Japanese Alcoholics Research Articles

Changes in the frequency and amount of alcohol intake before and during the COVID-19 pandemic.

Concerns have been raised regarding the impact of the COVID-19 pandemic on alcohol consumption patterns, which can have implications for public health. In this descriptive study, we aimed to show the change of the frequency and amount of alcohol consumption in Japan before and during the COVID-19 pandemic periods. We analysed data from annual health-check-ups among Japanese workers from April 2018 to March 2021. Changes in the frequency (daily, occasionally, rarely/never) and amount per one-time (four categories by Japanese alcohol unit) of alcohol consumed among 331,200 participants were summarised by sex as 1-year changes in the periods before (FY2018 to FY2019) and during (FY2019 to FY2020) the COVID-19 pandemic. Among daily drinkers and rarely/never drinkers, overall, 1-year changes in the frequency of alcohol consumption during the pandemic were mostly consistent compared with changes before the pandemic, for both sexes. The number of occasional drinkers who drank less frequently a year later increased during the pandemic compared with before the pandemic (from 9.6% to 11.6% among men and 12.9% to 16.5% among women); however, occasional drinkers who drank more frequently showed a small increase. Collectively, both men and women showed a slight decrease in both the frequency and amount of alcohol consumption during the pandemic among occasional drinkers. No major shifts in alcohol consumption habits occurred during the pandemic in our study population. Occasional drinkers tended to drink less during the pandemic, suggesting that initial concerns about increased alcohol consumption owing to the pandemic were unfounded.

Japanese Alcohol, Nicotine & Drug Addiction Conference 2023

Japanese Alcohol, Nicotine & Drug Addiction Conference 2023

Patterns of alcohol and alcohol-flavoured non-alcoholic beverage advertisements over Japanese free-to-air television networks

BackgroundAlcohol use is a serious public health challenge worldwide. Japan has no government regulations or legal penalties against advertising alcoholic beverages on television (TV). Instead, advertisements depend on the Japanese alcohol industry’s self-regulation on airtime (no advertisements from 5 am to 6 pm) and the content of alcoholic beverages, which must not tempt minors. However, many adolescents (10 to 19 years old) watch TV from 6 pm to 11 pm. The aim of this study was to describe the pattern in the advertising of alcoholic beverages and alcohol-flavoured non-alcoholic beverages (AFNAB) in Japan during the popular TV viewing time for adolescents.MethodsA secondary analysis of advertising airtime data from five free-to-air Japanese TV networks in the Greater Tokyo area that aired between 12 August and 3 November 2019, was performed.ResultsDuring the study period, 5215 advertisements for alcoholic beverages and AFNABs aired (1451.75 min). In total, 2303 advertisements (44.2%) were beer, low-malt beer, or beer-taste beverages, 277 (5.3%) were whisky, 2334 (44.8%) were local alcoholic beverages (shochu and seishu), and 301 (5.8%) were AFNAB. On average, more advertisements aired on weekends (67.6 advertisements) than on weekdays (59.3 advertisements) per day. Approximately 30% of advertisements for AFNABs were aired during the time restricted for alcohol advertising, although AFNABs are considered alcohol according to industry guidelines. During the popular television viewing time for young adolescents, about two to three times more advertisements were aired per hour than during the rest of the day, on both weekdays and weekends (p < 0.001).ConclusionThe number of alcohol advertisements aired at times when adolescents often watch TV is 2 to 3.2 times higher than that at other times of the day. Furthermore, despite the industry’s self-imposed regulations, some alcoholic beverages are still advertised. Therefore, other methods to protect children and adolescents from exposure to advertisements for alcoholic beverages should be investigated and implemented.

