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Background Typically, land use regression (LUR) models have been developed using campaign monitoring data rather than routine monitoring data. However, the latter have advantages such as low cost and long-term coverage. Based on the idea that LUR models representing regional differences in air pollution and regional road structures are optimal, the objective of this study was to evaluate the validity of LUR models for nitrogen dioxide (NO2) based on routine and campaign monitoring data obtained from an urban area. Method We selected the city of Suita in Osaka (Japan). We built a model based on routine monitoring data obtained from all sites (routine-LUR-All), and a model based on campaign monitoring data (campaign-LUR) within the city. Models based on routine monitoring data obtained from background sites (routine-LUR-BS) and based on data obtained from roadside sites (routine-LUR-RS) were also built. The routine LUR models were based on monitoring networks across two prefectures (i.e., Osaka and Hyogo prefectures). We calculated the predictability of the each model. We then compared the predicted NO2 concentrations from each model with measured annual average NO2 concentrations from evaluation sites. Results The routine-LUR-All and routine-LUR-BS models both predicted NO2 concentrations well: adjusted R2 = 0.68 and 0.76, respectively, and root mean square error = 3.4 and 2.1 ppb, respectively. The predictions from the routine-LUR-All model were highly correlated with the measured NO2 concentrations at evaluation sites. Although the predicted NO2 concentrations from each model were correlated, the LUR models based on routine networks, and particularly those based on all monitoring sites, provided better visual representations of the local road conditions in the city. Conclusion The present study demonstrated that LUR models based on routine data could estimate local traffic-related air pollution in an urban area. The importance and usefulness of data from routine monitoring networks should be acknowledged.

Typically, land use regression (LUR) models have been developed using campaign monitoring data rather than routine monitoring data. However, the latter have advantages such as low cost and long-term coverage. Based on the idea that LUR models representing regional differences in air pollution and regional road structures are optimal, the objective of this study was to evaluate the validity of LUR models for nitrogen dioxide (NOWe selected the city of Suita in Osaka (Japan). We built a model based on routine monitoring data obtained from all sites (routine-LUR-All), and a model based on campaign monitoring data (campaign-LUR) within the city. Models based on routine monitoring data obtained from background sites (routine-LUR-BS) and based on data obtained from roadside sites (routine-LUR-RS) were also built. The routine LUR models were based on monitoring networks across two prefectures (i.e., Osaka and Hyogo prefectures). We calculated the predictability of the each model. We then compared the predicted NOThe routine-LUR-All and routine-LUR-BS models both predicted NOThe present study demonstrated that LUR models based on routine data could estimate local traffic-related air pollution in an urban area. The importance and usefulness of data from routine monitoring networks should be acknowledged.

In 1968, rice oil contaminated with polychlorinated biphenyls and polychlorinated dibenzofurans caused a severe outbreak of food poisoning in Japan and was termed locally as "Yusho" (oil disease). In our previous study, we found that area-based standardized mortality ratios (SMRs) of some diseases were elevated shortly after the incident. This previous study, however, was unable to determine whether these elevated SMRs were a result of other area-specific factors. To overcome this limitation, we obtained mortality data from the 5 years before the incident and conducted an area-based study using vital statistics records dating from 1963 to 2002.The population of Nagasaki Prefecture was set as the reference population for calculating SMRs. We also included data on cause-specific mortality attributable to cancer and expanded the population to encompass two severely exposed areas where contaminated rice oil was distributed (namely Tamanoura and Naru). We also calculated SMRs in the remainder of the Shimo-Goto region, excluding the exposed area, which was used as a comparison area.Even after considering the time trends in mortality before the incident, mortality due to diabetes mellitus and heart disease, as well as all-cause mortality, was found to be elevated shortly afterward. Additionally, mortalities due to uterine cancer in Tamanoura and leukemia were also elevated at 30-34 and 10-59 years after the event in both exposed areas, respectively. SMRs for leukemia in Tamanoura were as high as 3.0 (95% confidence interval 1.4-6.2) and 2.4 (1.2-4.8) 10-19 years later. In this period, SMRs for leukemia in the comparison area were not elevated.Further epidemiological studies are needed regarding this rice-oil, "Yusho" outbreak, especially with regard to cancer and non-cancer mortality.

Soluble GTP-bound transglutaminase 2 (TG2) induces hypertrophic differentiation in chondrocyte cultures in a beta1 integrin-dependent fashion. beta1 integrin subfamily consists of 12 heterodimers with 12 different alpha subunits and a beta1 subunit. To identify the specific integrin heterodimer(s) responsible for this process, we specifically blocked individual beta1 integrins on the CH-8 immortalized human chondrocytes during hypertrophic differentiation. Blockade of alpha5beta1 inhibited matrix metalloproteinase 13 (MMP-13), type X collagen expression, alkaline phosphatase activity and matrix calcification by 30-50% associated with weak effects of anti-alpha3beta1 and -alpha4beta1. Anti-alpha1beta1, -alpha2beta1 and -alpha6beta1 had no effect. To examine whether the dominant effect of integrin alpha5beta1 was due to a direct interaction with TG2, we incubated the chondrocytic cells on plates coated with GTP-bound TG2. The immobilized GTP-bound TG2 induced hypertrophic differentiation to the same extent as the soluble GTP-bound TG2, which was also inhibited by anti-alpha5beta1. CH-8 cells grown on plates coated with GTP-bound TG2 demonstrated adherence associated with focal adhesion kinase phosphorylation. These properties were inhibited by anti-alpha5beta1. Furthermore, engagement of alpha5beta1 on CH-8 cells via anti-alpha5beta1 antibody did, in fact, induce differentiation. Although CH-8 cells adhered to GTP-free TG2 via integrin alpha5beta1, the cells failed to undergo hypertrophic differentiation. Thus, integrin alpha5beta1 is critical for the chondrocyte hypertrophic differentiation induced by GTP-bound TG2, and this induction is ligand dependent.

