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The Tokyo Metropolitan Home Vision Screening Program for amblyopia in 3-year-old children.

In August 1989, the Tokyo Metropolitan Government officially began a vision screening program for children aged 3 years 1 month. A 1988 pilot study of 1,303 children this age disclosed five cases (0.38%) of amblyopia. The home vision test, which uses picture cards of familiar figures, proved to be an efficient and inexpensive method of screening when incorporated into the existing health-check program for 3-year-old children. In the initial eight months of the program, 21,906 children were screened. Of these, 419 children (1.9%) were referred to an ophthalmologist for follow-up, and amblyopia was detected in 41 children (0.19%).

Amblyopia↗

Survey of dioxins in Tokyo Bay bottom sediment.

This paper examines dioxin profiles in bottom sediments from Tokyo Bay, Japan using sedimentation dating based on 210Pb measurements and dioxin measurements based on particle size distributions. Dioxin concentrations in surface sediment ranged from 3.2 to 52 pg-TEQ g(-1), with the concentrations in the bay back and central region being higher than those at the front of the bay. The vertical dioxin concentration in sediment core samples showed peak levels from years 1962 to 1980, with the maximum being 110 pg-TEQ g(-1). Principal component analysis indicates that the main source of dioxins in bottom sediment from the back of bay are herbicides such as CNP, while in the front of bay atmospheric deposition due to incineration activities are responsible. Dioxins in bottom sediment were mainly found in the particles <75 microm in size.

Dioxins↗

Polychlorinated dibenzo-p-dioxins and dibenzofurans in sediment, soil, fish, shellfish and crab samples from Tokyo Bay area, Japan.

Concentrations of tetra- to octa-chlorinated dibenzo-p-dioxins and dibenzofurans in samples collected in or near Tokyo Bay, Japan, with a densely inhabited catchment area, were congener-specifically determined and discussed. Analyzed in this study were samples of surface sediment covering the whole bay area, reference soil representing atmospheric impact, and fish, shellfish and crab commonly consumed as food. The range of concentrations were comparable to or higher than those in other parts of Japan. The origins of these compounds in the catchment area of the bay were investigated in terms of homolog and isomeric compositions in the sediment samples. Biota-sediment accumulation factors for benthic species declined as the degree of chlorination increased.

Animals↗

Serum cholesterol, uric acid and cholinesterase in victims of the Tokyo subway sarin poisoning: a relation with post-traumatic stress disorder.

Cholesterol and uric acid, which might correlate with steroidogenesis and monoamine functions, may change under emotionally stressful conditions and in mental disturbances. Among anxiety disorders, an increase of serum cholesterol has been observed in panic disorder. However, the issue has not been adequately investigated in other anxiety disorders, including post-traumatic stress disorder (PTSD). The present study investigated serum cholesterols, uric acid and cholinesterase in victims of the Tokyo subway sarin poisoning, 1995, in a series of 5-year follow-ups. Cholinesterase was studied, in relevance with serum lipid changes and symptoms of PTSD, and also in light of a biological effect of sarin. Out of 34 victims, eight developed PTSD and two were currently diagnosed with PTSD using the Clinician-Administered PTSD Scale (CAPS). No significant relationship was observed between PTSD and serum cholesterols or uric acid. Several factors including co-occurrence of other mental disturbances with PTSD, in addition to the limited sample size, might have affected the result. In contrast, serum cholinesterase level was significantly reduced in the victims with the development of PTSD, compared with the matched controls (P<0.02, t-test). This might partly reflect a long-term remnant effect of sarin intoxication, although an effect of the psychological experience could not be totally excluded.

Adult↗

The by-products generated during sarin synthesis in the Tokyo sarin disaster induced inhibition of natural killer and cytotoxic T lymphocyte activity.

