記述言語：日本語   出版者・発行元：(公社)日本産業衛生学会  

目的:北海道・東北地方における病院の産業保健活動の実態を明らかにし,さらに労働関連法令に定められた項目の未実施に関連する要因を明らかにすることである.方法:北海道・東北地方の1,108病院に調査票を2024年4月に郵送し6月2日までに回答のあった307病院が解析対象となった.調査票は病院の特徴と産業保健活動や関連法令への対応である.統計解析は,所在地,病床数,職員数,救急医療体制を説明変数,法定項目5項目(産業医・衛生管理者選任,労働基準法第36条に基づく労使協定(36協定),長時間労働医師面談,ストレスチェック)の未実施数をアウトカムとする多変量順序ロジスティック回帰分析を行った.結果:産業医の選任なしは4.2%に認め,施設管理者の医師が産業医である割合は11.9%,衛生管理者の選任なしは11.1%,36協定の締結なしは8.5%,長時間労働の医師面接なしは48.5%,ストレスチェックの実施なしは2.6%であった.多変量順序ロジスティック回帰分析では,病床数が少ないこと,職員数が少ないこと,救急指定がないことが有意に法定項目未実施のオッズ比を上昇していた.結論:北海道・東北地方の病院では,特に小規模病院や救急指定病院がない病院において産業保健活動の適切な対応ができていない割合が高くなる傾向があり,外部からのサポートがなされる必要があると考えられる.(著者抄録)

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その他リンク： https://search.jamas.or.jp/default/link?pub_year=2024&ichushi_jid=J02911&link_issn=&doc_id=20240530280001&doc_link_id=%2Fcf8sangy%2F2024%2F006603%2F001%2F0117-0127%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcf8sangy%2F2024%2F006603%2F001%2F0117-0127%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

掲載種別：研究論文（学術雑誌）  

Correction to: Pediatric Researchhttps://doi.org/10.1038/s41390-023-02851-4, published online 19 October 2023 The authors identified a siginificant modification related to the results of the regression analysis. The primary focus of the analysis, manganese, remains almost unchanged. However, there are slight alterations in the 95% confidence intervals and p-values for cadmium, lead, mercury, and selenium in Table 3, Supplementary Table 2 and Supplementary Table 3. Consequently the original Table 3, Supplementary Table 2 and Supplementary Table 3: Table 3. Association of maternal blood Cd, Pb, Hg, Se, and Mn quartile concentrations with physical abnormalities. (Table presented.) Physical abnormalities (ncase = 11,163) Crudea Adjustedb Participants (n = 89,887)/Maternal blood Cd, Pb, Hg, Se, and Mn quartile concentrations OR (95% CI)c p value OR (95% CI)c p value Cd 1st quartile (≤0.495 ng/g) (n = 22,591) 1.00 (Reference) 1.00 (Reference) 2nd quartile (0.496–0.662 ng/g) (n = 22,472) 1.05 (1.00−1.11) 0.122 1.02 (0.97−1.08) 0.435 3rd quartile (0.663-0.903 ng/g) (n = 22,395) 1.04 (0.99−1.10) 0.138 1.01 (0.95−1.07) 0.844 4th quartile (≥0.904 ng/g) (n = 22,429) 1.07 (1.01−1.13) 0.023 1.00 (0.95−1.06) 0.925 p-value for trend 0.142 0.861 Pb 1st quartile (≤4.69 ng/g) (n = 22,520) 1.00 (Reference) 1.00 (Reference) 2nd quartile (4.70–5.84 ng/g) (n = 22,544) 1.02 (0.96−1.08) 0.557 1.01 (0.96−1.07) 0.694 3rd quartile (5.85–7.32 ng/g) (n = 22,461) 1.03 (0.98−1.09) 0.282 1.02 (0.96−1.08) 0.513 4th quartile (≥7.33 ng/g) (n = 22,362) 1.00 (0.95−1.06) 0.926 0.97 (0.92−1.03) 0.357 p-value for trend 0.686 0.411 Hg 1st quartile (≤2.54 ng/g) (n = 22,638) 1.00 (Reference) 1.00 (Reference) 2nd quartile (2.55–3.63 ng/g) (n = 22,394) 0.98 (0.93−1.04) 0.563 0.98 (0.93−1.03) 0.433 3rd quartile (3.64–5.19 ng/g) (n = 22,418) 0.99 (0.94−1.05) 0.685 0.98 (0.93−1.04) 0.486 4th quartile (≥5.20 ng/g) (n = 22,437) 0.97 (0.92−1.03) 0.297 0.96 (0.91−1.02) 0.154 p-value for trend 0.772 0.564 Se 1st quartile (≤156 ng/g) (n = 24,235) 1.00 (Reference) 1.00 (Reference) 2nd quartile (157–167 ng/g) (n = 21,083) 1.02 (0.96−1.08) 0.496 1.02 (0.97−1.08) 0.433 3rd quartile (168–181 ng/g) (n = 23,122) 1.03 (0.97−1.08) 0.372 1.03 (0.97−1.09) 0.311 4th quartile (≥182 ng/g) (n = 21,447) 1.01 (0.96−1.07) 0.619 1.02 (0.96−1.08) 0.584 p-value for trend 0.830 0.767 Mn 1st quartile (≤12.5 ng/g) (n = 22,639) 1.00 (Reference) 1.00 (Reference) 2nd quartile (12.6–15.3 ng/g) (n = 22,941) 0.98 (0.92−1.03) 0.384 0.98 (0.93−1.04) 0.517 3rd quartile (15.4–18.6 ng/g) (n = 22,351) 1.00 (0.95−1.06) 0.891 1.01 (0.96−1.07) 0.645 4th quartile (≥18.7 ng/g) (n = 21,956) 1.05 (1.00−1.11) 0.070 1.06 (1.01−1.13) 0.031 p-value for trend 0.056 0.034 OR odds ratio, CI confidence interval. aLogistic regression models are non-adjusted. bLogistic regression models were adjusted for maternal age, parity, artificial pregnancy, smoking in the first trimester, alcohol consumption in the first trimester, and child sex. cOR (95% CI) represents the expected odds ratio (95% confidence interval) compared with 1st quartile for Cd, Pb, Hg, Se, and Mn concentrations. have been corrected as follows: Table 3. Association of maternal blood Cd, Pb, Hg, Se, and Mn quartile concentrations with physical abnormalities. (Table presented.) Physical abnormalities (ncase = 11,163) Crudea Adjustedb Participants (n = 89,887)/Maternal blood Cd, Pb, Hg, Se, and Mn quartile concentrations OR (95% CI)c p value OR (95% CI)c p value Cd 1st quartile (≤0.495 ng/g) (n = 22,591) 1.00 (Reference) 1.00 (Reference) 2nd quartile (0.496–0.662 ng/g) (n = 22,472) 1.05 (1.00−1.11) 0.122 1.02 (0.97−1.08) 0.437 3rd quartile (0.663–0.903 ng/g) (n = 22,395) 1.04 (0.99−1.10) 0.138 1.01 (0.95−1.07) 0.849 4th quartile (≥0.904 ng/g) (n = 22,429) 1.07 (1.01−1.13) 0.023 1.00 (0.95−1.06) 0.927 p-value for trend 0.142 0.862 Pb 1st quartile (≤4.69 ng/g) (n = 22,520) 1.00 (Reference) 1.00 (Reference) 2nd quartile (4.70–5.84 ng/g) (n = 22,544) 1.02 (0.96−1.08) 0.557 1.01 (0.96−1.07) 0.695 3rd quartile (5.85–7.32 ng/g) (n = 22,461) 1.03 (0.98−1.09) 0.282 1.02 (0.96−1.08) 0.511 4th quartile (≥7.33 ng/g) (n = 22,362) 1.00 (0.95−1.06) 0.926 0.97 (0.92−1.03) 0.360 p-value for trend 0.686 0.414 Hg 1st quartile (≤2.54 ng/g) (n = 22,638) 1.00 (Reference) 1.00 (Reference) 2nd quartile (2.55–3.63 ng/g) (n = 22,394) 0.98 (0.93−1.04) 0.563 0.98 (0.93−1.03) 0.434 3rd quartile (3.64–5.19 ng/g) (n = 22,418) 0.99 (0.94−1.05) 0.685 0.98 (0.93−1.04) 0.491 4th quartile (≥5.20 ng/g) (n = 22,437) 0.97 (0.92−1.03) 0.297 0.96 (0.91−1.02) 0.157 p-value for trend 0.772 0.569 Se 1st quartile (≤156 ng/g) (n = 24,235) 1.00 (Reference) 1.00 (Reference) 2nd quartile (157–167 ng/g) (n = 21,083) 1.02 (0.96−1.08) 0.496 1.02 (0.97−1.08) 0.435 3rd quartile (168–181 ng/g) (n = 23,122) 1.03 (0.97−1.08) 0.372 1.03 (0.97−1.09) 0.313 4th quartile (≥182 ng/g) (n = 21,447) 1.01 (0.96−1.07) 0.619 1.02 (0.96−1.08) 0.581 p-value for trend 0.830 0.769 Mn 1st quartile (≤12.5 ng/g) (n = 22,639) 1.00 (Reference) 1.00 (Reference) 2nd quartile (12.6–15.3 ng/g) (n = 22,941) 0.98 (0.92−1.03) 0.384 0.98 (0.93−1.04) 0.516 3rd quartile (15.4–18.6 ng/g) (n = 22,351) 1.00 (0.95−1.06) 0.891 1.01 (0.96−1.07) 0.643 4th quartile (≥18.7 ng/g) (n = 21,956) 1.05 (1.00−1.11) 0.070 1.06 (1.01−1.13) 0.031 p-value for trend 0.056 0.034 OR odds ratio, CI confidence interval. aLogistic regression models are non-adjusted. bLogistic regression models were adjusted for maternal age, parity, artificial pregnancy, smoking in the first trimester, alcohol consumption in the first trimester, and child sex. cOR (95% CI) represents the expected odds ratio (95% confidence interval) compared with 1st quartile for Cd, Pb, Hg, Se, and Mn concentrations. The original article has been corrected.

DOI： 10.1038/s41390-024-03099-2

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

The quality of indoor environment is a risk factor for early childhood eczema and atopic dermatitis; however, its influence during pregnancy on childhood eczema in Japan has not been investigated. In this study, we aimed to determine the indoor environmental factors that are associated with eczema in children up to 3 years of age, using national birth cohort data from the Japan Environment and Children's Study (JECS). Information on indoor environments and eczema symptoms until 3 years of age was collected using self-administered questionnaires to the mothers. A total of 71,883 and 58,639 mother-child pairs at 1.5- and 3-years-old, respectively, were included in the former analyses. To account for prenatal indoor risk factors, 17,568 (1.5-years-old) and 7063 (3-years-old) children without indoor mold and/or ETS exposure were included in the final analysis. A higher mold index, gas heater use, parquet flooring use, and frequent insecticide use showed significantly increased risks for childhood eczema up to 3 years of age. These associations were consistent after stratification analysis among children whose parents did not have a history of allergies. The updated WHO guidelines on indoor air quality should be implemented based on recent findings regarding the effects of prenatal exposure to indoor dampness on health effects of children further in life, including asthma, respiratory effects, eczema, and other immunological effects.

DOI： 10.1016/j.envres.2024.118871

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掲載種別：研究論文（学術雑誌）  

Background: The modern 24/7 society demands night shift work, which is a possible risk factor for chronic diseases. This study aimed to examine the associations of rotating night shift work duration with tooth loss and severe periodontitis. Methods: This cross-sectional study used data from a self-administered questionnaire survey conducted among 3,044 permanent employees aged 20–64 years through a Japanese web research company in 2023. The duration of rotating night shift work was assessed using a question from the Nurses’ Health Study. Tooth loss was assessed based on self-reported remaining natural teeth count. Severe periodontitis was assessed using a validated screening questionnaire comprising four questions related to gum disease, loose tooth, bone loss, and bleeding gums. We employed linear regression models for tooth loss and Poisson regression models for severe periodontitis, adjusting for demographic, health and work-related variables and socioeconomic status. Results: Among participants included, 10.9% worked in rotating night shifts for 1–5 years, while 11.0% worked in such shifts for ≥6 years. In fully adjusted models, rotating night shift work duration of 1–5 years was associated with tooth loss (beta −0.74, 95% confidence interval (CI) [−1.55 to 0.08]) and severe periodontitis (prevalence ratio 1.80, 95% CI [1.33–2.43]); however, the association with tooth loss was not statistically significant. Conclusions: This study supports that employees who work short-term rotating night shifts may experience poor oral conditions. Further research is needed to determine whether long-term rotating night shift work is associated with deteriorated oral health.

DOI： 10.7717/peerj.17253

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掲載種別：研究論文（学術雑誌）  

Purpose: Previous studies have reported that levels of rurality and deprivation are factors associated with suicide risk. Reports on the association between rurality, deprivation and suicide incidence during the COVID-19 pandemic are scarce. The study aims to investigate how suicide rates evolved in areas with different levels of rurality and deprivation among Japanese adults aged 20 years or older between 2009 and 2022. Methods: This study used population density in 2020 as an indicator of rurality and per capita prefectural income in 2019 as a proxy for deprivation in Japan’s 47 prefectures. Joinpoint regression analysis was performed to analyze secular trends in suicide rates by rurality and deprivation. Results: Suicide rates for both men and women at different levels of rurality and deprivation remained roughly parallel during the research period. Suicide rates for men and women at all levels of rurality and deprivation were on a downward trend until around 2019, just before the onset of the pandemic. Following this, suicide rates in women showed a clear upward trend, while the trend in suicide rates for men also changed around 2019, with a slightly increasing or flat trend thereafter. Changes in suicide rates were greater among women and those aged 20–59 years. Conclusions: In Japan, time trends in suicide rates for both men and women have changed before and after the pandemic, but levels of rurality and deprivation across the 47 prefectures do not appear to have contributed much to these changes.

DOI： 10.1007/s00127-024-02718-x

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Childhood asthma is known to be affected by a range of factors, including conditions in the indoor environment. While flooring material influences indoor air conditions, the potential association between flooring materials and childhood asthma remains poorly understood in Japan. OBJECTIVE: The present study aims to assess the association between childhood asthma incidence and the primary flooring material with the ongoing prospective nationwide birth cohort data of the Japan Environment and Children's Study (JECS). METHODS: The JECS gathered data on mothers and children through 15 Regional Centres across Japan. The present study assessed flooring materials used in the home and asthma incidence at age four among children born between 2011 and 2014. We implemented logistic regressions, setting asthma incidence among the children as the outcome and home floor type as the exposure. Additional analyses were conducted, stratifying the home's age as a proxy for tatami age, to assess whether the potential effect of tatami flooring on asthma risk is influenced by its age. RESULTS: The present study included total of 75,629 infants. For tatami flooring, the main multivariable regression and additional sub-group regression for homes over ten years old produced odds ratios of 1.09; 95% Confidence Interval (CI) [1.01-1.17] and 1.10; 95% CI [1.00-1.21] compared with flooring, respectively. CONCLUSION: These results imply that exposure to tatami flooring, particularly in older homes, may be associated with childhood asthma incidence. Moreover, our study highlights the importance of evaluating the relationship between regional and cultural differences between asthma and flooring materials.

DOI： 10.1371/journal.pone.0305957

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Heavy metals such as lead (Pb) and cadmium (Cd) have been associated with adverse pregnancy and developmental outcomes, including congenital abnormalities. This study investigated the association between exposure to heavy metals and trace elements during fetal life and congenital limb abnormalities in infants. METHODS: This study is based on a prospective ongoing nationwide birth cohort from the Japan Environment and Children's Study (JECS). The concentrations of Cd, Pb, mercury (Hg), selenium (Se), and manganese (Mn) were measured in maternal blood collected during the mid-late trimesters. Inclusion criteria were available from questionnaires filled in during pregnancy, including information about congenital limb abnormalities at birth or at one month. To examine the associations with limb anomalies and individual chemicals, logistic regression models were applied following log-transformation or division into quartiles of Cd, Pb, Hg, Se, and Mn concentrations. To assess the associations with the heavy metals and trace elements mixture, quantile g-computation was employed. All models were adjusted for age, maternal smoking history, maternal alcohol intake, history of smoking, and infant sex. RESULTS: Data from 90,163 participants were included in the analysis, of whom 369 had congenital limb abnormalities in any of the collected information, and 89,794 had none. Among the 369 cases of congenital limb abnormalities, there were 185 and 142 cases of polydactyly and syndactyly, respectively. The median concentrations of Pb, Cd, Hg, Se, and Mn were 5.85, 0.66, 3.64, 168, and 15.3 ng/g, respectively. There were no associations between maternal blood concentrations of Pb [adjusted odd ratio = 0.83; 95% confidence interval = 0.61, 1.11], Cd [0.87; 0.68, 1.10], Hg [0.88; 0.73, 1.07], Se [1.07; 0.44, 2.59], and Mn [0.91; 0.64, 1.30] with congenital limb abnormalities. No significant association was observed between the mixture of heavy metals and trace elements [0.85; 0.72, 1.02] and any congenital limb abnormalities. Moreover, there was no association with all polydactylies and all syndactylies, or any type of abnormality as a subdivision. CONCLUSION: At the maternal exposure levels of Cd, Pb, Hg, Se, and Mn assessed in the present study, no association was identified with the risk of developing congenital limb abnormalities in children.

DOI： 10.1265/ehpm.23-00366

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掲載種別：研究論文（学術雑誌）  

Background: Physicians in public health administration agencies (public health physicians: PHP) play important roles in public health; however, there are not enough such physicians in Japan. This study aimed to elucidate the factors related to the resignation and migration of PHPs using nationwide survey data. Methods: Data from the Survey of Physicians, Dentists, and Pharmacists (2010, 2012, 2014, and 2016) were analyzed. The outcome was the resignation of PHPs or migration to public health administration agencies. The explanatory variables in the resignation analysis were age, sex, workplace, and board certification status. The type of work was added as an explanatory variable in the migration analysis, and clinical specialty was added to the clinical doctor-restricted analysis. The odds ratios (ORs) of the explanatory variables were calculated using generalized estimation equations. Results: In the resignation analysis among PHPs, women had a significantly lower OR, whereas younger PHPs and those with board certifications had significantly higher ORs. In the migration to public health administration agencies analysis among medical doctors, women and those aged between 35 and 39 years had significantly higher ORs, but those with board certifications had significantly lower ORs. Hospital/clinic founders or directors had significantly lower ORs, but the clinic staff and ‘others/not working’ had significantly higher ORs. In the migration to public health administration agencies analysis among clinical physicians, those aged between 35 and 39 years had significantly higher ORs. Still, those with two or more board certifications had significantly lower ORs. Hospital/clinic founders or directors had significantly lower ORs, but the clinic staff had significantly higher ORs. Clinical doctors specializing in surgery and other specialties had significantly lower ORs, but those specializing in pediatrics and psychiatry/psychosomatic medicine had significantly higher ORs. Conclusions: Having board certifications were significantly related to the resignation of PHPs and migration to public health administration agencies. Women migrated to public health administration agencies more than men and younger PHPs were more likely to resign. However, medical doctors aged between 35 and 39 years were more likely to migrate to public health administration agencies. Similarly, clinic staff, non-clinical physicians, and those whose specialties were pediatrics and psychiatry/psychosomatic medicine were more likely to migrate to public health administration agencies.

DOI： 10.1186/s12913-023-10085-7

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Kawasaki disease (KD) is common among pediatric patients and is associated with an increased risk of later cardiovascular complications, though the precise pathophysiology of KD remains unknown. Per- and polyfluoroalkyl substances (PFAS) have gathered notoriety as the causal pathogens of numerous diseases as well as for their immunosuppressive effects. The present epidemiological study aims to assess whether PFAS may affect KD risk. We evaluated research participants included in the ongoing prospective nationwide birth cohort of the Japan Environment and Children's Study (JECS). Among the over 100,000 pregnant women enrolled in the JECS study, 28 types of PFAS were measured in pregnancy in a subset of participants (N = 25,040). The JECS followed their children born between 2011 and 2014 (n total infants = 25,256; n Kawasaki disease infants = 271), up to age four. Among the 28 types of PFAS, those which were detected in >60 % of participants at levels above the method reporting limit (MRL) were eligible for analyses. Multivariable logistic regressions were implemented on the seven eligible PFAS, adjusting for multiple comparison effects. Finally, we conducted Weighted Quantile Sum (WQS) and Bayesian kernel machine regression (BKMR) to assess the effects of the PFAS mixture on KD. Therefore, we ran the BKMR model using kernel mechanical regression equations to examine PFAS exposure and the outcomes of KD. Upon analysis, the adjusted multivariable regression results did not reach statistical significance for the seven eligible substances on KD, while odds ratios were all under 1.0. WQS regression was used to estimate the mixture effect of the seven eligible PFAS, revealing a negative correlation with KD incidence; similarly, BKMR implied an inverse association between the PFAS mixture effect and KD incidence. In conclusion, PFAS exposure was not associated with increased KD incidence.

DOI： 10.1016/j.envint.2023.108321

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The association between prenatal metal exposure and congenital anomalies is unclear. We aimed to examine the association between exposure to cadmium, lead, mercury, selenium, and manganese and physical abnormalities. METHODS: Data from 89,887 pregnant women with singleton pregnancies who participated in the Japan Environment and Children's Study (JECS) were used. The correlation between maternal blood metal concentrations and physical abnormalities during the second or third trimester was investigated using logistic regression models. Physical anomalies included those observed at birth or at 1 month, primarily from ICD-10 Chapter 17, particularly congenital anomalies associated with environmental factors (e.g., hypospadias, cryptorchidism, cleft lip and palate, digestive tract atresia, congenital heart disease, and chromosomal abnormalities) and minor abnormalities. RESULTS: After adjusting for covariates, the OR (95% CIs) of physical abnormalities for a one-unit rise in Mn concentrations in all individuals were 1.26 (1.08, 1.48). The OR (95% CIs) of physical abnormalities in the 4th quartile (≥18.7 ng/g) were 1.06 (1.01, 1.13) (p-value for the trend = 0.034) compared with those in the 1st quartile (≤12.5 ng/g). CONCLUSION: In Japan, maternal blood Mn concentrations above threshold during pregnancy may slightly increase the incidence of physical abnormalities. IMPACT: Physical abnormalities (including minor anomalies and congenital anomalies) are associated with prenatal manganese concentrations. They are not associated with cadmium, lead, mercury, and selenium concentrations.

DOI： 10.1038/s41390-023-02851-4

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掲載種別：研究論文（学術雑誌）  

Background The government of Japan has spent a significant amount on dental healthcare, but it remains unknown how the spending varies across age, type of service, and time. This study describes trends in dental expenditures in Japan. Methods This descriptive study used two national data sources: Estimates of National Medical Care Expenditure and Survey on Economic Conditions in Health Care. We obtained annual total and average per capita dental expenditures by age in Japan from 1984 to 2020 and estimated the proportions of types of service from 1996 to 2021. All costs were adjusted for the 2020 Consumer Price Index (1 US dollar ≈ 100 yen in 2020). Results Total dental expenditures increased from 1.96 trillion yen in 1984 to 3.00 trillion yen in 2020. In particular, total and average per capita dental spending for older persons showed a rapid increase (total: from 185 billion yen in 1984 to 1.18 trillion yen in 2020; average per capita: from 15,500 yen in 1984 to 32,800 yen in 2020), contributing to the total amount increase. The crown restoration and prosthesis category amounted to 50.3% of the total expenditure in 1996, and this proportion declined to 32.4% by 2021. In 0-14 years persons, expenses on the crown restoration and prosthesis category decreased while the medical management category (mainly including fees for a management plan for oral diseases or oral functions) increased. In persons aged 65 years or older, expenses on the crown restoration and prosthesis category decreased, with increasing expenses in the medical management and athome treatment categories. Conclusion The amount of dental spending in Japan substantially increased from 1.96 trillion yen in 1984 to 3.00 trillion yen in 2020), a 1.53-fold increase. The observed changes in annual dental spending varied across age groups and types of service.

DOI： 10.1371/journal.pone.0292547

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掲載種別：研究論文（学術雑誌）   出版者・発行元：BMJ  

Objectives

Multimorbidity is defined as the coexistence of two or more chronic physical or psychological conditions within an individual. The association between maternal multimorbidity and adverse perinatal outcomes such as preterm delivery and low birth weight has not been well studied. Therefore, this study aimed to investigate this association.

Methods

We conducted a prospective cohort study using data from the Japan Environment and Children’s Study of pregnant women between 2011 and 2014. Those with data on chronic maternal conditions were included in the study and categorised as having no chronic condition, one chronic condition or multimorbidities. The primary outcomes were the incidence of preterm birth (PTB), low birth weight (LBW) and small for gestational age (SGA). Adjusted logistic regression was performed to estimate ORs (aORs) and 95% CIs.

Results

Of the 104 062 fetal records, 86 885 singleton pregnant women were analysed. The median maternal age and body mass index were 31 years and 20.5 kg/m², respectively. The prevalence of pregnant women with one or more chronic conditions was 40.2%. The prevalence of maternal multimorbidity was 6.3%, and that of PTB, LBW, and SGA were 4.6%, 8.1%, and 7.5%, respectively. Pre-pregnancy underweight women were the most common, observed in 15.6% of multimorbidity cases, followed by domestic violence from intimate partner in 13.0%. Maternal multimorbidity was significantly associated with PTB (aOR 1.50; 95% CI 1.33–1.69), LBW (aOR 1.49; 95% CI 1.35–1.63) and SGA (aOR 1.33; 95% CI 1.20–1.46).

Conclusion

Maternal multimorbidity was associated with adverse perinatal outcomes, including PTB, LBW and SGA. The risk of adverse perinatal outcomes tends to increase with a rise in the number of chronic maternal conditions. Multimorbidity becomes more prevalent among pregnant women, making our findings important for preconception counselling.

DOI： 10.1136/bmjopen-2022-069281

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Internal medicine (IM) doctors in Japan play the role of primary care physicians; however, the shortage of rural physicians continues. This study aims to elucidate the association of age, sex, board certification, type of work, and main clinical work with the retention or migration of IM doctors to rural areas. METHODS: This retrospective cohort study included 82,363 IM doctors in 2010, extracted from the national census data of medical doctors. The explanatory variables were age, sex, type of work, primary clinical work, and changes in board certification status. The outcome was retention or migration to rural areas. The first tertile of population density (PD) of municipalities defined as rural area. After stratifying the baseline ruralities as rural or non-rural areas, the odds ratios (ORs) of the explanatory variables were calculated using generalized estimation equations. The analyses were also performed after age stratification (<39, 40-59, ≥60 years old). RESULTS: Among the rural areas, women had a significantly higher OR for retention, but obtaining board certification of IM subspecialties had a significantly lower OR. Among the non-rural areas, physicians who answered that their main work was IM without specific subspecialty and general had a significantly higher OR, but obtaining and maintaining board certification for IM subspecialties had a significantly lower OR for migration to rural areas. After age stratification, the higher OR of women for rural retention was significant only among those aged 40-59 years. Those aged under 40 and 40-59 years in the non-rural areas, who answered that their main work was IM without specific subspecialty had a significantly higher OR for migration to rural areas, and those aged 40-59 years in the rural areas who answered the same had a higher OR for rural retention. CONCLUSIONS: Obtaining and maintaining board certification of IM subspecialties are possible inhibiting factors for rural work, and IM doctors whose main work involves subspecialties tend to work in non-rural areas. Once rural work begins, more middle-aged female IM doctors continued rural work compared to male doctors.

DOI： 10.1265/ehpm.22-00169

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: This cross-sectional study aimed to examine factors potentially associated with psychological distress among undergraduate students during the coronavirus disease 2019 pandemic in Japan. METHODS: We analysed data of 958 undergraduates (median age 20 years; 56.8% women) from a web-based, self-administered questionnaire survey conducted from August to September 2020. Prevalence ratios (PRs) for psychological distress defined as 5 points or over of the Kessler Psychological Distress Scale (K6) were calculated by Poisson regression models. RESULTS: The proportion of psychological distress was 40.0%. In the mutually-adjusted model, the following were significantly associated with psychological distress: decreases in household income to 50-99% of the pre-pandemic amount compared to no change (PR = 1.48), newly experiencing unpaid wages compared to no experience (PR = 1.44), insufficient money to buy necessities compared to no shortage (PR = 1.45), receiving a student loan or scholarship compared to none (PR = 1.27), and communication one to three times a month compared to at least once a week (PR = 1.22). In contrast, school closure during the pandemic compared to no closure was inversely associated with psychological distress (PR = 0.78). CONCLUSIONS: Among undergraduate students in Japan, economic difficulties significantly predicted psychological distress.

DOI： 10.1017/dmp.2022.245

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

AIMS/INTRODUCTION: This study aimed to investigate the neurodevelopment of infants born to women with gestational diabetes mellitus (GDM). MATERIALS AND METHODS: Data from the National Birth Cohort in the Japan Environment and Children's Study from 2011 to 2014 (n = 81,705) were used. Japan uses the GDM guidelines of the International Association of Diabetes and Pregnancy Study Groups. The Japanese translation of the Ages and Stages Questionnaires, third Edition, was used to assess neurodevelopment in the following domains: communication skills, gross motor skills, fine motor skills, problem-solving ability, and personal and social skills. The survey was carried out every 6 months from the age of 6 months to 4 years (total of eight times). Generalized estimating equations were used to evaluate the association between maternal GDM and neurodevelopmental delay based on odds ratios (ORs) and 95% confidence intervals (95% CIs). RESULTS: Neurodevelopmental delays, particularly in problem-solving ability, fine motor skills, and personal and social skills, were significantly higher in infants born to women with GDM than in those born to women without GDM (adjusted OR 1.24, 95% CI 1.12-1.36; adjusted OR 1.15, 95% CI 1.03-1.27; and adjusted OR 1.18, 95% CI 1.04-1.33). Furthermore, stratification showed no significant increase in the adjusted ORs (95% CIs) of girls. CONCLUSIONS: Neurodevelopment was significantly delayed up to 4 years-of-age among boys born to women with GDM.

DOI： 10.1111/jdi.13907

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担当区分：責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Springer Science and Business Media LLC  

<title>Abstract</title><sec>
<title>Background</title>
The extremes of maternal pre-pregnancy body mass index (BMI) are known to be risk factors associated with obstetric and adverse perinatal outcomes. Among Japanese women aged 20 years or older, the prevalence of underweight (BMI &lt; 18.5 kg/m²) was 11.5% in 2019. Maternal thinness is a health problem caused by the desire to become slim. This study aimed to investigate the association between the severity of maternal low pre-pregnancy BMI and adverse perinatal outcomes, including preterm birth (PTB), low birth weight (LBW), and small-for-gestational age (SGA).


</sec><sec>
<title>Methods</title>
We conducted a prospective cohort study using data from the Japan Environment and Children’s Study, which recruited pregnant individuals between 2011 and 2014. Pre-pregnancy BMI was categorized as severe-moderate underweight (BMI <underline>&lt;</underline> 16.9 kg/m²), mild underweight (BMI, 17.0–18.4 kg/m²), low-normal weight (BMI, 18.5–19.9 kg/m²), high-normal weight (BMI, 20.0–22.9 kg/m²), overweight (BMI, 23.0–24.9 kg/m²), and obese (BMI ≥ 25.0 kg/m²). The high-normal weight group was used as the reference for statistical analyses. Adjusted logistic regression was performed to evaluate the association between pre-pregnancy BMI and PTB, LBW, and SGA.


</sec><sec>
<title>Results</title>
Of 92,260 singleton pregnant individuals, the prevalence was 2.7% for severe-moderate underweight, 12.9% for mild underweight, and 24.5% for low-normal weight. The prevalence of adverse outcomes was 4.6% for PTB, 8.1% for LBW, and 7.6% for SGA. The adjusted odds ratios (aORs) for PTB were 1.72 (95% confidence interval [CI], 1.46–2.03) for severe-moderate underweight and 1.26 (95% CI, 1.14–1.39) for mild underweight. The aORs of LBW were 2.55 (95% CI, 2.27–2.86) for severe-moderate underweight, 1.64 (95% CI, 1.53–1.76) for mild underweight, and 1.23 (95% CI, 1.16–1.31) for low-normal weight. The aORs of SGA were 2.53 (95% CI, 2.25–2.84) for severe-moderate underweight, 1.66 (95% CI, 1.55–1.79) for mild underweight, and 1.29 (95% CI, 1.21–1.38) for low-normal weight.


</sec><sec>
<title>Conclusions</title>
A dose-response relationship was found between the severity of low pre-pregnancy BMI and PTB, LBW, and SGA. Even low-normal BMI (18.5–19.9 kg/m²) increased the risk of LBW and SGA. This study provides useful information for pre-conception counseling in lean individuals.


</sec>

DOI： 10.1186/s12884-022-04418-3

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その他リンク： https://link.springer.com/article/10.1186/s12884-022-04418-3/fulltext.html

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SAGE Publications  

Although children with orofacial clefts have an increased risk for sleep-disordered breathing, no studies have examined the association of sleep duration. Thus, this study aimed to examine associations between orofacial clefts and sleep duration at 1 month, 6 months, 1 year, and 3 years of age in Japan.

A cohort study from the Japan Environment and Children's Study.

This study consisted of 91 497 children, including ones with isolated cleft lip and palate (n = 69), isolated cleft lip only (n = 48), and isolated cleft palate only (n = 37), for which recruitment was undertaken during 2011 to 2014.

Seep durations (hours per day) at 1 month, 6 months, 1 year, and 3 years of age, as reported by their mothers.

In the control group, mean sleep durations and standard deviations at 1 month, 6 months, 1 year, and 3 years of age were 15.2 (2.5), 13.6 (1.9), 12.9 (1.6), and 11.6 (1.2) h, respectively. Compared to the control group, linear regression models reported effect sizes and 95% confidence intervals shorter than 1 h for sleep duration of each type of isolated orofacial cleft at each time point.

This study suggested null associations between isolated orofacial clefts and sleep duration at 1 month, 6 months, 1 year, and 3 years of age. Children with isolated orofacial clefts had sufficient mean sleep duration.

DOI： 10.1177/10556656221128425

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その他リンク： http://journals.sagepub.com/doi/full-xml/10.1177/10556656221128425

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Wiley  

This study aimed to document the complication status of infants with orofacial clefts born between 2011 and 2014 in Japan. This was a descriptive study using data from the Japan Environment and Children's Study. Among 103 060 pregnancies, 248 infants with orofacial clefts were included (livebirth, 239; stillbirth, 4; miscarriage, 5). The items of interest were complication status of orofacial clefts: isolated (typical orofacial clefts only); multi-malformed (orofacial clefts with unrelated major defects); syndromic (orofacial clefts with a syndrome or a chromosomal defect). Regarding the cleft subtypes, of 248 infants with orofacial clefts, 104 had cleft lip with cleft palate (CLP) (41.9%), 68 had cleft lip without cleft palate (CL) (27.4%), 58 had cleft palate without cleft lip (CP) (23.4%), and 18 were nonclassified (7.3%). In infants with CLP, the proportions of isolated, multi-malformed, and syndromic phenotypes were 73.1%, 15.4%, and 11.5%, respectively. In infants with CL, the proportions were 79.4%, 16.2%, and 4.4%, respectively. In infants with CP, the proportions were 69.0%, 13.8%, and 17.2%, respectively. The most frequently associated congenital anomaly was congenital heart disease. In infants with syndromic CLP, 41.7% had trisomy 13. In infants with syndromic CP, 80.0% had the Pierre Robin sequence. Congenital heart disease could be the most frequently associated congenital anomaly. The most frequently associated syndrome could be trisomy 13 in those with CLP and Pierre Robin sequence in those with CP.

