Specific immunotherapy of experimental myasthenia gravis in vitro and in vivo: the Guided Missile strategy.

Current immunotherapy of myasthenia gravis (MG) is often effective, but entails risks of infection and neoplasia. The "Guided Missile" strategy described here is designed to target and eliminate the individual's unique AChR-specific T cell repertoire, without otherwise interfering with the immune system. We genetically engineered dendritic cells to present AChR epitopes and simultaneously express Fas ligand in an ongoing EAMG model. In both in vitro and in vivo experiments, these engineered cells specifically killed AChR-responsive T cells without otherwise damaging the immune system. AChR antibodies were markedly reduced in the treated mice. Translation of this method to treat human MG is possible.

The influence of patterns of welfare receipt during the child-rearing years on later physical and psychological health.

This study examined interrelations among welfare receipt, social integration, and later physical and mental health in a cohort of African American mothers from the Woodlawn neighborhood on the south side of Chicago. These women (N = 681) have been followed prospectively from 1966-67 to 1997-98. Findings indicate that receiving welfare during the child-rearing stage of life is related to both social integration and later health, with those who had received welfare in young to middle adulthood being more socially isolated and having more health problems twenty to thirty years later. Findings provided no support for the hypothesis that social integration mediated the relationship between welfare receipt and later physical and psychological health problems. Welfare receipt had a direct detrimental effect on later health outcomes. Attending church regularly was protective for later physical and psychological health. The relationship between early welfare and later health remained even when the women's current poverty was added to the model.

Cardiovascular disease risk factors in Korean American elderly.

An in-depth cardiovascular risk factor assessment was carried out in a sample of 205 Korean American elderly in Maryland, consisting of 75 males and 130 females aged 60 to 89 years (mean age = 69.9 +/- 6.5 years). Six risk factors were assessed in each participant: high blood pressure, current smoking, high blood cholesterol, overweight, sedentary lifestyle, and diabetes. The findings of this cross-sectional study suggested that high blood pressure was the leading cardiovascular disease risk factor among Korean American elderly (71%), followed by high blood cholesterol (53%), overweight (43%), sedentary life style (24%), diabetes (18%), and smoking (7%). Two thirds of the sample had multiple cardiovascular disease risk factors. The pattern of prevalence and risk factors that was observed was consistent with the distribution of multiple risk factors in that the combination of high blood pressure, high blood cholesterol, and overweight was most common in Korean American elderly (62%). These findings indicate that culturally relevant and salient strategies are needed to reduce multiple risk factors in this population.

Prevalence and factors associated with high blood pressure in Korean Americans.

This study, conducted from October 1998 to February 1999, included a cross-sectional epidemiological survey administered to Korean Americans (KAs) living in Maryland (N = 761). One third (32%) of participants had high blood pressure (HPB: SBP > or = 140 mm Hg and/or DBP > or = 90 mm Hg or were on hypertension medication). HBP was more common among males (35%) than females (30%) and those who were aged 50 years or older (53%) compared to those who were less than 50 years old (12%). The prevalence of HBP in Maryland KAs was found to be much higher than in other Americans (24%) and in their counterparts in Korea (22% overall: 29% in males, 11% in females). Only 40% of the hypertensive KAs were taking HBP medication, and 74% of those did not have controlled HBPs. Further, multivariate logistic analyses were conducted to estimate the relative biobehavioral risk factors related to hypertension. Several significant risk factors were identified, including family history of HBP, gender, level of education, level of acculturation, regular exercise, and being overweight. Findings from this study indicate that culturally relevant approaches to prevention and treatment of HBP are urgently needed to address the HBP problem in Korean Americans.

Cancer screening behaviors among Korean-American women.

