start-ver=1.4 cd-journal=joma no-vol=79 cd-vols= no-issue=2 article-no= start-page=93 end-page=100 dt-received= dt-revised= dt-accepted= dt-pub-year=2025 dt-pub=202504 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Lower Work Engagement Is Associated with Insomnia, Psychological Distress, and Neck Pain among Junior and Senior High School Teachers in Japan en-subtitle= kn-subtitle= en-abstract= kn-abstract=School teachers are subject to both physical and mental health problems. We examined cross-sectional relationships between work engagement and major health outcomes among junior and senior high school teachers in Japan via a nationwide survey in 2019-2020. A total of 3,160 respondents were included in the analyses (19.9% response rate). Work engagement was assessed with the Utrecht Work Engagement Scale-9 (UWES-9), and we thus divided the teachers into quartiles according to their UWES-9 scores. Based on validated questionnaires, we assessed insomnia, psychological distress, and neck pain as health outcomes. A binomial logistic regression adjusted for age, gender, school type, teacher’s roles, involvement in club activities, division of duties, employment status, and whether they lived with family demonstrated that the teachers with lower UWES-9 scores had higher burdens of insomnia, psychological distress, and neck pain (odds ratios [95% confidence intervals] in 4th vs. 1st quartile, 2.92 (2.34-3.65), 3.70 (2.81-4.88), and 2.12 (1.68-2.68), respectively; all trend p<0.001). There were no significant differences in these associations between full-time and part-time teachers. Our findings indicate that low work engagement may contribute to physical and mental health issues among junior and senior high school teachers, thus providing insights for preventing health problems in this profession. en-copyright= kn-copyright= en-aut-name=TsuchieRina en-aut-sei=Tsuchie en-aut-mei=Rina kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=FukudaMari en-aut-sei=Fukuda en-aut-mei=Mari kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=TsumuraHideki en-aut-sei=Tsumura en-aut-mei=Hideki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KinutaMinako en-aut-sei=Kinuta en-aut-mei=Minako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=HisamatsuTakashi en-aut-sei=Hisamatsu en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=KandaHideyuki en-aut-sei=Kanda en-aut-mei=Hideyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= affil-num=1 en-affil=Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Psychology, Graduate School of Technology, Industrial and Social Sciences, Tokushima University kn-affil= affil-num=4 en-affil=Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=work engagement kn-keyword=work engagement en-keyword=school teachers kn-keyword=school teachers en-keyword=insomnia kn-keyword=insomnia en-keyword=psychological distress kn-keyword=psychological distress en-keyword=neck pain kn-keyword=neck pain END start-ver=1.4 cd-journal=joma no-vol=14 cd-vols= no-issue=7 article-no= start-page=2242 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2025 dt-pub=20250325 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Impact of Lifestyle Changes on Body Weight Gain During Nationwide Lockdown Due to COVID-19 Pandemic en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background: During the coronavirus disease 2019 (COVID-19) pandemic, people in Japan were urged to stay at home as much as possible, and this resulted in significant changes in lifestyle behavior. The new lifestyle included factors affecting both energy intake and energy consumption, and it is now thought that weight gain during the lockdown was the result of complex effects. The aim of this study was to determine the relationships among lifestyle habits, laboratory data, and body weight gain during the lockdown using medical check-up data. Methods: A total of 3789 individuals who had undergone consecutive medical check-ups during the period from 2018 to 2020 were included in this study. Participants whose body weight had increased by 5% or more were divided into two groups: a before-lockdown group (participants who had gained weight between 2018 and 2019) and an after-lockdown group (participants who had gained weight between 2019 and 2020). Physical measurements, laboratory data, and answers to six questions about lifestyle habits, for which information was obtained from the records from medical check-ups, were compared in the two groups. Results: There was no significant difference between the distribution of weight changes in 2018-2019 before the lockdown and the distribution of weight changes in 2019-2020 after the lockdown. The before-lockdown and after-lockdown groups both included about 7% of the total participants (279 and 273 participants, respectively). Diastolic blood pressure and levels of AST, ALT, and LDL-C were significantly higher in the after-lockdown group than in the before-lockdown group. The percentages of participants with alcohol consumption and exercise habits were significantly higher in the after-lockdown group than in the before-lockdown group, and an analysis by gender showed that the differences were significant for women but not for men. Conclusions: The distributions of weight changes before and during the COVID-19 pandemic were similar. Exercise habits and alcohol consumption might have been unique factors causing weight gain during the COVID-19 pandemic, particularly in women. Our findings suggest that the impact of behavioral restrictions and lifestyle changes during a pandemic may be different in men and women. en-copyright= kn-copyright= en-aut-name=NishidaChisa en-aut-sei=Nishida en-aut-mei=Chisa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=HondaHiroyuki en-aut-sei=Honda en-aut-mei=Hiroyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=OtsukaYuki en-aut-sei=Otsuka en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=HagiyaHideharu en-aut-sei=Hagiya en-aut-mei=Hideharu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=NakanoYasuhiro en-aut-sei=Nakano en-aut-mei=Yasuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=OguniKohei en-aut-sei=Oguni en-aut-mei=Kohei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=TokumasuKazuki en-aut-sei=Tokumasu en-aut-mei=Kazuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=SakuradaYasue en-aut-sei=Sakurada en-aut-mei=Yasue kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=ObikaMikako en-aut-sei=Obika en-aut-mei=Mikako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=OtsukaFumio en-aut-sei=Otsuka en-aut-mei=Fumio kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= affil-num=1 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=COVID-19 pandemic kn-keyword=COVID-19 pandemic en-keyword=lockdown kn-keyword=lockdown en-keyword=weight gain kn-keyword=weight gain en-keyword=medical check-ups kn-keyword=medical check-ups en-keyword=lifestyle kn-keyword=lifestyle END start-ver=1.4 cd-journal=joma no-vol=15 cd-vols= no-issue=1 article-no= start-page=2486 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2025 dt-pub=20250120 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Nomogram models for predicting outcomes in thyroid cancer patients with distant metastasis receiving 131iodine therapy en-subtitle= kn-subtitle= en-abstract= kn-abstract=This study aimed to establish and validate prognostic nomogram models for patients who underwent I-131 therapy for thyroid cancer with distant metastases. The cohort was divided into training (70%) and validation (30%) sets for nomogram development. Univariate and multivariate Cox regression analyses were used to identify independent predictors for overall survival (OS) and progression-free survival (PFS). Nomograms were developed based on these predictors, and Kaplan-Meier curves were constructed for validation. Among 451 patients who were screened, 412 met the inclusion criteria and were followed-up for a median duration of 65.2 months. The training and validation sets included 288 and 124 patients, respectively. Pathological type, first I-131 administrated activity, and lesion I-131 uptake in lesions were independent predictors for PFS. For OS, predictors included gender, age, metastasis site, first I-131 administrated activity, I-131 uptake, pulmonary lesion size, and stimulated thyroglobulin levels. These predictors were used to construct nomograms for predicting PFS and OS. Low-risk patients had significantly longer PFS and OS compared to high-risk patients, with 10-year PFS rates of 81.1% vs. 51.9% and 10-year OS rates of 86.2% vs. 37.4%. These may aid individualized prognostic assessment and clinical decision-making, especially in determining the prescribed activity for the first I-131 treatment. en-copyright= kn-copyright= en-aut-name=JinShui en-aut-sei=Jin en-aut-mei=Shui kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=YeXuemei en-aut-sei=Ye en-aut-mei=Xuemei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=YeTing en-aut-sei=Ye en-aut-mei=Ting kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=ChenXinyu en-aut-sei=Chen en-aut-mei=Xinyu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=JiJianfeng en-aut-sei=Ji en-aut-mei=Jianfeng kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=WangJinyu en-aut-sei=Wang en-aut-mei=Jinyu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=ZhuXin en-aut-sei=Zhu en-aut-mei=Xin kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=MaoXiaochun en-aut-sei=Mao en-aut-mei=Xiaochun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=HiguchiTakahiro en-aut-sei=Higuchi en-aut-mei=Takahiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=YiHeqing en-aut-sei=Yi en-aut-mei=Heqing kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= affil-num=1 en-affil=Department of Nuclear Medicine, Zhejiang Cancer Hospital kn-affil= affil-num=2 en-affil=Department of Nuclear Medicine, Zhejiang Cancer Hospital kn-affil= affil-num=3 en-affil=Department of Nuclear Medicine, Zhejiang Cancer Hospital kn-affil= affil-num=4 en-affil=Nuclear Medicine, Faculty of Medicine, University of Augsburg kn-affil= affil-num=5 en-affil=Department of Nuclear Medicine, Zhejiang Cancer Hospital kn-affil= affil-num=6 en-affil=Medical records and statistics office, Zhejiang Cancer Hospital kn-affil= affil-num=7 en-affil=Key Laboratory of Head and Neck Cancer Translational Research of Zhejiang Province, Zhejiang Cancer Hospital kn-affil= affil-num=8 en-affil=Department of Thyroid Surgery, Zhejiang Cancer Hospital kn-affil= affil-num=9 en-affil=Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=10 en-affil=Department of Nuclear Medicine, Zhejiang Cancer Hospital kn-affil= en-keyword=131iodine kn-keyword=131iodine en-keyword=Activity kn-keyword=Activity en-keyword=Distant metastasis kn-keyword=Distant metastasis en-keyword=Iodine radioisotopes kn-keyword=Iodine radioisotopes en-keyword=Thyroid cancer kn-keyword=Thyroid cancer END start-ver=1.4 cd-journal=joma no-vol=58 cd-vols= no-issue= article-no= start-page=71 end-page=89 dt-received= dt-revised= dt-accepted= dt-pub-year=2024 dt-pub=20241227 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Exploring the Link Between Modern Household Amenities and Health in Vietnam en-subtitle= kn-subtitle= en-abstract= kn-abstract=　The correlation between the impact of the external and internal environment of a household on its occupants’ health has been well documented by various research studies. Yet a limitation of the literature is the prevalence of modern household basic amenities and occupant health, especially in Vietnam. This paper examines the impact of modern household basic amenities on occupant health by applying the Vietnam Household Standard Survey 2018. By applying the Tobit method, it is revealed that household amenities displayed a significant association with health outcomes. For instance, individuals residing in concrete houses or employing waste collection systems exhibited decreased illness likelihood. Handwashing with soap correlated with a diminished illness probability. Tobit analysis highlights internet accessibility as significant in reducing days of work incapacity (approximately 6 days less). Gender, residential location, and total income also impact workdays. Age and education exhibit inverse relationships with workdays missed. In essence, these findings contribute to the broader discourse on public health and underscore the importance of considering diverse factors, ranging from basic amenities to socio-economic indicators, in formulating comprehensive health policies and interventions. en-copyright= kn-copyright= en-aut-name=Do Thi Hoai Giang en-aut-sei=Do Thi Hoai Giang en-aut-mei= kn-aut-name=ド ティ ホアイ ジャン kn-aut-sei=ド ティ ホアイ ジャン kn-aut-mei= aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学大学院社会文化科学研究科 en-keyword=Modern household amenity kn-keyword=Modern household amenity en-keyword=occupant health kn-keyword=occupant health en-keyword=Vietnam kn-keyword=Vietnam en-keyword=Tobit regression kn-keyword=Tobit regression en-keyword=Logit model kn-keyword=Logit model END start-ver=1.4 cd-journal=joma no-vol=2 cd-vols= no-issue=3 article-no= start-page=98 end-page=101 dt-received= dt-revised= dt-accepted= dt-pub-year=2023 dt-pub=20230727 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=A Case of a Transwoman with Colorectal Cancer after Flap Vaginoplasty en-subtitle= kn-subtitle= en-abstract= kn-abstract=Vaginoplasty is a gender-affirming surgery (GAS) for transwomen that laid its foundation in the 1950s and continues to be widely practiced worldwide. We present here a case of a 70-year-old transwoman who underwent lower anterior resection for rectal cancer 12 years after vaginoplasty. The preoperative diagnosis was rectal cancer (Rb-Ra, type 2, cT2N0M0, stage 1). All imaging studies showed a cord-like structure between the prostate and the anterior wall of the rectum, which was thought to be the neovagina. Careful dissection of the anterior rectal wall was required because the distance between the neovagina and the rectum was only 1.5 mm. The role of hormonal therapy and GAS in cancer development in transwomen is unclear. It is important to have regular check-ups for malignancies in patients who have undergone GAS, and if surgical procedures are needed, they should be treated by physicians who are familiar with the procedure. en-copyright= kn-copyright= en-aut-name=WatanabeShiho en-aut-sei=Watanabe en-aut-mei=Shiho kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=TeraishiFuminori en-aut-sei=Teraishi en-aut-mei=Fuminori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=FujimotoSari en-aut-sei=Fujimoto en-aut-mei=Sari kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=WatanabeToshiyuki en-aut-sei=Watanabe en-aut-mei=Toshiyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=TakedaSho en-aut-sei=Takeda en-aut-mei=Sho kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=NaritaShuhei en-aut-sei=Narita en-aut-mei=Shuhei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=YamashitaKoya en-aut-sei=Yamashita en-aut-mei=Koya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=ShigeyasuKunitoshi en-aut-sei=Shigeyasu en-aut-mei=Kunitoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=KagawaShunsuke en-aut-sei=Kagawa en-aut-mei=Shunsuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=NambaYuzaburo en-aut-sei=Namba en-aut-mei=Yuzaburo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=KimataYoshihiro en-aut-sei=Kimata en-aut-mei=Yoshihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= affil-num=1 en-affil=Department of Plastic and Reconstructive Surgery, Okayama University Hospital kn-affil= affil-num=2 en-affil=Department of Minimally Invasive Therapy Center, Okayama University Hospital kn-affil= affil-num=3 en-affil=Department of Plastic and Reconstructive Surgery, Okayama University Hospital kn-affil= affil-num=4 en-affil=Department of Plastic and Reconstructive Surgery, Okayama University Hospital kn-affil= affil-num=5 en-affil=Department of Gastroenterological Surgery, Okayama University Hospital kn-affil= affil-num=6 en-affil=Department of Gastroenterological Surgery, Okayama University Hospital kn-affil= affil-num=7 en-affil=Department of Gastroenterological Surgery, Okayama University Hospital kn-affil= affil-num=8 en-affil=Department of Gastroenterological Surgery, Okayama University Hospital kn-affil= affil-num=9 en-affil=Department of Gastroenterological Surgery, Okayama University Hospital kn-affil= affil-num=10 en-affil=Department of Gender Center, Okayama University Hospital kn-affil= affil-num=11 en-affil=Department of Plastic and Reconstructive Surgery, Okayama University Hospital kn-affil= en-keyword=vaginoplasty kn-keyword=vaginoplasty en-keyword=gender-affirming surgery kn-keyword=gender-affirming surgery en-keyword=transwomen kn-keyword=transwomen en-keyword=rectal cancer kn-keyword=rectal cancer END start-ver=1.4 cd-journal=joma no-vol=31 cd-vols= no-issue=2 article-no= start-page=102554 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2024 dt-pub=20241105 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Human Papillomavirus vaccination awareness and uptake among healthcare students in Japan en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background: The vaccination rate for HPV (Human Papillomavirus) has remained significantly low in Japan because of the administrative suspension of active recommendation. This study investigates the awareness and uptake of the HPV vaccine among healthcare students in Japan following the reinstatement of active recommendation for young women in April 2022.
Methods: A web-based survey was administered to 2567 healthcare students from Okayama and Shujitsu Universities in Japan in July 2023. The survey assessed participants' backgrounds, immunization status, awareness of vaccine recommendations, and knowledge of cervical cancer across various demographics, including sex, academic year, and department (Medicine, Health Science, Pharmaceutical, and Dentistry).
Results: The response rate was 36.3 % (933 students; 181 male, 739 female, and 13 unspecified gender). The overall immunization rate among female students was 55.6 %, with higher rates observed in medical (73.8 %) and dental (63.0 %) students. Awareness of the government's change in vaccine recommendation was notably high among female and senior male students. Over half of the female students (54.7 %) reported receiving vaccinations based on their parents' advice. Among those unvaccinated but interested in future immunization, concerns about adverse reactions (47.4 %) and challenges in scheduling vaccinations (29.1 %) were predominant.
Conclusion: Healthcare students exhibited a higher HPV vaccination rate than the general population. Ongoing education to improve vaccine literacy is crucial for augmenting HPV vaccination rates in Japan. en-copyright= kn-copyright= en-aut-name=ShimbeMadoka en-aut-sei=Shimbe en-aut-mei=Madoka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=OtsukaYuki en-aut-sei=Otsuka en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=HagiyaHideharu en-aut-sei=Hagiya en-aut-mei=Hideharu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=YamadaYoichi en-aut-sei=Yamada en-aut-mei=Yoichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=OtsukaFumio en-aut-sei=Otsuka en-aut-mei=Fumio kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= affil-num=1 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Infectious Diseases, Okayama University Hospital kn-affil= affil-num=4 en-affil=School of Pharmacy, Shujitsu University kn-affil= affil-num=5 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=Cervical cancer kn-keyword=Cervical cancer en-keyword=Human Papillomavirus kn-keyword=Human Papillomavirus en-keyword=Immunization kn-keyword=Immunization en-keyword=Vaccine literacy kn-keyword=Vaccine literacy END start-ver=1.4 cd-journal=joma no-vol=78 cd-vols= no-issue=2 article-no= start-page=115 end-page=122 dt-received= dt-revised= dt-accepted= dt-pub-year=2024 dt-pub=202404 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Impacts of Age and Gender on Brain Edema in a Mouse Water Intoxication Model en-subtitle= kn-subtitle= en-abstract= kn-abstract=Brain edema causes abnormal fluid retention and can be fatal in severe cases. Although it develops in various diseases, most treatments for brain edema are classical. We analyzed the impacts of age and gender on the characteristics of a water intoxication model that induces pure brain edema in mice and examined the model’s usefulness for research regarding new treatments for brain edema. C57BL/6J mice received an intraperitoneal administration of 10% body weight distilled water, and we calculated the brain water content by measuring the brain-tissue weight immediately after dissection and after drying. We analyzed 8-OHdG and caspase-3 values to investigate the brain damage. We also applied this model in aquaporin 4 knockout (AQP4−) mice and compared these mice with wild-type mice. The changes in water content differed by age and gender, and the 8-OHdG and caspase-3 values differed by age. Suppression of brain edema by AQP4− was also confirmed. These results clarified the differences in the onset of brain edema by age and gender, highlighting the importance of considering the age and gender of model animals. Similar studies using genetically modified mice are also possible. Our findings indicate that this water intoxication model is effective for explorations of new brain edema treatments. en-copyright= kn-copyright= en-aut-name=Nakamura-MaruyamaEmi en-aut-sei=Nakamura-Maruyama en-aut-mei=Emi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=IrieKeiichiro en-aut-sei=Irie en-aut-mei=Keiichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=NaritaKazuhiko en-aut-sei=Narita en-aut-mei=Kazuhiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=HimiNaoyuki en-aut-sei=Himi en-aut-mei=Naoyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=MiyamotoOsamu en-aut-sei=Miyamoto en-aut-mei=Osamu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=NakamuraTakehiro en-aut-sei=Nakamura en-aut-mei=Takehiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= affil-num=1 en-affil=Department of Physiology2, Kawasaki Medical School kn-affil= affil-num=2 en-affil=Department of Neurological Surgery, Kagawa University Faculty of Medicine kn-affil= affil-num=3 en-affil=Department of Physiology2, Kawasaki Medical School kn-affil= affil-num=4 en-affil=Department of Physiology2, Kawasaki Medical School kn-affil= affil-num=5 en-affil=Department of Physiology2, Kawasaki Medical School kn-affil= affil-num=6 en-affil=Department of Physiology2, Kawasaki Medical School kn-affil= en-keyword=brain edema kn-keyword=brain edema en-keyword=water intoxication model kn-keyword=water intoxication model en-keyword=age kn-keyword=age en-keyword=gender kn-keyword=gender en-keyword=AQP4 kn-keyword=AQP4 END start-ver=1.4 cd-journal=joma no-vol=19 cd-vols= no-issue=2 article-no= start-page=e0297347 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2024 dt-pub=20240208 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Japan-epiretinal membrane (J-ERM) registry: A prospective cohort study protocol investigating the surgical outcome of epiretinal membrane en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background
Epiretinal membrane (ERM) causes visual impairment such as reduction in visual acuity and metamorphopsia due to retinal traction. With the improvement of optical coherence tomography (OCT) and microincision vitrectomy surgery (MIVS), the surgery of ERM has significantly advanced. However, there have been no large-scale studies on the following: (1) how to evaluate visual impairment in ERM, (2) the relationship between OCT findings and visual function, (3) when is the optimal timing of surgery, and (4) the relationship between the surgical instruments as well as techniques and prognosis. The purpose of this study was to obtain evidence regarding these ERM surgeries.
Methods and design
This is a prospective, multicenter cohort study of ERM surgery in Japan from March 1, 2023, to March 31, 2027 (UMIN000048472, R-3468-2). Patients who underwent ERM surgery during the study period and agreed to participate in this study will be included. The goal is to have a total of 5,000 eyes surgically treated for ERM. The following data will be collected: age, gender, medical history, subjective symptoms, visual function before and 6 and 12 months after surgery, clinical findings, OCT data, surgical technique, instruments used in surgery, and complications.
Discussion
The results of this study will support the surgical decisions and procedures in ERM practices. en-copyright= kn-copyright= en-aut-name=KanzakiYuki en-aut-sei=Kanzaki en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=MatobaRyo en-aut-sei=Matoba en-aut-mei=Ryo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=IshiharaKenji en-aut-sei=Ishihara en-aut-mei=Kenji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=MoritaTetsuro en-aut-sei=Morita en-aut-mei=Tetsuro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=MuraokaYuki en-aut-sei=Muraoka en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=KimuraShuhei en-aut-sei=Kimura en-aut-mei=Shuhei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=KotoTakashi en-aut-sei=Koto en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=KawasakiRyo en-aut-sei=Kawasaki en-aut-mei=Ryo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=BabaTakayuki en-aut-sei=Baba en-aut-mei=Takayuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=OkamotoFumiki en-aut-sei=Okamoto en-aut-mei=Fumiki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=InoueMakoto en-aut-sei=Inoue en-aut-mei=Makoto kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=SakamotoTaiji en-aut-sei=Sakamoto en-aut-mei=Taiji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=TsujikawaAkitaka en-aut-sei=Tsujikawa en-aut-mei=Akitaka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=MorizaneYuki en-aut-sei=Morizane en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= affil-num=1 en-affil=Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine kn-affil= affil-num=4 en-affil=Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine kn-affil= affil-num=6 en-affil=Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Kyorin Eye Center, Department of Ophthalmology, Kyorin University School of Medicine kn-affil= affil-num=8 en-affil=Division of Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine kn-affil= affil-num=9 en-affil=Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine kn-affil= affil-num=10 en-affil=Department of Ophthalmology, Graduate School of Medicine, Nippon Medical School kn-affil= affil-num=11 en-affil=Kyorin Eye Center, Department of Ophthalmology, Kyorin University School of Medicine kn-affil= affil-num=12 en-affil=Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences kn-affil= affil-num=13 en-affil=Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine kn-affil= affil-num=14 en-affil=Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= END start-ver=1.4 cd-journal=joma no-vol=14 cd-vols= no-issue= article-no= start-page=1 end-page=15 dt-received= dt-revised= dt-accepted= dt-pub-year=2024 dt-pub=20240329 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=A Preliminary Study of School-Based Strengths Intervention with Japanese elementary school students: Through Classroom Activity to Promote Awareness of Strengths kn-title=児童を対象とした強み介入の予備的検討 ―強みへの気付きを促す学級活動の授業を通して― en-subtitle= kn-subtitle= en-abstract=This study aimed to assess the effectiveness of a preliminary strengths intervention lesson for children. The participants included 95 sixth-grade students, comprising 50 boys, 40 girls, and 5 of unknown gender. The findings revealed three key points. Firstly, life satisfaction and the sense of trust and acceptance significantly improved in post-event scores. Secondly, a noteworthy positive partial correlation was identified between the amount of change in attention to one's strengths and the amount of change in feelings of trust and acceptance. Additionally, a quantitative text analysis was conducted to explore the learning impressions of children whose focus on strengths improved versus those whose attention did not improve. Results indicated no significant bias in descriptions for each group. Overall, most of the children described subjective experiences of positive emotions. Lastly, the study discussed the lessons for intervention and research design as areas to address, providing insights into future perspectives. kn-abstract=　本研究の目的は，児童を対象とした強み介入の予備的検討のために実践した強みへの気付きを促す授業の効果について検討することである。対象者は小学６年生95名(男子50名，女子40名，不明５名)であった。本研究によって以下の３点が明らかになった。まず，生活充実感と被信頼感・受容感の事後の得点が有意に向上した。次に，自己の強みへの注目の変化量と被信頼感・受容感の変化量で有意な正の偏相関が確認された。さらに，強みへの注目が向上した児童と向上しなかった児童の学習の感想を計量テキスト分析で検証した。その結果，群ごとに有意な記述の偏りは確認されなかった。全体として，児童の多くはポジティブな感情に関する主観的経験について記述していた。最後に，課題として介入で実施する授業と研究デザインを取り上げ，今後の展望について議論した。 en-copyright= kn-copyright= en-aut-name=IZUMITsuguyuki en-aut-sei=IZUMI en-aut-mei=Tsuguyuki kn-aut-name=伊住継行 kn-aut-sei=伊住 kn-aut-mei=継行 aut-affil-num=1 ORCID= en-aut-name=TODAAkane en-aut-sei=TODA en-aut-mei=Akane kn-aut-name=戸田朱音 kn-aut-sei=戸田 kn-aut-mei=朱音 aut-affil-num=2 ORCID= en-aut-name=OKURAHisashi en-aut-sei=OKURA en-aut-mei=Hisashi kn-aut-name=大倉尚志 kn-aut-sei=大倉 kn-aut-mei=尚志 aut-affil-num=3 ORCID= affil-num=1 en-affil=Faculty of Education, Okayama University kn-affil=岡山大学学術研究院教育学域 affil-num=2 en-affil=Shintoku Elementary School kn-affil=新得町立新得小学校 affil-num=3 en-affil=Hayashima Kindergarten kn-affil=早島町立早島幼稚園 en-keyword=促進的援助 (facilitative assistance) kn-keyword=促進的援助 (facilitative assistance) en-keyword=強み介入 (strengths intervention) kn-keyword=強み介入 (strengths intervention) en-keyword=学級活動(２) (classroom activities (2)) kn-keyword=学級活動(２) (classroom activities (2)) en-keyword=児童 (children) kn-keyword=児童 (children) en-keyword=計量テキスト分析 (quantitative text analysis) kn-keyword=計量テキスト分析 (quantitative text analysis) END start-ver=1.4 cd-journal=joma no-vol=3 cd-vols= no-issue= article-no= start-page=1 end-page=20 dt-received= dt-revised= dt-accepted= dt-pub-year=2024 dt-pub=20240325 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=How is subjective well-being affected by different factors and groups: Income threshold induces asymmetric effects en-subtitle= kn-subtitle= en-abstract= kn-abstract=Holistic well-being has rapidly developed in the 21st century as a policy measurement tool. Nevertheless, there continue to be some gaps in the literature regarding the interrelation between subjective well-being and other factors, and, regarding disaggregation of the well-being status within a country, by age group, gender, and community. This study first illustrates how the concept of well-being developed from a philosophical and psychological conception of “happiness” to being measured by multidimensional tools that measure the impact of policy and the progress of society, such as OECD’s Better Life Index, UK’s National Well-being Measurement, and Japan’s Well-being Survey and Quality of Life. Subsequently, it analyzes the relationships between subjective well-being and objective variables by comparing the country, regional, and individual datasets. It found that some indicators, such as social relationships, have asymmetric effects on life satisfaction depending on the income level or threshold. In other words, if the income is less than a certain level, the effects of some indicators on life satisfaction are complementary to income, while if the income is above that level, the effects are substitutional. Finally, it estimates these effects and confirms them statistically by using the OECD Regional Statistics. Regarding the relationship between social connection and self-evaluation of life satisfaction rated on a 10-point Likert scale, the base score in the estimation is approximately 5.1 points higher in the lowest quartile group of income. However, the substitution is lower than that of the other groups by approximately -0.061. The coefficient of social connection for the other groups was approximately 0.059, and the lowest group had almost zero coefficients for substitution. en-copyright= kn-copyright= en-aut-name=TSURIMasao en-aut-sei=TSURI en-aut-mei=Masao kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=AOOKen en-aut-sei=AOO en-aut-mei=Ken kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= affil-num=1 en-affil=Faculty of Economics, MUSASHI UNIVERSITY kn-affil= affil-num=2 en-affil=Graduate School of Humanities and Social Sciences, OKAYAMA UNIVERSITY kn-affil= en-keyword=well-being kn-keyword=well-being en-keyword=household income kn-keyword=household income en-keyword=social connection kn-keyword=social connection en-keyword=OECD Regional Statistics kn-keyword=OECD Regional Statistics END start-ver=1.4 cd-journal=joma no-vol=18 cd-vols= no-issue=10 article-no= start-page=e0291677 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2023 dt-pub=20231020 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Shortage and unequal distribution of infectious disease specialists in Japan: How can we refine the current situation? en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background
This study aimed to assess the distribution of board-certified infectious disease (ID) specialists at medical schools and Designated Medical Institutions (DMIs) in Japan.
Methods
Data on the number of board-certified ID specialists was extracted by gender, prefecture, and hospital from the Japanese Association for Infectious Diseases database. The numbers and types of Japanese university hospitals that have a Faculty of Medicine, as well as the DMIs legally determined by the Infectious Diseases Control Law, were collected from the database of the Ministry of Health, Labour, and Welfare of Japan.
Results
As of November 2022, there were 1,688 board-certified ID specialists in Japan, with 510 employed at 82 university hospitals. Two medical schools had no ID specialists, and six had only one ID specialist. There was no ID specialists in 14.3% of Class I DMIs and 66.7% of Class II DMIs. Additionally, 14.9% of prefectures had no ID specialists at all in their Class II DMIs. The percentage of female doctors among ID specialists was 12.7%, approximately half of the overall male-to-female ratio of medical doctors in Japan.
Conclusion
The allocation of Japanese ID specialists to medical schools and legally designated healthcare institutes is inadequate and skewed. Female physicians are expected to play a more active role in this increasing demand. en-copyright= kn-copyright= en-aut-name=HagiyaHideharu en-aut-sei=Hagiya en-aut-mei=Hideharu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= affil-num=1 en-affil=Department of Infectious Diseases, Okayama University Hospital kn-affil= END start-ver=1.4 cd-journal=joma no-vol=77 cd-vols= no-issue=6 article-no= start-page=607 end-page=612 dt-received= dt-revised= dt-accepted= dt-pub-year=2023 dt-pub=202312 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Fine Particulate Matter and Diabetes Prevalence in Okayama, Japan en-subtitle= kn-subtitle= en-abstract= kn-abstract=Many studies have shown an association between long-term exposure to particulate matter having an aerodynamic diameter of 2.5 μm or less (PM2.5) and diabetes mellitus (DM), but few studies have focused on Asian subjects. We thus examined the association between long-term exposure to PM2.5 and DM prevalence in Okayama City, Japan. We included 76,591 participants who had received basic health checkups in 2006 and 2007. We assigned the census-level modeled PM2.5 data from 2006 and 2007 to each participant and defined DM using treatment status and the blood testing. PM2.5 was associated with DM prevalence, and the prevalence ratio (95% confidence interval) was 1.10 (1.00-1.20) following each interquartile range increase (2.1 μg/m3) in PM2.5. This finding is consistent with previous results and suggests that long-term exposure to PM2.5 is associated with an increased prevalence of DM in Okayama City, Japan, where the PM2.5 level is lower than in other cities in Asian countries. en-copyright= kn-copyright= en-aut-name=TaniYasunari en-aut-sei=Tani en-aut-mei=Yasunari kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=KashimaSaori en-aut-sei=Kashima en-aut-mei=Saori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=MitsuhashiToshiharu en-aut-sei=Mitsuhashi en-aut-mei=Toshiharu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=SuzukiEtsuji en-aut-sei=Suzuki en-aut-mei=Etsuji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=TakaoSoshi en-aut-sei=Takao en-aut-mei=Soshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=YorifujiTakashi en-aut-sei=Yorifuji en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= affil-num=1 en-affil=Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Environmental Health Sciences Laboratory, Graduate School of Advanced Science and Engineering, Center for the Planetary Health and Innovation Science, The IDEC Institute, Hiroshima University kn-affil= affil-num=3 en-affil=Center for Innovate Clinical Medicine, Okayama University Hospital kn-affil= affil-num=4 en-affil=Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=air pollution kn-keyword=air pollution en-keyword=diabetes mellitus kn-keyword=diabetes mellitus en-keyword=epidemiology kn-keyword=epidemiology en-keyword=glycosylated hemoglobin kn-keyword=glycosylated hemoglobin en-keyword=particulate matter kn-keyword=particulate matter END start-ver=1.4 cd-journal=joma no-vol=77 cd-vols= no-issue=4 article-no= start-page=415 end-page=422 dt-received= dt-revised= dt-accepted= dt-pub-year=2023 dt-pub=202308 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Immunohistochemical Expression of Placental Vitamin D Receptors in Pregnancies Complicated by Early and Late-Onset Preeclampsia en-subtitle= kn-subtitle= en-abstract= kn-abstract=The aim of our study was to determine whether the immunohistochemical expression of placental vitamin D receptors is altered in pregnancies complicated by preeclampsia. Vitamin D receptor expression was immunohistochemically analysed in the placentas of three groups: a control group, and early- and late-onset preeclampsia groups. Total immunohistochemical intensity staining of placentas showed that the control group had a median vitamin D receptor (VDR) expression significantly higher than the placentas of mothers with early- and late-onset preeclampsia. There was no difference among the three groups in a semiquantitative analysis of VDR staining of the stroma only. Vitamin D receptors showed lower median expression in preeclampsia-affected pregnancies, especially early-onset preeclampsia. Therefore, Vitamin D receptor expression may be an important marker for normal placentation and preeclampsia onset. en-copyright= kn-copyright= en-aut-name=JelcicDzenis en-aut-sei=Jelcic en-aut-mei=Dzenis kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=PuzovicVelibor en-aut-sei=Puzovic en-aut-mei=Velibor kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=BenzonBenjamin en-aut-sei=Benzon en-aut-mei=Benjamin kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=PaladaIvan en-aut-sei=Palada en-aut-mei=Ivan kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=JerkovićJelena en-aut-sei=Jerković en-aut-mei=Jelena kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=VulicMarko en-aut-sei=Vulic en-aut-mei=Marko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= affil-num=1 en-affil=Department of Gynecology and Obstetrics, University Hospital of Split kn-affil= affil-num=2 en-affil=General Hospital Dubrovnik, Department of Pathology and Cytology kn-affil= affil-num=3 en-affil=University of Split School of Medicine kn-affil= affil-num=4 en-affil=University Department of Health Studies of the University of Split kn-affil= affil-num=5 en-affil=Department of Gynecology and Obstetrics, University Hospital of Split kn-affil= affil-num=6 en-affil=Department of Gynecology and Obstetrics, University Hospital of Split kn-affil= en-keyword=vitamin D receptor kn-keyword=vitamin D receptor en-keyword=immunohistochemistry kn-keyword=immunohistochemistry en-keyword=early and late-onset preeclampsia kn-keyword=early and late-onset preeclampsia END start-ver=1.4 cd-journal=joma no-vol=77 cd-vols= no-issue=4 article-no= start-page=395 end-page=405 dt-received= dt-revised= dt-accepted= dt-pub-year=2023 dt-pub=202308 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Association of Tumor Necrosis Factor-Alpha with Psychopathology in Patients with Schizophrenia en-subtitle= kn-subtitle= en-abstract= kn-abstract=We investigated the relationship between serum tumor necrosis factor-alpha (TNF-α) levels and psychopathological symptoms, clinical and socio-demographic characteristics and antipsychotic therapy in individuals with schizophrenia. TNF-α levels were measured in 90 patients with schizophrenia and 90 healthy controls matched by age, gender, smoking status, and body mass index. The Positive and Negative Syndrome Scale (PANSS) was used to assess the severity of psychopathology in patients. No significant differences in TNF-α levels were detected between the patients and controls (p=0.736). TNF-α levels were not correlated with total, positive, negative, general, or composite PANSS scores (all p>0.05). A significant negative correlation was observed between TNF-α levels and the PANSS cognitive factor (ρ=−0.222, p=0.035). A hierarchical regression analysis identified the cognitive factor as a significant predictor of the TNF-α level (beta=−0.258, t=−2.257, p=0.027). There were no significant differences in TNF-α levels among patients treated with different types of antipsychotics (p=0.596). TNF-α levels correlated positively with the age of onset (ρ=0.233, p=0.027) and negatively with illness duration (ρ=−0.247, p=0.019) and antipsychotic treatment duration (ρ=−0.256, p=0.015). These results indicate that TNF-α may be involved in cognitive impairment in schizophrenia, and would be a potential clinical-state marker in schizophrenia. en-copyright= kn-copyright= en-aut-name=PavlovicMarko en-aut-sei=Pavlovic en-aut-mei=Marko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=BabicDragan en-aut-sei=Babic en-aut-mei=Dragan kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=RastovicPejana en-aut-sei=Rastovic en-aut-mei=Pejana kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=ArapovicJurica en-aut-sei=Arapovic en-aut-mei=Jurica kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=MartinacMarko en-aut-sei=Martinac en-aut-mei=Marko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=JakovacSanja en-aut-sei=Jakovac en-aut-mei=Sanja kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=BarbaricRomana en-aut-sei=Barbaric en-aut-mei=Romana kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= affil-num=1 en-affil=University Hospital Center Mostar, University of Mostar kn-affil= affil-num=2 en-affil=University Hospital Center Mostar, University of Mostar kn-affil= affil-num=3 en-affil=University Hospital Center Mostar, University of Mostar kn-affil= affil-num=4 en-affil=University Hospital Center Mostar, University of Mostar kn-affil= affil-num=5 en-affil=Health Care Center Mostar, University of Mostar kn-affil= affil-num=6 en-affil=University Hospital Center Mostar, University of Mostar kn-affil= affil-num=7 en-affil=University Hospital Center Mostar, University of Mostar kn-affil= en-keyword=tumor necrosis factor-alpha kn-keyword=tumor necrosis factor-alpha en-keyword=schizophrenia kn-keyword=schizophrenia en-keyword=psychopathology kn-keyword=psychopathology en-keyword=immune system kn-keyword=immune system END start-ver=1.4 cd-journal=joma no-vol=13 cd-vols= no-issue= article-no= start-page=245 end-page=259 dt-received= dt-revised= dt-accepted= dt-pub-year=2023 dt-pub=20230330 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Post-graduation career aspirations and career views among university students – A focus on active and passive views of work kn-title=大学生における卒業後の進路希望とキャリア観 ―積極的・消極的な労働観に着目して― en-subtitle= kn-subtitle= en-abstract=The purpose of this study was to approach the career views of university students from both the GOAL and MUST dimensions, and to examine the values behind their thinking about working, including negative motivations. First of all, regardless of the desired career path, significant main effects were found for each subscale of blame avoidance, family consideration and sense of security in both the GOAL and MUST dimensions. Aspiring teachers, undecided professionals and people on other career paths differed in terms of their emphasis on avoiding negative public perception, being able to provide for their families, and feeling secure in their families and themselves. Secondly, when gender was examined, women were more likely to focus on personal growth and economic improvement as the purposes of working, to be more conscious of their superiority over others, and to have a strong perception of having to work for the sake of their families. Taking these findings into account, effective career support f or students was discussed. kn-abstract=本研究では大学生のキャリア観について，GOAL 次元とMUST 次元の両側面からアプローチし，働くことをめぐる考え方の背景にある価値観を消極的な動機も含めて検討することを目的とした。まず第一に，希望する進路にかかわらず，GOAL 次元とMUST 次元のいずれにおいても，非難回避，家族配慮，安心感の各下位尺度において有意な主効果が認められた。世間から悪く思われないように，家族を養えるように，そして家族と自身が安心感を得られるように，ということを重視する点で，教員志望者，職業未決定者，そしてその他の進路希望者は異なっていた。第二に性別について検討したところ，女性の方が働く目的として自己成長や経済的向上に力点を置いた考え方をし，他者よりも優位な立場になることへの意識が高く，家族のために働かなければならないと強く認識していた。これらの知見を加味した上で，学生への効果的なキャリア支援のあり方が論じられた。 en-copyright= kn-copyright= en-aut-name=IidaMiyako en-aut-sei=Iida en-aut-mei=Miyako kn-aut-name=飯田都 kn-aut-sei=飯田 kn-aut-mei=都 aut-affil-num=1 ORCID= affil-num=1 en-affil=Faculty of Education, Okayama University kn-affil=岡山大学学術研究院教育学域 en-keyword=大学生 (university students) kn-keyword=大学生 (university students) en-keyword=職業観 (occupational outlook) kn-keyword=職業観 (occupational outlook) en-keyword=職業未決定 (undecided occupation) kn-keyword=職業未決定 (undecided occupation) en-keyword=教員志望 (aspiring teachers) kn-keyword=教員志望 (aspiring teachers) en-keyword=キャリア観 (career outlook) kn-keyword=キャリア観 (career outlook) END start-ver=1.4 cd-journal=joma no-vol=134 cd-vols= no-issue=1 article-no= start-page=22 end-page=27 dt-received= dt-revised= dt-accepted= dt-pub-year=2022 dt-pub=20220401 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Developing a scale to measure nurses' difficulty related to the treatment of gender dysphoric patients kn-title=看護師の性別違和への関わりにくさについての尺度作成 en-subtitle= kn-subtitle= en-abstract= kn-abstract=　This study aimed to develop a scale to measure the perceived difficulty experienced by nurses in treating and caring for patients diagnosed with gender dysphoria and examine its reliability and validity. We developed a 26-item preliminary scale through discussions with experts in gender dysphoria treatment. We administered a questionnaire including this scale to 1,010 nurses working at Okayama University Hospital and analyzed the data of 346 nurses who had been involved in the treatment of gender dysphoria and had no missing responses.
　A total of 20 items consisting of two factors, “relationship building” and “negative emotion for gender dysphoria,” were extracted by exploratory factor analysis, and we used them in the final version of the scale. Cronbach's alpha coefficient for the entire scale was 0.879, indicating a high degree of internal consistency.
　However, the correlations with a communication skills scale (ENDCOREs) and the Scale of Gender Conception were limited, and the external validity could not be proven. This scale may be useful for evaluating nursing practice and educational support for nurses; however, there is room for further study on the scale validation. en-copyright= kn-copyright= en-aut-name=MiyakeMaki en-aut-sei=Miyake en-aut-mei=Maki kn-aut-name=三宅麻希 kn-aut-sei=三宅 kn-aut-mei=麻希 aut-affil-num=1 ORCID= en-aut-name=OshimaYoshitaka en-aut-sei=Oshima en-aut-mei=Yoshitaka kn-aut-name=大島義孝 kn-aut-sei=大島 kn-aut-mei=義孝 aut-affil-num=2 ORCID= en-aut-name=NambaShihoko en-aut-sei=Namba en-aut-mei=Shihoko kn-aut-name=難波志穂子 kn-aut-sei=難波 kn-aut-mei=志穂子 aut-affil-num=3 ORCID= en-aut-name=MatsumotoYosuke en-aut-sei=Matsumoto en-aut-mei=Yosuke kn-aut-name=松本洋輔 kn-aut-sei=松本 kn-aut-mei=洋輔 aut-affil-num=4 ORCID= en-aut-name=HoriuchiMakiko en-aut-sei=Horiuchi en-aut-mei=Makiko kn-aut-name=堀内真希子 kn-aut-sei=堀内 kn-aut-mei=真希子 aut-affil-num=5 ORCID= en-aut-name=YamadaNorihito en-aut-sei=Yamada en-aut-mei=Norihito kn-aut-name=山田了士 kn-aut-sei=山田 kn-aut-mei=了士 aut-affil-num=6 ORCID= affil-num=1 en-affil=Department of Nursing, Okayama University Hospital kn-affil=岡山大学病院　看護部 affil-num=2 en-affil=Department of Neuropsychiatry, Okayama University Hospital kn-affil=岡山大学病院　精神科神経科 affil-num=3 en-affil=Department of Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil=岡山大学病院　新医療研究開発センター affil-num=4 en-affil=Department of Gender Center, Okayama University Hospital kn-affil=岡山大学病院　ジェンダーセンター affil-num=5 en-affil=Department of Medical Support, Clinical Psychology section, Okayama University Hospital kn-affil=岡山大学病院　医療技術部　臨床心理部門 affil-num=6 en-affil=Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil=岡山大学学術研究院医歯薬学域　精神神経病態学 en-keyword=性別違和 (gender dysphoria) kn-keyword=性別違和 (gender dysphoria) en-keyword=関わりにくさ (difficulty in relating) kn-keyword=関わりにくさ (difficulty in relating) en-keyword=コミュニケーション (communication) kn-keyword=コミュニケーション (communication) en-keyword=性差観 (gender conception) kn-keyword=性差観 (gender conception) END start-ver=1.4 cd-journal=joma no-vol=23 cd-vols= no-issue=1 article-no= start-page=81 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2023 dt-pub=20230202 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Eleven years of data on the Jefferson Scale of Empathy - medical student version: Japanese norm data and tentative cutoff scores en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background
More and more studies investigate medical students' empathy using the Jefferson Scale of Empathy (JSE). However, no norm data or cutoff scores of the JSE for Japanese medical students are available. This study therefore explored Japanese norm data and tentative cutoff scores for the Japanese translation of the JSE-medical student version (JSE-S) using 11 years of data obtained from matriculants from a medical school in Japan.

