2.Prevalence of Metabolic Syndrome in Rural Populace: A Study of Its Association With Adipocytokines
Hiroyuki OHBAYASHI ; Hirohiko YAMASE ; Shiro KAWASHIMA ; Koutarou HAYASHI ; Hiroyuki NOSAKA ; Takashi HIRAISHI
Journal of the Japanese Association of Rural Medicine 2006;55(5):449-458
The purpose of this study was to shed light on the prevalence of the metabolic syndrome (MetS) in a rural community and examine whether or not serum adipocytokine levels are associated with the Diagnostic Criteria for MetS and how many MetS components laid down in the standards subjects have. The subjects were 2,858 people (1,744men and 1,114 women, mean age 49.8+/-9.9 yrs) who had participated in our health screening program between April and December, 2005. After obtaining informed consent from them, we measured serum leptin, adiponectin and high-sensitivity C-reactive protein levels, while performing routine blood tests. In the present study, these measurements were used in combination with the number of MetS components applicable to the conditions of our subjects. Two hundred men (11.5%) and 25 women (2.2%) were diagnosed with MetS. The number of MetS women was extremely small. Those women who were above the standard waist circumference of above 90cm accounted for 8.7% of the total. Thus, most women subjects were excluded as MetS candidates here. The leptin levels of the MetS group were higher than those of the non-MetS group in accordance with the number of applicable components in the diagnostic standards for MetS. Especially, the MetS group which met three MetS criteria showed significantly high leptin levels (p/5=0.0081) of 5.26+/-1.86 (ng/ml) compared to 3.31+/-1.44 (ng/ml) of the non-MetS group with waist circumference below 85cm. On the other hand, no significant difference was noted between the groups in adiponectin level. However, in contrast to leptin levels, adiponectin levels were lower in the group having three MetS components than the non-MetS group 4.37+/-1.57 (ng/ml) as against 5.52+/-3.34 (ng/ml). High-sensitivity CRP levels did not show any significant difference between the two groups.As regards the cutoff value of women's waist circumference, further study needs to be done. It was suggested that serum leptin levels might be closely related to the diagnostic criteria for MetS and the number of MetS components applicable.
Human Females
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Leptin
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ng/mL
;
seconds
;
adiponectin
3.Improvement of NASH with two-year treatment with oral polyenephosphatidylcholine
Hiroyuki Ohbayashi ; Masao Fujimoto ; Hirohiko Yamase ; Masafumi Ito
Journal of Rural Medicine 2006;2(1):67-73
A 46-year-old female patient with non-alcoholic steatohepatitis (NASH) was administered nateglinide, an insulin secretagogue, for 7 months, and then polyenephosphatidylcholine, an anti-oxidant medication, in accordance with the two-step hypothesis of NASH, with insulin resistance as the initial pathogenesis and oxidative stress as the second. HOMA-R, an index of insulin resistance, improved, and hepatic marker levels improved markedly by four weeks after initiation of polyenephosphatidylcholine. The beneficial effects of treatment continued over the 24 months of the study. A liver biopsy evaluated using Brunt's criteria showed improvement from stage 2 to stage 0 after 9 months. These findings suggest the therapeutic efficacy of step by step treatment of NASH in accordance with the two-stage hypothesis.
therapeutic aspects
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month
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Diagnostic Neoplasm Staging
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agreement
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Oral
4.Evaluation of the Appropriateness of the Japanese Metabolic Syndrome Diagnostic Criteria on Routine Medical Health Checkups in a Rural Area.
Hiroyuki Ohbayashi ; Takayuki Naruse ; Masaki Yamada ; Koutaro Hayashi ; Sirou Kawashima ; Hiroyuki Nosaka ; Hirohiko Yamase
Journal of Rural Medicine 2005;1(2):2_30-2_35
Objective: The diagnostic criteria for the metabolic syndrome (MetS) were published in Japan in April 2005. However, there have been no large-scale studies in rural areas to confirm these criteria. We examined the prevalence of MetS in subjects who had undergone a routine medical health checkup at our hospital, located in a rural area. This data was used to investigate the appropriateness of the diagnostic criteria for MetS.Subjects and Methods: The MetS status was examined retrospectively in 2340 subjects (1408 men, 932 women ; mean age 49.6 ± 9.7 years) who underwent a routine medical health checkup at our hospital between April 2004 and March 2005.Results: Of the 1408 men and 932 women, 209 men (14.8%) and 23 women (2.5%) were diagnosed with MetS. Forty-four men (3.1%) and 4 women (0.4%) met all three diagnostic criteria for metabolic disorders. In the female group, only 8.7% of the 932 women met the waist circumference criterion of ≥90 cm. Because this waist circumference criterion was used during the first screening but was not met by most of the women, they were eliminated from our study. Using receiver operating characteristic (ROC) analysis, the cutoff values for waist circumference were 85.0 cm (sensitivity 0.750, specificity 0.564) in men and 79.5 cm (sensitivity 0.787, specificity 0.709) in women. If the women's waist circumference criterion had been set at the value of ≥79.5 cm, this would have resulted in 48 (5.2%) women meeting the criterion.Conclusion: From the viewpoint of preventive medicine, the Japanese male MetS diagnostic criteria are fairly appropriate. However, for the women, the waist circumference criterion of ≥90 cm has been set too high and was not met by most of the female subjects. Therefore, the Japanese MetS criteria for women, particularly the cutoff value for waist circumference, requires further verification.
