Biomedical subjects
Publications and source records attributed to T Umenai.
The establishment of a revolving drug fund project in Viet Nam is described and the factors responsible for its success are considered. As well as being a tool for cost recovery a revolving drug fund can serve as an entry point for strengthening health care and improving health security at local and district level.
An interventional study was conducted in southern Vietnam to evaluate the feasibility and effectiveness of a new approach to control dengue fever. The approach consisted of active surveillance of dengue patients and the use of insecticidal aerosol cans. Febrile patients were tested serologically at local health centers and insecticidal aerosol cans were given to the family and employed in the neighborhood of dengue patients instead of ultra low volume (ULV) fogging with insecticide. The number of dengue IgM antibody positive cases among febrile patients, the number of reported dengue hemorrhagic fever patients and the total cost were compared in the 2 approaches (prompt focal ULV fogging and the use of insecticidal aerosol cans) in 1997. The aerosol cans were employed 5 times (in June, July, August, September and October) in the study area. ULV fogging in the control area was performed 5 times (in March, May, July, August and September). Twenty-two serologically positive cases were found in the study area which was about half that found in the control area (43 cases). A total of 16 dengue hemorrhagic fever patients was reported in the study area and 43 in the control area. Compared with the reported numbers of the previous year, the reduction rate in the number of dengue hemorrhagic fever cases was 71.4% in the study area and 51.7% in the control area. There were statistically significant differences in the morbidity of dengue fever and the reduction rate of dengue hemorrhagic fever. The cost of the insecticidal aerosol cans was US$393 which was lower than the cost of US$553 for ULV fogging. The findings suggest that insecticidal aerosol cans were effective and feasible for dengue fever control.
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We report a case of myelodysplastic syndrome (MDS) with the 11q23 translocation at its leukemic transformation. Southern blot analysis demonstrated that the MLL gene on chromosome 11 was rearranged during the progression from MDS to acute leukemia. The clinical observation in this case supports the notion that leukemic transformation involves multiple cytogenetic evolutionary progresses, and that MLL gene rearrangement corresponds to the final step of leukemogenesis.
In the present study, we examined the chewing performance of 70 elderly persons. Self-assessment of chewing problems and clinical classification using the modified Eichner index showed little correlation (Kappa value = 0.28; 95% confidence interval (CI) = 0.05-0.51). The sensitivity and specificity were 0.52 and 0.76, respectively. On the other hand, the mastication score determined by evaluation of a questionnaire on food intake and classification using the modified Eichner index showed high agreement (Kappa value = 0.73; 95% CI = 0.50-0.96). The sensitivity and specificity were 0.76 and 0.95, respectively. The mastication score showed significant correlation with other masticatory functions such as maximum biting force, occlusal contact area and the number of missing teeth (P < 0.01). These results suggest that the use of a questionnaire on food intake would be informative for epidemiological surveys of chewing activity in the elderly.
The purpose of the present study was to statistically analyse the relationship between subjective evaluation of chewing ability and self-rated general health status in elderly Japanese residents. Interviews were conducted with 1,544 respondents over 65 years of age in Yamanashi Prefecture, Japan. The interviews included questions concerning age, sex, health status, capacity to understand conversation, chewing ability, and ADL status. First, the age-adjusted odds ratio between subjective evaluation of chewing ability and self-rated health status was 2.242 (p < or = 0.01). Second, the age-adjusted odds ratio between respondentive evaluation of chewing ability and ADL status was 2.572 (p < or = 0.01). Third, the age-adjusted odds ratio between self-assessment of chewing ability and the degree of understanding conversations was 5.290 (p < or = 0.01). These results suggest that chewing ability is related to self-rated general health, ADL status, and the degree of understanding conversation among the elderly.
