Hiroshima and Nagasaki

"Having found the bomb we have used it. We have used it against those who attacked us without warning at Pearl Harbor, against those who have starved and beaten and executed American prisoners of war, against those who have abandoned all pretense of obeying international laws of warfare. We have used it in order to shorten the agony of war, in order to save the lives of thousands and thousands of young Americans."

Any similarity with claims made by terror groups are purely co-incidental. Any similarity between "post hoc" editing of the rationale to a more politically-acceptable doctine and (say) justification for a pre-emptive attack on another country are, again, purely co-incidental.

Damage caused by the atomic bombs dropped on Japan, 1945

A-bomb survivors continue suffering

Hiroshima Gallery

Summary of RERF Findings

Life Span Study

About 120,000 subjects, including proximally and distally exposed A-bomb survivors living in Hiroshima or Nagasaki and nonexposed controls, were selected on the basis of data from the 1950 National Census. Whether the life span and causes of death of A-bomb survivors differ from those of unexposed individuals in the general Japanese population is epidemiologically studied with the help of information from vital- statistics surveys and other sources. Revised doses (Dosimetry System 1986 [DS86], see item 9, page 38) are available for the majority of these survivors. The average dose received by exposed survivors in this population is 0.16 Gy. Data are maintained and coded in the computer in the Research Information Center. As of the end of 1985, there have been almost 29,000 deaths, including about 6,000 cancer deaths among the 76,000 survivors with known DS86 doses. Approximately 350 of these cancer deaths are estimated to be attributable to radiation. Figure 1 shows the estimated relative risks of various types of cancer.

A relative risk of, e.g., 1.29, for all malignant tumors except leukemia means that a person who received a radiation dose of 1 Gy (see Remark 1, page 64) is 1.29 times as likely to develop cancer as an unexposed person. Relative risks do not describe the absolute excess in risk, which also depends on the frequency of the disease in an unexposed population. For example, although the relative risk of leukemia is high, leukemia is a rare disease, and thus the actual number of radiation-induced cases is small. Cumulative radiation doses from natural, medical, and occupational sources are estimated to be about 2 milliGy (or 0.002 Gy) per annum for man.

From "Figure 1" which is partly in Japanese ;-) we find the following increased "relative risks":

leukemia	4.97
lymphoma et al	1.29
esophagial	1.43
stomach	1.20
colon	1.56
lung	1.46
breast	2.80
laryngeal	2.07
multiple myeloma	2.68

But the GIF document is very hard to read.

Genetic Studies

The search for genetic effects in children (F1) born to A-bomb survivors includes the following studies. To date no genetic effects resulting from parental exposure have been verified in any study program. However, final conclusions have not been reached yet, since the studies are in various stages of completion.

1. Untoward Pregnancy Outcome: The Untoward Pregnancy Outcome Study was conducted during the period between 1948 and 1953, to search for the possible genetic effects of A-bomb radiation on over 70,000 pregnancy terminations in Hiroshima and Nagasaki. This study estimated the incidence of infants that were stillborn, exhibited major congenital malformation, or died within the first week of life.
2. Mortality Study: This study looks for any shortening of the life span of the F1 generation compared with the nonexposed and attempts to find the predominant diseases regarded as causes of death. It is a long-term investigation directed at about 54,000 subjects born between May 1946 and December 1958. Later, approximately 23,000 people born in or after January 1959 were added.
3. Cytogenetics: The frequency of chromosome mutations induced in parental germ cells was assayed by measuring the frequency of children with chromosome abnormalities. As shown in Table 1, a study on a total of 16,000 participants, 8,000 proximally exposed and 8,000 distally exposed, has been completed. An increase in genetic effects due to A-bomb radiation exposure has not been demonstrated.

   Table 1.  Frequencies of F1 children with chromosome abnormalities
   -------------------------------------------------------------------------
                                    Children of          Children of
                                proximally exposed     distally exposed
                                   parents*             parents**
   -------------------------------------------------------------------------
   No. of cases examined               8322                 7976
   Abnormalities
      Sex chromosomes              19(0.23%)            24(0.30%)
      Structural rearrangements     23(0.28%)            27(0.34%)
      Trisomics                     1(0.01%)             0(0)
   -------------------------------------------------------------------------
       Total                       43(0.52%)            51(0.64%)
   -------------------------------------------------------------------------
   * Proximally exposed = exposed within 2,000m from the hypocenter.
   ** Distally exposed = exposed at 2,500m or more from the hypocenter.
   

4. Biochemical Genetics: A total of 23,700 F1 subjects, including 11,400 whose parents were proximally exposed and 12,300 whose parents were distally exposed (or nonexposed), are electrophoretically examined for the presence of radiation-induced mutations of enzymes and proteins in the blood. As shown in Table 2-1, no radiation effect was detected; however, this might be because radiation-induced changes as detected by this method do not often (or easily) occur. The deficiency variant study (Table 2-2), did not include a sufficient number of subjects.

