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[Studies on epidemiology of nontuberculous mycobacteriosis--on the regional difference of the incidence of pulmonary diseases due to M. kansasii and M. avium complex in Tokyo area].

On 397 patients with pulmonary disease due to nontuberculous mycobacteria (NTM) [102 due to M. kansasii (MK) and 295 due to M. avium complex (MAC)] observed at National Tokyo Chest Hospital, 191 patients with pulmonary disease (59 due to MK and 132 due to MAC) observed at Fukujuji Hospital of Antituberculosis Association and 257 patients from whose sputum MK (36) or MAC (221) were isolated in Byotai-Seiri Clinical Laboratory, the distribution of these patients by domicile in Tokyo area was analysed. The percentage of patients with MK disease among the whole patients with MK disease and MAC disease (MK ratio) in each community area was investigated. MK ratio was 30.9% in the 23 wards and 16.4% in Tama section of Tokyo in the patients observed at National Tokyo Chest Hospital. It was 37.0% in the 23 wards and 32.1% in Tama section in the patients observed at Fukujuji Hospital and was 17.7% in the 23 wards and 8.1% in Tama section in the patients observed at Byotai-Seiri Clinical Laboratory. MK ratio in Tokyo was considerably higher in the 23 wards that were densely populated industrial and commercial areas than in Tama section, a comparatively sparsely populated suburb. MK ratio in patients of Ota Hospital located in the 23 wards was higher (36.4%) than that of Tachikawa-Sogo Hospital located in Tama area (10.0%). Regional differences in MK ratio were remarkable in Tokyo area. A high MK ratio appeared to correlate with a high incidence rate of tuberculosis. From the results mentioned above, it was suggested that M.K. disease may be transmitted from person to person.

Humans

[Analysis of factors influencing the recent decline in birth rate in Tokyo].

This study was undertaken in an attempt to find factors which affected the recent declining birth rate in Tokyo. Vital statistics of the female population, age 20-39, for the period of 1970 through 1985 for Tokyo were compared to national averages. Indices examined were birth rate, percentage of married women, birth rate for married women, and birth rate for married women by live birth order. Results thus obtained were as follows: 1. Birth rates for females aged 20-24 and 25-29 were largely dependent on percentages of married women rather than birth rates for married women both in Tokyo and in the nation as a whole, while the birth rates for females aged 30-34 and 35-39 were more dependent on birth rates for married women. 2. Percentages of married women aged 20-24 and 25-29 decreased during the observation period both in Tokyo and in the nation as a whole. 3. Birth rates for married women aged 30-34 and 35-39 dropped in the first 5 or 10 years of observation in both groups as a result of the reduction in high order live births. Thereafter, the decline changed to an upturn trend. 4. Yearly changes of birth rate, percentage of married women, birth rate for married women, birth rate for married women by live birth order, and birth rate of first child for married women appeared to have the same timing both in Tokyo and in Japan as a whole in each age category.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

A comparative study of some pathologic features of mammary carcinoma in Tokyo, Japan and New York, USA.

Epidemiologic and clinical studies conducted in the past 15 years have demonstrated striking differences in the biology of mammary carcinoma among Japanese and American women living in their native countries. These variations have, in part, been related to some differences in the characteristics of the primary tumors between the two groups. As part of a collaborative study we have had an opportunity to compare the stage of disease and to examine and compare histological sections of patients with breast carcinoma treated in 1973-74 at the National Cancer Center Hospital (NCH) in Tokyo and in 1974 at the Memorial Hospital (MH) in New York. The former group consisted of 216 and the latter of 555 carcinomas. Fewer patients in each group had axillary metastases than reported in a prior study of patients treated at MSKCC and in Tokyo 20 to 30 years earlier. Negative axillary nodes were now found in 58% of the MH patients and in 63% of women treated at the NCH. The magnitude of improvement in stage relative to the prior report was similar in both groups. However, it would appear that the change occurred mainly from the mid-1950s to the 1960s in New York and approximately 10 years later in Tokyo. Results of this study confirming prior reports were: (1) higher frequency of colloid and of medullary carcinoma with lymphoid stroma and lesser frequency of lobular carcinoma in the Japanese patients; (2) more intense lymphoid infiltrate in and around primary tumors in Japanese women; (3) higher frequency of rounded or circumscribed tumors in Japanese women; and (4) the more frequent occurrence of intralymphatic tumor emboli within the breast in American women. The difference in the frequency of lobular carcinoma was less striking when comparison was limited to patients with unilateral carcinoma.

Adenocarcinoma, Mucinous

Crimes in New York and Tokyo: sociocultural perspectives.

Patterns of major crimes in Tokyo and New York City, based on official reports, are compared. Among other findings, the rate of infanticides among the total of murder cases was strikingly higher in Tokyo than in New York City. Intruders in New York City, on the other hand, were found to seek confrontation with victims more actively than their counterparts in Tokyo. Social and cultural factors underlying or contributing to the causes of major crimes are discussed.