DOI： 10.1111/cga.12496

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier BV  

Urinary cotinine concentration (UCC) reflects smoking status. However, in pregnant women, its association with adverse birth outcomes related to fetal growth is not widely known. Thus, we aimed to explore this relationship by focusing on dose-response relationships. We investigated 86,638 pregnant women enrolled between 2011 and 2014 in a prospective cohort study in Japan and observed three birth outcomes (preterm birth, low birth weight, and small-for-gestational age). We measured UCC in the second or third trimester, and categorized the participants using cut-off values (negative cotinine concentration, passive cotinine concentration, and active cotinine concentration corresponding to non-smokers, passive smokers, and active smokers, respectively). Logistic regression analyses were conducted to evaluate the risks, and dose-response relationships were visualized using restricted cubic spline curves. Analyses based on self-reported smoking status were also performed. We found that in low active and highly active cotinine concentrations, the adjusted odds ratios (aORs) of birth outcomes were significantly increased (preterm birth, 1.24 [95% CI 1.06-1.46], 1.39 [95% CI 1.19-1.62]; low birth weight, 1.40 [95% CI 1.24-1.58], 2.27 [95% CI 2.05-2.53]; small-for-gestational age, 1.35 [95% CI 1.19-1.52], 2.39 [95% CI 2.16-2.65]). Restricted cubic spline curves demonstrated risk elevations in the active cotinine concentration range. Our research revealed dose-response relationships between UCC during pregnancy and the risks of preterm birth, low birth weight, and small-for-gestational age. Measurement of UCC to ascertain smoking status during pregnancy may be a useful approach for predicting the risks of these birth outcomes.

DOI： 10.1016/j.envres.2022.114302

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: Previous studies have indicated that spatial variation in suicide mortality is associated with area-specific socioeconomic characteristics, such as socioeconomic deprivation and social fragmentation. However, most of these studies have been conducted in the West and findings from Asian countries are limited. This study aims to investigate associations between socioeconomic characteristics and suicide mortality rates across 1887 municipalities in Japan between 2009 and 2017. We also assessed these associations by gender and age group. METHODS: Suicide data were obtained from the suicide statistics of the Ministry of Health, Labour and Welfare in Japan and included information on the number of suicides by gender, age and municipality location. Social fragmentation, socioeconomic deprivation and urbanicity were used as socioeconomic characteristics in this study and were created from survey data obtained from the 2010 census. Bayesian hierarchical models were used to examine associations between socioeconomic characteristics and suicide risk. RESULTS: Suicide rates were significantly higher in municipalities with higher levels of deprivation, with a rate ratio of 1.13 (95% credible interval: 1.10 to 1.17) in the highest quartile compared with the lowest. Higher levels of urbanicity had significantly lower suicide rates, with a rate ratio of 0.79 (95% credible interval: 0.77 to 0.82) in the highest quartile compared with the lowest. However, associations between exposures and suicide varied considerably by gender and age. Among both men and women aged 0-39 years, fragmentation was significantly associated with suicide, with rate ratios of 1.07 and 1.15 for men and women, respectively, in the highest quartile compared with the lowest. CONCLUSION: Suicide prevention in Japan should particularly focus on areas with high levels of deprivation or low levels of urbanicity. Furthermore, young Japanese people residing in the most fragmented municipalities were also at high risk of suicide, and appropriate measures need to be taken.

DOI： 10.1136/bmjopen-2022-063255

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Public Library of Science (PLoS)  

Maternal intake of folic acid supplements is reportedly associated with the risk of early-onset allergies in offspring. However, only a few studies have considered the intake of both folic acid supplements and dietary folate. Here, the relationship between maternal intake of folic acid supplements and allergic symptoms such as wheeze and eczema in offspring was analyzed while considering dietary folate intake. We examined 84,361 mothers and 85,114 children in the Japan Environment and Children’s Study. The participants were divided into three groups depending on maternal folic acid supplementation (“no use,” “occasional use,” and “daily use”). Each group was then subdivided into three groups based on total folic acid and dietary folate intake. Outcomes were determined considering the wheeze and eczema status of each child at the age of 2 years. The status was based on the International Study of Asthma and Allergies in Childhood. It was found that 22.1% of the mothers took folic acid supplements daily. In contrast, 56.3% of the mothers did not take these supplements. Maternal intake of folic acid supplements was not associated with wheeze and eczema in the offspring. In contrast, only dietary folate intake was positively associated with wheeze at the age of 2 (adjusted odds ratio, 1.103; 95% confidence interval, 1.003–1.212). However, there is no scientific evidence of a biological mechanism that clarifies this result. Potential confounders such as other nutrition, outdoor/indoor air pollution, and genetic factors may have affected the results. Therefore, further studies on the association between maternal intake of folic acid and allergic symptoms at the age of 3 or above are needed to confirm the results of this study.

Trial registration

UMIN Clinical Trials Registry (number: UMIN000030786)

DOI： 10.1371/journal.pone.0272968

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Neurodevelopmental delay is associated with neurodevelopmental disorders. Prenatal metal exposure can potentially cause neurodevelopmental delays in children. This study examines whether prenatal exposure to mercury (Hg) and selenium (Se) is associated with the risk of neurodevelopmental delays in children up to 4 years of age. Children enrolled in a prospective birth cohort of the Japan Environment and Children's Study were examined. Hg and Se levels in maternal (nchild = 48,731) and cord (nchild = 3,083) blood were analyzed by inductively coupled plasma-mass spectrometry. Neurodevelopmental delays were assessed in children between the ages of 0.5 to 4 years using the Ages and Stages Questionnaires, Third Edition. The association between exposure and outcomes was examined using the generalized estimation equation models. In maternal blood, compared to participants with Se levels in the first quartile (83.0 to < 156 ng/g), the odds ratio (95 % confidence intervals) for problem-solving ability in children of mothers in the third (168 to < 181 ng/g) and fourth quartiles (181 to 976 ng/g) were 1.08 (1.01 to 1.14) and 1.10 (1.04 to 1.17), respectively. Furthermore, communication, gross and fine motor skills, and problem-solving delays were also observed. However, prenatal Hg levels in maternal and cord blood and Se levels in the latter were not associated with neurodevelopmental delays in children. Thus, the findings of this study suggest an association between Se levels in maternal blood and slightly increased risks of neurodevelopmental delays in children up to the age of 4 years.

DOI： 10.1016/j.envint.2022.107448

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Postoperative atrial fibrillation is a poor prognostic factor associated with increased mortality rates. Patients experiencing significant pericardial effusion develop postoperative atrial fibrillation; however, little is explored about the association between postoperative atrial fibrillation and post-cardiotomy pericardial effusion. This retrospective, single-center study included adult patients who underwent cardiovascular surgery via median sternotomy from January 2016 to December 2019. Patients who underwent routine postoperative computed tomography at 7 ± 3 days after surgery (n = 294) were included. Pericardial effusion was measured at the thickest point. Patients were classified into those with (n = 127) and without (n = 167) postoperative atrial fibrillation. The association of pericardial effusion with other factors was evaluated. A possible confounder-adjusted logistic regression analysis after multiple imputation was performed to obtain odds ratios for postoperative atrial fibrillation using previously published risk factors. Age, intraoperative bleeding volume, and pericardial effusion size were all significantly higher in the group with postoperative atrial fibrillation. Multivariate logistic regression after multiple imputation revealed that age, intraoperative bleeding volume, and postoperative pericardial effusion were significantly associated with postoperative atrial fibrillation. Our findings suggest that post-cardiotomy pericardial effusion is associated with postoperative atrial fibrillation. However, the causality remains unknown, making further studies mandatory.

DOI： 10.1007/s10554-022-02560-9

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES: This study aims to clarify the association between alcohol intake and stroke severity at admission and discharge according to sex and stroke subtype in Japanese patients with acute stroke. MATERIALS AND METHODS: We analyzed the data of 199,599 patients registered in the Japan Stroke Data Bank from 1999 to 2018, including sex, age, stroke subtypes (cardioembolic ischemic, noncardioembolic ischemic, hypertensive hemorrhagic, nonhypertensive hemorrhagic, and subarachnoid hemorrhagic), dates of onset and admission, National Institutes of Health Stroke Scale score at admission, modified Rankin Scale score at discharge, and alcohol intake. Multivariable logistic regression analysis adjusted for stroke-related factors was performed to estimate the odds ratios of alcohol intake for stroke severity. RESULTS: In cardioembolic ischemic stroke, a significant protective effect of moderate intake on severity at admission was observed in both sexes. In noncardioembolic ischemic stroke, a significant protective effect on stroke severity at admission was found for each sex. At discharge, the results also showed a significant protective effect for each sex with moderate intake. For both subtypes of ischemic stroke, a J-shaped relationship between alcohol intake and stroke severity at admission and discharge was observed in women and men. In hypertensive hemorrhagic stroke, a significant protective effect was found in men at both admission and discharge. In women, heavy drinking had a significant harmful effect on stroke severity at admission. CONCLUSIONS: Habitual alcohol intake is associated with stroke severity at admission and discharge regardless of sex.

DOI： 10.1016/j.jstrokecerebrovasdis.2022.106513

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Background: The COVID-19 pandemic is negatively impacting mental health globally. While increased social cohesion may have initially decreased suicide risk, there are few reports on the long-term impact. We examined the impact of the pandemic on suicide by gender and age through December 2021 in Japan. Methods: We analyzed trends in monthly suicide rates by age and gender from January 2016 to December 2021 using provisional mortality data in an interrupted time series analysis. We also considered linear trends in the pre-pandemic period and seasonal variations. Pandemic onset was defined as from April 2020. Estimated excess deaths by suicide that occurred during the pandemic were calculated. Findings: Excess number of suicide deaths during the pandemic period was estimated to be 1208 for men and 1825 for women. While there was no statistically significant increase in suicide rates overall for both men and women during the pandemic compared to the pre-pandemic, age-specific analyses showed a statistically significant increase in men 20-29 and 40-49 years, and in women of all age groups, except those under 20, 40-49 and over 80 years. Interpretation: The COVID-19 pandemic has had a negative impact on suicide rates in Japan and the impact is most pronounced in women and younger age groups. Subgroup analyses are needed, with a particular focus on those considered to be vulnerable and at increased suicide risk. Funding: A Grant-in-Aid for scientific research from the Ministry of Education, Culture, Sports, Science and Technology of Japan (Award Number 21K10462).

DOI： 10.1016/j.lanwpc.2022.100480

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Caffeine intake by pregnant women may have neurodevelopmental effects on the fetus due to adenosine antagonism. However, there are insufficient data and inconsistent results from epidemiological studies on the effect of maternal caffeine intake on child development. AIMS: This study examined the association between mothers' estimated caffeine intake during pregnancy and their children's score on the Japanese version of the Ages & Stages Questionnaires™ (J-ASQ) at 6 and 12 months of age. STUDY DESIGN: The study is a part of nationwide prospective birth-cohort study: the Japan Environment and Children's Study. SUBJECTS: In total, 87,106 participants with the Food Frequency Questionnaire (FFQ) data and J-ASQ at 6 or 12 months of age were included in the study. OUTCOME MEASURES: The data were analyzed by logistic regression analysis to determine whether the scores of the five subscales on the J-ASQ were below the cutoff point as the dependent variable. RESULTS: The results showed that children born to mothers who consumed >300 mg caffeine per day had a 1.11-fold increased odds of gross motor developmental delay at 12 months of age (adjusted odds ratio [AOR] = 1.114 [95 % CI: 1.013-1.226]). CONCLUSIONS: Issues in gross motor development can emerge prior to future developmental issues. Therefore, further studies on developmental outcomes in older children, including the future outcomes of the children who participated in this study, are needed.

DOI： 10.1016/j.earlhumdev.2022.105607

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Objective: To evaluate the effectiveness of the 5-minute test (FMT), developed to record the amount of pericardial bleeding in patients undergoing general cardiac surgery, and determine the relationship between this test and postcardiotomy bleeding. Methods: The medical records of 573 patients who underwent adult cardiac surgery between January 2016 and December 2019 were reviewed retrospectively. Patients were divided into 2 groups: the FMT group included patients who underwent general cardiac surgery between January 2018 and December 2019 (n = 278), and the control group included patients who underwent general cardiac surgery between January 2016 and December 2017 (n = 295). The postcardiotomy reexploration rate due to intrapericardial bleeding or cardiac tamponade within 1 week after surgery and the amount of bleeding until 2 days after surgery were compared. The FMT procedure involved counting the amount of bleeding by packing 4 to 6 surgical gauze sheets for 5 minutes. Sternal closure was performed when the amount of blood measured by the FMT was <100 g. Results: Compared with the control group, the FMT group had a significantly lower incidence of postcardiotomy reexploration (1.5% vs 5.7%; P = .007) and a reduced amount of bleeding after cardiac surgery (median, 1165 mL [interquartile range (IQR), 756.2-1743.8 mL] versus 1440 mL [IQR, 825.0-2130.0 mL]; P = .005). There was a significant positive correlation between the FMT gauze sheet weight and postcardiotomy bleeding (r = 0.322; P < .001). Conclusions: The FMT is an objective and effective tool for estimating postoperative bleeding during cardiac surgery that can prevent postcardiotomy reexploration and reduce the amount of postcardiotomy bleeding.

DOI： 10.1016/j.xjtc.2021.08.049

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier {BV}  

Objective: To identify whether preoperative magnetic resonance imaging findings of the brain can predict postoperative delirium in patients who undergo arch replacement for aneurysms. Methods: Overall, 193 patients who underwent aortic replacement for the first time at a single institution between April 2014 and September 2020 were enrolled in this retrospective study. After we excluded patients with acute aortic dissection, no preoperative magnetic resonance imaging findings of the brain, and postoperative cerebral infarction, 50 patients were included and divided into 2 groups, according to their confusion scale results: postoperative delirium (group D) and nonpostoperative delirium (group ND). Preoperative magnetic resonance imaging findings of the brain were classified into lacunar stroke, periventricular hyperintensity, and deep subcortical white matter hyperintensity groups; the latter 2 groups were further classified based on the Fazekas scale, grade 0 to 3. Results: There were 23 patients (46%) in group D and 27 (54%) in group ND. The mean age was significantly greater in group D than in group ND (75 vs 70 years; P = .007). The mean operative time was significantly longer in group D than in group ND (447 vs 384 minutes; P = .024). As for preoperative magnetic resonance imaging findings of the brain, there were significantly more lacunar stroke cases in group D than in group ND (P = .027). In multivariable logistic regression with stepwise selection, high-grade periventricular hyperintensity was significantly related to postoperative delirium (odds ratio, 9.38; 95% confidence interval, 1.55-56.56; P = .015). Conclusions: Silent cerebral ischemia detected by preoperative magnetic resonance imaging of the brain was a significant risk factor for postoperative delirium.

DOI： 10.1016/j.xjon.2022.02.026

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Wiley  

This prospective cohort study aimed to examine the associations between mold growth, type of stoves, and fragrance materials and early childhood wheezing and asthma, using data from the Japan Environment and Children's Study. Mold growth at home, usage of kerosene/gas stove, wood stove/fireplace, and air freshener/deodorizer were surveyed using a questionnaire at 1.5-year-old, and childhood wheezing and doctor-diagnosed asthma during the previous year were obtained using a 3-year-old questionnaire. Multilevel logistic regression analysis was performed to evaluate the association between exposure to childhood wheezing and asthma. A total of 60 529 children were included in the analysis. In multivariate analyses, mold growth and wood stove/fireplace had significantly higher odds ratios (ORs) for wheezing (mold growth: 1.13; 95% CI, 1.06-1.22; wood stove/fireplace: 1.23; 95% CI, 1.03-1.46). All four exposures had no significant ORs for childhood doctor-diagnosed asthma; however, in the supplemental analysis of northern regions, wood stove/fireplace had a significantly higher OR for asthma. Mold growth and wood stove/fireplace had significant associations with childhood wheezing in the northern regions. Mold elimination in the dwellings and use of clean heating (no air pollution emissions) should be taken into consideration to prevent and improve childhood wheezing and asthma.

DOI： 10.1111/ina.12931

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Background: Psychological stress is a potential risk factor for oral diseases. However, evidence for the association between work stress and oral diseases is scarce. We aimed to examine the associations of work stress, according to the effort-reward imbalance model, with dental caries, periodontal status, and tooth loss. Methods: This cross-sectional study included 184 regular employees at a medical university and 435 registrants of a web research company. Work stress was assessed using the effort-reward imbalance (ERI) ratio. Dental caries and tooth loss were assessed according to the number of decayed, filled, and missing teeth (DMFT) among the set of 28 teeth. Periodontal status was assessed using a self-administered questionnaire. For the DMFT, a linear regression model was used to estimate the unstandardised coefficients. A Poisson regression model was used to estimate the prevalence ratios (PRs) of poor periodontal status. Results: Among medical university employees and employees enrolled from among the registrants of an online research company, a one-unit increase in the ERI ratio was associated with -2.81 (95% CI [-4.70 to -0.92]; p-value = 0.004) and -0.84 (95% CI [-1.80 to 0.12]; p-value = 0.085) changes in the DMFT from adjusted linear regression models, respectively. In employees enrolled from among the registrants of an online research company, a one-unit increase in the ERI ratio was also associated with 1.55 (95% CI [1.04-2.32]; p-value = 0.032) of the PR for poor periodontal status based on Poisson regression models. Conclusion: ERI at work was associated with an increased risk of poor periodontal status.

DOI： 10.7717/peerj.13792

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：National Institute of Industrial Health  

The association between oral diseases and work productivity loss remains unclear. This study examined whether dental caries, tooth loss, and poor periodontal status were associated with absenteeism and presenteeism. This cross-sectional study used two independent datasets: 184 employees at a medical university and 435 employees from among the registrants of an online research company. Absenteeism and presenteeism, according to the World Health Organization Health and Work Performance Questionnaire, were dependent variables. The independent variables were the number of decayed and filled teeth (DFT), missing teeth (MT), and self-reported periodontal status. Multivariable linear regression models were developed to estimate unstandardised coefficients with 95% confidence intervals (CIs) for absenteeism and presenteeism. After adjusting for covariates, among the 435 employees enrolled from among the registrants of an online research company, poor periodontal status was significantly associated with a 7.8% (95%CI = -14.5, -1.0) decline in presenteeism but not absenteeism. DFT and MT were not significantly associated with either absenteeism or presenteeism in both populations. Given that periodontal status was potentially associated with a 7.8% decline in work performance, occupational specialists, managers, and dental health professionals should be aware of the impact on work productivity.

DOI： 10.2486/indhealth.2021-0274

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Purpose: We aimed to identify the risk factors of critical bleeding and investigate the safety of recombinant activated factor VII (rFVIIa) in aortic surgery under hypothermic circulatory arrest (HCA). Patients and Methods: The present single-center retrospective study compared the baseline characteristics of 144 patients who underwent aortic surgery under HCA at our institute. Among the total cohort of 144 patients, 42 received rFVIIa (rFVIIa group), while the remaining 102 patients did not (non-rFVIIa group). Perioperative bleeding and transfusions, postoperative 30-day mortality, and adverse events (AEs) were analyzed in 29 propensity score-matched pairs. Results: Before surgery, the rFVIIa group demonstrated a greater number of shocks (p=0.019), higher JapanSCORE II mortality rate (p=0.033), low platelet count (p=0.015) and fibrinogen (p<0.001) level, prolonged activated partial thromboplastin time (aPTT) (p=0.005) and prothrombin time international normalized ratio (PT-INR) (p=0.006), and longer aortic cross clamp time (p=0.049). Postoperative bleeding, transfusion, 30-day mortality, and AEs were comparable between the groups both in the entire-unmatched cohort and propensity score matching cohort. Conclusion: Preoperative shock, higher JapanSCORE II mortality rates, low platelet and fibrinogen levels, prolonged aPTT and PT-INR, and longer aortic clamping time might be risk factors for excessive bleeding and indicate the need for rFVIIa treatment. The present study suggests that rFVIIa can be safely used to address critical and continuous bleeding in spite of adequate transfusion and supplementation of other coagulation factors in aortic surgery under HCA, without an increase in 30-day mortality and AEs.

DOI： 10.2147/TCRM.S352609

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Wiley  

AIMS/INTRODUCTION: We investigated the association between gestational diabetes mellitus (GDM) and perinatal outcomes stratified by pre-pregnancy body mass index (BMI) and/or gestational weight gain (GWG). MATERIALS AND METHODS: Data from the national birth cohort in the Japan Environment and Children's Study from 2011 to 2014 (n = 85,228) were used. Japan uses the GDM guidelines of the International Association of Diabetes and Pregnancy Study Groups. The odds ratios (ORs) of perinatal outcomes were compared between women with and those without GDM. RESULTS: The OR (95% confidence interval) of having a small for gestational age infant in the GDM group with a pre-pregnancy BMI of ≥25.0 kg/m2 and insufficient GWG (<2.75 kg) was 1.78 (1.02-3.12). The OR of having a large for gestational age infant of the same BMI group with excessive GWG (>7.25 kg) was 2.04 (1.56-2.67). The OR of hypertensive disorders of pregnancy was higher in women with a BMI ≥18.5 kg/m2 in the GDM group than in the non-GDM group. CONCLUSIONS: Large for gestational age and hypertensive disorders of pregnancy were associated with pre-pregnancy BMI and GWG in either normal weight or overweight/obese women, and the relationship was strengthened when GDM was present. Women with GDM and a BMI of ≥25.0 kg/m2 are at risk of having small for gestational age and large for gestational age infants depending on GWG.

DOI： 10.1111/jdi.13723

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その他リンク： https://onlinelibrary.wiley.com/doi/full-xml/10.1111/jdi.13723

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：MDPI AG  

Abdominal congenital malformations are responsible for early mortality, inadequate nutrient intake, and infant biological dysfunction. Exposure to metallic elements in utero is reported to be toxic and negatively impacts ontogeny. However, no prior study has sufficiently evaluated the effects of exposure to metallic elements in utero on abdominal congenital malformations. The aim of the present study was to evaluate associations between metallic elements detected in maternal blood during pregnancy and congenital abdominal malformations. Data from participants in the Japan Environment and Children’s Study was used in the present study, and contained information on singleton and live birth infants without congenital abnormalities (control: n = 89,134) and abdominal malformations (case: n = 139). Heavy metals such as mercury (Hg), lead (Pb), cadmium (Cd), and trace elements of manganese (Mn) and selenium (Se) were detected in maternal serum samples during mid- and late-gestation. Infant congenital abnormalities were identified from delivery records at birth or one month after birth by medical doctors. In a multivariate analysis adjusted to account for potential confounders, quartiles of heavy metals and trace elements present in maternal blood were not statistically correlated to the prevalence of abdominal congenital malformations at birth. This study is the first to reveal the absence of significant associations between exposure levels to maternal heavy metals and trace elements in utero and the prevalence of abdominal congenital malformations in a large cohort of the Japanese population. Further studies are necessary to investigate the impact of exposure to heavy metals and trace elements via maternal blood in offspring after birth.

DOI： 10.3390/ijerph181910103

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Frailty has been associated with a risk of adverse outcomes, and mortality in patients with various conditions. However, there have been few studies on whether or not frailty is associated with mortality in patients with accidental hypothermia (AH). In this study, we aim to determine this association in patients with AH using Japan's nationwide registry data. METHODS: The data from the Hypothermia STUDY 2018&19, which included patients of ≥18 years of age with a body temperature of ≤35 °C, were obtained from a multicenter registry for AH conducted at 120 institutions throughout Japan, collected from December 2018 to February 2019 and December 2019 to February 2020. The clinical frailty scale (CFS) score was used to determine the presence and degree of frailty. The primary outcome was the comparison of mortality between the frail and non-frail patient groups. RESULTS: In total, 1363 patients were included in the study, of which 920 were eligible for the analysis. The 920 patients were divided into the frail patient group (N = 221) and non-frail patient group (N = 699). After 30-days of hospitalization, 32.6% of frail patients and 20.6% of non-frail patients had died (p < 0.001). Frail patients had a significantly higher risk of 90-day mortality (Hazard ratio [HR], 1.64; 95% confidence interval [CI], 1.25-2.17; p < 0.001). Based on the Cox proportional hazards analysis using multiple imputation, after adjustment for age, potassium level, lactate level, pH value, sex, CPK level, heart rate, platelet count, location of hypothermia incidence, and rate of tracheal intubation, the HR was 1.69 (95% CI, 1.25-2.29; p < 0.001). CONCLUSIONS: This study showed that frailty was associated with mortality in patients with AH. Preventive interventions for frailty may help to avoid death caused by AH.

DOI： 10.1186/s12877-021-02459-5

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The influence of maternal psychological distress on infant congenital heart defects (CHDs) has not been thoroughly investigated. Furthermore, there have been no reports on the combined effect of maternal psychological distress and socioeconomic status on infant CHDs. This study aimed to examine whether maternal psychological distress, socioeconomic status, and their combinations were associated with CHD. METHODS: We conducted a prospective cohort study using data from the Japan Environment and Children's Study, which recruited pregnant women between 2011 and 2014. Maternal psychological distress was evaluated using the Kessler Psychological Distress Scale in the first trimester, while maternal education and household income were evaluated in the second and third trimesters. The outcome of infant CHD was determined using the medical records at 1 month of age and/or at birth. Crude- and confounder-adjusted logistic regression analyses were performed to evaluate the association between maternal psychological distress and education and household income on infant CHD. RESULTS: A total of 93,643 pairs of mothers and infants were analyzed, with 1.1% of infants having CHDs. Maternal psychological distress had a significantly higher odds ratio in the crude analysis but not in the adjusted analysis, while maternal education and household income were statistically insignificant. In the analysis of the combination variable of lowest education and psychological distress, the P for trend was statistically significant in the crude and multivariate model excluding anti-depressant medication, but the significance disappeared in the full model (P = 0.050). CONCLUSIONS: The combination of maternal psychological distress and lower education may be a possible indicator of infant CHD.

DOI： 10.1186/s12884-021-04001-2

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES: The aims of the present study were to evaluate and compare the safety and feasibility, including hospitalization, intensive care unit (ICU) stay, frequency of conversion to general anesthesia (GA), pH, PaCO2, and PaO2, of selected patients who underwent minimally invasive mitral valve surgery (MIMVS) via a right minithoracotomy under conscious sedation (CS) to avoid GA. The authors also aimed to evaluate the perioperative management of spontaneous breathing. DESIGN: A retrospective, observational study. SETTING: Single-center. PARTICIPANTS: This study enrolled 101 patients who underwent MIMVS under CS or GA. INTERVENTIONS: The patients who underwent MIMVS were managed under CS or GA according to indication criteria. MEASUREMENTS AND MAIN RESULTS: ICU stay (p = 0.010), postoperative time until first fluid intake (p < 0.0001), and duration of mechanical ventilation (p = 0.004) were shorter in the CS group than in the GA group. No patients converted to GA from CS. PaCO2 during cardiopulmonary bypass (CPB) in the CS group was significantly lower than that in the GA group. However, PaCO2 at the termination of CPB in the CS group was significantly higher than that in the GA group. CONCLUSIONS: In the CS group, advanced-age patients with comorbidities underwent mitral surgery without postoperative complications. The authors' findings suggested that MIMVS under CS could be a potentially less-invasive method, providing a quicker recovery than MIMVS under GA.

DOI： 10.1053/j.jvca.2021.07.005

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Pets may play a role in the social-emotional development of children. In particular, some studies have suggested that family dog ownership is associated with better health outcomes. To date, no study has assessed child development in association with dog ownership of different time points. The purpose of the current study was primary to investigate whether "ever" family dog ownership was associated with early child development, and secondary to further examine whether associations between family dog ownership and early child development differ among family dog ownership of status, including "past only", "current only", and "always" groups, using the data of family dog ownership obtained at multiple time points. Associations between family dog ownership and infant development at 3 years of age were examined using data from a nationwide prospective birth cohort study, the Japan Environment and Children's Study (n = 78,941). "Ever" family dog ownership was categorized to "past only", "current only", and "always". We observed that children with "ever" family dog ownership showed a significantly decreased risk of developmental delay in the communication (odds ratio [OR] = 0.87; 95% confidence interval [CI]: 0.78, 0.96), gross motor (OR = 0.83; 95% CI: 0.76, 0.92), problem-solving (OR = 0.89; 95% CI: 0.83, 0.96) and personal-social (OR = 0.86; 95% CI: 0.72, 0.92) domains compared to children with "never" family dog ownership. Furthermore, a significantly decreased risk of developmental delay in gross motor function was observed in association with living with dogs in the "past only" (OR = 0.83; 95% CI: 0.73, 0.95) and "always" (OR = 0.86; 95% CI: 0.75, 0.98). In addition, a decreased risk of developmental delay in the problem-solving domain was associated with "past" family dog ownership (OR = 0.87; 95% CI: 0.79, 0.97) and in the personal-social domain was associated with "always" family dog ownership (OR = 0.81; 95% CI = 0.68, 0.95). Given the possible positive association between early life child development and family dog ownership, living with dogs may be an important factor to be considered when assessing child development.

DOI： 10.3390/ijerph18137082

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUNDS: Japanese studies on the association between maternal alcohol consumption and fetal growth are few. This study assessed the effect of maternal alcohol consumption on fetal growth. METHODS: This prospective birth cohort included 95,761 participants enrolled between January 2011 and March 2014 in the Japan Environment and Children's Study. Adjusted multiple linear and logistic regression models were used to assess the association between prenatal alcohol consumption and infant birth size. RESULTS: Consumption of a weekly dose of alcohol in the second/third trimester showed a significant negative correlation with standard deviation (SD; Z) scores for body weight, body length, and head circumference at birth, respectively. Consumption of a weekly dose of alcohol during the second/third trimester had a significant positive correlation with incidences of Z-score ≤ -1.5 for birth head circumference. Associations between alcohol consumption in the second/third trimester and Z-score ≤ -1.5 for birth weight or birth length were not significant. Maternal alcohol consumption in the second/third trimester above 5, 20, and 100 g/week affected body weight, body length, and head circumference at birth, respectively. CONCLUSION: Low-to-moderate alcohol consumption during pregnancy might affect fetal growth. Public health policies for pregnant women are needed to stop alcohol consumption during pregnancy. IMPACT: This study examined the association between maternal alcohol consumption and fetal growth restriction in 95,761 pregnant Japanese women using the prospective birth cohort. Maternal alcohol consumption in the second/third trimester more than 5, 20, and 100 g/week might affect fetal growth in body weight, body length, and head circumference, respectively. The findings are relevant and important for educating pregnant women on the adverse health effects that prenatal alcohol consumptions have on infants.

DOI： 10.1038/s41390-021-01595-3

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES: Although psychological stress is a risk factor for oral diseases, there seems to be no review on work stress. This study aimed to review the evidence on the association between work stress and oral conditions, including dental caries, periodontal status and tooth loss. DESIGN: A systematic review of published observational studies. DATA SOURCES: A systematic literature search was conducted in PubMed and Scopus databases on 12 August 2020. STUDY SELECTION: Articles were screened based on the following inclusion criteria: published after 1966; in English only; epidemiological studies on humans (except case studies, reviews, letters, commentaries and editorials); and examined the association of work stress with dental caries, periodontal status and tooth loss. DATA EXTRACTION: Data were extracted from eligible studies. A quality assessment was conducted using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. RESULTS: Of 402 articles identified, 11 met the inclusion criteria, and 1 study assessed the association of work stress with dental caries and periodontal status. Of 11 studies, 1 reported a non-significant association between work stress and dental caries; 8 of 9 studies reported a significant association between work stress and worse periodontal status; and 1 of 2 studies reported a significant association between work stress and tooth loss. Nine of 11 studies were cross-sectional, while the remaining 2 studies had unclear methodology. Only two studies were sufficiently adjusted for potential confounders. Eight studies assessed work stress but did not use the current major measures. Three studies were rated as fair, while eight studies had poor quality. CONCLUSIONS: There is a lack of evidence on the association of work stress with dental caries and tooth loss. Eight studies suggested potential associations between periodontal status and work stress. Cohort studies using the major work stress measures and adjusting for the potential confounders are needed.

DOI： 10.1136/bmjopen-2020-046532

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

PURPOSE: There are notable geographic variations in incidence rates of suicide both in Japan and globally. Previous studies have found that rurality/urbanity shapes intra-regional differences in suicide mortality, and suicide risk associated with rurality can vary significantly by gender and age. This study aimed to examine spatial patterning of and rural-urban differences in suicide mortality by gender and age group across 1887 municipalities in Japan between 2009 and 2017. METHODS: Suicide data were obtained from suicide statistics of the Ministry of Health, Labour and Welfare in Japan. We estimated smoothed standardized mortality ratios for suicide for each of the municipalities and investigated associations with level of rurality/urbanity using Bayesian hierarchical models before and after adjusting for socioeconomic characteristics. RESULTS: The results of the multivariate analyses showed that, for males aged 0-39 and 40-59 years, rural residents tended to have a higher suicide risk compared to urban ones. For males aged 60+ years, a distinct rural-urban gradient in suicide risk was not observed. For females aged 0-39 years, a significant association between suicide risk and rurality was not observed, while for females aged 40-59 years and females aged 60 years or above, the association was a U-shaped curve. CONCLUSION: Our results showed that geographical distribution of and rural-urban differences in suicide mortality in Japan differed substantially by gender and age. These findings suggest that it is important to take demographic factors into consideration when municipalities allocate resources for suicide prevention.

DOI： 10.1007/s00127-020-01978-7

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Population impact of modifiable risk factors on orofacial clefts is still unknown. This study aimed to estimate population attributable fractions (PAFs) of modifiable risk factors for nonsyndromic cleft lip with or without cleft palate (CL±P) and cleft palate only (CP) in Japan. METHODS: We conducted a prospective cohort study using data from the Japan Environment and Children's Study, which recruited pregnant women from 2011 to 2014. We estimated the PAFs of maternal alcohol consumption, psychological distress, maternal active and passive smoking, abnormal body mass index (BMI) (<18.5 and ≥25 kg/m2), and non-use of a folic acid supplement during pregnancy for nonsyndromic CL±P and CP in babies. RESULTS: A total of 94,174 pairs of pregnant women and their single babies were included. Among them, there were 146 nonsyndromic CL±P cases and 41 nonsyndromic CP cases. The combined adjusted PAF for CL±P of the modifiable risk factors excluding maternal alcohol consumption was 34.3%. Only maternal alcohol consumption was not associated with CL±P risk. The adjusted PAFs for CL±P of psychological distress, maternal active and passive smoking, abnormal BMI, and non-use of a folic acid supplement were 1.4% (95% confidence interval [CI], -10.7 to 15.1%), 9.9% (95% CI, -7.0 to 26.9%), 10.8% (95% CI, -9.9 to 30.3%), 2.4% (95% CI, -7.5 to 14.0%), and 15.1% (95% CI, -17.8 to 41.0%), respectively. We could not obtain PAFs for CP due to the small sample size. CONCLUSIONS: We reported the population impact of the modifiable risk factors on CL±P, but not CP. This study might be useful in planning the primary prevention of CL±P.

DOI： 10.2188/jea.JE20190347

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: A wide gender gap exists in many fields in Japan, including the academic society of dermatology. Women are substantially underrepresented in the highest academic ranks. OBJECTIVE: We aimed to clarify the possible factors contributing to the current gender gap in the field of academic dermatology and to recommend necessary measures to decrease the gender gap. METHODS: We performed a cross-sectional study of faculty members' academic productivity at the dermatology departments of all the educational institutions in Japan in 2019. RESULTS: Women had significantly lower academic productivity than men. A significant gender difference in academic productivity was found in lecturers and assistant professors but not in associate professor and professor positions. This gender difference was still significant after normalizing the productivity for career length. CONCLUSION: Our findings suggest the need to encourage women lecturers and assistant professors to improve their academic achievement to decrease the gender gap in academic dermatology.

