Individual variation in the sequence of ages at peak velocity in seven body dimensions

Seven body dimensions of 35 Japanese children, 15 boys and 20 girls, were measured longitudinally at six-monthly intervals from 9 through 15 years of age. Spline curves were fitted to each dimension to obtain age at peak velocity and magnitude of peak velocity for each child. Ages at peak velocity for the seven dimensions were chronologically arranged within each individual, and the arrangement was labeled “sequence.” Kendall's rank order correlation coefficients among average and individual sequences were calculated to determine whether there was a regular order among individuals in ages at peak velocity of the seven dimensions. There were no sex differences in average sequences, but there was considerable variation among individual sequences. © 1994 Wiley-Liss, Inc.     

Effects of an ACE Inhibitor and a Calcium Channel Blocker on Cardiovascular Autonomic Nervous System and Carotid Distensibility in Patients with Mild to Moderate Hypertension

We investigated the relationship between cardiovascular autonomic nervous system function and carotid arterial distensibility during treatment with an angiotensin converting enzyme inhibitor (derapril) or a calcium channel blocker (manidipine) for hypertension. In 37 patients with hypertension, autonomic function was assessed by heart rate variability and baroreceptor sensitivity using phenylephrine injection. Left ventricular mass index and carotid arterial distensibility were assessed by ultrasound examinations. Before the medication, both baroreceptor sensitivity and heart rate variability correlated with carotid arterial distensibility, but not with left ventricular mass index by multiple regression analysis. Subsequently, patients were randomly allocated into two groups, derapril (n = 18) and manidipine (n = 19) for 20 weeks. At the end of the study, the change in baroreceptor sensitivity correlated with change in carotid arterial distensibility (r = 0.41, P < .05), but not with change in left ventricular mass index. Although derapril and manidipine decreased blood pressure and left ventricular mass index to the same extent, the former improved heart rate variability, baroreceptor sensitivity (5.0 ± 1.9 → 5.6 ± 2.0 msec/mm Hg), and carotid arterial distensibility (2.1 ± 0.8 → 2.5 ± 1.0 %kPa), but the latter did not improve them at all. Thus, impairment of the autonomic balance was related to the impairment of carotid arterial distensibility in hypertension; derapril, but not manidipine, significantly improved these abnormalities.     

Membranous and Soluble Forms of Fas Antigen in Cutaneous Lupus Erythematosus

The role of Fas-mediated apoptosis in cutaneous lupus erythematosus (LE) is still unclear, although the Fas/FasL system has been investigated in autoimmune diseases in relation to impaired apoptosis. In order to elucidate the connections between acute cutaneous LE (ACLE) and chronic cutaneous LE (CCLE), we determined the expression of membranous Fas antigen (mFas) on peripheral blood mononuclear cells (PBMC) by flow cytometry and the levels of the soluble form of the Fas antigen (sFas) in sera. The ratio and the mean fluorescence intensity of mFas were much higher in ACLE patients than in others, including patients with CCLE and atopic dermatitis and normal healthy controls. The levels of sFas in ACLE and CCLE patients were also elevated, and there was a significant increase in sFas levels in ACLE patients over that in CCLE patients. Immunohistochemical studies revealed that Fas antigen was predominantly expressed on infiltrating cells around blood vessels and appendages in ACLE and CCLE patients. Based on these findings, it is suggested that the expression of Fas antigen is closely associated with the activation of circulating lymphocytes, especially in ACLE patients, but is not directly associated with keratinocyte damage.     

7-Nitroindazole, a selective inhibitor of neuronal nitric oxide synthase: effect on sevoflurane MAC and cerebellar cyclic GMP in mice

Purpose Considerable evidence suggests that nitric oxide (NO) plays a role in synaptic transmission in the central and peripheral nervous systems. However, whether inhibition of NO synthesis decreases minimum alveolar concentration (MAC) of inhalational anesthetics is controversial. We examined the effects of 7-nitroindazole (7-NI), a selective inhibitor of neuronal NOS (nNOS), on the MAC of sevoflurane and cerebellar cyclic guanosine monophosphate (cGMP) levels in mice. Methods Sevoflurane MAC and cerebellar cGMP levels were determined in mice after acute intraperitoneal or weeklong gavage feeding of 7-NI. Sevoflurane MAC and cerebellar cGMP levels after chronic treatment were measured on days 1, 4, and 7 and were repeated after an acute intraperitoneal dose of nitro ^g -l-arginine methylester (l-NAME). Results Acute and chronic treatment with 7-NI decreased the sevoflurane MAC by 20%–30%. Reduction of cerebellar cGMP levels was greater after intraperitoneal administration of NOS inhibitors than after gavage feeding of 7-NI. Conclusion Acute or chronic selective inhibition of neuronal NOS decreases the sevoflurane MAC and cerebellar cGMP levels in mice. 7-NI permitted probing of the role of NO in perception of noxious stimuli.     

Intracoronary Optical Frequency Domain Imaging for Identifying Stent-Related Complications

Percutaneous coronary intervention is the most common treatment of coronary artery disease with the majority of cases undergoing stent implantation. Furthermore, adequate stent deployment is of primary importance to avoid late stent thrombosis and achieve a favorable clinical outcome. Optical coherence tomography (OCT) is a new imaging modality that utilizes advanced photonics and fiberoptics to obtain intravascular images on a microscopic scale. Today, many new drug-eluting stents (DES) are now undergoing clinical trials. Moreover, the intricacies of stent design, local pharmacology, tissue biology, and rheology preclude an intuitive understanding of usability of DES. After stent implantation, assessment should include both the acute and chronic stent/vessel-related changes which include stent malapposition, tissue prolapse, edge dissections, and thrombus formation. OCT plays an indispensable part in determining mechanistic information on the relevance of these phenomena among each DES that cannot be covered by several other modalities.     

