Risk of haemolytic uraemic syndrome caused by shiga-toxin-producing Escherichia coli infection in adult women in Japan.

Shiga-toxin-producing Escherichia coli (STEC) infections usually cause haemolytic uraemic syndrome (HUS) equally in male and female children. This study investigated the localization of globotriaosylceramide (Gb3) in human brain and kidney tissues removed from forensic autopsy cases in Japan. A fatal case was used as a positive control in an outbreak of diarrhoeal disease caused by STEC O157:H7 in a kindergarten in Urawa in 1990. Positive immunodetection of Gb3 was significantly more frequent in female than in male distal and collecting renal tubules. To correlate this finding with a clinical outcome, a retrospective analysis of the predictors of renal failure in the 162 patients of two outbreaks in Japan was performed: one in Tochigi in 2002 and the other in Kagawa Prefecture in 2005. This study concludes renal failure, including HUS, was significantly associated with female sex, and the odds ratio was 4·06 compared to male patients in the two outbreaks. From 2006 to 2009 in Japan, the risk factor of HUS associated with STEC infection was analysed. The number of males and females and the proportion of females who developed HUS were calculated by age and year from 2006 to 2009. In 2006, 2007 and 2009 in adults aged >20 years, adult women were significantly more at risk of developing HUS in Japan.

Liver cancer risk, coffee, and hepatitis C virus infection: a nested case-control study in Japan.

We examined hepatocellular carcinoma mortality in relation to coffee consumption and anti-hepatitis C virus (HCV) antibody seropositivity in a nested case-control study involving 96 cases. The multivariate-adjusted odds ratios (95% confidence interval) for daily coffee drinkers vs non-drinkers were 0.49 (0.25-0.96), 0.31 (0.11-0.85), and 0.75 (0.29-1.92) in all cases, in HCV-positive and in HCV-negative individuals, respectively.

The effect of interaction between hepatitis C virus and cigarette smoking on the risk of hepatocellular carcinoma.

We evaluated the interaction between hepatitis C virus (HCV) and cigarette smoking on death from hepatocellular cancer in The Japan Collaborative Cohort Study. The odds ratio of death from HCC for smoking was 9.60 (1.50-61.35) and 1.71(0.58-5.08) among anti-HCV positive and negative individuals, respectively.

Coffee and risk of death from hepatocellular carcinoma in a large cohort study in Japan.

We examined the relation between coffee drinking and hepatocellular carcinoma (HCC) mortality in the Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC Study). In total, 110,688 cohort members (46,399 male and 64,289 female subjects) aged 40-79 years were grouped by coffee intake into three categories: one or more cups per day, less than one cup per day and non-coffee drinkers. Cox proportional hazards model by SAS was used to obtain hazard ratio of HCC mortality for each coffee consumption categories. The hazard ratios were adjusted for age, gender, educational status, history of diabetes and liver diseases, smoking habits and alcohol. The hazard ratio of death due to HCC for drinkers of one and more cups of coffee per day, compared with non-coffee drinkers, was 0.50 (95% confidence interval 0.31-0.79), and the ratio for drinkers of less than one cup per day was 0.83 (95% confidence interval 0.54-1.25). Our data confirmed an inverse association between coffee consumption and HCC mortality.

Risk factors for fatality and neurological sequelae after status epilepticus in children.

Using multivariate regression analysis, we examined risk factors for fatality and neurological sequelae after status epilepticus (SE) in children. Possible risk factors included sex, age at onset, the cause of SE, pyrexia, asthmatic attack during SE, past history of seizure, predisposing neurological abnormality, seizure duration, type of seizure, and medication with theophylline. Consecutive patients with SE, aged 1 month to 18 years, who were referred to Tottori University Hospital from 1984 to 2002 were reviewed. Of the 234 patients enrolled, 45 patients (19.2 %) showed poor outcomes, namely early death in 9 and neurological sequela in 36. Acute neurological insult and progressive neurological disease as the cause of SE were very significantly related to poor outcome (OR = 33.68, p = 0.000). We excluded 21 patients with the etiology of acute neurological insult and progressive neurological disease and then reanalyzed risk factors in the remaining 213 patients. Twenty-nine patients (13.6 %) showed poor outcome, namely early death in 6 and neurological sequela in 23. Seizure duration of more than 2 hours (OR = 12.73, p = 0.000) and moderate to severe asthmatic attack (OR = 31.61, p = 0.010) were associated with poor outcome. These results indicate that long-lasting seizure activity and asthmatic attack can exacerbate SE-associated brain injury.

Current perception thresholds in vibration-induced neuropathy.

The authors evaluated the usefulness of current perception threshold testing for the assessment of vibration-induced neuropathy. The study population comprised 20 male controls and 59 males with hand-arm vibration syndrome. Current perception threshold at three test frequencies (i.e., 5 Hz, 250 Hz, and 2,000 Hz) was determined on the distal phalanges of the index and little fingers. Large myelinated fibers, small myelinated fibers, and unmyelinated fibers were evaluated selectively at 2,000-Hz, 250-Hz, and 5-Hz frequencies, respectively. The vibration-induced neuropathy groups had significantly increased current perception thresholds in both the index and little fingers. There was a significant increase in current perception threshold for the myelinated fibers, but not the unmyelinated fibers. The diagnostic sensitivity for vibration-induced neuropathy was relatively high. It appeared that current perception threshold evaluation was useful for the assessment of vibration-induced neuropathy.

