Pharmacists’ perspectives on traditional, complementary, and integrative medicine in Japan with special reference to Kampo medicines: an internet survey with preliminary interviews

Background

Pharmacists guide patients in their use of traditional, complementary, and integrative medicine (TCIM). The present study aimed to evaluate the opinions of Japanese pharmacists regarding TCIM, and to evaluate the usability of the evidence-based Japanese Integrative Medicine (eJIM) website from the pharmacists’ point of view.

Methods

We conducted a two-stage, mixed-method study using interviews and an internet-based survey. In-person interviews were conducted with 20 pharmacists working in hospitals, dispensing pharmacies, or retail pharmacies. We analyzed their perspectives on TCIM and the usability of the eJIM. Based on the interviews, questionnaires for an internet survey conducted in February 2019 were developed.

Results

In the interviews, 55% of pharmacists acknowledged TCIM as a supportive measure for modern medicine, and 45% responded that TCIM was efficacious. However, pharmacists’ evaluation levels of Kampo medicine were high, whereas pharmacists’ attitudes towards dietary supplements were primarily negative. There have been various proposals to improve the eJIM, such as highlighting important information and providing more specific information on TCIM in Japan. An internet survey of 365 pharmacists showed that 67.4% were consulted by patients regarding TCIM. Of these TCIM, pharmacists’ evaluation levels of Kampo medicines were high. Only 5% of the respondents had visited the eJIM website prior to the survey, and the overall usability score of each web page was high.

Conclusions

Kampo medicines and dietary supplements are common TCIMs that pharmacists use or advise on in Japan. Pharmacists’ evaluation levels of Kampo medicine were high, whereas pharmacists’ attitudes towards dietary supplements were generally negative.

Current Status and Issues of Ethical Review for Surgical Research in Japanese University Hospitals

Introduction:

In clinical research, ethical review is required prior to conducting the research. A surgical procedure is a complex intervention with properties that make it more difficult to evaluate rigorously and monitor than drug treatments. This study aimed to clarify the current status and issues in the ethical review and monitoring of surgical research.

Methods:

We developed a self-administered questionnaire on surgical ethical review. The questionnaire was distributed to university hospitals in Japan and collected from November 2018 to February 2019. The distributed questionnaire consisted of the reviewed items, items with difficulties, and important items on ethical review. Fisher’s exact test or the chi-square test was used for analysis.

Results:

The questionnaires from 39 medical university hospitals were completed with appropriate answers to all items. “Technical review” was conducted at a significantly lower proportion (n = 30/39, 76.9%, p = 0.002). “Evaluation of the progress and results” was also (n = 22/39, 56.4%, p < 0.001). University hospitals in which “technical aspects and ethical review” was regarded the most important and difficult were higher (n = 24/39, 61.5%; n = 26/39, 66.7%, respectively). Respondents considered not only items written in the study protocol but also those on monitoring or oversight of surgical research as difficult.

Conclusions:

Our findings suggest that it is necessary to improve the ethical review system and provide supports to conduct an appropriate review for surgical research, e.g., technical aspect review or study progress/result evaluation.

Characteristics of Asian 4 countries on cancer clinical trials registered in the International Clinical Trials Registry Platform between 2005 and 2018

BACKGROUND

The characteristics and comparison of countries regarding clinical trials for cancer were unknown. The World Health Organization-International Clinical Trials Registry Platform (WHO-ICTRP) are providing data from various countries and releases them generally in a downloadable format. We aimed to examine and descriptively identify the number of cancer clinical trials registered in the world and the fundamental characteristics in Asian 4 countries of China, India, Japan and South Korea, focusing on study characteristics, e.g., phase or targeted size, using the WHO-ICTRP.

METHODS

We extracted information on cancer clinical studies in the ICTRP database on September 20, 2019. Then, we performed a cross-sectional study on the annual number of registered studies and country, registered registry, phase, target sizes and sponsors.

RESULTS

We identified 80,677 cancer clinical studies. The annual number of registered cancer clinical studies significantly increased between 2005 and 2018 (3,172 to 8,156, β =382.2, 95% CI: 329.6, 434.8). Among the Asian 4 countries, the numbers of trials were significantly increasing in 2005-2018 (P<0.001). The characteristics on interventional studies for cancer differed in those 4 countries, e.g., the registered registries, phase and sponsors, compared with the US.

CONCLUSIONS

This study descriptively clarified an increase and the characteristics of cancer clinical trials in Asian 4 countries. It suggests to take that characteristics into account and select a database or data source discreetly for analysis of clinical trials, according to the purpose of the research and the required data.

Supervision of new surgical procedures in Japan: Current practice and supervision issues at university hospitals in Japan

BACKGROUND

Sometimes the development of new surgical procedures takes place during patient treatment in clinical practice but can result in undesirable outcomes and social concerns. This study aims to reveal how university hospitals in Japan supervise the implementation of new surgical procedures and what difficulties they confront.

METHODS

Self-administered questionnaire surveys were conducted, targeting all university-affiliated hospitals in Japan.

RESULTS

It was found that most university hospitals in Japan supervised new surgical procedures internally, but they considered it difficult and burdensome to review and monitor them, both technically and practically, owing to several factors.

CONCLUSION

It is advisable to set up more effective and efficient organizational collaborations and implement standard processes of supervision, in both domestic and international clinical settings.

Physician perspectives on traditional, complementary, and integrative medicine and the national evidence-based Japanese integrative medicine information website: A mixed-method study

Background

The evidence-based Japanese integrative medicine (eJIM) website was launched by the Japanese government in 2014 to provide information on integrative medicine to the general public and physicians. While Japanese physicians discourage the use of traditional, complementary, and integrative medicine (TCIM), there are very few reports that explore this issue. We aimed to understand the attitudes of Japanese physicians towards TCIM and evaluate the usability of the eJIM website according to physicians.

Methods

We conducted a two-staged, mixed-method study with interviews and an internet-based survey. Face-to-face interviews were conducted with 12 physicians who worked for large-scale hospitals in two different areas of Japan. We assessed their understanding of TCIM and the usability of the eJIM website. Based on the interviews, the internet survey was developed and was conducted in February 2019.

Results

In the interviews, 12 physicians provided their opinion on TCIM and highlighted important areas, such as increasing the resources available for patients, and ensuring more information on TCIM is available. The internet survey of 231 physicians showed that 35% of the physicians used or advised on TCIM in clinical practice. Kampo medicines (87.8%) and dietary supplements (24.7%) were common. The physicians did not use TCIM primarily because of concerns regarding its efficacy, safety, and cost. Most physicians were not aware of which TCIM their patients used.

Conclusion

Physicians in Japan may not have comprehensively understood TCIM and do not actively use TCIM. The eJIM website could help physicians to gain a better understanding of TCIM if improvements are made.

