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Papers - FUJII Chieko

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高齢患者の安全のための服薬アドヒアランス　パーキンソン病患者の服薬の自己調整に関連する症状と受療行動のリスク要因

岩佐由美, 藤井千枝子

日本健康医学会雑誌 (日本健康医学会) 31 ( 2 ) 150 - 158 2022.07

ISSN 1343-0025

高齢患者の安全な服薬に示唆を得るため、パーキンソン病患者会会員436人に質問紙調査を行った。248人の分析対象者(有効回答率56.9%)の平均年齢は72.2歳だった。173人(69.8%)が服薬の「自己調整なし」、75人(30.2%)が「自己調整あり」と回答した。両群を比較した結果、「自己調整あり」の平均年齢と平均発症年齢は低く、平均罹患期間は長かった。薬の平均種類数と残薬の平均日数は「自己調整あり」において多く、ともに有意差があった(p<0.05)。二項ロジスティック回帰分析の結果、症状では不眠(OR=3.56:95%CI=1.740-7.271)、オフ症状(OR=2.44:95%CI=1.224-4.864)が服薬の自己調整に対して有意差があるリスク要因で、受療行動では医師に症状を伝えることに困る(OR=2.85:95%CI=1.136-7.131)、医師に薬の考えを話さない(OR=0.34:95%CI+0.131-0.896)、薬を減らしたいと考える(OR=2.33:95%CI=1.045-5.174)が有意差がある服薬の自己調整のリスク要因だった(p<0.05)。医師の専門性、治療満足度は服薬の自己調整に対して有意差があるリスク要因ではなかった。これらから、服薬を自己調整することによる有害事象から高齢患者を守るためには、不眠やオフ症状がある患者に対して症状緩和のために生活環境調整をあわせて行うことや、薬を減らしたいと考える患者や自らの考えを強く持ち治療に積極的に参加する患者に対して本人の考えや思いをより丁寧に把握していく支援が必要だと考えられた。(著者抄録)

Subjective sleep quality and personality traits of patients with Parkinson’s disease post-diagnosis

Fujii C

British Journal of Neuroscience Nursing 17 ( 4 ) 2021.09

Accepted

Video analysis of safety and reproducibility issues with the timed up-and-go test applied to patients with Parkinson's disease.

Fujii C, Wakizaka N, Araki Y, Tashiro K, Endou M

Disability and rehabilitation. Assistive technology 1 - 6 2021.06

ISSN 1748-3107

Access to Document (DOI)

パーキンソン病患者の転倒予防　オンオフ現象の有無からみた転倒の特徴と転倒予防自己効力感の分析を通して

藤井千枝子, 岩佐由美

高齢者のケアと行動科学 (日本老年行動科学会) 25 99 - 112 2020.12

Joint Work, Accepted, ISSN 1880-3474

本研究は、パーキンソン病(PD)患者のオンオフ現象の有無からみたPD患者の転倒の特徴から転倒予防の示唆を得ることを目的とした。「一般社団法人・全国PD友の会」の東京都PD友の会の協力を得て、2017年2月に会員822名に対し、無記名自記式質問紙を郵送した。年齢や性別などの基本属性の回答と転倒に関する調査項目に無記入項目がない336名(有効回答率40.9%)を分析対象者とした。オンオフ現象の有無により分類し、オンオフ現象がある回答者が136名(40.5%)、ない回答者が200名(59.5%)であり、オンオフ現象がある群とない群として分析した。平均年齢はある群が71.9±7.9歳、ない群は73.8±7.4歳であった。オフ時間の平均が5.6±4.3時間であった。また、前月に転倒があった140名の受傷部位、転倒時の場所と状況を比較し、ある群は立つ時と服の着脱時に転倒が多く、頭部や臀部を受傷した割合が高かった。転倒予防自己効力感の得点はオンオフ現象の有無に関わらず全体的に低く、重症度が上がるとともに平均得点が下がった。オンオフ現象がある場合は、運動症状を多く有し、薬物の調整が困難となることが考えられ、転倒予防の視点から一つの指標として重要である。PD患者の転倒予防は、(1)転倒予防自己効力感を支えること、(2)オンオフ現象のある場合のオン状態とオフ状態それぞれの転倒予防、(3)自立した活動の時期の転倒予防と介助を伴う時期の転倒予防が必要と思われた。(著者抄録)

