Re-emergence of paragonimiasis in Kyushu, Japan

During 1986-1998 we found 104 paragonimiasis cases, which were referred to our laboratory for immunodiagnosis or identification of parasite eggs in sputum or bronchoscopic aspirate smears, or in histopathological sections. A majority of patients were middle-aged males. Except for 2 cases of chronic occult infection in an unexpected site, 102 cases were assumed as having active infection. Abnormal findings in chest radiograms were noted over 80% of the patients, though about 20% of them were asymptomatic. Parasite egg detection rates in sputum or bronchoscopic aspirate smears were about 50%. About 80% of patients have eosinophilia and/or elevated serum IgE level. Paragonimiasis is a re-emerging public health issue in Kyushu, Japan.     

Health status and satisfaction of asymptomatic HIV-positive haemophiliacs in Kyushu, Japan

The purpose of this study was to elucidate the effects of human immunodeficiency virus (HIV) on haemophiliacs with physical functional disabilities induced by haemophilia in Kyushu, Japan. The subjects were 38 adult haemophiliacs who were selected from 129 patients registered with the North Kyushu Haemophilia Centre. They were divided into 21 asymptomatic HIV-positive and 17 HIV-negative adult haemophiliacs. Coagulation factor levels, modified DePalma classification, Arthritis Impact Measurement Scale 2 (AIMS 2), and a satisfaction in daily life (SDL) questionnaire were used to investigate the clinical severity of their haemophilia and arthropathy, physical functional disabilities, and satisfaction. Although there were no significant differences in the objective assessments of health status between the HIV-positive and -negative haemophiliacs, the HIV-positive haemophiliacs were significantly more dissatisfied with their social activities and mood, according to AIMS 2, and with social intercourse, job, self-development, and social security and pension according to SDL assessment. These dissatisfactions were due to the effects of HIV, in addition to the physical functional disabilities that were caused by haemophilia. Dissatisfaction with social security and pension may be a specific feature in HIV-positive haemophiliacs in Japan resulting from the origin of HIV infection.     

Current status of food-borne parasitic zoonoses in Japan

Epidemiological data on food-borne parasitic zoonoses in Japan is obscure because of the lack of legislated registration system for the incidence of such diseases. Attempts were made to draw rough estimates of the current status of food-borne parasitic diseases in Japan by gathering the annual incidence of each disease by literal survey and personal communications. In addition, parasitic diseases referred to and diagnosed in the Department of Parasitology, Miyazaki Medical College during 1999 were analyzed for the causative agents and the route of infection.     

Coronary atherosclerosis in youths in Kyushu Island, Japan: histological findings and stenosis

We histologically examined the coronary arteries of 52 autopsied cases of the youths (3 to 39 years of age, mean 28.5 years) in Kyushu island, Japan, without clinical events of coronary artery diseases. The coronary artery specimens were taken from the proximal portions of the right coronary artery (Seg. 1), the left anterior descending artery (Seg. 6), and the macroscopically most stenotic region (ST). Atherosclerotic lesions were histologically classified into four types: concentric fibrous, eccentric fibrous, concentric lipid rich, or eccentric lipid-rich type. The degrees of stenosis (< 25%, 25-50%, 50 75%, > 75%) were morphometrically evaluated. The majority of coronary arteries with under 50% stenosis were of the concentric fibrous type. Lipid-rich types of coronary atherosclerosis increased in the coronary arteries with over 50% stenosis and were observed in the Seg. 6 and ST, while 70% of Seg. 1 lesions with over 50% stenosis were of a fibrous type. Serum cholesterol levels of patients with a lipid rich type of coronary atherosclerosis were significantly higher than those with a fibrous type. These results suggested that the early stage of coronary atherosclerosis in Japanese youths is mainly of a concentric fibrous type, which later develops to a lipid rich type. Hypercholesterolemia would promote the progression of atherosclerosis.     

Angiostrongylus cantonensis infection in Ampullarius canaliculatus (Lamarck) in Kyushu, Japan

Ampullarius canaliculatus is a large fresh-water snail of which the original habitat is said to be Argentina. Recently, the snail which grew wild has propagated in various parts of Japan, and is causing damage to aquatic plants by feeding on them. The present study was performed to find out whether the snail can be a suitable intermediate host for Angiostrongylus cantonensis. Natural infection with A. cantonensis was confirmed in the snails collected from 5 different places in 4 hamlets in Okinawa and in those from Ishigaki Island. All snails experimentally infected with first-stage larvae of the parasite showed second-stage and third-stage larvae developing at the time of examination later on. Thus, A. canaliculatus is a suitable intermediate host for A. cantonensis, and, if eaten raw, it can be a potential source of human infection with eosinophilic meningoencephalitis in the endemic areas.     

Lifestyles, glucose tolerance and blood pressure in male self-defence officials in northern Kyushu, Japan.