More than 5000 passengers on Tokyo subway trains were injured by the nerve gas, sarin and its by-products. Analysis of phosphor-carrying metabolites of sarin and its by-products in urine samples from the victims suggested that they were exposed not only to sarin, but also by-products generated during sarin synthesis, i.e. diisopropyl methylphosphonate (DIMP) and diethyl methylphosphonate (DEMP). We suspected genetic after-effects due to sarin by-products, thus, we checked the frequency of sister chromatid exchange (SCE) and found that SCE was significantly higher in the victims than in a control group, and that DIMP and DEMP significantly induced human lymphocyte SCE in vitro. In the present study, to explore whether DIMP and DEMP, which induced a high frequency of SCE of lymphocytes, also affected the lymphocyte functions, we examined the effect of DIMP and DEMP on splenic natural killer (NK) and splenic cytotoxic T lymphocyte (CTL) activity in mice, and NK activity of human lymphocytes in vitro. We found that DIMP and DEMP significantly inhibited NK and CTL activity in a dose-dependent manner. The inhibition induced by DIMP was stronger than that by DEMP. The effect of DIMP and DEMP on the splenic NK activity of mice was stronger than on the splenic CTL activity, and the human lymphocytes is more sensitive to DIMP and DEMP than the splenocytes of mice.

Animals↗

Elevated frequency of sister chromatid exchanges in lymphocytes of victims of the Tokyo sarin disaster and in experiments exposing lymphocytes to by-products of sarin synthesis.

More than 5000 passengers of Tokyo subway trains were injured with toxic chemicals including the nerve gas sarin. Most of the victims examined had marked miosis and decreased serum cholinesterase activity. To monitor the genetic aftereffects of sarin exposure, we measured sister chromatid exchanges (SCEs) of the victims using peripheral blood lymphocytes. The frequency of SCEs was significantly higher in the victims than in the control group. Analyzing results using samples of urine from the victims suggested that the victims were exposed to not only sarin per se, but by-products of sarin synthesis, i.e. diisopropyl methylphosphonate (DIMP), diethyl methylphosphonate (DEMP) and ethyl isopropyl methylphosphonate (EIMP). Thus, the in vitro SCE-inducing effect of DIMP, DEMP and EIMP was examined using human lymphocytes and we obtained positive results.

Adult↗

Tokyo Metropolitan Institute of Gerontology.

The Tokyo Metropolitan Institute of Gerontology (TMIG) celebrates its 30th anniversary in 2002. Since its establishment, TMIG has been carrying out inter-disciplinary research on aging as a core institute in Japan and functions as a knowledge bank and a source for capable researchers of gerontology. The proportion of people aged 65 and above in Japan will reach 30% in the near future, which might be associated with serious medical, social, political, and financial problems. Because most developed countries will face similar situations in the near future, multidisciplinary studies in gerontology on a worldwide scale are necessary to solve the associated problems.

Academies and Institutes↗

Chronic neurobehavioral and central and autonomic nervous system effects of Tokyo subway sarin poisoning.

To evaluate delayed (prolonged) neurobehavioral and neurophysiological effects of acute sarin poisoning, nine male and nine female patients of the Tokyo subway sarin poisoning in Japan were examined by neurobehavioral tests, posttraumatic stress disorder (PTSD) checklist, brain evoked potentials, computerized static posturography, and electrocardiographic R-R interval variability, 6-8 months after the poisoning. Their serum cholinesterase activities on the day of the poisoning (March 20, 1995) were 13-131 (mean 72.1) IU/L. The results suggested delayed effects on psychomotor performance, the higher and visual nervous system and the vestibulo-cerebellar system with psychiatric symptoms resulting from PTSD.

Autonomic Nervous System Diseases↗

Pollution of the medical air at a university hospital in the metropolitan Tokyo area.

