Relationship between the degree of property damage and changes in red blood cells, hematocrit, and hemoglobin among victims of the Noto Peninsula Earthquake

Objectives

The aim of this study was to assess the impact of the Noto Peninsula Earthquake on various hematologic parameters. We studied the relationships between the degree of property damage and changes in red blood cells (RBCs), hemoglobin (Hb), and hematocrit (Ht) among residents before and after the March 2007 Noto Peninsula Earthquake.

Methods

A total of 5,563 residents of Wajima City who were not receiving oral treatment for anemia and who had received basic health screenings for fiscal years (FYs) 2006 and 2007, before and after the earthquake. We analyzed changes in their RBCs, Hb, and Ht levels by gender, age, body mass index (BMI), level of property damage, and evaluation standards.

Results

RBCs, Hb, and Ht for FY2007 showed a trend of decreasing values compared to FY2006 in both male and female subjects. RBCs and Hb significantly decreased in females aged between 65 and 74 years who experienced total property damage, and Ht significantly increased for those younger than 65 years who experienced the same level of damage. In addition, significant differences by degree of property damage and FY2007/FY2006 ratio were seen only among subjects with a BMI ratio <1. Furthermore, we found a significant relationship between reduction of RBCs or Hb and increasing age in females; however, no significant relationship to property damage was found. No significant relationships were found for males.

Conclusions

A significant association between property damage and changes in RBCs, Hb, and Ht was not found in this population of residents who experienced the Noto Peninsula Earthquake.     

Supply of goods from hospitals to outpatients practicing intermittent self‐catheterization in Japan

Hospitals supply goods to patients practicing intermittent self‐catheterization (ISC), yet procedures for distribution have yet to be standardized, making it difficult to track the types of goods that are shipped and their amounts. The aim of this study was to standardize the types and amounts of goods provided by medical facilities on the basis of the survey results. We conducted a survey of medical facilities and patients regarding the status of goods supplied for ISC. Data were collected from January to May 2010 from 5 outpatient urology clinics and 26 patients practicing ISC. The first finding of this research is that the amount of supplied goods was insufficient and part of the supply method was incorrect. The second is that the status of goods supplied changed not only with ISC, but also with hospital characteristics. The third is that hospital costs averaged $63·10; the supplied catheter number affected hospital costs. Patient costs per month averaged $26·50, clearly showing that patients experience an economic burden. Patient costs were high in cases in which the percentage of types of goods supplied was low. A researcher analysed survey data to determine issues and procedures relevant to the supply of goods. The study showed a need to develop an optimal supply system for ISC patients and identified issues in the current system in Japan that require resolution.     

Mutations in the mitotic check point gene, MAD1L1, in human cancers.

Aneuploidy is a characteristic of the majority of human cancers, and recent studies suggest that defects of mitotic checkpoints play a role in carcinogenesis. MAD1L1 is a checkpoint gene, and its dysfunction is associated with chromosomal instability. Rare mutations of this gene have been reported in colon and lung cancers. We examined a total of 44 cell lines (hematopoietic, prostate, osteosarcoma, breast, glioblastoma and lung) and 133 fresh cancer cells (hematopoietic, prostate, breast and glioblastoma) for alterations of MAD1L1 by RT-PCR-SSCP and nucleotide sequencing. Eight mutations consisting of missense, nonsense and frameshift mutations were found, together with a number of nucleotide polymorphisms. All the alterations in cell lines were heterozygous. Frequency of mutations was relatively high in prostate cancer (2/7 cell lines and 2/33 tumor specimens). We placed a mutant truncated MAD1L1, found in a lymphoma sample, into HOS, Ht161 and SJSA cell lines and found that it was less inhibitory than wild type MAD1L1 at decreasing cell proliferation. Co-expression experiments showed that the mutant form had a dominant-negative effect. Furthermore, this mutant impaired the mitotic checkpoint as shown by decreased mitotic indices in HOS cells expressing mutant MAD1L1 after culture with the microtubule-disrupting agent, nocodazole. Our results suggest a pathogenic role of MAD1L1 mutations in various types of human cancer.     

