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Study Design:This was a retrospective observational study.Objectives:The objectives were to describe the prognosis of upper extremity function following cervical spinal cord injury (CSCI), and to identify prognostic factors for functional recovery.Setting:Spinal Injuries Center, Japan.Methods:Sixty patients with C3-4 CSCI without major bone injury participated in the study. Patients were treated nonsurgically and evaluated using the American Spinal Injury Association (ASIA) scales for the upper and lower extremities, their residual cervical motor functions, the modified Frankel grade and an upper extremity function scale. We compared the findings for the upper extremity function scale at 6 months with those for the residual cervical motor functions and modified Frankel grade obtained 3 days after injury.Results:Most patients with CSCI who could flex their hip and knee from a supine position (95%) or who showed some active elbow extension (86%) 3 days after their injury could use a spoon at 6 months. We compared patients who used their fingers at 6 months to those who could not, and observed significant differences in age and ASIA scores for the upper and lower extremities obtained 3 days after injury. A strong correlation was observed between the initial motor scores and the extent of functional recovery at 6 months.Conclusion:Hip and knee flexion from the supine position and elbow extension 3 days after injury significantly predicted a positive prognosis for upper extremity function. Younger age and higher ASIA motor scores obtained 3 days after injury were factors associated with neurological recovery. [ABSTRACT FROM AUTHOR]

Abstract: In an ITER facility, about 3kg of tritium will be stored in about 50 hydride beds. The safe design and operation of tritium storage beds will be one of the most important points for enhancing overall safety in the facility. In the Tritium Process Laboratory at the Japan Atomic Energy Agency, many tritium storage beds with zirconium–cobalt (ZrCo) and uranium (U) have been used with/without self-accountancy measures, and 20 years of safe handling experience has been accumulated. From this experience, the key issues to be considered for the safety design are the effects of tritium decay, such as decay heat transfer and 3He behavior, which can cause an increase in temperature and pressure in the tritide vessel, along with the normal protection against over-temperature, over-pressure and leaks in the metal-hydride bed. Concerning the safety operation, the key issues are the hydrogenation–dehydrogenation cycle sequence under the requirements of the storage system and the emergency action, such as rapid hydrogen recovery and loss of normal cooling function. [Copyright &y& Elsevier]

Abstract: At Tritium Process Laboratory (TPL) of Japan Atomic Energy Agency (JAEA), tritium technologies for a fusion reactor have been carried out up to date. The design studies of Air Detrtiation and Vent Detritiation System (ADS/VDS) of ITER have been carried out in JAEA as a contribution of Japan to ITER. For the tritium processing technologies, our efforts have been focused on the R&D of the tritium recovery system of ITER test blanket system. A ceramic proton conductor has been studied as an advanced blanket system. A series of fundamental studies on tritium safety technologies for ITER and for fusion DEMO plants has also been carried out. The main R&D activities in this field are the tritium behavior in a confinement and its barrier materials, monitoring, accountancy, detritiation and decontamination, etc. Especially, for the fundamental studies for a DEMO plants, a part of the studies will be carries out a new facility at Rokkasho in Aomori in the Broader Approach (BA) program in coming 10 years. For this purpose, a design study of the facility at Rokkasho has first been started. [Copyright &y& Elsevier]

Examines manufacturing firms' restructuring behavior in the Asia-Pacific Basin and focuses on Japanese multinational enterprises (MNE) and the intrafirm division of labor between the Japanese parents and their Asian affiliates. Pattern of restructuring behavior; Time lag in the production transfer; Gaps in the stages of economic development.

