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As one of the countries that have invested greatly in the field of bioscience, Japan is facing difficulties introducing human genetic research to the market. A key issue is how to regulate the quality of genetic testing. Since genetic testing is a part of clinical laboratory tests, the regulatory framework for these tests should cover the regulation of genetic testing. Nevertheless, the quality of clinical laboratory tests has been regulated largely by the authority of medical professionals. The fact that genetic testing can be provided without supervision of medical professionals reveals the necessity for the regulation of quality of genetic testing. While medical geneticists have publicly criticized direct-to-consumer (DTC) genetic testing, a group of industries related to DTC genetic testing have established self-regulatory guidelines on the quality control of genetic analysis, based on the OECD guidelines. This article describes the regulatory framework for clinical laboratory tests including genetic tests, and the gaps in regulation, which are particularly highlighted by the appearance of DTC genetic testing. Furthermore the current initiatives taken by different organizations, especially the self-regulatory initiatives by related industries, will be discussed. To conclude the article, recommendations to improve the situation will be made. Copyright © 2009 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Objectives: The intent of the present study was to elucidate the association of eating alone and depressive symptoms with the development of disability among community-dwelling older adults, using a longitudinal study., Method: Participants included 4648 Japanese older adults (mean age 73.8 ± 5.4 years; 44.3% men) aged ≥ 65 years at the time of the examination. Eating status was divided into two categories: "Eating with others at least once a day" and "Other." The 15-item Geriatric Depression Scale was used to measure depressive symptoms. Incident disability was certified by long-term care insurance (median duration: 36 months)., Results: During a median follow-up at 36 months, 8.0% of the participants developed an incident disability. Adjusted for covariates, the participants who ate alone were associated with a higher hazard ratio of incident disability compared to those who ate with others (hazard ratio: 1.36, 95% confidence interval: 1.05-1.75). However, adjusted for the covariate depressive symptoms, eating alone was not significantly associated with incident disability. Structural equation models revealed that the indirect model confirmed eating alone habits were associated with disability via depressive symptoms., Conclusions: This study confirmed that eating alone was associated with an incident disability after adjusting for the covariates. Furthermore, the present study suggests an indirect relationship between eating alone and incident disability via depressive symptoms, the result of the structural equation model., Competing Interests: Declaration of competing interest The authors have no affiliation with any organization with a direct or indirect financial interest in the subject matter discussed in the manuscript., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Aim: Sarcopenia's high prevalence in older adults with cardiovascular disease (CVD) suggests that the risk of comorbidity in sarcopenia might also be increased during the at-risk phase of CVD. However, the relationship between CVD risk and sarcopenia has not been elucidated. Therefore, the purpose of this cross-sectional study was to investigate the association between CVD risk and sarcopenia in community-dwelling Japanese older adults., Methods: The participants in this cross-sectional study included 14 923 community-dwelling Japanese older adults (mean age 73.2 ± 5.6 years). The present study estimated the CVD risk using the revised World Health Organization risk chart, and classified CVD risk into "low" (<10%) and "mid-high" (≥10%). Assessments of sarcopenia, muscle mass, muscle strength and gait speed were measured based on the clinical definitions., Results: Among the participants, 654 people (4.4%) had sarcopenia, and 4857 (32.6%) had CVD mid-high risk. A multiple logistic model showed that the CVD mid-high risk was associated with sarcopenia (odds ratio [OR] 1.55, 95% confidence interval [CI] 1.28-1.89). In addition, CVD mid-high risk was associated with low muscle mass (OR 1.74, 95% CI 1.50-2.01), low muscle strength (OR 1.25, 95% CI 1.14-1.37) and slow gait speed (OR 1.17, 95% CI 1.07-1.27) in the adjusted model., Conclusions: Among community-dwelling older adults, high or moderate CVD risk was associated with an increased risk of sarcopenia. Our findings could help identify older adults with a future high risk for sarcopenia. Geriatr Gerontol Int 2024; 24: 1328-1334., (© 2024 Japan Geriatrics Society.)

