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PubMed2002

[Willingness to implement mental health measures among small-scale enterprise employers in Ohta ward, Tokyo, Japan].

Due to the increase in mental health problems among Japanese workers in recent years, effective approaches to address these problems are of growing concern. Although such an effort is now under way in largescale enterprises (LSEs), small-scale enterprises (SSEs) are lagging behind LSEs for a number of reasons. In the present study, to know the reason, the presidents of 263 SSEs (fewer than 50 employees) in the Ohta ward of Tokyo were surveyed with a self-administered questionnaire from October 1999 to March 2000 (response rate, 51.0%). The main business types were manufacturing (71.2%), transportation & storage (6.1%), and construction (5.3%). The results revealed that employers attribute the mental health problems of employees to "Job content/Aptitude for job (78.6%)", "Communication among employees (71.0%)", "Physical problems/Illness (50.4%)", "Family problems (33.6%)". These results are very similar to those obtained in the same enterprises employees survey in 1996, suggesting that employers perceive the factors responsible for employees' mental health problems with substantial accuracy. Sixty-nine point five percent of the employers answered that they need mental health measures for employees. And 62.7% of employers agreed to take mental health measures in their enterprises. Taken together, it is considered that employers are willing to improve their employees' mental health problems. Nevertheless, 95% of employers are doing nothing to improve the situation. The major reasons cited were 1) Cannot obtain a consultant or counselor (44.8%), 2) Lack of time (43.1%), 3) Manpower shortage (41.4%), 4) Difficulty in ensuring employees' privacy (36.2%), and 5) Lack of financial resources (30.2%). The results of the present study suggest that perception of the mental health problems among employers and employees of SSEs in the Ohta area were close to each other. Effective strategies are needed to improve mental health problems in SSEs.

Attitude↗
PubMed1983

Prevalence of diabetes mellitus detected by 75 g GTT in Tokyo.

Oral glucose tolerance test (75 g GTT) was performed on 5,172 subjects who received physical checkups at Daiichi Survey Center from April 1981 to March 1982 and the Prevalence of diabetes in Tokyo was studied using the new diagnostic criteria of WHO (1980). The diabetic test was obtained in 3.6% of the subjects over 30 years old. Diabetic retinopathy was found in 4.3% of the diabetic cases. The prevalence of diabetes increased with fasting blood glucose (FBG) and it was considered to be adequate to set the screening point for diabetes mellitus by FBG at 100 mg/dl. 50 g GTT and 75 g were performed in 10,456 cases and 11,925 cases, respectively, and mean 1-hour and 2-hour values were compared by FBG levels. The results show that 2-hour values in 50 g GTT which correspond those of 120 mg/dl and 180 mg/dl in 75 g GTT may be 105 mg/dl and 150 mg/dl, respectively. However it is not reasonable to make the conversion by adding a certain value, because the differences varies markedly with each case.

Adult↗
PubMed1996

Disappearance of differences in nutrient intake across two local cultures in Japan: a comparison between Tokyo and Kyoto.

Nutritional survey was conducted in a winter season of 1992 3 by collecting seventy-one 24-hour food duplicate samples from three groups of middle-aged women (22 to 25 subjects per group) in traditional residential areas in the cities of Tokyo (two groups) and Kyoto (one group), two cultural centers in Japan known to have different food customs. The analysis in terms of intake of nutrients such as energy, carbohydrate, protein, lipid, minerals, vitamins and fibers did not show significant difference among the three groups studied. Sodium chloride intake also did not differ. Daily consumption of food materials (evaluated as classified in terms of, e.g., cereals, meat, fish and vegetables) was similar. Relative weight of three meals and snacks in energy intake did not vary among the groups. Consumption of milk and bread as indicators of intake of non-traditional food was also comparable among the groups. The observation as a whole suggests that the different food custom once known to be present between the two local cultures is no longer detectable. Nationwide extensive transport of food materials is discussed as one of possible causes.

