Predicting the changes in depressive symptomatology in later life: how much do changes in health status, marital and caregiving status, work and volunteering, and health-related behaviors contribute?

This study examined the unique effects of four variable groups on changes in older adults' depressive symptoms for a 2-year period: (1) baseline health and disability status, (2) changes in health and disability since baseline, (3) stability and changes in marital and caregiving status and in work and volunteering, and (4) stability and changes in health-related behaviors. With data from the 1998 and 2000 interview waves of the Health and Retirement Study, the authors used gender-separate multistep (hierarchical) residualized regression analyses in which the Center for Epidemiological Studies Depression scale (CES-D) score at follow-up is modeled as a function of the effect of each group of independent variables. As hypothesized, changes in health, disability, marital, and caregiving status explained a larger amount of variance than the existing and stable conditions, although each group of variables explained a relatively small amount (0.3-3.4%) of variance in the follow-up CES-D score.     

Why and how to implement sodium, potassium, calcium, and magnesium changes in food items and diets?

The present average sodium intakes, approximately 3000-4500 mg/day in various industrialised populations, are very high, that is, 2-3-fold in comparison with the current Dietary Reference Intake (DRI) of 1500 mg. The sodium intakes markedly exceed even the level of 2500 mg, which has been recently given as the maximum level of daily intake that is likely to pose no risk of adverse effects on blood pressure or otherwise. By contrast, the present average potassium, calcium, and magnesium intakes are remarkably lower than the recommended intake levels (DRI). In USA, for example, the average intake of these mineral nutrients is only 35-50% of the recommended intakes. There is convincing evidence, which indicates that this imbalance, that is, the high intake of sodium on one hand and the low intakes of potassium, calcium, and magnesium on the other hand, produce and maintain elevated blood pressure in a big proportion of the population. Decreased intakes of sodium alone, and increased intakes of potassium, calcium, and magnesium each alone decrease elevated blood pressure. A combination of all these factors, that is, decrease of sodium, and increase of potassium, calcium, and magnesium intakes, which are characteristic of the so-called Dietary Approaches to Stop Hypertension diets, has an excellent blood pressure lowering effect. For the prevention and basic treatment of elevated blood pressure, various methods to decrease the intake of sodium and to increase the intakes of potassium, calcium, and magnesium should be comprehensively applied in the communities. The so-called 'functional food/nutraceutical/food-ceutical' approach, which corrects the mineral nutrient composition of extensively used processed foods, is likely to be particularly effective in producing immediate beneficial effects. The European Union and various governments should promote the availability and use of such healthier food compositions by tax reductions and other policies, which make the healthier choices cheaper than the conventional ones. They should also introduce and promote the use of tempting nutrition and health claims on the packages of healthier food choices, which have an increased content of potassium, calcium, and/or magnesium and a lowered content of sodium. Such pricing and claim methods would help the consumers to choose healthier food alternatives, and make composition improvements tempting also for the food industry.     

Neuron-like phenotypic changes in pancreatic β-cells induced by NGF, FGF, and dbcAMP

We studied the effects of nerve growth factor (NGF), fibroblast growth factor (FGF), and dibutyryl-cAMP (dbcAMP) on rat pancreatic β-cell morphology and of NGF and dbcAMP on insulin secretion. After 2 wk in culture, nearly 3% of β-cells extended neurite-like processes spontaneously; when cells were treated with NGF, almost 30% of them extended processes. In the presence of dbcAMP, almost all β-cells flattened, and the extension of neurite-like processes was more pronounced in fetal than in adult cells. The most prominent effect, regardless of age, was observed in cells treated with NGF and dbcAMP together, since the percentage of neurite-like bearing β-cells increased to 50%. β-cells cultured under these conditions maintained their immunoreactivity to insulin and nearly all β-cells and their neurite-like processes were also positive to GABA, tubulin, tau protein, and N-CAM. FGF increased the percentage of adult β-cells bearing neurite-like processes to 13%, and FGF and dbcAMP applied together to 40%. β-cells treated with NGF and dbcAMP for 5 to 7 d preserved their capability to secrete the hormone in response to different extracellular glucose concentrations. Insulin secretion of dbcAMP-treated β-cells was 2.5-fold higher than in control cells. NGF-treated cells were able to discriminate between different glucose concentrations, a property lost in control cells with time in culture.     