Rotavirus vaccines carry a small risk of intussusception mainly 1-7 days after vaccination in the United States of America, Europe, Australia, and Latin America where the background rate of intussusception is relatively low. Such risks are undetectable in Africa and India where the background rate is the lowest. Because few studies were carried out in high-background-rate countries such as Japan, we examined how intussusception occurred in infants living in Akita prefecture, Japan, while the vaccines were sold in the private market. Between 2011 and 2018, an estimated 21,677 infants (46%) were vaccinated and 54% were not. Through a retrospective survey of medical records in 18 hospitals in the prefecture, we identified 58 infants, 28 of whom were vaccinated and 30 of whom were unvaccinated, as having intussusception that met level 1 of the Brighton criteria. Thus, the intussusception rate was 123 per 100,000 infant-years (95% confidence interval [CI]: 94-160). Despite the high rate, none developed intussusception 1-7 days after the first dose of either the monovalent human rotavirus vaccine (GSK) or the pentavalent human-bovine reassortant vaccine (MSD). The incidence rate ratio of vaccinated to unvaccinated infants between 42 and 245 days of life was estimated at 0.96 (95%CI: 0.43-2.1; p = 0.92). Given that over 95% of infants received the first dose before 15 weeks of age, the risk of intussusception associated with the rotavirus vaccines in high-incidence-rate countries can be reduced to a minimum by adhering to the recommended schedule at 2, 3, and 4 months of age.

Objectives: A high rate of preterm birth has been reported in Okinawa Prefecture, the southernmost island prefecture of Japan. Hence, this study aimed to identify the risk factors for preterm birth in this prefecture., Methods: This retrospective study included data from January 2013 to December 2019 from three facilities in Okinawa Prefecture. Of 13,468 cases of preterm birth at ≥ 22 weeks of gestation, 11,868 were included in this study. Stillbirth and multiparity cases were excluded. First, we compared the overall preterm and full-term birth groups by categorizing the patient background, obstetric, and fetal risk factors. Further, we categorized preterm births into three groups (22-27, 28-33, and 34-36 weeks of gestation) and examined patient background factors to identify potential risk factors for the occurrence of preterm birth in each group., Results: Preterm births accounted for 21.2% (2,521 cases) of all cases, with the rates of 2.6% (317 cases), 6.7% (800 cases), and 11.8% (1,404 cases) at 22-27, 28-33, and 34-36 weeks of gestation, respectively. To prevent preterm birth in Okinawa Prefecture, the present study specifically focused on patient background characteristics. In the multinomial logistic regression, the risk factors for preterm birth at 22-27 weeks of gestation were previous preterm birth (P < 0.0001) and lower age (P = 0.026); at 28-33 weeks of gestation, the risk factors were previous preterm birth (P < 0.0001) and history of cervical conization (P = 0.009); and at 34-36 weeks of gestation, only previous preterm birth (P < 0.0001) was a risk factor., Conclusions for Practice: Previous preterm birth, younger age, and history of cervical conization were risk factors for Preterm birth in Okinawa. To reduce premature births in Okinawa Prefecture, it is important to pick up women with these risk factors and provide them with appropriate guidance and education on an ongoing basis., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

We identified a new subgroup of koala retrovirus (KoRV), named KoRV-J, which utilizes thiamine transport protein 1 as a receptor instead of the Pit-1 receptor used by KoRV (KoRV-A). By subgroup-specific PCR, KoRV-J and KoRV-A were detected in 67.5 and 100% of koalas originating from koalas from northern Australia, respectively. Altogether, our results indicate that the invasion of the koala population by KoRV-J may have occurred more recently than invasion by KoRV-A.

