Objective: To explore the association between multi-dimensional aspects of hostility and coronary heart disease among middle-aged urban Japanese. Subjects and Methods: We conducted a case-control study. Cases were consecutive patients with acute coronary syndrome admitted to a hospital in Japan. Fifty-three patients (45 men and 8 women) aged 35 to 65 were enrolled. For each case, two sex and age (±2 years) matched controls were recruited from among participants in a health check-up program at a health promotion center located in the same area as the hospital. Two questionnaires, both with four components, were used to measure hostility and coping with anger: the one was for anger, hostility, physical aggression and verbal aggression, and the other for aggression, social inhibition, guilt, and controlled affect. Results: The scores of all components from two questionnaires were higher for cases than controls, but the differences were not significant. Multivariate analysis showed that anger, fat intake, alcohol consumption and house size were significantly associated with the etiology of acute coronary syndrome. Conclusion: Anger, lifestyle, and socioeconomic status play important roles for the etiology of coronary heart disease in middle-aged urban Japanese. J Epidemiol, 2001 ; 11 : 243-248
Epidemiologic studies have suggested that benzene exposure may be a risk factor of multiple myeloma (MM). We performed meta-analyses of case-control studies to assess the association between occupational exposure to benzene and the risk of MM. We divided the occupational sources of benzene exposure into 4 categories, benzene and/or organic solvents, petroleum, petroleum products, and engine exhaust, for conducting the meta-analysis. As a result, a significant positive association was indicated between exposure to engine exhaust and MM (summary odds ratio or summary OR=1.34, 95% confidence interval or 95%C1=1.14-1.57). However, no significant associations were obtained for benzene and/or organic solvents (summary OR=0.74, 95%C1=0.60-0.90), petroleum (summary OR=1.11, 95%CI=0.96-1.28) and petroleum products (summary OR=1.08, 95%CI=0.89-1.33) with risk of MM. These results suggested that benzene exposure itself was not likely to be a risk factor of MM. It is thought that several harmful chemical agents in engine exhaust, other than benzene, could be etiologically related to the risk of MM. Further case-control studies on MM are needed to obtain more information about detailed occupational exposure to toxic substances. J Epidemiol, 2001 ; 11 : 249-254
Following the Pan American Health Organization (PAHO) recommendation on measles elimination, the Western Pacific Region of WHO (WPR) is emphasizing accelerated measles control programme especially since the achievement of polio eradication in WPR in 2000. This includes upgraded surveillance and mass measles vaccination campaign for children aged 9 months to 4 years. However, there are limited scientific evidences supporting the feasibility of this programme in Laos. To examine measles elimination feasibility in the country, we conducted measles outbreak investigation using immunoglobulin M (IgM). From March 1999 to March 2000, we conducted 7 outbreak investigations. At the outbreak sites, we examined clinical manifestations of cases and collected individual data. About five blood samples were drawn from each outbreak, and lgM antibodies to measles were tested. Of 7 investigated outbreaks, 5 were confirmed as measles, one was chickenpox, and one occurred in the inaccessible area due to flooding. In a village of high land Lao, blood drawn was refused. Of 185 cases, 64 (34.6%) cases were immunized, and 110 (59.5%) were unimunized. The estimated vaccine efficacy is 67.9%. The number of measles cases among school-aged children was 74 (40.0%), which represented 2.5% of the total population in investigated villages. Our findings showed various difficulties of the surveillance and the limited outcomes of mass measles vaccination campaign under the accelerated measles control programme by WPR. Efforts to improve cold chain as well as increasing routine immunization coverage must be the priority of measles control. J Epidemiol, 2001 ; 11 : 255-262
The reference value of immunoglobulins (Igs) should be known for a population concerned because it is influenced by many clinical and local conditions. As yet the reference value of the Igs have not been determined in Bangladeshi children. This study determined the reference value of Igs in apparently healthy 261 rural Bangladeshi primary school children (aged 5 to14 years, mean 9.3 years). IgG, IgM and IgA were determined by an auto-analyzer. The mean (standard deviation) value of IgG was 1728 (344) mg/dl. The corresponding values for IgM and IgA were 200 (88) and 163 (63) mg/dl, respectively. The 95% reference value calculation in all subjects showed that the range for IgG was 1103 to 2524, IgM was 92 to 390, and IgA was 72 to 325 mg/dl. These values could be used to evaluate Ig status in children with a variety of clinical conditions. J Epidemiol, 2001 ; 11 : 263-265
Assessment of dietary intake is important to understand the relationship between nutrition and health. Although the role of specific carotenoids has recently been of great interest, there are no comprehensive food composition tables for intake of specific carotenoids in Japan. We have therefore developed a new carotene food composition table that shows the alpha- and betacarotene values based on an extensive review of the literature (FCT1). Using a 14- or 28-day diet record data of sample population (n=1 88), we selected 12 important foods to two carotene intakes. We analyzed the carotene contents of the foods, and developed the another composition table in which the food contents were replaced by the analytical values (FCT2). Carotene intakes of the population were significantly different between these two composition tables. However, the correlations between the dietary intake and the serum concentrations were almost identical, i.e., partial correlations using FCT1/FCT2 were 0.32/0.30 and 0.33/0.36 for alpha-carotene and 0.28/0.28 and 0.30/0.29 for beta-carotene in men and women. The similar correlations with the serum concentrations may indicate an comparable value for ranking individuals between the two tables. However, the results were inconclusive for the estimation of absolute intakes. J Epidemiol, 2001 ; 11 : 266-275
Civil lawsuits relating air pollution health effects presented often times in Japan. As a evidence of causal relation between air pollution exposure and respiratory diseases, epidemiological studies were submitted to the courts. An interpretation of these studies by judges were markedly different and unique from ordinal epidemiological understanding; scientific understanding of the studies. Based on these unique implication of the evidence, the judgment announced forcefully recognizing a existence of causal relationship between exposure to pollution and disease outcome. The author wishes to let epidemiologists know the details of this phenomena, hoping a correct usage of epidemiology in the course of deciding judgment at civil lawsuit. J Epidemiol, 2001 ; 11 : 276-280
Grossarth-Maticek and colleagues have shown, in their prospective studies, a strong relationship of their personality types, Types 1 and 2, to cancer and coronary heart disease (CHD), respectively. Relevant information is limited from replication studies, and little is known about psychosocial factors in relation to cancer or CHD in Japan. Subjects included 95 cases of lung cancer (LC), 94 cases of myocardial infarction (MI) and 596 controls. The controls were men and women who visited a clinic for a health checkup. The Grossarth-Maticek personality types, Types 1 to 6, were assessed using the Short Interpersonal Reactions Inventory. The distributions of the 6 personality types were compared between the case and control groups, adjusting for sex and age class. The relation of each of the 6 types to LC and MI were examined in terms of odds ratio, using a logistic regression model controlling for age, sex, job status, education level, and smoking status. As regards the distribution analysis, Types 1 and 2 in the LC and MI groups each were not more prevalent than the controls, respectively. High score of the Type 1 scale was associated with a statistically nonsignificant decrease in LC risk. MI risk was significantly, positively associated with the Type 2 and 5 scales, and unexpectedly, positively related to the Type 3 scale. The present findings partly supported the Grossarth-Maticek theory, but there remain some conflicting issues to be confirmed in future studies. J Epidemiol, 2001 ; 11 : 281-287
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