Biomedical subjects

H Yanagawa

Publications and source records attributed to H Yanagawa.

At least 109 records · Page 6Linked to original sources

PubMed1997

Serum C-reactive protein levels in patients with Kawasaki disease: from the results of nation-wide surveys of Kawasaki disease in Japan.

Thirteen nation-wide epidemiological surveys of Kawasaki disease have been carried out successively since 1970 in Japan. In the latest survey, questionnaires on serum C-reactive protein (CRP) levels of the patients were included to clarify whether serum CRP levels could be available for the diagnosis and prediction of prognosis. A questionnaire from and diagnostic guidelines for Kawasaki disease were sent to all paediatric departments of hospitals with 100 or more beds throughout Japan, and information including maximal serum CRP levels was obtained on patients with Kawasaki disease diagnosed during the 2-year period from January 1993 to December 1994. Of the 11458 patients diagnosed during the 2-year period, maximal serum CRP levels were reported in 11040 patients (96.4%). The values of maximal serum CRP were higher in the age groups < 6 months and > 2 years. The mean value and the distribution of serum CRP levels in-suspected cases were lowest among the three diagnostic categories and this difference among diagnostic categories was highly significant in the age groups 6 M-1 Y and 1-2 Y. The proportion of patients with cardiac sequelae increased with serum CRP levels in each age group. The mean value and the distribution of serum CRP levels of the patients with cardiac sequelae was higher than those without it and this difference between cardiac prognoses was outstanding in the age groups 6 M-1 Y and < 6 M. The Receiver/Response Operating Characteristic (ROC) curve for maximal serum CRP levels in Kawasaki disease revealed that accuracy of maximal serum CRP levels for prediction of cardiac sequelae was highest in the age group 6 M-1 Y. A large-scale observation and analysis of serum CRP levels of the patients with Kawasaki disease revealed age-dependent relationships among maximal serum CRP levels, diagnostic categories and prognosis. Serum CRP levels may be helpful for the prediction of prognosis with the consideration of age.

Adolescent↗

PubMed1997

Leukocyte counts in patients with Kawasaki disease: from the results of nationwide surveys of Kawasaki disease in Japan.

In the latest survey of Kawasaki disease in Japan, questionnaires on maximal leukocyte counts of the patients were included to clarify whether leukocyte counts could be of value for the diagnosis and prediction of outcome. A questionnaire form and diagnostic guidelines for Kawasaki disease were sent to all pediatric departments of hospitals with > or = 100 beds throughout Japan, and information including maximal leukocyte counts was obtained on patients with Kawasaki disease diagnosed during the 2-y period from January 1993 to December 1994. Of the 11,458 patients diagnosed during the 2-y period, maximal leukocyte counts were reported in 11,062 patients (96.5%). The mean value and the distribution of maximal leukocyte counts were lower in the age group under 1 y. The mean values and the distribution of leukocyte counts were lowest in suspected cases among three diagnostic categories: typical cases of Kawasaki disease, atypical cases, and suspected cases. The mean values of maximal leukocyte counts of the patients with cardiac sequelae were significantly higher than those without cardiac sequelae in each age group. The proportion of patients with cardiac sequelae increased with leukocyte counts in each age group. The Receiver/Response Operating Characteristic (ROC) curve for maximal leukocyte counts in Kawasaki disease revealed that the accuracy of maximal leukocyte counts for prediction of cardiac sequelae was highest in the age group < 6 months, and the most accurate cut-off point was 16 x 10(9)/l. The strongest association between higher leukocyte counts (> or = 16 x 10(9)/l) and cardiac sequelae was observed in the age group < 6 M. A large-scale analysis of leukocyte counts in patients with Kawasaki disease revealed age-dependent relationship between maximal leukocyte counts, diagnostic categories and outcome. Maximal leukocyte counts may be helpful for the prediction of outcome with the consideration of age.

Analysis of Variance↗

PubMed1997

Family history evaluation in epidemiologic studies; an evaluation of bias in the conventional methods and a proposal of a new one.