To clarify the attitude toward genetic testing for neuromuscular diseases, a questionnaire was sent to 4,762 neurologists certified by the Japanese Society of Neurology. By December 21, 2011, 1,493 questionnaires (31.4%) were returned. Of these, 1,233 (82.6%) had experienced genetic testing, but only 396 (26.5%) had referred to the guideline for genetic testing of the Japanese Society of Neurology (2009). The numbers of respondents who were positive, or more positive than negative for genetic testing for myotonic dystrophy type 1 (DM1), Huntington's disease (HD), and familial amyloid polyneuropathy (FAP) were 753 (50.4%), 915 (61.3%), and 980 (65.6%), respectively. The predominant reason for a positive attitude toward genetic testing was to confirm or exclude the diagnosis. Conversely, the predominant reason for a negative attitude toward genetic testing differed between the diseases. For DM1, it was to confirm the diagnosis without genetic testing. For HD, it was that genetic testing would not result in effective prevention or therapy. In FAP, it was that post-testing psychosocial support for the patient and their family was difficult. Common to DM1, HD, and FAP, a significant number of respondents (approximately 60%) felt it difficult to explain the negative aspects that might occur after the disclosure of test results. Concerning predictive or prenatal genetic testing, most respondents referred at-risk individuals to specialized genetic counseling clinics. In general, neurologists are likely to conduct genetic testing properly in consideration not only of the characteristics of the diseases but also of the circumstances of each patient and his or her family. To support neurologists who are involved in genetic testing, the guidelines should be more easily accessible. Many respondents wanted information on the institutions that provide genetic counseling and testing; however, financial support to such institutions is indispensable for fulfilling this requirement.

Koala retrovirus (KoRV) is considered to be associated with leukemia, lymphoma and immunodeficiency-like diseases in koalas. We therefore conducted a pilot study of KoRV infection in five Queensland koalas in Kobe Municipal Oji Zoo. By polymerase chain reaction to detect partial env and pol genes of KoRV in genomic DNA isolated from whole blood and feces, all five koalas were found to be positive for KoRV proviruses. We succeeded in culturing koala lymphocytes from less than 1 ml blood for over 14 days in the presence of recombinant human interleukin-2. By coculturing the lymphocytes with human embryonic kidney (HEK) 293T cells, we isolated KoRVs from all five koalas. We designated these isolates as strains OJ-1 to OJ-5. By electron microscopy, we observed C-type retroviral particles in HEK 293T cells chronically infected with KoRV strain OJ-4. This is the first report on the isolation of KoRV from koalas in a Japanese zoo.

To seek the factors associated with the degree of Japanese workers' satisfaction with their annual health checkups, a survey with an anonymous self-administered questionnaire was conducted. A total of 1,389 questionnaires were analyzed. The average age of the analyzed subjects was 37.4 yr (range, 18-66 yr). Multiple linear regression analysis showed that the degree of such satisfaction was significantly associated with the effectiveness of annual health checkups, the hassle of receiving them, the receptionist's good manners, cleanliness of the examination site, the long waiting time, privacy invasion issues, anxiety concerning the skills of the persons conducting the examinations, and helpful advice from a physician. Various activities including promoting primary preventions, e.g., medical education must be conducted to convey the effectiveness of annual health checkups to examinees and to reduce the hassle of receiving those checkups. Health checkup staffs must keep their health checkup sites clean and try to find ways to reduce the waiting time. Moreover, they must pay particular attention to examinees' privacy. It is imperative that examinees are not anxious concerning the skills of the persons conducting the examinations. Many examinees want helpful advice from a physician regarding their health management.

Recent advances in studies on human genetics have led to the use of genetic information in various applications. We conducted a survey to know the opinions of healthcare providers in Japan on new genetic testing services, such as direct-to-consumer (DTC) genetic testing. A total of 1124 general practitioners and 294 clinical geneticists replied to our questionnaire. Thirty-eight percent of the general practitioners and 68.4% of the clinical geneticists were aware of DTC genetic testing. Some physicians had gained information on this service through their patients or commercial activities of companies providing such services. General practitioners expected that DTC genetic testing would be convenient, promote preventive medicine, provide personalized services and would enable to maintain confidentiality of information. Clinical geneticists showed greater concern with regard to the reliability of the results, provision of information/counseling and the understanding of results. Awareness of DTC genetic testing enhances general practitioners' positive opinions of it. Although the market for DTC genetic testing in Japan may still be limited, it is possible that general practitioners will play a role in the provision of DTC genetic testing services in the future. On the basis of their knowledge and experience, clinical geneticists should provide information to both healthcare providers and to the public.

