Effect of Laughter Yoga on Pulmonary Rehabilitation in Patients with Chronic Obstructive Pulmonary Disease.

Objective: To evaluate the clinical usefulness of laughter yoga for patients with chronic obstructive pulmonary disease (COPD) in a pulmonary rehabilitation setting. Design: Pilot study, with randomization of participants. Setting: This study was conducted by the Yoshino-cho National Health Insurance Yoshino Hospital Department of Internal Medicine. Participants: Stable outpatients with COPD (7 men and 1 woman, age 64 to 84 years) participated in the pulmonary rehabilitation program during a 2-week period. Intervention : The patients were divided into two groups based on a sealed envelope randomization method. The laughter yoga group had a 10-min laughter yoga session before exercise training. Patients in both groups had exercise training, educational programs, lung physiotherapy, and nutrition counseling. Outcome Measures: Health-related quality of life using the St. George's Respiratory Questionnaire (SGRQ) and the Medical Research Council (MRC) Health Survey Short Form 36-item (SF-36), depression scores using the Self-rating Depression Scale (SDS), anxiety scores using State-Trait Anxiety Inventory (STAI), and spirometry, the 6-minute walk test and mMRC dyspnea scale results were evaluated before and at 2 weeks after the program in both groups. Results: There were significant improvements in the SGRQ impacts domain and the SF-36 general health domain in the laughter yoga group, while the SF-36 physical functioning domain significantly improved in the control group. SDS and STAI result did not significantly change in either group. Spirometry, the 6-minute walk test, and MRC dyspnea scale results did not significantly change in either group. Conclusion: Laughter yoga may improve the psychological quality of life in patients with COPD

Health impact assessment of PM2.5-related mitigation scenarios using local risk coefficient estimates in 9 Japanese cities

Previous studies have highlighted the negative effects of PM2.5 on mortality, expressed in terms of attributable deaths and life years lost. However, there are very few studies assessing the health impacts of air pollution in terms of economic burden/benefits. This study assessed the health impact of two hypothetical interventions among sex- and age-specific risk populations using a robust risk estimation and economic valuation process. We utilized the sex- and age-stratified daily all-cause mortality together with the daily PM2.5 of the 9 Japanese cities from 2002 to 2008 in estimating the relative risks. The estimated risks were then utilized for the economic valuation of co-benefits/burden with respect to the two hypothetical PM2.5-related mitigation scenarios, in comparison to status quo, namely: i) decrease to Japanese standards, and ii) decrease to WHO standards. Impact of these interventions on health were assessed using the following HIA metrics: attributable mortality, attributable years life lost, and environmental health impact. A 10-μg/m3 increase in PM2.5 would increase the risk by 0.52% (95% CI: −0.91% to 1.99%) for all-cause mortality, with varying risk estimates per subgroup. High economic burdens were estimated at status quo, with particularly distinct burden difference for age-specific mortality; 0.40 trillion yen (0–64 y.o.) and 1.50 trillion yen (>64 y.o.). If stricter standards, relative to status quo, were to be enforced, i.e. WHO standard, there is a potential to yield economic benefits in the same risk population; 0.26 trillion yen (0–64 y.o.) and 0.98 trillion yen (>64 y.o.). We did not observe any substantial difference with the burden and benefit related to sex-specific mortality. Using the estimated local risk coefficients complemented with the valuation of the risks, policymaking entities will have the opportunity to operate their own HIA to assess the relevant air pollution-related health impacts

Jiadifenolide induces the expression of cellular communication network factor (CCN) genes, and CCN2 exhibits neurotrophic activity in neuronal precursor cells derived from human induced pluripotent stem cells

Jiadifenolide has been reported to have neurotrophin-like activity in primary rat cortical neurons, and also possesses neurotrophic effects in neuronal precursor cells derived from human induced pluripotent stem cells (hiPSCs), as we have previously reported. However, the molecular mechanisms by which jiadifenolide exerts its neurotrophic effects in rat and human neurons are unknown. Thus, we aimed to investigate the molecular mechanisms and pathways by which jiadifenolide promotes neurotrophic effects. Here, we found that jiadifenolide activated cellular communication network factor (CCN) signaling pathways by up-regulating mRNA level expression of CCN genes in human neuronal cells. We also found that CCN2 (also known as connective tissue growth factor, CTGF) protein promotes neurotrophic effects through activation of the p44/42 mitogen-activated protein kinase signaling pathway. This is the first discovery which links neurotrophic activity with CCN signaling

