Yokohama Welfare Service Association

Objectives:The prevalence of metabolic syndrome is increasing worldwide, especially in Asian populations. Early detection and effective intervention are vital. Plasma free amino acid profile is a potential biomarker for the early detection for lifestyle-related diseases. However, little is known about whether the altered plasma free amino acid profiles in subjects with metabolic syndrome are related to the effectiveness of dietary and exercise interventions.Methods:Eighty-five Japanese subjects who fulfilled the Japanese diagnostic criteria for metabolic syndrome were enrolled in a 3-month diet and exercise intervention. The plasma free amino acid concentrations and metabolic variables were measured, and the relationships between plasma free amino acid profiles, metabolic variables and the extent of body weight reduction were investigated. Those who lost more than 3% of body weight were compared with those who lost less than 3%.Results:Baseline levels of most amino acids in the subset that went on to lose <3% body weight were markedly lower compared with the counterpart, although both groups showed similar proportional pattern of plasma amino acid profiles. The weight loss induced by the diet and exercise intervention normalized plasma free amino acid profiles. For those with a high degree of weight loss, those changes were also associated with improvement in blood pressure, triglyceride and hemoglobin A1c levels.Conclusions:These data suggest that among Japanese adults meeting the criteria for metabolic syndrome, baseline plasma free amino acid profiles may differ in ways that predict who will be more vs less beneficially responsive to a standard diet and exercise program. Plasma free amino acid profiles may also be useful as markers for monitoring the risks of developing lifestyle-related diseases and measuring improvement in physiological states.

This study was designed to elucidate whether the plasma visfatin level reflects visceral or subcutaneous fat accumulation and metabolic derangement in obese children. Fifty-six obese Japanese children, including 37 boys and 19 girls were enrolled in the study. The age of the subjects ranged from 5 to 15 (10.2 +/- 0.3; mean +/- s.e.m.) years. The age-matched control group for measuring visfatin consisted of 20 non-obese children. Visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) areas were measured by computed tomography. The plasma concentrations for visfatin and leptin were assayed by enzyme-linked immunosorbent assay kits. The plasma visfatin level was higher in the obese (14.7 +/- 0.9 ng/ml) than in the control children (8.6 +/- 0.6 ng/ml). In a univariate analysis, the visfatin correlated significantly with age, height, body weight, waist circumference, VAT and SAT area, triglyceride (TG), insulin, and the homeostasis model assessment for insulin resistance (HOMA-R). After being adjusted for age and sex, only the VAT area retained significant partial correlation with visfatin, and in contrast the body weight, BMI-s.d., and SAT area with leptin. The plasma visfatin concentration was not correlated with leptin. The plasma visfatin levels in the control, non-metabolic syndrome (MS) (n = 49), and MS groups (n = 7) were significantly different from each other. These results suggest that plasma visfatin level is a specific marker for visceral fat accumulation in obese children. As a good surrogate marker, plasma visfatin level can predict the VAT area in obese children.

To determine the present condition of treatment of childhood-onset Graves' disease in Japan, a nationwide questionnaire survey was conducted among councilors of the Japanese Society for Pediatric Endocrinology and the Japan Thyroid Association. Responses were received from 125 individuals, and the rate of collection of questionnaires was 47%. Methimazole was selected for first-line initial antithyroid drug therapy by 92% of respondents. Antithyroid drugs tended to be given at larger initial doses and over longer periods of time to childhood-onset patients than to adult patients, and these tendencies were more pronounced for pediatric endocrinologists. Combination therapy with an antithyroid drug and thyroxine was used more frequently by pediatric endocrinologists. Thyroidologists had more experience with radioiodine therapy than pediatric endocrinologists. Opinions regarding preparation of guidelines for the initial dose of methimazole in childhood-onset Graves' disease were almost equally divided among the following: the dose of methimazole should be adjusted according to the severity of disease as in adult cases, methimazole should be started at a dose of 1mg/kg per day in all patients, and the dose should be determined based on results of a randomized study. The present condition of treatment of childhood-onset Graves' disease in Japan was clarified.

