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社会福祉施設に勤務する栄養士59名を対象に,職務満足度とその関連要因について調査した。満足の度合によって「満足群」と「不満足群」に分け,身体症状や職業性ストレス等との関連を検討した.結果,以下の如く,職務満足度は多様な要因と関連していることが示唆された。1)身体・心身症状(21項目)では「体のふしぶしが痛む」「励まされても気分が晴れない」の2項目において,「満足群」に比べて「不満足許」の有訴率が高かった.2)職業性ストレス(38項目)では「中長期の課題が不明確である」「将来に展望が持てない」などの5項目で「不満足群」の有訴率が高く,反対に「働きがいのある職場だ」の1項目で「満足群」の有訴率が高かった.3)ソーシャルサポート(12項目)では「職場のスタッフと気軽に話せる」,上司(13項目)では「上司は意見を聞いてくれる」「必要なとき適宜助言してくれる」の3項目で「満足群」の有訴率が高かった., The subjects of this research were 59 dieticians who worked for social welfare institutions in Sapporo City. Using a questionnaire, we asked them about the degree of satisfaction of the job and various factors, such as occupational stress and health conditions. The subjects were divided into 2 groups according to the degree of satisfaction of the job (satisfactory group "SG" and unsatisfactory group "UG"). It turned out that the job satisfaction was accounted for by several factors : 1) Factors for physical and mental conditions : the percentages among the UG were higher of those who had painful joints and/or were not cheered up by encouragement of family members or friends. 2) Factors for occupational stress : the percentages among the UG were higher of those who had no definite long-term aim and/or had no hope for the future. The percentages among the SG were higher of those who thought that her workplace was worth working for. 3) Factors for social supports : the percentages among the SG were higher of those who could talk with staffs in her workplace, and/or whose superior accepted her opinions or advised appropriately.

【目的】本研究は,健康な生活を確立するための様々なライフスタイル要因のうち,特に自己の捉え方に関連する要因を検討することを目的とした.【方法】北海道医療大学2005年度新入学生(570名)を調査対象とし,調査当日の講義出席者に対し回答を求めた.回収した質問紙票を基にOKグラムを分類し,自己の捉え方を目的変数として健康生活習慣,ソーシャル・サポート,自覚症状とのクロス表を作成し,関連の有意性を検討した.【結果】健康生活習慣の「趣味の有無」「悩みの有無」,「ソーシャル・サポートの有無」に有意な関連が認められ,それぞれの項目について好ましい回答群の方が自己肯定群の相対的出現率が上がる傾向がみられた.【考察】これらの結果から,「趣味があり,悩みが無く,ソーシャル・サポートがある」という方が自己肯定的な構えを持つ傾向が示唆された., Purpose : This study was aimed at examining a factor to be related to a posture of self in particular among various lifestyle factors to establish healthy life. Method : An investigation object is fresh students in 2005 of Health Science University of Hokkaido(570). For the students that it attends during a lecture of the investigation day to have demanded an answer. We classified OK grams based on the questionnaire which collected. We examined related significance with various lifestyle factors as a purpose variable by posture of self. Results : As a result of analysis, the item where there was significant relation in posture of self was "presence of a hobby" and "presence of a trouble" of a healthy habit, it and "presence of social support". The tendency that was high relative incidence of "affirmative self was recognized "favorable answer group" in comparison with "unfavorable answer group", in those items. Consideration : From these results, a tendency that "the person whom there was a hobby, and there was not a trouble, and had social support" was affirmative by oneself was suggested.

