English version of the interim report published in 1998 by the members of the Advisory Committee on Atopic Dermatitis Severity Classification Criteria of the Japanese Dermatological Association

The Japanese Dermatological Association established an advisory committee in 1995 to set up severity scoring systems for atopic dermatitis (AD). Its interim report was published in Japanese in the Japanese Journal of Dermatology (108: 1491-1496, 1998) by Chairman Hikotaro Yoshida. Because of the strong demand for an English version, we have decided to publish the report in English. This prospective study was designed to evaluate the status of 259 AD patients using Method 1, which involves a simple global evaluation of disease severity; Method 2, which involves global evaluation by summing severity scores obtained from five body regions (i.e. the head and neck, anterior and posterior trunks, and upper and lower limbs); Method 3, which consists of both assessment of the extent of involved areas at each of the five body regions and that of the severity scores of each eruption component observed in the most severely affected body region; and Method 4, which consists of the evaluation of only subjective components (daytime pruritus and sleep disturbance). Employing the results obtained with Method 1 as a tentative benchmark, we analyzed its correlation with those of Methods 2, 3 and 4 to statistically assess the validity and reliability of these methods. Method 2, Method 3 and the portion of Method 4 involving evaluation of only the subjective symptom of daytime pruritus but not the sleep disturbance were considered useful in evaluating AD severity.     

Body mass index and cardiovascular disease mortality in Japan: the Ohsaki Study

OBJECTIVE: Although there is a clear positive association between obesity and the incidence and severity of cardiovascular disease, the association between underweight and cardiovascular disease is unclear. The objective of this study was to examine the relation between body mass index (BMI) and cardiovascular disease in Japan, where the proportion of the population that is underweight is relatively high. METHOD: A total of 43,916 Japanese adults (21,003 men and 22,913 women) aged 40 to 79 years who had no history of cancer, ischemic heart disease (IHD), or stroke participated in the baseline survey in 1994. Hazard ratios (HR) and their 95% confidence intervals (CIs) for death due to total cardiovascular disease, all strokes, ischemic stroke, hemorrhagic stroke, and IHD were calculated according to BMI by using Cox's proportional hazards regression models. The 22.5-24.9 kg/m(2) BMI category was used as the reference category in all analyses. RESULTS: There were U-shaped associations between BMI and total cardiovascular disease, all stroke, hemorrhagic stroke, and IHD mortality, and a J-shaped association between BMI and ischemic stroke mortality. Participants with a BMI <18.5 kg/m(2) had a significantly increased risk of total cardiovascular disease, all stroke, hemorrhagic stroke, and IHD mortality, and the multivariate HR (95% CI) was 1.62 (1.19-2.19), 1.50 (1.02-2.21), 2.11 (1.07-4.17), 1.83 (1.11-3.01), respectively. CONCLUSION: Underweight was substantially associated with hemorrhagic stroke and IHD mortality in Japan, while obesity was associated with increased risk of total cardiovascular disease mortality and mortality from individual cardiovascular diseases.     

Dietary intake of six minerals in relation to the risk of chronic obstructive pulmonary disease

To investigate the relationship between dietary intake of minerals and the risk of chronic obstructive pulmonary disease (COPD), a case-control study was conducted in central Japan. A total of 278 referred patients (244 men and 34 women) aged 50-75 years with COPD diagnosed within the past four years and 340 community-based controls undertook spirometric measurements of lung function. A structured questionnaire was administered face-to-face to obtain information on demographics and habitual food consumption. Dietary intakes of six major minerals were derived from the Japanese food composition tables. The COPD patients had lower habitual energy-adjusted intakes of calcium, phosphorus and iron than controls, but not sodium. A significant reduction in prevalence of COPD was observed for calcium, with adjusted odds ratio 0.65 (95% confidence interval: 0.37- 0.98) for the highest level versus lowest level of intake. A high iron intake was also inversely associated with the COPD risk. In conclusion, an inverse association was evident between dietary calcium intake and the risk of COPD for Japanese adults.     

Pharmacokinetics of combination chemotherapy with paclitaxel and carboplatin in a patient with advanced epithelial ovarian cancer undergoing hemodialysis

Few reports delineate the pharmacokinetics of combination chemotherapy with paclitaxel and carboplatin in hemodialysis (HD) patients with epithelial ovarian cancer. However, the optimal carboplatin dose and the timing of HD have yet to be elucidated. We presented a case of an advanced-stage epithelial ovarian cancer patient with chronic renal failure requiring HD. After 4 courses of combination chemotherapy consisting of paclitaxel and carboplatin, a partial response was obtained; therefore, she underwent interval debulking surgery. Paclitaxel was administered for 3 h at a dose of 150 mg/m(2), and carboplatin was administered for 1 h at a dose of 4-7 area under the concentration/time curve (AUC), which was calculated by the Calvert formula. HD was initiated 24 h after the start of administration of carboplatin and performed for a period of 3 h. Pharmacokinetic studies showed that the AUCs of free platinum and paclitaxel were 3.48-5.55 mg·min/ml and 13.5 μg·h/ml, respectively. Combination chemotherapy consisting of paclitaxel and carboplatin is a feasible approach to improving the treatment outcome of epithelial ovarian cancer patients with chronic renal failure requiring HD. The measurement of free platinum is useful in determining the optimal dose of carboplatin in order to obtain an adequate AUC. Determining the dose of carboplatin according to the Calvert formula and initiating HD after 24 h would ensure a favorable therapeutic effect with limited side effects.     

