Sumihisa Honda - Academia.edu (original) (raw)

Papers by Sumihisa Honda

Research paper thumbnail of Value of systematic intervention for chronic obstructive pulmonary disease in a regional Japanese city based on case detection rate and medical cost

International Journal of Chronic Obstructive Pulmonary Disease, 2015

We established a COPD taskforce for early detection, diagnosis, treatment, and intervention. We i... more We established a COPD taskforce for early detection, diagnosis, treatment, and intervention. We implemented a pilot intervention with a prospective and longitudinal design in a regional city. This study evaluates the usefulness of the COPD taskforce and intervention based on COPD case detection rate and per capita medical costs. We distributed a questionnaire to all 8,878 inhabitants aged 50-89 years, resident in Matsuura, Nagasaki Prefecture in 2006. Potentially COPD-positive persons received a pulmonary function test and diagnosis. We implemented ongoing detection, examination, education, and treatment interventions, performed follow-up examinations or respiratory lessons yearly, and supported the health maintenance of each patient. We compared COPD medical costs in Matsuura and in the rest of Nagasaki Prefecture using data from 2004 to 2013 recorded by the association of Nagasaki National Health Insurance Organization, assessing 10-year means and annual change. As of 2014, 256 people have received a definitive diagnosis of COPD; representing 31% of the estimated total number of COPD patients. Of the cases detected, 87.5% were mild or moderate in severity. COPD medical costs per patient in Matsuura were significantly lower than the rest of Nagasaki Prefecture, as was rate of increase in cost over time. The COPD program in Matsuura enabled early detection and treatment of COPD patients and helped to lower the associated burden of medical costs. The success of this program suggests that a similar program could reduce the economic and human costs of COPD morbidity throughout Japan.

Research paper thumbnail of Health-related quality of life among women in rural Bangladesh after surgical repair of obstetric fistula

International Journal of Gynecology & Obstetrics, 2015

To identify factors influencing health-related quality of life (QOL) among women in Bangladesh af... more To identify factors influencing health-related quality of life (QOL) among women in Bangladesh after successful surgical repair of obstetric fistula. In 2012, a cross-sectional study was conducted of women who had undergone a successful surgical repair of an obstetric fistula at a hospital in northwest Bangladesh between June 2005 and May 2012. Sociodemographic, obstetric, and fistula-related information was collected by interview. Health-related QOL was assessed using the 36-item Short Form Health Survey (SF-36). A total of 113 women were included. Linear regression analysis showed that discrimination experiences negatively affected four of the eight scales of SF-36, as well as both the physical and mental component summaries (P<0.05 for all). Married status had a positive effect on four scales and the mental component summary (P<0.05 for all). Age inversely affected two scales and the physical component summary (P<0.01 for all). Internalized stigma negatively influenced two scales (P<0.05 for both). Not having living children and experiencing two or more previous stillbirths negatively influenced one scale (P<0.05 for both). Several factors influence health-related QOL after obstetric fistula repair; a comprehensive approach is needed to address these issues.

Research paper thumbnail of Clinicoradiological outcomes of 33 cases of surgically resected pulmonary pleomorphic carcinoma: correlation with prognostic indicators

European Radiology, 2015

To retrospectively review the clinical, radiological and pathological data in patients who underw... more To retrospectively review the clinical, radiological and pathological data in patients who underwent surgical resection for pulmonary pleomorphic carcinoma (PC), and to analyse the prognostic predictors of survival. The data were retrospectively examined for 33 consecutive patients (28 males and five females) who had undergone surgical resection for pulmonary PC. Cox's proportional-hazards model was used to analyse the prognostic predictors of survival. The size of the tumours ranged from 1.1 to 12.0 cm (mean 5.4 cm). The majority (26) of the tumours were located at the lung periphery, five tumours had cavitation, two had calcification and 14 had peritumoral ground-glass opacity. Most of the tumours showed heterogeneous enhancement and contained a low-density area (LDA) within the tumour. The 5-year overall survival of surgically resected PC was 36 % (standard error = 0.093). A multivariate analysis revealed the LDA grade [hazard ratio (HR), 2.019], pathological stage (HR, 7.552) and pathological N factor (HR, 0.370) to be significant predictors of a poorer prognosis. A greater component of LDA within the tumour on contrast-enhanced CT is associated with a poorer prognosis in patients with PC. • PC has a poorer prognosis than other conventional NSCLC. • The five-year OS of surgically resected PC was 36 %. • A greater component of LDA on contrast-enhanced CT suggests a poorer prognosis.

Research paper thumbnail of The Impact of Multiple Roles on Psychological Distress among Japanese Workers

Safety and Health at Work, 2015

There has been considerable interest in Japanese society in the problem of work-related stress le... more There has been considerable interest in Japanese society in the problem of work-related stress leading to depressive symptoms, and an increasing number of primary houseworkers maintain paid employment. The purpose of this study was to examine the differential impact of multiple roles associated with psychological distress among Japanese workers. We studied 722 men and women aged 18-83 years in a cross-sectional study. The K10 questionnaire was used to examine psychological distress. The proportion of participants with psychological distress was higher in women (17.8%) compared with men (11.5%). Having three roles significantly decreased the risk of psychological distress [women: odds ratio (OR), 0.37-fold; men: OR, 0.41] compared with only one role. In working married women, there was significantly less psychological distress (OR, 0.27), and those with childrearing or caregiving responsibilities for elderly parents had significantly less psychological distress (OR, 0.38) than those with only an employment role. Similarly, working married men who had childrearing or caregiving responsibilities for elderly parents had significantly less psychological distress (OR, 0.41) than those who had only an employment role. The present study demonstrated that participants who had only an employment role had an increased risk of psychological distress. The degree of psychological distress was not determined solely by the number of roles. It is important to have balance between work and family life to reduce role conflict and/or role submersion, which in turn may reduce the risk of psychological distress.

