Background: This study aimed to evaluate the differences in common types of epidermal growthfactor receptor (EGFR) mutations in non-small cell lung cancer (NSCLC) with brain metastasis (BM) treated using linear accelerator-based stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (fSRT). Methods: Between January 2011–December 2023, among 294 consecutive patients with BMfrom NSCLC, 84 patients with EGFR-mutated NSCLC were enrolled in this study. Results: The median follow-up time after SRS/fSRT was 20.1 months (range: 0.6–109.7months), while the median overall survival (mOS) after SRS/fSRT was 25.1 months (95% confidence interval [CI]: 18.4–33.5 months). The mOS after initial treatment for NSCLC was 56.2 months (95% CI:41.7–77.0 months). The mOS after SRS/fSRT in 34 patients with exon 19 deletions and 45 patients with exon 21 mutations with L858R was 20.4 months (95% CI: 13.6–55.9 months) and 28.5 months (95% CI: 16.2–33.5). The two groups showed no difference in the mOS. In univariate analyses using the Cox proportional hazards model, no prognostic factors associated with prolonged survival were identified except for good pretreatment Karnofsky Performance Status score and no prior tyrosine kinase inhibitor use before SRS/fSRT in EGFR-mutated NSCLC. There was no difference in both distant failure and local control in the two groups. Conclusion The difference in survival between EGFR subtypes (exon 21 L858R mutations vs.exon 19 deletion) was not observed after SRS/fSRT in NSCLC.

BACKGROUND: The Hokkaido Study on Environment and Children's Health is an ongoing study consisting of two birth cohorts of different population sizes: the Sapporo cohort and the Hokkaido cohort. Our primary objectives are to (1) examine the effects that low-level environmental chemical exposures have on birth outcomes, including birth defects and growth retardation; (2) follow the development of allergies, infectious diseases, and neurobehavioral developmental disorders, as well as perform a longitudinal observation of child development; (3) identify high-risk groups based on genetic susceptibility to environmental chemicals; and (4) identify the additive effects of various chemicals, including tobacco. METHODS: The purpose of this report is to provide an update on the progress of the Hokkaido Study, summarize recent results, and suggest future directions. In particular, this report provides the latest details from questionnaire surveys, face-to-face examinations, and a collection of biological specimens from children and measurements of their chemical exposures. RESULTS: The latest findings indicate different risk factors of parental characteristics on birth outcomes and the mediating effect between socioeconomic status and children that are small for the gestational age. Maternal serum folate was not associated with birth defects. Prenatal chemical exposure and smoking were associated with birth size and growth, as well as cord blood biomarkers, such as adiponectin, leptin, thyroid, and reproductive hormones. We also found significant associations between the chemical levels and neuro development, asthma, and allergies. CONCLUSIONS Chemical exposure to children can occur both before and after birth. Longer follow-up for children is crucial in birth cohort studies to reinforce the Developmental Origins of Health and Disease hypothesis. In contrast, considering shifts in the exposure levels due to regulation is also essential, which may also change the association to health outcomes. This study found that individual susceptibility to adverse health effects depends on the genotype. Epigenome modification of DNA methylation was also discovered, indicating the necessity of examining molecular biology perspectives. International collaborations can add a new dimension to the current knowledge and provide novel discoveries in the future.
Biomarkers/blood* ; Child ; Child Health ; Child, Preschool ; Cohort Studies ; Environmental Exposure/adverse effects* ; Environmental Health ; Environmental Pollutants/adverse effects* ; Female ; Fetal Blood/chemistry* ; Follow-Up Studies ; Growth/drug effects* ; Humans ; Hypersensitivity/etiology* ; Infant ; Japan/epidemiology* ; Male ; Neurodevelopmental Disorders/etiology* ; Pregnancy ; Prenatal Exposure Delayed Effects/etiology* ; Prevalence ; Smoking/adverse effects*

Purpose: To clarify current status of nurses in support of children with parents with cancer in Akita Prefecture. Method: Questionnaire surveys were administered on nurses in Akita prefecture. Their experiences, educational backgrounds, and ability to recognize the need for support were examined. Descriptive statistics were used for the attributes, and chi-square test or Fisher’s exact Test or Wilcoxon rank sum test was used to examine the relationship between the support experience and the attributes (p<0.05). The contents of their open comments were then analyzed using a qualitative integration method. Results: Responses were obtained from 141 nurses at 10 facilities (collection rate: 43.9%). Of the 141 nurses, 135 (96%) recognized the necessity of support for children, and 28 (20%) already had experience supporting them. The contents of support were [direct support for children] [support for children through parents] [support through coordination and coordination with resources]. Most apparent difficulties in support were “Intervene for children” and “to have a connection with children”. Conclusion: The results indicate that nurses recognize that children need support. However, they lack experience in providing such support. It is necessary to enhance support by learning support methods and sharing information with other occupations. Support from parents is important when children cannot be met.

