Neuro-physiological study in persons with cervico-brachial disorders

OBJECTIVES: In order to clarify the involvement in the nervous system by cervico-brachial disorders (CBD), we performed neurophysiological tests on the peripheral nervous system (PNS) and the central nervous system (CNS) in patients with CBD, subclinicals and healthy controls. SUBJECTS AND METHODS: We employed antidromic sensory nerve conduction velocities (SCV) in the hands and fingers for PNS function and event-related potentials (P300) for CNS higher function. Subjects for SCV were 27 patients, 14 workers with sign and symptoms of CBD (subclinicals) and 22 controls. Subjects for P300 were 23 patients, 12 subclinicals and 10 healthy controls. CONCLUSIONS: In the PNS, since significant reduction SCV in the index finger among patients was observed, we could not find clear evidence of decrease of conduction function. In the CNS, since the latencies and amplitudes of auditory P300 among patients were significantly delayed and decreased, respectively, and the latencies significantly correlated with symptom score, it was suggested that the dysfunction of the cognition and memory function. However, further investigation is necessary to clarify the mechanism.     

Comparison between coefficient of R-R interval variation and gastric emptying in type 2 diabetes mellitus patients

BACKGROUND: Autonomic neuropathy is a common complication of diabetes mellitus (DM). METHOD: To clarify the relationship between cardiovascular autonomic function and gastric emptying rate, we investigated the gastric emptying and coefficient of R-R interval variation (CV(RR)) of 84 type 2 diabetic patients: 28 cases without peripheral neuropathy and 56 cases with peripheral neuropathy. All patients were subjected to a gastric emptying test according to the marker method (administration of a capsule containing 20 pieces of radiopaque marker during breakfast, followed by abdominal X-ray imaging 3 and 5 h later). Patients had their CV(RR) assessed at rest and during deep breathing. RESULTS: Gastric emptying scores were significantly correlated with CV(RR) during deep breathing and with the duration of DM, but neither age nor CV(RR) at rest in all patients. Gastric emptying scores and CV(RR) at rest and during deep breathing in patients with peripheral neuropathy were significantly deteriorated than those in patients without peripheral neuropathy. A significant correlation between gastric emptying and CV(RR) during deep breathing could be observed in the patients with peripheral neuropathy, but not in those without it. CONCLUSIONS: These findings showed that CV(RR) during deep breathing might be a good indicator of diabetic gastropathy and that peripheral neuropathy was closely related with cardiac and gastric autonomic neuropathy in the type 2 diabetic patients.     

Magnetoencephalographic analysis in children with Panayiotopoulos syndrome

The aims of this study were to identify the generator of the paroxysmal partial discharges in Panayiotopoulos syndrome by means of magnetoencephalography and to determine the significance of these formations in the epileptogenesis of the developing nervous system. We report magnetoencephalographic data for two cases of Panayiotopoulos syndrome showing the rapid generalization of the source of interictal spikes that explains extraoccipital manifestations such as ictal vomiting and consciousness disturbance.     

Lipoxygenase inhibition and protection of cardiovascular system

The arachidonic cascade involves three types of metabolic pathways; cyclo-oxygenase, lipoxygenase(LO), and cytochrome P450. The products of LO pathway participate in the pathogenesis of variety of disease such as allergic diseases and hypertension. In particular, 12-hydroxyeicosatetraenoic acid(12-HETE); product of 12-LO pathway, is concerned in the development of hypertension induced by angiotensin-II. In fact, several investigators have reported that 12-HETE has a critical role in hypertension and LO inhibitors have antihypertensive effects in experimental animals. And so, we can expect organ-protective effects of LO inhibitors as well as antihypertensive effects. Besides 12-LO, several investigators mentioned that 5- and 15-LO also have influences to cardiovascular systems. Therefore, we can expect further elucidation of the mechanism of 12-LO's participation in the organ damage and the clinical roles of 12-LO inhibitors to prevent from organ failure in future.     

Endothelin-1-induced impairment of endothelium-dependent relaxation in aortas isolated from controls and diabetic rats

An accumulating body of evidence indicates that an increased endothelin-1 level is related to endothelial dysfunction in cardiovascular diseases. In this study, we tested whether prolonged treatment of aortas with endothelin-1 induces endothelial dysfunction. When isolated aortas from control rats were cultured with endothelin-1, at levels above the plasma concentration, the acetylcholine-induced endothelium-dependent relaxation was significantly decreased (as compared with endothelin-1-nontreatment). This endothelin-1-induced endothelial dysfunction was more marked in aortas obtained from rats with streptozotocin-induced diabetes than in those from the controls. The endothelin-1- induced attenuation was very strongly suppressed by co-incubation with J-104132, endothelin receptor A/B antagonist, or polyethylene-glycolated superoxide dismutase, a cell-permeant superoxide anion scavenger or LY294002, phosphoinositide 3-kinase inhibitor. These results indicate that endothelin-1 can induce endothelial dysfunction, and that this may be related to superoxide generation and to PI3-kinase activity.     

Review of arrythmias related to acute myocardial infarction and its treatment

Because reperfusion therapy for AMI has been widely performed, complicated fatal ventricular arrythmias related to AMI has been dramatically decreased. However, there still remain the incidence of fetal arrhythmias such as ventricular fibrillation(VF), ventricular tachycardia(VT) at the early phase in occurrence of AMI. Besides spreading bolus intravenous administration of mutant-tPA, Bystander CPR, Public access defibrillation (PAD), and setting of automated external defibrillators(AED) in the public facilities are actually required to reduce the mortality of AMI. In this article, we reviewed that arrhythmias associated with AMI and strategy for treatments of complicated arrhythmias in the clinical settings.     

Involvement of inflammation in acute coronary syndromes assessed by levels of high-sensitivity C-reactive protein, matrix metalloproteinase-9 and soluble vascular-cell adhesion molecule-1

OBJECTIVES: Inflammation is important in the development of atherosclerosis. Matrix metalloproteinases (MMPs) and interferon-gamma which participate in collagen degradation are pathological factors in plaque vulnerability as an important mechanism underlying acute coronary syndrome. This study investigated whether inflammation is related to the onset of acute coronary syndrome. METHODS: This study included 56 patients with acute coronary syndrome (ACS group), 104 patients with chronic coronary artery disease (S group), and 38 control subjects with no evidence of ischemic heart disease (C group). High-sensitivity C-reactive protein (hs-CRP), MMP-9, and interferon-gamma were measured in peripheral blood samples. Soluble adhesion molecules (VCAM-1, ICAM-1) were also measured as inflammatory markers. RESULTS: The hs-CRP level was significantly higher in the ACS group (44.5 mg/l) than in the S group (2.1 mg/l) and the C group (0.6 mg/l) (p < 0.0001). The MMP-9 level was also significantly higher in the ACS group (333.8 ng/ml) than in the S group (110.8 ng/ml) and the C group (72.0 ng/ml) (p < 0.0001). The VCAM-1 level was significantly higher in the ACS group (506.5 ng/ml) than in the C group (448.8 ng/ml) (p < 0.05). The ICAM-1 level and the interferon-gamma level did not differ between the groups. There was a significant positive correlation between the level of hs-CRP and the level of the collagen degradation product MMP-9 (r = 0.52) in all subjects. CONCLUSIONS: These results suggest that plaque destabilized by MMP-9 produced in response to inflammation participates in the mechanism of acute coronary syndrome.