Cardiac and vascular changes in cirrhosis： Pathogenic mechanisms

Cardiovascular abnormalities accompany both portal hy-pertension and cirrhosis.These consist of hyperdynamiccirculation,defined as reduced mean arterial pressureand systemic vascular resistance,and increased cardiacoutput.Despite the baseline increased cardiac output,ventricular inotropic and chronotropic responses tostimuli are blunted,a condition known as cirrhotic car-diomyopathy.Both conditions may play an initiating oraggravating pathogenic role in many of the complicationsof liver failure or portal hypertension including ascites,variceal bleeding,hepatorenal syndrome and increasedpostoperative mortality after major surgery or livertransplantation.This review briefly examines the majormechanisms that may underlie these cardiovascular ab-normalities,concentrating on nitric oxide,endogenouscannabinoids,central neural activation and adrenergicreceptor changes.Future work should address the com-plex interrelationships between these systems.     

Do age-associated changes in 'physiologic' autoantibodies contribute to infection,atherosclerosis, and Alzheimer's disease?

More than 25 years ago, Pierre Grabar proposed that the age-associated increase in serum autoantibodies reflected a homeostatic function of the immune system that defended the internal milieu by targeting senescent molecules and cells for elimination. This mini-review examines recent evidence that autoantibodies may influence the risk of the elderly developing infectious, atherosclerotic, or Alzheimer's disease. Auto-anti-idiotypic antibodies suppress the antibody response to the nominal antigen and, thus, may contribute to the increased risk of infection and poor response to vaccines in the elderly. In contrast, low levels of autoantibodies to oxidised low-density lipoproteins or to the amyloid beta peptide may contribute to the increased risk of developing atherosclerosis of Alzheimer's disease, respectively.     

From the Cover: Agricultural intensification and changes in cultivated areas, 1970–2005

Does the intensification of agriculture reduce cultivated areas and, in so doing, spare some lands by concentrating production on other lands? Such sparing is important for many reasons, among them the enhanced abilities of released lands to sequester carbon and provide other environmental services. Difficulties measuring the extent of spared land make it impossible to investigate fully the hypothesized causal chain from agricultural intensification to declines in cultivated areas and then to increases in spared land. We analyze the historical circumstances in which rising yields have been accompanied by declines in cultivated areas, thereby leading to land-sparing. We use national-level United Nations Food and Agricultural Organization data on trends in cropland from 1970–2005, with particular emphasis on the 1990–2005 period, for 10 major crop types. Cropland has increased more slowly than population during this period, but paired increases in yields and declines in cropland occurred infrequently, both globally and nationally. Agricultural intensification was not generally accompanied by decline or stasis in cropland area at a national scale during this time period, except in countries with grain imports and conservation set-aside programs. Future projections of cropland abandonment and ensuing environmental services cannot be assumed without explicit policy intervention.     

Morphologic and biomechanical changes of rat oesophagus in experimental diabetes

AIM:To study morphologic and biomechanical changes ofoesophagus in diabetes rats.METHODS:Diabetes was induced by a single injection ofstreptozotocin(STZ).The type of diabetes mellitusinduced by parenteral STZ administration in rats wasinsulin-dependent(type I).The samples were excisedand studied in vitro using a self-developed biomaterialtest machine.RESULTS:The body mass was decreased after 4 d with STZtreatment.The length of esophagus shortened after 4,7,14 d.The opening angle increased after 14 d.The shear,longitudinal and circumferential stiffness were obviouslyraised after 28 d of STZ treatment.CONCLUSION:The changes of passive biomechanicalproperties reflect intra-structural alteration of tissue to acertain extent.This alteration will lead to some dysfunctionof movement.For example,tension of esophageal wallwill change due to some obstructive disease.     

