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Background: Oral health conditions and related factors of patients with Parkinson's disease (PD) have not been well elucidated. The aim of the present study was to investigate oral health conditions and related factors which may influence oral health conditions among patients with PD., Methods: We compared oral health conditions and related factors between 104 PD patients and 191 inhibitants (controls) who received dental health check-ups in Hokkiado, Japan. The unconditional logistic regression model was used for adjusting for sex and age. We also conducted stratified analysis by sex and age group using this model. The chi2 test and the Cochran-Mantel-Haenzel test were used for simple and stratified analyses of knowledge of oral health among PD patients, respectively., Results: In the present survey, we found the following results. (1) PD patients had more complaints of chewing difficulties and denture discomfort than controls. (2) Fewer PD patients had their own teeth than controls regardless of sex. (3) Fewer PD patients cleaned their dentures every day than controls, regardless of sex or age. (4) More than half of the PD patients had problems with swallowing., Conclusion: We found that PD patients had more complaints about their oral health and more problems in oral health behavior than the general population. These findings may provide useful information for the caregivers of PD patients to conduct oral health care as well as for making oral health plans for PD patients and for medical and welfare services.

Background: Pulse wave velocity (PWV) and ankle brachial index (ABI) are a useful method to estimate atherosclerosis in adults, while a history of Kawasaki disease (KD) may be a risk factor for later atherosclerosis of systemic arteries. PWV and ABI in patients with a history of KD have not been reported., Method: In total, 90 patients ranging in age from 4 to 25 years who had a history of KD previously, any time from 1 month to 19 years ago, were studied. As a control group, 119 patients with other trivial cardiovascular diseases such as a small ventricular, an atrial septal defect or mild arrhythmias, were also evaluated. A high value of PWV was determined as >/=120% of normal predicted value of PWV, while a low value of ABI was determined as /= 120%, and ABI

Background: Health education and screening are two components of preventive health services in Japan since 1983. This study investigated their relationships with all-cause mortality as they are studied insufficiently in Hokkaido, Japan., Methods: This study enrolled 1,532 men and 1,653 women aged 40-97 years from 1,702 randomly selected households of 60 areas during 1984-1985 and followed them until 2002. At baseline survey, staffs of 45 health centers collected sociodemographic, medical, behavioral, and dietary information including health education and screening from study subjects with informed consent., Results: For men, age-adjusted Cox proportional hazard model indicated lower mortality for those who received health education (RR = 0.76, P < 0.01) and screening (RR = 0.83, P < 0.05) than those who did not. Health education showed lower mortality even after adjusting for many variables. Similarly for women, health education (RR = 0.66, P < 0.01) and screening (RR = 0.64, P < 0.001) revealed lower age-adjusted mortality. Almost similar results were found for both services when models were adjusted for many variables and when the deaths including lost to follow-up cases of the first 4 years of baseline survey are excluded., Conclusions: This study shows protective effects of health education and screening over all-cause mortality for both sexes. However, further studies are needed to confirm the results.

The age-adjusted incidence of prostate cancer is low in Japan, and it has been suggested that the traditional Japanese diet, which includes many soy products, plays a preventive role against prostate cancer. We performed a case-control study on dietary factors and prostate cancer in order to assess the hypothesis that the traditional Japanese diet reduces the risk of prostate cancer. Four geographical areas (Ibaraki, Fukuoka, Nara, and Hokkaido) of Japan were selected for the survey. Average daily intake of food from 5 years before the diagnosis was measured by means of a semi-quantitative food frequency questionnaire. We studied 140 cases and 140 individually age ( +/- 5 years)-matched hospital controls for analysis. Estimates of age-adjusted odds ratios (ORs) and linear trends were calculated by conditional logistic regression models with adjustment for cigarette smoking and total energy intake as confounding factors. Consumption of fish, all soybean products, tofu (bean curds), and natto (fermented soybeans) was associated with decreased risk. ORs of the fourth vs. first quartile and 95% confidence intervals (95%CIs) were 0.45 (0.20-1.02) for fish, 0.53 (0.24-1.14) for all soybean products, 0.47 (0.20-1.08) for tofu, and 0.25 (0.05-1.24) for natto. Consumption of fish and natto showed significantly decreasing linear trends for risk (P < 0.05). Consumption of meat was significantly associated with increased risk (the OR of the second vs. first quartile was 2.19, 95%CI 1.00-4.81). Consumption of milk, fruits, all vegetables, green-yellow vegetables, and tomatoes showed no association. Our results provide support to the hypothesis that the traditional Japanese diet, which is rich in soybean products and fish, might be protective against prostate cancer.

