Involvement of plasma membrane H+-ATPase in anoxic elongation of stems in pondweed (Potamogeton distinctus) turions.

• Pondweed (Potamogeton distinctus) turions can elongate in the absence of O(2). Alcoholic fermentation serves to produce energy for anoxic elongation via the breakdown of starch stored in cells. However, the mechanism of cell growth during anoxic elongation is not fully understood. • Changes in pH, H(+) equivalent and lactate content of the incubation medium were measured during anoxic elongation. The effects of fusicoccin (FC), indole-3-acetic acid (IAA), vanadate, erythrosine B and K(+) channel blockers on anoxic elongation were examined. Cytoplasmic pH and vacuolar pH were measured by (31)P nuclear magnetic resonance (NMR) spectroscopy. • Acidification of the incubation medium occurred during anoxic elongation. The contribution of CO(2) and lactic acid was not sufficient to explain the acidification. FC and IAA enhanced the elongation of stem segments. Vanadate and erythrosine B inhibited anoxic elongation. Acid growth of notched segments was observed. The activity of plasma membrane H(+)-ATPase extracted from pondweed turions was increased slightly in anoxic conditions, but that from pea epicotyls sensitive to anoxic conditions was decreased by incubation in anoxic conditions. Both the cytoplasmic pH and vacuolar pH of pondweed turion cells chased by (32)P NMR spectroscopy were stabilized during a short period < 3 h after anoxic conditions. • We propose that the enhancement of H(+) extrusion by anoxic conditions induces acidification in the apoplast and may contribute to the stabilization of pH in the cytoplasm.

[Establishment of a comprehensive anti-suicide project in an urban city].

For the establishment of an effective comprehensive anti-suicide policy, a multifaceted strategy including primary, secondary, and tertiary prevention measures is needed. In urban cities, however, there are many obstacles to projects such as comprehensive programs for suicide prevention. In Sendai city, which has a population of approximately 1,000,000, a comprehensive anti-suicide project was launched as a public enterprise as a pioneer among ordinance-designated cities in Japan. This project was supported by several important factors. 1) A series of epidemiological observation and intervention studies on depression among the elderly had previously been conducted in a large residential district. As a result, a comprehensive community program for depression among the elderly was implemented as a public enterprise and a subsequent decreasing trend in the later-life suicide rate was found. 2) The municipal authorities recognized the importance of the anti-suicide program and made an effort to reorganize the existing health-related programs in terms of suicide prevention. 3) the action of the municipality was facilitated by the passing of an anti-suicide law by the National Diet in 2006 and the establishment of fundamental principles for a comprehensive anti-suicide policy by the National Diet in 2007. 4) The activities of nongovernmental groups also influenced the municipality. In order to establish a comprehensive anti-suicide program in urban cities with a large population, an interaction model in which various governmental and nongovernmental networks influence and activate each other should be considered.

[Informed diagnosis and psycho-education on psychiatric illnesses by primary care physicians--a result from pathway to psychiatric care in Japan study].

On the path to psychiatric care, many patients who experience their first episode of mental disorder consult general practitioners or physicians of general hospitals before consulting psychiatrists. Some patients receive proper care promptly while others experience a delay in treatment. We investigated treatments and psycho-education given to patients by general practitioners or physicians of general hospitals, particularly focusing on informed diagnosis. We conducted a multi-center collaborative study in Japan. In this study, 15 facilities participated, including 4 university hospitals, 3 general hospitals, and 8 psychiatric hospitals. A total of 382 patients experiencing their first episode of mental disorder were enrolled. Among them, 157 patients primarily consulted general practitioners or general hospitals. We divided the 157 patients into 3 groups according to the kind of psycho-education given by general practitioners or physicians of general hospitals: those who were told nothing about their diagnosis nor mental condition (N = 74, 47.1%), those who were not given a direct diagnosis but were informed about their condition in some way (N = 55, 35.0%), and those who were directly informed of their diagnosis (N = 28, 17.8%). We found that almost half of the patients were told nothing about their diagnosis nor mental condition by general practitioners or physicians of general hospitals. Patients who were likely to be directly informed of their diagnosis were those who were recommended to see a doctor by someone, or those with a lower global psychosocial function. The patients who were told nothing about their diagnosis nor mental condition were mainly covered by national health insurance, and had decided to go to hospitals or clinics under their own volition. Sorted by ICD-10 F code, patients diagnosed as F0, F3, or F4 accounted for 89.9% of all subjects. We compared treatment delays among these 3 categories. The median treatment delay in patients diagnosed correctly as F0 by general practitioners or physicians of general hospitals was 50 weeks, that in patients diagnosed as F3 was 4 weeks, and that in patients diagnosed as F4 was 5 weeks. These findings suggest that patients might be treated in different ways according to their diagnosis by general practitioners or physicians in general hospitals. Our results suggest the importance of further educating general practitioners and physicians of general hospitals about mental disorders, in order to not only shorten the duration of untreated psychosis, but also for patients to be given proper primary care.

