCLUSIONS: Quick arrival of a paramedic team would improve the survival after out-of-hospital cardiac arrest. General education of lifesaving techniques would be another key factor.

Adult↗

Risk modification by CYP1A1 and GSTM1 polymorphisms in the association of environmental tobacco smoke and lung cancer: a case-control study in Japanese nonsmoking women.

Genetic backgrounds may modify the association of environmental tobacco smoke (ETS) with lung cancer risk. Polymorphisms of both the activating and detoxifying enzymes, cytochrome P4501A1 (CYP1A1) and glutathione-S-transferase M1 (GSTM1), may be important as genetic factors. We conducted a multicenter case-control study in Japanese nonsmoking women. Cases were women aged 30-89 years and newly diagnosed as having lung cancer from November 1997 to March 2001 in 4 study areas. We also recruited age-matched (5-year strata) and hospital-matched nonsmoking controls. A total of 158 cases and 259 hospital controls supplied blood for genotyping. Detailed information on ETS exposure from husbands and that in other situations and on potential confounders was collected by interview. Odds ratios (ORs) were estimated by using conditional logistic models. We found no increase in the risk of lung cancer for CYP1A1 Msp I genotypes. For the GSTM1 null genotype vs. nonnull genotype, the OR was 1.37 [95% confidence interval (CI) 0.90-2.09], which indicated a somewhat increased risk for the GSTM1 null genotype. A gene-environment interaction was suggested, with combined GSTM1 null genotype and high-dose ETS exposure (>/=40 pack-years by husbands) conferring significantly higher risk (OR = 2.27, 95% CI 1.13-4.57) compared to the GSTM1 nonnull genotype and low-dose ETS exposure (<40 pack-years). Our results do not support a major role of Msp I polymorphism of the CYP1A1 gene as a risk factor for lung cancer among nonsmoking women. In contrast, the GSTM1 null genotype posed an increased, although not significant, risk among them. Additional studies are warranted to confirm the ETS-GSTM1 polymorphism interaction suggested in our present study.

Adult↗

Clinical and epidemiologic analysis of giant cell (temporal) arteritis from a nationwide survey in 1998 in Japan: the first government-supported nationwide survey.

OBJECTIVE: To elucidate epidemiologic and clinical manifestations of Japanese patients with giant cell arteritis (GCA), the first nationwide survey for GCA was conducted in 1998 in Japan. METHODS: The first questionnaire on GCA for patients treated in 1997 was sent to 10,717 medical departments in Japan. A total of 177 patients were reported. Among the 177 patients, 66 GCA patients with detailed clinical and epidemiologic features on second survey were analyzed. RESULTS: Prevalence in patients 50 years of age and older in 1997 was 1.47 per 100,000 population in Japan. The average age at onset was 71.5 years old. The male:female ratio was 1:1.7. The association with permanent and complete visual loss (6.5%), jaw claudication (15.2%), and polymyalgia rheumatica (PMR) (30.3%) were low in frequency compared with those reported from other countries. All patients were treated with corticosteroids. Only 3 (4.5%) patients were reported as deceased due to other causes. CONCLUSION: The prevalence of GCA in Japan was revealed to be extremely low compared with other countries. Clinical findings of permanent and complete visual loss, jaw claudication, and PMR were infrequent among Japanese patients with GCA.

Aged↗

Prospective study of screening for stomach cancer in Japan.

Although screening for stomach cancer is a widespread community service in Japan, the benefits of the screening program remain unclear. Our study investigated prospectively the relation between participation in stomach-cancer screening during the past 12 months and subsequent deaths. Data was derived from the Japan Collaborative Cohort Study, in which 480 stomach-cancer deaths were identified during an 8-year follow-up period. Cox proportional hazard regression was used to estimate the relative risk of death from stomach cancer and that from other causes while adjusting for potential confounding factors. In men, screening participation was associated significantly with a reduced risk of death from stomach cancer (relative risk [RR] = 0.54; 95% confidence interval [CI] = 0.41-0.70). The extent of the risk reduction was greater than potential health selection (for deaths other than stomach, RR = 0.71). The adjustment for potential confounding variables, however, attenuated the difference in risk of death (stomach cancer, RR = 0.65; other causes, RR = 0.71). In women, the magnitude of the association between screening participation and death from stomach cancer (RR = 0.74; 95% CI = 0.52-1.07) was equal to that for deaths from non-stomach cancers (RR = 0.74). Subgroup analysis showed that women with a parental history of stomach cancer had a reduced risk of death from stomach cancer associated with screening (RR = 0.32; 95% CI = 0.12-0.87). The present results underline the potential for selection bias in observational studies, and thus it remains an open question whether screening for stomach cancer is effective.

