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Measurements of cosmic-ray neutron dose rates with a balloon in Sanriku, Japan (geographic location: 39° N, 142° E; corresponding geomagnetic latitude: 30° N) were conducted at an altitude from 0.2 to 25 km on 25–26 August 2004 when solar activity was at an average level. Neutron dose rates given as ambient dose equivalent rates (H*(10)) were measured with high-sensitive neutron dose equivalent counters and electronic silicon personal dosimeters (EPDs). The neutron dose rates increased with increasing altitude, but they were saturated around 15–20 km and decreased with increasing altitude beyond 20 km. The neutron ambient dose equivalent rate was 1.5 µSv/h− 1 at 20 km. Measured values were corrected for the deviation of the energy response of the dose equivalent counter from the fluence-to-ambient dose equivalent conversion coefficient, and the corrected values were very close to the calculated values with EPCARD. On the other hand, neutron measurements by the EPDs gave about 10 times overestimation because of the high sensitivity to cosmic-ray protons. [ABSTRACT FROM PUBLISHER]

Abstract: Objectives: This study was initiated to examine if exposure to cadmium (Cd) was high also outside of the previously identified Itai-itai disease endemic region in the Jinzu River basin in Toyama prefecture in Japan. Methods: Morning spot urine samples were collected in June–August 2004 from 651 adult women (including 535 never-smokers) in various regions in Toyama prefecture, and subjected to urinalyses for cadmium (Cd), α1-microglobulin (α1-MG), β2-microglobulin (β2-MG), N-acetyl-β-d-glucosaminidase (NAG), specific gravity (SG or sg) and creatinine (CR or cr). Three months later, the second urine samples were collected from those with elevated Cd in urine (e.g., ≧4 μg/g cr), together with answers to questionnaires on shellfish consumption. Results: The geometric mean (GM) Cd, α1-MG, β2-MG and NAG (after correction for CR) for the total participants were 2.0 μg/g cr, 2.4 mg/g cr, 104 μg/g cr and 2.8 units/g cr, respectively; further analysis with never-smoking cases only did not induce significant changes in these parameters. Analyses of the second urine samples from the high Cd subjects showed that there was substantial decrease (to about a half) in Cd in the 3-month period, and that the decrease was accompanied by reduction in α1-MG and NAG (β2-MG did not show elevation even in the first samples). The urinalysis results in combination with the results of the questionnaire survey suggest that the high urinary Cd was temporary and might be induced by intake of shellfish that is edible whole. Conclusions: The overall findings appear to suggest that Cd exposure in Toyama populations (outside of the Itai-itai disease endemic region) was at the levels commonly observed on the coast of the Sea of Japan, and that the Cd level in urine might be modified by the intake of some types of seafood. Further studies are necessary to elucidate the relation of urinary Cd with seafood intake. [Copyright &y& Elsevier]

Abstract: Launching a large balloon in a limited launching field is a long standing problem in Japan. The largest balloon ever launched successfully was 200,000m3 in volume. It was launched in 1973. A larger balloon with a volume of 500,000m3 was tried later, but it burst during the ascending phase. For launching balloons with a large lift exceeding 500kg, the conventional static launching method had the most serious problem with possible damage to the polyethylene film of the balloon caused by the holding mechanism. After that, we had developed a new static launching method to launch balloons with a total lift of 1.0ton. For launching a large balloon with a total lift above 1.5ton, the new static launching method had a weak point in that if there was an air bubble in the folded part of the balloon, it may puncture the balloon as it is pushed by a spool. To avoid this problem, we developed a semi-dynamic launching method in 1999 using a launcher fixed to the ground leaving a freedom of rotation around the vertical axis. We have launched some balloons using the method and have gradually enriched our experience in using this system. In 2003, we successfully launched a balloon with a volume of 500,000m3 by using the method. This balloon was made of polyethylene films with a thickness of 20μm and it is the largest balloon ever launched in Japan. [Copyright &y& Elsevier]

To examine the associations between lifestyle factors and quality of life (QOL) among Japanese children. Participants were 7794 children (3869 boys and 3925 girls) aged 9–10. They completed a questionnaire regarding lifestyles at baseline survey and were followed up for 3 years. In the follow-up survey, QOL was evaluated using a Japanese version of the COOP charts. Children rated their QOL as one of five response categories. Subjects rated as‘very well’ or‘pretty good’ were considered to have good QOL, and the remainder was assumed to have poor QOL. Logistic regression analysis was performed to evaluate the relationship between lifestyles or changes in lifestyles and QOL. In the multivariate analysis model, age, sex, body mass index (BMI), and lifestyle factors were simultaneously entered. During the follow-up period, children became more sedentary. Compared to children participating in physical activity‘very often’ at baseline, those who exercised‘almost never’ were more likely to have poor QOL[OR (95% CI): 1.92 (1.26–2.93)]. Children who developed or maintained undesirable lifestyles had high OR for poor QOL. Compared to children taking breakfast‘often’ during the follow-up period, those changing from‘often’ to‘seldom’ or those taking breakfast‘seldom’ were more likely to have poor QOL[1.61 (1.24–2.07), 2.05 (1.03–4.09), respectively]. When compared with children maintaining their participation in physical activity‘often’, those who changed from‘often’ to‘seldom’ and those who kept‘seldom’ were more likely to have poor QOL[2.10 (1.84–2.39), 2.21 (1.88–2.59), respectively]. This study shows that unfavourable lifestyles in childhood are associated with poor QOL in early adolescence. Early intervention could be worth considering to keeping desirable lifestyles during childhood. [ABSTRACT FROM AUTHOR]

Development of a balloon flying at higher altitude is one of the most attractive trials for balloon technology. We, the balloon group at the Institute of Space and Astronautical Science (ISAS), have been engaged in the development of a light balloon to go to higher altitudes since 1991. We have developed light equipment for house keeping modules and an ultra-thin film with a thickness of only 3.4 μm. Using the equipment and film, we have made and launched some balloons from 1000 m3 in volume. We gradually enlarged the balloon volume, and on May 23, 2002, we launched a 60,000 m3 balloon. The balloon reached the altitude of 53.0 km, which is the highest altitude ever reached by a balloon. This event opened a new era for scientific observations at high altitude. [Copyright &y& Elsevier]