Burden of cancer attributable to consumption of alcohol in Japan in 2015

Alcohol can cause or contribute to the development of many non-communicable diseases, including cancer. We calculated the proportion of cancer incidence and mortality in 2015 attributable to alcohol consumption in 2005. Data on alcohol consumption, provided in go, a traditional Japanese alcohol measurement unit, was derived from the 2005 Japanese National Health and Nutrition Survey for each sex and age group, then converted into grams of ethanol per day. The optimal consumption of alcohol for the purpose of this study was determined to be none, based on a global assessment derived from previous observational studies that have looked at the association between alcohol consumption and cancer. Using standard formulas, population attributable fractions (PAFs) for all cancers positively associated with alcohol drinking - oral cavity, pharynx, esophagus, stomach, colorectum, liver, larynx, and female breast - were calculated for each sex and age group and aggregated to obtain the PAF among total cancer incidence and mortality. For Japan in 2015, 59,838 cases of cancer incidence and 23,929 cancer deaths were attributable to alcohol consumption. The estimated PAF for cancer incidence and mortality attributable to alcohol consumption was 6.2% and 6.5%, respectively. For both cancer incidence and mortality, the highest percentage of alcohol-attributable cancer sites was esophageal (54.0% for incidence, 52.3% for mortality). Avoidance of alcohol consumption would reduce the burden of alcohol on cancer in Japan.

Compound Specific Carbon Isotope Analysis in Sake by LC/IRMS and Brewers\u2019 Alcohol Proportion

Sake is a traditional Japanese alcohol. Nowadays, the consumption for Sake is increasing in worldwide and its popularity is growing. However, there are act of fraudulence by additional brewers’ alcohol and sugar. Therefore, a method is needed to find illegal fraud on label. In this work, we analyzed the δ13C values of the ethanol (δ13Ceth) and glucose (δ13Cglu) in Sake by liquid chromatography combined with isotope ratio mass spectrometry for the first time. Further, we developed the criteria using δ13Ceth and δ13Cglu to check brewers’ alcohol and sugar. In addition, there are some sake categories (Ginjyo and Futsu-shu) allowed to additional brewers’ alcohol up to legally determined percentage. The experimental additions of brewers’ alcohol from a C4 plant were conducted to Junmai, as sake by C3 plants. There was a strong correlation (R = 0.98, P < 0.05) between the percentage of added brewers’ alcohol and the δ13C values. We developed the method using the relationship for calculating percentage of brewers’ alcohol for the first time and estimated the percentage for commercial sake. Further, the price of sake was found to be inversely related to the percentage of brewers’ alcohol in the sake.

Analysis of the emotional experiences of Japanese Alcoholics Anonymous members striving for sobriety

BackgroundJapan’s tolerance of alcohol consumption and intoxication pose extreme difficulties for community-dwelling alcoholics who wish to abstain from alcohol and maintain sobriety. Emotional problems triggered in daily life can easily lead to relapse, especially after abstinence. Alcoholics Anonymous places great emphasis on dealing with attendees’ emotional experiences. However, the specific nature of this support is not well understood. Therefore, this study aimed to elucidate the emotional experiences of AA members who strive for sobriety while attending AA and to identify suggestions for new methods of support.MethodsThe present study employed an interview method. Data were analyzed using the KJ Method, which was developed by Japanese cultural anthropologist Jiro Kawakita. Study participants were 36 men chosen from AA groups in the Kanto and Kyushu regions of Japan.ResultsLong-term abstinence was achieved through the following process: 1) gaining objectivity, 2) striving to maintain an attitude of acceptance, and 3) remaining devoted to discipline for one’s goals, thereby 4) recovering one’s contradictory self. This was an unending process that unfolded as the individual tasks affected each other. To facilitate this process, AA members dealt with risk cues that destabilized post-cessation emotional balance while making daily efforts to regulate their own emotions.ConclusionsTo maintain sobriety, AA members strove to regulate their emotions. By doing so, they experienced personal growth and attained a life in which they did not require alcohol (i.e., sobriety). The present study indicated that Japanese nursing and health care workers should be willing to learn from AA members, such as by understanding the 12-step culture. The data also suggest the need to create environments conducive to AA activities, from which many alcoholics derive emotional support.