   Table 2-1  Electrophoretic Variants
   -------------------------------------------------------------------------
                             Children of           Children of
                        proximally exposed     distally exposed        Total
                               parents               parents
   -------------------------------------------------------------------------
   No. of children examined    11,364                12,297           23,661
   Equivalent locus tests     544,779               589,506        1,134,285
   Mutations                        2                     4                6
   Mutation rate per locus  0.37 x 10^(-5)   0.68 x 10^(-5)   0.53 x 10^(-5)
   per generation
   -------------------------------------------------------------------------
   
   Table 2-2  Deficiency Variants
   -------------------------------------------------------------------------
                             Children of           Children of
                         proximally exposed     distally exposed       Total
                               parents               parents
   -------------------------------------------------------------------------
   No. of children examined    4,989                 5,026            10,015
   Equivalent locus tests     60,529                61,741           122,270
   Mutations                       1                     0                 1
   Mutation rate per locus   1.65 x 10^(-5)               0    0.82 x 10^(-5)
   per generation
   -------------------------------------------------------------------------
   

5. Cancer Mortality: The Mortality Study has been further extended to analyze and compare the death rates from malignant tumors of the children of the exposed with the rates of their control parents to see if there is any increase in the cancer mortality attributable to parental A-bomb exposure.

Currently, development of methods to determine mutation rates on the basis of direct analysis of DNA (deoxyribonucleic acid) are under intensive investigation. Blood cells and permanent cell lines from peripheral-blood lymphocytes of children and their parents in the exposed and control groups are being stored.

Technical Reports (1990~1992)

1-90

Detecting deletions, insertions, and single nucleotide substitutions in cloned~-globin genes and new polymorphic nucleotide substitutions in ~-globin genes in a Japanese population using ribonuclease cleavage at mismatches in RNA:DNA duplexes (Hiyama K et al)

2-90

Organ doses to examinees during photofluorography, fluoroscopy and computed tomography (Kato K et al)

3-90

An improved method for detecting genetic variation in DNA using denaturing gradient gel electrophoresis (Takahashi N et al)

4-90

Frequency of malignant tumors during the first two decades of life in the offspring (Fl) of atomic bomb survivors (Yoshimoto Y et al)

5-90

Isolation and partial characterization of peripheral blood CD4+ T cell clones expressing Gamma-Sigma T cell receptors (Kyoizumi S et al)

6-90

Radiosensitivity of skin fibroblasts from atomic bomb survivors with and without breast cancer (Ban S et al)

7-90

An investigation of random errors in the DS86 dosimetry using data on chromosome aberrations and severe epilation (Sposto R et al)

8-90

Hyperparathyroidism among atomic bomb survivors in Hiroshima, 1986~88 (Fujiwara S et al)

9-90

Gamma-ray- and fission-neutron-induced micronuclei in PHA-stimulated and unstimulated human lymphocytes (Ban S et al)

10-90

Frequency of mutant T lymphocytes defective in the expression of the T-cell antigen receptor gene among radiation-exposed people (Kyoizumi S et al)

1-91

Mortality among the offspring (F1) of atomic bomb survivors, 1946~85 (Yoshimoto Y et al)

2-91

Life Span Study Report 11. Part 3. Noncancer mortality, 1950~85, based on the revised doses (DS86) (Shimizu Y et al)

3-91

Development of a flow-cytometric HLA-A locus mutation assay for human peripheral blood lymphocytes (Kushiro J et al)

4-91

The effect of diagnostic misclassification on noncancer and cancer mortality dose response in the RERF Life Span Study (Sposto R et al)

5-91

Thyroid cancer incidence among atomic bomb survivors, 1958~79 (Akiba S et al)

6-91

Flow-cytometric measurement of CD4-8- T cells bearing T-cell receptor Alpha-Beta chains: 1. Results for a normal population including two cases with unusually high frequencies (Kusunoki Y et al)

7-91

Detection in a Japanese population of a length polymorphism in the 5~ flanking region of the human ~-globin gene with denaturing gradient gel electrophoresis (Takahashi N et al)

8-91

Radon concentrations in residential housing in Hiroshima and Nagasaki (Aoyama T et al)

9-91

Differential effects of atomic bomb irradiation in inducing major leukemia types: Analyses of open-city cases including the Life Span Study cohort based upon updated diagnostic systems and the Dosimetry System 1986 (DS86) (Tomonaga M et al)

10-91

Study of skin cancer incidence in Nagasaki atomic bomb survivors, 1958~85 (Sadamori N et al)

11-91

X-ray induction of micronuclei in human lymphocyte subpopulations differentiated by immunoperoxidase staining (Ban S et al)

12-91

Simple, rapid HLA-DQA1 genotyping using the polymerase chain reaction and analysis by single-strand conformation polymorphism and restriction-enzyme cleavage (Hayashi T et al)

13-91

Brain abnormalities among the mentally retarded prenatally exposed atomic bomb survivors (Schull WJ et al)

14-91

A longitudinal study of the association between ABO blood phenotype and total serum cholesterol level in the Adult Health Study, 1958~86 (Wong FL et al)

15-91

Combining diagnostic categories to improve agreement between death certificate and autopsy classifications of cause of death for atomic bomb survivors, 1950~87 (Carter RL et al)

