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Background and Objective Electric current is used to promote wound healing. However, it is unclear whether electrical stimulation contributes to gingival tissue remodeling. This study examined the effects of electrical stimulation on gingival tissue remodeling in a rat periodontitis model. Material and Methods Male Wistar rats ( n = 28, 8 wks of age) were divided into four groups of seven rats each. The control group did not receive any treatment for 6 wks. In the other groups, periodontitis was ligature-induced for 4 wks. After 4 wks, the rats with periodontitis were given daily electrical stimulation of 0, 50 or 100 μA for 2 wks. Results The periodontitis group stimulated with 0 μA showed a higher density of polymorphonuclear leukocytes and a lower density of collagen in gingival tissue compared with the control group ( p < 0.05). The two remaining groups treated with 50 or 100 μA of electrical stimulation exhibited a lower density of polymorphonuclear leukocytes ( p < 0.05) and a higher density of collagen than the group stimulated with 0 μA ( p < 0.05). They also showed higher expression of fibroblast growth factor-2 than the group treated with 0 μA of electrical stimulation ( p < 0.05). Conclusion Electric stimulation may offer a novel approach to promote gingival tissue remodeling in periodontal lesions. [ABSTRACT FROM AUTHOR]

Kasuyama K, Tomofuji T, Ekuni D, Azuma T, Irie K, Endo Y, Morita M. Effects of topical application of inorganic polyphosphate on tissue remodeling in rat inflamed gingiva. J Periodont Res 2012; 47: 159-164. © 2011 John Wiley & Sons A/S Background and Objective: Inorganic polyphosphate [poly(P)] is a biopolymer found in almost all cells and tissues, and which promotes tissue remodeling. However, there is limited information on how poly(P) affects the connective tissue in inflamed gingiva. This study examined the effects of topical application of poly(P) on gingival connective tissue and its remodeling in a rat periodontitis model. Material and Methods: Male Wistar rats ( n = 36, 8 wk of age) were used in this 6-wk study. The rats were divided into six groups of six rats each. The control group received no treatment. In the other groups, periodontitis was ligature-induced for 4 wk. After 4 wk, the rats with periodontitis were further divided into five groups, and were left untreated (periodontitis group) or subjected to topical application of oral rinses containing 0, 0.1, 1 or 5% poly(P) for 2 wk. Results: The periodontitis and 0% poly(P) groups showed a higher density of polymorphonuclear leukocytes and a lower density of collagen in gingival tissue than the control group ( p < 0.05). In contrast, groups treated with more than 1% poly(P) exhibited a lower density of polymorphonuclear leukocytes ( p < 0.05) and a higher density of collagen than the periodontitis and 0% poly(P) groups ( p < 0.05). A higher expression of fibroblast growth factor-2 was observed in the gingiva of rats treated with 1% poly(P) than in those treated with 0% poly(P) ( p < 0.05). Conclusion: Topical application of poly(P) may induce connective tissue remodeling, contributing to improvement of inflamed gingiva in rats. [ABSTRACT FROM AUTHOR]

Oral Diseases (2010) 16, 781-787 Objective: This study addressed the relationship between periodontal condition and second derivative of the finger photoplethysmogram (SDPTG) in Japanese adults. Subject and methods: The Community Periodontal Index (CPI) and SDPTG were recorded in 415 subjects (mean age: 44.0 years). For assessing SDPTG, we mainly focused on the ratio of the absolute value of the height of the early negative 'b' wave and ratio of the late re-decreasing 'd' wave to the height of the initial positive 'a' wave, namely the b/a and d/a ratios. Results: The CPI score was positively correlated with the b/a ratio ( P < 0.001), and negatively correlated with the d/a ratio ( P < 0.001). Logistic regression analysis showed that subjects with CPI scores ≥3 were more likely to have a higher level (male >−0.69, female >−0.64) of b/a ratio (Odds ratio = 1.7, P = 0.026) and lower level (male ≤−0.29, female ≤−0.32) of d/a ratio (Odds ratio = 2.2, P = 0.001) than those with CPI scores 0-2, after adjusting for age, gender, smoking status, pulse rate and presence of hypertension. Conclusion: There was a statistical association between the CPI scores and SDPTG indices in Japanese adults. [ABSTRACT FROM AUTHOR]

