Language：English   Publisher：Public Health  

Objectives The extent to which modifiable behavioral factors mediate educational disparities in mortality nationally remains unelucidated. Therefore, we examined whether educational level affects overall and cause-specific mortalities in Japan. Study design A multi-centered cohort study. Methods This national, multicenter study included 58,831 participants (57 % female) from the Japan Multi-Institutional Collaborative Cohort Study (mean age: 54 years). Baseline data were collected between 2004 and 2014, with a maximum 12-year follow-up period. Outcomes included mortalities from cancer, cardiovascular disease, and other causes. Participants were categorized by educational level: high school or lower, junior college, and university or higher. The hazard ratio (HR) for mortality was estimated using Cox regression, with the university or higher cohort as the reference. Causal mediation analysis was conducted to assess the mediated effect of modifiable behaviors on education-related mortality risk. Results Among male participants, the high school or lower cohort exhibited a higher overall mortality rate (adjusted HR: 1.23; 95 % confidence interval = 1.08–1.41) and elevated risks for cancer-related and other causes of death (HRs: 1.18 and 1.75, respectively). This disparity was most pronounced in men aged 35–59 years. Smoking, excessive alcohol consumption, and inadequate leisure-time physical activity accounted for 11 %, 9 %, and 12 % of the educational mortality discrepancy, respectively. Female participants did not exhibit a significant educational mortality disparity. Conclusions Educational disparities in mortality persist among the younger male population in Japan, with modifiable behavioral risks identified as key mediators.

DOI： 10.1016/j.puhe.2026.106142

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PubMed

Language：Japanese   Publisher：Discover Applied Sciences  

Exposure to heavy metals through food consumption is a crucial chronic exposure pathway and a concern for health effects during pregnancy. We estimated heavy metal exposure among Indonesian pregnant women consuming seafood during pregnancy and its health impact on hemoglobin (Hb) and random blood glucose (RBG) levels, as well as the mother’s hair mercury. Marine (N = 25) and freshwater (N = 6) fish species were collected from seven shelters in the Jepara coastal area. Using heavy metal (Hg, Pb, Cd, and Sn) concentrations and fish consumption data, we estimated the daily intake of heavy metals (DIM) for 173 pregnant women and analyzed the RBG and Hb levels. Marine fish species showed higher levels of all heavy metals. Daily intake of Hg was negatively related to Hb level, and women with anemia showed higher DIM and hair Hg levels. A similar trend was observed for Pb levels. An increased trend in anemia risk with DIM and hair Hg levels remained after adjusting for age, gestational age at blood collection, and body mass index before pregnancy. The DIM of Cd and Sn showed insignificant negative relationship with Hb levels. None of the metal levels were related to the RBG levels. This is first data that indicates the higher DIM, particularly Hg and Pb from seafood intake and hair Hg, is related to Hb, but unrelated to RBG levels in pregnant women in Jepara coastal area of Indonesia.

DOI： 10.1007/s42452-026-08239-3

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Language：English  

DOI： 10.1093/ntr/ntaf252

PubMed

Language：English   Publisher：Environmental Health and Preventive Medicine  

Background: Exposure to microplastics (MPs) can have adverse gastrointestinal effects by inducing inflammation and oxidative stress. The types of MPs in stool vary with the dietary intake. However, how MPs in the intestinal tract influence the inflammatory cytokine levels in the gastrointestinal tract in healthy individuals remains unclear, particularly in Japan, characterized by a high intake of vegetables and seafood. In this study, we investigated the relationship between food intake, stool MPs, and inflammatory markers in healthy Japanese individuals, and estimated the sources of the stool MPs. Methods: Twenty-two participants completed a questionnaire on daily food intake for 7 days. Thereafter, stool samples were collected to examine MP density via Fourier-transform infrared spectrophotometry. On day 8, blood samples were collected and analyzed for serum oxidative stress markers and cytokine levels. Next, the effect of total stool MP particle density (Low vs. High) on oxidative stress markers and cytokines levels was analyzed. Results: The median total MP particle density of the participants (median age: 44 years) was 7.20 MP particles per g of stool. Seafood intake was higher in the High MP group than in the Low MP group, with a Mann-Whitney U test yielding p=0.035 for seafood intake. However, after the false discovery rate (FDR) correction, this effect was not significant. Nevertheless, the effect size for seafood intake was large, suggesting an association with MP level. Relative to the Low MP group, the High MP group showed significantly higher thymic stromal lymphopoietin (TSLP) levels (odds ratio: 13.5; 95% confidence interval: 0.99–183, p=0.050). The analysis further revealed that the seafood consumed by the High MP group contained significant amounts of polyethylene (PE) and polypropylene (PP), MPs commonly used in plastic packaging (PE, p=0.028; PP, p=0.053). Conclusion: This study showed that stool MP particle density is likely associated with seafood intake and the TSLP level, implying that excessive MP intake may adversely affect human health. Therefore, measures to reduce MP exposure are urgently required.

DOI： 10.1265/ehpm.25-00403

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PubMed

Language：English   Publisher：Nutrition Journal  

Background: The consumption of a healthy diet may play an important role in the prevention of noncommunicable diseases (NCDs). Although associations between nutrient patterns and cardiometabolic risk factors or NCDs have been examined, the associations between nutrient patterns and mortality remain unknown. The present study examined the relationships between nutrient patterns and all-cause and cause-specific mortalities in a large Japanese population. Methods: A prospective cohort analysis was performed on the data of 72,939 participants aged 35–69 years with a mean follow-up of 11.7 years in the Japan Multi-Institutional Collaborative Cohort Study. A factor analysis was applied to the energy-adjusted intakes of 21 nutrients, and 4 nutrient patterns were extracted: Factor 1 (folate, carotene, fiber, vitamin C, potassium, iron, and retinol patterns); Factor 2 (unsaturated fatty acid and vitamin E patterns); Factor 3 (saturated fatty acid, calcium, vitamin B2 and low carbohydrate patterns); and Factor 4 (sodium, protein and vitamin D patterns). A multivariable Cox proportional hazards model was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause and cause-specific mortalities according to the quartiles of nutrient patterns adjusted for potential confounders including age, sex, research site, drinking and smoking habits. Results: During the follow-up period, 3,488 deaths were identified. A higher Factor 1 (folate, carotene, fiber, vitamin C, potassium, iron, and retinol) score was associated with lower all-cause (HR 0.81, 95% CI 0.73–0.90), CVD (HR 0.65, 95% CI 0.49–0.85) and cerebrovascular disease (HR 0.60, 95% CI 0.38–0.96) mortalities. The second lowest quartile group of the Factor 2 (unsaturated fatty acid and vitamin E) score was associated with lower all-cause (HR 0.86, 95% CI 0.79–0.94) and cancer (HR 0.85, 95% CI 0.76–0.95) mortalities. On the other hand, a higher Factor 2 score was associated with greater cerebrovascular disease mortality (HR 1.57, 95% CI 1.03–2.40). Conclusions: The results of the present study suggest that increased adherence to nutrient patterns rich in folate, carotene, fiber, vitamin C, potassium, iron, and retinol or moderate adherence to unsaturated fatty acids and vitamin E are associated with a decreased risk of mortality in Japanese adults.

DOI： 10.1186/s12937-025-01274-7

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Language：English   Publisher：Scientific Reports  

The impact of diet on the body acid-base balance may be related to the risk of various chronic diseases. This prospective cohort study examined the relationships between the dietary acid load and all-cause and cause-specific mortalities in a large Japanese population. The data of 74,293 participants (aged 35–69 years in the baseline survey) in the Japan Multi-Institutional Collaborative Cohort Study were analyzed. The dietary acid load was estimated using the net endogenous acid production (NEAP) score. Cox proportional hazards regression analyses were performed to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause and cause-specific mortalities according to the quartiles of the energy-adjusted NEAP score after adjustments for potential confounders. During a mean follow-up of 11.6 years, 3,755 deaths were identified. Participants with higher NEAP score had increased HR of all-cause (HR 1.18, 95% CI 1.07–1.29) and cause-specific death including cerebrovascular disease death. Sex-stratified analyses showed that NEAP scores were significantly associated with higher HR of all-cause and cause-specific death, including cerebrovascular disease death in male participants, but not in female participants. This study suggests that the dietary acid load may be associated with all-cause and cause-specific mortalities in Japanese male adults.

DOI： 10.1038/s41598-025-25081-6

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Language：Japanese   Publisher：Radioprotection  

Our group has developed a “Creative Health” project as a participatory educational approach after Japan’s 2011 earthquake, tsunami, and nuclear disaster in Fukushima. The project engages elementary school children in three workshops: “ACT” was first, developed by a specialist in participatory theater, to empower children to express what they think about their community. “BODY” and “FOOD” came next, developed, respectively, by an academic pathologist specializing in blood transfusion and a university-based nurse-dietitian. Each workshop provides creative activities (e.g., drama and performance in ACT, storyboard presentation in BODY, and drawing in FOOD) for children to express their opinions. To assess the impact of Creative Health, attendees were asked about their feelings on health, food, and community. We compared responses between two groups: those involved in all three workshops (Group I) and those attending just BODY and FOOD (Group II). Group II showed increases in viewing their own health and the food in their community more positively. Similar increases were observed in Group I regarding views about their own health, the food in their community, and community overall. Text-mining analysis of children’s free written opinions showed that “taking care of my health” and “communication” appeared only in Group I. ACT had positive impacts on facilitating children to communicate with their peers, become responsible for their own health, and have positive perspectives about themselves and their community.

DOI： 10.1051/radiopro/2025007

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Language：English   Publisher：Npj Metabolic Health and Disease  

Polygenic risk scores (PRS) are useful for assessing disease risk; however, knowledge about their effectiveness among Asian and other populations is limited. This study aimed to compare the classification accuracy of PRSs for type 2 diabetes (T2D-PRS) developed from different ancestry groups using genotype data from 14,083 Japanese participants. Participants’ scores were calculated using T2D-PRS models, and logistic regression analysis and receiver operating characteristic curves were assessed. The odds ratio of diabetes per 1 standard deviation increase in PRS was 2.18 and 1.55 for the Japanese and European T2D-PRSs, respectively. The area under the curve (AUC) for the Japanese T2D-PRS was 0.781, whereas that for the European T2D-PRS was 0.738 (P < 0.001). Additionally, age-stratified analysis showed higher AUCs in younger than older age groups. The PRS developed from matched ancestry populations has high classification accuracy for diabetes and is particularly useful for the early detection of high-risk individuals with diabetes.

DOI： 10.1038/s44324-025-00059-0

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PubMed

Language：English   Publisher：(一社)日本毒性学会  

溶接ヒュームは鉄やマンガンなどの金属酸化物を含む微細粒子であり、呼吸器障害や神経疾患の原因となることが知られている。本研究では、九州および関東の溶接工場10施設に勤務する溶接作業員105名と事務職員129名、さらに工場から離れた南鹿児島市の一般住民30名を対象に血液を採取し、血清中のサイトカインおよびケモカイン濃度を測定した。IL-1β濃度は一般住民と比較して溶接作業員および事務員で有意に高値を示した。事務員ではIL-12p70、IL-17A、IL-33、TNF-α、CCL3が一般住民より有意に高値を示したが、これらの分子について溶接作業員と一般住民の間に有意差は認められなかった。事務職員は防護具着用義務がなく高濃度ヒュームに長期曝露することで全身性炎症のリスクが高い可能性が示された。したがって、曝露評価とリスク低減策は溶接作業員のみならず事務職員にも適用する必要があると考えられた。

Language：English   Publisher：Oxford University Press (OUP)  

<jats:title>Abstract</jats:title>
<jats:p>Cigarette smoking is one of the most important risk factors for lung cancer. Genetic studies have shown that smoking behavior-related genetic variants are directly associated with lung cancer, independent of smoking behavior, mainly in European populations. A recent genome-wide association study in Japan identified five loci associated with the number of cigarettes smoked per day. This study aimed to evaluate whether these loci are associated with lung cancer risk directly or indirectly through changing smoking behavior. Here, we conducted a case-control study (1427 cases and 5595 controls) and a prospective cohort study (128 incident cases in 10 520 subjects). Using mediation analysis, we decomposed the total effect of the lead single nucleotide polymorphism (SNP) at each locus on lung cancer risk into direct and indirect effects. The results of the two studies were pooled using a random-effects model to estimate summary relative risks (RRs) and their 95% confidence intervals (CIs). Two studies showed that: (i) rs78277894 (EPHX2-CLU, G &gt; A) had a protective direct effect (RR: 0.84; 95% CI: 0.77–0.93) on lung cancer risk; and (ii) rs56129017 (CYP2A6, C &gt; T) had carcinogenic direct and indirect effects on lung cancer risk (RR: 1.26; 95% CI: 1.15–1.39 and RR: 1.01; 95% CI: 1.00–1.01, respectively). This mediation analysis revealed that two smoking behavior-related SNPs, EPHX2-CLU rs78277894 and CYP2A6 rs56129017, were associated with lung cancer risk through pathways independent of changing smoking behavior. Our findings may contribute to our understanding of lung carcinogenesis pathways that cannot be addressed by changes in smoking behavior.</jats:p>

DOI： 10.1093/carcin/bgaf011

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CiNii Research

Publisher：Ovid Technologies (Wolters Kluwer Health)  

<jats:sec xml:lang="en">
<jats:title>Background</jats:title>
<jats:p xml:lang="en">Although utility of composite trait‐specific polygenic risk score (multi‐trait PRS) has been examined among European ancestries, few studies investigated among East Asians and incorporated modifiable risk factors. We examined the associations of multi‐trait PRS for cardiometabolic factors with cardiovascular disease mortality by integrating nongenetic determinants.</jats:p>
</jats:sec>
<jats:sec xml:lang="en">
<jats:title>Methods</jats:title>
<jats:p xml:lang="en">A total of 14 086 Japanese participants (mean age, 55±9; 55.8% women) of the J‐MICC (Japan Multi‐Institutional Collaborative Cohort) study were analyzed in this study. We calculated 6 PRSs for cardiometabolic traits (systolic blood pressure, body mass index, triglycerides, low‐density lipoprotein cholesterol, estimated glomerular filtration rate, and hemoglobin A1c). Based on these PRSs, we developed multi‐trait PRS and considered as a primary exposure. Three nongenetic factors (smoking, alcohol drinking, and educational attainment) from the self‐reported questionnaire were also examined.</jats:p>
</jats:sec>
<jats:sec xml:lang="en">
<jats:title>Results</jats:title>
<jats:p xml:lang="en">During a median 12.1‐year follow‐up period, a total of 472 all‐cause and 79 cardiovascular disease mortality cases were documented. Compared with 0% to 90% of multi‐trait PRSs, an adjusted hazard ratio (HR) among the top 10% of multi‐trait PRSs was 1.32 (95% CI, 1.00–1.73) for all‐cause death and 2.63 (95% CI, 1.48–4.67) for cardiovascular disease death. Incorporation of educational attainment with multi‐trait PRSs showed null associations in those who went beyond high school (HR, 2.07 [95% CI, 0.44–9.66]) even in the top 10% of multi‐trait PRS.</jats:p>
</jats:sec>
<jats:sec xml:lang="en">
<jats:title>Conclusions</jats:title>
<jats:p xml:lang="en">Our analysis combining both genetic and nongenetic determinants highlighted that lifestyle factors and educational attainment can slightly reduce an individual's composite genetic risk for cardiovascular disease death.</jats:p>
</jats:sec>

DOI： 10.1161/jaha.124.038572

CiNii Research

Language：English   Publisher：「Annals of Thoracic and Cardiovascular Surgery」編集委員会  

胃癌肺転移に対して肺切除術を施行された患者の予後を明らかにし、手術適応となる症例の選定基準について考察した。2005年5月～2023年3月に当科で胃癌肺転移に対して切除術が施行された患者12例(年齢58～80歳、男性10例)を対象とした。全例、異時性肺転移であり、胃切除の術式は胃全摘8例、噴門側胃切除3例、幽門側胃切除1例であった。術前化学療法は3例に施行されていた。肺転移巣に対しては、葉切除4例、区域切除1例、部分切除7例が行われた。肺転移切除前の血清CEA値、転移巣のサイズ・個数、無病期間(DFI)、術後経過などを調べた。その結果、胃切除後のDFIが12.5ヵ月未満の患者(5例)は12.5ヵ月超の患者(7例)に比べて肺切除後の全生存期間(OS)が有意に不良であった。胃切除後DFI≦12.5ヵ月群と胃切除後DFI>12.5ヵ月群の比較では、肺切除時の血清CEA値に有意差が認められた。肺切除時の血清CEA値が5.8ng/mLを超える患者は、それ以外の患者よりもOSが有意に不良であった。以上より、胃癌肺転移に対する肺切除術の予後は、DFIおよび切除時の血清CEA値と関連しており、これらの因子が手術適応の選定に有用である可能性が示唆された。

Language：English   Publisher：Canadian Journal of Anesthesia  

Purpose: Subcutaneous emphysema is a common complication of laparoscopic surgery. We aimed to determine the incidence, outcomes, and risk factors of postlaparoscopic subcutaneous emphysema. Methods: We conducted a single-centre historical cohort study of adult patients who underwent laparoscopic surgery at Kagoshima University Hospital between 1 April 2018 and 31 March 2021. We used multivariable logistic regression analysis to identify independent factors associated with postlaparoscopic subcutaneous emphysema. Results: We included 1,642 patients with a median [interquartile range] age of 65 [53–72] yr. Postlaparoscopic subcutaneous emphysema was diagnosed in 600 (37%) patients. Female sex (odds ratio [OR], 1.82; 99.5% confidence interval [CI], 1.29 to 2.58), peak end-tidal carbon dioxide ≥ 45 mm Hg (OR, 2.07; 99.5% CI, 1.43 to2.98), and use of the AirSeal® Intelligent Flow System (CONMED Corp., Largo, FL, USA) (OR, 3.37; 99.5% CI, 2.34 to 4.87) were independent factors associated with postlaparoscopic subcutaneous emphysema. In addition, a lower body mass index was significantly associated with increased postlaparoscopic subcutaneous emphysema (P for trend < 0.001). No complications were associated with postlaparoscopic subcutaneous emphysema. Conclusions: This historical cohort study showed a relatively high incidence of postlaparoscopic subcutaneous emphysema. In addition to previously reported risk factors, female sex and use of the AirSeal Intelligent Flow System were found to be associated with postlaparoscopic subcutaneous emphysema.

