Hiroshi Aono

Molecular epidemiology of dengue virus serotypes 2 and 3 in Paraguay during 2001-2006: the association of viral clade introductions with shifting serotype dominance.

To determine the genetic variability of dengue viruses (DENVs) in Paraguay, the complete envelope gene was sequenced for 4 DENV-2 and 22 DENV-3 strains isolated from 2001 to 2006. The sequence data were used in Bayesian phylogenetic analyses, which revealed that Paraguayan DENV-2 strains fell into two distinct clades within the American/Asian genotype, thus suggesting that the introduction of a new DENV-2 clade was likely associated with the shift of dominant serotype from DENV-3 to DENV-2 in 2005 and might have caused an outbreak of DENV-2. This study also indicated that DENV-3 strains fell into genotype III, of which, several 2006 isolates varied from the remaining isolates in their tree locations. The introduction of this new clade was likely associated with the shift of dominant serotype from DENV-2 to DENV-3 in 2006 and might have caused an epidemic of DENV-3. More data are needed to test this hypothesis.

Program of Exercise Training as Total Health Promotion Plan and its Evaluation.

Program of Exercise Training as Total Health Promotion Plan and its Evaluation: Masaru Fukahori, et al. Department of Public Health and Hygiene, Oita Medical University—As part of a Total Health Promotion Plan (THP) at the workplace, quantitative exercise on the basis of the maximum heart rate (HRmax) on a treadmill was continued for six months and the possible relationship with lipid metabolism was evaluated. Subjects were 108 male workers selected from among 1,300 employees of a petroleum complex, having two or more risk factors for circulatory disorders including hypertension, hyperlipidemia, obesity and hyperglycemia confirmed by annual health checkups at the workplace in 1996 and being able to take exercise. They were randomly assigned to one exercise group (54 men) and one control group (54 men). The exercise group was instructed to take 20 minutes walking exercise on a treadmill, three times a week for six months. The speed of the treadmill was set so that the heart rate while walking would be maintained within the range 70‐75% of the HRmax. After six months exercise, decreases in the waist‐hip ratio (WHR) and significant increases in HDL‐ and HDL2 cholesterol (HDL2C) were seen in the exercise group. The HDL2C/HDL3 cholesterol ratio increased in the exercise group, and decreased in the control group, but no effect in improving total cholesterol was observed, Furthermore, in the exercise group an increase was noted in the adaptive walking speed at which the walking in the 70‐75% HRmax range could be continued. In the present study a 6‐month exercise program with the heart rate as an index was proposed as a part of THP. As a result, the exercise group were found to have increases in HDLC and HDL2C, which are known to have an anti‐arteriosclerotic action. In addition to these effects on serum lipids, the exercise program proved to be effective in increasing adaptive walking speed and in lowering WHR.

Molecular evolution of Japanese encephalitis virus isolates from swine in Oita, Japan during 1980-2009.

In order to identify the patterns of genetic change of Japanese encephalitis virus (JEV) strains circulating in Oita, the complete envelope (E) gene has been sequenced for 35 isolates from swine in a 30-year span. Based on nucleotide and deduced amino acid sequences, the genetic variation was examined, phylogeny was estimated and selection pressures were also analyzed. This study demonstrated that the major genotype (G) of JEV isolates had shifted from GIII to GI in the mid-1990s in Oita. The intensities of selection acting on the Oita GIII and GI strains were found to be almost same. It suggests that the intensity of selection might not be the reason for such a genotype shift observed in Oita. Pairwise comparisons revealed the high conservation of the E gene at the protein level. Compared with the Oita GIII strains, all the Oita GI strains shared four amino acid changes at E129 (T-M), E222 (A-S), E327 (S-T) and E366 (A-S). Among all 70 JEV isolates involved in this paper, the GI strains shared only one amino acid change at E222 (A-S) in comparison with the GIII strains. No strong evidence for positive selection was found, the JEV evolution has generally been subject to strong purifying selection, but one ongoing evolutionary pathway was found to be under relaxed purifying selection in Oita. This study is a localized example of JEV molecular evolution in nature.

