Protective Mechanism of High-Density Lipoprotein against Endotoxemia in Chronic Alcohol Ingestion

In the present study, we evaluated the role of high-density lipoprotein (HDL) as an endotoxin-binding protein in chronically alcohol-fed rats. Although the blood endotoxin level was significantly elevated in chronic ethanol-loaded rats, compared with control rats, serum tumor necrosis factor (TNF), ALT, and lactate dehydrogenase were not elevated. Serum HDL and its endotoxin-binding capacity were significantly increased in chronic ethanol-loaded rats. When Kupffer cells isolated from control and chronic ethanol-loaded rats were cultured in the medium containing 3 to 30 mg/dl HDL and endotoxin (500 ng/ml), endotoxin uptake and TNF production of Kupffer cells were decreased in proportion to the concentration of HDL in the medium. These results suggest that the increase in endetoxin-binding capacity of HDL may serve as a protective mechanism against endotoxin in chronic ethanol-loaded rats.     

Changes in urinary zinc and copper with strenuous physical exercise

BACKGROUND: Air rescue trainees in the Japan Air Self Defense Force participate in a curriculum that includes 24 wk of strenuous physical training. The trace minerals zinc and copper are directly involved in many physiologic processes that are altered by physical exercise of this sort. It has also been demonstrated that urinary excretion of catecholamines (adrenaline and noradrenaline) increases during both mental work and physical exercise. HYPOTHESIS: Air rescue trainees will exhibit changes in trace mineral excretion and catecholamine levels that vary with the type of training undertaken. METHODS: The levels of urinary zinc (Zn), copper (Cu), noradrenaline (NAd), and adrenaline (Ad) were determined in 11 air rescue trainees before and after daily training sessions for consecutive 3- or 4-d periods during four phases of the curriculum, as follows: control (Cont), classroom instruction without physical exercise; preliminary (Prelim), daily exercise sessions for increased physical strength; basic (Basic), a combination of lectures and demanding physical exercise; and simulated mountain rescue (Sim). RESULTS: The mean urinary concentrations of Zn and Cu increased significantly after sessions with physical exercise (Prelim, Basic, and Sim), but remained unchanged for Cont. The NAd levels also increased significantly after training with physical exercise. In contrast, Ad levels increased significantly after sessions in all phases, both with and without physical exercise. CONCLUSIONS: The urinary levels of Zn, Cu, NAd, and Ad rose with strenuous exertion, whereas only Ad responded to both physical and mental tasking.     

Clinical results and issues of acute myeloid leukemia in elderly patients aged 75 years and older

Aim: Clinical outcomes of acute myeloid leukemia (AML) in elderly patients still remain unsatisfactory and the optimal treatment has yet to be clearly established. This report describes the results of a retrospective study of clinical outcomes and prognostic factors of AML in patients aged 75 years and older. In addition, we aimed to elucidate the situation of patients with AML accompanied by dementia, which has been largely ignored in previous studies. Methods: The subjects consisted of 31 patients with untreated AML (including previous myelodysplastic syndrome: AML/MDS). All patients underwent chemotherapy, with 25 undergoing conventional therapy and six undergoing low‐intensity therapy. Results: Complete remission was obtained in 16 of the 31 cases (51.6%), with a 3‐year survival rate of 11.5%. However, in seven cases, Alzheimer's disease (AD) was observed. Although we were able to perform induction therapy in each of these cases, consolidation therapy was difficult in cases of moderate AD. Conclusion: The results of this study suggest that even very elderly patients can benefit from chemotherapy. However, it is thought that the treatment selection for cases which are complicated by moderate to severe dementia should be determined carefully while considering the patient's quality of life. Geriatr Gerontol Int 2011; 11: 290–296 .     

An elderly autopsy case of chronic myelomonocytic leukemia with infiltration of a giant liver cyst and multiple organs

A 78-year-old man was referred to his local hospital at the beginning of July 2006 with low grade fever and cough, and was admitted on August 22 with pneumonia. Hematology tests on admission revealed leukocytosis, anemia, and thrombocytopenia, so he was subsequently transferred to our hospital on August 24. A diagnosis of chronic myelomonocytic leukemia (CMML) was made from the hematological findings and he was given hydroxycarbamide from September 7. Seventeen days later, abdominal CT revealed hemorrhage into a giant liver cyst, as well as both intraabdominal and intrathoracic hemorrhage. He died of hemorrhagic shock on September 25. Autopsy showed extensive infiltration of myelomonocytic leukemic cells into the walls of the liver cyst, as well as the pleura and multiple other organs. In summary, we report an elderly autopsy case of CMML with infiltration of a giant liver cyst and multiple organs.