Background Delayed chemotherapy-induced nausea and vomiting (CINV) is not well controlled in patients with colorectal cancer (CRC) treated with oxaliplatin (L-OHP)-based chemotherapy. Whether adding a neurokinin-1 receptor antagonist to a first-generation 5HT3 antagonist (1st-5HT3RA) and dexamethasone (DEX) is beneficial in patients on L-OHP-based chemotherapy is controversial. It is unclear whether palonosetron (PALO) or aprepitant (APR) is more effective in controlling delayed CINV. We, therefore, investigated whether PALO+DEX (PALO group) or 1st-5HT3RA+DEX+APR (APR group) was more effective in controlling delayed CINV, as well as risk factors for delayed CINV, in patients with CRC treated with L-OHP-based chemotherapy. Methods We pooled data from two prospective observational studies in Japan and one phase III clinical trial and compared the incidence of CINV between the PALO and APR groups using propensity score-matched analysis. Risk factors for CINV were identified using logistic regression models. Results Among the 404 eligible patients, those in the PALO group showed a higher incidence of delayed CINV than those in the APR group (nausea: 43.4% vs. 32.4%, P = 0.061; vomiting: 12.5% vs. 4.4%, P = 0.017). The logistic regression analysis identified alcohol consumption, motion sickness, and PALO+DEX regimen as independent risk factors for delayed nausea, and female sex and PALO+DEX regimen as those for delayed vomiting. Conclusions Treatment with the three antiemetics, including APR, was more effective in controlling delayed CINV than prophylactic treatment with the two antiemetics, including PALO. Thus, patients with CRC receiving L-OHP-based chemotherapy should be treated with three antiemetics, including APR. Legal entity responsible for the study The authors. Funding Has not received any funding. Disclosure All authors have declared no conflicts of interest. [ABSTRACT FROM AUTHOR]

Summary Aims To assess the impact of cigarette smoking on the incidence of Type 2 diabetes mellitus (DM) in middle-aged Japanese men. Methods The study enrolled 6250 men aged 35–60 years and free of diabetes, impaired fasting glucose and hypertension at entry. Type 2 DM was defined by a fasting plasma glucose level ≥ 7.0 mmol/l or physician-diagnosed Type 2 DM. Results Four hundred and fifty cases of Type 2 DM were confirmed during the 60 904 person-years follow-up. After adjustment for multiple covariates, including age, body mass index, alcohol consumption, physical activity, parental history of diabetes and the level of fasting plasma glucose, total cholesterol, triglycerides, high-density lipoprotein cholesterol and haematocrit, the relative risk of Type 2 DM among current smokers compared with non-smokers was 1.47 (95% confidence interval (CI) 1.14–1.92). Men who smoked > 30 cigarettes/day had a multivariate-relative risk of 1.73 (95% CI 1.20–2.48) compared with non-smokers. The number of cigarettes smoked daily and the pack-year values were positively related to the development of Type 2 DM in a dose-dependent manner (P for trends = 0.0026 and 0.001, respectively). Conclusions A cigarette smoking habit is an independent risk factor for Type 2 DM. [ABSTRACT FROM AUTHOR]

Acral melanoma (AM) is an epidemiologically and molecularly distinct entity that is underrepresented in clinical trials on immunotherapy in melanoma. We aimed to analyze the efficacy of anti-programmed cell death 1 (anti-PD-1) antibodies in advanced AM. We retrospectively evaluated unresectable stage III or stage IV AM patients treated with an anti-PD-1 antibody in any line at 21 Japanese institutions between 2014 and 2018. The clinicobiologic characteristics, objective response rate (ORR, RECIST), survival estimated using Kaplan–Meier analysis, and toxicity (Common Terminology Criteria for Adverse Events 4.0.) were analyzed to estimate the efficacy of the anti-PD-1 antibodies. In total, 193 patients (nail apparatus, 70; palm and sole, 123) were included in the study. Anti-PD-1 antibody was used as first-line therapy in 143 patients (74.1%). Baseline lactate dehydrogenase (LDH) was within the normal concentration in 102 patients (52.8%). The ORR of all patients was 16.6% (complete response, 3.1%; partial response, 13.5%), and the median overall survival (OS) was 18.1 months. Normal LDH concentrations showed a significantly stronger association with better OS than abnormal concentrations (median OS 24.9 versus 10.7 months; P < 0.001). Although baseline characteristics were similar between the nail apparatus and the palm and sole groups, ORR was significantly lower in the nail apparatus group [6/70 patients (8.6%) versus 26/123 patients (21.1%); P = 0.026]. Moreover, the median OS in this group was significantly poorer (12.8 versus 22.3 months; P = 0.03). Anti-PD-1 antibodies have limited efficacy in AM patients. Notably, patients with nail apparatus melanoma had poorer response and survival, making nail apparatus melanoma a strong candidate for further research on the efficacy of novel combination therapies with immune checkpoint inhibitors. • Acral melanoma is a distinct entity that is underrepresented in clinical trials on immunotherapy in melanoma. • We retrospectively examined advanced-stage acral melanoma patients treated with an anti-PD-1 antibody. • Anti-PD-1 antibodies have limited efficacy in Japanese acral melanoma patients. • Patients with nail apparatus melanoma had poorer response and survival than patients with palm and sole melanoma. [ABSTRACT FROM AUTHOR]

