Factors related to employment in childhood cancer survivors in Japan: A preliminary study

PURPOSE

Previous research has revealed vocational and academic difficulties in childhood cancer survivors, and explored impact of survivors' medical history and physical function on vocational and academic status. However, we often encounter survivors with similar diagnoses and late effects but different academic or employment statuses. This raises the question of what affects academic attainment and employment other than treatment or late effects. This study aimed to explore factors associated with childhood cancer survivors' employment status and academic achievement.

METHODS

Comprehensive health check-up and questionnaire survey were conducted for 69 survivors who were over the age of 18 and participated in St. Luke's Lifetime cohort study. We obtained survivors' biological function using comprehensive health check-up, neurocognitive states, quality of life, transition readiness, and family function. We conducted univariate analysis (Mann-Whitney U tests or chi-square tests) to compare the differences between the regular workers/students and non-regular workers/unemployed groups. The variables with p-values <0.1 were used as independent variables multivariate logistic regression to explore predictors of employment status and academic attainment.

RESULTS

Result of the univariate analysis, intelligence quotient, SF-8 PCS, transition readiness, family function were used for multivariate logistic regression as independent variables. The stepwise likelihood method was conducted; intelligence quotient (odds ratio [OR] = 1.100; 95% confidence interval [CI] 1.015-1.193; p = 0.021), transition readiness (OR = 0.612; 95% CI 0.396-0.974; p = 0.038), and family function (OR = 2.337; 95% CI 1.175-4.645; p = 0.015) were found to be associated with survivors' regular workers/students in the final regression model.

CONCLUSION

Long-term follow-up of pediatric cancer survivors requires the provision of total care, which supports physical, psychological, and social functions to improve health, readiness for transition to self-management, and family functioning.

Significance of active screening for detection of health problems in childhood cancer survivors

BACKGROUND

Childhood cancer survivors (CCSs) have a lifelong increased risk of chronic health problems, most of which are associated with the curative therapies. Recent studies have suggested that prospective active screening using comprehensive assessments for CCSs is superior in identifying undiagnosed chronic health problems.

METHODS

To assess the significance of active screening using comprehensive medical examinations for detecting chronic health problems in multiple organ systems in CCSs, we retrospectively compared the frequency and severity of health problems between two different cohorts of CCSs in a single institution: 110 CCSs who visited the outpatient clinic for regular follow-ups between December 2010 and December 2015 (regular follow-up group) vs. 58 CCSs who underwent comprehensive medical examinations between February 2016 and September 2019 (active screening group). CCSs were defined as patients aged ≥ 18 years who had been diagnosed as having childhood cancer ≥ 10 years before and had survived without cancer for ≥ 5 years.

RESULTS

Patient characteristics were similar between the two groups except for primary diagnosis (more brain tumors and embryonal tumors in the active screening group) and treatment history (more alkylating agents used and surgical interventions performed in the active screening group). The prevalence and the median number of health problems were significantly higher in the active screening group than in the regular follow-up group: 93% vs. 67% and 1.0 [0.0-8.0] vs. 2.0 [0.0-7.0] respectively. In term of organ-specific health problems, pulmonary dysfunction, neurocognitive impairment, ocular abnormalities, and dental abnormalities were identified more in the active screening group, partly because these problems had not been assessed in the regular follow-up group. Nevertheless, the prevalence of grade 3-5 health problems was similar between the two groups, except for pulmonary dysfunction.

CONCLUSION

Active screening using comprehensive medical examinations was effective for identifying health problems in CCSs. Although the prevalence of severe problems identified by both approaches was similar, comprehensive medical examinations could detect overlooked problems such as severe pulmonary dysfunction, dental maldevelopment, and borderline intellectual functioning, which might have an impact on quality of life in CCSs.

Directed synthesis of germanium oxide nanowires by vapor-liquid-solid oxidation

We report on the directed synthesis of germanium oxide (GeO(x)) nanowires (NWs) by locally catalyzed thermal oxidation of aligned arrays of gold catalyst-tipped germanium NWs. During oxygen anneals conducted above the Au-Ge binary eutectic temperature (T > 361 °C), one-dimensional oxidation of as-grown Ge NWs occurs by diffusion of Ge through the Au-Ge catalyst droplet, in the presence of an oxygen containing ambient. Elongated GeO(x) wires grow from the liquid catalyst tip, consuming the adjoining Ge NWs as they grow. The oxide NWs' diameter is dictated by the catalyst diameter and their alignment generally parallels that of the growth direction of the initial Ge NWs. Growth rate comparisons reveal a substantial oxidation rate enhancement in the presence of the Au catalyst. Statistical analysis of GeO(x) nanowire growth by ex situ transmission electron microscopy and scanning electron microscopy suggests a transition from an initial, diameter-dependent kinetic regime, to diameter-independent wire growth. This behavior suggests the existence of an incubation time for GeO(x) NW nucleation at the start of vapor-liquid-solid oxidation.

Changes in glucose transport activities in mammary adenocarcinoma of dogs

The activities of D-glucose transport (D-GT) and cytosolic enzymes were significantly higher in mammary adenocarcinoma of dogs than in mammary gland from normal dogs. The activities of D-GT in adenocarcinoma were over three-and-a-half times higher than in the controls. The K(m) value of the D-GT activity for glucose in both the adenocarcinoma and normal mammary gland was approximately 0.9 mM. The activities of the key glycolytic enzymes, hexokinase and pyruvate kinase, in the adenocarcinoma were also more than three-and-a-half times higher than in the controls. The increased activities of D-GT are considered to be accompanied by an acceleration of glucose utilisation in the adenocarcinoma of dogs.

Establishment of transgenic mice carrying human fetus-specific CYP3A7

CYP3A7 is a cytochrome P450 isozyme expressed prenatally in humans. Six lines of mice transgenic for human CYP3A7 were established by microinjecting a CYP3A7 cDNA downstream of a mouse metallothionein-1 promoter gene into the male pronucleus of fertilized mouse oocytes. The inserted CYP3A7 transgene was expressed at a mRNA level in a variety of tissues including the liver, kidney, lung, spleen, testis, small intestine, thymus, brain, skin, and heart of adult mice. The protein expression of the transgene was also detected in the liver and testis of line M10 mice. A significantly higher level of total testosterone in the serum was found in line M10 male mice. In addition, this transgenic line exhibited weight increases in the liver, kidney, and uterus but a decrease in the testis (P < 0.01). The transcript of the integrated CYP3A7 gene possessed the ability to activate aflatoxin B1 in Ames test in which the his+ revertants of Salmonella typhimurium TA100 per plate were significantly higher (P < 0.01) when liver microsomes of line M10 transgenic mice were used. This result demonstrates that the CYP3A7 gene has been integrated into the mouse genome and translated into a catalytically active enzyme. These transgenic mice are expected to give useful information for studies on fetal toxicities in humans.