DOI： 10.1016/j.jdermsci.2021.01.011

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The incidence of accidental hypothermia (AH) is low, and the length of hospital stay in patients with AH remains poorly understood. The present study explored which factors were related to prolonged hospitalization among patients with AH using Japan's nationwide registry data. METHODS: The data from the Hypothermia STUDY 2018, which included patients ≥18 years old with a body temperature ≤ 35 °C, were obtained from a multicenter registry for AH conducted at 89 institutions throughout Japan, collected from December 1, 2018, to February 28, 2019. The patients were divided into a "short-stay patients" group (within 7 days) and "long-stay patients" group (more than 7 days). A logistic regression analysis after multiple imputation was performed to obtain odds ratios (ORs) for prolonged hospitalization with age, frailty, location, causes underlying the hypothermia, temperature, pH, potassium level, and disseminated intravascular coagulation (DIC) score as independent variables. RESULTS: In total, 656 patients were included in the study, of which 362 were eligible for the analysis. The median length of hospital stay was 17 days. Of the 362 patients, 265 (73.2%) stayed in the hospital for more than 7 days. The factors associated with prolonged hospitalization were frailty (OR, 2.11; 95% confidence interval [CI], 1.09-4.10; p = 0.027), the occurrence of indoor (OR, 3.20; 95% CI, 1.58-6.46; p = 0.001), alcohol intoxication (OR, 0.17; 95% CI, 0.05-0.56; p = 0.004), pH (OR, 0.07; 95% CI, 0.01-0.76; p = 0.029), potassium level (OR, 1.36; 95% CI, 1.00-1.85; p = 0.048), and DIC score (OR, 1.54; 95% CI, 1.13-2.10; p = 0.006). CONCLUSIONS: Frailty, indoor situation, alcohol intoxication, pH value, potassium level, and DIC score were factors contributing to prolonged hospitalization in patients with AH. Preventing frailty may help reduce the length of hospital stay in patients with AH. In addition, measuring the pH value and potassium level by an arterial blood gas analysis at the ED is recommended for the early evaluation of AH.

DOI： 10.1016/j.ajem.2021.03.079

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: This study examined psychological status trajectories of mothers of infants with nonsyndromic orofacial clefts in Japan. DESIGN: Prospective cohort study. SETTING: Data from the Japan Environment and Children's Study. PARTICIPANTS: Infants with a nonsyndromic cleft (N = 148) including cleft lip and palate (CLP; n = 72), cleft lip (CL; n = 46), and cleft palate (CP; n = 30). The control group included unaffected infants (N = 84 454). MAIN OUTCOME MEASURES: At 15 weeks and 27 weeks of pregnancy and 12 months after birth, the Kessler Psychological Distress Scale (clinical cutoff ≥5) was used. At 1 month and 6 months after birth, the Edinburgh Postnatal Depression Scale (clinical cutoff ≥9) was used. RESULTS: Prenatal diagnosis rates were unavailable. Mothers of infants with CLP had higher psychological distress than controls at 27 weeks of pregnancy (prevalence ratio [PR] = 1.36, 95% CI: 1.06-1.74) and postnatal depression at 1 month after birth (PR = 2.21, 95% CI: 1.53-3.19). Mothers of infants with CP showed heightened psychological distress at 27 weeks of pregnancy (PR = 1.62, 95% CI: 1.21-2.17) and postnatal depression 6 months after birth (PR = 1.86, 95% CI: 1.01-3.43). There was no significant association between CL and maternal psychological status. At 12 months after birth, no differences in distress were found between mothers of infants with a cleft and controls. CONCLUSIONS: Mothers of infants with orofacial clefts may need psychosocial support, particularly during pregnancy and the first year after birth.

DOI： 10.1177/1055665620951399

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Lower respiratory tract infections (LRTIs) are a cause of inpatient and outpatient care among children. Although orofacial clefts seem to be associated with LRTIs, epidemiological studies are scarce on this topic. This study aimed to examine whether infants with orofacial clefts were associated with LRTIs. METHODS: This prospective cohort study used data from the Japan Environment and Children's Study, whose baseline recruitment was conducted during 2011-2014. This study included 81,535 participants. The number of infants with cleft lip and palate (CLP), cleft lip (CL), and cleft palate only (CP) was 67, 49, and 36, respectively. We defined history of LRTIs until 12 months' age reported by their mothers as the dependent variable. Accumulated breastfeeding duration was used as potential mediators. RESULTS: The incidence proportion of LRTIs among the control group was 6.0%. The incidence proportion among infants with CLP, CL, and CP were 11.9%, 14.3%, and 5.6%, respectively. After adjusting for covariates, compared with the control group, infants with CLP and CL were associated with risk of LRTIs (incidence risk ratio [IRR] of CLP = 2.38 [95% confidence interval = 1.30, 4.36] and of CL = 2.73 [1.40, 5.33]) , but not ones with CP (1.08 [0.28, 4.15]). Accumulated breastfeeding duration decreased the IRR of CLP only (IRR of CLP = 2.16 [1.19, 3.93]). CONCLUSIONS: Infants with orofacial clefts aged 1 year have a potentially high incidence proportion of LRTIs. Accumulated breastfeeding duration might mediate the associations of CLP.

DOI： 10.2188/jea.JE20200438

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Wiley  

AIM: This study describes the clinical characteristics and outcomes as well as the prognostic factors of patients with accidental hypothermia (AH) using Japan's nationwide registry data. METHODS: The Hypothermia study 2018 and 2019, which included patients aged 18 years or older with a body temperature of 35°C or less, was a multicenter registry conducted at 87 and 89 institutions throughout Japan, with data collected from December 2018 to February 2019 and December 2019 to February 2020, respectively. RESULTS: In total, 1363 patients were enrolled in the registry, of which 1194 were analyzed in this study. The median (interquartile range) age was 79 (68-87) years, and the median (interquartile range) body temperature at the emergency department was 30.8°C (28.4-33.6°C). Forty-three percent of patients with AH had a mild condition, 35.2% moderate, and 21.9% severe. AH occurred in an indoor setting in 73.4% and was caused by acute medical illness in 49.3% of patients. A total of 101 (8.5%) patients suffered from cardiopulmonary arrest on arrival at the hospital. The overall 30-day mortality rate was 24.5%, the median (interquartile range) intensive care unit stay was 4 (2-7) days, and the median (interquartile range) hospital stay was 13 (4-27) days. In the multivariable logistic analysis, the prognostic factors were age (≥75 years old), male, activities of daily living (needing total assistance), cause of AH (trauma, alcohol), Glasgow Coma Scale score, and potassium level (>5.5 mEq/L). CONCLUSION: The mortality rate of AH was 24.5% in Japan. The prognostic factors developed in this study may be useful for the early prediction, prevention, and awareness of severe AH.

DOI： 10.1002/ams2.694

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その他リンク： https://onlinelibrary.wiley.com/doi/full-xml/10.1002/ams2.694

記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The influence of mothers' and fathers' educational levels in separate evaluations of asthma has not been fully investigated. This study aims to examine the associations of the mother's and fathers' educational levels with childhood wheeze and asthma adjusting for crude and pre-and post-natal modifiable risk factors. METHODS: We conducted a prospective cohort study using data from the Japan Environment and Children's Study, which recruited pregnant women from 2011 to 2014. The mother's and father's educational levels were surveyed by a questionnaire during the pregnancy, and childhood wheezing and doctor-diagnosed asthma were estimated using a 3-year questionnaire. Multilevel logistic regression analysis was performed to evaluate the association between the mother's and father's educational levels and childhood wheezing and asthma, adjusted for pre-and post-natal factors. RESULTS: A total of 69,607 pairs of parents and their single infants were analyzed. We found 17.3% of children had wheezing and 7.7% had asthma. In crude analyses, lower educational level of parents was associated with an increased risk of childhood wheezing and asthma. After full adjustment, a lower educational level of mothers was associated with an increased risk of childhood asthma (junior high school (reference: high school); odds ratio (OR): 1.17, 95% CI, 1.01-1.36), and higher educational level, especially the mother's, was associated with an increased risk of childhood wheezing (technical junior college, technical/vocational college, or associate degree (ECD3); OR: 1.12, 95% CI, 1.06-1.18, bachelor's degree, or postgraduate degree; OR: 1.10, 95% CI, 1.03-1.18), and asthma (ECD3; OR: 1.13, 95% CI, 1.04-1.21). CONCLUSIONS: Parents' lower educational level was a crude risk factor for childhood wheezing and asthma. However, an increased risk of wheezing due to mothers' higher educational level was found after adjusting for pre-and post-natal factors.

DOI： 10.1371/journal.pone.0250255

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Levels of student loan debt have been increasing, but very little research has assessed if this is associated with poor health. The aim was to examine the association between student loans and psychological distress in Japan. METHODS: We conducted a cross-sectional web-based self-administered questionnaire survey in 2017. The sample comprised of 4,149 respondents aged 20-34, with 3,170 graduates and 979 current university students. The independent variables were whether or not current students had student loans, and for graduates, the total amount of their student loan debt. The dependent variable was severe psychological distress assessed using the Kessler Psychological Distress Scale (K6; the cut-off point was 12/13). Covariates were demographic and parents' socioeconomic variables. A Poisson regression analysis with a robust error variance was conducted to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs). Because there was a significant interaction between current student status and the status of borrowing student loans, stratified analyses were conducted. RESULTS: The percentage of those with student loans was 33.8% among graduates and 35.2% among current university students. Among graduates, student loan debt was significantly associated with a high possibility of having severe psychological distress after adjusting for covariates (PR of ≥4 million yen, 1.44; 95% CI, 1.02-2.03). Among current university students, there was no significant association (PR of borrowing student loans, 0.91; 95% CI, 0.60-1.37). CONCLUSIONS: There was a significant association between student loan debt and psychological distress among graduates but not current university students.

DOI： 10.2188/jea.JE20190057

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Angiotensin receptor blockers (ARBs) plus calcium channel blockers (CCBs) are a widely used combination therapy for hypertensive patients. In order to determine which combination was better as the next-step therapy for standard-dose combination of ARBs and CCBs, a combination with high-dose CCBs or a triple combination with diuretics, the authors conducted a prospective, randomized, open-label trial to determine which of the following combination is better as the next-step treatment: a combination with high-dose CCBs or a triple combination with diuretics. Hypertensive outpatients who did not achieve their target blood pressure (BP) with usual dosages of ARBs and amlodipine 5 mg were randomly assigned to treatment with irbesartan 100 mg/amlodipine 10 mg (Group 1: n = 48) or indapamide 1 mg in addition to ARBs plus amlodipine 5 mg (Group 2: n = 46). The primary end point was changes in the systolic BP (SBP) and diastolic BP (DBP) after the 12-week treatment period, while secondary end points were changes in BP after the 24-week treatment period and laboratory values. At 12 weeks, the SBP/DBP significantly decreased from 152.1/83.4 mm Hg to 131.5/76.1 mm Hg in Group 1 and 153.9/82.1 mm Hg to 132.7/75.9 mm Hg in Group 2. Although both groups produced a similar efficacy in reducing the SBP/DBP (-19.2/-9.2 mm Hg in Group 1 and -21.6/-8.8 mm Hg in Group 2; SBP P = .378, DBP P = .825), high-dose CCBs combined with ARBs controlled hypertension without elevation of serum uric acid. These results will provide new evidence for selecting optimal combination therapies for uncontrolled hypertensive patients.

DOI： 10.1111/jch.13977

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Poor accessibility to physicians might be linked to the inadequate control of cardiovascular risk factors. The aim of this study was to investigate whether the accessibility of primary care physicians was related to a lower incidence of ischemic heart disease and stroke mortality via ecological data analyses of both primary care facility density and internal physician density. The unit of observation was the Japanese secondary medical service area, the basic unit for healthcare planning and administration. A primary care facility was defined as a clinic or medical institution with less than 200 inpatient beds, whose specialty included internal medicine. The number of primary care facilities per 10,000 population and the number of internal physicians per 10,000 population were used as explanatory variables. Bayesian hierarchical models were used to analyze the relative risks (RR) of primary care facility density and internal physician density using the socioeconomic confounders of designated emergency hospitals, natural log-transformed population density, birth rate, secondary and tertiary industrial workers, and taxable income. In multivariate models for ischemic heart disease mortality, primary care facility density was significantly related to the total population (RR = 0.986, 95% credible interval [CrI]: 0.979-0.993), men (RR = 0.988, 95% CrI: 0.981-0.996), and women (RR = 0.986, 95% CrI: 0.979-0.993). No significant results were obtained for internal physician density. In the multivariate models for stroke mortality, neither primary care facility density nor internal physician density showed any significant effects. Increasing primary care facility density may reduce ischemic heart disease mortality.

DOI： 10.1620/tjem.251.217

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier {BV}  

Background: Birch pollen allergy affects pregnant women, and such allergy may affect the development of allergic diseases in their children. Using nationwide birth cohort data, this study aimed to investigate the prevalence of birch pollen IgE positivity and to identify correlating factors in pregnant women in Hokkaido, Japan, a high-latitude island. Methods: Participants included 6856 pregnant women. Participants responded to questionnaires regarding lifestyle factors and history of allergies. Data regarding parity, height, and pre-pregnancy weight were collected from medical records. Blood samples were obtained from participants during the first trimester of pregnancy, and serum allergen-specific IgE titers were determined. Results: The serum of 30.2% participants was positive for birch pollen IgE (≥0.35 UA/mL). Such positivity significantly correlated with a history of other allergic diseases, particularly food allergy and allergic rhinitis/hay fever. In multivariate logistic regression analysis, pre-pregnancy high body mass index (BMI ≥ 25) significantly correlated with birch pollen IgE positivity [odds ratio (OR), 1.24; 95% CI, 1.05-1.47; reference BMI, 18.5-24.9] and higher income (≥10 million yen per year; OR,0.55; 95% CI, 0.37-0.81; reference, household income < 2 million yen per year), and second quintile level physical activity (OR,0.75; 95% CI, 0.63-0.88; reference, the first quintile of physical activity) had significant protective effects. Conclusions: Birch pollen IgE positivity in pregnant women was positively associated with food allergy, allergic rhinitis, pre-pregnant high BMI, and was negatively associated with light exercise and high household income in Hokkaido. Trial registration: UMIN000030786.

DOI： 10.1016/j.waojou.2020.100128

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Oral diseases produce enormous productivity loss. However, epidemiological evidence of work stress and tooth loss is scarce. The aim of this study was to examine the association of work stress, according to effort-reward imbalance (ERI), with tooth loss. We conducted a cross-sectional study using data obtained between 2010 and 2011 in Japan. This study included 1,195 employees aged 25-50 years old (response rate=32%). The dependent variable was self-reported tooth loss (having or not). The independent variable was a dichotomized ERI ratio (>1.4 and ≤1.4). Age, sex, sociodemographic variables, work-related factors, and health-related variables were adjusted. Psychological distress was used as a potential mediator. We also examined an additive interaction between support from supervisors and ERI. The median age was 37, and 48% were women. After adjusting for the covariates, ERI was still associated with tooth loss (prevalence ratio=1.20 [95% confidence interval=1.01, 1.42] from Poisson regression models with a robust error variance). Psychological distress partially explained the association, and support from supervisors significantly attenuated the association. In conclusion, high ERI ratio was still associated with an increased risk of tooth loss among working adults.

DOI： 10.2486/indhealth.2018-0226

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

There are some fee-charged questionnaires in the social medicine field. If a questionnaire is fee-charged, the researcher developing it may have a financial incentive, and the existence of a conflict of interest should be considered. Therefore, when a manuscript reporting a fee-charged questionnaire is submitted, future fee-charging and the institution managing the questionnaire should be described as potential conflicts of interest. They should also be so described in forms for ethical review and informed consent.

DOI： 10.11236/jph.67.3_167

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掲載種別：研究論文（学術雑誌）   出版者・発行元：Open Access Text Pvt, Ltd.  

DOI： 10.15761/imm.1000406

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：{MDPI} {AG}  

Contact with companion animals has been suggested to have important roles in enhancing child development. However, studies focused on child development and pet ownership at a very early age are limited. The purpose of the current study was to investigate child development in relation to pet ownership at an early age in a nationwide prospective birth cohort study: the Japan Environment and Children's Study. Associations between cat and dog ownership at six months and infant development at 12 months of age were examined in this study. Infant development was assessed using the Ages & Stages QuestionnairesTM (ASQ-3) at 12 months. Among participants of (Japan Environment and Children's Study) JECS, those with available data of cat and dog ownership at six months and data for the ASQ-3 at 12 months were included (n = 78,868). Having dogs showed higher percentages of pass in all five domains measured by ASQ-3 (communication, gross motor, fine motor, problem-solving, and personal-social) compared to those who did not have dogs. Significantly decreased odds ratios (ORs) of developmental delays were observed in association with having dogs in all fix domains (communication: OR = 0.73, gross motor: OR = 0.86, fine motor: OR = 0.84, problem-solving: OR = 0.90, personal-social: OR = 0.83). This study suggested that early life dog ownership may reduce the risks of child developmental delays.

DOI： 10.3390/ijerph17010205

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Public smoke-free legislation has been in place since July 2016 in a small city (Bibai) in Hokkaido (Japan); the effects of public smoke-free legislation in small cities in Japan on cardiovascular and cerebrovascular events have not been fully investigated. Monthly numbers of acute myocardial infarctions (AMIs) and stroke admissions were obtained from medical records, and the adjacent area, Naka-Sorachi, was used as a control region. According to the results of the Poisson regression, significant direct outcomes after the enactment of smoke-free legislation in Bibai city were not observed. After the implementation of the smoke-free legislation, the average monthly admission rates per population and risk ratios for AMI, stroke, and the combined outcome (AMI plus stroke) decreased in the Bibai region but increased in the control region (Naka-Sorachi), although there was no statistically significant difference between the two regions. However, significant interactions between the region (Bibai or Naka-Sorachi) and period (before or after the legislation) for stroke and the combined outcome were noted. Although a direct admission effect was not observed, the significant interaction indicated that Bibai had a decreasing trend in emergency admissions compared with the control region (Naka-Sorachi). Public smoke-free legislation in small cities may also decrease cardiovascular events.

DOI： 10.1038/s41440-019-0299-2

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier {BV}  

BACKGROUND: The aim of this study is to evaluate in the relationships between alcohol intake and ischemic stroke severity in Japanese stroke patients. METHODS: Of a total of 101,165 registered cases of stroke in Japan, patient data of total strokes (n = 60,836), cardiogenic strokes (n = 11,894), and noncardiogenic strokes (n = 29,129) were extracted. The National Institutes of Health Stroke Scale (NIHSS) score at admission and the modified Rankin Scale (mRS) score at discharge were used. Significant alcohol consumption in regard to stroke severity at admission and discharge was identified by multivariate adjusted logistic regression analysis. RESULTS: Among all subject and males, nondrinkers had significantly poorer NIHSS scores of cardiogenic strokes as did those consuming greater than or equal to 60 g/day, whereas there was a significant difference in past heavy drinkers with noncardiogenic strokes. Among females, nondrinkers had a significance of cardiogenic stroke and non-cardiogenic strokes. Among all subjects and males, 20-39 g/day and 40-59 g/day were significantly associated with protective effects on mRS severity of cardiogenic strokes, whereas 40-59 g/day also had significant protective effects for noncardiogenic strokes. Among females, greater than or equal to 60 g/day had a significant protective effect for cardiogenic strokes. CONCLUSIONS: For males, alcohol intake of less than 60 g/day played a protective role in functional prognosis at discharge and showed a J-shape relationship. For females, although there was a limitation that the number of female drinkers was small, negative effects were shown at admission with less consumption than males.

DOI： 10.1016/j.jstrokecerebrovasdis.2019.02.034

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Few previous studies have investigated the association between prenatal caffeine intake and birth size (small for gestational age [SGA], preterm birth, and birthweight Z-score) in Japan. OBJECTIVES: We examined the dose-dependency of this association (prenatal caffeine consumption and birth size) as part of the Japan Environment and Children's Study. METHODS: A prospective birth cohort included 94 876 fetuses in Japan. Participants were enrolled between January 2011 and March 2014. Adjusted multiple linear regression and Cox regression models were used to examine the association between prenatal caffeine levels and infant birth size. RESULTS: The median estimated caffeine consumption during pregnancy was 125.5 mg/day, as determined by self-administered questionnaires. There were 7252 SGA infants (7.6%) and 4281 preterm birth infants (4.5%). Compared with infants of mothers whose caffeine consumption during pregnancy was in the lowest quartile (4.2 to <86.4 mg/day), infants of mothers whose caffeine consumption was in the highest quartile 4 (205.5-5080.0 mg/day) were at an increased risk of SGA (relative risk [RR] 1.18, 95% confidence interval [CI] 1.10, 1.27), and at an increased risk of preterm birth at the second trimester of gestation (RR 1.94, 95% CI 1.12, 3.37), with a 0.32-day reduction in gestational age (95% CI -0.52, -0.12) and with a 0.07 reduction in birthweight Z-score observed (95% CI -0.09, -0.05). CONCLUSIONS: Prenatal caffeine consumption was associated with birth size. However, as the association between prenatal caffeine consumption and birth size was likely confounded by unpredicted potential factors, our confidence in the true causality of the association is moderate.

DOI： 10.1111/ppe.12551

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier {BV}  

BACKGROUND: It is necessary to determine whether there are adverse health effects of prenatal exposure to long-term, low levels of mercury and selenium. However, there are limited that reports on the association between mercury levels by selenium levels and birth size. Therefore, we examined whether maternal mercury levels during pregnancy had any effect on infant birth size, and size, and whether selenium levels influenced this relationship. OBJECTIVES: To examine the association between mercury and selenium levels during pregnancy with infant birth size. METHODS: The Japan Environment and Children's Study is a prospective birth cohort conducted between 2011 and 2014. Total mercury levels and total selenium levels in maternal blood during the second and third trimesters were measured using Inductively Coupled Plasma-Mass Spectrometry. Birth weight and small-for-gestational-age were confirmed by medical records. Small-for-gestational-age was defined as birth weight below the 10th percentile according to standard percentile for gender, parity, and gestational age. Multiple linear and logistic regression analyses were used to examine the association between maternal mercury exposure and birth weight or small-for-gestational-age adjusted for confounders (including maternal age and body mass index pregnancy). RESULTS: Overall, 15,444 pregnant women were included in this study. Median (inter-quartile range) of blood mercury and selenium levels were 3.66 (2.59-5.18) ng/g and 170.0 (158.0-183.0) ng/g, respectively. Compared to infants of mothers with the highest blood selenium level, those of mothers with the lowest blood selenium level had neither a significant birth weight increase (9 g, 95% confidence interval: -6, 25) nor a significant odds ratio for small-for-gestational-age (0.903, 95% confidence interval: 0.748, 1.089). Compared to infants of mothers with the lowest blood mercury level, those of mothers with the highest blood mercury level had neither a significant birth weight reduction (-12 g, 95% confidence interval: -27, 4) nor a significant odds ratio for small-for-gestational-age (0.951, 95% confidence interval: 0.786, 1.150). Compared to infants of mothers with the lowest quartile of maternal blood mercury level, all infants of mothers with the highest quartile of maternal blood mercury level had a reduced birth head circumference of 0.073 cm (95% confidence interval: -0.134, -0.011). CONCLUSIONS: There was no association between maternal blood mercury levels and small-for-gestational-age and birth weight among 15,444 pregnant women. In a Japanese population, which has a relatively higher blood mercury level than reported in Western population, reduced birth size was not found to be associated with blood mercury levels, with the exception of birth head circumference.

DOI： 10.1016/j.envint.2019.01.051

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Approximately 15% of couples are infertile, with half of these cases being due to a male factor. Testis-specific cytoplasmic poly(A) polymerase beta (PAPOLB) is known to be critical for spermatogenesis. In mice, the loss of function of the Papolb gene results in the arrest of spermiogenesis and in male infertility. To analyse the role of the PAPOLB gene in human male infertility, this study investigated the relevance of this gene to human Sertoli-cell-only syndrome (SCOS) with azoospermia. Mutation analysis of the PAPOLB coding region was performed on 139 Japanese patients by PCR and direct sequence analysis. No critical mutations directly causing SCOS were detected, but three single-nucleotide polymorphisms (SNPs; SNP1 (c1101C > T), SNP2 (c1347T > C) and SNP3 (c1903C > A)) were found in the coding region. However, there were no significant associations in the allelic and genotypic distributions of these three SNPs between the SCOS and control groups (p>.05). This study suggests a lack of association of PAPOLB with azoospermia due to SCOS in humans.

DOI： 10.1080/01443615.2018.1504205

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

This study aimed to construct a childhood obesity risk index based on predictors identified in pregnant women and 1-yr-old infants. The primary outcome was an identified obesity index of > 20% at 6-8 yr of age. Of a total sample size of 6,846 mother-child pairs, 80% and 20% were randomly allocated to the derivation and validation cohorts, respectively. For the derivation cohort, univariate and multivariate logistic regression analyses of data were conducted to identify the final predictors to determine the childhood obesity risk score algorithm. These included pre-pregnancy body mass index (BMI), child's gender, smoking during pregnancy, education, and obesity index at one yr of age. The β coefficients for categories of predictor variables were each divided by the smallest value among them. The quotient was rounded off to the integer and assigned to the risk score, and a value of zero was assigned to reference categories. A total risk score was calculated for each individual. A cutoff point ≥ 16 had 22.2% and 21.8% positive predictive values in the derivation and validation cohorts, respectively. In conclusion, the childhood obesity risk score algorithm was constructed based on generic predictors that can be easily obtained from maternal and child health handbooks.

DOI： 10.1297/cpe.28.81

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Prenatal psychological stress may increase the risk of placental abruption (PA). This study aimed to clarify the effects of psychological distress during pregnancy and exposure to stressful life events in the year before or during pregnancy on the occurrence of PA in Japanese women. METHODS: Using a nationwide prospective birth cohort study, we obtained data from 103,099 women between January 2011 and March 2014. Information on exposure to 14 stressful life events and psychological distress (Kessler 6 scale) was collected using a self-administered questionnaire during pregnancy. Clinical diagnoses of PA were obtained from medical records. A total of 80,799 women with singleton births were analyzed using logistic regression models that adjusted for possible confounders. RESULTS: PA was diagnosed in 335 (0.4%) women. There was no significant difference in the Kessler 6 score during pregnancy between the PA group and non-PA group. Exposure to the death of a child in the year before or during pregnancy was significantly associated with PA in multigravid women (adjusted odds ratio [aOR] 3.57; 95% confidence interval [CI] 1.50-8.34). A spouse's loss of employment was significantly associated with PA in parous women (aOR 3.25; 95% CI 1.40-7.56). CONCLUSIONS: This study identified the possible effects of exposure to the death of a child on PA occurrence that adjusted for important confounding factors.

DOI： 10.1371/journal.pone.0219379

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Recent large-scale clinical studies demonstrate that sodium-glucose cotransporter 2 (SGLT2) inhibitors protect the diabetic kidney. However, clinical and animal studies have not shown the changes of the total glomeruli in the whole kidney treated with SGLT2 inhibitors. METHODS: We performed computed tomography (CT) imaging on mice using synchrotron radiation to investigate the impact of luseogliflozin, a SGLT2 inhibitor, on the number and volume of glomeruli in the whole kidney. FINDINGS: We did not observe a significant difference in the total glomerular number (Nglom) among mice. Luseogliflozin redistributed the number of glomeruli in different regions, accompanied by the normalization of diabetes-augmented renal volume (Vkidney). Diabetic db/db mice had a larger glomerular volume in the mid-cortex than did control db/m mice, and luseogliflozin increased the glomerular volume in all renal cortical zones of the whole kidney in db/db mice. According to the multivariate regression analysis, hemoglobin A1c level was the most relevant determinant of Vkidney, not Nglom or mean glomerular volume (Vglom), indicating that hyperglycemia induced renal (tubular) hypertrophy, but not glomerular enlargement. Luseogliflozin increased hypoxia in the juxtamedullary region, sustained upregulated renal renin expression and plasma renin activity, and failed to decrease albuminuria by downregulating megalin in db/db mice. INTERPRETATION: Based on our findings, SGLT2 inhibitors may alter glomerular distribution and size in addition to their glucose-lowering effects, presumably by affecting oxygen metabolism and humoral factors. FUND: Funding for this research was provided by The Japan Society for the Promotion of Science, the Japan Diabetes Foundation, and Asahikawa Medical University.

DOI： 10.1016/j.ebiom.2018.09.048

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Shortage of healthcare workers is a global problem. It is important to clarify factors, including job stress, that influence workplace resignation and factors that cause burnout among rural physicians. The study was designed as a cross-sectional questionnaire survey. We sent questionnaires to town or village hospitals and clinics (n = 1,898) in Hokkaido, Tohoku, Shikoku, and Kyushu and Okinawa. The number of participants was 509. Of these 7.7% were female and 21.6% were < 50 years. Internal or general medicine physicians were asked about personal and job factors, job stress based on the demand-control-support model, intention to resign from current position, and burnout evaluated using the Maslach Burnout Inventory-General Survey. Overall, 10.4% of the participants intended to resign, and 21.8% was defined as burnout positive. In the multivariate logistic regression analysis, dissatisfaction with income (OR, 3.63; 95% CI, 1.63-8.10), having one's hometown in another town or village in the same prefecture (OR, 3.53; 95% CI, 1.18-10.62) were significantly related to intention to resign, while high job control (OR, 0.72; 95% CI, 0.58-0.88) had a significantly protective effect. In the multivariate analysis, high job demand (OR, 1.48; 95% CI, 1.28-1.72) was significantly related to burnout, and high job control (OR, 0.66; 95% CI, 0.55-0.78) and high support from co-workers (OR 0.88, 95% CI, 0.78-1.00) had a significantly protective effect. Improving job stress factors, especially job control, and taking into consideration physicians' hometown and income may be important factors to prevent resignation from a current position and burnout among Japanese rural physicians.

DOI： 10.1620/tjem.245.167

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Prenatal exposure to polychlorinated dibenzo-p-dioxins (PCDDs) or polychlorinated dibenzofurans (PCDFs) and dioxin-like polychlorinated biphenyls (dioxin-like compounds [DLCs]) through environmental chemicals may affect the neurodevelopment of children. In our previous study, an inverse association was observed between prenatal DLCs and neurodevelopment of infants aged 6months in both sexes. However, studies are yet to determine how long these adverse effects last. OBJECTIVE: To examine whether the effects of DLCs on cognitive development remains at 42months. METHODS: In this prospective cohort study conducted in Sapporo, Japan, pregnant mothers' blood was analyzed for the congener level of DLCs. The Kaufman Assessment of Battery for Children (K-ABC) was used to test their children's cognitive development at 42months. A total of 141 mother-child pairs were included in the final analysis. The multiple linear regression analysis was used to examine the association between the K-ABC scores and DLC levels in the maternal blood. RESULTS: Seven isomers (1,2,3,6,7,8-HxCDD, 2,3,4,7,8-PeCDF, 33'44'55'-HxCB(#169), 2344'5- PenCB(#114), 233'44'5-HexCB(#156), 233'44'5'-HexCB(#157), 23'44'55'-HexCB(#167), total PCDF, and TEQ-PCDD, PCDF, PCDD/DFs levels were positively associated with the achievement score (AS) of K-ABC. However, total non-ortho PCBs were negatively associated with the Mental Processing Composite Score (MPCS) of K-ABC in males. In females, increased TEQ-dl PCB and TEQ-PCDD/F/dl-PCB were also associated with increasing AS score. CONCLUSIONS: This study suggests that the negative effects of prenatal DLC exposure on children's cognitive development at 6months were not observed in children aged 42months. Regarding the sex-specific effects, AS and DLCs were positively correlated in females, whereas those of MPCS and DLCs were significantly negative in males.

DOI： 10.1016/j.scitotenv.2017.09.267

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

PURPOSE: The role of insomnia in chronic kidney disease (CKD) is controversial. To date, there have been no prospective studies investigating insomnia, CKD and the effect of shift work. We assessed insomnia and CKD risk in a prospective, occupational cohort study. METHODS: A total of 3600 participants with normal kidney function were followed for an average of 4.4 years. Insomnia was assessed using the Athens Insomnia Scale (AIS). CKD was defined as an estimated glomerular filtration rate of <60 mL/min/1.73 m2 at the first health examination. Cox proportional hazard regression models were used to estimate hazard ratios with 95% confidence intervals of insomnia for CKD development. RESULTS: A total of 182 CKD cases were identified. After adjustment for potential confounders, we did not observe an association between insomnia (AIS score ≥6) and CKD. However, the AIS item of awakening during the night was associated with a significantly increased CKD risk (hazard ratio = 3.10, 95% confidence interval 1.68-5.30). In further analyses, having difficulty with sleep induction was associated with an increased CKD risk among shift workers (hazard ratio = 3.34, 95% confidence interval 1.22-8.31). This association was not present among non-shift workers. CONCLUSIONS: Awakening during the night is associated with a moderately increased CKD risk.

DOI： 10.1007/s11325-017-1508-3

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Wiley-Blackwell  

Objective: Poor access to a primary care physician may lead to poor control of risk factors for disease. This study investigated whether geographic access to a primary care physician was related to ischemic heart disease and stroke mortality. Methods: Road-distances from the centroids of the basic unit blocks of the 2010 Japanese Census to the nearest primary care facilities in Hokkaido, northern Japan, were measured using geographic information system (GIS) software. Next, block population-weighted mean road-distances to primary care facilities in all municipalities were calculated. The numbers of deaths from ischemic heart disease and stroke were obtained from the Vital Statistics Bureau. A Bayesian spatial conditional autoregressive (CAR) model was used to analyze relative risk (RR) by road-distance with the numbers of physicians in the municipality included as a covariate. Results: Relative risk (per 1 kilometer increased) of death from ischemic heart disease to road-distance to the nearest primary care facility was not significantly higher in men (1.108: 95% credible interval [CI] 0.999-1.037) and women (1.023: 95% CI 1.000-1.046). However, RR of death from stroke was significantly higher in men (1.019: 95% CI 1.005-1.032) and women (1.019: 95% CI 1.006-1.033). Conclusion: Longer road-distance to a primary care facility may increase the risk of stroke mortality.

DOI： 10.1002/jgf2.140

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

Recently, we have published a book containing evidence-based public health guidelines and a practical manual for the prevention of sick house syndrome. The manual is available through the homepage of the Ministry of Health, Labour and Welfare (http://www.mhlw.go.jp/file/06-Seisakujouhou-11130500-Shokuhinanzenbu/0000155147.pdf). It is an almost completely revised version of the 2009 version. The coauthors are 13 specialists in environmental epidemiology, exposure sciences, architecture, and risk communication. Since the 1970s, health problems caused by indoor chemicals, biological pollution, poor temperature control, humidity, and others in office buildings have been recognized as sick building syndrome (SBS) in Western countries, but in Japan it was not until the 1990s that people living in new or renovated homes started to describe a variety of nonspecific subjective symptoms such as eye, nose, and throat irritation, headache, and general fatigue. These symptoms resembled SBS and were designated "sick house syndrome (SHS)." To determine the strategy for prevention of SHS, we conducted a nationwide epidemiological study in six cities from 2003-2013 by randomly sampling 5,709 newly built houses. As a result 1,479 residents in 425 households agreed to environmental monitoring for indoor aldehydes and volatile organic compounds (VOCs). After adjustment for possible risk factors, some VOCs and formaldehyde were dose-dependently shown to be significant risk factors. We also studied the dampness of the houses, fungi, allergies, and others. This book is fully based on the scientific evidence collected through these studies and other newly obtained information, especially from the aspect of architectural engineering. In addition to SHS, we included chapters on recent information about "multi-chemical sensitivity."

DOI： 10.1265/jjh.73.116

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：S.O.G. CANADA Inc.  

