<臨床>胃切除術後の単位体積当たりの骨密度の変化 : Dual energy X-ray absorptiometry (DXA) 法による検討

We used dual energy X-ray absorptiometry (DXA) to study changes in estimated volumetric bone mineral density (EstVBMD) of the lumbar spine after gastrectomy. The study group comprised 41 men and 32 women. When EstVBMD was compared according to sex among patients younger than 60 years of age, patients 60 to 69 years of age, and patients these three groups in men (0.185 g/cm_3, 0.187 g/cm_3, 0.187 g/cm_3, respectively). In contrast , EstVBMD was significantly lower in women 60 to 69 years of age (0.157 g/cm_3) and those 70 years of age or older (0.159 g/cm_3) than in women younger than 60 years (0.200 g/cm_3) (P<0.01). When the relation between EstVBMD and the number of months after gastrectomy was studied according to sex in patients younger than 70 years, EstVBMD negatively correlated with the interval after operation in men (r= -0.365, P<0.05), whereas ther e was no correlation between these variables in women. These results suggest that after gastrectomy bone mineral density decreases gradually in men younger than 70 years, but not in women. The lack of a consistent change in bone mineral density after gastrectomy in women is apparently caused by the marked effect on bone metabolism of decreased female hormone levels after menopause.胃切除後の腰椎の骨密度の変化を dual energy X-ray absorptiornetory （DXA） 法で測定し, 単位体積当たりの計測値（Estimated volumetric bone mineral density: EstVBMD）を求めることにより検討した. 男女別に60歳未満, 60歳代, 70歳以上の群で比較すると, 男性では 0.185 g/cm_3, 0.187 g/cm_3, 0.187 g/cm_3と大差がなかった. 一方, 女性では 0.200 g/cm_3, 0.157 g/cm_3, 0.159 g/cm_3 と60歳未満の症例と比較し60歳代, 70歳以上の症例では減少し有意差を認めた. 70歳未満の症例で男女別に術後月数と骨密度との関係をみると, 男性では経過期間とともに骨密度は減少し, 負の相関関係 （r= -0.365, P<0.05）が認められたが, 女性では両者は独立した関係であった. 70歳未満の男性では胃切術後に徐々に骨塩量が低下するが, 女性では閉経後の女性ホルモン減少が強く骨代謝に現れるため胃切術後の影響が個々で異なることが示唆された

Inhibitory Effects of Heavy Metal Ions on Endolymphatic DC Potential and Cochlear Microphonics in the Guinea Pig

Endocochlear DC potential (EP) and cochlear microphonics (CM) were investigated in the guinea pig under the influence of the following heavy metal ions; manganese, nickel, cobalt, cadmium and lanthanum. The scala tympani and scala vestibuli were perfused with control and test solutions. CM decreased gradually to 50-80%, but EP showed no change after perfusion with a solution containing 1 mM of metal ions. At a concentration of 10 mM, EP decreased from +80 mV to +11-+48 mV and CM decreased to 15-55%. These decreases in EP and CM were irreversible, and perfusion of the area with the standard solution for 20 min had no effect

Cetuximab plus FOLFOX for Patients with Metastatic Colorectal Cancer with Poor Performance Status and/or Severe Tumor-Related Complications

Introduction: Cetuximab-based chemotherapy showed a statistically significantly higher response rate compared with chemotherapy such as FOLFOX. Therefore, FOLFOX plus cetuximab is suspected to be the best regimen to alleviate tumor-related symptoms with a high response rate. Case Report: Here we present the results of 8 consecutive patients with metastatic colorectal cancer with poor performance status and/or severe complications who were treated with first-line FOLFOX with cetuximab. Six of 8 patients achieved an apparent clinical benefit, including radiological response and symptoms improvement. Two patients with BRAF mutation could achieve neither clinical benefit nor radiological response. Conclusion: Although an optimal line of therapy with cetuximab is unclear yet with bevacizumab in mind, we propose that patients who need a tumor response to alleviate their symptoms due to advanced disease might be candidates for first-line cetuximab-based therapy as shown in our cases. Additionally, patients with BRAF mutant tumors might be important candidates for novel targeted therapy in the future to improve their poor prognosis

