Prevalence of asthma and allergic rhinitis among adult population in Ulaanbaatar, Mongolia

Background

Mongolia is changing lifestyle, unhealthy habits, increase of air pollution, increasing life expectancy have led to an up rise of chronic respiratory diseases. Over 10 years ago, the prevalence of asthma and allergic rhinoconjunctivitis in Mongolia were in the lower range reported from previous studies.

Objective

The main aim of the survey is to know the prevalence of asthma and allergic rhinitis among adult population of Ulaanbaatar city, Mongolia and their risk factors.

Methods

Total of approximately 1,200 adults aged 20 years and over were planned to be randomly selected. The questionnaire was developed on the basis of WHO Protocol for Assessment of Prevalence of Major Respiratory Diseases and modified by local risk factors assessment and by other international survey approach including Global Initiative for Asthma and European Community Respiratory Health Survey.

Results

Prevalence of current wheezer in all age group was 15.7% (95% CI: 14.7-16.8). Age and sex segregated distribution of current wheezer were defined among male and female and prevalence was 14.5% (95% CI: 13.3-16.2) in male and female 16.6% (95% CI: 15.2-18.3) respectively. Prevalence of diagnosed asthma among adults was 4.7% (95% CI: 4.3-5.6) in all age group, 3% (95% CI: 2.4-3.7) in male and 6.8% (95% CI: 5.8-7.9) in female. Prevalence of rhinoconjunctivitis was 14.6% in all age group. 28.4% out of subjects with allergic rhinitis has current asthma, while 11.6% of subjects without allergic rhinitis has asthma (p < 0.01).

Conclusion

The prevalence of asthma increased for one decade in Ulaanbaatar. Prevalence of diagnosed asthma is approximately 5% and current wheezer is approximately 15% in adults of population, which is close to other Asia and European countries. Allergic rhinitis is a risk factor for asthma.

Microsatellite polymorphisms of the MICA gene among Japanese patients with Behçet's disease

BACKGROUND

Behçet's disease (BD) is a multisystemic inflammatory disease of unknown origin. Because some researchers have recently suggested a primary association of BD with the A6 allele of the human major histocompatibility complex class I chain-related A (MICA) gene, we investigated microsatellite polymorphisms of the MICA gene in subjects with and without BD.

METHODS

This was a case-control study of 23 Japanese patients with BD and 23 Japanese volunteers without BD who were compared for MICA microsatellite polymorphisms using the polymerase chain reaction (PCR). We also analysed associations between 5 MICA alleles and the clinical features of patients.

RESULTS

There was no significant difference between case patients and control subjects in phenotype frequencies. The MICA-A6 allele showed the strongest positive correlation with the human leukocyte antigen allele HLA-B51. Allele A5 showed a strong positive correlation with age at onset and a strong negative correlation with iridocyclitis and HLA-B51. A4 showed a strong negative correlation with ocular lesions and HLA-B51. Patients with the MICA-A6 allele had significantly higher HLA positivity than patients without the allele.

INTERPRETATION

While the MICA-A6 allele had no significant association with BD, it showed a strong association with HLA-B51. This finding suggests that an association between MICA-A6 and BD may be a secondary phenomenon related to HLA-B51. As several associations with MICA alleles and clinical features have been found, further investigation is expected to elucidate the biological mechanism of action of the MICA protein relative to disease onset.

Inhibitory effect of acetic acid on growth of hyperthermophilic archaeon Pyrococcus furiosus

The growth inhibition of Pyrococcus furiosus by acetic acid was stronger than that by hydrogen and could be described by a non-competitive inhibition model in which the inhibition constants of undissociated acetic acid, K(p) and n, were estimated to be 0.69 mM (25 mM total acetic acid at pH 6.5; pKa=4.96; 98 degrees C) and 1.0, respectively. In order to reduce the acetic acid inhibition, repeated-batch culturing was performed using a filtration module. This yielded 0.49 g of dry cells l(-1) after growth for 12 h after inoculation. It became impossible, however, to continue repeated-batch culturing manually because the time intervals for medium replacement became too short. In order to automatically maintain a low concentration of acetic acid, a perfusion culture was carried out in which medium feeding coupled to a pH-auxostat was performed. In this perfusion culture, it was possible to maintain the acetic acid concentration below 7.6 mM during exponential growth of P. furiosus, resulting in 1.8 g of dry cells l(-1) at 15 h after inoculation.

