Usefulness of blood parameters, especially viscosity, for the diagnosis and elucidation of pathogenic mechanisms of the hand-arm vibration syndrome

In the present study it was found that, in vibrating-tool operators with Raynaud's phenomenon, whole blood viscosity was significantly higher than in operators without Raynaud's phenomenon at shear rates from 230 to 11.5 s-1. In addition rats were experimentally exposed to local vibration (60 Hz, 5 g) on their hind limbs for 4 h/d for 30 or 90 d. In the case of 30-d exposure, the small arteries in the exposed site did not change. However, after exposure for 90 d, disruption of the internal elastic lamina was observed in the small arteries. The disruption was followed by focal cell proliferation with regenerative formation of collagen and elastic fibers. The fibro-cellular thickening of the intima was further augmented, and, in addition, a complete stenosis of the small lumen of the small artery was observed. Medial thickness did not show significant differences between the control and exposed groups for either exposure duration. The whole blood viscosity was significantly increased by the 90-d but not by the 30-d exposure. These results suggest that there are some relationships between the increase in whole blood viscosity and the intimal thickening of some small arteries in the exposed site.     

Whole-pelvic volumetric-modulated arc therapy for high-risk prostate cancer: treatment planning and acute toxicity

The objectives of this study were to evaluate dosimetric quality and acute toxicity of volumetric-modulated arc therapy (VMAT) and daily image guidance in high-risk prostate cancer patients. A total of 100 consecutive high-risk prostate cancer patients treated with definitive VMAT with prophylactic whole-pelvic radiotherapy (WPRT) were enrolled. All patients were treated with a double-arc VMAT plan delivering 52 Gy to the prostate planning target volume (PTV), while simultaneously delivering 46.8 Gy to the pelvic nodal PTV in 26 fractions, followed by a single-arc VMAT plan delivering 26 Gy to the prostate PTV in 13 fractions. Image-guided RT was performed with daily cone-beam computed tomography. Dose–volume parameters for the PTV and the organs at risk (OARs), total number of monitor units (MUs) and treatment time were evaluated. Acute toxicity was assessed using the Common Terminology Criteria for Adverse Events, version 4.0. All dosimetric parameters met the present plan acceptance criteria. Mean MU and treatment time were 471 and 146 s for double-arc VMAT, respectively, and were 520 and 76 s for single-arc VMAT, respectively. No Grade 3 or higher acute toxicity was reported. Acute Grade 2 proctitis, diarrhea, and genitourinary toxicity occurred in 12 patients (12%), 6 patients (6%) and 13 patients (13%), respectively. The present study demonstrated that VMAT for WPRT in prostate cancer results in favorable PTV coverage and OAR sparing with short treatment time and an acceptable rate of acute toxicity. These findings support the use of VMAT for delivering WPRT to high-risk prostate cancer patients.     

Role of Maternal Antibodies in Infants with Severe Diseases Related to Human Parechovirus Type 3

Human parechovirus type 3 (HPeV3) is an emerging pathogen that causes sepsis and meningoencephalitis in young infants. To test the hypothesis that maternal antibodies can protect this population, we measured neutralizing antibody titers (NATs) to HPeV3 and other genotypes (HPeV1 and HPeV6) in 175 cord blood samples in Japan. The seropositivity rate (>1:32) for HPeV3 was 61%, similar to that for the other genotypes, but decreased significantly as maternal age increased (p<0.001). Furthermore, during the 2014 HPeV3 epidemic, prospective measurement of NATs to HPeV3 in 45 patients with severe diseases caused by HPeV3 infection showed low NATs (<1:16) at onset and persistently high NATs (>1:512) until age 6 months. All intravenous immunoglobulin samples tested elicited high NATs to HPeV3. Our findings indicate that maternal antibodies to HPeV3 may help protect young infants from severe diseases related to HPeV3 and that antibody supplementation may benefit these patients.     

Change in digital blood flow with simultaneous reduction in plasma endothelin induced by hand-arm vibration

Involvement of endothelium-derived relaxing factor (EDRF) or endothelium-derived constricting factor (EDCF) has been proposed as the pathophysiologic mechanism of vibration-induced white finger (VWF). Recent evidence that endothelin is a potent vasoconstrictor peptide indicates that it may play a role in vasoregulation during vibration exposure through the local actions of EDRF or EDCF. Therefore, we examined the effects of grasping (50 N) and hand-arm vibration (50 m/s² rms, 120 Hz, x-axis) on digital blood flow (DBF) and on the level of plasma endothelin in seven healthy male office workers. Grasping decreased DBF without affecting endothelin, and vibration increased DBF with a simultaneous reduction in endothelin. The grasping-induced decrease in DBF seemed to be due to mechanical compression of the vessels. The negative correlation between DBF and endothelin during vibration exposure suggests that a reduction in release of endothelin from smooth muscle into the vessel cavity during vibration leads to vasodilatation, possibly attributable to the local axon reflex.     

