Urinary incontinence is a common problem as women age. The aims of this study were to assess the prevalence and risk factors of urinary incontinence and their impact on the quality of life of working Japanese women. In this cross-sectional study, 975 women completed the Urogenital Distress Inventory-6, the Short Form (SF)-36 Health Survey, and the King's Health Questionnaire. Their mean age was 47.6 years and the reported prevalence of stress, urge, and mixed urinary incontinence symptoms during the past month was 19.3%, 4.2%, and 7.8%, respectively. The prevalence rate of all the three types of incontinence increased with age and Body Mass Index. There was no significant difference in the questionnaire subscale scores of the SF-36 Health Survey and the King's Health Questionnaire between these types and those without urinary incontinence. However, in relation to the SF-36 scores, we found that urge urinary incontinence had more effect on women than stress urinary incontinence. There was a high prevalence of urinary incontinence in the participants. The results emphasize the need for women to be provided with education programs about incontinence and to perform preventive exercises.

Evaluation of the Effect of Heat Exposure on the Autonomic Nervous System by Heart RateVariability and Urinary Catecholamines: Shinji YAMAMOTO, et al. Department of Hygiene, Yamaguchi University Graduate School of Medicine-The aim of this study was to investigate the usefulness of heart rate variability (HRV) and urinary catecholamines (CA) as objective indices of heat stress effect. We examined physiological responses, subjective symptoms, HRV and urinary CA to evaluate the effect of heat exposure on the autonomic nervous system. Six healthy male students volunteered for this study. They were exposed on different days to either a thermoneutral condition at wet bulb globe temperature (WBGT) 21°C, or a heated condition at WBGT 35°C for 30 min, while seated on a chair. In the thermoneutral condition, differences of all parameters between the values before and after 30 min exposure were not statistically significant. In the heated condition, heart rate, body temperature and scores for subjective symptoms (feverishness, sweating, mood, and face flushing) significantly increased after 30 min exposure (p<0.05). Also, the high frequency component (HF%) of HRV significantly decreased and the low frequency/high frequency (LF/ HF) ratio of HRV significantly increased after 30 min exposure to the heated condition (p<0.05). There were no significant differences between the amounts of urinary CA before and after the 30 min exposures; however, the norepinephrine amount after 30 min exposure to the heated condition was significantly greater than that of the thermoneutral condition (p<0.05). The heat exposure (WBGT 35°C) induced activation of the sympathetic nervous system and a withdrawal of the parasympathetic nervous system. These findings coincide with observed changes of heart rate, body temperature and subjective symptoms. It is suggested that HRV (HF% and LF/HF ratio) and urinary norepinephrine may be useful objective indices of heat stress; HRV seems to be more sensitive to heat stress than urinary CA.