Research report: Frequencies of mica gene polymorphism: a comparison between Indonesians on Bacan Island and suburban Japanese

MHC class I chain related gene A (MICA) is located near the HLA-B gene on the short arm of human chromosome 6. In the transmembrane (TM) of region of MICA, there is a trinucleotide repeat (GCT/AGC) microsatellite polymorphism in exon 5. Five alleles with 4, 5, 6 and 9 repetitions or 5 repetitions with 1 additional nucleotide insertion (GGCT) are identified and they were named A4, A5, A5.1, A6, and A9 respectively. We report the allele frequencies of 127 Indonesians on Bacan Island and 250 Japanese in the Kanto area. From the genotyping result, the frequency among Indonesians was as follows: A4 15.4%, A5 26.0%, A5.1 16.5%, A6 5.5%, and A9 36.6%. The frequency among Japanese was as follows: A4 20.6%, A5 28.1%, A5.1 10.8%, A6 27.2%, and A9 13.2%. Allele 9 is significantly increased and allele 6 significantly decreased in Indonesians compared with Japanese subjects. The results suggested that MICA microsatellite polymorphism are quite different in each race. Among Indonesians, the frequency of MICA-A9 allele, which was reported to be negatively associated with Behçet's disease, was significantly higher, whereas the MICA-A6 allele frequency, which was reported to be positively associated with Behçet's disease, was significantly lower among Japanese.

[Analysis of SMON at 30 years after its outbreak ending: special reference to those patients with blindness]

We analysed the present state of those SMON patients with severely disturbed visual acuity. In medical screening of SMON Research Group at 1999, 52 out of 1,083 patients and 549 out of 1128 had their histories of complete blindness and complete loss of locomotion ability at the onset of SMON, respectively. Eighty one out of 1,149 patients showed severe visual impairment, including 22 with complete blindness. The number of patients with complete loss of locomotion and that of gait with cane/assistance were 59 and 443, respectively. Then, a large number of SMON patients have been still suffering from sequelae of clioquinol intoxication. Those patients groups with blindness and severe visual acuity yet showed after 30 years more severe disorders in locomotive activity, muscle strength and spasticity of lower extremities, degree of dysesthesia as well as vibratory sensory deficit, and ADL score. Those patients with complete or near complete blindness were profoundly handicapped so that the ratio of patients with a life-long institutionalization was high compared to the groups with less severe visual disturbance. Thus, it seems necessary to make a more extensive and meticulous supports for those SMON patients with blindness as they are in need of more finance and care providers.

A study among related pairs of Japanese patients with familial Behçet's disease: group comparisons by interval of disease onsets

OBJECTIVE

To investigate the relationship between clinical features and the interval between onset of disease in pairs of related Japanese patients with Behçet's disease (BD).

METHODS

Questionnaires were sent to hospitals in which patients with familial occurrence of BD had been treated according to previous nationwide hospital surveys, and to an additional 341 hospitals selected at random.

RESULTS

A total of 35 patients (19 male, 16 female) in 17 families (19 related pairs) were reported. The positive rate of HLA-B51 was 60.9% (14/23). The familial pairs were divided into 2 groups, with the mean interval between disease onset between each pair being either < or = 9 years or > or = 10 years. Among the short interval group, the total number of clinical findings and difference in age of onset was significantly larger than the long interval group. The interval between onsets had a high positive correlation with concordance of clinical findings and a high negative correlation with the difference in onset age. Difference in onset age had a higher negative correlation with same sex. Moreover, age difference had a high negative correlation with HLA-B5 (B51). Analysis of data showed that the related pairs with the short interval between onsets had larger difference in onset age and greater concordance of symptoms than the long interval patients.

