OBJECTIVESPolyamines have long been known to have an insulin-like action, but their antiglycating effect has only recently attracted the attention of researchers. The aim of our investigation was to determine the whole blood polyamine concentration in a healthy population in order to examine its relationship with glycemic profiles.

METHODSThe study cohort comprised 622 men aged 40-59 who participated in a health checkup program conducted in 1997, when they underwent measurements of fasting plasma glucose (FPG), insulin (FPI), and fructosamine as glycemic indices. Colorimetric assay methods using oat and barley seedling polyamine oxidase were used to determine total polyamine (spermidine + spermine) and spermine concentrations in the whole blood, respectively. Polyamine concentrations adjusted for hemoglobin were quartiled for the analysis of covariance to assess the association with glycemic indices.

RESULTSA significant association was demonstrated between the FPG and total polyamine concentrations. In the trend test, FPG and fructosamine levels increased in accordance with the shift of quartiles of total polyamine concentrations from low to high. In contrast, the association between the spermine and glycemic indices was not statistically significant based on the test for difference of multivariate-adjusted means or trend for linearity.

CONCLUSIONSThis is the first epidemiological study to reveal that the concentrations of blood polyamines are related with either FPG or fructosamine level in a healthy population. There may be some feedback mechanism for the elevation of circulating polyamines to quench the glycation reaction under hyperglycemic conditions. In addition, total polyamines, rather than spermine alone, seem to be a sensitive biomarker representing the antiglycation effect of polyamines.

OBJECTIVES: One of the important risk factors of falling is decreased muscle mass and muscle strength. Recently, there has been an increasing concern on the role of vitamin D in muscle strength and physical activity. Aim of our study is to examine the relationships between vitamin D status and muscle mass and muscle strength in middle-aged healthy adults. METHODS: Subjects were 40 healthy volunteers aged 42.0 ± 10.6 years old. Evaluation was made for serum vitamin D₃ metabolites including 25-hydroxyvitamin D₃ [25(OH)D₃] and 24,25-dihydroxyvitamin D₃ [24,25(OH)₂D₃] concentrations, lower limb muscle strength, and dietary intake by food frequency questionnaire. Body composition was measured by dual-energy X-ray absorptiometry (DXA), and appendicular skeletal mass index (ASMI) was calculated as skeletal muscle mass/squared height. RESULTS: 70% of the subjects had vitamin D insufficiency/deficiency (serum total 25(OH)D < 20 ng/mL), and female subjects had significantly lower serum total 25(OH)D level compared with males. Vitamin D insufficiency/deficiency group had significantly higher body fat, lower SMI and muscle strength, probably reflecting higher percentage of female subjects. Serum vitamin D₃ metabolites levels were significantly correlated with whole and site-specific ASMI, and lower limb muscle strength, except for the correlation between serum 24,25(OH)₂D₃ concentration and lower limb muscle strength. In addition, serum 25(OH)D₃ level was a positive significant predictor for both ASMI and lower limb muscle strength, while serum 24,25(OH)₂D₃ level was not their significant predictor. CONCLUSIONS: Serum 25(OH)D₃ level was significantly correlated with both skeletal muscle mass and lower limb muscle strength.
Absorptiometry, Photon ; Accidental Falls ; Adipose Tissue ; Adult ; Asian Continental Ancestry Group* ; Body Composition ; Calcifediol* ; Female ; Healthy Volunteers ; Humans ; Lower Extremity* ; Male ; Motor Activity ; Muscle Strength* ; Muscle, Skeletal* ; Risk Factors ; Vitamin D ; Vitamins

OBJECTIVESThe ingestion of pesticides in the daily diet is assumed to be the main modality of pesticide exposure for most people. A widely used class of pesticides in agricultural or residential settings is pyrethroid. We have examined the relationship between the intake frequency of selected items of vegetables and fruits and urinary metabolites of pyrethroid pesticides in a healthy general population.

METHODSA total of 535 residents (184 men and 351 women) who attended a healthcare checkup program conducted in a rural area of Hokkaido, Japan, in August 2005 provided informed consent for their spot urine samples to be used for the determination of 3-phenoxybenzoic acid (3-PBA) levels. They also completed a self-administered questionnaire regarding the intake frequency of 12 food items. The concentrations of creatinine-corrected 3-PBA were predicted by the intake frequency of each item, using analysis-of-covariance models to adjust for age, sex, body mass index, and drinking and smoking status.

RESULTSBoth a significant association between the 3-PBA concentration and the frequency of tomato consumption and a significant positive linear trend was found in female subjects. In contrast, no such association was found in the male subjects.

CONCLUSIONSThe frequency of tomato consumption was confirmed to strongly predict the urinary pyrethroid metabolite levels in the general population-presumably because tomatoes are most often consumed raw and unpeeled (more so than all other vegetables and fruits analyzed in the current study). However, it should be noted that the 3-PBA levels, even among those subjects with the highest consumption of tomatoes, were far below the levels of toxicological significance, although the health consequences from long-term low-level exposure to pyrethroid requires further exploration.

