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PubMed1993

[Seroepidemiological study of human rotavirus in northern part of Tokyo from 1990 to 1992 by using reverse transcription-polymerase chain reaction].

A seroepidemiological study of rotavirus was conducted in the northern part of Tokyo from 1990 to 1992 by using reverse transcription-polymerase chain reaction (RT-PCR). G1 and G3 types were detected in the winter between 1990 and 1991, however G1 type was appeared mainly in the winter between 1991 and 1992. G3 type was observed as the main type during the winter in the 10 year survey in the Tokyo area for the first time. RT-PCR was useful in the seroepidemiological studies of rotavirus infection.

Base Sequence↗
PubMed1996

[Characterization of Salmonella ser. enteritidis phage type 34 isolated from food poisoning outbreaks in Tokyo by epidemiological makers].

Since 1989, outbreaks of Salmonella ser. Enteritidis food poisoning has dramatically increased in Tokyo, and a total of 95 outbreaks has been reported between 1989 and 1993. As the results of examination of phage type by the method of Ward, et al., strains isolated from 31 (32.6%) of 95 outbreaks were phage type 34 which is a very rare type in Europe and America. To characterize these unique strains of phage type (PT) 34, 302 isolates obtained from patients and vehicle foods of the outbreaks, eggs and environments in Tokyo were examined for plasmid DNA profiles and antimicrobial resistance patterns. Plasmid DNA was extracted by the Kado's method, and analysed by agalose gel electrophoresis. Antimicrobial susceptibility was tested for CP, TC, SM, KM, ABPC, NA, SXT, FOM and NFLX by the K-B disc method. The strains of PT 34 were further subdivided to 4 types by plasmid profile and antibiogram. The prevalent pattern of PT 34 strains was type plasmid profile which carried 2 different plasmids (> 250 and 60 kb) and was streptomysin-resistant. A total of 28 (90.3%) of 31 outbreaks were found to be caused by this specific type of Salmonella ser. Enteritidis. Several kinds of egg-related foods were suspected for the vehicles of transmission among 12 outbreaks. Especially, in 5 outbreaks, this specific type (type B plasmid profile and streptomysin resistant) of Salmonella ser. Enteritidis strains were isolated both from patients and incriminated food which were cooked with eggs. The phase type of Salmonella ser. Enteritidis strains isolated from raw egg and poultry or environmental specimens from poultry farm showed that the prevailing phage types were almost the same as those of foods poisoning outbreaks. This strongly suggests that these foods may be considered as a source of infection in Salmonella ser. Enteritidis outbreaks.

Anti-Bacterial Agents↗
PubMed2001

[The trends of Vibrio parahaemolyticus foodborne outbreaks in Tokyo: 1989-2000].

The total number of foodborne outbreaks due to Vibrio parahaemolyticus in Tokyo during the last 12 years between 1989 and 2000 were 710. The number of outbreaks in a year was 55 in 1989, 75 in 1990, and there was a gradual decrease to 24 outbreaks in 1993 which was the smallest number during those 12 years. After 1994, the number of outbreaks increased dramatically year by year until 1998 (107 outbreaks). Then they had decreased slightly to 74 in 1999, 65 in 2000. The monthly incidence of V. parahaemolyticus foodborne outbreaks showed a peak in August (44.2%) each year. In the last 12 years, 88.7% of V. parahaemolyticus foodborne outbreaks occurred during the 3 months between July and September, while 99.9% occurred between June and October. The most prevalent serotype of V. parahaemolyticus also changed, the most prevalent was O4:K4 in 1989, O4:K8 in both 1990 and 1991, O1:K56 in 1992, and O4:K8 from 1993 through 1995. Serotype O3:K6 became the most prevalent in 1996 and has remained so to date. In addition, the new serotype O4:K68 had also appeared in 1998. The number of outbreaks due to serotype O4:K68 followed that of O3:K6. Thus, the trends of V. parahaemolyticus foodborne outbreaks during the last 12 years in Tokyo showed various characteristics and dramatic changes in causal organisms.

