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Biomedical subjects

S Wakai

Publications and source records attributed to S Wakai.

At least 37 records · Page 2Linked to original sources
PubMed2003

Car seatbelt use during pregnancy in Japan: determinants and policy implications.

CONTEXT: Pregnant women are exempted from the current seatbelt legislation in Japan despite the fact that seatbelt use is essential to reduce the risk of fatalities for these women and their fetuses in car crashes. OBJECTIVE: To examine factors that might influence seatbelt use during pregnancy. METHODS: A cross sectional study, with data collected via an anonymous, self administered questionnaire at obstetric clinics in suburban areas of Japan. Altogether 880 pregnant women receiving prenatal care in July 2001 were recruited. The relative effects of factors that might influence seatbelt use during pregnancy were estimated using logistic regression analysis. RESULTS: Almost 70%-80% of pregnant women were consistent seatbelt wearers before pregnancy but seatbelt compliance was reduced by about half at 20 weeks or more gestation. Only 20% had received information on maternal seatbelt use, with one third reporting that seatbelt use is beneficial during pregnancy. Those who perceived that maternal seatbelt use is beneficial tended to maintain use, but daily car users and those who knew that they were exempted from seatbelt legislation were more likely to reduce use. CONCLUSIONS: Knowledge of the legislative exemption for pregnant women, misunderstanding of the benefits, and daily car use contributed to the reduction in seatbelt use after pregnancy.

Adult↗
PubMed2002

The impact on health and risk factors of the diarrhoea epidemics in the 1998 Bangladesh floods.

The 1998 flood in Bangladesh ravaged approximately 60% of the land and affected over 30 million people. The aim of this study is to examine the impact of the flood on the health of the communities affected and to explore factors associated with episodes of diarrhoea. We conducted structured interviews with 517 people in two districts that had been affected in October 1998, when the flood water level was at its peak. Of the 517 respondents, 98.3% developed health problems or found that existing health problems were exacerbated. Many perceived that their general health condition was 'much worse' (16.9%) or 'worse' (64.3%). The most prevalent condition was fever (63.6%), followed by respiratory problems (46.8%), diarrhoea (44.3%), and skin problems (41.0%). Only 1.0% and 6.7% of the respondents treated water before drinking, by boiling and chlorination, respectively, although water collected from tube-wells (93.2%) and rivers (6.0%) was perceived by 75.0% of the respondents to be contaminated. Factors associated with developing or worsening diarrhoea were as follows; the number of family members, poor economic status, a lack of distribution of water purification tablets, the type of water storage vessels, not putting a lid on the vessel, no use of latrines, perceived change of drinking water, food scarcity, and worries about the future. In logistic regression analysis, men, poor economic status, lack of distribution of water purification tablets, and the type of water storage vessels had a significant association with diarrhoea. The 1998 Bangladesh flood had a substantial impact on the health of communities. Diarrhoea was associated with socioeconomic status, water handling and household sanitation. There ought to be more emphasis on health education in the pre-disaster period in order to empower communities against floods.

Adolescent↗
PubMed2002

Differences between Japanese pre-school and school-age pedestrian mortality and morbidity trends.

The risk of pedestrian injury during childhood in industrialised countries is decreasing in a trend that is related to exposure to traffic. Examining the differences between age groups and their behaviour provides an insight into exposure to risks. Using data for the period 1968-1998, we compared the changes in pedestrian mortality and morbidity in pre-school children (aged 0-6) with those of school-age children (aged 7-12). Pedestrian mortality and morbidity decreased in children of all ages in the early 1970s. However, after the mid-1970s, both mortality and morbidity continued to decrease only in pre-schoolers. In school-age children, mortality continued to decrease but morbidity did not change. These age-related differences in mortality and morbidity indicate that over the past 30 y the environment for child pedestrians did not become safer. Instead, some of the decrease in children's injuries was probably achieved at the expense of their outdoor activities. Efforts to protect children from vehicular traffic should focus on changing the outdoor environment rather than on restricting children's activities.

Accidents, Traffic↗
PubMed2001

An evaluation of screening for lung cancer in Niigata Prefecture, Japan: a population-based case-control study.

Although an annual screening programme for lung cancer has been carried out widely in Japan since 1987, there is insufficient evidence to confirm its efficacy in terms of reducing mortality. In order to evaluate the efficacy of the lung cancer screening which has been widely carried out in Japan since 1987, a case-control study was conducted in Niigata Prefecture, Japan. In the study area, chest X-ray examinations for all participants and sputum cytology for high-risk participants were offered annually. Case subjects, who had died from lung cancer (174), and control subjects matched by sex, year of birth, residence and smoking status (801), who had been alive at the time of diagnosis of the corresponding case, were selected from the National Health Insurance holders. Screening histories of the subjects were compared between cases and matched controls for the identical calendar period before the time of diagnosis of the cases. The odds ratio of death from lung cancer for those screened within 12 months vs those not screened was 0.401 (95% CI: 0.272-0.591) with adjustment by smoking index. Our results suggest that annual lung cancer screening might reduce mortality from lung cancer by approximately 60%.

