Appendicular Muscle Mass Index was Stronger than Body Mass Index in Association with Atherosclerosis in the Community-Dwelling Elderly.

AIMS: Low muscle mass is associated with advanced atherosclerosis. However, only very few studies on the elderly have investigated a dose-response relationship between muscle mass and atherosclerosis. Furthermore, whether the relationship between muscle mass and atherosclerosis is stronger than that between body mass index (BMI) and atherosclerosis among the elderly population remains to be determined. METHODS: A community-based sample of apparently healthy elderlies (≥ 65 years) was cross-sectionally examined for the association between appendicular skeletal muscle mass (ASM) and brachial-ankle pulse wave velocity (baPWV), a measure of atherosclerosis. We categorized the participants according to sex-specific quintiles of the ASM index (ASM/height2) or BMI. Using multivariable linear regression, we compared the slope of one standard deviation higher ASM index for baPWV with the corresponding slope of BMI, separately (single-index model) and jointly (simltaneously-adjusted model). RESULTS: The ASM index and BMI of a total of 995 participants (60.0% women, mean age 73 years) were significantly inversely associated with baPWV in a dose-response manner across the quintiles in both sexes. The slope for the ASM index tended to be greater than that for BMI in the single-index and simultaneously-adjusted models in both sexes after adjusting for confounders. CONCLUSIONS: Among a community-dwelling elderly population, the association between ASM and baPWV was stronger than, and independent of that between BMI and baPWV. These findings suggest that ASM provides more important information on atherosclerosis in the elderly than BMI does.

[Efforts to improve workplaces considering for older workers: A questionnaire survey focusing on company size in Wakayama Prefecture, Japan].

OBJECTIVES: The "Guidelines for Ensuring the Safety and Health of Older Workers (hereafter referred to as "Guidelines")," formulated in 2021, require employers to implement measures that proactively prevent occupational accidents among older workers. This study aimed to clarify the status of awareness of the Guidelines and workplace improvement efforts with consideration of older workers, focusing on company size. METHODS: Overall, 780 businesses in Wakayama Prefecture, Japan, were randomly selected from a Wakayama Occupational Health Support Center workplace list. Anonymous self-administered questionnaires were distributed by mail. The questionnaires comprised questions about the workplace, status of awareness of the Guidelines, comprehensive management of safety and health, considerations for working conditions, workers, workload reduction, work posture, work environment, and safety and health. RESULTS: One hundred and seventy-one businesses (effective response rate: 21.9%) provided questionnaires with complete responses. For the Guidelines, 39.0% of small-sized (less than 50 employees) businesses answered, "never even heard of the name," while many medium-sized (50-99 employees) and large-sized (100 or more employees) businesses answered that they had heard of the name but did not exactly know about it (33.3% of medium-sized businesses and 47.8% of large-sized businesses). Regarding the system that subsidizes the expenses required for the improvement of a working environment for older workers to work safely and securely (hereinafter referred to as the subsidy system), many businesses of all sizes answered that they had "never even heard of the name." In the comprehensive management of safety and health, half of the businesses of all sizes had developed a system that made it easy to consult about the risk against occupational accidents of older workers. Regardless of size, more than half of businesses were able to consider working conditions and workers. However, there were only a few items where more than half of the businesses considered workload reduction, work posture, work environment, and safety and health, regardless of business size. It became clear that workplace improvement had not progressed very much. CONCLUSIONS: These results suggest that to promote workplace improvement that considers older workers, it is necessary to disseminate the Guidelines and proactively take on workplace improvement by utilizing the subsidy system.

Decomposition of Unpolarized Fluorescence Spectrum of Uniaxially Oriented 1,3,5-Triphenylbenzene Microcrystals Into Polarized Fluorescence Spectra.

Luminescence from solids such as crystals and aggregates is of growing academic and industrial interest. In this study, we report decomposition of the unpolarized fluorescence spectrum of uniaxially oriented 1,3,5-triphenylbenzene (TPB) microcrystals into four polarized spectra measured with polarizer (V: vertical and H: horizontal) and analyser (V: vertical and H: horizontal), where V and H indicate perpendicular and parallel to the layer of TPB molecules in the crystal, respectively. Resolved spectra were interpreted in terms of the molecular and excimer like (J- and H-dimer) emissions. The origin of the excimer like emissions was discussed in relation to the molecular packing in the crystal. It was shown that polarized crystal fluorescence can provide insight into the excitation/emission process in the crystal. Although preliminary, this study demonstrates the potential of polarized fluorescence to elucidate the luminescent mechanism.

