We examined the rubella antibody-positive rate of students who entered Showa University between 1985 and 1996 and the seroconversion rates after the vaccination. Female students had a high positive rate, ranging from 92.4% to 96.6%. The positive rate in male students was 74.7% in 1985, and this increased slightly to 82% in 1996. The positive rate for all students taken together was 82.3% in 1985, and this increased slightly to 90.1% in 1996. The seroconversion rate following vaccinations for the 6 years between 1991 and 1996 was 93.7 % (271/289 students) . However, low antibody titer acquisitions, where the rubella antibody titer was 8 fold were also observed in 37 of 289 students (12.8%) . Moreover, 18 of 289 students (6.2%) were negative for the antibody after inoculation. In 1996, the final antibodypositive rate that included anti-rubella antibody-positive students entering school and anti-rubella antibody acquired students after the vaccination was 98.3 %. We consider the vaccination to be effective, because no new rubella epidemic has been recognized in the dormitory since the vaccinations were started in 1985.

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The effects of clarithromycin and erythromycin estolate on hepatic drug-metabolizing enzyme capacity in Sprague Dawley (SD) and Wistar strain rats were studied. Effects of both antibiotics on hepatic microsomal drugmetabolizing enzymes were estimated by antipyrine pharmacokinetics and the formation rates of 3-hydroxymethyl antipyrine (HMA), 4-hydroxyantipyrine (OHA) and norantipyrine (NORA), and by the serum ratio of dimethadione to trimethadione (DMO/TMO) . In SD rats, both clarithromycin and erythromycin estolate significantly decreased formation clearance of OHA (CLHHA ) after single and multiple dosing. Clearances of NORA (CLNOHA) and HMA (CLHMA) tended to decrease after 5 days of treatment with clarithromycin.
Erythromycin estolate significantly decreased CLNORA after 5 days of treatment but tended to increase CLHMA. In Wistar rats, both CLHMA and CLNORA were significantly decreased with clarithromycin for 5 days but CLOHA did not show any significant changes with the drug treatment. For trimethadione metabolism, 5 days of treatment with clarithromycin increased the serum concentration ratio of DMO/TMO from 0.51±0.1 to 0.72±0.06 in SD rats, but significantly decreased the ratio from 0.84±0.06 to 0.53±0.06 (p<0.01) in Wistar rats. Clarithromycin increased the hepatic microsomal concentration of CYP 1A1, 2C 11 and decreased CYP3A2 in both SD and Wistar rats by Western blot analysis. With clarithromycin, the content of CYP2C13 was decreased in Wistar rats but increased in SD rats. In conclusion, the inhibition and the induction mechanism of clarithromycin and erythromycin estolate on hepatic drug metabolyzing enzyme system may be different between SD and Wistar rats.

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We studied the production of soluble Fas (sFas), Fas ligand (sFasL), and nuclear matrix protein (NMP) by cultured mononuclear cells from peripheral blood of patients with untreated Graves' disease and Hashimoto's disease. SFasL and NMP levels in the supernatants of cultured mononuclear cells from patients with untreated Graves' disease were significantly higher than those of normal subjects. While sFasL levels of untreated Graves' disease mononuclear cells were markedly reduced in the presence of tumor necrosis factor (TNF) -α or interleukin (IL) -6, there were no such reductions in the levels of sFas or NMP. However, there was no difference in the sFas levels of cultured mononuclear cells from normal subjects and patients with Graves' disease or Hashimoto's disease. In Hashimoto's disease cultured mononuclear cells, sFas, sFasL, and NMP levels did not change significantly in the presence of TNF-α or IL-6. These results suggested that in patients with untreated Graves' disease, TNF-α and/or IL-6 may affect the production of sFasL by mononuclear cells.

