A novel prediction score for predicting the baseline risk of recurrence of stage I–II endometrial carcinoma / 부인종양

OBJECTIVE: To develop and validate a 3-year recurrence prediction score (RPS) system for predicting the baseline risk of recurrence of stage I–II endometrial carcinoma. METHODS: We reviewed 427 patients with International Federation of Gynecology and Obstetrics staging I–II endometrial carcinoma underwent surgery without any adjuvant therapy from 2005 to 2013. The patients were divided into 2 groups: the test cohort (n=251) comprising those who underwent surgery in odd-numbered years, and the validation cohort (n=176) comprising those who underwent surgery in even-numbered years. Multivariate analysis was performed using 7 candidate predictors to identify the risk factors for 3-year recurrence-free interval (RFI) in the test cohort. Each risk factor was scored based on logistic regression analyses of the test data set, and the sum of the risk factor scores was defined as the RPS system. We then applied the system in the validation cohort. RESULTS: Multivariate analysis revealed that the significant risk factors were age ≥60 years, pathological type II, positive cervical stromal invasion, and positive peritoneal cytology. In the test cohort, the 3-year RFI rates were 100%, 95.8%, 79.9%, and 33.3% for RPSs of 0, 1, 2, and 3, respectively. In the validation cohort, the 3-year RFI was significantly higher in the low-RPS group (RPS 0 or 1) than in the high-RPS group (RPS 2 or 3) (95.2% vs. 79.9%, p < 0.01). CONCLUSIONS: The RPS system shows significant reproducibility for predicting the baseline risk of recurrence. The system could potentially impact the choice of adjuvant therapy for stage I–II endometrial carcinoma.

Baseline risk of recurrence in stage I–II endometrial carcinoma / 부인종양

OBJECTIVE: Though there are no evidences that postoperative therapy improves overall survival (OS) in stage I–II endometrial carcinoma, many women receive postoperative radiation or chemotherapy. This study aimed to investigate the baseline risk of recurrence after complete resection without any adjuvant therapies and to suppose the validity of postoperative therapy for stage I–II endometrial carcinoma. METHODS: Charts for patients with stage I–II endometrial carcinoma who underwent operation without postoperative therapy between January 2005 and December 2011 were retrospectively reviewed and the baseline risk of recurrence and prognosis were assessed. Risk classifications were performed according to European Society for Medical Oncology (ESMO) clinical practice guidelines and Japanese guideline written by Japan Society of Gynecologic Oncology Group. RESULTS: Among 374 patients who underwent complete resection, 311 were evaluable. Five-year recurrence rates by ESMO and Japanese were 2.6% and 3.1% in low-risk, 9.2% and 6.6% in intermediate-risk and 13.5% and 13.8% in high-risk group (p=0.003 and 0.015, respectively). High-risk group had worse OS compared with low- and intermediate-risk groups (5-year OS, low: 97.9% and 97.6%, intermediate: 97.9% and 98.8%, and high: 89.5% and 87.5%; p=0.003 and 0.008, respectively). Independent predictive factors of recurrence were age over 60 years, type 2 (estrogen-independent) and peritoneal cytology. CONCLUSION: ESMO and Japanese risk classification similarly stratify the baseline risk of recurrence. Patients with stage I–II endometrial carcinoma, especially low- and intermediate-risk diseases, have low recurrence rate and favorable OS, and the benefit of postoperative therapy might be small.

Questionnaire results on exposure characteristics of pregnant women participating in the Japan Environment and Children Study (JECS)

BACKGROUND@#The Japan Environment and Children's Study (JECS) is a nation-wide birth cohort study investigating environmental effects on children's health and development. In this study, the exposure characteristics of the JECS participating mothers were summarized using two questionnaires administered during pregnancy.@*METHODS@#Women were recruited during the early period of their pregnancy. We intended to administer the questionnaire during the first trimester (MT1) and the second/third trimester (MT2). The total number of registered pregnancies was 103,099.@*RESULTS@#The response rates of the MT1 and MT2 questionnaires were 96.8% and 95.1%, respectively. The mean gestational ages (SDs) at the time of the MT1 and MT2 questionnaire responses were 16.4 (8.0) and 27.9 (6.5) weeks, respectively. The frequency of participants who reported "lifting something weighing more than 20 kg" during pregnancy was 5.3% for MT1 and 3.9% for MT2. The Cohen kappa scores ranged from 0.07 to 0.54 (median 0.31) about the occupational chemical use between MT1 and MT2 questionnaires. Most of the participants (80%) lived in either wooden detached houses or steel-frame collective housing. More than half of the questionnaire respondents answered that they had "mold growing somewhere in the house". Insect repellents and insecticides were used widely in households: about 60% used "moth repellent for clothes in the closet," whereas 32% applied "spray insecticide indoors" or "mosquito coil or an electric mosquito repellent mat."@*CONCLUSIONS@#We summarized the exposure characteristics of the JECS participants using two maternal questionnaires during pregnancy.

