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Get PDFObjectives: To assess reducing travel time to perinatal care centers, and to examine whether reducing travel time influences the neonatal mortality rate (NMR). Methods: The travel time from a population centroid in each municipality to the nearest perinatal care center was measured using the Geographic Information System at two time points, 2002 and 2006. Areas with and without reductions in travel time were compared for changes in the NMR. The Difference-In-Difference Estimation was used to examine whether the NMR decreased in areas with reducing travel times. Results: The median travel time was reduced from 66.99 minutes in 2002 to 39.09 minutes in 2006, and the mean NMR decreased from 1.72 (2002) to 1.33 (2006). The travel time showed great disparities. Of the areas that in 2002 had travel times longer than 60 minutes, by 2006 some areas that had improved accessibility by reducing travel time also had significant reductions in the NMR compared with regions that did not reduce travel time by 2006. Conclusions: Reducing travel time to perinatal care centers by reconsidering the location of such centers is an effective strategy to reduce the NMR in Japan.departmental bulletin pape
Get PDFThis study examined the effects of early intervention on mothers and their preterm infants. Intervention aimed to facilitate mother-infant interaction by enhancing the mother's ability to modulate her infant's state and to read infant cues. Specifically, the intervention consisted of a nurse researcher visiting the Neonatal Intensive Care Unit (NICU) before each infant was discharged, and conducting post-discharge home visits until the infant reached a corrected age of 60 weeks. For research design purposes, mother-infant dyads were placed into either (1) an Intensive Intervention Group (IIG) or (2) a Mild Intervention Group (MIG). The outcomes of the groups were then compared. The effects of early intervention were rated by examining mother-infant interaction and the durations of infant sleep and crying. Despite individual differences, there were more improved interaction scores at Time 1 in IIG members that had recorded lower interaction scores earlier than those of MIG. A lower frequency of night crying was also recorded from the IIG. The results implied that interventions teaching state-modulation methods and cue reading to the mothers should be started while their infants are in the NICU.departmental bulletin pape
Get PDFThe present study investigated resting cardiac autonomic function in Japanese climacteric women using heart rate variability (HRV) power spectral analysis to evaluate the relationship between HRV indices and estrogen, as well as the ability of each HRV index to predict vasomotor symptoms. Fortyfive peri- and postmenopausal women completed a questionnaire about the presence of vasomotor symptoms (hot flashes, sweating). To analyze the relationship between HRV and hot flashes or sweating, we classified subjects into groups based on symptoms and combinations of symptoms: no hot flashes (H1), hot flashes (H2), non-sweating (S1), sweating (S2), neither hot flashes nor sweating (V1), either hot flashes or sweating (V2), and both hot flashes and sweating (V3). Values for total power and the low-frequency component of HRV were significantly lower in the H2 group than in H1 ( p < 0.05); values for total power and the high-frequency and low-frequency components of HRV were significantly lower in group S2 than S1 ( p < 0.05); and values for total power and the high-frequency and low-frequency component of HRV were significantly lower in groups V2 and V3 compared to V1 ( p < 0.05). Clinical diagnosis of climacterium relies upon subjective complaints of patients. Our findings suggest that HRV indices may help to evaluate vasomotor symptoms.departmental bulletin pape
Get PDFIntroduction: Endobronchial ultrasound-guided tranbronchial needle aspiration (EBUS-TBNA) can be applied to not only the determination of the clinical stages of lung cancer, but also the diagnosis of lymphadenopathies such as lymphoma and sarcoidosis. Case Report: We report the successful diagnosis of a combined thymic epithelial tumor in a 68-yearold female by EBUS-TBNA. The patient presented with a 6-month history of dysesthesia in bilateral legs. Chest computed tomography revealed a 5.5 cm-tumor with heterogeneous enhancement in the superior and anterior mediastinum. The serum levels of ProGRP and NSE were elevated and anti- Hu antibody was positive at the time of diagnosis. A biopsy by EBUS-TBNA revealed histological evidence of a combined thymic epithelial tumor consisting of small cell neuroendocrine carcinoma and thymic carcinoma. Chemo-radiotherapy reduced the tumor remarkably in size, but the patient’s neurologic symptoms remained. Conclusion: This case suggests that EBUS-TBNA is a safe and useful technique for the diagnosis of paratracheal mediastinal tumors.departmental bulletin pape
Get PDFIt has become clear that food crushing is performed in the circumscribed region between functional cusps, that is, at “the main occluding area”. However, the position of the main occluding area in patients with fixed partial dentures (FPDs) has not been investigated quantitatively yet. There is a possibility that the load onto the abutment teeth of FPDs is loaded excessively depending on the position of the main occluding area at the early stage of mastication. Therefore the position of the main occluding areas of the FPDs was investigated. The purpose of this study was to evaluate the position of the main occluding area in patients with FPDs quantitatively. We compared the position of the main occluding area between the control subjects who had complete dentition and the patients who wore FPDs for replacing missing first lower molars. Pieces of temporary filling material were used as test material to decide the position of the main occluding area. The centroid coordinate of the test material was calculated and projected onto the reference axis in order to evaluate the position of the main occluding area. Moreover, we recorded the occlusal contact areas at the intercuspal position in order to evaluate the relationship between the position of main occluding area and occlusal contacts. As a result, the position of the main occluding areas in the FPD group were significantly posterior to those in the control group and tended to be less stable. Besides occlusal contact area, existence of periodontal ligaments in the pontic region may cause the difference of the positions of the main occluding area between the FPD group and the control group.departmental bulletin pape