北海道の女性労働者586名に質問紙票(CES-D:the Center for Epidemiologic Study Depression Scale)を用いた抑うつ調査を実施した。一般職域の従業員542名と栄養士144名の2群に分けてCES-D(20質問項目)の因子構造を比較・検討した結果、以下の諸点が明らかとなった。1)一般職域従業員の探索的(因子数を指定しない)因子分析では、直交回転法、斜交回転法のいずれにおいても、第1因子:「不安6項目・孤立4項目」、第2因子:「抑うつ6項目」、第3因子:「生活に対する満足4項目」の3因子に縮約された。2)栄養士の探索的因子分析では、直交回転法では因子構造が同定できず、斜交回転法では6因子構造が示唆されたものの相関係数が1.0を越えるなど構造に不安定さがみとめられた。3)栄養士の確認的(因子数を3に指定した斜交回転法)因子分析では、第1因子:「不安6項目・抑うつ6項目」、第2因子:「孤立4項目」、第3因子:「生活に対する満足4項目」に集約された。4)一般職域従業員と栄養士の因子構造では、第3因子の「生活に対する満足4項目」は同じ質問項目で構成され、第1因子の「不安6項目」についても共通していた。また、一般職域従業員の第1因子の「孤立4項目」は栄養士の第2因子の「孤立4項目」と等しく、栄養士の第1因子の「抑うつ6項目」は一般職域従業員の第2因子の「抑うつ6項目」と対応していた。5)一般職域従業員、栄養士ともに第1因子の「不安6項目」を中核として共有し、それに「孤立4項目」が付随すると一般職域従業員の因子構造となり、「抑うつ6項目」が付随すると栄養士の因子構造となることが示唆された。以上のことから、北海道内女性労働者のCES-Dは、潜在的に「不安6項目」、「孤立4項目」、「抑うつ6項目」、「生活に対する満足4項目」の4因子で構成されていることが推察された。

2006年度本学新入学生(歯学部、薬学部、看護福祉学部、心理科学部)590名を対象として、「対人関係の基本的構え」と「精神的・身体的自覚症状」に関するアンケート調査を実施した。エゴグラムをもとに対人関係の基本的構えを1)自己肯定型(I am OK)、2)他者肯定型(You are OK)、3)自他肯定型(We are OK)に類型化して、精神的自覚症状(16項目)および身体的自覚症状(15項目)の有訴率との関連性について性別に比較検討した。結果、以下の諸点が明らかになった。1)自己の捉え方の分類[肯定群(I am OK):非肯定群(I am not OK)]において、男性女性ともに肯定群にくらべて非肯定群で精神的・身体的自覚症状の有訴率が高い傾向がみとめられた。精神的自覚症状について、男性では「することに自信がもてない」「自分が他人より劣っていると思えて仕方がない」「将来に希望がもてない」などの9項目、女性では「することに自信がもてない」「自分が他人より劣っていると思えて仕方がない」「理由もなく不安を感じる」などの9項目で有訴率が有意に(p, We examined fundamental posture to interpersonal relationship and subjective symptoms of mind and body. The questionnaire survey was done by using the question papers for the fresh students in Health Science University of Hokkaido. We classified posture to the interpersonal relationship into three categories, and analyzed relationship of subjective symptoms. The posture types were classified as follows : type 1 : Self Affirmative or Negative, type 2 : Others Affirmative or Negative, type 3 : Self and Others Affirmative or the rest. The subjective symptoms varied between each posture types. Negative attitude to self and others increased the subjective symptoms. There were much significant differences in mental subjective symptoms than in physical ones. Especially, there were a lot of relationship between posture types and mental subjective symptoms in women.

Aim. To evaluate the governmental regulation system introduced in October 2002 by investigating the prevalence of pressure ulcers (PUs) and to investigate the relationship between the change in prevalence and the structure and system within hospitals.This retrospective cohort study used 2582 randomly sampled hospitals in Japan. Questionnaires were mailed to each type of hospital, including university hospitals, acute hospitals, acute and long-term (mixed care) hospitals, long-term care hospitals, and psychiatric hospitals. Prevalence and severity of pressure ulcers over 4 consecutive periods (1 month before the introduction of regulation, immediately after the introduction, 6 months later, and 1 year later) and related factors for the improved prevalence were assessed.The overall prevalence before the regulation was 4.26%, which decreased to 4.18% immediately after regulation, and to 3.95% and 3.64% 6 months and 1 year later, respectively. The overall proportion of Stage III and IV pressure ulcers acquired after admission was 23.9% and 10.9%, respectively, before introduction of regulation, and gradually decreased to 18.8% and 8.1%, respectively, after 1 year. The related factor for improved PU prevalence was sufficient distribution of alternating air mattresses (odds ratio = 2.259, 95% CI; 1.091-4.679, P = 0.028).The governmental regulation had a clinically important effect on the decrease in PU prevalence. The regulation focused on the structure of hospitals was confirmed to influence the outcome of hospital care quality.

