Prevalence and trends of underweight and BMI distribution changes in Japanese teenagers based on the 2001 National Survey data

BACKGROUND: Excessive thinness has been glamorized among Japanese adolescent girls, and unhealthy dieting to lose weight has become a popular practice among them. The prevalence of underweight in contemporary Japanese girls in comparison with that of boys, however, remains to be studied. AIM: The purpose of this study was to determine the prevalence and trends of underweight in contemporary Japanese teenagers of both sexes using nationally representative cross-sectional data. SUBJECTS AND METHODS: Underweight was defined as BMI < 3rd percentile by age and sex of the 1978-1981 reference population as previously reported. These reference values were compared with BMIs of the contemporary population based on the 2001 Cross-sectional National Survey data of Japanese teenagers (215 972 boys and 216 496 girls). RESULTS: The prevalence of underweight was approximately 2-3% in junior high school students of both sexes, 12.5-14.5 years of age, approximately 3% in senior high school students of both sexes, 15.5-16.5 years of age, and approximately 4% in senior high school students of both sexes, 17.5 years of age. CONCLUSION: The prevalence of underweight decreased among Japanese teenage students of both sexes during the past decades. Female preponderance in the prevalence of underweight was not confirmed.     

Effect of cisplatin on rat placenta development

We examined the sequential histopathological changes in the placenta from rats exposed to cisplatin. Cisplatin was intraperitoneally administered at 2 mg/kg/day during GDs 11–12 (GD11,12-treated group), or GDs 13–14 (GD13,14-treated group), and the placentas were sampled on GDs 13, 15, 17 and 21. Fetal mortality rates were increased up to approximately 65% from GD 17 onward, and fetal weights were decreased on GD 21 in the GD11,12-treated group. A reduction in placental weights was detected from GD 15 onward, and the placentas on GD 21 were macroscopically small and thin in both treated groups. Histopathologically, in the GD13,14-treated group, an increase in apoptotic cells was detected on GDs 15 and 17 in the labyrinth zone, and on GD 21 in the basal zone, resulting in labyrinth zone hypoplasia. By contrast, in the GD11,12-treated group, an increase in apoptotic cells was detected on GDs 13, 15 and 17 in the labyrinth zone, and during the experimental period in the basal zone. A decrease in Phospho-Histone H3 positive cells was detected on GD 13 in the labyrinth zone and basal zone, resulting in hypoplasia of the labyrinth zone and basal zone. In addition, a marked decrease in glycogen cell-islands in the basal zone was also detected on GDs 15 and 17. There was a reduction in interstitial invasion of glycogen cell-like trophoblasts into the metrial gland on GD 15, resulting in metrial gland hypoplasia. Therefore, we consider that cisplatin administration in pregnant rats induces growth arrest of the labyrinth zone and basal zone, leading to small placenta. It is assumed that metrial gland hypoplasia is secondarily induced by the failure of glycogen cell island development associated with basal zone hypoplasia.     

Spasm induced by protection balloon during carotid artery stenting

Purpose The PercuSurge system is a distal balloon embolic protection device used for carotid artery stenting (CAS). We performed a retrospective study on the prognosis and clinical effects of spasms induced by the PercuSurge GuardWire system (PercuSurge-induced spasm). Materials and methods We performed CAS in 118 carotid stenoses using the PercuSurge system. Of the 118 procedures, 31 (26.3%) of the patients experienced PercuSurge-induced spasm, and all underwent postoperative follow-up studies by cerebral angiography and antiplatelet treatment. Results On follow-up angiograms obtained a mean of 5.2 months (range 3–10 months) after CAS, all 31 PercuSurge-induced spasms had disappeared, and no delayed stenosis was found at the sites where the spasms had occurred. No ischemic events due to the spasms occurred during a mean follow-up of 13 months (range 3–32 months). Conclusion In the hands of physicians experienced in endovascular surgery, CAS using the PercuSurge system is a safe method with which to treat patients with carotid stenosis. Our study demonstrated that PercuSurge-induced spasms had no morphological or clinical adverse effects.     

