Nagasaki National Hospital

Nagasaki-shi, Japan

Nagasaki National Hospital

Nagasaki-shi, Japan
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Shimizu Y.,Nagasaki University | Nakazato M.,Nagasaki University | Sato S.,Nagasaki University | Koyamatsu J.,Nagasaki University | And 9 more authors.
Journal of Physiological Anthropology | Year: 2015

Background: Recent studies have reported an association between both higher and lower levels of hemoglobin A1c (HbA1c) and higher mortality of diabetes patients. Like diabetes, carotid atherosclerosis is a well known lifestyle-related disease. However, no studies have yet reported an association between HbA1c levels and carotid atherosclerosis. Methods: We conducted a cross-sectional study of 1,150 Japanese elderly men aged ≥60 years who were undergoing general health checkups. Carotid atherosclerosis was defined as a carotid intima-media thickness (CIMT) ≥1.1 mm. Since body mass index (BMI) is regarded as a cardiovascular risk factor that exerts a strong influence on both HbA1c levels and carotid atherosclerosis, we performed a stratified analysis of this risk based on BMI. Results: Using the intermediate HbA1c quintile as a reference group, the groups in the lowest HbA1c quintiles showed a significantly higher risk of carotid atherosclerosis in patients with low BMI (≤23 kg/m2) vs. no increased risk in those with high BMI (>23 kg/m2). The association of HbA1c with carotid atherosclerosis became slightly stronger when these analyses were limited to subjects who were not taking glucose-lowering medications or medications for hyperlipidemia and cardiovascular disease. After adjusting for classical cardiovascular risk factors, adjusted odds ratios (ORs) for carotid atherosclerosis were 1.36 (0.84 to 2.20) for total subjects, 2.29 (1.12 to 4.66) for low-BMI groups, and 0.68 (0.33 to 1.41) for high-BMI groups. Conclusions: Lower HbA1c level is a significant risk factor for carotid atherosclerosis in rural community-dwelling elderly Japanese men with low, but not high BMI, particularly in those not taking glucose-lowering medication. © Shimizu et al.; licensee BioMed Central.


Shimizu Y.,Nagasaki University | Sato S.,Nagasaki University | Koyamatsu J.,Nagasaki University | Yamanashi H.,Nagasaki University | And 8 more authors.
Journal of Physiological Anthropology | Year: 2014

Background: Renal impairment is known to be associated with atherosclerosis, which in turn is reported to be positively associated with hemoglobin levels. In addition, renal impairment is known to be associated with a form of anemia known as renal anemia.Methods: To clarify the associations between renal impairment and anemia, we conducted a cross-sectional study of 1,105 60 to 89-year-old men, who were not taking medication for anemia and were undergoing general health check-ups.Results: Compared with non-chronic kidney disease, chronic kidney disease (CKD) with a glomerular filtration rate (GFR) <60 mL/min/1.73 m2 was found to constitute a significant risk of anemia. However, we noted that this risk was lower for mild renal impairment (60 mL/min/1.73 m2 ≤ GFR <90 mL/min/1.73 m2). Compared with the non-CKD reference group, the classical cardiovascular risk factors adjusted odds ratio (OR) for anemia was 1.81 (1.23 to 2.68) and compared with the normal renal function (GFR ≥90 mL/min/1.73 m2) reference group, the ORs for mild renal impairment and CKD were 0.26 (0.15 to 0.47) and 0.60 (0.33 to 1.09).Conclusions: Independent from classical cardiovascular risk factors, CKD, which was identified during general health check-ups, appeared to constitute a significant risk of anemia for older Japanese men. For mild renal impairment, however, this association was a reduced risk of anemia and thus possibly a higher risk of atherosclerosis. © 2014 Shimizu et al.; licensee BioMed Central Ltd.


Orita M.,Nagasaki University | Hayashida N.,Nagasaki University | Shinkawa T.,Nagasaki University | Kudo T.,Nagasaki University | And 6 more authors.
Tohoku Journal of Experimental Medicine | Year: 2012

