Perinatal exposure to di-(2-ethylhexyl) phthalate induces hepatic lipid accumulation mediated by diacylglycerol acyltransferase 1

INTRODUCTION

Di-(2-ethylhexyl) phthalate (DEHP) is a commonly used plasticizer in consumer products and medical devices. It is also suspected to exacerbate the development of fatty liver. However, the mechanisms underlying excessive lipid synthesis and its deposition in the liver are yet to be identified. This study was aimed to evaluate the molecular mechanisms of hepatic lipid accumulation in adult male offspring after perinatal exposure to DEHP.

METHOD

Corn oil and DEHP (0.75 mg/kg/day) were administered once per day to dam from gestation day 6 to postnatal day (PND) 21 by oral gavage. After the weaning period, DEHP treated male pups were categorized into early life stage- and lifelong period group. Male rats both control and early life stage group administered corn oil, and lifelong period group administered DEHP from PND 22 to 70. Histological examination and triglyceride (TG) levels in the liver were analyzed. Expressions of transcription factors associated with lipid accumulation in the liver were analyzed.

RESULTS

Both early life stage- and lifelong period group, hepatic TG levels, and mRNA and protein expression of diacylglycerol acyltransferase 1 (DGAT1) were significantly higher than control (TG: all p < 0.05, mRNA & protein: p < 0.05 and p < 0.001, respectively). The average body weight from PND 35 to 63, and mRNA and protein expression of sterol regulatory element binding protein 1c in lifelong period group were significantly lower than control (all p < 0.05); however, alanine transaminase were significantly higher than control (p < 0.01).

CONCLUSION

Perinatal exposure to DEHP may induce the hepatic lipid accumulation through up-regulation of DGAT1 expression.

The routine value of anogenital distance as an anthropometric measurement in newborns

OBJECTIVE

Anogenital distance (AGD) is a sexually dimorphic trait; AGD is an external marker of sexual differentiation at birth in animals.

STUDY DESIGN

The present study used a prospective, cross-sectional design. Data were collected from newborn infants that were delivered at hospital in Bucheon between March and September 2009. The mothers of the infants provided sociodemographic information and obstetric history. The relationships between AGD and other anthropometric measures (i.e., weight, height, and head circumference) were analyzed. Moreover adjusted AGD values were compared with obstetric characteristics, including number of deliveries, abortion history, preterm history, and duration of gestation.

RESULTS

Significant correlations were noted for all anthropometric measures in male and female newborns (p < 0.0001). The adjusted AGD values in males and females were also significantly associated with the duration of gestation (p = 0.0008 and p = 0.0148, respectively). Moreover, the adjusted AGD in female newborns, but not in males, was significantly associated with maternal abortion history (p = 0.0242).

CONCLUSION

The AGD is a valuable anthropometric marker in term infants.

Conditional survival in patients treated with vascular endothelial growth factor-targeted therapy for advanced renal cell carcinoma

PURPOSE

Conditional survival (CS) offers more relevant prognostic information for patients once they have survived for some time. The objective of this study was to determine the CS for advanced renal cell carcinoma (RCC) patients treated with vascular endothelial growth factor-targeted therapy.

METHODS

A total of 345 patients treated between 2006 and 2011 fulfilled the inclusion criteria and were reviewed for analyses. The 1-year conditional and actual survival rates were calculated for survivors from treatment to month 24. Subgroup-specific CS rates were generated after adjustment of the covariate influence. The Cox proportional hazard models were used to assess the prognostic factors at baseline and 1-year landmark.

RESULTS

The probabilities of surviving an additional year given survival to 6, 12, 18, and 24 months were 72.2, 76.3, 78.2, and 78.6 %, respectively. Remarkable increase in CS was observed in patients initially classified as intermediate or poor risk according to Heng risk groups. For patients survived 24 months after treatment, the adjusted CS for the following year was over 80 % regardless of initial risk attribution. Compared to baseline analysis, Heng risk groups were less predictive of survivorship after surviving 1 year. The addition of disease control status to multifactorial model significantly improved survival estimation for 1-year survivors (p < 0.01).

CONCLUSIONS

CS provides useful information regarding life expectancy for survivors of advanced RCC treated with targeted therapy. Furthermore, disease control status within a specific period of time is critical to the prediction of subsequent survival.

Retraction of articles by H. Zhong et al

Retraction of 41 articles by H. Zhong et al..

A series of 41 papers by H. Zhong et al. are retracted.

Ambulatory treatment of multidrug-resistant pulmonary tuberculosis patients at a chest clinic

SETTING

Retrospective cohort analysis of multidrug-resistant tuberculosis (MDR-TB) patients treated at a Korean National Tuberculosis Association out-patient chest clinic.

