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Fujishima A, Maeda E, Sato K, Saito H, Ozeki C, Terada Y. Feasibility and effectiveness of preconception check-ups at workplaces in Japan. J Occup Health 2024:uiae021. [PMID: 38684110 DOI: 10.1093/joccuh/uiae021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 03/22/2024] [Indexed: 05/02/2024] Open
Abstract
OBJECTIVES Despite the recent increase in infertility and perinatal complications, preconception care is not commonly available in Japan. Working women are considered to have the greatest need for preconception care, as they increasingly marry and have children later in life. This study aimed to assess the feasibility and effectiveness of preconception check-ups in the workplace. METHODS We provided 51 female employees aged 18-39 years with free preconception check-ups, including additional blood tests and an online medical questionnaire, during mandatory health check-ups at their workplace. A doctor provided online counselling based on the check-up results. We assessed fertility knowledge using the Cardiff Fertility Knowledge Scale (CFKS-J) and childbearing desire pre- and post-intervention. RESULTS Preconception check-ups revealed various potential risk factors for future pregnancies, including underweight (12%), obesity (20%), Chlamydia trachomatis IgG antibody positivity (22%), low Rubella IgG antibody levels (47%), iron deficiency (12%), and 25-hydroxyvitamin D levels <30 ng/mL (98%). Post-intervention, the participants reported high satisfaction with the check-ups and significantly advanced their reproductive plans (P=0.008). Further, 95% of the participants indicated an intention to seek medical attention or make lifestyle changes. The post-intervention CFKS-J score (mean ± SD) was higher than the pre-intervention score (71.7 ± 19.3 versus 63.0 ± 22.0, P=0.006). CONCLUSIONS We developed a preconception check-up package that can be integrated into workplace health examinations, complemented by tailored counselling. This novel check-up package is a feasible and effective approach for improving preconception health and fertility awareness.
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Affiliation(s)
- Akiko Fujishima
- Department of Obstetrics and Gynaecology, Akita University Graduate School of Medicine, Akita, Japan
| | - Eri Maeda
- Department of Public Health, Faculty of Medicine, Hokkaido University, Hokkaido, Japan
| | - Koki Sato
- Specified Non-profit Corporation FORECIA, Akita, Japan
| | | | - Chihiro Ozeki
- Akita University School of Medicine, Department of Medicine, Akita, Japan
| | - Yukihiro Terada
- Department of Obstetrics and Gynaecology, Akita University Graduate School of Medicine, Akita, Japan
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Ozeki C, Maeda E, Hiraike O, Nomura K, Osuga Y. Changes in menstrual symptoms and work productivity after checklist-based education for premenstrual syndrome: an 8-month follow-up of a single-arm study in Japan. BMC Womens Health 2024; 24:242. [PMID: 38622575 PMCID: PMC11017586 DOI: 10.1186/s12905-024-03067-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 04/01/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Premenstrual syndrome (PMS) is prevalent among women of reproductive age, but most do not seek medical advice. We hypothesized that building PMS awareness could promote medical help-seeking for PMS and thus reduce menstrual symptoms and improve work productivity. METHODS In January 2020, women aged between 25 and 44 years, having paid work, and not currently consulting with an obstetrics and gynecology doctor (n = 3090) responded to the Menstrual Distress Questionnaire (MDQ), the Premenstrual Symptoms screening tool, and the World Health Organisation Health and Work Performance Questionnaire. In addition, they received checklist-based online education for PMS. Of 3090 participants, 2487 (80.5%) participated in a follow-up survey in September 2020. We conducted multiple logistic regression analyses and text analyses to explore factors that encouraged and discouraged medical help-seeking. We also evaluated changes in menstrual symptoms and work productivity, using generalized estimating equations with interactions between the severity of PMS, help-seeking, and time. RESULTS During the follow-up period, 4.9% of the participants (121/2487) sought medical help. Those having high annual income (adjusted odds ratio [aOR] = 2.07, 95% confidence interval [CI]: 1.21-3.53) and moderate-to-severe PMS (aOR = 2.27, 95% CI: 1.49-3.46) were more likely to have sought medical help. Those who did not seek medical help despite their moderate-to-severe PMS reported normalization of their symptoms (36%), time constraints (33%), and other reasons for not seeking medical help. Participants with moderate-to-severe PMS who had sought medical help showed a significant improvement of - 8.44 points (95% CI: - 14.73 to - 2.15 points) in intermenstrual MDQ scores during the follow-up period. However, there were no significant improvements in premenstrual and menstrual MDQ scores or absolute presenteeism. CONCLUSION Medical help-seeking alleviated intermenstrual symptoms in women with moderate-to-severe PMS, but only a small proportion of them sought medical help after PMS education. Further research should be conducted to benefit the majority of women who are reluctant to seek medical help, including the provision of self-care information. TRIAL REGISTRATION UMIN Clinical Trials Registry number: UMIN000038917.
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Affiliation(s)
- Chihiro Ozeki
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita, Japan
| | - Eri Maeda
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita, Japan.
- Department of Public Health, Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-Ku, Sapporo, 060-8638, Japan.
| | - Osamu Hiraike
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kyoko Nomura
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita, Japan
| | - Yutaka Osuga
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Yamamoto A, Nagao M, Nishizaki Y, Maeda E, Ishijima M. Risk factors for nonresponse to 2 years of denosumab administration in patients with osteoporosis: A retrospective single-center cohorts study. Health Sci Rep 2024; 7:e1993. [PMID: 38585014 PMCID: PMC10995440 DOI: 10.1002/hsr2.1993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 03/01/2024] [Accepted: 03/04/2024] [Indexed: 04/09/2024] Open
Abstract
Background and Aims To investigate the factors associated with changes in bone mineral density (BMD) and the incidence of fractures in osteoporotic patients treated with denosumab. Methods This retrospective study included 162 osteoporotic patients treated with denosumab for 24 months between 2013 and 2019. Patients were divided according to the changes in BMD as nonresponders (NL group: <3% increase in lumbar spine BMD [LBMD], NH group: <0% increase in femoral neck BMD [FNBMD]) or responders (RL group: ≥3% increase in LBMD, RH group: ≥0% increase in FNBMD). Results The respective changes in the LBMD and FNBMD after 24 months of denosumab treatment were 9.3% (95% confidence interval [CI]: 8.1-10.6) and 3.3% (95% CI: 2.1-4.5). Twenty-eight (17.3%) patients were in the NL group, and 134 (82.7%) were in the RL group. A history of bisphosphonate treatment was a risk factor for being in the NL group (odds ratio [OR]: 3.84, 95% CI: 1.38-10.71, p = 0.007; adjusted OR: 3.21, 95% CI: 1.01-10.19, p = 0.048). Although the NH (n = 48; 30.8%) and RH (n = 108; 69.2%) groups had similar baseline characteristics, the NH group had a significantly higher baseline FNBMD than the RH group (p = 0.003). The change in FNBMD was negatively associated with the FNBMD at baseline (r = -0.34, p < 0.001). No new osteoporotic fractures occurred in either group during follow-up. Conclusion In osteoporotic patients receiving denosumab treatment, a history of bisphosphonate treatment was a risk factor for a lack of increase in LBMD, and a higher FNBMD at baseline was negatively associated with the change in FNBMD.
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Affiliation(s)
- Akiko Yamamoto
- Clinical Translational ScienceJuntendo University Graduate School of MedicineTokyoJapan
| | - Masashi Nagao
- Clinical Translational ScienceJuntendo University Graduate School of MedicineTokyoJapan
- Medical Technology Innovation CenterJuntendo UniversityTokyoJapan
- Department of Medicine for Orthopaedics and Motor OrganJuntendo University Graduate School of MedicineTokyoJapan
- Department of Sports MedicineJuntendo University School of Sports and Health ScienceChibaJapan
| | - Yuji Nishizaki
- Clinical Translational ScienceJuntendo University Graduate School of MedicineTokyoJapan
- Medical Technology Innovation CenterJuntendo UniversityTokyoJapan
| | - Eri Maeda
- Department of Medicine for Orthopaedics and Motor OrganJuntendo University Graduate School of MedicineTokyoJapan
- Department of Orthopaedic SurgeryJuntendo Tokyo Koto Geriatric Medical CenterTokyoJapan
| | - Muneaki Ishijima
- Department of Medicine for Orthopaedics and Motor OrganJuntendo University Graduate School of MedicineTokyoJapan
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Martins MV, Koert E, Sylvest R, Maeda E, Moura-Ramos M, Hammarberg K, Harper J. Fertility education: recommendations for developing and implementing tools to improve fertility literacy†. Hum Reprod 2024; 39:293-302. [PMID: 38088127 PMCID: PMC10833069 DOI: 10.1093/humrep/dead253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 10/05/2023] [Indexed: 02/02/2024] Open
Abstract
Many recent societal trends have led to the need for fertility education, including the age at which individuals become parents, the development of new reproductive technologies, and family diversity. Fertility awareness has emerged as a concept very recently and is increasingly gaining recognition. However, fertility education is often neglected as there is no consensus on the appropriate content, target populations, or on who should provide it. This article attempts to provide an overview of the use of interventions to improve fertility education. We emphasize the importance of delivering evidence-based information on fertility and reproductive health through various methods while providing guidelines for their standardization and systematization. Recommendations are provided to aid the development and implementation of fertility education tools, including: the establishment of a comprehensive understanding of the target populations; the incorporation of theories of behavioural change; the inclusion of the users' perspectives and the use of participatory research; and the use of specific guidelines for increasing engagement. By following these recommendations, it is expected that fertility education resources can contribute to improving fertility literacy, empowering individuals and couples to make informed reproductive decisions, and ultimately reducing the incidence of infertility and need for fertility treatment.
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Affiliation(s)
- Mariana V Martins
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
- Centre for Psychology at University of Porto, Porto, Portugal
| | - Emily Koert
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Randi Sylvest
- The Fertility Department, University hospital Rigshospitalet, Copenhagen, Denmark
| | - Eri Maeda
- Department of Public Health, Faculty of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Mariana Moura-Ramos
- Clinical Psychology Unit, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- Center for Research in Neuropsychology and Cognitive and Behavioural Intervention, University of Coimbra, Coimbra, Portugal
| | - Karin Hammarberg
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Victorian Assisted Reproductive Treatment Authority, Melbourne, Australia
| | - Joyce Harper
- EGA Institute for Women’s Health, University College London, London, UK
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Shirasawa H, Kumazawa Y, Sato W, Iwasawa T, Togashi K, Ono N, Fujishima A, Takahashi K, Maeda E, Terada Y. The first nationwide website survey of the availability and costs of medical and non-medical oocyte cryopreservation in Japan. Heliyon 2023; 9:e19074. [PMID: 37636403 PMCID: PMC10448461 DOI: 10.1016/j.heliyon.2023.e19074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 08/02/2023] [Accepted: 08/10/2023] [Indexed: 08/29/2023] Open
Abstract
Research question How does the cost-related oocyte cryopreservation (OoC) vary by the facility in Japan, and what data is provided on the websites about OoC procedures? Design Website survey. The websites of all 621 facilities that provide assistive reproductive technology registered in Japan were surveyed in 2021. Data included the rates of explicit statements regarding the provision of OoC for only medical reasons (medical only group) or non-medical reasons (non-medical group). Based on whether or not facilities that perform OoC clearly stated the cost on their websites, we compared the costs of OoC and annual storage cost between medical only and non-medical groups. Furthermore, we examined the stated number of OoC procedures performed and their clinical outcomes. Results Of the 621 facilities, 146 (23.5%) clearly stated that they offer OoC on their websites. Of the 88 medical only groups and 58 non-medical groups, 24 (27.3%) and 42 (72.4%) clearly stated the OoC cost, and 27 (30.7%) and 44 (75.9%) clearly states the annual oocyte storage cost, respectively. The OoC costs were significantly higher for the non-medical group than in the medical group. In the medical only group, the annual storage cost remained almost the same regardless of the number of oocytes, while in the non-medical group, the annual storage cost was 2-3 times higher than in the medical only group. Only 16 facilities (16/146, 11.0%) had mentioned the number of OoC procedures, and five facilities (3.4%) provided information on the clinical outcomes after OoC. Conclusion Costs related to OoC are higher for the non-medical group in Japan. In addition, the websites contain scant information on the costs and clinical outcomes of OoC.
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Affiliation(s)
- Hiromitsu Shirasawa
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, Akita, Japan, Hondo 1-1-1, Akita City, Akita Prefecture, 10-0825, Japan
| | - Yukiyo Kumazawa
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, Akita, Japan, Hondo 1-1-1, Akita City, Akita Prefecture, 10-0825, Japan
| | - Wataru Sato
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, Akita, Japan, Hondo 1-1-1, Akita City, Akita Prefecture, 10-0825, Japan
| | - Takuya Iwasawa
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, Akita, Japan, Hondo 1-1-1, Akita City, Akita Prefecture, 10-0825, Japan
| | - Kazue Togashi
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, Akita, Japan, Hondo 1-1-1, Akita City, Akita Prefecture, 10-0825, Japan
| | - Natsuki Ono
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, Akita, Japan, Hondo 1-1-1, Akita City, Akita Prefecture, 10-0825, Japan
| | - Ayaka Fujishima
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, Akita, Japan, Hondo 1-1-1, Akita City, Akita Prefecture, 10-0825, Japan
| | - Kazumasa Takahashi
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, Akita, Japan, Hondo 1-1-1, Akita City, Akita Prefecture, 10-0825, Japan
| | - Eri Maeda
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita, Japan, Hondo 1-1-1, Akita City, Akita Prefecture, 10-0825, Japan
- Department of Public Health, Hokkaido University, Faculty of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo City, Hokkaido, 60-8638, Japan
| | - Yukihiro Terada
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, Akita, Japan, Hondo 1-1-1, Akita City, Akita Prefecture, 10-0825, Japan
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Jwa SC, Goto R, Maeda E, Kajihara T, Ishihara O. Model-based estimation of the health care expenditure and out-of-pocket payment for assisted reproductive technology: A retrospective linkage study using the Japanese national ART registry. J Obstet Gynaecol Res 2023. [PMID: 37194162 DOI: 10.1111/jog.15676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 05/04/2023] [Indexed: 05/18/2023]
Abstract
AIM From April 2022, the Japanese government funding system for assisted reproductive technology (ART) has shifted from government subsidies to universal health insurance. To date, studies estimating the health care expenditure for ART are scarce. We estimated health care expenditures for ART cycles and compared the proportion of patients' out-of-pocket payment by ovarian stimulation protocols under the Japanese government subsidy system. METHODS We linked payment information for government subsidies in Saitama Prefecture during 2016 and 2017 with the Japanese ART registry. Health care expenditures for all treatment cycles in Japan during 2017 among women aged <43 years (n = 369 757) were estimated using a generalized linear model. RESULTS We linked 6269 subsidy applications to the Japanese ART registry. The average treatment fee for a fresh cycle was 376 434 JPY (standard deviation = 159 581). However, significant variation was observed across ovarian stimulation protocols. The estimated health care expenditure for ART during 2017 was 101 278 629 888 JPY (920 714 817 USD), leading to a 0.24% increase in the national health care expenditure for fiscal year 2017. Fresh cycles accounted for 70% of the expenditure. The proportion of the average patient out-of-pocket payment for one treatment cycle was smaller for natural (0%) and mild ovarian stimulation using clomiphene citrate (4.5%-20.7%) than those of conventional stimulation (30.3%-32.4%). CONCLUSIONS Health insurance coverage for ART would increase national health care expenditure by 0.24%. Under the subsidy system, the proportion of the average patient out-of-pocket payment was smaller for natural and mild ovarian stimulation than conventional stimulations.
