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To acquire iron (Fe), graminaceous plants secrete mugineic acid family phytosiderophores (MAs) from their roots into the rhizosphere. MAs are biosynthesized from methionine via nicotianamine (NA). ...

The aim of this study was to investigate the efficacy of concurrent treatment with vitamin K2 and risedronate compared with treatment with risedronate alone in patients with osteoporosis and to explore subsets of patients for which concurrent treatment is particularly efficacious. Women with osteoporosis aged 65 years or older were recruited from 123 institutes in Japan and allocated to take either vitamin K2 (45 mg/day) and risedronate (2.5 mg/day or 17.5 mg/week) or risedronate (2.5 mg/day or 17.5 mg/week) alone. The primary end point was the incidence of any fracture (vertebral and nonvertebral). The secondary end points were bone mineral density, height, undercarboxylated osteocalcin concentration, quality of life, and safety. Over a 2-year follow-up, vertebral or nonvertebral fractures occurred in 117 or 22 sites respectively among 931 patients in the risedronate and vitamin K2 group and in 104 or 26 sites respectively among 943 patients in the risedronate alone group. The rates of any incident fracture were similar between the two groups (incidence rate ratio 1.074, 95 % confidence interval 0.811-1.422, p = 0.62), implying that the primary end point was not met. There were no differences in the degree of increase in bone mineral density between the two groups. Undercarboxylated osteocalcin concentration decreased from 5.81 ± 3.93 ng/mL to 2.59 ± 1.52 ng/mL at 6 months in the risedronate and vitamin K2 group, whereas the change in the risedronate alone group was minimal (from 5.96 ± 4.36 ng/mL to 4.05 ± 3.40 ng/mL at 6 months) (p

We planned to conduct multi-center, open-labeled, blinded-endpoints, head-to-head randomized trial of minodronate and raloxifene to compare incidences of vertebral and non-vertebral fractures. The study is the Japanese Osteoporosis Intervention Trial protocol number 4 (JOINT-4). Here, we present the pre-fixed study design. The inclusion criteria are ambulatory older women with osteoporosis, aged > 60 years, and without pre-specified risk factors for secondary osteoporosis and dementia. The subjects who meet selection criteria will be randomly allocated to the raloxifene (60 mg/day) or minodronate (1 mg/day or 50 mg/4 weeks) groups using the central registry. The co-primary endpoints are osteoporotic (vertebral, humeral, femoral, and radial), vertebral, and major osteoporotic (clinical vertebral, humeral, femoral, and radial) fractures. Furthermore, we plan to use the Hochberg procedure to preserve an overall type 1 error rate. In addition, changes in bone mineral density (BMD), hip-structure analysis (HSA) variables, height, bone turnover markers, serum cholesterol and triglyceride concentrations, dental health questionnaire, fall frequency, fall risk index, nursing care level, physical function, quality of life (QOL), and safety profiles were assessed as secondary endpoints. To detect 24% reduction of major osteoporotic fractures with 80% power and a two-sided significance level of 5% with a 2-year observation period, 1734 patients/treatment arm would be required. Subgroup analysis stratified to the following factors age, body mass index, BMD, 25-hydroxyvitamin D concentration, estimated glomerular filtration rate (eGFR), prevalent vertebral fracture number, hypertension status, and diabetes mellitus is pre-specified. The protocol is registered in the trial registry system, and the trial identification number is UMIN000005433.

We report a case of asynchronous bilateral neuroendocrine breast carcinoma. The patient was a 49-year-old woman presenting with a bloody nipple discharge from the right breast. We suspected intraductal papilloma and performed a microdochectomy. A pathological analysis of the resected specimen confirmed the diagnosis as neuroendocrine carcinoma. The tumor was positive for estrogen receptor, progesterone receptor, chromogranin A, and synaptophysin, but negative for the HER2/neu marker. The Ki-67 labeling-index was 40%. As the tumor margin was positive, breast-conserving surgery plus level II axillary lymph node dissection was performed. After surgery, radiotherapy(total dose of 50 Gy)was administered for treating residual breast involvement. Adjuvant hormonal therapy was performed for 5 years. Ten years after surgery, ultrasonography revealed a 12mm irregular hypoechoic mass in the left breast. The mass was diagnosed as a solid tubular carcinoma based on core needle biopsy findings. Subsequently, we performed breast-conserving surgery. The pathological diagnosis was a neuroendocrine carcinoma, and the tumor was positive for estrogen receptor, progesterone receptor, chromogranin A, synaptophysin, and CD56, but negative for the HER2/neu marker. The Ki-67 labeling-index was 50%. We report our experiences with a rare case of asynchronous bilateral neuroendocrine breast carcinoma. In this case, ultrasonography was a useful modality for detecting both the lesions.

