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Biomedical subjects

N Kawakami

Publications and source records attributed to N Kawakami.

At least 163 records · Page 9Linked to original sources

Changes seen on magnetic resonance imaging in the intervertebral disc space after chemonucleolysis: a hypothesis concerning regeneration of the disc after chemonucleolysis.

Measurements of the intervertebral disc space were made by magnetic resonance imaging and plain film examinations over a period of 2 years in 26 patients who had undergone chemonucleolysis. The height of the posterior portion of the disc decreased after 3 months and never recovered; the height of the anterior portion also decreased but recovered slightly over the same period. The angle of lordosis and the range of motion in the treated segment were decreased, but recovered. Marked decrease in signal from the disc was observed after 2 weeks which did not recover till 2 years after chemonucleolysis. We suspect that the disc degenerated markedly after chemonucleolysis and changed into a type of scar tissue, maturation of which could stabilize the affected segment.

Adolescent↗

Intraoperative sonography of intramedullary spinal cord tumours.

Intraoperative spinal sonography was performed 23 times in 20 patients with intramedullary spinal cord tumours, and the sonographic features were examined. Eight cases of astrocytoma were classified into three types: type 1, seen in 3 children, had intramedullary, circular or oval, hyperechogenic multiple tumour shadows; type 2 presented inter-multimyelomere, relatively well-defined single tumour shadows corresponding to grade III and I for two juvenile and aged cases each, respectively; and type 3 appeared ill-defined and diffusely infiltrating. The relationships between these types, the ages of patients and histological grades were considered a potential clue to mechanisms of occurrence and infiltration of astrocytoma. All 7 ependymomas had syrinxes, of three types; central canal was very large, the tumour lying within it like an island; or the tumour was in contact with a cephalocaudal side part of the syrinx; or the tumour had a syrinx or cyst. Sonographic images thus differ according to the tumour, but differential diagnosis is currently limited. Development of sonographic equipment, with upgrading its resolving power are hoped for.

Adolescent↗

Intraoperative ultrasonography of extramedullary spinal tumours.

Intraoperative spinal sonography (IOSS) was performed in 28 patients with extramedullary spinal tumours. Images were obtained of 31 tumours, because 2 patients had multiple tumours. There were 17 neurilemmomas, 9 meningiomas and 2 dermoid cysts. All tumours appeared well-defined and highly echogenic. There was no difficulty differentiating extramedullary spinal tumours from intramedullary masses excepting case, a big neurilemmoma at the conus medullaris. All images were assessed with reference to the surface of the lesions, the existence of cysts, and movement. Neurilemmomas had smooth surfaces, some cysts, and exhibited a "floating" movement. Meningiomas had irregular surfaces, were more highly echogenic than neurilemmomas, and adhered tightly to the dura mater. However, some neurilemmomas and meningiomas did not have these, and it was not always possible to differentiate them. Although IOSS has limitations of resolution, it gave useful information about the size of the tumours, the degree of displacement of the spinal cord, and even about the type of tumour in some cases. It was extremely helpful to the surgeon.

Adult↗

Prevalence and demographic correlates of alcohol-related problems in Japanese employees.

To examine the relationship of basic sociodemographic characteristics to alcohol-related problem in Japanese employees, a questionnaire survey was conducted of a total of 2,581 employees of a computer factory in a suburb of Tokyo. The questionnaires included items on gender, age, marital status, social class (i.e., education, family income and occupation), alcohol consumption, and the Kurihama Alcoholism Screening Test (KAST). Data from 1098 male and 265 female current drinkers aged 20 years or older were analyzed; 15% and 6% of the male and female subjects, respectively, were classified as having alcohol-related problems on the basis of the KAST score (13% and 4% of the entire study population, respectively). Multiple logistic regression analysis indicated that alcohol-related problems were more prevalent in the less educated, managers and those who had a high alcohol consumption. The results suggested that education and occupation are important factors related to alcohol-related problems in Japanese employees.

Adult↗

Serial changes observed by magnetic resonance imaging in the intervertebral disc after chemonucleolysis. A consideration of the mechanism of chemonucleolysis.

Changes in the intervertebral disc after chemonucleolysis in 26 patients were observed by magnetic resonance imaging for 1 year, and from the results a mechanism for chemonucleolysis was considered. A reduction in size of the herniation was not recognized 2 weeks after treatment, when chymopapain had caused necrosis of the disc, but began after 4 weeks, when regeneration of the disc had occurred. The herniation was further reduced after 3 months, and the disc had become fibrocartilaginous in a cicatricial process. Marked decrease in disc signal was observed after 2 weeks, and never recovered. From these facts, it is considered that chymopapain might never cause primary diminution of disc herniation, and any reduction of herniation that occurs is due to the effects of a secondary cicatricial contraction.

Adolescent↗

Effects of perceived job stress on depressive symptoms in blue-collar workers of an electrical factory in Japan.

