Association between evacuation and becoming overweight after the Great East Japan Earthquake: a 7-year follow-up of the Fukushima Health Management Survey

OBJECTIVES

Disaster evacuation increases the risk of becoming overweight or obese owing to lifestyle changes and psychosocial factors. This study evaluated the effect of evacuation on becoming overweight during a 7-year follow-up among residents of Fukushima Prefecture during the Great East Japan Earthquake.

STUDY DESIGN

This was a prospective cohort study.

METHODS

We analysed data collected from 18,977 non-overweight Japanese participants who completed the 'Comprehensive Health Checkup Program' and 'Mental Health and Lifestyle Survey', as part of the Fukushima Health Management Survey, between July 2011 and November 2012. An evacuation was defined as the moving out of residents of municipalities designated as an evacuation zone by the government or having a self-reported experience of moving into shelters or temporary housing. Follow-up examinations were conducted in March 2018 to identify patients who became overweight. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were calculated using a Cox proportional hazards regression model.

RESULTS

Among 15,875 participants (6091 men and 9784 women; mean age 63.0 ± 11.1 years) who received follow-up examination (mean follow-up, 4.29 years), 2042 (856 men and 1186 women) became overweight. Age-, baseline body mass index-, lifestyle-, and psychosocial status-adjusted HRs (95% CIs) for becoming overweight after evacuation were 1.44 (1.24-1.66) for men and 1.66 (1.47-1.89) for women.

CONCLUSION

Evacuation was associated with the risk of becoming overweight 7 years after the disaster. Thus, maintaining physical activity, healthy diet, and sleep quality and removing barriers to healthy behaviour caused by disasters, including anxiety concerning radiation, may prevent this health risk among evacuees.

Examination of the relationship between masseter muscle activity during sleep and wakefulness measured by using a wearable electromyographic device

Purpose This study aimed to measure masseter muscle activity throughout the day in outpatients suspected of having awake bruxism (AB) and/or sleep bruxism (SB) and examine the relationship between AB and SB by comparing muscle activity during daytime wakefulness and nighttime sleep.Methods Fifty outpatients with suspected SB and/or AB participated in this study. A single-channel wearable electromyogram (EMG) device was used for EMG recording. The selected EMG bursts were divided into bursts during sleep (S-bursts) and bursts during awake state (A-bursts). The number of bursts per hour, average burst duration, and ratio of burst peak value to maximum voluntary contraction were calculated for both the S- and A-bursts. These values of the S- and A-bursts were then compared, and the correlations between them were analyzed. Additionally, the ratios of phasic and tonic bursts in the S- and A-bursts were compared.Results The number of bursts per hour was significantly higher for A-bursts than for S-bursts. No significant correlation was found between the numbers of S- and A-bursts. The ratio of phasic bursts was large and that of tonic bursts was small in both the S- and A-bursts. A comparison of the S- and A-bursts showed that the S-bursts had a significantly lower ratio of phasic bursts and higher ratio of tonic bursts than the A-bursts.Conclusions The number of masseteric EMG bursts during wakefulness did not show any association with that during sleep. It became clear that sustained muscle activity was not dominant in AB.

Frequency distribution of the number and amplitude of electromyographic waveforms of the masseter muscle during sleep in patients with a clinical diagnosis of sleep bruxism

OBJECTIVE

This study aimed to clarify frequency distribution of number and peak amplitude of electromyographic (EMG) waveforms of sleep bruxism (SB) in outpatients with clinical diagnosis of SB (probable bruxer: P-bruxer).

METHODS

Subjects were 40 P-bruxers. Masseteric EMG during sleep was measured at home using a wearable EMG system. EMG waveforms with amplitude of more than two times the baseline and with duration of 0.25 s were extracted as SB bursts. Clusters of bursts, i.e. SB episodes, were also scored.

RESULTS

There were large variations among the subjects in numbers of SB bursts and episodes and in burst peak amplitude. As for burst peak amplitude within a subject, a wide right-tailed frequency distribution was shown with the highest frequency at the class of 5-10% maximum voluntary contraction.

CONCLUSION

The number and amplitude of SB waveforms for P-bruxers were distributed over a wide range, indicating the existence of large individual differences.

Portable and wearable electromyographic devices for the assessment of sleep bruxism and awake bruxism: A literature review

OBJECTIVE

The current state of portable/wearable electromyographic (EMG) devices for assessment of bruxism was reviewed.

METHODS

A search of full-text articles relevant to portable/wearable EMG devices capable of being used at home was performed. The data source used was MEDLINE via PubMed from January 1970 to July 2019.

