Fish consumption and mortality from all causes, ischemic heart disease, and stroke: an ecological study.

BACKGROUND: The present study examined the relation between fish consumption and mortality from all causes, ischemic heart disease, and stroke. METHODS: The fish consumption data in 1961-1963, 1979-1981, and 1989-1991 and mortality data, age-standardized to 45-74 years, mean of the latest available 3 years, mostly around 1992-1993, in 36 countries, were obtained from the Food and Agriculture Organization and the World Health Organization, respectively. RESULTS: There exists an inverse univariate correlation between log fish consumption in 1961-1963, 1979-1981, and 1989-1991 and log all-cause (P < 0.01 to < 0.001) and ischemic heart disease (P < 0.05 to < 0.01) mortality in both sexes. An inverse univariate correlation between log fish consumption and log stroke mortality was found only for the period 1961-1963 in both sexes (P < 0.05). Log fish consumption was independently, significantly, and inversely associated with log all-cause (all P < 0.001), ischemic heart disease (P < 0.01 to < 0.001), and stroke (P < 0.05 to < 0.001) mortality in all three time periods in both sexes, after adjusting for confounding factors. These associations remained significant even after exclusion of Iceland and Japan, countries with the highest amount of fish consumption and the lowest all-cause mortality rate. CONCLUSIONS: Fish consumption is associated with a reduced risk from all-cause, ischemic heart disease, and stroke mortality at the population level.     

Intrathoracic omental herniation through the esophageal hiatus: Report of a case

(Received for publication on Dec. 8, 1997; accepted on July 7, 1998)     

Current trends in cataract and refractive surgery in Japan: 1997 survey.

PURPOSE: A sixth annual survey was carried out by mail in January 1998, to investigate the current trends in cataract and refractive surgery in Japan. RESPONDENTS: Questionnaires were sent to 816 ophthalmologist members of the Japanese Society of Cataract and Refractive Surgery. Data received from 409 (50.1%) of the recipients were cross-analyzed and compared with those from the previous surveys. RESULTS AND CONCLUSION: In cataract surgery, there have been trends toward more surgical procedures performed by a surgeon, shorter period of hospitalization, and increased number of outpatient surgery. Ninety-two percent of respondents preferred phacoemulsification, 54% used the self-sealing wound-closure technique, and 19% used topical anesthesia for phacoemulsification. As for refractive surgery, surgeons remained rather conservative; with 28% and 7% of surgeons doing astigmatic keratotomy and refractive keratotomy, respectively. Photorefractive keratectomy, laser in situ keratomileusis, and phakic intraocular lens were judged to be useful refractive surgical procedures by 56.6%, 43.3%, and 25.1% of the respondents, respectively.     

Neuropathological findings of an autopsy case of adult β-galactosidase and neuraminidase deficiency

Summary An autopsy case of a Japanese male with familial -galactosidase and neuraminidase deficiency is reported. The clinical picture was characterized by adult onset, a gargoyle-like face, cerebellar ataxia, myoclonus, convulsions, retinal degeneration and cortical blindness.Histopathologically, most neurons seemed to have become degenerated in the whole cerebral cortex. Moreover, the calcarine cortex appeared spongy with depopulation of nerve cells. Stuffed neurons or neuronal storage changes were found throughout the brain, especially in the motor nuclei of the spinal cord and brain stem.The inclusions in the stuffed neurons revealed various profiles on the electron microscope. They were composed of membranous lamellar and/or multilamellar structures, often accompanying vacuoles and reminiscent of lipofuscin-like profiles.     

Characteristics of epilepsy in severely mentally retarded individuals

In order to clarify the characteristics of epilepsy in patients with severe mentally retarded (SMR) subjects, we analyzed 52 SMR subjects with epilepsy from the institute for SMR subjects at Kikuchi National Hospital, Kumamoto, Japan. A total of 61.5% patients had uncontrolled seizures which were resistant to treatment. The most common combinations of seizure types in those not responding to conventional anticonvulsants were generalized tonic-clonic seizures (GTCS) with tonic seizure and GTCS with atypical absence. Their clinical features were characterized by spastic paralysis associated with a slower background electroencephalogram and abnormal computed tomography scans of the head, suggesting the involvement of cortical damage. These findings suggest that a large proportion of epilepsy in SMR subjects does not respond to treatment and that the severity of organic brain damage may therefore affect the natural course of epilepsy in such patients.     

Late onset X-linked hydrocephalus with normal cerebrospinal fluid pressure

A family with X-linked hydrocephalus with normal cerebrospinal fluid (CSF) pressure and in which three brothers and a grandson of case 1, a proband, were affected is reported. The symptoms at onset were epileptic attacks that started in adulthood in the three brothers and at the age of 6 years in the grandson. In the three brothers, from 10 to 27 years after the onset of epileptic episodes, disorganization of intelligence and psychiatric deterioration were gradually noticed by their families. At the same time, they showed occasional urinary incontinence. Brain computed tomography (CT) scans revealed dilatation of the ventricular systems. Based on the results of the measurement of CSF pressure and radioactive-iodinated human serum albumin (RISA)-cysternography, two of the brothers were diagnosed as having normal pressure hydrocephalus (NPH), and they were treated neurosurgically. However, no obvious improvement in clinical symptoms was observed. Although the grandson had shown normal psychomotor development during his early childhood, temporal epilepsy and temper tantrums started at the age of 6 years. Computed tomography-scanning revealed dilatation of the ventricular system similar to the other three cases at the age of 8 years. With the diagnosis of NPH, the patient underwent a shunt operation, which resulted in no obvious effects. As it is reasonable to surmise that the pathological gene would have been transferred via the daughter of the proband to the grandson, it is suggested that the inheritance manner might be X-linked recessive. The cases presented here are different from the cases of hydrocephalus due to stenosis of the aqueduct Sylvius (HSAS) and other types of X-linked hydrocephalus reported previously in terms of the age of onset, course, symptoms, and CT findings. Thus, it is suggested that the present cases might be a new type of X-linked hydrocephalus.