[Support for a balance between work schedules and treatment regimens among workers with illness: A questionnaire survey focusing on company size in Wakayama Prefecture, Japan].

OBJECTIVES: The support from businesses to create a balance between work schedules and treatment regimens among employees suffering from illnesses, such as cancer and diabetes, seems to be insufficient. This study aimed to investigate efforts of businesses to support the balance of work schedules and treatment regimens among employees with illness, focusing on company size and to identify potential workplace improvements for such employees. METHODS: Overall, 789 businesses in Wakayama Prefecture, Japan were randomly selected from a workplace list of the Wakayama Occupational Health Support Center. Anonymous questionnaires were distributed by mail. The questionnaires consisted of question items on workplace, current employees who had suffered or were suffering from cancer (employees with cancer), employees with illnesses (diseases such as cancer and diabetes), and support for businesses and employees. RESULTS: Questionnaires with complete responses were collected from 187 businesses (response rate: 23.7%). The ratios of businesses where employees with cancer were engaged or had been engaged were 43.4% for small-sized (less than 50 employees), 70.9% for medium-sized (50-99 employees), and 83.1% for large-sized (100 and more employees) businesses. In all business sizes, the most common support in reinstatement or hiring employees with cancer was "absenteeism for treatment." The most common difficulty that occurred in the workplace due to the presence of employees with cancer was "the insufficient number of workers." The information from the attending physician, etc. necessary for deciding the reinstatement was mostly "the current health condition and physical strength." Additionally, in all business sizes, the most common support for employees with illness to balance work schedule and treatment regimens was "considering measures suitable to the situation such as hospital visits and physical condition." The most common challenge was "securing alternative personnel." The information from the attending physician, etc. necessary for deciding the reinstatement was "the current health condition and physical strength," similar to that for employees with cancer. More than 60% of the businesses of varying sizes reported being unaware of the work-treatment balance support coordinator. CONCLUSIONS: Considering measures suitable to the situation, such as hospital visits and physical condition, securing alternative personnel, and actively disseminating information regarding work-treatment balance support coordinators are recommended as workplace improvements for employees with illnesses.

[Allergy and immunotoxicology in preventive and clinical medicine from theory to practice: Occupational allergy and isocyanate-induced asthma].

Genetic and environmental factors and their interactions cause diseases and deteriorate health (Genetic and Environmental Interaction). Exposure to environmental factors plays a major role in the deterioration of health in the workplace.Occupational asthma (OA) is a common disorder in the workplace. Approaches to OA are well described and discussed in "Japanese Guideline for Diagnosis and Management of Occupational Allergic Diseases" by the Japanese Society of Occupational and Environmental Allergy. According to the guideline, OA and work-aggravated asthma comprise work-related asthma, and OA can be further divided into two disease entities: sensitizer-induced OA and irritant-induced OA. The guidelines also describe diagnostic and therapeutic strategies for OA. Since a definitive diagnosis of OA requires a comprehensive decision based on a detailed interview on clinical symptoms related to employment status and clinical tests, including inhalation tests of suspected substances as needed, the possibility of OA should be considered as the first step toward diagnosis of the patient. Otherwise, OA may not be diagnosed. Therapeutic strategies include exposure avoidance, environmental arrangements in the workplace, utilization of social resources for workers, and conventional pharmacotherapy for asthma.Artificially synthesized small compounds are used in various industries and can cause allergies. For example, isocyanates are small compounds in the -NCO group, which have been toxicologically studied. It was later shown that isocyanate could cause various nontoxic adverse health effects, including allergic reactions. Since small agents with low molecular weights bind to proteins, detecting their specific immunoglobulin E (IgE) antibodies targeting small compounds is generally difficult. In contrast, isocyanate-specific IgE antibodies are detectable in individuals with isocyanate allergies.Suspecting OA is essential in cases exposed to newly synthesized compounds, or to those that are already known but applied to new uses, which can be better understood and predicted by studying the health effects of isocyanates.Academic interest in various issues related to allergies, immunology, and toxicology in the workplace includes clinical medicine, epidemiology, and epigenetics related to environmental exposure. Further advanced research in these areas is necessary and promising.

