Ventilatory efficiency during ramp exercise in relation to age and sex in a healthy Japanese population

BackgroundThe current understanding of ventilator efficiency variables during ramp exercise testing in the normal Japanese population is insufficient, and the responses of tidal volume (VT) and minute ventilation (V?E) to the ramp exercise test in the normal Japanese population are not known.MethodsA total of 529 healthy Japanese subjects aged 20–78 years underwent cardiopulmonary exercise testing using a cycle ergometer with ramp protocols. VT and V?E at rest, at anaerobic threshold, and at peak exercise were determined. The slope of V?E versus carbon dioxide (V?CO₂) (V?E vs. V?CO₂ slope), minimum V?E/V?CO₂, and oxygen uptake efficiency slope (OUES) were determined.ResultsFor males and females in their 20 s, peak VT (VTpeak) was 2192 ± 376 and 1509 ± 260 mL (p < 0.001), peak V?E (V?Epeak) was 80.6 ± 18.7 and 57.7 ± 13.9 L/min (sex differences p < 0.001), the V?E vs. V?CO₂ slope was 24.4 ± 3.2 and 25.7 ± 3.2 (p = 0.035), the minimum V?E/V?CO₂ was 24.2 ± 2.3 and 27.0 ± 2.8 (p < 0.001), and the OUES was 2452 ± 519 and 1991 ± 315 (p < 0.001), respectively. VTpeak and V?Epeak decreased with age and increased with weight and height. The V?E vs. V?CO₂ slope and minimum V?E/V?CO₂ increased with age, while conversely, the OUES decreased with age.ConclusionsWe have established the normal range of VT and V?E responses, the V?E vs. V?CO₂ slope, the minimum V?E/V?CO₂, and the OUES for a healthy Japanese population. Some of these parameters were influenced by weight, height, sex, and age. These results provide useful reference values for interpreting the results of cardiopulmonary exercise testing in cardiac patients.     

HLA analysis of immune checkpoint inhibitor-induced and idiopathic isolated ACTH deficiency

Pituitary - Isolated adrenocorticotropic hormone deficiency is a rare disease; however, since immune check point inhibitors (ICIs) have become widely used, many more cases have been reported. In...     

Tumor promoting activity of teleocidin in skin and forestomach of mice initiated transplacentally with 7,12-dimethylbenz(a)anthracene

Summary Experiments on the effect of transplacental initiation with 7,12-dimethylbenz(a)anthracene (DMBA) and postnatal promotion with teleocidin were carried out in mice. The percentage of tumorbearing mice among females treated with DMBA transplacentally on day 17 of gestation and postnatally by topical application of teleocidin to the skin of the back was 73.3% in week 30, whereas that among females treated with DMBA on day 10 of gestation and postnatally by topical application of teleocidin was 20.0%. This indicates that teleocidin shows potent tumor promoting activity on mouse skin in a transplacental initiation and postnatal promotion protocol.Furthermore, in the males treated with DMBA transplacentally on day 17 of gestation and given diet containing 0.01% teleocidin postnatally five tumors of the forestomach were found in 5 of 19 effective mice (26.3%) in week 52. One of these five tumors was a squamous cell carcinoma, and the others were papillomas. This indicates that teleocodin also has tumor promoting activity in the forestomach of mice.Dedicated to Professor Erich Hecker on the occasion of his 60th birthday     

Evaluation of the depth score of type V pit patterns in crypt orifices of colorectal neoplastic lesions

Background We developed and evaluated the clinical usefulness of a scoring system that subclassified type Vi pit patterns. Methods We studied 119 colon cancer lesions (pTis, n = 26; pT1, n = 93) and 22 tubular adenoma lesions with severe atypia in which a type Vi pit pattern was visible under a stereomicroscope. Four type Vi pit pattern formation appearances (existing pits, marginal irregularities of the gland duct, narrowing of the gland duct lumen, and unclear outline of the gland duct) were defined, and the relationship between each appearance and the invasive depth of the cancer was evaluated. Results When the four type Vi pit pattern appearances were considered in a logistic regression analysis, the odds of a more invasive submucosal cancer were significantly increased by the appearance of marginal irregularities, a narrowed lumen, and an unclear outline. In the logistic regression analysis results, when 0.63 was used as the cutoff score for prediction of a more invasive submucosal cancer, 80 cases in the less invasive group were classified correctly (specificity, 1.0), whereas 53 (86.9%) of the 61 cases in the more invasive group were classified correctly (sensitivity, 0.869). Conclusions It is important first to understand the usability and limitations of objective scoring of type V pit pattern findings and then to apply this score to the determination of cancer depth in order to accurately identify lesions suitable for endoscopic treatment.     

