Anthropometry of 5-19-year-old Tongan children with special interest in the high prevalence of obesity among adolescent girls

BACKGROUND: Despite much concern about adult obesity among Pacific Islanders, childhood obesity has seldom been investigated. AIM: Based on the anthropometry of Tongan children aged 5-19 years, this study aims to elucidate age and sex differences in obesity prevalence calculated from BMI and its relation to body fat estimated by skinfold thicknesses. SUBJECTS AND METHODS: 895 students, aged 5-19 years, in the most modernized island and a remote island, were measured for stature, body weight, circumferences at waist, hip and mid-upper arm, and skinfold thicknesses at biceps, triceps and subscapular. The prevalence of overweight and obesity was calculated using the reference data of the International Obesity Task Force (IOTF) and the Centers for Disease Control and Prevention (CDC). RESULTS: The prevalence of obesity of Tongan adolescent girls defined by the IOTF and CDC references was 19.4% and 22.8%, respectively, being considerably higher than that of not only juvenile girls but also adolescent boys. Among adolescents, the girls' BMI was positively correlated with fat mass whereas in boys it was not. The sex difference in adolescents was parallel to that in adults, being attributable to gender differences in daily behavioural patterns. CONCLUSIONS: Among Tongan adolescents, obesity prevalence in girls was much higher than in boys, in association with fat accumulation in the former.     

Electrophysiological responses from the cochlea and inferior colliculus in guinea pigs after head injury

Electrical responses from the inferior colliculus (ER) and round window (CP) to acoustical stimuli were compared in control and experimental guinea pigs which had received a single blow to the freely movable head. After the blow to the head, all of the animals showed signs of commotio cerebri, and some of them died. The experimental animals were divided into two groups so that the physiologic responses to sound could be evaluated one day (early group) and seven days (intermediate group) following the head blow. The animals of the early group had elevated ER thresholds over the entire frequency range tested with an average threshold of 37.8 db. The animals of the intermediate group also had elevated ER thresholds which averaged 23.9 db. Input-output intensity function of ER for the experimental animals showed a recruitment-like phenomenon. The CP thresholds in the injured animals did not differ significantly from those in the control group. Damage to the VIIIth nerve and higher central pathways is very likely a more frequent cause of the otoneurologic manifestations following head injury than end organ damage.     

Delayed-onset temporary auditory threshold shift following head blow in guinea pigs

This study attempts to investigate the development of sensorineural hearing loss following a head blow without skull fracture in association with physiological and histopathologic changes in an experimental animal model. With the head in a freely movable position, albino guinea pigs were given a single blow to the occipital region by a head blow device. At 1, 7, and 14 days after the blow, the animals' auditory brainstem response (ABR) and cochlear microphonics (CM) were examined, and both the temporal bone and brain stem were observed by light and electron microscopy. The ABR threshold was unchanged at day 1, was significantly increased at day 7, and was fully recovered at day 14. The I-V and I-II interpeak latencies were significantly prolonged at days 1 and 7, and wave I latency was significantly prolonged at day 7 only. These latencies were recovered to normal limits at day 14. On the other hand, no significant change in CM versus the control group was observed at any point in the measurements. Histopathologically, no abnormal finding was seen at the light microscopic level. However, at the electron microscopic level, there were some injuries to the eighth nerve. At day 1, the lamellar structure of the myelin sheath was irregular, and the periaxonal space was expanded; at day 7, the myelin sheath was disintegrated. At day 14, however, these changes were partially reversed. These results suggest that sensorineural hearing loss following a head blow in this model is attributed to dysfunction of the eighth nerve rather than to cochlear impairment.     

Mortality and cause of death after hospital discharge in 10,981 patients with ischemic stroke and transient ischemic attack

BACKGROUND: The aim of this study was to examine the 1-year cumulative mortality rate and cause of death, and to identify the predictive factors for death after hospital discharge following ischemic stroke and transient ischemic attack (TIA) using data from the Japan Multicenter Stroke Investigators' Collaboration study. METHODS: We prospectively registered 16,922 consecutive patients with acute ischemic stroke or TIA from May 1999 to April 2000 in 156 Japanese hospitals. We mailed a questionnaire to the 15,322 patients who were alive at hospital discharge. RESULTS: 10,981 patients (6,945 men, 4,036 women, age 70 +/- 11 years, median 71, range 19-100 years) were enrolled in the follow-up study. The mean follow-up period was 271 +/- 110 days (median 272 days; range 1-487 days). The 1-year cumulative mortality was 6.8% (7.0% for 10,234 stroke patients and 3.5% for 747 TIA patients). The causes of death were: cerebrovascular disease, 24.1%; pneumonia, 22.6%; heart disease, 18.1%; cancer, 11.0%, and miscellaneous causes, 24.1%. Multivariate analysis suggested that male gender, age, diabetes mellitus, atrial fibrillation, history of stroke, nonlacunar stroke, functional disability and transfer to another hospital or nursing home on discharge were significant independent predictors of death during the follow-up period. CONCLUSIONS: The major causes of death after hospital discharge were found to be cerebrovascular diseases, pneumonia and heart diseases. Thus, in order to improve survival after hospital discharge, in addition to appropriate management of vascular risk factors following stroke, it appears to be important to take measures to prevent pneumonia and to discharge patients to their own home, if possible.     