[Usefulness of Simple Dietary Check Sheet as Screening Tool to Assess the Risk of Muscle Mass Reduction in Community-Dwelling Middle-Aged and Older Adults].

OBJECTIVES: The aim of this study was to investigate the usefulness of a simple dietary check sheet to assess the risk of muscle mass reduction in middle-aged and older adults. METHODS: The study participants comprised 1,272 community-dwelling individuals aged 50-89 years (mean age; 68.7 years). Bioelectrical impedance analysis was performed to estimate the appendicular skeletal muscle mass index (SMI, kg/m2). The SMIs were expressed as z-scores and adjusted for age and gender. A simple dietary check sheet was used to assess the daily intake of foods associated with maintaining muscle mass, such as meat, fish, eggs, milk, soybean products, and vegetables. RESULTS: Individuals with reduced muscle masses (SMI z-scores < -1.0) had significantly lower intakes of meat, fish, eggs, milk, and vegetables, and a lower overall dietary intake than individuals without reduced muscle masses (SMI z-scores ≥ -1.0). Food intake score was calculated to obtain quantitative estimates of the daily intake of these foods. The scores ranged from 0 to 14, with higher scores indicating higher intakes of foods that contribute to maintaining the muscle mass. Compared with the reference group with scores of ≥ 10, the groups with lower scores were at a higher risk of muscle mass reduction. The odds ratios (95% confidence interval) of the groups with scores of 9, 8, 7, 6, and ≤ 5 were 1.15 (0.42-3.13), 2.10 (0.89-4.95), 3.64 (1.61-8.23), 4.49 (1.90-10.58), and 7.53 (3.06-18.51), respectively, after adjusting for age, gender, obesity, alcohol intake, smoking, physical inactivity, hypertriglyceridemia, diabetes mellitus, and liver dysfunction. CONCLUSIONS: As the food intake scores were significantly associated with decreased muscle mass, the proposed simple dietary check sheet may help assess the risk of muscle mass reduction in middle-aged and older adults from a nutritional perspective.

[Development of a Risk Prediction Model and a Simple Assessment Sheet for Cold Disorder (Hiesho) in Middle-aged and Older Adults].

OBJECTIVES: In this study, we aimed to develop a risk prediction model and a simple assessment sheet for cold disorder (hiesho) in middle-aged and older adults. METHODS: The 889 participants in this study were from a community-dwelling general population (mean age, 62.4±8.8 years). The skin surface temperatures of the face and hands of the participants were measured by thermography. The cold disorder was objectively defined as having a temperature difference of ≥8°C between the forehead and fingertips. Data on the body regions with cold perception and the various concomitant signs were collected by a self-administered questionnaire and structured interviews. RESULTS: The objectively assessed cold disorder was observed in 22.7% of participants and strongly associated with coldness of the back of the hand, palms, fingers, dorsal torso, toes, and soles of the feet. Its prevalence was found to increase with the number of signs of coldness. Older age, being female, low body mass index, hypertension, anemia, and physical inactivity were identified as potential risk factors. A logistic model for predicting the cold disorder was designed on the basis of the perceived cold, accompanying signs, and risk factors. The model showed good discrimination (area under the curve=0.737) and calibration capabilities (Hosmer-Lemeshow test, P=0.426). On the basis of this prediction model, a simple assessment sheet was developed to estimate the individual risk of experiencing the cold disorder, in middle-aged and older adults. CONCLUSIONS: With the proposed risk prediction model showing good discrimination capability, the assessment sheet may serve as a prescreening tool to evaluate the potential of middle-aged and older population to develop the cold disorder.

Evaluation of darrow red-organosilane composite as a photosensitizer for application in dye-sensitized zinc oxide photocatalysts: DFT and TD-DFT studies.

