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Biomedical subjects

S Tominaga

Publications and source records attributed to S Tominaga.

At least 91 records · Page 5Linked to original sources
PubMed1998

Evaluation of the death certificate follow-up method for the analysis of survival rate: data from Aichi Prefecture, Japan.

To evaluate the use, for studies on survival, of death certificates from population-based cancer registries in Japan, we compared 5-year survival rates by two different methods: passive, derived from death certificates, and active, using family register systems. Registered cancer cases from Aichi Prefectural Cancer Registry were used as a model. The study subjects comprised 9244 cancer patients (3830 males and 5414 females) newly diagnosed at the Aichi Cancer Center Hospital and recorded in the Aichi Prefectural Cancer Registry between 1983 and 1991. The passive follow-up method, using death certificates, identified 87-89% of deaths among the study subjects. The proportion of deaths which were not identified by the passive follow-up method did not vary greatly with age or gender, but was higher among patients in the earlier rather than the later stages of cancer. Overall, the absolute and relative effects of unregistered deaths on apparent survival rate vary with the absolute survival rate. The absolute and relative differences between the survival rates calculated by the two methods are explained more clearly when data are analyzed by cancer site. The results of the present study provide useful information for interpreting the survival rate following diagnosis of cancer estimated by the passive follow-up method, i.e. using death certificates from a population-based cancer registry.

Aged↗
PubMed1998

Nested consent design for clinical trials.

BACKGROUND: Since random treatment allocation is hardly understood by the majority of patients, a new 'nested consent design' for clinical trials is proposed. PROPOSED DESIGN: The design consists of a two-step enrollment of study subjects. The first step is the enrollment of participants into a follow-up study, where consent to be subjects involved in the follow-up is obtained. The second step is the enrollment of randomly sampled eligible participants into a new treatment group. After the explanation of (1) treatment mode, (2) additional burdens associated with the proposed treatment and (3) expected effects and possible adverse events, written informed consent is obtained. Those who reject participation and those who are not allocated into the new treatment are treated by standard care. Endpoints are set to be the same for all follow-up study participants whether allocated into the new treatment or not, and follow-up is carried out in the same manner. Analyses are performed between those allocated to the new treatment and those non-allocated on an intent-to-treat basis. EXAMPLE: Although not a clinical trial, this design was applied in a smoking cessation program at Aichi Cancer Center Hospital for first-visit patients who answered in a questionnaire survey that they were smokers. Out of 1330 necessary participants, 324 were enrolled in the follow-up study during the first three months of enrollment. CONCLUSIONS: The design was found to be feasible for prevention trials, and possibly for clinical trials to compare a new treatment with a standard treatment. There seems to be no ethical difference between this design and the one-arm study design.

Clinical Trials as Topic↗
PubMed1998

Cerebral revascularization using muscle free flap for ischemic cerebrovascular disease in adult patients.

The efficacy of encephalo-myo-synangiosis (EMS) using muscle free flap was evaluated for the treatment of ischemic cerebrovascular disease in adult patients. Three patients with adult moyamoya disease and three patients with atherosclerotic ischemic cerebrovascular disease were treated. EMS used four latissimus dorsi muscles and two serratus anterior muscles. Postoperative selective angiography showed collateral circulation from the transferred muscle to the brain in four of the six patients. The other two patients showed patent nutrient artery of the transferred muscle flap. Cerebral blood flow study disclosed postoperative improvement of perfusion reserve capacity in all sides. One patient suffered a perioperative stroke by hemoconcentration due to poor control of diabetes mellitus. The mean follow-up period was 23 months. EMS using muscle free flap is a possible procedure in selected patients with impaired cerebral perfusion reserve capacity due to multiple stenosis or occlusion of cerebral arteries including moyamoya disease or who required cerebral blood flow augmentation in the anterior and/or posterior cerebral artery territories due to internal carotid artery occlusion.