Summary It has been observed that obese children receive genetic and environmental effects that are associated with them being overweight. With regard to the latter, lifestyles such as eating habits and physical activity have been focused on. In the present study, the social characteristics which would dominate their lifestyles were investigated as background variables. For this purpose, 9668 Japanese children aged three years who were all born in Toyama prefecture, Japan, in 1998, served as birth cohort subjects. For the comparison between obese (Kaup index; mass in kg/(height in m)2 >=18) and nonobese (Kaup index 18) children, irregular snack intake, physical inactivity and reduced sleeping hours were chosen as statistically significant obesity-related lifestyle indicators for the children. For social characteristics, family construction (expanded family with grandparents/nonexpanded family), main caregiver (mother/other), attending a nursery school (yes/no) and mother’s employment (full-time worker/other) were chosen. These were significantly associated with the obesity-related lifestyles mentioned above using multiple logistic regression analysis adjusted for other variables of social characteristics as well as for gender and birth month (July–December/January–June). The two greatest population-attributable risk percentages were observed for mother as main caregiver (-36.5%) and attending a nursery school (-28.9%) for irregular snack intake. Therefore, these two social characteristics substantially reduced the number of children with irregular snack intake. On the other hand, the two social characteristics were reversed in children with reduced sleeping hours (population-attributable risk percentage of mother as main caregiver: 15.4%; attending a nursery school: 17%). In contrast with favourable effects on snack intake these social characteristics showed an adverse influence on the sleeping habits of children. [ABSTRACT FROM AUTHOR]

Abstract: Since 1971, numerous balloons have been launched from the Japanese balloon base, the Sanriku Balloon Center (SBC). Through these years, balloon technologies have been developed continuously and many scientific achievements have resulted. Recently, however, because of the limited area of the launching pad of the SBC, we have been faced with the difficulty of safely launching large balloons. To solve this issue, we decided to move the balloon base from the SBC to the Taiki Aerospace Research Field (TARF) in northern Japan. The TARF had an existing huge hanger and a paved launch pad capable of being utilised for balloon operations. To evolve the TARF into a new balloon base, new balloon facilities have been constructed at the TARF and equipment was transferred from the SBC to the TARF during July 2007 and March 2008. The SBC was closed in September 2007, and the new base became operational in May 2008. The new base at the TARF is designed to launch larger balloons with greater safety and to perform balloon operations more effectively than ever before. In the summer of 2008, we carried out the first series of the balloon campaign at the TARF, and succeeded in two engineering flights of stratospheric balloons. By the success of these flights, we have verified that the whole system of the new balloon base is well established. [Copyright &y& Elsevier]

This study (1) evaluated the perceptual and objective physical quality of digital radiographic chest images processed for different purposes (routine hospital use, lung cancer screening, and pneumoconiosis screening), and (2) quantified objectively the quality of chest images visually graded by the Japan National Federation of Industrial Health Organization (ZENEIREN). Four observers rated the images using a visual grading score (VGS) according to ZENEIREN's quality criteria. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were measured. Between groups, differences were assessed using ANOVA (followed by Bonferroni multiple comparisons) or unpaired t-test. The Pearson's correlation coefficients were calculated for the correlation between perceptual quality and objective physical image quality. The image quality perceived by the observers and the SNR measurements were highest for the images generated using parameters recommended for lung cancer screening. The images processed for pneumoconiosis screening were rated poorest by the observers and showed the lowest objective physical quality measurements. The chest images rated high quality by ZENEIREN generally showed a higher objective physical image quality. The SNR correlated well with VGS, but CNR did not. Highly significant differences between the processing parameters indicate that image processing strongly influences the perceptual quality of digital radiographic chest images.

When a large-scale epidemic of porcine epidemic diarrhea (PED) occurred in 2013 in Japan, feedback feeding (feeding feces and gut tissues of infected piglets) was attempted to impart immunity to sows and immunize nursing piglets via breastfeeding. This study evaluated the effect of feedback feeding on PED control at 172 farms in Kagoshima and Miyazaki Prefectures. Univariable and multivariable generalized linear models were used to analyze the associations between conduct of feedback feeding and damage from the outbreak (outbreak period and the number of piglet deaths) at the farm level. The within-farm outbreak period shortened over time after the regional outbreak began on Kyushu Island (P=0.009) and was longer on large-scale farms (mean 66.0 days, P=0.003) than small-scale farms (29.4 days) and on farms that used feedback feeding (145.2 days, P=0.059) than those that did not (66.0 days). The number of dead piglets decreased over time since the first regional case (P<0.001) and was higher at farrow-to-finish farms (3.8 piglets/sow, P<0.001) than reproduction farms (0.7 piglets/sow). The effect of feedback feeding on the number of dead piglets was not significant, but its interaction term with farm style had a significant effect (5.0 more piglet deaths at reproduction farms than fallow-to-finish farms, P=0.001). These results suggest that feedback feeding made the damage from PED worse, though it was well established at a later stage of the regional PED epidemic.

Background: This study aimed to develop and validate the Dementia Caregiver Positive Feeling Scale 21-item version (DCPFS-21) in Japan., Methods: We selected and generated 27 items based on the preliminary 25-item version of the DCPFS. Next, the DCPFS-21 was developed and validated through two phases. In Phase 1, we obtained data from 147 caregivers of people with dementia by using the 27-item version, examined the construct validity and internal consistency of the scale and then selected 21 items (DCPFS-21). In Phase 2, we compared the scores of 30 caregivers of people with dementia on the DCPFS-21 with the standard scales. Four weeks after the first examination, we re-examined the intra-rater reliability., Results: In Phase 1, via factor analysis, we reduced the 27 items to 21 items (DCPFS-21). Moreover, the DCPFS-21 was grouped into four subscales, namely, meaning in caregiving, caregiving mastery, positive emotion on caregiving and support from others. This classification agreed with the following factors extracted from the pilot study. The DCPFS-21 showed good internal consistency (Cronbach's α = 0.92). In Phase 2, the DCPFS-21 correlated with the Caregiving Gratification Scale by 0.54 (P < 0.01). The DCPFS-21 also showed good intra-rater reliability (1.1: ρ = 0.62)., Conclusion: We developed and validated the DCPFS-21, which measures the positive feelings of family caregivers of people with dementia, in Japan., (© 2021 The Authors. Psychogeriatrics published by John Wiley & Sons Australia, Ltd on behalf of Japanese Psychogeriatric Society.)

