Transient osteoporosis of the hip in pregnancy associated with generalized low bone mineral density--a case report.

Transient osteoporosis of the hip (TOH) in pregnancy is characterized by severe pain in unilateral or bilateral hips and has been diagnosed as localized osteopenia. However, we evaluated a case of unilateral TOH with generalized profound osteoporosis involving both the hips and the lumbar vertebrae by dual-energy X-ray absorptiometry. The diagnosis was based on the clinical course and confirmed by magnetic resonance imaging. Three-dimensional helical computed tomography (3D-CT), which has not been used in patients with TOH, revealed a markedly thin bilateral proximal femoral cortex, particularly in the symptomatic femoral head. Despite the difference in the severity of bone destruction between the two femora, they both showed the same pattern of damage on 3D-CT. Furthermore, despite continuing treatment with the same dose of alendronate and calcitriol, a high rate of bone mineral density gain, involving both the femora and lumbar vertebrae, was limited to the early postpartum months. A majority of reported female patients with TOH are pregnant. Thus, the association between TOH and pregnancy was not considered to be fortuitous, and chemical or hormonal factors related to pregnancy may play an etiologic role in this disease. The possible etiologies of TOH in pregnancy are also discussed.

[CR obtained by CPT-11 and CDDP combination-therapy in a small-cell lung-cancer patient through effective pharmaceutical care].

We encountered a 64-year-old UGT1A1*28 heterotype patient who received CPT-11 and CDDP chemotherapy for Stage III A small-cell lung-cancer and developed grade 4 neutropenia as assessed by CTCAE v3.0 in Pharmaceutical Management. The therapeutic effect was good; 4 courses of chemotherapy could be safely administered at 1/3 of the applied dose of CPT-11, and CR was obtained. In this period, we participated in selecting antibiotics to neutropenia and CPT-11 closing regimen as pharmacists. Additionally, we carefully monitored patients about their bowel pattern and hematotoxicity, and collected information about gene searching for the patient and the Hospital Ethics Committee. The analysis of the gene polymorphism of CPT-11 is useful to predict the occurrence of serious side effects, but this judgment cannot easily be made clinically. In the event of a marked decrease in the neutrophil count of a patient during the first courses of treatment with CPT-11, we believe that it is important to consider gene polymorphism, to closely monitor the symptoms and laboratory parameters, and to give a smaller dose of the drug.

Survey of the morphogenetic dynamics of the ventricular surface of the developing mouse neocortex.

To understand the morphogenetic dynamics of the inner surface of the embryonic pallial (neocortical) wall, we immunohistochemically surveyed the cellular endfeet facing the lateral ventricle and found that the average endfoot area was minimal at embryonic day (E)12 in mice. This endfoot narrowing at E12 may represent a change in the mode of cell production at the surface from a purely proliferative mode that retains all daughter cells to a more differentiation-directed mode that allows some daughter cells to leave the surface. The apices of cells undergoing mitosis were 1.5-3.9 times larger than the overall cell apices and 6.7-8.7 times smaller than the cross-sectional area of mitotic somata. En face time-lapse monitoring of each endfoot permitted observation of its cell cycle-dependent size changes, division, and relationships with neighboring endfeet. Planar divisions oriented along the lateral-medial axis were less abundant than those oriented along the rostral-caudal axis at E10 and E11, but basal body distribution in each endfoot was random.

Maternal weight gain rate in the second trimester are associated with birth weight and length of gestation.

BACKGROUND: Low total weight gain during pregnancy has been widely accepted as a valid risk factor for small-for-gestational-age infants and pre-term births. However, it is not obvious in which trimester the weight gain rate most affects birth weight and length of gestation. METHOD: Using logistic regression analysis and Pearson's correlation coefficient test, data from 472 women who had vaginally delivered an infant at term without any complications were analyzed retrospectively. RESULTS: Pre-pregnancy underweight and low total maternal weight gain were significant independent predictors of small-for-gestational-age infants and shortened gestations. Pre-pregnancy weight was significantly related to the birth weight and length of gestation (r = 0.18, p < 0.0001; r = 0.10, p = 0.04, respectively), and total weight gain was also significantly related to those (r = 0.17, p = 0.0003; r = 0.11, p = 0.03, respectively). Significant correlations between maternal weight gain rate in the second trimester and the birth weight and length of gestation were found (r = 0.32, p = 0.005; r = 0.40, p = 0.0003, respectively), while such correlations were not found in the first or third trimester. CONCLUSION: The most sensitive period of maternal weight gain for the birth weight and length of gestation was the second trimester.