Animals↗
PubMed2004

A study on the needs of medical, maternal and child health care in Chinese women students at the University of Tokyo.

According to the information provided by the University of Tokyo (UT) in 2001, 317 Chinese women students were enrolled in the UT, and 88% of them were graduate students. Although the surveys on the life of international students at the UT had been conducted in 1989 and 1998, the medical and health issues were not included. With the objective of exploring the medical and heath care needs of Chinese women students at the UT a survey was carried out from December 2001 to January 2002. With the cooperation of the International Students Center at the UT a questionnaire in Chinese was sent to each department in which 317 Chinese women students were studying. Out of 104 students responded, eligible subjects were 98. The results of present study revealed some problems, such as the language barrier, preference for a translator in hospitals or health centers, and a medical guidebook with information on vaccinations in Chinese. They also stated their lack of knowledge about the Japanese medical and health system, and their distress for being separated from their children. In conclusion, the most severe problem was language barrier for Chinese women students in obtaining medical and health care for themselves and their children. It was also noted that lack of knowledge of the Japanese medical and health care system was another obvious problem.

Adolescent↗
PubMed2004

Determination of degradation products of alkylphenol polyethoxylates in municipal wastewaters and rivers in Tokyo, Japan.

An analytical method for the simultaneous determination of nonylphenoxy acetic acid (NP1EC), nonylphenol monoethoxy acetic acid (NP2EC), nonylphenol (NP), octylphenol (OP), and nonylphenol monoethoxylate (NP1EO) was developed. The method was applied to environmental samples to demonstrate the distribution and behavior of nonylphenol polyethoxylates and their degradation intermediates in aquatic environments in Tokyo, Japan. In sewage treatment plants, more than 85% of NP, OP, and NP1EO were removed, whereas NP1EC and NP2EC were generated during the treatment. Concentrations of NP1EC and NP2EC in secondary effluents (1.9-2.9 microg/L) were higher than those of NP and NPIEO (0.12-0.63 microg/L). In river waters. NPIEC and NP2EC concentrations (0.11-2.8 microg/L) were higher than NP and NP1EO concentrations (<0.015-3.4 microg/L). with some exceptions. In surface sediments, neither NPIEC nor NP2EC was detectable (<0.01 microg/g dry wt) whereas NP and NPIEO were detected significantly (0.03-1.82 microg/g dry wt and 0.04-0.46 microg/g dry wt, respectively).

Acetates↗
PubMed1994

Observation study on natural walking in the Tokyo metropolitan.

In this study, data on walking speed, step numbers, cadence of natural walking were collected and their relations to foot wear, clothing, luggage carried and time of the day as well as crowdedness were investigated. This survey was held in Shinjuku, Tokyo in 1991. Six thousand three hundred and seventy nine walking people were observed from 10:00 am to 5:00 pm. Ten students who were trained to observe the walking were employed for the data collection. The observed subjects were divided into three age groups, namely young (less than 30 years), middle (31-60 years) and elder (over 61 years), and their age groups were decided by the students based on their appearance. For the analysis, they were further classified into male and female groups. The factors which affect walking speed, step number and cadence were taken into consideration. It was found that young people were more sensitive to their factors in their natural walking and old people showed lower flexibility to these factors.

Adult↗
PubMed1996

Clinical presentation of pulmonary tuberculosis associated with acquired immunodeficiency syndrome in metropolitan Tokyo.

The clinical features of pulmonary tuberculosis associated with acquired immunodeficiency syndrome (AIDS) in Japan were surveyed utilizing questionnaires completed by 48 institutes around the Tokyo metropolitan area. We found 11 Japanese and six foreign patients. The average number of patients per institute was 0.37. The Japanese patients had advanced human immunodeficiency virus (HIV) infection. A middle aged man, with fever and cough, nonspecific chest X-ray infiltrates, decreased lymphocyte counts, and a negative tuberculin skin test was the typical presentation of the Japanese patients. The clinical diagnosis was often difficult. The smear positive rate was high among those from whom smears were obtained, suggesting high communicability. None of the isolates indicated multidrug-resistant tuberculosis at the time of diagnosis. In conclusion, sputum smear and culture remain the keys to diagnosing tuberculosis in patients with AIDS, although the clinical picture may be atypical for pulmonary tuberculosis.