16-91

Flow-cytometric measurements of somatic cell mutations in Thorotrast patients (Umeki S et al)

17-91

Joint analysis of site-specific cancer risks for the atomic bomb survivors (Pierce DA et al)

18-91

Radiation-related ophthalmologic changes and aging among the atomic bomb survivors: a re-analysis (Otake M et al)

1-92

Adult Health Study Report 7. Non-cancer disease incidence in the atomic-bomb survivors, 1958~1986 (Examination cycles 1~14) (Wong FL et al)

2-92

Monoclonal gammopathy in atomic-bomb survivors (Neriishi K et al)

3-92

Unique association of p53 mutations with undifferentiated but not with differentiated thyroid gland carcinomas (Ito T et al)

4-92

Autoantibodies and immunoglobulins among A-bomb survivors (Fujiwara S et al)

5-92

Cancer incidence in atomic bomb survivors. Part II: Solid tumor incidence, 1958~87 (Thompson DE et al)

6-92

Radiation-related small head sizes among prenatally exposed atomic bomb survivors (Otake M et al)

7-92

Restricted expression of recombination activating gene (RAG-1) in mouse lymphoid tissues (Yamamoto A et al)

8-92

Dose survival of G0 lymphocytes irradiated in vitro: a test for a possible population bias in the cohort of atomic-bomb survivors exposed to high doses (Nakamura N et al)

9-92

Proliferative and nonproliferative breast disease in atomic-bomb survivors: Results of a histopathology review of autopsy breast tissue (Tokunaga M et al)

10-92

Radiosensitivity of A-bomb survivors as determined with a micronucleus assay (Ban S et al)

11-92

Radiation cataracts among Hiroshima A-bomb survivors, 1949~1964 (Schull WJ et al)

12-92

Thyroid diseases among A-bomb survivors in Nagasaki (Inoue S et al)

13-92

Stable chromosome aberrations among A-bomb survivors; an update (Stram DO)

14-92

Study of the titers of anti-Epstein-Barr virus antibodies in the sera of atomic-bomb survivors (Akiyama M et al)

15-92

Colorectal cancer incidence among atomic-bomb survivors, 1950~80 (Nakatsuka H et al)

16-92

Rapid translocation frequency analysis in humans decades after exposure to ionizing radiation (Lucas JN et al)

17-92

A novel blocker-PCR method for detection of rare mutant alleles in the presence of an excess amount of normal DNA (Seyama T et al)

18-92

Serum parathyroid hormone and calcitonin levels among atomic-bomb survivors (Fujiwara S et al)

19-92

A longitudinal study of growth and development of stature among prenatally exposed atomic-bomb survivors (Otake M et al)

20-92

Radiation-associated lung cancer: A comparison of the histology of lung cancers in uranium miners and atomic-bomb survivors (Land CE et al)

21-92

Variations among Japanese of the factor IX gene (F9) detected by PCR-denaturing gradient gel electrophoresis (Satoh C et al)

22-92

Accurate and rapid detection of heterozygous carriers of a deletion by combined polymerase chain reaction and high performance liquid chromatography (Asakawa J et al)

23-92

Immune responses to Epstein-Barr virus in atomic-bomb survivors: Study of precursor frequency of cytotoxic lymphocytes and titer levels of anti-Epstein-Barr virus-related antibodies (Kusunoki Y et al)

24-92

Cancer incidence in atomic bomb survivors. Part III: Leukemia, lymphoma, and multiple myeloma, 1950~87 (Preston DL et al)

Research Projects

Adaptability of Human Populations

The main concern in this project is devoted to understanding man's survival strategies in a regional ecosystem. Special attention is paid to human adaptation and survival at the population level and their relation to health status. Items included are human activities, physiological adjustment, food consumption, physical growth and population change. Field research is the principal approach and regional areas studied include various rural and urban localities in Japan, and those of Asia, Oceania and Latin America.

Ecological Health: Methodological and Case Studies

This project aims to develop research methodologies in the area of ecological health. Applicability and reliability of the relevant methods are examined in the process of the actual field survey or by making use of ready-made statistics in a variety of ecological settings. Health related micro- and macro-indicators examined include body-build and composition, physiological capability, physical complaints, nutritional status, behavioral patterns, morbidity, and fertility and mortality.

Interactions of Humans with Their Environment

This project is conducted to better understand exposure levels of environmental agents and their effects on human individuals and groups. The agents investigated include heavy metals, pesticides, hydrocarbon and nitrogen oxides which are contained in the ambient air, water, cigarette smoke, food and noise. Individual exposure level in daily life as well as the difference in levels among human populations are of importance in this project. Both field survey and experimental work progress simultaneously. The former includes measurement and elucidation of the dose levels in various environments, and the latter deals with not only serum, urine, etc. of man but also those of experimental animals.