Disease Outbreaks↗
PubMed1989

Western blot (immunoblot) assay of small, round-structured virus associated with an acute gastroenteritis outbreak in Tokyo.

Small, round-structured virus (SRSV) was detected in a stool specimen of a patient during an acute gastroenteritis outbreak in Tokyo and was tentatively named SRSV-9. SRSV-9 was purified by sucrose velocity gradient centrifugation after CsCl density gradient centrifugation. The buoyant density of SRSV-9 appeared to be 1.36 g/ml in CsCl. A Western blot (immunoblot) assay using the biotin-avidin system revealed that SRSV-9 was antigenically related to the Hawaii agent but distinct from the Norwalk agent and contained a single major structural protein with a molecular size of 63.0 +/- 0.6 kilodaltons. The prevalence of SRSV-9 infection in Tokyo was surveyed by the Western blot antibody assay by using a crude virus preparation as the antigen. Seroconversion was observed in 56.5% of the patients involved in the outbreaks from which SRSV was detected by electron microscopy.

Acute Disease↗
PubMed2005

Effects of sarin on the nervous system of subway workers seven years after the Tokyo subway sarin attack.

This study was designed to assess the after effects of sarin exposure on the nervous system in victims of the Tokyo Subway Sarin Attack, which occurred on 20 March, 1995. We performed a similar study 3 yr after the disaster. This time, we newly enrolled 36 staff of the Teito Rapid Transit Authority (Tokyo Eidan subway) to assess the 7 yr after effects on the nervous system, and merged previous data including unpublished data to enhance statistical power. New subjects consisted of 23 male exposed subjects and 13 referent subjects matched for age and working types. Neurobehavioral tests for psychomotor function and memory, stabilometry, and Benton visual retention test were performed. As reported previously, the exposed group performed significantly less well in the psychomotor function test (tapping) than the referent group (117.8 +/- 1.2 vs. 105.6 +/- 1.2 msec). Using merged data, this phenomenon was also observed in a dose-dependent manner and the exposed group performed significantly less well in the backward digit span test (4.47 +/- 1.17 vs. 5.11 +/- 1.65 digits). These results indicate that chronic decline of psychomotor function and memory function still exist 7 yr after the sarin exposure.

Adult↗
PubMed1983

The epidemiology of childhood diabetes mellitus in Tokyo metropolitan area.

Prevalence and incidence of IDDM and NIDDM in children in the Tokyo Metropolitan area were estimated using data obtained from a hospital population study, a school population study, urine glucose screening and also from the central registry. The calculated prevalence of diabetes from the data of the central registry in Tokyo was 4 or 6 per 100,000 children. The number of schoolchildren with IDDM was estimated to be about 20 from the data of the school population study performed in a population of about 220,000, giving a prevalence rate of approximately 9.1 per 100,000 schoolchildren. From the data of our hospital population study, the overall annual incidence of IDDM was approximately 3.3 per 100,000 population. It is apparent that the incidence and prevalence of IDDM in Japan are significantly lower than in the United States and European countries.

Adolescent↗
PubMed1993

Rises in urinary bicarbonate contents and pH of adult Tokyo citizens.

Urinary bicarbonate has been considered to be negligible, and the pH of urine to be low (around pH 5.5) for these fifty years. It was, however, found that the contents of bicarbonate and pH of the urine of adult Tokyo citizens (435 adults including 148 males and 287 females) substantially increased. The findings may be correlated with increased inhaled amounts of carbon dioxide which finally causes the increase of urinary excretion of bicarbonate, though evidence that the gas accumulates in the atmosphere of Tokyo due to air pollution has not been directly demonstrated.

Adult↗
PubMed2005

Infant mortality and income in 4 world cities: New York, London, Paris, and Tokyo.