The utilization of complementary and alternative medicine in Taiwan: An internet survey using an adapted version of the international questionnaire (I-CAM-Q)

BACKGROUND

In Taiwan, numerous studies have been conducted to investigate the use of complementary and alternative medicine (CAM). However, most of them focused on specific diseases or the use of particular methods. Therefore, the results of those studies were quite different and difficult to compare with those of studies from other countries. The International CAM Questionnaire (I-CAM-Q), meanwhile, is a unified tool that can provide comparable results for studies conducted worldwide. Thus, the aim of this study was to discover the proportions of people in Taiwan receiving CAM treatments from different types of health care providers by using an adapted version of I-CAM-Q (I-CAM-QT).

METHODS

I-CAM-QT was developed by translating the Korean version of I-CAM-Q (I-CAM-QK) into traditional Chinese language because of the similarity of CAM usage and doctor licensing system. This study had two stages: the first was a pretest survey used to adjust the questionnaire, while the second was an internet-based survey used to collect data from the community.

RESULTS

Of the 1200 survey respondents, 37% and 37.7% were prescribed or advised to use Chinese herbal medicine (CHM) by Western medicine (WM) physicians and traditional Chinese medicine (TCM) doctors, respectively. Other than CHM, dietary supplements and massage were the forms of CAM most commonly prescribed or recommended by WM physicians or TCM doctors. Overall, walking and relaxation techniques were the most commonly used self-help practices (used by 61.9% and 40.4% of the respondents, respectively). Additionally, 70.3% of the respondents had used at least one kind of dietary supplement in the past 12 months.

CONCLUSION

Regarding the utilization of CAM in Taiwan, this internet-based survey revealed that CHM, dietary supplements, and massage were the types of CAM most commonly prescribed or recommended by WM physicians or TCM doctors.

Large-vessel vasculitis associated with PEGylated granulocyte-colony stimulating factor

A 71-year-old female with advanced endometrial cancer was treated with pegfilgrastim. She developed a fever within seven days, and contrast-enhanced computed tomography scans repeated within three days revealed rapidly progressive thickening of the aortic wall. When clinicians administer PEGylated granulocyte-colony stimulating factor (G-CSF) to cancer patients, drug-associated vasculitis should be suspected. This report discusses the manifestation of G-CSF-associated large-vessel vasculitis (LVV).

Use of Complementary and Alternative Medicine in Japan: A Cross-sectional Internet Survey Using the Japanese Version of the International Complementary and Alternative Medicine Questionnaire

Introduction:

Although there have been several national survey studies on complementary and alternative medicine (CAM) use in Japan, previous studies have not been compared with investigations conducted in other countries. An international CAM questionnaire known as I-CAM-Q was developed through a two-day international workshop in 2006. The purpose of this study was to investigate the use of CAM by the general Japanese population using a modified version of the I-CAM-Q for the Japanese (I-CAM-QJ).

Methods:

We developed the I-CAM-QJ to conduct an internet survey of 3,208 participants from the general population of Japan in February 2016. The respondents included 1,592 males (49.6%), 1,348 university graduates (38.8%), 1,105 individuals in good health (34.4%), and 1,028 individuals with long-term illness or disability (32.0%).

Results:

Of the 3,208 respondents, 411 participants reported CAM use during the past 12 months (12.8%). The following therapies and products were used: Kampo medicines (over-the-counter Kampo medicines: 15.7%; prescribed Kampo medicines: 15.4%), dietary supplements 11.8%, massage services 3.9%, and physical therapy 3.5%. Regarding the use of self-care methods during the last 12 months, the following methods and products were used: bath salts 25.8% and walking 25.3%.

Conclusions:

An internet survey on CAM use by the general Japanese population with a modified I-CAM-Q (I-CAM-QJ) revealed that Kampo medicines and dietary supplements were the most commonly used CAMs in Japan.

Tumour necrosis factor α augments the inhibitory effects of CTLA-4-Ig on osteoclast generation from human monocytes via induction of CD80 expression

Cytotoxic T lymphocyte antigen-4-immunoglobulin (CTLA-4-Ig) exerts anti-rheumatic action via negative regulation of the co-stimulation process between antigen-presenting cells and T cells. CTLA-4-Ig also binds to CD80/CD86 on monocytes of osteoclast precursors. However, little is known about the effect of CTLA-4-Ig on osteoclastogenesis in rheumatoid arthritis (RA). In this study we evaluated the effects of CTLA-4-Ig on osteoclast generation from human blood monocytes (PBM) and rheumatoid synovial fluid monocytes (RSFM). Highly purified monocytes were cultured with receptor activator of nuclear factor kappa-B ligand (RANKL) and macrophage colony-stimulating factor (M-CSF) in the presence of CTLA-4-Ig. CTLA-4-Ig inhibited RANKL-induced osteoclast generation in PBM and RSFM, as determined by tartrate-resistant acid phosphatase (TRAP) staining and bone resorption assay using osteo assay surface plates. In addition, CTLA-4-Ig reduced the gene and protein expressions of nuclear factor of activated T cells, cytoplasmic 1 (NFATc1) and cathepsin K during osteoclastogenesis. Furthermore, CTLA-4-Ig significantly inhibited cell proliferation during osteoclastogenesis. Interestingly, the gene expression of indoleamine 2,3-dioxygenase-1, an inducer of apoptosis, was enhanced by CTLA-4-Ig. We next examined the effect of tumour necrosis factor (TNF)-α, a major inflammatory cytokine in rheumatoid synovium, on the expression of CD80 and CD86 by flow cytometric analysis. TNF-α potently induced the surface expression of CD80, which is known to have much higher affinity to CTLA-4-Ig than CD86, and this induction was observed at mRNA levels. Interestingly, freshly prepared rheumatoid synovial monocytes also expressed CD80 as much as TNF-α-treated PBM. Furthermore, TNF-α enhanced CTLA-4-Ig-induced inhibition of osteoclastogenesis and cell proliferation. Taken together, the TNF-α-induced CD80 may augment CTLA-4-Ig-induced inhibition of osteoclastogenesis, suggesting that CTLA-4-Ig potently inhibits osteoclast differentiation and protects bone destruction in rheumatoid inflamed joints.

Internet survey on the provision of complementary and alternative medicine in Japanese private clinics: a cross-sectional study

OBJECTIVE

Although the use of complementary and alternative medicine (CAM) by the general population has been surveyed previously, the provision of CAM by Japanese physicians in private clinics has not been studied. Universal health insurance system was established in Japan in 1961, and most CAMs are not on the drug tariff. We aimed to clarify the current status of CAM provided by physicians at private clinics in Japan.

METHODS

We conducted an internet survey on 400 directors/physicians of private clinics nationwide on the provision of CAM from February 6 to February 10, 2017. Survey items included attributes of subjects, presence/absence of sections or facilities for provision of CAM, proportions of health insurance coverage for medical practices, and source of information. Private clinic was defined as a clinic run by one physician, with less than 20 beds.

