Hirotoshi Iwata

Epidemiological and clinical features of Budd-Chiari syndrome in Japan

The Japanese Ministry of Health and Welfare Research Committee on Aberrant Portal Blood Flow carried out an epidemiological survey and clinical study on Budd-Chiari syndrome in 1990. In the primary survey for determining the prevalence of the disease, a questionnaire was sent to all major hospitals throughout Japan and 160 cases seen in 1989 were compiled. More epidemiological details were obtained in 87 of these 160 cases. The number of patients with Budd-Chiari syndrome in this country was estimated to be about 300 (prevalence of 2.4/million) with about 20 new cases occurring every year. In the clinical study, 157 authentic cases of Budd-Chiari syndrome studied in 15 years (1975-89) were analyzed. There were 87 males (average age, 36.4 years) and 70 females (46.5 years), and the average period from the likely onset to the first medical consultation was 6.6 years, suggesting that these patients were mostly chronic cases. The main clinical features were hepatomegaly, leg edema, ascites and venous dilatation over the trunk. Abdominal pain was recorded in only four (2.5%). There were 16 (10.2%) with known identifiable etiologies. Of the patients 93% showed an obstructing lesion of various thickness in the hepatic portion of the inferior vena cava. Only nine (5.7%) had hepatic vein obstruction without caval lesions. Thus, the majority of Budd-Chiari syndrome patients in Japan are idiopathic, having an obstructing lesion in the inferior vena cava. The main causes of 33 deaths (21%) were liver failure, variceal bleeding and hepatocellular carcinoma. Hepatocellular carcinoma occurred in 10 (6.4%) in the 15-year period. However, the incidence of Budd-Chiari syndrome among all cases of hepatocellular carcinoma was less than 1% in the survey made by the Liver Cancer Study Group of Japan.

SYSTEMIC LUPUS ERYTHEMATOSUS: A CASE-CONTROL EPIDEMIOLOGIC STUDY IN JAPAN

Background. Systemic lupus erythematosus (SLE) is designated by the Japanese government as one of the intractable diseases and all patients, who suffer from these diseases, are registered to get financial aid for treatment. Using newly registered SLE patients, a case‐control study was conducted to evaluate potential risk factors.

Symptoms of contruction workers exposed to whole body vibration and local vibration

SummaryTo study the effects of construction machinery operation on subjective symptoms, a questionnaire survey was caried out among construction machinery operators by a self-reporting method. Subjects were 184 power shovel operators, 127 bulldozer operators, 44 forklift operators as operator groups, and 44 office workers as a control. Their ages were in a range of 30–49 years. The questionnaire contained 20 symptoms referring to fatigue, digestive problems, and upper or lower limbs or back problems. The prevalence rate and symptom characteristics were examined. The dominant symptoms of the operator groups were stiff shoulder, low back pain, and stomack symptoms. The prevalence rate of low back pain was significantly different between forklift operators and controls. No significant differences were found in the symptoms of upper limbs and fingers between operator groups and controls. The prevalence of Raynauds phenomenon was 0.5%–2.3% in the operator groups and 2.3% in the control group.

Subjective complaints in orthopedists and general surgeons

The aim of this study was to investigate the prevalence of subjective complaints among two groups of health care personnel. Using a mail questionnaire, 63 male orthopedists and 78 male general surgeons were asked to respond to questions on their subjective musculoskeletal complaints as well as their age, occupational career, and daily working time. In the final analysis, 54 orthopedists and 63 general surgeons who were aged ⩽ 59 years and had worked for at least 5 years in clinical practice were considered. The mean age was 43.3 (SD 7.6) years for the orthopedists and 41.8 (SD 9.5) years for the general surgeons. Their mean employment time was 18.1 (SD 8.9) years and 16.6 (SD 9.5) years, respectively. The average working time per day was 9.5 h. In general, the orthopedists had a higher prevalence of subjective complaints than the general surgeons. Problems in the shoulders and lower back were the most frequently reported complaints, followed by neck problems. There were significant differences (P < 0.05) between the two groups regarding stiffness in the shoulders, stiffness in the lower back, pain in the neck, and numbness in the fingers. When subjective complaints were compared between the junior (employment time: < 20 years) and senior (employment time: ⩾ 20 years) staff, the junior orthopedists had significantly higher prevalence rates for stiffness in the shoulders, pain in the neck, and stiffness in the lower back. This subgroup had significantly higher odds ratios (ORs) for some subjective complaints as compared to the junior surgeons, e.g., pain in the neck [OR = 6.19, 95% confidence interval (95% Cl) 1.91–20.04], shoulder stiffness (OR = 3.75, 95% Cl 1.36–10.31), pain in the shoulders (OR = 4.41, 95% Cl 3.64–4.70), and stiffness in the lower back (OR = 4.93, 95% Cl 1.74–13.94). It was concluded that ergonomic intervention to improve the working environment is imperative. In addition to ergonomic factors, consideration might also be given to psychological factors with a view to reducing the risk of subjective complaints among these subjects.

Effects of long-term moderate exercise and increase in number of daily steps on serum lipids in women: randomised controlled trial [ISRCTN21921919]

BackgroundThis study was designed to evaluate the effects of a 24-month period of moderate exercise on serum lipids in menopausal women.MethodsThe subjects (40–60 y) were randomly divided into an exercise group (n = 14) and a control group (n = 13). The women in the exercise group were asked to participate in a 90-minute physical education class once a week and to record their daily steps as measured by a pedometer for 24 months.ResultsMean of daily steps was significantly higher in the exercise group from about 6,800 to over 8,500 steps (P < 0.01). In the control group, the number of daily steps ranged from 5,700 to 6,800 steps throughout the follow-up period. A significant interaction between the exercise group and the control group in the changes og total cholesterol (TC), high-density lipoprotein cholesterol (HDLC) and TC : HDLC ratio could be observed (P < 0.05). By multiple regression analysis, the number of daily steps was related to HDLC and TC : HDLC levels after 24 months, and the changes in TC and HDLC concentrations.ConclusionsThese results suggest that daily exercise as well as increasing the number of daily steps can improve the profile of serum lipids.

