Triglyceride level and soft drink consumption predict nonalcoholic fatty liver disease in nonobese male adolescents

Aim

Differential metabolic risk factors of nonalcoholic fatty liver disease (NAFLD) in nonobese male adolescents were analyzed examining relationships between NAFLD and clinical parameters of metabolic syndrome, including exercise and soft drink consumption, in male adolescents.

Methods

In total, 134 male university students (nonobese, n = 78; obese, n = 56) who underwent the first-year health checkup were divided into the NAFLD and non-NAFLD groups based on abdominal ultrasonography (AUS) findings. Relationships between NAFLD and metabolic parameters, including body mass index (BMI) and AUS score, were examined in nonobese students.

Results

Metabolic factors associated with hypertension, abdominal fat, liver damage, dyslipidemia, and impaired glucose tolerance were significantly less common in nonobese students than in obese students. The aforementioned factors and soft drink consumption were significantly more common in the NAFLD group than in the non-NAFLD group. The univariate and multivariate analyses of nonobese students showed that the triglyceride level (odds ratio [OR], 1.06; 95% confidence interval [CI], 1.01–1.10, p = 0.001) was higher and soft drink consumption (OR, 36.8; 95% CI, 3.69–368, p < 0.001) was more common in the NAFLD group than the non-NAFLD group.

Conclusions

Triglyceride level and soft drink consumption could aid in the detection of NAFLD in nonobese male adolescents. Our findings could provide useful information related to NAFLD and metabolic syndrome in nonobese adolescents.     

Primary repair for complete atrioventricular canal: recommendation for early primary repair

Forty patients with complete atrioventricular canal (CAVC) underwent primary repair at Fukuoka Children's Hospital in Fukuoka, Japan, between August 1, 1981 and July 31, 1989. The age at repair ranged from 2 months to 6 years (mean 19 months); weight ranged from 2.3 to 22 kg. The surgical mortality was 2.5%. Justification for early primary repair was examined. Eleven patients underwent repair before 6 months of age (Group 1), 12 patients, between 7 and 11 months of age (Group 2), and 17 patients, after 12 months of age (Group 3). Degenerative changes in the atrioventricular valve increased significantly as age at repair increased (p less than 0.05 Group 1 versus Group 3). The incidence of residual mitral regurgitation tended to increase in the order of Group 1, 2 and 3, though the degree ranged from trivial to mild. Study of the left atrium/aorta ratio by echocardiography revealed that stable values of around 1.1 in Groups 1 and 2 and around 1.3 in Group 3 continued during the follow-up period of 3 years. Assessment of the diameter of the repaired mitral valve in the mean interval of 26 months in groups 1 and 2 revealed normal growth of the mitral valve annulus. The angle between the repaired mitral valve and ventricular septum, which can be affected by the growth of the ventricular septum, converged to normal range in the mean interval of 26 months. Postoperative pulmonary vascular resistance in Groups 2 and 3 was higher at 4.4 +/- 2.3 and 6.3 +/- 2.2, respectively, than in Group 1 at 3.3 +/- 2.2 (p less than 0.01 versus Group 3).(ABSTRACT TRUNCATED AT 250 WORDS)     

Norwood procedure without circulatory arrest.

In the Norwood procedure for hypoplastic left heart yndrome, the distal descending thoracic aorta was cannulated just superior to the diaphragm through median sternotomy. In combination with cerebral perfusion through the graft anastomosed to the innominate artery, which was used as a systemic-to-pulmonary shunt later, this technique enabled us to completely avoid circulatory arrest and deep hypothermia throughout the operation.     

Clinical feature of the diabetic patients with recurrent pulmonary tuberculosis]

We investigated the clinical feature of 22 diabetic patients diagnosed as having recurrent pulmonary tuberculosis. More than half of the patients relapsed within five years after discharge from the hospital. The mean serum albumin concentration of those patients who experienced relapses within three years was significantly lower than that of the patients who experienced relapses a period of time greater than three years. We recognized a significant negative correlation between the recurrent period and body mass index or fasting plasma glucose values. Among these patients, 50% of them ceased treatment for diabetes mellitus personally or had not been diagnosed as having diabetes mellitus before the relapse. All of the patients who ceased treatment for diabetes mellitus before readmission were able to obtain good plasma glucose control only through diet therapy during their first hospital admission for pulmonary tuberculosis. From this study, We concluded that strict plasma glucose control is important for the prevention of a relapse of the mycobacterial infection in patients with diabetes mellitus.     

