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Objectives: Road traffic injuries, particularly pedestrian injuries, are a major health issue among children worldwide. The present study quantitatively analyzed the time trends of child pedestrian injuries in Japan from 1975 to 2013 by age. Study design: Time trend analysis of nationally aggregated data. Methods: We analyzed police data on pedestrian injuries requiring medical treatment among children aged 0e15 years occurring between 1975 and 2013. To quantify the time trends of pedestrian injury morbidity rates and to identify change-points in the trends, joinpoint regression analysis was applied by age group. Children were categorized into the age groups of 0e3, 4e6, 7e9, 10e12, and 13e15 years old. Results: Preschool children aged 0e6 years old showed continuous declining trends throughout the study period; these declining trends accelerated in the 2000s. School-age children aged 7e15 years old showed minimal changes from the early 1970s to the 1990s; of this age group, children aged 7e12 years old showed slight but significant declining trends in the first half and increasing trends in the latter half of this period. Children aged 7e15 years old showed declining trends in the 2000s. Despite the consistent declining trends among all age groups in the 2000s, the younger age groups showed steeper declines during this period. Conclusions: The declining trends in all age groups in the 2000s may reflect the improved traffic environments in Japan although the environmental approaches are not yet sufficiently adopted yielding modest effects. The continuing contrast between preschool and school-age children may reflect different behaviour changes by age such as more restricted outdoor activities among young children. [ABSTRACT FROM AUTHOR]

To investigate the accuracy and clinical value of a new adhesion scoring system using transvaginal ultrasonography for endometriosis. Prospective observational study. Nippon medical school hospital, Tokyo, Japan. 131 patients with endometriosis who underwent surgery at Nippon medical school Hospital. Before surgery, transvaginal ultrasonography and adhesion mapping were performed to determine the presence or absence of adhesions at 10 sites of the pelvis. To determine the severity of pelvic adhesions, we developed an adhesion score (0-10). With the adhesion score, we assessed the effect of surgical adhesiolysis and evaluated the relationship between postoperative adhesions and infertility.Results: Of the 10 sites assessed for adhesions, the most frequent site of adhesions was the site between the left ovary and the uterus (70.5%). The overall sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, and accuracy of adhesion mapping were 80.4%, 86.1%, 78.8%, 87.2%, 5.79, 0.23, and 83.9%, respectively. The adhesion score in this system was significantly correlated with the adhesion-related score in the r-ASRM classification (R2 = 0.734). Surgical adhesiolysis yielded only about 30% improvement postoperatively. The adhesion score in the non-in vitro fertilization (IVF) pregnancy group was significantly lower than that in the IVF pregnancy group (3.45 vs. 5.00; p = 0.04). Our adhesion scoring system allowed an accurate prediction of the pelvic adhesion status and may potentially be an indicator of postoperative adhesions and infertility. [ABSTRACT FROM AUTHOR]

Dy3+- and Nd3+-doped stoichiometric 20GaS3/2·50GeS2·30SbS3/2 glasses were prepared. Judd–Ofelt analyses were performed to estimate radiative transition parameters for the excited levels. Near- and mid-infrared emission spectra were observed and their emission bands were carefully assigned on the basis of the transition parameters and the comparison of the spectra obtained by the different excited levels. The 4.4-μm emission band from Dy3+ due to the transition, 6H11/2 → 6H13/2, had a branching ratio more than 10% and a quantum efficiency was 63% for the glass doped with 0.3mol% of DyS3/2. The radiative transition rate of the initial level for this transition, 6H11/2, is larger than that of the final level, 6H13/2. However, the latter was more rapidly quenched at higher Dy concentration, which means that the problem of the self-termination for the four-level system could be avoided at an adequate concentration range. [ABSTRACT FROM AUTHOR]

The objective of this study was to develop a novel morphological classification for Douglas fossa obliteration in endometriosis. Retrospective study. Nippon Medical School Hospital. 29 patients with endometriosis. On the basis of the recently revealed clinical knowledge of the membrane structure of the Douglas fossa and the anatomical information derived from cadaveric dissection, a hypothetical model of the normal Douglas fossa was established. This was used to examine past surgical videos (n = 29 cases) to evaluate the patterns that exist in Douglas fossa obliteration in endometriosis. The recto–vaginal fascia that constitutes the front of the Douglas fossa has a wing-shaped structure, with the upper edge of the wing corresponding to the uterosacral ligaments (USLs). The tip of the wing is bifurcated (a λ-type structure), and the inside is connected to the rectum to form the upper part of the rectal lateral ligament. The outer side comprises the fusion surface between the peritoneum and the underlying ureterohypogastric fascia. The patterns of the Douglas fossa obliteration could be classified into six types: 1: normal, 2: upper peripheral lesion type, 3: lateral displacement type (right or left), 4: forward displacement type, 5: median elevation type, and 6: diffuse median elevation type (frozen pelvis); furthermore, in terms of proportions, there were 2 (7%), 8 (28%), 6 (20%), 1 (3%), 7 (24%), and 6 (21%) cases of each type, respectively. In the median elevation type, the left and right USLs and lateral ligaments were extremely shortened, the uterus and rectum were completely attached, and the Douglas fossa was completely closed. The cases that showed complete occlusion of the Douglas fossa were either the median elevation type or the diffuse median elevation type. [ABSTRACT FROM AUTHOR]

