Psychosocial functioning and self-rated health in Japanese school-aged children: A cross-sectional study.

Emotional and behavioral disorders in children are school-health concerns; however, Japanese screening tools for such disorders are not yet available. We examined the association between psychosocial functioning as measured by the Pediatric Symptom Checklist (PSC) and self-rated health within school settings. A cross-sectional study was conducted for 2513 fifth and eighth graders from all of the primary and secondary schools in Shunan City, Japan. The Japanese PSC had high internal consistency (Cronbach's α = 0.90) and a factor structure similar to that of the English PSC. When the cut-off values were set to ≥ 28 and ≥ 17, 4-9% and 20-39% of our respondents, respectively, reported high PSC scores. A multiple ordinal logistic regression analysis showed that the odds ratio of a positive PSC score (≥ 28) for poorer self-rated health among ratings of "very good," "good," "fair," and "poor" was 3.5 (95% confidence interval = 2.6-4.8). There was a clear association between psychosocial dysfunction identified by a PSC score ≥ 28 and poor self-rated health. We offer directions for further research on appropriate PSC cut-off values with Japanese samples.

Use of body mass index and percentage overweight cutoffs to screen Japanese children and adolescents for obesity-related risk factors.

BACKGROUND: Cutoffs based on percentage overweight (POW) are used for screening students in Japan; however, body mass index (BMI) is more common in the rest of the world. To screen for risk factors related to obesity among Japanese primary and secondary school students, we compared fasting and postprandial values, and the receiver operating characteristic (ROC) curves for the POW and BMI criteria. METHODS: The subjects were students aged 10 and 13 years living in Shunan City, Japan between 2006 and 2008 (n = 6566). POW and International Obesity Taskforce (IOTF) BMI criteria were used to screen for obesity-related risk factors. The lower (20%, 18-year-old equivalent: 25 kg/m(2)) and higher (50%, 18-year-old equivalent: 30 kg/m(2)) cutoffs were examined, and ROC curves were drawn. RESULTS: Fasting cholesterol levels were higher than postprandial levels. The prevalences of overweight/obesity were 6.6% to 10.0% using the lower cutoff and 0.6% to 5.0% using the higher cutoff. Among overweight subjects under fasting conditions, dyslipidemia was present in 12% to 52%, hypertriglyceridemia in 29% to 54%, hyperglycemia in 11% to 21%, and hypertension in 15% to 40%. Although the use of the lower and higher POW cutoffs resulted in lower sensitivity and the higher specificity, the POW and BMI ROC curves largely overlapped. However, for girls aged 10 years, the POW curve for >or=3 risks factors was lower than that of the latter (P = 0.013). CONCLUSIONS: For Japanese aged 10 and 13 years, both BMI and POW are useful for risk factor screening. However, subjects may be misclassified with dyscholesterolemia if postprandial blood samples are used.

Variance in the transaminase levels over the body mass index spectrum in 10- and 13-year-olds.

BACKGROUND: Transaminase levels increase with body mass index (BMI) and also with an extreme drop in the BMI, as in the case of patients with anorexia nervosa. We examined these levels over the BMI spectrum in Japanese 10- and 13-year-olds. METHODS: Fifth- and eighth-grade students (n= 3747) from all schools in Shunan City, Japan, between 2006 and 2008 were included in the study. BMI z-score and serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma-glutamyltransferase (GGT) were measured. RESULTS: The ALT and GGT levels increased with z-BMI values in the boys and 10-year-old girls (P≤ 0.001). In the 13-year-old girls, only the ALT levels increased with the z-BMI values (P= 0.018). Similarly, the proportion of subjects with elevated ALT and GGT levels increased with the z-BMI values (p(trend) < 0.05). The AST levels were negatively associated with BMI in the girls (P < 0.001). Among the boys, these levels were elevated at the highest z-BMI values and slightly elevated at lower values, but not significantly. These associations did not change after adjustments for confounders. Generalized additive model analyses revealed that transaminase had non-linear relationships with z-BMI, except for the AST levels in the girls. CONCLUSION: The elevated ALT and GGT levels were associated with high BMI in both sexes. In the same study population, however, AST increased in the girls with low BMI and in the boys with high BMI.

Cytokine levels in sputum of patients with tracheostomy and profound multiple disabilities.

BACKGROUND: Airway immunopathogenesis is unclear in patients with profound multiple disabilities (PMD) who undergo tracheostomy. METHODS: The levels of tumor necrosis factor-alpha (TNF-alpha), interleukin-1beta (IL-1beta), IL-6, IL-8, IL-10, and IL-12p70 cytokines were determined in sputum of 28 patients with PMD who underwent tracheostomy and in 14 healthy subjects, using a cytometric bead array. RESULTS: The concentrations of IL-1beta, IL-6 and IL-8 in the patients were significantly higher than those in controls (p < 0.001). IL-6, and IL-8 levels in eight PMD patients in the febrile period were significantly higher than those in the afebrile period (p < 0.01 and p < 0.05, respectively). Serum CRP levels were slightly elevated in 12 of the 28 patients (43%) in the afebrile period, but there were no significant differences in the level of any cytokine between patients with normal and elevated serum CRP. CONCLUSION: PMD patients with tracheostomy have chronic airway inflammation.

Effects of edaravone on N-methyl-D-aspartate (NMDA)-mediated cytochrome c release and apoptosis in neonatal rat cerebrocortical slices.

N-Methyl-D-aspartate-mediated neurotoxicity is known to involve nitric oxide production and to be augmented in an environment of reactive oxygen species. We used TUNEL staining and homogenous cytosolic immunoreactivity of cytochrome c in an acute brain slice preparation to investigate the influence of edaravone (3-methyl-1-phenyl-2-pyrazolin-5-one), a free radical scavenger, on N-methyl-D-aspartate-induced apoptosis. Cerebrocortical slices were obtained from parietal lobes of 7-day-old Sprague-Dawley rats, superfused with well-oxygenated artificial cerebrospinal fluid, and metabolically recovered. Subsequent 30-min exposures to 10 microM N-methyl-D-aspartate in treated and untreated slices were followed by 4 h of recovery superfusion with oxygenated artificial cerebrospinal fluid. Outcomes were compared for three groups of slices: "the N-methyl-D-aspartate-only group"; "the edaravone treatment group", which had 20 microM edaravone present throughout and subsequent to N-methyl-D-aspartate exposure; the "control group", in which slices were superfused only with oxygenated artificial cerebrospinal fluid. At the conclusion of recovery (t = 4 h), the percentage of TUNEL-positive cells in the edaravone treatment group (7.0+/-3.3%) was significantly reduced from the percentage for the N-methyl-D-aspartate-only group (21.9+/-4.1%), and insignificantly greater than the percentage for the control group (3.4+/-2.1%). Percentages of cytochrome c positive cells at t = 1 h were significantly increased (p < 0.01) in the N-methyl-d-aspartate-only group (30.6+/-1.9%) compared to percentages for both the control group (11.4+/-2.6%) and the edaravone treatment group (15.2+/-2.1%). Edaravone's reduction in TUNEL staining and cytochrome c release provides evidence of reactive oxygen species mechanisms and antioxidant benefits in cytochrome c-mediated apoptosis during N-methyl-D-aspartate excitotoxicity.