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To investigate potential clinical and multimodal imaging factors in central serous chorioretinopathy (CSC) recurrence.The study was performed at nine Japanese medical institutions for patients who had experienced an active CSC episode. Demographic data and medical history were reviewed retrospectively. Significant differences in chronic manifestation, leakage site, leakage point number, leakage intensity, choroidal hyperpermeability, central retinal thickness (CRT) and subfoveal choroidal thickness were analysed between the recurrence and non-recurrence groups.In total, 538 eyes (538 patients) diagnosed with CSC (402 men, 136 women; mean age: 53.4 ± 11.9 years) were enrolled. Among them, 253 eyes (47.0%) developed ≥1 recurrence (follow-up: 15.9 ± 13.5 months, range 3-86 months). Univariate and multivariate analyses indicated that a history of corticosteroid use (odds ratio [OR], 5.52; 95% confidence interval [CI], 1.39-21.92; p = 0.015), bilateral disease (OR, 3.94; 95% CI, 1.47-10.6; p = 0.007), chronic manifestations (OR, 7.12; 95% CI, 2.93-17.28; p 0.001), non-intense fluorescein leakage (OR, 3.34; 95% CI, 1.44-7.75; p = 0.005) and initial CRT (OR, 0.997; 95% CI, 0.993-0.999; p = 0.049) were significantly associated with CSC recurrence. Receiver operating characteristic curves were created, and the area under the curve for the multivariate logistic regression model of these five factors was 0.814.Patients with CSC who received corticosteroids and had bilateral disease, chronic manifestation, non-intense fluorescein leakage on fluorescein angiography or a relatively thinner CRT should be closely monitored to identify whether they are at high risk of recurrence.

Aim: The early resignation of newly graduated nurses (NGNs) will become a concern in Japan as the need for nurses increases. The aim of this study was to conduct an investigation using the Effort–Reward Imbalance (ERI) questionnaire to examine the effect of stressful experiences in the work environment and over-commitment on NGNs' intention to leave and to identify the factors that were associated with their intention to leave, clarifying the appropriate times at which to conduct interventions to prevent NGNs from leaving advanced-treatment hospitals. Methods: Anonymous self-administered questionnaires were distributed to all the NGNs (n = 1364) in 14 advanced-treatment university hospitals. Questionnaires with no missing data were returned by 737 NGNs (54%). For the development of the questionnaire, we designed a framework that consisted of the factors that occur during three stages of the NGNs' transition into the workplace. The questions addressed items for individual attributes, employment and organizational characteristics, the Role Model Scale, the ERI questionnaire, two scale items for health status, and the intention to leave. In order to determine the factors that related to the dependent variables, hierarchical multiple linear regression analyses were carried out. Results: We revealed that effort, subjective health status, role models, and effort were important factors that related to the NGNs' intention to leave, as well as their age and city size. Over-commitment and reward were not significant factors. We also found that three subscales of the Job Readiness Scale independently related to the NGNs' intention to leave. Conclusion: These findings can help employers, supervisors, and senior staff of advanced-treatment university hospitals in Japan to improve their work environment in order to benefit NGNs and aid in their retention.

Retinitis pigmentosa (RP) is a collection of diseases in which rod photoreceptors die from a variety of mutations. After rods die, the level of tissue oxygen in the outer retina becomes elevated and there is progressive oxidative damage to cones that ultimately triggers apoptosis. In this study, we investigated the hypothesis that NADPH oxidase and/or xanthine oxidase serve as critical intermediaries between increased tissue oxygen and the generation of excessive reactive oxygen species that cause oxidative damage to cones. Apocynin, a blocker of NADPH oxidase, but not allopurinol, a blocker of xanthine oxidase, markedly reduced the superoxide radicals visualized by hydroethidine in the outer retina in the retinal degeneration-1 (rd1+/+) model of RP. Compared to rd1+/+ mice treated with vehicle, those treated with apocynin, but not those treated with allopurinol, had significantly less oxidative damage in the retina measured by ELISA for carbonyl adducts. Apocynin-treated, but not allopurinol-treated, rd1+/+ mice had preservation of cone cell density, increased mRNA levels for m- and s-cone opsin, and increased mean photopic b-wave amplitude. In Q344ter mice, a model of dominant RP in which mutant rhodopsin is expressed, apocynin treatment preserved photopic electroretinogram b-wave amplitude compared to vehicle-treated controls. These data indicate that NADPH oxidase, but not xanthine oxidase, plays a critical role in generation of the oxidative stress that leads to cone cell death in RP and inhibition of NADPH oxidase provides a new treatment strategy.