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Affiliation(s)
- Seung Chik Jwa
- Department of Obstetrics and Gynecology, Saitama Medical University, Saitama, Japan
- Department of Obstetrics and Gynecology, Jichi Medical University, Tochigi, Japan
| | - Rei Goto
- Graduate School of Business Administration, Keio University, Yokohama, Japan
| | - Eri Maeda
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita, Japan
| | - Takeshi Kajihara
- Department of Obstetrics and Gynecology, Saitama Medical University, Saitama, Japan
| | - Osamu Ishihara
- Department of Obstetrics and Gynecology, Saitama Medical University, Saitama, Japan
- Kagawa Nutrition University, Sakado, Saitama, Japan
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Sato Y, Wakita A, Maeda E, Nagaki Y, Sasamori R, Kemuriyama K, Nozaki S, Ito S, Terata K, Imai K, Nanjo H, Nomura K, Minamiya Y. High TLR6 Expression Status Predicts a More Favorable Prognosis after Esophagectomy for Locally Advanced Thoracic Esophageal Squamous Cell Carcinoma. Curr Oncol 2023; 30:4724-4735. [PMID: 37232814 DOI: 10.3390/curroncol30050356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/29/2023] [Accepted: 05/01/2023] [Indexed: 05/27/2023] Open
Abstract
Most so-called "beneficial bacteria" in gut microbiota are Gram-positive, and TLR6 recognizes the peptidoglycan (PGN) present in their cell walls. We hypothesized that a high TLR6 expression status predicts a more favorable prognosis after esophagectomy. We used an ESCC tissue microarray (TMA) to examine TLR6 expression status in ESCC patients and to determine whether TLR6 expression status correlates with prognosis after curative esophagectomy. We also examined whether PGN influences the cell proliferation activity of ESCC lines. Clinical ESCC samples from 177 patients tested for the expression of TLR6 were categorized as 3+ (n = 17), 2+ (n = 48), 1+ (n = 68), or 0 (n = 44). High TLR6 expression (3+ and 2+) correlated with significantly more favorable 5-year overall survival (OS) and disease-specific survival (DSS) after esophagectomy than a lower TLR6 expression (1+ and 0). Univariate and multivariate analyses showed that TLR6 expression status is an independent prognostic factor that affects 5-year OS. PGN significantly inhibited the cell proliferation activity of ESCC lines. This is the first study to show that high TLR6 expression status predicts a more favorable prognosis in locally advanced thoracic ESCC patients after curative esophagectomy. PGN released from "beneficial bacteria" seems to have potential to inhibit the cell proliferation activity of ESCC.
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Affiliation(s)
- Yusuke Sato
- Esophageal Surgery, Akita University Hospital, Akita 010-8543, Japan
- Department of Thoracic Surgery, Akita University Graduate School of Medicine, Akita 010-8543, Japan
| | - Akiyuki Wakita
- Esophageal Surgery, Akita University Hospital, Akita 010-8543, Japan
- Department of Thoracic Surgery, Akita University Graduate School of Medicine, Akita 010-8543, Japan
| | - Eri Maeda
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita 010-8543, Japan
| | - Yushi Nagaki
- Esophageal Surgery, Akita University Hospital, Akita 010-8543, Japan
- Department of Thoracic Surgery, Akita University Graduate School of Medicine, Akita 010-8543, Japan
| | - Ryohei Sasamori
- Esophageal Surgery, Akita University Hospital, Akita 010-8543, Japan
- Department of Thoracic Surgery, Akita University Graduate School of Medicine, Akita 010-8543, Japan
| | - Kohei Kemuriyama
- Esophageal Surgery, Akita University Hospital, Akita 010-8543, Japan
- Department of Thoracic Surgery, Akita University Graduate School of Medicine, Akita 010-8543, Japan
| | - Shu Nozaki
- Esophageal Surgery, Akita University Hospital, Akita 010-8543, Japan
- Department of Thoracic Surgery, Akita University Graduate School of Medicine, Akita 010-8543, Japan
| | - Satoru Ito
- Department of Pathology, Akita University Graduate School of Medicine, Akita 010-8543, Japan
| | - Kaori Terata
- Department of Thoracic Surgery, Akita University Graduate School of Medicine, Akita 010-8543, Japan
| | - Kazuhiro Imai
- Department of Thoracic Surgery, Akita University Graduate School of Medicine, Akita 010-8543, Japan
| | - Hiroshi Nanjo
- Department of Pathology, Akita University Graduate School of Medicine, Akita 010-8543, Japan
| | - Kyoko Nomura
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita 010-8543, Japan
| | - Yoshihiro Minamiya
- Esophageal Surgery, Akita University Hospital, Akita 010-8543, Japan
- Department of Thoracic Surgery, Akita University Graduate School of Medicine, Akita 010-8543, Japan
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Ota Y, Nomura K, Hirayama J, Maeda E, Komatsu J, Nakamura M, Yamada R, Ishikawa H, Kobayashi T, Shirakawa H, Aisaka K, Ono M, Hiraike H, Hiraike O, Okinaga H. Relationship between somatic symptoms with menstruation and intention to leave work among university hospital nurses in Japan: a cross-sectional study. Int Arch Occup Environ Health 2023; 96:155-166. [PMID: 35913561 DOI: 10.1007/s00420-022-01905-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 06/23/2022] [Indexed: 01/11/2023]
Abstract
PURPOSE This study investigated the association between menstrual symptoms and the intention to leave work among female nurses in Japan. METHODS This cross-sectional study investigated female nurses (n = 317) at two university hospitals. The items measured were their characteristics (e.g., age, body mass index), "intention to leave" work, somatic symptoms related with menstruation, self-reported menstrual characteristics (e.g., pain), physical workloads (e.g., working hours and night shifts) and psychological workloads, measured with the Copenhagen Burnout Inventory (CBI), and the Job Content Questionnaire (JCQ). Participants with at least four somatic symptoms (e.g., cold, fatigue) which are present during their menstrual cycles were considered to have "somatic symptoms associated with menstruation." We also measured serum ovarian and gonadotropin-releasing hormones. RESULTS Approximately 40% of women answered "intention to leave" work, and 17% had "somatic symptoms associated with menstruation." Multiple logistic regression analysis suggested that nurses reporting "somatic symptoms associated with menstruation" were more likely to have "intention to leave" work: the adjusted odds ratios (AOR, 95% confidence interval [CI]) were 2.15 (1.12-4.11) in the personal-burnout model, 2.23 (1.16-4.31) in the work-related burnout model, 2.91 (1.52-5.56) in the client-related burnout model; 2.96 (1.50-5.82) in the JCQ model. There was no association between serum and gonadotropin hormones and the intention to leave. CONCLUSION Somatic symptoms with menstruation were associated with intention to leave work among female Japanese nurses. Intervention for somatic symptoms with menstruation might support nurses to continue work.
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Affiliation(s)
- Yu Ota
- School of Medicine, Akita University, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Kyoko Nomura
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.
| | - Junko Hirayama
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Eri Maeda
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Junko Komatsu
- Akita University Hospital, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Mio Nakamura
- Akita University Hospital, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Rouko Yamada
- Akita University Hospital, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Hitomi Ishikawa
- Akita University Hospital, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Teiko Kobayashi
- Akita University Hospital, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Hideko Shirakawa
- Akita Nursing Station, 6-6 Sensyukubotamachi, Akita, 010-0874, Japan
| | - Kozo Aisaka
- Hamada Hospital, 2-5, Kandasurugadai, Chiyoda, Tokyo, 101-0062, Japan
| | - Mariko Ono
- School of Medicine, Teikyo University, 2-11-1 Kaga, Itabashi, Tokyo, 173-8605, Japan
| | - Haruko Hiraike
- Department of Obstetrics and Gynecology, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi, Tokyo, 173-8606, Japan
| | - Osamu Hiraike
- Department of Obstetrics and Gynecology, Tokyo University School of Medicine, 7-3-1 Hongo, Bunkyo, Tokyo, 113-8655, Japan
| | - Hiroko Okinaga
- Support Center for Women Physicians and Researchers, Teikyo University, 2-11-1 Kaga, Itabashi, Tokyo, 173-8605, Japan
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9
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Maeda E, Jwa SC, Kumazawa Y, Saito K, Iba A, Yanagisawa-Sugita A, Kuwahara A, Saito H, Terada Y, Fukuda T, Ishihara O, Kobayashi Y. Out-of-pocket payment and patients' treatment choice for assisted reproductive technology by household income: a conjoint analysis using an online social research panel in Japan. BMC Health Serv Res 2022; 22:1093. [PMID: 36030225 PMCID: PMC9420282 DOI: 10.1186/s12913-022-08474-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 08/22/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Economic disparities affect access to assisted reproductive technology (ART) treatment in many countries. At the time of this survey, Japan provided partial reimbursement for ART treatment only for those in low- or middle-income classes due to limited governmental budgets. However, the optimal level of financial support by income class remains unclear. METHODS We conducted a conjoint analysis of ART in Japan in January 2020. We recruited 824 women with fertility problems aged 25 to 44 years via an online social research panel. They completed a questionnaire of 16 hypothetical scenarios measuring six relevant ART attributes (i.e., out-of-pocket payment, pregnancy rate, risk of adverse effects, number of visits to outpatient clinics, consultation hours and kindness of staff) and their relations to treatment choice. RESULTS Mixed-effect logistic regression models showed that all six attributes significantly influenced treatment preferences, with participants valuing out-of-pocket payment the most, followed by pregnancy rates and kindness of staff. Significant interactions occurred between high household income (≥ 8 million JPY) and high out-of-pocket payment (≥ 500,000 JPY). However, the average marginal probability of the highest-income patients (i.e., ≥ 10 million JPY, ineligible for the subsidy) receiving ART treatment at the average cost of 400,000 JPY was 47%, compared to 56 - 61% of other income participants, who opted to receive ART at an average cost of 100,000 JPY after a 300,000 JPY subsidy. CONCLUSION Our results suggest that out-of-pocket payment is the primary determinant in patients' decision to opt for ART treatment. High-income patients were more likely to choose treatment, even at a high cost, but their income-based ineligibility for government financial support might discourage some from receiving treatment.
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Affiliation(s)
- Eri Maeda
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita-shi, Akita, 010-8543, Japan.
| | - Seung Chik Jwa
- Department of Obstetrics and Gynecology, Saitama Medical University, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan
| | - Yukiyo Kumazawa
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita-shi, Akita, 010-8543, Japan
| | - Kazuki Saito
- Department of Comprehensive Reproductive Medicine, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Arisa Iba
- Department of Public Health, Graduate School of Medicine, the University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Ayako Yanagisawa-Sugita
- Department of Public Health, Graduate School of Medicine, the University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Akira Kuwahara
- Department of Obstetrics and Gynecology, Graduate School of Biomedical Sciences, Tokushima University, 3-18-15 Kuramoto-cho, Tokushima-shi, Tokushima, 770-8503, Japan
| | - Hidekazu Saito
- Umegaoka Women's Clinic, 1-33-3 Umegaoka, Setagaya-ku, Tokyo, 154-0022, Japan
| | - Yukihiro Terada
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita-shi, Akita, 010-8543, Japan
| | - Takashi Fukuda
- Center for Outcomes Research and Economic Evaluation for Health, National Institute of Public Health, 2-3-6 Minami, Wako-shi, Saitama, 351-0197, Japan
| | - Osamu Ishihara
- Department of Obstetrics and Gynecology, Saitama Medical University, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan
| | - Yasuki Kobayashi
- Department of Public Health, Graduate School of Medicine, the University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
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10
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Nomura K, Yamazaki T, Maeda E, Hirayama J, Ono K, Fushimi M, Mishima K, Yamamoto F. Longitudinal survey of depressive symptoms among university students during the COVID-19 pandemic in Japan. Front Psychol 2022; 13:863300. [PMID: 36092090 PMCID: PMC9454255 DOI: 10.3389/fpsyg.2022.863300] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 08/02/2022] [Indexed: 11/13/2022] Open
Abstract
While changes in response to the different stages of the pandemic remain unknown, this study investigated the longitudinal impact of the COVID-19 pandemic on depressive symptoms in Japanese university students and identified factors associated with new onset of depression and suicidal ideation. Two surveys were conducted at one university in Akita, Japan, during the first COVID-19 outbreak period (T1: May–June 2020) and 1 year later (T2: March–May 2021). Moderate depressive symptoms were defined as a Patient Health Questionnaire-9 score ≥ 10 and suicide-related ideation score ≥ 1 on question 9 of the questionnaire. Among 985 students who completed surveys in T1 and T2, participants with moderate depressive symptoms and suicide-related ideation increased from 11 to 17% and from 5.8 to 11.8%, respectively. Among 872 students at risk after excluding those with moderate depressive symptoms at T1, 103 students (11.8%) developed moderate depressive symptoms at T2. Among the 928 students at risk, after excluding those who had suicidal ideation at T1, 79 (8.5%) developed suicidal ideation. Multivariate logistic modeling revealed financial insecurity and academic performance as risk factors (ps < 0.01), while having someone to consult about worries was a coping factor for depressive symptoms and suicidal ideation (ps < 0.001). Our findings demonstrated that socioenvironmental factors may determine depressive symptoms of university students.
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Affiliation(s)
- Kyoko Nomura
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita, Japan
- *Correspondence: Kyoko Nomura,
| | - Teiichiro Yamazaki
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita, Japan
| | - Eri Maeda
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita, Japan
| | - Junko Hirayama
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita, Japan
| | - Kyoichi Ono
- Department of Cell Physiology, Akita University Graduate School of Medicine, Akita, Japan
| | | | - Kazuo Mishima
- Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan
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11
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Maeda E, Hiraike O, Sugimori H, Kinoshita A, Hirao M, Nomura K, Osuga Y. Working conditions contribute to fertility-related quality of life: A cross-sectional study in Japan. Reprod Biomed Online 2022; 45:1285-1295. [DOI: 10.1016/j.rbmo.2022.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 06/29/2022] [Accepted: 07/11/2022] [Indexed: 10/17/2022]
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12
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Yanagisawa-Sugita A, Iba A, Maeda E, Jwa SC, Saito K, Kuwahara A, Saito H, Terada Y, Ishihara O, Kobayashi Y. O-080 Impact of age-limit policy change for assisted reproductive technology (ART) subsidy in Japan. Hum Reprod 2022. [DOI: 10.1093/humrep/deac104.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
What was the impact on treatment age in Japan after a subsidy policy change that set age limits for assisted reproductive technology (ART) treatment?
Summary answer
The national policy introducing age limits in the subsidy may have promoted ART treatment among younger women.
What is known already
Japan has provided partial subsidies for ART treatment since 2004. To promote treatment at a younger age, the government introduced a subsidy policy in 2016 that set age limits: up to six treatment cycles for women younger than 40 years of age; and up to three cycles for women between 40 and 42 years old. However, two out of 47 prefectures continued to provide subsidies to women aged 43 and older.
Study design, size, duration
We conducted a time series analysis of the utilisation of ART before and after the introduction of age limits, using data from the Japanese national ART registry from 2012 to 2016.
Participants/materials, setting, methods
We described the number of fresh and frozen treatment cycles, comparing the number between 45 prefectures that followed the national policy change (hereafter, prefectures with age limits) and two prefectures that did not (hereafter, prefectures without age limits). Ordinary least squares regression models were used to assess the impact of the policy change by prefecture on the number of ART cycles by women of different ages.
Main results and the role of chance
The overall number of fresh and frozen ART cycles continuously increased in all age groups from 2012 to 2016. Meanwhile, the number of fresh ART cycles among women aged ≤ 36 and 37-39 years in 2016 increased from the previous year by + 4.0% and +1.8% in prefectures with age limits, whereas it decreased in prefectures without age limits: -3.1% and -2.3%, respectively. The number of fresh ART cycles among women aged 40-42 and 43-45 years in prefectures with age limits in 2016 changed by + 1.5% and -0.1%, respectively, whereas it increased considerably in prefectures without age limits by + 9.6% and +65.4%, respectively. Similar changes were shown for the frozen cycles. After controlling for underlying time trends and prefectural characteristics, the policy change significantly increased the number of fresh and frozen ART treatment cycles among women aged ≤ 36 years and decreased the treatment cycles of women aged 40-42 years.
