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Study design:Analysis of answers to a new questionnaire.Objective:To examine current practice patterns of physicians in the urological surveillance and management of spinal cord injury (SCI) patients in Japan.Setting:Nationwide questionnaire survey to physicians in Japan.Methods:A Japanese version of the 14-item questionnaire survey carried out in US was mailed to 770 members of the Japanese Neurogenic Bladder Society (JNBS).Results:We received answers to our questionnaire from 333 (43.2%) members of JNBS. The responders were all urologists. For surveillance of the upper urinary tract (UUT), 239 (71.8%) respondents preferred abdominal ultrasound. Cystometry was performed routinely by 174 (52.3%) respondents for the evaluation of vesicourethral function. Cystoscopy was carried out in cases of hematuria (88.0%) and bladder stone (55.3%). Surveillance of the urinary tract was performed every year in 154 (46.2%). For detection of bladder cancer, which 119 (37.9%) respondents have experienced, 94.9% physicians perform cystoscopy, 76.3% urinary cytology, and 60.4% ultrasound. For initial treatment of detrusor-sphincter dyssynergia (DSD), 225 (69.2%) respondents chose α-blocker, and 94 (28.9%) chose clean intermittent catheterization (CIC) with/without anticholinergic agent(s). For initial treatment of overactive bladder, 245 (74.7%) chose anticholinergic agent(s) only and 63 (19.2%) chose anticholinergic agent(s) with CIC. For initial treatment of areflexic bladder, 233 (73.7%) chose CIC and 63 (19.9%) chose Credé maneuver or tapping.Conclusions:This survey shows that there are some differences in urological surveillance and management of SCI patients between Japan and the US. Reasons for the discrepancy should be examined.Spinal Cord (2006) 44, 362–368. doi:10.1038/sj.sc.3101854; published online 6 December 2005 [ABSTRACT FROM AUTHOR]

Background: We aimed to evaluate the validity of self-administered questionnaire surveys and face-to-face interview surveys for the detection of Helicobacter pylori eradication therapy., Methods: Participants were a cohort, aged 40-74 years, living in three different locations of Japan, who took part in the baseline survey (2011-2012) of the Japan Public Health Center-based Prospective Study for the Next Generation (JPHC-NEXT). Five years after the baseline survey, a questionnaire and interview survey were independently conducted to determine the history of Helicobacter pylori eradication treatment over the 5-year period. Prescription of Helicobacter pylori eradication medications in national insurance claims data from the baseline survey to the 5-year survey was used as a reference standard., Results: In total, 15,760 questionnaire surveys and 8,006 interview surveys were included in the analysis. There were 3,471 respondents to the questionnaire and 2,398 respondents to the interview who reported having received Helicobacter pylori eradication treatment within the past 5 years. Comparison of the questionnaire survey to national insurance claims data showed a sensitivity of 95.1% (2,213/2,328), specificity of 90.6% (12,174/13,432), positive predictive value of 63.8% (2,213/3,471), negative predictive value of 99.1% (12,174/12,289), and Cohen's Kappa value of 0.71. Respective values of the interview survey were 94.4% (1,694/1,795), 88.7% (5,507/6,211), 70.6% (1,694/2,398), 98.2% (5,507/5,608), and 0.74., Conclusion: Both the questionnaire and the interview showed high sensitivity, high specificity, and good agreement with the insurance claim prescriptions data. Some participants may have received eradication treatment without going through the public insurance claim database, resulting in a low positive predictive value.