DOI： 10.1007/s12630-024-02859-2

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Language：English   Publisher：The Japanese Society for Hygiene  

<p><b>Background:</b> Exposure to methylmercury (MeHg) is predominantly attributed to consumption of marine products. However, the general population is exposed to low MeHg levels, which can induce chronic inflammation. Although some MeHg-related microRNAs (miRNAs) have been reported, their functions remain elusive. The objective of this study was to identify the miRNAs induced by low-level MeHg exposure in a human endothelial cell line (HAECs). This study aimed to determine the specific miRNAs induced by low-level MeHg exposure using a HAECs as a potential novel and sensitive biomarker. The roles of miRNAs in inflammatory processes have been examined.</p><p><b>Methods:</b> Using HAECs, a miRNA microarray assay was performed to identify miRNAs with altered expression upon exposure to a non-cytotoxic MeHg level (0.1 and 1.5 µM). The expression patterns of interleukin-6 and -8, cyclooxygenase 2 (COX-2), RelB, and prostaglandin E₂ (PGE₂) were examined after transfection of the identified miRNAs with mimics/inhibitors.</p><p><b>Results:</b> Although the microarray assay identified six MeHg-specific miRNAs, miR-3613-5p, upregulated by 0.1 and 1.5 µM MeHg exposures, demonstrated the best reproducibility in HAECs. Transfection with the miR-3613-5p mimic enhanced the MeHg-induced inflammatory responses, including PGE₂ and COX-2 protein levels, whereas the miR-3613-5p inhibitor suppressed these inflammatory responses.</p><p><b>Conclusion:</b> This study observed that miR-3613-5p is induced by low-dose MeHg exposure, plays a crucial role in the inflammatory process, and could serve as a novel and sensitive biomarker for low-level MeHg exposure.</p>

DOI： 10.1265/ehpm.25-00292

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CiNii Research

Language：English   Publisher：The Japanese Society of Toxicology  

<p>Welding fumes are metal particles of 1 µm or less generated during welding. Welding fumes generated in welding factories spread throughout the workplace. However, the effects of exposure have been measured primarily in welding workers, and no research has been conducted on the effects of fumes on workplace office workers. In this study, we recruited welding and office workers who worked in the same factories at ten workplaces in Japan, mainly in the Kyushu and Kanto regions, and separated their serum after blood sampling. We also obtained serum from the general subjects of Minami-Kagoshima City, which is located far from the welding factory. Cytokines and chemokines were quantified in the serum samples, and the concentration of interleukin (IL)-1β was significantly increased in office workers and welders compared with general subjects. Importantly, the serum concentrations of IL-12p70, IL-17A, IL-33, tumor necrosis factor α, and C-C motif chemokine ligand 3 in office workers were significantly higher than those in the general subjects, and there was no significant difference in the levels of these inflammatory molecules between welders and general subjects. This study suggests that office workers exposed to high fume concentrations exhibit increased systemic inflammation. Exposure assessments should be conducted not only for welders but also for office workers to reduce exposure risks.</p>

DOI： 10.2131/jts.50.215

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CiNii Research

Language：Japanese   Publisher：Hypertension Research  

Although previous studies reported that BP PRS is associated with CVD, it is less explored whether BP PRS and BP are jointly associated with CVD, especially among non-European populations. Therefore, we examined joint associations of BP control and BP polygenic risk score (PRS) with CVD mortality in a Japanese population. Data were obtained from the Japan Multi-Institutional Collaborative Cohort (J-MICC) Study, the multi-centered cohort study with 14 study areas throughout Japan. Of which, we analyzed ~35,000 Japanese individuals (Mean age: 55 years old, Men: 44%) with measured BP data (11,242 and 23,904 participants in subgroup #1 and #2). We developed PRS for systolic blood pressure (SBP) and diastolic blood pressure (DBP) in each subgroup. Participants were followed up from the baseline survey (2005–2014) to the end of 2020. Not elevated BP was defined as SBP ≤ 140 mmHg or DBP ≤ 90 mmHg regardless of antihypertensive medications. During the follow-up period, a total of 381 CVD deaths were observed. Compared with not elevated BP, HRs (95% CI) of CVD mortality were 1.98 (1.37–2.88) for elevated SBP and 2.41 (1.66–3.49) for elevated DBP. Compared to not elevated BP in the lowest PRS tertile, HRs (95% CI) of CVD mortality in the highest PRS tertile were 2.28 (1.17–4.43) for SBP and 3.08 (1.61–5.91) for DBP even though BP was not elevated. These associations in the subgroup #1 were replicated in the subgroup #2. Our findings highlighted the importance of BP PRS to detect a hidden CVD risk strata in addition to laboratory BP measurements. (Figure presented.)

DOI： 10.1038/s41440-025-02486-4

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Language：English   Publisher：Plos One  

Although the clinical importance of serum albumin and gamma gap levels is well established, it is unclear how these levels are associated with health risks in the general population. This cohort study aimed to clarify the association between serum albumin and gamma gap levels, and their combined effect, and mortality risk in a Japanese population. The participants totaled 35,746 (17,160 men and 18,586 women) aged 35–69 years from the Japan Multi-Institutional Collaborative Cohort (J-MICC) Study. The mean follow-up period was 11.8 years, with 1,529 deaths and 1,907 censoring. The Cox proportional hazards model was used to estimate hazard ratios (HRs) and 95% confidence intervals after adjusting for related factors. Increased HRs of low albumin and high gamma gap levels were respectively observed for deaths from all-causes, cancer, cardiovascular diseases, respiratory system diseases without pneumonia, and other-causes; and the HR was the highest on respiratory system diseases without pneumonia (HR=7.31, 4.15–12.9). Low albumin and low gamma gap levels were strongly associated for pneumonia death (HR=12.4, 3.98–38.5). The interaction between albumin and gamma gap levels was significant for deaths from all-causes, pneumonia and other-causes. The dose relationship for each association was dose-dependent in albumin and threshold-type in gamma gap, except for other-causes. This study suggests that albumin and gamma gap levels are independent indicators of an increased risk of mortality in a Japanese population. Combined effect was apparent for mortality from all-causes, pneumonia, and other-causes.

DOI： 10.1371/journal.pone.0336926

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PubMed

Language：Japanese   Publisher：XMLink  

DOI： 10.35500/jghs.2025.7.e2

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CiNii Research

Language：English   Publisher：Informa UK Limited  

Beginning in 2020, the COVID-19 pandemic limited onsite international activities and challenged us to plan and implement new ways of collaboration. We reviewed our online trials during a three-year period to better understand how to use digital technologies to continue knowledge and skills transfer. In this cross-national case study, we compare two illustrative cases: Japanese experts training Indonesian health professionals for participatory school health education, and Swiss experts training Malagasy health providers for respectful obstetric and newborn emergencies. We first describe our cases, referring to Vargo’s framework for summarizing reports on digital technology usage. Second, we draw commonalities between the two cases. Third, gleaned from these experiences during the pandemic, we offer a practical framework for efficient and effective international collaboration using new technologies. For both cases, basic digital technologies, such as online meetings and e-mailing, were used and training sessions were successfully conducted. Trusting relationships between the training and participant groups were in place before the pandemic. This led to enthusiasm for continuing learning even after the pandemic started. Our case comparison presents the usefulness of digital technologies for continuing international collaboration and highlights the importance of human factors, such as trusting relationships and enthusiasm to pursue a shared goal, as the basic condition for success.

DOI： 10.1080/23288604.2024.2387646

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CiNii Research

Language：English   Publisher：Springer Science and Business Media LLC  

<title>Abstract</title>
<p>Purpose: The impact of diet on the body acid-base balance may be related to the risk of various chronic diseases. This prospective cohort study examined the relationships between the dietary acid load and all-cause and cause-specific mortalities in a large Japanese population.
Methods: The data of 74,360 subjects (aged 35-69 years in the baseline survey) in the Japan Multi-Institutional Collaborative Cohort Study were analyzed. The dietary acid load was estimated using the net endogenous acid production (NEAP) score. Cox proportional hazards regression analyses were performed to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause and cause-specific mortalities according to the quartiles of the energy-adjusted NEAP score after adjustments for potential confounders.
Results: During a mean follow-up of 11.6 years, 3,761 deaths were identified. A higher NEAP score was associated with higher all-cause (HR 1.16, 95% CI 1.04-1.28) and cerebrovascular disease mortality (HR 1.69, 95% CI 1.08-2.65). Sex-stratified analyses showed that the NEAP score was associated with all-cause and cause-specific mortalities, including cerebrovascular disease mortality in male subjects, but not in female subjects.
Conclusion: This study suggest that the dietary acid load is associated with all-cause and cause-specific mortalities, including cerebrovascular disease mortality, in Japanese male adults.</p>

DOI： 10.21203/rs.3.rs-5297181/v2

CiNii Research

Language：Japanese   Publisher：Annals of the ICRP  

The 2011 Fukushima nuclear disaster placed health professionals and the public in the centre of an ‘infodemic’. We introduced health literacy training for health professionals to improve communication skills when facing a health crisis. By 2019, one in four public health nurses – our gatekeepers of community health – had been trained in Fukushima. Follow-up evaluations showed that the trained nurses applied their newly learned skills in practice, with more positive attitudes toward – and increased confidence in – their interactions with community residents. We also found that older residents and those unfamiliar with health services were more likely to notice improvements in written health information from the trained health workers. Health literacy training enhances communication between professionals and the public and makes health information more equitably accessible. This training has been incorporated into medical and nursing education, and also into primary school education, with participatory health-related activities for children in Fukushima and beyond. Our health literacy initiative covers the two arcs of health literacy: health professionals' ability to communicate health information and people's (including children's) ability to use the information.

DOI： 10.1177/01466453241283931x

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Language：English   Publisher：(一社)日本疫学会  

＜Highlight＞●日本人を含む東アジア集団における腎機能形質に関する遺伝疫学的エビデンスは、まだ比較的不十分である。●私たちは、日本人約20万人(推定糸球体濾過量[eGFR]は202,406名、血清クレアチニン値[SCr]は200,845名)を対象とした代表的な大規模ゲノムコホート研究のGWAS要約データを活用して、腎機能形質のGWASメタ解析を行った。●今回のGWASメタ解析では、SCrに関して1つのバリアント(7番染色体上のCD36 rs146148222)を持つ1つの新規遺伝子座(既知の遺伝子座から1Mb以上の距離)を同定した。●慢性腎臓病(CKD)における脂肪酸酸化(FAO)の低下は腎線維化に重要な役割を担っており、CD36は脂肪酸のミトコンドリアへの輸送機能を通じてFAOに重要な役割を果たしていると考えられている。●今回の日本人を対象とした最大規模のゲノムコホート研究のGWASメタ解析により、日本人の腎機能に関連するいくつかの新規のゲノム遺伝子座が得られ、近い将来、腎臓病の個別化予防に役立つ可能性がある。(著者抄録)

Language：English   Publisher：鹿児島大学医学会  

【背景と目的】様々な健康食品がテレビやインターネットで紹介され,販売されているが,それらの有効性と効果の証拠は,多くの場合,in vitroおよびin vivo研究に限定されている.本研究では,健康食品摂取と全死亡とがん罹患リスクとの関連を検索するため,鹿児島県の一般人口を対象としたコーホート研究を行った.【方法】研究対象者は奄美群島と鹿児島県本土の一般集団7,561人(男性3,136人,女性4,425人)である.健康食品全体および9種類の健康食品(黒酢,グルコサミン,クロレラ,アガリクス,ローヤルゼリー,青汁,ニンニク,ブルーベリー,ターメリック)について,Cox比例ハザードモデルを用いて交絡変数を調整し,全死亡およびがん発生のハザード比(HR)と95%信頼区間を見積もった.【結果】健康食品の中で,最も高頻度に摂取されていたのは黒酢であった(男性で2.3%,女性で2.6%).ベースライン時の横断的解析では,ニンニクと耐糖能異常との間に正の関連が見られた.しかし,前向き研究では,青汁摂取とがん罹患HR上昇(2.84,1.15-7.04)が認められた他には,健康食品全体および9種類それぞれの健康食品摂取と全死亡および,がん罹患との間に有意な関連は認められなかった.【結論】鹿児島の一般集団が一般的に摂取している健康食品と全死亡およびがん罹患リスクとの間に有意な関連は,青汁摂取以外には認められなかった.青汁摂取に伴うがんリスク上昇の可能性に関しては,さらなる研究が必要である.(著者抄録)

Language：English   Publisher：Cancers  

Background/Objectives: Cancer incidence in young adults or those aged 15–49 years old has increased during the past decade. Knowledge about the risk factors for cancer-related deaths in young adults is limited, particularly in low- and middle-income countries (LMICs). Methods: This analysis was based on the Hanoi Prospective Cohort Study, an ongoing study of 39,401 participants aged 15 or older in Northern Vietnam in the 2007–2019 period. A Cox proportional hazard regression model was used to calculate the hazard ratio (HR) and 95% confidence intervals (95% CIs) for the association between potential factors and the risk of cancer-related deaths. Results: With a median follow-up of 11.01 years, we identified 164 deaths in young adults out of 554 total deaths. Overall, family history of cancer (HR = 7.34; 95% CI: 3.30–16.36), drinking alcohol (HR = 1.82; 95% CI: 1.18–2.81), and smoking (HR = 2.22; 95% CI: 1.36–3.63) were found to be risk factors, while drinking coffee was found to be a protective factor (HR = 0.49; 95% CI: 0.24–1.00) for cancer-related deaths in young adults. Young male adults were found to be at a higher risk due to excessive cigarette smoking (HR = 1.91; 95% CI: 1.00–3.68) and alcohol consumption (HR = 2.15; 95% CI: 1.32–3.53) than those aged 50 years and older (HR = 1.36 and 95% CI: 0.96–1.93 and 1.27 and 95% CI: 0.97–1.67, respectively). The risk of death from cancer in women compared with men in the young population was twice as high as that in the older population (HR = 1.18 and 95% CI: 0.72–1.94 vs. 0.47 and 95% CI: 0.35–0.63, respectively). Conclusions: Our data suggest that the young Vietnamese population is vulnerable to the risk of cancer-related deaths and that cancer in women will increase rapidly in the future.