Six months after the explosion of TEPCO's Fukushima Dai-ichi nuclear power plant, radioactive silver ((110m)Ag), was detected in concentrations of 3754 Bq/kg in Nephila clavata (the orb-web spider; Joro-gumo in Japanese) collected at Nimaibashi, Iitate village in Fukushima Prefecture, whereas (110m)Ag in the soil was 43.1 Bq/kg. A survey of 35 faunal species in the terrestrial environment during the 3.5 years after the accident showed that most of Anthropoda had two orders higher (110m)Ag in their tissues than soils, although silver is not an essential element for their life. However, tracing of the activity of (110m)Ag detected in spider Atypus karschi collected regularly at a fixed location showed that it declined much faster than the physical half-life. These results suggest that (110m)Ag was at once biologically concentrated by faunal species, especially Arthropoda, through food chain. The factors affecting the subsequent rapid decline of (110m)Ag concentration in faunal species are discussed.

Assessment of vertebral fracture is critically important for the diagnosis and treatment of osteoporosis. This study aimed to clarify the effectiveness of the semiquantitative (SQ) method in the assessment of vertebral fractures in Japanese clinical practice. Forty-four physicians (seven experts and 37 nonexperts) assessed the spinal radiographs of 40 patients participating in the Adequate Treatment of Osteoporosis (A-TOP) Japanese Osteoporosis Intervention Trial (JOINT)-02 at the baseline, 12 months, and 24 months using the SQ method. The proportion of diagnosed fracture cases per spine was higher in the nonexpert group than in the expert group at each time point, and was especially high in the upper thoracic spine (T4-T6). The least mean squares spinal fracture index was significantly higher in the nonexpert group than in the expert group for all time points. The kappa statistics were also higher in the expert group than in the nonexpert group for all vertebral levels at all time points. Assessment of vertebral fractures using the SQ method tended to be overestimated by nonexpert physicians compared with the experts, with poor nonexpert interobserver reliability and well-matched expert interobserver reliability. Conscious efforts to avoid overestimation and to obtain higher reliability with the SQ method should be made to achieve more precise diagnoses and treatment of osteoporosis in Japanese clinical practice.

Radioactivity levels of cesium (Cs)-134 and 137Cs in bamboo [Phyllostachys reticulata (Rupr) K. Koch] sprouts grown from April to June 2011 over a wide area (including Fukushima Prefecture) were elevated (max. 3100 Bq kg−1 fresh weight) after the Tokyo Electric Power Company, Inc. (TEPCO) Fukushima Daiichi Nuclear Power Plant disaster in March 2011. Bamboo sprouts in 2012 also contained high radioactivity levels. Radioactivity imaging analysis of bamboo sprouts harvested in 2012 showed increasing concentration gradients of radioactivity from the lower parts to the top of the sprouts. The peels were individually separated from the sprouts, and the inner edible part (trunk) was cross-sectioned at the internodal sections from the top to the lower parts. Each segmented trunk and its corresponding peel were analyzed for radioactive cesium (134Cs and 137Cs) and stable cesium (133Cs). The concentrations of 134Cs and 137Cs showed significant increases from the lower part to the top, whereas 133Cs showed a...

To characterize preperimetric retinal nerve fiber layer (RNFL) defects on speckle noise-reduced spectral-domain optical coherence tomography (SD-OCT), and to determine whether detection of preperimetric RNFL defects can be improved by speckle noise reduction.Thirty-two eyes of 32 patients with preperimetric glaucoma and 30 normal eyes of 30 volunteers underwent complete ophthalmic examinations and scanning by speckle noise-reduced SD-OCT (Spectralis), single-scan SD-OCT (RTVue-100), and single-scan time-domain (Stratus) OCT.All 40 RNFL defects identified by photography had angular widths30 degrees and no disruption of RNFL reflectivity on Spectralis. Circumpapillary RNFL (cpRNFL) boundaries were accurately determined by Spectralis for 38 (95.0%) of the 40 defects, by RTVue-100 for 25 (62.5%), and by Stratus OCT for 23 (57.5%). Sensitivity for the detection of RNFL defects (cpRNFL thinning to1% of normal for an age-matched database) was 15% for Stratus, 42.5% for RTVue, and 47.5% for Spectralis on sector maps and significantly higher for SD-OCT on temporal-superior-nasal-inferior-temporal (TSNIT) thickness graphs: RTVue-100 (57.5%; P=0.031) and Spectralis (90.0%; P=0.0001). On the basis of TSNIT thickness graphs, sensitivity for the detection of RNFL defects was significantly higher for Spectralis compared with RTVue-100 (P=0.001) and Stratus (P=0.0005). Spectralis TSNIT graphs were more sensitive (P=0.001) for glaucoma detection without significant reduction (P=0.125) in specificity compared with Spectralis sector maps.Our results suggest that accurate measurement of cpRNFL thickness by speckle noise-reduced SD-OCT and a comparison of the results with normative database using TSNIT graphs are required to improve the sensitivity for detecting preperimetric RNFL defects.

