Clinical trial: the effect of Johrei on symptoms of patients with functional chest pain.

BACKGROUND: Patients with functional chest pain (FCP) represent a therapeutic challenge for practising physicians. AIM: To determine the efficacy of Johrei as compared to wait-list in improving symptoms of FCP patients. METHODS: Patients with chest pain of noncardiac origin for at least 3 months were enrolled into the study. All patients had to have negative upper endoscopy, pH testing and oesophageal manometry prior to randomization. Subsequently, patients were randomized to either Johrei or wait-list control. Patients received 18 Johrei sessions from a Johrei practitioner for 6 weeks. RESULTS: A total of 21 FCP patients enrolled into the Johrei group and 18 into the wait-list group. There was no difference in symptom intensity score between Johrei group and wait-list group at baseline (20.28 vs. 23.06, P = N.S.). However, there was a significant pre- and post-treatment reduction in symptom intensity in the Johrei group (20.28 vs. 7.0, P = 0.0023). There was no significant reduction in symptom intensity score between baseline and at the end of the study in the wait-list group (23.06 vs. 20.69, P = N.S.). CONCLUSION: This pilot study shows that Johrei may have a role in improving FCP symptoms; however, future studies are needed to compare Johrei treatment with sham Johrei or supportive care.

Orchiectomy and response to testosterone in the development of obesity in young Otsuka-Long-Evans-Tokushima Fatty (OLETF) rats.

OBJECTIVE: Withdrawal of testosterone prevents the development of hyperglycaemia in male Otsuka-Long-Evans-Tokushima Fatty (OLETF) rats, a model of non-insulin-dependent diabetes mellitus (NIDDM), but the exact mechanism has not been established. The present studies were undertaken to examine a possible role of testosterone in the development of obesity in young OLETF rats who have not shown marked hyperphagia. METHODS: Body weight, food intake and circulating concentrations of metabolic factors including immunoreactive leptin (IRL) were measured at five weeks of age in young male OLETF rats and their lean controls, Long-Evans-Tokushima-Otsuka (LETO) rats. At six weeks of age, both LETO and OLETF rats were bilaterally orchiectomized (Orchx) and half of each group implanted with a silastic tube containing testosterone. After a three week observation period, all animals were killed and circulating concentrations of metabolic factors and the ob gene expression in retroperitoneal white adipose tissues were measured. RESULTS: Body weight and 24h food intake were already increased in OLETF rats at five weeks of age. Serum testosterone concentrations were significantly lower in OLETF rats than in LETO rats. Expression of the ob gene was significantly decreased in the retroperitoneal white adipose tissue of OLETF rats, and their serum IRL concentrations were lower. Food intake and body weight gain for three weeks after the operation were significantly lower in the Orchx group of OLETF rats than in the sham-operated group. Hyperglycaemia, accompanied by hyperinsulinaemia, was attenuated by orchiectomy in OLETF rats. Circulating IRL concentrations were significantly higher in OLETF rats than in LETO rats and decreased by orchiectomy. Testosterone supplement reversed all of the changes caused by orchiectomy in OLETF rats. In contrast, the changes, which were observed after orchiectomy in OLETF rats, were not obvious in LETO rats. CONCLUSION: The present data indicate that testosterone plays a role in the development of obesity and NIDDM in young OLETF rats, but that changes of leptin production in white adipose tissue may not be important in the development of obesity in young OLETF rats.

Calcium supplements increase bone mineral density in women with low serum calcium levels during long-term estrogen therapy.

In order to clarify whether the long-term effect of estrogen on bone mineral density (BMD) is reinforced by low dose calcium supplements, 600-800 mg of calcium lactate was administered to postmenopausal or oophorectomized women who had been undergoing unopposed estrogen therapy for at least 2 years and whose serum calcium level was suppressed to below the normal range. To patients whose serum calcium levels had been within the normal range, the same dose of estrogen alone was continued. Changes in lumbar spine BMD before and after calcium supplementation was measured by dual-energy X-ray absorptiometry. Lumbar spine BMD decreased by -0.37% for 2 years in women treated with estrogen alone, while that of women treated with estrogen and calcium increased by 2.78% (P = 0.003). These results indicate that low dose calcium supplements potentiate the effect of estrogen in women with decreased serum calcium during long-term hormone replacement therapy.