DOI： 10.3390/cancers16223853

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Language：English   Publisher：Japan Epidemiological Association  

<p><b>Background:</b> Genetic epidemiological evidence for the kidney function traits in East Asian populations, including Japanese, remain still relatively unclarified. Especially, the number of genome-wide association studies (GWASs) for kidney traits reported still remains limited, and the sample size of each independent study is relatively small. Given the genetic variability between ancestries/ethnicities, implementation of GWAS with sufficiently large sample sizes in specific population of Japanese is considered meaningful.</p><p><b>Methods:</b> We conducted the GWAS meta-analyses of kidney traits by leveraging the GWAS summary data of the representative large genome cohort studies with about 200,000 Japanese participants (<i>n</i> = 202,406 for estimated glomerular filtration rate [eGFR] and <i>n</i> = 200,845 for serum creatinine [SCr]).</p><p><b>Results:</b> In the present GWAS meta-analysis, we identified 110 loci with 169 variants significantly associated with eGFR (on chromosomes 1–13 and 15–22; <i>P</i> < 5 × 10⁻⁸), whereas we also identified 112 loci with 176 variants significantly associated with SCr (on chromosomes 1–22; <i>P</i> < 5 × 10⁻⁸), of which one locus (more than 1 Mb distant from known loci) with one variant (<i>CD36</i> rs146148222 on chromosome 7) for SCr was considered as the truly novel finding.</p><p><b>Conclusion:</b> The present GWAS meta-analysis of the largest genome cohort studies in Japanese subjects provided some original genomic loci associated with kidney function, which may contribute to the possible development of personalized prevention of kidney diseases based on genomic information in the near future.</p>

DOI： 10.2188/jea.JE20230281

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Language：English   Publisher：American Association for Cancer Research (AACR)  

<jats:title>Abstract</jats:title>
<jats:p>The present study investigated the relationship between metabolic phenotypes and the risk of cancer in a Japanese population using the criteria of metabolic phenotypes based on an examination and those based on questionnaires. We used data from 25,357 subjects for examination-based analyses and those from 53,042 subjects for questionnaire-based analyses in the Japan Multi-institutional Collaborative Cohort study. Metabolic phenotypes were defined by classifying subjects according to their body mass index (BMI; obesity: BMI  ≥25 kg/m2; normal weight: BMI  &lt;25 kg/m2) and the number of metabolic abnormalities. Metabolic abnormalities were defined according to metabolic syndrome components of the Joint Interim Statement criteria for examination-based analyses and self-reported histories of diabetes, dyslipidemia, and hypertension for questionnaire-based analyses. Cox proportional hazards regression analyses adjusted for potential confounders were performed for total and site-specific cancer incidence rates according to metabolic phenotypes. Metabolically unhealthy obesity (MUHO) was significantly associated with cancer incidence in both examination-based [HR (95% confidence interval), 1.17 (1.01–1.36)] and questionnaire-based analyses [HR (95% confidence interval), 1.15 (1.04–1.26)]. Regarding site-specific cancer in questionnaire-based analyses, metabolically healthy obesity and MUHO were associated with colorectum and liver cancers in all subjects and with breast cancer in female subjects. Subjects with a metabolically unhealthy normal weight had a higher risk of pancreatic cancer. Moreover, MUHO was associated with corpus uteri cancer in female subjects. This prospective cohort study suggests that metabolic phenotypes are important risk factors for total and some site-specific cancers in Japanese adults.</jats:p>
<jats:sec>
<jats:title>Significance:</jats:title>
<jats:p>The prospective cohort study in a large Japanese population suggested that metabolic phenotypes are important risk factors for total and some site-specific cancers in Japanese adults. Moreover, the risk of each site-specific cancer may differ according to metabolic phenotypes.</jats:p>
</jats:sec>

DOI： 10.1158/2767-9764.CRC-24-0249

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Language：English   Publisher：Informa UK Limited  

Occupational exposure to welding fumes constitutes a serious health concern. Although the effects of fumes on the respiratory tract have been investigated, few apparent reports were published on their effects on the skin. The purpose of this study was to investigate the effects of exposure to welding fumes on skin cells, focusing on interleukin-24 (IL-24), a cytokine involved in the pathophysiology of skin conditions, such as atopic dermatitis and psoriasis. Treatment with welding fumes increased IL-24 expression and production levels in human dermal microvascular endothelial cells (HDMEC) which were higher than that in normal human epidermal keratinocytes. IL-24 levels in Trolox and deferoxamine markedly suppressed welding fume-induced IL-24 expression in HDMEC, indicating that oxidative stress may be involved in this cytokine expression. IL-24 released from HDMEC protected keratinocytes from welding fume-induced damage and enhanced keratinocyte migration. Serum IL-24 was higher in welding workers than in general subjects and was positively correlated with elevated serum levels of 8-hydroxy-2’-deoxyguanosine, an oxidative stress marker. In summary, welding fumes enhanced IL-24 expression in HDMEC, stimulating keratinocyte survival and migration. IL-24 expression in endothelial cells may act as an adaptive response to welding-fume exposure in the skin.

DOI： 10.1080/15287394.2024.2372403

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Language：English   Publisher：Journal of Gastroenterology  

Background: Pancreatic ductal occlusion can accompany pancreatic head cancer, leading to pancreatic exocrine insufficiency (PEI) and adverse effects on nutritional status and postoperative outcomes. We investigated its impact on nutritional status, body composition, and postoperative outcomes in patients with pancreatic head cancer undergoing neoadjuvant therapy (NAT). Methods: We analyzed 136 patients with pancreatic head cancer who underwent NAT prior to intended pancreaticoduodenectomy (PD) between 2015 and 2022. Nutritional and anthropometric indices (body mass index [BMI], albumin, prognostic nutritional index [PNI], Glasgow prognostic score, psoas muscle index, subcutaneous adipose tissue index [SATI], and visceral adipose tissue index) and postoperative outcomes were compared between the occlusion (n = 78) and non-occlusion (n = 58) groups, in which 61 and 44 patients, respectively, ultimately underwent PD. Results: The occlusion group showed significantly lower post-NAT BMI, PNI, and SATI (p = 0.011, 0.005, and 0.015, respectively) in the PD cohort. The occlusion group showed significantly larger main pancreatic duct, smaller pancreatic parenchyma, and greater duct–parenchymal ratio (p < 0.001), and these morphological parameters significantly correlating with post-NAT nutritional and anthropometric indices. Postoperative 3-year survival and recurrence-free survival (RFS) rates were significantly poorer (p = 0.004 and 0.013) with pancreatic ductal occlusion, also identified as an independent postoperative risk factor for overall survival (hazard ratio [HR]: 2.31, 95% confidence interval [CI] 1.08–4.94, p = 0.030) and RFS (HR: 2.03, 95% CI 1.10–3.72, p = 0.023), in multivariate analysis. Conclusions: Pancreatic ductal occlusion may be linked to poorer postoperative outcomes due to PEI-related malnutrition.

DOI： 10.1007/s00535-024-02125-8

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Language：Japanese   Publisher：Hypertension Research  

Although previous polygenic risk score (PRS) studies for cardiovascular disease (CVD) focused on incidence, few studies addressed CVD mortality and quantified risks by environmental exposures in different genetic liability groups. This prospective study aimed to examine the associations of blood pressure PRS with all-cause and CVD mortality and to quantify the attributable risk by modifiable lifestyles across different PRS strata. 9,296 participants in the Japan Multi-Institutional Collaborative Cohort Study without hypertension at baseline were analyzed in this analysis. PRS for systolic blood pressure and diastolic blood pressure (PRS<inf>SBP</inf> and PRS<inf>DBP</inf>) were developed using publicly available Biobank Japan GWAS summary statistics. CVD-related mortality was defined by the International Classification of Diseases 10th version (I00-I99). Cox-proportional hazard model was used to examine associations of PRSs and lifestyle variables (smoking, drinking, and dietary sodium intake) with mortality. During a median 12.6-year follow-up period, we observed 273 all-cause and 41 CVD mortality cases. Compared to the middle PRS group (20–80th percentile), adjusted hazard ratios for CVD mortality at the top PRS group (> 90th percentile) were 3.67 for PRS<inf>SBP</inf> and 2.92 for PRS<inf>DBP</inf>. Attributable risks of CVD mortality by modifiable lifestyles were higher in the high PRS group (> 80th percentile) compared with the low PRS group (0–80th percentile). In summary, blood pressure PRS is associated with CVD mortality in the general Japanese population. Our study implies that integrating PRS with lifestyle could contribute to identify target populations for lifestyle intervention even though improvement of discriminatory ability by PRS alone is limited. (Figure presented.)

DOI： 10.1038/s41440-024-01766-9

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Language：English   Publisher：シュプリンガー・ジャパン(株)  

膵頭部癌では膵管閉塞が認められることがあり、膵外分泌機能不全(PEI)に至り、また栄養状態や術後治療成績に悪影響を与える。ネオアジュバント治療(NAT)を行う膵頭部癌患者における、栄養状態、身体組成、術後治療成績に対する膵管閉塞の影響について検討した。2015年から2022年までの間に、予定膵頭十二指腸切除(PD)前にNATを施行した膵頭部癌患者136例を解析した。栄養学的および人体計測学的指数(肥満指数(BMI)、アルブミン、予後推定栄養指数(PNI)、Glasgow予後スコア、腸腰筋指数、皮下脂肪組織指数(SATI)、内臓脂肪指数)および術後治療成績を、閉塞群(78例)および非閉塞群(58例)で比較した。最終的にPDを施行したのは各群でそれぞれ61および44例であった。PDを行ったコホートにおいて、閉塞群は非閉塞群と比較して、有意にNAT後のBMI、PNI、SATIが低かった(それぞれP=0.011、0.005、0.015)。閉塞群は非閉塞群と比較して膵管径が有意に大きく、膵実質が小さく、膵管-実質比が大きかった(P<0.001)。これらの形態学的変数は、術後NAT栄養指数および人体計測学的指数と有意に関連した。膵管閉塞群は術後3年生存および無再発生存(RFS)が有意に低く(それぞれP=0.04およびP=0.003)、多変量解析で全生存(ハザード比(HR) 2.31、95%信頼区間(CI) 1.08-4.94、P=0.030)およびRFS(HR 2.03、95%CI 1.10-3.72、P=0.023)の独立した術後危険因子であった。以上より、膵管閉塞はPEI関連栄養障害のため、術後治療成績が不良となる原因である可能性がある。

Language：English   Publisher：Japan Epidemiological Association  

<p><b>Background:</b> Improving diets requires an awareness of the need to limit foods for which excessive consumption is a health problem. Since there are limited reports on the link between this awareness and mortality risk, we examined the association between awareness of limiting food intake (energy, fat, and sweets) and all-cause mortality in a Japanese cohort study.</p><p><b>Methods:</b> Participants comprised 58,772 residents (27,294 men; 31,478 women) aged 35–69 years who completed baseline surveys of the Japan Multi-Institutional Collaborative Cohort Study from 2004 to 2014. Hazard ratios (HRs) for all-cause mortality and 95% confidence intervals (CIs) were estimated by sex using a Cox proportional hazard model, with adjustment for related factors. Mediation analysis with fat intake as a mediator was also conducted.</p><p><b>Results:</b> The mean follow-up period was 11 years, and 2,516 people died. Estimated energy and fat intakes according to the Food Frequency Questionnaire were lower in those with awareness of limiting food intake than in those without this awareness. Women with awareness of limiting fat intake showed a significant decrease in mortality risk (HR 0.73; 95% CI, 0.55–0.94). Mediation analysis revealed that this association was due to the direct effect of the awareness of limiting fat intake and that the total effect was not mediated by actual fat intake. Awareness of limiting energy or sweets intake was not related to mortality risk reduction.</p><p><b>Conclusion:</b> Awareness of limiting food intake had a limited effect on reducing all-cause mortality risk.</p>

DOI： 10.2188/jea.JE20220354

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Language：English   Publisher：(一社)日本疫学会  

＜Highlights＞・日本人一般集団における食物摂取制限意識と全死亡リスクとの関連を検討した。・特に、脂肪摂取制限意識のある女性は、全死亡リスクの低下を示しており、その関連は実際の脂肪摂取量を介するものではなかった。・食物摂取制限意識による全死亡リスク低下への影響は限定的であった。(著者抄録)

Language：English   Publisher：John Wiley & Sons Australia, Ltd  

1日の座位時間と乳癌リスクの関連性を大規模な日本人集団で調査した。日本多施設共同コホート研究(J-MICC study)の参加者92527名のうち、必要なデータが利用できた35～69歳の女性36023名を抽出して本解析に組み入れた。315189人-年の追跡期間中、乳癌の新規症例は554例発生した。1日の座位時間が7時間未満(短座位群)と7時間以上(長座位群)に分類して比較した。その結果、乳癌リスクは長座位群の方が有意に上昇していることが示された(ハザード比[HR]1.36、95%CI 1.07～1.71)。身体活動量が多い3種の亜集団(余暇時間の代謝等価が1時間/日以上、余暇時の身体活動頻度が3日/週以上、1日歩行時間が1時間/日以上)でも上記のHRを算出したが、上記の結果と同じく、どの亜集団でも長座位群の方が乳癌リスクは高いことを表すHRが有意に示された。1日のうち7時間以上を座位で費やすことは乳癌リスクと関連していることが本解析から明らかになった。その乳癌リスクに対しては、余暇時の身体活動、ウォーキング運動のどちらにも予防効果はみられなかった。

Language：English   Publisher：Cancer Science  

This study aimed to investigate the association between daily sedentary time and the risk of breast cancer (BC) in a large Japanese population. The participants were 36,023 women aged 35–69 years from the Japan Multi-Institutional Collaborative Cohort Study. Cox proportional hazards analysis was used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for BC incidence in relation to time spent sedentarily (categorical variables: <7 and ≥7 hours/day [h/d]). Additionally, the associations of BC incidence to the joint effect of sedentary time with each component of physical activity, such as leisure-time metabolic equivalents (METs), frequency of leisure-time physical activity, and daily walking time, were examined. During 315,189 person-years of follow-up, 554 incident cases of BC were identified. When compared to participants who spent <7 h/d sedentary, those who spent ≥7 h/d sedentary have a significantly higher risk of BC (HR, 1.36; 95% CI, 1.07–1.71). The corresponding HRs among participants who spent ≥7 h/d sedentary with more physical activity, such as ≥1 h/d for leisure-time METs, ≥3 days/week of leisure-time physical activity, and ≥1 h/d of daily walking were 1.58 (95% CI, 1.11–2.25), 1.77 (95% CI, 1.20–2.61), and 1.42 (95% CI, 1.10–1.83), respectively, compared with those who spent <7 h/d sedentary. This study found that spending ≥7 h/d of sedentary time is associated with the risk of BC. Neither leisure-time physical activity nor walking had a BC-preventive effect in those with ≥7 h/d of sedentary time.

DOI： 10.1111/cas.16020

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Language：English   Publisher：BMC Pediatrics  

Background: Bisphenol A diglycidyl ether (BADGE) and Bisphenol F diglycidyl ether (BFDGE) are used in medical devices, such as intravenous sets, syringes, and catheters. Several studies have reported that these compounds are endocrine disruptors, cytotoxic, and genotoxic, raising concerns about their adverse effects on infants, in a stage of remarkable growth and development. The present study aimed to measure the serum concentrations of BADGE, derivatives of BADGE, and BFDGE in infants and examine the factors that influence them. Methods: Ten infants admitted to the neonatal intensive care unit (NICU) were enrolled in the present study. Blood samples from each infant and questionnaires from their mothers were collected twice, at 1–2 months and 7 months of age. BADGE, BADGE·H<inf>2</inf>O, BADGE·2H<inf>2</inf>O, and BFDGE were quantified using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Results: Serum BADGE·2H<inf>2</inf>O was identified in all infants, at both 1–2 months (2.30–157.58 ng/ml) and 7 months of age (0.86–122.85 ng/ml). One of the two infants who received invasive ventilation showed a substantially increased BADGE·2H<inf>2</inf>O concentration. There was no significant difference in BADGE·2H<inf>2</inf>O concentrations at 7 months of age between the group that ate commercial baby food at least ≥ 1 time per week and the group that did not. Conclusions: BADGE·2H<inf>2</inf>O was detected in the serum of all infants with a history of NICU hospitalization. Future studies are needed to determine the source of BADGE exposure and investigate its effects on infant development.

DOI： 10.1186/s12887-023-04493-1

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Language：English   Publisher：The Editorial Committee of Annals of Thoracic and Cardiovascular Surgery  

<p><b>Purpose:</b> Regardless of the devastating outcomes of pulmonary resection for metastases from gastric cancer, a handful of patients survive long after pulmonary metastasectomy. This study aimed to identify a good candidate for pulmonary resection for metastases from gastric cancer.</p><p><b>Methods:</b> Between 2005 and 2023, 564 patients underwent pulmonary metastasectomy in our department, of which 12 patients underwent pulmonary resection for metastases from gastric cancer. Variables evaluated were the number and size of metastatic lesions, surgical procedure, disease-free interval (DFI), and the serum carcinoembryonic antigen at pulmonary metastasectomy.</p><p><b>Results:</b> The DFI following gastrectomy ≤12.5 months group had a significantly worse overall survival (OS) than the other group (p = 0.005). A comparison between DFI following gastrectomy ≤12.5 months group and DFI following gastrectomy >12.5 months group showed a significant difference in serum carcinoembryonic antigen (CEA) value at pulmonary metastasectomy (p = 0.048). The serum CEA value at pulmonary metastasectomy >5.8 ng/ml group had a significantly worse OS than the other group (p = 0.001).</p><p><b>Conclusion:</b> Pulmonary metastasectomy can be indicated in some patients with metastasis from gastric cancer who have longer DFI from gastrectomy and lower serum CEA at pulmonary metastasectomy.</p>

DOI： 10.5761/atcs.oa.24-00044

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Authorship：Last author   Language：Japanese   Publisher：BMC Health Services Research  

Background: The role of public health nurses (PHNs) in the community is expected to become increasingly important, along with the promotion of a comprehensive community care system. However, a comprehensive study of all municipalities is yet to be undertaken, and the relationship between the workforce of PHNs and health indicators is yet to be clarified. This study examined the effect of workforce change among PHNs, one of the structural indicators of PHNs’ activities regarding changes in the empirical Bayes estimate of standardized mortality ratios (EBSMRs). Methods: An ecological study was conducted using municipality-level aggregate data. The data used were publicly available Japanese government statistics. The first-difference model of panel data analysis was used to examine the relationship between changes in EBSMR and changes in the number of PHNs per 100,000 population from 2010 to 2015, adjusting for the effects of population and other healthcare resources, including the number of physicians, medical clinics, general hospitals, and welfare facilities. The variation by the 47 prefectures was added to the linear model as a random effect. We also performed a sensitivity analysis using the full Bayesian inference using the Besag-York-Mollie model. Results: For males, EBSMRs for all causes and malignant neoplasms significantly decreased with an increase in the number of PHNs per population (coefficients: -1.00 and -0.89, p values: 0.008 and 0.043, respectively). For females, although all EBSMRs except malignant neoplasms showed decreased tendencies due to the increase in the number of PHNs per population, none of them were significant. The full Bayesian inference confirmed these associations. Conclusions: An increase in the number of PHNs per population was significantly associated with a greater reduction in deaths from all causes and malignant neoplasms in males. The results of the full Bayesian inference also suggest that the workforce of PHNs may be related to changes in standardized mortality ratios for deaths from all causes in females.

