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Masamichi Ishioka,1 Norio Sugawara,1 Ayako Kaneda,1 Noriyuki Okubo,2 Kaori Iwane,2 Ippei Takahashi,2 Norio Yasui-Furukori1 1Department of Neuropsychiatry, 2Department of Social Medicine, Graduate School of Medicine, Hirosaki University, Hirosaki, JapanIntroduction: Screening tools for dementia should be valid and easy to complete and have a low psychological burden. Consistent with these principles, the Yamaguchi fox/pigeon-imitation test (YFPIT) has been developed. However, there is little information on the utility of the YFPIT for preclinical populations, although the detection of proven prodromal and preclinical states is important.Materials and methods: We recruited 392 volunteers who were at least 60 years old (139 men and 253 women) and had participated in the Iwaki Health Promotion Project. The YFPIT was administered to all participants.Results: Most subjects succeeded in imitating the fox gesture regardless of their cognitive function impairment, while the success rates for the pigeon gesture were 75.3% in the normal group and 56.3% in the cognitive impairment group. The sensitivity, specificity, positive predictive value (PV+), and negative predictive value (PV-) were 43.8%, 75.3%, 7.0%, and 97.0%, respectively. The greatest significant difference between the imitation of the pigeon gesture and cognitive impairment was found in females with subjective memory impairments (P=0.001). In that group, the sensitivity, specificity, PV+, and PV- were 100%, 81.9%, 18.8%, and 100%, respectively.Conclusion: This study suggests that the utility of the YFPIT is limited in the general population, but that it is a useful tool in females with subjective memory impairments in a community-dwelling population.Keywords: dementia, gesture imitation, brief screening

Abstract Background Studies of the associations between diet and depression have primarily focused on single nutrients or foods. Recently, dietary patterns representing a combination of foods have attracted more interest than individual nutrient. The objective of this study was to examine the association between dietary patterns and depressive symptoms among a community-dwelling population in Japan. Methods We examined the association between dietary patterns and the risk of depression among 791 Japanese community-dwelling individuals. Diet was assessed with a validated brief-type self-administered diet history questionnaire (BDHQ). Dietary patterns from 52 predefined food groups [energy-adjusted food (g/d)] were extracted by principal component analysis. The Center for Epidemiologic Studies Depression Scale (CES-D) with a cut-off point of 16 was used to assess the prevalence of depression. Results A total of 97 subjects (12.3%) were classified as having depression. Four dietary patterns were identified: “Healthy”, “Western”, “Bread and confectionery”, and “Alcohol and accompanying” dietary patterns. After adjusting for potential confounders, the dietary patterns were not related to the risk of depression. Conclusions The present study failed to find associations between dietary patterns and the risk of depression. However, the interpretation of our results was hampered by the lack of certain data, including employment physical activity and longitudinal observations. Potential associations between dietary patterns and depressive symptoms were not completely ruled out. Future research exploring dietary patterns and depressive symptoms is warranted.

Among VLF wave phenomena observed by the S-310JA-1 rocket, what is thought as a kind of plasma wave phenomenon has been investigated in detail. The phenomenon is characteristic in that its frequency was spin-modulated and it appeared once during one spin period, and it was detected with a ferrite core loop antenna as well as with a 28 m dipole antenna. It is concluded that this phenomenon may be an electrostatic wave with a wave length of the order of 10 cm. The loop antenna is considered to have worked as an electric sensor by the whip antenna effect, when the phenomenon was detected. It is also found that the 28 m dipole antenna is a very short antenna with an effective length of ～1 mm for the above plasma wave. Therefore, the phenomenon can be quantitatively understood from these characteristics of the antennas

Before planning future rocket exoeriments at Syowa Station in Antarctica, the IMS rocket projects already partly made and partly to be made at Syowa Station have been critically examined. For the post-IMS project, it is first proposed that the bandwidth of data transmission by rocket telemetry must be widened by powering up of the rocket-borne transmitter and by reconstructing the ground-based telemetry receiver. As to the kinds of observation, almost all IMS projects will be tried again with improving reliability of the experiments. A big comnlex payload will become feasible by an appearance of the S-500 type of rocket.

Some important points on the plasma wave experiments in the polar ionosphere are indicated. Concrete proposals of the antarctic rocket experiments on the plasma waves are given. One is a passive observation of the plasma waves and the others are active experiments of linear and nonlinear wave-particle and wave-wave interactions.

A full wave treatment including the ground effect is briefly described for a whistler wave incident onto the ionosphere from above. The absorption of the VLF hiss and chorus waves in the lower ionosphere of the polar region is comouted. Two kinds of electron density profiles observed at Syowa Station are taken as the ionospheric models, one is in disturbed condition and the other in quiet condition. Intensities of the Poynting flux on the ground are calculated as parameters of the frequency and the dlp angle of the geomagnetic field. The results are as follows ; (1) Absorption in the disturbed model is much greater than that in the quiet one (2) The absorption increases as the frequency grows higher. (3) The absorption decreases as the dip angle increases. Finally, seasonal variations of the collisional damping in the polar region are discussed.