Acquired Immunodeficiency Syndrome↗
PubMed2001

Clinical features and therapeutic outcomes of 65 patients with acromegaly at Tokyo Women's Medical University.

OBJECTIVE: The purpose of this study was to survey the clinical characteristics, complications, and therapeutic outcome in patients with acromegaly. PATIENTS AND METHODS: The clinical features of 65 patients with acromegaly (31 males, 34 females; mean age: 50+/-2 yr.) who were admitted to Tokyo Women's Medical University between 1990 and 1999 were analyzed retrospectively from medical records. RESULTS: The retrospective analysis revealed that the diagnosis of acromegaly was preceded by approximately 8.1+/-1.1 years of signs and symptoms of the disease. Forty-six of the 65 patients (71%) had macroadenomas, 16 (25%) had microadenomas, and the remaining three had empty sella. The rate of biochemical cure or remission was 81% for microadenoma (13/16), 64% for macroadenoma without extrasellar extension (9/14), and 13% for macroadenoma with cavernous sinus extension (2/15). Eighteen (28%) patients had impaired glucose tolerance (IGT) and 32 (49%) had diabetes mellitus (DM). After treatment for acromegaly, glucose metabolism was analyzed again in 38 patients, and it improved in 26 patients with IGT or DM. Twenty-five of 65 patients (38%) had hypertension. Of 26 patients who underwent barium enema or colonoscopy, 10 had colonic polyps and 4 had colon cancer. CONCLUSION: This study suggests that long-term excessive growth hormone (GH) secretion causes many complications. Therefore, awareness of the early symptoms and signs of acromegaly and long-term careful management of complications, along with therapy to reduce serum GH/insulin-like growth factor (IGF)-I levels, are important for patients with acromegaly.

Acromegaly↗
PubMed2006

Social course patterns of urban dwellers with tuberculosis under fragile living conditions in Tokyo, Japan.

BACKGROUND: People under fragile-living conditions show a high rate of interruption of tuberculosis treatment. We examined the social courses of fragile-living urban dwellers with tuberculosis without customary and regular access to a conventional residence and investigated the factors associated with interruption of treatment. METHODS: One hundred and nineteen tuberculosis patients without customary and regular access to a conventional residence who were discharged from a hospital with the largest number of tuberculosis beds in Tokyo between January 1998 and October 2000 were followed up. The associations between demographic, social, and clinical characteristics and interruption of treatment were examined. RESULTS: The subjects (mean age, 51.2 years) were followed up for a median of 342 days. The percentage of cases of interruption of treatment during inpatient care among patients with alcohol problems (56%) was significantly higher than that among patients without such problems (11%). The proportion of cases of interruption of treatment during outpatient care among patients who were literally homeless before admission (40%) was significantly higher than that in others (5%), and that among those who used transient hostels after the initial inpatient treatment (55%) was significantly higher than that in others (4%). The prevalence of drug resistance was higher in cases with than without a history of tuberculosis treatment (P<0.05). CONCLUSIONS: Factors associated with interruption of tuberculosis treatment in patients under fragile-living conditions were identified. Interruption during inpatient care was significantly associated with alcohol problems, and interruption during outpatient care was significantly associated with the use of transient hostels.

Adult↗
PubMed2004

Approach to obstructive sleep apnea syndrome at Tokyo Dental College, Ichikawa General Hospital.

