Theatrical work using Japanese text: portfolio of compositions and commentary

My main research was to write a theatrical work combining Japanese text with music that is to be performed as ‘shadow play’ theatre. This was my first attempt to create such a large-scale work, writing both the music and the text. There have been discoveries during the process of working on this large project. Most significant was my awareness of what makes my creation more ‘individual’ or ‘original’ as a composer. Personal experiences and background are basically reflected on determinations of what is to be written next and how to process materials. In my case, these determinations often come out of my experience of the mixed cultural environment which is that of Japan, even if it is not my intention to be ‘Japanese’. Among the elements behind Japanese culture, I discovered key words which are time, space, colour and nuance, and these, particularly, became my strong concerns. The portfolio comprises seven works which I composed during the research period, which was from 2004 until 2010. The first part of this commentary will be a description of my thoughts on composition, particularly on what made my works individual and original. In the second part, I will be focusing on the details of my main work Kosatsuki for shadow play. The portfolio comprises the following seven pieces. • dialogues for ensemble (2004) • The brother sun, the sister moon for cello and piano (2005) • In the Gray Dawn for orchestra (2006) • The moon out of the blue for ensemble (2007) • Echoes from the inland sea for string quartet (2007) • Song of the Muro Women for voice and piano (2008) • Kosatsuki for shadow play theatre (2010) comprising a script and a score Recordings of the following pieces are also found on the CD enclosed. [mp3 files encoded and apended here] • dialogues for ensemble (2004) • The brother sun, the sister moon for cello and piano (2005) • The moon out of the blue for ensemble (2007

Variations in societal characteristics of spatial disease clusters: examples of colon, lung and breast cancer in Japan

BACKGROUND: Spatial analyses and ecological studies are essential for epidemiology and public health. The present study combining these two methods was performed to identify spatial clusters of selected types of cancer in Japan and to determine their societal characteristics focusing on homogeneity among clusters. RESULTS: Spatial clusters of high mortality rates of male colon and lung cancer and of female breast cancer were identified by the spatial scan statistic using Japanese municipal data (N = 3360) from 1993 to 1998 and also municipalities were divided into four societal clusters based on socioeconomic indicators and population density (urban-rich, suburban, rural-poor, and clutter). Five, seven, and four mortality clusters were identified for lung, colon and breast cancer, respectively. For colon and breast cancer, most municipalities of all except one cluster were included in a single societal cluster (urban-rich). The municipalities associated with mortality clusters for lung cancer belonged to various societal clusters. CONCLUSION: Increased mortality rates of colon and breast cancer can be explained by homogenous societal characteristics related to urbanisation, although there were exceptional areas with higher mortality rates. The regional variation in lung cancer mortality rate appeared to be due to heterogeneous factors. These findings and the analysis performed in the present study will contribute to both nationwide and region-specific cancer prevention strategies

Prevalence of and factors influencing posttraumatic stress disorder among mothers of children under five in Kabul, Afghanistan, after decades of armed conflicts

<p>Abstract</p> <p>Background</p> <p>In the period following wars and other forms of armed conflict, health and quality of life of mothers is a major concern as they have the closest contact with children. The present study was performed to examine the impact of exposure to events related to armed conflicts on post traumatic stress disorder (PTSD) among women raising children, and to identify factors that alleviate the negative consequences of exposure to traumatic events.</p> <p>Methods</p> <p>A structured interview survey was conducted in Kabul Province, Afghanistan, in 2006. The subjects were the mothers of children less than 5 years old randomly selected from 1400 households in Kabul Province, Afghanistan. Symptoms of PTSD were assessed according to the criteria of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Exposure to traumatic events related to armed conflict, experience of hardship with regard to basic needs, resources that the subjects seek for mental health support, and socioeconomic variables were evaluated. Logistic regression analysis was performed to determine the association between PTSD symptoms and predictor variables.</p> <p>Results</p> <p>The prevalence rate of PTSD among 1172 women participated in this study was 29.8%. The most prevalent symptom was arousal (74.8%), followed by re-experiencing (54.9%) and avoidance (33.7%). The prevalence rate of PTSD symptoms among subjects who reported having experienced at least one event related to armed conflict (52.7%) was significantly higher than that among those who reported no such experiences (9.6%). Experience of food shortage was independently associated with PTSD. Seeking support for mental health was related to lower prevalence of PTSD symptoms among those who reported no direct experience of events related to armed conflict. However, no such relationship was observed with PTSD symptoms among those who reported having direct experience of events related to armed conflict.</p> <p>Conclusion</p> <p>Direct exposure to traumatic events was significantly associated with PTSD symptoms among women raising children. For those who had experienced armed conflict-related events, food security mitigated the occurrence of PTSD symptoms; however, support seeking behavior did not show a significant mitigating influence on PTSD. Means to alleviate the negative influence of exposure to armed conflicts on the quality of life of women should be developed from the viewpoint of quality of mental health support and avoidance of material hardship.</p