Autocrine and/or paracrine growth of aggressive ATLL cells caused by HGF and c-Met

Adult T-cell leukemia/lymphoma (ATLL) is a neoplasia characterized by the massive invasion of various organs by tumor cells. Previously, we found that expression of the gene for c-Met, a receptor tyrosine kinase for hepatocyte growth factor (HGF), was specific to the acute type among 41 patients with ATLL by microarray. First in the present study, we analyzed the survival of the patients in relation to expression of c-Met and HGF in ATLL cells. Expression of the former but not the latter was associated with poor prognosis. Then, we analyzed the growth of ATLL cells caused by HGF and c-Met. c-Met was expressed in 0/7 chronic ATLLs, 12/14 acute ATLLs, 1/1 IL-2-independent ATLL cell line and 1/7 IL-2-dependent ATLL cell lines as assessed by flow cytometry. HGF induced the proliferation of primary cells from most acute cases examined as well as the c-Met-positive KK1 cell line in contrast to c-Met-negative cells. HGF induced autophosphorylation of c-Met in c-Met-positive cells from an acute case and KK1 cells. The plasma level of HGF was elevated in acute as compared to chronic cases. The levels of HGF and/or IL-6 which induces the production of HGF by stromal cells, were elevated in the supernatant of short-term cultured cells from certain patients with acute or chronic disease. Finally, infiltrated ATLL cells and adjacent stromal cells in liver were shown to be positive for c-Met/HGF and HGF, respectively, in acute cases. Autocrine and/or paracrine growth caused by HGF and c-Met was suggested in aggressive ATLL cells secreting HGF and/or IL-6, respectively.     

Interferon alfa and antiretroviral agents: a treatment option for adult T-cell leukemia/lymphoma

Adult T-cell leukemia/lymphoma (ATL) is a peripheral T-cell malignancy caused by human T-cell lymphotropic virus type I, and its clinical subtypes are categorized into smoldering, chronic, lymphoma and acute types. The standard care for patients with the acute, lymphoma and unfavorable chronic types (aggressive ATL) consists of intensive chemotherapy with or without subsequent allogeneic hematopoietic stem cell transplant, or a combination of interferon alfa and an antiretroviral agent, while that for the chronic type without unfavorable prognostic factors and the smoldering type (indolent ATL) is watchful waiting. Recently, early intervention for indolent ATL employing interferon alfa and an antiretroviral agent has been reported to lead to a marked benefit in a retrospective study. This modality should be evaluated in larger clinical trials, since patients with indolent ATL show a median survival time of as short as 4-5 years.     

Factors related to preparedness for emergency hemodialysis in the event of a natural disaster

This study aimed to explore patients’ preparedness for emergency hemodialysis in the event of a natural disaster and to determine the factors affecting such preparedness.A cross-sectional study was conducted in undergoing hemodialysis at dialysis facilities in Sapporo, Hokkaido. The participants were a cohort of 256 outpatients aged 20 years or older, 186 (72.7%) were male, and the average age was 61.9 ± 10.9 years. The participants were divided into those who had prepared for emergency dialysis treatment and those who had not. Cross tabulations were performed on the 2 groups using the following participant attributes: preparedness for dialysis during a disaster, knowledge of how to protect themselves during a disaster, and intention to dialyze and evacuate during a disaster, followed by binomial logistic regression analysis.Of the 256 study patients, 184 (71.9%) were not prepared for dialysis treatment. In logistic regression models, patients who were not prepared for dialysis treatment were found to have higher odds of being employed (odds ratio (OR): 2.469; 95% confidence interval (CI): 1.205-5.058), not being aware of disaster information acquisition methods in the event of a disaster (OR: 4.580, 95%; CI: 2.048-10.241), did not receive explanations on proper disaster response from dialysis facility staff (OR: 2.557, 95%; CI: 1.319-4.954), and believing that their family away from home would not be concerned about them (OR: 2.021; 95% CI: 1.062-3.847).Disaster preparedness in patients undergoing dialysis remain inadequate. Dialysis facilities need to strengthen their explanations of disaster response, particularly with regard to working, middle-aged people.