2.Ten-year Follow-up of Obesity and Obesity-related Metabolic Disorders in Male Rural Japanese Workers
Motoko Sato ; Tsuyoshi Hamano ; Masayuki Yamasaki ; Kuninori Shiwaku
Journal of Rural Medicine 2008;4(1):15-20
Objectives: Prevention of obesity is a high priority of health management at workplaces. We conducted a follow-up study of obesity and obesity-related metabolic disorders in Japanese male workers. Subjects and Methods: Ninety-eight male workers engaged in the operation of a nuclear power plant in Shimane Prefecture, aged 41 ± 8 years in 2006, were subjected to regular health check-ups in 1996 and 2006. Results: The changes in their body weights and metabolic parameters (blood pressure, AST, ALT, γ-GTP, LDL-cholesterol, HDL-cholesterol, triglycerides, glucose and uric acid) were compared by BMI class and age group. Twenty-three percent of the subjects fell within the 23.0 to 24.9 BMI range, and 23% were over 25.0 BMI. Body weight increased significantly, by 3.6 ± 5.3 kg in all subjects, but there was no significant difference in weight gain over the 10 years by age or BMI group. Weight gain was positively associated with metabolic parameters, such as the values of systolic blood pressure, ALT, triglycerides and uric acid, and negatively associated with the value of HDL-C. Conclusions: Japanese male workers, regardless of age and BMI at baseline, experienced an increase of body weight and obesity-related metabolic disorders. Therefore, health professionals in the workplace should consider educating workers about stress-coping methods to reduce job stress, promote a health-supportive environment, such as healthy menus in employee cafeterias and fitness clubs, and be cognizant of high-risk factors in the individual employee.
Obesity
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workforce
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seconds
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Male gender
;
Body Mass Index
3.Huge Unruptured Aneurysm of the Sinus of Valsalva with Bicuspid Aortic Valve: A Case Treated Successfully by Surgery.
Manabu Sato ; Shinya Higuchi ; Yukio Kosako ; Yuji Katayama ; Tsuyoshi Ito
Japanese Journal of Cardiovascular Surgery 1998;27(6):376-379
An isolated huge unruptured aneurysm of the right coronary sinus of Valsalva was detected incidentally in a 47-year-old man. Echocardiography and aortograms revealed severe aortic insufficiency with moderate stenosis, and mild dilatation of the lower ascending aorta without annulo-aortic ectasia. At operation, a sclerotic bicuspid aortic valve was confirmed. These abnormal findings necessitated a reconstruction of the aortic root with a valved conduit and reimplantation of the coronary arteries (Bentall operation with the Carrel patch technique). Pathologic examination of the resected aortic wall showed diffuse sclerotic change and partial medial degeneration.
4.A prototype interactive seminar on pediatric emergency practice in Yokohama
Atsuo Sato ; Atsushi Isozaki ; Hideyasu Oto ; Wataru Kubota ; Yoshinori Kobayashi ; Tsuyoshi Sogo ; Fumiko Tanaka
Medical Education 2013;44(4):261-263
We describe a prototype seminar, inspired by the problem-based learning tutorial system, on pediatric emergency practice for young physicians working in 7 pediatric emergency centers in Yokohama. The seminar was received favorably by the participants, especially as an opportunity for individual learning. We expect that the seminar will contribute to the standardization of emergency practice in these pediatric centers and the establishment of an interhospital network.
5.A Case of Vasculo-Behçet's Disease Complicated by an Intracardiac Thrombus
Takashi Igarashi ; Hirono Satokawa ; Shinya Takase ; Yoshiyuki Sato ; Tsuyoshi Yamabe ; Hitoshi Yokoyama
Japanese Journal of Cardiovascular Surgery 2011;40(3):115-119
We report a rare case of vasculo-Behçet's disease complicated by an intracardiac thrombus. A 48-year-old woman with a history of Behçet's disease and deep vein thrombosis in a lower limb, and who had been treated with colchicine and warfarin, was given a diagnosis of an appendectal tumor by colonoscopy. Preoperative examinations, including chest computed tomography, showed a pedunculated mobile tumor from her inferior vena cava (IVC) to the right atrium (RA). Urgent surgery was performed to prevent pulmonary embolism. We exposed the RA through a median sternotomy under cardiopulmonary bypass and extirpated the tumor that appeared macroscopically to be an organized thrombus attached to the IVC wall. The pathological diagnosis was organized thrombus. A month later, she underwent ileocecal resection and was given a pathological diagnosis of mucinous cystadenoma. Her postoperative course was uneventful. Intracardiac thrombus complicated by vasculo-Behçet's disease is rare, and it is important in the differential diagnosis of intracardiac tumor.