AbstractObjectives  To explore factors related to difficulty in caring for foreign patients among Japanese nurses.Methods  A self-administered online survey was conducted with nurses working in a university hospital and a general hospital in Tokyo using Google Forms. The survey involved participants’ demographics, including language ability and international experiences, and 16 questions on difficulty in caring for foreign patients.Results  A total of 138 nurses completed the survey (response rate of 11.3%). The average nursing experience was 14.1 (±10.6) years, and 50% of the participants had a bachelor’s degree. The higher-difficulty items were predominantly related to communication, followed by insurance or payment. The most difficult item was “communication in a language other than English,” but no factor was associated with it. The path analysis showed that “being able to speak a foreign language” was directly and significantly associated with a lower total difficulty score (β＝−0.313, p＝0.011). Higher educational degree was associated with higher “self-evaluated English level” (β＝0.282, p<0.001), which was associated with “being able to speak a foreign language” (β＝0.396, p<0.001). Higher educational degree was also associated with “international experiences (study)” (β＝0.161, p＝0.044), which was associated with both “self-evaluated English level” (β＝0.256, p<0.001) and “being able to speak a foreign language” (β＝0.286, p<0.001). Lower educational degree was associated with more nursing experience (β＝−0.454, p<0.001), which was associated with a higher “number of foreign patients cared for” (β＝0.291, p<0.001) but not with lower difficulty. Although “international experiences (sightseeing)” was highly correlated with “international experiences (study)” (β＝0.338, p<0.001), sightseeing was not significantly related to higher “self-evaluated English level” or lower difficulty. Conclusion  Learning foreign languages, including English, and international study experiences could reduce difficulty in caring for foreign patients. An intervention study that evaluates the effect of training that includes a language aspect on caring for foreign patients may be necessary.

Objectives  The objective of this study was to investigate the needs and motivation of nurses regarding training on how to take care of foreign patients at hospitals and to explore related demographic factors.Methods  A questionnaire was distributed to all nurses working at two hospitals in Tokyo, one university and one general, using Google form. The needs and contents of training they would like to participate were summarized using descriptive statistics. Fisher’s exact test, t test, Mann-Whitney U test and Spearman’s correlation coefficients were used to analyze related factors. Results  Responses of 138 nurses were analyzed (98 university and 40 general) with a response rate of 11.3%. More nurses in the university hospital held a bachelor’s degree and higher subjective English ability than the general hospital. In both hospitals, 59.7% answered that they “strongly feel” or “feel” stress/anxiety in dealing with foreign patients and 77.5% answered that training is necessary.   “Language training” was felt most necessary, followed by training regarding “different cultures and religions.” In regard to language training, “daily conversation” was most necessary, followed by “technical terms”; English being most necessary, followed by Chinese. Approximately one-fourth of participants (24.6%) answered in the affirmative for attending such training by adjusting their private schedules and 59.4% answered they only wanted to attend if it fits into their schedule.   Nurses who answered, “unable to speak English”, had a higher desire to improve their ability to take care of foreign patients; also, those who had higher stress/anxiety felt it was necessary to attend the training. Participants who had been studying a foreign language showed higher motivation.Conclusion  Daily conversation in English was felt most necessary regarding training to care for foreign patients. Training during work hours rather than on private time was preferred.

OBJECTIVESThe aim of this study was to determine whether the serum nitrite plus nitrate (NO( x )) level correlates with biomarkers that are known components of the metabolic syndrome (MetS).

METHODSSerum NO( x ) levels were measured using a commercial kit in 608 Japanese men and women between the ages of 39 and 85 years. Multivariate adjustments for age, smoking status, alcohol consumption and exercise were made in the analysis of covariance (ANCOVA). The components of the metabolic syndrome were defined based on the following criteria: body mass index (BMI) >/=25.0 kg/m(2), glycated hemoglobin (HbA1c) >/=5.6%, systolic blood pressure >/=130 mmHg or diastolic blood pressure >/=85 mmHg, high-density lipoprotein-cholesterol (HDL-C) /=1.69 mmol/l.

RESULTSThe logarithmically transformed age-adjusted serum NO( x ) (lnNO( x )) value was significantly higher in the low HDL-C group (1.76 +/- 0.05 mumol/l; p < 0.05) than MetS component groups (1.65 +/- 0.01 mumol/l) in men, but no difference was found in women. The means of serum lnNO( x ) after multivariate adjustment were 1.64, 1.65, 1.64, 1.66, and 1.81 mumol/l for 0, 1, 2, 3, and 4-5 MetS components for all subjects, respectively. The results of ANCOVA confirmed that the serum lnNO( x ) level was significantly correlated with the clustering of MetS components in both men and women (p < 0.0001 for trend).

CONCLUSIONOur results suggest that an increase in the clustering of MetS components was associated with the increase in serum NO levels in our general population.

The Japan Society for Oriental Medicine has summarized randomized controlled trials (RCTs) using Japanese traditional (Kampo) medicine in structured abstracts, named “Evidence Reports of Kampo Treatment” (EKAT). In this study, we developed a method of classification based on study design, method of intervention, study aim, journal credibility, and year of publication. Then we classified 416 RCTs in EKAT and examined the current status and evolution of RCTs using Kampo medicine in Japan. Double-­blinded RCTs (DB-RCTs) accounted for only 8.9% of the RCTs in EKAT, and 86.5% of DB-RCTs were placebo-controlled. Among the RCTs that aimed to investigate the efficacy of Kampo medicine for diseases without standard Western medical treatment, DB-­RCT accounted for 64.9%. In recent years, there have been fewer envelope RCTs and quasi-­RCTs, which are prone to an increased risk of bias. The proportion of articles reporting RCTs in journals with an impact factor ( > 0.79 points reported by Journal Citation Reports) has been increasing with each passing year. This implies that the recent research in Kampo medicine has improved its quality and has gained an appreciation in modern medicine. The present study was conducted in “Problem-based Learning” in the 2nd grade of Tohoku University School of Medicine.