STUDY OBJECTIVE: To investigate the quality of medical air in a hospital in the metropolitan area. DESIGN: Prospective study. SETTING: University hospital in the metropolitan Tokyo area. INTERVENTIONS: Medical air introduced into a bio-clean operating room was sampled. MEASUREMENTS: The concentrations of nitric monoxide (NO), nitrogen dioxide (NO(2)), sulfur dioxide (SO(2)), and carbon monoxide (CO) in the medical air were measured every 30 minutes for 15 days. MAIN RESULTS: The concentrations (mean +/- SD) of NO, NO(2), SO(2), and CO were 34.4 +/- 35.0 ppb (range 0-200 ppb), 7.7 +/- 5.5 ppb (0-29 ppb), 33.8 +/- 2.9 ppb (21-46 ppb), and 1.65 +/- 0.87 ppm (0.5-7.5 ppm), respectively. The concentrations of these gases peaked at rush hours within a day. CONCLUSIONS: In the metropolitan area, we occasionally provide our patients with medical air of poor quality.

Air Pollution, Indoor↗

Multiple births and congenital anomalies in Tokyo Metropolitan Hospitals, 1979-1990.

The rate of multiple births and the incidence of congenital anomalies in Tokyo Metropolitan Hospitals were studied during the period 1979-1990. The number of twins was 968 pairs (8.23 per 1,000 deliveries) and of triplets 18 sets (15.3 per 100,000 deliveries) among 117,672 deliveries including 1,587 stillbirths after 16 weeks gestation. Multiple birth rates increased yearly. Stillbirth rates in twins and triplets were 5.5% and 16.7% respectively, which were both significantly higher than that in singletons (1.3%). The number of congenital anomalies was 42 in 1,936 twins (2.17%), 2 in 54 triplets (3.7%) and 1721 in 116,686 singletons (1.47%). The most common defects in twins were those of the cardiovascular system (0.72% in twins vs 0.52% in singletons) and of the musculoskeletal system (0.72% in twins vs 0.50% in singletons), followed by upper respiratory tract and/or mouth conditions (0.67% in twins vs 0.35% in singletons), all of which had no significant difference in frequency between twins and singletons. Though some anomalies had a significantly higher frequency in twins than in singletons, the concordance rate in the like-sexed twins was very low.

Congenital Abnormalities↗

Daily time budgets of long-distance commuting workers in Tokyo megalopolis.

In Tokyo Megalopolis, long-distance commuting between residences in the suburbs and work places in the centre of the city was examined. Using a questionnaire, heads of household in two suburbs were asked about the influences of long commuting hours on their daily time budgets. The results showed that on workdays, the workers who spent longer commuting rose and left home for work earlier, and came back home and retired later; accordingly, both time spent on in-home activities on workdays and hours slept on the day before a workday were shorter. Comparison of time budgets between the subjects who work 5 and 6 days per week revealed more vulnerable influences of long commuting hours in the former than the latter. The expected health consequences of these findings are discussed from a biosocial/human ecological viewpoint.

Adult↗

Incidence and clinical symptoms of Aeromonas-associated travellers' diarrhoea in Tokyo.

In a survey examining the causes of travellers' diarrhoea treated in Tokyo between July 1986 and December 1995, Aeromonas species were isolated from 1265 (5.5%) of 23,215 travellers returning from developing countries. Aeromonas species were the fourth most frequent enteropathogen isolated, following enterotoxigenic E. coli (8.5%), Salmonella spp. (7.6%) and Plesiomonas shigelloides (5.6%). Aeromonas species were found in 1191 (5.6%) of 21,257 patients with diarrhoea and in 74 (3.8%) of 1958 healthy individuals without diarrhoea. Mixed infection was observed in 512 (40.5%) cases. No significant difference in the prevalence of Aeromonas by year, season, age distributions, or sex was observed, but a slight difference was noted depending on the country where the travellers visited. Of the 1265 Aeromonas isolates, 893 strains (70.6%) were A. veronii biovar sobria, 330 (26.1%) were A. hydrophila, and 42 (3.3%) were A. caviae. The clinical symptoms of patients from whom Aeromonas species was isolated as the only potential enteric pathogen were almost similar, which were watery diarrhoea (about 60%), abdominal cramps (43%), fever (around 15%), and nausea or vomiting (13%). Although the severity of illness was milder than that of enterotoxigenic E. coli alone, these data suggest that Aeromonas species are important enteric pathogens in travellers' diarrhoea.