Evidence on determinants of BP is mostly derived from studies in western populations. The relationship of BP with lifestyle variables and glucose tolerance was studied in 1,302 male self-defence officials aged 49-56 years who received a health examination before retirement at the Self-Defense Forces Fukuoka Hospital from October 1986 to December 1988. Those with treated hypertension or diabetes mellitus and those with conditions affecting BP levels were excluded from the study. In multiple regression analysis, alcohol use, body mass index and glucose intolerance were strongly associated with elevated BP while there was an inverse relation between cigarette smoking and BP. Physical activity expressed as the time spent in vigorous exercise was not associated with either systolic or diastolic BP. These findings indicate that alcohol use, obesity and glucose intolerance are also important determinants of BP in male Japanese, and that cigarette smoking is a potential covariate in the study of BP.     

我国重要食源性寄生虫病的流行和控制

华支睾吸虫病、带绦虫病和囊尾蚴病、并殖吸虫病、片形吸虫病、广州管圆线虫病、弓形虫病等是我国重要的食源性寄生虫病。 本文介绍了上述寄生虫病在我国的流行和控制状况,并探讨进一步控制的挑战及应对策略。     

Epidemiological investigation of a food-borne gastroenteritis outbreak caused by Norwalk-like virus in 30 day-care centres

In March 1999, an outbreak of gastroenteritis occurred affecting 30 day-care centres served by the same caterer. A retrospective cohort study was performed in 13 randomly selected day-care centres to determine the source and mode of transmission. Electron microscopy and PCR were used to verify the diagnosis. The overall attack rate (AR) was 37% (195/524): 30% in children and 62% in adults. Modified by the age of the patient, eating pumpkin salad served on 1 March was associated with becoming an early case (odds ratio = 3.9; 95% confidence interval 1.8-8.8). No significant association was found between food consumption and becoming a late case. The primary food-borne AR was 27% and the secondary AR was 14%. The same genotype of Norwalk-like virus was found in 5 cases and in 1 ill and 1 asymptomatic food-handler. Contamination by 1 of the food-handlers seems the most likely route of spread of the virus and underlines the importance of strict hygienic routines.     

Epidemiological study of hepatitis E virus infection in the general population of Okinawa,Kyushu, Japan

Background and Aim: The aim of this study was to investigate the prevalence of hepatitis E virus (HEV) infection in the general population of Japan by determining presence of the antibody to HEV (anti‐HEV). Methods: The prevalence of HEV infection was determined by positivity of serum antibody to HEV (anti‐HEV). Results: On retrospective analysis, a significant decrease in anti‐HEV prevalence was found in Okinawa healthy residents from 1995 (15.8%) to 2005 (5.5%) (P < 0.0001). In 2005, the anti‐HEV prevalence was significantly higher in Okinawa wild boar hunters (25.3%) than in the residents (male 7.7% and female 4.1%) (P < 0.0001). A significant difference was found in the history of consumption of undercooked or raw boar meat between anti‐HEV positive and negative hunters (100% vs 64.3%) (P = 0.0018). Conclusions: In conclusion, the anti‐HEV prevalence has decreased in the residents of this area, but HEV infection has continued at a high rate in the hunters through the custom of eating undercooked or raw boar meat.     

Surveillance of viral gastroenteritis in Japan: pediatric cases and outbreak incidents

Surveillance results from pediatric cases and outbreaks of viral gastroenteritis in Japan are presented. In winter, both small round structured virus (SRSV, or Norwalk-like viruses) and rotavirus were detected from infants with gastroenteritis; however, in recent years, the prevailing time of SRSV infection has preceded that of rotavirus infection. Most nonbacterial gastroenteritis outbreaks were related to SRSV infection, and >60% of the outbreaks were caused by contaminated food. In small-sized outbreaks, raw oysters were the primary source of transmission. In large-sized outbreaks, school lunches and catered meals that were served at schools, banquet halls, and hospitals were most often implicated in the transmission of foodborne gastroenteritis.     

急腹症临床误诊为胃肠炎原因分析及对策

目的分析急腹症误诊为胃肠炎的影响因素与解决方法,以期提高诊断准确率。方法选择该院2015-09~2016-09就诊的200例急腹症患者进行研究,其中16例误诊为胃肠炎。根据患者的临床表现以及检查情况,探讨误诊为胃肠炎的原因,并提出合理解决对策。结果 200例中16例(8.00%)误诊为胃肠炎,分别为急性阑尾炎6例,肠梗阻3例,消化道穿孔4例,胆囊结石并胆囊炎2例,宫外孕1例。在16例误诊者中,误诊原因为症状相似7例,病史描述不全3例,查体不仔细1例,病情分析缺乏全面性5例。16例误诊者经手术治疗后,病情显著改善,平均住院时间为(8±2)d。结论大部分急腹症患者发病初期有腹痛、腹泻、呕吐等症状,若查体、病史询问不到位,则会误诊。     

