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PubMed2005

Midlife pulse pressure and incidence of dementia: the Honolulu-Asia Aging Study.

BACKGROUND AND PURPOSE: Previous studies have shown that midlife systolic blood pressure (SBP) predicts late-life cognitive decline and incident dementia. This study explores whether this association is attributable to the pulsatile, ie, pulse pressure (PP), or the nonpulsatile component of blood pressure (BP). METHODS: Data are from the Honolulu-Asia Aging Study, a community-based study of Japanese American men. Midlife BP was measured in 1971 to 1974 and dementia assessment was conducted in late-life. The 2505 men who were dementia free in 1991 and had complete follow-up data were re-examined for incident dementia in 1994 to 1996 and 1997 to 1999. Their age ranged from 71 to 93 years. Survival analysis with age as the time scale was performed to estimate the risk (hazard ratio [HR] and 95% CI) for incident dementia associated with mid- and late-life tertiles of PP and mean arterial BP, as well as SBP and diastolic BP categories. RESULTS: Over a mean of 5.1 years of follow-up, 189 cases (7.5%) of incident Alzheimer disease or vascular dementia were identified. After adjustment for cerebrovascular risk factors, dementia was significantly associated with SBP (HR 1.77; 95% CI, 1.10 to 2.84, for SBP > or =140 mm Hg compared with SBP <120 mm Hg), but not with PP tertiles. Limiting the analysis to those never treated with antihypertensives, high levels of all 4 BP components were significantly associated with dementia. In models with 2 BP components, only SBP remained significant in both the total sample and the never-treated subgroup (HR 2.29; 95% CI, 1.23 to 4.25, for SBP > or =140 mm Hg in total sample), whereas PP was not significantly associated with the risk for dementia. CONCLUSIONS: Midlife PP is not independently associated with dementia incidence. Midlife SBP is the strongest BP component predicting incident dementia.

Aged↗
PubMed1981

Pleural paragonimiasis in a Southeast Asia refugee.

We report a Laotian patient with pleural paragonimiasis who did not have the usual diagnostic triad for this parasitic disease. He did not have chronic hemoptysis (considered by many to be an "invariable" finding), there were no pulmonary infiltrations, and stool and sputum examinations did not yield Paragonimus ova. The diagnosis was made on the basis of ova found in the pleural fluid. Paragonimiasis pleural effusion did not resolve with bithionol, the drug of choice for pulmonary paragonimiasis, and, as a result, chest tube drainage was required. The difference between pleural paragonimiasis and pulmonary paragonimiasis is that the classic clinical presentation of the latter (hemoptysis, ova in sputum and stools, lung infiltration, etc.) requires an intrapulmonary location on the parasite. A search for ova in the pleural fluid may be the only diagnostic tool for patients suspected of pleural paragonimiasis. With the influx of Southeast Asia refugees, this case report may be of relevance to U.S. physicians involved in the care of patients in whom not all chronic pleuropulmonary diseases are tuberculous.

Adult↗
PubMed1990

Multi-cultural study of minor psychiatric disorders in Asia: symptom manifestations.

Patients with minor psychiatric disorders, including neuroses, situational adjustment reaction or acute emotional reaction, were investigated using symptom questionnaires at five research sites in Asia including: Chiang-Mai, Thailand; Bali, Indonesia; Kao-Hsiung, Taiwan, China; Shanghai, China; and Tokyo, Japan. The results revealed that the symptom profiles differ significantly among groups of different settings indicating that sociocultural background does contribute to the manifestation of neurotic symptomatology. It was also found that numerous and various subtypes of somatic scales were identified through factor analysis of symptoms for these Asian populations. It demonstrates that the spectrum of neurotic symptoms has a different focus for subjects in different sociocultural settings.

Adult↗
PubMed2005

Recent clinical-pathologic research on the causes of dementia in late life: update from the Honolulu-Asia Aging Study.

In this study, we compare neuropathological findings at autopsy with clinical dementia diagnoses, such as Alzheimer's disease and vascular dementia. Participants consisted of 363 aged Japanese-American men from the Honolulu-Asia Aging Study. Results indicated that the correspondence between clinical and neuropathologic diagnosis was not great, with 56% of patients diagnosed with probable or possible Alzheimer's disease during life but with only 19% having neuritic plaques and/or neurofibrillary tangles as the sole or dominant dementia-related lesions in the brain at autopsy. Although 16% of cases were attributed to mixed causes during life, almost 40% were found to have significant mixtures of dementia-related lesions at autopsy. Finally, both Alzheimer's disease and non-Alzheimer's disease neuropathologic lesions contributed independently to the explanation of variance on a test of overall cognitive performance. The results suggest that clinical diagnosis of dementia made during life may fail to reflect the pathogenic complexity of this condition in very elderly persons.