Background: and Purpose Although numerous measures for stroke exist, stroke remains one of the leading causes of death in Japan. In this study, we aimed to determine the long-term survival rate after first-ever stroke using data from a large-scale population-based stroke registry study in Japan. Methods: Part of the Shiga Stroke and Heart Attack Registry, the Shiga Stroke Registry is an ongoing population-based registry study of stroke, which covers approximately 1.4 million residents of Shiga Prefecture in Japan. A total 1,880 patients with non-fatal first-ever stroke (among 29-day survivors after stroke onset) registered in 2011 were followed up until December 2016. Five-year cumulative survival rates were estimated using the Kaplan-Meier method, according to subtype of the index stroke. Cox proportional hazards models were used to assess predictors of subsequent all-cause death. Results: During an average 4.3-year follow-up period, 677 patients died. The 5-year cumulative survival rate after non-fatal first-ever stroke was 65.9%. Heterogeneity was present in 5-year cumulative survival according to stroke subtype: lacunar infarction, 75.1%; large-artery infarction, 61.5%; cardioembolic infarction, 44.9%; intracerebral hemorrhage, 69.1%; and subarachnoid hemorrhage, 77.9%. Age, male sex, Japan Coma Scale score on admission, and modified Rankin Scale score before stroke onset were associated with increased mortality during the chronic phase of ischemic and hemorrhagic stroke. Conclusions In this study conducted in a real-world setting of Japan, the 5-year survival rate after non-fatal first-ever stroke remained low, particularly among patients with cardioembolic infarction and large-artery infarction in the present population-based stroke registry.

Many researchers report that cigarette smoking by parents adversely affects their children. We carried out a survey about cigarette puffing by distributing questionnaires to mothers of sucklings and little children. The survey found that mothers and family members were not well aware of the health consequences of passive smoking. It was also found that children frequently exposed to smoking are at high risk of contracting infections of the respiratory tract. The average weight at birth was less in babies borned by smoking mothers than by those who do not smoke. Furthermore, it was revealed that a larger number of smoking mothers had given birth to low birth weight infants than nonsmoking mothers had.
These findings suggested that passive cigarette smoking is linked to low birth weight and respiratory tract infection. We think it is incumbent on us, health-care professionals, to bring home to mothers and the rest of the family members how serious the consequences of passive smoking are.

Our survey was conducted at 522 elementary schools and junior high schools in Akita prefecture in July 1981. Thus the survey was intended for 105, 137 elementary school pupils bnd 51, 029 junior high school pupils. Questionnaires were sent to teachers in charge at each school. The return rate of questionnaires wan 98.4 % for elementary school and 100.0 % for junior high school. The rate of bronchial asthma was 1.2 %(boy 1.5 %, girl 0.9 %) in elementary school pupils and 0.6 %(boy 0.8 %, girl 0.5 %) in junior high school pupils. The number of schools where pupils with bronchial asthma were found was 205 elementary schools (56.0 %) and 71 junior high schools (47.0 %). The rate of bronchial asthma in boys was greater than girls, by 1.7 times in case of elementary school and 1.6 times in junior high school. The rate of bronchial asthma in urban children was 1.2 %, while that in rural children was 0.8 %. Out of the children interpreted as bronchial asthma at the time of our survey 82.4 % of the elementary school children and 77.6 % of the junior high school children with bronchial asthma were or had been undergoing apropriate treatment. The rate of children who are absent from school due to asthma more than 10 days a year was 24.4 % in elementary school and 26.7 % in junior high school.

We have carried out the mass survey for diabetes mellitus by a 50 g GTT as the first screening since 1971. Average incidences of diabetic pattern, IGT pattern, borderline pattern and normal pattern in a Glucose Tolerance Test (GTT) were 2.3±1.8%, 6.6±1.7%, 19.8±6.6% and 71.4 ±7.8%, respectively. 21 males and 6 females were found to be diabetic by this survey for 11 years. Insulinogenic indices (I. Is.) of diabetic, IGT, borderline and normal patterns were 0.13±0.07, 0.70±0.37, 0.58±0.40 and 1.05±0.30, respectively, and the values of I. I. in diabetics and borderline diabetics were significantly lower than that in the normal pattern. A I. I. in the subjects who have revealed the normal glucose tolerance every year for 11 year, 2.62±1.28, was high in the normal range. On the other hand, a I. I. in the subjects who became overtly diabetic from the IGT, borderline or normal pattern, 0.36±0.31, was significantly lower. Therefore, taking into consideration that one of the characteristics of NIDDM is low insulin response to glucose, the mass survey for diabetes mellitus should be carried out by a Glucose Tolerance Test (GTT) as the first screening with the measurement of plasma insulin concentrations. A follow-up study for the low insulin responder is considered to be one of the most preferable investigations for the detection of the early stage of diabetes mellitus.