Distribution of adenylyl cyclase/cAMP phosphodiesterase gene, CAPE, in streptophytes reproducing via motile sperm.

We recently isolated a novel adenylyl cyclase/cAMP phosphodiesterase gene from the liverwort, Marchantia polymorpha. The protein encoded by this gene has a class III adenylyl cyclase (AC) in the C-terminal domain and class I phosphodiesterase (PDE) in the N-terminal domain; therefore, we named it CAPE (COMBINED AC with PDE). CAPE protein is likely involved in spermatogenesis and sperm motility due to its tissue-specific expression pattern in M. polymorpha and the distribution of CAPE genes in streptophytes. However, little is known about the distribution of CAPE in gymnosperms that use motile sperm for fertilization, such as cycads and ginkgo. The present study aimed to isolate CAPE genes from the cycad, Cycas revoluta, the ginkgo, Ginkgo biloba, and the hornwort, Anthoceros agerestis. Sequences with high homology to CAPE were obtained from these species. Our analyses revealed that all plant taxonomic groups reproducing via motile sperm possessed CAPE, whereas those that do not produce motile sperm did not possess CAPE, with one exception in gymnosperm Cupressales. The phylogenic distribution of CAPE almost corresponds to the evolutionary history of motile sperm production and further suggests that CAPE may be involved in sexual reproduction process using motile sperm in streptophytes.

Report on support activity for the East Japan Great Earthquake (May 27-29, 2011).

The M9.0 great earthquake that occurred on March 11, 2011 triggered a huge tsunami on the Pacific coast in the Tohoku region and caused enormous damage, resulting in 15,854 deaths and 3,276 missing persons (as of March 1, 2012, according to the Japanese National Police Agency). Presently, inhabitants in Fukushima Prefecture continue to live as refugees because of radiation contamination caused by explosions at the Fukushima nuclear power plants. Immediately after the earthquake, DMATs (Disaster Medical Assistance Teams) went to the affected areas to begin relief operations. The Japan Medical Association then founded the JMAT (Japan Medical Association Team), an organization to take over DMAT activities. The purpose of JMAT is (1) to assist hospitals and clinics in affected areas with daily care and (2) to provide medical care in refuge and aid stations. The Osaka Medical Association was assigned to be in charge of medical support in Iwate Prefecture. For medical services, team activities are more effective than individual efforts. Therefore, JMAT is basically a team composed of one doctor, two nurses, and one clerical officer. The team of Yao Municipal Hospital consists of two doctors, two nurses, two pharmaceutical chemists, and two office clerks. It is 13,000 km each way from Osaka to Iwate, and it is an estimated 15 hours by road. Our initial schedule was five days and four nights, leaving Osaka on the afternoon of May 26 and heading for Iwate on a chartered bus, engaging in medical care from the morning of May 27 to 30, leaving Iwate on the morning of May 30 and returning to Osaka that evening. However, since Hanamaki Airport in the inland area of Iwate Prefecture became usable starting in mid-May, we arrived in Hanamaki City by air and used a large taxi from the airport. In accordance with the recovery of local medical institutions, the Osaka Medical Association JAMT dispatch was to be terminated by the end of May. As a result, our team's itinerary was reduced to three days and two nights, leaving on the morning of May 27 (by air), and returning to Osaka on the evening of May 29 (by air).

The prevalence of pandemic (H1N1) 2009 in a suburb of Osaka city--based on reports on the temporary closing of classes.

An outbreak of pandemic (H1N1) 2009 occurred in May 2009 in Osaka and Kobe, Japan. We studied the prevalence of this strain of influenza in Yao City. According to the study, the frequency of temporary class closure did not vary significantly among the first to sixth grades of elementary schools; however, there was a markedly lower frequency of temporary closures among junior high school third-year classes.

Age-period-cohort analysis of suicides among Japanese 1950-2003: a Bayesian cohort model analysis.