Acute effects of particulate matter on FEV1 and respiratory symptoms of college students in winter / 中华预防医学杂志

<p><b>OBJECTIVE</b>To evaluate the acute effects of indoor and outdoor particulate matter on lung function and respiratory symptoms of college students in winter.</p><p><b>METHODS</b>A panel of 37 college students aged 19-21 in Wuhan were included and the investigation was carried out from 12/23/2009 to 01/05/2010. Daily morning/evening forced expiratory volume in one second (FEV1) and respiratory symptoms (cough, phlegm and runny) were measured and reported by subjects, respectively. Meanwhile, daily data of indoors and outdoors PM10, PM2.5, temperature, and relative humidity were collected. Generalized Estimating Equations (GEEs) were used to estimate the association between particulate matters exposure and respiratory symptoms and FEV1).</p><p><b>RESULTS</b>Average daily concentrations of indoor, outdoor PM2.5 during the study period were (110.6 ± 42.3), (143.5 ± 51.2) µg/m³, (148.2 ± 43.2) and (239.1 ± 71.3) µg/m³ for indoor, outdoor PM10, respectively. Outdoor exposure to PM2.5 on lag 0 had little effect on evening FEV1). However, researchers observed a significant lagging effect (lag 1 d) and accumulative effect (lag 0-1 d and lag 0-2 d). A rise in the PM2.5 concentration of 10 µg/m³ resulted in the change of evening FEV1) of -0.28% (95% CI: -0.52%, -0.03%), -0.45% (95% CI: -0.81%, -0.08%) and -0.63% (95% CI: -1.15%, -0.11%), respectively. For respiratory symptoms of coughing up phlegm, 10 mg/m³ increase of indoor/outdoor PM2.5 concentration were associated with odds ratio of 1.18 (95% CI: 1.02-1.36) and 1.08 (95% CI: 0.97-1.19), respectively. Moreover, risk of coughing up phlegm increased with lagging time, and accumulative time of indoor and outdoor PM2.5 and PM10.</p><p><b>CONCLUSION</b>Our study suggested that short-term exposure to particulate matters in winter was significantly associated with acute changes of respiratory symptoms and FEV1) of college students in Wuhan. Moreover, the effects of particulate matters tended to be larger as the increase of lagged and accumulative days.</p>

The short-term effects of particulate matter on lung function of college students in autumn and winter in Wuhan / 中华预防医学杂志

