Severely comminuted olecranon fractures, for which elbow stability becomes the main goal of surgery, remain a challenge for surgeons. We conducted a study to determine the percentage loss of articular surface at which a bridge plating (BP) construct becomes too unstable and an acute shortening (AS) construct is required. The olecranon process of 8 fresh-frozen cadaveric upper limbs was serially resected. At each resection, the simulated fracture was fixed first with BP and then with AS. Stability was tested by performing valgus and varus stress tests at various angles under fluoroscopy. As many as 6 serial resections were made on the cadaveric models. Maximum resection was 88%. The ulnohumeral joint remained stable to valgus and varus stress at all resections for both BP and AS. The elbow joint lost a significant amount of flexion with AS above 20% resection. The ulnohumeral joint can tolerate substantial loss of articular surface in the olecranon before becoming unstable. In this study, range of motion was preserved more with the BP construct than with the AS construct. The presented data may be considered when approaching a severely comminuted olecranon fracture in which the articular surface cannot be reconstructed.

Background: Myalgic Encephalomyelitis/Chronic fatigue syndrome (ME/CFS) is an illness characterized by disabling fatigue. We examined the applicability of Waon therapy as a new method of fatigue treatment in patients with ME/CFS. Methods: Nine female ME/CFS patients (mean age, 38.4±11.2 years old; range, 21-60) who fulfilled the criteria of the Canadian clinical case definition of ME/CFS participated in this study. Patients received 30 sessions of modified Waon therapy, infrared-ray dry sauna maintained at an even temperature of 40°C or 45°C for 15 minutes twice a day for 3 weeks in a hospital, or once a day for five weeks at an outpatient clinic. Their functional health and well-being scores were determined using SF-36 and compared with those of six ME/CFS patients who did not undergo Waon therapy. Results: Seven of nine Waon therapy patients experienced a significant improvement in physical and mental condition, and the effect continued throughout the observation period. Waon therapy brought improvements in the scores of: Role physical (p<0.05); Bodily pain (p<0.05); General health perceptions (p<0.05); and Role emotional (p<0.05) of SF-36 in those who responded well (good responders) to the therapy. In two patients who responded poorly (poor responders) to Waon therapy, and in the non-Waon therapy patients, no significant improvement in the scores was observed. Conclusions: Waon therapy is effective for the treatment of ME/CFS.

千葉県は、平成15年度から、協力市町村において「健康診査データ収集システム確立事業」を行った。平成14年度から18年度にわたる5年間のデータ数は22市町村366,862件（男性111,877件、女性254,985件）であった。健診結果を概略する。 (1) BMI：男性では、40～49歳の24前後をピークに、その後徐々に減少する。女性では、40歳（21～22）から徐々に上昇し、70歳代で男性に追い付き、追い越す。 (2) T-chol、TG（隋時）、HDL-Chol：T-chol、TGは男性では40～49歳をピークに（T-chol200mg/dL前後、TG 180mg/dL強）徐々に減少し、TGは70歳代になると女性とほぼ同じになる。女性では、T-cholは35歳から徐々に上昇し、50歳代に男性を凌駕し以後男性に比し高値を保つ。TGは、年齢とともに徐々に上昇し70歳代では男性に追い付く。しかし男性の 180mg/dL強に対し、女性では49歳以下のTGの平均値は 100mg/dLを割っている。HDL-Cholは男性ではどの年齢区分でも、55mg/dL前後である。女性では、HDL-Cholは年齢とともに徐々に減少するものの、65歳以上でも 60mg/dLをキープしている。 (3) γ-GTP, GPT：男性では、GPT・γ-GTPは、40歳～49歳の各々 30U/L前後、55U/L前後をピークとして、徐々に減少する。一方、女性では年齢とともに上昇するが、全年齢層でGPT は 20U/L以下、γ-GTPは 20U/L前後である。 (4) 収縮期血圧（SBP）・血糖値（BS）：SBP・BSは男女とも年齢が上昇するとともに上昇するが、男性では、SBP平均値が至適血圧（120mmHg）を35歳以上で、正常血圧（130mmHg）を55歳以上で上回るのに対して、女性では、至適血圧（120mmHg）は50歳以上で、正常血圧（130mmHg）は65歳以上で上回る。 性差・年齢差を念頭に置いた健診制度と個別保健指導が健診受診率ならびに保健指導効果の向上のためには、必要である。

Hormone replacement therapy (HRT) is highly effective for women suffering from climacteric symptoms, with occasionally severe side effects. To determine which women needs HRT for climacteric symptoms indeed, pharmacogenetical approach for HRT was performed. Under the condition of minimal HRT, 33 patients required HRT for more than 1 year and the remaining 156 did not. Three single nucleotide polymorphisms (SNPs) in estrogen receptor α (ERα) gene and 3 SNPs and a microsatellite polymorphism in estrogen receptor β (ERβ) gene were analyzed using LightTyper and PCR. Homozygous for 18 CA repeats of D14S1026 (OR 8.00, 95% CI 2.56–25.02, P < 0.001) and rs1256049 (OR 6.35, 95% CI 2.38–16.92, P = 0.004) in ERβ associated with minimal HRT. In contrast, rs1271572 in 789 bp upstream region of ERβ (OR 0.30, 95% CI 0.14–0.65, P = 0.002) gene decreased HRT. rs2228480 in ERα gene also increased HRT. Tailored decisions can be expected on the future use of HRT referring genetic polymorphisms of individuals.