RESULTS

There were nine kinds of wearable EMG devices capable of being used under unrestrained conditions. Ultra-miniaturized wearable EMG devices with a level of performance equivalent to that of conventional stationary EMG devices have been developed and are being used during sleep and in the daytime. The devices have a high level of diagnostic accuracy for sleep bruxism. A definite cut-off value for awake bruxism has not been established.

DISCUSSION

Assessment of sleep bruxism with a high level of accuracy can be performed using a portable/wearable EMG device. However, a definite cut-off value is required for assessment of awake bruxism.

Impact of Hospital Environmental Cleaning with a Potassium Peroxymonosulphate-Based Environmental Disinfectant and Antimicrobial Stewardship on the Reduction of Hospital-Onset Clostridioides difficile Infections

BACKGROUND

A 1% potassium peroxymonosulphate-based environmental disinfectant (PPED) produces sodium hypochlorite when combined with sodium chloride, which functions as a disinfectant. However, little is known about the impact of hospital cleaning with PPED on hospital-onset Clostridioides difficile infection (HO-CDI).

AIM

To reduce HO-CDI, we promote antimicrobial stewardship and hospital ward cleaning with PPED. This study was conducted to evaluate their impact.

METHODS

We began a promotion of post-prescription review with feedback for broad-spectrum antimicrobials and hospital ward cleaning with PPED. We reviewed the ratio of HO-CDI, PPED consumption, and days of therapy (DOT) of broad-spectrum antimicrobials between July 2014 and March 2018, dividing this time into the pre-promotion (July 2014 to June 2015) and post-promotion periods (July 2015 to March 2018).

FINDINGS

Using interrupted time series analysis, an immediate significant change in HO-CDI was observed after intervention (P = 0.03), although a downward trend was not observed over this period (P = 0.19). Trends in PPED consumption significantly changed over this period (P = 0.02). DOT of carbapenems decreased immediately after the intervention began (P < 0.01). A Poisson regression analysis showed that PPED consumption and DOT of carbapenems were independent factors affecting HO-CDI (P = 0.039 and 0.016, respectively).

CONCLUSION

We revealed that DOT of carbapenems and use of PPED were associated with the HO-CDI ratio and that both interventions reduced the rate of HO-CDI. This is the first report on the impact of hospital ward cleaning with PPED on the reduction of HO-CDI.

Validity of clinical diagnostic criteria for sleep bruxism by comparison with a reference standard using masseteric electromyogram obtained with an ultraminiature electromyographic device

Evaluation of sleep bruxism (SB) in clinical practice is currently conducted based on clinical findings, i.e., clinical diagnostic criteria consisting of medical interview, findings of tooth wear, and symptoms of temporomandibular joint (TMJ) and muscles. However, there are many unclear points about validity of the criteria. In this study, validity tests were conducted to clarify the accuracy of the clinical diagnostic criteria for SB by comparison with a reference standard using a single-channel masseteric electromyogram (EMG) obtained with ultraminiature electromyographic devices. The subjects included 30 'probable' bruxers (P-bruxers) who were clinically diagnosed as having SB and 30 non-bruxers. EMG was recorded during sleep under unrestrained and accustomed condition at each subject's home using ultraminiature cordless EMG devices. Bursts with amplitudes of more than 5%, 10%, 20% of the maximum voluntary contraction (MVC) value (EMG-burst-5%, EMG-burst-10%, and EMG-burst-20%) and episodes of sleep bruxism (EMG-episode) were selected for analyses. In all conditions for burst selection, the P-bruxer group showed a significantly larger number of bursts and episodes than those in the non-bruxer group. Accuracy of the clinical diagnosis criteria was 66.7% with the reference standard using EMG-burst-5%/h and 58.3% with that using EMG-episodes/h. By applying single-channel EMG as the reference standard, we were able to conduct validity tests of clinical diagnostic criteria with a larger sample. It was clarified that the level of accuracy of clinical diagnostic criteria for SB were not high despite using the combination of an interview and clinical findings.

Perspectives on follow-up care and research for childhood cancer survivors: results from an international SIOP meet-the-expert questionnaire in Kyoto, 2018

INTRODUCTION

Survival of childhood cancer has increased over the past decades. This has led to the development of strategies aiming to enhance follow-up care and research, for which priorities may vary globally. We explored perspectives of an international healthcare workers panel.

METHODS

Attendants of a meet-the-expert session on childhood cancer survivorship at the 2018 SIOP conference completed a survey about their view on important follow-up care and research aspects for survivors below and over 18 years. We analysed overarching categories and subtopics, and compared Asian versus European and North American healthcare workers.