Aeromonas↗

Dry deposition fluxes and deposition velocities of trace metals in the Tokyo metropolitan area measured with a water surface sampler.

Dry deposition fluxes and deposition velocities (=deposition flux/atmospheric concentration) for trace metals including Hg, Cd, Cu, Mn, Pb, and Zn in the Tokyo metropolitan area were measured using an improved water surface sampler. Mercury is deposited on the water surface in both gaseous (reactive gaseous mercury, RGM) and particulate (particulate mercury, Hg(p)) forms. The results based on 1 yr observations found that dry deposition plays a significant if not dominant role in trace metal deposition in this urban area, contributing fluxes ranging from 0.46 (Cd) to 3.0 (Zn) times those of concurrent wet deposition fluxes. The deposition velocities were found to be dependent on the deposition of coarse particles larger than approximately 5 microm in diameter on the basis of model calculations. Our analysis suggests that the 84.13% diameter is a more appropriate index for each deposited metal than the 50% diameter in the assumed undersize log-normal distribution, because larger particles are responsible for the flux. The deposition velocities for trace metals other than mercury increased exponentially with an increase in their 84.13% diameters. Using this regression equation, the deposition velocities for Hg(p) were estimated from its 84.13% diameter. The deposition fluxes for Hg(p) calculated from the estimated velocities tended to be close to the mercury fluxes measured with the water surface sampler during the study periods except during summer.

Air Movements↗

Concentrations, enrichment and predominant sources of Sb and other trace elements in size classified airborne particulate matter collected in Tokyo from 1995 to 2004.

APM was collected and trace elements existing in the particles were monitored since May 1995 in this study. APM sample was collected separately by size (d < 2 microm, 2-11 microm and >11 microm) on the roof of the university building (45 m above ground) in the campus of Faculty of Science and Engineering, Chuo University, Tokyo, Japan, using an Anderson low volume air sampler. The collected sample was digested by HNO3, H2O2 and HF using a microwave oven, and major elements (Na, Mg, Al, K, Ca and Fe) were measured by ICP-AES, and trace elements (Li, Be, Ti, V, Cr, Mn, Co, Ni, Cu, Zn, As, Se, Mo, Cd, Sb, Ba and Pb) were measured by ICP-MS. It was observed that the APM concentration was higher between the winter and the spring, compared to during the summer. The enrichment factor was calculated for each element in each set of APM (d < 2 microm, 2-11 microm and >11 microm). Seasonal trends of enrichment factors were examined, and the elements were classified into 3 groups according to the common seasonal behavior. It is likely that the elements in the same group have common origins. Toxic pollutant elements (Sb, Se, Cd, Pb and As) were found in small particles with d of <2 microm in concentrated levels. Antimony (Sb) had the highest enrichment factor, and the results suggested that Sb level in APM was extremely high. The origins of Sb were sought, and wastes from plastic incineration and brake pad wears of automobiles were suspected. Each set of APM (d < 2 microm, 2-11 microm and >11 microm) was classified by the shape, and the shape-dependent constituents of a single APM particle were quantitatively measured by SEM-EDX. High concentration of Sb was found in APM <2 microm and square particles. Particles less than 2 microm and square shaped particles were major particles produced by actual car braking experiments. From these experimental results it was concluded that the source of Sb in squared APM <2 microm is considered to be from brake pad wear.

Air Pollutants↗

Clinical and mycological study of occult tinea pedis and tinea unguium in dermatological patients from Tokyo.

