Masaaki Yamada

Leisure time physical activity and subsequent physical and mental health functioning among midlife Finnish, British and Japanese employees: a follow-up study in three occupational cohorts

Objectives The aim of this study was to examine whether leisure time physical activity contributes to subsequent physical and mental health functioning among midlife employees. The associations were tested in three occupational cohorts from Finland, Britain and Japan. Design Cohort study. Setting Finland, Britain and Japan. Participants Prospective employee cohorts from the Finnish Helsinki Health Study (2000–2002 and 2007, n=5958), British Whitehall II study (1997–1999 and 2003–2004, n=4142) and Japanese Civil Servants Study (1998–1999 and 2003, n=1768) were used. Leisure time physical activity was classified into three groups: inactive, moderately active and vigorously active. Primary outcome measure Mean scores of physical and mental health functioning (SF-36) at follow-up were examined. Results Physical activity was associated with better subsequent physical health functioning in all three cohorts, however, with varying magnitude and some gender differences. Differences were the clearest among Finnish women (inactive: 46.0, vigorously active: 49.5) and men (inactive: 47.8, active vigorous: 51.1) and British women (inactive: 47.3, active vigorous: 50.4). In mental health functioning, the differences were generally smaller and not that clearly related to the intensity of physical activity. Emerging differences in health functioning were relatively small. Conclusions Vigorous physical activity was associated with better subsequent physical health functioning in all three cohorts with varying magnitude. For mental health functioning, the intensity of physical activity was less important. Promoting leisure time physical activity may prove useful for the maintenance of health functioning among midlife employees.

Clinical Search for Undiagnosed Mesenteric Phlebosclerosis at Outpatient Departments Specializing in Herbal (Kampo) Medicine

OBJECTIVEnMesenteric phlebosclerosis (MP) is a disease characterized by calcification of the mesenteric vein, which causes chronic mesenteric ischemia. Recently, the long-term intake of gardenia fruit (Sanshishi in Japanese) has been attracting attention as a possible cause. Usually, only advanced, severe MP cases get reported. However, we suspected that some latent cases of this disease may exist. We performed this study in order to determine the prediagnostic cases at our outpatient departments of herbal (Kampo) medicine, with particular attention paid to the initial changes, such as any slight color change of the colon, as shown in colonoscopy.nnnMETHODSnWe recommend colonoscopy and computed tomography (CT) scans for patients with a long-term history of taking herbal medicines containing gardenia fruit. Clinical examinations were performed upon receiving patients consent from December 2013 to November 2014.nnnRESULTSnOf the 103 patients who took gardenia fruit long-term, 29 agreed to be checked for MP. 14 patients underwent colonoscopy. Four patients were confirmed to have MP due to the presence of fibrotic deposition of the colonic membrane on histological inspection. Twenty-one patients underwent abdominal CT screening. Characteristic calcification of the mesenteric vein was observed on CT scans in 2 patients. All 4 MP patients took Kampo formulas containing gardenia fruit for more than 6.8 years. The other patients did not develop MP, despite long-term gardenia fruit intake.nnnCONCLUSIONnWe detected the latent and undiagnosed MP cases. All diagnoses were made while paying careful attention to any slight changes in colonoscopy and CT scans.

Total dosage of gardenia fruit used by patients with mesenteric phlebosclerosis.

BackgroundMesenteric phlebosclerosis (MP) is a disease characterized by fibrotic change or calcification of the mesenteric vein. Recently, there has been an increase in case reports of MP related to herbal medicine usage. Long-term intake of gardenia fruit (GF) is suspected as a possible cause. However, many GF users do not develop this disease and the association between GF and MP remains unclear. In this study, we investigated for the first time the dosage of GF used by patients with and without MP.MethodsWe used a medical chart review study design to assess the association between GF and MP. We reviewed patients with a history of intake of herbal medicines containing GF. Among these patients, we selected patients who were examined by colonoscopy and abdominal plain computed tomography (CT). We investigated the findings of colonoscopy, CT scan and histological examination. We assessed the total dosages of GF alongside the duration of ambulatory visit, the administration period of herbal medicine containing GF and pre-existing disease in order to compare MP cases and non-MP patients.ResultsTen MP cases and 42 non-MP patients were analyzed. We summarized clinical findings of MP cases. All MP cases used more GF than non-MP patients and were administered more than approximately 5,000 grams of GF in cumulative dosage.ConclusionsThis study indicated that excessive intake of GF contributes to and/or accelerates the development of MP suggesting that long-term usage of GF in excessive amounts increases the risk of MP.

