Intramolecular G-quadruplex-hairpin loop structure competition of a GC-rich exon region in the TMPRSS2 gene.

We identified cytosine-rich regions adjacent to guanine-rich regions in protease genes. A typical GC-rich sequence derived from the TMPRSS2 gene showed structural competition between a G-quadruplex and a hairpin loop, and this competition significantly affected transcription efficiency. These results suggest an impact of neighboring sequences on the gene expression of guanine-rich sequences.

Work-related Musculoskeletal Disorders in Korea and Japan: A Comparative Description.

OBJECTIVES: Work related Musculoskeletal disorders (WMSD) is one of the most important problem in occupational health system of Korea and Japan, where the OHS system developed in similar socio-cultural environment. This study compared WMSD in Korea and Japan to review similarities and differences in their historical background, and development of prevention policies. METHODS: Scientific articles, government reports, and related official and non-official statistics on WMSD since the 1960s in Japan and Korea were reviewed. RESULTS: The historical background and basic structure of the compensation system in Korea and Japan largely overlapped. The issuing of WMSD in both countries appeared as upper limb disorder (ULD), named occupational cervicobrachial diseases (OCD) in Japan, and neck-shoulder-arm syndrome (NSA) 30 years later in Korea, following the change from an industrial structure to automated office work. Both countries developed manuals for diagnosis, guidelines for workplace management, and prevention policies. At present, compensation cases per covered insurers for WMSD are higher in Korea than in Japan, due to the social welfare system and cultural environment. Prevention policies in Korea are enforced more strongly with punitive measures than in Japan. In contrast, the Japanese system requires autonomous effort toward risk control and management, focusing on specific risky processes. CONCLUSIONS: WMSD in Korea and Japan have a similar history of identification and compensation structure, yet different compensation proportions per covered insurer and prevention policies. Follow-up study with international cooperation is necessary to improve both systems.

Cigarette smoking, proteinuria, and renal function in middle-aged Japanese men from an occupational population.

OBJECTIVES: To clarify the renal effects of cigarette smoking in a middle-aged occupational population because the effects have previously been demonstrated mainly in community populations that included many elderly people who are thought to be vulnerable to such effects. METHODS: In 990 middle-aged men recruited from a chemical plant, proteinuria was measured by a dipstick method and the glomerular filtration rate was estimated (eGFR) using a formula proposed by the Japanese Society of Nephrology. RESULTS: Proteinuria was found in 4.6% of the current smokers and 1.5% of the never-smokers. It was found in 4.8% of the subjects having a Brinkman index (BI) of 400-599 and 6.3% of those having a BI of 600 or above. The odds ratio for proteinuria in them was 2.94 (CI: 1.01-8.55) and 3.61 (CI: 1.29-10.1), respectively, adjusting for possible confounders. The mean eGFR was higher in smokers than in nonsmokers throughout middle age up to 64 years. Normal but high eGFR was found in 6.7% of the current heavy smokers and subnormal eGFR in 5.7% of the largest cumulative cigarette consumers in contrast to 3.0% or less of the never-smokers. Proteinuria was found in 13.3% of the subjects showing subnormal eGFR, specifically in 16.7% of the smokers and 8.3% of the nonsmokers. CONCLUSIONS: Smoking causes proteinuria in working middle-aged men. Smokers tend to have a high eGFR, but those with subnormal eGFR showed proteinuria most frequently. Whether the high eGFR in smokers will eventually decrease and cause proteinuria remains an important focus for further studies.

Cardiovascular and muscle activity during chewing in whiplash-associated disorders (WAD).

OBJECTIVE: The present study aimed to elucidate possible physiological mechanisms behind impaired endurance during chewing as previously reported in WAD. We tested the hypothesis of a stronger autonomic reaction in WAD than in healthy subjects in response to dynamic loading of the jaw-neck motor system. DESIGN: Cardiovascular reactivity, muscle fatigue indicies of EMG, and perceptions of fatigue, exhaustion and pain were assessed during standardised chewing. Twenty-one WAD subjects and a gender/age matched control group participated. Baseline recordings were followed by two sessions of alternating unilateral chewing of a bolus of gum with each session followed by a rest period. RESULTS: More than half of the WAD subjects terminated the test prematurely due to exhaustion and pain. In line with our hypothesis the chewing evoked an increased autonomic response in WAD exhibited as a higher increase in heart rate as compared to controls. Furthermore, we saw consistently higher values of arterial blood pressure for WAD than for controls across all stages of the experiment. Masseter EMG did not indicate muscle fatigue nor were there group differences in amplitude and mean power frequency. Pain in the WAD group increased during the first session and remained increased, whereas no pain was reported for the controls. CONCLUSION: More intense response to chewing in WAD might indicate pronounced vulnerability to dynamic loading of the jaw-neck motor system with increased autonomic reactivity to the test. Premature termination and autonomic involvement without EMG signs of muscle fatigue may indicate central mechanisms behind insufficient endurance during chewing.

Evaluation of cognitive behavioural training and physical activity for patients with stress-related illnesses: a randomized controlled study.

