Indium is mainly used as indium-tin oxide (ITO), which has a unique character of transparency, and is a requisite in making liquid crystal displays. Pulmonary toxicity of indium compounds in humans were not recognized until the last 2 decades. Several initial human cases of indium-related lung disease, named indium lung, were reported in Japan, with their main pathologic findings being interstitial pneumonia, emphysema and cholesterol crystals-containing granulomas. In 2010, three cases with alveolar proteinosis were reported from the United States and China. As of March 2019, more than 10 cases of interstitial pneumonia-dominant indium lung have been reported. Cross-sectional studies in indium workers indicate that the serum indium concentration (sIn) is closely related to the exposure period, the extent of interstitial as well as emphysematous changes of the lung on high-resolution computed tomography (HRCT) and serum biomarkers of interstitial pneumonia, including KL-6 and surfactant protein-D (SP-D). Longitudinal studies have shown it is possible to reduce the sIn as well as the interstitial shadows on HRCT; however, emphysematous lesions increased progressively in heavily exposed workers, even after cessation of exposure. Early detection is required to prevent irreversible changes. The first case of lung cancer associated with indium lung developed in a nonsmoking ex-worker. He had been diagnosed with indium lung and stopped working in indium processing 17 years before. This suggested there is a need for appropriate screening to detect for complications of lung cancer at early stages for those with indium lung.
Japan is still a patriarchal society. There is an increasing number of female doctors who wish to follow a career path in surgery. This new generation of female surgeons need support not only in their career but also in work-life balance, especially after they have a family. We founded the Japan Association of Women Surgeons (JAWS) with the aims to advance females in surgery by providing networking and to develop leadership, mentorship, education, expertise and advocacy. This article describes our philosophy and activities, and our concept of role modeling. To find a single perfect role model is impossible in Japan, because lifestyle and family situations are quite different among individuals. Many young doctors in Japan find difficulties in identifying role models appropriate to their own situations. Our concept of remote role modeling is to identify multiple outstanding persons with excellent roles that one wishes to emulate; classify them by field of work, lifestyle, family situations, and others; then select the parts that one needs and assemble them to customize one’s own ideal role model. This type of role modeling is probably the most practical approach. While modern technology is good for communication, meeting role models in person at meetings and social occasions is important in building an ideal role model.
Rhegmatogenous retinal detachment (RRD) is a serious condition that can cause blindness without surgical treatment. RRD occurs when a retinal tear or hole allows fluid to accumulate below the retinal surface, causing the retina to separate from the underlying layers. RRD is difficult to treat because each case is unique, varying with the location, size, and duration of the detachment, as well as patient age. The first successful methods to reattach the retina in RRD used thermocautery to repair the detachment. Many renowned ophthalmologists continued to study RRD and developed many new surgical approaches, notably: scleral buckling (SB), in which a silicone band is placed around the eye to reduce traction on the retina caused by the vitreous humor that fills the eye; pars plana vitrectomy (PPV), which eliminates traction on the retina by removing the vitreous; and pneumatic retinopexy (PR), in which the retina is reattached by pushing it back into place with an expanding gas bubble injected into the eye. However, no consensus has been reached on which approach is ideal. Furthermore, recent surgical and non-surgical breakthroughs, such as artificial vitreous substitutes and neuroprotective drugs, must also be considered. Thus, this review provides a guide for ocular specialists and non-specialists on the historical background of RRD, summarizes the three current main techniques (SB, PR and PPV) compares these three techniques, and provides an overview of new technologies that promise to greatly improve outcomes after RRD surgery.