The suicide rate in Japan is one of the highest in the world and presents us with a considerable challenge. Demographic statistics show that the number of suicides is on the rise, and at roughly 30,000 people per year have committed suicide since 1998. Suicide trends are not only related to economic boom and bust but also to certain generations and age groups. During the 1950s, there was a remarkably high suicide rate among people in their 20s, and this cohort was identical to that of the middle-age generation in the 1980s. It is important to separately understand both the trend of suicide rates and the numbers analyzed to determine the different factors that influence suicide. These include age, time period, cohort, interaction between age and time period, and changes in population composition. We performed an age-period-cohort analysis of annual trends of suicide rates by age group in Japan using a Bayesian cohort model. With the help of the Nakamura method, we have been able to break down the effects of age, time period, cohort, and the age-by-period interaction. The cohort comprised of people born in the 1930s demonstrated a relatively high suicide rate. Men currently in their 50s also belong to a high suicide rate cohort. Regarding the period effect, business cycles and by-period interaction effect, it became apparent that the high suicide rate among young adults in their early 20s around 1960 was slowing, especially among men. Instead, there was an obvious recent trend for men in their late 50s to have the highest suicide rate. This study confirmed that age-period-cohort analysis can describe these trends of suicide mortality of the Japanese.

The development of network infrastructure in rural areas and problems in applying IT to the medical field.

The financial condition of the Japanese health insurance system is said to be compounded with the aging of the population. The government argues that the application of IT and networking is required in order to streamline health care services while avoiding its collapse. The Internet environment has been furnished with broadband connection and multimedia in the span of one year or shorter, and is becoming more and more convenient. It is true that the Internet is now a part of Tokyo's infrastructure along with electricity and water supply, as it is the center of politics. However, in local cities, development of the Internet environment is still insufficient. In order to use the network as a common infrastructure at health care facilities, we need to be aware of this digital divide. This study investigated the development status of network infrastructure in regional cities.

A three-year-follow-up study on the change in physical and mental functions of the aged by the level ofADL. Evaluation of data from the Japanese elderly care insurance certification of long-term care need.

Using the value in which the physical and mental condition of elderly persons was converted into the amount of care required time, this paper estimates the average change of physical and mental functions according to the subject's sex and independence level of primary ADL (Activities of Daily Living) over a span of 3 years. The following comparative examination was also carried out: 1) Over a span of 3 years, how did the physical and mental functions of the elderly change? 2) Of the function items, which parts showed a change in function as time passed? 3) Was there any difference in terms of sex? 4) Was there an influence of the care service benefits from Long Term-care Insurance System on functional recovery? In Higashi-Osaka City, from October 1999 to March 2002, of the 20,393 elderly persons aged 65 years old and above who were administered a visit assessment to determine the level of care required, 10,812 persons who had been visited 3 or more times at intervals of 6 months to 1 year and had had data on their physical and mental conditions continuously obtained from them, were used as subjects. A "Multilevel Model Analysis" was conducted based on the ADL from the first visit which was divided into 1) almost independent, almost no need for nursing care (low-grade), 2) can lead an independent life if appropriate care is given (middle-grade), 3) unable to lead a normal day-today life without complete nursing care (severe-grade). For the basic model, the response variable was the hours spent for care required time, level 1 (i) was across multiple visit assessment occasions, level 2 (j) was multiple occasions nested within individuals, and the response variable was age at initial visit assessment and years from initial visit assessment (elapsed time). The prolongation of care required time during the 3 years was calculated at; low-grade male 19.3, middle-grade male 17.6, severe-grade male 2.6, low-grade female 15.2, middle-grade female 16.7, severe-grade female 2.2. The functions that changed over time were those asked in "complex movement" and "the physical hygienics field" items in the survey. These items showed a decrease in function thus increasing the level of required care. During 3 years the elderly care required time was prolongated. In low-grade and middle-grade, the use of nursing-care service did not prevent worsening of the care required level. In severe-grade an improvement was seen in the nursing-care condition. This may be due to the quantity of care provided. In examining the relationship of the care service and the care condition, it is necessary to look into the kind and quantity of severe-grade service that was used.

Closure of dispensing pharmacies during bon holidays--a problem on separation of prescribing and dispensing.

The separation rate of prescribing and dispensing in Japan has doubled to 62.3% in the 2006 fiscal year from 36.2% in the 1999 fiscal year. Although it is great that the separation rate of prescribing and dispensing has approached the level of other developed countries, is it actually convenient for the user? The greatest demerit of the application of separation is that patients must go to a pharmacy to obtain medicine after a medical examination. Although public hospitals are open except for national holidays, private pharmacies may be closed for holidays that are not in the calendar (ex. Bon holidays etc.) In this case, the situation where "a patient cannot obtain medicine because of closure of pharmacies even if he/she has a prescription" may arise. Therefore, we have investigated the situation on closure of dispensing pharmacies in Osaka city during Bon holidays.

