BACKGROUND: Glyphosate and its salt formulations are nonselective herbicides that have been extensively used worldwide, both for residential and agricultural purposes. The possible carcinogenicity and teratogenicity of glyphosate remain to be elucidated. We developed a sensitive and high-throughput analytical method for urinary glyphosate using liquid chromatography-tandem mass spectrometry with the aim of contributing to glyphosate exposure assessment in epidemiological studies. METHODS: After urine dilution (creatinine matching dilution to 0.05 g creatinine/L), glyphosate was extracted using two types of solid phase extraction columns (SCX and NH2) with automated sample preparation instruments. The eluate was dried and dissolved in the mobile phase, followed by liquid chromatography-tandem mass spectrometry analysis. The optimized method was applied to urine samples obtained from 54 Japanese adults and children. RESULTS: The results from the validation study demonstrated good recoveries (91.0-99.6%), within- and between-run precisions (< 15%), low detection limits (0.1 μg/L), and lower limit of quantification (0.3 μg/L). The detection frequency and median concentration of the urinary glyphosate in Japanese subjects were 59% and 0.25 μg/L (0.34 μg/g creatinine). CONCLUSIONS Our reliable determination method was successful in measuring urinary glyphosate concentration. Moreover, this is the first biomonitoring report of urinary glyphosate levels in the Japanese general population.
Adult ; Aged ; Chromatography, Liquid/methods* ; Female ; Glycine/urine* ; Humans ; Male ; Middle Aged ; Solid Phase Extraction/methods* ; Tandem Mass Spectrometry/methods*

OBJECTIVE: Rikkunshito, an herbal medicine, is widely prescribed in Japan for the treatment of anorexia and functional dyspepsia, and has been reported to recover reductions in food intake caused by cisplatin. We investigated whether rikkunshito could improve chemotherapy-induced nausea and vomiting (CINV) and anorexia in patients treated with cisplatin. METHODS: Patients with uterine cervical or corpus cancer who were to receive cisplatin (50 mg/m² day 1) and paclitaxel (135 mg/m² day 0) as first-line chemotherapy were randomly assigned to the rikkunshito group receiving oral administration on days 0–13 with standard antiemetics, or the control group receiving antiemetics only. The primary endpoint was the rate of complete control (CC: no emesis, no rescue medication, and no significant nausea) in the overall phase (0–120 hours). Two-tailed p<0.20 was considered significant in the planned analysis. RESULTS: The CC rate in the overall phase was significantly higher in the rikkunshito group than in the control group (57.9% vs. 35.3%, p=0.175), as were the secondary endpoints: the CC rate in the delayed phase (24–120 hours), and the complete response (CR) rates (no emesis and no rescue medication) in the overall and delayed phases (63.2% vs. 35.3%, p=0.095; 84.2% vs. 52.9%, p=0.042; 84.2% vs. 52.9%, p=0.042, respectively), and time to treatment failure (p=0.059). Appetite assessed by visual analogue scale (VAS) appeared to be superior in the rikkunshito group from day 2 through day 6. CONCLUSION: Rikkunshito provided additive effect for the prevention of CINV and anorexia.
Administration, Oral ; Anorexia* ; Antiemetics ; Appetite ; Cisplatin* ; Drug Therapy ; Dyspepsia ; Eating ; Herbal Medicine* ; Humans ; Japan ; Nausea* ; Paclitaxel* ; Time-to-Treatment ; Vomiting*

Laparoscopic distal gastrectomy has become widespread as a treatment for early gastric cancer in eastern Asia, but a standard method for setting the stomach transection line has not been established. Here we report a novel method of setting this line based on anatomical landmarks. At the start of the operation, two anatomical landmarks along the greater curvature of the stomach were marked with ink: the proximal landmark at the avascular area between the last branch of the short gastric artery and the first branch of the left gastroepiploic artery, and the distal landmark at the point of communication between the right and left gastroepiploic arteries. Just before specimen retrieval, the stomach was transected from the center of these two landmarks toward the lesser curvature. Then, about two-third of the stomach was reproducibly resected, and gastroduodenostomy was successfully performed in 26 consecutive cases. This novel method could be used as a standard technique for setting the transection line in laparoscopic distal gastrectomy.
Arteries ; Far East ; Gastrectomy* ; Gastroepiploic Artery ; Ink ; Stomach Neoplasms ; Stomach*

We report an extremely rare case of primary squamous cell carcinoma of the stomach. A 69-year-old man was admitted to our hospital with a 2-month history of dysphagia and tarry stools. Endoscopic examination revealed a cauliflower-shaped protruding mass along the lesser curvature of the gastric cardia. Biopsy of the lesion revealed squamous cell carcinoma of the stomach. Computed tomography revealed a thickened stomach wall and a mass protruding into the gastric lumen. Total gastrectomy with splenectomy, distal pancreatectomy, and Roux-en-Y reconstruction was performed, together with a lower thoracic esophagectomy via a left thoracotomy. Histopathological examination of the specimen revealed well-differentiated squamous cell carcinoma of the stomach. Postoperative follow-up was uneventful for the first 18 months. However, multiple liver metastases and para-aortic lymph node metastasis developed subsequently. Despite systemic combination chemotherapy, the patient died because of progression of the recurrent tumors. Here, we review the characteristics of 56 cases of gastric squamous cell carcinoma reported in Japan.
Aged ; Biopsy ; Carcinoma, Squamous Cell* ; Cardia ; Deglutition Disorders ; Drug Therapy, Combination ; Esophagectomy ; Follow-Up Studies ; Gastrectomy ; Humans ; Japan* ; Liver ; Lymph Nodes ; Neoplasm Metastasis ; Pancreatectomy ; Splenectomy ; Stomach Neoplasms ; Stomach* ; Thoracotomy