RESULTS

A total of 58 participants from different medical specialties (67.2% paediatric oncologists) and continents (48.3% Asia, 39.7% Europe/North America) responded. Follow-up care priorities for survivors below and over 18 years included physical care (39.3% ≤18 years, 35.9% >18 years) and healthcare structure (29.4%, 26.0%). Physical care was also the most important research aspect for both age groups (52.5%, 50.7%). Psychological support was the most frequently reported subtopic. Asian clinicians (n = 22) primarily prioritized physical care aspects of follow-up care, whereas European/North American (n = 19) clinicians underscored the importance of healthcare structure.

CONCLUSION

Physical care is the most important aspect of survivorship care and research according to clinicians from several continents. Asian and European/North American respondents shared most priorities, however, healthcare structure was a more important category for European/North American clinicians. The most common subtopic was psychological support, underlining also the need to involve psychologists in follow-up.

Dealing with Community Mental Health post the Fukushima disaster: lessons learnt for the COVID-19 pandemic

Under the COVID-19 pandemic, mitigation of psychological distress is required. At present, the demand for remote intervention for the numerous affected people is increasing, and telephonic support can be useful. Since the Fukushima nuclear disaster in 2011, we have been developing a large-scale telephonic support system and implementing brief interventions for the Fukushima people identified at risk of psychological problems such as depression and post-traumatic stress disorder. In this article, we report the lessons from the Fukushima disaster that can be applied to the COVID-19 pandemic and describe how the telephonic intervention facilitates easier access to psychological help for people with a broad range of psychological distress who are not able to visit treatment or care resources. In our telephonic intervention, we first sent a mental health and lifestyle survey to the people affected by the Fukushima disaster. The counselor team then provided telephonic intervention to high-risk persons as identified on the basis of the survey results. The individuals had expected to receive from the telephonic system help mainly in the form of stress-coping methods, social resource information such as schools, public offices or medical facilities, and lifestyle advice. Since we also experienced that psychological care for telephone counselors was necessary to mitigate the substantial emotional burden, we used the following three approaches: (i) regular supervision of the telephone counseling methods, (ii) seminars for improvement of counseling skills and (iii) individual psychological support. The positive loops between counselors and consulters will help advance a society affected by a disaster.

Quantitative analyses of jaw-opening muscle activity during the active phase of jaw-closing muscles in sleep bruxism

Rhythmic masticatory muscle activity (RMMA), which is defined as three or more consecutive phasic bursts, accounts for a large part of sleep bruxism (SB). RMMA is thought to be characterized by co-contraction, a jaw muscle activity in which jaw-opening muscles contract during the active phase of jaw-closing muscles, which is different from that during mastication. However, there has been limited information about co-contraction. The aim of the present study was to clarify the amplitudes and patterns of jaw-opening muscle activity during the active phase of jaw-closing muscles in RMMA. Data from 14 healthy volunteers with bruxism, which was diagnosed by using polysomnographic recording with audio-video, were analysed. RMMA with electromyographic amplitudes of more than two times the baseline amplitude was selected. From the selected RMMA, burst groups consisting of five or more consecutive phasic bursts, including tonic bursts, were selected for analyses. Electromyographic activities during gum chewing were also recorded before sleeping. The minimum, maximum and average value of the amplitudes of jaw-opening muscle activity during the active phase of jaw-closing muscles were calculated. Jaw-opening muscle activity during the active phase of jaw-closing muscles in RMMA was closer to the baseline than that in gum chewing. The minimum, maximum and average values of amplitudes of jaw-opening muscle activity during the phase were significantly smaller than those of gum chewing. Contrary to our hypothesis prior to the study, the obtained results suggested that the pattern of electromyogram activity of jaw-opening and jaw-closing muscles in RMMA was not necessarily co-contraction.

Evaluation of the Effects of Cultured Bone Marrow Mesenchymal Stem Cell Infusion on Hepatocarcinogenesis in Hepatocarcinogenic Mice With Liver Cirrhosis

OBJECTIVES

Liver transplantation remains the only curative therapy for decompensated liver cirrhosis. However, it has several limitations, and not all patients can receive liver transplants. Therefore, liver regenerative therapy without liver transplantation is considered necessary. In this study, we attempted minimally invasive liver regenerative therapy by peripheral vein infusion of bone marrow-derived mesenchymal stem cells (BMSCs) cultured from a small amount of autologous bone marrow fluid and evaluated the effects of BMSCs on hepatocarcinogenesis in a mouse model.

METHODS

C57BL/6 male mice were injected intraperitoneally with N-nitrosodiethylamine once at 2 weeks of age, followed by carbon tetrachloride twice a week from 6 weeks of age onwards, to create a mouse model of highly oncogenic liver cirrhosis. From 10 weeks of age, mouse isogenic green fluorescent protein-positive BMSCs (1.0 × 10⁶/body weight) were infused once every 2 weeks, for a total of 5 times, and the effects of frequent BMSC infusion on hepatocarcinogenesis were evaluated.