Aged↗
PubMed1996

Occasional series: lupus around the world systemic lupus erythematosus research in the Asia-Pacific region: a co-ordinated and co-operative approach.

Research on SLE in the Asia-Pacific region is presently conducted separately in various centres. A co-ordinated and co-operative approach is advocated for a long-term, prospective study on lupus patients in this region. A pilot study involving Beijing, Shanghai and Singapore has been initiated with the intention of expanding it to a larger study, involving up to 1000 newly diagnosed lupus patients who will be followed up for 10 years. The study design and term definitions are patterned after that of the Euro-Lupus project so as to allow for meaningful comparisons. The protocol was discussed, pretested and revised before arriving at the final version to be used. The principal co-ordinators met and discussed with all pioneer participating rheumatologists to ensure common understanding of definitions and standardisation of laboratory procedures. Preliminary results are expected to be presented in about six months' time together with an invitation for more rheumatologists to participate in the project.

China↗
PubMedDate not supplied

Community demonstration programs for cardiovascular disease prevention: the Asia-Pacific experience.

Cardiovascular diseases are an important and increasing cause of death in many countries in the Asia-Pacific Region. Formal demonstration programs for the prevention of cardiovascular disease are few in number and not likely to be widely used in the future. Prevention programs focused on key risk factors are widely used in the Region and have been successful. Smoking prevention remains a high priority for all countries in the Region.

Cardiovascular Diseases↗
PubMed2005

Genotyping of Mycobacterium tuberculosis clinical isolates in two cities of Turkey: description of a new family of genotypes that is phylogeographically specific for Asia Minor.

BACKGROUND: Population-based bacterial genetics using repeated DNA loci is an efficient approach to study the biodiversity and phylogeographical structure of human pathogens, such as Mycobacterium tuberculosis, the agent of tuberculosis. Indeed large genetic diversity databases are available for this pathogen and are regularly updated. No population-based polymorphism data were yet available for M. tuberculosis in Turkey, at the crossroads of Eurasia. RESULTS: A total of 245 DNAs from Mycobacterium tuberculosis clinical isolates from tuberculosis patients residing in Turkey (Malatya n = 147 or Ankara n = 98) were genotyped by spoligotyping, a high-throughput genotyping method based on the polymorphism of the Direct Repeat locus. Thirty-three spoligotyping-defined clusters including 206 patients and 39 unique patterns were found. The ST41 cluster, as designated according to the international SpolDB3 database project, represented one fourth and when gathered to three genotypes, ST53, ST50 and ST284, one half of all the isolates. Out of 34 clinical isolates harboring ST41 which were further genotyped by IS6110 and by MIRU-VNTR typing, a typical 2-copy IS6110-RFLP pattern and a "215125113322" MIRU-VNTR pattern were observed among 21 clinical isolates. Further search in various databases confirms the likely Turkish-phylogeographical specificity of this clonal complex. CONCLUSION: We described a new phylogeographically-specific clone of M. tuberculosis, designated LAM7-TUR. Further investigations to assess its frequency within all regions of Turkey and its phylogeographical origin and phylogenetic position within the global M. tuberculosis phylogenetic tree will shed new light on its endemicity in Asia Minor.

DNA, Bacterial↗
PubMed2005

Vasectomy surgical techniques in South and South East Asia.

