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PubMed1995

Markedly increased renal disease mortality and incidence of renal replacement therapy among IDDM patients in Japan in contrast to Allegheny County, Pennsylvania, USA. Diabetes Epidemiology Research International (DERI) U.S.-Japan Mortality Study Group.

The aim of this study was to evaluate factors related to the markedly increased risk of dying from diabetic renal disease in Japanese insulin-dependent diabetic patients compared to those in the USA. The study was based on two population-based cohorts consisting of 1374 cases from Japan and 995 cases from Allegheny County, Pennsylvania, USA, who were diagnosed between 1 January 1965 and 31 December 1979. The living status and dialysis experience were determined as of 1 January 1990. The duration-adjusted renal-failure-related mortality rates in the Japanese cohort and the USA cohort were 277.2 and 130.9 per 100,000 person-years, and the duration-adjusted incidence rates of dialysis were 564.9 and 295.6 per 100,000 person-year, respectively. After adjustment for sex, age at onset, calendar year of onset, and duration of diabetes, individuals with insulin-dependent diabetes in the Japanese cohort were still 2.4-fold more likely to receive dialysis compared to those in the USA cohort. Ten of the 36 renal-failure-related deaths in the Japanese cohort had never been treated by dialysis, while all renal-failure-related deaths in the USA cohort had been treated by dialysis. Survival after initiation of dialysis in the Japanese cohort was virtually the same as the USA cohort. These data suggest that a greater frequency of diabetic end-stage renal disease and reduced access to acceptance at dialysis underlie much of the excess of diabetic renal deaths in Japan.

Adolescent↗
PubMed1993

Hybrid dysgenesis in natural populations of Drosophila melanogaster in Japan. III. The P-M system in and around Japan.

The P-M system of hybrid dysgenesis in Drosophila melanogaster was investigated on the basis of gonadal dysgenesis, using 1,590 strains from 28 natural populations in Japan, and 20 populations from Southeast Asia, the Pacific area and Africa. Strong P strains were found sporadically in several populations in Japan. Few strong M strains were observed. Q strains were present at a high frequency in most populations. Thus, most populations in these areas were regarded as Q populations. The distribution of the P element and the evolution of P, Q and M populations are also discussed.

Animals↗
PubMed1994

Diagnostic criteria for diabetes mellitus in Japan--from a report of the Japan Diabetes Society (JDS) Committee on the Diagnosis of Diabetes Mellitus, 1982.

After the proposal of diagnostic criteria for diabetes mellitus by the National Diabetes Data Group (1979) and by WHO (1980), a committee was set up by the Japan Diabetes Society (JDS) to reconsider the old criteria by the JDS which had been proposed in 1970. Items covered by the report of the committee in 1982 included the concept of diabetes mellitus, describing it's features, and stating that it's diagnosis is a procedure of recognizing the disease 'diabetes' characterized by these features. Cutoff blood glucose values for fasting samples, after a 75 g oral glucose tolerance test, were proposed to define normal and diabetic types. The cutoff values for the diabetic type are identical to those of the WHO defining diabetes, whereas the values for the normal type (fasting < 110 mg/dl and 1-h < 160 and 2-h < 120 mg/dl for venous plasma) are much lower than those for the lower limit of IGT by the WHO. Subjects whose glucose tolerance is neither diabetic nor normal are classified as borderline type, which includes not only IGT but cases with milder glucose intolerance. The cutoff points for the normal type were selected based on the long-term follow-up data for mild glucose intolerance in Japan. The Committee further stated that the clinical diagnosis of diabetes should be made not only on the basis of the glucose tolerance data, but also after clinical consideration of the possibility of any other diseases which might impair glucose tolerance.

Blood Glucose↗
PubMed1988

Diabetes mellitus in twins: a cooperative study in Japan. Committee on Diabetic Twins, Japan Diabetes Society.