DOI： 10.1186/s12913-023-09273-2

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Language：English   Publisher：Asia Pacific Journal of Clinical Nutrition  

Background and Objectives: Although excess white sugar intake imposes various health burdens, brown sugar is high in minerals, polyphenols, and polycosanol. However, few epidemiological studies have assessed brown sugar intake for health benefit. People in the Amami islands region, with a relatively high proportion of individuals with longevity, consume brown sugar as a type of refreshment. This cohort study was conducted in Amami to clarify the association of brown sugar intake with mortality risk and cancer incidence. Methods and Study Design: Participants were recruited from the general population of Amami as part of the Japan Multi-Institutional Collaborative Cohort Study. The number of eligible participants was 5004 (2057 men and 2947 women). During the median follow-up period of 13.4 years, 274 deaths and 338 cases of cancer were observed. HRs and 95% CIs were estimated using the Cox proportional hazard model, after adjusting for sugar-related and other variables. Results: After adjusting for their related confounding factors, brown sugar intake was associated with decreased HRs and a decreasing trend for all-site and stomach cancer incidence (p = 0.001 and 0.017, respectively) in women and men, and for breast cancer incidence (p = 0.034) in women. Additionally, a decreasing trend in the HRs for lung cancer incidence was observed among never and ex-smokers (p = 0.039). Decreased HRs for overall death, cancer, and cardiovascular disease were not apparent. Conclusions: Brown sugar intake was associated with decreased risk of all-site, stomach, and breast cancer incidences in the Amami population.

DOI： 10.6133/apjcn.202312_32(4).0007

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Language：English   Publisher：(一社)日本動脈硬化学会  

日本多施設共同コホート(J-MICC)研究に参加した大規模な日本人集団のデータを用いて、食事パターンと血清LDLコレステロール(LDL-C)との関連を調べた。国内13コホートのJ-MICC研究ベースライン調査(2005～2013年)に参加した35～69歳の男女92530名のうち、収集データに欠損・不備がある者を除く男性13243名(平均54.8±9.6歳)、女性13994名(平均53.2±9.5歳)を解析対象とした。過去1年間の食習慣を調べる食物摂取頻度調査法を用いて各食品・飲料の1週間あたりの摂取頻度を算出し、因子分析により男女別の五つの食事パターンを抽出した。その結果、食事パターンは男女とも「高野菜パターン」「高肉類・揚げ物パターン」「高パン・低米飯パターン」が共通していた。男性では「高魚介類パターン」「高菓子・低アルコールパターン」、女性は「日本食パターン」「高アルコール・低米飯パターン」がそれぞれ抽出された。男性の血清LDL-Cは、「高パン・低米飯パターン」「高菓子・低アルコールパターン」と関連しており、女性の血清LDL-Cは「高パン・低米飯パターン」と関連していた。

Language：Japanese   Publisher：International Journal of Cancer  

The association between kidney function and cancer incidence is inconsistent among previous reports, and data on the Japanese population are lacking. It is unknown whether kidney function modifies the cancer risk of other factors. We aimed to evaluate the association of estimated glomerular filtration rate (eGFR) with cancer incidence and mortality in 55 242 participants (median age, 57 years; 55% women) from the Japan Multi-Institutional Collaborative Cohort Study. We also investigated differences in cancer risk factors between individuals with and without kidney dysfunction. During a median 9.3-year follow-up period, 4278 (7.7%) subjects developed cancer. Moderately low and high eGFRs were associated with higher cancer incidence; compared with eGFR of 60-74 ml/min/1.73 m2, the adjusted hazard ratios (HRs) (95% confidence intervals [CIs]) for eGFRs of ≥90, 75-89, 45-59, 30-44 and 10-29 ml/min/1.73 m2 were 1.18 (1.07-1.29), 1.09 (1.01-1.17), 0.93 (0.83-1.04), 1.36 (1.00-1.84) and 1.12 (0.55-2.26), respectively. High eGFR was associated with higher cancer mortality, while low eGFR was not; the adjusted subdistribution HRs (95% CIs) for eGFRs of ≥90 and 75-89 ml/min/1.73 m2 were 1.58 (1.29-1.94) and 1.27 (1.08-1.50), respectively. Subgroup analyses of participants with eGFRs ≥60 and <60 ml/min/1.73 m2 revealed elevated cancer risks of smoking and family history of cancer in those with eGFR <60 ml/min/1.73 m2, with significant interactions. Our findings suggest that the relationship between eGFR and cancer incidence was U-shaped. Only high eGFR was associated with cancer mortality. Kidney dysfunction enhanced cancer risk from smoking.

DOI： 10.1002/ijc.34554

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Language：Japanese   Publisher：Anticancer Research  

Background/Aim: Transanal total mesorectal excision (TaTME) remains a challenging technique for rectal dissection. This study aimed to evaluate the clinical and oncological outcomes of TaTME, compared to those of the laparoscopic TME (LaTME) in rectal cancer. Patients and Methods: Using propensity score-matched analyses, we analyzed retrospective data from 134 consecutive patients with rectal cancer who underwent TaTME or LaTME from January 2011 to June 2020 in our hospital. Clinical and oncological outcomes were evaluated. The primary endpoint was the 2-year local recurrence rate. Results: Before data analysis, significant group-dependent differences were observed only in the tumor height (p<0.01). After analysis, preoperative patient demographics were similar between the TaTME and LaTME groups. The operative time was significantly shorter in the TaTME group (p=0.02), and the rates of hand-sewn anastomosis and protective loop ileostomy were significantly higher (p<0.01). The TaTME group showed a null conversion to open surgery compared to the LaTME group (5.9%). The postoperative complications, including anastomotic leak, were comparable between the two groups. However, the rate of Clavien-Dindo grade III tended to be lower in the TaTME group (p=0.07). There were no statistically significant differences in terms of pathological findings, and the 2-year local recurrence rate was similar between the two groups (both 5.9%). Conclusion: TaTME based on embryology along the fascia is feasible and seems a safe alternative to LaTME in selected patients with rectal cancer when considering the conversion rate and the operative time.

DOI： 10.21873/anticanres.16539

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Language：Japanese   Publisher：Journal of Nutrition  

Background: Previous cohort studies have yielded contradictory findings regarding the associations of dietary carbohydrate and fat intakes with risks of mortality. Objectives: We examined long-term associations of carbohydrate and fat intakes with mortality. Methods: In this cohort study, 34,893 men and 46,440 women aged 35–69 y (mean body mass index of 23.7 and 22.2 kg/m2, respectively) were followed up from the baseline survey (2004–2014) to the end of 2017 or 2018. Intakes of carbohydrate, fat, and total energy were estimated using a food frequency questionnaire. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated for all-cause and cause-specific mortality according to percentage of energy intakes of carbohydrate and fat. Results: During a mean 8.9-y follow-up, we identified 2783 deaths (1838 men and 945 women). Compared with men who consumed 50% to <55% of energy from carbohydrate, those who consumed <40% carbohydrate energy experienced a significantly higher risk of all-cause mortality (the multivariable-adjusted HR: 1.59; 95% CI: 1.19–2.12; P-trend = 0.002). Among women with 5 y or longer of follow-up, women with high-carbohydrate intake recorded a higher risk of all-cause mortality; the multivariable-adjusted HR (95% CI) was 1.71 (0.93–3.13) for ≥65% of energy from carbohydrate compared with that for 50% to <55% (P-trend = 0.005). Men with high fat intake had a higher risk of cancer-related mortality; the multivariable-adjusted HR (95% CI) for ≥35% was 1.79 (1.11–2.90) compared with that for 20% to <25%. Fat intake was marginally inversely associated with risk of all-cause and cancer-related mortality in women (P-trend = 0.054 and 0.058, respectively). Conclusions: An unfavorable association with mortality is observed for low-carbohydrate intake in men and for high-carbohydrate intake in women. High fat intake can be associated with a lower mortality risk in women among Japanese adults with a relatively high-carbohydrate intake.

DOI： 10.1016/j.tjnut.2023.05.027

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Language：English   Publisher：(公社)日本産業衛生学会  

溶接ヒュームに関連する生体試料中の金属濃度と個人曝露の時間加重平均値(TWA)の関連に対してマスクフィットテストの結果が及ぼす影響を検討した。男性溶接工94名の血液・尿検体を採取するとともに、個人曝露測定により吸入性粉塵の8時間TWA、吸入性マンガン濃度のTWAおよび8時間TWAを算出した。54名(57%)が定量的マスクフィットテストに合格した。交絡因子で調整後、血中マンガン濃度はマスクフィットテスト合格群に比べ不合格群で有意に高かった。また多変量因子調整後、マスクフィットテスト不合格群の血中マンガン濃度は個人曝露の測定値と正の関連を示した(吸入性粉塵の8時間TWA:回帰係数0.066、標準誤差0.028、P=0.018、吸入性マンガン濃度のTWA:各々0.048、0.020、P=0.019、吸入性マンガン濃度の8時間TWA:各々0.041、0.020、P=0.041)。マスクと顔面がフィットせず漏れ込みがある場合、呼吸域の溶接ヒュームが高濃度である溶接工は粉塵およびマンガンに曝露していることが示された。

Language：Japanese   Publisher：Health Promotion International  

We quantitatively analysed the relationship of health literacy with both anxiety about the COVID-19 outbreak and free-Text qualitative data. A questionnaire was mailed to 5450 citizens aged 16-89 years in four prefectures between late April and May 2020. It gauged the level of anxiety about COVID-19, assessed health literacy (HL) on both critical and communicative HL subscales, and invited free-Text responses. We compared anxiety levels in three groups of both HL subscales. Text-mining analyses were also conducted among the three HL groups. Two-Thirds of respondents reported anxiety about COVID-19, and 42% of them also reported fear. The level of communicative HL was negatively associated with no or low anxiety (p < 0.01), and the same association was observed for critical HL (p < 0.01). Free-Text analysis identified 11 categories related to concerns about COVID-19: response of the national government, appreciation of health care practitioners, early convergence, vaccine development, fear of infection, invisible, a school for children, everyday life, information-related issue, novel coronavirus and self-quarantine. Words that were characteristic of the high-HL group were 'information', 'going out', 'vaccines' and 'government'. This survey reveals high public anxiety under COVID-19, and while anxiety is associated with HL levels, people with higher HL may make more prudent and healthier decisions. In situations of uncertainty, different approaches to alleviate anxiety depending on HL are warranted, providing new insights and contributing to public health measures during the outbreaks.

DOI： 10.1093/heapro/daac200

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Language：English   Publisher：シュプリンガー・ジャパン(株)  

日本人のHbA1c値および血糖値に関連する遺伝子座について検討した。Japan Multi-Institutional Collaborative Cohort(J-MICC)研究に参加した35～69歳の日本人4911名のデータを用いて探索的なゲノムワイド関連解析を行い、次いで別集団(8175名および40519名)を対象に、再現性解析を行った。その結果、HbA1c値に関連する遺伝子多型がKCNQ1(rs2299620)とTMC6(rs2748427、rs3834968、rs2748425、rs2748424)に同定された。血糖値と有意な関連を示す多型はなかった。KCNQ1のrs2299620とHbA1c値の関連はBMI≧25の肥満の有無によって有意に異なった(異質性検定P<0.05)。探索的解析集団においてHbA1c値と血糖値の双方に関連する遺伝子多型は検出されなかったが、既報の各種遺伝子多型について再現性解析を行った。その結果、KCNQ1のrs2237897とHbA1c値および血糖値の有意な関連が見出された。

Language：Japanese   Publisher：Nutrition, Metabolism and Cardiovascular Diseases  

Background and aims: To date, the relationship between coffee consumption and metabolic phenotypes has hardly been investigated and remains controversial. Therefore, the aim of this cross-sectional study is to examine the associations between coffee consumption and metabolic phenotypes in a Japanese population. Methods and results: We analyzed the data of 26,363 subjects (aged 35–69 years) in the baseline survey of the Japan Multi-Institutional Collaborative Cohort Study. Coffee consumption was assessed using a questionnaire. Metabolic Syndrome (MetS) was defined according to the Joint Interim Statement Criteria of 2009, using body mass index (BMI) instead of waist circumference. Subjects stratified by the presence or absence of obesity (normal weight: BMI <25 kg/m2; obesity: BMI ≥25 kg/m2) were classified by the number of MetS components (metabolically healthy: no components; metabolically unhealthy: one or more components) other than BMI. In multiple logistic regression analyses adjusted for sex, age, and other potential confounders, high coffee consumption (≥3 cups/day) was associated with a lower prevalence of MetS and metabolically unhealthy phenotypes both in normal weight (OR 0.83, 95% CI 0.76–0.90) and obese subjects (OR 0.83, 95% CI 0.69–0.99). Filtered/instant coffee consumption was inversely associated with the prevalence of MetS and metabolically unhealthy phenotypes, whereas canned/bottled/packed coffee consumption was not. Conclusion: The present results suggest that high coffee consumption, particularly filtered/instant coffee, is inversely associated with the prevalence of metabolically unhealthy phenotypes in both normal weight and obese Japanese adults.

DOI： 10.1016/j.numecd.2022.12.019

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Language：English   Publisher：(公社)日本産業衛生学会  

日本人男性の溶接工と非溶接工にみられるマンガン(Mn)曝露と神経機能との関連を検討した。同一の工場に勤務する溶接工94名(平均41.1歳)と非溶接工95名(平均40.2歳)を対象に血液サンプルと尿サンプルを採取してMn濃度を測定し、神経機能との関係を評価した。また、溶接工のみ個人サンプラーを用いて呼吸大気領域の採取を行った。尿中カドミウム(Cd)、血中Mn、尿中Mn、尿中クロム(Cr)、血中鉛(Pb)はいずれも溶接工の方が非溶接工より高く、各金属濃度が検出限界値未満であった被験者比率は血中Cdが89%、尿中Cdが58%、血中ニッケル(Ni)が79%などであった。多変量ロジスティック回帰分析では、握力、指タッピングと血中Mnとの間に有意な関係はみられなかったが、血中Mn高値群では作業記憶指数(WMI)低値のオッズ比が有意に高く、特に溶接工でこの関連が顕著であった。尿中Cr、血中PbとWMIスコアとの間に有意な関連はなかった。個人サンプラーを用いた検討では、血中Mnが高値であった溶接工において呼吸性粉塵とマンガン濃度が高値を示していた。

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Japan Society for Occupational Health  

<p><b>Objectives</b>: The mask fit test confirms whether the wearing condition of the wearer's face and the facepiece of the respirators are used appropriately. This study aimed to examine whether the results of the mask fit test affect the association between the concentration of metals related to welding fumes in biological samples and the results of time-weighted average (TWA) personal exposures.</p><p><b>Methods</b>: A total of 94 male welders were recruited. Blood and urine samples were obtained from all participants to measure the metal exposure levels. Using personal exposure measurements, the 8-h TWA (8 h-TWA) of respirable dust, TWA of respirable Mn, and 8-h TWA of respirable Mn were calculated. The mask fit test was performed using the quantitative method specified in the Japanese Industrial Standard T8150:2021.</p><p><b>Results</b>: Fifty-four participants (57%) passed the mask fit test. Only in the Fail group of the mask fit test, it was observed that blood Mn concentrations be positively associated with the results of TWA personal exposure after adjusting for multivariate factors (8-h TWA of respirable dust; coefficient, 0.066; standard error (SE), 0.028; <i>P</i> = 0.018, TWA of respirable Mn: coefficient, 0.048; SE, 0.020; <i>P</i> = 0.019, 8 h-TWA of respirable Mn: coefficient, 0.041; SE, 0.020; <i>P</i> = 0.041).</p><p><b>Conclusions</b>: The results clarify that welders with high concentrations of welding fumes in their breathing air zone are exposed to dust and Mn if there is leaking air owing to the lack of fitness between respirators and the wearer's face when using human samples in Japan.</p>

DOI： 10.1002/1348-9585.12399

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Japan Society for Occupational Health  

