Case report: A case of fetal umbilical vein varix presenting disseminated intravascular coagulation, polycythemia, and neonatal hepatitis in an extremely low birth weight infant

Reports on the clinical course of fetal umbilical vein varix in premature infants are limited. We report a case of an extremely low body weight infant with intra-abdominal umbilical vein varix who developed disseminated intravascular coagulation, polycythemia, and hyperbilirubinemia after birth; late-onset neonatal hepatitis; and fetal thrombotic vasculopathy confirmed by placental histopathology. Ultrasonography after birth showed a dilated portion of the umbilical vein at the hepatic hilum with thrombi inside. We speculate that the umbilical vein varix caused the fetal thrombotic vasculopathy, and the presence of umbilical vein varix and fetal thrombotic vasculopathy in combination with prematurity caused coagulopathy, polycythemia, hyperbilirubinemia, and hepatitis. Despite the favorable outcomes reported in the literature, premature infants with umbilical vein varix may require careful observation and management for coagulopathy and late-onset hepatitis. Furthermore, placental histopathology could aid in the understanding of various clinical outcomes in infants with umbilical vein varices

後期高齢女性における血清レプチン濃度

高齢者のアセスメント項目として,体組成と栄養素摂取に影響を与える血清レプチン濃度を明らかにすることは機能調節因子に必要であると考えられる。しかし,高齢者の血清レプチン濃度については,報告が少なく17,18,19)一定の見解が得られていない。そこで高齢者のうち,特に後期高齢女性の血清レプチン濃度を明らかにすることを目的とし検討を加えた結果,以下の結論を得た。1)QOLの高い日本人の後期高齢女性の血清レプチン濃度は,正常排卵性月経周期を有する日本人女性と同程度であった。2)後期高齢女性の血清レプチン濃度は,BMIと強い正相関を認めた。3)独力で生活する基礎活動能力を有する後期高齢女性では,やせ及び正常体重者が多かった。以上より,独力で生活できる基礎活動能力を有する後期高齢女性の血清レプチンは若年女性と同レベルであること,適正体重の維持は高齢女性の身体活動を低下させない要因である可能性が示唆された。Objective: Leptin is a protein that is synthesized and secreted from adipose tissue. This protein regulates fat stores and body weight by affecting appetite and thermogenesis. It is known that serum leptin levels are higher in women than men and change at various life stages such as pregnancy and puberty. Leptin may be an important predictive factor of body condition and nutritional intake. Little is known about serum leptin concentrations in elderly people. Thus, we examined serum leptin in elderly Japanese women. Methods: The subjects were thirty elderly women and comprised all residents age 75 and over, living in K-ku, Tokyo. They were all healthy members of the community at large not receiving any special medical care. We measured serum leptin concentrations and performed a survey of eating habits, habitual exercise and smoking. Results: Serum leptin concentrations in the elderly Japanese women were 7.1±0.7ng/ml. They were almost equal to young Japanese women with regular menstrual cycle. Serum leptin concentrations were highly correlated with body mass index (BMI). Serum leptin concentrations with low BMI were lower than that with normal BMI. The percentage of women with low and normal BMI was greater than that of the National Nutrition Survey 2000. These results indicate that serum leptin concentrations in elderly Japanese women with regular weight were not different from that in young Japanese women with regular menstrual cycle

後期高齢女性における生活機能に関連する要因

The present study was undertaken to clarify the content of items that support healthy ageing. The subjects were thirty elderly women aged > 75. We carried out a survey of their eating habits, habitual exercise and smoking. The healthy elderly women went out more than once a week, had regular eating, behavior with diets that took into consideration their salt intake, and exercised more than twice a week. None of the subjects skipped meals. Our results suggest that going out, having balanced nutrition and regular exercise are important for maintaining functional capacity in old old women