VLF hiss was observed on the S-310JA-2 rocket at Syowa Station in the Antarctic region (69°00'S, 39°35' E) at 03 22 LT on February 10, 1977, during polar magnetic storm (ΔH, -680γ) This hiss was observed only with a 24 m tip-to-tip electric dipole antenna, not observed with a ferrite core loop antenna, and exhibited a sharp lower cut-off frequency which seemed to be associated with lowerhybrid resonance (LHR) in the vicinity of rocket, If we assume the ion composition and electron density. at the observing altitude. Therefore it may be the first rocket observation of LHR hiss. We also obtained altitude profiles of sheath impedance and 7 kHz hiss strength.

Characteristics of auroral hiss emissions observed in the Antarctic rocket experiments using the S-210JA-20 and 21 rockets are described.The S-210JA-20 rocket was launched in a geomagnetically disturbed condition. whereas the S-210JA-21 was launched in a calm condition, although the both penetrated into auroras. From the ratio of the electric field intensity to the magnetic field intensity, the hiss emissions observed on the above two rockets are identified as the whistler mode. The Poynting fluxes of the auroral hiss observed on the rockets are compared with those observed on the ground and the difference in the flux is found to be ascribed to the attenuation through the lower ionosphere. Time variations of the VLF noise intensity observed on the rockets are compared with those of electron flux of 40-60 keV and electron density simultaneously observed on the same rockets. It is found that the VLF noise level corresponding to the auroral hiss is well correlated with the electron flux in the S-210JA-20 experiment, but the correlation is not good in the S-210JA-21 experiment.

This paper describes the results of VLF observations made by the S-310JA-1 and 2 rockets launched on February 13, 1976 and February 10,1977 respectively. Both rockets were equipped with a dipole and a loop antenna which measured VLF plasma wave phenomena in the frequency range of 0.2-10 kHz. The chorus or ELF hiss emissions in the frequency range less than 1 kHz the local wave phenomena identified as ion acoustic waves or electrostatic ion cyclotron waves were observed by S-310JA-1. In the S-310JA-2 experiment, VLF hiss was observed, which was identified as LHR hiss. As to the relationship between the VLF noise intensity and the energetic electron flux in the energy range less than 10 keV, no clear correlation was found in either of the experiments.

The first part of this report summarizes the results of observations of waves and particles by means of the S-310JA-1 and 2 rockets which were launched both in February at one year's interval. Geophysical data simultaneously observed on the ground are also introduced. In the second part of this report, the correlation of the data, especially those of waves and particles, obtained by various kinds of instruments on board the rockets is described.

As a part of the proceedings of "Symposium on future planning of rocket observation at Antarctica", problems of the rocket experiments on plasma wave phenomena are briefly discussed. Engineering requirements for the rocket experiments of the wave phenomena in the future are first described and then scientific missions of plasma wave observations and experiments at Antarctica are discussed.

The results of observation of ionospheric electron temperature by means of a small standard electron temperature probe on board the S-310JA-2 rocket are presented briefly.

Background: Pancreatic cancer is often diagnosed at advanced stages, and early-stage diagnosis of pancreatic cancer is difficult because of nonspecific symptoms and lack of available biomarkers., Methods: We performed comprehensive serum miRNA sequencing of 212 pancreatic cancer patient samples from 14 hospitals and 213 non-cancerous healthy control samples. We randomly classified the pancreatic cancer and control samples into two cohorts: a training cohort (N = 185) and a validation cohort (N = 240). We created ensemble models that combined automated machine learning with 100 highly expressed miRNAs and their combination with CA19-9 and validated the performance of the models in the independent validation cohort., Results: The diagnostic model with the combination of the 100 highly expressed miRNAs and CA19-9 could discriminate pancreatic cancer from non-cancer healthy control with high accuracy (area under the curve (AUC), 0.99; sensitivity, 90%; specificity, 98%). We validated high diagnostic accuracy in an independent asymptomatic early-stage (stage 0-I) pancreatic cancer cohort (AUC:0.97; sensitivity, 67%; specificity, 98%)., Conclusions: We demonstrate that the 100 highly expressed miRNAs and their combination with CA19-9 could be biomarkers for the specific and early detection of pancreatic cancer., (© 2024. The Author(s).)

Objectives: This study aimed to elucidate the clinical characteristics and predictors of long-term postoperative urinary incontinence (PUI) after robot-assisted radical prostatectomy (RARP)., Methods: This study included patients who underwent RARP at our institution and were stratified into PUI (≥1 pad/day) and continence (0 pad/day) groups at 60 months after RARP. A propensity score-matched analysis with multiple preoperative urinary status (Expanded Prostate Cancer Index Composite urinary subdomains, total International Prostate Symptom Score (IPSS), and IPSS-quality of life scores) was performed to match preoperative urinary status in these groups. Serial changes in urinary status and treatment satisfaction preoperatively and until 60 months after RARP were compared, and predictors of long-term PUI were assessed using multivariate logistic regression analysis., Results: A total of 228 patients were included in the PUI and continence groups (114 patients each). Although no significant difference in preoperative urinary status was observed between the two groups, the postoperative urinary status significantly worsened overall in the PUI group than in the continence group. Treatment satisfaction was also significantly lower in the PUI group than in the continence group from 12 to 60 months postoperatively. Multivariate logistic regression analysis revealed that age (≥70 years) and biochemical recurrence (BCR) were significant predictors of the long-term PUI group (p < 0.05)., Conclusions: Patients with long-term PUI had poor overall postoperative urinary status and lower treatment satisfaction than the continence group. Considering the age and risk of BCR is important for predicting long-term PUI when performing RARP., (© 2024 The Author(s). International Journal of Urology published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Urological Association.)