Human Females
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Male population group
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diagnostic criteria
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Japanese language
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Health
5.Effects of Vaccination Against Influenza Administered by Our Hospital: A 3-Year Retrospective Study
Hiroyuki OHBAYASHI ; Takenori HARADA ; Fusao HIRAI ; Tsugiyou MATSUSHITA ; Satoru FURUTA ; Akira SASAKI ; Hiroyuki NOSAKA ; Hirohiko YAMASE
Journal of the Japanese Association of Rural Medicine 2005;54(5):749-755
To review the outcome of our vaccination program against influenza, an investigation was made into the incidence of this acute infectious disease in our community from 2002 through 2004.Enrolled for this retrospective study were 1) all vaccinated individuals, 2) those who underwent nasal examinations by use of the swab, and 3) patients diagnosed as contracting influenza.The number of those administered with influenza virus vaccines increased year after year during the period under review. Over 70% of them were those aged 65years or above. The mean age of those who caught influenza was 42.9±21.3 in 2002, 34.9±20.4 in 2003 and 45.4±20.2 in 2004. Compared with unvaccinated old people, many unvaccinated young and middle-aged people contracted influenza, but among the vaccinated old people, there were some who came down with the flu.Morbidity was low for the old people whose vaccination rate was high.Therefore, it can be said that vaccination was effective in achieving adequate immunity. Nonetheless, for all the preventive injection, the fact that people of advanced age could be infected should be taken note of.
Influenza
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Vaccination
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Retrospective Studies
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Review [Publication Type]
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Hospitals
6.2005 Questionnaire Survey on Non-Smoking at Public Places, Schools, Nursery Schools and Post Offices in Mizunami (Comparison with 2004 Survey)
Tetsuo HATTORI ; Hiroyuki OHBAYASHI ; Masanori NISHIO ; Hirohiko YAMASE
Journal of the Japanese Association of Rural Medicine 2005;54(5):756-761
This paper reports the findings of a follow-up survey on non-smoking carried out in 2005. The previous survey was conducted in 2004 by distributing questionnaires to public facilities, schools, nursery schools and post offices in Mizunami. Method:The questionnaires consisted of the same questions as the previous ones and were sent to the same 64 facilities. Results:The questionnaires were recovered from 59 facilities(92.2%). Compared with the results of the previous survey, the number of public facilities, schools, offices and resting rooms where smoking is totally prohibited increased. In post offices, smoking corners disappeared. Progress was also made remarkably in division of public space and a workplace into smoking and nonsmoking areas. The smoking ratio of employees in these facilities surveyed decreased from 20% to 17%. Conclusion:Our survey confirmed that nonsmoking has steadily won public acceptance in a matter of one year.
Surveys
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Smoking
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public
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Schools, Nursery
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After values
7.A Survey of Attitude to Iyaku Bungyo Separation of Dispensing from Medical Practice
Masanori NISHIO ; Hirotsune ITATSU ; Izumi TSUYAMA ; Michiko ITO ; Hiroko AKITA ; Hirohiko YAMASE
Journal of the Japanese Association of Rural Medicine 2004;53(1):38-45
Iyaku Bungyo means separation of dispensing from medical practice. Under this system, physicians provide outpatients with prescriptions, if need be, after examinations. The patients visit neighborhood drugstores and produce the prescriptions to pharmacists, who are authorized to accept patients covered by health insurance and to make up prescriptions. The prescribed medicines will be given to the patients in exchange for the payment. The pharmacists will also instruct the customers how to take in the prescribed medicines properly. The system has been so designed as to improve the quality of health care services with the physicians and pharmacists performing their respective roles as the specialists. However, the government office is promoting the Iyaku Bungyo system in favor of the pharmacies outside the hospitals in the name of the containment of medical costs, charging that the medical institutions prescribe and dispense so many kinds and quantities of medicines the patients can hardly take in, simply to make large profits from a comfortable margin between the market price for each pharmaceutical and the price at which it is actually purchased. Ministry of Health, Labor and Welfare officials and insurers have trumpeted the system as if it were an ideal scheme to curb health care costs. In reality, however, medical expenses have been boosted up. It can be taken for granted that the expenditure on national health care is increasing year after year with the population of the elderly on the rise and progress in medical technology. Notwithstanding, it is an important task to hold down increases in the cost of health care with the advent of an era of an aging population.
