Relationships between bone mass and dietary/lifestyle habits in Japanese women at 3-4 months postpartum.

OBJECTIVES: The relationships between calcaneal bone mass and dietary/lifestyle habits in women at 3-4 months postpartum were examined in the context of osteoporosis prevention. STUDY DESIGN: Cross-sectional survey. METHODS: We measured bone mass using calcaneal ultrasound in mothers who brought their 3- to 4-month-old babies to healthcare centers in Japan for health examination and administered a self-report questionnaire on physical characteristics and dietary/lifestyle habits to those who agreed to participate in the survey. Valid data were available for 1220 women (valid response rate, 97.5%). RESULTS: Based on their stiffness score, a measure of bone mass, 70.9% (n = 865) of the participants were classified as 'no apparent abnormality (stiffness score ≥78.8)' (low-risk group), 18.2% (n = 222) as 'guidance required (≥70.1-<78.8)' (intermediate-risk group), and 10.9% (n = 133) as 'complete examination required (<70.1)' (high-risk group), according to the criteria for osteoporosis screening test results. The percentage of individuals with a history of fracture was higher in the guidance required/complete examination required than in the no apparent abnormality group (P = 0.016). The analysis of relationships between the consumption frequency of certain foods, such as calcium-rich foodstuffs, and bone mass found that women who reported lower frequencies of milk and dark-colored (beta-carotene rich) vegetables for breakfast consumption had a significantly lower bone mass than those who consumed these foods more often. Furthermore, the guidance required/complete examination required group had a significantly lower calcium intake than the no apparent abnormality group (P = 0.022). CONCLUSIONS: These results indicate the need to provide postpartum women with dietary education programs to promote healthy eating habits, such as increased consumption of calcium-rich foods, and prevent osteoporosis.

Purification, characterization, and sequence determination of phospholipase D secreted by Streptoverticillium cinnamoneum.

Phospholipase D (PLD), secreted into the culture medium of an actinomycete, Streptoverticillium cinnamoneum, has been purified to homogeneity and characterized. The Stv. cinnamoneum PLD efficiently catalyzes both the hydrolysis and transphosphatidylation of various phospholipids, including phosphatidylethanolamine (PE), phosphatidylcholine (PC), and phosphatidylserine (PS). However, the substrate specificity differs between the two reactions; PE serves as the most preferred substrate for the hydrolysis, but PC and PS are better substrates than PE for the transphosphatidylation. In addition, the transphosphatidylation but not the hydrolysis of PE and PC is markedly activated on the addition of metal ions, especially Al3+. Nucleotide and amino acid sequence determination of the Stv. cinnamoneum PLD revealed the presence of common structural motifs identified in all PLD sequences from various species.

Functional indications for bullectomy of giant bulla.

Nineteen patients with giant bulla were followed for more than 1 year after bullectomy. They were divided into two groups according to their postoperative symptoms. Group 1 consisted of 16 patients who had no problems in their postoperative clinical course, while Group 2 included 3 patients who complained of severe dyspnea at 5 to 6 years of follow-up. Prior to operation, the forced expiratory volume in 1 sec over vital capacity (FEV1%) was 66.8 +/- in Group 1 and 27.6 +/- 5.4% in Group 2. Differences in preoperative and postoperative FEV1% were statistically significant within Group 1 and between the two groups. Postoperative FEV1% (Y) correlated significantly with preoperative FEV1% (X) (Y = 0.74X + 25.4; r = 0.836; p less than 0.001). Thus, we were able to predict the postoperative FEV1% from the preoperative value. Regional ventilation over volume was computed from the washout curve of xenon 133 after reaching equilibrium with rebreathing in a closed circuit (V/V dynamic). Group 2 had significantly lower regional ventilation over volume in all regions, both before and even after bullectomy, compared with normal subjects or Group 1 patients. Preoperative V/V dynamic was below 0.5 in all regions of Group 2. Furthermore, postoperative V/V dynamic (Y) correlated significantly with preoperative V/V dynamic (X) in the upper region (Y = 0.46X + 0.40; r = 0.638; p less than 0.02) and in the lower region (Y = 0.72X + 0.33; r = 0.869; p less than 0.001). We conclude that functional indications of bullectomy for giant bulla are that FEV1% should be greater than 40%, and that regional V/V dynamic should be greater than 0.5. On the other hand, symptomatic and functional improvement following bullectomy was reduced in patients whose FEV1% was less than 35% in whose V/V dynamic was remarkably disturbed in all regions of the involved hemithorax.