We discuss problems of conventional methods to evaluate family histories as risk factors in epidemiologic studies, and propose a new one. In the proposal, incidence rates of the disease interested among family members are treated as exposure levels. Besides, we show the quantitative difference between the results obtained by the conventional methods and the new one using models. Because of not so much information required for the new method, we recommend it even though the difference was not so large.

Adult↗

PubMed1997

Estimation of the future numbers of patients with mental disorders in Japan based on the results of National Patient Surveys.

To estimate the future numbers of patients with mental disorders, schizophrenic disorders, and neurotic disorders, prevalence obtained from the National Patient Surveys conducted by the Ministry of Health and Welfare of the Japanese government was projected by using linear models by age and sex. The prevalence of whole mental disorders and neurotic disorders will increase, while that of schizophrenic disorders will not do so much. The numbers of patients with mental disorders were estimated to be 973 thousand for males and 1,359 thousands for females in the year of 2008, which were 622 thousand and 733 thousand in 1993, respectively. The disease-specific numbers in 2008 were 562 thousand for schizophrenic disorders and 867 thousand for neurotic disorders, both were 451 and 437 thousand in 1993, respectively. Because of the increase of old age population, the number of old patients with each disorder will also become large.

Adolescent↗

PubMed1997

[Survey of patients with intractable diseases. Analyses of patients receiving financial aid for treatment].

The Research Committee of Epidemiology of Intractable Disease (Ministry of Health and Welfare, Japan) conducted a Nationwide survey of 34 intractable diseases with each of the 47 prefectural governments reporting information on all patients having any of 34 intractable diseases, and who received financial aid for the disease from April 1992 to March 1993. Information collected about each patient was the identification number, which included the disease code, sex, age, the code of the municipality where the patient lived, the medical institution which treated the patient, and the department where the patient was treated. The results can be summarized as follows: 1) The total number of patients who received financial aid for disease was 247,726 (Male 93,251 Female 154,274) for a sex ratio of 0.60, and 61.7% of patients were between 40 and 69 years of age. Of 109,387 patients whose status could be confirmed regarding either outpatient or inpatient, 13.5 percent were inpatients. Of the patients, 47,222 (53.0%) were treated in departments of internal medicine. 2) Of all 34 intractable diseases, the greatest number receiving aid were patients with systemic lupus erythematosus with 35,690 receiving aid between April 1992 and March 1993. Of new patients commencing financial aid between April 1992 and March 1993, the largest group was patients with ulcerative colitis with 5,361. 3) The numbers of patients and those who started receiving the aid in the observed one year was larger than those in 1984 and 1988. The increase in numbers between 25 and 34 years of age was remarkable. By age group, the largest number of patients became older within the 8 years from 1984 to 1992.

Adult↗

PubMed1997

[Estimation of the future numbers of patients with circulatory diseases in Japan based on the results of national patient surveys].

The numbers of patients aged 35 years or more with hypertension, ischemic heart disease, and cerebrovascular disease 15 years from now were estimated. First, the numbers of patients with these diseases in 1984, 1987, 1990, and 1993 were calculated by age and sex using data from the National Patient Surveys conducted by the Ministry of Health and Welfare. Then, population prevalence for calendar years 1996, 1999, 2002, 2005, and 2008 were estimated based on the past data using linear regression models. Finally, the total numbers of patients were calculated from the estimated prevalence multiplied by the estimated population figure of the national government. The numbers of patients with hypertension will decrease in younger age classes but increase in older age classes; the total number of all patients, therefore, will increase. While the number of patients with ischemic heart disease in males is estimated to increase, that in females will level off. The number of cerebrovascular disease patients in each age and sex group will grow larger.

Adult↗

PubMed1997

[Required manpower for health care and nursing services for the aged at home public health nurses, visiting nurses, dental hygienists, dietitians, physical therapists, and occupational therapists].

