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H Yanagawa

Publications and source records attributed to H Yanagawa.

At least 145 records · Page 8Linked to original sources
PubMed1995

[Recent progress of epidemiological studies on intractable diseases in Japan].

Since 1972, the Ministry of Health and Welfare of the Japanese Government has been promoting researches on the etiology of and treatment for so-called intractable diseases of unknown causes for which no specific medical treatment is established. The Research Committee of the Epidemiology of Intractable Diseases was first organized in 1976. The committee has continuously undertaken researches on the epidemiology of these diseases. The paper shows examples of the results of the research projects of the committee. The frequency and distribution of the patients with intractable diseases were estimated by the statistics of patients receiving financial subsidies, national patient surveys and nationwide hospital surveys. Descriptive epidemiology of examples of the diseases are shown. Case-control studies for selected diseases have been conducted by the Research Committee with the cooperation of health centers and university hospitals to which members of the committee belonged. A few examples are given in this report. Pathologists and epidemiologists are exploring the possibility of applying autopsy registration data to epidemiological studies. Examples of such studies are also given.

Case-Control Studies↗
PubMed1995

[Characteristics of medical institutions visited by patients with 26 intractable diseases who are residents of Saitama Prefecture (comparison of the data for 1984 and 1988)].

To obtain basic data concerning the availability of medical care for intractable diseases in a large city and its environs, we analyzed the data of Saitama Prefecture. These data were selected from a nationwide survey conducted by the Epidemiology of Intractable Diseases Research Committee of the Ministry of Health and Welfare in Japan. The characteristics of medical institutions visited by patients with 26 intractable diseases were analyzed. The patients were receiving financial aid for treatment. The subjects were 4234 patients in 1984 and 6804 patients in 1988. In addition, we compared the data of 1984 with those of 1988. The results are as follows: 1) In both years, the characteristics of medical institutions which were visited varied in terms of the individual disease. The proportion of patients who visited medical institutions in the same medical service area and in the same prefecture were both very low. The percentage of patients who visited medical institutions in Tokyo was more than 30% of the total, and was more than 50% for the disease with the highest proportion of patients. The dependency on Tokyo for medical institutions was inversely proportional to the distance from Tokyo. Most patients were highly dependent on a large hospital, but the proportion of patients with SMON and ulcerative colitis who visited a large hospital was markedly lower than that for other diseases. 2) A comparison of the data of 1984 with those of 1988 showed that in most of medical service areas, the proportion of patients who visited medical institutions in the same medical service area and in Saitama Prefecture increased, but in Tokyo Prefecture the proportion decreased. We continuously observed a high dependency on a university hospital located about 60km distance from downtown Tokyo, but the dependency slightly decreased in 1988. When a new branch of a university hospital opened, many intractable disease patients then depended on that branch. These results suggest that the self-sufficiency levels of medical services for intractable diseases gradually rose in Saitama Prefecture. The illness behavior of intractable disease patients in Saitama Prefecture did not show any remarkable changes, therefore those results in Saitama Prefecture might indicate a universal characteristic of medical institutions visited by intractable disease patients who live in the envirous of a large city (Tokyo).

Critical Illness↗
PubMed1995

Influence of systemic chemotherapy on anti-P-glycoprotein antibody-dependent cell-mediated cytotoxicity in patients with small cell lung cancer.

Anti-P-glycoprotein antibody (MRK-16)-dependent cell-mediated cytotoxicity (ADCC) by blood mononuclear cells (MNC) was examined in patients with small cell lung cancer (SCLC) before and after systemic chemotherapy. The effect of in vitro treatment of MNC with interleukin (IL)-2 and macrophage-colony-stimulating factor (M-CSF) was also examined. The ADCC reaction was assessed by a 6 h 51Cr-release assay using a multidrug-resistant (MDR) SCLC cell line (H69/VP cells). The MRK-16 monoclonal antibody was able to augment spontaneous cytotoxicity by MNC, even in SCLC patients. Pretreatment of MNC with IL-2 significantly augmented their ADCC ability in SCLC patients, while M-CSF had no effect on ADCC activity. After the first cycle of systemic chemotherapy, the ADCC activity tended to decline, but ADCC of MNC pretreated with IL-2 was not affected. The results suggest that anti-P-glycoprotein antibody, in combination with a cytokine such as IL-2, may be therapeutically useful against human SCLC resistant to chemotherapeutic drugs.