6.An Operative Case of Primary Cardiac Angiosarcoma of the Left Atrium.
Manabu Sato ; Shinya Higuchi ; Yukio Kosako ; Hisao Suda ; Yuji Katayama ; Tsuyoshi Ito
Japanese Journal of Cardiovascular Surgery 1998;27(5):331-334
Primary cardiac tumors are comparatively rare. Primary cardiac angiosarcoma is the most common cardiac malignant tumor and the most common site of this tumor is in the right atrium. It is usually difficult to diagnose and treat this condition before death. The present case of primary cardiac angiosarcoma was located in the left atrium, which is very rare. A cardiac malignant tumor was suspected in this 56-year-old man based on chest MRI examination. The operation was performed successfully but its outcome was very poor.
7.Two-Staged Operation for Multiple Aortic Aneurysm.
Etsuro Suenaga ; Hisao Suda ; Yuji Katayama ; Manabu Sato ; Noriko Yamada ; Tsuyoshi Itoh
Japanese Journal of Cardiovascular Surgery 2000;29(6):396-399
A 69-year-old man was admitted for treatment of thoracic aneurysm. DSA revealed multiple aortic aneurysms: three true aneurysms which were located at the distal arch, the thoraco-abdominal aorta at the diaphragm level and the infrarenal abdominal aorta, 60mm, 55mm and 55mm in diameter, respectively and two pseudo-aneurysms which were located in the abdominal aorta just below the right renal artery and the right common iliac artery. We decided to perform a two-staged operation. Before the first operation, 1, 200ml of autologous blood was stored for perioperative blood transfusion. Initially, total arch replacement was performed using deep hypothermic circulatory arrest and antegrade selective cerebral perfusion. One month after the first operation, total thoraco-abdominal aorta replacement was performed by a retroperitoneal approach with mild hypothermia. The Th 9, 10 and 11 intercostal arteries were reconstructed. Distal anastomosis was performed at both common iliac arteries. Blood transfusion was not required for blood pooling and reduction of priming volume in the cardiopulmonary bypass system.
8.Determinants of One-year Response of Lumbar Bone Mineral Density to Alendronate Treatment in Elderly Japanese Women with Osteoporosis.
Jun IWAMOTO ; Tsuyoshi TAKEDA ; Yoshihiro SATO ; Mitsuyoshi UZAWA
Yonsei Medical Journal 2004;45(4):676-682
The purpose of this study was to determine factors that could predict the one-year response of the lumbar bone mineral density (BMD) to alendronate treatment in elderly Japanese women with osteoporosis. Eighty-five postmenopausal women with osteoporosis, all of whom were between 55-88 years of age, were treated with alendronate (5 mg daily) for 12 months. Serum calcium, phosphorus, and alkaline phosphatase (ALP) and urinary NTX levels were measured at the baseline and 6 months, and lumbar (L1-L4) BMD was measured by dual energy X-ray absorptiometry at the baseline and 12 months. Multiple regression analysis was used to determine factors that were correlated with the percent change in lumbar BMD at 12 months. Lumbar BMD increased by 8.1 % at 12 months with a reduction in the urinary NTX level by 51.0 % at 6 months. Baseline lumbar BMD (R2=0.226, p< 0.0001) and percent changes in serum ALP and urinary NTX levels (R2=0.044, p< 0.05 and R2=0.103, p< 0.001, respectively) had a negative correlation with the percent change in lumbar BMD at month 12, while the baseline number of prevalent vertebral fractures (R2=0.163, p< 0.001), serum ALP level, and urinary NTX level (R2=0.074, p< 0.05 and R2=0.160, p< 0.001, respectively) had a positive correlation with it. However, baseline age, height, body weight, body mass index, years since menopause, serum calcium and phosphorus levels, and percent changes in serum calcium and phosphorus levels at 6 months did not have any significant correlation with the percent change in lumbar BMD at 12 months. These results suggest that lumbar BMD was more responsive to one-year of alendronate treatment in elderly osteoporotic Japanese women with lower lumbar BMD, more prevalent vertebral fractures, and higher bone turnover, who showed a greater decrease in bone turnover at 6 months, regardless of age, years since menopause, and physique. Alendronate may be efficacious in elderly Japanese women with evident osteoporosis that is associated with high bone turnover, and the percent changes in serum ALP and urinary NTX levels at 6 months could predict the one-year response of lumbar BMD to alendronate treatment.