An increase in the number of erythroblasts can be seen to some extent in the bone marrow of rats in the early stage of experimentally induced hemolytic anemia prior to any elevation in the plasma erythropoietin (Epo) level. This observation suggests that there is another erythroid stimulating factor present other than Epo. We studied the enhancing effect of serum, taken sequentially during experimentally induced hemolysis in rats, on erythroid proliferation, differentiation and maturation in vitro. Single intraperitoneal injection of 60 mg/kg of acetylphenylhydrazine (APH) induced self-limited hemolytic anemia in rats, in which the hematocrit dropped rapidly with a nadir at day 4 after APH injection, followed by a gradual increase with return to normal level by day 8. Serum obtained consecutively every day after APH injection from day 1 to day 7 was applied to an in vitro culturing system of erythroid progenitors. Addition of day 1 serum, in which an elevation of Epo level had not occurred, to a conventional methyl-cellulose culture of rat bone marrow mononuclear cells (BM-MNCs) resulted in a significant increase in the number of colonies derived from colony forming unit erythroid, but not in burst forming unit erythroid. This erythropoietic activity of the serum was particularly evident in the presence of Epo. In the liquid culture of BM-MNCs, day 1 serum also showed some enhancing effect on erythroblast formation. We were able to see significant differences in these erythroid enhancing activities induced by serum drawn on day 1 in comparison to the serum drawn on subsequent days. These results suggest that an unknown erythroid enhancing factor besides Epo stimulates erythropoiesis in the early stage of hemolytic anemia or sudden hypoxia before there is a measurable rise in the serum Epo level. We propose that this factor be termed erythroid accelerating factor (EAF).
OBJECTIVE: To evaluate the prevalence of cigarette smoking in Cambodia and identify prevailing knowledge, attitudes and practices (KAP). DESIGN: Information on tobacco smoking and KAP was collected using the 30-cluster survey design wherein 10-15 males (age over 15 years) were interviewed from each of 30 randomly-selected population clusters in Phnom Penh (herein referred to as 'urban') and Siem Reap (herein referred to as 'rural') for a total of 601 interviews. RESULTS AND DISCUSSION: Findings show that 65% of urban respondents and 86% of rural respondents smoke. Rural men start smoking at an earlier age, but the average urban smoker spends more. 17% of an urban smoker's personal cash income is spent on tobacco, whereas his rural counterpart spends 8%. This discrepancy is partly due to extensive tobacco brandname promotion in urban areas which has resulted in the average price of a pack of cigarettes being four times higher than that of rural. Other findings show an inverse correlation between incidence of smoking and levels of education/income. Concerning smoking cessation, 66% of urban smokers and 86% of rural smokers interviewed indicated they would attend a program in their area to stop smoking if such a program were available. CONCLUSION: The high prevalence of smoking in Cambodia, and the health impact it has and will increasingly have on its people is significant. The high cash expenditure for tobacco, especially in urban, is an important factor contributing to Cambodia's impoverished economy. Education, regulatory policies, and smoking cessation are important measures to be considered for effective tobacco control planning and implementation.
The purpose of the present study was to analyze statistically correlations between socioeconomic factors and the prevalence of dental caries in developing countries. The DMFT index, which evaluates the incidence of dental caries, showed a positive correlation (P < 0.01) with several socioeconomic factors, such as life expectancy, adult literacy rate, school attendance rate, population employed in the service sector, population aged 15-64 years, and urban population. According to multiple regression analysis, population aged 15-64 years, population employed in the service sector, and urban population were the most influential independent socioeconomic variables, in descending order, with a regression coefficient of 0.635 and a coefficient of determination of 0.404 (P < 0.001). This finding suggests that the prevalence of dental caries in developing countries increases with the degree of urbanization.
