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Biomedical subjects

Eiji Kajii

Publications and source records attributed to Eiji Kajii.

At least 19 recordsLinked to original sources
PubMed2007

Metabolic syndrome and C-reactive protein in the general population: JMS Cohort Study.

BACKGROUND: In recent years some studies have shown that metabolic syndrome (MS) is associated with inflammation, indicated by high-sensitivity C-reactive protein (hsCRP), but there have been few population-based studies, especially in Japan. METHODS AND RESULTS: The study subjects were 2,191 men and women examined between 1992 and 1995 with the necessary data to ascertain MS as part of the Jichi Medical School Cohort Study. CRP was measured by nephelometry. There were 109 subjects defined as having MS (5.0%), and the proportion of MS cases was higher in men (9.4%) than in women (1.8%). Geometric mean and median CRP in the MS group was higher than that in the non-MS (geometric mean; p<0.001, median: 0.312 mg/L in MS and 0.122 mg/L). Proportion of MS increased with CRP, after the subjects were divided by tertile of CRP (odds ratio, 95% confidence interval 1st tertile as a reference; 2nd tertile: 2.9, 1.5-5.9, 3rd tertile: 5.7, 3.1-11.1). CONCLUSION: Inflammation, measured by the concentration of hsCRP, was elevated in cases of MS in the general Japanese population. Longitudinal data should be examined in the future.

Adult↗
PubMed2006

The nursing home versus the hospital as the place of dying for nursing home residents in Japan.

OBJECTIVES: To determine the characteristics of nursing home residents that are associated with dying in a nursing home versus a hospital in Japan. DESIGN: Retrospective case-control study. SETTING: A nonprofit nursing home with 110 beds in Tokyo, Japan. PARTICIPANTS: Eighty-six nursing home residents who died in the nursing home (n=43) or in a hospital (n=43) between 1 April 1999 and 30 September 2004. MEASUREMENTS: Nursing home records were reviewed to gain information regarding the following domains: demography, the family decision-maker, health status, resident and family preference for nursing home end-of-life care, and presence of a full-time physician. RESULTS: The variables older age [adjusted odds ratio (adjusted OR)=1.08, 95% confidence interval (95% CI)=1.01-1.17], the family decision-maker's preference for nursing home end-of-life care (adjusted OR=3.95, 95% CI=1.21-12.84), and presence of a full-time physician (adjusted OR=3.74, 95% CI=1.03-13.63) were associated with dying in the nursing home. CONCLUSION: Older age, the family's preference for nursing home end-of-life care, and the presence of a full-time physician were significantly related to dying in the nursing home versus in a hospital.

Aged, 80 and over↗
PubMed2006

An intronic variable number of tandem repeat polymorphisms of the cold-induced autoinflammatory syndrome 1 (CIAS1) gene modifies gene expression and is associated with essential hypertension.

Cold-induced autoinflammatory syndrome 1 (CIAS1) gene is a member of the NALP subfamily of the CATERPILLER protein family that is expressed predominantly in peripheral blood leukocytes, which is to regulate apoptosis or inflammation through the activation of NF-kappaB and caspase. Recent genetic analyses suggested an association between inflammation and oxidative stress-related genes in the development of hypertension. This is the first genetic study indicating an association between the CIAS1 gene and susceptibility to essential hypertension (EH). The frequency of subject with the homozygote of 12 repeat allele was significantly higher in patients with hypertension compared with control subjects (987 cases, 924 controls) (P=0.030; odds ratio=1.24) at a novel VNTR polymorphism of CIAS1 intron 4 loci. We also found that the mean of systolic blood pressure of homozygotes of 12 repeat allele was 6.4 mmHg higher than those of homozygotes of non-12 repeat allele in male random population (P=0.009). The frequency of six SNPs spanning of the CIAS1 gene was not significantly between patients and controls. The real-time PCR analysis showed that among healthy young adults, 12-12 subjects expressed CIAS1 mRNA in peripheral leukocytes significantly more abundantly than homozygote of non-12 repeat alleles subjects (P<0.05). Reporter gene assay of the CIAS1-VNTR in HL60 stimulated by lipopolysaccharides showed that the intronic sequence involving 12 repeat increased the expression of luciferase compared with 9, 7, and 6 repeats. Thus, we propose here the CIAS1 is associated with EH through the dominant expression of transcripts, which may depend on the CIAS1-VNTR genotype.