Adult↗
PubMed1998

The estimation of cancer incidence in Aichi Prefecture, Japan: use of degree of completeness of registration.

This study was conducted to estimate true incidence of the total number of cancer cases and of cancers at selected sites in the population of Aichi Prefecture, Japan, using the degree of completeness of registration (CR). Information on incidence (I), death (D), and cases first notified via death certificate (DCN) was based on the data from 1976 to 1993. Using this information, CR for each cancer site was calculated by gender and a 3-year period of diagnosis [CR = (1-PDCN l/D)/(1-PDCN), PDCN: proportion of DCN cases]. The true number of incident cases and incidence rates (estimated incidence rate: EIR) were then estimated from the number of cases observed and from CR. CR for all sites of cancer was 62-78 percent in males and 54-72 percent in females, and CR was higher in cancers with low I/D ratios than those with high I/D ratios. Annually, about 2,500-3,000 cases in each gender were unreported. The EIR of all sites was estimated at 252-280 in males and 213-207 in females compared with the incidence rates observed (observed incidence rate: OIR) as 157.0-218.6 in males and 115.3-149.2 in females. OIR was closer to the EIR for cancers with low I/D ratios than those with high I/D ratios. These values are important for planning and evaluating cancer control strategies in the population.

Death Certificates↗
PubMed1998

Agreement of endoscopic findings and serum pepsinogen levels as an indicator of atrophic gastritis.

Serum pepsinogen I and II levels have recently become popular as indicators of atrophic gastritis in epidemiological studies. Previous studies show a significant association between serum pepsinogen levels and endoscopically diagnosed atrophic gastritis. This study assesses the level of agreement between the degree of atrophic gastritis as assessed by endoscopic examination and by serum pepsinogen assays. Study subjects were 200 outpatients at Aichi Cancer Center Hospital, Nagoya, Japan, who were endoscoped between February and August 1995. Agreement of the degree of atrophic gastritis was assessed by endoscopic examination and by serum pepsinogen levels. Agreement in assessing the extent of atrophic gastritis between the two methods was 57%, and the presence of atrophic gastritis was 79%. Serum pepsinogen assays identify the majority of patients with atrophic gastritis, although they are less useful in assessing the degree of atrophy in detail.

Adult↗
PubMed1998

[Cancer prevention by stopping smoking].

Many epidemiological studies have revealed that cigarette smoking is associated with lung cancer and several other cancers and that the risk of lung cancer decreased after smoking cessation. The risk attributable to smoking from cancer can be calculated from the relative risk for smokers and the proportion of smokers in a given population. In Japan 26.7% of cancer of all sites was attributable to smoking among males, whereas only 4.4% was attributable to smoking in females, mainly because of their lower smoking frequency. It was also estimated that if the smoking rate was decreased from the present level of 56.1% to 40% and 20%, 7.7% and 17.2% of cancers of all sites could be prevented in males. The preventable fraction of cancer in females was small (1.4% and 2.9%) even if the smoking rate was decreased from the present level of 14.5% to 10% and 5%. Among males, 65.9% of lung cancer was considered attributable to smoking, and were the smoking rate decreased from the present level of 56.1% to 40% and 20%, up to 18.9% and 42.4% of lung cancer could be prevented. In view of the recent remarkable increase of lung cancer in Japan and the relatively low mortality reducing efficacy of lung cancer screening, it is necessary to promote primary prevention of lung cancer and of other smoking-related cancerous and non-cancerous diseases by extensive smoking control.

Female↗
PubMed1998

[Appearance of extrahepatic lesions in the superior lip and orbit of a patient with liver metastases of gastric cancer following partial response by hepatic arterial infusion chemotherapy].

