Relationship between lifestyle factors and defecation in a Japanese population

Summary. Background: There is a paucity of accurate data regarding any association in the general population between defecation and lifestyle factors such as diet, exercise, physique, and childbirth. Aims of the study: To evaluate the effects of such lifestyle factors on defecation among regional residents of Japan. Methods: Residents (n = 1,699) of northern Japan, aged over 40 years, were surveyed in 1995 using a questionnaire to assess their lifestyle factors (diet, beverage consumption, exercise, physique, and childbirth), and examining their defecation status. We evaluated the relationship between these lifestyle factors and defecation using logistic regression analysis. The authors used four measures (defecation frequency, subjective defecation state, subjective fecal properties, and fecal consistency) and assigned the subjects to a group defined by their defecatory status: constipation, diarrhea, or normal, depending on the responses of the subjects to all four criteria. Results: The tendency for constipation correlated positively with age in males (p = 0.130), although this trend was not observed in females (p = 0.641). Of the dietary factors examined, only rice, which accounts for the largest proportion of daily dietary fiber intake in Japan, demonstrated a preventive effect on constipation in both sexes (p = 0.050 in males and 0.003 in females). Walking was a preventive factor for constipation among males (p = 0.049), and alcohol also inhibited constipation among males (p = 0.007). Conclusions: These results suggest that exercise, such as walking, and a high intake of dietary fiber, such as rice, were useful in the maintenance of defecation. Received: 19 April 2002, Accepted: 22 August 2002 Correspondence to: Shigeyuki Nakaji, MD, PhD     

Efficiency of a transtympanic approach to the round window membrane using a microendoscope

There has been increasing interest in cochlear drug delivery through the round window membrane (RWM). However, placing drugs on the RWM is difficult because of anatomical barriers. We examined the efficacy of a microendoscope for a transtympanic approach to the RWM. We evaluated the visibility of the RWM using four approaches: transtympanic microendoscopic, transtympanic microscopic, transmastoid microendoscopic, and transmastoid microscopic in ten human temporal bones. For the transtympanic approach, we made a fenestration (2 × 1 mm) in the postero-inferior quadrant of the tympanic membrane. For the transmastoid approach, conventional posterior hypotympanotomy was performed. The transtympanic microendoscopic approach enabled visualization of the RWM in all specimens, whereas the transtympanic microscopic approach only permitted visualization in three specimens. Through the transmastoid approach, the RWM was visible in all specimens using either a microendoscope or a microscope. The transtympanic microendoscopic approach can be utilized for cochlear drug delivery through the RWM.     

Age-related changes of the prostate gland in the senescence-accelerated mouse

Aging is of utmost importance in the pathogenesis of the prostate gland (i.e., benign prostate hyperplasia or prostatic carcinoma). The object of this study was to examine the morphological and histological changes of the aging prostate of the so-called senescence-accelerated mouse (SAM). Ventral and dorsolateral lobes of prostate glands of SAM were microdissected into two-dimensional ductal arrays. Gross morphology, ductal branching patterns, and histology were examined in these microdissected specimens. Wet weight and numbers of ductal tips in ventral and dorsolateral prostate glands in senescence accelerated-prone (SA-P) mice were significantly smaller than those of senescence accelerated-resistant (SA-R) mice, although the changes of patterns of gross ductal morphology were virtually identical in these groups. High incidence of stromal hyperplasia with fibrosis and inflammation was observed in the dorsal lobe of the aged SA-P mouse. Atypical glandular epithelial cells and cribriform glandular deformity were observed in the dorsal and lateral lobe of aged SA-P mice. Marked heterogeneity in age-related pathological changes was observed between prostatic lobes. These data suggest that the aging process occurs heterogeneously within the prostate gland, and that SA-P mice may be an important model for the study of age-related changes in the prostate gland. © 1994 Wiley-Liss, Inc.     