Postoperative preservation of pulmonary function in patients with chronic empyema thoracis: a one-stage operation.

Twenty-two patients with chronic empyema thoracis underwent decortication. In 11 of them, simple decortication achieved sufficient reexpansion of the lung. In the other 11 patients, our new method was indicated because the pleural space was not closed completely by simple decortication. In our procedure, the parietal wall is collapsed, without rib resection, to contact the surface of the decorticated lung. All 11 patients had a one-stage cure. Two of these 11 patients had bronchopleural fistula. The preoperative and postoperative percentage of vital capacity, percentage of forced expiratory volume in 1 second, arterial oxygen tension, alveolar-arterial oxygen pressure difference, and xenon 133 radiospirometry revealed that pulmonary function was well preserved in patients treated by our method as well as in those undergoing simple decortication. The alveolar-arterial oxygen pressure difference during oxygen inhalation improved significantly (p less than 0.05) after operation compared with the preoperative values in both groups. From the pulmonary function studies, we conclude that our method achieves results comparable with those of simple decortication for the treatment of chronic empyema thoracis. Our procedure is indicated in patients for whom it is thought simple decortication will not lead to primary cure of empyema.

Effects of thyrotropin-releasing hormone in chronic schizophrenic patients.

The effects of oral and intravenous thyrotropin-releasing hormone (TRH) were studied in 11 male, chronic schizophrenic inpatients in an open trial and a double-blind, crossover design. The general beneficial effects of TRH as assessed on the Brief Psychiatric Rating Scale were not obtained, although improvement of contact, apathy and emotional rapport was observed in a few patients. Serum prolactin, L-triiodothyronine and thyroxine were assayed throughout the study. Since the effects of TRH on behavior were not related to changes in these endocrine factors, the mechanism of action might be independent of its original functions on the pituitary-thyroid axis.

[Palliation of airway obstruction under a T-tube stent in a patient with thyroid carcinoma invading the trachea: a case report].

Invasion of the neoplasma to the upper airway tract is the life threatening factor. We experienced a 74-year-old female with thyroid carcinoma invading the trachea, for whom radical resection was infeasible. So for the palliation of airway obstruction we inserted the silicone rubber T-tube stent from 0.5 cm above the vocal cord to 2 cm before the carina after endotracheal tumor resection with Nd-YAG laser. As the result, she has led an active life for the last 6 months after the operation. We consider that the T-tube stent is effective tool in the management of airway obstruction for the slow growing neoplasma.

[Aortic valve replacement with Medtronic Hall valve (#21) using technique of enlargement of aortic annulus].

Aortic valve replacement was performed in 2 patients with severe aortic stenosis. They showed severe calcified valve and narrow aortic annulus. The aortic annulus was enlarged to 22 mm and 23 mm in diameter in each patient by the technique of Nicks. Then aortic valve replacement was performed with Medtronic-Hall valve (#21) which is supposed to get larger valve area than Björk-Shiley valve. They had good operative course except a complication of complete AV block in the first patient. In this patient a DDD pacemaker was implanted 19 days after operation. Cardiac catheterization was performed 11 or 12 months after operation and good hemodynamics was obtained in both patients. The aortic mean pressure gradient was 6 and 5 mmHg at rest, and 9 and 13 mmHg during exercise on bicycle ergometer in each patient. The aortic valve area was 1.7 and 1.9 cm2, respectively. Body surface area in these patients was 1.29 and 1.36 m2. We concluded that in the small patients we could get a good result with Medtronic Hall valve (#21).