BackgroundDeteriorated quality of life (QOL) is a major problem in osteoporotic women. However, little is known regarding the determinants of QOL in patients with osteoporosis.ObjectiveOur aim was to explore the role of vitamin D status on QOL score in osteoporosis with high fracture risk.MethodsPatients were osteoporotic women aged ≥70 years and with ≥1 risk factor for incident fracture, namely prevalent osteoporotic fracture, bone mineral density (BMD) >–3.0 SD of young adult mean, or high bone turnover marker. Health-related QOL was assessed using the Japanese Osteoporosis Quality of Life Questionnaire (JOQOL). When patients were classified into quartiles by total QOL score). Serum 25-hydroxyvitamin D (25[OH]D) level was measured by immunoassay.ResultsA total of 1585 osteoporotic women were included in the study (age range, 70–95 years). Age, body mass index, serum 25(OH)D status (low, normal, or high), bone mineral density, number of prevalent vertebral fractures, presence of hypertension, presence of osteoarthritis, and history of falls were significantly correlated with QOL quartile. Multivariate liner regression analysis indicated that low serum 25(OH)D level (20 ng/mL may be required to maintain patients’ QOL in osteoporosis.

Background: Acetabular dysplasia (AD) is the main cause of hip osteoarthritis in Japan. A simple method to evaluate acetabular dysplasia would be helpful for early treatment or prevention of hip osteoarthritis. Acetabular dysplasia is reported to be associated with pathological transverse growth of the pelvis, indicating that the distance between the 2 anterior superior iliac spines might be useful for screening and detection of acetabular dysplasia. The purpose of this study was to determine if the acetabular dysplasia radiographic parameters are related to the distance between the 2 anterior superior iliac spines in patients with hip osteoarthritis. Material/Methods: In this study, data obtained in a previous multi-institutional examination of patients with hip osteoarthritis in Japan were evaluated. The anterior superior iliac spine distances of 176 female patients (mean age, 54 years; range, 18-85 years) were measured by physical examination. The relationship between the anterior superior iliac spine distance and acetabular dysplasia was analyzed, and the anterior superior iliac spine distances of the patients with acetabular dysplasia who were at relatively high risk for hip osteoarthritis were compared with that of the patients at lower risk. Results: A statistically significant relationship between the anterior superior iliac spine distance and all of the acetabular dysplasia parameters was observed. The anterior superior iliac spine distances of the acetabular dysplasia patients with a relatively high risk for radiographic acetabular dysplasia parameters were significantly smaller than those of patients at lower risk. Even after adjustment for age, height, and weight, significantly increased relative risk for having high risk AD was found in patients with an ASIS distance of less than 24.5 cm. Conclusions: There was a significant relationship between the anterior superior iliac spine distance and the degree of acetabular dysplasia., Medical Science Monitor, 20, pp.116-122; 2014

