Impact of Fish Intake Frequency on Cardiovascular Disease-Specific Survival in Hemodialysis Patients.

Introduction: Cardiovascular disease (CVD) is the leading cause of death in hemodialysis patients (HPs). As a food source, fish contains both CVD-preventive and CVD-promoting fatty acids; however, there is no consensus on fish consumption as a preventive measure for CVD in HPs. This single-center longitudinal cohort study aims to assess the impact of fish intake frequency (FIF) per week on CVD in Japanese HPs. Methods: Upon the initiation of the study, 148 HPs were evaluated to determine the FIF, and blood samples were analyzed. These patients were then monitored for 6 years.The relationships between each FIF and blood sampling data, CVD-specific survival (CSS), and new CVD-free survival (nCFS) were statistically calculated using Kaplan-Meier survival curves. Results: During the observation period, 65 deaths were reported, 16 of which were attributed to CVD. Further, 53 patients developed new CVD onset, and no association was found between the FIF and blood sampling data. Based on the Kaplan-Meier survival curves, there was a significant difference in the CSS probability rates at 72 months between patients with an FIF of ≥4 (0.719, 95% confidence interval (CI): 0.530-0.842) and those with an FIF of ≤3 (0.930, 95% CI: 0.851-0.968) (p < 0.01). However, the nCFS probability at 72 months did not significantly differ between patients with an FIF of ≥4 and those with an FIF of ≤3. Multivariate Cox proportional hazards regression showed that an FIF of ≥4 (hazard ratio: 3.64, 95% CI: 1.22-10.9, p = 0.02) was an independent predictor of CSS, but not of nCFS. Conclusions: It was suggested that a higher FIF in HPs might be one of the risks for developing CVD with increased mortality.

Drug offenses in the Tokyo Metropolitan Area: Trends for 2016-2018.

In Japan over the past few years, approximately 13,000 individuals were arrested for drug offenses each year. It is useful to know the trends in drug offenses, in order to devise the most effective countermeasures and addiction treatment programs. Herein, we have revealed the trends in drug offenses in the Tokyo Metropolitan Area. This report was researched the number of individuals arrested for drug offenses in Tokyo during the 3-year study period 2016-2018. The drugs are classified into the six categories: stimulants, narcotics, psychoactive drugs, opium, cannabis, and designated substances. We also calculated the percentages of individuals arrested for various drug offenses based on these six categories. Approximately 86% of the arrests for drug offenses in Tokyo during the 3-year period were for stimulants or cannabis. A higher percentage of individuals were arrested for stimulants, but the percentage of individuals arrested for cannabis increased each year. Given the percentage of individuals arrested for designated substances or narcotics, preventive measures for drug offenses involving stimulants and cannabis should be promptly implemented. Further campaigns to prevent drug offenses and public lectures are also needed. Public education must be provided to prevent drug offenses involving designated substances and narcotics.

Japanese cross-cultural validation study of the Pain Stage of Change Questionnaire.

INTRODUCTION: Although evidence supports efficacy of treatments that enhance self-management of chronic pain, the efficacy of these treatments has been hypothesized to be influenced by patient readiness for self-management. The Pain Stage of Change Questionnaire (PSOCQ) is a reliable and valid measure of patient readiness to self-manage pain. However, there is not yet a Japanese version of the PSOCQ (PSOCQ-J), which limits our ability to evaluate the role of readiness for pain self-management in function and treatment response in Japanese patients with chronic pain. OBJECTIVE: Here, we sought to develop the PSOCQ-J and evaluate its psychometric properties. METHODS: We recruited 201 patients with chronic pain. The study participants were asked to complete the PSOCQ-J and other measures assessing pain severity, pain interference, catastrophizing, self-efficacy, and pain coping strategies. RESULTS: The results supported a 4-factor structure of the PSOCQ-J. We also found good to excellent internal consistencies and good test-retest reliabilities for the 4 scales. The Precontemplation scale had weak to moderate positive correlations with measures of pain-related dysfunction and maladaptive coping. The Action and Maintenance scales had weak to moderate positive correlations with measures of self-efficacy and adaptive coping. The Contemplation scale had weak positive correlations with measures of pain interference and both adaptive and maladaptive coping. CONCLUSIONS: The PSOCQ-J demonstrated adequate psychometric properties in a sample of Japanese patients with chronic pain. This measure can be used to evaluate the role that readiness to self-manage pain may play in adjustment to chronic pain in Japanese pain populations.

A Cross-Cultural Validation of the Multidimensional Pain Readiness to Change Questionnaire 2 for Japanese Individuals With Chronic Pain.