Effectiveness of an acellular pertussis vaccine in Japanese children during a non-epidemic period: a matched case-control study

The number of pertussis cases in Japan has decreased dramatically following the nationwide use of an acellular pertussis vaccine combined with diphtheria-tetanus toxoids (DTaP vaccines) which began in 1981. However, the effectiveness of the DTaP vaccine has not been systematically evaluated using appropriate epidemiological methods during a non-epidemic period in Japan. We evaluated the vaccine effectiveness (VE) of the Kaketsuken DTaP vaccine which contains two-component pertussis antigens in Japanese children from 1999 to 2001 using a matched case-control design and data from the Basic Resident Registration and Maternal and Child Health Handbooks. The DTaP vaccination history of 15 children with pertussis and 59 controls was obtained. The VE of 3 or 4 pertussis vaccinations compared with non-vaccination (baseline) was 96.9% for coughing attacks that lasted 7 days, 96.4% for those lasting 14 days, and 95.9% for those lasting 21 days. These findings suggest that DTaP vaccination effectively prevented pertussis during a non-epidemic period in Japan.     

Effectiveness of Comprehensive Health Education Combining Lifestyle Education and Hot Spa Bathing for Male White-Collar Employees: A Randomized Controlled Trial with 1-Year Follow-Up

Background

Physical activity is known to prevent obesity and metabolic syndrome in middle-aged and elderly people; however, the effectiveness of a comprehensive health education program for male white-collar employees is uncertain.

Methods

Forty-three men volunteered to participate in this study and were randomly assigned into 2 groups. The intervention group participated in a 2-hour program comprising comprehensive health education and hot spa bathing, offered once every 2 weeks, in addition to individualized programs once a week, for 24 weeks. The control group received only general health guidance. We compared their lifestyle characteristics and physical and mental health criteria at baseline, immediately after the intervention, and 1 year after the end of the intervention.

Results

Rates of adherence to individualized programs were 60.0 ± 27.2% and 30.5 ± 29.6% at the end of the intervention and at 1 year after the end of the intervention, respectively. Significant (P < 0.05) interaction of criteria was observed for cluster of differentiation 4+ (CD4+) cells and the ratio of cluster of differentiation 4+ to 8+ (CD4/8) cells, which were used to represent the participants'' immunological function. We divided the intervention group into 2 subgroups on the basis of their attendance. Among the resulting 3 groups, significant interaction of criteria was observed for CD4+ and CD4/8 cells. In addition, the high attendance group had the highest CD4+ count and CD4/8 ratio.

Conclusions

Participants who attended classes and/or performed the supplementary individualized programs tended to maintain their immunological function and to experience a decrease in body fat percentage. However, few effects were noted in participants with poor adherence, even in the intervention group.Key words: male, white-collar-employees, randomized controlled trial, lifestyle education, hot spa, and exercise     

Differential mechanisms underlie the regulation of serotonergic transmission in the dorsal and median raphe nuclei by mirtazapine: a dual probe microdialysis study

Rationale

Blockade of α₂ adrenoceptors and histamine H₁ receptors plays important roles in the antidepressant and hypnotic effects of mirtazapine.

Objectives

However, it remains unclear how mirtazapine’s actions at these receptors interact to affect serotonergic transmission in the dorsal (DRN) and median (MRN) raphe nuclei.

Method

Using dual-probe microdialysis, we determined the roles of α₂ and H₁ receptors in the effects of mirtazapine on serotonergic transmission in the DRN and MRN and their respective projection regions, the frontal (FC) and entorhinal (EC) cortices.

Results

Mirtazapine (<30 μM) failed to alter extracellular serotonin levels when perfused alone into the raphe nuclei, but when co-perfused with a 5-HT_1A receptor antagonist, mirtazapine increased serotonin levels in the DRN, MRN, FC, and EC. Serotonin levels in the DRN and FC were decreased by blockade and increased by activation of H₁ receptors in the DRN. Serotonin levels in the MRN and EC were not affected by H₁ agonists/antagonists perfused in the MRN. The increase in serotonin levels in the DRN and FC induced by DRN H₁ receptor activation was attenuated by co-perfusion with mirtazapine. Furthermore, the increase in serotonin levels (DRN/FC) induced by DRN α₂ adrenoceptor blockade was attenuated by concurrent DRN H₁ blockade, whereas the increase in serotonin levels (MRN/EC) induced by MRN α₂ adrenoceptor inhibition was unaffected by concurrent MRN H₁ receptor blockade.