Acute eosinophilic pneumonia caused by cigarette smoking

金沢大学医薬保健研究域医学系It has been suggested that acute eosinophilic pneumonia (AEP) is associated with cigarette smoking because in Japan, the patients with AEP are young and have a high incidence of short-term smoking history. However, there has been no direct evidence to support that cigarette smoke causes AEP. Herein is reported the first case showing the direct evidence and a long-term clinical course of cigarette smoking-induced AEP, in which tolerance to repeated resumption of smoking cigarettes might have occurred. We should pay attention to the history of cigarette smoking in seeing patients with AEP, especially in young patients

Community Trial on Heat Related-Illness Prevention Behaviors and Knowledge for the Elderly

This study aims to explore whether broadcasting heat health warnings (HHWs), to every household and whether the additional home delivery of bottled water labeled with messages will be effective in improving the behaviors and knowledge of elderly people to prevent heat-related illness. A community trial on heat-related-illness-prevention behaviors and knowledge for people aged between 65 and 84 years was conducted in Nagasaki, Japan. Five hundred eight subjects were selected randomly from three groups: heat health warning (HHW), HHW and water delivery (HHW+W), and control groups. Baseline and follow-up questionnaires were conducted in June and September 2012, respectively. Of the 1524 selected subjects, the 1072 that completed both questionnaires were analyzed. The HHW+W group showed improvements in nighttime AC use (p = 0.047), water intake (p = 0.003), cooling body (p = 0.002) and reduced activities in heat (p = 0.047) compared with the control, while the HHW group improved hat or parasol use (p = 0.008). An additional effect of household water delivery was observed in water intake (p = 0.067) and cooling body (p = 0.095) behaviors. HHW and household bottled water delivery improved heat-related-illness-prevention behaviors. The results indicate that home water delivery in addition to a HHW may be needed to raise awareness of the elderly

Quantification of image quality of intra-fractional cone-beam computed tomography for arc irradiation with various imaging condition

BACKGROUND: 3-dimensional intra-cone beam computed tomography (intra-CBCT) could be a potentially powerful tool for use with arc irradiation such as volumetric modulated arc therapy. The aim of the study was to evaluate the image quality of intra-cone beam computed tomography (intra-CBCT) for arc irradiation with various imaging condition. MATERIALS AND METHODS: Two types of intra-CBCT imaging techniques were evaluated — intra-fractional CBCT with flattening filtered (FF) beam (intra-FF CBCT) and that with flattening filter free (FFF) beam (intra-FFF CBCT). For the intra-MV beams, four different field sizes (2 cm x 2 cm, 5 cm x 5 cm, 10 cm x 10 cm, and 20 cm x 20 cm) were used with dose rates of 500 MU/min and 1600 MU/min, for 6 MV FF and 6 MV FFF, respectively. For all image acquisitions, two rotation angles (full-arc and half-arc) were investigated. Thereafter, the linearity, contrast-to-noise ratio (CNR), and uniformity index (UI) of intra-CBCT image were compared with those of conventional CBCT image. RESULTS: All acquisition conditions had good linearity of the CT value (R2 > 0.99). For CNR, the change rates from conventional CBCT ranged from 0.6–33.7% for a 2 cm x 2 cm beam, whereas that for a 20 cm x 20 cm beam ranged from 62.7–82.3%. Similarly, the UI increased from 1.5% to 7.0% as the field size increased. CONCLUSION: Quality of intra-CBCT image was affected by the field size and acquisition angle. Image quality of intra-CBCT was worse than that of conventional CBCT, but it was better under a smaller field and wider correction angle and would be acceptable for clinical use.