The purpose of this study was to estimate the manpower required for the health care and nursing services for the aged at home. For prefectural health care and welfare planning for the aged, data such as the proportion of the aged who need help, service demand, and required frequency of services were obtained. The means and "mean +/- 2 x standard deviations" were calculated to obtain various parameters. Calculated figures were those which can be obtained with some effort. The results are as follows (middle level estimation (low level estimation-high level estimation)): requirements are 1.9 (0.61-5.7) public health nurses, 2.6 (0.63-14) visiting nurses, 0.20 (0.084-0.42) dental hygienists, 0.35 (0.17-0.66) dietitians, and 0.25 (0.014-1.27) physical and occupational therapists per population 10,000. For the national total, requirements are 23 (7.3-67) thousand public health nurses, 31 (7.5-160) thousand visiting nurses, 2.4 (1.0-5.0) thousand dental hygienists, 3.9 (2.0-7.8) thousand dietitians, and 3.0 (0.17-15) thousand physical and occupational therapists. By population sizes, for example in the municipalities which has 10-30 thousand people, required are 4.2 (1.7-11) public health nurses, 5.3 (1.3-27) visiting nurses, 0.4 (0.2-0.8) dental hygienists, 0.5 (0.3-0.9) dietitians, and 0.5 (0.0-2.5) physical and occupational therapists. Comparison of the present numbers with estimated manpower needs show that, the present number of public health personnel is almost the same as the low level estimation. But the present numbers of other manpower is lower than the low level estimation. Considering other services such as maternal and child health, it seems that the municipalities which has 10+ thousand population should employ full-time dietitians and dental hygienists. For policy making in a municipality, the policies of other municipalities should be considered. Because it is based on means for municipalities, the results of this study should be useful for application by other municipalities.

Community Health Nursing↗

PubMed1997

[Geographic distribution of medical supplies and the numbers of hospital inpatients in the secondary medical areas in Japan].

A secondary medical area is defined as a medical administrative area under the Medical Care Law by which every prefectural government is expected to provide general medical care supplies such as beds for inpatients. This study evaluated the distribution in medical supplies among the secondary medical areas in Japan and the correlation between medical supply and demand. The numbers of hospital inpatients (residence of patients), physicians, and general beds excluding those for mental disorders and tuberculosis were analysed in relation to the population in all secondary medical areas in Japan. Those data were obtained from surveys conducted by the Ministry of Health and Welfare. The main results were as follows; 1) The distribution of physicians and general hospital beds among the secondary medical areas was not equal. 2) Even adjusted for the sex and age distribution, the highest hospital inpatients/population ratio among the secondary medical areas was four times as large as that of the lowest. 3) With multiple regression models, two independent variables (normal hospital beds/population ratio and aged 65 and over/total population ratio) accounted about 60% of the variance in hospital inpatients/population ratio. 4) The differences in medical supplies among the secondary medical areas may cause the differences in hospital inpatients/population ratio.

Age Factors↗

PubMed1996

Immunocytochemistry of tau phosphoserine 413 and tau protein kinase I in Alzheimer pathology.

One unique phosphorylation site consistently found in paired helical filament tau, serine 413, is modified by tau protein kinase I/glycogen synthase kinase-3 beta but no other known tau kinase. Here we present immunocytochemistry from Alzheimer's disease brains showing that focal subpopulations of hippocampal CA1 pyramidal neurons and neuritic plaques are strongly reactive for tau protein kinase I/glycogen synthase kinase-3 beta and tau phosphoserine 413 in early stages of pathology. Colocalization of these epitopes suggests that tau protein kinase I/glycogen synthase kinase-3 beta abnormally phosphorylates tau and is in a position to disrupt neuronal metabolism in anatomical areas vulnerable to Alzheimer's disease.

Adult↗

PubMed1996

T helper 2 cytokines differently regulate monocyte chemoattractant protein-1 production by human peripheral blood monocytes and alveolar macrophages.