RESULTS

Commonly provided CAMs were Kampo (traditional Japanese herbal) medicines (34.8%) and supplements/health foods (19.3%). CAMs on the drug tariff were provided in 46.5% of cases at the clinics, but only 16.5% of cases were provided CAMs which were not on the drug tariff, at different neighboring facilities. Among different specialties, Kampo medicines were prescribed at obstetrics/gynecology (54.0%), orthopedics (44.4%), and dermatology (43.0%). Clinics not providing any CAM accounted for 53.5%. With regard to health insurance coverage, 96.8% of the clinics provided only or mainly health services on the universal national health insurance tariff (29.8% and 67.0%, respectively).

CONCLUSION

Kampo medicines represent the most commonly used CAM in private clinics in Japan, and universal national health insurance coverage is considered to be the reason for the high rate of their use.

An assessment of the use of complementary and alternative medicine by Korean people using an adapted version of the standardized international questionnaire (I-CAM-QK): a cross-sectional study of an internet survey

Background

In Korea, there are two types of medical doctors: one practises conventional medicine (hereafter called a physician), and the other practises traditional medicine (hereafter called a Korean medical doctor). This study aimed to compare the provision of complementary and alternative medicine (CAM) by these providers to CAM use per self-judgement in Korea.

Methods

We analysed 1668 Korean people via an internet survey with the Korean adopted version of the I-CAM-Q, namely, the International Questionnaire to measure use of CAM, to understand whether respondents used CAM based either on a prescription or advice from a physician or a Korean medical doctor or on self-judgement.

Results

In the previous 12 months, the proportions of respondents who were treated by a physician, who were treated by a Korean medical doctor and who were not treated by anyone were 67.9, 20.7 and 14.2%, respectively. Among the respondents who received CAM based on a prescription or advice from a physician, traditional Korean medicine practices and dietary supplements were commonly used; only a small percentage used other CAM therapies. Respondents who received CAM based on a prescription or advice from a Korean medical doctor showed similar results. Acupuncture and moxibustion, traditional Korean medicines (decoction), or cupping were more commonly used. Korean traditional medicines as over-the-counter (OTC) drugs were more commonly used by respondents who received CAM therapy based on a prescription or advice from a physician than by those who received CAM therapy based on a prescription or advice from a Korean medical doctor. A total of 74% of the responders used any CAM by self-judgement in the previous 12 months.

Conclusions

For the use of CAM in Korea, in addition to the Korean traditional medical care provided by Korean medical doctors, general physicians advised people regarding Korean traditional medical care and dietary supplements.

Electronic supplementary material

The online version of this article (10.1186/s12906-018-2294-6) contains supplementary material, which is available to authorized users.

Usability of the evidence-based Japanese integrative medicine (eJIM) information site: analysis with focus group discussion and internet survey on the general population

Background

The information site for evidence-based Japanese Integrative Medicine (eJIM) was launched by the Japanese Ministry of Health, Labour and Welfare to enable patients, medical staff, and others to obtain appropriate information, but it has not been objectively evaluated by users. The present study aimed to assess the usability of the eJIM website from the viewpoint of the general population.

Methods

We held a focus group discussion with 12 persons in November 2016, conducted an Internet survey of 1107 people (general population) in February 2017, and assessed their understanding of basic concepts of complementary and alternative medicine and usefulness of the contents after browsing the eJIM website. Levels of functional, communicative, and critical health literacy were also assessed.

Results

Most patients had never visited the eJIM website, because basic terms such as "integrative medicine" and "evidence" were not fully understood. Most overseas information in English was difficult to understand for the general Japanese population, although approximately 50% of the information was translated into Japanese. The degree of appropriate responses depended on health literacy level.

Conclusion

The usability of eJIM website was low, because the currently available information did not meet the needs of the general population. Moreover, simpler expressions and visual tools would help the general population to understand the website contents more easily. A further survey that considers cultural and quantitative perspectives is warranted.

Predicting complete loss to follow-up after a health-education program: number of absences and face-to-face contact with a researcher

Background

Research on health-education programs requires longitudinal data. Loss to follow-up can lead to imprecision and bias, and complete loss to follow-up is particularly damaging. If that loss is predictable, then efforts to prevent it can be focused on those program participants who are at the highest risk. We identified predictors of complete loss to follow-up in a longitudinal cohort study.

Methods

Data were collected over 1 year in a study of adults with chronic illnesses who were in a program to learn self-management skills. Following baseline measurements, the program had one group-discussion session each week for six weeks. Follow-up questionnaires were sent 3, 6, and 12 months after the baseline measurement. A person was classified as completely lost to follow-up if none of those three follow-up questionnaires had been returned by two months after the last one was sent.

We tested two hypotheses: that complete loss to follow-up was directly associated with the number of absences from the program sessions, and that it was less common among people who had had face-to-face contact with one of the researchers. We also tested predictors of data loss identified previously and examined associations with specific diagnoses.

Using the unpaired t-test, the U test, Fisher's exact test, and logistic regression, we identified good predictors of complete loss to follow-up.

Results

The prevalence of complete loss to follow-up was 12.2% (50/409). Complete loss to follow-up was directly related to the number of absences (odds ratio; 95% confidence interval: 1.78; 1.49-2.12), and it was inversely related to age (0.97; 0.95-0.99). Complete loss to follow-up was less common among people who had met one of the researchers (0.51; 0.28-0.95) and among those with connective tissue disease (0.29; 0.09-0.98). For the multivariate logistic model the area under the ROC curve was 0.77.

Conclusions

Complete loss to follow-up after this health-education program can be predicted to some extent from data that are easy to collect (age, number of absences, and diagnosis). Also, face-to-face contact with a researcher deserves further study as a way of increasing participation in follow-up, and health-education programs should include it.

Specific downregulation of death-associated protein kinase enhances Fas-mediated apoptosis in the human differentiated endometrial adenocarcinoma cell line, HHUA

PURPOSE OF INVESTIGATION

Death-associated protein kinase (DAPK) is a serine/threonine kinase that is well-known as a positive mediator of Fas-mediated apoptosis. Previous reports have shown that DAPK and Fas are expressed in human endometrial adenocarcinoma cells. In this study, we examined the effects of specific downregulation of DAPK expression on Fas-mediated apoptosis in the human endometrial adenocarcinoma cell line, HHUA.

METHODS AND RESULTS

Transfection of DAPK small-interfering RNAs (siRNAs) into the HHUA cells reduced DAPK protein expression, and enhanced Fas-mediated apoptosis, in a dose-dependent manner.

CONCLUSIONS

These results indicate that, in contrast to cases with other malignant tumor cells, DAPK negatively regulates Fas-mediated apoptosis in these human differentiated endometrial adenocarcinoma cells.

Effectiveness of Chronic Disease Self-management Program in Japan: preliminary report of a longitudinal study

This is the preliminary report of a study to evaluate the effectiveness of the Chronic Disease Self-management Program in Japan by comparing changes in health outcomes at the baseline and 3-month and 6-month follow-ups. The program is a patient-centered educational program for the self-management of chronic conditions. The study's participants were recruited from among the attendees of the program workshops. During the study period (August 2006 to May 2007), 18 workshops were held and 128 attendees agreed to participate in the study. The health outcomes that were measured included health status, self-management behaviors, utilization of health services, self-efficacy, satisfaction with daily living, and clinical indicators. These indicators were further analyzed by disease type: diabetes, rheumatic disease, and cardiovascular disease/dyslipidemia. The findings indicated statistically significant positive changes in health distress, coping with symptoms, stretching exercises, communication with the physician, and satisfaction with daily living. The positive changes were especially remarkable among the groups with diabetes and rheumatic disease. These findings suggest that the Chronic Disease Self-management Program can be effective for Japanese people with chronic conditions.

