Prenatal exposure to selenium, mercury, and manganese during pregnancy and allergic diseases in early childhood: The Japan Environment and Children's study.

BACKGROUND: Prenatal exposure to metallic elements may adversely affect early childhood health. However, more evidence is needed as population-based cohort studies are currently limited. OBJECTIVES: We aimed to examine the associations between prenatal metallic (mercury, selenium, and manganese) exposure and the risk of allergic diseases in early childhood until three years of age. METHODS: The data from 94,794 mother-infant pairs, who participated in the Japan Environment and Children's study, were used in this study. Prenatal metallic element exposure was measured in maternal blood collected during mid-pregnancy. The incidence of atopic dermatitis, food allergies, asthma, and allergic rhinitis during the first three years of life was prospectively investigated using self-reports of physician-diagnosed allergies. A multivariable modified Poisson regression model was used to estimate the cumulative incidence ratio and their 95% confidence intervals of allergic diseases associated with prenatal exposure to mercury, selenium, and manganese. We further evaluated the interaction between mercury and selenium exposures in this association. RESULTS: We confirmed 26,238 cases of childhood allergic diseases: atopic dermatitis, food allergies, asthma, and allergic rhinitis in 9,715 (10.3%), 10,897 (11.5%), and 9,857 (10.4%), 4,630 (4.9%), respectively. No association was found between prenatal mercury or manganese exposure and the risk of allergic diseases. Prenatal selenium exposure was inversely associated with atopic dermatitis, food allergies, allergic rhinitis, and any allergic diseases, but not with asthma. These inverse associations were more pronounced for lower mercury exposures than for higher exposures. CONCLUSIONS: Our findings suggest that prenatal exposure to selenium may be beneficial for reducing the risk of atopic dermatitis, food allergies, allergic rhinitis, and any allergic diseases in early childhood, especially with lower prenatal mercury exposure.

Low Periconceptional Dietary Intakes among Japanese Women: The Japan Environment and Children's Study (JECS).

Pregnancy is usually associated with dietary imbalances. We aim to assess the changes in Japanese women's diet and nutritional adequacy before and during pregnancy. In the Japan Environment and Children's Study (JECS), we recruited a large cohort of pregnant women (>100,000) from 15 Japanese communities. We assessed their diet before and during pregnancy by a food frequency questionnaire. The before and during pregnancy intakes of energy, macronutrients, and micronutrients were lower than the recommended level for Japanese women by 1% to 49%. The dietary intakes of pregnant women were lower than their intakes before pregnancy, except for milk, dairy products, and calcium. The daily during pregnancy intake of energy, carbohydrate, fat, protein, folic acid, and iron decreased by 85 kcal, 11.6 g, 2.3 g, 2.8 g, 20 µg, and 0.5 mg than the before pregnancy intake. Pregnant women's declined food and nutrients intakes were moderately correlated to their dietary intakes before pregnancy; the correlation coefficient ranged between 0.47 and 0.67. The inter-individual variability was greater than the intra-individual variability of the dietary intakes. Almost half of the pregnant women remained in the same intake quartile for all nutrients and food groups as before pregnancy. Yet, approximately 10% of pregnant women changed their pregnancy intake by ≥50% (≥2 quartiles up or down) compared to before pregnancy. In conclusion, the study identified low periconceptional dietary intakes among Japanese pregnant women. The low dietary intake of essential nutrients, such as folate, requires revising the Japanese national periconceptional dietary and supplementation guidelines.

Green Tea Consumption and Risk of Depression Symptoms: A Systematic Review and Meta-Analysis of Observational Studies.

This systematic review and meta-analysis aimed to investigate the association between green tea consumption and depression symptom risk, using subgroup analyses concerning study design, geographical region of study, adjustment factors, age, cut-off for the highest consumption category, and depression assessment methods applied. We used PubMed to search for relevant literature. The inclusion criteria were studies that (a) investigated this association as a primary or secondary outcome; (b) published in English; (c) assessed and reported hazard ratios or odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) for depression symptoms, or included sufficient information to allow their calculation; (d) included at least two groups differentiated based on green tea consumption (e.g., high and low); (e) reported the prevalence of depression symptoms in each group; and (f) reported the sample size for each group. Eight articles were found to meet all criteria. The results indicated that high green tea consumption is inversely associated with depression symptoms. The pooled OR was 0.66 (95% CI 0.58-0.74), and significant heterogeneity was not observed. Subgroup analysis showed that study design impacted results (cohort study [one study]: OR=0.29, 95% CI=0.04-2.14; cross-sectional study [seven studies]: OR=0.66, 95% CI=0.59-0.75). These findings suggest that green tea consumption reduces the risk of depression symptoms. This association was also observed in the cohort study included, but the results in which did not reach the significant level. Therefore, further cohort studies are needed to confirm the potential causal relationship in this regard.

