Perinuclear mitochondrial clustering creates an oxidant-rich nuclear domain required for hypoxia-induced transcription.

Mitochondria can govern local concentrations of second messengers, such as reactive oxygen species (ROS), and mitochondrial translocation to discrete subcellular regions may contribute to this signaling function. Here, we report that exposure of pulmonary artery endothelial cells to hypoxia triggered a retrograde mitochondrial movement that required microtubules and the microtubule motor protein dynein and resulted in the perinuclear clustering of mitochondria. This subcellular redistribution of mitochondria was accompanied by the accumulation of ROS in the nucleus, which was attenuated by suppressing perinuclear clustering of mitochondria with nocodazole to destabilize microtubules or with small interfering RNA-mediated knockdown of dynein. Although suppression of perinuclear mitochondrial clustering did not affect the hypoxia-induced increase in the nuclear abundance of hypoxia-inducible factor 1α (HIF-1α) or the binding of HIF-1α to an oligonucleotide corresponding to a hypoxia response element (HRE), it eliminated oxidative modifications of the VEGF (vascular endothelial growth factor) promoter. Furthermore, suppression of perinuclear mitochondrial clustering reduced HIF-1α binding to the VEGF promoter and decreased VEGF mRNA accumulation. These findings support a model for hypoxia-induced transcriptional regulation in which perinuclear mitochondrial clustering results in ROS accumulation in the nucleus and causes oxidative base modifications in the VEGF HRE that are important for transcriptional complex assembly and VEGF mRNA expression.

Active life expectancy for people over 65 years old in a local city in the northern part of Tohoku district.

Life expectancy does not necessarily match quality of life (QOL). A cohort study involving a population of 10,107 in a certain city of Japan was conducted to evaluate active life expectancy (ALE), which has a direct relationship with QOL. The ALE that took functional recovery rates into account was 17.20 and 19.08 years for males and females respectively, at the age of 65. These values increased by 2.98 and 3.87 years for men and women, respectively, compared with when functional recovery rates were not considered. ALE may serve as an indicator for the objective evaluation of various public health services provided by local governments.

Bone mineral density and osteo sono assessment index in adolescents.

The standard value for bone mineral density in the distal radius (R-BMD) and the osteo sono assessment index (OSI) in the os calcaneus for each sex and age in teenagers have not yet been fully reported. The R-BMD and OSI of junior and senior high school students were measured by dual energy X-ray absorptiometry (DEXA) or by a quantitative ultrasound technique. Subjects measured by DEXA included 635 junior and senior high school students (274 males and 361 females, aged 12-17 years). Ultrasound measurements were made for 2878 subjects (1733 males, 1145 females, aged 12-18 years). All subjects filled out questionnaires about their past history, family history, past and present eating habits, sports activities, and for females, the presence of menses, regularity of menses, and so on. The R-BMD in 15- to 17-year-old males was significantly higher than that in females. The R-BMD rate of increase in males was almost linear; the rate of increase in females was significantly highest from ages 12 to 13, after which R-BMD increased gradually. The OSI in 15- to 18-year-old males was significantly higher than that in females. The OSI rate of increase in males was almost linear from ages 12 to 17. The OSI in females, except in 14-year-olds, was roughly equal at each age. The OSI was significantly higher in those who regularly participated in sports, either currently or in the past. It was significantly higher in those who previously or currently consumed milk on a daily basis compared with those who had consumed little or no milk. To prevent osteoporosis, increasing peak bone mass is very important. Adequate calcium intake from dairy products which are rich in calcium and absorbed easily, and exercise in adolescence, are expected to result in increased bone formation and increased OSI.

A study on the daily physical activity of junior high school students in Japan.