OBJECTIVES: The Multidimensional Pain Readiness to Change Questionnaire 2 (MPRCQ2) is a reliable and valid measure that assesses readiness to adopt a variety of discrete pain self-management responses. We sought to translate and evaluate psychometric properties of the Japanese version of the MPRCQ2 (MPRCQ2-J) in individuals with chronic pain. METHODS: One hundred seventy-three individuals with chronic pain were asked to complete the MPRCQ2-J, as well as measures assessing pain intensity, pain interference, self-efficacy, and general readiness to adopt a self-management approach for pain. Forty-eight of these participants provided additional MPRCQ2-J data to assess test-retest reliability. RESULTS: The findings supported a 2-factor structure of the MPRCQ2-J when error covariances between the some of the nine primary scales were allowed. Adequate internal consistencies of the MPRCQ2-J scales (Cronbach's α ranged 0.71 to 0.86), except for the total score (α = 0.68), were observed. However, adequate test-retest reliabilities (intraclass correlation coefficients ≥ 0.60) were found for only 59% of the MPRCQ2-J scales. The MPRCQ2-J evidenced its construct validity via confirmation of the predicted patterns of associations with validity criterion measures and the anticipated effects of participation in an exercise treatment. DISCUSSION: The findings support the internal consistency (except for the total score) and construct validity for MPRCQ2-J scales. However, potential limitations with respect to test-retest reliability of some of the scales were also suggested. The MPRCQ2-J can be used to examine the role that specific readiness domains of pain self-management responses may play in an adjustment process in Japanese individuals with chronic pain.

Detailed discussion on evidence for the further prevention of traffic fatalities in Japan: a comparison of trends in three countries.

The total number of traffic fatalities has decreased in recent years. To further reduce the number of traffic fatalities, details regarding traffic fatalities and various aspects of traffic accidents must be studied. Therefore, this research examined the number of traffic fatalities by age group and the number of traffic fatalities by situation in Japan from 2003 to 2007, and the percentage of traffic fatalities by age group and the percentage of traffic fatalities by situation during the same period were calculated. In addition, aspects of traffic accidents in Japan were compared with those in Germany and France, and additional measures to counter traffic accidents that need to be taken in Japan in order to further reduce the number of traffic fatalities were studied. Results indicated that in each year of the period studied the highest percentage of traffic fatalities involved the 25-64 age group in Germany and France and the 65-or-over age group in recent years in Japan. In addition, additional measures to counter traffic accidents involving the elderly are needed in Japan, Germany and France. The percentage of traffic fatalities by situation indicated that attention should be paid to 'fatalities of pedestrians' in Japan and to 'fatalities of motor vehicle occupants' in all the three countries studied. In particular, measures to counter traffic accidents leading to 'fatalities of pedestrians' must be studied further in Japan. With the above findings in mind, bodies involved in implementing measures to counter traffic accidents must formulate specific measures.

An analysis of drug-related offenses in Japan: focusing on a discussion of future preventive measures.

Recently, drug use has become a major social problem in Japan. Therefore, this study examined recent trends of drug use in detail. Specifically, this report researched the number of people arrested for drug-related offenses in the 8 years since 2001 and it discusses measures to prevent drug use. During the period studied, the proportion of drug-related offenses related to 'stimulants' has decreased, despite those drugs accounting for the highest proportion of such offenses, and the proportion of offenses related to 'cannabis' has increased markedly. Therefore, organizations implementing measures to prevent drug-related offenses should be aware of the recent increase in the number of people arrested for 'cannabis' and the high proportion of arrests for 'stimulants'.

Introduction of endobronchial ultrasonography (EBUS) in bronchoscopy clearly reduces fluoroscopy time: comparison of 147 cases in groups before and after EBUS introduction.

BACKGROUND: Endobronchial ultrasonography (EBUS) has been used in diagnosing peripheral lung cancer and has allowed for higher rates of peripheral lung cancer diagnosis. However, no studies have reported that fluoroscopy time is shortened by the use of endobronchial ultrasonography. We aimed to investigate whether fluoroscopy time is shortened using endobronchial ultrasonography. METHODS: We retrospectively researched fluoroscopy time in terms of the rate of diagnosis, lesion size, age, gender, histologic type and lesion site in 147 cases of malignant lesions from January 2006 to September 2007 at the Tokai University Hospital. The location of the bronchial brush or biopsy forceps was confirmed by fluoroscopy without endobronchial ultrasonography with guide-sheath group in 96 of the 147 cases, while fluoroscopy with endobronchial ultrasonography guide sheath group was confirmed in 51 cases. RESULTS: The result was that fluoroscopy time was significantly shortened in the endobronchial ultrasonography guide-sheath group (4.08 ± 3.27 min) compared with the non-endobronchial ultrasonography guide-sheath group (7.06 ± 3.99 min), but there was no significant difference between either groups in terms of bronchoscopic diagnosis, lesion size, age, gender, histologic type and lesion site. CONCLUSION: The use of endobronchial ultrasonography guide sheath allows a reduction in fluoroscopy time and may reduce the adverse effects of radiation exposure on patients and staff.

Relationships between suicide and three economic factors in South Korea.

