Aging attenuates the association of central obesity with the accumulation of metabolic risk factors when assessed using the waist circumference measured at the umbilical level (the Japanese standard method).

OBJECTIVE: The objective of this study was to clarify the generation and gender differences in the association between central obesity and the accumulation of metabolic risk factors (RFs) in the Japanese population. MATERIAL AND METHODS: A total of 12 389 subjects (age: 18-80 years) without receiving medication for diabetes, dyslipidemia or hypertension were enrolled in this study and divided according to age and gender. In each group, we performed analyses as follows: (1) a receiver operating characteristic (ROC) analysis to evaluate the utility of the waist circumference (WC) for detecting subjects with multiple RFs of metabolic syndrome (MS); (2) a cross-sectional study to examine the relationship between the WC and the odds ratio (OR) for detecting those subjects and (3) a longitudinal study to examine how longitudinal changes (Δ) in WC over a 1-year period affected the values of each metabolic RF. RESULTS: With age, the WC cutoff values yielding the maximum Youden index for detecting subjects with multiple RFs increased only in women, and the areas under the curves of the ROC analysis of WC for detecting those subjects decreased in both genders. The positive correlation between the WC and the OR for detecting subjects with multiple RFs became weaker with age, especially in women. In the longitudinal study, the significant correlation between ΔWC and Δ each metabolic RF, except for hypertension, and between ΔWC and Δ the number of RFs became weaker with age in women, whereas the significant correlation between ΔWC and Δ the number of RFs was not affected with age in men. In women aged 60 years, none of the changes in each metabolic RF were significantly associated with ΔWC. CONCLUSIONS: Aging attenuates the association of central obesity with the accumulation of metabolic RFs, especially in women.

[A case of giant sebaceous gland carcinoma without adequate treatment].

BACKGROUND: A patient with a sebaceous gland carcinoma without adequate treatment is reported. CASE: A 67-year-old man underwent an operation on his left upper eyelid after a diagnosis of chalazion in 1981. Two years after the initial operation, he noticed a tumor in the left upper eyelid. In 1987, he visited another hospital and was diagnosed with sebaceous gland carcinoma by a tissue biopsy. He left it untreated against medical advice. When he visited our hospital in 1996, the tumor was as large as 80 x 75 x 40 mm and the left upper and lower eyelids stuck together. After admission, he died of myocardial infarction 23 days after his visit to our hospital. Autopsy revealed that the tumor had extended into the orbital cavity, paranasal sinus, and base of the skull, with metastasis to the preauricular, submandibular, and cervical lymph nodes and both lungs. The pathology of the tumor was a moderately differentiated sebaceous gland carcinoma. CONCLUSION: This case showed the natural course of extension and metastasis of a sebaceous gland carcinoma.

[Visual exploration and cognitive articulation of the compound figures in children].

Visual articulation of compound figures is more fragmentary in children whereas it is more integrated in adults. In this experiment, eye movement of children during visual exploration of test figures was recorded under the hypothesis that the fragmentary articulation should be related to the same fragmentary character of the eye movement. The subjects were 20 children of 4-, 5- and 6-years old and the eye movement was recorded by a video monitor system accompanied by an EOG. The cognitive articulation was analyzed by a picture drawing task of the same figures and compared with the patterns of the eye movement. As the results, the children of fragmentary articulation in drawing also showed more partial-successive and inefficient explorative movement than those children of integrated articulation. The hypothesis was confirmed.