Research paper thumbnail of Factors associated with the annual change in forced expiratory volume in 1 second of officially acknowledged victims of pollution-related illness in improved environments: a longitudinal study

Journal of Physical Therapy Science, 2015

[Purpose] We examined factors affecting annual change in pulmonary function in residents previous... more [Purpose] We examined factors affecting annual change in pulmonary function in residents previously exposed to air pollution in an area where pollution has been reduced and a long time period has elapsed. [Subjects and Methods] Data of 730 officially acknowledged victims of pollution-related illness from an annual survey during 2000 to 2009 were analyzed. The primary outcome was forced expiratory volume in 1 second (FEV1), along with factors such as age, body composition, smoking habits, respiratory symptoms, and classification of medical management (an index of the need for treatment). Multiple regression analyses were used to identify factors associated with the annual change in FEV1. [Results] Three significant factors were identified: smoking habit, classification of medical management, and gender. Smoking habits and classification of medical management had stronger effects on the annual change in FEV1 than gender. [Conclusion] With an improved environment, continuation of smoking accelerates the decline in FEV1.

Research paper thumbnail of Tobacco use among designated air pollution victims and its association with lung function and respiratory symptoms: a retrospective cross-sectional study

BMJ open, 2014

We sought to elucidate the long-term association of tobacco use and respiratory health in designa... more We sought to elucidate the long-term association of tobacco use and respiratory health in designated pollution victims with and without obstructive pulmonary defects. A retrospective cross-sectional study. The register of pollution victims in Kurashiki, Japan. 730 individuals over 65 years of age previously diagnosed with pollution-related respiratory disease. Patients were classified into four groups according to their smoking status and whether they had obstructive pulmonary disease. We then compared the prevalence of respiratory symptoms and lung function over time between groups. Spirometry was performed and a respiratory health questionnaire completed in the same season each year for up to 30 years. Rates of smoking and respiratory disease were high in our sample. Although respiratory function in non-smoking patients did not completely recover, the annual rate of change in lung function was within the normal range (p<0.01). However, smokers had worse lung function and were m...

Research paper thumbnail of Impact of aneurysm location on cardiopulmonary dysfunction after subarachnoid hemorrhage

Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 2014

Cardiopulmonary dysfunction may occur after aneurysmal subarachnoid hemorrhage (SAH), but its cha... more Cardiopulmonary dysfunction may occur after aneurysmal subarachnoid hemorrhage (SAH), but its characteristics have not been fully clarified. We investigated the impact of aneurysm location on systemic hemodynamics after SAH. This multicenter prospective cohort study measured hemodynamic parameters in relation to aneurysm location in patients with SAH using a single-indicator transpulmonary thermodilution system (PiCCO) on days 1-14. Of 204 subjects enrolled, 58 had aneurysms of the anterior communicating artery (ACA), 61 of the middle cerebral artery (MCA), 57 of the internal carotid artery (ICA), and 28 of the vertebrobasilar artery (VA/BA). Patient characteristics were similar except for predominance of coiling in the VA/BA. Patients with ACA aneurysm had a lower systemic vascular resistance index (SVRI) in the acute phase and afterload mismatch (lower cardiac index [CI] and higher SVRI) in the spasm phase. Those with ICA aneurysm had a lower CI in the acute phase, and those with ...

Research paper thumbnail of Physical Function Traits of Long-term Officially Acknowledged Victims of Pollution-related Illnesses Compared with Elderly Patients with Chronic Obstructive Pulmonary Disease

Journal of Physical Therapy Science, 2014

Purpose] To examine the long-term effects of air pollution on the physical functioning of a group... more Purpose] To examine the long-term effects of air pollution on the physical functioning of a group of officially acknowledged victims of pollution-related illnesses (Victims group) who were exposed to air pollution more than 50 years ago, we compared them with age-matched patients with chronic obstructive pulmonary disease (COPD group). [Subjects and Methods] The Victims group comprised 34 subjects and the COPD group 24, all of whom were aged over 65 years. Respiratory function, muscle strength, exercise capacity and physical activity were measured and compared between the groups.

Research paper thumbnail of Analysis for threshold levels of cadmium in urine that induce tubular dysfunction among women in non-polluted areas in Japan

International archives of occupational and environmental health, 2003

To examine if there is a threshold in urinary cadmium concentration that induces elevation in uri... more To examine if there is a threshold in urinary cadmium concentration that induces elevation in urinary microglobulins. The database developed in a previous field survey (Ezaki et al. 2002) was employed. In the survey conducted in 2000 and 2001, more than 10,000 middle-aged women (with no occupational exposure to Cd) in ten prefectures all over Japan gave morning spot urine samples, which were analyzed for cadmium (Cd-U), calcium (Ca-U), magnesium (Mg-U), zinc (Zn-U), alpha(1)- and beta(2)-microglobulins (alpha(1)- and beta(2)-MG-U), and creatinine (cr). The urinary analyte concentrations were corrected for cr concentration (to be expressed as, e.g., Cd-Ucr), and the data thus obtained were subjected to statistical evaluation. The largest geometric mean (GM) for Cd-Ucr among the ten prefecture was 3.2 microg Cd/g cr, and the maximum Cd-Ucr observed among the women studied was 20.9 microg Cd/g cr. Both alpha(1)-MG-Ucr and beta(2)-MG-Ucr increased as a function of the increase in Cd-Ucr...

Research paper thumbnail of No clear-cut evidence for cadmium-induced renal tubular dysfunction among over 10,000 women in the Japanese general population: a nationwide large-scale survey

International archives of occupational and environmental health, 2003

To examine whether environmental exposure to cadmium has been inducing kidney dysfunction among m... more To examine whether environmental exposure to cadmium has been inducing kidney dysfunction among middle-aged women in the general population in Japan. This study was conducted in 2000 and 2001. Morning spot urine samples were collected from 10,753 women (mostly aged 35 to 60 years) in ten prefectures all over Japan (thus about 1,000 women per site). Urine samples were analyzed for cadmium (Cd-U), calcium (Ca-U), magnesium (Mg-U), zinc (Zn-U), alpha(1)- and beta(2)-microglobulins (alpha(1)- and beta(2)-MG-U). The urinary analyte concentrations were corrected for creatinine (cr) concentration (i.e., Ucr). The data thus obtained were subjected to statistical evaluation by chi-square test, ANOVA, multiple comparison test, and simple regression analysis (SRA) as well as multiple regression analysis (MRA) including logistic regression analysis (LRA). Log-normal distribution was assumed for Cd-Ucr, alpha(1)-MG-Ucr and beta(2)-MG-Ucr, whereas normal distribution was considered for age, Ca-Uc...