Work, family, and personal characteristics explain occupational and gender differences in work–family conflict among Japanese civil servants

OBJECTIVESnA high level of work-family conflict (WFC) is an important risk factor for physical and mental health problems. Although individual work-related factors for WFC have been extensively studied, relatively little is known about whether occupation and gender affect WFC and how such effects might be generated.nnnSTUDY DESIGNnCross-sectional study.nnnMETHODSnThis study surveyed 3053 civil servants aged 20-65 years working in a local government in the west coast of Japan in 2003. Logistic regression analyses were used to examine whether there are occupational and gender differences in WFC and to clarify the factors underlying these differences.nnnRESULTSnWFC was higher in professional and technical workers compared with other occupations for both men and women, with age-adjusted odds ratios (ORs) for these workers of 1.29 in men and 2.58 in women. In men, occupational differences in WFC disappeared after adjusting for work and family characteristics (ORxa0=xa01.15). In women, significant occupational differences remained in the final model, but after adjusting for work characteristics the adjusted OR for professional and technical workers was reduced to 1.69. Women were more likely than men to experience high WFC (ORxa0=xa02.52). After controlling for work characteristics, the gender difference was considerably reduced (ORxa0=xa01.68).nnnCONCLUSIONSnWork characteristics play a fundamental role in the difference in WFC between not only occupational but also gender differences. Stressful work characteristics among professional and technical workers and among women in all work roles should be addressed to reduce occupational and gender differences in WFC in Japan.

Colonoscopic reduction of colo-colic intussusception in an adult with immunoglobulin A vasculitis (Henoch-Schönlein purpura)

A 45-year-old patient with immunoglobulin A vasculitis (Henoch-Schönlein purpura: HSP) had been receiving 30mg/day prednisolone at Toyama University Hospital and had visited the hospital’s emergency room as a result of sudden abdominal pain. On physical examination, purpura was shown over the bilateral dorsum of the hands and feet. Laboratory examination indicated that the activity level of coagulation factor XIII had slightly decreased to 60%, whereas urinalysis showed hematuria 2+ and proteinuria 2+. Ultrasonography (US) and computed tomography (CT) revealed colonic intussusception (Fig. 1) without any ischemic or necrotic signs in the cecal wall. Colonoscopy was carried out to investigate the site of the intussusception and to treat the condition, and this revealed a colonic intussusception with a hematoma-like mass (Fig. 2a). While the colon was insufflated to more closely examine the intussusception, the mass retracted and the intussusception gradually reduced without perforation or other complications. The colonoscope could be advanced to the normal ileocecal valve and the terminal ileum (Fig. 2b,c). Accordingly, we determined that the leading point was a submucosal hematoma of the cecal wall, caused by vasculitis resulting from HSP, and represented a type of colo-colic intussusception. After reduction was achieved, the prednisolone dose was increased to 60mg/day. Seven days after the intussusception, colonoscopy was repeated, and no hematoma-like mass was observed, although several superficial ulcers remained in the cecum (Fig. 2d). Intussusception in HSP cases is rarely found in adults. Two previous literature reviews that evaluated 250 and 115 adults with HSP did not report any cases of intussusception. In Japan, colo-colic intussusception associated with HSP in adults has been reported in two cases. One of those cases underwent colonoscopy, and the intussusception was reduced by colonoscopic insufflation, similar to the present case. ACKNOWLEDGMENTS

Association between lifestyle and overall health in high school children: Results from the Toyama birth cohort study, Japan

The aim of this study was to investigate the relationship between lifestyle and overall health in high school children.