Morphological and serum hyaluronic acid, laminin and type Ⅳ collagen changes in dimethylnitrosamine-induced hepatic fibrosis of rats

AIM: To study the morphological and serum hyaluronic acid (HA), laminin (LN), and type Ⅳ collagen changes in hepatic fibrosis of rats induced by dimethylnitrosamine (DMN). METHODS: The rat model of liver fibrosis was induced by DMN. Serum HA, type Ⅳ collagen, and LN were measured by ELISA. The liver/weight index and morphological changes were examined under electron microscope on d 7, 14, 21, and 28 by immunohistochemical alpha smooth muscle actin α-SMA staining as well as Sirius-red and HE staining. RESULTS: The levels of serum HA, type Ⅳ collagen and LN significantly increased from d 7 to d 28 (P = 0.043). The liver/weight index increased on d 7 and decreased on d 28. In the model group, the rat liver stained with HE and Sirius-red showed evident hemorrhage and necrosis in the central vein of hepatic 10 lobules on d 7. Thin fibrotic septa were formed joining central areas of the liver on d 14. The number of α-SMA positive cells was markedly increased in the model group. Transitional hepatic stellate cells were observed under electron microscope. All rats in the model group showed micronodular fibrosis in the hepatic parenchyma and a network of α-SMA positive cells. Typical myofibroblasts were embedded in the core of a fibrous septum. Compared to the control group, the area-density percentage of collagen fibrosis and pathologic grading were significantly different in the model group (P<0.05) on different d (7, 14, and 28). The area-density percentage of collagen fibrosis in hepatic tissue had a positive correlation with the levels of serum HA, LN, and type Ⅳ collagen. CONCLUSION: The morphological and serum HA, type Ⅳ collagen, and LN are changed in DMN-induced liver fibrosis in rats.     

Metabolic syndrome induces changes in KATP-channels and calcium currents in pancreatic β-cells

Metabolic syndrome (MS) can be defined as a group of signs that increases the risk of developing type 2 diabetes mellitus (DM2). These signs include obesity, hyperinsulinemia and insulin resistance. We are interested in the mechanisms that trigger hyperinsulinemia as a step to understand how β cells fail in DM2. Pancreatic β cells secrete insulin in response to glucose variations in the extracellular medium. When they are chronically over-stimulated, hyperinsulinemia is observed; but then, with time, they become incapable of maintaining normal glucose levels, giving rise to DM2. A chronic high sucrose diet for two months induces MS in adult male Wistar rats. In the present article, we analyzed the effect of the internal environment of rats with MS, on the activity of ATP-sensitive potassium channels (K_ATP) and calcium currents of pancreatic β cells. After 24 weeks of treatment with 20% sucrose in their drinking water, rats showed central obesity, hyperinsulinemia and insulin resistance, and their systolic blood pressure and triglycerides plasma levels increased. These signs indicate the onset of MS. K_ATP channels in isolated patches of β cells from MS rats, had an increased sensitivity to ATP with respect to controls. Moreover, the macroscopic calcium currents, show increased variability compared with cells from control individuals. These results demonstrate that regardless of genetic background, a high sucrose diet leads to the development of MS. The observed changes in ionic channels can partially explain the increase in insulin secretion in MS rats. However, some β cells showed smaller calcium currents. These cells may represent a β cell subpopulation as it becomes exhausted by the long-term high sucrose diet.     

Metabolic syndrome induces changes in KATP-channels and calcium currents in pancreatic β-cells

