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Examines the therapeutic effect of sitafloxacin on the catheter-associated urinary tract infection model. Materials and methods; Results.

Using Japanese professional chess (Shogi) players' records in the setting where various external factors are controlled in deterministic and finite games, this paper examines how and the extent to which the emergence of technological changes influences the ageing and innate ability of players' winning probability. We gathered games of professional Shogi players from 1968 to 2019, which we divided into three periods: 1968-1989, 1990-2012 (the diffusion of as information and communications technology (ICT)) and 2013-2019 (artificial intelligence (AI)). We found (1) diffusion of AI reduces the impact of innate ability in players performance. Consequently, the performance gap among same-age players has narrowed; (2) in all the periods, players' winning rates declined consistently from 20 years and as they get older; (3) AI accelerated the ageing decline of the probability of winning, which increased the performance gap among different aged players; (4) the effects of AI on the ageing decline and the probability of winning are observed for high innate skill players but not for low innate skill ones. The findings are specific to Shogi as a kind of board games although it is valuable to examine the extent to which the findings hold for other labor market., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 YAMAMURA, HAYASHI. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Teachers in Japanese schools employ alphabetical surname lists that call students sooner, with surnames appearing early on these lists. We conducted Internet surveys nearly every month from March 2020 to September 2022 with the same participants, wherein we asked participants where the alphabetical columns of their childhood and adult surnames were located. We aimed to identify how surname order is important for the formation of noncognitive skills. During the data collection period, the COVID-19 vaccines became available; Japanese people could receive their third dose starting in December 2021. The 19th wave of the survey was conducted in January 2022. Therefore, to examine how a surname's alphabetical order could influence intention to revaccinate, we used a subsample of data from December 2021 to September 2022. The major findings were as follows. Women with early surnames had an approximately 4% stronger likelihood of having such intentions than men with early surnames. Early name order was more strongly correlated with revaccination intention among women than among men. The surname effect for women was larger when a mixed-gender list was used compared with when it was not used. This effect was only observed for childhood surnames and not for adult surnames., (© 2024. The Author(s).)

Vaccination has been promoted to mitigate the spread of the coronavirus disease 2019 (COVID-19). Vaccination is expected to reduce the probability of and alleviate the seriousness of COVID-19 infection. Accordingly, this might significantly change an individual's subjective well-being and mental health. We observed the same individuals on a monthly basis from March 2020 to September 2021 in all parts of Japan. Then, large sample panel data (N = 54,007) were independently constructed. Using the data, we compared the individuals' perceptions of COVID-19, subjective well-being, and mental health before and after vaccination. Furthermore, we compared the effect of vaccination on the perceptions of COVID-19 and mental health for females and males. We used the fixed-effects model to control for individual time-invariant characteristics. The major findings were as follows: First, the vaccinated people perceived the probability of getting infected and the seriousness of COVID-19 to be lower than before vaccination. This was observed not only when we used the whole sample but also when we used subsamples of males and a subsample of females. Second, subjective well-being and mental health improved. The same results were also observed using the subsample of females, whereas the improvements were not observed when using a subsample of males. This implies that females' quality of life was more likely to be improved by vaccination than males' one. The novelty of the work is to show the gender difference in the vaccination effects.

The coronavirus (COVID-19) vaccine is key to reducing the probability of contracting COVID-19. The vaccine is generally known to prevent severe illness, death, and hospitalization as a result of the disease and for considerably reduce COVID-19 infection risk. Accordingly, this might significantly change an individual's perceived risk of altering everyday behaviors. For instance, the proliferation of vaccination is anticipated to reduce preventive behaviors such as staying at home, handwashing, and wearing a mask. We corresponded with the same individuals monthly for 18 months from March 2020 (early stage of COVID-19) to September 2021 in Japan to independently construct large sample panel data (N = 54,007), with a participation rate of 54.7%. We used a fixed effects model, controlling for key confounders, to determine whether vaccination was associated with a change in preventive behaviors. The major findings are as follows. Contrary to the prediction, (1) based on the whole sample, being vaccinated against COVID-19 led people to stay at home; however, it did not change the habit of handwashing and wearing a mask. Especially after the second shot, respondents were likelier to stay at home by 0.107 (95% CIs: 0.059-0.154) points on a 5-point scale compared to before the vaccination. Dividing the entire sample into young and old, (2) those aged ≤ 40 years were more likely to go out after being vaccinated, and (3) people over 40 years of age were more likely to stay at home (similar to the first result). Preventive behaviors impact all individuals during the current pandemic. Informal social norms motivate people to increase or maintain preventive behaviors even after being vaccinated in societies where these behaviors are not enforced.

