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Objective　Although a number of previous studies have investigated the association between natural disaster-related physical injury and mental health, very few have focused on mild physical injury. The aim of this study was to evaluate the association between natural disaster-related mild physical injury and psychological distress in a cross-sectional study.Method　This study is a part of the Shichigahama Health Promotion Project, which was conducted in cooperation with the Tohoku University and Shichigahama Town, Miyagi Prefecture, after the Great East Japan Earthquake (GEJE). We conducted the research about one year after the GEJE, and performed logistic regression analyses using 3,844 participants (1,821 males/2,023 females) aged 20 years or older, who answered all the questions on physical injuries and the Kessler 6 scale (K6), after adjusting for gender, age, social factors, and lifestyles. Psychological distress was defined as a K6 score ≥ 13 out of 24 points. We also investigated the effect of other disaster situations on the association between mild physical injury and psychological distress by stratifying the dataset by bereavement, witnessing someone's death, and house damage.Results　The participants with physical injury were at a significantly higher risk of psychological distress, with an adjusted odds ratio (aOR) of 2.05 and 95% confidence interval (CI) of 1.26-3.34, than those uninjured. Additionally, the participants with mild physical injury were at a significantly higher risk of psychological distress (aOR=2.18, 95% CI=1.32-3.59). In the subgroup of participants with small-scale house damage, mild physical injury was significantly associated with psychological distress with an aOR of 4.01 and 95% CI of 2.03-7.93, whereas not in the subgroup of those with large-scale house damage, and a significant interaction was detected between mild physical injury and house damage.Conclusion　We investigated the association between natural disaster-related physical injury and psychological distress in a cohort of approximately 4,000 residents in an area devastated by the GEJE. In this study, natural disaster-related physical injury was positively associated with psychological distress. The finding indicates that even mild physical injury can be an indicator of high risk for psychological distress.

Objectives: Interventions that promote physical activity to prevent psychological distress and disuse syndromes were carried out in disaster-stricken areas. However, the effect of these interventions to promote physical activity in disaster-stricken areas has not yet been fully clarified. The purpose of this study was to examine the health effects of promoting physical activity in a disaster-stricken area., Methods: We conducted an exercise intervention as part of a health survey project among residents of Ishinomaki-city, Miyagi, Japan in 2012. To determine if changes in health condition differed between intervention participants and nonparticipants, health condition data from 81 participants were compared with data from 81 nonparticipants selected by propensity score matching. Factors including sex, age, original address (pre-quake), and six outcome variables (psychological distress [K6 score], subjective health status, sleep duration, sleep quality, frequency of outings, and time spent walking) were used for matching. A linear mixed model was used for statistical analysis., Results: There were no significant differences in K6 score between participants and nonparticipants (P=0.913). Significant improvements were observed in subjective health status (P=0.011) and outing frequency (P=0.002), but not in other outcome variables., Conclusion: Subjective health status and outing frequency were significantly improved among participants of the exercise intervention. Exercise intervention may be an effective public health strategy in disaster-stricken areas.

Adjuvant chemotherapy for advanced gastric cancer has not yet been established. We report a patient with advanced gastric cancer responding remarkably to neo-adjuvant combination chemotherapy consisting of CPT-11 and S-1. The patient was a 69-year-old woman diagnosed with large type 3 advanced gastric cancer with esophageal invasion and having No.3 lymph node metastasis (cT3, cN1, cM0, cStage IIIA), treated with 2 courses of CPT-11 plus S-1 as neo-adjuvant chemotherapy. Computed tomography after neo-adjuvant chemotherapy showed improvement of gastric wall thickness and reduction of lymph node metastasis. Subsequently, she underwent an operation. There was no lymph node swelling,so we performed curative surgery consisting of total gastrectomy, splenectomy, cholecystectomy, and D 2 lymph node dissection. Histological diagnosis was pT2 (MP), pN1, pStage II, and estimation of the histological change by chemotherapy was Grade 2. The course after surgery was good, and she was treated by S-1 after discharge. To date, 8 months after surgery, there is no evidence of recurrence. Combination chemotherapy consisting of CPT-11 plus S-1 can be performed safely as a neo-adjuvant treatment, and may be an effective treatment modality for advanced gastric cancer.

This study was designed to seek for the optimal anticancer agents for a combination of chemotherapy and specific immunotherapy using dendritic cells (DC) in gastric cancer. We investigated the immuno-suppressive activity of anticancer agents on human peripheral blood mononuclear cells (PBMC), apoptosis inducing activity on gastric cancer cells and expression of Toll-like receptor (TLR)-4 mRNA on immatureDCs (iDCs) by paclitaxel (TXL) and docetaxel (TXT). We further compared the cytotoxicity of cytotixic T lymphocytes (CTLs) induced by DCs pulsed with tumor cell lysate and apoptotic cells induced by TXT. Although most of the anticancer agents demonstrated the suppression activity on proliferation of PBMC in a dose dependent manner, TXT, doxifluridine and irinotecan did not show the suppressive activity on PBMC even in the highest drug concentration. About 60% of gastric cancer cells demonstrated apoptosis after a 24-48 hour treatment with both TXL and TXT. Expression of TLR-4 mRNA in iDCs was up-regulated by TXT, not by TXL, and peaked at 2 hours after the treatment. CTLs induced by DCs pulsed with tumor cell lysate and apoptotic cells showed a similar killing activity to target cells. These results suggest that TXT appears to be an optimal anticancer agent for a combination therapy with chemotherapy and tumor specific immunotherapy using dendritic cells in gastric cancer.