CONCLUSION

Although our findings did not show any direct evidence of an environmental cause in the etiology of BD, we speculate that there may be a multifactorial etiology including genetic factors such as HLA-B51 positivity.

[Allergic rhinitis epidemiology in Japan]

We epidemiologically surveyed allergic rhinitis nationwide, mailing questionnaires to 9,471 otorhinolaryngologists and their families nationwide in June 1998 responses by the end of September 1998: 42.8%, providing 17,301 subjects. Few differences were seen in the age composition between the subject population and the general Japanese population. Cedar pollinosis morbidity after adjustment for population distribution was 17.3%, higher overall on the Pacific Ocean side and in central districts of Japan compared to districts on the Sea of Japan and the Inland Sea and lower in high or low latitudes. By age, morbidity increased sharply among subjects in their teens and decreased among subjects in their 60s. Morbidity was high in districts of heavy cedar pollen dissemination. By housing, morbidity was high in the suburbs, followed by residential areas and cities. Pollinosis due to causes other than cedar pollen showed results similar to those for cedar pollinosis in morbidity by age and the relationship between the housing environment and morbidity, with morbidity after population distribution adjustment 11.7%. Morbidity of perennial allergic rhinitis after adjustment for population distribution was 19.8% was slightly higher than that of pollinosis. By age, morbidity increased sharply at 5 to 9 years of age, being highest in the young than in cedar pollinosis; no decrease in morbidity after age 60 was seen. Unlike cedar pollinosis, perennial allergic rhinitis showed no difference in morbidity by area or housing environment. The present survey using otorhinolaryngologists and their families nationwide as subjects enabled us to find areawise differences in morbidity for cedar pollinosis and perennial allergic rhinitis. Ours is useful epidemiologically in allergic rhinitis mainly for cedar pollinosis in Japan because it is superior to other questionnaires in response and because reply reliability is high.

A Study of Familial Occurrence of Behçet's Disease With and Without Ocular Lesions

PURPOSE

To examine retrospectively the features of Behçet's disease patients with familial occurrence and make a comparison between familial Behçet's patients with ocular lesions and those without ocular lesions.

METHODS

We sent questionnaires about Behçet's disease patients with familial occurrence to 114 hospitals that reported treating such patients in previous nationwide hospital surveys, and to 341 hospitals selected at random in Japan.

RESULTS

We obtained reports on 83 Behçet's patients with familial occurrence. The positive rate of HLA-B51 was 53.1%. The positive rate of HLA-B51 among patients with ocular lesions was 64.0%, that in patients without ocular lesions was 14.3%, and that in patients with genital ulcers was 40.9%. The mean birth year and onset year of the patients with ocular symptoms was significantly lower than that of the patients without ocular symptoms. Although there was no significant difference between these two groups, parent-child involvement was more common among the patients without ocular lesions than in those with ocular lesions.

CONCLUSIONS

The findings of this study suggest that the number of familial Behçet's disease patients with ocular lesions and high HLA-B51 positivity has been decreasing recently. To elucidate the etiology of familial occurrence, larger scale epidemiological studies and further molecular studies of Behçet's disease are needed.

Molecular analysis of familial androgen insensitivity syndrome due to replacement of glutamic acid 802 by lysine

We studied a Japanese family presenting at least two cases of complete androgen insensitivity syndrome (CAIS) and negative androgen receptor binding. The index subject showed a 46, XY karyotype and a complete female phenotype. For the purpose of further diagnosis and genetic counseling, molecular analysis of the androgen receptor (AR) gene was performed. Direct sequencing of the AR gene identified a mutation at nucleotide 2935 (A-->G). This replacement was a novel missense mutation, resulting in the substitution of glutamic acid 802 by lysine which deleted a recognition site for EcoRI in exon 6 of the AR gene. We identified another affected individual, using chromosome and molecular analysis of the AR gene at exon 6. Furthermore, although heterozygote carriers could not be identified on clinical grounds, molecular identification of healthy individuals and heterozygote carriers in the family members provided definitive information for genetic counseling. We believe that the molecular analysis of familial CAIS is very informative for both the affected individuals and other family members.