Background: Suicide rates in Japan have increased during the COVID-19 pandemic, and foreign residents may be more vulnerable to mental stress during such crises. Therefore, we aimed to compare the trends in suicide rates during the COVID-19 pandemic between foreign residents and Japanese citizens., Methods: Vital statistics of Japan data from January 1, 2016 to December 31, 2021 were used to calculate quarterly sex-specific suicide rates for foreign residents and Japanese citizens. An event-study analysis was conducted to evaluate whether suicide rates during the COVID-19 pandemic increased compared to pre-pandemic estimates; foreign residents and Japanese citizens were compared using difference-in-difference-in-differences estimates., Results: Between 2016 and 2021, 1,431 foreign residents and 121,610 Japanese citizens died from suicide in Japan. Although the suicide rate for foreign residents was lower than that for Japanese citizens, Korean residents, who comprise approximately half of the foreign decedents, had largely higher suicide rates than Japanese citizens. The event-study analysis indicated that suicide rates increased among foreign residents for both men and women, and continued for men by the end of 2021. In Japanese citizens, after a decline in suicide rates in the second quarter of 2020, suicide rates increased both among men and women, and lasted for women until the fourth quarter of 2021. The difference-in-difference-in-differences analyses confirmed the initial decline in the second quarter of 2020 in suicide rate only in Japanese men and women, and the persistent increase through 2021 in foreign men., Conclusions: We found differential trends in suicide rates between foreign and Japanese men and women during the COVID-19 pandemic featuring a persistent increase in foreign men. Suicide prevention measures should be focused on these high-risk subpopulations., (© 2024. The Author(s).)

The impact of immigrant parents' premigration family background on their second-generation children residing in destination countries remains underexplored in the literature on historical social mobility. Using multigenerational historical survey records from the Japanese American Research Project, this study investigates the influence of premigration socioeconomic and cultural background of Japan-born grandparents and parents on the social mobility of second-generation Japanese Americans born in the continental United States in the early twentieth century. The analysis reveals the enduring effects of family premigration socioeconomic status, as indicated by occupation and education, and culture conducive to upward mobility, proxied by samurai ancestry, on second-generation Japanese Americans' educational and income levels. These effects may extend back to their nonmigrant grandparents and possibly contrast with their European second-generation immigrant counterparts, who typically experienced upward mobility regardless of their family background. The results point to the critical role of origin-country socioeconomic status and culture in immigrant social mobility research, particularly for populations whose negative reception has hindered their resource access in their new countries., (Copyright © 2024 The Authors.)

Objectives: This study investigated conventional cardiovascular and lifestyle risk factors affecting mortality from chronic kidney disease as the underlying cause in the general Japanese population., Methods: We conducted an 18.8-year follow-up study of 44,792 men and 61,522 women aged 40-79 from the Japan Collaborative Cohort Study for Evaluation of Cancer Risk between 1986 and 1990. Cox proportional hazard models were used to analyze the association between risk factors and mortality from chronic kidney disease., Results: During the follow-up period, 373 participants (185 men and 188 women) died from chronic kidney disease. A body mass index of ≥27.0 kg/m2 (hazard ratio [HR], 2.00; 95% confidence interval [CI], 1.19 to 3.36 for men and HR, 1.91; 95% CI, 1.19 to 3.07 for women, compared with 23.0-24.9 kg/m2), a history of hypertension (HR, 2.32; 95% CI, 1.67 to 3.22 for men and HR, 2.01; 95% CI, 1.44 to 2.81 for women) and a history of diabetes mellitus (HR, 5.21; 95% CI, 3.68 to 7.37 for men and HR, 7.10; 95% CI, 4.93 to 10.24 for women) were associated with an increased risk of mortality from chronic kidney disease in both genders. In men, smoking was also associated with an increased risk (HR, 1.91; 95% CI, 1.25 to 2.90), while current drinking (HR, 0.58; 95% CI, 0.34 to 0.98 for <23 g/day; HR, 0.48; 95% CI, 0.29 to 0.80 for 23-45 g/day and HR, 0.53; 95% CI, 0.32 to 0.86 for ≥46 g/day) and exercising ≥5 hr/wk (HR, 0.42; 95% CI, 0.18 to 0.96) were associated with a lower risk. Similar but non-significant associations for smoking and drinking were observed in women., Conclusions: In addition to a history of hypertension and a history of diabetes mellitus, body mass index, smoking status, drinking status, and exercise habits were associated with the risk of mortality from chronic kidney disease.