ATP Binding Cassette Transporter, Subfamily B, Mem↗
PubMed1995

Epidemiologic pictures of Kawasaki disease in Japan: from the nationwide incidence survey in 1991 and 1992.

OBJECTIVE: Since 1970, twelve nationwide epidemiologic surveys of Kawasaki disease (KD) have been conducted throughout Japan every two years to describe KD in Japan. By the end of 1992, a total of 116,848 cases were reported. This paper summarizes the statistical analysis of the latest survey for the 2-year period from January 1991 through December 1992. METHOD: A questionnaire form and diagnostic guidelines for KD were sent to all pediatric departments of hospitals with 100 or more beds throughout Japan and information was obtained on patients with KD diagnosed during the 2-year period from January 1991 through December 1992. RESULTS: The summary of the results is: 1) the number of patients reported was 11,221 (6604 males and 4617 females; male/female ratio = 1.43) with a yearly incidence rate of 90 per 100,000 children < 5 years old; 2) the monthly number of patients was higher in winter and summer, although the monthly difference was not marked; 3) age-specific incidence rates showed a unimodal peak at 1 year of age; 4) the proportion of patients with a family history of KD in a sibling was 1%; 5) the proportion of recurrent patients was 3%; 6) the proportion of patients with cardiac sequelae 1 month after disease onset was 13%; and 7) the number of patients who died was 9, which conforms to 0.08% of total patients. CONCLUSION: The incidence rates of KD in Japan are ten times higher than those reported in western countries and almost constant over 6 years. The descriptive epidemiology of the disease, which supports the infection theory, does not change for years.

Age Distribution↗
PubMed1994

Incidence rate of recurrent Kawasaki disease in Japan.

To calculate the incidence of recurrent Kawasaki disease and to discuss some potential risk factors for its recurrence, we observed a cohort consisting of those followed-up since the first episode of the disease. A total of 4560 persons, with 16,500.4 person-years were observed from the second month after the first episode of the disease to the end of 1989. The mean observation period was 3.62 years. The overall incidence rate was 5.21 per 1000 person-years, with a higher incidence within the 2 years from the first episode; although not statistically significant, the incidence was higher among males and those who experienced the first episode at < or = 2 years of age. The possibility of i.v. gamma globulin therapy being one of the risk factors was negated by a stratified analysis to control confounding factors but supported by univariate analysis.

Child↗
PubMed1994

Gastric cancer screening programme in Japan: how to improve its implementation in the community.

STUDY OBJECTIVE: The aim was to investigate which factors in the operating procedure of the gastric cancer screening programme carried out by local Japanese municipalities affect the participation rate. DESIGN: This was a cross-sectional study. Data were mainly obtained by questionnaire completed by the person in charge of health in each municipal council. Information was sought on screening motivation, screening programme organisation, payment for the examination, the scheduling and filing system, and community manpower. Data on the participation levels were obtained from the health data service system published by the Ministry of Health and Welfare in 1991. SETTING: All of Japan's 3268 local municipalities were sent the questionnaire. Altogether 2795 municipalities responded (85.5% response rate). SUBJECTS: The local municipality was regarded as the study unit. The municipalities were classified into two groups--small municipalities, those with < 10,000 population aged 40 years and over, and large municipalities, those with > 10,000 population aged 40 years and over. MAIN RESULTS: The participation rate in the screening programme varied according to the municipality population size and age. Small municipalities had higher participation rates. The rate in people aged 60-69 years was highest and that in those aged 70+ years was lowest. The participation rate was positively associated with factors related to the operating procedure before (for example, giving information about screening), during (for example, assisting the screening staff), and after (setting up the relevant filing systems) the gastric examination. CONCLUSIONS: The results suggest that personal motivation, manpower in local residents' organisations, scheduling time for convenience, and a basic filing system for individual data, especially for people who have not participated in the programme for a few years, are important in increasing participation.

Adult↗
PubMed1994

Identification of a novel first exon in the human dystrophin gene and of a new promoter located more than 500 kb upstream of the nearest known promoter.