Adult↗
PubMed2001

Vagus nerve stimulation for children and adolescents with intractable epilepsies.

BACKGROUND: Vagus nerve stimulation (VNS) has been shown to be efficacious in the treatment of patients > 12 years of age with refractory partial epilepsies and it is suggested that VNS should be considered as one of the treatment options for these patients. METHODS: Four patients had partial epilepsies and one had symptomatic generalized epilepsy. After observation of the baseline seizure frequency and the average seizure frequency for 3 months, the VNS system was implanted. Thereafter, seizure frequency, average seizure frequency of each seizure type during the month just before the evaluation, seizure severity, side effects and quality of life were recorded. RESULTS: In four of five patients, overall seizure frequency was reduced > 50% after VNS treatment. The seizure types that showed a > 50% reduction in frequency were auras, focal clonic, generalized tonic clonic seizures, astatic, versive, hypomotor, generalized tonic and generalized clonic seizures according to Lüders' classification. In two patients, as major convulsive seizures were reduced in number after VNS treatment, dialeptic seizures (non-convulsive seizure with lapse of consciousness) gradually appeared. In one patient without significant seizure reduction, quick recovery from postictal periods after generalized tonic seizure was seen after treatment. In one patient with generalized epilepsy, improvement of cognitive function was reported by his guardians. After VNS, the number of antiepileptic drugs was reduced from three to one in one patient. No significant adverse effects were noted in any patients. CONCLUSIONS: Our results suggest that VNS is well tolerated in young patients with intractable epilepsies and it may be an important non-pharmacologic treatment option for children with severe epilepsies who cannot tolerate medical therapy and/or are not candidates for epilepsy surgery.

Adolescent↗
PubMed2001

Mother's working status and nutritional status of children under the age of 5 in urban low-income community, Surabaya, Indonesia.

A cross-sectional anthropometrics survey was carried out in a low-income community of Surabaya, Indonesia, to examine the association between mother's employment and the child's nutritional status for identifying a group at risk of having malnourished children. Subjects were 274 children under the age of 5. The children of non-working mothers had significantly higher height-for-age z-score (HAZ) (p < 0.05) than those of working mothers. When mother's work was divided into 'formal' and 'informal', HAZ and weight-for-age z-score (WAZ) of children of the informal worker's group were significantly lower than those of the non-working mother and the formal worker's group (p < 0.05). Mother's education and income of the formal worker's group were significantly higher than those of the informal worker's group (p < 0.01). Our study identified a group at risk of malnutrition, i.e., children of mothers working in informal sectors. The programs to provide childcare for working mothers should target this particular group of poor households.

Adult↗
PubMed2001

Underreporting of traffic injuries involving children in Japan.

BACKGROUND: Significant underreporting of road traffic injuries by the police has been documented, even in developed countries. The objective of this study was to clarify the magnitude of underreporting of police data in Japan. METHODS: Police reports were compared with those of the fire department and the Marine and Fire Insurance Association of Japan. RESULTS: The results reveal significant underreporting by police of child vehicle occupant injuries. The true incidence of these injuries in preschoolers was twice as high as that provided by official police reports. CONCLUSION: Police reports would underestimate the magnitude of vehicle occupant injuries in children and distort any evaluations of preventive initiatives. Improving the police report system, and establishing a more comprehensive trauma registry, that would include data from hospitals and insurance companies should be implemented.

Accidents, Traffic↗
PubMed2001

Should community-managed drug stores be phased out?

UNLABELLED: The existence of community-managed drug stores (CDS), operated by trained village health workers under the supervision of health officials, is under threat in the Philippines. This is to determine if there is an association between households' access to medicines and three types of CDS, namely, Botika Binhi (BB), Family Health Management By and For Urban Poor Settlers Pharmacy (FAMUSCY) and Botika ng Barangay (BnB) in selected urban and rural communities in a province where all three types operate. The study design was case-control using structured interviews and observations. A total of 1,710 households or 90% of the total were interviewed, and the medicines at home were inspected. Indicators for the five dimensions of access are affordability, availability, A1 quality, acceptability and appropriateness. The village with the longest-running CDS for each type was selected. RESULT: There is an association between the presence of any of the three CDS and villagers' perception of affordability of medicines, between FAMUSCY or BnB and availability of unbranded medicines at home as well as perception of counselling provided by prescribers and dispensers to be more than expected. On the contrary, there is an inverse association between the presence of FAMUSCY and availability of herbal plants at home, between BnB and percent of correct uses of medicines at home, and between either FAMUSCY or BnB and perceptions of availability of medicines and quality of services by dispensers at patronized drug outlets. CONCLUSION: Phasing out CDS should be weighed against the benefit of making medicines affordable at the village level, promoting the use of unbranded medicines and herbal plants with recognised therapeutic value, and keeping the clients informed through drug counselling provided by prescribers and dispensers.

