A study was conducted to investigate the validity of bioelectrical impedance measurement (BIM) for determining changes in body composition during treatment of obesity with an exercise and diet regimen. Eleven obese women, aged 38-57 yr (44±6.0 yr), participated in a weight reduction study. Before and after the weight reduction period, body composition was measured by the deuterium oxide (D₂O) dilution and BIM methods. For both methods, the correlation coefficients were of the same order of magnitude under both pre- and postregimen conditions. Mean weight reduction was 3.59±1.518 kg and loss of total body fat was estimated to be 4.8±1.72 kg by the D₂O method and 2.5±1.14 kg by the BIM method. Thus the BIM method underestimated the change in body fat compared with the D₂O method. Changes in resistance (R) and height squared divided by R were not significant at the p>0, 05 level. However, the mean change in fat-free mass (FFM) found by the D₂O method was significantly greater than that found by the BIM method. Furthermore, there was no significant correlation between the changes in FFM estimated by the D₂O and BIM methods. These results show that after weight reduction the BIM method overestimates body composition. It is concluded that the BIM method is not a valid approach for measuring the small changes in body composition that occur during treatment of obesity.

A 61-year-old man with aortic regurgitation was found to have a quadricuspid aortic valve during operation. The aortic valve consisted of four equal sized cusps with an accessory cusp located between the left and right coronary cusps. The right coronary ostium was placed in a lower position. Aortic replacement with a St. Jude Medical prosthesis was performed successfully. Quadricuspid aortic valve is a rare anomaly and 14 cases of quadricuspid aortic valves in the Japanese literature which were corrected surgically are reviewed.

In von Recklinghausen's disease vascular involvement is rare, especially rupture of peripheral arterial aneurysms. A 65-year-old man with previously diagnosed neurofibromatosis was admitted because of left lateral neck and left shoulder pain. Computed tomography and selective left subclavian angiography revealed ruptured aneurysm of left costocervical artery, and therefore an emergency operation was performed. Left costocervical artery was exposed and proximal ligation of the aneurysm was performed. Angiography is a most useful and important procedure in operations for vascular involvement in von Recklinghausen's disease.

In the present study, we investigated the associations of the body mass index (BMI ; kg/m²) and the waist to hip circumference ratio (WHR) with metabolic features in 134 Japanese women ranging in age from 24 to 79 years. We found that the BMI was reasonably well correlated with the WHR (r=0.693, p<0.001), which may be related to the health risk profile. The BMI and WHR both showed significant negative correlation with high-density lipoprotein cholesterol (HDL) level, and positive correlation with triglyceride (TG) and plasma glucose (GL) levels and systolic blood pressure (SBP) and diastolic blood pressure (DBP) . Following adjustment for the effect of the BMI, the partial correlation coefficients of WHR with HDL, TG, and GL were lower than those obtained before adjustment, and were not significant. However, the partial correlation coefficient of WHR with HDL/total cholesterol ratio (HDL/TC), SBP, and DBP were significant. These results suggest that the levels of HDL, TG and GL are associated with the BMI among subjects with similar WHR. We therefore propose that a combination of the BMI and WHR would be a superior indicator in obesity screening than the BMI alone.

Objective: This study aimed to elucidate the electro-clinical characteristics of epilepsy and immunological markers in patients with epilepsy after infl uenza-associated encephalopathy/encephalitis (IAE). Methods: Eighteen patients with epilepsy after IAE (8 males, 10 females; mean age of onset 6.4±6.4 years) were studied. Antibodies to glutamate receptor (GluR) ε2 (NR2B) were examined by immunoblot and ELISA. Cytokines were measured by BioPlex. Results: Mean interval between IAE and epilepsy onset was 63.2 ± 95.0 days (mean ± SD). In 16 of 18 patients, complex partial seizures were observed. Most complex partial seizures were of short durations and showed few lateralizing signs. Interictal discharges were seen in the frontal area in 7 of 14 patients. Ictal EEG showed rapid propagation to bilateral hemispheres. Patients with higher cerebrospinal fl uid levels of anti-GluRε2 antibodies, higher cerebrospinal fl uid levels of IL-1β, soluble tumor necrosis factor receptor 1 and IFN-γ during chronic stage, had higher frequency of epileptic seizures. Conclusion: This study indicates that the frontal lobes are susceptible to rapid epileptogenesis after IAE, and that epileptic partial seizures after IAE had characteristics resembling generalized seizures. Presence of anti-GluRε2 antibodies and elevated IL-1β, TNFα, and IFN-γ in cerebrospinal fl uid may be associated with intractability of epileptic seizures.

Magnetoencephalography (MEG) and magnetic source imaging (MSI) are becoming increasingly important modalities in the functional neuroimaging of children. MEG is the magnetic equivalent of electroencephalography (EEG) and is thus capable of noninvasively characterizing neuronal activity on a millisecond time scale. MSI combines this functional information provided by MEG with the high anatomic detail of conventional magnetic resonance imagings. Considerable effort is placed on analyzing the configuration and number of spike waves by MEG that relate to a primary epileptiform discharge. Such MEG spike clusters are corroborated now by intraoperative invasive subdural grid monitoring that show good correlation in the majority of cases. Another important role of MEG relates to the mapping of critical regions of brain function using known paradigms for speech, motor, sensory, visual, and auditory brain cortex. In this review, I would introduce the background of MEG, data acquisition and analysis, and clinical application of MEG in children with epilepsy.
Brain ; Child* ; Electroencephalography ; Epilepsy ; Functional Neuroimaging ; Humans ; Magnetoencephalography* ; Neurons