本研究は,対人関係と健康との関連を明らかにするため,特に自我構造(エゴグラム)から類型化した対人関係の基本的構え(OKグラム)と自覚的健康感および自覚症状との関連を分析し,性別に比較した.その結果,以下のことが明らかになった.1)基本的構えと自覚的健康感との関連について,男性では有意な関連が示されなかったのに対して,女性では自己の捉え方と自覚的健康感において有意な関連が示された.2)基本的構えと自覚症状との関連について,男性よりも女性の方がより多くの自覚症状,特に精神的な自覚症状との関連が多数示された.3)いずれの自覚症状においても,自己・他者の捉え方が肯定的な群に比べ,否定的な群の有訴率が高くなる傾向が示された.よって,対人関係の基本的構えと健康との関連には性差があり,特に女性においては自己の捉え方が精神的な症状の有訴率を低下させる一要因である可能性があるということが示唆された., Purpose : To clarify the factors that influence health, we examined posture to interpersonal relationship and Self Assessed Health Status (S.A.H.S) to fresh students in Health Science University of Hokkaido. Method : The questionnaire survey was done by using the question papers for the fresh students. We classified posture to the interpersonal relationship into four categories, and analyzed relationship of S.A.H.S by using the univariate analysis and the multivariate analysis. The posture to interpersonal relationship was classified as follows : type 1 : Self Affirmative and Others Affirmative, Self Affirmative and Others Negative, Self Negative and Others Affirmative, Self Negative and Others Negative, type 2 : Self Affirmative or Negative, type 3 : Others Affirmative or Negative, type 4 : Self and Others Affirmative or the rest. Result : There was no significant relation between each category and S.A.H.S in the male. On the other hand, a significant relation between posture to self and S.A.H.S was shown in the female. Moreover, female's significant relation between each category and the subjective symptom was more than that of the male. Especially, there were a lot of relations to a mental subjective symptom. The subjective symptom that had a significant relation between each categories tended to describe symptoms by becoming of posture to self and others negative. Discussion : There was a character difference in the relation between posture to interpersonal relationship and S.A.H.S, and the subjective symptoms. Especially, the female have the possibility that posture to the self is a factor to decrease mental symptoms.

本研究は,「どのような人が自覚的健康感が高いのか」,自覚的健康感の高い人の典型例を抽出することを目的として,自覚的健康感とライフスタイル要因全般との関連を多角的,総合的に検討した.結果は以下の通りに約言される.1)健康生活習慣に関する分野では,健康群において,「栄養のバランス」,「自覚的ストレス」,「睡眠時間」の実践率が高い傾向がみられた.2)エゴグラム(自我構造)に関する分野では,健康群において,「気分転換が上手」,「物事を明るく考える」など,FC領域の得点が高い傾向にあった.3)対人関係の基本的構えに関する分野では,健康群において,「人に恵まれている」,「自分の周りにいる人が好きである」などの割合が高かった.4)ソーシャルサポートに関する分野では,男性の健康群において「日ごろからあなたの実力を評価し,認めてくれる人がいる」,女性の健康群において「良いところも悪いところもすべて含めて,あなたの存在を認めてくれる人がいる」などの割合が高い傾向が認められた.以上の結果から,自覚的健康感は,すべてのライフスタイル要因と多面的に関連していることが読み取れる.したがって,「健康生活習慣を実施し,物事をあかるく考え,自他肯定的で,他人との良好な関係を得ている人」が自覚的健康感の高い人の典型であることが示唆された., In this research, we investigated a relationship between self assessed health status and all factor of life styles multilaterally and comprehensively to show "what is people who have high self assessed health status like?" and their typical instances. The results indicated the following. 1) HPI : A tendency that rate of practice of "balance of nourishment", "conscious stress", and "sleep time" was high appears in a healthy group. 2) Self grow-up ego-gram : For example "I was good at feeling switch", "I thought about things cheerfully" score of a FC tended to be high. 3) Self structure : The ration that "liked the person who was around oneself" and "blessed with people" and so on was high in a healthy group. 4) Social support : A ration that in a group of the man "there was the person who usually evaluated their ability and recognized their", and in a group of the woman "there was the person who recognized their existence including their strengths and defects" and so on tend to be high. As a result we found that self-assessed health status related with all factor of life styles multilaterally. Therefore "the person who practiced life styles thought about things optimistically, and got oneself and others affirmation, have good relation with other person" was type of a person who have high self assessed health status.