[Effects of topical prostaglandin analogues on the aqueous flare intensity in rabbit eyes at an early phase of endotoxin-induced uveitis]

PURPOSE

We examined the effects of prostaglandin analogues on the blood-aqueous barrier(BAB) permeability in rabbit eyes at an early phase of endotoxin-induced uveitis(EIU).

SUBJECTS AND METHODS

One drop of 0.005% latanoprost or 0.12% unoprostone were applied to rabbit eyes. Escherichia coli lipopolysaccharides were injected to induce uveitis. The changes in flare intensity in normal eyes and EIU eyes after application of eye drops were evaluated. The effect of cyclooxygenase inhibitor on the flare intensity changes caused by the application of unoprostone was also examined.

RESULTS

Flare intensity increased significantly after a single instillation of unoprostone, and the increase was not prevented by pretreatment with cyclooxygenase inhibitor. In eyes with EIU, unoprostone caused an additional increase of flare intensity to uveitis induced flare change. Latanoprost had no effects on BAB in eyes with normal and with uveitic conditions.

CONCLUSION

Latanoprost and unoprostone did not cause an excessive inflammatory reaction in rabbit eyes at an early phase of EIU.

Migrastatin, a new inhibitor of tumor cell migration from Streptomyces sp. MK929-43F1. Taxonomy, fermentation, isolation and biological activities

A new compound, migrastatin, was isolated from a cultured broth of Streptomyces sp. MK929-43F1, as an inhibitor of tumor cell migration. It was purified by column chromatographies on silica gel and Sephadex LH-20 and HPLC. Migrastatin has the molecular formula of C27H39NO7 consisting of 14-membered macrolide and glutarimide moiety. It inhibited spontaneous migration of human esophageal cancer EC17 cells. Migration inhibitory activity of migrastatin was not dependent on cytotoxicity or inhibition of protein synthesis.

The human behavioral and socioeconomic determinants of malaria in Bacan Island, North Maluku, Indonesia

In eastern Indonesia, malaria control activities mainly depend on residual spraying but the situation is almost unchanged since the past decade. Understanding the socioeconomic and human behavior determinants is needed to implement an effective malaria control in accordance with the local condition and development. Hence we conducted an unmatched case control study. Two hundred samples were recruited from all, 11 villages surrounding the centre in Bacan Island, Maluku. For children aged 0 to 15 years old, the association of socioeconomic determinants: crowding and poor type of houses with malaria remained significant in the multivariate analysis. Meanwhile for persons above 15 years old, younger persons and regular going outside at night remained significant in the multivariate analysis. And for persons above 15 years old, a higher proportion of controls (14%) than cases (4%) slept under mosquito net regularly. The Indonesia Family Program should be promoted. There was a better quality of life in small family. For persons above 15 years old, going outside at night should be discouraged because exposed to mosquito bites. The malaria control strategy use of effective personal, regular use of mosquito net could be used as a completion for the present activities. Considering the low malaria knowledge among samples, inhabitants should be enhanced the malaria knowledge on causation, transmission, prevention and to provide proper knowledge on residual spraying.

The comparison of tuberculosis treatments: a short course therapy and the directly observed short course treatment (DOTS), East Java Province, Indonesia

Tuberculosis has been given great attention as HIV/AIDS has increased. Because HIV causes a higher tuberculosis risk is becoming more and more important better tuberculosis treatment. This study aimed to compare the smear conversion rate between short course therapy and the tuberculosis treatment with directly observed short course therapy (DOTS), in East Java, Indonesia. The average smear conversion rate in short course therapy among 35,292 cases was 94.40% over 5 year period (1989/90-1993/94). The tuberculosis treatment with DOTS was started in 1994/95. In the first 2 years the smear conversion rate were 97.67% (42/43) and 98.00% (196/200), respectively. The smear conversion rate of the treatment with DOTS was significantly higher compared to a short course therapy (p-value: <0.001). Thus, tuberculosis treatment with DOTS should be promoted. The concept of supervision by health workers or health cadres should be applied considering mostly are given by family members. And there should be readiness of tuberculosis staff to do the treatment with DOTS in all levels to expand the coverage.