Abstract: To assess the information on safety belt use for pregnant women and infants in maternity and baby magazines, we reviewed 2003 issues of the three top-selling monthly baby and maternity magazines. Articles on safety belt use during pregnancy and child safety seat (CSS) use for infants, and advertisements of the CSS, automobiles, or CSS-related products were examined for their informational content. Of the 9418 pages in the maternity magazines, 46 pages were on infants, 16 pages on pregnant women and 162 pages displayed advertisements. Of the 9750 pages in the baby magazines, 34 pages of articles addressed CSS use; no articles addressed the issue of pregnant women; 83 pages were advertisements. Although the magazines showed accurate information in general; its amount was not sufficient, and little specific information on appropriate use and selection of a CSS was seen. Some information was misleading and even incorrect: specifically related to when to start using a forward-facing seat, what products are attachable to the CSS, and the reuse of a CSS. Greater amounts and accuracy of safety information in these magazines would help pregnant women and parents acquire important safety knowledge that healthcare providers are falling short of providing in Japan. [Copyright &y& Elsevier]

Medical records of 513 patients with aneurysmal subarachnoid hemorrhage were reviewed to analyze the factors precipitating aneurysmal rupture. There was no seasonal difference in incidence. A significantly higher incidence was observed during 6:00 AM to 9:00 AM and 6:00 PM to 9:00 PM when engaging in daily routines such as defecation/micturition, brushing teeth/washing face/dressing, eating/drinking, and taking a bath. These activities are associated with a Valsalva maneuver that results in sudden pressure changes across the aneurysmal wall precipitating aneurysmal rupture. Aneurysmal rupture occurred most frequently during talking, chatting, watching television, or staying home without any strenuous physical activity. Considering the time spent, the highest incidence rate was found during defecation/micturition. There was no significant difference between men and women or between younger and older age groups regarding activities or events preceding aneurysmal rupture. Hypertension was the most common pre-existing medical problem. The main results are the same as those of the previous study except for aging of the patients. Copyright © 2007 by the National Stroke Association. [ABSTRACT FROM AUTHOR]

The establishment of international monographs for herbs is in progress. Here, we propose both a marker compound and a method for its analysis for the identification of garlic bulbs and their products. The constituents in 26 kinds of fresh edible parts of Allium vegetables and three types of garlic preparations were analyzed. Sulfur compounds are the most characteristic constituents in garlic, but manufacturing processes of garlic products dramatically affect these constituents. Thus, no sulfur compound could be specified as a universal marker of identification applicable for any type of garlic. On the other hand, garlic contains other characteristic compounds, namely, saponins. After analyzing Allium vegetables and garlic preparations, we concluded that sapogenins, especially β-chlorogenin, may be a viable candidate for identifying and distinguishing garlic from other Allium vegetables. [ABSTRACT FROM AUTHOR]

Otsuka Long Evans Tokushima Fatty (OLETF) rats were developed as a model of noninsulin-dependent diabetes mellitus (NIDDM) with mild obesity. Changes in carcass composition and in the daily profile of energy expenditure were examined before and after manifestation of diabetes (8 and 24 wk, respectively), and compared with the normal control Long Evans Tokushima (LETO) rats and streptozotocin (STZ)-induced diabetic LETO rats. OLETF rats had greater body weights than LETO rats and significantly greater absolute and relative fat weights. A diurnal rhythm of energy expenditure associated with two peaks was observed in LETO rats, but the two peaks were not apparent in OLETF rats at 24 wk of age. A diurnal rhythm associated with one peak was observed in STZ-induced diabetic LETO rats. Energy derived from fat constituted this peak; the pattern of the daily energy expenditure was significantly different from that of either nontreated LETO or OLETF rats at 24 wk of age. NIDDM in OLETF rats at 24 wk of age has only a small role in modification of the diurnal rhythm of energy expenditure, whereas STZ-induced diabetes significantly affected the rhythm. [ABSTRACT FROM AUTHOR]