An epidemiological investigation was conducted to determine the prevalence and circumstances of untreated, unsuspected tinea pedis and tinea unguium, morbid conditions that could be termed occult athlete's foot, in patients visiting a dermatology clinic in Tokyo, Japan, for the first time, for other complaints. All subjects completed a questionnaire covering comprehensive anamnestic details, and were examined for disposition of toes, presence of signs suggestive of tinea pedis, other diseases of the foot, score of clinical signs and symptoms, potassium hydroxide (KOH) test, severity score, and mycological culture. The results showed that the prevalence of occult athlete's foot was 25%, and that 59% of those cases were complicated by tinea unguium. The characteristics of patients with occult athlete's foot included a higher proportion of men and a tendency toward a low clinical score together with a high severity score. In the patient background, a strong correlation was observed between a positive KOH test result and characteristics such as age, disposition of toes, and predisposing disease.

Adolescent↗

Present status of the total artificial heart at the University of Tokyo.

At the University of Tokyo, various types of total artificial heart (TAH) systems have been studied since 1959. At the present time, 2 types of implantable TAH have been developed. One is an undulation pump TAH (UPTAH) and the other is a flow transformed pulsatile TAH (FTPTAH). Using the UPTAH, 14 cases of implantation were performed in goats and 10 days' survival obtained. The new type of FTPTAH is under a prototype study. To prevent ring thrombus, a polyurethane membrane valve, a jellyfish valve, has been developed. The longest in vivo experiences with this valve in the TAH blood pump have been 312 days in the left side blood pump and 414 days in the right side blood pump. Conductance and arterial pressure based control (1/R control) can realize the physiological control of the TAH. Using 1/R control, 532 days of survival could be obtained in a goat with a paracorporeal TAH. The technique required to apply this control method to a implantable TAH is under development. We have proposed a new 5 year research project of the implantable TAH entitled "Comprehensive Basic Research on the Development of a Japanese Original Implantable Total Artificial Heart" to The Ministry of Welfare.

Animals↗

Height and weight of Tokyo schoolchildren with and without intellectual handicaps.

The heights, weights and Rohrer Indices (W/H3; RIs) of Tokyo schoolchildren born in 1972/73 with and without intellectual handicaps were compared from 6 to 15 years. The samples of children consisted of 303 children with no intellectual handicaps ('controls') and 308 children with intellectual handicaps including subgroups with Down's syndrome (39 children), autism (49 children) and epilepsy (58 children). Boys and girls with no intellectual handicaps were at all ages significantly taller than schoolchildren with intellectual handicaps. However, there were few significant differences in mean weight between children with and without intellectual handicaps--only in boys at age 15 years and girls at 6, 7, 11 and 12 years. The mean RIs of boys and girls with intellectual handicaps were at all ages significantly higher than those of controls. The subgroup of children with Down's syndrome were the shortest and had the highest mean RI at all ages. Children with epilepsy were also significantly shorter than children with no intellectual handicaps but did not differ much in RI. Autistic children did not differ in height from controls, except for autistic boys who at the ages 6-12 years were significantly taller, indicating a comparatively earlier maturational rate of this specific sample. Autistic boys had a higher RI than controls at 9, 11, 12, 13 and 14 years but autistic girls did not differ significantly from controls at these ages.

Adolescent↗

Standard RUS skeletal maturation of Tokyo children.

A total of 704 girls and 753 boys, all healthy, from 3 to 18 years of age, from Tokyo and its suburbs, were radiographed on the left hand and wrist in 1986. Their RUS (TW2) skeletal maturity was estimated, the 50th-centile skeletal maturity scores were obtained, and the smoothed RUS maturity curves were determined applying the cubic spline function to the 50th-centile scores. On this maturity curve the score at each 0.1 year of chronological age was obtained and allocated as a given RUS skeletal age. This set of scores and ages we termed the TW2-J RUS, i.e. the Japanese TW2 RUS maturity standard. Comparing this RUS standard with the British standard, the Belgian, the southern Chinese, and the northern Indian, it became clear that Japanese children's RUS skeletal maturity progresses rapidly during puberty (after ages 9 in girls and 11 in boys), and that the maximum score difference between neighbouring age groups was observed at ages 12.5 in girls and 14.5 in boys on the spline-smoothed curve. Japanese children attain the adult stage 1 or 2 years earlier than other groups of children (at ages 15 in girls and 16 in boys).

Adolescent↗