Background: Our previous case-control study revealed that the Japanese residents in Japan could be divided into those who are able to degrade daidzein, a soybean isoflavone, to equol and those without this ability, and that the incidence of prostate cancer is higher in the latter group., Methods: We recently conducted a similar case-control study involving not only Japanese residents in Japan but also Korean residents in Korea. The incidence of prostate cancer in Korean residents is known to be close to that of Japanese residents in Japan. On the other hand, American residents in the United States have a markedly higher incidence of prostate cancer as compared to Japanese residents in Japan., Results: The number of subjects was 295 in Japan (133 patients and 162 controls), 122 in Korea (61 patients and 61 controls) and 45 in the United States (24 patients and 21 controls). The percentage of equol producers among patients and controls was 29% and 46% in Japan (P = 0.004) and 30% and 59% in Korea (P = 0.001), respectively. The active isoflavone level was markedly lower and the percentage of equol producers was also lower (17% for patients and 14% for controls) for Americans as compared to the Japanese and Koreans., Conclusions: These results suggest that the ability of producing equol or equol itself is closely related to the lower incidence of prostate cancer. The results also suggest that a diet based on soybean isoflavones will be useful in preventing prostate cancer.

In the present study, the associations of dietary habits with the risk of urothelial cancer death were evaluated taking into consideration sex, age, and smoking habits. The Japan Collaborative Cohort Study was established in 1988-1990 and consisted of 47,997 men and 66,520 women observed until the end of 1999. A self-administered food-frequency questionnaire was used as a baseline survey. Hazard ratios for dietary factors were calculated by Cox's proportional hazards model. During the observation period, 63 men and 25 women died of urothelial cancer. Increasing age, male gender, and history of smoking were all significantly associated with increased risk of urothelial cancer death. A high intake of milk and fruits other than oranges reduced the risk significantly and dose dependently, in particular among subjects with smoking history. However, consumption of butter and yogurt had no associations with the risk. Intakes of cabbage, lettuce, green leafy vegetables, carrots, squash, tomatoes, and oranges were not significantly associated with the risk. It was suggested that urothelial cancer death could be potentially preventable by smoking cessation and regular intake of milk and fruit.

Objective: The aim of this study was to evaluate the clinicopathological features of uterine sarcoma in Hokkaido, Japan, between 1990 and 1999, and to identify prognostic factors of patients with such malignancies in this area and period., Methods: One hundred and six patients with histologically proven uterine sarcoma were evaluated retrospectively., Results: 93.5% of the patients with carcinosarcoma (CS) were diagnosed as having malignant disease preoperatively, while 65% of those with leiomyosarcoma (LMS) and 75% of those with endometrial stromal sarcoma (ESS) were preoperatively diagnosed as benign leiomyoma. When patients had no residual disease postoperatively, 5-year survival rates in patients with CS and LMS were 78.8 and 73.0%, respectively. ESS cases had a better prognosis (94.7% for stage I cases). In patients with early-stage sarcoma, pelvic lymphadenectomy and adjuvant chemotherapy, with or without cis-diamminedichloroplatinum, failed to show a survival benefit in both CS and LMS cases. Distant metastasis, myometrial invasion, and no residual disease at surgery were significantly associated with risk of death or recurrence in CS and LMS cases., Conclusion: Accurate preoperative diagnosis of uterine sarcoma was difficult, and no residual disease at surgery was the most important prognostic factor in patients with this disease. Postoperative adjuvant therapy had little effect on survival, especially in early-stage disease., (Copyright 2004 S. Karger AG, Basel)

