An index of the fractal characteristic of an airway tree is associated with airflow limitations and future body mass index reduction in COPD patients.

Disorders of the fractality of an airway tree and a vessel tree have been studied in pulmonary diseases. Here we successfully applied Mishima's D to the bronchial minimal inner cross-sectional area (iCSA) measured in multidetector computed tomography (MDCT) images of chronic obstructive pulmonary disease (COPD) and non-COPD smokers ( = 162), by defining D in the following formula: log(≥) = -D × log + c, where is a certain iCSA value, (≥) is the number of airway branches having iCSA greater than or equal to , and c is a constant. Mathematically, this D of iCSA was associated with the expected reduction ratio of iCSA at bifurcations, which can be estimated by 2.

Japanese citizens' attitude toward end-of-life care and advance directives: A qualitative study for members of medical cooperatives.

Background: Japanese citizens are interested in choosing their own end-of-life care, but few have created their own advance directive. This study examined changes among Japanese citizens' attitudes toward end-of-life care and advance directives and explored factors that affected these attitudes.

Methods: We conducted five focus groups with 48 participants in 2009 and 2010.

Psychological impact of lifestyle-related disease disclosure at general checkup: a prospective cohort study.

Background: Little is known about psychological impact of disclosing lifestyle-related diseases. Previous studies discussed the long-term psychological impact of disease disclosure, and a significant psychological impact was not observed. This study clarified the psychological impact on anxiety state of patients when lifestyle-related diseases are disclosed at general checkups for local residents.

Recognition of and intent to use gastrostomy or ventilator treatments in older patients with advanced dementia: differences between laypeople and healthcare professionals in Japan.

Aim: We compared differences between laypeople and healthcare professionals in the recognition of and intent to use gastrostomy and ventilator treatments in older patients with dementia.

Methods: Between November 2011 and January 2012, a questionnaire survey was carried out. People who underwent a general health check-up at Nomura Hospital Preventive Medical Center were recruited as the laypeople group.