In this communication, we report the current status of OSAS (Obstructive Sleep Apnea Syndrome) in the southern region of Higashikatsushika around Ichikawa City, our effort to improve patient QOL as well as to establish diagnostic and therapeutic methods, and the results of a comparison of therapeutic options with the focus on improvement of compliance by using nCPAP (nasal continuous positive airway pressure). We examined 112 patients who visited the Otolaryngology Department at Tokyo Dental College, Ichikawa General Hospital, with the chief complaint of nocturnal snoring or sleep apnea from January 2001 to April 2003 and underwent all-night PSG (polysomnography). Based upon the results of these all-night PSGs, 89 and 23 patients were diagnosed as having OSAS and simple snoring, respectively. Using the AHI classification of severity, 58 and 31 patients were assessed as having severe OSAS and mild OSAS, respectively. (1) nCPAP was tried in 61 patients, and 39 patients (63%) were able to continue it. After the introduction of nCPAP, surgery was performed in 18 patients (30%). As a result, weaning from nCPAP was successfully achieved in 10 cases, compliance with nCPAP was improved in six cases, alleviation of symptoms (decreased pressure) was seen in one case, and aggravation was noted in one case. In addition, four patients (7%) unilaterally discontinued nCPAP. (2) Surgery was performed in 34 patients, and 18 of them had surgery after nCPAP was tried. (3) We asked the dental department to make OAs (oral appliances) for 31 patients but seven of them did not attend the department, so a total of 24 patients used OAs. Fourteen patients (58%) were able to tolerate an OA for 3 months or more. Based on these results, we are hoping to achieve a better control of OSAS by combining nCPAP and other modalities.

Adolescent↗
PubMed2005

Insomnia as a sequela of sarin toxicity several years after exposure in Tokyo subway trains.

More than 5,000 passengers on Tokyo subway trains were injured with toxic chemicals including the nerve gas "sarin" on March 20, 1995. The purpose of this study was to identify the effect of sarin exposure on insomnia in a cross-sectional study. A self-administered questionnaire concerning sleep-related items was distributed to victims of sarin exposure in October and November, 2003. Questionnaires were completed by 161 of the 163 participants (98.8%), who were selected from 1,500 subjects. Among them, the authors selected 75 women 30 to 69 years of age. Control participants were collected from inhabitants living in Maebachi City, Gunma Prefecture, Japan. For the younger exposed group (under 50 yr. of age), percentages of poor sleep, difficulty falling asleep, intermittent awakening, early morning awakening, a feeling of light overnight sleep, and insomnia were significantly higher than those for the control group. In contrast, the older exposed group (ages 50 to 69 years) had significantly higher prevalence of poor sleep, a feeling of light overnight sleep, and early morning awakening for the exposed group when compared with the control group. The high prevalence of insomnia and insomnia-related factors for victims especially under 50 years of age suggests a need for research on sleep quality after sarin exposure. Although posttraumatic stress disorder is assumed to be a psychological effect of exposure to a toxic substance, a cause-and-effect relationship has not been established.

Adult↗
PubMed1999

Alexithymic traits as predictors of difficulties with adjustment in an outpatient cohort of expatriates in Tokyo.

The purpose of this study was to examine whether alexithymic characteristics, which are thought to be related to poor coping with stress, would be associated with variables thought to reflect adjustment to life abroad. The subjects were 56 expatriates living in Tokyo, Japan. The Expatriate Adaptation Inventory, the Toronto Alexithymia Scale, and the Social Support Questionnaire of the Stress and Coping Inventory were given to the subjects. Scores on alexithymia were significantly associated with dissatisfaction with life abroad, higher satisfaction with life in one's home country prior to departure, and higher ratings on the perception of poor social support. An alexithymia variable, difficulty identifying feelings, was a significant predictor of dissatisfaction with life abroad and satisfaction with life in the home country. The results suggest that, because alexithymia was associated with lower satisfaction with life abroad and higher satisfaction in the home country prior to departure, it may be a predictor of adjustment difficulties when individuals live abroad. Empirical confirmation is needed.