OBJECTIVE

To evaluate treatment outcomes and contributing factors.

DESIGN

A review of clinical records of 1011 pulmonary MDR-TB patients retreated with individualised regimens selected on the basis of previous chemotherapy and drug susceptibility testing from 1988 to 1996.

RESULTS

The patients (mean age 38.6 years) had resistant organisms to an average of 3.7 drugs and were retreated with an average of 4.2 drugs which they had previously not taken and to which they were susceptible. Treatment outcomes were as follows: 487 cases (48.2%) cured, 82 (8.1%) failed, 394 (39.0%) defaulted, 45 (4.5%) transferred out, and three (0.3%) died. The treatment efficacy among those who completed chemotherapy was 85.6%. In a multivariate analysis favourable response was significantly associated with a greater number of newly prescribed drugs in the regimen to which they were susceptible (odds ratio [OR] 3.6; 95% confidence interval [CI] 1.3-9.5), younger age (OR 2.0; 95%CI 1.1-3.9), and a lower number of drugs to which they were resistant (OR 1.8; 95%CI 1.1-3.1). The case fatality rate, including the follow-up period, was 1.7% (17 cases).

CONCLUSION

The cure rate of MDR-TB patients treated at an out-patient clinic was 48.2% due to a high defaulter rate (39.0%). However, 85.6% of those who completed treatment were cured.

Twenty-year trend of chronic excretors of tubercle bacilli based on the nationwide tuberculosis prevalence surveys in Korea, 1975-1995

SETTING

A study of chronic excretors of tubercle bacilli (chronic cases) based on the nationwide random sample surveys of tuberculosis prevalence conducted in Korea from 1975 through 1995.

OBJECTIVE

To investigate the temporal trend of the prevalence of chronic cases, and to match these with treatment outcomes and drug resistance rates.

DESIGN

Bacillary cases were classified by history of chemotherapy into new (those who denied a history of chemotherapy), non-chronic (those who had taken chemotherapy for less than 2 years) and chronic cases (those who had taken chemotherapy for more than 2 years).

RESULTS

Chronic cases decreased from 107 to 12 per 100000 population (annual rate of reduction [ARR] 11.89%) over the 20-year period. The ARR of chronic cases was significantly greater than that of new cases, and accelerated from 1985 (ARR 15.83%), after the application of short course chemotherapy. Rates of overall drug resistance rates increased up to 1980, and those of multidrug resistance up to 1985, followed by a decrease thereafter. A reduction in chronic cases was observed even during the period of increase in drug resistance (including multidrug resistance).

CONCLUSION

The prevalence of chronic tuberculosis cases has decreased due to improvements in overall treatment outcome.

Upregulated expression of the cDNA fragment possibly related to the virulence of Acanthamoeba culbertsoni

Identification of the genes responsible for the recovery of virulence in brain-passaged Acanthamoeba culbertsoni was attempted via mRNA differential display-polymerase chain reaction (mRNA DD-PCR) analysis. In order to identify the regulatory changes in transcription of the virulence related genes by the brain passages, mRNA DD-PCR was performed which enabled the display of differentially transcribed mRNAs after the brain passages. Through mRNA DD-PCR analysis. 96 brain-passaged amoeba specific amplicons were observed and were screened to identify the amplicons that failed to amplify in the non-brain-passaged amoeba mRNAs. Out of the 96 brain-passaged amoeba specific amplicons, 12 turned out to be amplified only from the brain-passaged amoeba mRNAs by DNA slot blot hybridization. The clone, A289C, amplified with an arbitrary primer of UBC #289 and the oligo dT11-C primer, revealed the highest homology (49.8%) to the amino acid sequences of UPD-galactose lipid transferase of Erwinia amylovora, which is known to act as an important virulence factor. The deduced amino acid sequences of an insert DNA in clone A289C were also revealed to be similar to cpsD, which is the essential gene for the expression of type III capsule in group B streptococcus. Upregulated expression of clone A289C was verified by RNA slot blot hybridization. Similar hydrophobicity values were also observed between A289C (at residues 47-66) and the AmsG gene of E. amylovora (at residues 286-305: transmembrane domains). This result suggested that the insert of clone A289C might play the same function as galactosyl transferase controlled by the AmsG gene in E. amylovora.

Treatment of bacillary pulmonary tuberculosis at the chest clinics in the private sector in Korea, 1993

SETTING

Cohort study of bacillary pulmonary tuberculosis patients treated at private sector chest clinics in Korea.

OBJECTIVE

To assess the treatment behaviour of physicians in private chest clinics and the treatment outcomes of their patients.