Purpose of investigation: Approximately 15% of couples are infertile, and male and female factors are believed to be equally important. Genetic mechanisms are implicated in aspects of male infertility and male mice lacking the gene Etv5 exhibited azoospermia with loss of germ cells: a phenotype identical to human Sertoli cell-only syndrome (SCOS). The ETV5 gene family encodes transcription factors sharing the evolutionarily conserved DNA-binding ETS domain. Therefore, the authors hypothesized that ETV5 variants might be associated with azoospermia caused by SCOS. Materials and Methods: ETV5 was sequenced in 140 Japanese men with SCOS and in 116 healthy controls using the Sanger method. Results: Four single-nucleotide polymorphism variants (SNPs 1-4) were detected in the patient group. An association study was performed for patients and controls. Two ETV5 variants, SNP2 and SNP3, were nominally associated with susceptibility to SCOS (p = 0.002 and p &lt
0.001, respectively). Conclusion: These results indicate a potential role for ETV5 in human spermato-genesis.

DOI： 10.12891/ceog3797.2018

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掲載種別：研究論文（学術雑誌）   出版者・発行元：Medknow  

DOI： 10.4103/aja.aja_66_17

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Consistent reports are not available on the effects of dioxin-like polychlorinated biphenyls (PCBs) and polychlorinated dibenzo-p-dioxins (PCDD)/ polychlorinated dibenzofurans (PCDF) (dioxin-like compounds [DLCs]) on child neurodevelopment. Further, the effect of background-level exposure to individual DLC isomers is not known. OBJECTIVES: We carried out the Sapporo cohort study to evaluate the effect of prenatal exposure to each DLC isomer on child neurodevelopment at 6 and 18 months of age, and assessed sex-specific differences in these effects. METHODS: The levels of all and each individual DLC isomers were estimated in maternal peripheral blood. Neurodevelopment was evaluated using the Bayley Scales of Infant Development-2nd Edition for 6-month-old infants (n = 190) and 18-month-old children (n = 121). RESULTS: In male children, levels of 10 DLC isomers were significantly negatively associated with the Psychomotor Developmental Index (PDI) at 6 months of age after adjustment for potential confounding variables. However, at 18 months of age, these associations were absent. In female children, the level of only one DLC isomer was significantly negatively associated with PDI at 6 months of age. However, in contrast to the male children, the levels of six DLC isomers in 18-month-old female children were significantly positively associated with the Mental Developmental Index. CONCLUSIONS: These findings indicate that adverse neurodevelopmental effects of prenatal background-level exposure to DLCs may be stronger in male children.

DOI： 10.1016/j.envres.2017.08.006

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Genetic mechanisms are implicated in some cases of male infertility. Recently, it was demonstrated that male mice lacking the gene for RAD21L exhibited azoospermia caused by meiotic arrest. Mouse RAD21L is a functionally relevant meiotic α-kleisin that is essential for male fertility. Therefore, we hypothesized that RAD21L mutations or polymorphisms may be associated with male infertility, especially azoospermia secondary to meiotic arrest. To determine if RAD21L defects are associated with azoospermia in groups of patients with meiotic arrest, we performed direct sequencing of the RAD21L coding regions in 38 Japanese patients with meiotic arrest and in 200 normal controls. Three coding single-nucleotide polymorphisms (SNP1-SNP3) were detected in the meiotic arrest patient group. Sertoli cell-only syndrome is considered a common cause of non-obstructive azoospermia. For comparison, the RAD21L coding regions in which SNP1-SNP3 were detected were sequenced in 140 patients with Sertoli cell-only syndrome. Statistical analyses were used to compare the two groups of patients with the control group. Genotype and allele frequencies of SNP2 and SNP3 were notably higher in the two patient groups compared with the control group (Bonferroni adjusted p value <0.016). These results suggest a critical role for RAD21L in human spermatogenesis.

DOI： 10.1080/14647273.2017.1292004

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Springer Nature  

OBJECTIVES: To elucidate the impact of social support and its interrelations with other demand-control-support (DCS) model factors on presenteeism and absenteeism, and to determine which DCS factors were most influential. METHODS: Questionnaires from 2535 local government employees were analyzed. The Brief Job Stress Questionnaire (BJSQ) was used to assess DCS factors including job demand, job control, and social support from supervisors and coworkers. The Stanford Presenteeism Scale 13-item version (SPS-13) was used to evaluate both absenteeism (absent days) and presenteeism. For the latter, the Work Impairment Score (WIS) and the Work Output Score (WOS) were also used. Possible confounder-adjusted logistic and negative binomial regression analyses were performed to obtain odds ratios (ORs) for WIS and WOS and relative risks (RRs) for absenteeism according to DCS factors. RESULTS: Higher job control had a significantly protective effect on higher WIS in both males and females and a lower WOS in males. Based on a point estimate of an OR per 1 standard deviation change of each DCS factor, job control had the strongest effect on higher WIS in both males and females and a lower WOS in males. Higher job demand resulted in significantly higher ORs for both male and female WIS, and a lower WOS in females. Support from supervisors had a significantly protective effect on higher WIS in females and a lower WOS in males. Support from coworkers had a significantly protective effect on higher WIS in males. Higher support from coworkers had a significantly protective effect on absenteeism among both males and females, and higher job control had a significantly protective effect in females. The combination of high job strain and low support from supervisors had a significantly worsening effect, except for absenteeism in females. High job strain and low support from coworkers had a significantly worsening effect except for WOS in males. CONCLUSIONS: The results suggest job control was the DCS factor most related to presenteeism. Higher support from supervisors and coworkers had a protective effect on presenteeism, and higher job demand had a worsening effect. Higher support from coworkers had a protective effect on absenteeism among both males and females. Interventions should focus on improving job control as a possible countermeasure to presenteeism, and encouraging support from coworkers as a possible countermeasure to absenteeism.

DOI： 10.1007/s00420-017-1218-y

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

AIM: The aim of this study was to elucidate the relation between premorbid personality traits and behavioral and psychological symptoms in dementia (BPSD) in dementia with Lewy bodies (DLB) and Alzheimer's disease (AD) patients. METHODS: Forty-one DLB patients and 98 AD patients were assessed for BPSD using the Neuropsychiatric Inventory (NPI). Each patient's midlife personality traits were rated by a family member using the NEO Five-Factor Inventory (NEO-FFI) questionnaire. RESULTS: In multiple regression analyses for DLB patients, NPI total score and anxiety were significantly associated with premorbid openness, delusion with premorbid agreeableness, and agitation with premorbid conscientiousness. In AD patients, depression was significantly associated with premorbid neuroticism, and agitation, apathy, and irritability with premorbid agreeableness. CONCLUSION: Premorbid personalities affected BPSD differently in DLB and AD. Given the differences in the effects of premorbid personalities on BPSD, additional studies are needed to develop interventions to reduce these symptoms.

DOI： 10.1111/pcn.12511

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: In Japan, a dramatic rise in suicide rates was observed in the 1950s, especially among the younger population, and then the rate decreased rapidly again in the 1960s. The aim of this study was to assess secular trends in method-specific suicides by gender and age in Japan between 1950 and 1975. We paid special attention to suicides by poisoning (solid and liquid substances), and their contribution to dramatic swings in the overall suicide rate in Japan during the 1950s and 1960s. METHODS: Mortality and population data were obtained from the Vital Statistics of Japan and Statistics Bureau, Ministry of Internal Affairs and Communications in Japan, respectively. We calculated method-specific age-standardized suicide rates by gender and age group (15-29, 30-49, or 50+ years). RESULTS: The change in the suicide rate during the research period was larger in males than females in all age groups, and was more marked among people aged 15-29 years compared to those aged 30-49 years and 50 years or over. Poisoning by solid and liquid substances overwhelmingly contributed to the dramatic change in the overall suicide rates in males and females aged 15-49 years in the 1950s and 1960s. For the peak years of the rise in poisoning suicides, bromide was the most frequently used substance. CONCLUSIONS: Our results for the 1950s and 1960s in Japan illustrated how assessing secular trends in method-specific suicides by gender and age could provide a deeper understanding of the dramatic swings in overall suicide rate. Although rapid increases or decreases in suicide rates have been also observed in some countries or regions recently, trends in method-specific suicides have not been analyzed because of a lack of data on method-specific suicide in many countries. Our study illustrates how the collection and analysis of method-specific data can contribute to an understanding of dramatic shifts in national suicide rates.

DOI： 10.1186/s12963-017-0131-7

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Recently, due to the detrimental effects on the ventricular function associated with right ventricular apical (RVA) pacing, right ventricular septal (RVS) pacing has become the preferred pacing method. However, the term RVS pacing refers to both right ventricular outflow-tract (RVOT) and mid-septal (RVMS) pacing, leading to a misinterpretation of the results of clinical studies. The purpose of this study, therefore, was to elucidate the functional differences of RVA, RVOT, and RVMS pacing in patients with atrioventricular block. METHODS: We compared the QRS duration, global longitudinal strain (GLS), and left ventricular (LV) synchronization parameters at the three pacing sites in 47 patients. The peak systolic strain (PSS) time delay between the earliest and latest segments among the 18 LV segments and standard deviation (SD) of the time to the PSS were also calculated for the 18 LV segments at each pacing site using two-dimensional (2D) strain echocardiography. RESULTS: RVMS pacing was associated with a significantly shorter QRS duration compared with RVA and RVOT pacing (154.4±21.4 vs 186.5±19.9 and 171.1±21.5 ms, P<0.001). In contrast, RVOT pacing revealed a greater GLS (-14.69±4.92 vs -13.12±4.76 and -13.51±4.81%, P<0.001), shorter PSS time delay between the earliest and latest segments (236.0±87.9 vs 271.3±102.9 and 281.9±126.6%, P=0.007), and shorter SD of the time to the PSS (70.8±23.8 vs 82.7±30.8 and 81.5±33.7 ms, P=0.002) compared with RVA and RVMS pacing. CONCLUSIONS: These results suggest that the functional characteristics of RVOT pacing may be a more optimal pacing site than RVMS, regardless of the pacing QRS duration, in patients with atrioventricular conduction disorders.

DOI： 10.1016/j.joa.2016.04.009

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

The pro-arrhythmic triggers in Brugada and early repolarization syndromes (BrS, ERS) have not been analyzed systematically except for case reports. We clinically investigated the circumstances which precede/predispose to arrhythmic events in these syndromes during long-term follow-up. A detailed history from the patients/witnesses was taken to investigate the antecedent events in the last few hours that preceded syncope/ventricular fibrillation (VF); medical records, ECG and blood test from the emergency room (ER) were reviewed. 19 patients that fulfilled the investigation criteria were followed up for 71 ± 49 months (34-190 months). Prior to the event (syncope/VF), the patients were partaking different activities in the following decreasing order; drinking alcoholic beverage, having meal, and getting up from sleep, exercise. 3 patients reported mental/physical stress prior to the event and 2 patients developed VF several days after starting oral steroid for treatment of bronchial asthma. In the ER, elevated J-wave amplitude (0.27 ± 0.15 mV) was found with 58 % of the patients having hypokalemia. After electrolyte correction and cessation of steroids, the following day plasma K+ (4.2 ± 0.3 mEq/L, P < 0.001) was significantly increased and J-wave amplitude (0.13 ± 0.1 mV, P < 0.001) was remarkably reduced. Three patients were kept on oral spironolactone/potassium supplements. During follow-up for 71 ± 49 (34-190) months, among 4 patients with VF recurrence, one patient developed VF after taking oral steroid. In ERS and BrS, hypokalemia and corticosteroid therapy add substantial pro-arrhythmic effects, but potentially treatable. Stopping steroid therapy and avoiding hypokalemia had excellent long-term outcome.

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The impact of long working hours on diabetes is controversial; however, shift work is known to increase the risk of diabetes. This study aimed to investigate the association between long working hours and diabetes among civil servants in Japan separately by shift work schedules. METHODS: A prospective cohort study was conducted from April 2003 to March 2009. A total of 3195 men aged ≥35 years who underwent an annual health checkup at baseline were analyzed by shift work schedules (2371 non-shift workers and 824 shift workers). Self-reported working hours were categorized as 35-44 and ≥45 hours per week. The incidence of diabetes was confirmed by fasting plasma glucose concentration ≥126 mg/dL and/or self-reported medical diagnosis of diabetes at the annual checkup. A Cox proportional model was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for developing diabetes associated with long working hours. RESULTS: The median follow-up period of non-shift and shift workers was 5.0 and 4.9 years, respectively. During this period, 138 non-shift workers and 46 shift workers developed diabetes. A decreased HR was found among non-shift workers working ≥45 hours per week (HR 0.84; 95% CI, 0.57-1.24); however, shift workers working ≥45 hours per week had a significantly increased risk of diabetes (HR 2.43; 95% CI, 1.21-5.10) compared with those working 35-44 hours per week. An analysis restricted to non-clerical workers also showed similar results. CONCLUSIONS: The risk of diabetes associated with long working hours differed by shift work schedules.

DOI： 10.2188/jea.JE20150155

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

PURPOSE: An epidemic of carbon monoxide poisoning suicide by burning charcoal occurred in Hong Kong and Taiwan. An epidemic also emerged in Japan from February 2003 and resulted in an increase of 10-20 % in overall suicide rates in younger adults (aged <45 years) in the mid-2000s. We investigated the spatial and temporal evolution of the epidemic to assess its impact on the epidemiology of suicide in Japan. METHODS: Mortality data were obtained from the official vital statistics of Japan. Smoothed standardized mortality ratios of charcoal-burning and non-charcoal-burning suicide were estimated for the period 2003-2013 using Bayesian hierarchical models. Joinpoint regression analysis was performed to analyze secular trends in suicide rates by gender, method used and geographic location between 1999 and 2013. RESULTS: Suicide by burning charcoal rose sharply in the mid-2000s and was not accompanied by a simultaneous decline in alternative methods. The epidemic of charcoal-burning suicide in Japan showed a pronounced spatial pattern, being concentrated in rural prefectures particularly among males. For men but not women, the epidemic contributed to the widening of urban-rural disparities in suicide rates (higher rates in rural areas). CONCLUSIONS: Our results differ from previous research in other Asian countries (e.g., Taiwan), where the epidemic of charcoal-burning suicide emerged more prominently in urban areas. In Japan, the introduction and diffusion of charcoal burning contributed to a real excess in suicide rates, as well as a widening of the urban/rural disparity in suicide.

DOI： 10.1007/s00127-016-1172-0

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記述言語：日本語   出版者・発行元：(一社)日本衛生学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The distribution of late gadolinium enhancement (LGE) on the cardiac MRI (CMR) indicates myocardial fibrosis and provides information of possible reentry substrates. QT dynamicity reflecting repolarization abnormalities has gained attention as a potential prognostic predictive factor. OBJECTIVE: To clarify the correlation between the LGE distribution on CMR and QT dynamicity represented by the QT/RR relationship. METHODS: CMR and QT/RR analyses using Holter monitoring were performed in 34 patients (24 males, 60 ± 11 years) with ventricular tachycardia (VT) and/or ventricular fibrillation (VF). The LGE on CMR was scored using a 4-point score in 17 left ventricular segments. The sum of the LGE scores was calculated for each patient. The QT/RR slope and daytime/nighttime QT/RR ratio (day/night ratio) were calculated. The correlation between the slope or the day/night QT/RR ratio and late enhancement findings was analyzed. RESULTS: All patients were divided into 23 LGE positive (LGE(+)) and 11 LGE negative (LGE(-)) patients. The slopes of the QTe/RR and QTa /RR were significantly steeper in the LGE(+) than in LGE(-) patients (0.21 ± 0.03 vs 0.13 ± 0.02; P < 0.001, 0.19 ± 0.03 vs 0.13 ± 0.02; P < 0.001, respectively), and both slopes were significantly correlated with the total LGE scores (r = 0.83, P < 0.001; r = 0.71, P < 0.001, respectively). In the LGE(+) patients, the QTe day/night (1.37 ± 0.38 vs 0.91 ± 0.33; P = 0.002) and QTa day/night ratios (1.33 ± 0.26 vs 1.06 ± 0.30; P = 0.011) were significantly greater than those in the LGE(-) patients. CONCLUSION: The LGE distribution was closely related to the QT dynamicity, suggesting that a combination of these markers can be a powerful tool for understanding the background pathophysiology.

DOI： 10.1111/anec.12280

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掲載種別：研究論文（学術雑誌）  

DOI： 10.1017/s2045796014000675

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

INTRODUCTION: While the beneficial effects of prenatal yoga have been reported in recent years, little is known about its effectiveness in pregnant Japanese women. Despite several adverse effects, ritodrine hydrochloride is frequently prescribed to suppress preterm labor in Japan, and its usage may therefore indicate cases of preterm labor. This study aimed to clarify the association between prenatal yoga and ritodrine hydrochloride use during pregnancy. METHODS: An observational study was conducted as an adjunct study by the Hokkaido unit of the Japan Environment and Children's Study. Information on prenatal yoga practice was collected using a self-questionnaire between March 21, 2012, and July 7, 2015, targeting women who had recently delivered. Ritodrine hydrochloride use was identified from medical records. A total of 2,692 women were analyzed using logistic regression models that adjusted for possible confounders. RESULTS: There were 567 (21.1%) women who practiced prenatal yoga, which was associated with a lower risk of ritodrine hydrochloride use (adjusted odds ratio [OR] 0.77; 95% CI 0.61-0.98). This was especially evident in women with a total practice duration that exceeded 900 minutes throughout their pregnancy (adjusted OR 0.54; 95% CI 0.38-0.76). A sensitivity analysis that excluded patients with threatened abortion during the study period produced similar results. CONCLUSIONS: Prenatal yoga was associated with a lower risk of ritodrine hydrochloride use, particularly in women with more than 900 minutes of practice time over the course of their pregnancy. Prenatal yoga may be a beneficial option for pregnant women in the selection of alternative therapies.

DOI： 10.1371/journal.pone.0158155

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

This study aims to elucidate the relationships among the factors of the demand-control-support model (DCS) on the intention to leave a hospital job and depressive symptoms. Participants included 1,063 nurses. Job demand, job control, and support from supervisors were found to be significantly related to both the intention to leave and depressive symptoms. Based on the odds ratios per 1 SD change in the DCS factors, low support from supervisors was found to be most related to the intention to leave, and low job control was found to be most related to depressive symptoms. In models that did not include "job demand" as an independent variable, 60-h working weeks were found to have a significantly higher odds ratio for depressive symptoms. Support from supervisors is more important in preventing intention to leave and depressive symptoms among nurses than is support from co-workers. Improving job control and avoiding long working hours may be important to prevent depressive symptoms.

DOI： 10.2486/indhealth.2015-0083

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記述言語：日本語   出版者・発行元：北海道公衆衛生学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The presence of myocardial scar detected by late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) imaging has been described as a good independent predictor of mortality in patients with hypertrophic cardiomyopathy (HCM). Time-domain T-wave alternans (TWA) is also a potential predictor of cardiac mortality in patients with left ventricular dysfunction. OBJECTIVE: The purpose of this study was to elucidate the relationship between LGE distribution and TWA in patients with HCM. METHODS: CMR and TWA analyses using Holter monitoring were performed in 42 patients with HCM. The average transmural extent of LGE was scored as 1-4 in each segment, and the sum of the LGE scores (total LGE score) was calculated for each patient. The correlation between the maximal time-domain TWA voltage and LGE findings was analyzed, and the differences in time-domain TWA voltage, total LGE score, and cardiac function assessed by CMR imaging in the presence or absence of ventricular tachycardia (VT) were also compared. RESULTS: The total LGE score was significantly and positively correlated with the maximal time-domain TWA voltage (r = 0.59; P < .001). Furthermore, the total LGE score and maximal time-domain TWA voltage were significantly greater in patients who had episodes of VT (n = 21) than in those without VT (23 ± 7 vs. 10 ± 8; P < .001 and 87 ± 26 μV vs. 62 ± 12 μV; P < .001, respectively). However, the left ventricular ejection fraction did not statistically differ between patients with VT and those without VT (56% ± 14% vs. 61% ± 7%; P = .102). CONCLUSION: The magnitude of the localized LGE was significantly correlated with abnormalities in ventricular repolarization as assessed by TWA and QT dispersion.

DOI： 10.1016/j.hrthm.2015.04.028

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Persistent organic pollutants and mercury are known environmental chemicals that have been found to be ubiquitous in not only the environment but also in humans, including women of reproductive age. The purpose of this study was to evaluate the association between personal lifestyle characteristics and environmental chemical levels during the perinatal period in the general Japanese population. This study targeted 322 pregnant women enrolled in the Hokkaido Study on Environment and Children's Health. Each participant completed a self-administered questionnaire and a food-frequency questionnaire to obtain relevant information on parental demographic, behavioral, dietary, and socioeconomic characteristics. In total, 58 non-dioxin-like polychlorinated biphenyls, 17 dibenzo-p-dioxins and -dibenzofuran, and 12 dioxin-like polychlorinated biphenyls congeners, perfluorooctane sulfonate, perfluorooctanoic acid, and mercury were measured in maternal samples taken during the perinatal period. Linear regression models were constructed against potential related factors for each chemical concentration. Most concentrations of environmental chemicals were correlated with the presence of other environmental chemicals, especially in the case of non-dioxin-like polychlorinated biphenyls and, polychlorinated dibenzo-p-dioxins and -dibezofurans and dioxin-like polychlorinated biphenyls which had similar exposure sources and persistence in the body. Maternal smoking and alcohol habits, fish and beef intake and household income were significantly associated with concentrations of environmental chemicals. These results suggest that different lifestyle patterns relate to varying exposure to environmental chemicals.

DOI： 10.1016/j.chemosphere.2015.02.062

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The presence of a myocardial scar detected by late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) has been described as a predictor of all-cause mortality in hypertrophic cardiomyopathy (HCM). However, the detailed spatial relationship between LGE site and electrical abnormality is unclear in high-risk HCM with malignant arrhythmia. OBJECTIVE: The purpose of this study was to elucidate the detailed relationship between the site on CMR imaging and the electrically damaged site, a potential origin of ventricular arrhythmias in patients with HCM. METHODS: Fifty consecutive HCM patients underwent contrast-enhanced CMR. Of those patients, 18 patients with ventricular tachycardia underwent electrophysiology study including endocardial mapping of the left ventricle (LV). The LGE area was calculated at 12 different LV sites: anterior, lateral, posterior, and septal segments of the basal, middle, and apical portions. At each LV site, the bipolar electrogram, effective refractory period (ERP), and monophasic action potential were recorded. RESULTS: LGE-positive segments demonstrated a significantly lower amplitude (4.0 ± 2.8 mV vs 7.3 ± 3.6 mV; P < .001), longer duration (54.7 ± 17.8 vs 40.6 ± 7.8 ms; P < .001), longer ERP (320 ± 42 ms vs 284 ± 37 ms; P = .001), and longer monophasic action potential duration measured at 90% repolarization (321 ± 19 ms vs 283 ± 25 ms; P < .001) than did LGE-negative segments. The LGE area negatively correlated with the amplitude (r = -0.59; P < .001) and positively correlated with the duration (r = 0.64; P < .001), ERP (r = 0.44; P < .001), and action potential duration measured at 90% repolarization (r = 0.63; P < .001). All the observed VTs originated from LGE-positive segments. CONCLUSION: The spatial distribution of LGE significantly correlates with depolarizing and repolarizing electrical damage in high-risk HCM with malignant ventricular arrhythmia.

DOI： 10.1016/j.hrthm.2015.02.004

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

PURPOSE: To elucidate whether low job control and low social support at work have synergistic interaction on mental health. The synergistic interaction was also analyzed after stratification by high and low job demands. METHODS: Participants were 2,121 local government employees in Asahikawa city, Japan. The Brief Job Stress Questionnaire was used to assess job demands, job control, and social support. Depression was assessed using the Patient Health Questionnaire-9. The Maslach Burnout Inventory-General Survey was used to assess burnout. Insomnia was assessed using the Athens Insomnia Scale. Possible confounder-adjusted logistic regression analyses were performed to obtain odds ratios for depression, burnout, and insomnia, and synergy indices between job control and social support at work were assessed. RESULTS: The synergy indices among men and women, respectively, were 2.08 (80 % confidence interval: 1.01, 4.27) and 1.98 (0.67, 5.89) for depression, 1.79 (1.28, 2.51) and 2.62 (1.07, 6.40) for burnout, and 1.92 (1.22, 3.02) and 2.77 (0.43, 18.01) for insomnia. Men with high job demands had higher synergistic interaction on depression and burnout, compared to men with low job demands, and women with low job demands had higher synergistic interaction between job control and social support at work on burnout and insomnia, compared to women with high job demands. CONCLUSIONS: There were more-than-additive interactions of job control and social support at work on depression, burnout, and insomnia. After stratification by job demands, the synergistic interaction may be different between men and women. To assess job stress, it is necessary to consider the interactive effect of not only job demands and job control but also job control and social support at work.

DOI： 10.1007/s00420-014-0945-6

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES: To measure current Hg, Cd, and Pb exposure in Japanese children, and to estimate dietary intakes of foods responsible for high body burden. METHODS: Blood, hair, and urine samples were collected from 9 to 10-year-old 229 children in Asahikawa and measured for Hg, Cd, and Pb in these matrices. Diet history questionnaire was used to estimate intake of marine foods and other food items. Hg level was measured by cold vapor atomic absorption spectrometry. Cd and Pb levels were determined with inductively coupled plasma mass spectrometry. RESULTS: Geometric mean (GM) of blood Hg, Cd, and Pb was 4.55 μg/L, 0.34 μg/L, and 0.96 μg/dL, respectively. Urinary Cd level was 0.34 μg/g creatinine (GM) and hair Hg was 1.31 μg/g (GM). Approximately one-third (35%) of blood samples had Hg level above the U.S. EPA reference dose (RfD; 5.8 μg/L). Hair Hg level exceeded U.S. EPA RfD (1.2 μg/g) in 59 % samples. Children in the upper quartile of blood Hg level had significantly higher intake of large predatory fish species compared to those in the lower quartile of blood Hg. CONCLUSIONS: Those with high blood Hg level may be explained by more frequent intake of big predatory fish. Cd and Pb exposure is generally low among Japanese children. As no safety margin exists for Pb exposure and high exposure to MeHg is noted in Japanese population; periodic biomonitoring and potential health risk assessment should continue in high-risk populations, notably among children.

DOI： 10.1007/s12199-014-0416-4

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Combination antihypertensive therapy with an angiotensin receptor blocker (ARB) and a calcium channel blocker (CCB) or diuretics is common. This subanalysis investigated blood pressure (BP) variability in patients receiving ARB-based combination therapy. METHODS: In a prospective, randomized, open-label trial, hypertensive outpatients (≥65 years) who did not achieve their target BP with ARB monotherapy switched to losartan 50 mg/hydrochlorothiazide 12.5 mg (ARB + D) or ARB plus amlodipine 5 mg (ARB + C) for 12 months. Clinic BP and heart rate (HR), measured every 3 months, visit-to-visit variability and seasonal variation were evaluated. RESULTS: No significant between-group differences in average, maximum, or minimum systolic or diastolic BP, or HR, were found. Visit-to-visit BP variability (systolic) was significantly higher in the ARB + D group than in the ARB + C group. When each group was subdivided into two seasonal groups (summer and winter), no significant between-group differences in BP were found. Multivariate regression analyses showed a tendency toward negative correlation between outdoor temperature and urinary albumin:creatinine ratio and estimated glomerular filtration rate at 12 months in the ARB + D group. CONCLUSION: Combination therapy with an ARB plus a CCB may be preferable to that with an ARB plus diuretics for decreasing BP variability. As for seasonal variability, both treatments can be used safely regardless of season.

DOI： 10.3109/10641963.2014.995802

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掲載種別：研究論文（学術雑誌）  

DOI： 10.1684/mrh.2015.0379

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES: While several studies on the preventive and therapeutic effects of prenatal yoga (maternity yoga) have been reported in recent years, there has been no systematic review on the effects of prenatal yoga based on randomized controlled trials (RCT). The purpose of this study, therefore, was to systematically review the literature to clarify the effects of prenatal yoga in RCT focusing on the contents of the intervention, the intervention means, and the frequency of practice. METHODS: The literature search was performed using the electronic database, PubMed. The inclusion criteria were RCT, pregnant women, and yoga intervention. RESULTS: In total, 54 citations were found; of these, eight studies (10 reports) were included in the final analysis. In four studies on healthy pregnant women, significant improvement in pain and pleasure at delivery, duration of delivery, perceived stress levels during pregnancy, anxiety levels, depression, pregnancy-related experiences, quality of life, and interpersonal relationships were compared to those in the control group. In two studies on depressed pregnant women, one reported that depression, anxiety levels, anger levels, leg pain, and back pain significantly improved with yoga, while the other found no differences from the control group. In one study of high-risk pregnant women with morbidity factors such as obesity or advanced age, yoga resulted in significantly fewer cases of pregnancy-induced hypertension, gestational diabetes, and intrauterine growth restriction, as well as a decrease in perceived stress levels. In one study on pregnant women with pelvic pain, the median pain score was lower in the yoga group. Regarding the contents of the intervention, while the two studies for depressed pregnant women only included physical postures, the remaining six studies also included breathing technique and meditation. Interventions were performed using lectures by instructors alone or together with self-teaching. The frequency of the intervention varied within each study. CONCLUSION: The findings suggest that prenatal yoga may help reduce pelvic pain. It may also improve mental condition (stress, depression, anxiety, etc.), physical condition (pain and pleasure at the delivery, etc.), and perinatal outcomes (obstetrical complications, delivery time, etc.). However, further studies are needed. The contents of the intervention, the intervention means, and the frequency varied with each study. Thus, it is necessary to further examine the content of effective interventions, intervention means, and frequency that suit participant's characteristics and each outcome. Further research in this field, particularly randomized controlled trials, is merited.

DOI： 10.11236/jph.62.5_221

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES: Days off, on call, night duty, working hours and job stress can affect physicians' mental health, and support from supervisors and co-workers may have a buffering effect. This study elucidates whether job strain and job factors affect physicians' mental health, and whether support from supervisors and co-workers has a protective effect on their mental health. MATERIAL AND METHODS: The subjects included 494 physicians. The Brief Job Stress Questionnaire (BJSQ) was used to evaluate job demand, job control and support. High job strain was defined as a combination of high job demand and low job control. Depressive symptoms were assessed using the Patient Health Questionnaire-9. The Maslach Burnout Inventory-General Survey was used to evaluate burnout. Possible confounder adjusted logistic regression analyses were performed to obtain odds ratios for depressive symptoms and burnout. RESULTS: As per the analysis, high job strain had significantly higher odds ratios, and support from co-workers had significant protective odds ratios for depressive symptoms. High job strain and having only 2-4 days off per month (compared to > 8 days off per month) had significantly higher odds ratios, and support from co-workers had significant protective odds ratios for burnout. CONCLUSIONS: High job strain was related to depressive symptoms and burnout, and support from co-workers had a buffering effect on depressive symptoms and burnout. An inadequate number of days off was related to burnout. Assessment of job strain may be a good tool to measure physicians' mental health, and a sufficient number of days off may be needed to prevent burnout.

DOI： 10.2478/s13382-014-0324-2

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

INTRODUCTION: We reported impaired QT-rate dependence in early repolarization syndrome (ERS); however, contemporary data have shown peak incidence of sudden cardiac death (SCD) in ERS and Brugada syndrome (BrS) at mid-night and early morning. Taken together, we analyzed the nocturnal QT-rate dependence in both syndromes. METHODS AND RESULTS: A total of 172 subjects were enrolled: 11 ERS, 11 BrS patients, 50 subjects with an uneventful ER pattern (ERP), and 100 non-J-wave control subjects. Ambulatory ECG-derived parameters (QT, QTc, and QT/RR slope) and day-night QT difference were analyzed and compared. Among the groups, there was no significant difference in the average QT or QTc; however, the 24-hour QT/RR slope was significantly smaller in ERS and BrS patients (0.103 ± 0.01 and 0.106 ± 0.01, respectively) than in the control group (0.156 ± 0.03, P < 0.001). Detailed analysis showed a lower day-night QT difference in ERS and BrS patients (19 ±18.7 and 24 ±14 milliseconds, respectively) than in the controls (40 ± 22 milliseconds, P = 0.007) with the lowest QT/RR slopes seen in the ERS and BrS groups from 0 to 3:00 am (QT/RR; 0.076 ± 0.02 vs. 0.092 ± 0.04 vs. 0.117 ± 0.04, for the ERS, BrS, and controls, respectively, P = 0.004) and from 3 to 6 am (QT/RR 0.074 ± 0.03 vs. 0.079 ± 0.02 vs. 0.118 ± 0.04, P < 0.001). CONCLUSION: In a large population of age- and gender-matched groups, both ERS and BrS patients showed attenuated QT-rate dependence and impaired QT day-night modulation that may provide a baseline reentrant substrate. Importantly, QT/RR maladaptation was most evident at mid-night and early morning, which may explain the propensity of such patients to develop SCD during this critical period.

DOI： 10.1111/jce.12566

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: To investigate the association of sleep duration and shift work with development of chronic kidney disease (CKD) in Japanese workers. METHODS: A total of 3600 participants without CKD were observed for an average of 4.4 years. The Cox proportional-hazards regression model was used to estimate hazard ratios and 95% confidence intervals of the risk of CKD associated with sleep duration and shift work. RESULTS: Sleep duration and shift work showed no significant association with the risk of CKD. Nevertheless, when the results were stratified by shift work status, short sleep duration was associated with a significantly higher risk of CKD among shift workers (hazard ratio = 3.60; 95% confidence interval: 1.52 to 10.68). CONCLUSIONS: Short sleep duration was a risk factor for early CKD but only among shift workers.

DOI： 10.1097/JOM.0000000000000322

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記述言語：日本語   出版者・発行元：日本公衆衛生学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Although an association between exposure to phthalates in house dust and childhood asthma or allergies has been reported in recent years, there have been no reports of these associations focusing on both adults and children. We aimed to investigate the relationships between phthalate levels in Japanese dwellings and the prevalence of asthma and allergies in both children and adult inhabitants in a cross-sectional study. The levels of seven phthalates in floor dust and multi-surface dust in 156 single-family homes were measured. According to a self-reported questionnaire, the prevalence of bronchial asthma, allergic rhinitis, allergic conjunctivitis, and atopic dermatitis in the 2 years preceding the study was 4.7%, 18.6%, 7.6%, and 10.3%, respectively. After evaluating the interaction effects of age and exposure categories with generalized liner mixed models, interaction effects were obtained for DiNP and bronchial asthma in adults (Pinteraction=0.028) and for DMP and allergic rhinitis in children (Pinteraction=0.015). Although not statistically significant, children had higher ORs of allergic rhinitis for DiNP, allergic conjunctivitis for DEHP, and atopic dermatitis for DiBP and BBzP than adults, and liner associations were observed (Ptrend<0.05). On the other hand, adults had a higher OR for atopic dermatitis and DEHP compared to children. No significant associations were found in phthalates levels collected from multi-surfaces. This study suggests that the levels of DMP, DEHP, DiBP, and BBzP in floor dust were associated with the prevalence of allergic rhinitis, conjunctivitis, and atopic dermatitis in children, and children are more vulnerable to phthalate exposure via household floor dust than are adults. The results from this study were shown by cross-sectional nature of the analyses and elaborate assessments for metabolism of phthalates were not considered. Further studies are needed to advance our understanding of phthalate toxicity.

DOI： 10.1016/j.scitotenv.2014.03.059

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Recent studies reported that gamma-glutamyltransferase (GGT) and beta 2-microglobulin (β2M) are possible markers of cardiovascular disease in adults, however, their roles among children have not been fully elucidated. We have examined the relationships of GGT and β2M on C-reactive protein (CRP) among 326 healthy elementary school children. To investigate the relationships of serum GGT and β2M levels on measuring of CRP, multiple regression analysis and analysis of covariance (ANCOVA) were performed. After being adjusted for confounders, body mass index, log-transformed GGT, and β2M were significantly related to CRP. Independent of other risk factors, ANCOVA showed that serum β2M levels were significantly associated with serum CRP (p=0.012, p for trend <0.001), and GGT levels had similar results (p=0.211, p for trend=0.035). These results suggest that serum β2M and GGT levels are useful indicators for evaluating the occurrence of slight inflammation as background, which promotes atherosclerosis even in healthy children.

