These results indicate that the responsiveness to maxacalcitol therapy of secondary hyperparathyroidism is dependent on parathyroid gland size and that the simple measurement of maximum parathyroid gland diameter by ultrasonography may be useful for predicting responsiveness to maxacalcitol treatment.

No abstract

We evaluated the risk factors for osteoporosis in men. The subjects of this study consisted of 686 healthy middle-aged (40-59 years) men who had undergone bone mineral density (BMD) measurement and medical examination, including physical strength. BMD of L2-4 was measured at the anterior-posterior position, using dual X-ray absorptiometry. Physical investigations, such as height, weight, and physical strength, were carried out on the examination day. Details of tobacco and alcohol consumption, exercise, and food intake were described on a questionnaire completed by the subjects. Sixty-five (9.5%) of the 686 subjects had a BMD less than 2.5 SD below the peak bone mass (PBM), 182 (26.5%) had a BMD between 1 SD and 2.5 SD below the PBM; and 439 (64.0%) had a BMD no less than 1 SD below the PBM. Body mass index (BMI) and leg strength were significant positive determinants of BMD, and smoking was a significant negative determinant on multiple regression analysis, with a coefficient of determination of 9.5%. Calcium intake, exercise, and alcohol consumption were not significant determinants of BMD. These results suggest that poor lifestyle behaviors (i.e., smoking) accelerate the reduction of bone density.

Background: Sclerosing encapsulating peritonitis (SEP) is a serious complication seen in patients on long-term continuous ambulatory peritoneal dialysis (CAPD). We have previously reported that mesothelial cells in effluent dialysate significantly increased in size as the duration of CAPD progressed. In this study, we investigated the relationship between mesothelial cytology, histopathology of the peritoneum, and clinical outcomes of 34 CAPD patients. Methods: When peritoneal dialysis catheters were inserted (n = 7) or removed (n = 27), a peritoneal biopsy was performed and results compared with mesothelial cytology in effluent dialysate. Results: A significant positive correlation was noted between the duration of CAPD and the surface area of peritoneal mesothelial cells (r = 0.721, p < 0.0001). The surface area of mesothelial cells in peritoneal sclerosis (n = 9; 584 ± 97 µm²) was significantly greater than in peritoneal fibrosis (n = 14; 389 ± 26 µm², p < 0.05), pathologic acute peritonitis (n = 3; 223 ± 10 µm², p < 0.005), and normal peritoneum (n = 7; 247 ± 12 µm², p < 0.001). The surface area in sclerosing peritonitis (n = 1; 1,200 µm²) was greater than that of all the others. Giant cells were found in the 1 case with sclerosing peritonitis and in 3 of 9 cases with peritoneal sclerosis, although they were found in only 1 of 14 patients with peritoneal fibrosis and in none of those with pathologic acute peritonitis or normal peritoneum. As the surface area of mesothelial cells increased to more than 400 µm² and giant cells appeared in the effluent, the frequency of peritoneal sclerosis and/or clinical SEP increased. Conclusion: An increase in the mesothelial cell surface area and the emergence of giant cells in the effluent indicate advanced peritoneal histopathology, and may be useful indicators to determine appropriate timing of discontinuation of CAPD to prevent the development of SEP.

No abstract