Research paper thumbnail of Smoking Aggravates the Impaired Pulmonary Function of Officially Acknowledged Female Victims of Air Pollution of 40 Years Ago

The Tohoku Journal of Experimental Medicine, 2014

Air pollution due to industrial waste and tobacco smoke is detrimental to pulmonary function. How... more Air pollution due to industrial waste and tobacco smoke is detrimental to pulmonary function. However, the combined effects of air pollution and smoking on pulmonary function have not been investigated. We examined the combined effect of air pollution of 40 years ago and concurrent smoking on the pulmonary function of officially acknowledged female victims in Japan, because females are more susceptible to the adverse effects of both irritants than males. The subjects comprised 655 female victims living in one of two areas with air pollution of 40 years ago and 572 females living in an area without air pollution. All victims have been prescribed standard respiratory medications. Pulmonary function was measured in 2000 for air-pollution groups (130 smokers and 525 non-smokers; mean age, 68.4 years) and during the period of 2004 to 2013 for non-air-pollution groups (113 smokers and 459 non-smokers; mean age, 69.0 years). The smokers included both current smokers and ex-smokers. The victims with a history of smoking had significantly lower forced expiratory volume in 1 second (FEV1 % predicted) (mean, 74%) and significantly lower FEV1/forced vital capacity (FVC) (mean, 70%) than the other groups (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). Thus, smoking aggravates the pulmonary function in officially acknowledged female victims, despite the improved air pollution and the continuous medical care provided by the government. In conclusion, exposure to air pollution of 40 years ago and cigarette smoking are associated with reduced pulmonary function. These results highlight the importance of measures aimed at smoking cessation and limiting air pollution.

Research paper thumbnail of Secular trends of sizes at birth in Japanese healthy infants born between 1962 and 1988

Journal of physiological anthropology and applied human science, 2004

Body sizes at birth are important clinical indicators widely used for evaluation of prenatal grow... more Body sizes at birth are important clinical indicators widely used for evaluation of prenatal growth. Japan had significant socioeconomic improvement around the 1960s, and these environmental changes may influence physiologically prenatal growth. Furthermore, in Japan, measurements of size at birth for birth certificates are weight and height. Thus, we can refer to annual data on weight and height, but not on head and chest circumference at birth. In this study we measured the weight, height, and head and chest circumference at birth among 6,563 Japanese singleton healthy infants, annually in 1962 and 1988, and examined secular trends of these anthropometric measurements. The boys consistently exceeded the girls in all four variables. Birth weight and height increased significantly from the 1960s to '70s, but did not differ between the '70s and '80s in both boys and girls. Secular trends of head and chest circumference were different from them. In both boys and girls, hea...

Research paper thumbnail of Risk factors for malaria infection among ethnic minorities in Binh Phuoc, Vietnam

The Southeast Asian journal of tropical medicine and public health, 2009

A cross-sectional study was undertaken to identify the prevalence of malaria infection, behaviora... more A cross-sectional study was undertaken to identify the prevalence of malaria infection, behavioral patterns of inhabitants and risk factors for malaria infection in a minority village in an area endemic for malaria in Vietnam. The target population were all the inhabitants of a village in Binh Phuoc Province, Vietnam. Interviews using a structured questionnaire and blood examination for malaria infection were conducted in house-to-house visits. Relationships between malaria infection and variables were examined using uni- and multivariate adjusted analysis. A total of 682 individuals from 159 households participated in both the interview and blood examinations. All households earned income through farming without forest activities at night, and the socio-economic status was generally not very low. The total prevalence of malaria infection was 6.2%, with a peak among 3- to 5-year-old children. Univariate analysis identified 3 - 5 year olds, a family size of > or =5 people, sleepin...

Research paper thumbnail of Air Pollution Irreversibly Impairs Lung Function: A Twenty-Year Follow-Up of Officially Acknowledged Victims in Japan

The Tohoku Journal of Experimental Medicine, 2013

Lung function is one of the strongest determinants of cardiopulmonary health and longevity. Long-... more Lung function is one of the strongest determinants of cardiopulmonary health and longevity. Long-term exposure to air pollution has been associated with decreased lung function. We undertook a retrospective study to compare the long-term consequences of air pollution in two areas of Japan: Mizushima, Okayama Prefecture and Kitakyushu, Fukuoka Prefecture. Industrialization began in Mizushima in the 1940s, whereas it began in Kitakyushu in the early 1900s. In Kitakyushu, levels of nitrogen dioxide have been higher compared to the Mizushima area. The subjects comprised 623 officially acknowledged victims of pollution-related illness (489 from Mizushima and 134 from Kitakyushu). All subjects were lifetime non-smokers and aged 65 years or older at the time of their last medical examination in 2009. Demographic data including diagnosed lung diseases and lung function at the time of certification assessment performed between 1973 and 1988 were obtained. The subjects from Kitakyushu were significantly younger (47.1 vs. 51.0 years, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001) and a higher percentage had asthma (91.2 vs. 36.8%, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001) compared to those from Mizushima. Furthermore, all measures of lung function were significantly lower in Kitakyushu group at the time of the certification assessment (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001) and at the follow-up (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). However, no significant differences were observed in the annual mean decline in lung function between the two groups, despite the overall decrease in air pollution. In conclusion, the normal lung function is not restored even after improvement of air pollution. It is essential for every city to prevent air pollution.

