Okayama University Medical School Acta Medica Okayama 0386-300X 57 4 2003 Differential responses of serum gamma-glutamyltransferase to alcohol intake in Japanese males. 171 178 EN Yoko Matsuka Da-Hong Wang Narufumi Suganuma Kaori Imai Satoru Ikeda Kazuhisa Taketa Shohei Kira Article 10.18926/AMO/32805 We studied the association of gamma-glutamyltransferase (GGT) and other serum markers of liver injury with daily alcohol consumption in a healthy population of 1,043 Japanese males. A positive correlation between daily alcohol consumption and biochemical markers, such as log GGT (r = 0.432), log AST (r = 0.244) or log LAP (r = 0.246), was seen in all drinkers. However, there was a negative correlation, such as log GGT (r = -0.434), log AST (r = -0.424) or log LAP (r = -0.430), in heavy drinkers who consumed more than 70 g ethanol a day. On the other hand, a positive correlation, such as log GGT (r = 0.426), log AST (r = 0.247) or log LAP (r = 0.216) was found in moderate drinkers who consumed less than 70 g ethanol a day. Interestingly, there was a tendency toward negative association between alcohol consumption and the Tokyo University ALDH2 Phenotype Screening Test (TAST) score in the heavy drinkers, and there was a tendency toward positive association between GGT and TAST score in this group. Our results suggest that there are 2 groups of drinkers, those with elevated GGT (good responders) and those with normal GGT (poor responders) despite heavy drinking. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 54 6 2000 Epidemiological studies of coincidental outbreaks of enterohemorrhagic Escherichia coli O157:H7 infection and infectious gastroenteritis in Niimi City. 265 273 EN Kenji Tsumagari Hideki Yamamoto Narufumi Suganuma Masahiko Kato Satoru Ikeda Kaori Imai Shohei Kira Kazuhisa Taketa Article 10.18926/AMO/32284 A sharp rise in the number of patients with infectious gastroenteritis was observed in the 25th week of year 1996 in the Takahashi-Ashin district by researchers with the Infectious Disease Surveillance Program for tuberculosis and other infectious diseases in the Okayama Prefecture. This sharp rise occurred coincidentally with an outbreak of enterohemorrhagic Escherichia coli O157:H7 (EHEC O157) infection in Niimi City of the Takahashi-Ashin district. However, this phenomenon of coincidental outbreaks was not observed during the outbreak of EHEC O157 infection in Oku Cho. By reviewing outpatients' charts in a sentinel hospital in Niimi City for the Infectious Disease Surveillance Program, it was noted that patients with acute gastrointestinal infection visiting the hospital during the increased incidence of infectious gastroenteritis may have been included as misclassified cases of EHEC O157 infection. On the other hand, the exponential probability plotting of symptomatic patients with EHEC O157 infection in Niimi City revealed a breaking point which suggested a dual exposure to contaminated food or an overlap with other acute gastrointestinal infections. The latter possibility was discounted, because stool culture-positive patients with EHEC O157 infection also exhibited a similar breaking point, and furthermore, the coincidental increase in infectious gastroenteritis in the same area was attributable to the EHEC O157 infection. The present study demonstrates the association between the sharp rise in gastroenteritis and the outbreak of EHEC O157 in the Takahashi-Ashin district. A careful analysis of the cases of infectious gastroenteritis by the Infectious Disease Surveillance Program would have predicted the outbreak of EHEC O157. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 55 5 2001 Serum total cholesterol of new students enrolled at Okayama University: trend during 1989-1998. 269 276 EN Toshio Ogura Kazuharu Matsuura Hisao Suzuki Masayuki Kishida Satoru Ikeda Chiaki Tsukamoto Ayumi Imai Kazuo Tobe Article 10.18926/AMO/32015 No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 40 3 1986 Distribution of electrophoretically separated serum high density lipoprotein subfraction levels among healthy students and its alteration in patients with liver diseases. 