Regulation of follistatin messenger ribonucleic acid in cultured rat granulosa cells.

The regulation of the follistatin mRNA by hormones and endocrine manipulations was examined in granulosa cell cultures. The follistatin mRNA accumulation was stimulated in a dose-dependent manner by follicle-stimulating hormone (FSH) with a maximal response twice as great as in control cultures at a dose of 100 ng/ml FSH. The time course of the FSH effect on follistatin mRNA had a biphasic effect in which FSH increased follistatin mRNA within 2 h, and subsequently reduced it to below the control level. 8-Br-8 brom-adenosine 3,5-cyclic monophosphate (cAMP) (2 mM) and phorbol 12-myristate 13-acetate (PMA) (10 nm) induced a time-dependent increase in follistatin mRNA levels, with the maximal response at 6 h and 2 h, respectively. Co-treatment of the granulosa cells with cAMP and PMA demonstrated that 0.2 mM of 8-Br-cAMP suppressed the follistatin mRNA of the control and the samples with a small amount of PMA in the granulosa cells. Follistatin expression is therefore regulated by protein kinase A and protein kinase C pathways in rat granulosa cells. A more dramatic stimulation of follistatin mRNA was observed when this culture was treated with activin, and follistatin also blocked the effect of activin on the follistatin mRNA.

Example of a woman with multiple intrauterine deaths due to anti-M who delivered a live child after plasmapheresis.

Serological and hematological investigations are reported for a woman who had multiple intrauterine deaths due to anti-M. The mother was group O Ns and the husband's cells were shown to be group O MSs. In the serological examination during the third pregnancy anti-M antibodies were identified in her serum. The antibodies comprised IgM saline agglutinin at a titer of 256 at 4 degrees C and IgG agglutinin reacted in an indirect antiglobulin technique at a titer of 4,096 at 37 degrees C. After the intrauterine death at 14 weeks gestation of her fifth pregnancy she underwent plasmapheresis 6 times on a biweekly program. Approximately 2 liters of plasma were exchanged for 1 liter of plasma protein fraction and 1 liter of fresh frozen plasma. In her sixth pregnancy, intensive plasmapheresis was started from 2 months gestation and a total of 56 liters plasma were exchanged. The anti-M titer fell to 256. She delivered a live girl by induction of labor at 35 weeks. The child was group O MNs. Her red cells had a positive direct antiglobulin reaction and her serum contained IgG anti-M antibody. Phototherapy was carried out and the child developed normally.

Small hepatocellular carcinoma: diagnosis with US angiography with intraarterial CO2 microbubbles.

Ultrasonographic (US) angiography enhanced with intraarterial CO2 microbubbles, a contrast material used in US imaging, was performed of 103 histologically proved hepatocellular carcinomas (HCCs) smaller than 3 cm in diameter in 95 patients. The detection rate for hypervascular HCC with US angiography was compared with the rate of detection with conventional angiography, digital subtraction angiography (DSA), and computed tomography (CT) after intraarterial injection of iodized oil. Sensitivity in detection of hypervascular HCCs with US angiography was 86% (89 of 103 HCCs), compared with 63% (44 of 70 HCCs) detected with conventional angiography, 70% (23 of 33 HCCs) with DSA, and 82% (75 of 91 HCCs) with CT with iodized oil. US angiography depicted small hypervascular HCCs, especially those less than 1 cm in diameter, and helped clarify vascularity as isovascular or hypovascular in angiographically undetectable HCCs. Findings at US angiography assisted the choice of a therapeutic strategy for treatment of HCC, such as transarterial therapy, percutaneous ethanol injection therapy, or resection.