BACKGROUND: This cross-sectional study examined meal patterns based on daily energy intake distribution and their associations with nutrient and food intake, diet quality, and body mass index (BMI). METHODS: Body height, weight, habitual dietary intake and the Healthy Eating Index (HEI)-2020 score by eating occasion were assessed using the validated Meal-based Diet History Questionnaire among employees (465 males and 193 females aged 20-75 years) in the Tokyo Metropolitan Area. Meal patterns were extracted based on % energy intake from breakfast, lunch, dinner, and snacks using K-means clustering by sex. Dietary intake, HEI-2020 score, and BMI were then compared between sex-specific meal patterns. RESULTS: The identified patterns were "large lunch and dinner" (n = 299), "three meals-balanced" (n = 97), and "large dinner" (n = 69) patterns in males and "large dinner" (n = 79); "large afternoon snack" (n = 54) and "large lunch" (n = 60) patterns in females. The HEI-2020 scores were the highest for dinner, followed by breakfast, lunch, and snacks in any meal pattern. Males with the "large dinner" pattern had lower intakes of rice, bread, carbohydrates, dietary fibre, and thiamine; higher intake of alcoholic beverages; and higher HEI-2020 scores than those with other patterns. Females with a "large dinner" pattern had a lower intake of bread, confectionery, total and saturated fats, and carbohydrates; higher intake of fish, meat, and alcoholic beverages; higher HEI-2020 scores; and lower BMI. Thus, a meal pattern with higher energy intake distribution at dinner was associated with higher diet quality among males and females and lower BMI among females in Japanese workers. CONCLUSIONS These findings suggest that improving the quality of the meal with the highest energy contribution could help enhance overall dietary quality and metabolism.
Humans ; Female ; Male ; Middle Aged ; Adult ; Energy Intake ; Body Mass Index ; Cross-Sectional Studies ; Aged ; Meals ; Young Adult ; Tokyo ; Feeding Behavior ; Diet/statistics & numerical data*

The Tokyo 2020 Olympic and Paralympic Games provided a significant opportunity to consider global warming as an issue to be seriously addressed to run the safe and fair games in the era of climate change. As the global temperature continuously rises and extreme hot-weather events increase in frequency and intensity, the future summer Olympic and Paralympic games will need to deal with the heat by applying thorough and appropriate countermeasures. In the recent decades, many mitigation measures to protect athletes from heat have been rapidly discussed by the sports community, including countermeasures to hold games at times and places with moderate temperature and climatic risk assessments with Wet Bulb Globe Temperature (WBGT) during the games. However, the excessive heat conditions in the Tokyo 2020 Games affected not only athletes, but also all people concerned the events. While deliberate considerations by organizers had been given to mitigate extraordinary heat, the evaluations of these measures and epidemiological analyses of risk factors of patients must be further enhanced to develop efficient measures for the future. Therefore, we discussed the underlying climate-related problems of the summer Olympic and Paralympic Games in view of what we had experienced in the Tokyo 2020 Games. Facing with emerging global warming, future intervention against heat in the summer Olympic and Paralympic games will need to integrate systematic disease surveillance and evaluation of intervention with an effective combination with the approaches previously conducted. The Tokyo 2020 Games is a wake-up call to accelerate the public health measures towards the creeping global warming.
Biodiversity ; Global Warming ; Humans ; Sports ; Temperature ; Tokyo

Due to the widespread acceptance of gastric and esophageal endoscopic submucosal dissections (ESDs), the number of medical facilities that perform colorectal ESDs has grown and the effectiveness of colorectal ESD has been increasingly reported in recent years. The clinical indications for colorectal ESD at the National Cancer Center Hospital, Tokyo, Japan include laterally spreading tumor (LST) nongranular type lesions >20 mm and LST granular type lesions >30 mm. In addition, 0-IIc lesions >20 mm, intramucosal tumors with nonlifting signs and large sessile lesions, all of which are difficult to resect en bloc by conventional endoscopic mucosal resection (EMR), represent potential candidates for colorectal ESD. Rectal carcinoid tumors less than 1 cm in diameter can be treated simply, safely, and effectively by endoscopic submucosal resection using a ligation device and are therefore not indications for ESD. The en bloc resection rate was 90%, and the curative resection rate was 87% for 806 ESDs. The median procedure time was 60 minutes, and the mean size for resected specimens was 40 mm (range, 15 to 150 mm). Perforations occurred in 23 (2.8%) cases, and postoperative bleeding occurred in 15 (1.9%) cases, but only two perforation cases required emergency surgery (0.25%). ESD was an effective procedure for treating colorectal tumors that are difficult to resect en bloc by conventional EMR. ESD resulted in a higher en bloc resection rate as well as decreased invasiveness in comparison to surgery. Based on the excellent clinical results of colorectal ESDs in Japan, the Japanese healthcare insurance system has approved colorectal ESD for coverage.
Asian Continental Ancestry Group ; Carcinoid Tumor ; Colorectal Neoplasms ; Delivery of Health Care ; Emergencies ; Hemorrhage ; Humans ; Insurance ; Japan ; Ligation ; Tokyo