<p><b>Objectives</b>: There are some studies reporting the association between (manganese [Mn]) exposure to welding fume and neurological dysfunction. This study examined the relationship between Mn exposure and neurological behavior in Japanese male welders and non-welders using biological samples, which to date has not been assessed in Japan.</p><p><b>Methods</b>: A total of 94 male welders and 95 male non-welders who worked in the same factories were recruited. The blood and urine samples were obtained from all the participants to measure Mn exposure levels. Neurological function tests were also conducted with all participants. The sampling of the breathing air zone using a personal sampler was measured for welders only.</p><p><b>Results</b>: The odds ratios (ORs) for the Working Memory Index (WMI) scores were significantly higher among all participants in the low blood Mn concentration group than those in the high blood Mn concentration group (OR, 2.77; 95% confidence interval [CI], 1.24, 6.19; <i>P</i> = .013). The association of WMI scores and blood Mn levels in welders had the highest OR (OR, 3.73; 95% CI, 1.04, 13.38; <i>P</i> = .043). Although not statistically significant, a mild relationship between WMI scores and blood Mn levels was observed in non-welders (OR, 2.09; 95% CI, 0.63, 6.94; <i>P</i> = .227).</p><p><b>Conclusions</b>: The results revealed a significant positive relationship between blood Mn and neurological dysfunction in welders. Furthermore, non-welders at the same factories may be secondarily exposed to welding fumes. Further research is needed to clarify this possibility.</p>

DOI： 10.1002/1348-9585.12393

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Language：English   Publisher：Japan Atherosclerosis Society  

<p><b>Aims: </b>The association between dietary patterns and serum low density lipoprotein (LDL) cholesterol would be changing in recent dietary habits in Japan. We investigated the relationship between dietary patterns and serum LDL cholesterol in a large general population.<b> </b></p><p><b>Methods: </b>From the baseline survey of Japan Multi-Institutional Collaborative Cohort Study between 2005 and 2013, 27,237 participants (13,994 were women) aged 35-69 years were cross-sectionally analyzed. Using a semi-quantitative food frequency questionnaire, five major sex-specific dietary patterns were identified using factor analysis. We assessed serum LDL cholesterol by quintiles of dietary pattern factor score.<b> </b></p><p><b>Results: </b>We identified dietary patterns; “vegetable rich pattern” , “meat and fried food rich pattern” and “high bread and low rice pattern” in women and men; “fish and shellfish rich pattern” and “high confectioneries and low alcohol pattern” in men; “healthy Japanese diet pattern” and “high alcohol and low rice pattern” in women. Serum LDL cholesterol in men was associated with “high bread and low rice pattern” score (Q5 was 4.2 mg/dL higher than Q1, <i>p</i> for trend ＜0.001) and “high confectioneries and low alcohol pattern” scores (Q5 was 9.5 mg/dL higher than Q1, <i>p</i> for trend ＜0.001). In women, serum LDL cholesterol was associated with “high bread and low rice pattern” score (Q5 was 7.1 mg/dL higher than Q1, <i>p</i> for trend ＜0.001).</p><p><b>Conclusion:</b> Some recent dietary patterns in Japan were associated with serum LDL cholesterol. Serum LDL cholesterol was associated with high bread and low rice pattern in both sex, and high confectioneries and low alcohol pattern in men.</p>

DOI： 10.5551/jat.63675

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Language：Japanese   Publisher：Diabetology International  

Aims: Hemoglobin A1c (HbA1c) levels are widely employed to diagnose diabetes. However, estimates of the heritability of HbA1c and glucose levels are different. Therefore, we explored HbA1c- and blood glucose-associated loci in a non-diabetic Japanese population. Methods: We conducted a two-stage genome-wide association study (GWAS) on variants associated with HbA1c and blood glucose levels in a Japanese population. In the initial stage, data of 4911 participants of the Japan Multi-Institutional Collaborative Cohort (J-MICC) were subjected to discovery analysis. In the second stage, two datasets from the Tohoku Medical Megabank project, with 8175 and 40,519 participants, were used for the replication study. Association of the imputed variants with HbA1c and blood glucose levels was determined via linear regression analyses adjusted for age, sex, body mass index (BMI), smoking, and genetic principal components (PC1–PC10). Moreover, we performed a BMI-stratified GWAS on HbA1c levels in the J-MICC. The discovery analysis and BMI-stratified GWAS results were validated with re-analyses of normalized HbA1c levels adjusted for site in addition to the above, and blood glucose adjusted for fasting time as an additional covariate. Results: Genetic variants associated with HbA1c levels were identified in KCNQ1 and TMC6. None of the genetic variants associated with blood glucose levels in the discovery analysis were replicated. Association of rs2299620 in KCNQ1 with HbA1c levels showed heterogeneity between individuals with BMI ≥ 25 kg/m2 and BMI < 25 kg/m2. Conclusions: The variant rs2299620 in KCNQ1 might affect HbA1c levels differentially based on BMI grouping in the Japanese population.

DOI： 10.1007/s13340-023-00618-0

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Language：Japanese   Publisher：Sleep Medicine  

Objective: Findings on the increased mortality risk in individuals with insomnia are inconsistent across studies. Rather than improving insomnia by sleep control, hypnotic use may be one factor in the increased risk of death; however, the effects of hypnotics on mortality remains unclear. This study aimed to examine the association between all-cause mortality and hypnotic use in a large sample, while adjusting for the effects of comorbidities. Methods: Overall, 92,527 individuals aged 35–69 years were followed up for mortality in the Japan Multi-Institutional Collaborative Cohort Study. Regular use of hypnotics was assessed using a self-administered questionnaire. Since cancer history carries a substantial risk of death and is associated with the treatment of insomnia with hypnotics, participants with a cancer history were excluded. The hazard ratio (HR) and 95% confidence interval (CI) for all-cause mortality related to hypnotic use were estimated using a Cox proportional hazard model with adjustments for covariates including sleeping hours and comorbidities (body mass index, ischemic heart disease, stroke, and diabetes). Results: During the follow-up (mean, 8.4 ± 2.5 years), 1,492 mortalities were recorded, and the prevalence of taking hypnotics was 4.2%. Hypnotic use was associated with significantly greater risk of all-cause mortality, even after adjustment for the covariates (HR, 1.32; 95% CI, 1.07–1.63). The association between hypnotic use and all-cause mortality was robust in males (HR, 1.51; 95% CI, 1.15–1.96), and participants aged <60 years (HR, 1.75; 95% CI, 1.21–2.54). Conclusions: Our study revealed sex-age specific associations between hypnotic use and all-cause mortality.

DOI： 10.1016/j.sleep.2022.09.020

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Language：Japanese   Publisher：(NPO)日本小児禁煙研究会  

子どもと同居している20代から40代の成人について、喫煙状況と感染症に対する予防行動との関連について検討した。2020年4月24日～5月8日の間に東京都、愛知県、福島県、鹿児島県に在住する16歳から89歳までの一般市民5450人を対象に、「新型コロナウイルス感染症(COVID-19)に関する一般市民の意識や行動変容に関する調査」として郵送による質問紙調査を実施した。3554人(回収率65.2%)から回答を得て、このうち子どもと同居していると回答した20代から40代の男女845人を解析対象とした。喫煙者の割合は男性が33.4%、女性が10.8%であった。喫煙者における予防行動の維持・改善のオッズ比(OR)は、手洗いについて男性ではOR 1.0、女性ではOR 0.3、マスクの着用頻度について男性ではOR 0.6、女性ではOR 0.9であった。インフルエンザワクチンの接種については男性ではOR 0.5、女性ではOR 0.5であった。子どもと同居する20代から40代の成人において、喫煙状況と感染症予防行動に関連がある可能性が示唆された。

Language：Japanese   Publisher：AIDS Research and Human Retroviruses  

Japan is one of the world's highly endemic areas for human T cell leukemia virus type 1 (HTLV-1), and it is known that the infection rate of HTLV-1 increases with age. The infection rate among the elderly has been estimated based on data from blood donors under the age of 65, and the actual number and rate of infection among the elderly are unknown. Data of 26,090 preoperative HTLV-1 screening tests conducted at Kagoshima University Hospital from 2001 to 2020, including 2726 HTLV-1-positive patients, were used for calculating the decadal infection rates for the year of birth. Estimated infection rates by birth year and demographic tables were used to estimate the current number of infected people in Kagoshima. The estimated total numbers of people infected with HTLV-1 in Kagoshima prefecture were 139,436 in 2005 and 80,975 in 2019. The infection rate increased with age for both men and women, reaching 17.3% for women born before the 1920s. Next, we tried to clarify whether the increase in infection rates with age was due to post-school age infections. The age of birth with the greatest increase in infection rate after 10 years was women born in the 1970s, and the increase in infection rate was only 0.98%, which is not a statistically significant increase. The number of infected people in Kagoshima was >80,000 in 2019. No data were available in this study to point to the involvement of horizontal transmission after school age in the high infection rate among the elderly. The high infection rate among the elderly is thought to have been high even when they were infants.

DOI： 10.1089/aid.2021.0164

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Language：Japanese   Publisher：Heliyon  

Objective: Vinegar has been reported to have a hypotensive effect. We aimed to investigate the relationship between the consumption of vinegar-based side dishes and blood pressure. Research methods & procedures: This cross-sectional study included 746 individuals (257 men and 489 women) aged ≥40 years from Tarumizu, Kagoshima, Japan. Nutrient intake was estimated based on the brief-type self-administered diet history questionnaire. The intake frequency of vinegar-based side dishes (Sunomono and pickles) was determined using a self-administered diet history questionnaire. Participants who did not consume vinegar-based side dishes for a month were defined as having no Sunomono or pickle eating habit. Blood pressure was categorized into four groups according to the Japanese Society of Hypertension Guidelines for the Management of Hypertension. The association between the intake of vinegar-based side dishes and blood pressure categories was analyzed using ordinal logistic regression analysis adjusted for age, body mass index, smoking history, excessive alcohol intake, living situation, energy intake, protein intake, sodium intake, potassium intake, and seaweed intake. Results: Approximately 13.6% men and 6.1% women had no Sunomono eating habits. In men, eating Sunomono, but not pickles, was significantly related to blood pressure categories (estimate, −0.702; 95% CI, −1.122 to −0.310), whereas more frequent consumption of Sunomono did not show an improvement in the blood pressure category. The relationship between eating Sunomono and blood pressure categories was not recognized in women. Conclusion: This was the first study assessing the association between consumption of vinegar-based side dishes and blood pressure categories. We highlighted the effect of Sunomono consumption on blood pressure categories in men. Consumption of Sunomono may improve blood pressure in men.

DOI： 10.1016/j.heliyon.2022.e09505

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Language：Japanese   Publisher：Scientific reports  

The purpose of this study was to investigate the effects of surgeon-related factors on the surgical outcome of pars plana vitrectomy (PPV) and scleral buckling (SB) surgery on eyes with a rhegmatogenous retinal detachment (RRD). This was a nationwide, multicenter, observational study of the data in the Japan-RD Registry. Registered cases that had undergone surgery for a RRD by 128 accredited surgeons in 26 institutions were studied. The surgeon-related factors that significantly affected surgical success and visual outcomes of simple RRD treated by PPV or SB at 6 months postoperatively were analyzed and compared. Among 3446 registered cases, 2533 cases met the inclusion criteria with 1896 in the PPV group and 637 cases in the SB group. The median total number of lifetime cases was 150 and the rate of surgeries/year was 22. Multivariate regression analyses showed that the number and rate of surgeries/year were not significantly associated with the surgical outcome in the PPV group. However, surgeons with a higher average annual number of surgeries had significantly better surgical outcomes in the SB group (P = 0.038). Analyses of a nationwide registry showed that SB but not PPV surgeries require sufficient experience and case numbers to acquire and maintain skills to treat RRDs successfully.

DOI： 10.1038/s41598-022-07838-5

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Language：Japanese   Publisher：International Journal of Environmental Research and Public Health  

The “Creative Heath” project, a participatory school activity to foster community resilience, was implemented in Fukushima, Japan, and children’s experiences of the project were assessed both quantitatively and qualitatively. The project consists of three workshops: BODY, FOOD, and ACT, with activities to facilitate students’ scientific and creative thinking, working in teams, presenting, and expressing their opinions. The first two schools participated with 105 students aged 9–11 years old. Before and after each workshop, students were given questionnaires to rate their satisfaction with their own health (BODY), local foods (FOOD), and the community at large (ACT) on a five-level scale, with space to add free comments. Ratings for BODY and FOOD changed significantly, and the proportion of students who increased their rating of an evaluation indicator after each workshop was 25% for BODY, 28% for FOOD, and 25% for ACT. Text analysis of free comments showed that students in the “increased” group appreciated presenting, measuring, learning connections between nutrition and health, and working collaboratively with peers. Children perceived their health and the foods in their community more positively after participating. Moreover, the Creative Health project could be a way to enhance children’s creativity and autonomy as agents of change in the community.

DOI： 10.3390/ijerph19063417

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PubMed

CiNii Research

Language：Japanese   Publisher：Legal Medicine  

Fetal age is estimated widely by body length and weight and skeletal or dental development and maturation. Regarding dental development, dental development charts reported by Schour and Massler and Ubelaker are well known. We tried to calculate the calcification rate of the deciduous teeth, mandibular cortical bone, and clavicle in fetuses utilizing postmortem computed tomography (CT) image analysis. The CT values within the circumferential area of the region of interest were automatically calculated using a software, and the calcification rate was calculated by performing single regression analysis. Our results showed that deciduous tooth calcification could be detected in over 19-week-old fetuses using CT images. The calcification of bones (mandibular cortical bone and clavicle) started earlier than the calcification of deciduous teeth. However, the calcification rate of the bones was slower compared to that of the deciduous teeth. The calcification rate of the deciduous teeth in fetuses using CT value may be effective to estimate fetal age and evaluate deciduous teeth development, suggesting that our established method is effective for age estimation in forensic dentistry.

DOI： 10.1016/j.legalmed.2021.101969

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PubMed

Language：English   Publisher：エルゼビア・ジャパン(株)  

胎齢の推定法を確立するため、死後CT画像解析から胎児の乳歯歯胚、下顎皮質骨と鎖骨の石灰化速度を計測した。なお、本報では医学教育のため献体された胎児25体(男児13体、女児12体、死亡時胎齢13～33週齢)を用いて、関心領域の円周領域内CT値はソフトウェアで自動計算し、石灰化速度は単回帰分析から求めた。その結果、CT画像から、胎齢19週齢以上の胎児乳歯歯胚の石灰化が検出され、下顎皮質骨と鎖骨の石灰化は、乳歯の石灰化よりも早期に開始されていたが、下顎皮質骨と鎖骨の石灰化速度は、乳歯よりも遅かった。これらの所見から、CT値を用いた胎児石灰化速度が、胎齢の推定と乳歯歯胚発達の評価に有効で、法歯学領域での年齢推定に本法が有用と判断された。

Language：English   Publishing type：Research paper (scientific journal)  

Language：Japanese   Publisher：Frontiers in Public Health  

Although the epidemiological studies provide evidence for an increased risk of lung cancer risk associated with residential radon, an issue of radon-thoron discrimination remains to be solved. In this study, an updated evaluation of lung cancer risk among the residents in Gansu, China was performed where one of the major epidemiological studies on indoor radon demonstrated an increased risk of lung cancer. We analyzed data from a hospital-based case-control study that included 30 lung cancer cases and 39 controls with special attention to internal exposure assessment based on the discriminative measurement technique of radon isotopes. Results from the analyses showed non-significant increased lung cancer risks; odds ratios (ORs) adjusted for age, smoking, and total income were 0.35 (95% CI: 0.07–1.74) and 0.27 (95% CI: 0.04–1.74) for groups living in residences with indoor radon concentrations of 50–100 Bq m−3 and over 100 Bq m−3, respectively, compared with those with < 50 Bq m−3 indoor radon concentrations. Although the small sample size hampers the usefulness of present analyses, our study suggests that reevaluation of lung cancer risk associated with residential radon in the epidemiological studies will be required on the basis of precise exposure assessment.

DOI： 10.3389/fpubh.2021.764201

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PubMed

Language：Japanese   Publisher：Cancer Epidemiology  

Background: In the Karunagappally cohort, esophageal cancer is the third most common cancer with an age-adjusted incidence rate of 6.2 per 100,000 person-years among men. The present study analyzed the risk of esophageal cancer in relation to alcohol drinking and tobacco use. Methods: The study included 65,528 men aged 30–84 years in the Karunagappally cohort, India. Results: Poisson regression analysis showed that alcohol drinking significantly increased (P = 0.027) the risk of esophageal cancer and the relative risk (RR) for current drinkers was 1.6, (95 % confidence interval (CI) = 1.1–2.3). The risk increased significantly in heavy alcohol drinkers (250 g of ethanol or above per day) (RR = 2.1, 95 % CI = 1.2–3.5) (P for trend = 0.014) and among current arrack consumers (RR = 1.8, 95 % CI = 0.99–3.29) (P for trend = 0.025). Current bidi and cigarette smokers showed an increase in the trend of cancer risk. A significantly higher risk was seen in those who had started smoking bidi before the age of 18 years, RR = 1.9 (95 % CI = 1.1–3.3) (P for trend = 0.044). Furthermore, increased RR for heavy bidi and cigarette smokers were 1.6 (95 % CI = 1.1–2.5) and 2.4 (95 % CI = 1.3–4.5), respectively. Conclusion: To the best of our knowledge, this is the first cohort study in India to report an increased esophageal cancer risk with respect to alcohol drinking.

