Right ventricular systolic function and the manner of transformation of the right ventricle in patients with dilated cardiomyopathy.

BACKGROUND: Dilated cardiomyopathy (DCM) is generally considered to be accompanied by both left and right ventricular dysfunction, but most studies only analyze the left ventricular function. METHODS AND RESULTS: Biplane right ventriculography was performed in 13 control subjects and 13 patients with DCM and New York Heart Association functional class II. Three dimensions of the right ventricle (RV) (the long axis dimension (LA), the anterior - posterior dimension (AP), and the septum -free wall dimension (SF)) and 2 dimensions of the left ventricle (LV) (LA and AP) were examined to assess regional function. The group with DCM had a lower stroke volume index and RV ejection fraction. In the RV dimensional analysis, the group with DCM had a smaller SF and a larger AP at end-diastole, and larger AP and LA at end-systole. There was a significant linear negative correlation between SF of RV and AP of LV at end-diastole. CONCLUSION: In clinically well-controlled cases of DCM, RV systolic function is depressed, and the RV is compressed by the LV, becoming less thick than in the controls. This transformation results from some parallel interaction between the RV and a markedly enlarged LV.     

Prognostic significance of the nocturnal decline in blood pressure in individuals with and without high 24-h blood pressure: the Ohasama study

OBJECTIVE: To examine the relationship between the normal nocturnal decline in blood pressure and the risk of cardiovascular mortality in individuals with and without high 24-h blood pressure values. METHODS: We obtained 24-h ambulatory blood pressure readings from 1542 residents of Ohasama, Japan, who were aged 40 years or more and were representative of the Japanese general population. We then followed up their survival for a mean of 9.2 years. The relationship was analysed using a Cox proportional hazards model adjusted for possible confounding factors. RESULTS: There was a linear relationship between the nocturnal decline in blood pressure and cardiovascular mortality. On average, each 5% decrease in the decline in nocturnal systolic/diastolic blood pressure was associated with an approximately 20% greater risk of cardiovascular mortality. There were no significant interactions for the risk between 24-h systolic/diastolic blood pressure values and continuous values for the nocturnal decline in blood pressure ( for interaction 0.6). Even when 24-h blood pressure values were within the normal range ( 135/80 mmHg, average 118/69 mmHg), diminished nocturnal decreases in systolic/diastolic blood pressure were associated with an increased risk of cardiovascular mortality. CONCLUSIONS: This is the first study to demonstrate that a diminished nocturnal decline in blood pressure is a risk factor for cardiovascular mortality, independent of the overall blood pressure load during a 24-h period, in the general population.     

Severity of eczema and mental health problems in Japanese schoolchildren: The ToMMo Child Health Study

Background

The association between eczema and mental health problems in schoolchildren has been underexplored. We aimed to investigate this association with the validated questionnaires.

Small cell carcinoma of the prostate: a case report

A 76-year-old man had been treated with maximum androgen blockade therapy for a poorly-differentiated prostate adenocarcinoma (T3cN1M0, prostate specific antigen (PSA) 65 ng/ml, Gleason Score 4+5=9) since September 2002. By August 2003, his serum PSA levels were undetectable and the lymph node swelling had vanished. However, in December 2004, his serum PSA levels started rising gradually up to 0.66 ng/ml. Radiation therapy on the prostate was then performed (66 Gy). At that time, no metastasis was detected by computed tomography and bone scintigraphy. In August 2005, multiple bone metastases were detected. Immunohistochemical examination of a biopsy specimen from the bone lesion revealed a small cell carcinoma/neuroendocrine cell carcinoma. He died with undetectable PSA levels (less than 0.008 ng/ml) in December 2005. The autopsy showed multiple organ metastases including bone, liver, lungs and others. The immunohistochemical examination revealed pure small cell carcinoma in all metastatic lesions. A precise histological examination of the lungs using a 1 cm serial section could not reveal any tumors compatible with primary lung cancer. We concluded from the clinical history and autopsy findings that his initial poorly-differentiated adenocarcinoma of the prostate dedifferentiated into a pure small cell carcinoma with neuroendocrine differentiation.     

Immunocytochemical localization of ubiquitin A-52 protein in the mouse inner ear

The ubiquitin A-52 residue ribosomal protein fusion product 1 (UbA52) is a gene highly expressed specifically in the inner ear. Through cellular localization we immunocytochemically investigated its function in the inner ear. In the adult mouse, UbA52 protein was distributed in the strial marginal cells and vestibular dark cells, which regulate the endolymphatic ion homeostasis. In the developing mouse cochlea, no significant staining was observed from birth to postnatal day 3, whereas after postnatal day 6, strong UbA52-immunoreactivities were observed in strial marginal cells. Endolymphatic K concentration is elevated between postnatal days 3-8: therefore, our results indicate that UbA52 may have a functional role in regulation of ion secretion in the inner ear.     

Validity and utility of the Japanese version of the WHO-Five Well-Being Index in the context of detecting suicidal ideation in elderly community residents

OBJECTIVE: The aim of this study is to evaluate the validity and the utility of the Japanese version of the WHO-Five Well-Being Index (WHO-5-J) in the context of detecting suicidal ideation in elderly community residents. METHODS: A sample of 696 subjects aged 70 years or over who completed a set of questionnaires was examined. RESULTS: Cronbach's alpha was 0.87 and Loevinger's coefficient was 0.64. The total score was significantly correlated with the number of cohabitants, the number of physical illnesses, physical functioning, instrumental activities of daily living, and depressive symptoms. Subjects with suicidal ideation had significantly lower scores on the WHO-5-J. The receiver-operating characteristic curve analysis indicated that the scale significantly discriminated the subjects with suicidal ideation. When combined with the assessment of a lack of perceived social support (PSS), a standard cut-off criterion of "a total score < or = 12 or answering 0 or 1 to any of the five items" more appropriately identified elderly subjects with suicidal ideation: sensitivity = 87%, specificity = 75%, negative predictive value = 99%, and positive predictive value = 10%. CONCLUSIONS: In combination with PSS, the scale has predictive utility to detect suicidal ideation in elderly community residents.