Objectives: In a mouse model, aldehyde dehydrogenase 2 (ALDH2) knockout resulted in lower bone mineral density; however, higher parathyroid hormone receptor expression than wild-type mice. This study aimed to investigate whether ALDH2 polymorphisms influence efficacy of intermittent parathyroid hormone therapy and bone mineral density changes in humans. Methods: Eighty-two patients with primary osteoporosis treated with parathyroid hormone for > 1 year were divided into wild-type ALDH2 (ALDH2*1) and variant (ALDH2*2) groups. Bone mineral densities were measured by dual-energy X-ray absorptiometry. Changes in bone mineral density, treatment response, bone turnover markers, and new fracture incidence were evaluated. Furthermore, bone mineral density was analyzed using a mixed-effects model. Results: Femoral neck bone mineral density increased by 1.0 ± 7.4% in the ALDH2*1 group and 4.3 ± 8.1% in the ALDH2*2 group (P < 0.05), whereas lumbar spine bone mineral density increased by 5.7 ± 8.2% and 9.4 ± 9.1% without significance. Treatment success rates were higher in ALDH2*2 group (femoral neck 38.7%, lumbar spine 68.8%) compared with ALDH2*1 (16.3%, 51.0%). Statistical significance was observed only at the femoral neck. Bone turnover markers and fracture incidence were comparable between groups. Mixed-effects analysis adjusting for confounders showed a significant ALDH2 genotype × duration interaction for femoral neck, indicating genotype-related differences in the rate of bone mineral density increase over time. For lumbar spine, the genotype main effect was significant, whereas the interaction was not. Conclusions These findings suggest that ALDH2 polymorphisms may influence the therapeutic response to PTH treatment and highlight the need for larger future studies.

Methods: Lateral radiographs were obtained from 100 healthy adults in standing and seated postures at 25°, 35°, and 45° recline angles. Spinal parameters (cervical lordosis, thoracic kyphosis, thoracolumbar kyphosis, lumbar lordosis, sacral slope, pelvic tilt, and T1 spinopelvic inclination) and seat belt metrics (X-value, Z-value, and lap belt angle) were measured. Multivariate regression was used to assess associations with sex, age, height, and body mass index (BMI). Results: Reclining reduced cervical/lumbar lordosis and sacral slope, while thoracic kyphosis and pelvic tilt increased. Higher BMI was associated with a cranially shifted and more horizontal lap belt. Taller individuals showed greater T1 spinopelvic inclination and pelvic parameters. Females exhibited more pronounced thoracic kyphosis and pelvic retroversion across reclining angles. Conclusions Car seat recline significantly alters spinal alignment and seat belt positioning, with changes influenced by age, height, and BMI. These findings support ergonomic improvements in seat design and may inform surgical planning for ASD.

Background/Aims: In patients undergoing endoscopic extraction of common bile duct stones (CBDs) and subsequent cholecystectomy, CBDs sometimes recur during the preoperative and perioperative periods. In this study, the incidence and risk factors for CBDs recurrence were investigated. Methods: A total of 245 patients (mean age: 66 years; 138 men) who underwent cholecystectomy within 180 days of CBDs extraction between October 2017 and June 2023 were included. Recurrence was defined as the detection of the CBDs during the preoperative or perioperative period using imaging modalities such as computed tomography or re-endoscopic retrograde cholangiopancreatography, regardless of the presence of cholangitis. Results: CBDs recurrence occurred in 4.1% of the patients (10/245). The median time to recurrence was 40 days. Preoperative recurrence was observed in nine patients, and only one patient had postoperative recurrence. Multivariate analysis identified cystic duct stones as the only significant risk factor for CBDs recurrence (hazard ratio, 15.6; 95% confidence interval, 3.7–66; p<0.001). Conclusions The risk of CBDs recurrence after endoscopic extraction during the pre and perioperative periods is high in patients with cystic duct stones. Prophylactic biliary stenting may be considered in high-risk patients.