The number of elderly workers has also been increasing and poor psychological well-being in elderly workers has been reported. The aim of this study is to elucidate the factors that are related to poor psychological well-being in elderly workers. We administered General Health Questionnaire-12 (GHQ-12) as an indicator of psychological well-being to 330 male elderly workers in the age range of 50–69, and analyzed different psychological factors, namely sense of coherence (SOC), and physical and lifestyle variables such as blood pressure, serum total cholesterol, smoking frequency, alcohol intake, exercise frequency, and body mass index (BMI) that are related to GHQ-12. When the cut-off point of GHQ-12 was 2/3, 97 workers who showed high GHQ-12 score were classified as one group having poor psychological well-being. A statistically significantly lower SOC score, higher stress score, lower frequency of exercise, higher smoking score and higher BMI, but not longer working hours or higher shift work score in the workers with higher GHQ-12 scores were observed than in the workers with normal GHQ-12 scores. Multiple logistic regression analysis showed that the low SCO score, low frequency of exercise, high smoking frequency and high BMI significantly contributed to the high GHQ-12 score. A low SOC score in elderly workers is assumed to be directly related to poor psychological well-being, or via the development of lifestyle problems such as lack of exercise, obesity, and smoking in elderly workers. This assumption must be confirmed by conducting future intervention studies on lifestyle.

Introduction: In 1968, rice-oil contaminated with polychlorinated biphenyls and polychlorinated dibenzofurans caused a severe outbreak of food poisoning in Japan, and was termed locally as “Yusho” ...

Objectives: Whether traffic remoteness from health care service in rural areas influences usage of ambulance service has not been well investigated. This study aimed to evaluate the relation between remoteness to health care facilities and incidence of ambulance calls in rural areas of Japan. Methods: We analyzed 155 rural communities of Hiroshima. Data were obtained on all ambulance dispatches from 2010 to 2012. Driving time was calculated from each community to the closest primary/secondary and tertiary health care facility (equivalent to tertiary emergency care centers). We estimated the incidence rate and the incidence rate ratio (IRR) of ambulance calls for each 10-minute increase in the driving time, using generalized log-linear regression models, and evaluated the effect among each specific subgroup of emergency level and season. Results: During the study period, the median incidence rate was 436 per 10 000 people in targeted communities. When driving time to the closest primary/secondary facility increased by an increment of 10 minutes, there was a significant increase in the IRR of ambulance calls, especially during colder seasons (IRR: 1.29 [95% confidence interval: 1.11-1.49]), and this relation was also obtained for most emergency levels. In comparison, there was no such increase in IRRs observed for driving time to a tertiary facility. Conclusion: This study indicated a positive association between remoteness to primary/secondary medical facilities and the frequency of ambulance calls. The remoteness to a primary/secondary health care may induce an increase in ambulance calls, particularly during cold seasons.

Whole genome scan analyses have revealed that the chromosomal region 3p21.3, which contains a gene cluster of the CC chemokine receptor, is possibly critical for the pathogenesis of allergic inflammation. Japanese cedar pollinosis is mediated by a type I allergy and induces seasonal rhinitis and conjunctivitis in humans as the most common form of hay fever in spring in Japan, although the candidate genes for cedar pollinosis remain to be elucidated. We sequenced CCR1, CCR2, CCR3, CCR5, and CCXCR1 using the PCR restriction fragment length polymorphism method in subjects with cedar pollinosis and controls. We found 8 polymorphisms of A111G, Arg127Cys and Arg252Gln in CCXCR1, T885C in CCR1, Val64Ile and T780C in CCR2, T51C in CCR3 and Arg223Gln in CCR5. The transmission disequilibrium test using 60 children with pollinosis and their parents and an association study using unrelated adult subjects (151 patients and 157 controls) showed a significant association of 64Ile in CCR2 and 51C in CCR3 with cedar pollinosis. The frequency of haplotype 64Ile/780C/51C in pollinosis was significantly higher than in controls. Our results suggest that CCR2 and CCR3 genes are candidate genes for Japanese cedar pollinosis.

We examined the association between residential proximity to 60 Hz high voltage (22-500 kV) overhead transmission lines (HVOTLs) and mental health (MH). The subjects were 223 mothers with a mean age of 37 years. The distance from the subject's residence to the closest HVOTL was measured on a map. MH status was assessed by the SF-36 Health Survey, which was scored on a 0-100 point scale, and an individual with a score of 52 points or less was defined as having poor MH. Logistic regression models were used to examine the association between the distance from the subjects' residence to the closest HVOTL and MH status. The prevalence of poor MH was 15%. Among the 223 subjects, 10 lived within 100 m of a HVOTL. The adjusted odds ratios (OR) for poor MH among those who lived 101-300 m or within 100 m from HVOTL were 1.29 (95% confidence interval (CI): 0.35-10.13) and 1.87 (95% CI: 0.35-10.13), respectively, against the reference category (300+ m). MH status was not significantly associated with the distance between the subject's residence and the closest HVOTL.

