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Tetsuro Tominaga, Takashi Nonaka, Shosaburo Oyama, Yuma Takamura, Shintaro Hashimoto, Toshio Shiraishi, Terumitsu Sawai, Takeshi Nagayasu Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, JapanCorrespondence: Tetsuro Tominaga, Department of Surgical Oncology, Nagasaki University Graduate School of Biological Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan, Tel +81-95-819-7304, Fax +81-95-819-7306, Email tetsuro.tominaga@nagasaki-u.ac.jpPurpose: The prognostic value of neutrophil-to-lymphocyte ratio (NLR) has been studied for colorectal cancer. Elderly patients in general tend to have comorbidities and decreased organ function that potentially influence the NLR score. The aim of this study was to investigate the relationship between NLR and cancer-specific survival in elderly patients with colon cancer, using a propensity score-matched analysis.Patients and Methods: A total of 203 patients aged over 75 years who underwent curative resection for colon cancer and were diagnosed pathologically with stage II/III disease were eligible for entry to the study. Patients were divided into two groups according to NLR score: NLR-High (NLR≥ 4.5) group (NLR-H, n=60) and NLR-Low (NLR< 4.5) group (NLR-L, n=143). After propensity score matching, 57 patients in each group were matched.Results: Before matching, Charlson comorbidity index was significantly higher in the NLR-H group (4 vs 2, p< 0.001). After matching, all factors were similar between the groups. The median follow-up period was 43 months (range, 1– 160 months). Five-year relapse-free-survival (69.8% vs 87.3%, p=0.030) and cancer-specific survival (83.0% vs 96.0%, p=0.042) were significantly lower in the NLR-H group.Conclusion: NLR appears to be a cancer-specific prognostic marker in elderly patients with colon cancer.Keywords: cancer-specific survival, colon cancer, neutrophil-to-lymphocyte ratio

Kazuaki Suyama, Ryo Kozu, Takako Tanaka, Yuji Ishimatsu, Terumitsu Sawai Department of Cardiopulmonary Rehabilitation Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan Background: The impact of airway obstruction of nonsmoking women caused by their husband’s smoking is unclear, despite the association between environmental tobacco smoke (ETS) exposure at home and obstructive pulmonary diseases among nonsmoking women. The aim of this study was to provide evidence that ETS exposure from the husband at home has a more significant influence on the airway obstruction of nonsmoking women than other housemates. Participants and methods: Nonsmoking women aged 40 years or older were recruited from the health checkup during May 2015–December 2016, Japan. They answered structured questionnaires, including ETS exposure from their husbands and other housemates (parents, siblings and dependants), and performed spirometry. We categorized the women with any history of ETS exposure from housemates into three groups (A = husband, B = others and C = both of husband and others) and defined the control group as those with no ETS exposure from housemates. Results: A total of 811 nonsmoking women completed questionnaires and spirometry. The proportion of nonsmoking women who had airway obstruction (forced expiratory volume in 1 second [FEV1]/forced vital capacity [FVC]

Yuichi Tawara,1 Hideaki Senjyu,1 Kenichiro Tanaka,1 Takako Tanaka,1 Masaharu Asai,1 Ryo Kozu,2 Mitsuru Tabusadani,3 Sumihisa Honda,1 Terumitsu Sawai1 1Department of Cardiopulmonary Rehabilitation Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; 2Department of Rehabilitation Medicine, Nagasaki University Hospital, Nagasaki, Japan; 3Center for Industry, University and Government Cooperation, Nagasaki University, Nagasaki, Japan Objective: We established a COPD taskforce for early detection, diagnosis, treatment, and intervention. We implemented a pilot intervention with a prospective and longitudinal design in a regional city. This study evaluates the usefulness of the COPD taskforce and intervention based on COPD case detection rate and per capita medical costs.Method: We distributed a questionnaire to all 8,878 inhabitants aged 50–89 years, resident in Matsuura, Nagasaki Prefecture in 2006. Potentially COPD-positive persons received a pulmonary function test and diagnosis. We implemented ongoing detection, examination, education, and treatment interventions, performed follow-up examinations or respiratory lessons yearly, and supported the health maintenance of each patient. We compared COPD medical costs in Matsuura and in the rest of Nagasaki Prefecture using data from 2004 to 2013 recorded by the association of Nagasaki National Health Insurance Organization, assessing 10-year means and annual change.Results: As of 2014, 256 people have received a definitive diagnosis of COPD; representing 31% of the estimated total number of COPD patients. Of the cases detected, 87.5% were mild or moderate in severity. COPD medical costs per patient in Matsuura were significantly lower than the rest of Nagasaki Prefecture, as was rate of increase in cost over time.Conclusion: The COPD program in Matsuura enabled early detection and treatment of COPD patients and helped to lower the associated burden of medical costs. The success of this program suggests that a similar program could reduce the economic and human costs of COPD morbidity throughout Japan. Keywords: chronic obstructive pulmonary disease, systematic intervention, case detection rate, medical cost, longitudinal study

Eriko Takatori,1 Tadahiro Shoji,1 Takashi Sawai,2 Akira Kurose,3 Toru Sugiyama11Department of Obstetrics and Gynecology, 2Department of Pathology, Iwate Medical University, Morioka, Japan; 3Department of Anatomic Pathology, Hirosaki University, Hirosaki, JapanBackground: Differences in the incidence and type of DNA damage induced by antitumor agents for ovarian clear-cell carcinoma (CCC) were determined in two CCC cell lines, using γH2AX.Materials and methods: The antitumor activity of gemcitabine (GEM) and carboplatin (CBDCA) were examined using cultured cell lines of CCC (OVISE and RMG-I). Each cell line was treated with GEM and CBDCA, the cells were collected, fixed, and then reacted with anti-γH2AX antibody. γH2AX and nuclear DNA were then simultaneously detected by flow cytometry using fluorescein isothiocyanate and propidium iodide, respectively, to determine the amounts of γH2AX formed in each cell-cycle phase.Results: After administration of GEM, both cell lines showed DNA damage and cell-cycle arrest in the S and G2/M phases, and increased apoptosis. Similarly, with CBDCA, OVISE showed S- and G2/M-phase arrest, while RMG-I showed G2/M-phase arrest.Conclusion: The mechanism of action of GEM and CBDCA in CCC cell lines was elucidated using γH2AX as a DNA damage marker. Our findings suggested that concomitant use of GEM plus CBDCA may be effective in the treatment of CCC.Keywords: γH2AX, clear-cell carcinoma, ovarian cancer, DNA damage, apoptosis, gemcitabine, carboplatin