Severely and multiply disabled children (SMDC) are frequently affected in more than one area of development, resulting in multiple disabilities. The aim of the study was to evaluate the efficacy of music therapy in SMDC using monitoring changes in the autonomic nervous system, by the frequency domain analysis of heart rate variability. We studied six patients with SMDC (3 patients with cerebral palsy, 1 patient with posttraumatic syndrome after head injury, 1 patient with herpes encephalitis sequelae, and 1 patient with Lennox-Gastaut syndrome characterized by frequent seizures, developmental delay and psychological and behavioral problems), aged 18-26 (mean 22.5 ± 3.5). By frequency domain method using electrocardiography, we measured the high frequency (HF; with a frequency ranging from 0.15 to 0.4 Hz), which represents parasympathetic activity, the low frequency/high frequency ratio, which represents sympathetic activity between the sympathetic and parasympathetic activities, and heart rate. A music therapist performed therapy to all patients through the piano playing for 50 min. We monitored each study participant for 150 min before therapy, 50 min during therapy, and 10 min after therapy. Interestingly, four of 6 patients showed significantly lower HF components during music therapy than before therapy, suggesting that these four patients might react to music therapy through the suppression of parasympathetic nervous activities. Thus, music therapy can suppress parasympathetic nervous activities in some patients with SMDC. The monitoring changes in the autonomic nervous activities could be a powerful tool for the objective evaluation of music therapy in patients with SMDC. © 2012 Tohoku University Medical Press.


Shimizu Y.,Nagasaki University | Nakazato M.,Nagasaki University | Sato S.,Nagasaki University | Koyamatsu J.,Nagasaki University | And 9 more authors.
Journal of physiological anthropology | Year: 2015

BACKGROUND: Recent studies have reported an association between both higher and lower levels of hemoglobin A1c (HbA1c) and higher mortality of diabetes patients. Like diabetes, carotid atherosclerosis is a well known lifestyle-related disease. However, no studies have yet reported an association between HbA1c levels and carotid atherosclerosis.METHODS: We conducted a cross-sectional study of 1,150 Japanese elderly men aged ≥60 years who were undergoing general health checkups. Carotid atherosclerosis was defined as a carotid intima-media thickness (CIMT) ≥1.1 mm. Since body mass index (BMI) is regarded as a cardiovascular risk factor that exerts a strong influence on both HbA1c levels and carotid atherosclerosis, we performed a stratified analysis of this risk based on BMI.RESULTS: Using the intermediate HbA1c quintile as a reference group, the groups in the lowest HbA1c quintiles showed a significantly higher risk of carotid atherosclerosis in patients with low BMI (≤23 kg/m(2)) vs. no increased risk in those with high BMI (>23 kg/m(2)). The association of HbA1c with carotid atherosclerosis became slightly stronger when these analyses were limited to subjects who were not taking glucose-lowering medications or medications for hyperlipidemia and cardiovascular disease. After adjusting for classical cardiovascular risk factors, adjusted odds ratios (ORs) for carotid atherosclerosis were 1.36 (0.84 to 2.20) for total subjects, 2.29 (1.12 to 4.66) for low-BMI groups, and 0.68 (0.33 to 1.41) for high-BMI groups.CONCLUSIONS: Lower HbA1c level is a significant risk factor for carotid atherosclerosis in rural community-dwelling elderly Japanese men with low, but not high BMI, particularly in those not taking glucose-lowering medication.


Orita M.,Nagasaki University | Hayashida N.,Nagasaki University | Shinkawa T.,Nagasaki University | Urata H.,Nagasaki University | And 5 more authors.
Life Science Journal | Year: 2014

Background: Patients with profound multiple disabilities (PMD) are defined as individuals with profound cognitive disabilities (IQ < 35) and neuromotor dysfunction. Additionally, PMD patients often have sensory impairment and clinical manifestations. These conditions may result in severe developmental disability, functional and behavioral deficits, and a lack of language-based communication. Warm footbaths are implemented for patients with PMD. But the objective evaluation of warm footbaths has not been established. The aim of this study was to investigate the effectiveness of warm footbaths through the monitoring of autonomic nervous activity using heart rate variability (HRV) in patients with PMD. Methods: Eight patients with PMD (five patients with cerebral palsy, one with Aicardi's syndrome, one with post-traumatic syndrome after a head injury, and one with Lennox-Gastaut syndrome) and one healthy adult male volunteer had a warm footbath for 20 minutes. We used electrocardiography to measure the high frequency components (HF; with frequency ranging from 0.15 to 0.4 Hz), which represent HRV due to parasympathetic activity. Analysis of variance was used to compare the level of HF pretreatment, during warm footbath, and post-treatment in each study participant. Results: Six of the eight patients, including three patients with clinically severe behavioral and emotional disturbance, showed significantly lower log HF during the warm footbath than pretreatment. Seven of the eight patients showed lower log HF in the first period phase (soak lower legs and feet in 40°C water) of the warm footbath.Discussion: Our results showed that warm footbaths in patients with PMD suppressed parasympathetic nervous activity and stimulated their tactile senses and emotional inputs when soaking their feet in warm water.


