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PubMed1989

Comparison of bone mineral content between Japan-born and US-born Japanese subjects in Hawaii.

The bone mineral content (BMC) of the calcaneus, and distal and proximal radius was measured by the single photon absorptiometric technique for 2307 US-born and 172 Japan-born subjects of Japanese ancestry living in Hawaii. The bone mineral content of the US-born subjects was greater than that of their Japan-born counterparts, on the average, by 8.8% at the calcaneus, 3.5% at the distal radius and 4.5% at the proximal radius. Differences between the two groups in height, weight, thiazide use, exercise (in men), estrogen therapy (in women), and calcium and vitamin D intake accounted for much of the difference in BMC between the US-born and Japan-born women, but less so for the men. Additional studies of BMC in migrant populations are needed to characterize further the environmental factors affecting bone mineral content.

Adult↗
PubMed1988

The distribution of estradiol in the sera of normal Caucasian, Chinese, Filipina, Hawaiian and Japanese women living in Hawaii.

Mean concentrations of sex-hormone-binding-globulin (SHBG) and the percentage distribution of estradiol between the non-protein-bound, albumin-bound and SHBG-bound fractions were not different in Caucasian, Hawaiian, Chinese, Japanese and Filipinas living in Hawaii. The widely varying incidence rates for breast cancer are therefore not explained by variations in the availability of estradiol.

Adult↗
PubMed1983

Gains in life expectancies if heart disease and stroke were eliminated among Caucasians, Filipinos and Japanese in Hawaii.

Life tables were constructed based on all deaths in Hawaii occurring between 1968-1972 for Caucasians, Filipinos and Japanese. Gains in life expectancies to be attained if coronary heart disease (CHD) and cerebrovascular accidents (CVA) were eliminated were presented by sex and ethnic group. The expectation of life at birth for both males and females is greatest for Japanese, followed by Filipinos and then Caucasians. The gain in life expectancy by eliminating CHD would not benefit Caucasians while Filipinos would benefit the most from the elimination of CVA. For all ethnic groups and both sexes, the gain in expectation of life due to the elimination of CHD is more than were CVA eliminated as a cause of death.

Actuarial Analysis↗
PubMed1992

Prevalence of antibodies to Toxoplasma gondii and Trichinella spiralis in 509 pigs from 31 farms in Oahu, Hawaii.

Serum samples from 509 pigs from 31 farms in Oahu, Hawaii were examined for antibodies to Toxoplasma gondii using the agglutination test in dilutions of 1:25, 1:50, and 1:500 and for Trichinella spiralis using the enzyme-linked immunosorbent assay. Toxoplasma gondii antibodies were found in 48.5% of pigs. Antibody titers were: 5.1% positive at 1:25 dilution, 28.6% positive at 1:50 dilution and 14.7% positive at 1:500 dilution. The prevalence of Toxoplasma gondii antibodies in garbage-fed pigs (67.3% of 199 pigs) was higher than in grain-fed pigs (33.8% of 180 pigs). Antibodies to Trichinella spiralis were found on seven of 31 farms. On five of these farms only a single serum was positive for Trichinella spiralis antibodies. The two remaining farms each had three positive sera (three of ten and three of 25 pigs tested); both of these farms fed garbage to pigs.

Agglutination Tests↗
PubMed1991

Medical conditions at death among the Caucasian and Japanese elderly in Hawaii: analysis of multiple causes of death, 1976-78.

This paper discusses the prevalence of selected medical conditions at death among elderly Caucasians and Japanese in Hawaii and the associations among conditions listed in the death certificates of the two ethnic groups during 1976-78. For the individual conditions, wide variations were found in the ratio between the total number of times a condition was mentioned in the death certificates and the number of times it was identified as the underlying cause of death. Distinctly different patterns of disease clustering emerged for deaths involving cancer and those not involving cancer. Although in most situations causal combinations were similar for the two ethnic groups, deaths involving two conditions, cerebrovascular disease and cancer of digestive organs, presented different patterns.