Objective: Comprehensive genomic profiling testing using a hybrid-capture next-generation sequencing is commonly used in clinical practice to employ precision medicine in cancer treatment worldwide. In this study, we aimed to analyze the profiles obtained using comprehensive genomic profiling testing that was performed in Japanese castration-resistant prostate cancer patients and to discuss the genetic findings in a real-world setting., Methods: A total of 60 cases and 57 castration-resistant prostate cancer patients underwent comprehensive genomic profiling testing between 1 January 2021 and 31 December 2022. Four types of comprehensive genomic profiling testing were selected, and clinically significant cancer-specific gene alterations were identified., Results: The median age of patients was 74 years, and the median prostate-specific antigen value at the time of submission was 18.6 ng/ml. Fifty-seven (95%) of 60 cases were metastatic castration-resistant prostate cancers, and 3 cases (5%) were non-metastatic. Among all genetic alterations, androgen-receptor alteration was the most frequently detected in 17 cases (28.3%), followed by 15 cases of TP53 (25.0%), 14 cases of CDK12 (23.3%), 10 cases of phosphatase and tensin homolog (16.7%) and 9 cases of ATM (15.0%) mutations. A total of 13 patients (21.7%) received systemic therapy according to the comprehensive genomic profiling testing results. Overall, the survival rate was significantly greater in the group treated through systemic therapy based on comprehensive genomic profiling testing compared with the group without new therapeutic treatment (P = 0.041)., Conclusions: Comprehensive genomic profiling testing is recommended in castration-resistant prostate cancer patients identified as resistant to standard therapy as this can provide a new therapeutic option., (© The Author(s) 2023. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permission@oup.com.)

Background: The histogenesis of thymic epithelial tumors (TETs) has been a subject of debate. Recent technological advancements have revealed that thymic carcinomas often exhibit a phenotype akin to tuft cells, which is a subset of medullary TECs. Here, we further explored the gene expression signatures of thymic carcinomas in relation to tuft cells and their kinships-ionocytes and neuroendocrine cells (neuroendocrine group)., Methods: We analyzed a single-cell RNA sequencing dataset from the normal human thymus. Concurrently, we examined publicly available datasets on the mRNA expression and methylation status of TECs and lung cancers. Real-time quantitative PCR was also conducted with our tissue samples., Results: Thymic carcinomas displayed a neuroendocrine phenotype biased toward tuft cells and ionocytes. When exploring the possible regulators of this phenotype, we discovered that HDAC9 and NFATC1 were characteristically expressed in the neuroendocrine group in adult TECs and thymic carcinomas. Additionally, the pan-thymic epithelium markers, exemplified by PAX9 and SIX1 , were significantly suppressed in thymic carcinomas., Conclusions: Thymic carcinomas might be characterized by unique neuroendocrine differentiation and loss of identity as thymic epithelial cells. Future studies investigating the role of HDAC9 and NFATC1 in thymic epithelium are warranted to explore their potential as therapeutic targets in TETs.

Mesenchymal activation, characterized by dense stromal infiltration of immune and mesenchymal cells, fuels the aggressiveness of colorectal cancers (CRC), driving progression and metastasis. Targetable molecules in the tumor microenvironment (TME) need to be identified to improve the outcome in CRC patients with this aggressive phenotype. This study reports a positive link between high thrombospondin-1 (THBS1) expression and mesenchymal characteristics, immunosuppression, and unfavorable CRC prognosis. Bone marrow-derived monocyte-like cells recruited by CXCL12 are the primary source of THBS1, which contributes to the development of metastasis by inducing cytotoxic T-cell exhaustion and impairing vascularization. Furthermore, in orthotopically generated CRC models in male mice, THBS1 loss in the TME renders tumors partially sensitive to immune checkpoint inhibitors and anti-cancer drugs. Our study establishes THBS1 as a potential biomarker for identifying mesenchymal CRC and as a critical suppressor of antitumor immunity that contributes to the progression of this malignancy with a poor prognosis., (© 2023. Springer Nature Limited.)

Biliary tract cancer (BTC) has poor prognosis. The Notch receptor is aberrantly expressed in extrahepatic cholangiocarcinoma (eCCA). However, the role of Notch signaling in the initiation and progression of eCCA and gallbladder (GB) cancer remains unknown. Therefore, we investigated the functional role of Notch signaling during tumorigenesis of the extrahepatic bile duct (EHBD) and GB. Activation of Notch signaling and oncogenic Kras resulted in the development of biliary intraepithelial neoplasia (BilINs) in the EHBD and GB, which were premalignant lesions that progressed to adenocarcinoma in mice. The expression of genes involved in the mTORC1 pathway was increased in biliary spheroids from Hnf1b-CreERT2; Kras LSL-G12D ; Rosa26 LSL-NotchIC mice and inhibition of the mTORC1 pathway suppressed spheroid growth. Additionally, simultaneous activation of the PI3K-AKT and Notch pathways in EHBD and GB induced biliary cancer development in mice. Consistent with this, we observed a significant correlation between activated NOTCH1 and phosphorylated Ribosomal Protein S6 (p-S6) expression in human eCCA. Furthermore, inhibition of the mTORC1 pathway suppressed the growth of Notch-activated human biliary cancer cells in vitro and in vivo. Mechanistically, the Kras/Notch-Myc axis activated mTORC1 through TSC2 phosphorylation in mutant biliary spheroids. These data indicate that inhibition of the mTORC1 pathway could be an effective treatment strategy for Notch-activated human eCCA. © 2023 The Pathological Society of Great Britain and Ireland., (© 2023 The Pathological Society of Great Britain and Ireland.)