Obesity and depressive symptoms in elderly Japanese: the Tsurugaya Project.

OBJECTIVE: The aim of this study is to examine the association between obesity and depressive symptoms in Japan. METHODS: We conducted a cross-sectional study of 1128 community-dwelling elderly Japanese aged 70 years or older in 2002. We calculated the body mass index [BMI=weight (kg)/height (m)2] from measured weight and height and evaluated depressive symptoms using the 30-item Geriatric Depression Scale (GDS 30), with a cut-off point of 11. RESULTS: In men, no apparent association was observed between BMI and depressive symptoms. An inverse linear trend was observed in women overall, but stratified analysis of chronic medical conditions, such as stroke or cancer, showed an inverse association was evident only among women with the conditions. Among women without these chronic conditions, no apparent association was evident. CONCLUSION: No apparent association was observed in men overall or in apparently healthy women. An inverse trend was observed only in women with chronic medical conditions.

[Association between depressive symptoms and cerebrovascular lesions on MRI in community-dwelling elderly individuals].

AIM: We conducted a community-based study to verify relationships between cerebrovascular lesions (CVL) on magnetic resonance imaging and depressive symptoms (DS) in elderly individuals, and the validity of Krishnan's MRI-defined vascular depression (MRI-VD). METHODS: MRI was performed in 196 community-dwelling elderly individuals (mean age, 72.3 +/- 1.7 years; range, 70-75 years) with a Mini Mental State (MMS) score of 22 or more who participated in the comprehensive geriatric assessment. The DS (+) group consisted of 41 subjects with Geriatric Depression Scale (GDS) score of 15 or more. The DS (-) group consisted of 141 subjects with a GDS score of 9 or less. Hyperintensities of deep white matter and subcortical gray matter were scored according to the modified Fazekas criteria. The CVL score was defined as the higher of the two scores, and 3 grades were defined as scores of 0, 1, or 2 or more. According to Krishnan's MRI-VD, a CVL score of 2 or more was defined as CVL (+). Logistic regression analyses were used to test associations between CVL and DS, and univariate analyses were used to examine differences in clinical features between CVL (+) and CVL (-) within the DS (+) group; RESULTS: Logistic regression analysis adjusting for age, sex, cognitive function, educational level, instrumental activities of daily life (IADL) and subjective healthiness, CVL scores of 1 and 2 or more displayed significant associations with DS compared with a score of 0. However, no significant differences in DS were found between CVL (+) and CVL (-). Within the DS (+) group, no significant differences were noted between CVL (+) and CVL (-) in MMS, IADL, subjective healthiness, sleeping symptoms, alcohol-related problem or suicidal ideation. CONCLUSION: CVL was associated with DS independent of various confounders. However, clarification of clinical profiles is required to define MRI-VD as an independent clinical entity.

Increased plasma 8-isoprostane levels in hypertensive subjects: the Tsurugaya Project.

To examine the relationship between 8-isoprostane and blood pressure, we measured plasma 8-isoprostane concentration and home blood pressure levels in an elderly Japanese population. Our study population comprised 569 subjects aged 70 years and over who were not receiving antihypertensive medication. On the basis of their blood pressure values, the participants were classified into three groups: normotensive (home blood pressure <135/85 mmHg), hypertensive (home blood pressure 135/85-160/90 mmHg), and severely hypertensive (home blood pressure > or =160/90 mmHg). The mean plasma 8-isoprostane level in the severely hypertensive group (21.1+/-5.2 pg/ml) was significantly higher than that in the normotensive (20.2+/-4.9 pg/ml) or hypertensive (19.7+/-5.1 pg/ml) group, and this result was unchanged when we adjusted for possible confounding factors such as age, sex, use of vitamin A, C or E supplements, smoking status, drinking status, body mass index, use of non-steroidal anti-inflammatory drugs, history of diabetes, hypercholesterolemia, home heart rate and serum creatinine level. Thus, the level of plasma 8-isoprostane appears to be elevated in older subjects with severe hypertension.

