Years Of Age In Japan Research Articles

Impact of Cardiovascular Risk Factors on Progression of Arteriosclerosis in Younger Patients: Evaluation by Carotid Duplex Ultrasonography and Cardio-Ankle Vascular Index(CAVI)

To evaluate progression of arteriosclerosis using cardio-ankle vascular index(CAVI) and carotid duplex ultrasonography(DUS) in young and adolescent patients considered to be at risk of cardiovascular disease. We evaluated the progression of arteriosclerosis using CAVI and carotid DUS in 240 young and adolescent patients. Dyslipidemia(DL), hypertension(HT), and diabetes mellitus(DM) were major cardiovascular risk factors. Patients were divided to 4 groups according to number of risk factors. In terms of risk factors, CAVI and CAVI difference(CAVI-D) were elevated only in the HT group(p=0.0290, p=0.0243 vs. no risk respectively). CAVI-D was positively associated with diastolic blood pressure(DBP). Mean IMT was positively associated with LDL-C or systolic blood pressure, and negatively with HDL-C. Plaque score was associated with LDL-C or DBP. In patients with the 3 risk factors, CAVI, CAVI-D and mean intima-media thickness(IMT) were significantly higher than in those without risk(p=0.0009, p=0.0042 and p=0.0151 respectively), and CAVI and CAVID were higher than in those with 1 risk(p=0.0204 and p=0.0231). Carotid plaque develops from around 30 years of age in Japan. Despite numbers of risk factors, there were no differences in CAVI, CAVI-D, mean IMT or plaque score between smoker and non-smoker groups. In conclusion, an increase in the number of risk factors also results in progression of arteriosclerosis in young and adolescent patients. HT was the most important risk factor for arteriosclerosis in these patients.

Recent pregnancy trends among early adolescent girls in Japan

The paper examines recent time trends, explores potentially influential background factors and discusses prevention strategies of pregnancy among girls under 15 years of age in Japan. Using Japanese government data, we first analyzed time trends of early adolescence (<15 years of age) abortion, live birth and child sexual abuse from 2003 to 2010. Second, we analyzed ecological correlations of early adolescent pregnancy (abortion, live birth and stillbirth) with pregnancy in other age groups, child sexual abuse, and indicators of juvenile victimization and juvenile delinquency, using prefectural data. We found that rates of both abortion and live birth in early adolescents have increased since 2005 (annual percent change 5.3% and 2.3%, respectively), despite declining rates in older age groups. The abortion ratio in early adolescence remained the highest among all age groups in Japan. The early adolescent pregnancy rate showed significant correlation with the rates of juvenile victimization of welfare crimes (obscenity, alcohol drinking, smoking and drug use) (Spearman's rank correlation coefficient [rs] = 0.42, P = 0.00) and juvenile delinquency among junior high school students (12-14 years of age) (rs = 0.69, P = 0.00). The observed rise in rates of abortion, live birth and child sexual abuse among early adolescents along with strong ecological correlations of their pregnancy rate with juvenile victimization and delinquency indicators suggests that epidemiological investigation and public health programs at the individual and community levels are needed to address the complex social roots of these trends and to produce effective improvements in early adolescent reproductive health.

One Year Since the First and Only Organ Procurement Case from a Brain-Dead Child Donor Under 6 Years of Age in Japan (Case Report)

The enforcement of the revised Act on Organ Transplant of Japan in July 2010 paved the way for organ procurement from a child donor. After the revision, a male child who was admitted to the Toyama University Hospital in June 2012 became the second brain death and organ procurement case in the under-15 age group in Japan, and the first case of a child donor aged less than 6 years. Since then, a year has passed without any new donors. This situation epitomizes the current challenges involved in organ donation from brain-dead donors in Japan. This case report describes the first and only organ procurement case from a brain-dead child donor under 6 years of age in Japan, and highlights the issues of the case, focusing on the problem of provisions for preventing an abused/neglected child patient from becoming an organ donor, which can have implications for the organ procurement practice overseas.