16q22.1-linked autosomal dominant cerebellar ataxia (16q-ADCA) is a recently defined subtype of ADCA identified by a disease-specific C/T substitution in the 5' untranslated region of the puratrophin-1 gene. In Nagano, the central mountainous district of the main island of Japan, 16q-ADCA and spinocerebellar ataxia type 6 (SCA6) are the most and second most prevalent subtypes of ADCA, respectively. Both subtypes are classified into Harding's ADCA III, but little attention has been given to the differences in the severity and progression rate of cerebellar ataxia between 16q-ADCA and SCA6. We investigated the clinical severity and progression rate of cerebellar ataxia of 16q-ADCA patients using international cooperative ataxia rating scale and scale for the assessment and rating of ataxia and compared them with those of SCA6 patients. The age at onset was much higher in 16q-ADCA patients (60.1 +/- 9.8 years, n = 66) than in SCA6 patients (41.1 +/- 8.7 years, n = 35). Clinical features of 16q-ADCA were basically consistent with pure cerebellar ataxia, as well as in SCA6, but gaze-evoked nystagmus was observed less frequently in 16q-ADCA patients than in SCA6 patients. When compared at almost the same disease duration after onset, the severity of cerebellar ataxia was a little higher, and the progression rate seemed more rapid in 16q-ADCA patients than in SCA6 patients, but the differences were not significant.

The molecular bases of autosomal dominant cerebellar ataxia (ADCA) have been increasingly elucidated, but 17-50% of ADCA families still remain genetically undefined in Japan. In this study we investigated 67 genetically undefined ADCA families from the Nagano prefecture, and found that 63 patients from 51 families possessed the -16C>T change in the puratrophin-1 gene, which was recently found to be pathogenic for 16q22-linked ADCA. Most patients shared a common haplotype around the puratrophin-1 gene. All patients with the -16C>T change had pure cerebellar ataxia with middle-aged or later onset. Only one patient in a large, -16C>T positive family did not have this change, but still shared a narrowed haplotype with, and was clinically indistinguishable from, the other affected family members. In Nagano, 16q22-linked ADCA appears to be much more prevalent than either SCA6 or dentatorubral-pallidoluysian atrophy (DRPLA), and may explain the high frequency of spinocerebellar ataxia.

Primary systemic carnitine deficiency (SCD) is a rare hereditary disorder transmitted by an autosomal recessive mode of inheritance. The disorder includes cardiomyopathy, muscle weakness, hypoketotic coma with hypoglycemia, and hyperammonemia. In this study, we conducted a linkage analysis of a Japanese SCD family with a proband-a 9-year-old girl-and 26 members. The serum and urinary carnitine levels were determined for all members. The entire genome was searched for linkage to the gene locus for SCD, by use of a total of approximately 300 polymorphic markers located approximately 15-20 cM apart. In the family, there were two significantly different phenotypes, in terms of serum free-carnitine levels: low serum free-carnitine level (29.5+/-5.0 microM; n=14) and normal serum free-carnitine level (46.8+/-6.2 microM; n=12). There was no correlation of urinary free-carnitine levels with the low serum-level phenotype (putative heterozygote), but in normal phenotypes (wild type) urinary levels decreased as the serum levels decreased; renal resorption of free carnitine appeared to be complete in wild-type individuals, when the serum free-carnitine level was <36 microM. Linkage analysis using an autosomal dominant mode of inheritance of heterozygosity revealed a tight linkage between the disease allele and D5S436 on chromosome 5q, with a two-point LOD score of 4.98 and a multipoint LOD score of 5.52. The haplotype analysis revealed that the responsible genetic locus lies between D5S658 and D5S434, which we named the "SCD" locus. This region was syntenic with the jvs locus, which is responsible for murine SCD. Phylogenic conversion of the SCD locus strongly suggests involvement of a single gene, in human SCD.