パーキンソン病患者の服薬アドヒアランス薬を自己調整する患者のニーズ分析

岩佐由美, 藤井千枝子

日本公衆衛生学会総会抄録集 (日本公衆衛生学会) 79回 355 - 355 2020.10

Joint Work, ISSN 1347-8060

パーキンソン病患者の生活上の困難と社会参加状況の変化および介護サービス利用の現状 2017年の現状と1995年との比較

藤井千枝子, 岩佐由美

日本難病看護学会誌 ((一社)日本難病看護学会) 24 ( 2 ) 213 - 222 2019.12

Joint Work, Accepted, ISSN 1343-1692

本研究は、パーキンソン病(以下PD)患者の療養生活支援のために現状を明らかにすることを目的として2017年に東京都PD友の会の会員822名に対し、無記名自記式質問紙を郵送した。本研究に必要な内容に欠損値がない353名(有効回答率40.9%)の回答により、2017年の要介護認定とヤールの分類によるステージと、介護保険のサービス利用状況を分析した。また、1995年に行った同患者会への調査を用いて、社会参加の場と生活上の困難の状況を比較した。平均年齢は、1995年が69.0歳に対し、2017年は73.1歳と高くなり、同居人数は、1995年が2.9±1.6人であり、2017年は2.3±1.1人と減少した。(P<0.001)。1995年と比較し、2017年は社会参加の場と、日常生活で困難ありと答えた回答者が増えた。要介護認定を受けている患者は、66.5%であり、介護保険とヤールの分類のSpearmanの相関係数は0.5であった(P<0.001)。PD患者の高齢化と療養生活の長期化の中での健康寿命の延伸に向けた療養生活支援がさらに重要となる。(著者抄録)

患者安全第一のための基本戦略は何か? 看護の立場から

藤井千枝子

日本医療安全学会学術総会抄録集 ((一社)日本医療安全学会) 5回 158 - 158 2019.02

Single Work

医療系学生の多職種連携に対する準備状態の変化

門川俊明, 藤井千枝子, 大谷壽一, 横田恵理子

医学教育 ((一社)日本医学教育学会) 49 ( Suppl. ) 95 - 95 2018.07

Joint Work, ISSN 0386-9644

慶應義塾大学医療系三学部合同教育における「チーム形成」についての学び

FUJII CHIEKO

日本薬学会 ((公社)日本薬学会) 138年会 ( 4 ) 229 - 229 2018.03

Joint Work, ISSN 0918-9823

医療安全管理者との連携による教育への還元

FUJII CHIEKO

日本医療安全学会学術総会 ((一社)日本医療安全学会) 4回 140 - 140 2018.02

Single Work

Investigation of the treatment and living assistance needed by patients with young-onset Parkinson’s disease

Iwasa Y, Saito I, Fujii C

Kobe Journal of Medical Sciences (Kobe Journal of Medical Sciences) 64 ( 5 ) E180 - E188 2018

Joint Work, Accepted, ISSN 00232513

© 2018, Kobe University School of Medicine. All rights reserved. This study assessed the symptoms, treatment, social systems use, and perception of living conditions of patients with young-onset Parkinson’s disease (YOPD), and investigated the support needed by them. Method: Among the 252 people who completed our questionnaire, we defined YOPD patients as those diagnosed as young onset or those with onset at ≤40 years. The data were compared with others. Results: There were 24 patients with YOPD (9.5%) (average age: 61.7 years), with an average disease duration 6.4 years longer (p < 0.01) and time until diagnosis 0.7 years longer (p < 0.1) than those of other patients. This group took 1.6 times more types of medicines, and time to their next appointment was 8.6 days shorter than that of other patients (p < 0.05). Patients with YOPD had more pulsive walking and more sweating (p < 0.05), and more motor fluctuation (p < 0.1). More patients with YOPD had a physical disability certificate but felt they were not obtaining the required services (p < 0.05). 45.0% of the YOPD group wanted to work more, more used information and communication equipment (p < 0.05), and more felt their medications were adequate (p < 0.1). Conclusions: Increased awareness of YOPD is needed. YOPD patients have motor fluctuation because of the longer disease duration. Thus, the support of doctors and nurses, and frequent examination visits, are indispensable for controlling symptoms to achieve middle age developmental tasks. Increased support for care-giving, leisure-time activities, and work is also necessary and may help maintain the desire to work in this group.