CONTEXT: Density functional theory (DFT) and time-dependent DFT (TD-DFT) studies of darrow red covalently attached to 3-glycidyloxypropyltrimethoxysilane (DR-GPTMS) were conducted, and it was shown that DR-GPTMS can be applied as a photosensitizer in dye-sensitized zinc oxide (ZnO) photocatalysts. The frontier molecular orbital (FMO) levels of DR-GPTMS simulated using a conductor-like polarizable continuum model in water were suitable for electron injection from photoexcited DR-GPTMS to ZnO. Additionally, the oxidized DR-GPTMS produced by electron injection can be regenerated using triethanolamine. UV-visible absorption spectra, FMOs, and density of states spectra of DR-GPTMS adsorbed on the Zn2O3 cluster were also investigated to understand the mechanism of electron injection. The results suggest that DR-GPTMS induces good visible-light absorption and efficient electron injection to ZnO. METHODS: DFT and TD-DFT calculations were performed using the Gaussian 09W package (Gaussian, Inc., Wallingford, CT, USA). The density of states spectra was obtained using GaussSum (3.0.2). The B3LYP/6-31G** level of theory was employed for all calculations except for the UV-visible absorption spectra simulation. In calculations involving ZnO, the LanL2DZ or SDD basis set was assigned to the zinc atoms. TD-DFT calculations were performed at the eight different functionals (B3LYP, PBE0, M06-L, M06, M06-2X, M06-HF, CAM-B3LYP, and ωB97XD) with the 6-31+G** basis set. A conductor-like polarizable continuum model (CPCM) using water was employed determining the solvent effect.

Exaggerated blood pressure response to exercise is associated with subclinical vascular impairment in healthy normotensive individuals.

BACKGROUND: This study was designed to evaluate the possible association between an exaggerated blood pressure (BP) response to exercise and subclinical vascular impairment in normotensive individuals. METHODS: The study participants consisted of 92 untreated normotensive men (aged 42 ± 9 years) without a history of cardiovascular disease or stroke. A graded exercise test was conducted using a bicycle ergometer, and the mean arterial pressure (MAP) during submaximal exercise was evaluated. The brachial-ankle pulse wave velocity (baPWV) was measured as an index of arterial stiffness. The second peak of radial systolic BP (SBP2) was used as an estimate of central BP. The albumin-to-creatinine ratio (ACR) values were determined as the mean of two nonconsecutive spot urine specimens. RESULTS: Compared with individuals with a normal response (MAP z-score < +1.0, n = 60), those with an exaggerated BP response to exercise (MAP z-score ≥ +1.0, n = 32) exhibited significantly higher baPWV (1412 ± 158 vs. 1250 ± 140 cm/s), radial SBP2 (122 ± 11 vs. 106 ± 13 mmHg), and greater log-ACR (0.93 ± 0.30 vs. 0.59 ± 0.23 mg/gCre). Multiple regression analysis revealed that an exaggerated BP response to exercise was significantly associated with baPWV (ß = 0.198, P= .043), radial SBP2 (ß = 0.156, P = .049), and log-ACR (ß = 0.276, P = .006) independent of potential confounding factors. CONCLUSIONS: These results suggest that subclinical vascular impairment is associated with an exaggerated increase in BP during exercise even in the absence of clinical hypertension.

Muscle mass reduction, low muscle strength, and their combination are associated with arterial stiffness in community-dwelling elderly population: the Wakayama Study.

Age-related loss of skeletal muscle mass and function is associated with some predisposing factors that increase the risk of vascular damage. This study aimed to examine whether muscle mass reduction, low muscle strength, and their combination were related to arterial stiffness in community-dwelling elderly population. Study participants consisted of 1046 elderly individuals (aged 72 ± 5 years) without cardiovascular disease, chronic kidney disease, or liver disease. Bioelectrical impedance analysis was performed to estimate appendicular skeletal muscle mass (ASM). A value for ASM was normalized for height (ASM index, kg/m2). Handgrip strength (HGS) was measured using a Smedley grip dynamometer. Brachial-ankle pulse wave velocity (baPWV) was evaluated as an index of arterial stiffness using a simple automatic oscillometric technique. When participants were stratified based on baPWV cut-off values (< 1800 cm/s, 1800 to 1999 cm/s, ≥ 2000 cm/s), ASM index and HGS progressively decreased with an increase in baPWV levels (P for trend < 0.001). In multiple regression analysis, baPWV was significantly associated with ASM index (ß = -0.270, P < 0.001) and HGS (ß = -0.102, P < 0.001) independent of potential confounding factors. The baPWV of the subgroup with low ASM index and low HGS was significantly higher than that of those with only low ASM index or low HGS (P < 0.001). These results suggest that loss of skeletal muscle mass and function is associated with increased arterial stiffness in the elderly population, and the combination of muscle mass reduction and low muscle strength may lead to greater arterial stiffness than each of the individual conditions.

