Hiroki Sugimori

Persistent Insomnia is a Predictor of Hypertension in Japanese Male Workers

Persistent Insomnia is a Predictor of Hypertension in Japanese Male Workers: Machi Suka, et al. Department of Preventive Medicine, St. Marianna University School of Medicine—Insomnia is one of the most common complaints at worksites, as well as in the general population. This study aims to assess the effect of insomnia on the development of hypertension in Japanese male workers. Using the annual health examination database of a Japanese telecommunication company, eligible middle‐aged male participants in the 1994 health examination were followed up until 1998 or the development of hypertension (either initiation of antihypertensive therapy or a systolic blood pressure ≥140 mmHg and/ or a diastolic blood pressure ≥90 mmHg). The effect of difficulty initiating sleep (DIS) was assessed with a DIS dataset (n=4,794), which included non‐DIS (n=4,602) and persistent‐DIS (n=192) subjects. That of difficulty maintaining sleep (DMS) was assessed with a DMS dataset (n=4,443), which included non‐DMS (n=4,157) and persistent‐DMS (n=286) subjects. The incidence of hypertension among persistent‐DIS (40.1%; 130.7 per 1,000 person‐yr) was significantly higher than that among non‐DIS (30.6%; 89.9 per 1,000 person‐yr). The incidence of hypertension among persistent‐DMS (42.3%; 136.7 per 1,000 person‐yr) was significantly higher than that among non‐DMS (30.7%; 90.8 per 1,000 person‐yr). After adjusting for potential confounding factors (i.e. age, body mass index, smoking, alcohol drinking, and job stress), persistent complaints of DIS and DMS were significantly associated with an increased risk of hypertension (OR=1.96; 95%CI: 1.42–2.70 and OR=1.88; 95%CI: 1.45–2.45, respectively). Persistent insomnia may be a useful predictor of hypertension in Japanese male workers.

Analysis of factors that influence body mass index from ages 3 to 6 years: A study based on the Toyama cohort study

Abstract Background : The aim of the present study was to elucidate both environmental and behavioral factors that influence body mass index (BMI, kg/m2) among Japanese children from ages 3−6.

NK-cell neoplasms in Japan

Abstract Neoplasms putatively originating from precursor and mature natural killer (NK) cells are rare, and their clinical features are unclear. A nationwide survey was performed in Japan to clarify the clinical features of these neoplasms diagnosed between 1994 and 1998, and data for 237 patients who met the criteria for putative NK cell-lineage neoplasms were analyzed. Among them, 11 had myeloid/NK-cell precursor acute leukemia, 15 blastic NK-cell lymphoma, 21 precursor NK-cell acute lymphoblastic leukemia, 22 aggressive NK-cell leukemia/lymphoma, 149 nasal-type NK-cell lymphoma (123 nasal and 26 extranasal) and 19 chronic NK lymphocytosis. The median overall survival time of patients with aggressive NK-cell leukemia/lymphoma was 2 months, which for chronic NK lymphocytosis was more than 8 years, and that for the other types of NK-cell neoplasms was between 6 and 22 months. Nasal NK-cell lymphoma and extranasal NK-cell lymphoma share the same histology. The age of affliction was the same, but the sex was different with males predominantly having nasal NK-cell lymphoma and females extranasal NK-cell lymphoma. Patients with extranasal NK-cell lymphoma had the tendency to exhibit a more advanced state of disease, with significantly higher International Prognostic Index and LDH levels, and significantly lower hemogolobin and platelet levels. The overall survival, however, did not differ significantly. Precursor NK-cell acute lymphoblastic leukemia and blastic NK-cell lymphoma were arbitrarily defined by the presence or absence of 30% or more of blastic cells in the bone marrow or peripheral blood, but there were no significant differences for affected age, gender, involved sites or prognosis. Aggressive NK-cell leukemia/lymphoma and extranasal NK-cell lymphoma were arbitrarily defined by the presence or absence of 30% or more of large granular lymphocytes in the bone marrow or peripheral blood and it is possible that aggressive NK-cell leukemia/lymphoma is a leukemic phase of extranasal NK-cell lymphoma. The incidence of skin involvement, however, was significantly higher for extranasal NK-cell lymphoma, suggesting that the two diseases are different. In nasal NK-cell lymphoma, Epstein–Barr virus in tumor cells was detected in all patients tested, suggesting its causative role.

