The purpose of the experimental study is to observe the effect of the immune recall responses induced by intramuscular (IM) injection with concentrated Primary Hamster Kidney Cell Vaccine(PHKCV) on days 180, 365, 545 and 730 after 0.1 mL nonconcentrated PHKCV was inoculated intradermally (ID), so as to determine the duration of the immunologic memory induced by ID 0.1 mL nonconcentrated PHKCV and chieve the goal of protecting the rabies patients with a short incubation . The results indicated that there were four intervals of 180, 365, 545 and 730 days between ID and IM PHKCV, the seroconversion rates being respectively 96.55%, 100%, 100%(180 day); 76.67%, 100%, 100%(365 day); 75.86%, 100%, 100%(545 day) and 75.00%, 100%, 100%(730 day) on days 7, 14 and 30 after the first dose IM, the seroconversion rates of four experimental groups were all markedly higher than that of five routine doses (40.74%) (P<0.01) on days 7 after the first dose IM. The immune endurance of concentrated PHKCV and the enhancing immune effect of the vaccine following booster injection 365 days later were also observed . The results indicated that the seroconversion rates on days 180, 365 and 380 (on day 15 after boosting injection) were 96%, 83.33% and 100% respectively. The stated results prove that the concentrated PHKCV has better immune endurance and the immunologic memory induced by ID 0.1mL nonconcentrated PHKCV can maintain two years. The immune effect inoculated by IM two or three doses on day 730 after ID 0.1 mL nonconcentrated PHKCV was better than that of five routine doses as the first time vaccination. If intradermal micro-injection were performed with higher titre of rabies vaccines, the longer time of immunologic memory would be maintained. J Epidemiol, 1999 ; 9 : 209-215.
We developed a simple food frequency questionnaire (FFQ) based on one-day dietary records (DRs) among 1001 subjects in Nagoya, Japan. A total of 97 foods and dishes were selected through a two-step procedure; first by ranking food items according to the contribution to the population intake of nutrient variables, and second by stepwise multiple regression analyses of individual food items as the independent variables and of total nutrient intake as the dependent variables. For simplicity, questions on portion sizes were not included except for a few selected food items, which resulted in short time (about 20 minutes) to complete the questionnaire. This FFQ was validated for food groups by referring to four 4-day DRs among 88 men and women in central Japan, from 1996 to 1997. The energy-, sex- and age-adjusted test-retest correlation coefficients between the two FFQs administered at an one year interval ranged from 0.34 to 0.78. The de-attenuated, energy-, sex- and age-adjusted correlation coefficients between the second FFQ and the DRs were larger than 0.40 for most food groups, indicating the usefulness of this simple FFQ with its sufficient validity in epidemiological surveys. J Epidemiol, 1999; 9 : 216-226.
A self-administered 97-item simple food frequency questionnaire (FFQ), without portion size questions for most items, was completed twice at an one-year interval by 88 men and women in central Japan to evaluate its reproducibility. This FFQ was further validated by referring to four 4-day weighed dietary records (DRs) which were performed at 3-month intervals. Mean energy and 18 nutrient intakes measured by the first and the second FFQs were quite similar to those measured by the DRs. In our reproducibility study, Pearson and intraclass correlation coefficients, adjusted for energy intake, sex and age, ranged from 0.48 to 0.82 (median =0.67). In the validation study, adjusted and de-attenuated correlation coefficients between the second FFQ and the DRs ranged from 0.42 for iron to 0.83 for calcium (median=0.61). The proportion of subjects classified by the FFQ into the same or adjacent quintiles defined by the DRs was between 65.9% and 83.0% (median=69.9%). These findings essentially suggested that our FFQ is well reproducible and sufficiently valid, and therefore, reasonably useful for nutritional epidemiological studies for Japanese diets, particularly for those of Tokai Area. J Epidemiol, 1999; 9 : 227-234.