Factors associated with TT (tetanus toxoid) immunization among pregnant women, in Saparua, Maluku, Indonesia

A cross sectional study was conducted at Saparua Health Center to determine factors associated with the administration of tetanus toxoid. In all, 64 pregnant women were recruited. The majority of the women were housewives, aged 17 to 30 years old, and having more than one child. They were educated to high school, knew some information on tetanus toxoid, and knew at least one of the tetanus symptoms. Almost all did not know the cause of tetanus. The logistic regression of knowledge on tetanus and TT immunization: mothers who heard of TT were 1.54 more likely to have been immunized than those who did not, while mothers who knew the use of tetanus toxoid were 2.15 times more likely to have been immunized than those who did not, and those who knew at least one of the tetanus symptoms were 1.86 times more likely to have been immunized than those who did not, respectively controlling other variables constant. Furthermore, women who had antenatal care were 30 times more likely to have been immunized than those who did not. Enhancing mothers knowledge on tetanus is important to increase the coverage of tetanus toxoid. Moreover, antenatal care would cause contact with sources of tetanus toxoid and hence increase the chance of having the immunization. At the same time, this decreases tetanus neonatorum. Considering the majority of pregnant women received information on tetanus from healthworkers, the use a variety of media would be advantageous.

Complete epiretinal membrane separation in highly myopic eyes with retinal detachment resulting from a macular hole

PURPOSE

Epiretinal membranes (ERMs) in highly myopic eyes may result in macular holes and subsequent retinal detachment. However, removing friable, thin ERMs from detached retinas is often difficult. We report the efficacy of a diamond-dusted silicone cannula in the removal of ERMs from detached retinas.

METHODS

Seventeen consecutive highly myopic eyes (16 patients) with retinal detachment underwent pars plana vitrectomy with gas tamponade. Peeling of the ERM adjacent to the macular hole was performed using either conventional tools (n = 11) or a diamond-dusted silicone cannula (n = 6). The rate of complete membrane peeling and the effect of membrane removal on the anatomic success rate were compared between groups.

RESULTS

Retinal reattachment occurred in 13 (92.9%) of the 14 eyes in which the ERM was removed completely; redetachment occurred in the other three eyes, with further surgical interventions in two eyes. The reattachment rate was significantly higher (P = .005) when ERM removal was complete than when there was residual ERM. In the initial surgery, the ERM was successfully removed in all 6 eyes (100%) in the diamond-dusted silicone cannula group and in 5 of 11 eyes (45.5%) in the conventional group (P = .041); the reattachment rate was 100% in the diamond-dusted silicone cannula group and 45.5% in the conventional group (P = .005). When a second surgery was performed, the use of the diamond-dusted silicone cannula was also better than conventional tools for removing the residual ERMs, resulting in retinal reattachment.

CONCLUSION

In highly myopic eyes with a macular hole and subsequent retinal detachment, complete ERM removal is closely related to successful retinal reattachment. The diamond-dusted silicone cannula appears to be more effective than conventional tools for removing ERM and may increase the anatomic success rate. Because of the limitations of a small series, a prospective, randomized trial is required to confirm the current beneficial results of using a diamond-dusted silicone cannula.

A central role for Stat3 in IL-6-induced regulation of growth and differentiation in M1 leukemia cells

Interleukin-6 (IL-6) induces either differentiation or growth of a variety of cells. Little is known about the molecular basis of this cellular decision. The family of signal transducer and activator of transcription (Stat) proteins are involved in signaling through a variety of cytokine and growth factor receptors, although their biological roles have not been established. To address whether Stat proteins play roles in IL-6-induced growth or differentiation, we introduced two types of mutant Stat3 acting in a dominant-negative manner into M1 leukemic cells which respond to IL-6 with growth arrest and terminal differentiation. We show that dominant-negative forms of Stat3 inhibited both IL-6-induced growth arrest at G(0)/G1 and macrophage differentiation in the M1 transformants. Blocking of Stat activation resulted in inhibition of IL-6-induced repression of c-myb and c-myc. Furthermore, IL-6 enhanced the growth of M1 cells primarily through shortening the length of the G1 period when Stat3 was suppressed. Thus IL-6 generates both growth-enhancing signals and growth arrest- and differentiation-inducing signals at the same time. Stat3 may be a key molecule which determines the cellular decision from cell growth to differentiation in M1 cells.