DESIGN

1) A retrospective analysis of a cohort of patients admitted from July through October in 1993, and 2) comparison with results from health centres under the National Tuberculosis Programme (NTP).

RESULTS

Nine hundred and sixty bacillary patients (507 newly diagnosed--'new', and 453 retreatment--'old') were admitted to the study. Initial smears and cultures were not performed in 7% and 21%, and follow-up smears and cultures not done in 19% and 28%, respectively. The regimens prescribed were variable: 23 in 'new' and 72 in 'old' patients, 86 in total. Six-month short-course treatment using HRZE was prescribed for 26.2% of 'new' patients. In many instances, the planned treatment duration was excessive. The success rates (cured plus completed) for 'new' and 'old' patients were 74% and 51%, respectively. The failure rates were less than 1% in 'new' and 9% in 'old' patients.

CONCLUSION

Prescribed regimens were variable in terms of drug combinations and treatment duration. Overall treatment outcome was inferior to that of the health centres under the NTP.

Tuberculin PPD RT23: has it lost some of its potency?

PPD RT23 is a tuberculin that is used worldwide. Korea has been using 1TU RT23 for its nationwide tuberculosis prevalence surveys at five-yearly intervals since 1965, and found a drop in its potency after the 1975 survey. This finding draws attention to the interpretation of tuberculin survey data observed with RT23 at different time periods.

Cohort analyses of the treatment of smear-positive pulmonary tuberculosis patients under programme conditions in Korea, 1983-1994

SETTING

Cohort analyses of the results of sputum smear-positive pulmonary tuberculosis patients registered in health centres in Korea under programme conditions from 1983 to 1994.

OBJECTIVE

To assess the overall treatment results and their annual changing trend.

DESIGN

Retrospective sample surveys of the nationwide treatment results of registered new smear-positive and retreatment patients.

RESULTS

The numbers of registered smear-positive pulmonary tuberculosis patients have decreased steadily, from over 35000 in 1983 to about 14000 in 1994. Over 90% of health centres, and 60-80% of registered patients, were covered in the cohort analyses. The overall cure rate for all patients was 56% in 1983; this improved to around 80% in the last three years of the period studied, owing to increased use of short-course chemotherapy. Over 5000 patients per year required retreatment during the first four years; this number decreased steadily to less than 700 in 1994, due to the reduction in initial treatment failures.

CONCLUSION

The overall treatment results have improved significantly in Korea, due to the application of short-course chemotherapy.

Prevalence and risk factors of urinary stones in Koreans

To estimate the prevalence of urinary stone disease in Koreans, and to determine the inter-relationships between urinary stone disease and various epidemiological factors, 1,521 controls and 1,177 cases with urinary stones were evaluated. Of special interest in this study were: 1) proportion of past urinary stone history among controls; 1.9% 2) the point prevalence rate of urinary stones among controls; 0.2% 3) the recurrence rate of urinary stones (the proportion of past history of urinary stone) among cases; 56.8% 4) high incidences (76.3%) in the thirties to the fifties among cases 5) the risk factors for urolithogenesis; obesity [higher than 25 of BMI (body mass index, weight/height2)], more than 10 year-experience as a production worker, past stone history, familial stone history, low physical activity (< 2,000 Kcal/day), and low intake of fruit. However, the well-known risk factors for urinary stones; over intake of meat or fish and milk or dairy products, perspiration, amount and kind of drinking water, and stress unexpectedly were not significantly different between the controls and the cases.

The seventh nationwide tuberculosis prevalence survey in Korea, 1995

SETTING

Nationwide random sample survey for tuberculosis prevalence in Korea in 1995.

OBJECTIVE

To investigate the prevalence of tuberculosis infection, morbidity and drug resistance, and BCG coverage, and to compare the findings with those of the previous six surveys.

DESIGN

The following investigations were performed: tuberculin test, BCG scar screening, chest miniature radiography (70 x 70 mm) for those aged over five years, sputum direct smear, culture and drug susceptibility test, and a questionnaire to obtain history of antituberculosis chemotherapy and symptoms.

RESULTS

The coverages of the 1995 survey were as follows: tuberculin 87.0%, radiology 88.4%, bacteriology 98.3%. The observed tuberculin positivity (> or =10 mm in diameter) of subjects aged under 30 was 15.5%. The prevalence of pulmonary tuberculosis per 100000 has decreased in the last 30 years: direct smear positive from 686 to 93, smear and/or culture positive from 940 to 219, active tuberculosis from 5065 to 1032. Rates of drug resistance have also fallen: of those with no previous chemotherapy from 26.2% to 5.8%, of those with history of chemotherapy from 55.2% to 25.0%, and in total from 38.0% to 9.9%. BCG scar prevalence of infants (aged under one year) was 87.7%, and of those under 30 it was 91.8% in 1995.