This study applies the difference-in-difference method on panel data collected from internet surveys to investigate changes in the preventive behaviors and mental health of individuals as influenced by the COVID-19 state of emergency declaration between March and June 2020. The key findings are: (1) The declaration led people to exhibit preventive behaviors but also generated negative emotions; (2) Such behaviors persisted even after deregulation of the state of emergency; (3) Making the declaration early (vs. late) had a larger effect on preventive behavior, with the gap between residents' behaviors for areas that made early vs. late declarations persisting after the deregulation; and (4) The effects on mental health diminished during the state of emergency and disappeared after its deregulation., (© 2022 The Authors.)

Using a large sample of individual-level records in Japan speedboat racing where men and women racers participate, we investigated how racers' performance meets fans' pre-race expectations. To control for endogeneity bias, we measured the order of racers' attractiveness randomly determined in each race and then used this order as instrument for measuring racers' popularity. The fixed-effects IV estimations revealed the following. (1) Racers who are more attractive than their competitors tend to be more popular even after controlling for the condition of the race, racer ability, and other characteristics. (2) More popular men show better performance in the race even if the reward does not vary according to popularity; such tendency is not observed for women. This study contributes a novel setting for determining the expectation-enhancing effects of physical attractiveness., (© Japanese Economic Association 2020.)

This study investigates how people in Japan perceived the severity of and probability of infection from coronavirus disease 2019 (COVID-19), and how their willingness to purchase a hypothetical vaccine depends on these perceptions and their risk attitudes. We conducted a large-scale panel survey three times between 13 March to 13 April 2020 in Japan. By analyzing the data, we found that the perception of COVID-19 became more serious. The estimation of the fixed effect model reveals that a person becomes more willing to pay for a vaccine as the person evaluates COVID-19 as a more severe disease, considers a higher probability of infection, and becomes more risk averse. Since the sensitivity of willingness to pay for the vaccine on risk aversion increased during the period, the change in risk attitude contributed to an increase in willingness through the sensitivity channel, while it decreased through the magnitude channel.

Background: Ames test is used worldwide for detecting the bacterial mutagenicity of chemicals. In silico analyses of bacterial mutagenicity have recently gained acceptance by regulatory agencies; however, current in silico models for prediction remain to be improved. The Japan Pharmaceutical Manufacturers Association (JPMA) organized a task force in 2017 in which eight Japanese pharmaceutical companies had participated. The purpose of this task force was to disclose a piece of pharmaceutical companies' proprietary Ames test data., Results: Ames test data for 99 chemicals of various chemical classes were collected for disclosure in this study. These chemicals are related to the manufacturing process of pharmaceutical drugs, including reagents, synthetic intermediates, and drug substances. The structure-activity (mutagenicity) relationships are discussed in relation to structural alerts for each chemical class. In addition, in silico analyses of these chemicals were conducted using a knowledge-based model of Derek Nexus (Derek) and a statistics-based model (GT1_BMUT module) of CASE Ultra. To calculate the effectiveness of these models, 89 chemicals for Derek and 54 chemicals for CASE Ultra were selected; major exclusions were the salt form of four chemicals that were tested both in the salt and free forms for both models, and 35 chemicals called "known" positives or negatives for CASE Ultra. For Derek, the sensitivity, specificity, and accuracy were 65% (15/23), 71% (47/66), and 70% (62/89), respectively. The sensitivity, specificity, and accuracy were 50% (6/12), 60% (25/42), and 57% (31/54) for CASE Ultra, respectively. The ratio of overall disagreement between the CASE Ultra "known" positives/negatives and the actual test results was 11% (4/35). In this study, 19 out of 28 mutagens (68%) were detected with TA100 and/or TA98, and 9 out of 28 mutagens (32%) were detected with either TA1535, TA1537, WP2uvrA, or their combination., Conclusion: The Ames test data presented here will help avoid duplicated Ames testing in some cases, support duplicate testing in other cases, improve in silico models, and enhance our understanding of the mechanisms of mutagenesis., (© 2021. The Author(s).)