PURPOSE: The present study investigates the effects of pharmacologic pupil dilatation on ocular, corneal and internal aberrations. METHODS: Sixty-two right eyes of 62 healthy participants were included in the present study. Ocular, corneal and internal aberrations were measured with a KR-1W wavefront aberrometer (Topcon Corp., Tokyo, Japan) before mydriasis in mesopic conditions. After pupil dilatation with a mydriatic drug (phenylephrine chloride 0.5% + tropicamide 0.5%) (Mydrin-P, Santen, Osaka, Japan), the measurements were repeated. The wavefront data of 4-mm and 6-mm diameter zones were analyzed. The changes of aberrations before and after mydriasis were evaluated by paired t-test. RESULTS: The values of ocular, corneal and internal spherical aberrations before and after mydriasis on the 4-mm diameter pupil zone were not statistically significantly different. On the 6-mm diameter zone, the ocular and internal spherical aberrations were statistically significantly different (p = 0.025, p = 0.002, respectively, paired t-test). However, the corneal aberrations did not show significant changes. The internal aberrations average before mydriasis was -0.043 (+/-0.21) microm and was shifted in a negative direction to -0.093 (+/-0.17) microm after mydriasis. The ocular aberrations average also changed toward negative after mydriasis. The high-order aberrations and astigmatism did not change significantly. CONCLUSIONS: The ocular and internal spherical aberrations changed toward negative with mydriasis in the participants' eyes suggesting the change of the ocular spherical aberration to be attributed to internal changes.
Astigmatism ; Dilatation ; Eye ; Mydriasis ; Pupil ; Tokyo ; Tropicamide

PURPOSE: To investigate the visualization of cystoid macular edema (CME) using noninvasive retromode imaging by a new scanning laser ophthalmoscope (SLO) and compare to previous imaging modalities. METHODS: The authors of the present study retrospectively reviewed the medical records of 21 eyes of 20 patients with CME due to various etiologies. All eyes were examined with fundus camera, fluorescein angiography (TRC-50EX, Topcon, Tokyo, Japan), SLO (F-10, Nidek, Gamagori, Japan), and spectral-domain optical coherence tomography (OCT) (3D OCT-1000, Topcon, Tokyo, Japan). In the present study the SLO was used in the retro-mode with an infrared laser. RESULTS: Previous fundus photography could not detect CME adequately although SLO retro-mode could show numerous oval or polygonal cystoid spaces more readily. Furthermore, each individual small cystoid space could be detected and the area of each cystoid space could be measured. The area of the largest cystoid space showed a correlation with its height, as measured with OCT (R = 0.606, p = 0.004). The area of the whole foveal cystoid space showed a correlation with central macular thickness, as measured with OCT (R = 0.493, p = 0.023). CONCLUSIONS: A new commercially available SLO (F-10) in the retro-mode can allow us to detect each cystoid space non-invasively and to measure the extent of CME.
Eye ; Fluorescein Angiography ; Humans ; Macular Edema ; Medical Records ; Ophthalmoscopes ; Ophthalmoscopy ; Photography ; Retrospective Studies ; Tokyo ; Tomography, Optical Coherence

PURPOSE: To measure choroidal thickness in healthy myopic eyes and to evaluate the relationship among choroidal thickness and refractive power and axial length. METHODS: Eighty healthy myopic eyes were evaluated in the present study. The refractive power was measured using an automatic refractor and the axial length using A-scan. The subjects were divided into two groups based on refractive power (> or =-6.0 D and <-6.0 D) and axial length (> or =25 mm and <25 mm). The choroidal thickness was measured using spectral domain (SD) optical coherence tomography (3-dimensional [3D] OCT-2000, Software Version 6.01; Topcon Corp., Tokyo, Japan), and the statistical relationship between the two groups was analyzed. RESULTS: A statistically significant difference was found in choroidal thickness according to refractive power and axial length between the two groups (p < 0.001 and p < 0.05, respectively). CONCLUSIONS: Refractive power and axial length had a significant relation to choroidal thickness measured by OCT. When excluding eyes with pathologic myopia, high myopia in healthy eyes may cause choroidal thinning.
Choroid ; Eye ; Myopia ; Tokyo ; Tomography, Optical Coherence

