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A Okayama

Publications and source records attributed to A Okayama.

At least 19 recordsLinked to original sources
PubMed2001

Generational and regional differences in trends of mortality from ischemic heart disease in Japan from 1969 to 1992.

The authors compared generational and regional trends of premature mortality from ischemic heart disease (IHD) from 1969 to 1992 for persons aged 30-69 years. They selected Tokyo and Osaka prefectures as the most urbanized and compared them with the rest of Japan. The data were divided into two periods: period I (1969-1978, International Classification of Diseases, Eight Revision) and period II (1979-1992, International Classification of Diseases, Ninth Revision). In both populations, IHD mortality decreased for both sexes, but mortality from nonspecific heart disease remained constant in men and decreased in women. In Tokyo and Osaka prefectures, the percentage decline per year in IHD mortality for both sexes was significantly smaller in period II than in period I. However, in the rest of Japan, it did not decrease for either sex. Age-specific analysis showed that the percentage decline per year in period II was smallest for the group aged 30-49 years (men, 0.05%; women, 0.76%) in Tokyo and Osaka prefectures, while it was similar for all age groups in the rest of Japan. For men, the IHD mortality rate in 1991-1992 for those aged 30-49 years was higher in Tokyo and Osaka prefectures (9.4/100,000) than in the rest of Japan (5.4/100,000).

Adult↗
PubMed2001

Sequential change of virus markers in seroconverters with community-acquired infection of human T lymphotropic virus type I.

Twenty-three human T lymphotropic virus type I (HTLV-I) seroconverters were identified among 1120 HTLV-I-seronegative adults followed up for 11 years in an area of Japan endemic for HTLV-I. The geometric mean titer of anti-HTLV-I was 1:453 in the first year after seroconversion; the titer of each subject did not change significantly during 2-10 years of follow-up. HTLV-I proviral DNA load was quantified in 15 seroconverters, and a broad range of levels was observed-from <10 to >1000 copies/10(5) peripheral blood mononuclear cells. However, there was no obvious change in HTLV-I proviral DNA load over several years within individual subjects. Therefore, both proviral DNA load and humoral response in adult HTLV-I seroconverters were shown to stabilize within a few years after initial infection. In addition, 1 subject tested positive for HTLV-I proviral DNA before antibody seroconversion, which suggests the existence of a window period in community-acquired infection.

Aged↗
PubMed2001

Sex-specific mortality from adult T-cell leukemia among carriers of human T-lymphotropic virus type I.

Perinatal infection with human T-lymphotropic virus type I (HTLV-I) is considered a risk factor for adult T-cell leukemia (ATL). Incidence of ATL in Japan is generally higher in males compared with females, perhaps partly due to an earlier average age of infection among males. We estimated sex-specific ATL mortality among perinatally-infected HTLV-I carriers in the prospective Miyazaki Cohort Study in Japan. Based on the approximated proportion of perinatally-infected carriers, the relative risk (RR) of ATL for males compared with females was calculated. Six ATL deaths (4 males, 2 females) occurred among the 550 HTLV-I carriers in the cohort during 13 years of follow-up. The overall ATL mortality was 190.5 (95% CI 51.9-487.7) per 10(5) person-years for males and 51.7 (6.3-186.8) per 10(5) person-years for females (age-standardized RR = 3.9, p=0.02). By approximating the number of persons who acquired infection perinatally, the estimated mortality among those perinatally-infected HTLV-I carriers was 209.1 (57.0-535.2) per 10(5) person-years for males and 60.9 (7.4-219.9) per 10(5) person-years for females (age-standardized RR = 3.7, p=0.02). The adjusted RR changed minimally from the unadjusted RR, suggesting that earlier age of infection alone is unlikely the explanation for the male predominance in ATL. Based on the small number of cases available for analysis, aspects of gender itself appear to play a role in the development of this malignancy.

Adult↗
PubMed2001

The role of imaging modalities in the diagnosis of primary dedifferentiated parosteal osteosarcoma.

