Ryuichiro Sasaki

Functional outcome after hip fracture in Japan

One thousand one hundred sixty-nine elderly Japanese patients who sustained a hip fracture were observed prospectively. Ninety-two percent had operative fracture treatment. Hospital length of stay averaged 67 days; 81% of patients were discharged to their place of residence where they resided before sustaining the fracture. Mortality rates at 120 days, 1 year, and 2 years after injury were 6%, 11%, and 19%, respectively. At 1-year followup, ambulatory status was recovered to that of the level experienced before injury in 67% of patients.

Serum concentrations of carotenoids, retinol, and α-tocopherol in healthy persons determined by high-performance liquid chromatography

Serum concentrations of alpha-carotene (AC), beta-carotene (BC), lycopene (LY), beta-cryptoxanthin (CR), zeaxanthin (including lutein. ZX), canthaxanthin (CX), retinol (RE), and alpha-tocopherol (TO) in healthy persons (618 males and 1,196 females) aged 7-86 years were determined by HPLC. Serum concentrations of BC among persons aged 20-49 years were higher with increasing age in females, but not in males. Serum CR concentrations decreased with age ranging from 7 to 39 years, while ZX concentrations rose in the age group of 20 to 59 years for both sexes. In contrast, serum RE concentrations and ratios of RE/BC and RE/CR, especially in males aged 20-49, were higher with age. Serum TO values in both sexes rose with age and were similar.

Juvenile dermatomyositis: a statistical study of 114 patients with dermatomyositis.

We conducted a statistical review of 114 cases of dermatomyositis (DMS) treated primarily at the Department of Dermatology at Nagoya University Hospital over 27 years from 1965 to 1991 in order to determine the primary characteristics of juvenile DMS with the following results.

Hip fracture incidence in Japan

The purpose of this study was to determine incidence and regional distribution of hip fracture throughout Japan. The incidence rate of hip fracture in Japan was estimated by a nationwide survey for departments of orthopedics of all hospitals with 200 beds or more and supplementary survey for all medical institutions in three prefectures.The mail survey was used in main and supplementary survey. The mail questionnaire included items such as the number of new patients seen during 1 January through 31 December 1987 regardeless of cause of fracture, and also sex, age and address of each patients.According to these two surveys, the incidence of hip fracture in Japan was estimated to be approximately 41,000–48,000 (males 10,400–12,000, females 30,600–36,000) in 1987. Incidence rate of hip fracture increased approximately exponential throughout life. The incidence rate was 22–26 per 10,000 persons in females aged 70–74 and 118–139 in those aged 85–89.As regards regional differences, incidence for females showed to be higher in the western region than in the eastern, while such tendency was not observed in males.A further epidemiological survey will be necessary to elucidate regional differences of hip fracture.

Changes in Serum Concentrations of β‐Carotene and Changes in the Dietary Intake Frequency of Green‐Yellow Vegetables among Healthy Male Inhabitants of Japan

Serum levels of β‐carotene among 147 healthy male inhabitants were measured twice with an interval of one year in order to determine the relationship between changes in serum β‐carotene levels and changes in the dietary intake of green‐yellow vegetables. A positive association was found to exist between changes in the intake frequency of green‐yellow vegetables and changes in serum β‐carotene levels, whereas changes in alcohol intake and smoking were discovered to be negatively associated with changes in serum β‐carotene levels. The positive association between changes in the intake frequency of green‐yellow vegetables and changes in serum β‐carotene levels was preserved after adjustment for these negative factors.

Serum antioxidants and subsequent mortality rates of all causes or cancer among rural Japanese inhabitants.

The purpose of this study was to investigate whether a relationship exists between mortality rates and serum antioxidant levels among Japanese inhabitants. The follow-up subjects, who participated in comprehensive health examinations, consisted of 2444 inhabitants (949 males and 1495 females) of a rural area in Hokkaido, Japan. Between 1991 and December 2000, 146 subjects (94 males and 52 females) died, with cancer accounting for 76 of these deaths (48 males and 28 females). Serum samples at fasting were collected at entry into the study, and serum levels of beta- and alpha-carotenes, lycopene, beta-cryptoxanthin, canthaxanthin, zeaxanthin/lutein, tocopherols, and retinol were measured separately by high-performance liquid chromatography (HPLC). The statistical analyses were conducted using the Cox proportional hazard model. Age- and gender-adjusted hazard ratios of the groups with high serum levels of lycopene, beta-carotene, zeaxanthin/lutein, and total carotenoids compared to those with low serum levels were 0.36 (95% C.I: 0.19-0.69), 0.53 (0.29-0.95), 0.73 (0.43-1.25), and 0.52 (0.30-0.92) for cancers of all sites, and 0.44 (95% C.I: 0.28-0.69), 0.59 (0.39-0.90), 0.61 (0.40-0.93), and 0.50 (0.33-0.76) for all causes, respectively. Similar results were found after adjusting for gender, age, smoking habits, alcohol consumption, and serum levels of total cholesterol and glutamic pyruvic transaminase (GPT) activity. Moreover, after excluding mortality within the first three years of follow-up, the hazard ratios of subjects with high serum levels of lycopene, total carotenes, and total carotenoids were significantly and inversely associated with subsequent mortality from all causes and cancers of all sites after adjusting for gender, age, and serum levels of total cholesterol, alpha-tocopherol, and retinol. These results suggest that high serum levels of antioxidants, such as lycopene, beta-carotene and zeaxanthin/lutein, play roles in preventing death from cancer and from all causes. However, high serum levels of tocopherols and retinol did not demonstrate clear associations with either low mortality rates from all causes or cancer of all sites.

Analysis of Lymphocyte Subpopulations in Peripheral Blood in Adult and Juvenile Cases of Dermatomyositis

Dermatomyositis, recognized as an autoimmune disorder, occurs not only in adults but also in children. In this study, we evaluated lymphocyte subpopulations in the peripheral blood of 24 adult dermatomyositis and 14 juvenile dermatomyositis patients and in 17 healthy adults and 9 healthy children by flow cytometry using monoclonal antibodies. When compared with healthy adults and adult patients with inactive dermatomyositis, the adult patients with active disease had significantly lower percentages of CD3+ and CD8+ cells and a significantly higher percentage of CD20+ cells. In contrast, juvenile dermatomyositis patients had lymphocyte subpopulations not significantly different from those of healthy children; the activity/inactivity of disease did not make any difference. These results support our hypothesis that adult and juvenile dermatomyositis may be diseases of entirely different scope.

Connection of atopic disease in Japanese patients with juvenile dermatomyositis based on serum IgE levels

SummarySerum IgE levels of 22 patients with juvenile dermatomyositis (JDMS), 44 normal children, and 43 patients with adult dermatomyositis were compared. The geometric mean of serum IgE levels was significantly higher in the juvenile patients when compared with normal children (p<0.01) and adult patients (p<0.01). Of the 22 patients with JDMS, 11 (50%) had elevated serum IgE levels accompanied by atopic disease. Dermatomyositis was accompanied by atopic dermatitis (AD) in 9 (41%) of these 22 patients, a high prevalence when compared with reports among the general population. Following the appearance of muscular symptoms in JDMS patients with AD, the ratio of OKT4 to OKT8 cells rose due to a reduction in the percentage of OKT8-positive cells, along with further elevations in serum IgE levels and intractable cutaneous manifestations of dermatomyositis. All this may be a result of an interaction between the immuno-mechanism of this disease and that of AD. We suspect that, in general, children with impaired cell-mediated immunity, presenting with such symptoms as AD, may have a higher tendency for developing JDMS.