Japanese encephalitis: surveillance and elimination effort in Japan from 1982 to 2004

Japanese encephalitis (JE) surveillance has been conducted since 1965 as a part of the National Epidemiological Surveillance of Vaccine Preventable Diseases in Japan. Over 1,000 JE cases were reported annually in the late 1960s. The number of JE cases has since markedly decreased, with less than 10 cases reported annually from 1992 to 2004. A total of 361 JE cases were reported between 1982 and 2004. Prognosis was available for 320 cases; 58 (18%) died, 160 (50%) recovered with neuropsychiatric sequelae, and 102 (32%) completely recovered. Seventy-eight percent of these cases were 40 years old or over with a peak age group of 60-69 years old. JE predominantly occurred in unvaccinated populations. A high seroconversion rate among sentinel pigs was recorded every year. This suggests the presence of JE virus-infected mosquitoes during the summer in most areas of Japan, including the northern districts where no JE cases were reported from 1982 to 2004. Although JE cases have been reported in single figures since 1992, the risk of JE virus infection is still present. Thus, high immunization rates of JE vaccine should be maintained in Japan.     

2003～2012年广西钦州市流行性乙型脑炎疫情分析

目的了解钦州市流行性乙型脑炎（简称乙脑）的流行情况,为有效预防控制乙脑提供科学依据。方法对钦州市2003-01~2012-12的乙脑疫情资料用描述流行病学方法进行整理分析。结果 2003~2012年该市共报告乙脑病例91例,年均发病率为0.29/10万;散居儿童发病69例,占75.82%;男性、女性分别占69.23%、30.77%;2~10岁儿童发病77例,占发病总数为84.62%;5~7月份发病90例,占病例总数的98.90%,呈明显的夏秋季发病高峰;病例主要集中在农村边远地区,共65例,占病例总数的71.43%。结论预防控制乙脑要重点抓好农村边远地区2~10岁散居儿童的乙脑疫苗常规接种和查漏补种工作,在乙脑高发的夏秋季节加强监测力度和宣传教育力度,落实防蚊措施,减少乙脑发病。     

2005~2013 年成都市流行性乙型脑炎流行病学分析

目的 分析2005~2013 年成都市乙脑报告发病情况,探讨乙脑防治措施。方法 采用Excel软件对2005~2013 年成都市乙脑病例资料进行分析。结果 2005~2013 年成都市共报告乙脑病例124 例,死亡3 例,病例主要分布在金堂、金牛、郫县和双流。男女比例为1.70∶1,年龄最小6 个月,最大61 岁,以3~5 岁为主,占41.94%。无免疫史或免疫史不详占69.44%。蚊密度监测三带喙库蚊占4.27%。结论 成都市近年乙脑呈低水平散发态势,应做好乙脑疫苗查验补种,尤其要加强农村、偏远地区和流动人口密集地区的免疫接种,提高乙脑疫苗覆盖率,减少免疫空白,同时做好宣传教育、防蚊灭蚊等防控措施,减少乙脑发病。     

Epidemiological profile of Japanese encephalitis in Gorakhpur district, Uttar Pradesh, 1982-1988.

An in-depth study of Japanese Encephalitis (JE) situation in Gorakhpur district of Uttar Pradesh from 1982-1988 showed increasing trend in the incidence of JE. Total number of annual cases and case fatality rate (CFR) rose from 118 and 23.7 per cent in 1982 to 772 and 32.2 per cent in 1988 respectively. A definite increase was noticed in the number of cases per block following lull years in 1984 and 1987. Among the total affected 1201 villages, 1083 were affected only once. All age groups were affected and the disease showed marked seasonality during August to November. JE, which came in epidemic form in earlier years has established in the area in endemic form.     