Th2 cytokines, such as IL-4, IL-10, and IL-13, suppress proinflammatory cytokine production by monocytes/macrophages. Since monocyte chemoattractant protein-1 (MCP-1) is presumed to play an important role in monocyte recruitment and activation during inflammatory and immune responses, we examined here the effects of these Th2 cytokines on MCP-1 production by human blood monocytes and alveolar macrophages. Unstimulated, highly purified blood monocytes did not produce MCP-1 spontaneously, while LPS treatment induced the production of MCP-1 and its mRNA expression. All Th2 cytokines tested suppressed LPS-induced MCP-1 production and its mRNA expression, although the suppressive effect of IL-13 was weaker than that of IL-4 or IL-10. In contrast, IL-10, but neither IL-4 nor IL-13, induced unstimulated peripheral blood monocytes to produce biologically active MCP-1 protein within 4 h, reaching a maximal level at 12 h. IL-10-induced MCP-1 production was reduced by pretreatment of IL-10 with anti-IL-10 Ab, negating the involvement of contaminated endotoxin. Moreover, IL-10 induced MCP-1 mRNA expression in unstimulated monocytes, independent of de novo protein synthesis. Furthermore, human alveolar macrophages produced MCP-1 spontaneously, and the production was inhibited by IL-4 or IL-13, but was augmented by IL-10. These findings suggest that IL-10 regulates MCP-1 production by monocytes/macrophages in a different way from other Th2 cytokines, such as IL-4 and IL-13, and contributes to host defense responses.

Cells, Cultured↗

PubMed1996

A case-control study of recurrent Kawasaki disease using the database of the nationwide surveys in Japan.

UNLABELLED: In spite of many reports of recurrent Kawasaki disease, little information about the risk factors associated with recurrence is available. We conducted a case-control study on 150 cases of recurrent Kawasaki disease and 1173 pair-matched controls selected from the database of nationwide surveys of the same disease in Japan. Items observed were: sex, age, use of intravenous gamma globulin, and cardiac sequelae at the first episode. Sex and cardiac sequelae did not affect the risk of recurrence. One- to 2-year-old children were more likely to be affected again than infants (odds ratio [OR] = 1.42; 95% confidence interval [CI], 0.94-2.13), and children who were 3 years of age or older were less likely to experience a recurrence than infants (OR = 0.59; 95% CI, 0.34-1.02). Intravenous gamma globulin therapy at the first episode increased the risk for recurrence of Kawasaki disease within 12 months (OR = 2.66, 95% CI, 1.06-6.66). However, it did not affect recurrences 12 months after the first episode (OR = 1.02; 95% CI, 0.53-1.97). CONCLUSION: Patients with Kawasaki disease treated with intravenous gamma globulin are 2.66 times as likely to be affected by the disease again within 12 months as those treated without intravenous gamma globulin.

Case-Control Studies↗

PubMed1996

[Evaluation of a nationwide surveillance system for Kawasaki disease over an eleven-year period from 1984].

OBJECTIVE: The Japan Kawasaki Disease Research Committee has conducted a surveillance of Kawasaki disease in order to monitor changes in incidence continually, and to provide timely incidence data to the hospitals and related organizations. This study aims at clarifying the 11-year time trend between 1984 and 1995 of the incidence of Kawasaki disease in Japan and evaluating the validity of the surveillance system. METHODS: Incidence data were obtained from 143 monitor hospitals throughout Japan with a postcard notification form, which included the number of patients with Kawasaki disease by sex for each of three 10-day periods every month. RESULTS: 1. The total number of patients thus reported in the 11-year period by the 143 facilities was 21,406. 2. After experiencing the two major outbreaks observed in 1984 and 1985, no abnormal increase has been seen for a least 8 1/2 years. 3. The changes in the time trend of the incidence from the surveillance data was almost identical to those of the nationwide surveys, indicating the high validity of the surveillance system for timely estimation of an abnormal increase in incidence. 4. Because about one-third of the total number of the patients reported by the nationwide surveys come from only about 9% of the total number of hospitals included in the nationwide survey, efficiency in data collection without serious distortion was confirmed for the surveillance system. 5. The estimated number of patients in 1993 and 1994 calculated from the ratio of the numbers of patients between the surveillance and nationwide surveys was 5700 in 1993 and 6000 in 1994. The average yearly incidence rates per 100,000 children aged 0-4 years was 90. CONCLUSION: From the above results it is recommended that the surveillance system be continued in order to provide timely data on changes in the incidence of Kawasaki disease in Japan. It appears that the methods of data collection adopted in this system is applicable to the surveillance of other diseases.