BACKGROUND: Use of universal leukoreduction for prevention of leukocyte associated transfusion reactions is common practice in many countries. This study was conducted in order to evaluate the performance of a newly developed leukoreduction filter for red blood cells (RBCs), the RF300 (Kolon Industries, Inc, Gumi, Korea). METHODS: Filtration time, RBC recovery, residual leukocyte count, and leukocyte removal rate were evaluated. To assess the quality of RBCs after filtration, percent hemolysis was monitored for a period of 21 days. Performance of the RF300 (N=78) was compared with that of the Bio-R O2 plus (Fresenius, Hamburg, Germany), the Pall Purecell RC (Pall Co., Washington, USA), and the Sepacell R-500N (Asahi, Tokyo, Japan). RESULTS: The shortest filtration time was observed using the RF300 (P<0.05). Using the RF300, recovery of RBC was 96.5%, which was higher than that of two filters (P<0.05). Mean residual leukocyte count was 0.26x10(6)/unit, with a leukocyte removal rate of 3 log. Using the RF300, mean percent hemolysis was 0.32% at day 21, which was comparable with that of two filters, but lower than that of one filter (P<0.05). CONCLUSION: The RF300 meets all established quality requirements for conduct of safe and effective leukoreduction of RBCs.
Blood Group Incompatibility ; Collodion ; Erythrocytes ; Filtration ; Hemolysis ; Leukocyte Count ; Leukocytes ; Tokyo ; Washington

BACKGROUND: Delivery of Bacille Calmette-Gurein (BCG) Tokyo vaccine, with the multipuncture device, has been much preferred over BCG Pasteur, with the intradermal method, possibly due to the easier manner of administration, a desire to avoid any trouble with scars, as well as side effects and higher profits to providers in South Korea. METHODS: To determine BCG scar status in 0~6 year old children vaccinated with two BCG vaccines (Pasteur BCG vaccine with intradermal method and BCG Tokyo vaccine with percutaneous method), the data from the national BCG scar survey in 2006 was analyzed. RESULTS: Based on the national survey, the high proportion that were vaccinated with BCG Tokyo vaccines with the multipuncture method (64.5%) was noted in 0~6 year old Korean children. From inspection of scar formation, as an indicator of vaccination, the median number of the visible pin scars from the percutaneous method was 16 (interquartile range, 12~18) in the Korean children, and pin scars decreased as the age of the children increased (p<0.001). CONCLUSION: The findings in this survey clearly showed a growing preference of parents for the BCG Tokyo vaccines by the multipuncture method in South Korea.
BCG Vaccine ; Child ; Cicatrix ; Humans ; Mycobacterium bovis ; Parents ; Republic of Korea ; Tokyo ; Tuberculosis ; Vaccination ; Vaccines

PURPOSE: To evaluate changes in corneal and ocular high-order aberration, ocular fatigue, and tear break-up time (TBUT) before and after playing computer games and the correlations among the variables. METHODS: Thirty-nine normal healthy subjects played computer games for 1 hour. Ocular fatigue was evaluated with a questionnaire, TBUT was measured with slit-lamp biomicroscopy, and high-order aberrations were measured with a KR-1W aberrometer (Topcon Medical System, Inc., Tokyo, Japan) in each subject before and after playing computer games. The right eye was used for statistical analyses. RESULTS: Subjective ocular fatigue (expressed as the interview score) increased from 4.23 +/- 5.35 to 12.05 +/- 8.68 after playing games (p < 0.001) and TBUT decreased from 8.03 +/- 6.43 sec to 4.90 +/- 3.31 sec (p < 0.001). Ocular high-order aberrations in the 4 mm and 6 mm zones were not significantly changed before and after playing games (p = 0.150, p = 0.202, respectively). However, corneal high-order aberrations in the 4 mm and 6 mm zones were significantly increased after playing computer games (p = 0.002, p = 0.002, respectively). Changes in TBUT, interview score, and corneal high-order aberration were not correlated with each other. CONCLUSIONS: Playing computer games increased corneal high-order aberrations as well as subjective ocular fatigue and TBUT.
Eye ; Fatigue ; Surveys and Questionnaires ; Tokyo

PURPOSE: To formulate an equation to estimate corneal spherical aberration using Orbscan (Bausch & Lomb Surgical, Rochester, NY, USA) parameters. METHODS: The study was carried out retrospectively. The participants were 76 eyes of 76 senile cataract patients with the mean age of 57.37 +/- 17.63 years. Both Orbscan and KR-1W (Topcon Corp, Tokyo, Japan) were taken as preoperative examinations. Correlation analysis between various parameters from Orbscan and corneal spherical aberrations for a 6 mm pupil by KR-1W was performed. And multivariable linear regression was performed with the significantly correlated Orbscan parameters from the correlation analysis. RESULTS: The mean corneal spherical aberration from KR-1W system was 0.25 +/- 0.08 microm. As a result of the multivariable linear regression, we could generate following equations. If the Q-value was available, estimated corneal spherical aberration = 0.389 x Q-value + (0.022 x Axial power 3 mm) - 0.633 (R2 = 0.436). If the Q-value was not available, estimated corneal spherical aberration = 0.184 x (Mean power 5 mm - Mean power 3 mm) + (0.02 x Axial power 3 mm) - 0.563 (R2 = 0.429). By using the equations, 93.4-94.7% of subjects were in the error range of 0.10 microm. CONCLUSIONS: Even when equipped with Orbscan only, an appropriate aspheric intraocular lens can be selected using the estimated corneal apherical aberration by the equations.
Cataract ; Eye ; Humans ; Lenses, Intraocular ; Linear Models ; Pupil ; Retrospective Studies ; Tokyo