1.A Study of the Shoulder Stiffness of High School Student as an Epidemiologic Research. The 1st Report.
Journal of the Japan Society of Acupuncture and Moxibustion 2001;51(2):157-164
Purpose : To study and promote the practical use of acupuncture and moxibustion treatment for the young, we investigated shoulder stiffiness in high school students.
Method : We surveyed 6, 251 students at twelve high schools in Kyoto, Japan about the prevalence and the characteristics of shoulder stiffness using our original questionnaire. We used chi-square test to compare the proportion of the respondents.
Result : Of the subjects we inquired, 5, 846 completed the questionnaire. The overall prevalence rate of shoulder stiffness was 65.3%. The sense of “languid” was 54.9% and “heavy” was 43.9%. While 11.5% of respondents considered their condition to be in tolerable 68.0% said it was “tolerable”. The result of crosstabulation showed that women were more likely to have the symptoms than men and the prevalence rate significantly increased as the academic grade increased.
Conclusion : The rate of shoulder stiffness, 65.3% was higher than we expected. And 12th grades had the most frequency of shoulder stiffness. We considered that the stresses at the graduation on to study hard to graduate are important factors of affecting from shoulder stiffness. The application of acupuncture and moxibustion may help relieve the symptoms among high school students.
2.A Pharmacologic Study on Risk Factors of Hyperkalaemia or Increased Blood Potassium Associated with ACE-Inhibitor Therapy
Mari Hosoda ; Toshiharu Fujita ; Masayuki Hashiguchi ; Yosuke Fujii ; Mayumi Mochizuki
Japanese Journal of Pharmacoepidemiology 2010;15(2):49-59
Objective: To investigate quantitatively the risk factors of hyperkalaemia or increased blood potassium associated with ACE-inhibitor therapy
Design: Nested case-control study
Methods: We used the antihypertensive drug database(72,379 subjects)developed by the RAD-AR Council, Japan and the Institute of Statistical Mathematics based on the post-marketing surveillance(PMS) data of pharmaceutical companies. Of 37,372 subjects taking ACE-inhibitors, the case group was composed of 64 patients who experienced hyperkalaemia or blood potassium increase while taking ACE-inhibitors, and the control group was composed of 1,280 patients(20 patients per case)randomly selected from patients who did not experience hyperkalaemia or blood potassium increase while taking ACE-inhibitors. The relevant factors that can be extracted from the database were the followings: age, WHO classification of hypertension, complications, antihypertensive drugs used before the PMS survey, and concomitant drugs.
Results: Among the subjects taking antihypertensive agents, 65 patients experienced hyperkalaemia orincreased blood potassium, 64(98.5%)of whom were taking ACE-inhibitors. The factors that were significantly different between two groups(p<0.05)by univariate analysis were WHO classification of hypertension(p=0.005), complications of nephritis/nephrosis(p<0.001), other disorder of urinary system(p<0.001), unclear symptom or diagnosis(p=0.005), taking diuretics as antihypertensive drugs before study(p=0.032), and concomitant treatment with diuretics(p=0.004), vasodilators(p<0.001), and antigout agents(p=0.001). Conditional multivariate logistic analysis of these factors yielded adjusted odds ratio of 21.31 for complications of nephritis/nephrosis(p<0.001), 6.83 for other disorder of urinary system(p<0.001), and 2.30 for concomitant therapy with diuretics(p=0.049).
Conclusion: The risk factors of hyperkalaemia or blood potassium increase associated with taking ACE-inhibitors were nephritis/nephrosis, other disorder of urinary system and concomitant therapy with diuretics.
3.For better MCH training on French speaking African countries-Monitoring and evaluation based on daily trainee's voice
Mari NAGAI ; Miho GOTO ; Yasuyo MATSUMOTO ; Noriko FUJITA ; Yoichi HORIKOSHI ; Yasuo SUGIURA ; Chiaki MIYOSHI ; Tamotsu NAKASA
Journal of International Health 2010;25(1):47-57
Purpose
Every year, a lot of training programs by Japan International Cooperation Agency (JICA) are conducted in Japan. However, the method of monitoring and evaluation of those trainings are not always conducted other than simple questionnaire survey. The purpose of this research is to demonstrate the significance of daily recording and analysis of the trainee’s voice as a way of the improvement of the quality of training.
