Nagoya Journal of Medical Science

In order to improve the quality of medical care, an assessment of patients’ quality of life (QOL) has been recognized to be important as well as an assessment of physical impairment. Since diseases affect a wide range of QOL facets, including physical, emotional, and social conditions, disease severity and treatment effi cacy should not be assessed only by clinical parameters. Urinary incontinence has a strong infl uence on patients’ QOL. Health-related QOL is a multidisciplinary and subjective construct that refers to an individual’s perception of his/her state of health or disease. The treatment of urinary incontinence should be selected based on questionnaires. Since 1987, various questionnaires for QOL assessment in patients with urinary incontinence have been developed. During the meeting of the International Consultation on Incontinence (ICI), held in 1998, 2001, and 2004, various QOL questionnaires for urinary incontinence were assessed and ranked based on scientifi c verifi cations. This paper describes the infl uence of urinary incontinence on QOL and the measurement of QOL in patients with several urinary problems.

Mouse embryonic stem (ES) cells are pluripotent and retain their potential to form cells, tissues and organs originated from three embryonic germ layers. Recently, we developed in vitro organ — gut-like structures — from mouse ES cells. They had basically similar morphological features to a mouse gastrointestinal tract in vivo composed of three distinct layers (i.e., epithelium, connective tissue and musculature). Gut-like structures showed spontaneous contractions derived from pacemaker cells (interstitial cells of Cajal) in the musculature. We also examined their formation process and expression pattern of transcription factors crucial for gut organogenesis such as Id2, Sox17, HNF3β/Foxa2 and GATA4. We found that they mimic the development of embryonic gut in vivo and showed a similar expression pattern of common transcription factors. They also maintain their developmental potential after transplantation to a renal capsule. Therefore, gut-like structures are suitable for in vitro models of gastrointestinal tracts and their development. In addition, we pointed out several unique features different from gut in vivo that provide useful and advantageous tools to investigate the developmental mechanism of the gastrointestinal tract.

Recently, in Western countries, metabolic syndrome as well as such classical risk factors as hypertension and smoking has been considered to be closely associated with the occurrence of acute myocardial infarction (AMI). Therefore, we conducted a case-control study to investigate how the co-morbidity of obesity or thinness with hypertension, hyperlipidemia and diabetes mellitus would affect AMI occurrence among Japanese aged 30 to 69. Cases were comprised of 788 patients (590 men and 198 women) registered in the “Aichi Prefecture Cardiovascular Disease Registry Program” during hospitalization due to their fi rst AMI attack. Controls were 2,300 randomly sampled inhabitants (1,142 men and 1,158 women) who responded to the questionnaire survey on lifestyle. We decided BMI < 18.5 as thin, 18.5 <= BMI < 25.0 as normal, and BMI >= 25.0 as obese, then divided subjects into six groups according to the presence or absence of histories of the above-mentioned three diseases in connection with their physique. In both sexes, multivariately adjusted odds ratios of fi rst AMI attacks were much higher in groups with such histories (men, 4.14~5.07; women, 5.62~15.24) than in those without them (men, 0.90~1.13; women, 1.54~3.03) regardless of physique. Only in women, obesity uncombined with histories was signifi cantly associated with AMI occurrence and not obesity but thinness intensifi ed the association between histories and AMI. Among the six groups, population attributable risk percent was highest in the normal physique group with histories. It was suggested that persons with disease histories should be carefully treated irrespective of the presence or absence of obesity.

In order to examine whether a notifi cation of genotypes related to a susceptibility to smoking has any infl uence on an intention to quit, a pilot study was conducted for 61 smokers out of 66 municipal government employees who attended an anti-smoking seminar in November 2005 or January 2006 (MG), and for 46 smokers (employees and students) on a medical campus (Tsurumai Campus) of Nagoya University (TC), who voluntarily responded to the study enrollment notice in August 2006. They were genotyped for four polymorphisms; GSTM1 null/present, GSTT1 null/present, NQO1 C609T, and CYP1A1 Ile/Val. For the MG group, their smoking habits were ascertained three times; at enrollment, one month later just before the genotype notifi cation by in-house mail, and three months after the notifi cation. The smoking cessation rate was 8.2%. For the TC group, their genotypes were mailed two weeks after blood sampling. The follow-up questionnaire three months after the genotype notifi cation found a 10.9% cessation rate. Their stage of smoking cessation signifi cantly improved after the genotype notifi cation. This study demonstrated that the effects of the genotype notifi cation in this context of smoking cessation were moderate and less remarkable than might have been expected. Although the genotype notifi cation in TC improved their stage of readiness to quit smoking, additional skills or tools in support of the notifi cation are needed to achieve a higher cessation rate.

The prevalence of HIV/AIDS in Mongolia is still low. Only 29 HIV/AIDS cases have been registered in Mongolia with a population of 2.6 millions, as of April, 2007. In all of the cases the infection has been sexually transmitted and almost 90.0% of total HIV/AIDS cases have been detected since 2005. Past studies conducted in Mongolia indicated that sexually transmitted infections (STIs) had been spreading rapidly among high risk groups, which highlights an urgent need for prevention mainly targeting these groups. This study was conducted to evaluate HIV/AIDS related knowledge/behaviors, as well as to assess the prevalence of HIV and syphilis among female sex workers (SWs) in two major cities of Mongolia. A total of 342 sex workers (199 females from Darkhan and 143 females from Ulaanbaatar city) with the mean age of 25.8 years participated in the study. In Darkhan, HIV/AIDS related knowledge of SWs was higher (99.0%) and the prevalence of syphilis was lower (3.5%) than in Ulaanbaatar (88.8% and 36.0%, respectively). No new HIV cases among the female SWs have been detected despite high syphilis rates (17.4%) among the study subjects. Although condom use at last sex with paying clients was high (92.3%), the rate was low with non-paying, non-regular sex partners (56.9%). These fi ndings indicated that despite relatively good HIV/AIDS related knowledge, high risk sexual behaviors were still common among the female SWs.

Previous experimental research showed an attenuated vasoconstrictor response after acute exercise. This study aims to determine the effect of aerobic physical exercise on the endothelium-derived circulating nitric oxide (NO) concentrations among healthy young persons. A total of 10 subjects (5 men and 5 women) aged 21–28 were examined for the difference in concentrations of serum and plasma NO metabolites (NOx) before and after a single bout of aerobics, in which they performed cycling exercises at a constant workload corresponding to 90% of the subject-specifi c anaerobic threshold. A paired t-test resulted in no statistically signifi cant differences between pre- and post-exercise concentrations of serum or plasma NOx. It is suggested that the acute effect of aerobic exercise on the vasoconstrictor/vasodilator response is not mediated by an increase in the endothelial NO release.