In 1984, the Japan Diabetes Society organized a committee to collect data on diabetic twins in Japan. Within 3 years, through correspondence with Society members and hospitals, the Committee had contacted 87 pairs of twins, one or both of which had diabetes mellitus or glucose intolerance. Sixty-three pairs were monozygotic and 24 dizygotic. The probands, who had been diagnosed as diabetic or glucose-intolerant earlier, included 21 patients with insulin-dependent diabetes mellitus (IDDM), 56 with non-insulin-dependent diabetes (NIDDM), one with an unknown type of diabetes, and nine with glucose intolerance. Concordance between monozygotic twins was 45% for IDDM and 83% for NIDDM; between dizygotic twins, concordance was 0% (0/10) for IDDM and 40% (4/10) for NIDDM. Concordance was significantly greater in NIDDM than in IDDM, and in monozygotic than in dizygotic twins. Concordance was greater among twins in which one twin had developed diabetes after the age of 20 than among twins in which the age of onset had been earlier. There was no evidence that the period of discordance was shorter in the discordant pairs than in the concordant pairs. About 90% of the IDDM twin pairs lived together, against 20% of the NIDDM pairs, probably due to the later age of onset of NIDDM. The frequency of diabetes in family members other than the twins was higher in NIDDM than in IDDM regardless of concordance. In concordant pairs the presence or absence of various complications agreed in 68-97%; a few pairs were discordant for the severity of retinopathy, which may have resulted from differences in duration and hyperglycemic degree. A 75-g glucose tolerance test administered to the 'normal' discordant twins revealed borderline glucose intolerance in two of six IDDM co-twins and six of eight NIDDM co-twins. The early-phase insulin response was low in two of six IDDM co-twins and four of six NIDDM co-twins. These results are generally consistent with previous reports of diabetic twins in Western countries, reinforcing the importance of genetic factors in the pathogenesis of diabetes. Heredity has a particularly strong influence in NIDDM.

Adolescent↗
PubMed2002

Trend of brain tumor incidence by histological subtypes in Japan: estimation from the Brain Tumor Registry of Japan, 1973-1993.

In order to estimate the risk of primary brain tumor (PBT), we attempted to estimate the national incidence rates of PBT by histological subtypes using the Brain Tumor Registry of Japan (BTR). The number of deaths due to PBT in a certain year is the sum of the deaths among patients diagnosed in different years. Registered cases in the BTR represent incident cases of PBT in the whole country multiplied by a cover rate. The cover rate is defined as the proportions of PBT cases that the Registry counts in relation to all the cases in the country in a given year. If the survival experience among the registered cases represents the survival experience of all cases, then the rate of registered deaths represents all deaths due to PBT in Japan. By this logic, we estimated the cover rates and incidence rates from 1973 to 1993 using the BTR and National Vital Statistics data. Our estimates showed three patterns of time trends: (1) a gradual linear increasing trend before the 1980s followed by a plateau (total PBT, gliomas, meningioma, and hemangioblastoma), (2) a trend with a step-up increase in the 1980s followed by a plateau (germ cell tumor and pituitary tumor), and (3) a linear increasing trend throughout the observation period with no plateau (malignant lymphoma and neurinoma). Furthermore, obvious sex differences in time trends were observed in rates of meningioma, germ cell tumor, and pituitary tumor. The results of this study demonstrated several distinctive patterns in time trends, which give us insight into the possible etiologies of brain tumors. Further epidemiological study is needed to elucidate these findings.

Age Factors↗
PubMed2000

Comparative study of oral squamous cell carcinoma in Okinawa, Southern Japan and Sapporo in Hokkaido, Northern Japan; with special reference to human papillomavirus and Epstein-Barr virus infection.

In Okinawa, a subtropical island in Southern Japan, the incidence of oral squamous cell carcinoma is 1.5 times higher than that in mainland Japan. Sixty cases of oral squamous cell carcinoma from 1993 to 1996 in Okinawa and 42 cases over the same period in Sapporo were examined histologically. Human papillomavirus (HPV) and Epstein-Barr virus (EBV) were detected by polymerase chain reaction (PCR) amplification with primers specific for HPV and EBV. In situ hybridisations of the viruses were also carried out. In the case of Epstein-Barr virus, in situ PCR was also performed. Thirty-five (58.3%) Okinawan tumours were well-differentiated in type, but in Sapporo, 18 (42%) were of such type. In Okinawa, tumours of the mouth floor (10 cases, 16.7%) and oropharynx (12 cases, 20%) were frequently observed, whereas in Sapporo only five cases (12%) of each were found. HPV was demonstrated in 78% of Okinawan cases and 26.2% of Sapporon cases by PCR or non-isotopic in situ hybridisation (NISH). There were 76.6% (46 cases) of Okinawan and 38.1% (16 cases) of Sapporo cases positive for EBV by PCR. In only 12 Okinawan cases and 4 Sapporon cases, were positive signals demonstrated by in situ PCR on the cancer cells themselves. EBV was demonstrated in the large number of infiltrating lymphocytes, most of which were CD3+, and a few were CD19+. In Okinawa, HPV might be an important causative factor of oral squamous cell carcinoma and EBV a less important factor, whereas in Sapporo HPV and EBV might play only a small part in the aetiology of the tumour.