Computational Study of Cresyl Violet Covalently Attached to the Silane Coupling Agents: Application to TiO2-Based Photocatalysts and Dye-Sensitized Solar Cells.

The covalent attachment of photosensitizing dyes to TiO2 using silane coupling agents (SCAs) is a promising strategy for enhancing the photocatalytic activity of TiO2-based photocatalysts and the photovoltaic conversion of dye-sensitized solar cells (DSSCs). This approach can control the geometry and orientation of the photosensitizing dye on the TiO2 surface. In this study, a density functional theory (DFT) and time-dependent DFT (TD-DFT) investigation was carried out on cresyl violet (CV) covalently attached to SCAs with a terminal oxirane group (OTES-Cn) to reveal the influence of OTES-Cn on the geometry of the photosensitizing dyes. The potential of CV covalently attached to OTES-Cn (CV-OTES-Cn) to act as a photosensitizing dye was also analyzed. The hydroxyl group formed by the epoxy-opening reaction between CV and OTES-Cn strongly influenced the geometry of CV-OTES-Cn, which was attributed to a CH-O interaction. Additionally, TD-DFT, frontier molecular orbital and molecular electrostatic potential calculations revealed that CV-OTES-Cn has excellent optical properties and electron injection ability. In particular, the characteristics of the unbent conformation of CV-OTES-Cn are expected to contribute significantly to the photocurrent in TiO2-based photocatalysts and DSSCs. These findings enhance the understanding of the covalent attachment strategy using SCAs and contribute to improving TiO2-based photocatalysts and DSSCs.

Very Long-Term Treatment with a Lactobacillus Probiotic Preparation, Lactobacillus casei Strain Shirota, Suppresses Weight Loss in the Elderly.

Weight loss, often observed in the elderly, is associated with increased risks of various diseases. No large and long-term human study has been conducted to demonstrate the health maintenance-related effects of lactic acid bacteria preparations. To reveal the potential benefit of long-term lactic acid, the effects of bacteria-based probiotics for health maintenance were examined. This observational study included the participants from a previous clinical study designed to evaluate the effects of wheat bran biscuits or Lactobacillus preparation, 3 g/day biolactis powder (BLP), in preventing colorectal tumor. The participants were provided an option to continue treatment with BLP on an outpatient basis after completion of the study. The 380 patients who completed the study were contacted and asked to participate in the present study and those who consented were surveyed for cancer incidence, treatment compliance, lifestyle, weight, and other variables. Informed consent was obtained from 237 of the 380 (62.4%) patients. The mean follow-up period was 7913 days (21.7 years). Cancer developed in 24 of 128 (18.8%) patients in the BLP extension group and 24 of 109 (22.0%) patients in the non-BLP extension group (risk ratio 0.88 [95% confidence interval 0.53-1.47]). Although no significant difference was observed, the cumulative cancer incidence rose at a slightly lower rate in the BLP extension group. Both groups showed a significant weight decrease over the course of 20 years, although the decrease in the BLP extension group was only 1.4 kg, compared with 2.8 kg in the non-BLP extension group. Very long-term treatment with a Lactobacillus probiotic preparation suppressed weight loss in the elderly.

[Supporting a balance between work schedules and treatment regimens among cancer patients: A questionnaire survey focusing on company size in Wakayama Prefecture, Japan].

OBJECTIVES: The support from businesses to create a balance between work schedules and treatment regimens among employees suffering from cancer seems to be insufficient. The aims of this study were to investigate efforts to find a balance between work schedules and treatment regimens among cancer patients focusing on company size and to identify potential workplace improvements for these employees. METHODS: Seven hundred and seventy businesses in Wakayama Prefecture, Japan, were randomly selected from a workplace list consisting of businesses that had received support from either the Wakayama Occupational Health Support Center or the Regional Occupational Health Center. An anonymous questionnaire was distributed by mail. It consisted of question items on the workplace, support systems, current employees who had suffered or were suffering from cancer (cancer patient employees), their reinstatement, promoting reinstatement and employment of cancer patient employees, and job description of respondents. RESULTS: A completed questionnaire was collected from 188 businesses (response rate: 24.4%). Among small-sized businesses (less than 50 employees), 55% carried out or recommended consultation for cancer screening. This ratio was higher than that of medium-sized businesses (50-99 employees) or large-sized businesses (100 or more employees). Approximately 20% of the businesses had a support system for employees who were working while undergoing cancer treatment, and more small-sized businesses had a system of annual paid leave by the hour than the medium-sized or large-sized businesses. Among the small-sized businesses, 51% had a system of sick leave for regular employees, but this ratio was significantly lower than that among the large-sized businesses. Approximately 20% of businesses had established a system of paid sick leave for regular employees. Reinstatement of employment was possible in over 80% of the businesses. The condition for reinstatement that was most frequently stipulated was that the employee's doctor had provided a medical certificate stating that the employee was able to return to work. However, among small-sized businesses, the condition that colleagues at the workplace were willing to accept him/her was more frequently stipulated. CONCLUSIONS: Cancer screening, annual paid leave by the hour, and institutionalization of sick leave are recommended as workplace improvements for cancer patient employees.

