Males In Japan Research Articles

Cost-effectiveness analysis of minimally invasive surgical treatments for benign prostatic hyperplasia: implications for Japan’s public healthcare system

Aims Benign prostatic hyperplasia (BPH) represents a significant public health issue in Japan. This study evaluated the lifetime cost-effectiveness of water vapor energy therapy (WAVE) versus prostatic urethral lift (PUL) for men with moderate-to-severe BPH from a public healthcare payer’s perspective in Japan. Materials and methods A decision analytic model compared WAVE to PUL among males in Japan. Clinical effectiveness and adverse event (AE) inputs were obtained from a systematic literature review. Resource utilization and cost inputs were derived from the Medical Data Vision database and medical service fee national data in Japan. Experts reviewed and validated model input parameters. One-way and probabilistic sensitivity analyses were conducted to determine how changes in the values of uncertain parameters affect the model results. Results Throughout patients’ lifetimes, WAVE was associated with higher quality-adjusted life years (0.920 vs. 0.911 year 1; 15.564 vs. 15.388 lifetime) and lower total costs (¥734,134 vs. ¥888,110 year 1; ¥961,595 vs. ¥1,429,458 lifetime) compared to PUL, indicating that WAVE is a more effective and less costly (i.e. dominant) treatment strategy across all time horizons. Lifetime cost-savings for the Japanese healthcare system per patient treated with WAVE instead of PUL were ¥467,863. The 32.7% cost difference between WAVE and PUL was predominantly driven by lower WAVE surgical retreatment rates (4.9% vs. 19.2% for WAVE vs PUL, respectively, at 5 years) and AE rates (hematuria 11.8% vs. 25.7%, dysuria 16.9% vs. 34.3%, pelvic pain 2.9% vs. 17.9%, and urinary incontinence 0.4% vs. 1.3% for WAVE vs PUL, respectively, at 3 months). Model findings were robust to changes in parameter input values. Limitations The model represents a simplification of complex factors involved in resource allocation decision-making. Conclusions Driven by lower retreatment and AE rates, WAVE was a cost-effective and cost-saving treatment for moderate-to-severe BPH in Japan compared to PUL, providing better outcomes at lower costs to the healthcare system.

Immuno-genomic analysis reveals eosinophilic feature and favorable prognosis of female non-smoking esophageal squamous cell carcinomas

Most of esophageal squamous cell carcinoma (ESCC) develop in smoking males in Japan, but the genomic etiology and immunological characteristics of rare non-smoking female ECSS remain unclear. To elucidate the genomic and immunological features of ESCC in non-smoking females, we analyzed whole-genome or transcriptome sequencing data from 94 ESCCs, including 20 rare non-smoking female cases. In addition, 31,611 immune cells were extracted from four ESCC tissues and subject to single-cell RNA-seq. We compared their immuno-genomic and microbiome profiles between non-smoking female and smoking ESCCs. Non-smoking females showed much better prognosis. Whole-genome sequencing analysis showed no significant differences in driver genes or copy number alterations depending on smoking status. The mutational signatures specifically observed in non-smoking females ESCC could be attributed to aging. Immune profiling from RNA-seq revealed that ESCC in non-smoking females had high tumor microenvironment signatures and a high abundance of eosinophils with a favorable prognosis. Single-cell RNA-sequencing of intratumor immune cells revealed gender differences of eosinophils and their activation in female cases. ESCCs in non-smoking females have age-related mutational signatures and gender-specific tumor immune environment with eosinophils, which is likely to contribute to their favorable prognosis.

Pancreatic Cancer and its Attributable Risk Factors in East Asia, Now and Future.