Background: Health research is not a priority sector in Bangladesh. By and large, physicians and academicians are neither interested nor are they properly trained to conduct quality research. The objective of this study is to quantify the volume of researches related to health in Bangladesh with a view to propose remedial measures. Methods: Data regarding health research, originating from Bangladesh during the period of 1990-1996, were extracted from MEDLINE database using certain inclusion criteria. Data on name of the institution, main author (Bangladeshi or foreigner), country of publication, and research topics were abstracted and analyzed using descriptive statistics. Results: A total of 580 (on average 83 per year) articles met the inclusion criteria. About two- third (64.0%) of the researches were from International Center for Diarrheal Disease Research, Bangladesh, followed by Institute of Post Graduate Medicine & Research with 5.7%. Seven medical colleges and one dental college collectively contributed 5.8%. Infectious diseases was the single largest (54.8%) topic dealt with, followed by non-infectious diseases (7.7%), and nutrition and nutrition-related diseases (6.9%). Conclusion: The number of research articles from Bangladesh is very small possibly owing to the lack of proper training and funding shortage. Incorporating research methodology in both graduate and postgraduate medical education, appointing researchers in clinical and academic departments and allocating more funding towards research activities are necessary to boost health related research activities in Bangladesh. J Epidemiol, 1999; 9 : 235-239.
The relation between each question in the Self-rating Depression Scale (SDS) of Zung and mortality in elderly people was investigated. Subjects were 2, 166 inhabitants aged from 60 to 74 years in the Hidaka district of Hokkaido Prefecture, Japan, who were the same as in our previous prospective study concerning mental depression and mortality (J. Epidemiol. 1997). They were followed until February 1996. Among the original 20 questions of the SDS, 12 ones showed significant risk ratio for mortality (those whose score was 3 or 4 vs 1 or 2; P<0.01). The mortality of those whose average score of the 12 questions was more than 2.4 (severe depression) was 157.2 per 1, 000, which was about 5.8 time as high as that of those who were not depressive (average score < 2.0). The 12 questions showed different risk ratios concerning the mortality of cancer, heart disease and cerebrovascular disease. The questions "Morning is when I feel the best" and " My heart beats faster than usual, " e.g., showed a significant risk ratio only for the mortality of heart disease (3.96) and for that of cerebrovascular disease (16.49), respectively (P<0.01). Similar results were obtained from the subjects without respective diseases at the time of survey. Using these 12 questions, the risk for death and its cause can be estimated to a certain extent, and consequently, social supports can be given more effectively and more carefully. J Epidemiol, 1999 ; 9 : 240-244.
This study aims to evaluate the relationships between awareness of blood pressure testing and health-related knowledge. Among 9 blocks in Japan, one or two areas were selected and a questionnaire survey including physical activity, nutrient intake, drinking habits, smoking habits, medical history, annual frequency of blood pressure testing, subjective sense of wellness, and health related knowledge was conducted. Respondents' sex and age were adjusted as potential confounding factors and the association between possession of health-related knowledge and awareness of blood pressure testing were examined by using a multiple logistic regression model. Among the 1, 834 effective responses, 263 (14.3%) answered that they could state their blood pressure levels. These individuals tended to have a greater health-related knowledge. Even after adjusting for other potential confounders (smoking habits, medical history, annual frequency of blood pressure testing, and subjective sense of wellness) health-related knowledge were significantly related to blood pressure awareness. J Epidemiol, 1999; 9 : 245-253.
We conducted surveys on cigarette smoking among junior and senior high school students in Jiangxi province, China and throughout Japan using the same anonymous, self-administered questionnaire in order to compare correlates of adolescent smoking between the two areas. Cross-sectional surveys were used to measure smoking behavior and correlates in two samples of 57, 566 Japanese students and 11, 836 Jiangxi students. The correlate on smoking with the highest relative risk was friend's smoking in both sexes in each area. The magnitude of the relative risk was bigger for Japanese students. The relative risk of the variable that a student doesn't think cigarette smoking harms his/her health was higher among Jiangxi students than among Japanese students. Mother's smoking and sister's smoking were significantly related to smoking experiment of Japanese students. In Japan, important measures are to support students getting coping techniques against peer pressure and to elevate concern toward adolescent smoking among family members and society. In Jiangxi, the anti-smoking education to teach students to correctly recognize the harm of smoking to their health is more important. J Epidemiol, 1999 ; 9 : 254-260.