Adolescent↗
PubMed1992

The association of drinking levels and drinking attitudes among Japanese in Japan and Japanese-Americans in Hawaii and California.

This study examined cross-cultural differences in drinking attitudes and drinking levels and their correlation among Japanese in Japan and Japanese-Americans in Hawaii or California. In most situations, an increase in drinking levels was associated with more tolerant drinking attitudes in all three groups. Abstainers were less likely to say that getting drunk is sometimes all right, whereas the reverse was true for heavier drinkers. Drinking levels among Japanese, especially among Japanese women, were not highly associated with how much drinking was perceived as acceptable in each situation, whereas among Japanese-Americans, drinking levels were highly associated with drinking attitudes. Although the Japanese had generally tolerant attitudes toward drinking, they indicated higher abstention rates before driving than Japanese-Americans regardless of their drinking levels. This may reflect the impact of public education on drunken driving in Japan.

Adolescent↗
PubMed2006

Association between angiotensin-converting enzyme gene polymorphisms and QT duration in a multiethnic population in Hawaii.

OBJECTIVES: Recent studies have suggested that heart-rate corrected QT interval (QTc) in normal populations may be influenced by genetic factors. We report findings of a study of the relationship between QTc, increased QTc (> 440 ms) and angiotensin-converting enzyme (ACE) genotype in a multiethnic, population-based study completed in rural Hawaii. METHODS: Blood samples were obtained while fasting and after an oral glucose challenge from 1452 individuals between 1997 and 2000. The clinical examination included an electrocardiogram. Medical histories, behavioral and socio-demographic information were obtained during the interview. Ethnicity was estimated by self-report. The insertion/deletion (I/D) polymorphism in intron 16 of the ACE gene was determined by polymerase chain reaction (PCR) from a random sample of 588 participants. Multiple linear and logistic regression was used to test for associations between QTc and ACE gene polymorphisms. RESULTS: The overall crude prevalence of increased QTc was 21.2%. The prevalence of increased QTc was lowest among those with ACE DD genotype, and highest among those with ACE insertion/insertion (II) genotype. The adjusted odds ratio for increased QTc was 2.29 (95% CI 1.02-5.12) and 3.61 (95% CI 1.60-8.13) for ID and II genotypes, respectively, compared to the DD genotype. The test for trend was highly significant (p < 0.001). CONCLUSIONS: The ACE insertion allele was associated with increased prevalence of prolonged QTc independent of ethnicity, age, gender, and BMI. These findings may implicate the ACE gene as an important genetic risk factor for cardiovascular disease morbidity and mortality.

Adult↗
PubMed2005

Prevalence and risk factors for prolonged QTc in a multiethnic cohort in rural Hawaii.

BACKGROUND: Few studies have examined the biochemical risk factors for prolonged QTc, a predictor of mortality in numerous studies. We report on the prevalence and risk factors for prolonged QTc in a multiethnic population in rural Hawaii. METHODS: Electrocardiograms were collected from 1415 participants in a cross-sectional survey. The QT interval lengths were corrected for heart rate using Bazett's formula. Linear and logistic regression models were used to examine associations between various cardiovascular risk factors with QTc. RESULTS: Among the CVD risk factors examined, only age, gender, 2-h glucose, and systolic blood pressure (SBP) were independently associated with QTc interval length. Significant ethnic differences in prevalence were also observed, which persisted after controlling for other risk factors. CONCLUSIONS: Significant associations between prolonged QTc and ethnic ancestry, but not cholesterol or triglyceride levels, suggest that genetic factors may play a more important role in determining QTc interval length than conventional biochemical and metabolic CVD risk factors.

Adult↗
PubMed2004

Cross-cultural comparison of workplace stressors, ways of coping and demographic characteristics as predictors of physical and mental health among hospital nurses in Japan, Thailand, South Korea and the USA (Hawaii).