Limitations, reasons for caution
We evaluated the change observed in the year of the policy change and could not assess longer-term trends. Additionally, unobserved factors might have contributed to the change in treatment numbers.
Wider implications of the findings
The introduction of a policy to set an age limit for the partial ART subsidy resulted in a significant increase in treatment even among age groups younger than the boundary groups. The policy change might have conveyed educational messages regarding the benefits of early treatment.
Trial registration number
not applicable
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Affiliation(s)
| | - A Iba
- The University of Tokyo, Public Health, Tokyo , Japan
| | - E Maeda
- Akita University Graduate School of Medicine, Environmental Health Science and Public Health, Akita , Japan
| | - S C Jwa
- Saitama Medical University, Obstetrics and Gynecology, Saitama , Japan
| | - K Saito
- Tokyo Medical and Dental University, Comprehensive Reproductive Medicine, Tokyo , Japan
| | - A Kuwahara
- Tokushima University, Obstetrics and Gynecology, Tokushima , Japan
| | - H Saito
- Umegaoka Women's Clinic, ART center, Tokyo , Japan
| | - Y Terada
- Akita University Graduate School of Medicine, Obstetrics and Gynecology, Akita , Japan
| | - O Ishihara
- Saitama Medical University, Obstetrics and Gynecology, Saitama , Japan
| | - Y Kobayashi
- The University of Tokyo, Public Health, Tokyo , Japan
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13
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Maeda E, Miura H, Terada Y. The validity of claim-based cesarean deliveries in Japan. J Obstet Gynaecol Res 2022; 48:2021-2022. [PMID: 35416368 DOI: 10.1111/jog.15261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 03/27/2022] [Accepted: 03/29/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Eri Maeda
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita, Japan
| | - Hiroshi Miura
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, Akita, Japan
| | - Yukihiro Terada
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, Akita, Japan
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Akita M, Maeda E, Ishida R, Morikawa T, Nishimura T, Abe K, Kozuki A, Tanaka T, Imai Y, Kaneda K. Aggressive behavior of anaplastic undifferentiated carcinoma arising from the hilar bile duct. Surg Case Rep 2022; 8:14. [PMID: 35038019 PMCID: PMC8762531 DOI: 10.1186/s40792-022-01368-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 01/11/2022] [Indexed: 12/02/2022] Open
Abstract
Background Undifferentiated carcinoma of the biliary tree is extremely rare, and biliary undifferentiated carcinoma mostly originates from the gallbladder. We herein present a case of anaplastic undifferentiated carcinoma of the hilar bile duct and reviewed the literature. Case presentation The patient was an 81-year-old male with obstructive jaundice. Contrast-enhanced computed tomography (CT) showed a protruded tumor located at the hepatic hilum. Obstructive jaundice was relieved by endoscopic drainage. Endoscopic biopsy revealed carcinoma without glandular differentiation, and the patient was diagnosed with resectable hilar undifferentiated carcinoma. During the 5-week preoperative examination, the tumor increased in size from 23 to 45 mm. Left hemi-hepatectomy and extrahepatic bile duct resection were performed, and there were no postoperative complications. Histological findings demonstrated that the tumor was mainly composed of non-cohesive polygonal neoplasms with pleomorphic nuclei, and was diagnosed as anaplastic undifferentiated carcinoma of the common hepatic duct (T2a N0 M0 Stage II). One month after surgery, the patient was readmitted to our hospital with pyrexia due to cholangitis, and liver nodules suggestive of multiple liver metastases were detected by CT. Three months after surgery, the patient died of multiple liver metastases. Conclusions This is the first case report of undifferentiated cholangiocarcinoma with anaplastic features. Anaplastic undifferentiated carcinoma of the hilar bile duct showed preoperative rapid growth and early relapse despite a cancer-negative surgical margin.
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Affiliation(s)
- Masayuki Akita
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan.
| | - Eri Maeda
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
| | - Ryo Ishida
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
| | - Tatsuya Morikawa
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
| | - Tohru Nishimura
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
| | - Koichiro Abe
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
| | - Akihito Kozuki
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
| | - Tomohiro Tanaka
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
| | - Yukihiro Imai
- Depertment of Diagnostic Pathology, Kakogawa Central City Hospital, Kakogawa, Japan
| | - Kunihiko Kaneda
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
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15
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Jwa SC, Ishihara O, Kuwahara A, Saito K, Saito H, Terada Y, Kobayashi Y, Maeda E. Social capital and use of assisted reproductive technology in young couples: Ecological study using application information for government subsidies in Japan. SSM Popul Health 2021; 16:100995. [PMID: 34950764 PMCID: PMC8671120 DOI: 10.1016/j.ssmph.2021.100995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 11/28/2021] [Accepted: 12/03/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Assisted reproductive technology (ART) is a globally established treatment; however, large disparities exist in ART use among young couples. We investigated regional-level factors associated with ART use in Japan. METHODS We calculated the use rate of ART using the number of women aged <35 years who applied for government subsidies in 2017; we divided that figure by the number of women aged 20-35 years in each prefecture. Prefectural-level average household income; social capital indicators including voting rate, volunteer rate, and move-in rate; and Gini coefficients as indicators of income inequality were linked to ART use, adjusting for prefectural size, the mean age of women at first marriage, number of ART facilities, and additional prefectural subsidies. RESULTS The rate of ART use (per 10,000 women) varied significantly from 22.0 to 58.8 across Japan's 47 prefectures. Multivariate analysis demonstrated that the use rate increased by 0.048 (95% confidence interval [CI], 0.007 to 0.088) for each 10,000-yen increase in average household income and 1.5 (95% CI, 0.65 to 2.3) for each 1% increase in volunteer rate. Conversely, the use rate decreased by 18.4 (95% CI, -28.6 to -8.1) for each 1% increase in the move-in rate. There was no significant association between ART use and income inequality. CONCLUSION Although we cannot infer causal relationships, the findings suggest that improving financial access and enhancing social capital may increase access to ART. Further research, particularly multilevel analysis using individual data, is required to confirm these findings.
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Affiliation(s)
- Seung Chik Jwa
- Department of Obstetrics and Gynecology, Saitama Medical University, 38 Morohongo, Moroyama, Saitama, 350-0495, Japan
| | - Osamu Ishihara
- Department of Obstetrics and Gynecology, Saitama Medical University, 38 Morohongo, Moroyama, Saitama, 350-0495, Japan
| | - Akira Kuwahara
- Department of Obstetrics and Gynecology, Graduate School of Biomedical Sciences, Tokushima University, 3-18-15, Kuramoto-cho, Tokushima, 770-8503, Japan
| | - Kazuki Saito
- Department of Pediatrics, Perinatal, and Maternal Medicine (Ibaraki), Graduate School, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Hidekazu Saito
- Umegaoka Women's Clinic, 1-33-3, Umegaoka, Setagaya-ku, Tokyo, 154-0022, Japan
| | - Yukihiro Terada
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Akita University, 1-1-1, Hondo, Akita, 010-8543, Japan
| | - Yasuki Kobayashi
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Eri Maeda
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, 1-1-1, Hondo, Akita, 010-8543, Japan
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16
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Suto M, Mitsunaga H, Honda Y, Maeda E, Ota E, Arata N. Development of a health literacy scale for preconception care: a study of the reproductive age population in Japan. BMC Public Health 2021; 21:2057. [PMID: 34758797 PMCID: PMC8579655 DOI: 10.1186/s12889-021-12081-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 10/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Preconception care aims to improve both maternal and child health in the short as well as long term, along with providing health benefits to adolescents, women, and men, whether or not they plan to become parents. However, there is limited evidence regarding the effectiveness of interventions for improving preconception health in population-based settings. To accumulate evidence in this field, this study focused on the concept of health literacy, and aimed to develop a self-report health literacy scale in Japanese, focusing on preconception care. METHODS We conducted a cross-sectional online survey. Participants were recruited from December 2019 to February 2020 from the registered members of a web-based research company. Participants were Japanese men and women aged 16-49 (n = 2000). A factor analysis was conducted to select both factors and items for health-related behavior and skills (33 initial items were generated), along with an item response theory analysis to examine how the 16 items were related to people's knowledge of preconception care. RESULTS We developed a 6-factor (including "appropriate medical examinations," "appropriate diet," "stress coping," "healthy weight," "safe living environment," and "vaccinations"), 25-item behavior and skills scale, as well as a 13-item knowledge scale, to evaluate participants' health literacy around preconception care. A shortened version, consisting of 17 items, was also prepared from the 25 items. The reliability coefficients of total scores and each factor of the behavior and skills scale were comparatively high, with weak-to-moderate correlation between behavior and skills and knowledge. CONCLUSIONS The new scale will, ideally, provide information on the current state of preconception care health literacy of the general population. In addition, this scale, which consists of both behavioral/skills and knowledge dimensions, should help support the effective implementation of risk assessment programs and interventions aimed at promoting behavioral changes using a population-based approach. Future studies using different question/administration formats for diverse populations, and considering respondents' opinions on health literacy scales should be effective in improving this scale.
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Affiliation(s)
- Maiko Suto
- Department of Health Policy, National Center for Child Health and Development, 10-1 Okura 2-chome, Setagaya, Tokyo, 157-8535, Japan
| | - Haruhiko Mitsunaga
- Graduate School of Education and Human Development, Nagoya University, Furo-cho, Chikusa-ku Nagoya, 464-8601, Japan
| | - Yuka Honda
- Division of Maternal Medicine, Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, 10-1 Okura 2-chome, Setagaya, Tokyo, 157-8535, Japan
| | - Eri Maeda
- Department of Environmental Health Sciences, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Erika Ota
- Global Health Nursing, Graduate School of Nursing Science, St. Luke's International University, 3-6-2 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Naoko Arata
- Division of Maternal Medicine, Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, 10-1 Okura 2-chome, Setagaya, Tokyo, 157-8535, Japan.
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17
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Jwa SC, Ishihara O, Kuwahara A, Saito K, Saito H, Terada Y, Kobayashi Y, Maeda E. Cumulative live birth rate according to the number of receiving governmental subsidies for assisted reproductive technology in Saitama Prefecture, Japan: A retrospective study using individual data for governmental subsidies. Reprod Med Biol 2021; 20:451-459. [PMID: 34646073 PMCID: PMC8499586 DOI: 10.1002/rmb2.12397] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/20/2021] [Accepted: 06/01/2021] [Indexed: 01/31/2023] Open
Abstract
PURPOSE We investigated the cumulative live birth rate (CLBR) in women receiving governmental subsidies for assisted reproductive technology (ART) in Saitama Prefecture, Japan. METHODS Women who applied for subsidies from Saitama Prefectural Government for the first time in 2016 were enrolled and followed up until the end of 2017. Treatment information, including live birth, was obtained from the Japanese ART registry by linking it with unique identification numbers for treatment. Patients' factors associated with having a live birth were investigated. RESULTS Of 1,072 women (2,513 applications), 495 (46.2%) had a live birth with 8 (1.6%) twin pregnancies. The CLBR over six subsidized cycles was 53.7% for women aged <40 years, and 17.2% over three subsidized cycles for women 40-42 years; highest among women <35 years (58.4%), followed by those aged 35-39 years (49.3%). Multivariate analysis revealed patient age as the only independent factor for having a live birth. CONCLUSIONS The CLBR of women receiving subsidies for ART was greatest in women aged <35 years. Effective policies for promoting ART among younger couples who seek infertility treatment are essential.
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Affiliation(s)
- Seung Chik Jwa
- Department of Obstetrics and GynecologySaitama Medical UniversitySaitamaJapan
| | - Osamu Ishihara
- Department of Obstetrics and GynecologySaitama Medical UniversitySaitamaJapan
| | - Akira Kuwahara
- Department of Obstetrics and GynecologyGraduate School of Biomedical SciencesTokushima UniversityTokushimaJapan
| | - Kazuki Saito
- Department of Comprehensive Reproductive MedicineGraduate SchoolTokyo Medical and Dental UniversityTokyoJapan
| | | | - Yukihiro Terada
- Department of Obstetrics and GynecologyGraduate School of MedicineAkita UniversityAkitaJapan
| | - Yasuki Kobayashi
- Department of Public HealthGraduate School of MedicineThe University of TokyoTokyoJapan
| | - Eri Maeda
- Department of Environmental Health Science and Public HealthAkita University Graduate School of MedicineAkitaJapan
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Akita M, Maeda E, Nishimura T, Abe K, Kozuki A, Yokoyama K, Tanaka T, Kishi S, Kaneda K. Anatomical change of SMV branches after the Cattell Braasch maneuver facilitates safe resection around the uncinated process in pancreatoduodenectomy. BMC Surg 2021; 21:341. [PMID: 34496813 PMCID: PMC8425086 DOI: 10.1186/s12893-021-01338-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 08/31/2021] [Indexed: 01/04/2023] Open
Abstract
Background The aims of the present study were to demonstrate the anatomical change of superior mesenteric vein (SMV) branches and to show how the Cattell Braasch maneuver facilitates a safer ligation of these venous branches during a pancreatoduodenectomy (PD). Methods Between January 2010 and December 2019, 97 patients with peripancreatic tumors underwent pancreatectomy. We retrospectively reviewed preoperative triple-phase enhanced computed tomography (CT) images and analyzed variations in SMV branches. Anatomical changes in SMV branches after the Cattell Braasch technique were observed using our operation video and illustrations. Results The first jejunal vein (J1v) in 75% of patients ran posterior to the superior mesenteric artery (SMA), while the remainder (25%) ran anterior to it. The inferior pancreatoduodenal vein (IPDV) was preoperatively detected in 91% of patients. The IPDV drained into the J1v in 74% of patients and into the SMV in 37%. After the Cattell Braasch maneuver, the J1v which ran posterior to the SMA now was found to lie to the right anterolateral side the SMA and the visualization of both the J1v and the IPDV were much more clearly visualized. Conclusions The most frequent venous variation was the IPDV draining into the J1v posterior to the SMA. After the Cattell Braasch maneuver, the IPDV was now located to the right anterolateral anterior aspect of the SMA which facilitates its visualization and should allow a safer ligation. Supplementary Information The online version contains supplementary material available at 10.1186/s12893-021-01338-5.
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Affiliation(s)
- Masayuki Akita
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan.
| | - Eri Maeda
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
| | - Tohru Nishimura
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
| | - Koichiro Abe
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
| | - Akihito Kozuki
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
| | - Kunio Yokoyama
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
| | - Tomohiro Tanaka
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
| | - Shinji Kishi
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
| | - Kunihiko Kaneda
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
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19
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Maeda E, Jwa SC, Kumazawa Y, Saito K, Iba A, Yanagisawa A, Kuwahara A, Saito H, Terada Y, Fukuda T, Ishihara O, Kobayashi Y. P–721 Probability of receiving assisted reproductive technology treatment through out-of-pocket payment and household income: A discrete choice experiment in Japan. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
What is the probability that patients will receive assisted reproductive technology (ART) treatment based on their out-of-pocket payment and income class?
Summary answer
Higher-income patients opted for ART even at a higher cost, whereas an out-of-pocket payment was the most influential determinant in all income groups.
What is known already
Economic disparities affect access to ART treatment in many countries. At the time of this survey, Japan provided partial reimbursement for ART treatment exclusively for those in low- or middle-income classes due to limited governmental budgets. However, the optimal financial support by income class is unknown.
Study design, size, duration
We conducted a discrete choice experiment (DCE) in Japan in January 2020 including 824 women with fertility problems who were recruited via an online social research panel.
Participants/materials, setting, methods
Participants included women aged 25–44 years undergoing fertility diagnosis or treatment. They completed a DCE questionnaire including 16 hypothetical scenarios, created by orthogonal design, to measure six relevant ART attributes (pregnancy rate, risk of adverse effects, number of visits to outpatient clinics, consultation hours, kindness of staff, and out-of-pocket expense) and their relation to treatment choice. We used mixed-effect logistic regression models to estimate the probability of receiving ART treatment for each attribute.
