[Show abstract][Hide abstract] ABSTRACT: To clarify the prevalence and incidence of diabetes and to evaluate which risk factors are predictive of future diabetes in the general population of Okinawa, 1,690 residents were screened in 1989 and 758 were prospectively followed-up in 1999. Of the 1,690 residents surveyed in 1989 and 1, 163 in 1999, diabetes was found in 91 (5.4%) in 1989 and 52 (4.5%) in 1999. Residents with diabetes were significantly older, more likely to have significantly higher levels of HbA1c, fasting glucose, serum triglyceride, ALT, BMI, systolic blood pressure, and a history of hypertension than non diabetic residents, both in 1989 and 1999. 717 residents who did not have diabetes at the 1989 screening were re-examined in 1999. Among them, 17 (incidence rate 2.4%) had developed diabetes over the ten years. Multivariate logistic regression analysis showed HbA1c, BMI, and systolic blood pressure to be independent risk factors for newly developed diabetes (p < 0.0001, odds ratio; 28.1, p = 0.020, odds ratio; 1.21, p = 0.039, odds ratio; 1.04, respectively) after adjusting for age, sex, BMI, blood pressure, hystory of hypertension, HbA1c, fasting glucose, serum triglyceride, ALT, and y GTP. Our results showed that the prevalence and incidence of diabetes are low in the general population of the Yaeyama district of Okinawa and that elevated HbA1c level, even in the normal range, is one of the best predictors of diabetes. Following BMI and systolic blood pressure is important.
[Show abstract][Hide abstract] ABSTRACT: Cutaneous infections such as impetigo contagiosum (IC), molluscum contagiosum (MC) and herpes virus infection (HI) appear to be associated with atopic dermatitis (AD), but there are no reports of concrete epidemiological evidence.
We evaluated the association of childhood AD with these infections by conducting a population-based cross-sectional study.
Enrolled in this study were 1117 children aged 0-6 years old attending nursery schools in Ishigaki City, Okinawa Prefecture, Japan. Physical examination was performed by dermatologists, and a questionnaire was completed on each child's history of allergic diseases including AD, asthma, allergic rhinitis and egg allergy, and that of skin infections including IC, MC and HI, as well as familial history of AD.
In 913 children (AD; 132), a history of IC, MC or HI was observed in 45.1%, 19.7%, and 2.5%, respectively. Multiple logistic regression analysis revealed that the odds of having a history of IC were 1.8 times higher in AD children than in non-AD children. Meanwhile, a history of MC was significantly correlated to the male gender, but not to a personal history of AD. As for HI, we found no correlated factors in this study.
The lifetime prevalence of IC was indeed higher in young children with a history of AD.
Journal of dermatological science 10/2010; 60(3):173-8. · 3.71 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To analyze the efficacy and safety of a combination therapy of pegylated interferon (PEG-IFN) α-2b plus ribavirin (RBV) in older Japanese patients (65 years or older) infected with hepatitis C virus (HCV).
This multicenter study included 938 patients with HCV genotype 1 who received 1.5 μg/kg per week PEG-IFN α-2b plus RBV 600-1000 mg/d for 48 wk and 313 HCV genotype 2 patients who received this treatment for 24 wk.
At 24 wk after the end of combination therapy, the overall sustained virological response (SVR) for genotypes 1 and 2 were 40.7% and 79.6%, respectively. The SVR rate decreased significantly with age in each genotype, and was markedly reduced in genotype 1 (P < 0.001). Moreover, the SVR was significantly higher in patients with genotype 1 who were less than 65 years (47.3% of 685) than in those 65 years or older (22.9% of 253) (P < 0.001) and was higher in patients with genotype 2 who were less than 65 years (82.9% of 252) than in those 65 years or older (65.6% of 61) (P = 0.004). When patients received a dosage at least 80% or more of the target dosage of PEG-IFN α-2b and 60% or more of the target dosage of RBV, the SVR rate significantly increased to 66.5% in patients less than 65 years and to 45.2% in those 65 years or older (P < 0.001). Adverse effects resulted in treatment discontinuation more often in patients with genotype 1 (14.4%) than in patients with genotype 2 (7.3%), especially by patients 65 years or older (24.1%).
PEG-IFN α-2b plus RBV treatment was effective in chronic hepatitis C patients 65 years or older who completed treatment with at least the minimum acceptable treatment dosage.