CONCLUSION

Tuberculosis prevalences and the drug resistance rates have decreased significantly.

[cDNAs encoding the antigenic proteins in pathogenic strain of Entamoeba histolytica]

The differential display reverse transcription polymerase chain reaction (DDRT-PCR) analysis was performed to identify the pathogenic strain specific amplicons. mRNAs were purified from the trophozoites of the pathogenic strain YS-27 and the non-pathogenic strain S 16, respectively. Three kinds of first stranded cDNAs were reverse transcribed from the mRNAs by one base anchored oligo-dT11M (M: A, C, or G) primers. Each cDNA template was used for DDRT-PCR analysis. A total of 144 pathogenic strain specific amplicons was observed in DDRT-PCR analysis using primer combinations of the 11 arbitrary primers and the 3 one base anchored oligo-dT11M primers. Of these, 31 amplicons were verified as the amplicons amplified only from the mRNAs of the pathogenic strain by DNA slot blot hybridization. Further characterization of the 31 pathogenic strain specific amplicons by DNA slot blot hybridization analysis using biotin labeled probes of the PCR amplified DNA of cysteine proteinase genes revealed that 21 of them were amplified from the mRNAs of the cysteine proteinase genes. Four randomly selected amplicons out of the rest 10 amplicons were used for screening of cDNA library followed by immunoscreening and all of them were turned out to be amplified from the mRNA.

Drug-resistant tuberculosis in Korea, 1994

SETTING

Sample survey based on pulmonary tuberculosis (TB) patients registered in 264 health centres in Korea, compared with data obtained from nationwide TB prevalence surveys conducted since 1965.

OBJECTIVE

To determine the level of antituberculosis drug resistance (DR) and to assess its impact on treatment outcome and its relationship with cure rates in the National TB Programme (NTP).

DESIGN

Mycobacterium tuberculosis isolates from 2,486 new patients and 189 previously treated patients were subjected to susceptibility testing against 10 antituberculosis drugs. Treatment outcome was assessed. The DR levels were compared with those observed in the national TB prevalence surveys, and the trend was correlated with the cure rate of patients treated in the NTP.

RESULTS

Resistance to any drug was 11.3% in new cases and 54.0% in previously treated cases. Initial resistance to isoniazid (INH) or rifampicin (RMP) was 7.7% or 2.2%, and to INH and RMP (+/- other drugs) 1.6%. Compared with previous data, initial drug resistance (IDR) has decreased significantly and is inversely related to improvement of cure rates in the NTP. The treatment outcome of patients with single drug resistance was satisfactory.

CONCLUSION

Drug-resistant TB has decreased remarkably during the last decades in Korea as a result of improved efficiency in the treatment programme of the NTP.

Hypertension awareness, treatment and control rates for an Asian population: results from a national survey in Korea

OBJECTIVE

This observational study was performed in order to determine the hypertension awareness, treatment, and control rates for the country of Korea.

METHODS

Rates were determined in conjunction with a national blood pressure survey in Korea in 1990. Through cluster sampling, individuals aged > 30 in 190/146,944 districts were selected for study. Among 25,567 eligible individuals, 21,242 had measurement of blood pressure (BP) and answered a standard questionnaire. BP was recorded as the mean of two measurements with a standard mercury manometer. Hypertension was defined either as BP > or = 160/95 mm Hg or on treatment (n = 2628), or as BP > or = 140/90 mm Hg or on treatment (n = 4219). Treatment was defined as any method of BP treatment, including dietary, traditional, or medication.

RESULTS

Rates for BP > or = 160/95 mm Hg or on treatment: aware 1057 (40%), treated 696 (27%), controlled 367 (14%). Rates for BP > or = 140/90 mm Hg or on treatment: aware 1069 (25%), treated 696 (16%), controlled 221 (5%).

CONCLUSIONS

Hypertension awareness, treatment, and control rates are relatively low in Korea. Blood-pressure control programs, including detection strategies, are needed here and worldwide.

Detection of genetic diversity using RAPD-PCR and sugar analysis in watermelon [Citrullus lanantus (Thunb.) Mansf.] germplasm

RAPD (random amplified polymorphic DNA) markers generated by 15 arbitrary decamers were used to determine the frequency of DNA polymorphism in 39 watermelon [Citrullus lanantus (Thunb.) Mansf.] germplasms. Of the 15 primers tested, all except 1 (primer 275) directed the amplification of polymorphic products. A total of 162 amplification products were generated across all 39 genotypes. Among the 162 fragments, 35 (21%) appeared to be reliable polymorphic markers. The mean value by marker difference in this comparison was 0.24, and the highest, 0.69. Eight RAPD markers could be utilized in the unique variety discrimination 8 watermelon genotypes. From the phenograms constructed by UPGMA based on the comparison of RAPD markers, four clusters were resolved. Each group was also characterized and identified with morphological and genetic characteristics for each genotype. The free sugars of the edible parts of watermelons were analyzed by HPLC (high-performance liquid chromatography). Results from the phylogenetic analysis of band sharing data were consistent with sweetness as measured by HPLC. In conclusion, RAPD assays can be used for providing alternative markers for identifying genotypes and quantitative characteristics in watermelon.