テキストマイニングで見た難病に対する関心とニーズ

FUJII CHIEKO

医療情報学 37 ( 3 ) 135 - 145 2017.07

Research paper (scientific journal), Accepted

看護の機能・役割と安全

FUJII CHIEKO

医療と安全 6 60-61 2016.12

Perspectives on effective educational practices regarding venepuncture

FUJII CHIEKO

Journal of Nursing Education and Practice 6 ( 4 ) 76 - 84 2015.09

Research paper (scientific journal), Single Work, Accepted

Comparison of skill in novice nurses before and after venipuncture simulation practice　

FUJII CHIEKO

Journal of Nursing Education and Practice 4 ( 5 ) 16 - 22 2014

Research paper (scientific journal), Single Work, Accepted

Safe venepuncture techniques using a vacuum tube system

Fujii Chieko, Ishii Hiroyuki, Takanishi Atsuo

International Journal of Nursing Practice 19 ( SUPPL.3 ) 11 - 19 2013.09

Research paper (scientific journal), Accepted, ISSN 1322-7114

The purpose of this study was to determine safe techniques of performing blood collection using an evacuated tube system, particularly with regard to manipulation of the equipment and at the puncture site. Careful observation of the procedure was used to collect data for evaluating the various venepuncture techniques. Nurses were digitally videotaped performing simulated venepuncture. A self-administered questionnaire and unstructured observation of a videotaped recording were evaluated, and valid responses were analyzed from participants who performed venepuncture using various techniques. The participants who changed hands during the procedure were older than those who did not change hands. Needle movements during puncture and insertion, including rotation and insertion in a wave-like trajectory, were observed. Appropriate training, including recommendations for maintaining the stability of the needle tip, is important to ensure safety when performing venepuncture. Movement of the needle should not place too much pressure on the puncture site. © 2013 Wiley Publishing Asia Pty Ltd.

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Vacuum venipuncture skills: time required and importance of tube order

Fujii Chieko

Vascular Health and Risk Management 9 ( 1 ) 457 - 464 2013

Accepted, ISSN 1176-6344

Background: The purpose of this study was to assess specific vacuum-venipuncture skills and the influence of the time involved in skin puncture and blood collection. Methods: Thirty subjects undergoing venipuncture in which video analysis was possible were included. These procedures were carried out by four nurses and recorded with a digital camera. Venipuncture skills classified by our observations were delineated on the basis of frame-by-frame video images, and a graph of x and y coordinates was created. Results: With the first blood-collection tube, strong blood flow required the practitioner to push the tube back in to compensate for the strong repulsive force in approximately 46% of cases. By the third blood-collection tube, the blood flow had weakened; therefore, the tube was moved up and down. In cases that required a second venipuncture, the tube was already pierced, so the time required to fill it to 5 mL was significantly longer. Conclusion: Hand movement of the practitioner is adjusted according to blood flow. Reflex movement in response to strong blood flow may increase the risk of pushing the needle through the vein with excessive force. The time required to fill the tube varies among nurses, tube order, and level of venipuncture skills. © 2013 Fujii.

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Clarification of the characteristics of needle-tip movement during vacuum venipuncture to improve safety

Fujii Chieko

Vascular Health and Risk Management 9 ( 1 ) 381 - 390 2013

Research paper (scientific journal), Single Work, Accepted, ISSN 1176-6344

Background: Complications resulting from venipuncture include vein and nerve damage, hematoma, and neuropathic pain. Although the basic procedures are understood, few analyses of actual data exist. It is important to improve the safety standards of this technique during venipuncture. This study aimed to obtain data on actual needle movement during vacuum venipuncture in order to develop appropriate educational procedures. Methods: Six experienced nurses were recruited to collect blood samples from 64 subjects. These procedures were recorded using a digital camera. Software was then used to track and analyze motion without the use of a marker in order to maintain the sterility of the needle. Movement along the X-and Y-axes during blood sampling was examined. Results: Approximately 2.5 cm of the needle was inserted into the body, of which 6 mm resulted from advancing or moving the needle following puncture. The mean calculated puncture angle was 15.2°. Given the hazards posed by attaching and removing the blood collection tube, as well as by manipulating the needle to fix its position, the needle became unstable whether it was fixed or not fixed. Conclusion: This study examined venipuncture procedures and showed that the method was influenced by increased needle movement. Focusing on skills for puncturing the skin, inserting the needle into the vein, and changing hands while being conscious of needle-tip stability may be essential for improving the safety of venipuncture. © 2013 Fujii, publisher and licensee Dove Medical Press Ltd.