Reduction of alkalinity supplementation for acid-based wastewater treatment using a thermophilic multi-feed upflow anaerobic sludge blanket reactor

ABSTRACT Generally, Shochu distillery wastewater treatment is required the addition of alkalinity agents for an increase of pH in the UASB reactor. However, to reduce the cost of alkalinity supplementation, cost-effective reactor operation method has been desired. This study aimed to reduce the alkalinity supplementation for a thermophilic (55°C) multi-feed up-flow anaerobic sludge blanket (MF UASB) reactor for the low-cost treatment of the wastewater from the production of the Japanese distilled alcohol called shochu. Shochu distillery wastewater contains high concentrations of organics (46,500–57,600 mgCOD L−1; COD: chemical oxygen demand) and volatile fatty acids (16,200–25,000 mgCOD L−1), and low pH (4.1–4.5). With alkalinity supplementation of 0.045 mgCaCO3 mgCOD−1 using 24% NaOH, the MF UASB reactor achieved an 87 ± 2% COD removal rate with an organic loading rate of 24 kgCOD m−3 day−1 for 554 days reactor operation (hydraulic retention time of 10 h and influent concentration of 10,000 mgCOD L−1). The organic removal rate decreased to 19 ± 3% in the MF UASB reactor when alkalinity supplementation was reduced to 0.015 mgCaCO3·mgCOD−1. In this study , the minimum alkalinity supplementation was 0.045 mgCaCO3 mgCOD−1 at an organic loading rate of 24 kgCOD m−3 day−1.

JFOODO’s Challenges for Creating Overseas Market of Japanese Alcohol Beverages

JFOODO’s Challenges for Creating Overseas Market of Japanese Alcohol Beverages

Presence of columnar-lined esophagus is negatively associated with the presence of esophageal varices in Japanese alcoholic men

AIMTo determine whether the presence of columnar-lined esophagus (CLE) is associated with the presence of esophageal varices (EVs) in male Japanese alcoholics.METHODSThe subjects were 1614 Japanese alcohol-dependent men (≥ 40 years of age) who had undergone upper gastrointestinal endoscopic screening. Digitalized records of high-quality endoscopic images that included the squamocolumnar junction and esophagogastric junction were retrospectively jointly reviewed by four expert endoscopists for the purpose of diagnosing CLE. The authors investigated whether and to what extent there were associations between the presence of CLE and the presence of EVs, especially in the group with liver cirrhosis (LC).RESULTSCLE ≥ 5 mm in length was found in 355 subjects (≥ 30 mm in 6 of them), LC without EVs in 152 subjects, LC with EVs in 174 subjects, and EVs without LC in 6 subjects. Advanced EVs, i.e., nodular, large or coiled forms, red color sign, or post-treatment, were found in 88 subjects. The incidence of CLE ≥ 5 mm decreased in the following order (P < 0.0001): 23.3% in the group without EVs, 17.4% in the group with small and straight EVs, and 5.7% in the group with advanced EVs. The multivariate ORs (95%CI) for EVs and advanced EVs in the group with LC were lower when CLE ≥ 5mm was present [0.46 (0.23-0.93) and 0.24 (0.08-0.74), respectively, vs 0-4 mm CLE].CONCLUSIONThe presence of CLE in male Japanese alcoholics was negatively associated with the presence of EVs.

Scripting Addiction, Constraining Recovery: Alcoholism and Ideology in Japan

ABSTRACTJapan’s medical establishment relies heavily on the ideology of Alcoholics Anonymous (A.A.) in treating the nation’s addicts and alcoholics. Japanese individuals diagnosed as ‘alcohol dependent’ and trying to stay sober must embrace and fully incorporate a prescribed recovery ideology into their daily life. A.A. demands acceptance of alcoholism as a lifelong and incurable disease, requires belief in the possibility of a ‘spiritual transformation’, and positions any relapses as the individual’s fault. This organizational system purports to transform individuals into fundamentally new people but runs the risk of casting alcoholics as permanently diseased. It also can shield its methodological framework from criticism. Oftentimes, Japanese alcoholics are cast into a narrow, constraining recovery space without recourse to assert agency over their struggles with addiction. The Japanese A.A. system allows exploration of how prevailing recovery models and views on addiction can exacerbate the suffering of individual addicts through mandated conformity to the dominant views of what constitutes addiction and successful recovery.