Abstract:The urinary concentration of , which is a biomarker of oxidative DNA damage, was measured in 248 healthy Japanese, and its correlations with life style, urinary metal elements, serum antioxidants, and other plasma or serum factors were investigated. The mean urinary concentration of 8-OHdG was 15.2∫5.71 ng/mg creatinine. Mean urinary 8-OHdG was not significantly different in terms of age (Ͻ45, Ն45), gender, smoking (no, Ͻ20, Ն20), and alcohol consumption (no, occasionally, sometimes and usually). Moreover, multiple regression analysis showed a significant association between urinary 8-OHdG and urinary arsenic (As) or chromium (Cr), and a tendency for association between the former and aluminum (Al) and nickel (Ni). Age, gender and plasma or serum factors including antioxidants, lipid peroxide, HbA1c, BUN, and iron did not show such an association. The present study suggests that natural exposure to toxic metal elements such as As, Cr, and Ni may influence oxidative DNA damage in healthy people under usual environmental management. Therefore, the measurement of urinary metals such as As, Ni and Cr is prerequisite for the study of the relationship between urinary 8-OHdG and other variable factors.Many chemical and physical factors in the general environment can be hazardous to a person's health and induce oxidative stress. Reactive oxygen species generated in tissues or organs may affect proteins, carbohydrates, lipids and nucleosides in several ways. Reactive oxygen species such as hydroxyl radicals (OH ¡ ) can add on to guanine at positions 4, or 8 in the purine ring. Addition to C-8 produces a C-8 OH-adduct radical that can be reduced to 8-hydroxy-7, 8-dihydroguanine, and oxidized to 8-hydroguanine (Halliwell & Gutteridge 1999). The formation of 8-hydroxyguanine (8-OHdG) was recently examined in oxidatively damaged DNA (Kasai & Nishimura 1984;Floyd et al. 1986). The measurement of urinary 8-OHdG was extensively studied in pathological conditions such as carcinogenesis, coronary heart disease and diabetes because of its non-invasive and since it is less technically involved. Therefore, although the ultimate source of 8-OHdG is not clearly understood, urinary 8-OHdG is a candidate for biomarker of oxidative DNA damage. Urinary 8-OHdG can be assessed in good association with diabetes mellitus (Kanauchi et al. 2002) antioxidants (Prieme et al. 1997) and dietary supplements (Hakim et al. 2003) are also related to urinary 8-OHdG. However, the relationship between non-occupational factors and urinary 8-OHdG in healthy people has not been determined. Moreover, new evidence showing that the urinary elevation of 8-OHdG in acute or chronic arsenic poisoning patients suggested the importance of urinary detection of arsenic in a population study. Therefore, the present study was designed to clarify the associations of urinary toxic metals such as arsenic with urinary 8-OHdG and to observe the influences of non-occupational factors on urinary 8-OHdG in healthy people. Materials and MethodsParticipants. This study wa...

Abstract:For diagnosing the hand-arm vibration syndrome, peripheral circulation and sensory tests immersing one hand in cold water at 10°C for 10 min have been performed widely in Japan. For estimating circulatory function of the upper extremities using the finger skin temperature, the room temperature should be strictly controlled and the effect of seasonal condition must be taken into consideration.

By using the STAI developed by Spielberger et al. we have investigated the validity and reliability of two scales, that is, State Anxiety (A-State) and Trait Anxiety (A-Trait), and at the same time have examined them under various conditions. The results obtained are as follows :1) As a result of factor analysis concerning 40 items of the STAI used in this research, we have confirmed that both A-State and A-Trait have independent factor structures of their own, and that the items of the scales also carry their own validity.2) After due consideration of the test-retest reliability of the two scales, we have found that A-Trait has rather high stability.Moreover, we have noticed that Cronbach's alpha coefficients, which show the reliability of the two scales, are high. In consequence, we have confirmed the high reliability of the two scales.3) In comparing the scores of A-State and A-Trait obtained from young healthy people with those from healthy aged people, we have noticed that the aged get low scores on each of the two scales, and that each score distribution shows an excellent fit to the normal one. 4) We have found that A-State scores go up significantly when people are in a condition of emotional stress, but that there is not any change of A-Trait scores. 5) We have observed a significant increase of A-State scores at each noise level over 75 dB (A). From the above-mentioned results, we have reached the conclusion that the STAI is very valid and reliable, and that the A-State scale, especially, is a very good indicator of men's psychological states under conditions of temporary stress.

School of Medicine-The aim of this study was to e v a l u a t e h e a r t r a t e v a r i a t i o n a n d u r i n a r y catecholamines in response to acute psychological stress in hand-arm vibration syndrome (HAVS) patients and healthy controls. LF% (indicator of both the sympathetic and parasympathetic nervous activity), HF% (indicator of the parasympathetic nervous activity) and their ratio LF/HF (indicator of sympathovagal b a l a n c e ) w e r e c a l c u l a t e d f r o m s h o r t -t e r m electrocardiographic data from 16 HAVS patients and 14 healthy controls before and immediately after exposure to acute psychological stress. Urinary catecholamines (norepinephrine, epinephrine and dopamine) were analyzed from urine samples collected from every subject during rest and after exposure. The LF% and LF/HF of the patients significantly increased after exposure. The after exposure LF/HF of the patients was significantly greater than that of the controls. The amount of norepinephrine in the patients significantly increased after exposure. The after exposure amount of norepinephrine and epinephrine in the patients were significantly greater than the respective amount of the controls. The results of the present study indicated the predominance of sympathetic tone in the cardiac sympathovagal balance and greater sensitivity of the sympathoadrenal medullary system in response to acute psychological stress in the patients than in the healthy controls.