Main results and the role of chance
Of the 1,247 eligible women recruited, 824 completed the survey (66% participation rate). All six attributes significantly influenced treatment preference, with participants valuing out-of-pocket payment the most, followed by pregnancy rates and kindness of staff. The odds ratios of each attribute to receiving ART treatment were 0.58 (95% confidence interval [CI]: 0.57 − 0.59) for out-of-pocket payments per additional 100,000 Japanese yen (JPY; i.e., 800 euros), 1.47 (95% CI: 1.43 − 1.53) for pregnancy rates per additional 5%, and 4.16 (95% CI: 3.73 − 4.64) for kindness of staff, after adjusting for clinical and socioeconomic factors. Significant interactions occurred between high household income (≥8 million JPY) and high out-of-pocket payment (≥500,000 JPY). However, the mean predicted probability of the highest-income patients (i.e., ≥10 million JPY) to receive ART treatment at the average cost without public funding (i.e., 400,000 JPY) was 47% (interquartile range: 18%−76%), whereas that of middle-income patients (i.e., 6–8 million JPY) to receive ART at the average subsidized cost (i.e., 100,000 JPY) was 60% (interquartile range: 33%–88%).
Limitations, reasons for caution
Other attributes not included in our DCE scenarios might be relevant in real-life settings. Choices made in a DCE would not wholly match the actual treatment choices.
Wider implications of the findings: The present DCE suggested that out-of-pocket payment was the primary determinant in patients’ ART decisions. High-income patients were more likely to receive ART treatment even at a high cost, but their ineligibility for government financial support due to their high income might discourage them from receiving treatment.
Trial registration number
NA
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Affiliation(s)
- E Maeda
- Akita University Graduate School of Medicine, Environmental Health Science and Public Health, Akita, Japan
| | - S C Jwa
- Saitama Medical University, Obstetrics and Gynecology, Saitama, Japan
| | - Y Kumazawa
- Akita University Graduate School of Medicine, Obstetrics and Gynecology, Akita, Japan
| | - K Saito
- Tokyo Medical and Dental University, Department of Comprehensive Reproductive Medicine, Tokyo, Japan
| | - A Iba
- Graduate School of Medicine- the University of Tokyo, Department of Public Health, Tokyo, Japan
| | - A Yanagisawa
- Graduate School of Medicine- the University of Tokyo, Department of Public Health, Tokyo, Japan
| | - A Kuwahara
- Graduate School of Biomedical Sciences- Tokushima University, Department of Obstetrics and Gynecology, Tokushima, Japan
| | - H Saito
- Umegaoka Women’s Clinic, ART center, Tokyo, Japan
| | - Y Terada
- Akita University Graduate School of Medicine, Obstetrics and Gynecology, Akita, Japan
| | - T Fukuda
- National Institute of Public Health, Center for Outcomes Research and Economic Evaluation for Health, Saitama, Japan
| | - O Ishihara
- Saitama Medical University, Obstetrics and Gynecology, Saitama, Japan
| | - Y Kobayashi
- Graduate School of Medicine- the University of Tokyo, Department of Public Health, Tokyo, Japan
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20
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Nagaki Y, Motoyama S, Sato Y, Wakita A, Fujita H, Kemuriyama K, Sasaki Y, Imai K, Maeda E, Minamiya Y. PET-Uptake Reduction into Lymph Nodes After Neoadjuvant Therapy is Highly Predictive of Prognosis for Patients Who have Thoracic Esophageal Squamous Cell Carcinoma Treated with Chemoradiotherapy Plus Esophagectomy. Ann Surg Oncol 2021; 29:1336-1346. [PMID: 34355333 DOI: 10.1245/s10434-021-10564-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 07/20/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Patients with 18F-fluorodeoxyglucose-positron emission tomography (FDG-PET)-positive lymph nodes before treatment have a poor prognosis after esophagectomy. This study investigated whether FDG uptake into lymph nodes on FDG-PET (PET-N) during the pre- or posttreatment stage is more predictive of survival for thoracic esophageal squamous cell carcinoma (TESCC) patients who received neoadjuvant chemoradiotherapy (NACRT) followed by esophagectomy. METHODS Of 129 TESCC patients with clinical lymphatic metastasis who underwent curative-intent esophagectomy after NACRT between 2010 and 2018, 97 who received PET before and after NACRT were enrolled in the study. The study defined lymph nodes with a maximum standardized uptake value (SUVmax) greater than 2.5 on FDG-PET before NACRT as cPET-N(+) and after NACRT as CRT-cPET-N(+). Both the cPET-N(+) and CRT-cPET-N(-) patients were defined as PET-N responders. Survival was analyzed using the Kaplan-Meier method and Cox proportional hazard models. RESULTS No significant difference in survival was detected between the cPET-N(+) and cPET-N(-) patients. However, the CRT-cPET-N(-) patients had significantly better 5-year overall survival (OS) and disease-specific survival (DSS) than the CRT-cPET-N (+) patients. The PET-N responders had significantly better 5-year OS and DSS than the PET-N non-responders, and PET-N response was an independent prognostic factor for 5-year DSS. CONCLUSION The PET-N response is a highly predictive prognostic marker for TESCC patients who undergo NACRT followed by esophagectomy. The PET-N response may help clinicians to establish a strategy for perioperative treatments that improves survival for patients with lymph node metastasis in TESCC.
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Affiliation(s)
- Yushi Nagaki
- Division of Esophageal Surgery, Akita University Hospital, Akita, Japan. .,Department of Thoracic Surgery, Akita University Graduate School of Medicine, Akita, Japan.
| | - Satoru Motoyama
- Division of Esophageal Surgery, Akita University Hospital, Akita, Japan.,Department of Thoracic Surgery, Akita University Graduate School of Medicine, Akita, Japan.,Department of Comprehensive Cancer Control, Akita University Graduate School of Medicine, Akita, Japan
| | - Yusuke Sato
- Division of Esophageal Surgery, Akita University Hospital, Akita, Japan.,Department of Thoracic Surgery, Akita University Graduate School of Medicine, Akita, Japan
| | - Akiyuki Wakita
- Division of Esophageal Surgery, Akita University Hospital, Akita, Japan.,Department of Thoracic Surgery, Akita University Graduate School of Medicine, Akita, Japan
| | - Hiromu Fujita
- Division of Esophageal Surgery, Akita University Hospital, Akita, Japan.,Department of Thoracic Surgery, Akita University Graduate School of Medicine, Akita, Japan
| | - Kohei Kemuriyama
- Division of Esophageal Surgery, Akita University Hospital, Akita, Japan.,Department of Thoracic Surgery, Akita University Graduate School of Medicine, Akita, Japan
| | - Yoshihiro Sasaki
- Division of Esophageal Surgery, Akita University Hospital, Akita, Japan.,Department of Thoracic Surgery, Akita University Graduate School of Medicine, Akita, Japan
| | - Kazuhiro Imai
- Department of Thoracic Surgery, Akita University Graduate School of Medicine, Akita, Japan
| | - Eri Maeda
- Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita, Japan
| | - Yoshihiro Minamiya
- Department of Thoracic Surgery, Akita University Graduate School of Medicine, Akita, Japan
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21
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Iba A, Maeda E, Jwa SC, Yanagisawa-Sugita A, Saito K, Kuwahara A, Saito H, Terada Y, Ishihara O, Kobayashi Y. Household income and medical help-seeking for fertility problems among a representative population in Japan. Reprod Health 2021; 18:165. [PMID: 34344417 PMCID: PMC8336394 DOI: 10.1186/s12978-021-01212-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 07/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Fertility treatments help many infertile couples to have children. However, disparities exist in access to fertility tests and treatments. We investigated the association between household income and medical help-seeking for fertility in Japan. METHODS We conducted a cross-sectional study using nationally representative data from the National Fertility Survey 2015. Respondents were 6598 married women younger than 50 years old. The primary outcome was medical help-seeking for fertility among those who experienced fertility problems. Multiple logistic regression models were used to assess the association between household income and medical help-seeking, adjusting for age, length of marriage, educational level, employment status, number of children, childbearing desires, living with parents, and region of residence. RESULTS Among 2253 (34%) women who experienced fertility problems, 1154 (51%) sought medical help. The proportion of help-seekers increased linearly from 43% in the low-income group (< 4 million Japanese yen [JPY]) to 59% in the high-income group (≥ 8 million JPY) (P for trend < 0.001). Respondents with upper-middle (6-8 million JPY) or high household income were more likely to seek medical help, compared to those with low household income: adjusted odds ratio [aOR] 1.37 (95% confidence interval [CI]: 1.00-1.86) and aOR 1.78 (95% CI: 1.29-2.47), respectively. CONCLUSIONS We found that higher household income was associated with a higher probability of seeking medical help among Japanese women who experienced fertility problem. Along with policy discussion about additional financial support, further studies from societal, cultural, or psychological views are required.
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Affiliation(s)
- Arisa Iba
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Eri Maeda
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, Akita, 010-8543, Japan
| | - Seung Chik Jwa
- Department of Obstetrics and Gynecology, Saitama Medical University, 38 Morohongo, Moroyama-machi, Iruma, Saitama, 350-0495, Japan
| | - Ayako Yanagisawa-Sugita
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Kazuki Saito
- Department of Pediatrics, Perinatal, and Maternal Medicine (Ibaraki), Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Akira Kuwahara
- Department of Obstetrics and Gynecology, Graduate School of Biomedical Sciences, Tokushima University, 3-18-15 Kuramoto-cho, Tokushima, Tokushima, 770-8503, Japan
| | - Hidekazu Saito
- Umegaoka Women's Clinic, 1-33-3 Umegaoka, Setagaya-ku, Tokyo, 154-0022, Japan
| | - Yukihiro Terada
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, Akita, 010-8543, Japan
| | - Osamu Ishihara
- Department of Obstetrics and Gynecology, Saitama Medical University, 38 Morohongo, Moroyama-machi, Iruma, Saitama, 350-0495, Japan
| | - Yasuki Kobayashi
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
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22
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Motoyama S, Maeda E, Iijima K, Anbai A, Sato Y, Wakita A, Nagaki Y, Fujita H, Minamiya Y, Higashi T. Differences in treatment and survival between elderly patients with thoracic esophageal cancer in metropolitan areas and other areas. Cancer Sci 2021; 112:4281-4291. [PMID: 34288283 PMCID: PMC8486216 DOI: 10.1111/cas.15070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/04/2021] [Accepted: 07/16/2021] [Indexed: 12/25/2022] Open
Abstract
To address the major issue of regional disparity in the treatment for elderly cancer patients in an aging society, we compared the treatment strategies used for elderly patients with thoracic esophageal cancer and their survival outcomes in metropolitan areas and other regions. Using the national database of hospital‐based cancer registries in 2008‐2011, patients aged 75 years or older who had been diagnosed with thoracic esophageal cancer were enrolled. We divided the patients into two groups: those treated in metropolitan areas (Tokyo, Kanagawa, Osaka, Aichi, Saitama, and Chiba prefectures) with populations of 6 million or more and those treated in other areas (the other 41 prefectures). Compared were patient backgrounds, treatment strategies, and survival curves at each cancer stage. In total, 1236 (24%) patients from metropolitan areas and 3830 (76%) patients from nonmetropolitan areas were enrolled. Patients in metropolitan areas were treated at more advanced stages. There was also a difference in treatment strategy. The 3‐year survival rate among cStage I patients was better in metropolitan areas (71.6% vs. 63.7%), and this finding mainly reflected the survival difference between patients treated with radiotherapy alone. For cStage II‐IV patients, there were no differences. Multivariable Cox proportional hazard analysis including interaction terms between treatment areas, cStage, and the first‐line treatments revealed that treatments in the metropolitan areas were significantly associated with better survival among patients treated with radiotherapy alone for cStage I cancer. Treatment strategies for elderly patients with thoracic esophageal cancer and its survival outcomes differed between metropolitan areas and other regions.
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Affiliation(s)
- Satoru Motoyama
- Division of Esophageal Surgery, Akita University Hospital, Akita, Japan.,Department of Comprehensive Cancer Control, Akita University Graduate School of Medicine, Akita, Japan
| | - Eri Maeda
- Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita, Japan
| | - Katsunori Iijima
- Department of Gastroenterology, Akita University Graduate School of Medicine, Akita, Japan
| | - Akira Anbai
- Department of Radiology, Akita University Graduate School of Medicine, Akita, Japan
| | - Yusuke Sato
- Division of Esophageal Surgery, Akita University Hospital, Akita, Japan.,Department of Thoracic Surgery, Akita University Graduate School of Medicine, Akita, Japan
| | - Akiyuki Wakita
- Division of Esophageal Surgery, Akita University Hospital, Akita, Japan.,Department of Thoracic Surgery, Akita University Graduate School of Medicine, Akita, Japan
| | - Yushi Nagaki
- Division of Esophageal Surgery, Akita University Hospital, Akita, Japan.,Department of Thoracic Surgery, Akita University Graduate School of Medicine, Akita, Japan
| | - Hiromu Fujita
- Division of Esophageal Surgery, Akita University Hospital, Akita, Japan.,Department of Thoracic Surgery, Akita University Graduate School of Medicine, Akita, Japan
| | - Yoshihiro Minamiya
- Department of Thoracic Surgery, Akita University Graduate School of Medicine, Akita, Japan
| | - Takahiro Higashi
- Division of Health Services Research, Center for Cancer Control and Information Services, National Cancer Center, Akita University Graduate School of Medicine, Akita, Japan
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23
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Iwasawa T, Takahashi T, Maeda E, Ishiyama K, Takahashi S, Suganuma R, Matsuo K, Tachibana M, Fukuhara R, Shirasawa H, Sato W, Kumazawa Y, Terada Y. Effects of localisation of uterine adenomyosis on outcome of in vitro fertilisation/intracytoplasmic sperm injection fresh and frozen-thawed embryo transfer cycles: a multicentre retrospective cohort study. Reprod Biol Endocrinol 2021; 19:84. [PMID: 34088314 PMCID: PMC8176737 DOI: 10.1186/s12958-021-00764-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 05/19/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Uterine adenomyosis is a benign disease, common among women in their 40 and 50 s, characterised by ectopic endometrial tissue in the uterine myometrial layer. Adenomyosis causes infertility and has a negative effect on the outcomes of in vitro fertilisation (IVF)/intracytoplasmic sperm injection (ICSI) embryo transfer (ET) cycles. It has also been reported to have different characteristics depending on the adenomyotic lesion localisation. The effect of its localisation on IVF/ICSI-ET outcomes is unclear. This study aimed to investigate whether adenomyotic lesion localisation, assessed using magnetic resonance imaging (MRI), was associated with outcomes of IVF/ICSI-ET cycles. METHODS This multicentre, joint, retrospective cohort study analysed the medical records of 67 infertile patients with adenomyosis who underwent IVF/ICSI with fresh and frozen-thawed ET at five participating facilities from January 2012 to December 2016 and for whom MRI data were available. Fifteen patients were excluded; therefore, the MRI data of 52 patients were evaluated by two radiologists. We assessed the localisation of and classified adenomyotic lesions into advanced (invades the full thickness of the uterine myometrium), extrinsic (localised on the serosal side), and intrinsic (localised on the endometrial side) subtypes. RESULTS There were 40 advanced, nine extrinsic, and three intrinsic cases, and the outcomes of 100, 27, and nine ET cycles, respectively, were analysed. Pregnancy loss/clinical pregnancy and live birth rates of the advanced, extrinsic, and intrinsic groups were 64 % (16/25) and 9 % (9/100), 33.3 % (3/9) and 22.2 % (6/27), and 50 % (1/2) and 11.1 % (1/9), respectively. A logistic regression analysis adjusted for age, prior miscarriage, and body mass index showed that the extrinsic group had fewer pregnancy losses (odds ratio 0.06; 95 % confidence interval [CI]: 0.00-0.54, p = 0.026) and more live births (odds ratio 6.05; 95 % CI: 1.41-29.65, p = 0.018) than the advanced group. CONCLUSIONS Adenomyotic lesions exert different effects on IVF/ICSI-ET outcomes. Thus, MRI assessments of adenomyosis in infertile patients are beneficial. Establishment of treatment plans based on adenomyotic lesion localisation should be considered.