BACKGROUND: Simple ligation of the vas with suture material and excision of a small vas segment is believed to be the most common vasectomy occlusion technique performed in low-resource settings. Ligation and excision (LE) is associated with a risk of occlusion and contraceptive failure which can be reduced by performing fascial interposition (FI) along with LE. Combining FI with intra luminal thermal cautery could be even more effective. The objective of this study was to determine the surgical vasectomy techniques currently used in five Asian countries and to evaluate the facilitating and limiting factors to introduction and assessment of FI and thermal cautery in these countries. METHODS: Between December 2003 and February 2004, 3 to 6 major vasectomy centers from Cambodia, Thailand, India, Nepal, and Bangladesh were visited and interviews with 5 to 11 key informants in each country were conducted. Vasectomy techniques performed in each center were observed. Vasectomy techniques using hand-held, battery-driven cautery devices and FI were demonstrated and performed under supervision by local providers. Information about interest and open-mindedness regarding the use of thermal cautery and/or FI was gathered. RESULTS: The use of vasectomy was marginal in Thailand and Cambodia. In India, Nepal, and Bangladesh, vasectomy was supported by national reproductive health programs. Most vasectomies were performed using the No-Scalpel Vasectomy (NSV) technique and simple LE. The addition of FI to LE, although largely known, was seldom performed. The main reasons reported were: 1) insufficient surgical skills, 2) time needed to perform the technique, and 3) technique not being mandatory according to country standards. Thermal cautery devices for vasectomy were not available in any selected countries. Pilot hands-on assessment showed that the technique could be safely and effectively performed by Asian providers. However, in addition to provision of supplies, introducing cautery with FI could be associated with the same barriers encountered when introducing FI in combination with LE. CONCLUSION: Further studies assessing the effectiveness, safety, and feasibility of implementation are needed before thermal cautery combined with FI is introduced in Asia on a large scale. Until thermal cautery is introduced in a country, vasectomy providers should practice LE with FI to maximize effectiveness of vasectomy procedure.

Bangladesh↗
PubMed2000

Ninth Asia Pacific League of Associations for Rheumatology (APLAR) Congress, Beijing, China, 21-26 May, 2000.

The Congress covered the broad field of rheumatology, with participants from China, the Asia Pacific League of Associations of Rheumatology (APLAR) region and the rest of the world. The programme consisted of a mix of plenary lectures, concurrent symposia, workshops, free paper sessions and poster presentations. Basic sciences were well represented, with the general theme of inflammatory cytokines being of particular interest. One plenary lecture and a number of other presentations addressed the problem of atherosclerosis and rheumatic diseases. Diseases prominent in the region, such as Behcet's disease and Takayasu's disease, were represented with large series. Other areas of interest were musculoskeletal infections in HIV-positive patients and the management of spondyloarthritis. Although the use of the most recently developed drugs is restricted in the APLAR region because of cost factors, there were symposia on the latest pharmacological advances such as COX-2 technology, leflunomide and anti-tumour necrosis factor (TNF) therapy.

China↗
PubMed2006

Environmental impacts on children's health in Southeast Asia: genotoxic compounds in urban air.

Air pollution is a serious problem in many countries in Southeast Asia, particularly in major metropolises with high levels of traffic congestion generating significant amounts of genotoxic substances. The contribution of such environmental exposure to children's illnesses, such as respiratory diseases and cancer, is a public health concern. Inner-city children may have higher levels of exposure to genotoxic substances in the air than those living in rural areas. This study was conducted in Bangkok, where ambient levels of polycyclic aromatic hydrocarbons (PAHs) and benzene are relatively high. Bangkok school children were exposed to total PAHs at about sixfold higher levels than those in rural areas, with levels of urinary 1-hydroxypyrene (1-OHP) also being significantly higher. PAH-DNA adduct levels in lymphocytes were fivefold higher in Bangkok children. Benzene exposure in Bangkok school children was more than twofold higher than the levels measured in children from the rural areas. This is in agreement with the biomarkers of internal dose, that is, blood benzene and urinary trans, trans-muconic acid (t,t-MA) levels. The potential health risks from exposure to PAHs and benzene were assessed through the use of DNA damage and DNA repair capacity as markers of early biological effect. DNA strand breaks were significantly higher in Bangkok school children, while DNA repair capacity was significantly lower. It appears that children in major cities in developing countries may have an increased health risk for the development of certain diseases, such as cancer due to exposure to genotoxic substances in their environment.

Air Pollutants↗
PubMed2001

Accuracy of clinical criteria for AD in the Honolulu-Asia Aging Study, a population-based study.