Purpose: To clarify neonatal bacterial infection management in near term and term infants at a regional hospital in Japan., Methods: Between 2018 and 2020, of 729 births, 236 patients who underwent blood examination at least twice by the age of 3 days, were included. Data from the medical records were analyzed retrospectively., Results: Median gestational age was 39 weeks, with 116 boys (49.1%) and 202 vaginal deliveries (85.6%). There were 37 cases of maternal group B streptococcus, 24 cases of premature rupture of membranes for more than 24 hours (PROM group), and 107 cases of amniotic fluid turbidity at birth (AFT group). Comparing groups, C-reactive protein (CRP) was significantly lower in the cesarean section (C/S) group (median 0.22 mg/dL; p < 0.05), and higher in the AFT group (0.44 mg/dL; p < 0.05). There were 77 positive cultures, (p < 0.05). Antibiotics were administered more frequently in cesarean section (19 cases; p < 0.001) and less in the PROM group (2 cases; p < 0.01)., Conclusions: There were no asymptomatic cases of CRP >2 mg/dL, and no cases of severe sepsis in normal neonatal deliveries. CRP levels were elevated in the AFT group, where culture was positive, but few antibiotics were administered. In the C/S group, antibiotics were administered if respiratory symptoms occurred unless the CRP level was high. Further, all patients in PROM group who received antibiotics had any symptoms, suggesting that routine blood tests may not be necessary.

An oral food challenge (OFC) is useful for managing food allergies. However, because OFCs have the risk of severe allergic reactions, including anaphylaxis, conducting OFCs under this situation without allergy specialists is difficult. To investigate the safety of a low-dose OFC for eggs, milk, and wheat in a general hospital without allergy specialists. We retrospectively analyzed the medical records of children who were hospitalized in a general hospital without allergy specialists for a low-dose OFC of egg, milk, or wheat between April 2018 and March 2021. The records of 108 patients were evaluated. The median age was 15.8 months (range: 7.5-69.3 months). Challenged foods were eggs (n = 81), milk (n = 23), and wheat (n = 4). Fifty-three (49.0%) patients showed positive allergic reactions. Thirty-five (66.0%) patients showed grade 1 (mild), 18 (34.0%) showed grade 2 (moderate), and none showed grade 3 (severe) reactions. The interventions comprised antihistamines (n = 18), prednisolone (n = 3), inhaled Β2-agonist (n = 2). No patients required adrenaline and no deaths occurred. Low-dose OFCs may be safe in a general hospital without allergy specialists. Conducting a low-dose OFC may be essential in food allergy practice.

Aims: Active cigarette smoking was intensively reported to increase the risk of aortic mortality while research on the association between smoking cessation and aortic mortality remains scarce. This study aimed to reconfirm the associations of exposure to cigarettes and smoking cessation associated with aortic mortality in a large Japanese population., Methods: In the Japan Collaborative Cohort (JACC) Study, 91,141 residents (57±10 years; men, 43%) who were free of stroke, coronary heart disease, and cancer were followed up from 1989-90 until 2009 during which 110 deaths from aortic dissection and 112 deaths from aneurysm were identified. Cox proportional hazard model was used to estimate multivariable hazard ratios (95%CI) for total and specific aortic mortality., Results: Compared to never smoking, HRs for total aortic mortality were 2.39 (1.40-4.08) for ＜20, 3.57 (2.19-5.83) for 20-39, and 3.92 (2.37-6.48) for ≥ 40 pack-years exposure. Compared to current smoking, HRs for total aortic mortality were 0.42 (0.18-0.97) for 10-15 years, 0.27 (0.11-0.66) for ＞15 years of cessation, and 0.24 (0.13-0.44) for never smoking. Similar inverse dose-response pattern was observed between smoking cessation duration and risk of mortality from aortic aneurysm (p for trend=0.001), but the association with aortic dissection mortality did not reach statistical significance., Conclusions: Cigarette smoking was associated with an increased risk of aortic mortality while smoking cessation was so with a reduced risk among the Japanese population.

