Health effects of smoking: current concepts.
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Environmental Exposure↗
Biomedical subjects
H Kasuga
Publications and source records attributed to H Kasuga.
[Development and factors related to the appearance of diaphragmatic pleural calcifications--follow up study of employees in an asbestos plant].
Seventy-eight subjects who had continuously worked for more than 25 years until 1985 in an asbestos plant were investigated for diaphragmatic pleural lesions (mainly calcifications) on chest roentgenograms. Diaphragmatic pleural lesions were found in 21 cases (32 sites). Among these cases, calcifications were found in 18 cases (26 sites) and bilateral calcifications in 8 cases. In retrospective observation, 19 sites initially showed diaphragmatic protuberant shadows, and of these, 13 sites subsequently showed calcification in the same positions. The duration between first exposure and appearance of calcification ranged from 15 years to 31 years. The duration of exposure was significantly correlated to the appearance of diaphragmatic pleural calcification, whereas age, smoking habit, and exposure level showed no significant correlation.
Adult↗
Smoking and health: a review prepared by the Smoking and Health Subcommittee of the Tobacco Industries Council, a council formed by the Minister of Finance of Japan.
Any definition of health is inevitably broad and contains various elements that may differ from one individual to another. Recent studies on the effects of smoking on physical and mental health have progressed remarkably and have great value in the fields of epidemiology, pathology, clinical medicine, and psychiatry. This report concludes that while smoking may have beneficial psychological effects on smokers, it may pose a risk to physical health.
Adolescent↗
[A case of prolonged eosinophilic pneumonia with pulmonary emphysema and bronchial asthma diagnosed by open lung biopsy].
A 65-year-old man was admitted to our hospital complaining of productive cough, dyspnea and stridor. Chest X-ray disclosed overinflation with micronodular infiltrates. Blood examination showed mild eosinophilia and IgE elevation. Pulmonary function test disclosed severe airway obstruction and diffusion capacity impairment. Although clinical improvement was achieved after bronchodilator therapy, laboratory abnormalities continued. Open lung biopsy demonstrated mononuclear cellular and eosinophilic infiltration at alveolar lumen and vessel walls without prominent fibrosis, which was compatible for prolonged eosinophilic pneumonia. From above findings, this case was thought as a prolonged eosinophilic pneumonia combined with pulmonary emphysema and bronchial asthma.
Aged↗
Comparative epidemiology of oral cancer in Brazil and India.
A comparison of the risk factors and occurrence of oral cancer in Brazil and India is presented. These two countries have among the highest incidence rates for such cancer in the world. A distinct pattern of risk factors was observed for each country: in India, tobacco chewing was the predominant risk factor: in Brazil, the major risk factor was the combination of tobacco smoking and alcohol consumption. Observations by descriptive epidemiology reveal high age-standardized incidence rates of oral cancer along with some distinctive differences associated with age distribution, sex ratios, and trends in each country. The desirability of additional oral cancer prevention research is also emphasized.
Adult↗
Pulmonary tuberculosis. An occupational hazard for pathologists and pathology technicians in Japan.
The incidence of pulmonary tuberculosis among pathology workers in Japan is elevated, presumably due to frequent exposure to tubercle bacilli in the work place. To demonstrate the etiological significance of the association between this disease and occupation epidemiologically, a questionnaire survey was performed to assess the incidence of pulmonary tuberculosis among 1,201 pathologists and 1,187 pathology technicians throughout Japan. Pathology department workers other than pathologists and technicians, such as secretaries (n = 207), and workers in university departments of preventive medicine and public health (n = 732) served as control groups. While non-occupation-related tuberculosis was found in both departmental groups with nearly equal incidence, the incidence of pulmonary tuberculosis among pathologists and pathology technicians after engagement in their current specialist work was significantly higher than that in the control groups (odds ratio = 6.08-10.98). The incidence of disease among pathology technicians who assisted in autopsies was markedly higher than among those not involved in autopsies (odds ratio = 6.65). This elevated incidence was significantly related to the duration of work in pathology activities, and showed little change over the last decade. These findings indicate that specific environmental conditions in pathology departments, particularly autopsy of cadavers harboring active tuberculosis, constitute a serious occupational hazard.
Adult↗
Guanine levels in house dust as a means of estimating the mite population.