Hypertensive Disorders of Pregnancy in Relation to Coffee and Tea Consumption: The Japan Environment and Children's Study.

BACKGROUND: The association between coffee/tea intake and hypertensive disorders of pregnancy (HDP) remains unclear. This study aimed to investigate the association of caffeine, coffee, and tea intake during pregnancy with the risk of HDP. METHODS: We assessed this association in 85,533 singleton pregnant women with live births in the Japan Environment and Children's Study, a prospective cohort in Japan that included women from early pregnancy onward. Caffeinated and decaffeinated coffee and tea (green, oolong, and black) consumption during pregnancy was assessed using a validated food frequency questionnaire conducted at mid-pregnancy, and caffeine intake was calculated based on coffee and tea consumption. Multivariable logistic regression was used to assess the association with the risk of HDP. RESULTS: HDP developed in 2222 women (2.6%). Caffeine intake was weakly associated with increased risk of HDP; the multivariable odds ratio of HDP for the highest versus the lowest quartile was 1.26 (95% confidence interval: 1.11, 1.43). Coffee drinkers of two or more cups per day showed a decreased risk compared with non-drinkers (multivariable odds ratio 0.79; 0.62, 0.99) even after adjustment for total caffeine intake. Tea consumption was not associated with the risk of HDP. CONCLUSIONS: Our study suggests that higher caffeine intake may increase HDP risk, while coffee drinkers had a lower risk. Further high-quality studies are needed to replicate these findings, and to elucidate if other substances in coffee may be protective against HDP.

The coronary artery calcium score correlates with left atrial low-voltage area: Sex differences.

INTRODUCTION: In patients with coronary artery disease, a high coronary artery calcium score (CACS) correlates with atrial fibrillation (AF); however, the association between left atrial (LA) remodeling progression and coronary arteriosclerosis is unclear. This study aimed to evaluate the relationship between LA remodeling progression and the CACS. METHODS: This retrospective study enrolled 148 patients with AF (paroxysmal AF, n = 94) who underwent catheter ablation. Voltage mapping for the left atrium and coronary computed tomography for CACS calculations were performed. The ratio of the LA low-voltage area (LA-LVA), defined by values less than 0.5 mV divided by the total LA surface without pulmonary veins, was calculated. Patients with LA-LVA (<0.5 mV) >5% and ≤5% were classified as the LVA (n = 30) and non-LVA (n = 118) groups, respectively. Patient characteristics and CACS values were compared between the two groups. RESULTS: LA volume, age, CHA2 DS2 VASc score, and percentage of female patients were significantly higher, and the estimated glomerular filtration rate was lower in the LVA group than in the non-LVA group. The CACS was significantly higher in the LVA group (248.4 vs. 13.2; p = .001). Multivariate analysis identified the LA volume index and CACS as independent predictors of LA-LVA (<0.5 mV) greater than 5%. The areas under the receiver operating characteristic curves for predicting LA-LVA (<0.5 mV) greater than 5% with CACS were 0.695 in the entire population, 0.782 in men, and 0.587 in women. CONCLUSION: Progression of LA remodeling and coronary artery calcification may occur in parallel. A high CACS may indicate advanced LA remodeling, especially in men.

A Novel Combination of Prion Strain Co-Occurrence in Patients with Sporadic Creutzfeldt-Jakob Disease.

Six subgroups of sporadic Creutzfeldt-Jakob disease have been identified by distinctive clinicopathologic features, genotype at polymorphic codon 129 [methionine (M)/valine (V)] of the PRNP gene, and type of abnormal prion proteins (type 1 or 2). In addition to the pure subgroups, mixed neuropathologic features and the coexistence of two types of abnormal prion proteins in the same patient also have been reported. Here, we found that a portion of the patients previously diagnosed as MM1 had neuropathologic characteristics of the MM2 thalamic form (ie, neuronal loss of the inferior olivary nucleus of the medulla). Furthermore, coexistence of biochemical features of the MM2 thalamic form also was confirmed in the identified cases. In addition, in transmission experiments using prion protein-humanized mice, the brain material from the identified case showed weak infectivity and generated characteristic abnormal prion proteins in the inoculated mice resembling those after inoculation with brain material of MM2 thalamic form. Taken together, these results show that the co-occurrence of MM1 and MM2 thalamic form is a novel entity of sporadic Creutzfeldt-Jakob disease prion strain co-occurrence. The present study raises the possibility that the co-occurrence of the MM2 thalamic form might have been overlooked so far because of the scarcity of abnormal prion protein accumulation and restricted neuropathology.

