Working hours and mental and physical fatigue in Japanese workers

BACKGROUND: Establishing a threshold number of working hours is very important when making recommendations to protect people from the potentially harmful health effects caused by long working hours. AIM: To clarify the influence of working hours on both mental and physical symptoms of fatigue and use the data obtained to determine permissible working hours. METHODS: Cross-sectional survey of male day-shift workers using the Self-Rating Depression Scale (SDS) and the Cumulative Fatigue Symptoms Index (CFSI). Working hours were subdivided into six groups and odds ratios were calculated for positive outcomes on the SDS and CFSI using logistic regression analysis. RESULTS: A total of 715 workers participated. In the group working 260-279 h/month, the odds ratios for SDS and 'irritability', 'anxiety' and 'chronic tiredness' of the CFSI were significantly increased. In the group working >or=280 h/month, the odds ratios on CFSI for 'general fatigue', 'physical disorders', 'anxiety' and 'chronic tiredness' were likewise significantly increased. CONCLUSIONS: The present results clarified that working hours should be <260 h/month in order to minimize fatigue symptoms in male day workers.     

Oral health status of vulnerable groups in a village of the Central Highlands, southern Vietnam

Abstract:  Objectives:  Oral health status of vulnerable people in developing countries tends to be given lower priority than other health issues. Consequently, few studies have examined the oral health status of the poor and minorities in developing countries. We aim to examine the dental caries and periodontal status, and explore the risk indicators of dental caries between two ethnic groups in rural villages in southern Vietnam. Methods:  We examined the caries status and its risk indicators of 150 participants (Co-Ho minority and Kinh majority) living in a hamlet of Dangphuong village in Vietnam. We also assessed periodontal status of the participants aged 14 and over by Community Periodontal Index. Results:  We first found that dental caries were highly prevalent among both the Co-Ho minority and Kinh majority groups. Second, the higher numbers of dental caries among children with primary teeth were associated with a higher frequency of consuming sweets. Third, most people (87%) aged 14 and over had periodontal problems. Finally, the Kinh majority tended to have more dental caries than Co-Ho among people aged less than 30. Conclusion:  Oral health promotion should be considered as a part of the development programmes for vulnerable groups in Vietnam and other developing countries.     

Extracorporeal Membrane Oxygenation with rituximab‐combined chemotherapy in AIDS‐associated primary cardiac lymphoma: A case report

Although effective combination of antiretroviral medications is being developed, the incidence of non‐Hodgkin lymphoma (NHL) with human immunodeficiency/acquired immunodeficiency syndrome (HIV/AIDS) still remains significantly higher than that in individuals without infection. Primary cardiac lymphoma (PCL) is an NHL that involves the heart and/or the pericardium. PCL is very rare and often causes serious complications, which can be a diagnostic challenge. To our knowledge, no study has reported the measurement of rituximab concentration under venoarterial extracorporeal membrane oxygenation (VA‐ECMO). Herein, we report the case of a 54‐year‐old male patient with AIDS‐associated primary cardiac NHL who developed right ventricular outflow tract obstruction. The patient experienced fatigue and dyspnea on exertion. Contrast‐enhanced computed tomography showed a bulky tumor mass in his right atrium and ventricle, and an echocardiogram revealed severe hypokinesis of his heart and poor cardiac output. A biopsy was performed, and immunohistochemistry revealed diffuse large B‐cell lymphoma. Therefore, he was treated with rituximab‐combined chemotherapy under VA‐ECMO. Blood levels of rituximab were measured during chemotherapy with VA‐ECMO. Thereafter, he was temporarily discharged from the hospital. This clinical case suggests that VA‐ECMO and rituximab‐combined chemotherapy are useful in rescuing patients with severe cardiopulmonary failure due to AIDS‐associated PCL.     

MRI findings of an inflammatory variant of well-differentiated liposarcoma

The inflammatory variant of well-differentiated liposarcoma (WDLPS) is a rare subtype. We present a 75-year-old woman who had a tumor that was difficult to diagnose preoperatively. Magnetic resonance imaging of the tumor revealed a large, lobulated heterogeneous soft tissue mass with a distinctive pattern of intermingled well-differentiated fatty elements and nodular areas of high T2-intensity tissue.     

Association between exposure to cadmium and blood pressure in Japanese peoples

The authors studied the effects of environmental cadmium exposure on blood pressure (BP). Subjects 1140 men and 1713 women, aged > or =50 yr lived in three areas of Japan considered "unpolluted" by cadmium. Multiple logistic regression analysis was used to evaluate relationships between hypertension/nonhypertension and cadmium concentrations in blood (B-Cd) or urine (U-Cd). Age, body mass index, drinking and smoking habits, and blood and urine chemistry data were incorporated into the model. Odds ratios for hypertension were significantly less than 1 in either gender when U-Cd was the indicator of cadmium exposure and hypertension was defined as systolic BP > or =140 mmHg and/or diastolic BP > or =90 mmHg. The results suggest a significant negative association between cadmium exposure and BP in inhabitants in Japan.     