Biceps brachii muscle consists of a long head (BBL) and a short head (BBS). Shortening the BBL and BBS causes tendinopathy of the intertubercular groove and coracoid process. Therefore, it is necessary to stretch the BBL and BBS separately. This study aimed to determine the positions where the BBL and BBS were most stretched, using shear wave elastography (SWE). Fifteen healthy young males participated in the study. The shear elastic moduli of the BBL and BBS of the non-dominant arm were measured using SWE. The measurement positions were the resting position (shoulder flexion and abduction 0°) and four stretching positions.. The elbow was extended, and the forearm was pronated in all positions. Statistical analysis was performed using Wilcoxon's signed-rank test to compare the shear elastic moduli between the resting and stretched limb positions. In addition, Wilcoxon's signed-rank test was used to compare shear elastic moduli between the stretching positions that were significantly different compared to the resting position.. Results show that for BBL and BBS, shear elastic moduli were significantly higher in the shoulder extension + external rotation and shoulder horizontal abduction + internal rotation positions than in the resting position. Moreover, the shear elastic modulus of the BBL was significantly higher in shoulder extension + external rotation than in shoulder horizontal abduction + internal rotation. In contrast, the shear elastic modulus of the BBS was significantly higher in shoulder horizontal abduction + internal rotation than in shoulder extension + external rotation. The BBL and BBS were effectively stretched by shoulder extension + external rotation and horizontal abduction + internal rotation., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background: Breast cancer is highly heterogeneous, suggesting that small but relevant subsets have been under-recognized. Rare and mainly triple-negative breast cancers (TNBCs) were recently found to exhibit tuft cell-like expression profiles, including POU2F3, the tuft cell master regulator. In addition, immunohistochemistry (IHC) has identified POU2F3-positive cells in the normal human breast, suggesting the presence of tuft cells in this organ., Methods: Here, we (i) reviewed previously identified POU2F3-positive invasive breast cancers (n = 4) for POU2F3 expression in intraductal cancer components, (ii) investigated a new cohort of invasive breast cancers (n = 1853) by POU2F3-IHC, (iii) explored POU2F3-expressing cells in non-neoplastic breast tissues obtained from women with or without BRCA1 mutations (n = 15), and (iv) reanalyzed publicly available single-cell RNA sequencing (scRNA-seq) data from normal breast cells., Results: Two TNBCs of the four previously reported invasive POU2F3-positive breast cancers contained POU2F3-positive ductal carcinoma in situ (DCIS). In the new cohort of invasive breast cancers, IHC revealed four POU2F3-positive cases, two of which were triple-negative, one luminal-type, and one triple-positive. In addition, another new POU2F3-positive tumor with a triple-negative phenotype was found in daily practice. All non-neoplastic breast tissues contained POU2F3-positive cells, irrespective of BRCA1 status. The scRNA-seq reanalysis confirmed POU2F3-expressing epithelial cells (3.3% of all epithelial cells) and the 17% that co-expressed the other two tuft cell-related markers (SOX9/AVIL or SOX9/GFI1B), which suggested they were bona fide tuft cells. Of note, SOX9 is also known as the "master regulator" of TNBCs., Conclusions: POU2F3 expression defines small subsets in various breast cancer subtypes, which can be accompanied by DCIS. The mechanistic relationship between POU2F3 and SOX9 in the breast warrants further analysis to enhance our understanding of normal breast physiology and to clarify the significance of the tuft cell-like phenotype for TNBCs., (© 2023. The Author(s).)

(Introduction) In this study, we investigated the surgical outcomes and cancer control achieved with cytoreductive radical prostatectomy (cRP) in patients with castration-resistant prostate cancer (CRPC). (Patients and Methods) The study included 12 patients who underwent cRP at Kure Medical Center between August 2010 and April 2022 for diagnosis of CRPC. Perioperative outcomes, decline in serum prostate-specific antigen (PSA) levels from baseline, PSA progression-free survival, and postoperative treatment-free survival were recorded. (Results) We observed that 5 of 12 patients showed no metastases at the time of initial diagnosis, 2 had only regional lymph node metastases, and 5 had distant metastases. No patient showed identifiable metastases on imaging studies at the time of surgery. The median PSA value at the time of surgery was 0.47 ng/mL, and 5 patients had PSA values ≥1 ng/mL. All patients underwent laparoscopic cRP. Postoperative adverse events included Clavien-Dindo grade I complications in 4 and grade III complications in 1 patient; however, no patient developed rectal injury. Postoperative serum PSA levels were < 0.2 ng/mL in 8 of 12 patients (66.7%) and undetectable in 5 patients (41.7%). The median postoperative PSA progression-free survival and postoperative treatment-free survival were 12.4 and 14.5 months, respectively. (Conclusion) cRP was associated with a good anti-cancer effect in selected cases of CRPC and may serve as a potentially useful treatment option in this patient population.