A 76-year-old man was totally gastrectomized in June, 1996 for advanced gastric cancer. In February, 1997, multiple liver metastases were found by abdominal CT scan, and hepatic arterial infusion chemotherapy was started with 5-FU, EPI and MMC by an implantable reservoir indwelled via the left subclavian artery. This treatment was judged to have led to a partial response because reduced focus size of the liver metastasis was revealed by CT scan and levels of tumor markers decreased significantly. However, metastatic foci were found in the skin of the superior lip and the orbit in December 1997. He was treated with a variety of therapies, but died in January, 1998. Many cases with metastatic hepatic cancer have a poor prognosis because of the appearance of extrahepatic lesions in spite of the fact that a partial response can be obtained by hepatic arterial infusion chemotherapy. The present case was unique since extrahepatic lesions appeared at very rare sites such as the superior lip and the orbit.

Aged↗
PubMed1997

Descriptive Epidemiology of Male Breast Cancer in Japan.

To examine the characteristics of male breast cancer in Japan, time trends and geographical distribution of the mortality of male breast cancer were analyzed by using " Vital Statistics " over the last four decades, compared with female breast cancer mortality. The male to female sex ratio of the number of deaths from breast cancer over the period between 1950-1994 was 1:103.6. The age-specific death rates of breast cancer in males rose steadily with age while the rates in females having the peak in the latter half of the sixth decade, then decreasing, rising again in the ninth decade for the years 1973-1993. The number of deaths from breast cancer has increased, and while the crude death rate has risen from 1948-1952 to 1988-1992 in both sexes, and the increasing trend in females was larger than that in males in recent years. On the other hand, the age-adjusted death rate from breast cancer has leveled off or decreased in males while the rate in females has increased over the last few decades. Thus, the female to male sex ratios of both the number of deaths and the death rates from breast cancer increased continuously in recent years. The average age at death from breast cancer in males gained 11.7 years during the last 40 years(71.2 years old in 1988-1992 vs 59.5 years in 1948-1952), but only 3.1 years in females(58.6 vs 55.5).

Journal Article↗
PubMed1997

An ecological study on diet/nutrition and cancer in Japan.

Correlation or ecological studies may be useful in identifying cancer risk factors which are distributed relatively homogeneously within a population, but differ greatly between populations or between different periods within a given population. In Japan, the westernization of dietary habits has progressed remarkably in the last few decades and may have resulted in changes of incidence/mortality rates of diet-related diseases, especially cancer. Based on data from the National Nutritional Survey of Japan (1955-1993) and the vital statistics of Japan (1955-1993), we conducted correlation analyses between food/nutrient intake and cancer mortality. The present study on chronological correlations suggests the relationship between westernized dietary habits and mortality by cancers of the colon, breast, ovary and prostate and also the relationship between traditional Japanese dietary habits and mortality by stomach cancer. Our results suggest the importance of diet in the etiology of diet-related cancer. Further observation and analyses are needed to confirm the relationship between food/nutrient intake and cancer mortality, while also considering the consumption of tobacco and alcohol and improvement in cancer diagnostic and therapeutic techniques.

Diet↗
PubMed1997

Cerebral revascularization by omental free flap using contralateral superficial temporal vessels as recipient vessels: case report.

BACKGROUND: Although the most common technique of cerebral revascularization is superficial temporal artery to middle cerebral artery bypass, we occasionally encounter a situation in which the ipsilateral superficial temporal artery is not available. Treatment may require several techniques including long vein graft bypass. METHODS: A 54-year-old man experienced transient ischemic attacks, and cerebral angiography revealed occlusion of the right common carotid artery. Cerebral blood flow study revealed reduced perfusion reserve capacity of the right cerebral hemisphere. We applied an omental free flap to the brain surface using the contralateral superficial temporal vessels as recipient vessels. RESULTS: Cerebral blood flow study revealed improvement of perfusion reserve capacity. Cerebral angiography revealed good collateral circulation from the omentum to the brain. The patient has not experienced a transient ischemic attack, following additional ligation of the occipital artery 13 months after the first operation. CONCLUSIONS: Because an omental flap has a long pedicle and its circulation can be monitored easily, this method is safe and as effective as a long bypass graft in a patient such as ours in whom the ipsilateral superficial temporal artery is not available for anastomoses.