Residential power-frequency magnetic fields (MFs) were labeled as a possible human carcinogen by the International Agency for Research on Cancer panel. In response to great public concern, the World Health Organization urged that further epidemiologic studies be conducted in high-exposure areas such as Japan. We conducted a population-based case-control study, which covered areas inhabited by 54% of Japanese children. We analyzed 312 case children (0-15 years old) newly diagnosed with acute lymphoblastic leukemia (ALL) or acute myelocytic leukemia (AML) in 1999-2001 (2.3 years) and 603 controls matched for gender, age and residential area. Weekly mean MF level was determined for the child's bedroom. MF measurements in each set of a case and controls were carried out as closely in time as possible to control for seasonal variation. We evaluated the association using conditional logistic regression models. The odds ratios for children whose bedrooms had MF levels of 0.4 microT or higher compared with the reference category (MF levels below 0.1 microT) was 2.6 (95% CI=0.76-8.6) for AML+ALL and 4.7 (1.15-19.0) for ALL only. Controlling for some possible confounding factors did not alter the results appreciably. Even an analysis in which selection bias was maximized did not fully explain the association. Most of the leukemia cases in the highest exposure category had MF levels far above 0.4 microT. Our results provided additional evidence that high MF exposure was associated with a higher risk of childhood leukemia, particularly of ALL.

We researched the medical expenditure of the elderly who participated in exercise group (aerobic exercise and muscle exercise), comparing control subjects who matched sex and birth year with exercise groups in 2 cities and 2 towns. We calculated the cumulative medical expenditures from the previous years. In result, yearly cumulative medical costs of control subjects increased more than exercise groups in all test areas. Similar tendencies were shown in medical costs of each year's May in 2 cities. In another town we compared medical expenditures of elderly people between 3 different types of exercise groups: muscle exercise using their own body weight, quoits, and Swiss ball exercise. Medical costs of muscle exercise group increased less although not significantly. In conclusion, cumulative medical costs are useful for evaluating effects of exercise on medical economy, and the exercise, especially muscle exercise using their own body weight, might reduce the medical costs among the elderly.

Until the idea of the “health promotion” was advocated by the Ottawa charter in 1986, the purpose of health care was only seen as the improvement of an individual's health. Up to that time, social environmental factors and the processes involved in carrying out health projects and physical fitness promotion — its practice, evaluation, public participation and so on — had not been appreciated. In keeping with the basic concept of health promotion, and with the effort of individuals, it is essential to establish public policy for the support of health care. This implies that specialist groups, including administration, must respond to the demands of health care and physical fitness promotion. Furthermore, we can say that health care and physical fitness promotion must be carried out with regard for social policy. However, the ideals of health promotion have not been achieved so far. We examined the actual status of Health Japan 21 health promotion in two surveys, a basic survey in October 2003 and the main examination in October 2004. All local governments were examined in order to propose a community system for promoting life function and social participation for the elderly. We analyzed and assessed the questionnaire including 1) the planning and practice of Health Japan 21 strategies (a concrete assessment of the status of each of the nine items and of the details of each sub-item of plans in administrative divisions, government-designated major cities, special districts, and cities, towns, and villages); 2) the level of recognition of public participation in and opinion of projects, during execution and evaluation, and the level of cooperation with civilian organizations; 3) ways of spreading awareness of projects; 4) project evaluations (intermediate evaluation); and 5) the importance of and prospects for the future of health care Health Japan 21 projects. It is thought that research into these factors will become a reference point for an intermediate evaluation of Health Japan 21, and will help solve various problems facing health improvement in our country.

This article presents the results of a field survey on health promotion policies and programs in various countries, including Australia, Sweden and Korea. In order to develop and implement effective health promotion policies and programs, the importance of a trans-organizational system for the close collaboration of various responsible bodies and a financial infrastructure, such as transfer of tobacco tax into health promotion activities, should be underlined. Policies that contribute to capacity building in the community should be more practical to improve the health level of the public, as opposed to an approach that tries to solve specific health problems one by one. Building a comprehensive ecological support system for the community would be a core strategy for health promotion policies and programs.

The extracellular matrix protein, osteopontin, is a ligand for several members of the integrin family, including α5β1, αvβ3, αvβ5 and α9β1. Osteopontin is a substrate for a number of extracellular proteases, including thrombin and the metalloproteases MMP-3 and MMP-7, which cleave osteopontin at sites close to or within the mapped integrin binding sites. Using affinity chromatography and cell adhesion assays, we now identify the integrin αvβ6 as an additional osteopontin receptor. Utilizing a series of recombinant forms of osteopontin, we compared the structural requirements for αvβ6 binding with those for the 4 other osteopontin-binding integrins. Like α5β1, αvβ3 and αvβ5 (but not α9β1), αvβ6 binds to the RGD site in osteopontin, since RGD peptide or mutation of this site to RAA completely inhibits αvβ6-mediated cell adhesion. For both α9β1 and α5β1, the N-terminal fragment generated by thrombin cleavage is a much better ligand than full length osteopontin, whereas thrombin-cleavage does not appear to be required for optimal adhesion to αvβ3, αvβ5 or αvβ6. A recombinant fragment predicted to be generated by MMP cleavage no longer supported α5β1 or α9β1-mediated adhesion, but adhesion mediated by αvβ5 or αvβ6 was unaffected. Finally, adhesion of αvβ5 or αvβ6 was inhibited by mutation of two aspartic acid residues upstream of the RGD site, whereas adhesion mediated by αvβ3, α5β1 or α9β1 was unaffected by these mutations. These results suggest that the hierarchy of integrin interactions with osteopontin can undergo complex regulation at least in part through the action of extracellular proteases.