(Objectives)The usefulness of partial nephrectomy for renal tumors has been highlighted in various guidelines. Since 2006, we have been actively performing laparoscopic partial nephrectomy for renal tumors. We investigated the postoperative recurrence of renal tumors diagnosed as renal cell carcinoma after laparoscopic partial nephrectomy. (Patients and methods)From August 2006 to March 2020, 320 patients who underwent laparoscopic partial nephrectomy at our hospital and were pathologically diagnosed with renal cancer were included. A retrospective statistical study was conducted to analyze the postoperative recurrence. (Results)Postoperative recurrence was observed in 11 patients (3.4%). The median time to recurrence was 12 months (3-26 months), non-distant metastasis was observed in four cases (1.3%), and distant metastasis was observed in seven cases (2.2%). No statistically significant difference was found in the factors related to recurrence, in this study. (Conclusions)In this study, no statistically significant factors were found, but the higher the clinical stage, the higher the recurrence rate.

Background/purpose: The purpose of the present study was to investigate the possibility of reducing clinical impacts of acute necrotic collection (ANC) on patients with acute pancreatitis (AP) using recombinant human soluble thrombomodulin (rTM)., Methods: In this retrospective multicenter study, 233 consecutive AP patients with ANC and acute peripancreatic fluid collection (APFC) from 2012 to 2016 were enrolled. To assess clinical impacts of ANC, severity on admission (JPN score, JPN CT grade, and Modified CT severity index), development of walled-off necrosis (WON), imaging costs for follow-up, and mortality were recorded. Finally, we investigated whether rTM could reduce the clinical impacts, adjusting the severity using propensity analysis with Inverse probability of treatment weighting., Results: Patients with ANC developed WON with higher ratio than APFC (58/98 [59.2%] vs 20/135 [14.8%], OR = 8.3, P < .01]. Severity on admission and imaging costs for follow-up in ANC patients were significantly higher than those in APFC (P < .01). However, regarding mortality, there was no significant difference between patients with ANC and APFC (P = .41). Adjusting severity, it was revealed that rTM administration significantly reduced the risk of ANC developed WON (OR = 0.23, P = .01)., Conclusions: While ANC had a higher clinical impact than that of APFC, we found that early administration of rTM may reduce the impact., (© 2021 Japanese Society of Hepato-Biliary-Pancreatic Surgery.)

The clinical outcome of laparoscopic radical prostatectomy (LRP) was retrospectively investigated taking into consideration the surgeon's position during the procedure. The study cohort included 184 consecutive patients who had undergone LRP performed by a single surgeon from February 2013 to July 2018. During the study period,the surgeon stood alternately on either the left or right side of the patient. The D'Amico risk classification was low,intermediate and high in 26 (14.1%),45 (24.5%) and 113 (61.4%) patients,respectively. Mean surgical duration was 203.5 minutes and mean estimated blood loss was 437.6 ml. Nerve sparing (NS) was implemented in 82 (44. 6%) patients. The mean period of having an indwelling urethral catheter was 5. 0 days. Perioperative Clavien-Dindo degree ≥IIIa complications occurred in three (1.6%) patients. Except for cases with presurgical hormonal treatment,surgical margins were positive in 41 (22.3%) patients,among whom 23 (17.4%) had pT2 disease. The 5-year biochemical recurrence-free survival rate was 81.4%,and 84.8% of patients regained urinary continence at 12 months after surgery. Where the surgeon stood during LRP was not associated with significant differences in any parameter. However,the margin positive rate was higher on the side away from where the surgeon stood than the side closer to the surgeon (70.7% vs 29.3%). In conclusion,the position of the surgeon during LRP does not influence the outcome.

A 57-year-old female presented with a chief complaint of odynophagia during medical treatment for systemic lupus erythematosus (SLE). Endoscopy revealed sloughed mucosa along the entire esophageal length, and normal mucosa was easily stripped by withdrawal of the biopsy forceps. Blistering eruptions subsequently appeared on her upper extremities, trunk, and oral cavity. Direct immunofluorescence of a skin biopsy specimen demonstrated linear deposits of IgG, IgM, and complement at the dermoepidermal junction. On the basis of these findings, a diagnosis of bullous SLE was made. This autoimmune blistering disease can occur in the course of SLE and is rarely accompanied by sloughing of the esophageal mucosa.

We describe the case of a 60-year-old man who presented at our hospital with abdominal pain and elevated hepatobiliary enzymes. Computed tomography showed portal thrombosis and cavernous transformation as well as increased wall thickness and a stricture in the biliary tract. At that time, the cause of the portal thrombosis was unknown. During follow-up, the blood cell counts (WBCs and platelets) were remarkably increased, and a test performed for the JAK2V617F mutation was positive. We diagnosed the patient with polycythemia vera. Our findings demonstrate that a patient presenting with portal thrombosis, portal biliopathy, and underlying myeloproliferative neoplasms should be carefully examined, even in the absence of the typical blood alterations.

A Japanese male in his 70s with chronic hepatitis C was diagnosed with diffuse large B-cell lymphoma and achieved and maintained complete remission following treatment with eight cycles of R-CHOP (rituximab, cyclophosphamide, doxorubicin hydrochloride, vincristine sulfate, and prednisolone). Seven years later, he received the direct-acting antivirals (DAAs) sofosbuvir/ledipasvir for hepatitis C virus (HCV) genotype 1b. Although the patient achieved sustained virological response immediately after the initial treatment period, laboratory data showed elevation of LD and soluble IL-2R. Computer tomography showed diffuse intraabdominal lymph node swelling and splenomegaly. Lymph node biopsy revealed the relapse of lymphoma. The lymphoma cells were resistant to chemotherapy, and the patient died five months later. Several studies reported early recurrence of hepatocellular carcinoma after HCV treatment using DAAs. However, the relationship between DAAs and hepatocellular carcinoma recurrence remains unclear. Nonetheless, possible cancer recurrence should be considered in patients with a history of lymphoma who are prescribed DAAs to treat HCV.

