Aim: This study compared the efficacy and safety of Bmab+oral 5-Fluorourasil (Bmab+o-5-FU) including Bmab+Capecitabine (Cape) with that of intensive chemotherapy including L-OHP or CPT-11 for patients with metastatic colorectal cancer (mCRC). Methods: Between January 2006 and February 2017, 40 elderly ( ≥ 70 years) chemotherapy-naïve patients with mCRC (male/ female=22/18; median age, 76.0 years) were retrospectively reviewed. The treatment regimens were Bmab+o-5-FU (n=19) and intensive regimens (n=21). Intensive regimens comprised 17 L-OHP and 4 CPT-11 doublet chemotherapies. Results: The median progression-free survival (PFS) with Bmab+o-5-FU and intensive regimens was 281 and 215 days, respectively. The median survival time with Bmab+o-5-FU and intensive regimens was 961 and 1,002 days, respectively. No significant differences were observed in the overall survival or PFS between Bmab+o-5-FU and the other regimens. The disease control rate was 94.7% with Bmab+o-5-FU and 81.0% with intensive regimens. The rate of grade ≥3 hematological adverse events was 5.3% for Bmab+o-5-FU and 15.8% for intensive regimens. Conclusions: With its similar survival benefit to intensive regimens, high disease control rate and good feasibility, Bmab+o5-FU seems a fine treatment choice for elderly mCRC patients.

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Background: Mt. Unzen-Fugendake, located in southwestern Japan, began erupting in November 1990. Forty-three people were killed in the 1991 pyroclastic flow. The eruption lasted for 6 years, and approximately 11,000 people, or about 25% of the population, were forced to live in shelters, some for up to 10 years. Aim: This study was conducted 25 years later to investigate the relationship between post-traumatic stress disorder (PTSD) symptoms a long time after a disaster and the evacuation period. Methods: In 2015, a questionnaire survey was conducted. The 12-item General Health Questionnaire (GHQ-12), Impact of Event Scale-Revised (IES-R), and Post-Traumatic Growth Inventory-Short Form (PTGI-SF) were distributed to residents affected by the disaster and collected by mail. Results: In total, 300 responded to the survey, and 278 of whom provided complete answers and were included in the analysis. The mean evacuation period was 35.8±27.9 months. The percentage of those with a high score on the IES-R was 11.5%, which is higher than the general population, and the mean PTGI-SF score was 18.09. Injury to family members and the need to evacuate were related to PTSD and post-traumatic growth (PTG). Conclusion: PTSD symptoms were still apparent 25 years after the disaster. The length of the evacuation period at the time of the disaster was significantly related to the appearance of PTSD symptoms. PTG was similarly affected by the length of the evacuation period. These findings suggest the need to continue measures and support with a longer perspective to support residents after a disaster.

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Background: Trends towards a nuclear family unit, a decline in birth rate, and lack of community relationships make it difficult for adolescents to improve parental readiness in Japanese society. Low parenting skills will be a risk factor for high parenting stress or child abuse. The purpose of the present study is to investigate the factors associated with parental readiness amongst Japanese female undergraduate nursing students. Methods: The study design is cross-sectional. An anonymous self-reported questionnaire survey was distributed to 225 female undergraduate nursing students from Kyushu, Japan, and the factors associated with parental readiness were examined. Results: Of the 225 recipients, 208 responded to the questionnaire. Multiple linear regression analysis showed that the parental readiness score was significantly higher in the following groups: students who lived alone or without parents (regression coefficient: β = 1.82, p = .027), students who often interacted with children (β = 1.88, p = .018), students who wanted to give birth (β = 5.72, p = .007), and students who wanted to rear children as their own parents did (β = 2.73, p = .009). Conclusions: The factors associated with parental readiness were living without parents, experiences interacting with children, desire to give birth, and desire to rear children as their own parents did.

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Studies have demonstrated that motivation, aggression, excitation intensity, competitive spirit, and tolerance to psychological stress are included in major psychological factors affecting the performance of athletes. However, to date, there have not been sufficient scientific studies on the relationship between genetic polymorphisms affecting psychological abilities and competitive strength/sport. In this study, we compared the distribution of the brain-derived neurotrophic factor (BDNF) gene polymorphism (Val66Met) in athletes between competitive swimming, which needs closed skill without opponents, and judo, which needs open skill with opponents, in order to investigate the genetic basis of sports performance and related psychological factors. The results showed that the prevalence of Met carriers of the BDNF polymorphism associated with vulnerability to psychological stress was lower in judo players, suggesting that judo athletes had a higher stress tolerance. In addition, the prevalence of the BDNF heterozygous group was higher in competitive swimmers, supporting the hypothesis that closed skill sports without opponents receive less stress than open skill sports with opponents, furthre suggesting that they are excellent in motor control and motor learning.

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[Introduction] Trisomy X is a sex chromosome abnormality that occurs in approximately 1 in 1,000 female births. We provided genetic counseling to a pregnant woman and her husband following the prenatal diagnosis of trisomy X by amniocentesis. [Case] A 27-year-old pregnant woman, gravida 2, para 1, underwent a prenatal checkup by her general practitioner. Nuchal translucency (NT) of 3.4 mm was detected in the fetus at 11 weeks of gestation and had disappeared by 12 weeks of gestation. The pregnant woman and her husband consulted our unit for genetic counseling at 13 weeks of gestation. Although we did not detect any NT or other abnormality in the fetus, the parents were concerned about possible abnormalities and requested amniocentesis. Amniocentesis followed by chromosomal analysis at 16 weeks of gestation revealed a 47,XXX karyotype. We explained the results and characteristics of trisomy X to the couple. The frequency of trisomy X is 1 in 1,000, and it can be characterized by tall stature, developmental delay, learning disability, anxiety, and mood disorders. However, the features of trisomy X vary and we were therefore unable to predict the newborn’s precise postnatal physical and psychological characteristics. The couple decided to continue the pregnancy, and a female newborn was delivered at 38 weeks of gestation weighing 2,418 g. The karyotype was confirmed as 47,XXX, but her development to date (age of 2 years) has been normal. [Conclusions] Careful genetic counseling is important for pregnant women and their partners following a prenatal diagnosis of trisomy X.

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Rectourethral fistula is rare complication after ¹²⁵ I low-dose-rate prostate brachytherapy, and gastrointestinal fistulas are widely recognized as a complication of bevacizumab. To our knowledge, this is the first case of rectourethral fistula during bevacizumab administration for cecum cancer after prostate brachytherapy. A 75-year-old man visited our hospital because of urinary retention and fecaluria. He had been receiving chemotherapy for one year against recurrence of cecum cancer. The chemotherapy regimens were bevacizumab and capecitabine plus oxaliplatin. He had undergone laparoscopic ileocecal resection for cecum cancer 1.5 years earlier. Eight months after the operation, recurrence was recognized. He had a history of prostate cancer and had received ¹²⁵ I low-dose-rate prostate brachytherapy for prostate cancer 17 years earlier. Computed tomography revealed air bubble from the rectum to the prostate and urethra. To prevent urinary tract infection, laparoscopic transverse colostomy and percutaneous cystostomy were performed. Although the patient’s quality of life subsequently improved, the performance status declined remarkably. He was therefore transferred to another hospital and received the best supportive care. Rectourethral fistula is a rare but serious complication after ¹²⁵ I low-dose-rate prostate brachytherapy. The introduction of bevacizumab to patients who have received this therapy should be carefully considered.

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