Among the gastrointestinal cancers, esophageal cancer is supposed to be relatively sensitive to both radiotherapy and chemotherapy. The efficacy of combined chemo-radiotherapy in unresectable patients has been confirmed by several investigators. However, no prospective randomized controlled trials with surgery alone as a control had demonstrated significant survival benefit by postoperative adjuvant radiotherapy or chemotherapy in resectable patients. Only a slight prolongation of disease-free survival has been demonstrated with postoperative CDDP + 5-FU therapy. Thus, at present time, postoperative adjuvant therapy is not considered to be a standard therapy for resectable esophageal cancer. Clinical trials with more active combination chemotherapy including new anticancer drugs and new therapeutic strategies such as specific cancer immunotherapy and molecular targeting agents are hoped for in the future.

We previously reported that serum complements in patients with Behçet's disease were extremely low just before the ocular attack. On the other hand, C3a and C5a levels, which have anaphylactic activity and chemotactic activity for polymorphonuclear leucocytes, were higher just before the ocular attack than at the time of the ocular attack, and there was negative correlation between C3a/C5a and CH50. In this report, we evaluated complement regulatory proteins. The results of low levels of C3b/C4b receptor (CR1) and membrane cofactor protein (MCP), and low tendency of decay accelerating factor (DAF) and membrane attack complex inhibition factor (MACIF) suggested that the function of complement regulatory proteins in patients with Behçet's disease decreases as a whole. But mean levels of both CH50 and ACH50 were significantly higher than in the controls. Although it is unclear which is the cause and which is the result, we suppose the function of complement production works excessively and these phenomena are caused by making up for the lack of complement regulatory proteins.

Corticosteroid are the main treatment in both systemic and ocular sarcoidosis. Most cases of ocular sarcoidosis, such as iridocyclitis, retinal periphlebitis, optic disc inflammation, vitritis and snowballs can be managed with topical or subconjunctival injections of corticosteroids. However, only rarely cases are systemic steroids indicated. High doses of systemic steroids are effective in unusual manifestations of retinal vein occlusions, retinal and optic disc neovascularization and vitreous hemorrhage. Systemic corticosteroids starting with moderately high doses (40-60 mg/day) with slow tapering according to the clinical response is necessary. Photocoagulation has not been widely used in the treatment of neovascularization, secondary to sarcoidosis.

The postoperative arrhythmias (exclusive of sinus tachycardia) was reviewed in 77 patients (male: 69, female: 8, mean age: 63.9 years) who underwent esophagectomy for esophageal carcinoma. The results were as follows: 1. The incidence of postoperative arrhythmias in all patients but seven who had preoperative chronic atrial fibrillation (af) or pacemaker rhythm was 47.1%, and af was observed most frequently (45.5%). Postoperative arrhythmias occurred in patients with abnormal preoperative electrocardiographic findings more often than in those with normal preoperative electrocardiographic findings (53% vs 41%). The incidence of postoperative arrhythmias in aged patients (> or = 66 years old) was significantly higher than that in younger patients (< or = 65 years old) (64% vs 35%, p < 0.05). Other risk factors for postoperative arrhythmias were sex and history of hypertension. 2. Postoperative arrhythmias occurred more often in patients who underwent blunt dissection of the thoracic esophagus and reconstruction using the whole stomach via the posterior mediastinal route than in those who underwent esophagectomy with right thoracotomy and reconstruction using the gastric tube via the poststernal route (60.0% vs 45.0%). 3. Most supraventricular premature contractions and ventricular premature contractions occurred immediately after surgery or on the first postoperative day, and af often occurred during the first postoperative night or the second postoperative day. 4. For treatment, various antiarrhythmic agents were administered according to the patient's condition. Glucose-insulin-kalium therapy was especially effective (63%). None of the arrhythmias was fatal.