The number of suicides in South Korea totaled 4840 in 1995 and 8569 in 1998; in Japan, suicides totaled 21,420 in 1995 and 31,755 in 1998. Suicide prevention is an important issue for both South Korea and Japan. In South Korea, factors related to the increase in suicides must be clarified, and specific suicide prevention measures must be promptly discussed in order to decrease the number of suicides. Therefore, this report examined suicide and unemployment rates and increased rates of mining and industrial production and of money supply in South Korea from 1990 to 2002. This report also discusses the relationships between suicide and unemployment rates and increased rates of mining and industrial production and increased rates of money supply during the same period. During the period studied, annual suicide rates ranged from 7.1 to 18.3 per 100,000 populations. Multiple regression analysis indicated that the suicide rate was clearly related to the unemployment rate, but the suicide rate was not related to increased rates of mining and industrial production and increased rates of money supply. Thus, when unemployment rates increase, relevant organizations and the community should pay close attention to the increase in suicide rates.

An epidemiological analysis of drunk driving accidents in Kagawa Prefecture - comparison of 1997-2000 and 2003-2006.

In this study, we examined the number of drunk driving accidents and drunk driving accident toll in 1997-2000 and 2003-2006 for Kagawa Prefecture, which had Japan's highest number of traffic accident fatalities per 100,000 population.

Clinical significance of thymidylate synthase expression in bladder cancer.

BACKGROUND: The purpose of the present paper was to investigate the clinical significance of thymidylate synthase (TS) expression in bladder cancer and its association with proliferation markers, such as p53, Ki-67, and proliferating cell nuclear antigen (PCNA). METHODS: Thymidylate synthase gene expression in 54 patients with bladder cancer was measured by the reverse transcription polymerase chain reaction (RT-PCR) method using glyceraldehyde-3-phosphate dehydrogenase (GAPDH) as an internal standard. The TS expression was also examined immunohistochemically. Immunohistochemical studies of p53, Ki-67, and PCNA expression were carried out to examine the correlation between TS expression and the expression of proliferation markers in the tumors. Prognostic and clinical outcome factors such as vascular invasion and distant metastasis were also examined along with TS expression. RESULTS: Twenty-four patients with invasive bladder cancer had TS levels of 5.07 +/- 0.77 (mean +/- SE), while 30 patients with superficial bladder cancer had TS levels of 2.28 +/- 0.38. There was a significant difference in TS levels between invasive and superficial bladder cancer (P = 0.001). There was a positive correlation between TS expression and each proliferation marker of p53 (r = 0.686, P < 0.01), Ki-67 (r = 0.715, P < 0.0001) or PCNA expressions (r = 0.670, P < 0.0001) in these patients. Patients with high TS levels (TS > or = 2.63, the median value) had significantly higher rates of vascular invasion and distant metastasis. Kaplan-Meier analysis demonstrated that patients with high TS levels (TS > or = 2.63) had unfavorable prognosis compared to patients with low TS levels (TS < 2.63; P = 0.034). Furthermore, patients with high TS staining had a significantly poorer prognosis than those with low staining (P = 0.012). CONCLUSION: Determination of level of TS expression may help in the selection of an appropriate treatment for bladder cancer because TS expression influences the biological characteristic of bladder tumor.

Involvement of adrenomedullin induced by hypoxia in angiogenesis in human renal cell carcinoma.

BACKGROUND: Adrenomedullin (AM) has pluripotent activities and is involved in the regulation of vasomotor tone, cell differentiation and embryogenesis. However, the expression and pathophysiological role of AM has not been determined in human renal cell carcinoma (RCC). METHODS: Twenty-six RCC specimens and three cultured human RCC cell lines (A498, SN12C and KPK-13) were analyzed. Expression of AM was determined by immunohistochemistry and reverse transcription-polymerase chain reaction (RT-PCR) analysis. The correlation between AM expression and microvessel count (MVC) in RCC specimens was examined to determine if AM plays a role in tumor angiogenesis. The correlation between the expression of AM and vascular endothelial growth factor (VEGF) was also investigated. Lastly, the effect of hypoxia upon the mRNA expression of AM, VEGF and hypoxia inducible factor-1 (HIF-1) by RCC cell lines was determined. RESULTS: Immunohistochemistry indicated that AM and VEGF were primarily localized in the cytosol of RCC cells. AM and VEGF mRNA were detected in all RCC specimens and cultured RCC cell lines analyzed by RT-PCR. There was a positive correlation between AM mRNA expression and MVC (r = 0.516, P = 0.0062), and between VEGF mRNA expression and MVC (r = 0.485, P = 0.0111). We also observed a positive correlation between AM mRNA expression and VEGF mRNA expression (r = 0.552, P = 0.0029). Hypoxia significantly induced AM and VEGF mRNA expression, although the increase of the AM mRNA level (10.6-26.7 fold) was markedly greater than that of the VEGF mRNA level (1.5-1.9 fold). CONCLUSION: These results suggest that hypoxia-induced AM plays a part in tumor angiogenesis in conjunction with VEGF and facilitates human RCC growth under hypoxic conditions.