OBJECTIVES: We investigated the association between average income or deprivation and infant mortality rate across neighborhoods of 4 world cities. METHODS: Using a maximum likelihood negative binomial regression model that controls for births, we analyzed data for 1988-1992 and 1993-1997. RESULTS: In Manhattan, for both periods, we found an association (.05% significance level) between income and infant mortality. In Tokyo, for both periods, and in Paris and London for period 1, we found none (5% significance level). For period 2, the association just missed statistical significance for Paris, whereas for London it was significant (5% level). CONCLUSIONS: In stark contrast to Tokyo, Paris, and London, the association of income and infant mortality rate was strongly evident in Manhattan.

Data Collection↗
PubMed1996

Malaria--eight years of experience in a Tokyo metropolitan hospital.

Malaria patients who were admitted to the Department of Infectious Diseases of the Tokyo Metropolitan Bokutoh General Hospital during the past 8 years are reviewed. Cases included 17 patients infected with Plasmodium falciparum (14 Japanese), 13 patients infected with P. vivax (9 Japanese), 3 patients infected with P. ovale (2 Japanese) and 1 Chinese patient with a mixed infection of P. falciparum and P. vivax. About 70% of Japanese patients infected with P. falciparum contracted the disease in Africa, about 90% P. vivax-infected Japanese patients contracted the disease in Asia and all P. ovale-infected patients contracted the disease in Africa. Only 13% of all (17% of Japanese) patients infected with P. falciparum who initially contracted doctors of other Japanese hospitals were correctly diagnosed, but 78% of all (67% of Japanese) patients infected with P. vivax who initially contacted doctors of other Japanese hospitals were correctly diagnosed. At present, malaria is not a rare disease in Tokyo among travelers to or from Africa or Asia.

Adult↗
PubMed2001

Sudden death due to cardiovascular disorders: a review of the studies on the medico-legal cases in Tokyo.

The Tokyo Metropolitan Government has a medical examiner system, in which all cadavers classified as "unusual death" in the city of Tokyo should be examined, and if necessary, autopsied to determine the cause of death. Of about 10,000 unusual deaths examined per year, two thirds are usually determined to have died of natural causes. The most common cause of sudden natural death is ischemic heart disease, especially acute myocardial infarction. Pathological examination, however, proves acute myocardial ischemia in only one third of autopsies. Subarachnoid hemorrhage and intracerebral hemorrhage, acute myocarditis and cardiomyopathies and aortic dissection/aneurysm as well as pulmonary thromboembolism are frequent causes of death in medical examiner cases. Both pathological and socio-medical problems associated with these diseases are discussed.

Aortic Aneurysm↗
PubMed2005

Annual incidence and clinical characteristics of type 2 diabetes in children as detected by urine glucose screening in the Tokyo metropolitan area.

OBJECTIVE: This study investigates the annual incidence and clinical characteristics of type 2 diabetes among school-aged children as detected by urine glucose screening from 1974 to 2002 in the Tokyo metropolitan area. RESEARCH DESIGN AND METHODS: In total, 8,812,356 school children were examined for glucosuria. Morning urine was used for the analysis. When the urine was positive for glucose, an oral glucose tolerance test was carried out to confirm diabetes. RESULTS: In all, 232 students were identified to have type 2 diabetes. The overall annual incidence of type 2 diabetes was 2.63/100,000. The annual incidence after 1981 was significantly higher than that before 1980 (1.73 vs. 2.76/100,000, P < 0.0001). The annual incidence was significantly higher for junior high school students compared with primary school students (0.78 vs. 6.43/100,000, P < 0.0001). The overall male-to-female ratio of students with type 2 diabetes was 1.0:1.19 (P = 0.296), but it was 1.0:1.56 (P = 0.278) for primary school students. Overall, 83.4% of children with diabetes were obese (> or = 20% overweight). However, nonobese girls (<20% overweight) with diabetes accounted for 23.0% of the patients, whereas markedly obese boys (> or = 40% overweight) accounted for 61.5% of the patients. The frequency of a family history of type 2 diabetes in second- and first-degree relatives was 56.5%. CONCLUSIONS: We confirmed that the incidence of young people with type 2 diabetes increased after 1981 in the Tokyo metropolitan area. The increase in the frequency of this disorder seemed to be strongly related to an increasing prevalence of obesity. Age and genetic susceptibility may be associated with the occurrence of type 2 diabetes.