In an attempt to cross-culturally compare factors that may contribute to the nursing shortage within countries that have produced a limited number of research findings on role stress in nurses, this research examined work stressors, ways of coping and demographic characteristics as predictors of physical and mental health among hospital nurses from Japan, South Korea, Thailand and the USA (Hawaii). Subjects (n = 1554 hospital-based nurses) were administered four self-report questionnaires: Demographic Questionnaire, "Nursing Stress Scale", "Ways of Coping Questionnaire" and "SF-36 Health Survey". Findings suggested that nurses indicated similar workplace stressors, ways of coping, and levels of physical and mental health. While subjects, across countries, demonstrated a variety of predictors of physical and mental health, several predictors were found to be the same. Cross-culturally the role of nurses may vary; however, certain factors are predictive of the status of hospital nurses' physical health and mental health.

Adaptation, Psychological↗
PubMed2005

Results of breast conservation therapy from a single-institution community hospital in Hawaii with a predominantly Japanese population.

PURPOSE: To evaluate the outcome data from breast conservation therapy performed at the Kuakini Medical Center in Honolulu, Hawaii. The remarkably low rates of recurrence found in this study prompted a review of the literature and evaluation of the prognostic factors that may explain these results. METHODS AND MATERIALS: The data from patients with Tis, T1 or T2 breast tumors, treated with lumpectomy and radiotherapy during the 12-year period between January 1990 and December 2001 were retrospectively reviewed and compared to results found in national publications. RESULTS: Current follow-up data was available in 97.1% of patients who met these criteria, identifying a total of 896 patients who were analyzed in this study. With a median follow-up exceeding 6 years, the local in-breast failure rate was 0.67%. Survival data was superior to the National Cancer Data Base for each stage of disease. CONCLUSION: This low rate of local relapse is extraordinary and unmatched by the published results generally cited in the literature. The findings are consistent with other studies reporting unusually low rates of breast cancer recurrence in patients of Japanese ancestry.

Adult↗
PubMed2006

Modeling protected species as an undesirable output: the case of sea turtle interactions in Hawaii's longline fishery.

Interactions with sea turtles have occurred at an alarming rate in swordfish longlining in Hawaii in recent years and various regulations have been put forward to protect sea turtles. In order to understand the cost of reducing sea turtle interactions, methods have been developed to derive the shadow price of sea turtle bycatch based on fisher's welfare loss from a specific regulation. This paper illustrates an alternative method of calculating temporal and trip-specific cost of sea turtle bycatch reduction. The advantages of this method lie in the computation of shadow price without assuming specific regulation implementation and its relatively modest data requirement. A parametric output distance function is used to simultaneously model desirable and undesirable catches. Using the duality argument, the revenue-related shadow price of sea turtle bycatch can be derived from the estimated distance function. Average shadow price of sea turtle bycatch for the period 1991-1999 is estimated to be US $30873 in 1991 dollars. Average shadow prices of sea turtle bycatch by trip characteristics, such as fishing year, trip type and location are also estimated. Such information can be useful for policy makers to analyze tradeoffs and make appropriate policy decisions.

Animals↗
PubMed2004

Age, apolipoprotein E4, and the risk of HIV dementia: the Hawaii Aging with HIV Cohort.

There are discrepant findings regarding the risk of HIV-associated dementia (HAD) relating to apolipoprotein E4, suggesting other factors may modulate risk. Furthermore, evidence suggests a changing phenotype of HAD in the era of highly active antiretroviral therapy (HAART), prompting a need to determine if new disease markers have emerged. In this analysis, APOE genotype was determined for 182 participants enrolled in the Hawaii Aging with HIV Cohort. After controlling for age and diabetes status, an independent risk of HAD relating to E4 was seen in older participants [OR=2.898 (1.031-8.244)] but not in younger participants [OR=0.373 (0.054-1.581)]. Several proposed mechanisms may underlie this association. Consideration of non-traditional risk factors for HAD in older HIV patients may yield new markers of disease in the era of HAART.

AIDS Dementia Complex↗
PubMed2005

Volcano related atmospheric toxicants in Hilo and Hawaii Volcanoes National Park: implications for human health.