Evaluation of strongly hyperintense area in breast lesions on fat-suppressed T2-weighted images correlated with histopathology

The purpose of this study was to correlate strongly hyperintense areas(SHI) in breast lesions on FS-T2WI with histopathology and to evaluate the usefulness of the distribution patterns of SHI in the differentiation of benign and malignant breast lesions. MR imaging with pathological correlation was available in 157 breast lesions of 153 patients. The distribution patterns of SHI were classified into seven types. SHI on FS-T2WI was identified in 36 of 157 breast lesions. The irregular and inhomogenous types corresponded to various histological features and were only seen in malignant lesions. The central type corresponded to central necrosis and was only seen in 2 solid-tubular carcinomas. The crescent type corresponded to peripheral fluid collection in the intracystic tumor. The septal type corresponded to fibromyxoid stroma with fibrous septations in the lesions except for one cavernous hemangioma, and was only seen in benign lesions. The smooth type corresponded to mucinous pool, fibromyxoid stroma, and ductal dilatation and did not contribute to differentiation between benign and malignant lesions only on FS-T2WI. SHI in breast lesions on FS-T2WI pathologically corresponded to mucin, fibromyxoid change, necrosis, and ductal dilatation. Evaluation of patterns of SHI is useful in differentiating between benign and malignant lesions.     

Normal radiographic anatomy of thoracic structures: analysis of 316 lateral chest radiographs

PURPOSE: To study the frequency of visualization and characteristics of normal thoracic structures on lateral chest radiographs in the Japanese population. MATERIALS AND METHODS: We reviewed 316 lateral chest radiographs of men and women ranging in age from 20 to 90 years. The frequency of visualization and configuration of structures including major, minor, superior and inferior accessory fissures, and orifices of the right and left upper lobe bronchi were reviewed. RESULTS: On lateral chest radiographs, major fissure and minor fissure were visualized in 99.4% and 87.3%, respectively. Superior accessory fissure and inferior accessory fissure were visualized in 1.9% and 9.5%, respectively. Orifices of the right and left upper bronchi were seen in 92.4% and 98.4%, respectively. CONCLUSION: Frequency of visualization and characteristics of various normal anatomic structures on lateral chest radiographs in the Japanese population differ from those reported previously from the West. Familiarity with these normal thoracic structures and variations is important for daily image interpretation.     

Involvement of large tenascin-C splice variants in breast cancer progression

Alternative splicing of fibronectin-like type III (FNIII) repeats of tenascin-C (Tn-C) generates a number of splice variants. The distribution of large variants, typical components of provisional extracellular matrices that are up-regulated during tumor stroma remodeling, was here studied by immunoblotting and immunohistochemistry using a monoclonal antibody against the FNIII B domain (named 4C8MS) in a series of human breast cancers. Large Tn-C variants were found at only low levels in normal breast tissues, but were highly expressed at invading sites of intraductal cancers and in the stroma of invasive ductal cancers, especially at invasion fronts. There was a positive correlation between the expression of large Tn-C variants and the cell proliferation rate determined by immunolabeling of the Ki-67 antigen. Of the Tn-C recombinant fragments (all FNIII repeats or mFNIII FL, the conserved FNIII domain only, the epidermal growth factor-like domain, and the fibrinogen-like domain) which were expressed by CHO-K1 cells transfected with mouse Tn-C cDNAs, only the mFNIII FL enhanced in vitro migration and mitotic activity of mammary cancer cells derived from a Tn-C-null mouse. Addition of 4C8MS blocked the function of mFNIII FL. These findings provide strong evidence that the FNIII alternatively spliced region has important roles in tumor progression of breast cancer.     

MR assessment of movement and morphologic change in the menisci during knee flexion

PURPOSE: To examine movement and morphologic alteration in the menisci during knee flexion. MATERIAL AND METHODS: Twenty healthy knees were imaged at 0 degrees, 45 degrees, and 90 degrees of passive non-weight-bearing flexion in the sagittal plane with MR. In each meniscus, posterior movement distance during knee flexion and the ratio of anteroposterior (a.p.) diameter at flexion to that at extension were calculated. RESULTS: Each meniscus moved posteriorly during knee flexion. Movement was greater in the anterior horn than in the posterior horn, and greater in the medial meniscus than in the lateral meniscus (p<0.05). The a.p. diameter of each meniscus was reduced at flexion (p<0.05). CONCLUSION: Knee flexion normally leads to posterior movement and shortening of the a.p. diameter of the menisci, which may be related to the positioning and curvature of femoral condyles at the femorotibial contact point at knee flexion.