Adolescent↗
PubMedDate not supplied

Health impact assessment of particulate matter in Tokyo, Japan.

Among industrialized countries, Japan still maintains an old set of guidelines for particulate matter (PM); therefore, we assessed the public health impacts of PM exposure in various situations using data from the Tokyo metropolitan area. Subjects were 7.8 million people aged older than 30 years. Based on a linear relationship between exposure and health effects, we estimated attributable cases of mortality caused by PM. Even at the recent exposure level, the number of deaths will occur after both short- and long-term exposure. When the guideline for PM2.5 (particles < 2.5 microm in diameter) long-term exposure was set at 12 microg/m3, we could prevent 8% of all causes mortality or 6,700 deaths in the Tokyo metropolitan area per year. This assessment shows that guidelines for long-term exposure, especially for PM2.5, should be recommended in Japan.

Adult↗
PubMed2002

[Medical consultation dynamics in Japanese cedar pollinosis patients at an office building clinic in central Tokyo].

To clarify medical consultation dynamics in Japanese cedar pollinosis patients visiting an office building clinic in an office block in central Tokyo, we surveyed number of patient at a private ENT clinic in Chiyoda-ku, Tokyo, during the Japanese cedar pollen season from 1990 to 1999. Based on questionnaires and CAP RAST tests in 1995, we studied the profiles of Japanese cedar pollinosis patients and determined positive rates of noncedar antigens. The gender ratio in 1995 was 674 men versus 501 women, most frequently men in their 40s and women in their 20s. Of these, 79.2% worked in Chiyoda-ku and Chuo-ku, but only 1.9% lived in these districts. Positive rates of noncedar antigens in 232 who received simultaneous CAP RAST tests were 64.7% for Japanese cypress, 38.3% for house dust, 35.3% for Dermatophagoides pteronyssinus, 34.4% for Epidermoptidae spp, 19.8% for mixed grasses, and 10.3% for mixed weeds (asteraceous plants). Patients positive for cedar alone were 19.0% and positive for both cedar and cypress but negative for other antigens were 23.3%; about 60% of these were suspected of multiple sensitization to antigens other than cedar and cypress. The number of pollens and patients were summarized weekly and compared. Those paying a first visit were peaked with an increase in pollen in the first week of March almost every year; second visits peaked 1 or 2 weeks later than the first visit. Little increase in first visit was noted even with increasing pollen dissemination from the latter half of March. The relationship between the number of pollen and patients each year from 1990 to 1999 correlated highly with the linear regression equation y = 0.1005x + 547.07 with R2 = 0.7562. The relationship between square roots of the number of pollen and patients each year for 5 year from 1995 to 1999 correlated very highly with the linear regression equation y = 11.167x + 376.72 with R2 = 0.9941. We concluded that the number of patients may be predicted with substantially higher accuracy based on the estimated amount of pollen in a given year.

Adult↗
PubMed1990

Prevalence of Cryptosporidium infection among domestic cats in the Tokyo Metropolitan District, Japan.

From February, 1988 to February, 1989, an epidemiological survey for feline cryptosporidiosis was carried out on domestic cats that had been committed to the Tokyo Metropolitan Animal Protection Center by owners residing in the Tokyo Metropolitan District. Of a total of 608 cats, 23 (3.8%) were found to have Cryptosporidium oocysts. The percentage of cats positive for the infection ranged from 0 to 13.6% by month. The infection was found to be more common in "baby" and "young" cats than in "middle" and "old" ones. No significant difference in incidence was shown between the sexes. In each positive cat, no apparent clinical symptom such as diarrhea was found, and the size of the oocysts measured from 4.3 to 4.7 microns in diameter (small type).

Age Factors↗
PubMed2003

A seasonal model to simulate influenza oscillation in Tokyo.

