Biomedical subjects
Publications and source records attributed to M Uetani.
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The relationship between the G-protein beta3 subunit variant C825T and risk of hypertension was examined in a prospective cohort study of Japanese workers. This study included observations over a 5-year period from 1997 to 2002 on 878 males and 692 females who were normotensive at entry. Hypertension was defined as systolic blood pressure > or =140 mmHg and/or diastolic blood pressure > or =90 mmHg, or taking antihypertensive medication. Pooled logistic regression analyses were performed using C825T genotype, age, body mass index, lifestyle, and the result of blood chemistries as the covariates. Multivariate pooled logistic regression analysis showed the risk of hypertension was 2.31 times higher in females with the TT genotype than in females with the CC genotype (95% confidence interval: 1.07-4.96), after adjustment for the effects of other potential covariates. In contrast, no significant risk of hypertension was observed with the TT genotype in male subjects. This study indicates that the 825T allele is an independent risk factor for hypertension in Japanese females, and suggests that this polymorphism may be a beneficial prognostic marker for hypertension in the general Japanese female population.
OBJECTIVES: Oral health status of vulnerable people in developing countries tends to be given lower priority than other health issues. Consequently, few studies have examined the oral health status of the poor and minorities in developing countries. We aim to examine the dental caries and periodontal status, and explore the risk indicators of dental caries between two ethnic groups in rural villages in southern Vietnam. METHODS: We examined the caries status and its risk indicators of 150 participants (Co-Ho minority and Kinh majority) living in a hamlet of Dangphuong village in Vietnam. We also assessed periodontal status of the participants aged 14 and over by Community Periodontal Index. RESULTS: We first found that dental caries were highly prevalent among both the Co-Ho minority and Kinh majority groups. Second, the higher numbers of dental caries among children with primary teeth were associated with a higher frequency of consuming sweets. Third, most people (87%) aged 14 and over had periodontal problems. Finally, the Kinh majority tended to have more dental caries than Co-Ho among people aged less than 30. CONCLUSION: Oral health promotion should be considered as a part of the development programmes for vulnerable groups in Vietnam and other developing countries.
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OBJECTIVES: To characterise serum concentrations of various cytokines and detection by magnetic resonance imaging (MRI) of synovial hypervascularity in patients with remitting seronegative symmetrical synovitis with pitting oedema (RS3PE) syndrome before and after corticosteroid treatment. METHODS: Vascular endothelial growth factor(165) (VEGF(165)), tumour necrosis factor alpha (TNFalpha), and interleukin 1beta (IL1beta) were measured by enzyme linked immunosorbent assay (ELISA) in serum samples from three patients with RS3PE syndrome. As controls, serum samples from 26 healthy volunteers, 12 patients with rheumatoid arthritis, 10 patients with systemic lupus erythematosus, 13 patients with polymyositis/dermatomyositis, 13 patients with vasculitis syndrome, and 6 patients with mixed connective tissue disease were also analysed. Synovial hypervascularity of patients with RS3PE syndrome was estimated by rate of enhancement (E-rate) in a dynamic MRI study. RESULTS: Serum concentrations of VEGF(165) (mean (SD) 2223.3 (156.3) pg/ml) were significantly higher in patients with active RS3PE syndrome than in controls before corticosteroid treatment. TNFalpha and IL1beta levels were similar in patients and controls. Synovial hypervascularity in affected joints and subcutaneous oedema decreased during corticosteroid treatment, in parallel with the fall in serum VEGF(165). CONCLUSIONS: VEGF promotes synovial inflammation and vascular permeability in patients with RS3PE syndrome, suggesting that RS3PE can be classified as a VEGF associated disorder.
The distinction between malignant and benign compression fractures is a common problem in clinical practice. Various imaging techniques (plain radiography, computed tomography, bone scintigraphy) have been used to differentiate these conditions but they are often inadequate in distinguishing the nature of compression fracture. This review illustrates the magnetic resonance imaging (MRI) features of malignant and benign compression fractures with emphasis on the usefulness, limitations and pitfalls of MRI.
The objective of this study was to clarify the cause and clinical significance of a large number of ring-down artefact (RA) observed on the dorsal side of the right hepatic lobe on abdominal ultrasound (US). 2000 abdominal US examinations were evaluated to investigate the frequency and number of RA behind the right lobe of the liver. In this study, RA observed by subcostal or intercostal US were described as the "aurora sign" when they were numerous. US findings were correlated with high resolution CT or three-dimensional CT of the right lung base. Experimental study was also performed to investigate the mechanism of the aurora sign. The results were as follows. (1). Aurora sign was noted in 43 patients. In 37 of these 43 patients (86.0%), chest CT or plain radiography revealed diffuse interstitial changes in the right lower lung field. Three-dimensional CT of the lung and the experimental model revealed that the aurora sign derived from the irregularity of air spaces immediately below the pleura associated with interstitial pulmonary disorders. (2). One or more bands of RA were observed in 907 of the 2000 patients (45.4%). Of 177 patients with fatty liver, RA was observed in 14 (7.9%), while of the 1823 patients with no fatty liver, RA was observed in 893 (49.0%). The frequency of RA was significantly different (p<0.001) between the patients with and without fatty liver. In conclusion, parenchymal lung disease should be suspected when the aurora sign is noted on the dorsal side of the right hepatic lobe. However, RAs are rare in patients with fatty liver.
