Characteristics and course of bone mineral densities among fast bone losers in a rural Japanese community: the Miyama Study

The aim of this study was to clarify and compare the temporal course of bone mineral density (BMD) between fast bone losers and normal residents in Miyama Village, a rural Japanese community. BMD was measured over a 10-year period in a cohort study in Miyama Village, Wakayama Prefecture, Japan, to provide information on rate of bone loss in the mature and elderly population. Subjects (n=400) were selected by sex and age stratum from the full list of residents born in 1910–1949, with 50 men and 50 women in each age decade. Baseline BMD of the lumbar spine and proximal femur was measured using dual energy X-ray absorptiometry in 1990, 1993, 1997 and 2000. In the cohort, 171 men and 189 women completed the follow-up survey performed in 1993. After calculating the rate of bone loss between 1990 and 1993, the greatest tertile from the distribution of bone loss was categorized as fast bone losers, with the remainder considered as normal subjects. Changes in BMD were compared between normal subjects and fast bone losers over the 10-year period. Mean rate of change for BMD at both lumbar spine and femoral neck in fast bone losers recovered to levels similar to those in normal subjects over 7 years of observation. By contrast, BMD at the lumbar spine and femoral neck decreased steeply over the 10-year period in both groups, and mean BMD for fast bone losers was significantly lower than that of normal subjects (P<0.05). These differences were apparent only at the lumbar spine in both men and women, even after adjusting for age. These results indicate that fast bone loss is a transient phenomenon rather than a fixed status, although individuals who have been categorized as fast bone losers at some stage continue to display low BMD in the lumbar spine.     

Intradiscal Thermal Annuloplasty for Discogenic Pain: An Outcome Study

Objectives: Published studies of intradiscal thermal annuloplasty (IDTA) have shown at most 50% pain relief as an improved outcome with little focus on functional improvement in the treatment of discogenic pain. Previous studies have used a number of criteria for patient selection including low back pain unresponsive to conservative care, no compressive radiculopathy, positive provocative discography and absence of previous surgery at the same symptomatic level. The purpose of present study is to examine the hypothesis that additional inclusion criteria for patient selection such as disc height, absence of degenerative disc disease (DDD) in untreated discs, absence of herniated nucleus pulposus or lumbar canal stenosis may improve the outcome of treatment. Methods: In this prospective case‐series study additional criteria of patient selection were introduced, namely disc height of at least 50%, no lumbar canal stenosis, one or two levels of DDD, no evidence of nucleus pulposus herniation on magnetic resonance image. Thirty‐four patients were enrolled in the study and 32 of them were followed over a period of 12 months. The visual analog scale (VAS) pain score and seven activities of daily living (ADLs) were followed and reported on a scale from 0 to 10. Results: Sustained decrease of the VAS pain scores was observed from 3 to 12 months following IDTA. ADLs improved in all patients between 3 and 12 months post‐treatment. Patients in the Bureau of Workers Compensation (BWC) group had a higher VAS score but showed the same level of improvement in ADLs as compared to commercial insurance or self‐pay patients. In the non‐BWC patient group an average VAS pain score decrease of more than 6 points on a 10‐point scale was reported at 6 to 12 months following IDTA. Conclusions: We found dramatic improvement of pain scores and ADLs following IDTA when strict patient selection was applied. We believe that IDTA is an effective, minimally invasive treatment for discogenic pain in properly selected patients.     

经皮等离子消融髓核成形术治疗腰椎间盘突出症: 28例随访报告

目的 探讨腰椎间盘突出症的治疗方法。方法经体格检查，CT和／或MRI检查确诊的腰椎间盘突出症患者28例，采用等离子消融髓核成形术治疗，以Prolo功能和经济结果评定法和VAS评分评定疗效。结果髓核成形组总体治疗成功率82．1％；平均住院时间7．6天，复发率10．8％。并发椎间盘炎1例，进行腰椎融合术后治愈。结论髓核成形术治疗腰椎间盘突出症的满意率较高，复发率低，住院治疗时间短，创伤小，不影响再次手术治疗。髓核成形术是一种安全、有效的治疗腰椎间盘突出症的微创介入治疗新方法。     

体重、体质指数、腰围和腰臀比对正常成人骨密度的影响

目的探讨体重、体质指数(BMI)和腰围、腰臀比(WHR)对正常成人骨密度的影响。方法采用MarcomMx8000多层螺旋CT测定560例正常成人腰椎松质骨密度,将受试者按年龄不同分为青年组、中年组和老年组,然后在同年龄组根据BMI及腰围的不同将受试者分为肥胖组和正常体重组,分析骨密度与体重、BMI、腰围及WHR的关系。结果①以BMI分组,老年肥胖组BMD高于体重正常组(P<0.05);②以腰围分组,中年女性肥胖组BMD低于非肥胖组(P<0.05);③青年组和中年组BMD与腰围及WHR呈负相关,老年组BMD与体重和BMI呈正相关与腰围和WHR不相关。结论预防骨质疏松症在中青年应提倡运动锻炼,避免肥胖,在老年人不应该过分强调降低体重减少肥胖以避免骨量的丢失。     

TEN YEARS' EXPERIENCE IN LOW VISION PRACTICE

The Low Vision Clinic at the Palmerston North Hospital has now been oerating for 70 years. Over the course of these ten years a number of factors have emerged which can be as readily applied to general ophthalmological practice as to low vision practice. The philosophy of low vision care is one of which all ophthalmologists should be aware and includes factors to be taken into account when dealing with children, people in the workplace, and everyday factors involved in daily living activities, all of which are equally relevant in routine ophthalmological practice. This paper endeavours to share some thoughts on these factors and also discusses means by which the visually handicapped can be helped in areas where specialist low vision services are not readily available.     