Adult↗
PubMed2000

Influence of monopoly privatization and market liberalization on smoking prevalence in Japan: trends of smoking prevalence in Japan in 1975-1995.

AIMS: In Japan, smoking prevalence in males has been among the highest among industrialized countries, while the prevalence in females has remained relatively low. There have been long-term declining trends since the early 1970s. In the mid-1980s, the public tobacco monopoly was privatized and the tobacco market was liberalized in Japan. This study examines whether the trends in smoking prevalence changed at the time of these market changes. DESIGN AND MEASUREMENTS: Smoking prevalence data, tabulated by age group and sex, were plotted over the period 1975-95. Trends of smoking prevalence were then analyzed by using linear regressions, and their changes at the time of monopoly privatization and market liberalization were examined by Chow tests. FINDINGS: The trends in smoking prevalence changed at the time of the monopoly privatization and trade liberalization in both males and females, except for the males in their twenties and thirties. Rates of decline in smoking prevalence diminished in many age groups and prevalence for younger females started to increase. CONCLUSIONS: Market changes, that result from the privatization of a public tobacco monopoly and trade liberalization, may adversely affect smoking prevalence in many age groups and in both sexes, unless effective countermeasures are taken.

Adult↗
PubMed2000

Incidence of Type 1 diabetes mellitus in children aged 0-14 in Japan, 1986-1990, including an analysis for seasonality of onset and month of birth: JDS study. The Data Committee for Childhood Diabetes of the Japan Diabetes Society (JDS).

AIMS: To detect the incidence of childhood Type 1 diabetes mellitus (DM) (0-14 years) in Japan and to find out whether there is a seasonal pattern in the onset of disease and month of birth of children with diabetes. METHODS: Ascertained data for the period 1986-1990 could be collected in 35 out of 47 local government areas representing 69.4% of the childhood population (aged 0-14 years) of Japan. RESULTS: A total of 1,260 children with Type 1 DM were identified (738 girls, 522 boys). With age there was a progressive increase in incidence from 0.7 to 2.1/10(5) in boys and from 0.6 to 3.5/10(5) in girls. With the exception of 1987, when a coxsackie B3 virus epidemic was registered, no seasonal variation in the month of onset was observed, nor was a seasonal pattern of the month of birth registered in this cohort. CONCLUSIONS: Compared to European countries, the USA and Israel, the Japanese cohort of children with diabetes presents the following differences: the incidence is much lower, there is a preponderance of girls and there is (with one exception) no seasonal pattern.

Adolescent↗
PubMed1991

Clinical evaluation of delapril in Japan. Report from the Japan Study Group on Delapril.

Delapril, a new angiotensin converting enzyme (ACE) inhibitor discovered in the laboratory of Takeda Chemical Industries, Ltd., is the result of drug design based on the structure-activity relationships of ACE inhibitors. Delapril is an antihypertensive agent with a relatively long duration of action and no SH moiety in its structure. Following administration, it is converted into two active metabolites. Delapril effectively lowered blood pressure in 73% of 1,008 patients with hypertension during clinical trials in Japan. Efficacy rates were 73% for essential hypertension, 85% for renal hypertension, and 80% for renovascular hypertension. Excellent hypotensive response was observed in all age groups, from young to elderly patients. Side effects during administration of delapril, based on subjective evidence, were reported in 80 out of the 1,008 cases (7.9%). The main symptoms included orthostatic dizziness (1.7%), dizziness (1.3%), and nausea (1.1%). Dry cough, which has attracted attention in recent years as a side effect of ACE inhibitors, was reported at a low incidence of 1.1%. In a double-blind, controlled study in patients with mild to moderate essential hypertension in which captopril served as a positive control, delapril showed superior hypotensive effect and greater safety. Data derived from the Japan Study Group on Delapril indicate that this ACE inhibitor has excellent hypotensive effects and a high level of safety. It is suitable as a first-line drug in both monotherapy and combined therapy.