The disease burden of pancreatic cancer in East Asia is at a high level, but the epidemiological characteristics of pancreatic cancer in the region have not been systematically studied. Joinpoint analysis was used to identify average annual percentage change (AAPC) and annual percentage change (APC) in mortality. Age-period-cohort models were used to analyze age-period cohort effects across countries. Bayesian age-period-cohort (BAPC) analysis was used to project the burden of disease for 2020-2030. Pancreatic cancer mortality in males in Japan (2012-2019, APC = -0.97) and Korea (2012-2019, APC = -0.91) has shown a decreasing trend since 2012 (P < .05). However, China (2016-2019, APC = 3.21), Mongolia (2015-2.019, APC = 2.37), and North Korea (2012-2019, APC = 0.47) showed a significant increase in pancreatic cancer in both genders (P < .05). Risk factors for pancreatic cancer in East Asia remained largely stable between 2010 and 2019. Mortality of pancreatic cancer due to smoking began to decline in areas with high socio-demographic index (SDI), and mortality of pancreatic cancer due to high body mass index and high fasting plasma glucose increased with SDI. The age-standardized mortality for pancreatic cancer in Chinese males is expected to exceed that of Japan and South Korea by 2030, but the disease burden of pancreatic cancer in Japan and South Korea remains at extremely high levels. Economically developed countries are beginning to show a decreasing trend in the burden of pancreatic cancer disease, and developing countries are experiencing a rapid increase in the age-standardized death rate (ASDR) of pancreatic cancer.

Clinical presentation and organ-based outcomes of Multifocal fibrosclerosis: A systematic review.

Multifocal fibrosclerosis is a rare disorder causing progressive fibrosis of multiple organ systems. Existing data on the disease show that there are multiple manifestations of the disease, with different outcomes. However, quantitative data are scarce, prompting the need for our investigation. A comprehensive systematic review was performed from inception to November 16, 2022, with the restriction of English language, not including review articles. Article screening and extraction was performed independently, and shortlisted articles were assessed for bias. Analysis was performed using SPSS Version 25 (IBM® SPSS® Statistics; Chicago, IL, USA). Data were presented as frequencies and percentages, with a confidence interval of 95%. This review included 134 patients, with 78 (58.2%) males. Mean age was 53.6 years and included two pediatric patients. The most common comorbidity was diabetes (9.7%). Prevalent presenting symptoms included pain (47.8%) and swelling (35.1%). A mean of 2.51 organs or anatomical sites was affected, retroperitoneum (64.2%) being most affected. The pancreas (30.0%) and digestive system (47.0%) were the organs/organ systems most affected. Patients had favorable outcomes in 79.1% of cases, 87.3% had no relapse, and 91.8% of patients survived the condition. The findings in this study provide a quantitative measurement of the demographics, presentations, organ manifestations, and outcomes of multifocal fibrosclerosis. We found the disease to be prevalent in males in Japan or the United States, with the abdomen and its organs being commonly involved.

Developing a Group Program for Older Males to Participate in Social Activities in Japan: A Mixed-Methods Study.

This study analyzes the effect of social participation in a program that encourages participation in social activities as an approach to counteract the social isolation of elderly males in Japan. The design of this study was an open-label, before-and-after trial for a single group using the convergent design of the mixed-methods study. This program led to significant improvement in independent living and interest in society, but it did not help increase satisfaction with social activities. Additionally, a qualitative data identify that this program encouraged subjects to proactivity participate in social activities. While it has been identified that this program may have had a considerable effect by integrating quantitative and qualitative data, it is necessary to improve the program to further promote change in the subjects’ social behavior.

A rapidly increasing trend of thyroid cancer incidence in selected East Asian countries: Joinpoint regression and age-period-cohort analyses.

This study described the incidence and mortality trends and analyzed age-period-cohort effects on incidences in China, Japan, and Korea. Data were extracted from the Cancer Incidence in Five Continents series and the World Health Organization Cancer Mortality Database, and the age-standardized incidence and mortality rates by Segi's world population were calculated. Joinpoint regression analysis was used to evaluate the time trend of age-standardized incidence and mortality rates and the age-period-cohort model with intrinsic estimator was applied for estimating the effects of age, period, and cohort on thyroid cancer (TC) incidence in individuals between 20 and 84 years of age. An increasing trend in TC incidence rates was observed among males from China (10.3%), Japan (4.7%), and Korea (20.8%) and among females from China (9.4%), Japan (3.5%), and Korea (20.5%). TC incidence rates in females were much higher than those in males. A downward trend of TC mortality rates was observed, especially in both sexes of Japan and Chinese females. The slope of the age effect curve peaked at an earlier age in females than males in Japan and Korea. A strong period effect and remarkedly increasing rate ratios were observed in all regions and for both sexes. The cohort effect had a declining tendency on TC incidence in males and females in these areas. The rapidly upward incidence trend and strong period effect suggest that overdiagnosis caused by higher diagnostic intensity might be an explanation for the upward trend, and some environmental risk factor exposures are also not excluded. In addition, the discrepant trends of TC incidence and mortality reveal the need to identify the few high-risk patients who needed further treatment from those patients who may not need treatment.