RESULTS

In the histologic evaluation, no significant differences were observed between the controls and BMSC-administered mice in terms of incidence rate, number, or average size of foci and tumors. However, significant suppression of fibrosis and liver injury was confirmed in the group that received BMSC infusions.

DISCUSSION

Considering that BMSC infusion did not promote carcinogenesis, even in the state of highly oncogenic liver cirrhosis, autologous BMSC infusion might be a safe and effective therapy for human decompensated liver cirrhosis.

NON-RADIOLOGICAL IMPACT OF A NUCLEAR EMERGENCY: PREPAREDNESS AND RESPONSE WITH THE FOCUS ON HEALTH

Available experience from Chernobyl and Fukushima clearly demonstrate that nuclear emergencies may result in low and very low exposure levels, at which psychological and social effects among the affected population will dominate over the actual biological effects of ionising radiation. International protection standards and guidelines request, that both radiological and non-radiological health consequences have to be considered in preparedness and response to an actual emergency and there is a need to broaden the radiation protection system's philosophy beyond the metrics of radioactivity and radiation dose. During the past decade a number of multidisciplinary projects were set up with the aim of evaluating management options according to social, economic and ethical criteria, in addition to technical feasibility to achieve this goal. WHO and partners from the Inter-Agency Standing Committee Task Force on Mental Health and Psychosocial Support in Emergency Settings have developed a comprehensive framework and guidelines, which can be applied to any type of an emergency or disaster regardless of its origin. There is a need to include the available scientific expertise and the technical, managerial and personal resources to be considered within a similar 'decision framework' that will apply to radiation emergencies. Key areas of the required expertise needed to develop such a framework are radiation protection, medical support (especially primary care and emergency medicine, mental health support), social sciences (anthropology, psychology, ethics) and communications experts. The implementation of such a multidisciplinary concept in the operational world requires education and training well beyond the level currently available.

Relationship between Economic Security and Self-Rated Health in Elderly Japanese Residents Living Alone

OBJECTIVES

The purpose of this study was to assess the relationship between economic security and self-rated health for elderly Japanese residents living alone.

DESIGN

A secondary analysis of a cross-sectional study.

SETTING

N City, H. Prefecture, Japan.

PARTICIPANTS

Survey questionnaires were distributed to 2,985 elderly residents living alone, aged ≥70 years, of which, 1,939 (65.0%) were returned and treated as valid responses.

MEASUREMENTS

The survey included questions about gender, age, number of years spent in N City, self-rated health, economic security, number of years spent living alone, reason for living alone, life satisfaction, cooking frequency, frequency of seeing a doctor, long-term care service usage, as well as whether they enjoyed their lives, participated in social organizations.

RESULTS

Of the respondents, 1,563 (80.6%) reported that they were economically secure, and 376 (19.4%) responded that they were insecure. The odds ratio predicting poor self-rated health for the economically insecure participants was significantly high (odds ratio: 3.19, 95%, Confidence Interval (CI): 2.53-4.02, and P < 0.001). Similarly, the adjusted odds ratio for poor self-rated health was significantly high for the economically insecure participants in multivariate analyses controlling for factors such as age, gender, cooking frequency, and social participation (adjusted odds ratio: 2.21, 95%, CI: 1.70-2.88, and P < 0.001). Furthermore, a similar trend was observed in stratified analyses based on gender and age groups.

CONCLUSION

Economic security predicted self-rated health independently of confounders, including social participation and cooking frequency, among the elderly Japanese living alone in communities.

Increased levels of sodium chloride directly increase osteoclastic differentiation and resorption in mice and men

To better understand the association between high salt intake and osteoporosis, we investigated the effect of sodium chloride (NaCl) on mice and human osteoclastogenesis. The results suggest a direct, activating role of NaCl supplementation on bone resorption.

INTRODUCTION

High NaCl intake is associated with increased urinary calcium elimination and parathyroid hormone (PTH) secretion which in turn stimulates the release of calcium from the bone, resulting in increased bone resorption. However, while calciuria after NaCl loading could be shown repeatedly, several studies failed to reveal a significant increase in PTH in response to a high-sodium diet. Another possible explanation that we investigated here could be a direct effect of high-sodium concentration on bone resorption.

METHODS

Mouse bone marrow macrophage and human peripheral blood mononuclear cells (PBMC) driven towards an osteoclastogenesis pathway were cultivated under culture conditions mimicking hypernatremia environments.

