[Daily practice using the guidelines for prevention and treatment of osteoporosis. Use of clinical risk factors for osteoporotic fractures in the evaluation of risk of future fracture].

A number of clinical risk factors that provide information on fracture risk over and above that given by BMD have been defined. WHO proposed FRAX (fracture risk assessment tool) in which the fracture probability could be calculated by the use of risk factors with or without BMD. The proposed independent risk factors are age, a prior fragility fracture, a parental history of hip fracture, smoking, use of systemic corticosteroids, excess alcohol intake, secondary osteoporosis, and rheumatoid arthritis.

Amniotic fluid levels of tumor necrosis factor-alpha and soluble tumor necrosis factor receptor 1 before and after the onset of labor in normal pregnancies.

Tumor necrosis factor-alpha (TNF-alpha) is present in human placental and uterine cells and promotes the regulation of trophoblast growth and invasion. Tumor necrosis factor receptor 1 (TNF-R1) is a receptor for TNF-alpha, and soluble TNF-R1 (sTNF-R1) is present in amniotic fluid after receptor shedding. We evaluated whether amniotic fluid TNF-alpha and sTNF-R1 levels during labor differed from those before the onset of labor in normal pregnancies.

[Neoadjuvant chemotherapy with combination of S-1 and CPT-11 in advanced rectal cancer - a case report].

We report a case of advanced rectal cancer successfully treated with a combination of S-1 and CPT-11 as neoadjuvant chemotherapy. The patient, a 61-year-old man, had a rectal cancer with pelvic viscera invasion and severe stenosis. After colostomy for removing stenosis, he was treated with a combination of S-1 and CPT-11 (S-1 120 mg/body day on day 1-14, CPT-11 120 mg/body/day on day 1 and day 15, every 4 weeks).

[Absolute risk for fracture and WHO guideline. Selection of drugs for the prevention of fractures in postmenopausal women].

It is crucial to select drugs for the prevention of fracture in postmenopausal osteoporosis. In early postmenopausal women with climacteric symptoms hormone replacement therapy (HRT) would be a first choice. Selective estrogen receptor modulator (SERM) could be prescribed in postmenopausal women who had been treated with HRT.

Elevation of amniotic fluid macrophage colony-stimulating factor in normotensive pregnancies that delivered small-for-gestational-age infants.

Problem: Macrophage colony-stimulating factor (M-CSF) promotes placental growth and maintenance. We evaluated whether amniotic fluid M-CSF levels were altered in normotensive pregnancies that produced small-for-gestational-age (SGA) infants arising from unknown factors.

Method Of Study: This study enrolled 68 Japanese women experiencing normotensive pregnancies with single fetuses.

Effects of histologic type on levels of macrophage colony-stimulating factor in liquid contents of benign ovarian tumors.

Background: Normal ovarian tissue is rich in cytokines. Cytokines are important in the physiology of ovarian function. Most of the same cytokines that are found in normal ovarian tissue are also found in association with benign and malignant tumors in contrast to their functions in normal tissues.

CYP17 and COMT gene polymorphisms can influence bone directly, or indirectly through their effects on endogenous sex steroids, in postmenopausal Japanese women.

We aimed to assess whether circulating sex steroids would influence bone density and bone loss, whether part of this influence could be explained by genetic variation measured as polymorphisms in candidate genes affecting circulating hormone levels, or whether gene polymorphisms would have direct effects on bone in 229 postmenopausal Japanese women aged 46 years and over who had been followed for eight years (Yokohama Cohort). Bone mineral density (BMD) in the lumbar spine (L), femoral neck (FN), total hip (T) and distal radius (R) was measured every year, and endogenous sex steroid levels were determined at the start of the study. We investigated the polymorphisms of estrogen-metabolizing enzyme gene, CYP17; estrogen biosynthesis (high activity, A2/A2), CYP1A1; hydroxylation (high inducibility, vt/vt) and COMT; inactivation (low activity, L/L) with PCR-based restriction fragment length polymorphism assays.

[Bone and bone related biochemical examinations. Bone and collagen related metabolites. Bone resorption marker; urinary and serum CTX].

The determination of C-terminal telopeptide of type I collagen degradation products (CTX) was made by using the monoclonal antibody recognizing the eight amino acids that are specific for alpha1 chain of type I collagen. CTX values show a diurnal variation, with a nadir from 1 to 11 o'clock in the afternoon, increase at midnight with peaks from 2 to 8 o'clock in the morning. The levels of CTX at peaks are approximately twice those at a nadir, which implies the sampling of serum and urine should be made at an identical time at each patient.

Elevation of macrophage colony-stimulating factor in amniotic fluid at late stage of normal pregnancy.

Problem: Macrophage colony-stimulating factor (M-CSF) promotes placental growth and maintenance, and regulates trophoblast invasion into the placental bed. We evaluated whether the amniotic fluid M-CSF levels at the late stage of normal pregnancy is altered compared with those at the middle stage.

Method Of Study: This study enrolled 52 subjects experiencing normotensive pregnancies with single fetuses, of whom 26 were women at the late stage (term gravidas) and 26 were women at the middle stage (controls).

Outcome of surgery for small cell lung cancer -- response to induction chemotherapy predicts survival.

Background: The role of surgery for local control of small cell lung cancer (SCLC) is controversial.

Methods: Sixty-nine consecutive patients who underwent complete resection of SCLC in our hospital were reviewed. The patients included 62 men and 7 women.