<p><b>OBJECTIVE</b>To evaluate the effects of indoor and outdoor PM2.5 (fine particulate matter, particulate matter with an aerodynamic diameter ≤ 2.5 µm) on lung function of college students in autumn and winter in Wuhan.</p><p><b>METHODS</b>In this panel study, 37 college students (excluded subject of respiratory disease and smoking history) aged 19 - 21 were investigated by cluster sampling in a university in Wuhan. The follow-up study lasted for 28 days in total, including two study periods, Oct. 29 to Nov. 11, 2009 (autumn) and Dec. 23, 2009 to Jan.5, 2010 (winter), the peak expiratory flow (PEF) of the college students were measured daily in the morning and evening in the university. PM10 and PM2.5 were monitored indoors and outdoors. The effects of PM on lung function of college students were analyzed by using generalized estimating equation (GEE).</p><p><b>RESULTS</b>Average daily concentrations of indoor, outdoor PM2.5 in autumn were (91.3 ± 43.7) and (104.2 ± 49.4) µg/m(3) respectively, while in winter the concentrations of indoor and outdoor PM2.5 were (110.6 ± 42.3) and (143.5 ± 51.2) µg/m(3). The single pollutant model showed that in winter, the evening PEF decrement was significantly associated with increasing outdoor PM2.5. With an increase of 10 µg/m(3) outdoor PM2.5, the PEF measured in the evening decreased 1.27 L/min (95%CI: 0.02 - 2.52 L/min, respectively). Meanwhile, the results showed that 2-days lagged outdoor PM2.5 was also significantly associated with morning PEF. An increase of 10 µg/m(3) 2-days lagged outdoor PM2.5 caused the decrease of 1.82 L/min (95%CI: -3.53 - -0.11 L/min) of PEF measured in the morning. Controlling the influence of gaseous pollutants and building the two pollutants models, the results indicated that no significant changes of PEF of students being exposed to PM2.5 on same day (lag 0) were observed. However, under consideration of SO2 effect, significant association between an increase of 10 µg/m(3) 2-days lagged outdoor PM2.5 and changes of morning PEF (-1.81 L/min, 95%CI: -3.51 - -0.11 L/min, P = 0.037) was found. The relationship between changes of concentrations and PEF was not observed in autumn in this study.</p><p><b>CONCLUSION</b>In our panel study, exposure to outdoor PM2.5 is significantly associated with PEF among college students in winter, but not in autumn.</p>

Fluoride Levels in Principal Foodstuffs (Dried Corn, Capsicum) in a Fluoride-Contaminated Area in the Province of Sichuan, China, and Their Chemical Properties / 日本農村医学会雑誌

The incidence of fluorosis, believed to arise from the burning of coal, has been frequently reported in the highlands in the southern part of China. With a lot of rain and a climate of low temperature, the hilly region produces coal and inhabitants use it as a fuel for cooking and heating. The fossil fuel used by them is mostly powdery. It is mixed with dirt and rolled up into bolls. In that way,the people make the briquettes that burn a long time.Ordinary houses have no chimneys to belch forth smoke, so that it stagnates indoors for a while. Soot and smoke, before flowing out via the openings in the roof shingle of the loft, spoils farm produce stored there. Because the smoke contains high concentrations of fluoride derived from coal and dirt, it is believed that eating farm produce exposed to the smoke is one of the major factors for fluoride poisoning. Many researchers have thus far analyzed farm products for fluoride content and confirmed that high levels of fluoride were contained in their samples.In the present study, we measured fluoride concentrations in some samples of corn and capsicum produced in a rural area of Sichuan, China on one hand and on the other examined the water-solubility of fluoride. Furthermore, screening tests for chronic endemic dental fluorosis were performed on students to survey the fluoride contamination in the past as compared with the present state.Incidentally, indoor air-borne fluoride concentrations in this area averaged out at0.047mg F/m3 (15 times as high as the mean in a community that was free of fluoride contamination). The fluoride content of the drinking water from a spring in the nearby hill, measured with use of a fluoride-specific electrode method,was within the range from 0.2 to 0.3μg/ml.

Research on Fluoride Pollution and Fluorosis in Rural Areas of China / 日本農村医学会雑誌

A China-Japan joint project was carried out to study the incidence of fluorosis caused by coal burning in China from 1995 to 1997.<BR>The health survey covered a control area and two flourosis areas. In those research areas, drinking water was not polluted with fluorides. The survey was designed to analyze the health status of people exposed to fluorides and evaluate the relationships between the dose and incidence of fluorosis. The concentration of airborne pollutants in both indoor and outdoor air was measured. The concentration of fluoride in the urine was analyzed and definite diagnoses for dental fluorosis and skeletal fluorosis were determined.<BR>As a result, the incidence of coal burning fluorosis was confirmed in studied areas. Moreover, the fluorosis was caused not only by the direct inhalation of the airbone fluorides in indoor air but also by the intake of cereals polluted with fluorides. Fluoride was contained in both coal and soil. Therefore the mixture of coal and soil used for the adjustment of fire energy contributed to the air pollution to a great extent. The typical polluted crops were red pepper, corn and potato. An extremely high concentration of fluoride in the urine of residents in the polluted areas was detected.