Asian soybean rust (ASR) caused by Phakopsora pachyrhizi , an obligate biotrophic fungal pathogen, is the most devastating soybean production disease worldwide. Currently, timely fungicide application is the only means to control ASR in the field. We investigated cellulose nanofiber (CNF) application on ASR disease management. CNF-treated leaves showed reduced lesion number after P. pachyrhizi inoculation compared to control leaves, indicating that covering soybean leaves with CNF confers P. pachyrhizi resistance. We also demonstrated that formation of P. pachyrhizi appressoria, and also gene expression related to these formations, such as chitin synthases ( CHSs ), were significantly suppressed in CNF-treated soybean leaves compared to control leaves. Moreover, contact angle measurement revealed that CNF converts soybean leaf surface properties from hydrophobic to hydrophilic. These results suggest that CNF can change soybean leaf surface hydrophobicity, conferring resistance against P. pachyrhizi , based on the reduced expression of CHSs , as well as reduced formation of pre-infection structures. This is the first study to investigate CNF application to control field disease., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Saito, Yamashita, Sakata, Ishiga, Shiraishi, Usuki, Nguyen, Yamamura and Ishiga.)

COVID-19 has led to the closure of various schools in Japan to cope with the pandemic. This study explores how school closure influences parents' work style based on short panel data for the period of school closure from mid-March to mid-April 2020. Specifically, we analyze how the presence of their children influences parents' work at home and examine how the effect differs by the parent's gender. After controlling for various factors, we find that in cases where parents are full-time employees and the children are: (1) in primary school, mothers are more likely to work remotely, while fathers are less likely to do so and (2) in junior high school, the parents' work styles are hardly affected. This shows that mothers shoulder the burden of working remotely and caring for small children at home, while fathers tend to work in the office and spend less time with their childcare at home. Inevitably, COVID-19 has increased the inequality in the burden of child care., Competing Interests: Conflicts of interestThe authors declare that they have no conflict of interest., (© The Author(s) 2021, corrected publication 2021.)

The spread of the novel coronavirus disease caused schools in Japan to close to cope with the pandemic. In response to the school closures, parents of students were obliged to care for their children during the daytime, when children usually were at school. Did the increase in the burden of childcare influence parents' mental health? Based on short panel data from mid-March to mid-April 2020, we explore how school closures influenced the mental health of parents with school-aged children. Using a fixed-effects model, we find that school closures led to mothers of students suffering from worse mental health compared to other females, while the fathers' mental health did not differ from that of other males. This tendency is only observed for less-educated mothers who had children attending primary school, not for those with children attending junior high school nor for more-educated mothers. The contribution of this paper is showing that school closures increased the inequality of mental health between genders and parents with different educational backgrounds., Competing Interests: Conflict of interestThe authors declare no competing interests., (© The Author(s) 2021.)

Pancreatic schwannoma is difficult to diagnose preoperatively. A 79-year-old man was found to have a 9-mm pancreatic mass on abdominal ultrasonography. On EUS, there was a 9-mm, clearly demarcated, round, solid, hypo-echoic mass in the pancreatic body. The differential diagnosis included a pancreatic neuroendocrine tumor, a solid-pseudopapillary neoplasm, and an atypical pancreatic cancer. EUS-FNA was performed with a 22G needle. On pathology examination, spindle-shaped tumor cells were seen proliferating in bundles. On immunostaining, the lesion was negative for c-kit, CD34, and α-SMA but positive for S-100 protein. The MIB-1 index was < 2%. Based on the above findings, the lesion was diagnosed as a benign pancreatic schwannoma. We, therefore, decided to follow the patient with careful observation rather than resecting the lesion surgically. The tumor has not changed significantly after 3 years of follow-up. EUS-FNA is useful for the diagnosis of pancreatic schwannoma. If the tumor can be determined to be benign preoperatively, unnecessary surgery can be avoided. EUS-FNA should be actively implemented for pancreatic tumors that are difficult to diagnose definitively on imaging.