A case-control analysis of intra-arterial urokinase thrombolysis in acute cardioembolic stroke

BACKGROUND: Intra-arterial urokinase (IA-UK) thrombolysis is frequently given in Japan to selected patients with acute cerebral artery occlusion. However, it is not clear whether or not IA-UK thrombolysis has an efficacy for acute stroke patients. The purpose of this study was to assess the effects of IA-UK thrombolysis in acute cardioembolic stroke patients, by performing a case-control analysis using data from Japan's Multicenter Stroke Investigator's Collaboration (J-MUSIC). METHODS: 16,922 acute ischemic stroke patients were enrolled into J-MUSIC. From these patients, we selected 91 patients (UK group) who met the following criteria: treatment with IA-UK; 20-75 years of age; cardioembolic stroke; presenting with a carotid stroke; admission within 4.5 h of symptom onset, and a National Institutes of Health Stroke Scale (NIHSS) score of 5-22 points on admission. A control group of 182 patients without IA-UK treatment and matched to the NIHSS score, gender, and age was chosen. We compared the modified Rankin scale (mRS) score at discharge and the mortality between the 2 groups. RESULTS: In both groups, the mean age was 65 +/- 8 years, and the median NIHSS score was 14. The mean interval between symptom onset and UK administration was 3.4 +/- 1.3 h, and the IA-UK dose was 392,000 +/- 200,000 units. The mRS score at discharge was lower in the UK group than in the control group (mean, SD, median; 2.8, 2.9, 2 in UK group vs. 3.3, 1.8, 4, in the control, respectively p = 0.031). A favorable outcome (mRS of 0-2) was more frequently observed in the UK group (50.5%) than in the control group (34.1%, p = 0.0124). No difference in the mortality rate was seen between the UK group (11.0%) and the control group (13.3%). As well, there was no difference in the length of hospital stay between the UK group (46 +/- 41 days, mean +/- SD) and the control group (42 +/- 42 days, mean +/- SD). CONCLUSIONS: IA-UK thrombolytic therapy may improve the outcome in hyperacute cardioembolic stroke patients.     

Intensive cycle training with artificial gravity maintains muscle size during bed rest

INTRODUCTION: The present study aimed to investigate the effect of intensive cycle training with short-arm centrifuge-induced hypergravity during bed rest on muscle size and function. METHODS: This study involved 10 healthy men who were divided into 2 groups: a countermeasure group, BR-CM (n = 5); and a control group, BR-Cont (n = 5). The BR-CM subjects partook in intensive cycle training (to 90% of maximum HR) with short-arm centrifuge-induced artificial gravity on alternate days during 20-d bed rest. Muscle volume of the thigh and maximum voluntary contraction (MVC) during isometric knee extensions was measured before and after bed rest. Muscle functional magnetic resonance imaging (mfMRI) and electromyogram (EMG) of the quadriceps femoris were obtained during submaximal knee extension exercises at a load of 30% MVC. RESULTS: The volume of the total thigh muscles was maintained in the BR-CM group (-1%), whereas it was not in the BR-Cont group (-9%, p < 0.05). MVC decreased in the BR-CM (7%) and BR-Cont groups (23%). EMG activity in the BR-CM group after bed rest was significantly lower than that of before; however, no significant change was found in the BR-Cont group. There were no significant changes in the resting and exercised mfMRI signals in either the BR-CM or BR-Cont groups. CONCLUSION: These results suggest that intensive cycle training with hypergravity maintained the size of human skeletal muscles during bed rest.     

Congenital hypothyroidism caused by a unique thyroid peroxidase allele containing two mutations, C1708T and C2737T

Thyroid peroxidase (TPO) is a key enzyme of thyroid hormone biosynthesis. TPO abnormality is considered to be a major cause of congenital hypothyroidism (CH) with total iodide organification defect. In the present study, we examined the TPO gene of three siblings, 3 and 2 year-old brothers and a newborn sister, with severe CH. All 17 exons and the promoter region in the TPO gene were directly sequenced using genomic DNA. Two homozygous mutations, C1708T and C2737T, were found in all three patients. The C1708T mutation introduces a premature terminal codon, which is suggested to be a cause of CH. The other mutation, C2737T, and 13 single nucleotide polymorphisms in the patients' TPO genes were also detected as homozygous. We suspect that the mutated alleles were inherited from a single, common ancestor. The haplotype including the two mutations was conserved in a narrow region between D2S2268 and D2S323 microsatellite markers on the end of chromosome 2.     

Incremental benefits of FDG positron emission tomography over CT alone for the preoperative staging of ovarian cancer

OBJECTIVE: The purpose of this study was to determine whether the addition of positron emission tomography (PET) with the radiotracer FDG to cross-sectional imaging, such as CT, increases accuracy in the detection of tumor spread. SUBJECTS AND METHODS. Fifteen patients who were thought to have ovarian cancer on the basis of the results of physical examination, sonography findings, and level of serum cancer antigen 125 were enrolled over an 11-month period. After screening, patients underwent two imaging examinations-abdominopelvic CT and whole-body FDG PET- within 2 weeks before surgery. Also before surgery, staging accuracy was assessed separately using CT with or without FDG PET (which was based on modifications of the International Federation of Gynecology and Obstetrics [FIGO] criteria). The results of the histology and surgery findings were used to assess the accuracy of the scanning findings. RESULTS: Staging revealed stage III disease in seven patients (IIIC, n = 6; IIIB, n = 1), stage II in three (IIC, n = 2; IIB, n = 1), and stage I in five (IC, n = 3; IA, n = 2), according to the FIGO criteria. Although CT staging correlated with postoperative staging in eight (53%) of 15 patients, consensus evaluation of CT with FDG PET staging improved correlation with postoperative staging in 13 (87%) of 15 patients. CONCLUSION: The addition of FDG PET to CT increases accuracy in staging of ovarian cancer.