腰椎全板减压术后顽固下腰痛的原因分析

[目的]分析腰椎全板切除术后残留下腰痛的原因,指导选择合理的手术方法。[方法]回顾分析1996～2000年作者采用全椎板切除减压治疗的腰椎管狭窄症患者临床资料,69例获得5年以上随访的患者作为本组研究对象,使用日本骨科学会(JOA)标准对患者的神经功能和下腰痛程度进行评分,根据手术前后下腰痛程度的变化将病例分为无残存下腰痛(lowbackpain,LBP)组和残存LBP组,针对术前的临床和影像学参数,使用软件包SPSS13.0进行对数回归分析,确定术后残存下腰痛的临床预测因素,并对这些影响因素进行两组间比较和统计分析。[结果]术前腰椎前突角、腰椎活动度和手术减压范围与术后残存下腰痛密切相关。残存LBP组患者术前腰椎生理前突和活动度分别为(22.27°±3.12°)和(22.91°±2.31°),显著低于无残存LBP组患者的腰椎前突和活动度(37.23°±2.19°)和(31.66°±1.52°),P值分别为0.000和0.002;而残存LBP组的减压节段(2.77±0.19节)明显高于无残存LBP组(1.70±0.10节),P值为0.000。[结论]对于术前腰椎前突减小,腰椎活动度下降的椎管狭窄症患者单纯施行多节段的腰椎全板减压容易导致术后顽固性下腰痛的出现,应引起作者重视。     

The effect of seamustard on blood lipid profiles and glucose level of rats fed diet with different energy composition

Recently, Korean people are consuming seaweeds almost 3.5 times more now than three decades ago. It is well known that seaweeds contain lots of soluble dietary fiber in addition to micronutrients such as β-carotene, iodine and some bioactive components. Seaweeds are considered to be effective for preventing chronic diseases including obesity, diabetes mellitus, atherosclerosis, cancer or constipation. This study was conducted to investigate the effect of seamustard intake on body weight gain, blood glucose level and lipid profiles in rats fed diets with different energy nutrient composition. Male Sprague-Dawley rats (average initial weight 103.7 g) were divided into groups for two experiments as follows; Control, M2.5 & M5 groups (Exp. I) and M5, M10, HCM5, HCM10, HFM5 & HFM10 groups (Exp. II). The rats were fed diet and water ad libitum for 4 weeks. In general, there was no significant difference in blood glucose and triglyceride concentration among groups. In Exp. I, serum LDL-cholesterol level of rats fed diet with 5% seamustard powder (M5) was significantly lower than that of control group, while HDL-cholesterol level, TC/LDL ratio and weight of adrenal gland were higher. In Exp. II, food intake, body weight gain and EER of high fat diet with 10% seamustard group (HFM10) were the lowest among groups. Except gastrocnemius muscle, all organ weights of HFM10 group were the lowest. Fecal cholesterol excretion and serum LDL-cholesterol concentration of HFM10 group were the highest, while serum HDL-cholesterol level was the lowest among groups. Interestingly, HDL-cholesterol concentration was the highest in HCM5 group among groups. From these results, it was suggested that seamustard intake might be more effective for body weight control, but not for improving blood lipid profiles in high fat diet than in high carbohydrate diet.     

妊娠高血压综合征尿蛋白的丢失对新生儿出生体重的影响

目的: 几乎没有研究报道妊娠高血压综合征 (妊高征 ) 患者尿蛋白对新生儿出生体重的影响, 该研究欲探讨妊高征患者不同水平尿蛋白对新生儿出生体重的影响关系。方法: 1997年 1月 ~2004年 6月期间, 住院分娩患中、重度妊高征产妇 136例, 对新生儿出生体重与各种因素进行回归分析及t检验分析。结果: 单变量回归分析尿蛋白、孕龄分别与新生儿出生体重有高度显著性关系 (P<0. 01); 尿蛋白和孕龄一起进入多元回归分析, 校正影响因素, 尿蛋白和孕龄仍然是影响新生儿出生体重显著性因素 (P<0 .01); 与妊高征尿蛋白 ( +) 比较, 尿蛋白 无显著性影响新生儿出生体重 (P>0. 05), 尿蛋白 有显著性影响新生儿出生体重 (P<0. 01)。结论: 新生儿出生体重与妊高征患者尿蛋白丢失有关, 尿蛋白 丢失将严重影响新生儿出生体重。     

更昔洛韦治疗婴幼儿手足口病的疗效观察

目的 探讨更昔洛韦对婴幼儿手足口病（HFMD）的临床疗效。方法 将65例婴幼儿HFMD患儿随机分为治疗组和对照组，治疗组加用更昔洛韦，观察临床有效率及不良反应率，并对结果进行统计学分析。结果 临床有效率治疗组为90．91地，对照组56．25％，引起白细胞下降，血小板下降治疗组为33．33％、27．27％，对照组为9．38％、3．13％，差异均有显著性。结论 治疗组疗效优于对照组，但须随访对白细胞和血小板的影响。     

早产儿静脉补钙的护理体会

目的:探讨早产儿静脉补钙的护理。方法:回顾性分析总结38例早产儿静脉补钙的临床观察和护理体会。结果:38例早产儿静脉补钙均未发生皮下组织的坏死与钙化灶。结论:高度认真负责,细心观察和护理,早预防,早发现,早期干预,及时有效处理,是避免钙剂外渗,促进好转的关键。