Objective: The study compared the health-related quality of life (HRQOL) of Japanese mothers of children with leukemia to that of mothers of children without leukemia. Method: We used the Medical Outcomes Study 36-item Short-Form (SF-36) to measure the HRQOL of 97 mothers of children (average age 6.2, range 0–14) with leukemia diagnosed between 1999 and 2000, and compared their scores to those of 240 mothers of children without leukemia matched to the children with leukemia. Main results: Of the eight unadjusted domain scores of the SF-36, five were significantly low among mothers of children with leukemia compared to mothers of children without leukemia: ‘role-physical functioning’ (RP), ‘general health perception’ (GH), ‘vitality’ (VT), ‘social functioning’ (SF) and ‘mental health’ (MH). Their SF-36 domain scores, when adjusted for demographic and clinical factors were also significantly low in RP, GH, VT, SF, RE and MH. The MH and SF scores in mothers of children with leukemia requiring hospital care were, respectively, approximately 20 points (1 standard deviation (SD), p < 0.0001) and 30 points (1.5 SD, p < 0.0001) lower than that of mothers of children without leukemia. Conclusion: Mothers of children with leukemia requiring hospital care have poor HRQOL, particularly with regard to mental health and social functioning, and are at a greater risk for depression. These results suggest that the current system for treating leukemic diseases of children in Japan should also include close monitoring of mothers’ mental health, and provision of appropriate treatment and psycho-social support.

In Japan, over the last 40 years, the change in lifestyle, particularly the westernization of the diet, has led to increased frequency of "lifestyle-related disorders" such as, hyperlipidemia, diabetes mellitus, and atherosclerosis. Consequently, the morbidity and mortality due to coronary heart disease have increased, and the prevention of this disorder is now one of the major concerns when considering the quality of life of individuals and the public health policy. Hyperlipidemia, particularly hypercholesterolemia, is one of the major risk factors of atherosclerosis. Therefore, the clarification of the mechanisms of the development of hyperlipidemia is important in the consideration of the prevention and management of atherosclerotic disorders. Genetic and epidemiological studies have provided compelling evidence that genetic factors, environmental influences and the interaction between them all contribute to the development of this complex disorder. Various unexpected mechanisms of the development of hyperlipidemia have been elucidated by analyzing some hereditary disorders. Furthermore, the cloning of the genes involved in the maintenance of cholesterol and/or lipid homeostasis has made it possible to investigate the molecular mechanisms of the development of hyperlipidemia in detail. Elucidation of the genetic and environmental factors and detailed understanding of the molecular pathophysiology of hyperlipidemia are essential in the pursuit of evidence-based preventive medicine and health policy.

Background: Japanese cedar pollinosis, caused by the pollen of the Japanese cedar tree (Cryptomeria japonica), is the commonest seasonal allergic disease in Japan. A number of epidemiological surveys have been reported on Japanese cedar pollinosis, but it has never been assessed systematically or quantitatively. To confirm the increasing prevalence of Japanese cedar pollinosis and related factors, we conducted a meta-regression analysis on population-based surveys in Japan. Methods: We searched for data from population-based surveys in which serological methods were used to test all participants. Weighted regression of logit-transformed prevalence and sensitization rates were used to evaluate the effects of the year of survey, age, and degree of urbanization. We also analyzed the relationship between prevalence and sensitization rate. Results: Thirty-eight reports with 27 subgroups for prevalence and 134 subgroups for sensitization rate were selected from the literature published in the years between 1986 and 2000. The Japanese cedar pollen sensitization rate was found to be significantly correlated with the year of survey, age, and degree of urbanization (adjusted R2 = 0.55). The coefficient for the correlation between the prevalence and the sensitization rate revealed a statistically significant correlation (Pearson’s r = 0.70, p < 0.001). Conclusions: The prevalence of Japanese cedar pollinosis among adolescents was predicted to be 28.7% in metropolitan areas and 24.5% in the general population in urban areas in the year 2004, derived from the estimated sensitization rate and the relationship between sensitization rate and prevalence. The prevalence of Japanese cedar pollinosis increased 2.6-fold between 1980 and 2000, and the prevalence differed considerably according to age and degree of urbanization.

Background Japanese cedar pollinosis is the most common form of hayfever in Japan in spring and has remarkably increased since 1960. Objective We sought to clarify the candidate genes for cedar pollinosis using a case-control study. Methods After diagnosing 351 subjects on the basis of an intradermal test, nasal provocation test, and questionnaire regarding nasal and conjunctival symptoms, we determined the blood-specific IgE values and genotypes of eosinophil peroxidase (EPO) and interleukin-4 receptor α-chain (IL4RA) in 145 patients with pollinosis and 206 healthy subjects, including 75 healthy subjects with higher specific IgE values. Results We found significant differences in the frequencies of Pro358Leu in EPO and of Ile50Val and Glu375Ala in IL4RA between patients and healthy subjects. There was a significantly higher frequency of 358Leu in EPO in patients than in healthy subjects showing a higher specific IgE value. In contrast, we recognized significant changes in the prevalence of Ile50Val and Glu375Ala in IL4RA in healthy subjects with a normal IgE value compared with those in healthy subjects with a higher specific IgE value. The relationship between EPO polymorphisms and the onset of symptoms was exactly opposite that for IL4RA. Conclusions These results suggest that Pro358Leu in EPO is strongly involved in the development of cedar pollinosis. Ile50Val and Glu375Ala in IL4RA seem to be related to cedar pollen sensitization. Subjects with Ile50 or Glu375 might develop cedar pollinosis with increased exposure to cedar pollen.