Objective: A binary grading system has been proposed to assess the amount of solid growth, the pattern of invasion, and the presence of necrosis, and thereby divide endometrial endometrioid carcinomas into low- and high-grade tumors. We analyzed this system for predicting the prognosis, with respect to inter- and intraobserver reproducibility and treatment modalities., Methods: A total of 200 endometrial carcinomas, based on hysterectomy specimens, were graded according to the binary grading system, for comparison against The International Federation of Gynecology and Obstetrics (FIGO) system and nuclear grading., Results: Both inter- and intraobserver agreement using the binary grading system (kappa = 0.57; percent agreement: 82% and kappa = 0.62; 84%) were superior compared with the FIGO system (0.50; 60% and 0.62; 73%) and the nuclear grading (0.23; 49% and 0.43; 65%). Patients with early-stage low-grade tumors had a 98% rate for 5-year survival (5YS). Patients with early-stage high-grade tumors, and those with advanced-stage low-grade tumors, had respectively 86% to 87% rates for 5YS. But patients with advanced-stage high-grade tumors had a 49% rate for 5YS. In binary low-grade early-stage tumors, the patient outcome was better with no adjuvant therapy and chemotherapy, compared with other therapies., Conclusion: A binary grading system was superior to others in permitting greater reproducibility and predicting the prognosis of endometrial cancer patients., (Copyright (c) 2004 S. Karger AG, Basel)

The purpose of this study was to examine whether a high serum concentration of phytoestrogens reduces the risk of prostate cancer in a case-control study nested in a community-based cohort in Japan (Japan Collaborative Cohort (JACC) Study). Information on lifestyles and sera of the subjects were collected in 1988-90, and they were followed up to 1999. Incident and dead cases of prostate cancer and controls were matched for study area and age. Phytoestrogens and sex hormones in sera stored at - 80 degrees C were measured in 2002. Of 14,105 male subjects of the cohort who donated their sera, 52 cases and 151 controls were identified. Three datasets were analyzed; 1) all subjects, 2) 40 cases and 101 controls after excluding subjects with low testosterone levels who were suspected of having had medical intervention, and 3) 28 cases and 69 controls with prostate specific antigen level of

Dietary factors are thought to be closely associated with the development of human cancers and hence numerous studies in this area have already been conducted in the United States and other Western countries. Comparatively few prospective studies have been published in Japan, especially for Hokkaido people. The present investigation was therefore performed to assess links between four leading cancers and some of the Japanese common dietary factors through a cohort study (1984-2002) in Hokkaido by analyzing 1,524 men and 1,634 women separately aged 40 and over. Adjusted Cox proportional hazard regression was used to calculate the relative risk (RR) for each dietary factor. For men, two dietary factors, miso soup (RR=0.2, 95% confidence interval (95%CI)=0.1-0.8) and pickled vegetables (RR=0.2, 95%CI=0.1-0.8) were associated with lower risk for stomach and colorectal cancer respectively. For women, three factors, namely salty confectionary (RR=3.5, 95%CI=1.1-10.9), black tea (RR=3.8, 95%CI=1.1-13.6), and carbonated drink/juice (RR=3.9, 95% CI=1.4-11.1) appeared related to an elevated risk of stomach cancer. However, further analysis simultaneously with all other adjusted factors indicated only carbonated drink/juice (RR=3.1, 95%CI=1.1-8.9) to present a significant risk factor for stomach cancer. One factor, namely wild edible plants (RR=3.3, 95%CI=1.1-9.8), increased the risk for colorectal cancer in women. None of the dietary components were significantly associated with lung or pancreatic cancers. This study also indicated a wide variation in the impact of dietary factors by sex and cancer site, in line with earlier work, pointing to a necessity for careful interpretation. Further epidemiological investigations by sex with more study subjects and confounding factors will be useful for determining the contribution of individual dietary factors to development of human cancers in Hokkaido, Japan.

This study aimed to evaluate the correlation between symptoms and endoscopic findings in reflux esophagitis. Subjects, 8031 persons without medication for gastrointestinal disease, were briefly asked about the presence of heartburn, dysphagia, odynophagia, and acid regurgitation by associated medical staff before endoscopy for assessment of esophagitis utilizing the Los Angeles Classification. Endoscopically, 1199 (14.9%) were classified as positive reflux esophagitis, and 2223 (27.7%) had heartburn, 1522 (19.0%) had dysphagia, 493 (6.1%) had odynophagia, and 1466 (18.3%) had acid regurgitation. Multivariate analysis indicated that the symptom most related to esophagitis was heartburn (odds ratio: 2.46), although approximately 40% of subjects with grade C or D did not complain of heartburn. Regarding the other symptoms, less than 30% subjects with severe esophagitis complained of the symptoms and the odds ratio was approximately 1. These results indicate that endoscopic esophagitis was not equivalent to any reflux symptoms from which subjects suffered in their daily lives.