Attitude to Health↗
PubMed2001

Influence of women's knowledge on maternal health care utilization in southern Laos.

This study aims to clarify women's knowledge on obstetric care and to analyse the situation of maternal health care (MHC) utilization in southern Laos. Face to face structured questionnaire and focus group discussions were carried out for 205 mothers aged 29.6 +/- 6.7 who had children under the age of five. Three measurements of MHC utilization comprised: 1) antenatal care (ANC), 2) tetanus toxoid (TT) inoculation, and 3) attendance delivery by health professional. Women's knowledge on obstetric care was scored. Women's knowledge was positively correlated with ANC and TT inoculation. It was found that the women with strong superstitious belief were less likely to utilize all three types of MHC than the others. Accessibility to health care facilities strongly affected ANC and attendance delivery. Enhancing women's knowledge on obstetric care and reducing barriers related with sociocultural beliefs are essential to improving maternal health in southern Laos.

Adult↗
PubMed2001

[Recent advances in investigations into brain function and its clinical application].

Recent advances in investigations into brain function and its clinical application are described. The investigations were divided into three method groups consisting of the examinations of; 1) brain electric activity; 2) imaging techniques on activated brain tissue; and 3) collation of the metabolic information on the area of brain focused on. The first group included electroencephalogram(EEG), dipole tracing(DT) and magnetoencephalogram(MEG). The second one, single photon emission computed tomography(SPECT), positron emission tomography(PET) and functional magnetic resonance imaging(fMRI), and the third, magnetic resonance spectrometry(MRS). Here I overview these examinations and report some cases diagnosed with these technologies.

Brain↗
PubMed2001

Identification of Thiobacillus ferrooxidans strains based on restriction fragment length polymorphism analysis of 16S rDNA.

The 16S rDNA sequences from ten strains of Thiobacillus ferrooxidans were amplified by PCR. The products were compared by performing restriction fragment length polymorphism (RFLP) analysis with restriction endonucleases Alu I, Hap II, Hha I, and Hae III. The RFLP patterns revealed that T. ferrooxidans could be distinguished from other iron- or sulphur-oxidizing bacteria such as T. thiooxidans NB1-3, T. caldus GO-1, Leptospirillum ferrooxidans and the marine iron-oxidizing bacterium strain KU2-11. The RFLP patterns obtained with Alu I, Hap II, and Hae III were the same for nine strains of T. ferrooxidans except for strain ATCC 13661. The RFLP patterns for strains NASF-1 and ATCC 13661 with Hha I were distinct from those for other T. ferrooxidans strains. The 16S rDNA sequence of T. ferrooxidans NASF-1 possessed an additional restriction site for Hha I. These results show that iron-oxidizing bacteria isolated from natural environments were rapidly identified as T. ferrooxidans by the method combining RFLP analysis with physiological analysis.

DNA, Bacterial↗
PubMed2000

Risk of poliomyelitis importation and re-emergence in Laos.

The declaration of poliomyelitis eradication in the western pacific region is scheduled for Oct 29, 2000, in Kyoto, Japan. Our survey in the border areas of the southeast Asia region, however, revealed that there remains a risk of re-emergence and importation of poliomyelitis into Laos. We report the evidence based on our border area investigations during the past 4 years under the bilateral supervision of the governments of Laos and Japan.

Child, Preschool↗
PubMed2000

Haplotype-phenotype correlation in Fukuyama congenital muscular dystrophy.

In typical Fukuyama congenital muscular dystrophy (FCMD), peak motor function is usually only unassisted sitting or sliding on the buttocks, though a few patients are able to walk at some point. However, a few patients have a severe phenotype and never acquire head control. In addition, it is clinically difficult to differentiate this severe FCMD from Walker-Warburg syndrome (WWS) or from muscle-eye-brain disease (MEBD). In order to establish a genotype-phenotype correlation, we performed haplotype analysis using microsatellite markers closest to the FCMD gene (FCMD) in 56 Japanese FCMD families, including 35 families whose children were diagnosed as FCMD with the typical phenotype, 12 families with a mild phenotype, and 9 families with a severe phenotype. Of the 12 propositi with the mild phenotype, 8 could walk and the other 4 could stand with support; 10 cases were homozygous for the ancestral founder (A-F) haplotype whereas the other 2 were heterozygous for the haplotype. In the 9 severe cases, who had never acquired head control or the ability to sit without support, 3 had progressive hydrocephalus, 2 required a shunt operation, and 7 had ophthalmological abnormalities. Haplotype analysis showed that 8 of the 9 cases of the severe phenotype are heterozygous for the A-F haplotype, and the other one homozygous for the haplotype. We confirmed that at least one chromosome in each of the 56 FCMD patients has the A-F haplotype. The rate of heterozygosity for the A-F haplotypes was significantly higher in severe cases than in typical or mild cases (P < 0.005). Severe FCMD patients appeared to be compound heterozygotes for the founder mutation and another mutation. Thus, the present study yielded molecular genetic evidence of a broad clinical spectrum in FCMD.

Brain↗