Background The organ donation rate in Japan is much lower than that in other developed countries for several reasons. An advanced educational program for in-hospital procurement coordinators is a possible solution for this. We introduced a Transplant Procurement Management (TPM) educational program at Hyogo Prefecture, Japan. Methods Ten healthcare professionals at Hyogo Prefecture participated in the Advanced International TPM course to educate themselves on TPM and held 2 TPM Model Organ Procurement Training Workshops at Hyogo Prefecture for in-hospital procurement coordinators. Furthermore, we held 2 workshops outside Hyogo Prefecture and at the same time undertook a pre-workshop questionnaire survey to evaluate the ability and motivation with respect to organ donation. To evaluate the effectiveness of the workshops, we conducted post-workshop and 3-months-after workshop questionnaire surveys. Results The results of the pre-workshop survey revealed that in-hospital procurement coordinators lacked the knowledge regarding the entire organ donation process, the current status of organ donation in Japan, and the definition of brain death. Moreover, they did not completely understand the meaning of “organ donation.” The results of the post-workshop questionnaire survey showed that the educational program was effective to improve the knowledge and skills of organ donation and motivated behavioral changes among the participants. Conclusions The survey results showed that our TPM model educational program offered sufficient knowledge and skills to increase organ donation at Hyogo Prefecture. We will continue this program and make an effort to further contribute to the Japanese organ donation activities. [ABSTRACT FROM AUTHOR]

Background and study aims: Only a few large cohort studies have evaluated the efficacy and safety of endoscopic necrosectomy for infected walled- off pancreatic necrosis (WOPN). Therefore, a multicenter, large cohort study was conducted to evaluate the efficacy and safety of endoscopic necrosectomy and to examine the procedural details and follow-up after successful endoscopic necrosectomy. Patients and methods: A retrospective review was conducted in 16 leading Japanese institutions for patients who underwent endoscopic necrosectomy for infected WOPN between August 2005 and July 2011.The follow-up data were also reviewed to determine the long-term outcomes of the procedures. Results: Of 57 patients, 43 (75 %) experienced successful resolution after a median of 5 sessions of endoscopic necrosectomy and 21 days of treatment. Complications occurred in 19 patients (33 %) during the treatment period. Six patients died (11 %): two due to multiple organ failure and one patient each from air embolism, splenic aneurysm, hemorrhage from a Mallory-Weiss tear, and an unknown cause. Of 43 patients with successful endoscopic necrosectomy, recurrent cavity formation was observed in three patients during a median follow-up period of 27 months. Conclusions: Endoscopic necrosectomy can be an effective technique for infected WOPN and requires a relatively short treatment period. However, serious complications can arise, including death. Therefore, patients should be carefully selected, and knowledgeable, skilled, and experienced operators should perform the procedure. Further research into safer technologies is required in order to reduce the associated morbidity and mortality. [ABSTRACT FROM AUTHOR]

Gender-related risk factors in the survival of transplanted teeth with complete root formation have not yet been identified. The purpose of this study was to investigate gender differences in tooth autotransplantation at dental clinics. We asked participating dentists to provide information on transplantations they had undertaken from 1 January 1990 to 1931 December 2010. The data were screened to exclude patients who underwent more than one transplantation, smokers or those whose smoking habits were unknown, patients under 30 or who were 70 years old and over, cases where the transplanted teeth had incomplete root formation or multiple roots and those with fewer than 20 present teeth post-operation. We analysed 73 teeth of 73 males (mean age, 47·2 years) and 106 teeth of 106 females (mean age, 45·3 years) in this study. The cumulative survival rate and mean survival time were calculated using the Kaplan-Meier method. The cumulative survival rate for males was 88·3% at the 5-year mark, 64·8% at 10 years and 48·6% at 15 years; for females, it was 97·2% at the 5-year mark, 85·9% at 10 years and 85·9% at 15 years. A log-rank test indicated the difference between males and females to be significant ( P = 0·011). There was also a significant difference in the main causes for the loss of transplanted teeth: males lost more transplanted teeth due to attachment loss than females ( P < 0·05). These results indicate that males require more attention during the autotransplantation process, particularly at the stage of pre-operation evaluation and that of follow-up maintenance. [ABSTRACT FROM AUTHOR]