Extensive use of Wi-Fi has contributed to radiofrequency electromagnetic radiation (RF-EMR) pollution in environment. Various studies have been conducted to evaluate the effect of RF-EMR emitted by Wi-Fi transmitter on male reproduction health. However, there are conflicting findings between studies. Thus, this review aims to elucidate the possible effects of 2.45 GHz Wi-Fi exposure on both animal and human male reproductive system. A computerized database search performed through MEDLINE via Ovid and PUBMED with the following set of keywords: ‘Wi-Fi or WiFi or wireless fidelity or Wi-Fi router or WiFi router or electromagnetic or radiofrequency radiation’ AND ‘sperm or spermatozoa or spermatogenesis or semen or seminal plasma or testes or testis or testosterone or male reproduction’ had returned 526 articles. Only 17 studies conformed to pre-set inclusion criterion. Additional records identified through Google Scholar and reviewed article further revealed six eligible articles. A total of 23 articles were used for data extraction, including 15 studies on rats, three studies on mice, and five studies on human health. Sperm count, motility and DNA integrity were the most affected parameters when exposed to RF-EMR emitted by Wi-Fi transmitter. Unfortunately, sperm viability and morphology were inconclusive. Structural and/or physiological analyses of the testes showed degenerative changes, reduced testosterone level, increased apoptotic cells, and DNA damage. These effects were mainly due to the elevation of testicular temperature and oxidative stress activity. In conclusion, exposure towards 2.45 GHz RF-EMR emitted by Wi-Fi transmitter is hazardous on the male reproductive system.
Beta3-adrenergic receptor (ADRB3) is a mediator of catecholamine-stimulated lipolysis in humans. The Trp64Arg polymorphism with T/C transition in the ADRB3 gene has been considered to reduce lipolysis and metabolic expenditure. Here, we investigated the hitherto unknown role of the Trp64Arg substitution on food preference among healthy young adults (mean age, 24.3; n = 53, including 25 men). Preference toward four food types (bitter, sour, salty, or sweet) and greasy (high-fat) foods was examined using a self-reported questionnaire. There was no noticeable sex-difference in food preference. Incidentally, only among female subjects, the genotype frequencies of the Trp64Arg polymorphism were in accordance with the Hardy-Weinberg equilibrium. Consequently, female subjects were divided into two groups for further analyses: 18 subjects with TT genotype (Trp64Trp) (wild-type group) and 10 subjects with TC genotype (Trp64Arg) (heterozygous group). No significant difference was observed in preference for four food types between the groups. However, when sweet foods were divided into high-fat and low-fat subgroups, food preference for high-fat sweet foods in heterozygous group was significantly higher than that in wild-type group. Moreover, when subjects were divided into two classes based on preference for greasy foods (like, n = 16 or dislike, n = 12), the preference degree in heterozygous group who liked high-fat foods (n = 5) was significantly higher than that in wild-type group (n = 11), suggesting that the Trp64Arg substitution might genetically enhance high-fat food preference. Thus, understanding the relationship between ADRB3 Trp64Arg substitution and fat preference will be valuable for obesity prevention.
Idiopathic short stature (ISS) is a heterogeneous group and their responsiveness to growth hormone treatment varies among individuals. The aim of this study was to identify homogeneous phenotypes to better assess response before the initiation of treatment. We focused on person-centered approaches using a latent profile analysis. Clinical data of 218 children (127 boys and 91 girls) aged 4-15 years were obtained from the “LG Growth Study” which is a non-interventional Korean multicenter registry for growth hormone treatment. Growth hormone dose, first-year difference in height standard deviation score (Δheight SDS), mid-parental height SDS, and initial bone age were inputted into the model. The distribution of scatter plot was clearly distinguished at the chronological age of 8.83 years, Δheight SDS of 0.82 and mean GH dose of 0.36 mg/kg/week. The latent profile analysis revealed three distinct phenotypes names as follows: younger good responder (n = 56), older good responder (n = 111), and older poor responder (n = 51) groups. Despite more than twice the mean growth hormone dose, the older poor responder group showed the least improvement in the mean Δheight SDS. The pretreatment height velocity and peak growth hormone level were lower for the older poor responder group compared with those of the older good responder group. The statistically optimal cutoff point for predicting poor response was 3.41 cm/year for pretreatment height velocity and 9.18 ng/mL for peak growth hormone level. This study offers a new multidimensional approach to enable personalized growth hormone treatment optimization according to ISS phenotypes.