The dystrophin gene, which is mutated in patients with Duchenne and Becker muscular dystrophies, is the largest known human gene. Five alternative promoters have been characterized until now. Here we show that a novel dystrophin isoform with a different first exon can be produced through transcription initiation at a previously unidentified alternative promoter. The case study presented is that of a patient with Duchenne muscular dystrophy who had a deletion extending from the 5' end of the dystrophin gene to exon 2, including all promoters previously mapped in the 5' part of the gene. Transcripts from lymphoblastoid cells were found to contain sequences corresponding to exon 3, indicating the presence of new promoter upstream of this exon. The nucleotide sequence of amplified cDNA corresponding to the 5' end of the new transcript indicated that the 5' end of exon 3 was extended by 9 codons, only the last (most 3') of which codes for methionine. The genomic nucleotide sequence upstream from the new exon, as determined using inverse polymerase chain reaction, revealed the presence of sequences similar to a TATA box, an octamer motif and an MEF-2 element. The identified promoter/exon did not map to intron 2, as might have been expected, but to a position more than 500 kb upstream of the most 5' of the previously identified promoters, thereby adding 500 kb to the dystrophin gene. The sequence of part of the new promoter region is very similar to that of certain medium reiteration frequency repetitive sequences. These findings may help us understand the molecular evolution of the dystrophin gene.

Amino Acid Sequence↗
PubMed1994

Intravascular bronchioloalveolar tumor with skin metastases.

Intravascular bronchioloalveolar tumor (IVBAT) is a rare pulmonary tumor that occurs in the younger age groups. In the present article, we describe a patient who manifested systemic growth after the resection of the primary tumor. Skin metastasis, which has never been reported, is histologically examined.

Adult↗
PubMed1994

[Prevalence estimates for non-insulin dependent diabetes mellitus (NIDDM) in Japan from National Survey of Circulatory Disorders 1990 data].

Prevalence of diabetes mellitus in Japan was estimated from fructosamine and hemoglobin A1c measurement data obtained from the National Survey of Circulatory Disorders 1990, using a previously reported method which used the results of a screening test for estimating true prevalence. The prevalence for males was higher than that for females. The prevalences were less than 10% for those 49 years or younger and approximately 20% for those 50 years or older. The estimated values derived from fructosamine or hemoglobin A1c did not vary considerably.

Adult↗
PubMed1994

[A method of estimation for prevalence of diabetes mellitus from fructosamine levels].

A method for estimating the prevalence interval of diabetes mellitus from fructosamine data is presented, which is based on the previously reported method for estimating prevalence from results of screening tests and on the results of 75 gram glucose tolerance test and fructosamine test in 1,359 examinees. Where true prevalences are 1-20% and population size is 100-10,000, the estimates for prevalence of diabetes mellitus are generally minimum when a screening level of 310 mumol/l of fructosamine is utilized. In our method, a screening level for fructosamine of 310 mumol/l was specified. Standard error ratios of estimated prevalence of diabetes mellitus to true prevalence in a population with an actual prevalence of 10% were about 40% for a population of 200 persons, and about 20% for 2,000 persons or more.

Diabetes Mellitus↗
PubMed1993

Protein anatomy: functional roles of barnase module.

Globular proteins are composed of several modules that are contiguous polypeptide segments of compact conformation. Module boundaries are closely correlated with the intron positions of genes that encode proteins. The modules may thus have a one-to-one correspondence with exons in primordial genes. They may also be vestiges of polypeptide segments that initially appeared as primordial proteins in prebiological evolution. Clarification as to whether modules disconnected from one another have functional potentiality may validate these possibilities. Thus, in this study, each module of a protein was synthesized and assessed for functional potentiality. For this purpose, barnase, a bacterial ribonuclease, was decomposed into six modules (M1-M6), which were examined to determine whether they have an affinity for RNA and RNase activity. M2, M3, and M6, all of which form a shallow but wide cavity for RNA binding in native barnase, were found to bind to RNA and to possess RNase activity. However, M1 and M5, which support the other modules from the back side, and M4 did not bind to RNA and had no RNase activity. Protein modules with catalytic functions are described in this paper for the first time. That some modules of barnase possess catalytic activity indicates that protein modules may possibly have functioned as primitive catalysts in prebiological evolution.

Amino Acid Sequence↗
PubMed1993

Protein anatomy: spontaneous formation of filamentous helical structures from the N-terminal module of barnase.

