Several factors have been reported as risk factors for the development of osteoporosis. In this study, we aimed to examine the relationship among lifestyle factors, biologic factors, and bone mineral density (BMD) using structural equation modeling (SEM). The subjects in the present study consisted of 866 postmenopausal Japanese women aged between 40 and 80 years old. In the analysis by the SEM, we employed a multiple basic model. As the structural variables, lifestyle factors and biologic factors were selected. The goodness of fit index (GFI) of the final model was 0.991 and the Akaike’s information criteria (AIC) showed the lowest value in the peripheral models. The degree of association between biologic factors and BMD was −0.576 (direct association), 0.012 (indirect association), and −0.564 (total association). With regard to the correlation between lifestyle factors and BMD, the degrees of association were 0.085, −0.084, and 0.001, respectively. This study defined a pilot model for factors influencing BMD. Although is remains necessary to conduct further analyses with more valid measurements and constructs, this model indicated that the correlation between BMD and lifestyle factors was lower than that between BMD and biologic factors.
Relationship by association ; Models ; Life Style ; structural equation model ; Japanese language

The effects of low- and high-intensity endurance training on the capillary network of rat left ventricle were studied morphometrically. Eighteen male albino rats of Wistar strain (4-wk-old) were assigned at random to a sedentary control group (Cont, n=8) and two trained groups which were both subjected to exercise on a motor-driven treadmill for 60 min a day, 5 days/wk for 9 weeks from 7 wks to 16 wks of age with different running speed; the low-intensity trained group (T-20, n=5) ran at 20 m/min and the high-intensity trained group (T-40, n=5) at 40 m/min. All morphometric parameters for the capillary and muscle fiber were determined in perfusion-fixed hearts. After the training period, the average muscle fiber cross-sectional area in the T-20 and the T-40 was not significantly different from the Cont. There were no significant differences in the capillary density and the capillary-to-fiber ratio between any groups, suggesting no significant change in capillary number. On the other hand, the number of capillary with large luminal diameter (8-10 μm) in the T-40 but not the T-20 was significantly greater than the Cont. These results indicate that the high-intensity endurance training causes enlargement of the capillary luminal area, while neither the low-nor the high-intesnity endurance training stimulate the proliferation of capillaries in the left ventriclular myocardium. In conclusion, a structure of the capillary network of rat left ventricle responds to the high-intensity endurance training by enlarging capillary luminal area rather than by increasing capillary number.

Background: Rapid diagnostic tests (RDTs) have widely been used in the diagnosis of malaria. Although the effectiveness of RDTs for malaria has previously been described in many reports, the low performance of RDTs particularly for Plasmodium ovale malaria in travellers have rarely been reported. Methods: This was retrospective cohort study conducted among Japanese travellers who were diagnosed with malaria at the National Center for Global Health and Medicine between January 2004 and June 2013. Diagnosis of malaria by microscopic examination, RDT, and polymerase chain reaction were performed for all the patients. The RDTs used in our study were Binax NOW Malaria (Binax Inc., Scarborough, Maine, USA) (BN) and SD Malaria Antigen Pf/Pan (Standard Diagnostics Inc., Korea) (SDMA). We compared the sensitivity of the RDTs of P. ovale malaria with that of Plasmodium vivax malaria. Results: A total of 153 cases of malaria were observed, of which 113 patients were Japanese travellers. Nine patients with P. ovale malaria and 17 patients with P. vivax malaria performing RDTs were evaluated. The overall sensitivity of RDTs for P. ovale malaria was 22.2% and that for P. vivax malaria was 94.1% (P < 0.001). The sensitivity of SDMA for P. vivax malaria was 100% and that for P. ovale malaria was 50%. The sensitivity of BN for P. vivax malaria was 90.0%; however, it was unable to detect the cases of P. ovale malaria. Conclusions: The sensitivity of RDTs was not high enough to diagnose P. ovale malaria in our study. Thus, microscopic examination is indispensable not to overlook P. ovale malaria.

