Age and the architecture of oral mucosa

Age changes affect the oral mucosa (the protective lining of the oral cavity), but few of these have been studied objectively. The aim of this study was to quantitatively analyse a number of morphometric parameters of the ageing oral mucosa. The fractal dimension of the epithelial connective tissue interface (ECTI) was estimated in 42 samples of normal buccal mucosa to correlate any changes in their irregularity to the age of the individuals. Morphometric parameters extracted from theoretical cell areas computed programatically were also analysed. Results showed no significant change in ECTI complexity associated with age; however, there was indication that epithelial cells tended to become larger and flatter with age. Interestingly, while some parameters did not show significant differences case wise, cluster analysis showed that the data clustered the cases into three main age groups: one representing the first two decades of life, another group represents adult life (21–50 years) and the last group representing the ageing population (50–90 years).     

Receiver-operated characteristics (ROCs) of the relationships between obesity indices and multiple risk factors (MRFs) for atherosclerosis at different ages in men and women

The aim of this study was to clarify whether age affects ROC curves for the relationships between obesity indices and MRFs for atherosclerosis. Subjects were 35-70-year-old men (n=37,697) and women (n=19,891) who received health checkup examinations. ROC curves were analyzed for relationships of body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR) with MRFs for atherosclerosis consisting of two or more risk factors (RFs) of metabolic syndrome (MetS) including high blood pressure, dyslipidemia (hypertriglyceridemia and/or hypo-HDL-cholesterolemia) and hyperglycemia. Both in men and women, AUC (area under the curve) of the ROC curves tended to be smaller as age increased. In women, cut-off values of WHtR tended to be higher as age increased, while no apparent relationships were found between age and cut-off values of BMI and WC in women and between age and cut-off values of the three obesity indices in men. The results suggest that both in men and women, the associations between obesity and MRFs for atherosclerosis become weaker as age increases, while age does not influence cut-off values of obesity indices except for higher WHtR at an older age in women.     

Prognostic value of aortic valve area index in asymptomatic patients with severe aortic stenosis

Recently, an aortic valve area (AVA) index (AVAI) <0.6 cm(2)/m(2) was proposed as an indicator of severe aortic stenosis. The purpose of the present study was to clarify the prognostic value of the AVAI. We identified 103 consecutive asymptomatic patients (mean age 72 ± 11 years) with severe aortic stenosis, defined by an AVA of <1.0 cm(2), who had not undergone aortic valve replacement on initial evaluation. During follow-up (median 36 ± 27 months), 31 aortic valve replacements and 20 cardiac deaths occurred. Multivariate analysis revealed that an AVAI <0.6 cm(2)/m(2) (hazard ratio 2.6, 95% confidence interval 1.1 to 6.3; p = 0.03) and peak aortic jet velocity (Vp) >4.0 m/s (hazard ratio 2.6, 95% confidence interval 1.2 to 5.8; p = 0.02) were associated with cardiac events but that an AVA <0.75 cm(2) was not. The event-free survival of patients with an AVAI of ≥0.6 cm(2)/m(2) was better than that for those with an AVAI <0.6 cm(2)/m(2) (86% vs 41% at 3 years, p <0.01). Furthermore, patients with an AVAI of ≥0.6 cm(2)/m(2) and Vp of ≤4.0 m/s showed an excellent prognosis, but those without these findings had poorer outcomes. In conclusion, AVAI is a powerful predictor of adverse events in asymptomatic patients with severe aortic stenosis. Furthermore, the combination of AVAI and Vp provides additional prognostic information. Watchful observations are required for timely aortic valve replacement in patients with an AVAI of <0.6 cm(2)/m(2) or a Vp >4.0 m/s.     

Prognostic utility of metabolic exercise testing in minimally symptomatic patients with obstructive hypertrophic cardiomyopathy

Patients with obstructive hypertrophic cardiomyopathy (HC) are at increased risk of death or severe symptoms. Although metabolic exercise testing is routinely used in the evaluation of a variety of cardiac diseases, data on the prognostic information that can be derived from such testing in HC is lacking. We examined 182 patients (mean age 53 ± 15 years; 65% men) with obstructive HC and minimal or no cardiovascular symptoms. Each patient underwent maximum exercise testing with simultaneous metabolic gas exchange measurement. Follow-up (mean 4.0 ± 3.0 years; 100% complete) was performed to determine the vital status and occurrence of severe symptoms, defined as class III or IV symptoms of dyspnea or angina. Multiple parameters of metabolic exercise were associated with a risk of death and the development of severe symptoms. On multivariate analyses, the independent predictors of death and severe symptoms were the severity of the left ventricular outflow tract gradient at rest and the percentage of predicted peak myocardial oxygen consumption achieved during exercise. For patients with a percentage of predicted peak myocardial oxygen consumption of <60%, the 4-year survival rate free of death and severe symptoms was only 59%. In conclusion, among patients with obstructive HC and mild or no symptoms, a low metabolic exercise capacity is associated with an increased risk of death and the subsequent development of severe symptoms.     

Usefulness of pet ownership as a modulator of cardiac autonomic imbalance in patients with diabetes mellitus, hypertension, and/or hyperlipidemia

Among patients with coronary artery disease, pet owners exhibit a greater 1-year survival rate than nonowners. Lifestyle-related diseases are well-known risk factors for coronary artery disease and induce imbalances in autonomic nervous activity. The purpose of the present study was to determine whether pet ownership modulates cardiac autonomic nervous activity imbalance in patients with lifestyle-related diseases such as diabetes mellitus, hypertension, and hyperlipidemia. A total of 191 patients (mean age 69 ± 8 years) were interviewed about their pet ownership status and were classified into pet owner and nonowner groups. After recording a 24-hour Holter electrocardiogram for heart rate variability analysis, frequency-domain and nonlinear-domain analyses were performed to determine the high-frequency (HF) and low-frequency (LF) components, LF/HF ratio, and entropy. The heart rate variability parameters were assessed for 24 hours, during the day (8.00 A.M. to 5.00 P.M.), and during the night (0:00 A.M. to 6.00 A.M.), and compared between the 2 groups. To evaluate the potential predictive factors for cardiac autonomic imbalance, univariate and multivariate analyses of HF and LF/HF were conducted for potential confounding variables. The pet owner group exhibited significantly greater HF(24h), HF(day), HF(night), entropy(24h), entropy(day), and entropy(night) and significantly lower LF/HF(24h) and LF/HF(night) compared to the nonowner group. On multivariate analysis, pet ownership was independently and positively associated with HF(24h,) HF(day), and HF(night) and inversely associated with LF/HF(24h) and LF/HF(night). In conclusion, these results suggest that pet ownership is an independent modulator of cardiac autonomic imbalance in patients with lifestyle-related diseases.     

AQP3、7、9在人下颌下腺的免疫组化定位

采用免疫组化ABC法检测源自10例颈淋巴清扫患者的正常下颌下腺组织AQP3、7、9蛋白的表达。AQP3在浆液性腺泡和黏液性腺泡细胞均有表达,分布于腺泡细胞的基底膜和侧膜,在浆液性腺泡细胞中的表达明显高于黏液性腺泡细胞,导管系统未见AQP3表达;AQP7在极少数肌上皮细胞有表达;AQP9在部分浆液性腺泡腔、混合性腺泡腔以及部分闰管管腔和浆液性半月体上有表达。