Effect of minimally invasive distal first metatarsal osteotomy on blood flow of the metatarsal head

BackgroundDistal first metatarsal osteotomy is an option for operative treatment of mild to severe hallux valgus (HV) deformities. Minimally invasive distal linear metatarsal osteotomy (DLMO) provides good outcomes without avascular necrosis (AVN) of the metatarsal head. However, no reports have described the in vivo blood flow changes in the metatarsal head after osteotomy. This study was performed to evaluate the in vivo blood flow of the pre- and post-osteotomy metatarsal head in patients with HV using laser Doppler flowmetry and thus clarify the effect of minimally invasive distal first metatarsal osteotomy on the change in blood flow.MethodsFrom April 2015 to October 2016, DLMO was performed on 13 feet with HV in 10 patients (2 men, 8 women). Blood flow measurements of the pre- and post-osteotomy first metatarsal head in all feet were performed by laser Doppler flowmetry. AVN was evaluated using plain radiographs at the final postoperative follow-up.ResultsThe median pre- and post-osteotomy blood flow was 1.5 (0.97–1.95) and 1.46 (0.98–1.77) ml/min/100 g, respectively (median change in blood flow, 0.00; 95% CI, ?0.23–0.13; P = 0.72). The rate of change in the blood flow was 0.0% (95% CI, ?11.9%–8.7%; range, ?28.6%–64.7%), and only three patients (23.1%) showed a decrease of ≥10%. The median pre- and post-osteotomy systolic blood pressure was 90 (84.5–97) and 93 (84.5–95) mmHg, respectively (median change in blood pressure, 0.00; 95% CI, ?3.0–2.0; P = 0.82). The rate of change in the systolic blood pressure was 0.0% (95% CI, ?3.1%–2.2%; range, ?9.1%–24.0%). No radiographic evidence of AVN was present at the final follow-up.ConclusionsNo significant difference was found in the rate of change in blood flow pre- and post-osteotomy, suggesting that minimally invasive distal first metatarsal osteotomy does not influence blood flow of the metatarsal head.     

Creation and validation of an I-123 FP-CIT template for statistical image analysis using high-resolution SPECT for parkinsonian patients

Objective

The aim of this study was to create a new template for the anatomical normalization of I-123 FP-CIT SPECT images of Japanese people to evaluate dopamine transporter binding.

Methods

The subjects consisted of 16 normal control subjects (5 females and 11 males; mean age ± SD, 51.6 ± 9.5 years, ranging from 25 to 62 years) and 21 parkinsonian patients (7 females and 14 males; mean age ± SD, 70.7 ± 9.4 years, ranging from 49 to 85 years). All normal control subjects and 21 patients with parkinsonism underwent MRI. A total of 148 MBq of I-123 FP-CIT was intravenously injected as a bolus, and a SPECT scan was started 4 h later. Data were analyzed with the Statistical Parametric Mapping 8 (SPM8) software. At first, I-123 FP-CIT SPECT images were co-registered to MRI images and MRI images were normalized to Montreal Neurological Institute (MNI) space using a gray.nii template. Co-registered I-123 FP-CIT SPECT images were normalized using the predetermined normalization parameters for MRI images. Then, anatomically normalized I-123 FP-CIT SPECT images were divided by background counts individually measured using ROIs set on the cerebral cortices. The I-123 FP-CIT template was created by averaging the normalized SPECT images of the 16 normal control subjects. Thereafter, the averaged MRI images of the 16 normal control subjects were also created.

Results

A visual inspection revealed that there were no apparent differences between the I-123 FP-CIT images subjected to the two methods of anatomical normalization in normal control subjects. However, a group comparison by a paired t test using SPM8 revealed that the I-123 FP-CIT binding was significantly higher in the substriatal and temporal regions in I-123 FP-CIT images directly normalized with the I-123 FP-CIT template than in those normalized by the predetermined parameters with MRI, while it was higher in the bilateral frontal cortical regions in the latter than in the former images.

Conclusion

We successfully created an I-123 FP-CIT template for Japanese people. This template is thought to be useful and reliable for the statistical analysis of I-123 FP-CIT images, although some problems exist in the evaluation of parkinsonian patients. The results of a paired t test using SPM suggest that we should use the same normalization method in statistical image analyses.

