夏威夷美籍日本人与日本本土人群结肠直肠癌的特征和存活率比较

目的：该研究旨在明确夏威夷美籍日本人结肠直肠癌的特征、预后危险因素和存活率是否有别于日本本土结肠直肠癌患。方法：回顾性调查1996-2002年夏威夷和日本各自同一所医院的结肠直肠癌手术切除患。结果：该研究共纳入410例美籍日本患（男性218例；年龄中值73岁）和621例日本本土患（男性382例；年龄中值65岁）。两组患的年龄（P〈0．001）、年龄分布（P〈0．001）、性别（P=0．008）、术前癌胚抗原（P〈0．001）以及解剖部位分布（P〈0．001）存在显性差异。对监测资料、流行病学资料和最后结果进行比较显示，美籍日本患肿瘤的特征类似于普通美国人群。两组患的肿瘤大小、组织学分级、TNM状态以及TNM分期没有显性差异。总体5年存活率（美籍日本人75．5％，本土日本人76．2％；P=0．55）和四个分期中任何相应分期的存活率相似。除癌胚抗原（P=0．036）外，与存活相关的危险因素无差别。     

Risk factors of low APGAR score in Japanese full-term deliveries: a case-control study

To elucidate maternal characteristics and pregnancy complications associated with low APGAR score, a case-control study of low APGAR score was conducted under matching both gestational age and route of delivery, in full-term deliveries at a Japanese hospital with 102 cases and 204 controls. Previous induced abortion and occurrence of preeclampsia were more frequently observed in the low APGAR score cases. In the multiple conditional logistic regression analysis, each of these factors more than doubled the risk of low APGAR score. Even if only those without perinatal troubles were included in the analysis, previous induced abortion was recognized as an independent risk factor of low APGAR score (odds ratio=2.68, 95% confidence interval:1.01-7.04). Despite of the potential limitations of this study, previous induced abortion might be a useful predictor of adverse state of newborn infant.     

Analysis of factors that influence body mass index from ages 3 to 6 years: A study based on the Toyama cohort study

BACKGROUND: The aim of the present study was to elucidate both environmental and behavioral factors that influence body mass index (BMI, kg/m2) among Japanese children from ages 3-6. METHODS: In 1992 (at age 3) and 1995 (at age 6), 8170 6-year-old children (4176 boys and 3994 girls) were surveyed using a questionnaire on both body build (height and weight) and lifestyle. The correlation between BMI for 3-year-olds and for 6-year-olds were analyzed. From the temporal changes of body build between age 3 and 6 years, we categorized children into four groups: group 1, normal at both age 3 years and 6 years (normal/normal); group 2, overweight at age 3 years and normal at age 6 years (overweight/normal); group 3, normal at age 3 years and overweight at age 6 years (normal/overweight); and group 4, overweight at both age 3 years and 6 years (overweight/overweight). The authors compared the four groups with each other according to sex, concerning frequencies of children who matched the categories of environmental and behavioral factors. Each factor was tested using the chi2 test. Overweight children were defined as those whose BMI value was age-sex specific in the 90th percentile or more. RESULTS: A significant correlation was found between body builds for children aged 3 and 6 years in both genders (boys, r = 0.559, P < 0.01; girls, r = 0.584, P < 0.01). Significant factors associated with overweight children were diet (eating rice, green tea, eggs, meat, but less breads and juice), rapid eating, short sleep duration, early bedtime, long periods of television viewing, avoidance of physical activity, and frequent bowel movement. DISCUSSION: Temporal changes in BMI from age 3 years to 6 years are significantly associated with both environmental and behavioral factors at age 6 years. The results of this study may be useful for health promotion programs designed to prevent obesity during the early stages of childhood.     

Changing patterns of blood culture isolates from patients with acute leukemia: a review of twenty years' experience.