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人の健康そして地球の健康にとって大切な水と塩の話塩害という環境問題を広げないために

FUJII CHIEKO

Keio SFC journal 11 ( 1 ) 117-125 2011.09

Research paper (scientific journal), Single Work, Accepted, ISSN 1347-2828

Survey on the current status of patients with Parkinson's disease

Fujii Chieko, Masuda Shinya

[Nippon kōshū eisei zasshi] Japanese journal of public health 54 ( 5 ) 338 - 347 2007.05

Research paper (scientific journal), Accepted, ISSN 0546-1766

OBJECTIVE: The objective was to conduct a survey to examine what support is necessary for patients with Parkinson's Disease (PD) given in-home care in Japan and to determine the current status of care service utilization. In 2004, a questionnaire survey was conducted on the Tokyo chapter members of the Japan PD METHODS: Association and the results were compared with those from the 1995 survey performed on subjects from the same association. In the 1995 survey, half of the association members of the chapter were selected via random systematic sampling. In the 2004 survey, the questionnaire was mailed with a newsletter to all the association members of the chapter. The individuals returned their questionnaires by postal mail. The collection rates were 52.9% in 1995 and 21.3% in 2004. In both surveys, the mean age of RESULTS: the participants was 69.0 years old. The respondents in the 2004 survey had a higher severity of disease and a larger percentage answered that they had predominant symptoms and difficulties with daily life. Regarding participation in various activities, opportunities to work had decreased, but the possibility of meeting people other than at work and to engage in hobbies and relax had increased. Regarding sources of information, decrease was noted for public health nurses and increase for magazines. There was an increase in the number of people who were told that their problem was psychological at their initial diagnosis. 58.2% of the respondents in the 2004 survey received approval for long-term care insurance, and 37.3% of these reported that they their symptoms were more severe than the level for which they were approved. 7.5% of the respondents answered that their condition had worsened after admission to a nursing facility. CONCLUSION: The results of this 2004 survey have limitations and might not be characteristic of all PD patients. However, the respondents answered that their severity of disease was high and their difficulties increased, despite increase in opportunities to enjoy hobbies and to relax. Clearly, some patients feel that their condition is more severe than the level recognized by the primary nursing care authorities, with some considering that their conditions worsened after receipt of services. Understanding the characteristics of PD, provision of services appropriate to patients' symptoms, and ways of incorporating rehabilitation in patients' daily lives appear to be increasingly necessary. Information support is necessary to understand how best to provide psychological support for PD patients.