Incidence of pulmonary tuberculosis in Korean civil servants

SETTING

Longitudinal epidemiological study based on civil servants in Korea.

OBJECTIVE

To estimate the incidence of pulmonary tuberculosis (PTB) for the general population from a reliable sample.

DESIGN

New active PTB developing between 1988 and 1990 in civil servants has been determined from (1) the findings of biennial medical examinations and (2) perusal of the medical records of those claiming health insurance for tuberculosis (TB).

RESULTS

A total of 790,204 subjects was available for investigation. Active PTB was diagnosed in 5107 patients over the 2 years of the study. Bacteriological examination of 3847 patients yielded 575 (14.9%) positive smears and 350 (9.1%) smear-negative positive cultures from them. Applying these rates to the 1260 whose sputum was not examined, 702 were smear-positive, and 431 were culture-positive. Overall PTB incidence was 393 per 10(5), with 84 and 53 per 10(5) smear- and culture-positive. Incidence was high in males, and in the age group 20-29 years in both sexes.

CONCLUSION

Such high PTB incidence, particularly in the age group 20-29, clearly indicates that TB in Korea remains a serious health problem.

[Genetic status of Acanthamoeba spp. Korean isolates on the basis of RAPD markers]

Genetic status of Acanthamoeba spp. were tested on the basis of random amplified polymorphic DNA (RAPD) marker analysis. Four previously established Acanthamoeba species, 4 Korean isolates of Acanthamoeba sp., and one American isolate of Acanthamoeba sp. were analyzed by RAPD-PCR using an arbitrary decamer primers. Amplification products were fractionated by agarose gel electrophoresis and stained by ethidium bromide. Eighteen primers produced DNA amplification profiles revealing clear differences among 4 species. Nine of them also produced DNA amplification profiles which included some isolate-specific amplification products. On the basis of amplified fragments by 18 primers, the pairwise similarity indices between A. culbertsoni and other species (i.e., A. hatchetti, A. triangularis, A. polyphaga) were 0.300, 0.308, and 0.313, respectively. Similarity index between A. hatchetti and A. triangularis was 0.833. The mean similarity index among the 3 Korean isolates (YM-2, -3, -4) was 0.959 and 0.832 among them and 2 other species (A. hatchetti and A. triangularis). The mean similarity index among YM-5 and other Korean isolates (YM-2, -3, -4) was 0.237. However, the similarity index between YM-5 and A. culbertsoni was 0.857, which suggests that YM-5 is genetically more similar to A. culbertsoni than other Korean isolates. Phenogram reconstructed by UPGMA method revealed that there are two groups: one group consists of A. hatchetti, A. triangularis, and 3 Korean isolates (YM-2, -3, -4), and the other group consists of A. culbertsoni, A. polyphaga, HOV, and YM-5.

Incidence of pulmonary tuberculosis among diabetics

SETTING

Longitudinal epidemiological study based on diabetic and non-diabetic civil servants in Korea.

OBJECTIVE

To determine a comparative incidence of pulmonary tuberculosis (PTB) between diabetic and non-diabetic subjects.

DESIGN

Investigation of newly developed PTB among diabetics and non-diabetics between 1988 and 1990, on the basis of biennial medical examination and the medical records of those who claimed health insurance for tuberculosis.

RESULTS

The 1990 medical examination and investigation of medical records of the health insurance claimants revealed that PTB had developed in 170 patients (including 37 smear and eight culture positives) among 8015 diabetics, and in 4935 patients (including 538 smear and 342 culture positives) among 806,698 control subjects. Estimated annual incidence rates of PTB of (1) all types, (2) smear and/or culture positive versus (3) smear positive cases were 1061, 281 and 231 per 10(5) respectively among diabetics and 306, 55 and 33 per 10(5) among non-diabetic controls. PTB developed in 167 of 7695 male diabetics and in 3 of 320 female diabetics. The greater the age, the more diabetics were found.

CONCLUSION

Relative risks (RR) of developing PTB of all types and bacteriologically confirmed cases were 3.47 times and 5.15 times higher in the diabetics than in the matched controls. A greater RR was observed on those at the age of 30-49 than in those of 50 years or more.