Aim: In this study, we aimed to evaluate the association between age at menarche and risk of cardiovascular disease mortality., Methods: In total, 54,937 women aged 40-79 years old between 1988 and 1990 without a history of cardiovascular disease were eligible for analysis and were followed through December 2009. We used the Cox proportional hazards models to examine the association between age at menarche and risk of cardiovascular disease., Results: Compared with women with age at menarche of 15 years, the hazard ratios (95% confidence intervals) of stroke were 1.22 (0.85-1.75) for women with age at menarche of 9-12 years, 1.08 (0.85-1.36) for those of 13 years, 1.23 (1.02-1.47) for those of 14 years, 1.27 (1.07-1.50) for those of 16 years, 1.16 (0.95-1.41) for those of 17 years, and 1.39(1.16-1.68) for those of 18-20 years (P for trend=0.045). A similar pattern was observed for hemorrhagic stroke, ischemic stroke, and total cardiovascular disease. No such association was found for coronary heart disease. When stratified by age, for women aged 40-59 at baseline, the similar U-shaped association was observed. In contrast, for women aged 60-79 years at baseline, a significantly high hazard ratio was noted in the group of late age at menarche, but not in the group of early age at menarche., Conclusions: Both women with early and late age at menarche were determined to have higher risk of death from stroke and cardiovascular disease.

Several studies have shown that smoking is a significant risk factor for pneumonia, but it is uncertain to what extent smoking cessation reduces the risk. This study aimed to investigate whether and to what extent smoking cessation is associated with reduced risk of mortality from pneumonia in a Japanese, prospective, community-based cohort. We examined 94,972 individuals (mean age, 57 years; women, 57%) who provided valid responses to a lifestyle questionnaire including questions about smoking. We used years of smoking cessation at baseline to divide former smokers into 5 groups: 0-1 year, 2-4 years, 5-9 years, 10-14 years, and 15 years or more. The endpoint was the underlying cause of death from pneumonia. During the median 19-year follow-up of 94,972 study participants, 1806 died from pneumonia. Multivariable hazard ratios (95% confidence intervals) compared with the current smokers were 1.02 (0.72-1.45) for 0-1 year of smoking cessation at baseline, 0.92 (0.70-1.22) for 2-4 years, 0.95 (0.74-1.21) for 5-9 years, 0.71 (0.53-0.96) for 10-14 years, 0.63 (0.48-0.83) for 15 years or more, and 0.50 (0.36-0.70) for never-smokers. Although smoking increases the risk of pneumonia mortality, the present study showed that the risk of pneumonia mortality decreased with years of smoking cessation, eventually improving to levels similar to those of non-smokers for 10 years or more. Continued smoking cessation may be effective in preventing pneumonia deaths., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022. Published by Elsevier Inc.)

Aim: Reports have shown that physical activity is inversely associated with heart failure risk, but evidence in Asian populations is lacking. We sought to examine the impacts of walking and sports participation on heart failure mortality among a Japanese population., Methods: We involved 36,223 Japanese men and 50,615 women (aged 40-79 years) who completed a self-administered questionnaire between 1988 and 1990. We divided participants into four categories of walking (＜0.5, 0.5, 0.6-1.0, and ≥ 1 h/day) and sports participation (＜1, 1-2, 3-4, and ≥ 5 h/week) and examined associations with activity and heart failure mortality through 2009., Results: We found inverse associations between physical activity and heart failure mortality. The multivariable hazard ratios (95% confidence intervals) for the highest category of walking time compared with the second-lowest category were 0.76 (0.59-0.99) in men and 0.78 (0.61-0.99) in women, while the ratios for the highest category of sports participation time compared with the second-lowest category were 0.62 (0.41-0.93) in men and 1.09 (0.73-1.65) in women. The lower hazard ratios in the highest categories of walking and sports participation time in men became no longer statistically significant after excluding heart failure deaths for the first 5, 10, and 15 years for walking time and 10 and 15 years for sports participation. However, in women, the low hazard ratios for the highest category ≥ 1.0 h/day of walking time did not change materially., Conclusions: Physical activity was associated with a lower risk of mortality from heart failure in this Japanese community-based population. The attenuated and nonsignificant association of walking and sports participation with the risk in men after exclusion of first 5-15 years heart failure death was probably due to changes in physical activity and death certificate diagnosis during the follow-up and reverse causation. However, the persistent inverse association between walking and the risk in women suggests a beneficial preventive effect on heart failure.

