Serum DJ-1 level is positively associated with improvements in some aspects of metabolic syndrome in Japanese women through lifestyle intervention.

DJ-1 is a protein that is associated with Parkinson disease and cancer, and the reduction of DJ-1 function and expression is also thought to be a cause of diabetes and hypertension. However, little is known about the association between the plasma concentration of DJ-1 and risk of metabolic syndrome. We hypothesized that a lifestyle intervention would increase serum DJ-1 and that up-regulated DJ-1 functions will result in the prevention of metabolic syndrome. The objective of our study is to examine whether the level of serum DJ-1 is associated with the risk of metabolic syndrome. Therefore, to reveal the association between DJ-1 and metabolic syndrome, this study investigated lifestyle intervention in a control group (n = 37) and intervention group (n = 45). The results showed that body mass index, body fat ratio, waist-hip ratio, waist circumference, blood pressure, and plasma glucose level were improved in the intervention group, as compared with those in the control group. Furthermore, serum levels of DJ-1 were increased in the intervention group, when compared with those in the control group. These results suggest that serum DJ-1 is increased by lifestyle intervention and that increased serum DJ-1 prevents metabolic syndrome. Thus, the level of serum DJ-1 will become one of the indexes for the risk of metabolic syndrome.

A case of informed consent obtained from a patient with terminal cancer and his family using family function by the primary care physician.

We evaluated the contents and characteristics of informed consent obtained by the primary care physician from a male patient with advanced cancer and his family, and clarified the influences of the informed consent on family function. This patient was diagnosed as having advanced cancer at the age of 46 years, underwent surgery/chemotherapy, but died after 4 months at the hospital. Semi-structured interviews were held with the elder daughter of the patient, and notes on the patient's disease, the course of treatment, his family's responses, and the informed consent obtained by the primary care physician were taken during the interview. The informed consent obtained by the primary care physician had the following characteristics: (1) The physician transmitted accurate and detailed information on the treatment methods, side effects, and prognosis by appropriate communication techniques with consideration for the feelings of the patient and his family, and proposed choices so that they could participate in the decision of treatment principles. (2) During the entire course, the primary care physician frequently visited the bedside and encouraged the patient and his family to express their feelings of anxiety and to ask questions, giving continuous emotional support. With the progression of the disease and explanation by the primary care physician, the patient and his family expressed and shared feelings such as grief and powerlessness and supported each another. Gradually, they began to show practical/adaptive coping behavior and could accept the patient's death. Appropriate informed consent obtained by the primary-care physician promoted the family function of this family.