Objective: To investigate the clinical features of ocular lesions in Behçet's disease in different countries. Methods: A descriptive questionnaire survey was performed. Results: 25 eye centres in 14 countries returned questionnaires on prevalent cases in 2006. Clinical data were analysed on 1,465 patients with ocular lesions. Recurrent oral aphthous ulcers were reported in 94.5%, skin lesions in 69.5% and genital ulcers in 61.4%. Most of the patients had bilateral and recurrent intraocular inflammation. Poor visual acuity was seen in 18.9% in women, but 24.8% in men (p,0.01). Panuveitis was seen more in men than in women (p,0.01). 23% of the patients had visual acuity equal to or worse than 20/ 200 at the final visit. The patients with poor vision were more frequently in India, Iran and Japan than in other countries (p,0.01). Conclusions: We report the largest contemporary international case series of patients with ocular involvement in Behçet's disease. Panuveitis was significantly more frequent in men than women, and men tended to have a worse visual prognosis. There were some differences in the clinical pattern of Behçet's disease in different countries. Despite modern treatment, the disease still carries a poor visual prognosis with one-quarter of the patients blind. B ehçet's disease is a multisystem disorder characterised by recurrent oral aphthous ulcers, skin lesions, genital ulcers and ocular lesions. The disease often leads to blindness in severely affected individuals. It is most prevalent between the second and fourth decades of life. Behçet's disease is found predominantly between East Asia and the Mediterranean basin, and is uncommon in the American continents, Oceania and sub-Saharan Africa.1 The distribution of uveitis and intraocular inflammation may differ in different regions of the world. In Japan, Behçet's disease is one of the three most frequent diagnoses in patients with uveitis.2 The highest prevalence rate of the disease has been reported from Turkey.3 This disease is strongly associated with the major histocompatibility complex antigen HLA-B51, first reported in 1973. 4 Populations with a high prevalence of HLA-B51 lie predominantly north of the equator, spanning Japan and Western Europe between 30˚and 45˚N. 5 The frequency of ocular involvement in patients is thought to be between 50 and 70%.6-10 The characterisitic ocular feature is a relapsing uveitis, which may involve the anterior segment, posterior segment or both. The classification of the patient's uveitis is important both therapeutically and prognostically, because those lesions affecting the posterior part of the eye tend to be persistent and blinding.11 The disease may be more severe in men than in women. 12In the present study, we examined the differences in ocular features in Behçet's disease between regions and ethnic groups on a worldwide scale and retrospectively analysed the clinical features, ocular manifestations, visual outcomes and complications in more than 1400 Behçet's patients with ocular involvement. METHODSD...

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ABSTRACT.Purpose: We aimed to investigate the clinical features of intraocular inflammation ⁄ uveitis in Hokkaido, Japan. Methods: We retrospectively reviewed the medical records of 1240 uveitis patients (511 men, 729 women) who visited Hokkaido University Hospital, Sapporo, Japan between 1994 and 2003. Results: Mean age at disease onset was 41.7 ± 17.8 years in men and 45.7 ± 18.3 years in women. Anterior, posterior and combined anterior and posterior segment intraocular inflammation accounted for 45.1%, 4.7% and 50.2% of cases, respectively. Sarcoidosis was the most frequent aetiology (14.9%), followed by Vogt-Koyanagi-Harada (VKH) disease (9.7%) and Behc¸et's disease (6.7%). Aetiologies in 49.8% patients were unknown. In sarcoidosis, women represented 72.4% of patients, and disease onset occurred at 35.1 ± 19.0 years of age in men and 50.3 ± 16.5 years in women. In VKH disease, 54.2% of patients were women, and disease onset took place at 45.9 ± 15.8 years in men and 46.4 ± 14.1 years in women. In Behc¸et's disease, men accounted for 56.6% of patients, and disease onset occurred at 35.5 ± 8.5 years in men and 44.5 ± 11.5 years in women. Conclusions: Women were more prone to developing sarcoidosis compared with men. By contrast, men were more prone to developing Behc¸et's disease. The mean age at disease onset in both sarcoidosis and Behc¸et's disease was significantly lower in men than in women.

To enzymatically synthesize active metabolites of vitamin D3, we screened about 500 bacterial strains and 450 fungal strains, of which 12 strains were able to convert vitamin D3 to 1 alpha,25-dihydroxyvitamin D3 [1 alpha,25(OH)2D3] via 25-hydroxyvitamin D3 [25(OH)D3]. The conversion activity was only detected in strains belonging to the genus Amycolata among all the organisms tested. A preparative-scale conversion of vitamin D3 to 25(OH)D3 and 1 alpha,25(OH)2D3 in a 200-1 tank fermentor using A. autotrophica FERM BP-1573 was accomplished, yielding 8.3 mg 25(OH)D3/l culture and 0.17 mg 1 alpha,25(OH)2D3/l culture. A related compound, vitamin D2, could be also converted to 25-hydroxyvitamin D2 and 1 alpha,25-dihydroxyvitamin D2 using the same strain. The cytochrome P-450 of FERM BP-1573 was detected by reduced CO difference spectra in whole-cell suspensions. Vitamin D3 in the culture induced cytochrome P-450 and the conversion activity simultaneously, suggesting that the hydroxylation at C-25 of vitamin D3 and at C-1 of 25(OH)D3 originates from cytochrome P-450.

Patients with LAC, ATI, and LAA were significantly older and were more likely to be hypertensive than patients with NOR. Significantly higher insulin resistance was observed in patients with LAC, ATI, and LAA than in patients with NOR (KITT 2.21 +/- 0.17, 2.10 +/- 0.17, 2.19 +/- 0.25, and 3.25 +/- 0.21% per min, respectively, P < 0.001). Adjustment for age, sex, BMI, and duration of diabetes did not influence this result. Multiple logistical regression analysis showed that insulin resistance was an independent risk factor for all subtypes of ischemic stroke in type 2 diabetic patients. The same analysis showed that a high pulse pressure was a risk factor for LAC, postprandial C-peptide (hyperinsulinemia) was a risk factor for ATI, and longstanding hyperglycemia was a risk factor for LAA.