The purpose of this study was to clarify the association between dietary patterns and cognitive function in a community-dwelling population in Japan. A total of 388 volunteers (60 years and older) who participated in the Iwaki Health Promotion Project 2011 were recruited. Diet was assessed with a validated, self-administered brief-type diet history questionnaire. Dietary patterns were extracted from 52 predefined food groups by principal component analysis. The Mini-Mental State Examination was also used to measure global cognitive status. Three dietary patterns were identified as follows: "Healthy," "Noodle," and "Alcohol and accompaniment." Compared with the low tertile of the "Alcohol and accompaniment" pattern, only the middle tertile was independently related to an increased risk of poor cognitive function. In conclusions, present study failed to substantiate dose-dependent associations between dietary patterns and the risk of poor cognitive function. Further studies with longitudinal observations are warranted., (© 2013 APJPH.)

Background: Radiographic findings may provide clues to the underlying cause of neck symptoms. However, these associations remain controversial. This study investigates the association between roentgenographic findings of the cervical spine and neck symptoms in a Japanese community population., Methods: A total of 762 volunteers participated in this study. Sagittal radiographs of the cervical spine were taken and a questionnaire about the presence of and visual analog scale (VAS) for neck pain or stiff shoulder was completed. The sagittal alignment of the cervical spine (C2-C7) and the degenerative index were measured from lateral aspect radiographs. Three groups based on the sagittal alignment of C2-C7 were defined: straight-spine, lordotic-spine, and kyphotic-spine. The roentgenographic findings were examined in relation to symptoms., Results: The prevalence rate of stiff shoulder on the day of examination was significantly higher in females than males. Although the VAS for neck pain and stiff shoulder on the examination day and for stiff shoulder in the preceding 12 months were not significantly different between females and males, that for neck pain in the preceding 12 months was significantly higher in females than males. Although there was no association between the sagittal alignment of C2-C7 and neck symptoms in males or females, a significant correlation between the degenerative index and VAS for neck pain on the examination day and in the preceding 12 months was seen in females after adjusting for age. The prevalence of and VAS for neck pain and stiff shoulder were not significantly different among the three C2-C7 sagittal alignment groups., Conclusion: Although the sagittal alignment of the cervical spine was not associated with neck symptoms, degenerative changes were associated with the severity of neck pain in females.

Aim: The aim of this study was to investigate the association between subjective memory complaints (SMC) and sex., Methods: We researched the prevalence of SMC in a sample of 394 participants who were at least 60 years of age (138 male and 256 female). We also administered the Mini-Mental State Examination (MMSE) and the Center for Epidemiologic Studies for Depression (CES-D) scale. A multiple logistic regression analysis, which included SMC in association with the MMSE or CES-D scores and other confounding factors, was performed to determine the influence of sex on SMC. A P-value < 0.05 was considered statistically significant., Results: The durations of education of male participants were significantly higher than those of female participants. MMSE scores for female participants were significantly higher than those for male participants. There was no significant difference in CES-D scores between male and female participants. Twenty-four male participants and 72 female participants showed evidence of SMC. The incidence of SMC was more frequent in female participants than in male participants. In all participants, sex difference and CES-D score were significantly associated with SMC. In male participants, MMSE score was independently and significantly associated with SMC. Both in female participants and all participants, CES-D score was independently and significantly associated with SMC., Conclusion: SMC varied by sex and were associated with the degree of cognitive impairment in male participants, while they were associated with depressive symptoms in female participants.

The concept of peaking ensures that athletes have trained to attain their absolute peak performance levels prior to a competition. This study investigates the effects of peaking on the functions of neutrophils and lymphocytes in university soccer players during a five-day soccer training camp followed by two weeks of tapering. The study subjects were 22 soccer players who were members of a university soccer club. We carried out our investigation during a five-day training camp and two weeks after the training camp (i.e. the tapering period). We measured body composition, immune-related parameters (leukocyte count, neutrophil count, lymphocyte count, immunoglobulins and complements), myogenic enzymes, superoxide dismutase activity (SOD) and neutrophil functions [reactive oxygen species (ROS) production, phagocytic activity, serum opsonic activity and lymphocyte subtypes]. Leukocyte and neutrophil counts tend to increase after the training camp compared with values before the training camp, and recovered during the conditioning period, although the final values were still lower than those before the training camp. The amount of ROS production per neutrophil and level of SOD decreased significantly during the conditioning period compared with before the training camp (p < 0.05, p < 0.01, respectively). Levels of Th1 cells decreased significantly during the conditioning period compared with the training camp (p < 0.05). In conclusion, the period of two weeks for the tapering period was considered insufficient to allow the athletes' immune function to recover completely after an intensive training camp., (Copyright © 2013 John Wiley & Sons, Ltd.)