Purpose: This study aimed to examine MRI features and staging of neuroendocrine carcinoma (NEC) of the endometrium and evaluate survival., Methods: Clinical data, pathological, and preoperative pelvic MRI findings in 22 patients with histologically surgery-proven endometrial NEC were retrospectively reviewed. Tumors were pure NEC (n = 10) or mixed histotype (n = 12), with 13 large and nine small cell type., Results: International Federation of Gynecology and Obstetrics (FIGO) staging was I, II, III, and IV in 6, 2, 12, and 2 patients, respectively. In 13 (76.4%) of 17 patients with pathological deep myometrial invasion, MRI showed abnormal diffusely infiltrative high T 2 signal intensity throughout the myometrium with loss of normal uterine architecture. All tumors had restricted diffusion (apparent diffusion coefficient map low signal intensity, diffusion weighted imaging high signal intensity). Accuracy of T staging by MRI for all cases was 81.8%, with reference to pathology staging, while patient-based sensitivity, specificity, and accuracy for detecting metastatic pelvic lymph nodes was 60.0%, 100%, and 77.8%, respectively. Two intrapelvic peritoneal dissemination cases were detected by MRI. During follow-up (mean 30.4, range 3.3-138.4 months), 16 patients (72.7%) experienced recurrence and 12 (54.5%) died of disease. Two-year disease-free and overall survival rates for FIGO I, II, III, and IV were 66.7% and 83.3%, 50% and 100%, 10% and 33.3%, and 0% and 0%, respectively., Conclusion: Abnormal diffusely infiltrative high T 2 signal intensity throughout the myometrium with normal uterine architecture loss and obvious restricted diffusion throughout the tumor are suggestive features of endometrial NEC. Pelvic MRI is reliable for intrapelvic staging of affected patients.

Aim: The fact that low concentrations of high-density lipoprotein cholesterol are associated with the risk of cardiovascular disease is well known, but high-density lipoprotein metabolism has not been fully understood. Apolipoprotein A2 (ApoA2) is the second-most dominant apolipoprotein of high-density lipoprotein. We tested the hypothesis that ApoA2 isoforms are inversely associated with myocardial infarction., Methods: We measured the plasma levels of three ApoA2 isoforms (ApoA2-ATQ/ATQ, ApoA2-ATQ/AT, ApoA2-AT/AT) in nested case-control study samples of 1:2 from the Japan Public Health-Center-based Study (JPHC Study): 106 myocardial infarction incidence cases and 212 controls., Results: ApoA2-AT/AT was inversely associated with risk of myocardial infarction, in a matched model (OR, 2.78; 95% CI, 1.26-6.09 for lowest compared with the highest quartile), but its association was attenuated after adjustment for smoking only (OR=2.13; 95% CI, 0.91-4.97) or drinking only (OR=2.11; 0.91-4.89), and the multivariable OR was 1.20 (95% CI, 0.41-3.57). Neither ApoA2-ATQ/ATQ nor ApoA2-ATQ/AT was associated with the risk of myocardial infarction., Conclusions: Our nested case-control study did not show a significant association of ApoA2 isoforms with a risk of myocardial infarction.

