In the conventional reconstruction of microtia, skin grafting is an absolute necessity because of the scantiness of the skin tissue at the affected site. As the result, color- and texture- matching as well as sensory preservation remain to be improved. To solve these problems, we developed a surgical procedure for reconstruction of microtia by using a tissue expander, which allowed us to reconstruct the erect auricle without the need for skin grafting. In this paper, we introduce and discuss our method using the tissue expander with a review of the literature. We operated on a total of 38 patients with microtia. Most of the patients were around 10 years of age, but 3 were adults. Autogenous cartilage was used, and the helix, antihelix, concha, and tragus were reproduced. Initially, 70 ml custommade expanders were used; after that, 75 ml or 95 ml ready-made expanders were used. The erect auricle was reconstructed by the primary procedure in 33 patients. The reconstructed auricle was satisfactory in color- and texture­- matching and had nearly normal sensation. No major absorption of the cartilage has been noted for 15 years, although a slight retraction of the expanded skin was observed in each patient. In conclusion, microtia repair by using a tissue expander is superior to that by conventional procedures in color- and texture- matching and sensory preservation of the reconstructed auricle.

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The objective of this study was to elucidate changes in the health-related lifestyle of Mongolian pastoralists in China in connection with their urbanization. A total of 592 people participated in a survey that included a medical examination and an interview questionnaire. Files of 72 pastoral Mongolians, 78 urban Mongolians, 380 urban Han/Man and 21 urban Hui were used for this analysis. Urban Mongolians consumed meat and milk products less frequently than did pastoral populations (p<0.001), and consumed fish and vegetables more frequently than did pastoral populations (p<0.001). Urban Mongolian consumed mutton, beef, rengyo fish, milk, milk tea, curd, butter, yogurt, and sheep milk less frequently (p<0.05) and pork, sword fish, and dried milk more frequently (p<0.05) than pastoral Mongolian. Male pastoral Mongolians were more likely to drink and smoke than were urban Mongolians (p<0.01), urban Han/Man (p<0.01), or urban Hui (p<0.01). The lifestyles of pastoral Mongolians in Inner Mongolia, China have changed in connection with urbanization. Understanding of the traditional pastoral lifestyle and the urban-living acculturation process will contribute to maximizing the positive impacts of urbanization on people’s health in Inner Mongolia.

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School-based dental health activities conducted in Hiraizumi over the past 20 years have remarkably improved the dental health status of schoolchildren. For example, DMFT index of 12-year-old children decreased to 1.5 in 1998, one-half that of the national average. School dental health activities, which were focused on dental health education, resulted in an increase of filled teeth rates, a decrease in the number of missing teeth, and a decline in incisor caries (1979-1986). In addition, the introduction of a school-based fluoride mouth-rinsing program (1986-） showed a positive effect on the prevention of dental caries; a significant decrease was observed in the overall prevalence of dental caries, particularly in the molars. In Japan it seems advantageous to promote the dental health of schoolchildren by school-based programs that combine dental health examination, dental health education and fluoride mouth-rinsing program. Especially, to prevent dental caries in the mandibular first molars more effectively, it is recommended to start fluoride mouth-rinsing at age 5.

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Heat shock proteins (HSPs) are highly con­served molecules and distributed widely in nature. They are also distributed in the skin, however, only limited information is available on the role of HSPs in the skin diseases. lmmuno­histochemical study of HSPs in the skin revealed that HSPs are differently expressed in the epidermal cells of patients with systemic lupus erythematosus (SLE), atopic dermatitis, graft versus host disease (GVHD) and so on. In normal healthy skin HSPs are constantly expressed in the epidermal cells. HSPs are expressed in the skin according to the influence of both external and internal milieu of the diseased conditions. Cytokines released in the skin strongly affect to express HSPs in epidermal cells. HSPs expressed in the skin can be targets for infiltrated T cells to modulate immune response of skin diseases. Roles of HSPs in the pathogenesis of SLE, GVHD, atopic dermatitis and psoriasis are discussed in this review. HSPs play an important role in the pathogenesis of many inflammatory skin diseases. They can be the molecules to evaluate both diseased conditions and inflammatory process of the skin diseases.

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