After lobectomy, it is recognized that functional as well as absolute reduction occurs in residual lobes of the operated side. So whether lobectomy is indicated or not is determined by the same criteria as those for pneumonectomy, namely, by the unilateral pulmonary artery occlusion (UPAO) test. However, is it really appropriate to use the same criteria for both lobectomy and pneumonectomy? To answer to this question, in patients with lung cancer we compared the hemodynamics after lobectomy (13 cases) and pneumonectomy (14 cases) with that at the UPAO test. After pneumonectomy, the mean pulmonary arterial wedge pressure (mPWP) was significantly lower than that on the preoperative day and at the test. It seemed that hypovolemic change occurred in the hemodynamics after pneumonectomy. After pneumonectomy, the pulmonary arteriolar resistance index (PARI) was significantly higher than the preoperative value. It was the same as that as at the time of the UPAO test. The total pulmonary vascular resistance index (TPVRI) at the time of the test was significantly higher than the preoperative value, but the TPVRI after pneumonectomy was not significantly higher. The TPVRI tended to decrease after pneumonectomy, compared to the value predicated by the test. These results indicated that some of the cases judged inoperable on the basis of the UPAO test might be operable. On the day of lobectomy, the PARI was significantly higher than the preoperative value, but significantly lower than that at the time of the test. The cardiac index (CI) was significantly higher and the mPWP was significantly lower than each preoperative value.(ABSTRACT TRUNCATED AT 250 WORDS)

In Caucasians, there is close correlation between acute anterior uveitis and histocompatibility antigen HLA-B27. But in Japanese, this is not clear. Therefore, we examined 58 patients with non-granulomatous anterior uveitis (NGAU) about HLA typing in our uveitis clinic at Tokyo Women's Medical College Hospital. HLA-B27 was identified in 20 out of 58 patients (34.5%) with NGAU and it was statistically significant. We also studied the clinical features of patients with HLA-B27 positive NGAU. We found that in HLA-B27-positive NGAU, the visual acuity was more strongly affected during the attack and the duration of inflammation was longer than HLA-B27 negative NGAU patients. The duration of the first attack was longer than re-attack, and the duration of the first attack was longer than HLA-B27 negative NGAU patients. It was less commonly associated with systemic disorders in Japanese HLA-B27 positive anterior uveitis than in Caucasian. However, in Japanese NGAU patients without systemic disorders, there was the same tendency concerning the HLA-B27 positive rate as in Caucasians.

Manometric study was performed to compare the inhibitory effect of glucagon and secretin on the gastroduodenal motor activity by infused catheter method. The subjects consisted of 3 healthy volunteers and 7 patients with peptic ulcer and other diseases. The following results were obtained. After the intravenous administration of glucagon (1 mg), the motor activity of the stomach and duodenum was inhibited promptly. According to statistic evaluation, the contraction numbers and motility index decreased significantly during 25 minutes compared with the basal values in both stomach and duodenum. After the administration of secretin (100 units), gastric motor activity was markedly inhibited, although duodenal motility increased during 10 minutes due to the initiation of secretin-induced migrating motor complex. The contraction numbers and motility index in stomach decreased significantly during 20 minutes after the administration. The inhibitory effect of glucagon was more remarkable in duodenum than in stomach. On the other hand, secretin was more effective in stomach than in duodenum.

Guanabenz (WY-8678) was given to pregnant rabbits to examine its effects on the dams and their fetuses. The drug was administered orally to rabbits at does of 10, 8, 5 and 1 mg/kg/day from the 6th to 18th days of gestation. The vehicle used was 5%-Arabic Gum at dose level of 10 ml/kg, and a control experiment where only the vehicle was administered was also conducted. The results obtained were as follows. 1. Concerning the effects on the dams, the symptoms of decrease in spontaneous movement and sedation were observed at 10 mg/kg. However, mean body weight, food consumption, and organ weight were not influenced by Guanabenz. 2. In the observation of the fetuses, no difference was observed among groups in the number of corpora lutea, the number of implantations, implantation rate, the number of resorption, the number of dead fetuses, the number of live fetuses, sex ratio, mean body weight of the fetuses, mean body length of the fetuses, and mean placenta weight of the fetuses. 3. No difference was observed among groups regarding external malformations, visceral malformations, skeletal malformations, skeletal variations and degree of ossification in the fetuses. From these results, it is concluded that Guanabenz has no teratogenic potential in pregnant rabbits and on effect no fetuses at doses of 8 mg/kg or lower.

Manometric study was performed to investigate the effects of cisapride, a new non-antidopaminergic gastrointestinal prokinetic compound, on interdigestive lower esophageal sphincter pressure (LESP) and gastroduodenal motility using infused catheter technique. The subjects consisted of 9 healthy volunteers and 29 patients with progressive systemic sclerosis (19), reflux esophagitis (8) and others (2). 4 mg of cisapride was given by bolus injection, continuous infusion or oral administration. The following results were obtained: Intravenous and oral cisapride increased LESP compared with basal pressure. Especially, bolus injection of cisapride caused a significant elevation of LESP during 30 minutes after administration. After administration of cisapride, gastroduodenal motility was accelerated gradually, then inducing IMC-like contractions. By bolus injection, IMC-like contractions were induced in healthy subjects more frequently than in patients group. On the other hand, motility index of stomach and duodenum showed persistent increase in patients group compared with healthy subjects. Cisapride-induced IMC-like contractions initiated from LES and upper part of stomach and mediated to duodenum, though aborad migration was not confirmed in the present study.