To establish drug therapy for climacteric disorders based on CA repeat polymorphism in the estrogen receptor β gene, the present study investigated the issuance of prescriptions to patients with climacteric disorders in relation to CA repeat polymorphism. Prescription data used in this study included that for drugs that were prescribed for more than 3 months to 63 patients undergoing treatment for climacteric disorders. The 195 prescriptions analyzed included traditional Kampo medicines (49.7%), central nervous system medicines (26.7%) and Hormones (21.5%). The scale of combination therapy with Kampo to monotherapy with Kampo was 2.14 for SS genotype subjects, 1.43 for SL genotype subjects and 0.86 for LL genotype subjects. Thus the usage of combination therapy in SS subjects was 2.5 times greater than that in LL subjects. The percentages of the medicines predominantly prescribed for treatment of climacteric disorders-Kamishoyosan, Keishibukuryogan and Tokishakuyakusan-for each genotype were 72.7% for SS, 47.1% for SL and 38.5% for LL, and the percentage for the SS genotype was significantly higher than that for the LL genotype. The prescription rate for Keishibukuryogan for patients with the SS genotype was 31.8% versus 10.0% for the other 2 genotypes, the rate for SS being significantly higher.In conclusion, the use of CA repeat polymorphism in addition to symptoms in the selection of drugs for climacteric disorders may allow therapy to be personalized.

BACKGROUND:The nature and severity of menopausal symptoms are highly variable among women. Polymorphisms of the estrogen receptor-beta (ERbeta) gene, such as cytosine-adenine (CA) dinucleotide repeats in intron 5, have been implicated in various diseases. OBJECTIVE:We investigated the possible role of a CA dinucleotide repeat polymorphism in intron 5 of the ERbeta gene in the occurrence of menopausal and premenstrual symptoms. METHODS:Fifty-one postmenopausal Japanese women were interviewed about premenstrual symptoms, menopausal symptoms, and use of hormone replacement therapy. Menopausal symptoms were divided into vasomotor, psychological, and musculoskeletal symptoms, and summary scores were created on the basis of severity. CA repeat polymorphism of the ERbeta gene was examined using denaturing high-performance liquid chromatography with the WAVE DNA Fragment Analysis System (Transgenomic Inc., Omaha, Nebraska). RESULTS:The number of CA repeats of the ERP gene ranged from 14 to 25, and subjects could be divided into 3 groups: those with < or =17 repeats, or extremely short (E); 18 to 21 repeats, or short (S); and > or =22 repeats, or long (L). Four genotypes of CA repeats (EL, SS, SL, and LL) were found among the subjects, with SL being the most common. Relative to subjects with the SL genotype, women with SS had a 7.0-fold increased risk of vasomotor symptoms (odds ratio [OR] = 7.0; 95% CI, 1.25-39.15; P < 0.05), a 13.0-fold higher risk of psychological symptoms (OR = 13.0; 95% CI, 1.44-117.2; P < 0.01), and a 7.6-fold increased risk of premenstrual symptoms (OR = 7.6; 95% CI, 1.61-35.9; P = 0.01). The EL genotype was associated with an increased risk of vasomotor symptoms (P < 0.05), depression (P < 0.01), and premenstrual symptoms (P < 0.01). CONCLUSIONS:CA repeat polymorphism of the ERbeta gene may be associated with menopausal and premenstrual symptoms. Premenstrual symptom scores were significantly related to menopausal symptom scores.

The aim of this report was to clear the change of the physical fitness and life style of 1,773 freshmen (M: 969, F: 804) of Tokyo University of Fisheries, using their fitness measurements in 1995‐2000. Though in both sex the average of their height and weight was almost same through all this period, the female freshmen’s skin fold thickness of triceps and subscapula was becoming larger in these few years. ‘Masked obesity’ might be a new problem for the female students. The freshmen’s muscular power was on the decline, but their agility and endurance were rising in both sex. In all these years approximately 70 percent of male students took exercise once or more a week, and they spent one hour or more in one time for their exercise. In female students, the frequency and duration that they spent for exercise were different on each year. Less than half of males, but most of females had breakfast everyday in each year. Most of the freshmen got 6‐8 hours sleep a day, but among females the percentage of 6 or less hours sleep gradually increased.