Introduction: USA300 is the most common community-acquired methicillin-resistant Staphylococcus aureus (MRSA) strain. Sequence type (ST) 764 MRSA is a new local variant of the ST 5 lineage. The objective of this study was to determine the clinical characteristics of USA300 and ST 764 infections among outpatients in Japan., Methods: We obtained MRSA isolates from 132 outpatients who visited our hospital from January 2016 to December 2017 and compared USA300 infection group to ST 764 infection group. Molecular analysis, including that of various toxins and other virulence factors, of the MRSA isolates were performed. In particular, we investigated the relationships among PCR-based open reading frame typing (POT) scores, MRSA clones, and virulence factors., Results: Twenty-seven USA300 isolates (20.5%) and 16 ST 764 isolates (12.1%) were identified. Although USA300 and ST 764 had lower rates of risk factors, their infection rates were higher. USA300-infected patients had higher rates of deep skin and soft tissue infections compared with the non-USA300 CA-MRSA-infected patients. Notably, the USA300 and ST 764 isolates had unique POT scores., Conclusions: Our results indicated that USA300 MRSA was spreading in an area 120 km west of Tokyo, Japan. We observed multiple cases of ST 764 MRSA infection, raising concerns about the antimicrobial resistance of ST 764, as it limits the choices of antibiotics to treat infection. The POT score can predict the presence of toxins and virulence factors, as well as the clone identity of MRSA with high accuracy., Competing Interests: Declaration of competing interest None declared., (Copyright © 2020 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)

Objectives: International guidelines recommend opportunistic screening for atrial fibrillation (AF); however, there is no current data to inform how often to repeat screening. We aimed to investigate the incremental annual yield and stroke risk of new AF cases in individuals screened annually over 4 years., Design: A retrospective cohort study., Setting: Hokuriku Health Service Association, Toyama prefecture, Japan., Participants: Employees and their families receiving annual health examinations from Hokuriku Health Service Association., Intervention: Each subject received an annual health examination (including 12-lead ECG) from 2014 to 2017. Only subjects with baseline ECGs in 2012 and/or 2013 were included., Main Outcome Measures: Rates (cases/100 person-years) of new AF identified each year for 4 consecutive years of screening (stratified according to gender and age groups). Calculated stroke risk of new AF cases using modified CHA 2 DS 2 -VASc scores (without heart failure data) (CHA 2 DS 2 VASc = C: congestive heart failure [1 point]; H: hypertension [1 point]; A2: age 65-74 years [1 point] or age ≥75 years [2 points]; D: diabetes mellitus [1 point]; S: prior stroke or transient ischemic attack [2 points]; VA: vascular disease [1 point]; and Sc: sex category [female] [1 point]) RESULTS: In 2014, 88 218 subjects had an ECG (46.8±12.5 years; 64% men): identifying 346 (0.39%) known AF and 69 (0.08%) new AF. The incidence rate of new AF increased with age from 0.01% (<50 years) to 0.98% (≥75 years) and was higher in men (0.1%) than women (0.05%). Repeated annual screening over 4 years identified a consistent new AF yield 0.06%-0.10% per year (0.33%-0.55% ≥65 years). Forty-two per cent of all new AF cases, and 76% of cases aged ≥65 years, had a class-1 oral anticoagulation (OAC) recommendation (modified CHA 2 DS 2 -VASc score ≥2 men, ≥3 women)., Conclusions: Repeated annual ECG screening of the same population provides a consistent yield of new AF each year. The majority of new AF (≥65 years) are eligible for anticoagulation for stroke prevention. Although AF prevalence and incidence are lower in Japan than Western countries, 2318 new cases would be identified in Toyama prefecture each year with annual screening, of whom ~927 would have a high stroke risk with a recommendation for OAC therapy., Competing Interests: Competing interests: SBF reports grants, personal fees and non-financial support from Bayer, grants, personal fees and non-financial support from BMS-PFizer, personal fees and non-financial support from Daiichi-Sankyo, outside the submitted work., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Aim: Evaluating effects of an enjoyable walking-habituation program., Methods: We carried out a 12-week intervention, consisting of an enjoyable walking-habituation program based on five principles of brain-activating rehabilitation: pleasant atmosphere, interactive communication, social roles, praising each other and errorless support. The program, once a week for 90 min, was carried out in small groups. Participants were 71 community-dwelling people (72.2 ± 4.3) without dementia. Cognitive function was evaluated in five cognitive domains: memory, executive function, word fluency, visuospatial abilities and sustained attention. Additionally, quality of life, depressive state, functional capacity, range of activities, social network and subjective memory complaints were assessed using questionnaires. Motor function was also evaluated. Measurement was carried out before the observation period, after observation and after intervention., Results: A total of 63 participants were included in the analysis. Daily steps, executive function, subjective memory complaints, functional capacity and 5-m maximum walking time significantly improved during the intervention period (after observation to after intervention) compared with the observation period (before the observation period to after observation). No significant differences were seen in other evaluations. At 6 months after the intervention, 52 of 63 participants (82.5%) continued to walk once a week or more, and all of them were confident about continuing to walk in the future. Furthermore, all participants were satisfied with our walking-habituation program and all replied that they felt delighted., Conclusion: The intervention program, based on the five principles of brain-activating rehabilitation, resulted in improvement of some cognitive and physical functions, as well as a high walking-habituation rate at 6 months' follow up. Geriatr Gerontol Int 2015; ●●: ●●-●●., (© 2015 Japan Geriatrics Society.)

The Japanese Population-based Osteoporosis (JPOS) Cohort Study was launched in 1996 to produce a reference database of areal bone mineral density (aBMD) by dual energy X-ray absorptiometry (DXA) and bone turnover markers in the Japanese female population and to determine risk factors for osteoporotic fractures. At baseline, 3984 women aged 15 to 79 years were randomly selected to provide representative bone status data and aBMD values for the diagnosis of osteoporosis. Follow-up surveys were conducted in 1999, 2002, 2006 and 2011/12 to determine changes in aBMD and identify incident morphometry-confirmed vertebral fractures and clinical fractures. These outcomes were obtained from 2174 women who participated in at least one follow-up survey. JPOS is a unique resource of individual-level bone health information with radiological and biological archives that include DXA images, and serum, plasma and DNA for future analyses with emerging radiological and biological techniques. The JPOS dataset is not freely available, but new collaborations are encouraged. Potential collaborators are invited to contact the Secretary General (M.I.) at the administrative office of the JPOS Study Group., (© The Author 2014; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.)