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Affiliation(s)
- Takuya Iwasawa
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, 010-8543, Akita, Japan.
- Department of Obstetrics and Gynecology, Omagari Kousei Medical Center, 014- 0027, Daisen, Akita, Japan.
| | - Toshifumi Takahashi
- Fukushima Medical Center for Children and Women, Fukushima Medical University, 960-1295, Fukushima, Japan
| | - Eri Maeda
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, 010-8543, Akita, Japan
| | - Koichi Ishiyama
- Department of Radiology, Akita University Graduate School of Medicine, 010-8543, Akita, Japan
| | - Satoshi Takahashi
- Department of Radiology, Hiraka General Hospital, 013-8610, Akita, Japan
| | - Ryota Suganuma
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, 960-1295, Fukushima, Japan
| | - Koki Matsuo
- Department of Obstetrics and Gynecology, Yamagata University Faculty of Medicine, 990-9585, Yamagata, Japan
| | - Masahito Tachibana
- Department of Obstetrics and Gynecology, Tohoku University School of Medicine, 980-8574, Sendai, Miyagi, Japan
| | - Rie Fukuhara
- Department of Obstetrics and Gynecology, Hirosaki University Graduate School of Medicine, 036-8563, Hirosaki, Aomori, Japan
| | - Hiromitsu Shirasawa
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, 010-8543, Akita, Japan
| | - Wataru Sato
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, 010-8543, Akita, Japan
| | - Yukiyo Kumazawa
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, 010-8543, Akita, Japan
| | - Yukihiro Terada
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, 010-8543, Akita, Japan
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24
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Nishimura T, Fuse C, Akita M, Takase N, Maeda E, Abe K, Kozuki A, Yokoyama K, Tanaka T, Kishi S, Sakamoto T, Sakai T, Kaneda K. A case report of a gastrobronchial fistula and lung abscess caused by leakage from the staple line of a gastric tube after esophagectomy for esophageal cancer. Surg Case Rep 2021; 7:95. [PMID: 33856574 PMCID: PMC8050132 DOI: 10.1186/s40792-021-01178-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 04/09/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Gastrobronchial fistulas are rare, but life-threatening, complications of esophagectomy. They are caused by anastomotic leakage and mainly occur around anastomotic sites. In the present paper, we report a rare case of leakage from the staple line of a gastric tube after esophagectomy for esophageal cancer, which was successfully treated using an intercostal muscle flap and lung resection. CASE PRESENTATION A 61-year-old male underwent subtotal esophagectomy with regional lymphadenectomy for esophageal cancer. The sutures along the staple line of the gastric tube failed 11 days after surgery, and a pulmonary abscess was also found on imaging. The abscess did not heal after conservative treatment; therefore, right lower lobectomy, gastrobronchial fistula resection, primary closure, and patching of the leaking portion of the gastric tube with an intercostal muscle flap were performed 9 months after the first operation. The patient's postoperative course was uneventful, and he was discharged on the 354th day. CONCLUSIONS We experienced a case involving a gastrobronchial fistula caused by leakage from the staple line of a gastric tube and successfully treated it by performing right lower lobectomy and patching the leak with an intercostal muscle flap.
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Affiliation(s)
- Tohru Nishimura
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan.
| | - Chisakou Fuse
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
| | - Masayuki Akita
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
| | - Nobuhisa Takase
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
| | - Eri Maeda
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
| | - Koichiro Abe
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
| | - Akihito Kozuki
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
| | - Kunio Yokoyama
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
| | - Tomohiro Tanaka
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
| | - Shinji Kishi
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
| | - Toshihiko Sakamoto
- Department of Thoracic Surgery, Steel Memorial Hirohata Hospital, Himeji, Japan
| | - Tetsuya Sakai
- Department of Surgery, Steel Memorial Hirohata Hospital, Himeji, Japan
| | - Kunihiko Kaneda
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
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25
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Maeda E, Ishihara O, Tomio J, Miura H, Kobayashi Y, Terada Y, Murata K, Nomura K. Cesarean delivery rates for overall and multiple pregnancies in Japan: A descriptive study using nationwide health insurance claims data. J Obstet Gynaecol Res 2021; 47:2099-2109. [PMID: 33779012 DOI: 10.1111/jog.14772] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 03/01/2021] [Accepted: 03/10/2021] [Indexed: 12/30/2022]
Abstract
AIM Due to the lack of national perinatal registries, population-wide descriptive statistics on cesarean deliveries in Japan are unknown. We aim to describe cesarean deliveries for overall and multiple pregnancies using the Japan National Database of health insurance claims. METHODS We calculated the national and prefectural cesarean delivery rates for overall and multiple pregnancies in 2014. We described maternal morbidities (e.g., blood transfusion) and the place and type of the institutions providing prenatal and perinatal care. RESULTS The national cesarean delivery rates were 18.6% overall and 82.7% for women with multiple pregnancies. Prefectural cesarean delivery rates for overall and multiple pregnancies varied from 12.5% to 24.2% and from 49.2% to 100%, respectively, showing a moderate positive correlation (r = 0.59, p < 0.001). Overall, 1.4% of cesarean patients received an allogeneic blood transfusion, compared to 3.2% for those with multiple pregnancies. In addition, 65.9% of overall cesarean deliveries occurred at hospitals with ≥20 beds, whereas 94.6% of cesarean patients with multiple pregnancies delivered at hospitals. Older patients were more likely to receive their cesarean section at a different institution than their first visit within the same prefecture, but trans-prefectural movement during pregnancy covered by health insurance was most frequent among those in their early thirties: 7.0% overall and 10.7% for multiple pregnancies. CONCLUSIONS The overall cesarean delivery rate in Japan was optimal, but the rate was high for multiple pregnancies, with large regional differences. Data on patient movement across institutions and areas would help to improve the perinatal care system.
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Affiliation(s)
- Eri Maeda
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita, Japan
| | - Osamu Ishihara
- Department of Obstetrics and Gynecology, Saitama Medical University, Saitama, Japan
| | - Jun Tomio
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiroshi Miura
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, Akita, Japan
| | - Yasuki Kobayashi
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yukihiro Terada
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, Akita, Japan
| | - Katsuyuki Murata
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita, Japan
| | - Kyoko Nomura
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita, Japan
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26
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Nomura K, Minamizono S, Maeda E, Kim R, Iwata T, Hirayama J, Ono K, Fushimi M, Goto T, Mishima K, Yamamoto F. Cross-sectional survey of depressive symptoms and suicide-related ideation at a Japanese national university during the COVID-19 stay-home order. Environ Health Prev Med 2021; 26:30. [PMID: 33673802 PMCID: PMC7934991 DOI: 10.1186/s12199-021-00953-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 02/23/2021] [Indexed: 12/19/2022] Open
Abstract
Background We aimed to estimate the prevalence of depressive symptoms as well as suicide-related ideation among Japanese university students during the stay-home order necessitated by the coronavirus disease 2019 pandemic in Japan, and offer evidence in support of future intervention to depression and suicide prevention strategies among college and university students. Methods The data for this cross-sectional study were derived from the Student Mental Health Survey conducted from May 20 to June 16, 2020 at a national university in Akita prefecture. Among the 5111 students recruited, 2712 participated in this study (response rate, 53%; mean age ± standard deviation, 20.5 ±3.5 years; men, 53.8%). Depressive symptoms were identified by using the Patient Health Questionnaire-9 (PHQ-9). Results The prevalence of moderate depressive symptoms based on a PHQ-9 score ≥10 and suicide-related ideation based on question 9 of PHQ-9 ≥1, which encompasses thoughts of both suicide and self-harm, was 11.7% and 6.7%, respectively. Multivariable logistic regression analyses showed that risk factors for depression included being a woman, smoking, alcohol consumption, and social network communication using either video or voice. For suicide-related ideation, alcohol consumption was the only risk factor. Exercise and having someone to consult about worries were associated with decreased risk of both depressive symptoms and suicide-related ideation. Conclusions Negative lifestyles of smoking and drinking, and being a woman, may be important risk factors for depressive symptoms, whereas exercise and having someone to consult about worries may be protective factors. Supplementary Information The online version contains supplementary material available at 10.1186/s12199-021-00953-1.
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Affiliation(s)
- Kyoko Nomura
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita, Japan.
| | - Sachiko Minamizono
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita, Japan
| | - Eri Maeda
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita, Japan
| | - Roseline Kim
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita, Japan
| | - Toyoto Iwata
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita, Japan
| | - Junko Hirayama
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita, Japan
| | - Kyoichi Ono
- Department of Cell Physiology, Akita University Graduate School of Medicine, Akita, Japan
| | | | | | - Kazuo Mishima
- Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan
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Fujishima A, Takahashi K, Goto M, Hirakawa T, Iwasawa T, Togashi K, Maeda E, Shirasawa H, Miura H, Sato W, Kumazawa Y, Terada Y. Live visualisation of electrolytes during mouse embryonic development using electrolyte indicators. PLoS One 2021; 16:e0246337. [PMID: 33513193 PMCID: PMC7845971 DOI: 10.1371/journal.pone.0246337] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 01/18/2021] [Indexed: 11/27/2022] Open
Abstract
Studies have shown that some electrolytes, including Na+ and K+, play important roles in embryonic development. However, these studies evaluated these electrolytes by using inhibitors or knockout mice, with no mention on the changes in the intracellular electrolyte concentrations during embryogenesis. In this study, we used the electrolyte indicators CoroNa Green AM and ION Potassium Green-2 AM to directly visualise intracellular concentrations of Na+ and K+, respectively, at each embryonic developmental stage in mouse embryos. We directly observed intracellular electrolyte concentrations at the morula, blastocyst, and hatching stages. Our results revealed dynamic changes in intracellular electrolyte concentrations; we found that the intracellular Na+ concentration decreased, while K+ concentration increased during blastocoel formation. The degree of change in intensity in response to ouabain, an inhibitor of Na+/K+ ATPase, was considered to correspond to the degree of Na+/K+ ATPase activity at each developmental stage. Additionally, after the blastocyst stage, trophectoderm cells in direct contact with the blastocoel showed higher K+ concentrations than in direct contact with inner cell mass, indicating that Na+/K+ ATPase activity differs depending on the location in the trophectoderm. This is the first study to use CoroNa Green AM and ION Potassium Green-2 AM in mouse embryos and visualise electrolytes during embryonic development. The changes in electrolyte concentration observed in this study were consistent with the activity of Na+/K+ ATPase reported previously, and it was possible to image more detailed electrolyte behaviour in embryo cells. This method can be used to improve the understanding of cell physiology and is useful for future embryonic development studies.
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Affiliation(s)
- Akiko Fujishima
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, Akita, Japan
| | - Kazumasa Takahashi
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, Akita, Japan
| | - Mayumi Goto
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, Akita, Japan
| | - Takeo Hirakawa
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, Akita, Japan
| | - Takuya Iwasawa
- Department of Obstetrics and Gynecology, Omagari Kousei Medical Center, Akita, Japan
| | - Kazue Togashi
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, Akita, Japan
| | - Eri Maeda
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita, Japan
| | - Hiromitsu Shirasawa
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, Akita, Japan
| | - Hiroshi Miura
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, Akita, Japan
| | - Wataru Sato
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, Akita, Japan
| | - Yukiyo Kumazawa
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, Akita, Japan
| | - Yukihiro Terada
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, Akita, Japan
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Takayama Y, Masuzaki Y, Mizutani F, Iwata T, Maeda E, Tsukada M, Nomura K, Ito Y, Chisaki Y, Murata K. Associations between blood arsenic and urinary arsenic species concentrations as an exposure characterization tool. Sci Total Environ 2021; 750:141517. [PMID: 32829259 DOI: 10.1016/j.scitotenv.2020.141517] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 07/28/2020] [Accepted: 08/03/2020] [Indexed: 06/11/2023]
Abstract
Blood arsenic has various toxicities including carcinogenicity, but urinary concentrations are often substituted to determine the exposure level. Since there is little information on the relation of urinary arsenic species to blood arsenic, the aim was to investigate relationships between blood total arsenic (T-As) and the urinary species adjusted by creatinine and specific gravity (SG). Blood and spot urine samples were collected from 109 Japanese subjects aged 18-66 years without occupational exposure. Positive correlations of blood T-As (median, 3.49 μg/L) with urinary creatinine-adjusted and SG-adjusted T-As and arsenobetaine were statistically significant and greater than those with the unadjusted ones. The magnitude of associations of blood T-As with creatinine-adjusted arsenic species was significantly larger than those with unadjusted or SG-adjusted ones. Most of the correlation coefficients among urinary arsenic species concentrations were significant in three adjustment methods, but there was not a significant correlation between monomethylarsonic acid and arsenobetaine after urinary creatinine and SG corrections. Given multiple regression analysis, plasma T-As concentrations showed significant relations to creatinine-adjusted T-As, dimethylarsinic acid, and arsenobetaine concentrations, but erythrocyte T-As did hardly reflect the variation of urinary arsenic species. In conclusion, creatinine-adjusted arsenic concentrations are suggested to be the most appropriate predictor of blood T-As; by contrast, use of the urinary unadjusted arsenic concentration may result in a misleading interpretation of inorganic arsenic toxicity because the associations between inorganic and organic arsenic species based on the unadjusted concentration were mutually close. Plasma T-As appeared to be the best indicator of low-level exposure in blood samples.
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Affiliation(s)
- Yuko Takayama
- Department of Environmental and Public Health, Akita University Graduate School of Medicine, 1-1 Hondo, Akita 010-8543, Japan
| | - Yuko Masuzaki
- Institute of Environmental Ecology, IDEA Consultants, Inc., 1334-5 Riuemon, Yaizu, Shizuoka 421-0212, Japan
| | - Futoshi Mizutani
- Institute of Environmental Ecology, IDEA Consultants, Inc., 1334-5 Riuemon, Yaizu, Shizuoka 421-0212, Japan
| | - Toyoto Iwata
- Department of Environmental and Public Health, Akita University Graduate School of Medicine, 1-1 Hondo, Akita 010-8543, Japan
| | - Eri Maeda
- Department of Environmental and Public Health, Akita University Graduate School of Medicine, 1-1 Hondo, Akita 010-8543, Japan
| | - Mikako Tsukada
- Seirei Women's Junior College, 10-33 Terauchi-Takano, Akita 011-0937, Japan
| | - Kyoko Nomura
- Department of Environmental and Public Health, Akita University Graduate School of Medicine, 1-1 Hondo, Akita 010-8543, Japan
| | - Yasunori Ito
- Institute of Environmental Ecology, IDEA Consultants, Inc., 1334-5 Riuemon, Yaizu, Shizuoka 421-0212, Japan
| | - Yoichi Chisaki
- Institute of Environmental Ecology, IDEA Consultants, Inc., 1334-5 Riuemon, Yaizu, Shizuoka 421-0212, Japan
| | - Katsuyuki Murata
- Department of Environmental and Public Health, Akita University Graduate School of Medicine, 1-1 Hondo, Akita 010-8543, Japan.