Purpose: The purpose of this study was to determine health problems of citizens of the city of Obihiro with reference to the Healthy Japan 21 plan., Method: The subjects were a total of 2,000 men and women (6-74 years old) who were selected at random from the resident ledger of Obihiro. The questionnaire included the 6 fields (nutrient intake/dietary habits, physical activity/exercise, rest/mental health, tobacco, alcohol, dental health) of Healthy Japan 21. The path-analysis model was used by sex, in order to examine the relationship between lifestyle factors (dietary habits, restful sleep, stress, smoking habits, alcohol intake) and subjective health., Results: A total of 979 subjects (49.0%) responded. The items that showed a higher proportion than for all Japan were as follows: the proportions of persons who felt stress, required a drug or alcohol to sleep, drank heavily, and were female smokers. In questions about the harm caused to health by smoking, the following items showed lower awareness than deserved: bronchitis, gastric ulcer, problems with regard to pregnancy, and periodontitis. The following characteristics were found in the path-analysis: 1) If sleep rest is sufficient, subjective health is unaffected by stress in men and women; 2) Smoking affects dietary habits in men and women, especially in the latter; 3) Heavy smoking affects subjective health in men and women independent of whether dietary habits are good; 4) There is a positive relation between drinking and subjective health in women., Conclusion: This study showed that stress and smoking are problems for the health of citizens of the city of Obihiro, and suggested that the best measure to counter stress is sufficient sleep, while to counter smoking spread of knowledge about the harm to health caused by smoking is best.

Self-perceived health and fitness are epidemiological predictors of subsequent mortality and/or functional limitation. The present study was designed to analyze which lifestyle factors contribute to good status of self-perceived health and fitness in middle-aged male employees. Participants (n=401) aged 50-59 were assessed as to the status of self-perceived health and fitness, and various lifestyle factors including nutrition, smoking, drinking, physical activity, psychological stress, sleeping and relaxation. Logistic regression analysis revealed that among the lifestyle factors surveyed in the present study, doing exercise/sports at a medium level (either > or =4.5METs/1-2 times per week or <4.5METs/> or =3-4 times per week) of physical activity index (PAI) was the only predictor of good self-perceived health. Similarly, doing exercise/sports at or above the medium level of PAI was identified as the only independent predictor of good self-perceived fitness. In addition, maintaining the habit of doing exercise/sports at or above the medium level of PAI throughout the year, and having this habit through the 4th and 5th decades of life or starting to have it from the age of 50 through 59 were important to obtain a good status of self-perceived health and fitness. These findings suggest that leisure time physical activity level is a determinant of good health and fitness in the middle-aged male employees in the present study.

Objectives: The burden of tobacco-induced cancer is so heavy that every country should give the highest priority to tobacco control in its fight against cancer. The purpose of the present study was to investigate the actual conditions of tobacco smoking among boys in Japan., Methods: A self-administered questionnaire survey. Two thousand and fourteen high school boys in Fukuoka City, Japan, answered unsigned self-administered anonymous questionnaires about tobacco smoking., Results: Among 2014 students, 10.9% were current smokers. The rates of current smokers increased with the school age: 6.3% in the first grade; 11.3% in the second grade; and 15.5% in the third grade (P(trend)<0.01). A total of 35.1% of students had the experience of smoking and 30% experienced smoking before entering high school. Of the students with smoking experience, 28.6% answered that they started smoking because their friends had offered them cigarettes and 52.5% of current smokers bought cigarettes from vending machines., Conclusions: Health education for anti-smoking in all primary and secondary schools as well as restriction of cigarette vending machines should be strongly recommended.

Background: Our previous case-control study revealed that Japanese living in Japan and Koreans living in Korea can be divided into equol producers who have an ability to metabolize daidzein to equol and non-producers, and that the incidence of prostate cancer is higher in the latter group. In the present study, we examined relationships between type of food intake and the capacity for equol production in Japanese subjects., Methods: The subjects were the individuals analyzed for the ability to produce equol in our previous study and newly registered cases. From December 2000 to December 2002, 276 hospitalized patients were interviewed face-to-face and blood samples were collected before breakfast. These included 122 patients with prostate cancer and 154 age-matched controls., Results: The frequency of equol producers (0.5 ng/ml or more) among cases and controls was 29% and 45%, respectively (p = 0.004). The consumption of soybeans and green tea were significantly higher in equol producers than in the non-producers (p<0.05). By contrast, the consumption of selenium and fiber was significantly lower in equol producers (p<0.05)., Conclusions: Our results suggest that higher consumption of soybean and green tea are strongly related to the establishment of a capacity for equol production.