パーキンソン病患者の在宅療養生活と介護サービス利用についての現状調査

FUJII CHIEKO

日本公衆衛生雑誌 54 ( 5 ) 338-347 2007.05

Research paper (scientific journal), Joint Work, Accepted, ISSN 0546-1766

ホームページ作成ソフトを利用したスケジュールと書類管理

FUJII CHIEKO

看護教育 48 ( 4 ) 315-318 2007.04

Research paper (scientific journal), Single Work, ISSN 0047-1895

on-off現象に焦点をあてたパーキンソン病患者の療養生活に関する研究

FUJII CHIEKO

訪問看護と介護 12 ( 4 ) 306-312 2007.04

Research paper (scientific journal), Single Work, ISSN 1341-7045

よりよい情報伝達のための採血に関する個人の手技の比較

FUJII CHIEKO

安全医学 3 ( 1 ) 43-54 2007.01

Research paper (scientific journal), Single Work, ISSN 1349-5224

遺伝情報と看護

藤井千枝子

看護学雑誌 68 ( 1 ) 48-52 2004.01

Research paper (scientific journal), Single Work

司法精神医療と患者の権利擁護

藤井千枝子

精神科看護 30 ( 9 ) 42-46 2003

Research paper (scientific journal), Single Work

パーキンソン病に関する患者参加型継続看護教育の一例　ペプロウの人間関係の看護論をとりいれながら

藤井千枝子

看護教育 44 ( 2 ) 157-161 2003

Research paper (scientific journal), Single Work, Accepted

Charring Cross警察手続き視察（精神保健イギリス・オランダ視察報告書）

藤井千枝子

福岡県弁護士会精神保健委員会 19-22 2003

Research paper (other academic), Single Work

改めて患者の権利を問い直す

藤井千枝子、谷直樹

看護学雑誌 67 ( 6 ) 550-556 2003

Research paper (scientific journal), Joint Work

多因子遺伝疾患の基礎知識と看護の課題　孤発性パーキンソン病を例として

藤井千枝子，原田勝二

看護学雑誌 66 ( 7 ) 645-652 2002.07

Research paper (scientific journal), Joint Work, Accepted

うつること：遺伝と環境とひと

藤井千枝子

(身体医文化研究会) 2002.06

Research paper (other academic), Single Work

触法患者処遇における看護の役割

藤井千枝子

刑事弁護 32 42 2002

Research paper (scientific journal), Single Work

介護をめぐる事件・事故に関する新聞報道の検討

藤井千枝子、志田小寿恵、奥野純子、安藤邑恵

こころの健康（日本精神衛生学会） 17 ( 1 ) 45-56 2002

Research paper (scientific journal), Joint Work, Accepted

An association between idiopathic Parkinson's disease and polymorphisms of phase II detoxification enzymes: glutathione S-transferase M1 and quinone oxidoreductase 1 and 2.

Harada S,Fujii C, Hayashi A, Ohkoshi N.

Biochem Biophys Res Commun 288 ( 4 ) 887-892 2001.11

Research paper (scientific journal), Joint Work, Accepted

福祉住環境コーディネーター検定受験のすすめ　看護に福祉・住環境の視点をとりいれよう(解説)

藤井千枝子

看護学雑誌 65 ( 11 ) 1048-1049 2001.11

Research paper (scientific journal), Single Work

快適性（住環境と看護：ナイチンゲールを在宅に生かす）

藤井千枝子

看護学雑誌 65 ( 7 ) 598-601 2001.07

Research paper (scientific journal), Single Work

Q&A 解剖生理からみた看護行為の意味と解説　与薬

藤井千枝子

看護実践の科学 26 ( 7 ) 100-108 2001.06

Research paper (scientific journal), Single Work

看護婦(士)の喪の儀式と精神保健に関する研究

藤井千枝子

健康文化研究助成論文集 ( 7 ) 94-104 2001.03

Research paper (conference, symposium, etc.), Single Work

遺伝子治療

藤井千枝子

プチナース 94-95 2001

Research paper (scientific journal), Single Work

パーキンソン病患者の病前ライフスタイルとタイプA行動

藤井千枝子、原田勝二、大越教夫、林明人、吉沢和朗

日本心身医学雑誌 40 ( 1 ) 33-40 2001

Research paper (scientific journal), Joint Work, Accepted

Studies on drinking behavior, personality and L-dopa induced hallcination of idiopathic Parkinson's disease

藤井千枝子

筑波大学医学研究科学位論文 2001

Research paper (other academic), Single Work

換気と保温（住環境と看護）

藤井千枝子

看護学雑誌 65 ( 7 ) 602-607 2001

Research paper (scientific journal), Single Work

住居の清潔（住環境と看護）

藤井千枝子

看護学雑誌 65 ( 7 ) 607-614 2001

Research paper (scientific journal), Single Work

安全と安楽（住環境と看護）

藤井千枝子

看護学雑誌 65 ( 7 ) 614-621 2001

Research paper (scientific journal), Single Work

家庭の医療廃棄物

藤井千枝子

看護学雑誌 65 ( 7 ) 621-623 2001

Research paper (scientific journal), Single Work

福祉用具の活用と住宅改装・住宅整備

藤井千枝子

看護学雑誌 65 ( 7 ) 624-627 2001

Research paper (scientific journal), Single Work

Cross-cultural traits for personality of patients with Parkinson's disease in Japan

