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Toshihiro Saito,1 Shuichi Komatsubara,2 Noboru Hara,3 Tsutomu Nishiyama,3 Akiyoshi Katagiri,4 Fumio Ishizaki,5 Akihiko Hatano,6 Takeshi Komeyama,7 Shugo Hanyu,8 Masahiro Terunuma,9 Tomoyuki Imai,10 Hideto Go,11 Hiroaki Iida,12 Shigenori Kurumada,13 Shunsuke Yamaguchi,4,14 Keisuke Takeda,5,15 Takashi Ando,14,15 Tatsuhiko Hoshii,5 Takashi Kasahara,5 Yoshihiko Tomita5 1Department of Urology, Niigata Cancer Center Hospital, Niigata, Japan; 2Department of Urology, Niigata Minami Hospital, Niigata, Japan; 3Department of Urology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Minamiuonuma, Japan; 4Department of Urology, Niigata Prefectural Central Hospital, Joetsu, Japan; 5Department of Renal and Urinary Pathology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan; 6Department of Urology, Niigata Prefectural Shibata Hospital, Shibata, Japan; 7Department of Urology, Nagaoka Red Cross Hospital, Nagaoka, Japan; 8Department of Urology, Kashiwazaki General Hospital and Medical Center, Kashiwazaki, Japan; 9Department of Urology, Nagaoka Chuo General Hospital, Nagaoka, Japan; 10Department of Urology, Niigata City General Hospital, Niigata, Japan; 11Department of Urology, Niigata Saiseikai Sanjo Hospital, Sanjo, Japan; 12Department of Urology, Joetsu General Hospital, Joetsu, Japan; 13Department of Urology, Saiseikai Niigata Hospital, Niigata, Japan; 14Department of Urology, Tachikawa General Hospital, Nagaoka, Japan; 15Department of Urology, Murakami General Hospital, Murakami, JapanCorrespondence: Toshihiro SaitoDepartment of Urology, Niigata Cancer Center Hospital, 2-15-3 Kawagishi-cho, Niigata, 951-8566, JapanTel +81-25-266-5111Fax +81-25-233-3849Email urotoshi@niigata-cc.jpPurpose: This study aims to investigate the utility of prostate-specific antigen (PSA) screening by conducting an all-case survey of newly diagnosed prostate cancer patients at Niigata Prefecture, Japan.Patients and Methods: Depending on whether patients were subjected to screening, information was prospectively collected on all prostate cancer patients newly diagnosed between October 1, 2019, and September 30, 2020, at all institutions in Niigata Prefecture where urologists performing prostate biopsy routinely work and differences in clinical parameters were investigated.Results: PSA was measured in 478 out of 1332 patients (35.8%) as part of a community health screening. The rate of metastatic carcinoma (M1) in all patients was 14.9%. When patients were divided into three categories of population-based screening (community health screening and workplace health screening), opportunistic screening (PSA measurements at complete medical check-ups or on patient request), and testing triggered by clinical symptoms or findings, the proportion of metastatic cancer was 4.5%, 3.7%, and 30.6%, respectively, demonstrating that the number of distant metastases was significantly lesser in all patients who underwent screening.Conclusion: The one-year all-case survey of newly diagnosed prostate cancer patients demonstrated that PSA screening significantly contributed to the early diagnosis of current prostate cancer in Japan.Keywords: prostate cancer, PSA screening, population-based screening, opportunistic screening, one-year all-case survey