Prevalence of Raynaud's phenomenon in different groups of workers operating hand-held vibrating tools

In eight groups of subjects operating various hand-held vibrating tools and aged from 30 to 59 years, the prevalence rates of vibration-induced white finger (VWF) and numbness, pain, or stiffness in the upper and lower extremities were investigated. Hand-transmitted vibration levels (HTVLs) were measured on the back of the hand, by means of unidirectional (x-axis) vibration dosimeters, and the frequency-weighted acceleration levels [(Lh,w)eq,t] were determined as the vibration levels. The prevalence rates of VWF and numbness of the hands in these subjects were compared to the prevalence rates of Raynauds phenomenon (RP) and numbness of the hands in 1027 males and 1301 females not occupationally exposed to vibration (age range: 30–59 years). It was observed that in subjects exposed to HTVLs of between 1.1 and 2.5 m/s2, the prevalence of VWF was between 0.0% and 4.8%. The prevalence of VWF reached 9.6% in a group of workers exposed to HTVLs of 2.7–5.1 tn/s2. The latter group showed a significant difference (P < 0.05) in the prevalence of VWF compared to the 2.7% prevalence of RP in male subjects of the general population. The prevalence of VWF in female subjects exposed to vibration (4.3%) was not significantly different from the prevalence of RP in females of the general population (3.4%). The prevalence rates of numbness of the hands were in the range of 6.5%–30.4% in the exposed groups and in the range of 13.4%–29.5% in the general population. Among the subjective symptoms, only VWF showed a significant positive correlation with HTVLs (R2 = 0.5, P < 0.05). It was concluded that in decisions concerning quantitative recommendations for vibration exposure, the prevalence of VWF should be employed. With a view to decreasing the risk of developing VWF, estimated vibration safety values for 4 h and 2 h daily exposures are discussed.

Significance of the atherosclerogenic index and body fat in children as markers for future, potential coronary heart disease

Abstract Background: The purpose of this study is to establish a simple marker in children for future, potential risks of coronary heart disease.

Cutaneous signs (Raynaud's phenomenon, sclerodactylia, and efladema of the hands) and hand-arm vibration exposure

SummaryDermatological tests and examinations of the hand(s) were carried out in vibration-exposed and un exposed males. The subjects were 179 chain-saw workers in private forestry companies and 205 local inhabitants who had never used vibrating tools. The prevalences of Raynauds phenomenon (RP), sclerodactylia, and edema of the hands were estimated in both groups, and associations between these cutaneous signs and vibration exposure were evaluated. The prevalences of RP and edema in the exposed group were 9.5% and 1.7%, respectively, and in the unexposed group, 2.9% and 1.5%, respectively. Sclerodactylia was seen in 31.8% of the chain-saw workers but in only 6.4% of the unexposed individuals. In statistical analyses based on unconditional logistic regression models with adjustment for age, RP was associated with long-term (≥ 20 years) vibration exposure [odds ratio (OR) = 7.06; 95% confidence interval (CI) = 2.51−19.87]. Sclerodactylia was associated with both short- and long-term vibration exposure (OR = 6.54, Cl = 3.30-13.36; OR = 7.05; CI = 3.41-14.60, respectively). There were significant dose-response relationships between RP and duration of exposure and between sclerodactylia and duration of exposure. Results of function tests indicated a longer recovery time and a higher vibration threshold for the workers with RP. The presence of sclerodactylia, however, did not have any significant influence on function test results. It is possible to conclude that not only RP but also sclerodactylia could be induced by vibration exposure. However, most cases of sclerodactylia were not so serious as to involve disturbances of peripheral circulatory and nerve function.

Modifying effects of maharishi amrit kalash 4 and 5 on phagocytic and digestive functions of macrophages in male icr mice

A study was carried out to examine modifying effects of Maharishi Amrit Kalash 4 (MAK 4) and Maharishi Amrit Kalash 5 (MAK 5) on phagocytic and digestive functions of macrophages in male ICR mice. Mice at 4 week of age were divided into 3 groups: no treatment group (control), MAK 4 treated group (MAK 4 group) and MAK 5 treated group (MAK 5 group). MAK 4 and MAK 5 were given p.o. at 50 mg/kg per day (5 days/week) for 7 weeks. Phagocytic function of reticuloendothelial system evaluated by the carbon clearance was enhanced by the treatment of MAK 4 and MAK 5. Superoxide anion (O2-) production of peritoneal macrophages increased significantly in both MAK 4 and MAK 5 groups. The acid phosphatase activity of peritoneal macrophages increased significantly in MAK 4 group compared to the control group, but not in MAK 5 group. The activities of β-glucuronidase and lactate dehydrogenase in both MAK 4 and MAK 5 groups increased significantly when compared to the control group. These results suggest that MAK 4 and MAK 5 promote the phagocytic and digestive functions of macrophages and have a stimulatory effect on macrophages.

PREVALENCE OF RAYNAUD'S PHENOMENON AND SPECIFIC CLINICAL SIGNS RELATED TO PROGRESSIVE SYSTEMIC SCLEROSIS IN THE GENERAL POPULATION OF JAPAN

Background. In order to evaluate the prevalence rates of Raynauds phenomenon (RP) and specific clinical signs related to progressive systemic sclerosis (PSS) in the general population of Japan, inquiries were made concerning RP in the hands and dermatologic examinations were also conducted.