Cytokine effects on phagocytosis of rod outer segments by retinal pigment epithelial cells of normal and dystrophic rats

PURPOSE

Phagocytosis of rod outer segments (ROS) is an important function of retinal pigment epithelial (RPE) cells. Since the details of the process are not fully known, we studied effects of cytokines produced by RPE and photoreceptor cells on phagocytosis of ROS by rat RPE cells.

METHODS

RPE cells were isolated and cultivated from two strains of rats: Sprague-Dawley (SD) rats with normal phagocytosis and Royal College of Surgeons (RCS) rats, which have genetic deficiencies in ROS phagocytosis. A double immunofluorescence staining technique was used to study the effects in vitro of several cytokines on phagocytosis of ROS.

RESULTS

We found that transforming growth factor beta-1 (TGF-beta 1) had dose-dependent effects on RPE cells of both strains of rat: at a concentration of 10 ng/ml, TGF-beta 1 significantly (p < 0.01) reduced total ROS (to 74% of control in SD rats and to 51% of control in RCS rats), reduced bound ROS (to 56% of control in SD rats and to 48% in RCS rats), and increased the ratio of ingested ROS to total ROS (to 140% in SD rats but not significantly in RCS rats). Treatment of medium with anti-TGF-beta 1 antibody before incubation of RPE cells of SD rats with TGF-beta 1 decreased the magnitude of these effects. The cytokine acidic fibroblast growth factor (aFGF, 10 ng/ml) affected RPE cells of SD rats only, decreasing ROS ingested to 56% of control and the ratio of ingested ROS to total ROS to 64% of control. We also examined effects of basic fibroblast growth factor and insulin-like growth factor. None of the cytokines tested increased ingestion of ROS by RPE cells of RCS rats.

CONCLUSIONS

Our results suggest that TGF-beta 1 and aFGF have roles in regulating ROS phagocytosis by normal and dystrophic RPE cells in the rat.

ERM, a PEA3 subfamily of Ets transcription factors, can cooperate with c-Jun

A human cDNA clone for ERM, a member of the ets gene family, has been obtained by polymerase chain reaction with degenerate primers corresponding to highly conserved regions within an Ets DNA binding domain. ERM mRNA is expressed ubiquitously. The gene was mapped to chromosome 3q27. In in vivo transient-expression assays, ERM induced transcription more efficiently from a synthetic element containing both an ets-binding site (EBS) and a cyclic AMP response element (CRE) than from one containing an EBS alone. The activation of a synthetic EBS-CRE site by ERM was likely to involve a leucine zipper protein capable of dimerizing with CRE-BP1 leucine zipper. Indeed, ERM and c-Jun synergistically activated the EBS-CRE without making an apparent ternary complex. The synergy between c-Jun and ERM may be attributed to the enhancing effect of c-Jun on the transcription activity of ERM, because c-Jun increased ERM transcription activity by more than 20-fold in an assay system using a variety of fusion proteins between a Gal4 DNA-binding domain and a portion of ERM. This enhancing effect of c-Jun required the amino-terminal portion of ERM.

Effects of endurance training on gene expression of insulin signal transduction pathway

Alternative splicing of insulin receptor mRNA and gene expression of insulin receptor, IRS-1 and MAP kinase isoforms were examined in skeletal muscle of trained and sedentary rats. Adult male Sprague-Dawley rats were trained for 9 weeks on a treadmill: 30 m/min at 6 degrees incline, 90 min/day, 5 days/week. Endurance training increased insulin receptor mRNA level without change in alternative splicing of insulin receptor mRNA in skeletal muscle. The levels of IRS-1 and MAP kinase (ERKI) mRNA were significantly higher in trained rats than sedentary rats. Our findings provide the first evidence that gene expression of insulin receptor and postreceptor signal transduction pathway is enhanced by endurance training, without affecting alternative splicing of insulin receptor isoforms.