Child

[Epidemiological study on Chlamydia trachomatis infection in obstetrics and gynecology field in Tokyo].

In conjunction with the Tokyo Branch of Japan Association for Maternal Welfare, we have been carrying out examinations of Chlamydial infection on women, especially pregnant women, living in Tokyo. Specimens were collected from 212 gyneco-obstetric clinics in Tokyo during 4 years from January 1987-December 1990. A total of 13,925 swab specimens from patients who were suspected of sexually transmitted diseases from clinical findings and pregnant women who requested the examination were tested for the presence of antigen to C. trachomatis with EIA (Chlamydiazyme). Epidemiological analysis based on the results and case cards that were described sex, age, occupation and clinical findings were conducted. The results obtained are briefly summarized as follows. 1) C. trachomatis antigen was detected in 12.8% (1,237/9,657) of the female patients, 31.0% (124/400) of the male patients and 6.8% (10/168) of the infants. The detection rates of C. trachomatis antigen in the male patients was significantly higher than that in the female and the infants patients. C. trachomatis antigen was detected in 6.1% (226/3,683) of pregnant women. 2) The detection rates of C. trachomatis antigen were compared by occupation of female patients. Most high rate was 26.6% (53/199) in bar hostess , subsequently 20.1% (102/508) in students, 19.8% (59/298) in prostitutes, 13.6% (455/3,348) in office girls and 7.2% (471/6,573) in house-wives. It was noteworthy that the detection rates of C. trachomatis antigen in students was as similarly high as that in prostitutes. 3) The detection rates of C. trachomatis antigen was also compared by age groups. The detection rate had a tendency to be high in younger people.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent

Comparative study of the aerobic, heterotrophic bacterial flora of Chesapeake Bay and Tokyo Bay.

A comparative study of the bacterial flora of the water of Chesapeake Bay and Tokyo Bay was undertaken to assess similarities and differences between the autochthonous flora of the two geographical sites and to test the hypothesis that, given similarities in environmental parameters, similar bacterial populations will be found, despite extreme geographic distance between locations. A total of 195 aerobic, heterotrophic bacterial strains isolated from Chesapeake Bay and Tokyo Bay water were examined for 115 biochemical, cultural, morphological, nutritional, and physiological characters. The data were analyzed by the methods of numerical taxonomy. From sorted similarity matrices, 77% of the isolates could be grouped into 30 phena and presumptively identified as Acinetobacter-Moraxella, Caulobacter, coryneforms, Pseudomonas, and Vibrio spp. Vibrio and Acinetobacter species were found to be common in the estuarine waters of Chesapeake Bay, whereas Acinetobacter-Moraxella and Caulobacter predominated in Tokyo Bay waters, at the sites sampled in the study.

Aerobiosis

A deletional frameshift mutation of the beta-spectrin gene associated with elliptocytosis in spectrin Tokyo (beta 220/216).

A novel spectrin variant carrying a truncated beta-chain and designated Spectrin Tokyo (beta 220/216) is presented. It was associated with elliptocytosis and moderate uncompensated hemolysis. The dimer self-association was reduced. An increase of the alpha I 74-Kd fragment was detected upon partial trypsin digestion. Analysis of cDNA and genomic DNA showed a 1-base deletion in codon 2059 (GCC AGC-->GCA GCT; Ala-Ser-->Ala-Ala) that belongs to exon X of spectrin beta-gene. A missense sequence extended down to (new) codon 2075. Serine 2060, a potential phosphorylation site, was replaced by alanine. The shortened beta-chain failed to undergo phosphorylation in vitro. Spectrin Tokyo shared the same stop codon, overlapping normal codons 2076 and 2077 (CTG AAA), as Spectrin Nice (beta 220/216), which is caused by a dinucleotide insertion in codon 2046 and contains 2076 amino acids. However, for some reason, Spectrin Tokyo had a lower incorporation level into the membrane than Spectrin Nice.

Base Sequence

Diagnostic patterns of social phobia. Comparison in Tokyo and Hawaii.

A comparison was made of the diagnosis of social phobia by Japanese psychiatrists in Tokyo and American psychiatrists in Hawaii. A brief segment of videotaped interviews and written case histories of four Japanese patients from Tokyo and two Japanese-American patients from Hawaii, who were clinically diagnosed with social phobia, were presented to the clinicians for their diagnosis. Japanese psychiatrists tended to diagnose social phobia congruently for the Japanese cases but not for the Japanese-American cases. American psychiatrists tended to diagnose various categories including anxiety disorder and avoidant personality disorder, in addition to social phobia, disregarding the ethnic background of the patients. This illustrates that the diagnostic pattern for social phobia varied considerably between psychiatrists of these two countries. The reasons considered are the patient's cardinal symptom manifestation, style of problems presentation, as well as the clinician's professional orientation and familiarity to this particular disorder.

