Use of a food composition database to estimate daily dietary intake of nutrient or trace elements in Japan, with reference to its limitation.

Daily dietary intake of 28 trace elements (Al, As, B, Ba, Be, Bi, Cd, Co, Cr, Cu, Ga, Ge, Li, Mg, Mn, Mo, Ni, Pb, Sb, Sc, Se, Si, Sn, Sr, Ti, Tl, V and Zn) were estimated from the food intake records (collected by the 24-h total food duplicate method), taking advantage of recently published trace element composition tables for foods in Japan. Because the number of food items listed in the tables was not sufficient, the calculation was made with not all foods recorded, and the results should be taken as semi-quantitative. The estimated intake was high (i.e. > 1 mg/day as a median) for Al, Cu, Mg, Mn, Si, Sr and Zn, medium (i.e. 2-985 micrograms/day) for As, B, Ba, Be, Cr, Ge, Mo, Ni, Sb, Sc, Se, Sn and Ti, and low (i.e. < 1 microgram/day) for Cd, Co, Li, Pb and V. Comparison of the present estimates with the reported values in the literature on 15 elements showed that close agreements were observed in the cases of 10 elements (i.e. Al, B, Cr, Cu, Mg, Mn, Mo, Ni, Se and Zn) for which the present estimates are above 1 microgram/day, whereas the discrepancies were significant for four elements (i.e. Cd, Co, Pb and V) with < 1 microgram/day intake. When the expected dietary uptake was compared with that by respiration in the cases of the 16 elements for which the atmospheric concentration data in Japan are available, the uptake was exclusively attributable to the dietary route for all 16 elements with the possible exception of vanadium.

Chronological changes and inter-regional differences in dietary fiber intakes among middle-aged Japanese women.

Dietary fiber intake was estimated by the total food duplicate method, using a computerized system for fiber calculation recently developed by this study group. Collection of food duplicates were conducted twice, once in 1979-83 and then in 1990-95, in 20 sites across Japan. Altogether 294 and 384 nonsmoking, nonhabitually drinking adult women offered the samples, in the first and second survey, respectively. The average intake of total fiber was 20.7 g/day in the first study, and it was 18.7 g/day in the second survey with a significant reduction. Soluble fiber accounted for 18 to 19%, and the reduction was more marked in soluble fiber than in insoluble fiber. There was an inter-regional difference in fiber intake which was more evident in the first survey than in the second; farmers in Okinawa took less soluble, insoluble and total fiber than in Hokkaido and Honshu farmers and also urban residents. Throughout the four groups, the leading fiber sources were vegetables, followed by cereals, fruits and pulse in the decreasing order. Intakes of these foods diminished during the two survey period, and the reduction of fiber from cereals was most evident in Honshu and Okinawa farmers. International comparison showed that the current level of fiber intake in Japan is essentially similar to the levels in Europe and USA, despite the long-term trend of reduction.

[A report of successful surgical management of right coronary artery to right atrium fistula forming giant aneurysms at the posterior wall of the right atrium].

A 52-year-old woman was diagnosed by echocardiography to have a fistula of the right coronary artery (RCA) and the right atrium (RA). Aortography demonstrated a remarkably dilated and undulating fistulous tract originating from the region corresponding to the orifice of the normal RCA. The fistulous tract detoured to the posterior wall of the RA, and forming 2 aneurysms there, opened to the RA. A RCA of normal size originating midway of the fistulous tract was also observed. The patient was operated on under cardio-pulmonary bypass. Aortocoronary saphenous vein graft to the RCA having normal diameter was performed, and the RCA was ligated in the proximal side of the anastomosis. The orifice of the fistulous tract from the aorta was closed with a patch and the entrances into the RA were also closed by pledgetted mattress sutures. The post operative course was uneventful and the patient is now doing well without any complaints.

Auditory brainstem responses in leptomeningeal metastatic spread. Presentation of 2 cases.

