Takeshi Yoda

Pre-Existing Arteriosclerotic Intimal Thickening in Living-Donor Kidneys Reflects Allograft Function

Background: Donor shortage is a serious problem worldwide and it is now debated whether kidneys from marginal donors are suitable for renal transplantation. Recent studies have shown that the findings of preimplantation kidney biopsy are useful to evaluate vasculopathy in the donated kidney, and may predict transplant outcomes in deceased- donor kidney transplantation. However, few studies have focused on the pathological findings of preimplantation biopsy in living-donor kidney transplantation. Therefore, we investigated whether arteriosclerotic vasculopathy in living-donor kidneys at the time of transplantation predicts the recipient’s kidney function (allograft function) later in life. Methods: We retrospectively analyzed 75 consecutive adult living-donor kidney transplants performed at Kagawa University Hospital. Renal arteriosclerotic vasculopathy was defined according to the presence of fibrous intimal thickening in the interlobular artery. Results: Forty-one kidneys exhibited mild arteriosclerotic vasculopathy on preimplantation kidney biopsies. The decreases in estimated glomerular filtration rate after donation were similar in donors with or without renal arteriosclerotic vasculopathy. Pre-existing arteriosclerotic vasculopathy did not affect graft survival rate, patient survival rate or the incidence of complications. Recipients of kidneys with arteriosclerotic vasculopathy had lower allograft function at 1 and 3 years after transplantation than the recipients of arteriosclerosis-free kidneys with or without donor hypertension. In multivariate analysis, fibrous intimal thickening on preimplantation biopsy was predictive of reduced allograft function at 1 year after transplantation. Conclusions: The present study demonstrated that mild arteriosclerotic vasculopathy in the donated kidney is an important pathological factor that reflects future impaired function of renal allografts from marginal donors.

The new school absentees reporting system for pandemic influenza A/H1N1 2009 infection in Japan

Objective To evaluate the new Japanese School Absentees Reporting System for Infectious Disease (SARSID) for pandemic influenza A/H1N1 2009 infection in comparison with the National epidemiological Surveillance of Infectious Disease (NESID). Methods We used data of 53,223 students (97.7%) in Takamatsu city Japan. Data regarding school absentees in SARSID was compared with that in NESID from Oct 13, 2009 to Jan 12, 2010. Results Similar trends were observed both in SARSID and NESID. However, the epidemic trend for influenza in SARSID was thought to be more sensitive than that in NESID. Conclusion The epidemic trend for influenza among school-aged children could be easily and rapidly assessed by SARSID compared to NESID. SARSID might be useful for detecting the epidemic trend of influenza.

Effort-reward Imbalance and Low Back Pain among Eldercare Workers in Nursing Homes: A Cross-sectional Study in Kagawa Prefecture, Japan

Effort‐reward Imbalance and Low Back Pain among Eldercare Workers in Nursing Homes: A Cross‐sectional Study in Kagawa Prefecture, Japan; Katsunori YOKOYAMA, et al. Department of Anesthesiology, Graduate School of Medicine, Kagawa University—

Association of brain metabolites with blood lactate and glucose levels with respect to neurological outcomes after out-of-hospital cardiac arrest: A preliminary microdialysis study