Fujii Chieko, Harada Shoji, Ohkoshi Norio, Hayashi Akito, Yoshizawa Kazuo

American Journal of Medical Genetics - Neuropsychiatric Genetics 96 ( 1 ) 1 - 3 2000.02

ISSN 1552-4841

Recent studies suggest that Parkinson's disease (PD) is associated with particular personality traits. Using Cloningers's Tridimensional Personality Questionnaire (TPQ), Menza and colleagues [1993: Neurology 43: 505-508] reported a possible association between PD and a reduced score in the novelty seeking (NS) dimension of the TPQ. We sought to determine whether this association, which was found in a study conducted in the United States, could also be found among Japanese PD patients. We performed personality assessments of 67 Japanese PD patients, using the TPQ test. The results suggest that Japanese PD patients have significantly lower scores in the NS dimension of the TPQ, as well as significantly higher harm avoidance (HA) scores, compared with matched control subjects. Furthermore, the PD patients undergoing treatment for depression using antidepressant drugs scored significantly higher in the HA dimension than PD patients who did not receive antidepressant drug treatment. Our results suggest that the high HA score, and the low NS score in the TPQ test observed in patients with PD, is a cross-cultural phenomenon, although the influence of depression, long-term treatment, and premorbid gene/environmental interactions may also affect these personality traits. (C) 2000 Wiley-Liss, Inc.

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孤発性パーキンソン病と関連する遺伝的変異の検索

藤井千枝子、原田勝二

第８回DNA多型学会 2000

Research paper (conference, symposium, etc.), Joint Work, Accepted

アルデヒド脱水酵素2の遺伝子型とアルコール飲料の嗜好性との関連

石橋徳雄、原田勝二、藤井千枝子、田口文子、石井照周

日本アルコール薬物医学会 34 ( 2 ) 117-129 2000

Research paper (scientific journal), Joint Work, Accepted

A novel polymorphism of the ALDH2 gene Linkage disequilibrium and an association with Alcoholism

Harada S, Okubo T, Nakamura T,Fujii C, Nomura F, Higuchi S, Tsutsumi M

Alcoholism:Clin & Experiment Res 23 ( 6 ) 958-962 2000

Research paper (scientific journal), Joint Work, Accepted

排泄ケア教育の授業展開-手話とロールプレイを用いて

藤井千枝子

介護福祉教育学雑誌 5 ( 1 ) 20-23 2000

Research paper (scientific journal), Single Work, Accepted

看護における遺伝医学-チームアプローチのなかの役割を考える

藤井千枝子

看護展望 24 ( 13 ) 1505-1512 2000

Research paper (scientific journal), Single Work

Investigation of Genetic Variants Correlated with idiopathic Parkinson's disease

Fujii C, Harada S

DNA多型 8 43-48 2000

Research paper (scientific journal), Joint Work

包帯法

藤井千枝子

看護実践の科学　看護技術のチェックポイント 24 ( 7 ) 96-98 2000

Research paper (scientific journal), Single Work

死後の処置

藤井千枝子

看護実践の科学　看護技術のチェックポイント 24 ( 7 ) 114-117 2000

Research paper (scientific journal), Single Work

内分泌・感染（アレルギー）疾患に関する看護技術の知識

藤井千枝子

クリニカルスタディ 20 ( 10 ) 939-942 2000

Research paper (scientific journal), Single Work

Parkinson病患者の嫌酒傾向に関与する遺伝要因の探求

藤井千枝子、原田勝二、大越教夫、林明人、吉沢和朗

遺伝子診療学会 2000

Research paper (conference, symposium, etc.), Joint Work, Accepted

A novel polymorphism (-357 G/A) of the ALDH2 gene

Harada Shoji, Okubo Takehito, Nakamura Takako, Fujii Chieko, Nomura Fumio, Higuchi Susumu, Tsutsumi Mikihiro