We assessed the association of neutrophil function with glycated hemoglobin (HbA1c) levels in a Japanese general population. Participants were 809 males and females who were over 20 years old living in the Iwaki region in Aomori Prefecture located in northern Japan. Lifestyle parameters (smoking, alcohol consumption, and exercise habits), HbA1c and neutrophil function such as reactive oxygen species (ROS) production capability and phagocytic activity (PA) were measured. ROS production capability was measured before and after phagocytic stimulus to obtain basal ROS production and stimulated ROS production. Level of HbA1c had a positive correlation with basal ROS production (p=0.053), a negative correlation with stimulated ROS production (p=0.072) and PA (p=0.059) only in post-menopausal groups, and not in pre-menopausal groups. However, there were no correlations between levels of HbA1c and neutrophil functions in male. In conclusion, in the present study, despite the presence of diabetes, chronic hyperglycemia was found to cause an increase in daily basal ROS production of neutrophils, and increased susceptibility to infection caused by reduced neutrophilic reaction in females in their menopause. Therefore, from the oxidative point of view, strict glycemic control is necessary to prevent post-menopausal females from developing diabetic complications in spite of the presence of diabetes., (Copyright © 2013 John Wiley & Sons, Ltd.)

In this study, changes in physical fatigue and biological functions of Japanese female soccer players were investigated by determining changes in neutrophil and lymphocyte functions. Study subjects included 18 female soccer players. Body composition, serum myogenic enzymes, neutrophil function, including reactive oxygen species (ROS) production capability, phagocytic activity (PA) and serum opsonic activity, as well as lymphocyte subpopulation were measured before and after a soccer match. Levels of myogenic enzymes (AST, ALT, CK and LDH) and immunoglobulins (IgG and IgA) and complements (C3) increased significantly after the match. In addition, leukocyte, neutrophils and lymphocyte counts increased whereas total PA decreased significantly. The number of T and Th1 cells (subsets of T helper cells) decreased whereas Th2 increased significantly. In addition, the number of B cells increased and NK cells decreased significantly after the match. The match was found to result in degenerative changes in and damage to athlete muscle tissues together with damage- and change-mediated stress. These data also suggest a post-match accelerated inflammatory reaction and potential immunosuppression as indicated by reductions in neutrophil PA and lymphocyte functions., (Copyright © 2012 John Wiley & Sons, Ltd.)

We examined changes in neutrophil function of soccer players over a 10-month period and determined its effectiveness as an index for athlete physical condition. Subjects included 21 male professional Japanese soccer players. Data on body composition, myogenic enzymes and neutrophil function were obtained before and after 2 h of training at 3 investigation points: one week before opening season, at season mid-point, and one week before the last game of the season. As a result, change ratios of myogenic enzyme levels before and after the 2-hr training session at the third investigation point were significantly higher compared to the two other points. Reactive oxygen species production and phagocytic activity significantly increased after 2-hr training session at point 1, although the extent of the increase became smaller over time and ROS production capability decreased significantly by point 3 assessment. Fatigue, especially muscle fatigue, chronically accumulated along with a gradual decrease in neutrophil immune function over the 10-month season. Therefore, determination of neutrophil function can be used as a useful index to assess and understand an athlete's physical condition., (Copyright © 2012 John Wiley & Sons, Ltd.)

We investigated the effects of dehydration after a judo practice session on player muscle and immune functions. Subjects included 25 female university judoists. Investigations were performed before and after 2.5 h of regular judo practice. Body composition, serum enzymes (myogenic enzymes, immunoglobulins and complements), neutrophils counts, reactive oxygen species (ROS) production capability, and phagocytic activity (PA) were measured. Subjects were divided into two groups according to level of dehydration after practice (mild dehydration and severe dehydration groups) and results were compared. Creatine kinase was found to increase significantly after practice. In addition, neutrophil count also increased significantly after practice in both groups. The changing ratios of IgA, IgG and C3 observed in the mild dehydration group were significantly higher than those in the severe dehydration group. In the severe dehydration group, post-practice PA/neutrophil had decreased significantly. Significant positive correlations were found between severity of dehydration and changing ratios of IgA, IgG, IgM, C3, C4 and ROS production capabilities, whereas no significant association was seen with PA and/or serum SOD activity. These results suggest that dehydration resulted in immunosuppression, including decreased neutrophil function., (Copyright © 2012 John Wiley & Sons, Ltd.)

We studied the effects of a high intensity and high frequency 3-month training program on muscle damage and neutrophil function in male judoists. The study included 15 male judoists who started intensive judo training program after a 6-month break. Creatine kinase (CK), neutrophil counts and reactive oxygen species (ROS) production capability as well as phagocytic activity (PA) of neutrophils were measured at 2 stages; entering university (pre-training) and after 3-month training (post-training). At both points, we investigated parameters three times: just before, immediately after and 24 h after a 2-h practice session. Practice-mediated change in CK was lower at post-training than at pre-training. Neutrophil count significantly increased after 2-h practice but recovered 24 h later whereas it showed no subsequent and further increased at 24 h post-practice. Although neutrophil ROS production capability and PA both decreased (breakdown) after practice session, ROS production capability increased and PA decreased (well-adapted) at the post-training. Long-term training strengthened muscular function and improved neutrophil reaction against practice-mediated stress., (Copyright © 2012 John Wiley & Sons, Ltd.)