We investigated the differences in three-dimensional microstructure of bone in cases of osteopenia caused by two different procedures: ovariectomy (ovx) and sciatic neurectomy (nx). Thirty-nine 8-week-old female Lewis rats were divided into two groups: (1) ovx and sham operation; and (2) nx and sham operation. At 12 weeks of age these rats were killed to sample the right tibiae. The samples were scanned using microcomputed tomography to obtain metric parameters such as bone volume fraction (BV/TV), trabecular thickness (Tb.Th), and trabecular separation (Tb.Sp), and nonmetric parameters such as structure model index (SMI), trabecular bone pattern factor (TBPf), and degree of anisotropy (DA). The changes in all microstructural parameters were significant in both the ovx and nx groups, with those of BV/TV, Tb.Th, Tb.Sp, and SMI more significant in the ovx group than in the nx group, in comparison to their respective controls. The significantly higher coefficient of variance for Tb.Th across the entire analyzed area of the individual samples indicated that the trabecular thinning occurred heterogenously and that the microstructural deterioration induced by ovx and nx appeared to be locally accelerated, so as to induce perforation and disappearance of trabeculae. The DA increased significantly in the ovx rats, whereas it decreased in the nx rats. The appearance of microstructural deterioration differed between the two osteopenic models. The three-dimensional (3D) images from the nx rats showed flake-like trabeculae, whereas the ovx rats exhibited a diffuse disappearance of trabeculae, especially in the central part of the tibia, but with a preservation of shape for those trabeculae that were retained. The reduction in cortical area was more significant in the nx group. nx and ovx resulted in significant changes in bone microstructure, showing perforation and removal of trabeculae due to locally accelerated bone resorption. The 3D microcomputed tomography images demonstrated the different microstructural changes that occurred in the ovx and nx groups. Loading during bone resorption increased the anisotropy, whereas immobilization increased the isotropy. In addition, immobilization had a more significant effect on the cortical area.
To evaluate the mechanical contributions of the spongiosa and cortex to the whole rat vertebra, we developed a finite element analysis (FEA) system linked to three-dimensional data from microcomputed tomography (micro-CT). Twenty-eight fifth lumbar vertebrae (L-5) were obtained from 10-month-old female rats, comprised of ovariectomized (ovx, n = 6), sham operated (n = 7), and alfacalcidol-treated after ovx (0.1 microg/kg [n = 8] and 0.2 microg/kg [n = 7]) groups. The trabecular microstructure of L-5 was measured by micro-CT. Yield strength at the tissue level (YS), defined as the value at which 0.034% of all elements reached yield stress, was calculated by the FEA. Then, the ultimate compressive load of each specimen was measured by mechanical testing. The YS of the whole bone (YSw) showed a significant correlation with ultimate load (r = 0.91, p < 0.0001). The YS values of the isolated spongiosa (YSs) and cortex (YSc) were calculated in models with varying amounts of trabecular or cortical bone mass. The mechanical contribution of the spongiosa showed a nonlinear relationship with bone mass, and ovx reduced the mean mechanical contribution of the spongiosa to the whole bone by 13% in comparison to the sham group. YSs had a strong relationship with trabecular microstructure, especially with trabecular bone pattern factor (TBPf) and structure model index (SMI), and YSc had a strong relationship with cortical bone volume. The structural parameters most strongly related to YSw were BV/TV and TBPf. Our micro-FEA system was validated to assess the mechanical properties of bone, including the individual properties of the spongiosa and cortex, in the osteoporotic rat model. We found that the mechanical property of each component had a significant relationship with the respective bone mass, volume, or structure. Although trabecular microstructure has a significant relationship with bone strength, in ovx bone with deteriorated trabecular microstructure, the strength depended mainly on the cortical component.