During the 20-year period, 1972-1991, 286 episodes of bacteremia occurred in 200 (45%) of 445 patients with acute leukemia in a hematology ward, giving an incidence of 482 episodes per 1,000 hospital admissions. The frequency of bacteremia was almost unchanged throughout the study period. The frequency of gram-negative bacilli decreased significantly, however, from 81% of all the isolates for the first half of the study period to 50% for the latter half. Despite the common use of ceftazidime and imipenem during the last 5-year period, Pseudomonas aeruginosa increased in frequency to be the most frequent organism. This was opposite to the decreased frequencies of Escherichia coli, Klebsiella pneumoniae and Enterobacter cloacae. The isolates of P. aeruginosa obtained during this period, all of which proved sensitive to ceftazidime and/or imipenem, were almost equally distributed among five serogroups, although a temporal preponderance of a limited number of serogroups was observed during the preceding 15-year period. On the other hand, the frequency of gram-positive cocci increased from 9% in the first decade to 35% in the latter decade. Staphylococcus epidermidis, Enterococcus species and, to a lesser extent, Staphylococcus aureus were ranked as major pathogens. Among the recent isolates of S. aureus, methicillin-resistant strains virtually replaced methicillin-sensitive ones. Therefore, until more effective means for control of P. aeruginosa bacteremia in particular become available, the occurrence of this infection will continue to limit the successful treatment of acute leukemia.     

Development of disease burden score concerning bone and joint diseases: comparison between rheumatoid arthritis and osteoarthritis]

OBJECTIVES: To develop disease burden score concerning bone and joint diseases by evaluating the burdens of rheumatoid arthritis (RA) and osteoarthritis (OA) based on two quantitative measures of quality of life (QOL). METHODS: In a questionnaire, the qualified doctors of Japan Rheumatism Foundation were asked to evaluate patients' QOL, including 6 items of physical functions, 7 items of daily living activities and 3 items of social activities, for three severity levels defined by treatment status. The burdens of RA and OA were determined based on two quantitative measures of QOL, that is, 'principal component score' and '0-0.5-1 score'. RESULTS: In the two-way ANOVA of severity level and doctor's specialism, two quantitative measures of QOL showed significant differences by severity level, having approximately the same F-statistics each other. The burden of RA was 1.4-times (for 'principal component score') and 1.6-times (for '0-0.5-1 score') as great as that of OA. The differences in burden between RA and OA were observed especially in daily living activities and social activities. CONCLUSIONS: Our methodology may be applicable to examining differences in burden between bone and joint diseases.     

Body image and body satisfaction play important roles in the path to dieting behavior in Japanese preadolescents: The Toyama birth cohort study

Objectives To analyze the path to dieting behavior in Japanese preadolescents. Methods A cross-sectional study of dieting behavior among 5,244 preadolescents (2,452 boys and 2,792 girls aged 12–13) born in Toyama prefecture. Results While increasing with body mass index (BMI), the percentage of those who had tried dieting was higher in those who perceived themselves fat than in those who perceived themselves thin or average. Of those who wanted to be thinner, 16.1% of boys and 26.8% of girls had tried dieting. Path analysis in nonobese subjects (2,116 boys and 2,334 girls) showed that (1) body image was primarily based on BMI, (2) body image led to body dissatisfaction, and (3) body dissatisfaction led to dieting behavior. Pubertal changes had a significant effect on body image (path coefficient <0)for boys and body satisfaction (path coefficient >0) for girls, in addition to that on BMI. Maternal BMI had a significant effect on BMI but not on body image, body satisfaction, or dieting behavior. Conclusions Body image and body satisfaction play important roles in the path to dieting behavior in Japanese preadolescents. Pubertal changes may reinforce dieting behavior, but the mechanism may differ by sex.     

The national burdens of rheumatoid arthritis and osteoarthritis in Japan: projections to the year 2010, with future changes in severity distribution

We projected the national burdens of rheumatoid arthritis (RA) and osteoarthritis (OA) in Japan in the year 2010, together with future changes in severity distribution. The age-, sex-, and in/outpatient-specific prevalence rates of RA and OA from the 1999 National Patient Survey were multiplied by the National Census population projections for 2000 and 2010. The years lived with disability (YLD) of RA or OA in 2010 were adjusted for the projected changes in the summed measure of severity distribution (i.e., the sum products of the percentage distribution and the health-related quality of life score for three severity classes) using the corresponding regression equations. Between 2000 and 2010, the numbers of patients with RA and OA in Japan will increase by 14% (from 0.31 million to 0.36 million) and 27% (from 0.77million to 0.98 million), respectively, and accordingly, the YLD of RA and OA will increase by 3% (from 42.8 to 43.6 per 100 000) and 21% (from 65.8 to 79.1 per 100 000), respectively. Because of the decreasing proportion of severely affected patients, the increase in YLD may be smaller compared with the increase in the number of patients. As in other developed countries, the national burdens of RA and OA in Japan will increase between 2000 and 2010. However, any projection is likely to be an overestimate unless it considers future changes in the severity distribution associated with medical progress.