Although hyperhomocysteinemia is an important and independent risk factor for vascular disease, the relationship between plasma homocysteine concentration (Hcy) and subclinical atherosclerosis in the general population remains controversial. We screened 1,845 participants who resided on Japanese remote islands and in mainland. Hcy and clinical values were measured, and methylenetetrahydrofolate reductase gene C677T polymorphism (C677T/MTHFR), which is an important genetic factor for regulating Hcy, was analyzed. Carotid intima-media thickness (CIMT) and the cardio ankle vascular index (CAVI) were measured to clinically evaluate subclinical atherosclerosis. CAVI had statistically significant association with Hcy (regression coefficient 0.3159, p=0.025), but CIMT was not. Hcy had statistically significant association with age, systolic blood pressure, high-density lipoprotein cholesterol, creatinine, C677T/MTHFR, smoking status and alcohol intake. Although C677T/MTHFR was not different among residing areas, Hcy was significantly higher on small islands than in other areas even after adjustment for confounding factors. We found the statistically significant association between Hcy and CAVI in the general population residing on Japanese remote islands, and significant differences in Hcy among residing areas, suggesting strong influence by acquired factors as well as genetic factors.

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Objective: Mental health disorders among community dwelling Japanese people has not been well documented. The objective of the present study was to gain insights into the relationships between lifestyle factors and mental health in a community population. Methods: Associations between lifestyle factors and mental health were investigated in Nagasaki prefecture with a selfadministrated questionnaire including socio-demographic (age and sex), lifestyle (diet, exercise, sleep, smoking, alcohol drinking), and mental health factors. Results: A total of 2,146 people (1,052 men and 1,094 women) responded fully to the 12-item version of the General Health Questionnaire (GHQ-12). High GHQ-12 scores (defined as a score of ≥ 4, to indicate poor mental health) were more prevalent in women (18.9%) than in men (15.6%) (P=0.041). Moreover, the proportion of high GHQ-12 score was higher in the younger age group (20 to 39 years), comparing to other age groups. As the result of multiple logistic regression analysis, four variables were selected as factors associated with a high GHQ-12 score: women (odds ratio (OR): 1.3, 95% confidence interval (95% CI): 1.0-1.6); 20 to 39 years (OR: 2.5, 95% CI: 1.7-3.6) and 40 to 64 years (OR: 1.4, 95% CI: 1.0-1.9), both with ≥ 65 years as reference; not eating meals regularly (OR: 1.7, 95% CI: 1.2-2.4); and not getting enough sleep (OR: 2.8, 95% CI: 2.1-3.6). Conclusion: The findings indicate that the young and women are more likely to have poor mental health, and that lifestyle factors such as diet behavior and sleep are associated with mental health.

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Purpose: Intensity modulated radiation therapy (IMRT) is characterized by a relatively long period for beam exposure and consequently the risk for unnecessary exposure to non-targeted organs, mainly due to the scattered radiation, should be considered. The puposes of this study are to measure the absorbed dose of the peripheral organs during helical IMRT using a fluorescent glass dosimeter. Materials and Methods: In this research, we took lung cancer as a model and measured the absorbed dose of the peripheral organs during helical IMRT using a fluorescent glass dosimeter. The planning target volume (PTV) dose of 95% was set to be 5 Gy in the phantom. Results and Discussion: The highest exposure dose was observed for the breasts, which were on the PTV trajectory, with the left and right breasts receiving doses of 227.94 mGy and 371.90 mGy, respectively. The exposure doses of the left and right lenses were 3.13 mGy for the left lens and 3.22 mGy for the right lens. An exponential dose reduction to the distance from PTV was confirmed. Our data suggest that the doses for peripheral organs were acceptable in lung cancer case based on past literature search. However, the use of custom blocks for the eyes should be considered to prevent possible late occurance of cataract.

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Coronary artery disease (CAD) is a multifactorial and polygenic disorder, which arises due to atherosclerosis of the coronary arteries. Both numerous genetic factors and environmental risk factors may contribute to the pathogenesis of atherosclerosis. Thus, in order to identify the genetic determinants of CAD, an association of genetic polymorphisms of the liver X receptoralpha (NR1H3) and -beta (NR1H2) genes with susceptibility to CAD was examined in a Japanese population. Eight tag single nucleotide polymorphisms (SNPs) in NR1H3 and NR1H2 were analyzed by PCR-restriction fragment length polymorphism or PCR-direct DNA sequencing method in 143 Japanese patients with CAD and 164 healthy control subjects with normal coronary arteries. Subsequently, haplotypes composed of the two tag SNPs in NR1H2 were constructed. Significant differences in the clinical risk factors, dyscholesteremia and diabetes mellitus, were observed between CAD patients and controls (P = 0.040 and P = 0.005, respectively). The frequencies of a C allele in the multiplicative model and its homozygous C/C genotype in the recessive model at rs2279238 in NR1H3 were significantly higher in CAD patients as compared to those in controls (P = 0.039 and P = 0.016, respectively). Furthermore, the frequency of a Hap 4/any diplotype of NR1H2 was significantly higher in CAD patients in comparison to controls (P = <0.0001, OR = 17.16). Multivariate logistic regression analysis revealed that these polymorphisms, dyscholesteremia, and diabetes mellitus independently contributed to susceptibility to CAD. In conclusion, NR1H3 and NR1H2 appears to be the genetic determinants of CAD. Furthermore, the genetic polymorphisms of NR1H3 and NR1H2 may be useful as new DNA-based diagnostic biomarkers for identifying high-risk individuals susceptible to CAD.

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The plunging ranula is an extravasation cyst of the saliva from the sublingual gland. We report a case of plunging ranula, which was diagnosed through CT and analysis of aspirated fluid, and was treated successfully by excision of the sublingual gland via an oral approach. We consider the essentials of management for plunging ranulas to be correct preoperative diagnosis and excision of the sublingual gland via a transoral route.

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Duodenal duplication cysts are relatively rare congenital anomalies that occur most often in infants and children. We report a case of a 13-year-old boy who presented with duodenal obstruction caused by bleeding of a duodenal duplication cyst. Operative findings and hispathological examination confirmed the diagnosis. We treated him with subtotal excision of the duodenal duplication cyst and mucosal stripping and ablation of the remaining mucosa.

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AMP-activated protein kinase (AMPK) is a key molecule that controls energy homeostasis at cellular and whole body levels. Calorie restriction (CR) may exhibit the anti-aging effect through modulation of AMPK activity. We investigated the hepatic AMPK pathways for gluconeogenesis (the transducer of regulated cyclic adenosine monophosphate response element-binding protein (CREB) 2; CRTC2) and cell growth (mammalian target of rapamycin, mTOR). Male F344 rats at 2.5 months (mo) and 18 mo of age were subjected to 4-mo-long 30% CR; control rats were fed ad libitum (AL) throughout the experiment. Rats were killed 15 min after saline or glucose injection to evaluate activation of signal molecules under transient hyperglycemic and subsequent hyperinsulinemic conditions. Western blot analyses demonstrated a modest reduction of threonine-172- phosphorylated (p)-AMPKα levels and an increment of nuclear CRTC2 in the young CR group as compared with the agematched AL group. We also confirmed the increased binding of CRTC2 and CREB and up-regulation of gluconeogenic genes (PGC-1α and PEPCK) in the CR group. However, there was no CR-specific alteration in total or phosphorylated mTOR levels. The results suggest down-regulation of hepatic AMPK activity by CR for metabolic adaptation that promotes gluconeogenesis. The effect of CR on mTOR remains elusive.

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