World Journal of Gastroenterology 09/2010; 16(35):4400-9. · 2.43 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: After extensive discussion with the Fukuoka City government of measures for the prevention and control of the 2009 H1N1 influenza pandemic, Kyushu University Hospital organized the infection control teams of 39 hospitals in the Fukuoka City area in preparation for a possible outbreak. A facility was set up at Kyushu University Hospital for the screening of outpatients with fever, and those with influenza and an underlying disease or severe symptoms were admitted to the hospital. 37 (22%) of the 171 outpatients with fever were infected with the new strain of influenza, confirmed by rapid influenza antigen test and PCR: Of these 37 patients, 17 (45.9%) were negative by influenza antigen test. Other 37 patients (5 adults, 32 children) were admitted, all of whom were successfully treated with neuraminidase inhibitors and discharged with no aftereffects.
Nippon rinsho. Japanese journal of clinical medicine 09/2010; 68(9):1707-12.
[Show abstract][Hide abstract] ABSTRACT: Peripheral arterial disease (PAD) is associated with cerebrovascular disease, ischemic heart disease, and other cardiovascular disease. We investigated the prevalence of and factors related to PAD to clarify the relationship between PAD and carotid atherosclerosis in a cross-sectional population-based study.
The study included 2,402 (900 males and 1,502 females; mean+/-SD=64.9+/-10.9 years) of 3,862 residents of two Japanese rural areas who reported for a free health examination in 2005 or 2006. An ankle brachial index value < or =0.9 was considered to be PAD. The carotid artery intima-media thickness (CA-IMT) was measured by carotid ultrasound.
The prevalence of PAD was 1.71% (n=41) of all participants. The risk factors independently associated with a significantly higher risk of PAD, identified by multivariate analysis, are as follows: For males, age, dyslipidemia, and CA-IMT, and for females, age, waist circumference, and dyslipidemia.
The prevalence of PAD in Japan was confirmed to be lower than that of similar studies performed in other countries. PAD was strongly correlated with age and dyslipidemia in both sexes, carotid atherosclerosis in males, and abdominal fat in females.
Journal of atherosclerosis and thrombosis 07/2010; 17(7):751-8. · 2.93 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: There are insufficient data available on the efficacy and safety of lipid-lowering therapy for patients with dyslipidaemia complicated by multiple metabolic abnormalities.
This study aimed to examine the efficacy and safety of ezetimibe 10 mg/day administered to Japanese patients with dyslipidaemia.
This was a prospective study carried out at Kyushu University Hospital, Fukuoka, Japan. In one group, ezetimibe 10 mg/day alone was given to 33 patients for 12 weeks. In the other two groups, ezetimibe was given with an HMG-CoA reductase inhibitor (statin) to 13 patients for 12 weeks: pravastatin 10 mg/day (n = 7) or rosuvastatin 2.5 mg/day (n = 6). The main outcome measure was the effect of ezetimibe on low-density lipoprotein cholesterol (LDL-C) and other lipid levels from baseline to 12 weeks.
After 12 weeks of treatment, all groups showed marked reductions in mean +/- SD LDL-C level (from 155.4 +/- 22.0 mg/dL at baseline to 118.0 +/- 28.1 mg/dL, i.e. -37.4 mg/dL; p < 0.001). The mean reduction in LDL-C level with ezetimibe monotherapy was significantly greater in patients with impaired LDL-C metabolism, glucose metabolism or hypertension than in those without such abnormalities (-21.0% vs -8.4%, p < 0.01; -22.7% vs -9.5%, p < 0.05; and -22.5% vs -5.9%, p < 0.05; respectively). The reduction in LDL-C levels with ezetimibe monotherapy was also correlated with the number of metabolic abnormalities (rho = 0.426, p = 0.013).
Both ezetimibe monotherapy and combination therapy with ezetimibe and a statin were able to safely and effectively control LDL-C levels in Japanese patients with dyslipidaemia, including those with metabolic abnormalities.
Clinical Drug Investigation 01/2010; 30(3):157-66. · 1.70 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: An early virological response (EVR) after the start of interferon (IFN) treatment for chronic hepatitis C leads to a successful virological outcome. To analyze an association between sustained virological response (SVR) and EVR by comparing TaqMan with Amplicor assays in HCV genotype 1-infected patients treated with pegylated (PEG)-IFN alpha-2b plus ribavirin (RBV).