本研究は、性格行動と健康との関連を明らかにするため、特に自我構造(エゴグラム)から類型化した対人関係の基本的構え(OKグラム)と、健康状態を示す抑うつ症状や疲労感などの心身の自覚症状との関連性を分析することを目的とした。その結果、以下の事柄が明らかになった。1)OKグラムの各分類において、肯定的群に比べ否定的群の方が自覚症状有訴率は上がる傾向がみられた。2)OKグラムと有意な関連が認められた自覚症状は、身体的な症状よりも精神的な症状が多かった。3)特に自己の捉え方の分類において2)のような傾向が顕著であった。以上のことから、対人関係の基本的構えに代表される自我構造は、精神的な自覚症状に影響を与える一要因であり、特に自己の捉え方がより大きく関連しているといえる。よって、健康教育等の啓発活動を講じる際には、自己の捉え方に着目かつ配慮した内容である必要性があるということが示唆された。, This research aimed to analyze the relation to OK gram and mind and body's subjective symptoms to clarify the relation between the character action and health. As a result, it can be said that the ego-gram, for example, a fundamental posture of the interpersonal relationship is one factor that influences a mental subjective symptom, and how to capture the self is more greatly related especially. Therefore, it was suggested that there be a necessity that was the content that paid attention to how to catch the self and was considered when lecturing on the enlightening activity of the health education.

本研究では、対人関係の基本的構えと自覚症状の関連を明らかにすることで、健康な生活を送るための望ましい対人関係の基本的構えのあり方を示唆し、今後の健康教育対策に資するべく、1)自身の対人関係の基本的構え、2)現在の健康状態および心身の自覚症状について調査し、これらの諸要因の関連を検討した。エゴグラムを構成する因子からOKグラムを推定し、対人関係の基本的構えを、自己の捉え方、他者の捉え方にそれぞれ分類し、分析した。その結果、以下の諸点が明らかとなった。1)自己および他者の捉え方の四群と、自覚症状細目の関連を検討した結果、「生活に張り合いを感じない」、「なんとなくゆううつな気分がする」、「人との付き合いがおっくうである」、「勉強や学生生活に対する意欲がない」、「将来に希望がもてない」、「理由もなく不安になる」、「することに自信が持てない」、「自分が他人より劣っていると思えて仕方がない」、「勉強ヤアルバイトの後でくたくたに疲れる」、「足がだるい」の10項目において有意な関連がみられた。2)自覚症状の31項目を、精神的自覚症状(16項目)と身体的自覚症状(15項目)に分類し、OKグラムにおける肯定的群と否定的群の得点を比較した結果、自己肯定群と比較し、自己否定群の自覚症状得点、殊に精神的自覚症状得点が有意に高かった。3)自覚症状の31項目をそれぞれ目的変数、OKグラムのカテゴリを説明変数とし、ロジスティック回帰分析を行った結果、OKグラムとの関連が示唆された自覚症状は、精神的自覚症状に分類されるものが多くを占めた。また、自己の捉え方が肯定的であることが、年齢、性別などの影響を除いてもなお、自覚症状の有訴率を抑制する要因として重要であることが示唆された。以上の結果から、対人関係の基本的構えは自覚症状の有訴率を規定する一要因であることが示唆された。今後の健康教育対策を講ずる際には、対人関係の基本的構え、中でも自己の捉え方を肯定的に捉えることの重要性を啓発する内容が求められる。, For future health promotion as a university, this study aimed to identify if there is a connection between participants basic attitude towered intrapersonal, interpersonal relationships and their awareness of physical psychic symptoms. 383 students asked a questionnaire by a question list, according to OK gram, that consists 4 categories, we categorized what kind of particularly in each category. In the result, we have found that there is a close connection between participants basic attitude towered intrapersonal, interpersonal relationships and their awareness of physical psychic symptoms.