RESULTS

In this study, a direct effect of increased NaCl concentrations on mouse osteoclast differentiation and function was observed. Surprisingly, in a human osteoclast culture system, significant increases in the number of tartrate-resistant acid phosphatase (TRAP)-positive osteoclasts, calcitonin receptor (CTR)-positive osteoclasts, nuclear factor-activated T cells c1 (NFATc1) gene expression, and areal and volumetric resorptions were observed for increasing concentrations of NaCl. This suggests a direct, activating, cell-mediated effect of increased concentrations of NaCl on osteoclasts.

CONCLUSIONS

The reported that enhanced bone resorption after high-sodium diets may not only be secondary to the urinary calcium loss but may also be a direct, cell-mediated effect on osteoclastic resorption. These findings allow us to suggest an explanation for the clinical findings independent of a PTH-mediated regulation.

Photoluminescence from vibrational excited-states for organic molecules adsorbed on Si nanoparticles

Herein, Si nanoparticles have been fabricated from Si swarf using a bead milling method. The adsorption of 9,10-dimethylanthracene (DMA) on Si nanoparticles enhances the photoluminescence (PL) intensity by ∼60 000 times that of DMA in hexane. The PL spectra possess peaked structures due to the vibronic transition of DMA. For the excitation energies higher than 4.0 eV, vibronic bands with energies higher than the (0, 0) band were observed and attributed to PL from the vibrational excited-states. The excitation spectra showed that incident light was absorbed by both DMA and the Si nanoparticles. The lifetime of the photo-generated electron-hole pairs in the Si nanoparticles was much longer than the DMA PL lifetime; this indicated that either a hole or an electron transferred to DMA first, followed by an opposite charge transfer. In the cases where a hole is first transferred to DMA, an electronic ground-state is stabilized via solvation. When an electron is captured by the potential of the electronic excited-state, transitions from the vibrational excited-states proceed due to the high transition probability, generating PL bands with energies higher than the (0, 0) band. In the cases where an electron is first transferred to DMA, internal relaxation to the vibrational ground-state occurs, and the potential of the electronic excited-state is lowered via solvation.

Effect of GLP-1 receptor agonist on gastrointestinal tract motility and residue rates as evaluated by capsule endoscopy

AIM

This study evaluated the effects of a glucagon-like peptide-1 receptor agonist on gastrointestinal (GI) tract motility and residue rates by examining GI transit time and lumen using capsule endoscopy.

MATERIAL AND METHODS

GI motility and lumen were assessed by capsule endoscopy before and after liraglutide administration in 14 patients with type 2 diabetes mellitus (T2DM).

RESULTS

Gastric transit time in the group with diabetic neuropathy (DN) was 1:12:36±1:04:30h before liraglutide administration and 0:48:40±0:32:52h after administration (nonsignificant difference, P=0.19). Gastric transit time in the non-DN group was 1:01:30±0:52:59h before administration and 2:33:29±1:37:24h after administration (significant increase, P=0.03). Duodenal and small intestine transit time in the DN group was 4:10:34±0:25:54h before and 6:38:42±3:52:42h after administration (not significant, P=0.09) and, in the non-DN group, 3:51:03±0:53:47h before and 6:45:31±2:41:36h after administration (significant increase, P=0.03). The GI residue rate in the DN group was 32.1±24% before administration and 90.0±9.1% after administration (significant increase, P<0.001), and increased in all patients; in the non-DN group, it was 32.1±35.3% before and 78.3±23.9% after administration (significant increase, P<0.001), and also increased in all patients.

CONCLUSION

Liraglutide causes delayed gastric emptying and inhibits duodenal and small intestine motility. However, these GI movement-inhibiting effects may be decreased or absent in patients with DN-associated dysautonomia.

EXTERNAL AND INTERNAL EXPOSURE TO FUKUSHIMA RESIDENTS

The Great East Japan Earthquake of 11 March 2011, caused the Fukushima Daiichi Nuclear Power Plant Accident, which resulted in the release of a large amount of radioactive materials into the environment, and there is a serious concern about the radiation effects on the health of residents living in the affected areas. The evaluation of exposure dose is fundamental for the estimation of health effects, and whenever possible, the exposure dose should be evaluated by actual measurements as opposed to estimations. Here, the outline of the exposure doses of residents estimated from surveys or obtained by measurements is described. Fukushima Health Management Survey reported the results for 460 408 residents during the first 4 months after the accident; 66.3% received doses <1 mSv, 94.9% received <2 mSv, 99.7% received <5 mSv and the maximum dose was 25 mSv. Thus, it was demonstrated that the results from personal dosemeter measurements were comparable to the estimations. The dose assessment of internal exposure of 184 205 residents conducted by Fukushima Prefecture by using whole body counter showed that 99.986% received <1 mSv, with the maximum dose being 3 mSv. Regarding exposure of the thyroid, there is not enough data for the Fukushima accident, but it is presumed that thyroid doses are much lower than those from Chernobyl. The outline of exposure doses of residents in result of the accident is still being clarified, questions and uncertainties in dose assessment remain and further efforts for more accurate dosimetry are required continuously.