Research paper thumbnail of Effects of Lifestyle Factors on Stiffness Index of Calcaneus Measured by Quantitative Ultrasound Systemamong Japanese Women Aged 40 Years and Over: The Hizen-Oshima Study

The Tohoku Journal of Experimental Medicine, 2003

To explore how the stiffness index of the calcaneus is related to lifestyle factors, we examined ... more To explore how the stiffness index of the calcaneus is related to lifestyle factors, we examined the associations of lifestyle factors, age, and years since menopause, with stiffness index of the calcaneus among 573 community-dwelling Japanese women aged 40-89 years. Stiffness index of the calcaneus was obtained from quantitative ultrasound measurement. Body height and weight were measured, from which body mass index (BMI) was calculated. Physical activity index was calculated using a validated questionnaire. Dietary calcium intake and amount of ingested alcohol were estimated by a semiquantitative food frequency questionnaire. Current smoking status was obtained by questionnaire. In univariate analysis, stiffness index was positively related to physical activity index and BMI, and inversely to age and years since menopause, but not to dietary calcium intake. Stiffness index of drinkers and current smokers was not significantly different from that of non-drinkers and non-smokers, respectively. Among the natural menopausal women, multiple regression analysis showed that advancing age and years since menopause were associated with lower stiffness index, while higher physical activity index and greater BMI were associated with higher stiffness index. In conclusion, higher physical activity, in combination with adequate nutrition for weight maintenance, should be emphasized as a part of a healthy lifestyle in order to maintain bone health among middle-aged and elderly Japanese women.

Research paper thumbnail of Demographic and Reproductive Factors for High Seroprevalence of Chlamydia Trachomatis among Pregnant Women in Japan

The Tohoku Journal of Experimental Medicine, 2000

Research paper thumbnail of The prevalence and pattern of insomnia in Japanese industrial workers: Relationship between psychosocial stress and type of insomnia

Psychiatry and Clinical Neurosciences, 1998

We examined the prevalence of insomnia among Japanese male industrial workers and analyzed the ef... more We examined the prevalence of insomnia among Japanese male industrial workers and analyzed the effect of psychosocial stress on the prevalence of three types of insomnia: &#39;difficulty in falling asleep&#39;, &#39;frequent sleep interruption&#39; and &#39;early morning arousal&#39;. The study population consisted of male day workers (n = 319) in a manufacturing heavy industry company located in Nagasaki City, Japan. The subjects answered a questionnaire consisting of six sleep-related items and 24 questions related to occupational and private life conditions. A total of 271 men (average age 40.9 years) completed the questionnaire; a response rate of 85%. Insomnia within the month preceding the survey was present in 27.7% of the workers (75/271). Multiple logistic regression analysis demonstrated that different psychosocial stressors were associated with different types of insomnia. Visual display terminal (VDT) work overload was significantly associated with all types of insomnia, while &#39;over-involvement in the job&#39; was associated with difficulty in falling asleep and early morning arousal. Our results demonstrated that the prevalence of insomnia in Japanese workers is similar to that reported among European and American general adult population. Our results also indicate that the use of VDT in the workfield is associated with insomnia.

Research paper thumbnail of Mental health conditions among atomic bomb survivors in Nagasaki

Psychiatry and Clinical Neurosciences, 2002

To elucidate the effects of the bombing on the atomic bomb survivors' mental health, a mental hea... more To elucidate the effects of the bombing on the atomic bomb survivors' mental health, a mental health survey was conducted using a 12-item version of the General Health Questionnaire (GHQ-12) and a mail survey on atomic bomb exposure conditions and lifestyle using a selfadministered questionnaire. A total of 3526 atomic bomb survivors in Nagasaki responded and a high GHQ-12 score, as defined when the responses to four or more items were positive, was observed in 296 (8.4%) subjects. It was indicated that the risk of a high GHQ-12 score will decrease 0.98-fold with every 1-year increase in age, and will increase 1.45-fold and 1.70-fold in those who lost family members due to the bombing and those who had acute symptoms, respectively, compared with those who did not. It was indicated that the atomic bomb exposure has affected survivors' mental health and that the care of their mental health is important.

Research paper thumbnail of A Study of the Impact of Occupational and Domestic Factors on Insomnia among Industrial Workers of a Manufacturing Company in Japan

Occupational Medicine, 1996

... factors on insomnia among industrial workers of a manufacturing company in Japan H. Tachibana... more ... factors on insomnia among industrial workers of a manufacturing company in Japan H. Tachibana, T. Izumi, S. Honda, 1 I. Horiguchi, ... good) Socioeconomic dissatisfaction (yes vs. no) Pleasure of a happy home (never/seldom vs. often/always) Domestic troubles (yes vs. ...

Research paper thumbnail of A proposed method for the evaluation of body fat in Japanese adults that predicts obesity

Nutrition Research, 2011

The present study was designed to develop a simple predictive equation for the percent body fat (... more The present study was designed to develop a simple predictive equation for the percent body fat (%BF) in Japanese adults based on variables collected during health examinations. We hypothesized that a benchmark for defining metabolic syndrome and obesity could be based on %BF, which was measured by underwater weighing (UW) as a gold standard for body composition assessment. Thus, we developed a predictive equation for %BF derived from UW that may contribute to the assessment of obesity status, characterized by an excess accumulation of visceral or subcutaneous fat. The subjects were 810 Japanese participants (283 men, 527 women, ages 18-59 years). Anthropometric variables, including height, weight, 7 circumferences, and 8 skinfold thicknesses, were measured. The developed predictive equation was as follows: %BF = 10.558 × sex (1 for men; 2 for women) + 0.069 × age + 0.667 × body mass index + 0.314 × abdominal circumference - 35.881.The coefficient of determination (r(2)) was 0.69. The predicted %BF derived from this equation was highly correlated with UW-measured values and did not show underestimation or overestimation in either sex. These data suggested that this predictive equation for %BF can be used for all Japanese adults and does not require the use of medical equipment and special measurement techniques. By combining the equation for %BF developed in this study with a %BF cutoff value of metabolic syndrome and obesity (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;25.0% in men and &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;30.0% in women), all Japanese adults can easily and conveniently assess obesity status.

