Maintenance of the rate of stair use over a long-term period using a stair climbing campaign.

OBJECTIVE: This study was a long-term survey of a stair climbing campaign that made use of point-of-choice prompts aimed at achieving exemplary behavior in citizens. METHODS: The campaign began in September 2007 at the Kochi Prefectural Office. We monitored office workers who climbed the stairs or used the elevator in the prefectural office building, excluding weekends, from August 2007 through February 2009. Prompts were placed on the stair risers. A total of 59 days were monitored during the observation period. A questionnaire was distributed to 250 workers to examine the influence of the prompts following completion of the observation period. RESULTS: A total of 16,583 observations of the choice of workers to use the elevators or stairs were made during the observation period. The mean number of stair users was 281.0 ± 66.0 per day. Stair use increased significantly from 31.5 to 58.1% among women and from 26.3 to 62.4% among men during months 1-3 of the campaign. Stair use was maintained in more than 51% of women and 60% of men during the entire campaign period. The following response (valid records: 81) was given by 10% of the respondents regarding the use of stairs: "my use of stairs increased due to the message banners". CONCLUSIONS: The stair climbing campaign was effective for increasing stair use and was maintained over a long-term period. However, most office workers thought that their increased stair use was not due to prompts placed on risers; therefore, the reason for the increased stair use remains unclear.

A prospective observational study to examine the relationship between quality of life and adverse events of first-line chemotherapy plus cetuximab in patients with KRAS wild-type unresectable metastatic colorectal cancer: QUACK Trial.

We have planned a multicentre prospective study to examine the relative impact of the efficacy and adverse events of cetuximab plus first-line chemotherapy on the quality of life in Japanese patients with KRAS wild-type unresectable colorectal cancer. The Dermatology Life Quality Index and the European Organization for Research Treatment of Cancer Quality of Life Questionnaire Core 30 will be used to assess dermatology-specific and health-related quality of life. The severity of adverse events will be assessed by using the National Cancer Institute Common Terminology Criteria for adverse Events ver. 4.0. The endpoints will be the following associations: adverse events, including skin toxicity and quality of life; efficacy and skin toxicity; efficacy and quality of life; and skin-related quality of life and health-related quality of life. A total of 140 patients are considered to be appropriate for inclusion in this study. The results of this study will provide more information to both patients and physicians regarding the practical use of cetuximab and its impact on quality of life in patients with unresectable colorectal cancer in Japan. This study was registered at the University Hospital Medical Information Network Clinical Trial Registry as UMIN000010985.

Changing behavioral patterns to promote physical activity with motivational signs.

OBJECTIVES: We have evaluated the effectiveness of motivational signs in promoting stair use instead of escalators, in terms of gender and age, at a train station with a 37-step staircase. We also examined whether a newspaper article, or booster, had any effect on augmenting the impact of the signs. METHODS: In a serial cross-sectional survey with prompted signs, the subjects were coded by gender and age (over 65 years, under 65 years), and students (13-18 years old and school uniforms). We used a 2-week baseline period, followed by a 4-week intervention in which a total of 45 posters and banners with motivational messages were used to encourage stair use. As a booster, we published a news release of this study on a web site and in a local newspaper during the intervention period. RESULTS: A total of 43,241 escalator/stair-choice observations were made. Stair use increased significantly from 3.58 to 4.93% during the intervention period of 1-2 weeks for all subjects. In addition, stair use had a significantly high value of 5.80% during the intervention period of 3-4 weeks. Stair use also increased in subgroups during the intervention periods with the exception of women 65 and older. Attempts to publicize the study had no effect on the increase in stair use. CONCLUSIONS: The use of signs was effective in changing behavior during the period of sign use, but this effectiveness was limited by gender, age, and the physical ability (e.g., muscle strength) and energy required to climb the stairs. The possible synergistic effects of publicity were inconclusive but are worthy of further investigation.

The weight-bearing rate on the paretic limb of cerebrovascular hemiplegic patients necessary for an independent obstacle negotiation gait.