House dust has recently been incriminated as an important causative allergen in bronchial asthma and allergic rhinitis. In particular attention is being focused on the mites contained in house dust. Previously, the number of mites contained in house dust was determined by counting under a microscope. This method is not appropriate, however, for epidemiological investigations which require large numbers of specimens, as it is time-consuming and labor intensive. Guanine makes up about 0.3% of the body weight of mites and is present in large amounts in mite excrement, and by using an improved method for quantifying guanine in house dust we obtained a correlation coefficient of 0.776 between the number of mites and amount of guanine. In addition, because virtually no guanine is contained in human nails and hair, thus eliminating possible sources of error, it became clear that the amount of guanine in house dust can be used to estimate the total amount of mite allergen resulting from the bodies and excrement of the acarids.
Animals↗
Epidemiological study of mites and guanine in house dust.
The total number of mites, and the amount of guanine contained in house dust was determined in samples obtained from homes with and without asthmatic patients in Yokohama City. The data were quantified and their possible association with various factors within the home was examined. The largest number of mites and the greatest amount of guanine were most strongly associated with carpet floor coverings, followed by tatami mats, and then by wooden flooring. A multi-variate analysis revealed that the major factors influencing the number of mites and the amount of guanine in homes were the living room flooring, and the age of the house. Correlation to such living factors ranged from 60 to 70 percent. In the families with asthmatics the frequency of cleaning was an important additional factor. This likely was a result of the strict instructions given by doctors to asthmatic patients. It was shown that the amount of guanine contained in house dust is an indicator of not only the number of mites but also of the amount of allergens contained in home dust.
Animals↗
[Nutritional assessment of chronic pulmonary emphysema and the significant relation of malnutrition to pulmonary function and respiratory muscle function].
We assessed nutritional status in 30 patients with pulmonary emphysema and 60 healthy controls. The relationship between nutritional status, pulmonary function and respiratory muscle function was also studied. Anthropometric measures, visceral proteins such as PA and RPB, and the Fischer ratio (BCAA/AAA), an index of imbalance of amino acids were significantly lower in the patients. The incidence of moderately malnourished patients with less than 80% of IBW was 40%. The incidence of hyporetinol-binding protein was 40%. 48% of the patients were found to show an amino acid imbalance. These findings suggested that protein-energy malnutrition in association with amino acid imbalance occurred commonly in patients with pulmonary emphysema. FEV1% correlated significantly with some anthropometric indices and the Fischer ratio. Respiratory muscle function, assessed by P1 max, correlated significantly with some anthropometric indices and grasp strength. These results suggested that the degree of airway obstruction and respiratory muscle function was associated with malnutrition characterized by the reduction of the Fischer ratio.
Adult↗
[Clinical study on asbestos pleurisy and review of literature].
Seven asbestos workers with asbestos pleurisy were investigated in terms of clinical symptoms, findings of pleural biopsies and course of chest roentgenograms. All cases were male and smokers. Duration of asbestos exposure ranged from 3 to 33 years (mean: 20.6 years). Duration between initial exposure and onset of the pleurisy ranged from 22 to 34 years (mean: 28.7 years). Five pleural effusions were aseptic and exudative, and one had sanguineus and eosinophilic effusion. According to the findings of pleural biopsies, our cases were classified into 2 groups. Group A (4 cases) had "basket-weaving formation" on the parietal side and inflammatory changes on the visceral side. No circulating autoantibodies were found in group A. Group B (3 cases) had no "basket-weaving formation" but only intensive inflammatory changes. These 3 cases were respectively complicated with anti-GBM antibody mediated glomerulonephritis, with acute interstitial pneumonia, and with rheumatoid arthritis and acute interstitial pneumonia. They all had circulating autoantibodies. In the course of chest roentgenograms, 6 of the 7 cases finally showed diffuse pleural thickenings which involved obliterations of costo-phrenic angles. Among them, one case developed into progressive pleural fibrosis. It was concluded that asbestos pleurisy can be classified into 2 groups according to the mechanism of occurrence, and immunological changes should be recognized as one of the mechanisms of asbestos pleurisy.
Adult↗
[An operative case of chronic constrictive pericarditis with silicosis and lumbar caries].