DOI： 10.1515/jpem-2013-0479

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記述言語：日本語   出版者・発行元：(公社)日本産業衛生学会  

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記述言語：日本語   出版者・発行元：(公社)日本産業衛生学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Genetic mechanisms have been implicated as a cause of some cases of male infertility. Recently, ten novel genes involved in human spermatogenesis, including human LRWD1, have been identified by expression microarray analysis of human testictissue. The human LRWD1 protein mediates the origin recognition complex in chromatin, which is critical for the initiation of pre-replication complex assembly in G1 and chromatin organization in post-G1 cells. The Lrwd1 gene expression is specific to the testis in mice. Therefore, we hypothesized that mutation or polymorphisms of LRWD1 participate in male infertility, especially azoospermia. To investigate whether LRWD1 gene defects are associated with azoospermia caused by SCOS and meiotic arrest (MA), mutational analysis was performed in 100 and 30 Japanese patients by direct sequencing of the coding regions, respectively. Statistical analysis was performed for patients with SCOS and MA and in 100 healthy control men. No mutations were found in LRWD1; however, three coding single-nucleotide polymorphisms (SNP1-SNP3) could be detected in the patients. The genotype and allele frequencies in SNP1 and SNP2 were notably higher in the SCOS group than in the control group (P < 0.05). These results suggest the critical role of LRWD1 in human spermatogenesis.

DOI： 10.1111/and.12077

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掲載種別：研究論文（学術雑誌）  

DOI： 10.1111/ina.12054

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The charcoal burning suicide epidemics in both Hong Kong and Taiwan have been well documented. However, little is known about the situation in Japan. AIMS: To examine the impact of charcoal burning suicide on the overall and other method-specific suicide rates between 1998 and 2007 in Japan. METHOD: Using data obtained from the Vital Statistics of Japan, negative binomial regression analyses were performed to investigate the impact of the charcoal burning method. RESULTS: In males and females aged 15-24 and 25-44 years, the charcoal burning epidemic led to a substantial increase in overall suicides, without a decrease in other methods. In all other age groups, no such trend was observed. CONCLUSIONS: In young Japanese, the charcoal burning method may have appealed to individuals who might not have chosen other highly or relatively lethal methods, and consequently led to an increase in overall suicides.

DOI： 10.1192/bjp.bp.113.135392

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Epidemiological data indicate the existence of a J-shaped association between alcohol consumption and cardiovascular mobility and mortality. However, studies assessing the relationship between alcohol consumption and pulse wave velocity (PWV) as a marker of arterial stiffness have provided inconsistent results. In addition, data regarding the effect of alcohol on arterial stiffness in women has been limited. This study aimed to clarify the relationship between alcohol consumption and PWV among female and male workers in Japan. Study participants were local government employees in Hokkaido, Japan, who underwent annual health check-ups. All data were collected using self-administered questionnaires. The average daily alcohol consumption of the previous month, based on the alcohol concentration of each beverage type (g/day, ethanol equivalent), was estimated according to the frequency and amount of consumption. Data from 3893 participants (812 women and 3081 men) were analyzed. In women, non-drinkers had significantly higher PWV than women who consumed <10 g/day of alcohol. In men, compared with those who reportedly drank 20-39 g/day, non-drinkers and those who drank <20 g/day and ≥60 g/day had significantly higher PWV. Alcohol consumption showed a J-shaped association with PWV in men (p for quadratic term < 0.036) and marginally in women (p < 0.056). The results of stratified analyses by age groups showed a significant J-shaped association, which was most notable for men ≥45 years (p < 0.005). In middle-aged Japanese women and men, light-to-moderate alcohol consumption is associated with lower PWV, which in turn correlates with a reduction in vascular stiffness.

DOI： 10.1016/j.alcohol.2013.10.003

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Little is known about the combined risk of socioeconomic status and psychosocial environment for insomnia. PURPOSE: The purpose of this study was to investigate the combined risk of employment level and psychosocial work environment for insomnia in a large Japanese male working population. METHOD: We investigated 5,951 male employees aged 34-59 years from two local governments in Japan. Data were obtained from a questionnaire distributed in advance of their annual health check-up. Employment level was categorized as higher-level non-manual workers, lower-level non-manual workers, and manual workers. Psychosocial work environment was assessed using the Demand-Control Model and the Effort-Reward Imbalance Model (ERI). Insomnia was assessed using the Athens Insomnia Scale. RESULTS: The results showed that 1,382 (23.2 %) participants suffered from insomnia. Lower employment level was significantly associated with a higher risk of insomnia. Job strain (ratio of job demand to job control), E/R (ratio of job effort to job reward), and OC (over commitment) were also significantly associated with insomnia. The relative excess risk due to the interaction between employment level and psychosocial environment (job strain, E/R, and OC) was 0.09 (95 % CI -0.57 to 0.76), 2.61 (0.74 to 4.48), and 3.14 (0.82 to 5.45), respectively; synergy index = 1.07 (0.66 to 1.74), 1.99 (1.37 to 2.90), and 2.25 (1.46 to 3.46), respectively. CONCLUSION: We found supra-additive interactions between employment level and psychosocial environment, assessed by the ERI (E/R and OC). Our findings suggested that lower level workers are more vulnerable to an adverse psychosocial environment than those at a higher level.

DOI： 10.1007/s12529-012-9230-9

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The analysis of prognostic factors in Japanese cases of cutaneous T-cell lymphoma (CTCL) is scarce. Clusterin is a ubiquitous 80kDa heterodimeric glycoprotein expressed on tumor cells of systemic and primary cutaneous anaplastic large cell lymphoma. The expression of clusterin in mycosis fungoides (MF) and Sézary syndrome (SS) has only been sporadically reported in a small number of cases. OBJECTIVE: To determine the long-term prognosis of Japanese patients with MF and SS, to identify clinical and pathological factors predictive of survival, and to evaluate the prognostic significance of the International Society for Cutaneous Lymphomas (ISCL) revised staging system (2007). METHODS: We performed a retrospective cohort study of 105 Japanese patients with MF and SS managed at the Department of Dermatology Asahikawa Medical University from 1976 to 2011. Formalin-fixed, paraffin-embedded sections of MF and SS were immunostained for clusterin, CD30, and Ki-67. RESULTS: No statistically significant difference in survival was found between stages IA-IIA and IIIA patients. The significant prognostic factors in the univariate analysis were higher age, TNMB classification, clinical staging, performance status, increased serum LDH level, dermal Ki-67-positive cells, and clusterin expression. In the multivariate analysis, T classification, extracutaneous disease, increased serum LDH level, clusterin expression, and performance status were the significant independent prognostic factors. CONCLUSION: Japanese stage IIIA MF/SS patients contain a subpopulation with a favorable prognosis. The most significant prognostic factor for survival of MF and SS was the presence of extracutaneous disease. Clusterin expression was shown to be a novel unfavorable prognostic factor.

DOI： 10.1016/j.jdermsci.2013.04.020

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: To elucidate the differences in job stress and burnout status of Japanese hospital physicians between large cities, small cities, and towns and villages. DESIGN: Cross-sectional study. SETTING: Postal self-administered questionnaires were distributed to 2937 alumni of Asahikawa Medical University. PARTICIPANTS: Four hundred and twenty-two hospital physicians. MAIN OUTCOME MEASURES: The Brief Job Stress Questionnaire was used to evaluate job demand, job control and social support. The Japanese version of the Maslach Burnout Inventory-General Survey (MBI-GS) was used to evaluate burnout. An analysis of covariance was conducted on the mean scores on the Brief Job Stress Questionnaire and the MBI-GS scales after adjusting for sex, age and specialties. RESULTS: In adjusted analyses, the job demand score was significantly different among physicians in the three areas. In Bonferroni post-hoc tests, scores in large cities was significantly higher than those in small cities and towns and villages. The job control score showed a significant difference and a marginally significant trend, with large cities associated with lower job control. There were significant differences in support from supervisors and that from family/friends, and scores in large cities was significantly higher than those in small cities in the post-hoc test. There was a significant effect on the exhaustion scale of the MBI-GS, with large cities associated with higher exhaustion, and scores in large cities was significantly higher than those in small cities. CONCLUSIONS: Urban hospital physicians had more job demand, less job control and exhaustion caused by burnout, and rural hospital physicians had less social support.

DOI： 10.1111/ajr.12040

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Dioxins are metabolized by cytochrome P450, family 1 (CYP1) via the aromatic hydrocarbon receptor (AHR). We determined whether different blood dioxin concentrations are associated with polymorphisms in AHR (dbSNP ID: rs2066853), AHR repressor (AHRR; rs2292596), CYP1 subfamily A polypeptide 1 (CYP1A1; rs4646903 and rs1048963), CYP1 subfamily A polypeptide 2 (CYP1A2; rs762551), and CYP1 subfamily B polypeptide 1 (CYP1B1; rs1056836) in pregnant Japanese women. These six polymorphisms were detected in 421 healthy pregnant Japanese women. Differences in dioxin exposure concentrations in maternal blood among the genotypes were investigated. Comparisons among the GG, GA, and AA genotypes of AHR showed a significant difference (genotype model: P=0.016 for the mono-ortho polychlorinated biphenyl concentrations and toxicity equivalence quantities [TEQs]). Second, we found a significant association with the dominant genotype model ([TT+TC] vs. CC: P=0.048 for the polychlorinated dibenzo-p-dioxin TEQs; P=0.035 for polychlorinated dibenzofuran TEQs) of CYP1A1 (rs4646903). No significant differences were found among blood dioxin concentrations and polymorphisms in AHRR, CYP1A1 (rs1048963), CYP1A2, and CYP1B1. Thus, polymorphisms in AHR and CYP1A1 (rs4646903) were associated with maternal dioxin concentrations. However, differences in blood dioxin concentrations were relatively low.

DOI： 10.1016/j.toxlet.2013.03.013

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: Combination therapy with angiotensin receptor blockers (ARBs) and calcium channel blockers or diuretics is common for hypertensive patients. This study aimed to determine which combination is better for elderly hypertensive patients. METHODS: In this prospective, randomized, open-label trial, hypertensive outpatients aged at least 65 years who had not achieved their target blood pressure (BP) with standard ARB dosages were randomly assigned to receive either a fixed-dose combination of losartan (50 mg) and hydrochlorothiazide (12.5 mg) (ARB+D; n = 72) or a combination of amlodipine (5 mg) and the typical dosage of ARBs (ARB+C; n = 68) to evaluate the change in the BP, laboratory values and cognitive function. RESULTS: At 3 months, the SBP/DBP was found to have significantly decreased from 156/83 ± 15/11 mmHg to 139/76 ± 14/10 mmHg in the ARB+D group and 155/83 ± 11/10 mmHg to 132/72 ± 14/10 mmHg in the ARB+C group. The BP reduction efficacy was greater in the ARB+C group than in the ARB+D group. At 6 months, the SBP/DBP reached the same level in both groups. At 12 months, the urine albumin/creatinine ratio was significantly decreased from the geometric mean of 17.1 to 9.6 mg/g in the ARB+D group, whereas it was increased from 19.8 to 23.7 mg/g in the ARB+C group. Conversely, the estimated glomerular filtration rate tended to show a decrease in the ARB+D group. There was no significant difference in mini-mental state examination after 1 year. CONCLUSION: ARB+amlodipine (5 mg) yielded a greater BP reduction, whereas ARB+HCTZ (12.5 mg) resulted in a greater reduction in the albuminuria, suggesting that each combination therapy is advantageous in a different manner for elderly hypertensive patients.

DOI： 10.1097/HJH.0b013e32835fdf60

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掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: To identify epidemiologic risk factors and investigate whether the characteristics of removed ovarian tissue during surgery influence the recurrence of endometriomas. DESIGN: Retrospective cohort study. SETTING: Medical university hospital. POPULATION: 248 women with endometriomas. METHODS: All women who had a minimum of 2 years of follow-up after the laparoscopic excision of endometriomas were analysed retrospectively. Specimens were analysed histologically. MAIN OUTCOME MEASURES: Sixteen epidemiologic variables were analysed as possible risk factors for recurrence. The association between the characteristics of removed ovarian tissue (the thickness of the cyst wall, the thickness of ovarian tissue, and the morphological features) and endometrioma recurrence was investigated. RESULTS: The cumulative incidence of endometriomas reached 42% at 60 months after surgery. We identified only a younger age at surgery as a risk factor, and postoperative pregnancy as a preventive factor. There were no differences in the mean thickness of the cyst wall and the removed ovarian tissue between patients with and without recurrence. No statistically significant associations were found between the morphologic characteristics of removed cyst wall, ovarian tissue, graded on a semi-quantitative basis, and recurrence. CONCLUSIONS: These results suggest that the rate of endometrioma recurrence had a significant relation to patient age and postoperative pregnancy; however, there was no association between the histological characteristics of the excised tissue and recurrence.

DOI： 10.1111/aogs.12051

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Only a few studies have specifically considered the role of caregiver characteristics in the presence of behavioral and psychological symptoms of dementia (BPSD). The aim of this study was to determine whether there were differences in the presence of individual BPSD between community-dwelling dementia care recipients with spouse caregivers and those with non-spouse caregivers. METHODS: Care recipients (n = 109) and their primary caregivers were recruited from memory clinic outpatients at the public psychiatric hospital in Sapporo City, Japan. Data were collected by questionnaire. Relationship with the care recipient was categorized as either 'spouse' or 'non-spouse.' The frequency of BPSD occurrence observed by the caregiver was assessed using the Troublesome Behavior Scale (TBS). Logistic regression analyses were performed to examine whether there were differences with regard to each of the 14 TBS items between spouse and non-spouse caregivers. RESULTS: The number of spouse caregivers was 47 (43.1%). TBS items presented by >50% care recipients were 'repetition and/or clinging' and 'ill-natured denial and/or distortion.' After adjustment for the characteristics of caregivers and care recipients, non-spouse caregivers were found to be significantly associated with the presence of 'hiding and/or losing things,' 'rummaging,' 'crying and/or screaming,' and 'interfering with a happy home circle,' compared with spouse caregivers. CONCLUSIONS: Our results suggest that non-spouse caregivers need more support with regard to certain symptoms of individual BPSD compared with spouse caregivers. Identifying caregiver characteristics that are independently associated with each individual BPSD may help customize interventions for caregivers with specific characteristics.

DOI： 10.1080/13607863.2013.790927

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

INTRODUCTION: Recently, great attention has been paid to the risk stratification of asymptomatic patients with an electrocardiographic early repolarization (ER) pattern. We investigated several repolarization parameters including the Tpeak-Tend interval and Tpeak-Tend/QT ratio in healthy individuals and patients with J wave syndrome who were aborted from sudden cardiac death. METHODS AND RESULTS: Ninety-two subjects were enrolled: 12 patients with ventricular fibrillation associated with J waves, 40 healthy subjects with an uneventful ER pattern and 40 healthy control subjects (C) without any evident J waves. Using ambulatory electrocardiogram recordings, the average QT interval, corrected QT interval (QTc), Tpeak-Tend (Tp-e) interval, which is the interval from the peak to the end of the T wave, and Tp-e/QT ratio were calculated. Using ANOVA and post hoc analysis, there was no significant difference in the average QT and QTc in all 3 groups (QT; 396 ± 27 vs 405 ± 27 vs 403 ± 27 m, QTc; 420 ± 26 vs 421 ± 21 vs 403 ± 19 milliseconds in the C, ER pattern and J groups, respectively). The Tp-e interval and Tp-e/QT ratio were significantly more increased in the J wave group than the ER Pattern group (Tp-e: 86.7 ± 14 milliseconds vs 68 ± 13.2 milliseconds, P < 0.001, Tp-e/QT; 0.209 ± 0.04 vs 0.171 ± 0.03, P < 0.001), but they did not significantly differ between the C and ER pattern groups (Tp-e: 68.6 ± 7.5 vs 68 ± 13.2, P = 0.97, Tp-e/QT 0.174 ± 0.02 vs 0.171 ± 0.03, P = 0.4). CONCLUSION: As novel markers of heterogeneity of ventricular repolarization, Tpeak-Tend interval and Tp-Te/QT ratio are significantly increased in patients with J wave syndromes compared to age and sex-matched uneventful ER.

DOI： 10.1111/j.1540-8167.2012.02363.x

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Genetic mechanisms are implicated as a cause of some male infertility, yet are poorly understood. Meiosis is unique to germ cells and essential for reproduction. The synaptonemal complex is a critical component for chromosome pairing, segregation and recombination. Hormad1 is essential for mammalian gametogenesis as knockout male mice are infertile. Hormad1-deficient testes exhibit meiotic arrest in the early pachytene stage and synaptonemal complexes cannot be visualized. To analyze the hypothesis that the human HORMAD1 gene defects are associated with human azoospermia caused by meiotic arrest, mutational analysis was performed in all coding regions by direct sequence analysis of 30 Japanese men diagnosed with azoospermia resulting from meiotic arrest. By the sequence analysis, three polymorphism sites, Single Nucleotide Polymorphism 1 (c. 163A>G), SNP2 (c. 501T>G) and SNP3 (c. 918C>T), were found in exons 3, 8 and 10. The 30 patients with azoospermia and 80 normal pregnancy-proven, fertile men were analyzed for HORMAD1 polymorphisms. Both SNP1 and SNP2 were associated with human azoospermia caused by complete early meiotic arrest (P<0.05). We suggest that the HORMAD1 has an essential meiotic function in human spermatogenesis.

DOI： 10.1038/aja.2011.180

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

The aim of this study was to document the exposure levels of pregnant women in Hokkaido to persistent organochlorine (POC) pesticides and the relationship between the body burdens of these pesticides and the study population's characteristics, such as age, pre-pregnancy body weight and calendar year in which blood was collected. From 2002 to 2005, whole blood samples were obtained from 186 pregnant women (aged 17 to 47 years) from the population of 514 women registered with the Sapporo Toho hospital cohort of the Hokkaido Study. Blood samples were analyzed by GC/NCIMS and GC/HRMS to quantify 29 POC pesticides. The subjects' demographic details were obtained from medical records and self-administered questionnaires. The Jonckheere-Terpstra test was used to determine relevant trends in the chemical concentrations of these pesticides and their relationship to the subjects' demographic details. Twenty-one of the 29 targeted compounds (including pesticides that have never been used in Japan, such as Mirex, Parlar-26 and Parlar-50) were detected in whole blood samples, and their log-transformed concentrations were found to significantly correlate with each other. The concentrations of p,p'-DDD, o,p'-DDE, p,p'-DDE, Parlar-26 and Parlar-50 declined from 2002 to 2005 (p<0.05). The pesticide concentrations appeared to have stronger associations with past conception than with parity, with most pesticide concentrations declining in a manner that appeared inversely related to past conceptions (p<0.05). Maternal age was positively associated with the following pesticide concentrations: p,p'-DDE, chlordanes group, cis-heptachlorepoxide, β-HCH and mirex. Maternal pre-pregnancy body weight was positively associated with the concentrations of dieldrin, HCB, β-HCH, Parlar-26 and Parlar-50, and appeared to be more strongly related to the body burdens of POC pesticides when compared with BMI associations. Further studies are required to evaluate the effects of POC pesticides on human health with regard to reproductive outcomes and child development.

DOI： 10.1016/j.scitotenv.2012.02.073

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Microbial volatile organic compounds (MVOCs) are a type of VOCs produced by microorganisms. Exposure to 1-octen-3-ol, one of the known MVOCs, has been reported to reduce nasal patency and increase nasal lavage myeloperoxidase, eosinophil cationic proteins, and lysozymes in both experimental and field studies. We reported in a previous paper that 1-octen-3-ol exposure at home is associated with mucosal symptoms. In this study, our aim was to investigate the relationship between asthma and allergies and MVOC exposure in single-family homes. The subjects were 624 inhabitants of 182 detached houses in six regions of Japan. Air samples were collected using diffusive samplers, and the concentrations of eight selected MVOCs were analyzed using gas chromatography/mass spectrometry in selected-ion-monitoring mode. Each inhabitant of each of the dwellings was given a self-administered questionnaire. Among the 609 subjects who answered all of the questions about allergies, history of the medical treatment for asthma, atopic dermatitis, allergic rhinitis, and allergic conjunctivitis within the preceding two years was 4.8%, 9.9%, 18.2%, and 7.1%, respectively. A significant association between 1-octen-3-ol (per log(10) unit) and allergic rhinitis odds ratio (OR): 4.10, 95% confidence interval (CI): 1.71 to 9.80 and conjunctivitis (OR: 3.54, CI: 1.17 to 10.7) was found after adjusting for age, sex, tobacco, wall-to-wall carpeting, signs of dampness, history of treatment for hay fever, and other potentially relevant environmental factors. No relationships were found between any MVOCs and asthma or atopic dermatitis after the adjustment. The levels of MVOCs and airborne fungi were only weakly correlated. These results are consistent with previous studies that have associated higher levels of 1-octen-3-ol exposure with increased irritation of nasal and ocular mucosae. Although the indoor-air concentrations of 1-octen-3-ol found in this study were relatively low, we conclude that exposure to MVOC may be related to rhinitis and conjunctivitis.

DOI： 10.1016/j.scitotenv.2012.02.026

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

PURPOSE: A higher prevalence of insomnia in females has been consistently demonstrated across countries and cultures. The aim of this study was to clarify whether gender differences in insomnia could be explained by gender differences in paid work and family responsibilities. METHODS: Participants were employees at two local governments in Hokkaido, Japan, who underwent annual health checkups from April 2003 to March 2004. All data were obtained via self-administered questionnaires. Insomnia was evaluated by the Athens Insomnia Scale. For work and family characteristics, occupation, working hours, days off, shift work, visual display terminal (VDT) work, occupational stress, marital status, hours spent on household tasks, childcare, and caregiving were chosen. Data from 7,451 participants (5,951 men and 1,500 women) were analyzed. Logistic regression analysis examined how much paid work and family responsibilities explained gender differences in insomnia. RESULTS: The prevalence of insomnia in female subjects (31.0%) was significantly larger than in males (23.2%), but the gender difference disappeared after adjustment for paid work and family responsibilities. The results of stratified analyses revealed that significant gender differences were found only among workers with comparatively favorable work and family conditions, such as non-shift work, less than 6 h/day of VDT work, exposure to low levels of occupational stress, household tasks for less than 1 h/day, and not living with persons who needed care and support. CONCLUSIONS: These results suggest that gender differences in insomnia are explained, in the main, by gender differences in work and family characteristics.

DOI： 10.1007/s00127-011-0370-z

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

To determine whether indoor chemicals act as possible environmental risk factors responsible for sick building syndrome (SBS)-related symptoms in new houses (<6 years old) in Japan, we studied 871 people living in 260 single-family houses in 2004 and 2005. We measured the indoor concentrations of aldehydes and volatile organic compounds and longitudinal changes in the living rooms over two consecutive years. Participants answered standardized questionnaires on SBS symptoms and lifestyle habits. Approximately 14% and 12% of subjects were identified as having SBS in the first and second year, respectively. According to analysis adjusted for sex, age, smoking, and allergic diseases, increases in aldehydes and aliphatic hydrocarbons contributed to the occurrence of SBS. Elevated levels of indoor aldehydes and aliphatic hydrocarbons increased the possible risk of SBS in residents living in new houses, indicating that source controls against indoor chemicals are needed to counter SBS.

DOI： 10.1016/j.scitotenv.2011.12.060

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

INTRODUCTION: Post-traumatic stress disorder (PTSD) is a common condition among Japanese firefighters. The purpose of this study was to clarify the relationship of PTSD scores to job stress, social support, and depressive stress among Japanese firefighters. METHODS: A total of 1,667 Japanese firefighters working for the local government completed a questionnaire that was used to gather information pertaining to age, gender, job type, job class, marital status, and smoking and drinking habits. Questionnaires from the Center for Epidemiologic Studies Depression Scale (CES-D), the Japanese version of the U.S. National Institute for Occupational Safety and Health (NIOSH) Generic Job Stress Questionnaire, and the IES-R were also used. RESULTS: After adjustment for age and gender, subjects in the PTSD-positive group had significantly higher scores for inter-group conflict, role ambiguity, and CES-D, as well as significantly lower scores for social support from their supervisors compared to those in the PTSD-negative group. CONCLUSIONS: High inter-group conflict and role ambiguity, as well as low social support from supervisors and the presence of depressive symptoms, may influence the development of PTSD among Japanese firefighters.

DOI： 10.1017/S1049023X12000222

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: To investigate whether a difference in the risk for diabetes exists in Japanese workers with regard to sleep duration/quality and the presence or absence of a family history of diabetes (FHD). RESEARCH DESIGN AND METHODS: The researchers conducted a prospective, occupational-based study of local government employees in Sapporo, Japan. Between April 2003 and March 2004, 3,570 nondiabetic participants, aged 35-55 years, underwent annual health checkups and completed a self-administered questionnaire that included information on sleep duration/quality and FHD at baseline. Having diabetes was defined as taking medication for diabetes or a fasting plasma glucose level of ≥126 mg/dL at follow-up (2007-2008). RESULTS: A total of 121 (3.4%) new cases of diabetes were reported. In multivariate logistic regression models of workers without an FHD, and after adjustment for potential confounding factors, the odds ratio (95% CI) for developing diabetes was 5.37 (1.38-20.91) in those with a sleep duration of ≤5 h compared with those with a sleep duration of >7 h. Other risk factors were awakening during the night (5.03 [1.43-17.64]), self-perceived insufficient sleep duration (6.76 [2.09-21.87]), and unsatisfactory overall quality of sleep (3.71 [1.37-10.07]). In subjects with an FHD, these associations were either absent or weaker. CONCLUSIONS: The current study shows that poor sleep is associated with a higher risk of developing diabetes in workers without an FHD. Promoting healthy sleeping habits may be effective for preventing the development of diabetes in people without an FHD.

DOI： 10.2337/dc11-1455

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

PURPOSE: To investigate the association between SEPTIN12 gene variants and the risk of azoospermia caused by meiotic arrest. METHODS: Mutational analysis of the SEPTIN12 gene was performed using DNA from 30 Japanese patients with azoospermia by meiotic arrest and 140 fertile male controls. RESULTS: The frequencies of the c.204G>C (Gln38His) allele and the CC genotype were significantly higher in patients than in fertile controls (p < 0.05). CONCLUSION: The c.204G>C (Gln38His) variant in the SEPTIN12 gene was associated with increased susceptibility to azoospermia caused by meiotic arrest.

DOI： 10.1007/s10815-011-9679-5

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Recent studies have shown effects of prenatal exposure to perfluorooctane sulfonate (PFOS) and perfluorooctanoate (PFOA) on infants in the general environmental levels. Laboratory animal studies have shown that exposure to PFOS and PFOA is associated with immunotoxic effects. OBJECTIVES: To investigate the relationship between maternal PFOS and PFOA levels and infant allergies and infectious diseases during the first 18 months of life. Cord blood immunoglobulin (Ig) E levels were also evaluated. METHODS: We conducted a prospective cohort study of pregnant women from 2002 to 2005 in Sapporo, Japan. Maternal PFOS and PFOA levels were measured in relation to cord blood IgE concentrations (n=231) and infant allergies and infectious diseases (n=343). Characteristics of mothers and their infants were obtained from self-administered questionnaires and medical records. Development of infant allergies and infectious diseases was determined from self-administered questionnaires at 18 months of age. Concentrations of PFOS and PFOA in maternal serum and concentrations of IgE in umbilical cord serum at birth were measured. RESULTS: Cord blood IgE levels decreased significantly with high maternal PFOA concentration among female infants. However, there were no significant associations among maternal PFOS and PFOA levels and food allergy, eczema, wheezing, or otitis media in the 18 month-old infants (adjusted for confounders). CONCLUSIONS: Although cord blood IgE level decreased significantly with high maternal PFOA levels among female infants, no relationship was found between maternal PFOS and PFOA levels and infant allergies and infectious diseases at age in 18 months.

DOI： 10.1016/j.envres.2011.10.003

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Angiotensin receptor blockers (ARBs) with calcium channel blockers (CCBs) or diuretics are a widely used combination therapy for hypertensive patients. The present study aimed to determine which combination was better for elderly hypertension patients aged ≧ 65 years.We designed a multicentre, randomized, open-label, parallel comparison study. Hypertensive outpatients aged ≧ 65 years who did not achieve the target blood pressure (BP < 140/90 mmHg) with usual dosages of ARBs were randomly assigned to switch treatment to losartan 50 mg/hydrochlorothiazide 12.5 mg or amlodipine 5 mg in addition to ARBs. The primary endpoint was a change in the systolic blood pressure (SBP) and diastolic blood pressure (DBP) after the 3-month treatment period, while secondary endpoints were changes in the BP, albuminuria, laboratory values, and cognitive function with the mini-mental state examination (MMSE) at baseline and after one year. The results from the CAMUI trial should provide new evidence for selecting optimal combination therapies for elderly hypertensive patients.

DOI： 10.1536/ihj.53.244

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掲載種別：研究論文（学術雑誌）   出版者・発行元：Wiley  

DOI： 10.2164/jandrol.110.012146

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES: The aim of this study is to examine the relationship between self-reported sleep duration and arterial stiffness in a large-scale Japanese study. DESIGN: Cross-sectional study. SETTING: Sapporo City, Hokkaido, Japan. PARTICIPANTS: Local government employees aged 35-62 years, who underwent annual health checkups from April 2003 to March 2004. After excluding those with incomplete data, data from 4,268 employees (males: 3,410) participants were analyzed. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: Brachial-ankle pulse-wave velocity (baPWV) was investigated as an indicator of arterial stiffness. We used a self-administered questionnaire, which included items on daily sleep duration, lifestyle factors, and occupational factors. Sleep duration was classified into 5 categories; " ≤ 5 h," "6 h," "7 h," "8 h," and " ≥ 9 h." Results of multiple linear regression analysis after fully adjusting the model revealed that subjects with ≥ 9 h of daily sleep had significantly elevated baPWV values compared with the reference group with 7 h of sleep. Stratified analyses by sex showed that there was a significant association among male subjects only. CONCLUSIONS: Daily sleep duration ≥ 9 h was found to be associated with elevated values of baPWV. This suggests that there is an association between long sleep duration and arterial stiffness.

DOI： 10.5665/sleep.1434

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

PURPOSE: To investigate the association between the UBR2 gene and the risk of azoospermia caused by meiotic arrest. METHODS: Mutational analysis of the UBR2 gene was performed using DNA from 30 patients with azoospermia by meiotic arrest to 80 normal controls. RESULTS: The genotypic and allelic frequencies of c.1,066A>T variant were significantly higher in patient than control groups (p < 0.001). CONCLUSION: The c.1,066A>T variant in the UBR2 gene is associated with increased susceptibility to azoospermia caused by meiotic arrest.

DOI： 10.1007/s10815-011-9576-y

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES: Cardiovascular morbidity and mortality are closely associated with hypertension, however, predictors of incident hypertension have not been fully established. We have conducted a study aimed at evaluating whether brachial-ankle pulse wave velocity (baPWV) is a predictor of incident hypertension. METHODS: The relation between baPWV, a noninvasive index of aortic stiffness, and incident hypertension was evaluated in a cohort of 2278 Japanese normotensive male subjects with a follow-up of 3 years. RESULTS: Of the 2278 study participants, 151 (6.6%) had incident hypertension during the follow-up. After adjustment for variables, including age, gender, body mass index (BMI), smoking habit, alcohol consumption, diabetes mellitus, hyperlipidemia, family history of hypertension, heart rate, systolic blood pressure, low-density lipoprotein cholesterol, triglyceride, and fasting plasma glucose, multiple logistic regression analysis revealed that baPWV was a significant and independent predictor of incident hypertension with an adjusted odds ratio 1.45 (95% confidence interval 1.17-1.79, P < 0.01). In addition, baPWV values >1380 cm/s indicated a high risk for incident hypertension. CONCLUSIONS: Among the Japanese normotensive male subjects participating in this study, BaPWV was a significant and independent predictor of incident hypertension. This result suggests that BaPWV could be a useful screening method to identify normotensive individuals who should be targeted for interventions aimed at preventing the incident hypertension.

DOI： 10.1007/s12199-010-0189-3

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1093/ije/dyq071

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掲載種別：研究論文（学術雑誌）  

DOI： 10.1111/j.1600-0668.2010.00698.x

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Although metabolic syndrome confers an increased risk of cardiovascular disease in the general population, little is known about the alteration of abdominal adiposity and its association with adipocytokines in hemodialysis patients. We investigated the plasma high-molecular-weight (HMW) adiponectin level and its relationship to visceral fat area (VFA) and various markers of atherosclerosis in hemodialysis patients. In a cross-sectional study, conventional cardiovascular risk factors, plasma total and HMW adiponectin, the number of components of the metabolic syndrome and, using computed tomography, the distribution of abdominal adiposity were assessed in 144 hemodialysis patients (90 men and 54 women; mean age, 60.7 years) and 30 age- and sex-matched patients with chronic kidney disease (CKD). Plasma HMW adiponectin levels in hemodialysis patients were significantly higher than those in patients with CKD, negatively associated with VFA and serum triglycerides and positively associated with plasma total adiponectin, as well as the HMW-to-total adiponectin ratio in men and women (all P < 0.05) in a simple regression analysis. In a multiple regression analysis, VFA was a significant determinant of HMW adiponectin in hemodialysis patients. Furthermore, after adjustment for classical risk factors, HMW adiponectin levels were significantly higher in patients undergoing treatment with renin-angiotensin system inhibitors or calcium channel blockers compared with patients not undergoing such treatment. This study shows that plasma HMW adiponectin levels were negatively associated with VFA and positively associated with treatment with blockade of the renin-angiotensin system and of the calcium channel. Therefore, these drugs might be effective for improving adipocytokine-related metabolic abnormalities in hemodialysis patients.

DOI： 10.1038/hr.2010.282

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Dioxin-like compounds are endocrine disruptors. The effects of prenatal exposure to environmental levels of dioxins on immune function during infancy have not been clarified, although dioxins induce immunosuppression in offspring of animals. Moreover, human studies have not assessed the effects of gender- or congener-specific differences. The purpose of this study was to investigate the association between dioxin levels in maternal blood and the risk of infection and allergies in infancy. We examined 364 mothers and their infants enrolled in a Hokkaido Study on Environment and Children's Health between 2002 and 2005 in Sapporo, Japan. Relevant information was collected from a baseline questionnaire during pregnancy, medical records at delivery, and a follow-up questionnaire when the child was 18 months of age that assessed development of allergies and infections in infancy. Dioxin-like compound levels in maternal blood were measured with high-resolution gas chromatography/high-resolution mass spectrometry. Relatively higher levels of polychlorinated dibenzofuran were associated with a significantly increased risk of otitis media, especially among male infants (odds ratio=2.5, 95% confidence interval=1.1-5.9). Relatively higher levels of 2,3,4,7,8-pentachlorodibenzofuran were also associated with a significantly increased risk of otitis media (odds ratio=5.3, 95% confidence interval=1.5-19). However, we observed a weak association between dioxin-like compound levels and allergic symptoms in infancy. At environmental levels, prenatal exposure to dioxin-like compounds may alter immune function and increase the risk of infections in infancy, especially among males. The compound 2,3,4,7,8-pentachlorodibenzofuran may be responsible for this.