Regenerative medicine of the trachea: the first human case

OBJECTIVES: The objective of the present study was to demonstrate regenerative medicine of the tracheal tissue by using an in situ tissue engineering technique for airway reconstruction. METHODS: Based on the previous successful experimental animal studies, the current regenerative technique was applied to repair of the trachea of a 78-year-old woman with thyroid cancer. A Marlex mesh tube covered by collagen sponge was used as a tissue scaffold. The operative intervention included right hemithyroidectomy, resection of the trachea, and tracheoplasty using the scaffold. The right half of three rings of the trachea was resected, and the scaffold material was sutured to the defect of the trachea. RESULTS: After 2 weeks, the mesh collagen structure of the artificial material could be seen with endoscopy in most of the implanted area. The artificial material was covered with epithelial growth after 2 months. Epithelialization continued to cover the artificial material completely for 2 years without any complications. CONCLUSIONS: The current regenerative technique avoided tracheotomy, a second operation, and deformity. Good epithelialization has been observed on the tracheal luminal surface without any complications for 2 years. Although long-term observation is required, regenerative medicine of the tracheal tissue appears feasible for airway reconstruction.     

Validity and limitation of manual rotational test to detect impaired visual-vestibular interaction due to cerebellar disorders

The aim of this study was to investigate validity and limitation of the novel infrared system to record and analyze horizontal visual-vestibular interaction using whole-body rotation rapidly and conveniently in the routine vestibular clinic. We examined 11 patients with cerebellar dysequilibrium and 25 patients with peripheral dysequilibrium for vestibulo-ocular reflex in darkness (DVOR), visually-enhanced vestibulo-ocular reflex (VEVOR), and fixation suppression of vestibulo-ocular reflex (FSVOR), and compared the results with those of examination for head-fixed smooth pursuit and fixation suppression during caloric stimulation. The manual rotation stimuli were 0.5-0.75 Hz in frequency and 60-90 degrees /s in maximal angular velocity. Gain of vestibulo-ocular reflex in darkness was not significantly correlated with maximal slow phase velocity (MSPV) of caloric-induced nystagmus at that stimulus condition either in patients with peripheral dysequilibrium or in those with cerebellar dysequilibrium. An index for fixation suppression of vestibulo-ocular reflex during rotation stimulus was significantly lower in patients with cerebellar dysequilibrium than in normal control subjects and those with peripheral dysequilibrium. On the other hand, there was no significant difference among the two disease groups and the normal control group in gain of visually-enhanced vestibulo-ocular reflex. In about a half of patients with cerebellar dysequilibrium, measured smooth pursuit gain was lower than estimated smooth pursuit gain calculated based on a simple superposition theory of vestibulo-ocular reflex and smooth pursuit. Testing fixation suppression using the present system is an unusually convenient tool for detection of cerebellar dysequilibrium.     

Comparison of the amount of pectin in the human terminal ileum with the amount of orally administered pectin

OBJECTIVE: Dietary fiber by definition is resistant to digestion and absorption in the human small intestine, and it should naturally reach the large intestine. To date, there have been several reports that have examined in vivo how much dietary fiber actually reaches the terminal ileum in human subjects using glucose, with large differences in results. We compared the amount of pectin in the human terminal ileum with that of orally administered pectin. METHODS: Seven healthy male volunteers ages 20 to 27 y were given a test meal containing 4.05 g of pectin. A double-lumen tube was placed in the terminal ileum by using the endoscopic retrograde bowel insertion method, and the ileal contents were aspirated through the tube. Amounts of pectin orally administered and collected from the terminal ileum were estimated as galacturonic acid concentrations (Englyst's method) and were compared with each other. RESULTS: The mean +/- standard deviation amount of pectin collected in the terminal ileum was 3.58 +/- 0.43 g, or 88.4 +/- 10.5% of pectin administered. Further, there were large individual differences in recovery, ranging from 76.8% to 105.1%. CONCLUSIONS: Approximately 90% of ingested pectin was recovered in the terminal ileum in this study. Ten percent may have been degraded by bacteria within the digestive tract, especially the terminal ileum.     