Research paper thumbnail of Value of systematic intervention for chronic obstructive pulmonary disease in a regional Japanese city based on case detection rate and medical cost

International Journal of Chronic Obstructive Pulmonary Disease, 2015

We established a COPD taskforce for early detection, diagnosis, treatment, and intervention. We i... more We established a COPD taskforce for early detection, diagnosis, treatment, and intervention. We implemented a pilot intervention with a prospective and longitudinal design in a regional city. This study evaluates the usefulness of the COPD taskforce and intervention based on COPD case detection rate and per capita medical costs. We distributed a questionnaire to all 8,878 inhabitants aged 50-89 years, resident in Matsuura, Nagasaki Prefecture in 2006. Potentially COPD-positive persons received a pulmonary function test and diagnosis. We implemented ongoing detection, examination, education, and treatment interventions, performed follow-up examinations or respiratory lessons yearly, and supported the health maintenance of each patient. We compared COPD medical costs in Matsuura and in the rest of Nagasaki Prefecture using data from 2004 to 2013 recorded by the association of Nagasaki National Health Insurance Organization, assessing 10-year means and annual change. As of 2014, 256 people have received a definitive diagnosis of COPD; representing 31% of the estimated total number of COPD patients. Of the cases detected, 87.5% were mild or moderate in severity. COPD medical costs per patient in Matsuura were significantly lower than the rest of Nagasaki Prefecture, as was rate of increase in cost over time. The COPD program in Matsuura enabled early detection and treatment of COPD patients and helped to lower the associated burden of medical costs. The success of this program suggests that a similar program could reduce the economic and human costs of COPD morbidity throughout Japan.

Research paper thumbnail of Health-related quality of life among women in rural Bangladesh after surgical repair of obstetric fistula

International Journal of Gynecology & Obstetrics, 2015

To identify factors influencing health-related quality of life (QOL) among women in Bangladesh af... more To identify factors influencing health-related quality of life (QOL) among women in Bangladesh after successful surgical repair of obstetric fistula. In 2012, a cross-sectional study was conducted of women who had undergone a successful surgical repair of an obstetric fistula at a hospital in northwest Bangladesh between June 2005 and May 2012. Sociodemographic, obstetric, and fistula-related information was collected by interview. Health-related QOL was assessed using the 36-item Short Form Health Survey (SF-36). A total of 113 women were included. Linear regression analysis showed that discrimination experiences negatively affected four of the eight scales of SF-36, as well as both the physical and mental component summaries (P&amp;amp;lt;0.05 for all). Married status had a positive effect on four scales and the mental component summary (P&amp;amp;lt;0.05 for all). Age inversely affected two scales and the physical component summary (P&amp;amp;lt;0.01 for all). Internalized stigma negatively influenced two scales (P&amp;amp;lt;0.05 for both). Not having living children and experiencing two or more previous stillbirths negatively influenced one scale (P&amp;amp;lt;0.05 for both). Several factors influence health-related QOL after obstetric fistula repair; a comprehensive approach is needed to address these issues.

Research paper thumbnail of Clinicoradiological outcomes of 33 cases of surgically resected pulmonary pleomorphic carcinoma: correlation with prognostic indicators

European Radiology, 2015

To retrospectively review the clinical, radiological and pathological data in patients who underw... more To retrospectively review the clinical, radiological and pathological data in patients who underwent surgical resection for pulmonary pleomorphic carcinoma (PC), and to analyse the prognostic predictors of survival. The data were retrospectively examined for 33 consecutive patients (28 males and five females) who had undergone surgical resection for pulmonary PC. Cox&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s proportional-hazards model was used to analyse the prognostic predictors of survival. The size of the tumours ranged from 1.1 to 12.0 cm (mean 5.4 cm). The majority (26) of the tumours were located at the lung periphery, five tumours had cavitation, two had calcification and 14 had peritumoral ground-glass opacity. Most of the tumours showed heterogeneous enhancement and contained a low-density area (LDA) within the tumour. The 5-year overall survival of surgically resected PC was 36 % (standard error = 0.093). A multivariate analysis revealed the LDA grade [hazard ratio (HR), 2.019], pathological stage (HR, 7.552) and pathological N factor (HR, 0.370) to be significant predictors of a poorer prognosis. A greater component of LDA within the tumour on contrast-enhanced CT is associated with a poorer prognosis in patients with PC. • PC has a poorer prognosis than other conventional NSCLC. • The five-year OS of surgically resected PC was 36 %. • A greater component of LDA on contrast-enhanced CT suggests a poorer prognosis.

Research paper thumbnail of The Impact of Multiple Roles on Psychological Distress among Japanese Workers

Safety and Health at Work, 2015

There has been considerable interest in Japanese society in the problem of work-related stress le... more There has been considerable interest in Japanese society in the problem of work-related stress leading to depressive symptoms, and an increasing number of primary houseworkers maintain paid employment. The purpose of this study was to examine the differential impact of multiple roles associated with psychological distress among Japanese workers. We studied 722 men and women aged 18-83 years in a cross-sectional study. The K10 questionnaire was used to examine psychological distress. The proportion of participants with psychological distress was higher in women (17.8%) compared with men (11.5%). Having three roles significantly decreased the risk of psychological distress [women: odds ratio (OR), 0.37-fold; men: OR, 0.41] compared with only one role. In working married women, there was significantly less psychological distress (OR, 0.27), and those with childrearing or caregiving responsibilities for elderly parents had significantly less psychological distress (OR, 0.38) than those with only an employment role. Similarly, working married men who had childrearing or caregiving responsibilities for elderly parents had significantly less psychological distress (OR, 0.41) than those who had only an employment role. The present study demonstrated that participants who had only an employment role had an increased risk of psychological distress. The degree of psychological distress was not determined solely by the number of roles. It is important to have balance between work and family life to reduce role conflict and/or role submersion, which in turn may reduce the risk of psychological distress.