BACKGROUND: Meals are provided at nursery schools for Japanese preschool children, and this may result in different energy and nutrient intakes on weekdays and weekends. The purpose of this study was to obtain basic information for public nutrition policies in early childhood by examining differences in energy and nutrient intakes of preschool children between weekdays and weekends using meal categories such as breakfast, lunch, dinner, and snacks. METHODS: Energy and nutrient intakes were examined in 761 Japanese preschool children (423 boys, 338 girls) aged 3-6 years attending childcare facilities in seven regions in Japan. Data collection was based on non-consecutive four-day dietary records (two weekdays, two weekend days) in 2019 or 2020. Energy and nutrient intake by meal category were compared using a generalized linear mixed model adjusted for demographic factors. RESULTS: Total energy intake was significantly higher on weekdays for boys (1,478 vs. 1,415 kcal) and girls (1,349 vs. 1,296 kcal) (both P < 0.001). Weekday lunches had higher protein content and essential micronutrients such as potassium, iron, vitamins, and lower fat, saturated fatty acids, and salt, compared to weekend lunches. Similarly, weekday snacks also had significantly higher nutritional consumption for most nutrients compared to weekend equivalents. CONCLUSION These findings suggest that meals at nursery schools, particularly lunch and snacks, result in more desirable nutrient intake in preschool children. On weekdays, children consume meals with higher nutrient density, possibly due to the role of dietitians in menu planning. However, some children still fail to meet the Dietary Reference Intakes for Japanese, indicating a need for improvements in nursery school and home meals. More communication is needed between nursery schools and families, including sharing menus and recipes is essential. The results of this study are of value for development of public health nutrition strategies targeting early childhood.
Humans ; Child, Preschool ; Male ; Japan ; Female ; Energy Intake ; Meals ; Child ; Nutrients/analysis* ; Diet/statistics & numerical data* ; East Asian People

BACKGROUND: Chronic constipation is a long-term problem that decreases children's quality of life. Information and communication technology devices have developed rapidly in recent decades and have had various impacts on children. This prospective cohort study examined the association between television/digital versatile disc (TV/DVD) screen exposure time at age 1 and the risk of chronic constipation at age 3. METHODS: Data from 63,697 infants in the Japan Environment and Children's Study (JECS) were analyzed. We divided participants into five groups according to TV/DVD exposure time per day: no exposure (0 h), short exposure (<1 h), middle exposure (1.0-<2.0 h), long exposure (2.0-<4.0 h), and very long exposure (≥4 h). Logistic regression analysis was performed to assess the association between TV/DVD exposure time and the risk of constipation. For logistic regression analysis, odds ratios (ORs) were adjusted for sex, parents' education, household income, nursery school, feeding contents, and obesity. The interaction between the sexes was also examined. RESULTS: The prevalence of constipation for males, females, and all participants at age 3 was 9.3, 11.0, and 10.1%, respectively. The TV/DVD screen time distribution per day at age 1 was 10.6% for none, 34.1% for short, 29.9% for middle, 19.2% for long, and 6.2% for the very long exposure group. After adjusting for confounding factors, a dose-response pattern was identified between TV/DVD exposure time and constipation in all participants (p for trend < 0.001). The adjusted ORs increased progressively in the short (OR 1.15, 95% confidence interval [CI] 1.04-1.27), middle (OR 1.22, 95% CI 1.11-1.35), long (OR 1.37, 95% CI 1.24-1.52), and very long exposure groups (OR 1.53, 95% CI 1.35-1.74). This association was not significantly different between the sexes (p for interaction = 0.36). CONCLUSIONS Longer TV/DVD exposure time at age 1 was associated with the risk of chronic constipation at age 3. Excessive screen exposure may need to be avoided from infancy to decrease the risk of chronic constipation in later years.
Humans ; Constipation/etiology* ; Male ; Female ; Japan/epidemiology* ; Television/statistics & numerical data* ; Child, Preschool ; Infant ; Screen Time ; Prospective Studies ; Risk Factors ; Chronic Disease/epidemiology* ; Prevalence