Introduction: Oral frailty leads to poor nutritional status, which, in turn, leads to frailty. This cross-sectional study aimed to determine regional differences in the prevalence of oral frailty and to identify factors associated with oral frailty using 3-level multilevel models., Methods: This study comprised 165,164 participants aged ≥65 y without long-term care requirements in the Japan Gerontological Evaluation Study. The dependent variable was oral frailty, which was calculated based on age, number of teeth, difficulty in eating tough foods, and choking. The individual-level independent variables included sociodemographics, present illness, social participation, frequency of meeting friends, and social capital. The local district-level independent variable was social capital ( n = 1,008) derived from exploratory factor analyses. The municipality-level independent variable was population density ( n = 62). Three-level multilevel Poisson regression analysis was performed to calculate the prevalence ratios (PRs)., Results: The prevalence of oral frailty in municipalities ranged from 39.9% to 77.6%. Regarding district-level factors, higher civic participation was significantly associated with a lower probability of oral frailty. At the municipality level, the PR of the rural-agricultural area was 1.17 (95% confidence interval, 1.11-1.23) (reference: metropolitan)., Conclusion: These results highlight the usefulness of oral frailty prevention measures in encouraging social participation in rural areas., Knowledge Transfer Statement: The results of the present study showed regional differences in oral frailty. In particular, rural-agricultural areas show higher prevalence rates of oral frailty than those in metropolitan cities. Promoting measures of social participation among older adults may help prevent oral frailty in rural areas., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Pemuchiamides A and B ( 1 and 2 ) were isolated from a marine Hormoscilla sp. cyanobacterium collected from Pemuchi Beach on Hateruma Island, Japan. Although 1 and 2 existed as a complex mixture of rotamers in chloroform- d , detailed analyses of their 2D NMR and tandem mass spectra revealed their planar structures, respectively. The absolute configurations of 1 and 2 were established via the degradation and derivatization reactions. Pemuchiamide A ( 1 ) exhibited potent growth-inhibitory activity against Trypanosoma brucei rhodesiense , the causative organism of African sleeping sickness, while 2 showed 10-fold weaker activity than 1 . This result indicates that the presence of a hydroxy group at the C-3 position of the 4-aminobutanoic acid moiety negatively affects antitrypanosomal activity.

Plasma aldosterone concentration (PAC) was routinely measured using radioimmunoassay (RIA); however, the RIA kit was discontinued in March 2021 in Japan. This study examined PAC conversion in adrenal venous sampling (AVS) and AVS criteria when measured using chemiluminescent enzyme immunoassay (CLEIA). PAC of 415 adrenal venous blood samples from AVS (including segmental AVS) of 63 patients with primary aldosteronism was measured using RIA (Spac-S aldosterone kit; Fujirebio Inc.) and CLEIA (Lumipulse Presto Aldosterone; Fujirebio Inc.). PAC of 70 AVS samples was also measured using liquid chromatography-mass spectrometry (LC-MS/MS, ASKA Pharma Medical Co., Ltd.). PAC conversion formulas were determined for each AVS sample assay. PAC measured using CLEIA was significantly correlated with that measured using RIA (correlation coefficient = 0.971). The PAC conversion formula was PAC (CLEIA) = PAC (RIA) × 0.772 - 1,199 pg/mL. The PAC of 14,000 pg/mL in RIA was equivalent to 9,613 pg/mL in CLEIA. PAC measured using CLEIA was also correlated with that measured using LC-MS/MS, and the PAC conversion formula was PAC (CLEIA, pg/mL) = 0.97 × PAC (LC-MS/MS, pg/mL) + 211. The inter-assay coefficient of variability (CV) was 1.1-1.3% and intra-assay CV was 1.0-1.7%, measured using CLEIA. The PAC conversion formula for AVS samples was obtained using CLEIA and RIA, and the conversion formula was different from that for peripheral blood. PAC values measured by CLEIA showed preferable accuracy and high concordance with those measured by LC-MS/MS, even in AVS samples. The study outcomes are useful for interpreting AVS results using non-RIA measurement methods.