Research paper thumbnail of Factors associated with the annual change in forced expiratory volume in 1 second of officially acknowledged victims of pollution-related illness in improved environments: a longitudinal study

Journal of Physical Therapy Science, 2015

[Purpose] We examined factors affecting annual change in pulmonary function in residents previous... more [Purpose] We examined factors affecting annual change in pulmonary function in residents previously exposed to air pollution in an area where pollution has been reduced and a long time period has elapsed. [Subjects and Methods] Data of 730 officially acknowledged victims of pollution-related illness from an annual survey during 2000 to 2009 were analyzed. The primary outcome was forced expiratory volume in 1 second (FEV1), along with factors such as age, body composition, smoking habits, respiratory symptoms, and classification of medical management (an index of the need for treatment). Multiple regression analyses were used to identify factors associated with the annual change in FEV1. [Results] Three significant factors were identified: smoking habit, classification of medical management, and gender. Smoking habits and classification of medical management had stronger effects on the annual change in FEV1 than gender. [Conclusion] With an improved environment, continuation of smoking accelerates the decline in FEV1.

Research paper thumbnail of Tobacco use among designated air pollution victims and its association with lung function and respiratory symptoms: a retrospective cross-sectional study

BMJ open, 2014

We sought to elucidate the long-term association of tobacco use and respiratory health in designa... more We sought to elucidate the long-term association of tobacco use and respiratory health in designated pollution victims with and without obstructive pulmonary defects. A retrospective cross-sectional study. The register of pollution victims in Kurashiki, Japan. 730 individuals over 65 years of age previously diagnosed with pollution-related respiratory disease. Patients were classified into four groups according to their smoking status and whether they had obstructive pulmonary disease. We then compared the prevalence of respiratory symptoms and lung function over time between groups. Spirometry was performed and a respiratory health questionnaire completed in the same season each year for up to 30 years. Rates of smoking and respiratory disease were high in our sample. Although respiratory function in non-smoking patients did not completely recover, the annual rate of change in lung function was within the normal range (p<0.01). However, smokers had worse lung function and were m...

Research paper thumbnail of Impact of aneurysm location on cardiopulmonary dysfunction after subarachnoid hemorrhage

Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 2014

Cardiopulmonary dysfunction may occur after aneurysmal subarachnoid hemorrhage (SAH), but its cha... more Cardiopulmonary dysfunction may occur after aneurysmal subarachnoid hemorrhage (SAH), but its characteristics have not been fully clarified. We investigated the impact of aneurysm location on systemic hemodynamics after SAH. This multicenter prospective cohort study measured hemodynamic parameters in relation to aneurysm location in patients with SAH using a single-indicator transpulmonary thermodilution system (PiCCO) on days 1-14. Of 204 subjects enrolled, 58 had aneurysms of the anterior communicating artery (ACA), 61 of the middle cerebral artery (MCA), 57 of the internal carotid artery (ICA), and 28 of the vertebrobasilar artery (VA/BA). Patient characteristics were similar except for predominance of coiling in the VA/BA. Patients with ACA aneurysm had a lower systemic vascular resistance index (SVRI) in the acute phase and afterload mismatch (lower cardiac index [CI] and higher SVRI) in the spasm phase. Those with ICA aneurysm had a lower CI in the acute phase, and those with ...

Research paper thumbnail of Physical Function Traits of Long-term Officially Acknowledged Victims of Pollution-related Illnesses Compared with Elderly Patients with Chronic Obstructive Pulmonary Disease

Journal of Physical Therapy Science, 2014

Purpose] To examine the long-term effects of air pollution on the physical functioning of a group... more Purpose] To examine the long-term effects of air pollution on the physical functioning of a group of officially acknowledged victims of pollution-related illnesses (Victims group) who were exposed to air pollution more than 50 years ago, we compared them with age-matched patients with chronic obstructive pulmonary disease (COPD group). [Subjects and Methods] The Victims group comprised 34 subjects and the COPD group 24, all of whom were aged over 65 years. Respiratory function, muscle strength, exercise capacity and physical activity were measured and compared between the groups.

Research paper thumbnail of Analysis for threshold levels of cadmium in urine that induce tubular dysfunction among women in non-polluted areas in Japan

International archives of occupational and environmental health, 2003

To examine if there is a threshold in urinary cadmium concentration that induces elevation in uri... more To examine if there is a threshold in urinary cadmium concentration that induces elevation in urinary microglobulins. The database developed in a previous field survey (Ezaki et al. 2002) was employed. In the survey conducted in 2000 and 2001, more than 10,000 middle-aged women (with no occupational exposure to Cd) in ten prefectures all over Japan gave morning spot urine samples, which were analyzed for cadmium (Cd-U), calcium (Ca-U), magnesium (Mg-U), zinc (Zn-U), alpha(1)- and beta(2)-microglobulins (alpha(1)- and beta(2)-MG-U), and creatinine (cr). The urinary analyte concentrations were corrected for cr concentration (to be expressed as, e.g., Cd-Ucr), and the data thus obtained were subjected to statistical evaluation. The largest geometric mean (GM) for Cd-Ucr among the ten prefecture was 3.2 microg Cd/g cr, and the maximum Cd-Ucr observed among the women studied was 20.9 microg Cd/g cr. Both alpha(1)-MG-Ucr and beta(2)-MG-Ucr increased as a function of the increase in Cd-Ucr...

Research paper thumbnail of No clear-cut evidence for cadmium-induced renal tubular dysfunction among over 10,000 women in the Japanese general population: a nationwide large-scale survey

International archives of occupational and environmental health, 2003

To examine whether environmental exposure to cadmium has been inducing kidney dysfunction among m... more To examine whether environmental exposure to cadmium has been inducing kidney dysfunction among middle-aged women in the general population in Japan. This study was conducted in 2000 and 2001. Morning spot urine samples were collected from 10,753 women (mostly aged 35 to 60 years) in ten prefectures all over Japan (thus about 1,000 women per site). Urine samples were analyzed for cadmium (Cd-U), calcium (Ca-U), magnesium (Mg-U), zinc (Zn-U), alpha(1)- and beta(2)-microglobulins (alpha(1)- and beta(2)-MG-U). The urinary analyte concentrations were corrected for creatinine (cr) concentration (i.e., Ucr). The data thus obtained were subjected to statistical evaluation by chi-square test, ANOVA, multiple comparison test, and simple regression analysis (SRA) as well as multiple regression analysis (MRA) including logistic regression analysis (LRA). Log-normal distribution was assumed for Cd-Ucr, alpha(1)-MG-Ucr and beta(2)-MG-Ucr, whereas normal distribution was considered for age, Ca-Uc...