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Motoyama S, Maeda E, Iijima K, Sato Y, Koizumi S, Wakita A, Nagaki Y, Fujita H, Yoneya T, Imai K, Terata K, Minamiya Y, Higashi T. Does Esophagectomy Provide a Survival Advantage to Patients Aged 80 Years or Older? Analyzing 5,066 Patients in the National Database of Hospital-Based Cancer Registries in Japan. Ann Surg 2020; 276:e16-e23. [DOI: 10.1097/sla.0000000000004437] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Maeda E, Miyata A, Boivin J, Nomura K, Kumazawa Y, Shirasawa H, Saito H, Terada Y. Promoting fertility awareness and preconception health using a chatbot: a randomized controlled trial. Reprod Biomed Online 2020; 41:1133-1143. [PMID: 33039321 DOI: 10.1016/j.rbmo.2020.09.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 08/21/2020] [Accepted: 09/08/2020] [Indexed: 01/25/2023]
Abstract
RESEARCH QUESTION What are the effects of using a fertility education chatbot, i.e. automatic conversation programme, on knowledge, intentions to improve preconception behaviour and anxiety? DESIGN A three-armed, randomized controlled trial was conducted using an online social research panel. Participants included 927 women aged 20-34 years who were randomly allocated to one of three groups: a fertility education chatbot (intervention group), a document about fertility and preconception health (control group 1) or a document about an irrelevant topic (control group 2). Participants' scores on the Cardiff Fertility Knowledge Scale and the State-Trait Anxiety Inventory, their intentions to optimize preconception behaviours, e.g. taking folic acid, and the free-text feedback provided by chatbot users were assessed. RESULTS A repeated-measures analysis of variance showed significant fertility knowledge gains after the intervention in the intervention group (+9.1 points) and control group 1 (+14.9 points) but no significant change in control group 2 (+1.1 points). Post-test increases in the intentions to optimize behaviours were significantly higher in the intervention group than in control group 2, and were similar to those in control group 1. Post-test state anxiety scores were significantly lower in the intervention group than in control group 1 and control group 2. User feedbacks about the chatbot suggested technical limitations, e.g. low comprehension of users' words, and pros and cons of using the chatbot, e.g. convenient versus coldness. CONCLUSIONS Providing fertility education using a chatbot improved fertility knowledge and intentions to optimize preconception behaviour without increasing anxiety, but the improvement in knowledge was small. Further technical development and exploration of personal affinity for technology is required.
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Affiliation(s)
- Eri Maeda
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita 010-8543, Japan.
| | - Akane Miyata
- Reproduction Center, Dokkyo Medical University, Saitama 343-8555, Japan
| | - Jacky Boivin
- Cardiff Fertility Studies Research Group, School of Psychology, Cardiff University, Cardiff CF10 3AT, UK
| | - Kyoko Nomura
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita 010-8543, Japan
| | - Yukiyo Kumazawa
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, Akita 010-8543, Japan
| | - Hiromitsu Shirasawa
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, Akita 010-8543, Japan
| | | | - Yukihiro Terada
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, Akita 010-8543, Japan
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Kurokawa R, Ota Y, Gonoi W, Hagiwara A, Kurokawa M, Mori H, Maeda E, Amemiya S, Usui Y, Sato N, Nakata Y, Moritani T, Abe O. MRI Findings of Immune Checkpoint Inhibitor-Induced Hypophysitis: Possible Association with Fibrosis. AJNR Am J Neuroradiol 2020; 41:1683-1689. [PMID: 32763900 PMCID: PMC7583108 DOI: 10.3174/ajnr.a6692] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 06/02/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND PURPOSE Hypophysitis is one of the well-known adverse effects of immune checkpoint inhibitors. Immune checkpoint inhibitor-induced hypophysitis frequently causes irreversible hypopituitarism, which requires long-term hormone replacement. Despite the high frequency and clinical significance, characteristic MR imaging findings of immune checkpoint inhibitor-induced hypophysitis have not been established. In the present study, we aimed to review and extract the MR imaging features of immune checkpoint inhibitor-induced hypophysitis. MATERIALS AND METHODS This retrospective international multicenter study comprised 20 patients with melanoma who were being treated with immune checkpoint inhibitors and clinically diagnosed with immune checkpoint inhibitor-induced hypophysitis. Three radiologists evaluated the following MR imaging findings: enlargement of the pituitary gland and stalk; homogeneity of enhancement of the pituitary gland; presence/absence of a well-defined poorly enhanced area and, if present, its location, shape, and signal intensity in T2WI; and enhancement pattern in contrast-enhanced dynamic MR imaging. Clinical symptoms and hormone levels were also recorded. RESULTS Enlargement of the pituitary gland and stalk was observed in 12 and 20 patients, respectively. Nineteen patients showed poorly enhanced lesions (geographic hypoenhancing lesions) in the anterior lobe, and 11 of these lesions showed hypointensity on T2WI. Thyrotropin deficiency and corticotropin deficiency were observed in 19/20 and 12/17 patients, respectively, which persisted in 12/19 and 10/12 patients, respectively, throughout the study period. CONCLUSIONS Pituitary geographic hypoenhancing lesions in the anterior lobe of the pituitary gland are characteristic and frequent MR imaging findings of immune checkpoint inhibitor-induced hypophysitis. They reflect fibrosis and are useful in distinguishing immune checkpoint inhibitor-induced hypophysitis from other types of hypophysitis/tumors.
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Affiliation(s)
- R Kurokawa
- From the Department of Radiology (R.K., W.G., E.M., S.A., Y.U., O.A.), Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Y Ota
- Division of Neuroradiology (Y.O., T.M.), Department of Radiology, Michigan Medicine, Ann Arbor, Michigan
| | - W Gonoi
- From the Department of Radiology (R.K., W.G., E.M., S.A., Y.U., O.A.), Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - A Hagiwara
- Department of Radiology (A.H.), Juntendo University School of Medicine, Tokyo, Japan
| | - M Kurokawa
- Department of Radiology (M.K.), Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - H Mori
- Department of Radiology (H.M.), Jichi Medical University, Tochigi-ken, Japan
| | - E Maeda
- From the Department of Radiology (R.K., W.G., E.M., S.A., Y.U., O.A.), Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - S Amemiya
- From the Department of Radiology (R.K., W.G., E.M., S.A., Y.U., O.A.), Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Y Usui
- From the Department of Radiology (R.K., W.G., E.M., S.A., Y.U., O.A.), Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - N Sato
- Department of Radiology (N.S.), Tokyo Metropolitan Neurological Hospital, Tokyo, Japan
| | - Y Nakata
- Department of Radiology (Y.N.), National Center of Neurology and Psychiatry, Tokyo, Japan
| | - T Moritani
- Division of Neuroradiology (Y.O., T.M.), Department of Radiology, Michigan Medicine, Ann Arbor, Michigan
| | - O Abe
- From the Department of Radiology (R.K., W.G., E.M., S.A., Y.U., O.A.), Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Maeda Y, Maeda E, Arata N. Preconception folic acid supplementation use and the occurrence of neural tube defects in Japan. Congenit Anom (Kyoto) 2020; 60:100. [PMID: 32160359 DOI: 10.1111/cga.12369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 02/29/2020] [Accepted: 03/06/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Yuto Maeda
- Division of Maternal Medicine, Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Eri Maeda
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita, Japan
| | - Naoko Arata
- Division of Maternal Medicine, Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
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Akita M, Yamasaki N, Miyake T, Mimura K, Maeda E, Nishimura T, Abe K, Kozuki A, Yokoyama K, Kominami H, Tanaka T, Takamatsu M, Kaneda K. Bochdalek hernia in an adult: two case reports and a review of perioperative cardiopulmonary complications. Surg Case Rep 2020; 6:72. [PMID: 32303918 PMCID: PMC7165220 DOI: 10.1186/s40792-020-00833-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 04/02/2020] [Indexed: 11/10/2022] Open
Abstract
Background Bochdalek hernia in an adult is very rare and often needs an immediate surgical repair for the herniation. Although its etiology and surgical techniques have frequently been reported, perioperative complications, especially cardiopulmonary problems, remain unknown. We reported two adults with Bochdalek hernia and reviewed the published literatures with a focus on these issues. Case presentation We experienced two adult cases of Bochdalek hernia with gastrointestinal strangulation. One case had massive herniation of the stomach, colon, spleen, and pancreas in the left chest, causing repeated vomiting. The other had a right-side hernia with strangulation of the colon. We successfully performed emergency repairs of these diaphragmatic hernias without any postoperative complications. Conclusions Our literature review revealed that life-threatening cardiopulmonary complications, such as empyema or cardiac arrest caused by the tamponade effect of the herniated viscera, sometimes occurred in patients with Bochdalek hernia. These complications were found in Bochdalek hernia with gastrointestinal strangulation.
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Affiliation(s)
- Masayuki Akita
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan.
| | - Nobuaki Yamasaki
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
| | - Taiichiro Miyake
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
| | - Kazuya Mimura
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
| | - Eri Maeda
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
| | - Tohru Nishimura
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
| | - Koichiro Abe
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
| | - Akihito Kozuki
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
| | - Kunio Yokoyama
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
| | - Hiroaki Kominami
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
| | - Tomohiro Tanaka
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
| | - Manabu Takamatsu
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
| | - Kunihiko Kaneda
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa, 675-8611, Japan
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Akita M, Yamasaki N, Miyake T, Mimura K, Maeda E, Nishimura T, Abe K, Kozuki A, Yokoyama K, Kominami H, Tanaka T, Takamatsu M, Kaneda K. Cattell‐Braasch maneuver facilitates the artery‐first approach and complete excision of the mesopancreas for pancreatoduodenectomy. J Surg Oncol 2020; 121:1126-1131. [DOI: 10.1002/jso.25892] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 02/25/2020] [Indexed: 12/22/2022]
Affiliation(s)
- Masayuki Akita
- Department of SurgeryKakogawa Central City HospitalKakogawa Japan
| | - Nobuaki Yamasaki
- Department of SurgeryKakogawa Central City HospitalKakogawa Japan
| | - Taiichiro Miyake
- Department of SurgeryKakogawa Central City HospitalKakogawa Japan
| | - Kazuya Mimura
- Department of SurgeryKakogawa Central City HospitalKakogawa Japan
| | - Eri Maeda
- Department of SurgeryKakogawa Central City HospitalKakogawa Japan
| | - Tohru Nishimura
- Department of SurgeryKakogawa Central City HospitalKakogawa Japan
| | - Koichiro Abe
- Department of SurgeryKakogawa Central City HospitalKakogawa Japan
| | - Akihito Kozuki
- Department of SurgeryKakogawa Central City HospitalKakogawa Japan
| | - Kunio Yokoyama
- Department of SurgeryKakogawa Central City HospitalKakogawa Japan
| | - Hiroaki Kominami
- Department of SurgeryKakogawa Central City HospitalKakogawa Japan
| | - Tomohiro Tanaka
- Department of SurgeryKakogawa Central City HospitalKakogawa Japan
| | - Manabu Takamatsu
- Department of SurgeryKakogawa Central City HospitalKakogawa Japan
| | - Kunihiko Kaneda
- Department of SurgeryKakogawa Central City HospitalKakogawa Japan
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Motoyama S, Maeda E, Yano M, Yasuda T, Ohira M, Kajiyama Y, Higashi T, Doki Y, Matsubara H. Esophagectomy performed at institutes certified by the Japan Esophageal Society provide long-term survival advantages to esophageal cancer patients: second report analyzing 4897 cases with propensity score matching. Esophagus 2020; 17:141-148. [PMID: 31939000 PMCID: PMC7066103 DOI: 10.1007/s10388-019-00712-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 12/29/2019] [Indexed: 02/03/2023]
Abstract
BACKGROUND It will be important for the Japan Esophageal Society (JES) to show an evident advantage of its institution certification system. To achieve this essential task, we used nationally acquired big data to re-analyze 5-year survival information. METHODS In 2008-2009, there were 4897 thoracic esophageal cancer patients who underwent esophagectomy and were registered in the National Database of Hospital-based Cancer Registries. We divided these patients into two groups, those who underwent surgery at an Authorized Institute for Board Certified Esophageal Surgeons (AIBCES) or a Non-AIBCES. We then compared the patient backgrounds and 5-year survival rates between these two groups, with and without propensity score matching. RESULTS There were 3080 (63%) patients who underwent esophagectomy at an AIBCES and 1817 (37%) who underwent surgery at a Non-AIBCES. Comparison of the Kaplan-Meier survival curves using log-rank tests indicated a significant difference between the AIBCES and Non-AIBCES groups at all cStages (cStages I-IV). Multivariable Cox proportional hazard analysis stratified by clinical stage and adjuvant treatment revealed that AIBCES vs. Non-AIBCES is a significant independent factor (adjusted HR 0.78) for survival. After propensity score matching ensuring the backgrounds of the two groups being equivalent, there were significant differences in the 5-year survival rates for patients with cStages I-III disease between the AIBCES and Non-AIBCES groups. CONCLUSIONS There is a survival advantage to undergoing esophagectomy at an AIBCES. The institute certification system from the JES will contribute to the future establishment of a more appropriate surgery delivery system for thoracic esophageal cancer.
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Affiliation(s)
- Satoru Motoyama
- The Japan Esophageal Society, Tokyo, Japan ,grid.251924.90000 0001 0725 8504Esophageal Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543 Japan
| | - Eri Maeda
- grid.251924.90000 0001 0725 8504Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita, Japan
| | | | | | | | | | - Takahiro Higashi
- grid.272242.30000 0001 2168 5385Division of Health Services Research, Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan
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Maeda E, Nomura K, Hiraike O, Sugimori H, Kinoshita A, Osuga Y. Domestic work stress and self-rated psychological health among women: a cross-sectional study in Japan. Environ Health Prev Med 2019; 24:75. [PMID: 31847805 PMCID: PMC6918574 DOI: 10.1186/s12199-019-0833-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 11/25/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite the huge burden of domestic work on women in Japan, its effects on their health have been poorly investigated. We aimed to assess the association between domestic work stress and self-rated psychological health among women. METHODS We conducted a cross-sectional survey using an online social research panel in February 2018. Participants were 2,000 women with paid work (the "workers" group) and 1,000 women without paid work (the "homemakers" group), aged between 25 and 59 years old and living with a partner. Self-rated psychological health (Mental Health and Vitality scales of the Japanese SF-36), occupational and domestic work stress (the Brief Job Stress Questionnaire), the 10-item Work-Family Conflict Scale, and sociodemographic factors were assessed. RESULTS The workers had lower domestic job control and higher support from a partner and their parents than the homemakers (p < 0.001), whereas domestic job demand and psychological health were similar between the groups. After adjustment for the covariates using multiple linear regression models, better psychological health was significantly associated with lower domestic job demand, higher domestic job control, and having a young child in both groups. In addition, work-family conflicts and occupational job stress among the workers and caregiving among the homemakers showed negative associations with psychological health. CONCLUSION Self-rated psychological health in women was associated with domestic work stress regardless of employment status. To promote women's health, we need to take into account the effects of domestic work, work-family conflicts, and social support from families, as well as occupational factors.