The occupational environment is an important factor for oral health because people spend a long time in the workplace throughout their lives and are affected by work-related stress and occupational health policies. This study aimed to review evidence for the association between occupation and oral health status and behaviors. A literature search of PubMed was conducted from February to May 2022, as well as a manual search analyzing the article origins. Articles were screened and considered eligible if they met the following criteria: (1) published in English; (2) epidemiological studies on humans; and (3) examined the association between occupation and oral health status and behaviors. All 23 articles identified met the eligibility criteria. After full-text assessments, ten articles from Japan were included in this review: four on the association between occupation and dental caries, three on occupation and periodontal disease, two on occupation and tooth loss, and one on occupation and oral health behaviors. An association was apparent between occupation, oral health status and behaviors among Japanese workers. In particular, skilled workers, salespersons, and drivers who work longer hours and often on nightshifts, tended to have poor oral health.

This is a post hoc multivariate analysis of the modified World Federation of Neurosurgical Societies (WFNS) grading project, multicenter prospective observational study including 38 neurosurgical institutions across Japan. Japan Neurosurgical Society WFNS grading committee conducted a modified WFNS grading project as a nationwide prospective registry study. We investigate the clinical outcome of both surgical and endovascular interventions after aneurysmal subarachnoid hemorrhage (SAH) in Japan. A total of 792 patients received surgical intervention and 417 patients received endovascular treatment. Eight hundred patients were female, and 409 patients were male. The mean age was 61.5 ± 13.7 years. At 3 month follow-up, there was no statistically significant difference in good clinical outcome between surgical (68.2%) and endovascular (60.9%) group (odds ratio, 0.89; 95% confidence interval, 0.68-1.16; p = 0.381). Unfavorable outcome rate was 31.8% (238 patients) in the surgical group and 39.1% (154 patients) in the endovascular group. Male, elderly people, modified Rankin scale condition before onset, high-grade modified WFNS clinical grading scale, intracerebral hematoma, posttreatment normal pressure hydrocephalus, and neurological deficit due to symptomatic vasospasm were risk factors for the clinical outcome. Treatment modality was not a statistical factor for clinical outcomes. Surgical clipping has still a major role in the management of SAH in Japan. The present study was not a randomized controlled study, but clinical outcome is not influenced by treatment modalities.

This prospective observational study analyzed the pharmacokinetics of busulfan in Japanese children and evaluated the predicting accuracy of previous pediatric PPK models of busulfan. This study enrolled five patients (aged 2-12 years, BW 14-48 kg) receiving a busulfan-based conditioning regimen for hematopoietic stem cell transplantation at our hospital between January 2017 and December 2018. All patients received a 2-hour intravenous busulfan infusion four times daily for a total of 16 doses. After the infusions, 51 plasma samples were collected with the plasma busulfan concentration measured by liquid chromatography-tandem mass spectrometry. PPK model fitting was analyzed using the (%MPE) and the (%MAPE). Limited sampling strategies for estimating busulfan AUC were also evaluated. High interpatient variability was observed in the PK parameters. The most suitable PPK model that reflected our data was McCune's two-compartment model (%MPE -8.7, %MAPE 19.3). A combination sampling method using the busulfan concentration at 2 and 6 hours after the start of the first busulfan dose was found to be able to estimate AUC 4 day . These results provide useful information on busulfan therapeutic drug monitoring in the Japanese pediatric population., (© 2020 Wiley Periodicals, Inc.)

