Knowledge Does Not Correlate with Behavior toward Deceased Organ Donation: A Cross-Sectional Study in Japan.

BACKGROUND Although knowledge is an important factor that influences decisions regarding deceased organ donation, the associations of knowledge with attitude and behavior regarding organ donation remain uncertain in countries with low organ donation rates like Japan. MATERIAL AND METHODS We conducted a cross-sectional survey of hospital medical and non-medical staff in 15 Japanese medical facilities. The questionnaire included items on knowledge, attitude, and behavior toward deceased organ donation and transplantation. Participants were divided into 3 groups according to the tertile of knowledge score. Modified Poisson regression models were used for associations of knowledge score with organ donor registration and willingness to become an organ donor after death. RESULTS Of the 1967 staff, 1275 returned the questionnaires (response rate, 64.8%). There were 1190 study subjects with complete data for analysis. For the lowest (n=512), middle (n=428), and highest (n=250) tertile knowledge groups, the proportions of participants who registered and expressed willingness to donate organs were 20.1%, 23.4%, and 28.4% and 31.1%, 38.3%, and 44.0%, respectively. The adjusted proportion ratios for organ donor registration were 0.90 (95% CI, 0.73-1.10) for the middle and 1.00 (0.80-1.26) for the highest tertile of knowledge, compared with the lowest tertile. However, participants with the highest tertile of knowledge score expressed higher willingness for organ donation than the lowest tertile (adjusted proportion ratio, 1.37; 95% CI, 1.13-1.66). CONCLUSIONS For hospital staff in Japanese medical facilities, high knowledge about organ donation and transplantation was not associated with donor registration, but was associated with willingness to become an organ donor.

Trends in paraquat poisoning in Japan - viewed from surveys on clinical cases.

OBJECTIVE: Paraquat poisoning occurs worldwide, and both the fatality rate and the number of deaths are out of the ordinary. Japan is one of the few countries in the world that have replaced 24% products with 5% products. This report is an attempt to introduce information about paraquat poisoning in Japan. METHODS: The Japanese Association of Rural Medicine has carried out extensive surveys on clinical cases of pesticide poisoning at its 122 member installations since 2007. Of all the findings, we have picked out and evaluated those concerned with paraquat poisoning. FINDINGS: Twenty-two out of 28 persons who attempted to commit suicide with paraquat died in 2007-2011. The rate of deaths from suicide attempts with paraquat stands at somewhere near 80% or so even with 5% products, so it appears that the attempts to reduce the death rate did not have the intended effect even with products having a lower concentration. CONCLUSION: The "outcome prediction line" propounded in 1979 still stands today, while a wide variety of therapies have been studied. It seems that paraquat should at least be classified into Class Ib (highly hazardous) given that the mortality remains high and efficacious therapies remain elusive.

Association between dietary heterocyclic amine levels, genetic polymorphisms of NAT2, CYP1A1, and CYP1A2 and risk of colorectal cancer: a hospital-based case-control study in Japan.

OBJECTIVE: Although associations between dietary HCA intake and colorectal cancer risk have been investigated, results have been suggestive but inconsistent. The aim of this hospital-based case-control study was to examine the impact of heterocyclic amine (HCA) intake on colorectal cancer risk. A further objective was to investigate the possible effect of genetic polymorphisms of NAT2, CYP1A1, and CYP1A2 on colorectal cancer. MATERIAL AND METHODS: HCA exposure data were assessed using a self-administered food frequency questionnaire, and estimated HCA intake was verified by measuring the PhIP value in human hair. A total of 117 cases and 238 controls were included in these analyses. Odds ratios (ORs) were calculated using conditional logistic regression analysis to compare intake levels between the first and third tertiles. RESULTS: No statistically significant increase in the risk of colorectal cancer with respect to total HCA intake was shown by analysis (OR = 0.99, 95% CI = 0.21-4.81). Furthermore, no association with risk was seen for individual HCAs, including PhIP, MeIQ, and MeIQx. Although variant alleles of CYP1A2 were associated with colorectal cancer (OR = 0.27; 95% CI = 0.07-0.99), genetic polymorphisms of NAT2, CYP1A1, and CYP1A2 did not influence the association of HCA intake with colorectal cancer. CONCLUSIONS: In the present study in subjects with low HCA exposure and with a limited sample size, no association was found between HCA intake and colorectal cancer, or any evidence of influence by genetic polymorphisms of NAT2, CYP1A1, and CYP1A2.

Association between dietary heterocyclic amine levels, genetic polymorphisms of NAT2, CYP1A1, and CYP1A2 and risk of stomach cancer: a hospital-based case-control study in Japan.

BACKGROUND: Although the associations between grilled (broiled) or barbecued meats or fish intake and stomach cancer risk have been investigated, the evidence implicating heterocyclic amine (HCA) intake as a cause of stomach cancer is limited. We conducted a case-control study to investigate the association between HCA intake and stomach cancer risk. We also investigated the possible effect of genetic polymorphisms of NAT2, CYP1A1, and CYP1A2 on stomach cancer. METHODS: HCA exposure data were assessed using a self-administered food-frequency questionnaire, and estimated HCA intake was verified by measuring 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP) values in human hair. A total of 149 cases and 296 controls were included in the analyses. Odds ratios (ORs) were calculated, using conditional logistic regression analysis, to compare intake levels between the first and third tertiles. RESULTS: Results showed no statistically significant increase in the risk of stomach cancer with respect to total HCA intake (OR, 1.11; 95% confidence interval [CI], 0.36, 3.49), or with respect to the intake of individual HCAs; namely, PhIP, 2-amino-3, 4-dimethylimidazo[4,5-f]quinoline (MeIQ), and 2-amino-3,8-dimethylimidazo[4,5-f]quinoxaline (MeIQx). Genetic polymorphisms of NAT2, CYP1A1, and CYP1A2 did not influence the association of HCA intake with stomach cancer. CONCLUSION: In the present study, with a limited sample size of subjects with low HCA exposure, no association was found between HCA intake and stomach cancer, nor was there any evidence of any influence by genetic polymorphisms of NAT2, CYP1A1, and CYP1A2 on the risk of stomach cancer.