Alleles↗
PubMed2006

Age at menopause and mortality in Japan: the Jichi Medical School Cohort Study.

BACKGROUND: Although several studies have reported increased mortality risk with early menopause, there were no studies examining the relationship between age at menopause and mortality in Japan. The goal of this analysis is to investigate the relationship between age at menopause and all-cause mortality among the Japanese. METHODS: Study subjects were 4,683 postmenopausal females in the Jichi Medical School Cohort Study, a population-based prospective study. Baseline data were obtained by questionnaire and health checkups between April 1992 and July 1995 in 12 rural areas in Japan. Main outcome measures were all-cause mortality derived from death certificates up to December 31, 2002. Cox's proportional hazard models were used to analyze the association of age at menopause with mortality. RESULTS: A total of 215 deaths were observed during the average of 9.2 year follow-up period. After adjusting for age, systolic blood pressure, serum total cholesterol level, serum high density lipoprotein cholesterol level, history of diabetes mellitus, body mass index, smoking habits, alcohol drinking habits, marital status, study area, and types of menopause, the hazard ratios (95% confidence intervals) of all-cause mortality were 2.10 (1.07-4.11), 0.68 (0.36-1.26), 0.94 (0.68-1.30), and 1.17 (0.63-2.20) for females with a menopause at ages younger than 40 years, 40-44, 50-54, and 55 or older, respectively, relative to those with menopause at age 45-49 years. CONCLUSIONS: Our data suggest that menopause aged younger than 40 years increases the risk of death from all causes among the Japanese.

Adult↗
PubMed2006

[Molecular approaches to the Rh blood group system].

The Rh system clinically is one of the important blood groups. The major Rh antigens are RhD, RhC/c, and RhE/e, which are carried by two integral membrane polypeptides consisted of 416 amino acids. These polypeptides are encoded by two closely related genes, RHD and RHCE. Both RH genes are composed of ten exons. It is thought that multiple recombinations, nucleotide substitutions, large nucleotide gaps (due to Alu sequence), and high level of the homology between the RHD and RHCE genes are the important factors in the formation and evolution of these genes. The RHD gene is deleted in most white individuals who lack the RhD antigen, while 12% of Japanese individuals have an RHD gene. Molecular analyses have elucidated the background of various Rh-related variants; D--, partial D, weak D, and Rhnull. The Rhnull phenotype is divided into the most common type by the Rhnull regulator gene and second type by the amorph gene that arose by homozygosity of a silent allele at the RH locus. The RhAG glycoprotein has been regarded as a most critical Rhnull gene of the reglurator type and a critical co-expressing factor of the Rh polypetides on red blood cells. Studies on the autoantibodies against red blood cells in aoutoimmune hemolytic anemia have suggested that the public epitopes of autoantigens exist on the Rh polypeptides.

Anemia, Hemolytic, Autoimmune↗
PubMed2005

The effects of reactive oxygen species on amphibian aging.

To clarify the role of reactive oxygen species (ROS) in the aging process of amphibians, antioxidant enzyme activity and indexes of ROS damage were investigated biochemically using the livers of 3- and 10-year-old Rana nigromaculata frog males and females. Findings revealed no significant difference in survival rate between males and females. Antioxidant enzyme activity displayed an age-related decline. Superoxide dismutase (SOD), catalase, and glutathione peroxidase (GPx) activity in 10-year-old liver decreased 40-80% from 3-year-old liver levels. In contrast, urate oxidase activity in the 10-year-old liver increased more than 200% from 3-year-old liver levels. At the same time levels of ROS damage, including the concentration of inorganic peroxide and thiobarbituric acid reactive substances (TBARS), greatly increased with age. Liver catalase from 10-year-old frogs proved to be more susceptible to aminotriazole and urea, losing approximately 80% of its original activity after 30 min of treatment. It seems likely that liver catalase in older frogs has diverged from liver catalase in younger frogs through oxidative modification. These findings suggest that a decrease in the activity of antioxidant enzymes over time results in increased levels of ROS damage in the livers of older frogs.