Survey of knowledge, attitudes and practices for tuberculosis among general practitioners

SETTING

Representative sample survey of knowledge, attitudes and practices (KAP) for tuberculosis among private general practitioners (GPs) in 1993 in Korea,

OBJECTIVE

To investigate the KAP of general practitioners on the prevention and treatment of tuberculosis.

DESIGN

Questionnaire surveys were performed for 923 private general practitioners through 29 health centres.

RESULTS

49% of GPs considered that the Korean tuberculosis situation is not serious. 54% were worried about infection from patients. 47% answered that BCG vaccination causes untoward reactions with no or limited effectiveness. 47% considered the National Tuberculosis Programme (NTP) unfavourably. Over 50% did not consider sputum examination essential in case finding/diagnosis, and 75% in monitoring of treatment response. For initial treatment of active tuberculosis, only 11% were prescribing the current Korean NTP's six-month standard regimen. 73% were giving currently non-recommendable regimens, and 16% unacceptably bad regimens. However, this situation could be improved, as 80% of GPs expressed the wish to acquire knowledge.

CONCLUSION

Many misunderstandings were found in the field of transmission, BCG vaccination and the performance of the NTP; sputum examinations were considerably neglected in case finding/diagnosis and treatment monitoring. As for treatment, 89% were giving either non-recommendable regimens or bad regimens.

Body mass index and blood pressure in Korean men and women: the Korean National Blood Pressure Survey

AIMS AND METHODS

The association between body mass index (BMI) and blood pressure is well known in relatively obese populations. The purpose of the present study was to investigate the relationship between BMI and blood pressure in a lean population. Through cluster sampling, individuals aged > 30 years in 190 out of 154,082 districts were selected for study. Among 25,567 eligible individuals, measurements of blood pressure and BMI were made in 22,354.

RESULTS

The BMI for males was 22.8 +/- 2.7 kg/m2 and for females was 23.4 +/- 3.2 kg/m2 (means +/- SD). Over a BMI range from 16 to 31 kg/m2 the relationships between BMI and systolic and diastolic blood pressure were almost linear. Over the BMI range 25-31 kg/m2 (overweight-to-obese) each BMI unit was associated with a difference of 1.0 mmHg in diastolic blood pressure. Over the BMI range 16-25 kg/m2 (normal-to-lean) each BMI unit was associated with a difference of 0.89 mmHg in diastolic blood pressure.

CONCLUSION

We conclude that a strong association between BMI and blood pressure exists for lean as well as for obese subjects.

Hypertension in Korea: a national survey

To determine the prevalence of hypertension (HTN) and its risk factors, we performed a population-based national cross-sectional blood pressure (BP) survey in Korea in 1990. Through cluster sampling, we selected for study individuals older than 30 years of age in 190 of 154,082 districts. Among 25,567 eligible individuals, 21,242 subjects had measurements of BP and body mass index (BMI) and underwent a standard interview. BP was recorded as the mean of two measurements on a standard mercury manometer. The prevalence of HTN varied widely by area of residence. Overall prevalence was 19.8% for HTN defined as BP > or = 140/90 mm Hg or subject on medication, and 12.4% for BP > or = 160/95 mm Hg or subject on medication. Correlates for HTN identified by logistic regression analysis included positive family history of HTN (odds ratio [OR] = 2.2,), age (10 years); OR = 1.9), alcohol intake (500 cc; OR = 1.4), urban location (versus rural; OR = 1.3), and BMI (1 BMI unit; OR = 1.2). [Am J Prev Med 1994;10:200-4]

Chloroplast DNA transgresses species boundaries and evolves at variable rates in the California closed-cone pines (Pinus radiata, P. muricata, and P. attenuata)

We studied phylogenetic relationships among populations and species in the California closed-cone pines (Pinus radiata D. Don, P. attenuata Lemm., and P. muricata D. Don) via chloroplast DNA restriction site analysis. Data on genetic polymorphism within and among 19 populations in the three species were collected using 9 to 20 restriction enzymes and 38 to 384 trees. Because only five clades and extremely low intraclade diversity were found, additional phylogenetic data were collected using a single representative per clade and two outgroup species, P. oocarpa Schiede and P. jeffreyi Loud. In total, 25 restriction enzymes were employed and approximately 2.7 kb surveyed (2.3% of genome). The five clades recognized were Monterey pine, knobcone pine, and the southern, intermediate, and northern races of bishop pine. On the basis of bootstrapping, both Wagner and Dollo parsimony analyses strongly separated the northern and intermediate races of bishop pine from the southern race; knobcone pine from Monterey and bishop pines; and the closed-cone pines from the two outgroups. Approximate divergence times were estimated for the lineages leading to knobcone pine and to the intermediate and northern populations of bishop pine. The position of Monterey pine relative to bishop pine within their monophyletic clade was unresolved. Surprisingly, Montery pine and the southern race of bishop pine were much more similar to one another than was the southern race of bishop pine to its conspecific intermediate and northern races. Both the Monterey and southern bishop pine lineages also evolved severalfold more slowly than did the knobcone pine and intermediate-northern bishop pine lineages.(ABSTRACT TRUNCATED AT 250 WORDS)