Impact of conflict on infant immunisation coverage in Afghanistan: a countrywide study 2000–2003

<p>Abstract</p> <p>Background</p> <p>Infant immunisation is an effective public health intervention to reduce the morbidity and mortality of vaccine preventable diseases. However, some developing countries fail to achieve desirable vaccination coverage; Afghanistan is one such country. The present study was performed to evaluate the progress and variation in infant immunisation coverage by district and region in Afghanistan and to assess the impact of conflict and resource availability on immunisation coverage.</p> <p>Results</p> <p>This study analysed reports of infant immunisation from 331 districts across 7 regions of Afghanistan between 2000 and 2003. Geographic information system (GIS) analysis was used to visualise the distribution of immunisation coverage in districts and to identify geographic inequalities in the process of improvement of infant immunisation coverage. The number of districts reporting immunisation coverage increased substantially during the four years of the study. Progress in Bacillus Calmette-Guerin (BCG) immunisation coverage was observed in all 7 regions, although satisfactory coverage of 80% remained unequally distributed. Progress in the third dose of Diphtheria-Pertussis-Tetanus (DPT3) immunisation differed among regions, in addition to the unequal distribution of immunisation coverage in 2000. The results of multivariate logistic regression analysis indicated a significant negative association between lack of security in the region and achievement of 80% coverage of immunisation regardless of available resources for immunisation, while resource availability showed no relation to immunisation coverage.</p> <p>Conclusion</p> <p>Although progress was observed in all 7 regions, geographic inequalities in these improvements remain a cause for concern. The results of the present study indicated that security within a country is an important factor for affecting the delivery of immunisation services.</p

コウカセイ エシセイ ジュウカクエン オ ハッショウ シタ カガク チシ シュウイエン ノ 1レイ

We present a case of pericoronitis of lower wisdom tooth leading to descending necrotizing mediastinitis. A 52-year-old man visited our hospital because of swelling and pain in buccal region on the right side in spite of chemotherapeutics at a practicing physician, whose diabetic nephropathy had been treated with dialysis treatment by the same physician. Orthopantomography elucidated an impacted wisdom tooth of the right side mandible and osteosclerosis around there. CT revealed inflammatory thickening of subcutaneous fat tissue from buccal to cervical region. In the blood examination, the values of WBCs, RBCs, platelets, CRP, AST, LDH, TG, BUN, creatinine, GLU, K and Ca increased abnormally, while those of hemoglobin, MCV，MCH，MCHC, albumin, Cl, decreased extraordinarily. Immediate medication of antibiotics was worked out under a clinical diagnosis of pericoronitis of lower wisdom tooth, periostitis of the mandible and cervical cellulitis. Nevertheless, rapid inflamation progressed downward; mediastinal abscess was found by CT image taken 6 days later from the beginning of the therapy. Immediately, extraction of pathogenic teeth, cervical drainage, and transcervical and transthoracic mediastinal drainage were performed under a diagnosis of descending necrotizing mediastinitis. Moreover, bacterial examination was performed using a pus specimen derived from abscess; α-Streptococcus and Prevotella intermedia were detected. CT taken 2 weeks later from the beginning of the therapy revealed continuing bilateral pleural and pericardial effusion in spite of intensive care. Unfortunately he was died of multi organ failure caused by septic shock a month later from the beginning of the therapy