Transcriptional activation of the IL-6 response element in the junB promoter is mediated by multiple Stat family proteins

IL-6 signals activate an IL-6 response element in the junB promoter, JRE-IL6, in a Ras-independent manner. IL-6 rapidly induced a DNA-binding activity to the Ets binding site of JRE-IL6 (JEBS), one of necessary DNA motifs of the IL-6 response element. The IL-6-induced JEBS-binding activity was indistinguishable from those to acute phase response element (APRE) in both kinetics of induction and its DNA-binding specificity. Purified APRE binding factors (APRFs) from IL-6-stimulated rat liver were found to be composed of multiple Stat3-related proteins and Stat1. Moreover the purified APRFs specifically made a complex with JRE-IL6 with the same mobility as that observed in the crude extracts. These results indicate that an immediate early signal of IL-6 leading to activation of JRE-IL6 is mediated by STAT family transcription factors.

[Studies on the reduction and correction risk factors for arteriosclerosis in junior high school pupils]

Circulatory system examinations performed on first-grade pupils of junior high schools (12 years old; N = 1,204), identified 105 high-risk pupils with arteriosclerosis-promoting factors. These pupils were consulted on life-style modification, emphasizing nutrition and exercise, and encouraged to practice personal health management and self-monitoring. Reduction and correction of high risk factors were studied in these subjects, based on review of results of health examinations performed regularly up to the time of their graduation. Results are as follows: 1. Averages for obesity grade (for both sexes) in the second and the third years were significantly lower than that in the first year. Based on a general reference value > or = 20%, improvements were observed in 22.5% of males and 50.0% of females. 2. In both sexes average total cholesterol (TC) and triglyceride (TG) were lower in the second and the third years than in the first year, and a significant increase in HDL cholesterol was seen. With regard to a general reference value > or = 3.0 for AI (Atherogenic Index) calculated using TC and HDL cholesterol, improvements (reduction) were observed in 29.4%, of males and 46.2% of females. 3. While the numbers of subjects with elevated SBP, DBP, GPT, FPG and BUN were few, there were significant decreases in averages in the second and third years compared with those in the first year. Using general reference values, improvements in these risks were seen in 100% for all values except for GPT where 75.0% showed improvement. 4. Comparison of grouped distribution of summed values of examination results between the first year and the third year, showed improvements (reduction and correction of risks) in 69 pupils (65.7%), while 30 pupils (28.6%) remained in the same group with no improvement and 6 pupils (5.7%) turned for the worse, dropping one rank.(ABSTRACT TRUNCATED AT 250 WORDS)

Identification of a novel interleukin-6 response element containing an Ets-binding site and a CRE-like site in the junB promoter

Interleukin-6 (IL-6) activation of the immediate-early gene junB has been shown to require both a tyrosine kinase and an unknown 1-(5-isoquinolinesulfonyl)-2-methylpiperazine (H7)-sensitive pathway. Here we report the identification and characterization of an IL-6 immediate-early response element in the junB promoter (designated JRE-IL6) in HepG2 cells. The JRE-IL6 element, located at -149 to -124, contains two DNA motifs, an Ets-binding site (EBS) (CAGGAAGC) and a CRE-like site (TGACGCGA). Functional studies using variously mutated JRE-IL6 elements showed that both motifs were necessary and sufficient for IL-6 response of the promoter. The EBS of the JRE-IL6 element (JEBS) appears to bind a protein in the Ets family or a related protein which could also form a major complex with the EBSs of the murine sarcoma virus long terminal repeat or human T-cell leukemia virus type 1 long terminal repeat. The CRE-like site appears to weakly bind multiple CREB-ATF family proteins. Despite the similarity in the structure between the JRE-IL6 element and the polyomavirus enhancer PyPEA3, composed of an EBS and an AP1-binding site and known to be activated by a variety of oncogene signals, JRE-IL6 could not be activated by activated Ha-Ras, Raf-1, or 12-O-tetradecanoylphorbol-13-acetate. We show that IL-6 activates JRE-IL6 through an H7-sensitive pathway that does not involve protein kinase C, cyclic AMP-dependent kinase, Ca(2+)- or calmodulin-dependent kinases, Ras, Raf-1, or NF-IL6 (C/EBP beta). The combination of JEBS and the CRE-like site appears to form the basis for the selective and efficient response of JRE-IL6 to IL-6 signals, but not to signals generated by activated Ha-Ras, Raf-1, or protein kinase C.