Methods
Participants were 1,216 students (836 men and 380 women) who matriculated at a medical school in Japan from 2011 to 2021. The JSE-S questionnaire was administered to participants prior to the start of the program. Data were summarized using descriptive statistics and statistical tests were performed to show the norm data and tentative cutoff scores for male and female students separately.

Results
The score distributions of the JSE-S were moderately skewed and leptokurtic for the entire sample, with indices -0.75 and 4.78, respectively. The mean score (standard deviation) for all participants was 110.8 (11.8). Women had a significantly higher mean score (112.6) than men (110.0; p < 0.01). The effect size estimate of gender difference was 0.22, indicating a small effect size. The low and high cutoff scores for men were <= 91 and >= 126, respectively, and the corresponding scores for women were <= 97 and >= 128, respectively.

Conclusions
This study provides JSE-S norm data and tentative cutoff scores for Japanese medical school matriculants, which would be helpful in identifying those who may need further training to enhance their empathy. en-copyright= kn-copyright= en-aut-name=KataokaHitomi U. en-aut-sei=Kataoka en-aut-mei=Hitomi U. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=TokinobuAkiko en-aut-sei=Tokinobu en-aut-mei=Akiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=FujiiChikako en-aut-sei=Fujii en-aut-mei=Chikako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=WatanabeMayu en-aut-sei=Watanabe en-aut-mei=Mayu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=ObikaMikako en-aut-sei=Obika en-aut-mei=Mikako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= affil-num=1 en-affil= Center for Diversity and Inclusion, Okayama University Hospital kn-affil= affil-num=2 en-affil= Center for Diversity and Inclusion, Okayama University Hospital kn-affil= affil-num=3 en-affil= Center for Diversity and Inclusion, Okayama University Hospital kn-affil= affil-num=4 en-affil=Division of Kidney, Diabetes and Endocrine Diseases, Okayama University Hospital kn-affil= affil-num=5 en-affil=Department of General Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= en-keyword=Jefferson Scale of Empathy kn-keyword=Jefferson Scale of Empathy en-keyword=Norm data kn-keyword=Norm data en-keyword=Cutoff scores kn-keyword=Cutoff scores en-keyword=Medical students kn-keyword=Medical students en-keyword=Empathy kn-keyword=Empathy END start-ver=1.4 cd-journal=joma no-vol=77 cd-vols= no-issue=1 article-no= start-page=57 end-page=64 dt-received= dt-revised= dt-accepted= dt-pub-year=2023 dt-pub=202302 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Development, Disappearance, and Clinical Course of Melanosis Coli: Sex Differences in the Progression of Severity en-subtitle= kn-subtitle= en-abstract= kn-abstract=Melanosis coli (MC) is an acquired colorectal disorder visualized as colonic mucosa pigmentation. Disease severity is confirmed based on MC depth, shape, and coloration, although the clinical course is not fully understood. This study sought to clarify characteristics of MC development and disappearance and to investigate its clinical course and severity. Contributors to MC grade progression were explored. This study reviewed MC cases discovered via colonoscopy at a single institution over a 10-year period. Of all 216 MC cases, 17 developing and 10 disappearing cases were detected. Anthranoid laxative use was a key factor: 29.4% of the developing cases had used such agents before the initial MC diagnosis, whereas 40% of disappearing cases had discontinued anthranoids prior to detection of MC disappearance. Among 70 grade I cases, progression to grade II occurred in 16 cases during a mean follow-up of 3.67±2.1 years (rate of progression=22.8%). Males more commonly showed progressive than stable grade I cases, and the probability of progression was higher for male than for female cases. An association between anthranoid administration and MC presence was presumed, and grade I MC was found to progress in severity over 5 years. en-copyright= kn-copyright= en-aut-name=KatsumataRyo en-aut-sei=Katsumata en-aut-mei=Ryo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=ManabeNoriaki en-aut-sei=Manabe en-aut-mei=Noriaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=MonobeYasumasa en-aut-sei=Monobe en-aut-mei=Yasumasa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=AyakiMaki en-aut-sei=Ayaki en-aut-mei=Maki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=SuehiroMitsuhiko en-aut-sei=Suehiro en-aut-mei=Mitsuhiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=FujitaMinoru en-aut-sei=Fujita en-aut-mei=Minoru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=KamadaTomoari en-aut-sei=Kamada en-aut-mei=Tomoari kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=KawamotoHirofumi en-aut-sei=Kawamoto en-aut-mei=Hirofumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=HarumaKen en-aut-sei=Haruma en-aut-mei=Ken kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= affil-num=1 en-affil=Department of General Internal Medicine 2, Kawasaki Medical School General Medical Center kn-affil= affil-num=2 en-affil=Division of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School General Medical Center kn-affil= affil-num=3 en-affil=Pathology, Kawasaki Medical School General Medical Center kn-affil= affil-num=4 en-affil=Division of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School General Medical Center kn-affil= affil-num=5 en-affil=Department of General Internal Medicine 2, Kawasaki Medical School General Medical Center kn-affil= affil-num=6 en-affil=Division of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School General Medical Center kn-affil= affil-num=7 en-affil=Health Care Medicine, Kawasaki Medical School General Medical Center kn-affil= affil-num=8 en-affil=Department of General Internal Medicine 2, Kawasaki Medical School General Medical Center kn-affil= affil-num=9 en-affil=Department of General Internal Medicine 2, Kawasaki Medical School General Medical Center kn-affil= en-keyword=melanosis kn-keyword=melanosis en-keyword=sex characteristics kn-keyword=sex characteristics en-keyword=laxatives kn-keyword=laxatives en-keyword=colorectal neoplasms kn-keyword=colorectal neoplasms en-keyword=colonoscopy kn-keyword=colonoscopy END start-ver=1.4 cd-journal=joma no-vol=20 cd-vols= no-issue=2 article-no= start-page=1579 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2023 dt-pub=20230115 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Differences in Stress Perception of Medical Students Depending on In-Person Communication and Online Communication during the COVID-19 Pandemic: A Japanese Cross-Sectional Survey en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background: Excessive psychological stress in medical students affects their mental health and causes problems such as burnout and depression. Furthermore, changes in the learning environment to online learning due to the COVID-19 pandemic have had a psychological effect on medical students. However, the relationships between medical students' perceived stress and different methods of communication, including in-person and online communication, remain unclear. The purpose of this study was to investigate the differences in stress perception of medical students depending on in-person communication and online communication during the COVID-19 pandemic. Methods: This study was a cross-sectional study conducted from September to October in 2020. All of the students of Okayama University School of Medicine were asked to participate in a questionnaire survey. The explanatory variables were the frequency and length of communications with others (by in-person or online communication), empathy, and lifestyle. The main outcome measure was perceived stress. Subgroup analysis was conducted for students who preferred to be by themselves and students who preferred to study together and interact with other people. Univariate analysis and multivariate multiple regression analysis were conducted. Gender and grade, which have been shown to be associated with stress in previous studies, were used as covariates for multiple regression analysis. Results: Valid responses to the questionnaire survey were received from 211 (29.4%) of the 717 students. There was no significant association between perceived stress and online communication, but the number of people with which students had in-person communication (1-2 people compared to 0 as a control, regression coefficient [B] = -4.4, 95% confidence interval [CI]; -7.8, -1.1, more than 10 people, B = -12, 95% CI: -18, -5.8) and the length of communication (more than 120 min, B = -4.5, 95% CI: -8.1, -0.92) were associated with a reduction in perceived stress. In subgroup analysis, the number of people with in-person communication and the length of communication had significant associations with stress reduction even in the group of students who had a preference for being by themselves. Conclusion: In-person communications rather than online communications were associated with a lower level of perceived stress. In subgroup analysis, this trend was statistically significant in the group of students who had a preference for being by themselves. en-copyright= kn-copyright= en-aut-name=TokumasuKazuki en-aut-sei=Tokumasu en-aut-mei=Kazuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=NishimuraYoshito en-aut-sei=Nishimura en-aut-mei=Yoshito kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=SakamotoYoko en-aut-sei=Sakamoto en-aut-mei=Yoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=ObikaMikako en-aut-sei=Obika en-aut-mei=Mikako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=KataokaHitomi en-aut-sei=Kataoka en-aut-mei=Hitomi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=OtsukaFumio en-aut-sei=Otsuka en-aut-mei=Fumio kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= affil-num=1 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Medicine, John A. Burns School of Medicine, University of Hawai’i kn-affil= affil-num=3 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=4 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=COVID-19 kn-keyword=COVID-19 en-keyword=medical student kn-keyword=medical student en-keyword=medical education kn-keyword=medical education en-keyword=in-person communication kn-keyword=in-person communication en-keyword=online communication kn-keyword=online communication en-keyword=stress perception kn-keyword=stress perception END start-ver=1.4 cd-journal=joma no-vol=76 cd-vols= no-issue=6 article-no= start-page=705 end-page=713 dt-received= dt-revised= dt-accepted= dt-pub-year=2022 dt-pub=202212 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=The Impact of Tofogliflozin on Physiological and Hormonal Function, Serum Electrolytes, and Cardiac Diastolic Function in Elderly Japanese Patients with Type 2 Diabetes Mellitus en-subtitle= kn-subtitle= en-abstract= kn-abstract=The sodium glucose transporter 2 (SGLT2) inhibitor tofogliflozin is a glucose-lowering drug that causes the excretion of surplus glucose by inhibiting SGLT2. Because of tofogliflozin’s osmotic diuresis mechanism, patients’ serum electrolytes, body fluid levels, and cardiac function must be monitored. We retrospectively analyzed the cases of 64 elderly Japanese patients with type 2 diabetes mellitus (T2DM) who received tofogliflozin for 3 months. Their HbA1c, serum electrolytes (sodium, potassium, chloride), hematocrit, brain natriuretic peptide (cardiac volume load marker) and renin and aldosterone (RAA; an index of regulatory hormones involved in body fluid retention) were continuously monitored during the investigation period. Renal function and cardiac function (by echocardiography) were assessed throughout the period. HbA1c significantly decreased (β1=−0.341, p<0.0001, linear regression analysis [LRA]). Most of the hormonal, electrolyte, and physiological parameters were maintained throughout the study period. In these circumstances, E/e’ tended to decrease (β1=−0.382, p=0.13, LRA). Compared to the baseline, E/e’ was significantly decreased at 1 and 3 months (p<0.01, p<0.05). In the higher E/e’ group (E/e’≥10, n=34), E/e’ decreased significantly (β1=−0.63, p<0.05, LRA). ΔE/e’ was correlated with body-weight change during treatment (r=0.64, p<0.01). The 3-month tofogliflozin treatment improved glycemic control and diastolic function represented by E/e’ in T2DM patients, without affecting serum electrolytes, renal function, or RAA. No negative impacts on the patients were observed. Three-month tofogliflozin treatment lowered glucose and improved cardiac diastolic function. en-copyright= kn-copyright= en-aut-name=HigashikawaToshihiro en-aut-sei=Higashikawa en-aut-mei=Toshihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=ItoTomohiko en-aut-sei=Ito en-aut-mei=Tomohiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=MizunoTakurou en-aut-sei=Mizuno en-aut-mei=Takurou kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=IshigamiKeiichiro en-aut-sei=Ishigami en-aut-mei=Keiichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=KurokiKengo en-aut-sei=Kuroki en-aut-mei=Kengo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=MaekawaNaoto en-aut-sei=Maekawa en-aut-mei=Naoto kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=UsudaDaisuke en-aut-sei=Usuda en-aut-mei=Daisuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=IzumidaToshihide en-aut-sei=Izumida en-aut-mei=Toshihide kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=YamadaShinya en-aut-sei=Yamada en-aut-mei=Shinya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=SangenRyusho en-aut-sei=Sangen en-aut-mei=Ryusho kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=HamadaKazu en-aut-sei=Hamada en-aut-mei=Kazu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=KiyosawaJun en-aut-sei=Kiyosawa en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=SaitoAtsushi en-aut-sei=Saito en-aut-mei=Atsushi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=IguchiMasaharu en-aut-sei=Iguchi en-aut-mei=Masaharu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=KasamakiYuji en-aut-sei=Kasamaki en-aut-mei=Yuji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= en-aut-name=NakahashiTakeshi en-aut-sei=Nakahashi en-aut-mei=Takeshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=16 ORCID= en-aut-name=FukudaAkihiro en-aut-sei=Fukuda en-aut-mei=Akihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=17 ORCID= en-aut-name=SaitoHitoshi en-aut-sei=Saito en-aut-mei=Hitoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=18 ORCID= en-aut-name=KandaTsugiyasu en-aut-sei=Kanda en-aut-mei=Tsugiyasu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=19 ORCID= en-aut-name=OkuroMasashi en-aut-sei=Okuro en-aut-mei=Masashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=20 ORCID= affil-num=1 en-affil=Kanazawa Medical University Himi Municipal Hospital kn-affil= affil-num=2 en-affil=Kanazawa Medical University Himi Municipal Hospital kn-affil= affil-num=3 en-affil=Kanazawa Medical University Himi Municipal Hospital kn-affil= affil-num=4 en-affil=Kanazawa Medical University Himi Municipal Hospital kn-affil= affil-num=5 en-affil=Kanazawa Medical University Himi Municipal Hospital kn-affil= affil-num=6 en-affil=Kanazawa Medical University Himi Municipal Hospital kn-affil= affil-num=7 en-affil=Kanazawa Medical University Himi Municipal Hospital kn-affil= affil-num=8 en-affil=Kanazawa Medical University Himi Municipal Hospital kn-affil= affil-num=9 en-affil=Kanazawa Medical University Himi Municipal Hospital kn-affil= affil-num=10 en-affil=Kanazawa Medical University Himi Municipal Hospital kn-affil= affil-num=11 en-affil=Kanazawa Medical University Himi Municipal Hospital kn-affil= affil-num=12 en-affil=Kanazawa Medical University Himi Municipal Hospital kn-affil= affil-num=13 en-affil=Kanazawa Medical University Himi Municipal Hospital kn-affil= affil-num=14 en-affil=Kanazawa Medical University Himi Municipal Hospital kn-affil= affil-num=15 en-affil=Kanazawa Medical University Himi Municipal Hospital kn-affil= affil-num=16 en-affil=Kanazawa Medical University Himi Municipal Hospital kn-affil= affil-num=17 en-affil=Kanazawa Medical University Himi Municipal Hospital kn-affil= affil-num=18 en-affil=Kanazawa Medical University Himi Municipal Hospital kn-affil= affil-num=19 en-affil=Kanazawa Medical University Himi Municipal Hospital kn-affil= affil-num=20 en-affil=Department of Geriatric Medicine, Kanazawa Medical University kn-affil= en-keyword=tofogliflozin kn-keyword=tofogliflozin en-keyword=SGLT2 inhibitor kn-keyword=SGLT2 inhibitor en-keyword=elderly patient kn-keyword=elderly patient en-keyword=HbA1c kn-keyword=HbA1c en-keyword=cardiac diastolic function kn-keyword=cardiac diastolic function END start-ver=1.4 cd-journal=joma no-vol=76 cd-vols= no-issue=5 article-no= start-page=597 end-page=603 dt-received= dt-revised= dt-accepted= dt-pub-year=2022 dt-pub=202210 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Genital Feminizing Surgery without Vaginoplasty as a Safe, Aesthetic, and Cost-Effective Option for Gender-Affirming Surgery for Transwomen en-subtitle= kn-subtitle= en-abstract= kn-abstract=Gender affirming surgery (GAS) has important impacts for people with gender incongruence (GI), both physically and socially. As the societal acceptance of gender diversity spreads, the number of individuals with GI who wish to be identified as the gender of their choice is increasing. Indeed, many elderly people who have lived a long time with GI now wish to undergo GAS, but face greater surgical risks due to greater burdens of underlying medical conditions. Generally, vaginoplasty is performed for transwomen; however, this surgery is time-consuming and involves heavy bleeding, and thus, should be avoided in elderly people. A less invasive technique is needed. In this article, we describe a new, less invasive genital feminizing surgical technique for transwomen with reports from two clinical cases. We present this novel technique as a safe, aesthetic, and cost-effective option for gender-affirming surgery for transwomen. en-copyright= kn-copyright= en-aut-name=WatanabeShiho en-aut-sei=Watanabe en-aut-mei=Shiho kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=WatanabeToshiyuki en-aut-sei=Watanabe en-aut-mei=Toshiyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=YamadaKiyoshi en-aut-sei=Yamada en-aut-mei=Kiyoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=NambaYuzaburo en-aut-sei=Namba en-aut-mei=Yuzaburo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=KimataYoshihiro en-aut-sei=Kimata en-aut-mei=Yoshihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= affil-num=1 en-affil=Department of Plastic and Reconstructive Surgery, Okayama University Hospital kn-affil= affil-num=2 en-affil=Department of Plastic and Reconstructive Surgery, Okayama University Hospital kn-affil= affil-num=3 en-affil=Department of Plastic Surgery, Kousei Hospital kn-affil= affil-num=4 en-affil=Department of Gender center, Okayama University Hospital kn-affil= affil-num=5 en-affil=Department of Plastic and Reconstructive Surgery, Okayama University Hospital kn-affil= en-keyword=gender-affirming surgery, kn-keyword=gender-affirming surgery, en-keyword=vaginoplasty kn-keyword=vaginoplasty en-keyword=gender incongruence kn-keyword=gender incongruence en-keyword=transwomen kn-keyword=transwomen END start-ver=1.4 cd-journal=joma no-vol=53 cd-vols= no-issue= article-no= start-page=57 end-page=74 dt-received= dt-revised= dt-accepted= dt-pub-year=2022 dt-pub=20220330 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Categorizing the Kindness Demanded by Friends, and Gender Differences ― A Preliminary Study with College Students ― kn-title=友人に求めるやさしさの分類とその性差 ― 大学生を対象とした予備的研究 ― en-subtitle= kn-subtitle= en-abstract= kn-abstract= en-copyright= kn-copyright= en-aut-name=UCHIDASoma en-aut-sei=UCHIDA en-aut-mei=Soma kn-aut-name=内田　蒼麻 kn-aut-sei=内田　 kn-aut-mei=蒼麻 aut-affil-num=1 ORCID= en-aut-name=YamauchiHiroto en-aut-sei=Yamauchi en-aut-mei=Hiroto kn-aut-name=山内裕斗 kn-aut-sei=山内 kn-aut-mei=裕斗 aut-affil-num=2 ORCID= affil-num=1 en-affil= kn-affil=岡山大学大学院社会文化科学研究科 affil-num=2 en-affil= kn-affil=岡山大学大学院社会文化科学研究科 END start-ver=1.4 cd-journal=joma no-vol=12 cd-vols= no-issue= article-no= start-page=103 end-page=117 dt-received= dt-revised= dt-accepted= dt-pub-year=2022 dt-pub=20220330 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=The Current Status and Issues of Gender-Free Education in Japan and China: Focusing on the Analysis of School Curriculum at the Elementary and Middle School Levels kn-title=日中におけるジェンダーフリー教育の現状と課題 ―小中段階における学校教育のカリキュラムの分析を中心に― en-subtitle= kn-subtitle= en-abstract=At the end of the twentieth century, various legal and institutional developments were underway to build equal relationships between the genders and to achieve a gender-equal society, starting from the principles of human rights, respect and diversity of human existence. However, despite the spread of the idea of gender equality in Japan and China, gender inequality in the curriculum may still persist in current school education. In this study, we will examine the educational content related to gender-free in the curriculum of elementary and middle school education in Japan and China. We will take up Japan's Curriculum Guideline and China's Curriculum Standard as the curriculum for elementary and middle school education in each country, and analyze them from the perspective of gender. The differences in gender-free education in the elementary and middle school curriculum of Japan and China will be clarified. kn-abstract=20世紀末、人権理念の尊重や人間存在の多様性を出発点として平等な両性関係の構築や男女共同参画社会の実現を達成するべく、様々な法制度が整備されていった。だが、日本および中国において、ジェンダーにおける平等の理念が広がっているにもかかわらず、いまだ現在の学校教育にはカリキュラムにおけるジェンダーの不平等が温存されている可能性がある。本研究は、日中の小中学校のカリキュラムにおけるジェンダーフリーに関わる教育内容を考察対象とする。各国の小中段階における学校教育のカリキュラムとして日本の学習指導要領、中国の課程標準を取り上げ、ジェンダーフリーの視点から分析を加える。そして、日本と中国の小中段階のカリキュラムにおけるジェンダーフリー教育の異同点を明らかにする。 en-copyright= kn-copyright= en-aut-name=WANGHeqiao en-aut-sei=WANG en-aut-mei=Heqiao kn-aut-name=王鶴橋 kn-aut-sei=王 kn-aut-mei=鶴橋 aut-affil-num=1 ORCID= en-aut-name=HirataYoshitsugu en-aut-sei=Hirata en-aut-mei=Yoshitsugu kn-aut-name=平田仁胤 kn-aut-sei=平田 kn-aut-mei=仁胤 aut-affil-num=2 ORCID= affil-num=1 en-affil= kn-affil= affil-num=2 en-affil=Graduate School of Education, Okayama University kn-affil=岡山大学学術研究院教育学域 en-keyword=ジェンダーフリー教育 (Gender-free education) kn-keyword=ジェンダーフリー教育 (Gender-free education) en-keyword=日中比較(Japan-China comparison) kn-keyword=日中比較(Japan-China comparison) en-keyword=カリキュラム(Curriculum) kn-keyword=カリキュラム(Curriculum) en-keyword=学習指導要領(Curriculum Guideline) kn-keyword=学習指導要領(Curriculum Guideline) en-keyword=課程標準(Curriculum Standard) kn-keyword=課程標準(Curriculum Standard) END start-ver=1.4 cd-journal=joma no-vol=76 cd-vols= no-issue=1 article-no= start-page=41 end-page=49 dt-received= dt-revised= dt-accepted= dt-pub-year=2022 dt-pub=202202 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Urinary Protein-to-creatinine Ratios Predict Recurrence in Pediatric and Young Adult Cases of Minimal Change Nephrotic Syndrome en-subtitle= kn-subtitle= en-abstract= kn-abstract=High-dose steroids are required for the treatment of minimal change nephrotic syndrome (MCNS), especially for episodes of recurrence. Predicting and avoiding recurrence can help reduce the steroid dose, but prediction is currently difficult. We herein examined whether changes in laboratory data, especially the urinary protein- to-creatinine ratio (UTP/UCr), can predict clinical recurrence. We also assessed differences in clinical features between children and young adults. We included 36 patients with MCNS; for each case, we retrospectively studied laboratory data during stable remission and pre-recurrence, with the “stable” period defined as all but the 6 weeks before recurrence, and pre-recurrence defined as the 4±2 weeks before recurrence. UTP/UCr, serum albumin, etc. were measured every 5 years during stable periods. We divided patients into cohorts by age at recurrence, < 15 years and ≥ 15 years, and compared stable and pre-recurrence values for the two groups. UTP/UCr values during stable periods tended to be higher in younger patients. UTP/UCr and serum albumin showed statistically significant changes during pre-recurrence periods, but only in those aged ≥ 15 years. Thus, clinical features of recurrence differed depending on age. Signs of recurrence can be confirmed via UTP/UCr or serum albumin several weeks before recurrence in patients ≥ 15 years. en-copyright= kn-copyright= en-aut-name=MiyaharaHiroyuki en-aut-sei=Miyahara en-aut-mei=Hiroyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=MiyaiTakayuki en-aut-sei=Miyai en-aut-mei=Takayuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=AyaKunihiko en-aut-sei=Aya en-aut-mei=Kunihiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=TsukaharaHirokazu en-aut-sei=Tsukahara en-aut-mei=Hirokazu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= affil-num=1 en-affil=Department of Pediatrics, Okayama University Hospital kn-affil= affil-num=2 en-affil=Department of Pediatrics, Okayama University Hospital kn-affil= affil-num=3 en-affil=Department of Pediatrics, Okayama University Hospital kn-affil= affil-num=4 en-affil=Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=minimal change nephrotic syndrome kn-keyword=minimal change nephrotic syndrome en-keyword=recurrence kn-keyword=recurrence en-keyword= urinary protein to creatinine ratio kn-keyword= urinary protein to creatinine ratio END start-ver=1.4 cd-journal=joma no-vol=323 cd-vols= no-issue= article-no= start-page=129089 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2021 dt-pub=20211110 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=The response of anthropogenic mercury release in China to the Minamata Convention on Mercury: A hypothetical expectation en-subtitle= kn-subtitle= en-abstract= kn-abstract=The combination of anthropogenic activities and long-term atmospheric transport has resulted in a sustained increase in global mercury concentrations in air, in water and on land. The Minamata Convention on Mercury (MCM), is a global treaty with the goal of protecting human health and the environment from anthropogenic releases of mercury. This study aimed to quantify the mercury inputs and outputs in China in 2016–2019 according to five source categories and investigate the effect of an accelerated scenario/technology transformation required by the MCM on the subsequent distribution of mercury among environmental and intermediate reservoirs. Mercury releases to natural environment decreased dramatically after the MCM, such that around 840 t of mercury was released to those reservoirs in 2019, which is less than 21% of that in 2016 (1,063 t) when an accelerated scenario/technology transformation (STranf) was taken into consideration. Applying the accelerated STranf can hardly change the total release amount to the natural environment, also can reduce 53 t and 58 t of atmospheric emission in 2018 and 2019 respectively. Atmospheric emission was most sensitive to STranf, followed by emissions to land and water. This is the first attempt to provide a systematic evaluation of the effectiveness of the MCM based on the hypothetical expectations. As the MCM moves into the implementation phase, further information from scientific data and studies is critically needed to support decision-making and management. The results of this study can provide such information, facilitating the creation of strategic management policies for mercury as the MCM is implemented in China. en-copyright= kn-copyright= en-aut-name=Habuer en-aut-sei=Habuer en-aut-mei= kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=FujiwaraTakeshi en-aut-sei=Fujiwara en-aut-mei=Takeshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=TakaokaMasaki en-aut-sei=Takaoka en-aut-mei=Masaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= affil-num=1 en-affil=Graduate School of Environmental and Life Science, Okayama University kn-affil= affil-num=2 en-affil=Graduate School of Environmental and Life Science, Okayama University kn-affil= affil-num=3 en-affil=Graduate School of Engineering, Kyoto University kn-affil= en-keyword=Mercury kn-keyword=Mercury en-keyword=Anthropogenic release kn-keyword=Anthropogenic release en-keyword=Distribution flow kn-keyword=Distribution flow en-keyword=Substance flow analysis kn-keyword=Substance flow analysis en-keyword=Minamata Convention on Mercury kn-keyword=Minamata Convention on Mercury en-keyword=China kn-keyword=China END start-ver=1.4 cd-journal=joma no-vol=75 cd-vols= no-issue=5 article-no= start-page=611 end-page=623 dt-received= dt-revised= dt-accepted= dt-pub-year=2021 dt-pub=202110 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Relation Between Identity Disclosure to Family Members and Mental Health in Japanese Transgender People en-subtitle= kn-subtitle= en-abstract= kn-abstract=Family members are critical mediators of the experiences of transgender people. We studied whether transgen-der subjects had disclosed their identity to their families and their families’ reactions after the disclosure. We also evaluated the subjects’ mental state and its association with disclosure status. Transgender people were recruited for this anonymous questionnaire survey in the Okayama University Hospital gender clinic. Subjects disclosed their identity to family members at the following rates: 68.7% to the father, 89.1% to the mother, 59.1% to a brother, 77.8% to a sister, and 47.6% to grandparents. Fathers had the lowest rate (26.7%) of posi-tive reactions, while over 50% of fathers showed an ambiguous response. Approximately 20% of parents showed a negative response. The majority of parents agreed to hormonal treatment and sex-reassignment sur-gery and that the transgender child should live with the gender they wanted to express. However, the rate of subjects with mood and anxiety disorders according to the Kessler 6 scale was significantly higher in those who experienced negative or ambiguous reactions from family members compared to those who experienced posi-tive reactions. Educational and mental health professionals should support the disclosure process of transgen-der people as well as their family members. en-copyright= kn-copyright= en-aut-name=ZhouYu en-aut-sei=Zhou en-aut-mei=Yu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=FurutaniMichiyo en-aut-sei=Furutani en-aut-mei=Michiyo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=AthurupanaRukmali en-aut-sei=Athurupana en-aut-mei=Rukmali kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=NakatsukaMikiya en-aut-sei=Nakatsuka en-aut-mei=Mikiya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= affil-num=1 en-affil=Graduate School of Health Sciences, Okayama University kn-affil= affil-num=2 en-affil=Graduate School of Health Sciences, Okayama University kn-affil= affil-num=3 en-affil=Graduate School of Health Sciences, Okayama University kn-affil= affil-num=4 en-affil=Graduate School of Health Sciences, Okayama University kn-affil= en-keyword=disclosure kn-keyword=disclosure en-keyword=family functioning kn-keyword=family functioning en-keyword=gender nonconformity kn-keyword=gender nonconformity en-keyword=mental health kn-keyword=mental health en-keyword=transgender kn-keyword=transgender END start-ver=1.4 cd-journal=joma no-vol=75 cd-vols= no-issue=5 article-no= start-page=601 end-page=609 dt-received= dt-revised= dt-accepted= dt-pub-year=2021 dt-pub=202110 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=The Effect of Peer Instruction Lectures on Learning Attitudes in Epidemiology Education en-subtitle= kn-subtitle= en-abstract= kn-abstract=Research suggests that the fundamental concepts of epidemiology cannot be sufficiently learned in traditional lectures, and interactive learning is necessary. However, few studies have investigated interactive epidemiology education in general, or peer instruction (PI) in particular. This study investigated the effect of PI. Study par-ticipants were fourth-year medical students. The attitude of participants in regard to PI learning was examined in a non-PI and a PI group. The Survey of Attitudes Toward Statistics (SATS) (containing six sub-categories) was conducted as a learning-attitudes index. The pre- and post-lecture scores were compared between the non-PI and PI groups using double robust (DR) estimation. The non-PI and PI groups consisted of 20 and 121 student participants, respectively. In DR estimation, affect exhibited the lowest SATS score changes, at −0.51 (95% confidence interval −0.78 to −0.24; p-value < 0.001), whereas effort exhibited the highest score changes of 0.01 (95% confidence interval −0.30 to 0.32; p-value = 0.952). The epidemiology lecture with PI did not increase the SATS scores. This might be due to issues related to the experimental design. Further research investigating the effects of interactive epidemiology education, it will be necessary to develop tools for assessing the learning of epidemiological concepts and to improve the research design. en-copyright= kn-copyright= en-aut-name=MitsuhashiToshiharu en-aut-sei=Mitsuhashi en-aut-mei=Toshiharu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= affil-num=1 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= en-keyword=medical students kn-keyword=medical students en-keyword=peer instruction kn-keyword=peer instruction en-keyword=epidemiological education kn-keyword=epidemiological education en-keyword=learning attitude kn-keyword=learning attitude en-keyword=double robust esti-mation kn-keyword=double robust esti-mation END start-ver=1.4 cd-journal=joma no-vol=13 cd-vols= no-issue=9 article-no= start-page=e18070 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2021 dt-pub=20210918 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Gender-Dependent Characteristics of Serum 1,25-Dihydroxyvitamin D/25-Hydroxyvitamin D Ratio for the Assessment of Bone Metabolism en-subtitle= kn-subtitle= en-abstract= kn-abstract=Y Objectives Vitamin D deficiency, which is common worldwide, increases the risks of falls and fractures and can lead to increased morbidity and mortality. However, the clinical utility and relevance of vitamin D activation remain unknown. The aim of the present study was to clarify the clinical usefulness of serum 1,25-dihydroxyvitamin D (1,25D)/25-hydroxyvitamin D (25D) ratio for assessment of the extent of bone metabolism. Methods We retrospectively screened data for 87 patients whose serum 1,25D and 25D levels were measured. Eight patients who were taking vitamin D preparations were excluded, and data for 79 patients (33 males and 46 females) were analyzed. Since menopausal status can be associated with serum vitamin D level, we divided the patients by gender and divided the female patients into two groups at the age of 50 years. Results The median serum 1,25D/25D ratio was significantly lower in males than in females, with the most considerable difference in all males [4.1 (interquartile range: 2.3-5.8) x 10(-3)] versus elderly females (aged >= 50 years) [7.9 (3.3-10.1) x 10(-3)). Main disorders were endocrine (30.6%), inflammatory (18.5%), and bone related (16.7%) disorders. The ratios of serum 1,25D/25D had significant negative correlations with femoral dual-energy X-ray absorptiometry % young adult mean (DEXA %YAM) (R=-0.35) and lumbar DEXA %YAM (R=-0.32). Significant correlations were found between the 1,25D/25D ratio and serum levels of inorganic phosphate (iP), parathyroid hormone, and alkaline phosphatase (ALP). The 1,25D/25D ratio had gender specific characteristics: the ratio was significantly correlated with age in males (R=-0.49), while it was significantly correlated with BMI in females (R=0.34). Conclusions The results of this study suggested that vitamin D activity is negatively correlated with bone mineral density, being reduced in aged males but enhanced in obese females. en-copyright= kn-copyright= en-aut-name=Fujita-YamashitaManami en-aut-sei=Fujita-Yamashita en-aut-mei=Manami kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=YamamotoKoichiro en-aut-sei=Yamamoto en-aut-mei=Koichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=HondaHiroyuki en-aut-sei=Honda en-aut-mei=Hiroyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=HanayamaYoshihisa en-aut-sei=Hanayama en-aut-mei=Yoshihisa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=TokumasuKazuki en-aut-sei=Tokumasu en-aut-mei=Kazuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=NakanoYasuhiro en-aut-sei=Nakano en-aut-mei=Yasuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=HasegawaKou en-aut-sei=Hasegawa en-aut-mei=Kou kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=HagiyaHideharu en-aut-sei=Hagiya en-aut-mei=Hideharu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=ObikaMikako en-aut-sei=Obika en-aut-mei=Mikako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=OgawaHiroko en-aut-sei=Ogawa en-aut-mei=Hiroko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=OtsukaFumio en-aut-sei=Otsuka en-aut-mei=Fumio kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= affil-num=1 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=11 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=aging kn-keyword=aging en-keyword=bone metabolism kn-keyword=bone metabolism en-keyword=calcium kn-keyword=calcium en-keyword=cyp27b1 kn-keyword=cyp27b1 en-keyword=vitamin d kn-keyword=vitamin d END start-ver=1.4 cd-journal=joma no-vol=75 cd-vols= no-issue=3 article-no= start-page=323 end-page=334 dt-received= dt-revised= dt-accepted= dt-pub-year=2021 dt-pub=202106 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Gender Expression among Transgender Women in Japan: Support Is Needed to Improve Social Passing as a Woman en-subtitle= kn-subtitle= en-abstract= kn-abstract=Gender expression is important for transgender women to improve their social passing as women. Herein, a questionnaire about the status of gender expression and support needs was distributed to 54 transgender women aged 17-71 in Japan. Most of the respondents noted that they had found it relatively difficult to handle physical changes and weight gain due to hormone treatment. They also found it difficult to enact and sustain practices such as a feminine use of voice and to use women-only services, whereas practicing and continuing with routine skin and hair care and feminine mannerisms were relatively easy for them. In the questionnaire regarding the support for gender transitioning, many items showed only a small percentage of the transgender women had received the support that they were looking for, and most of their needs for support were not addressed. Some of the factors that increased the respondents’ needs and achievement of gender expression as women included estrogen treatment, sex reassignment surgery, and living as a woman; these aspects met their support needs as well. Gender support professionals need to coordinate and collaborate with specialists in areas such as nutritional guidance and voice training to enable transgender women to improve the extent to which they can socially ‘pass’ as women. en-copyright= kn-copyright= en-aut-name=FurutaniMichiyo en-aut-sei=Furutani en-aut-mei=Michiyo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=YuZhou en-aut-sei=Yu en-aut-mei=Zhou kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=NakatsukaMikiya en-aut-sei=Nakatsuka en-aut-mei=Mikiya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= affil-num=1 en-affil=Graduate School of Health Sciences, Okayama University kn-affil= affil-num=2 en-affil=Graduate School of Health Sciences, Okayama University kn-affil= affil-num=3 en-affil=Graduate School of Health Sciences, Okayama University kn-affil= en-keyword=transgender kn-keyword=transgender en-keyword=gender expression kn-keyword=gender expression en-keyword=social passing as a woman kn-keyword=social passing as a woman en-keyword=real life experience kn-keyword=real life experience en-keyword=gender transition kn-keyword=gender transition END start-ver=1.4 cd-journal=joma no-vol=11 cd-vols= no-issue= article-no= start-page=75 end-page=88 dt-received= dt-revised= dt-accepted= dt-pub-year=2021 dt-pub=20210322 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=The Effects of Taking a Class on Knowledge about Sexual and Gender Minorities and Homophobia kn-title=性的マイノリティに関する授業が性的マイノリティへの知識や受容感に及ぼす影響 : 性的マイノリティに関する授業の前後で en-subtitle= kn-subtitle= en-abstract=The purpose of this study is to clarify the effects of taking a class on knowledge about sexual and gender minorities, confidence in one's own knowledge, and levels of homophobia. We measured the amount of knowledge students had about sexual and gender minorities, students’ confidence in answering the questionnaires correctly, and their levels of homophobia. The results showed that taking a class about sexual and gender minorities significantly increased the amount of knowledge students had about sexual and gender minorities and decreased their homophobia. However, the effect size in the level of homophobia was very small. As for the students’ confidence of their correct answers, before the class, those who had incorrect knowledge about sexual and gender minorities were more confident in their knowledge, but after the class, those who had correct knowledge were more confident in their knowledge, a positive correlation. Based on these results, it is necessary to find an effective way to decrease homophobia. kn-abstract=本研究の目的は，性的マイノリティへの関心やレディネスが備わっていない場合であっても授業を受けることにより性的マイノリティへの受容感や知識及び自身の知識に対する自信が変化するかどうかを明らかにすることである。方法は，教員志望の学生を対象に 100分の授業を実施した。調査項目は，性的マイノリティに関する知識量および正答確信度と同性愛者受容感尺度であった。結果は，授業を受けることで，有意に性的マイノリティに関する知識量が増え，同性愛者への受容感が高まることが分かった。しかし，受容感に対する授業の効果量は僅かであった。正答確信度に関しては，授業前は，誤った知識をもっている人ほど自分の知識に自信をもっていたが，授業後は，正しい知識を持っている人ほど自分の知識に自信を持っているという正の相関へ転じた。以上の結果から，性的マイノリティに対する受容感を高める効果的な授業の方法を模索していく必要があると考えられた。 en-copyright= kn-copyright= en-aut-name=NODAYukina en-aut-sei=NODA en-aut-mei=Yukina kn-aut-name=野田夕月奈 kn-aut-sei=野田 kn-aut-mei=夕月奈 aut-affil-num=1 ORCID= en-aut-name=YAMADATsuyoshi en-aut-sei=YAMADA en-aut-mei=Tsuyoshi kn-aut-name=山田剛史 kn-aut-sei=山田 kn-aut-mei=剛史 aut-affil-num=2 ORCID= en-aut-name=OHMORIIori en-aut-sei=OHMORI en-aut-mei=Iori kn-aut-name=大守伊織 kn-aut-sei=大守 kn-aut-mei=伊織 aut-affil-num=3 ORCID= affil-num=1 en-affil=Student at the Graduate School of Education, Okayama University kn-affil=岡山大学大学院教育学研究科大学院生 affil-num=2 en-affil=Graduate School of Urban Social and Cultural Studies, Yokohama City University kn-affil=横浜市立大学都市社会文化研究科 affil-num=3 en-affil=Graduate School of Education, Okayama University kn-affil=岡山大学大学院教育学研究科 en-keyword=性的マイノリティ (sexual and gender minority) kn-keyword=性的マイノリティ (sexual and gender minority) en-keyword=性の多様性 (diversity of sexuality) kn-keyword=性の多様性 (diversity of sexuality) en-keyword=教育 (education) kn-keyword=教育 (education) END start-ver=1.4 cd-journal=joma no-vol=21 cd-vols= no-issue=1 article-no= start-page=53 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2021 dt-pub=20210114 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=What impact does postgraduate clinical training have on empathy among Japanese trainee dentists? en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background
Enhancing empathy in healthcare education is a critical component in the development of a relationship between healthcare professionals and patients that would ensure better patient care; improved patient satisfaction, adherence to treatment, patients’ medication self-efficacy, improved treatment outcomes, and reduced patient anxiety. Unfortunately, however, the decline of empathy among students has been frequently reported. It is especially common when the curriculum transitions to a clinical setting. However, some studies have questioned the significance and frequency of this decline. Thus, the purpose of this study was to determine the impact of postgraduate clinical training on dental trainees’ empathy from cognitive, behavioral, and patients’ perspective.
Methods
This study included 64 trainee dentists at Okayama University Hospital and 13 simulated patients (SPs). The trainee dentists carried out initial medical interviews with SPs twice, at the beginning and the end of their clinical training. The trainees completed the Japanese version of the Jefferson Scale of Empathy for health professionals just before each medical interview. The SPs evaluated the trainees’ communication using an assessment questionnaire immediately after the medical interviews. The videotaped dialogue from the medical interviews was analyzed using the Roter Interaction Analysis System.
Results
No significant difference was found in the self-reported empathy score of trainees at the beginning and the end of the clinical training (107.73 [range, 85–134] vs. 108.34 [range, 69–138]; p = 0.643). Considering the results according to gender, male scored 104.06 (range, 88–118) vs. 101.06 (range, 71–122; p = 0.283) and female 109.17 (range, 85–134) vs. 111.20 (range, 69–138; p = 0.170). Similarly, there was no difference in the SPs’ evaluation of trainees’ communication (10.73 vs. 10.38, p = 0.434). Communication behavior in the emotional responsiveness category for trainees in the beginning was significantly higher than that at the end (2.47 vs. 1.14, p = 0.000).
Conclusions
Overall, a one-year postgraduate dental training program neither reduced nor increased trainee dentists’ empathy levels. Providing regular education support in this area may help trainees foster their empathy. en-copyright= kn-copyright= en-aut-name=YoshidaToshiko en-aut-sei=Yoshida en-aut-mei=Toshiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=WatanabeSho en-aut-sei=Watanabe en-aut-mei=Sho kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=KonoTakayuki en-aut-sei=Kono en-aut-mei=Takayuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=TaketaHiroaki en-aut-sei=Taketa en-aut-mei=Hiroaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=ShiotsuNoriko en-aut-sei=Shiotsu en-aut-mei=Noriko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=ShiraiHajime en-aut-sei=Shirai en-aut-mei=Hajime kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=NakaiYukie en-aut-sei=Nakai en-aut-mei=Yukie kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=ToriiYasuhiro en-aut-sei=Torii en-aut-mei=Yasuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= affil-num=1 en-affil=Center for Education in Medicine and Health Sciences (Dental Education), Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=2 en-affil=Comprehensive Dental Clinic, Okayama University Hospital kn-affil= affil-num=3 en-affil=Comprehensive Dental Clinic, Okayama University Hospital kn-affil= affil-num=4 en-affil=Comprehensive Dental Clinic, Okayama University Hospital kn-affil= affil-num=5 en-affil=Comprehensive Dental Clinic, Okayama University Hospital kn-affil= affil-num=6 en-affil=Comprehensive Dental Clinic, Okayama University Hospital kn-affil= affil-num=7 en-affil=Department of Dental Hygiene, University of Shizuoka, Junior College kn-affil= affil-num=8 en-affil=Comprehensive Dental Clinic, Okayama University Hospital kn-affil= en-keyword=Empathy kn-keyword=Empathy en-keyword=Trainee dentists kn-keyword=Trainee dentists en-keyword=Clinical training kn-keyword=Clinical training en-keyword=Jefferson Scale of Empathy kn-keyword=Jefferson Scale of Empathy en-keyword=Roter interaction analysis system kn-keyword=Roter interaction analysis system en-keyword=Simulated patients kn-keyword=Simulated patients END start-ver=1.4 cd-journal=joma no-vol=74 cd-vols= no-issue=6 article-no= start-page=467 end-page=474 dt-received= dt-revised= dt-accepted= dt-pub-year=2020 dt-pub=202012 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Clinical Application of the Ratio of Serum Bone Isoform to Total Alkaline Phosphatase in General Practice en-subtitle= kn-subtitle= en-abstract= kn-abstract=Alkaline phosphatase (ALP) is an enzyme that is expressed in a variety of tissues. Among the isoforms of ALP, bone-specific alkaline phosphatase (BAP) is used as a marker for evaluating bone metabolism. We investigated the clinical usefulness of the ratio of serum BAP to total ALP for the diagnosis of various disorders in general practice. We retrospectively analyzed the cases of 107 Japanese patients whose serum BAP levels were exam-ined, focusing on clinical characteristics. We observed that the BAP/ALP ratios of the patients with fever and those with inflammatory diseases were significantly lower than the ratios of other patient groups. The BAP/ALP ratios of the patients with osteoporosis and those with metabolic bone diseases were higher than those of the patients with other conditions. The BAP/ALP ratio was found to be negatively correlated with age, a cor-relation that has not been found in other ethnicities. The serum BAP/ALP ratio was inversely correlated with serum CRP levels but was positively correlated with serum albumin levels and hemoglobin concentrations. Collectively, our results suggest that the BAP/ALP ratio could be a useful predictor for important geriatric con-ditions seen in general practice. en-copyright= kn-copyright= en-aut-name=YokotaYuya en-aut-sei=Yokota en-aut-mei=Yuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=NishimuraYoshito en-aut-sei=Nishimura en-aut-mei=Yoshito kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=AndoAkemi en-aut-sei=Ando en-aut-mei=Akemi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=HanayamaYoshihisa en-aut-sei=Hanayama en-aut-mei=Yoshihisa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=HasegawaKou en-aut-sei=Hasegawa en-aut-mei=Kou kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=HagiyaHideharu en-aut-sei=Hagiya en-aut-mei=Hideharu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=OgawaHiroko en-aut-sei=Ogawa en-aut-mei=Hiroko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=ObikaMikako en-aut-sei=Obika en-aut-mei=Mikako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=UedaKeigo en-aut-sei=Ueda en-aut-mei=Keigo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=OtsukaFumio en-aut-sei=Otsuka en-aut-mei=Fumio kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= affil-num=1 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=alkaline phosphatase kn-keyword=alkaline phosphatase en-keyword=BAP kn-keyword=BAP en-keyword=CRP kn-keyword=CRP en-keyword=inflammation kn-keyword=inflammation en-keyword=osteoporosis kn-keyword=osteoporosis END start-ver=1.4 cd-journal=joma no-vol=20 cd-vols= no-issue= article-no= start-page=101203 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2020 dt-pub=202012 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Gender differences in dietary behaviors among Japanese adolescents en-subtitle= kn-subtitle= en-abstract= kn-abstract=Unhealthy dietary behaviors in adolescence are an important public health problem. Gender differences in dietary behaviors have already appeared during adolescence. However, few studies have assessed a variety of adolescent dietary behaviors in Japan. We aimed to clarify gender differences in unhealthy dietary behaviors among Japanese adolescents. The participants consisted of 84,988 participants from seventh to 12th grades. Unhealthy dietary behaviors were defined according to the National Health and Nutrition Survey. Multivariable logistic regression was used to analyze a nationally representative sample of Japanese adolescents from the 2014 to 2015 Lifestyle Survey. The effective response rate was 51.4%. The prevalence of unhealthy dietary behaviors (skipping breakfast, snacking, eating out, skipping meals, eating alone at dinner, and subjectively poor diet quality) among boys and girls was 14.2% versus 12.4%, 19.6% versus 14.1%, 10.6% versus 7.0%, 7.9% versus 5.6%, 13.3% versus 12.1%, and 12.3% versus 15.8%, respectively. Compared with boys, girls were more negatively associated with skipping breakfast [OR = 0.76 (95% CI 0.73–0.79)], snacking [OR = 0.67 (95% CI 0.65–0.70)], eating out [OR = 0.62 (95% CI 0.59–0.66)], skipping meals [OR = 0.61 (95% CI 0.58–0.65)], and eating alone at dinner [OR = 0.79 (95% CI 0.76–0.83)]. However, girls were more positively associated with subjectively poor diet quality [OR = 1.19 (95% CI 1.14.1.24)]. The findings suggest that gender differences existed in dietary behaviors. Gender differences in dietary behaviors suggest opportunities for tailoring interventions related to dietary education in schools. en-copyright= kn-copyright= en-aut-name=OtsukaYuichiro en-aut-sei=Otsuka en-aut-mei=Yuichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=KaneitaYoshitaka en-aut-sei=Kaneita en-aut-mei=Yoshitaka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=ItaniOsamu en-aut-sei=Itani en-aut-mei=Osamu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=JikeMaki en-aut-sei=Jike en-aut-mei=Maki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=OsakiYoneatsu en-aut-sei=Osaki en-aut-mei=Yoneatsu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=HiguchiSusumu en-aut-sei=Higuchi en-aut-mei=Susumu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=KandaHideyuki en-aut-sei=Kanda en-aut-mei=Hideyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= affil-num=1 en-affil=Division of Public Health, Department of Social Medicine, Nihon University School of Medicine kn-affil= affil-num=2 en-affil=Division of Public Health, Department of Social Medicine, Nihon University School of Medicine kn-affil= affil-num=3 en-affil=Division of Public Health, Department of Social Medicine, Nihon University School of Medicine kn-affil= affil-num=4 en-affil=Division of Public Health, Department of Social Medicine, Nihon University School of Medicine kn-affil= affil-num=5 en-affil=Division of Environmental and Preventive Medicine, Department of Social Medicine, Faculty of Medicine kn-affil= affil-num=6 en-affil=National Hospital Organization Kurihama Medical and Addiction Center kn-affil= affil-num=7 en-affil=Department of Public Health, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, University Faculty of Medicine kn-affil= en-keyword=Adolescents kn-keyword=Adolescents en-keyword=Dietary behaviors kn-keyword=Dietary behaviors en-keyword=Cross-sectional study kn-keyword=Cross-sectional study en-keyword=Gender difference kn-keyword=Gender difference END start-ver=1.4 cd-journal=joma no-vol=74 cd-vols= no-issue=5 article-no= start-page=381 end-page=389 dt-received= dt-revised= dt-accepted= dt-pub-year=2020 dt-pub=202010 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Clinical Relevance of Serum Prolactin Levels to Inflammatory Reaction in Male Patients en-subtitle= kn-subtitle= en-abstract= kn-abstract=To clarify the relevance of prolactin (PRL) to clinical parameters in patients who visited our general medicine department, medical records of 353 patients in whom serum PRL levels were measured during the period from 2016 to 2018 were retrospectively reviewed. Data for 140 patients (M/F: 42/98) were analyzed after excluding patients lacking detailed records and patients taking dopaminergic agents. Median serum PRL levels were significantly lower in males than females: 6.5 ng/ml (IQR: 4.2-10.3) versus 8.1 ng/ml (5.9-12.9), respectively. Pain and general fatigue were the major symptoms at the first visit, and past histories of hypertension and dyslipidemia were frequent. Male patients with relatively high PRL levels (≥ 10 ng/ml) had significantly lower levels of serum albumin and significantly higher levels of serum LDH than those with low PRL (< 10 ng/ml). There were significant correlations of male PRL level with the erythrocyte sedimentation rate (R=0.62), serum LDH level (R=0.39) and serum albumin level (R=−0.52), while the level of serum CRP (R=0.33) showed an insignificant but weak positive correlation with PRL level. Collectively, these results show that PRL levels had gender-specific relevance to various clinical factors, with PRL levels in males being significantly related to inflammatory status. en-copyright= kn-copyright= en-aut-name=YamamotoKoichiro en-aut-sei=Yamamoto en-aut-mei=Koichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=HanayamaYoshihisa en-aut-sei=Hanayama en-aut-mei=Yoshihisa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=HasegawaKou en-aut-sei=Hasegawa en-aut-mei=Kou kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=TokumasuKazuki en-aut-sei=Tokumasu en-aut-mei=Kazuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=MiyoshiTomoko en-aut-sei=Miyoshi en-aut-mei=Tomoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=HagiyaHideharu en-aut-sei=Hagiya en-aut-mei=Hideharu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=OgawaHiroko en-aut-sei=Ogawa en-aut-mei=Hiroko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=ObikaMikako en-aut-sei=Obika en-aut-mei=Mikako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=ItoshimaKoichi en-aut-sei=Itoshima en-aut-mei=Koichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=OtsukaFumio en-aut-sei=Otsuka en-aut-mei=Fumio kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= affil-num=1 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of Laboratory Medicine, Okayama University Hospital kn-affil= affil-num=10 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=hormones kn-keyword=hormones en-keyword=hyperprolactinemia kn-keyword=hyperprolactinemia en-keyword=inflammation kn-keyword=inflammation en-keyword=pituitary kn-keyword=pituitary en-keyword=prolactin kn-keyword=prolactin END start-ver=1.4 cd-journal=joma no-vol=26 cd-vols= no-issue=3 article-no= start-page=430 end-page=434 dt-received= dt-revised= dt-accepted= dt-pub-year=2020 dt-pub=20200704 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=High body mass index is a risk factor for unfavorable clinical outcomes after medial meniscus posterior root repair in well-aligned knees en-subtitle= kn-subtitle= en-abstract= kn-abstract=BackgroundSevere chondral lesions and varus knee alignment are associated with poor outcomes following transtibial pullout repair for medial meniscus posterior root tears and meniscus tear is strongly associated with body mass index. The prognostic factors in well-aligned knees (femorotibial angle < 180°) with mild chondral lesions are unknown. Therefore, we investigated the prognostic factors in these patients. We hypothesized that high body mass index would lead to poor clinical outcomes following pullout repair of medial meniscus posterior root tears.