Pyrrole adducts in globin and plasma of workers exposed to hexane.

OBJECTIVES: Urinary excretion of 2,5-hexanedione is currently used to estimate the exposure levels of hexane occurring to an individual during the previous work shift. However, because hexane exposures and urinary 2,5-hexanedione levels can vary considerably from day to day, and subchronic to chronic exposures to hexane are required to produce neuropathy, this biomarker may not accurately reflect the risk of an individual for developing hexane neuropathy. This investigation examines the potential of hexane-derived pyrrole adducts produced on globin and plasma proteins as markers for integrating cumulative exposures. Because the pyrrole markers incorporate bioactivation of hexane to 2,5-hexandione and the initial step of protein adduction involved in hexane-induced neuropathy, they potentially can serve as biomarkers of effect through reflecting pathogenetic events within the nervous system. Additionally, pyrrole formation is an irreversible reaction suggesting that hexane-derived protein pyrroles can be used to assess cumulative exposures to provide a better characterization of individual susceptibilities. METHODS: To examine the utility of the proposed markers, blood samples were obtained from eleven workers who used hexane for granulating metal powders in a slurry to produce metal machining die tools and four non-exposed volunteers. Globin and plasma were isolated, and the proteins were digested using pepsin, reacted with Ehrlich's reagent and the level of pyrrole adducts were determined by absorbance at 530 nm. To determine the dose-response curve and dynamic range of the assay, erythrocytes were incubated with a range of 2,5-hexanedione concentrations and the net absorbance at 530 nm of isolated globin was measured. RESULTS: Pyrrole was detected in both the globin and plasma samples of the workers exposed to hexane and the levels of pyrroles in plasma were positively correlated with the levels of pyrroles in globin for most of the workers. CONCLUSIONS: This investigation demonstrates that detectable levels of hexane-derived protein pyrrole adducts are produced on peripheral proteins following occupational exposures to hexane and supports the utility of measuring pyrroles for integrating cumulative exposures to hexane.

Pseudomesotheliomatous Carcinoma with a High Pleural Hyaluronic Acid Concentration Arising from a Primary Esophageal Squamous Cell Carcinoma.

BACKGROUND Pseudomesotheliomatous carcinomas are rare tumors that develop like malignant pleural mesothelioma (MPM). These tumors have similar features, and thus pseudomesotheliomatous carcinomas can sometimes be misdiagnosed as MPM. Most pseudomesotheliomatous carcinomas develop from primary lung cancers, although there have been some reports involving other malignancies; however, there has been no report describing a pseudomesotheliomatous carcinoma developing from an esophageal squamous cell carcinoma (ESCC). To the best of our knowledge, this is the first case report describing pseudomesotheliomatous carcinoma originating from primary ESCC. CASE REPORT A 65-year-old man was admitted to our hospital because of persistent cough and right chest pain. Radiological examination suggested MPM, and a high concentration of pleural hyaluronic acid was also observed. Cytological examination of pleural effusion confirmed metastatic squamous cell carcinoma, and ESCC was confirmed by upper-gastrointestinal endoscopy. The patient received cisplatin and 5-FU combination chemotherapy as first-line treatment, and docetaxel chemotherapy as second-line treatment. However, the patient's condition deteriorated, and he died 6 months after the diagnosis was established. We performed an autopsy and found that ESCC had invaded the lung, pleura, peritoneum, liver, stomach, ureter, bladder, spine, and lymph nodes. CONCLUSIONS We demonstrated that primary ESCC can give rise to a pseudomesotheliomatous carcinoma. This report describes the clinical features and outcome of such a patient, with an emphasis on differential diagnosis of MPM.