PREVENTION OF ROS GENERATION VIA STABILIZATION OF Nrf2 ACTIVATION

Chemotherapy‑induced oral mucositis is a common adverse event in patients with oral squamous cell carcinoma, and is initiated through a variety of mechanisms, including the generation of reactive oxygen species (ROS). In this study, we examined the preventive effect of γ‑tocotrienol on the 5‑FU‑induced ROS production in human oral keratinocytes (RT7). We treated RT 7 cells with 5‑FU and γ‑tocotrienol at concentrations of 10 μg/ml and 10 nM, respectively. When cells were treated with 5‑FU alone, significant growth inhibition was observed as compared to untreated cells. This inhibition was, in part, due to the RO S generated by 5‑FU treatment, because N‑acetyl cysteine (NAC), a RO S scavenger, significantly ameliorated the growth of RT7 cells. γ‑tocotrienol showed no cytotoxic effect on the growth of RT 7 cells. Simultaneous treatment of cells with these agents resulted in the significant recovery of cell growth, owing to the suppression of RO S generation by γ‑tocotrienol. Whereas 5‑FU stimulated the expression of NF‑E2‑related factor 2 (Nrf2) protein in the nucleus up to 12 h after treatment of RT 7 cells, γ‑tocotrienol had no obvious effect on the expression of nuclear Nrf2 protein. Of note, the combined treatment with both agents stabilized the 5‑FU‑induced nuclear Nrf2 protein expression until 24 h after treatment. In addition, expression of Nrf2‑dependent antioxidant genes, such as heme oxygenase‑1 (HO‑1) and NAD(P)H:quinone oxidoreductase‑1 (NQO‑1), was significantly augmented by treatment of cells with both agents. These findings suggest that γ‑tocotrienol could prevent 5‑FU ‑induced ROS generation by stabilizing Nrf2 activation, thereby leading to ROS detoxification and cell survival in human oral keratinocytes

PREVENTION OF ROS GENERATION VIA STABILIZATION OF Nrf2 ACTIVATION

Chemotherapy‑induced oral mucositis is a common adverse event in patients with oral squamous cell carcinoma, and is initiated through a variety of mechanisms, including the generation of reactive oxygen species (ROS). In this study, we examined the preventive effect of γ‑tocotrienol on the 5‑FU‑induced ROS production in human oral keratinocytes (RT7). We treated RT 7 cells with 5‑FU and γ‑tocotrienol at concentrations of 10 μg/ml and 10 nM, respectively. When cells were treated with 5‑FU alone, significant growth inhibition was observed as compared to untreated cells. This inhibition was, in part, due to the RO S generated by 5‑FU treatment, because N‑acetyl cysteine (NAC), a RO S scavenger, significantly ameliorated the growth of RT7 cells. γ‑tocotrienol showed no cytotoxic effect on the growth of RT 7 cells. Simultaneous treatment of cells with these agents resulted in the significant recovery of cell growth, owing to the suppression of RO S generation by γ‑tocotrienol. Whereas 5‑FU stimulated the expression of NF‑E2‑related factor 2 (Nrf2) protein in the nucleus up to 12 h after treatment of RT 7 cells, γ‑tocotrienol had no obvious effect on the expression of nuclear Nrf2 protein. Of note, the combined treatment with both agents stabilized the 5‑FU‑induced nuclear Nrf2 protein expression until 24 h after treatment. In addition, expression of Nrf2‑dependent antioxidant genes, such as heme oxygenase‑1 (HO‑1) and NAD(P)H:quinone oxidoreductase‑1 (NQO‑1), was significantly augmented by treatment of cells with both agents. These findings suggest that γ‑tocotrienol could prevent 5‑FU ‑induced ROS generation by stabilizing Nrf2 activation, thereby leading to ROS detoxification and cell survival in human oral keratinocytes

イチジルシイ コツキュウシュウ オ トモナッタ シセイ ジョウガクドウエン ノ 1レイ

We present a case of odontogenic maxillary sinusitis with marked perisinuous bone resorption. A 29-year-old man visited to our hospital because of pain in buccal region on left side after extraction of teeth at a dental practitioner. Orthopantomography and CT were performed and revealed inflammatory thickening of maxillary sinus mucosa and marked perisinuous bone resorption. In the blood examination, the values of WBCs and CRP were elevated abnormally. Moreover, bacterial examination was performed using the exudate from maxillary sinus through a fistula after extraction of teeth; α-Streptococcus, Prevotella buccae, Prevotella intermedia, Prevotella melaninogenica and Acinetobacter baumannii were detected. First, medication of antibiotics and irrigation of maxillary sinus was worked out under a clinical diagnosis of odontogenic maxillary sinusitis. These therapies didn't change perisinuous bone resorption for the better. Sequestrum and mucosa of maxillary sinus were biopsied to examine thoroughly; diagnosis of odontogenic maxillary sinusitis was confirmed histopathologically. Moreover, biochemical examination of blood showed normal serum level of specific markers for bone metabolism or Aspergilli. The similar therapies were continued from then and perisinuous bone resorption stopped suddenly for unknown reasons 3 months after these therapies. Time course of perisinuous bone regeneration was found by CT. Finally, operation to close the antrooral fistula with palatal flap was performed. There has been no relapse of inflammation for more than 5 years