Earlier BMI rebound and lower pre-rebound BMI as risk of obesity among Japanese preschool children.

OBJECTIVES: Longitudinal growth data of children were analyzed to clarify the relationship between the timing of body mass index (BMI) rebound and obesity risk in later ages. SUBJECTS/METHODS: Of 54 558 children born between April 2004 and March 2005 and longitudinally measured in April and October every year in the preschool period, 15 255 children were analyzed wherein no longitudinal measurement is missing after 1 year of age. BMI rebound age was determined as the age with smallest BMI value across longitudinal individual data after 1 year of age. Rebound age was compared between overweight and non-overweight groups. The subjects were divided into groups based on the timing of rebound. The sex- and age-adjusted mean of the BMI, height and weight s.d. scores for age group, along with 6 months weight and height gain, were compared among groups using analysis of covariance. RESULTS: Among those who were overweight at 66-71 months of age, BMI rebound age obtained at approximately 3 years of age was compared with the non-overweight group, whose BMI rebound age was utmost 66 months or later (P<0.001). The comparison among BMI age group showed that earlier BMI rebound results in larger BMI (P<0.001) and larger weight and height gain after the rebound (P<0.001). Among the group with BMI rebound earlier than 30 months of age, low BMI was observed (P<0.001). Slight elevation of height and weight gain was observed before the BMI rebound among groups with rebound age earlier than 60 months of age (P<0.001). CONCLUSION: Earlier BMI rebound timing with pre-rebound low BMI leads to greater childhood obesity risk; hence, early detection and prevention is necessary for such cases.

Longitudinal changes in body mass index of children affected by the Great East Japan Earthquake.

BACKGROUND: The evacuation and disruption in housing caused by the 2011 Great East Japan Earthquake and following nuclear radiation may have influenced child health in many respects. However, studies regarding longitudinal childhood growth are limited. Therefore, in this study we aimed to explore the influence of the earthquake on longitudinal changes in body mass index in preschool children. METHODS: Participants were children from nursery schools who cooperated with the study in the Iwate, Miyagi and Fukushima prefectures. The exposed group consisted of children who experienced the earthquake during their preschool-age period (4-5 years old). The historical control group included children who were born 2 years earlier than the exposed children in the same prefectures. Trajectories regarding body mass index and prevalence of overweight/obesity were compared between the two groups using multilevel analysis. Differences in the changes in BMI between before and after the earthquake, and proportion of overweight/obesity was compared between the two groups. We also conducted subgroup analysis by defining children with specific personal disaster experiences within the exposed group. RESULTS: A total of 9722 children were included in the study. Children in the exposed group had higher body mass indices and a higher proportion of overweight after the earthquake than the control group. These differences were more obvious when confined to exposed children with specific personal disaster experiences. CONCLUSIONS: Children's growth and development-related health issues such as increased BMI after natural disasters should evoke great attention.

Physician's attitudes towards disclosure of cancer diagnosis to elderly patients: a report from Tokyo, Japan.

Physicians' attitudes towards the disclosure of a cancer diagnosis to 114 consecutive patients (age range, 65-93 years; median 78 years) admitted to the Tokyo Metropolitan Tama Geriatric Hospital from April 1994 to May 1995 were analyzed utilizing a questionnaire administered to the attending physicians. Eighty-seven patients (76%) had been informed of their diagnosis before the initiation of cancer treatment, while 27 patients (24%) were not told. 'To carry out the treatment under patient's understanding' and 'consideration for patient's quality of life' were the major reasons for diagnosis disclosure, while 'lack of patient's ability to understand the information' and 'family's wish that the patient not be informed of the truth' were the major reasons for non-disclosure. Dementia, deteriorated performance status, and non-curability were major factors related to non-disclosure. Even with decisional ability, 15% of patients were not told their cancer diagnosis because wishes of their families were preferred. The current results suggest that telling cancer diagnosis to the elderly patients will not yield negative attitude of the patients and that there is no rationale for physicians to hesitate to disclose cancer diagnosis merely because of patient's high age.

[Successful UFT-E granule and 5-FUCDDP combination therapy for an unresectable advanced gastric cancer complicated with liver metastasis].

A 79-year-old man having advanced gastric cancer with liver metastasis was treated by gastric dissection and gastro-jejunostomy. At this time CDDP was injected intraperitoneally at the dose of 30 mg/m2. After operation UFT-E granule was administered orally at the dose of 400 mg/body every day. Two months later he was treated with 5-FU 500 mg/m2 and CDDP 20 mg/m2 intravenously for 3 days. After this treatment, the liver metastatic lesion disappeared and the primary gastric lesion was reduced on CT scan. The same FP chemotherapy was done eight months later. The patient has now survived for more than 1 year and 2 months with a good quality of life by home parenteral nutrition. This UFT-E granule and FP combination therapy seemed to be effective for advanced gastric cancer with liver metastasis.

Complement receptor type 1 (CR1) deficiency on neutrophils in myelodysplastic syndrome.

We present a patient with myelodysplastic syndromes (MDS) whose neutrophils exhibited defective expression of complement receptor type 1 (CR1). A 73-year-old man was admitted with an evolution of MDS from RA into RAEBT according to the FAB classification of MDS. The neutrophil alkaline phosphatase (NAP) score was zero. The surface expression of membrane effector molecules on neutrophils was determined by indirect immunofluorescence using flow cytometry and monoclonal antibodies. The expression of CR1 on neutrophils as identified by staining with CD35 was defective in the patient, and the expression of other complement receptors (CR3 and CR4), Fc receptors and adhesion molecules was normal. CR1 deficiency and defective NAP score on neutrophils in the patient might account for impairment of common storage pool, presumably novel intracellular secretory vesicles.

