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This article reports the occurrence of B. penaei in an additional host species, Penaeus marginatus Randall, and geographical area, Hawaii. Penaeus marginatus or Opai Lolo is the only member of the genus Penaeus indigenous to the Hawaiian Islands. Additional juvenile (01 to 4-0 g) P. marginatus were collected from the Kuliouou tidal flats from January to March 1984. These shrimp were held in aquaria for 7-10 days prior to examination. Shrimp were sacrificed by injection and immersion in Davidson's fixative, and after 24 h transferred to 50% ethanol for storage. Preserved hepatopancreata were processed for routine histopathology and stained with haematoxylin and eosin.

Background: Japanese (both in Japan and Hawaii) have a lower incidence of falls and of hip fracture than North American and European Caucasians, but the reasons for these differences are not clear.Subjects and Methods: A cross-sectional study. We compared neuromuscular risk factors for falls using performance-based measures (chair stand time, usual and rapid walking speed, and grip strength) among 163 Japanese women in Japan, 681 Japanese-American women in Hawaii and 9403 Caucasian women in the United States aged 65 years and over.Results: After adjusting for age, the Caucasian women required about 40% more time to complete 5 chair stands than either group of Japanese. Walking speed was about 10% slower among Caucasians than native Japanese, whereas Japanese-American women in Hawaii walked about 11% faster than native Japanese. Grip strength was greatest in Japan, which may reflect the rural farming district that this sample was drawn from. Additional adjustment for height, weight or body mass index increased the adjusted means of chair stand time and grip strength among Japanese, but the differences remained significant.Conclusions: Both native Japanese and Japanese-American women in Hawaii performed better than Caucasians on chair stand time and walking speed tests, and native Japanese had greater grip strength than Japanese in Hawaii and Caucasians. The biological implications of these differences in performance are uncertain, but may be useful in planning future comparisons between populations. [ABSTRACT FROM AUTHOR]

Objective: Environmental factors such as farming contribute to the frequency of joint symptoms. The purpose of this study is to explore the possible role of environment (lifestyle), by comparing the prevalence of joint pain between Japanese in a rural farming district in Japan and in urban Hawaii., Subjects and Methods: Current or previous pain at specific joints was surveyed among 222 women in rural Japan and 638 Japanese women in urban Hawaii aged 60-79. The age adjusted prevalence was compared using logistic regression., Results: The prevalence of pain at one or more joints was approximately 70% in Japan and 50% in Hawaii. The prevalence of knee pain in Japan ranged from 36% at ages 60-69 years to 53% at 70-79 years (mean 41%), whereas knee pain affected only 20% of women in Hawaii in both age groups. The odds ratio (and 95% CI) was 3.2 (2.1, 4.8) for knee pain, and 4.0 (2.2, 7.4) for mid-back pain in Japan, compared with Hawaii. Pain was also significantly more common in Japan at the shoulder, elbow, and ankle, but not at other joints. Women in Japan were shorter and weighed less than in Hawaii. Adjustment for body mass index increased the odds ratios to 4.4 (2.9, 6.8) for knee, and 4.5 (2.4, 8.5) for mid-back pain., Conclusion: Although the potential influence of cultural factors or other sources of bias cannot be ruled out, the large differences in the prevalence of pain at specific joints suggest that environmental factors are probably responsible, because both populations are of similar genetic stock.

Japanese have a lower incidence of hip fracture than Caucasians despite having lower bone mass. Hip fractures usually occur after a fall, and differing incidence rates of falls might explain the observed differences in hip fracture rates. To explore this hypothesis, we studied falls and related conditions among 1534 (624 men, 910 women) community-dwelling people aged 65 years and over in Japan and compared the prevalence of falls to Japanese-Americans living in Hawaii and to published studies of Caucasians. In Japan, 9% of the men and 19% of the women reported one or more falls during the past year. The prevalence of falls increased with age in both genders and was greater among women compared with men. In logistic regression models, having musculoskeletal disease, physical disability or limited activity increased the risk of falls by two to four times in both genders. Most fallers (92%) reported fear of future falls, and about one third of fallers reported that they went out less often as a result of their falls. Compared with native Japanese, the age-standardized prevalence of falls among Japanese-Americans was similar but about twice as high for Caucasians, which may explain the lower hip fracture risk of Japanese.