     

Afferent and efferent connections of the nucleus prethalamicus in the yellowfin goby Acanthogobius flavimanus

The nucleus prethalamicus (PTh) receives fibers from the optic tectum and then projects to the dorsal telencephalon in the yellowfin goby Acanthogobius flavimanus. However, it remained unclear whether the PTh is a visual relay nucleus, because the optic tectum receives not only visual but also other sensory modalities. Furthermore, precise telencephalic regions receiving prethalamic input remained unknown in the goby. We therefore investigated the full set of afferent and efferent connections of the PTh by direct tracer injections into the nucleus. Injections into the PTh labeled cells in the optic tectum, ventromedial thalamic nucleus, central and medial parts of the dorsal telencephalon, and caudal lobe of the cerebellum. We found that the somata of most tecto‐prethalamic neurons are present in the stratum periventriculare. Their dendrites ascend to reach the major retinorecipient layers of the tectum. The PTh is composed of two subnuclei (medial and lateral) and topographic organization was appreciated only for tectal projections to the lateral subnucleus (PTh‐l), which also receives sparse retinal projections. In contrast, the medial subnucleus receives fibers only from the medial tectum. We found that the PTh projects to nine subregions in the dorsal telencephalon and four in the ventral telencephalon. Furthermore, cerebellar injections revealed that cerebello‐prethalamic fibers cross the midline twice to innervate the PTh‐l on both sides. The present study is the first detailed report on the full set of the connections of PTh, which suggests that the PTh relays visual information from the optic tectum to the telencephalon.     

Randomized comparative study of omeprazole and famotidine in reflux esophagitis

BACKGROUND: Although proton pump inhibitors (PPI) and H2-receptor antagonists (H2-RA) are routinely used in the treatment of reflux esophagitis (RE), no consensus has been reached yet as to whether the first-choice drug should be PPI or H2-RA. In this study, the effects of omeprazole (OMP) and famotidine (FAM) on RE have been examined in a randomized comparative study. METHODS: Protocols of OMP 20 mg once daily or FAM 20 mg twice daily for 8 weeks were allocated to 56 cases with RE at random, using an envelope randomization method. Their efficacy in achieving healing was examined endoscopically and a relief from subjective symptoms was compared. RESULTS: Patient's background such as sex, age, recurrence, hiatal hernia, smoking and drinking habits, and complications, and the severity of esophagitis at the time of enrolment were not significantly different between the two groups. Healing in the OMP group and the FAM group was observed in 72 and 32% (P = 0.025) of patients at week 4 and 95 and 53% (P = 0.003) of patients at week 8, respectively. Subjective symptoms were relieved more frequently in the OMP group (at week 2, 67% compared with 29%, P = 0.005; at week 4, 95% compared with 55%, P = 0.009), but this superiority was not significant at week 8 (94% compared with 65%, P = 0.085). No serious adverse events occurred. CONCLUSIONS: Omeprazole provided quicker healing and a greater relief from subjective symptoms than did FAM in the treatment of RE, and was considered more suitable as a first-choice drug.     

Basic and clinical evaluation of the measurement of bone resonant frequency

Summary A new computerized apparatus was constructed to measure the resonant frequency of human ulnain vivo with high sensitivity and reproducibility. Experimental studies using aluminum bar and dried human bone revealed the importance of the ulna being positioned parallel to the radius, approximately 90 degree flexion of the elbow joint, and minimal muscle activity in order to demonstrate maximum resonant frequency of ulna. Measurement of bone resonance in monkeysin vivo and after removal of the bonein vitro showed good agreement. Product of F (maximum resonant frequency in Hz) and L (ulnar length in cm), FL, indicating the speed of propagation of sound wave through the ulna, showed a significant positive correlation with bone mineral content/bone width (BM/BW) measured by Norland-Cameron apparatus and age-bound decline in both sexes. Patients with osteomalacia and primary hyperparathyroid bone disease tended to have higher FL values than expected from BM/BW. Two-dimensional display of FL and BM/BW thus appears to be useful in distinguishing osteoporosis from osteomalacia better than the use of BM/BW alone.     

Acute promyelocytic leukemia after living donor partial orthotopic liver transplantation in two Japanese girls

Organ transplant recipients are generally considered to be at greater risk for developing malignant disorders because of prolonged immunosuppression for organ grafting, but acute leukemia is a rare complication after organ transplantation (0.2 - 2.5%). We encountered two girls with acute promyelocytic leukemia (APL) after living donor partial orthotopic liver transplantation. In one patient, APL developed 21 months after liver transplantation for ornithine transcarbamylase deficiency. She had been administered tacrolimus for prophylaxis of graft-versus-host reaction. In the other patient, APL was diagnosed 46 months after liver transplantation for congenital biliary atresia. Both patients were successfully treated by chemotherapy including all-trans retinoic acid (ATRA), and after reaching complete remission, they have subsequently been in continuous remission. Although leukemia after liver transplantation is generally thought of as a rare complication, increases in survival rate following liver transplantation is likely to lead to more such cases, and documentation of these cases is therefore of importance.