Research paper thumbnail of Smoking Aggravates the Impaired Pulmonary Function of Officially Acknowledged Female Victims of Air Pollution of 40 Years Ago

The Tohoku Journal of Experimental Medicine, 2014

Air pollution due to industrial waste and tobacco smoke is detrimental to pulmonary function. How... more Air pollution due to industrial waste and tobacco smoke is detrimental to pulmonary function. However, the combined effects of air pollution and smoking on pulmonary function have not been investigated. We examined the combined effect of air pollution of 40 years ago and concurrent smoking on the pulmonary function of officially acknowledged female victims in Japan, because females are more susceptible to the adverse effects of both irritants than males. The subjects comprised 655 female victims living in one of two areas with air pollution of 40 years ago and 572 females living in an area without air pollution. All victims have been prescribed standard respiratory medications. Pulmonary function was measured in 2000 for air-pollution groups (130 smokers and 525 non-smokers; mean age, 68.4 years) and during the period of 2004 to 2013 for non-air-pollution groups (113 smokers and 459 non-smokers; mean age, 69.0 years). The smokers included both current smokers and ex-smokers. The victims with a history of smoking had significantly lower forced expiratory volume in 1 second (FEV1 % predicted) (mean, 74%) and significantly lower FEV1/forced vital capacity (FVC) (mean, 70%) than the other groups (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). Thus, smoking aggravates the pulmonary function in officially acknowledged female victims, despite the improved air pollution and the continuous medical care provided by the government. In conclusion, exposure to air pollution of 40 years ago and cigarette smoking are associated with reduced pulmonary function. These results highlight the importance of measures aimed at smoking cessation and limiting air pollution.

Research paper thumbnail of Secular trends of sizes at birth in Japanese healthy infants born between 1962 and 1988

Journal of physiological anthropology and applied human science, 2004

Body sizes at birth are important clinical indicators widely used for evaluation of prenatal grow... more Body sizes at birth are important clinical indicators widely used for evaluation of prenatal growth. Japan had significant socioeconomic improvement around the 1960s, and these environmental changes may influence physiologically prenatal growth. Furthermore, in Japan, measurements of size at birth for birth certificates are weight and height. Thus, we can refer to annual data on weight and height, but not on head and chest circumference at birth. In this study we measured the weight, height, and head and chest circumference at birth among 6,563 Japanese singleton healthy infants, annually in 1962 and 1988, and examined secular trends of these anthropometric measurements. The boys consistently exceeded the girls in all four variables. Birth weight and height increased significantly from the 1960s to '70s, but did not differ between the '70s and '80s in both boys and girls. Secular trends of head and chest circumference were different from them. In both boys and girls, hea...

Research paper thumbnail of Risk factors for malaria infection among ethnic minorities in Binh Phuoc, Vietnam

The Southeast Asian journal of tropical medicine and public health, 2009

A cross-sectional study was undertaken to identify the prevalence of malaria infection, behaviora... more A cross-sectional study was undertaken to identify the prevalence of malaria infection, behavioral patterns of inhabitants and risk factors for malaria infection in a minority village in an area endemic for malaria in Vietnam. The target population were all the inhabitants of a village in Binh Phuoc Province, Vietnam. Interviews using a structured questionnaire and blood examination for malaria infection were conducted in house-to-house visits. Relationships between malaria infection and variables were examined using uni- and multivariate adjusted analysis. A total of 682 individuals from 159 households participated in both the interview and blood examinations. All households earned income through farming without forest activities at night, and the socio-economic status was generally not very low. The total prevalence of malaria infection was 6.2%, with a peak among 3- to 5-year-old children. Univariate analysis identified 3 - 5 year olds, a family size of > or =5 people, sleepin...

Research paper thumbnail of Air Pollution Irreversibly Impairs Lung Function: A Twenty-Year Follow-Up of Officially Acknowledged Victims in Japan

The Tohoku Journal of Experimental Medicine, 2013

Lung function is one of the strongest determinants of cardiopulmonary health and longevity. Long-... more Lung function is one of the strongest determinants of cardiopulmonary health and longevity. Long-term exposure to air pollution has been associated with decreased lung function. We undertook a retrospective study to compare the long-term consequences of air pollution in two areas of Japan: Mizushima, Okayama Prefecture and Kitakyushu, Fukuoka Prefecture. Industrialization began in Mizushima in the 1940s, whereas it began in Kitakyushu in the early 1900s. In Kitakyushu, levels of nitrogen dioxide have been higher compared to the Mizushima area. The subjects comprised 623 officially acknowledged victims of pollution-related illness (489 from Mizushima and 134 from Kitakyushu). All subjects were lifetime non-smokers and aged 65 years or older at the time of their last medical examination in 2009. Demographic data including diagnosed lung diseases and lung function at the time of certification assessment performed between 1973 and 1988 were obtained. The subjects from Kitakyushu were significantly younger (47.1 vs. 51.0 years, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001) and a higher percentage had asthma (91.2 vs. 36.8%, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001) compared to those from Mizushima. Furthermore, all measures of lung function were significantly lower in Kitakyushu group at the time of the certification assessment (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001) and at the follow-up (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). However, no significant differences were observed in the annual mean decline in lung function between the two groups, despite the overall decrease in air pollution. In conclusion, the normal lung function is not restored even after improvement of air pollution. It is essential for every city to prevent air pollution.