Aim As society ages, there is a vast number of elderly people with locomotive syndrome. In this study, the factors associated with functional limitations in daily living activities evaluated by female hip osteoarthritis (OA) patients were investigated. Methods This study was a cross‐sectional study. The subjects were 353 female patients who were newly diagnosed with hip OA at an orthopedic clinic with no history of hip joint surgery. Outcome indices were functional limitations in two daily living activities obtained from a questionnaire completed by the patients: (i) standing up (standing from a crouched position) and (ii) stair‐climbing (climbing and/or descending stairs). The odds ratios (ORs) and 95% confidence intervals (CIs) were computed for explanatory variables using the proportional odds model in logistic regression to evaluate their associations with functional limitations. Results Functional limitations in standing up were associated with heavy weight (third tertile vs. first tertile: 1.91, 1.11–3.27), participation in sports at school (0.62, 0.40–0.98), parity (vs. nullipara: 1.96, 1.08–3.56), old age and OA stage. Associations with functional limitations in stair‐climbing were seen with short height (< 151.0 cm vs. ≥ 156.0 cm: 2.05, 1.02–4.12), bilateral involvement (vs. unilateral: 1.71, 1.01–2.88), old age and OA stage. Conclusion Old age, OA stage, heavy weight, parity, shorter height and bilateral OA were associated with functional limitations in standing up and/or stair‐climbing, whereas participation in sports such as club activities in school maintained standing up.

Concurrent treatments with bisphosphonates and vitamin K are promising given that bisphosphonates possibly interfere with vitamin K activation. This is a prospective, multi-center, open-labeled, randomized trial of the efficacy of concurrent treatment with vitamin K2 and risedronate compared with risedronate alone and to explore subsets of patients for which concurrent treatment is particularly efficacious (trial identification number UMIN000000991). Inclusion criteria are women who meet the criteria for pharmacological therapy for osteoporosis, aged ≥65 years, have any of pre-specified risk factors, can walk unassisted, and are able to answer questionnaires. Exclusion criteria are prior warfarin use, secondary osteoporosis or non-osteoporotic metabolic bone diseases, contraindication for vitamin K2 and risedronate, hyper- or hypoparathyroidism, mental disorders, prevalent vertebral fracture at ≥6 sites, severe degenerative spinal deformation between T4 and L4, serious heart, liver, or kidney disease, or bisphosphonate use within the previous 6 months. Patients were recruited from 123 institutes between January 2008 and February 2010, and allocated to vitamin K2 (45 mg/day) and risedronate (2.5 mg/day or 17.5 mg/week) or risedronate alone (2.5 mg/day or 17.5 mg/week) groups. Primary endpoint is a vertebral or non-vertebral fracture. Secondary endpoints are bone mineral density, height, undercarboxylated osteocalcin, JOQOL, EQ-5D and safety. A sample size of 910 subjects per group and 2-year follow-up will provide 80 % power to detect 35 % risk reduction for fracture, with a two-sided significance level of 5 %. Subgroup analysis stratified to adjustment factors for random allocation, body mass index, 25-hydroxyvitamin D, estimated glomerular filtration rate, grade of vertebral fracture, JOQOL, EQ-5D, and co-morbidity is pre-specified.

Background In Japan, the majority of hip osteoarthritis (OA) was caused by acetabular dysplasia, and about 90 % of patients were female. The present study focused on Japanese female patients with hip OA due to acetabular dysplasia, and examined the associated factors with OA staging at diagnosis, in special reference to body weight. Methods Study subjects were 336 Japanese women who were newly diagnosed with hip OA caused by acetabular dysplasia at 15 hospitals in 2008. The self-administered questionnaire elicited patients’ body weight at age 20 and at OA diagnosis. Four ranked OA staging according to radiographic findings of the hip joint (pre-OA, initial stage, advanced stage or terminal stage) was regarded as the outcome index. Proportional odds models in logistic regression were used to calculate odds ratios (ORs) and 95 % confidence intervals (CIs) for severer stage of OA. Results At diagnosis, 45 % of patients suffered from terminal stage of OA, whereas 13 % and 14 % were categorized into pre-OA and initial stage, respectively. After adjustment for potential confounders, weight gain since age 20 revealed the increased ORs for severer OA stage at diagnosis (OR 2.02; 95 % CI, 1.07–3.80). Other significant characteristics were age (67+ vs. 20–49 years, OR 12.4), lower education (junior high school vs. junior college or higher, OR 4.00), parity (OR 2.19), lower acetabular head index (