Intravenous patient-controlled analgesia (IV-PCA) for relief of postoperative pain

Intravenous patient-controlled analgesia (IV-PCA) using opioids such as morphine and fentanyl can be an effective analgesic method for post-operative pain that is resistant to conventional administration of narcotic analgesics and nonsteroidal anti-inflammatory drugs, and where epidural block and peripheral nerve block are not feasible. In addition to post-operative pain relief, IV-PCA can facilitate early ambulation, reduce respiratory complications, and increase patient satis-faction. However, respiratory and circulatory depression, and post-operative nausea and vomiting (PONV) often occur as side effects of IV-PCA with opioids. Administration of droperidol can be an effective treatment for PON.     

Use of doubly labeled water to validate a physical activity questionnaire developed for the Japanese population

Background

No study has attempted to use the doubly labeled water (DLW) method to validate a physical activity questionnaire administered to a Japanese population. The development and refinement of such questionnaires require that physical activity components related to physical activity level be examined.

Methods

Among 226 Japanese men and women 20 to 83 years of age, total energy expenditure (TEE) was assessed using the Japan Arteriosclerosis Longitudinal Study Physical Activity Questionnaire (JALSPAQ), and the results were compared with TEE measured by the DLW method as a gold standard. Resting metabolic rate (RMR) was measured using the Douglas Bag method.

Results

The median TEE by DLW and physical activity level (PAL: TEE/RMR) were 11.21 MJ/day and 1.88, respectively, for men, and 8.42 MJ/day and 1.83 for women. JALSPAQ slightly underestimated TEE: the differences in mean and standard error were −1.15 ± 1.92 MJ/day. JALSPAQ and DLW TEE values were moderately correlated (Spearman correlation = 0.742, P < 0.001; intraclass correlation coefficient = 0.648, P < 0.001), and the 95% limit of agreement was −4.99 to 2.69 MJ. Underestimation of TEE by JALSPAQ was greater in active subjects than in less active subjects. Moderate and vigorous physical activity and physical activity during work (ie, occupational tasks and housework) were strongly related to physical activity level. However, the physical activity components that differentiated sedentary from moderately active subjects were not clear.

Conclusions

Physical activity level values on JALSPAQ and DLW were weakly correlated. In addition, estimation of TEE in active subjects should be improved, and the use of a questionnaire to differentiate activity in sedentary and moderately active subjects must be reassessed.Key words: physical activity questionnaire, doubly labeled water, physical activity, energy expenditure     

Validity of predictive equations for basal metabolic rate in Japanese adults

Many predictive equations for basal metabolic rate (BMR) based on anthropometric measurements, age, and sex have been developed, mainly for healthy Caucasians. However, it has been reported that many of these equations, used widely, overestimate BMR not only for Asians, but also for Caucasians. The present study examined the accuracy of several predictive equations for BMR in Japanese subjects. In 365 healthy Japanese male and female subjects, aged 18 to 79 y, BMR was measured in the post-absorptive state using a mask and Douglas bag. Six predictive equations were examined. Total error was used as an index of the accuracy of each equation's prediction. Predicted BMR values by Dietary Reference Intakes for Japanese (Japan-DRI), Adjusted Dietary Reference Intakes for Japanese (Adjusted-DRI), and Ganpule equations were not significantly different from the measured BMR in either sex. On the other hand, Harris-Benedict, Schofield, and Food and Agriculture Organization of the United Nations/World Health Organization/United Nations University equations were significantly higher than the measured BMR in both sexes. The prediction error by Japan-DRI, Adjusted-DRI, and Harris-Benedict equations was significantly correlated with body weight in both sexes. Total error using the Ganpule equation was low in both males and females (125 and 99 kcal/d, respectively). In addition, total error using the Adjusted-DRI equation was low in females (95 kcal/d). Thus, the Ganpule equation was the most accurate in predicting BMR in our healthy Japanese subjects, because the difference between the predicted and measured BMR was relatively small, and body weight had no effect on the prediction error.     

Distribution and frequency of thin-capped fibroatheromas and ruptured plaques in the entire culprit coronary artery in patients with acute coronary syndrome as determined by optical coherence tomography

The aim of this study was to investigate the distribution and frequency of thin-capped fibroatheromas (TCFAs) within the entire length of culprit coronary arteries in patients with acute coronary syndrome. Our population was drawn from 43 consecutive patients with acute coronary syndrome (with or without ST-segment elevation) who underwent optical coherence tomography to visualize the entire culprit coronary artery using a nonocclusive optical coherence tomographic technique. Patients were categorized divided into a TCFA group or a no-TCFA group on the basis of the optical coherence tomographic findings. There were no differences in baseline characteristics or angiographic findings between the 2 groups. High-sensitive C-reactive protein in the TCFA group was significantly higher than in the no-TCFA group (median 3.3 mg/L, interquartile 3.1, vs 1.7 mg/L, interquartile 2.2, p = 0.03). Plaque rupture was found in 28 patients (65%) and multiple plaque ruptures in 5 patients (12%). Optical coherence tomogram revealed 21 TCFAs in 18 patients (42%). Multiple TCFAs were found in the same vessel in 3 patients (7%). The distribution of TCFAs in the right coronary arteries of our subject population was relatively even (proximal 2 [12%], mid 5 [29%], distal 3 [18%], p = 0.42), whereas TCFAs in the left anterior descending artery were common in proximal sites (proximal 6 [27%], mid 2 [9%], distal 0, p = 0.018). In conclusion, the use of optical coherence tomography to look for TCFAs and identify their distribution when combined with C-reactive protein may contribute to forming a strategy for preventing impending coronary events.