Suicide Rates, Social Capital, and Depressive Symptoms among Older Adults in Japan: An Ecological Study.

Depression is considered the primary risk factor for older people’s suicide. When considering suicide measures, it is necessary to clarify the relationship between depressive symptoms, social capital, and suicide rates. Therefore, we aimed to clarify the relationship between community-level social capital, depressive symptoms, and suicide rates among older people in Japan. We analyzed the data gathered from 63,026 men and 72,268 women aged 65 years and older, totaling 135,294 subjects in 81 municipalities with a population of over 100,000 participants in the 2013 Sixth Long-Term Care Needs Survey and another survey conducted by Japan Gerontological Evaluation Study (JAGES) in 2013 including the same question items as the survey in Japan. Multiple regression analysis revealed that the male suicide standardized mortality ratio (SMR) was positively correlated with depressive symptoms (B = 2.318, p = 0.002), and received emotional support (B = −2.622, p = 0.014) had a negative correlation with the male suicide SMR. In older males particularly, the received emotional support in the community was independently associated with the suicide rate. Therefore, fostering social support in a community could act as a countermeasure to suicide among older males in Japan.

Estimates of hip fracture incidence in Japan using the National Health Insurance Claim Database in 2012-2015.

Nationwide registry data on hip fractures have not yet been established in Japan. Using the newly developed National Database of Health Insurance Claims (NDB), which covers the entire Japanese population, we investigated the incidence rates of hip fractures and the associated regional differences. We also assessed the frequency of osteoporosis prescriptions, bone turnover marker (BTM) level, and bone mineral density (BMD) measurements. The annual numbers of hip fractures, osteoporosis prescriptions, and BTM level and BMD measurements by prefecture from 2012 to 2015 were obtained from NDB data. We calculated the standardized claims-data ratio (SCR) in each prefecture. The age-standardized incidence rates from 2012 to 2015 indicated no significant change in females and significant increase in males (p value for trend; 0.920, 0.002, respectively). The fracture risk decreased in females aged 75-84years and indicated no increase in females aged 85-89years during 2012-2015, while the fracture risk indicated no change in males aged 75-84years and increased in males aged 85-89years. The frequency of osteoporosis prescriptions, BTM level measurements, and BMD measurements in the general population in the corresponding period increased with statistical or marginal significance in females and males. West-east regional differences were observed in the incidence rates; the highest SCR values in the western prefectures were approximately double the lowest values in the eastern prefectures. The age-standardized hip fracture incidence rates indicated no significant change in females and significant increase in males in Japan from 2012 to 2015.

What does Klinefelter syndrome mean for men with azoospermia in Japan

Background & aim: The aim of this study was to explore the men’s perceptions of being diagnosed with Klinefelter syndrome. Methods: This qualitative study was conducted on five azoospermic men diagnosed with Klinefelter syndrome referring to two special infertility treatment clinics for males in Japan. The paqrticipants were selected through purposive sampling technique.The data were collected by semi-structured interviews within April 2013 to March 2015 and analyzed using a thematic analysis approach. Results: The analysis of the data resulted in the emergence of four themes, including ‘I cannot understand my diagnosis’, ‘the cause of my azoospermia was identified’, ‘I do not have any other healthcare problems besides Klinefelter syndrome’, and ‘Klinefelter syndrome means that I am more likely to have viable sperm’. Through these themes, we found that azoospermic men considered their diagnosis of the chromosomal disorder as good news; and as a reason for their infertility which might not affect their lives. Furthermore, they believed that having Klinefelter syndrome means that they are more likely to have their own child. Conclusion: The men diagnosed with Klinefelter syndrome had various feelings about their diagnosis. They were hopeful about the outcome of undergoing micro dissection testicular sperm extraction (Micro-TESE). These findings are useful for healthcare workers and could raise their awareness; as they understand that those men with Klinefelter diagnosis have higher expectations regarding micro-TESE.

