The Keio Journal of Medicine

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A prospective study was conducted to clarify the 1-year changes in lumbar spine and hip bone mineral density (BMD) and bone turnover markers in premenopausal amateur runners and to determine whether jumping and muscle-strengthening exercises have additive effects on the bone parameters in these runners. Thirty-six premenopausal amateur runners were recruited and were divided into the following two groups: a jumping plus muscle-strengthening exercise group (n =21) and a control group (n =15). All participants continued their running practice for 1 year, and the lumbar spine and total hip BMD and bone turnover markers were monitored. For all participants, the lumbar spine and total hip BMD increased modestly after 1 year (1.31% and 1.54%, respectively) in addition to increases in the bone-specific alkaline phosphatase, osteocalcin, and tartrate-resistant acid phosphatase 5b levels (13.2%–27.8%), indicating mild effects of running activity on bone turnover and BMD at clinically relevant skeletal sites. Jumping plus muscle-strengthening exercises did not significantly influence any bone parameters; however, it was difficult to draw definite conclusions because compliance was poor. These results suggest that long-distance running at the recreational level may be useful in maintaining bone health in premenopausal women.

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A 16-year-old Japanese girl with a huge 13-cm-diameter tumor in the pancreas head presented with life-threatening symptoms and findings including severe anemia, obstructive jaundice, duodenal stenosis, and serious portal vein compression. She underwent a pancreatoduodenectomy with combined resection of the portal vein. Reconstruction of the portal vein was successfully performed using an external iliac vein graft and postoperative anticoagulant therapy. Pathological examination revealed a solid pseudopapillary neoplasm of the pancreas. The patient’s postoperative course was uneventful, but her menstruation ceased for 14 months. She is now alive with no evidence of recurrence 100 months postoperatively and she suffers no impairments in daily activities of life. As a treatment of solid pseudopapillary neoplasms of the pancreas, pancreatoduodenectomy combined with portal vein resection is rarely performed in adolescent patients, but is reportedly successful, with patients tolerating the operation and surviving without recurrence. An aggressive surgical attitude is recommended when dealing with this tumor type with curative resection, even in adolescent patients.

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