The post‐infection outcomes of influenza and acute respiratory infection in patients above 50 years of age in Japan: an observational study

Please cite this paper as: Ikematsu et al. (2011) The post‐infection outcomes of influenza and acute respiratory infection in patients above 50 years of age in Japan: an observational study. Influenza and Other Respiratory Viruses 6(3), 211–217. Objectives Influenza can be a serious illness, especially for older people, and reducing the impact of influenza in elderly is important. The objective of this study was to estimate the prevalence and postinfection outcomes of influenza among the over‐50 population in Japan. Design An observational study was designed to ascertain the proportion of influenza cases in a population aged ≥50 years with acute respiratory infection (ARI) and to determine the postinfection outcomes of their illness during the 2008–09 influenza season in Japan. Respiratory specimens obtained from a total of 401 patients were tested by PCR for influenza viruses, respiratory syncytial virus (RSV) and human metapneumovirus (hMPV). The effectiveness of the seasonal trivalent influenza vaccine was estimated by a test‐negative case control analysis. Setting Seventeen outpatient clinics located in four separate areas of Japan. Sample Respiratory swab specimens from the ARI patients aged ≥50 years. Main outcome measures Laboratory confirmed influenza in patients presenting with ARI. Results In all, 89 (22.2%) of the patients were positive for one of the tested viruses; 70 (78.7%) with influenza, 17 (19.1%) with RSV, and 2 (2.2%) with hMPV. Cough (95.7% vs 73.4%), loss of appetite (67.1% vs 35.5%), absence from work (50.0% vs 23.0%), impact on daily activity (90.0% vs 62.5%), and caregiver absence from work (5.7% vs 0.6%) were observed higher in influenza patients. The duration of feeling weakness (6.3 ± 5.4 vs 3.6 ± 1.9 days) and average days of reduced activity (5.2 vs 3.6 days) were longer for influenza patients. Vaccine effectiveness was estimated to be 32.1% (95% CI: −14.9, 59.9%). Conclusions Influenza was the dominant ARI‐causing virus and the clinical and socio‐economic outcomes imposed on patients over 50 years of age was high for influenza.

Height Growth of Triplets from Birth to 12 Years of Age in Japan

We analyzed the characteristics associated with the growth in height of Japanese triplets from birth to 12 years of age. The study included 376 mothers and their 1,128 triplet children, who were born between 1978 and 2006. Data were collected through a mailed questionnaire sent to the mothers asking for information recorded in medical records. For these births, data on triplets' length and height growth, gestational age, sex, parity, maternal age at delivery, and maternal height were obtained from records in the Maternal and Child Health Handbooks and records in the school which children receive health check-ups. The height deficit of the triplets compared to the general population of Japan remained between 2% and 5% until 12 years of age. Moreover, at 12 years of age, the differences of height between the general population and triplets were approximately -3.6 cm for male and -4.4 cm for female. Maternal height showed the strongest contribution to height of triplets from 6 to 12 years of age. In conclusion, triplets remain shorter than singletons until 12 years of age.

Diastolic dysfunction in patients with Kawasaki disease

Kawasaki disease (KD) is one of the common vasculitic disease of childhood. It is most prevalent in Asia with an annual incidence of nearly 140 cases per 100,000 children younger than 5years of age in Japan [1] compared with 3.6–3.7 per 100,000 people in Britain and Australia [2,3]. However, the real prevalence of KD is likely to be much higher since there are many cases that remain undiagnosed.

Comparison of prevalence rates of strabismus and amblyopia in Japanese elementary school children between the years 2003 and 2005.

We previously revealed the prevalence of strabismus and amblyopia in elementary school children between 6 and 12 years of age in Japan in the year 2003. Questionnaires asking the number of children with different types of strabismus and amblyopia were sent to all elementary schools in Okayama Prefecture in the year 2005, and the results in the year 2005 were compared with those obtained in the year 2003. The number of children covered by the return of questionnaires was 84,619 (74%) of 113,763 total pupils, including grades 1 to 6, in Okayama Prefecture in the year 2005. The total numbers of children with strabismus and amblyopia, including grades 1 to 6, were 844 (0.99%, 95% confidence interval: 0.94-1.06%) and 173 (0.20%, 95% confidence interval: 0.17-0.23%), respectively. The numbers of children with any type of exotropia and any type of esotropia were 524 (0.62%) and 187(0.22%), respectively. In the previous survey conducted in 2003, the number of children covered by the return of questionnaires was 86,531 (76%) of 113,254 total pupils. The total numbers of children with strabismus and amblyopia were 1,112 (1.28%, 95% confidence interval: 1.24-1.36%) and 125 (0.14%, 95% confidence interval: 0.12-0.17%), respectively. The numbers of children with any types of exotropia and esotropia were 602 (0.69) and 245 (0.28%), respectively. The prevalence of strabismus in this large population of Japanese elementary school children was significantly different between the years 2003 and 2005, while the prevalence of amblyopia was similar between the years.