A 66-year-old man who was on oral medication for type 2 diabetes experienced a rapid decline in glycemic control (increase in glycosylated hemoglobin level from 7.7 to 10.2% over 3 months). Abdominal ultrasonography revealed a 20-mm hypoechoic mass in the pancreatic tail. Serum tumor marker carbohydrate antigen 19-9 and DUPAN2 levels were within the respective normal ranges; serum IgG4 level was also normal at 21.8 mg/dL. Abdominal contrast computed tomography revealed a 26-mm tumor in the pancreatic tail. Magnetic resonance cholangiopancreatography revealed disruption of the main pancreatic duct and dilation of the caudal pancreatic duct. Endoscopic ultrasonography revealed a near-round-shaped hypoechoic mass with interspersed hyperechoic areas. Endoscopic ultrasonography-guided fine needle aspiration was performed using a 22-G needle, but no malignant findings were observed. There were no signs of sialadenitis, retroperitoneal fibrosis, nephropathy, or other conditions associated with IgG4-related diseases. Distal pancreatectomy was performed; a 23-mm white mass was resected from the pancreatic tail. A histopathological examination showed advanced inflammatory cell infiltration mainly involving lymphocytes/plasma cells along with storiform fibrosis and obliterative phlebitis. No more than five IgG4-positive cells were observed per high-power field. These were level 1 pathological findings, and a definitive diagnosis of type 1 autoimmune pancreatitis (AIP) was made according to the International Consensus Diagnostic Criteria. Type 1 AIP associated with normal serum IgG4 levels and absence of IgG4-positive cells on histological examination is a rare clinical entity, which is very difficult to distinguish from pancreatic cancer. Here we report such a case and present a review of the relevant literature.

Anaplastic pancreatic carcinoma is a rare form of pancreatic cancer with an extremely poor prognosis. Its diagnosis is often based on surgical specimens and few reports have described the use of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for diagnosis. In this study, we examined six patients (mean age, 70.5 years;sex ratio, 1:1) who were diagnosed with anaplastic pancreatic carcinoma using EUS-FNA. The carcinomas were located in the pancreatic head, body, and tail in one, three, and two patients, respectively. The mean tumor diameter was 49.2mm. Five patients opted for best supportive care due to poor performance status and one underwent chemotherapy (GEM+nab-PTX). The median survival was 40.5 (14-98) days. The characteristic imaging findings of anaplastic pancreatic carcinoma, including central necrosis, marginal contrast enhancement, cystic findings, and internal calcification, were frequently observed in the patients. Anaplastic pancreatic carcinoma can also be diagnosed using biopsy tissue;however, a pathologist's consultation is required to differentiate the disease based on imaging findings for an accurate diagnosis.

Background and Study Aims:  In endoscopic retrograde cholangiopancreatography (ERCP), precutting is widely used when achieving biliary cannulation is difficult. However, no consensus has been reached with regard to the best time to initiate precutting., Patients and Methods:  We retrospectively examined 63 patients who underwent precutting for naïve papilla with difficulty in biliary cannulation between 2009 and 2016. The outcomes of the early precut group (≤ 20 min from cannulation until initiating precutting) and the late precut group (> 20 min) were compared., Results:  Of the 63 patients, 17 (27 %) were in the early precut group and 46 (73 %) were in the late precut group; median time until the initiating precutting was 28 minutes (7 - 50). No significant difference was observed between the two groups in terms of clinical features (age, sex, and indication for ERCP), precutting method, and rate of pancreatic duct stent placement. Significantly higher rates of successful biliary cannulation were observed in the early precut group (16/17; 94 %) than in the late precut group (32/46; 70 %) ( P  < 0.05). In 13 patients in whom precutting was commenced after 40 minutes, the rate of successful biliary cannulation was very low at 53 % (7/13). No significant difference was found between the two groups in terms of incidence of complications (pancreatitis in 5 patients and bleeding in 1 patient)., Conclusion:  In actual clinical practice, precutting is commenced approximately 30 minutes after cannulation; however, to successfully achieve biliary cannulation, precutting is recommended to be performed within 20 minutes. Precutting is effective when little inflammation and swelling of the ampulla of Vater is observed. This study was limited in that it was single-center, retrospective and had a small subject sample.