Volcanic fog (vog) from Kilauea volcano on the island of Hawaii includes a variety of chemical species including sulfur compounds and traces of metals such as mercury. The metal species seen tended to be in the nanograms per cubic meter range, whereas oxides of sulfur: SO2 and SO3 and sulfate aerosols, were in the range of micrograms per cubic meter and rarely even as high as a few milligrams per cubic meter of air (nominally ppb to ppm). These sulfur species are being investigated for associations with both acute and chronic changes in human health status. The sulfate aerosols tend to be less than 1 microm in diameter and tend to dominate the mass of this submicron size mode. The sulfur chemistry is dynamic, changing composition from predominantly sulfur dioxide and trioxide gasses near the volcano, to predominantly sulfate aerosols on the west side of the island. Time, concentration and composition characteristics of submicron aerosols and sulfur dioxide are described with respect to the related on-going health studies and public health management concerns. Exposures to sulfur dioxide and particulate matter equal to or less than 1 microm in size were almost always below the national ambient air quality standards (NAAQS). These standards do not however consider the acidic nature and submicron size of the aerosol, nor the possibility of the aerosol and the sulfur dioxide interacting in their toxicity. Time series plots, histograms and descriptive statistics of hourly averages give the reader a sense of some of the exposures observed.

Air Pollutants↗
PubMed2004

Cu, Pb and Zn contamination in Nuuanu watershed, Oahu, Hawaii.

Trace metal contamination in urban aquatic ecosystems in Hawaii is a significant problem, especially in terms of Cu, Pb, and Zn. These trace metals are linked to automobile usage. An in-depth study was designed to determine the influence of road sediments and storm sewers on bioavailable (0.5 M HCl) trace metal concentrations in bed sediments of Nuuanu stream, Oahu. Lead was the most enriched trace metal in the watershed. Compared to baseline Pb concentrations of <3 mg/kg, road sediments averaged 186 mg/kg, with a maximum value of 3140 mg/kg. Stream bed sediments had average Pb values of 122 mg/kg, with a maximum of 323 mg/kg. Al-normalized enrichment ratios (ERs) for the <63 microm fraction indicated that the watershed was significantly polluted in the lower, urbanized reaches, with maximum ER values of 560 and 94 for Pb in road sediments and stream sediments, respectively. Median ER values for Cu, Pb, and Zn in stream sediments were 2, 36, and 5, respectively. Rainfall events prior to sediment sampling masked any influence that storm sewer outlets might have had on the localized spatial distribution of metals associated with bed sediments. However, there was a general pattern of increasing trace metal concentrations downstream as the fluvial network traversed residential areas and commercial, highly trafficked areas in the lower portions of the watershed.

Biological Availability↗
PubMed2003

Personal, temporal and spatial characteristics of seriously injured crash-involved seat belt non-users in Hawaii.

The characteristics of crash-involved seat belt non-users in a high use state (Hawaii) are examined in order to better design enforcement and education programs. Using police crash report data over a 10-year period (1986-1995), we compare belted and unbelted drivers and front seat occupants, who were seriously injured in crashes, in terms of personal (age, gender, alcohol involvement, etc.) and crash characteristics (time, location, roadway factors, etc.). A logistic regression model combined with the spline method is used to analyze and categorize the salient differences between users and non-users. We find that unbelted occupants are more likely to be male, younger, unlicensed, intoxicated and driving pickup trucks versus other vehicles. Moreover, non-users are more likely than users to be involved in speed-related crashes in rural areas during the nighttime. Passengers are 70 times more likely to be unbelted if the driver is also unbelted than passengers of vehicles with belted drivers. While our general findings are similar to other seat belt studies, the contribution of this paper is in terms of a deeper understanding of the relative importance of various factors associated with non-use among seriously injured occupants as well as demonstrating a powerful methodology for analyzing safety problems entailing the categorization of various groups. While the former has implication for seat belt enforcement and education programs, the latter is relevant to a host of other research questions.