Bureau of International Cooperation in National Center for Global Health and Medicine (NCGM) conducted detailed monitoring and evaluation for “JICA training for Maternal and Child Health in French speaking African countries in 2009” which NCGM itself had planned training curriculum and implemented the training. The key word of this training was “Continuum of care”. At the end of the 5 weeks training, NCGM expected the trainees to obtain comprehensive understanding of continuum of care, especially two different perspectives, which were “the health system” and “the dignity of individual client”.
Method
NCGM training team kept recording the trainee’s voice, then analyzed them every day during five weeks’ training. At the end of the training course, the team divided trainee’s voice into several categories, and then analyzed their time-dependent change.
Results
The everyday recording and analysis of the trainee’s voice made NCGM training team possible to differentiate the trainee’s fundamental interest and understanding from simple guesses or curiosity. Based on the result of daily analysis, the training team could introduce unscheduled discussion or fine-tuned the contents of lectures for better understanding of trainees. The trainees’ interpretation about “continuum of care” showed obvious change before and after the training. The active learning program by using Laboratory method gave deeper impact on trainees than the expectation of training team. At the end of training course, the trainees formulated concrete and detailed action plans. The purpose of their action plans was to establish the continuum of care from aspects of both “the health system” and “the dignity of individual client” by analyzing the existing stakeholders and institutions, and ensuring a collaborative linkage among them, which were exactly the expected outcome.
Conclusion
Daily recording and analysis of the trainee’s voice was effective and useful to monitor the training. The comprehensive analysis at the end of training course revealed the short impact of the training on trainees, which could be used as a self evaluation tool for the training team.
NCGM plans to visit the trainees’ workplace in their home countries for middle and long term monitoring and evaluation. The results will be feed backed into the training curriculum of next year.
4.How Can Oversea Training Programs Be Effective?Lessons Learned from Training Follow-up
Noriko FUJITA ; Miho GOTO ; Yasuyo MATSUMOTO ; Mari NAGAI ; Yoichi HORIKOSHI ; Yasuo SUGIURA ; Chiaki MIYOSHI ; Tamotsu NAKASA
Journal of International Health 2010;25(2):89-97
Introduction
Even though many oversea training programs end in developing an action plan from what they learned during the course, follow-up opportunities are quite limited. Group training program on maternal and child health for Francophone African countries are conducted in Japan since 2003, organized by National Center for Global Health and Medicine and funded by Japan International Cooperation Agency. Follow-up activities in Senegal and Benin are reported with lessons learned.
Methods
Training organizer team made a semi-structured interview with 11 trainees, 6 superintendents and 4 Japanese advisors, asking “Do trainees implement what they planned at the end of the training course in Japan? If not, what are the difficulties implementing their plans?”Organizer team also provided some interventions to solve the problems they faced.
Results
In Senegal, actions were not implemented yet, because plans were shared neither with their superintendents nor with Japanese advisors working with trainees as project counterparts. Organizer team set up a meeting with all stakeholders to clarify the objectives and outcomes of the training course within the concept of the project. This process made the superintendents understand and support the action plans, and facilitated to start implementing them. In Benin, trainees started activities by themselves based on their action plan under a small financial support from a Japanese advisor. It was rather easy, because they were decision makers of a hospital, but they faced difficulties to manage the staff to continue the activities. Organizer team encouraged them to continue the activities during the meeting in the hospital.
Conclusions
Appropriate participants can be selected and training could be effective, when cooperation project are well defined and the role of advisors is clear in the follow-up. Involvement of decision makers or superintendents for the selection and follow-up process can be a contributing factor to improve the effectiveness of the training.