Objectives: Heat stroke is a life-threatening condition with high mortality and morbidity. Although several cooling methods have been reported, the feasibility and safety of treating heat stroke using intravascular temperature management are unclear. This study evaluated the efficacies of conventional treatment with or without intravascular temperature management for severe heat stroke., Design: Prospective multicenter study., Setting: Critical care and emergency medical centers at 10 tertiary hospitals., Patients: Patients with severe heat stroke hospitalized during two summers., Interventions: Conventional cooling with or without intravascular temperature management., Measurements and Main Results: Cooling efficacy, Sequential Organ Failure Assessment score, occurrence rate of serious adverse events, and prognosis based on the modified Rankin Scale and Cerebral Performance Category. Patient outcomes were compared between five centers that were prospectively assigned to perform conventional cooling (control group: eight patients) and five centers that were assigned to perform conventional cooling plus intravascular temperature management (intravascular temperature management group: 13 patients), based on equipment availability. Despite their higher initial temperatures, all patients in the intravascular temperature management group reached the target temperature of 37°C within 24 hours, although only 50% of the patients in the control group reached 37°C (p < 0.01). The intravascular temperature management group also had a significant decrease in the Sequential Organ Failure Assessment score during the first 24 hours after admission (4.0 vs 1.5; p = 0.04). Furthermore, the intravascular temperature management group experienced fewer serious adverse events during their hospitalization, compared with the control group. The percentages of favorable outcomes at discharge and 30 days after admission were not statistically significant., Conclusions: The combination of intravascular temperature management and conventional cooling was safe and feasible for treating severe heat stroke. The results indicate that better temperature management may help prevent organ failure. A large randomized controlled trial is needed to validate our findings.

Introduction: We examined the correlation between the results of in vitro and in vivo chromosomal damage tests by using in-house data of 18 pharmaceutical candidates that showed positive results in the in vitro chromosomal aberration or micronucleus test using CHL/IU cells, and quantitatively analyzed them especially in regard to exposure levels of the compounds., Findings: Eight compounds showed that the exposure levels [maximum plasma concentration (C max ) and AUC 0-24h ] were comparable with or higher than the in vitro exposure levels [the lowest effective (positive) concentration (LEC) and AUC vitro  = LEC (μg/mL) × treatment time (h)]. Among them, 3 compounds were positive in the in vivo rodent micronucleus assays using bone marrow cells. For 2 compounds, cytotoxicity might produce false-positive results in the in vitro tests. One compound showed in vitro positive results only in the condition with S9 mix which indicated sufficient concentration of unidentified active metabolite(s) might not reach the bone marrow to induce micronuclei., Conclusion: These facts suggested that the in vivo exposure levels being equal to or higher than the in vitro exposure levels might be an important factor to detect in vivo chromosomal damage induced by test chemicals., Competing Interests: Animal experiments were conducted in accordance with the rules of animal welfare in the testing facilities and approved by the ethical committee.Not applicable.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This paper explores how the role of men and women's height in the marriage market has changed across generations. Using individual-level data from Japan, we compared the effect of height on marriages between men and women, and investigated how the effect of height on marriage has changed across generations. Our key findings are: (1) for men born before 1965, a 1% increase in height led to an approximately 0.56% increase in the probability of being married. Conversely, for women born before 1965, a 1% increase in height led to an approximately 0.56% decrease in the probability of being married. (2) For men born in or after 1965, a 1% increase in height led to an approximately 1.05% (0.18%) increase (decrease) in the probability of being married (divorced). However, the height effect was not present for women. Japan experienced astounding economic development after World War II, which resulted in changes in its economic and social structure. These changes may have also altered the role of height for Japanese men and women in the marriage market., (Copyright © 2017 Elsevier B.V. All rights reserved.)

The patient was a 60-year-old man without any particular complaints, but he underwent abdominal computed tomography (CT) and magnetic resonance cholangiopancreatography (MRCP) due to a fatty liver, which revealed two similar cystic lesions regarded as branch duct-type intraductal papillary mucinous neoplasm (BD-IPMN) in the pancreatic body [BD-IPMN (b), 16 mm in size] and tail [BD-IPMN (t), 13 mm in size] without a "high-risk stigmata" or "worrisome features". He subsequently received follow-up by MRCP every 6 months. Two years later, MRCP showed prominent dilation of the main pancreatic duct (MPD) and mural nodule formation within the dilated MPD adjacent to the BD-IPMN (b). Distal pancreatectomy specimens revealed that the BD-IPMN (b) was lined by low-papillary gastric mucinous epithelium with low-to-intermediate-grade dysplasia and involved the MPD, forming a malignant mural nodule showing pancreatobiliary-type IPMN. In contrast, the BD-IPMN (t) was lined by flat, monolayer columnar gastric mucinous epithelium without atypia, which suggested the possibility of a "simple mucinous cyst". A genetic analysis showed KRAS mutation only in BD-IPMN (b). Differences in the histological and genetic findings between two similar BD-IPMNs in the present case may suggest what kinds of examinations should be performed in patients with BD-IPMNs without any worrisome features.