[Association between social support and depression in the elderly Japanese population].

To determine the association between social support and depression in elderly Japanese, we conducted a Comprehensive Geriatric Assessment among residents aged 70 years or over. Out of 2,730 eligible subjects, 1,179 participated in the survey and 1,146 (480 men and 666 women) were analyzed. The Geriatric Depression Scale (GDS) was used to estimate depression status. The subjects were divided into two groups: depressive (GDS>11 or taking antidepressant drugs) and non-depressive (GDS<11). Various levels of social support were assessed by the following questions: Do you have someone (1) whom you can consult when you are in trouble ? (2) whom you can consult when your physical condition is not good ? (3) who can help you in daily housework ? (4) who can take you to a hospital when you don't feel well ? (5) who can take care of you when you are ill in bed? In multivariate logistic regression analysis, the calculated odds ratios (95% CIs) for the lack of each type of social support for depression status were: (1) 2.5 (1.5-4.1),(2) 1.9 (1.1-3.2),(3) 2.7 (1.7-4.4),(4) 1.9 (1.1-3.2),(5) 2.8 (1.6-4.9) in men, and (1) 1.2 (0.8-1.8),(2) 1.2 (0.8-1.8),(3) 1.4 (1.0-2.0),(4) 1.6 (1.1-2.3),(5) 2.0 (1.4-2.9) in women. A significant association was found between social support and depression in this elderly population. We also found that this association was stronger in men.

Phylogenetic position of Oxygyne shinzatoi (Burmanniaceae) inferred from 18S rDNA sequences.

The genus Oxygyne comprises three species disjunctly distributed in Africa and Japan and is the least examined genus of the Burmanniaceae due to the scarcity of living material. We obtained living samples of Oxygyne shinzatoi and examined the phylogenetic position of this species on the basis on the 18S rDNA sequence. Oxygne shinzatoi was consistently found to belong to the monophyletic group of tribe Thismieae, but its position in the tribe differed depending on the criteria applied (maximum parsimony, maximum likelihood, Bayesian inference). Distance analysis from the most recent common ancestor indicated that O. shinzatoi had the lowest substitution rate among the species of tribe Thismieae. Combined with recent knowledge of basic chromosome numbers and substitution rate characteristics, O. shinzatoi can be considered to be one of the basal taxon of tribe Thismieae.

Pathway to psychiatric care in Japan: A multicenter observational study.

BACKGROUND: This study examines pathways to psychiatric care in Japan using the same method as the collaborative study carried out in 1991 under the auspices of the World Health Organization. METHODS: Thirteen psychiatric facilities in Japan were involved. Of the 228 patients who contacted psychiatric facilities with any psychiatric illness, eighty four visiting psychiatric facilities for the first time were enrolled. Pathways to psychiatric care, delays from the onset of illness to treatment prior to reaching psychiatrists were surveyed. RESULTS: Thirty three patients (39.4%) directly accessed mental health professionals, 32 patients (38.1%) reached them via general hospital, and 13 patients (15.5%) via private practitioners. The patients who consulted mental health professionals as their first carers took a longer time before consulting psychiatrists than the patients who consulted non-mental health professionals as their first carers. The patients who presented somatic symptoms as their main problem experienced longer delay from the onset of illness to psychiatric care than the patients who complained about depressive or anxiety symptoms. Prior to the visit to mental health professionals, patients were rarely informed about their diagnosis and did not receive appropriate treatments from their physicians. Private practitioners were more likely to prescribe psychotropics than physicians in general hospitals, but were less likely to inform their patients of their diagnosis. CONCLUSION: This first pathway to psychiatric care study in Japan demonstrated that referral pathway in Japan heavily relies on medical resources. The study indicates possible fields and gives indications, underlining the importance of improving skills and knowledge that will facilitate the recognition of psychiatric disorders presenting with somatic and depressive symptoms in the general health care system and by private practitioners.

Green tea and the risk of colorectal cancer: pooled analysis of two prospective studies in Japan.