Dysphagia is a common problem among older adults, causing aspiration pneumonia and malnutrition. It has been reported that calf circumference (CC), an index of nutritional status and physical activity, correlated with dysphagia in acute care hospitals, suggesting that CC can be a useful index for assessing dysphagia. We therefore aimed to explore the association between dysphagia and CC among community elderly people who require long-term care and determined the optimal CC cut-off value for patients with dysphagia. Our cross-sectional study, conducted at Tokyo Metropolis, included 154 participants (65 men) aged > 65 years (mean age: 80.1 ± 7.1) who required long-term care and were examined for dental disease and dysphagia during home visiting treatment. Age, body mass index (BMI), mini-nutritional assessment short-form (MNA-SF) score, Barthel index (BI), CC, functional oral intake scale (FOIS), and dysphagia severity scale (DSS) were evaluated. A DSS score < 5 was defined as dysphagia. To determine the association between CC and dysphagia, we performed logistic regression analysis and calculated the CC cut-off value for dysphagia. Thirty-seven participants (24.0%) were diagnosed with dysphagia. The logistic regression analysis showed that the presence of dysphagia was independently associated with CC after adjusting for age and sex. The CC cut-off value for the presence of dysphagia was 31.0 cm in men (sensitivity, 0.818; specificity, 0.868) and 29.3 cm in women (sensitivity, 0.760; specificity, 0.859). CC is a useful index for assessing dysphagia among community dwelling individuals who require long-term care.
Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by systemic joint inflammation and may manifest as interstitial pneumonia (IP). Methotrexate (MTX) is one of the main therapeutic drugs used for RA, but MTX could cause severe side effects, including Pneumocystis jirovecii pneumonia (PCP) and IP. Owing to similar symptoms, it is sometimes difficult to discriminate MTX therapy-associated PCP (MTX-PCP) and MTX therapy-associated IP (MTX-IP). Soluble interleukin-2 receptor (sIL-2R) is considered a marker of T-cell activation, and serum sIL-2R levels are elevated in RA and PCP. This led us to hypothesize that serum sIL-2R is a potential biomarker for discriminating MTX-PCP and MTX-IP. Accordingly, we carried out a retrospective analysis of 20 MITX-PCP cases, 30 MTX-IP cases, and as controls, 16 patients with RA-associated IP (RA-IP) and 13 patients with PCP without MTX treatment (PCP group). C-reactive protein and alveolar-arterial oxygen differences were higher in the MTX-PCP group than those in the RA-IP and MTX-IP groups. Importantly, serum levels of sIL-2R in MTX-PCP were significantly higher than those in other three groups. Based on the receiver operating characteristic curve, the cut-off level of sIL-2R resulting in the highest diagnostic accuracy for MTX-PCP was 1,311.5 U/mL, discriminating between MTX-PCP and other groups with 91.7% sensitivity and 78.6% specificity. Thus, patients with MTX-PCP show a higher degree of systemic inflammation, severe hypoxemia, and increased sIL-2R levels compared with those in MTX-IP cases. In conclusion, serum sIL-2R could be a biomarker for PCP diagnosis among patients with RA under MTX therapy.
Body composition (BC) is related to the pathogenesis of musculoskeletal disease, especially research focused on the role of fat and muscle mass. This study aimed to identify the associations between the pressure pain threshold (PPT) and pain-related factors including BC. A total of 64 healthy farmers (21 males and 43 females) were recruited, and baseline data were analyzed cross-sectionally. Demographic characteristics (sex, age, marital status, education duration, current status of smoking and alcohol drinking, height, body weight, and underlying diseases) and a psychologic characteristic (a Korean version of the Beck Depression Inventory [BDI]) were assessed. Additionally, body composition analysis using bioelectrical impedance analysis (BIA) was performed. PPT was measured by applying an increasing amount of blunt pressure using a 1 cm2 hard rubber end at the thenar region of the right hand with a constant increase in pressure of 50 kPa/s. The PPT was measured on a single day, and the average value was used for analysis. The male group (67.00 ± 9.12 years) was older than the female group (62.21 ± 6.77 years; p = 0.021). In the body composition analysis, only segmental water of the right arm was positively related to PPT (β = 0.331, p = 0.030) in the multivariate linear regression analysis. In conclusion, hydration status was related to PPT with clinical implication that sufficient hydration could reduce the pain susceptibility. Thus, when assessing the painful condition, checking the hydration status could be helpful before the intensive treatment.