Evaluation of the comprehensive palatability of Japanese sake paired with dishes by multiple regression analysis based on subdomains.

Many factors contribute to palatability. In order to evaluate the palatability of Japanese alcohol sake paired with certain dishes by integrating multiple factors, here we applied an evaluation method previously reported for palatability of cheese by multiple regression analysis based on 3 subdomain factors (rewarding, cultural, and informational). We asked 94 Japanese participants/subjects to evaluate the palatability of sake (1st evaluation/E1 for the first cup, 2nd/E2 and 3rd/E3 for the palatability with aftertaste/afterglow of certain dishes) and to respond to a questionnaire related to 3 subdomains. In E1, 3 factors were extracted by a factor analysis, and the subsequent multiple regression analyses indicated that the palatability of sake was interpreted by mainly the rewarding. Further, the results of attribution-dissections in E1 indicated that 2 factors (rewarding and informational) contributed to the palatability. Finally, our results indicated that the palatability of sake was influenced by the dish eaten just before drinking.

Stable Isotope Analysis of Hydrogen and Oxygen in a Traditional Japanese Alcoholic Beverage, Sake, from Niigata Prefecture in Japan and Other Countries.

Stable hydrogen and oxygen isotopic compositions (δD and δ18O values, respectively) were analyzed for "sake," a traditional Japanese alcohol beverage, to assess these values for the identification of its geographic origin. We collected sake (Junmai-shu; made of only rice, water, and koji) and its source water (i.e., brewing water) from breweries in Niigata Prefecture, Japan, and measured the isotopic compositions of water in these samples. The δD and δ18O values for the sake are well correlated with their respective values for the corresponding brewing water (δD; r = 0.92, δ18O; r = 0.80). Furthermore, based on the δD-δ18O cross plot, sake brewed in Niigata Prefecture is distinguishable from that brewed in countries other than Japan. These results imply that this dual isotope (δD and δ18O) analysis is potentially useful in identifying the geographic origin of sake.

Acute effects of traditional Japanese alcohol beverages on blood glucose and polysomnography levels in healthy subjects.

Background. Alcohol consumption is a lifestyle factor associated with type 2 diabetes. This relationship is reportedly different depending on the type of alcohol beverage. The purpose of this study was to examine the acute effects of traditional Japanese alcohol beverages on biochemical parameters, physical and emotional state, and sleep patterns.Methods. Six healthy subjects (three men and three women; age, 28.8 ± 9.5 years; body mass index, 21.4 ± 1.6 kg/m2) consumed three different types of alcohol beverages (beer, shochu, and sake, each with 40 g ethanol) or mineral water with dinner on different days in the hospital. Blood samples were collected before and 1, 2, and 12 h after drinking each beverage, and assessments of physical and emotional state were administered at the same time. In addition, sleep patterns and brain waves were examined using polysomnography.Results. Blood glucose levels at 1 h and the 12-h area under the curve (AUC) value after drinking shochu were significantly lower than that with water and beer. The 12-h blood insulin AUC value after drinking shochu was significantly lower than that with beer. Blood glucose × insulin level at 1 h and the 2-h blood glucose × insulin AUC value with shochu were significantly lower than that with beer. The insulinogenic indexes at 2 h with beer and sake, but not shochu, were significantly higher than that with water. The visual analogue scale scores of physical and emotional state showed that the tipsiness levels with beer, shochu, and sake at 1 h were significantly higher than that with water. These tipsiness levels were maintained at 2 h. The polysomnography showed that the rapid eye movement (REM) sleep latency with shochu and sake were shorter than that with water and beer.Conclusions. Acute consumption of alcohol beverages with a meal resulted in different responses in postprandial glucose and insulin levels as well as REM sleep latency. Alcohol beverage type should be taken into consideration for people with impaired glucose tolerance.

