Yasuo Haruki

Treatments of Generalized Pustular Psoriasis: A Multicenter Study in Japan

This study analyzed data from treatments of 385 cases of generalized pustular psoriasis (GPP) from 325 hospitals in Japan. Retinoid treatment was effective in 84.1% of patients, methotrexate in 76.2%, cyclosporine in 71.2%, oral PUVA therapy in 45.7%, and tonsillectomy in 16.7%. Short‐term therapy with systemic corticosteroid for GPP during only the phase with severe systemic clinical findings may be also effective (75.4%). However, these treatments for GPP each differed in clinical effects, prognosis, and side effects. These findings may be useful in creating guidelines for treatment of generalized pustular psoriasis. Further studies based on these specific clinical effects are necessary.

On the correlation between sexual behavior and ovarian hormone level during the menstrual cycle in captive Japanese monkeys

The amount of estradiol and progesterone in the systemic blood plasma of six adult female Japanese monkeys was measured by radioimmunoassay. Data on heterosexual pairing tests was also collected and examined for correlation with these hormones. The relationship between ovarian hormones and frequency of ejaculation varied with each female. In nine normal menstrual cycles, the frequencies of invitation and approach by the female reached peaks on the day of the estradiol surge, after which they rapidly decreased. Frequencies of male behaviors including approach, leaving, invitation, and yawning significantly decreased during the luteal phase, as compared with those at the midcycle. Grooming by both sexes of the partner reached low points during the late follicular phase. The number of ejaculations per test increased significantly at the midcycle and reached a maximum a few days after the estradiol surge. The present results suggest that female proceptivity is highly correlated with the amount of estradiol, but her attractiveness is little correlated with estradiol and is lowered by progesterone.

Frequency and clinical features of pervasive developmental disorder in adolescent suicide attempts.

OBJECTIVE The goal of this clinical study was to examine the frequency and clinical features of pervasive developmental disorder (PDD) relative to suicide attempts by adolescents. METHOD Ninety-four adolescent patients under age 20 participated in this study; it was a consecutive study of individuals who had attempted suicide and had been hospitalized for inpatient treatment. RESULTS Twelve of the 94 subjects (12.8%) were diagnosed with PDD. The ratio of males in the PDD group was higher than that in the non-PDD group (P=.017). There was a significant difference between the two groups regarding the rate of patients having mood or anxiety disorder (P=.037). CONCLUSION This study indicates that PDD should always be a consideration when dealing with adolescent suicide attempts.

Application of telepsychiatry: A preliminary study

Telemedicine is the provision of professional medical services from sites removed from the patient. This study was conducted in order to assess the reliability of psychiatric evaluations via video‐consultation. The inter‐rater reliability was determined for each interviewing condition by employing the reliability‐testing paradigm in which the brief psychiatric rating scale (BPRS) and the interclass correlation coefficient (ICC) are used. The inter‐rater reliability scores between face‐to‐face interviews and interviews conducted by video at two different levels of image qualities were compared by the authors. Reliability was found to be in perfect agreement in each of the interviewing conditions. This study verifies that telepsychiatry is a reliable method of assessing patient conditions. It may be used to provide much needed mental health‐care services to patients whose access to them is restricted.

Follow‐up of Clinical Efficacy of Iontophoresis Therapy for Postherpetic Neuralgia (PHN)

A great variety of therapies have been attempted for PHN, including pharmacotherapy and physical therapy. However, there has been no decisive treatment, and reports of the clinical efficacy of all available therapies have been rather controversial. Almost all studies conducted so far have looked only at short‐term therapeutic efficacy, and only a few investigators have conducted long‐term observations or studies on long‐term outcome. We followed up the clinical efficacy of iontophoresis therapy using lidocaine and methylprednisolone in 197 PHN patients. Monitoring conducted for an average of 4 years after completion of the treatment showed that pain remained unchanged or improved compared to pain observed upon completion of the treatment in 90.4% of patients. Although 42.6% of patients were still continuing some treatment, 90.9% were found to be able to take care of themselves. Findings obtained were reviewed and discussed from various viewpoints. Our findings showed that iontophoresis therapy is not only effective at the end of the treatment, but its efficacy is maintained over a long period of time, indicating that it is clinically very useful for the treatment of PHN.

Lifestyle and colorectal cancer: A case-control study

A case-control study has been conducted to investigate the relationship between lifestyle and risk of colorectal cancer. Cases are one hundred patients diagnosed with colon and rectal cancer in Tokai University Hospital between 1986 and 1994. Three controls per case were individually matched by age, sex, local areas and date of health checkups at the Automated Multi-phasic Health Testing and Services (AMHTS ) Center of the hospital. The results were analyzed by multi-factorial logistic regression models. Positive history of maternal cancer, large consumption of alcohol, frequent consumption of potato products and white-collar job were predominant risk factors while frequent intake of seaweed was a protective factor. Frequent intakes of dairy foods and lack of exercise showed no significant tendency to increase risk of colorectal cancer. Smoking habits, intakes of meat and egg were shown not to be related to this disease. These findings suggest that family history of cancer and dietary factors play a key role in causation and prevention of colorectal cancer.

Health and welfare data on optical memory cards in Isehara city

An off-line network system of health and welfare for elderly people using optical memory cards has been established in Isehara city (Japan) since 1991. 2775 citizens have the cards and 24 offices have the terminals. It covers almost one third of people aged over 65 in Isehara city and almost all of the offices concerned with their health and welfare. About a half of holders use optical memory cards every time they visit these offices. The optical memory card holds data including basic data for health and welfare, health check data over 5 years, medical images with scripts and history of welfare services. All the data are used for medical care, health consultation and management of health and welfare services. A card can hold health and welfare data for a lifetime, and it is easy to expand the system. It has been a good experience for us, because the optical memory card system needs co-operation among citizens, medical association and local government, and the experience will help us to expand the system in the future.

Long-term efficacy of psoriasis vulgaris treatments: Analysis of treatment with topical corticosteroid and/or vitamin D3 analog, oral cyclosporin, etretinate and phototherapy over a 35-year period, 1975–2010

Various therapies have been tried for psoriasis. In Japan, biologics began to be used for psoriasis treatment in January 2010. Their clinical efficacy is well known, but biologics cannot be used in all psoriasis patients for reasons such as side‐effects and cost. It is necessary to evaluate the effect of long‐term psoriasis treatment, but there have been no reports evaluating long‐term treatment. Therefore, the outcomes of patients who had been treated at the Tokai University Hospital for more than 5 years, before biological agents were released, were examined. Three categories, classified by initial severity, changes in severity by method of treatment and background characteristics, were investigated. In conclusion, cases of long‐term treatment with a combination of topical corticosteroid and topical vitamin D3 analog or oral cyclosporin were found to be effective therapies. Patients with a history of diabetes mellitus or cardiovascular disease of psoriasis were likely to be treatment resistant.

Personal Health Data on Optical Memory Cards in Isehara City

About 2,800 optical memory cards with personal health and welfare data have been at work in Isehara city (pop. 98,119 (1995)) since 1992. The card contains mainly the patient’s basic personal health data including records of consultations for up to five years, the period stipulated in Japanese law. In some cases, the card may contain more data: examples include welfare data and medical images.