127 138 EN Satoru Ikeda Article 10.18926/AMO/31934 In an attempt to evaluate high density lipoprotein (HDL) subfraction levels in liver diseases, HDL was separated by a precipitation method with dextran sulfate-Mg2+ from sera of 289 healthy adults and 50 patients with liver diseases. The HDL was subdivided into HDL2e and HDL3e by Utermann's polyacrylamide gel electrophoresis with lauric acid. Ultracentrifugally separated HDL2 and HDL3 roughly corresponded to HDL2e and HDL3e, respectively. Male and female groups had different distributions of HDL2e/HDL3e ratios. Among healthy males, 121 cases had ratios less than 1.0 (mean +/- SD = 0.72 +/- 0.39, n = 150), while among healthy females, the ratios were generally larger than those of males and varied widely from 0.2 to 6.6 (mean +/- SD = 1.77 +/- 1.05, n = 139). Low levels of HDL-cholesterol were found in patients with liver diseases, except those with mild alcoholic liver injury and intrahepatic cholestasis. Apparent decreases in HDL3e, but not in HDL2e, were found in all cases with liver diseases investigated, even in those who did not show decreases in the total HDL level, when male and female patients were analyzed separately. The analysis of HDL subfractions by the present method is simple and useful for the study on altered lipid metabolism in liver diseases. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 53 1 1999 Seroepidemiologic Studies of Hepatitis C Virus Infection in a Population of Okayama Prefecture Screened for Liver Disease 31 38 EN Seiichiro Uesugi Kazuhisa Taketa Nirmal Rimal Satoru Ikeda Tetsu Kariya Narufumi Suganuma Hideki Yamamoto Shohei Kira Article 10.18926/AMO/31643 To better understand the spread of hepatitis C virus (HCV) infection, we studied the association of HCV infection with similarly transmissible hepatitis B virus (HBV) infection and with hepatitis A virus (HAV) infection, which is supposed to be related to a nosocomial transmission of HCV. This was done by studying the presence or absence of antibodies to these viruses, as well as hepatitis B surface antigen, in a population of 1,398 inhabitants with abnormal liver function tests or history of liver disease and/or blood transfusion. This group was drawn from a group of 7,905 examinees screened for liver disease in 26 districts of Okayama prefecture, Japan. The prevalence of antibody-positive cases increased with age for those viruses. Small but significantly increased odds ratios were obtained among anti-HCV antibodies (HCVAb), anti-hepatitis B core antibodies (HBcAb) and anti-hepatitis A antibodies (HAVAb). After adjusting odds ratios by logistic regression analysis, a significant association was present only between HCVAb and HBcAb. The distribution of age-adjusted prevalences (AAP) of HCVAb in 26 districts was significantly wider than those of HBcAb or HAVAb. The district-based AAP of HCVAb, but not of HBcAb and HAVAb, correlated significantly with the district-based prevalence of infectious hepatitis having a tendency of chronicity reported in 1953-1955. Adjusted odds ratios calculated by logistic regression analysis of the virus markers showed that HCVAb was significantly associated with a past history of blood transfusion. Thus, the spread of HCV infection is speculated to have been triggered by blood transfusion, particularly from paid donors initially, followed by transmission by nosocomial or close person-to-person contact. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 53 3 1999 Urinary excretion of type I collagen cross-linked N-telopeptides, bone mass and related lifestyle in middle-aged women. 