Blood Leukocyte Counts and Genetic Polymorphisms of Alcohol Dehydrogenase-1B and Aldehyde Dehydrogenase-2 in Japanese Alcoholic Men.

Roughly 40% of East Asians have inactive aldehyde dehydrogenase-2 (ALDH2) encoded by the ALDH2*2 allele, and 90% have highly active alcohol dehydrogenase-1B (ADH1B) encoded by the ADH1B*2 allele. Macrocytosis and macrocytic anemia in alcoholics have been associated with ADH1B and ALDH2gene variants which increase acetaldehyde (AcH) levels. We investigated the relationship between ADH1B*2, ALDH2*2, and leukocyte counts of Japanese alcoholic men (N=1,661). After adjusting for age, drinking habits, smoking habits, body mass index, presence of liver cirrhosis, and serum levels of C-reactive protein, we found that total and differential leukocyte counts were lower in the presence of the ALDH2*1/*2 genotype (vs. ALDH2*1/*1 genotype). ALDH2*2/*2 carriers were not found in our study population. Leukocyte, granulocyte, and monocyte counts were also lower in the presence of ADH1B*2 (vs. ADH1B*1/*1 genotype), but the lymphocyte count was higher. The ALDH2*1/*2 genotype was associated with leukocytopenia (<4,000/μl; adjusted odds ratio [95% confidence interval]=1.89 [1.27 to 2.80]), granulocytopenia (<2,000/μl; 1.86 [1.22 to 2.82]), monocytopenia (<250/μl; 2.22 [1.49 to 3.29]), and lymphocytopenia (<1,000/μl; 1.93 [1.32 to 2.83]). In contrast, the ADH1B*2 had the opposite effect on lymphocytopenia (0.65 [0.46 to 0.93]). Considering genotype effects under conditions of immune stimulation, we observed suppressive effects of ADH1B*2 allele on leukocytosis (≥9,000/μl; 0.69 [0.50 to 0.97]), granulocytosis (≥6,500/μl; 0.66 [0.47 to 0.93]), and monocytosis (≥750/μl; 0.56 [0.39 to 0.79]). The ADH1B*2 plus ALDH2*1/*2 combination had the greatest suppressive effects on the leukocyte, granulocyte, and monocyte counts. The total and differential blood leukocyte counts of Japanese alcoholics were strongly affected by their ADH1B and ALDH2 gene variants. High AcH exposure levels probably play a critical role in the suppression of blood leukocyte counts in alcoholics.

Major Anaerobic Bacteria Responsible for the Production of Carcinogenic Acetaldehyde from Ethanol in the Colon and Rectum.

The importance of ethanol oxidation by intestinal aerobes and facultative anaerobes under aerobic conditions in the pathogenesis of ethanol-related colorectal cancer has been proposed. However, the role of obligate anaerobes therein remains to be established, and it is still unclear which bacterial species, if any, are most important in the production and/or elimination of carcinogenic acetaldehyde under such conditions. This study was undertaken to address these issues. More than 500 bacterial strains were isolated from the faeces of Japanese alcoholics and phylogenetically characterized, and their aerobic ethanol metabolism was studied in vitro to examine their ability to accumulate acetaldehyde beyond the minimum mutagenic concentration (MMC, 50 µM). Bacterial strains that were considered to potentially accumulate acetaldehyde beyond the MMC under aerobic conditions in the colon and rectum were identified and referred to as 'potential acetaldehyde accumulators' (PAAs). Ruminococcus, an obligate anaerobe, was identified as a genus that includes a large number of PAAs. Other obligate anaerobes were also found to include PAAs. The accumulation of acetaldehyde by PAAs colonizing the colorectal mucosal surface could be described, at least in part, as the response of PAAs to oxidative stress. Ethanol oxidation by intestinal obligate anaerobes under aerobic conditions in the colon and rectum could also play an important role in the pathogenesis of ethanol-related colorectal cancer.

Genetic polymorphisms of alcohol dehydrogense-1B and aldehyde dehydrogenase-2, alcohol flushing, mean corpuscular volume, and aerodigestive tract neoplasia in Japanese drinkers.