Background: Solar (brachioradial) pruritus is an enigmatic condition affecting the lateral aspects of the arm(s) and is primarily seen in Caucasian people living in the tropics or subtropics., Methods: Over a 5-year period we prospectively evaluated 68 patients with solar pruritus seen in an outpatient dermatology clinic. Clinical, biochemical, and microscopic and ultramicroscopic studies were performed. An open-label trial of capsaicin cream application was initiated in 15 patients., Results: An almost equal number of men and women were seen with an average age of 44 years. Brown-eyed and blue-eyed patients were seen with equal frequency. Most patients (86%) had outdoor occupations or avocations. The pruritus was intense, usually bilateral (72%) and invariably affected the lateral (as opposed to medial) aspects of the arm(s) in the absence of primary lesions. The most commonly affected area was the elbow area superficial to the brachioradialis and extensor carpi longus muscles, but extension of the pruritus to include the forearm and/or upper arm was common. Biopsy specimens (stained with hematoxylin and eosin) were normal or showed mild actinic elastosis in 15 patients tested. Ultramicroscopy showed myelin sheath splitting in all four patients studied. This is a nonspecific finding that may also be found in diabetic or alcoholic neuropathy. Ten of thirteen patients completing the capsaicin-cream study found significant relief (itching much improved or gone) after 3 weeks compared with the untreated control arm., Conclusions: The cause of solar pruritus remains unknown, but circumstantial evidence implicates chronic exposure to solar radiation. Capsaicin may offer relief to these patients, but the patients need to be cautioned about the burning sensation that occurs with capsaicin cream.

Background and Purpose: This report examines the hypothesis that the higher risk of stroke among Japanese men in Japan compared with those in Hawaii is related to pathology in small intracerebral arteries by comparing the prevalence of such lesions in autopsied participants from two cohorts of Japanese men in Japan and Hawaii., Methods: Existing histological sections from the left basal ganglia from 232 men from Japan and 175 men of Japanese ancestry in Hawaii were examined for selected abnormalities in arteries between 100 and 300 microns in diameter by three pathologists. The presence of lacunar infarcts was also noted, and information about cerebral infarcts, cerebral hemorrhages, and atherosclerosis in the circle of Willis was available for the Hawaii group., Results: Lacunar infarcts and all small intracerebral artery lesions except medial fibrosis were more common at every age in Japan than in Hawaii. By cause of death, all lesions were three or more times more prevalent among men who died of stroke than of noncardiovascular causes in both areas. In the Hawaii group, the small intracerebral artery lesions were significantly associated with autopsy evidence of cerebral and lacunar infarcts, and with atherosclerosis in the large arteries of the circle of Willis. Among a large number of risk factors measured at the baseline examination in Hawaii, only high blood pressure and reported usual Asian diet were significantly associated with one or more measures of small intracerebral artery lesions., Conclusions: An overview of the accumulated data indicated that small intracerebral artery pathology plays an important role in the high risk of stroke in Japanese men in Japan compared with those in Hawaii. These studies support the idea that hypertension is a necessary factor in the causal pathway, but also indicate that some other factors are involved. Some aspect of an Asian diet continues to be of importance for future research.

While the excess risk of clinical cardiovascular disease among persons with diabetes mellitus is well established, most autopsy studies have not been able to elucidate reasons for the excess, to assess potential selection bias, or to adjust for other cardiovascular risk factors. The purpose of this study was to examine the predictive relation between diabetes and autopsy evidence of coronary atherosclerosis and myocardial lesions. Among 8,006 Japanese-American men examined at baseline in 1965-1968 as part of the Honolulu Heart Program, 7,591 were free of cardiovascular disease, and 1,515 of these men died over a 17-year follow-up period. Protocol autopsies were performed for 83 diabetic men and 159 nondiabetic men. Diabetes status was defined using self-reported history and treatment at several examinations, as well as physician diagnoses during hospitalization between 1965 and 1984. An excess of coronary artery atherosclerosis, assessed by mean panel score (3.4 vs. 3.0, p = 0.017) and percentage of intimal surface with raised lesions (56.6% vs. 47.4%, p = 0.024), was present among diabetic men but diminished to nonsignificant levels (3.3 vs. 3.0, p = 0.102, and 53.9% vs. 48.8%, p = 0.183, respectively) after adjustment for other cardiovascular risk factors. Myocardial lesions (acute, healing, or fibrotic) occurred significantly more frequently among diabetics than among nondiabetics (77.7% vs. 63.4%, p = 0.035), even after adjustment for other risk factors. Potential autopsy selection bias assessed in several ways appeared minimal. Among men with mild atherosclerosis, diabetics had more small and large myocardial lesions than did nondiabetics, although differences were not statistically significant (p < 0.10). It appears that the more adverse risk factor profile among diabetics accounts for some of the observed excess of coronary atherosclerosis. However, diabetes was independently associated with myocardial lesions, and these findings suggest a role for nonatherosclerotic mechanisms, such as clotting abnormalities or microvascular disease, in accounting for the excess clinical heart disease found in persons with diabetes.