Research paper thumbnail of Effects of Lifestyle Factors on Stiffness Index of Calcaneus Measured by Quantitative Ultrasound Systemamong Japanese Women Aged 40 Years and Over: The Hizen-Oshima Study

The Tohoku Journal of Experimental Medicine, 2003

To explore how the stiffness index of the calcaneus is related to lifestyle factors, we examined ... more To explore how the stiffness index of the calcaneus is related to lifestyle factors, we examined the associations of lifestyle factors, age, and years since menopause, with stiffness index of the calcaneus among 573 community-dwelling Japanese women aged 40-89 years. Stiffness index of the calcaneus was obtained from quantitative ultrasound measurement. Body height and weight were measured, from which body mass index (BMI) was calculated. Physical activity index was calculated using a validated questionnaire. Dietary calcium intake and amount of ingested alcohol were estimated by a semiquantitative food frequency questionnaire. Current smoking status was obtained by questionnaire. In univariate analysis, stiffness index was positively related to physical activity index and BMI, and inversely to age and years since menopause, but not to dietary calcium intake. Stiffness index of drinkers and current smokers was not significantly different from that of non-drinkers and non-smokers, respectively. Among the natural menopausal women, multiple regression analysis showed that advancing age and years since menopause were associated with lower stiffness index, while higher physical activity index and greater BMI were associated with higher stiffness index. In conclusion, higher physical activity, in combination with adequate nutrition for weight maintenance, should be emphasized as a part of a healthy lifestyle in order to maintain bone health among middle-aged and elderly Japanese women.

Research paper thumbnail of Demographic and Reproductive Factors for High Seroprevalence of Chlamydia Trachomatis among Pregnant Women in Japan

The Tohoku Journal of Experimental Medicine, 2000

Research paper thumbnail of The prevalence and pattern of insomnia in Japanese industrial workers: Relationship between psychosocial stress and type of insomnia

Psychiatry and Clinical Neurosciences, 1998

We examined the prevalence of insomnia among Japanese male industrial workers and analyzed the ef... more We examined the prevalence of insomnia among Japanese male industrial workers and analyzed the effect of psychosocial stress on the prevalence of three types of insomnia: &#39;difficulty in falling asleep&#39;, &#39;frequent sleep interruption&#39; and &#39;early morning arousal&#39;. The study population consisted of male day workers (n = 319) in a manufacturing heavy industry company located in Nagasaki City, Japan. The subjects answered a questionnaire consisting of six sleep-related items and 24 questions related to occupational and private life conditions. A total of 271 men (average age 40.9 years) completed the questionnaire; a response rate of 85%. Insomnia within the month preceding the survey was present in 27.7% of the workers (75/271). Multiple logistic regression analysis demonstrated that different psychosocial stressors were associated with different types of insomnia. Visual display terminal (VDT) work overload was significantly associated with all types of insomnia, while &#39;over-involvement in the job&#39; was associated with difficulty in falling asleep and early morning arousal. Our results demonstrated that the prevalence of insomnia in Japanese workers is similar to that reported among European and American general adult population. Our results also indicate that the use of VDT in the workfield is associated with insomnia.

Research paper thumbnail of Mental health conditions among atomic bomb survivors in Nagasaki

Psychiatry and Clinical Neurosciences, 2002

To elucidate the effects of the bombing on the atomic bomb survivors' mental health, a mental hea... more To elucidate the effects of the bombing on the atomic bomb survivors' mental health, a mental health survey was conducted using a 12-item version of the General Health Questionnaire (GHQ-12) and a mail survey on atomic bomb exposure conditions and lifestyle using a selfadministered questionnaire. A total of 3526 atomic bomb survivors in Nagasaki responded and a high GHQ-12 score, as defined when the responses to four or more items were positive, was observed in 296 (8.4%) subjects. It was indicated that the risk of a high GHQ-12 score will decrease 0.98-fold with every 1-year increase in age, and will increase 1.45-fold and 1.70-fold in those who lost family members due to the bombing and those who had acute symptoms, respectively, compared with those who did not. It was indicated that the atomic bomb exposure has affected survivors' mental health and that the care of their mental health is important.

Research paper thumbnail of A Study of the Impact of Occupational and Domestic Factors on Insomnia among Industrial Workers of a Manufacturing Company in Japan

Occupational Medicine, 1996

... factors on insomnia among industrial workers of a manufacturing company in Japan H. Tachibana... more ... factors on insomnia among industrial workers of a manufacturing company in Japan H. Tachibana, T. Izumi, S. Honda, 1 I. Horiguchi, ... good) Socioeconomic dissatisfaction (yes vs. no) Pleasure of a happy home (never/seldom vs. often/always) Domestic troubles (yes vs. ...

Research paper thumbnail of A proposed method for the evaluation of body fat in Japanese adults that predicts obesity

Nutrition Research, 2011

The present study was designed to develop a simple predictive equation for the percent body fat (... more The present study was designed to develop a simple predictive equation for the percent body fat (%BF) in Japanese adults based on variables collected during health examinations. We hypothesized that a benchmark for defining metabolic syndrome and obesity could be based on %BF, which was measured by underwater weighing (UW) as a gold standard for body composition assessment. Thus, we developed a predictive equation for %BF derived from UW that may contribute to the assessment of obesity status, characterized by an excess accumulation of visceral or subcutaneous fat. The subjects were 810 Japanese participants (283 men, 527 women, ages 18-59 years). Anthropometric variables, including height, weight, 7 circumferences, and 8 skinfold thicknesses, were measured. The developed predictive equation was as follows: %BF = 10.558 × sex (1 for men; 2 for women) + 0.069 × age + 0.667 × body mass index + 0.314 × abdominal circumference - 35.881.The coefficient of determination (r(2)) was 0.69. The predicted %BF derived from this equation was highly correlated with UW-measured values and did not show underestimation or overestimation in either sex. These data suggested that this predictive equation for %BF can be used for all Japanese adults and does not require the use of medical equipment and special measurement techniques. By combining the equation for %BF developed in this study with a %BF cutoff value of metabolic syndrome and obesity (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;25.0% in men and &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;30.0% in women), all Japanese adults can easily and conveniently assess obesity status.