[The expression of IL-2 receptor subunits on various leukemic cells].

Interleukin-2 receptors are composed of at least two polypeptide chains of alpha (55KD) and beta (75KD). The IL-2R beta chain is an essential component of the functional receptor for signal transduction of IL-2. We previously reported the distribution of IL-2R subunits among peripheral blood mononuclear cells. We here present some data regarding the expression of IL-2R subunits on various hemopoietic malignant cells. Fresh leukemic cells obtained from adult T cell leukemia patients expressed both alpha and beta chains, and leukemic cells derived from some patients with T cell leukemia, B cell leukemia or myeloid leukemia expressed the alpha and/or beta chain of IL-2R. The IL-2R beta chain on these leukemic cells were demonstrated to be functional for cell growth signaling. IL-2R alpha and beta chains should be tumor markers.

[Angio-immunoblastic lymphadenopathy with fibrosis of bone marrow, lymph node, liver and spleen, and proliferation of epithelioid cells in lymph nodes].

We report a 47-year-old man diagnosed as angio-immunoblastic lymphadenopathy with dysproteinemia (AILD) with fibrosis of the bone marrow, lymph node, liver and spleen, and proliferation of epithelioid cells in lymph node. He was admitted to a hospital in May, 1980 because of general fatigue, cough, fever and systemic lymphadenopathy. The diagnosis of AILD was based on a biopsy of right cervical lymph node. His symptoms were improved but recurred with the addition of icterus and progressive pancytopenia with decrement of prednisolone. He was referred to our hospital in July, 1980 and his physical examination revealed generalized lymphadenopathy, icterus and hepatosplenomegaly. Hemogram showed pancytopenia, and needle biopsy of the bone marrow disclosed fibrosis. Sections from the lymph node showed AILD with proliferation of epithelioid cells. Administration of 60 mg/day of prednisolone improved the fever, lymphadenopathy and hepatosplenomegaly. However he died suddenly of acute respiratory failure on July 30. Autopsy showed fibrosis of bone marrow, lymph node, liver and spleen with infiltration of abnormal lymphocytes, and pulmonary aspergillosis.

A study of intracytoplasmic inclusions in myeloma cells from two patients with multiple myeloma.

Two cases of multiple myeloma which showed inclusions within the cytoplasma of myeloma cells were reported. One contained crystalline inclusions which were not stained by May-Grünwald and Giemsa, and the other contained Auer rod-like spindle shaped inclusions which were stained by May-Grünwald and Giemsa and PAS. Both cases were stained intensively by acid phosphatase but they were not stained by Congo red or by thioflavine-T. Moreover, they reacted only with anti-kappa sera in the immunofluorescent study and showed the same structure on electron microscopic observation. Although they showed different staining behaviors according to their compositions, they were considered to be essentially the same. It appears that light chains produced in excess are concentrated and form inclusions through the addition of sugar or digestion by lysosomal enzymes.

[Effect of transection on gastrointestinal electric activities (author's transl)].

Alterations in the pattern of basic electric rhythm of the stomach and jejunum were studied in a total of 12 dogs subjected to following procedures; (a) transection and close contact repair of the entire seromuscular layer in the upper jejunum; (b) transection and close contact repair of the seromuscular layer in the stomach; (c) transection and interposition repair with alpha cyano acrylate in the stomach. Jejunal transection has resulted in permanent interruption in coupling of the basic electrical rhythm irrespective of repair procedures of the muscle layers. Gastric transection has revealed interruption in coupling of the basic electrical rhythm temporarily, but coupling phenomenon was observed in about 14 days. Gastrin transection with alpha cyano acrylate interposition has resulted in interruption in coupling of the basic electrical rhythm when the animal is maintained in fasting state. However, coupling has occurred immediately after the feeding or intragastric balloon distension. These results indicate that there exists some difference between the stomach and the jejunum in the effects of transection on electrical activities. Coupling phenomenon of the basic electrical rhythm observed in the transected stomach is probably due to an interaction of nervous system or a mechanical stimulus acting across the transection line.

[Effect of selective proximal and truncal vagotomy on canine gastric electrical activity (author's transl)].

Alterations in the electrical activity of the stomach were studied in 40 unanesthetized dogs with intact vagal innervation, with selective proximal vagotomy (SPV) and with truncal vagotomy (TV) using a chronically implanted unipolar needle electrodes. The basic electrical rhythm (BER) of the normal canine stomach occurred regularly in the frequency of 4.5 to 5.5 cycles per minutes with a waxing and waning of initial and second potentials repeated in every 5 to 6 minutes. After SPV, irregular BER was observed occasionally within a few days postoperatively. After TV, irregularity of BER was more marked and frequent for the first 2 weeks. Subcutaneous administration of bethanechol chloride or histamine decreased the frequency of regular BER and increased the magnitude of second potentials equally in any dog of the control, SPV and TV groups. Similar changes were observed after feeding of the canned meat. Insulin-induced hypoglycemia increased the magnitude of antral second potentials in either control or SPV dogs. In contrast, TV dogs revealed repetition of initial potentials shortly after intravenous adminstration of insulin, but failed to show any changes relevant to hypoglycemia.