Deletion and Copy Number Variation of Y‐Chromosomal Regions in Coho Salmon, Chum Salmon, and Pink Salmon Populations

AbstractThe linkage between the Y‐chromosomal DNA marker GH‐Y (growth hormone pseudogene) and the Y‐associated sex‐determining locus was examined in 31 populations of Coho Salmon Oncorhynchus kisutch, 29 populations of Chum Salmon O. keta, and 14 populations of Pink Salmon O. gorbuscha from North America (British Columbia [BC] and Yukon, Canada; Oregon and Washington, USA) and Japan to examine the stability of Y‐chromosome sequences in salmonids. This marker is used for genetic sexing of multiple salmon species both for population studies and for aquaculture strain development. We found a strong association between GH‐Y and sex in Coho Salmon (with rare exceptions seen in Washington and Oregon only), whereas the association of GH‐Y and sex was weak in Chum Salmon and Pink Salmon. Up to 100% of males lacking GH‐Y were found in some BC Chum Salmon populations, whereas there were no exceptional (GH‐Y‐negative) males in Japan, the Yukon, or Washington, indicating strong geographic clustering of GH‐Y marker deletion. For Pink Salmon, there was an average of 29% male exceptions in BC populations. For both Pink Salmon and Chum Salmon, many more GH‐Y‐negative males than GH‐Y‐positive females were observed. To investigate whether sex reversal, recombination, or differential mutation and selection mechanisms occur in Pink Salmon, we conducted reciprocal single‐pair crosses using regular males, regular females, and exceptional individuals (GH‐Y‐negative males and GH‐Y‐positive females). The results showed that the GH‐Y locus from GH‐Y‐positive males and females was stably inherited by the F1 progeny independently of the sex‐determining locus and that this chromosomal region was not necessary for male differentiation. The present data suggest that the genomic organization of the salmonid Y‐chromosome is highly dynamic and subject to multiple forms of sequence copy number variation at multiple loci. Whether this variation has fitness implications or is selectively neutral in populations remains to be examined.Received July 13, 2016; accepted October 19, 2016 Published online January 20, 2017

Larva migrans syndrome caused by Toxocara and Ascaris roundworm infections in Japanese patients.

Larva migrans syndrome (LMS) caused by Toxocara and Ascaris roundworms is generally believed to be more common in children, while a report from Japan suggests that it is more common in adults. We conducted a large-scale retrospective study to confirm these findings and to clarify what caused the difference between Japan and other countries, to reveal overlooked aspects of this disease. The clinical information of 911 cases which we diagnosed as Toxocara or Ascaris LMS during 2001 and 2015 was analysed. Information used included age, sex, address (city or county), chief complaint, present history, dietary history, overseas travelling history, medical imaging findings and laboratory data (white blood cell count, peripheral blood eosinophil number and total IgE). The sex ratio of the disease was 2.37 (male/female = 641/270). The number of patients not younger than 20 years old were 97.8 and 95.1 % among males and females, respectively. Major disease types were visceral, ocular, neural and asymptomatic. The visceral type was more prevalent in older patients, while younger patients were more vulnerable to ocular symptoms. More than two-thirds of the patients whose dietary habits were recorded had a history of ingesting raw or undercooked animal meat. LMS caused by Toxocara or Ascaris is primarily a disease of adult males in Japan, who probably acquired infections by eating raw or undercooked animal meat/liver. Healthcare specialists should draw public attention to the risk of raw or undercooked animal meat in Europe as well.

Modeling mortality and pricing life annuities with Lévy processes

We consider the pricing of annuity-due under stochastic force of mortality. Similarly to Renshaw et al. (1996) and Sithole et al. (2000), the force of mortality will be defined using an exponential function of Legendre polynomials. We extend the approach of Ballotta and Haberman (2006) by conditionally adding α-stable Lévy subordinators in the force of mortality. In particular, we focus on the Gamma and Variance-Gamma processes in order to show how Lévy subordinators can capture mortality shocks. Generalized Linear Models is used to estimate coefficients of the explanatory variables and the Lévy process. For this purpose, the coefficients of the process are obtained by maximizing the log-likelihood function. We use the mortality data of males in Japan from 1998–2011 and the U.S. from 1965–2010 in order to compare our results with the model proposed by Renshaw et al. (1996). Some preferences are indicated based on Akaike’s information criterion, Bayesian information criterion, likelihood ratio test and Akaike weights to support the proposed model. We then use a cubic smoothing spline method to fit the interest rate curve and illustrate some over (under) estimations in the prices of annuities under the structure suggested by Renshaw et al. (1996).