133 140 EN Chie Masatomi Kaori Imai Da-Hong Wang Satoru Ikeda Kazuhisa Taketa Shinji Takata Shohei Kira Article 10.18926/AMO/31637 The relationship between past and present lifestyle and urinary excretion of type I collagen cross-linked N-telopeptides (NTx) was studied in 61 Japanese females aged 34-59, with a view toward using NTx excretion rates as a predictor of future osteoporosis. Bone mineral density (BMD) of the lumbar spine, the speed of sound (SOS) and broadband ultrasound attenuation (BUA) of the os calcis, urinary NTx, serum osteocalcin (BGP) and bone-specific alkaline phosphatase (BAP) were measured. Stiffness index (stiffness) was calculated from SOS and BUA. The subjects were asked whether they took regular exercise in their childhood and teen years (in elementary, junior-high, senior-high school and college), the past (20-40 years of age) and present adulthood. Regular calcium intake, smoking habits, alcohol and other beverage consumption and milk consumption were also covered in the questionnaire. The mean NTx values of premenopausal and postmenopausal group were 22.2 and 56.0 nM bone collagen equivalents (BCE)/mM urinary creatinine (Cr), respectively. The group which did not exercise regularly between the ages of 20 and 40 had a higher mean NTx value (40.9 nMBCE/mMCr) than the group which did exercise regularly (22.7 nMBCE/mMCr). In multiple regression analyses, age, stiffness and exercise in past adulthood could explain 43.5% of the NTx variance. For prevention of bone metabolic increases around menopause, habitual exercise in early adulthood seems to be effective. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 52 3 1998 Serum alpha-fetoprotein levels in healthy Japanese adults. 149 154 EN Hiroaki Matsui Nirmal Rimal Kozue Kamakura Seiichiro Uesugi Hideki Yamamoto Satoru Ikeda Kazuhisa Taketa Article 10.18926/AMO/31332 With advances in lectin affinity electrophoresis of alpha-fetoprotein (AFP), the detection of significant changes in serum AFP at low levels in cirrhotics has become important for early detection of hepatocellular carcinoma. Serum AFP levels of 616 healthy individuals without abnormal liver function tests or virus markers of hepatitis B and C were determined by enzyme immunoassay with IMx-AFP Dainapack using automated IMx apparatus set at twice the ordinary sensitivity and compared with those of 241 individuals with abnormal liver function tests and/or positive hepatitis virus markers. The coefficient of variation in this assay was less than 10% at AFP levels as low as 0.2 ng/ml with a lower detection limit of 0.1 ng/ml. The AFP level of healthy population showed a Gaussian distribution curve after logarithmic transformation with a median and 2.5-97.5 percentile reference range of 2.2 (0.6-5.6) ng/ml. There was no significant difference in the AFP level between males and females. Individuals with abnormal liver function tests alone showed no significant increase in serum AFP unless they were associated with positive hepatitis virus markers. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 52 3 1998 Wider Distribution of Salivary-Type Isoamylase Activity as Compared with Pancreatic-Type Isoamylase Activity in Serum: A Study on Young Female Adults 143 148 EN Masako Nishimura Satoru Ikeda Kazuhisa Taketa Article 10.18926/AMO/31329 The clinical implications of a wider distribution of salivary type (S-type) isoamylase activity, as compared with that of pancreatic type (P-type) isoamylase activity in the serum of young female adults of 18-23 years old was studied. A high correlation existed between the S-type isoamylase levels in the initial determination and those in the second determination one year after on the same subjects, indicating that the wider distribution of S-type isoamylase level reflects an individual variation. The serum level of S-type isoamylase was highly correlated with the S-type isoamylase activity in saliva. Among the additional factors studied, a weak positive correlation was present between energy intake and the total and S-type isoamylase activities in serum. However, there was no negative correlation between the S-type isoamylase level and body mass index (BMI), which was reported for young male adults. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 52 3 1998 Risk analysis of the exposure to GB virus C/hepatitis G virus among populations of intravenous drug users, commercial sex workers and male outpatients at STD clinic in Chiang Mai, Thailand: a cross-sectional case-control study. 