Zemenu Sifr,1 Telto Ando,1 Wosenyeleh Semeon,1 Muse Rike,1 Kidist Ashami2 1Department of Health Information Technology, Hawassa College of Health Sciences, Hawassa, Ethiopia; 2Harvard Graduate School of Arts and Science, Boston, MA, 02138, USACorrespondence: Zemenu SifrDepartment of Health Information Technology, Hawassa College of Health Sciences, P.O. Box 84, Hawassa, EthiopiaEmail sifrezemenu2020@gmail.comBackground: Human immune deficiency virus (HIV) remains one of the leading causes of infectious disease mortality and morbidity in Sub-Saharan Africa. Although remarkable progress has been made in prevention and treatment of HIV, there is a higher rate of loss to follow-up in HIV-infected children than in adults, once they enter care.Objective: To determine the incidence and identify predictors of loss to follow-up among HIV-infected children on anti-retroviral treatment in Sidama Zone, Ethiopia.Methods: A retrospective cohort study was done among children that were enrolled in ART care in Sidama Zone from September 2014 to August 2018. A total of 143 eligible children were included in this study. A structured checklist was used to extract data from patients’ medical records such as patient intake forms, electronic database, and registers. Data were entered, cleaned, coded, and analyzed by STATA version 12. Cox proportional hazards models were fitted to investigate predictors of loss to follow-up.Results: Of the 143 participants, 76 (53.15%) were female children with a median age of 7 years and interquartile range of 4– 9. The incidence rate was 5 per 100 person-years and the cumulative incidence 12.59%. The median follow-up time was 2.46 years and the total time at risk was 356.06 person-years. Furthermore, 55.56% and 72.22% of those lost to follow-up were within the first and the second years of follow-up, respectively. In multivariable Cox proportional model, only the TB status of the children was significantly associated with loss to follow-up with hazard ratio 3.348 [1.174831, 9.543494] and p-value of 0.024.Conclusion: In this study, TB status of children was the significant determinant of loss to follow-up. However, the overall retention was 87.4% and a substantially higher proportion of loss was observed within the first and second years of follow-up.Keywords: lost to follow-up, attrition, HIV-infected children, ART, Sidama zone

Anorexia nervosa (AN) is a complex and heritable eating disorder characterized by dangerously low body weight. Neither candidate gene studies nor an initial genome-wide association study (GWAS) have yielded significant and replicated results. We performed a GWAS in 2907 cases with AN from 14 countries (15 sites) and 14 860 ancestrally matched controls as part of the Genetic Consortium for AN (GCAN) and the Wellcome Trust Case Control Consortium 3 (WTCCC3). Individual association analyses were conducted in each stratum and meta-analyzed across all 15 discovery data sets. Seventy-six (72 independent) single nucleotide polymorphisms were taken forward for in silico (two data sets) or de novo (13 data sets) replication genotyping in 2677 independent AN cases and 8629 European ancestry controls along with 458 AN cases and 421 controls from Japan. The final global meta-analysis across discovery and replication data sets comprised 5551 AN cases and 21 080 controls. AN subtype analyses (1606 AN restricting; 1445 AN binge-purge) were performed. No findings reached genome-wide significance. Two intronic variants were suggestively associated: rs9839776 (P=3.01 × 10(-7)) in SOX2OT and rs17030795 (P=5.84 × 10(-6)) in PPP3CA. Two additional signals were specific to Europeans: rs1523921 (P=5.76 × 10(-)(6)) between CUL3 and FAM124B and rs1886797 (P=8.05 × 10(-)(6)) near SPATA13. Comparing discovery with replication results, 76% of the effects were in the same direction, an observation highly unlikely to be due to chance (P=4 × 10(-6)), strongly suggesting that true findings exist but our sample, the largest yet reported, was underpowered for their detection. The accrual of large genotyped AN case-control samples should be an immediate priority for the field.

Mitsutoshi Shindo,1 Hiroaki Takemae,2 Takafumi Kubo,2 Masatsugu Soeno,2 Tetsuo Ando,2 Yoshiyuki Morishita1 1Division of Nephrology, First Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan; 2Department of Dialysis and Transplant Surgery, Hidaka Hospital, Gunma, Japan Purpose: This study was performed to investigate the primary patency rate and catheter-related problems associated with use of the femoral vein as a route for tunneled hemodialysis catheterization compared with those of the right internal jugular vein as the first-choice route in patients undergoing maintenance hemodialysis. Patients and methods: Twenty-two patients underwent placement of indwelling tunneled hemodialysis catheters in the right internal jugular vein as the first option for maintenance hemodialysis, and 20 patients underwent placement in the right femoral vein as the second option. The primary patency rate of the catheters and catheter-related problems at 1, 3, 6, and 12 months after placement were investigated. Results: The 1-, 3-, 6-, and 12-month primary patency rates of the tunneled hemodialysis catheters in the right internal jugular vein were 95.5%, 95.5%, 81.3%, and 58.3%. The primary patency rates of the catheters in the right femoral vein were 95.0%, 89.5%, 86.7%, and 66.7%. There were no statistically significant differences in the primary patency rates at 1, 3, 6, and 12 months or in catheter-related problems between the right internal jugular vein and right femoral vein. Conclusion: The primary patency rate and catheter-related problems of indwelling tunneled hemodialysis catheters placed in the right femoral vein were not different from those in the right internal jugular vein in patients undergoing maintenance hemodialysis. These results suggest that the right femoral vein might be a useful option for placement of indwelling tunneled hemodialysis catheters in patients undergoing maintenance hemodialysis. Keywords: tunneled hemodialysis catheter, right femoral vein, primary patency rate, catheter-related problems