It is well known that BCL-2 protects against cell death by both apoptosis and necrosis. The culture of bcl-2-transfected normal fibroblasts showed a shorter life span by about 12 population doubling levels compared to that of vector transfectants (64 vs 76 population doubling levels, respectively). An MTT assay revealed that BCL-2-overexpressing cells (HCA2/bcl-2) showed more severe growth suppression due to hydrogen peroxide or doxorubicin treatment than vector control cells (HCA2/vector). We observed a significant number of dead cells in the HCA2/bcl-2 culture, but not in the HCA2/vector culture. Other BCL-2 family proteins with both antiapoptotic and proapoptotic activity and other apoptosis-related factors were maintained at similar levels, indicating that overexpression of BCL-2 is the major reason that normal fibroblasts are sensitized to cell death. A broad caspase inhibitor (z-Val-Ala-Asp-fmk) and inhibitors of specific caspases (acetyl-Asp-Glu-Val-Asp-CHO, acetyl-Ile-Glu-Thr-Asp-CHO, and acetyl-Leu-Glu-His-Asp-CHO) suppressed cell death of HCA2/bcl-2 effectively, suggesting involvement of caspase 3-, 8-, and 9-dependent pathways in cell death and that the form of death is apoptosis. Unexpectedly, involvement of active MEK in cell death was shown by the use of its inhibitor, suggesting that crosstalk between BCL-2 and the MAP kinase cascade regulates death as well as life span.

The HIV/AIDS surveillance system in Japan, which began collecting data on the number of AIDS patients in 1984 and the number of HIV-infected persons in 1987, has played an important role in monitoring the trend and magnitude of Japan's HIV/AIDS epidemic and its distribution across various population subgroups. However, the system lacks any personal identifiers, making it impossible to eliminate duplication or to track cases for disease progression. It also does not permit the identification of the residence of HIV-infected persons because the residence of only the reporting physician is documented under the New Infectious Diseases Control Law, effective since April 1, 1999. The number of people with HIV/AIDS in Japan continues to grow. Among youth, sexually transmitted diseases, induced abortion, and sexual activities have shown a marked increase since the mid-1990s. Behavioral risk of infection for both injection drug users (IDUs) and men who have sex with men (MSM) remains alarmingly high. Accurate monitoring of infection rates is critical to the planning and evaluation of treatment, care and prevention programs. Japan should restructure its HIV/AIDS surveillance system to more accurately monitor the HIV/AIDS epidemic and related risk behaviors.

85% in CSF 14-3-3 protein. The most frequent vague symptom that patients experienced was dizziness and it prolonged for more than 3.5 months accompanied by incremental complex vague symptoms. DWI imaging is the most sensitive study in stage 2 and its high detection rate has tendency to maintain until the last stage. When we analysis the region of DWI high signal as subdividing neocortex, limbic cortex and subcortical nucleus, there was the highest signal rate in neocortex during the stage 2. But as the disease was progress, the signal rate of limbic cortex was increasing and finally became the highest rate in stage 5. The more disease progress, the more periodic sharp wave was detected in EEG and showed the highest detection rate in stage 5. On the other hand, the sensitivity of CSF 14-3-3 protein was rather decreased in terminal stage.Conclusions: Sporadic CJD patients usually have initial vague symptoms which persist for more than 3 months followed by other complex vague symptoms. At this period, it can help early suspicion about CJD to take DWI MRI than any other test.

Biological effects of dietary isoflavones, such as daidzein and genistein are of interest in preventive medicine. We estimated the dietary intake of isoflavones from dietary records and compared the values with the plasma concentrations and urinary excretions in Japanese middleaged women. The dietary intake of daidzein and genistein was 64.6 and 111.6μ mol/day/capita (16.4 and 30.1 mg/day/capita), respectively. The isoflavones intake was mostly attributable to tofu, natto and miso. The median of plasma daidzein and genistein concentration was 72.46 and 206.09 nmol/L, respectively. The median of urinary excretion was 20.54μ mol/day for daidzein, 10.79 for genistein, 15.74 for equol and 1.64 for O-desmethylangolensin (0-DMA). Equol and 0DMA were excreted by 50 % and 84 % of all participants, respectively. Equol metabolizers were significantly lower the plasma and urinary daidzein and urinary O-DMA. The dietary intake of daidzein and genistein after the adjustment for total energy intake was significantly correlated with the urinary excretion (r=0.365 for daidzein and r=0.346 for genistein) and plasma concentration (r=0.335 for daidzein and r=0.429 for genistein). The plasma concentration of isoflavones was also significantly correlated with the urinary excretion. We conclude that in epidemiological studies measurements of plasma concentration or urinary excretion of these isoflavones are useful biomarkers of dietary intake and important for studies on their relation to human health. J Epidemiol, 2000 ; 10 : 127-135

Effects of the isoflavone supplement on hormonal states in young premenopausal women were studied by cross-over study design. Administration of 20 mg or 40 mg isoflavones (IF) by tablets, of which 1 g contained 43.5 mg daidzein, 6.0 mg genistein, 24.0 mg glycitein, to 40 young female students for one month caused a prolonged menstruation in 60% of young women, shortened menstruation in 20% of young women, 17% remained unchanged and 3% became irregular. Larger dose tended to elongate more, but 17beta-estradiol levels in both follicular and luteal phages were not different between 20 mg and 40 mg isoflavone intake. Equor excreters tended to show low plasma progesteron level in the luteal phase. Detailed hormonal analysis on 3 of students by a cross over study design showed decreased level of 17beta-estradiol throughout the menstruation cycle. SHBG significantly increased about 10% in all three. DEAS, androstendione, and testosterone showed different responses according to the follicular or luteal phase. T3 and T4 increased as a result of isoflavone tablet administration in the follicular phase, but it decreased in the luteal phase. These changes suggest that isoflavones influence not only estrogen receptor-related functions but the hypothalamo-hypophysis-gonadal axis.