We conducted an epidemiological study of systemic sclerosis in Japan using the records of patients who had been registered to receive public financial aid. A total of 10,956 patients were registered as having systemic sclerosis in 1999. We statistically analyzed the data on the patients, including sex, age, major symptoms, and laboratory findings. We also made contingency tables in order to evaluate the correlations of the data. Our study estimated that the male/female ratio was 1:7.3. The mean ages of male and female patients were 58.8 and 58.5 years old, respectively. The major symptoms were as follows: Raynaud's phenomenon 92.4%, skin sclerosis 94.7%, dyspnea 29.9%, and dysphagia 32.2%. With respect to specific antibodies, antinuclear antibody was present in 92.2%, antitopoisomerase I antibody in 27.5%, anticentromere antibody in 37.7%, and antiribonucleoprotein antibody in 19.9%. Making contingency tables, we could elucidate the association of antitopoisomerase I with lung fibrosis.

The present study was conducted to investigate the factors related to the feeling of psychological stress, called heavy burden, in caregivers who took care of frail elderly persons 1 year after the introduction of the public long-term care insurance system (i.e., kaigo hoken) in the northern part of Fukuoka Prefecture, Kyushu, Japan. Forty-seven caregivers answered a self-administered questionnaire involving the Japanese version of the Zarit Caregiver Burden Interview (ZBI) and thus described their own caregiving situation. Compared to caregivers with a light burden, heavily burdened caregivers were less likely to have time to go out without their frail elderly, but tended to spend a longer time with them in providing for their physical care. Compared with less burdened caregivers, heavily burdened caregivers tended to be concerned with what others thought or said and more likely to use a short-stay service (i.e., temporary nursing home assistance). More social services should be provided to let caregivers have their own time without caring for their patients. In addition, local governments and caremanagers should help caregivers to understand the benefits of services available for the elderly and their caregivers.

This study investigated the relationship between smoking habits and serum levels of 8-OHdG, oxidized LDL antibodies (oLAB), Mn-SOD, and carotenoids. Subjects were 79 males (mean age +/- standard deviation; 62.1 +/- 10.0 years) and 79 females (60.3 +/- 10.3 y) who attended a health examination screening in the town of Hokkaido, Japan. Serum 8-OHdG, Mn-SOD, and oLAB levels were measured by ELISA and serum carotenoids levels were measured by HPLC. Smoking habits were assessed by public health nurses using a questionnaire. Serum 8-OHdG levels were significantly higher in males than in females. On the other hand, serum levels of beta-carotene, alpha-carotene, beta-cryptoxanthin, and zeaxanthin and lutein were significantly lower in males than in females. Serum beta-carotene, beta-cryptoxanthin, and zeaxanthin and lutein were significantly lower in males who were current smokers, compared to non-smokers. Serum 8-OHdG levels were also significantly higher in current smokers. Furthermore, in males, serum oLAB and beta-carotene levels were significantly and negatively correlated with the number of cigarettes smoked per day. Serum Mn-SOD levels were unrelated to smoking habits in males. In conclusion, this preliminary study suggests that cigarette smoking increases serum 8-OHdG levels and reduces serum levels of oLAB and carotenoids, such as beta-carotene, beta-cryptoxanthin, and zeaxanthin and lutein in healthy male subjects. Serum levels of 8-OHdG, oLAB, and carotenoids may be useful biomarkers of oxidative conditions affected by smoking.