We retrospectively analyzed a total of 80 HCV genotype 1 patients (39 SVR and 41 non-SVR patients), who received an enough dosage and a complete 48-week treatment of PEG-IFN alpha-2b plus RBV. Serum HCV RNA levels were measured by both TaqMan and Amplicor assays for each patients at Weeks 2, 4, 8 and 12 after the start of the antiviral treatment.
Of the 80 patients with undetectable HCV RNA by Amplicor, 17 (21.3%) patients were positive for HCV RNA by TaqMan at Weeks 12. The quantification results showed that no significant difference in the decline of HCV RNA level between TaqMan and Amplicor 10-fold method assays within the initial 12 weeks of the treatment was found. However, the qualitative analysis showed significant differences of the positive predictive rates for SVR were found between TaqMan (100% at weeks 4 and 100% at weeks 8) and Amplicor (80.0% and 69.6%, respectively).
The COBAS TaqMan HCV assay is very useful for monitoring HCV viremia during antiviral treatment to predict a SVR in HCV genotype 1 patients.
[Show abstract][Hide abstract] ABSTRACT: Protein-losing enteropathy (PLE) is defined as a condition in which excess protein loss into the gastrointestinal lumen, due to various causes, is severe enough to produce hypoproteinemia and hypoalbuminemia. We report a 28-year-old Japanese woman with PLE. She had been diagnosed with AIDS and disseminated Mycobacterium avium complex (MAC) infection at age 26. Although highly active antiretroviral and antimycobacterial treatments helped her overcome this critical situation, 2 years after initiation of the treatments, she was readmitted to our hospital because of hypoalbuminemia and edema of the lower extremities, and she was diagnosed, by the use of double-balloon enteroscopy, with PLE due to intestinal lymphangiectasia (IL). The etiology was thought to be obstruction of the mesenteric and retroperitoneal lymphatic drainage systems by MAC lymphadenitis. Even with intensive antimycobacterial treatment, octreotide treatment as a long-acting somatostatin analogue, and a low-fat diet enriched with medium-chain triglyceride, IL was not cured during the follow-up period. In patients with AIDS, complete clinical remission of MAC (especially disseminated MAC) infection is very difficult.
Journal of Infection and Chemotherapy 09/2009; 15(4):252-6. · 1.38 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: An association has been demonstrated between Chlamydophila pneumoniae (C. pneumoniae) infection and atherosclerosis, but data on the relationship between C. pneumoniae DNA in peripheral blood mononuclear cells (PBMC) and antibodies to this organism are lacking. We investigated the C. pneumoniae DNA in PBMC by polymerase chain reaction (PCR) and C. pneumoniae IgG and IgA antibodies by enzyme-linked immunosorbent assay of 168 patients with atherosclerotic diseases and 27 controls (healthy control subjects). C. pneumoniae DNA was detected for 48/168 (29%) atherosclerosis patients, IgG for 79 (47%), and IgA for 98 (58%), whereas the corresponding numbers for the controls were 11 (41%), 13 (48%), and 7 (26%). There was no significant difference of the C. pneumoniae DNA positivity rate between the atherosclerosis patients and the controls. However, the C. pneumoniae IgA-positive rate was significantly higher for carotid atherosclerosis patients who had C. pneumoniae DNA in their PBMC than for those without it (74% vs. 18%, P < 0.05). Among the patients with coronary artery disease, the C. pneumoniae IgA antibody positive rate was significantly higher for the patients with DNA than for those without it (68% vs. 18%, P < 0.05). Our results suggest that a high C. pneumoniae IgA antibody titer and C. pneumoniae DNA positivity are associated with an increased risk of atherosclerotic diseases due to endovascular C. pneumoniae infection.
[Show abstract][Hide abstract] ABSTRACT: Atherosclerotic vascular diseases are a major cause of morbidity and mortality for end-stage renal disease patients. We followed prospectively 226 hemodialysis patients by carotid ultrasonography to determine if ultrasonographic markers are predictive of the prognosis of these patients. The end-point was death or completion of the five-year follow-up period. Fatal cerebrovascular and cardiovascular events were the most common cause of death. By multivariate analysis, diabetes mellitus (DM) (P = 0.005), plaque number (PN) by ultrasonography (P = 0.023), age (P = 0.001), calcium–phosphate product (P = 0.049), and serum albumin (P = 0.009) were extracted as independent risk factors. The five-year increase of PN was significantly greater for DM patients than for non-DM patients. Moreover, PN was an independent marker of a fatal event, irrespective of DM status. Our results suggest that PN may be a useful predictor of the long-term prognosis of hemodialysis patients.