Background/Aims: The actual prevalence of dementia in Japan as well as the changes in the prevalence are not well known. Therefore, we undertook a systematic review to collect evidence regarding the prevalence of dementia in Japan. Methods: For this systematic review, we searched 2 electronic databases to identify cross-sectional or repeated cross-sectional studies with data regarding the study population, study location, diagnostic criteria, and prevalence of dementia. Results: Twenty-one studies were selected from 782 references. Sixteen studies surveyed individuals living at home; of these, 5 studies also included hospitalized or institutionalized patients. Most of the studies were conducted using a two-phase survey (phase I: screening, phase II: diagnosis of dementia). The clinical diagnosis of dementia was made based on the guidelines of the Diagnostic and Statistical Manual of Mental Disorders (DSM) in a majority of the studies. The prevalence of all types of dementia ranged from 2.9 to 12.5% and has been gradually increasing over the past few years. Conclusion: The results of this systematic review suggest that the prevalence of dementia has recently increased. However, further well-designed studies taking into account factors that affect the prevalence of dementia are needed to clarify the actual prevalence.

Few stimulant drug users receive adequate treatment. This cross-sectional study describes the characteristics of female drug offenders that use stimulants and clarifies the factors related to the awareness of treatment for drug dependencies. We included 80 females imprisoned due to stimulant control law violations from 2012 to 2015. The characteristics of the female prisoners were stratified according to various treatment awareness levels, and associations between each characteristic and treatment awareness were evaluated using logistic regression models. The average period of stimulant drug use was 17.7 years. Participants imprisoned for the second time were significantly more likely to consider treatment compared to those imprisoned only once: odds ratio (OR) = 3.2 (95% confidence interval (CI): 1.0–10.7). This elevated OR was diluted in repeat offenders. Participants who had experienced multiple aftereffects (≥7) or serious depressive symptoms were also more likely to consider treatment: OR = 6.1 (95% CI: 1.8–20.8) and OR = 2.5 (95% CI: 1.0–6.2), respectively. Second-time stimulant offenders or offenders who had experienced health problems were more likely to consider it important to receive drug dependence treatment. To overcome relapses of stimulant use, it is recommended that stimulant use offenders are encouraged to accept adequate treatment.

Objective Desert dust, which is included in course particles, is considered to have potential toxicity. The effect modification of desert dust on associations between anthropogenic air pollution and mortality has been evaluated. However, the independent effects of Asian dust are less clear. Thus, we evaluated the effects of Asian dust on mortality independent of particulate matter (PM) in western Japan. Methods We obtained daily mean concentrations of Asian dust using Light Detection and Ranging measurements and suspended particulate matter (SPM) concentrations (approximately PM 8 ) during March 2005 to December 2010. We then evaluated city-specific associations of Asian dust and SPM with daily mortality using a time-series analysis targeting 1 379 052 people aged 65 or above living in 47 cities. The city-specific results were then combined with a Bayesian-hierarchical model. Results Asian dust did not modify the effects of SPM on mortality. Meanwhile, Asian dust was adversely associated with mortality independent of SPM. The excess risk following a 10 μ/m 3 increase in mean of the current to the previous 2 days Asian dust concentration was 0.6% (95% CI 0.1 to 1.1) for heart disease, 0.8% (95% CI 0.1 to 1.6) for ischaemic heart disease, 2.1% (95% CI 0.3 to 3.9) for arrhythmia and 0.5% (95% CI 0.2 to 0.8) for pneumonia mortality. Furthermore, the effects of Asian dust were stronger in northern areas close to the Eurasian continent (source of Asian dust). Conclusions Asian dust had adverse effects on circulatory and respiratory mortality independent of PM.

Backgrounds The geographic disparity of prevalence rates among dialysis patients is unclear. We evaluate the association between travel time to dialysis facilities and prevalence rates of dialysis patients living in 1,867 census areas of Hiroshima, Japan. Furthermore, we study the effects of geographic features (mainland or island) on the prevalence rates and assess if these effects modify the association between travel time and prevalence. Methods The study subjects were all 7,374 people that were certified as the “renal disabled” by local governments in 2011. The travel time from each patient to the nearest available dialysis facility was calculated by incorporating both travel time and the capacity of all 98 facilities. The effect of travel time on the age- and sex-adjusted standard prevalence rate (SPR) and 95% confidence intervals (CIs) at each census area was evaluated in two-level Poisson regression models with 1,867 census areas (level 1) nested within 35 towns or cities (level 2). The results were adjusted for area-based parameters of socioeconomic status, urbanity, and land type. Furthermore, the SPR of dialysis patients was calculated in each specific subgroup of population for travel time, land type, and combination of land type and travel time. Results In the regression analysis, SPR decreased by 5.2% (95% CI: −7.9–−2.3) per 10-min increase in travel time even after adjusting for potential confounders. The effect of travel time on prevalence was different in the mainland and island groups. There was no travel time-dependent SPR disparity on the islands. The SPR among remote residents (>30 min from facilities) in the mainland was lower (0.77, 95% CI: 0.71–0.85) than that of closer residents (≤30 min; 0.95, 95% CI: 0.92–0.97). Conclusions The prevalence of dialysis patients was lower among remote residents. Geographic difficulties for commuting seem to decrease the prevalence rate.

Background and Aims: A 2-stage spatio-temporal regression model has been developed for predicting pollutants, although its application has been limited to western countries. Moreover, most of the m...