Mitsutoshi Shindo,1 Hiroaki Takemae,2 Takafumi Kubo,2 Masatsugu Soeno,2 Tetsuo Ando,2 Yoshiyuki Morishita1 1Division of Nephrology, First Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan; 2Department of Dialysis and Transplant Surgery, Hidaka Hospital, Gunma, Japan Abstract: Hepatitis E is caused by infection with the hepatitis E virus (HEV). HEV is transmitted orally via HEV-contaminated food or drink. Hepatitis E usually shows mild symptoms and is self-limiting in the general population; however, it may progress to chronic hepatitis in immunosuppressed patients such as recipients of organ transplantation. However, a few cases of acute hepatitis E have been reported in organ transplantation recipients. We herein report a case of acute hepatitis E in a 31-year-old male renal transplant recipient. The patient underwent renal transplantation 2 years ago, and his postoperative course was uneventful without rejection. After complaining of general fatigue and low-grade fever for 1 week, he was referred to and admitted to our hospital. Careful interview revealed that he ate undercooked pork 10 weeks prior. Blood analysis revealed liver dysfunction but was serologically negative for hepatitis A, B and C virus, cytomegalovirus infection and collagen diseases. Immunoglobulin A antibody against hepatitis E virus (HEV-IgA) was also negative at that point. After 2 weeks of admission, HEV-IgA and HEV-RNA were measured again as hepatitis E could not be ruled out due to history of ingestion of undercooked meat that may have been contaminated with HEV. At that time, HEV-IgA and HEV-RNA (genotype 3) were positive. Thus, an acute hepatitis E was diagnosed. His liver function gradually improved to within the normal range, and HEV-IgA and HEV-RNA were negative at 11 weeks after admission. In conclusion, we describe here a case of acute hepatitis E in a renal transplant recipient. Careful interview regarding the possibility of ingestion of HEV-contaminated food and repeated measurements of HEV-IgA were helpful in finalizing a diagnosis. Keywords: hepatitis E virus, anti-HEV IgA, recipient, renal transplantation, zoonosis

Jusen Tsuru,1 Yoshihiro Tanaka,1 Yoshinobu Ishitobi,1 Yoshihiro Maruyama,1 Ayako Inoue,1 Aimi Kawano,1 Rie Ikeda,1 Tomoko Ando,1 Harumi Oshita,2 Saeko Aizawa,1 Koji Masuda,1 Haruka Higuma,1 Masayuki Kanehisa,1 Taiga Ninomiya,1 Jotaro Akiyoshi1 1Department of Neuropsychiatry, 2Department of Applied Linguistics, Faculty of Medicine, Oita University, Oita, Japan Background: Decreased expression of brain-derived neurotrophic factor (BDNF) is implicated in enhanced stress responses. The BDNF Val66Met polymorphism is associated with psychological changes; for example, carriers of the Met allele exhibit increased harm avoidance as well as a higher prevalence of depression and anxiety disorder.Methods: To analyze the effects of BDNF Val66Met on stress responses, we tested 226 university students (88 women and 138 men) using a social stress procedure (Trier Social Stress Test [TSST]) and an electrical stimulation stress test. Stress indices were derived from repeated measurements of salivary α-amylase, salivary cortisol, heart rate, and psychological testing during the stress tests. All subjects were genotyped for the Val66Met polymorphism (G196A).Results: A significant three-way interaction (time [3 levels] × BDNF [Val/Val, Val/Met, Met/Met]; P