This paper reports the conformation of the N-terminal module (24 amino acid residues) of barnase in aqueous solution. This module contains the first of three helices in the intact protein. Circular dichroism spectra showed the peptide fragment to have a predominantly random coil structure immediately following dissolution in aqueous solution and to be gradually converted to a helical structure at 5 degrees C. This was mediated by aggregation, and an electron micrograph indicated the aggregate to be comprised of filamentous helical structures. Scanning tunneling microscopy showed the filamentous structures to be made up of protofilamentous structures containing many disks apparently stacked on top of each other. A monomer of the peptide predominantly took on a random coil conformation in aqueous solution and the multimer, a stable helical structure. A local amino acid sequence would thus appear to determine the secondary structure corresponding to that in a native protein but stability to be governed by other factors such as tertiary interactions. Helical wheel representation indicated the peptide fragment to have the features of an amphiphilic helix. Hydrophobic burial may provide the driving force for producing a stable helical structure in aqueous solution.

Amino Acid Sequence↗
PubMed1993

Association of alcohol intake, cigarette smoking, and occupational status with the risk of idiopathic osteonecrosis of the femoral head.

To investigate the association of alcohol intake, cigarette smoking, occupation, and other factors with the development of idiopathic osteonecrosis of the femoral head, a nationwide multicenter case-control study was conducted in Japan during 1988-1990, comparing 118 cases with no history of systemic corticosteroid use with 236 controls matched for sex, age, ethnicity, clinic, and date of initial examination. The risks of developing femoral head necrosis associated with potential risk factors were estimated by adjusted relative odds obtained by a conditional logistic regression model. The elevated relative odds were observed for occasional drinkers (relative odds = 3.2, 95% confidence interval 1.1-9.2) and regular drinkers (relative odds = 13.1, 95% confidence interval 4.1-42.5) with a significant dose-response relation (p < 0.001). For current drinkers, the relative odds were 2.8, 9.4, and 14.8 for < 320, 320-799, and > or = 800 g/week of ethanol intake, respectively. An increased risk was found for current smokers (relative odds = 4.7, 95% confidence interval 1.5-14.5), but a linear increasing trend in the cumulative effect of smoking was not evident at 20 pack-years or over. A weak but significant dose-response relation was observed for daily occupational energy consumption (p < 0.05). The present study confirmed the strong association of alcohol intake and positive association of cigarette smoking and suggested the role of heavy physical work.

Adult↗
PubMed1993

Secondary structural features of modules M2 and M3 of barnase in solution by NMR experiment and distance geometry calculation.

Proteins consist of structural units such as globular domains, secondary structures, and modules. Modules were originally defined by partitioning a globular domain into compact regions, each of which is a contiguous polypeptide segment having a compact conformation. Since modules show close correlations with the intron positions of genes, they are regarded as primordial polypeptide pieces encoded by exons and shuffled, leading to yield new combination of them in early biological evolution. Do modules maintain their native conformations in solution when they are excised at their boundaries? In order to find answers to this question, we have synthesized modules of barnase, one of the bacterial RNases, and studied the solution structures of modules M2 (amino acid residues 24-52) and M3 (52-73) by 2D NMR studies. Some local secondary structures, alpha-helix, and beta-turns in M2 and beta-turns in M3, were observed in the modules at the similar positions to those in the intact barnase but the overall state seems to be in a mixture of random and native conformations. The present result shows that the excised modules have propensity to form similar secondary structures to those of the intact barnase.

Amino Acid Sequence↗
PubMed1993

[Combination chemotherapy with carboplatin and etoposide against lung adenocarcinoma in a patient undergoing hemodialysis: a case report].

A 60-year-old male with chronic renal failure undergoing hemodialysis was treated with combination chemotherapy with carboplatin and etoposide against stage IV adenocarcinoma of the lung. Three hundred mg/m2 of carboplatin on day 1, and 50 mg/m2 of etoposide on days 1 and 3 were injected intravenously before hemodialysis. Pharmacokinetic results revealed that carboplatin was dialyzed. No severe side effects were observed. These observations suggest that combination chemotherapy with carboplatin and etoposide seemed to be applicable to the patients with chronic renal failure undergoing hemodialysis.

Adenocarcinoma↗