Adult↗

Attributable and absolute risk of lung cancer death by smoking status: findings from the Japan Collaborative Cohort Study.

Estimating the proportion of lung cancer deaths that can be avoided is important in assessing the potential impact of antismoking efforts on the reduction of lung cancer deaths. We calculated the population attributable risk (PAR) and absolute risk of lung cancer death according to smoking status based on the Japan Collaborative Cohort (JACC) Study. The analytic cohort included 45,010 males and 55,724 females aged 40-79 years. Cox proportional hazards model was used to determine age-adjusted relative risks and PAR according to smoking status. We also computed lung cancer mortality according to age and smoking status. In males, 52.2% and 14.8% of lung cancer deaths were attributable to current and former cigarette smoking, respectively. In females, the corresponding figures were 11.8% and 2.8%. Among current male smokers, the relative risk was strongly correlated with the intensity and duration of cigarette smoking. In contrast, the PAR was associated with an intermediate level of smoking except for the years of smoking: the largest PARs were observed in those with 20-29 cigarettes per day, 40-59 pack-years and 20-22 years old at starting smoking. Absolute risks were estimated to increase with age and duration of smoking and not to decrease even after cessation. These findings suggest that avoidable lung cancer deaths are primarily among light to moderate smokers who are considered amenable to population-based antismoking strategies. For all current smokers, immediate cessation is encouraged because it offers the only realistic way to avoid a substantial increase in lung cancer mortality brought about by further continuation of smoking.

Adult↗

Menstrual and reproductive factors and the mortality risk of gastric cancer in Japanese menopausal females.

OBJECTIVE: The relationship between gastric cancer and menstrual and reproductive history was investigated for 40,535 postmenopausal females from a large-scale prospective cohort in Japan (JACC: Japan Collaborative Cohort Study for Evaluation of Cancer Risk, sponsored by Monbusho). METHODS: A Cox proportional hazard model was used to estimate risk with respect to menstrual and reproductive factors for gastric cancer mortality. The effects on risk of potential confounders such as lifestyle, dietary habits, and socioeconomic status were controlled for using a stepwise procedure. RESULTS: During the study period (mean 8.2 years), 156 deaths due to gastric cancer were identified. Longer fertility tended to be inversely associated with risk of gastric cancer mortality, although the association was not significant. Late menopause had no obvious effect on gastric cancer risk. The risk ratio of delivery experience compared to no delivery was 0.62 (95% confidence interval 0.27-1.41), and this effect was consistent regardless of the number of deliveries. Early menarche was not associated with the risk of gastric cancer. The potential confounders were not seen to have distinct effects on the associations. CONCLUSIONS: Multiparity appears to confer a protective tendency on gastric cancer mortality; however, this result is inconsistent with previous reports. Further information needs to be accumulated from epidemiological studies in order to clarify the role of reproductive factors in gastric cancer.

Adult↗

Aggregation of stomach cancer history in parents and offspring in comparison with other sites.

BACKGROUND: The aim of this study is to evaluate the magnitude of the aggregation of a stomach cancer history in parents and their offspring in comparison with that of a history at other sites. METHODS: We used the baseline data from the Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC Study), which was initiated during 1988-1990 in Japan. Association of the cancer history of the subjects' parents with that of the subjects themselves and any of the subjects' siblings was evaluated with odds ratios (OR) by the crude and generalized estimating equations (GEE) technique for four sites: stomach, colorectum, liver, and lung/bronchus. RESULTS: The aggregation of a history of stomach cancer between parents and their offspring was evident with significant OR >2.5. The magnitude of the parent-offspring association of a disease history of the colorectum and liver was found to be greater than that for stomach cancer. Conversely, lung and bronchus cancer failed to demonstrate a significant aggregation. CONCLUSIONS: The hereditary and environmental influences shared by parents and offspring are likely to play a strong aetiological role in colorectal or liver cancer versus a weaker but still significant role in stomach cancer. In contrast, the aetiological role of familial predisposition to lung cancer was indeterminate, which suggests a predominant role of non-familial factors in the development of lung cancer.

Adult↗

Serum carotenoids and mortality from lung cancer: a case-control study nested in the Japan Collaborative Cohort (JACC) study.

