Recently, alternative medicine has been re-evaluated and increasingly recognized as effective treatments in the United States and Europe. Caregivers have shown a greater interest in obtaining information about of and practical experience in alternative medicine. Accordingly, the possible reorganization of the medical education curriculum has been examined and alternative medicine classes have been started in many medical schools in the United States. St. Marianna University has started lectures and practical instruction in alternative medicine as part of the preventive medicine course. We also investigated the efficacy of acupuncture and obtained favorable results. A questionnaire survey showed that most students have a great interest in alternative medicine and would like to see it introduced as soon as possible.

Lithium, prescribed for bipolar disorder, is known to induce thyroid dysfunction, most commonly hypothyroidism. Thyrotoxicosis due to lithium-induced painless thyroiditis is a rare complication. We have previously reported that the serum concentration of immunosuppressive acidic protein (IAP), an α1-acid glycoprotein, increased during the acute phase of subacute thyroiditis, but was within the normal range in patients with painless thyroiditis. In the present case, a 31-year-old woman, receiving long-term lithium therapy for bipolar disorder, had a recurrent episode of painless thyroiditis, and her serum IAP was increased. The pathogenic mechanism for lithium-associated painless thyroiditis may differ from that of autoimmune conditions.
Thyroiditis ; Lithium measurement ; Lithium ; PROTEIN.IMMUNOACIDIC ; Painless

Objective: Although the Japanese EuroQol instrument was developed in 1998 by a Japanese translation team, the reliability of health state valuations of the fuller questionnaire has not yet been investigated in Japan. We carried out a pilot study to investigate the reliability of health state valuations of the Japanese EuroQol instrument. Methods: The survey was conducted twice with the fuller questionnaire of the Japanese EuroQol instrument in a class of preventive medicine. We analyzed test-retest reliability based on the health state valuations and calculated Cronbach’s coefficient alpha of both tests. Results and Conclusions: The mean valuations of 14 hypothetical health states and ‘death’ between test and retest were not significantly different by paired t-test. The reliability by calculated correlation between test and retest was 0.996 (p<0.0001). In addition, Cronbach’s coefficient alpha of the first test was 0.827, and that of the second test was 0.865. Although good reliability was shown in the present study, our conclusion was limited to applications of population-based surveys because of the small number and limited subjects of the present study. Further investigations are required in the form of a population-based survey.
Japanese language ; Health ; seconds ; instruments ; Surveys

To determine the optimal strategy for prostate cancer screening, the cost-effectiveness of screening was analyzed using a medical decision model. One hundred thousand asymptomatic males between the ages of 40 and 69 were modeled with and without screening. The subjects were divided into three 10−year age groups. We used a 5−year survival rate as an effectiveness point and assumed after 5 year survival free from prostate cancer. We considered three potential programs: 1)screening with digital rectal examination(DRE), 2)screening with prostate specific antigen(PSA), and 3)screening with a combination of DRE and PSA. The study was analyzed from the payer’s perspective, and only direct medical costs were included. For each of the three age groups, PSA screening was more cost−effective than either DRE screening or a combination of DRE and PSA screening. The cost−effectiveness ratio for the combination of DRE and PSA screening was 1.1−2.3 times more expensive than that of PSA screening. If the compliance rate for work−up exams is 80%, the cost−effectiveness of prostate cancer screening is approximate to that of gastric cancer screening. In conclusion, PSA screening is the most cost−effective strategy for prostate cancer screening when compared with both DRE and the combination of DRE and PSA screening. But prostate cancer screening should be carefully conducted, taking the cost−effectiveness of the different strategies and target groups into consideration.
Aspects of disease screening ; public service announcement ; screening for prostate cancer ; Cost aspects ; seconds

Objectives: The aim of this study was to identify characteristic lifestyles in children with obese parents. Methods: 8,030 children (4,072 males and 3,958 females) aged 6 to 7 years were investigated. A questionnaire relating to the lifestyles of children was distributed through elementary schools for completion by parents. The heights and weights of parents were self-reported. A parent with a body mass index (weight in kilograms divided by the square of height in meters) greater than the 90th percentile for gender (26.7 kg/m2 for fathers and 24.3 kg/m2 for mothers) was defined as an obese parent. A chi-square test for each trend was applied to evaluate an increasing trend in the frequency or level of each lifestyle in children with obese parents. Results: Children with obese parents were significantly associated with increasing trends in the proportions categorized by irregular intake of breakfast, faster eating, longer TV watching, and shorter sleeping hours. Conclusions: These lifestyles are considered to be possible risk factors for the development of obesity. These characteristic lifestyles observed in children with obese parents could strengthen the relationship between child and parental body compositions, in addition to the genetic predisposition to obesity in children with obese parents. These findings indicate that education with lifestyle modification for obese parents will be required to prevent further weight gain in children with obese parents.
Child ; Parents ; Life Style ; seconds ; trends

Schwannomas are benign tumors of neuroectodermal origin and can be found in any part of the body. Although schwannomas are common in the head and neck region, they are rare in the auricle. Auricular schwannomas are rarely symptomatic but the mass itself or a surgical procedure to remove it may disrupt the complicated structure of the auricle. We report a rare case of auricular schwannoma with a literature review and describe the surgical technique used in this case.

Schwannomas are benign tumors of neuroectodermal origin and can be found in any part of the body. Although schwannomas are common in the head and neck region, they are rare in the auricle. Auricular schwannomas are rarely symptomatic but the mass itself or a surgical procedure to remove it may disrupt the complicated structure of the auricle. We report a rare case of auricular schwannoma with a literature review and describe the surgical technique used in this case.

OBJECTIVESTo evaluate the impacts of health examinations (HE) and smoking on disease mortality risk in Japan.

METHODSBy using the large cohort database of a Japanese life insurance company, 720,611 subjects aged 20 to 80 years, who had contracted for life insurance between April 1, 1995 and March 31, 1998, were followed up until September 30, 1999. Cox's proportional hazard model was used to estimate age-adjusted relative risk (RR) for disease death.

RESULTSAfter adjusting for age, disease mortality in smokers was significantly higher than that in non-smokers (men, RR 1.51, 95% CI: 1.25-1.81; women, RR 1.54, 95% CI: 1.12-2.11). Meanwhile, disease mortality in HEees (those who had got HE within the past 2 years) was significantly lower than that in non-HEees (men, RR 0.70, 95% CI: 0.56-0.88; women, RR 0.71, 95% CI: 0.54-0.92). The magnitude of the impact of HE on disease mortality risk varied according to smoking status. Non-smokers showed a significantly lower risk associated with HE, whereas smokers did not.

CONCLUSIONSHE may allow an appreciable reduction in disease mortality, however, the reduction effect may be limited to non-smokers. Smoking cessation may be essential to improve the preventive effects of HE.

OBJECTIVESTo examine the effective preventive strategy for hypertension in a Japanese male population, based on attributable risk measures.

METHODSA 7-year follow-up study of hypertension among 6,306 middle-aged male office workers in a Japanese telecommunication company.

RESULTSIn terms of population attributable risk percentage (PAR%), regular alcohol intake and physical inactivity showed great contributions to the development of hypertension in the population no less than obesity. The PAR% of each risk factor varied by age group, and the total PAR% of the three modifiable risk factors was considerably higher in the 30-39 year old group (71%) than in the older groups.

CONCLUSIONSReduced alcohol intake and increased physical activity, as well as weight control, may have a larger impact on prevention of hypertension in younger groups than in older groups.