Objective To explore the mutation of RET gene exon 11 in sporadic medullary thyroid carcinoma and to clarify the relationship between RET mutation and sporadic medullary thyroid carcinomas. Methods Genomic DNA was extracted from 17 sporadic medullary thyroid carcinoma tissues. Exon 11 of RET gene was amplified by polymerase chain reaction, analyzed by automated DNA sequencer after purification and results were compared with normal sequence. Results RET mutation was detected in 1 of 17 cases and the mutation revealed the wrong base at the position 15165(G→A) and the missense codon at 691 (ser 691 →lys). Conclusion The low rate of RET exon 11 mutation in sporadic medullary thyroid carcinomas indicate that the key gene mutations may locate on other exons of RET gene or other genes.

Objective: This study aims to investigate the drinking behavior on the remote islands of Okinawa Prefecture.Patients/Materials and Method: This was a cross-sectional study conducted with residents of Okinawa Prefecture’s small, isolated islands. Between October 1 and December 3, 2014, island residents over 20 years of age who visited island clinics for an annual health checkup or influenza vaccination were recruited. An anonymous entry survey was administered to those who provided their consent. The survey included information on age, sex, presence or absence of drinking, age at drinking initiation, smoking status, comorbidities, and family and social background. The Alcohol Use Disorder Identification Test (AUDIT) was used to assess alcohol consumption. Participant characteristics were analyzed descriptively, and logistic regression analysis was conducted to assess relationships between the high-risk drinking group (AUDIT score ≥10 points) and other measured variables (age, sex, age at drinking initiation, smoking, residence, and employment status).Results: Compared to the results of a national survey in 2013, there was a significantly higher prevalence of male island residents who drank ≥40 g of alcohol per day and female island residents who drank ≥20 g/day, levels which are considered risk factors for lifestyle diseases. Among both male and female island residents, there were significantly higher proportions of those with AUDIT scores ≥8 points, referred to as high-risk drinkers, and those with AUDIT scores ≥20, individuals considered to have probable alcohol dependence, as compared to the results of the national survey. In a logistic regression analysis, factors related to high-risk drinking included younger age, male sex, smoking history, inoccupation, and underage drinking initiation.Conclusion: This is the first report on drinking behavior among inhabitants of Okinawa’s remote islands. The degree of alcohol consumption is serious and must be recognized as a regional health problem.

The first examination of the new board of the Japanese cardiovascular surgery took place in 2022. As it is a transitional period for the new system, many doctors are not familiar with the changes and details of the new system, and some have their concerns. Here, we held a round-table discussion with doctors who actually took the new board of the Japanese cardiovascular surgery under the new system, and we summarized their opinion.

Parkinson’s disease is often complicated by psychiatric symptoms. Psychiatrists are caught in a dilemma between such symptoms and physical treatment since Parkinson’s disease sometimes shows treatment resistance based on pharmacological treatment-induced dopamine dysfunction. Here, we report on a 64-year-old woman with a 15-year history of Parkinson’s disease with stage IV severity based on the Hoehn and Yahr scale. She was admitted to our hospital with a diagnosis of major depressive disorder with psychotic features. Unfortunately, her treatment course for depression was complicated by neuroleptic malignant syndrome. Because we were concerned about the persistence of her depressive symptoms, the risk of psychotropic drugs causing adverse effects, and progressive disuse syndrome, we administered modified electroconvulsive therapy. Her symptoms of neuroleptic malignant syndrome and depression sufficiently improved after five sessions of modified electroconvulsive therapy. Additionally, the primary motor symptoms of her Parkinson’s disease also markedly improved. The improvement of neuroleptic malignant syndrome and her motor symptoms based on dopamine dysfunction can be explained by electroconvulsive therapy’s effectiveness in activating dopamine neurotransmission. Besides, the marked improvement of her depressive episode with psychotic features was presumed to involve dopamine receptor activation and regulation. Because advanced Parkinson’s disease can sometimes be refractory to treatment based on pharmacological treatment-induced dopamine dysfunction, psychiatrists often have difficulty treating psychiatric symptoms; electroconvulsive therapy may stabilize the dopaminergic system in such cases, presenting a possible non-pharmacologic treatment option for Parkinson’s disease.