Background: Atopic dermatitis (AD) and Japanese cedar pollinosis (JCP) are common chronically allergic diseases associated with the activation of T-helper 2 cells. Recent studies have shown that polymorphisms in the genes for IL-4 receptor α chain (IL4RA) may contribute to susceptibility of AD and JCP, although the differences in the involvements of loci of IL4RA gene between AD and JCP are unclear. In this study, we investigated the role of polymorphisms in IL-4RA gene in conferring susceptibility to the development of AD and/or JCP using a family analysis and an association analysis in a Japanese population. Methods: Five polymorphisms in the IL-4RA gene, C-3223 T, T-1914C, T-890C, Ile50Val and Glu375Ala, have been genotyped using PCR-based methods in 75 trios families, including 15 AD families, 30 JCP families, and 30 families with combination of AD and JCP in the family analysis. Forty-five AD, 60 JCP and 125 control children constituted the association study. Results: The transmission disequilibrium test showed that the allele of Ile50 was significantly transmitted to children with JCP alone (p

Background: The strength of the association between brain tumors in children and residential power-frequency magnetic fields (MF) has varied in previous studies, which may be due in part to possible misclassification of MF exposure. This study aimed to examine this association in Japan by improving measurement techniques, and by extending measurement to a whole week.Methods: This population-based case-control study encompassed 54% of Japanese children under 15 years of age. After excluding ineligible targeted children, 55 newly diagnosed brain tumor cases and 99 sex-, age-, and residential area-matched controls were included in the analyses. The MF exposures of each set of matching cases and controls were measured in close temporal proximity to control for seasonal variation; the average difference was 12.4 days. The mean interval between diagnosis and MF measurements was 1.1 years. The weekly mean MF level was defined as the exposure. The association was evaluated using conditional logistic regression analysis that controlled for possible confounding factors.Results: The odds ratios (95% CI) for exposure categories of 0.1 to 0.2, 0.2 to 0.4, and above 0.4 µT, against a reference category of

Background: Asthma is a common respiratory disease worldwide. However, few reports are available on the prevalences of asthma and asthma symptoms among Asian subjects. Methods: To determine the prevalences of asthma and asthma symptoms among Japanese subjects, we performed a nationwide cross-sectional, population-based study on Japanese adults aged 20–79 years. Ten areas spread throughout the country were randomly selected. Door-to-door or postal surveys were performed using a translated version of the European Community Respiratory Health Survey questionnaire. Results: The survey was completed by 23,483 participants. The overall response rate was 70.6%. The prevalences of wheeze and current asthma among all participants aged 20–79 years were 10.1% (95% CI: 9.7–10.5%) and 4.2% (95% CI: 4.0–4.5%), respectively. The prevalences among young adults aged 20–44 years were 9.3% (95% CI: 8.7–9.9%) and 5.3% (95% CI: 4.8–5.8%), respectively. The prevalence of current asthma was highest in females aged 30–39 years in comparison with the other gender and age groups. Conclusions: This nationwide study determined the prevalences of asthma and asthma symptoms among Japanese adults. The results provide fundamental information on the respiratory health of Japanese adults.

The population of Japan is aging rapidly, and maintaining the quality of life of elderly people has become an important issue in contemporary Japan. This study was conducted to verify the validity of the self-administered visual analogue scale (VAS) for assessing the health status of elderly people. A survey was conducted in two villages in western Japan in 2003. A total of 2040 participants, aged between 60 and 75 years, completed questionnaires comprising the VAS and six Likert-type items for health status, physical strength, life enjoyment, appetite, sleep, and life satisfaction. Data of the valid participants who properly completed both the VAS and the Likert-type item on health status were analyzed (n=1579, 77.4%). Among the Likert-type items, the VAS score was the most associated with health status (r = 0.532), followed by physical strength (r = 0.509). The VAS score showed a weak negative correlation with age (r = -0.130), but no association with socioeconomic factors such as the number of family members or annual income. The correlations between the VAS and the Likert-type item on health status varied between categories in some attributes. Since the VAS score was moderately correlated with similar questions about health status in the Likert-type health questionnaire, it was considered that the VAS is a valid self-administered instrument for collecting data on the health status of elderly people. However, further investigations need to be conducted to improve the VAS and to establish better explanations for aged respondents.

Mice lacking the integrin alphaMbeta2 (Mac-1, CD11b/CD18) develop an obese phenotype on western diet rich in fat. However, no association has been found between variations in the human genes encoding the integrin alphaMbeta2 and obesity. This study was aimed to investigate the association between a single-nucleotide polymorphism (SNP) (rs235326) in the gene encoding human integrin beta2 subunit (ITGB2) with obesity. Our subject cohort comprised 651 people of Japanese ethnicity, of which 274 were Japanese Americans living in Hawaii, and the remaining 377 were native Japanese, two populations in the same genetic background with or without westernized life style. We genotyped the rs235326 polymorphism using a TaqMan assay. In the Japanese-American population, the risk of obesity was found to be 3.29-fold higher (a 95% confidence interval of 1.25-8.67, P = 0.02) in TT homozygotes than in C carriers, using a recessive model and logistic regression analysis that had been adjusted for age. This association was not found in native Japanese individuals. These results indicate that the rs235326 polymorphism in the ITGB2 gene is associated with obesity in Japanese living in the United States whose diet has become "westernized."

Osteopontin is a multifunctional glycoprotein with roles in immunomodulation, inflammatory response, tissue mineralization, and tissue remodeling, which are mediated primarily through integrins. Transglutaminase 2 selectively cross-links proteins by isopeptide bonding. Osteopontin is one of the substrates of this enzyme and undergoes polymerization; however, the biological meaning of this polymerization remains unknown. Using recombinant osteopontin polymerized with purified transglutaminase 2, we examined cell adhesion, spreading, focal contact formation, and migration of SW480 or HUVE cells. All of these cellular behaviors were dramatically enhanced with polymeric osteopontin. These enhancements of cellular functions imply that polymerization might modulate physiological and pathological functions of osteopontin.