1949-2018年石家庄市流行性乙型脑炎发病趋势分析

目的 分析流行性乙型脑炎(简称乙脑)流行特征的长期趋势。方法 对石家庄市疫情资料汇编((1949-2018年)、国家传染病报告信息管理系统(2004-2018年)与急性脑炎脑膜炎监测合作项目(2007-2018年)中的乙脑资料,采用年度变化百分比(annual percent change,APC)和圆形分布定量评估乙脑疫情变化特征。结果 1949-2018年,石家庄市累计报告乙脑病例5 884例,病死率为19.02%。职业中,农民占51.16%。2001-2018年,流动人口病例占40.85%。年发病率范围为0.03/10万~72.43/10万,年均发病率1.72/10万,APC为-2.57(t=6.38,P<0.001)。1949-1993年的1~14岁病例占62.59%,而2016-2018年的50岁及以上病例占76.56%。每20年左右出现一次明显的流行高峰。病例主要集中在7-9月份。1949-1999年的发病高峰为8月24日(8月1日-9月17日)(z=4712.17,P<0.001),2000-2018年的发病高峰为8月6日(7月18日~10月25日)(z=146.10,P<0.001),两阶段的发病高峰期差异具有统计学意义(t=2.03,P<0.05)。结论 石家庄市乙脑疫情明显下降,高发人群年龄呈上升趋势,流动人口成为新的易感人群,严格的季节性发病高峰特征有所减弱,高峰日提前,高峰期间增宽。     

Case-Based Surveillance of Pandemic (H1N1) 2009 in Maebashi City, Japan

After national case-based surveillance for pandemic influenza A (H1N1) ceased on July 23, 2009, a daily case-based surveillance system was implemented in Maebashi City, Japan. All medical facilities in the city reported all patients who had positive rapid antigen tests for influenza A. When the epidemic exploded in late October, case-based surveillance for influenza-like illness (ILI) was implemented from November 3, 2009 until the end of the epidemic. A total of 7,781 influenza cases were reported between July 25 and November 2, 2009, with a cumulative incidence rate of 22.5 per 1,000 population. Nearly 70% of the patients were under 15 years old. Between November 3, 2009 and the end of March 2010, a total of 16,394 ILI cases were reported, with a cumulative incidence rate of 47.4 per 1,000 population. Of the ILI cases reported, 63% were in patients younger than 15 years old. Only one death with laboratory confirmation of the H1N1 2009 virus was reported during the epidemic. The age-specific reproduction number among children under 15 years of age was almost 1.40, whereas between children and adults (15 years of age and above) it was considerably less than 1.0. The reproduction number derived from the next-generation matrix using data from September 30 to October 14 was estimated to be 1.48 (95% confidence interval, 1.41-1.56). Among individuals under 15 years of age, the infection rate calculated using the final size equation under the assumption of no mitigation measures was nearly twice the rate reported during the epidemic. These findings indicate that the majority of the transmission of influenza A (H1N1) 2009 in the city occurred among children.     

A nationwide incidence survey of Kawasaki disease in 1985-1986 in Japan

Nationwide epidemiological surveys of Kawasaki disease have been conducted nine times in Japan since 1970. By the end of 1986, 83,857 (male:female ratio, 1.4) cases were reported. We summarize the results of these surveys, especially the latest survey of cases from January 1985 to December 1986. There were three epidemic years - 1979, 1982, and 1986. The ratios of the number of patients diagnosed in each of those years to the number in the preceding year were 2.0, 2.4, and 1.7, respectively. The last epidemic started in a metropolitan area of Tokyo in December 1985 and propagated northwards and southwards to involve almost all of the country in six months. The age-specific incidence curve showed a unimodal peak at nine to 11 months of age. The proportion of sibling cases was approximately 2%. The epidemiological pictures suggested that the disease was caused by an unknown biologic agent that is common in the community and that spreads easily among very young children.     