Trends in fatal coronary heart disease among people aged 25-74 years in Oita City, Japan, from 1987-1998

Serum cholesterol has been increasing in recent years in Japan. There is concern that risk of coronary heart disease (CHD) may be increasing too, but there is little information on validated fatal CHD trends in the Japanese population. We identified 1,056 deaths from heart disease and other deaths possibly hiding CHD from death certificates of residents aged 25-74 years in Oita City, Japan in 1987-1988, 1992-1993, and 1997-1998 (mean population, 273,000 in 1997-1998). We validated 994 of them by medical record review and physician interviews, classifying them into definite fatal acute myocardial infarction (AMI) and possible fatal AMI or CHD death based on Monitoring Trends and Determinants in Cardiovascular Disease projects criteria. Sudden death was defined to estimate the number of CHD sudden deaths. In men, age-adjusted mortality rates due to validated fatal CHD remained quite stable over 10 years (25.3 per 100,000 [95% CI, 15.0-35.5] in 1987-1988 to 24.2 per 100,000 [95% CI, 16.1-32.3] in 1997-1998). When 50% or all sudden deaths were included as fatal CHD, the rates for men tended to decline. This was due to decreasing out-of-hospital deaths in connection with a declining CHD death rate among men aged 65-74 years, whereas in-hospital CHD deaths were level. In women, the rate of validated fatal CHD was highest in 1992-1993, but the 1997-1998 rate was similar to the 1987-1988 rate. We did not find that fatal CHD rates increased in Oita men and women from 1987-1998. Rather, out-of-hospital fatal CHD tended to decline in Oita men.

Food Intake and Food Consumption Patterns of Hospital Workers in the Dominican Republic

Coronary heart disease (CHD) is the leading cause of death according to official mortality statistics in the Dominican Republic. The purpose of this study was to assess food intake and food consumption patterns of Dominicans and to discuss CHD risks related to nutrient intake. The subjects were 22 men and 81 women voluntarily recruited among 230 hospital workers in Santo Domingo. The mean nutrient intake and food consumption were estimated from a single 24-hour recall method administered by trained persons who elicited each subject’s previous day’s intake from midnight to midnight. The mean energy intake was 2030 kcal. The mean intake of total protein, total fat and carbohydrates were 66.3g, 89.1 g and 248g, respectively. Percentage of energy from total fat was 39.5%, which was higher than WHO recommendations. But, the percentage of animal fat per total fat was 46.8%. Especially, the value in the low income group was 31.7%. Moreover, we analyzed the food consumption structure in order to understand the Dominican dietary pattern, and three factors were found to explain the characteristics on the basis of factor analysis.The low percentage of animal fat was due to the diets rich in vegetable oil. Our results suggested that it was difficult to assume that CHD risks increased as a result of the Dominican dietary pattern. This was consistent with our previous findings that the average serum cholesterol level of Dominicans was generally low.

Results of second-stage screening for skin cancers in Oita Prefecture, Japan

We performed skin cancer screenings for 2 or 3 days annually from 2006 through 2013 in Oita Prefecture, Japan. Screening of approximately 3000 people in total allowed us to identify and treat several skin cancers, including five cases of malignant melanoma, four of squamous cell carcinoma, 16 of basal cell carcinoma, 11 of Bowens disease, 17 of actinic keratosis, one of extramammary Pagets disease and one of metastatic breast carcinoma. The sensitivity and specificity for the category defined by an identified lesion associated with risk of cancer and requiring further examination (category C) were 92.7% and 95%, respectively. We cannot estimate the outcome of our skin cancer screenings in terms of cancer mortality because of the small number of subjects examined and the brief follow‐up period. However, we did estimate the effectiveness of these screenings in terms of stages or sizes of cancerous lesions. The relative numbers of subjects with malignant melanoma at various clinical stages, identified during skin cancer screenings and during a routine visit to our hospital, were significantly different. We also compared, statistically, the sizes of lesions in Bowens disease that were found during cancer screenings and during a direct visit to our hospital. The former lesions were smaller than the latter. Our data suggest the benefits of our skin cancer screenings and the importance of campaigns and education to encourage people to visit dermatologists for the detection of skin cancers at an early stage.