Aging↗
PubMed2005

Factors associated with rural doctors' intention to continue a rural career: a survey of 3072 doctors in Japan.

OBJECTIVE: To show the relationship between the personal and educational backgrounds of rural doctors and their intention to continue a rural career. DESIGN: Nationwide postal survey. SETTING: Public clinics or hospitals in municipalities that are classified as 'rural' by the national government. SUBJECTS: A total of 4896 doctors working for 828 public clinics and hospitals. MEASUREMENTS: A questionnaire was mailed. The questionnaire inquired about the subject's age, sex, hometown, exposure to rural practice in undergraduate education, postgraduate training, continuing medical education, current position and affiliation status with a medical school, as well as his or her intention to continue a rural career. RESULTS: Response rate was 64%; 26% answered that they intended to continue a rural career. Postgraduate training in general internal medicine, general surgery, anaesthesiology, paediatrics and gastroenterology were positively related with the intention to continue a rural career (odds ratio = 2.045, 1.59, 1.30, 1.48, 1.38). Rural background, undergraduate exposure to rural practice, multispecialty-rotation in postgraduate training and current administrative position had positive correlations with the intention to continue in logistic regression analysis (odds ratio = 1.80, 2.47, 1.54, 2.17). Affiliation with a medical school department was negatively related with the intention to continue (odds ratio = 0.45). CONCLUSION: In addition to the rural background of physicians, some undergraduate and postgraduate factors were independently associated with the intention to continue a rural career.

Adult↗
PubMed2005

Aly/ REF, a factor for mRNA transport, activates RH gene promoter function.

The rhesus (Rh) blood group antigens are of considerable importance in transfusion medicine as well as in newborn or autoimmune hemolytic diseases due to their high antigenicity. We identified a major DNaseI hypersensitive site at the 5' flanking regions of both RHD and RHCE exon 1. A 34 bp fragment located at -191 to -158 from a translation start position, and containing the TCCCCTCCC sequence, was involved in enhancing promoter activity, which was assessed by luciferase reporter gene assay. A biotin-labelled 34 bp probe isolated an mRNA transporter protein, Aly/REF. The specific binding of Aly/REF to RH promoter in erythroid was confirmed by chromatin immunoprecipitation assay. The silencing of Aly/REF by siRNA reduced not only the RH promoter activity of the reporter gene but also transcription from the native genome. These facts provide second proof of Aly/REF as a transcription coactivator, initially identified as a coactivator for the TCRalpha enhancer function. Aly/REF might be a novel transcription cofactor for erythroid-specific genes.

Amino Acid Sequence↗
PubMed2005

Smoking and risk of all-cause mortality: the Jichi Medical School (JMS) Cohort Study.