Epidemiological Study on the Health Effects of Air Pollution

Basically, the health effects of air pollution are the results of combined effects of various pollutants. It should not be unreasonable inducing a guide for some specific pollutant, for example NO2, from the results of experimental studies alone on these pollutants. The present project is designed to investigate relevant exposure patterns of NO2 with housewives and children living in urban areas using a reliable badge type NO2 dosimeter. In addition to NO2, we are now starting new research plan concerning particulate exposure levels. Because we believe that next topic related would turn into the effects of particulate exposure.

Pharmacoepidemiology

The objective of pharmacoepidemiology is an assessment of benefits/risks of drugs by using epidemiologic approaches. Because of the rare occurrences of adverse effects, the utilization of established data-bases and record linkage techniques are expected to be useful tools for research. As the first step, this project aims at compiling a data-resource handbook of data-bases which have potential for pharmacoepidemiologic research and, in the near future, also aims to do basic research for establishing systems of data collection on the benefits/risks of drugs.

Methodology and Information Systems for Clinical Trials

This project aims at developing statistical methodology for the design and analysis of randomized controlled clinical trials. For conducting prolonged and large scale quality of data. This project also tries to conduct fundamental research for establishing such efficient and reliable information systems.

Biostatistics and Theoretical Epidemiology

The aim of this project is to develop biostatistical and epidemiological methodology for designing clinical/epidemiological research and analyzing data. Recent topics include: survival data analysis, analysis of pharmacokinetic data, the random effect model and the computer intensive Bayesian approach. Many research projects involving data analysis are carried out with the collaboration of clinical researchers in a variety of clinical fields such as cancer, diabetes and vascular diseases.

Health Care Data Management and Data Processing

With the increasing activities of health sciences and the prevalence of computers, more and more health care data have become available in machine readable forms. This research project aims at the development of the health care data management and processing methodology, including health care data coding, health care data processing, information systems for health care research and ones for information retrieval.

Studies on Risk Sciences

Due to the fact that public environmental problems are the net results of multiple influences of industrialization and urbanization, multidisciplinary studies at the international level (i.e. risk sciences aiming at systematic risk estimation and risk management) are very necessary. On-going studies include methodological discussions about risk assessment of ionizing radiation and of heavy metals, and an international collaborative study on risk perception by the public in various countries.

Promotion of Biological Defense Mechanism against Harmful Environmental Factors

Based upon our previous findings that animals induce an accelerated synthesis of metallothionein in the liver under stressful situations and the organism gets resistance against harmful factors, optimal measures to produce body resistance against environmental factors are under investigation. The function of metallothionein, which seems to work as emergency protein against environmental factors, is also one of our present research targets.

Neurotransmitters in the Brain

Whole brain and regional turnover and regulation of neurotransmitters are studied with various techniques such as in vivo microdialysis, microdissection, picomole analysis of neurotransmitters and metabolites, and so forth. Metabolic and physiological responses based upon metabolic and receptor perturbations are applied to assess the regulation, system/system interaction, circadian and ultradian rhythms in the brain.

Basic and Applied Enzymology

In addition to general enzymology and enzyme engineering, enzymatic derivatization of biological substances and in vivo application of enzymes, new types of enzymes and reactions are discussed with special reference to those for amino acids, amino acid residues and biogenic amines.

Amino Acid Homeostasis

Metabolic and cellular responses involved in amino acid turnover are studied upon specific amino acid loading and depletion from blood to assess the regulation of amino acid homeostasis by steady state level of blood amino acid.

Brain Calcium Issues

The brain exhibits an extraordinary redundancy of calcium-binding protein species as yet unassigned. A new major type, exclusively localized in the central nervous system (CNS), has been recently isolated, purified, and characterized. This protein (cephalocalcin), possessing discrete binding sites for three classes of ligands and undergoing calcium-induced marked conformational/ionic changes, is a new candidate for calcium signal mediator/regulator specific for CNS functions and may provide a clue to brain calcium issues.

Bioavailability of Nondigestible Carbohydrates

Mono- and oligo-saccharides localized naturally in foods are manufactured enzymatically from glucose, sucrose, lactose and/or starch etc. and are expected as sweetener with a special role for human health. We herein focus on the structure, digestion, absorption, metabolism, and physiological implication of newly developed carbohydrates including dietary fiber.

Evaluation of Metabolizable Energy of Nutrients

It is considered that the parts of food which are not hydrolyzed by digestive enzymes, are useless as energy sources or nutrients. However, these nondigestible carbohydrates include dietary fiber and are fermented by intestinal bacteria and the products, such as short chain fatty acids, are utilized as an energy source. The current project is focusing mainly on the estimation of metabolizable energy of nondigestible carbohydrates which are not hydrolyzed by digestive enzymes and are fermented by intestinal bacteria.

Development of Physical Training System for the Aged

To prevent inactivity problems and cardiovascular disease of aged people, we developed a physical training system incorporating safety during training. This system includes an electronically controlled cycle ergometer, ECG monitor, and automatic sphygmomanometer, which are controlled by a micro-computer system. We also developed a training program and criterion to stop training for aged people, through measurement of heart rate and blood pressure, and monitoring of ECG using system.