Background: Anticoagulation is recommended as standard of care for venous thromboembolism (VTE) (pulmonary embolism [PE]/deep vein thrombosis [DVT]), for which unfractionated heparin (UFH) and warfarin are used in Japan. In the multi-regional AMPLIFY study, a fixed-dose regimen of apixaban alone was non-inferior to conventional therapy for treatment of PE/DVT and was associated with significantly fewer bleeding events., Methods and Results: Japan phase 3 study (AMPLIFY-J), randomized, active-controlled, open-label study in Japanese subjects with acute PE/DVT, was designed based on AMPLIFY. Key objectives were to investigate safety and efficacy of apixaban in symptomatic PE/DVT subjects during 24-week treatment. UFH/warfarin was used as control treatment. Apixaban was initiated at 10 mg twice daily for 7 days, followed by 5 mg twice daily for 23 weeks. All endpoints and imaging for thrombotic burden were assessed by an event adjudication committee. Eighty subjects were randomized, 33 subjects (41.3%) were aged <65 years. Proportion of major/clinically relevant non-major bleeding was lower in apixaban (7.5%) compared with well-controlled UFH/warfarin (28.2%; median TTR, 70.4%). [corrected]. Recurrent VTE occurred in no subjects in apixaban and in 1 subject in UFH/warfarin. Thrombotic burden results were similar in both groups. Proportions of subjects with adverse events was generally similar in both groups., Conclusions: Apixaban was well-tolerated and had a favorable safety profile. No clinically important efficacy difference compared with UFH/warfarin was observed.

A 5-year-old castrated Japanese domestic cat was presented with persistent vomiting. Ultrasound examinations revealed many masses only in the liver, and the fine needle aspiration was performed. Cytologically, polygonal or oval shaped tumor cells forming rosette and cord-like patterns were demonstrated, and then, the hepatic lesions were diagnosed as neuroendocrine carcinoma tentatively. The cat died one month after admission and was necropsied. Histopathologically, the tumor cells of the hepatic mass were arranged in typical rosette and cord-like structures. They were considerably uniform in size with hyperchromatic round nuclei and eosinophilic cytoplasm. Most of tumor cells were immunopositive for chromogranin A, and some were positive for gastrin. The findings indicate the possibility that the present case was a gastrin-producing neuroendocrine carcinoma.

Aim: Japan is one of the most rapidly aging societies in the world. Measures to prevent dementia are urgently required in Japan, although such strategies have not yet been established. This study investigated the effectiveness of a pleasant physical exercise intervention on the prevention of cognitive decline in community-dwelling elderly participants with subjective memory complaints. In this intervention, a pleasant atmosphere was emphasized to enhance the participants' motivation., Method: We administered a 12-week intervention program consisting of pleasant physical exercise. This program for the prevention of cognitive decline was carried out as a service of Maebashi city. The service targeted elderly residents aged 65 years and older who had subjective memory complaints. After a control period of 12 weeks, 42 participants, aged between 65-86 years, received intervention once a week at community centers. Participants carried out group exercise, and were encouraged to perform home exercise and walking during the intervention period. The program was carried out by co-medical professional staff, with the help of senior citizen volunteers., Results: A total of 30 participants were included in the analysis. There was significant improvement on the Wechsler digit symbol substitution test (P = 0.01)., Conclusion: Participants with subjective memory complaints who continued the pleasant physical exercise programs for 12 weeks showed improvement in some aspects of cognitive function. Participation of senior citizen volunteers enabled smooth implementation of the program, and alleviated the burden on the professional staff. The pleasant physical exercise intervention described in the present study could be regarded as a community-led intervention to prevent cognitive decline., (© 2012 Japan Geriatrics Society.)

Background/aims: The goal of our study was to determine the usefulness of the percutaneous placement of a drainage catheter using a one-step technique under guidance of computed tomography (CT) fluoroscopy., Methodology: Subjects were 11 patients (3 women, 8 men; mean age 65 years) who underwent percutaneous thoracic, abdominal, and pelvic drainage procedures for fluid collections between August 2010 and June 2011. The mean maximum diameter of the lesions was 53.8mm (range 30 to 82 mm) and the mean depth was 37.6mm (range 18 to 70mm). A drainage catheter that can be inserted by a one- step technique without a guide wire was used. The procedures were guided by use of a helical CT scanner that provided real-time fluoroscopic reconstruction., Results: Percutaneous drainage was successfully achieved in every procedure. Use of real-time CT-fluoroscopy and a drainage catheter that can be inserted with a one-step technique allowed rapid assessment of catheter placement. No patient had a serious complication related to the drainage procedure. The mean procedure time required to drain one lesion was 21.1 minutes (range 12 to 41 minutes)., Conclusions: Thoracic, abdominal, and pelvic drainage procedures using the one-step technique under CT-fluoroscopy guidance were accurate, safe and easy.

Background: Body image, defined here as an inaccurate perception of personal bodyweight, plays a significant role in the development of obesity, eating problems and eating disorders. Certain lifestyle factors may influence an individual's body image, but current knowledge is based mainly on studies in Western populations., Methods: The associations between body image and lifestyle factors were investigated in samples of the Japanese female adolescent population., Results: Respondents who reported that they ate meals slowly (odds ratio [OR] 1.81, P < 0.001) or only consumed small amounts of food (OR 3.17, P < 0.001) were more likely to underestimate their body image, as determined by their body mass index, than eaters who had average behavior for this age group. Individuals who reported eating faster (OR 1.47, P < 0.001) or consuming large amounts (OR 1.67, P < 0.001); those who do not eat breakfast on a daily basis (OR 1.35, P = 0.006); those who go to bed later than the average time for this age group (OR 1.38, P < 0.001) or sleep <7 h (OR 1.40, P < 0.001) and those individuals who rarely exercise (OR 1.27, P = 0.03) were more likely to overestimate their body image, as determined by BMI, compared with those who had average eating, sleeping and exercise behaviors for this age group., Conclusions: Variation from the norm in eating, sleeping and exercise behaviors showed a relationship with a distorted perception of body image in Japanese adolescent girls. These findings are of potential importance in understanding the underlying mechanisms involved in the development of body image and for exploring interventional approaches.

