Evaluating measles surveillance: comparison of sentinel surveillance, mandatory notification, and data from health insurance claims.

Inadequate notification is a recognized problem of measles surveillance systems in many countries, and it should be monitored using multiple data sources. We compared data from three different surveillance sources in 2007: (1) the sentinel surveillance system mandated by the Act on Prevention of Infectious Diseases and Medical Care for Patients Suffering Infectious Diseases, (2) the mandatory notification system run by the Aichi prefectural government, and (3) health insurance claims (HICs) submitted to corporate health insurance societies. For each dataset, we examined the number of measles cases by month, within multiple age groups, and in two categories of diagnostic test groups. We found that the sentinel surveillance system underestimated the number of adult measles cases. We also found that HIC data, rather than mandatory notification data, were more likely to come from individuals who had undergone laboratory tests to confirm their measles diagnosis. Thus, HIC data may provide a supplementary and readily available measles surveillance data source.

Massive immature teratoma in a neonate.

Teratomas are embryonal tumours composed of diverse tissues from three germinal layers with variable levels of maturity. The authors report a female patient with a large immature epignathus. Prenatal diagnosis permitted a caesarean section and tracheotomy to be planned under ex utero intrapartum treatment for airway obstruction. The tumour was successfully controlled, even though it was impossible to distinguish from normal tissue because it lacked a pedicle and capsule, using multidisciplinary therapy, including a series of surgical treatments and adjuvant chemotherapy. This case suggested that the level of serum alpha fetoprotein might be a useful indicator after surgery. At present, after 4 years, no regrowth has been observed and the patient has no problems with respiration or swallowing.

Adolescent smoking behaviour and cigarette brand preference in Japan.

OBJECTIVES: As part of efforts to develop a smoking control strategy for Japanese adolescents, the results of two nationwide surveys on adolescent smoking behaviour were compared. DESIGN: Descriptive study on smoking behaviour among high school students was conducted. Self-reporting anonymous questionnaires were administered to 115,814 students in 1996 and 106,297 in 2000 through randomly sampled junior and senior high schools throughout Japan. MAIN OUTCOME MEASURES: Smoking prevalence, proportion of smokers by usual sources of cigarettes, national estimated cigarettes consumed by minors, share of cigarette brands smoked by high school students. RESULTS: The experiment rate among junior high school boys decreased in 2000 compared with that in 1996, whereas current and daily smoking rates did not. Although prevalence among Japanese girls was much lower than that among boys, prevalence among girls increased in 2000. The main source of cigarettes among high school smokers was vending machines. The proportion of smokers who usually purchased cigarettes from vending machines increased in 2000, in spite of the 1998 introduction of restrictions on night-time operations. Japanese adolescents were more likely than adults to smoke American cigarette brands, and the adolescent market share of American brands has increased rapidly, especially for menthol brands. CONCLUSIONS: This survey revealed the seriousness of the problem of smoking behaviour among Japanese high school students, and suggested that this behaviour may be influenced by social environmental factors, including the marketing strategies of the tobacco industry. Action should be taken to reduce the prevalence and impact of pro-tobacco marketing messages and to abolish cigarette vending machines.

Role of heat shock protein 60 (HSP60) on paraquat intoxication.

The possibility of establishing a new method of treatment against pulmonary fibrosis caused by acute paraquat intoxication, which takes into consideration the role of heat shock protein 60 (HSP60), was investigated in paraquat-exposed rat lung mitochondria. In polyacrylamide electrophoresis, mitochondrial protein bands appeared, especially in the range of molecular weight 60 kDa and higher, whereas protein bands disappeared in the 20-40 kDa range on the 4th day after paraquat exposure. The protein profile was normalized on the 7th day and no remarkable changes were seen thereafter up to the 56th day. The changes seen during the observation period were thought to reflect the course of paraquat-induced dysfunction and subsequent repair. The malondialdehyde concentration in mitochondria decreased until the 7th day but subsequently increased and recovered to normal levels by the 56th day. The relative density of HSP60 increased until the 7th day but subsequently decreased and recovered to normal levels by the 56th day. These two parameters therefore showed symmetrical changes. The change in the malondialdehyde concentration was thought to reflect the course of activation of the antioxidation function in mitochondria and the progression of repair. The change in the relative density of HSP60 was thought to have increased to repair the proteins affected by the paraquat radical and to have normalized with the progression of healing. These results suggest that HSP60 may play an important role in preventing the progression of pulmonary fibrosis induced by paraquat.