Adolescent↗
PubMed2005

Twelve-month prevalence, severity, and treatment of common mental disorders in communities in Japan: preliminary finding from the World Mental Health Japan Survey 2002-2003.

To estimate the prevalence, severity, and treatment of Diagnostic and Statistical Manual of Mental Disorders (4th edn; DSM-IV) mental disorders in community populations in Japan, face-to-face household surveys were conducted in four community populations in Japan. A total of 1663 community adults responded (overall response rate, 56%). The DSM-IV disorders, severity, and treatment were assessed with the World Mental Health version of the World Health Organization (WHO) Composite International Diagnostic Interview (WMH-CIDI), a fully structured lay-administered psychiatric diagnostic interview. The prevalence of any WMH-CIDI/DSM-IV disorder in the prior year was 8.8%, of which 17% of cases were severe and 47% were moderate. Among specific disorders, major depression (2.9%), specific phobia (2.7%), and alcohol abuse/dependence (2.0%) were the most prevalent. Although disorder severity was correlated with probability of treatment, only 19% of the serious or moderate cases received medical treatment in the 12 months before the interview. Older and not currently married individuals had a greater risk of having more severe DSM-IV disorders if they had experienced any within the previous 12 months. Those who had completed high school or some college were more likely to seek medical treatment than those who had completed college. The study confirmed that the prevalence of DSM-IV mental disorders was equal to that observed in Asian countries but lower than that in Western countries. The percentage of those receiving medical treatment was low even for those who suffered severe or moderate disorders. Possible strategies are discussed.

Adult↗
PubMed1989

High-incidence of C9 deficiency throughout Japan: there are no significant differences in incidence among eight areas of Japan.

From 92,686 sera sent from hospitals throughout Japan to the Special Reference Laboratories for CH50 assay, we were able to classify 80 patients as C9-deficient using a sensitive screening test, as well as hemolytic and immunochemical C9 assays. The incidence of C9 deficiency was determined to be 0.086%, and there were no distinct differences among the eight areas of Japan tested. Serum CH50 levels of these C9-deficient patients varied widely (9.4-63.8 U/ml), and exhibited a higher value (average: 34.1 U/ml) than that of healthy C9-deficient individuals, probably due to elevated C3, C4, and C5 levels. These patients suffered from a variety of autoimmune, renal, and infectious diseases, which, however, are thought to be only incidentally associated with C9 deficiency.

Complement C9↗
PubMed2004

Control of blood pressure as measured at home and office, and comparison with physicians' assessment of control among treated hypertensive patients in Japan: First Report of the Japan Home versus Office Blood Pressure Measurement Evaluation (J-HOME) study.

The Japan Home versus Office Blood Pressure Measurement Evaluation (J-HOME) study was conducted to measure the control of blood pressure (BP) as evaluated by home BP measurement among 3,400 patients with essential hypertension (mean age: 66 years; females: 55%) receiving antihypertensive treatment in primary care settings in Japan. The purpose of this first report was to compare characteristics of BP control as measured at home and in the clinic (office) and define their association with BP control as evaluated by physicians. Mean systolic/diastolic BP (SBP/DBP) values were 140/82 mmHg for home BP and 143/81 mmHg for office BP. BP levels were not adequately controlled among approximately 60% of the patients, according to reference values described in the national guidelines (office BP: <140/90 mmHg; home BP: <135/85 mmHg). Even among patients evaluated by physicians as having excellent or fairly good BP control, office and home SBP values were insufficiently controlled in approximately 50%. Although the tendency was more remarkable among older patients, whose recommended target BP levels are higher than those of middle-aged patients in the Japanese Hypertension Society 2000 criteria, office and home BP values were not adequately controlled in approximately 50% of the middle-aged patients whose BP control was evaluated as good. Our findings suggest that an important reason why home and office BP values are not adequately controlled is that physicians approve relatively higher BP levels under treatment, even among middle-aged patients.

Aged↗
PubMed1992

Poliovirus surveillance: isolation of polioviruses in Japan, 1980-1991. A report of the National Epidemiological Surveillance of Infectious Agents in Japan.