Alcoholism: Clinical and Experimental Research 23 ( 6 ) 958 - 962 1999.06

ISSN 0145-6008

Background: Human mitochondrial aldehyde dehydrogenase (ALDH2) is a major enzyme responsible for the oxidation of acetaldehyde derived from ethanol metabolism. The human ALDH2 gene shows genetic polymorphism at position 1510 with a G to A transition in exon 12. This mutation leads to ALDH2 enzyme deficiency and protection against alcoholism. As yet, no polymorphism for the promoter region of the ALDH2 gene has been reported. Methods: We analyzed 600 nucleotides of the promoter region in addition to exon 12 from 571 Japanese, 68 Chinese, 80 Myanmar, 60 Mongolians, and 82 North-American Caucasians using single-strand conformational change polymorphism (SSCP) analysis and the polymerase chain reaction (PCR). PCR products that showed an aberrant banding pattern detected by the SSCP analysis were subjected to PCR direct sequencing. Results: A novel polymorphism at -357 with a G to A substitution was found in all the population groups, including North-American Caucasians. In addition, the polymorphic status in the promoter and exon 12 suggested linkage disequilibrium between the two loci, which indicated that among Japanese, the ALDH2*2 allele is linked to the G promoter allele, and the ALDH2*1 allele is linked to the A allele. A total of 206 healthy male controls and 185 alcoholic male patients with the homozygous ALDH2*1 genotype were analyzed for the polymorphism in the promoter. Genotypic frequencies of GG, GA, and AA for alcoholics were 54.1%, 44.3%, and 1.6%, and those for controls were 52.9%, 40.3%, and 6.8%, respectively. The A allele frequencies for alcoholics and controls were 0.24 and 0.27, respectively. A χ² test for the entire 3 x 2 table indicated significant variations in the three genotypes (χ² = 6.40, p < 0.05). However, no significant difference in allelic frequencies between the two groups was observed. Conclusion: This new polymorphism in the ALDH2 promoter is present in all populations studied. Further analysis in other ethnic groups is necessary to establish this as an additional risk factor for alcoholism.

Association between polymorphism of the cholecystokinin gene and idiopathic Parkinson's disease

Fujii Chieko, Harada S., Ohkoshi N., Hayashi A., Yoshizawa K., Ishizuka C., Nakamura T.

Clinical Genetics 56 ( 5 ) 394 - 399 1999

ISSN 0009-9163

Parkinson's disease (PD) is characterized by major alterations of neurotransmitter activity due to damage of the substantia nigra. Changes in neuropeptide concentration within the basal ganglia may play an important role in the putative dopaminergic-peptidergic interactions associated with the disease. Cholecystokinin (CCK) modulates the release of dopamine in the mesolimbic pathway and affects dopamine-related behavior. We analyzed genetic variations in the CCK gene, in both the coding and promoter region, in order to investigate the role of polymorphism in idiopathic PD. Four polymorphic sites of the CCK gene (-196G/A, -45C/T, 1270C/G, 6662C/T) were found in PD patients and controls. Complete linkage disequilibrium was observed between the -45 locus and the 1270 locus, and also a possible linkage disequilibrium was found between the -45 and -196 loci. A significant difference was found in the distributions of three identified genotypes at the -45 locus between 116 PD patients and 95 age-matched control subjects (χ² = 7.95, p = 0.018, Bonferroni correction p = 0.054). In addition, a significant difference was obtained amongst the three genotypic groups at the -45 locus when compared between PD patients who experienced hallucinations (n = 23) and those (n = 93) who did not (χ² = 8.08, p = 0.018, Bonferroni correction; p = 0.126). Our data suggested that mutations at the -45 locus in the promoter region of the CCK gene may influence vulnerability to hallucinations in PD patients treated with L-dopa.

Study on Parkinson's disease and alcohol drinking

Fujii C, Harada S, Ohkoshi N, Hayashi A, Yoshizawa K

Japan Journal of Alcohol & Drug depence 33 ( 6 ) 683-691 1999

Research paper (scientific journal), Joint Work, Accepted

Cross-cultural traits for personality of patients with Parkinson's disease in Japan

Fujii C, Harada S, Ohkoshi N, Hayashi A, Yoshizawa K

Am J Med Gent Neuropsychiatric Genetics 96 ( 1 ) 1-3 1999

Research paper (scientific journal), Joint Work, Accepted

海外文献情報 Empowerment

藤井千枝子

日本健康教育学雑誌 42 1999

Research paper (scientific journal), Single Work

海外文献情報　Self-efficacy

藤井千枝子

日本健康教育学雑誌 47 1999

Research paper (scientific journal), Single Work

麻薬の取り扱い

藤井千枝子

看護実践の科学　看護技術のチェックポイント 24 ( 7 ) 42-43 1999

Research paper (scientific journal), Single Work

Study on parkinson's disease and alcohol drinking

Fujii C., Harada S., Ohkoshi N., Hayashi A., Yoshizawa K.