Conclusion

These results suggest that enhanced serotonergic transmission resulting from α₂ adrenoceptor blockade is offset by subsequent activation of 5-HT_1A receptors and, in the DRN but not MRN, H₁ receptor inhibition. These pharmacological actions of mirtazapine may explain its antidepressant and hypnotic actions.     

Effects of an hERG Activator,ICA-105574, on Electrophysiological Properties of Canine Hearts

In short QT syndrome, inherited gain-of-function mutations in the human ether a-go-go-related gene (hERG) K⁺ channel have been associated with development of fatal arrhythmias. This implies that drugs that activate hERG as a side effect may likewise pose significant arrhythmia risk. hERG activators have been found to have diverse mechanisms of activation, which may reflect their distinct binding sites. Recently, the new hERG activator ICA-105574 was introduced, which disables inactivation of the hERG channel with very high potency. We explored characteristics of this new drug in several experimental models. Patch clamp experiments were used to verify activation of hERG channels by ICA-105574 in human embryonic kidney cells stably-expressing hERG channels. ICA-105574 significantly shortened QT and QTc intervals and monophasic action potential duration (MAP₉₀) in Langendorff-perfused guinea-pig hearts. We also administered ICA-105574 to anesthetized dogs while recording ECG and drug plasma concentrations. ICA-105574 (10 mg/kg) significantly shortened QT and QTc intervals, with a free plasma concentration of approximately 1.7 μM at the point of maximal effect. Our data showed that unbound ICA-105574 caused QT shortening in dogs at concentrations comparable to the half maximal effective concentration (EC₅₀, 0.42 μM) of hERG activation in the patch clamp studies.     

Addition of adult serum improves endothelium-dependent relaxation of organ-cultured rat mesenteric artery via inhibiting mitochondrial reactive oxygen species

Organ culture of blood vessels is a useful technique to investigate the long-term effects of drugs. Organ culture in a serum-free condition is so far the best way to maintain differentiated cell function. However some functional changes may occur from freshly isolated blood vessel (fresh) presumably due to lack of some key factors for vascular homeostasis in the medium. We investigated the long-term effects of addition of adult rat serum on acetylcholine-induced endothelium-dependent relaxation (EDR). Rat isolated mesenteric arteries were cultured for 3 days without (0% serum) or with 3% serum. In 0% serum, EDR was significantly impaired from fresh, whereas sodium nitroprusside-induced relaxation of smooth muscle didn't change. Addition of 3% serum significantly normalized the impaired EDR. Acute treatment with N-acetyl-l-cysteine or a mitochondrial inhibitor, rotenone normalized the impaired EDR in 0% serum. Mitochondrial superoxide production increased in the endothelium with 0% serum, which was normalized by 3% serum. Mitochondrial membrane potential increased in the endothelium with 0% serum, which was not normalized by 3% serum. In summary, the increased endothelial mitochondrial membrane potential in 0% serum may lead to mitochondrial reactive oxygen species (ROS) production and subsequent impairment of EDR. Addition of adult serum normalized the impaired EDR in part through inhibiting the increased mitochondrial ROS but not the membrane potential.     

Cell delivery system: a novel strategy to improve the efficacy of cancer immunotherapy by manipulation of immune cell trafficking and biodistribution

Tumor cells that generally accumulate mutations in the genome express molecules different both qualitatively and quantitatively from normal cells. An immunosurveillance system for these molecules, known as the tumor-associated antigens (TAAs), plays an important role in the elimination of cancer cells during the initial stage. Although cancer immunotherapy targeting TAAs has progressed steadily with the development of various vaccine strategies, satisfactory efficacy, such as marked tumor regression and complete response, has not been previously reported in a clinical setting. To improve the therapeutic effects of cancer immunotherapy, the application of chemokine-chemokine receptor coupling, which controls the trafficking and biodistribution of immune cells in the living body, is an attractive potential approach. This review introduces our novel "cell delivery system," which employs an Arg-Gly-Asp (RGD) fiber-mutant adenovirus vector encoding the chemokine or chemokine receptor gene in cancer immunotherapy.