Population-based study of asymptomatic infection with Chlamydia trachomatis among female and male students.

There are few epidemiological studies of asymptomatic chlamydial infection among students in non-medical settings with minimal bias and improved accuracy; thus, useful data from screening among students are limited. We aimed to obtain accurate epidemiological information about asymptomatic chlamydial infection among students in non-medical settings. A population-based cross-sectional survey of 10,440 >or=18-year-old asymptomatic students who volunteered for a urine screening test for chlamydia was conducted. The prevalences of asymptomatic infection were 9.5% for women and 6.7% for men. Multivariate analysis revealed the risk factors to be a lifetime history of >or=4 sexual partners for women (odds ratio [OR] 3.17) and inconsistent condom use for men (OR 4.18). For both sexes, younger age at first intercourse was associated with a higher rate of inconsistent condom use. This study produced accurate epidemiological information on asymptomatic chlamydial infection. These results may contribute to the establishment of preventive countermeasures against such infection.

Prevalence of Mycoplasma genitalium among female students in vocational schools in Japan.

OBJECTIVE: In Japan it was reported that about 9% of sexually active female teenagers had Chlamydia trachomatis. Most of them were asymptomatic, which may lead to continuing spread of the infection. Like C trachomatis, Mycoplasma genitalium is a pathogen in male non-gonococcal urethritis. However, few studies of the prevalence of M genitalium in the general population have been reported. The objective of this study was to determine the prevalence of M genitalium infection among younger females and to determine risk factors for this infection. METHODS: The study was conducted between October 2005 and January 2006 using first voided urine specimens and questionnaires from female students of three vocational schools in the Miyazaki prefecture, Japan. C trachomatis was detected with Amplicor PCR. M genitalium was detected with inhibitor controlled real-time TaqMan PCR detecting the MgPa adhesion gene and with a PCR detecting the 16S rRNA. Risk factors associated with infection of M genitalium or C trachomatis were analysed with Fisher's exact test. RESULTS: Among 298 female, 249 (84%) had had experience of sexual intercourse. The prevalence of M genitalium was 2.8% (95% CI 0.76% to 4.86%) and the prevalence of C trachomatis was 8.8% (95% CI 5.31% to 12.36%). CONCLUSIONS: The risk factors of infection with M genitalium were more than five lifetime sexual partners and co-infection with C trachomatis.

Fish intake and serum levels of organochlorines among Japanese women.

This study evaluates background serum levels of selected organochlorine compounds among Japanese women of reproductive age and investigates whether lifestyle factors, especially dietary factors, may be associated with these levels. A cross-sectional study was performed on 80 Japanese women, aged 26-43 years, who complained of infertility and were confirmed not to have endometriosis. The serum levels of total toxic equivalency (TEQ), 18 polychlorinated dibenzo-p-dioxins (PCDDs)/polychlorinated dibenzofurans (PCDFs), 4 coplanar polychlorinated biphenyls (cPCBs), 36 ortho-substituted polychlorinated biphenyls (PCBs), and 13 chlorinated pesticides or their metabolites were measured and data were collected on the women's age, residence, occupation, body mass index (BMI), smoking and alcohol habit and 6 dietary intakes (fish, meats, rice, vegetables, fruits and dairy products). The serum median level of total TEQ was 25.1 pg TEQ/g lipid, that of PCDDs/PCDFs/cPCBs was 11.5 pmol/g lipid, that of PCBs was 0.46 nmol/g lipid, and that of total pesticides was 1.32 nmol/g lipid. The serum levels of total TEQ, PCDDs/PCDFs/cPCBs, PCBs and pesticides were positively associated with age (P for trend=0.003, 0.01, 0.005 and 0.01, respectively) and frequent fish consumption (P for trend=0.002, 0.003, 0.0003 and 0.006, respectively). Other lifestyle factors were not associated with serum organochlorine levels. The present study suggests that Japanese women who consume fish frequently in their reproductive period tend to accumulate organochlorines in their bodies.

Glutathione S-transferase (GST) M1, T1 and N-acetyltransferase 2 (NAT2) polymorphisms and urothelial cancer risk with tobacco smoking.