Development of Health Promotion System

We developed an integrated system for health promotion. Some microcomputer programs were developed to evaluate health status and for health education, which included obesity, physical fitness, food intake and life style evaluation programs and consulting programs for physical fitness and food intake. This health promotion system is aimed not only at health screening but also to support behavioral changes among those have some risk factors of cardiovascular disease and/or cancer. We are going to assess the effectiveness of this system by application in some fields.

Research and Development of Health Care System

Through a rapid increasing number of aged, the health care system in Japan must be undergoing great changes. To assure the quality of care, the most important subject of analysis is the development of an evaluation system. Other major concerns include: regional health planning, utilization of hospital/health care facilities, home care services.

Health Promotion Activities in Community-based Fitness Center

Recently, many fitness centers have opened in Japan. This study aims to present the ideal model of health promotion activities in these centers. First of all, a medical check-up system is important when sedentary middle-aged men begin their fitness program. Second, the effects of regular exercise on cardiovascular risk-factors should be evaluated. Third, adherence to exercise programs should be appreciated from health-behavior approaches.

Study on Effective Blood Supply

In order to increase the domestic blood supply and decrease the amount of blood imported, so as to avoid AIDS and for other reasons, we analyzed the behavior of donors and investigated the blood supply system in Japan. For the next step, from the results of this study, the best way of getting new donors from the young generation and an improved blood supply system or acceptable one for all donors will be discussed.

Effects of Physical Activity on Health

The importance of physical exercise is increasing, as one of the positive health promotion activities. This project aims to investigate the effects of exercise on health scientifically from two points of view. One is to study the effects of exercise, the other is to examine the influence of inactivity on physiological function, especially blood pressure, lipid metabolism, cardio-respiratory functions, and physical performance.

Studies on Theories and Methods of Health Sociology

This project studies sociological theories and methods for the analysis of health problems and aims to introduce basic social scientific concepts relevant to health problems.

The Community and its Relationship to Health/Medicine

Research is centered on the analysis of vital statistics and socio-economic data at the local and community level. Since medical treatment has expanded to include positive health promotion and rehabilitation, the role and responsibilities that must be fulfilled by the community have greatly increased.

Studies on Health Behavior

This project studies behavioral sciences and their application to health problems. Main research matters are smoking behavior, behavior concerning health check-ups.

Study on Lay Initiatives in Health

Recently lay self-care appears to be the dominant from of health care in Western Europe and North America, for example, life-style change, health promotion, consumer health, mutual help, holistic health, etc. This study tries to investigate how self-care is performed, who uses self-care, public interest in self-care as compares with the situation of Japan.

Traditional and Alternatives in Health

This project is designed to study traditional health-related culture and life styles and non-western health care systems. Currently, there is no accurate grasp of the characteristics of the people who use these methods, or of the relationship of using these methods to other behavior patterns. We hope to strengthen our theoretical bases and methods in this field through this project.

Patient Education

The purposes of this project are to find out key factors influencing patient behavior change, to assess the present patient education levels, and to set up some guidelines for patient education. For the time being, diabetes has been selected as an important disease which seems to share common educational problems with other chronic diseases.

Studies on Theories and Methods of Health Education

The project studies what health education is, why it is needed, and how planning, methods and evaluation in health education are developed.

Study on Environmental Problems

There are a lot of people whose health and lives were damaged on account of pollution and/or environmental destruction in modern Japan. The purpose of this project is to examine the actual conditions of such people as mentioned above, to analyze the social backgrounds of the pollution problems, and also the social movements related to these problems.

Studies on Quality of Working Life and Worker's Health

The purpose of this project is to look at the working conditions and environment of workers in various occupations, and to examine the effects on their health (stress, chronic fatigue, relevant ill-health, disease, mortality, etc.) and their daily lives in the perspective of the quality of working life.

Global Health from the Perspective of Health Sociology

Research is conducted as a part of the above research project. The object of this research is: 1) to review the studies regarding community-based problem-solving in PHC and relevant concepts such as health belief, initiation, self-help, social support, community participation and leadership by doing a literature review and interviewing local professionals in Japan, Thailand and U.S.A. 2) to determine community-based problem-solving ability and to clarify the factors which influence community based problemsolving, by performing field surveys in three countries (Japan, Thailand and U.S.A.) where local people are actively involved.

Research on Social Co-existence with Foreign Immigrants in Japan

Through this research, we aim to (a) elucidate the nature of the stress and problems which are experienced by the immigrants after coming to Japan, (b) clarify the causes of illness, poverty and involvement in crime among them, and (c) consider ways in which Japanese society can help prevent these problems and in which better co-existence can be achieved.

Studies on Health Professionals and Practitioner-Patient Relationship

This project studies the changing relationship between practitioners and patients. Owing to increasing opportunities for patients' participation in their care, the concept of informed consent and patient satisfaction become more important. We try to research these topics, and also hope to investigate how to teach communication skills and attitudes to patients in health professional education.

Community Health Services of Mothers and Children

The health status of mothers and children is evaluated, and the delivery system for comprehensive maternal and child services is designed effectively in cooperation with the allied regional administrative agencies.