Evaluation of the potency and safety of inactivated Japanese encephalitis vaccine in US inhabitants

In 1981 and 1982, two US citizens died from Japanese encephalitis (JE) acquired in China. In 1983, the Centers for Disease Control initiated an evaluation of a purified, inactivated, mouse-brain-derived JE vaccine produced and used in Japan since 1966. Two doses of this vaccine given 1-2 weeks apart evoked neutralizing antibody titers greater than or equal to 8 in only 77% of recipients. After three JE vaccine doses administered 1-2 weeks apart, 99% developed titers greater than or equal to 8. When a third dose was given to 29 participants 6-12 months after the primary series, all developed titers greater than or equal to 16. Reported adverse reactions included injection site tenderness (18%), erythema (6%), or swelling (3%); headache (9%); and dizziness, fatigue, sleepiness, nausea, chills, fever, or lower back pain (less than or equal to 5%). On the basis of this study, three doses of BIKEN JE vaccine are recommended for US citizens who may be at risk of exposure to JE virus.     

An unexpected outbreak of Japanese encephalitis in the Chugoku district of Japan, 2002

Six patients unexpectedly presented with Japanese encephalitis (JE) from early August to mid-September 2002 in the Chugoku district of Japan. The mean age was 67.5 years (range 42 - 89 years); the onset period in two patients shifted to the middle of September. The JE virus was isolated from the cerebrospinal fluid samples from two patients, and the strain isolated in the one was identified as genotype III. Neurologically, consciousness impairment, meningeal signs, rigidity, hemiparesis, tetraparesis, and convulsive seizures were commonly observed. Magnetic resonance imaging uniformly revealed high signal intensities in the bilateral thalami, brainstem (substantia nigra), hippocampi, and brain cortices. In all patients, acyclovir was used, due to the unexpected outbreak of JE. Five patients, except for one without sequelae, had a severe outcome, including one death. This report indicates that JE in Japan is still a threat to adults and the elderly with decreased or absent immunity to the JE virus.     

年龄对老年高血压患者伴急性肾功能衰竭诱发多器官功能衰竭的预测价值

目的分析年龄对老年高血压患者伴急性肾功能衰竭(ARF)后诱发多器官功能衰竭(MODSE)的影响,探讨年龄和ARF对老年高血压患者发生MODSE的预测价值。方法回顾性分析年龄≥60岁的高血压患者19 996例临床资料,以10岁为界分为60～69岁10 644例、70～79岁7427例、80～89岁1750例和≥90岁175例4个年龄段,再以69岁、79岁和89岁为分界点,分别分析4个年龄段及3个年龄分界点上下患者中,因ARF并发MODSE的发生率。结果所有ARF患者MODSE发生率较非ARF患者MODSE发生率明显升高(66.7%vs1.3%,P=0.00)。与60～69岁比较,≥90岁患者发生ARF的比例明显升高(2.8%vs 20.0%,P<0.05);4个年龄段伴ARF发生MODSE分别为51.4%、71.3%、84.9%、94.3%(P=0.00)。年龄与ARF和MODSE均呈正相关(r=1.00,P=0.000);排除年龄因素的影响后,偏相关分析表明,ARF与MODSE无相关性(r=-0.914,P=0.266)。结论年龄是老年高血压患者发生ARF及并发ARF后出现MODSE的重要影响因素。年龄对ARF诱发老年高血压患者发生MODSE具有一定的早期预测价值。     