Background: Emphysematous liver abscesses are defined as liver abscesses accompanied by gas formation. The fatality rate is extremely high at 27%, necessitating prompt intensive care., Case Presentation: The patient was a 69-year-old Japanese man with type 2 diabetes. He visited the emergency outpatient department for fever and general malaise that had been ongoing for 2 weeks. Abdominal computed tomography revealed an abscess 5 cm in diameter accompanied by gas formation in the right hepatic lobe. Markedly impaired glucose tolerance was observed with a blood sugar level of 571 mg/dL and a glycated hemoglobin level of 14.6%. The patient underwent emergency percutaneous abscess drainage, and intensive care was subsequently initiated. Klebsiella pneumoniae was detected in both the abscess cavity and blood cultures. The drain was removed 3 weeks later, and the patient was discharged., Conclusion: Emphysematous liver abscesses are often observed in patients with poorly controlled diabetes, and the fatality rate is extremely high. Fever and malaise occasionally mask life-threatening infections in diabetic patients, necessitating careful examination.

Helium is a colorless, tasteless, and odorless gas that is used as a lifting gas for air balloons and small airships due to its high level of safety. In recent years, it has become easy to search the Internet for methods to commit suicide, and the use of helium gas for this purpose has recently been garnering attention. We report a case of a male in his 30's in which helium gas was used to commit suicide. He was found unconscious on a bed with a plastic bag covering his head. When emergency personnel arrived at the scene, he was in cardiac arrest and remained in cardiac arrest at the time of his arrival at the hospital. Continued cardiopulmonary resuscitation resulted in a return of spontaneous circulation. Head computed tomography showed the corticomedullary border was indistinct. Fifteen hours at the hospital, the patient died. Recently, there has been an increasing trend for suicide being performed according to methods obtained through the Internet or mass media. Although there are only a few cases of suicide by helium gas in Japan, attention must be paid to this issue as the number of such cases may increase in the future.

The case patient was a previously healthy 82-year-old male. Abdominal ultrasound during a medical check-up revealed a dilatation of the main pancreatic duct, and the patient was referred to our hospital for closer examination. Contrast-enhanced computed tomography (CT) revealed a low-density mass of 20 mm in the pancreatic head-body transitional area. Magnetic resonance cholangiopancreatography (MRCP) revealed marked dilatation of the main pancreatic duct and branches in the body-tail. On endoscopic ultrasonography (EUS), a hypoechoic mass with irregular shape was detected, which was consistent with the area of pancreatic duct stenosis. Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) and pancreatic juice cytology were performed; however, there were no malignant findings. Serum IgG4 levels had increased to 299 mg/dL. Cancer of the pancreatic head was suspected and a pancreaticoduodenectomy was thus performed. Macroscopic findings included a white mass with indistinct border in the constricted part of the pancreatic duct and mottled fatty replacement of the pancreatic head. Pathologically, a large amount of IgG4-positive plasma cells was found in the white mass, with storiform fibrosis and obstructive phlebitis, which led to the diagnosis of type 1 autoimmune pancreatitis (AIP). Furthermore, scattered low-high grade pancreatic intraepithelial neoplasia lesions were observed throughout the pancreatic head, separately from the AIP lesion. This is an interesting case that suggests an association between AIP and pancreatic cancer. We report the case with a review of relevant literature.

Background and Study Aims: Gallstone impaction at the ampulla of Vater is a critical condition, and the standard treatment is endoscopic papillotomy. However, the clinical features remain largely unclear, and some patients are reluctant to undergo papillotomy because of a bleeding tendency. The aim of this study was to clarify the clinical features of gallstone impaction at the ampulla of Vater and to examine the effectiveness of endoscopic biliary drainage without papillotomy., Patients and Methods: We retrospectively examined 30 patients who had undergone endoscopic treatment for gallstone impaction at the ampulla of Vater between 2010 and 2015., Results: According to the severity classification for acute cholangitis in the Tokyo Guidelines (TG13), the condition was mild in 8 patients, moderate in 14, and severe in only 8 (27 %), despite the stone impaction at the ampulla of Vater. Hyperamylasemia was observed in 18 patients (60 %); computed tomography (CT) revealed clear pancreatitis in 5 cases (17 %). Patients were classified into Group A (13 patients who received biliary drainage with papillotomy) and Group B (17 patients receiving biliary drainage without papillotomy). All patients in Group B had 1 or more types of hemorrhage risk. There were no differences between the 2 groups in the success rate of biliary drainage, the rate of elevated serum amylase the following day, or procedure-related complications. Serum amylase levels decreased the following day in all patients, even in Group B (including the 10 patients with hyperamylasemia and the 3 patients with clear pancreatitis on CT)., Conclusions: Even with stone impaction at the ampulla of Vater, typical clinical features of cholangitis and pancreatitis are relatively rare. Biliary drainage without papillotomy is acceptable for gallstone impaction at the ampulla of Vater.