Metabolic syndrome (MS) can be defined as a group of signs that increases the risk of developing type 2 diabetes mellitus (DM2). These signs include obesity, hyperinsulinemia and insulin resistance. We are interested in the mechanisms that trigger hyperinsulinemia as a step to understand how β cells fail in DM2. Pancreatic β cells secrete insulin in response to glucose variations in the extracellular medium. When they are chronically over-stimulated, hyperinsulinemia is observed; but then, with time, they become incapable of maintaining normal glucose levels, giving rise to DM2. A chronic high sucrose diet for two months induces MS in adult male Wistar rats. In the present article, we analyzed the effect of the internal environment of rats with MS, on the activity of ATP-sensitive potassium channels (K_ATP) and calcium currents of pancreatic β cells. After 24 weeks of treatment with 20% sucrose in their drinking water, rats showed central obesity, hyperinsulinemia and insulin resistance, and their systolic blood pressure and triglycerides plasma levels increased. These signs indicate the onset of MS. K_ATP channels in isolated patches of β cells from MS rats, had an increased sensitivity to ATP with respect to controls. Moreover, the macroscopic calcium currents, show increased variability compared with cells from control individuals. These results demonstrate that regardless of genetic background, a high sucrose diet leads to the development of MS. The observed changes in ionic channels can partially explain the increase in insulin secretion in MS rats. However, some β cells showed smaller calcium currents. These cells may represent a β cell subpopulation as it becomes exhausted by the long-term high sucrose diet.     

“Cuffitis” and inflammatory changes in the columnar cuff, anal transitional zone, and ileal reservoir after stapled pouch-anal anastomosis

PURPOSE: During the past eight to ten years most surgeons have adopted the double-stapled technique to accomplish the pouch-anal anastomosis in restorative proctocolectomy for ulcerative colitis. Little attention has been focused on the functional implications of retaining a segment of diseased columnar mucosa in the upper anal canal. The aim of this study was to investigate clinically significant inflammation in the columnar cuff. METHOD: In all, 113 patients were studied and 715 biopsies were performed during a 2.5-year period. Biopsy specimens were taken from two or three sites, including the columnar cuff, ileal pouch, and anal transitional zone. Acute and chronic inflammation was scored for biopsy specimens from all three sites and compared with endoscopic assessment and pouch function. RESULTS: In the columnar cuff acute histologic inflammation was found in 13 percent of patients, and in 9 percent this was symptomatic during follow-up and was accompanied by evidence of endoscopic inflammation. Most patients had mild inflammation in the cuff that persisted over time. Inflammation in the pouch, pouch frequency, and anastomotic height were not related to columnar cuff inflammation. CONCLUSIONS: Cuffitis is a cause of pouch dysfunction after a double-stapled restorative proctocolectomy. We propose a triad of diagnostic criteria, including symptoms and endoscopic and histologic inflammation.Mark Thompson-Fawcett received funding from the Oxford Radcliffe Colorectal Surgery Research Trust Fund.Presented at the meeting of the Association of Coloproctology of Great Britain and Ireland, St. Helier, Jersey, United Kingdom, June 29 to July 1, 1998.     

Dynamic changes in the expression of matrix metalloproteinases and their inhibitors,TIMPs,during hepatic fibrosis induced by alcohol in rats

AIM:To determine the dynamic changes in the expressionof matrix metalloproteinases (MMPs) and the endogenoustissue inhibitors of MMPs inhibitors (TIMPs) during hepaticfibrosis induced by alcohol.METHODS:Male Sprague-Dawley rats were randomly dividedinto normal,4 d,2 wk,4 wk,g wk and 11 wk groups,and themodel rats were fed with a mixture of alcohol by gastricinfusion at the designed time,respectively,then decollatedand their livers were harvested for the examination of MMP-2,MMP-3,MMP-9,MMP-13,TIMP-1 and TIMP-2 by immunoh-istochemistry,zymograghy and Western blotting,respectively.RESULTS:Normal rats had moderate expression of MMP-2,which was decreased in the model rats except in the 11 wkgroup,where MMP-2 expression slightly increased.MMP-3had the similar changing pattern to MMP-2 despite weakerexpression.MMP-9 expression decreased in the 4 d and 2 wkgroups,rose in the 4 wk group,decreased again in the 9 wkgroup and returned to normal levels in the 11 wk group.MMP-13 expression decreased in the 4 d and 2 wk groups,and returned to normal levels in the 4 wk,9 wk and 11 wkgroups.TIMP-1 expression decreased in the 4 d and 2 wkgroups,but sharply increased in the 4 wk group and sustainedat a high level even after modeling was stopped for 2 wk.Innormal rats TIMP-2 expression was strong.However,itdecreased as soon as modeling began,and then graduallyrose,but remained to a level lower than that in normal ratseven after modeling was stopped for 2 wk.CONCLUSION:MMP-2 may not always expresses at a highlevel during hepatic fibrosis.MMP-13 and MMP-3 areacutely affected by TIMP-1.In this model TIMP-1 is the mostpowerful factor imposed on capillarization and peri-sinusoidalfibrosis.TIMP-2 is the most effective regulator on the metabolismof type Ⅳ collagen located in the basement of sinus.     