Aged
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Aged, 80 and over
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Alendronate/*administration & dosage
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Alkaline Phosphatase/blood
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Bone Density/*drug effects
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Calcium/blood
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Collagen/urine
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Densitometry, X-Ray
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Female
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Humans
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Incidence
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Japan
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*Lumbar Vertebrae/radiography
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Middle Aged
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Osteoporosis, Postmenopausal/*drug therapy/epidemiology/radiography
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Peptides/urine
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Phosphorus/blood
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Spinal Fractures/epidemiology/prevention & control
9.Effects of Risedronate on Osteoarthritis of the Knee.
Jun IWAMOTO ; Tsuyoshi TAKEDA ; Yoshihiro SATO ; Hideo MATSUMOTO
Yonsei Medical Journal 2010;51(2):164-170
The purpose of the present study was to discuss the effects of risedronate on osteoarthritis (OA) of the knee by reviewing the existing literature. The literature was searched with PubMed, with respect to prospective, double-blind, randomized placebo-controlled trials (RCTs), using the following search terms: risedronate, knee, and osteoarthritis. Two RCTs met the criteria. A RCT (n = 231) showed that risedronate treatment (15 mg/day) for 1 year improved symptoms. A larger RCT (n = 1,896) showed that risedronate treatment (5 mg/day, 15 mg/day, 35 mg/week, and 50 mg/week) for 2 years did not improve signs or symptoms, nor did it alter radiological progression. However, a subanalysis study (n = 477) revealed that patients with marked cartilage loss preserved the structural integrity of subchondral bone by risedronate treatment (15 mg/day and 50 mg/week). Another subanalysis study (n = 1,885) revealed that C-terminal crosslinking telopeptide of type II collagen (CTX-II) decreased with risedronate treatment in a dose-dependent manner, and levels reached after 6 months were associated with radiological progression at 2 years. The results of these RCTs show that risedronate reduces the marker of cartilage degradation (CTX-II), which could contribute to attenuation of radiological progression of OA by preserving the structural integrity of subchondral bone. The review of the literature suggests that higher doses of risedronate (15 mg/day) strongly reduces the marker of cartilage degradation (CTX-II), which could contribute to attenuation of radiological progression of OA by preserving the structural integrity of subchondral bone.
Animals
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Calcium Channel Blockers/pharmacology/*therapeutic use
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Cartilage/drug effects
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Diphosphonates/therapeutic use
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Etidronic Acid/*analogs & derivatives/pharmacology/therapeutic use
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Humans
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Osteoarthritis, Knee/*drug therapy
10.Efficacy of Oral Etidronate for Skeletal Diseases in Japan.
Jun IWAMOTO ; Tsuyoshi TAKEDA ; Yoshihiro SATO
Yonsei Medical Journal 2005;46(3):313-320
Etidronate is an oral bisphosphonate compound that is known to reduce bone resorption through the inhibition of osteoclastic activity. The efficacy of etidronate for involutional (postmenopausal and senile) and glucocorticoid-induced osteoporosis, as well as that for other skeletal diseases, was reviewed in Japanese patients. Cyclical etidronate treatment (200 mg or 400mg/day for 2 weeks about every 3 months) increases the lumbar bone mineral density (BMD) in patients with involutional osteoporosis and prevents incident vertebral fractures in patients with glucocorticoid-induced osteoporosis. The losses of the lumbar BMD in patients with liver cirrhosis and the metacarpal BMD in hemiplegic patients after stroke are prevented, and the lumbar BMD is possibly increased, preventing fragile fractures in adult patients with osteogenesis imperfecta type I. Furthermore, proximal bone resorption around the femoral stem is reduced and some complications may be prevented in patients who undergo cementless total hip arthroplasty. Oral etidronate treatment may also help to transiently relieve metastatic cancer bone pain followed by a decrease in abnormally raised bone resorption in patients with painful bone metastases from primary cancer sites, such as the lung, breast and prostate. Thus, oral etidronate treatment is suggested to be efficacious for osteoporosis, as well as other skeletal diseases associated with increased bone resorption, in Japanese patients. Randomized controlled trials needed to be conducted on a large number of patients to confirm these effects.
Administration, Oral
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Bone Diseases/*drug therapy
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Etidronic Acid/*administration & dosage
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Humans
;
Japan