Structure and function of Fc epsilon receptor II (Fc epsilon RII/CD23): a point of contact between the effector phase of allergy and B cell differentiation

The Fc epsilon receptor II (Fc epsilon RII/CD23) has been proposed to have multiple functions as a membrane-bound or soluble molecule: a function in B cell growth and differentiation and a role in the effector phase of IgE-mediated immunity. We recently demonstrated the presence of two forms of Fc epsilon RII (Fc epsilon RIIa and Fc epsilon RIIb) whose structures differ only at their N-terminal cytoplasmic regions. The regulatory mechanisms of their expression strongly suggest that Fc epsilon RIIa and Fc epsilon RIIb function in B cells and in the effector cells of IgE-mediated immunity, respectively. To elucidate the function of soluble Fc epsilon RII/CD23 (sFc epsilon RII) the recombinant soluble molecule was produced. This recombinant receptor could competitively block the IgE binding of eosinophils, monocytes and even basophils and could inhibit the IgE-mediated function of effector cells such as monocytes. These findings suggested that sFc epsilon RII could competitively regulate the function of effector cells in IgE-mediated immunity and that the recombinant sFc epsilon RII could be applied clinically for the control of allergic reactions. The expression of Fc epsilon RII on Fc epsilon RII-negative B and T cell lines by cDNA transfection resulted in homocytic aggregation. The function of Fc epsilon RII on B cells as an adhesion molecule was also demonstrated.

Radiation reduces carboplatin sensitivity and enhances nedaplatin sensitivity in cervical squamous cell carcinoma in vitro

BACKGROUND

The study was performed to examine how the platinum anticancer drugs other than cisplatin, such as carboplatin (CBDCA) and nedaplatin (NEP) can be effectively used in chemoradiotherapy for cervical squamous cell carcinoma patients.

MATERIALS AND METHODS

The radiosensitive human cervical squamous cell carcinoma cell line ME180 was examined to investigate the radiation effects on CBDCA and NEP sensitivities of the cells.

RESULTS

Irradiation significantly reduced cellular CBDCA sensitivity. There were no significant changes in CBDCA sensitivity between the cells concurrently irradiated and those treated with CBDCA 8 h before or 8 h after irradiation. However NEP sensitivity of the cells treated 8 h before or 8 h after irradiation was significantly higher than that in cells concurrently irradiated.

CONCLUSIONS

Although CBDCA sensitivity in the concurrently irradiated cells is reduced, NEP sensitivity is enhanced by irradiation. NEP, but not CBDCA, therefore, may be a candidate anticancer drug for concurrent chemoradiotherapy for cervical cancer. For the greatest efficacy, NEP should be administered to patients several hours before or after irradiation.

Irradiation reduces bleomycin sensitivity in cervical squamous cancer cells in vitro

PURPOSE OF INVESTIGATION

The study was performed to examine how bleomycin (BLM) and peplomycin (PEM) should be effectively used in radiotherapy for cervical squamous cancer patients.

METHODS

The effects of BLM on radiosensitivity and the effects of radiation on the sensitivity to BLM of cancer cells were investigated using the radiosensitive human cervical squamous cell carcinoma cell line ME180.

RESULTS

BLM treatment did not affect radiosensitivity. However, irradiation significantly reduced cell BLM sensitivity in a dose-dependent manner. There was no significant difference in BLM sensitivity and PEM sensitivity between cells concurrently irradiated and those treated with BLM or PEM 8 h before or 8 h after irradiation.

CONCLUSION

Since sensitivity to BLM is reduced during irradiation, BLM should be administered to cervical cancer patients as an adjuvant chemotherapeutic drug after completion of radiotherapy.

Effective chemoradiotherapy protocol with 5-fluorouracil for cervical squamous cell carcinoma in vitro

PURPOSE OF INVESTIGATION

5-Fluorouracil (5FU) is frequently used in concurrent chemoradiotherapy for patients with advanced cervical cancer, although its optimal chemoradiotherapy protocol has not yet been established. In search of an optimal chemoradiotherapy protocol, some in vitro experiments were carried out.

METHODS

The radiosensitive human cervical squamous cell carcinoma cell line ME180 was examined to investigate the effects of 5FU on radiosensitivity and the effects of irradiation on 5FU-sensitivity.

RESULTS

5FU dose-dependently enhanced cellular radiosensitivity at therapeutic concentrations. Although high doses of y-ray irradiation significantly reduced the 5FU-sensitivity, a low dose of irradiation at therapeutic doses (< 2.5 Gy) had no effect on 5FU-sensitivity of the irradiated cells. Cells pretreated with 5FU eight hours before irradiation showed significantly higher 5FU-sensitivity than cells concurrently treated with 5FU and irradiation. In contrast, cells treated with 5FU eight hours after irradiation showed significantly lower 5FU-sensitivity than cells concurrently treated with 5FU and irradiation. Moreover, all four post-irradiation surviving subclones obtained from repeatedly irradiated ME180 cells showed significantly lower 5FU-sensitivity than the non-irradiated parent cells.

CONCLUSION

5FU acts as a radiosensitizer for cervical squamous cell carcinoma and 5FU-sensitivity is reduced in irradiated cells. Therefore, 5FU administration immediately before irradiation may be a more effective treatment than concurrent chemoradiotherapy or post-irradiation chemotherapy with 5FU.

Radiation enhances cisplatin-sensitivity in human cervical squamous cancer cells in vitro

PURPOSE AND METHODS OF INVESTIGATION: Cisplatin (CDDP) is regularly used in concurrent chemoradiotherapy in patients with advanced cervical cancer although an effective protocol of chemoradiotherapy with CDDP has not yet been established. In search of a better chemoradiotherapy protocol, we investigated both CDDP effects on radiosensitivity and irradiation effects on CDDP-sensitivity using the radiosensitive human cervical squamous cell carcinoma cell line ME180.

RESULTS

We found that CDDP did not affect cellular radiosensitivity, and that irradiation significantly enhanced CDDP-sensitivity. Moreover, all the four post-irradiation surviving subclones obtained from repetitively irradiated ME180 cells showed significantly higher CDDP sensitivities than those of the non-irradiated parent cells.

CONCLUSION

These results suggest that an effective protocol would involve the concurrent administration of CDDP with radiotherapy and further administration following completion of radiotherapy in order to achieve higher CDDP-sensitivities.