161 167 EN Narufumi Suganuma Satoru Ikeda Kazuhisa Taketa Da-hong Wang Hideki Yamamoto Kannika Phornphukutkul Supatra Peerakome Kriegsak Sitvacharanum Jaroon Jittiwutlkarn Article 10.18926/AMO/31326 An exposure to GB virus C/hepatitis G virus (GBV-C/HGV) was studied among populations at risk for blood and sexual exposure to analyze risk factor of the transmission of the virus. Blood samples were drawn from 98 intravenous drug users (IVDU), 100 female high-class commercial sex workers (CSW) and 50 male outpatients (MOP) at a sexually transmitted diseases (STD) clinic in Chiang Mai, Thailand. These blood samples were analyzed for GBV-C/HGV RNA; antibodies against second envelope protein of GBV-C/HGV (anti-E2); anti-hepatitis C virus antibody (HCV-Ab); hepatitis B core antibody (HBcAb); and antibodies against human immunodeficiency virus (HIV-Ab). Prevalences of GBV-C/HGV RNA, anti-E2, HCV-Ab, HBcAb and HIV-Ab were 27.6%, 16.3%, 84.7%, 76.5% and 45.0% in IVDU; 0%, 21.5%, 2.0%, 72.0% and 11.0% in CSW; 6.0%, 13.6%, 0%, 64.0% and 14.0% in MOP. While the prevalence of GBV-C/HGV RNA was higher in IVDU than in CSW and MOP, comparable prevalences of anti-E2 among the three populations were found. Intravenous drug injection showed association with GBV-C/HGV RNA, while history of STD associated with anti-E2. In conclusion, intravenous drug injection and STD were found to be risk factors for the previous exposure to GBV-C/HGV, but STD did not increase the risk of the GBV-C/HGV viraemia. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 35 2 1981 Complete in vitro replication of SV40 DNA and chromatin in saponin-treated permeable cells. 149 154 EN Satoru Ikeda Hideo Nagashima Kazuhisa Taketa Makoto Watanabe Brief Note 10.18926/AMO/31266 Effect of nicomol on high density lipoprotein (HDL) subfractions, HDL2e and HDL3e, separated by electrophoresis. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 34 5 1980 Interrelated changes in gamma-glutamyltransferase activity and HDL-cholesterol level in the sera of patients with alcoholic liver injury. 293 299 EN Takero Ide Kazuhisa Taketa Makoto Watanabe Satoru Ikeda Masaki Izumi Teruko Sokabe Hiroshi Kono Yoshio Yamamoto Article 10.18926/AMO/30548 The levels of HDL-cholesterol and gamma-glutamyltransferase in the sera of 17 patients with alcoholic liver injury were followed after abstinence and compared with those of 11 patients with acute non-alcoholic hepatitis. The activity of gamma-glutamyltransferase decreased in all cases irrespective of the type of liver injuries. The level of HDL-cholesterol also decreased in 11 of 17 cases with alcoholic liver injury. The other alcoholics, in whom HDL-cholesterol level increased or showed no definite change after withdrawal of alcohol, had severe and advanced liver injuries. In non-alcoholic hepatitis, the HDL-cholesterol level increased as normal liver functions were restored except for one case with cholestatic features. It was concluded that alcohol intake can increase HDL-cholesterol level even in the presence of a concomitantly induced hepatic lesion. No potential conflict of interest relevant to this article was reported.

岡山大学医学部附属病院三朝分院 Acta Medica Okayama 0918-7839 66 1995 温泉療法と気管支喘息患者のQOL 72 77 EN Yoshiro Tanizaki Takashi Mifune Fumihiro Mitsunobu Kazuhiro Kajimoto Yasuhiro Hosaki Satoshi Yokota Koji Ochi Hideo Harada Satoru Ikeda Kazuhisa Taketa 10.18926/15127 気管支喘息のなかでも,ステロイド依存性重症難治性喘息では,気管支拡張薬その他の抗喘息薬のみでは発作のコントロ-ルが極めて困難であり,したがって副腎皮質ホルモンの長期投与を余儀なくされる｡そして,投与薬剤,特に気管支拡張薬の心臓刺激作用や副腎皮質ホルモンの副作用,さらには運動誘発喘息がひき起こされやすいなどの理由により,体動制限が加えられることが多い｡このことが,また精神活動の低下へとつながる｡したがって,重症難治性喘息患者のQuality of life (QOL)を高めるためには,薬剤の副作用をできるだけ低くするための投与薬剤の減量をはかるとともに,十分な運動のもとに治療を行い全身状態の改善,それにともなう精神活動の活性化をはかる必要がある｡かかる観点からすれば,温泉療法は最も理想的な治療法であり,その直接作用(気道への作用:気道浄化作用,気道粘膜正常化作用)により,白,他覚症状の改善,換気機能の改善,気道過敏性の低下などが観察される｡また,間接作用(気道以外への作用)により,全身状態の改善,自律神経系の安定化作用,副腎皮質機能の改善作用などが見られる｡すなわち,重症難治性喘息に対する温泉療法では,十分な運動のもとに,精神活動の活性化をともなった喘息症状の改善がはかられるため,患者のQOLをより一層高めることができると判断される｡ No potential conflict of interest relevant to this article was reported.