Gene amplification CCNE1 is related to poor survival and potential therapeutic target in ovarian cancer

BACKGROUND:

This study examined the clinical significance of CCNE1 (Cyclin E1) amplification and assessed whether CCNE1 is a potential therapeutic target in ovarian cancer.

METHODS:

CCNE1 expression and amplification in ovarian cancer was assessed by immunohistochemistry, fluorescence in situ hybridization and clinical data collected by retrospective chart review. CCNE1 gene knockdown using silencing RNA and a CCNE1 gene transfection system were used to asses CCNE1 function in tissue samples of ovarian cancer.

RESULTS:

Gene amplification was identified in 18 (20.4%) of 88 ovarian carcinomas. CCNE1 copy number significantly correlated with CCNE1 protein expression (r = 0.522, P < .0001). CCNE1 amplification significantly correlated with shorter disease‐free survival and overall survival (P < .001). There were nonsignificant trends between high protein expression and poor disease‐free survival (P = .2865) and overall survival (P = .1248). Multivariate analysis showed gene amplification was an independent prognostic factor for disease‐free survival and overall survival after standard platinum‐taxane chemotherapy (P = .0274, P = .0023). Profound growth inhibition and apoptosis were observed in silencing RNA‐treated cancer cells with gene amplification compared with results in cancer cells with CCNE1 moderate expression without gene amplification or with low CCNE1 expression. CCNE1 overexpression stimulated proliferation in ovarian cancer cell lines ES2 and TOV‐21G, which have lower endogenous CCNE1 expression.

CONCLUSIONS:

These findings indicate that CCNE1 overexpression is critical to growth and survival of ovarian cancer tumors with CCNE1 gene amplification. Furthermore, they suggest that CCNE1 silencing RNA‐induced phenotypes depend on amplification status of ovarian cancers. Therefore, CCNE1‐targeted therapy may benefit ovarian cancer patients with CCNE1 amplification. Cancer 2010. © 2010 American Cancer Society.     

Effects of abdominoplasty on female sexuality: a pilot study

IntroductionChanges in the pubic region resulting from abdominoplasty may have a psychosexual impact. Thus, it is important to study the influence of physical changes on the sexuality of patients after abdominoplasty.AimTo evaluate the effects of the elevation of the mons pubis and consequent exposure of the clitoris in the vulvar commissure on the sexual functioning and sexual satisfaction of women who underwent abdominoplasty.MethodsData were presented as mean ± standard deviation. Nineteen women with a mean age of 35 ± 7 years, mean body mass index of 23 ± 2 kg/m² and who expressed a desire to undergo abdominoplasty were selected from consecutive patients attending the abdominal plastic surgery outpatient unit of a university hospital.Main Outcome MeasuresPhysical change (measured by the distance between the xiphoid process and vulvar commissure [xipho‐vc]), sexual functioning, and sexual satisfaction (assessed with the Sexuality Assessment Scale), and body image (measured using the Body Shape Questionnaire [BSQ]) were evaluated preoperatively and 6 months after abdominoplasty.ResultsThere was a significant reduction (P = 0.0004; z = ?3.53) in the xipho‐vc distance 6 months after abdominoplasty compared with baseline (mean difference 3.63 ± 2.79 cm), corresponding to an elevation of the mons pubis and consequent exposure of the clitoris. All patients reported a significant improvement in sexual functioning and sexual satisfaction 6 months after abdominoplasty when compared with baseline (P = 0.0001; z = ?3.83). BSQ scores indicated an improvement in the patients' concerns about body shape (P = 0.0003; z = ?3.58).ConclusionOur results suggest that physical change and the new position of the clitoris may have a positive impact on sexuality. de Brito MJA, Nahas FX, Bussolaro RA, Shinmyo LM, Barbosa MVJ, and Ferreira LM. Effects of abdominoplasty on female sexuality: A pilot study. J Sex Med 2012;9:918–926.     

Significance of venous thromboembolism in women with uterine carcinosarcoma

Objective

To identify risk factors for venous thromboembolism (VTE) and to examine the association of VTE and survival in women with uterine carcinosarcoma.

Effect of astaxanthin in combination with alpha-tocopherol or ascorbic acid against oxidative damage in diabetic ODS rats

The present study was performed to investigate the effect of astaxanthin in combination with other antioxidants against oxidative damage in streptozotocin (STZ)-induced diabetic Osteogenic Disorder Shionogi (ODS) rats. Diabetic-ODS rats were divided into five groups: control, astaxanthin, ascorbic acid, alpha-tocopherol, and tocotrienol. Each of the four experimental groups was administered a diet containing astaxanthin (0.1 g/kg), in combination with ascorbic acid (3.0 g/kg), alpha-tocopherol (0.1 g/kg), or tocotrienol (0.1 g/kg) for 20 wk. The effects of astaxanthin with other antioxidants on lipid peroxidation, urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG) excretion, serum creatinine (Cr) level, creatinine clearance (Ccr), and urinary protein content were assessed. The serum lipid peroxide levels and chemiluminescent (CL) intensity in the liver of the alpha-tocopherol and tocotrienol groups were significantly reduced in comparison to that of the control group. In the alpha-tocopherol group, urinary 8-OHdG excretion, serum Cr level, Ccr, urinary albumin excretion, and urinary protein concentration were significantly decreased as compared with those in the control group. Additionally, the CL intensity in the kidney of the alpha-tocopherol group was significantly lower, but that of the ascorbic acid group was significantly higher than that in the control group. These results indicate that dietary astaxanthin in combination with alpha-tocopherol has an inhibitory effect on oxidative stress. On the other hand, our study suggests that excessive ascorbic acid intake increases lipid peroxidation in diabetic rats.