OBJECTIVE: To determine diagnostic accuracy for AD in a population-based study of Japanese-American men. AD is neuropathologically confirmed for more than 80% of cases at major referral centers (primarily Caucasians); however, information on diagnostic accuracy in population-based studies and studies of different ethnic groups is limited. METHODS: There were 3,734 men who participated in the Honolulu-Asia Aging Study 1991 through 1993 dementia examination and 2,603 in the 1994 through 1996 examination. Diagnoses were based on published criteria. Neuropathologists blinded to clinical data quantified neurofibrillary tangles (NFT) and neuritic plaques (NP). RESULTS: Of 220 autopsied subjects, clinical evaluation revealed 68 with normal cognition, 73 intermediate, and 79 with dementia: 20 AD, 27 vascular dementia, 19 AD + other, and 13 other dementia. Among 20 cases with pure AD, the median value for maximum neocortical NFT density was 6.9/mm(2) and for neocortical NP density was 8.0/mm2. Corresponding densities for other groups were <3.0/mm2. Using established neuropathologic criteria, 25% (5/20) of clinical AD cases had enough NP to meet definite AD criteria, whereas 65% (13/20) had sufficient NP to meet neuropathologic definite or probable AD criteria. Among nine AD cases with moderately severe dementia, only two (22%) had NP densities great enough to meet definite neuropathologic criteria, whereas seven (78%) met neuropathologic criteria for probable AD. CONCLUSIONS: Neuropathologic confirmation and NP density among decedents with clinical AD in this population-based study were lower than reported by referral centers and similar to reports from two other community studies. Ethnic differences in propensity for amyloid deposition as well as differences in clinical severity and representativeness of cases might contribute to these findings.

Aged↗
PubMed2003

Surface aerosol radiative forcing derived from collocated ground-based radiometric observations during PRIDE, SAFARI, and ACE-Asia.

An approach is presented to estimate the surface aerosol radiative forcing by use of collocated cloud-screened narrowband spectral and thermal-offset-corrected radiometric observations during the Puerto Rico Dust Experiment 2000, South African Fire Atmosphere Research Initiative (SAFARI) 2000, and Aerosol Characterization Experiment-Asia 2001. We show that aerosol optical depths from the Multiple-Filter Rotating Shadowband Radiometer data match closely with those from the Cimel sunphotometer data for two SAFARI-2000 dates. The observed aerosol radiative forcings were interpreted on the basis of results from the Fu-Liou radiative transfer model, and, in some cases, cross checked with satellite-derived forcing parameters. Values of the aerosol radiative forcing and forcing efficiency, which quantifies the sensitivity of the surface fluxes to the aerosol optical depth, were generated on the basis of a differential technique for all three campaigns, and their scientific significance is discussed.

Journal Article↗
PubMed1993

Novel organization of the spermatozoon in two species of murid rodents from southern Asia.

The morphology and structural organization of unusual spermatozoa from two species of bandicoot rats (Bandicota spp) from Southern Asia were studied with the light and transmission electron microscope. Unlike those described for nearly all other eutherian species the heads of Bandicota savilei and B. indica spermatozoa were bulbous or globular in shape and had no narrow uniformly defined apex nor a clearly delineated perforatorium. The nucleus, which had one or more prominent vacuoles, was capped by a huge, bulky, acrosome with no obvious morphologically recognizable equatorial segment. The postacrosomal dense lamina was extremely short and a posterior ring lay anterior to the caudal pole of the nucleus. In addition, the tail of the spermatozoon was only 28-45 microns in length. The organization of the spermatozoon of these two species of Bandicota is thus quite unlike that described for any other murid rodent or even mammalian species. Its highly divergent features suggest that the processes of zona penetration and incorporation of the fertilizing spermatozoon into the egg may differ markedly from those of all eutherians so far investigated.

Acrosome↗
PubMed2006

Male demography in East Asia: a north-south contrast in human population expansion times.

The human population has increased greatly in size in the last 100,000 years, but the initial stimuli to growth, the times when expansion started, and their variation between different parts of the world are poorly understood. We have investigated male demography in East Asia, applying a Bayesian full-likelihood analysis to data from 988 men representing 27 populations from China, Mongolia, Korea, and Japan typed with 45 binary and 16 STR markers from the Y chromosome. According to our analysis, the northern populations examined all started to expand in number between 34 (18-68) and 22 (12-39) thousand years ago (KYA), before the last glacial maximum at 21-18 KYA, while the southern populations all started to expand between 18 (6-47) and 12 (1-45) KYA, but then grew faster. We suggest that the northern populations expanded earlier because they could exploit the abundant megafauna of the "Mammoth Steppe," while the southern populations could increase in number only when a warmer and more stable climate led to more plentiful plant resources such as tubers.

Asian People↗
PubMed1998

Height as a marker of childhood development and late-life cognitive function: the Honolulu-Asia Aging Study.