The purpose of this study was to estimate daily energy expenditure (EE) and daily activity factor (DAF: EE/basal metabolism - 1) of junior high school students in Japan using heart rate (HR) monitoring method. Daily activity recording and 24 hour HR monitoring were measured in all the subjects. The relational formulas between HR and oxygen consumption were obtained from bicycle ergometer test. Subjects were 112 junior high school students (68 male and 44 female) from the 1st to the 3rd year. The averages of EE (kcal/kg) of the 1st, 2nd, and 3rd year students were 54.3, 46.7, and 44.5 (kcal/kg) for males and 50.1, 44.4, and 40.5 (kcal/kg) for females respectively. In the same way DAF were 0.80, 0.61, and 0.59 for males and 0.77, 0.65, and 0.51 for females. It was shown that EE (kcal/kg) and DAF have a tendency to decrease as school year increases in both male and female students.

A study of Atopic dermatitis in elementary school children in Hirosaki city, Aomori prefecture, Japan.

The purpose of this study was to investigate the relationship between residential environments and atopic dermatitis (AD). Subjects were 1378 elementary school children from 4 elementary schools in Hirosaki City, Aomori Prefecture located in die northeastern of Japan. Physical examinations, which adhered to the diagnostic criteria set by die Japanese Dermatological Association, were given by dermatological specialists in October 1994 (first series) and April 1995 (second series). Half of die children with AD showed symptoms in only one of two seasons, either the autumn or spring, so the drifting of symptoms of AD occurred largely by seasons. The data on residential environments was gathered by questionnaire. Multiple logistic regression analysis showed that more children who were diagnosed positive as AD twice (AD(+,+)), lived in damp and moldy homes than did children who were diagnosed negative as AD twice (AD(-,-)). Moreover AD(+,+) were more likely to live in homes built between 1984 and 1989 than did AD(-,-). In addition, most AD(+,+) children frequently lived in homes in which the bedrooms were vacuumed 3-5 times or more in a week. Then damp and moldy houses or houses built between 1984 and 1989 may be risk factors for the outbreak of AD.

One-year increment of fat mass and lean body mass of Japanese school children using bioelectrical impedance.

Bioelectrical impedance analysis (BIA) and skinfold thickness (SF) (triceps and subscapular) methods were applied to 436 Japanese school children (228 boys and 208 girls) aged from 9 to 11 years with a one-year follow-up to determine changes in body composition. By BIA oneyear increment (Δ) of lean body mass (LBM) for boys increased significantly (p<0.01) and Δ LBM was almost equivalent to that for Δ weight (Wt). Δ Wt and Δ fat mass (FM) between the age 10 (from ages 10 to 11) and age 11 (from ages 11 to 12) groups in girls achieved statistical significance (p<0.01 and p<0.001, respectively) and Δ Wt was almost completely comprised of the Δ FM in these age groups. Δ FM in die age 11 group for girls was statistically higher than that in the age 10 group, and this obvious increase of FM in the age 11 group was presumed to be die effect of menses in consideration of die maximum oneyear increment of Ht (Δ Ht) in die age 10 group.These results of the assessment of body composition by BIA supported those of previous reports, and therefore BIA can be considered as a useful mediod to estimate changes in body composition of school children because it is simple and non-invasive and can be performed rapidly.

Eating patterns, weight status and egogram characteristics among Japanese pupils.

The purpose of this study was to investigate the actual conditions of eating patterns and the relationships among eating patterns, degree of overweightness and egogram characteristics among pupils. The subjects were 871 boys and girls whose grades ranged from 4th to 6th. They were selected from five elementary schools in Hirosaki and its suburbs, Japan. They were classified into the following 5 groups by the degree of overweightness: lean group, standard group, slightly obese group, moderately obese group, and extremely obese group. Eating patterns were measured by questionnaries, and AN-egogram was used for the measurement of egogram characteristics.The results were as follows: 1. The ego state of pupils who eat their favorite dish even with a full stomach showed significantly lower A (adult) qualities and higher FC (free child) qualities than those who would not eat in this situation. The egogram pattern of the former pupils exhibited the NP (nurturing parent)-low type. 2. The egogram pattern of pupils who engage in substitutive food intake exhibited the NP-low type. 3. Significant differences existed among the ego states CP (critical parent), NP, A, and FC as to reasons given for eating between meals. 4. The egogram pattern of the person who eats between meals at the time of "an empty stomach" showed a flat type of ego state with relatively low NP. The person who eats "just at meal time" showed an A-dominant type. The person who eats "when food is present" showed an NP - low type with relatively low CP. 5. The ego state A was significandy less common in the extremely obese group than in the lean group. 6. The egogram pattern of the lean, standard, and slightly obese groups showed an A - dominant type of ego state, and that of moderately and extremely obese groups showed an AC-dominant type with CP slightly high.