Trends of Morbidity in Urban and Rural Areas Estimated from National Health Insurance Records / 日本農村医学会雑誌

The national health insurance record is an important source of information regarding the trend of morbidity throughout Japan. Using the record, we clarified the characteristics and annual trends of morbidity for main diseases in municipalities in Ibaraki Prefecture.<BR>Age-adjusted morbidity rates in each municipality were calculated from the number of patients actually covered by the national health insurance and the number of the insured population from 1980 to 1992. To classify municipalities by the degree of urbanization, the proportions of farming population were used. Eighty-seven municipalities were classified into the three groups; urban group (UG), middle group (MG) and rural group (RG).<BR>According to the pattern of annual morbidity in the three groups (UG, MG, RG) from 1980 to 1992, main diseases were classified as follows. The diseases for which the rates in UG were always higher than that in RG during the study period: Total morbidity rate in UG was about 10% higher than other two groups. Diabetes, heart disease and liver disease were included in this category, and especially, morbidity rate for allergic rhinitis in UG was nearly twice as much as that in other groups. The diseases for which the rates in RG are higher than UG during the study period: Only hypertension was included in the category. The diseases for which the rates in RG were higher than that in UG in the beginning while the rate intersected in the study period: Cerebral hemorrhage and cerebral infarction were included in this category.<BR>There were no differences between UG and RG in morbidity rates for gastric cancer, intestinal cancer and lung cancer.<BR>The results were confirmed by classifying the maps of municipalities into the three categorieswith 12-year average morbidity rates for main diseases.

Chronic toxic ellects of herbicide paraquat on rats / 日本農村医学会雑誌

Paraquat is one the most popular herbicides in agriculture in Japan. To study the chronic toxicological effects of paraquat on animals, rats were fed a paraquat-containing diet for 1 year and 2 months (1, 5, 25mg/kg of body weight/day). Paraquat administration induced serious histochemical changes in various organs, such as the lung, heart, kidney and liver in rast. Pulmonary fibrosis occurred in the group of rats given 1mg paraquat/kg of body weight/day in diet.<BR>The alkaline phosphatase activity and creatinine content in the blood serum significantly increased. The concentrations of cholesterol, triglyceride and phospholipid in the serum decreased significantly.<BR>A significant increase of lipid peroxidation was observed in the brain, kidney and liver.

Lipid peroxidative damage and inhalation toxicity by suspended particulate pesticide / 日本農村医学会雑誌

High concentration of airborne particles was detected in greenhouse air after suspended particulate pesticide spraying. The reduction of aerial concentration of resprirable particulate pesticide was relatively slow.<BR>To study the potential health effects of inhaled pesticide, the animals were exposed to the pesticide, methidathion particles in the inhalation exposure chamber. The exposed pesticide particles were approximately 2.16 μm mass median diameter.<BR>The animals exposed to suspended particulate pesticide had a considerable amount of particles within alveolar macropharges and alveolar epithelia. The serious lesion of alveolar epithelia and capillary endothelia of the animals occured after inhalation of methidathion particles.<BR>The vacuolar degeneration of hepatic cell was also cytosol decreased significantly after inhalation of methidathione particles.<BR>The exposure to suspended particulate methidathion induced production of thiobarbituric acid reacting substances (TBARS) in hepatic cells of the exposed animals. The induction of TBARS formation in hepatic cells was remarkable at early period of exposure.<BR>The change of serum transaminase (GOT) activities after exposure to methidathion particle was remarkable. GOT activities also markedly increased at early period of exposure.

Inhalation toxicity of suspended particulate pesticide-supracide FD / 日本農村医学会雑誌

To study the potential health effects of suspended particulate pesticide-Supracide FD, the animals were exposed to the pesticide particle in the inhalation exposure chamber. The suspended particulate pesticide was approximately 2.16μm mass median diameter.<BR>The animals exposed to suspended particulate pesticide had a considerable amount of particles throughout the alveolar region.The particles deposited mainly within alveolar macropharge and alveolar epithelium. The epithelial lesion of the pulmonary tissue and the vacuolar degeneration of hepatic cell of the animals occured after inhalation of pesticide particle.<BR>The exposure to Supracide FD induced production of more thiobarbituric acid reacting substances (TBARS) in comparison to the controls. The change of serum GOT and LDH activities after exposure to pesticide particle was also remarkable. The exposure to the pesticide particle caused no significant effect on the serum cholinesterase activity.

