The basal metabolic rate (BMR) of 70 postmenopausal women (age: 60.6±4.2 yrs., height: 154.9±5.2cm, body weight (BW) : 52.7±6.2kg; mean ±SD) was evaluated in relation to body composition (body fat mass (FM) : 17.3±3.9kg, lean body mass (LBM) : 35.3±3.6kg) . BMR was 1, 148±126kcal/day, 21.9±2.2kcal/kgBW/day, 32.7±3.2kcal kgLBM/day in all subjects. BMR (kcal/day) significantly correlated with BW (r=.635, p<0.001) and LBM (r=.598, p<0.001) . When divided into two groups, (lower %fat group (LF; <35%fat) and higher %fat group (HF; ≥35%fat) ), BW and FM were significantly higher in HF than in LF (BW: 56.6±6.4 vs 51.0±5.3 kg, FM: 21.7±2.8 vs 15.5±2.7 kg, p<0.001, respectively) . No difference was observed in LBM between the two groups (34.9±3.9 vs 35.5±3.5 kg) . BMR (kcal/kgBW/day) was lower in HF than in LF (21.0±1.8 vs 22.3±2.3, p<0.05), but HF group had higher BMR in terms of kcal/kgLBM/ day than LF (34.0±3.1 vs 32.1±3.1, p<0.05) . Multiple regression analysis was performed to predict BMR. A single predictor LBM and a pair of predictors LBM and FM explained 35.7% and 42.7% of the variance of BMR. This study suggested that a decrease in LBM is a major factor in affecting the reduction of BMR in postmenopausal women, whereas FM gained after menopause could be considered to have metabolic activity related to BMR.

In this study, we investigated the effects of a 2-year swimming program on suppressing bone loss in postmenopausal women. There were 22 subjects who participated in the swimming program (mean age 59.5 yr) and 19 controls (mean age 59.3 yr) . The program consisted of one-hour exercise sessions ; and the swimmers had on average 1.5 sessions per week. BMD at the lumbar spine (L2-L4) and proximal femur (neck, trochanter, and Ward's triangle) were measured by dual X-ray absorptiometry (DXA) ; and leg extensor power was measured using a dynamic leg extensor power rig. All the measurements were taken at baseline, 1 and 2 years. Height, weight, calcium intake and daily activity profiles were similar between the two groups, and these changed little throughout the experiment. In regard to leg extensor power, the swimming group had a significant increase at 1 and 2 years. At 2 year, the swimming group demonstrated 4.4%, 5.7% and 3.4% increases in BMD at the femoral neck, trochanter and Ward's triangle, respectively, while the control group showed slight decreases of BMD at the femoral neck (-0.2%) and Ward's triangle (-1.4%) . Significant differences in the rate of change in BMD at each site were observed between the two groups. The swimming group showed a decrease in lumbar spine BMD, as did the control group and the rate of the decline did not differ between the two groups. This study suggests that a 2-year swimming program for postmenopausal women can induce the beneficial effects of retarding bone loss at the proximal femur site and increasing leg extensor power.

Sleep disturbance is often observed among patients with diabetes and poor sleep is associated with higher HbA 1 c levels. Therefore, treatment of sleep disturbance is important. We experienced two cases in which sansoninto was useful in the treatment of insomnia with type 2 diabetes mellitus. A 58-year-old man had been treated with insulin for 10 years and a 79-yerar-old man had been treated oral hypoglycemic agents for 15 years. We administered sansoninto in each patient, after which sleep disturbance disappeared gradually. These results suggest that sansoninto is useful for sleep disturbance in patients with diabetes.

In repair of the tricuspid valve (TV) due to Ebstein's anomaly, mobilization of the anterior leaflet associated with longitudinal right ventricle placation (Carpentier's procedure) has provided good results in both short- and long-term follow-up. However, if the anterior leaflet is small or severely deformed, such repair may be ineffective. We report two cases of Ebstein's anomaly (63 and 53 years old) with deformed anterior leaflets of the TV in whom Carpentier's procedure was not feasible. In one patient, the anterior leaflets were broadly plastered on the right ventricle and Carpentier's procedure was tried. However, the repair was converted to valve replacement because of significant residual regurgitation. The other patient had a cleft in the anterior leaflet, therefore Carpentier's procedure was not suitable. The repair restructured the valve mechanism below the true annulus by using the most mobile leaflets for valve closure (modified Hetzer's procedure). This method of repair could be an alternative method to repair of the TV in Ebstein's anomaly, particularly when the anterior leaflet is deformed.

Purpose : Rhythmic gymnasts sometimes develop severe iron-deficiency anemia. Preventing such anemia could thus enhance both their performance and health. We compared the relationship between a dietary intervention and RBC metabolism.Methods : Ten female rhythmic gymnasts were recruited for this study. Changes in the RBC delta-aminolevulinate dehydratase (δ-ALAD) activity were used as an index of biosynthesis, and changes in the haptoglobin (hp) were used to assess degradation.Results : During the one month intervention period, the athletes consumed traditional Japanese foods which provide 1500 kcal energy, 2 g/kg body weight protein, 200 g carbohydrate and 15 mg iron. No main effect of this intervention on the hematological indexes was observed. The δ-ALAD activity was significantly greater in August than in July or September. Hp concentration was significantly lower in August in comparison to the other periods.Conclusion : Dietary intervention might enhance the RBC turnover by increasing the capacity for erythrocyte biosynthesis and degradation.