DOI： 10.1016/j.canep.2021.102018

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PubMed

Language：Japanese   Publisher：Japan Science Support Foundation  

DOI： 10.5363/tits.26.9_29

CiNii Research

Language：Japanese   Publisher：Anticancer Research  

Background/Aim: The frequency of somatic mutations of epidermal growth factor receptor (EGFR) in primary lung adenocarcinoma varies among populations and countries. The aim of the present study was to clarify whether the frequency of EGFR mutations in patients with lung adenocarcinoma depends on their mitochondrial DNA haplogroup, which reflects their maternal lineage. Patients and Methods: Using normal lung tissue specimens, the mitochondrial DNA haplogroup was determined by multiplex polymerase chain reaction in 135 Japanese patients who underwent surgery for primary lung adenocarcinoma. Results: The 135 patients were divided into two groups according to the two primitive haplotypes (N group, n=32; M group, n=103). The frequency of EGFR mutations in the N group was significantly higher than that in the M group (69% vs. 48%, p=0.044). The difference was prominent when the analysis was restricted to non-smokers (95% vs. 57%, p<0.01). Conclusion: The frequency of EGFR mutations in lung adenocarcinoma patients depends on their mitochondrial lineage.

DOI： 10.21873/anticanres.15197

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PubMed

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Surgery Today  

Purpose: Using a circular stapler to create an anastomosis for esophagogastrostomy after esophagectomy is well accepted; however, it remains uncertain if the greater curvature (GC) or lesser curvature (LC) of the gastric conduit is better for the anastomosis. We conducted this prospective study to compare the integrity of esophagogastrostomy between the esophagus and the GC or LC side of the gastric conduit. Methods: The subjects of this study were 70 patients who underwent esophagectomy and were randomized to a “GC” group and an “LC” group (n = 35 each). The primary and secondary end points were anastomotic leakage (AL) and anastomotic stricture (AS), respectively. Results: The overall AL rate was 22.1%, without a significant difference between the groups. Stump leakage developed in eight of nine patients in the GC group, whereas leakage developed at the esophagogastric anastomosis in five of six patients in the LC group. The rate of stump leakage was significantly higher than that of esophagogastric AL in the GC group. The overall AS rate was 4.4%, with a significant difference between the groups (0% in the GC group vs. 9.1% in the LC group). Conclusions: AL rates were comparable in the two groups, but the sites of leakage were significantly different.

DOI： 10.1007/s00595-020-02147-8

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PubMed

Language：English   Publisher：シュプリンガー・ジャパン(株)  

食道癌に対する食道切除後の食道胃吻合に際して、導管として胃大彎(GC)を用いた場合と小彎(LC)を用いた場合の成績を比較検討した。食道切除術を施行された食道癌患者70例を対象に前向き無作為化比較試験を実施し、GCでのサーキュラーステープラー使用群35例(男性33例、女性2例、年齢中央値65歳)とLCでのサーキュラーステープラー使用群35例(男性32例、女性3例、年齢中央値65歳)に割り付けた。主要評価項目は吻合部漏(AL)、副次評価項目は吻合部狭窄(AS)とした。検討の結果、手術アプローチ、再建ルート、総手術時間および術中出血量に関してGC群とLC群との間に有意差はみられなかった。AL発症率は全例で22.1%(15例)、GC群が25.7%、LC群が18.2%で有意な群間差はなかった。GC群ではALを呈した9例のうち8例はgastric conduit断端に発症し、LC群ではALを呈した6例のうち5例がステープラー吻合部からの漏出であった。再建ルートに差はなかったが、GC群では皮下ルートでAL発症率が高く、LC群では後縦隔ルートにおいて発症率が高くなっていた。また、ASの発症率は全例で4.4%(3例)で、GC群が0%、LC群が9.1%と有意差が認められた。このほか、反回神経麻痺、肺炎、膿胸、乳び胸、手術部位感染症の発症率にGC群とLC群で有意差はなかった。ALの発症率はGC群とLC群で同等であったが、漏出部位に差があることが明らかになった。

Language：English   Publisher：(公社)日本栄養・食糧学会  

高齢者815名(女性515名、平均74.9歳)を対象に、栄養素摂取状況とプレフレイル(疲労感、動作緩慢、虚弱、活動量低下、または体重減少のいずれか一つ以上の存在)との関係について検討した。男性の52%および女性の54%がプレフレイルに該当した。男性では栄養素摂取状況とプレフレイルの間に有意な関連はみられなかった。女性の場合、健常群と比較して、プレフレイル群はビタミンKとB群(B1、B2、葉酸、パントテン酸)、リン、カリウム、カルシウム、マグネシウム、鉄、亜鉛、銅の摂取量が有意に少なかった。このうちプレフレイルに関連する有意な変数として抽出されたのはマグネシウムのみであった。マグネシウム摂取量の四分位別にみた女性のプレフレイルの調整オッズ比(95%信頼区間)は、第1分位を基準として、第2分位が0.52(0.29～0.92,p=0.024)、第3分位が0.51(0.28～0.95,p=0.033)、第4分位が0.38(0.19～0.74,p=0.005)であった。以上から、高齢日本人女性において、マグネシウムはプレフレイル予防に重要な栄養素であると考えられた。

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Center for Academic Publications Japan  

<p>We examined the association between nutrient intake and prefrailty. Data from 815 older people (63% women) who participated in a community-based health check survey (Tarumizu Study) were analyzed. Prefrailty were defined using five parameters (exhaustion, slowness, weakness, low physical activity, and weight loss). Participants with one or more components were considered to belong to the prefrailty group. Nutrition intake was estimated from a validated brief-type self-administered diet history questionnaire. Among the participants, 154 men (52%) and 278 women (54%) were found to be in a status of prefrailty. In men, there were no significant associations between nutrient intake and prefrailty. In women, carbohydrate intake was slightly higher in prefrailty group. Vitamins K, B₁, B₂, folic acid, pantothenic acid, phosphorus, potassium, calcium, magnesium, iron, zinc, and copper intake was significantly lower in the prefrailty group. Among the nutrients, magnesium was identified as a significant covariate of prefrailty using a stepwise regression method. In women adjusted ORs (95%CI, <i>p</i> value) for prefrailty in the first, second, third, and fourth quartiles of magnesium intake were 1.00 (reference), 0.52 (0.29–0.92, 0.024), 0.51 (0.28–0.95, 0.033), and 0.38 (0.19–0.74, 0.005), respectively, by multivariate logistic regression analysis (variates: age, body mass index, energy intake, supplement use, osteoporosis, magnesium, and protein intake). Protein intake did not related to prefrailty. Protein intake might be sufficient to prevent prefrailty in the present study. We propose magnesium to be an important micronutrient that prevents prefrailty in community-dwelling older Japanese women.</p>

DOI： 10.3177/jnsv.67.39

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CiNii Research

Language：Japanese   Publisher：British Journal of Ophthalmology  

Background/aims: To compare the effects of silicone oil tamponade (SOT) to that of gas tamponade (GT) on the best-corrected visual acuity (BCVA) after successful vitrectomy for retinal detachment (RD). Methods: A retrospective, multicentre, nationwide study with RD who were registered in the Japan-RD Registry. All cases with RD treated with successful vitrectomy between February 2016 and March 2017 were studied. A propensity score matching was performed using the preoperative findings as covariates to adjust the relevant confounders. The primary outcome was the estimated mean difference of the postoperative BCVA in 6 months between eyes treated with SOT to those treated with GT. Results: Of the 3446 cases registered, 2097 cases met the entry criteria. There were 2042 eyes that had GT and 55 eyes that had SOT. Primary success was defined as a reattached retina with no tamponade at 6 months. After propensity score matching, each group contained 40 cases. The preoperative BCVA was 0.966±0.738 logMAR units in the GT group and 1.270±0.945 logMAR units in the SOT group (p=0.177). Six months postoperatively, the BCVA in the GT group was significantly better at 0.309 logMAR units in the GT group than the 0.671 logMAR units in the SOT group (p=0.002). Conclusions: Even after successful surgery for RD, eyes that experienced SOT had poorer BCVA than eyes treated with GOT. SOT should be considered cautiously. Precis: Propensity score analysis of eyes with rhegmatogenous RD showed that postoperative vision was worse in eyes treated once with silicone oil than with gas even after completely successful surgery.

DOI： 10.1136/bjophthalmol-2021-319876

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Neurotoxicity Research  

DOI： 10.1007/s12640-020-00174-4

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Publisher：日本疫学会  

＜Highlight＞●妊婦を対象に抗原特異的IgE抗体と血中金属濃度との関係を調べた。●抗原特異的IgE抗体は2群(低値群<0.35UA/ml,高値群≧0.35UA/ml)に分けて解析された。●スギ特異的IgE抗体と血中水銀およびセレン濃度の間に正の相関が認められた。●ハウスダストおよび動物上皮特異的IgE抗体と血中水銀濃度の間に負の相関が認められた。(著者抄録)

Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1007/s12020-019-02071-z

PubMed

Language：English   Publisher：Frontiers in Behavioral Neuroscience  

DOI： 10.3389/fnbeh.2019.00213

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PubMed

Language：Japanese   Publisher：Japanese Society of Public Health  

DOI： 10.11236/jph.66.8_391

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CiNii Research

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Wiley  

<jats:p><jats:italic>Purpose</jats:italic>. Platelet derived growth factor-BB (PDGF-BB) has emerged as one of the key cytokines in malignant transformation of different cells. PDGF-BB also exhibits a potent mitogenic effect on liver cells; studies have advocated clinical implications of monitoring serum PDGF-BB (sPDGF-BB) in patients with liver disease. We thus investigated the predictive relevance of perioperative sPDGF-BB after curative resection of hepatocellular carcinoma (HCC).<jats:italic> Methods</jats:italic>. We evaluated perioperative sPDGF-BB in a prospective homogenous cohort of 40 patients diagnosed with HCC. During the first two-year follow-up, patients were evaluated every three months for postresection HCC recurrence.<jats:italic> Results</jats:italic>. Patients who developed recurrence during two-year follow-up were found to have lower concentration of sPDGF-BB than those without recurrence in both pre- and postoperative settings (<jats:italic>P</jats:italic> < 0.05 and<jats:italic> P</jats:italic> < 0.001, resp.). We validated that the reduced postoperative sPDGF-BB (< 2133.29 pg/mL) was associated with an increased incidence of postresection HCC recurrence [area under curve (AUC) > 0.8, 95% confidence interval (CI) = 0.68 - 0.94,<jats:italic> P</jats:italic> < 0.001]; furthermore, we were able to demonstrate that postoperative sPDGF-BB was an independent predictor of HCC recurrence (hazard ratio = 5.64, 95% CI = 1.56 - 20.30,<jats:italic> P</jats:italic> < 0.01).<jats:italic> Conclusions</jats:italic>. These findings provide a new insight into an association between diminished perioperative sPDGF-BB and HCC recurrence. Patients with low perioperative sPDGF-BB progressed early HCC recurrence. Therefore, evaluating perioperative sPDGF-BB may provide useful clinical information to characterize patients with postresection HCC recurrence.</jats:p>

DOI： 10.1155/2019/1925315

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CiNii Research

Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1186/s40001-018-0358-1

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1016/j.envres.2018.06.025

PubMed

Language：English   Publisher：Clinical Nutrition  

DOI： 10.1016/j.clnu.2017.07.014

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PubMed

Language：English   Publisher：Environmental Health and Preventive Medicine  

DOI： 10.1186/s12199-018-0713-4

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PubMed

Publisher：(一社)日本衛生学会  

ウレタンフォーム工場の男性労働者75名と、同工場で勤務中に呼吸器症状が悪化し、職業性アレルギー(OA)が疑われる男性2名(43歳、52歳)を対象に、実際のモニタリングにおける複数の化学物質特異的免疫グロブリンG(IgG)評価の有用性について検討した。被験者から血液を採取し、トルエンジイソシアネート(TDI)および無水トリメリット酸(TMI)特異的IgGのレベルを評価した。対照男性87名のTDI特異的IgG濃度は平均0.98μg/mL、TMA特異的IgG濃度は平均2.10μg/mLであった。OAが疑われる2名のTDI特異的IgG濃度は15.6μg/mLと9.51μg/mL、TMA特異的IgG濃度は4.56μg/mLと14.4μg/mLで、対照男性よりも著明に上昇していた。男性労働者75名のTDI特異的IgG濃度は平均1.89μg/mL、TMA特異的IgG濃度は平均2.41μg/mLで、いずれも対照男性よりも有意に上昇していた(それぞれp<0.001,p<0.026)。プラスチック樹脂を用いる労働者において、TDIおよびTMA特異的IgGの評価は、曝露状況のモニタリングに有用であることが示された。

Publisher：(一社)日本毒性学会  

ヒト血清アルブミン(HSA)部分ペプチドを用いたELISAにより、血清中の化学物質特異的免疫グロブリンG(IgG)の定量分析を行った。リジン残基を含むHSA部分ペプチドをホルムアルデヒド(FA)または無水フタル酸(PA)と混合して、ペプチド中のリジン残基とそれぞれイミンまたは3級アミンを形成させ、血清中のFAおよびPA特異的IgG検出用の人工抗原であるFAおよびPAペプチド付加物を調製した。プラスチック樹脂を用いる工場労働者および一般被験者の血清を採取し、HSAペプチドを用いたELISAでFAおよびPA特異的IgGを測定したところ、工場労働者の特異的IgGは、一般被験者よりも有意に高かった。本法は化学物質への曝露レベル推定が可能で、労働者のアレルギー診断や有害化学物質による健康障害の防止に寄与することが示唆された。

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Environment International  

DOI： 10.1016/j.envint.2017.11.001

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Language：English   Publishing type：Research paper (scientific journal)  

Language：English   Publishing type：Research paper (scientific journal)  

Language：English   Publisher：British Journal of Radiology  

<jats:sec>
<jats:title>Objective:</jats:title>
<jats:p>To identify risk factors for symptomatic radiation pneumonitis (RP) after stereotactic radiation therapy (SRT) for lung tumours.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Methods:</jats:title>
<jats:p>We retrospectively evaluated 68 lung tumours in 63 patients treated with SRT between 2011 and 2015. RP was graded according to the National Cancer Institute—Common Terminology Criteria for Adverse Events version 4.0. SRT was delivered at 7.0–12.0 Gy per each fraction, once daily, to a total of 48–64 Gy (median, 50 Gy). Univariate analysis was performed to assess patient- and treatment-related factors, including age, sex, smoking index (SI), pulmonary function, tumour location, serum Krebs von den Lungen-6 value (KL-6), dose-volume metrics (V5, V10, V20, V30, V40 and VS5), homogeneity index of the planning target volume (PTV), PTV dose, mean lung dose (MLD), contralateral MLD and V2, PTV volume, lung volume and the PTV/lung volume ratio (PTV/Lung). Performance of PTV/Lung in predicting symptomatic RP was also analysed using receiver operating characteristic (ROC) analysis.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Results:</jats:title>
<jats:p>The median follow-up period was 21 months. 10 of 63 patients (15.9%) developed symptomatic RP after SRT. On univariate analysis, V10, V20, PTV volume and PTV/Lung were significantly associated with occurrence of RP  ≥Grade 2. ROC curves indicated that symptomatic RP could be predicted using PTV/Lung [area under curve (AUC): 0.88, confidence interval (CI: 0.78–0.95), cut-off value: 1.09, sensitivity: 90.0% and specificity: 72.4%].</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Conclusion:</jats:title>
<jats:p>PTV/Lung is a good predictor of symptomatic RP after SRT.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Advances in knowledge:</jats:title>
<jats:p>The cases with high PTV/Lung should be carefully monitored with caution for the occurrence of RP after SRT.</jats:p>
</jats:sec>

DOI： 10.1259/bjr.20170453

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CiNii Research

Language：English   Publisher：The Japanese Society of Toxicology  

<p>Many different types of chemicals are used in industry, and occupational allergies are becoming a serious problem in the field of industrial hygiene. In this study, we employed a novel enzyme-linked immunosorbent assay (ELISA) with partial peptides of human serum albumin (HSA) to quantify chemical-specific immunoglobulin G (IgG) in serum for evaluating exposure to chemicals. When HSA partial peptides containing lysine residues were mixed with formaldehyde (FA) or phthalic anhydride (PA), almost all lysine residues were lost. Mass spectrometry revealed that PA and FA formed imine and tertiary amine, respectively, with lysine residues in the peptides. Thus, we used FA- or PA-peptide adducts as an artificial antigen to detect FA- and PA-specific IgGs in serum. The concentrations of FA- and PA-specific IgGs in workers at plants utilizing plastic resins were significantly higher than those in general subjects. This method can estimate exposure levels to chemicals and thus be expected to contribute to the diagnosis of allergies in workers and to the prevention of health hazards due to harmful chemicals.</p>

DOI： 10.2131/jts.43.25

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CiNii Research

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Polish Journal of Radiology  

DOI： 10.5114/pjr.2018.77024

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Language：English  

DOI： 10.21037/gs.2017.12.03

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

Language：English   Publishing type：Research paper (scientific journal)  