Deep and subcortical white matter hyperintensity (DSWMH) lesions are a small-vessel disease of the brain. The aim of this cross-sectional study was to investigate the relationship between DSWMH lesions and periodontal status in Japanese adults who participated in a health check. We enrolled 444 consecutive participants (mean age, 54.5 years) who received both brain and oral health evaluation services at the Asahi University Hospital. Magnetic resonance imaging was used to detect DSWMH lesions. Periodontal status was assessed using the community periodontal index. Of the study participants, 215 (48.4%) had DSWMH lesions. Multivariate logistic regression showed that the presence of DSWMH lesions was significantly related to age ≥ 65 years (vs. < 65 years, odds ratio [OR] = 2.984, 95% confidence interval [CI] = 1.696-5.232), systolic blood pressure ≥ 140 mmHg (vs. < 140 mmHg, OR = 2.579, 95% CI = 1.252-5.314), the presence of ≥ 28 teeth (vs. < 28 teeth, OR = 0.635, 95% CI = 0.420-0.961), and probing pocket depth (PPD) ≥ 6 mm (vs. PPD < 6 mm, OR = 1.948, 95% CI = 1.132-3.354) after adjustment for confounding factors. Having PPD ≥ 6 mm may be a risk factor for DSWMH lesions in Japanese adults.

Background: Self-rated oral health is a valid and useful summary indicator of overall oral health status and quality of life. However, few studies on perception of oral health have been conducted among Japanese young adults. This study investigated whether oral health behavior, subjective oral symptoms, or clinical oral status were associated with self-rated oral health in Japanese young adults., Methods: This cross-sectional survey included 2,087 students (1,183 males, 904 females), aged 18 and 19 years, at Okayama University, Japan. A self-administered questionnaire was distributed and an oral examination was performed., Results: In a structural equation modeling analysis, the score of decayed, missing and filled teeth (DMFT) significantly affected self-rated oral health (p <0.05) and the effect size was highest. Malocclusion, subjective symptoms of temporomandibular disorders (TMD) and stomatitis, and poor oral health behavior significantly induced self-rated poor oral health with small effect sizes (p <0.05). Clinical periodontal conditions and Oral Hygiene Index-simplified were not related to self-rated oral health., Conclusion: Self-rated oral health was influenced by subjective symptoms of TMD and stomatitis, oral health behavior, the score of DMFT, and malocclusion. The evaluation of these parameters may be a useful approach in routine dental examination to improve self-rated oral health in university students.

Being overweight is an important risk factor for lifestyle-related diseases. The objective of the present study was to examine whether eating until full, eating quickly, or both eating behaviors were associated with being overweight, defined as a body mass index (BMI) ≥ 25, in young adults. This cross-sectional survey comprised 1918 students (1139 male and 779 female students) at the Okayama University in Japan. In logistic regression analysis, eating until full was not associated with being overweight in either sex. The adjusted odds ratio of being overweight among those who reported eating quickly was 3.93 (2.45-6.31; P < .0001) for male and 1.59 (0.79-3.21; P = .193) for female students. Moreover, the adjusted odds ratio of being overweight was 2.72 (1.72-4.30; P < .001) in male students who frequently reported eating a fatty diet. The combination of eating quickly and frequently eating a fatty diet had a supra-additive effect on being overweight in the male students.

Six bryostatins were isolated from Japanese bryozoan by evaluating their binding to the C1B domain of protein kinase Cδ (PKCδ). Structure-activity studies of bryostatins 4, 10, and 14 suggested that the ester group at C20 was not necessary for binding to and activating PKCδ. These bryostatins showed significant anti-tumor-promoting activity in induction tests with the Epstein-Barr virus early antigen.