5.Temporal Hemostasis with Kampo Medicine for Bleeding Due to Enhanced Fibrinolytic Type of Chronic Disseminated Intravascular Coagulation : A Case Report
Yuzo FUKUSHIMA ; Ryosuke FUJITA ; Nobuhiro MIYAMOTO ; Mari HAMAYOSHI ; Yuma OTSUKA
Kampo Medicine 2021;72(2):130-134
A 74-year-old woman presented to our clinic with a history of vascular-and stent-graft insertion for aortic dissection developed a tendency to bleed from a palmar wound due to chronic disseminated intravascular coagulation (DIC). Initially, she sustained the palmar wound due to a fall. On the second day after the injury, she experienced continuous bleeding and consulted the orthopedic department of a general hospital, where her dressing was changed. On the third day after injury, she sought consultation at our clinic. The clot and wound remained intact even 12 days after the injury. Therefore, the clot was removed and the bleeding was stopped surgically. On the same day, 5 hours after the surgical treatment, the patient presented to our clinic because of continuous bleeding. She was then administered kyukikyogaito and kamikihito to stop the bleeding. Her laboratory findings revealed thrombocytopenia, and additional inspection was performed. The bleeding stopped on the next day. On the third day after administration, the bleeding remained controlled and an additional inspection revealed DIC. In the cardiology hospital, the cause of tendency to bleed of chronic DIC was pointed out as being due to a leakage at the end of the stent-graft. Kampo medicine was thought to be useful for temporal hemostasis for bleeding due to chronic DIC.
6.Comparison of the Side Effects of Lenvatinib between the Type of Cancer Using the Japanese Adverse Drug Event Report Database
Katsuhiro IWANISHI ; Mari TAKAGI ; Yoko KONDO ; Yoshihiro SAKAJO ; Keiko FUJITA
Japanese Journal of Drug Informatics 2020;22(3):141-146
Lenvatinib hasapplicationsin thyroid and hepatocellular carcinomas. When lenvatinib wasapproved for hepatocellular carcinoma in Japan, the manufacturer noted an increase of 5% in the incidence of side effects than those observed in thyroid cancer, based on the clinical-trial data. The monitoring of side effectsisimportant during chemotherapy. It isdifficult to confirm all the side effects within a single practice, and it is important to consider the incidence and severity of side effects before prescribing a particular treatment regimen. An antineoplastic agent is often used for different diseases, and it may be difficult to confirm a specific side effect. Because clinical conditions vary among different diseases, it is likely that the onset of side effects also differs. We investigated the difference between the onset of side effects in thyroid and hepatocellular carcinomas using the Japanese Adverse Drug Event Report database. The main side effects reported for thyroid cancer included bleeding, hypertension, cardiac disorders, myelosuppression,acute cholecystitis, delayed wound healing, infection, gastrointestinal perforation, fistula formation, and pneumothorax. In addition,patients with hepatocellular carcinoma experienced liver damage and hepatic encephalopathy. A significant strong correlation was observed between the drug dose and number of reports of the varied side effects. We compared the side effects in patients with thyroid cancer to those with hepatocellular carcinoma; although the same drug was used, there was varied expression of the side effects. Thisneedsto be taken into account when determining which drugsare to be used for the treatment of a particular cancer type.
7. Effect of roselle calyx extract on in vitro viability and biofilm formation ability of oral pathogenic bacteria
Herastuti SULISTYANI ; Mari FUJITA ; Hiroshi MIYAKAWA ; Futoshi NAKAZAWA
Asian Pacific Journal of Tropical Medicine 2016;9(2):119-124
Objective: To investigate the effect of the roselle calyx extract (RCE) (Hibiscus sabdariffa L.) on the in vitro viability and biofilm formation ability of oral pathogenic bacteria. Methods: RCE was prepared by soaking roselle calyx powder with ethyl alcohol for 24 h at room temperature. After centrifugation, the extract was lyophilized. Then, the extract was dissolved in phosphate-buffered saline, the pH was adjusted, and the extract was aseptically filtered. We used Streptococcus mutans, Streptococcus sanguinis, Lactobacillus casei, Actinomyces naeslundii, Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, Porphyromonas gingivalis and Prevotella intermedia in this study. The antibacterial activity of the RCE was determined by treating the cells of these bacteria with the extract for 10 or 20 min at room temperature. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration was determined using the microdilution method, and the effect of the RCE on the ability to form biofilm was determined using a polystyrene micro plate assay. In addition, we used the WST-1 assay to determine the cytotoxicity of the RCE on HGF, Ca9-22 and KB cells. Results: The RCE had antibacterial activity against oral bacteria used in this study. In particular, most significant antibacterial activity was observed against Fusobacterium nucleatum, Prevotella intermedia and Porphyromonas gingivalis. The MIC and minimum bactericidal concentration were 7.2 mg/mL-28.8 mg/mL and 14.4 to >57.6 mg/mL. The RCE had an inhibitory effect on biofilm formation at the MIC and sub-MIC levels. In addition, the RCE had low cytotoxic effects on HGF, Ca9-22 and KB cells. Conclusions: Thus, our results indicate that the RCE may be used for preventing oral diseases.