Dedifferentiated parosteal osteosarcoma (dd-POS) is defined as high-grade sarcomatous components coexisting with low-grade POS components. With regard to the histological diagnosis of dd-POS, the sampling of a small area of dedifferentiation through the densely mineralized POS can be a problem. In this situation, imaging is important to identify the area with the highest possibility of dedifferentiation. We report a patient in whom dedifferentiation was shown by computed tomography (CT) and magnetic resonance imaging (MRI). CT revealed a radiolucency in a highly mineralized area. T2-Weighted MRI showed a relatively high signal intensity, corresponding to the radiolucency, surrounded by a very low signal intensity area. Furthermore, gadolinium-enhanced T1-weighted MRI showed marked enhancement. Based on these imaging techniques, the condition was diagnosed as most likely to be a dd-POS, although a representative sample was not accessible by incisional biopsy. Neoadjuvant chemotherapy was administered, followed by wide resection and adjuvant chemotherapy. Four years after the surgery, partial lobulectomy was required because of a pulmonary metastasis. Three years after the second surgery, the patient remained well without evidence of metastases. Based on the initial diagnosis and, consequently, the optimal treatment of combined chemotherapy and wide resection, our patient showed a good clinical outcome.

Adult↗
PubMed2001

[An adult case of systemic cat-scratch disease with hepatosplenic involvement].

A previously healthy 25-year-old female was admitted to our hospital in November, 1997, for treatment of a spike-fever of 2 weeks' duration. She had a cat in her house but reported no history of cat bites or scratches. No peripheral lymphadenopathy was detected. White blood cell count was within normal limits, but an increased C-reactive protein level of 11.4 mg/dl was noted. Infectious disease was suspected but ruled out as blood cultures were negative. Empiric therapy with clarithromyoin, isoniazid, and rifampicin was ineffective. In January, 1998, abdominal ultrasonogram revealed multiple hypoechoic mass lesions in the spleen and liver, and a splenectomy was performed in March. Histopathologic examination showed numerous necrotizing and caseating granulomas, which tested positive for Bartonella henselae DNA by PCR. Furthermore, the patient tested positive for B. henselae antibody by immunofluorescence assay. A diagnosis of systemic cat-scratch disease with hepatospnenic involvement was made. Combination therapy with minocycline, sulbactam/cefoperazone, and tosufloxacin was administered and her inflammatory findings improved gradually. We report an adult case of systemic cat-scratch disease with liver and spleen involvement in the non-immunocompromised host.

Adult↗
PubMed2000

Vergence disorders in patients with spinocerebellar ataxia 3/Machado-Joseph disease: a synoptophore study.

Diplopia, a common symptom in spinocerebellar ataxia 3/Machado-Joseph disease (SCA3/MJD) cases, is not always due to asymmetric ophthalmoplegia. We found a Japanese SCA3/MJD family, in which three patients clearly had an impairment of divergence eye movement. We thus quantitatively examined the vergence ranges in eight Japanese SCA3/MJD cases using the synoptophore test. An impairment of the vergence eye movements was found in all patients, and the vergence impairment pattern, but not the ophthalmoplegia pattern, was found to be compatible with the diplopia pattern. The diplopia in SCA3/MJD cases is, therefore, attributed, at least in part, to the impairment of the vergence eye movements.

Abducens Nerve↗
PubMed2000

A follow-up study of morbidity and mortality associated with hepatitis C virus infection and its interaction with human T lymphotropic virus type I in Miyazaki, Japan.

A follow-up study was performed to analyze the effects of hepatitis C virus (HCV) infection on morbidity and mortality in the adult population from a village in Japan found to have endemic levels of both HCV and human T lymphotropic virus type I (HTLV-I). By use of the Cox proportional hazards model, rate ratios (RRs) and 95% confidence intervals (CIs) were estimated. Strong, significant effects of seropositivity for antibodies to HCV on self-reported incident liver disease (RR, 3.5; 95% CI, 1.9-6.4) and on death due to liver cancer (RR, 8.2; 95% CI, 1.6-41.4) were observed. Dual infection with HCV and HTLV-I seemed to have a synergistic effect on incident liver disease (RR, 5.9) as well as on death from liver cancer (RR, 21.9). HCV infection also was positively, although not significantly, associated with reported incident diabetes. Our findings suggest that coinfection with HTLV-I may affect the course of HCV-associated disease.

Adolescent↗
PubMed2000

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Journal Article↗
PubMed2000

Acute myelitis after asthma attacks with onset after puberty.