A main symptom of chronic fatigue syndrome (CFS) is fatigue which continues for more than 6 months and does not improve with rest, leading to a marked decrease in quality of life. Other problems include fever, sleep disorder, and headache. Etiologically, a preceding viral infection, immunological disorder, and changes in the central nervous system, especially in hippocampus have been reported. However, the precise pathogenesis of CFS has not been elucidated, and neither diagnostic markers nor effective treatments have yet to be discovered. Here, we report a case of CFS, successfully treated with Kampo medicines.
The patient was a 16-year-old high school student, who had received medical therapy for one year under the diagnosis of CFS. His chief complaint was a continuing fever and strong malaise after influenza infection. At his visit to our outpatient clinic, we confirmed that his symptoms met the criteria for CFS. A combination treatment with Kampo medicine (sanoshashinto) and duloxetine improved his malaise and fatigue in 4 weeks, but fever and anorexia remained. The addition of hochuekkito to the combination dramatically ameliorated his symptoms. This case suggests that Kampo medicines would contribute to the effective treatment of CFS, which is refractory to Western medicines.

In C1–C2 posterior fixation, the C1 lateral mass and C2 pedicle/translaminar screw insertion under spine navigation have been used frequently. To avoid the risk of neurovascular damage in atlantoaxial stabilization, we assessed the safety and effectiveness of a preoperative computed tomography (CT) image-based navigation system with intraoperative independent C1 and C2 vertebral registration. It is ideal when a reference frame can be linked directly to the C1 posterior arch for C1-direct-captured navigation, but there is a mechanical challenge. A new spine clamp-tracker system was implemented recently, which allows reliable C1- and C2- direct-captured navigation in nine patients with traumatic C2 fractures. In this way, there was no misalignment of C1–C2 screws. C1 lateral mass screws were used except for one case, and translaminar screws were primarily used as an anchor for C2. The C1 lateral mass screw locations, which are 19 mm laterally from the C1 posterior arch’s center, are taken to be constant. However, there is one unusual circumstance in which using a C1 laminar hook instead of a C1 lateral mass screw appears to be a beneficial substitute. The increase of surgical accuracy for posterior C1–C2 screw fixation without cost constraints is significantly facilitated by intraoperative C1- and C2-direct-captured navigation with preoperative computed CT images.

BACKGROUND: We aimed to examine the association of exposure to environmental tobacco smoke with dental caries among preschool children. Exposure to environmental tobacco smoke was assessed in terms of urinary cotinine concentrations and pack-years of exposure to smoking by parents and other family members at home. METHODS: This cross-sectional study included 405 preschool children aged 3-6 years from two preschools in Japan in 2006. Information on the smoking habits of family members living with the child was obtained from parent-administered questionnaires. Dental examination was conducted to assess dental caries, that is, decayed and/or filled teeth. Urinary cotinine levels were measured using first-void morning urine samples. RESULTS: Overall, 31.1% of the children had dental caries, and 29.5% had decayed teeth. Exposure to current maternal and paternal smoking was positively associated with the presence of dental caries after controlling for covariates. More than three pack-years of exposure to maternal smoking and more than five pack-years of exposure to smoking by all family members were significantly associated with the presence of dental caries as compared with no exposure (odds ratio [OR] = 5.55, 95% confidence interval [CI] = 2.17-14.22, P for trend < 0.001 and OR = 2.00, 95% CI = 1.12-3.58, P for trend = 0.004, respectively). These exposure variables were similarly associated with the presence of decayed teeth (OR = 2.92, 95% CI = 1.23-6.96, P for trend = 0.01 and OR = 1.75, 95% CI = 0.96-3.20, P for trend = 0.03, respectively). As compared with lowest tertile of the urinary cotinine level, the highest tertile of the urinary cotinine level was significantly associated with the presence of dental caries as well as decayed teeth; the ORs for the highest vs. lowest tertile of urinary cotinine levels were 3.10 (95% CI = 1.71-5.63, P for trend = 0.012) and 2.02 (95% CI = 1.10-3.70, P for trend = 0.10), respectively. CONCLUSIONS These data suggest that exposure to tobacco smoke may have a dose-dependent influence on the development of caries.
Child ; Child, Preschool ; Cotinine ; urine ; Cross-Sectional Studies ; Dental Caries ; epidemiology ; etiology ; Female ; Humans ; Japan ; epidemiology ; Logistic Models ; Male ; Maternal Exposure ; adverse effects ; Parents ; Paternal Exposure ; adverse effects ; Risk Factors ; Surveys and Questionnaires ; Tobacco Smoke Pollution ; adverse effects ; Tobacco Smoking ; adverse effects ; epidemiology