Suspected Metallic Embolism following Endovascular Treatment of Intracranial Aneurysms

We describe a case series of suspected metallic embolism after coil embolization for intracranial aneurysms. Between January 2012 and December 2014, 110 intracranial aneurysms had been treated by coil embolization in our institution. In 6 cases, the postprocedural MR imaging revealed abnormal spotty lesions not detected on the preprocedural MR imaging. The lesions were also undetectable on the postprocedural CT scan. They were demonstrated as low-intensity spots on T1WI, T2WI, DWI, and T2*-weighted imaging. On DWI, they were accompanied by bright "halo," and on T2*-weighted imaging, they showed a "blooming" effect. In 3 of the 6 cases, follow-up MR imaging was available and all the lesions remained and demonstrated no signal changes. Although histologic examination had not been performed, these neuroradiologic findings strongly supported the lesions being from metallic fragments. No specific responsible device was detected after reviewing all the devices used for the neuroendovascular treatment in the 6 cases.

MR Imaging of Monostotic Fibrous Dysplasia of the Clivus

We describe the MR appearance of a case of monostotic fibrous dysplasia confined to the clivus. The lesion showed intermediate signal intensity on T2-weighted images which is uncommon among clival diseases.

Temporomandibular Joint Movement

Ten temporomandibular joints (TMJs) of 5 healthy volunteers and 19 TMJs of internal derangements in 16 patients with splint therapy were examined with MR imaging. T1-weighted images were obtained only in the closed mouth position, and gradient recalled acquisition in steady state (GRASS) images were obtained in active opening and closing phases, allowing a pseudodynamic display of TMJ movement. All patients received protrusive splint treatment. The usefulness of MR imaging to assess the efficacy of splint therapy was evaluated. Corrected disk position with the splint in place was clearly demonstrated in 9 TMJs, corresponding with elimination of reciprocal clicking. Ten other TMJs of anterior disk displacement without reduction showed uncorrected disk position by the splint. This information could confirm the therapeutic efficacy, or suggest other treatment alternatives. GRASS MR imaging can provide accurate and physiologic information about disk function in initial and follow-up assessment of protrusive splint therapy.

Effects of Contrast Media on the RR and QT Interval during Coronary Arteriography

During coronary arteriography, transient prolongation of the RR and QT intervals can be observed to occur. Animal experiments have suggested that low-osmolality contrast media have less effect, but there have been few clinical studies of this phenomenon. We analyzed 95 electrocardiographic records from patients who had undergone coronary arteriography and assessed the maximal prolongation of the RR and QT intervals. The contrast media used for arteriography included meglumine sodium diatrizoate, iopamidol, iohexol, and meglumine sodium ioxaglate. Diatrizoate caused the greatest electrocardiographic changes. Among the low osmolality contrast media, ioxaglate caused the smallest bradycardial effect and iohexol the smallest prolongation of the QT interval. It appears necessary to consider some additional factors for osmolality or ionicity, such as the chemotoxicity of the chemical structure of the iodinated contrast medium moiety, when assessing their potential adverse effect on the cardiac conduction system.

Limited reduction of ferrihydrite encrusted by goethite in freshwater sediment

Many physical and chemical processes control the extent of Fe(III) oxyhydroxide reduction by dissimilatory Fe(III)-reducing bacteria. The surface precipitation of secondary Fe minerals on Fe(III) oxyhydroxides limits the extent of microbial Fe(III) reduction, but this phenomenon has not yet been observed in nature. This paper reports the observation of secondary Fe-mineral (goethite) encrustation on ferrihydrite surface within freshwater sediment up to 10 cm deep. The sediment surface was characterized by the predominance of ferrihydrites with biogenic stalks and sheaths. An Fe(II)-oxidizing bacterium (Gallionellaceae) was detected by 16S rRNA gene analysis at sediment depths of 1 and 2 cm. Fe(2+) concentration in the sediment pore water was relatively higher at 2-4 cm depths. The 16S rRNA genes affiliated with dissimilatory Fe(III)-reducing bacteria were detected at 1, 2, and 4 cm depths. The results of the Fe K-edge extended X-ray absorption fine structure (EXAFS) analysis suggested the presence of goethite and siderite at depths below 3 cm. However, the change in the Fe-mineral composition was restricted to sediment depths between 3 and 4 cm, despite the presence of abundant ferrihydrite at depths below 4 cm. An increase in CH4 concentration was observed at deeper than 6 cm. Stable isotopic analysis of CH4 in the pore water indicated that acetoclastic CH4 occurred at depths below 7 cm. Transmission electron microscope observations suggested the presence of goethite and siderite on stalks and sheaths at depths below 3 cm. Results from conversion electron yield EXAFS analysis suggested that goethite dominated at 10 cm depth, thereby indicating that ferrihydrite was encrusted by goethite at this depth. Moreover, the incomplete reduction of ferrihydrite below depths of 4 cm was not due to the lack of organic carbon, but was possibly due to the surface encrustation of goethite on ferrihydrite.