Two types of Planecta™ ports are commonly used as sampling ports in blood pressure transducer kits: a flat-type port (FTP) and a port with a three-way stopcock (PTS). Recently, a new type of three-way stopcock (Marvelous™) has been released as a Planecta™ counterpart, but its effects on the frequency characteristics and reliability of blood pressure monitoring have not been investigated. We assessed the influence of the Marvelous™ stopcock on the frequency characteristics of the pressure transducer kit. The basic pressure transducer kit, DT4812J, was modified by replacing one or two of the original three-way stopcocks with Marvelous™ stopcocks. The frequency characteristics (i.e., natural frequency and damping coefficient) of each kit were determined using wave parameter analysis software, and subsequently evaluated on a Gardner chart. Replacement of the original blood pressure transducer kit stopcocks with Marvelous™ stopcocks decreased the natural frequency (48.3 Hz) to 46.3 Hz or 44.8 Hz, respectively; the damping coefficient was not significantly changed. Plotting the data on a Gardner chart revealed that the changes fell within the adequate dynamic response region, indicating they were within the allowable range. Insertion of Marvelous™ stopcocks slightly affects the natural frequency of the pressure transducer kit, similar to inserting a PTS. The results indicate that the Marvelous™ stopcock is useful for accurate monitoring of arterial blood pressure, and may be recommended when insertion of two or more closed-loop blood sampling systems is necessary.

Animals make decisions on behavioral choice by evaluating internal and external signals. Individuals often make decisions in different ways, but the underlying neural mechanisms are not well understood. Here, we describe a system for observing the behavior of individual Drosophila melanogaster larvae simultaneously presented with contradictory signals, in this case attractive (yeast paste) and aversive (NaCl) signals. Olfaction was used to detect the yeast paste, whereas the ENaC/Pickpocket channel was important for NaCl detection. We found that wild-type (Canton-S) larvae fall into two decision making groups: one group decided to approach the yeast paste by overcoming the aversive signal, whereas the other group decided to forgo the yeast paste because of the aversive signal. Our findings indicate that different endogenous sensitivities to NaCl contribute to make differences between two groups and that diverse decision making steps occur in individual animals.

The aim of this study was to investigate the efficacy of concurrent treatment with vitamin K

The bone has the functions of mineral reservoir and mechanical support as skeleton. Bone remodeling is the adult mode of bone metabolism, replacing old bone tissue to new one. Bone strength is determined by bone volume, structure and quality such as micro damage, degree of mineralization and collagen cross linkage, which are all controlled by bone remodeling. Bone strength decreases under high turn-over condition by decreasing bone volume and deterioration of bone structure, which also decreases under low turn-over condition by increased micro damage, increasing mineralization and AGE collagen cross linkage.

Periodically crystallized nanostructure was self-assembled inside Al 2 O 3 -R 2 O 3 binary glass (R = Y, La, Dy) with a low glass formation ability by the femtosecond laser irradiation. Such polarization-dependent nanostructures exhibit periodic modulation in magnetic properties.

“Urushi” syrup from Rhus vernicifera DC. was collected monthly from June to October 2011, to represent sieve tube exudates from trees, and the radioactivity of samples was measured. In the syrup, the cesium (Cs) concentration (134Cs and 137Cs) originating from the meltdown at the Tokyo Electric Power Company, Inc. (TEPCO) Nuclear Power Station in Fukushima peaked in July and decreased to a minimum in October, while the natural radioactive potassium-40 (40K) remained constant during the same period. On the basis of these results, we assumed that the radioactive Cs in the urushi syrup was directly translocated from the fallout adsorbed to tree bark rather than from contaminated soil.

The accurate monitoring of arterial blood pressure is important for cardiovascular management. However, the frequency characteristics of pressure transducer kits are influenced by the length of the pressure-resistant tube. To date, there have been few studies addressing the frequency characteristics of pressure transducer kits with inserted pressure-resistant extension tubes (pressure-resistant extension tube (ET) circuits). In this study, we examine ET circuits from the viewpoint of the frequency characteristics of pressure transducer kits. DT4812J transducer kits (length 150 cm; Argon Medical Devices, TX, USA) were used. Three original ET circuits were prepared, with the pressure-resistant tube of the DT4812J being extended with a 30-cm length of pressure-resistant tube (180ET circuit), a 60-cm length of pressure-resistant tube (210ET circuit), and a 90-cm length of pressure-resistant tube (240ET circuit). Each of these circuits was evaluated as part of this study. The natural frequency of the original DT4812J circuit was 45.90 Hz while the damping coefficient was 0.160. For the 180 ET circuit, the natural frequency and damping coefficient were 36.4 Hz and 0.162, respectively. For the ET210 circuit, the natural frequency and damping coefficient were 30.3 Hz and 0.175, respectively. For the ET210 circuit, the natural frequency and damping coefficient were 25.3 Hz and 0.180, respectively. As a result of extending the circuit, it was found that the natural frequency decreased drastically, while the damping coefficient increased slightly. When the extension of a pressure transducer kit is required, we should pay careful attention to the major decrease in the natural frequency, which may influence the pressure monitoring.