Four years' experience with the Edwards-Tekna bileaflet valve prosthesis

BACKGROUND AND AIM OF THE STUDY: Although over 20,000 Edwards-Duromedics valves were implanted worldwide between 1982 and May 1988, use of the valve was voluntarily suspended by the manufacturer in May 1988 on the basis of reported leaflet escapes. In 1990, a modified version was introduced to the market, the Edwards-Tekna. The study aim was to evaluate the short-term outcome with this revised valve. METHODS: Between 1994 and 1998, 137 patients (67 males, 70 females; mean age 36.3+/-9.1 years) underwent heart valve replacement with the Edwards-Tekna prosthesis. Among these patients, 72 had isolated mitral valve replacement, 59 isolated aortic valve replacement, and six double-valve replacement. RESULTS: Early hospital mortality was 0.72% (n = 1). Follow up was 95% complete (129/136 patients discharged from hospital). Mean follow up was 24.9+/-10.5 months (range: 2 to 48 months); total follow up was 282.9 patient-years (pt-yr). Actuarial freedom from complications at two-year follow up and linearized incidence (%/pt-yr) of these events were: late mortality 87.8+/-8.5% (1.77%/pt-yr); thromboembolism 89.8+/-4.9% (2.12%/pt-yr); anticoagulation-related bleeding 97.8+/-1.5% (0.71%/pt-yr); prosthetic valve endocarditis 99.1+/-0.9% (0.35%/pt-yr); valve-related mortality 98.2+/-1.2% (0.71%/pt-yr); and valve-related morbidity and mortality 85.0+/-5.0% (4.24%/pt-yr). There was no structural valve failure such as leaflet escape in this series. Clinically significant hemolysis was not encountered (mean postoperative plasma LDH level 345+/-124 IU/l). Preoperatively, 69% of patients were in NYHA classes III/IV; at two years postoperatively 90% of survivors were in classes I/II. CONCLUSION: The Edwards-Tekna mechanical valve prosthesis has shown excellent overall clinical performance in the short term, though long-term data are needed to confirm its durability.     

Surveillance for Japanese encephalitis in Vietnam, 1998-2007

Japanese encephalitis (JE) is recognized as an important public health problem in Vietnam. A JE immunization program was introduced in 1997 in high-risk districts and expanded to additional districts over subsequent years. We reviewed national acute encephalitis syndrome (AES) surveillance data for 1998-2007 and analyzed more detailed data regarding JE from five northern provinces in 2004 and 2005. The annual reported incidence of AES in Vietnam ranged from 3.0 to 1.4 cases per 100,000 population with a decreasing trend over the 10-year period. The mean annual incidence of AES was highest in the northern region of the country. Of 421 AES cases from five northern provinces with laboratory results reported, 217 (52%) had laboratory evidence of recent JEV infection. As Vietnam moves closer to control of JE through immunization, accurate JE surveillance data will be important to evaluate and guide the program.     

Primary sclerosing cholangitis in Japan—analysis of 192 cases

Primary sclerosing cholangitis is very rare in Japan. The aim of the present study was to identify the characteristics of such patients in Japan. A questionnaire was sent to the members of the Japanese Society of Gastroenterology and responses for 192 cases were analyzed. There was male predominancy (61%), and two peaks in the age distribution at diagnosis (20–30 years and 50–70 years). Bile duct damage was mainly intra + extrahepatic (69%) versus intrahepatic (17%) or extrahepatic (14%). The incidences of eosinophilia and positivity for anti-nuclear antibody were 27% and 30%, respectively. The incidence of associated inflammatory bowel disease was 21 % (38 ulcerative colitis and 2 Crohn's disease). Chronic pancreatitis, gallstones, and biliary cancers occurred in 15%, 12%, and 4%, respectively, of the 192 patients. Patients less than 40 years of age had a higher incidence than the patients 40 years old or more of damage intra + extrahepatic bile ducts (89% vs 56%) and of associated ulcerative colitis (36% vs 9%), whereas the incidence of chronic pancreatitis was lower in patients aged less than 40 years (4%). The characteristics of patients with primary sclerosing cholangitis in Japan differ from those in other countries in regard to age distribution and the incidence of complications, and at least two different groups of patients seem to exist in terms of the degree of bile duct damage and the incidence of complications.     