DOI： 10.1016/j.envres.2011.01.021

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES: The purpose of this study was to investigate annual variations in indoor environmental chemical, fungal and dust mite allergen levels, with regards to variations in sick house syndrome (SHS) symptoms over a three-year period. METHODS: Detached houses were randomly selected from a building plan approval application, and a questionnaire survey was conducted in 2003 in Sapporo, Japan. Indoor environmental measurements and a self-administered questionnaires survey were conducted on the selected houses in 2004, 2005 and 2006. The same protocol was used for the three-year period to measure the levels of chemicals, fungi and dust mite allergens. A personal questionnaire to assess SHS was distributed to all inhabitants of the dwellings along with one questionnaire to assess housing characteristics. RESULTS: In 2004, 2005 and 2006, the owners of 104, 64 and 41 houses, respectively, agreed to participate in this study. Forty-one houses and the 127 inhabitants who participated in this three-year survey period were included in the analysis to evaluate the associations between differences in environmental measurements and SHS. The levels of formaldehyde, acetone, toluene, Alternaria and Cladosporium tended to decrease, whereas those of limonene and Aspergillus tended to increase over the three-year period. Increasing levels of Cryptococcus and the dampness index in individual houses correlated with increasing SHS symptom scores in the inhabitants after mutual adjustment. CONCLUSIONS: Although the average levels of chemicals and fungi were relatively low, the results show the relationship between annual variations in indoor environmental measurements and variations in SHS symptom scores.

DOI： 10.1265/jjh.66.589

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記述言語：日本語   出版者・発行元：(公社)日本産業衛生学会  

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記述言語：英語   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

DOI： 10.1097/01.ede.0000391784.44762.63

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

AIM: Helicobacter Pylori infection was associated with the risk of cardiovascular disease; however, the relation between Helicobacter Pylori infection and the lipid profile has not been fully established. METHODS: We measured anti-Helicobacter Pylori antibody concentration and lipid profiles in 6,289 Japanese subjects aged 21-64 years (5,077 male and 1,212 female). RESULTS: The prevalence of Helicobacter Pylori-seropositive subjects was 46.8% and 39.6% in men and women, respectively. Adjusted mean values of low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol in men were significantly higher and lower in Helicobacter Pylori-seropositive than-negative subjects, respectively, (LDL-cholesterol: 129.0±0.8 vs. 125.3±0.7 mg/dL, p< 0.001, HDL-cholesterol: 54.6±0.3 vs. 56.6±0.3 mg/dL, p< 0.01), whereas these associations were not significant in female subjects. Moreover, the odds ratio of Helicobacter Pylori infection for high LDL-cholesteremia and low HDL-cholesteremia in male subjects was 1.23 (95% CI (confidence interval): 1.08-1.40, p< 0.05) and 1.29 (95% CI: 1.03-1.59, p< 0.05), respectively. Female subjects did not have such associations. CONCLUSIONS: The present study demonstrates that Helicobacter Pylori infection is significantly associated with high LDL-cholesteremia and low HDL-cholesteremia in Japanese male subjects.

DOI： 10.5551/jat.5157

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES: We investigated dampness/mold in schools and dwellings, and food habits and subjective symptoms in elementary school pupils, in order to clarify the effect of dampness and food habits on subjective symptoms in elementary school pupils. METHODS: Questionnaires were used to investigate dampness in classrooms and dwellings in Hokkaido, Japan, and its effect on subjective symptoms in 1,077 pupils in 8 elementary schools. We used a dampness index for both the home and classroom; the index was the sum of the presence of four dampness indicators: (1) visible mold, (2) moldy odor, (3) water leakage, and (4) condensation on windowpanes. The questionnaire also contained queries about food habits, as follows: the frequency of eating breakfast, whether the energy provided by the school lunch was sufficient, and whether eating too many snacks and/or sweets were consumed. Adjusted logistic regression was used to determine whether dampness and food habits were related to the subjective symptoms. RESULTS: In fully adjusted models, the home dampness index was significantly related to cough, general symptoms, and having at least one symptom; the classroom dampness index was significantly related to nasal symptoms. In addition, usually not eating breakfast was significantly related to eye symptoms, and too many snacks and/or sweets was significantly related to eye, nasal, and general symptoms. CONCLUSIONS: Both home and classroom dampness can affect pupils' health. Home dampness, in particular, was significantly related to cough and general symptoms, and classroom dampness was significantly related to nasal symptoms. Furthermore, favorable food habits have a positive effect on pupils' subjective symptoms.

DOI： 10.1007/s12199-010-0139-0

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Both epilepsy and paragonimiasis had been known to be endemic in Southwest Cameroon. A total of 188 people (168 and 20 with and without symptoms confirmed by clinicians, respectively, 84.6% under 20 years old) were selected on a voluntary basis. Among 14 people (8.3%) with history of epilepsy, only one suffered from paragonimiasis. Therefore, we challenged to check antibody responses to highly specific diagnostic recombinant antigens for two other helminthic diseases, cysticercosis and toxocariasis, expected to be involved in neurological diseases. Soil-transmitted helminthic infections were also examined. METHODOLOGY/PRINCIPAL FINDINGS: Fecal samples were collected exclusively from the 168 people. Eggs of Ascaris lumbricoides, Trichuris trichiura and hookworms were found from 56 (33.3%), 72 (42.8%), and 19 (11.3%) persons, respectively. Serology revealed that 61 (36.3%), 25 (14.9%) and 2 (1.2%) of 168 persons showed specific antibody responses to toxocariasis, paragonimiasis and cysticercosis, respectively. By contrast, 20 people without any symptoms as well as additional 20 people from Japan showed no antibody responses. Among the 14 persons with epilepsy, 5 persons were seropositive to the antigen specific to Toxocara, and one of them was simultaneously positive to the antigens of Paragonimus. The fact that 2 children with no history of epilepsy were serologically confirmed to have cysticercosis strongly suggests that serological survey for cysticercosis in children is expected to be useful for early detection of asymptomatic cysticercosis in endemic areas. CONCLUSIONS/SIGNIFICANCE: Among persons surveyed, toxocariasis was more common than paragonimiasis, but cysticercosis was very rare. However, the fact that 2 children were serologically confirmed to have cysticercosis was very important, since it strongly suggests that serology for cysticercosis is useful and feasible for detection of asymptomatic cysticercotic children in endemic areas for the early treatment.

DOI： 10.1371/journal.pntd.0000732

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES: We explored the relationship between bone mineral density (BMD) and lifestyle in juveniles to identify factors leading to higher peak bone mass and prevention of osteoporosis in later life. METHODS: Juveniles (1,364 students: 770 boys and 594 girls, aged 6-18 years) attending school in Hokkaido prefecture, Japan, were asked to complete a brief self-administered diet history questionnaire for 10-year-olds (BDHQ10y) providing information about personal history, lifestyle, and intake of nutritional elements. In addition, BMD and grip strength were measured. We analyzed the relationship between BMD and lifestyle factors. RESULTS: The difference in BMD for boys was larger among the junior and senior high school groups. The difference in BMD for girls was larger among older elementary and later school children. Anthropometric variables and grip strength were strongly correlated with BMD. Having a nap-time routine was significantly correlated with BMD, but sleep time and sports club activities were not. BMD among juveniles who attained secondary sexual characteristics was significantly higher than that of juveniles of the same age who had not attained these characteristics. Calcium intake was significantly lower in senior high school students compared with other grades. Consumption of milk by senior high school boys and junior high school girls was weakly correlated with BMD. CONCLUSIONS: Our findings encourage educational interventions to counsel students to avoid weight loss and calcium deficiency. This effective intervention should begin before the higher elementary school, when juveniles have the greatest likelihood for preventing lower peak bone mass and osteoporosis.

DOI： 10.1007/s12199-009-0131-8

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES: The aims of this study are to evaluate the associations between residential factors and sick house syndrome (SHS) in a cold region and in a temperate region in Japan. METHODS: A questionnaire survey was conducted on dwellings aged within 7 years from 2003 to 2004 in Sapporo and 'Honshu and northern Kyushu' including Fukushima, Aichi, Osaka, Okayama, and Kitakyushu. The questionnaire consisted of questions about the characteristics of dwellings, manner of living, and health problems of occupants. SHS was identified from the 'yes' responses to the questions on the five items on nasal, throat and respiratory, eyes, skin, and general symptoms that appeared frequently or sometimes at home and improved upon leaving the home. RESULTS: The dwellings with the SHS problem, where at least one inhabitant reported any symptoms of SHS, were 4.7% in Sapporo City and 3.3% in Honshu and northern Kyushu. Regarding ventilation, the principal method was the enforced ventilation in Sapporo and ventilation from open windows in Honshu and northern Kyushu. The sums of five signs of dampness were 0.8 +/- 1.0 in Sapporo and 1.3 +/- 1.0 in Honshu and northern Kyushu. The elevated scores were accompanied by the increased percentage of SHS in both groups. Condensation on both window panes and walls was strongly associated with SHS. CONCLUSIONS: Differences were found in the ventilation method and in the dampness state between Sapporo and Honshu and northern Kyushu. In both groups, the dampness state was associated with SHS.

DOI： 10.1265/jjh.65.447

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Microorganisms are known to produce a range of volatile organic compounds, so-called microbial VOC (MVOC). Chamber studies where humans were exposed to MVOC addressed the acute effects of objective and/or subjective signs of mucosal irritation. However, the effect of MVOC on inhabitants due to household exposure is still unclear. The purpose of this epidemiological study was to measure indoor MVOC levels in single family homes and to evaluate the relationship between exposure to them and sick building syndrome (SBS). All inhabitants of the dwellings were given a self-administered questionnaire with standardized questions to assess their symptoms. Air samples were collected and the concentrations of eight selected compounds in indoor air were analyzed by gas chromatography/mass spectrometry - selective ion monitoring mode (GC/MS-SIM). The most frequently detected MVOC was 1-pentanol at a detection rate of 78.6% and geometric mean of 0.60 microg/m(3). Among 620 participants, 120 (19.4%) reported one or more mucous symptoms; irritation of the eyes, nose, airway, or coughing every week (weekly symptoms), and 30 (4.8%) reported that the symptoms were home-related (home-related symptoms). Weekly symptoms were not associated with any of MVOC, whereas significant associations between home-related mucous symptoms and 1-octen-3-ol (per log(10)-unit: odds ratio (OR) 5.6, 95% confidence interval (CI): 2.1 to 14.8) and 2-pentanol (per log(10)-unit: OR 2.3, 95% CI: 1.0 to 4.9) were obtained after adjustment for gender, age, and smoking. Associations between home-related symptoms and 1-octen-3-ol remained after mutual adjustment. However, concentrations of the selected compounds in indoors were lower than the estimated safety level in animal studies. Thus, the statistically significant association between 1-octen-3-ol may be due to a direct effect of the compounds or the associations may be being associated with other offending compounds. Additional studies are needed to evaluate these possibilities.

DOI： 10.1016/j.scitotenv.2010.02.012

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掲載種別：研究論文（学術雑誌）  

DOI： 10.1111/j.1600-0668.2009.00629.x

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES: This study explored possible associations between chemical substances and sick building syndrome (SBS)-type symptoms of residents living in new houses in Japan. METHODS: We randomly sampled 5,709 newly built conventional homes. In the end, 1,479 residents in 425 households completed a questionnaire survey and agreed to environmental monitoring for indoor aldehydes and volatile organic compounds (VOCs) to be conducted in their homes. If the residents had complained about at least one SBS-related symptom, they were classified as suffering from SBS. Multiple logistic regression analysis was used to select predictive chemical factors of SBS symptoms. RESULTS: About 14% of the subjects suffered from SBS. Many aldehydes and VOCs were associated factors of optical, nasal, and gular symptoms in univariate analysis. After adjustment for other possible risk factors, formaldehyde dose-dependently showed to be a significant risk factor for SBS. Several chemicals had tendency to be associated with SBS symptoms. CONCLUSIONS: Chemicals detected in Japanese newly built houses tend to increase the risk of subjective symptoms in residents suffering from SBS.

DOI： 10.1007/s00420-009-0475-9

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掲載種別：研究論文（学術雑誌）  

DOI： 10.1111/j.1600-0668.2009.00589.x

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Inflammation and pulse wave velocity (PWV) are a potential risk factor and marker, respectively, for atherosclerosis in the primary prevention setting. Atherosclerosis is now generally accepted to be an inflammatory disorder of the arterial wall, and the high-sensitivity C-reactive protein (hs-CRP) level has been reported to be a strong predictor of cardiovascular events. High-sensitivity-CRP is associated with two factors related to inflammation: (1) the local production of CRP by atheromatous tissue or coronary artery smooth muscle cells and (2) adipose tissue as a potent source of inflammatory cytokines. Based on studies in North America and Europe, hs-CRP has been established as a cardiovascular risk factor and a cut-off value has been recommended. However, Japanese have lower hs-CRP values than their Western counterparts, partly because Japanese have a lower body mass index (BMI), which correlates positively to hs-CRP, and partly because lifestyle and genetic factors can affect hs-CRP values. Therefore, a cut-off value needs to be established by cohort studies for the Japanese population. Carotid-femoral PWV is most commonly measured by applanation tonometry, particularly in Europe, but this method is critically dependent upon the accurate placing of transducers over the arteries and is both time-consuming and complex. A novel device has been recently developed in Japan that measures brachial-ankle PWV (baPWV) using a volume-rendering method. Brachian-ankle PWV is a suitable screening method because of its technical simplicity and shorter measurement time. It is associated not only with conventional cardiovascular risk factors but also with new risk factors, such as inflammation, gamma-glutamyltransferase, chronic kidney disease, and psychosocial factors. However, a suitable cut-off value has yet to be established.

DOI： 10.1007/s12199-009-0080-2

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

Sick house syndrome is caused by not only chemicals but also dampness and biological factors. Many European and North American studies have shown that dampness associated with condensation, visible mold, moldy odor, and water-induced damage among others affects residents' health. Recent Japanese studies have also shown a similar significant relationship. Mold can cause infection and allergy, and can produce chemicals such as microbial volatile organic compounds (MVOCs) and (1-->3)-Beta-D-glucan. Mold exposure can be analyzed using culture-based (colony forming unit count) enumeration techniques. More recently, other nonculture-based methods of measuring mold concentrations in indoor environments have been described, which may provide more valid measures of exposure. These are based on measurement of specific mold markers in dust or air, such as ergosterol, genus-specific extracellular polysaccharides or (1-->3)-Beta-D-glucan. Mites are major indoor allergens. The gold standard for measuring exposure to mite allergens is enzyme-linked immunosorbent assay (ELISA), but it is relatively expensive and requires specialized techniques. Several simple semiquantitative dust mites allergen test have b available in Japan.

DOI： 10.1265/jjh.64.665

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

The aim of this study was to examine the effects of a stress inoculation training program for civil servants through a non-randomized trial. We divided 140 civil servants into two groups (an intervention group and a waiting list control group), and carried out three sessions with the intervention group at intervals of four weeks. The sessions included lectures on responses to stress and coping skills, problem-solving training, group discussions and self-monitoring. Data from 65 subjects in the intervention group and 63 subjects in the waiting list group were analyzed using two-way analysis of covariance (ANCOVA). The intervention group showed statistically significant development of problem-solving skills and positive cognition, with a significant effect remaining one month after the intervention. The effect sizes in the intervention group showed a small-to-medium change in problem-solving coping and small changes in positive cognitive coping. However, no interventional effects were seen in terms of response to stress and health competence. As the number of existing studies on job stress management for workers is limited, further research in this field is necessary, including examination of the frequency and methods of intervention sessions, the effects of intervention by gender, etc.

DOI： 10.2486/indhealth.47.173

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Perfluorooctane sulfonate (PFOS) and perfluorooctanoate (PFOA) are man-made, ubiquitous, and persistent contaminants in the environment, wildlife, and humans. Although recent studies have shown that these chemicals interfere with fetal growth in humans, the results are inconsistent. OBJECTIVES: Our goal was to investigate the correlation between relatively low levels of PFOS and PFOA in maternal serum and birth weight and birth size. METHODS: We conducted a hospital-based prospective cohort study between July 2002 and October 2005 in Sapporo, Japan. A total of 428 women and their infants were involved in the study. We obtained characteristics of the mothers and infants from self-administered questionnaire surveys and from medical records. We analyzed maternal serum samples for PFOS and PFOA by liquid chromatography-tandem mass spectrometry (LC/MS/MS). RESULTS: After adjusting for confounding factors, PFOS levels negatively correlated with birth weight [per log10 unit: beta = -148.8 g; 95% confidence interval (CI), -297.0 to -0.5 g]. In addition, analyses stratified by sex revealed that PFOS levels negatively correlated with birth weight only in female infants (per log10 unit: beta = -269.4 g; 95% CI, -465.7 to -73.0 g). However, we observed no correlation between PFOA levels and birth weight. CONCLUSION: Our results indicate that in utero exposure to relatively low levels of PFOS was negatively correlated with birth weight.

DOI： 10.1289/ehp.11681

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES: Indoor air contaminants and dampness in dwellings have become important environmental health issues. The aim of this study is to clarify which factors are related to sick building syndrome (SBS) in newly built dwellings at Hokkaido, Japan, through a comprehensive evaluation of the indoor environment and validated sick building symptom questionnaires. METHODS: The symptoms of 343 residents in 104 detached houses were surveyed by standardized questionnaires, and the concentrations of formaldehyde, acetaldehyde, volatile organic compounds (VOCs), airborne fungi, and dust mite allergen in their living rooms were measured. By summing the presence or absence of the five dampness indicators (condensations, mold growth, moldy odor, high air humidity of the bathroom, water leakage), a dampness index was calculated. RESULTS: SBS symptoms were found in 21.6% of surveyed individuals. In a fully adjusted multivariate logistic regression analysis, the dampness index [odds ratio (OR) = 1.50; 95% confidence interval (CI): 1.06-1.11], log formaldehyde (OR = 23.79, 95% CI: 2.49-277.65), and log alpha-pinene (OR = 2.87, 95% CI: 1.36-6.03) had significantly higher ORs for SBS symptoms. However, other VOCs, airborne fungi, and dust mite allergen did not have significantly higher ORs. CONCLUSION: Dampness, formaldehyde, and alpha-pinene were significantly related to SBS symptoms in newly built dwellings. We should, therefore, take measures to reduce the chemicals and dampness in dwellings.

DOI： 10.1007/s00420-009-0395-8

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The prevalence of obesity is gradually increasing in Japan, but in women aged in their 20 s to 50 s it has been disproportionately decreasing. However, the exact body composition of this subset of the population has not been elucidated. METHODS AND RESULTS: Body composition was determined using whole-body dual energy X-ray absorptiometry and metabolic parameters in 157 Japanese female university students (21.1+/-1.9 years); 31 women had a normal body mass index (BMI), but an increased body fat mass (BFM). Only the 31 had significantly higher low-density lipoprotein-cholesterol levels (90.5 vs 99.0 mg/dl, P<0.01) and leptin concentration (7.0 vs 4.6 ng/ml, P<0.05) and lower high-density lipoprotein-cholesterol (80.4+/-15.1 vs 73.5+/-14.5 mg/dl, P<0.01) than females with normal BMI and normal BFM. CONCLUSIONS: A considerable number of young Japanese women with a normal BMI have excess BFM and relatively higher lipid and leptin levels. These findings may provide an important basis for future epidemiological surveys and studies.

DOI： 10.1253/circj.cj-08-0381

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掲載種別：研究論文（学術雑誌）  

DOI： 10.1093/molehr/gan078

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES: The effect of dampness on sick building syndrome (SBS) symptoms has not been fully investigated in Japan. The purpose of this study is to elucidate the possible effects of dampness on SBS symptoms among residents in Japanese public apartment houses. METHODS: A questionnaire was used to investigate the degree of dampness in public apartment houses in Asahikawa, Japan, and its effect on SBS symptoms, involving 480 residents in 64 buildings. Dampness indicators were as follows: condensation on the windowpanes, condensation on the walls and/or closets, visible mold in the bathrooms, visible mold on the walls, window frames, and/or closet, moldy odor, slow drying of the wet towels in bathrooms, water leakage, and bad drainage in bathrooms. RESULTS: All dampness indicators except for visible mold in bathrooms had significantly higher odds ratios (ORs) for all or any SBS symptoms after adjustment. The dampness index, the number of positive dampness indicators, was significantly related to all SBS symptoms after adjustment. CONCLUSIONS: There are serious problems relating to dampness in Japanese public housing, which affects the health of residents. There is a need to educate the residents about the relationship between dampness and SBS, and building problems should be rectified.

DOI： 10.1007/s12199-008-0052-y

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: Numerous studies have reported the relationships between job characteristics and coronary heart diseases. However, there are only a few reports on the association between occupational stresses and arterial stiffness as a marker of early stage arthrosclerosis. The aim of this study was to clarify the relationship between occupational stress models--Siegrist's effort reward imbalance and Karasek's demand control model (DCM)--and arterial stiffness using brachial-ankle pulse-wave velocity (baPWV). METHODS: The participants were local government employees (3,412 men and 854 women) aged 35 and over who had their annual health checkups. The associations between occupational stress questionnaires of the two theoretical models and a risk of increased arterial stiffness using baPWV were examined. RESULTS: On performing multiple linear regression analysis after fully adjusting the model, high strain, which was defined as a combination of both low job control and high job demands in the DCM, was found to be significantly associated with a high risk of arterial stiffness (P = 0.027) in women. However, in men, although low job control was positively significant with a high value of baPWV adjusted for each step, modest but not significant association was found after adjustment for all covariates. CONCLUSION: In conclusion, the present study indicates that high strain indicated by high demands and low control is associated with increased arterial stiffness in women. The types of job stress associated with a high risk of arterial stiffness may differ by gender.

DOI： 10.1007/s00420-008-0319-z

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

We conducted a congener-specific analysis of non-dioxin-like polychlorinated biphenyls (non-dioxin-like PCBs) in blood collected between July 2002 and July 2004 from 195 pregnant women living in Sapporo City of Hokkaido Prefecture, Japan. The present study is one of the few studies in which full congener concentrations of non-dioxin-like PCBs have been measured in the blood of pregnant women. Of the 195 pregnant women, 101 were primipara (mean: 28.8 years, median: 28.0 years) and 94 were multipara (mean: 32.3 years, median: 33.0 years). Among the 197 non-dioxin-like PCB congeners, 58 congeners were identified in the blood of pregnant women. The arithmetic mean total concentrations of 58 non-dioxin-like PCB congeners in the blood of primiparous and multiparous mothers in Sapporo City were 42.2-329.3 (mean: 114.5, median: 98.6) and 31.5-258.0 (mean: 100.3, median: 91.4)ngg(-1)lipid, respectively. The results show that the contamination of non-dioxin-like PCBs in the blood of women has decreased compared to past levels in other domestic areas, in which the subject age was similar to that in this study. The results of the present study indicate that current levels of non-dioxin-like PCBs in the blood of Japanese women and can be used as baseline data for future temporal trends. The sums of the ratios of the concentrations of hexaCBs and heptaCBs to the total concentrations of 58 non-dioxin-like PCB congeners in the blood of primiparous and multiparous mothers were 78.5% and 77.7%, respectively. The hexaCBs ratios in the blood of primiparous and multiparous mothers were 45.4% and 44.7%, respectively. HexaCB-153 among hexaCBs congeners, the most abundant congener in the blood of primiparous and multiparous mothers, contributed approximately 22.0% and 21.8% to the total concentrations of 58 non-dioxin-like PCBs congeners that were measured in the blood, respectively. Among the non-dioxin-like PCB congeners measured in the present study, hexaCB-138, heptaCB-170, heptaCB-180, and heptaCB-182/heptaCB-187 also showed high ratios to total concentrations of 58 non-dioxin-like PCB congeners detected in the blood of primiparous and multiparous mothers. With regard to the relationship between the total concentrations of 58 non-dioxin-like PCB congeners in maternal blood and the number of deliveries or the age of primiparous and multifarious mothers, the total levels of these PCB congeners tended to decreases with increases in the number of deliveries and significantly increased with increasing maternal age in both groups. Furthermore, significant correlations were observed between the total concentrations of these PCB congeners in blood and the age of primiparae and multiparae. The concentrations of hexaCB-153 in the blood of primiparous and multiparous mothers showed a close correlation to the total concentrations of these PCBs, suggesting that hexaCB-153 could be an indicator of total concentrations of non-dioxin-like PCB congeners in the blood of pregnant women.

DOI： 10.1016/j.chemosphere.2008.06.071

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

This study investigates whether the two socioeconomic status indicators, educational level and employment grade, are associated with C-reactive protein (CRP) levels and arterial stiffness among Japanese urban civil servants. Brachial-ankle pulse-wave velocity (baPWV) as an indicator of arterial stiffness, CRP, occupational stress and conventional risk factors were evaluated in 3412 men and 854 women. Although the socioeconomic gradient showed a significant association with the CRP levels in men after adjustment for age, the significance disappeared after multivariate adjustment, whereas in women, the socioeconomic gradient showed no significant association with the CRP levels. In men, educational level was significantly associated with the baPWV value after adjustment for conventional risk factors, CRP and occupational stress (P for trend <0.0001). With regards to employment grade, only low-level non-manual workers had a significantly lower baPWV value as compared to manual workers at a fully adjusted model, and trend significance disappeared. However, in women, neither educational level nor employment grade was associated with the baPWV value. In summary, the socioeconomic gradient, especially the educational level, was significantly inversely related to the baPWV value in men. In women, the socioeconomic gradient was not related to the baPWV value. An inverse relationship between the socioeconomic gradient and CRP levels was found in men only after age adjustment. We suggest that because the educational level is an important aspect in the adolescent environment and hence might influence the future lifestyle, early health education should be provided to prevent an unfavourable lifestyle and atherosclerotic diseases in later life.

DOI： 10.1016/j.socscimed.2008.06.014

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Inorganic sodium arsenite (iAs) is a ubiquitous environmental contaminant and is associated with an increased risk of skin hyperkeratosis and cancer. OBJECTIVES: We investigated the molecular mechanisms underlying the regulation of the keratin 16 (K16) gene by iAs in the human keratinocyte cell line HaCaT. METHODS: We performed reverse transcriptase polymerase chain reaction, luciferase assays, Western blots, and electrophoretic mobility shift assays to determine the transcriptional regulation of the K16 gene by iAs. We used gene overexpression approaches to elucidate the nuclear factor erythroid-derived 2 related factor 2 (NRF2) involved in the K16 induction. RESULTS: iAs induced the mRNA and protein expression of K16. We also found that the expression of K16 was transcriptionally induced by iAs through activator protein-1-like sites and an antioxidant response element (ARE) in its gene promoter region. Treatment with iAs also enhanced the production and translocation of the NRF2 transcription factor, an ARE-binding protein, into the nucleus without modification of its mRNA expression. In addition, iAs elongated the half-life of the NRF2 protein. When overexpressed in HaCaT cells, NRF2 was also directly involved in not only the up-regulation of the detoxification gene thioredoxin but also K16 gene expression. CONCLUSIONS: Our data clearly indicate that the K16 gene is a novel target of NRF2. Furthermore, our findings also suggest that NRF2 has opposing roles in the cell--in the activation of detoxification pathways and in promoting the development of skin disorders.

DOI： 10.1289/ehp.10696

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

We measured the concentrations of polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), non-ortho polychlorinated biphenyls (non-ortho PCBs), and mono-ortho polychlorinated biphenyls (mono-ortho PCBs) in paired samples of blood and breast milk collected from 60 mothers in Sapporo City, Hokkaido Prefecture, Japan. The present study is one of the few studies in which PCDDs, PCDFs, and dioxin-like PCBs have been measured in blood and breast milk collected from 60 same mothers. Of these 60 mothers, 30 were primipara (mean: 30.1 years, median: 28.0 years) and 30 were multipara (mean: 32.2 years, median: 32.5 years). The arithmetic mean TEQ concentrations of PCDDs, PCDFs, non-ortho PCBs, and mono-ortho PCBs in blood and breast milk of the primiparous mothers were 9.0, 3.3, 5.7, and 0.4 pg TEQ g(-1) lipid, respectively, and 5.2, 2.2, 4.5, and 0.4 pg TEQ g(-1) lipid, respectively, with the total TEQ concentrations of these dioxin-like compounds being 9.3-42.9 (mean: 18.4, median: 17.3) and 7.0-41.1 (mean: 12.3, median: 11.4) pg TEQ g(-1) lipid, respectively. In the case of multiparous mothers, the arithmetic mean TEQ concentrations of these dioxin-like compounds in blood and breast milk were 7.1, 2.7, 5.3, and 0.4 pg TEQ g(-1) lipid, respectively, and 3.9, 1.7, 3.8, and 0.4 pg TEQ g(-1) lipid, respectively, with the total TEQ concentrations being 3.4-28.1 (mean: 15.5, median: 13.9) and 2.7-20.0 (mean: 9.8, median: 9.2)pg TEQ g(-1) lipid, respectively. The total TEQ concentrations of PCDDs, PCDFs, non-ortho PCBs, and mono-ortho PCBs in blood and breast milk of primiparous mothers in Sapporo City appeared to be generally lower than those recently surveyed throughout the greater area of Japan. Significant correlations were observed between age and the total TEQ concentrations of PCDDs, PCDFs, non-ortho PCBs, and mono-ortho PCBs in the blood of primiparae and multiparae, and significant correlations were also observed between age and the total TEQ concentrations of these dioxin-like compounds in the breast milk of primiparae and multiparae. The total TEQ concentrations of PCDDs, PCDFs, and dioxin-like PCBs in the blood of primiparous mothers showed a close correlation to those in their breast milk and also showed good correlations between the total TEQ concentrations of these dioxin-like compounds in the blood of multiparous mothers and those in their breast milk. The result of a comparison of the arithmetic mean concentrations of each congener of PCDDs, PCDFs, non-ortho PCBs, and mono-ortho PCBs in blood and breast milk indicated that the transfer of octachlorodibenzo-p-dioxin (OCDD) from the blood to the breast milk was lower than those of other congeners. In contrast, among mono-ortho PCBs congeners, the arithmetic mean concentrations of 2,3',4,4',5-pentachlorobiphenyl (PentaCB) (#118) and 2,3,3',4,4'-PentaCB (#105) in the breast milk were slightly higher than those in the blood, which suggested that breast-fed infants may be at higher risk from mono-ortho PCBs.

DOI： 10.1016/j.chemosphere.2008.03.050

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The influence of a 24-hr shift-work burden on firefighters' mental health has not been fully investigated. The purpose of this study is to clarify the relationships between specific workload items among firefighters engaged in 24-hr shift work and job stress as estimated by the generic job-stress questionnaire on depressive symptoms and job dissatisfaction from the National Institute for Occupational Safety and Health (NIOSH). METHOD: The subjects were 1,301 firefighters. The questionnaire covered age, gender, job type, job class, marital status, smoking and drinking habits, number of attendances, turnout time, extra work hours, average nap-time, the Center for Epidemiologic Studies Depression Scale (CES-D), and questions from the NIOSH generic job-stress questionnaire, including those on job satisfaction. RESULTS: In multivariate logistic regression analyses, a model that included all variables except the measures from the NIOSH generic job-stress questionnaire showed that shorter nap-time had significant higher odds ratios (ORs) for depressive symptoms and job dissatisfaction, but the significances disappeared in a fully adjusted model. In fully adjusted logistic regression analyses, low quantitative workload, low variance in workload, high intra- and intergroup conflict, low social support from a supervisor, high role conflict and ambiguity, and low self-esteem had significant higher ORs for depressive symptoms and/or job dissatisfaction. CONCLUSIONS: Amount of workload, variance in workload, intra- and intergroup conflict, social support from a supervisor, role conflict and ambiguity, and self-esteem were significantly related to depressive symptoms and/or job dissatisfaction among Japanese firefighters. Moreover, inadequate nap-time may affect their mental health.

DOI： 10.1002/ajim.20571

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Maternal smoking during pregnancy can result in both pregnancy complications and reduced size of the fetus and neonate. Among women who smoke, genetic susceptibility to tobacco smoke also is a likely causative factor in adverse pregnancy outcomes. A prospective cohort study was conducted among 460 pregnant women who delivered live singletons in Sapporo, Japan, from 2002 to 2005. Multiple linear regression models were used to estimate associations of maternal smoking and polymorphisms in two genes encoding N-nitrosamine-metabolizing enzymes-NAD(P)H: quinone oxidoreductase 1 (NQO1) and cytochrome P-450 2E1 (CYP2E1)-with birth size. Among infants born to smokers with the NQO1 homozygous wild-type allele, birth weight, birth length, and birth head circumference were significantly reduced (p < 0.01 for each factor). For the homozygous wild-type CYP2E1 allele, birth weight was lower by an estimated 195 g (standard error, 55; p < 0.001) among smokers. These genotypes did not confer adverse effects among women who had never smoked or who quit smoking during the first trimester. The adverse effects of maternal smoking on infant birth size may be modified by maternal genetic polymorphisms in N-nitrosamine-metabolizing enzymes among Japanese subjects. These results may help in directing smoking cessation interventions during pregnancy, especially among susceptible women.

DOI： 10.1093/aje/kwm360

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND AND AIMS: The relationships between gamma-glutamyltransferase (GGT), C-reactive protein (CRP), and arterial stiffness have not been fully investigated. The aim of this study was to clarify whether serum GGT is related to CRP and arterial stiffness estimated using brachial-ankle pulse wave velocity (baPWV). METHODS AND RESULTS: The subjects were 3412 males and 854 females. GGT, CRP, baPWV, and conventional risk factors were evaluated. On multiple regression analysis, after adjustment for the conventional risk factors, log GGT was significantly associated with log CRP in male and female subjects (male subjects: beta=0.168, p<0.0001; female subjects: beta=0.098, p<0.05). After adjustment for the conventional risk factors, log GGT was significantly associated with PWV in male subjects (beta=0.060, p<0.0001), but in female subjects, no significant relationships were found after adjustment (beta=0.007, p=0.82). CONCLUSION: These results suggest that GGT is independently associated with an increased level of CRP in both males and females. In addition, in males, GGT is related to an increased level of arterial stiffness.

DOI： 10.1016/j.numecd.2006.10.002

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Chronic kidney disease (CKD) is associated with an increased risk of cardiovascular disease, and thus is a major worldwide public health problem. Recently, an estimated glomerular filtration rate (eGFR) using the Modification of Diet in Renal Disease equation for Japanese patients was proposed by the Japanese Society of Nephrology. However, the role of eGFR in the assessment of atherosclerosis is not well understood in Japanese patients. We analyzed the relationship between eGFR and severity of arterial stiffness using brachial-ankle pulse wave velocity (baPWV) in 647 adult Japanese patients. baPWV correlated significantly and positively with age, hypertension, diabetes, prior cardiovascular disease, blood pressure, pulse pressure and heart rate, and negatively with eGFR (r=-0.405, p<0.0001). A multiple regression analysis revealed that baPWV correlated independently with eGFR. Furthermore, there was a stepwise increase in baPWV, corresponding to advances in CKD through stages 1 to 5. When CKD stage 3 was divided at eGFR 45 mL/min/1.73 m2, the baPWV of stage 3b (eGFR 30 to 44) was significantly higher than that of stage 3a (eGFR 45 to 59) independent of traditional risk factors, suggesting that an eGFR of 45 mL/min/1.73 m2 may be a critical cut off value to predict arterial stiffness in CKD. In conclusion, the newly proposed eGFR is significantly associated with arterial stiffness, independent of traditional risk factors for cardiovascular disease.

DOI： 10.1291/hypres.31.193

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Visual display terminal (VDT) work has become very common among office workers in developed countries; however, studies investigating the association between the duration of daily VDT work and insomnia are limited. METHODS: The aim of this study was to clarify the association between the duration of daily VDT work and sleep disturbances. We investigated 2,417 clerks (men, 2,030; women, 387) at local government offices. Sleep disturbances were evaluated using the Athens Insomnia Scale (AIS). RESULTS: VDT work of 6 hr or more per day was significantly associated with insomnia (odds ratio = 1.62, 95% confidence interval: 1.16-2.27) and, in particular, caused problems with "total sleep duration" and "sleepiness during the day" among sleep-related symptoms, even after adjusting for possible confounding factors. CONCLUSIONS: Our study suggested that VDT work of 6 hr or longer per day was related to insomnia.