Estimation of annual incidence, age-specific incidence rate, and cumulative risk of rotavirus gastroenteritis among children in Japan

Rotavirus gastroenteritis is a common childhood infection, but the exact morbidity of the disease is not well described in Japan. We aimed at estimating morbidity measures to determine the magnitude of rotavirus gastroenteritis. An estimate for acute infectious gastroenteritis of all causes, to which rotavirus gastroenteritis belongs, has been available since the enactment in 1999 of the Law concerning the Prevention of Infectious Diseases and Medical Care of Patients with Infectious Diseases. Using this estimate and another estimate for the detection proportion of rotavirus among outpatients with acute infectious gastroenteritis, we calculated the annual incidence, the age-specific annual incidence rate, and the cumulative risk by the age of 6 years for rotavirus gastroenteritis. The latter estimate was obtained by a meta-analysis of four independent studies previously performed in Japan. According to our estimates, approximately 800,000 children in Japan under the age of 6 years visit pediatric practices or the outpatient department of hospitals because of rotavirus gastroenteritis at a rate of 11 cases/100 persons/year, and one in two children will visit pediatricians before they go to primary school. Such pediatrician visits most frequently occur at the age of 1 year (27 cases/100 persons/year). Thus, the magnitude of the burden of rotavirus disease among Japanese children is substantial.     

Long-term survivors of advanced esophageal cancer without surgical treatment: a multicenter questionnaire survey in Kyushu, Japan

Since the introduction of recent improvements in adjuvant therapy for esophageal cancer, some patients have demonstrated good prognosis. In the present study, we analyzed 3- and 5-year survivors of advanced esophageal cancer who did not undergo any surgical treatment. Between 1990 and 1998, 831 patients were admitted to 14 university hospitals and one cancer center associated with the membership of the Kyushu study group for adjuvant therapy of esophageal cancer. Twelve (1.4%) of the patients were 3-year survivors and 13 (1.6%) were 5-year survivors. The reasons for non-operation were refusal (eight patients), tumor-related factors (11 patients), and host-related factors (six patients). With a single exception, all patients had locally advanced tumors. Almost all long-term survivors had fewer than five lymph node metastases, in regions limited to the neck and/or mediastinum. Radiation therapy was combined with chemotherapy for 16 of the 25 patients, and chemotherapy-based cisplatin was used for 15 of these 16 patients. Fifteen of the patients remain alive; 10 died seven of them from esophageal cancer. Chemoradiation therapy was effective for some patients with locally advanced esophageal cancer, particularly in the absence of or with few lymph node metastases. To improve the prognosis of patients with advanced esophageal cancer who, for various causes, cannot undergo surgical treatment, a new protocol for adjuvant therapy is required.     

在校大学生食源性寄生虫病知行信调查

目的 目的 了解在校大学生食源性寄生虫病知识、 态度和行为的情况, 为制定健康教育策略提供依据。 方法 方法 采用分层整群随机抽样法抽取扬州市职业大学在校大学生1 114名, 通过问卷调查了解其食源性寄生虫病相关知识、 态度和行为。 结果 结果 被调查大学生对食源性寄生虫病及其危害的知晓率分别为42.2 %和41.7%; 不同性别、 年龄、 地区 （江苏省内）、 专业大学生食源性寄生虫病危害知晓率差异有统计学意义 （P均 < 0.01）, 其中男生、 17~<19岁年龄组、 苏南地区、机械工程专业学生知晓率相对偏低。除家中不养宠物 （32.0%）、 家用切菜砧板切生熟食物完全分开 （28.6%）、 饭前洗手（67.1%） 3项外, 其余9项健康行为形成率均≥ 80.0%, 不同性别、 年龄、 地区、 专业大学生在不吃醉虾醉蟹、 不吃烧烤、 不喜吃半生不熟或未煮熟食物、 不喜猎奇等方面健康行为形成率差异有统计学意义 （P均 < 0.05）, 其中男生、 21~<23岁年龄组、 苏南地区、 机械工程专业学生正确行为形成率相对偏低。大学生正确态度形成率均≥ 84.8%, 不同性别及专业大学生对存在可能感染食源性寄生虫病的食物持 “不会再去吃” 、 “建议他人不要去吃” 、 “改掉这些特殊喜好或改变不良生活习惯” 等态度的形成率差异有统计学意义 （P均 < 0.01）, 其中男生、 机械工程专业学生形成率相对偏低。 结论 结论 被调查大学生食源性寄生虫病知识知晓率偏低, 健康行为及正确态度形成率相对较高, 应有针对性地、 差别化地对其开展食源性寄生虫病知识宣传教育, 以提高防病意识和自我保护能力。