BACKGROUND: There have been comparatively few large-scale cohort studies analyzing all-cause mortality due to cigarette smoking. The goal of this analysis is to investigate the relationship between smoking status and all-cause mortality, and to evaluate the effect of smoking in the Japanese. METHODS: The baseline data were collected between 1992 and 1995. Ultimately, 10,873 Japanese (4,280 males and 6,593 females) aged 19 years or older from 12 rural communities located across Japan participated in the study. This analysis is based on the results, including the information on those who died and moved out of the communities, obtained by December 31, 2001. The Cox's proportional hazards model was used to calculate the hazard ratio (HR) of mortality for smoking with adjustment for age, systolic blood pressure, total cholesterol, body mass index, alcohol drinking habit and education. RESULTS: The mean follow-up period was 8.2 years, during which time, 284 males and 192 females died. The multivariate-adjusted HRs for total mortality among former and current smokers compared with never smokers were 1.09 (95% confidence interval [CI]: 0.73-1.61) and 1.65 (95% CI: 1.16-2.35) in males, and 0.98 (95% CI: 0.40-2.42) and 0.91 (95% CI: 0.42-1.95) in females, respectively. Those for the consumption of 1-14, 15-24, and 25+ cigarettes per day among male smokers were 1.62, 1.57, and 1.89, respectively. In females, there was no great difference in all-cause mortality between smokers and never smokers. CONCLUSIONS: The results of our study confirm an increased risk in males of premature death from all causes among Japanese with a smoking habit.

Adult↗
PubMed2004

Rural doctors' satisfaction in Japan: a nationwide survey.

OBJECTIVES: The purpose of this paper was to discover to what degree Japanese rural doctors are satisfied with various aspects of their jobs and lives, and to find out whether they intend to continue their rural careers. DESIGN: Nationwide postal survey. SETTING: Public clinics or hospitals in municipalities that are authorised as 'rural' by the national government. SUBJECTS: A total of 4896 doctors working for public clinics or hospitals. INTERVENTIONS: Self-evaluation questionnaires were mailed. The rural doctors were asked to evaluate their satisfaction with 19 items related to their job conditions and 10 items concerning life conditions, using a four-point scale. They also were asked to evaluate their intent to stay in rural practice until retirement. RESULTS: The response rate was 64%. Overall, rural doctors were satisfied with both their work and life conditions. However, only 27% of respondents hoped to continue rural practice beyond the usual age of retirement. Among job-related items, continuing medical education and interactions with municipal governments were rated as least satisfactory. Among lifestyle-related items, duration of holidays and workload were unsatisfactory. Subgroup analysis revealed male doctors showed greater intent to stay in rural practice. Doctors aged > 50 years were more satisfied with most aspects of their job and lifestyle than younger doctors. A strong correlation was found between the degree of intent to stay and several items such as interactions with municipal government, human interactions salary and job fulfillment. CONCLUSIONS: Strategies, based on the results of this survey, should be implemented. Particularly in Japan, positive interaction between doctors and municipal governments is crucial. WHAT THIS PAPER ADDS: Though rural doctors in Japan in general were satisfied with their lifestyle and work conditions, they have low intentions to stay in rural areas. Among the various factors that can cause this dissociation between satisfaction and intention to stay, doctors' interactions with municipal governments play a pivotal role.

Adult↗
PubMed2004

High-tech rural clinics and hospitals in Japan: a comparison to the Japanese average.

CONTEXT: Japanese medical facilities are noted for being heavily equipped with high-tech equipment compared to other industrialised countries. Rural facilities are anecdotally said to be better equipped than facilities in other areas due to egalitarian health resource diffusion policies by public sectors whose goal is to secure fair access to modern medical technologies among the entire population. OBJECTIVES: To show the technology status of rural practice and compare it to the national level. DESIGN: Nationwide postal survey. SETTING, SUBJECTS & INTERVENTIONS: Questionnaires were sent to the directors of 1362 public hospitals and clinics (of the 1723 municipalities defined as 'rural' by four national laws). Information was collected about the technologies they possessed. The data were compared with figures from a national census of all hospitals and clinics. RESULTS: A total of 766 facilities responded (an effective response rate of 56%). Rural facilities showed higher possession rates in most comparable technologies than the national level. It is noted that almost all rural hospitals had gastroscopes and colonoscopes and their possession rates of bronchoscopes and dialysis equipment were twice as high as the national level. The discrepancy in possession rates between rural and national was even more remarkable in clinics than in hospitals. Rural clinics owned twice as many abdominal ultrasonographs, and three times as many gastroscopes, colonoscopes, defibrillators and computed tomography scanners as the national level. CONCLUSIONS: Rural facilities are equipped with more technology than urban ones. Government-led, tax based, technology diffusion in the entire country seems to have attained its goal. What is already known on this subject: As a general tendency in both developing and developed countries, rural medical facilities are technologically less equipped than their urban counterparts. What does this paper add?: In Japan, rural medical facilities are technologically better equipped than urban facilities.