Accidents, Traffic↗
PubMed1995

Atrial myxomas: experiences with 35 patients in Hawaii.

BACKGROUND: Thirty-five patients with an intracardiac myxoma underwent excision of the tumor in Hawaii between 1974 and 1993. PATIENTS AND METHODS: There were 28 female and 7 male patients in the group. Their ages ranged from 11 to 79 years (mean 48) with the majority (71%) between 30 and 60 years old. The patients' medical records were reviewed and special attention was paid to clinical presentation, methods of diagnosis, operative findings, and postoperative course. RESULTS: No ethnic predisposition was found. Forty-six percent of the presenting symptoms were cardiac (congestive heart failure 26%, palpitations 14%, and syncope 6%) while arterial embolization accounted for 11%. Diagnosis was made by angiography, echocardiography, or gated cardiac blood pool imaging. All were reliable, but two-dimensional (2-D) echocardiography was used most often, with no false-positive or false-negative results. There were 32 left atrial, 2 right atrial, and 1 biatrial myxomas. Limited septectomy was performed in most cases, but 9 patients (26%) required Dacron patch repair of the atrial septum. There was 1 death from a cerebrovascular accident the day after the removal of a left-sided atrial myxoma. Other patients had few minor postoperative complications. One patient presented with a recurrence 8 years after resection at another institution; no further recurrences were found. CONCLUSIONS: We conclude that due to the non-specific presentation of atrial myxoma, a high index of suspicion is needed. The diagnostic method of choice is 2-D echocardiography. Limited septectomy is a safe procedure, but close follow-up for at least 10 years may be needed to rule out recurrence.

Adolescent↗
PubMed2001

Gender differences in exercise-induced changes in sex hormone levels and lipid peroxidation in athletes participating in the Hawaii Ironman triathlon. Ginsburg-gender and exercise-induced lipid peroxidation.

BACKGROUND: Exercise reduces the risk of coronary heart disease in men and women but paradoxically, may promote free-radical formation, lipid peroxidation and vascular tissue injury. In this study, we assessed whether exercise-induced oxidative stress similarly affected men and women who participated in the Hawaii Ironman triathlon. METHODS AND RESULTS: Fifty-seven athletes (38 males) who completed the triathlon (3.9 km swim, 180.2 km bike, 42.2 km run) participated in this study. Blood samples were obtained 2 days before and immediately after the triathlon for the measurement of lipids, antioxidants and sex hormones and for the assessment of the susceptibility of plasma lipids to peroxidation. Lipid changes after exercise were similar for men and women. However, the susceptibility of plasma lipids to peroxidation was reduced by 61% (P < 0.001) in men and only 14% (P = NS) in women postrace. These changes were not associated with the supplemental use or levels of antioxidants. In addition, in men there was an increase of 58% in the antioxidant sex hormone estradiol and a decrease of 58% in testosterone (P < 0.001) postrace. No significant changes were noted for these two hormones in women. CONCLUSIONS: There are significant gender-specific differences in the susceptibility of lipids to peroxidation and in changes in estradiol and testosterone levels as a result of ultra-endurance exercise. These changes may in part explain the salutary effect of exercise on the development of vascular disease.

Adult↗
PubMed1982

An epidemic of Kawasaki syndrome in Hawaii.

A community-wide outbreaks of Kawasaki syndrome, apparently the first in the United States, occurred in Hawaii in the first half of 1978. Twenty-seven of the 33 cases were subjected to intensive epidemiologic and microbiologic study. Patients with Kawasaki syndrome, compared to the general population, more often had Japanese ancestry, high-income status, and possibly a history of respiratory infection in the preceding month (44%). Staphylococcus aureus was not found in high frequency in the patients (15%), and viral cultures and serologic studies, immune electron microscopy, and guinea pig and primate inoculation did not reveal a causative microorganism. Febrile illnesses in guinea pigs inoculated with a skin biopsy specimen should not be further passaged.

Child↗