Discrimination of hie and hiesho using toe blood pressure in young women.

OBJECTIVE: In Western medicine, hie (cold sensation) is thought as a subjective complaint. Consequently, despite women's complaints of health problems due to hie, such as distress and decreased quality of life, it is not diagnosed as a disease or given active treatment. However, hie sometimes requires emergency treatment or is a symptom of other disorders. Thus, diagnosing hie and eliminating distress due to hie are clinically significant. This research aimed to discriminate between hie and hiesho (cold disorder) and quantify hie by using objective assessments in addition to subjective assessments. METHODS: A questionnaire was administered to 159 healthy young women without any underlying disease that could cause hie, followed by assessment of vascular function. These data were examined through exploratory factor analysis, exploratory cluster analysis, and multivariate logistic analysis. Two- and three-group comparisons were made using the Mann-Whitney test and Kruskal-Wallis test, respectively, followed by multiple comparisons using Scheffé's method. RESULTS: The hie (including hiesho) and normal groups comprised 81 (51%) and 78 (49%) subjects, respectively. The questionnaire was a low reliability screening method for determining the severity of hie symptoms. As an index of discrimination of hie and hiesho, we determined the toe-brachial index (TBI) to be 0.81 and toe systolic blood pressure (SBP) to be 87.73 mmHg with a linear function (TBI=0.007 5× toe SBP+0.152, adjusted R2=0.829, F(1,79)=388.79, P<0.001). CONCLUSION: Toe SBP and TBI were suggested to be capable of discriminating and quantifying symptoms when used in combination with a questionnaire.

Sparassis crispa (Hanabiratake) ameliorates skin conditions in rats and humans.

Sparassis crispa (SC) is an edible mushroom with various medicinal properties. In this study, we investigated to determine whether SC would affect skin conditions in rats and humans. Oral administration of SC increased both turnover of the stratum corneum and dermal soluble collagen content in collagen synthetic activity-reduced model rats. To investigate the effects of oral intake of SC in humans, we performed a randomized, double-blind, placebo-controlled study. We found that cheek transepidermal water loss was significantly lower in the experimental group than in the control group at 4 weeks of ingestion. This study suggests that SC is effective and safe for the improvement of skin conditions.

Megavoltage photon beam attenuation by carbon fiber couch tops and its prediction using correction factors.

The purpose of this study was to evaluate the effect of megavoltage photon beam attenuation (PBA) by couch tops and to propose a method for correction of PBA. Four series of phantom measurements were carried out. First, PBA by the exact couch top (ECT, Varian) and Imaging Couch Top (ICT, BrainLAB) was evaluated using a water-equivalent phantom. Second, PBA by Type-S system (Med-Tec), ECT and ICT was compared with a spherical phantom. Third, percentage depth dose (PDD) after passing through ICT was measured to compare with control data of PDD. Forth, the gantry angle dependency of PBA by ICT was evaluated. Then, an equation for PBA correction was elaborated and correction factors for PBA at isocenter were obtained. Finally, this method was applied to a patient with hepatoma. PBA of perpendicular beams by ICT was 4.7% on average. With the increase in field size, the measured values became higher. PBA by ICT was greater than that by Type-S system and ECT. PBA increased significantly as the angle of incidence increased, ranging from 4.3% at 180 degrees to 11.2% at 120 degrees . Calculated doses obtained by the equation and correction factors agreed quite well with the measured doses between 120 degrees and 180 degrees of angles of incidence. Also in the patient, PBA by ICT was corrected quite well by the equation and correction factors. In conclusion, PBA and its gantry angle dependency by ICT were observed. This simple method using the equation and correction factors appeared useful to correct the isocenter dose when the PBA effect cannot be corrected by a treatment planning system.

Colonic metastasis from primary carcinoma of the lung: report of a case and review of Japanese literature.