MethodsWe retrospectively reviewed the files of 28 patients who had undergone pullout repair of medial meniscus posterior root tears between October 2016 and December 2017. We recorded the baseline characteristics (age, gender, height, weight, and body mass index) and the time between injury and surgery. We recorded the International Knee Documentation Committee scores, Knee injury and Osteoarthritis Outcome Scores, and pain visual analog scale scores. Using magnetic resonance imaging preoperatively and 1 year after surgery, we measured the medial meniscus body width and absolute and relative medial meniscus extrusion. Pearson correlation and multivariate linear regression analyses were used to assess potential associations between these factors and clinical outcomes.
ResultsAge positively correlated (coefficient = 0.49, P < 0.01) and body mass index negatively correlated with the postoperative International Knee Documentation Committee score (coefficient = −0.64, P < 0.01). In multivariate linear regression analysis, body mass index was a significant factor leading to poor postoperative International Knee Documentation Committee score (R2 = 0.29, P < 0.05).
ConclusionsBody mass index > 30 kg/m(2) is a risk factor for unfavorable clinical outcomes following pullout repair of medial meniscus posterior root tears in well-aligned knees. Level of evidenceIII, Comparative retrospective study. en-copyright= kn-copyright= en-aut-name=ZhangXiming en-aut-sei=Zhang en-aut-mei=Ximing kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=FurumatsuTakayuki en-aut-sei=Furumatsu en-aut-mei=Takayuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=OkazakiYuki en-aut-sei=Okazaki en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=HiranakaTakaaki en-aut-sei=Hiranaka en-aut-mei=Takaaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=KodamaYuya en-aut-sei=Kodama en-aut-mei=Yuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=XueHaowei en-aut-sei=Xue en-aut-mei=Haowei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=OkazakiYoshiki en-aut-sei=Okazaki en-aut-mei=Yoshiki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=OzakiToshifumi en-aut-sei=Ozaki en-aut-mei=Toshifumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= affil-num=1 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Orthopaedic Surgery, Okayama University Hospital kn-affil= END start-ver=1.4 cd-journal=joma no-vol=74 cd-vols= no-issue=2 article-no= start-page=145 end-page=150 dt-received= dt-revised= dt-accepted= dt-pub-year=2020 dt-pub=202004 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=The Efficacy of Mirabegron for the Relief of Ureteral Stent-Related Symptoms en-subtitle= kn-subtitle= en-abstract= kn-abstract= To investigate the efficacy of mirabegron for lower urinary tract symptoms in patients with an indwelling ureteral stent after ureterorenoscopic lithotripsy. This was a prospective follow-up study of 76 patients with stent-related symptoms (SRSs). Patients with upper urinary calculi who were pre-stented for > 2 weeks before lithotripsy were examined for the presence of SRSs by tests including the International Prostate Symptom Score (IPSS), OAB Symptom Score (OABSS), and urinary bother and pain measured by a Visual Analogue Scale (VAS) before lithotripsy. Mirabegron (50 mg/day) was prescribed post-lithotripsy for 2 weeks. SRSs were assessed at the time of stent removal. The IPSS scores improved significantly from 16.2 to 14.3 (p<0.001) and the IPSS-QoL scores decreased significantly from 5.0 to 4.6 (p=0.012). The OABSS scores improved significantly from 7.7 to 6.8 (p=0.006), and the urinary urgency scores (OABSS-Q3) decreased significantly from 3.24 to 2.68 (p<0.001). The number of nocturia episodes decreased significantly from 2.5 to 2.2 (p=0.045). Urinary bother and pain assessed by the VAS declined from 4.2 and 3.1 to 3.8 (p=0.15) and 2.5 (p=0.075), respectively. Mirabegron significantly improved SRSs and the number of nocturia episodes due to a ureteral stent. en-copyright= kn-copyright= en-aut-name=OtsukiHideo en-aut-sei=Otsuki en-aut-mei=Hideo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=YamasakiTomoya en-aut-sei=Yamasaki en-aut-mei=Tomoya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=HoriShunsuke en-aut-sei=Hori en-aut-mei=Shunsuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=AokiHiroshi en-aut-sei=Aoki en-aut-mei=Hiroshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=KosakaTakeo en-aut-sei=Kosaka en-aut-mei=Takeo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=UeharaShinya en-aut-sei=Uehara en-aut-mei=Shinya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=FujioKei en-aut-sei=Fujio en-aut-mei=Kei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= affil-num=1 en-affil=Department of Urology, Abiko Toho Hospital kn-affil= affil-num=2 en-affil=Department of Urology, Abiko Toho Hospital kn-affil= affil-num=3 en-affil=Department of Urology, Abiko Toho Hospital kn-affil= affil-num=4 en-affil=Department of Urology, Abiko Toho Hospital kn-affil= affil-num=5 en-affil=Department of Urology, Keio University kn-affil= affil-num=6 en-affil=Department of Urology, Kawasaki Medical School General Medical Center kn-affil= affil-num=7 en-affil=Department of Urology, Abiko Toho Hospital kn-affil= en-keyword=stent-related symptoms kn-keyword=stent-related symptoms en-keyword=overactive bladder kn-keyword=overactive bladder en-keyword=mirabegron kn-keyword=mirabegron en-keyword=ureterorenoscopic lithotripsy kn-keyword=ureterorenoscopic lithotripsy en-keyword=ureteral stent kn-keyword=ureteral stent END start-ver=1.4 cd-journal=joma no-vol=16 cd-vols= no-issue=19 article-no= start-page= 3540 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2019 dt-pub=20190922 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Influence of Occupational Stress and Coping Style on Periodontitis Among Japanese Workers: A Cross-Sectional Study en-subtitle= kn-subtitle= en-abstract= kn-abstract= The aim of this cross-sectional study was to evaluate the association between the influence of occupational stress and coping style on periodontitis among Japanese workers. The study sample included 738 workers (age range: 19-65 years) at a manufacturing company in Kagawa Prefecture, Japan. To analyze occupational stress and coping style, all participants answered a self-report questionnaire composed of items on their work environment and oral health behavior. Oral examinations were performed by calibrated dentists. Among all workers, 492 (66.7%) workers were diagnosed with periodontitis, and 50 (6.8%) were diagnosed with a high stress-low coping condition. Significant differences (p < 0.05) were observed between the periodontitis and non-periodontitis groups in terms of age, gender, body mass index, smoking status, daily alcohol drinking, monthly overtime work, worker type, and stress-coping style. Logistic regression analysis showed that a high stress-low coping condition was associated with an increased risk of periodontitis (odds ratio: 2.79, 95% confidence interval: 1.05-7.43, p = 0.039). These findings suggest that a high stress-low coping condition is associated with periodontitis among the 19-65 years of age group of Japanese workers. en-copyright= kn-copyright= en-aut-name=Md Monirul Islam en-aut-sei=Md Monirul Islam en-aut-mei= kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=EkuniDaisuke en-aut-sei=Ekuni en-aut-mei=Daisuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=YonedaToshiki en-aut-sei=Yoneda en-aut-mei=Toshiki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=YokoiAya en-aut-sei=Yokoi en-aut-mei=Aya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=MoritaManabu en-aut-sei=Morita en-aut-mei=Manabu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= affil-num=1 en-affil=Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=Japanese workers kn-keyword=Japanese workers en-keyword=coping kn-keyword=coping en-keyword=occupational stress kn-keyword=occupational stress en-keyword=periodontitis kn-keyword=periodontitis END start-ver=1.4 cd-journal=joma no-vol=74 cd-vols= no-issue=1 article-no= start-page=89 end-page=94 dt-received= dt-revised= dt-accepted= dt-pub-year=2020 dt-pub=202002 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=A Multicenter, Open-label, Clinical Trial to Assess the Effectiveness and Safety of Allogeneic Hematopoietic Stem Cell Transplantation Using Reduced-intensity Conditioning in Relapsed/refractory Anaplastic Large-cell Lymphoma in Children en-subtitle= kn-subtitle= en-abstract= kn-abstract= No standard treatment for relapsed or refractory anaplastic large-cell lymphoma (ALCL) has been established. This study is a multicenter, open-label trial to examine the effectiveness and safety of transplantation with reduced-intensity conditioning (RIC) for patients under 20 years old with relapsed or refractory ALCL. We defined RIC as the administration of fludarabine (30 mg/m2/day) for five days plus melphalan (70 mg/m2/day) for two days and total body irradiation at 4 Gy, followed by allogeneic hematopoietic stem cell transplantation. en-copyright= kn-copyright= en-aut-name=KadaAkiko en-aut-sei=Kada en-aut-mei=Akiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=FukanoReiji en-aut-sei=Fukano en-aut-mei=Reiji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=MoriTetsuya en-aut-sei=Mori en-aut-mei=Tetsuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KameiMichi en-aut-sei=Kamei en-aut-mei=Michi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=TanakaFumiko en-aut-sei=Tanaka en-aut-mei=Fumiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=UeyamaJunichi en-aut-sei=Ueyama en-aut-mei=Junichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=SekimizuMasahiro en-aut-sei=Sekimizu en-aut-mei=Masahiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=OsumiTomoo en-aut-sei=Osumi en-aut-mei=Tomoo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=MoriTakeshi en-aut-sei=Mori en-aut-mei=Takeshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=KogaYuhki en-aut-sei=Koga en-aut-mei=Yuhki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=OhkiKentaro en-aut-sei=Ohki en-aut-mei=Kentaro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=FujitaNaoto en-aut-sei=Fujita en-aut-mei=Naoto kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=MitsuiTetsuo en-aut-sei=Mitsui en-aut-mei=Tetsuo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=SaitoAkiko M. en-aut-sei=Saito en-aut-mei=Akiko M. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=HashimotoHiroya en-aut-sei=Hashimoto en-aut-mei=Hiroya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= en-aut-name=KobayashiRyoji en-aut-sei=Kobayashi en-aut-mei=Ryoji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=16 ORCID= affil-num=1 en-affil=Clinical Research Center, NHO Nagoya Medical Center kn-affil= affil-num=2 en-affil=Department of Pediatrics, Yamaguchi University Graduate School of Medicine kn-affil= affil-num=3 en-affil=Department of Pediatrics, St. Marianna University School of Medicine Hospital kn-affil= affil-num=4 en-affil=Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences kn-affil= affil-num=5 en-affil=Department of Pediatrics, Saiseikai Yokohamashi Nanbu Hospital kn-affil= affil-num=6 en-affil=Department of Pediatrics, Tottori University Hospital, kn-affil= affil-num=7 en-affil=Department of Pediatrics, NHO Nagoya Medical Center kn-affil= affil-num=8 en-affil=Children’s Cancer Center, National Center for Child Health and Development kn-affil= affil-num=9 en-affil=Department of Hematology and Oncology, Children’s Cancer Center, Kobe Children’s Hospital kn-affil= affil-num=10 en-affil=Department of Pediatrics, Graduate School of Medical Sciences Kyushu University kn-affil= affil-num=11 en-affil=Department of Pediatric Hematology and Oncology Research, National Center for Child Health and Development kn-affil= affil-num=12 en-affil=Department of Pediatrics, Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital kn-affil= affil-num=13 en-affil=Department of Pediatrics, Yamagata University Hospital kn-affil= affil-num=14 en-affil=Clinical Research Center, NHO Nagoya Medical Center kn-affil= affil-num=15 en-affil=Clinical Research Center, NHO Nagoya Medical Center kn-affil= affil-num=16 en-affil=Department of Pediatrics and Adolescence, Sapporo Hokuyu Hospital kn-affil= en-keyword=anaplastic large-cell lymphoma kn-keyword=anaplastic large-cell lymphoma en-keyword=relapsed/refractory kn-keyword=relapsed/refractory en-keyword=fludarabine kn-keyword=fludarabine en-keyword=melphalan kn-keyword=melphalan en-keyword=total body irradiation kn-keyword=total body irradiation END start-ver=1.4 cd-journal=joma no-vol=74 cd-vols= no-issue=1 article-no= start-page=59 end-page=63 dt-received= dt-revised= dt-accepted= dt-pub-year=2020 dt-pub=202002 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Examination of the Causality Relationship between Psychological Distress and Social Participation in Elderly People: A Pilot Study en-subtitle= kn-subtitle= en-abstract= kn-abstract= Few studies have considered the causal relationship between psychological distress and social participation in elderly people. Here we investigated this relationship based on an initial survey and a follow-up survey. In 2016, a survey was distributed to 86 participants. A follow-up survey of 80 of those participants was performed in 2017. We adopted the following variables: psychological distress and social participation as represented by the Kessler psychological distress scale and social participation scores, respectively. By using cross-lagged and synchronous effects models, we found that the 2016 Kessler psychological distress scale had a significant influence on the 2017 social participation scores (standardization factor=−0.221, p=0.020) and the 2017 Kessler psychological distress scale significantly influenced the 2017 social participation scores (standardization factor=−0.345, p=0.039). The results suggest that psychological distress may affect social participation one year later. en-copyright= kn-copyright= en-aut-name=OwariYutaka en-aut-sei=Owari en-aut-mei=Yutaka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=MiyatakeNobuyuki en-aut-sei=Miyatake en-aut-mei=Nobuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=SuzukiHiromi en-aut-sei=Suzuki en-aut-mei=Hiromi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= affil-num=1 en-affil=Shikoku Medical College kn-affil= affil-num=2 en-affil=Department of Hygiene, Faculty of Medicine, Kagawa University kn-affil= affil-num=3 en-affil=Department of Hygiene, Faculty of Medicine, Kagawa University kn-affil= en-keyword=causal relationship kn-keyword=causal relationship en-keyword=elderly people kn-keyword=elderly people en-keyword=psychological distress kn-keyword=psychological distress en-keyword=social participation kn-keyword=social participation en-keyword=structural equation modeling (SEM) kn-keyword=structural equation modeling (SEM) END start-ver=1.4 cd-journal=joma no-vol=73 cd-vols= no-issue=6 article-no= start-page=479 end-page=486 dt-received= dt-revised= dt-accepted= dt-pub-year=2019 dt-pub=201912 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Correlations between Depressive Condition and Gastroesophageal Reflux Symptoms in Patients Visiting a Department of General Medicine en-subtitle= kn-subtitle= en-abstract= kn-abstract= To clarify the potential relevance of patients’ chief complaints at a general medicine department to their self-rating depression scale (SDS) and frequency scale for symptoms of gastroesophageal reflux disease (GERD) (FSSG) scores, we analyzed data of 478 patients who visited our general medicine department. The chief complaints (553 symptoms of 447 patients) were categorized into major symptom-based groups: respiratory (31%), circulatory (3%), gastrointestinal (GI) tract (26%), neurology (8%), orthopedic and skin (10%), and systemic (22%) symptoms. The SDS score tended to be higher in females and younger patients. The FSSG score did not differ by gender but was higher in younger patients. The patients receiving social welfare had higher SDS and FSSG scores. A close inter-relationship between the FSSG (including both degrees of reflux and dysmotility) and SDS was observed in all patients. Although the averages of the SDS and FSSG scores were not significantly different among the symptom-based categories, we observed significantly positive correlations between the FSSG and SDS in each category, suggesting that depressive status may be closely related to GERD-related symptoms regardless of the patients’ chief complaints. An initial checkup of patients’ psychological condition and/or GERD-like symptoms could help screen for latent disorders in outpatients with uncertain complaints. en-copyright= kn-copyright= en-aut-name=SuganamiYu en-aut-sei=Suganami en-aut-mei=Yu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=OkaKosuke en-aut-sei=Oka en-aut-mei=Kosuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=HanayamaYoshihisa en-aut-sei=Hanayama en-aut-mei=Yoshihisa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=HondaHiroyuki en-aut-sei=Honda en-aut-mei=Hiroyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=HamaharaJun en-aut-sei=Hamahara en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=ObikaMikako en-aut-sei=Obika en-aut-mei=Mikako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=KariyamaKazuya en-aut-sei=Kariyama en-aut-mei=Kazuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=KishidaMasayuki en-aut-sei=Kishida en-aut-mei=Masayuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=OtsukaFumio en-aut-sei=Otsuka en-aut-mei=Fumio kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= affil-num=1 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=chief complaints kn-keyword=chief complaints en-keyword=frequency scale for the symptoms of gastroesophageal reflux disease (FSSG) kn-keyword=frequency scale for the symptoms of gastroesophageal reflux disease (FSSG) en-keyword=self-rating depression scale (SDS) kn-keyword=self-rating depression scale (SDS) en-keyword=welfare kn-keyword=welfare END start-ver=1.4 cd-journal=joma no-vol=73 cd-vols= no-issue=6 article-no= start-page=475 end-page=477 dt-received= dt-revised= dt-accepted= dt-pub-year=2019 dt-pub=201912 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=The Aging Population and Research into Treatments for Abdominal Aortic Aneurysms en-subtitle= kn-subtitle= en-abstract= kn-abstract= Abdominal aortic aneurysms (AAAs) usually expand asymptomatically until the occurrence of a life-threatening event such as aortic rupture, which is closely associated with high mortality. AAA and aortic dissection are ranked among the top 10 causes of death in Japan. The major risk factors for AAA are age over 65 years, male gender, family history, and smoking. Thus, for prevention, smoking cessation is the most important lifestyle-intervention. For treatment, since AAA generally affects elderly people, less invasive treatment is preferable. However, the only established treatment for AAA is open repair and endovascular repair. This review describes potential medical treatments to slow aneurysm growth or prevent AAA rupture. en-copyright= kn-copyright= en-aut-name=UmebayashiRyoko en-aut-sei=Umebayashi en-aut-mei=Ryoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=UchidaHaruhito A. en-aut-sei=Uchida en-aut-mei=Haruhito A. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=WadaJunzo en-aut-sei=Wada en-aut-mei=Junzo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= affil-num=1 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=abdominal aortic aneurysms kn-keyword=abdominal aortic aneurysms en-keyword=medical treatment kn-keyword=medical treatment en-keyword=anti-platelet drugs kn-keyword=anti-platelet drugs END start-ver=1.4 cd-journal=joma no-vol=3 cd-vols= no-issue=1 article-no= start-page=96 end-page=103 dt-received= dt-revised= dt-accepted= dt-pub-year=2018 dt-pub=20181011 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Multicenter retrospective study to evaluate the efficacy and safety of the double-flap technique as antireflux esophagogastrostomy after proximal gastrectomy (rD-FLAP Study) en-subtitle= kn-subtitle= en-abstract= kn-abstract=AIM: As a result of the difficulty in effective prevention of gastroesophageal reflux, no standard reconstruction procedure after proximal gastrectomy (PG) has yet been established. The double-flap technique (DFT), or Kamikawa procedure, is an antireflux reconstruction procedure in esophagogastrostomy. The efficacy of DFT has recently been reported in several studies. However, these were all single-center studies with a limited number of cases.
METHODS:
We conducted a multicenter retrospective study in which patients who underwent DFT, irrespective of disease type and reconstruction approach, at each participating institution between 1996 and 2015 were registered. Primary endpoint was incidence of reflux esophagitis at 1-year after surgery, and secondary endpoint was incidence of anastomosis-related complications.
RESULTS:
Of 546 patients who were eligible for this study, 464 patients who had endoscopic examination at 1-year follow up were evaluated for reflux esophagitis. Incidence of reflux esophagitis of all grades was 10.6% and that of grade B or higher was 6.0%. Male gender and anastomosis located in the mediastinum/intra-thorax were independent risk factors for grade B or higher reflux esophagitis (odds ratio [OR]: 4.21, 95% confidence interval [CI]: 1.44-10.9, P = 0.0109). Total incidence of anastomosis-related complications was 7.2%, including leakage in 1.5%, strictures in 5.5% and bleeding in 0.6% of cases. Laparoscopic reconstruction was the only independent risk factor for anastomosis-related complications (OR: 3.93, 95% CI: 1.93-7.80, P = 0.0003).
CONCLUSION:
Double-flap technique might be a feasible option after PG for effective prevention of reflux, although anastomotic stricture is a complication that must be well-prepared for. en-copyright= kn-copyright= en-aut-name=KurodaShinji en-aut-sei=Kuroda en-aut-mei=Shinji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=ChodaYasuhiro en-aut-sei=Choda en-aut-mei=Yasuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=OtsukaShinya en-aut-sei=Otsuka en-aut-mei=Shinya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=UeyamaSatoshi en-aut-sei=Ueyama en-aut-mei=Satoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=TanakaNorimitsu en-aut-sei=Tanaka en-aut-mei=Norimitsu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=MuraokaAtsushi en-aut-sei=Muraoka en-aut-mei=Atsushi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=HatoShinji en-aut-sei=Hato en-aut-mei=Shinji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=KimuraToshikazu en-aut-sei=Kimura en-aut-mei=Toshikazu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=TanakayaKohji en-aut-sei=Tanakaya en-aut-mei=Kohji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=KikuchiSatoru en-aut-sei=Kikuchi en-aut-mei=Satoru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=TanabeShunsuke en-aut-sei=Tanabe en-aut-mei=Shunsuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=NomaKazuhiro en-aut-sei=Noma en-aut-mei=Kazuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=NishizakiMasahiko en-aut-sei=Nishizaki en-aut-mei=Masahiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=KagawaShunsuke en-aut-sei=Kagawa en-aut-mei=Shunsuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=ShirakawaYasuhiro en-aut-sei=Shirakawa en-aut-mei=Yasuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= en-aut-name=KamikawaYasuaki en-aut-sei=Kamikawa en-aut-mei=Yasuaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=16 ORCID= en-aut-name=FujiwaraToshiyoshi en-aut-sei=Fujiwara en-aut-mei=Toshiyoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=17 ORCID= affil-num=1 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Surgery, Hiroshima City Hiroshima Citizens Hospital kn-affil= affil-num=3 en-affil=Department of Surgery, Fukuyama Medical Center kn-affil= affil-num=4 en-affil=Department of Surgery, Mihara Red Cross Hospital kn-affil= affil-num=5 en-affil=Department of Surgery, Kagawa Prefectural Center Hospital kn-affil= affil-num=6 en-affil=Department of Surgery, Kagawa Rosai Hospital kn-affil= affil-num=7 en-affil=Department of Surgery, Shikoku Cancer Center kn-affil= affil-num=8 en-affil=Department of Surgery, Okayama Saiseikai General Hospital, kn-affil= affil-num=9 en-affil=Department of Surgery, Iwakuni Clinical Center kn-affil= affil-num=10 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=11 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=12 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=13 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=14 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=15 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=16 en-affil=Department of Surgery, Matsuda Hospital kn-affil= affil-num=17 en-affil=Department of Gastroenterological Surgery Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=Kamikawa procedure kn-keyword=Kamikawa procedure en-keyword=antireflux surgery kn-keyword=antireflux surgery en-keyword=double‐flap technique kn-keyword=double‐flap technique en-keyword=esophagogastrostomy kn-keyword=esophagogastrostomy en-keyword=proximal gastrectomy kn-keyword=proximal gastrectomy END start-ver=1.4 cd-journal=joma no-vol=73 cd-vols= no-issue=5 article-no= start-page=441 end-page=447 dt-received= dt-revised= dt-accepted= dt-pub-year=2019 dt-pub=201910 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Risk Factors for Postoperative Hematoma after Chest Wall Contouring for Female-to-Male Transsexuals: A Clinical Study en-subtitle= kn-subtitle= en-abstract= kn-abstract= Gender dysphoria is a condition in which a discrepancy between biological sex and gender identity causes distress. Many female-to-male transsexuals (FTMTS) are uncomfortable with female breasts. Chest wall contouring surgery is effective for obtaining a male-type chest, reducing mental stress, and increasing sexual satisfaction in such cases. At the Okayama University Hospital Gender Center, we have obtained positive results using an algorithm to determine the most appropriate surgical method for chest wall contouring in FTMTS patients. However, serious complications requiring reoperation, such as hematoma, may still occur. Postoperative hematomas were found in 15 (4.18%) of 358 FTMTS patients who underwent chest contouring surgery at our hospital between 2006 and 2018. Postoperative hematoma was examined retrospectively. The median time to the onset of hematoma was 7 (6-12) h after the initial surgery. The main blood vessels causing bleeding were those in the head-side skin flap region where visual confirmation was difficult and the perforator vessels from the pectoralis major muscle. Intraoperative bleeding and the operation time had a significant impact on the onset of postoperative hematoma. This is the first retrospective study that investigated the blood vessels and other factors contributing to postoperative hematoma development after chest wall contouring. en-copyright= kn-copyright= en-aut-name=WatanabeToshiyuki en-aut-sei=Watanabe en-aut-mei=Toshiyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=SakuraiToru en-aut-sei=Sakurai en-aut-mei=Toru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=MukaiYuko en-aut-sei=Mukai en-aut-mei=Yuko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KimataYoshihiro en-aut-sei=Kimata en-aut-mei=Yoshihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=NambaYuzaburo en-aut-sei=Namba en-aut-mei=Yuzaburo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= affil-num=1 en-affil=Department of Plastic and Reconstructive Surgery,Okayama University Hospital kn-affil= affil-num=2 en-affil=Department of Plastic and Reconstructive Surgery,Okayama University Hospital kn-affil= affil-num=3 en-affil=Department of Plastic and Reconstructive Surgery,Okayama University Hospital kn-affil= affil-num=4 en-affil=Department of Plastic and Reconstructive Surgery,Okayama University Hospital kn-affil= affil-num=5 en-affil=Department of Gender Center, Okayama University Hospital kn-affil= en-keyword=female-to-male transsexuals kn-keyword=female-to-male transsexuals en-keyword=chest wall contouring kn-keyword=chest wall contouring en-keyword=postoperative hematoma kn-keyword=postoperative hematoma END start-ver=1.4 cd-journal=joma no-vol=73 cd-vols= no-issue=5 article-no= start-page=403 end-page=411 dt-received= dt-revised= dt-accepted= dt-pub-year=2019 dt-pub=201910 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Risk Factors for Low Bone Mineral Density Determined in Patients in a General Practice Setting en-subtitle= kn-subtitle= en-abstract= kn-abstract= Osteoporosis increases the risk of bone fractures. It is diagnosed based on an individual’s bone mineral density (BMD) or a fracture without trauma. BMD is usually measured by the dual energy X-ray absorptiometry (DXA) method. Here we investigated factors for the earliest possible prediction of decreased BMD by examining the relationships between patients’ BMD values and changes in the patients’ physical and laboratory values. We retrospectively reviewed the medical records of 149 patients who visited our department in 2014-2015 for a variety of reasons and underwent an area BMD examination by DXA. We analyzed the relationships between decreasing BMD and the patients’ gender, age, body mass index (BMI), medical background, hemoglobin, electrolytes, and thyroid function. Thirty-nine of the patients were diagnosed with osteoporosis based on their T-scores. An adjusted analysis showed that female gender, aging, and increased serum calcium level were significantly related to decreasing femoral BMD, whereas high BMI was associated with an increase in femoral BMD. Collectively the results indicate that for the early detection of low BMD, it is important for general-practice physicians to consider conducting a BMD checkup when treating female and elderly patients with a low BMI and/or elevated serum calcium level. en-copyright= kn-copyright= en-aut-name=AndoAkemi en-aut-sei=Ando en-aut-mei=Akemi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=MitsuhashiToshiharu en-aut-sei=Mitsuhashi en-aut-mei=Toshiharu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=Honda Mitsugi en-aut-sei=Honda en-aut-mei= Mitsugi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=HanayamaYoshihisa en-aut-sei=Hanayama en-aut-mei=Yoshihisa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=HasegawaKou en-aut-sei=Hasegawa en-aut-mei=Kou kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=ObikaMikako en-aut-sei=Obika en-aut-mei=Mikako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=KataokaHitomi en-aut-sei=Kataoka en-aut-mei=Hitomi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=OtsukaFumio en-aut-sei=Otsuka en-aut-mei=Fumio kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= affil-num=1 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=3 en-affil=Division of Radiology, Department of Medical Technology, Okayama University Hospital kn-affil= affil-num=4 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=bone mineral density (BMD) kn-keyword=bone mineral density (BMD) en-keyword=body mass index (BMI) kn-keyword=body mass index (BMI) en-keyword=female gender kn-keyword=female gender en-keyword=hypercalcemia kn-keyword=hypercalcemia en-keyword=osteoporosis kn-keyword=osteoporosis END start-ver=1.4 cd-journal=joma no-vol=5 cd-vols= no-issue=5 article-no= start-page=722 end-page=734 dt-received= dt-revised= dt-accepted= dt-pub-year=2019 dt-pub=20190713 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Current Disease Management of Primary Urethral Carcinoma en-subtitle= kn-subtitle= en-abstract= kn-abstract=Context: Primary urethral cancer (PUC) is a rare cancer entity. Owing to the low incidence of this malignancy, the main body of literature consists mainly of case reports, making evidence-based management recommendations difficult.
Objective: To review reported disease management strategies of PUC and their impact on oncological outcomes.
Evidence acquisition: A systematic research was performed according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement using Medline, Scopus, and Web of Science, to find studies of the past 10yr including ≥20 patients, and investigating treatment strategies and their impact on outcomes of the three most frequent histologies: urothelial carcinoma, adenocarcinoma, and squamous cell carcinoma. Evidence synthesis: In localized PUC, penis-sparing surgery can be performed in males, while in females, complete urethrectomy with surrounding tissue is advised to minimize recurrence due to positive margins. Radiotherapy (RT) has worse survival and recurrence rates, as well as more adverse effects, than surgery, limiting its use in genital-preserving therapy. Locally advanced PUC should be treated with multimodal therapy, as monotherapies result in inferior recurrence and survival rates. Extent of surgery is still undecided, favoring radical cyst(oprostat)ectomy with total urethrectomy (RCU). Lymph node involvement is a predictor of survival, highlighting the role of lymph node dissection for disease control and staging. RT can improve survival in combination with surgery and/or chemotherapy (CHT). Neoadjuvant platinum-based CHT can improve overall and recurrence-free survival. At recurrence, salvage therapy with surgery and/or CHT can improve survival. Superficial urothelial carcinoma of the prostatic urethra can be treated with transurethral resection. Stromal invasion often features concomitant bladder cancer with a poor prognosis and requires RCU with or without systemic preoperative CHT.
Conclusions: PUC is a rare malignancy with an often poor natural course, requiring a stage- and gender-specific risk-based treatment strategy. The role of systematic perioperative CHT and the extent of surgery are becoming more important.
Patient summary: In this review, we looked at the treatment options for primary urethral cancer. We found that while an organ-confined disease can be managed with local resection, growth beyond the organ border makes a combination of different treatment modalities, such as surgery and systematic chemotherapy, necessary to improve outcomes. en-copyright= kn-copyright= en-aut-name=JanischFlorian en-aut-sei=Janisch en-aut-mei=Florian kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=AbufarajMohammad en-aut-sei=Abufaraj en-aut-mei=Mohammad kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=FajkovicHarun en-aut-sei=Fajkovic en-aut-mei=Harun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KimuraShoji en-aut-sei=Kimura en-aut-mei=Shoji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=IwataTakehiro en-aut-sei=Iwata en-aut-mei=Takehiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=NyiradyPeter en-aut-sei=Nyirady en-aut-mei=Peter kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=RinkMichael en-aut-sei=Rink en-aut-mei=Michael kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=ShariatShahrokh F. en-aut-sei=Shariat en-aut-mei=Shahrokh F. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= affil-num=1 en-affil=Department of Urology, Medical University of Vienna kn-affil= affil-num=2 en-affil=Department of Urology, Medical University of Vienna kn-affil= affil-num=3 en-affil=Department of Urology, Medical University of Vienna kn-affil= affil-num=4 en-affil=Department of Urology, Medical University of Vienna kn-affil= affil-num=5 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Urology, Semmelweis University kn-affil= affil-num=7 en-affil=Department of Urology, University Medical Center Hamburg-Eppendorf kn-affil= affil-num=8 en-affil=Department of Urology, Medical University of Vienna kn-affil= en-keyword=Disease management kn-keyword=Disease management en-keyword=Primary urethral carcinoma kn-keyword=Primary urethral carcinoma en-keyword=Prognosis kn-keyword=Prognosis en-keyword=Therapy kn-keyword=Therapy en-keyword=Treatment kn-keyword=Treatment END start-ver=1.4 cd-journal=joma no-vol=105 cd-vols= no-issue=1 article-no= start-page=107 end-page=111 dt-received= dt-revised= dt-accepted= dt-pub-year=2019 dt-pub=20190228 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Injury patterns of medial meniscus posterior root tears en-subtitle= kn-subtitle= en-abstract= kn-abstract=INTRODUCTION:
Medial meniscus posterior root tear (MMPRT) can occur in middle-aged patients who have a posteromedial painful popping during light activities. MMPRTs are more common in patients with increased age, female gender, sedentary lifestyle, obesity, and varus knee alignment. However, injury mechanisms of minor traumatic MMPRTs are still unclear. We hypothesized that high flexion activities are the major cause of MMPRTs. The aim of this study was to clarify injury patterns of MMPRTs.
MATERIALS AND METHODS:
One hundred patients were diagnosed having MMPRTs after posteromedial painful popping episodes. Details of posteromedial painful popping episode, situation of injury, and position of injured leg were obtained from the patients by careful interviews. Injury patterns were divided into 8 groups: descending knee motion, walking, squatting, standing up action, falling down, twisting, light exercise, and minor automobile accident.
RESULTS:
A descending knee motion was the most common cause of MMPRTs (38%) followed by a walking injury pattern (18%) and a squatting action related to high flexion activities of the knee (13%). The other injury patterns were less than 10%.
DISCUSSION:
Descending knee motions associated with descending stairs, step, and downhill slope are the most common injury pattern of MMPRTs. High flexion activities of the knee are not the greatest cause of MMPRTs. Our results suggest that the descending action with a low knee flexion angle may trigger minor traumatic MMPRTs. en-copyright= kn-copyright= en-aut-name=FurumatsuTakayuki en-aut-sei=Furumatsu en-aut-mei=Takayuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=Okazaki Yuki en-aut-sei=Okazaki en-aut-mei= Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=Okazaki Yoshiki en-aut-sei=Okazaki en-aut-mei= Yoshiki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=Hino Tomohito en-aut-sei=Hino en-aut-mei= Tomohito kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=Kamatsuki Yusuke en-aut-sei=Kamatsuki en-aut-mei= Yusuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=Masuda Shin en-aut-sei=Masuda en-aut-mei= Shin kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=MiyazawaShinichi en-aut-sei=Miyazawa en-aut-mei=Shinichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=Nakata Eiji en-aut-sei=Nakata en-aut-mei= Eiji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=Hasei Joe en-aut-sei=Hasei en-aut-mei= Joe kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=Kunisada Toshiyuki en-aut-sei=Kunisada en-aut-mei= Toshiyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=OzakiToshifumi en-aut-sei=Ozaki en-aut-mei=Toshifumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= affil-num=1 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School, kn-affil= affil-num=2 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School, kn-affil= affil-num=3 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School, kn-affil= affil-num=4 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School, kn-affil= affil-num=5 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School, kn-affil= affil-num=6 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School, kn-affil= affil-num=7 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School, kn-affil= affil-num=8 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School, kn-affil= affil-num=9 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School, kn-affil= affil-num=10 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School, kn-affil= affil-num=11 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School, kn-affil= en-keyword=Descending knee motion kn-keyword=Descending knee motion en-keyword=Injury pattern kn-keyword=Injury pattern en-keyword=Medial meniscus kn-keyword=Medial meniscus en-keyword=Posterior root tear kn-keyword=Posterior root tear en-keyword=Squatting kn-keyword=Squatting END start-ver=1.4 cd-journal=joma no-vol=73 cd-vols= no-issue=4 article-no= start-page=333 end-page=339 dt-received= dt-revised= dt-accepted= dt-pub-year=2019 dt-pub=201908 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=The Efficacy and Safety of Steroids for Preventing Postembolization Syndrome after Transcatheter Arterial Chemoembolization of Hepatocellular Carcinoma en-subtitle= kn-subtitle= en-abstract= kn-abstract= Steroids are often administered at the time of transcatheter arterial chemoembolization (TACE), a standard treatment of hepatocellular carcinoma (HCC), with the expectation of preventing postembolization syndrome. Here we investigated the precise effects of steroids on TACE. We prospectively enrolled 144 HCC patients from 10 hospitals who underwent TACE. Three hospitals used steroids (steroid group, n=77) and the rest did not routinely use steroids (control group, n=67). The occurrence of adverse events and the algetic degree at 1-5 days post-treatment were compared between the groups. Fever (grades 0-2) after TACE was significantly less in the steroid group (56/21/0) compared to the control group (35/29/3, p=0.005, Cochran-Armitage test for trend). The suppressive effect of steroids against fever was prominent in females (p=0.001). Vomiting (G0/G1/ G2-) was also less frequent in the steroid group (70/5/2) versus the control group (53/10/3), but not significantly (p=0.106). The algetic degree and the grade of hematological adverse events, including hyperglycemia, did not differ between the groups. We conclude that the administration of steroids was useful for the prevention of adverse events after TACE in patients with HCC. en-copyright= kn-copyright= en-aut-name=KuwakiKenji en-aut-sei=Kuwaki en-aut-mei=Kenji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=NousoKazuhiro en-aut-sei=Nouso en-aut-mei=Kazuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=MiyashitaManabi en-aut-sei=Miyashita en-aut-mei=Manabi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=MakinoYasuhiro en-aut-sei=Makino en-aut-mei=Yasuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=HagiharaHiroaki en-aut-sei=Hagihara en-aut-mei=Hiroaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=MoriyaAkio en-aut-sei=Moriya en-aut-mei=Akio kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=AdachiTakuya en-aut-sei=Adachi en-aut-mei=Takuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=WadaNozomu en-aut-sei=Wada en-aut-mei=Nozomu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=YasunakaYuki en-aut-sei=Yasunaka en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=YasunakaTetsuya en-aut-sei=Yasunaka en-aut-mei=Tetsuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=TakeuchiYasuto en-aut-sei=Takeuchi en-aut-mei=Yasuto kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=OnishiHideki en-aut-sei=Onishi en-aut-mei=Hideki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=NakamuraShinichiro en-aut-sei=Nakamura en-aut-mei=Shinichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=IkedaFusao en-aut-sei=Ikeda en-aut-mei=Fusao kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=ShirahaHidenori en-aut-sei=Shiraha en-aut-mei=Hidenori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= en-aut-name=TakakiAkinobu en-aut-sei=Takaki en-aut-mei=Akinobu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=16 ORCID= en-aut-name=OkadaHiroyuki en-aut-sei=Okada en-aut-mei=Hiroyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=17 ORCID= affil-num=1 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Gastroenterology, Iwakuni Clinical Center kn-affil= affil-num=4 en-affil=Department of Gastroenterology, Iwakuni Clinical Center kn-affil= affil-num=5 en-affil=Department of Internal Medicine, Sumitomo Besshi Hospital kn-affil= affil-num=6 en-affil=Department of Gastroenterology, Mitoyo General Hospital kn-affil= affil-num=7 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=11 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=12 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=13 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=14 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=15 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=16 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=17 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=antipyretic kn-keyword=antipyretic en-keyword=hepatocellular carcinoma kn-keyword=hepatocellular carcinoma en-keyword=therapeutic chemoembolization kn-keyword=therapeutic chemoembolization en-keyword=steroid kn-keyword=steroid END start-ver=1.4 cd-journal=joma no-vol=73 cd-vols= no-issue=3 article-no= start-page=205 end-page=211 dt-received= dt-revised= dt-accepted= dt-pub-year=2019 dt-pub=201906 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Laparoscopic Rectosigmoid Colon Vaginoplasty in Male-to-Female Transsexuals: Experience in Japan en-subtitle= kn-subtitle= en-abstract= kn-abstract= Intestinal vaginoplasty has several advantageous features, such as scarless surgery, low incidence of contraction of the reconstructed vagina, maintenance of vaginal depth, spontaneous mucus production, and a low rate of complications. Therefore, this technique is becoming popular in many countries. Following the global trend, the demand for intestinal vaginoplasty for transsexuals is also increasing in Japan. However, there are few reports on intestinal vaginoplasty in Japan. In this study, we examined the safety and effectiveness of rectosigmoid colon vaginoplasty in the Japanese population. We retrospectively surveyed 18 male-to-female transsexuals who underwent laparoscopic rectosigmoid colon vaginoplasty at the Okayama University Hospital Gender Center between October 2012 and December 2017. One patient had developed an anastomotic leak and 2 patients experienced vaginal prolapse, which needed revision surgery. Both adverse outcomes were comparable with those from previous studies. The anastomotic leak was managed adequately with conservative treatment. To avoid vaginal prolapse, it is important to decide the length of the rectosigmoid segment so that a pull on it does not cause it to become lax, while excessive stress on the feeder vessels is avoided. Based on our study, we concluded that rectosigmoid vaginoplasty was a reliable technique in the Japanese population. en-copyright= kn-copyright= en-aut-name=MukaiYuko en-aut-sei=Mukai en-aut-mei=Yuko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=SakuraiToru en-aut-sei=Sakurai en-aut-mei=Toru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=WatanabeToshiyuki en-aut-sei=Watanabe en-aut-mei=Toshiyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=SakoTomoko en-aut-sei=Sako en-aut-mei=Tomoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=SugimotoMorito en-aut-sei=Sugimoto en-aut-mei=Morito kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=KimataYoshihiro en-aut-sei=Kimata en-aut-mei=Yoshihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=MoriYoshiko en-aut-sei=Mori en-aut-mei=Yoshiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=NagasakaTakeshi en-aut-sei=Nagasaka en-aut-mei=Takeshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=NambaYuzaburo en-aut-sei=Namba en-aut-mei=Yuzaburo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= affil-num=1 en-affil=Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Urology, Onomichi Municipal Hospital kn-affil= affil-num=6 en-affil=Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Clinical Oncology, Kawasaki Medical School Hospital kn-affil= affil-num=9 en-affil=Department of Gender Center, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=vaginoplasty kn-keyword=vaginoplasty en-keyword=male-to-female transsexuals kn-keyword=male-to-female transsexuals en-keyword=rectosigmoid colon kn-keyword=rectosigmoid colon END start-ver=1.4 cd-journal=joma no-vol= cd-vols= no-issue= article-no= start-page= end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2018 dt-pub=20180323 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=性同一障害 MTF male to female当事者の性別違和感に関する記述的研究 kn-title=Descriptive Study on Gender Dysphoria in Japanese Individuals with Male Male-to-Female Gender Identity Disorder en-subtitle= kn-subtitle= en-abstract= kn-abstract= en-copyright= kn-copyright= en-aut-name=ShinoharaYoshie en-aut-sei=Shinohara en-aut-mei=Yoshie kn-aut-name=篠原好江 kn-aut-sei=篠原 kn-aut-mei=好江 aut-affil-num=1 ORCID= affil-num=1 en-affil=Graduate School of Health Sciences, Okayama University kn-affil=岡山大学大学院保健学研究科 END start-ver=1.4 cd-journal=joma no-vol=72 cd-vols= no-issue=2 article-no= start-page=143 end-page=151 dt-received= dt-revised= dt-accepted= dt-pub-year=2018 dt-pub=201804 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Descriptive Study of Gender Dysphoria in Japanese Individuals with Male-to-Female Gender Identity Disorder en-subtitle= kn-subtitle= en-abstract= kn-abstract= We focus on Japanese individuals with gender identity disorder (GID), especially male-to-female (MTF) GID, who have experienced difficulty in adapting to social life. We clarify what gender dysphoria is, and we examine methods of intervention. Semi-structured interviews were conducted with 11 individuals with MTF-GID from August 2015 to April 2017. We categorized the subjects’experiences regarding dysphoria into the ‘Onset of gender dysphoria,’ ‘Experience of feeling gender dysphoria,’ and ‘Changes due to receiving medical care.’ The subjects reported experiencing great pain and distress because they did not fully understand that they were experiencing dysphoria and could not align their gender identity and their self-identity. All subjects described their experiences of dysphoria as negative. Additionally, all said that the dysphoria was alleviated by a medical intervention such as visiting a gender clinic, receiving a diagnosis and treatment, and changing their physical sex to the sex congruent with their gender identity. The provision of information at the gender clinic and the physical changes achieved by medical intervention exerted a positive effect both mentally and socially on the subjects, who suffered various physical, mental and social problems. en-copyright= kn-copyright= en-aut-name=ShinoharaYoshie en-aut-sei=Shinohara en-aut-mei=Yoshie kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=NakatsukaMikiya en-aut-sei=Nakatsuka en-aut-mei=Mikiya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= affil-num=1 en-affil=Graduate School of Health Sciences, Okayama University kn-affil= affil-num=2 en-affil=Department of Obstetrics and Gynecology and Gender Clinic, Okayama University Hospital, kn-affil= en-keyword=gender identity disorder kn-keyword=gender identity disorder en-keyword=gender dysphoria kn-keyword=gender dysphoria en-keyword=gender identity kn-keyword=gender identity en-keyword=male to female kn-keyword=male to female END start-ver=1.4 cd-journal=joma no-vol=71 cd-vols= no-issue=5 article-no= start-page=399 end-page=405 dt-received= dt-revised= dt-accepted= dt-pub-year=2017 dt-pub=201710 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Vaginoplasty with a Pudendal-groin Flap in Male-to-female Transsexuals en-subtitle= kn-subtitle= en-abstract= kn-abstract= Many vaginoplasty techniques have been introduced to improve the outcomes of sex reassignment surgery for male-to-female transsexuals. Some vaginoplasty patients still require additional skin grafts, making dilation mandatory to overcome shrinkage. We developed a new vaginoplasty method (called the “pudendal-groin flap”) that uses pudendal-groin flaps. One of this procedure’s advantages is that skin grafts are unnecessary, even for patients with small penises and scrotums. We introduce the procedure here and describe our evaluation of its utility. We retrospectively analyzed the cases of the 15 patients who underwent vaginoplasty using pudendal-groin flaps from May 2010 to January 2016 at our institution. We compared the complications as well as the functional and aesthetic outcomes with those of previous studies. The most common complication was bleeding, which occurred at the corpus spongiosum or while creating a new vaginal cavity. Bleeding can be reduced with more careful hemostasis and dissection. Aside from inadequate vaginal depth in one patient, the incidence of other complications, sexual intercourse, and aesthetic outcomes were acceptable. The pudendal- groin flap is thin and pliable and can create sufficient vaginal depth without skin grafts. The resulting scar is inconspicuous. Our findings suggest that vaginoplasty using the pudendal-groin flap method is feasible. en-copyright= kn-copyright= en-aut-name=MukaiYuko en-aut-sei=Mukai en-aut-mei=Yuko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=WatanabeToshiyuki en-aut-sei=Watanabe en-aut-mei=Toshiyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=SugimotoMorito en-aut-sei=Sugimoto en-aut-mei=Morito kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KimataYoshihiro en-aut-sei=Kimata en-aut-mei=Yoshihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=NambaYuzaburo en-aut-sei=Namba en-aut-mei=Yuzaburo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= affil-num=1 en-affil=Department of Plastic and Reconstructive Surgery, Okayama University Hospital kn-affil= affil-num=2 en-affil=Department of Plastic and Reconstructive Surgery, Okayama University Hospital kn-affil= affil-num=3 en-affil=Department of Urology, Okayama University Hospital kn-affil= affil-num=4 en-affil=Department of Plastic and Reconstructive Surgery, Okayama University Hospital kn-affil= affil-num=5 en-affil=Department of Gender Center, Okayama University Hospital kn-affil= en-keyword=vaginoplasty kn-keyword=vaginoplasty en-keyword=male-to-female transsexuals kn-keyword=male-to-female transsexuals en-keyword=pudendal-groin flap kn-keyword=pudendal-groin flap END start-ver=1.4 cd-journal=joma no-vol=105 cd-vols= no-issue=6 article-no= start-page=812 end-page=818 dt-received= dt-revised= dt-accepted= dt-pub-year=2017 dt-pub=201706 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Predictors of vasovagal reactions during preoperative autologous blood donation: a single-institution analysis en-subtitle= kn-subtitle= en-abstract= kn-abstract= Studies examining risk factors associated with vasovagal reactions (VVRs) during autologous blood donations, especially in younger subjects, have been limited. The aim of the present study was to define risk factors for VVRs during preoperative autologous blood donation in patients, including those younger than 18 years old. We retrospectively analyzed 4192 autologous, preoperative blood donations between 2007 and 2015 at Okayama University Hospital. Eighty-seven (2.08%) of the patients experienced VVRs. VVRs occurred approximately three times as often in patients 0-17 years old (16/320, 5.0%) than in patients 18 years and older (71/3872, 1.8%). In particular, VVRs occurred more frequently in those 10-13 years old, and decreased with older age (P = 0.006). In a univariate analysis, younger age, lower body mass index, lower systolic blood pressure, lower body weight, lower total blood volume, female gender, first-time collection, and higher heart rate were associated with a higher incidence of VVRs. In a multivariate analysis, lower systolic blood pressure (P < 0.001), higher heart rate (P = 0.007), and first-time collection (P = 0.015), remained independent predictors of VVRs. These results emphasize the need for careful attention during blood collection. en-copyright= kn-copyright= en-aut-name=NishimoriHisakazu en-aut-sei=Nishimori en-aut-mei=Hisakazu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=FujiiNobuharu en-aut-sei=Fujii en-aut-mei=Nobuharu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=FujiiKeiko en-aut-sei=Fujii en-aut-mei=Keiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=IkedaTohru en-aut-sei=Ikeda en-aut-mei=Tohru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=AsanoNaomi en-aut-sei=Asano en-aut-mei=Naomi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=OgoHiroaki en-aut-sei=Ogo en-aut-mei=Hiroaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=YamakawaMiwa en-aut-sei=Yamakawa en-aut-mei=Miwa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=TakagiNaoe en-aut-sei=Takagi en-aut-mei=Naoe kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=OtsukaFumio en-aut-sei=Otsuka en-aut-mei=Fumio kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=IkedaKazuma en-aut-sei=Ikeda en-aut-mei=Kazuma kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= affil-num=1 en-affil=Department of Transfusion Medicine, Okayama University Hospital kn-affil= affil-num=2 en-affil= Department of Transfusion Medicine, Okayama University Hospital kn-affil= affil-num=3 en-affil= Department of Transfusion Medicine, Okayama University Hospital kn-affil= affil-num=4 en-affil= Department of Transfusion Medicine, Okayama University Hospital kn-affil= affil-num=5 en-affil= Department of Transfusion Medicine, Okayama University Hospital kn-affil= affil-num=6 en-affil= Department of Transfusion Medicine, Okayama University Hospital kn-affil= affil-num=7 en-affil=Department of Nursing, Okayama University Hospital kn-affil= affil-num=8 en-affil=Department of Nursing, Okayama University Hospital kn-affil= affil-num=9 en-affil=Department of Transfusion Medicine, Okayama University Hospital kn-affil= affil-num=10 en-affil=Department of Transfusion Medicine, Okayama University Hospital kn-affil= en-keyword=Autologous blood donation kn-keyword=Autologous blood donation en-keyword=Vasovagal reactions kn-keyword=Vasovagal reactions END start-ver=1.4 cd-journal=joma no-vol=45 cd-vols= no-issue=11 article-no= start-page=1172 end-page=1182 dt-received= dt-revised= dt-accepted= dt-pub-year=2010 dt-pub=201011 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Laparoscopic findings of reddish markings predict hepatocellular carcinoma in patients with hepatitis B virus-related liver disease en-subtitle= kn-subtitle= en-abstract= kn-abstract=For patients with chronic hepatitis due to hepatitis B virus (HBV), factors predicting hepatocellular carcinoma (HCC) other than high levels of HBV-DNA and alanine aminotransferase (ALT) are needed to prevent HCC development, as many patients with chronic HBV infection fulfill these conditions. The purpose of this study was to clarify factors predictive of HCC development for those patients. The study was a systematic cohort analysis of 303 consecutive patients with hepatitis B e-antigen, receiving laparoscopic examination for assessment of liver disease. Laparoscopic, histological, and clinical characteristics were investigated as related to HCC development. HCC occurred in 27 patients during a mean follow-up of 8.0 +/- A 5.0 years, at the age of 37-72 years. Significant associations with HCC development were shown for liver cirrhosis, histological activity grade, reddish markings, and older age. Multivariate analysis revealed that HCC development was strongly associated with older age and male gender (P = 0.002 and P = 0.043, respectively). HCC occurred more frequently in patients of age a parts per thousand yen30 years even with early stage than in patients of age < 30 years (P = 0.031). Severe reddish markings, a laparoscopic finding of widespread parenchymal destruction, were highly associated with HCC development in patients of age a parts per thousand yen30 years at diagnosis (odds ratio = 1.67, P = 0.034), while histological activity grade and ALT level were not (P = 0.075 and P = 0.69, respectively). HCC development is associated with older age, male gender, and liver cirrhosis. Reddish markings, rather than histological activity or ALT level, can be useful to predict HCC for HBV patients of age a parts per thousand yen30 years. en-copyright= kn-copyright= en-aut-name=ShojiBon en-aut-sei=Shoji en-aut-mei=Bon kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=IkedaFusao en-aut-sei=Ikeda en-aut-mei=Fusao kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=FujiokaShin-ichi en-aut-sei=Fujioka en-aut-mei=Shin-ichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KobashiHaruhiko en-aut-sei=Kobashi en-aut-mei=Haruhiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=YasunakaTetsuya en-aut-sei=Yasunaka en-aut-mei=Tetsuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=MiyakeYasuhiro en-aut-sei=Miyake en-aut-mei=Yasuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=ShirahaHidenori en-aut-sei=Shiraha en-aut-mei=Hidenori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=TakakiAkinobu en-aut-sei=Takaki en-aut-mei=Akinobu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=NousoKazuhiro en-aut-sei=Nouso en-aut-mei=Kazuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=IwasakiYoshiaki en-aut-sei=Iwasaki en-aut-mei=Yoshiaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=YamamotoKazuhide en-aut-sei=Yamamoto en-aut-mei=Kazuhide kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= affil-num=1 en-affil= kn-affil=Okayama Univ, Dept Gastroenterol & Hepatol, Grad Sch Med Dent & Pharmaceut Sci affil-num=2 en-affil= kn-affil=Okayama Univ, Dept Gastroenterol & Hepatol, Grad Sch Med Dent & Pharmaceut Sci affil-num=3 en-affil= kn-affil=Okayama Saiseikai Gen Hosp, Dept Internal Med affil-num=4 en-affil= kn-affil=Okayama Univ, Dept Gastroenterol & Hepatol, Grad Sch Med Dent & Pharmaceut Sci affil-num=5 en-affil= kn-affil=Okayama Univ, Dept Gastroenterol & Hepatol, Grad Sch Med Dent & Pharmaceut Sci affil-num=6 en-affil= kn-affil=Okayama Univ, Dept Gastroenterol & Hepatol, Grad Sch Med Dent & Pharmaceut Sci affil-num=7 en-affil= kn-affil=Okayama Univ, Dept Gastroenterol & Hepatol, Grad Sch Med Dent & Pharmaceut Sci affil-num=8 en-affil= kn-affil=Okayama Univ, Dept Gastroenterol & Hepatol, Grad Sch Med Dent & Pharmaceut Sci affil-num=9 en-affil= kn-affil=Okayama Univ, Dept Gastroenterol & Hepatol, Grad Sch Med Dent & Pharmaceut Sci affil-num=10 en-affil= kn-affil=Okayama Univ, Dept Gastroenterol & Hepatol, Grad Sch Med Dent & Pharmaceut Sci affil-num=11 en-affil= kn-affil=Okayama Univ, Dept Gastroenterol & Hepatol, Grad Sch Med Dent & Pharmaceut Sci en-keyword=Hepatitis B virus kn-keyword=Hepatitis B virus en-keyword=Hepatocellular carcinoma kn-keyword=Hepatocellular carcinoma en-keyword=Laparoscopy kn-keyword=Laparoscopy END start-ver=1.4 cd-journal=joma no-vol=68 cd-vols= no-issue=6 article-no= start-page=331 end-page=337 dt-received= dt-revised= dt-accepted= dt-pub-year=2014 dt-pub=201412 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Mental Health Status among Japanese Medical Students: A Cross-Sectional Survey of 20 Universities en-subtitle= kn-subtitle= en-abstract= kn-abstract=The purposes of this study were to evaluate the mental health status of Japanese medical students and to examine differences based on gender, as well as on university type and location, using the results of a nationwide survey. Between December 2006 and March 2007, we conducted a questionnaire survey among fourth-year medical students at 20 randomly selected medical schools in Japan. The data from 1,619 students (response rate:90.6%;male:1,074;female:545) were analyzed. We used the Japanese version of the 12-item General Health Questionnaire (GHQ-12) to measure mental health status. Poor mental health status (GHQ-12 score of 4 points or higher) was observed in 36.6% and 48.8% of the male and female medical students, respectively. The ratio of the age-adjusted prevalence of poor mental health status in female versus male medical students was 1.33 (95% confidence interval:1.10-1.62). The universities were categorized into two groups based on the university type (national/public:15 vs. private:5) or location (in a large city:7 vs. in a local city:13 cities). The prevalence of poor mental health status in both men and women differed between these groups, although not significantly. The GHQ-12 scores in men significantly differed between the categorized groups of universities. These results suggest that adequate attention must be paid to the mental health of medical students, especially females, and that a system for providing mental health care for medical students must be established in the context of actual conditions at each university. en-copyright= kn-copyright= en-aut-name=OhtsuTadahiro en-aut-sei=Ohtsu en-aut-mei=Tadahiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=KaneitaYoshitaka en-aut-sei=Kaneita en-aut-mei=Yoshitaka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=OsakiYoneatsu en-aut-sei=Osaki en-aut-mei=Yoneatsu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KokazeAkatsuki en-aut-sei=Kokaze en-aut-mei=Akatsuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=OchiaiHirotaka en-aut-sei=Ochiai en-aut-mei=Hirotaka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=ShirasawaTakako en-aut-sei=Shirasawa en-aut-mei=Takako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=NanriHinako en-aut-sei=Nanri en-aut-mei=Hinako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=OhidaTakashi en-aut-sei=Ohida en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= affil-num=1 en-affil= kn-affil=Department of Public Health, Showa University School of Medicine affil-num=2 en-affil= kn-affil=Department of Public Health and Epidemiology, Faculty of Medicine, Oita University affil-num=3 en-affil= kn-affil=Division of Environmental and Preventive Medicine, Department of Social Medicine, Faculty of Medicine, Tottori University affil-num=4 en-affil= kn-affil=Department of Public Health, Showa University School of Medicine affil-num=5 en-affil= kn-affil=Department of Public Health, Showa University School of Medicine affil-num=6 en-affil= kn-affil=Department of Public Health, Showa University School of Medicine affil-num=7 en-affil= kn-affil=Department of Public Health, Showa University School of Medicine affil-num=8 en-affil= kn-affil=Department of Public Health, Nihon University School of Medicine en-keyword=medical students kn-keyword=medical students en-keyword=mental health kn-keyword=mental health en-keyword=12-item General Health Questionnaire kn-keyword=12-item General Health Questionnaire en-keyword=gender difference kn-keyword=gender difference en-keyword=Japan kn-keyword=Japan END start-ver=1.4 cd-journal=joma no-vol=9 cd-vols= no-issue=1 article-no= start-page= end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2014 dt-pub=20140131 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=The Bright Side and Dark Side of Workplace Social Capital: Opposing Effects of Gender on Overweight among Japanese Employees en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background: A growing number of studies have sought to examine the health associations of workplace social capital; however, evidence of associations with overweight is sparse. We examined the association between individual perceptions of workplace social capital and overweight among Japanese male and female employees. Methodology/Principal Findings: We conducted a cross-sectional survey among full-time employees at a company in Osaka prefecture in February 2012. We used an 8-item measure to assess overall and sub-dimensions of workplace social capital, divided into tertiles. Of 1050 employees, 849 responded, and 750 (624 men and 126 women) could be linked to annual health check-up data in the analysis. Binomial logistic regression models were used to calculate odds ratios and 95% confidence intervals for overweight (body mass index: >= 25 kg/m(2), calculated from measured weight and height) separately for men and women. The prevalence of overweight was 24.5% among men and 14.3% among women. Among men, low levels of bonding and linking social capital in the workplace were associated with a nearly 2-fold risk of overweight compared to high corresponding dimensions of social capital when adjusted for age, sleep hours, physiological distress, and lifestyle. In contrast, among women we found lower overall and linking social capital to be associated with lower odds for overweight even after covariate adjustment. Subsequently, we used multinomial logistic regression analyses to assess the relationships between a 1 standard deviation (SD) decrease in mean social capital and odds of underweight/overweight relative to normal weight. Among men, a 1-SD decrease in overall, bonding, and linking social capital was significantly associated with higher odds of overweight, but not with underweight. Among women, no significant associations were found for either overweight or underweight. Conclusions/Significance: We found opposite gender relationships between perceived low linking workplace social capital and overweight among Japanese employees. en-copyright= kn-copyright= en-aut-name=KobayashiTomoko en-aut-sei=Kobayashi en-aut-mei=Tomoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=SuzukiEtsuji en-aut-sei=Suzuki en-aut-mei=Etsuji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=OksanenTuula en-aut-sei=Oksanen en-aut-mei=Tuula kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KawachiIchiro en-aut-sei=Kawachi en-aut-mei=Ichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=TakaoSoshi en-aut-sei=Takao en-aut-mei=Soshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= affil-num=1 en-affil= kn-affil=Okayama Univ, Dept Epidemiol, Grad Sch Med Dent & Pharmaceut Sci affil-num=2 en-affil= kn-affil=Okayama Univ, Dept Epidemiol, Grad Sch Med Dent & Pharmaceut Sci affil-num=3 en-affil= kn-affil=Finnish Inst Occupat Hlth, Ctr Expertise Dev Work & Org affil-num=4 en-affil= kn-affil=Harvard Univ, Sch Med, Dept Social & Behav Sci affil-num=5 en-affil= kn-affil=Okayama Univ, Dept Epidemiol, Grad Sch Med Dent & Pharmaceut Sci END start-ver=1.4 cd-journal=joma no-vol=60 cd-vols= no-issue=12 article-no= start-page=1321 end-page=1327 dt-received= dt-revised= dt-accepted= dt-pub-year=2013 dt-pub=201312 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Testosterone replacement elevates the serum uric acid levels in patients with female to male gender identity disorder en-subtitle= kn-subtitle= en-abstract= kn-abstract=Gender identity disorder (GID) results from a disagreement between a person's biological sex and the gender to which he or she identifies. With respect to the treatment of female to male GID, testosterone replacement therapy (TRT) is available. The uric acid (UA) level can be influenced by testosterone; however, the early effects and dose-dependency of TRT on the serum UA concentration have not been evaluated in this population. We herein conducted a dose-response analysis of TRT in 160 patients with female to male GID. The TRT consisted of three treatment groups who received intramuscular injections of testosterone enanthate: 125 mg every two weeks, 250 mg every three weeks and 250 mg every two weeks. Consequently, serum UA elevation was observed after three months of TRT and there was a tendency toward testosterone dose-dependency. The onset of hyperuricemia was more prevalent in the group who received the higher dose. We also demonstrated a positive correlation between increased levels of serum UA and serum creatinine. Since the level of serum creatinine represents an individual's muscle volume and the muscle is a major source of purine, which induces UA upregulation, the serum UA elevation observed during TRT is at least partially attributed to an increase in muscle mass. This is the first study showing an association between serum UA elevation and a TRT-induced increase in muscle mass. The current study provides important information regarding TRT for the follow-up and management of the serum UA levels in GID patients. en-copyright= kn-copyright= en-aut-name=KurahashiHiroaki en-aut-sei=Kurahashi en-aut-mei=Hiroaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=WatanabeMasami en-aut-sei=Watanabe en-aut-mei=Masami kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=SugimotoMorito en-aut-sei=Sugimoto en-aut-mei=Morito kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=AriyoshiYuichi en-aut-sei=Ariyoshi en-aut-mei=Yuichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=MahmoodSabina en-aut-sei=Mahmood en-aut-mei=Sabina kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=ArakiMotoo en-aut-sei=Araki en-aut-mei=Motoo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=IshiiKazushi en-aut-sei=Ishii en-aut-mei=Kazushi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=NasuYasutomo en-aut-sei=Nasu en-aut-mei=Yasutomo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=NagaiAtsushi en-aut-sei=Nagai en-aut-mei=Atsushi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=KumonHiromi en-aut-sei=Kumon en-aut-mei=Hiromi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= affil-num=1 en-affil= kn-affil=Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Dept Urol affil-num=2 en-affil= kn-affil=Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Dept Urol affil-num=3 en-affil= kn-affil=Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Dept Urol affil-num=4 en-affil= kn-affil=Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Dept Urol affil-num=5 en-affil= kn-affil=Okayama Univ, Okayama Univ Hosp, Ctr Innovat Clin Med affil-num=6 en-affil= kn-affil=Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Dept Urol affil-num=7 en-affil= kn-affil=Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Dept Urol affil-num=8 en-affil= kn-affil=Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Dept Urol affil-num=9 en-affil= kn-affil=Kawasaki Med Univ, Dept Urol affil-num=10 en-affil= kn-affil=Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Dept Urol en-keyword=Gender identity disorder kn-keyword=Gender identity disorder en-keyword=Testosterone kn-keyword=Testosterone en-keyword=Uric acid kn-keyword=Uric acid en-keyword=Creatinine kn-keyword=Creatinine en-keyword=Muscle kn-keyword=Muscle END start-ver=1.4 cd-journal=joma no-vol=68 cd-vols= no-issue=1 article-no= start-page=17 end-page=22 dt-received= dt-revised= dt-accepted= dt-pub-year=2014 dt-pub=201402 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Impact of Comorbid Hepatic Steatosis on Treatment of Chronic Hepatitis C in Japanese Patients and the Relationship with Genetic Polymorphism of IL28B, PNPLA3 and LDL Receptor en-subtitle= kn-subtitle= en-abstract= kn-abstract=The impact of hepatic steatosis on interferon therapy for patients with chronic hepatitis C (CHC) has been associated with single-nucleotide polymorphisms (SNP) of IL28B, patatin-like phospholipase domain-containing protein 3 (PNPLA3), and low-density lipoprotein (LDL) receptor. Whether this holds true for Japanese patients, however, remains unresolved. The present study prospectively enrolled 226 Japanese patients with CHC, and investigated the impact of hepatic steatosis and its related SNPs, including rs8099917 of IL28B, rs738409 of PNPLA3, and rs14158 of LDL receptor, on outcomes of peg-interferon and ribavirin therapy. In multivariate logistic regression analysis, significant factors affecting the severity of hepatic steatosis were high body mass index and the minor alleles of IL28B SNP (p＝0.020 and 0.039, respectively). The risk alleles of PNPLA3 SNP also showed weak association (p＝0.059). Severe steatosis and the minor alleles of IL28B SNP were significantly associated with null or partial virological response in patients with HCV genotype 1, as were female gender, and low LDL cholesterol (p＝0.049, and ＜0.001, respectively). The SNP genotype of PNPLA3 and LDL receptor did not have a significant impact on therapeutic outcomes. With respect to the SNP sites examined, the SNP of PNPLA3 has a weak association with severe hepatic steatosis, but not with the outcome of interferon therapy. en-copyright= kn-copyright= en-aut-name=MoritouYuki en-aut-sei=Moritou en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=IkedaFusao en-aut-sei=Ikeda en-aut-mei=Fusao kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=IwasakiYoshiaki en-aut-sei=Iwasaki en-aut-mei=Yoshiaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=BabaNobuyuki en-aut-sei=Baba en-aut-mei=Nobuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=TakaguchiKouichi en-aut-sei=Takaguchi en-aut-mei=Kouichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=SenohTomonori en-aut-sei=Senoh en-aut-mei=Tomonori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=NaganoTakuya en-aut-sei=Nagano en-aut-mei=Takuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=TakeuchiYasuto en-aut-sei=Takeuchi en-aut-mei=Yasuto kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=YasunakaTetsuya en-aut-sei=Yasunaka en-aut-mei=Tetsuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=OhnishiHideki en-aut-sei=Ohnishi en-aut-mei=Hideki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=MiyakeYasuhiro en-aut-sei=Miyake en-aut-mei=Yasuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=TakakiAkinobu en-aut-sei=Takaki en-aut-mei=Akinobu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=NousoKazuhiro en-aut-sei=Nouso en-aut-mei=Kazuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=YamamotoKazuhide en-aut-sei=Yamamoto en-aut-mei=Kazuhide kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= affil-num=1 en-affil= kn-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=2 en-affil= kn-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=3 en-affil= kn-affil=Health Service Center, Okayama University affil-num=4 en-affil= kn-affil=Department of Internal Medicine, Kagawa Prefectural Central Hospital affil-num=5 en-affil= kn-affil=Department of Internal Medicine, Kagawa Prefectural Central Hospital affil-num=6 en-affil= kn-affil=Department of Internal Medicine, Kagawa Prefectural Central Hospital affil-num=7 en-affil= kn-affil=Department of Internal Medicine, Kagawa Prefectural Central Hospital affil-num=8 en-affil= kn-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=9 en-affil= kn-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=10 en-affil= kn-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=11 en-affil= kn-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=12 en-affil= kn-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=13 en-affil= kn-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=14 en-affil= kn-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences en-keyword=hepatic steatosis kn-keyword=hepatic steatosis en-keyword=genetic polymorphism kn-keyword=genetic polymorphism en-keyword=interferon kn-keyword=interferon en-keyword=HCV kn-keyword=HCV END start-ver=1.4 cd-journal=joma no-vol=44 cd-vols= no-issue=9 article-no= start-page=1000 end-page=1006 dt-received= dt-revised= dt-accepted= dt-pub-year=2009 dt-pub=200909 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Mortality rate of patients with asymptomatic primary biliary cirrhosis diagnosed at age 55 years or older is similar to that of the general population en-subtitle= kn-subtitle= en-abstract= kn-abstract=Recent routine testing for liver function and anti-mitochondrial antibodies has increased the number of newly diagnosed patients with primary biliary cirrhosis (PBC). This study investigated the prognosis of asymptomatic PBC patients, focusing on age difference, to clarify its effect on the prognosis of PBC patients. The study was a systematic cohort analysis of 308 consecutive patients diagnosed with asymptomatic PBC. We compared prognosis between the elderly (55 years or older at the time of diagnosis) and the young patients (< 55 years). The mortality rate of the patients was also compared with that of an age- and gender-matched general population. The elderly patients showed a higher aspartate aminotransferase-to-platelet ratio, and lower alanine aminotransferase level than the young patients (P < 0.01 and P = 0.03, respectively). The two groups showed similar values for alkaline phosphatase and immunoglobulin M. Death in the young patients was more likely to be due to liver failure (71%), while the elderly were likely to die from other causes before the occurrence of liver failure (88%; P < 0.01), especially from malignancies (35%). The mortality rate of the elderly patients was not different from that of the age- and gender-matched general population (standardized mortality ratio, 1.1; 95% confidence interval, 0.6-1.7), although this rate was significantly higher than that of the young patients (P = 0.044). PBC often presents as more advanced disease in elderly patients than in the young. However, the mortality rate of the elderly patients is not different from that of an age- and gender-matched general population. en-copyright= kn-copyright= en-aut-name=KubotaJunichi en-aut-sei=Kubota en-aut-mei=Junichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=IkedaFusao en-aut-sei=Ikeda en-aut-mei=Fusao kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=TeradaRyo en-aut-sei=Terada en-aut-mei=Ryo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KobashiHaruhiko en-aut-sei=Kobashi en-aut-mei=Haruhiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=FujiokaShin-ichi en-aut-sei=Fujioka en-aut-mei=Shin-ichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=OkamotoRyoichi en-aut-sei=Okamoto en-aut-mei=Ryoichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=BabaShinsuke en-aut-sei=Baba en-aut-mei=Shinsuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=MorimotoYouichi en-aut-sei=Morimoto en-aut-mei=Youichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=AndoMasaharu en-aut-sei=Ando en-aut-mei=Masaharu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=MakinoYasuhiro en-aut-sei=Makino en-aut-mei=Yasuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=TaniguchiHideaki en-aut-sei=Taniguchi en-aut-mei=Hideaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=YasunakaTetsuya en-aut-sei=Yasunaka en-aut-mei=Tetsuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=MiyakeYasuhiro en-aut-sei=Miyake en-aut-mei=Yasuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=IwasakiYoshiaki en-aut-sei=Iwasaki en-aut-mei=Yoshiaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=YamamotoKazuhide en-aut-sei=Yamamoto en-aut-mei=Kazuhide kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= affil-num=1 en-affil= kn-affil=Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Dept Gastroenterol & Hepatol affil-num=2 en-affil= kn-affil=Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Dept Gastroenterol & Hepatol affil-num=3 en-affil= kn-affil=Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Dept Gastroenterol & Hepatol affil-num=4 en-affil= kn-affil=Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Dept Gastroenterol & Hepatol affil-num=5 en-affil= kn-affil=Okayama Saiseikai Gen Hosp, Dept Internal Med affil-num=6 en-affil= kn-affil=Hiroshima City Hosp, Dept Internal Med affil-num=7 en-affil= kn-affil=Kagawa Prefectural Cent Hosp, Dept Internal Med affil-num=8 en-affil= kn-affil=Fukuyama City Hosp, Dept Internal Med affil-num=9 en-affil= kn-affil=Mitoyo Gen Hosp, Dept Internal Med affil-num=10 en-affil= kn-affil=Natl Hosp Org Iwakuni Clin Ctr, Dept Gastroenterol affil-num=11 en-affil= kn-affil=Sumitomo Besshi Hosp, Dept Internal Med affil-num=12 en-affil= kn-affil=Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Dept Gastroenterol & Hepatol affil-num=13 en-affil= kn-affil=Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Dept Gastroenterol & Hepatol affil-num=14 en-affil= kn-affil=Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Dept Gastroenterol & Hepatol affil-num=15 en-affil= kn-affil=Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Dept Gastroenterol & Hepatol en-keyword=Primary biliary cirrhosis kn-keyword=Primary biliary cirrhosis en-keyword=Age difference kn-keyword=Age difference en-keyword=Mortality rate kn-keyword=Mortality rate END start-ver=1.4 cd-journal=joma no-vol= cd-vols= no-issue= article-no= start-page= end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2013 dt-pub=20130201 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Comparison of serum ferritin and oxidative stress biomarkers between Japanese workers with and without metabolic syndrome en-subtitle= kn-subtitle= en-abstract= kn-abstract=Objective Metabolic syndrome (MS) is closely associated to life-style and is characterized by central obesity causing severe diseases such as diabetes mellitus (DM) or atherosclerosis. This study investigates the role of oxidative stress and inflammation in MS. Subjects Total of 685 workers stratified by gender (293 men and 392 women) with a mean age of 41.2 ± 10.4 in different offices in a city in Japan. Methods Fasting blood and urine tests for MS, oxidative and/or inflammatory biomarker analysis and blood pressure (BP) measurement were performed. MS was defined on the basis of the Japanese criterion. Results Serum ferritin and urinary hydrogen peroxide (H2O2) levels were significantly higher in subjects with MS than those without. Ferritin was positively correlated with 8-hydroxy-2′-deoxyguanosine (8-OHdG) in all subjects and it was negatively correlated with 8-isoprostane and H2O2 in men. In addition, there was a significant positive correlation between ferritin and homeostasis model assessment (HOMA-R) in men. By using multiple regression analysis, ferritin was closely correlated with HOMA-R, γ-GT, 8-OHdG, smoking value and amount of alcohol ingestion in men, and it was correlated with 8-OHdG, γ-GT, HOMA-R in women under 50 years old. Conclusions Ferritin is a useful marker of MS including insulin resistance, reflecting the importance of oxidative stress as a cause of MS, especially in men. en-copyright= kn-copyright= en-aut-name=IwanagaSuketaka en-aut-sei=Iwanaga en-aut-mei=Suketaka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=SakanoNoriko en-aut-sei=Sakano en-aut-mei=Noriko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=TaketaKazuhisa en-aut-sei=Taketa en-aut-mei=Kazuhisa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=TakahashiNoriko en-aut-sei=Takahashi en-aut-mei=Noriko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=WangDa-Hong en-aut-sei=Wang en-aut-mei=Da-Hong kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=TakahashiHidekazu en-aut-sei=Takahashi en-aut-mei=Hidekazu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=KuboMasayuki en-aut-sei=Kubo en-aut-mei=Masayuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=MiyatakeNobuyuki en-aut-sei=Miyatake en-aut-mei=Nobuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=OginoKeiki en-aut-sei=Ogino en-aut-mei=Keiki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= affil-num=1 en-affil= kn-affil=Department of Public Health, Faculty of Medicine, Kyoto University affil-num=2 en-affil= kn-affil=Department of Hygiene, Faculty of Medicine, Kagawa University affil-num=3 en-affil= kn-affil=Geriatric Health Service Facility, Niwanosato Home affil-num=4 en-affil= kn-affil=Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=5 en-affil= kn-affil=Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=6 en-affil= kn-affil=Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=7 en-affil= kn-affil=Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=8 en-affil= kn-affil=Department of Hygiene, Faculty of Medicine, Kagawa University affil-num=9 en-affil= kn-affil=Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences en-keyword=Oxidative stress kn-keyword=Oxidative stress en-keyword=Ferritin kn-keyword=Ferritin en-keyword=8-Hydroxy-2′-deoxyguanosine (8-OHdG) kn-keyword=8-Hydroxy-2′-deoxyguanosine (8-OHdG) en-keyword=Hydrogen peroxide (H2O2) kn-keyword=Hydrogen peroxide (H2O2) en-keyword=Metabolic syndrome kn-keyword=Metabolic syndrome END start-ver=1.4 cd-journal=joma no-vol=7 cd-vols= no-issue=12 article-no= start-page= end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2012 dt-pub=20121213 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Developmental Trajectories of Body Mass Index Among Japanese Children and Impact of Maternal Factors during Pregnancy en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background The aims of this study were to 1) determine the distinct patterns of body mass index (BMI) trajectories in Japanese children, and 2) elucidate the maternal factors during pregnancy, which contribute to the determination of those patterns. Methodology/Principal Findings All of the children (1,644 individuals) born in Koshu City, Japan, between 1991 and 1998 were followed in a longitudinal study exploring the subjects’ BMI. The BMI was calculated 11 times for each child between birth and 12 years of age. Exploratory latent class growth analyses were conducted to identify trajectory patterns of the BMI z-scores. The distribution of BMI trajectories were best characterized by a five-group model for boys and a six-group model for girls. The groups were named “stable thin,” “stable average,” “stable high average,” “progressive overweight,” and “progressive obesity” in both sexes; girls were allocated to an additional group called “progressive average.” Multinomial logistic regression found that maternal weight, smoking, and skipping breakfast during pregnancy were associated with children included in the progressive obesity pattern rather than the stable average pattern. These associations were stronger for boys than for girls. Conclusions/Significance Multiple developmental patterns in Japanese boys and girls were identified, some of which have not been identified in Western countries. Maternal BMI and some unfavorable behaviors during early pregnancy may impact a child’s pattern of body mass development. Further studies to explain the gender and regional differences that were identified are warranted, as these may be important for early life prevention of weight-associated health problems. en-copyright= kn-copyright= en-aut-name=HagaChiyori en-aut-sei=Haga en-aut-mei=Chiyori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=KondoNaoki en-aut-sei=Kondo en-aut-mei=Naoki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=SuzukiKohta en-aut-sei=Suzuki en-aut-mei=Kohta kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=SatoMiri en-aut-sei=Sato en-aut-mei=Miri kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=AndoDaisuke en-aut-sei=Ando en-aut-mei=Daisuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=YokomichiHiroshi en-aut-sei=Yokomichi en-aut-mei=Hiroshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=TanakaTaichiro en-aut-sei=Tanaka en-aut-mei=Taichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=YamagataZentaro en-aut-sei=Yamagata en-aut-mei=Zentaro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= affil-num=1 en-affil= kn-affil=Univ Yamanashi, Interdisciplinary Grad Sch Med & Engn, Dept Hlth Sci affil-num=2 en-affil= kn-affil=Univ Yamanashi, Interdisciplinary Grad Sch Med & Engn, Dept Hlth Sci affil-num=3 en-affil= kn-affil=Univ Yamanashi, Interdisciplinary Grad Sch Med & Engn, Dept Hlth Sci affil-num=4 en-affil= kn-affil=Univ Yamanashi, Interdisciplinary Grad Sch Med & Engn, Dept Hlth Sci affil-num=5 en-affil= kn-affil=Natl Def Acad, Dept Phys Educ affil-num=6 en-affil= kn-affil=Univ Yamanashi, Interdisciplinary Grad Sch Med & Engn, Dept Hlth Sci affil-num=7 en-affil= kn-affil=Toho Univ, Fac Med, Dept Environm & Occupat Hlth affil-num=8 en-affil= kn-affil=Univ Yamanashi, Interdisciplinary Grad Sch Med & Engn, Dept Hlth Sci END start-ver=1.4 cd-journal=joma no-vol=67 cd-vols= no-issue=1 article-no= start-page=45 end-page=53 dt-received= dt-revised= dt-accepted= dt-pub-year=2013 dt-pub=201302 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=A Prospective Study of Long-term Outcomes in Female Patients with Nonalcoholic Steatohepatitis Using Age- and Body Mass Index-matched Cohorts en-subtitle= kn-subtitle= en-abstract= kn-abstract=In patients with nonalcoholic steatohepatitis (NASH), the prevalence of cirrhosis is higher among women than men, and hepatocellular carcinoma (HCC) develops mainly in the cirrhotic stage among women. However, the long-term outcomes in female patients with NASH have not been fully elucidated, and age, gender and BMI were not simultaneously adjusted in previous studies on the prognosis of NASH. To elucidate the outcomes in female patients with NASH, we prospectively compared NASH patients with advanced fibrosis (advanced NASH) with hepatitis C virus-related advanced fibrosis (advanced CHC) patients and NASH patients with mild fibrosis (mild NASH) using study cohorts that were adjusted for body mass index (BMI) in addition to age. The median follow-up period was 92.5 months. Liver-related complication-free survival was significantly reduced in the advanced NASH group compared to the mild NASH group. No liver-related complications developed in the mild NASH group. The overall survival, liver-related complication- and cardiovascular/cerebrovascular disease-free survival were not significantly different between the advanced NASH and CHC groups. Female patients with NASH and advanced fibrosis may have a less favorable prognosis for liver-related complications than the matched cohorts with NASH and mild fibrosis, but may have a similar prognosis to the matched cohorts with CHC. en-copyright= kn-copyright= en-aut-name=HashizumeHiroaki en-aut-sei=Hashizume en-aut-mei=Hiroaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=SatoKen en-aut-sei=Sato en-aut-mei=Ken kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=YamazakiYuichi en-aut-sei=Yamazaki en-aut-mei=Yuichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=HoriguchiNorio en-aut-sei=Horiguchi en-aut-mei=Norio kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=KakizakiSatoru en-aut-sei=Kakizaki en-aut-mei=Satoru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=MoriMasatomo en-aut-sei=Mori en-aut-mei=Masatomo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= affil-num=1 en-affil= kn-affil=Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine affil-num=2 en-affil= kn-affil=Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine affil-num=3 en-affil= kn-affil=Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine affil-num=4 en-affil= kn-affil=Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine affil-num=5 en-affil= kn-affil=Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine affil-num=6 en-affil= kn-affil=Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine en-keyword=nonalcoholic steatohepatitis kn-keyword=nonalcoholic steatohepatitis en-keyword=chronic hepatitis C kn-keyword=chronic hepatitis C en-keyword=prognosis kn-keyword=prognosis en-keyword=female kn-keyword=female END start-ver=1.4 cd-journal=joma no-vol=124 cd-vols= no-issue=1 article-no= start-page=41 end-page=45 dt-received= dt-revised= dt-accepted= dt-pub-year=2012 dt-pub=20120401 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Current state and challenges of Japanese medical education kn-title=医療人育成の現況と課題 en-subtitle= kn-subtitle= en-abstract= kn-abstract= en-copyright= kn-copyright= en-aut-name=KataokaHitomi U en-aut-sei=Kataoka en-aut-mei=Hitomi U kn-aut-name=片岡仁美 kn-aut-sei=片岡 kn-aut-mei=仁美 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科　地域医療人材育成 en-keyword=医学教育 kn-keyword=医学教育 en-keyword=地域医療教育 kn-keyword=地域医療教育 en-keyword=女性医師支援 kn-keyword=女性医師支援 en-keyword=プロフェッショナリズム kn-keyword=プロフェッショナリズム en-keyword=empathy kn-keyword=empathy END start-ver=1.4 cd-journal=joma no-vol=65 cd-vols= no-issue=6 article-no= start-page=379 end-page=385 dt-received= dt-revised= dt-accepted= dt-pub-year=2011 dt-pub=201112 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Clinical Features of Acute Myocardial Infarction in Elderly Patients en-subtitle= kn-subtitle= en-abstract= kn-abstract=The aim of this study was to clarify the prevalence of coronary risk factors in order to characterize the prognostic factors in elderly patients and to also identify any factors beneficial for the prevention of further cardiac events and death. We studied 888 patients with ST-elevation acute myocardial infarction who were admitted within 48h of symptom onset. The patients were divided into 3 groups according to age for comparison of variables:a younger group (n＝99) aged＜50, a middle-aged group (n＝435)＞51 years but＜70 years and an elderly group (n＝354) aged＞71 years. The elderly group had higher rates of female gender, pulmonary congestion, in-hospital mortality, and atrial fibrillation and a higher plasma concentration of high-sensitivity CRP (hs-CRP) (p＜0.05). Hypertension, diabetes mellitus, and dyslipidemia were more common in the middle-aged group (p＜0.05). The prevalence of smokers and the plasma level of total cholesterol, LDL-cholesterol and triglycerides were lower in the elderly group (p＜0.05). The grade of collateral circulation was highest in the elderly group, but the success rate of reperfusion therapy was lowest. Multiple regression analysis showed that age, pulmonary congestion, CKD and hs-CRP were predictors of in-hospital mortality.This investigation indicated that elderly patients with acute myocardial infarction have different clinical characteristics than younger patients. A specific algorithm might be needed in elderly patients, and could use hs-CRP, eGFR and atrial fibrillation as factors. en-copyright= kn-copyright= en-aut-name=ShirakiTeruo en-aut-sei=Shiraki en-aut-mei=Teruo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=SaitoDaiji en-aut-sei=Saito en-aut-mei=Daiji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= affil-num=1 en-affil= kn-affil=Department of Cardiology, Iwakuni Clinical Center, National Hospital Organization affil-num=2 en-affil= kn-affil=Department of Cardiology, Iwakuni Clinical Center, National Hospital Organization en-keyword=acute myocardial infarction kn-keyword=acute myocardial infarction en-keyword=coronary risk factor kn-keyword=coronary risk factor en-keyword=elderly kn-keyword=elderly END start-ver=1.4 cd-journal=joma no-vol=64 cd-vols= no-issue=4 article-no= start-page=225 end-page=232 dt-received= dt-revised= dt-accepted= dt-pub-year=2010 dt-pub=201008 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=General Consumer Awareness of Warnings Regarding the Consumption of Alcoholic Beverages en-subtitle= kn-subtitle= en-abstract= kn-abstract=Over the past two decades, the liquor industry in Japan has strived to address alcohol-related problems through initiatives such as warnings in the various media. In this study, we conducted an Internet-based questionnaire survey to examine general consumer awareness of such warnings, and the media by which they are conveyed, on the consumption of alcoholic beverages. A total of 985 subjects (males:487, females:498) in age groups ranging from 20s to 70s responded (response rate:22.4%). The awareness rates for warnings regarding underage drinking, drunk driving, and drinking during pregnancy, and those for messages encouraging moderation in drinking, were 96.4%, 83.7%, 59.6%, and 45.5%, respectively. Logistic regression analysis adjusted for habitual alcohol consumption demonstrated significant gender- and/or age-based differences in the rates of awareness of warnings and the media publicizing them. For example, the odds ratio of awareness among women of warnings against underage drinking was significantly higher than that of awareness among men. Issues that must be addressed in the future include:(1) increasing public awareness about messages regarding drinking during pregnancy and drinking in moderation;(2) reviewing the wording of warnings to make them more effective;and (3) devising and employing, on a regular basis, more effective means of transmitting messages in consideration of gender and age. en-copyright= kn-copyright= en-aut-name=OhtsuTadahiro en-aut-sei=Ohtsu en-aut-mei=Tadahiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=KokazeAkatsuki en-aut-sei=Kokaze en-aut-mei=Akatsuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=ShimadaNaoki en-aut-sei=Shimada en-aut-mei=Naoki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KaneitaYoshitaka en-aut-sei=Kaneita en-aut-mei=Yoshitaka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=ShirasawaTakako en-aut-sei=Shirasawa en-aut-mei=Takako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=OchiaiHirotaka en-aut-sei=Ochiai en-aut-mei=Hirotaka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=HoshinoHiromi en-aut-sei=Hoshino en-aut-mei=Hiromi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=TakaishiMasahiro en-aut-sei=Takaishi en-aut-mei=Masahiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= affil-num=1 en-affil= kn-affil=Department of Public Health, School of Medicine, Showa University affil-num=2 en-affil= kn-affil=Department of Public Health, School of Medicine, Showa University affil-num=3 en-affil= kn-affil=Department of Public Health, School of Medicine, Showa University affil-num=4 en-affil= kn-affil=Department of Public Health, School of Medicine, Nihon University affil-num=5 en-affil= kn-affil=Department of Public Health, School of Medicine, Showa University affil-num=6 en-affil= kn-affil=Department of Public Health, School of Medicine, Showa University affil-num=7 en-affil= kn-affil=Department of Public Health, School of Medicine, Showa University affil-num=8 en-affil= kn-affil=Department of Preventive Medicine and Public Health en-keyword=alcoholic beverages kn-keyword=alcoholic beverages en-keyword=warnings kn-keyword=warnings en-keyword=consumer awareness kn-keyword=consumer awareness en-keyword=Internet-based survey kn-keyword=Internet-based survey END start-ver=1.4 cd-journal=joma no-vol=144 cd-vols= no-issue= article-no= start-page=75 end-page=83 dt-received= dt-revised= dt-accepted= dt-pub-year=2010 dt-pub=20100625 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=A Gender-Based Study of Word-Pairs in Richardson's Pamela kn-title=RichardsonのPamelaにおける性差に基づく対語について en-subtitle= kn-subtitle= en-abstract= kn-abstract=English has a multitude of word-pairs based on gender differences. In their usage, however, many of the paired words have not been treated equally in a strict sense as can typically be seen in the case of 'man' and 'woman.' The present article discusses the most basic issue of masculine and feminine tenns mainly through a historical perspective. Our linguistic material here is Samuel Richardson's Pamela (1740) which offers good examples to show gender and class differences of address forms; for its theme concerns a maid-servant's conflict against her master and his equals. We hope to explore the author's social attitudes reflected in his choice of gender-specific words. en-copyright= kn-copyright= en-aut-name=WakimotoKyoko en-aut-sei=Wakimoto en-aut-mei=Kyoko kn-aut-name=脇本恭子 kn-aut-sei=脇本 kn-aut-mei=恭子 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学大学院教育学研究科社会･言語教育学系英語教育講座 en-keyword=対語 kn-keyword=対語 en-keyword=ジェンダー kn-keyword=ジェンダー en-keyword=pamela kn-keyword=pamela en-keyword=呼称 kn-keyword=呼称 en-keyword=18世紀 kn-keyword=18世紀 END start-ver=1.4 cd-journal=joma no-vol=19 cd-vols= no-issue=3 article-no= start-page=465 end-page=475 dt-received= dt-revised= dt-accepted= dt-pub-year=2003 dt-pub=20038 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Effects of an increase in patient copayments on medical service demands of the insured in japan en-subtitle= kn-subtitle= en-abstract= kn-abstract=