Only after a decade from 1993, arsenic contamination of groundwater in Bangladesh has been reported as the biggest arsenic catastrophe in the world. It is a burning public health issue in this country. More than 50 percent of the total population is estimated at risk of contamination. Already thousands of people have been affected by the disease arsenicosis. Many more may be on the way to manifest lesions in future. We conducted a review of previous studies and published articles including MEDLINE database on this issue. We found that 59 districts out of 64 have been already affected by arsenic in underground drinking water, where this particular source of drinking water is the main source for 97 percent of the rural people. The water is unfortunately now a great threat for the human being due to high level of arsenic. Continuous arsenic exposure can lead people to develop arsenicosis, which in turn elevates the risk of cancer. Skin lesions are the most common manifestations in arsenicosis patients. Relatively poor rural people and other socio-economically disadvantaged groups are more affected by this exposure. Until now cancer patients have been relatively limited in Bangladesh. One of the reasons may be that several years are needed to show cancer manifestations from the beginning of arsenic exposure. But it is suspected that after some years a large number of patients will appear with cancer in different sites for arsenic exposure in drinking water. Various studies have been conducted in arsenic affected countries - notably in Argentina, Chile, China, Japan, and Taiwan -to find the potential of arsenic exposure to cause development of cancer. Among the arsenic related cancers, liver, lung, skin, bladder and kidney cancers are reported to be prevalent in these countries. Unfortunately no scientific study has been yet conducted in Bangladesh to find the relationship between arsenic exposure and cancers in different sites of the body. So our aim is to conduct an ecological as well as a case-control study in the country in the future.

Purpose: The purpose of this study was to evaluate effects of education about a donor card on college students., Methods: Doctors at Kitami Health Center gave education about a donor cards to 548 university students or students of vocational college in Kitami city in 2000. To evaluate the effects according to a time-series design, surveys on knowledge and attitudes to the card as well as behavior regarding possession were carried out before and after the education. The subjects were divided into three groups for comparison, studying nursing at college, learning engineering at university, and welfare at college., Results: The numbers of respondents were 432 (the response rate: 78.8%) and 359 (the response rate: 65.5%) before and after the education, respectively. 1. 94.2% of the respondents knew about the donor card. The proportion was significantly larger for nursing students than for the others (P < 0.05). 2. The proportion of subjects demonstrating accurate knowledge about the card was significantly increased after the education in every group. 3. Before the education, nursing students were most likely to possess the card. The percentage of welfare subjects who possessed the card significantly increased after the education (P < 0.001). 4. The nurse students more than the other groups obtained the card because they were concerned with medicine. The university students with the card were less likely to have appropriate knowledge, while significantly more welfare students than in the other groups obtained the card because it was recommended by another person (P < 0.01). 5. The proportion of the subjects who did not possess the card because they were not willing to donate their organs increased after the education in every group, albeit without significance., Conclusion: This study suggested that the education about the donor card promoted not only accurate knowledge about the card, but also a clear decision on whether to possess it.

Objective: To evaluate factors associated with admission of frail elderly to hospitals or nursing homes with a home-visit nursing service., Design: Retrospective cohort study., Subjects: 395 consecutive frail elderly who were receiving domiciliary visits by nurses from St. Mary's home-visit nursing station between April 1993 and March 1998., Results: 1) During the six-month follow-up, malignancy was positively related to admission to either hospitals or nursing homes while severe disability curtailing activities of daily living was negatively related to admission. During both one-year and two-years follow-up, severe disability of daily living was negatively related to admission. 2) Elderly people consulting doctors at general hospitals were more commonly hospitalized or institutionalized than those consulting family doctors in clinics. 3) The need for a short-stay service (i.e., "temporary nursing home assistance") was a risk factor for admission during the six months, one-year and two-years follow-up periods., Conclusion: The frail elderly should consult family doctors in clinics in order to avoid admission to hospitals or nursing homes.

Background: It has been postulated that soybean isoflavones act as inhibitory factors in prostate cancer. However, to date there have been no case-controlled clinical studies carried out to compare the circulating concentrations of isoflavones in prostate cancer patients and control subjects., Methods: The serum levels of genistein, daidzein and equol were determined and compared in 253 experimental subjects (141 prostate cancer patients and 112 cancer-free controls)., Results: The serum concentrations of isoflavones were compared in hospitalized and non-hospitalized subjects and for both the prostate cancer patients and the controls the concentrations were lower in the hospitalized subjects. The serum concentrations of genistein and daidzein were compared in subjects <70 years of age and subjects >/=70 years old and the levels were significantly lower in the younger group. Contrary to our expectation, comparison of the patient group and the control group revealed the serum concentrations of isoflavones to be higher in the patient group. Daidzein non-metabolizers were compared in the hospitalized experimental subjects of the patient group and the control group and they were significantly more common in the patient group. The poorly differentiated cancer patient group included a significantly lower percentage of daidzein metabolizers., Conclusions: The above findings revealed that equol itself or some unknown factor regulating the metabolism of daidzein is deeply involved in the biology of prostate cancer. Future studies are urgently needed to compare the incidence of daidzein metabolizers among various countries.