OBJECTIVE: Growing evidence suggests that structural and functional brain reserves, thought to develop in childhood and adolescence, may be crucial in determining when cognitive impairment begins. The purpose of this report is to examine the relationship of height, as a marker of childhood development, to late-life cognitive function in a sample of elderly Japanese-American men. METHOD: Cognitive performance was assessed from 1991 to 1993 in the Honolulu-Asia Aging Study in 3733 men aged 71 to 93 years and related to height that was measured 25 years earlier. RESULTS: Among the study sample, shorter men were older, leaner, and less educated than taller men. Shorter men also spent more years of their childhood living in Japan and were more likely to have had fathers in unskilled professions. After adjustment for age, the prevalence of poor cognitive performance declined consistently with increasing height from 25% in men shorter than 154 cm (61 in) to 9% in those taller than 174 cm (69 in). Excluding men with stroke or dementia did not alter the association between height and cognitive performance. Apolipoprotein E4 was unrelated to height and did not effect the association between height and cognitive function. The prevalence of Alzheimer's disease was higher in men who were 154 cm (61 in) or shorter as compared with men who were taller (4.7% vs 2.9%, respectively). There was no association between height and vascular dementia. CONCLUSION: Efforts to improve prenatal and early life conditions to maximize growth in childhood and adolescence could diminish or delay the expression of cognitive impairments that occur later in life. Prevention of some late-life cognitive impairments may have pediatric origins.

Aged↗
PubMed2001

Traceback systems used during recent epizootics in Asia.

Traceback systems in most countries of Asia are not well developed, as indicated by responses to a questionnaire by veterinary officials in thirteen countries. Marking of animals for traceback is practised only in a limited number of countries in specific areas or zones and for specific purposes only. In Malaysia, traceback has been undertaken by marking farm code tattoos on pigs. This enables the identification of the farm of origin of pigs found to be infected by Nipah virus in sero-surveillance programmes. The origin of the foot and mouth disease (FMD) virus that surfaced in the Republic of Korea in March 2000 was investigated through several epidemiological studies of suspected sources of contamination such as imported hay, yellow sand, milk collection trucks and feed delivery trucks. None of these studies gave results that indicated the origin of the FMD virus. The origin of the FMD virus that was recorded in Japan in March 2000 was also investigated in epidemiological studies; in this case, imported wheat straw was incriminated as the most likely source of infection. Comparative studies of the pathogenicities of FMD (type O) viruses isolated in Taipei China, the Republic of Korea and Japan, suggest that these viruses might have originated as vaccine strains used in a third country.

Abattoirs↗
PubMed2005

Prevalence of physical activity among Chinese adults: results from the International Collaborative Study of Cardiovascular Disease in Asia.

OBJECTIVES: Determining physical activity levels in the community provides a context for the development and implementation of programs aimed at increasing these activity levels. Therefore, we assessed overall, work-related, and leisure-time physical activity in a representative sample of Chinese adults, aged 35 to 74 years, using data from the International Collaborative Study of Cardiovascular Disease in Asia. METHODS: Being physically active was defined as participating in 30 or more minutes of moderate or vigorous activity daily. Work-related and leisure-time physical activities were defined as being physically active and participating in any moderate or vigorous activity at work or during leisure time, respectively. RESULTS: In rural and urban China, 78.1% and 21.8% of residents, respectively, were physically active; 75.8% and 16.5%, respectively, participated in work-related activity; and 28.9% and 7.9%, respectively, participated in leisure-time physical activity. In both rural and urban settings, younger adults, men, and southern residents were more likely to be physically active and to participate in work-related and leisure-time physical activity than older adults, women, and northern residents. CONCLUSIONS: Intervention strategies to promote leisure-time physical activity, especially among urban residents, should be considered a major health priority in China.

Adult↗
PubMed2003

Morphometric geographic variation in the Asian lesser white-toothed shrew Crocidura shantungensis (Mammalia, Insectivora) in East Asia.

This study investigated geographic variation in the Asian lesser white-toothed shrew, Crocidura shantungensis Miller, 1901, among a number of localities in East Asia, including the Korean Peninsula, Tsushima Island, Cheju Island, and Taiwan, using univariate and multivariate analyses of cranial morphometric characters. Sexual differences were found in Taiwanese shrews, but were not evident in those from Korea or Tsushima. The samples from Taiwan had a larger overall cranial size than those from Korea and Tsushima, and were well separated from the latter two samples in the discriminant analyses. The overall size of the Cheju shrews was also greater, but lay within the variation of those from Taiwan. Crocidura dsinezumi quelpartis Kuroda, 1934, described from Cheju Island, is actually a junior synonym of C. shantungensis, and is not related to C. dsinezumi.

Adaptation, Physiological↗