The objective of this study was to examine the association between the genetic polymorphism of glutathione S-transferase (GST) M1, T1 and N-acetyltransferase 2 (NAT2) genes and urothelial cancer risk in relation to smoking status. In this study, 325 Japanese patients with urothelial transitional cell carcinoma and 325 healthy controls were compared for frequencies of GSTM1, T1 and NAT2 genotypes. The frequencies of GSTM1 null genotype and NAT2 slow genotype were significantly higher in the cases than in the controls (adjusted odds ratio (OR) 1.37, 95% confidence interval (CI) 1.01-1.87, adjusted OR 3.09, 95% CI 1.69-5.63, individually). Furthermore, the risk of GSTM1 null genotype and NAT2 slow genotype was higher among smokers (adjusted OR 1.48, 95% CI 1.01-2.15, adjusted OR 4.28, 95% CI 1.96-9.36, individually). The regression analysis of cancer risk as a function of the amount of smoking showed that the susceptibility of people who had GSTM1 null genotype increased from 45 pack-years, while the susceptibility of people with NAT2 intermediate or slow genotype increased rapidly from 25 pack-years, compared with non-smokers. A multiplicative interaction between NAT2 intermediate or slow genotype and pack-years of smoking was found (P<0.001), but GSTM1 null genotype was not (P=0.06). Our results indicate that the GSTM1 null genotype and NAT2 intermediate or slow genotype are associated with an increased risk of urothelial cancer in relation to smoking amounts. Furthermore, the interaction between NAT2 intermediate or slow genotype and pack-years of smoking has a strong impact on urothelial cancer.

[Small cell carcinoma of the prostate: a case report].

A 81-year-old man was admitted to our department with the chief complaints of pollakisuria and difficulty in voiding. He presented with increased serum PSA level (over 100 ng/ml). We performed biopsy of the prostate and found a moderately differentiated adenocarcinoma. Various urological examinations showed metastases to paraaortic lymph nodes and systemic bones. He was started-on hormonal therapy. Nine months from the start of hormonal therapy, this therapy was effective and the serum PSA level was decreased to 14 ng/ml. Thereafter, the serum PSA level and the tumor volume were increased and he died 29 months from the start of treatment. The autopsy revealed small cell carcinoma with adenocarcinoma of the prostate.

[Recurrence of vesicoureteral reflux detected 19 years after ureterocystoneostomy: a case report].

A 21-year-old male, who had been operated on for bilateral vesicoureteral refluxes (VURs) with bilateral ureterocystoneostomy (Politano-Leadbetter's method) 19 years before, was admitted to our hospital due to recurrent VUR. Since the former operation, he had undergone voiding cystography (VCUG) twice for two years, and no refluxes were found. Moreover, no evidence of upper urinary tract deterioration was found by either intravenous pyelography (IVP) or renal ultrasound scanning taken the year before this admission. Nineteen years after the operation, the dilation of the left lower ureter was found on IVP and, consequently, he suffered from pyelonephritis. The VCUG revealed the recurrence of left VUR. Because of his allergic reaction to collagen, we again performed left ureterocystoneostomy (Politano-Leadbetter's method). At three months postoperatively, there was no VUR found on VCUG.

Mesenteric plexiform neurofibroma associated with Recklinghausen's disease.

We present a rare case of plexiform neurofibroma involving the ileal mesentery of a 10-year-old boy with Recklinghausen's disease. MRI showed multiple ring-like structures in the masses on T2-weighted and contrast enhanced T1-weighted images. Probably these findings reflect enlarged peripheral nerves with myxoid degeneration. MRI is useful for the diagnosis of mesenteric plexiform neurofibroma because of this characteristic appearance.

[A case of primary adenosquamous carcinoma of the stomach showing Borrmann 4 type].

Adenosquamous carcinoma is a rare histological type of gastric cancer. We reported a 61-year-old man with primary adenosquamous carcinoma of the stomach showing Borrmann 4 type. Gastrofibroscopic biopsy and lymph node biopsy showed squamous and adenosquamous carcinoma respectively. Operated specimen revealed a adenosquamous carcinoma with diffuse infiltration.

A case of minute gastric cancer preoperatively diagnosed.

A case of minute gastric cancer which was preoperatively diagnosed, measuring 3 X 3 mm in diameter is reported. The X-ray examination revealed a faint barium collection surrounded by the mucosal folds. The endoscopic findings showed a small ulcerated lesion with a reddish and irregular margin and convergent folds. Radiological characteristics of the minute gastric cancer and its diagnostic approach are discussed.

Comparison of survival of patients with lung cancer between elderly (greater than or equal to 70) and younger (70 greater than) age groups.

Results of radiotherapy for lung cancer in the elderly were compared with those in younger patients. A total of 129 patients were treated by radiation therapy with or without chemotherapy. Fifty-six patients (43.4%) were 70 years old or more (elderly group) at the time of treatment, and the remaining 73 patients were below age 70 (younger group). Treatment results in the elderly group were nearly the same as those in the younger group in all stages of the disease. Survival time was longer for patients with performance status (PS) of 0 to 2 than for those with PS 3 or 4 regardless of age (p less than 0.05). The survival time of the elderly group was nearly the same as that of the younger group for squamous cell carcinoma, but somewhat shorter for adenocarcinoma although the difference was not statistically significant. There was no difference in survival between the two groups when they were treated by combined radiation therapy and chemotherapy. Our results suggest that elderly patients can be treated as safely as younger patients by radiotherapy alone or combined radiation therapy and chemotherapy.