Reminiscence intervention in nursing homes: what and who changes?

The results of experimental studies of reminiscing are not as uniformly optimistic about its therapeutic value as is the theoretical literature. Moreover, anecdotal evidence regarding the impact of reminiscence interventions is more positive than the statistical evidence. This study suggests reasons for these previous findings, and examines data from a discussion group intervention in thirty nursing homes, in which 185 residents completed pre- and posttests. It analyzes the characteristics of participants in relation to modifications in selected attitudes and behaviors over the intervention period. Analysis of variance and discriminant analysis revealed no significant relationships between attitudinal or behavioral modifications and demographic or other characteristics, with one exception. Value-choices made by participants were related to such modifications. The findings are interpreted in terms of the "mental adaptability" of participants and the compensatory nature of reminiscence in an institutional setting.     

Functional and structural adaptations in the pancreatic α-cell and changes in glucagon signaling during protein malnutrition

Chronic malnutrition leads to multiple changes in β-cell function and peripheral insulin actions to adapt glucose homeostasis to these restricted conditions. However, despite glucose homeostasis also depends on glucagon effects, the role of α-cells in malnutrition is largely unknown. Here, we studied α-cell function and hepatic glucagon signaling in mice fed with low-protein (LP) or normal-protein diet for 8 wk after weaning. Using confocal microscopy, we found that inhibition of Ca2? signaling by glucose was impaired in α-cells of LP mice. Consistent with these findings, the ability of glucose to inhibit glucagon release in isolated islets was also diminished in LP mice. This altered secretion was not related with changes in either glucagon gene expression or glucagon content. A morphometric analysis showed that α-cell mass was significantly increased in malnourished animals, aspect that was probably related with their enhanced plasma glucagon levels. When we analyzed the hepatic function, we observed that the phosphorylation of protein kinase A and cAMP response-binding element protein in response to fasting or exogenous glucagon was impaired in LP mice. Additionally, the up-regulated gene expression in response to fasting observed in the hepatic glucagon receptor as well as several key hepatic enzymes, such as peroxisome proliferator-activated receptor γ, glucose-6-phosphatase, and phosphoenolpyruvate carboxykinase, was altered in malnourished animals. Finally, liver glycogen mobilization in response to fasting and the ability of exogenous glucagon to raise plasma glucose levels were lower in LP mice. Therefore, chronic protein malnutrition leads to several alterations in both the α-cell function and hepatic glucagon signaling.     

Dynamic changes of capillarization and peri-sinusoid fibrosis in alcoholic liver diseases

