成人に見られた後腹膜腔原発の良性奇形腫の1例

A 25-year-old male patient with a primary retroperitoneal teratoma is described. The chief complaint was right hypochondralgia during exercise for seven days. Various diagnostic imagings disclosed an expansive, heterogeneous and fat-rich mass associated with multiple cystic lesions in the right suprarenal fossa. Sagittal, transaxial and coronal magnetic resonance imaging scan visualized the extent and character of the tumor very clearly. Histological examination of the tumor removed through a thoracoabdominal approach showed cystic teratoma with out malignant transformations

T1c前立腺癌診断における予測因子としての前立腺体積およびvolume-adjusted prostate-specific antigenの検討

We examined the usefulness of the volume-adjusted prostate-specific antigen (PSA) parameters for prediction of T1c prostate cancer on 210 patients who had abnormal PSA levels but no abnormal findings in digital transrectal examination (DRE) or transrectal ultrasonography (TRUS). PSA, prostate volume (PV), transition zone volume (TZV), PSAD (PSA/PV) and PSATZD (PSA/TZV) were assessed with the receiver operating characteristic (ROC) curve and the area under the curve (AUC). Simple and stepwise logistic regression models were used to calculate the odds ratios of these parameters. Fifty-three (25.2%) of all 210 patients and 31 (19.9%) of 156 patients with intermediate PSA levels had biopsy-proved prostate cancer. The ROC curves of all patients revealed that PSA, PV, TZV, PSAD and PSATZD had significant predictive values, while AUCs of PV, PSAD and PSATZD had significant predictive values as compared to that of PSA. In the patients with intermediate PSA levels, the ROC curves revealed that PV, TZV, PSAD and PSATZD had significant predictive values, but there were no significant differences in AUCs among these parameters. The stepwise logistic regression analysis showed that PV and PSATZD were significant predictive parameters in all patients and that PSATZD was the only significant predictive parameter in the patients with intermediate PSA levels. In conclusion, not only PSAD and PSATZD but also PV and TZV had significant predictive values in discriminating prostate cancer. However, the multivariate analysis showed that PSATZD had the strongest predictive value in all patients and in those with intermediate PSA levels.T1c前立腺癌の診断におけるPSA density(PSAD)およびPSA transition zone density(PSATZD)の有用性について, 生検前にPSAのみに異常を認めた210例について検討した。210例中53例(25.2%), 生検前PSA値がグレーゾーン(4.1～10.0ng/ml)を示した156例中31例(19.9%)が癌と診断された。ROC曲線解析では, 全体210例では, PSA, PSAD, PSATZD, 前立腺体積(PV)および移行域体積(TZV)が癌診断の有効なパラメータであった。グレーゾーンを示した156例では, PSAD, PSATZD, PVおよびTZVが癌診断の有効なパラメータであった。多変量解析ではPSATZDが最も有効なパラメータであった。T1c前立腺癌を疑う症例において, PSATZDが最も有用性が高いことが示された。(著者抄録

Yellow Tongue Coating is Associated With Diabetes Mellitus Among Japanese Non-smoking Men and Women: The Toon Health Study

Background: Yellow tongue coating is one of the clinical signs for diabetes mellitus according to traditional East Asian medicine. Few reports have been available on the association between yellow tongue coating and the prevalence of type 2 diabetes in the general population. We examined that association among population samples of non-smoking men and women. Methods: The study subjects were Japanese non-smoking men (n = 315) and women (n = 654) aged 30–79 years who resided in Toon city and participated in the Toon Health Study from July 2011 through November 2014. Tongue coating was assessed by a nationally licensed acupuncturist and classified into three categories of white (normal), light yellow, and yellow. We performed an oral glucose tolerance test to confirm the presence of diabetes mellitus and prediabetes. The associations between yellow tongue coating and the prevalence of diabetes mellitus and prediabetes were examined using multivariable logistic regression analyses, adjusting for age, sex, body mass index, drinking status, and physical activity. Results: The multivariable odds ratios of diabetes mellitus were 1.39 (95% confidence interval [CI], 0.72–2.67) for light yellow tongue coating and 2.23 (95% CI, 1.16–4.30) for yellow tongue coating compared with white tongue coating. The respective multivariable odds ratios of prediabetes were 1.13 (95% CI, 0.80–1.61) and 1.43 (95% CI, 0.96–2.12). Conclusions: Yellow tongue coating was associated with higher prevalence of diabetes mellitus and tended to be associated with that of prediabetes among Japanese non-smoking men and women

The independent association between salivary alpha-amylase activity and arterial stiffness in Japanese men and women: the Toon Health Study

Psychological stress is considered to be a potential contributor in the development of arterial stiffness. However, an independent association between arterial stiffness and biological markers of stress has not yet been established. We examined the independent association between salivary alpha-amylase (sAA) activity and arterial stiffness, not mediated by cardiometabolic disease associated with arterial stiffness, in a sample of healthy Japanese men and women. Participants (992 in total, 296 men and 696 women aged 30-79 years) had neither previous cardiovascular events or stroke, nor coexisting hypertension, diabetes, or dyslipidemia. Arterial stiffness was measured by the cardio-ankle vascular index (CAVI), and increased CAVI was defined as a CAVI value of 9 or higher. A saliva sample was collected in the morning and sAA was measured with a commercial assay kit. Higher sAA activity was positively associated with greater arterial stiffness particularly among women (β = 0.070; 95% CI = 0.014-0.126; p = 0.01), and not across all participants (β = 0.042; 95% CI = -0.005-0.089; p = 0.08) and in men (β = -0.005; 95% CI = -0.097-0.087; p = 0.91). The association was strongest in the group of women aged 60 years and older (β = 0.121; 95% CI = 0.018-0.224; p = 0.02). Although the association between sAA and increased CAVI (CAVI ≥ 9) was not significant in all and sex subgroups, odds ratios (OR) for CAVI ≥ 7 were significantly high in all participants (OR = 1.25; 95% CI = 1.03-1.53) and women (OR = 1.43; 95% CI = 1.12-1.82). Elevation of sAA was associated with an increase in arterial stiffness, particularly for women aged 60 years or older