To clarify the effects of habitual volleyball exercise on bone in women during the menopausal periods, we measured bone mineral densities (BMDs) of the lumbar spine, calcaneus and tibia every 12 months for 2 years and estimated factors related to the baseline values and annual loss rates. Forty Japanese female volleyball players 42-62 years of age, who had belonged to the district non-professional club for more than 10 years on average, were recruited. Twenty women had regular menstruation at the start, but 7 underwent menopause during the study. Fifty-nine healthy women who did not participate in habitual exercise, but were otherwise comparable with the players, were recruited as the controls. The lumbar and calcaneus BMDs were measured by dual-energy X-ray absorptiometry (DXA), and both the volumetric BMDs and cross-sectional geometry at the diaphysis of the tibia were measured by peripheral quantitative computed tomography. The baseline BMDs of all measured sites and the values of the cortical area and moment of inertia of the tibia in the players were significantly higher than the values in the control women. In the peri- and postmenopausal players, the baseline values of the lumbar and calcaneus BMDs related to total years of participating in regular exercises during adulthood including volleyball (TYE), body mass index (BMI) and years since menopause (YSM). Tibia cortical area and moment of inertia values related to TYE. Annual bone loss rates in the tibia and calcaneus of players were significantly smaller than those values in the controls. However, the bone loss rates in the lumbar spine did not differ significantly between the groups. The bone loss rate in the calcaneus was significantly related to the current number of training hours per week and YSM. The rate of bone loss in the tibia was related to BMI. These data indicated that the total number of years participating in exercise activity during adulthood have positive effects on lumbar and calcaneus BMDs and the cortical structure of the tibia. Habitual volleyball exercise apparently did not alleviate the menopause-related bone loss in the lumbar spine.
We report a 29-month-old girl with osteopathia striata with cranial sclerosis (OS-CS), who showed several unusual manifestations, including short stature, muscular hypotonia, short lingual frenulum, an accessory ear and a granuloma at the oral edge. The most unusual distressing finding was severe cervical kyphosis with a dysplastic cervical spine. MRI revealed impingement of the upper spinal cord. To clarify the mode of inheritance of this disease in this patient, we performed a methylation-specific PCR analysis. It eventually showed random inactivation of X-chromosomes, suggesting an autosomal dominant trait.
The characteristic of osteoporosis in the Japanese population is different from that in the Caucasian population. The different incidence of vertebral and hip fracture may be related to both genetic and lifestyle factors. In the aspect of genetics, approximately 77% of the Japanese have the bb genotype of the vitamin D receptor gene, which is considered to be associated with higher bone mass and lower bone turnover than the Bb genotype. The incidence of vertebral fracture is significantly lower in the younger birth cohorts in both genders. However, the total number of hip fractures rapidly grows as the elderly population increases in Japan. It may be explained by some epidemiological studies that the traditional Japanese lifestyle may prevent hip fractures in the Japanese elderly. The knowledge of the differences of osteoporosis between Caucasian and Japanese people must contribute to the prevention of osteoporosis and its complications.
This commentary focuses on the clinical application of magnetic resonance (MR) imaging in the assessment of articular cartilage of the knee. MR imaging is superior to conventional imaging techniques for evaluation of the articular cartilage. Several pulse sequences are advocated for demonstration of the normal articular cartilage and cartilage lesions. However, a consensus has not yet been reached in regard to the most appropriate sequence for evaluation of the articular cartilage. Early morphological changes in the degenerative cartilage are not reliably diagnosed even with the use of tailored MR imaging techniques. The detection of the biochemical changes of cartilage will serve as an important tool for the early diagnosis of cartilage degeneration in the near future. Further prospective studies are needed to establish the role of MR imaging in clinical use.
OBJECTIVE: The purpose of this study was to evaluate unenhanced CT findings for predicting the degree of vascular compromise in intussusception observed at surgery. MATERIALS AND METHODS: The imaging studies, clinical records, and surgical and pathologic findings in 25 patients with intussusception were reviewed retrospectively. We evaluated six CT findings based on the abnormalities of each component of intussusception. Presence or absence of these findings was compared with the degree of vascular compromise as observed on pathologic examination, such as edema, ischemia, or necrosis. RESULTS: The hypodense layer was observed in 16 of 18 intussusceptions with various degrees of vascular compromise. A fluid collection surrounded by the returning wall, which was revealed to correspond to trapped peritoneal fluid, was observed in eight of nine intussusceptions with ischemia or necrosis. A gas collection surrounded by the returning wall was observed in two of four intussusceptions with necrosis. Free peritoneal fluid coexisted with a fluid collection surrounded by the returning wall in all the intussusceptions except one. Bowel obstruction was observed in six of nine intussusceptions with ischemia or necrosis. The maximum wall thickness was not related to the degree of vascular compromise. CONCLUSION: The CT findings of a hypodense layer in the returning wall, fluid collection in the space surrounded by the returning wall, and gas collection in the space surrounded by the returning wall can be useful in predicting the degree of vascular compromise in intussusception.
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