BACKGROUND: Although laboratory experiments suggest protective effects of green tea against colorectal cancer, few prospective cohort studies have been conducted. METHODS: We conducted a pooled analysis of two prospective cohort studies among residents in Miyagi Prefecture in rural northern Japan. The first study started in 1984 and included 26,311 subjects. The second study started in 1990 and included 39,604 subjects. The subjects responded to a self-administered questionnaire including an item on green tea consumption. With 7 to 9 years of follow-up, 305 colon and 211 rectal cancers were identified in the two cohorts through record linkage to a regional cancer registry. We used Cox regression to estimate the hazard ratio (HR) of colorectal cancer according to the consumption of green tea with adjustment for potential confounders, and pooled the estimates obtained from each cohort by general variance-based method. RESULTS: Multivariate pooled HRs for colon cancer associated with drinking 1-2, 3-4, and 5 or more cups of green tea per day, as compared with less than 1 cup per day, were 1.06 (95% confidence interval [CI]=0.74-1.52), 1.10 (0.78-1.55), 0.97 (0.70-1.35), respectively (trend p=0.81). Corresponding HRs for rectal cancer were 0.85 (95% CI=0.56-1.29), 0.70 (0.45-1.08), 0.85 (0.58-1.23), respectively (trend p=0.31). CONCLUSIONS: Consumption of green tea was not associated with lower risk of colorectal cancer.

Coffee consumption and the risk of primary liver cancer: pooled analysis of two prospective studies in Japan.

Although case-control studies suggested that coffee consumption is associated with a decreased risk of liver cancer, no prospective cohort study has been carried out. To examine the association between coffee consumption and the risk of liver cancer, we conducted a pooled analysis of data available from 2 cohort studies in Japan. A self-administered questionnaire about the frequency of coffee consumption and other health habits was distributed to 22,404 subjects (10,588 men and 11,816 women) in Cohort 1 and 38,703 subjects (18,869 men and 19,834 women) in Cohort 2, aged 40 years or more, with no previous history of cancer. We identified 70 and 47 cases of liver cancer among the subjects in Cohort 1 (9 years of follow-up with 170,640 person-years) and Cohort 2 (7 years of follow-up with 284,948 person-years), respectively. We used Cox proportional hazards regression analysis to estimate the relative risk (RR) and 95% confidence interval (CI) of liver cancer incidence. After adjustment for potential confounders, the pooled RR (95% CI) of drinking coffee never, occasionally and 1 or more cups/day were 1.00 (Reference), 0.71 (0.46-1.09) and 0.58 (0.36-0.96), respectively (p for trend = 0.024). In the subgroup of subjects with a history of liver disease, we found a significant inverse association between coffee consumption and the risk of liver cancer. Our findings support the hypothesis that coffee consumption decreases the risk of liver cancer. Further studies to investigate the role of coffee in prevention of liver cancer among the high-risk population are needed.

Association between social support and depression status in the elderly: results of a 1-year community-based prospective cohort study in Japan.

We conducted a prospective cohort study on subjects aged>or=70 years in an urban community to determine whether there is any association between lack of social support and depression status. Of the 2730 eligible subjects, 1178 participated and were interviewed in a Comprehensive Geriatric Assessment (CGA) in 2002. We investigated the five social supports items using the following questions: (i) do you have someone with whom you can consult when you are in trouble?, (ii) do you have someone with whom you can consult when your physical condition is not good?, (iii) do you have someone who can help you with your daily housework?, (iv) do you have someone who can take you to a hospital when you do not feel well?, and (v) do you have someone who can take care of you when you are ill in bed? The Geriatric Depression Scale was used to estimate depression status. The subjects were divided into two groups: depressive and non-depressive. Of 753 subjects classified as non-depressive, 475 also took part in a CGA in 2003 and 278 dropped out. We calculated the risk of depression status in the elderly without social support. Lack of social support items (i) and (v) were significantly associated with an increased risk of depression status. The multivariate odds ratios (95% confidence intervals) regarding the risk of depression status among the elderly without (i) and (v) social support items were 2.6 (1.2-5.3) and 3.0 (1.4-6.1), respectively. We also found the increase risk of depression status with lack of social support item (v) was significantly different for different sexes and for different pain conditions. We conclude that there is a significant increase in the risk of depression status associated with the lack of social support in Japanese elderly people in an urban community.