Research on Statistical Evaluation, Sex Education and Health Promotion in Maternal and Child Health

While the quality of life has remarkably improved in Japan, various factors influencing the nation's health have become more complex and diverse, partly because of the change in the population structure. Family planning, adolescent pregnancy and sex education are emerging problems to be solved. Studies on health promotion have been also required in the field of maternal and child health.

Studies on Chromosome and Congenital Abnormalities

Diagnosis and care for malformed children and genetic counseling is being done. Studies on the frequency of chromosome aberrations in Japanese newborn babies and follow-up observations of the cases are progress with international collaboration. Studies of in vitro and in vivo chromosomal sensitivity towards mutagenic agents are also carrying out.

Biochemical Study of Post-translational Modification of Glycoprotein Hormones

Glycoprotein hormones are known to be produced in many tissues. hCG and prolactin, for example, are synthesized in placenta, pituitary or malignant tissues. Functional genes are thought to be the same. The difference between them should be tissue specific processing and the resulting glycosylated structures. The interrelationship between hormone and receptor is controlled by their sugarchain structure. We are analyzing the processing of hCG and prolactin difference between the pituitary and placenta.

Analysis of Calcium and Bone Metabolism during Pregnancy and Puerperium and in Osteoporosis

Osteoporosis will become one of the most prevailing diseases in the 21st century. Nowadays, Ca and its metabolism are actively investigated all around the world for the prophylactics and treatment of osteoporosis. During pregnancy, however, Ca metabolism is quite different from the no pregnant state, due to the existence of the placenta and fetus, and also to lactation, and remains to be elucidated. We study them for the following points: 1) to analyze the dynamic change of Ca regulating hormones, 2) to study the gene expression of vitamin D conversion enzymes and PTH-rP, 3) to study the dynamic change of bone absorption and formation parameters, like pyridinolin, deoxypyridinolin and so on, and 4) to analyze the immune state affecting cytokine release.

Studies on Prenatal and Perinatal Behavior in Relation to Child Health

Only recently have techniques become available to define and quantify the qualities of the infant environment such as maternal perception of the newborn, the developmental stimulation which objects and persons present and the ways in which children and parents interact. This project is concerned with the development of normal and deviate parental behavior in relation to child health as a family.

Effects of High-rise Living on Physical and Mental Development of Children

Considering the fact that high-rise housing is increasing in big cities and suburban areas, possible effects, short or long, of high-rise living on the physical and mental development of children have been studied with special reference to mother-to-child interaction.This research aims at finding high-rise living specific problems and proposing desirable solutions in terms of maternal and child health.

Studies on Relationships among Congenital Malformations, Genetics, Aging and Immunology

Cultured cells of patients with Down syndrome are studied from the points of view of cytogenetics, sensitivity for various kinds of mutagens, and immunology.

Immunological and Molecular Immunogenetical Approach to B. Pertusis and its Components and the Application to Congenital Anomalies

Bordetella pertussis, an etiological agent of human whooping cough, is known to have various biologically active components, including filmentous hemagglutinin (FHA), pertussis toxin (PT), adenylate cyclase, and heat-labile agglutinogen. Among these PT is one of the most interesting molecules, having various activities. This research involves elucidating the mechanism by which the side reaction after pertussis vaccination occurs, the role of PT in the signal transduction system which involves GTP-binding proteins, the interaction of PT with tumors and/or oncogene ras product, etc.

Community Health

With the rapid transformation of societal and family structure, efficient health care delivery for the elderly in the community is becoming increasingly important. We seek the optimal norm of health care delivery in a given community in terms of psychosocial as well as physical well-being of the elderly and their families.

Studies on Aging Phenomenon

In order to study aging phenomena, we are carrying out two methods: one is based on a statistical analysis of the population, and the other is involves a medical and socio-biological analysis. Aging in Japan now should be represented through cohorts. We have reported some findings as follows: 1) The death rate from emphysema showed a cohort phenomenon which coincided with the increasing death rate. The speed of increase is so high that emphysema can be considered as one of the most important problems in respiratory system diseases. 2) Malignant neoplasms of many sites showed a cohort phenomenon. 46. Cerebro-cardiovascular Disease Control This project is one of the most popular issues in medical sciences for the diseases called adult diseases. We have been one of the main executives of the Japanese Association for Cerebro-Cardio-Vascular Disease Control. Our papers on the project are on planning mass examinations as well as methodology.

Structural Analyses of Diseases and Security for the Aged

Structural analyses of diseases might be a new concept in medical sciences. It seems structural and group effects on disease and deaths in consequence, concerning with the socio-economic and cultural background of the patients. We have experienced such a rapid transition in society after World War II that the nature of diseases has also changed structurally, and the structure of death and that of population have changed simultaneously. We have reported some findings as follows: 1) Cohort phenomena were classified into three groups. 2) Many infectious diseases showed interesting transitions over the past 100 years. 3) Yubyoritu (number of persons who feel ill or have injuries/population) and Juryoritsu (number of out- and in-patient/population) showed changes according to the health insurance establishment. 4) Transition of the relationship between death rate by age group and Juryoritsu can be observed in four phases. Older age groups stay earlier phase. 5) The relationship between supply, intake of nutrients and death rates from some diseases were classified into several types.