A new sodium ion image sensor containing a CCD-type semiconductor and a plasticized PVC sodium ion selective membrane was developed. The output potential slope was linear for sodium ion concentrations from 10−1 to 10−5 M. The optimum membrane possessed a near Nernstian response and high selectivity to sodium ions. The sensor can take sodium ion images with a fast response, 0.2 s per image, allowing it to easily monitor the ion-exchange reactions of a single Na-type cation-exchange resin bead. It was found that Na+-Ba2+ ion-exchange was faster than Na+-Ca2+ ion-exchange in the initial period.

OBJECTIVE:To visualize the macular ganglion cell layer (GCL) and measure its thickness in normal eyes and eyes with preperimetric glaucoma, using speckle noise-reduced spectral domain optical coherence tomography (SD-OCT). DESIGN:Retrospective consecutive case series. PARTICIPANTS:Thirty-seven eyes of 37 patients with preperimetric glaucoma and 39 normal eyes of 39 volunteers. METHODS:Vertical and horizontal SD-OCT B-scan images were acquired with minimal speckle noise by using eye-tracking to obtain and average 50 B-scans at each identical location of interest. B-scan images were manually analyzed for GCL, retinal nerve fiber layer (RNFL), and inner plexiform layer shapes and thicknesses in the macula. MAIN OUTCOME MEASURES:Macular GCL images and thickness in normal eyes and in eyes with preperimetric glaucoma. RESULTS:The macular GCL was clearly seen on speckle noise-reduced SD-OCT images in normal eyes and eyes with preperimetric glaucoma. In each eye with preperimetric glaucoma, thinning of the macular GCL was visually apparent, particularly on vertical scans. The mean regional macular GCL was most severely thinned in the inferior perifoveal region, where its thickness was

BackgroundThe Japanese Orthopaedic Association Hip Score is widely used in Japan, but this tool is designed to reflect the viewpoint of health-care providers rather than that of patients. In gauging the effect of medical therapies in addition to clinical results, it is necessary to assess quality of life (QOL) from the viewpoint of patients. However, there is no tool evaluating QOL for Japanese patients with hip-joint disease.MethodsWith the aim of more accurately classifying QOL for Japanese patients with hip-joint disease, we prepared a questionnaire with 58 items for the survey derived from 464 opinions obtained from approximately 100 Japanese patients with hip-joint disease and previously devised evaluation criteria. In the survey, we collected information on 501 cases, and 402 were subjected to factor analysis. From this, we formulated three categories—movement, mental, and pain—each comprising 7 items, for a total of 21 items to be used as evaluation criteria for hip-joint function.ResultsThe Cronbach’s α coefficients for the three categories were 0.93, 0.93, and 0.95, respectively, indicating the high reliability of the evaluation criteria. The 21 items included some related to the Asian lifestyle, such as use of a Japanese-style toilet and rising from the floor, which are not included in other evaluation tools.ConclusionsThis self-administered questionnaire may become a useful tool in the evaluation of not only Japanese patients, but also of members of other ethnic groups who engage in deep flexion of the hip joint during daily activities.

We conducted a nationwide epidemiologic study regarding hip osteoarthritis (OA) in Japan, and a previous report found these patients to be unique in comparison to Caucasians. This report focused on the data regarding each hip joint, and the involvement of acetabular dysplasia with hip OA was analyzed.Seven hundred twenty OA hips were examined. Sixty-five joints with osteonecrosis of the femoral head and 215 non-OA contralateral joints of the unilateral patients were examined as controls. The revised system of stage classification for hip OA of the Japanese Orthopedic Association (JOA) was used according to the reproducibility in order to ensure reliable data from the multiple institutions. The acetabular dysplasia indexes were also chosen according to the reproducibility and measured in the radiograph of bilateral hip joints. The clinical score was assessed using the JOA scoring system. The relative risk of the grade of acetabular dysplasia indexes for hip OA was calculated as the odds ratio and the 95% confidence interval.The stage of the OA joints deteriorated with increasing age. The clinical scores also decreased. The grade of the acetabular dysplasia indexes of the OA joints was significantly higher than that of the control joints. Each index of acetabular dysplasia demonstrated significantly increased odds ratios for hip OA. Among the OA joints, the deterioration of the OA stage was found to be significantly associated with an increasing grade of acetabular dysplasia. The odds ratio for OA deterioration in the acetabular dysplasia index was also obtained. The joints of females tended to have a higher grade and prevalence of acetabular dysplasia than those of males.These findings confirmed a high prevalence of acetabular dysplasia in hip OA joints in Japan. Acetabular dysplasia was one of the most important factors associated with hip OA.

