The purpose of this study was to investigate the relationships between muscle mass or muscle power and bone mineral density in 43 postmenopausal women. Single photon absorptiometry was used to measure the bone mineral density and bone width of the calcaneuse. Isotonic muscle power of knee extensions (KE), knee flexions and incline squats (ISQ) were measured, using the power processor (VINE Co., Ltd.) . Statistical analysis demonstrated a significant positive correlation (p<0.05) between bone mineral density and lean body mass or muscle thickness. Although, bone mineral density was not significantly correlated with body mass index or fat mass, it was significantly corre-lated with leg muscle power. Further, the bone mineral density was also positively correlated with muscle contraction speed in the motion of KE (p<0.01) and ISQ (p<0.05), but not with muscle strength. This data suggest that the bone mineral density is closely related to the muscle power and/or speed rather than the muscle strength in postmenopausal women.

A 60-year-old woman visited our hospital, complaining of hyperpigmentation and itching of the skin. The case was histologically diagnosed as acanthosis nigricans by skin biopsies. It is usually associated with malignancies, of which gastric cancer is by far the most common. Upper endoscopy revealed advanced gastric cancer (Borrmann type 3). Total gastrectomy was performed, but the patient died of peritonitis carcinomatosa 21 months after resection. It is important to examine the upper GI tract periodically when acanthosis nigricans is present from the early stage.

A cDNA encoding novel type III polyketide synthase (PKS) was cloned and sequenced from young leaves of Chinese club moss Huperzia serrata (Thunb.) Trev. by RT-PCR using degenerated primers based on the conserved sequences of known CHSs, and named as H. serrata PKS2. The terminal sequences of cDNA were obtained by the 3'- and 5'-RACE method. The full-length cDNA of H. serrata PKS2 contained a 1212 bp open reading frame encoding a 46.4 kDa protein with 404 amino acids. The deduced amino acid sequence of H. serrata PKS2 showed 50%-66% identities to those of other chalcone synthase super family enzymes of plant origin. The recombinant H. serrata PKS2 was functionally expressed in Escherichia coli with an additional hexahistidine tag at the N-terminus and showed unusually versatile catalytic potency to produce various aromatic tetraketides, including chalcones, benzophenones, phloroglucinols, and acridones. In particular, the enzyme accepted bulky starter substrates N-methylanthraniloyl-CoA, and carried out three condensations with malonyl-CoA to produce 1, 3-dihydroxy-N-methylacridone. Interestingly, H. serrata PKS2 lacks most of the consensus active site sequences with acridone synthase from Ruta graveolens (Rutaceae).

A 77-year-old man had undergone CABG (coronary artery bypass grafting) (SVGs (saphenous vein grafts) to LAD (left anterior descending coronary artery), OM (obtuse marginal) and RCA (right coronary artery)) 15 years previously. Three years previously, he underwent CABG again (LITA (left internal thoracic artery)-OM, RGEA (right gastroepiploic artery)-RCA) due to recurrence of angina pectoris, but there was no evidence of graft disease in the SVG to the LAD. Six months before the present procedure, graft disease developed in the SVG to the LAD and caused unstable angina pectoris. Therefore, the left axillary artery was bypass grafted to the coronary artery (LAD) using SVG without cardiopulmonary bypass by means of the MIDCAB (minimally invasive direct coronary artery bypass) technique. The patient has had no angina pectoris subsequently. Postoperative angiography revealed that the graft was patent. The axillo-coronary (LAD) bypass appears to be a useful procedure for re-revascularization to the LAD in patients with no available arterial graft, such as ITA (internal thoracic artery) or RGEA.

To investigate whether magnesium abnormalities are associated with the administration of magnesium-containing laxatives in a palliative care setting, we measured the serum magnesium levels in 48 patients with advanced cancer at our palliative care unit (PCU). The mean magnesium concentration in all patients was 2.09 mg/dl (confidence interval [CI], 1.38-3.62). Patients receiving magnesium-containing laxatives (n=38) showed significantly higher serum magnesium concentrations than patients without laxatives (n=10) (2.17 mg/dl vs 1.8 mg/dl, p=0.006). Although 10 patients had serum magnesium abnormalities (hypomagnesemia, 8 and hypermagnesemia, 2), we did not observe clinical manifestation associated with magnesium abnormalities. Interestingly, neither the duration nor the dose of laxatives correlated with serum magnesium concentration. Overall, patients at the PCU tend to have magnesium abnormalities and their symptoms may be analogous to those of advanced cancer patients; in particular, terminal patients with such symptoms might be considered to have magnesium abnormalities.

　　Case 1: A woman in her 70s was carried into emergency department of our hospital. Apparently she had dyspnea. Acute pulmonary heart was suspected. Electrocardiography S I Q III T III-pattern. The patient was diagnosed with popliteal vein vascular aneurysm by ultrasonography. Case 2: A man in his 60s, was referred to our hospital for treatment of lower extremity swelling and pain. Like Case 1, the male patient was suspected of having deep vein thrombosis and femoral artery aneurysms by ultrasound inspection and also diagnosed with pulmonary thromboembolism based on CT findings. We were able to rescue these two patients by rapid medical cooperation. Ultrasonography was particularly useful for diagnosis and morphological evaluation of blood vessels.