A preoperative sleep study with nasal airway occlusion in pharyngeal flap surgery

PURPOSE: Obstructive sleep apnea is a major complication of pharyngeal flap surgery. The purpose of the present study is to predict preoperatively the risk of upper airway obstruction after surgery. MATERIAL AND METHODS: We performed an overnight sleep study preoperatively and postoperatively in 16 pediatric patients considered for pharyngeal flap surgery. Preoperative sleep study was done for two nights, once in normal breathing condition and once with complete nasal occlusion by packing of nostril with tampon gauze. RESULTS: In preoperative sleep recordings in normal breathing condition, all subjects had a normal apnea hypopnea index (AHI) less than 5/h. In preoperative recording with complete nasal occlusion, five patients exceeded 5/h in AHI. In particular, for two patients who had AHI higher than 15/h, we gave up a surgery in one case and performed pharyngeal flap operation for the other following a tracheotomy for severe disturbance of oral breathing. The remaining 14 subjects underwent surgery without airway obstructive complications. There was strong correlation between preoperative AHI with nasal tampon gauze and AHI at two weeks postoperatively (r = 0.88 P < .0001). There was no significant correlation between preoperative AHI in normal breathing condition and postoperative AHI (P > .05). CONCLUSIONS: These results exhibit preoperative sleep study with complete nasal airway occlusion represent postoperative breathing condition well during early postoperative period. Preoperative sleep study with complete nasal airway occlusion with nasal tampons could be useful for predicting the risk of upper airway obstruction secondary to pharyngeal flap surgery.     

Regeneration of mastoid air cells: clinical applications

The objective of this study was to establish a method for regenerating mastoid air cells and their functions for clinical use in incurable otitis media. For this clinical study three patients (one male, two female) were randomly selected from patients with severe cholesteatoma about to undergo staged operations. Hydroxy-apatite in three-dimensional, honeycomb-like structures (3D-HA) were used as artificial pneumatic bones. This 3D-HA is made of calcium phosphate and has a high percentage of micropores (90%). Its surface is coated with collagen. At the first stage of tympanoplasty, collagen-coated 3D-HA was put into the opened mastoid cavity and fixed by fibrin glue. Recovery of mastoid aeration and regeneration of the pneumatic air cells of the mastoid cavity were estimated on CT scan images after the first operation. Aeration was recovered in all cases. The mastoid air cells were regenerated in two cases. In the failed case, subcutaneous connective tissues and granulations invaded into the spaces of the 3D-HA. This study demonstrated that mucosa would grow on the surface of a 3D-HA implant and could provide gas exchange functions in the newly opened mastoid cavity. This tissue engineering method may be a possible treatment for intractable otitis media.     

A fine method of evaluating the physiological function of vestibular hair cells

We have established a fine method of evaluating the physiological function of vestibular hair cells. We examined the mechano-electrical transduction (MET) to study the physiological function of a hair cell. Hair cells composing the vestibular maculae were loaded with fura-2 AM, and the Ca2+ responses to the mechanical stimulation of hair bundles were monitored. The vestibular maculae were dissected from 1 to 3-day-old rats and were incubated with fura-2 AM for 30 min. Next, the Ca2+ responses generated through the activation of the MET were studied by the water puff stimulation of hair bundles. In addition, the acute effect of gentamicin was confirmed by this method.     

Role of the F-box protein Skp2 in cell proliferation in the developing auditory system in mice

The F-box protein, Skp2 positively regulates the G1-S transition by controlling the stability of several G1 regulators, including p27. To evaluate the role of Skp2 in the mammalian developing auditory systems, the expression of Skp2 was examined together with the expression of p27 in auditory systems. Our data show expression of Skp2 in auditory epithelia and neurons at an early stage of development. During differentiation processes, the onset of p27 expression was observed together with the down-regulation of Skp2 expression, in auditory epithelia. In contrast, an alteration of expression of p27 and Skp2 in the greater epithelial ridge and spiral ganglion appeared after differentiation of hair cells. These findings suggest that Skp2 plays a crucial role in development of mammalian auditory systems.