Serum Thiocyanate Concentration as an Indicator of Smoking in Relation to Deaths from Cancer

All residents aged 40 years or more in Oyabe City, Toyama Prefecture, Japan were involved in an annual medical check-up between 1987 and 1988. The cohort was followed and death certificates from cancers were confirmed prospectively. During follow-up to December 31st, 1994, 100 deaths (28 gastric, 17 lung and 55 other cancers) from cancers occurred, and these subjects were included in this study as the case group. Subjects in the control group, matched for gender and age with the cases, were selected randomly from participants whose serum samples had been stocked during annual medical check-up. The concentration of serum thiocyanate in all (79.8 μmol/l), gastric (86.7 μmol/l) and lung (90.0 μmol/l) cancer patients were significantly higher than that of relevant controls (64.3 μmol/l, 59.0 μmol/l and 61.0 μmol/l, respectively; and p<0.001, p<0.001 and p<0.05, respectively). After adjusting for BMI, blood pressure and total serum cholesterol, the results of multiple logistic regression analysis showed that the risk of all cancers (OR=3.40, 95% confidence interval (95% CI): 1.67−6.96, p<0.01), gastric cancer (OR=7.98, 95% CI: 1.91−33.34, p<0.05) and lung cancer (OR=8.83, 95% CI: 1.19−65.65, p<0.05) were elevated significantly with logarithm transformed values of serum thiocyanate increased. The present findings suggested that in epidemiological studies confirmation of smoking status with biomarkers such as serum thiocyanate may be important, although considering the small sample size, a relatively weaker risk to interested factors rather than the strong relationship between smoking and cancer was noted.

Differences in dietary factors among areas in a small city in Japan / 日本農村医学会雑誌

To study diffrences in dietary factors among communities with different living environments, we carried out a survey by the Cardiac Study method in 241 people (106 men and 135 women) aged between 50 and 54 years who were selected by random sampling from a total of 37, 000 inhabitants in a small city. The city was geographically divided into town, flatland farming area, and mountainous farming area, and the results of the survey were compared among these areas.<BR>The mean Na excretion in 24-hour specimens of urine was slightly higher in the mountainous farming area than in the other two-areas. The mean serum total cholesterol was higher in men in the town than in those in the other areas.<BR>Factor analysis of the data for nutrient intake patterns revealed a lower fat intake in the two farming areas than in the town in the men, and a higher intake of animal foods in the town and a lower fat intake in the mountainous area in the women.<BR>These results show that risk factors for circulatory diseases such as urinary Na excretion, serum cholesterol level, and nutrient intake patterns differ even among small areas if the living environment differs.

Integrated lectures: Some proposals to substantiate their significance / 医学教育

Undergraduate medical students in their 5th year were given integrated lectures on two topics, “ The cerebellum ” and “Patient -centered medical care”. The results of a questionaire survey indicated that students had hoped for continuation and expansion of the lectures to include many other topics. A series of discussions among faculty however, disclosed two problems with regard to continuation and expansion, i. e., a lack of experts for integration and lack of adequate means to assess educational impact. Teaching personnel in integrated lectures need not necessarily be experts or professors, but persons who can be in close contact with one another for the purpose of integration. Setting aside rigid discussions on validity, small achievement tests may be useful in assessing the degree of student comprehension.