Objectives: To establish a Japanese version of the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and to determine its validity and applicability in patients with chronic prostatitis, comparing the results with those from patients with benign prostatic hyperplasia (BPH) and normal men., Methods: The study included 103 patients with chronic prostatitis, 60 with BPH, and 87 normal men who agreed to respond to a self-administered questionnaire of the Japanese version of the NIH-CPSI (JPN-NIH-CPSI). Testing-retesting was done to confirm the reliability of the index in 23 patients with chronic prostatitis, with a 2-week interval between tests., Results: Pain or discomfort was more prominent in the prostatitis group than in the BPH and normal groups. Overall, quality of life in the prostatitis group was impaired more severely than that in the other two groups. The scores of three domains (pain, urinary symptoms, and quality-of-life impact) in the prostatitis group were clearly higher than those in the BPH and normal groups, except for those of urinary symptoms in the BPH group. The test-retest analysis showed good reliability and internal consistency for the JPN-NIH-CPSI, with a Cronbach's alpha coefficient of more than 0.8., Conclusions: The JPN-NIH-CPSI can be reliably used for evaluation of Japanese patients with prostatitis, as is the NIH-CPSI for English-speaking men.

To assess the familial aggregation of uterine myomas in Japanese women with myomas, one hundred forty four women requiring surgery for myomas and 288 age-matched healthy controls were studied in Hokkaido, Japan. The incidence of positive first-degree family history of myomas among women aged 45-54 years with myomas was greater than that among controls (31.5% versus 15.2%, respectively, p < 0.01). Analyses categorized by the status of parity and familiality among subjects showed that the risk for myomas was the greatest in women who had both fewer births (parity = 0 or 1) and the positive family history of myomas as compared with those who had both more births (parity > or = 2) and the negative familiality of myomas (odds ratio = 5.8, 95% confidence interval = 2.3 - 14.6). The results of this study suggest that Japanese middle-aged women with myomas have the familial predisposition of uterine myomas. Furthermore, nulliparous women with the familial aggregation of myomas may be at increased risk of the disease.

Epidemiological studies of cancer of the ovaries, among the leading sites for cancer incidence and mortality in women in very many countries of the world, have pointed to high saturated fat and carbohydrate intake, postmenopausal hormone replacement therapy and use of cosmetic talc as risk factors. Conversely, vegetable consumption, parity, lactation and generally appear to confer protection. Genetic influence also clearly plays a role, women with mutations in the BRCA1 or BRCA2 genes having an elevated risk, for example. Overall there appear to be shared risk factors for breast cancer. However, there are many types of epithelial ovarian cancer and cross-country comparisons of incidence data from various cancer registries in Europe and North America published in the IARC Cancer Incidence in Five Continents Vol VII suggest that only the serous type is linked to mammary tumour development. Thus future studies should concentrate more attention on the individual subtypes of ovarian cancer in order to better establish preventive measures.

We conducted a review of previous cohort studies on the association between a history of diabetes mellitus (DM) and the occurrence of cancer. We limited the papers to those concerning cohort studies on 9 cancer sites, i.e. the kidney, liver, biliary tract, pancreas, colon or rectum, prostate, breast, endometrium, and ovary, in addition to all cancers. With regard to kidney, liver, biliary tract, pancreatic, colorectal, breast, and endometrial cancers, the risk of cancer development has been consistently reported to be positively associated with DM by two or more cohort studies. In contrast, DM was shown to relate negatively to the risk of prostate cancer by two cohort studies. However, there were no cohort studies which showed an either significantly positive or negative association of DM with ovarian cancer. Elevated levels of insulin or IGFs among DM patients have been proposed as a causal mechanism of increased risk for most of the reviewed cancers. In addition, increased estrogen levels in DM patients have been suggested to explain the casual mechanism of increased risk for kidney, breast and endometrial cancers, and decreased risk for prostate cancer. On the other hand, the possibility of detection bias has been suggested in the association of DM with the risk of most of these cancers. Obesity and heavy consumption of alcohol have been indicated as confounding factors in the relationship of DM to the risk for some of them. Thus, further studies are necessary for firm conclusions regarding the association of DM with cancer risk.