本稿では、好ましいライフスタイル確立に資する早期健康教育のあり方を模索すべく、日常の健康生活習慣の実践状況と心身の自覚症状や自覚的健康感の関連を検討した。その結果は、以下のように約言される。1)女性は、男性より健康生活習慣実践指標(以下HPI: Health Practice Index)総得点が高く、自覚症状得点が低い。2)HPI各項目の実施群、非実施群の間で、自覚症状得点に有意な差がみられた項目は、男性では「栄養のバランス」、「拘束時間」が、女性では「適正飲酒」であった。また、男女ともに有意な差が見られた項目は、「朝食摂取」、「自覚的ストレス」であった。3)自覚症状で、男性の有訴率が有意に高い項目は「生活に張り合いを感じない」、「自分が他人より劣っていると思えて仕方がない」、「横になりたいぐらい勉強・アルバイト中に疲れる」、「全身の力が抜けたようになることがある」、「自分の健康の事が心配で仕方がない」、「何かでスパーっとうさばらしをしたい」が、女性の有訴率が有意に高い項目は「肩が凝る」、「便秘をする」であった。4)自覚的健康感を目的変数、HPI各項目を説明変数として多変量ロジスティックモデルを構築し、ステップワイズ法によって変数選択したところ、男性では「栄養のバランス」、「自覚的ストレス」が、女性では「適正睡眠」の項目が独立性の高い変数として検出された。5)HPI実践群と比較して、非実践群の自覚症状得点が高くなると同時に自覚的健康感が低くなる傾向が認められた。以上の結果から、HPIの実践が、自覚症状有訴率の低下および自覚的健康感の向上を図るうえで有効な要因の1つであることが示唆された。また、男性では精神的自覚症状の有訴率が高く、女性では身体的自覚症状の有訴率が高いことから、早期健康教育を実施する際には、性別に配慮したプログラムを用意することの重要性が示唆された。, We investigated the relationships between the life styles and subjective symptoms in 560 freshman of Health Sciences Univeesity of Hokkaido. The results indicated the following. 1) Practice of HPI produced a fall of the rates of subjective symptoms and improvement of self-assessed health status. 2) Many male students complained mental subjective symptoms, while many female students complained physical subjective symptoms. Accordingly preparing for the program that considered sex is important in early stage health education.

To assess the association between the egogram and hypertension in pregnancy (HP), a case-control study was carried out. Seventy-one HP cases, primiparous aged 20 to 34 years, and 109 controls, were enrolled among pregnant women who visited our hospitals for obstetrical care. Data from a self-administered questionnaire containing a Self Grow-Up Egogram (SGE) were subjected to univariate and multivariate analyses with prepregnancy body mass index (BMI) and angiotensinogen (AGT) genotype. The mean +/- standard error of total scores for the critical parent (CP) scale were 9.7 +/- 0.5 for cases and 8.3 +/- 0.3 for controls, those for the nurturing parent (NP) scale were 13.6 +/- 0.4 for cases and 13.4 +/- 0.3 for controls, those for the adult (A) scale were 11.3 +/- 0.5 for cases and 10.9 +/- 0.3 for controls, those for the free child (FC) scale were 12.3 +/- 0.3 for cases and 13.8 +/- 0.3 for controls, and those for the adapted child (AC) scale were 10.2 +/- 0.4 for cases and 8.5 +/- 0.4 for controls. A low FC scale score (FCor = 10) and a high AC scale score (AC10) were significantly associated with HP ( p0.05; p0.01, respectively). In the multivariate analysis, FCor = 10, AC10, prepregnancy BMIor = 24, and homozygosity of the T235 allele genotype of the AGT gene were detected as the potent independent risk factors for HP. The odds ratios were 2.2, 2.8, 4.0, and 2.5, respectively. The present results suggest that a low FC score and a high AC score may be potent, independent risk factors for HP.

We sought to perform a tree-based analysis of lifestyle risk factors for hypertension in pregnancy (HP) with univariate and multivariate analyses. Seventy-eight HP patients and 199 normal controls were recruited from primiparous women 20 to 34 years of age. Data from angiotensinogen (AGT) genotyping and data from a self-administered questionnaire about lifestyle were subjected to univariate and multivariate analyses. By dividing the subjects into two subgroups--those who possessed "the TT genotype of AGT" and "body mass index (BMI) < 24" and those who did not--we were able to examine the acquired risk factors for HP during pregnancy in these two groups. Multivariate analysis selected "mentally stressful condition" and "no antenatal training during pregnancy" in the former group, and "poorly balanced diet" in the latter group. Determination of factors obvious before pregnancy, such as genotype or prepregnancy BMI, may be useful for devising effective individualized strategies for preventing HP.

