Glucagon-like peptide-1 receptor agonist ameliorates renal injury through its anti-inflammatory action without lowering blood glucose level in a rat model of type 1 diabetes.

AIMS/HYPOTHESIS: Glucagon-like peptide-1 (GLP-1) has various extra-pancreatic actions, in addition to its enhancement of insulin secretion from pancreatic beta cells. The GLP-1 receptor is produced in kidney tissue. However, the direct effect of GLP-1 on diabetic nephropathy remains unclear. Here we demonstrate that a GLP-1 receptor agonist, exendin-4, exerts renoprotective effects through its anti-inflammatory action via the GLP-1 receptor without lowering blood glucose. METHODS: We administered exendin-4 at 10 µg/kg body weight daily for 8 weeks to a streptozotocin-induced rat model of type 1 diabetes and evaluated their urinary albumin excretion, metabolic data, histology and morphometry. We also examined the direct effects of exendin-4 on glomerular endothelial cells and macrophages in vitro. RESULTS: Exendin-4 ameliorated albuminuria, glomerular hyperfiltration, glomerular hypertrophy and mesangial matrix expansion in the diabetic rats without changing blood pressure or body weight. Exendin-4 also prevented macrophage infiltration, and decreased protein levels of intercellular adhesion molecule-1 (ICAM-1) and type IV collagen, as well as decreasing oxidative stress and nuclear factor-κB activation in kidney tissue. In addition, we found that the GLP-1 receptor was produced on monocytes/macrophages and glomerular endothelial cells. We demonstrated that in vitro exendin-4 acted directly on the GLP-1 receptor, and attenuated release of pro-inflammatory cytokines from macrophages and ICAM-1 production on glomerular endothelial cells. CONCLUSIONS/INTERPRETATION: These results indicate that GLP-1 receptor agonists may prevent disease progression in the early stage of diabetic nephropathy through direct effects on the GLP-1 receptor in kidney tissue.

Comparative study of the work load between one-man buses and two-man buses.

The differences in physiological and safety conditions of one-man buses and two-man buses were examined from the view point of occupational fatigue. This survey consisted of a work load study which included a time study, study of subsidiary behavior, auditory task, memory test, Galvanic Skin Response (GSR) and physiological function tests and a self-administered questionnaire which involved items concerning safety and subjective fatigue complaints. The visual and postural restrictions in the one-man bus were greater than in the two-man bus. The mental capacity of the one-man bus drivers was found to be less. Greater mental fatigue and stress were observed in the one-man bus. More subjective fatigue complaints were observed in the one-man bus. More cases of near accidents were observed in the one-man bus. From these results it was concluded that the one-man bus caused bus drivers a greater mental and physical work load.

[Relationship of AIDS-related knowledge with attitudes of nursing students toward HIV-infected persons].

The relationship of AIDS-related knowledge of nursing students to their attitude toward HIV-infected persons was examined, and the effect of a 90-minute educational seminar on their knowledge and attitudes was evaluated. A survey of 72 nursing students was performed in Kochi prefecture in October, 1992 using a questionnaire. Eighty-six mothers whose children received medical examinations at the health center of the surveyed area during the same period functioned as the control group. Although the students had more knowledge about HIV/AIDS, their attitudes toward HIV-infected persons were no more positive than those of the control group. However the higher their level of knowledge was, the more positive their attitudes toward people with AIDS were. Two items of knowledge: symptoms of infection and safety in sharing utensils appeared to be related to positive attitudes. Those students who thought that "the number of HIV-infected persons will rapidly increase" tended to respond that "they are worried about getting AIDS in the future"; "they will not change their attitudes to their HIV-infected friends"; and "the persons who got AIDS through coagulation factor products should be supported." The results also show that a seminar about HIV/AIDS that provides information in a short period of time is effective in reducing prejudice and improving attitudes toward HIV-infected persons.

2D electron temperature diagnostic using soft x-ray imaging technique.

We have developed a two-dimensional (2D) electron temperature (T(e)) diagnostic system for thermal structure studies in a low-aspect-ratio reversed field pinch (RFP). The system consists of a soft x-ray (SXR) camera with two pin holes for two-kinds of absorber foils, combined with a high-speed camera. Two SXR images with almost the same viewing area are formed through different absorber foils on a single micro-channel plate (MCP). A 2D Te image can then be obtained by calculating the intensity ratio for each element of the images. We have succeeded in distinguishing T(e) image in quasi-single helicity (QSH) from that in multi-helicity (MH) RFP states, where the former is characterized by concentrated magnetic fluctuation spectrum and the latter, by broad spectrum of edge magnetic fluctuations.

A comparative study of psychiatric services in Japan and England.

Psychiatric services in Japan and England are compared using government statistics. In Japan, the number of in-patients per 100,000 population has increased from the 1950s, while that of England has decreased since 1954. Since 1972 the prevalence of in-patients has been higher in Japan than in England. The admission rate is lower in Japan than in England, and there are more long-stay patients. Most Japanese in-patients are admitted compulsorily, whereas most are admitted voluntarily in England. The attendance at out-patient clinics is higher in Japan than in England, but there are far fewer day-hospital places in Japan. Differing government policies are the main reason for these differences.