Chloroplast DNA diversity among trees, populations and species in the California closed-cone pines (Pinus radiata, Pinus muricata and Pinus attenuata)

The amount, distribution and mutational nature of chloroplast DNA polymorphisms were studied via analysis of restriction fragment length polymorphisms in three closely related species of conifers, the California closed-cone pines-knobcone pine: Pinus attenuata Lemm.; bishop pine: Pinus muricata D. Don; and Monterey pine: Pinus radiata D. Don. Genomic DNA from 384 trees representing 19 populations were digested with 9-20 restriction enzymes and probed with cloned cpDNA fragments from Douglas-fir [Pseudotsuga menziesii (Mirb.) Franco] that comprise 82% chloroplast genome. Up to 313 restriction sites were surveyed, and 25 of these were observed to be polymorphic among or within species. Differences among species accounted for the majority of genetic (haplotypic) diversity observed [Gst = 84(+/- 13)%]; nucleotide diversity among species was estimated to be 0.3(+/- 0.1)%. Knobcone pine and Monterey pine displayed almost no genetic variation within or among populations. Bishop pine also showed little variability within populations, but did display strong population differences [Gst = 87(+/- 8)%] that were a result of three distinct geographic groups. Mean nucleotide diversity within populations was 0.003(+/- 0.002)%; intrapopulation polymorphisms were found in only five populations. This pattern of genetic variation contrasts strongly with findings from study of nuclear genes (allozymes) in the group, where most genetic diversity resides within populations rather than among populations or species. Regions of the genome subject to frequent length mutations were identified; estimates of subdivision based on length variant frequencies in one region differed strikingly from those based on site mutations or allozymes. Two trees were identified with a major chloroplast DNA inversion that closely resembled one documented between Pinus and Pseudotsuga.

The sixth Nationwide Tuberculosis Prevalence Survey in Korea, 1990

SETTING

Nationwide random sample survey for tuberculosis in 1990.

OBJECTIVE

To investigate the prevalence of tuberculosis infection, morbidity and drug resistance and BCG coverage, and to compare the findings with those of the previous 5 surveys.

DESIGN

The following investigations were performed: tuberculin test, BCG scar screening, chest miniature radiography (70 mm x 70 mm) for those aged over 5 years, sputum direct smear, culture and drug susceptibility test, and a questionnaire to obtain history of chemotherapy and symptoms.

RESULTS

The coverage of the investigation has been of more than 95% in each survey. The main findings are as follows: BCG coverage of those aged under 30 and of infants (aged under 1 year) has increased from 24% to 86% and from 1% to 79% respectively. The observed tuberculin positivity (> or = 10 mm in diameter) of subjects aged under 30 has decreased from 45% to 27%. The reduction of positivity was significant in children aged 5-9 years, from 34% to 8%. The annual risk of infection has dropped by over 6% annually. The prevalence of pulmonary tuberculosis per 100,000 has decreased: direct smear-positive from 690-143, smear and/or culture positive from 940-241 and active cases from 5065-1842 respectively. The drug resistance rate had increased to the peak of 47% in 1980, but had decreased to 27% in the last survey.

CONCLUSION

The tuberculosis situation has improved significantly in every aspect in the last 25 years.

High levels of population differentiation for mitochondrial DNA haplotypes inPinus radiata, muricata, andattenuata

We analyzed mitochondrial (mt) DNA restriction fragment length polymorphisms (RFLPs) associated with cytochrome oxidase, subunit I (coxI)-related gene sequences in 268 trees derived from 19 natural populations of three species of pines from California (USA): Monterey pine (Pinus radiata D. Don), bishop pine (P. Muricata D. Don), and knobcone pine (P. attenuata Lemm.). Total genomic DNA was digested with four restriction endonucleases and probed with a 750-bp fragment of the mitochondrialcoxI gene amplified fromP. attenuata via the polymerase chain reaction (PCR). ThecoxI gene is repeated at least 4 times in some populations, and all variants that we observed resulted from complex rearrangements rather than from point mutations. There was limited intrapopulation variation, but strong differentiation among populations. When applied to haplotype frequencies, Nei's gene diversity within populations (Hs) averaged 7% (±3), and Gst varied from 75% forP. Radiata to 96% forP. muricata. The high degree of population differentiation for mtDNA suggests that it can be a powerful marker of population differences, but its rapid rate of structural evolution appears to result from recombination among a limited number of repetitive elements-giving frequent homoplasious fragment phenotypes. The phylogenetic trees disagreed with results from chloroplast DNA, nuclear gene, and morphological studies.

