Search PubMed⌕ Search

Biomedical subjects

T Kuboki

Publications and source records attributed to T Kuboki.

82 records · Page 5Linked to original sources

Anorexia nervosa in monozygotic twins.

Which is more important, hereditary factors or psychological environment factors, in the etiology of anorexia nervosa? The question is studied by considering 7 cases of anorexia nervosa in monozygotic twins of the authors' own practice. In 5 of 7 cases, only 1 of a set of twins was found to be suffering from anorexia nervosa. On the other hand, in 2 of 7 cases, both twins were diagnosed as having anorexia nervosa. Even in the concordant cases studied by the authors, however, the quality or degree of anorexia nervosa in each case was different. Therefore, even given the existence of concordant cases, without inquiring precisely into the quality or degree of anorexia nervosa, it is not possible to conclude that hereditary factors play a determining role in the etiology of anorexia nervosa.

Adolescent↗

Statistical studies on anorexia nervosa in Japan: detailed clinical data on 1,011 patients.

Statistical studies on anorexia nervosa in Japan were carried out by our research group. Questionnaires were sent to physicians at 1,030 representative institutions throughout Japan and data were collected from 315 institutions. The total number of patients with anorexia nervosa in 1981 was 940 outpatients and 372 inpatients. The number of patients in 1981 was twice as high as in 1976. Detailed data on 1,011 patients were investigated. As most of the patients had certain endocrinological abnormalities which improved after weight gain, indications are that at least a part of the endocrinological abnormalities might be secondary changes due to weight loss.

Adolescent↗

Statistical studies on the prognosis of anorexia nervosa.

Statistical studies on the prognosis of anorexia nervosa were carried out by our research group. Subjects were 224 cases from 36 university hospitals throughout Japan. A questionnaire was mailed to each of the 224 patients in cooperation with their doctors. The outcome of 143 of the 224 cases was judged by their doctors as 'good' in 47 cases, 'intermediate' in 69 cases and 'poor' in 19 cases. 8 of the patients had died. The prognosis of typical cases was much poorer than that of atypical cases.

Adolescent↗

[Mitral valve prolapse in patients with anorexia nervosa].

Mitral valve prolapse (MVP) is frequently observed in patients with low body weight and/or skeletal abnormalities such as pectus excavatum and straight spines. There may be a variety of associated autonomic dysfunctions. Whether MVP is a complication of anorexia nervosa which has similar clinical features, including weight loss, skeletal abnormalities and autonomic dysfunctions, has not been reported. The present study was an investigation of the incidence of MVP and cardiac function in anorexia nervosa by echocardiography. Two-dimensional and M-mode echocardiography, and systolic time intervals were evaluated for 19 women with anorexia nervosa, from 13 to 25 years of age and having a mean age of 18.2 years. Their body weights ranged from 23.9 to 43 kg with a mean of 33.5 kg, and were at least 25% less than their ideal body weights (ranges were from 25 to 52%). The same studies were performed for 19 women with MVP diagnosed echocardiographically and without anorexia nervosa as controls. Their ages ranged from 14 to 26 years. Results were as follows: MVP was observed in 74% of patients with anorexia nervosa. The mean heart rates were 51.7 and 70.5/min in the anorexia nervosa and control groups, respectively. A significant difference (p less than 0.001) was observed between the two groups. The mean heart rate of patients with anorexia nervosa having MVP of both leaflets and no MVP were 45.8 and 59.0/min, respectively. The difference between these two sub-groups was statistically significant (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Clinical effects of blood pressure biofeedback treatment on hypertension by auto-shaping.

OBJECTIVE: Although biofeedback has been reported to be efficacious in the treatment of hypertension, the degree of response has varied. This study investigated the mechanisms of blood pressure reduction by biofeedback. METHOD: Thirty outpatients with essential hypertension (10 men and 20 women) aged 38 to 65 years were studied. Subjects were randomly assigned to group A or B. Subjects in group A underwent biofeedback treatment once a week for a total of four sessions. Those in group B self-monitored their blood pressure during the sessions as the control period and later underwent the same biofeedback treatment. RESULTS: Blood pressure measured by doctor was reduced by 17 +/- 18/8 +/- 7 (p < .01) and elevation of pressure induced by mental stress testing was suppressed by 8 +/- 9 (p < .05)/4 +/- 8 during the treatment period in group A (mm Hg). In group B, both blood pressure measured by doctor and elevation of pressure by mental stress testing remained unchanged during the control period and they were later suppressed by 20 +/- 15/9 +/- 7 (p < .01) and 11 +/- 10(p < .05)/5 +/- 9 by the biofeedback treatment. Self-monitored pressure in both groups tended to decrease by the biofeedback treatment. Systolic and diastolic pressures as well as pulse rate decreased, skin temperature increased, and alpha-wave amplitude on electroencephalography increased during the therapy (p < .05). CONCLUSION: This treatment was effective in suppressing the pressor response to stress. Patients whose blood pressure increases with stress may be suited for biofeedback intervention.

