Relationships between blood rheology and age, body mass index, blood cell count, fibrinogen, and lipids in healthy subjects

We investigated the relationships between blood rheology assessed by microchannel method and the various hemorheologic factors in healthy subjects. One hundred seventy-six healthy volunteers (90 men and 86 women, mean age; 32.9+/-11.3 years) were participated in this study. Body weight, body mass index, red blood cell count, hematocrit, hemoglobin, white blood cell count, and platelet count, plasma fibrinogen, and fasting serum lipid and lipoprotein concentrations were measured. In order to assess blood rheology, blood passage time was determined by a microchannel method (Micro Channel Array Flow Analyzer). Age, body mass index, red blood cell count, hematocrit, hemoglobin, white blood cell count, total cholesterol, low-density lipoprotein cholesterol, and triglyceride were positively correlated with blood passage time in all subjects, respectively (p<0.01) and high-density lipoprotein cholesterol was inversely correlated with blood passage time (p<0.01). However, platelet count, and fibrinogen were not correlated with blood passage time. The present study showed that increased age, body mass index, red blood cell count, white blood cell count, total cholesterol, low-density lipoprotein cholesterol, and triglyceride and decreased high-density lipoprotein cholesterol were associated with impaired blood rheology measured by microchannel method in healthy subjects, suggesting that aging, obesity, erythrocytosis, leukocytosis, and dyslipidemia may be related to hemorheological disorders. This microchannel method may be useful to study blood rheology which may be associated with various risk factors of cardiovascular disorders.     

Aromatic constituents of Cymbidium Great Flower Marie Laurencin and their antioxidative activity

Two novel aromatic glucosides, named marylaurecinosides B (1) and C (2), were isolated from Cymbidium Great Flower Marie Laurencin, together with six known aromatic compounds (3–8). These structures were determined on the basis of NMR experiments as well as chemical evidence. All of the isolated compounds (1–8) were tested for antioxidative activity using a superoxide dismutase-like assay.     

Sleep-disordered breathing in the usual lifestyle setting as detected with home monitoring in a population of working men in Japan

STUDY OBJECTIVES: To examine (1) the prevalence of home-monitored sleep-disordered breathing (SDB) and obstructive sleep apnea syndrome in a Japanese working population and (2) whether home monitoring with a type 3 portable monitor and actigraphy can produce reliable data to analyze SDB in usual lifestyles. METHODS: A cross-sectional survey using a self-administered questionnaire was conducted on a group of employees at a wholesale company in Osaka, Japan. Examinations by physicians and by sleep monitoring were also performed. Unattended home cardiorespiratory (type 3) sleep studies with actigraphy were conducted for 2 nights to diagnose SDB in 322 subjects. From the baseline questionnaires and sleep diaries, participants were assessed to follow their usual lifestyles during the study (e.g., time in bed, alcohol intake). RESULTS: Of 466 Japanese male employees, 396 responded to the questionnaire survey (85.0%). Results from 322 male employees aged 23 to 59 (43.8 +/- 8.4 years) were analyzed. Respiratory disturbance index (RDI), calculated from the type 3 portable monitors and actigraphy, was highly reliable with an intraclass correlation of 0.98 for interscorer reliability and with an intraclass correlation of 0.95 for night-to-night reliability. Prevalence of mild (5 < or = RDI < 15), moderate (15 < or = RDI < 30) and severe (RDI < or = 30) SDB in this population were 37.4%, 15.7%, and 6.6%, respectively. The prevalence of obstructive sleep apnea syndrome (RDI > or = 5 and Epworth Sleepiness Scale score > 10) was 17.6%. CONCLUSIONS: The prevalence of moderate to severe SDB (RDI > or = 15) was 22.3% in this Japanese male working population aged 23 to 59, measured in participant's usual life settings. Unattended home monitoring with type 3 portable monitors and actigraphy was highly reliable and may be suitable for analyzing SDB in the usual lifestyle setting.     

Electrical stimulation of the abdomen preserves motor performance in the inactive elderly: a randomized controlled trial

Abdominal muscle strength declines easily with the process of aging and/or disuse, and it is difficult to strengthen weak abdominal muscles in the inactive elderly. In the present study, we applied surface electrical stimulation (ES) to the abdomen of inactive elderly people to investigate its chronic effects. Twenty inactive elderly people (65-89 years) who spent most of the day in their bedroom participated in the study. The subjects were assigned to ES and non-ES groups in a random order. In addition to conventional physical therapy and occupational therapy, ES was applied to both sides of the flank of 10 subjects (ES group) for 8 weeks. For evaluation of the abdominal muscles, the cross-sectional area (CSA) was measured with computed tomography and the electrical muscle activity (iEMG) was measured by electromyography. Functional examinations were performed at 2, 4, and 8 weeks after the beginning of the study with the following parameters: grip strength; maximum walking speed (WS); movement time for sitting up (MSU); number of trunk flexions (NTF); flexibility of the trunk; sit-to-stand time (STS); and Barthel index (BI) score. In the ES group, the NTF and MSU were significantly improved at 4 weeks and thereafter. Furthermore, the STS and WS were also improved significantly after 8 weeks (p < 0.05). The CSA and iEMG both increased significantly (p < 0.05). However, the flexibility of the trunk and BI score did not change. In conclusion, ES to the abdomen has the potential to improve motor function in the inactive elderly.     