[The effects of various factors on cerebrovascular disease mortality rates in the 20th century and future trends in Japan].

PURPOSES: To analyze the outcomes of measures designed to decrease cerebrovascular diseases (CVDs) in Japan and to project CVD mortality trends into the 21st century based on an analysis of rates observed in the 20th century. METHODS: The numbers of CVD deaths and population sizes from 1920 to 2003 (excluding 1940 to 1946) by sex, year, and 5-year age group (from 20 to 79 years old) were used and effects of various factors on CVD mortality rates were estimated using Nakamura's Bayesian age-period-cohort model. The numbers of CVD deaths up to the year 2050 were projected based on estimates of age, cohort, and future period effects under three scenarios: (i) values remaining constant after year 2003; (ii) linearly extrapolated values; and (iii) quadratically extrapolated values, we obtained using a regression line for period effects from 1995 to 2003. RESULTS: The age, cohort, and period effects on CVD mortality rates were large and in order of the magnitude of their ranges. There were small differences between males and females. The age effect increased with aging and the period effect started decreasing after 1970. The cohort effect was high for birth cohorts born from the 1840s to the 1890s and low for those born from the 1920s to the 1970s. There were some differences in the cohort effect between males and females for birth cohorts born after 1940s; for females there was a gradual decrease, while for males there was a slight increase, after which it remained almost constant. According to the three scenarios, CVD deaths: (i) had upward trends through the projected period and peaked at around 2025 and 2045; (ii) remained almost constant at the present level for males, and decreased slightly for females; (iii) decreased for both males and females. CONCLUSIONS: The outcomes of measures designed to decrease CVDs were observed as period effects after 1970. Exposure to these measures is associated with prevention of CVD deaths. Nevertheless, in the first half of the 21st century, the number of CVD deaths is projected to increase due to the aging of the baby boomers and upward trends in the cohort effect for males. It would be necessary to adopt and develop both population strategies to decrease future period effects and high-risk strategies to decrease cohort effects for younger males who are currently in their twenties and thirties.

[The influence of a doctor's opinion on notification delay in the long-term care insurance system in Japan--a two year study].

Prompt notification of recognition of the need for nursing is necessary for smooth application of Long-term Care Insurance Services. The Long-term Insurance Act requires notification of applicants of certification within 30 days. However, recognition of the need actually may be delayed for various reasons. To explain the influence of investigation for certification and the doctor's opinion for notification delay, 38,285 applications were investigated for 2 years in a city close to Osaka. The investigation period was divided into two stages, the first stage (from July 2000 to June 2001) and the second stage (from July 2001 to June 2002). The notification rate of the recognition result within 30 days was 42.0% in the first stage, and it improved to 46.8% in the second stage. However, the approximate number of days required for investigation for certification improved from 10.5 to 10.3, and that for the doctor's opinion improved from 20.2 to 19.1. Thus the doctor's opinion is a rate-controlling factor for the notification. By the standard operating procedures of the city, a two-week period is needed to prepare the long-term care requirement certification, thus it is necessary to obtain the doctor's opinion within 15 days.

Patients' attitude toward dispensing pharmacies: questionnaire survey conducted August 15.

BACKGROUND: In Japan, the separation rate of institutions prescribing and dispensing medications has tripled in 10 years, and reached 46.0% in 2002. Ever since the Japanese government promoted this separation in 1998, Osaka National Hospital (ONH) has maintained an out-of-hospital prescription rate of more than 90%. To learn patients' recognition of the separation, we conducted a questionnaire survey on a Bon holiday, one of the traditional holidays in Japan. METHOD: On August 15, 2001, we conducted a questionnaire survey concerning dispensing pharmacies that are closed on holidays. In-hospital pharmacists of ONH and pharmaceutical internship students asked outpatients who visited ONH on that day to participate in the survey. RESULTS: 406 out-of-hospital prescriptions were issued on that day, and 228 questionnaires were collected. In this survey, 53 patients (23.3%) did not know if their dispensing pharmacies were open or closed on that day. CONCLUSION: Patients were not so concerned if their dispensing pharmacies were open or closed. We found that the information dispensing pharmacies provided their patients was not adequate. It seems necessary for hospitals and dispensing pharmacies to take more action in cooperatively informing patients of their holidays.