Objectives: This study was initiated to investigate the extents of biological variations in cadmium and three common tubular dysfunction marker levels in blood and urine through repeated sampling., Methods: A 12-month survey and a 10-week survey were conducted in an area with no known cadmium pollution. In the 12-month survey, five adult women offered urine samples once every month and blood samples once in every season, respectively. In the 10-week survey, 17 adult women gave urine samples once every week. Blood and urine samples were analyzed for cadmium (Cd-B and Cd-U) by graphite-furnace atomic absorption spectrometry, and urine samples were analyzed also for alpha 1-microglobulin (alpha 1-MG-U), beta 2-microglobulin (beta 2-MG-U) and N-acetyl-beta-D-glucosaminidase (NAG-U) by conventional methods, all under strict quality control. The results were subjected to statistical analysis to examine the extents of biological variations through-out the study periods., Results: Variations in geometric means (GMs) for Cd-B, Cd-U, alpha 1-MG-U, beta 2-MG-U, and NAG-U were all small; the ratio of the largest GM over the lowest GM was 1.1 for Cd-B, 2 for Cd-U and 2 to 3 for alpha 1-MG-U, beta 2-MG-U, and NAG-U in the 12-month survey, and 1.7 at largest for all parameters in the 10-week survey. The within-subject variations during the 12-month or 10-week periods were however large, i.e., more than 4-5-fold difference between the smallest and the largest values obtained for the same subject. Effects of the correction for urine density to reduce the variations were limited. In contrast, within-subject variation in Cd-B was small with a ratio of 1.3., Conclusions: Variations in GM values for Cd-U, alpha 1-MG-U, beta 2-MG-U, and NAG-U at different time of sampling are small so that single measurement would be acceptable as far as the evaluation on a group basis is the study objective. Within-subject variations are wide however, the ratio of the largest value over the smallest value being 4-5 or more, irrespective of correction for urine density. Therefore, care should be practiced when evaluation on an individual basis is intended. Very low within-subject variation in Cd-B may suggest the advantage of Cd-B over Cd-U for individual evaluation among general populations if blood sampling is accepted.

Purpose: To examine the characteristics of lung tumors for which radiofrequency (RF) ablation therapy is effective, and to determine what RF ablation parameters are effective for obtaining complete coagulation of the entire ablation zone with a single RF ablation session., Materials and Methods: Computed tomography (CT)-guided RF ablation of lung tumors was performed on 82 lesions in 34 patients between April 2003 and May 2005. Tumor characteristics and ablation parameters, including tumor size, location, and depth, and ablation duration, power deployed during ablation, and temperatures achieved were analyzed with regard to local tumor progression., Results: In all, 103 RF ablation sessions were performed on 82 tumors. As a procedure-related complication, pneumothorax occurred in 27 procedures. During the mean follow-up period of 10 months (range, 6-28 months), local tumor progression occurred in 18 (22.0%) of the 82 ablated tumors (3 months after RF ablation in 10, 6 months after RF ablation in 5, 9 months after RF ablation in 1, and 12 months after RF ablation in 2). Mean local progression-free duration was 8.7 +/- 4.5 months (range, 3-28 months). The frequency of local tumor progression was significantly correlated with size, whereas other variables had no statistical association. In tumors with a diameter > or =2.5 cm, only the period of ablation during the initial session was significantly correlated with subsequent local tumor progression (P = 0.000002, chi-square test)., Conclusion: A long duration of RF ablation is desirable for large lung tumors. The success of RF ablation is dependent upon tumor size. RF ablation treatment is most effective for lesions < 2.5 cm.

Objective: To examine daytime sleepiness and sleepiness interrelationship with sleep-wake patterns, eating habits, physical activity, and TV/video game time., Study Design: A cross-sectional survey with 9,261 school children (mean age of 12.8 years) from 93 junior high schools in Toyama prefecture, Japan., Results: The main outcome measures were daytime sleepiness during schooldays and sleepiness interrelationship with sleep-wake patterns, eating habits, physical activity, and visual media use. A total of 2,328 children (25.2%) reported sleepiness almost always and 4,401 (47.6%) sleepiness often. Regarding sex difference, a higher proportion of girls reported sleepiness in comparison to boys (79% vs 66%, P < .001). Higher body mass index values were associated with the presence of sleepiness. In girls with preferences for daily snack (versus those who reported no snack) sleepiness presented significantly (P < .001) higher values. Reduced sleep time was significantly associated with sleepiness. The prevalence of sleepiness did not significantly differ among groups who had 7.5 hours sleep or more. A dose-response relation was found between sleepiness and sleep disturbances, physical activity, and media use time., Conclusions: Sleep insufficiency represents a main cause for daytime sleepiness in Japanese junior high school children. Proper sleep habits, high physical activity level, and limited TV viewing time should be promoted among school children.

Purpose: To evaluate the feasibility and safety of withdrawal of a Gunther tulip retrievable vena cava filter (GTF)., Methods: Between June 2001 and December 2005, at our institution 86 GTFs were implanted for temporary caval filtration in 59 patients (37 women, 22 men; mean age 59.3 years, range 18-87 years). For GTFs retrieved thereafter, we retrospectively reviewed the following parameters: rate of success in retrieval, degree of trapped thrombus in the filter, and complications during retrieval., Results: Worsening of or new development of pulmonary embolism after filter implantation did not occur in any patient. Of the 86 GTFs implanted, retrieval of 80 was attempted. Among those 80 filters, 77 (96%) were successfully retrieved (with the standard method, n = 72; with the modified method, n = 5) without any complication. The period of implantation of the retrieved filters was 13.4 +/- 4.2 days. In the 5 filters that were filled to a height of > or = 1/4 with trapped thrombus, retrieval was performed after attempts were made to decrease trapped thrombi. In addition, a temporary filter or another GTF was temporarily placed at the cephalad level of the GTF during this removal procedure., Conclusion: GTFs can be retrieved in the majority of cases. Even when encountering situations in which the filter could not be removed using the standard method, withdrawal was possible in a high frequency of cases through various trials using modified methods.

Objective: To investigate whether there is a relationship between sib-size, birth order and the risk of overweight in junior high school students., Method: Sib-size, birth order, height and weight of subjects and their parents, and other lifestyle factors were obtained through a questionnaire survey conducted between June and July 2002 from 7,959 junior high students in Toyama prefecture, Japan. Logistic regression analysis was performed to examine the associations. Boys and girls were analyzed separately., Results: Boys from three-child families showed a significantly lower risk of overweight than only boys (odds ratio (OR)=0.66, p=0.010), and girls from larger families have a significantly lower risk than only girls (p for trend=0.001). Compared to middle-born girls, only girls have a significantly higher risk of overweight (OR=2.22, p<0.001). The risk of overweight in boys was significantly lower with increasing number of elder sibling or sister. However, increasing of any one sibling almost had the same risk reduction effect on the risk of overweight in girls (OR ranged from 0.74 to 0.76, p<=0.001)., Conclusion: Children without siblings are the ones most at risk for overweight, especially in girls. Birth order and sib-size are possible risk factors for the development of overweight and obesity.

