Mutations in Japanese subjects with primary hyperlipidemia--results from the Research Committee of the Ministry of Health and Welfare of Japan since 1996--

Primary hyperlipidemia is caused by various molecular defects in lipid metabolism. The Research Committee on Primary Hyperlipidemia organized by the Ministry of Health and Welfare of Japan (present: the Ministry of Health, Labour and Welfare) has investigated reported mutations in Japanese patients with primary hyperlipidemia and related disorders (including hypolipidemia), and has created a database based on the questionnaire sent to the members of council board of the Japan Atherosclerosis Society. Mutations in the following genes were investigated: low density lipoprotein receptor, lecithin: cholesteryl acyltransferase, lipoprotein lipase (LPL), hepatic lipase, apolipoproteins A-I, A-II, A-IV, B, C-II, C-III and E, microsomal triglyceride transfer protein, and cholesterol ester transfer protein (CETP). Until 1998, 922 patients with primary hyperlipidemia and related disorders has been registered with the Research Committee, and 190 mutations in 15 genes had been reported, showing a marked variation in Japanese patients with primary hyperlipidemia and related disorders. So-called "common mutations" have been described in Japanese patients with familial hypercholesterolemia, LPL deficiency and CETP deficiency. The genetic defect of familial combined hyperlipidemia (FCHL) is still unknown although FCHL is speculated to be the most prevalent genetic hyperlipidemia, and further investigations should be performed to elucidate the molecular mechanisms of FCHL     

Diagnosis and management of type I and type V hyperlipoproteinemia

Both type I and type V hyperlipoproteinemia are characterized by severe hypertriglyceridemia due to an increase in chylomicrons. Type I hyperlipoproteinemia is caused by a decisive abnormality of the lipoprotein lipase (LPL)- apolipoprotein C-II system, whereas the cause of type V hyperlipoproteinemia is more complicated and more closely related to acquired environmental factors. Since the relationship of hypertriglyceridemia with atherosclerosis is not as clear as that of hypercholesterolemia, and since type I and V hyperlipoproteinemia are relatively rare, few guidelines for their diagnosis and treatment have been established; however, type I and V hyperlipoproteinemia are clinically important as underlying disorders of acute pancreatitis, and appropriate management is necessary to prevent or treat such complications. Against such a background, here we propose guidelines primarily concerning the diagnosis and management of type I and V hyperlipoproteinemia in Japanese.     

Fundamentals of prosthetic practice. Part II--The surgery

It is important for the smooth running of appointments that everyone, patient, receptionist, dental surgery assistant (DSA), the laboratory and, of course, the dental surgeon should know what is happening. Obviously, they do not all require the same information, but certain points will be essential to each of them for maximum efficiency of treatment.     

带铜不锈钢环形宫内节育器与不锈钢环形宫内节育器放置二年的临床效果比较

本文对1978年1月至1980年4月同期放置带铜不锈钢环形宫内节育器1154例和不锈钢环形宫内节育器1298例进行定期随访,以比较临床效果。资料均满二年,按生命表统计临床效果,结果为:①粗累计带器妊娠率,带铜节育器为2.85/100妇女,明显低于不带铜金属单环7.90/100妇女(p<0.01)。②脱落率,带铜节育器为19.28/100妇女,高于不带铜的15.78/100妇女(p<0.05)。③因症取出率分别为8.74及7.60/100妇女(p>0.05),二组间无差异。④二年继续存放率分别为67.56/100妇女和67.71/100妇女(p>0.05),二组相似。带铜节育器带器妊娠率明显降低,且不明显增加因症取出率,建议扩大使用。对于带铜宫内节育器的脱落率稍高的缺点有待研究和改进。