Although a previous meta analysis showed some substantial relationships between social support and immune function, there is still no knowledge about the effects of social support on natural killer (NK) cell number. In this study we examined the direct relationships between peripheral lymphocyte subpopulations and several aspects of social support. We administered the Japanese version of the Stress and Coping Inventory (SCI) by Rahe (1994) to 98 male workers with a written informed consent. Blood samples were collected at 10.00 hours. Lymphocytes subsets were measured by flowcytometry using CD3, CD16, and CD56 antibodies. Partial correlation coefficient controlled by age and smoking between social support and immune cells revealed that there were weak but significant correlations between perceived social support and the numbers of CD3-/CD16+and CD3-/CD56+ NK cells (r = 0.25, 0.26). There was no correlation between social support and percentage of NK cells. Positive correlation of perceived social support with NK cell numbers suggested that perceived social support has a direct effect on NK cells and that increased social support might be accompanied by high natural immunity. Further investigation should be undertaken to elucidate why only perceived social support was correlated to NK cells. Copyright © 2003 John Wiley & Sons, Ltd.

applicability of the effort-reward imbalance model, particularly if statistical approaches that measure the model's core notion are extended, and recommendation of repeated measures for exposure. Cross-cultural research on occupational stress is instructive in terms of health science. (J Occup Health 2002; 44: 398-407) Abstract: The Effort-reward Imbalance Model: Experience in Japanese Working Population: Akizumi TSUTSUMI, et al. Okayama University Graduate School of Medicine and Dentistry—The validity of Siegrist's effort-reward imbalance model was examined in Japanese workers: 105 dental technicians, 902 employees of production companies, and 2,827 selected from staff of hospitals. After controlling for possible confounders, levels of the two stress measures, 'effort-reward imbalance' and 'overcommitment', were similar for both genders. The effort-reward imbalance was most prevalent in the 25- 30 age employees and then decreased with age, but the level of overcommitment increased with age. Those with lower educational attainment and others who reported working long hours were more often exposed to effort-reward imbalance and those in the private sector reported higher overcommitment levels than their respective counterparts. Hospital staff (predominantly nurses) had almost twice as high a level of effort-reward imbalance as production workers. A review of empirical studies confirmed validity of the criterion with respect to a self-reported health outcome and the responsiveness of the measures to organizational changes. Nevertheless, the low prevalence of an effort-reward imbalance (originally formulated by Siegrist's group on European samples) in Japanese employees seemed to reduce the statistical power of these tests. A subsequent change in exposure prevalence by defining the top quintile of the distribution of the logarithmic-transformed effort- reward ratio resulted in an improvement in the statistical fit. The Japanese evidence indicates promising

To evaluate the effects of calcium disodium ethylenediamine tetraacetate (CaEDTA) injection on human immune system in relation to exposure to lead, we administered CaEDTA by intravenous injection for 1 hr three times (three consecutive days) a week to two male lead workers. They had been engaged in recycling lead for 31 and 22 years, aged 61 and 53 years (workers 1 and 2), respectively. Before the treatment of CaEDTA, their blood lead concentrations (PbB) were 81 and 68 μg/dl, respectively. The administration of CaEDTA had been carried out to worker 1 for 10 weeks and to worker 2 for 6 weeks. A significant decrease in PbB between before and after three-times CaEDTA injection was found in both workers. Significant increases in IgG, IgA, IgM, CD8+, and CD57+ cells were found in worker 1. A significant increase in IgD was found in worker 2. During the study period, IgG in worker 1 and CD4+ cells in worker 2 were gradually increasing. There was a significant negative correlation between IgG and PbB in worker 1. It is suggested that the immunological function such as antibody formation in lead workers might be improved by CaEDTA injection. Am. J. Ind. Med. 32:674–680, 1997. © 1997 Wiley-Liss, Inc.

An extract obtained from Cynops sperm induced the activation of both Cynops and Xenopus eggs with accompanying changes in the potential of the egg membrane that were quite similar to those caused by the Cynops sperm. The activation-inducing properties of the extract were abolished by treatment with proteinase K or by heating (60°C, 15 min) and were associated with a protease activity against peptidyl Arg-MCA substrates. The activation of Xenopus eggs by the extract was inhibited by those substrates, or by protease inhibitors, aprotinin or leupeptin. The protease activity was localized in the acrosomal region of Cynops sperm. The activation of Xenopus eggs by the extract was prevented when the exterior concentration of Ca2+ions, [Ca2+]0, was reduced to 1.5 μM, but it was enhanced when [Ca2+]0 was increased to 340 μM. The activation of Xenopus eggs by the extract was not affected by positive clamping when [Ca2+]0 was 340 μM. These results suggest that the sperm extract contains a protease that causes an increase in the influx of Ca2+ions that results in voltage-insensitive activation of the egg.