8.A Case of Qi-deficiency Fever Successfully Treated with Hochuekkito
Yuzo FUKUSHIMA ; Ryosuke FUJITA ; Mari HAMAYOSHI ; Kenkichiro TAIRA ; Toshiko TODA ; Atsuko SHIOTA
Kampo Medicine 2022;73(1):81-86
We report a case of qi-deficiency fever that was successfully treated with hochuekkito. A 26-year-old woman presented to our clinic with a complaint of pain of her fingers. Clinical findings revealed no evidence of rheumatoid arthritis. Since she wanted treatment for the recent mild fever, additional examination was performed. Infection, malignant tumor, and collagen disease were ruled out as probable cause of the fever. Clinically, she was diagnosed with qi-deficiency fever. After treatment with hochuekkito, her body temperature normalized, indicating that treatment with hochuekkito was effective. Hochuekkito was originally prescribed for treatment of qi deficiency due to yin fire ; however, it is currently used for treatment of other diseases. In this report, we described a case using hochuekkito.
9.Trunk-to-peripheral fat ratio predicts a subsequent blood pressure in normal-weight pubertal boys: a 3-year follow-up of the Kitakata Kids Health Study.
Katsuyasu KOUDA ; Masayuki IKI ; Yuki FUJITA ; Harunobu NAKAMURA ; Masami HAMADA ; Kazuhiro UENISHI ; Mari MIYAKE ; Toshimasa NISHIYAMA
Environmental Health and Preventive Medicine 2020;25(1):41-41
BACKGROUND:
Limited evidence exists regarding the relationship between central-to-peripheral fat ratio measured by dual-energy X-ray absorptiometry (DXA) and subsequent cardiometabolic risk in both pediatric and adult populations.
METHODS:
The present cohort study investigated the relationship between DXA-measured body fat distribution and cardiometabolic parameters. The source population was 275 4th-6th graders (aged 9.6-12.6 years) in the northeast region of Japan (Shiokawa area in Kitakata). A 3-year follow-up was conducted to obtain complete information from 155 normal-weight children (87 boys and 68 girls). Normal-weight children were identified using sex- and age-specific international cut-offs for body mass index (BMI) based on adult BMI values of 25 kg/m and 18.5 kg/m, respectively. Body fat distribution was assessed using the trunk-to-appendicular fat ratio (TAR) and trunk-to-leg fat ratio (TLR) measured by DXA.
RESULTS:
In boys, systolic blood pressure (SBP) at follow-up showed a significant relationship with TAR at baseline after adjusting for age, height, pubic hair appearance, SBP, and whole body fat at baseline (β = 0.24, P < 0.05), and SBP also showed a significant relationship with TLR after adjusting for confounding factors including whole body fat (β = 0.25, P < 0.05). In girls, there were no significant relationships between blood pressure and TAR/TLR.
CONCLUSION
Body fat distribution in normal-weight boys predicted subsequent blood pressure levels in adolescence. The relationship between fat distribution and blood pressure was independent of fat volume.
Absorptiometry, Photon
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Adolescent
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Blood Pressure
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Body Fat Distribution
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Child
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Cohort Studies
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Humans
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Japan
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Male