DOI： 10.1002/ajim.20543

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掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.archger.2007.08.015

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

We measured the concentrations of polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), non-ortho coplanar polychlorinated biphenyls (non-ortho PCBs), and mono-ortho coplanar polychlorinated biphenyls (mono-ortho PCBs) in blood collected between 2002 and 2004 from 195 pregnant women living in Sapporo City of Hokkaido Prefecture, Japan. The present study is one of the few studies in which PCDDs, PCDFs, and dioxin-like PCBs have been measured in the blood of pregnant women. Of the 195 pregnant women, 101 were primipara (mean: 28.8 years) and 94 were multipara (mean: 32.4 years). The arithmetic mean total TEQ concentrations of PCDDs, PCDFs, non-ortho PCBs, and mono-ortho PCBs of primiparous and multiparous mothers in Sapporo City were 17.4 (median: 15.7) and 14.0 (median: 13.9)pgTEQ/glipid, respectively, and the concentrations were in the range of 6.6-43.4 and 3.4-28.2pgTEQ/glipid, respectively. In regard to the relationship between the total TEQ concentrations of PCDDs, PCDFs, non-ortho PCBs, and mono-ortho PCBs in maternal blood and the number of deliveries or age of primiparous and multiparius mothers, the levels of these dioxin-like compounds tended to decrease with increases in the number of deliveries and significantly increased with increasing maternal age in both groups. Furthermore, significant correlations were observed between the total TEQ concentrations of these dioxin-like compounds and the age of primiparae and multiparae. The total TEQ concentration of PCDDs, PCDFs, non-ortho PCBs, and mono-ortho PCBs measured in 195 pregnant women has decreased compared to past levels in Japan for the last several decades. The results of the present study have indicated that dioxin contamination in the blood of young women in Japan is continuing to decrease.

DOI： 10.1016/j.chemosphere.2007.05.083

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

AIM: To investigate whether the pro- and anti-inflammatory cytokine gene polymorphisms, IL1B-511C/T, IL1B-31C/T, IL6-634C/G, TNF-1031T/C, TNF-857C/T, and IL10-1082A/G, interact with smoking and drinking habits to influence infection with H pylori. METHODS: The subjects were 410 Japanese transit company employees. C-reactive protein and conventional cardiovascular risk factors were evaluated. Serum anti-H pylori antibodies were measured. The genotypes of IL1B-511C/T, IL1B-31C/T, IL6-634C/G, TNF-1031T/C, TNF-857C/T, and IL10-1082A/G polymorphisms were determined by allelic discrimination using fluorogenic probes and a 5' nuclease assay. RESULTS: In gender- and age-adjusted logistic analyses, the subjects with TNF-857T/T had a significantly lower odds ratio (OR) for H pylori seropositivity (reference -857C/C; OR = 0.15, 95% CI: 0.03-0.59, P = 0.007). After stratification according to smoking and drinking status, among never-smokers, the subjects with IL1B-511C/T had a significantly lower OR (reference -511C/C; OR = 0.30, 95% CI: 0.10-0.90, P = 0.032). Among drinkers in the 1-5 times/wk category, the subjects with IL1B-511T/T had a significantly lower OR (reference C/C; OR = 0.38, 95% CI: 0.16-0.95, P = 0.039), and the subjects with IL1B-31C/T and T/T had a significantly higher OR (reference C/C; C/T: OR = 2.59, 95% CI, P = 0.042: 1.04-6.47; C/C: OR = 3.17, 95% CI: 1.23-8.14, P = 0.017). Among current smokers, the subjects with IL6-634C/G had a significantly higher OR (reference C/C; OR = 2.28, 95% CI: 1.13-4.58, P = 0.021). However, the interactions terms between the aforementioned genotypes and lifestyles were not statistically significant. CONCLUSION: Contrary to previous findings, the results herein suggest that the TNF-857T/T genotype may be protective against chronic infection with H pylori. Drinking and smoking habits may influence the effect of cytokine gene polymorphisms. Further studies are required to clarify the effects of the pro- and anti-inflammatory cytokine polymorphisms and gene-environmental interactions on H pylori infection.

DOI： 10.3748/wjg.v13.i33.4445

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: Two simple, commercially available and semiquantitative dust mite allergen tests, namely, the Acarex test(®) and Mitey Checker(®), were compared using 2 and 10 μg of Der 1 allergen per gram of dust, as evaluated by enzyme-linked immunosorbent assay (ELISA), to clarify which method is better suited for practical use. METHODS: Mite allergen exposure levels of 106 floor, bed and sofa surfaces were evaluated by the Acarex test(®), Mitey Checker(®), and ELISA. A template of 100 cm×100cm was placed on the same surfaces to identify the examined areas. A dust collection filter was attached to a vacuum cleaner, and the area in the template (1 m(2)) was vacuumed. Then, to evaluate the other two tests, samples from the two other areas in the template (1 m(2)) that neighbored each other and did not overlap were vacuumed. RESULTS: To predict Der 1 levels of 2 μg/g dust or higher, the sensitivity and specificity of the Acarex test(®) were 100% and 13.3%, and those, of Mitey Checker(®) were 91.8% and 71.1%, respectively. To predict Der 1 levels of 10 μg/g dust or higher, the sensitivity and specificity of the Acarex test(®) were 50.0% and 96.2%, and those of Mitey Checker(®) were 85.7% and 79.5%, respectively. Compared with Der 1<2.0, 2.0-9.9.≥10.0 (μg/g dust), the percent agreement and kappa of the Acarex test(®) were 47.2% and 0.234, and those of Mitey Checker(®) were 70.0% and 0.505, respectively. CONCLUSION: To evaluate mite allergen exposure level for practical use in Japanese living environments, Mitey Checker(®) is better than the Acarex test(®) because of its higher sensitivity and specificity.

DOI： 10.1265/ehpm.12.187

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Smoking and interleukin-6 (IL-6) are major factors in inflammation. The aim of this study was to investigate whether or not the IL6 -634C/G polymorphism (rs1800796) and its interaction with smoking influence serum C-reactive protein (CRP) concentrations. The subjects were 347 Japanese male employees of a transit company. CRP and conventional cardiovascular risk factors were evaluated. IL6 -634C/G polymorphisms were genotyped by allelic discrimination using fluorogenic probes and the 5' nuclease assay. The mean values of CRP were significantly higher in current smokers than in nonsmokers after adjustment for age, body mass index (BMI), systolic blood pressure, total cholesterol, log triglycerides, high-density lipoprotein cholesterol (HDL-C), fasting glucose, and drinking habit (p=0.011). Comparison of three genotypes revealed significant interaction between smoking and the IL6 -634C/G genotype manifested by CRP concentrations (p=0.007) after the adjustments cited above. After stratification by smoking status, CRP differed significantly among IL6 -634C/G genotypes groups in nonsmokers (p=0.010, p for trend=0.007), whereas no significant difference was found in current smokers. Comparison between -634C/C and C/G+G/G groups revealed also a significant interaction between smoking and the IL6 -634C/G genotype (p=0.007). These findings suggest that the impact of the -634G allele on CRP elevation is greater in nonsmokers than in current smokers. Since gene-environment interactions have been insufficiently examined, further studies are required to clarify their effect on inflammation, including CRP elevation.

DOI： 10.1291/hypres.30.593

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Associations between job stresses, as assessed by theoretical job stress model and depressive symptoms among fire fighters have not been fully investigated. The purpose of this study is to clarify the factors of job stress that influence the depressive symptoms in Japanese fire fighters. METHODS: The subjects involved 1,672 fire fighters from a local government. The questionnaire comprised age, gender, job type, job class, martial status, smoking, and drinking habit, the Center for Epidemiologic Studies Depression Scale (CES-D), and The National Institute for Occupational Safety and Health (NIOSH) generic job questionnaire. RESULTS: A group showing depressive symptoms (CES-D > or = 16) included 373 subjects (22.3%). In a multivariate logistic regression analysis, high variance in workload, high intergroup conflict, high role conflict, and low self-esteem had significantly higher odds ratio for depressive symptoms. CONCLUSIONS: High variance in workload, high intergroup conflict, high role conflict, and low self-esteem were significantly related to depressive symptoms among Japanese fire fighters. Further prospective studies are needed to clarify the influence of these stress factors on other health outcomes, and to elucidate whether alleviation of these stress factors improve the mental health among fire fighters.

DOI： 10.1002/ajim.20460

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

The aim of the present study was to identify relations between occupational stress and occupational class in Japanese civil servants, using two occupational stress models-the Effort-Reward Imbalance (ERI) Model and the Job Demand-Control (JDC) Model. The subjects were employees of three local public organizations. We distributed self-administered questionnaires and assessed occupational stress by ERI and JDC. We used seven occupational categories based on the Standard Occupational Classification for Japan. The data of 6,423 male and 1,606 female subjects were analyzed by logistic regression analysis to obtain odds ratios (OR) for relations between occupational stress and occupational class. In JDC, male clerical workers, transport/communication workers and protective service workers showed a significantly higher OR of being in the high occupational stress group, compared to managers. In ERI, male professionals/technicians, transport/communication workers, clerical workers and protective service workers showed a significantly higher prevalence OR, compared to managers, the two models giving different results. In ERI, female production workers/laborers and clerical workers had a significantly lower prevalence OR, compared to managers. The results of this study showed that occupational stress differed by occupational class and the two occupational stress models gave different results for occupational classes with high occupational stress.

DOI： 10.2486/indhealth.45.247

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.numecd.2006.08.002

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES: The pathophysiologic processes that occur at the cellular and molecular levels in intrauterine fetal growth restriction are largely unknown. Catechol-O-methyltransferase (COMT) is a phase II enzyme that inactivates catechol estrogens by transfer of a methyl group. A functional Val158Met polymorphism in the COMT gene has been known as a susceptible marker for breast cancer. The aim of this study was to examine the association between this polymorphism and fetal growth. METHODS: A consecutive series of 412 women who experienced singleton deliveries was assessed in the birth cohort study. Genotyping of COMT and CYP17A1 polymorphisms was determined by allelic discrimination using fluorogenic probes and the 5'nuclease assay. RESULTS: The adjusted odds ratio for the risk of low birth weight (<2.500 g) in women with homozygous low-activity (COMT-L) alleles was 2.98 (95% confidence interval, 1.10-8.11). The mean birth weight of infants whose mothers were homozygous for COMT-L was less than that of infants whose mothers had at least one high-activity (COMT-H) allele (2.610 versus 2.800 g, P=0.07). The odds ratio for the risk of intrauterine fetal growth restriction, defined as birth weight <10th percentile or <mean-1.5 SD, in women homozygous for COMT-L alleles was 2.63/2.57 (95% confidence interval, 1.14-6.05/0.96-6.88). In the recessive genotype model, the odds ratios for the risk of low birth weight and intrauterine fetal growth restriction in women homozygous for COMT-L were 3.36 (95% confidence interval, 1.30-8.65) and 2.89/2.65 (95% confidence interval, 1.31-6.34/1.06-6.65), respectively. A positive association exists between birth weight and the homozygous CYP17A1 A2 genotype (P<0.01). When both COMT and CYP17A1 genotypes were considered, the highest risk of low birth weight/intrauterine fetal growth restriction was found among women with the homozygous COMT-L and CYP17A1 A1 genotype. The odds ratio for the risk of intrauterine fetal growth restriction (<10th percentile) in those women was 5.35 (95% confidence interval, 1.15-25.0). CONCLUSION: Our findings suggest that the allele encoding low-activity COMT may be a susceptible marker for intrauterine fetal growth restriction.

DOI： 10.1097/01.fpc.0000230116.49452.c0

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

The aim of this study was to investigate whether the metabolic syndrome (MS) was associated with an elevated level of C-reactive protein (CRP) and increased arterial stiffness, and to clarify whether combined MS and CRP data had a stronger relation to arterial stiffness than did MS data alone. Brachial-ankle pulse wave velocity (baPWV), CRP, and conventional risk factors were evaluated in 3,412 men and 854 women. Adjusted mean values of baPWV in men with 0, 1, 2, and > or = 3 components were 1,309, 1,372, 1,422, and 1,462 cm/s, respectively (p for trend <0.001). Adjusted mean values of baPWV in women with 0, 1, 2, and > or =3 components were 1,212, 1,292, 1,357, and 1,391 cm/s, respectively (p for trend <0.001). Adjusted geometric mean concentrations of CRP in men with 0, 1, 2, and > or = 3 components were 0.036, 0.049, 0.059, and 0.076 mg/dI, respectively (p for trend <0.001). Adjusted geometric mean concentrations of CRP in women with 0, 1, 2, and > or = 3 components were 0.023, 0.030, 0.057, and 0.077 mg/dI, respectively (p for trend <0.001). In analyses of adjusted mean values of baPWV according to the number of MS components and according to CRP levels within or without top quartile levels, the p value for the trend was significant (<0.001) in both men and women but, in post hoc analyses, comparing high and low CRP levels in each MS component-number group, no significant difference was found. These results suggest that, for prediction of increased arterial stiffness, combining MS and CRP data has little additive effect compared to the use of MS data alone.

DOI： 10.1291/hypres.29.589

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Pregnancy-associated plasma protein-A (PAPP-A)/insulin-like growth factor-binding protein-4 (IGFBP4) protease is a member of the metzincin family of metalloproteases, known as a sensitive biomarker of adverse pregnancy outcomes. Recently, a missense A/C (Tyr/Ser) polymorphism (dbSNP: rs7020782) in the PAPPA gene has been reported. To examine the association between recurrent pregnancy loss (RPL) and this polymorphism, a case-control study of 215 cases with two or more pregnancy losses (PLs) and 420 fertile controls was performed. Genotyping of the PAPPA polymorphism was determined by allelic discrimination using fluorogenic probes and the 5' nuclease assay. Sixty-nine cases (32.1%) were heterozygous and 11 cases (5.1%) were homozygous for the C allele of PAPPA; the respective figures were 127 (30.2%) and 11 (2.6%) in the controls. Women carrying the C allele had a tendency to increased risk of RPL (AA genotype [reference]; AC genotype: odds ratio [OR], 1.17; 95% confidence interval [CI], 0.82-1.68; CC genotype: OR, 2.06; 95% CI, 0.87-4.90), but it was not significant. Women with three or more PLs had a similar tendency (AA genotype [reference]; AC genotype: OR, 1.04; 95% CI, 0.66-1.64; CC genotype: OR, 2.20; 95% CI, 0.82-5.91). The risk of RPL with at least one PL after 9 weeks' gestation significantly increased in women carrying the C allele (AA genotype [reference]; AC genotype: OR, 1.54; 95% CI, 0.95-2.49; CC genotype: OR, 2.83; 95% CI, 1.00-8.05; AC+CC genotypes: OR, 1.65; CI, 1.04-2.62). This is the first report on the PAPPA gene polymorphism in women with RPL, demonstrating some association between the investigated polymorphism and the risk of RPL.

DOI： 10.1016/j.jri.2005.11.004

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Several studies have shown that prenatal and/or postnatal background-level exposure to environmental chemicals, such as polychlorinated biphenyls (PCBs) and dioxins, induces adverse effects on the neurodevelopment of children. However, other studies have not detected any harmful influences on neurodevelopment. Furthermore, except in western countries, no developmental tests have been carried out in relation to detailed assessment of exposure to PCBs and dioxins. In this study (the Hokkaido Study on Environment and Children's Health), the effect of prenatal exposure to background levels of PCBs and dioxins on infant neurodevelopment in Japan/Sapporo was elucidated. The associations between the total or individual isomer level of PCBs and dioxins in 134 Japanese pregnant women's peripheral blood and the mental or motor development of their 6-month-old infants were evaluated using the second edition of the Bayley Scales of Infant Development. The mean level of total toxicity equivalency quantity (TEQ) was 18.8 (4.0-51.2) pg/g lipid in blood of 134 mothers. After adjustment for potential confounding variables, the total TEQ value was shown not to be significantly associated with mental developmental index (MDI) or psychomotor developmental index (PDI). However, the levels of one polychlorinated dibenzo-p-dioxin (PCDD) isomer, total PCDDs, and total PCDDs/polychlorinated dibenzofurans (PCDFs) were significantly negatively associated with MDI, and the levels of two PCDD isomers and three PCDF isomers were significantly negatively associated with the PDI. In conclusion, the background-level exposure of several isomers of dioxins during the prenatal period probably affects the motor development of 6-month-old infants more than it does their mental development.

DOI： 10.1289/ehp.8614

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掲載種別：研究論文（学術雑誌）  

DOI： 10.1093/molehr/gal013

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Acute myocardial infarction (AMI) has gradually been increasing in Japan; however, since the burden of Japanese residents for risk factors (RFs) of AMI, such as hypercholesterolemia, is chronologically less accumulated compared with American and European people, their RFs of AMI may be different from those in western countries. To answer this question, a retrospective community-based study was carried out enrolling 722 first time AMI patients in Hokkaido, the northern island of Japan. As controls, 1748 age-, sex- and residence-matched subjects were randomly chosen from a data-base of a health check-up organization. We assessed associations between premorbid variables and the RFs for AMI. In men, the most important predictor reflected by high odds ratio (OR) was low HDL-cholesterol (HDL-C). Hypertension (HT) and impaired glucose tolerance (IGT) were also independent RFs. In women, HT represented the highest OR, and low HDL-C, high triglyceride (TG) and IGT followed. Total cholesterol (TC) was a negative predictor for AMI in both sexes, because mean TC level of AMI patients was less than that of controls probably because of acute phase reaction. Thus, low HDL-C, HT, IGT and high TG, which represent the state of metabolic syndrome, were important predictors of AMI. And it was suggested that low HDL-C plays a pivotal role in a population whose TC level is not high.

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: The objective of this study was to elucidate the relationship between risk factors and the coronary artery disease (CAD) in young middle-aged Japanese men. METHODS: A cohort study of 2,764 young middle-aged Japanese men aged 3544 (mean+/-SD: 42.3+/-2.5) years based on a 10-year followup to identify the risk factors for the occurrence of CAD was conducted. There were 35 cases of CAD during the follow up; 25 myocardial infarctions and 10 angina pectoris. The Cox Proportional hazard model was used to identify the independent risk factors for CAD. Adjustment was made for variables including age, body mass index, smoking habit, systolic blood pressure, total cholesterol (TC), high-density lipoprotein cholesterol (HDLC), fasting plasma glucose (FPG), and triglyceride. RESULTS: TC, low HDLC, and FPG were identified as significant independent risk factors for CAD. Adjusted hazard ratio (HR) of a high level of TC> or = 220 (mg/dl) for CAD was 5.46 (95% confidence interval (CI): 1.9617.51) and that of a high level of HDLC<50(mg/dl) was 9.01 (95%CI: 1.1372.17), and a high level of FPG> or = 110 (mg/dl) was 2.94 (95%CI: 1.228.23). Considering the combination of these risk factors, adjusted HR for CAD of the subjects who had 2 risk factors was 8.37 (95%CI: 2.2131.65). CONCLUSIONS: Using the database of young middle-aged Japanese men, TC, low HDLC, and FPG were found to be important risk factors for CAD, and the combination of these risk factors was associated with CAD.

DOI： 10.2169/internalmedicine.45.1532

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Here we evaluate the influence of individual genetic polymorphisms of drug-metabolizing enzymes as well as body mass index (BMI) and lifestyle (smoking, alcohol consumption) on urinary metabolites after occupational exposure to styrene. Seventy-three workers exposed to styrene in a reinforced-plastics workplace were studied. The personal styrene exposure in the air and the urinary styrene metabolites mandelic acid and phenylglyoxylic acid were measured. The subjects' genetic polymorphisms in the genes that encode the styrene-metabolizing enzymes CYP2E1, CYP2B6, EPHX1, GSTM1, GSTT1 and GSTP1 were determined. Neither genotype nor lifestyle significantly affected urinary metabolites. There was, however, an interaction between the CYP2E1 genotype and smoking. Among non-smokers, urinary styrene metabolites were significantly decreased in subjects with c1/c1 alleles of CYP2E1 as compared with those with the c1/c2 genotype. There was no significant difference in urinary metabolites among smokers. When the combined influence of the CYP2B6 genotype and the predicted activity of EPHX1 were examined, urinary metabolites in subjects with low enzyme activity were lower than in those with medium or high activity after high styrene exposure (>or=50 ppm). The results suggest that genetic susceptibility and lifestyle should be considered in biological monitoring of exposure to styrene.

DOI： 10.1016/j.toxlet.2005.06.011

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

The relationships between C-reactive protein (CRP), uric acid (UA), glomerular filtration rate (GFR), and arterial stiffness have not been fully investigated. The aim of this study was to clarify whether CRP, UA, and estimated GFR are related to arterial stiffness estimated using brachial-ankle pulse wave velocity (baPWV). The subjects were local government employees (3412 men and 854 women). baPWV, CRP, UA, GFR, and conventional risk factors were evaluated. Multiple linear regression analyses revealed that CRP and UA were significantly related to an elevation of PWV in male and female subjects, and that the estimated GFR was significantly related to an elevation of PWV in male subjects. Significant progressive increases in baPWV were observed across the quartiles of CRP in male subjects and for UA in male and female subjects. In female subjects, the relationship of quartile CRP to baPWV had marginal significance (P=0.055). But, in male and female subjects, quartile of estimated GFR had no significant association with PWV. These results suggest that CRP and UA are associated with an increase of arterial stiffness in male and female subjects, and that estimated GFR is possibly related to arterial stiffness in male subjects.

DOI： 10.1038/sj.jhh.1001913

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: Hypothermic circulatory arrest has been an important tool in aortic arch surgery, even though its use has recently been discussed controversially. We sought to clarify the role of hypothermic circulatory arrest as a risk factor for mortality and neurologic morbidity in aortic surgery by using a propensity score-matching analysis. METHODS: Five hundred eleven patients (60 +/- 13 years, 349 male patients) who underwent replacement of the ascending aorta with (n = 273) or without (n = 238) arch involvement were analyzed by means of multivariate analysis. Using propensity score matching, we identified comparable patient groups: HCA(+) group and HCA(-) group (n = 110 each). For aortic arch replacement, hypothermic circulatory arrest was used with a mean duration of 14 +/- 9 minutes: 12 +/- 7 minutes or 26 +/- 8 minutes for partial or total arch replacement, respectively. RESULTS: In the entire cohort multivariate analysis identified acute dissection and duration of cardiopulmonary bypass as significant predictors for hospital death. Predictors for stroke were acute dissection, diabetes mellitus, peripheral arterial disease, and concomitant mitral valve surgery, and predictors for temporary neurologic dysfunction were peripheral arterial disease and age. After propensity score matching, the incidence of death (HCA[+]: 0.9% vs HCA[-]: 2.7%), stroke (0% vs 1.8%, respectively), and temporary neurologic dysfunction (15.5% vs 13.6%, respectively) was comparable between the 2 groups. Multivariate analysis identified age, diabetes mellitus, peripheral arterial disease, and concomitant coronary artery bypass grafting as the independent risk factors for temporary neurologic dysfunction. CONCLUSIONS: In a standard clinical setting (hypothermic circulatory arrest of <30 minutes and nasopharyngeal temperature of <20 degrees C), hypothermic circulatory arrest constitutes no significant risk for mortality or neurologic morbidity and thus appears clinically safe. Patient-related risk factors primarily determine clinical outcome.

DOI： 10.1016/j.jtcvs.2005.03.043

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Recently, several investigations concerning disadvantageous genetic factors in human reproduction have progressed. Inherited thrombophilia, such as factor V Leiden, prothrombin, and methylenetetrahydrofolate reductase mutations; gene polymorphisms of detoxification enzyme (CYP1A1); growth factors (insulin-like growth factor-I); and hormones such as angiotensinogen and CYP17 are involved in the pathogenesis of fetal growth restriction. The inherited thrombophilia, gene polymorphisms of coagulation and anticoagulation factor such as thrombomodulin, endothelial protein C receptor, plasminogen activator inhibitor 1, and factor XIII; human lymphocyte antigen (HLA-G); detoxification enzymes (glutathione- S-transferase M1); cytokines such as interleukin (IL) -1 and IL-6; hormones (CYP17); vasodilators (nitric oxide synthase 3); and vitamins (transcobalamin) are involved in the pathogenesis of sporadic and recurrent miscarriage. It is likely that a gene polymorphism or mutation susceptible to reproductive failure has a beneficial effect on the process of human reproduction with or without the environmental interaction. The factor V Leiden mutation has genetic advantages that are believed to be an improved implantation rate in in vitro fertilization and a reduction of maternal intrapartum blood loss. It has also been demonstrated that the CYP17 A2 allele has bidirectional effects on human reproduction, including increases in susceptibility to recurrent miscarriage and fetal growth enhancement.

DOI： 10.1055/s-2005-872441

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Beta2-Microglobulin (beta2m) is related to inflammatory diseases, but there have been few reports of a relationship between beta2m and atherosclerosis. We have examined the influence of beta2m on brachial-ankle pulse wave velocity (baPWV) to clarify whether it is related to arterial stiffness. baPWV, beta2m, C-reactive protein (CRP), and conventional risk factors were measured in 614 males and 158 females. The adjusted means of baPWV were compared with the quartiles of beta2m, and significant differences in baPWV were observed across the quartiles of beta2m (p = 0.037). After being adjusted for potential confounders, quartile 4 of beta2m, quartile 4 of CRP, and the combination of high beta2m plus high CRP were significantly associated with a high value of PWV (quartile 4 of beta2m: odds ratio [OR] 2.53, 95% confidence interval [CI], 1.31-4.89; quartile 4 of CRP: OR 2.27, 95% CI, 1.18-4.34; high beta2m plus high CRP: OR 5.60, 95% CI, 2.38-13.2). These results suggest that beta2m is associated with an increase of arterial stiffness. Further studies are needed to clarify whether beta2m is related to atherosclerotic diseases, and whether the combination of beta2m and CRP measurement is a useful predictor for the development of atherosclerosis.

DOI： 10.1291/hypres.28.505

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

STUDY OBJECTIVE: The aims of this study were to (a) examine the association between occupational stress and insomnia and short sleep in Japanese workers and (b) demonstrate the difference between 2 occupational stress models-Effort Reward Imbalance and the Demand Control Model. DESIGN: All data were obtained via self-administrated questionnaires and annual health checkups. Insomnia was evaluated by the Athens Insomnia Scale, and short sleep was defined as less than 6 hours sleep per day. SETTING: Employees at local governments and a transit company who had annual health checkups during the period from April 2003 to March 2004. PARTICIPANTS: After excluding participants without complete data, data from 6,997 men and 1,773 women were analyzed. INTERVENTION: N/A. MEASUREMENTS AND RESULTS: In men, high occupational stresses were significantly associated with insomnia, especially a high level of Effort Reward Imbalance (defined as the presence of high effort and low reward), had a remarkably higher odds ratio. In women, high occupational stresses were significantly associated with insomnia as well. High occupational stresses were significantly associated with short sleep in men. However, in women, only Effort Reward Imbalance showed a significant association with short sleep. CONCLUSIONS: This study suggested that occupational stress is a possible risk factor for insomnia and short sleep.

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: To investigate the relationships between sick building syndrome and mold in newly-built dwellings. METHODS: Symptoms of 61 residents in 18 dwellings were surveyed by standardized questionnaires. Mold sampling was done by gravity sampling using an open Petri dish. Potato dextrose agar (PDA) and dichloran-18% glycerol agar (DG-18) were used as the culture medium. RESULTS: There were 6 dwellings in which at least one inhabitant complained of one or more symptoms and 12 dwellings in which none of the inhabitants complained of symptoms. There was a tendency for the dwellings with inhabitants reporting symptoms to have larger colony forming units (CFU) on PDA than those without inhabitants reporting symptoms (p=0.1), but there was no difference in DG-18 result. There was a tendency for the dwellings with inhabitants reporting symptoms to have larger CFU ofCladosporium on PDA than those without (p=0.08), but there was no difference in DG-18 result. Significantly moreUlocladium sp. was detected in the dwellings with inhabitants reporting symptoms than in those without (p=0.03).Cladosporium cladosporioides was detected in all the dwellings with inhabitants reporting symptoms and 75% of the dwellings without.Cladosporium macrocarpum andCladosporium herbarum were detected in 33% of the dwellings with inhabitants reporting e symptoms and none of the dwellings without (p=0.1). CONCLUSION: Cladosporium was dominant in the Japanese newly-built dwellings studied, andCladosporium andUlocladium were probably associated with the residents' symptoms in these newly-built dwellings.

DOI： 10.1007/BF02900809

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Some case-control studies have demonstrated that caffeine intake and high CYP1A2 activity increase risks of recurrent pregnancy loss (RPL) but the multifactorial effect is obscure. To investigate whether susceptible women who have more caffeine intake are at high risk of RPL, a case-control study of 58 cases with two or more RPL and fertile 147 controls was performed. The association between daily caffeine intake together with CYP1A21F (AA versus CA and CC) genotype and RPL was assessed. Without consideration of the genotype, there were no significant differences of the RPL risk in proportion to daily caffeine intake [less than 100 mg (reference); 100-299 mg: odds ratio (OR), 1.29; 95% confidence interval (CI), 0.66-2.50; 300 mg or more: OR, 1.82; 95% CI, 0.72-4.58; P for trend, 0.20]. However, the RPL risk significantly increased only among women who had homozygous CYP1A21F alleles with a dosage effect of daily caffeine intake [less than 100 mg (reference); 100-299 mg: OR, 1.94; 95% CI, 0.57-6.66; 300 mg or more: OR, 5.23; 95% CI, 1.05-25.9; P for trend, 0.03]. It was demonstrated for the first time that an increase in caffeine intake deteriorates the fecundity among susceptible women.

DOI： 10.1093/molehr/gah175

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

The role of Helicobacter pylori in the pathogenesis of atherosclerosis remains controversial, and the relationship between H. pylori and the early stage of atherosclerosis has not been fully investigated. We investigated the influence of H. pylori infection on arterial stiffness to clarify whether H. pylori infection is related to early-stage atherosclerosis. The subjects were 3,412 males and 854 females. Anti-H. pylori antibody and C-reactive protein (CRP) level were measured. Arterial stiffness was evaluated using the brachial-ankle pulse wave velocity (PWV). In multivariate logistic repression analyses of male subjects, H. pylori seropositivity (odds ratio [OR] 1.27 [95% confidence interval, 1.05-1.52]) and H. pylori seropositivity with a high CRP value (>0.045 mg/dl) (OR 1.50 [1.14-1.98]) were significantly related to a high value of PWV. In the analyses of male subjects aged < or = 49 years, H. pylori seropositivity (OR 1.40 [1.04-1.88]) and H. pylori seropositivity with a high CRP value (OR 1.81 [1.16-2.80]) were also significantly related to a high value of PWV. However, in male subjects aged > or = 50 years and female subjects, no associations were found. These results suggest that inflammation following H. pylori infection contributes to the early stage of atherosclerosis in younger males.

DOI： 10.1291/hypres.28.283

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: Although naloxone has been used to prevent ischemic spinal cord injury (SCI), its effect on excitatory amino acids (EAAs) has not been understood. We investigated the clinical significance of naloxone by measuring EAAs in the cerebrospinal fluid (CSF) in patients undergoing thoracoabdominal aortic surgery. METHODS AND SUBJECTS: Twenty-seven patients (15 men and 12 women; mean age, 66 +/- 12 years) undergoing prosthetic replacement of the thoracoabdominal aorta (n = 19) or the descending thoracic aorta (n = 8) from April 1997 to June 2003 under distal perfusion and mild hypothermia were enrolled in this cohort study with historical controls. Their etiology was 7 dissections and 20 nondissections. In 16 patients (naloxone group), intravenous infusion of naloxone (1 microg/kg/h) was continued until the patients became alert. In the remaining 11 patients (control group) naloxone was not given. CSF drainage was used in all patients. CSF levels of EAAs, glutamate, aspartate, and glycine were measured at 6 points in time until 72 hours postoperatively, using a high-performance liquid chromatography method. RESULTS: In 5 patients with SCI (2 patients in control group, 3 in naloxone group), CSF levels of glutamate and glycine continued to increase even at 72 hours postoperatively, and were significantly more elevated than those in patients without SCI ( P < .0001, glutamate; P = .0006, glycine). Postoperative maximum levels of CSF glutamate and glycine were also significantly higher in patients with postoperative SCI than in patients without SCI (glutamate: 215.3% +/- 158.6% vs 32.9% +/- 37.3% increase from baseline, P < .0001; glycine: 309.1% +/- 218.2% vs 89.2% +/- 103.1% increase from baseline, P = .0036). CSF levels of glutamate and aspartate in naloxone group were significantly lower than those in control group ( P = .0161, glutamate; P < .0001, aspartate). Postoperative maximum level of CSF aspartate was also significantly lower in the naloxone group than in the control group (8.3% +/- 75.5% vs 119.7% +/- 120.6% increase from baseline, P = .0077). In multivariate logistic regression analysis, postoperative maximum CSF glutamate >100% from baseline ( P < .001) and postoperative maximum level of CSF glycine ( P = .005)were identified as the independent risk factors for SCI. Both SCI ( P < .001) and postoperative maximum level of CSF glycine ( P = .005) were the independent predictors for postoperative maximum level of CSF glutamate >100% from baseline. CONCLUSIONS: CSF levels of EAAs are elevated in patients with SCI. CSF glutamate is the strongest independent predictor of SCI. Naloxone is effective in lowering CSF levels of EAAs.

DOI： 10.1016/j.jvs.2004.07.005

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掲載種別：研究論文（学術雑誌）   出版者・発行元：Springer Science and Business Media LLC  

DOI： 10.1007/s00420-004-0535-0

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

This is a pre-copy-editing, author-produced PDF of an article accepted for publication in Journal of Biochemistry following peer review. The definitive publisher-authenticated version Saijo, Y. ; Sata, F. ; Yamada, H. ; Suzuki, K. ; Sasaki, S. ; Kondo, T. ; Gong, Y. ; Kato, EH. ; Shimada, S. ; Morikawa, M. ; Minakami, H. ; Kishi, R., MHR: Basic science of reprod. Medicine, 10(10), 2004, 729-733 is available online at: http://molehr.oxfordjournals.org/cgi/content/abstract/10/10/729.The etiology of recurrent pregnancy loss (RPL) remains unclear, but it may be related to a possible genetic predisposition together with involvement of environmental factors. We examined the relation between RPL and polymorphisms in four genes, human aryl hydrocarbon (Ah) receptor, cytochrome P450 (CYP) 1A1, CYP1A2 and CYP1B1, which are involved in the metabolism of a wide range of environmental toxins and carcinogens. All cases and controls were women resident in Sapporo, Japan and the surrounding area. The Ah receptor, CYP1A1, CYP1A2 and CYP1B1 genotypes were assessed in 113 Japanese women with recurrent pregnancy loss (RPL) and 203 ethnically matched women experiencing at least one live birth and no spontaneous abortion (control). No significant differences in Ah receptor, CYP1A1, CYP1A2 and CYP1B1 genotype frequencies were found between the women with RPL and the controls [Ah receptor: Arg/Arg (reference); Arg/Lys and Lys/Lys, odds ratio (OR)=0.67; 95% confidence interval (CI)=0.40–1.11, CYP1A1: m1m1 (reference); m1m2 and m2m2, OR = 0.86; 95% CI = 0.53-1.40, CYP1A2: C/C and C/A (reference); A/A, OR = 1.16; 95% CI = 0.71-1.88, CYP1B1: Leu/Leu (reference); Leu/Val and Val/Val, OR = 1.18; 95% CI = 0.68–2.02]. The present study suggests that the Ah receptor, CYP1A1, CYP1A2 and CYP1B1 gene polymorphisms are not major genetic regulators in RPL.