Background: Rapid diagnostic tests (RDTs) are used widely in the diagnosis of malaria. Although the effectiveness of RDTs for malaria has been described in many previous studies, the low performance of RDT particularly for Plasmodium ovale malaria in traveller has rarely been reported. Methods: This was a retrospective cohort study conducted on Japanese travellers diagnosed with malaria at the National Center for Global Health and Medicine between January 2004 and June 2013. The diagnosis of malaria was confirmed by microscopic examination, RDT, and polymerase chain reaction in all patients. The RDTs used in our study were Binax NOW Malaria (Binax Inc., Scarborough, Maine, USA) (BN) and SD Malaria Antigen Pf/Pan (Standard Diagnostics Inc., Korea) (SDMA). We compared the sensitivity of the RDTs to P. ovale malaria and Plasmodium vivax malaria. Results: A total of 153 cases of malaria were observed, 113 of which were found among Japanese travellers. Nine patients with P. ovale malaria and 17 patients with P. vivax malaria undergoing RDTs were evaluated. The overall sensitivity of RDTs for P. ovale malaria and P. vivax malaria was 22.2% and 94.1%, respectively (P < 0.001). The sensitivity of SDMA for P. ovale malaria and P. vivax malaria was 50% and 100%, respectively. The sensitivity of BN for P. vivax malaria was 90.0%, but it was ineffective in detecting the cases of P. ovale malaria. Conclusions: The sensitivity of RDTs was not high enough to diagnose P. ovale malaria in our study. In order not to overlook P. ovale malaria, therefore, microscopic examination is indispensable.

PURPOSE: Postoperative pancreatic fistula is a serious and fatal complication of gastrectomy for gastric cancer. Blunt trauma to the parenchyma of the pancreas can result from an assistant's forceps compressing and retracting the pancreas, which in turn may result in pancreatic juice leakage. However, no published studies have focused on blunt trauma to the pancreas during laparoscopic surgery. Our aim was to investigate the relationship between compression of the pancreas and pancreatic juice leakage in a swine model. MATERIALS AND METHODS: Three female pigs were used in this study. The pancreas was gently compressed dorsally for 15 minutes laparoscopically with gauze grasped with forceps. Pancreatic juice leakage was visualized by fluorescence imaging after topical administration of chymotrypsin-activatable fluorophore in real time. Amylase concentrations in ascites collected at specified times was measured. In addition, pancreatic tissue was fixed with formalin, and the histology of the compressed sites was evaluated. RESULTS: Fluorescence imaging enabled visualization of pancreatic juice leaking into ascites around the pancreas. Median concentrations of pancreatic amylase in ascites increased from 46 U/L preoperatively to 12,509 U/L 4 hours after compression. Histological examination of tissues obtained 4 hours after compression revealed necrotic pancreatic acinar cells extending from the surface to deep within the pancreas and infiltration of inflammatory cells. CONCLUSIONS: Pancreatic compression by the assistant's forceps can contribute to pancreatic juice leakage. These findings will help to improve the procedure for lymph node dissection around the pancreas during laparoscopic gastrectomy.
Acinar Cells ; Administration, Topical ; Amylases ; Ascites ; Female ; Formaldehyde ; Gastrectomy* ; Hand Strength ; Humans ; Laparoscopy ; Lymph Node Excision* ; Lymph Nodes* ; Optical Imaging ; Pancreas ; Pancreatic Fistula ; Pancreatic Juice ; Stomach Neoplasms ; Surgical Instruments ; Swine ; Wounds, Nonpenetrating

Purpose: To investigate the clinical significance of adaptive radiotherapy (ART) in locally advanced nasopharyngeal carcinoma treated with intensity-modulated radiotherapy (IMRT). Materials and Methods: Eligible patients were treated with concurrent chemoradiotherapy using IMRT. Planning computed tomography in ART was performed during radiotherapy, and replanning was performed. Since ART was started in May 2011 (ART group), patients who were treated without ART up to April 2011 (non-ART group) were used as the historical control. The Kaplan-Meier method was used to calculate overall survival (OS), locoregional recurrence-free survival (LRFS), progression-free survival (PFS), and distant metastasis-free survival (DMFS). LRFS for the primary tumor (LRFS_P) and regional lymph node (LRFS_LN) were also studied for more detailed analysis. Statistical significance was evaluated using the log-rank test for survival. Results: The ART group tended to have higher radiation doses. The median follow-up period was 127 months (range, 10 to 211 months) in the non-ART group and 61.5 months (range, 5 to 129 months) in the ART group. Compared to the non-ART group, the ART group showed significantly higher 5-year PFS (53.8% vs. 81.3%, p = 0.015) and LRFS (61.2% vs. 85.3%, p = 0.024), but not OS (80.7% vs. 80.8%, p = 0.941) and DMFS (84.6% vs. 92.7%, p = 0.255). Five-year LRFS_P was higher in the ART group (61.3% vs. 90.6%, p = 0.005), but LRFS_LN did not show a significant difference (91.9% vs. 96.2%, p = 0.541). Conclusion Although there were differences in the patient backgrounds between the two groups, this study suggests the potential effectiveness of ART in improving locoregional control, especially in the primary tumor.