OBJECTIVE: To evaluate the effects of a cognitive behavioural training programme and a physical activity programme for patients with stress-related illnesses. DESIGN: In a randomized controlled study, patients were allocated randomly to 1 of 3 groups, where group 1 participated in a cognitive behavioural training programme, group 2 participated in a physical activity programme, and group 3, the control group, was offered usual care for the course of the study. SUBJECTS: A total of 75 patients participated in the study. They had been on sick leave for at least 50% of the time for between 1 month and 2 years due to stress-related illnesses. METHODS: Measurements of autonomic activity, pressure-pain thresholds and subjective ratings of health and behaviour were made before and after a 10-week intervention period, and at 6 and 12 months after the intervention. RESULTS: Minor differences in autonomic activity and pressure-pain thresholds were found between the groups immediately after the intervention. At the 6- and 12-month follow-up assessments, the differences were no longer present. Patients in the cognitive behavioural training group improved their ratings of general health compared with the physical activity group throughout the study. CONCLUSION: The study showed little difference in the effect of cognitive behavioural training and physical activity, compared with usual care, for patients with stress-related illnesses.

Occupational stress among Japanese emergency medical technicians: Hyogo Prefecture.

INTRODUCTION: As prehospital care became emphasized in emergency medical services in Japan, qualification as a "paramedic" was established in 1991 as a requirement for national qualification as a emergency medical technician (EMT). With recent increases in emergency transportation, the responsibilities of paramedics have become more complex and demand a higher level of competency; however, no method of evaluating occupational stress among Japanese EMTs currently exists. METHODS: A questionnaire survey of the working conditions and health of 2,017 EMTs in Hyogo Prefecture was conducted. To analyze stress levels among these EMTs, the survey was divided into two categories: (1) physical stress; and (2) mental stress. RESULTS: The number of responses was 1,551 (76.9%) and the average age of the respondents was 35.4 years. The lower back, neck, and shoulders were most frequently subjected to physical stress, which was related to the daily operations as an EMT. Mental stress was reported more frequently by those who were older or qualified paramedics. DISCUSSION: The high frequency of lower back pain suggests the need for improvement in the work environment and periodic education. CONCLUSIONS: Although job satisfaction among paramedics was high, they were exposed to greater mental stress. Therefore, systematic management of stress must be developed and established.

Solving tangled cases of work-related musculoskeletal disorders by international scientific cooperation.

Work-related musculoskeletal disorders (WRMSDs) have become a serious worldwide problem. At the same time a number of workers experience a problem in getting their WRMSDs acknowledged. As an attempt to solve these problems, Japanese school lunch cooks' working conditions were discussed at international scientific meetings and a detailed inspection was done at a Japanese school kitchen by Swedish researchers. It revealed that both national and international researchers' opinions coincided. Statements of medical views were written for several tangled cases in Japan and Sweden referring to both the national and international literature. As a result, these tangled cases were acknowledged officially as WRMSDs. New arbitrators and mediators of WRMSDs are required who can understand and communicate between the world of medical and labor sciences and also between the world of science and daily work life.

Autonomic activity, pain, and perceived health in patients on sick leave due to stress-related illnesses.

OBJECTIVE: The aim of the present study was to compare autonomic activity, pressure-pain thresholds, and subjective assessments of health and behavior between patients with stress-related illnesses and healthy control subjects. METHODS: Twenty sick-listed patients with stress-related illnesses and 20 age- and gender-matched healthy subjects performed tests of autonomic regulation and algometric tests, and completed questionnaires about physical and mental health and behavioral patterns. RESULTS: Patients exhibited higher autonomic reactivity to cognitive and physical laboratory tasks (p < 0.05), and had lower pressure-pain thresholds in the shoulders and lower back than healthy control subjects (p < 0.05). Furthermore, the patients rated considerably poorer health and health behavior than the control subjects (p < 0.05). CONCLUSIONS: The results indicate an engagement of the autonomic nervous system in stress-related illnesses. Furthermore, they show that patients with stress-related illnesses experience symptoms of musculoskeletal pain, and it is therefore recommended that assessments of musculoskeletal pain be incorporated in the clinical examinations and the rehabilitation of patients with stress-related illnesses.

[Trends in research and prevention policies for work-related musculoskeletal disorders at the European Agency for Safety and Health at Work (EU-OSHA)].

The European Agency for Safety and Health at Work (EU-OSHA) has been working on matters related to occupational health problems in 15 European Union (EU) member states. EU-OSHA established 10 topic centers on work and health research in 1998. One of the topic centers is assigned for research and information on work-related musculoskeletal disorders. The present report is written because such activities of EU-OSHA are scarcely known in Japan. Work-related musculoskeletal disorders have become a very serious problem in EU member states, i.e., 30% of workers complain of backache, and 17% complain of muscular pains in their arms and legs. The affected workers not only suffer at work but also in their home life. The economic costs of all work-related ill health range from 2.6 to 3.8% of the gross national product, and work-related musculoskeletal disorders constitute 40-50% of this. Therefore EU member states consider that prevention of work-related musculoskeletal disorders in itself is an extremely good economic policy. EU-OSHA published "Work-related neck and upper limb musculoskeletal disorders" in 1999, and "Research on work-related low back disorders" in 2000. These publications suggest various preventive methods which can be introduced in practice at work. One of the most remarkable things in EU-OSHA's activities for work-related musculoskeletal disorders is that EU-OSHA has been trying hard to introduce the results of its research into real policies for EU member states by several means, i.e., held a seminar participated in by policy makers, representatives of trade unions, and researchers from EU member states, and sent seminar resolutions to politicians who are responsible for employment and social affairs. Finally the resolution has been adopted in a new social affairs policy by the EU parliament and will be put into force during 2002. Work-related musculoskeletal disorders will remain one of the most serious occupational problems in EU member states, and EU-OSHA will continue to pay close attention to it.