We reported a case of chronic constrictive pericarditis complicated with silicosis and lumbar caries, who was improved by the operation. The patient was a 65 year old man whose past occupation was a mason. He was admitted to our hospital with chronic heart failure on March, 1986. Atypical silicosis was diagnosed from the occupational history and the histopathological silicotic changes in mediastinal lymph nodes and fibrosis of alveolar wall. The diagnosis of chronic constrictive pericarditis was made from chest roentgenogram and intracardiac catheterization. The symptoms of chronic constrictive pericarditis was improved by the pericardial resection. The exact pathogenesis of the chronic constrictive pericarditis could not be identified from the histology of pericardial tissue, but tuberculosis was suspected because of the past history of tuberculous pleurisy and the recurrence of lumbar caries.
Aged↗
[An epidemiological study on the relationships among HDL-cholesterol, smoking and obesity].
The relationships among high-density lipoprotein cholesterol (HDL-C) and other serum lipid items, and active smoking, passive smoking, obesity, alcohol drinking and working status were investigated. This study was performed both in healthy adults and in schoolchildren. The adult group was sampled at random from those who were diagnosed to be healthy by medical examination at the Automated Multiphasic Health Testing and Services Center in Tokai University Hospital, and the schoolchildren group was selected with regular health examinations in a primary school in Tokyo. In the case of adults, it was found that the greater the value of triglyceride (TG), the greater the number of cigarettes smoked. On the other hand, HDL-C decreased with increasing cigarette smoking. Obesity level increased with increasing values of TG, total cholesterol (TC) and low density lipoprotein (LDL-C) but in the case of HDL-C, the value decreased. Alcohol drinking made the HDL-C level increase. Although the HDL-C level increased slightly with obesity, the relationship between HDL-C and passive smoking was not clear in the case of schoolchildren.
Adult↗
Effects of health of automobile exhaust and environmental tobacco smoke (ETS) in areas alongside main road.
During a period of eight years from 1977, pupils in F primary school in S ward, Tokyo were monitored each year with a general medical check-up to identify and eliminate any children with urine abnormalities and then the hydroxyproline: creatinine ratio (HOP ratio) in the urine of 4,375 children chosen at random was measured. The children's area of residence was classified, according to distance, into three areas. In addition, the children were classified into four groups depending on their estimated degree of exposure to Environmental Tobacco Smoke (ETS). The relationship between ETS and the HOP ratio was observed annually. The HOP ratio was greatest in schoolchildren living in the area nearest the main roads. The influence of ETS also tended to increase when ventilation rates in their rooms were lowered. The strength of these associations was considered significant depending on the magnitude of the HOP ratio, the correlation coefficient, a two-way layout and relative risk (R.R.). In addition, the consistency and coherence observed in measurements each year suggested a causal relationship. The influence of ETS and area distinctions on the HOP ratio was totally independent and showed virtually no interaction. However, the changes in patterns of indoor smoking from 1980 onwards were not sufficiently accounted for by the previous interview and questionnaire surveys so we introduced an additional bias, namely misclassification of pupils. Subsequently, the possibility of underestimation of the influence of ETS was considered, thereby establishing the need for a revision of the relevant questionnaires.
Air Pollutants↗
An enzyme-linked immunosorbent assay (ELISA) for the quantitation of urinary desmosine.
An enzyme-linked immunosorbent assay (ELISA) method has been developed for the quantitation of the elastin cross-link desmosine in urine. The system employs Rabbit antisera directed to the conjugate of desmosine and bovine serum albumin which was conjugated using carbodiimide reagent. The ELISA was done in microtiter plates which were coated with a desmosine-gelatin conjugate. And the assay system is based on an inhibition immunoassay. With this assay system, desmosine could be detected in a range between 0.4-400 ng/ml. Recovery of desmosine (DES) added to urine was 90.6-117.0% as measured by this method. Anti-DES antisera obtained from rabbits, showed no cross-reaction to 19 standard amino acids, two elastines nor mouse acetone liver power (which contained degradated elastin). But iso-desmosine cross-reacted with the antisera 13-45% at the isodesmosine concentration range of 40-400 ng/ml. Column purification of the urinary desmosine with CF-1 cellulose will not be necessary for desmosine measurement in ELISA assay. This paper described the detail procedures for sample preparation and the desmosine measurement in urine. Desmosine measurement can be an effective marker for screening the lung elastin degradation caused by cigarette smoking and environmental pollution to human lung.
Air Pollutants↗
Polyclonal anti-desmosine antiserum is specific to desmosine molecule: no cross-reaction to pyridinoline.