[Relationship of atopic dermatitis to residential environment. A study of the comparison between diagnosis by medical examination and assessment by questionnaire].

Diagnosis of atopic dermatitis (AD) according to criterion of the Japanese Dermatology Society by medical examination and a questionnaire survey concerning the living environment and presence of allergic diseases were performed on 1725 elementary school children living in Hirosaki-city and its suburbs in Aomiri Prefecture. In addition a scratch test for mite antigen was conducted 523 of the children and a patch test on 240. No difference was found between the rate of children diagnosed as having AD during the medical examination which was 12.9%, and the rate of children who responded as presently having AD in the questionnaire which was 12.8%. However the rate of concordance between those diagnosed to have AD by medical examination and the group that responded as having AD in the questionnaire was about 50%. For AD in children diagnosed by medical examination, a residential environment of the houses that there were moldy and leaking appeared to be a risk factor. Risk factors of children with AD from the questionnaire survey appeared to be houses built within 20 years. Clearly there were differences in conclusions regarding risk factor between the medical examination and the questionnaire. In terms of increasing reliability, a medical examination would be preferred. From the results of allergic tests, the children who lived in houses built within 20 years had a high response to the patch test. These results suggest that houses that are moldy and leaking, or built within 20 years may be considered to be risk factors for outbreak of AD.

Evaluating rural Bangladeshi women's perspectives of quality in family planning services.

Several frameworks for understanding the quality of family planning care have been proposed. However, efforts to measure and quantify their components remain underdeveloped, especially with regard to nonclinical care and community-based distribution. This study examines a large-scale field survey conducted among married women of reproductive age in rural Bangladesh in 1989 and 1990 to measure and evaluate rural women's perceptions of the quality of outreach services they received. Initial analysis indicates that rural women are able to distinguish between good and poor quality of care and that these perceptions can be accurately documented and quantified through sample survey approaches. Implications of the use of a survey in the measurement of quality of care are discussed, as well as implications of the results for managers within the Bangladesh government family planning program, which has been regarded by donor agencies as having limited responsiveness to clients' needs.

PIP: While frameworks have been proposed for understanding the quality of family planning care, there has been too little effort to measure and quantify program components, particularly with regard to nonclinical care and community-based distribution. Findings are presented from a study which analyzed data from a large-scale field survey conducted among 10,127 married women of reproductive age in rural Bangladesh during 1989-90 to measure and evaluate their perceptions of the quality of outreach services they received. The initial analysis indicates that rural women are able to distinguish between good and poor quality of care and that these perceptions can be accurately documented and quantified through sample survey approaches. The authors discuss the implications of the use of a survey in the measurement of quality of care, as well as the implications of the results for managers within the Bangladesh government family planning program.

Diffusion of the culture of contraception: program effects on young women in rural Bangladesh.

This article describes a process of diffusion of family planning information, ideas, and technology among an unanticipated audience of young, unmarried women in rural Bangladesh. The data are derived from a focus-group study conducted in 1987-88 in the Maternal Child Health and Family Planning Project in Matlab, Bangladesh. A discussion with a staff member revealed her vivid memory of the arrival of the community-based family planning worker in her village 10 years earlier, before she was married. Based on this research lead, four focus-group sessions were held with newly married young women, and a set of questions about young women were incorporated into the sessions with other community women. The discussions showed that many young, unmarried women learn about family planning from an early age from the community-based family planning worker, from female relatives, peers, and the media. The findings of this exploratory study suggest that greater attention be paid to the contraceptive needs of young women and that continued research be conducted with this population of women.

