[Successful use of "juzen-taiho-to", a kampo medicine, for the treatment of perioperative anemia and hypoalbuminemia].

An 88-year-old woman suffering from femoral neck fracture was transported to the emergency room of a hospital. The patient and her family refused transfusion, despite anemia, stating their affiliation with Jehova's Witnesses. Surgery was performed under general anesthesia, and the following day, anemia (hemoglobin, 7.5 g x dl(-1)) and hypoalbuminemia (albumin, 2.7 g x dl(-1)) were observed, in addition to anorexia and general fatigue. The patient underwent nutritional treatment with a kampo medicine (Juzen-taiho-to), which was administered as a medication due to difficulties with swallowing the powdered form. On the 18th day after admission, anemia (hemoglobin, 8.9 g x dl(-1)) and hypoalbuminemia (3.6 g x dl(-1)) improved, as did anorexia and general fatigue. It is thought that the components Shimotsu-to, a component known to improve anemia, and Shikunshi-to, a vital energy supplementing component, were the main ingredients that conferred the improvements in anemia and hypoalbuminemia. These findings suggest that Chinese herbal medicine for the nutritional treatment of the elderly has minimal side effects.

Roughness and temperature effects on the filter media of a trickling filter for nitrification.

The performance of trickling filters using two types of plastic media with the same material, the same shape and different roughness was evaluated during a temperature-decreasing period to understand the roughness and temperature effects on the filter media. Real restaurant wastewater was used for the experiments. The chemical oxygen demand (COD) removal and nitrification performance of plastic media with a rough surface (LT-15) was superior to that with a smooth surface (KT-15). Because the biomass of microorganisms attached on the LT-15 was twice that attached on the KT-15, the larger biomass attached on the LT-15 was thought to be responsible for the higher performance. During the operation, the COD loading and water temperature varied in the range from 0.37 to 1.9 kg m(-3) d(-1) and 17.0--10.0 degrees C, respectively. However, the COD removal performance was not dependent on the COD loading or water temperature. On the contrary, the COD loading and the water temperature influenced the nitrification performance. Although a nitrification efficiency of 100% was recorded at a COD loading of 0.37 kg m(-3) d(-1), it deteriorated to 17-28% at higher COD loading. Moreover, a decline in the water temperature decreased the nitrification performance. The temperature-activity coefficient for nitrification was estimated to be 1.096. Based on this value, it was inferred that the COD loading should be set at less than 0.20 kg m(-3) d(-1) for the complete nitrification of the restaurant wastewater in winter, when the water temperature usually drops to around 10 degrees C.

The relationship between endogenous estrogen, sex hormone-binding globulin, and bone loss in female residents of a rural Japanese community: the Taiji Study.

The aim of this study was to clarify the relationship between endogenous estrogen, sex hormone-binding globulin (SHBG), and bone loss in pre-, peri-, and postmenopausal female residents of Taiji, a rural Japanese community. From a list of inhabitants aged 40 to 79 years, 200 participants-50 women in each of four age decades-were randomly selected, and baseline bone mineral density (BMD) at the lumbar spine and proximal femur were measured by dual-energy X-ray absorptiometry in 1993. Total estradiol (total E2) and SHBG were measured, and SHBG-unbound E2 (UBE2) was calculated using SHBG and the percent SHBG-unbound fraction ratio. BMD was measured again 3 years later, in 1996. Participants with ovariectomy or hysterectomy were excluded, and the remaining participants were categorized into four groups: premenopausal ( n = 38), perimenopausal ( n = 14), postmenopausal group 1 (5 years or less since menopause; n = 18), and postmenopausal group 2 (6 years or more since menopause; n = 74). The mean value of total E2 was highest in the premenopausal group (49.1 pg/ml), followed by the perimenopausal group (26.4 pg/ml), and the postmenopausal groups (0.83 pg/ml in postmenopausal group 1 and 0.96 pg/ml in postmenopausal group 2). The means for UBE2 showed the same pattern across the groups. After the multiple regression analysis of BMD at follow-up and endogenous estrogens, in premenopausal women, there were no significant associations between BMD at follow-up and serum total E2 and UBE2. In perimenopausal women, however, serum total E2 and UBE2 were significantly correlated with trochanteric BMD at follow-up ( P < 0.05); and in postmenopausal group 2, they were significantly correlated with lumbar spine and Ward's triangle BMD at follow-up ( P < 0.001 at lumbar spine, P < 0.05 at Ward's triangle). Concerning the association between BMD at follow-up and SHBG, in the premenopausal group, serum levels of SHBG were negatively correlated with BMD at the femoral neck ( P < 0.05). In regard to partial regression coefficients for the change rates of BMD over 3 years and serum estrogens and SHBG concentrations, in perimenopausal women, UBE2 was correlated with the change rate of BMD at Ward's triangle ( P < 0.05), and in postmenopausal group 1, serum levels of SHBG were significantly negatively related to change in BMD at the trochanter ( P < 0.01). No other relationships with change in BMD were observed at any sites. These findings suggest that serum E2, UBE2, and SHBG levels differentially predict BMD levels in groups of differing menstrual status. It would, however, be difficult to predict bone loss in middle-aged and elderly Japanese women over a 3-year period using these indices alone.