Objective: To investigate whether changes at computed tomography (CT) imaging in the ageing brain are associated with future risks for functional dependence. Subjects: 160 residents aged 69 years and older at the cranial CT and were independently living in a rural community in Hokkaido, Japan. Methods: Cranial CT was performed between 1991 and 1993, graded for ventricular enlargement, sulcal enlargement, white matter change, and small infarction. Functional status was reassessed in 1998 in each participant. Multiple logistic regression analysis was performed to estimate the association of CT changes in the ageing brain with development of functional dependence over six years. Results: Functional dependence was found in 19 residents at the second survey. After adjusting for age, sex, medical conditions, and cognitive functioning, small infarction and ventricular enlargement were significantly associated with development of functional dependence (adjusted odds ratio = 9.27 and 4.62). Conclusions: After controlling for age, the age-related changes on cranial CT have significant association on development of functional dependence.

The effects of long-term blood pressure (BP) levels on cerebrovascular changes were analyzed in a community-based healthy elderly population. Cranial computed tomography (CT) was performed for 300 residents aged 69 years and older. Long-term BP during the ten years prior to CT was assessed, and the cerebrovascular changes were compared among different patterns of long-term blood pressure variability. White matter lesions (WML) and/or silent infarctions (SI) were found in 73 subjects (23.6%). Multiple logistic regression analysis showed that subjects with long-term diastolic hypertension (DHT) had the highest risk of cerebrovascular changes (adjusted odds ratio (OR), 95% confidence interval (CI); 7.1, 2.4-21.6, for WML; 7.2, 2.7-19.4, for SI), and that long-term isolated systolic hypertension (ISHT) was significantly associated with SI (adjusted OR, 95%Cl, 2.3, 1.1-4.9), but not with WML (adjusted OR, 95%CI, 1.3, 0.5-3.3). Efforts to prevent both DHT and ISHT would be beneficial, though different underlying mechanisms for WML and SI were suggested.J Epidemiol, 2001 ; 11 : 190-198

Preeclampsia is known to be a multifactorial disease. Recently, the angiotensinogen gene has been shown to be a candidate gene that could be related to preeclampsia, and acquired factors such as lifestyle during pregnancy have also been considered to be risk factors. The aim of this study was to investigate the interrelations among the angiotensinogen gene and various acquired risk factors in preeclampsia. Fifty-eight primiparous patients with pre-eclampsia were compared with 164 normal primiparous controls. A variant of the angiotensinogen gene (M235T) was analyzed along with the acquired factors obtained from both medical records and a questionnaire consisting of 98 questions. Univariate analysis disclosed 11 factors that were significantly associated with preeclampsia (P.05). Multivariate analysis revealed four significant independent factors: "prepregnancy high body mass (body mass indexor = 24)," "T235 homozygotes of the angiotensinogen gene," "mentally stressful condition during pregnancy," and "salty dishes preferred during pregnancy." The odds ratios of the four factors were 6.2, 2.5, 3.0 and 2.6, respectively, in a multiple logistic model. Our results support the concept that T235 of the angiotensinogen gene is a potent, independent risk factor for preeclampsia, as well as other lifestyle-related risk factors.