DOI： 10.1093/molehr/gah096

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

PROBLEM: Enhanced secretion of type-2 T-helper (Th2) cytokine is a characteristic feature in normal physiological pregnancy. A study has demonstrated defective production of interleukine-4 (IL-4) and other Th2 cytokine in women with recurrent pregnancy loss (RPL). Several studies have suggested that IL-4 variable number of tandem repeat (VNTR) gene polymorphism is probably associated with different IL-4 production. METHODS OF STUDY: The IL-4 VNTR genotypes were assessed in 109 Japanese women with RPL and 210 ethnically matched women experiencing at least one live birth and no spontaneous abortion. RESULTS: No significant differences in IL-4 VNTR genotype frequencies were found between the RPL and the control [B1B1 genotype (reference); B1/B2 and B2/B2 genotypes, odds ratio, 0.91; 95% confidence interval, 0.58-1.45]. CONCLUSION: The present study suggests that the IL-4 VNTR allele is not a major genetic regulator in RPL.

DOI： 10.1111/j.1600-0897.2004.00193.x

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BLACKWELL MUNKSGAARD  

Problem: Enhanced secretion of type-2 T-helper (Th2) cytokine a characteristic feature in normal physiological pregnancy. A study has, demonstrated defective production of interleukine-4 (IL-4) and other Th2 cytokine in women with recurrent pregnancy loss (RPL). Several studies have suggested that IL-4 variable number of tandem repeat (VNTR) gene polymorphism is probably associated with different IL-4 production.
Methods of Study: The IL-4 VNTR genotypes were assessed in 109 Japanese women with RPL and 210 ethnically matched women experiencing at least one live birth and no spontaneous abortion.
Results: No significant differences in IL-4 VNTR genotype frequencies were found between the RPL and the control [B1B1 genotype (reference); B1/B2 and B2/B2 genotypes, odds ratio, 0.91; 95% confidence interval, 0.58-1.45].
Conclusion: The present study suggests that the IL-4 VNTR allele is not a major genetic regulator in RPL.

Web of Science

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Fluorinated organic compounds (FOCs), such as perfluorooctane sulfonate (PFOS), perfluoro-octanoate (PFOA), and perfluorooctane sulfonylamide (PFOSA), are widely used in the manufacture of plastic, electronics, textile, and construction material in the apparel, leather, and upholstery industries. FOCs have been detected in human blood samples. Studies have indicated that FOCs may be detrimental to rodent development possibly by affecting thyroid hormone levels. In the present study, we determined the concentrations of FOCs in maternal and cord blood samples. Pregnant women 17-37 years of age were enrolled as subjects. FOCs in 15 pairs of maternal and cord blood samples were analyzed by liquid chromatography-electrospray mass spectrometry coupled with online extraction. The limits of quantification of PFOS, PFOA, and PFOSA in human plasma or serum were 0.5, 0.5, and 1.0 ng/mL, respectively. The method enables the precise determination of FOCs and can be applied to the detection of FOCs in human blood samples for monitoring human exposure. PFOS concentrations in maternal samples ranged from 4.9 to 17.6 ng/mL, whereas those in fetal samples ranged from 1.6 to 5.3 ng/mL. In contrast, PFOSA was not detected in fetal or maternal samples, whereas PFOA was detected only in maternal samples (range, < 0.5 to 2.3 ng/mL, 4 of 15). Our results revealed a high correlation between PFOS concentrations in maternal and cord blood (r2 = 0.876). However, we did not find any significant correlations between PFOS concentration in maternal and cord blood samples and age bracket, birth weight, or levels of thyroid-stimulating hormone or free thyroxine. Our study revealed that human fetuses in Japan may be exposed to relatively high levels of FOCs. Further investigation is required to determine the postnatal effects of fetal exposure to FOCs. Key words: cord blood, fluorinated organic compounds, human, PFOA, PFOS, PFOSA, pregnancy.

DOI： 10.1289/ehp.6864

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掲載種別：研究論文（学術雑誌）   出版者・発行元：Wiley  

Aim:  Recent studies have suggested that the elevated C‐reactive protein (CRP) levels are associated with body fat, especially visceral adipose tissue, but most of them were investigated in Westerners who had higher body mass index (BMI) than Asians. To investigate the association between CRP concentrations, parameters of visceral obesity, the insulin resistance syndrome and carotid atherosclerosis in healthy Japanese who had a lower BMI than Westerners.

Methods:  We explored the relationships between fatness and visceral obesity parameters [by anthropometry, bioelectrical impedance analysis and abdominal computed tomography (CT)] and CRP (high sensitivity) and examined their associations with components of insulin resistance syndrome, interleukin‐6 (IL‐6), tissue necrosis factor‐α (TNF‐α) and intima‐media thickness (IMT) of common carotid arteries (CCAs) by ultrasonograms in 116 healthy Japanese subjects.

Results:  In crude regression analyses, CRP was significantly associated with measures of obesity. After adjustment for age, gender and smoking, the association with CRP was stronger for parameters of visceral obesity (waist circumference, waist‐to‐hip ratio and visceral adipose tissue accumulation) than for other parameters of obesity. IL‐6 and TNF‐α were not associated with CRP. Blood pressure (BP), metabolic variables and CCA‐IMT were also significantly associated with CRP. But, after being adjusted for age, gender, smoking and BMI, BP and high‐density lipoprotein cholesterol (HDLc) were significantly associated.

Conclusion:  CRP level is associated with visceral adipose tissue and is significantly associated with the components of insulin resistance syndrome in healthy Japanese subjects. These data support a possible role of visceral adipose tissue in inflammation component of atherosclerosis, and further studies are needed to study the mechanism of CRP elevation caused by visceral adipose tissue.

DOI： 10.1111/j.1462-8902.2003.0342.x

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: To investigate the relationships between recurrent pregnancy loss and single nucleotide polymorphisms (-634C-->G and -174G-->C genotypes) in the promoter region of the interleukin (IL)-6 gene in the Japanese population. DESIGN: A case-control study. SETTING: Obstetrics and gynecology department of a university hospital. PATIENT(S): Cases were 76 women with recurrent pregnancy loss; controls were 93 fertile women. INTERVENTION(S): Determination of IL-6 promoter gene polymorphisms performed by polymerase chain reaction and gel electrophoresis. MAIN OUTCOME MEASURE(S): Frequency and distribution of the promoter region of the IL-6 gene allele. RESULTS: There was a significant difference in the -634C-->G genotype frequency (CC vs. CG/GG) between women with recurrent pregnancy loss and controls. The risk of recurrent pregnancy loss was lower in the carriers of the G allele than in women with the wild type (CC) (odds ratio = 0.46; 95% confidence interval = 0.24-0.91). On the other hand, we did not detect any carrier of -174C among the 169 subjects. CONCLUSION(S): The results suggest that, in the Japanese population, women carrying the -634G allele of the IL-6 gene might have a decreased risk of recurrent pregnancy loss.

DOI： 10.1016/j.fertnstert.2003.06.023

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Intrauterine fetal growth restriction is a multifactorial disorder, and its aetiology includes both environmental and genetic components. We aimed to investigate whether maternal genetic polymorphisms of metabolic enzymes affects fetal growth and pregnancy duration. Genomic DNA was obtained from 134 women who experienced singleton deliveries beyond 24 weeks of gestation. Maternal age, birth weight, gestational age at birth and frequencies of fetal growth restriction, prematurity and pregnancy-induced hypertension were compared among genotypic subgroups of cytochrome p450 (CYP) and glutathione S-transferase (GST) genes. The polymorphisms of CYP1A1 (MspI), CYP17 (MspAI) and GSTP1 (BsmAI) genotypes, and the presence or absence of GSTM1 and GSTT1 genes were analysed by PCR-based methods. The frequency of fetal growth restriction (<10th percentile/<-1.5 SD; 22.7%/11.4%) in 44 women who were homozygous for the A1 allele (A1A1) of CYP17 was significantly higher than that (7.8%/2.2%) in 90 women who carried the A2 allele (A1A2/A2A2) of CYP17 (P < 0.05), with an odds ratio =3.41 (95% confidence interval = 1.18-9.84). The gestational age at birth (mean +/- SD, 37.5 +/- 3.1 weeks) in 67 women with GSTM1 null genotype was significantly lower than that (38.5 +/- 2.4 weeks) in 67 women who carried GSTM1 (P < 0.05). The polymorphism of CYP17 that encodes the cytochrome p450c17alpha enzyme might be associated with the pathophysiology underlying fetal growth restriction.

DOI： 10.1093/molehr/gah005

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掲載種別：研究論文（学術雑誌）  

DOI： 10.1093/molehr/gag089

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

Several previous reports have indicated an association between sleep apnea syndrome (SAS) and ischemic heart disease. However, it is not known whether SAS facilitates the development of coronary artery lesion. This is the first case report describing rapid progression of a coronary artery lesion observed in a SAS patient. In June, 1990, a 65-year-old man complaining of atypical chest pain was admitted to our hospital. The result of clinical examination for ischemic heart disease including thallium myocardial scintigraphy and coronary artery angiography (CAG) revealed no significant coronary artery disease. We finally made a diagnosis of SAS because of the positive results of overnight polysomnography showing an apnea index of 50 times/hour, and we instructed the patient mainly to control his body weight and his mild hypertension. In January, 1991, he suffered from acute myocardial infarction. CAG on admission demonstrated a total occlusion of his right coronary artery. Since this event, his chest pain has been controlled well with a calcium channel blocker, nitrates, and aspirin. However, his SAS had remained insufficiently treated. The nasal CPAP was found to be very effective for his SAS, but he refused its continuous use because of the unpleasant feeling he experienced when it was attached. In August, 1992, he was admmitted again because of a worsening type of chest pain on effort. CAG revealed a new lesion, 99% stenosis of his left anterior descending artery, which was subsequently treated by bypass grafting surgery. This case suggests that SAS may facilitate the progression of coronary artery lesion.

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記述言語：日本語   出版者・発行元：北海道公衆衛生学会  

地方で勤務する内科医による地方の医療を担う医師を増やす方策として有効と考える意見を質的に検討することを目的に、町・村の内科医・総合内科医への質問票調査を実施した。地方の医師を増やす有効な方法について自由記載で意見を求め、分析は自由記載データ(テクスト)を解釈するため、既存のカテゴリを使用する質的内容分析の手法を用いた。218人からの回答、総テクスト数335件が解析対象となった。テクスト数が最も多かったカテゴリは「負担軽減」、「金銭的インセンティブ」、「生活・福利面のサポート」の順であった。現在の医学部入試制度の強化や改革、地域医療を担当する事への義務化の意見も認めた。「負担軽減」では休日の確保や当直の負担軽減が重要と考えられ、また「金銭的インセンティブ」や「生活・福利面のサポート」があることも重要と考えられ、地方の医療担当医へのさらなるサポートも必要も考えられる。(著者抄録)

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記述言語：日本語   出版者・発行元：(一社)日本衛生学会  

科学的エビデンスに基づく「新シックハウス症候群に関する相談と対策マニュアル(改訂新版)」を作成したので紹介した。このマニュアルでは、近年震災や豪雨等の災害に伴って入居者が増えている仮設住宅の問題や、地球温暖化による熱中症と室内環境などの最近の問題、電磁過敏症に関する系統的レビューについて記載した。また、快適で健康な建物を実現する上で必要な基礎的な理論、設計の考え方と方法、建物の使い方、設備の調整の方法や扱い方についても解説した。

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記述言語：日本語   出版者・発行元：北海道公衆衛生学会  

かかりつけ医制度の推進について北海道の内科医の意見を把握する目的で質問票調査を行った。かかりつけ医制度は、義務化すべき・推進すべきとの意見は合わせて51.7%であった。かかりつけ医制度を義務化・さらに推進するべきは、多変量解析にて50歳以上が有意に低いオッズ比であった。選定療養費対象病院を増やすべきは、70歳以上が有意に低いオッズ比であった。選定療養費を増額すべきは、院長・副院長・所長が有意に高いオッズ比であった。自由記載から、「かかりつけ医の役割強化」、「かかりつけ医の経営安定化」といった制度への期待を認めたが、「業務量増加」の懸念、「単なるかぜ診療とゲートキーパーになる恐れ」も認めた。高齢の医師が変革を望まず、院長クラスは収入増を期待している可能性が考えられるが、かかりつけ医制度をさらに推進するためには、担当する医師が不利益にならないよう配慮し、医療資源不足の地方に改革の重点を置くべきと考える。(著者抄録)

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記述言語：日本語   出版者・発行元：北海道公衆衛生学会  

大病院受診の際に患者が紹介状を持参する要因と、患者側からの大病院受診の際の紹介状を必要とする制度への意見に関連する要因を検討し、今後の医療制度改革の資料となることを目的として、旭川医科大学病院を初診した患者について、アンケート調査を実施した。有効送付数1,264から621(49.1%の回収率)の回答があった。統計解析は多変量ロジスティック回帰を用いた。「紹介状持参なし」に有意に関連していたのは、入院した・する予定(オッズ比:0.24)、身内・友人のすすめ(4.36)、医大病院の設備が良い(1.68)、重い病気やけが(0.42)、別の医療機関に満足できない(2.20)であった。「紹介状にかかわらず大病院・専門医を自由に受診できるようにするべき」に有意に関連していたのは、学歴(中学・高校)(1.59)、紹介状あり(0.30)、入院した・する予定(0.55)、大きい病院が安心(1.72)であった。自由記載の質的検討では、かかりつけ医制度自体への不満や自由な受診を尊重すべきとの考えを認めた。かかりつけ医からの紹介がある場合のみ大病院・専門医を受診できるようになる制度の推進には、個人と社会への制度上のメリットについて十分な説明が必要である一方、日本のかかりつけ医機能と大病院の専門医機能に明確な線引きがないことが混乱を招いている可能性があり、それらの機能分担の明確化が必要ではないかと考えられた。(著者抄録)

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記述言語：日本語  

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記述言語：日本語   出版者・発行元：北海道母性衛生学会  

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記述言語：日本語  

北海道内の地域医療を担う2次救急において、各医療機関で行われているコンビニ受診対策や、医師・看護師の負担軽減策について、今後の対策に役立つ資料となることを目的として調査票を送付し101医療機関より回答を得た。救急車受け入れ台数は増加傾向にあるも、夜間休日・外来数について近年の減少傾向から、各医療機関で行われるポスターやその他の地域の対策の効果によりコンビニ受診が減少している可能性がある。医師の日当直は、休日に丸一日行うことや、当直明けもそのまま通常勤務を行っている割合も多く、負担は大きいと考えられる。大学からの非常勤日当直医が救急医療機関の負担軽減に必要となっていることもうかがえる。看護師についても一部であるが救急外来の休日連続日当直や、多くの待機看護師の配置が有り、夜勤・時間外勤務の減少の方向について検討していく必要がある。

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その他リンク： http://search.jamas.or.jp/link/ui/2016283753

記述言語：日本語   出版者・発行元：北海道公衆衛生学会  

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記述言語：日本語  

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記述言語：日本語   出版者・発行元：北海道母性衛生学会  

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記述言語：日本語   出版者・発行元：厚生労働統計協会  

雑誌掲載版目的 北海道内の居住地域から,脳梗塞アルテプラーゼ静注療法の実施できる脳卒中急性期医療拠点病院への自動車アクセス時間について地理情報システム(GIS)ソフトウエアを用いて推定し,またアクセス時間を短縮することで改善するための拠点病院配置案を示すことを目的とした。方法 北海道医療計画に掲載されている61医療機関を脳卒中急性期医療拠点病院とし,平成22年国勢調査における町丁字別人口に1人以上の居住者が存在する地区ごとに,直近の拠点病院への自動車アクセス時間を推定した。二次医療圏・市町村ごとのアクセス時間は町丁字別人口居住者数の重み付けをした平均値として算出した。またアクセス時間を改善するための拠点病院配置案については,二次医療圏ごとにアクセス時間上位の二次医療圏へ,7医療機関を新たに割り当てたアクセス時間改善案の検討も行った。結果 61拠点病院へのアクセス時間について,平均60分以上となる二次医療圏が6医療圏存在し,うち90分以上は5医療圏であった。アクセス時間を改善するための拠点病院追加案については,(1)二次医療圏でアクセス時間が平均60分以上であり,医療圏内に拠点病院が設定されていない6医療圏,(2)アクセス時間60分以上に該当する人数が,約7万4千人と医療圏では2番目に多い1医療圏に1拠点病院を追加したと仮定した。以上,計68拠点病院とした場合の二次医療圏ごとのアクセス時間を計算すると,平均60分以上は1医療圏のみとなった。結論 本研究では,GISソフトウエアを用いて,特に二次医療圏ごとの拠点病院への平均アクセス時間を示した上で,北海道の現状を考えた脳卒中急性期医療拠点病院の例を示した。脳梗塞急性期治療については,二次医療圏や自治体ごとのアクセス状況を検討し,地域の現状を考えて改善案を考えていく必要があると考える。

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その他リンク： http://amcor.asahikawa-med.ac.jp/modules/xoonips/detail.php?id=2015283969

記述言語：日本語   出版者・発行元：北海道産科婦人科学会  

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記述言語：日本語   出版者・発行元：北海道産科婦人科学会  

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記述言語：日本語   出版者・発行元：産業医学振興財団  

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記述言語：日本語   出版者・発行元：北海道母性衛生学会  

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記述言語：日本語   出版者・発行元：(株)東京医学社  

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記述言語：日本語   出版者・発行元：日本臨床環境医学会  

現在、自然由来の無機ヒ素による飲料水汚染からの大規模な慢性ヒ素中毒は広くアジアや中南米諸国に発生しているが、慢性ヒ素中毒に有効な治療薬はなく、予防や改善に関する研究の必要性が論じられている。ブロッコリーに含有されているスルフォラファンには、細胞内の無機ヒ素を排泄促進する作用が報告されている。本研究では、成人被験者6名による尿中ヒ素排泄へのブロッコリー粉末(BP)の効果と影響について検証した。被験者は通常の食生活においてBP摂取を14日間行い、摂取前と摂取期間中の尿中ヒ素化合物濃度を比較した。6名の平均尿中総ヒ素濃度の推移は、BP摂取1日後に上昇し、4日目以後では逆に濃度が低下する傾向を示し、摂取14日目の値は摂取前に比較して低下を示し(p<0.05)、BPによるdetox効果が示唆された。BPによる体内でのメチル化は、摂取14日目のジメチル化ヒ素(DMA)濃度の上昇から促進が示唆された。なお、尿中モノメヂル化ヒ素(MMA)とDMA濃度から求めた2nd methylation(MMAからDMAへの変換)の比率は、個人差が影響して統計学的な有意差は認められなかった。本研究は、先行研究である細胞試験と動物実験の結果を支持するものであり、無機ヒ素とその代謝物に対するメチル化や尿中排泄をそれぞれ促進する可能性があり、当該分野の研究の重要性が明らかとなった。(著者抄録)

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記述言語：日本語   出版者・発行元：医学書院  

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その他リンク： http://search.jamas.or.jp/link/ui/2013136993

記述言語：日本語   出版者・発行元：北海道公衆衛生学会  

エコチル調査は、子どもの健康に与える環境要因を解明することを目的とし、「胎児期から小児期にかけての化学物質曝露が子どもの健康に大きな影響を与えている」ことを中心仮説としており、全国10万組の親子を対象とした出生コホート調査である。北海道では、札幌、旭川、北見の3地区で調査を進めている。今回、エコチル調査がメディアに露出する前後の道民の認知度・意識を明らかにし、今後の課題について示唆を得る目的で検討を行った。方法は、北海道新聞情報研究所が管理運営する「Doshinインターネット」のモニターを対象とし、エコチル調査の広報を集中的に行った前後の平成24年3月と4月の2回WEBアンケートを実施した。回答者数は1回目が678名、2回目が675名であり、エコチル調査の認知度は1回目14.4%であったが2回目には30.9%に上昇していた。これは、新聞をはじめとしたマスメディアによるPR広告の効果と思われた。今後、エコチル調査への関心を持続させるための課題として、調査の進捗状況など得られた成果を開示していくことが必要と考えられた。

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その他リンク： http://search.jamas.or.jp/link/ui/2013270956

記述言語：日本語  

妊娠中の喫煙は，胎児の発育阻害など様々な悪影響がある．環境省「エコチル調査」北海道ユニットセンター登録の妊婦を対象に，喫煙実態を報告する．2011年1月の調査開始から，2013年7月までに妊娠中・後期調査票が登録された3901人の暫定データを集計した．平均年齢は30.9±4.8歳．喫煙経験者は1941人で，17.4%が16歳以下，25.4%が19歳以下で喫煙を開始していた．5.4%は妊娠後も喫煙を続け，15.1%は妊娠中に，30.0%は妊娠前に禁煙した．喫煙継続群は，妊娠中禁煙群，妊娠前禁煙群よりも喫煙開始年齢が早く，収入や学歴が低かった．喫煙継続群のパートナーの83.0%が喫煙していた．タバコは依存性があり家族の影響を受けやすい．家族やまわりの人々も含めて，受動喫煙を含む喫煙による胎児への影響に対する意識を高めていくこと，小児期から喫煙の害に関する組織的かつ継続的な啓発が必要である．

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その他リンク： http://search.jamas.or.jp/link/ui/2014321475

記述言語：日本語   出版者・発行元：北海道小児保健研究会  

近年、化学物質等の環境要因による子どもの成長や発達に及ぼす影響、特に妊娠中の胎児曝露による影響に対して世界的に関心が高まっている。そこで、環境省は「子どもの健康と環境に関する全国調査（以下エコチル調査）」を2011 年に開始した。「エコチル調査」は、子どもの健康に与える環境要因を解明することを目的とし、「胎児期から小児期にかけての化学物質曝露が、子どもの健康に大きな影響を与えている」ことを中心仮設としている。全国で10 万組の親子を対象とした出生コーホート調査で、妊娠初期の母親をリクルートし、胎児期から13 歳になるまで定期的に健康状態を追跡する。「エコチル調査」は対象者10 万人の「全体調査」のほか、「詳細調査」「追加調査」が設定されている。「全体調査」は妊娠初期から産後1 か月までの生体試料と生後6 か月から半年ごとに行う質問票調査により13 年間追跡して、子どもの健康状態をチェックする。「詳細調査」は、「全体調査」の対象者のうち2013 年4 月以降出産の児から無作為に抽出し、環境曝露調査と医学的検査、精神神経発達検査など、全体調査より詳細な調査項目を検討中である。「追加調査」は、全国に15 のユニットセンターが、独自の財源で、環境省の承認の元研究する調査である。

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記述言語：日本語   出版者・発行元：北海道公衆衛生学会  

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記述言語：日本語   出版者・発行元：厚生統計協会  

雑誌掲載版目的 北海道内の各市町村から産婦人科・小児科救急拠点病院へのアクセス時間について地理情報システム(Geographic Information System,以下,GIS)ソフトウエアを用いて推定し,それらの周産期アウトカムの影響を検討することを目的としている。方法 市町村ごとの平成15〜19年の乳児死亡数,新生児死亡数,周産期死亡数から,5年間平均の乳児死亡率,新生児死亡率(出生千対),周産期死亡率(出産千対)を計算した。産婦人科医と小児科医の常勤医がそれぞれ2名以上勤務する28施設を今回の産婦人科・小児科拠点病院とした。各市町村から28産婦人科・小児科拠点病院のうち直近の施設への乗用車でのアクセス時間を推定するためArcGIS9.3(ESRI,NYC)のNetwork analyst解析を用いた。各市町村からのアクセス時間を説明変数として乳児死亡率の第4四分位,新生児死亡率の第3三分位,周産期死亡率の第4四分位となるオッズ比についてロジスティック回帰分析を用いて算出した(新生児死亡率のみ分布が低値に偏っているため四分位に適さず,三分位とした)。結果 対象医療機関への到達時間の中央値は48.4分,平均値57.3分(標準偏差39.0),最小値,0.3分,最大値は181.0分で,90分以上の市町村は40(22.7%)に認め,そのうち13市町村(7.4%)が120分以上となっていた。ロジスティック回帰分析では,乳児死亡率ではアクセス時間による有意な差を認めなかった。新生児死亡率については,アクセス時間が60分以上90分未満の群が30分未満の群に比べて有意に減少していた(オッズ比(OR)=0.22,95%信頼区間(CI):0.07-0.73,P=0.013)。また,90分以上の群では上昇する傾向を認めた(OR=4.33,95%CI:0.17-1.09,P=0.076)。また,周産期死亡率はアクセス時間が30分以上60分未満の群において有意の上昇を認めた(OR=2.61,95%CI:1.04-6.58,P=0.041)。結論 新生児死亡率では60分以上90分未満で有意にオッズ比の低下を認めたが,90分以上でオッズ比の上昇傾向を認めた。しかし,周産期死亡率では,30分以上60分未満でオッズ比の上昇を認めた。都市部の未受診妊婦の増加などの影響も考えられ,アクセス時間は単純にはアウトカムに関係しなかったと考えられるが,90分以上のアクセス時間は問題である可能性もあり,今後も検討を重ね,道路やドクターヘリの整備,医療機関の効率的な配置などを考えていく必要がある。

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その他リンク： http://amcor.asahikawa-med.ac.jp/modules/xoonips/detail.php?id=2011324359

記述言語：日本語   出版者・発行元：(一財)厚生労働統計協会  

目的 近年,全国的な問題となっている周産期医療に携わる医師不足について,北海道内の二次医療圏別の産婦人科・小児科の医師数の推移を把握し,また,医師数の減少が周産期に関わる死亡率にどのような影響を及ぼしているかについて明らかにすることを目的に調査を行った。方法 北海道内の21の二次医療圏ごとに産婦人科および小児科の医師数,死亡の指標として乳児死亡率,新生児死亡率,周産期死亡率を集計した。医師数と死亡率の関係については,1995〜2000年,2001〜2006年の各々6年間の平均値として医師数と死亡率との相関解析を行った。新臨床研修制度導入の前後比較については2001〜2003年および2004〜2006年の医師数増減比および死亡率比を用いて解析した。結果 北海道内の医師数は,全診療科(総医師数)では1996年から2006年の間に12.6%増加している一方で,産婦人科は439人から359人と18.2%減少した。2006年における人口10万人当たりの産婦人科医師数および小児科医師数は,多くの医療圏で全国平均を大きく下回った。1995〜2000年と2001〜2006年の平均値比較で,乳児死亡率,新生児死亡率,周産期死亡率は,一部の医療圏で増加を認めた。医師数と死亡率との相関では,1995〜2000年において小児科医師数と新生児死亡率との間で相関係数r=-0.435(p=0.049)と有意な負の相関を認め,産婦人科医師数と周産期死亡率との間でr=-0.379(p=0.090)と負の相関傾向を認めた。2001〜2006年において小児科医師数と乳児死亡率との間でr=-0.395(p=0.077)と負の相関傾向を認めた。新臨床研修制度導入前後の産婦人科医師数増減比と新生児死亡率比の解析においてr=-0.509(p=0.022)と有意な負の相関を示した。近年の産婦人科,小児科の医師数と死亡率の負の相関傾向,および産婦人科医師数の増減と新生児死亡率比の有意な負の相関が見られたことから,近年急速に産婦人科および小児科の医師数が減少しているいわゆる医療過疎地域では,今後一層,乳児死亡率や新生児死亡率,周産期死亡率の悪化が予測された。結論 医療過疎地域における将来的な周産期指標の悪化が懸念されることから,医療資源の確保とともに周産期医療に適した医療圏,医療体制の整備が必要である。(著者抄録)

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2010&ichushi_jid=J00462&link_issn=&doc_id=20100223040005&doc_link_id=http%3A%2F%2Famcor.asahikawa-med.ac.jp%2Fmodules%2Fxoonips%2Fdetail.php%3Fid%3DK223040005&url=http%3A%2F%2Famcor.asahikawa-med.ac.jp%2Fmodules%2Fxoonips%2Fdetail.php%3Fid%3DK223040005&type=%88%AE%90%EC%88%E3%89%C8%91%E5%8Aw%81F%88%AE%90%EC%88%E3%89%C8%91%E5%8Aw%8Aw%8Fp%90%AC%89%CA%83%8A%83%7C%83W%83g%83%8A_AMCoR&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F80003_3.gif

記述言語：日本語   出版者・発行元：(一財)厚生労働統計協会  

目的 現在,社会的に問題となっているシックハウス症候群(以下,SHS)の予防対策を居住環境や住まい方の面から検討するため全国6地域(札幌,福島,名古屋,大阪,岡山,北九州)の一般住宅を対象に居住者の自覚症状と室内環境,生活感覚との関係を調査した。方法 築6年以内の一戸建て住宅の中から無作為に抽出した対象に自覚症状,住環境,生活感覚について質問票を配布し,425軒(1,479人)から回答を得た。SHSの判定には自覚症状の訴えが1つ以上あり,その症状は「家を離れるとよくなる」の回答群をSHSあり群とし,質問票調査と同時に測定した居間の化学物質,ダニアレルゲン,真菌,粉じんなどの測定値および質問票項目との間で関連を検討した。結果 環境測定値では,ホルムアルデヒド,総アルデヒド類,総VOC類,総ダニアレルゲン,真菌総コロニー数がSHS群でSHSなし群より有意に高値であった。住環境,生活感覚に関する質問項目では「カビ発生あり」「水漏れあり」などの高湿度環境の指標となる項目,「床材がフローリングである」,居間で「シンナーを使用・保管した」など直接的関連項目や「家のにおいが気になる」「家の空気が悪い・汚れていると感じる」などの居住者の汚染感覚の指標となる項目がSHS群で有意な関連を示した。質問項目中,SHSのリスクとして示された住環境や生活感覚に関する項目を選択し,温度,湿度,室内粉じん量,微生物測定値などの住宅が具備する条件も加えて,SHS発症原因物質との関連について検討した結果,アルデヒド類濃度の増加には温度,湿度,真菌総コロニー数,粉じん量,汚染感覚指標数が,総VOC濃度では汚染感覚指標数,高湿度環境指標数が関連した。総ダニアレルゲン値の増加には粉じん量,湿度,高湿度環境指標数,汚染感覚指標数が,真菌総コロニー数では湿度,粉じん量が関連した。結論 昨今の新築住宅では,建築基準法の改正や化学物質の室内濃度指針値の設定により,住居の換気・空調の向上や該当化学物質濃度の低減などSHS発症原因の除去対策が進められている。しかし,実生活上において化学物質や微生物などはSHS発症の独立の要因というより居住環境や居住者の住まい方が総合して影響しあっていることが示唆され,SHS対策には居住者・個人レベルでの湿気や清掃など居住環境に関する知識の蓄積,それらの実践も必要と考えられた。(著者抄録)

CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2009284204

記述言語：日本語   出版者・発行元：日本産業衛生学会-北海道地方会  

職業性ストレスの1次予防対策として、認知行動療法を応用したストレスマネジメント教育を実施し、その効果を検討した。対象は、北海道の1公務職場に勤務する事務職員65名とした。ストレスマネジメントプログラムの内容は、認知行動療法の主要な理論の一つであるストレス免疫訓練の考え方に基づき、3回の講習会(4週間ごと、1回1時間)で構成した。教育効果を評価するため、1回目講習会の開始前と3回目の終了直後および1ヵ月後、6ヵ月後に質問紙調査を行い、「ストレス対処行動」「ストレス反応」「主観的健康管理能力」を測定した。その結果、「ストレス対処行動」の問題解決スコアの平均が講習会開始前に比べて終了直後・1ヵ月後・6ヵ月後に有意な高値を示した。

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記述言語：日本語   出版者・発行元：日本衛生学会  

CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2008177131

J-GLOBAL

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記述言語：英語  

雑誌掲載版砒素曝露が皮膚の線維化に関与するとの報告は今日までなされていない。今回の論文の目的は、(1)亜砒酸ナトリウムを含む水をマウスに長期摂取させると皮膚組織に線維化が誘導されるか否か、(2)線維芽細胞への砒素曝露は線維化に関わる遺伝子変化を生じさせるか否かを明らかにすることである。C57BL/6Nマウスに砒素(1.0と10mg/L)を含む水を与え50日間飼育すると、皮膚組織で線維束の肥大が濃度依存的に認められた。次に、正常ヒト線維芽細胞において0.5-10μMの砒素曝露により、12-24時間の短期曝露ではコラーゲン(COL1A2)の減少とその主な分解酵素マトリックスメタロプロテネース(MMP-1)の増加が、それぞれRT-PCR及びウエスタンブロッティング法で確認された。この変化はプロモーターアッセイ法でも確認され、砒素曝露による転写因子の関与を示唆した。

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記述言語：日本語   出版者・発行元：日本臨床環境医学会  

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記述言語：日本語   出版者・発行元：(株)医薬ジャーナル社  

シックハウス症候群は欧米のシックビル症候群のように、狭義のシックハウス症候群、シックハウス関連病(アレルギー、感染症等)と化学物質過敏症に分けて考えるべきである。原因としては、化学物質のみならず、湿度環境の悪化、生物学的要因も重要な因子である。我々は、室内の結露、カビの発生、さらにカビ臭さ、風呂場のぬれタオルの乾きにくさ、水漏れといった湿度環境悪化の指標が症状出現に関連することを報告してきた。診療上においては、自覚症状と環境要因の詳しい問診に加えて、環境改善法を指導し、必要に応じて保健所などと連携して環境測定を行う必要がある。(著者抄録)

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記述言語：日本語   出版者・発行元：産業医学振興財団  

著者版日本の職域集団を対象として職業ストレスの心血管系への影響について上腕動脈足首動脈間法(baPWV)を用いて早期の動脈硬化への影響を検討した.定期職場健康診断を受診した35歳以上の地方自治体公務員(男3412,女854)を対象として,自記式質問紙調査票を用いた調査を行った.男性では,低仕事自由度が有意に脈波伝播速度(PWV)高値と関連した.女性では事要求度-コントロールモデル高ストレスが有意にPWV高値と関連した.努力報酬不均衡モデルとPWV高値の間には有意な関連は認めなかった

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その他リンク： http://amcor.asahikawa-med.ac.jp/modules/xoonips/detail.php?id=2006238449

記述言語：日本語   出版者・発行元：(一社)日本衛生学会  

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J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本周産期・新生児医学会  

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記述言語：日本語   出版者・発行元：(株)北隆館  

一般住宅を対象に自覚症状に影響する住居環境要因を疫学研究の形で検討した結果,結露・カビの発生といった湿度環境,トルエンなどの揮発性有機化合物濃度が自覚症状の出現率や程度に影響することがわかった.さらに現在,北海道から九州まで全国6地域において,同一プロトコールで,化学物質に加え,真菌・ダニなどの生物学的要因にも焦点をあて,シックハウス症候群の原因を解明すべく疫学調査研究を進行中である.途中経過を含め解説する(著者抄録)

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記述言語：日本語   出版者・発行元：(公社)日本精神神経学会  

CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2005183444

記述言語：日本語   出版者・発行元：国立保健医療科学院  

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2005&ichushi_jid=J03876&link_issn=&doc_id=20050704450002&doc_link_id=0503382&url=https%3A%2F%2Fkango-sakuin.nurse.or.jp%2Fnid%2F0503382&type=%8D%C5%90V%8A%C5%8C%EC%8D%F5%88%F8Web&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00014_1.gif

記述言語：日本語   出版者・発行元：日本公衆衛生学会  

現在までに報告されてきているpulse wave velocity(PWV)測定法を用いた知見の現状を客観的に総括し,今後の研究の方向性を指し示すことを目的に内外における文献的考察を行った.報告文献の検索には,米国立医学図書館の医学文献データベースpubmedを用いた.血圧が,PWVと強い関連があるとする報告がほとんどで,BMI,空腹時血糖,コレステロールもPWVと有意な関連があると多数の報告を認めた.しかし,喫煙とPWVの間には関連があるとする報告はなかった.また,多くの報告から,PWVの上昇が疾患発症の予測指標となりうることが示されたが,baPWVを用いて予測因子との関連を報告したものはなかった

DOI： 10.11236/jph.52.2_115

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