The aim of this study was to evaluate the association between a number of variables and the smokingbehavior of students at 2 medical and 4 nursing schools. Multivariate analysis was applied to clarify theassociation between the Brinkman index and 12 other independent variables.
The study population consisted of 1, 207 medical and 682 nursing students in Japan.
1) 35.4% of medical students (1-6th grades), 12.5% of nursing students and 28.7% of medical students (1-3rd grades) smoked. Medical students in the 5th or 6th grade smoked more frequently than the otherstudents.
2) Smokers in medical school and those giving up smoking in nursing school had more knowledge aboutsmoking and its physical effects than the others.
3) Multiple regression analysis showed that the coefficients of determination for the Brinkman indiceswere 0.197 in medical school (1-6th grades), 0.055 in nursing school and 0.106 in medical schools (1-3rd grades). The main independent variables were age, sex and maternal smoking history.

  We demonstrated the clinical features and outcome of 87 children with idiopathic thrombocytopenic purpure (ITP). Most of them were younger children with severe thrombocytopenia; 71.3% were under 5 years old and 49.4% had platelet counts below 1×10⁴/μl. Initial treatment consisted of high-dose intravenous immunoglobulin in 60 (69.0%), steroid in 10 (11.5%), and no therapy in 17 (19.5%). More than 90% of the children with platelet counts below 2×10⁴/μl received treatment, but most children with platelet counts above 2×10⁴/μl were observed without treatment. No patients had complications with CNS hemorrhage. Chronic ITP was noted in 17 patients (19.5%). Their mean age was 6 years 3 months compared with 2 years 8 months for the acute patients (p<0.01). But there were no significant differences in sex, platelet count, and initial treatment between chronic ITP and acute ITP. Six (35.3%) out of 17 children with chronic ITP subsequently achieved a spontaneous recovery. As of today, only 3 patients (3% of all patients, and 17.6% of patients with chronic ITP) have platelet counts below 5×10⁴/μl. The overall prognosis and quality of life were excollent. Helicobacter Pylori (H. pylori) infection was found in 7.1% of the chronic patients and 5.3% of the acute patients, but platelet counts of them returned to normal without H. pylori eradication thrapy. It seemed that H. pylodi infection played a minor role in pediatric ITP.

We demonstrated the clinical features and outcome of 87 children with idiopathic thrombocytopenic purpure (ITP). Most of them were younger children with severe thrombocytopenia; 71.3% were under 5 years old and 49.4% had platelet counts below 1×104/μl. Initial treatment consisted of high-dose intravenous immunoglobulin in 60 (69.0%), steroid in 10 (11.5%), and no therapy in 17 (19.5%). More than 90% of the children with platelet counts below 2×104/μl received treatment, but most children with platelet counts above 2×104/μl were observed without treatment. No patients had complications with CNS hemorrhage. Chronic ITP was noted in 17 patients (19.5%). Their mean age was 6 years 3 months compared with 2 years 8 months for the acute patients (p<0.01). But there were no significant differences in sex, platelet count, and initial treatment between chronic ITP and acute ITP. Six (35.3%) out of 17 children with chronic ITP subsequently achieved a spontaneous recovery. As of today, only 3 patients (3% of all patients, and 17.6% of patients with chronic ITP) have platelet counts below 5×104/μl. The overall prognosis and quality of life were excollent. Helicobacter Pylori (H. pylori) infection was found in 7.1% of the chronic patients and 5.3% of the acute patients, but platelet counts of them returned to normal without H. pylori eradication thrapy. It seemed that H. pylodi infection played a minor role in pediatric ITP.
Purpura, Thrombocytopenic, Idiopathic ; Child ; Platelet Count ; seconds ; Chronic

OBJECTIVESTo assess trends in smoking prevalence among Japanese adolescents and to analyze possible causal factors for the decrease in smoking prevalence observed in a 2004 survey.

METHODSNationwide cross-sectional surveys were conducted in 1996, 2000 and 2004. Survey schools, both junior and senior high schools, considered to be representative of the whole of Japan were sampled randomly. Enrolled students were asked to complete a self-reporting anonymous questionnaire on smoking behavior. The questionnaires were collected from 115,814 students in 1996, 106,297 in 2000, and 102,451 in 2004. School principals were asked about the policy of their respective school on smoking restrictions.

RESULTSCigarette smoking prevalence (lifetime, current, and daily smoking) in 2004, based on the completed questionnaires, had decreased relative to previous years in both sexes and in all school grades. The most important trends were: a decrease in smoking prevalence among the fathers and older brothers of the students; an increase in the proportion of students who did not have friends; a decrease in the proportion of current smokers who usually bought cigarettes in stores decreased in 2004, in particular for the oldest boys. An association was found between a lower smoking rate at a school and a smoke-free school policy.

CONCLUSIONSJapan has experienced a decrease in the prevalence of smoking among adolescents. A decrease in smoking prevalence among the fathers and older brothers, limitations to minors' access to tobacco, an increase in the proportion of students without friends, and a school policy restricting smoking may have contributed to this decreasing trend.

Background/Aims: Metabolic dysfunction-associated steatotic liver disease (MASLD) was recently proposed as an alternative disease concept to nonalcoholic fatty liver disease (NAFLD). We aimed to investigate the prognosis of patients with biopsy-confirmed MASLD using data from a multicenter study. Methods: This was a sub-analysis of the Clinical Outcome Nonalcoholic Fatty Liver Disease (CLIONE) study that included 1,398 patients with NAFLD. Liver biopsy specimens were pathologically diagnosed and histologically scored using the NASH Clinical Research Network system, the FLIP algorithm, and the SAF score. Patients who met at least one cardiometabolic criterion were diagnosed with MASLD. Results: Approximately 99% of cases (n=1,381) were classified as MASLD. Patients with no cardiometabolic risk (n=17) had a significantly lower BMI than patients with MASLD (20.9 kg/m2 vs. 28.0 kg/m2, P<0.001), in addition to significantly lower levels of inflammation, ballooning, NAFLD activity score, and fibrosis stage based on liver histology. These 17 patients had a median follow-up of 5.9 years, equivalent to 115 person-years, with no deaths, liver-related events, cardiovascular events, or extrahepatic cancers. The results showed that the prognosis for pure MASLD was similar to that for the original CLIONE cohort, with 47 deaths and one patient who underwent orthotopic liver transplantation. The leading cause of death was extrahepatic cancer (n=10), while the leading causes of liver-related death were liver failure (n=9), hepatocellular carcinoma (n=8), and cholangiocarcinoma (n=4). Conclusions Approximately 99% of NAFLD cases were considered MASLD based on the 2023 liver disease nomenclature. The NAFLD-only group, which is not encompassed by MASLD, had a relatively mild histopathologic severity and a favorable prognosis. Consequently, the prognosis of MASLD is similar to that previously reported for NAFLD.

BRCA2 Protein/genetics* ; Germ Cells ; Humans ; Male ; Muscular Atrophy ; Mutation ; Prostate ; Prostatic Neoplasms/genetics*