No abstract

One of the problematic features of hepatocellular carciBackground. Matrix metalloproteinase 9 (MMP-9), a noma (HCC) is its rapid invasion into the portal venous sys-92-kd gelatinase/type IV collagenase, has been implitem. Even in small HCCs, microscopic vascular invasion is cated as playing an important role in cancer invasion found in more than 40% of the nodules. 1,2 Macroscopic portal and metastasis. A previous study showed that serum venous invasion is reported to be the worst single prognostic type IV collagenase activity correlated with metastasis factor, after partial hepatectomy, for HCC.3 Thus the detecby hepatocellular carcinoma (HCC). The aims of this tion of vascular invasion and its potential is important in study were to determine the plasma levels of immunoredetermining therapy and prognosis. At present, there is no active MMP-9 in patients with HCC and to compare the clinical laboratory test to predict the potential for or the ongolevels with the clinical features including vascular invaing activity of vascular invasion by HCC. Theoretically, the sion. Patients and Methods. This study included 100 pameasurement of the plasma levels of specific proteins that tients with HCC, 21 patients with chronic hepatitis (CH), are released by cancer cells and that are necessary for the 24 patients with liver cirrhosis (LC), and 138 healthy invasive process is a feasible approach to predict the tumor control subjects. Plasma MMP-9 levels were measured behavior. with a specific one-step sandwich enzyme immunoassay.Invasive tumor growth and metastasis involve complex Results. Plasma MMP-9 levels in HCC (62 [33 to 130 ng/ steps. 4,5 The initial steps include the degradation of stromal mL] median [25%, 75%], 13 to 660 ng/mL, minimum, maxi-architecture and of basement membrane components, espemum) were significantly elevated compared with those cially type IV collagen. Two kinds of type IV collagenase in in normal controls (36 [25 to 45], range, 2.8-70 ng/mL), in the matrix metalloproteinases family, 6 matrix metallopro-CH (28 [18 to 30], 13 to 66 ng/mL) and in LC (35 [26 to teinase 9 (MMP-9) (92-kd gelatinase/type IV collagenase) and 58], 16 to 86 ng/mL) (P õ .0000001; P Å .0000003; and P Å matrix metalloproteinase 2 (MMP-2) (72-kd gelatinase/type .00205, respectively). When the cut-off level was defined IV collagenase), have been implicated as playing a major role as 60 ng/mL from a receiver operating characteristic in the degradation of the basement membrane in cancer invacurve, plasma MMP-9 concentrations had a sensitivity sion and metastasis. 4,5 A correlation between the tumor secreof 53% and a specificity of 89% for the detection of HCC tion of MMP-9 7 as well as MMP-2, 8 and experimental metasfrom CH and LC. The levels were significantly higher in tasis has been reported. HCC patients with macroscopic portal venous invasionPreviously, type IV collagenase activity (probably a mix-(79 [36 to 160], 15-660 ng/mL) than those without the inva-ture of MMP-2 and MMP-9 activity) in the tissue homogenate sion (44 [27...

Introduction Interventions targeting built environmental factors may encourage older people to engage in favorable behaviors and decrease dementia risk, but epidemiologic evidence is limited. This study investigated the association between neighborhood food environment and dementia incidence. Methods A 3-year follow-up (2010–2013) was conducted among participants in the Japan Gerontological Evaluation Study, a population-based cohort study of older adults aged ≥65 years. Dementia incidence for 49,511 participants was assessed through the public long-term care insurance system. Availability of food stores (defined as the number of food stores selling fruits and vegetables within 500 meters or 1 kilometer of residence) was assessed for each participant using objective (GIS-based) and subjective (participant-reported) measurements. Data were analyzed from 2017 to 2018. Results A total of 3,162 cases of dementia occurred during the follow-up. Compared with the highest quartile for objective availability of food stores, the hazard ratio adjusting for age and sex was 1.60 (95% CI=1.43, 1.78) for the second-lowest quartile. Compared with the highest subjective availability of food stores, the hazard ratio was 1.74 (95% CI=1.49, 2.04) for the lowest category. After successive adjustment for sociodemographic characteristics, health status, and other geographic neighborhood factors (availability of restaurants, convenience stores, and community centers), the hazard ratio remained statistically significant. Conclusions Lower food store availability was associated with increased dementia incidence. Given that food shopping is a routine activity and a main motive for going out among older adults, increasing the availability of food stores may contribute to dementia prevention.

<b><i>Background:</i></b> Elder abuse is a serious public health issue worldwide, but large-scale epidemiologic studies remain sparse. Although social factors in human relations such as social support and social isolation have been proposed as the factors related to elder abuse, cognitive social capital has not been examined. <b><i>Objective:</i></b> This study aims to clarify the prevalence of and the factors associated with elder abuse among independent older adults in Japan. <b><i>Methods:</i></b> The study design is a retrospective observational study. The data were derived from the Japan Gerontological Evaluation Study (JAGES). These self-report data were collected from 26,229 people aged 65 years or older living in 28 municipalities in 2013. The types of elder abuse and factors associated with them were examined using logistic regression analysis. <b><i>Results:</i></b> The prevalence of elder abuse among the sample was 12.3% (11.1% in males and 13.3 in females). In the entire sample, physical, psychological, and financial abuses were reported to be 1.26, 11.12, and 1.45%, respectively. Factors associated with increased odds of experiencing abuse were being a woman, living with family members, having poor self-rated health, and having mild or severe depression. By contrast, age ≥85 years, being widowed, or unmarried, and having a positive view of community trust were associated with a lower risk of experiencing abuse. <b><i>Conclusion:</i></b> While particular demographic factors and health are associated with a greater risk of elder abuse, our findings that trust within the community lessens the risk indicates the importance of social capital. This should be taken into consideration when developing population-based strategies to prevent elder abuse.

BackgroundPrevious research has linked lower availability of food stores selling fruits and vegetables to unhealthy diet. However, the longitudinal association between the availability of healthy food stores and mortality is unknown. This study examined the association between neighborhood availability of food stores and mortality by driving status among older adults.MethodsThis study drew upon a three-year follow up of participants in the Japan Gerontological Evaluation Study, a population-based cohort study of Japanese adults aged 65 years or older. Mortality from 2010 to 2013 was analyzed for 49,511 respondents. Neighborhood availability of food stores was defined as the number of food stores selling fruits and vegetables within a 500-m or 1-km radius of a person’s residence. Both subjective (participant-reported) and objective (geographic information system-based) measurements were used to assess this variable. Cox regression models were used to estimate hazard ratios (HR) for mortality.ResultsA total of 2049 deaths occurred during the follow up. Lower subjective availability of food stores was significantly associated with increased mortality. Compared with participants reporting the highest availability, the age- and sex-adjusted HR for those reporting the lowest availability was 1.28 (95% CI: 1.04–1.58; p = 0.02). The association remained significant after adjustment for sociodemographic (education, income, cohabitation, marital status, and employment status) and environmental (driving status, use of public transportation, and study site) status (HR = 1.24, 95% CI: 1.01–1.53, p = 0.04). This association was stronger among non-car users, among whom the HR for those reporting the lowest availability of food stores was 1.61 (95% CI: 1.08–2.41, p = 0.02). In contrast, no significant association was seen between objective availability and mortality.ConclusionsLower availability of healthy food stores measured subjectively, but not objectively, was associated with mortality, especially among non-car users. Considering the decline in mobility with age, living in a neighborhood with many options for procuring fruits and vegetables within walking distance may be important for healthy aging.Electronic supplementary materialThe online version of this article (10.1186/s12966-018-0732-y) contains supplementary material, which is available to authorized users.