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Purpose To investigate the clinical manifestations, prognosis, and HLA-type of tubulointerstitial nephritis and uveitis syndrome (TINU) with long-term follow-up. Methods Clinical data of five patients with TINU were retrospectively reviewed. Results The mean age was 15.8 years. The mean follow-up periods were 54.0 months. The initial subjective symptoms were bulbar injection (100%), ocular pain (80%), and blurred vision (60%). The medical department that the patients visited first was ophthalmology in 4 (80%) cases. Urinalysis showed the characteristic increase of the β2 microglobulin in all (100%) patients. Uveitis and nephritis were diagnosed within 1 week from each other. Although two showed recurrences, the topical and systemic steroid treatment with mean duration of 14.1 months brought the resolution of nephritis and uveitis in all patients. Recurrence-free periods ranged from 12 to 71 months. The final visual outcome was 20/20 or better in all cases. HLA-DR4 or the allele of DRB1∗04 was present in all (100%) patients. Conclusions TINU should be considered in the differential diagnosis in young patients with uveitis of unknown origin and renal dysfunction. Urinary β2 microglobulin level and HLA typing may help in the diagnosis of TINU. The prognosis for patients with TINU is generally good with steroid treatment.

We investigated serum lipoprotein(a) [Lp(a)] levels in 20 patients with the nephrotic syndrome. Lp(a) levels in the nephrotic syndrome patients were significantly higher than those in a control group (30.4±22.5 vs 10.4± 17.7 mg/dl). Overall, the serum Lp(a) and lipid levels showed no relationship, but on an individual basis the serum Lp(a) level varied with the serum levels of total cholesterol and low density lipoprotein cholesterol in the nephrotic syndrome patients. Our findings suggest that a decrease in serum albumin led to increased hepatic Lp(a) synthesis. It is well known that thrombotic disease supervenes on hypercoagulability in the nephrotic syndrome, so the determination of Lp(a) levels in these patients may provide information which is useful for pre venting thrombotic complications.

Since it has been reported that eicosapentaenoic acid (EPA) has a favorable effect on the incidence of myocardial infarction,' much interest is focused on EPA including fish oils. However, it is well known that one of the main causes of death in Eskimos is cerebral bleeding, which might be related to the reduction of platelet aggregation. The purpose of this study is to investigate whether EPA plays an important role in the incidence of cerebral bleeding in the stroke-prone spontaneously hypertensive rat (SHRSP). EPIDEMIOLOGICAL BACKGROUND IN JAPANESE2Death rates by myocardial infarction and apoplexy have been studied in Tokyo and Higashi Izu (a typical fishing village). The death rates by both myocardial infarction and apoplexy were higher in Tokyo than in Higashi Izu. This was thought to be related to the higher incidence of hyperlipidemia (Type IIa and IIb) in Tokyo. Although the main cause of death in the apoplexy cases in Tokyo was cerebral infarction, it was cerebral bleeding in Higashi Izu. In connection with this, it was of interest that the incidence of hyper-EPAemia (arbitrarily designated as values over the mean + 1 SD of the levels in Tokyo) was significantly higher in Higashi Izu than in Tokyo, though the incidences of hypertension were almost similar in the both places.These results indicate that a population taking a high amount of animal fat has a high serum cholesterol level and a high incidence of arteriosclerotic vascular disease; whereas a population taking a high amount of EPA has a high serum EPA level and a high incidence of cerebral bleeding. ANIMAL EXPERIMENT Dose Response Study Subjects and MethodsForty-eight 12-week-old male SHRSP, F-65, were bred under the barrier system, where temperature and humidity were maintained at 23 * 2°C and 60 2 10%. Basic 324 YASUGI el al.: EPA & APOPLEXY 300h Y m E CI)

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