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Affiliation(s)
- Eri Maeda
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita, Japan.
| | - Kyoko Nomura
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita, Japan
| | - Osamu Hiraike
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiroki Sugimori
- Department of Preventive Medicine, Graduate School of Sports and Health Sciences, Daito Bunka University, Saitama, Japan
| | - Asako Kinoshita
- Department of Preventive Medicine, Graduate School of Sports and Health Sciences, Daito Bunka University, Saitama, Japan
| | - Yutaka Osuga
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Maeda E, Boivin J, Toyokawa S, Murata K, Saito H. Two-year follow-up of a randomized controlled trial: knowledge and reproductive outcome after online fertility education. Hum Reprod 2019; 33:2035-2042. [PMID: 30265305 PMCID: PMC6195802 DOI: 10.1093/humrep/dey293] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 09/10/2018] [Indexed: 11/12/2022] Open
Abstract
STUDY QUESTION What are the long-term effects of fertility education on knowledge and reproductive outcome? SUMMARY ANSWER Participants in the intervention group retained some knowledge after 2 years and the partnered women had a new child more quickly than the comparison group. WHAT IS KNOWN ALREADY Fertility education improves knowledge, at least in the short-term. Attitudes toward childbearing and its timing can change after exposure to educational materials. STUDY DESIGN, SIZE, DURATION Participants were recruited via an online social research panel. In the original randomized controlled trial (RCT), knowledge of reproductive-aged participants was assessed before (T1) and immediately after (T2) receiving one of three information brochures: fertility (intervention group), healthy pre-pregnancy (focused on intake of folic acid during pregnancy, control group 1), or family policies in Japan (childcare provision, control group 2). The present follow-up study was conducted 2 years later in January 2017 (T3) with the same participants. PARTICIPANTS/MATERIALS, SETTING, METHODS Of the T1 participants (n = 1455), 383 men and 360 women (51%) responded to the T3 survey. Fertility knowledge measured with the Japanese version of the Cardiff Fertility Knowledge Scale (CFKS-J) and fertility status (e.g. new births, new medical consultations, and the timing of new birth) was assessed. MAIN RESULTS AND THE ROLE OF CHANCE Baseline (T1) characteristics of the T3 participants were well balanced between groups, but T3 participants were older, married, and more educated compared to those lost to follow-up. A repeated-measures analysis of variance showed significant knowledge gains among the intervention group from T1 to T3 (11.2% and 7.0% among men and women, respectively) but no significant change over time for the control groups. There were no differences between groups in the incidence of new births or new medical consultations. However, subgroup analysis showed that timing of new births was accelerated for partnered individuals in the intervention group. Specifically, the proportion of partnered participants at T1 who had a new birth in the first year subsequent to presentation of information was higher in the intervention group versus control group 1 (folic acid): 8.8% versus 1.4% (P = 0.09) among men and 10.6% versus 2.3% (P = 0.03) among women, respectively. The odds ratios (adjusted for age) were 7.8 (95% CI: 0.86-70.7) and 5.2 (95% CI: 1.09-25.0) among men and women, respectively. The timing of births and the proportion of new births during the 2-year follow-up period in the intervention group were similar to that of control group 2 (family policy). The incidence of new medical consultation was higher in the male intervention group (12.0%) than in male control group 2 (family policy, 1.5%, P = 0.04) but similar among women in all groups. LIMITATIONS REASONS FOR CAUTION First, the high attrition rate may limit the generalizability of these findings for longer-term acquisition of fertility knowledge, especially when applied to younger people who were more likely to be lost to follow-up. Second, this is a 2-year follow-up study and the results may change in the longer-term. Finally, we relied on self-reported questionnaire data and there is a possibility that some women were unknowingly pregnant at T1 but this risk should be distributed equally in the three groups through randomization. WIDER IMPLICATIONS OF THE FINDINGS Effects of one-time education were limited but retained beyond baseline levels. Importantly, education was found to potentially accelerate decision-making about achieving births in partnered subgroups compared to receiving healthy pre-pregnancy information. However, this finding should be confirmed in future stratified RCTs designed to evaluate effects in these subgroups. Follow-up 'booster' education sessions might help people retain knowledge and facilitate reproductive decisions for longer. In view of the high attrition rate, especially among young populations, novel educational strategies to retain young people in fertility education cohorts should be explored. STUDY FUNDING/COMPETING INTEREST(S) This study was funded by National Center for Child Health and Development, the Daiwa Anglo-Japanese Foundation, Pfizer Health Research Foundation, and the Japan Society for the Promotion of Science. E.M. reports joint research funds from a public interest incorporated foundation '1 more Baby Ohendan.'
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Affiliation(s)
- Eri Maeda
- Department of Environmental Health Sciences, Akita University Graduate School of Medicine, Akita, Japan
| | - Jacky Boivin
- Cardiff Fertility Studies Research Group, School of Psychology, Cardiff University, Cardiff, United Kingdom
| | - Satoshi Toyokawa
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Katsuyuki Murata
- Department of Environmental Health Sciences, Akita University Graduate School of Medicine, Akita, Japan
| | - Hidekazu Saito
- Center of Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
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Maeda E, Sugiyama Y, Kinoshita M, Naito K, Kaneko K. Devising Osteosynthesis for the Reverse Oblique Olecranon Fracture: A Case Report. J Orthop Case Rep 2019; 8:82-84. [PMID: 30915302 PMCID: PMC6424316 DOI: 10.13107/jocr.2250-0685.1270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Introduction: We encountered a patient with a reverse oblique olecranon fracture in whom redisplacement occurred after osteosynthesis using routine tension band wiring (TBW). In this case report, methods for stable fixation used during reoperation are reported with a review of the literature. Case Report: A 60-year-old male got the left olecranon fracture (Colton classification, type 2A) visited our hospital. However, osteosynthesis using TBW was performed, soft wire breakage, K-wire distortion, and olecranon bone fragment displacement at 2 weeks after surgery. Reoperation was performed. TBW was performed using K-wires as intramedullary nails so that compression force could be applied as vertically as possible to the bone fragments. Furthermore, for further control of distal bone fragment instability, olecranon locking plate fixation was performed using a posterior approach. 12 months after the operation, the visual analog scale score was 2/10, Quick Disabilities of the Arm, Shoulder, and Hand score were 2.27/100, and the Mayo Elbow Performance score was 85/100 (good). Plain X-ray examination showed favorable bone union. Conclusion: In reverse oblique fractures, the compression force applied to the fracture site is weak because it is not vertical to the fracture line. Therefore, stable osteosynthesis cannot be performed, and post-operative redisplacement occurs. The combination of TBW and plates should be actively considered in reverse oblique olecranon fractures for which adequate fixation cannot be provided by TBW alone.
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Affiliation(s)
- Eri Maeda
- Department of Orthopaedics, Juntendo University School of Medicine, Tokyo, Japan
| | - Yoichi Sugiyama
- Department of Orthopaedics, Juntendo University School of Medicine, Tokyo, Japan
| | - Mayuko Kinoshita
- Department of Orthopaedics, Juntendo University School of Medicine, Tokyo, Japan
| | - Kiyohito Naito
- Department of Orthopaedics, Juntendo University School of Medicine, Tokyo, Japan
| | - Kazuo Kaneko
- Department of Orthopaedics, Juntendo University School of Medicine, Tokyo, Japan
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Deguchi H, Tomoyasu M, Shigeeda W, Kaneko Y, Kanno H, Maeda E, Saito H. Usefulness of a suction ball coagulation probe for hemostasis in complete VATS lobectomy for patients with non-small cell lung cancer. Surg Today 2019; 49:580-586. [PMID: 30684049 DOI: 10.1007/s00595-019-1769-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 01/12/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE In recent years, several reports have noted that the specific coagulation mode called "soft coagulation" with modern electrosurgical tools offers superior hemostasis. The "suction ball coagulation" (SBC) device, which can achieve hemostasis using a soft coagulation mode and simultaneous suction, has been developed as a next step. This study aimed to evaluate the hemostatic effects of SBC in comparison to a conventional soft coagulation device (non-SBC) in video-assisted thoracoscopic surgery (VATS) for patients with non-small cell lung cancer (NSCLC). METHODS This study retrospectively analyzed 351 patients who underwent complete VATS lobectomy for NSCLC. A propensity score analysis generated matched pairs from the patients in the SBC and non-SBC groups (119 patients each). RESULTS After propensity score matching, the bleeding volume during surgery in the SBC group (27.0 g) was significantly less than that in the non-SBC group (42.0 g, p < 0.001). No significant difference was seen in the frequency of postoperative complications. A logistic regression analysis identified the non-use of SBC as an independent risk factor for greater intraoperative blood loss during complete VATS lobectomy (odds ratio 3.14, p < 0.001). CONCLUSIONS SBC was safe for complete VATS lobectomy in patients with NSCLC, and the use of this device was associated with significantly decreased intraoperative blood loss.
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Affiliation(s)
- Hiroyuki Deguchi
- Department of Thoracic Surgery, School of Medicine, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan
| | - Makoto Tomoyasu
- Department of Thoracic Surgery, School of Medicine, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan
| | - Wataru Shigeeda
- Department of Thoracic Surgery, School of Medicine, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan
| | - Yuka Kaneko
- Department of Thoracic Surgery, School of Medicine, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan
| | - Hironaga Kanno
- Department of Thoracic Surgery, School of Medicine, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan
| | - Eri Maeda
- Department of Environmental Health Sciences, Akita University Graduate School of Medicine, Akita, Japan
| | - Hajime Saito
- Department of Thoracic Surgery, School of Medicine, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan.
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Motoyama S, Maeda E, Yano M, Yasuda T, Ohira M, Doki Y, Toh Y, Higashi T, Matsubara H. Appropriateness of the institute certification system for esophageal surgeries by the Japan Esophageal Society: evaluation of survival outcomes using data from the National Database of Hospital-Based Cancer Registries in Japan. Esophagus 2019; 16:114-121. [PMID: 30324431 PMCID: PMC6514086 DOI: 10.1007/s10388-018-0646-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 10/08/2018] [Indexed: 02/03/2023]
Abstract
BACKGROUND Since 2013, The Japan Esophageal Society has been certifying "Authorized Institute for Board Certified Esophageal Surgeon (AIBCES)" to contribute to improving national medical care by enhancing the professional knowledge and skills of esophageal surgeons. However, the appropriateness on this certification system has not yet been verified. Our aim was to assess the appropriateness of the institute certification system for esophageal surgeries used by the medical society. METHODS Using data from the National Database of Hospital-based Cancer Registries, we analyzed the 5-year overall survival rates among 2135 patients with thoracic esophageal cancer who underwent an esophagectomy at 53 AIBCES or 141 non-AIBCES. RESULTS There were 1343 (63%) patients who underwent surgery at an AIBCES and 792 (37%) who underwent surgery at a non-AIBCES. Registered patients were followed up for a median of 53 (range 1-88) months. Over the followed-up period examined, 670 (50%) patients treated at an AIBCES died and 455 (57%) treated at a non-AIBCES died. Comparison of the Kaplan-Meier survival curves indicated that patients with cStage II or cStage III disease treated at an AIBCES had significantly better 5-year survival rates than those treated at a non-AIBCES (55.4% vs. 44.9% and 38.0% vs. 30.3%, respectively). Univariate and multivariate analyses stratified based on stages and adjuvant therapies revealed that institute certification (AIBCES vs. non-AIBCES) is a significant independent factor for 5-year survival. CONCLUSIONS The institute certification system used by the Japan Esophageal Society may be appropriate, as indicated by improved 5-year survival outcomes. The institute certification system has the potential to contribute to a more appropriate medical delivery system in the future.
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Affiliation(s)
- Satoru Motoyama
- The Japan Esophageal Society, Tokyo, Japan ,0000 0001 0725 8504grid.251924.9Esophageal Surgery, Akita University Hospital/Comprehensive Cancer Control, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543 Japan
| | - Eri Maeda
- 0000 0001 0725 8504grid.251924.9Department of Environmental Health Sciences, Akita University Graduate School of Medicine, Akita, Japan
| | | | | | | | | | | | - Takahiro Higashi
- 0000 0001 2168 5385grid.272242.3Center for Cancer Registries and Division of Health Services Research, Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan
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Maeda E, Murata K, Kumazawa Y, Sato W, Shirasawa H, Iwasawa T, Izumo K, Tatsuta N, Sakamoto M, Terada Y. Associations of environmental exposures to methylmercury and selenium with female infertility: A case-control study. Environ Res 2019; 168:357-363. [PMID: 30384229 DOI: 10.1016/j.envres.2018.10.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 09/13/2018] [Accepted: 10/03/2018] [Indexed: 05/28/2023]
Abstract
BACKGROUND Methylmercury exposure is a common health risk resulting from daily fish intake. However, studies addressing the link between methylmercury and infertility are limited and also inconsistent. In addition, no previous epidemiological studies have accounted for the interaction between methylmercury and selenium. We aimed to investigate the association between environmental exposures to metals and female fertility. METHODS This case-control study included 98 infertile women receiving fertility treatment (infertile group) and 43 female workers in their thirties (control group) who provided blood samples and returned a questionnaire on lifestyles and dietary characteristics. Blood levels of mercury, lead, cadmium, arsenic, manganese, zinc, and selenium were compared between the groups. Spearman correlation analyses between anti-Müllerian hormone and the metals were conducted. RESULTS The mean selenium level in blood (± SD) and the selenium/mercury molar ratio were significantly lower in the infertile group (189 ± 25 μg/L and 94.6 ± 44.3, respectively) than in the control group (200 ± 25 μg/L and 118.4 ± 70.5). By contrast, blood mercury levels after adjusting for blood selenium and age were significantly higher in the infertile group than in the control group. Multiple logistic regression analyses with the adjustment for the other metals and potential confounders confirmed significant associations of infertility with elevated mercury and reduced selenium levels. No significant correlations were observed between anti-Müllerian hormone and metals. CONCLUSIONS Methylmercury and selenium exposures appear to have adverse and protective effects on female fertility, respectively. This is the first report to suggest the antagonistic interaction between methylmercury and selenium in relation to human female fertility.
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Affiliation(s)
- Eri Maeda
- Department of Environmental Health Sciences, Akita University Graduate School of Medicine, Akita, Japan
| | - Katsuyuki Murata
- Department of Environmental Health Sciences, Akita University Graduate School of Medicine, Akita, Japan.
| | - Yukiyo Kumazawa
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, Akita, Japan
| | - Wataru Sato
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, Akita, Japan
| | - Hiromitsu Shirasawa
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, Akita, Japan
| | - Takuya Iwasawa
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, Akita, Japan
| | - Kimiko Izumo
- Department of Environment and Public Health, National Institute for Minamata Disease, Kumamoto, Japan
| | - Nozomi Tatsuta
- Department of Environmental Health Sciences, Akita University Graduate School of Medicine, Akita, Japan; Development and Environmental Medicine, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Mineshi Sakamoto
- Department of Environment and Public Health, National Institute for Minamata Disease, Kumamoto, Japan
| | - Yukihiro Terada
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, Akita, Japan
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Abstract
This article presents not only a brief overview of birth cohort studies focusing on environmental health in which the associations between health and environment were examined, but also a tentative plan to apply epidemiological data to benchmark dose calculation. According to the preceding studies, the checkpoints to be scrutinized when a result is not consistent with those of other researchers are as follows: (1) whether the study included all crucial confounders, (2) whether it included any exposure marker or confounder with a U-shaped dose-response curve, (3) whether the outcome measure was conducted by two or more examiners that might lead to measurement bias, (4) whether such examiners picked up information about exposure levels of the subjects before measuring the endpoints, and (5) whether subjects with different genetic factors were included in the analysis. In addition, (6) researchers conducting a children's study on developmental effects due to toxic substances must keep in mind that the impact of prenatal methylmercury exposure, independent of postnatal exposure, may continue for at least seven years. (7) When an environmental health research emphasizes to be population-based study, the levels of exposure to environmental chemical substances in developed countries with strict environmental regulations may be too low to examine a dose-response relationship for critical dose estimation. Such risk assessment should be carried out among the subjects with a wide range of exposure levels.
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Affiliation(s)
- Katsuyuki Murata
- Department of Environmental Health Sciences, Akita University Graduate School of Medicine
| | - Toyoto Iwata
- Department of Environmental Health Sciences, Akita University Graduate School of Medicine
| | - Eri Maeda
- Department of Environmental Health Sciences, Akita University Graduate School of Medicine
| | - Kanae Karita
- Department of Hygiene and Public Health, Kyorin University School of Medicine
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Fukui K, Takase N, Miyake T, Hisano K, Maeda E, Nishimura T, Abe K, Kozuki A, Tanaka T, Harada N, Takamatsu M, Kaneda K. Review of the literature laparoscopic surgery for metastatic hepatic leiomyosarcoma associated with smooth muscle tumor of uncertain malignant potential: Case report. World J Hepatol 2018; 10:402-408. [PMID: 29713398 PMCID: PMC5924371 DOI: 10.4254/wjh.v10.i4.402] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 03/10/2018] [Accepted: 04/03/2018] [Indexed: 02/06/2023] Open
Abstract
Metastatic hepatic leiomyosarcoma is a rare malignant smooth muscle tumor. We report a case of metastatic hepatic leiomyosarcoma associated with smooth muscle tumor of uncertain malignant potential (STUMP). A 68-year-old female presented with a liver mass (60 mm × 40 mm, Segment 4). She underwent left salpingo-oophorectomy for an ovary tumor with STUMP in a broad ligament 6 years ago. Though FDG-PET showed obvious metabolically active foci, abnormal metabolically active foci other than the lesion were not detected. A malignant liver tumor was strongly suspected and laparoscopic partial liver resection was performed with vessel-sealing devices using the crush clamping method and Pringle maneuver. Immunohistochemical findings revealed metastatic liver leiomyosarcoma associated with STUMP in a broad ligament. This case is an extremely rare case of malignant transformation from primary STUMP to metastatic hepatic leiomyosarcoma. It provides important evidence regarding the treatment for metastatic hepatic leiomyosarcoma associated with STUMP.