Purpose : To examine the characteristics of second-year residents intending to become primary care physicians.
Methods : Using a self-administered questionnaire, we surveyed 7344 second-year residents in March, 2006. Of the 4167 responders (response rate 56.7%), the 3838 who answered that they intended to make a career choice of being clinical practitioners were taken as subjects for analysis. The odds ratios (OR) for the intention of being a primary care physician was calculated, together with the 95% confidence interval (95% CI), using logistic regression models (primary care physicians intended=1 vs. specialist intended=0)
Results : In total, 56% of the residents affirmed an interest in becoming primary care physicians. Multiple stepwise logistic models showed that residents intending to become primary care physicians planned to open their own clinics in the future (OR 1.44, 95% CI : 1.20-1.73), did not wish to obtain doctor of medical science (DMSc) degrees (OR 1.29, 95% CI : 1.07-1.55), and were more likely to choose internal medicine (OR 1.44, 95% CI : 1.07-1.94).
Conclusion : This study demonstrated that second-year residents who aimed to be primary care physicians were associated with more interest in opening private clinics for their future practice, preferably in the field of internal medicine, and with less interest in earning DMSc degrees.

1)Professionalism should be explicitly introduced as a fundamental content into curricula/programs of undergraduate medical education, postgraduate clinical training, and of continuing medical education provided by professional societies and the Japan Medical Association.
2)We need to enhance our research activities on goals and objectives which should be accomplished through professionalism education, effective learning strategies, appropriate assessment methods, as well as the impact of informal and hidden curricula.
3)We propose that the medical profession should collaboratively develop various activities to win the trust of the general society in tandem with the introduction of professionalism education.

The number of female physicians is increasing. In Japan, marriage and child–bearing have been considered barriers preventing female physicians from working continuously. This study investigated the effects of marriage and child–bearing on career satisfaction among female physicians.
1)We surveyed the alumni of two private medical schools (University A: n=646; University B: n=316). The response rate was 38% for University A and 71% for University B.
2)When the subjects were asked if they were satisfied that they had chosen a career as a physician, 85%(n=400) answered that they were satisfied.
3)In total, 348 female physicians (74%) were married, and of them, 280 (80%) had experienced childbirth, and 259 (77%) were married to physicians.
4)Factors that significantly and positively affected career satisfaction were marriage for all female physicians and child–bearing for married female physicians.
5)The results of this study suggest that marriage and child–bearing, rather than being obstacles to career development, have positive effects on the career satisfaction of female physicians.

 Global health policies and strategies are influenced by world politics/economics and development. Thus, a clear and accurate understanding of global health requires proper knowledge of the history of world politics and economics. Since the end of World War II, world politics and economics have dramatically changed through the cold war era to the multipolar age. Meanwhile, the direction in which developing countries have progressed has been determined by select international financial organizations such as the International Monetary Fund and the World Bank in accordance with the policy of the USA Presidency.
 This paper reviews the history of global health policies and strategies in the context of world politics and economics as well as world development.

Introduction and Purpose
Overweight and obesity have recently emerged as major problems of malnutrition among children in developing countries. However, risk factors for childhood obesity in Asian countries remain largely unknown. Identification of target populations for its prevention and intervention is urgently needed. This survey was conducted to assess the prevalence of overweight and obesity and identify possible risk factors among kindergarten children in Ho Chi Minh City, Vietnam.
Methods
In this cross-sectional study conducted in March, 2005, 780 children in their third and fourth years in kindergarten and their mothers were randomly selected from eight local kindergartens. Height and weight of mother-child pairs were measured, and an interview was conducted by trained staff using a questionnaire in Vietnamese. Overweight/obesity was defined as a weight-for-height > 2 SD above the National Center for Health Statistics median reference value. Risk factors for overweight/obesity were analyzed using logistic regression.
Results
There were 741 respondents (377 boys and 364 girls); the response rate was 95.0%. Average age of children was 61.8 ± 6.8 months; the average age of mothers was 35.0 ± 5.2 years. The average height and weight were 110 ± 5.7cm and 21.2 ± 4.0kg respectively. Of the 741 children, 27.8% were identified as being overweight/obesity. Four possible variables selected were: 1) child's sex, 2) mother's awareness of her child's current body type, 3) mother's expectation for her child's body type in the future, 4) mother's awareness of her own current body type .
Conclusion
Our findings point to the importance of addressing appropriate body images in the management of children's nutritional health. Providing sufficient amounts of information on appropriate body type in addition to feeding practice to mothers should be a priority at the Ho Chi Minh City Nutrition Center to prevent child overweight and obesity.

Introduction
Women in northeast Asian countries follow special practices during prenatal and postnatal periods. The traditional ‘Yu fai’ custom in Thailand includes a food taboo known as kalum.This paper intends to describe the unknown details of parturient women's traditional taboos in northeast Thailand.
Methods
Ethnographic semistructured interviews in the Thai language were conducted in February 2006 with 10 women in northeast Thailand who had babies ranging in age from newborn to 6 years.
Results
The purpose of Yu fai is to enable a mother who has recently undergone parturition to recover her pregestation physical and mental conditions following childbirth. Some new mothers will complain of bad health if they fail to apply Yu fai. Certain food taboos and recommendations are part of the Yu fai practice, and each has a specific context based on traditional beliefs.
Conclusions
The three objectives of Yu fai are identified as follows: to recover the mother's body to its usual pregestation condition; to enable sufficient breast milk or the capability for future pregnancies; to endure a long and healthy life. Applying Yu fai will influence a mother's lifetime health conditions after childbirth. Each of the prohibited or recommended food items is the result of specific contexts based on traditional beliefs. However, Yu fai is now changing, along with urbanization and improved communications, even in the rural areas of northeast Thailand.