This three-year prospective study on the effects of job stress on depressive symptoms over time was conducted among male blue-collar workers in an electrical factory in Japan. Data were collected at yearly intervals by means of postal questionnaires. Initially ten job stress variables, five major covariates, and depressive symptoms (Zung Self-Rating Depression Scale) were measured. In the yearly examinations, depressive symptoms were measured for a total of 468 respondents. The results indicated that job unsuitability was a significant predictor of depressive symptoms in the second and third year, after control for the initial covariates and depressive symptoms. Lack of control over workplace and poor human relations at the workplace were significantly associated with depressive symptoms after one and two years, respectively. Job unsuitability and poor human relations at the workplace seem to be risk factors for long-lasting depressive symptoms in Japanese blue-collar workers.

Adult↗

Central nervous system effects and visual fatigue in VDT workers.

To assess central nervous system effects and visual fatigue induced by work with visual display terminals (VDT), symptom frequency was assessed and visual evoked potential (VEP), critical flicker fusion (CFF) and near-point distance were measured in 24 female keypunchers before and after 2.5 h of VDT work and in 6 non-VDT-exposed subjects at the same intervals. Each keypuncher had been engaged in data entry for 1-7 (mean, 4) years. After VDT work, the number of complaints of subjective fatigue as well as an objective measure of near-point distance were significantly increased as compared with those before work; also, the N75, P100 and N145 latencies of VEP were significantly prolonged. The change of P100 latency during VDT work was inversely correlated with the number of years worked in data entry. No significant change was seen in any of these tests in the non-VDT-exposed subjects. The changes in N75 latency and subjective fatigue related to drowsiness and dullness in the keypunchers were significantly larger than those in the non-VDT-exposed subjects. The CFF was significantly lower in keypunchers than in non-VDT-exposed subjects in both the first and the second tests. These data suggest that VDT work is associated with impairment of the visual nervous system function, that VEP latencies appear to be a sensitive indicator of visual fatigue, at least transiently, and that CFF appears to be a good parameter for estimations of chronic visual fatigue.

Adolescent↗

Job-stress and medical consultation rates for physical illness among blue collar workers of an electrical factory in Japan: a four-year prospective follow-up study.

To investigate the relationship between job-stress and medical consultation rates for physical illness, a prospective study was conducted for male blue workers of an electrical factory in Japan. 8 job-stress variables and 8 possible confounders were assessed by means of mailed questionnaires in the initial study; 375 workers without medical history of illness were followed for four years; they were interviewed once a year and medical consultations for physical illness were recorded. Age-adjusted rates of medical consultation during the four-year period were significantly higher in the subjects with higher job-dissatisfaction scores than in those with lower job-dissatisfaction scores (p less than 0.05). The results of the multiple logistic regression analysis indicated that job-dissatisfaction together with age and education was significantly correlated with medical consultation (p less than 0.05). The results suggest that job-dissatisfaction is a potential factor for medical consultation in Japanese blue collar workers.

Adult↗

[Factors affecting death at home in bedridden elderly people].

To examine factors which affect death at home in bedridden elderly people, relatives of bedridden elderly people, in three areas of Japan, who had died, were interviewed, and demographic, medical, social and familial factors were compared between 136 persons who died at home and 132 persons who died in the hospital. 1) In all three geographical areas, significantly more subjects who died at home had physicians who made home visits than in those who died at hospital (p less than 0.01). 2) The mean age at death was significantly higher in the elderly people who died at home than in those who died in the hospital in all three areas (p less than 0.01). 3) The results of multiple logistic regression analysis indicated that physician's home visits and death age were significantly related independently to death at home. This relation was independent of confounding factors such as residential area, disease type, or use of social services.

Age Factors↗

[Frequency of psychiatric patients visiting non-psychiatrist's outpatient clinic and its correlates].

To examine the frequency of psychiatric patients who visit outpatient clinic of non-psychiatrists in Japan, a mailed questionnaire survey was conducted of 200 non-psychiatrists randomly selected from the 703 registered members of the Kawasaki-city Medical Association, Kanagawa prefecture. Responses from 124 or 62% were received and data for 112 male respondents were analyzed. 1) The median number of psychiatric patients treated per month by respondents was 4, and the median proportion of the total outpatients that were psychiatric patients was 0.7%. 2) Sixty-one internists saw significantly greater numbers and proportions of psychiatric patients than the other 51 doctors. 3) The internists saw a higher proportion of mild anxiety, depression, alcohol-drug dependency and psychosomatic problems among all psychiatric patients than did other doctors. 4) For the internists a significant inverse correlation was observed between the total number of outpatients and the proportion of psychiatric patients. This was the result of a group of physicians who saw a relatively small number of outpatients but had a higher proportion of psychiatric patients among outpatients.

Adult↗