Green tea consumption and chronic atrophic gastritis: a cross-sectional study in a green tea production village.

Chronic atrophic gastritis (CAG) is well known as a precancerous lesion of the stomach, and Helicobacter pylori (H. pylori) infection increases the risk of CAG. While recent studies have reported that green tea consumption decreases the risk of gastric cancer, there has been no study analyzing the relationship between green tea consumption and the both risks H. pylori infection and CAG. We conducted a cross-sectional study on 636 subjects living in a farming village in Japan to examine the relationship among green tea consumption, H. pylori infection, and CAG. Smoking, alcohol drinking, consumption of four beverages, including green tea, and of five foods were investigated as lifestyle factors that may affect H. pylori infection and CAG. The measurement of H. pylori-IgG antibodies was used to define H. pylori infection, and serum pepsinogens were used to define of CAG. The unconditional logistic regression model was used for analyzing each odds ratio (OR). H. pylori infection was positively associated with the risk of CAG (OR = 3.73; 95% confidence interval [CI], 2.59-5.36). High green tea consumption (more than 10 cups per day) was negatively associated with the risk of CAG, even after adjustment for H. pylori infection and lifestyle factors associated with green tea consumption (OR = 0.63; 95% CI, 0.43-0.93). These results support the hypothesis that high green tea consumption prevents CAG.

[Serum leptin level among non-obese students: relationship to body fat, blood pressure, serum lipids, physical activity, and eating habits].

Leptin, a product of the ob gene, is thought to play a key role in the regulation of adiposity. However, it is unclear in humans as to whether or not leptin influences the blood pressure, serum lipids, physical activity level, or eating behavior in relation to obesity. Recent reports have indicated both gender-based differences in the leptin levels and a correlation of the percentage of body fat with leptin levels has been observed among obese subjects. As far as we know, these relationships among non-obese young adults have yet to be studied. Therefore, the serum leptin concentrations among 107 non-obese students (72 males and 35 females) were measured by a radioimmunoassay(RIA). Fasting leptin levels ranging between 1.2 and 23.4 ng/mL were observed in all subjects, and the levels among females were 2.6 times higher than in males (7.64 vs 2.95 ng/mL; p < 0.001). A close correlation was observed regarding the log-transformed leptin levels with the percentage of body fat as determined by the bioelectrical impedance analysis method(r = 0.734, p < 0.001 in males and r = 0.579, p < 0.001 in females). In conclusion, these data thus suggest the serum leptin levels among non-obese students show significant gender-based differences while, in addition, the leptin levels also correlate positively with the percentage of body fat. However, it remains unclear as to whether or not the leptin levels are independently related to the blood pressure, serum lipids, physical activity level (sports activity and leisure-time activity), and eating behavior (eating breakfast, mid-day snacking and nighttime snacking).

Serum leptin levels and their association with several factors related to arteriosclerosis among medical students in Japan.

The association between serum leptin levels and several factors related to arteriosclerosis were studied in subjects who were Japanese medical students taking no medications. The group was comprised of 75 males and 35 females. The age distribution in males was 21.4 to 29.8 years (median age, 24.0 years) and in females was 21.3 to 29.9 years (median age, 22.9 years). Statistical analyses were performed using the Wilcoxon rank sum test and Spearman correlation. Median levels of serum leptin were 3.3 ng/ml in males and 7.6 ng/ml in females. The largest correlation observed was widi percent body fat irrespective of sex [males; r=0.775, p<0.001, females; r=0.553, p<0.001]. However, body mass index (BMI) was similarly well correlated with serum leptin [r=0.631, p<0.001] in males but not in females [r=0.305, p=0.075]. A negative correlation was observed between high density lipoprotein cholesterol (HDL-C) and leptin in both sexes [males; r=-0.298, p<0.01, females; r=-0.363, p<0.05] .respectively. Percent body fat, BMI, diastolic blood pressure, apolipoprotein B, and HDL-C were the most significant factors in males. Percentage of body fat and HDL-C were the most important factors in females.