It is well known that psychological stress affects health status. Stiff neck and shoulder in a broad sense is one of the major somatic complaints among Japanese. The objective was to determine how much perceived stress and stiff neck/shoulder are associated with health-related quality of life (HRQoL) by gender. Participants (n = 512) completed the Japanese version of Perceived Stress Scale, the SF-8 Japanese version and original questions on perceived stiff neck/shoulder. Muscle hardness around the shoulder also was measured with the muscle tension meter. The multiple regression model of the men demonstrated that perceived stress was associated with not only the mental component summary (MCS) (beta: -0.494), but also the physical component summary (PCS) (beta = -0.319) of the SF-8. Although, in the model of the women, perceived stress was also associated with MCS (beta: -0.632) more than in that of the men, stiff neck/shoulder and age group (beta: -0.231; -0.268, respectively), but not stress, were related to PCS. The subjective neck/shoulder stiffness was hardly correlated with the objective shoulder muscle hardness. This study revealed the associations between perceived stress, stiff neck/shoulder and HRQoL, and their difference by gender. The hypothesis of gender differences was discussed with a focus on kind of stressors, perception of stress, admission of negative symptoms and cause of stiff neck/shoulder.

The association between the occurrence of acute myocardial infarction and meteorological factors was examined in five cities of the Chugoku area in Japan.This study used the emergency admission data for acute myocardial infarction in Yamaguchi, Matsue, Tottori, Okayama (from April 2000 to March 2005), and Hiroshima (from January 1993 to December 2002). Daily meteorological data was obtained from The Japan Meteorological Agency. The Poisson regression model was used to examine the association between acute myocardial infarction and daily average temperature and pressure.In Hiroshima, Okayama, Yamaguchi and Matsue City, daily average events of acute myocardial infarction were 30%, 30%, 33% and 40% higher in winter than those in summer (p0.05). Daily average events increased as atmospheric temperature decreased. In Hiroshima, Okayama and Yamaguchi City, daily average events in the low temperature group (T10 degrees C) were significantly higher than those in the high temperature group (Tor =20 degrees C) (p0.05). In Hiroshima City, a significant interaction was found between temperature and pressure. Daily events in the low temperature and low pressure group (1.38/day) was significant and 37% larger than in the high temperature and moderate pressure group (0.94/day; risk ratio = 1.37, 95% confidence interval 1.01-1.86, p0.05). Days with low temperature and low pressure were characterized by rain and/or snow.The occurrence of acute myocardial infarction was associated with low temperatures, especially daily average temperature lower than 10 degrees C. The risk was high on days with low temperature and low pressure in Hiroshima City.

In contrast to studies of the effects of atmospheric temperature and pressure on the occurrence of acute myocardial infarction (AMI), the interaction of these two factors has rarely been studied. We analyzed ambulance data (1993-2002) due to AMI in Hiroshima City using the poisson regression model to examine the main effects and the interaction of atmospheric temperature and pressure on AMI (n=3755). In the analysis, thermohydrological-index (THI), or humidity adjusted temperature, was calculated to involve the effect of relative humidity. The significant influence of atmospheric temperature on AMI was confirmed. Daily events of AMI decreased as temperature increased. Daily events in the low, moderate, and high temperature groups were 1.16, 1.07 and 0.90, respectively (average=1.03/day). Atmospheric pressure showed a weaker effect in the presence of temperature. A more profound interaction was found between temperature and pressure. The highest daily events 1.38 were observed in the low temperature and low pressure group, while this meteorological type was always accompanied by rain and/or snow. It was significant (p=0.047) and 37% higher than that of the high temperature and moderate pressure group. The lowest daily events 0.87 were observed in the high temperature and low pressure group. These associations were reinforced when temperature adjusted by relative humidity was used. Atmospheric temperature and the interaction of temperature and pressure had significant influences on the occurrence of AMI. The highest risk was found on days with low temperature and low pressure. Days with high risk were characterized by winter rain and/or snow.

In Japan, over the last 40 years, the change in lifestyle, particularly the westernization of the diet, has led to increased frequency of "lifestyle-related disorders" such as, hyperlipidemia, diabetes mellitus, and atherosclerosis. Consequently, the morbidity and mortality due to coronary heart disease have increased, and the prevention of this disorder is now one of the major concerns when considering the quality of life of individuals and the public health policy. Hyperlipidemia, particularly hypercholesterolemia, is one of the major risk factors of atherosclerosis. Therefore, the clarification of the mechanisms of the development of hyperlipidemia is important in the consideration of the prevention and management of atherosclerotic disorders. Genetic and epidemiological studies have provided compelling evidence that genetic factors, environmental influences and the interaction between them all contribute to the development of this complex disorder. Various unexpected mechanisms of the development of hyperlipidemia have been elucidated by analyzing some hereditary disorders. Furthermore, the cloning of the genes involved in the maintenance of cholesterol and/or lipid homeostasis has made it possible to investigate the molecular mechanisms of the development of hyperlipidemia in detail. Elucidation of the genetic and environmental factors and detailed understanding of the molecular pathophysiology of hyperlipidemia are essential in the pursuit of evidence-based preventive medicine and health policy.

The assessment of stress is a key issue in health promotion policies as well as in treatment strategies for patients. The aim of this study was to confirm the accessibility and reliability of computer-assisted data collection for perceived stress measurement, using the Japanese version of the Perceived Stress Scale (JPSS), within the setting of a community-based survey. There were two groups of participants in this survey. One group responded to a Web-based application, and the other to the VBA of a spreadsheet software. The total scores of JPSS were almost normally distributed. The means of total scores of JPSS were 23.6 and 23.1. These results were lower than the previous study of JPSS. Since Cronbach's alpha coefficients in both surveys were more than 0.8, high reliability was demonstrated despite a number of computer-illiterate and/or aged participants. They felt that the spreadsheet form was easier to respond to. Two components were extracted with the Varimax rotation of principal component analysis, and these were named "perception of stress and stressors" and "behavior to stress". This finding suggests that it is possible to determine sub-scales. From the viewpoint of preventive medicine, it is expected that the JPSS applications will be utilized to investigate the relationship between stress and other factors such as lifestyle, environment and quality of life.