Risk factors

By entrances to facilities, injury, invasions of the operation, and complication as cancer, etc., a crisis risk remarkably increases on pulmonary embolism thrombosis(PE). As risk factors of thrombosis except for above, abnormal protein C, abnormal protein S and abnormal antithrombin are often observed. Caucasians have frequently FV Leiden or abnormal FII as congenital thrombophilia, though those are not observed to Japanese. As an acquired risk factor for PE, there are cancer, high homocysteinemia, lipid abnormality and anti-phospholipid antibody syndrome. It is necessary to evaluate these risk factors for the prevention of PE.     

Hemodynamic factors

It is well-known that hypertension often coexists with diabetes. Based on previous reports, it appears that insulin resistance is promoted by hypertension and that hypertension is promoted by insulin resistance. In this review, we discuss hemodynamic factors underlying insulin resistance and hypertension. In addition, the insulin resistance seen in three hypertensive rat models (the high salt-fed Sprague-Dawley rat, the Dahl salt-sensitive rat and the chronically angiotensin II-infused rat) are presented. The findings presented suggest the importance of developing new therapeutic approaches (e.g., potassium supplementation and anti-oxidant administration) to the management of insulin resistance and hypertension.     

Feel good factors

As part of our Insight series we asked readers to tell us about their working lives. Many of those who responded are still motivated by a love for the job, but workload is taking a toll.     

Epidemiology of multiple sclerosis: environmental factors versus genetic factors

Although the mechanism of multiple sclerosis (MS) remains elusive, it is generally hypothesized to be an autoimmune disease targeting the central nervous system (CNS) myelin. Extensive epidemiological and genetic surveys indicate that MS is caused by an interplay between the environment and genetic traits determined by normal polymorphisms in multiple genes. In Japanese, epidemiological surveys gave the prevalence rates of 0.7 to 8.9/100,000. There is a small but significant north-to-south gradient of MS prevalence rates in Japan, suggesting that environmental factors varying with latitude also play a role in developing MS even in the low prevalence areas. Conventional MS in Japanese is, like MS in Caucasians, associated with HLA-DRB1*1501 whereas opticospinal MS is associated with HLA-DPB1*0501. The ratio of conventional to opticospinal MS has increased rapidly in Japanese born after 1960s, suggesting that the modernization occurred after 1960s in Japan has modifying effects on MS susceptibility and phenotypes.     

Endogenous digitalis-like factors

Recent research has demonstrated the presence of endogenous compounds in blood and urine that crossreact with antibodies raised against digoxin. Given the widespread therapeutic use of digoxin and its being monitored clinically by immunoassay, such digoxin-like immunoreactive compounds pose significant diagnostic and interpretive problems. Serum levels of this factor(s) approaching therapeutic digoxin levels have been found in digoxin-free patients in renal failure, pregnant women, and newborns. The compound is incompletely characterized; however, existing data suggest that it is a small, neutral, nonpeptidic compound. In serum it is highly protein bound, and alterations in this binding appear to give rise to the false-positive assay results. The urinary form is probably conjugated. Digoxin-like immunoreactive substances may play a role in volume homeostasis and appear associated with essential and pregnancy-induced hypertension. If such roles are primary, measurement of digoxin-like immunoreactive substances may prove to be of value in and of itself.