Body fat mass is correlated with serum transthyretin levels in maintenance hemodialysis patients

Serum transthyretin (TTR), also known as prealbumin, is a reliable nutritional indicator and an independent prognostic factor for maintenance hemodialysis patients. However, we recently reported that serum TTR levels did not affect protein−energy wasting (PEW). In this study, we investigated factors affecting serum TTR levels in 60 maintenance hemodialysis patients. The patients were divided into High-TTR and Low-TTR groups according to the median serum TTR level. Albumin levels were significantly higher and C-reactive protein (CRP) levels were significantly lower in the High-TTR group than in the Low-TTR group. Although body fat mass was significantly higher in the High-TTR group than in the Low-TTR group, no significant difference in body fat ratio were observed. These findings suggest that body fat mass is related to serum TTR levels, apart from factors such as albumin and CRP levels, which showed correlations with serum TTR levels. Because body fat mass is related to better survival in maintenance hemodialysis patients, it may contribute to the prognostic value of serum TTR levels. In addition, in such patients, it may be important to evaluate body fatmass rather than body fat ratio and to maintain the minimum necessary body fat mass

Laparoscopic cholecystectomy : Our experience of 75 consecutive cases

We peformed 75 consecutive laparoscopic cholecystectomy from July 1991 to October 1993 on the patients with gallstones and/or gallbladder polyps. The patients consisted of 30 males and 45 females between 32 and 88 years old with a mean age of 59.4 years. In 72 of these 75 patients (96.0%) laparoscopic cholecystectomy was successfully completed. In the remaining 3 cases (4.0%) the operation was converted to the open cholecystectomy. All patients were free of major complications. Three patients required conversion to a conventional open cholecystectomy due to fallen gallstones in the peritoneal cavity, dense adhesions surrounding the gallbladder and severe acute cholecystitis. This procedure is advantageous in comparison with the conventional open cholecystectomy, because of less postoperative pain, rapid postoperative recovery and high cosmetic value as well. Laparoscopic cholecystectomy seems to be a safe and effective treatment for selected patients with benign gallbladder diseases

Laparoscopic cholecystectomy in patients with nonvisualizing gallbaldder by DIC and previous upper abdominal surgery

Between July 1991 and December 1993, 80 patients with gallstone and/or gallbladder polyp were considered candidates for laparoscopic cholecystectomy. We attempted 7 cases of laparoscopic cholecystectomy for patients with nonvisualizing gallbladder by DIC, and in 6 cases, the laparoscopic cholecystectomy was successfully completed. In the remaining 1 case the operation was converted to open cholecystectomy due to severe acute cholecystitis. During the same period, there were 8 patients who had previous upper abdominal surgery, and in 4 of these patients, laparoscopic cholecystectomy was successfully completed. All patients were free of major complications intra and postoperatively. We can extend the indications for laparoscopic cholecystectomy as skill with this procedure increases. We believe that this procedure will become the standard operation for benign gallbladder diseases in the near future in Japan

Habitat-specific responses of shoot growth and distribution of alpine dwarf-pine (Pinus pumila) to climate variation

Alpine dwarf-pine (Pinus pumila) in dominant in the alpine regions of Japan, and often forms the krummholz zone of stunted alpine forest. The distribution of P. pumila is strongly related to the distribution of snow, and shoot growth is also sensitive to weather conditions. Changes in temperature and snowmelt regimes may well affect the distribution patterns of the krummholz zone. P. pumila usually occupies the habitat between the fellfield and snowbed communities, and responses to climate change may differ depending on whether plants are close to the fellfield or the snowbed. We compared the distribution and shoot growth patterns of P. pumila close to both surrounding ecosystems in the Taisetsu Mountains, northern Japan. P. pumila has expanded its distribution area by 14 % toward both edges over the last 32 years. Annual shoot growth was positively affected by summer temperature and sunshine duration, but negatively related to spring temperature toward the fellfield side. Shoot growth was greater at the southeastern edge of patches, where snowdrifts were formed. The results indicated that shoot growth and distribution area increased in warm summers. However, warm springs might have a negative influence on shoot growth, probably because the earlier reduction in cold-resistance enhances the risk of frost damage in spring close to the fellfield side. This study suggests the importance of understanding the site-specific responses of shrubs to predict the impacts of climate change on alpine ecosystems