Introduction: A large number of antibiotics are used for the treatment of uncomplicated cystitis owing to its high morbidity. As the administration of antibiotics for uncomplicated cystitis may be considered an example of inappropriate use, outpatient antimicrobial stewardship for this condition is important. We evaluated the current pharmacoepidemiology trends for the treatment of uncomplicated cystitis in Japan to predict stewardship strategies., Methods: This descriptive observational study analyzed data from an anonymized claims database of employees and their family members covered by the employer's health insurance. We identified female outpatients diagnosed with acute cystitis (ICD-10 code N300) aged ≥15 years and extracted oral antibiotic prescription records between 2013 and 2016. We excluded prescriptions for >7 days., Results: The most prescribed antibiotic category was fluoroquinolones (52.67%), followed by cephalosporins and penems (40.63%). Third-generation cephalosporins accounted for 90.91% of cephalosporin and penem prescriptions. The most common duration of antibiotic prescription was 5 days, except for first-generation cephalosporins, penem (7 days) and sulfamethoxazole and trimethoprim (3 days)., Conclusion: Fluoroquinolones and third-generation cephalosporins were prescribed to most uncomplicated cystitis cases in Japan. Although the lack of alternatives to quinolones and beta-lactams in Japan is an obstacle for antimicrobial stewardship for uncomplicated cystitis, promoting accurate diagnoses and establishing alternatives available in the Japanese market are important. Shortening the treatment duration is also an important strategy. Further research is needed on local antimicrobial resistance patterns to determine a fixed treatment strategy for uncomplicated cystitis., Competing Interests: Declaration of competing interest None., (Copyright © 2020 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)

Maintaining medication adherence is a critical issue in determining health outcomes in patients with chronic diseases. However, many patients do not adhere to their prescribed regimens. This study aimed to determine the effects of using adherence score sheets according to application timing in improving medication adherence among non-adherent outpatients. In community pharmacies, both patients and pharmacists evaluated medication adherence based on application timing (morning, noon, evening, and before going to bed) in 11 levels (0-10) for >4 months. A total of 58 outpatients were included in the study. The median scores among application timing at intermediate (patient 9.3, pharmacist 9.0) and final (patient 9.5, pharmacist 9.5) analyses were significantly higher than that at baseline (patient 7.6, pharmacist 7.0). At the end of the investigation, the ratio of non-adherent patients prescribed with hyperlipidemic medications was higher than those prescribed with medications for other lifestyle diseases. Approximately 80% of the patients reported improved medication adherence based on the questionnaires regarding their understanding on diseases and medications, medication awareness, and communication with pharmacists. Therefore, the utilization of an adherence score sheet according to application timing improved medication adherence of patients with chronic diseases.

Aim: The purpose of this study was to longitudinally analyse the morphology of maxilla and mandible over time in infants using a three-dimensional (3D) surface scanner., Materials and Methods: Seventeen Japanese full-term infants participated in the study. Dental plaster models were fabricated every 3 months from 1 month of age to 12 months. The plaster models were scanned using the 3D surface scanner to create 3D models. The arch width, arch length, arch angle, palatal depth and palatal area of the 3D models were analysed., Results: The arch width and length of maxilla and mandible increased as the arch angle decreased. The arch width and length of the maxilla were greater than those of the mandible. The total alveolar ridge morphology increased in size in the occlusal view, with marked growth in the sagittal direction. The palatal depth remained virtually unchanged although the palatal area increased as a result of buccal growth of the alveolar ridge., Conclusions: The morphological growth pattern of the maxilla and mandible in infants can be evaluated quantitatively using 3D analysis. Knowledge about the healthy development of children and their orofacial growth patterns during the predental period can be applied as an index for diagnostic criteria.