Objective: The objective of this study is to examine if overall correlation exists among cadmium levels (Cd) in the general environment, dietary Cd intake, and Cd body burden of local residents., Methods: Eleven prefectures in Japan were selected as the areas where large-scale data on Cd levels in urine of adult women (40-49 and 50-59 years of age, respectively) were available to calculate geometric mean (GM) values for each of the prefecture. Other data were cited from published or previously established databases on Cd in the sediments of river bottoms (as a representative of Cd in the environment), Cd in rice for local consumption, and Cd in daily food duplicate samples collected from local women populations, and calculated for GM values for the prefectures. The GM values were subjected to correlation matrix and regression analysis., Results: Marginally significant (P < 0.10) correlation was detected between Cd in sediment and Cd in rice. Furthermore, correlation of Cd in sediment was significant with Cd in total foods (P < 0.05) and possibly with Cd in urine (P < 0.05-0.10). Importance of data on Cd in rice paddy soil as a missing link is discussed., Conclusions: Correlation was demonstrated in the flow of Cd transport from the environment (expressed as Cd contents in river sediments) to humans (in terms of Cd in urine) among general populations in Japan.

Background: Lifestyles are associated with physical and mental health status, as well as health-related quality of life (QOL) in adults. There is little information about relation between lifestyles and QOL in children. This study aims to examine the correlation among Japanese children., Methods: Subjects were from the Toyama Birth Cohort Study, a prospective, longitudinal survey of children born between 1989 and 1990 in Toyama Prefecture, Japan. When children were 12-13 years in 2002, a cross-sectional questionnaire-based survey was administered. The questionnaire designed to measure lifestyles included questions on eating, physical activity, sleep, and other factors. For QOL measurement, a validated Japanese version of the COOP Charts was used. Data from 7,887 children were available and logistic regression analyses were used., Results: Children with undesirable lifestyles, such as skipping breakfast, less participation in physical activity, longer television viewing, and later bedtime, were more likely to have poor QOL in domains of physical fitness, feelings, overall health, and quality of life. These correlations were independent of sex, BMI, social background, and somatic symptoms., Conclusions: Undesirable lifestyles are positively associated with impaired QOL among children. Further understanding of these relationships will facilitate the development of interventions to help children with poor QOL.

Background: The aim of the present study was to elucidate both environmental and behavioral factors that influence body mass index (BMI, kg/m2) among Japanese children from ages 3-6., Methods: In 1992 (at age 3) and 1995 (at age 6), 8170 6-year-old children (4176 boys and 3994 girls) were surveyed using a questionnaire on both body build (height and weight) and lifestyle. The correlation between BMI for 3-year-olds and for 6-year-olds were analyzed. From the temporal changes of body build between age 3 and 6 years, we categorized children into four groups: group 1, normal at both age 3 years and 6 years (normal/normal); group 2, overweight at age 3 years and normal at age 6 years (overweight/normal); group 3, normal at age 3 years and overweight at age 6 years (normal/overweight); and group 4, overweight at both age 3 years and 6 years (overweight/overweight). The authors compared the four groups with each other according to sex, concerning frequencies of children who matched the categories of environmental and behavioral factors. Each factor was tested using the chi2 test. Overweight children were defined as those whose BMI value was age-sex specific in the 90th percentile or more., Results: A significant correlation was found between body builds for children aged 3 and 6 years in both genders (boys, r = 0.559, P < 0.01; girls, r = 0.584, P < 0.01). Significant factors associated with overweight children were diet (eating rice, green tea, eggs, meat, but less breads and juice), rapid eating, short sleep duration, early bedtime, long periods of television viewing, avoidance of physical activity, and frequent bowel movement., Discussion: Temporal changes in BMI from age 3 years to 6 years are significantly associated with both environmental and behavioral factors at age 6 years. The results of this study may be useful for health promotion programs designed to prevent obesity during the early stages of childhood.

A retrospective study of 3102 injured snowboarders from 1992 to 1999 was undertaken using the medical records and questionnaires the patients had been asked to complete at the time of consultation. These cases represent all the injuries with medical treatment that occurred in five skiing and snowboarding resorts in the Nagano area. The total number of the injuries was 3243. The number of patients each year rapidly increased over the eight seasons. In descending order, the injuries were seen in the head and face, left upper extremity, spine, chest and abdomen, left lower extremity, right upper extremity, and right lower extremity. The number of head and face injuries was 829 (25%) followed by 768 (24%) left upper extremity injuries. With regard to the type of injury, fracture was the most frequent injury. There were 998 fractures, of which 625 were fractures of the upper extremity. Contusions were frequent on the head, face, chest, abdomen, and pelvis. Lacerations were frequent on the head and face. Sprains were frequent in the lower extremities, and dislocations were seen frequently in the upper extremities. The sharp increase in the number of patients was thought to reflect the increase in the population of snowboarders in Japan. The reason for the high concentration of injuries to the head and upper extremity is thought to derive from the characteristic riding form of snowboarding, with both legs fixed to one short, wide board. To decrease the injuries and to develop snowboarding as a safe and exciting sport, snowboarders, instructors, slope managers, and equipment manufacturers must comprehend the patterns of snowboarding injuries and cooperate to devise preventive measures., (The Japanese Orthopaedic Association)

Background: There are few studies that clarify the characteristics of bone turnover in children and adolescents. Furthermore, little has been published on changes in urinary CrossLaps(TM) (CTx) in Japanese subjects., Aim: To investigate biochemical markers of bone turnover in subjects, in relation to age and puberty development., Subjects and Methods: We measured serum bone specific alkaline phosphatase (B-Alp) and CTx in 1207 Japanese subjects aged 9-18 years. As an indicator of puberty development, the age that pubic hair appeared in males and menstruation started in females was obtained from questionnaires., Results: B-Alp and CTx/Cr (creatinine) had high values before and just after the indicators and was lower thereafter, reaching a plateau in both genders. There was no significant difference in these values in males 5-6 years, or 7 years and more after the appearance of pubic hair. B-Alp and CTx/Cr values 7 years and more after menarche were significantly lower than those 5-6 years after menarche, however the differences were relatively small., Conclusions: Subjects in the second decade can be divided into three groups: 'before the appearance of pubic hair for males and menarche for females', 'up to and including 3-4 years after them' and '5-6 years and more after them'.