Circulating adhesion molecules in patients with vibration-induced white finger.

We investigated whether a relationship existed between soluble adhesion molecules and vascular damage from vibration-induced white finger. Thirty-five men exposed to vibration and 40 healthy control subjects were examined. Concentrations of soluble E-selectin intercellular adhesion molecules, and vascular cell adhesion molecules in serum were measured with sandwich enzyme-linked adhesion immunosorbent assay. Neither E-selectin nor intercellular adhesion molecule levels are elevated in men exposed to vibration with white finger compared to levels in men exposed to vibration without white finger and control subjects. The serum level of soluble vascular cell adhesion molecules is significantly increased in patients with vibration-induced white finger.

Inhibited cold-induced vasodilatation in patients with vibration-induced white finger.

We investigated cold induced vasodilatation in 37 vibration-exposed men without vibration-induced white finger (VWF) and 20 men with VWF. The left third finger was dipped into a cooling box and was cooled with cold air of 5 degrees C for 15 min. Finger skin blood flow during the cold stimulus was measured using the laser-Doppler method. We observed that cold-induced vasodilatation was inhibited in patients with VWF and the cold air test was relatively useful for diagnosis VWF.

Toe systolic blood pressure after local cooling in primary Raynaud's phenomenon.

First toe systolic blood pressures (FTSBP) before and after first toe cooling were measured with the laser Doppler method in 17 normal women and 10 female patients with primary Raynaud's phenomenon (PRP). The room temperature was maintained at 26 degrees C. There was no significant difference in toe-arm systolic blood pressure ratio between the two groups. After toe cooling at 10 degrees C, the PRP group had a significantly greater reduction in FTSBP than the normal group. Measurement of FTSBP before and after toe cooling is a useful method for assessing Raynaud's phenomenon in the toes of patients with PRP.

[Estimated prevalence of presenile dementia in Tottori prefecture].

A questionnaire study of dementia in the age group of 40-64 years old was performed among all hospitals and clinics in Tottori prefecture. Response rate was 52.9% (hospitals 53.2%, clinics 52.4%). A total of 100 patients (from April 1992 to March 1993) were reported. The estimated prevalence rate of all dementia in the age group of 40-64 years old was 81.4 per 100,000 population. Cerebrovascular dementia accounted for half and Alzheimer's disease, intoxication and trauma accounted for 14.0%, 11.5%, and 10.8% of dementia in the age group of 40-64 years old, respectively. There were several other types of dementia but numbers were very few. The estimated prevalence rates of cerebrovascular dementia in the age groups of 40-49, 50-59, and 60-64 years old were 0, 47.9 (male 66.0, female 31.5) and 113.2 (male 184.5, female 51.5), respectively. Those of Alzheimer's disease in the age groups of 40-49, 50-59, and 60-64 years old were 0, 5.6 (male 4.2, female 6.9) and 47.5 (male 50.3, female 45.0), respectively.

Finger systolic blood pressure measurements after finger cooling. Using the laser-Doppler method for assessing vibration-induced white finger.

Finger systolic blood pressure (FSBP) measurements after finger and body cooling using a strain-gauge plethysmograph is a useful objective test for diagnosing Raynaud's phenomenon (RP). Body cooling, however, is uncomfortable to subjects. In this study, the measurements of FSBP after finger cooling without body cooling, using Digitmatic DM2000 (Medimatic) combined with laser-Doppler flowmetry (ALF2100 Advance), were performed in 99 vibration-exposed men (40 men without RP, 39 men with mild RP, and 20 men with severe RP) and 13 healthy controls. This method is relatively useful for assessing the severity of vibration-induced white finger (VWF).

Diagnostic value of finger systolic blood pressure in the assessment of vasospastic reactions in the finger skin of vibration-exposed subjects after finger and body cooling.

To assess the severity of vibration-induced white finger (VWF), finger systolic blood pressure (FSBP) after finger cooling and after combined finger and body cooling was measured by strain-guage plethysmography for 100 vibration-exposed men and 22 healthy men. The exposed men were classified as being without VWF (EW), with mild VWF (EM), and with severe VWF (ES) according to records of blanching attacks. FSBP was significantly reduced only in the ES group after finger cooling and in the ES and EM groups after both body and finger cooling. The diagnostic sensitivity and specificity for VWF was 81.7 and 90.3%, respectively. Skin temperature measurements before and after immersion in cold water (5 degrees C, for 10 min) could not be used for the estimation of VWF severity.

Response of capsaicin pretreated skin blood vessels to exercise.

Six normal men performed cycle ergometer exercise from 50 W to 125 W in a room maintained at 26 degrees C. Capsaicin was introduced by iontophoresis into the forearm skin. Forearm skin blood flow (FSBF) during graded exercises before and after capsaicin treatment was measured by laser Doppler flowmetry. Forearm skin blood flow before capsaicin treatment increased depending on the intensity of exercise. However, forearm skin blood flow 24 hours after capsaicin treatment scarcely increased during graded exercise. The cause of this capsaicin effect was discussed.