Adult-Onset Adrenoleukodystrophy with Frontal Lobe Symptoms: A Case Report

ALD, which is the X-linked adrenoleukodystrophy (X-ALD), is a rare inherited metabolic disease caused by an enzyme deficiency leading to accumulation of saturated very long chain fatty acid (VLCFA), especially in brain and adrenal cortex. Its prevalence is currently estimated at 1:30,000 to 50,000 in males in Japan. We report a 34-year-old man, who acts of theft, peep and obscenity with adult onset cerebral adrenoleukodystrophy (ALD). An elevated VLCFA and a point mutation in the ABCD1 gene confirmed the diagnosis of ALD. Diffusion-weighted MRI revealed a high intensity area in the white matter of the frontal lobes. T2-weighted image revealed diffuse high signal intensity in the deep white matter. MR diffusion-weighted image revealed high signal intensity area in the white matter of the frontal lobes. Proton magnetic resonance spectroscopy (H-MRS) of the white matter of the frontal lobes revealed an extreme decrease of N-acetylaspartate (NAA) and an increase of the choline (Cho)/creatinine (Cr) ratio. The mild hypoperfusion was detected in the both cerebral hemispheres by the single photon emission CT (SPECT). The genetic phenotype was detected and he was diagnosed adult onset ALD. The only neurological sign was deviant behaviors as frontal lobe symptoms; despite a diffuse high signal intensity was detected in the deep white matter in the MRI examination. Psychiatric symptomatology is presented and may be one of the earliest manifestations of ALD. Psychiatrists as well as and physicians may encounter ALD.

Leadership at School: Does the Gender of Siblings Matter?

Having leader positions at school, as well as participating in sports and clubs helps promoting valuable non cognitive skills, including leadership, self-discipline, motivation, competitiveness and self-esteem. We use survey data from the US and Japan to investigate whether these behaviors in middle and high school are affected by the gender composition of siblings. We find that having only sisters at age 15 increases substantially the probability of school leadership both for males and for females in the US and the probability of sport participation for males in Japan. We also find that parental education matters more for these behaviors in the US than in Japan, and that in the latter country the oldest son or daughter are more likely to be leaders in school.

Discussion of Preventive Measures Against the Increase of Suicide Among Males in Japan

Discussion of Preventive Measures Against the Increase of Suicide Among Males in Japan

Labor supply response and preferences specification: Estimates for prime-age males in Japan

In this paper, we estimate labor responses of Japanese prime-age males by taking into consideration the Japanese income tax system and utilizing a large micro-data set. We employ three maximum likelihood methods: (i) a modified version of Hausman (1979, 1981), which assumes a linear labor supply function; (ii) that given by Zabalza (1983), which assumes CES preferences; and (iii) that given by Van Soest (1995), which employs the translog utility function and assumes discrete labor hour choice. While the estimates based on the Hausman and Zabalza methods fare poorly, those based on the Van Soest method result in more plausible labor responses. However, these responses are larger than those of the North American and European counterparts.

Smoking and Smoking Cessation in Relation to All-Cause Mortality and Cardiovascular Events in 25,464 Healthy Male Japanese Workers

Smoking is still a major health problem among males in Japan. The effects of smoking and quitting on mortality and cardiovascular disease (CVD) need updating. This was a prospective cohort study with a median follow-up of 7.5 years of a total of 25,464 healthy male Japanese workers aged 20-61 years who were not on any medication. The adjusted hazard ratios (HR; 95% confidence interval) for all-cause death were 1.51 (0.73, 2.94), 1.68 (1.07, 2.70), 1.30 (0.70, 2.34), and those for total CVD events 1.91 (0.72, 4.67), 2.94 (1.65, 5.63), and 3.25 (1.69, 6.54) for light smokers (1-10 cigarettes/day), moderate smokers (11-20/day), and heavy smokers (≥ 21/day) compared to never-smokers, respectively. Total CVD events increased dose-dependently as the number of cigarettes/day increased. Acute myocardial infarction was increased at any level of smoking. Stroke was increased at a moderate level of smoking. Quitting for ≥ 4 years, compared with continuing smokers, reduced the HR for all-cause death to 0.64 (0.38, 1.01), and total CVD events to 0.34 (0.17, 0.62). In healthy young- and middle-aged Japanese males, a significant increase in HR for total CVD events was confirmed for a smoking level of 11-20 cigarettes/day. Quitting reduced the HR for total CVD events, with quitting for ≥ 4 years being statistically significant. A similar trend was observed for all-cause mortality.