Health care of female farmers in flat rural areas / 日本農村医学会雑誌

We have carried out a health developing project for three years at two flat rural areas in Ibaraki prefecture, O in Ushiku town and N in Iwai city, taking female farmers as the subjects.<BR>As a result, people in these areas obtained by developing reciprocal assistance a belief in selfsupport and knowledge of diseases, which lead to remarkable progress of their health such as improvement of nutrition and cosolidation of agricultural and life environment. Some observations in the study are discussed below.<BR>1) In the two areas, the number of people with no abnormality increased while those requiring care decreased, The number of people to be treated or under treatment was nearly unchanged, probably because of chronic deseases. No death and complication occured during the three years.<BR>2) Owing to the difference between O and N areas in the age structure of examinees, areal characteristics and types of agricultural products, the results of health examinations in these two areas were somewhat different.<BR>3) The health developing project will become more effective if male farmers participate together with the female farmers.<BR>4) Continuation of the health care activity in these areas will establish voluntary organizations of residents.

Relationship between Serum Cholinesterase and some Biochemical Factors / 日本農村医学会雑誌

828 female agricultural workers were studied. Their age, blood pressure, Broca index, hemoglobin content, serum total cholesterol, activity of serum cholinesterase and transaminase (GOT and GPT) was measured. The distribution of each factor was examined in the sample of agricultural workers. The data for mean blood pressure, total cholesterol, activity of cholinesterase, GOT and GPT showed a log normal distribution.<BR>For the screening of the data, Mahalanobis's distance was calculated and the abnormal data (P<0.01) was compared with the worker's medical record. The data of non healthy women was excluded from the following calculation.<BR>The correlation coefficients between the activity of cholinesterase and other factors (age, Broca index, mean blood pressure, hemoglobin content, GOT and GPT) were statistically significant. This result indicates that the activity of cholinesterase somewhat depends on these factors.<BR>It is important to investigate the relationships between the activity of cholinesterase and some biochemical factors, and to establish the standard value of its activity in order to estimate the effect of pesticides.

Multiple Regression Analysis between the Activity of Cholinesterase and some Biochemical Factors of Female Agricultural Workers / 日本農村医学会雑誌

The regression analysis between the activity of serum cholinesterase and some biochemical factors of female agricultural workers was examined.<BR>To normalize the value of the factors, logarithmic value was calculated. Multiple regression analysis between the activity of cholinesterase and the factors related to liver function, such as the activity of GOT, GPT and total cholesterol content were calculated. The most significant factor related to cholinesterase was total cholesterol content, and the activity of GPT was the second. The Multiple regression coefficients of the equation between the cholinesterase and total cholesterol and GPT were from 9.7 to 18.3.<BR>Using all biochemical factors as independent variables, the most suitable equation was determined from calculating the predictive sum of square (PSS). The activity of cholinesterase (ln (ChE)) depends upon the following factors, age, ln (GPT), ln (TCh) and Broca index. Hemoglobin content could also be added as a variable. The equation is;<BR>ln (ChE) =0.002126 (age) +0.04028 ln (GPT) +0.2112 ln (TCh) +0.002188 (Broca index)-1.5687+α Where α is the parameter of each population.<BR>From this equation, the standard value of the activity of cholinesterase of each woman was calculated. The estimate of cholinesterase activity may be useful to examine the inhibitory effect of pesticides on cholinesterase.

Aerial Concentration Change of Pesticide Sprayed in the Orchard and Exposure of the Sprayman to it / 日本農村医学会雑誌

Respiratory and dermal exposures of the sprayman to pesticide sprayed by a dilute spray machine (speed sprayer) were studied in fruits orchards. Aerial concentration change of pesticide in the air were also investigated. The degrees of respiratory and dermal exposures were nearly independent on the size of machine, while they were higher in spring than in summer. The degree of respiratory exposure of pesticide was proportional to that of dermal exposure. The dermal exposure of sprayman was greatly reduced by the use of the machine equipped with a hood, which was not so effective against his respiratory exposure.<BR>Serum choline esterase activity of the sprayman was almost unchanged after pesticide spraying. The pesticide in orchard air was detected more than 3 hours after spraying. When pesticide was sprayed by the speed sprayer, the pesticide mist drifted into the house near the orchard.