PIP: During a focus group study examining the relationship between women's status and family planning in Matlab, Bangladesh, researchers learned that a group facilitator had clearly remembered the arrival of the community family planning worker in her village 10 years earlier when she was not yet married and the effect her arrival had on the facilitator and her friends. Four more focus group sessions with 15 young, recently married women (mean age = 16.7 years) and questions about young women were added to the study and session guidelines. The study revealed that the media was an important influence. These focus group discussions indicated that the family planning worker contributed greatly to the diffusion of information and ideas in the late 1970s, when the Matlab family planning/maternal and child health project began, and during the 1980s. The media, the rise of a culture of contraception, and the influence of modernization facilitated the family planning worker's role. Her presence in the community and the information disseminated through the media stimulated conversations. The interaction of peers and family members processed new knowledge and ideas. The Matlab project through its community workers introduced the idea that women can control their reproductive lives and consciously determine their family size. These findings emphasize the significant role of the female outreach worker in rural Bangladesh. They suggest that employment of women as community family planning workers may have had benefits other than those expected. The findings show the need for family planning programs to address the contraceptive needs of young, married women.

Resolution of type 1 reaction in multibacillary Hansen's disease as a result of treatment with cyclosporine.

Type 1 Hansen's disease reaction (reversal reaction) is believed to result from a change in the immune response in patients with borderline Hansen's disease. The only effective therapy for significant type 1 reactions has been systemic corticosteroid therapy. Cyclosporine is an immunosuppressive drug which has been widely used in organ transplantation. We report a case of type 1 reaction complicating borderline lepromatous Hansen's disease. Cyclosporine therapy resulted in prompt and sustained resolution of the reaction. The possible mechanism of action of cyclosporine and the implications regarding the immunopathogenesis of type 1 reaction are discussed.

Employment in family planning and women's status in Bangladesh.

This study investigates how employment in family planning affects the status of community workers. The focus is on three critical variables: prestige, professional status, and social influence. The data are derived from a focus-group study conducted in 1987-88 in the Maternal and Child Health and Family Planning Project in Matlab, Bangladesh. Focus-group sessions were held with community workers, their husbands, community leaders, and community women. Results show that although community workers initially faced intense hostility in the community, they succeeded in maintaining the prestige that is traditionally accorded to women in their conservative, rural society. Moreover, they established themselves as valued health and family planning professionals in a social context where professional roles for women have been extremely circumscribed. Finally, they gained social influence by performing a range of functions in the community that exceed formally prescribed job responsibilities. The professional and social leadership roles that community workers now assume imply a degree of status that seemed inconceivable a decade ago. That such change could result from a well-designed and appropriately managed family planning project deserves careful attention.

PIP: Focus group discussion from 1987-88 among 44 of the 65 community workers who had been with the Matlab Maternal and Child Health Family Planning Project (MCH-FP), Bangladesh over a decade, were conducted in order to investigate how FP affects the status of women. The variables under consideration were prestige, professional status, and social influence. Interviews were also conducted with husbands, community leaders, and educated community women. The social system of purdah which restricts extrafamilial activities places workers in conflict with established social and cultural norms. The findings of this investigation were that many changes took place over the decade. Prestige was regained by workers, who originally were thought to have lost their honor by violating the cultural patterns of seclusion and modesty. Recognition was given to these women for their professional expertise, community service, and control over medical resources. The rise in social status placed them in a position worthy of arbitrating family and neighborhood conflicts and sometimes advocating for women. Social and professional influences were possible because these women transformed traditional purdah into inner purdah, which placed them within the domain of the conservative definitions of gender. The strategy reflected accommodation and reform. The distinction is made between women's prestige which is respect for adherence to culturally defined patterns of female behavior and status which is women's control over resources, information, and other sources of power and influence. Project management was supportive in that routing of patients to the health subcenter or the Matlab hospital was accomplished through the community workers, and project staff deliberately showed respect to the worker when visiting a worker's area. In this manner, the worker's image was reinforced. The social conditions were such that there were adequate resources for service delivery also. Although there were socioeconomic changes taking place in the form of modernization, the status of employment may have been affected but responsibility for the changes in prestige, professional status, and social influence must be directed to the worker's and management. A well-designed and appropriately managed FP project can avail women of employment opportunities which provide access into male space, and provide control over resources, influence, and power.