Adaptation, Psychological↗
PubMed1998

Long commuting time, extensive overtime, and sympathodominant state assessed in terms of short-term heart rate variability among male white-collar workers in the Tokyo megalopolis.

To investigate the possible effects of long commuting time and extensive overtime on daytime cardiac autonomic activity, the short-term heart rate variability (HRV) both at supine rest and at standing rest of 223 male white-collar workers in the Tokyo Megalopolis was examined. Workers with a one-way commute of 90 min or more exhibited decreased vagal activity at supine rest and increased sympathetic activity regardless of posture, and those doing overtime of 60 h/month or more exhibited decreased vagal activity and increased sympathetic activity at standing rest. These findings suggest that chronic stress or fatigue resulting from long commuting time or extensive overtime caused these individuals to be in a sympathodominant state. Although these shifts in autonomic activities are not direct indicators of disease, it can be hypothesized that they can induce cardiovascular abnormalities or dysfunctions related to the onset of heart disease. Assessment of the daily and weekly variations in HRV as a function of daily life activities (such as working, commuting, sleeping, and exercising) among workers in Asia-Pacific urban areas might be one way of studying the possible effects of long commuting time, and extensive overtime, on health.

Adult↗
PubMedDate not supplied

Mobility function of the elderly living with their children and its relation to the home health care system in Tokyo.

Most elderly in Japan prefer living with their children once their spouse passes away. In comparison with western countries, home health care systems have developed quite differently in Japan. The traditional practice of the elderly living with their children is, however, changing. In 1989 we carried out a mail questionnaire survey focused on the relationship between mobility functions of the elderly living in Tokyo and their rate of living with family members. The subjects for the present analysis were 2368 widows and widowers. Under the group category 'independent in long walks', 72.8% were living with their families. With a decrease in mobility functions, this percentage rose to 81.1 and 84.6, although it decreased to 50.9 in the group with severely impaired mobility functions. The need to develop effective social services for families housing their parents is discussed.

Activities of Daily Living↗
PubMed1994

[Direct mail investigation of the social and physical background of centenarians in Tokyo metropolitan area].

This study was designed for the purpose of investigating the factors for longevity in the Tokyo metropolitan area. At first, we examined the social and physical background of centenarians by direct mail in 1992. A total of 398 questionnaires (from 81 males and 308 females) were returned. There was a significant gender difference in mobility, with 38% of males and 10% of females being able to take a walk. However 19% of male centenarians and 28% of female ones were bedridden. Hypertension, respiratory disease and heart disease were found in 22%, 16%, 16%, without any significant gender differences. On the contrary, there were more female centenarians with past histories of bone fracture (34%) than male (10%). This discrepancy suggest that bone fracture may be one of the factors causing the gender differences in mobility. Those who had a high level of education were more frequent in centenarians (27% of males and 8% of females) than in the general population of their contemporaries in Japan (less than 2%). The average age at death of the centenarians' parents was 69.6 +/- 15.7 y/o for their father and 71.2 +/- 17.2 y/o for their mother. These ages were significantly higher than the average life-span in the last decade of the 19th century, according to the First Life Tables in Japan. The possibility is suggested that longevity was inherited in these centenarians' families.

Aged↗
PubMed1997

[Tokyo Centenarian Study. 5. Nutritional status of Japanese centenarians].