Age-related pattern of body density and body composition in Japanese males and females, 11 and 18 years of age

The age-related pattern of body density and body composition in Japanese males (n = 266) and females (n = 318), 11.00 to 18.99 years of age was studied. Body density (BD) as well as height, body weight, and seven skinfold thicknesses were measured. Percentage fat (%Fat) was calculated using the age- and sex-specific equation of Lohman. Fat mass (FM), fat-free mass (FFM), and the body mass index (BMI) were calculated. The trend for BD in males was lowest at 11 years (1.0530 g/ml) and increased to 1.0695 g/ml at 14 years, and then decreased slightly at 15 to 17 years. In female, BD decreased from 1.0530 g/ml at 13 years to 1.0424 g/ml at 17 years. Mean %Fat was highest in males at 11 years (15.8%), and lowest at 14 years (10.1%). The highest mean %Fat in females occurred at 16 years (22.8%), and the lowest at age 11 years (15.2%). Overall, only 6.8% of males and 3.1% of females were classified as obese. Between 11 and 18 years, FFM of males differed by 20.7 kg or 67.9%, whereas females showed a difference of only 10.8 kg or 34.7%. Consequently, age effects explained approximately 60% of the male variance of FFM but only 26% in females. Body density of each sex and age group in this study did not differ significantly from previous Japanese studies, and the pooled BD data for 1,457 Japanese including the present study are reported as a reference.

The class IV semaphorin CD100 plays nonredundant roles in the immune system: defective B and T cell activation in CD100-deficient mice

The class IV semaphorin CD100/Sema4D differentially utilizes two distinct receptors: plexin-B1 in nonlymphoid tissues, such as brain and kidney, and CD72 in lymphoid tissues. We have generated CD100-deficient mice and demonstrated that they have functional defects in their immune system, without apparent abnormalities in other tissues. The number of CD5(+) B-1 cells was considerably decreased in the mutant mice, whereas conventional B cells and T cells appeared to develop normally. In vitro proliferative responses and immunoglobulin production were reduced in CD100-deficient B cells. The humoral immune response against a T cell-dependent antigen and in vivo priming of T cells were also defective in the mutant mice. These results demonstrate nonredundant and essential roles of CD100-CD72 interactions in the immune system.

[Validity of various obesity indices calculated from height and weight in adult females using the underwater-weighing method as a reference]

We evaluated association between excess percent body fat (%Fat) and various obesity indices calculated from height and weight in 322 adult females. %Fat was measured by the underwater-weighing method, and obesity indices were based on the following 5 methods; Broca-Katsura method (Katsura method), Kato-Wataya method (Kato method), Japan Society for the Study of Obesity method (BMI method; based on the body weight at which BMI is 22), Meiji Life Insurance Co. method, and Table and Figure for the Assessment of Obesity and Leanness by the Ministry of Health and Welfare (MHW method). %Fat was 30% or more (obese) in 73 females (22.7%), 25-30% in 97 (30.1%), 20-25% in 88 (27.3%), and less than 20% in 64 (19.9%). The correlation coefficient between the obesity indices and %Fat were 0.71 for the Katsura method, 0.70 for the Kato-method, 0.72 for the BMI method, 0.70 for the Meiji Life Insurance Co. Method, and 0.63 for the MHW method, being significant for all methods (P < 0.01). When the cut-off point was set as 110% for each obesity index, sensitivity was the highest for the Katsura method (67.1%), and specificity was the highest for the Meiji Life Insurance Co. method (95.2%). Receiver operating characteristic (ROC) curves were similar in figure for the Katsura method, Kato-method, BMI method, and Meiji Life Insurance Co. method. For the MHW method, however, the curve was slightly farther from the point of sensitivity of 100% and 1-specificity of 0% than the others. Excess fat accumulation could not be accurately assessed by the obesity indices calculated from body height and weight. Validity was similar among the obesity indices except for the MHW method.

Regulation of transcription factor C/ATF by the cAMP signal activation in hippocampal neurons, and molecular interaction of C/ATF with signal integrator CBP/p300

The CCAAT/enhancer binding proteins related activating transcription factor, C/ATF, is a mouse leucine-zipper transcription factor which is structurally homologous to ApCREB2, a suppressor integral to long-term synaptic plasticity in Aplysia. To gain a clue to whether C/ATF is involved in long-term plasticities of brain, we examined if the expression levels of C/ATF are modulated by cAMP, an inducer crucial for memory formation in Aplysia, Drosophila and mice. Our in situ hybridization analysis revealed the expression of C/ATF mRNA in hippocampal neurons. C/ATF protein levels increased after the cAMP signal stimulation in hippocampal neurons, while C/ATF mRNA levels remained constant. The human activating transcription factor 4 (hATF4), another homolog of ApCREB2, interacts with multiple domains of the coactivator CREB-binding protein (CBP), resulting in the potentiation of its ability to activate transcription. As expected, C/ATF was found to interact with three domains of CBP including CREB binding domain or kinase-inducible interaction (KIX) domain, the third cysteine-histidine-rich region (CH3 domain) and the nuclear receptor coactivator p160/SRC-1-interacting domain. Interestingly, C/ATF was further found to interact strongly with CREB binding protein/p300 (CBP/p300) CH1 domain. Mammalian two hybrid assays indicated that the interaction between C/ATF and CBP/p300 can occur in mammalian cells, and that the p300 CH1 domain is critical for the interaction. Thus, C/ATF may be implicated in transcription-dependent phase of hippocampal long-term plasticities through the modulation of its protein level under cAMP signal and the interaction with signal integrator, CBP/p300.

Clinical features of paroxysmal positional vertigo presenting combined lesions

Benign paroxysmal positional vertigo (BPPV) is one of the common vestibular disorders. Canalolithiasis is thought to be a likely lesion. A canalith repositioning procedure (CRP by Epley) generally yields good resolution of vertigo and nystagmus. The authors confirmed the efficacy of this procedure on typical BPPV of the posterior semicircular canal type. We designed a new procedure for BPPV of the lateral canal type, which also yielded satisfactory results. BPPV sometimes presents a nystagmus pattern, which suggests multiple lesions. We have seen eight cases of BPPV showing nystagmus that combines both the posterior and the lateral canal types. Combined CRP was performed on these cases, which again gave good clinical results. Other BPPV cases were associated with central lesions. We must be aware that BPPV may involve multiple canals and may be associated with central lesions.

Expressions of CCAAT/Enhancer-binding proteins beta and delta and their activities are intensified by cAMP signaling as well as Ca2+/calmodulin kinases activation in hippocampal neurons

The transcription factor, Aplysia CCAAT enhancer-binding protein (ApC/EBP), plays a crucial role in long term facilitation, a synaptic mechanism of long term memory in Aplysia. To gain a clue to whether the mammalian C/EBP family of transcription factors are also involved in long term memory, we examined how C/EBP activities in hippocampal neurons can be modulated in response to cAMP and Ca2+, crucial inductive signals for memory formation. As a result, stimulation of either cAMP or Ca2+ signals in hippocampal neurons was found to enhance mRNA expressions and DNA binding activities of C/EBPbeta and C/EBPdelta. Furthermore, it is indicated that CaM kinases have essential roles for increasing the expression and DNA binding activities of C/EBPbeta in hippocampal neurons activated by membrane depolarization. Overexpression of constitutively active calcium/calmodulin-dependent kinase IV was found to directly stimulate either C/EBPbeta-dependent or C/EBPdelta-dependent transcription, reinforcing the evidence that C/EBP family members contribute to Ca2+-dependent transcription. Thus, these results suggest that C/EBPbeta and C/EBPdelta may be involved in the transcription-dependent phase of memory formation by increasing the expression of both the DNA binding and the transcriptional activities under the direction of cAMP and/or Ca2+ signaling in hippocampal neurons.