Objectives:To examine quantitatively the effects of an increase in patient copayments from 10% to 20% on the demand for medical services in Japan.
Methods: The subjects of the study were the employees insured by the 1,797 health insurance societies, belonging to the National Federation of Health Insurance Societies, in 1996 and 1998. Indicators of medical service demands analyzed include the inpatient, outpatient, and dental case rates, the number of serviced days per case, the medical cost per day and the medical cost per insured.
Results: When the effects of an increase in patient copayments from 10% to 20% were evaluated, taking into account the average age, the average monthly salary, the total number, the gender (male-tofemale) ratio and the dependent ratio of the insured, the estimated change in the case rate was −6.96% for inpatient, −4.79% for outpatient, and −5.77% for dental care. The estimated change in the number of serviced day per case was −4.66% for inpatient, −5.67% for outpatient, and −1.82% for dental care. The estimated change in the medical cost per day was −3.15% for inpatient, −13.00% for outpatient, and −11.48% for dental care. The estimated change in the medical cost per insured was −14.08% for inpatient, −21.54% for outpatient, and −18.11% for dental care.
Conclusions: The increase in patient copayments from 10% to 20% enabled insurers to substantially reduce medical costs by cost shifting from the insurer to the insured, with resultant changes in the case rate and the number of service days per case.