岡山大学医学部附属病院三朝分院 Acta Medica Okayama 0918-7839 66 1995 Serum cortisol levels in patients with bronchial asthma. Relationship to glucocorticoid therapy and patient age. 30 36 EN Yasuhiro Hosaki Takashi Mifune Fumihiro Mitsunobu Kazuhiro Kajimoto Satoshi Yokota Yoshiro Tanizaki Koji Ochi Hideo Harada Satoru Ikeda Kazuhisa Taketa 10.18926/15121 Serum cortisol levels were examined in 94 patients with bronchial asthma in relation to dose of glucocorticoids and age. 1. The level of serum cortisol was significantly lower in group A patients, treated with glucocorticoids (prednisolone of 5mg/day or more) for more than 2 years, (2.4±1.2mcg/㎗) than in group B, treated with glucocorticoids (prednisolone of 5mg or less) for less than 2 years, (6.8±3.7mcg/㎗) (p<0.001) and in group C, treated without glucocorticoids, (12.6±3.9mcg/㎗) (p<0.001). The serum cortisol level was also significantly lower in group B than in group C (p<0.001). 2. The level of serum cortisol was significantly lower in patients over the age of 70 compared to that in those aged between 0 and 39 years (p<0.01) and those between 40 and 49 (p<0.05), and those between 50 and 59 (p<0.02). The level was also lower in patients between 60 and 69 compared to that in those between 0 and 39, however, this was not significant. These results demonstrate that the level of serum cortisol decreases by long-term glucocorticoid regimen and with aging. No potential conflict of interest relevant to this article was reported.

岡山大学医学部附属病院三朝分院 Acta Medica Okayama 0918-7839 66 1995 Characteristics of ventilatory function in clinical types of bronchial asthma in the elderly 21 29 EN Yasuhiro Hosaki Takashi Mifune Fumihiro Mitsunobu Kazuhiro Kajimoto Satoshi Yokota Yoshiro Tanizaki Koji Ochi Hideo Harada Satoru Ikeda Kazuhisa Taketa 10.18926/15120 Ventilatory function was examined in 55 patients with asthma (25 older patients over the age of 60 and 30 younger patients under the age of 59) in relation to four clinical types classified by clinical symptoms and signs. 1. Regarding cellular composition of bronchoalveolar lavage (BAL) fluid, number of BAL neutrophils was significantly increased in type II, bronchiolar obstruction type, of older and younger patients compared to that in type la-1 and type la-2 of same patients. In contrast, BAL eosinophilia was observed in type la-2 of both older and younger patients and in type Ib of younger patients. 2. The values of % FVC, FEV(1.0%) and % PEFR were not significantly different among four clinical types of asthma and between older and younger patients, although the values of these ventilatory parameters in type II asthma showed a tendency to be lower compared to other clinical types. 3. The values of % MMF, % V(50), and % V(25), showing ventilatory dysfunction of small airways, were lowest in type II asthma of both older and younger patients among four clinical types. A significant difference in these ventilatory parameters of type II asthma compared to type la-1 asthma was observed in younger patients, but not in older patients. These results show that ventilatory dysfunction of small airways is related to clinical asthma types in younger patients, and to aging rather than asthma types in older patients. No potential conflict of interest relevant to this article was reported.

