Sacral Stress Fracture following the Bone Union of Lumbar Spondylolysis

While 22 articles have reported on sacral stress fractures, it is a rare injury and its etiology is not well known. We present the case of a 16-year-old male who presented with low back pain in 2015. He was a high school soccer player with a previous history of a bilateral L5 lumbar spondylolysis in 2014. The patient refrained from soccer and wore a brace for six months. Two months after restarting soccer, he again complained of low back pain. After 1 year, a lumbar spine computed tomography revealed the bone union of the spondylolysis. At his first visit to our hospital, his general and neurological conditions were normal and laboratory data were within the normal range. Sacral coronal magnetic resonance imaging (MRI) of the left sacral ala revealed an oblique lineal signal void surrounding bone marrow edema. Based on his symptoms, sports history, and MRI, he was diagnosed with a sacral stress fracture. He again refrained from soccer; his low back pain soon improved, and, after 1 year, the abnormal signal change had disappeared on sacral MRI. Recurrent low back pain case caused by a sacral stress fracture occurring after the bone union of lumbar spondylolysis is uncommon

ポテトパルプ ト ビートパルプ ノ シハンコウソザイ ニヨル ヘンカ

ポテトパルプとビートパルプを食品素材として有効に利用する目的で,市販酵素剤を用いたパルプの簡便な液化を試みた。121℃,20分間のオートクレイブ処理によりパルプの単細胞化とデンプンのα化を行い,パルプ中の不溶性成分の液化率は液化後に得られた残渣の乾燥重量より求めた。各種酵素剤を用いたスクリーニングの結果,ペクチナーゼPL,セルラーゼA,ビオザイムA(α-アミラーゼ製剤)が二種のパルプの液化に効果的であった。三種類の酵素剤を組み合わせることで,オートクレイブ処理をしたホテトパルプとビートパルプ中の不溶性成分は,それぞれ89%と59%の液化率で消化された。With the goal of effective utilization of potato pulp and sugar-beet pulp as foodstuffs, we developed a simple and practical method for partial liquefaction of the pulps through the use of commercial food-processing enzymes. To improve the liquefaction process, swelling of insoluble components and gelatinization of starch in the pulps were performed by autoclaving at 121℃ for 20min prior to enzyme treatment. The liquefaction rates of the components in the autoclaved pulps were calculated from the dry weight of the residue obtained after enzymatic liquefaction. A screen of several commercial enzymes revealed that Pectinase PL, Cellulase A and Biozyme A (α-amylase preparation) were the most efficient enzymes for liquefaction. Using a combination of these three enzymes, the components in the autoclaved potato and sugar-beet pulps were digested with liquefaction rates of 89% and 59%, respectively

Safety and tolerability of diazoxide in Japanese patients with hyperinsulinemic hypoglycemia

Diazoxide is a non-diuretic benzothiadiazine derivative, one of a group of substances introduced into clinical practice in the 1950s for the treatment of hypertension. Fajans reported the use of diazoxide for the treatment of insulinoma in 1979. Although patients with hyperinsulinemic hypoglycemia worldwide have been treated with diazoxide for more than 30 years, there are no recent reports about the adverse effects of this drug in Asian patients, including Japanese patients. Herein, we report the results of our retrospective clinical record review of 6 Japanese patients (3 females and 3 males, ranging in age from 58 to 91 years) with hyperinsulinemic hypoglycemia and inoperable insulinoma treated with diazoxide. Diazoxide improved control of hypoglycemic symptoms and maintained normoglycemia in 5 of the 6 patients, and was ineffective in one patient. Surprisingly, although all 6 patients received diazoxide according to the treatment strategy recommended in Western patients, 5 of the 6 patients developed edema and two developed congestive heart failure. Thus, when starting treatment with diazoxide in Japanese patients, the symptoms and signs of fluid retention should be evaluated carefully. Also, appropriate protocols for treatment with diazoxide should be evaluated by means of clinical trials in Japanese patients with hyperinsulinemic hypoglycemia

Safety and tolerability of diazoxide in Japanese patients with hyperinsulinemic hypoglycemia

Diazoxide is a non-diuretic benzothiadiazine derivative, one of a group of substances introduced into clinical practice in the 1950s for the treatment of hypertension. Fajans reported the use of diazoxide for the treatment of insulinoma in 1979. Although patients with hyperinsulinemic hypoglycemia worldwide have been treated with diazoxide for more than 30 years, there are no recent reports about the adverse effects of this drug in Asian patients, including Japanese patients. Herein, we report the results of our retrospective clinical record review of 6 Japanese patients (3 females and 3 males, ranging in age from 58 to 91 years) with hyperinsulinemic hypoglycemia and inoperable insulinoma treated with diazoxide. Diazoxide improved control of hypoglycemic symptoms and maintained normoglycemia in 5 of the 6 patients, and was ineffective in one patient. Surprisingly, although all 6 patients received diazoxide according to the treatment strategy recommended in Western patients, 5 of the 6 patients developed edema and two developed congestive heart failure. Thus, when starting treatment with diazoxide in Japanese patients, the symptoms and signs of fluid retention should be evaluated carefully. Also, appropriate protocols for treatment with diazoxide should be evaluated by means of clinical trials in Japanese patients with hyperinsulinemic hypoglycemia