Mizukami S.,Nagasaki University | Mizukami S.,Nishi Isahaya Hospital | Arima K.,Nagasaki University | Abe Y.,Nagasaki University | And 5 more authors.
Tohoku Journal of Experimental Medicine | Year: 2013

Falls are a major public health problem and the second leading cause of death due to unintentional accidental injury after road traffic accidents. Inactive, older individuals with several chronic illnesses fall more frequently than older individuals who are active and healthy. No population-based study has addressed the association of stroke, arthritis, hypnotic and other prescription medications with falls among the elderly simultaneously in a single population in Japan. We examined the prevalence of falls among community-dwelling elderly Japanese individuals, whom we randomly selected from a list of inhabitants aged ≥ 65 years compiled from the resident registration, and the associations between falls and each of stroke, arthritis, and hypnotic and other prescription medications. We interviewed 295 men and 307 women, and collected information about the number of falls during the latest one year, hemiplegia due to stroke, arthritis in the legs, and the number of hypnotic and other medications. We found that 46 men (16%) and 67 women (22%) had fallen at least once during the latest one year. Logistic regression analysis adjusted for age showed that hemiplegia due to stroke (p < 0.001), arthritis in the legs (p < 0.001), and taking at least four daily prescription medications (p < 0.05) were significantly associated with falls in men. Arthritis in the legs (p = 0.05) and taking at least four daily prescription medications (p < 0.05) were associated with falls in women. Treatment of fall-related diseases and medication management are important strategies for reducing falls among elderly persons. © 2013 Tohoku University Medical Press.


Shimizu Y.,Nagasaki University | Nakazato M.,Nagasaki University | Sekita T.,Nagasaki University | Kadota K.,Nagasaki University | And 6 more authors.
Acta Medica Nagasakiensia | Year: 2014

Although bone metabolism is reportedly associated with production and maturation of blood corpuscles, and serum alkaline phosphatase (ALP) levels have been associated with bone metabolism, no published study has investigated the association between ALP and anemia. Furthermore, although ALP is known as an enzyme affected by alcohol consumption, there are no reports in the literature on associations between ALP and the risk of anemia in relation to drinking status. We conducted a cross-sectional study of 907 men aged 30-89 years undergoing a general health check-up to investigate the associations between ALP and anemia in relation to drinking status. Of the 907 participants, 120 men were diagnosed with anemia. The association between ALP and anemia was J-shaped. With the second quartile of ALP (194-228 IU/L) (Q2) as the reference group, the multivariable adjusted OR and 95%CI for anemia were 1.91 (95%CI: 0.96-3.82) for <194 IU/L (Q1), 1.84 (95%CI: 0.93-3.62) for 229-277 IU/L (Q3) and 2.83 (95%CI:1.49-5.37) for >277 IU/L (Q4). When the analysis was limited to non-drinkers, the associations became stronger with corresponding values of 3.34 (95%CI: 1.28-8.74), 3.18 (95%CI: 1.28-7.88) and 3.22 (95%CI:1.37-7.59). Not only lower but also higher levels of serum ALP are associated with anemia for men, especially non-drinkers. For analyses of associations between ALP and anemia, alcohol consumption should thus be considered a potential confounder.


PubMed | Nagasaki National Hospital and Nagasaki University
Type: | Journal: Journal of physiological anthropology | Year: 2015

Recent studies have reported an association between both higher and lower levels of hemoglobin A1c (HbA1c) and higher mortality of diabetes patients. Like diabetes, carotid atherosclerosis is a well known lifestyle-related disease. However, no studies have yet reported an association between HbA1c levels and carotid atherosclerosis.We conducted a cross-sectional study of 1,150 Japanese elderly men aged 60years who were undergoing general health checkups. Carotid atherosclerosis was defined as a carotid intima-media thickness (CIMT) 1.1mm. Since body mass index (BMI) is regarded as a cardiovascular risk factor that exerts a strong influence on both HbA1c levels and carotid atherosclerosis, we performed a stratified analysis of this risk based on BMI.Using the intermediate HbA1c quintile as a reference group, the groups in the lowest HbA1c quintiles showed a significantly higher risk of carotid atherosclerosis in patients with low BMI (23kg/m(2)) vs. no increased risk in those with high BMI (>23kg/m(2)). The association of HbA1c with carotid atherosclerosis became slightly stronger when these analyses were limited to subjects who were not taking glucose-lowering medications or medications for hyperlipidemia and cardiovascular disease. After adjusting for classical cardiovascular risk factors, adjusted odds ratios (ORs) for carotid atherosclerosis were 1.36 (0.84 to 2.20) for total subjects, 2.29 (1.12 to 4.66) for low-BMI groups, and 0.68 (0.33 to 1.41) for high-BMI groups.Lower HbA1c level is a significant risk factor for carotid atherosclerosis in rural community-dwelling elderly Japanese men with low, but not high BMI, particularly in those not taking glucose-lowering medication.

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