Female↗

PubMed1996

Palliative steroid therapy and serum interleukin-6 levels in a patient with lung cancer.

We report a patient with metastatic adenocarcinoma of the lung who had a detectable serum interleukin-6 (IL-6) level. Despite systemic chemotherapy, the tumor progressed, with elevation of serum IL-6 level. Palliative steroid therapy with 20 mg/day of prednisolone resulted in the decline of serum IL-6 level and, simultaneously, improved anorexia and oral intake. Although there was no weight gain or improvement in hypoalbuminemia, these results suggest that steroids may suppress the abnormal production of IL-6 in cancer patients and that this action affects symptoms. Further study is warranted to clarify the role of IL-6 in tumor-related symptoms and the effect of steroid therapy in relation to IL-6 production in cancer patients.

Aged↗

PubMed1996

Mortality rates for patients with a history of Kawasaki disease in Japan. Kawasaki Disease Follow-up Group.

OBJECTIVE: To determine whether the mortality rate of patients with a history of Kawasaki disease is higher than that of the general population. DESIGN: In a cohort study, 6585 patients with Kawasaki disease were observed from the first medical encounter because of the disease through the end of 1992, or until death. Standardized mortality ratios (SMRs) with 95% confidence intervals (CI) were calculated with vital statistics data of Japan for the control. RESULTS: Of 6585 patients who met the eligibility criteria, 6550 (99.5%) were followed through either the end of the study or the date of death. Nineteen patients (14 male subjects) died during the study period; an overall SMR of 1.56 (955 CI, 0.94 to 2.43) was calculated for the entire study period. The SMR was 1.78 (95% CI, 0.97 to 2.99) for male subjects and 1.16 (95% CI, 0.38 to 2.71) for female subjects. During the acute phase of the disease (the first 2 months after onset), the SMR was higher, particularly in male subjects (SMR, 10.12; 95% CI, 3.72 to 22.07). After the acute phase, however, both boys and girls had low SMRs. Nine of the 19 deaths were caused by Kawasaki disease; there were 2 deaths as a result of congenital anomalies of the circulatory system and 2 subjects died of malignant neoplasms of lymphatic or hematopoietic tissues. CONCLUSIONS: Although the mortality rate among those with a history of Kawasaki disease was elevated in Japan, many of the deaths that caused the elevation occurred during the acute phase of the disease. The mortality rate was not increased after the acute phase of the disease.

Age Distribution↗

PubMed1996

Anti-ganglioside GM2 monoclonal antibody-dependent killing of human lung cancer cells by lymphocytes and monocytes.

Ganglioside GM2 (GM2) frequently appears on the cell surface of human cancers of neuroendocrine origin. A mouse-human chimeric monoclonal antibody (mAb), KM966, against GM2 was previously found to promote the lysis of various cancer cells by human blood mononuclear cells (MNC). In this study, we analyzed the effector cells responsible for the chimeric mAb-dependent cell-mediated cytotoxicity (ADCC) against small cell lung cancer (SCLC) cells and examined the enhancing effect of various cytokines on the ADCC activity. The ADCC activity was assessed by 4-h 51Cr release assay. Highly purified lymphocytes (> 99%) and monocytes (> 90%) were separated by centrifugal elutriation from peripheral blood MNC of the same healthy donor. KM966 induced lysis of SCLC cells mediated by both lymphocytes and monocytes to similar extents, in a dose-dependent manner. Pretreatment of lymphocytes with various cytokines [interleukin (IL)-2, IL-12 and interferon-gamma] and that of monocytes with macrophage-colony-stimulating factor significantly augmented the killer activity against SCLC cells in the presence of KM966 mAb. KM966 was also effective for the lysis of non-small cell lung cancer cells in direct proportion to the GM2 expression levels. These findings suggest that combined treatment of KM966 mAb with cytokines may be therapeutically useful for in vivo killing of lung cancer cells expressing GM2 through the ADCC reaction.