Interferon regulatory factor 7 (IRF7) has an essential role in the production of type I interferon. Although recent studies detected association of a single nucleotide polymorphism (SNP) rs4963128 in PHD and ring finger domains 1 (PHRF1)/KIAA1542, located closely to IRF7, and IRF7 rs1131665 (glutamine (Gln) 412 arginine (Arg)) with systemic lupus erythematosus (SLE), causal variants have not been established. In this study, we resequenced exons and introns of IRF7 to screen for all common polymorphisms, and examined whether they were associated with SLE in 416 Japanese patients with SLE and 505 healthy controls. We also tested whether the association of PHRF1 rs4963128 with SLE was replicated in a Japanese population. None of the IRF7 polymorphisms was associated with SLE. PHRF1 rs4963128T was not significantly associated with occurrence of SLE either; however, this allele was significantly increased in SLE with anti-Sm antibodies (6.8%) as compared with healthy controls (3.1%, P = 0.014, odds ratio [OR] 2.31) and SLE without anti-Sm antibodies (3.3%, P =0.041, OR 2.12). This allele was also increased in SLE with renal disorder (5.1%) as compared with those without renal disorder (2.4%, P = 0.047, OR 2.17). These results confirmed recently reported association of PHRF1 rs4963128T with anti-Sm antibody positive SLE in African-American populations, and supported the role of PHRF1-IRF7 region in the genetics of SLE. [ABSTRACT FROM AUTHOR]

Summary: Bone mineral density of the 1/3 distal radius, ultra-distal radius, and lumbar spine correlated significantly and negatively with serum adiponectin. There was a significant positive correlation between serum adiponectin and serum NTX. Thus, adiponectin may play a role in mineral and bone disorder in chronic kidney disease stage 5 dialysis (CKD 5D) patients. Introduction: Serum adiponectin, an adipocyte-produced hormone, has been reported to correlate negatively with bone mineral density (BMD) in the general population. However, little is known about the association between adiponectin and BMD in patients with CKD. Methods: BMD of the 1/3 distal and ultra-distal radius, which are enriched with cortical and cancellous bone, respectively, and the lumbar spine was measured by dual X-ray absorptiometry in 114 Japanese male hemodialysis patients (age 61.0 ± 11.1 years; hemodialysis duration 6.6 ± 3.0 years; 43.9% diabetics). Serum total adiponectin, bone formation marker (bone alkaline phosphatase, BAP), and bone resorption marker (cross-linked N-telopeptide of type I collagen (NTX)) were measured. Results: The BMD of the 1/3 distal radius, ultra-distal radius, and lumbar spine correlated significantly and negatively with serum adiponectin level ( r = −0.229, p = 0.014; r = −0.286, p = 0.002; r = −0.227, p = 0.013, respectively). In multiple linear regression analyses, serum adiponectin was significantly and independently associated with the BMD of the 1/3 distal radius ( R = 0.173, p < 0.001) and ultra-distal radius ( R = 0.278, p < 0.001) after adjustment of age, hemodialysis duration, body weight, %fat mass, and log [intact PTH], although it was not with the BMD of the lumbar spine. There was a significant positive correlation between serum adiponectin and serum NTX ( r = 0.321, p < 0.001), although there was no significant correlation between serum adiponectin and serum BAP. Conclusion: Increased levels of serum adiponectin were associated with decrease in BMD in male hemodialysis patients. Adiponectin may play a role in mineral and bone disorder, possibly in bone resorption, of patients with CKD 5D. [ABSTRACT FROM AUTHOR]