AIM:To investigate the dynamic changes of capillarizationand ped-sinusoid fibrosis in an alcoholic liver disease modelinduced by a new method.METHODS:Male SD rats were randomly divided into 6groups,namely normal,4 d,2 w,4 w,9 w and 11 w groups.The animals were fed with a mixture of alcohol for designateddays and then decollated,and their livers were harvestedto examine the pathological changes of hepatocytes,hepaticstellate cells,sinusoidal endothelial cells,sinusoid,peri-sinusoid.The generation of three kinds of extra cellular matrixwas also observed.RESULTS:The injury of hepatocytes became severer asmodeling going on.Under electronic microscope,fattyvesicles and swollen mitochondria in hepatocytes,activatedhepatic stellate cells with fibrils could been seen near oraround it.Fenestrae of sinusoidal endothelial cells weredecreased or disappeared,sinusoidal basement was formed.Under light microscopy typical peri-sinusoid fibrosis,gridding-like fibrosis,broaden portal areas,hepatocyte's fatty andballoon denaturation,iron sediment,dot necrosis,congregated lymphatic cells and leukocytes were observed.Type Ⅰ collagen showed an increasing trend as modelinggoing on,slightly recovered when modeling stopped for 2weeks.Meanwhile,type Ⅳ collagen decreased rapidly whenmodeling began and recovered after modeling stopped for2 weeks.Laminin increased as soon as modeling began anddid not recover when modeling stopped for 2 weeks.CONCLUSION:The pathological changes of the modelwere similar to that of human ALD,but mild in degree.Ithad typical peri-sinusoid fibrosis,however,capillarizationseemed to be instable.It may be related with the reductionof type Ⅳ collagen in the basement of sinusoid duringmodeling.     

Are changes in cognitive functioning in older adults related to changes in subjective complaints?

In many areas of intellectual functioning, age-related declines in older adults' performance and increases in subjective complaints about intellectual performance are observed. However, the literature mostly reports very low relations between functioning and respective complaints. This finding could be the consequence of examining the relation between subjective complaints and the perceived level of functioning. If, however, persons are sensitive to relative changes in performance, they might base their subjective judgment on changes in the level of cognitive functioning. With 202 subjects (mean age=63 years) and two measurements, the authors examine (a) the relation between functioning and complaints at each measurement point, and (b) the relation between changes in functioning and changes in complaints between the measurement points with latent difference variables. The results indicate that there is no relation between level of functioning and level of complaints, but that there is a substantial relation between changes in functioning and complaints.     

Urinary N-acetyl-β-d-glucosaminidase changes in relation to age,sex, race,and diastolic and systolic blood pressure in a young adult biracial population The Bogalusa heart study

Increased urinary activity of N-acetyl-β-d-glucosaminidase (NAG) has been reported in many clinical conditions, including essential hypertension. Since hypertension is increasingly recognized as beginning in childhood, we hypothesized that urinary NAG changes with increasing blood pressure may start early in life and may also be the evidence of the existence of early hypertensive disease. We analyzed the urinary NAG changes in 980 young adults, ages between 18 to 32, in relation to age, race, sex, and systolic and diastolic blood pressure. We observed that black women had the highest level of NAG, with or without adjustment for creatinine. With aging, urinary NAG significantly increased in men. As blood pressure increased, urinary NAG excretion appeared to increase, and this was more apparent in black women (P < .05). Significant correlations between NAG excretion and systolic (r = 0.12, P = .04) and diastolic (r = 0.18, P = .003) blood pressures existed in the oldest age group, 28 to 32 years old. These findings show that a significant association between urinary NAG and blood pressure exists in normal young adults and changes in urinary NAG may be evidence of early hypertensive disease.     

The changes of serum nitric oxide, angiotensin Ⅱ and superoxide anion in renal artery hypertension rat

Objectives To study the changes of nitric oxide, angiotensin Ⅱ and superoxide anion in renal artery hypertension pathogenesis. Methods Male Wistar rats weighing 256 -285g were divided into 5 groups randomly, 10 rats of each group. Control group: false operation was made and routine diet was given; Ligature group: left renal artery was ligatured uncompletely and routine diet was given; Ligature + Losartan group: left renal artery was ligatured uneompletely and Losartan 20mg · kg~(-1) · d~(-1) was added in the drinking water; Ligature + L -Arg group: left renal artery was ligatured uncompletely and L -Arg 2g · kg~(-1) · d~(-1) was added in the drinking water; Ligature + L - Arg + Losartan group: left renal artery was ligatured uncompletely and L - Arg 2g· kg~(-1)· d~(-1) and Losartan 20mg · kg~(-1)· d~(-1) was added in the drinking water. Blood pressure and heart rate were measured before and at the end of the experiment. One week after ligature, blood was drawn to determine angiotensin Ⅱ, cGMP,