The purpose of our study was to establish a seasonal model to simulate the oscillation of the number of influenza cases with weather conditions and calendar months in Tokyo, Japan, during the winter season. Surveillance data for influenza in Tokyo was retrieved from the Infectious Agents Surveillance Report, published by the National Institute of Infectious Diseases in Japan. We obtained data for 86 parameters of weather conditions from the Meteorological Agency. The best-fit model was built by multiple regression with stepwise analysis. The reported number of patients with influenza per week was significantly increased with fewer days of maximum temperature 10 per week (T10) and more days of relative humidity <60% per week (S60), adjusted by calendar month, average temperature, and vapor pressure. Annual oscillation of the number of reported influenza cases at the start, peak, and end weeks almost exactly matched the model, although peak levels for each oscillation did not always match. However, this model showed that 81% of the variation among the observed number of influenza cases was explained by a linear relationship with the seasonal parameters utilized. The validity of this model applied to data from 1999 to 2002, showing a 75% correlation. Using this model, if the number of days with both T10 and S60 increased by one per week, the number of influenza cases was simulated to decrease by approximately half. These results suggest that most of the oscillation in the number of influenza cases may be explained using a seasonal model that can simulate the impact of global warming.

Humans↗
PubMed2003

Seasonal models of herpangina and hand-foot-mouth disease to simulate annual fluctuations in urban warming in Tokyo.

In order to investigate the effects of global warming, we attempted to establish seasonal models to predict fluctuations in rates of herpangina (HA) and hand-foot-mouth disease (HFMD) associated with weather conditions and calendar months in Tokyo, Japan. Surveillance data tracking HA/HFMD incidences in Tokyo was retrieved from the Infectious Agents Surveillance Report, published by the National Institute of Infectious Diseases in Japan. From the Meteorological Agency, we obtained data for 54 weather condition parameters. The annual fluctuations in reported HA cases comprising start, peak, and end weeks almost exactly matched the model, although peak levels for each fluctuation did not always match in HFMD. Furthermore, for the HA model, 88% of the variations among observed HA cases were explained by the linear relationship with the seasonal parameters investigated, which was higher than the 64% observed for the HFMD model. The HA and HFMD models were applied to data from the years 1999 to 2002, and demonstrated correlations of 86% and 64%, respectively. These models predicted that warmer climate conditions would lead to an increased number of HA and HFMD cases. These results suggest that our seasonal models may quantify the dependency of infectious diseases on seasonal parameters and simulate the impact of global warming.

Child↗
PubMed1992

[A study of the mentally ill in institutions for homeless people in Tokyo].

Homeless problems associated with poverty may be considered almost resolved in Japan because of the post World War II economic development, but in large cities such as Tokyo the homeless are still being produced, a reflection of a variety of social problems. This study is based on an analysis of admission records of an institution for the homeless which was established in 1952 in Tokyo. Subjects are 2,122 single persons who were admitted between 1952 and 1985. Among these, 136 are mentally ill persons, who are the main subjects of analysis in this study. Results show that, which after 1970 the number of the mentally ill significantly increased, many of those people dropped out of the institution mostly because they were originally admitted directly from discharge from hospitals because there was no other place to go except the institutions, and also because the institution, originally meant to house street people who had been detained, did not offer appropriate programs for the mentally ill. A solution to these problems requires that roles of institutions for the homeless and subjects admitted be reconsidered. Institution staff should enrich programs designed for the homeless mentally ill and help them organize their social network and live in the community.

Adult↗
PubMed2003

[The public system for dealing with incidental accidental report in Tokyo Metropolitan Government].

How to prevent medical adverse events and augment the public's confidence in healthcare has become an urgent one of the highest-priority medical policy issues in Japan. Accident reports for administrative organs are very usefully for patient safety, but are not concerned with the legal duty required under the Medical Act Law. Extending previous work, we established the public system following. First, we gave notice all hospital in Tokyo Metropolitan how incidental range should be reported. Second, we established "neutral center for collect incidental reports". Third, we established "Tokyo Metropolitan Patients' Advisory Service" that collects patient's complaints. We convince that cooperative actions with administrative organ, hospital and patients are very usefully for patient safety and should be extending in Japan.

Legislation, Medical↗