Summary The aim of this study was to investigate the usage of tooth autotransplantation in dental clinics which offer the treatment and evaluate its practicality. Participating dentists were requested to provide information on transplantations they had undertaken from 1 January 1990 to 31 December 2010. A total of 614 teeth from 552 patients (37 dentists) ranging in age from 17 to 79 (mean age: 44·1) were examined. Cumulative survival rate and mean survival time were calculated using the Kaplan-Meier method, and log rank test was used for analysis of factors. The mean number of autotransplantation patients per clinic per year was 1·4. Upper third molars constituted 36·8% of donor teeth, while 37·1% were lower third molars. The lower first molar region was the most common recipient site at 32·6%, followed by the lower second molar region (28·0%). Prosthodontic treatment of transplanted teeth involved coverage with a single crown (72·5%) and abutment of bridge (18·9%). A total of 102 transplanted teeth were lost owing to complications such as attachment loss (54·9%) and root resorption (25·7%). The cumulative survival rate in cases where donor teeth had complete root formation was 90·1% at 5 years, 70·5% at 10 years and 55·6% at 15 years. The mean survival time was 165·6 months. Older age was a significant risk factor ( P < 0·05) for survival. In cases where suitable donor teeth are available, autotransplantation of teeth may be a plausible treatment option for dealing with missing teeth in dental clinics. [ABSTRACT FROM AUTHOR]

Abstract: JT-60SA is a fully superconducting coil tokamak to be built under the framework of the EU-JA Broader Approach Agreement, and it aims to contribute to the complement of the ITER experiments and to the DEMO reactor design by the study of steady-state high-beta plasma experiments. The conceptual design of the JT-60SA tokamak and the peripheral systems has been carried out in close collaboration of EU and Japan from middle of 2006, and the JT-60SA Conceptual Design Report which involves an analysis of plasma physics and engineering design is summarized in May 2007. This paper intends to present an overall view of the JT-60SA project, and the latest design status of the key engineering issues such as superconducting magnets, divertor target, plasma heating devices, and magnet power supplies. [Copyright &y& Elsevier]

Background Chemotherapy-induced neutropenia (CIN) is a dose-limiting toxicity of many chemotherapy agents. Recently, CIN has been associated with longer survival time in various types of cancer, suggesting a role as a prognostic factor. However, no large-scale study has yet investigated the utility of CIN as a prognostic factor in small cell lung cancer. We therefore conducted this multicenter retrospective observational study to investigate the utility of CIN as a prognostic factor for overall survival (OS) in patients with extensive-disease small-cell lung cancer (ED-SCLC) treated with chemotherapy. Methods Clinical data, including data on CIN onset during chemotherapy, were collected from electronic medical records of patients with ED-SCLC who received standard-dose irinotecan and cisplatin (IP regimen) as primary therapy at 14 participating institutions across Japan between January 1, 2012 and December 31, 2016. Landmark analysis, with the association between OS and neutropenia as the primary endpoint was performed with 102 patients who completed all four cycles of the IP regimen and whose OS was ≥112 days. Univariate analysis using the log-rank test and multivariate analysis using the Cox proportional hazards model with factors previously identified as possible prognostic factors as covariates were also performed to examine the association between CIN and OS. Results Analysis of median OS by grade among patients who developed CIN revealed significantly longer survival in the group with grade 4 CIN (633 days, 95% confidence interval [CI]: 379–757) than in the group with grade 0 to 3 CIN (444 days, 95% CI: 360–505) (P = 0.0279). Multivariate analysis suggested that lactate dehydrogenase (LDH) of ≥ 230 IU/L (hazard ratio [HR]: 2.937; 95% CI: 1.739–4.958, P < 0.001) and grade 0 to 3 CIN (HR: 2.096; 95% CI: 1.151–3.818, P = 0.0156) are independent poor prognostic factors for ED-SCLC. Conclusions Onset of grade 4 CIN was associated with longer OS in patients with ED-SCLC. Our results also show that both LDH and CIN may be prognostic factors in patients treated using the IP regimen. Clinical trial identification This study was approved by the Institutional Review Board of our institution (approval no: T29-8-30-2-3). Legal entity responsible for the study The authors. Funding Has not received any funding. Disclosure All authors have declared no conflicts of interest. [ABSTRACT FROM AUTHOR]

Objectives Japanese universities are required to improve both international and Japanese students' mental health, because the number of international students increases annually. Moreover, mental health data for graduate school students in Japan are lacking. Therefore, the present study attempted to examine differences in graduate school students' mental health according to major, grade, and nationality. Methods A total of 587 students from a Japanese university, which only offers graduate school education, completed the Japanese version of Kessler 6 (K6) as part of their regular health assessments; 542 students agreed to the use of their data for research purposes. Results The K6 scores were analyzed using a 3-way (major × grade × nationality) between-subjects ANOVA, and a significant second-order interaction (F(6, 518) = 2.68, p < .05) was observed. As a subsequent 2-way (major × nationality) ANOVA, performed according to grade, only showed an interaction for first-grade master's degree students (M1; F(2, 167) = 7.88, p < .01), comparisons between Japanese and international students were made according to major. For one major, Japanese students' K6 scores tended to be higher relative to those observed in international students (t(36) = 1.98, p < .10). In contrast, international students' K6 scores for another major were significantly higher than were those of Japanese students (t(86) = 3.31, p < .01). Conclusions Japanese and international M1 students' K6 scores differed significantly. University staff should take these differences into account and examine ways to support students. [ABSTRACT FROM AUTHOR]