Parkinson’s disease is often complicated by psychiatric symptoms. Psychiatrists are caught in a dilemma between such symptoms and physical treatment since Parkinson’s disease sometimes shows treatment resistance based on pharmacological treatment-induced dopamine dysfunction. Here, we report on a 64-year-old woman with a 15-year history of Parkinson’s disease with stage IV severity based on the Hoehn and Yahr scale. She was admitted to our hospital with a diagnosis of major depressive disorder with psychotic features. Unfortunately, her treatment course for depression was complicated by neuroleptic malignant syndrome. Because we were concerned about the persistence of her depressive symptoms, the risk of psychotropic drugs causing adverse effects, and progressive disuse syndrome, we administered modified electroconvulsive therapy. Her symptoms of neuroleptic malignant syndrome and depression sufficiently improved after five sessions of modified electroconvulsive therapy. Additionally, the primary motor symptoms of her Parkinson’s disease also markedly improved. The improvement of neuroleptic malignant syndrome and her motor symptoms based on dopamine dysfunction can be explained by electroconvulsive therapy’s effectiveness in activating dopamine neurotransmission. Besides, the marked improvement of her depressive episode with psychotic features was presumed to involve dopamine receptor activation and regulation. Because advanced Parkinson’s disease can sometimes be refractory to treatment based on pharmacological treatment-induced dopamine dysfunction, psychiatrists often have difficulty treating psychiatric symptoms; electroconvulsive therapy may stabilize the dopaminergic system in such cases, presenting a possible non-pharmacologic treatment option for Parkinson’s disease.

A Valsalva aneurysm filled with thrombi can be difficult to diagnose, because it mimics a cardiac tumor. Both cardiac magnetic resonance imaging (MRI) and transesophageal echocardiogram (TEE) were performed on a patient who showed a low-echoic mass located between the atrial septum and the non-coronary sinus. Based on MRI findings allowing tissue characterization and the accurate location of the mass and the TEE findings of an irregular surface of the mass and a partial defect in the edge of the non-coronary sinus, we diagnosed the mass as a thrombosed Valsalva aneurysm that had perforated the inter-atrial septum. The operative findings coincided with the preoperative diagnosis. Both MRI and TEE are useful for diagnosing this condition.
Aneurysm ; Atrial Septum ; Echocardiography ; Heart Neoplasms ; Humans ; Magnetic Resonance Imaging ; Sinus of Valsalva

Background: The demand for palliative care in Japan has risen over recent years, and training of palliative care physicians is an important problem. However, little is known about unmet needs for education and training systems as well as career development among young physicians who wish to specialize in palliative care. Purpose: To explore unmet needs among palliative care physicians in training. Method: We held group discussions in a forum for physicians of postgraduate year≦15, and analyzed their opinion on topics such as "what are unmet needs?" using theme analysis. Results: Forty physicians participated. Theme analysis revealed the following unmet needs among young physicians; "securing of manpower", "securing of quality of training programs/education", "improvement of network", "removal of many barriers to keeping on a palliative care physician", and "establishment of career models for a specialist". Conclusions: We should discuss solutions for the unmet needs to secure more palliative care physicians.

BACKGROUND: It is important to achieve herd immunity by vaccinating as many people as possible to end the COVID-19 pandemic. We investigated the relationship between willingness to receive vaccination and sources of health information among those who did not want to be vaccinated against COVID-19. METHODS: This prospective cohort study collected data using a self-administered questionnaire survey. The baseline survey was conducted during December 22-25, 2020, and the follow-up survey during February 18-19, 2021. Participants were aged 20-65 years and worked at the time of the baseline survey (N = 33,087). After excluding 6,051 invalid responses, we included responses from 27,036 participants at baseline. In total, 19,941 people responded to the follow-up survey (74% follow-up rate). We excluded 7,415 participants who answered "yes" to the question "If a COVID-19 vaccine becomes available, would you like to get it?" in the baseline survey. We finally analyzed 12,526 participants. RESULTS: The odds ratio for change in willingness to be vaccinated from "no" to "yes" differed by source of health information. Compared with workers that used TV as a source of information, significantly fewer people who reported getting information from the Internet and friends/colleagues were willing to get the vaccine. CONCLUSIONS: It is important to approach workers who do not watch TV when implementing workplace vaccination programs. It is likely that willingness to be vaccinated can be increased through an active company policy whereby the top management recommend vaccination, coupled with an individual approach by occupational health professionals. TRIAL REGISTRATION Not applicable.
Adult ; Aged ; COVID-19/prevention & control* ; COVID-19 Vaccines ; Cohort Studies ; Cross-Sectional Studies ; Humans ; Influenza Vaccines ; Japan ; Middle Aged ; Pandemics ; Prospective Studies ; Young Adult