A poliomyelitis-like illness after asthma attacks has been found and is called asthmatic amyotrophy (Hopkins' syndrome). All of the previously reported cases were under 13 years of age. Three patients are described who developed acute myelitis after asthma attacks at 15, 22, and 73 years of age. All of them showed acute flaccid monoparesis, and needle EMG disclosed denervation potentials in the relevant muscles. In addition, in the two adult patients the sensory or pyramidal tracts were involved, and evoked potential studies confirmed an involvement of the pyramidal tracts in one of them. This 22 year old patient showed a second episode of monoparesis in the other limb after another asthma attack. All three patients had no significant changes in their antiviral antibody titres, whereas every patient had hyperIgEaemia and allergen specific IgE. These findings suggest that asthmatic amyotrophy can develop after puberty and that patients who develop this disease in adulthood seem to show both a widespread involvement of the spinal cord and a more varied course.

Acute Disease↗
PubMed2000

Effectiveness of smoking-cessation intervention in all of the smokers at a worksite in Japan.

In Japan, the prevalence of smoking among males and females was 56.1% and 14.2%, respectively, in 1997. Male smoking prevalence was exceedingly high as compared to those in other industrialized countries. We conducted a randomized controlled intervention study on smoking cessation for all smokers in a worksite regardless of their willingness to quit smoking. All of the male smokers in a radiator manufacturing factory (n=263) were randomly allocated to an intervention group (n=132) or a control group (n=131). Subjects in the intervention group received individual counseling by a doctor, and those who signed a Smoking Cessation Declaration underwent a five-month intervention. Subjects in the control group received equivalent delayed intervention for four months. The cessation rate after the original intervention was 12.9% (17/132) and 3.1% (4/131) in the intervention and control groups, respectively (p=0.003). Among those who once succeeded in quitting, 48.6% (18/37) maintained cessation at the long-term survey. Overall, the cessation rate was 8.4% (22/263) and the prevalence of smoking among males significantly decreased from 62.9 to 56.7% (p=0.038). As a conclusion, intervention in all smokers at a worksite regardless of their willingness to quit is effective and impacts the overall smoking rate.

Adolescent↗
PubMed2000

Anti-Ri-associated paraneoplastic cerebellar degeneration without opsoclonus in a patient with a neuroendocrine carcinoma of the stomach.

We report a case of a 63-year-old man suffering from anti-Ri-associated paraneoplastic cerebellar degeneration (PCD) with gastric cancer. The neurologic presentation was limited to severe cerebellar ataxia without opsoclonus. The gastric cancer was composed of both poorly differentiated adenocarcinoma and neuro-endocrine carcinoma. The patient's serum reacted with recombinant Ri antigen and the neuroendocrine tumor component. It is thus considered that PCD without opsoclonus in the present case was related to the gastric neuroendocrine tumor and anti-Ri antibody.

Adenocarcinoma↗
PubMed2000

[A case of mixed connective tissue disease with lupus-like manifestations of the central nervous system, successfully treated with cyclophosphamide combined with prednisolone].

A 29-year-old woman experienced Raynaud's phenomenon, swelling of her fingers, eruptions on her face, and muscle weakness in 1990. She was diagnosed as having mixed connective tissue disease (MCTD) and was treated with prednisolone (PSL) for 3 years. Most of her complaints disappeared after the treatment. In March 1997, she experienced fever, erythema, and lymphadenopathy. Although she was treated with PSL (20 mg/day) again, muscle weakness, mental disturbance, and recto-urinary disturbance appeared. When she was re-admitted to our hospital, increased levels of muscle-derived enzymes and positivity of anti-RNP antibody were found. High signal areas in her cerebrum were shown by magnetic resonance imaging, and slow and spike pattern was shown by electroencephalography. Hypoperfusion of the cerebral blood flow was suggested on single photon emission computed tomography. The number of mononuclear cells, amount of protein and level of interleukin-6 were found to be elevated in her cerebrospinal fluid (CSF). Her neurological manifestations were diagnosed as being due to MCTD, and showed characteristics similar to those of systemic lupus erythematosus. She was treated with PSL (60 mg/day) followed by steroid pulse therapy. Because the response to this treatment was partial, oral administration of cyclophosphamide (CPM) (100 mg/day) was added. Muscle weakness and neurological abnormalities as well as abnormal laboratory findings gradually improved over the following two months. We conclude that the treatment with CPM combined with PSL may be useful, when neurological manifestations of MCTD are serious and resistant to conventional therapy.