Various relationships of serum cholesterols and a-tocopherol in the blood to depressive status as assessed by a short version of the Geriatric Depression Score (GDS) were cross-sectionally and longitudinally investigated in the elderly using multivariate analysis. Subjects comprised 504 residents (195 men and 309 women) aged 65 years and over in a rural community. Neither cholesterols nor a-tocopherol significantly related to depressive status in either sex, adjusted for age and educational attainment in cross-sectional analysis. However, both total cholesterol and a -tocopherol at baseline significantly prevented a 4-year longitudinal progression of depressive status in men alone, adjusted for age, education, and the GDS score at baseline. LDL+VLDL cholesterol related in the same fashion as total cholesterol, whereas HDL cholesterol did not significantly relate to the progression of depressive status. J Epidemiol, 1999 ; 9 : 261-267.
Cerebrovascular disease was a leading cause of death from 1955 to 1980 in Japan. The mortality rate from this disease has decreased sharply in recent decades. This downward trend seems to correspond to the dietary habits of Japanese. Data from a large prospective cohort study were analyzed to examine the association between dietary habits and cerebrovascular disease mortality in Japan. The subjects for this analysis were 223, 170 men and women aged 40 to 69 at baseline in December 1965. There were 6, 168 deaths in men and 4, 862 deaths in women due to cerebrovascular disease (ICD7: 330-334) during the follow-up period from January 1966 to December 1981. Rate ratio (RR) and 95% confidence interval (95%Cl) adjusted for sex, attained age, follow-up period, prefecture, cigarette smoking, alcohol drinking and occupation was used for comparison. In this study, the risk of mortality from cerebrovascular disease was inversely associated with dairy milk, meat and fish consumption. Therefore the joint effect of dairy milk, meat and fish (DMF) as animal fat and protein was of interest. In the binary analysis, DMF (D, M, F) means the combination of dairy milk (1-3 times/week or more), meat (1-3 times/week or more) and fish (4 times/week or more). Thus DMF (d, m, f) was the reference group having dairy milk (less than 1 time/week), meat (less than 1 time/week) and fish (less than 4 times/week). For the disease, the RR of DMF (D, M, F) was 0.68 with 95%CI of 0.63 to 0.74, relative to the reference group. Furthermore the joint effect of DMF was more strongly associated with cerebral haemorrhage (ICD7: 331, DMF (D, M, F); RR: 0.63, 95%Cl: 0.55-0.70) than with cerebral embolism and thrombosis (ICD7: 332, DMF (D, M, F); RR: 0.79, 95%Cl: 0.70- 0.89). These findings suggest that the increasing intake of animal fat and/or protein may have played a key role in reducing cerebrovascular disease in Japan. J Epidemiol, 1999 ; 9 : 268-274.
Dietary factors were analyzed for the regional difference of GI tract cancer mortality rates in China. Sixty-five rural counties were selected among a total of 2, 392 counties to represent a range of rates for seven most prevalent cancers. The dietary data in the selected 65 counties were obtained by three-day dietary record of households in 1983. The four digestive cancer mortality rates (annual cases per 100, 000 standardized truncated rates for ages 35-64) and per capita food consumption were analyzed by the principal components factor analysis. Esophageal cancer associated with poor area, dietary pattern rich in starchy tubers, and salt, lack of consumption of meat, eggs, vegetables and rice. Stomach cancer seemed to be less associated with diet in this study because of its small model Kaiser-Meyer-Olkin (KMO) measure of sampling adequacy, suggesting some other carcinogenic factors would play more important role in the development of this cancer in China. The colon and rectal cancer showed close relation to diet; rich in sea vegetables, eggs, soy sauce, meat and fish, while lack in consumption of milk and dairy products. Rapeseed oil was more important risk factor for colon cancer than that of rectum. Rice, processed starch and sugar were closely associated with colon cancer, supporting the insulin/colon cancer hypothesis. J Epidemiol, 1999 ; 9 : 275-284.