Altered neurotrophic factors' expression profiles in the nucleus of the solitary tract of spontaneously hypertensive rats

AIM

Our previous findings suggest that the nucleus of the solitary tract (NTS), a pivotal region for regulating the set point of arterial pressure, exhibits abnormal inflammation in pre-hypertensive and spontaneously hypertensive rats (SHRs), with elevated anti-apoptotic and low apoptotic factor levels compared with that of normotensive Wistar-Kyoto (WKY) rats. Whether this chronic condition affects neuronal growth and plasticity in the NTS remains unknown. To unveil the characteristics of the neurodevelopmental environment in the NTS of SHRs, we investigated the expression of neurotrophic factors transcripts in SHRs.

METHODS

RT(2) Profiler PCR Array targeting rat neurotrophins and their receptors was used to screen for differentially expressed transcripts in the NTS of SHRs compared to that of WKY rats. Protein expression and physiological functions of some of the differentially expressed transcripts were also studied.

RESULTS

Gene and protein expressions of glial cell line-derived neurotrophic factor family receptor alpha-3 (Gfrα-3) factor were both upregulated in the NTS of adult SHRs. Gene expressions of corticotropin-releasing hormone-binding protein (Crhbp), interleukin-10 receptor alpha (Il-10ra) and hypocretin (Hcrt) were downregulated in the NTS of adult SHRs. The Gfrα-3 transcript was increased and the Hcrt transcript was decreased in the NTS of young pre-hypertensive SHRs, suggesting that these profiles are not secondary to hypertension. Moreover, microinjection in the NTS of hypocretin-1 decreased blood pressure in adult SHRs.

CONCLUSION

These results suggest that altered neurotrophic factors transcript profiles may affect the normal development and function of neuronal circuitry that regulates cardiovascular autonomic activity, thereby resulting in manifestations of neurogenic hypertension in SHRs.

Emergency Responses and Health Consequences after the Fukushima Accident; Evacuation and Relocation

The Fukushima accident was a compounding disaster following the strong earthquake and huge tsunami. The direct health effects of radiation were relatively well controlled considering the severity of the accident, not only among emergency workers but also residents. Other serious health issues include deaths during evacuation, collapse of the radiation emergency medical system, increased mortality among displaced elderly people and public healthcare issues in Fukushima residents. The Fukushima mental health and lifestyle survey disclosed that the Fukushima accident caused severe psychological distress in the residents from evacuation zones. In addition to psychiatric and mental health problems, there are lifestyle-related problems such as an increase proportion of those overweight, an increased prevalence of hypertension, diabetes mellitus and dyslipidaemia and changes in health-related behaviours among evacuees; all of which may lead to an increased cardiovascular disease risk in the future. The effects of a major nuclear accident on societies are diverse and enduring. The countermeasures should include disaster management, long-term general public health services, mental and psychological care, behavioural and societal support, in addition to efforts to mitigate the health effects attributable to radiation.

ORGAN CULTURE OF ADULT HUMAN SKIN

Proliferation and differentiation of the epidermis in organ culture of adult human skin by the sponge matrix method were studied histologically and autoradiographically, and the following results were obtained: 1) On the first day of culture, mitotic figures were already observable in the epidermis. The outgrowth of epidermal cells at the margins of the explants started. On the second day, there was transformation to a zone that will be referred to as the newly formed stratum corneum in the upper epidermis. 2) On the third and fourth days, the increased growth of epidermal cells caused thickening of the epidermis. Simultaneously, Malpighian cells progressively differentiated into a cornified layer. 3) On and after the fifth day, the basospinous cell layer was reduced in thickness in most of explants. On the ninth and tenth days, DNA synthesis in the basal layer was still obvious, although the epidermis showed a thickness of only one or two cells overlaid with a large number of horny layers. 4) In the culture medium supplemented with corticosteroid, the epidermal growth was slightly depressed with lessened formation of stratum corneum in the early stages of culture as compared with the explants cultured in the basic medium. The reduction of the basospinous layer was scarcely notable after the fifth day. Even after 10-11 days, epidermal cells were well preserved and their stratified squamous architecture was less disorganized. It seemed that corticosteroid could prolong the survival of adult human skin in vitro. These findings indicate that this culture technique could be used as a model for organ culture of adult human skin.