The aim of this study was to evaluate the validity of sleeping hours of young children as reported by their parents. The subjects were 21 healthy children aged 3 to 4 years. They were asked to attach a small instrument for calculating sleeping hours objectively, over 3 consecutive nights. Parents reported the sleeping hours of their children during the study periods. The mean values were used in the analysis. Pearson's correlation coefficients and paired t-tests were used to evaluate the correlations and differences between the reported and objectively measured sleeping hours. The correlation coefficient and difference between the reported and assumed (objective sleeping hours representing the difference between times for falling asleep and waking) sleeping hours were 0.90 (p<0.001) and 0.79 hours (95% confidence interval: 0.59-0.99), respectively. The correlation coefficient and difference between the reported and actual (the assumed sleeping hours minus the sum of epochs being scored as awake during the assumed sleep) sleeping hours were 0.90 (p<0.001) and 0.92 hours (0.73-1.10), respectively. Although parents tended to overestimate the sleeping hours of their children, the correlation between the reported and objective sleeping hours is high, which indicates that reported sleeping hours could be used in a survey that requires data on relative differences in sleeping hours amongst a given population.

The aim of the present study was to evaluate the validity of the estimated prevalence of childhood obesity from height and weight reported by parents. The subjects were 170 first-grade children (83 males and 87 females) and 206 fourth-grade children (99 males and 107 females). A questionnaire including questions on height and weight was distributed to children and completed by parents. Anthropometric measurements were conducted in the standard way. Age- and sex-specific cut-off points linked to adult overweight were employed to determine childhood obesity. The correlation and difference between reported and measured values were calculated separately for grade and gender. Correlation coefficients ranged from 0.90 to 0.96 for height, 0.95 to 0.99 for weight, and 0.86 to 0.97 for body mass index (BMI). Sensitivity and specificity, the indices predicting the presence or absence of actual obesity from reported height and weight, ranged from 83.3 to 93.3% and 96.3 to 98.9%, respectively. The estimated prevalence of obesity (as calculated by reported data) minus actual prevalence (as calculated by measured data) ranged from -1.2 to 1.0%. These results indicate that height and weight reported by parents provides a reliable assessment of childhood obesity.

The aim of this study was to clarify the impact of parental obesity and lifestyle factors on obesity in preschool children. The subjects consisted of 8941 children aged 3 years, born in 1989. Anthropometric measurements and questionnaire surveys were conducted between 1992 and 1994. Subjects of body mass index (BMI; (weight (kg))/(height (m))2) more than the age- and sex-specific centiles linked to adult overweight were defined as obese subjects. Parental obesity was defined as BMI of 25 kg/m2 or more. Logistic regression analysis was performed to clarify the strengths of parental and lifestyle factors on childhood obesity, adjusted for possible confounding factors. Odds ratios (ORs) of paternal and maternal obesity for childhood obesity were 1.70(1.43-2.02) and 2.56(2.07-3.17), respectively. There was a dose-response relationship between short sleeping hours and obesity. Compared to subjects taking 11 hours sleep or more, the adjusted OR was 1.20(0.97-1.49) for those taking 10 to 11 hours sleep, 1.34(1.05-1.72) for those taking 9 to 10 hours sleep, and 1.57(0.90-2.75) for those taking less than 9 hours sleep. Eating and exercising habits were not significantly associated with obesity. These results indicate that parental obesity and short sleeping hours are possible risk factors for obesity in preschool children.

The reverse transcription-polymerase chain reaction (RT-PCR) gene assay, as well as electron microscopic examination, is commonly used to detect Norwalk-like viruses (NLVs). Types and number of primer pairs used are considered to be of critical importance for efficiency of the RT-PCR detection. This study was performed to determine primer pairs useful for the detection of NLVs. NLVs genes were detected by RT-PCR in 48 cases in Yamanashi Prefecture between December 1997 and March 2000. The probe type of the gene was G2P-C in 21, G2P-B in 10, G2P-A in 6, G1P-A in 3, G1P-B in 2, and a mixture of G2P-A and G2P-B in 6. The NLVs genes of G2P-C and G2P-B were estimated to have undergone mutation in the polymerase region and poorly specific to the primer pair 35/36, a combination that has been used most commonly for the RT-PCR assay in Japan. The primer pair G2R1/F1 that amplifies the capsid (CAP) region of NLVs genes can detect all NLVs genes of the Genogroup2. The combination of this primer pair with another primer pair G1R1/F1, which like G2R1/F1, amplifies the CAP region, makes discrimination between NLVs of different groups possible. Consequently, this combination, may be the most useful for the NLVs detection by RT-PCR.

Osteoporosis is a major public health problem in Japan. The second decade is an important period in which to attain a high peak bone mass. However, normal values of forearm bone mineral density (BMD) are not well known in children and adolescents. BMD at one-third of forearm length proximal to the ulnar end plate (BMD1/3) and the ultradistal forearm (BMDud) was measured using dual-energy X-ray absorptiometry (DXA) in 1207 (631 males, 576 females) Japanese subjects aged 9-18 years. Puberty onset was assessed by questionnaire, by obtaining the time that pubic hair appeared in males and the time that menstruation started in females. BMD1/3 and BMDud increased steadily with age in males. In relation to puberty development, these parameters also increased after puberty onset although the increase in BMD1/3 was not statistically significant after the fifth year from puberty onset and that of BMDud was not significant after the sixth year from puberty onset. BMD1/3 and BMDud increased with age and then plateaued in females. The increase in BMD1/3 was not statistically significant after 15-16 years of age and that of BMDud was not significant after 13-14 years of age. In relation to puberty development, the increase in BMD1/3 leveled out after the fourth year from puberty onset and that of BMDud also plateaued after the third year from puberty onset. We provide reference values of forearm BMD in Japanese children and adolescents by DXA according to calendar age and puberty development. Peak bone mass of the forearm may be in the late second decade in Japanese females.

In order to clarify the factors which affect bone metabolism at a young age, we investigated the relationships among the change of biochemical markers of bone turnover, the height velocity (HV) and puberty onset in healthy Japanese children. One hundred and twelve children (61 boys and 51 girls) were recruited at the fourth grade level in the elementary school (9 years old) and followed for 6 years. Serum bone specific alkaline phosphatase (B-ALP), serum tartrate-resistant acid phosphatase (TR-ACP), urine hydroxyproline (Hyp) and urine calcium (Ca) were measured as the biochemical markers of bone turnover. Bone mineral density of calcaneus was also measured by ultrasound method at the first grade (12 years old) and the third grade (14 years old) of junior high school. Heights and weights of all subjects were measured every April and the HV were calculated between each year. Puberty onset was defined as the time when pubic hair appeared in boys and as the time when menarche started in girls by self-administered questionnaire. All the biochemical markers of bone metabolism except for urine Ca had a significant positive relationship with HV. The values of the markers were highest of the time when the HV was maximum. In girls, the values of the biochemical markers remained high before menarche and then decreased significantly within three years after menarche, suggesting that bone turnover changed rapidly from high turnover type to low turnover type after menarche. On the other hand, in boys, high turnover type remained for a few years after puberty onset. Bone mineral density of calcaneus by ultrasound method increased significantly in boys between the two years in junior high school, but the increase was unclear except for broadband ultrasound attenuation (BUA) in girls in the same period.