Marital separation
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experience (practice)
;
Medical
;
Health Care
;
Surveys
8.Danger of Saponated Cresol Solution in the Tohno Area ;
Hiroyuki OHBAYASHI ; Masanori NISHIO ; Misao ANDO ; Masaki YOSHIDA ; Hiroyuki NOSAKA ; Hirohiko YAMASE
Journal of the Japanese Association of Rural Medicine 2004;53(4):660-665
We experienced a clinical case of a patient with psychotic depression who ingested the residual saponated cresol solution from a 500ml bottle of cresol, a disinfectant, with the intention of committing suicide. Through this experience, we felt it neccessary to investigate the present commercial situation of cresol for domestic use, and to come up with some safty measares.All the 128 drugstores and pharmacies in four cities located in the Tohno area of Gifu Pref. (Mizunami, Toki, Tajimi and Ena) were queried by telephone about the sale and stock of cresol.Almost 80% of the drugstores in these four cities, excluding pharmacies, were found to deal in saponated cresol solutions. They carried a little more than two 500ml bottles of cresol on average. This volume exceeds an estimated adult lethal dose of 250ml.Although it is unlikely that an ordinary household will use the whole of 500ml bottle of the disinfectant at a time, the residual saponated cresol solution could increase the risk of accidental cresol poisoning at home.So, it would be desirable not to sell 500ml bottles in ordinary drugstores. Furthermore, before selling a bottle of cresol, the pharmacists, who have a specialized knowledge about it, should kindly explain to the user about its toxicity and usage.
cresol
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Solutions
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Area
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Disinfectants
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Cancer patients and suicide and depression
9.Results of Questionnaire Survey on Cigarette Smoking in Public Facilities
Hiroko AKITA ; Hiroyuki OBAYASHI ; Masanori NISHIO ; Hirohiko YAMASE
Journal of the Japanese Association of Rural Medicine 2004;53(5):783-788
To investigate the attitude of personnel at public facilities toward cigarette smoking, a poll was taken at 27 municipal facilities, 14 schools, 15 nursery schools, and 10 post offices in Mizunami City. Questionnaires were distributed to a total of 936 employees, asking them whether they smoke and whether their workplaces are divided into smoking and nonsmoking areas.All the questionnaires were collected, with the names of facilities entered. Of the pollees, 20.0% was found smokers. At about 80% of the facilities surveyed, smoking was prohibited at offices and resting rooms for employees. As it turned out, nosmoking zones were limited to only 30% of public space utilized by citizens. At most of the nursery schools surveyed, smoking was banned, but in many schools, smoking was not prohibited in the resting rooms for the teaching and clerical staff. Post offices, compared to the other facilities surveyed, were too lax in regulating smoking. The survey also found that less than half of the facilities have a good knowledge of Article 25 of the Health Promotion Law.The findings of the latest survey were such that we deemed it necessary to conduct more positively a campaign against smoking in public facilities open to local residents.
Smoking
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Surveys
;
cigarette smoking
;
seconds
;
Questionnaires
10.Screening for Colon Cancer---Present Situation and Problems Confronting Gifu Prefecture
Journal of the Japanese Association of Rural Medicine 2003;52(5):812-816
As a health care measure for the people in the prime of life, the Ministry of Health and Welfare (now the Ministry of Health, Labor and Welfare) of the Japanese government started off the first 5-year program for the senior citizens in 1983 with the enforcement of the Law Concerning Health and Medical Services for the Aged, followed by the second five-year program in 1988 and the third eight-year program in 1992. The screening project for colon cancer was incorporated in the third program with a target set of holding an increasing rate of morbidity at zero in a year-to-year comparison. The response rate to colon cancer screening (the ratio of the number of participants responding to colon cancer screening to the total number of qualified persons) was also to be raised steadily to reach a target of 30% in 1999. In Gifu Prefecture, the total number of examinees in 1999 increased twice the figure in 1992, but the response rate was 14.8%, which was only about half the target and below the national average of 15.3%. The detection ratio of colon cancer and the early cancer ratio in the prefecture were much the same as the national average. It could be taken that there is nothing wrong as far as the precision of screeming and management are concernd. To decrease the rate of mortality from cancer of the colon, the most important is to raise the response rate. For this purpose, we would like to propose that the cost should be covered by national health insurance in those health screening projects approved of by the competent authorities.
Malignant tumor of colon
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Aspects of disease screening
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Health
;
Cancer treatment response rate
;
Federal Government

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