Adult↗
PubMed1999

Gender difference in skin reactivity to purified protein derivative among carriers of HTLV-I in Japan.

The incidence of malignancies due to oncogenic virus infections tends to be higher in men than in women. Gender-related differences in cell-mediated immunity, which plays a role in viral pathogenesis, may explain this observation. To explore this possibility in the context of HTLV-I infection, we examined skin reactivity to purified protein derivative (PPD) among 128 residents of an HTLV-I endemic area in Japan, who were born before 1921 and are assumed to have been exposed to M. tuberculosis bacilli. The odds ratio (OR) for reduced PPD reactivity (erythema <10 mm in diameter) was calculated by multiple logistic regression analysis. Men were significantly less likely than women to have reduced PPD reactivity among HTLV-I-negative individuals (26% versus 59%; p < .01); whereas this gender difference was not apparent among HTLV-I carriers (63% versus 62%; p = .87). HTLV-I positivity was strongly associated with reduced PPD reactivity in men, but not in women (odds ratio [OR], 7.3 versus 1.2; p = .05). Although this observation may be due, in part, to a longer average duration of HTLV-I infection in men compared with women, the finding also raises the possibility that men may be inherently more susceptible to loss of PPD reactivity by HTLV-I infection.

Aged↗
PubMed1999

Rapid quantification of HTLV-I provirus load: detection of monoclonal proliferation of HTLV-I-infected cells among blood donors.

In this report, we quantified HTLV-I provirus load using the AmpliSensor system, which utilizes fluorescence to measure PCR products. With this method, provirus loads could be measured within 6 hr, and the results obtained correlated well with those obtained by other methods. Samples from 256 blood donors, who were positive for antibodies against HTLV-I, were analyzed, showing that provirus load ranged from less than 0.1% to 56% among carriers. We analyzed the association between provirus load and the biomarkers age and sex and found that it was not influenced by either. Provirus load was better correlated with soluble interleukin-2 receptor (sIL-2R) levels than with antibody titer against the virus. Among 18 blood donors with high provirus load (more than 10%), Southern blotting detected monoclonal integration of HTLV-I in infected cells in 2 cases, both of them showing high sIL-2R levels (more than 900 U/ml). Sequential analyses of provirus load showed stable levels of provirus in the same carriers, suggesting that some factors other than age or sex determined provirus load in infected individuals. Thus, this rapid method is a useful tool for the early detection of adult T-cell leukemia and other HTLV-I-associated diseases.

Adolescent↗
PubMed1999

Trends in blood pressure and urinary sodium and potassium excretion in Japan: reinvestigation in the 8th year after the Intersalt Study.

Using the identical protocol of an Intersalt Study previously conducted, we undertook a new study (Intersalt-2) 8 years later. We measured changes in various factors affecting blood pressure (BP) including urinary sodium and potassium excretion in three districts of Japan: Osaka, Tochigi, and Toyama. Also we evaluated the trends in the relationships of those factors to BP. The Intersalt Study revealed that the average sodium excretion of all three study centres was high (particularly in Toyama) while potassium excretion was relatively low. The sodium/potassium ratio was therefore relatively high. The body mass index (BMI) was favourable, but the prevalence of heavy alcohol drinkers was high. Comparing the first to the second study reveals a decrease in sodium excretion in Toyama, although that area still had the highest value of the three study centres. The average potassium excretion increased only in Osaka. Sodium/potassium ratio decreased in all centres. BMI and the prevalence of heavy drinkers among the subjects of both studies were nearly the same. The trend of the relationship of sodium to BP in Osaka changed from negative to positive. In Toyama, it changed from positive to negative. It is thought that this negative relationship might occur in conjunction with a reduction in salt consumption in a population. In conclusion this study reveals that average sodium consumption in Japan remains high while potassium consumption is still low. As a factor in the prevention of hypertension, further efforts to reduce salt consumption and increase potassium intake are still needed.

Adult↗