THYROID DYSFUNCTION FOLLOWING ALPHA-INTERFERON TREATMENT FOR CHRONIC HEPATITIS C

In order to evaluate the influnces of IFNα on thyroid function, thyroid-stimulating hormone (TSH), total thyroxine (T4), free T4, tri-iodothyronine (T3), and thyroxine-binding globulin were examined in IFNα-treated 351 patients with chronic hepatitis C before and during therapy. As therapy, either 3 million units (MU) of human lymphoblastoid IFNα or 9MU of recombinant IFNα2a was administrated daily for the initial two weeks followed by three times a week for 22 weeks. There were nine patients showing thyroid dysfunction during IFNα therapy. They consist of one relapse of Graves' disease, one relapse of Hashimoto thyroiditis, one development of apparent thyroid insufficiency from subclinical hypothyroidism, five cases with transient hyperthyroidism and one case with transient hypothyroidism. T4 and T3 levels in most patients who transiently developed thyroid dysfunction were normalized spontaneously after the discontinuation of IFNα. Thyroid-related autoantibodies were positive in 4 patients before IFNα therapy and newly developed in one patient during therapy. Attention should be paid first to the previous histories of autoimmune thyroid diseases and the existence of thyroid-related autoantibodies for the prediction of development of thyroid dysfunction during IFNα therapy. In addition, serial examinations of TSH, T3 and T4 should be also necessary for early detection of transient thyroid dysfunction during IFNα therapy

Identification of Disease-Promoting HLA Class I and Protective Class II Modifiers in Japanese Patients with Familial Mediterranean Fever

Objectives: The genotype-phenotype correlation of MEFV remains unclear for the familial Mediterranean fever (FMF) patients, especially without canonical MEFV mutations in exon 10. The risk of FMF appeared to be under the influence of other factors in this case. The contribution of HLA polymorphisms to the risk of FMF was examined as strong candidates of modifier genes. Methods: Genotypes of HLA-B and -DRB1 loci were determined for 258 mutually unrelated Japanese FMF patients, who satisfied modified Tel-Hashomer criteria, and 299 healthy controls. The effects of carrier status were evaluated for the risk of FMF by odds ratio (OR). The HLA effects were also assessed for clinical forms of FMF, subsets of FMF with certain MEFV genotypes and responsiveness to colchicine treatment. Results: The carriers of B?39:01 were increased in the patients (OR = 3.25, p = 0.0012), whereas those of DRB1?15:02 were decreased (OR = 0.45, p = 0.00050), satisfying Bonferroni\u27s correction for multiple statistical tests (n = 28, p<0.00179). The protective effect of DRB1?15:02 was completely disappeared in the co-existence of B?40:01. The HLA effects were generally augmented in the patients without a canonical MEFV variant allele M694I, in accordance with the notion that the lower penetrance of the mutations is owing to the larger contribution of modifier genes in the pathogenesis, with a few exceptions. Further, 42.9% of 14 colchicine-resistant patients and 13.5% of 156 colchicine-responders possessed B?35:01 allele, giving OR of 4.82 (p = 0.0041). Conclusions: The differential effects of HLA class I and class II polymorphisms were identified for Japanese FMF even in those with high-penetrance MEFV mutations

Quantification of muscle coordination underlying basic shoulder movements using muscle synergy extraction

Numerous muscles around the shoulder joint are required to work in a coordinated manner, even when a basic shoulder movement is executed. Muscle synergy can be utilized as an index to determine muscle coordination. The purpose of the present study was to investigate the muscle coordination among different shoulder muscles underlying basic shoulder movements based on muscle synergy. Thirteen men performed 14 multiplanar shoulder movements; five movements were associated with elevation and lowering, while five were associated with horizontal abduction and adduction. The four additional movements were simple rotations at different positions. Muscle activity was measured from 12 muscle portions using surface electromyography. Using the dimensionality reduction technique, synergies were extracted first for each movement separately ("separate" synergies), and then for the global dataset (containing all movements; "global" synergies). The least number that provided 90% of the variance accounted for was selected as the optimal number of synergies. For each subject, approximately two separate synergies and approximately six global synergies with small residual values were extracted from the separate and global electromyography datasets, respectively. Specific patterns of these muscle synergies in each task were observed during each movement. In the cross-validation method, six global synergies explained 88.0 ± 1.3% of the global dataset. These findings indicate that muscle activities underlying basic shoulder movements are expressed as six units, and these units could be proxies for shoulder muscle coordination