Coronaviruses in Children, Greece

Coronaviruses in Children, Greece

Proportion of De Novo Cancers Among Colorectal Cancers in Japan

Adenomatous polyps are main precursors of colorectal cancers (CRCs). In Japan, de novo cancers, which do not arise from preexisting adenomas, are considered to account for a substantial number of CRCs, but the relative importance of de novo carcinogenesis remains controversial. This study estimated the proportion of de novo cancers among CRCs in Japan. The subjects were persons 40-79 years of age who were relatively similar to those in the general population. The subjects underwent colonoscopy between 1997 and 2001. Early cancers among CRCs detected in this study were classified as de novo cancers or polyp cancers derived from adenomas. The age-specific incidence of the early CRCs was calculated, and the proportion of de novo cancers was estimated. The lifetime risk of early CRCs was estimated. The study group comprised 14,817 persons. CRCs were diagnosed in 189 subjects, including 83 early cancers. There were no differences with regard to size and location between de novo cancers and polyp cancers, but morphology differed. Eighty-four percent (16/19) of de novo cancers were flat elevated or depressed. The expected lifetime risk of developing early CRCs was 5.27% for men and 3.21% for women. Among persons with early cancers, the expected probabilities of developing de novo cancer were 18.6% for men, 27.4% for women. De novo cancers account for a considerable proportion in Japan. This information suggests that the recommended interval for colonoscopic examination in Japan should be shorter than that in the United States.

Cost-effectiveness analysis of influenza and pneumococcal vaccinations among elderly people in Japan.

During the periods of seasonal flu in 2003 and 2004, it was found that about 45 percent of elderly people in Japan had been inoculated with influenza vaccines. Comparatively, however, the proportion of inoculation with pneumococcal vaccine was only 0.1 percent. Taking into account such incongruent proportions, this study assesses health and economic benefits of vaccination strategies for both influenza and pneumonia particularly for the elderly population in Japan. To accomplish this objective, a cost-effectiveness analysis was conducted with the use of the Monte Carlo simulation based on the data from medical literature as well as from the public organizations, wherein three strategic patterns were delineated and compared (i) no vaccination (ii) influenza vaccine only, and (iii) combined influenza with pneumococcal vaccines. The cost for one year of life saved by each strategy was compared with the scenario of no vaccinations. It was found that for 100,000 elderly people over 65 years of age in Japan, the cost-effectiveness ratio of influenza-only vaccination was 516,332 Japanese yen per one year of life saved, while the combined vaccinations of influenza with pneumococcal was 459,874 Japanese yen for the same benefit. The incremental cost-effectiveness ratio of the strategies (iii) versus (ii) was 426,698 Japanese yen per one year of life saved for 100,000 people. Consequently it was indicated that the combined vaccinations would be more cost-effective than the vaccination for influenza only.

Low incidence of febrile convulsion during the acute phase of Kawasaki disease in Japan

Central nervous system complications in Kawasaki disease (KD) have been rarely described [2,3]. However, since KD is a highly febrile, systemic vasculitis syndrome, is often accompanied with aseptic meningitis, and usually affects children under 5 years of age [1], we hypothesised that febrile convulsion (FC) may occur in a substantial proportion of KD patients. To determine the incidence of FC in KD patients, we reviewed 217 KD patients (M/F: 80/137) admitted to the Nishi-Kobe Medical Centre between July 1994 and December 2004. Patient ages ranged between 1 month and 10 years with 175 (80.6%) and 206 (94.9%) subjects being £ 3 and £ 5 years of age, respectively. There was only one patient, a 1-year-8-month-old girl, with FC. Thus, the incidence of FC in our series was estimated as 0.46% (1/217). We reviewed the English literature and found three reports on this issue [2, 3,5], all of which were conducted in Japan. Patient number in each study was 155 [2], 540 [3], and 177 [5], and there has been only one patient, a 5year-old boy [2], with FC among them. On meta-analysis of our series and these reports, the incidence was 2/ 1089 (0.18%, 95% CI: 0.02%–0.66%). When limited to patients £ 5 years of age, a predominant period for FC, this figure was somewhat higher; however, the lack of age distribution in previous studies [3,5] precluded precise determination. In any case, the incidence was unexpectedly low, compared to an epidemiological finding on the FC prevalence (8.3%) at 3 years of age in Japan [4]. We found an extremely low incidence of FC in KD in Japan. This estimate, however, may not be applicable to other regions because of wide geographic differences in the prevalence of KD and FC [1,4].