Hypotensive effects of an angiotensin II type 1 receptor antagonist differ between exercised and sedentary rats aged from 4 to 19 weeks

The hypotensive effects of an angiotensin II type 1 receptor antagonist TCV-116 were accelerated by swimming training in the early period of chronic administration in young rats. In the latter period, however, a severe decrease in blood pressure that appeared during long-term administration of TCV-116 was prevented by swimming training. Therefore exercise may contribute to the stabilization of blood pressure in young rats treated with TCV-116.

Regulation of human papillomavirus transcription by the differentiation-dependent epithelial factor Epoc-1/skn-1a

Human papillomavirus (HPV) early gene expression is closely linked to the differentiation status of infected epithelial cells. Typically, HPV type 16 (HPV16) or HPV18 E6 and E7 transcripts are only barely detectable within the undifferentiated basal cell layer, but their levels increase concomitantly with higher degrees of epithelial cell differentiation in suprabasal cells. A similar differentiation-dependent distribution of expression has been reported for the recently cloned epithelial cell specific transcription factor Epoc-1/skn-1a. We therefore examined whether Epoc-1/skn-1a may be directly involved in the activation of HPV E6/E7 transcription. Transient transfection studies showed that Epoc-1/skn-1a specifically stimulated the HPV16 and HPV18 E6/E7 promoters. Moreover, ectopically expressed Epoc-1/skn-1a was sufficient to stimulate HPV transcription also in nonepithelial cells. By deletion analyses, the Epoc-1/skn-1a-responsive element was mapped to the promoter-proximal portion of the HPV18 transcriptional control region. Footprint analyses and gel retardation assays demonstrated direct binding of Epoc-1/skn-1a to a hitherto uncharacterized site within this region. Mutation of the Epoc-1/skn-1a recognition site within the context of the complete HPV18 upstream regulatory region inhibited Epoc-1/skn-1a-mediated transactivation. These results show that Epoc-1/skn-1a can directly activate the E6/E7 promoter by binding to the viral transcriptional control region. Thus, Epoc-1/skn-1a may be involved in the differentiation-dependent regulation of HPV transcription.

[Hydrostatic weighing, skinfold thickness, body mass index relationships in high school girls]

A study was conducted to evaluate body composition by hydrostatic weighing, skinfold thickness, and body mass index (BMI) in 102 senior high school girls, aged 15 to 18 in Nagasaki City. Body density measured by the underwater weighing method, was used to determine the fat weight (Fat) and lean body mass (LBM. or fat free weight: FFW) utilizing the formulas by Brozek et al. The results were as follows; 1. Mean values of body density were 1.04428 in the first grade girls, 1.04182 in the second grade, and 1.04185 in the third grade. 2. Mean values of percentage body fat (%Fat) were 23.5% in the first grade, 24.5% in the second and 24.5% in the third. 3. Percentage body fat (%Fat), lean body mass (LBM) and LBM/Height were not significantly with different advance of grade from the first to the third. 4. The correlation coefficients between percent body fat and the sum of two skinfold thicknesses, the sum of three skinfold thicknesses and the sum of seven skinfold thicknesses was 0.78, 0.79, and 0.80 respectively and were all statistically significant (p < 0.001). 5. The correlation coefficients between BMI and the sum of two skinfold thicknesses, the sum of three skinfold thicknesses and the sum of seven skinfold thicknesses was 0.74, 0.74, and 0.74 respectively and were all statistically significant (p < 0.001). 6. Mean values of BMI, Rohrer index and waist-hip ratio (WHR) in all subjects (n = 102) were 20.3, 128.2 and 0.72 respectively.

[Body density assessment utilizing skinfold thickness and age in Japanese men]

A study was conducted to investigate the validity of skinfold-based prediction equations for body density (g/ml) by Nagamine and Suzuki (1964), and to formulate more convenient and more useful equations for predicting body density from skinfold and age in men. Subjects of the study were 257 healthy men aged 19-60 years in or near Nagasaki City. The regression equation for the dependent variable, body density, was determined by hydrostatic weighing. Independent variables included eight skinfolds, the sum of two skinfolds (triceps, subscapular), the sum of three skinfolds (triceps, subscapular, and abdominal), age, and body surface area. Skinfolds were measured with an Eiken-model skinfold caliper. Age (mean 33.1, range 19-60 yrs.), weight (mean 65.3, range 46.6-107.7 kg), height (mean 168.8, range 152.3-185.4 cm), and body density (mean 1.05874, range 1.00860-1.09020 g/ml) were also recorded. Percent body fat was calculated using the formula by Brozek et al. and ranged from 6.1% to 38.9%. Multiple correlation coefficients (MR) and standard error (SE) of 10 regression equations (A-J) for predicting body density in men were obtained. The best-fitting and the most convenient prediction equation for body density was equation-E.: body density = 1.09556-0.00062 x sum of three skinfolds (mm)-0.00028 x age (MR = 0.815 and SE = 0.0087 g/ml). The equation was cross-validated on a different sample of 45 men. The correlation coefficient between predicted and hydrostatically determined body density was 0.781 (p < 0.001). Equation-E (Tahara's equation) appears to be useful in body density analysis particularly when the subjects are Japanese men, aged 18-50 yrs, with percent body fat 10 to 30%.

Changes in body shape of young individuals from the aspect of adult physique model by factor analysis

The purpose of this study was to clarify characteristics of age-related changes in body shape in adolescence, in 11- to 19-year-old boys and girls, by using previously reported physique models of adult men and women as the scale. The scale consisted of four factors obtained by factor analysis using 30 items as variables, such as the values measured for the physique, skinfold thickness and body composition. The four factors were Factor 1: body fat, Factor 2: mass, Factor 3: leg length to height ratio, and Factor 4: length, and were interpreted in the men and women in a similar manner. The subjects were 307 boys and 368 girls; all were healthy. Thirty items were measured and included the values measured for the physique, skinfold thickness and body composition, as in the men and women. Factor scores in the subjects were standardized by mean and standard deviation for each item in the adult subjects, and calculated for individuals by using the coefficient of factor score in the adult subjects. The body shapes of the boys and girls were investigated from the factor score by age calculated for each factor. The following results were obtained: 1. Factor 1 tended to gradually decrease and reached the adult level at 15 years of age in the boys.(ABSTRACT TRUNCATED AT 250 WORDS)

Japanese-language results for the speak strategy from Cochlear Pty Limited

Recognition of speech sounds with a new speech-coding strategy, Speak, was compared with that of the Multipeak (Mpeak) strategy. Results of consonant, word, and sentence tests on 10 postlingually deaf subjects demonstrated that the performance of the Speak strategy significantly exceeded that of the Mpeak strategy under both quiet and noise conditions. Information transfer ratios for consonant features were improved by 20% to 40% with the Speak strategy under the noise condition. Thus, the Speak coding strategy can provide better speech sound perception than the Mpeak coding strategy.