Language：English   Publisher：European Journal of Medical Research  

DOI： 10.1186/s40001-017-0287-4

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Radiation Protection Dosimetry  

DOI： 10.1093/rpd/ncx013

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PubMed

Language：English   Publishing type：Research paper (scientific journal)  

Language：English  

DOI： 10.1186/s12885-017-3681-y

PubMed

Publisher：(一社)日本毒性学会  

メチル水銀(MeHg)の曝露状況を調べるため、ハノイ在住のベトナム人196名(男性99名、女性97名、年齢16〜55歳)を対象に、毛髪水銀値と足指爪中のセレン(Se)濃度および魚食との関連を評価した。魚食に関する情報は食事質問票を用いて評価した。男性と女性の毛髪水銀値の幾何学的平均はそれぞれ617ng/gおよび575ng/gであった。本ベトナム人被験者の98%の毛髪水銀値はMeHgに対する暫定的耐容1週摂取量(1.6μgHg/kg体重:6.4の不確実性因子にて約2300ng/gの毛髪水銀濃度に相当)より低かった。新鮮な魚食頻度に関係する女性の毛髪水銀値の年齢調整幾何学的平均において有意差があった。毛髪水銀値と足指爪中のSe濃度は魚食頻度の増加にともなって増加し、海産魚≧1回/週を食した被験者では有意な正相関を示した。

Language：English   Publishing type：Research paper (scientific journal)  

Language：English   Publisher：Tumor Biology  

DOI： 10.1177/1010428317717718

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Language：English   Publisher：Journal of the Endocrine Society  

DOI： 10.1210/js.2017-00182

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：International Journal of COPD  

DOI： 10.2147/COPD.S130453

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PubMed

Publisher：(一社)日本衛生学会  

当大学病院の女性新人看護師を対象に、職業性ストレスに対する感受性の潜在的な予測因子を評価した。看護師62名にBrief Job Stress Questionnaireを行い、最終的に42名(年齢21〜24歳)を解析対象とした。全員に健康診断と泌尿器検査を行い、就職時に生活習慣に関する質問票調査を行った。登録から5ヵ月の時点で三つのストレス状態スコアが全て有意に低下し、職業性ストレス状態であることが示唆された。収縮期血圧(r=-0.324、p<0.05)と尿中ナトリウム(r=-0.313、p<0.05)は登録から5ヵ月後のBJSQスコアと有意に負の相関があった。登録後のストレス状態スコアは、1年間の体重変化が±3kg以下および夕食から就寝までが2時間以下の看護師では有意に低かった。尿中ナトリウム、1年間の体重変化、夕食から就寝までの時間は職業性ストレス感受性の予測因子として有望であることが示唆された。

Publisher：鹿児島産科婦人科学会  

1997年1月〜2010年9月に当施設で婦人科悪性腫瘍と診断し、一次治療として手術を施行した患者362例を対象に、皮下ドレーン留置が皮膚吻合後の創離開にどのような影響を及ぼすかを後向きに評価した。皮下ドレーン留置患者(留置群)は131例(平均56.2±14.0歳)、非留置患者(非留置群)は231例(平均54.0±14.6歳)であった。創離開の全発生率は留置群3/131例、非留置群18/231例であった(p=0.031)。創離開率はBMI(p=0.007)、疾患進行度(p=0.002)、手術時間(p=0.013)と正の相関が認められた。多重ロジスティック回帰分析により、肥満、疾患ステージ進行、長い手術時間を創離開の独立したリスクとして特定した。肥満患者では、非留置群の方が創離開率は高かった。以上より、婦人科悪性腫瘍手術時の皮下ドレーン留置は、皮膚吻合後の創離開率を低下させることが示された。

Publisher：John Wiley & Sons Australia, Ltd  

大腿骨近位部骨折手術1年後の日常生活動作(ADL)能力および生存に影響を及ぼす因子を明らかにすることを目的とした。鹿児島県内の33医療施設で治療を受けた患者387例を対象とする多施設共同前向きコホート研究を実施した。ロジスティック回帰分析においてBarthel Index(BI)の悪化リスクと有意な関連を示した術前因子は、加齢、骨折前BIの不良、大腿骨転子部骨折、術後因子は退院時BIの不良、認知障害であった。また退院後に疾患を新規発症した患者ではBI悪化のオッズ比が有意に高かった。死亡リスクと有意な関連を示した術前因子は年齢と性別のみで、それらの影響を調整後、術後因子としては退院時BIが唯一の有意な死亡リスク決定因子であった。退院時にADL能力が不良な患者は、手術1年後における機能の回復が不良で、死亡率が高い傾向にあることが示された。

Language：English   Publishing type：Research paper (scientific journal)  

Language：English   Publishing type：Research paper (scientific journal)  

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Environmental Health and Preventive Medicine  

DOI： 10.1186/s12199-017-0641-8

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Journal of Cancer  

DOI： 10.7150/jca.20971

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PubMed

Language：English   Publisher：The Japanese Society of Toxicology  

<p>People are exposed to methylmercury (MeHg) mainly through fish consumption, which is increasing in Vietnam. However, little information is available on estimating the health risk of MeHg exposure through fish consumption in Vietnam. The present study examined the association between mercury (Hg) levels in hair and selenium (Se) levels in toenails of 196 Vietnamese people and their fish consumption, using a dietary questionnaire to obtain information pertinent for assessing health risk owing to MeHg exposure. The geometric mean of Hg levels in the hair of males and females was 617 ng/g and 575 ng/g, respectively. We found that Hg levels in the hair of 98% of the Vietnamese study subjects were lower than the provisional tolerable weekly intake for MeHg (1.6 µg Hg/kg body weight; which is equivalent to a hair Hg concentration of approximately 2,300 ng/g, with an uncertainty factor of 6.4). There were significant differences in the age-adjusted geometric mean of Hg levels found in hair from females related to their frequency of freshwater fish consumption. The levels of Hg in hair and Se in toenails increased with an increased frequency of marine fish consumption, and both showed a significant positive correlation in subjects who consumed marine fish ≥ once/week. This is the first cross-sectional study to investigate the association between hair Hg levels and fish consumption in Vietnam. These findings provide valuable information for future assessments of the health risk of MeHg exposure through fish consumption in Vietnam.</p>

DOI： 10.2131/jts.42.651

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CiNii Research

Language：English  

DOI： 10.3892/mmr.2016.5496

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Wiley  

<jats:sec><jats:title>Aim</jats:title><jats:p>Given that different hospitals achieve different outcomes, optimal evaluation of treatment outcomes in the local community requires evaluation of many institutions in that area. We carried out a prospective multicenter cohort study in <jats:styled-content style="fixed-case">K</jats:styled-content>agoshima <jats:styled-content style="fixed-case">P</jats:styled-content>refecture to identify factors that contribute to deterioration in activities of daily living performance and patient mortality 1 year after surgical treatment of hip fractures.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We prospectively enrolled 387 patients who underwent surgery for hip fractures in 33 registered facilities within a 6‐month period from <jats:styled-content style="fixed-case">F</jats:styled-content>ebruary to <jats:styled-content style="fixed-case">J</jats:styled-content>uly 2007. Logistic regression analysis was carried out to identify factors that contribute to deterioration in activities of daily living performance and death within 1 year after surgery.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>An increased risk of Barthel Index (<jats:styled-content style="fixed-case">BI</jats:styled-content>) deterioration was associated with increased age (<jats:italic>P</jats:italic> for trend = 0.003), worse pre‐injury <jats:styled-content style="fixed-case">BI</jats:styled-content> (<jats:italic>P</jats:italic> for trend = 0.021), trochanteric fractures (<jats:styled-content style="fixed-case">OR</jats:styled-content> 2.07, 95% <jats:styled-content style="fixed-case">CI</jats:styled-content> 1.31–3.27), worse <jats:styled-content style="fixed-case">BI</jats:styled-content> at discharge (<jats:italic>P</jats:italic> for trend < 0.001) and postoperatively developed cognitive impairment (<jats:styled-content style="fixed-case">OR</jats:styled-content> 6.34, 95% <jats:styled-content style="fixed-case">CI</jats:styled-content> 2.15–18.7). The <jats:styled-content style="fixed-case">OR</jats:styled-content> for <jats:styled-content style="fixed-case">BI</jats:styled-content> deterioration in patients with newly‐diagnosed disease after discharge was approximately 9.16 (95% <jats:styled-content style="fixed-case">CI</jats:styled-content> 4.03–20.8). No factors except age and sex were statistically significant as the preoperative indicators of mortality risk. Only <jats:styled-content style="fixed-case">BI</jats:styled-content> at discharge was a significant determinant of mortality risk (<jats:styled-content style="fixed-case"><jats:italic>P</jats:italic></jats:styled-content> for trend = 0.013) after adjusting for the effects of age and sex.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Patients with poor activities of daily living performance at the time of hospital discharge were likely to show poor functional recovery and a high 1‐year postoperative mortality. <jats:bold>Geriatr Gerontol Int 2017; 17: 391–401.</jats:bold></jats:p></jats:sec>

DOI： 10.1111/ggi.12718

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：PeerJ  

<jats:p><jats:bold>Background.</jats:bold>Previous studies have shown that psychological stress is linked to asthma prevalence. Parental psychological stress may potentially influence inflammatory responses in their allergic children. The purpose of this study is to clarify the association between maternal psychological status and inflammatory response of allergic young children.</jats:p><jats:p><jats:bold>Methods.</jats:bold>The study subjects were 152 young allergic children (median age: 13 months) who had not shown any allergic symptoms in the past one month. mRNA expression levels of the inflammatory response genes IL-6, IL-8, IL-10 and IL-22 were quantified by qRT-PCR. Maternal psychological status was assessed by standardized questionnaires: the Centre for Epidemiological Studies Depression Scale (CES-D) for depression and the Japanese Perceived Stress Scale (JPSS) for perceived stress.</jats:p><jats:p><jats:bold>Results.</jats:bold>A significant positive association was observed between maternal CES-D scores and IL-6 mRNA expression in the children with asthma. The JPSS scores were also positively associated with IL-8mRNAexpression in asthmatic children and IL-6 mRNA expression in children with allergic rhinitis. Similar trends were observed among children positive for house dust mite-specific IgE, but these associations were not significant.</jats:p><jats:p><jats:bold>Conclusion.</jats:bold>This study supports the hypothesis that maternal psychological stress affects the inflammatory response in their allergic children.</jats:p>

DOI： 10.7717/peerj.1585

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Language：English   Publishing type：Research paper (scientific journal)  

Language：English   Publishing type：Research paper (scientific journal)  

Language：English  

DOI： 10.1371/journal.pone.0165587

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Language：English  

DOI： 10.2147/COPD.S110429

PubMed

Language：Japanese   Publisher：The Japan Society for Oriental Medicine  

[<b>Objective</b>] In this study, we retrospectively investigated the efficacy of Kampo medicine for refractory acne patients with standard therapy in Japan.<br>[<b>Patients</b>] Two hundred and thirty nine patients with inflammatory acne completed the study. Six Patients discontinued their systemic treatment because of adverse events. The patients included 193 females and 46 males, with a mean age of 26.5 years. They took Kampo medicine three times daily for 3 months, in a manner according to our protocol.<br>[<b>Result</b>] For females, 163 of 199 patients (82%) were in the KUOKETSUZAI Group taking medicines such as keisibukuryogankayokuinin, tokishakuyakusan, tokakujyokito, and kamishoyosan. Here, 124 of 163 patients (76%) had a significant decrease in new and inflammatory eruptions after taking the Kampo medicines alone or in combinations with other KUOKETSUZAI medicines. Fourteen of 19 patients (74%) took seijobofuto, of which 6 of 7 females (86%), and 1 of 3 males (33%) had decreased acne eruptions. Also in KUOKETSUZAI group, significant efficacy was shown in females over 21 years of age on combinations. For males, 18 of 23 patients (78%) taking keigairengyoto and 14 of 20 patients (70%) taking seijobofuto, also had decreased inflammatory acne eruptions.<br>[<b>Conclusion</b>] Kampo medicines exhibit significant efficacy for the treatment of the refractory acne.<br>KUOKESTUZAI : category of oriental medicines that improve peripheral blood flow while concurrently facilitating wound healing, and that regulate hormone balance, and improve gastrointestinal motility ; e.g. keisibukuryogankayokuinin, tokishakuyakusan, tokakujyokito, kamishoyosan.

DOI： 10.3937/kampomed.67.123

CiNii Research

Language：English   Publishing type：Research paper (scientific journal)   Publisher：International Institute of Anticancer Research  

Aim: The present study aimed to explore the etiological role of human papillomavirus (HPV) in tonsillar squamous cell carcinoma (TSCC). Materials and Methods: HPV status, including viral load and E6 variants, and the expression of P53, p16INK4A, and FANCD2, in tissues of TSCC (n=24) and tonsillitis (n=31) were investigated. Results: The frequency of high-risk HPV (HPV-16) in TSCCs (42%) was higher than that of tonsillitis (16%). HPV-16 genome was partially or fully integrated in all HPV-16-positive TSCCs. However, the viral genome was partially integrated in three out of five HPV-16-positive tonsillitis cases (p=0.037). HPV-16-positive TSCCs showed a higher frequency of p16INK4A expression than HPV-16-negative TSCCs and tonsillitis (p=0.011). Regardless of HPV status, TSCCs had a lower expression of FANCD2 than tonsillitis (p=0.008). Conclusion: The present study supports the etiological role of HPV-16 in the development of TSCC, and p16INK4A overexpression can be applied as a surrogate marker for the detection of high-risk-HPV in TSCC.

Language：English  

DOI： 10.1007/s12282-014-0523-5

PubMed

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Elsevir  

Aims

The aim of this study was to clarify the involvement of oxidative stress in methylmercury (MeHg)-induced pro-inflammatory cytokine expressions and the suppressive effects of N-acetylcysteine (NAC) in MeHg-induced cytokine expression.

Materials and methods

Using U-87-MG human astrocytoma cell line, interleukin (IL)-6 and monocyte chemoattractant protein (MCP)-1 expressions induced by 4 μM MeHg were measured at mRNA and protein levels. Hydrogen peroxide (H2O2) and superoxide anion (O2−) were quantified by flow-cytometry analysis. To examine the suppressive effects of NAC on the cytokine expressions among different timing of NAC treatment, cells were treated with 0.5 or 5 mM NAC before, simultaneously, or after MeHg administration.

Key findings

MeHg exposure at 4 μM, a non-cytotoxic concentration, significantly induced MCP-1 and IL-6 expressions at both mRNA and protein levels. A significant increase of H2O2 production but not O2− was observed. MeHg-induced expression of MCP-1 and IL-6 mRNA was reduced by 10–20% in the presence of 5 mM NAC (co-treatment experiment) compared to cells treated with MeHg only. Pre-treatment of cells with 0.5 or 5 mM NAC at 0.5 or 1 h and its subsequent washout before MeHg addition suppressed MCP-1 and IL-6 cytokine expressions. Post-treatment of cells with NAC after MeHg addition also suppressed the cytokine induction, but the magnitude of suppression was evidently lower than in co-treated cells even though the H2O2 generation was almost completely suppressed by NAC.

Significance

NAC may effectively suppress the MeHg-induced cytokine production through both, inhibition of reactive oxygen species as well as extracellular chelation of MeHg in astrocytes.