Prevention of elderly falls

Falling is a leading cause of morbidity and immobil‐ity in people over 65 years of age in Japan. Many researchers have studied the relationship of physical decline and falls in older adults. However, only a few studies have focused on describing the Japanese living environment and lifestyle as potential risk factors for falls. The purpose of this study is to describe situational factors contributing to falls among community dwelling elderly people in Japan. After analyzing traditional Japanese housing characteristics and daily living behaviors of older Japanese adults, possible interventions to reduce situational fall risk factors are discussed. The results from this study are important as they suggest strategies to prevent falls in community dwelling elderly in Japan as well as providing a foundation for future cross‐cultural research.

Impact of respiratory syncytial virus infection as a cause of lower respiratory tract infection in children younger than 3 years of age in Japan.

Respiratory syncytial virus (RSV) is the most important viral pathogen for lower respiratory tract infection (LRI) in infants and children. An RSV-specific monoclonal antibody has been developed to provide prophylaxis against RSV associated LRI (RSV-LRI). The objective of this study was to determine the impact of RSV as a cause of LRI in children younger than 3 years of age to provide data to aide in the implementation of forthcoming prophylaxis against RSV. We analyzed the viral etiology of LRI in hospitalized Japanese children younger than 3 years of age admitted to Shizuoka Red Cross Hospital from July, 1997 to June, 2000. A total of 535 patients younger than 3 years of age were hospitalized with LRI at Shizuoka Red Cross Hospital from July 1, 1997 to June 30, 2000. Of these, a positive diagnosis of RSV infection was made in 168 patients (31.4%). Most of the patients with RSV infection had been well and had had no underlying disease that was defined as risk factor of RSV infection (94.0%). The peak incidence of LRI was observed in the winter each year and the number of LRI was strongly associated with the epidemic of RSV (r=0.700, P<0.0001). The number of patients with LRI younger than 6 months of age was 116 (21.7%). Of these 116 patients younger than 6 months with LRI, 55 patients (47.4%) were confirmed to have RSV infection. The proportions of RSV infection to total LRI was greatest in early infants younger than 6 months (P<0.0001). The number of patients with which RSV infection was detected in LRI patients younger than 3 years was highest during the first five months of life and there was a dramatic decrease in incidence of RSV infection with increasing age thereafter. The incidence of LRI hospitalization is highly affected by RSV infection epidemic. The proportion of RSV infections among early infants younger than 6 months is greater than that of older patients. The prophylaxis against RSV will be needed to be toward early infants.

Seroepidemiology of human group C rotavirus in Japan based on a blocking enzyme-linked immunosorbent assay.

A novel blocking enzyme-linked immunosorbent assay (BL-ELISA) was developed for detection of antibodies to human group C rotavirus (CHRV). The specificity of the BL-ELISA was confirmed by using animal sera hyperimmunized to group A and group C rotaviruses and paired sera from five patients with acute CHRV gastroenteritis. Furthermore, there was concordance between the BL-ELISA and a neutralization assay for CHRV in 226 (95%) of 238 samples. By using the BL-ELISA, we determined the seroprevalence of CHRV in 704 serum samples obtained from nine different age groups of inhabitants of Okayama Prefecture, Japan, in 1992, 1994, and 1996. As a result, 211 sera (30%) were found to be positive for CHRV antibodies. The seroprevalence gradually increased with age and reached 52.7% in the oldest individuals. A further analysis of the youngest age group suggested that CHRVs predominantly prevail in persons older than 3 years of age in Japan. When comparing the three sampling years, a larger percentage of antibody-positive sera was detected in 1994 than in either 1992 or 1996 in individuals between 6 and 15 years of age, reflecting the occurrence of a CHRV outbreak among children during the winter of 1992 to 1993 that was previously documented. These results indicate that CHRV infections may occur more frequently in spite of the relatively low detection rate of the virus.