Temporal course of the development of obesity in Japanese school children: A cohort study based on the Keio Study

OBJECTIVE To demonstrate the temporal course of obesity development in Japanese school children by conducting a school-site cohort study over 12 years. METHODS From 1981 to 1984, height and weight of 479 subjects (343 boys and 136 girls) were measured every year from entrance into primary school until graduation from high school in Tokyo. Obese children were defined as those with a body mass index (BMI) at or above the age-sex-specific standard value, derived from Japanese nationwide data. RESULTS Approximately 50% of the children who were obese in the primary school period were obese at age 17. Likewise, 40% who were obese in the junior high school period and 70% who were obese in the high school period were obese at age 17. Among 44 children who were obese at age 17, 14 showed tracking of obesity from the preschool period, 14 showed tracking from ages 7 to 11 years, 10 showed tracking from the junior high school period, and 6 showed tracking from the high school period. CONCLUSIONS Among children who were obese at age 17, most tracked from the primary school age or earlier. The earlier the tracking commenced, the greater the BMI at age 17. This indicates the importance of conducting health education for school children at an early age.

A minor E-selectin ligand, CD65, is critical for extravascular infiltration of acute myeloid leukemia cells

Adhesive ligands on acute myeloid leukemic (AML) blasts may mediate transmigration and extravascular infiltration. In this study, 30 AML samples were examined for expression and density of adhesion antigens. By univariate analysis, four patients with extravascular infiltration showed significantly higher expression of CD2, CD11a, CD11b, CD11c, CD15, CD65, CD86, and HLA-DR as compared with patients without infiltration. These four patients also showed significantly higher density of CD11a, CD11b, CD11c, CD15 and CD65 expression. By multivariate analysis, CD65 expression was the only significant independent risk factor for infiltration, suggesting that this is a critical adhesion molecule for extravascular AML infiltration.

Body Image, Body Satisfaction and Dieting Behavior in Japanese Preadolescents: The Toyama Birth Cohort Study

ObjectivesTo examine the relationships between body image, body satisfaction and dieting behavior in the context of pubertal changes in Japanese preadolescents.MethodsA cross-sectional study of dieting behavior among 5,244 preadolescents (2,452 boys and 2,792 girls aged 12–13) born in Toyama prefecture.ResultsThe percentages of those who perceived themselves fat, wanted to be thinner, and had tried dieting, which increased with body mass index (BMI), were significantly higher in girls than in boys (34.2% vs. 20.0%, 58.0% vs. 26.0%, and 17.3% vs. 5.7%, respectively). Independent of sex and BMI, those who wanted to be thinner and those who had tried dieting were more frequently observed in those who perceived themselves fat, and those who had tried dieting were more frequently observed in those who wanted to be thinner. Pubertal changes were significantly associated with dieting behavior, but their relationships to body image and body satisfaction differed between sexes; for boys, those who perceived themselves fat were more frequently observed in those without pubertal changes; whereas for girls, those who wanted to be thinner were more frequently observed in those with pubertal changes.ConclusionsDieting behavior of Japanese preadolescents was associated with whether they perceived themselves fat and wanted to be thinner, sometimes independent of whether they were actually overweight. Pubertal changes might induce a positive perspective of growing fat among boys and a desire to be thinner among girls, with the consequence that dieting behavior would be reinforced in those with pubertal changes.

Body Image and Body Satisfaction Play Important Roles in the Path to Dieting Behavior in Japanese Preadolescents: The Toyama Birth Cohort Study

ObjectivesTo analyze the path to dieting behavior in Japanese preadolescents.MethodsA cross-sectional study of dieting behavior among 5,244 preadolescents (2,452 boys and 2,792 girls aged 12–13) born in Toyama prefecture.ResultsWhile increasing with body mass index (BMI), the percentage of those who had tried dieting was higher in those who perceived themselves fat than in those who perceived themselves thin or average. Of those who wanted to be thinner, 16.1% of boys and 26.8% of girls had tried dieting. Path analysis in nonobese subjects (2,116 boys and 2,334 girls) showed that (1) body image was primarily based on BMI, (2) body image led to body dissatisfaction, and (3) body dissatisfaction led to dieting behavior. Pubertal changes had a significant effect on body image (path coefficient <0)for boys and body satisfaction (path coefficient >0) for girls, in addition to that on BMI. Maternal BMI had a significant effect on BMI but not on body image, body satisfaction, or dieting behavior.ConclusionsBody image and body satisfaction play important roles in the path to dieting behavior in Japanese preadolescents. Pubertal changes may reinforce dieting behavior, but the mechanism may differ by sex.