The goals of this study were to evaluate breast and cervical cancer screening tests and to examine the correlates of cancer screening behaviors. A cross-sectional face-to-face survey of 438 Korean-American women residing in Maryland was conducted. About 50% of women age 18 and older had had a Pap smear and 46.6% of these women age 40 and older had had a mammogram in the past 2 years. In multiple logistic regression analyses, the strongest correlate of screening behaviors was having a regular medical checkup. Age and acculturation were found to be important correlates of cancer screening tests: Women less than 50 years of age were more likely to have cancer screening tests than those 50 years and older. English language proficiency was associated with having a mammogram and the proportion of life spent in the United States was associated with having a Pap smear. Employment interacted with marital status for a Pap smear, with those married and unemployed being less likely to have a Pap smear than women who were both married and employed. For strategies to increase cancer-screening tests among Korean-American women, we need to aim at developing culturally appropriate educational programs about cancer for less acculturated and recent immigrants.

Risk factors for suicide in Caucasians and in African-Americans: a matched case-control study.

It is known that suicide rates for Caucasians are higher than those for African-Americans. However, there has been little research examining whether risk factors associated with suicide differ by race, when the effects of age, gender, and educational-occupational status are taken into account. A matched case-control study was constructed from the 1986 National Mortality Followback Survey to address such concerns. Cases included all individuals aged between 25 and 64 years dying from suicide. Controls were those who died of natural causes, who were frequency matched to cases by age and gender. The study results for Caucasians indicate that those who had at least a high school education were more likely to commit suicide [odds ratio (OR) = 1.91; 95% confidence interval (CI) = 1.37-2.67] than those who had less than a high school education; those who were heavy drinkers were more likely to commit suicide (OR = 1.64; 95% CI = 1.16-2.33) than those who were light or moderate drinkers; those who lived alone were more likely to commit suicide (OR = 1.72; 95% CI = 1.28-2.30) than those who lived with others, those who had blue-collar occupations were more likely to commit suicide (OR = 1.79; 95% CI = 1.33-2.42) than those who had white-collar occupations, and those who had used mental health services were more likely to commit suicide (OR = 3.07; 95% CI = 2.34-4.01) than those who had not used them. For African-Americans, use of mental health services was the only factor significantly associated with suicide (OR = 4.56 95% CI = 1.69-12.29).

Childhood, adolescent, and young adult predictors of suicidal behaviors: a prospective study of African Americans.

This study examined the lifetime prevalence of suicidal behaviors and their relation to social integration, depression, and aggression/substance use in a cohort of African Americans followed prospectively from first grade to age 32. Lifetime depressive moods in adulthood, lifetime use of cocaine, and frequent mobility were associated with suicidal behaviors for both males and females. For males, having been in a mother-alone or mother-absent family at age 6, childhood psychopathology, and not being married were related to suicidal behaviors. Females who reported high assault behavior in adolescence were more likely to report suicide attempts. The results suggest that social integration, depression, and aggression/drug use are important risk factors for suicidal behaviors in this African American population.

Cigarette smoking among Korean adolescents: prevalence and correlates.

The purpose of this study was to examine the prevalence of cigarette smoking and to explore its relationship with individual, family, school, and psychological factors among Korean adolescents. As part of the Korean Institute for Health and Social Affairs' Adolescent Health Survey, 5,209 eighth graders and 4,677 eleventh graders from 70 junior and senior high schools completed a self-administered questionnaire during school hours in 1989. Current prevalence of cigarette smoking was 8.45% (15.43% of boys and 1.28% of girls). Smoking prevalence increased with age among boys. Based on logistic regression analyses, perceived peer use was most strongly associated with smoking status (OR = 9.97 for boys; and 68.27 for girls). Academic stress, grade, and type of school were also associated with smoking status for both boys and girls. In addition, mother's smoking, birth order, and urbanity were associated with smoking status for boys. Implications of the results for prevention efforts to inhibit the onset of cigarette smoking among Korean adolescents are discussed.

Epidemiology of suicidal behavior among Korean adolescents.

The purpose of this study was to estimate the prevalence of suicidal behaviors and their relation to background characteristics, social integration, academic stress, psychological distress, and substance use in a stratified random sample of 9886 high school students in Korea. In a multiple logistic regression, we found that depression was the strongest predictor of suicidal behaviors. The other factors significantly associated with suicidal behaviors were gender, academic stress, hostility and substance use. These results indicate that early identification of risk factors for suicidal behaviors may have potential for reducing possible future suicides.