Purpose To compare retinal morphologic alterations in eyes with polypoidal choroidal vasculopathy (PCV) and central serous chorioretinopathy (CSC) using speckle noise-reduced spectral-domain optical coherence tomography. Methods We retrospectively reviewed 63 eyes of 62 patients with active PCV and 38 eyes of 38 patients with active CSC. Patients underwent fundus photography, angiography, and speckle noise-reduced spectral-domain optical coherence tomography examinations, and retinal morphologic alterations were evaluated. Results Cystoid macular edema, lipid deposits, subretinal hemorrhage, and hemorrhagic pigment epithelial detachment were not seen in any eye with CSC but were seen in eyes with PCV. In PCV, mean visual acuity was significantly poorer in eyes with fibrin infiltration (P = 0.027) or hemorrhagic infiltration (P = 0.002) in the fovea than in eyes without fibrin or hemorrhagic infiltration. Conclusion Differentiating factors between PCV and CSC noted on spectral-domain optical coherence tomography include a lack of cystoid macular edema, lipid deposition, subretinal hemorrhage, and hemorrhagic pigment epithelial detachment in eyes with CSC, which makes spectral-domain optical coherence tomography helpful in differentiating CSC from PCV. More severe retinal alterations were seen in PCV than in CSC because of infiltration of fibrin and hemorrhage in the outer retina, which also correlated with poorer vision.

The phytosiderophores, mugineic acid (MA) and epi-hydroxymugineic acid (HMA), together with a related compound, nicotianamine (NA), were investigated for their ability to bind Al(III). Potentiometric titration analysis demonstrated that MA and HMA bind Al(III), in contrast to NA which does not under normal physiological conditions. With MA and HMA, in addition to the Al complex (AlL), the protonated (AlLH) and deprotonated (AlLH(-1)) complexes were identified from an analysis of titration curves, where L denotes the phytosiderophore form in which all the carboxylate functions are ionized. The equilibrium formation constants of the Al(III) phytosiderophore complexes are much smaller than those of the corresponding Fe(III) complexes. The higher selectivity of phytosiderophores for Fe(III) over Al(III) facilitates Fe(III) acquisition in alkaline conditions where free Al(III) levels are higher than free Fe(III) levels.

BACKGROUND: To evaluate retinal thickness using spectral-domain optical coherence tomography (SD-OCT) with reduced speckle noise in eyes with polypoidal choroidal vasculopathy (PCV) compared to those with normal eyes and those with central serous chorioretinopathy (CSC). METHODS: We retrospectively reviewed cases of foveal serous retinal detachment in 36 eyes of 36 patients with active CSC and 23 eyes of 23 patients with active PCV, and 44 eyes of 44 normal subjects. Patients were examined using SD-OCT with reduced speckle noise, and the thickness of the outer nuclear layer (ONL), photoreceptor inner segment (IS), and photoreceptor outer segment (OS) were measured. RESULTS: The ONL and IS were thicker in normal eyes than in eyes with CSC or PCV (P < 0.001). The OS was significantly less thick in eyes with PCV than in normal eyes (P < 0.001), whereas there was no significant difference between eyes with CSC and normal eyes. The thickness of IS and OS in eyes with PCV was related to fibrin or hemorrhage being present in the subretinal space. In eyes with PCV, best-corrected visual acuity at baseline correlated with IS thickness (P = 0.023). CONCLUSIONS: Thinning of each photoreceptor layer was observed in the eyes of PCV patients as compared to that observed in the case of normal individuals. The differentiating factors between PCV and CSC, observed using SD-OCT, include the thinning of the OS in eyes with PCV, which makes SD-OCT helpful in differentiating PCV from CSC. More severe photoreceptor alterations were seen in PCV, because fibrin and hemorrhage were present in the subretinal space, which correlated with poorer vision.