Background: In Japan, the annual number of deaths by suicide markedly increased in 1998 and leveled off at approximately 30,000 per year thereafter. The coping behaviors used to deal with stress may have implications for the prevention of depression and suicidal ideation. This study examined coping behaviors in relation to depression and suicidal ideation., Methods: In this cross-sectional study, a total of 6762 workers (40-60 years of age; 4119 males and 2643 females) completed both the Center for Epidemiologic Studies Depression scale (CES-D) and a questionnaire measuring suicidal ideation. A cut-off score of 19 was used to define probable depression for the CES-D. Stress-coping behaviors were surveyed via an inventory of 14 items that reflected of actual behaviors covering problem-focused, emotion-focused, and avoidant strategies., Results: In relation to depression, logistic regression analyses revealed that in both genders, the highest odds ratios (OR) for avoidant coping strategy and the lowest OR was associated with a problem-focused strategy after adjusting for covariates. After making the same adjustments, logistic regression analyses revealed that in both genders, the highest OR were for emotional distraction coping strategies in relation to suicidal ideation., Limitations: The cross-sectional nature of this study does not allow for causal assumptions regarding the sequential nature of the relationship between coping behaviors and the onset of depressive symptoms or suicidal ideation., Conclusions: These findings indicate that coping behaviors may affect both depressive symptoms and suicidal ideation. Furthermore, gender differences in coping behaviors among middle-aged workers were identified. Additional studies are needed to examine the relationships among coping behaviors, depression and suicidal ideation using a longitudinal design., (Copyright © 2012 Elsevier B.V. All rights reserved.)

We have evaluated the relationship between exhaled carbon monoxide (CO) level and neutrophil-related functions such as reactive oxygen species (ROS) production capability, phagocytic activity and serum opsonic activity in the general population. Serum opsonic activity was determined by measuring the effects of serum on neutrophil ROS production capability using lucigenin- and luminol-dependent chemiluminescence (LgCL, LmCL). LgCL is associated with the detection of O(2)(-) , whereas LmCL mainly detects H(2)O(2) and HOCl, which are higher reactive oxygen radicals. In females, exhaled CO level was found to have positive associations with ROS production capability and LgCL. However, the opposite tendency was seen between exhaled CO level and LmCL in both genders. This result suggests that neutrophil ROS production in females may have contributed to oxidative stress, which led to the increases in intrinsic CO and exhaled CO consequently. Such changes then may have inhibited the process of changing reactive oxygen radicals into higher oxidizing potential levels., (Copyright © 2010 John Wiley & Sons, Ltd.)

Background and Aims: A number of previous studies had revealed the association between trace elements in serum and bronchial asthma. However, only a few researches had focused on serum concentration of trace elements in a general population. In this study, an association between trace elements in serum and bronchial asthma was investigated in a general population., Methods: Subjects were 1025 volunteers (385 males and 640 females between ages 19 and 82 years old) who had participated in the Iwaki Health Promotion Project 2005. Bronchial asthma was diagnosed based on the European Community Respiratory Health Survey II according to the self-questionnaires on health conditions of subjects. The serum concentrations of certain trace elements (manganese, copper, zinc, selenium and iron) were measured and compared. Also, an association between serum trace elements level and neutrophil-related functions (oxidative burst activity, phagocytic activity, serum opsonic activity) were determined., Results: In males, no significant differences were seen in any serum trace elements concentrations. In females, serum zinc level was significantly higher in bronchial asthma group than in control. A positive correlation was seen between serum concentration of zinc and serum opsonic activity in both genders., Conclusions: In female asthmatics, increase of oxidative stress was suggested to be caused by superoxide dismutase pathway (elimination system of reactive oxygen species) rather than serum opsonic activity (production system of reactive oxygen species from neutrophils) pathway, as the zinc concentration in bronchial asthma group was higher than that in control., (Copyright © 2010 Elsevier GmbH. All rights reserved.)

In this study, by partial sequence analysis of the genome segments encoding VP5* and VP7, we characterized a novel bovine group A rotavirus, namely, Tak2, that was detected from adult cattle diarrhea in Tochigi Prefecture, Japan. The nucleotide (nt) and deduced amino acid (aa) sequences of the genome segments encoding VP5* and half of the amino terminal portion of VP7 of Tak2 revealed a low identity with those of group A rotaviruses carrying previously published P and G type specificities (VP5*: nt identity, 61.6%-67.6% and aa identity, 58.0%-71.4%; half of the amino terminal portion of VP7: nt identity, 57.8%-73.5% and aa identity, 61.2%-70.9%). Additionally, phylogenetic analysis of the nt sequences of the genome segments encoding VP5* and half of the amino terminal portion of VP7 revealed that Tak2 formed a branch separate from the established P and G types. These results suggested that Tak2 could possess novel P and G types yet not reported among group A rotaviruses.

Managed care organizations strive to prevent illness where possible and improve patient outcomes for enrollees. The objective of this study was to examine how data from the Medical Outcomes Study Short Form-12 from more than 45,000 health plan enrollees can be used to: compare enrollee health status with national norms, examine the relationship between health status and member characteristics, and determine the extent to which health status is related to member satisfaction. The member survey measured physical and mental health and the following aspects of satisfaction: access, communication, and medical services. The researchers found that physical and mental health status were significantly associated with age, education, and ethnicity, whereas satisfaction was positively correlated with mental health status. Monitoring the health status of enrollees through the administration of a short, well-validated questionnaire can provide useful information in comparison with national norms as well as important insights regarding potential areas to target for quality improvement initiatives.