岡山大学医学部附属病院三朝分院 Acta Medica Okayama 0918-7839 66 1995 Decrease in histamine release from bronchoalveolarcells with aging in patients with atopic asthma sensitive to house dust mite 1 7 EN Yoshiro Tanizaki Takashi Mifune Fumihiro Mitsunobu Kazuhiro Kajimoto Yasuhiro Hosaki Satoshi Yokota Koji Ochi Hideo Harada Satoru Ikeda Kazuhisa Taketa 10.18926/15117 Histamine release from bronchoalveolar cells induced by house dust mite (HDm) was compared in patients with atopic asthma sensitive to HDm in relation to age. 1. Total cell number in bronchoalveolar lavage (BAL) fluid was larger in patients over the age of 40 years (9.10×10(6)) than in those aged between 20 and 39 years (6.25×10(6)), however, this was not significant. 2. Number of BAL eosinophils was not significantly different between the two age groups. 3. Number of BAL basophilic cells was significantly higher in younger patients (20-39 years) (1.85±1.03×10(2)/mℓ) than in older patients (40+ years) (0.39±0.24×10(2)/mℓ) (p<0.001). 4. Histamine release from BAL cells induced by HDm was significantly higher in younger patients (38.1±24.8%) than in older patients (0%) (p<0.001). These results suggest that histamine release from BAL cells in patients with HDm allergy decreases with aging. No potential conflict of interest relevant to this article was reported.

岡山大学医学部附属病院三朝分院 Acta Medica Okayama 0918-7839 67 1996 Type Ⅱ (bronchiolar obstruction) asthma and number of neutrophils in bronchoalveolar lavage (BAL) fluid 79 84 EN Yoshiro Tanizaki Takashi Mifune Fumihiro Mitsunobu Yasuhiro Hosaki Kozo Ashida Satoshi Yokota Hirofumi Tsugeno Kazuaki Takeuchi Yuichiro Nawa Koji Ochi Hideo Harada Satoru Ikeda Kazuhisa Taketa 10.18926/15091 Bronchial asthma is classified into three types ; type Ia (Ia-1 and Ia-2), type Ib, and type Ⅱ, by clinical symptoms (clinical diagnosis). Asthma is also classified by clinical findings and examinations (score diagnosis). Both classification systems show that markedly increased proportion of BAL neutrophils and marked decrease in % V25 value are characteristic of type Ⅱ, bronchiolar　obstruction, asthma. However, there are some type Ⅱ asthma patients without BAL neutrophilia. In these patients, age is higher compared to those with BAL enutrophlia. Decrease in FEV1.0% value and decrease in the proportion of BAL lympocytes and serum IgG level, are not so remarkable as decrease in those with BAL neutrophilia. It has been suggested that type Ⅱ asthma with BAL neutrophilia correlates with suppression of humoral and cellular immunity, and same type of astma without BAL neutrophilia is in part caused by aging. No potential conflict of interest relevant to this article was reported.

岡山大学医学部附属病院三朝分院 Acta Medica Okayama 0918-7839 67 1996 Evaluation of Body Surface Temperature by Thermography 63 70 EN Yasuhiro Hosaki Yuichiro Nawa Kazuaki Takeuchi Hirofumi Tsugeno Kozo Ashida Satoshi Yokota Fumihiro Mitsunobu Takashi Mifune Yoshiro Tanizaki Koji Ochi Hideo Harada Satoru Ikeda Kazuhisa Taketa 10.18926/15088 Body Surface Temperature was observed by thermography. The surface temperature of a healthy person's lower limbs, after being cooled in a water bath, increased in parallel with time. Patients with Diabetes Mellitus had different patterns in the rate of increase of the surface temperature. After cold loading, one patient had a 99% recovery ratio of surface temperature, the same level as healthy volunteers (83%, and 88%), as calculated by a picture processing program with the computerized thermotracer. However, the recovery ratio of other patients was poorer, ranging from 56% to under 6% recovery. This measurement of elevation of body temperature is useful for the estimation of peripheral blood flow in patients with lower limbcirculation failure. No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 1986 Distribution of electrophoretically separated serum high density lipoprotein subfraction levels among healthy students and its alteration in patients with liver diseases EN No potential conflict of interest relevant to this article was reported.