Alterations of angiotensin II receptor contents in hypertrophied hearts

Tsukuba hypertensive mice, which carry the human genes for renin and angiotensinogen, show cardiac hypertrophy as well as hypertension due to activation of the renin-angiotensin system (RAS). Here, we compared the cardiac angiotensin II (Ang II) receptor contents in these and normotensive control mice by means of ligand binding studies and competitive reverse transcription-polymerase chain reaction analyses. The content of the Ang II receptor type 1 (AT1) was significantly higher at both the protein (2.5-fold; p < 0.01) and mRNA (1.4-fold; p < 0.05) levels in the hypertensive mice than that in control mice. Almost identical levels of the Ang II receptor type 2 (AT2) expression were identified at the mRNA levels in the two types of mice, although the levels were less than 20% of those of AT1 mRNA in control mice. These results suggest that AT1 in the heart is upregulated in response to Ang II-induced hypertrophic change and that, in particular, the upregulation of AT1 in particular contributes to the development and/or maintenance of cardiac hypertrophy in conjunction with the increase in Ang II production, because AT1 is responsible for cardiac hypertrophy related to the RAS.

[Body density assessment utilizing skinfold thickness and age in Japanese women]

A study was conducted to investigate the validity of skinfold-based prediction equations for body density (g/ml) by Nagamine and Suzuki (1964), and to formulate more convenient and more useful equations for predicting body density from skinfold and age in women. Subjects of the study were 512 healthy women aged 18-66 years in or near Nagasaki City. The dependent variable in the multiple regression equation, body density, was determined by hydrostatic weighing. Independent variables included eight skinfolds, the sum of two skinfolds (triceps, subscapular), the sum of three skinfolds (triceps, subscapular, and abdominal), age, and body surface area. Skinfolds were measured with an Eiken-model skinfold caliper. Age (mean 30.1, range 18-66 yrs.), weight (mean 52.6, range 38.0-83.3 kg), height (mean 157.0, range 142.0-172.0 cm), and body density, (mean 1.04125, range 0.98806-1.08650 g/ml) were also recorded. Percent body fat was calculated using the formula by Brozek et al. and ranged from 6.4% to 48.3%. Multiple correlation coefficients (MR) and standard error (SE) of 10 regression equations (A-J) for predicting body density in women were compared. The best-fitting and the most convenient prediction equation for body density was equation-E. The regression equation developed for predicting body density was: body density = 1.07931-0.00059 x sum of three skinfolds(mm)-0.00015 x age (MR = 0.77 and SE = 0.0089). The equation was cross-validated on a different sample of 46 women. The correlation coefficient between predicted and hydrostatically determined body density was 0.813 (p < 0.001). Equation-E (Tahara's equation) appears to be useful in body density analysis particularly when the subjects are Japanese women, aged 18-50 yrs, with percent body fat 17 to 34%.

Characteristics of body shape of female athletes based on factor analysis

We examined the body shape of female athletes in comparison with female adult non-athletes by factor analysis. The subjects were 433 adult non-athletes and 464 athletes participating in 11 different sporting events. The physique, skinfold thickness and body composition of each subject were measured. The values obtained from non-athletes were analyzed by factor analysis, and the body shape of the athletes was then analyzed according to these factors. Four main factors with which 80 percent of total variance could be explained were body fat (Factor 1), mass (Factor 2), leg length to height ratio (Factor 3) and length (Factor 4), and were extracted from the values from non-athletes. The body shape of the athletes could be classified into 4 categories by cluster analysis for factor score of sporting events: less body fat and slim type, average type like non-athletes, muscular and well-balanced type, and tall and well-developed mass. Compared with non-athletes, female athletes for all sporting events had less body fat. Moreover, the athletes had a body shape suitable for their sporting events; i.e., their mass, length of leg and height.

Classification of body shape of male athletes by factor analysis

The purpose of this study was to evaluate the body shape of athletes in comparison with adult non-athletes by factor analysis. The subjects were 210 male adult non-athletes and 485 male high school age and adult athletes participating in 13 different sporting events. Physique, skinfold thickness and body composition of each subject were measured. Measured values from adult non-athletes were analyzed by factor analysis, and body shape of the athletes was then analyzed according to these factors. The results are summarized as follows: 1. Four main factors, that is, body fat, mass, leg length to height ratio and length, which could explain 88.5 percent of total variance, were extracted from the measured values from adult non-athletes. 2. Similarity of body shape between sporting events was analyzed by cluster analysis. Body shape of the athletes could be classified into 3 categories: muscular and well-balanced type; rich muscular and large-built type; and rich muscular and long-torso type. Compared with adult non-athletes, male athletes had less body fat and greater mass except for long-distance runners. The present results suggested that the athletes had body shapes suitable to their sporting events.

[Testing of synthetic vowels in patients with 22 channel cochlear implant]

In the 22 multi-channel cochlear implant system, F0 information determines the frequency of electrical stimulation, and F1 and F2 information determine the number of stimulating electrodes. We performed tests using synthetic vowels on 16 patients who had undergone 22 channel cochlear implant surgery and 6 months' speech rehabilitation. Information transmission rates were calculated to analyze the response pattern. As a result, 1) the vowel recognition ability of patients with cochlear implant surgery correlated with the number of electrodes being used. 2) The value of vowel confusion decreased so as to be separated by a pair of stimulating electrodes, and the confusion in F1 information was regarded to be less than that for F2 information.

[Sex differences in interrelationships between percent body fat (%fat) and waist-to-hip ratio (WHR) in healthy male and female adults]

The purpose of the present study was to investigate sexual differences in relationships among percent body fat (%Fat), waist-to-hip ratio (WHR), waist-to-stature ratio (WSR), abdominal circumference to stature ratio (ASR), body mass index (BMI) and skinfold thicknesses in healthy male and female adults. Subjects were 64 males and 65 females, aged 22-60. Body density was measured by under water weighing and by skinfold anthropometry. Mean %Fat was 15.6% in males and 23.9% in females. Mean WHR was 0.83 in males and 0.72 in females. The correlation between %Fat and WHR was not significant in females (r = -0.104) but was significant in males (r = 0.631, p < 0.001). Highly significant correlations were obtained among %Fat, WSR, ASR, BMI, and sum of eight skinfolds in both sexes.