Laboratory-based Japanese encephalitis surveillance in Nepal and the implications for a national immunization strategy

We report on two years of Japanese encephalitis (JE) surveillance in Nepal and the implications for a national immunization strategy. From May 2004 to April 2006, 4,652 patients with encephalitis were evaluated. A serum or cerebrospinal fluid specimen was collected from 3198 (69%) patients of which 1,035 (32%) were positive by Japanese encephalitis IgM ELISA. Most cases (N = 951, 92%) were from the 24 Terai districts (i.e., southern plains, 12.3 million persons) with the majority (N = 616, 65%) from four western Terai districts (population = 1.8 million). The case fatality ratio was 14.7% and 6.3% and the proportion of cases under 15 years old was 52% and 62% in the four western and 20 non-western Terai districts, respectively. Japanese encephalitis immunization targeting residents one year of age and older in the western districts and one through 14 years old in the non-western Terai districts may have reduced Japanese encephalitis cases by 84% and deaths by 92%, nationally.     

Analysis on the epidemiological characteristics of pulmonary tuberculosis among children aged 0-14 in Sichuan Province from 2009 to 2018

目的 分析四川省0~14岁儿童肺结核流行特征,掌握流行变化趋势,为加强儿童肺结核防控工作提供依据。 方法 基于《中国疾病预防控制信息系统》子系统《传染病报告信息管理系统》及其基本信息项目中报告的四川省2009—2018年0~14岁儿童肺结核患者的报告发病数据和人口数据,利用Joinpoint回归模型进行趋势性分析。结果 2009—2018年,四川省共报告0~14岁儿童肺结核10981例,占全人口肺结核报告发病例数的1.79%(10981/612506),10年间儿童肺结核实际报告发病率从2009年的8.91/10万(1349/15140100)上升至2018年的9.35/10万(1229/13141100),年均增长率为0.50%;Joinpoint回归分析显示,儿童肺结核标准化报告发病率在2009—2015年[年度变化百分比(annual percent change,APC)=-1.98%,P=0.196]、2015—2018年间(APC=10.13%,P=0.061)呈现阶段性变化,但均趋于稳定。0~14岁男童肺结核报告发病6011例,平均报告发病率为8.43/10万(6011/71339600),女童报告发病4970例,平均报告发病率为7.64/10万(4970/65071300),男童肺结核报告发病率普遍高于女童(χ²=26.261,P<0.001)。不同年龄组中,各组报告发病率的差异有统计学意义(χ²=3629.827,P<0.001),0~岁组(9.08/10万,774/8523100)和10~14岁组(14.37/10万,6575/45769900)儿童肺结核报告发病率普遍高于1~岁组(4.09/10万,1423/34833900)和5~岁组(4.67/10万,2209/47284100)报告发病率;Joinpoint回归分析显示,0~岁组儿童肺结核报告发病率从2009年的13.32/10万(132/991000)快速下降至2018年的3.73/10万(31/831900)(APC=-10.80%,P=0.002),10~14岁组儿童肺结核报告发病率2016年以后呈快速上升趋势,由13.39/10万(760/5676700)上升至18.88/10万(786/4162100)(APC=17.99%,P=0.042)。结论 近年来四川省儿童肺结核报告发病率整体趋于稳定,但仍有上升趋势,需要继续加强新生儿卡介苗接种、学生结核病防控、家庭内肺结核患者儿童密切接触者筛查工作。     