AIM Out-of-hospital cardiac arrest (OHCA) is associated with poor prognosis. Cerebral microdialysis (CMD) is an efficient sampling technique to detect neurochemical changes in brain interstitial tissue. In this retrospective study, we hypothesised that there are different CMD levels between patients with favourable and unfavourable neurological outcomes. METHODS Data of patients with OHCA admitted to Kagawa University Hospital and administered therapeutic hypothermia (TH) were collected. Using a CMD probe, extracellular glucose, lactate and pyruvate levels were measured hourly along with intracranial perfusion pressure (ICP) and cerebral perfusion pressure (CPP) for the initial 72h during TH. The lactate/pyruvate (LP) ratio was calculated. Patients were divided into favourable [Glasgow-Pittsburgh cerebral performance category 1-2 at 30days after cardiac arrest] or unfavourable neurological outcome groups. CMD biochemical markers and blood lactate and glucose levels were compared between two groups. RESULTS Ten patients were included. ICP was significantly higher in the unfavourable than in the favourable neurological outcome group; there were no significant differences with respect to CPP. The CMD LP ratio in the unfavourable outcome group progressively increased; significant differences were observed on days 2, 3 and 4 (p<0.01). Significant differences in blood lactate levels were observed between the groups only on day 3.5. CMD and blood glucose levels were higher in the unfavourable than in the favourable outcome group during TH. CONCLUSION The association of CMD levels with long-term outcomes would be better defined in a large randomised prospective study.AIM Out-of-hospital cardiac arrest (OHCA) is associated with poor prognosis. Cerebral microdialysis (CMD) is an efficient sampling technique to detect neurochemical changes in brain interstitial tissue. In this retrospective study, we hypothesised that there are different CMD levels between patients with favourable and unfavourable neurological outcomes. METHODS Data of patients with OHCA admitted to Kagawa University Hospital and administered therapeutic hypothermia (TH) were collected. Using a CMD probe, extracellular glucose, lactate and pyruvate levels were measured hourly along with intracranial perfusion pressure (ICP) and cerebral perfusion pressure (CPP) for the initial 72h during TH. The lactate/pyruvate (LP) ratio was calculated. Patients were divided into favourable [Glasgow-Pittsburgh cerebral performance category 1-2 at 30days after cardiac arrest] or unfavourable neurological outcome groups. CMD biochemical markers and blood lactate and glucose levels were compared between two groups. RESULTS Ten patients were included. ICP was significantly higher in the unfavourable than in the favourable neurological outcome group; there were no significant differences with respect to CPP. The CMD LP ratio in the unfavourable outcome group progressively increased; significant differences were observed on days 2, 3 and 4 (p<0.01). Significant differences in blood lactate levels were observed between the groups only on day 3.5. CMD and blood glucose levels were higher in the unfavourable than in the favourable outcome group during TH. CONCLUSION The association of CMD levels with long-term outcomes would be better defined in a large randomised prospective study.

Insomnia and depression: Japanese hospital workers questionnaire survey

Abstract Objectives This study aimed to identify a correlation between insomnia and the occurrence of depression among Japanese hospital employees using the data obtained from a self-reported questionnaire. Methods A self-administered questionnaire on sleeping patterns, depression, fatigue, lifestyle-related diseases, and chronic pain was given to 7690 employees aged 20-60 years, and 5,083 employees responded. Results An insomnia score of >2 was observed in 840 (13%) respondents. Chronic insomnia correlated significantly with gender, occupation, overtime work, metabolic syndrome, chronic pain, fatigue, and depression. Moreover, significant negative effects on depression scores were observed in males aged 30-39 (partial regression coefficient: b=0.357, p=0.016), females aged 20-29 (b=0.494, p<0.001), male administrative staff (b=0.475, p=0.003), males with metabolic syndrome (b=0.258, p=0.023), and both genders with chronic insomnia (male; b=0.480, p<0.001: female; b=0.485, p<0.001), and fatigue (male; b=1.180, p<0.001: female; b=1.151, p<0.001). Discussion Insomnia is a risk factor for depression and for other lifestyle-related diseases. The insomnia score may be useful in preventative care settings because it is associated with a wide spectrum of diseases and serves as a valuable marker for early detection of depression. Thus, our future studies will focus on establishing a method for early detection of depression symptoms among workers across various job profiles.

Sex differences in attachment to spouses among older Japanese couples.

Attachment among older adults can partially explain sex differences in bereavement outcomes, but there is currently little evidence regarding this. The aim was to quantify sex differences in the proportion of spouses as attachment figures among older couples.

Relationship Between Long-term Flooding and Serious Mental Illness After the 2011 Flood in Thailand.

OBJECTIVE The present study aimed to evaluate the long-term psychological effects of the 2011 flood in Thailand on flood victims and unaffected residents, taking into account risk factors such as floodwater levels in the house, period of flooding, and disruption to essential services. METHODS Surveys were conducted in Salaya and Nakhon Chaisri subdistrict, Nakhonpatom Province, from May to June 2012. Approximately 400 households were selected. Measures of sociodemographic variables, exposure to flooding, incidents (eg, disruption of services), and outcome variables (Kessler 10) were recorded. RESULTS A total of 407 respondents completed the survey. The results of the univariate analysis showed that possible serious mental illness was approximately 1.5 times higher in flood victims than in unaffected respondents. After adjustment for potential confounding factors, significant associations were found for disruption of essential services and hypertension or diabetes with possible serious mental illness. CONCLUSIONS Disruption of essential services and chronic illness may affect psychological distress among flood victims. Public health agencies should develop and evaluate strategies to improve risk communication and psychological support for flood victims. (Disaster Med Public Health Preparedness. 2017;11:300-304).