16 BIOCHEMICAL ANALYSIS OF COMPONENT IN SEMINAL GEL SECRETED WITH BOAR SEMEN

Seminal gel (SG), a part of semen, of the boar originates from secretions from the Cowper's gland and has a high viscosity and water-holding capacity, preventing backflow of semen at natural mating. However, there are is little information available about biochemical and functional characteristics of boar SG. In this study, as a first step to elucidate the chemical features of the SG, we examined the structure of O-glycans and the primary structure of protein from the boar SG. Seminal gel was collected from ejaculated semen of a Berkshire boar with high fertility and freeze-dried. Samples were preserved in a refrigerator until experiments were conducted. For Exp. 1 the presence of O-glycans in SG was confirmed by detection of the amino sugar, galactosamine (GalNH2), from acid hydrolysis of GalNAc. The freeze-dried SG (1 mg) was hydrolyzed with 4N trifluoroacetic acid at 110°C for 2 h. The resulting amino sugar was labelled with phenyl isothiocyanate (PITC) and then analysed by RP-HPLC. The GalNAc was detected as a main amino sugar, suggesting that the SG contains O-glycosylated glycoprotein. For Exp. 2 the O-glycans were prepared from the freeze-dried SG (5 mg) by hydrazinolysis at 100°C for 2 h. After N-acetylation, the O-glycans were pyridylaminated. The structures were identified by anion-exchange HPLC, size-fractionation HPLC, glycosidase digestion, and ESI-MS and MS/MS analysis. Almost all glycans were digested by α2–3,6-sialidasae, indicating that these O-glycans are sialylated and give the glycoproteins viscosity. Furthermore, the MS analysis showed that the de-sialylated O-glycans consist of HexNAc-PA (m/z 300.0) and Hex-HexNAc-PA (m/z 462.0) and major glycans are di- or tri-saccharides. For Exp. 3 proteins in the SG were separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis under reducing condition with 5% 2-mercaptoethanol. Proteins were stained with Coomassie Brilliant Blue R-250. Three bands (~160, 140, and 70 kDa) were found on 7.5% polyacrylamide gel, but two bands (160, 140 kDa) were converted to ~130 kDa after the sialidase digestion, indicating that native two proteins (160 and 140 kDa) may be highly sialylated. For Exp. 4 internal amino acid sequence was analysed using one of the peptic peptides. The freeze-dried SG (5 mg) was digested with porcine pepsin in 5% formic acid at 37°C for 3 h. The resulting peptides were separated by RP-HPLC. N-terminal sequence of one of the peptic peptides was WSEKYGIPGGKAH. The amino acid sequence showed a high homology with tyrosine-protein kinase ZAP-70. These results suggest that boar SG contains mucin-like glycoproteins carrying heavily sialylated O-glycans. Additionally, the current study suggests a possibility that some protein components of the boar SG derive from high concentration of the kinase in (dead) sperms.

Vaccination during the 2013-2014 influenza season in pregnant Japanese women

This questionnaire survey was conducted at 11 hospitals in Japan to determine vaccination coverage against seasonal influenza and the prevalence rate of influenza among pregnant Japanese women. Of 2,808 postpartum women who gave birth at the 11 hospitals during the study period from March 1, 2014, to July 31, 2014, 1,713 (61 %) participated in this study and 876 (51 %) reported having received vaccination against influenza in or after October 2013. Women aged <25 years had a significantly lower vaccination rate than those aged ≥25 years (31 % vs. 53 %, respectively; p = 0.0000). Eighty-seven (5.1 %) and 1,626 (94.9 %) women did and did not contract influenza, respectively. Although prior birth did not affect overall vaccination coverage (50 % for primiparous vs. 53 % for multiparous), multiparous women had a significantly higher rate of contracting influenza than primiparous women, irrespective of vaccination status (5.6 % vs. 2.2 % [p = 0.0216] and 9.7 % vs. 3.5 % [p = 0.0003] for women with and without vaccination, respectively). The 2013-2014 vaccination program significantly reduced the influenza infection rate by 35 % (3.9 % vs. 6.3 % for women with and without vaccination, respectively; p = 0.0272). Seventy-two (83 %) of the 87 women took antiviral agents for the treatment of influenza and two (2.3 %) required hospitalization. These results suggested that pregnant Japanese women had a high level of concern regarding seasonal influenza. However, campaigns targeting young pregnant Japanese women, as well as multiparous women, for vaccination are needed in order to further reduce the incidence of influenza among pregnant Japanese women.