Effects of consecutive night-shift work on health conditions among car-cleaners of super-express trains.

The Shinkansen Super-Express trains of the Japanese National Railways, the so-called bullet trains, run from early morning until late at night. Accordingly the car-cleaners of the Shinkansen must do late night shift work. A self-administered questionnaire survey including items about health and work conditions was given to 246 workers at Osaka Station, who were then divided into 3 groups: Group A consisted of 102 night workers working 5 successive days with 2 days off, Group B consisted of 124 alternate-day 24-hour workers working 3 days a week, while Group C included 20 day-workers working 6 days a week. A subjective fatigue inventory was administered before and after work for a week to 20 workers selected from each of three groups, group A, B above group D whose shift was 2 times 2 successive night shifts with one day off, and one holiday a week. The results of the questionnaire survey revealed that the rates of complaints such as gastroenteric disorders and general fatigue were the highest in group A. The results of the subjective fatigue inventory show a tendency for the number of complaints in group A and B to increase significantly after the last work shift of the week, but not in the case of group D. The authors demonstrated that there was a close relationship between patterns of night-shift work and various kinds of health problems, and concluded that to insert a day off on the third day of the group D shift was effective in reducing the work load.

[An epidemiological study on low back pain and occupational risk factors among clinical nurses].

Recently medical services and nursing system are being reformed due to high medical costs and shortage of clinical nurses. The shortage of clinical nurses influences not only their working conditions but also their own health problems. In European countries and the United States, low back pain (LBP) has been reported to be one of the most common and costly health problems among clinical nurses. To estimate the occupational risk factors of LBP among nurses, a questionnaire survey of LBP and occupational risk factors was carried out in 1987 on 947 clinical nurses and as well as on 300 female clerical workers of three local governments. First, to examine the prevalence and the magnitude of the problem, we analyzed several kinds of prevalence rates of LBP and its characteristics among nurses and clerical workers. Second, a case-control study was conducted to investigate the relationship between LBP and occupational risk factors. In analyzing occupational risk factors of LBP, odds ratios, age adjusted odds ratios and 95% confidence intervals were computed. Finally, to estimate simultaneously the effect of multiple risk factors of LBP and to confirm univariate age adjusted odds ratio analyses, several multivariate analyses were performed. Point, period (a month), and lifetime prevalence rates of LBP and prevalence rate of severe LBP among clinical nurses were significantly higher than those of clerical workers (p less than 0.05-0.001, respectively). Demographic and occupational items, such as being an assistant nurse (as opposed to a registered nurse), and working in certain departments (internal medicine, orthopedic surgery, neurosurgery, psychiatry, tuberculosis ward) showed significantly higher odds ratios for LBP (p less than 0.05-0.001, for all). Many items pertaining to working conditions connected with shift work, hospitalized conditions of patients, taking breaks and holidays, working postures, weight of patients and equipment lifting and moving, working environments and so on had significantly elevated age adjusted odds ratios (p less than 0.05-0.001, for all). Intensity of work loads estimated subjectively such as 'caring for patients who are in bed', 'supporting patients when transporting and bathing them', 'preparing drugs and injections, and treating', 'observing and monitoring patients' conditions', 'instructing and explaining procedure to patients and their family' and so on also had significantly elevated age adjusted odds ratios (p less than 0.05-0.001, for all). Moreover, many items on the problems connected with working life and interpersonal relationships showed significantly higher age adjusted odds ratios (p less than 0.05-0.001). In multivariate analyses, independent variables which made a significant contribution to the model were similar to the items which had significantly elevated age adjusted odds ratios.(ABSTRACT TRUNCATED AT 400 WORDS)

Studies on motion sickness caused by high curve speed railway vehicles. Evaluation of the swing and its effects on passengers and conductors.

The high curve speed railway vehicles (HCSRVs) of the Japanese National Railway have been operating since 1973 with the aim of increasing speed on ordinary routes with many curve track sections. Although the aim of increased speed has been attained, it has been pointed out that the swing of HCSRVs is stronger than that of ordinary-type trains and it may increase motion sickness among the passengers and conductors. In this study, the authors examined motion sickness symptoms among 119 passengers and 100 conductors of both trains with a self-administered questionnaire, and evaluated the vibration acceleration on the floor by using the 1/3 Octave Band Analyzer and the Fast Fourier Transform method (FFT). The results can be summarized as follows: There were more passengers and conductors suffering from motion sickness riding on HCSRVs than those on the control trains. HCSRVs had the peak values of vibration acceleration within the range of 0.5 Hz and 1 Hz at horizontal, although the control train showed them above 1.0 Hz. These results suggest that the high rates of subjective complaints of passengers and conductors riding on HCSRVs were affected by vibration acceleration of frequency lower than 1 Hz.