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We examined the potential effects of body size and nutrient status on bone mass in an age-controlled study. Bone mass measured as bone mineral density (total-body: BMD_TB; L2-L4 spine: BMD_L2-4 in g/cm² ), and bone mineral content (total-body: BMC_TB; L2-L4 spine: BMC_L2-4ing), were measured by dual-energy X-ray absorptiometry (DXA) . Body size was evaluated by body mass index [BMI], skinfold thickness [SFT], lean mass [LM], and fat mass [FM] . We recruited 214 young healthy Japanese women living in the same area, who were college students of the same grade (aged 19-21 yr) . In simple correlation analysis, BMD_TB was significantly correlated with LM (r=0.31) and BMI (r=0.23), BMD_L2-4 was significantly correlated with LM (r=0.29) and BMI (r=0.26), and BMC_TB was significantly correlated (p<0.05) with LM (r=0.65), BMI (r=0.39), FM (r=0.32), and SFT (r=0.24) . In addition, BMC_L2.4 was correlated with LM (r=0.47) and BMI (r=0.22) . After adjusting for other body size factors by stepwise multivariate regression analyses, BMI, LM, and FM showed a significant association with BMD_TB and BMD_L2-4, whereas only LM showed significant associations with BMC_TB and BMC_L2-4. Our cross-sectional results suggested that measure of body size might be an important determinant of BMD and BMC in young female adults.

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We examined the reliability and validity of the Japanese version of the modified short-form of the Eysenck Personality Questionnaire (MS-EPQ) . The MS-EPQ measures two dimensions of personality (neuroticism and extroversion) and comprises 12 questions with 4 response choices. Since it takes about 3 minutes to complete, this test can be used even when time is limited or when patients are suffering from concentration disturbances due to depression or comorbid physical disorders. High test-retest correlations, high internal consistency and high correlation with the original EPQ support the reliability and validity of the MS-EPQ. We conclude that the MS-EPQ is a suitable method for quickly assessing these two dimensions of personality.

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Alexithymia is a condition where patients experience difficulty in identifying and describing inner feelings. We compared the patterns of coping behavior of 148 alexithymics (with scores of 74 or more on the Toronto Alexithymia Scale) with those of 127 non-alexithymics (with scores of 64 or less) . Challenge to cope with stress was significantly less frequently observed among alexithymics than non-alexithymics. Active avoidance, passive avoidance, and inappropriate emotional release were significantly more frequently observed in alexithymics than in non-alexithymics. Behavioral modification of coping may be effective in reducing the severity of alexithymia.

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We report herein three surgical cases of rectal prolapse. Three patients with a mental disorder; a 39-year-old woman with schizophrenia, a 14-year-old boy with mental retardation and a 22-year-old man with mental retardation, were admitted to our hospital because of rectal prolapse. Delorme's procedure with Thiersch repair was carried out. All patients could be discharged within ten days after operation with uneventful recovery. Treatment of complete rectal prolapse in patients with mental disorder may significantly improve their quality of life since this condition often remains unrecognized by both patients and their families for a long period. Therefore, Delorme's procedure with Thiersch repair may be an extremely effective treatment for rectal prolapse of patients with mental disorder.

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An 84-year-old man who was being treated for aseptic necrosis of the left femoral head was referred to our department for evaluation of epigastralgia, nausea and loss of appetite. Upper gastrointestinal endoscopy revealed duodenal ulcers on the anterior and posterior walls of the duodenal bulb. He was treated with omeprazole. About 8 weeks after the initiation of omeprazole therapy, he developed pain in both breasts. A physical examination revealed gynecomastia, which disappeared after administration of omeprazole was discontinued. Although the patient was positive for hepatitis C virus antibody, his liver function was fairly well preserved during his clinical course. Serum levels of luteinizing hormone, follicle stimulating hormone and human chorionic gonadotropin were elevated, and levels of testosterone and dehydroepiandrosterone-S were decreased. These hormonal abnormalities persisted even after discontinuance of omeprazole therapy, suggesting that they represented age-related hormonal changes. Our findings suggest that gynecomastia was induced by omeprazole.

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Video-assisted thoracic surgery (VATS) can be used to resect peripheral lung nodules in selected patients. Seeding of thoracoscopy trocar sites with malignant cells is uncommon. A 79-year-old male was admitted for evaluation of an abnormal radiographic shadow in the left middle lung field. He underwent VATS wedge resection of the pulmonary nodule. The mass was a primary pulmonary adenocarcinoma. Six months later, the patient developed dyspnea and a painful lateral chest wall mass at a trocar site. Multiple masses were found to be recurrent adenocarcinoma. Excessive manipulation of the pulmonary parenchyma should be avoided during resection of pulmonary nodules. Techniques to protect against implantation during the removal should be employed, such as irrigation of the pleural cavity and chest wall incision sites with large volumes of saline solution prior to closure of the wounds.

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