en-copyright= kn-copyright= en-aut-name=BabazonoAkira en-aut-sei=Babazono en-aut-mei=Akira kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=TsudaToshihide en-aut-sei=Tsuda en-aut-mei=Toshihide kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=YamamotoEiji en-aut-sei=Yamamoto en-aut-mei=Eiji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=MinoYoshio en-aut-sei=Mino en-aut-mei=Yoshio kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=UneHiroshi en-aut-sei=Une en-aut-mei=Hiroshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=HillmanAlan L. en-aut-sei=Hillman en-aut-mei=Alan L. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= affil-num=1 en-affil= kn-affil=Kyushu University affil-num=2 en-affil= kn-affil=Okayama University affil-num=3 en-affil= kn-affil=Okayama University of Science affil-num=4 en-affil= kn-affil=Osaka Prefecture University affil-num=5 en-affil= kn-affil=Fukuoka University affil-num=6 en-affil= kn-affil=University of Pennsylvania, US en-keyword=Copayments kn-keyword=Copayments en-keyword=Health insurance kn-keyword=Health insurance en-keyword=Health policy kn-keyword=Health policy en-keyword=Japan kn-keyword=Japan END start-ver=1.4 cd-journal=joma no-vol=126B cd-vols= no-issue=1 article-no= start-page=43 end-page=45 dt-received= dt-revised= dt-accepted= dt-pub-year=2004 dt-pub=20040401 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Association between the Glutathione S-transferase M1 gene deletion and female methamphetamine abusers en-subtitle= kn-subtitle= en-abstract= kn-abstract=Several lines of evidence suggest that increased generation of auto-oxidized dopamine (DA) o-quinone is associated with the neurotoxicity of methamphetamine (MAP) in the brain, and that, as a cellular defenses against DA-derived quinines, glutathione S-transferase (GST) detoxifies auto-oxidized DA o-quinone in the brain. Glutathione S-transferase M1 (GSTM1) of the mu-class of GSTs catalyzes reaction between glutathione and catecholamine o-quinones under physiological conditions. This study was undertaken to investigate the role of the GSTM1 gene deletion polymorphism in the neuropathology of MAP abuse. One hundred fifty-seven MAP abusers and 200 healthy comparison subjects were tested for a genetic polymorphism of GSTM1. The difference in the frequency of deletion (D)/nondeletion (N) alleles between the female abusers and female controls was close to statistical significance (P=0.071), although there was no statistical difference (P=0.651) between male abusers and male controls. Furthermore, the number of female abusers with deletion alleles was significantly (P=0.007, odds ratio: 2.77, 95% CI 1.30-5.89) higher than that of male abusers with deletion alleles. These findings suggest that GSTM1 gene deletion may contribute to a vulnerability to MAP abuse in female subjects, but not in male subjects. (C) 2003 Wiley-Liss, Inc. en-copyright= kn-copyright= en-aut-name=KoizumiHiroki en-aut-sei=Koizumi en-aut-mei=Hiroki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=HashimotoKenji en-aut-sei=Hashimoto en-aut-mei=Kenji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=KumakiriChikara en-aut-sei=Kumakiri en-aut-mei=Chikara kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=ShimizuEiji en-aut-sei=Shimizu en-aut-mei=Eiji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=SekineYoshimoto en-aut-sei=Sekine en-aut-mei=Yoshimoto kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=OzakiNorio en-aut-sei=Ozaki en-aut-mei=Norio kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=InadaToshiya en-aut-sei=Inada en-aut-mei=Toshiya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=HaranoMutsuo en-aut-sei=Harano en-aut-mei=Mutsuo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=KomiyamaTokutaro en-aut-sei=Komiyama en-aut-mei=Tokutaro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=YamadaMitsuhiko en-aut-sei=Yamada en-aut-mei=Mitsuhiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=SoraIchiro en-aut-sei=Sora en-aut-mei=Ichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=UjikeHiroshi en-aut-sei=Ujike en-aut-mei=Hiroshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=TakeiNori en-aut-sei=Takei en-aut-mei=Nori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=IyoMasaomi en-aut-sei=Iyo en-aut-mei=Masaomi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= affil-num=1 en-affil= kn-affil=Department of Psychiatry, Chiba University Graduate School of Medicine affil-num=2 en-affil= kn-affil=Department of Psychiatry, Chiba University Graduate School of Medicine affil-num=3 en-affil= kn-affil=Department of Psychiatry, Chiba University Graduate School of Medicine affil-num=4 en-affil= kn-affil=Department of Psychiatry, Chiba University Graduate School of Medicine affil-num=5 en-affil= kn-affil=Department of Psychiatry and Neurology, Hamamatsu University School of Medicine affil-num=6 en-affil= kn-affil=Department of Psychiatry, Fujita Health University School of Medicine affil-num=7 en-affil= kn-affil=Department of Psychiatry, Nagoya University Graduate School of Medicine affil-num=8 en-affil= kn-affil=Department of Neuropsychiatry, Kurume University School of Medicine affil-num=9 en-affil= kn-affil=National Center Hospital for Mental, Nervous, and Muscular Disorders, National Center of Neurology and Psychiatry affil-num=10 en-affil= kn-affil=Karasuyama Hospital, Showa University School of Medicine affil-num=11 en-affil= kn-affil=Division of Psychobiology, Tohoku University Graduate School of Medicine affil-num=12 en-affil= kn-affil=Department of Neuropsychiatry, Okayama University Graduate School of Medicine and Dentistry affil-num=13 en-affil= kn-affil=Department of Psychiatry and Neurology, Hamamatsu University School of Medicine affil-num=14 en-affil= kn-affil=Department of Psychiatry, Chiba University Graduate School of Medicine en-keyword=methamphetamine kn-keyword=methamphetamine en-keyword=drug abuse kn-keyword=drug abuse en-keyword=Glutathione S-transferase kn-keyword=Glutathione S-transferase en-keyword=gender difference kn-keyword=gender difference END start-ver=1.4 cd-journal=joma no-vol=5 cd-vols= no-issue= article-no= start-page= end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2005 dt-pub=2005823 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Evaluation of the Total Design Method in a survey of Japanese dentists en-subtitle= kn-subtitle= en-abstract= kn-abstract=

