Higher Iron Intake Is Independently Associated with Obesity in Younger Japanese Type-2 Diabetes Mellitus Patients

We aimed to analyze the association between dietary iron intake and obesity assessed by BMI after adjustment for nutrient intake (macronutrients and fiber) and food groups. The study design was cross-sectional. Patients with type-2 diabetes (n = 1567; 63.1% males; mean age 62.3 ± 11.6 years) were included in the study. To assess diet, consumption of typical food groups was determined by a food frequency questionnaire. Obesity was defined as BMI ≥ 25 kg/m². We performed a binary regression analysis between quartiles of iron intake and obesity by quartiles of age group. A direct linear association was found for the highest quartile of iron intake and obesity in the younger age group of 30 to 54 years (OR = 3.641, 95% CI = 1.020–12.990; p trend = 0.011). Multivariate analysis using food groups as opposed to nutrients revealed a positive trend for obesity in the younger age group after adjusting for lifestyle factors, energy intake and bean and vegetable intake (p trend = 0.023). In all participants, an inverse association was observed before adjustment by vegetable intake (OR = 0.453, 95% CI = 0.300–0.684; p trend = 0.001). Higher iron intake was associated with obesity independent of macronutrient and fiber intake but only in the youngest quartile of age group examined.     

The prevalence of sexual dysfunction and potential risk factors that may impair sexual function in Malaysian women

IntroductionFemale sexual dysfunction (FSD) is a prevalent sexual health problem that does not spare the women in Malaysia, a nation with a conservative multiethnic society.AimTo investigate the prevalence of FSD and the potential risk factors that may impair sexual function among women at a primary care setting in Malaysia.Main Outcome MeasureThe prevalence, the risk factors, and the main predictors for FSD were measured among these women.MethodsA validated Malay version of the Female Sexual Function Index was used to assess FSD. A total of 230 married women aged 18–70 years participated in this study. The sociodemographic and marital profiles of women who had FSD and those who did not were compared; the risk factors for FSD were determined.ResultsThe majority of the respondents were younger than 50 years old, predominantly Malays, and had a higher academic achievement. The prevalence of FSD in the primary care population was 29.6%. The prevalence of women with lack of orgasms, low sexual arousal, lack of lubrication, sexual dissatisfaction, and sexual pain were 59.1%, 60.9%, 50.4%, 52.2%, and 67.8%, respectively.ConclusionThe risk factors for FSD are older age, Malays, married longer (more than 14 years), having less sexual intercourse (less than 1–2 times a week), having more children, married to an older husband (aged >42 years), and having a higher academic status. Lack of lubrication is found to be the main predictor for FSD in this study. Is lack of lubrication a cause or a complication of FSD? Prospective research is needed in the near future. Sidi H, Puteh SEW, Abdullah N, and Midin M. The prevalence of sexual dysfunction and potential risk factors that may impair sexual function in Malaysian women.     

Development of the meniscus of the knee joint in human fetuses

Discoid meniscus of the knee joint occurs at a higher incidence in the lateral than in the medial menisci. Although its developmental origin has been suggested, it remains unclear. To verify the developmental etiology, we examined the meniscus of the knee joint in 41 human fetuses (from 14 to 30 weeks of gestation) and 14 adults (from 56 to 91 years of age) comparatively. The articular surfaces of the tibia and meniscus of the left knees in 40 fetuses and 14 adults were photographed and each area was measured by Scion Image (Scion; http://www.scioncorp.com ). Morphometric analyses revealed that the proportion of the area of meniscus to that of the plateau was continuously higher in the lateral side than in the medial side. The right knee joints of seven fetuses were histologically observed, and the layered structure of fibers developed earlier in the lateral meniscus than in the medial in fetuses. The observed differential development of lateral and medial sides of the meniscus may be involved in the etiology of discoid meniscus.     

Long-term motor practice induces practice-dependent modulation of movement-related cortical potentials (MRCP) preceding a self-paced non-dominant handgrip movement in kendo players

Effects of long-term motor practice on movement-related brain activities were investigated by measuring from the scalp, movement-related cortical potentials (MRCP) associated with self-paced right (dominant) and left (non-dominant) brisk handgrip movements with a 20% maximal voluntary contraction (MVC) in 8 elite kendo players (kendo group) and 8 healthy young adults (control group). The kendo players had engaged in regular practice since childhood. Three components of MRCP were obtained from all subjects. These components relating to the preparation (Bereitschaftspotential: BP and negative slope: NS′) and initiation (motor potential: MP) of the movements were compared between the two groups. The BP onset time for a non-dominant handgrip task was significantly earlier in the control group than in the kendo group. Moreover, BP onset time appeared significantly earlier preceding the non-dominant handgrip task as compared with the dominant one only in the control group. Furthermore, MP amplitudes in the kendo group were significantly larger than in the control group. These findings suggest that long-term motor practice affects brain activities, leading to practice-dependent modulations in the cortical areas involved in the preparation and initiation of self-paced non-dominant handgrip movements in kendo players.     