Anastomosis, Surgical↗
PubMed1997

Dietary and lifestyle correlates of passive smoking in Hong Kong, Japan, Sweden, and the U.S.A.

From epidemiologic studies in several countries, passive smoking has been associated with increased risk for lung cancer, respiratory diseases, and coronary heart disease. Since the relative risks derived from those studies are weak, i.e. relative risk less than two, we investigated whether poorer diets and less healthy lifestyles might act as confounders and be correlated with having a smoking husband on a cross-cultural basis. Characteristics of never-smoked wives with or without smoking husbands were compared between 530 women from Hong Kong, 13,047 from Japan, 87 from Sweden, and 144 from the U.S. In all four sites, wives with smoking husbands generally ate less healthy diets. They had a tendency to eat more fried food but less fruit than wives with nonsmoking husbands. Other healthy traits, e.g. avoiding obesity, dietary cholesterol and alcohol, or taking vitamins and participating in preventive screening were also less prevalent among wives with smoking husbands. These patterns suggest that never-smoked wives with smoking husbands tend to share the same less healthy dietary traits characteristic of smokers, and to have dietary habits associated with increased risk for lung cancer and heart disease in their societies. These results emphasize the need to take into account the potential confounding effects of diet and lifestyle in studies evaluating the health effects of passive smoking, especially since it is known that the current prevalence rates of smoking among men is indirectly associated with social class and education in affluent urban societies.

Adolescent↗
PubMed1997

Epidemiological features of first-visit outpatients in Japan: comparison with general population and variation by sex, age, and season.

To evaluate the methodological issues in using first-visit outpatients as controls in epidemiological studies, the features of general lifestyles of non-cancer outpatients at Aichi Cancer Center Hospital (ACCH) were compared with those of the general population, and their variation by sex, age, and season was determined by using a self-administered questionnaire. The study included 1231 subjects randomly selected from the Nagoya electoral roll (CRG), and three groups of non-cancer ACCH outpatients living in Nagoya; 800 from the period September to December 1992 (OPG1), 2326 from January to December 1992 (OPG2), and 12,243 from January 1991 to December 1992 (OPG3). In the younger age group, the proportion of current smokers was higher in the CRG than in the OPGs. In the older age groups, the proportion of those who consumed fresh vegetables and fruit everyday was higher in the OPGs than in the CRG. For other items, the features of the OPGs were not significantly different from those of the CRG. Among the OPG3, there were differences in the features of general lifestyles between sexes and consumption of several food items varied with age. Seasonal variation, however, was only observed in the specific food items where supply varied seasonally. It was concluded that, with due consideration of age, sex, and season in the analysis, it is feasible to use non-cancer outpatients as controls in epidemiological studies.

Adult↗
PubMed1997

The expression of ST2 gene in helper T cells and the binding of ST2 protein to myeloma-derived RPMI8226 cells.

The ST2 gene, which is specifically induced by growth stimulation, encodes interleukin-1 receptor-related proteins. Using the RT-PCR method, we found that the ST2 gene was broadly expressed in hematopoietic cell lines. It was also expressed specifically in helper T cell lines among lymphocytic cell lines. We analyzed the expression of ST2 in mouse helper T cell subsets with Northern blotting analysis. Mouse Th1 cell lines so far studied did not express ST2 mRNAs. On the other hand, one of the Th2 cell lines, D10, expressed ST2L (transmembrane form) without stimulation, while co-stimulation by PMA and A23187 induced ST2 (soluble form) mRNA. These results suggest that the ST2 gene is involved in the regulation of the immune system. IL-1 alpha, IL-1 beta, and receptor antagonist did not bind to ST2L protein, which prompted us to search for the specific ligand of ST2. The recombinant human ST2 protein was purified and labeled with FITC. The labeled human ST2 protein bound with myeloma-derived RPMI8226 cells among the various B-cell lines, indicating possible involvement of ST2 in T-cell/B-cell interaction.