Immunohistochemical analysis of p53 and p21WAF1/Cip1 expression in primary intracranial germ cell tumors

Primary intracranial germ cell tumors (GCTs) comprise 3.1% of all brain tumors and 13.6% of those in patients younger than 15 years of age in Japan. They are classified into five basic histological types: germinoma, teratoma, choriocarcinoma, yolk sac tumor, and embryonal carcinoma; or into mixed tumor types when they consist of two or more components. Radiation therapy with or without chemotherapy has proven effective in the treatment of germinoma, whereas there is a poor prognosis for choriocarcinoma, yolk sac tumor, embryonal carcinoma, and mixed tumors having components of the group of malignant intracranial GCTs. The underlying mechanisms for such different responses to radio- and chemotherapies of intracranial GCTs remain unknown. In this study, the authors analyzed the expression of p53 and p21(WAF1/Cip1) proteins by immunohistochemical analysis in 35 intracranial GCTs. Expression of p53 protein was observed in 33 (94%) of 35 intracranial GCTs. Expression of p21(WAF1/Cip1) was detected in seven (20%) of 35 intracranial GCTs. None of the 15 germinomas was immunoreactive for p21(WAF1/Cip1) protein, whereas in a group of malignant intracranial GCTs, four (80%) of five cases showed immunoreactivity for p21(WAF1/Cip1) protein. Analysis of the data suggests that overexpression of p21(WAF1/Cip1) in intracranial GCTs may correlate with decreased sensitivity to radio- and chemotherapy and suggest a poor prognosis.

Kawasaki Disease in Families

The rate of second-case Kawasaki disease occurring among 1788 siblings of children with the disease was derived from data obtained from questionnaires mailed to the members of the Japanese Association of Parents of Children With Kawasaki Disease. Within 1 year after the onset of the first case in a family, the overall second-case rate was 2.1% for siblings, as compared to an overall incidence of approximately 0.19% in the general population of children 0 to 4 years of age in Japan in the epidemic year 1982. For siblings younger than 1 year of age, it was 8.4%, and for those between 1 and 2 years of age, it was 9.3%. More than half (54.1%) of the second cases developed 10 days or less after the first cases occurred.

Classification of patients diagnosed with diabetes before 30 years of age in Japan

Classification of patients diagnosed with diabetes before 30 years of age in Japan

P-1-4 Classification of patients diagnosed with diabetes before 30 years of age in Japan

P-1-4 Classification of patients diagnosed with diabetes before 30 years of age in Japan

III. A Comparative Study of Colonic Polyps Found in Autopsy in Japan and Germany

Hara has examined 500 consequtive autopsy specimens of the colon in over 50 years of age in Japan and Matsumura has examined 121 consequtive autopsy colon specimens in Germany. The findings of the histological examinations were compared and following conclusions were obtained:1. The frequency of colonic polyps was high with increasing age.2. There was no definite difference about the frequency of colonic polyps in Japan and Germany over 50 years of age. Namely one in three to four examples over 50 years had approximately one to three tiny polyps in their colon.3. It seems that in Japan one finds polyps in the right half colon then in the left. Cancer incidence is also higher in the right half colon. The findings suggest that there could be some relationship between these two kinds of tumors of the colon.4. Diverticulosis was also examined. The frequency in Germany was four times higher than that in Japan.

Childhood cancer mortality in U.S.A. and Japan.

Study was made of mortality rates for 5 leading childhood cancers over 2 time intervals in the U.S. nd 3 in Japan. The U.S. rates changed very little over time, and, though the Japanese rates increased progressively, they still were well below those for the U.S. for each site considered. A peak in leukemia mortality appears to be emerging at 3 years of age in Japan as it did 25 years ago among U.S. white children. Kidney neoplasia (principally Wilms' tumor) appears from mortality data to be much less frequent and to have an earlier peak in Japan than in the U. S. The explanation of this difference awaits the accumulation of additional information through Japanese childhood cancer registries. Preliminary results from these registries suggest that the large differences between the U.S.A.nd Japan in mortality from neuroblastoma may be a consequence of dissimilar diagnostic or classification practice.