Social Psychiatric Study

Since various psychiatric conditions involve social and psychological factors in their causations, we conducted social psychiatric studies on various psychiatric conditions (e.g., psychotic disorders, neurotic conditions, suicide) based on a combination of detailed case analytical studies and statistical or epidemiological studies.

Cross-cultural Study on Mental Health

It is important for studies on mental health to be conducted from crosscultural viewpoints. We have completed a comparative study on the attitude toward mental illness among Korean, Taiwanese and Japanese people and have published its results. We are now conducting research on mental health problems of Japanese returnees and their family members from Mainland China.

Community Mental Health

This project is to study the theory and practice of mental health administration, individual and family care and the mental health delivery system.

Clinical Studies on Developmental Disorders

In this research project, we have investigated various clinical aspects of developmental disorders, which include mental retardation, pervasive developmental disorders, and specific developmental disorders, on the basis of large data bases of such conditions.

Child Psychiatric Diagnostic Study

We have developed and evaluated several diagnostic criteria and diagnostic rating scales for child psychiatric disorders in collaboration with many child psychiatric research centers in Japan.

Hyperkinetic Children

Hyperkinetic syndrome or attention-deficit hyperactivity disorder is one of the most common child psychiatric conditions with the incidence of several percent in child populations. We are now studying its similarity with pervasive developmental disorders through various clinical variables.

Child Psychiatric Treatment

Treatment of child psychiatric disorders depend more heavily on nonpharmacological treatment, such as play therapy and counseling for parents than adult psychiatric disorders. Various such methods have been our concern. However, we are now focusing on developing and evaluating remedial educational approaches for various developmental disorders.

Neurotic and Emotional Disorders in Childhood

Neurotic and emotional disorders are the most common mental health problems in childhood. Prevalences of such conditions, especially mild depression, in recent years are believed to be greater than those estimated 10 or 20 years ago. In this project, we are studying precise clinical features of these conditions in order to improve methods of early intervention as well as to clarify their causations.

Pathography and the Medical History

This project is to study the lives of geniuses, the relationship between mental disorders and creation, the literatural and philosophical works of the world, and the history of medicine, from the pathographical and psychopathological point of view.

Physiological Studies of Patient's Activities

Physiological studies both by field research and by experimental approaches are sure to provide a good basis for future advances in the nursing field. Our research aims at clarifying the various influences of the workload involved in daily activities, and at demonstrating the interrelationship between physiological bioinformations and the bodily burden. In addition, we have investigated behavioral patterns and physical activities of the hospitalized senile, and evaluated body weight and other physical indices of their health conditions.

Nursing Interview

It seems important for patients/clients to have more opportunities for counseling-type nursing interviews rather than directive medical advice. In the nursing interview, what kind of relationship is established between the counselor and the client? How does the interview work toward the patient's recovery? Our research is to answer such questions using physiological bio-information.

Studies of Nursing Education

At present, there are different levels of educational systems for nurses in Japan. In view of social changes as well as medical progress, nursing education should be restructured to meet the new situation. We discuss the roles of nursing in the future, and are developing effective educational measures and the appropriate curriculum in the baccalaureate program.

Community-oriented Primary Care Nursing for the Elderly

Although many older people who need health care services live in the community, the current system of health care is not necessarily adequate. We intend to develop useful tools for assessing the health status of the elderly and programs of primary care nursing to help promote, maintain and restore health of the elderly in the community.

Analysis of Current Nursing Issues

Today, the shortage of nurses has drawn the attention of the public. In Japan, the ratio of the number of patients to the number of nurses in hospitals is higher and the ratio of the number of support personnel to the number of nurses is much lower, than those ratios in Europe and America. To make matters worse, nurses are performing many nonclinical functions and other health-care personnel's duties in hospitals. We will analyze the work requirement of nurses and discuss the major role of nursing.

Ethical Issues among Nurses

The purpose of this study is to identify the ethical issues in nursing and to find out how nurses are coping.

Nursing Care of Pressure Sores

Pressure sores have been challenging problems from a long time in nursing care. This project aims to study and establish the principle and practical procedure of pressure sores prevention. We assess pressure sore risk. Also, we modify the Braden Scale predicting pressure sore risks and study the reliability and validity of the scale.

Nursing Care of Falls

Falls in later years causes injury which can be severe. This project aims to assess fall risks and establish practical procedure for fall prevention.

Transactional Relationships Between Infant Development and

Factors Related to it This project aims to investigate the relationships between child development and their home environment in a prospective study.

Nursing Care of Patients with Total Hip Replacement

This study aims to evaluate the recovery process of Activity of Daily Living post Surgical Treatment in patients with Total Hip Replacement and establish home care programs for them.

Community Nursing and Family Nursing Care Program

We aim to establish a nursing care system in a family and a community. This study aims to evaluate a home care program offered by nursing students.