A community-based survey to examine the actual number of ischaemic heart disease (IHD) deaths was undertaken in the western area of Toyama, a rural area with a population of 209,000. IHD deaths (International Classification of Diseases [ICD], ninth revision, codes 410-414) and heart failure (HF) deaths (ICD code 428) according to the death certificate aged 15 to 74 in 1987 to 1990 were reevaluated from medical records using the criteria of the multinational monitoring of trends and determinants in cardiovascular disease (MONICA). Of 97 subjects with IHD and of 170 subjects with HF according to the death certificate, 85 cases (87.6%) and 143 cases (84.1%) could be examined, respectively. Using the MONICA criteria, of 85 subjects with IHD, 18 (21.2%) were reevaluated as "definite acute myocardial infarction (AMI)" and 30 (35.3%) as "possible AMI". On the other hand, of 143 subjects with HF, 1 (0.7%) were reevaluated as "definite AMI" and 12 (8.4%) as "possible AMI". From these results, the number of deaths as reevaluated IHD was estimated 104.5 in the study period, and it was 7.7% increase at least compared with the number of deaths judged from the death certificate.

The two-year prognosis for malignant mammary tumours seen in 175 bitches in the Tokyo metropolitan area was assessed based on the extent of mastectomy and on whether an ovariectomy was carried out at the time of mastectomy. The prognosis for the bitches was not influenced by the excision size of the affected mammary glands. Ovariectomy had no effect on the two-year survival rate of the dogs that underwent the tumour excision. There was no significant difference in the two-year survival rate between the dogs ovariectomised prior to mastectomy and those ovariectomised at the time of mastectomy. These results suggest that ovariectomy at the time of mastectomy has no effect on the prognosis in dogs with established neoplasms of the mammary gland.

Background: It is interesting from the correct point of preventive health care whether allergy skin tests at entry have the positive relationship with common respiratory symptoms such as persistent cough, persistent phlegm and wheeze with colds at end point in longitudinal studies., Objective: The purpose of this study is to investigate this relationship in subjects followed from when they were school-children until they were young adults., Methods: Young adults aged 18-31 years who had participated in an allergy skin test and a health survey for common respiratory symptoms during primary and junior high school were asked about their respiratory symptoms at the end-point in the follow-up study. Three cohort groups were employed in the follow-up study., Results: According to a multiple logistic analysis with adjustments made for sex, symptoms at entry in childhood, and age and smoking habits at the end-point, young adults with a positive skin test to an extract of house dust as school-children showed a higher prevalence of wheeze with colds compared with those with a negative skin test. However, this relationship was not found for persistent cough or persistent phlegm, indeed, the latter symptom was significantly associated with negative skin tests in one cohort group., Conclusion: The respective symptoms at entry in childhood were also predictors of their occurrence in young adults. The results show that the common respiratory symptoms such as persistent phlegm and wheeze with colds in childhood are related to those in young adults rather than is an allergy skin test to an extract of house dust in childhood.

Beginning in 1972, a survey of respiratory symptoms and allergic skin tests in school children from an agricultural area in the Hokuriku region has been continuing. A higher prevalence of respiratory symptoms in school children with positive house dust skin test has been previously reported. In order to elucidate the relationship between results of a house dust skin test during childhood and manifestation of respiratory symptoms thereafter, an examination of respiratory symptoms was conducted in 1991, of the portion of the 5,334 subjects who participated in the earlier survey during childhood, who still live in the same town after leaving junior high school. The results are as follows: 1) During childhood (school-age), prevalence of respiratory symptoms (subacute cough, wheezing when having a cold, wheezing attack) was higher in the positive skin test group (612 subjects) compared to the negative group (856 subjects). There were no significant differences between the two groups in the prevalence of respiratory symptoms (subacute phlegm, wheezing when not having a cold). 2) In young adulthood, prevalence of respiratory symptoms (subacute cough, subacute phlegm) was higher in the negative skin test group compared to the positive group. There were no significant differences between the two groups in the prevalence of respiratory symptoms (wheezing when not having a cold, wheezing attack). The prevalence of wheezing when having a cold was higher in the positive group compared to the negative group. 3) The paradoxical results in young adulthood was due to a marked decline in the prevalence ratio of the high positive rate skin test group (184 subjects) to the negative skin test group. This suggested a decline in contribution of serum IgE to manifestation of respiratory symptoms in young adulthood compared to childhood, with the result that the positive skin test group had a higher prevalence of respiratory symptoms during childhood, but lower in young adulthood.

A data system which enables utilization of individual patient data by public health nurses, physicians and home helpers, is required both for the continuous and comprehensive monitoring of the various needs of the aged receiving care services at home in the local district and for facilitating welfare services. Therefore, an experimental and comprehensive system for public health, medical services and welfare was put into practice for district public health services for the aging society. The results of this trial system shows that this system is useful indeed for the welfare services, though it also has several problems.

The specific activities (S.A.) of the succinate dehydrogenase-coenzyme Q10 (CoQ10) reductase of a control group of 65 Japanese adults and 59 patients having essential hypertension were determined. The mean S.A. of the hypertensive group was significantly lower (p less than 0.001) and the mean % deficiency of enzyme activity was significantly higher (p less than 0.001) than the values for the control group. These data on Japanese in Osaka agree with data on Americans in Dallas. Some patients showed no CoQ10-deficiency, and others showed definite deficiencies. Emphasizing the CoQ10-enzyme for patient selection, CoQ10 was administered to hypertensive patients. Four individuals showed significant but partial reductions of blood pressure. Monitoring the CoQ10-enzyme before, during, and after administration of CoQ10 indicated responses. The maintenance of high blood pressure could be primarily due to contraction of the arterial wall. Contraction or relaxation of an arterial wall is dependent upon bioenergetics, which also provide the energy for biosynthesis of angiotensin II, renin, aldosterone, and the energy for sodium and potassium transport. A clinical benefit from administration of CoQ10 to patients with essential hypertension could be based upon correcting a deficiency in bioenergetics, and point to possible combination treatments with a form of CoQ and anti-hypertensive drugs.