A total of 129 consecutive gastrectomy specimens from Japanese (99), Philippinos (11), Hawaiians (8), Koreans (5), Chinese (4) and Caucasians born in Hawaii (2) were examined under high-power light microscopy (1000 x) for the presence of ciliated gastric cells. Fifty-two of the 129 gastrectomy specimens (40.3%) contained ciliated cells. Ciliated cells were found in the basal segments of antral glands (usually cystically dilated) whose superficial segments had undergone intestinal metaplasia. The presence of ciliated cells in the gastric mucosa was influenced by the age of the patient and by the degree of intestinal metaplasia: the older the patient, the greater the degree of intestinal metaplasia and the greater the frequency of specimens with ciliated cells. The presence of ciliated cells was also influenced by the type of lesion in the specimen. Although the highest frequency (47.2%) was found in stomachs removed for adenocarcinoma, a substantial number of stomachs removed for gastric ulcer also showed that change (36%). The data suggest that increasing age and advanced atrophic gastritis, especially of the antrum, provide the necessary conditions that lead to the development of cilia, not only in Japanese subjects, but in other Hawaiian ethnic groups as well.

The mortality rate from heart disease is much higher among the Japanese of Hawaii than those of Japan. A comparison of autopsy specimens from men who died in Honolulu and Hiroshima indicated that this difference can be explained by more frequent myocardial infarcts in the Hawaii population. The basis for this difference can, in turn, be explained by the presence of more severe degrees of coronary atherosclerosis among the Hawaii men. The mortality rates for stroke, on the other hand, are higher among the indigenous Japanese than among Hawaii Japanese men. The basis for this difference cannot be explained on the basis of atherosclerosis of the aorta or of the circle of Willis. This report summarizes the comparative anatomic studies of coronary arteries, aorta and circle of Willis that form the basis for these conclusions.

The aspect of nephrosclerosis reflected by fibrous intimal thickening of small arteries (arteriosclerosis) was measured by a newly introduced morphometric procedure in 154 autopsies of Japanese-American men in Honolulu. These men were subjects of the Honolulu Heart Program and had previously been assessed for blood pressure and other clinical characteristics in a prospective study. In periodic acid-Schiff (PAS)-stained sections of renal cortex, measurements were made of interlobular artery diameters and intimal thicknesses. Vessels of outer diameter 80 to 130 microns and 160 to 300 microns were examined separately and are called the "remote" and "close" levels of the interlobular arteries, respectively, defined in relation to the heart. Nephrosclerosis thus quantified, together with age, could be used to predict the levels of blood pressure (BP) to be found in retrospective review of past records. The mathematical function obtained in a former study to make these predictions was found to predict the observed levels of blood pressure to an acceptable degree in the groupings that involved 92% of the subjects. Verification of that formerly obtained predictive function is now claimed. Correlation coefficients relating BP to close and remote measures were about of equal magnitude (r = 0.34 and 0.40, respectively). Subjects with cardiovascular-renal causes of death differed in both nephrosclerosis and blood pressure from subjects whose cause of death was unrelated to cardiovascular-renal diseases; the two factors taken together each contributed significantly to the cause of death difference. Correlations between nephrosclerosis and aortic atherosclerosis were stronger than could be explained solely by a linkage to observed values of blood pressure.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult T-cell leukemia (ATL) is a disease found endemic in Southern Japan and the Caribbean basin. The human T-cell leukemia virus I (HTLV-I) has been implicated epidemiologically as the causative agent in this disease. This paper describes the identification of this disease in Hawaii in a second generation immigrant from Southern Japan. The disease was initially indolent, then clinically explosive, characterized by cutaneous lesions, leukemic lymphocytes with convoluted nuclei of T-cell phenotype, hypercalcemia, and a terminal infection.