This study used prefecture-level panel data from Japan for the period 2008-2014 to investigate the influence of the 2011 Fukushima nuclear accident on the body mass index (BMI) z-score and obesity rates of children over time. I adopted a difference-in-differences approach and found the following: (1) for the cohort aged 5-7 years in 2010, the BMI z-score and obesity rates in disaster-affected areas were higher than in other areas, although this was not observed for the other cohorts; (2) for the cohort aged 5-7 years in 2010, the influence of the accident persisted even after 3 years; and (3) the differences in the BMI z-score and obesity rate before and after the accident were greater for Fukushima Prefecture than for the other affected areas (Iwate and Miyagi prefectures). I infer that health-conscious parents, whose children had lower BMIs, may have moved from Fukushima, thereby increasing the BMI z-score of the child population living in Fukushima by around 0.05 for the cohort aged 5-7 years. The enforced reduction in physical activity increased the BMI z-score of children living in Fukushima by around 0.19 for that cohort., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Background. WGC in ERCP is considered a safe technique, although rare complications can occur. One unique complication of WGC is the perforation of the papilla of Vater by the guidewire. Subjects and Methods. Of 2032 patients who underwent ERCP at our department between January 2010 and December 2014, we selected 208 patients who underwent WGC for naïve papilla as subjects. A detailed examination of patients in whom a perforation occurred was conducted, and risk factors for perforations were investigated. Results. The perforation was observed in 7 of 208 patients (3.4%). All patients recovered with conservative treatment without the need for surgery. The perforation rate was significantly higher in the patients with juxtapapillary duodenal diverticula than those without diverticula (12.5% versus 0.6%, p < 0.001). Cannulation of the bile duct was ultimately achieved in 5 of 7 patients; PSP was performed for 4 of these patients. Conclusion. Caution must be exercised when dealing with patients who have a juxtapapillary duodenal diverticula because they are at higher risk of perforations. Because these are small perforations made by a wire, most of them heal with conservative treatment. However, perforations can make cannulation difficult, and PSP may be useful for deep cannulation.

A 49-year-old woman diagnosed with pseudomembranous enterocolitis was transferred to our hospital for medical treatment. She responded poorly to treatment with vancomycin hydrochloride and metronidazole, so she underwent fecal microbiota transplantation. Treatment effects were observed the next day, and the diarrhea disappeared within 3 days. Colonoscopy 4 days later revealed the resolution of pseudomembranes, and no recurrences were reported within the first year after discharge.

It is well known that height is positively associated with earnings. Based on individual level data, this paper investigates the channels through which height influences income in China. Our first key finding is that for males (females) a 1 centimeter (cm) increase in height leads to a 0.5% (0.02%) increase in the probability that he (she) becomes a Communist Party member. Further, the hourly wage of Communist Party members is approximately 11% higher than non-members for males, while no difference in the hourly wage between Party members and non-members is observed for females. Therefore, a 1cm increase in height leads to approximately a 0.06% increase in the hourly wage, which is observed only for males. We label this the height premium in earnings through the political channel. Second, controlling for the political channel of the height premium, a 1cm increase in height leads to a 1.18% (1.04%) increase in the hourly wage for males (females). We label this the height premium through the market channel. Together, these results suggest that the height premium in earnings through the market channel is much larger than that through the political channel., (Copyright © 2015 Elsevier B.V. All rights reserved.)