不同性别和年龄段老年慢性心力衰竭患者的临床特点

目的回顾调查分析不同性别和年龄段老年治疗慢性心力衰竭住院患者的临床特点,探讨防治对策。方法选择2003年1月²010年12月住院治疗的老年慢性心力衰竭患者1580例,男性936例,女性644例,602010年12月住院治疗的老年慢性心力衰竭患者1580例,男性936例,女性644例,60⁶9岁618例、7069岁618例、70⁷9岁682例和≥80岁280例,比较不同性别患者的临床特征。结果所有患者中,基本病因最多为冠心病702例,占44.4%,男性472例,占50.4%,女性230例,占35.7%,两者比较差异有统计学意义(P<0.05);伴随疾病最多为高血压778例,占49.2%,男性443例,占47.3%,女性335例,占52.0%,两者比较差异有统计学意义(P<0.05)。女性各年龄段患者风湿性心脏病发病率显著高于男性(P<0.05,P<0.01);男性6079岁682例和≥80岁280例,比较不同性别患者的临床特征。结果所有患者中,基本病因最多为冠心病702例,占44.4%,男性472例,占50.4%,女性230例,占35.7%,两者比较差异有统计学意义(P<0.05);伴随疾病最多为高血压778例,占49.2%,男性443例,占47.3%,女性335例,占52.0%,两者比较差异有统计学意义(P<0.05)。女性各年龄段患者风湿性心脏病发病率显著高于男性(P<0.05,P<0.01);男性60⁶9岁和7069岁和70⁷9岁冠心病发病率显著高于女性(P<0.05,P<0.01)。与女性比较,男性6079岁冠心病发病率显著高于女性(P<0.05,P<0.01)。与女性比较,男性60⁶9岁和7069岁和70⁷9岁左心衰竭比例明显升高,右心衰竭比例明显降低(P<0.01)。男女性病死率都随增龄增高(P<0.05,P<0.01),女性≥80岁增高更显著(P<0.01)。结论老年慢性心力衰竭住院患者中,高血压、冠心病、肺源性心脏病和肺炎随增龄增多,风湿性心脏病、心肌病随增龄减少,住院期病死率随增龄增高。     

云南省大理州1992～2001年流行性乙型脑炎流行现状分析(摘要)

目的本文对云南省大理州12个县(市)1992～2001年流行性乙型脑炎(简称乙脑)的流行现状进行了分析.方法乙脑病例和疫苗接种率资料从大理州疾病预防控制中心收集,气象和稻田种植面积资料分别从大理州气象局和大理州土地局获得.统计学分析用STADA 6.0 软件进行.结果在这10年间,大理州共报道839例乙脑病例,其中死亡101例,发病率为0.91/10万～ 6.45/10万,死亡率为0.09/10万～ 0.52/10万, 病死率为7.92% ～16.47%.每年乙脑病例从4月出现,12月止,主要流行季节8至10月(占病例数的90.46%),9月为流行高峰 (占病例数的41.72%).大理州12县(市)都有乙脑病例分布,各县市发病率由高到低分别为宾川(7.3/10万)、祥云 (5.2/10万) 、漾濞 (5.2/10万) 、剑川(4.4/10万) 、巍山 (4.2/10万) 、洱源 (2.8/10万) 、大理市 (2.7/10万) 、弥渡(2.7/10万) 、南涧(2.7/10万) 、鹤庆 (1.8/10万) 、永平 (1.6/10万)和云龙(0.7/10万).从1997～2001年所报道的297例乙脑病例分析,1997年5～9岁为发病率最高年龄组,但是,随后几年,这种流行模式发生了变化,发病率的最高年龄组从5～9岁组逐渐迁移到大于15岁组.对于成人,发病率最高的人群为农民.乙脑病例中,男∶女比率为1.4∶ 1;死亡病例中,男∶女比率为4∶ 1.统计学分析发现各县市乙脑年发病率与年平均温度,年平均降雨量和水稻面积无明显相关,而乙脑疫苗接种是一种有效的预防控制方法.结论鉴于流行模式的改变,为防止乙脑的流行, 不仅要重视1～14岁年龄组乙脑疫苗的接种,而且要加强对15岁年龄组疫苗的预防接种.     