We studied the effects of epalrestat, a specific inhibitor of aldose reductase, on renal sorbitol accumulation and the resulting urinary enzyme excretion in hyperglycaemic rats. The activities of proximal tubule-derived enzymes such as N-acetyl-beta-D-glucosaminidase (NAG), alanine aminopeptidase (AAP), gamma-glutamyltranspeptidase (GGT) and dipeptidyl aminopeptidase IV (DAPIV) in urine were determined in five groups of male Wistar rats (each n = 7): (a) 0.9% saline-loaded, (b) 10% glucose-loaded, (c) 10% glucose-loaded with epalrestat pretreatment, (d) 10% mannitol-loaded and (e) 10% mannitol-loaded with epalrestat pretreatment. Epalrestat was given mixed in chow at a dose of 50 mg/kg body weight. Urinary NAG, AAP, GGT and DAPIV activities were significantly increased (P<0.005, P<0.05, P<0.01, P<0.01, respectively) by the induction of hyperglycaemia. In contrast, enzyme excretion was not increased in the mannitol- or saline-loaded groups. Pre-treatment with epalrestat completely prevented the increased urinary excretion of NAG, AAP and GGT. At the end of the infusion study, renal cortical glucose concentrations of the glucose-loaded groups with and without epalrestat pretreatment were approximately fivefold higher than those of the mannitol- or saline-loaded groups (P<0.005 each). Renal cortical sorbitol concentrations of the glucose-loaded group was also approximately twofold higher than those of the mannitol- or saline-loaded groups (P<0.01 each). However, in the group that received both glucose and epalrestat, renal cortical sorbitol concentration was not increased. These results suggest that accumulation of intracellular sorbitol leads to proximal tubular cell dysfunction and abnormal enzymuria.

We found a 4-year-old boy in the screened cohort, who showed a low ceruloplasmin (CP) in urine (17 ng/mg-creatinine) and in blood (0.6 mg/dl), but his urine copper was in the normal range. Furthermore this child was diagnosed as Wilson disease (WD) by genetic analysis. Although no significant correlation was observed between urine and blood levels of CP, it is conceivable that WD may be accompanied by very low concentration of urine CP.

集団検診に於いてはインバータ式X線高電圧装置は歴史も浅く, 発展途上にあり, コンデンサ式X線高電圧装置がまだ主流である.しかし今回インバータ式X線装置での臨床効果について示したように被曝線量の低減をもたらすだけでなく, 厚い被写体の撮影を容易にし, 透視に於いても同様の結果が得られている.インバータ式はこのような優れた性能によりコンデンサ式のデメリットを克服すると同時に, 受診者スループットの向上もはかれ, より診断性能の高いX線写真が提供できるインバータ式X線装置の持つ効果は極めて大きいものと考える.

Using Silica Gel Tube N, N-

Changes in urinary cadmium, copper and zinc excretion in workers who had considerable exposure to cadmium oxide fumes were investigated over a 5-year period following the cessation of exposure. The 22 male subjects aged 22 to 55 had been welders on automobile parts for periods ranging from 7 months to 23 years, using silver solder which contained cadmium. They were divided into three groups according to levels of urinary cadmium in the first medical examination in 1975: 5 in the high excretion group, 11 in the moderate group, and 6 in the low group. Renal tubular dysfunctions were indicated in most workers in the high excretion group but not in the other two groups. The high and moderate groups showed a rapid decrease in the levels of urinary-excreted cadmium, with biological half-times of 1.42 and 1.21 years, respectively. Excreted cadmium levelled off in the two groups about 1.7 and 1.5 years after the last exposure. Urinary copper excretion in the high cadmium excretion group was about twice that in the moderate and low groups, the difference being statistically significant in comparison with the controls. Urinary zinc excretion was high in all subjects immediately after cessation of exposure but decreased rapidly. After three years it was found that the reduction of urinary zinc was greatest in the high cadmium group. Urinary cadmium showed significant correlations with both copper and zinc. Urinary copper showed a negative correlation with zinc excretion in the high cadmium excretion group and a significant positive correlation in the other two groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Abstract: The urinary concentration of cadmium, copper and zinc was deter-mined in 12 male workers who had been engaged in welding work with cadmium-containing silver solder. Sephadex chromatographic analysis for these urinary metals was performed in two workers suspected of suffering cadmium-induced renal injury. The mean values of the cadmium, copper and zinc concentrations in the urine of the welders were about 26, 2.4 and 2.6 times the control values, respec-tively. A linear relationship was obtained between the urinary concentrations of cadmium and both copper and zinc. The chromatographic distribution of these urinary metals in the welders showed that the metallothionein fraction contained cadmium and copper, but not zinc. The copper content of this fraction was much larger than the cadmium content. The cadmium and copper in this fraction repre-sented about 6% and 10% of the respective total amounts of these metals in the urine. The remaining cadmium and copper were recovered from the high molecular weight protein fraction and low molecular weight nonprotein fraction. The urinary zinc was recovered from both these fractions. The zinc in the latter fraction represented 85% of the total urinary zinc. The present results suggest that cadmium accumulation affects the excretion of copper and zinc in the urine, and that the urinary excretion of metallothionein containing cadmiun as well as copper may be involved in cadmium induced renal injury.