Ambulatory Care Facilities↗
PubMed2004

Sleep duration and mortality in Japan: the Jichi Medical School Cohort Study.

BACKGROUND: Although sleep is one of the most important health-related factors, relationship between sleep duration and mortality has not been fully discussed. METHODS: Study subjects were 11,325 participants (4,419 males and 6,906 females) in the Jichi Medical School Cohort Study, a population-based prospective study. Baseline data were obtained by questionnaire and health checkups between April 1992 and July 1995 in 12 rural areas in Japan. Main outcome measures were all-cause and cause-specific mortality derived from death certificates up to December 31, 2001. Cox's proportional hazard models were applied to analyze the association of sleep duration with mortality. RESULTS: A total of 495 deaths (289 males and 206 females) were observed during the average of 8.2-year follow-up period. After adjusting for age, systolic blood pressure, serum total cholesterol, body mass index, smoking habits, alcohol drinking habits, education, and marital status, the hazard ratios (95% confidence intervals) of all-cause mortality for individuals sleeping shorter than 6 hours and 9 hours or longer were 2.4 (1.3-4.2) and 1.1 (0.8-1.6) in males, and 0.7 (0.2-2.3) and 1.5 (1.0-2.4) in females, respectively, relative to those with 7-7.9 hours sleep. CONCLUSION: Our data suggest that males with short sleep and females with long sleep were at an elevated risk of death.

Adult↗
PubMed2004

[Community healthcare activities of physicians in public medical facilities and their evaluation by municipalities].

OBJECTIVES: In order to practice appropriate community healthcare activities, it is essential for healthcare providers to integrate medical, public health, and welfare systems into one comprehensive healthcare body. In Japan, local governments are obliged to provide their entire population with public health and welfare services And physicians who work as government employees at public medical facilities play an important role in combining the three systems. It has been reported that the level of subjective evaluation by the municipality of the degree of involvement by physicians in the region's public health activities and welfare services is associated with the standardized mortality rates for strokes in the area's population. However, little is known about which specific public health and welfare services are more important as factors contributing to the level of evaluation of physicians by the people or municipality. The present study was therefore conducted to determine associations between levels of participation by community physicians in each specific public health or welfare service and the respective levels of evaluation by their municipalities. METHODS: A cross-sectional study design using a self-reported postal questionnaire survey was conducted with all 3,152 local governments in Japan from July to September, 2000. A total of 3,059 local governments (94%) responded, and 1,315 (42%) that operated a public medical facility were analyzed. The aspects from which local governments evaluated the physicians working for their public medical facilities were: the frequency of involvement in each of 13 services related to public health and welfare; the degree of satisfaction of governments with the physicians' involvement in each of the services; and the relationship between the physicians and the municipal healthcare officials. RESULTS: The services in which the local governments responded that they 'always' appreciated the physicians involved was significantly associated with the degree of municipal satisfaction. In the multiple logistic regression analysis, the degree of municipal satisfaction was significantly associated with their perception of consistent involvement by the physicians in case conferences on homecare management, health counseling, health education, life style instruction after basic health screening (odds ratio > 2.0 respectively), and school healthcare, vaccination, school health screening, and basic health screening (0 < odds ratio < 1.5 respectively). There was no significant difference in the level of satisfaction between large and small municipalities. CONCLUSIONS: The findings showed that high levels of municipal appreciation of consistent participation by physicians in certain public health and welfare services is associated with a higher degree of local government satisfaction with the physicians. It is noteworthy that services found to be highly associated with municipal satisfaction were concerned with individual affairs or education, and with activities that do not entail any legal obligation.

Cities↗