Background: This study assessed the application of the Total Design Method (TDM) in a mail survey of Japanese dentists. The TDM was chosen because survey response rates in Japan are unacceptably low and the TDM had previously been used in a general population survey.
Methods: Four hundred and seventy eight dentist members of the Okayama Medical and Dental Practitioner's Association were surveyed. The nine-page, 27-item questionnaire covered dentist job satisfaction, physical practice, and dentist and patient characteristics. Respondents to the first mailing or the one-week follow-up postcard were defined as early responders; others who responded were late responders. Responder bias was assessed by examining age, gender and training.
Results: The overall response rate was 46.7% (223/478). The response rates by follow-up mailing were, 18% after the first mailing, 35.4% after the follow-up postcard, 42.3% after the second mailing, and 46.7% after the third mailing. Respondents did not differ from non-respondents in age or gender, nor were there differences between early and late responders.
Conclusion: The application of TDM in this survey of Japanese dentists produced lower rates of response than expected from previous Japanese and US studies.

en-copyright= kn-copyright= en-aut-name=NakaiYukie en-aut-sei=Nakai en-aut-mei=Yukie kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=MilgromPeter en-aut-sei=Milgrom en-aut-mei=Peter kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=YoshidaToshiko en-aut-sei=Yoshida en-aut-mei=Toshiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=IshiharaChikako en-aut-sei=Ishihara en-aut-mei=Chikako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=ShimonoTsutomu en-aut-sei=Shimono en-aut-mei=Tsutomu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= affil-num=1 en-affil= kn-affil=Department of Behavioral Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=2 en-affil= kn-affil=Department of Dental Public Heath Sciences, University of Washington affil-num=3 en-affil= kn-affil=Department of Behavioral Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=4 en-affil= kn-affil=Department of Behavioral Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=5 en-affil= kn-affil=Department of Behavioral Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences END start-ver=1.4 cd-journal=joma no-vol=61 cd-vols= no-issue=2 article-no= start-page=71 end-page=80 dt-received= dt-revised= dt-accepted= dt-pub-year=2007 dt-pub=200704 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=The effects of caregiving resources on the incidence of depression over one year in family caregivers of disabled elderly en-subtitle= kn-subtitle= en-abstract= kn-abstract=

The purpose of the study was to investigate the over-time effects of physical, psychological and social resources on the incidence of depression in family caregivers of the disabled elderly. Data were collected twice at a one-year interval from 1,141 primary caregivers of a disabled older person in an urban area of Japan using a self-reported questionnaire survey. The questionnaire included physical health as an indicator of physical resources, caregiving satisfaction and intention to care as indicators of psychological resources, and instrumental and emotional support network and formal home care service utilization as indicators of social resources. The mental health outcome measure was the General Health Questionnaire 12-item version (GHQ-12). Complete data on 235 non-depressed female caregivers were separated into 3 groups according to the relationship type (wife, daughter and daughter-in-law) and analyzed separately. Multivariate logistic regression models controlling for duration of caregiving, care-recipient's gender, ADL dependency and behavioral problems demonstrated that significant predictors of depression were caregiving satisfaction and intention to care in wives, caregiving satisfaction in daughters, and physical health and emotional support network in daughters-in-law. Noteworthy, intention to care increased the risk of depression in wives, while decreasing the risk of depression in daughters-in-law. The findings indicate that the effects of caregivers' resources on mental health may differ by relationship type.

en-copyright= kn-copyright= en-aut-name=YajimaYuki en-aut-sei=Yajima en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=TsutsuiTakako en-aut-sei=Tsutsui en-aut-mei=Takako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=NakajimaKazuo en-aut-sei=Nakajima en-aut-mei=Kazuo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=LiHui-Ying en-aut-sei=Li en-aut-mei=Hui-Ying kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=TakigawaTomoko en-aut-sei=Takigawa en-aut-mei=Tomoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=WangDa-Hong en-aut-sei=Wang en-aut-mei=Da-Hong kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=OginoKeiki en-aut-sei=Ogino en-aut-mei=Keiki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= affil-num=1 en-affil= kn-affil=Okayama University affil-num=2 en-affil= kn-affil=Okayama Prefectural University affil-num=3 en-affil= kn-affil=Nationala Institute of Public Health affil-num=4 en-affil= kn-affil=Okayama University affil-num=5 en-affil= kn-affil=Okayama University affil-num=6 en-affil= kn-affil=Okayama University affil-num=7 en-affil= kn-affil=Okayama University en-keyword=caregivers kn-keyword=caregivers en-keyword=kin relationships kn-keyword=kin relationships en-keyword=caregiving resources kn-keyword=caregiving resources en-keyword=depression kn-keyword=depression END start-ver=1.4 cd-journal=joma no-vol=54 cd-vols= no-issue=3 article-no= start-page=133 end-page=136 dt-received= dt-revised= dt-accepted= dt-pub-year=2000 dt-pub=200006 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Clinical significance and frequency of Blastocystis hominis in Turkish patients with hematological malignancy. en-subtitle= kn-subtitle= en-abstract= kn-abstract=

The effect of Blastocystis hominis (B. hominis) in both immunocompetent and immunocompromised subjects has been the subject of debate in recent years, mostly in response to its unknown pathogenicity and frequency of occurrence. We performed a non-randomised, open labelled, single institute study in our hospital in order to investigate the clinical significance and frequency of B. hominis in patients suffering from hematological malignancy (HM) who displayed symptoms of gastrointestinal diseases during the period of chemotherapy-induced neutropenia. The presence and potential role of other intestinal inclusive of parasites were also studied. At least 3 stool samples from each of 206 HM patients with gastrointestinal complaints (the HM group) were studied. These were compared with stool samples from a control group of 200 patients without HM who were also suffering from gastrointestinal complaints. Samples were studied with saline-lugol, formalin-ether, and trichome staining methods. Groups were comparable in terms of gender, age and type of gastrointestinal complaints. In the HM group, the most common parasite was B. hominis. In this group, 23 patients (13%) had B. hominis, while in the control group only 2 patients (1%) had B. hominis. This difference was statistically significant (P < 0.05). Symptoms were non-specific for B. hominis or other parasites in the HM group. The predominant symptoms in both groups were abdominal pain (87-89.5%), diarrhea (70-89.5%), and flatulence (74-68.4%). Although all patients with HM were symptom-free at the end of treatment with oral metranidazol (1,500 mg per day for 10 days) 2 patients with HM had positive stool samples containing an insignificant number of parasites (< 5 cells per field). In conclusion, it appears that B. hominis is not rare and should be considered in patients with HM who have gastrointestinal complaints while being treated with chemotherapy. Furthermore, metranidazol appears to be effective in treating B. hominis infection.

en-copyright= kn-copyright= en-aut-name=TasovaYesim en-aut-sei=Tasova en-aut-mei=Yesim kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=SahinBerksoy en-aut-sei=Sahin en-aut-mei=Berksoy kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=KoltasSoner en-aut-sei=Koltas en-aut-mei=Soner kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=PaydasSemra en-aut-sei=Paydas en-aut-mei=Semra kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= affil-num=1 en-affil= kn-affil=Cukurova University affil-num=2 en-affil= kn-affil=Cukurova University affil-num=3 en-affil= kn-affil=Cukurova University affil-num=4 en-affil= kn-affil=Cukurova University en-keyword=Blastocystis hominis kn-keyword=Blastocystis hominis en-keyword=gastrointestinal disorders kn-keyword=gastrointestinal disorders en-keyword=hematological malignancy kn-keyword=hematological malignancy END start-ver=1.4 cd-journal=joma no-vol=63 cd-vols= no-issue=1 article-no= start-page=9 end-page=17 dt-received= dt-revised= dt-accepted= dt-pub-year=2009 dt-pub=200902 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Nutrition and Depressive Symptoms in Community-dwelling Elderly Persons in Japan en-subtitle= kn-subtitle= en-abstract= kn-abstract=

A cross-sectional study was conducted to evaluate the association between dietary intake and depressivesymptoms in community-dwelling elderly persons. Five-hundred elderly persons aged 65 to 75 years were randomly selected from the population of O city in Okayama Prefecture, Japan. Among 401 respondents (response rate, 80.0%), data from 279 (133 males, 146 females) who completed the questionnaire concerning dietary intake and depressive state were analyzed using logistic regression. Each of 17 dietary intakes was classified into tertiles:high intake, moderate intake, and low intake. The Center for Epidemiology Studies Depression scale (CES-D) was used. Among males, the observed odds ratios (the 95% confidence intervals) for the depressive state were 0.36 (95% CI:0.13-0.98) in the highest tertile of carotene intake, 0.33 (95% CI:0.12-0.93) in the highest tertile of vitamin C intake, 0.29 (95% CI:0.10-0.85) in the highest tertile of carbohydrate intake, and 0.33 (95% CI:0.12-0.92) in the medium tertile of vitamin E intake. Among females, similar results were observed, but these results were not statistically significant. The results suggested that carbohydrate, carotene, and vitaminC intakes are associated with lowering depressive symptoms among elderly persons dwelling in communities in Japan.

en-copyright= kn-copyright= en-aut-name=OishiJunko en-aut-sei=Oishi en-aut-mei=Junko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=DoiHiroyuki en-aut-sei=Doi en-aut-mei=Hiroyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=KawakamiNorito en-aut-sei=Kawakami en-aut-mei=Norito kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= affil-num=1 en-affil= kn-affil=Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=2 en-affil= kn-affil=Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=3 en-affil= kn-affil=Department of Mental Health, Graduate School of Medicine and Faculty of Medicine, the University of Tokyo en-keyword=dietary intake kn-keyword=dietary intake en-keyword=depressive symptoms kn-keyword=depressive symptoms en-keyword=elderly persons kn-keyword=elderly persons en-keyword=cross-sectional study kn-keyword=cross-sectional study en-keyword=gender kn-keyword=gender END start-ver=1.4 cd-journal=joma no-vol=63 cd-vols= no-issue=4 article-no= start-page=177 end-page=186 dt-received= dt-revised= dt-accepted= dt-pub-year=2009 dt-pub=200908 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Factors affecting the choice of suicide method in Okayama: a database analysis from a forensic perspective en-subtitle= kn-subtitle= en-abstract= kn-abstract=

The annual number of suicides in Japan increased sharply in 1998, and since that time it has consistently exceeded 30,000 per year. In this study, we analyze a database of personal and background characteristics of 824 cases (605 men, 219 women) who completed suicide in Okayama Prefecture in 2002 and 2003. The data were obtained with cooperation from the police. Using the methodologies in a previous European study as a model, we classified the suicide methods into 8 categories. To examine the generational and regional differences in the choice of methods, we stratified the sample into 4 age groups (<-24, 2544, 4564, and >-65) and 2 regional groups (Okayama/Kurashiki vs. other areas). Our results on gender differences in 7 of the suicide methods were mostly similar to the European data. However, our data showed a remarkably higher proportionate male-to-female mortality ratio for poisoning by other substances (ICD-10, X65-X69 codes) (1.83, 1.15-2.92). In terms of generational differences in the choice of suicide methods, the Mantel-Haenszel test of homogeneity was significant for most of the categories in our study, suggesting an impact of age on how people commit suicide. There were no remarkable regional differences in our sample. An epidemic curve for suicides via carbon monoxide poisoning using charcoal briquets revealed a trend of time clustering not observed in the other 6 means. The database constructed and used in this study contains richer information than conventional death statistics and is expected to provide helpful knowledge and insights for future epidemiological studies.

en-copyright= kn-copyright= en-aut-name=KamizatoEigo en-aut-sei=Kamizato en-aut-mei=Eigo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=YoshitomeKei en-aut-sei=Yoshitome en-aut-mei=Kei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=YamamotoYuji en-aut-sei=Yamamoto en-aut-mei=Yuji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=IwaseToshihide en-aut-sei=Iwase en-aut-mei=Toshihide kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=TsudaToshihide en-aut-sei=Tsuda en-aut-mei=Toshihide kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=MiyaishiSatoru en-aut-sei=Miyaishi en-aut-mei=Satoru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=DoiHiroyuki en-aut-sei=Doi en-aut-mei=Hiroyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= affil-num=1 en-affil= kn-affil=Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=2 en-affil= kn-affil=Department of Legal Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=3 en-affil= kn-affil=Department of Legal Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=4 en-affil= kn-affil=Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=5 en-affil= kn-affil=Department of Human Ecology, Graduate School of Environmental Science, Okayama University affil-num=6 en-affil= kn-affil=Department of Legal Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=7 en-affil= kn-affil=Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences en-keyword=suicide methods kn-keyword=suicide methods en-keyword=gender-specific kn-keyword=gender-specific en-keyword=legal medicine kn-keyword=legal medicine en-keyword=cluster suicide kn-keyword=cluster suicide END start-ver=1.4 cd-journal=joma no-vol=56 cd-vols= no-issue=3 article-no= start-page=149 end-page=158 dt-received= dt-revised= dt-accepted= dt-pub-year=2002 dt-pub=200206 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Effect of change in body mass index on morbidity in non-obese university graduates. en-subtitle= kn-subtitle= en-abstract= kn-abstract=

To establish the actual serial changes in body weight in Japanese people and to elucidate the influence of changes in BMI on morbidity, we conducted a historical cohort study of university graduates from 1955 to 1990 using questionnaires and BMI data. The subjects of this study were 3,675 university graduates aged 26-62 years in whom BMI was determined at the time of enrollment in the university (Pre-BMI), 5 to 40 years earlier. Morbidity (one or more system diseases or obesity-related system diseases) was analyzed according to current age, sex, current BMI, deltaBMI (difference between current BMI and pre-BMI), and various lifestyle variables. The proportion of overweight subjects at enrollment to university was higher in recent male students compared to old students, but not in female graduates, and the BMI in both genders increased progressively after graduation, especially in recent male graduates. Pre-BMI correlated negatively and significantly with deltaBMI. The percentages of obese (BMI > or = 30 kg/m2) males and females were 1.6% and 0.5%, respectively, and high morbidity was observed in 56.1% and 42.2% of males and females, respectively. Stepwise regression analysis showed that in subjects with normal BMI at enrollment, prospective morbidity was dependent on ABMI in addition to age. Our results indicate that in subjects with normal body weight, prospective morbidity is determined by increment of ABMI, and suggest that maintenance of BMI at the late adolescence level is an important factor in preventing future disease.

en-copyright= kn-copyright= en-aut-name=TobeKazuo en-aut-sei=Tobe en-aut-mei=Kazuo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=OguraToshio en-aut-sei=Ogura en-aut-mei=Toshio kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=TsukamotoChiaki en-aut-sei=Tsukamoto en-aut-mei=Chiaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=InoueHajime en-aut-sei=Inoue en-aut-mei=Hajime kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=ArataJiro en-aut-sei=Arata en-aut-mei=Jiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=MatsuuraKazuharu en-aut-sei=Matsuura en-aut-mei=Kazuharu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= affil-num=1 en-affil= kn-affil=Okayama University affil-num=2 en-affil= kn-affil=Okayama University affil-num=3 en-affil= kn-affil=Okayama University affil-num=4 en-affil= kn-affil=Okayama University affil-num=5 en-affil= kn-affil=Okayama University affil-num=6 en-affil= kn-affil=Okayama University en-keyword=body mass index kn-keyword=body mass index en-keyword=morbidity kn-keyword=morbidity en-keyword=overweight kn-keyword=overweight en-keyword=lifestyle-related diseases kn-keyword=lifestyle-related diseases en-keyword=masked obesity kn-keyword=masked obesity en-keyword=adolescent kn-keyword=adolescent END start-ver=1.4 cd-journal=joma no-vol=48 cd-vols= no-issue=6 article-no= start-page=289 end-page=292 dt-received= dt-revised= dt-accepted= dt-pub-year=1994 dt-pub=199412 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Iodine Content in Urine Samples among Malays and Aborigines en-subtitle= kn-subtitle= en-abstract= kn-abstract=

A study was conducted to compare the urinary iodine concentrations in populations from Pahang, Central Malaysia, with those in the capital city Kuala Lumpur, and to compare those of Malays from villages at Batu Talam, Batu Malim, FELDA Sungai Koyan and Hulu Sungai with neighboring aboriginal settlements at Lanai and Buntu. Two hundred and forty urine samples were collected randomly among the population (male 1 1 1 and female 129). The urinary iodine concentrations, measured by the ashing method, among Malays were as follows: Batu Talam 1.1-7.6 micrograms/dl, Batu Malim 1.4-6.6 micrograms/dl, FELDA Sungai Koyan 0.5-6.9 micrograms/dl and Hulu Sungai 0.6-9.9 micrograms/dl. Among aborigines, the urinary iodine levels were 0.1-2.9 micrograms/dl in Lanai and 1.7-6.5 micrograms/dl in Buntu. There was a significant difference in the levels of urinary iodine with regard to gender, but not regarding age. The aborigines had significantly lower iodine levels than Malays (P < 0.001). This difference was also significant with regard to location. The urinary iodine content in Kuala Lumpur was the highest and that in the aboriginal Lanai village was the lowest. Thus, the study showed that the levels of iodine in the urine were influenced by ethnicity and geographic location.