Pharmacists, being compensated through the new dispensing fee, are required to educate patients on their adhesion to the use of prescribed drugs, and to inventory the levels of leftover drugs in outpatients. Recently, Fukuoka City Pharmaceutical Association started a campaign for regulating leftover drugs (Setsuyaku Bag Campaign). Thirty-one pharmacies joined the campaign. Pharmacists distributed convenience bags, called 'SETSUYAKU-BAG.' The patients put their leftover drugs in the bags and brought them to community pharmacies. The pharmacists inventoried the returned drugs and reported their results to the doctors. The doctors adjusted the prescriptions accordingly. We counted and analyzed old and new inventories. The number of leftover drugs was 252, for a total value was ¥839655. Cost of leftover drug prescriptions could be reduced by ¥702695, and the value of drugs thrown away was ¥94801. In total, we could reduce the amount of leftover drugs by 83.7%. The cost of leftover drug for one dose package (ODP) is higher than that for non-ODP. However, there were no significant differences in results per age, sex, number and kinds of drugs, prescription days and premium contribution rate. These results suggest that prescription regulation by inventory of leftover drugs in community pharmacies could significantly reduce overall medical expenses. Further studies are necessary in order to account for patients' health, and to establish more efficient patient education to raise outpatients' adherence to the new programs.

In October 2006, a new revision of the draft guideline (OECD Guideline for the Testing of Chemicals, Proposal for a New Guideline 426. Developmental Neurotoxicity Study) and Draft Document of the Retrospective Performance Assessment (RPA) of the Draft Test Guideline 426 on Developmental Neurotoxicity were distributed following incorporation of the results of the Expert Consultation Meeting in Tokyo on May 24-26, 2005. The draft guideline consists of 50 paragraphs and an appendix with 102 references; and the draft RPA consists of 37 paragraphs with 109 references. National coordinators were requested to arrange for national expert reviews of these draft documents in their member countries. Members of the Developmental Neurotoxicology (DNT) Committee of the Japanese Teratology Society (JTS) reviewed, discussed, and commented on the draft Test Guideline Proposal. The DNT Committee of the JTS also commented on the draft document of the RPA. These comments were sent to the OECD Secretariat. The DNT Committee of the JTS expects the comments to be useful for the finalization of these draft documents.

Background: The association between myocardial infarction (MI) and the R353Q polymorphism of the Factor VII (FVII) gene, which reportedly influences FVII concentrations, activated Factor VII (FVIIa), or FVII antigen (FVIIag), remains controversial., Methods and Results: The present case - control study in 127 Japanese men with their first MI at or before 45 years of age and 150 matched healthy controls was designed to clarify this association in premature MI. R353Q polymorphism was determined by polymerase chain reaction, and plasma concentrations of FVIIa and FVIIag were assayed. The distribution of the RR, RQ, and QQ genotypes with respect to R353Q polymorphism was 117, 10, and 0 in the patients, and 131, 17, and 2 in the controls. The Q allele was negatively associated with premature MI (odds ratio =0.41, p=0.038). The plasma concentration of FVIIa was slightly higher in patients (55.1+/-40.9 U/L) than in controls (44.8+/-20.2 U/L), but not significantly (p=0.078); the plasma concentration of FVIIag did not differ between patients (88.7+/-15.7%) and controls (87.0+/-9.0%) (p=0.557). Plasma FVIIa concentrations were influenced by R353Q polymorphism (p<0.001)., Conclusions: The Q allele may be protective against premature MI.

Dental radiography doses in Hiroshima and Nagasaki were estimated on the basis of survey data from dental hospitals and clinics in Hiroshima and Nagasaki, and doses were measured by thermoluminescent dosimeters and a phantom. Doses to organs, including the lens, pituitary fossa, thyroid gland, and skin were calculated from data obtained during a 2-week survey in both cities. The mean caput doses were calculated from the data indicating frequency per year and were tabulated by organs, age, teeth examined, type of examination, population, sex, and city. No significant difference was observed by age, population, sex, or city. Currently the doses incurred during dental radiography may not be sufficiently high to cause bias in the assessments for late radiation effects among atomic-bomb survivors. However, the mean caput thyroid doses of 62 mrad and 67 mrad in Hiroshima and Nagasaki, respectively, cannot be ignored from the standpoint of their potential in contributing to radiation-induced carcinogenesis.