Genetic polymorphisms of alcohol dehydrogenase-1B (ADH1B) and aldehyde dehydrogenase-2 (ALDH2) modulate exposure levels to ethanol/acetaldehyde. Endoscopic screening of 6,014 Japanese alcoholics yielded high detection rates of esophageal squamous cell carcinoma (SCC; 4.1%) and head and neck SCC (1.0%). The risks of upper aerodigestive tract SCC/dysplasia, especially of multiple SCC/dysplasia, were increased in a multiplicative fashion by the presence of a combination of slow-metabolizing ADH1B*1/*1 and inactive heterozygous ALDH2*1/*2 because of prolonged exposure to higher concentrations of ethanol/acetaldehyde. A questionnaire asking about current and past facial flushing after drinking a glass (≈180 mL) of beer is a reliable tool for detecting the presence of inactive ALDH2. We invented a health-risk appraisal (HRA) model including the flushing questionnaire and drinking, smoking, and dietary habits. Esophageal SCC was detected at a high rate by endoscopic mass-screening in high HRA score persons. A total of 5.0% of 4,879 alcoholics had a history of (4.0%) or newly diagnosed (1.0%) gastric cancer. Their high frequency of a history of gastric cancer is partly explained by gastrectomy being a risk factor for alcoholism because of altered ethanol metabolism, e.g., by blood ethanol level overshooting. The combination of H. pylori-associated atrophic gastritis and ALDH2*1/*2 showed the greatest risk of gastric cancer in alcoholics. High detection rates of advanced colorectal adenoma/carcinoma were found in alcoholics, 15.7% of 744 immunochemical fecal occult blood test (IFOBT)-negative alcoholics and 31.5% of the 393 IFOBT-positive alcoholics. Macrocytosis with an MCV≥106 fl increased the risk of neoplasia in the entire aerodigestive tract of alcoholics, suggesting that poor nutrition as well as ethanol/acetaldehyde exposure plays an important role in neoplasia.

P-22 * THE PREVALENCE OF COMORBID PSYCHIATRIC DISORDERS IN JAPANESE INPATIENTS WITH ALCOHOL DEPENDENCE

Introduction. It is known that patients with alcohol dependence frequently have comorbid psychiatric diseases and the profile of the comorbidities varies among countries. This study aims to estimate the prevalence of psychiatric comorbidities using semi-structured interview in Japanese alcoholics. Methods. This study was approved by the local Ethics Committee of Kurihama Medical and Addiction Center. The subjects were 258 alcoholic patients admitted to Kurihama Medical and Addiction Center and 355 healthy controls. The diagnosis of alcohol dependence and other psychiatric disorders was assessed with the Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA). Results. The prevalence of the history of major depression was significantly higher in alcoholics (21.2% in male, 44.6% in female) than in controls (10.0% in male, 13.6% in female). The prevalence of nicotine dependence was 40.2% in male alcoholics and 37.8% in female alcoholics. In addition, the occurrence of comorbid panic disorder and/or agoraphobia was higher in female alcoholic group (24.3%) than in male alcoholic group (4.3%). Conclusion. These results suggest that the psychiatric disorders which are likely to coexist with alcohol dependence are major depression and nicotine dependence in Japanese patients. In addition, the prevalence of panic disorder or agoraphobia was relatively high in female alcoholics.

P-20 * PRELIMINARY RESULTS OF PATTERN OF ALCOHOL METABOLISM AMONG DRIVING UNDER THE INFLUENCE OF ALCOHOL OFFENDERS: ASSOCIATION BETWEEN ALCOHOL METABOLISM, ALCOHOL USE BEHAVIOUR AND OTHER PSYCHOSOCIAL VARIABLES