This report presents an overall distribution of poliovirus isolations in Japan, where poliomyelitis has been under control over two decades as a result of legal administration of two doses of the trivalent live oral poliovirus vaccine of the Sabin strains (OPV) to children under 48 months of age. During the past 12 years from 1980 through 1991, a total of 1,126 poliovirus isolations from humans and 268 isolations from sewage/river water were reported by respectively 49 and nine of the participating laboratories. Type 2 was most frequently isolated from children after administration of one dose of OPV, followed by type 1 and type 3. On the contrary, after the second dose of OPV, the rate of isolation of type 3 exceeded those of type 2 and type 1. Seasonal and age distribution of poliovirus isolations from both humans and sewage/river water paralleled the OPV vaccination schedule in Japan. One percent of the isolations were, however, from infants younger than the vaccination-scheduled ages and 5% were from children older than those ages, including one each from 15 and 16 years olds. The data indicate that the poliovirus has silently been disseminated from vaccinated children to others and the community, thus suggesting repeated transmission of the viruses. The fact that some elder children had poliovirus colonization in their alimentary tracts indicates a potential risk of infection of such a population when exposed to a wild virus and of becoming a source of transmission to others.

Adolescent↗
PubMed1994

Epidemics of aseptic meningitis due to echovirus 30 in Japan. A report of the National Epidemiological Surveillance of Infectious Agents in Japan.

Two rages of epidemic of aseptic meningitis (AM) due to echovirus 30 (E30) in Japan were analyzed with respect to two sources of information, AM incidence and E30 isolation, both gathered through the National Epidemiological Surveillance of Infectious Diseases. The first E30 epidemic spread throughout Japan in 1983 and ceased within the year. The second epidemic, starting in 1989, continued for the three successive years, and in the last year, 1991, the total E30 reports numbered 4,061, the largest number of a single virus type ever reported. Although the epidemic showed temporal and geographical shift and lasted for one or two years in some areas, most laboratories reported the largest number of E30 isolation in 1991. Among E30-yielding cases with clinical information during 1982-1992, the associating frequency with AM was as high as 82.5%. Other central nervous system involvements such as encephalitis, myelitis, encephalomyelitis and/or paralysis were reported in 36 E30-yielding cases and their monthly and age distributions were different from those of AM cases. The proportion of such disease among E30-yielding cases (0.60%) was close to that of other enteroviruses (0.56%). During the epidemics, E30 was isolated more frequently from cerebrospinal fluid than was E4 or E9 which prevailed coincidentally. E30 was most frequently isolated from cases of 4-7 years of age, sharing the common characteristic pattern of age distribution with other enteroviral meningitis. E30-yielding cases, however, involved a large number of older age groups than those of other enterovirus infections, and this tendency was the most pronounced in the first epidemic year, 1983. The contribution of these E30 epidemics on the yearly trend of clinically reported AM incidence and on the shift of its age distribution was also analyzed.

Adolescent↗
PubMed1999

[First brain dead donor heart transplantation under new legislation in Japan and future aspects of heart transplantation in Japan].

After the brain death and organ transplantation law was settled in 1997, the first case of heart transplantation (HTx) was carried out successfully. The patient was 47 year-old male with hypertrophic cardiomyopathy of dilated phase and on Novacor Implantable LVAS for 4 months. The distance from the donor hospital was about 200 km taking 2 hours for transport, and total ischemic time was 3 hours and 24 minutes. The post-transplant course was smooth. The patient was discharged on 75 postoperative day. We described current status of HTx in Japan and worldwide and discussed current problems and future aspects of HTx in Japan.

Brain Death↗
PubMedDate not supplied

Cumulative results of chemosensitivity tests for antitumor agents in Japan. Japan Research Society for Appropriate Cancer Chemotherapy.