An increasing number of studies have addressed the determinants of suicide. Social capital is a key factor in preventing suicide. However, little is known about the experience of suicide ideation using subjective values. From the viewpoint of suicide prevention, it is worth examining how people think of suicide. This paper attempts to examine the effect of social capital on suicide ideation. Furthermore, the paper compares the effect of social capital between urban and non-urban areas. In this paper, urban areas are equivalent to mega-cities with populations over one million. Non-urban areas are cities with populations of less than one million, towns and villages. Individual-level data from the Japanese General Social Surveys (JGSSs) are used. The survey, which was conducted in 2006, provides information about the subjective value of suicide ideation. The survey was answered by 1413 subjects with a mean age of 54.5. Of the subjects, 49% were male. Social trust is used to measure the degree of social capital, and the outcome of interest is suicide ideation within the past 5 years. After controlling for various factors, the major findings are that both individual-level social trust and social trust accumulated in one's residential administrative district reduce the probability that one will consider suicide. After dividing the sample into urban and non-urban residents, particularized trust plays a role in deterring suicide ideation in urban areas, while generalized trust plays a role in deterring suicide ideation in non-urban areas. The effect of each type of trust depends on its scarcity in residential areas., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Mucinous cystic neoplasm of the liver (MCN-L) is a very rare tumor whose detailed behavior is still unknown. We describe two cases of MCN-L that exhibited extremely interesting growth patterns, and discuss the characteristics of MCN-Ls. Both cases exhibited MCN-L that originated from the left hepatic lobe (Segment 4) and then prolapsed into the left hepatic duct and common bile duct, resulting in obstructive jaundice due to expansive growth. Endoscopic retrograde cholangiopancreatographies showed the characteristic oval-shaped filling defects in the bile ducts. Endoscopic ultrasound and intraductal ultrasound were useful for differentiating the tumors from stones, since multiple septal formations were observed inside the tumors. A literature search revealed that, over the past 10 years, 15 cases of MCN-L (biliary cystadenomas with ovarian-like stroma) that showed expansive growth in the bile duct had been reported. Prolapse into the bile duct and expansive growth appear to be characteristic behavior of MCN-L. In the future, additional data on more cases needs to be collected to further elucidate MCN-L pathophysiology.

MP-124, a novel poly(ADP-ribose) polymerase-1 (PARP-1) inhibitor that competes with the binding of the PARP substrate nicotinamide adenine dinucleotide (NAD), is being developed as a neuroprotective agent against acute ischemic stroke. MP-124 increased structural chromosomal aberration in CHL/IU cells, but showed negative results in the bacterial reverse mutation test, and the rat bone marrow micronucleus (MN) and the rat liver unscheduled DNA synthesis tests after the intravenous bolus injection. Thus, MP-124 did not appear to be direct-acting mutagen. Since, PARP-1 is a key enzyme in DNA repair, the effect of continuous PARP-1 inhibition by MP-124 was further examined in the rat MN test under 24-h intravenous infusion, and an increase in micronucleated immature erythrocytes (MNIE) was observed. The increase was clearly reduced by co-treatment with nicotinic acid, which resulted in increased intracellular NAD levels. This is consistent with the established activity of MP-124 as a competitive inhibitor of PARP and provides strong evidence that the DNA-damaging effect that leads to the increase in MNIE is a secondary effect of PARP-1 inhibition. This mechanism is expected to result in a threshold for the induction of MNIE by MP-124, and allows for the establishment of a safe margin of exposure for the therapeutic use of MP-124., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Background: In Lemierre's syndrome, patients first exhibit pharyngitis and peritonsillar abscessation, followed by the development of anaerobic bacterial (usually Fusobacterium necrophorum) septicemia and metastatic infections throughout the body. However, these infections rarely affect the liver. We describe a case of Lemierre's syndrome, in which the first disease manifestation was liver abscess, for drawing attention of emergency physicians to this rare but fatal disease., Case Presentation: A 28-year-old Asian ethnicity Filipino male, who was previously healthy, entered the emergency department presenting with fever and pharyngeal pain that had persisted for 5 days. Contrast-enhanced abdominal computed tomography revealed a 3-cm area of low density in segment 6 of the liver, consistent with an abscess. Chest computed tomography also revealed that multiple nodes in both lungs were enlarged, and septic emboli were suspected. The patient was hospitalized and antibiotic treatment was initiated. On hospital day 6, blood culture results confirmed Fusobacterium necrophorum septicemia. The patient was diagnosed with Lemierre's syndrome, as pharyngitis developed into bacteremia associated with hepatic and pulmonary lesions. The patient's condition improved with antibiotics and he was discharged following three weeks of treatment in the hospital., Conclusion: With the widespread use of antibiotics, Lemierre's syndrome is rarely encountered anymore, but it can be fatal if not properly diagnosed. It is a crucial differential diagnosis in young patients exhibiting septicemia or multiple metastatic infection of unknown origin.