Background/Aims: The factors affecting the detection rate of lymphoplasmacytic sclerosing pancreatitis (LPSP) using endoscopic ultrasound-guided tissue acquisition (EUS-TA) in patients with type 1 autoimmune pancreatitis (AIP) have not been thoroughly studied. Therefore, we conducted a retrospective study to identify the predictive factors for histologically detecting level 1 or 2 LPSP using EUS-TA. Methods: Fifty patients with AIP were included in this study, and the primary outcome measures were the predictive factors for histologically detecting level 1 or 2 LPSP using EUS-TA. Results: Multivariate analysis identified the use of fine needle biopsy (FNB) needles as a significant predictive factor for LPSP detection (odds ratio, 15.1; 95% confidence interval, 1.62–141; ¬¬p=0.017). The rate of good-quality specimens (specimen adequacy score ≥4) was significantly higher for the FNB needle group than for the fine needle aspiration (FNA) needle group (97% vs. 56%; p<0.01), and the FNB needle group required significantly fewer needle passes than the FNA needle group (median, 2 vs. 3; p<0.01). Conclusions The use of FNB needles was the most important factor for the histological confirmation of LPSP using EUS-TA in patients with type 1 AIP.

Idiopathic inflammatory myopathies (IIM) are a heterogeneous group of autoimmune diseases characterized by muscle involvement and various extramuscular manifestations. Interstitial lung disease (ILD) is one of the most common extramuscular manifestations of IIM and is associated with significant mortality and morbidity. The clinical phenotypes, treatment responses, and prognosis of IIM-ILD are significantly related to myositis-specific antibody (MSA) profiles, with some racial differences. The features associated with MSA in IIM-ILD could also be relevant to cases of ILD where MSA is present but does not meet the criteria for IIM. The anti-melanoma differentiation-associated gene 5 antibody is highly associated with rapidly progressive ILD (RP-ILD), especially in Asian populations, and with characteristic cutaneous manifestations, such as skin ulcers. Radiologically, ground-glass opacities, consolidations, and nonsegmental linear opacities were more predominant than reticular opacities and honeycombing. While the mortality rate is still around 30%, the prognosis can be improved with early intensive therapy with corticosteroids and multiple immunosuppressants. In contrast, anti-aminoacyl-tRNA synthetase (ARS) antibodies are associated with chronic ILD, although RP-ILD is also common. Patients with anti-ARS antibodies often show lung-predominant presentations, with subtle muscle and skin involvement. Radiologically, reticular opacities, with or without consolidation, are predominant and may progress to honeycombing over time. Combination therapy with corticosteroids and a single immunosuppressant is recommended to prevent relapses, which often lead to a decline in lung function and fatal long-term outcomes. Significant advances in immunology and genetics holds promise for fostering more personalized approaches to managing IIMILD.

Background/Aims: The factors affecting the detection rate of lymphoplasmacytic sclerosing pancreatitis (LPSP) using endoscopic ultrasound-guided tissue acquisition (EUS-TA) in patients with type 1 autoimmune pancreatitis (AIP) have not been thoroughly studied. Therefore, we conducted a retrospective study to identify the predictive factors for histologically detecting level 1 or 2 LPSP using EUS-TA. Methods: Fifty patients with AIP were included in this study, and the primary outcome measures were the predictive factors for histologically detecting level 1 or 2 LPSP using EUS-TA. Results: Multivariate analysis identified the use of fine needle biopsy (FNB) needles as a significant predictive factor for LPSP detection (odds ratio, 15.1; 95% confidence interval, 1.62–141; ¬¬p=0.017). The rate of good-quality specimens (specimen adequacy score ≥4) was significantly higher for the FNB needle group than for the fine needle aspiration (FNA) needle group (97% vs. 56%; p<0.01), and the FNB needle group required significantly fewer needle passes than the FNA needle group (median, 2 vs. 3; p<0.01). Conclusions The use of FNB needles was the most important factor for the histological confirmation of LPSP using EUS-TA in patients with type 1 AIP.