Effects of a Non-Face-to-Face Behavioral Weight-Control Program Among Japanese Overweight Males: A Randomized Controlled Trial

Weight control has been major health issue in the prevention of lifestyle-related diseases especially among middle-aged working males in Japan. The computerized behavioral program is expected as an effective and feasible intervention tool. The purpose of this study is to examine two hypotheses. The first was that first month weight loss effect is obtained by a behavioral program assisted by computer-tailored advices (Kenkou-tatsujin [KTP]) among overweight males and maintained for 7 months; the second was that the effects in the full KTP is superior to the booklet only. Fifty-one males (body mass index [BMI] = 26.2) were randomly allocated to the KTP group (KTPG) or control group (CG). The KTPG (n = 23) read a booklet, set target behaviors, received advises, and self-monitored their weight and the targeted behaviors for 7 months. The CG (n = 28) read the same booklet. Weight, BMI, biological indices, and daily behaviors were compared at baseline, first, third, and seventh month. The subanalysis among 36 obese subjects was added. In KTPG, weight loss was larger at the first month (-1.1 vs. -0.3 kg), walking steps increased for the seventh month, and several biological indices tended to improve more at the third month than CG. However, the difference of weight loss was not significant at the seventh month. Among the obese subjects, weight loss in KTPG was larger than CG at the third month (-3.0 vs. -1.4 kg). Weight loss effects of KTP were significant at 1 month, walking steps increase was maintained for 7 months.

Safety of 400-ml whole-blood collection in 17-year-old Japanese male donors

Background: To overcome the shortage of blood and blood products, it is necessary to increase the total volume of blood collected from donors. This requires modifying the current standard of 200-ml whole-blood collection for young people (16-17 year-old), which is specified by the Departmental Regulation No.22 (Kouseishou-rei dai-22 gou). The objectives of this study were to evaluate the safety of 400-ml whole-blood collection in 17-year-old males. Methods: A total of 322 male volunteers aged 17 years and 363 aged 18 or 19 years were recruited for blood collection through advertisements at schools and blood center donation sites. Blood collected from the 17-year-old males was not used for transfusion, whereas that collected from the 18-19 year-olds was used for transfusion as normal. To evaluate the safety of 400-ml whole-blood collection in the 17-year-old males, Fisher's exact test was used to compare vasovagal reaction (VVR) occurrence rates between the two groups by using a two-by-two contingency table. Significance was defined as P 0.05). The recovery rate of cell counts and plasma components to the original level was similar between the two groups. We conclude that 400-ml whole-blood collection can be performed safely in 17-year-old males in Japan.

Frequent Early Discontinuation of SSRI Prescribed by Primary Care Physicians in Young Males in Japan

In the present study, we tried to clarify the prevalence of selective serotonin reuptake inhibitor (SSRI) prescription and early discontinuation of SSRI in a outpatient unit where primary care physicians are working in Japan. Consecutive outpatients who newly visited the Department of General Medicine, Asahikawa Medical College Hospital, Asahikawa, Japan between April 2004 and March 2008 were analyzed. Each parameter such as age, sex, diagnosis, period of continuation of SSRI or reason why they discontinued SSRI was investigated. Among 4670 patients, 126 patients (2.7%) had been prescribed SSRI because of depressive state (n=117) or panic disorder (n=9). Female patients with depression received SSRI (84/2714 = 3.10%) more frequently than male patients (33/1956 = 1.69%). Out of 117 patients with depression who had been prescribed SSRI, 28 (23.9%) patients discontinued SSRI within 4 weeks. Male patients (30.5%) discontinued SSRI within 4 weeks due to patient's decision more frequently than female patients (11.1%). The rate of patients who discontinued SSRI within 4 weeks due to patient's decision was particularly high (6/9; 67%) in male patients aged 20 to 29 years. These results suggest for the first time that there is a high prevalence of early discontinuation of SSRI in young male patients in Japan.