HIV/AIDS surveillance in Japan, 1984-2000

The HIV/AIDS surveillance system in Japan, which began collecting data on the number of AIDS patients in 1984 and the number of HIV-infected persons in 1987, has played an important role in monitoring the trend and magnitude of Japan's HIV/AIDS epidemic and its distribution across various population subgroups. However, the system lacks any personal identifiers, making it impossible to eliminate duplication or to track cases for disease progression. It also does not permit the identification of the residence of HIV-infected persons because the residence of only the reporting physician is documented under the New Infectious Diseases Control Law, effective since April 1, 1999. The number of people with HIV/AIDS in Japan continues to grow. Among youth, sexually transmitted diseases, induced abortion, and sexual activities have shown a marked increase since the mid-1990s. Behavioral risk of infection for both injection drug users (IDUs) and men who have sex with men (MSM) remains alarmingly high. Accurate monitoring of infection rates is critical to the planning and evaluation of treatment, care and prevention programs. Japan should restructure its HIV/AIDS surveillance system to more accurately monitor the HIV/AIDS epidemic and related risk behaviors.     

Twice-daily measurements of stature and body weight in two children and one adult

Stature and body weight of two children, 12.5 and 9.3 years, and their mother were measured twice daily for 488 days, immediately after rising and just before bed. The time of the measurements was also recorded and diurnal changes during daytime and nighttime were estimated. Stature began to decrease instantaneously after rising. Therefore, morning measurements were made immediately after rising. Stature decreased during the day, and the mean daytime loss was 1.78 cm in the older child, 1.61 cm in the younger child, and 1.43 cm in the adult. Stature increased during sleep hours at night, and the mean nighttime gain was 1.79 cm, 1.63 cm, and 1.43 cm in each subject, respectively. Stature also increased after naps and a bath. Body weight decreased during sleep hours at night, and the mean nighttime loss was 0.46 kg, and 0.38 kg, and 0.36 kg in each subject, respectively. Diurnal changes were largest in the older child, while the ratios of changes (ΔST/ST, ΔWT/WT) were largest in the younger child whose growth rate was the greatest. In the children, the nighttime gain of stature was not as highly correlated with hours of sleep as in the adult. Diurnal change varies depending upon sleep hours and stage of growth. Rapid growth in stature of 1 cm in only three weeks was observed once in the younger child. During this period, diurnal change was smaller than the mean value over 488 days. In the older child, the growth rate decreased in both stature and weight about three months after menarche. © 1993 Wiley-Liss, Inc.     

Extracorporeal circulation before and after ultrasonographic evaluation of the ascending aorta

BACKGROUND: To further gain insight into atheroembolization mechanisms epiaortic two-dimensional echocardiographic evaluation before extracorporeal circulation and after decannulation may be helpful. METHODS: Epiaortic two-dimensional echocardiography was performed before cannulation and after decannulation in 188 (124 men) patients (mean age, 67.7 years; range, 43 to 86 years) undergoing operation with extracorporeal circulation for ischemic heart disease during 1996. RESULTS: After decannulation, a new intimal lesion was recognized in 10 of 188 patients (5.3%): mobile type in 5 patients (3 ending with a stroke [60%], 2 having brain computed tomographic scans compatible with embolism), intimal tear in 2, and intimal irregularity in 3 patients. Stroke occurred in a significantly smaller number of patients (2 of 178 [1.1%]; p < 0.001) without new lesions. CONCLUSIONS: Clamp- or cannula-induced new lesions, especially of mobile type, are often complicated by postoperative stroke. Aggressive surgical technique modifications may need to be considered to avoid creating new lesions, particularly of the mobile type.     

Long-term results of bilateral internal thoracic artery grafting

Background. Little is known about the long-term results of the uniform group of patients who had bilateral internal thoracic artery (ITA) grafting with the method of left ITA-to-left anterior descending coronary artery and right ITA-to-circumflex artery.

Methods. Late follow-up study was performed in the first consecutive 203 patients (mean age, 62.6 ± 9.1 years) who underwent isolated coronary artery bypass grafting with the left ITA anastomosed to the left anterior descending coronary artery and the right ITA to major branches of the circumflex artery. The patients were grouped according to the patency of ITA grafts demonstrated by early postoperative angiography (Both patent (BP) group, 168 patients: both ITAs showed complete patency; Not patent (NP) group, 23 patients: at least one ITA was dysfunctional).

Results. Actuarial 7-year survival in all patients was 89.3% ± 3.1%. The cumulative probability of event-free survival for cardiac death, myocardial infarction, intervention, and angina at 7 years was 96.6% ± 1.8%, 98.0% ± 1.5%, 86.7% ± 3.2%, and 90.7% ± 2.9%, respectively. NP group had more myocardial infarction and angina than the BP group, but was not statistically significant. Because of failed grafts at the early angiography, intervention was performed more frequently in NP group (p < 0.01).

Conclusions. Our results of actuarial 7-year survival and the cumulative probability of event-free survival were at least comparable to the results of other similar studies using bilateral ITA. The freedom from angina appeared to be better than in the previous study. Overall our study supports the continued use of this method of ITA grafting.     

Dietary Vitamin B1 Intake Influences Gut Microbial Community and the Consequent Production of Short-Chain Fatty Acids

The gut microbiota is closely related to good health; thus, there have been extensive efforts dedicated to improving health by controlling the gut microbial environment. Probiotics and prebiotics are being developed to support a healthier intestinal environment. However, much work remains to be performed to provide effective solutions to overcome individual differences in the gut microbial community. This study examined the importance of nutrients, other than dietary fiber, on the survival of gut bacteria in high-health-conscious populations. We found that vitamin B1, which is an essential nutrient for humans, had a significant effect on the survival and competition of bacteria in the symbiotic gut microbiota. In particular, sufficient dietary vitamin B1 intake affects the relative abundance of Ruminococcaceae, and these bacteria have proven to require dietary vitamin B1 because they lack the de novo vitamin B1 synthetic pathway. Moreover, we demonstrated that vitamin B1 is involved in the production of butyrate, along with the amount of acetate in the intestinal environment. We established the causality of possible associations and obtained mechanical insight, through in vivo murine experiments and in silico pathway analyses. These findings serve as a reference to support the development of methods to establish optimal intestinal environment conditions for healthy lifestyles.