Objective: Obesity has been implicated as a risk factor for periodontitis and non-alcoholic fatty liver disease (NAFLD). In NAFLD, elevated alanine aminotransferase (ALT) is associated with obesity. Although a possible interrelationship between liver function and periodontitis has been reported among the middle-aged population, the correlation in young adults is little known. This study was designed to investigate the relationship between ALT and the presence of periodontitis in university students in Japan., Material and Methods: Medical and oral health data were collected in a cross-sectional examination conducted by the Health Service Center of Okayama University. Systemically healthy, non-smoking students aged 18 and 19 years old (n = 2225) were included. The protocol of the United States National Health and Nutrition Examination Survey was applied. Subjects with probing pocket depth >or= 4 mm were defined as having periodontitis. Logistic regression analysis was used to estimate the association between ALT, body mass index and periodontitis., Results: The number of subjects with periodontitis was 104 (4.7%). In males, having periodontitis was significantly associated with an increased level of ALT (>or= 41 IU/l) in logistic regression analysis (adjusted odds ratio 2.3; 95% confidence interval 1.0-5.2; p < 0.05). However, there was no significant association between periodontitis and ALT in female students., Conclusions: Elevated ALT could be a potential risk indicator for periodontitis among young males. Monitoring hepatic abnormalities to prevent periodontitis must be better understood, even in the young adult population.

Introduction/purpose: Low back pain (LBP) is a frequent injury in athletes. This study examined the relationship between isokinetic trunk muscle strength and the functional disability level of chronic LBP. We particularly focused on the existence of radiological abnormalities (RA) in the lumbar region., Methods: Subjects were 53 collegiate wrestlers. Trunk extensor and flexor muscle strength was measured at three angular velocities (60, 90, and 120degrees x s(-1)). The examined parameters for trunk muscle strength were peak torque, work, average torque, and average power. The disability level of LBP was estimated by using two questionnaires. Based on the RA evaluation with x-ray and MRI, all 53 wrestlers were assigned to two groups as the RA group (N = 35, 66%) and the non-RA group (N = 18, 34%). Correlations between trunk muscle strength and the disability level of LBP in each group were analyzed with Spearman's rank test., Results: Without considering the disability level, there were 14 subjects with LBP (40%) in the RA group and 8 (44%) in the non-RA. Significantly correlated parameters with the disability level of LBP could be observed only when the subjects were restricted to the non-RA group. The correlated parameters with the two questionnaires were peak torque at 120degrees x s(-1), work at 60degrees x s(-1) and 90degrees x s(-1), and average torque at 90degrees x s(-1) and 120degrees x s(-1). There were no significantly correlated parameters in the RA group. None of the trunk flexor parameters were significantly correlated with the disability level of LBP., Conclusion: The relatively low strength of trunk extensors may be one of the factors related to nonspecific chronic low back pain in collegiate wrestlers.

Background/aims: The present study was undertaken to compare the clinical characteristics, availability of initial treatment options and prognostic features of patients with hepatocellular carcinoma in relation to hepatitis B or C viral infection., Methodology: Six hundred and ninety-two patients with hepatocellular carcinoma treated during the 12-year-period from Jan 1989 to Dec 2000 were categorized into three groups as follows: 1) 59 were classified as the HBV group: positive for hepatitis B surface antigen (HBsAg) and negative for antibody to hepatitis C (HCVAb), 2) 594 were placed in the HCV group: negative for HBsAg and positive for HCVAb, and 3) 39 were put into the Non-B, Non-C (NBNC) group: negative for both HBsAg and HCVAb. The age distribution, gender ratio, serum alpha-fetoprotein level, the presence of underlying cirrhosis, tumor size, the number of hepatocellular carcinoma tumors at the initial detection, the types of follow-up until the initial detection of hepatocellular carcinoma, the initial treatments chosen, and the survival were analyzed and compared among the three groups., Results: Regarding age, the HBV group showed a younger age (56.3 +/- 12.2 years old) than the other two groups (the HCV group: 66.3 +/- 8.3, the NBNC group: 67.9 +/- 8.5 years old), however, no difference was observed in the male-to-female ratio of the three groups. The serum alpha-fetoprotein level, the prevalence of hepatocellular carcinoma measuring more than 3 cm in diameter, non-solitary hepatocellular carcinoma and portal thrombosis were strongly demonstrated at the initial detection in the HBV group, which was most likely due to the poor follow-up until detection. Consequently, the 1-, 3-, 5- and 7-year survivals of the patients in the HBV group were 40.4, 25.1, 18.8 and 5.2%, and were significantly shorter than both the HCV group which were 72.6, 44.9, 25.0 and 10.0%, and the NBNC group which were 71.2, 41.4, 31.1 and 31.1%, respectively. As for the NBNC group, in spite of the lack of a careful follow-up a longer survival was observed probably because they had a better preserved liver condition., Conclusions: Regarding the hepatocellular carcinoma patients, those infected with HBV presented at the advanced stage due to the lack of a careful follow-up, thus resulting in a shorter survival. As a result, hepatocellular carcinoma patients infected with HBV need to be strictly followed up.