Get PDFWe recently surveyed parasitic infections in 334 foreigners living as permanent residents in Japan. The survey results are presented herein. Our results highlight open issues in Japan, with reference to measures taken in Western countries where immigrants have long been accepted. In addition, we present our epidemiological method for investigating parasitic infection, making use of simple and valid large-scale screening. Among the foreigners participating in this survey, parasitic infections other than those in toxoplasmosis antibody positive individuals were rare. However, in view of the recent trend for increased total numbers of foreigners living in Japan, the onset of parasitic infections is anticipated to increase in Japan henceforth.departmental bulletin pape
Get PDFIt is not certain whether graduate-entry program (GEP) or non-graduate-entry program (non-GEP) in medical education is desirable to foster excellent medical physicians in Japan. In order to clarify the present state and problems of GEP, we visited 27 national medical schools which have introduced limited term college graduate-entry program and discussed with the deans, the education committee and administration affairs. GEP students are elder and usually study harder than regular non-GEP course students. Therefore, they got the higher grades at 1-2 classes of GEP course than the regular non-GEP course students. However, some GEP students lost motivation to study medicine and got poor grades at higher class. There was no definite difference of the final grades at the graduation between GEP and non-GEP students. Most of GEP students became medical practitioners and few students chose physician scientist majoring in basic medicine. We did not find any advantage of GEP compared with regular non-GEP. The results show that the introduction of GEP throughout Japan should be discussed carefully.departmental bulletin pape
Get PDFThis study was conducted to characterize the distribution of epithelial regeneration in lungs with diffuse alveolar damage (DAD) and to ascertain whether epithelial regeneration is associated with the underlying disease and/or DAD stage. Methods: Lung specimens obtained at autopsy from 18 patients were studied using p63, PE-10 and Ki-67 immunostaining. The patients were categorized into two groups: patients with acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF; IPF group) and patients without IPF (non-IPF group). Results: p63-positive cells were mostly observed in the alveolar ducts. No significant difference in the appearance of the p63-positive cells was observed between the IPF and non-IPF groups or between the exudative and the proliferative stages. PE-10- positive cells were observed in the alveoli. The number of PE-10-positive cells was significantly higher during the proliferative stage than during the exudative stage. However, p63-positive cells and PE-10-positive cells appeared at day 6 in the earliest case during the exudative stage and Ki- 67-positive cells were observed during the exudative stage. Conclusion: Epithelial regeneration was not associated with the underlying disease. This study revealed that regenerative epithelial cells appeared at day 6 during the exudative stage and that the number of type Ⅱ pneumocytes increased significantly during the proliferative stage.departmental bulletin pape
Get PDFObjectives: This study investigated the effects of reclining position on swallowing functions in the patients who had undergone surgery for oral tumors. Subjects and Methods: 53 Patients after oral tumor surgery who had undergone the videofluoroscopic swallowing study in the sitting position and reclining position were sampled. We measured Oral transit time (OTT), Pharyngeal transit time (PTT), Penetration-Aspiration scale, Locating of the leading edge of bolus at swallow onset, Route of bolus transit and Transit velocity. Results: Laryngeal penetration and aspiration were less likely to occur in the reclining position. The mean OTT was significantly shorter in the reclining position than in the sitting position. The leading edge of bolus at swallow onset was significantly lower in the reclining position than in the sitting position. The bolus went along the posterior wall of the pharynx in more patients in the reclining position. The mean PTT and the transit velocity did not significantly differ between the reclining position and the sitting position. Conclusion: This study suggested that, in patients after surgery on oral tumors, the reclining position is a useful posture to aid oral transit and to readily prevent aspiration and laryngeal penetrationdepartmental bulletin pape
Get PDFNAD(P)H:quinone acceptor oxidoreductase (NQO) 1 polymorphism is associated with various hematological malignancies, especially infant leukemia or therapy-related leukemias, which involve the rearrangement of mixed lineage leukemia (MLL ) gene. Epstein-Barr virus (EBV)- transformed lymphoblastoid cell lines (EBVLCLs) with either of 2 well known polymorphic variations of C609T and C465T were selected from our archives of EBV-LCL clones and studied the induction of p53 expression after DNA damage. Irradiation of cells with C609T/C609T polymorphism (NQO1 *2*2) did not affect the induction of p53 expression. However, irradiation of cells with C465T/WT polymorphism (NQO1 *1*3) resulted in attenuation of p53 and p21 induction. Our results suggest that increased risk of infant leukemia development in patients with NQO1 *1*3 polymorphism is partially dependent on the inhibition of p53 pathway, though further studies are needed to fully understand the pathological role of C465T variant in the development of childhood leukemia.departmental bulletin pape