[Prevention of cerebro-cardiovascular diseases by early intervention in youth]

A significant number of youth have obesity, hypertension, hypercholesterolemia and diabetes mellitus which are major risk factors for C.V.D and I.H.D. and which frequently occur after maturity. Analysis of lifestyle factors show a strong relationship between a series of these factors, and life style practices as typified by time-saving, dietary practice such as convenience foods, insufficient exercises, as well as family history of C.V.D. Prompt establish next of a system for screening high risk children with these factors and a corresponding support system for guiding and instructing them, is indicated. Studies should be performed from the viewpoint of life-cycle health management for establishing an integrated examination system for circulatory diseases for screening to follow-up.

[A cohort study on deaths from SMON in Japan]

Causes and risk factors of deaths from subacute myelo-optico neuropathy (SMON) were studied in a prospective cohort of 4,329 SMON patients followed for 3 years and 7 months (Sept. 1985-March 1989) with the following findings: (1) Recent excess deaths of SMON patients was estimated as 4% from ratio of O/E (SMR = 104) and deaths due to SMON itself was 6.4%. (2) The ratio of O/E was significantly higher for deaths from cancer of colon/rectum in females, cancer of pancreas in males, hypertension in males, pneumonia/influenza in females, chronic obstructive pulmonary diseases in males, tuberculosis and intestinal obstructive disease in males and females. (3) The ratio of O/E was 1.8 times or greater for those SMON patients with complications of cerebrovascular disease, severe blindness, complete loss of ambulation, and who were bedridden, and who are unable to receive home care from family members or trained home helpers.

[Epidemiological study of SMON death--from the observation of death certificates during a 13-year 6-month period from July 1972]

Eight hundred and twelve vital statistics death certificates, in which either the cause of death or complications was SMON, were selected from all the death certificates filed in Japan in a 13-year 6-month period from July 1972 to December 1985. In 411, or 50.6%, of these certificates, the SMON Research Committee had records of the clinical pictures as a result of the nationwide surveys conducted earlier. The epidemiological picture presented by the death certificates and the relationship between the information in these certificates and clinical records in nationwide surveys was observed. The results are summarized as follows: 1. The male/female ratio revealed in the 812 death certificates was 0.53, which is higher than those reported in nationwide surveys (0.4). 2. Although the yearly number of certificates was more than 70 in 1974 or before, it decreased year by year. The numbers in 1984 and 1985 were less than 50. 3. The leading underlying causes of death were; SMON in 44.0% of all the certificates, heart diseases in 10.3%, cerebrovascular diseases in 9.2% and malignant neoplasm in 8.6%. 4. The presence of clinical symptoms was compared between death cases and total cases reported by the nationwide surveys. Symptoms such as visual impairment and walking incapacity were seen more frequently in death cases. 5. From these results, it was suggested that the level of the severity of the disease at onset influences the long-term prognosis of the disease, although selection bias in the death certificates observed is unavoidable.

Double-masked trial of cyclosporin versus colchicine and long-term open study of cyclosporin in Behçet's disease

The efficacy and safety of oral cyclosporin 10 mg/kg per day in Behçet's disease were compared in a randomised double-masked study with those of colchicine, 1 mg orally per day, and were also investigated in a long-term open study. The double-masked study showed that cyclosporin was effective in treating not only the ocular manifestations of Behçet's disease but also oral aphthous ulcer, dermal lesions, and genital ulceration. Efficacy did not weaken during long-term treatment.