Adult↗

Stressful life events and smoking were associated with Graves' disease in women, but not in men.

OBJECTIVE: Although psychological stress and smoking have been proposed as contributing factors to Graves' disease, their independent roles in the pathogenesis of this disease have not been determined. We assessed the association between Graves' disease and psychological stress and smoking by using multivariate analysis. METHODS: By a matched case-control method, we investigated the association between Graves' disease and stressful life events, daily hassles, smoking, drinking habits, coping skills, and social support in 228 patients (182 women and 46 men) with newly diagnosed Graves' disease; we used the conditional maximum likelihood method. RESULTS: After data were adjusted for daily hassles, smoking, drinking habits, social support, and coping skills, we found that stressful life events were significantly associated with the risk of Graves' disease in women. The relative risk was 7.7 for women with the highest stress score compared with women with the lowest stress score (95% confidence interval, 2.2 to 27, p for trend < .001). Smoking was also independently associated with the risk of Graves' disease in women. The relative risk for women with the highest number group compared with women with the lowest number group for smoking cigarettes was 5.1 (95% confidence interval, 1.0 to 27; p for trend < .001). These factors were not significantly associated with Graves' disease in men. CONCLUSIONS: Psychological stress and smoking were associated with Graves' disease in women, but not in men.

Adaptation, Psychological↗

Psychosocial factors influencing the short-term outcome of antithyroid drug therapy in Graves' disease.

OBJECTIVE: Although psychological stress and smoking have been proposed as factors contributing to Graves' disease, their independent roles in the course of this disease have not been determined. We assessed the association between the course of Graves' disease and psychosocial factors by using multivariate analysis. METHODS: We investigated the association between the short-term outcome of Graves' disease (assessed 12 months after the beginning of antithyroid drug therapy) and stressful life events, daily hassles, smoking, drinking habits, coping skills, and social support (before and 6 months after beginning therapy) in 230 patients (182 women and 48 men) with newly diagnosed Graves' disease, using a logistic regression model. RESULTS: After adjustment for smoking, coping skills, and thyroid function, daily hassles scores in women at 6 months after beginning therapy were significantly associated with a hyperthyroid state 12 months after beginning therapy. The relative risk was 3.9 for women with higher daily hassles scores compared with women with lower daily hassles scores (95% confidence interval, 1.1 to 13.2; p < .05). Smoking was not significantly associated with a hyperthyroid state 12 months after beginning therapy in either women or men. CONCLUSIONS: Chronic psychological stress is associated with the course of Graves' disease in women.

Adult↗

Major depression and somatic symptoms in a mind/body medicine clinic.

This study examined the prevalence of somatic symptoms and psychiatric characteristics of major depression in a Japanese psychosomatic outpatient clinic. A total of 2,215 outpatients referred for mind/body complaints were assessed by DSM-III-R or DSM-IV. Somatic symptoms were rated using the Cornell Medical Index Questionnaire. Ninety-one outpatients (4.1%) were diagnosed with major depression. Prevalence of fatigue (86%), insomnia (79%), nausea/vomiting (50%), and back pain (36%) as well as degrees of psychosocial stress (DSM-III-R axis IV) were higher (all p < 0.05) and scores of global assessment of psychosocial functioning (DSM-III-R/DSM-IV axis V) were lower (p < 0.001) in the major depressive patients compared to the remaining outpatients. Among the major depressive patients, the total number of somatic symptoms was larger (p < 0.05) in patients with 'severe' major depressive episodes than in those with 'mild' depressive episodes. These findings suggest that the level of depression is closely linked to the reporting of somatic symptoms in a psychosomatic medicine population.

Adult↗