We report a rare case of colonic metastasis from primary carcinoma of the lung. A 59-year-old man who underwent pulmonary surgery for lung cancer was referred to our hospital in June 2007. The patient complained of abdominal pain, and barium enema examination at another hospital had demonstrated a descending colon tumor. Postoperative histopathological and immunohistochemical findings indicated that the tumor was a colonic metastasis of lung cancer. Three months postoperatively, the cancer had metastasized to the brain, and the patient underwent radiotherapy. He survived for more than 1 year after colonic surgery. Clinically apparent metastases from lung cancer to the colon are rare, and in the 50 Japanese cases retrospectively investigated here, the prognosis was poor.

Effects of medicinal mushroom (Sparassis crispa) on wound healing in streptozotocin-induced diabetic rats.

BACKGROUND: The impaired wound healing in diabetes mellitus is a major clinical problem. Sparassis crispa (SC) is a medicinal mushroom and its beta-glucan content is more than 40%. This study investigated whether oral administration of SC could improve the impaired wound healing in diabetic rats. METHODS: Full-thickness skin wounds were created on the backs of streptozotocin (STZ)-induced diabetic rats. Diabetic rats were then divided into 2 groups: SC-treated group that was orally administered doses of 1,000 mg/kg body weight per day of SC for 4 weeks and a control group without SC administration. Moreover, collagen synthesis of purified beta-glucan from SC was estimated in vitro. RESULTS: Wound closure was significantly accelerated by oral administration of SC. Furthermore, in SC-treated wounds there were significant increases in macrophage and fibroblast migration, collagen regeneration, and epithelialization compared with the control group. The levels of type I collagen synthesized by cultured human dermal fibroblasts for the SC group were significantly higher than those for the control group. CONCLUSIONS: SC can improve the impaired healing of diabetic wounds. This effect might involve an increase in the migration of macrophages and fibroblasts, and beta-glucan from SC directly increases the synthesis of type I collagen. Therefore, the use of SC may be extended to the clinical setting and prove an effective promoter of wound healing in patients with diabetes.

Loop diuretic precipitated beriberi in a patient after pancreaticoduodenectomy: a case report.

Upper gastrointestinal tract surgery and diuretic use are 2 unrecognized causes of thiamine (vitamin B1) deficiency. Upper gastrointestinal tract surgery decreases the thiamine absorption, and diuretic use increases urinary excretion of thiamine. We present a case of a patient with a history of pancreaticoduodenectomy who had development of beriberi by diuretic use. A 68-year-old man was referred to our hospital because of pretibial pitting edema, foot numbness, and gait disturbance. He had a history of pancreaticoduodenectomy 8 years before and had been taking loop diuretics for 2 months. He had signs of polyneuropathy and hyperkinetic heart. Beriberi was suspected, and thiamine supplementation was started immediately. Edema disappeared within several days, and signs of polyneuropathy gradually subsided. Because diuretics enhance urinary thiamine excretion, practitioners should use caution for thiamine deficiency when they prescribe diuretics for patients who have a history of upper gastrointestinal surgery and potentially have latent thiamine deficiency.

Antiproliferative activity of Rhinacanthus nasutus (L.) Kurz extracts and the active moiety, Rhinacanthin C.

Rhinacanthus nasutus (L.) Kurz (Acanthaceae) is a shrub widely distributed in South China and India. In this study, the antiproliferative activity of the ethanol extract of root and aqueous extract of leaves of R. nasutus, and the supposed active moiety rhinacanthin C was assessed in vitro using the human cervical carcinoma cell line HeLa, its MDR1-overexpressing subline Hvr100-6, human prostate carcinoma PC-3 cells and human bladder carcinoma T24 cells. Rhinacanthin C was chemically synthesized and its content in the R. nasutus extracts was determined by HPLC with a photodiode array detector. The antiproliferative activity of the R. nasutus extracts was also assessed in vivo using sarcoma 180-bearing mice. It was suggested that 1) the in vitro antiproliferative activity of rhinacanthin C was comparable with or slightly weaker than that of 5-FU, 2) rhinacanthin C showed antiproliferative activity for MDR1-overexpressing Hvr100-6 cells, similarly to parent HeLa cells, 3) the in vitro antiproliferative activity of the ethanol extract of root R. nasutus was due to rhinacanthin C, whereas that of the aqueous extract of leaves of R. nasutus was due to constituents other than rhinacanthin C, and 4) both of the R. nasutus extracts showed in vivo antiproliferative activity after oral administration once daily for 14 d.