Angiotensin-converting enzyme inhibitors (ACEIs) cause regression of hypertensive left ventricular hypertrophy (LVH) by reducing angiotensin II, increasing bradykinin, or both. The mechanisms of these cardioprotective effects remain controversial. The aims of this study were to determine whether the cardioprotective effects of ACEIs are mediated by reducing angiotensin II and whether ACEIs ameliorate the morphologic, physiologic, and biochemical changes in the hearts of stroke-prone spontaneously hypertensive rats (SHRSPs). Male SHRSPs were treated with hydralazine, captopril, or candesartan, an angiotensin II type 1 receptor (AT1R) antagonist, from age 12 to 24 weeks. We measured systolic blood pressure (SBP), left ventricular weight (LVW), left ventricular (LV) myocyte cross-sectional area (myocyte size), LV Interstitial collagen volume fraction (ICVF), perivascular collagen area/luminal area ratio (PVCA/LA), the medial area to luminal area ratio (MA/LA), the relative amount of V3 myosin heavy chain (MHCV3), and coronary reserve maximum (coronary flow max/ventricular weight (CFmax/VW)). These parameters were compared with those of untreated SHRSPs and Wistar-Kyoto rats (WKYs). SHRSPs exhibited decreased coronary reserve and LVH with an increase in myocyte size, PVCA/LA, MA/LA, and MHCV3 at 12 weeks of age. In addition to these changes, 24-week-old SHRSPs showed an increase in ICVF. The LVW, coronary reserve, myocyte size, PVCA/LA, ICVF, and MHCV3 of SHRSPs treated with captopril or candesartan all approached control values. In contrast, hydralazine decreased only ICVF. These results suggest that ACEIs regress LVH and normalize coronary reserve by modulating the effects of angiotensin II via AT1R on the induction of cardiomyocyte hypertrophy, perivascular fibrosis, and medial thickening of intramyocardial coronary arteries in SHRSPs. We concluded that these effects, in addition to the reduction of SBP, are important in causing the regression of LVH.

Diagnoses recorded in the chapter E of Minimum Data Set (MDS) were analyzed in patients requiring care admitted in a geriatric hospital in Sapporo, Japan. They were classified as: A-diseases causing care-requiring conditions, B-their symptoms, and C-coexisting diseases requiring no care. Orthopedic diseases were not analyzed because they were not adequately recorded in MDS system. Class A diagnoses varied, but only five diagnoses were responsible for 3% or more of the total patients who required care. They were 1) Alzheimer's disease (AD), 2) Parkinson's disease, 3) dementia other than AD without neurological symptoms, 4) dementia other than AD with sequelae of stroke, and 5) sequelae of stroke without dementia. These diagnoses pooled represented over 90% of all patients. "Diagnoses and symptoms" in MDS were useful to 1) describe medical problems briefly in a predetermined format, 2) evaluate urgent or unstable conditions separately from stable diagnoses and symptoms, and 3) use common information by various professions, but have difficulties because 1) preselected diagnoses were few and unsuited to practices in Japan, 2) it is impossible to record a previous disease in the past that initiated the process leading to the present disabilities, and 3) it is also impossible to record the severities of the diseases and symptoms.

To clarify whether the homozygous deletion (DD) genotype of angiotensin-converting enzyme gene ( ACE) is a genetic risk factor for preeclampsia in Japanese women, we performed ACE genotyping in patients with preeclampsia and healthy pregnant women, and analyzed the relationship between preeclampsia and ACE genotype, taking into account some well-known contributing factors for preeclampsia, such as primiparity, positive family history of hypertension, prepregnancy body mass index < 24, and heterozygosity and homozygosity of T235 (MT+TT) genotypes of the angiotensinogen ( AGT) gene. Among all of the subjects, the frequency of the DD genotype was not different between patients with preeclampsia and controls (16% and 12%, respectively). Regarding primiparity, prepregnancy body mass index < 24, and MT+TT genotypes of AGT, no significant differences in the frequency of the DD genotype of ACE were found between patients with preeclampsia and controls, although in a subgroup positive for family history of hypertension, the frequency of the DD genotype tended to be higher in patients with preeclampsia (25%) than in controls (8%; p = 0.061). Carrying the DD genotype may have some influence on the pathogenesis of preeclampsia, perhaps through effects on placental hypoxia or the interaction of hypertensive disease and atherosclerosis, although this influence may not be strong. Additional studies using a larger number of patients and analyses that include other genetic and environmental factors will be necessary to confirm these results.

In order to determine whether maternal smoking before or during pregnancy, or both, is associated with a reduced risk for preeclampsia in Japanese subjects, we conducted a case-control study that took other risk factors for preeclampsia into consideration. Seventy-one preeclampsia patients were matched with 142 controls for parity and age. Information from a self-administered questionnaire and clinical data such as maternal age, parity, family history of hypertension, prepregnancy body mass index (BMI), and pregnancy outcomes were analyzed. No significant difference was found between the groups in smoking rates before and during pregnancy (38.0 and 18.3% in preeclampsia patients and 38.0 and 16.9% in controls, respectively). However, classification of the subjects according to the presence of "prepregnancy high body mass (BMI > or = 24)" revealed a significant association between maternal smoking before pregnancy and preeclampsia in women with a prepregnancy high body mass (a smoking rate of 47.6% in patients with preeclampsia and 7.1% in controls, p < 0.05). This result suggests that there is a clear racial difference in the manifestation of preeclampsia with respect to the effect of smoking and that early intervention, particularly before pregnancy, to get obese women to stop smoking may be effective for preventing preeclampsia.