Parental Internet Use and Lifestyle Factors as Correlates of Prolonged Screen Time of Children in Japan: Results From the Super Shokuiku School Project

Background Prolonged screen time (ST), which includes TV viewing and gaming on smartphones and computers, is linked to poor health. Our aim was to explore the associations between school children with prolonged ST and parental internet use (IU) and lifestyles in Japan. Methods Children aged 6 to 13 years from the Super Shokuiku School Project, were surveyed using questionnaires in 2016. The survey assessed the grade, sex, and lifestyle of 1,659 children and parental internet use (IU) and lifestyle using Breslow’s seven health behaviors. IU consisted of internet surfing and gaming on personal computers (PC), smartphones, or consoles. Three or more hours of ST was defined as prolonged ST, and its correlates were analyzed using logistic regression. Results Of all, 643 (38.8%) children spent ≥2 hours/day of ST on a week day, whilst 153 (9.2%) children spent ≥3 hours/day. Prolonged ST was significantly associated with children in higher grade (odds ratio [OR] 1.74; 95% confidence interval [CI], 1.20–2.51), boys (OR 2.16; 95% CI, 1.49–3.14), skipping breakfast (OR 1.88; 95% CI, 1.05–3.35), late bedtime (OR 1.80; 95% CI, 1.15–2.82), physical inactivity (OR 1.79; 95% CI, 1.12–2.87), father’s IU ≥2 hours/day (OR 2.35; 95% CI, 1.52–3.63), mother’s prolonged IU ≥2 hours/day (OR 2.55; 95% CI, 1.43–4.52), mothers with unhealthy behaviors (OR 1.81; 95% CI, 1.05–3.13), no rule setting governing screen time (OR 2.41; 95% CI, 1.63–3.58), and mothers with full-time employment (OR 1.95; 95% CI, 1.06–3.64). Conclusions Prolonged ST among Japanese children was strongly associated with parental IU, no set rules for ST, and mother’s unhealthy lifestyles. To reduce children’s ST, parental engagement is warranted in the intervention strategy.

A pathway from low socioeconomic status to dementia in Japan: results from the Toyama dementia survey

BackgroundThe association between low socioeconomic status (SES) and dementia is reportedly mediated by lifestyle-related diseases (i.e., diabetes) in European countries and the United States; however, in Japan, the link between low SES and dementia has not been investigated. This study evaluated the possibility of a mediating role of lifestyle-related diseases in the relationship between low SES and dementia in Japan.MethodsA retrospective case-control study design, with data from the Toyama Dementia Survey, Japan, was used. Individuals aged ≥65xa0years (institutionalized and noninstitutionalized) living in Toyama prefecture were randomly selected, with a sampling rate of 0.5%. Of them, 1303 agreed to participate (response rate 84.8%). Overall, 137 cases of dementia and 1039 unimpaired controls were identified. Structured interviews with participants and family members or proxies were conducted, if necessary. Participants’ history of medically diagnosed disease, lifestyle factors (i.e., smoking and alcohol drinking habits), and SES (educational attainment and occupational history) were assessed. The possibility of low SES being a risk factor for dementia via lifestyle-related diseases was investigated using the Sobel test.ResultsThe odds ratio (OR) for dementia was higher for participants with low educational attainment (6xa0years or less) than for highly educated participants [age- and sex-adjusted OR 3.27; 95% confidence interval (CI) 1.84–5.81]; it was also higher for participants with a blue-collar job history than a white-collar job history (age- and sex-adjusted OR 1.26; 95% CI 0.80–1.98). After adjustment for employment history, the OR for dementia for participants with low educational attainment was 3.23–3.56. Former habitual alcohol consumption and a medical history of diabetes, Parkinson’s disease, stroke, and angina pectoris/cardiovascular disease were found to increase the risk of dementia. Educational attainment was not associated with alcohol consumption, smoking, diabetes, Parkinson’s disease, stroke, or cardiovascular disease. Occupational history was associated with diabetes and stroke. The role of diabetes in low educational attainment and dementia was found to be extremely limited.ConclusionsIn Japan, lifestyle-related diseases play a minimal role as mediators between low SES and dementia.

Lifestyle and bowel movements in school children: Results from the Toyama Birth Cohort Study

Constipation is a prevalent health disorder. There have been few epidemiological surveys on constipation in Japanese children. The aim of this study was to evaluate the prevalence of non‐daily bowel movements (BM) and irregular BM among children and to identify modifiable lifestyle factors relevant to bowel habits.