Correlation between serum phospholipase A(2) IIA levels and histological activity in patients with ulcerative colitis

BACKGROUND AND AIMS: Phospholipase A(2) (PLA(2)) participates in the regulation of phospholipid metabolism and biosynthesis of eicosanoids, serum levels of PLA(2) are suggested to reflect the disease activity in patients with ulcerative colitis (UC). We examined the relationship between histological disease activity and serum levels of PLA(2) IIA and also clarified mucosal production sites of PLA(2) IIA by immunohistochemistry. PATIENTS AND METHODS: Serum samples from 44 patients with UC, 125 with Crohn's diseases (CD), and 68 controls were studied. Biopsy specimens of colonic mucosa obtained from 23 patients with UC were used for assessment of histological activity. The histological score was determined active (1) or inactive (0), and the sum of each histological score from ten segments of the large intestine was assessed as disease activity. The levels of PLA(2) IIA in sera were measured by a radioimmunoassay kit using a specific monoclonal antibody; immunohistochemical study was performed using the same monoclonal antibody. RESULTS: The serum PLA(2) IIA levels in patients with UC and CD were significantly higher than those of controls. Serum PLA(2) IIA levels in UC were closely correlated with histological disease activity. Immunohistochemical study showed the production of PLA(2) IIA by the polymorphonuclear cells, macrophages, and colonic epithelial cells. CONCLUSION: Serum PLA(2) IIA is a good candidate for assessing disease activity in UC as one of clinical laboratory tests.     

Myeloid/Natural Killer Cell Precursor Acute Leukemia Accompanied by Homozygous Protein C Deficiency

A patient with myeloid/natural killer (NK) cell precursor acute leukemia who was also homozygous for protein C deficiency was treated and showed a complete remission while he simultaneously received low molecular weight heparin. He presented with fever spikes, lymphadenopathy, and a bulky tumor of the anterior mediastinum. A bone marrow aspirate showed the infiltration of immature lymphoblastoid cells. The patient's diagnosis was determined to be myeloid/NK cell precursor acute leukemia by morphologic and immunophenotypic analysis (CD7(+)CD33(+)CD34(+)CD56(+)). The patient developed a thrombosis in his jugular vein on cannulation of the internal jugular vein. An examination of the serum levels and the activities of proteins C and S demonstrated a slight decrease in the protein C level but an undetectable protein C activity. The patient received the diagnosis of homozygous protein C deficiency, because both parents were found to have heterozygous protein C activity. Treatment of the patient's leukemia included induction chemotherapy (Ara-C and idarubicin) with concomitant administration of low molecular weight heparin for his homozygous protein C deficiency. He achieved a complete remission without expressing any thrombosis during the course of chemotherapy. To our knowledge, this is the first case ever described in which acute myeloid leukemia was complicated with homozygous protein C deficiency.     

Do low birth weight infants not see eyes? Face recognition in infancy

BackgroundProgress in neonatal medicine has dramatically improved the survival rate of preterm births, but the evidence suggests that these low-birth weight infants (LBWIs) go on to develop pervasive development disorders and attention deficit hyperactivity disorder (ADHD) at greater rates than the general population. Children with neurodevelopmental disorders are known to suffer from deficits in visual cognition, such as in face perception and attentional functions, the characteristics of which already manifest in early infancy.PurposeThis study aimed to investigate visual cognition in LBWIs during infancy.Subjects20 LBWIs and 20 normal-birth-weight infants (NBWIs: control) of age 9–10 months (corrected age was used for LBWIs).MethodChildren were held seated in front of an eye tracking system by a parent, and presented with facial photos as visual stimuli. During the familiarization phase, the child was presented with two images of the same human face (familiarization stimulus) on the left and right side of a display screen (5 × 10 s trials). Next, during the test phase, the child was presented with the same image on one side of the screen, and a photo of a different person’s face (novel stimulus) on the other (2 × 5 s trials). Gaze behavior was assessed in terms of the total time spent looking at either facial stimulus, and specifically at the eyes of the stimuli, as well as the number of attentional shifts between stimuli, and novelty preference.Results/DiscussionLBWIs spent significant less time looking at facial stimuli overall, and less time at the eye region, than NBWIs. These findings seem to evidence developmental differences in functions related to visual cognition.