Animals↗
PubMed1997

Arterialized occipitoparietal osteocutaneous flap.

We treated a case of postoperative osteomyelitis and epidural abscess in the left temporal and parietal region. The scalp and skull defect following debridement was reconstructed immediately with an arterialized occipitoparietal osteocutaneous flap that was supplied proximally by the occipital artery and distally by the superficial temporal artery. This method is one of the alternative methods for small to moderately sized skull and scalp defects in the temporal, parietal, and occipital areas without available superficial temporal artery.

Female↗
PubMed1997

Lifestyle and anti-Helicobacter pylori immunoglobulin G antibody among outpatients.

Since eradication of Helicobacter pylori (H. pylori) is thought to be a preventive measure against stomach cancer, several studies have examined factors associated with the infection. This paper reports the association of the infection with lifestyle factors observed in a hospital-based case-control study. Cases were 140 anti-H. pylori IgG antibody-positive outpatients (75 males and 65 females). Controls were 52 antibody-negative outpatients (22 males and 30 females). Both groups had undergone gastroscopy at Aichi Cancer Center Hospital between February 1995 and February 1997, and lifestyle data collected on the first visit were linked to calculate odds ratios. A strong association was observed with smoking among males; age-adjusted odds ratio (OR) = 7.85, 95% confidence interval (CI), 2.03-30.4. Rice breakfast (OR = 3.74; 95% CI, 1.30-10.8) and soybean paste soup (every day vs. occasionally, OR = 5.24; 95% CI, 1.80-15.2) were also associated with antibody positivity in males, but not in females. In females, pickled Chinese cabbage (> or = 1/week vs. < or = 3/month, OR = 2.82; 95% CI, 1.06-7.48) and lettuce (> or = 1/week vs. < or = 3/month, OR = 2.90; 95% CI, 1.09-7.76) were significantly associated with positivity. Multivariate analysis gave similar estimates for the above factors. Although the association between smoking and H. pylori infection has not been detected in past studies of a general population, except one recent one, this study on outpatients suggested a possible association. Smoking may work as a cofactor disturbing incidental eradication of H. pylori by antibacterial agents administered for other reasons.

Adult↗
PubMed1997

Progressive interstitial pneumonia associated with myelodysplastic syndrome: implication of superoxide hyperproduction by neutrophils.

Interstitial pneumonia and aseptic neutrophilic infiltration in the lung are rare pulmonary manifestations of myelodysplastic syndrome (MDS). We report a patient with progressive interstitial pneumonia associated with MDS. Histological examination of the lung revealed infiltration of atypical haematopoietic cells associated with MDS and diffuse alveolitis with honeycombing. Neutrophils obtained from the patient showed superoxide hyperproduction after stimulation with phagocytosis and phorbol myristate acetate, which might be attributed to the pathogenesis of interstitial pneumonia.

Bronchoalveolar Lavage↗
PubMed1997

Cerebral revascularization using latissimus dorsi muscle free flap transfer--technical note.

A method for cerebral revascularization using latissimus dorsi muscle free flap transfer is described. Latissimus dorsi muscle is harvested with thoracodorsal vessels after completion of craniotomy and exposure of superficial temporal vessels. The size of muscle belly which is harvested is dependent on the area where the revascularization is necessary. Microvascular anastomoses of superficial temporal vessels and thoracodorsal vessels are performed in end-to-end fashion. A 31-year-old male patient with moyamoya syndrome was treated by this method. Postoperative angiography demonstrated successful revascularization in the affected hemisphere, with improved perfusion reserve capacity shown by cerebral blood flow study. This type of encephalo-myo-synangiosis (with free muscle flap) is a possible method when vascular reconstruction of an extensive ischemic area which involves anterior and posterior cerebral artery territories is needed in a patient with moyamoya disease or other similar ischemic conditions.

Adult↗