Japanese Journal of Alcohol Studies and Drug Dependence 33 ( 6 ) 683 - 691 1998

ISSN 1341-8963

To clarify alcohol drinking habits of patients with Parkinson's disease (PD) in Japanese, we compared mean values of alcohol consumption of PD patients and controls with special references to genetic polymorphism of ALDH2. Ninety-three Japanese outpatients with PD (39 males, 54 females) diagnosed by three skilled neurologists from 4 hospitals in Kanto area were analyzed for ALDH2 genotypes and alcohol consumption. A total of 297 healthy controls (156 males, 141 females) in the same area were also analyzed. PCR- SSCP (polymerase chain reaction-single strand conformational change polymorphism) analysis was used to determine ALDH2 genotypes. Mean values of alcohol consumption (ethanol g/month/person) from patients with PD were estimated by direct interview, and those from controls were obtained by questionnaire. Distributions of three genotypes and allele frequencies of ALDH2 were not different between patients and controls, however mean values of alcohol consumption of PD group were significantly lower than those of control group when compared between the same ALDH2 genotype. Our data suggested that the lower values of alcohol consumption in patients with PD for every ALDH2 genotypes may be caused by other factors such as premorbid personality rather than ALDH2 variant.

難病患者の心理的・社会的支援の重要性-パーキンソン病患者のセルフエフィカシーを通して

藤井千枝子

1998

Research paper (other academic), Single Work

難病患者のQuality of Lifeの向上についての一考察-パーキンソン病患者の主観的満足感

藤井千枝子、青島多津子、佐藤親次、森田展彰、大越教夫、中村俊規、小田晋

看護研究 30 ( 4 ) 273-283 1998

Research paper (scientific journal), Joint Work, Accepted

難病患者に対する障害者プランの充実に関する研究-パーキンソン病患者の生活調査から

藤井千枝子、大越教夫、佐藤親次、森田展彰、小田晋

日本保健福祉学雑誌 4 ( 1 ) 35-43 1998

Research paper (scientific journal), Joint Work, Accepted

Self-efficacy and related factors related in Parkinson's disease patients

Fujii C., Aoshima T., Sato S., Mori N., Ohkoshi N., Oda S.

[Nippon kōshū eisei zasshi] Japanese journal of public health 44 ( 11 ) 817 - 826 1997

ISSN 0546-1766

This study was designed to assess self-efficacy and the factors leading to higher self-efficacy in Parkinson's disease patients, as measured by General Self-Efficacy Scale (GSES). Questionnaires were mailed to patients with Parkinson's disease in Tokyo. This study surveyed 73 male and 70 female patients. Approximately 66.5% of the patients fell into the low self-efficacy group. Data was divided into 3 groups (high, moderate and low) and evaluated statistically. Approximately 66.5% of the patients fell into the low self-efficacy group. Patients in the high self-efficacy group exhibited the following features: Males: 1) The male patients in the high self-efficacy group tended to belong to more groups and had less trouble than any other groups in coping with their daily lives; 2) they generally had people to turn to for mental support outside their families, and for their daily life inside or outside their families; 3) they also felt confident that they had sufficient understanding of better life styles and how to exercise. Females: 1) The female patients in the high self-efficacy group tended to go out more often than any other groups and had places to go where they could practice hobbies and exercise; 2) they generally had people outside their families to turn to for mental support; 3) their subjective symptoms, such as freezing and dysarthria, tend to be less acute than in the moderate or low self-efficacy patients. 4) had les trouble than any other groups in coping with their housing accommodations; 5) they also felt confident that they understood how to exercise. In order to increase self-efficacy among Parkinson's disease patients, this study suggests that support, both social and psychological, and providing health education, are important.

パーキンソン病患者のセルフエフィカシ-とその関連要因

藤井千枝子、青島多津子、佐藤親次、森田展彰、大越教夫、小田晋

日本公衆衛生学雑誌 44 ( 11 ) 817-826 1997

Research paper (scientific journal), Joint Work, Accepted

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