Impact of Diarrhea after Drinking on Colorectal Tumor Risk: A Case Control Study

Background: Recently, the number of colorectal cancer (CRC) cases in Japan has been increasing, and is strongly influenced by alcohol consumption. On the other hand, there are several reports suggesting a relationship between bowel movement (constipation and diarrhea) and CRC development. Moreover, it is generally known that diarrhea may occur after drinking. However, the mechanism by which drinking alcohol increases CRC is not fully clarified yet. We hypothesized that diarrhea after drinking may play an important role in colorectal carcinogenesis. Methods: We examined the presence of diarrhea after drinking and further evaluated the correlation of diarrhea after drinking with the incidence of colorectal tumors. To obtain the status of the feces, a self-recorded questionnaire survey was administered using the dietary-recording method. Blood samples were obtained to analyze the ALDH2 Glu504Lys and ADH1B His48Arg polymorphisms. Results: The participants were 417 patients who had undergone a total colonoscopy. The control was selected from 186 patients who underwent a medical checkup at the same hospital during the same time period. The odds ratio for all subjects was 2.1 (95% CI: 1.18 - 3.80), and that for heavy drinkers was 4.2 (1.48 - 11. 90). Conclusions: The results demonstrated that those who have diarrhea after drinking possess a high risk of developing colon tumors.

[Liver Fibrosis is Associated with Loss of Skeletal Muscle Mass in Community-Dwelling Older Adults with No History of Liver Diseases].

OBJECTIVES: In this study, we aimed to examine the possible association between liver fibrosis and loss of skeletal muscle mass (SM) in community-dwelling older adults with no history of liver diseases. METHODS: A total of 2,028 older adults (mean age, 69.8 ± 5.2 years) who had not received any treatment for liver diseases and had participated in a comprehensive health survey for community residents in Wakayama, Japan were included in this study. We carried out bioelectrical impedance analysis to estimate the SM of the whole body including the arms, legs, and trunk of the subjects. Liver fibrosis was evaluated by calculating the Fib4 index based on the subject's age, AST level, ALT level, and platelet counts. RESULTS: The subjects were divided into three groups according to cutoff values of the Fib4 index (low: <1.30, medium: 1.30-2.66, high: ≥2.67). The SM index (kg/m2) was the lowest among subjects in the high-Fib4-index category, followed by the medium- and low-Fib4-index categories. This dose-response reduction in the SM index was more pronounced among individuals with lower blood albumin level (low nutrition) and in those with more sedentary behavior (physical inactivity). Among the selected 262 subjects who underwent SM measurement twice with an interval of 3 years, the subjects with a high Fib4 index showed greater reduction in the SM index than those with medium and low Fib4 indices. Multiple regression analysis revealed that the Fib4 index was significantly associated with the SM index, independent of age, sex, albumin level, sedentary behavior, diabetes mellitus, alcohol intake, and smoking status. CONCLUSIONS: The present findings suggest that the potential progression of liver fibrosis is associated with the excessive loss of SM among apparently healthy older adults without any treatment for liver diseases.

Photoionization and trans-to-cis isomerization of ß-cyclodextrin-encapsulated azobenzene induced by two-color two-laser-pulse excitation.

Azobenzene (1) and the complex resulting from the incorporation of 1 with cyclodextrin (1/CD) are attractive for light-driven applications such as micromachining and chemical biology tools. The highly sensitive photoresponse of 1 is crucial for light-driven applications containing both 1 and 1/CD to reach their full potential. In this study, we investigated the photoionization and trans-to-cis isomerization of 1/CD induced by one- and two-color two-laser pulse excitation. Photoionization of 1/CD, which was induced by stepwise two-photon absorption, was observed using laser pulse excitation at 266nm. Additionally, simultaneous irradiation with 266 and 532nm laser pulses increased the trans-to-cis isomerization yield (Υt→c) by 27%. It was concluded that the increase in Υt→c was caused by the occurrence of trans-to-cis isomerization in the higher-energy singlet state (Sn), which was reached by S1→Sn transition induced by laser pulse excitation at 532nm. The results of this study are potentially applicable in light-driven applications such as micromachining and chemical biology tools.