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Affiliation(s)
- Keisuke Fukui
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa 675-8611, Japan
| | - Nobuhisa Takase
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa 675-8611, Japan
| | - Taiichiro Miyake
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa 675-8611, Japan
| | - Koji Hisano
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa 675-8611, Japan
| | - Eri Maeda
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa 675-8611, Japan
| | - Tohru Nishimura
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa 675-8611, Japan
| | - Koichiro Abe
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa 675-8611, Japan
| | - Akihito Kozuki
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa 675-8611, Japan
| | - Tomohiro Tanaka
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa 675-8611, Japan
| | - Naoki Harada
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa 675-8611, Japan
| | - Manabu Takamatsu
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa 675-8611, Japan
| | - Kunihiko Kaneda
- Department of Surgery, Kakogawa Central City Hospital, Kakogawa 675-8611, Japan
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Enoki M, Maeda E, Iwata T, Murata K. The Association between Work-Related Stress and Autonomic Imbalance among Call Center Employees in Japan. TOHOKU J EXP MED 2017; 243:321-328. [PMID: 29269634 DOI: 10.1620/tjem.243.321] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
There is little epidemiological evidence linking subjective stress to objective etiologic indicators. To clarify an association between work-related stress and autonomic nervous function, we examined call center employees (167 males and 371 females) undergoing electrocardiography (ECG) at the time of annual health checkups. The questionnaire was composed of the Brief Job Stress Questionnaire based on the demand-control-support model and the Social Readjustment Rating Scale including detailed contents of home stress. The Bazett's corrected QT (QTc) interval, QT index, and heart rate were obtained from the ECG data. The male employees showed significantly higher scores of job demand, job control, and supervisor support than the female ones. In the male employees, QT index indicating the extent of autonomic imbalance and heart rate were associated with high score of supervisor support and low score of coworker support (P < 0.05), but no significant relationships were seen between QTc interval and either job strain (i.e., job demand and job control) or home stress. By contrast, the female employees showed no significant links between any autonomic indicators and either work-related stress or home stress. These data suggest that work-related stress affected QT index in male employees suffering specific occupational stressors such as emotional abuse from unsatisfied customers. Specifically, supports from supervisors and coworkers were paradoxically associated with QT index, implying that supervisors may have failed to effectively support such male employees. Also, autonomic nervous function in male employees appears to be more vulnerable to work-related stress than that in female ones.
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Affiliation(s)
- Mamiko Enoki
- Department of Environmental Health Sciences, Akita University Graduate School of Medicine
| | - Eri Maeda
- Department of Environmental Health Sciences, Akita University Graduate School of Medicine
| | - Toyoto Iwata
- Department of Environmental Health Sciences, Akita University Graduate School of Medicine
| | - Katsuyuki Murata
- Department of Environmental Health Sciences, Akita University Graduate School of Medicine
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Maeda E, Ishihara O, Tomio J, Sato A, Terada Y, Kobayashi Y, Murata K. Cesarean section rates and local resources for perinatal care in Japan: A nationwide ecological study using the national database of health insurance claims. J Obstet Gynaecol Res 2017; 44:208-216. [DOI: 10.1111/jog.13518] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 09/08/2017] [Indexed: 12/11/2022]
Affiliation(s)
- Eri Maeda
- Department of Environmental Health Sciences; Akita University Graduate School of Medicine; Akita Japan
| | - Osamu Ishihara
- Department of Obstetrics and Gynecology; Saitama Medical University; Saitama Japan
| | - Jun Tomio
- Department of Public Health, Graduate School of Medicine; The University of Tokyo; Tokyo Japan
| | - Aya Sato
- Department of Environmental Health Sciences; Akita University Graduate School of Medicine; Akita Japan
| | - Yukihiro Terada
- Department of Obstetrics and Gynecology; Akita University Graduate School of Medicine; Akita Japan
| | - Yasuki Kobayashi
- Department of Public Health, Graduate School of Medicine; The University of Tokyo; Tokyo Japan
| | - Katsuyuki Murata
- Department of Environmental Health Sciences; Akita University Graduate School of Medicine; Akita Japan
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Maeda E, Okano K, Suto H, Asano E, Oshima M, Kishino T, Fujiwara M, Yamamoto N, Sanomura T, Suzuki Y. Hybrid approach to laparoscopic decapsulation combined with splenic artery balloon occlusion in a patient with carbohydrate antigen 19-9 producing splenic cysts. Asian J Endosc Surg 2017; 10:459-462. [PMID: 29076276 DOI: 10.1111/ases.12376] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 02/24/2017] [Accepted: 02/28/2017] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Carbohydrate antigen 19-9 producing splenic cysts are relatively rare and usually occur in women and young individuals. This report describes the use of a novel splenic-preserving surgical approach in the hybrid operating room to reduce the risk of bleeding. MATERIALS AND SURGICAL TECHNIQUE A 27-year-old woman presented at our hospital with a chief complaint of chest pain. CT showed an encapsulated left pleural effusion and multiple splenic cysts. The patient was diagnosed with carbohydrate antigen 19-9-producing splenic cysts and was treated with laparoscopic decapsulation. In the hybrid operating room, a balloon catheter was positioned in the splenic artery. Four ports were inserted into the abdomen, the cysts were punctured, and intracystic fluid was suctioned out. Combined splenic artery balloon occlusion was performed to control bleeding when the cyst wall was resected near the splenic parenchyma. Occlusion was performed to create intermittent blockage and consisted of 20-min ischemia and 5-min reperfusion. Then, the inner surface of the cyst wall was cauterized. The total operation time was 170 min (laparoscopic time, 110 min), and blood loss was 100 mL. There were no intraoperative or postoperative complications. The patient has remained healthy, with no recurrence for 8 months. DISCUSSION Laparoscopic decapsulation for the treatment of splenic cysts can prevent life-threatening bacterial infections by preserving the spleen, but this can increase the risk of bleeding from the left splenic parenchyma. Combining splenic artery occlusion with laparoscopic decapsulation is a useful approach in the hybrid operating room.
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Affiliation(s)
- Eri Maeda
- Department of Gastroenterological Surgery, Faculty of Medicine, Kagawa University, Miki, Japan
| | - Keiichi Okano
- Department of Gastroenterological Surgery, Faculty of Medicine, Kagawa University, Miki, Japan
| | - Hironobu Suto
- Department of Gastroenterological Surgery, Faculty of Medicine, Kagawa University, Miki, Japan
| | - Eisuke Asano
- Department of Gastroenterological Surgery, Faculty of Medicine, Kagawa University, Miki, Japan
| | - Minoru Oshima
- Department of Gastroenterological Surgery, Faculty of Medicine, Kagawa University, Miki, Japan
| | - Takayoshi Kishino
- Department of Gastroenterological Surgery, Faculty of Medicine, Kagawa University, Miki, Japan
| | - Masao Fujiwara
- Department of Gastroenterological Surgery, Faculty of Medicine, Kagawa University, Miki, Japan
| | - Naoki Yamamoto
- Department of Gastroenterological Surgery, Federation of Public Services and Affiliated Personnel Aid Associations, Takamatsu Hospital, Takamatsu, Japan
| | - Takayuki Sanomura
- Department of Radiology, Faculty of Medicine, Kagawa University, Miki, Japan
| | - Yasuyuki Suzuki
- Department of Gastroenterological Surgery, Faculty of Medicine, Kagawa University, Miki, Japan
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Okano K, Suto H, Oshima M, Maeda E, Yamamoto N, Kakinoki K, Kamada H, Masaki T, Takahashi S, Shibata T, Suzuki Y. A Prospective Phase II Trial of Neoadjuvant S-1 with Concurrent Hypofractionated Radiotherapy in Patients with Resectable and Borderline Resectable Pancreatic Ductal Adenocarcinoma. Ann Surg Oncol 2017; 24:2777-2784. [PMID: 28608121 DOI: 10.1245/s10434-017-5921-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Indexed: 12/18/2022]
Abstract
BACKGROUND The ideal neoadjuvant treatment protocol for patients with pancreatic cancer (PDAC) remains unclear. We evaluated the efficacy and safety of neoadjuvant hypofractionated chemoradiotherapy with S-1 for patients with resectable (R) and borderline resectable (BR) PDAC. METHODS Eligibility criteria included patients with R and BR PDAC, performance status 0-1, and age 20-85 years. Hypofractionated external-beam radiotherapy (30 Gy in 10 fractions) with concurrent S-1 (60 mg/m2) was delivered 5 days/week for 2 weeks prior to pancreatectomy. RESULTS Fifty-seven patients were enrolled in this study, including 33 R and 24 BR [19 BR tumors with portal vein contact (BR-PV) and 5 BR tumors with arterial contact (BR-A)]. The total rates of protocol treatment completion and resection were 91% (50/57) and 96% (55/57), respectively. Seven patients failed to complete S-1 due to cholangitis (n = 5) or neutropenia (n = 2). The most common grade 3 toxicities [Common Terminology Criteria for Adverse Events (CTCAE) version 4.0] were anorexia (7%), nausea (5%), neutropenia (4%), and leukopenia (4%). No patient experienced grade 4 toxicity. Pathologically negative margins (R0) were achieved in 54 of 55 patients (98%) who underwent pancreatectomy. Pathological response was classified as Evans grade I in 8 patients (15%), IIa in 31 patients (56%), IIb in 14 patients (25%), III in 1 patient (2%), and IV in 1 patient (2%), and operative morbidity (Clavien-Dindo grade IIIb or less) was observed in 4 patients (8%). The 1- and 2-year overall survival (OS) rates were 91 and 83% in R patients, respectively, and 77 and 58% in BR patients, respectively (p = 0.03). CONCLUSION Neoadjuvant S-1 with concurrent hypofractionated radiotherapy is tolerable and appears promising for patients with R and BR PDAC.
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Affiliation(s)
- Keiichi Okano
- Department of Gastroenterological Surgery, Faculty of Medicine, Kagawa University, Miki-cho, Kagawa, Japan.
| | - Hironobu Suto
- Department of Gastroenterological Surgery, Faculty of Medicine, Kagawa University, Miki-cho, Kagawa, Japan
| | - Minoru Oshima
- Department of Gastroenterological Surgery, Faculty of Medicine, Kagawa University, Miki-cho, Kagawa, Japan
| | - Eri Maeda
- Department of Gastroenterological Surgery, Faculty of Medicine, Kagawa University, Miki-cho, Kagawa, Japan
| | - Naoki Yamamoto
- Department of Gastroenterological Surgery, Faculty of Medicine, Kagawa University, Miki-cho, Kagawa, Japan
| | - Keitaro Kakinoki
- Department of Gastroenterological Surgery, Faculty of Medicine, Kagawa University, Miki-cho, Kagawa, Japan
| | - Hideki Kamada
- Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Miki-cho, Kagawa, Japan
| | - Tsutomu Masaki
- Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Miki-cho, Kagawa, Japan
| | - Shigeo Takahashi
- Department of Radiation Oncology, Faculty of Medicine, Kagawa University, Miki-cho, Kagawa, Japan
| | - Toru Shibata
- Department of Radiation Oncology, Faculty of Medicine, Kagawa University, Miki-cho, Kagawa, Japan
| | - Yasuyuki Suzuki
- Department of Gastroenterological Surgery, Faculty of Medicine, Kagawa University, Miki-cho, Kagawa, Japan
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Toyokawa S, Maeda E, Kobayashi Y. Estimation of the number of children with cerebral palsy using nationwide health insurance claims data in Japan. Dev Med Child Neurol 2017; 59:317-321. [PMID: 27644438 DOI: 10.1111/dmcn.13278] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/11/2016] [Indexed: 11/29/2022]
Abstract
AIM Japan lacks a population-based registration system for cerebral palsy (CP), therefore the nationwide prevalence of CP is unknown. Our aim was to estimate the number of children with CP using the National Database of Health Insurance Claims and Specific Health Checkups of Japan, which has been recently developed by the government. METHOD Study participants were children and adolescents aged below 20 years, who had been assigned CP diagnosis codes more than once in claims issued between June 2012 and May 2013 from all health insurance schemes in Japan, except for Social Welfare and Elderly Health Insurance. RESULTS The number of participants with diagnosed CP was 44 381. The number of males with CP (25 237) was greater than the number of females (19 144). Peak CP prevalence per 1000 population was 2.39 at age 4 years, and this gradually declined with age. The prevalence of CP per 1000 population was 2.27 at age 5 to 9 years. The numbers of inpatients and outpatients with CP were 9126 (20.6%) and 35 255 (79.4%) respectively. INTERPRETATION Our estimation of CP prevalence per 1000 population at age 5 to 9 years lay in the higher range of figures from previous studies in Japan, and was close to figures reported by European countries.
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Affiliation(s)
- Satoshi Toyokawa
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Eri Maeda
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yasuki Kobayashi
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Tanaka O, Maeda E, Fushimi M, Iwata T, Shimizu T, Saito S, Murata K. Precarious Employment Is Not Associated with Increased Depressive Symptoms: A Cross-Sectional Study in Care Service Workers of Japan. TOHOKU J EXP MED 2017; 243:19-26. [DOI: 10.1620/tjem.243.19] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Oa Tanaka
- Department of Environmental Health Sciences, Akita University Graduate School of Medicine
| | - Eri Maeda
- Department of Environmental Health Sciences, Akita University Graduate School of Medicine
| | - Masahito Fushimi
- Akita University Health Center
- Akita Occupational Health Promotion Center
| | - Toyoto Iwata
- Department of Environmental Health Sciences, Akita University Graduate School of Medicine
| | - Tetsuo Shimizu
- Akita Occupational Health Promotion Center
- Department of Neuropsychiatry, Akita University Graduate School of Medicine
| | | | - Katsuyuki Murata
- Department of Environmental Health Sciences, Akita University Graduate School of Medicine
- Akita Occupational Health Promotion Center
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Iwata T, Takaoka S, Sakamoto M, Maeda E, Nakamura M, Liu XJ, Murata K. Characteristics of hand tremor and postural sway in patients with fetal-type Minamata disease. J Toxicol Sci 2016; 41:757-763. [PMID: 27853104 DOI: 10.2131/jts.41.757] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
About forty certified patients aged around 50 years old existed as living witnesses to fetal-type Minamata disease (methylmercury poisoning due to in utero exposure) in Minamata, Japan in 2006. Computerized hand tremor and postural sway tests with spectral analysis were conducted for 24 of them and in matched control subjects to examine the pathophysiological feature of neuromotor function. The tremor intensities of the patients with fetal-type Minamata disease were significantly larger than those of the 67 controls at every frequency band for both hands. In the patients, proportions for intensity at 1-6 Hz of both hands were larger, but those of the intensity at 6-10 Hz were smaller compared with the controls. The center frequency of a tremor was significantly lower in the patients than in the controls. Only eight males of the 24 patients were examined to evaluate postural sway because of extremely low scores in activities of daily living in the remaining. Most of the postural sway parameters obtained with eyes open and closed were significantly larger in the patients than in the male controls. Likewise, Romberg quotients of postural sway in anterior-posterior direction were significantly higher in the patients. In conclusion, the patients with fetal-type Minamata disease of our study showed a larger tremor of low frequency at less than 6 Hz and postural instability. Spectral analyses of computerized hand tremor and postural sway are suggested to be useful for assessing the pathophysiological change, related to a lesion of the cerebellum, resulting from prenatal methylmercury exposure.
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Affiliation(s)
- Toyoto Iwata
- Department of Environmental Health Sciences, Akita University Graduate School of Medicine
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