Adult

Season of birth of schizophrenics in Tokyo, Japan.

The monthly distribution of births of 7,960 schizophrenic patients in Tokyo born during the period of 1841-1950 was studied in comparison with that of a control population in Tokyo. A spring excess of schizophrenic births were found after 1901 as in previous studies in Western countries. Before 1900, however, there was no significant spring excess. The maximum excess of schizophrenic births occurred in May before 1900 and in April after 1901. The possibility of a shift in the seasonality of schizophrenic births was discussed.

Birth Rate

[A study of the mentally ill in institutions for homeless people in Tokyo].

Homeless problems associated with poverty may be considered almost resolved in Japan because of the post World War II economic development, but in large cities such as Tokyo the homeless are still being produced, a reflection of a variety of social problems. This study is based on an analysis of admission records of an institution for the homeless which was established in 1952 in Tokyo. Subjects are 2,122 single persons who were admitted between 1952 and 1985. Among these, 136 are mentally ill persons, who are the main subjects of analysis in this study. Results show that, which after 1970 the number of the mentally ill significantly increased, many of those people dropped out of the institution mostly because they were originally admitted directly from discharge from hospitals because there was no other place to go except the institutions, and also because the institution, originally meant to house street people who had been detained, did not offer appropriate programs for the mentally ill. A solution to these problems requires that roles of institutions for the homeless and subjects admitted be reconsidered. Institution staff should enrich programs designed for the homeless mentally ill and help them organize their social network and live in the community.

Adult

Changes in causes of visual handicaps in Tokyo.

Newly registered visually handicapped patients at the Tokyo Metropolitan Rehabilitation Center for the Physically and Mentally Handicapped were studied in 1968 (when the facility was opened), 1978, and 1988. Examinations were carried out by the same physicians and diagnoses were made by uniform criteria. Since approximately 10% of the total population of Japan lives in Tokyo, the statistics on the causes of visual handicaps in this area deserve to be reported. The changes observed over the past twenty years are as follows: There were few changes in the percentages of high myopia, retinal degeneration and senile cataract. The percentages of corneal opacity, retinopathy of prematurity, congenital cataract and optic atrophy decreased, while those of diabetic retinopathy, glaucoma and retinal macular degeneration increased. Advances in medical treatment and the shift into an aging society in Japan are responsible for these changes observed.

Adolescent

[Ablative and prophylactic effects of BCG Tokyo 172 strain for intravesical treatment in patients with superficial bladder cancer and carcinoma in situ of the bladder. Bladder cancer BCG Study Group].

We investigated the effects of intravesical instillation of BCG Tokyo 172 strain on patients with superficial bladder cancer and CIS of the bladder for tumor ablation and prophylaxis. This is the first controlled multicenter study for governmental approval of BCG Tokyo 172 strain for the treatment of superficial bladder cancer and CIS of the bladder. One hundred-fifty-seven patients (125 with Ta or T1, and 32 with CIS) were treated by 80 mg of BCG diluted in 40 ml of saline, once a week for 8 weeks. The dose and interval adopted in this multicenter study was determined by the previous Phase II study conducted by the same Study Group. Out of 125 superficial tumor Ta, T1, 83 (66.4%) showed complete disappearance of the tumor (CR) and 26 (20.8%) partial disappearance (PR), and out of 32 CIS, 27 (84.4%) showed CR and 2 (6.3%) PR. Among those patients showing CR, and PR who were treated with additional TUR-Bt, 98 patients were randomised for a controlled study of prophylactic BCG instillation. Prophylactic treatment consisted of 40 mg of BCG diluted in 40 ml of saline, monthly for 12 months. Forty-two patients were assigned to the treatment group, whereas the remaining 56 to the control group without any prophylactic instillation. Three cases showed tumor recurrence during the prophylactic phase. Twenty-five cases could not be treated for the whole course of prophylactic instillation mainly due to bladder irritable symptoms. Recurrent free curves were compared till 1050 days after the initiation of the study. However, there was no significant difference between the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Intravesical

Radical surgery for cervical carcinoma: experience with "the Tokyo method".

Thirty patients of cervical carcinoma were treated by radical abdominal hysterectomy and pelvic and lower paraaortic lymphadenectomy between November 1986 and October 1988 by the 'Tokyo method.' Blood loss in the majority of the patients (80%) was less than 1000 ml. The incidence of intra and postoperative complications was found to be low. None of the patients developed urinary fistula and the incidence of bladder dysfunction was also low (3.3%). Follow up of the patients for nine to 32 months revealed local recurrent tumour in only one case. We feel that the "Tokyo method" of radical hysterectomy offers several advantages over other methods.

Adult