Background/aims: This study was undertaken to evaluate the serial changes of various factors in patients with hepatocellular carcinoma, including hepatitis viruses, age distribution, female-to-male ratio, size and the number of hepatocellular carcinoma tumors at initial detection, the types of treatment and survival during a 12-year period., Methodology: Seven hundred and four consecutive patients with hepatocellular carcinoma lesions observed from Jan 1989 to Dec 2000 (12 years) at the Internal Medicine Department, Saga Prefectural Hospital Koseikan were retrospectively enrolled in the study. The follow-up period was divided into four terms as follows: 1989-91, 1992-94, 1995-97 and 1998-2000. The serial changes of causal hepatitis viruses, age distribution, gender ratio, tumor size, the number of hepatocellular carcinoma tumors at initial detection, the types of treatment and survival were analyzed and compared among the four different terms., Results: Regarding viral markers, the association of an HCV infection has become more predominant in hepatocellular carcinoma cases, while the ratio of hepatocellular carcinoma patients infected with HBV has decreased during this 12-year period. In addition, the rate of hepatocellular carcinoma measuring 3 cm or less in diameter or solitary hepatocellular carcinoma at initial detection has increased during the 12-year period. The female-to-male ratio has increased from 33.6% in 1989-1991, 34.8% in 1992-1994, 48.7% in 1995-1997 to 60.6% in 1998-2000, respectively. Due to increased early detection, the types of treatment for hepatocellular carcinoma have shifted from arterial interventional therapy to local ablation therapy combined with or without interventional therapy. Therefore, although the age distribution of all 704 hepatocellular carcinoma patients has shifted to slightly older ages as shown by the ages of 64.1 years old, 63.4 years old, 66.6 years old and 67.3 years old in the four terms, respectively, the survival of the patients with hepatocellular carcinoma proved to had become significantly longer than before during the 12-year period., Conclusions: Hepatocellular carcinoma patients tended to show an increased prevalence of HCV, a higher age distribution, an increasing female prevalence, an earlier detection, advanced multidisciplinary therapies and prolonged survival in the last 12 years.

Background/aims: Only limited amounts of data are available at present regarding the clinical differences in cases of hepatocellular carcinoma who have seropositivity or seronegativity for AFP (alpha-fetoprotein) and DCP (des-y-carboxy prothrombin). In the current study we investigated the different clinical variables in patients with hepatocellular carcinoma according to the serum levels of AFP and DCP., Methodology: Analyses were performed based on 168 consecutive patients with hepatocellular carcinoma observed for 4 years between July 1997 and December 2000 at the Internal Medicine Department, Saga Prefectural Hospital Koseikan. They were retrospectively evaluated for the analysis in the study. They were classified into four groups according to their serum levels of positivity for AFP and DCP as follows: a Negative group; seronegative for both AFP below 20 ng/mL and DCP below 40mAU/mL, an AFP group; seropositive for AFP above 100 ng/mL and seronegative for DCP, a DCP group; seronegative for AFP and seropositive for DCP above 100mAU/mL and an AFP/DCP group; seropositive for both AFP and DCP. Different clinical variables were compared among the four groups., Results: There were no significant differences among the groups regarding age, viral markers or the presence of underlying cirrhosis. The DCP group and the AFP/DCP group occurred more often in male patients and they also tended to have a higher incidence of large hepatocellular carcinoma measuring 3 cm or more in greatest dimension compared to the Negative group and the AFP group. The AFP/DCP group showed higher incidences of non-solitary hepatocellular carcinoma and larger hepatocellular carcinoma measuring 3 cm or more in greatest dimension, and the presence of portal thrombosis in comparison to the other three groups and also showed a shorter survival., Conclusions: Hepatocellular carcinomas seropositive for DCP were predominantly found in male patients, and hepatocellular carcinoma seropositive for both DCP and AFP tended to be initially diagnosed at an advanced stage which resulted in a shorter survival.