Adenocarcinoma↗

PubMed1996

Induction by interleukin-15 of human killer cell activity against lung cancer cell lines and its regulatory mechanisms.

Interleukin (IL)-15 is a novel cytokine with IL-2-like activity. In the present study, we examined IL-15-mediated induction of killer activity of peripheral blood mononuclear cells (MNC) against lung cancer cell lines, and the regulatory mechanisms of this induction by IL-15. Cytotoxic activity was measured by 51Cr release assay. IL-15 at concentrations of more than 10 ng/ml induced significant killer activity of blood MNC against a small cell lung cancer cell line (SBC-3), as well as Daudi cells, and 50 ng/ml was considered its optimal concentration. A time course study revealed that an incubation period of 4-6 days was optimal for induction of killer activity. MNC cultured with IL-15 also exhibited killer activity against other lung cancer cell lines (H-69, N-291 and PC-9 cells). IL-15 and IL-12 had additive effects on induction of killer activity against SBC-3 cells. On the other hand, IL-15 had no synergistic or additive effect on induction of killer activity by IL-2. Fresh human monocytes isolated by centrifugal elutriation augmented the development of killer activity of lymphocytes stimulated by IL-15. As a humoral regulatory factor, IL-4 had a suppressive effect on induction of killer activity by IL-15. IFN-gamma, IL-1beta, TNF-alpha, IL-6 or IL-10 had no effect on induction of killer activity by IL-15 at the optimal concentration. These results suggest that IL-15 has potential for the immunotherapy of lung cancers.

Antibody-Dependent Cell Cytotoxicity↗

PubMed1996

Hospital facilities available to patients with Kawasaki disease: results of a national survey of Kawasaki disease in Japan.

Since 1970, thirteen nationwide epidemiologic surveys of Kawasaki disease have been conducted, and questions on the current situation of hospitals and their facilities have been included in the survey form to assess the care available to patients with Kawasaki disease. To clarify the characteristics of medical care for Kawasaki disease, this paper summarizes the present condition of hospital facilities available to patients with Kawasaki disease. A questionnaire form including questions about the situation of hospital facilities was sent to all pediatric departments of hospitals with 100 or more beds throughout Japan. The proportion of hospitals in which successive observations with echocardiography (UCG) is available (UCG available hospital) was significantly increased compared with the ninth survey (1985-86), whereas that of the hospitals in which coronary angiography (CAG) is available (CAG available hospital) was significantly decreased. Almost all (96.2%) of the patients were reported from the UCG available hospitals. The proportion of patients reported from hospitals with a set policy for intravenous gamma globulin (IVGG) therapy was 74.5%. The proportion of UCG available and CAG available hospitals and that of hospitals with a set policy for IVGG therapy correlated with the increase in the number of patients. In conclusion, hospital facilities available to patients with Kawasaki disease in Japan have satisfactory capability for diagnosis and management of Kawasaki disease.

Child↗

PubMed1996

Epidemiology of infant Kawasaki disease with a report of the youngest neonatal case ever reported in Japan.

Our objectives were to describe epidemiological pictures of infant Kawasaki disease (KD) and to report the youngest patient ever reported in Japan. A Japanese database of 105755 KD patients reported in the 25 year period since 1970 was analyzed. Of all the cases registered, there were only six cases aged 30 days or younger and 1768 cases (1.67%) aged 90 days or younger. We reported a typical case of KD (female, the onset at 20 days old) who was the youngest patient ever reported in Japan. The epidemiology of KD in early infants does not contradict the infection theory of the etiology; the rare incidence in the neonatal period can be explained by the protective effects of the passive immunity transferred from the mother and by exposure to the unknown infectious agents.

Age of Onset↗