Auditory brainstem responses (ABRs) were recorded in 2 patients with hearing loss caused by leptomeningeal metastatic spread. These recordings showed similar characteristic findings. The absolute latencies of wave V and interwave latencies I-V were exceedingly increased. Definite effects on the wave morphology and latency of wave V were observed with the use of high repetition rates. It is surmised that the hearing loss caused by leptomeningeal metastatic spread is mainly an effect on the auditory nerve and/or the cochlear nucleus. ABR examination is of clinical value in detecting functional abnormalities resulting from leptomeningeal metastatic spread.

[Assessment of infarct-related coronary arteries using the bull's eye view method and unfolded surface mapping in thallium-201 myocardial tomography].

Infarct-related coronary lesions and collaterals were assessed by the bull's eye view and the unfolded surface map derived from thallium-201 myocardial tomography (Tl-201 SPECT) in 25 patients with anterior myocardial infarction. The patients were categorized in six groups according to their cine-angiographic findings: locations of stenosis (proximal or distal portions of the first diagonal branch or distal site of the first septal branch), and the presence or absence of collaterals. The anterior half of the left ventricle on the bull's eye view map was divided into eight regions from the anterior septum to the lateral wall and from the apex to the cardiac base. Tl-201 SPECT images were expressed as functional maps using maximum-count circumferential profile analysis: an "extent image" showing the extent of perfusion defect, and a "severity image" demonstrating the degree of hypoperfusion. The following results were obtained: 1. Perfusion defect of the "extent image" at the basal portion of the anterior septum reflected poor collaterals, with a sensitivity of 81.3%, a specificity of 77.8%, and a diagnostic accuracy of 80.0%. 2. Coronary stenosis at segment 6 (AHA classification) was differentiated from that at segment 7 by detecting hypoperfusion at the basal septum on the "severity image", with a sensitivity of 71.4%, a specificity of 77.8%, and a diagnostic accuracy of 75.0%. 3. Perfusion defect at the basal section of the proximal portion of the anterior wall on the "extent image" indicated stenosis at the proximal segment 6, with a sensitivity of 57.1% and a specificity of 88.9%.(ABSTRACT TRUNCATED AT 250 WORDS)

Hypertension and cardiovascular diseases in an epidemiological study in Hokkaido, Japan.

The present study describes the results from the 10-year follow-up data of a prospective epidemiological study for hypertension and cardiovascular diseases in two communities of rural agricultural districts in Hokkaido, Japan. The number of incidences of cerebrovascular accidents (CVAs) in persons who were normotensive, borderline hypertensive (BHT), untreated hypertensive (HT), well-controlled HT [blood pressure (BP) less than 150/90 mm Hg], and poorly controlled HT (BP greater than or equal to 150/90 mm Hg) were 0.46, 3.24, 4.17, 3.49, and 12.76 per 1,000 person-years. respectively: CVAs were markedly high in poorly controlled HT persons. The winter-summer mean BP differences in the first year were significantly and positively correlated with the differences in mean BP between the tenth and the first year, and were significantly higher in the progression to hypertension group than in the nonprogression group in both towns. Multivariate analysis indicated that the winter-summer mean BP difference was a significant variable for indication of progression to hypertension. From these results, we concluded that (a) good control of hypertension could considerably prevent CVA, (b) cold environment may contribute to the progression to hypertension, and (c) winter-summer variation in BP may predict the future course of BP.

The influence of cold temperatures on the progression of hypertension: an epidemiological study.

In order to clarify the relationship between cold temperatures and the progression of hypertension, a prospective epidemiological study was carried out in a cold area of Hokkaido, Japan. We analysed the findings in 909 subjects, who were followed up for 8 years (1977 to 1985). The difference between the mean blood pressure in winter and in summer in the first year was significantly and positively correlated with the difference between the mean blood pressure in the first and in the eighth year. The winter/summer difference was significantly higher in the group with progressive hypertension than in the other groups. The pressor response to exposure to cold was significantly greater in hypertensives, and tended to be higher in borderline hypertensives compared with normotensives. From these results, we conclude that a cold environment might increase the inhabitants' blood pressure levels, and the difference between a subject's blood pressure in winter and summer may predict future hypertension.