Parental influence on the development of obesity in 9-year-old Japanese children: the Toyama birth cohort study

ObjectivesTo examine parental influence on the development of obesity in 9-year-old Japanese children.MethodsA 6-year follow-up study of obesity among 6,102 children born in Toyama prefecture.ResultsAfter adjusting for obesity at age 3, either paternal obesity or maternal obesity at the age 3 survey more than double the risk of obesity at age 9 in both genders. Increases in parental body mass indexes (BMIs) from the age 3 survey through the age 9 survey were significantly associated with obesity at age 9 in girls.ConclusionsNot only parental obesity but also increases in parental BMIs were likely to be associated with development of obesity in children.

Data Mining for Seeking Relationships between Sickness Absence and Japanese Worker’s Profile

Since sickness absence causes great losses for both individual employees and their companies, decreasing sickness absence is one of major concern in occupational healthcare field. We conducted worksite-based study to elucidate the influence of lifestyle, medical findings and present illness on sickness absence of 1 week or longer during the fiscal year. Subjects were 6,010 Japanese male employees in a large telecommunication telephone company, aged 30 to 59 (the mean age 46.3±6.7 years), who had health check-up of in the fiscal year from 1991 to 1998 consecutively. We used data mining methods, such as ‘the Association Rule Analysis’, ‘the Correlation Coefficient Analysis’, and ‘the Risk Ratio Analysis’, to elucidate interrelationships in sickness absences, lifestyle (healthy / unhealthy), medical findings (normal / abnormal), and present illness (non-existent / existent), that were surveyed consecutively in the fiscal year from 1991 to 1998. In present illness, secular trend of Risk Ratio showed different patterns according to present illness category. Our results may contribute preventing sickness absence in Japanese worksite.

Acceptability and Long-Term Compliance with Drug Treatment for Hypercholesterolemia in Japanese Male Workers : I. Acceptability of Drug Treatment

Acceptability and Long‐Term Compliance with Drug Treatment for Hypercholesterolemia in Japanese Male Workers: 1. Acceptability of Drug Treatment: Masayuki Tatemichi, et al. Department of Environmental and Occupational Health, Toho University School of Medicine—We performed a prospective study to assess the acceptability and long‐ term compliance with drug treatment for hypercholesterolemia in Japanese male workers aged 40 to 57 yr with hypercholesterolemia detected in legally required periodical physical examinations. This paper describes the acceptability of statin‐based drug treatment. All eligible workers who had not improved after 3‐month diet therapy were recommended for drug treatment with simvastatin, a 3 hydroxy‐3‐ methylcoenzyme A reductase inhibitor. Subsequently, according to each individual preference, the subjects were divided to two groups: a group which accepted drug treatment (DT) and a group which rejected it. The subjects who did not accept drug treatment were further assigned to two groups according to their preference: a group which accepted only dietary intervention (Dl) and a non‐treatment group (NT). Among 1,278 workers recruited, 656 (51.3%) were placed in the DT group, 414 (32.4%) in the Dl group and 208 (16.3%) in the NT group. In the DT group, mean serum total cholesterol (TC) was the highest [272 ± 30 (SO) mg/dl]. The acceptability of drug treatment was significantly associated with the serum TC level, pre‐existing medical history of hypertension and a family history of ischemic heart disease (IHO). The occupational issues such as type of job, overtime worked, sleeping time and psychologicalstatus were different among the three groups, and habits of taking breakfast and daily exercise were associated with acceptability of drug treatment. These data suggest that acceptability of the drug treatment is low and associated with the work‐and lifestyle‐ related issues as well as IHO risk factors.