The Japan Research Society for Appropriate Cancer Chemotherapy set out to summarize the present status of chemosensitivity testing for antitumor agents in Japan. Two different questionnaires were sent to 122 and 94 institutes, respectively, whilst responses were received from 87 (71.3%) and 41 (43%) institutes, respectively. The results showed that chemosensitivity tests were performed in 42 institutes where a total of 2 in vivo and 10 in vitro different assays were performed. Actual cases of chemosensitivity detected by the tests varied from 1 to 368 cases/year/institute with a median of 15 cases and mean +/- standard deviation of 48 +/- 65 cases. The total number of tested cases increased from 1,747 cases in 1993 to 1,934 cases in 1994 and to 2,147 cases in 1995, resulting in an average of 1,891 cases year. The assays used included the adenosine triphopsphate inhibition assay,/the collagen droplet embed drug response assay, the fluorescent dye assay, the growth chamber assay, the histoculture drug response assay, human tumor clonogenic assay, the MTT assay (SDI test), the nuclear damage assay, the nude mouse model, the subrenal capsule assay and the thymidine incorporation assay (scintillation assay). The correlation of in vitro and in vivo results revealed 215 true positive (S/S), 246 false positive (S/R), 45 false negative (R/S) and 595 true negative (R/R) cases, resulting in rates of 47% for true positives and 93% for true negatives, with a 74% accuracy. We concluded that chemosensitivity testing is widely applied in this country and has a high accurate predictive value for advanced carcinomas.

Animals↗
PubMed2000

Prognostic factors in childhood acute lymphoblastic leukemia in Japan. Japan Association of Childhood Leukemia Study.

A retrospective analysis of children with acute lymphoblastic leukemia (ALL) was performed to evaluate the current status of diagnosis and treatment of ALL in Japanese children. Clinical records of 670 children with ALL were collected and analyzed; these children had been diagnosed between 1991 and 1995 at the 53 institutions in 4 areas participating in the Japan Association of Childhood Leukemia Study. It was found that T-cell ALL was significantly less frequent in Tokai and Hokkaido than in Kansai and Chu-Shikoku. The overall induction rate was 92.4%. The estimated 7-year overall survival rate and event-free survival (EFS) rate were 76.0% +/- 1.9% and 61.4% +/- 2.1%, respectively. EFS rates were significantly different among the geographic areas. In female patients with B-cell precursor (B-pre) ALL and white blood cell counts at diagnosis (WBCsdiag) below 50.0 x 10(9)/L, favorable outcomes were significant. Favorable outcomes were not significant in B-pre ALL patients with a WBCdiag above 50.0 x 10(9)/L or in T-cell ALL patients. The EFS rate for infants was significantly worse than that for patients over 1 year of age. In B-pre ALL, but not in T-cell ALL, it was found that the higher the WBCdiag, the worse the EFS rate. Multivariate analysis showed that the following factors were significantly unfavorable for EFS: the Philadelphia chromosome, an translocations associated with chromosome 11q23, an acute unclassified leukemia, mixed-lineage leukemia, a WBCdiag above 100.0 x 10(9)/L, and male gender. Hyperdiploidy (> 50 chromosomes) was significantly favorable for EFS. For further tailoring of treatment and to improve the outcome in childhood ALL, a prospective large-scale study should be undertaken in Japan.

Age Factors↗
PubMed1992

[The epidemiology and clinical features of anaphylactic and anaphylactoid reactions in the perioperative period in Japan: a survey with a questionnaire of 529 hospitals approved by Japan Society of Anesthesiology].

In an attempt to review the Japanese epidemiology of the anaphylactic and/or anaphylactoid reactions in the perioperative period, we surveyed 529 hospitals approved by Japan Society of Anesthesiology with a questionnaire about drug-induced immediate adverse reactions. Recovery rate of questionnaires was 15% (80 hospitals in 529 hospitals), and 28 cases of anaphylaxis or anaphylactoid reaction were reported. Most patients were in their teens and twenties. Male were 10, and female were 12 (unknown gender; 6). Reaction occurred during the induction of anesthesia in 28.6% of the patients, and during the maintenance of anesthesia in 67.9%. Seventy-five percent of the patients had no past history of drug-induced allergy nor tendencies of atopy. Most frequent clinical signs were cardiovascular (85.7%) and cutaneous (100%) manifestations. Respiratory signs appeared in 42.9% of the patients. Patients were frequently unconscious and covered with drapes, and there is a potentially danger of masking early signs and symptoms of anaphylaxis. In most of the patients, cardiovascular collapse appeared as the first noticeable sign. Causative drugs were confirmed only immunologically in one patient. In other cases causative drugs were presumed based on clinical courses. Anaphylaxis and anaphylactoid reaction are important causes of morbidity and mortality. The incidence in Japan was 0.01% (1:10,000) and the mortality was 4.76%.

Adolescent↗