This study reports on the potential utility of a saliva test to identify different patterns of driving under the influence of alcohol (DUI) offenders' alcohol metabolism. The pattern of alcohol metabolism, i.e., biogenetic disposition pertinent to alcohol intake is a significant issue, because only about half of Japanese people metabolise alcohol as people of non-Asian origin do. The remaining Japanese people exhibit different biochemical reactions after consuming alcohol, ranging from complete or partial alcohol intolerance to enhanced/prolonged alcohol intoxication. A sample of convicted DUI offenders was interviewed (N = 64). Together with results from a saliva test that classifies the participants' alcohol metabolism into five types, we collected information on alcohol intake, screening for alcohol use disorder, alcohol biomarkers, and psychosocial variables. RESULTS showed that (1) a significantly higher proportion of offenders was classified as being biogenetically susceptible to alcohol dependence as compared to the general Japanese population, and that (2) no significant associations were observed between alcohol metabolism typology and alcohol intake, alcohol use disorders and psychosocial variables, except for one biomarker and the past frequency of DUI. Although alcohol metabolism is only a part of various determinants leading to DUI behaviour, remedial intervention that utilises the saliva test may help DUI offenders to set forth a personalised, concrete coping strategy to stay away from the negative consequences of alcohol use including DUI. Language: en

P-8 * PREDICTION OF RELAPSE USING IMPLICIT ASSOCIATION TEST TO JAPANESE ALCOHOL DEPENDENCE INPATIENTS

The aim of the present study was to examine whether an implicit attitude to alcohol drinking for Japanese alcohol dependent inpatients predict their relapse after discharging from hospital. The participants were 21 inpatients of alcohol dependence with informed consent. During hospitalization, alcohol-pleasure Implicit Association Test (IAT) and self-rating scales including severity of their alcohol dependence with Alcohol Use Disorder Identification Test (AUDIT), relapse risk of alcohol with Alcohol Relapse Risk Scale (ARRS), subjective craving for alcohol with Visual Analogue Scale (VAS) were administered. A follow-up survey was executed within approximately two weeks after their discharging from hospital to measure their reuse of alcohol. As a result of correlation analysis, moderate correlation between IAT-D score and reuse alcohol (.487). Some of subscales in ARRS (stimulus-induced vulnerability, compulsivity for alcohol, and lack of insight) were also significantly correlated with reuse respectively (.454, .519, .466). Moreover, IAT-D score was significantly correlated with lack of insight subscale score (.596). These results indicated that implicit attitude for alcohol preference could predict their alcohol reuse, being associated with their lack of insight (This research is ongoing now until sufficient data collection).

Telomere Shortening in the Esophagus of Japanese Alcoholics: Relationships with Chromoendoscopic Findings, ALDH2 and ADH1B Genotypes and Smoking History

Chromoendoscopy with Lugol iodine staining provides important information on the development of squamous cell carcinoma (SCC). In particular, distinct iodine-unstained lesions (DIULs) larger than 10 mm show a high prevalence in high-grade intraepithelial neoplasia. It has also been reported that inactive ALDH2*1/*2 and less-active ADH1B*1/*1, and smoking, are risk factors for esophageal SCC. We previously examined telomere shortening in the esophageal epithelium of alcoholics, and suggested a high prevalence of chromosomal instability in such individuals. In the present study, we attempted to analyze telomere lengths in 52 DIULs with reference to both their size and multiplicity, ALDH2 and ADH1B genotypes, and smoking history. Patients with DIULs <10 mm (n = 42) had significantly longer telomeres than those with DIULs ≥10 mm (n = 10, p = 0.008). No significant differences in telomere length were recognized between the ALDH2 and ADH1B genotypes (ALDH2 active/inactive = 35/17, ADH1B active/inactive = 32/20; p = 0.563, 0.784, respectively) or among four groups of patients divided according to smoking history (never-, ex-, light, and heavy smokers = 3, 6, 21, and 22 patients, respectively; p = 0.956). Patients without multiple DIULs (n = 17) had significantly longer telomeres than patients with multiple DIULs (n = 35, p = 0.040). It is suggested that alcoholism reduces telomere length in the esophagus, irrespective of genotype or smoking habit. Telomere shortening may not generate cancer directly, but may create conditions under which SCC can develop more easily, depending on subsequent exposure to carcinogens.