Neutral atom emission coming from the direction of the high-latitude magnetopause under northward IMF

The Low Energy Neutral Atom (LENA) imager on the Imager for Magnetopause-to-Aurora Global Exploration (IMAGE) spacecraft in the magnetosphere can detect neutral particles coming from the direction of the magnetopause. During a period of dynamic pressure of ～6 nPa and IMF B_Z of ～15nT on March 27, 2001, significant neutral atom emissions occurred in the direction of the very high-latitude magnetopause. Simultaneous observations from IMAGE/LENA and SuperDARN radar show that the LENA emission appears concurrently with the enhancement of the sunward flow of the reverse convection in the ionosphere. In a recent paper (S. Taguchi et al., Geophys. Res. Lett., 33, L03101, doi: 10.1029/2005GL025020, 2006) this type of emission has been interpreted as being produced by the fast ion flow caused by cusp reconnection through charge exchange with the Earth\u27s hydrogen exosphere. In other words, remote sensing using LENA imager can be applied in order to determine the stability of the reconnection site. From results of analyses of LENA emission data we show that the reconnection "spot" mapped on a sphere having a radius of 8 R_E shifts tailward by approximately 1 R_E over 10min while fluctuating

Transcatheter retrieval of an Amplatzer Vascular Plug

Introduction: An Amplatzer Vascular Plug (AVP), which was designed as a permanent occluding device derived from the Amplatzer Septal Occluder and Amplatzer Duct Occluder, is a useful embolic device that can be precisely deployed in medium to large vessels with high resistance to migration. However, migration of these Amplatzer devices has been reported as a relatively rare but major complication. Case report: A 59-year-old woman was referred for the treatment of advanced pancreatic body cancer; after systemic chemotherapy, distal pancreatectomy with en bloc celiac axis resection (DP-CAR) was planned as curative treatment. Therefore, preoperative embolisation of the common hepatic artery (CHA) for arterial redistribution was performed. Although a 6-mm AVP II was deployed at the mid-portion of the CHA, the AVP migrated to the proper hepatic artery. Although migrated AVP retrieval using a goose neck snare was attempted, it was impossible to retrieve it into the 5-F guiding sheath. Therefore, the AVP was delivered to the splenic artery, which was planned to be resected in DP-CAR. Finally, a 10-mm AVP II was redeployed at the proximal portion of the CHA, and complete occlusion was achieved. Conclusions: When AVP retrieval is not possible, delivery to the other arteries having lesser influence might be an alternate technique

Simultaneous quasi-periodic optical and HF radar signatures observed in the postnoon sector

Zhongshan Station in Antarctica is located close to the polar cusp/cleft latitude. The field of view of the Syowa East HF radar also covers Zhongshan Station. Simultaneous quasi-periodic phenomena of optical aurora, HF radar backscatter power and Doppler velocity, and ground based magnetograms were observed in the magnetic postnoon sector (～330 MLT to 1510 MLT) on 3 August 1997. The characteristics of the quasi-periodic event are summarized in the following; 1) East-west aligned band/arc type discrete aurora showed quasi-periodic luminosity variations with period of -6-10 min, 2) Quasi-periodic variations of the optical aurora had one to one correspondence with the variations of HF radar backscatter powers and magnetic pulsations, 3) The HF backscatter region was located at the lower latitude of the quasi-periodic optical aurora, 4) Quasi-periodic variations of line-of-site Doppler velocity detected by HF radar showed very close relation to the magnetic pulsations observed at Zhongshan in Antarctica and the IMAGE magnetometer array in the northern hemisphere, 5) The IMAGE data revealed that the region of quasi-periodic HF radar backscatter (irregularities) corresponds to the region of intensity maximum of magnetic pulsations

A Case of Lipoma in the Deep Part of Neck

It is comparatively rare that lipoma is found in the deep part of neck, though lipoma is often found in parts of back, neck, breast, etc. And so the authors reported a case of lipoma in 71-year-old woman that was made the diagnosis of lipoma in the deep part of neck, from the clinical symptoms and CT examination, and was confirmed histologically after the enucleation under general anesthesia