To investigate whether high serum levels of carotenoids, tocopherols, and folic acid decrease risk of lung cancer in Japanese, we conducted a case-control study nested in the Japan Collaborative Cohort (JACC) Study. A total of 39,140 subjects provided serum samples at baseline between 1988 and 1990. We identified 147 cases (113 males and 34 females) of death from lung cancer during an 8-year follow-up. Of the subjects who survived to the end of this follow-up, 311 controls (237 males and 74 females) were selected, matched to each case of lung cancer death for gender, age and participating institution. We measured serum levels of antioxidants in cases of lung cancer death and controls. Odds ratios (ORs) for lung cancer death were estimated using conditional logistic models. The risk of lung cancer death for the highest quartile of serum alpha-carotene, beta-carotene, lycopene, beta-cryptoxanthin, and canthaxanthin was significantly or marginally significantly lower than for the lowest quartile: the ORs, adjusted for smoking and other covariates, were 0.35 (95% confidence interval (CI), 0.14-0.88), 0.21 (0.08-0.58), 0.46 (0.21-1.04), 0.44 (0.17-1.16) and 0.37 (0.15-0.91), respectively. The ORs for the highest serum levels of zeaxanthin/lutein and folic acid tended to be low, but the differences were not statistically significant. Serum total cholesterol was also inversely related to risk of lung cancer death: the OR for the highest vs. the lowest quartile was 0.39 (95% CI, 0.19-0.79). Higher serum levels of carotenoids such as alpha- and beta-carotenes may play a role in preventing death from lung cancer among Japanese.

Adult↗

Family history and risk of subarachnoid hemorrhage: a case-control study in Nagoya, Japan.

BACKGROUND AND PURPOSE: We sought to examine the relation between a family history of subarachnoid hemorrhage (SAH) and the risk of SAH by using a case-control study. METHODS: Case subjects consisted of a consecutive series of 195 patients with spontaneous SAH, aged 30 to 79 years, with aneurysms confirmed by angiography and/or CT scan. Hospital and community control subjects were identified and matched to each case by sex and age (+/-2 years). Multiple conditional logistic regression was used to calculate the odds ratio (OR) and 95% interval (CI) adjusted for potential confounders. RESULTS: Having a family member with SAH was significantly associated with an increased risk of SAH (OR, 4.0, 95% CI, 2.0 to 8.0), after adjusting for potential confounders. The risk for a positive family history of SAH was similar for men and women and was inversely related to the SAH patient's age. A maternal positive SAH history (OR, 5.4; 95% CI, 1.8 to 16.0) posed a much greater risk than a paternal positive history (OR, 3.2, 95% CI, 1.1 to 13.4). CONCLUSIONS: A positive family history of SAH was significantly and strongly associated with the risk of SAH. To prevent the onset of SAH at a younger age, much more attention should be given to individuals with any family member (first-degree relatives) suffering SAH episodes.

Adult↗

[Characteristics of patients with intractable diseases receiving public financial aid for treatment--results of a nationwide survey, 1997].

OBJECTIVES: In order to clarify the characteristics of medical institutions visited by patients with selected intractable diseases, we analyzed data from the fourth nationwide survey in 1997. METHODS: We asked 47 prefectural governments to provide data concerning every patient receiving financial aid for treatment of 39 selected intractable diseases from April 1997 to March 1998. Out of 399,719 whose information was reported by prefectural governments, we analysed data of 370,232 patients whose medical institutions were reported. We performed detailed analysis on the relation between patients' residences and locations of medical institution which the patients visited, and on the characteristics of medical institutions. These analyses were respectively compared by sex and age, the beginning year of the financial aid, whether the patients were inpatients or outpatients, type of insurance, and clinical division where the patient was treated. RESULTS: 1. Analysis showed that 7.4% of all patients were treated in medical institutions outside the prefectures where they lived. Patients who lived in the neighboring prefectures of huge cities like Tokyo, tended to be treated in the medical institutions there. 2. We found that 23.5% of patients were treated in university hospitals, and 11.9% were seen in clinics. 3. There was a difference between patients with SMON and patients with myastenia gravis, pemphigus, epidermolysis bullosa or primary pulmonary hypertension. Of the two groups, the former preferred to visit clinics and be treated in medical institutions located in the same cities, towns, and villages where they lived. On the contrary, patients with the latter 4 diseases tended to visit large hospitals and be treated in those outside their prefectures. 4. Elderly patients over 70 years old tended to be treated in clinics or hospitals located in their neighborhoods. 5. Compared with past surveys, the percentage of patients treated in university hospitals had decreased, and that of patients treated in clinics had increased year by year. No change was found in the proportion of patients treated in medical institutions outside their prefectures. CONCLUSIONS: By the present analysis of a nationwide survey taken in fiscal year 1997, we were able to clarify the characteristics of medical institutions visited by patients with selected intractable diseases. This kind of analysis should be continued to obtain important information on the epidemiology of intractable diseases.

Adolescent↗