Diabet. Med. 29, e41-e46 (2012) Abstract Aims Dehydroepiandrosterone exerts a protective effect against cardiovascular diseases. However, the relationship of dehydroepiandrosterone with the anticoagulant factor activated protein C, generated by the thrombin-thrombomodulin complex on vascular endothelial cells, remains unknown. This study aimed at studying the relationship between dehydroepiandrosterone and activated protein C generation in patients with Type 2 diabetes. Methods Sixty-two male patients with Type 2 diabetes were enrolled in this study. Data obtained from 40 healthy male subjects were used as controls. The plasma levels of dehydroepiandrosterone, the activated protein C-protein C inhibitor complex, high-sensitivity C-reactive protein and monocyte chemoattractant protein-1 were measured by enzyme immunoassays. Carotid intima-media thickness was measured by ultrasonography. Results The plasma levels of dehydroepiandrosterone (5.15 ± 2.81 vs. 3.76 ± 2.16 ng/ml; P < 0.005) and the activated protein C-protein C inhibitor complex (1.90 ± 1.07 vs. 1.02 ± 0.51 ng/ml; P < 0.001) were significantly lower in patients with diabetes than in normal subjects. Univariate analysis showed a significant correlation of the plasma level of dehydroepiandrosterone with that of the activated protein C-protein C inhibitor complex ( r = 0.48, P < 0.001), high-sensitivity C-reactive protein ( r = −0.30, P < 0.05) and with the mean intima-media thickness ( r = −0.28, P < 0.05) in patients with diabetes. Stepwise multiple regression analysis showed that the plasma level of dehydroepiandrosterone is significantly correlated with the plasma levels of the activated protein C-protein C inhibitor complex ( F = 18.06) and high-sensitivity C-reactive protein ( F = 4.94). There was no correlation between the plasma levels of dehydroepiandrosterone and monocyte chemoattractant protein-1. Conclusions These results suggest that lower circulating levels of dehydroepiandrosterone are associated with decreased activated protein C generation and higher intima-media thickness in patients with Type 2 diabetes. [ABSTRACT FROM AUTHOR]

Summary Background Japanese cedar (Cryptomeria japonica ) pollen is a major cause of seasonal pollinosis, and more than 10% of Japanese people suffer from this allergic disorder. However, only two major pollen allergens, Cry j 1 and Cry j 2, have been identified and exclusively characterized. Objective The aim of this study was to explore and identify important Japanese cedar pollen allergens other than Cry j 1 or Cry j 2. Methods C. japonica cDNA library was immunoscreened by rabbit antiserum raised against a partially purified cedar pollen allergen fraction. An isolated cDNA clone was inserted into a glutathione S-transferase (GST)-tagged Escherichia coli expression vector to obtain recombinant GST fusion protein. Non-fusion recombinant protein was purified by glutathione Sepharose affinity chromatography in conjunction with factor Xa cleavage of the GST moiety. IgE-binding ability of the recombinant protein was then evaluated by western blot analysis and enzyme-linked immunosorbent assay (ELISA). Results The cDNA encodes 306 amino acids with significant sequence similarity to those of plant isoflavone reductase-like proteins, which include a recently identified birch pollen allergen Bet v 5. Western blot analysis demonstrated that recombinant protein was recognized by cedar pollinosis patient IgE. In contrast to Bet v 5 being reported as a minor allergen, the recombinant protein exhibited 76% IgE binding frequency (19/25) against pollinosis patients. Conclusion Here we identified the third member of Japanese cedar pollen allergen homologous to isoflavone reductase. Its high IgE-binding frequency implicates that the isoflavone reductase homologue might be an additional major pollen allergen in C. japonica . [ABSTRACT FROM AUTHOR]