Drug resistance of Mycobacterium tuberculosis in Korea

Drug resistance of Mycobacterium tuberculosis has been investigated with isolates from patients screened from a sample population of the nationwide tuberculosis prevalence surveys or from routine cultures. The results showed a close inverse relationship between the prevalence of drug resistance and the efficiency of the past or current National Tuberculosis Control Program (NTP) treatment regimens. Individual drug resistance also showed a close relationship with the extent of use of the relevant drugs. Drug resistance was found in 38.0% of M. tuberculosis isolates from patients in the 1965 survey and remained unchanged until it increased to 48.0% in 1980. The resistance prevalence, however, dropped to 25.3% in the 1990 survey. Such a decrease coincided fairly well with a continuous increase of the treatment efficiency (from 60% in 1984 to 77% in 1989) in the 1980s. Initial drug resistance (IR) also showed a similar trend, namely 26.2% in 1965, 23.9% in 1970, 20.1% in 1975, 30.6% in 1980, 17.4% in 1985 and 15.0% in 1990. A higher prevalence of IR was observed among urban patients than rural patients and among young as opposed to old patients.

A contact study to evaluate the BCG vaccination programme in Seoul

A contact study was undertaken in Seoul to determine the protective effect of the BCG programme in children up to 5 years of age. There were 1993 contact children to 4484 smear-positive patients with pulmonary tuberculosis. 1223 completed the examination, 806 had evidence of BCG vaccination, 417 had not. In total, 129 or 126 children were considered cases of tuberculosis according to radiological/clinical classification or scoring system, respectively. For the unvaccinated the respective numbers of cases were 84 and 80 and for the vaccinated 45 and 46. The data were stratified for factors that could have distorted comparability: age and sex, relationship of index case, feeding habits, room occupancy, treatment history of index case and health centre that diagnosed the index case. Only age was found to have a small effect. Correcting for this, the observed level of protection was 74% with 95% confidence limits of 62% and 82%. It appeared to be the same for all types of disease observed.

Comparison of a daily and three intermittent retreatment regimens for pulmonary tuberculosis administered under programme conditions

One daily and 3 thrice weekly retreatment regimens given for 12 months under programme conditions were compared. The daily regimen was rifampicin and ethambutol (RE7). The three intermittent regimens also contained rifampicin and ethambutol: one of them, rifampicin and ethambutol throughout (RE3); the next one supplemented with pyrazinamide for the first 3 months (REZ3); the last one supplemented with prothionamide for the first 3 months (REPt3). The pyrazinamide containing regimen was subdivided into ordinary and high dose groups. The subjects for retreatment were those who have had, at least, more than 6 months of initial triple chemotherapy of isoniazid, PAS and streptomycin at the health centres, and failed to convert to bacteriologically negative status. Among 419 patients who were available for sensitivity tests before commencing retreatment, 393 (94.3%) were resistant to isoniazid. Six hundred and seventy-four patients (674) were allocated randomly to the regimens: 64 patients were excluded due to various pretreatment reasons and 109 did not complete 12 months of chemotherapy. There remain 501 patients who completed their retreatment. As assessed at 12 months, a bacteriologically favourable response was achieved in 68% of 135 RE7 patients, 62% of 129 RE3 patients, 74% of 132 REZ3 patients, and in 79% of 108 REPt3 patients. Adverse reactions were uncommon: 4% in RE7, 5% in RE3 and 9% in REZ3, but 32% in REPt3. Relapse rates during 2 years after termination of chemotherapy were 15% in RE7, 14% in RE3 and REZ3, and 26% in REPt3, as calculated by life table analysis.

An analysis of pulmonary tuberculosis data in Taiwan and Korea

An analysis is carried out on pulmonary tuberculosis survey data from Taiwan and Korea. A mathematical model based on a Markov process is developed and used to estimate transition rates between various disease states, as well as certain 'infection parameters', which measure the strength of the relative contributions of different disease states and of endogenous reactivation to the incidence of tuberculosis in the population. It is found that endogenous reactivation plays a primary role in generating cases, followed by chronic sources of infection, particularly those with drug-sensitive organisms. Some recommendations are made with regard to optimizing treatment regimens. The methodology can easily be applied to other countries.