Although we recently compared blood pressure (BP) changes during cataract surgery between groups that received topical and retrobulbar block anesthesia, a study has not been conducted in which patients were matched for age and sex. To draw more meaningful conclusions, we conducted a age- and sex-matched study in which the daily, pre- and postoperative blood pressures of 1,398 cataract patients were compared. All surgeries were performed using the same method of phacoemulsification and aspiration with intraocular lens implantation under local anesthesia. The postoperative BPs of the retrobulbar injection group decreased significantly more than the topical application group. Even when the patients were hypertensive, the postoperative BPs decreased. Following retrobulbar block anesthesia, the BP decreased postoperatively to a greater extent than after topical anesthesia.

We investigated the parasympathetic nervous response to psychological test using heart rate variation (HRV) during deep breathing in elderly patients with hand-arm vibration syndrome and healthy controls. Average age (SD) of 16 patients with vibration-induced white finger (VWF), 13 patients without VWF and 12 healthy controls was 60.1 (2.8), 60.6 (4.2) and 58.8 (3.8), respectively. After an initial supine rest for 40 min, psychological test (Stroop color word test and mirror drawing test) was performed for 20 min. The indexes of HRV (Mean R-R, SD, RMSSD and CV) were calculated. Blood pressure and heart rate were also measured. The indexes of HRV did not differ between the groups before exposure. The SD, RMSSD and CV of the patients without VWF during supine deep breathing after 3 min post-exposure supine rest were significantly lower than those of the control group (p<0.05). The Mean R-R of the patients without VWF significantly increased (p<0.05). Blood pressure did not differ in either before or after exposure measurements. The results suggest that the post-exposure response of the parasympathetic nervous system to psychological test reduced in the patients without VWF. Key words:Hand-arm vibration syndrome, Psychological test, Parasympathetic responseVibration-induced white finger, Heart rate variation, It has been suggested that exposure to hand-arm vibration might affect autonomic nervous functions and has been demonstrated on the basis of subjective symptoms complained with higher prevalence rates by patients with hand-arm vibration syndrome than healthy controls" 2).In clinical neurology the responses of cardiovascular reflexes have been used to examine the function of the autonomic nervous system3° 4). It has been accepted that respiratory sinus arrhythmia in supine deep breathing is vagally mediated, and variation of heart rate parameters due to respiratory arrhythmia is considered as an indicator of the parasympathetic nervous functions' 6)In this study, we examined a group of elderly patients with hand-arm vibration syndrome and healthy controls to *To whom correspondence should be addressed .evaluate the parasympathetic nervous activity using heart rate variation. Because the heart rate variation decreases with increasing age's, we manipulated levels of cardiac sympathetic and parasympathetic activity of the subjects exposing them to psychological test and measured R-R intervals in supine deep breathing before exposure and after 3 min post-exposure supine rest. Blood pressure and heart rate were also measured. We studied 41 male subjects. Sixteen of them with agerange 55 to 66 (60.1 ± 2.8) years, were workers exposed to vibration and experienced attacks of vibration-induced white finger during the past year (VWF(+) group), 13 with agerange 54 to 65 (60.6 ± 4.2) years, were workers exposed to vibration but did not experience attacks of vibration-induced white finger (VWF(-) group) and 12 healthy workers with age-range 51 to 61(58.8 ± 4.0) years, were examined as a