Epidemiological and Laboratoric Studies of Several Infectious Diseases

Epidemiological studies of rubella, measles, mumps and chlamydia in Japan have being carried out. Technical improvements on serological tests such as methods to measure the antibody using chemiluminescent immunoassay for chlamydia and enzyme-linked immunosorbent assay for measles have also performed. In order to understand the ecology of infectious diseases in children and young adults, a surveillance system for several infectious diseases has been designed to obtain the information from all prefectures in Japan.

Surveillance on Efficacy and Accidents of Vaccines in Japan

A nation-wide surveillance of communicable diseases and vaccines has been administered. Newly developed vaccines in Japan have been tested and evaluated. Long term follow-up studies on several vaccines are also carried out in order to survey the continuance of vaccine efficacy and to compare vaccine induced and naturally acquired immunity.

Studies on Blood Pressure and Body Fluid Circulation Change with Physical Compression

Compression stockings are effectively used for varicose veins, deep vein thrombosis (DVT) and other vein diseases. This project studies the effect of the stockings on the circulation system and aims at establishing an effective application of the stockings from the viewpoint of health science.

Radiation Safety and Health for Workers

The main objectives are to study and establish the principles and procedures of radiation protection and safety for workers in nuclear power plants and other radiation facilities. For its basis we assess risks and detriments from the viewpoints of radiation safety and protection. Furthermore, the fundamental concepts of labor compensation for radiation hazards are also studied.

Radiation Safety and Health for the Public

There are many radiation sources in the environment. Consequently, all populations are always exposed to both natural and artificial radiation. We periodically estimate the population dose from all sources in Japan and establish the principles and radiation protection standards for exposure of the public for each type of radiation.

Radiation Effects and Radiation Protection for Embryos/Fetuses

Embryos/Fetuses have a high susceptibility to radiation. The effects of radiation on embryos/fetuses are observed with mice. The principles of radiation protection for embryos/fetuses in the case of occupational and medical exposure are established.

The Combined Effects of Radiation and Other Agents

There are many harmful agents in the environment. The effects of radiation and these agents are combined. The combined effects is additive, synergistic or antagonistic. We are studying the combined effects of radiation and other agents on adult and fetal mice from the viewpoint of radiation safety. The observed effects are hematological effects, genetic effects, fetal death, growth retardation and malformation. Radiological criteria incorporating the combined effects with other agents are established on the basis of experimental data.

Radioprotectants for Radiation-induced Myelosuppression

As for radiation-induced myelosuppression, many radioprotecting agents have been studied , such as SH or SS chemicals, BRMs, rhG-CSF and so on. We are investigating the combination effects of Ok-432 and rhG-CSF for radiationinduced myelosuppression and the possibility of autologous transplantation with a small amount of bone marrow combined with rhG-CSH in mice.

Radiation Protection in the Medical Field

Radiation is used for diagnoses and therapies. The patients, medical staff and the general public are exposed to medical radiation. The doses of patients, workers and the public in each radiological diagnosis are measured with phantoms and dosimeters. On this basis, the justification as a principle of radiation protection are considered for various medical uses of radiation and radionuclides.

Medical Care and Surveillance of the Atomic Bomb Survivors

There are about 350 thousand atomic survivors in Japan. They receive periodical health surveillance and medical care. We consider the philosophy and practical procedure of health surveillance, and make proposals.

Health Information System

This project aims at developing basic technologies for various types of health information systems, including hospital information systems, regional health information systems, etc.. The results of the research have been continuously implemented in the hospital information system of the University of Tokyo Hospital.

Decision Support System in Medicine

Medical doctors and allied health personnel require a large amount of information in their daily activities. Because of the increase in information, decision support systems by means of information technologies will certainly contribute to this area. This project conducts research for the development of such systems utilizing database technologies and artificial intelligence.

Standardization and Utilization of Medical Records

Medical records are the source of information for most clinical research. The data, however, are not necessarily standardized and this fact makes it difficult for them to be utilized. Various methods of utilizing medical records are investigated in this project including terminology, coding, storing method and analysis.

Analysis of Dynamic Characteristics of Human Speech Production

This project aims at analyzing the patterns of phonatory and articulatory movements during the production of different types of human speech. The information obtained is to be used for establishing the model of speech articulation.

Analysis of Synthesis of Speech Signals

This project is to clarify the basic nature of human speech signals using both techniques of speech analysis and synthesis.

Studies on Speech Perception and Recognition

This project aims at clarifying the nature of speech perception and recognition processes. Significance of both temporal and spectral aspects of speech are investigated specifically using psychoacoustic experimental paradigms.

Evaluation and Control of Communication Disorders

This project aims at establishing standard clinical approaches for the evaluation and control of different kinds of disorders in human speech communication.

Studies on Protective Immunity to Schistosomiasis

Schistosomiasis is one of the most important tropical diseases and affects 200 million people in the world. We have produced a mouse monoclonal IgE antibody against Schistosoma japonicum. This antibody was found to recognize a 97 kDa molecule of schistosomula and to induce protection to challenge infection. Our recent studies demonstrate that this target molecule is paramyosin, one of the vaccine candidates for schistosomiasis.