1976—2013年四川省高县流行性脑脊髓膜炎流行病学分析

目的 分析四川省高县流行性脑脊髓膜炎（流脑）流行趋势,为有效控制流脑暴发和流行及探索经济有效的预防控制策略提供流行病学依据。方法 对高县流脑发病数和死亡数报告资料进行统计整理,采用描述性流行病学分析。结果 1976-2013年共报告流脑2 066例,死亡病例57例,年均发病率、死亡率和病死率分别为11.60/10万、0.32/10万和2.76%,发病率经趋势卡方检验,差异有统计学意义（χ^2=2916.60,P〈0.01）;全县19个乡镇均有流脑发病,发病居前3位的乡镇是文江、庆符和罗场,构成比分别为46.22%、16.99%和5.61%;2-4月是发病高峰,占病例总数的75.99%;发病率居前3位的是0~4岁、5~9岁和10~14岁年龄组,分别为21.70/10万、58.75/10万和34.24/10万;男女病例性别比1.25：1,农民发病最多,占病例总数的58.13%,其次为学龄前儿童占病例总数的19.80%。结论 高县流脑发病率呈明显下降趋势,但仍存在流行的隐患。发病具有明显的季节性,15岁以下年龄段是高危人群,提高儿童流脑疫苗的有效接种率是控制流行的关键。     

Increase in incidence and prevalence of inflammatory bowel disease in northern Denmark: a population-based study, 1978-2002

OBJECTIVES: Although incidence rates of inflammatory bowel disease have been reported worldwide, few long-term population-based studies with current time-trend analyses exist. We therefore examined time trends in the incidence rate of inflammatory bowel disease in a 25-year study period, and estimated the prevalence in 2002. All patients diagnosed between 1978 and 2002 were included as incident cases (n=2,326) and all patients living in North Jutland County on 31 December 2002 were used to estimate prevalent cases (n=2,205). METHODS: Medical records of all patients diagnosed with ulcerative colitis and Crohn's disease in the North Jutland County Hospital Discharge Registry were reviewed to examine if the diagnostic criteria were fulfilled. Age-specific and gender-specific standardized incidence rates were calculated. RESULTS: For ulcerative colitis, incidence rates in women increased from 8.3 (95% confidence interval (CI): 6.7-9.9) in 1978-1982 to 17.0 (95% CI: 14.7-19.3) per 100,000 person-years in 1998-2002. The corresponding figures for men were 7.7 (95% CI: 6.1-9.3) and 16.7 (95% CI: 14.4-18.8) per 100,000 person-years. For Crohn's disease, the incidence rates in women increased from 4.1 (95% CI: 3.0-5.2) in 1978-1982 to 10.7 (95% CI: 8.8-12.5) per 100,000 person-years in 1998-2002. The corresponding figures for men were 3.2 (95% CI: 2.1-4.2) and 8.5 (95% CI: 6.9-10.2) per 100,000 person-years. The prevalence of ulcerative colitis and Crohn's disease was 294 and 151 per 100,000 inhabitants, respectively. CONCLUSIONS: A marked and parallel increase was seen in both ulcerative colitis and Crohn's disease in both genders during the last 25 years, with a corresponding high prevalence of both diseases.     

Incidence of portal vein thrombosis in liver cirrhosis. An angiographic study in 708 patients

Portal vein thrombosis was thought to be a common complication of liver cirrhosis in the past. The incidence of angiographically demonstrable portal vein thrombosis was studied in 708 consecutive patients with unequivocal cirrhosis seen in the past 10 yr in whom either transhepatic portography or superior mesenteric arterial portography clearly delineated the major portal vein system. Excluding 2 cases that were thought to be associated with past splenectomy, there were 4 cases of portal vein thrombosis related to cirrhosis, all in a decompensated stage. The calculated incidence of portal vein thrombosis was 0.573% of all cirrhotic patients without splenectomy in the past. They constituted 23.5% of the 17 cases of extrahepatic portal vein obstruction encountered during the same period. There were 78 cases of idiopathic portal hypertension similarly studied angiographically, and the incidence of portal vein thrombosis unrelated to splenectomy was 2.86%. A statistical survey based on 247,728 necropsies recorded in the Japan Autopsy Registries of 1975-1982 showed a 0.05489% incidence of portal vein thrombosis and a 6.58857% incidence of cirrhosis of all types among them, suggesting that portal vein thrombosis is not a common complication of cirrhosis in Japan in recent years.