This study of cerebrovascular lesions at autopsy among Hawaiian Japanese men identifies similar risks factors for cerebral infarction and hemorrhage that have been identified in a previous incidence study. Demonstrated differences were essentially the same whether subjects with these tissue changes were compared to men showing no central nervous system disease at autopsy or when they were compared with men still alive. Cerebral infarcts accompanied myocardial infarction (CHD) in 58% of autopsy cases and were associated with CHD risk factors (high serum cholesterol, hypertension, severe atherosclerosis of the coronary arteries and aorta). These associations did not persist when CHD cases were removed from the analysis, indicating there were two subsets of men with cerebral infarction. Hypertension was strongly associated with hemorrhagic disease, as were cigarette use and alcohol consumption.

During the years 1965 to 1974, 481 men who had participated in a standardized examination at the Honolulu Heart Study died. Autopsies were conducted in 226 of the men, and in 137 the extent of coronary and/or aortic atherosclerosis was estimated by the American Heart Association panel method. This method was found to be simple and highly reproducible. In multivariate analysis, statistically independent associations were found between aortic atherosclerosis and age at death, cigarettes per day, serum cholesterol, and systolic blood pressure; between coronary atherosclerosis and relative weight, cigarettes per day, and serum cholesterol; and between heart weight and height, relative weight, and systolic blood pressure. Alcohol consumption was lower and hematocrit was higher in men with infarcts than in other decedents, but no statistically significant relation between these variables and coronary or aortic atherosclerosis could be demonstrated.

It is generally accepted that most colorectal cancers arise from adenomatous polyps and most coronary heart disease is caused by severe atherosclerosis. In order to compare the frequency of these disease precursors in men of Japanese ancestry in Hawaii, the degree of atherosclerosis of the aorta and coronary arteries was estimated by the panel method in 288 male autopsy subjects. The extent of atherosclerosis was then compared in men who did or did not have adenomatous polyps as determined at autopsy. The degree of atherosclerosis of the coronary arteries and aorta was positively and significantly related not only to the presence of adenomatous polyps, but to their size, multiplicity, and degree of atypia as well. This study suggests that shared environmental events could account for the development of severe atherosclerosis and adenomatous polyps. At the same time, it has been observed that hawaii Japanese men experience colon and rectal cancer rates higher than those of US Whites, but their coronary heart disease (CHD) rates are intermediate between the low rates of Japan and the high rates of the US white population. These differences in disease trends and differences in the serum cholesterol and fat intake of Hawaii Japanese men with CHD and colon cancer have suggested that men with these diseases represent different subsets of the westernized Japanese population. If CHD and colon cancer occur in different subsets of this population, they must stem from the accumulation of other risk factors superimposed upon the initiators of their precursor lesions.

Of 8,006 men of Japanese ancestry living in Hawaii who were followed from 1966 to 1983 for incident cardiovascular disease, 1,381 died and 290 had a protocol autopsy which included determination of the extent of atherosclerosis in the coronary arteries and aorta. More than 50 biologic, lifestyle, and dietary characteristics, measured in 258 of the men who did not have existing evidence of definite coronary disease or stroke at the baseline examination, were examined for association with the measures of atherosclerosis using models which did and did not include adjustments for autopsy selection bias. Blood pressure and serum cholesterol were the strongest and most consistent predictors of atherosclerosis in both the coronary arteries and aortas. Cigarette smoking was also consistently associated with aortic atherosclerosis and inconsistently with coronary atherosclerosis. Several other variables often associated with clinical coronary artery disease in this cohort were not found to be independently associated with atherosclerosis. These included alcohol use, physical activity, serum glucose, triglyceride, and uric acid levels. None of more than 25 measures of dietary patterns and 24-hour dietary intake was associated with atherosclerosis in any statistical model. Examination of age-adjusted and age-specific levels of atherosclerosis over time from 1966 to 1983 showed a slight decrease in coronary atherosclerosis and a slight increase in aortic atherosclerosis; however, these trends were not significant. Both myocardial scars measured at autopsy and clinical evidence of myocardial infarction were significantly associated with the coronary atherosclerosis scores.