Epoc-1: a POU-domain gene expressed in murine epidermal basal cells and thymic stromal cells

POU-domain transcription factors are known as developmental regulators which control organ development and cell phenotypes. In order to clarify the roles of POU-domain transcription factors in cell differentiation, we cloned a novel POU family gene, Epoc-1, from a murine thymus cDNA library. The amino acid (aa) sequence of the POU-specific domain of Epoc-1 is almost identical to those of Oct-1 and Oct-2. However, within the POU-homeodomain, 13 out of 60 aa differ between Epoc-1 and Oct-2. Recombinant Epoc-1 products were found to bind specifically to the octamer sequence. Epoc-1 was found to be expressed in skin, thymus, stomach and testis. In situ hybridization experiments and RNase protection assays indicated that Epoc-1 is expressed in the epidermal basal cells of the skin, which contain stem cells unipotent for keratinocyte differentiation and in thymic stromal elements. These results suggest that Epoc-1 might be one of the developmental regulators which controls epidermal development and thymic organogenesis.

[Body composition, VO2 max and O2 debt max in elite senior high school male cyclists]

This study was performed to evaluate the physical resources for elite male cyclists of senior high school. Nine track cyclists (mean age, 17.4 years) and seven road cyclists (mean age, 17.3 years) were examined for body composition and cardiorespiratory function (VO2 max and O2 debt max), from 1988 to 1992. These measurements were compared with those of elite junior cyclists, and the progress of physiological function due to one-year training was examined for 7 cyclists. The results were as follows: 1. The mean parameters for track cyclists were recorded: percentage body fat (%Fat): 10.3%; lean body mass (LBM): 56.5kg; VO2 max: 3.93l/min, 62.5ml/kg.min; O2 debt max: 8.81l, 139.1ml/kg. 2. The mean parameters for road cyclists were recorded: %Fat: 10.9%; LBM: 54.9kg; VO2 max: 3.78l/min, 61.4ml/kg.min; O2 debt max: 7.89l, 128.4ml/kg. 3. The average %Fat, LBM, LBM/Ht, VO2 max and O2 debt max were not significantly different between track and road cyclists. 4. The average %Fat and VO2 max (ml/kg.min) of track and road cyclists were similar to those of elite junior cyclists. 5. By training for one year, the average VO2 max (ml/kg.min) and O2 debt max (ml/kg) showed a significant increase of approximately 13.6% and 22.6% respectively. These results indicated that through training 9 track and 7 road cyclists had achieved a superior body composition, aerobic work capacity and anaerobic work capacity, equal to those of elite junior cyclists.

[Body composition (densitometry-hydrostatics), skinfold thickness, BMI and their relationships in junior high school girls]

A study was conducted to evaluate body composition (Hydrostatics = Under-Water Weighing), skinfold thickness, and BMI in 97 junior high school girls, aged 12 to 15, in Nagasaki City. Body density was measured by under-water weighing, and the two compartments--fat weight (Fat) and lean body mass (LBM, or fat free weight: FFW)--were calculated using the formulas of Brozek et al. The results were as follows; 1. Mean values of body density were 1.0501 in first grade girls, 1.0476 in the second grade, and 1.0466 in the third grade. 2. Mean values of percentage body fat (% Fat) were 21.1% in the first grade, 22.1% in the second and 22.5% in the third. 3. Lean body mass (LBM) and LBM/Height increased significantly with advance from the first to the third grade. 4. The correlation coefficient between percent body fat and the sum of two skinfold thicknesses, the sum of three skinfold thicknesses, or the sum of seven skinfold thicknesses were 0.81, 0.80, and 0.82 respectively and all statistically significant (p < 0.001). 5. The correlation coefficient between BMI and the sum of two skinfold thicknesses, the sum of three skinfold thicknesses (r = 0.841) or the sum of seven skinfold thicknesses were 0.85, 0.84, and 0.84 respectively, and all statistically significant (p < 0.001). 6. Mean values of BMI, WSR, ASR, and WHR in all subjects (n = 97) were 19.6, 0.72, 0.39 and 0.43 respectively.

Two forms of the low-affinity Fc receptor for IgE differentially mediate endocytosis and phagocytosis: identification of the critical cytoplasmic domains

We have previously identified two species of the low-affinity human Fc receptor for IgE, Fc epsilon RIIa and Fc epsilon RIIb, which differ only in a short stretch of amino acids at the N-terminal cytoplasmic end. Their differential expressions on B cells and monocytes suggest that Fc epsilon RIIa and Fc epsilon RIIb are involved in B-cell function and IgE-mediated immunity, respectively. Here we show that Fc epsilon RII-mediated endocytosis is observed only in Fc epsilon RIIa-expressing cells, whereas IgE-dependent phagocytosis is observed only in Fc epsilon RIIb-expressing cells, demonstrating the functional difference between Fc epsilon RIIa and Fc epsilon RIIb. Furthermore, site-directed mutagenesis revealed that the tyrosine residue in the Fc epsilon RIIa-specific region is important for endocytosis, and the Asn-Pro residues in the Fc epsilon RIIb-specific region are required for phagocytosis. These findings suggest that endocytosis and phagocytosis are functionally separable phenomena involving distinct amino acid residues.

[Image analysis of the inner ear with CT and MR imaging: pre-operative assessment for cochlear implant surgery]

Recent progress in magnetic resonance imaging (MRI) has made it possible to obtain detailed images of the inner ear by delineating the lymphatic fluid within the labyrinth. We analyzed CT scans and MR images in 70 ears manifesting profound deafness owing to inner ear lesions and compared their detective ability for inner ear lesions. The following results were obtained. 1) CT scan examination showed slight to extensive ossification of the labyrinth in six ears (9%), whereas MRI examination revealed low to absent signal intensity of the inner ear in nine ears (13%). Therefore, it was concluded that MRI is more sensitive in detecting abnormalities of the inner ear than CT scan. 2) MRI provided useful information as to whether the cochlear turn is filled with lymphatic fluid or obstructed. This point was one of the greatest advantages of MRI over CT scan. 3) Abnormal findings in either or both the CT scan and the MRI were detected in suppurative labyrinthitis occurring secondary to chronic otitis media, bacterial meningitis and in inner ear trauma. However, such abnormal findings were not detected in patients with idiopathic progressive sensorineural hearing loss, ototoxicity or sudden deafness. These findings should be taken into consideration in pre-operative assessment of cochlear implant candidates.

CT of gastric carcinoma: preliminary results with a new scanning technique

Usefulness of computed tomography (CT) for the demonstration of gastric carcinoma was evaluated in 250 cases with surgical proof of diagnosis: advanced gastric carcinoma (n = 193), early gastric carcinoma (n = 47), gastric submucosal tumor (n = 8), gastric polyp (n = 1), and benign gastric ulcer (n = 1). CT was performed on prone patients after 400-600 mL of water was orally administered and a 100-mL bolus of nonionic contrast material was injected. Water provided optimal distention and satisfactory contrast to depict the normal gastric wall. Prone positioning allowed visualization of the whole gastric wall except for the fundus and prevented artifacts caused by gas during supine imaging. CT demonstrated gastric tumor as a thickened or abnormally enhanced gastric wall in 95% of advanced carcinomas, 93% of elevated early carcinomas, and 18% of depressed early carcinomas. The authors believe that CT performed with this method is useful and that it should be used in addition to barium and endoscopic studies before surgery is planned.