Factors associated with suicidal ideation in an elderly urban Japanese population: a community-based, cross-sectional study.

The objective of the present study was to evaluate the association between suicidal ideation and potentially related factors in an elderly urban Japanese population. This was a community-based, cross-sectional study. Urban community residents aged 70 years or more were interviewed regarding suicidal ideation and sociodemographic and health-related variables. Subjects with depressive symptoms underwent further evaluation by psychiatrists using criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition. Associations were evaluated using univariate and multivariate logistic regression analyses. Of the 1145 eligible participants, 52 (4.5%) reported thoughts of suicide. Of 143 subjects with depressive symptoms (Geriatric Depression Scale, 14+), 22 (15.4%) reported suicidal ideation over a 2-week period. After controlling for depressive symptoms, lack of social support and impaired instrumental activities of daily living were significantly associated with thoughts of suicide. After controlling for the potentially associated factors detected in the univariate analysis, depressive symptoms were strongly associated with thoughts of suicide. In the elderly with depressive symptoms, mental disorders, including depressive and alcohol-related disorders, were significantly associated with suicidal ideation over a 2-week period. In the urban community setting, screening for lack of social support, impaired instrumental activities of daily living, and depressive symptoms, followed by diagnostic evaluation for mental disorders, particularly for depressive syndromes and alcohol-related disorders, may provide a practical and effective means of identifying elders at high risk of suicide.

Obesity and risk of cancer in Japan.

We conducted a population-based prospective cohort study in Japan to examine the relationship between body mass index (BMI) and the risk of incidence of any cancer and of cancer at individual sites. Body mass index was calculated from self-administered body weight and height at baseline. Relative risks (RR) and 95% confidence intervals (CI) were calculated in multivariate proportional-hazards models. Among 27,539 persons (15,054 women and 12,485 men) aged 40 years or older who were free of cancer at enrollment in 1984, 1,672 (668 women and 1,004 men) developed cancer during 9 years of follow-up. In women, after adjustment for potential confounders, the RR of all cancers associated with different BMI, relative to a BMI of 18.5-24.9, were 1.04 (95% CI = 0.85-1.27) for BMI = 25.0-27.4, 1.29 (1.00-1.68) for BMI = 27.5-29.9 and 1.47 (1.06-2.05) for BMI >/=30.0 (p for trend = 0.007). Higher BMI was also significantly associated with higher risk of cancers of the colorectum, breast (postmenopausal), endometrium and gallbladder in women. In men, we observed significantly increased all-cancer risk among only never-smokers. Overweight and obesity could account for 4.5% (all subjects) or 6.2% (never-smokers) of the risk of any cancer in women and -0.2% (all subjects) or 3.7% (never-smokers) in men. The value for women was within the range among women reported from Western populations (3.2%-8.8%). Our data demonstrate that excess weight is a major cancer risk among Japanese women.

Cigarette smoking and the risk of gastric cancer: a pooled analysis of two prospective studies in Japan.

To examine the association between cigarette smoking and the risk of gastric cancer, we conducted a pooled analysis of 2 population-based prospective cohort studies in rural northern Japan. Cohort 1 included 9,980 men (>or=40 years old) and Cohort 2 included 19,412 men (40-64 years old). The subjects completed a self-administered questionnaire on cigarette smoking and other health habits. We identified 228 cases of gastric cancer among Cohort 1 subjects (9 years of follow-up with 74,073 person-years) and 223 among Cohort 2 subjects (7 years of follow-up with 141,675 person-years). From each cohort, we computed the relative risk (RR) and 95% confidence interval (CI) of gastric cancer associated with smoking using a Cox regression analysis and pooled these estimates to obtain summary measures. The pooled multivariate RRs (95% CIs) for current smokers and past smokers compared to subjects who had never smoked were 1.84 (1.39-2.43) and 1.77 (1.29-2.43), respectively. The higher number of cigarettes smoked per day among current smokers was associated with a linear increase in risk (trend p < 0.05). The significant increase in risk for past smokers remained for up to 14 years after cessation. An increased risk was noted for cancer of the antrum but not for cardia or body lesions. The risk was increased for both differentiated and nondifferentiated histologic subtypes. Our findings support the hypothesis that cigarette smoking is a risk factor for gastric cancer.