To establish the guideline for nutrition in the very old, we analyzed biochemical and hematological data from 45 Japanese centenarians living in Tokyo metropolitan area during 1994 and 1995. Levels of cholesterol, HDL-cholesterol, apolipoprotein A1 and B, albumin, prealbumin in serum were lower than in a control group or lower than the reference range, which indicates that these centenarians were undernourished. RBC counts, hemoglobin, and hematocrit were also low in the centenarians. The concentration of albumin correlated positively with those of HDL-cholesterol and apolipoprotein A1, and negatively with concentration of Lp(a). The value for transferrin correlated positively with energy intake and with the concentration of apolipoprotein A1. The concentration of prealbumin correlated positively with the concentration of hemoglobin, hematocrit and the total cholesterol concentration. According to their nutritional status, the centenarians were divided into 2 groups: well-nourished and undernourished. Those who were well-nourished had higher levels of cholesterol, HDL, Hb, and apolipoprotein A1, their levels of ADL and cognitive function were also high. The findings of blood-chemical data in the centenarians may be partly due to undernutrition. Centenarians who were well-nourished were considered to be aging successfully. These results and others previously published indicate that the concentrations of albumin, prealbumin, transferrin and either CRI or IL-6 are useful for nutritional assessment in the very old.

Aged↗
PubMed1992

Nutritional assessment of a group of Japanese elementary school children in Tokyo: with special emphasis on growth, anemia, and obesity.

Anthropometric data, nutrient intake data, and blood biochemical parameters were analyzed for 66 elementary school children living in Tokyo, Japan, and their nutritional status was evaluated focusing on three problems: (1) zinc nutriture and growth, (2) anemia with iron deficiency, and (3) lipid nutriture and obesity. The subjects' mean energy and protein intakes met the recommended levels for Japanese children. However, their zinc intake levels were inadequate at 7.2, 8.3, and 8.5 mg in grades 2 (mean age: 8 yr), 4 (10 yr), and 6 (12 yr), respectively. Mean serum zinc concentration was 0.82 +/- 0.15 microgram/ml; the percentages of subjects who showed serum zinc concentration lower than 0.68 microgram/ml, the lower limit of the normal serum zinc concentration, were 28.6, 15.4, and 5.0% in grades 2, 4, and 6, respectively. These serum zinc concentrations indicated the existence of marginal zinc deficiency in some children, particularly in grade 2, though it was not severe enough to retard growth. Their iron intake levels (8.2, 10.2, and 10.2 mg for grades 2, 4, and 6, respectively) in combination with the proportion of iron intake from animal foods (37%) were judged to be adequate because no children showed serum ferritin, serum iron, or transferrin saturation levels lower than the criteria levels recommended for iron deficiency. Moreover, no definitely anemic children were found. Daily lipid intakes were 65.7, 74.5, and 78.3 g in grades 2, 4, and 6, respectively, and the mean percentage of energy intake from lipid to total energy intake, 32%, exceeded the level recommended. Mean serum total cholesterol concentrations and the percentage of subjects with elevated cholesterol levels (greater than or equal to 200 mg/dl) were high compared with the reported values. Means of the body mass index (BMI) and Rohrer Index (RI) for the subjects were slightly higher than Japanese standards. With these parameters for obesity, triglycerides and atherogenic index were positively correlated and HDL cholesterol and HDL cholesterol percentage to total cholesterol were negatively correlated.

Anemia, Hypochromic↗
PubMed1998

[A survey on condition of outpatients at prosthodontics II, University Hospital, Faculty of Dentistry, Tokyo Medical and Dental University].

The number of dental patients who have medical illnesses is increasing at the hospital of the Faculty of Dentistry, Tokyo Medical and Dental University. Although prosthodontic treatments are considered less invasive in all dental treatments, invasive procedures such as tooth extraction may be required occasionally. Therefore, it is necessary to treat patients in consideration of their condition. Under this situation, a clinical survey was conducted by health questionnaires answered by the patients who visited our clinic between October 1992 and March 1997. The number of patients whose illness was heart disease, hypertension, diabetes, nephritic disease, hepatitis, tuberculosis, hemodyscrasia, asthma, epilepsy, and so on during dental treatment was higher than the national average according to the Ministry of Health and Welfare. Dental psychosomatic diseases such as TMD and dental phobia were increased every year. These data reflect the contemporary disease structure in Japan characterized by the spreading of life-style related diseases and increase of neuropsychological and infectious diseases.

Adolescent↗