A retrospective morphologic survey (1973-1983) of 146 cases of malignant lymphoma among the Hawaii-Japanese (migrant Japanese and their offspring) was conducted to determine whether differences in the incidence and cytologic types of malignant lymphoma exist when compared to those of native Japanese (lifetime residents of Japan). The age-adjusted incidence rates for malignant lymphoma among the Hawaii-Japanese were similar to rates for U.S. whites. However, higher rates for follicular centre cell (FCC) lymphoma with a follicular pattern were observed in the Hawaii-Japanese population when compared with rates for native Japanese. On the basis of the cytologic types of the Lukes-Collins classification, non-Hodgkin's lymphomas among the Hawaii-Japanese resembled those of Western countries, rather than those of Japan. B-cell lymphomas predominated (72 per cent), while T-cell types comprised 23 per cent of cases. Follicular centre cell types were encountered most often (59 per cent), and the small cleaved FCC subtype was the most common (30 per cent). The high degree of follicularity (29 per cent) was at variance with the consistently low rates reported in Japan. This may be explained, in part, by higher rates of nodal lymphomas among the Hawaii-Japanese. Of the T-cell lymphomas, diffuse large cell types (T-cell immunoblastic sarcoma, T-IBS), often with cytologic pleomorphism, were relatively frequently encountered (16 per cent), and comprised 15 per cent of non-Hodgkin's lymphomas; this observation necessitates special clinical and epidemiologic consideration in view of the large Japanese migration to Hawaii from HTLV-I endemic regions of southern Japan. No registered cases of non-Hodgkin's lymphoma or of Hodgkin's disease were documented in Hawaii-Japanese subjects under the age of 15 years. The age-adjusted incidence rates for Hodgkin's disease among the Hawaii-Japanese were similar with those of native Japanese. Nodular sclerosis was the most frequent histologic subtype. The difficulty in distinguishing between Hodgkin's disease and non-Hodgkin's lymphoma, particularly when immunologic cell surface markers are not available, is addressed. Low rates for chronic lymphocytic leukemia among the Hawaii-Japanese were confirmed. Not one well-documented case was identified in the 11-year period surveyed.

Evidence of cerebrovascular disease at autopsy was compared in 2 groups of men: 186 long-time residents of Hiroshima, Japan, and 253 men of Japanese ancestry long resident in Honolulu, Hawaii. They were 45 to 71 years-of-age at death. Atherosclerosis of the circle of Willis and its major branches, sclerosis of the intraparenchymal arteries and the frequency of cerebral hemorrhage and cerebral infarct were compared in the 2 populations. The Honolulu subjects had significantly more atherosclerosis of the circle of Willis, but less intraparenchymal artery sclerosis and less cerebral infarction. Cerebral hemorrhage was equally frequent in the 2 cities. It was concluded that cerebral infarction is more frequent in Japanese men in Hiroshima than Honolulu, and that men of Japanese ancestry in Honolulu are spared an appreciable risk of cerebral infarction through decreased frequency of intraparenchymal arterial sclerosis despite higher levels of atherosclerosis of large intracranial arteries.

Comparisons of Hawaiian Japanese with Japanese living in Japan identify several differences between the 2 populations. The Hawaiian Japanese are heavier and taller; they consume more fat and protein; they have higher levels of serum cholesterol, more frequent fecal mutagens, and more frequent adenomatous polyps and diverticulae. These differences offer indirect support to the concept that the consumption of a Western diet favors the development of coronary heart disease and colon cancer which occur more frequently among the Japanese in Hawaii than in Japan. When assessed directly and prospectively, obesity, the serum cholesterol level, and dietary fat intake are positively associated with coronary heart disease. The serum cholesterol level and dietary fat intake are negatively associated with colon cancer, whereas the body mass index (height/weight) is positively related to this tumor in older men. The 2 diseases have shown dissimilar trends in the past 20 years, with coronary heart disease being stable at levels intermediate between the United States and Japan experience, whereas colon cancer has shown a steady increase with rates higher than those of whites in the United States. The differences in risk factors and trends displayed by the 2 diseases indicate that they affect different subsets of the westernized Japanese population. Additional studies are necessary if we are to establish the basis for these differences.

Autopsies were conducted on Japanese men from 45 to 71 years of age in Hiroshima, Japan (191 patients) and in Honolulu, Hawaii (298 patients). They were performed according to a common protocol. In both locations the patients studied were representative of decedents from population-based cohorts with respect to age and cause of death. The degree of atherosclerosis in the coronary arteries and aorta, assessed according to the panel method, was found to be substantially more severe in men in Hawaii than in those in Japan. Areas of recent myocardial necrosis were 3.5 times more frequent in men in Honolulu than in those in Hiroshima. Large myocardial scars were 1.5 times more frequent in the men in Honolulu. It was characteristic of men in Honolulu that severe atherosclerosis and myocardial lesions appeared at younger ages than in those in Hiroshima. These data demonstrate that there is an increase in the frequency and severity of ischemic lesion in the myocardium of Japanese who have migrated to Hawaii and that this increase is the result of atherosclerosis of the extramural segments of the coronary arteries.