The aim of osteoporosis treatment is to prevent future fractures. Although concurrent treatment has been used very frequently for osteoporosis in clinical practice, there are no data on accurate and verified effectiveness of concurrent treatment for fracture prevention in patients with osteoporosis. To clarify the clinical usefulness of concurrent treatment, the Japan Osteoporosis Society has authorized the establishment of the A-TOP (Adequate Treatment of Osteoporosis) research group. The objective of this research is to establish a design for a clinical trial to prove whether concurrent treatment using both alfacalcidol (1-alpha-hydroxycholecalciferol) and alendronate is more effective as compared to treatment using alendronate alone in terms of fracture prevention. The present study was named JOINT (Japanese Osteoporosis Intervention Trial) and is based on a method using national, prospective, randomized, open-labeled, blinded endpoints focusing on postmenopausal osteoporosis with a high risk for fracture. The patients were mainly selected by practitioners and allocated randomly by a central registration system into two groups, of which one received 5 mg/day of alendronate alone, and the other received 1 μg/day of 1-alpha-hydroxycholecalciferol (alfacalcidol) in addition to the alendronate. The endpoints focused primarily on fracture prevention, and the patients' quality of life (QOL) and change in body height, as well as adherence and the adverse events of the treatments were evaluated secondarily. To obtain sufficient statistical power in the events during a 2-year observation period, the patients who are expected to have higher risk were selected to participate in this study, and it was decided that the final plan would involve 890 patients per group (two-sided alpha = 0.05, power = 0.8). Data collection began in November 2003. Correspondence regarding the registration of the investigator and the progress of the study was conducted through a web system from the Public Health Research Foundation to practitioners.

We are planning a multicenter survey on coxarthrosis and acetabular dysplasia in Japan. To collect reliable data, we performed a preliminary study to elucidate the observer agreement on assessment items.We collected radiographs of hip joints in eight patients with various findings of coxarthrosis. Twelve registered orthopedic specialists evaluated them regarding the roentgenographic stage of coxarthrosis and five indexes of acetabular dysplasia (acetabular angle, center-edge angle, acetabular roof obliquity, acetabular head quotient, approximate acetabular quotient). To assess observer agreement, we calculated the value of the kappa statistic for stages and the coefficient of variation for the indexes. The same 12 specialists then assessed the coxarthritis stage on the same radiographs 1 month after the first evaluation based on our own descriptions of the roentgenographic stages.For the first evaluation of the roentgenographic stage, the value of the kappa statistic was 0.448; and for the second evaluation it was 0.600. The results of the coefficient of variation for the indexes of acetabular dysplasia, ranked in ascending order, were as follows: acetabular angle, acetabular head quotient, acetabular roof obliquity, center-edge angle, approximate acetabular quotient.For the upcoming multicenter survey, clear descriptions of the stages of coxarthrosis and selection of appropriate indexes can be helpful for collecting dependable results.

We investigated the effect of eel calcitonin (elcatonin) on the process of fracture repair in the osteotomized femur of cynomolgus monkeys, since they possess a Haversian remodeling system similar to that of humans. Alendronate was used for comparison. Twenty female cynomolgus monkeys (Macaca fascicularis), aged 18-22 years, were allocated into five groups: control (CNT, n = 4), low-dose elcatonin group (0.5 U/kg; ELL, n = 4), high-dose elcatonin group (5 U/kg; ELH, n = 4), low-dose alendronate group (10 microg/kg; ALL, n = 4) and high-dose alendronate group (100 microg/kg; ALH, n = 4). All animals were given subcutaneous injections twice a week for 3 weeks. Then fracture was produced surgically by transversely cutting the midshaft of the right femur and fixing with stainless steel plate. After fracture, treatments were continued until sacrifice at 26 weeks after surgery. The femora were assessed by micro CT, contact microradiograph, three-point bending mechanical test and histomorphometry. Micro CT showed that callus sizes in elcatonin-treated groups were similar to CNT, whereas alendronate-treated groups had larger calluses than those in the CNT and elcatonin-treated groups. Fracture lines almost disappeared in the CNT and elcatonin-treated groups but remained clear in the alendronate-treated groups. Total area did not differ significantly between the elcatonin-treated groups and the CNT but was significantly greater in the ALH compared to the CNT and elcatonin-treated groups, due to increased callus area in the ALH group. Callus remodeling was less suppressed in the elcatonin-treated groups than in the alendronate-treated groups when compared with callus remodeling in the CNT. Although no significant differences in structural mechanical properties such as ultimate load, stiffness and work to failure were found among all groups, ultimate stress was significantly reduced in the ALH group compared with CNT and ELL groups. In conclusion, mild suppression of callus remodeling by elcatonin did not impair overall fracture healing process. In contrast, alendronate delayed structural fracture healing process by strongly suppressing callus remodeling.