Inhibition ELISA assay was used to examine the cross-reaction of the polyclonal anti-desmosine antiserum produced in rabbit against molecules possessing a "pyridinium ring" as their core structure i.e. isodesmosine, pentasine, pyridinoline and 2'-deoxypyridinoline, highly purified with column chromatography, and structurally unrelated substances, i.e. cysteic acid, taurine and 2-aminopyridine (core structure of desmosine). No cross-reaction was observed to the pyridinoline, 2'-deoxypyridinoline possessing "pyridinium ring" and derived from collagen cross-links, structurally unrelated cysteic acid and taurine, nor core structure of 2-aminopyridine. The antiserum specifically recognized the molecules derived from the elastin cross-links. Using the ELISA assay system with antisera and amino acids analysis, 10 micrograms of desmosine were extracted from 1.0 mg of the hydrolysate of commercial elastin.
Amino Acids↗
The effect of abstinence from smoking on urinary excretion of hydroxyproline.
The effect of abstinence from smoking on the urinary hydroxyproline to creatinine ratio (HOP ratio) was assessed in 49 smokers who participated in an anti-smoking course. Urine samples were collected at the beginning of the course and weekly during the subsequent 14 weeks in 1985. The subjects were divided into five groups depending on the number of cigarettes smoked daily before abstinence: 1-10, 11-20, 21-30, 31-40 and greater than 40 cigarettes. The urinary HOP ratio immediately after abstinence from smoking was proportional to the mean daily number of cigarettes smoked in the past. All groups showed decreasing HOP ratios with a longer period of abstinence. Half of the total decrease observed in the HOP ratios after 14 weeks was reached within 5 or 6 weeks. When using the Brinkman index to adjust for the number of smoking years, half of the maximum decrease in all groups was reached within 4 weeks. In an exponential decay model fitted to the data, the half-life time taken to reach the non-smokers' level was 9-10 weeks for all groups. The HOP level of smokers who smoked less than 41 cigarettes before cessation approached the HOP level of the control group after 61-74 weeks. The results suggested that the urinary HOP ratio was useful as a biochemical marker for short-term breakdown of lung collagen and lung elastin.
Biomarkers↗
[A case of eosinophilic pneumonia with acute progressive dyspnea and diffuse small nodular shadows on chest X-ray film].
A 52-year-old man was admitted to our hospital with high-grade fever, dry cough and severe dyspnea. Chest X-ray films revealed diffuse small nodular shadows in all lung fields, prominently in the middle and lower lung fields. On examination, peripheral blood eosinophilic leukocytosis and severe hypoxemia were demonstrated. His clinical condition improved during five days after the admission without any therapy but oxygen inhalation. The abnormal shadows decreased in several days, and disappeared completely in thirty days. Bronchoalveolar lavage fluid revealed increased total cell counts, mostly with eosinophils (60%) and lymphocytes (21%). Histologically, the transbronchial lung biopsy specimen showed that the walls of pulmonary arteries and bronchioli were markedly infiltrated with eosinophils, and that alveolar septa were edematous with mononuclear and eosinophilic cells infiltration. There were no prominent changes in the alveolar lumen except few macrophage exudates. Our case was of importance for two reasons: first, eosinophilic pneumonia could take the form of interstitial pneumonia both roentgenologically and histologically; second, Crofton's classification of P.I.E. could not be applied to this case.
Acute Disease↗
[A case of multiple small pulmonary arteriovenous fistulas with chronic hepatitis and abdominal vessel abnormalities].
A 63-year-old female was admitted with dyspnea on exertion. She had previously suffered from a large amount of epistaxis. Chest X-ray showed the bilateral diffuse granular infiltrates. Arterial blood analysis revealed severe hypoxemia and pulmonary function test showed reduced function of diffusing capacity. Dynamic radionuclide perfusion scintigraphy performed with 99mTc-labeled MAA demonstrated passage of microspheres through the pulmonary vasculature into the systemic circulation, indicating a right-to-left shunt. Although selective pulmonary wedge angiography did not directly demonstrate pulmonary arteriovenous fistulae, the histopathological findings of TBLB specimens revealed multiple dilated alveolar vessels that microspheres could pass through. In addition, chronic hepatitis, dilatation of splenic vein and spleno-renal anastomosis had been present. This type of pulmonary arteriovenous fistula is said to be a rare dispersed telangiectasic type, associated with a part of Rendu-Osler-Weber syndrome and a cause of hypoxemia in liver cirrhosis. We consider that in this case, the chronic hepatitis may have played an important role of developing multiple small pulmonary arteriovenous fistulas.
Arteriovenous Fistula↗