Validation of the Japanese Version of the Functional Assessment of Cancer Therapy-Cognitive Function Version 3.

CONTEXT: Cancer therapy-induced cognitive impairment adversely affects the quality of life of patients with cancer but cannot be detected by neuropsychological tests. OBJECTIVES: This study aimed to validate a Japanese version of the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog) version 3, which is a self-report measure of the cognitive concerns of patients with cancer. METHODS: The FACT-Cog was translated into Japanese and pilot tested with five patients with breast cancer and five patients with hematologic malignancy. Study participants were recruited in Hiroshima University Hospital and Kagawa Breast Clinic in Hiroshima, Japan. Patients with breast cancer (N = 236) responded to the resultant assessment and Functional Assessment of Cancer Therapy-General version 4. The internal consistency and concurrent and construct validity of the FACT-Cog were examined. RESULTS: The Cronbach's alphas of the four FACT-Cog subscales, namely, CogPCI, CogOth, CogPCA, and CogQOL, were 0.95, 0.73, 0.93, and 0.88, respectively. The item-to-domain correlations ranged from 0.211 to 0.920. Most of the FACT-Cog subscales were significantly correlated with other subscale and total scores (r = 0.133-0.425). Structural equation modeling was barely acceptable (χ2 = 1361.8, df = 489, P < 0.001; goodness of fit index = 0.731, adjusted goodness of fit index = 0.691, comparative fit index = 0.848, root-mean-square error of approximation = 0.087). CONCLUSION: The Japanese version of the FACT-Cog is a valid and reliable self-report measure of the cognitive function of patients with breast cancer. Its utility to clinicians and researchers in measuring the cognitive concerns of patients with cancer in Japan will serve as a further test of its validity.

Pancreaticoduodenectomy following total occlusion of the superior mesenteric artery: a case report and literature review.

BACKGROUND: Patients with chronic occlusion of the celiac artery and superior mesenteric artery (SMA) are often asymptomatic, and occlusion may be caused by arteriosclerosis or median arcuate ligament compression. Pancreaticoduodenectomy (PD) is occasionally performed for patients with celiac artery occlusion; however, reports on patients with SMA occlusion are rare. We report a patient with cholangiocarcinoma and total atherosclerotic occlusion of the SMA without preoperative stenting or bypass. CASE PRESENTATION: A 73-year-old man suspected to have lower bile duct carcinoma was admitted to our hospital for further treatment. Three-dimensional computed tomography (3DCT) showed a common bile duct tumor and total occlusion of the SMA with collateral circulation of the gastroduodenal artery (GDA) and inferior mesenteric artery (IMA). We performed a PD. During the operation, we used test clamping of the GDA, which revealed no bowel ischemia. The postoperative course was uneventful, and the patient was discharged on postoperative day (POD) 30. 3DCT on POD 98 and POD 307 showed development of collateral circulation between the IMA and SMA. CONCLUSION: Here, we report the case of a patient with total occlusion of the SMA who subsequently underwent PD. 3DCT was instrumental in gathering vascular collateral information and thus we conclude that the assessment of collateral circulation before surgery is important.

Evaluation of a computer-tailored lifestyle modification support tool for employees in Japan.

To examine the effectiveness of a computer-tailored support tool for lifestyle modification developed for employees, we conducted an intervention study of pre-post test design. The program was based on principles of behavior science referring to goal setting processes, self monitoring, and feedback. The program of the support process was fully automated. A total of 650 participants of four workplaces in Japan completed the baseline assessment, 185 (28.5%) of those returned for the post-test assessment 4 months later. There were significant improvements in lifestyle behaviors between baseline and post-test: In men, low energy intake (p<0.01) and exercise frequency (p<0.05), and in women, low salt intake (p<0.05) and exercise frequency (p<0.05). Furthermore, significant improvements were shown in the stage of change between baseline and post-test: Low salt intake (p<0.01) and regular exercise in men (p<0.01). Our results suggest a possibility that the program, utilizing a computer-tailored lifestyle modification support tool developed for use by employees, had a positive effect on participants' lifestyle behaviors in Japanese workplaces. The degree to which our results generalize to effects of the program is unclear but examination to develop more efficient and effective programs is warranted.

A study among related pairs of Japanese patients with familial Behçet's disease: group comparisons by interval of disease onsets.

OBJECTIVE: To investigate the relationship between clinical features and the interval between onset of disease in pairs of related Japanese patients with Behçet's disease (BD). METHODS: Questionnaires were sent to hospitals in which patients with familial occurrence of BD had been treated according to previous nationwide hospital surveys, and to an additional 341 hospitals selected at random. RESULTS: A total of 35 patients (19 male, 16 female) in 17 families (19 related pairs) were reported. The positive rate of HLA-B51 was 60.9% (14/23). The familial pairs were divided into 2 groups, with the mean interval between disease onset between each pair being either < or = 9 years or > or = 10 years. Among the short interval group, the total number of clinical findings and difference in age of onset was significantly larger than the long interval group. The interval between onsets had a high positive correlation with concordance of clinical findings and a high negative correlation with the difference in onset age. Difference in onset age had a higher negative correlation with same sex. Moreover, age difference had a high negative correlation with HLA-B5 (B51). Analysis of data showed that the related pairs with the short interval between onsets had larger difference in onset age and greater concordance of symptoms than the long interval patients. CONCLUSION: Although our findings did not show any direct evidence of an environmental cause in the etiology of BD, we speculate that there may be a multifactorial etiology including genetic factors such as HLA-B51 positivity.