PURPOSE: The obstacle negotiation gait (ONG) is a fundamental activity of daily living. In cerebrovascular hemiplegic patients (stroke patients), the weight-bearing rate (WBR) on the paretic limb necessary for an independent ONG was studied. METHODS: One hundred and seventeen stroke patients were involved. The patients' average age at the time of the study was 67 years, and the average time from stroke onset was 102 days. There were 68 men and 49 women. Seventy patients were right hemiplegics, and 47 were left hemiplegics. The correlations between ONG and age, sex, body mass index (BMI), time from stroke onset, muscle strength of both the paretic and non-paretic limbs, Brunnstrom stage of the lower limbs, deep sensation, and the WBR on both the paretic and non-paretic limbs were studied. Patients who could perform ONG independently and safely were categorized as the independent group (IG), and those who needed observation or any assistance were categorized as the dependent group (DG). RESULTS: The BMI, muscle strength of both the paretic and non-paretic limbs, Brunnstrom stage of the lower limbs, deep sensation and the WBR for both the paretic and non-paretic limbs were significantly different between the IG and DG groups. In particular, the WBR on the paretic limb was found to correlate significantly with the ONG, and a WBR value of 80.5% on the paretic limb gave a clear cut-off value. CONCLUSION: Although multiple factors influenced the ONG of stroke patients, the WBR on the paretic limb was the most influential.

Loss of heterozygosity of the PTH/PTHrP type 1 receptor in oral squamous cell carcinoma.

Parathyroid hormone-related protein (PTHrP) is produced by various types of carcinomas, and is an important factor in the development of bone metastasis. The coexpression of PTHrP and parathyroid hormone/parathyroid hormone-related protein type 1 receptor (PTHR1) in cancer predicts poor patient survival. While genetic transformations of thyroid hormone receptor ß (THRß) have been reported as being associated with reduced survival in patients with oral squamous cell carcinoma (OSCC), the details of transformations in PTHR1 have not been extensively analyzed. The aim of this study was to examine loss of heterozygosity (LOH) and microsatellite instability (MSI) in PTHR1 in OSCC. Analysis of genetic transformations using microdissected clinical tissues revealed that the proportions of LOH and MSI in PTHR1 were 30.0 (3/10) and 20.0% (2/10), respectively. Furthermore, the proportion of carcinomas which developed with LOH on the chromosome of PTHR1 and without LOH for tumor suppressor genes such as p53, FHIT, APC, BRCA1, BRCA2 and DCC was 20.0% (2/10). These observations suggest that transformations in PTHR1 may be involved in carcinogenesis in human OSCC.

[Promoting daily physical activity by encouraging stair using banners].

OBJECTIVE: To test the effectiveness of stair-use banners in encouraging the use of stairs instead of escalators. DESIGN: Observational survey with prompted banners. PARTICIPANTS: Shoppers and a few employees. METHODS: The use of the escalator and adjacent stair was monitored in a department store in Kochi City, Japan. Participants were coded for gender, age, and presence of hand bags. A 2 week baseline period was followed by a 4-week intervention using motivating messages on the stair-use banners. Follow-up data were also collected for 1 week after the removal of the banners 2 weeks later. The details of the study were published in the Kochi newspaper (booster) on the last day of intervention in the third week. RESULTS: A total of 9,834 escalator/stair-choice observations were made. The percentage of people who used the stair increased significantly from 46.0% to 51.1% during the intervention of 3-4 weeks (p < 0.001). When the banners were removed, the percentage remained higher than the baseline. The booster had no effect on the stair use. CONCLUSION: This intervention method is effective in encouraging physical activity among the general public. As one method for encouraging exercise action for unspecified number of the general public, it was concluded that this intervention method was successful.

[Controversy of treatment for advanced colorectal cancer--intermedisine].

Until recently, few chemotherapy options were available to treat metastatic colorectalcancer. For years, the standard chemotherapy has been a Fluorouracil (5-FU) alone of 5-FU with leucovorin (LV) modulation. The newer cytotoxic drugs irinotecan (CPT-11) and oxaliplatin (L-OHP) has generated further improvement in survival. Additionally, improvement in convenience of drug administration has been achieved with the development of oral fluoropynmidines. In randomized trials, oral fluoropyrimidines were equally effective to bolus 5-FU and LV. Recently completed or ongoing clinical trials to study novel targeting agents have initiated a new generation of drug development such as angiogenesis inhibitors and epidermal growth factor inhibitors. Randomized trials will determine the impact of these newer agents on survival and quality of life.