Objective: The effects of miglitol on postprandial glucose and lipid metabolism were investigated in patients with type 2 diabetes mellitus (T2DM) treated with diet alone. Subjects and Methods: A meal tolerance test (MTT) was performed in 26 diabetic patients before and 2 weeks after 150 mg/day miglitol treatment, with the second MTT performed in patients after they had taken a dose of 50 mg miglitol. Results: Miglitol treatment decreased postprandial blood glucose and serum insulin levels 30 and 60 min after meal loading, but there was no change in blood glucose levels at 120 min. In addition, there were no significant decreases in the area under the curve (AUC) of blood glucose and serum insulin levels. However, the AUC of postprandial serum triglycerides and incremental triglycerides decreased significantly, as did the AUC of postprandial incremental remnant-like particle cholesterol. There were no significant changes in total cholesterol, high-density lipoprotein-cholesterol and low-density lipoprotein-cholesterol. Conclusions: Miglitol treatment improves postprandial hyperlipidemia, as well as postprandial hyperglycemia, in patients with T2DM. In T2DM patients treated with α-glucosidase inhibitors alone, measuring blood glucose levels 120 min after a meal may not be the best way to monitor postprandial glucose metabolism.

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In order to investigate the incidence of latent infections by parasites within the human digestive tract, we examined fresh stool samples from the colon of 31 patients (37-90 years, median age 71; 26 men and 5 women) collected within 12 hours of death. These subjects had been admitted to a university hospital in Yokohama, Japan, and died between April 2007 and December 2008 from causes other than parasitosis. Stool samples were fixed and stained for microscopic analysis, and PCR analysis for Entamoeba histolytica was performed for the parasite-positive samples. Results showed that ten out of 31 subjects were infected by E. histolytica only, one subject was infected by Giardia intestinalis only, and four subjects were infected by both E. histolytica and G. intestinalis. These findings are in contrast to conventional theories concerning general parasite infection in Japan, and indicate continuous or latent infection within the human digestive tract. The presence of pathogens such as E. histolytica and G. intestinalis in elderly or immuno-compromised patients is a serious issue and warrants further attention as a public health issue, particularly in relation to its mode of transmission.

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We report a case of cystic lesion in a 23-year-old female, consisting of an oval-shaped lesion adjacent to the temporomandibular joint (TMJ). She presented with a Class III malocclusion with facial asymmetry and tenderness to palpation on the right TMJ. The patient was treated conservatively with a splint for the TMJ-associated cyst and combined surgical-orthodontic treatment for the facial asymmetry. The post-treatment course was uneventful. The authors recommend a conservative approach as one of the treatment options for TMJ cyst.

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Perioperative acute arterial complications occur rarely after total hip arthroplasty (THA) but can be limb or life threatening. Here, we report a case of an arterial thrombosis after primary THA for an arthrodesed hip. The arterial occlusion occurred because of the surgical mobilization against the immovable flexion and adduction position. A review of the literature on vascular complications arising after THA suggests multiple possible mechanisms and clinical presentations that relate to these complications. Specific risk factors can be identified in THAs replacement cases and THA for the arthrodesed hip can be a major risk factor. Most of these vascular complications can be prevented or more efficiently treated by thorough preoperative assessment and careful postoperative monitoring.

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Crohn's disease (CD) is an idiopathic inflammatory bowel disease that can involve any part of the gastrointestinal tract. It frequently involves the ileum, colon, and anorectum. A 66-year-old man with CD had undergone a partial intestinal resection of the ileum for CD 27 years previously, and had been hospitalized several times, including two months prior to referral. The patient was admitted to our hospital with abdominal pain and distension. A computed tomography (CT) scan demonstrated an anastomotic stenosis with active inflammation and proximal intestinal extension. Colonoscopic examination revealed no abnormalities in the colon or rectum. A contrast Gastrografin enema revealed a stenosis in the ileum and a tight stricture at 3 cm with inflammation. We performed an ileocecal resection for an anastomotic stenosis due to possible recurrence of CD. Pathological examination showed no evidence of CD activity at the anastomotic region, indicating no recurrence of CD.

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The patient was 85-year-old woman. Five years and 8 months previously, bisphosphonate was prescribed for osteoporosis at a local clinic. Deformity of the thigh occurred when she tried to stand after sitting. X-ray findings revealed a transverse fracture of the right femoral diaphysis. Intramedullary nailing of the right femur was performed. Bone union was slightly delayed, but it was eventually achieved. Bisphosphonates have been reported to severely suppress bone turnover, resulting in the occurrence of fractures at the diaphysis or metaphysis of the femur. This type of fracture is characteristically induced by minor trauma and usually shows a simple transverse fracture. Bone union is delayed and these patients complain of prodromal symptoms. Because our case met all of the above criteria, it was concluded that the cause of her fracture was severely suppressed bone turnover (SSBT). We treated a patient who had a pathologic fracture associated with bisphosphonate therapy. Careful follow-up will be required, because it has been reported that such fractures can also occur on the contralateral side.

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