Aim: There is a limited amount of data regarding the gender difference in the survival in cases of hepatocellular carcinoma (HCC). The aim of the present study was to investigate the difference in the survival between males and females with HCC and the possible factors affecting the gender difference of survival in HCC., Methods: Analyses were performed based on 704 consecutive patients with HCC observed for 12 years between January 1989 and December 2000 at the Internal Medicine Department, Saga Prefectural Hospital Koseikan, who were retrospectively enrolled in the study. The 1-, 3-, 5- and 7-year survivals and various factors at the detection of HCC were compared between 487 male and 217 female patients with HCC using the Kaplan-Meier method, Mantel-Cox test, chi squared test and Fisher's exact analysis., Results: There was a significant difference in survival between male and female patients with a 1-, 3-, 5- and 7-year survival estimate of 67.7, 40.6, 23.8 and 8.7%versus 73.5, 50.3, 26.3 and 15.4%, respectively (P-value: 0.0167). Of the clinical variables examined, the significant factors related to gender difference were found to be age, tumor size, the number of tumors, the presence of portal thrombosis and the type of follow-up. Of the patients with HCC lesions measuring 3 cm or less in the greatest dimension or those with solitary HCCs, however, there was no significant difference in survival between both sexes. The patients were divided into three categories: closely followed-up group (regular periodic follow-up with monthly alpha-fetoprotein measurements plus ultrasonography at least every 4 months); a non-closely followed-up group; and an incidental group (incidentally discovered due to related symptoms). The detection rates of HCC through the closely followed-up, non-closely followed-up and incidental groups were 19.3%, 46.2% and 34.5% in men and 28.1%, 46.5% and 25.4% in women, respectively, which reached a significant difference between both sexes (P-value: 0.0097)., Conclusion: The survival of female cases of HCC was longer than that of male cases. Disparities in the type of follow-up for women in comparison to men exist and may contribute to gender disparities in survival. Women with a high risk for HCC tended to be better cared for during the follow-up. To reduce gender disparities in survival, efforts should be directed at the earlier identification of HCC.

A case control study was carried out in order to evaluate the various factors which may influence the occurrence of methicillin-resistant Staphylococcus aureus (MRSA) infections in a skilled nursing home. From April 1991 to March 1994, bacterial cultures were performed in 55 out of 102 residents in a nursing home based on various clinical aspects. We divided 102 residents into following three groups; (1) the MRSA group (n = 10), residents whose materials for bacterial culture were positive for MRSA, (2) the non-MRSA group (n = 45), residents whose specimens were negative for MRSA but positive for other bacteria, (3) the control group (n = 47), residents who did not have to undergo a bacterial culture because they were free from moderate and severe infectious diseases. Compared with the control group, the activities of daily living score and the serum albumin level were significantly lower in the MRSA group and the non-MRSA group at the beginning of the study. In contrast, the number of antibiotics used prior to the bacterial culture and the proportion of hospitalization within 6 months prior to the bacterial culture were significantly larger in the MRSA group than in either the non-MRSA group, or the control group. These results thus suggest that a low activities of daily living score, the use of many kinds of antibiotics and a recent previous hospitalization may be risk factors of MRSA infection in a nursing home environment.