The present study was conducted in order to determine the statistical relationship between chewing activity and activities of daily living (ADL) in the elderly. Subjects which took part were 79 elderly individuals (37 males, 42 females) ranging in age from 65 to 74 years. Based on questionnaires regarding diet, a mastication score was determined to evaluate chewing activity in each subject. This score was scaled from 0 to 100%. ADL levels were determined using two indices: the guidelines of the Ministry of Health and Welfare of Japan and the Tokyo Metropolitan Institute of Gerontology (TMIG) index. The TMIG index is a multidimensional 13-item index of competence in which scores range from 0 to 13 points. According to the guidelines of the Ministry of Health and Welfare, the independence level of each subject was evaluated as independent, home-bound, or bedridden. These independence levels showed a significant correlation with the mastication score (P < 0.01). The mastication score also significantly correlated with the TMIG index, showing a Spearman coefficient of correlation of 0.63 in males (P < 0.01) and 0.71 in females (P < 0.01). These results suggest that chewing activity is related to ADL levels in elderly subjects.
As the epicenter of the HIV/AIDS pandemic shifts from Africa to Asia, Japan is becoming ever more aware of the importance of containing and preventing spread of the virus. International collaboration, particularly with the United States, is a logical approach because it allows utilization of expertise from countries in other stages of the pandemic, can prevent duplication of efforts, and complements efforts of the other countries. Further, both Japan and the United States can use their combined influence and prestige to encourage cooperation among all nations. In 1994, Japan established the Global Issues Initiative to extend cooperation to developing countries in the areas of population and AIDS control. It has disbursed more than $460 million (U.S.$) to promote active cooperation and stimulate international attention to the importance of addressing these health issues. Japan has established four main programs for international collaboration for control of HIV and AIDS, three operated by ministries and one by a Japanese nongovernmental organization. Japanese/United States collaboration is developing through the United States/Japan Cooperative Medical Sciences Program, the Common Agenda for Cooperation in Global Perspective, the Paris Summit, and the United Nations Joint Programme on AIDS. It is critical that Japan and the United States, as the two largest donors to international development, demonstrate, through their collaboration, ways to maximize the use of limited resources, reduce duplication, and promote sustainable development programs in which HIV prevention and AIDS care programs are systemically integrated.
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An anonymous unlinked HIV antibody test was conducted on 1632 Chlamydia trachomatis (C. trachomatis) antibody positive women from 10 institutes of 7 prefectures in Japan. All the sera were negative for both HIV-1 and HIV-2 antibodies. The result may support the suggestion that HIV prevalence is low among general population in Japan. Such a test as this study will be useful not only for developing a reliable HIV surveillance system but also for the study of sexual behavior of general population, since C. trachomatis infection is sensitive to reflect sexual contact.
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The changing epidemiological and distribution patterns of Japanese encephalitis in various southern and east Asian countries are described. Immunization is considered to be the only practical way to control the infection. Several vaccines have been developed and two types of inactivated vaccine are now available for use in man.
A low-molecular-weight factor (less than 1000) which impairs the capacity of normal mice to resist Listeria infection has been isolated from the ascitic fluid of tumor-bearing mice. The factor showed potent suppressive activity when as little as 0.2 ml of 1:10(5) dilution of the factor was given iv to mice. The factor impaired stage 2 (72 hr after infection) of Listeria elimination in the liver when circulating monocytes migrate from the blood to the liver to begin eliminating the bacteria, but not stage 1 (within 24 hr after infection) when Listeria elimination depends on resident liver macrophages. The factor also inhibited macrophage accumulation in the peritoneum of mice after ip injection of phytohemagglutinin and macrophage chemotaxis in vitro. The factor was heat labile and lost its suppressive activity after being heated at 56 degrees C for 30 min. The factor was detectable in the ascitic fluid rather late after tumor implantation and its production was closely related to tumor growth.
Naturally occurring infection with Korean hemorrhagic fever virus among four families living in rural areas of northern and central Japan was proved by the demonstration of antibody to the virus. Furthermore, Korean hemorrhagic fever virus antigen was detected in the lung tissues of wild rodents captured in the endemic area. These findings indicate the endemic presence of Korean hemorrhagic fever virus on Honshu Island, Japan.