Other Link： http://www.sciencedirect.com/science/journal/00243205/134

Language：English  

DOI： 10.1097/MPA.0000000000000362

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Language：English  

DOI： 10.1007/s12199-015-0453-7

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Language：English  

DOI： 10.1016/j.pestbp.2014.10.014

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Language：English  

DOI： 10.3978/j.issn.2227-684X.2015.01.06

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Language：English   Publishing type：Research paper (scientific journal)  

Language：English  

DOI： 10.3892/mmr.2014.2612

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

Language：English   Publisher：Wiley  

<jats:sec><jats:title>Purpose</jats:title><jats:p>To evaluate whether the reduction rate of T1 relaxation time of the liver (T1 relaxation time index) before and 20 minutes after gadolinium‐ethoxybenzyl‐diethylenetriaminepentaacetic acid (Gd‐EOB‐DTPA) injection has the potential to serve as an magnetic resonance imaging (MRI)‐based liver function test in comparison with signal intensity‐based indices.</jats:p></jats:sec><jats:sec><jats:title>Materials and Methods</jats:title><jats:p>Ninety‐nine patients with suspected liver lesions underwent Gd‐EOB‐DTPA‐enhanced MRI. T1 maps using 3D T1‐weighted gradient‐echo volumetric interpolated examination with two different flip angles were also performed before and 20 minutes after Gd‐EOB‐DTPA administration. T1 relaxation time index was compared with four signal intensity‐based indices in terms of the ability to discriminate Child‐Pugh A (CPA) and Child‐Pugh B (CPB) from normal liver function (NLF), and in terms of its correlation with indocyanine green (ICG) clearance.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Twenty‐four patients were classified as NLF, 64 patients were classified as CPA, and 11 were classified as CPB group. The T1 relaxation time index was significantly lower for CPA (0.62 ± 0.08 vs. 0.68 ± 0.07, <jats:italic>P</jats:italic> = 0.021) and CPB (0.55 ± 0.15 vs. 0.68 ± 0.07, <jats:italic>P</jats:italic> < 0.001) than for NLF. All signal intensity‐based indices showed significant differences only when comparing NLF and CPB. The correlation coefficient with ICG clearance was the highest for T1 relaxation time index (<jats:italic>r</jats:italic> = −0.605, <jats:italic>P</jats:italic> < 0.001).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>The T1 relaxation time index has the potential to serve as an MRI‐based liver function test, and is most strongly correlated with ICG clearance among the Gd‐EOB‐DTPA MRI‐based indices investigated. <jats:bold>J. Magn. Reson. Imaging 2014;40:884–889</jats:bold>. © <jats:bold>2013 Wiley Periodicals, Inc</jats:bold>.</jats:p></jats:sec>

DOI： 10.1002/jmri.24443

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Language：English  

DOI： 10.1186/1471-2407-14-730

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Language：English  

DOI： 10.1093/jb/mvu015

PubMed

Publisher：Wiley  

<jats:title>Abstract</jats:title><jats:sec><jats:title>Aim</jats:title><jats:p>Incomplete brachytherapy is a major risk factor for recurrence. However, high‐dose‐rate intracavitary brachytherapy has not been assessed adequately in elderly patients with invasive cervical cancer. The present study investigated the clinical importance of intracavitary brachytherapy and risk factors of incomplete intracavitary brachytherapy in elderly patients with cervical cancer.</jats:p></jats:sec><jats:sec><jats:title>Material and Methods</jats:title><jats:p>Subjects were 76 patients aged 70–89 years old with invasive cervical cancer. All subjects were recruited between <jats:styled-content style="fixed-case">J</jats:styled-content>anuary 1997 and <jats:styled-content style="fixed-case">S</jats:styled-content>eptember 2010, and were planning to receive external beam radiation therapy followed by high‐dose‐rate intracavitary brachytherapy. Survival rates and the incidence of complications were compared between the 70s and 80s age groups. Risk factors for recurrence in elderly patients were evaluated using multivariate analysis, and risk factors for impractical intracavitary brachytherapy were also estimated.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>No significant differences were observed in 3‐year progression‐free survival rates or the incidence of complications in the two age groups. Cox multivariate analysis showed that histology (non‐squamous cell carcinoma), incomplete intracavitary brachytherapy, and lymph node swelling were significant prognostic factors for recurrence. Impractical application was the major reason for incomplete treatment. Multiple logistic regression analysis revealed that a previous history without vaginal births (<jats:italic>P</jats:italic> = 0.016) was an independent risk factor for the impractical application, independent of tumor diameter ≥4 cm (<jats:italic>P</jats:italic> = 0.007).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Incomplete intracavitary brachytherapy decreased the survival rates of elderly patients. Larger tumors and patients without a history of vaginal births were the two major causes of impractical intracavitary brachytherapy, which may be fatal, especially in elderly patients with bulky tumors.</jats:p></jats:sec>

DOI： 10.1111/jog.12387

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Language：English   Publishing type：Research paper (scientific journal)  

Language：English   Publishing type：Research paper (scientific journal)  

Language：English   Publishing type：Research paper (scientific journal)  

Language：English  

DOI： 10.3109/10428194.2013.772174

PubMed

Publisher：Wiley  

<jats:p><jats:italic>Helicobacter pylori</jats:italic> is the primary cause of gastric cancer. However, monoclonal Epstein–Barr virus (EBV) nucleic acid is also present in up to 10% of these tumors worldwide. EBV prevalence is increased with male sex, nonantral localization and surgically disrupted anatomy. To further examine associations between EBV and gastric cancer, we organized an international consortium of 11 studies with tumor EBV status assessed by <jats:italic>in situ</jats:italic> hybridization. We pooled individual‐level data on 2,648 gastric cancer patients, including 184 (7%) with EBV‐positive cancers; all studies had information on cigarette use (64% smokers) and nine had data on alcohol (57% drinkers). We compared patients with EBV‐positive and EBV‐negative tumors to evaluate smoking and alcohol interactions with EBV status. To account for within‐population clustering, multilevel logistic regression models were used to estimate interaction odds ratios (OR) adjusted for distributions of sex (72% male), age (mean 59 years), tumor histology (56% Lauren intestinal‐type), anatomic subsite (61% noncardia) and year of diagnosis (1983–2012). In unadjusted analyses, the OR of EBV positivity with smoking was 2.2 [95% confidence interval (CI) 1.6–3.2]. The OR was attenuated to 1.5 (95% CI 1.01–2.3) by adjustment for the possible confounders. There was no significant interaction of EBV status with alcohol drinking (crude OR 1.4; adjusted OR 1.0). Our data indicate the smoking association with gastric cancer is stronger for EBV‐positive than EBV‐negative tumors. Conversely, the null association with alcohol does not vary by EBV status. Distinct epidemiologic characteristics of EBV‐positive cancer further implicate the virus as a cofactor in gastric carcinogenesis.</jats:p>

DOI： 10.1002/ijc.28402

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Language：English   Publishing type：Research paper (scientific journal)  

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Language：English  

DOI： 10.1007/s00259-013-2424-9

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Language：English   Publishing type：Research paper (scientific journal)  

Language：English  

DOI： 10.1148/radiol.13121546

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Publisher：BMJ  

<jats:sec>
<jats:title>Background and objective</jats:title>
<jats:p>About 9% of gastric carcinomas have Epstein–Barr virus (EBV) in the tumour cells, but it is unclear whether viral presence influences clinical progression. We therefore examined a large multicentre case series for the association of tumour EBV status with survival after gastric cancer diagnosis, accounting for surgical stage and other prognostic factors.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Methods</jats:title>
<jats:p>We combined individual-level data on 4599 gastric cancer patients diagnosed between 1976 and 2010 from 13 studies in Asia (n=8), Europe (n=3), and Latin America (n=2). EBV positivity of tumours was assessed by in situ hybridisation. Mortality HRs for EBV positivity were estimated by Cox regression models stratified by study, adjusted for distributions of sex (71% male), age (mean 58 years), stage (52% tumour-node-metastasis stages III or IV), tumour histology (49% poorly differentiated, 57% Lauren intestinal-type), anatomic subsite (70% non-cardia) and year of diagnosis. Variations by study and continent were assessed using study-specific HRs for EBV positivity.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Results</jats:title>
<jats:p>During median 3.0 years follow-up, 49% of patients died. Stage was strongly predictive of mortality, with unadjusted HRs (vs stage I) of 3.1 for stage II, 8.1 for stage III and 13.2 for stage IV. Tumour EBV positivity was 8.2% overall and inversely associated with stage (adjusted OR: 0.79 per unit change). Adjusted for stage and other confounders, EBV positivity was associated with lower mortality (HR, 0.72; 95% CI 0.61 to 0.86), with low heterogeneity among the study populations (p=0.2). The association did not significantly vary across patient or tumour characteristics. There was no significant variation among the three continent-specific HRs (p=0.4).</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Conclusions</jats:title>
<jats:p>Our findings suggest that tumour EBV positivity is an additional prognostic indicator in gastric cancer. Further studies are warranted to identify the mechanisms underlying this protective association.</jats:p>
</jats:sec>

DOI： 10.1136/gutjnl-2013-304531

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Language：English  

DOI： 10.1038/bjc.2012.583

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Language：English   Publishing type：Research paper (scientific journal)  

Publisher：MDPI AG  

<jats:p>To facilitate the assessment of adverse effects of very low concentrations of air pollutants on general populations, we planned to establish a reliable biomarker that is also useful in identifying vulnerable populations. For this purpose we monitored several inflammation markers in blood samples from 2 year old Japanese children (N = 30), and found that those children living close to major highways (<50 m) show higher levels of mRNA expression IL-22 in their blood samples than those living further away (+50 m). This tendency was more pronounced among subjects showing positive IgE against egg and milk. We further examined association between IL-22 mRNA expression and PCB residues and found a number of significant positive correlations between each individual PCB congener and IL-22 expression. To identify the most vulnerable population among those children we selected asthma as a typical allergy-related disease, and could show that there are significant differences in the levels of IL-22 mRNA expression between IgE negative non-asthmatic subject and asthmatic children showing positive IgE reaction toward egg or milk, again. These observations support our main conclusion that IL-22 expression is a sensitive biomarker which is useful in identifying sub-populations of children who are especially vulnerable to air pollution.</jats:p>

DOI： 10.3390/ijerph9124321

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CiNii Research

Language：English   Publishing type：Research paper (scientific journal)  

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DOI： 10.1097/RLU.0b013e318248524a

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DOI： 10.1016/j.bbrc.2012.02.047

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DOI： 10.1016/j.surg.2011.07.031

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DOI： 10.1111/j.1442-200X.2011.03512.x

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DOI： 10.1016/j.jtcvs.2009.11.003

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DOI： 10.1016/j.jjcc.2009.11.007

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Language：English   Publishing type：Research paper (scientific journal)  

Publisher：American Chemical Society (ACS)  

In the present study, we analyze and characterize the levels of PCBs and OH-PCBs in serum and breast adipose tissue, and measure TH (total 3,5,5'-triiodothyronine (tT3) and total l-thyroxine (tT4)) levels in serum of Japanese women diagnosed with breast cancer (n = 51) to know how PCBs affect thyroid hormone homeostasis. Concentrations of Sigma(90)OH-PCBs in serum and adipose tissues were 630 pg g(-1) serum wet wt. and 140 pg/ g(-1) lipid wt., respectively, and the levels of OH-PCBs in adipose tissues were 4-5 times lower than in serum. The tT3 and tT4 concentrations in serum (n = 20) were 1.3 ng g(-1) serum wet wt. and 62 ng g(-1) serum wet wt., respectively. Among all the OH-PCBs, 4'-OH-CB101/120, 4-OH-CB107/4'-OH-CB108, 3'-OH-CB138, 4-OH-CB146, 3-OH-CB153, 4'-OH-CB172, and 4-OH-CB187 were the dominant isomers in serum. No significant correlation between the concentrations of the TH and OH-PCBs in serum was observed (p0.05). The results indicated that the relationship between the OH-PCB levels and the thyroid hormone markers was rare. From analysis of two kinds of human biological samples, it was estimated that OH-PCBs have little effect on thyroid hormone homeostasis.

DOI： 10.1021/es9012432

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DOI： 10.1136/bjo.2007.130575

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DOI： 10.1016/j.ultrasmedbio.2007.09.017

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Language：Japanese  

CiNii Research

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DOI： 10.1111/j.1349-7006.2007.00674.x

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Language：Japanese   Publisher：Japan Society for Medical Education  

1) In problem-based learning (PBL) tutorials during the2nd year, general symptoms (fatigue, weight change, bleeding, fever, pain, and edema) were chosen as subjects.Changes in the students'way of thinking about how to learn were evaluated before and after PBL tutorials.<BR>2) After tutorials students were significantly more likely to believe that their participation in tutorials was a more effective way of learning. The students'views after tutorials on listening to lectures differed between2006and2007.<BR>3) We conclude that PBL tutorials affect medical students'views about learning.

DOI： 10.11307/mededjapan1970.39.267

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DOI： 10.3748/wjg.v12.i36.5772

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Language：English   Publisher：Ovid Technologies (Wolters Kluwer Health)  

<jats:p>
<jats:bold>
<jats:italic>Background—</jats:italic>
</jats:bold>
We hypothesized that surgical annuloplasty for ischemic mitral regurgitation (MR) that displaces the posterior annulus anteriorly can potentially augment posterior leaflet (PML) tethering, leading to persistent MR. Relationships between leaflet configurations and persistent ischemic MR after the annuloplasty were investigated.
</jats:p>
<jats:p>
<jats:bold>
<jats:italic>Methods and Results—</jats:italic>
</jats:bold>
In 31 patients with surgical annuloplasty for ischemic MR and 20 controls, posterior and apical displacement of the leaflet coaptation, the anterior leaflet (AML) and PML tethering angles relative to the line connecting annuli, coaptation length (CL), and the MR grade were quantified before and early after surgery in echocardiographic left ventricular long-axis views. Six of the 31 patients showed persistent MR despite annuloplasty. Compared with patients without persistent MR, those with MR showed no improvement in the left ventricular ejection fraction and systolic volume, similar reduction in the annular area, significant increase in posterior displacement of the coaptation (
<jats:italic>P</jats:italic>
<0.01), no improvement in AML tethering, greater worsening in PML tethering (
<jats:italic>P</jats:italic>
<0.01), and no increase in the CL. All tethering variables were significantly correlated with both preoperative and postoperative MR in univariate analysis, and reduced CL was the primary independent determinant of both preoperative and postoperative MR. Although increased AML tethering was the primary determinant of the preoperative CL (r
<jats:sup>2</jats:sup>
=0.46,
<jats:italic>P</jats:italic>
<0.0001), increased PML tethering was the primary determinant afterward (r
<jats:sup>2</jats:sup>
=0.60,
<jats:italic>P</jats:italic>
<0.0001).
</jats:p>
<jats:p>
<jats:bold>
<jats:italic>Conclusion—</jats:italic>
</jats:bold>
Although tethering of both leaflets is the major determinant of ischemic MR before surgical annuloplasty, both leaflets tethering but with predominant and augmented PML tethering is related to persistent ischemic MR after the annnuloplasty.
</jats:p>

DOI： 10.1161/CIRCULATIONAHA.104.524561

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DOI： 10.1067/j.echo.2003.08.015

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DOI： 10.1016/s0304-3835(03)00410-5

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DOI： 10.1097/01.BRS.0000083206.24176.C8

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DOI： 10.1067/mtc.2003.78

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Language：English   Publishing type：Research paper (scientific journal)  

Language：Japanese  

CiNii Research

Language：English   Publisher：The Japanese Circulation Society  

Differentiation of normal from pseudonormal/restrictive mitral flow is not necessarily easy. Pseudonormal/restrictive flow is usually associated with left ventricular (LV) dysfunction, which can be detected using the TEI index, combining systolic and diastolic function. The purpose of this study was to test the feasibility of using the TEI index to differentiate pseudonormal/restrictive from normal mitral flow. In 33 patients with mitral flow E/A ≥1 and LV mid-diastolic pressure measured by catheterization, the LV volumes, mitral E and A velocity, deceleration time of the E velocity, and the TEI index, defined as the sum of the isovolumic contraction and relaxation time divided by ejection time, were evaluated using Doppler echocardiography. Pseudonormal/restrictive mitral flow was defined as mitral flow E/A ≥1 associated with LV mid-diastolic pressure >12 mmHg. There were 22 and 11 patients with normal and pseudonormal/restrictive mitral flow, respectively. Among the indices of LV function, the TEI index achieved the best correlation with LV mid-diastolic pressures (r2 = 0.63, p<0.0001). By setting the TEI index ≥0.65 as the criteria for pseudonormal/restrictive mitral flow, this diagnosis had sensitivity, specificity, and accuracy of 82%, 96%, and 91%, respectively. TEI index allows noninvasive differentiation of pseudonormal/restrictive from normal mitral flow. (<i>Circ J</i> 2002; <b>66:</b> 831 - 836)<br>

DOI： 10.1253/circj.66.831

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DOI： 10.1016/s0735-1097(02)01838-7

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DOI： 10.3171/spi.2002.96.2.0168

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DOI： 10.1159/000048612

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DOI： 10.1111/j.1349-7006.2001.tb01180.x

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Language：English   Publishing type：Research paper (scientific journal)  

Language：English   Publisher：The Japanese Circulation Society  

When heart rate (HR) increases, mitral flow can become monophasic. Prolonged isovolumic contraction and relaxation time (ICT and IRT), directly related to left ventricular (LV) function, can potentially influence the HR with monophasic mitral flow. The present study investigated the relation between HR that causes monophasic flow and LV function. During diagnostic catheterization, HR was increased using right atrial pacing by 2 beats/min every 2 min in a stepwise manner until the development of monophasic mitral flow in 17 patients with normal sinus rhythm. ICT, IRT, end-diastolic and end-systolic LV volumes, LV ejection fraction, LV peak + and -dP/dt, peak (+dP/dt)/P, and the relaxation time constant (tau) were measured by Doppler echocardiography or catheterization when monophasic mitral flow developed. The monophasic HR varied from 74 to 106 beats/min. By univariate analysis, ICT (p<0.01, r²=0.73), LV peak +dP/dt (p<0.05, r²=0.37), peak (+dP/dt)/P (p<0.01, r²=0.71), peak -dP/dt (p<0.05, r²=0.25), and tau (p<0.05, r²=0.33) had a significant correlation with monophasic HR. By multivariate analysis, prolonged ICT and reduced LV peak -dP/dt independently contributed to monophasic mitral flow with less increase in HR. Monophasic mitral flow with less increase in HR indicates impaired LV systolic and diastolic function during isovolumic contraction and relaxation. (<i>Jpn Circ J</i> 2001; <b>65:</b> 545 - 549)

DOI： 10.1253/jcj.65.545

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DOI： 10.1002/(sici)1096-9071(200004)60:4<411::aid-jmv8>3.0.co;2-8

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