en-copyright= kn-copyright= en-aut-name=AliOsman en-aut-sei=Ali en-aut-mei=Osman kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=MudaKhalida en-aut-sei=Muda en-aut-mei=Khalida kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=KhalidBak en-aut-sei=Khalid en-aut-mei=Bak kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= affil-num=1 en-affil= kn-affil=University Kebangsaan Malaysia affil-num=2 en-affil= kn-affil=University Kebangsaan Malaysia affil-num=3 en-affil= kn-affil=University Kebangsaan Malaysia en-keyword=urinary iodine kn-keyword=urinary iodine en-keyword=aborigines kn-keyword=aborigines en-keyword=Malays kn-keyword=Malays END start-ver=1.4 cd-journal=joma no-vol=70 cd-vols= no-issue=9 article-no= start-page=3093 end-page=3109 dt-received= dt-revised= dt-accepted= dt-pub-year=1958 dt-pub=19580930 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=The Studies on Fat Embolism in the Organs at the Time of Wound Report 1 The Study on Fat Embolism in the Organs on the Autopsy Cases at the Time of Wound kn-title=受傷時における臓器組織中遊離脂肪の意義 第1編 剖検例による受傷時における臓器組織中遊離脂肪の意義 en-subtitle= kn-subtitle= en-abstract= kn-abstract=Among 45 autopsy cases (including 13 cases as control), which have had in our laboratory from July 1956 on ward, the author picked out the lung and in some cases, heart, kidney, cerebrum, spleen, and liver, and examined microscopically the existance of fat embolus in the organs by means of Sudan Ⅲ Haematoxylin staining (Daddi method), after 10% formalin fixation. According to the degree of fat embolism, the author divided into six groups from zero to five and compared. He has arrived at the result as follows: 1) Among 45 autopsy cases 35 cases male, 10 cases female), there were no relations between gender and fat embolism. 2) Among 45 autopsy cases, there were no relations between age and fat embolism (9 cases under age 20, 24 cases age 21 to 40, and 12 cases over age 41). 3) Among 45 autopsy cases, there were confirmed the high degree of fat embolism in the lung in case the dead bodies have been left for about one or a few hours after wounded than those of sudden death. There were 30 cases with the sudden death or closely sudden death, 2 cases for about one hour after wounded, 9 cases for a few hours to fourteen or fifteen hours, and 4 cases from 4 to 10 days after injury. 4) Concerning with the time after death, there were 41 cases with from 6 to 24 hours, one case about 36 hours, 3 cases about 5 to 7 days and one case not cleary. 5) Among autopsy cases with hurt, there were 14 cases of injury on bones, one case of cut wound and subcutaneous bleeding, 15 cases of punctured wounds, and one case of incised wound, it is confirmed that, in all cases of injury on bones the fat embolism in the lung were from one to four. Among 15 cases with punctured wounds, there has been proved one degree in 8 cases, but zero in 7 cases, and in cut wound, subcutaneous bleeding and incised wound cases, there has been proved from one to three. As mentioned above, it could be supposed that there were high degrees of fat embolism in dull edged hurt rather than in sharp edged hurt. 6) As to 32 autopsy cases with hurt, there were divided according to the parts of hurt; 8 cases on head and face, 3 cases on cervical region, 11 cases on breast (back), 2 cases on abdomen, one case on hands and foots and 7 cases more than two parts of body. Among 9 autopsy cases found in the lung with over three degrees there were 6 cases with hurt on head or face, which showed strong fat embolism than the other parts of body. 7) As to 13 autopsy cases picked up for control (asphyxia, intoxication, drowning, disease and burns), there were nothing to be shown in any case but in case of burns, one degree in the lung. 8) There were proved fat embolism in the lung in case of vertebral fracture. 9) There were also proved fat embolism in the lung in all cases being run over and killed (4 cases); in both cases the train accident was remarkably showed three degree of embolus. 10) As to the fat embolism in the lung, it was remarkably shown in the left lung than the right, and stronger in lower lobe than in upper and middle lobe. 11) The degrees of the fat embolism on the organs were higher in the lung than in the other organs, and the existance of fat embolism in the other organs had no significance. en-copyright= kn-copyright= en-aut-name=KusakaHironao en-aut-sei=Kusaka en-aut-mei=Hironao kn-aut-name=草加宏直 kn-aut-sei=草加 kn-aut-mei=宏直 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部法医学教室 END start-ver=1.4 cd-journal=joma no-vol=9 cd-vols= no-issue=1 article-no= start-page=9 end-page=14 dt-received= dt-revised= dt-accepted= dt-pub-year=1998 dt-pub=19980930 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Relationships between the QOL components in kidney posttransplant recipients and their demographic characteristics kn-title=腎移植を受けたレシピエントのQOL構成要素とレシピエント属性との関係 en-subtitle= kn-subtitle= en-abstract=This study analyzed the relationships between QOL components in kidney posttransplant recipients and their demographic characteristics. The subjects were 329 resipients receiving a kidney transplant. QOL was analyzed using the Ferrans and Powers QLI kidney transplant version. Recipient's age, gender, marital status, job status, time since transplant, and type of kideny transplant were related to the QOL components. We believe that the findings are useful to provide information which must be considered, caring kidney posttransplant recipients. kn-abstract=本研究の目的は,レシピエントのQOL向上を目指した看護援助を行っていく上で,考慮すべきレシピエントの属性を明らかにすることである｡腎移植を受けたレシピエント329名を対象に,QOL(Ferrans and PowersのQuality of Life Index-kidney transplant version)及びレシピエント属性を分析した｡その結果,QOL構成要素別に見た考慮すべき属性は,①『社会･経済的な機能』,『家族の絆』,『情緒的な支え』,『安らぎと幸福』における年齢｡②『社会･経済的な機能』,『家族の絆』,『情緒的な支え』,『安らぎと幸福』における婚姻状況。③『社会的･経済的な機能』,『身体の健康』における就労状況。④『情緒的な支え』における移植後年数｡⑤『家族の絆』,『情緒的な支え』,『安らぎと幸福』における性別｡⑥『安らぎと幸福』におけるドナー腎の種類であった｡ en-copyright= kn-copyright= en-aut-name=HoshinaEiko en-aut-sei=Hoshina en-aut-mei=Eiko kn-aut-name=保科英子 kn-aut-sei=保科 kn-aut-mei=英子 aut-affil-num=1 ORCID= en-aut-name=HayashiYuko en-aut-sei=Hayashi en-aut-mei=Yuko kn-aut-name=林優子 kn-aut-sei=林 kn-aut-mei=優子 aut-affil-num=2 ORCID= en-aut-name=NakanishiYoshiko en-aut-sei=Nakanishi en-aut-mei=Yoshiko kn-aut-name=中西代志子 kn-aut-sei=中西 kn-aut-mei=代志子 aut-affil-num=3 ORCID= en-aut-name=KanaoNaomi en-aut-sei=Kanao en-aut-mei=Naomi kn-aut-name=金尾直美 kn-aut-sei=金尾 kn-aut-mei=直美 aut-affil-num=4 ORCID= en-aut-name=WatanabeKumi en-aut-sei=Watanabe en-aut-mei=Kumi kn-aut-name=渡邉久美 kn-aut-sei=渡邉 kn-aut-mei=久美 aut-affil-num=5 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医療技術短期大学部看護学科 affil-num=2 en-affil= kn-affil=岡山大学医療技術短期大学部看護学科 affil-num=3 en-affil= kn-affil=岡山大学医療技術短期大学部看護学科 affil-num=4 en-affil= kn-affil=岡山大学医療技術短期大学部看護学科 affil-num=5 en-affil= kn-affil=岡山大学医療技術短期大学部看護学科 en-keyword=腎移植 (kidney transplant) kn-keyword=腎移植 (kidney transplant) en-keyword=QOL構成要素 (QOL components) kn-keyword=QOL構成要素 (QOL components) en-keyword=レシピエント属性 (recipient demographic characteristics) kn-keyword=レシピエント属性 (recipient demographic characteristics) END start-ver=1.4 cd-journal=joma no-vol=9 cd-vols= no-issue=1 article-no= start-page=1 end-page=8 dt-received= dt-revised= dt-accepted= dt-pub-year=2009 dt-pub=20090310 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Influence on Stress Reactions of Social Skill and Cognitive Appraisal in Junior High Students kn-title=中学生の社会的スキルと認知的評価がストレス反応に及ぼす影響 en-subtitle= kn-subtitle= en-abstract=The purpose of this study was to determine the relations between social skills and cognitive appraisal and stress responses in junior high school students. Moreover, we examined whether social skills coordinate influence on stress responses of cognitive appraisal(coordination effects). As results, gender differences were observed in influences on stress responses of cognitive appraisal and social skills. In males, stress responses were negatively associated with fundamental social skills such as "Behavior for participating in relations" and "Behavior for maintaining relations". In female sample, stress responses had negative associations with "controllability" of cognitive appraisal in addition to these fundamental social skills. Furthermore, stress responses were positively association with "Behavior for developing relations" in female. The coordination effects were confirmed in female partially. These findings were discussed. kn-abstract=本研究の目的は､中学生を対象に､社会的スキルとストレッサーに対する認知的評価､ストレス反応の関係性を明らかにし､社会的スキルが､認知的評価のストレス反応への影響を調整する効果(調整効果)について検討することであった｡その結果､ストレス反応に対する社会的スキルと認知的評価の影響には男女差が認められ､男子ではストレス反応と｢関係参加行動｣・「関係維持行動｣という基礎的なスキルの間に負の関連が認められた｡一方女子では､それら2つの基礎的なスキルに加え､認知的評価の｢コントロール可能性｣とストレス反応の間にも負の関連が､｢関係向上行動｣とストレス反応との問には正の関連が認められた｡調整効果については､女子において部分的に確認された｡ en-copyright= kn-copyright= en-aut-name=NishimuraHiroki en-aut-sei=Nishimura en-aut-mei=Hiroki kn-aut-name=西村大樹 kn-aut-sei=西村 kn-aut-mei=大樹 aut-affil-num=1 ORCID= en-aut-name=TojoMitsuhiko en-aut-sei=Tojo en-aut-mei=Mitsuhiko kn-aut-name=東條光彦 kn-aut-sei=東條 kn-aut-mei=光彦 aut-affil-num=2 ORCID= affil-num=1 en-affil= kn-affil=岡山大学 affil-num=2 en-affil= kn-affil=岡山大学 en-keyword=junior high school students kn-keyword=junior high school students en-keyword=social skills kn-keyword=social skills en-keyword=cognitive appraisal kn-keyword=cognitive appraisal en-keyword=stress responses kn-keyword=stress responses END start-ver=1.4 cd-journal=joma no-vol=105 cd-vols= no-issue=5-6 article-no= start-page=475 end-page=487 dt-received= dt-revised= dt-accepted= dt-pub-year=1993 dt-pub=1993 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Flow cytometric DNA analysis in thyroid tumors kn-title=甲状腺腫瘍の核DNA量と生物学的悪性度に関する研究 en-subtitle= kn-subtitle= en-abstract= kn-abstract=To evaluate the biological malingnacy of differentiated thyroid cancer, we determined the nuclear DNA content in thyroid tumors by flow cytometry using paraffin-enbedded materials. The subjects were 80 patients with thyroid tumors. The thyroid tumors were follicular adenoma in 11 cases and thyroid cancer in 69 cases. Of the 69 cases of thyroid cancer, 42 were histologically classfied as papillary carcinoma, 18 as follicular carcinoma, 3 as medullary carcinoma and 6 as anaplastic carcinoma. DNA ploidy pattern and the percentage of proliferating phase cells were analyzed in relation to the prognosis and the following clinicopathological findings : age, gender, histological type, tumor size (t), extrathyroidal invasion (Ex), lymph node metastases (n) and distant metastases (M). DNA ploidy pattern correlated with histological type (p<0.005), but did not correlate with other clinicopathological findings. The percentage of prolipherating phase cells correlated with age (p<0.01) and the histlogical type (p<0.05), but did not correlate with other clinicopathological findings. The percentage of proliferating phase cells correlated with age (p<0.01) and the histological type (p<0.05), but did not correlate with other clinicopathological findings. The comulative survival rate (Kaplan- Meier) of differentiated carcinomas was worse in the aneuploid group than in the diploid group (p<0.0001). the percentage of proliferaging phase cells increased as the prognosis deteriorated. The results suggest that flow cytometric DNA analysis may be useful to evaluate biological malignancy of thyroid tumors. en-copyright= kn-copyright= en-aut-name=OnodaYuji en-aut-sei=Onoda en-aut-mei=Yuji kn-aut-name=小野田裕士 kn-aut-sei=小野田 kn-aut-mei=裕士 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部第二外科学教室 en-keyword=甲状腺癌 kn-keyword=甲状腺癌 en-keyword=フローサイトメトリー kn-keyword=フローサイトメトリー en-keyword=生物学的悪性度 kn-keyword=生物学的悪性度 en-keyword=プロイディパターン kn-keyword=プロイディパターン en-keyword=増殖期細胞 kn-keyword=増殖期細胞 END start-ver=1.4 cd-journal=joma no-vol=105 cd-vols= no-issue=5-6 article-no= start-page=427 end-page=436 dt-received= dt-revised= dt-accepted= dt-pub-year=1993 dt-pub=1993 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Clinical studies on atypical leukemia Part 1. Clinical and hematological studies on myelodysplasia with hypoplastic marrow kn-title=非定型的白血病の病態並びに治療に関する研究　第1編　低形成型骨髄造血異常症（Myelodysplasia with Hypoplastic Marrow) の検討 en-subtitle= kn-subtitle= en-abstract= kn-abstract=To evaluate characteristics of myelodysplasia with hypoplastic marrow (MDH), clinical and hematological findings in 7 patients with MDH (group A) were compared with those of 23 patients diagnosed with myelodysplastic syndromes (MDS), 13 RAEB and 10 RAEB-T, according to French-American-British co-operative roup classification (group B). Cytopenia and morphological changes in 2 or 3 blood cell lines, corresponding to hematological characteristics of MDS, were observed in all patients in group A. Age distributions and gender ratios did not differ between groups A and B. As the initial symptom, anemia was recognized with a high incidence in both groups. Organomegaly such as hepatomegaly and splenomegaly were observed with nearly equal incidnece in groups A and B. The grades of anemia, leukocytopenia and thrombocytopenia were nearly equal in groups A and B. The percentage of myeloblasts in peripheral blood was higher in group B than that in group A (3.4% versus 0.6%). However, in bone marrow, it was lower in group B than that in group A (11.3% versus 16.5%). The percentage of erythroblasts in bone marrow was lower in group A than group B (17.7% versus 26.6%). Two of 3 patients in group A and 7 of 18 patients in group B showed abnormal karyotypes. The progress from initial symptoms to definite diagnosis ranged from 0.7 months to 38.4 months (mean±SD : 10.1±13.0 months) in group A, and from 0.8 months to 83.3 months (mean±SD : 10.0±18.1 months) in group B, respectively. Four of 7 patients (57%) in group A developed overt leukemia (1 case of hypoplastic leukemia, 2 cases of M2, 1 case of M5b) 1.3～14.3 months after diagnosis of MDH (mean±SD : 8.1±6.5 months), and 9 of 23 patients (39%) in group B also developed overt leukemia (6 cases of M2, 3 cases of M4) 0.5～14.5 months after diagnosis of MDS (mean±SD : 3.8±4.2 months). The median survival time (MST) from the initial symptoms tended to be longer in group A than that in group B (24.2 months versus 18.7 months). The MST from definite diagnosis also tended to be longer in group A than that in group B ( 17.4 months versus 12.1 months). These results suggest that MDH can be included into the clinical entity of MDS in respect to dysmyelopoietic disorders preceeding the onset of acute leukemia. en-copyright= kn-copyright= en-aut-name=NakadaHiroshi en-aut-sei=Nakada en-aut-mei=Hiroshi kn-aut-name=仲田浩之 kn-aut-sei=仲田 kn-aut-mei=浩之 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部第二内科学教室 en-keyword=atypical leukemia kn-keyword=atypical leukemia en-keyword=myelodysplasia with hypoplastic marrow kn-keyword=myelodysplasia with hypoplastic marrow en-keyword=myelodysplastic syndromes kn-keyword=myelodysplastic syndromes END start-ver=1.4 cd-journal=joma no-vol=105 cd-vols= no-issue=11-12 article-no= start-page=987 end-page=997 dt-received= dt-revised= dt-accepted= dt-pub-year=1993 dt-pub=19931231 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=A clinical and radiological study of cervical spinal lesions in patients with progressive rheumatoid arthritis kn-title=慢性関節リウマチにおける頸椎X線病変に関する研究―特に疾患進行度との関連について― en-subtitle= kn-subtitle= en-abstract= kn-abstract=A multivariate analysis of the clinical and radiographic findings of 70 patients with rheumatoid arthritis (RA) was studied. Linear multiple regression analysis was performed on 23 clinical variables. The factors that contributed highly to the progression of vertical atlanto-axial subluxation (VS) were gender, presence of arthritis mutilans, blood hemoglobin level, carpal height ratio (CHR) and the number of joints treated by arthroplasty. This result suggests that the natural progression of VS may well relate to the indicators of the severity of destructive conditions. In contrast, anterior atlanto-axial subluxation (AAS) showed no statistical correlation with any factors. Therefore, the severity of AAS does not appear to be related to the factors that were closely related to VS. A follow-up study of the radiological changes in the cervical spine and hand was performed. There was a high correlation between the severity of VS and the reduction of CHR. As destructive changes in the hands were common and irreversible findings in RA, CHR was the most objective of the factors correlated with VS. Therefore, the measurement of CHR is useful in evaluating the progression of VS. en-copyright= kn-copyright= en-aut-name=NishizawaMasato en-aut-sei=Nishizawa en-aut-mei=Masato kn-aut-name=西澤正人 kn-aut-sei=西澤 kn-aut-mei=正人 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部整形外科学教室 en-keyword=慢性関節リウマチ kn-keyword=慢性関節リウマチ en-keyword=頸椎病変 kn-keyword=頸椎病変 en-keyword=X線学的変化 kn-keyword=X線学的変化 en-keyword=多変量解析 kn-keyword=多変量解析 END start-ver=1.4 cd-journal=joma no-vol=109 cd-vols= no-issue=7-12 article-no= start-page=141 end-page=150 dt-received= dt-revised= dt-accepted= dt-pub-year=1997 dt-pub=19971225 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=The effect of testosterone on the growth of the human chondrosarcoma-derived chondrocytic cell line HCS2/8 kn-title=培養軟骨肉腫細胞 HCS2/8 におけるテストステロンの作用 en-subtitle= kn-subtitle= en-abstract= kn-abstract=Sex steroids have a great influence on bone maturation in childhood, especially in adolescence. However, the precise mechanisums are not fully understood. Human chondrosarcoma-derived chondrocytic cell line HCS2/8 cells were cultured in DMEM culture medium supplemented with 1% fetal calf serum, 1×10(-7) M testosterone or estradiol for 24 hours in a subconfuluent state. Then the cells were pulse labeled with (3)H-thymidine to measure DNA synthesis. In addition, S1 nuclease protection assay of insulin-like growth factor (IGF)-Ⅰ,-Ⅱ and IGF-binding protein (IGFBP)-2, -3, -4 and IGFBP-5 mRNA was carried out. DNA synthesis of HCS2/8 cell was enhanced in the presence of teststerone but not in the presence of estradiol. Using S1 nuclease protection assay, testosterone increased expressions of IGF-Ⅰ,-Ⅱ, and IGFBP-3mRNA. However, estradiol decreased the expression of IGF-Ⅱ mRNA but did not change expressions of IGF-1, IGFBP-2, -3, -4 or IGFBP-5 mRNA. In conclusion, the present results indicate that teststerone stimulates the growth of chondrocytes, probably via increased expressions of IGF-Ⅰ,-Ⅱ, and IGFBP-3 mRNA. en-copyright= kn-copyright= en-aut-name=SatoMasayoshi en-aut-sei=Sato en-aut-mei=Masayoshi kn-aut-name=佐藤正義 kn-aut-sei=佐藤 kn-aut-mei=正義 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部小児科学講座 en-keyword=testosterone kn-keyword=testosterone en-keyword=cartilage kn-keyword=cartilage en-keyword=IGFs kn-keyword=IGFs en-keyword=IGFBPs kn-keyword=IGFBPs END start-ver=1.4 cd-journal=joma no-vol=113 cd-vols= no-issue=3 article-no= start-page=273 end-page=278 dt-received= dt-revised= dt-accepted= dt-pub-year=2001 dt-pub=20011231 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=産婦人科と性同一性障害 en-subtitle= kn-subtitle= en-abstract= kn-abstract= en-copyright= kn-copyright= en-aut-name= en-aut-sei= en-aut-mei= kn-aut-name=中塚幹也 kn-aut-sei=中塚 kn-aut-mei=幹也 aut-affil-num=1 ORCID= en-aut-name= en-aut-sei= en-aut-mei= kn-aut-name=小西秀樹 kn-aut-sei=小西 kn-aut-mei=秀樹 aut-affil-num=2 ORCID= en-aut-name= en-aut-sei= en-aut-mei= kn-aut-name=工藤尚文 kn-aut-sei=工藤 kn-aut-mei=尚文 aut-affil-num=3 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部産婦人科学教室 affil-num=2 en-affil= kn-affil=岡山大学医学部産婦人科学教室 affil-num=3 en-affil= kn-affil=岡山大学医学部産婦人科学教室 en-keyword=月経 kn-keyword=月経 en-keyword=思春期 kn-keyword=思春期 en-keyword=性同一性障害 kn-keyword=性同一性障害 en-keyword=生殖医療 kn-keyword=生殖医療 en-keyword=ホルモン療法 kn-keyword=ホルモン療法 END start-ver=1.4 cd-journal=joma no-vol=114 cd-vols= no-issue=3 article-no= start-page=275 end-page=281 dt-received= dt-revised= dt-accepted= dt-pub-year=2003 dt-pub=20030131 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Long-term prognosis of the chronic hepatitis C patients with interferon: Comparison among virological responders, biochemical responders and non-responders kn-title=インターフェロン治療後C型慢性肝炎患者の長期予後　―ウイルス学的著効例，生化学的著効例と無効例の比較― en-subtitle= kn-subtitle= en-abstract= kn-abstract=To evaluate the prognosis of the sustained biochemical responder after interferon (IFN) therapy, we retrospectively studied 252 chronic hepatitis C patients who were treated with IFN. Patients were divided into four groups: group A, sustained virological responders (n=84); group B,sustained biochemical but not virological responders (n=43); group C, incomplete responders (n=64); group D, non responders (n=61). The levels of several liver function tests were evaluated at the end of the observation period (4.2±1.6 years, mean±SD) compared with those at just before IFN therapy. The levels of cholinesterase, albumin, γ-globulin, zinc sufate turbidity test, platelet count and clearance rate of indocyanine green test improved in group A (p<0.05), became worse in group D (p<0.05) and did not change in group B. The incidence of hepatocellular carcinoma was significantly higher in group D than in group B (p<0.01);Kaplan-Meier method, log-rank test). The hazard ratio for hapatocarcinogenesis of the patients in group A and B was significantly lower than that in group C and D (hazard ratio: 0.27, range of 0.08-0.98; p=0.046) adjusted for age, gender, stage and total alcohol consumption. These results suggest that the progress of liver disease and liver carcinogenesis was more suppressed in sustained biochemical responders than in non reponders. en-copyright= kn-copyright= en-aut-name=MiyakeMasanobu en-aut-sei=Miyake en-aut-mei=Masanobu kn-aut-name=三宅正展 kn-aut-sei=三宅 kn-aut-mei=正展 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=Department of Medicine and Medical Science, Okayama University Graduate School of Medicine and Dentistry en-keyword=C型肝炎 kn-keyword=C型肝炎 en-keyword=インターフェロン kn-keyword=インターフェロン en-keyword=生化学的持続著効 kn-keyword=生化学的持続著効 END start-ver=1.4 cd-journal=joma no-vol=24 cd-vols= no-issue=1 article-no= start-page=36 end-page=47 dt-received= dt-revised= dt-accepted= dt-pub-year=2007 dt-pub=200711 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Study on Gender Equality in Employment from an ILO Perspective kn-title=ILOの視点から推察した男女雇用平等 -アメリカの労使の役割を中心として- en-subtitle= kn-subtitle= en-abstract= kn-abstract=今日の男女共同参画社会基本法は､国際連合から端を発した国際人権規約と｢国際労働機関｣ (以下ILO)のILO条約､さらには｢女性差別撤廃条約｣が深く影響して成り立ってきた｡しかしながら､｢改正男女雇用機会均等法｣が施行され､女工哀史時代と比較してはるかに女性の労働環境が是正されてきた現在も､職場での待遇に悩む女性は多い1)｡女性の人権について最初にとりあげたILOは1919年に設立された｡その後､1949年世界人権宣言､1966年国際人権規約でも保証されることとなった｡さらに1979年｢女子に対するあらゆる形態の差別の撤廃に関する条約(女性差別撤廃条約)｣が成立した2)0日本は労働基準法 (以下｢労基法｣とする)4条の存在を根拠に1967年にILO100号条約 (男女同一価値労働･同一報酬)を批准したが3)､ILO 111号条約 (1958年､雇用及び職業についての差別待遇)採択に際して日本の使用者団体が条約に反対､いまだに批准していない4)｡しかも批准したILO100号条約が日本の男女賃金格差を解消しているとはいえず､現在でも大企業勤務を含めた女性社員からの裁判が後を絶たない｡ そこで本稿では主に労使双方の立場から男女雇用平等への道を探るため､最初に日本の男女雇用平 等の現状を挙げ､ILOの男女平等の方向性を確認した上で､ILOの視点に基づき女性労働組合員の増加と労働市場における機会均等･男女賃金格差に関して先進国であるアメリカ (本稿ではアメリカ合衆国を指す)の見解を紹介していくことにする｡さいごに男女雇用差別是正へ向けた示唆を挙げて総括としたい。 en-copyright= kn-copyright= en-aut-name=TakagiSachiko en-aut-sei=Takagi en-aut-mei=Sachiko kn-aut-name=高木早知子 kn-aut-sei=高木 kn-aut-mei=早知子 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学 END start-ver=1.4 cd-journal=joma no-vol=119 cd-vols= no-issue=2 article-no= start-page=141 end-page=146 dt-received= dt-revised= dt-accepted= dt-pub-year=2007 dt-pub=20070903 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Accidents in dental treatment: A questionnaire investigation kn-title=歯科医師の就業状況と診療偶発事故 en-subtitle= kn-subtitle= en-abstract= kn-abstract=The relationship between the operational situation of dental treatment and accidents experienced was investigated through questionnaires sent to members of the Kagawa Dental Association. Responses were received from 261 dentists (53% response rate), of whom 113 (43%) had experienced accidents during dental examinations and/or treatment during the past one year. Dentists with a particularly high risk of having accidents were predominantly young males who possessed many medical chairs at their clinic and who daily examined many patients. Those dentists who worked together with two or more colleagues had a lower risk of accidents. These factors should be considered when trying to take preventive measures against accidents during medical examinations and treatment. en-copyright= kn-copyright= en-aut-name=OnoHiroshi en-aut-sei=Ono en-aut-mei=Hiroshi kn-aut-name=小野廣 kn-aut-sei=小野 kn-aut-mei=廣 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部医学科 en-keyword=歯科診療 (dental treatment) kn-keyword=歯科診療 (dental treatment) en-keyword=偶発事故 (accident) kn-keyword=偶発事故 (accident) en-keyword=質問紙調査 (questionnaires) kn-keyword=質問紙調査 (questionnaires) END start-ver=1.4 cd-journal=joma no-vol=137 cd-vols= no-issue= article-no= start-page=59 end-page=63 dt-received= dt-revised= dt-accepted= dt-pub-year=2008 dt-pub=20080225 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Gender and Japan-Korea Differences in Psychological Characteristics through DIPCA and POMS for All Japan Wheelchair Basketball Atheletes kn-title=日本代表車椅子バスケットボール選手の性差及び韓国代表選手との国際比較　－DIPCAとPOMSを用いて－ en-subtitle= kn-subtitle= en-abstract= kn-abstract=Although previous studies investigating physical performance and biomechanics in wheelchair-bound athletes were reported, few studies have characterized the psychological state of these athletes. This study investigated differences in psychological characteristics among 37 wheelchair-bound athletes (Japanese males, n=11; Japanese females, n=9; Korean males, n=17). All subjects belonged to their own national teams for disabled wheelchair basketball. All subjects completed both the Diagnostic Inventory of Psychological-Competitive Ability for Athletes (DIPCA) and the Profile Of Mood States (POMS). Statictics analysis of DIPCA showed that the psychological competitive abilities in the Japanese males were significantly better than those in the Korean males in this series. However. the scores on POMS did not show significant differences between the Japanese and Korean males, expect for the score for "anger". Neither DIPCA nor POMS showed any significant differences with regard to gender. Above all, we conclude that the psychological differences between Japanese and Koreans reflected the outcomes of international competitions and these there was no gender difference in psychological characteristics. en-copyright= kn-copyright= en-aut-name=MiuraKoji en-aut-sei=Miura en-aut-mei=Koji kn-aut-name=三浦孝仁 kn-aut-sei=三浦 kn-aut-mei=孝仁 aut-affil-num=1 ORCID= en-aut-name=MatsuiKumiko en-aut-sei=Matsui en-aut-mei=Kumiko kn-aut-name=松井久美子 kn-aut-sei=松井 kn-aut-mei=久美子 aut-affil-num=2 ORCID= en-aut-name=KatayamaKeiko en-aut-sei=Katayama en-aut-mei=Keiko kn-aut-name=片山敬子 kn-aut-sei=片山 kn-aut-mei=敬子 aut-affil-num=3 ORCID= en-aut-name=IshikawaKazuhiro en-aut-sei=Ishikawa en-aut-mei=Kazuhiro kn-aut-name=石川和裕 kn-aut-sei=石川 kn-aut-mei=和裕 aut-affil-num=4 ORCID= en-aut-name=SatoFumihiko en-aut-sei=Sato en-aut-mei=Fumihiko kn-aut-name=佐藤文彦 kn-aut-sei=佐藤 kn-aut-mei=文彦 aut-affil-num=5 ORCID= en-aut-name=OchiEisuke en-aut-sei=Ochi en-aut-mei=Eisuke kn-aut-name=越智英輔 kn-aut-sei=越智 kn-aut-mei=英輔 aut-affil-num=6 ORCID= affil-num=1 en-affil= kn-affil=岡山大学 affil-num=2 en-affil= kn-affil=岡山大学 affil-num=3 en-affil= kn-affil=岡山大学 affil-num=4 en-affil= kn-affil=岡山大学 affil-num=5 en-affil= kn-affil=広島大学 affil-num=6 en-affil= kn-affil=日本体育大学 en-keyword=Wheelchir Athletes kn-keyword=Wheelchir Athletes en-keyword=POMS kn-keyword=POMS en-keyword=DIPCA kn-keyword=DIPCA END start-ver=1.4 cd-journal=joma no-vol=10 cd-vols= no-issue=1 article-no= start-page=51 end-page=56 dt-received= dt-revised= dt-accepted= dt-pub-year=1999 dt-pub=19991220 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Analysis of three cases of renal transplant recipients whose feelings about life have become negative after transplantation kn-title=腎移植後に人生の受けとめ方が低下した3事例の分析 en-subtitle= kn-subtitle= en-abstract=We are seeking an effective nursing intervention for renal transplant recipients based on a nursing support model described by Hayashi. Among 119 patients we investigated, at least 90% of them experienced increased positive feelings about their lives after receiving a renal transplant, whereas three of them answered differently. The purpose of this study is to analyze the complaints of three recipients after renal transplantation. Factors such as age, gender, marital status, time-course after transplant, and type of kidney transplant are included in the study. As a result, their complaints are differentiated into 4 categories : (1) status of transplanted kidney and their own health, (2) status of medical support, or assistance from their friends and others, (3) situation of their immediate family, (4) a grade of their ability to fulfill their social and familial responsibilities. These results are important in our nursing approach in order to improve the quality of life (QOL) of renal transplant recipients. kn-abstract=筆者らは，林が作成した看護援助モデルに基づき，腎移植者への効果的な看護介入についての検討を行っている。その一環として，今回，腎移植を受けた119名を対象に，QOLや移植前と現在の人生に対する受けとめ方について調査した。人生に対する受けとめ方の移植前後の変化を分析したところ，ほぼ全数に近い腎移植者が移植前と比べよい状態であると受けとめていたが，3事例において受けとめ方が低下していた。そこで，この3事例に着目し，これらの事例が日常生活の中で不満を抱いている事柄を分析した。その結果，移植後に人生に対する受けとめ方が低下した3事例が抱く不満は，1．腎臓・健康などの身体状況，2．家庭環境，3．医療・友人・他人からのサポート，4．家族や社会の中で役割を果たす能力の4カテゴリーに分類された。移植後の人生の受けとめ方の否定的変化には，上記の4カテゴリーに対して抱く不満が影響していることが推測され，腎移植後の看護介入を検討する上で考慮すべき点であることが明らかになった。 en-copyright= kn-copyright= en-aut-name=WatanabeKumi en-aut-sei=Watanabe en-aut-mei=Kumi kn-aut-name=渡邉久美 kn-aut-sei=渡邉 kn-aut-mei=久美 aut-affil-num=1 ORCID= en-aut-name=HayashiYuko en-aut-sei=Hayashi en-aut-mei=Yuko kn-aut-name=林優子 kn-aut-sei=林 kn-aut-mei=優子 aut-affil-num=2 ORCID= en-aut-name=NakanishiYoshiko en-aut-sei=Nakanishi en-aut-mei=Yoshiko kn-aut-name=中西代志子 kn-aut-sei=中西 kn-aut-mei=代志子 aut-affil-num=3 ORCID= en-aut-name=KanaoNaomi en-aut-sei=Kanao en-aut-mei=Naomi kn-aut-name=金尾直美 kn-aut-sei=金尾 kn-aut-mei=直美 aut-affil-num=4 ORCID= en-aut-name=HosinaEiko en-aut-sei=Hosina en-aut-mei=Eiko kn-aut-name=保科英子 kn-aut-sei=保科 kn-aut-mei=英子 aut-affil-num=5 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部保健学科看護学専攻 affil-num=2 en-affil= kn-affil=岡山大学医学部保健学科看護学専攻 affil-num=3 en-affil= kn-affil=岡山大学医学部保健学科看護学専攻 affil-num=4 en-affil= kn-affil=岡山大学医学部保健学科看護学専攻 affil-num=5 en-affil= kn-affil=広島大学大学院医学系研究科 en-keyword=QOL (quality of life) kn-keyword=QOL (quality of life) en-keyword=腎移植 kn-keyword=腎移植 en-keyword=腎移植者 (renal transplant recipient) kn-keyword=腎移植者 (renal transplant recipient) en-keyword=看護 (nuising approach) kn-keyword=看護 (nuising approach) END start-ver=1.4 cd-journal=joma no-vol= cd-vols= no-issue= article-no= start-page= end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2007 dt-pub=20070323 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=要介護高齢者の家族介護者における1年間の介護資源が抑うつ発症に与える影響 kn-title=The Effects of Caregiving Resources on the Incidence of Depression over One Year in Family Caregivers of Disabled Elderly en-subtitle= kn-subtitle= en-abstract= kn-abstract=The purpose of the study was to investigate the over-time effects of physical, psychological and social resources on the incidence of depression in family caregivers of the disabled elderly. Data were collected twice at a one-year interval from 1,141 primary caregivers of a disabled older person in an urban area of Japan using a self-reported questionnaire survey. The questionnaire included physical health as an indicator of physical resources, caregiving satisfaction and intention to care as indicators of psychological resources, and instrumental and emotional support network and formal home care service utilization as indicators of social resources. The mental health outcome measure was the General Health Questionnaire 12-item version (GHQ-12). Complete data on 235 non-depressed female caregivers were separated into 3 groups according to the relationship type (wife, daughter and daughter-in-law) and analyzed separately. Multivariate logistic regression models controlling for duration of caregiving, care-recipient's gender, ADL dependency and behavioral problems demonstrated that significant predictors of depression were caregiving satisfaction and intention to care in wives, caregiving satisfaction in daughters, and physical health and emotional support network in daughters-in-law. Noteworthy, intention to care increased the risk of depression in wives, while decreasing the risk of depression in daughters-in-law. The findings indicate that the effects of caregivers' resources on mental health may differ by relationship type. en-copyright= kn-copyright= en-aut-name=YajimaYuki en-aut-sei=Yajima en-aut-mei=Yuki kn-aut-name=矢嶋裕樹 kn-aut-sei=矢嶋 kn-aut-mei=裕樹 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学 en-keyword=caregivers kn-keyword=caregivers en-keyword=kin relationships kn-keyword=kin relationships en-keyword=caregiving resources kn-keyword=caregiving resources en-keyword=depression kn-keyword=depression END start-ver=1.4 cd-journal=joma no-vol= cd-vols= no-issue= article-no= start-page= end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2007 dt-pub=20070323 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=同時性多発大腸癌は腫瘍発生部位により臨床的特徴が異なる kn-title=Clinical characteristics of synchronous colorectal cancer are different according to tumour location en-subtitle= kn-subtitle= en-abstract= kn-abstract=AIMS: The purpose of this study was to investigate the clinical characteristics of synchronous cancer patients, with particular attention given to variations in tumour location. METHODS: A retrospective evaluation of 249 synchronous cancer cases out of 3061 consecutive colorectal cancer patients. RESULTS: Multivariate analysis of risk factors for synchronous cancer according to tumour location revealed that male gender was a significant risk for synchronous lesions in the left colon only (odds ratio=2.05, 95% confidence interval 1.34-3.13). Meanwhile, aging was a risk factor for synchronous cancer in the right colon only (odds ratio=1.05, 95% confidence interval 1.02-1.08), and in both sides of the colon (odds ratio=1.03, 95% confidence interval 1.01-1.05), but not in the left colon only (odds ratio=0.98, 95% confidence interval 0.97-1.00). In addition, patients with synchronous lesions in the right colon only tended to have adenomas in the right colon, while those with synchronous lesions in the left colon only tended to have adenomas in the left colon (each P value <0.05). CONCLUSION: The risk factors and status of concurrent adenomas of synchronous cancer cases varied according to tumour location, suggesting that the colonic site susceptible to neoplasia varies according to patient characteristics. en-copyright= kn-copyright= en-aut-name=FukatsuHirotoshi en-aut-sei=Fukatsu en-aut-mei=Hirotoshi kn-aut-name=深津裕寿 kn-aut-sei=深津 kn-aut-mei=裕寿 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学 en-keyword=Colonoscopy kn-keyword=Colonoscopy en-keyword=Synchronous colorectal cancer kn-keyword=Synchronous colorectal cancer en-keyword=Tumour location kn-keyword=Tumour location END start-ver=1.4 cd-journal=joma no-vol=2 cd-vols= no-issue=1 article-no= start-page=21 end-page=34 dt-received= dt-revised= dt-accepted= dt-pub-year=2004 dt-pub=2004 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Community power and its supporters in middle class residential areas in Bangkok: On acculturation and gender kn-title=バンコク都中間層居住地域における地域力の担い手：文化変容とジェンダーの観点から en-subtitle= kn-subtitle= en-abstract= kn-abstract=本稿では、文化変容のメカニズムを仮説的にとらえるという目的に鑑みて、とくに後者に注目し、以下のふたつの事例を考察する。ひとつめの事例は、タイの首都バンコクにおいて、１９７０年頃から欧米のＮＧＯ支部などの指導により組織されはじめた地域住民組織の展開のあり方である。ふたつめの事例は、近年タイ国で職業開発施策として展開されている、日本にならった「一村一品」運動とその担い手である「主婦」グループのあり方である。両者とも地域社会開発政策の一環とし位置づけられるものである。とくに急激な人口流入により都市化にともなう問題をたえずかかえているバンコク都を対象とすることによって、これらふたつのプロジェクトの意味がより明確に示されるであろう。そして二つの事例から引き出される政策の機能的意義を明らかにすることによって、地域社会レベルにおける文化変容のメカニズムを仮説的にとらえることを試みたい。 en-copyright= kn-copyright= en-aut-name=FujiiWasa en-aut-sei=Fujii en-aut-mei=Wasa kn-aut-name=藤井和佐 kn-aut-sei=藤井 kn-aut-mei=和佐 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学 END start-ver=1.4 cd-journal=joma no-vol= cd-vols= no-issue= article-no= start-page= end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2005 dt-pub=20050630 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=非小細胞肺癌におけるEGFR遺伝子変異と臨床病理学的因子の関係 kn-title=The Relationship between Epidermal Growth Factor Receptor Mutations and Clinicopathologic Features in Non-Small Cell Lung Cancers en-subtitle= kn-subtitle= en-abstract= kn-abstract=PURPOSE: Recent studies reported that clinical responsiveness to gefitinib was associated with somatic mutation of epidermal growth factor receptor (EGFR) gene in non-small cell lung cancers (NSCLC). Here, we investigated the relationship between EGFR mutation and clinicopathologic features. EXPERIMENTAL DESIGN: EGFR mutational status of 120 NSCLCs was determined mainly in EGFR exons 18 to 21 by direct sequence and correlated with clinicopathologic parameters. RESULTS: EGFR mutations were present in 38 cases (32%) and the majority of mutations were in-frame deletions of exon 19 (19 cases) and a missense mutation in exon 21 (18 cases). EGFR mutations were frequently associated with adenocarcinoma (P < 0.0001), never smoker (P < 0.0001), and female gender (P = 0.0001). Of interest, increasing smoke exposure was inversely related to the rate of EGFR mutation (P < 0.0001). Multivariate analysis showed that smoking and histology were independent variables. Furthermore, gender difference was observed for the mutational location (P = 0.01) dominance of exon 19 for males and exon 21 for females. Twenty-one cases were treated with gefitinib and found that EGFR mutation was significantly related to gefitinib responsiveness (P = 0.002). In addition, median survival times of patients with and without EGFR mutations treated with gefitinib were 25.1 and 14.0 months, respectively. Patients with EGFR mutations had approximately 2-fold survival advantage; however, the difference was not significant. CONCLUSIONS: We show that EGFR mutations were significantly related to histology and smoke exposure and were a strong predictive factor for gefitinib responsiveness in NSCLC. en-copyright= kn-copyright= en-aut-name=TokumoMasaki en-aut-sei=Tokumo en-aut-mei=Masaki kn-aut-name=德毛誠樹 kn-aut-sei=德毛 kn-aut-mei=誠樹 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学 END