[A case of "cri-du-chat" syndrome with meningomyelocele (author's transl)].

This patients is a 48-day-old girl, born as the third child from a 29-year-old healthy mother. The pregnancy was uneventful, and the delivery was normal. Right after birth, she had episode of asphyxia for several minutes. Her weight of birth was 2,600 g, and the head circumference was 30.4 cm. Dyspnea and cyanosis after feeding were noted on the second day. At the time of admission to our service, she showed typical symptoms of "cri-du-chat" syndrome, namely, characteristic cry, mental retardation (DQ was 48), microcephaly (head circumference was 34.5 cm), rounded face, hypertelorism, oblique palpebral fissures, epicanthus, low-set ears, micrognathia, short neck, simian crease. Other abnormalities such as umbilical hernia, prolapsus ani, dislocation of the hip joint, and lumbosacral meningomyelocele. Cerebral angiogram demonstrated no pathological findings. Pneumoencephalogram showed accumulation of air at the cranial base. Operation was performed for repair of meningomyelocele at the age of 50 days. Postoperative course was smooth.

[A case of frontal arteriovenous malformation with optochiasmatic arachnoiditis as an initial symptoms (author's transl)].

A surgically cured case of chronic optochiasmal arachnoiditis presumably caused by concomitant right frontal arteriovenous malformation (AVM) is reported. When a 12-year-old boy, suffering from blurred vision for about 1 month, visited the Ophthalmological Clinic of Hirosaki University Hospital, only a chiasmal lesion was suspected because neuro-ophthalmological examination revealed no more than ophthalmic signs, such as bilateral diminution of vision (Vd, Vs = 0.2), concentric narrowing of visual fields and slight bilateral papilledema. The patient was referred to the Neurosurgical clinic for further examination. Left carotid angiograms showed no abnormalities but, thereafter the brain scintigram revealed an abnormal hot area in the right frontoparietal region. A right carotid angiography demonstreated an AVM in the posterior part of the right frontal lobe. This was fed through the right anterior and middle cerebral arteries and drained into the superior sagittal sinus through meandering dilated cortical vein.

[Successfully operated case of posterior fossa tuberculoma in childhood (author's transl)].

A case of intracerebellar tuberculoma is described in which a tuberculoma was removed successfully through the administration of antituberculous agents, and a full recovery was obtained. The patient was a 3-year-old boy who had been receiving antituberculous agents for about 4 months because of acute inflammation followed by osteomyelitis of his right big toe, which was suspected to be tuberculous, and because of pulmonary tuberculosis diagnosed in a chest roentgenogram taken about 1 month after osteomyelitis was cured. While his osteomyelitis was being treated, disturbance in his gait, due to progressive spastic paraparesis, was not iced, and thereafter left cerebellar symptoms with impairment of equilibrium appeared additionally. Then, he was reffered to our clinic for further neurosurgical examination, and was admitted on November 1, 1974 after right carotid and vertebral angiography was performed via the right axillar artery, in which findings suggesting left cerebellar tumor and internal hydrocephalus were obtained. After he was admitted to our clinic, a diagnosis of tumor of the left cerebellum and internal hydrocephalus was more precisely confirmed by pneumoventriculography. Suboccipital craniectomy was then carried out and the tumor, weighing 60 gm, was completely removed from the left cerbellar hemisphere. The tumor was confirmed as tuberculoma not only by histological findings but also by the vertification of tuberculous bacilli in it. Though, moderate fever lasted for about 2 weeks postoperatively, no obvious meningitic signs or new neurological deficits were noted. The patient showed marked improvement especially in his gait disturbance, and was discharged ambulatory 40 days after the operation, and has since been asymptomatic except for slight ataxic gait. The antituberculous agents have been continuously administered postoperatively.