Predictive grade of ultrasound synovitis for diagnosing rheumatoid arthritis in clinical practice and the possible difference between patients with and without seropositivity

Objective. To determine the degree of contribution and the contributing factors of ultrasound in the diagnosis of rheumatoid arthritis (RA) in daily clinical practice and the predictive differences depending on seropositivity.

Methods. We included 122 patients who presented with the main complaint of finger and/or wrist joint pain but for whom no definite diagnosis was reached or treatment strategy was provided. Ultrasound was performed on at least 22 joints (both wrist joints, proximal interphalangeal joint, and metacarpophalangeal joints), and patients were followed for ≥6 months. Factors contributing to RA diagnosis were determined and compared between seropositive and seronegative RA patients.

Results. RA was diagnosed in 52 of 122 patients, in whom the American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) classification criteria (odds ratio [OR] = 4.74, P = 0.01) and gray scale (GS) grade of 3 (OR = 3.64, P = 0.04) for ≥ 1 joint were the contributing factors. In seropositive RA, the ACR/EULAR criteria (OR = 15.53, P < 0.001) and power Doppler (PD) ≥ 2 for ≥ 1 joint (OR = 10.48, P = 0.0048) were the contributing factors. In seronegative RA, PD ≥ 1 for ≥ 1 joint contributed the most (OR = 20.00, P = 0.0044), but the ACR/EULAR criteria did not contribute to RA diagnosis (P = 0.57).

Conclusion. Ultrasound findings contributed to RA diagnosis in clinical practice. The contributing factors are different in the presence or absence of seropositivity, and ultrasound complementation was particularly useful in seronegative RA patients.     

Development of a Cardiovascular Disease Risk Prediction Model Using the Suita Study,a Population-Based Prospective Cohort Study in Japan

Aim: To construct a risk prediction model for cardiovascular disease (CVD) based on the Suita study, an urban Japanese cohort study, and compare its accuracy against the Framingham CVD risk score (FRS) model.Methods: After excluding participants with missing data or those who lost to follow-up, this study consisted of 3,080 men and 3,470 women participants aged 30–79 years without CVD at baseline in 1989–1999. The main outcome of this study was incidence of CVD, defined as the incidence of stroke or coronary heart disease. Multivariable Cox proportional hazards models with stepwise selection were used to develop the prediction model. To assess model performance, concordance statistics (C-statistics) and their 95% confidence intervals (CIs) were calculated using a bootstrap procedure. A calibration test was also conducted.Results: During a median follow-up period of 16.9 years, 351 men and 241 women developed CVD. We formulated risk models with and without electrocardiogram (ECG) data that included age, sex, systolic blood pressure, diastolic blood pressure, high-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, lowdensity lipoprotein cholesterol, diabetes mellitus, smoking, and urinary protein as risk factors. The C-statistics of the Suita CVD risk models with ECG data (0.782; 95% CI, 0.766–0.799) and without ECG data (0.781; 95% CI, 0.765–0.797) were significantly higher than that of the FRS model (0.768; 95% CI, 0.750–0.785).Conclusions: The Suita CVD risk model is feasible to use and improves predictability of the incidence of CVD relative to the FRS model in Japan.     

Combined small-cell carcinoma of the stomach: p53 and K-ras gene mutational analysis supports a monoclonal origin of three histological components

Primary small-cell carcinoma (SmCC) is extremely rare in stomach. We reported an autopsy case of combined gastric SmCC with p53 and K-ras mutational analysis. Histologically, the tumour was composed of well-differentiated adenocarcinoma surrounding the central dominant SmCC component with scattered nests of squamous cell carcinoma. Immunohistochemically, all the neoplastic components revealed strong expression for p53 protein. Based on these findings, we hypothesized that these histologically different components originated from a same progenitor cell that possessed p53 mutation. Using Laser-capture microdissection technique and mutational analysis, we identified the same point mutations of p53 gene (A-->G transversion in codon 239) and K-ras gene (G-->A transversion in codon 13) in all the neoplastic components, but not in the adjacent normal gastric epithelium. Our results strongly support a hypothesis that the combined SmCC of stomach in this case was of monoclonal origin.     

Immunolocalization of glucose transporter 1 and 3 in the placenta: application to cytodiagnosis of Papanicolaou smear

A positive immunostaining for glucose transporter 1 (GLUT1) was exclusively localized in microvilli on the free surface of syncytiotrophoblasts in the placenta. An enhanced immunoreaction for glucose transporter 3 (GLUT3) was elicited in the cell membrane of intermediate trophoblasts and cytotrophoblasts. Neither GLUT1 nor GLUT3 was positive in decidual cells and epithelial components from cervical dysplasia and carcinoma in situ. Cervicovaginal smears from six pregnant women containing atypical cells of unknown origin were subjected to immunocytochemical testing with antibodies against GLUT1 and GLUT3. Atypical cells in smears from two pregnant women were found to be positive for GLUT3 while no specific immunoreaction for GLUT1 was elicited, indicating their origin from either intermediate trophoblasts or cytotrophoblasts. Through the use of antibodies against vimentin and cytokeratin 17, GLUT3-negative atypical cells were further sorted into decidual cells and epithelial components from cervical dysplasia, respectively.