Retrobulbar optic neuritis and rhegmatogenous retinal detachment in a fourteen-year-old girl with retinitis pigmentosa sine pigmento

A 14-year-old girl complained of a sudden decrease in right visual acuity. The patient had night blindness, a mottled retina but no pigments, extinguished scotopic electroretinographic response, central scotoma in the right eye and rhegmatogenous retinal detachment. She had initially received laser photocoagulation around the retinal tear and then corticosteroid therapy, cryoretinopexy and segmental buckling. Her right visual acuity increased to 1.0. The association of retinitis pigmentosa sine pigmento, retrobulbar optic neuritis and rhegmatogenous retinal detachment, as demonstrated in our patient, may be uncommon.     

Human herpesvirus-8 negative primary effusion lymphoma with complete clinical remission after removal of ascites

A 58-year-old HIV-negative woman was admitted to our hospital with abdominal distension. She had a 5-year history of hypothyroidism and a 4-year history of diabetes mellitus. Physical examination revealed ascites. There was no lymphadenopathy or splenomegaly. Laboratory examination showed elevated levels of serum LDH and Al-p, polyclonal hypergammaglobulinemia, and was positive for anti-nuclear antibody, several autoantibodies and HCV-RNA. A computed tomographic scan of the abdomen and chest showed massive ascites, but there was no evidence of tumor masses or lymph node enlargement. Cytologic examination of the ascitic fluid revealed numerous abnormal lymphocytes which by flow cytometry demonstrated expression of CD5, CD19, CD20, and CD4. Cytogenetical analysis demonstrated a hyperdiploid karyotype, with numerical abnormalities. Southern blot analysis demonstrated rearranged monoclonal bands in JH and c-mycgenes. Polymerase chain reaction (PCR) analysis failed to detect the genomes of EBV and HHV-8 in the abnormal lymphocytes. A diagnosis of primary effusion lymphoma of B cell lineage was made. Following abdominal paracentesis, the patient remained in complete clinical remission for 7 months and died of an unrelated cause (cerebral bleeding). The present case demonstrated an HIV-, HHV-8-, and EBV-negative, and HCV-positive primary effusion lymphoma of B cell lineage, with a unique clinical course.     

Is segmentectomy with lymph node assessment an alternative to lobectomy for non-small cell lung cancer of 2 cm or smaller?

BACKGROUND: Lesser resection than the standard lobectomy for small-sized cT1N0M0 non-small cell lung cancers continues to be debated. METHODS: We reviewed specimens of 139 patients after lobectomy for cT1N0M0 cancer of 2 cm or less. In addition, we prospectively enrolled 70 patients able to tolerate a lobectomy, in a trial of lesser resection for these lesions. The limited procedure consisted of segmentectomy in which the resection line was delivered beyond the burdened segment, plus exploration of lymph nodes by frozen sectioning. This procedure was modified if the result was positive; this modified procedure was called extended segmentectomy. RESULTS: The nodal status after lobectomy was pN0, 107 patients; pN1, 12 patients; and pN2, 20 patients. Of the pN1 patients, 2 had only intralobar nodal involvement within the same segment of the main tumor. In the remaining 30 patients with nodal involvement, we ascertained the nodal involvement during the operation. Regarding intrapulmonary metastasis, 1 of 8 patients having this metastasis had the lesion at the segment where the main tumor was not located and had N2 disease, which was detected intraoperatively. If extended segmentectomy had been performed instead of lobectomy, the lesion could have been removed completely. The 5-year survival of patients with cT1N0M0 cancer of 2 cm or less was 87.3% after extended segmentectomy. There were no local recurrences and three noncancer-related deaths. Among patients with pT1N0M0 cancer of 2 cm or less, the 5-year survival was 87.1% in the extended segmentectomy group and 87.7% in the lobectomy group (p = 0.8008). CONCLUSIONS: Extended segmentectomy should be considered as an alternative for patients with cT1N0M0 non-small cell lung cancer of 2 cm or smaller.