Height loss in older women: Risk of hip fracture and mortality independent of vertebral fractures

We examined if height loss in older women predicts risk of hip fractures, other nonspine fractures, and mortality, and whether this risk is independent of both vertebral fractures (VFx) and bone mineral density (BMD) by dual‐energy X‐ray absorptiometry. Among 3124 women age 65 and older in the Study of Osteoporotic Fractures, we assessed the association with measured height change between year 0 (1986–1988) and year 15 (2002–2004) and subsequent risk of radiologically confirmed hip fractures, other nonspine fractures, and mortality assessed via death certificates. Follow‐up occurred every 4 months for fractures and vital status (>95% contacts complete). Cox proportional hazards models assessed risk of hip fracture, nonspine fracture, and mortality over a mean of 5 years after height change was assessed (ie, after final height measurement). After adjustment for VFx, BMD, and other potential covariates, height loss >5 cm was associated with a marked increased risk of hip fracture [hazard ratio (HR) 1.50, 95% confidence interval (CI) 1.06, 2.12], nonspine fracture (HR 1.48; 95% CI 1.20, 1.83), and mortality (1.45; 95% CI 1.21, 1.73). Although primary analyses were a subset of 3124 survivors healthy enough to return for a year 15 height measurement, a sensitivity analysis in the entire cohort (n = 9677) using initial height in earlier adulthood [self‐reported height at age 25 (?40 years) to measured height age >65 years (Year 0)] demonstrated consistent results. Height loss >5 cm (2″) in older women was associated with a nearly 50% increased risk of hip fracture, nonspine fracture, and mortality—independent of incident VFx and BMD. © 2012 American Society for Bone and Mineral Research     

The kinase Pyk2 is involved in renal fibrosis by means of mechanical stretch-induced growth factor expression in renal tubules

Unilateral ureteral obstruction is a well-established experimental model of progressive renal fibrosis. We tested whether mechanical stretch and subsequent renal tubular distension might lead to renal fibrosis by first studying renal tubular epithelial cells in culture. We found that mechanical stretch induced reactive oxygen species that in turn activated the cytoplasmic proline-rich tyrosine kinase-2 (Pyk2). This kinase is abundantly expressed in tubular epithelial cells where it is activated by several stimuli. Using mice with deletion of Pyk2 we found that the expression of transforming growth factor-β1 induced by mechanical stretch in renal tubular epithelial cells was significantly reduced. The expression of connective tissue growth factor was also reduced in the Pyk2(-/-) mice. We also found that expression of connective tissue growth factor was independent of transforming growth factor-β1, but dependent on the Rho-associated coiled-coil forming protein kinase pathway. Thus, Pyk2 may be an important initiating factor in renal fibrosis and might be a new therapeutic target for ameliorating renal fibrosis.     

A phase II study of oral VP-16 in primary lung cancer

A clinical trial of a new semi-synthetic podophyllotoxin, VP-16, was undertaken in patients with primary lung cancer; 56 of the 81 evaluable patients had small cell carcinoma, 9 adenocarcinoma, 8 epidermoid carcinoma, 7 large cell carcinoma, and 1 adenosquamous carcinoma. A dose of 200 mg/body/day orally for 5 consecutive days was administered every 3 to 4 weeks. Partial response (PR) was attained in 19 out of 81 (23%) and PR + MR was 35 out of 81 (43%). PR and minor response (MR) were seen as follows; small cell carcinoma, 17 PR (30%), 13 MR; epidermoid carcinoma, 2 PR (25%), 1 MR; adenocarcinoma, 1 MR; adenosquamous carcinoma, 1 MR. The dose-limiting factor was leukopenia, while thrombocytopenia was experienced in 2 cases. Clinical toxicities noted were anorexia, nausea, vomiting, stomatitis, diarrhea and alopecia, but these were well tolerated in all cases. The result indicated that VP-16 has considerable efficacy in small cell carcinoma and epidermoid carcinoma of the lung and hence its usefulness in combination chemotherapy was suggested.     

Vitreous changes and macular edema in central retinal vein occlusion

The condition of the posterior vitreous was determined in 56 eyes with central retinal vein occlusion (CRVO). Using a life-table analysis, it was studied in 56 eyes. The incidence of posterior vitreous detachment (PVD) in the CRVO eyes at the first vitreous examination did not differ significantly from that in 64 age-matched control eyes. However, the incidence of PVD in CRVO eyes increased from 39.3% at the first vitreous examination to 58.5% after 6 months, and to 69.6% 1 year from the examination. The incidence of PVD in CRVO eyes during follow-up was statistically higher than that of the controls (P = .009). The incidence of PVD after the first vitreous examination was significantly higher in eyes with hemorrhagic retinopathy than in eyes with venous stasis retinopathy (P = .04). In the 34 eyes with macular edema, the edema lasted significantly longer in those with vitreomacular attachment (VMA) at the first examination than in those without VMA at this time (P = .02). VMA may play an important role in the pathogenesis and chronicity of macular edema in CRVO.