A Minimum Data Set (MDS) was recorded in two geriatric hospitals every 4 months for about 5 years. The initial records were available in a total of 1,735 disabled elderly. In MDS, about 360 trigger items were recorded. A selection was made to determine whether there were problems of care in 18 areas of Resident Assessment Protocols. We analyzed errors and biases in selection of the diagnosis in the chapter E of MDS disclosing that: 1) they were almost satisfactorily made in diseases except dementias, 2) diagnosis of dementias was biased in several ways, particularly Alzheimer's disease was overselected, and 3) preprinted diagnostic options in MDS were not suited with the Japanese practice and were insufficient for comprehensive medical/nursing service and caregiving.

The contribution of genetic factors to hypertension in pregnancy, including pre-eclampsia, has been well documented. The association with a common molecular variant of the angiotensinogen (AGT) gene, in which methionine (M235) is substituted for threonine (T235) at residue 235, has been reported in both Caucasians and Japanese. In the present study, we examined 115 cases of pure type of hypertension in pregnancy (PHP) and 381 normal pregnant controls in order to look for subgroups in which the AGT gene is the major factor in the PHP pathogenesis. By classification of PHP cases according to the clinical diagnosis, gravidity, and maternal age, we found significantly higher frequencies of T235 in both all PHP patients and preeclampsia/eclampsia patients than in normal controls. These results are discordant with those reported for Caucasian subjects where only a group of preeclamptic primigravidae was associated with the AGT variant, possibly indicating the existence of a racial difference. We also found that the variant frequency was significantly higher in the PHP subgroup with maternal age of 20-34 years (0.93) than in a subgroup of multigravid PHP patients age 35 years or older (0.77, P < 0.05) or in normal controls of age 20-34 years (0.76, P < 0.001). The result indicates that the AGT variant plays a significant role in hypertension in the age group 20-34 years.

It has been reported that individuals with the D allele of an insertion/deletion (I/D) polymorphism of the angiotensin converting enzyme (ACE) gene are at greater risk for myocardial infarction (MI), especially among subjects normally considered to be at low risk. However, little is known about the mechanism by which the ACE polymorphism affects the risk of MI. Coronary artery spasm (CAS) is considered to be one possible mechanism for developing MI. We therefore examined the ACE polymorphism relation to CAS to determine if this was the mechanism by which the DD genotype influences MI. We studied 150 angiographically assessed Japanese males, all more than 60 yr old. CASs were detected using intracoronary injection of ergonovine maleate. Subjects were divided into three groups: those with CAS (group 1), those without CAS, but with fixed organic stenosis (group 2); and those without CAS and no organic stenosis (group 3). DD subjects were significantly represented in group 1 when compared with groups 2 (P = 0.002) and 3 (P = 0.026). These results suggest that the DD genotype relates to the greater risk for MI in the patients with CAS.

Diseases in old age affect organs which normally function for most of life. They clinically manifest themselves after a longstanding process influenced by cumulated effects of many genes and environmental factors, each with relatively minor contributions. In the present study, vascular dementias (VD) and Alzheimer’s disease (AD) were analyzed in an identical method in an attempt to compare the risk factors of the two major dementing diseases in old age.

A case-control study of Alzheimer''s disease was conducted in Japan; it involved 60 cases matched for sex and age with two resident controls each. Life-style was particularly highlighted in this study. Among many factors, 5 were accepted as significant risk factors: psychosocial inactivity, physical inactivity, head injury, loss of teeth and low education. A multiple logistic model was applied in order to evaluate synergism of major factors. Compared with those who have none of the factors, those who have all were 934.5 times more liable to develop Alzheimer''s disease. Risk factors are not only useful for etiological studies but they give clues to identify high-risk individuals, and by eliminating these factors, the studies may also be applicable in the primary and the secondary prevention of this tragic disease.