Aging Combined with High Waist-to-Hip Ratio Is Associated with a Higher Risk of Gastro-Esophageal Reflux Disease

Background and Objective: To assess whether the combination of high waist-to-hip ratio (WHR) and elderly age is associated with higher risk of GERD. Material and Methods: A total of 16,996 subjects aged ≥20 years who received esophagogastroduodenoscopy (EGD) between January 2010 and December 2019. We evaluated the risk of GERD in different age groups and WHR groups in unadjusted analysis and multivariate logistic regression models for predictors of GERD. Results: There was a trend towards more participants with both age ≥65 years and WHR ≥ 1 (n = 129) (n = 66, 51%) than participants with age < 65 and WHR < 0.9 (n = 10,422) (n = 2814, 27%) presenting with GERD. Participants who had both age ≥ 65 years and high WHR ≥ 1 had the highest risk of any type of GERD (adjusted OR, 2.07; 95% CI, 1.44−2.96, p value < 0.05) based on multivariate logistic regression analysis. Conclusions: The combination of having a high WHR and being elderly was associated with a higher risk of GERD, and preventing central obesity in the elderly population reduced the risk of GERD and the requirement for medical resources.

Risk assessment indicators and brachial-ankle pulse wave velocity to predict atherosclerotic cardiovascular disease

Brachial-ankle pulse wave velocity (baPWV) is used for predicting the severity of vascular damage and prognosis of atherosclerotic cardiovascular disease (ASCVD) in people with hypertension and diabetes mellitus. This correlation study aimed to compare the baPWV with other risk indicators for identification of subclinical vascular disease for primary prevention and to determine the clinical utility of baPWV-guided therapy in improving prognosis in high-risk subjects. We included 4881 subjects who underwent voluntary health examination at Mackay Memorial Hospital, Taiwan between 2014 and 2019. Participants were categorized into the low-risk (<5%), borderline-risk (5%-7.4%), intermediate-risk (7.5%-19.9%), and high-risk (≥20%) groups based on the 10-year risk for ASCVD. The predictive risk criteria, that is, the metabolic syndrome score, Framingham Risk Score, estimated glomerular filtration rate, and baPWV were compared among these groups. The chief cause of induced responses and the relationships between parameters were identified using principal component analysis. The participants' ages, body mass index, systolic, diastolic blood pressure, triglycerides, fasting glucose, hemoglobin A1c, creatinine, neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, metabolic syndrome, Framingham Risk Score, and age-related arterial stiffness (vascular age) increased significantly from the low-risk to high-risk groups (P < .001). The mean estimated glomerular filtration rate decreased significantly from the low- to high-risk groups (P < .001). The predicted vascular age and actual age differed significantly between the intermediate- and high-risk groups (P < .001). High-density lipoprotein levels plummeted significantly among the 4 groups (P < .001). The right and left baPWV and ankle brachial index differed significantly among the 4 groups (all P < .001) and increased from the low-risk to high-risk groups (P < .001). Carotid Doppler ultrasonography revealed a significant increase in plaque formation (23.5%, 35.4%, 46.3%, and 61.5% for the low-, borderline-, intermediate, and high-risk groups, respectively). The total explanatory variation was 61.9% for 2 principal variation factors (baPWV, 36.8% and creatinine, 25.1%). The vascular age predicted using baPWV greatly exceeded the chronological age. Plaque formation was significant even in the low-risk group, and its frequency increased with the predicted ASCVD risk. Risk indicators and baPWV are useful predictors of ASCVD, which in conjunction with conventional pharmacotherapy could be useful for primary prevention of plaque formation in subjects with cardiovascular comorbidities.

Helicobacter pylori infection and increased diabetes prevalence were the risks of colorectal adenoma for adults: A systematic review and meta-analysis (PRISMA-compliant article)

BACKGROUND

Helicobacter pylori infection and hyperglycemia are associated with an increased risk of colorectal neoplasm, and may have a synergistic effect in combination. However, these 2 factors that affect colorectal neoplasm remain controversial. We aimed to carry out a meta-analysis to evaluate the study population diabetes prevalence rate and H pylori infection rate with colorectal adenoma risk for adults.

METHODS

We conducted systemic research through English databases for medical reports. We also recorded the diabetes prevalence and H pylori infection prevalence in each study. We classified these studies into 4 subgroups as their background population diabetes prevalence <6% (Group 1); between 6% and 8% (Group 2); between 8% and 10% (Group 3), and more than 10% (Group 4). The random-effects model had used to calculate pooled prevalence estimates with 95% confidence interval (CI).

RESULTS

Twenty-seven studies were finally eligible for meta-analysis. The random-effects model of the meta-analysis was chosen, showing pooled odds ratio (OR) equal to 1.51 (95% CI 1.39-1.63). The subgroup meta-analyses showed in Group 1 the H pylori infection associated colorectal adenoma risk OR was 1.24 (95% CI 0.86-1.78). As the diabetes rate exceed 6%, the H pylori infection became the more significant increased risk of colorectal adenoma (Group 2: OR 2.16 (95% CI 1.61-2.91); Group 3: OR 1.40 (95% CI 1.24-1.57); and Group 4: OR 1.52 (95% CI 1.46-1.57)).

CONCLUSIONS

The results of this meta-analysis showed elevated diabetes prevalence combined H pylori infection increasing the risks of colorectal adenoma in the adult population.

Gut-flora metabolites is not associated with synchronous carotid artery plaque and non-alcoholic fatty liver disease in asymptomatic adults: A STROBE-compliant article

Synchronous non-alcoholic fatty liver disease (NAFLD) and carotid artery plaque formation increase the risk of mortality in patients with cardiovascular disease (CVD). Metabolic status and host gut flora are associated with NAFLD and CVD, but the risk factors require further evaluation.To evaluate the risk factors associated with NAFLD and CVD, including gut-flora-related examinations.This cross-sectional study included 235 subjects aged over 40 years who underwent abdominal ultrasound examination and carotid artery ultrasound examination on the same day or within 12 months of abdominal ultrasound between January 2018 and December 2019. All subjects underwent blood tests, including endotoxin and trimethylamine-N-oxide.The synchronous NAFLD and carotid artery plaque subjects had a higher proportion of men and increased age compared with those without NAFLD and no carotid artery plaque. The synchronous NAFLD and carotid artery plaque group had increased body mass index (BMI), blood pressure, hemoglobin A1C (5.71% vs 5.42%), triglyceride (TG) (164.61 mg/dL vs 102.61 mg/dL), and low-density lipoprotein (135.27 mg/dL vs 121.42 mg/dL). In multiple logistic regression analysis, increased BMI, mean systolic blood pressure, and TG > 110 mg/dL were independent risk factors for synchronous NAFLD and carotid artery plaque formation. Endotoxin and trimethylamine-N-oxide levels were not significantly different between the 2 groups.Host metabolic status, such as elevated BMI, TG, and systolic blood pressure, are associated with synchronous NAFLD and carotid artery plaque in asymptomatic adults. Aggressive TG control, blood pressure control, and weight reduction are indicated in patients with NAFLD.

914 A Comparison of Mortality, Indicators of Treatment Success and Complications of Resuscitative Endovascular Balloon Occlusion of Aorta (REBOA): A Systematic Review and Meta-Analysis

Introduction

This study aims to provide an updated review on in-hospital mortality rates in patients who underwent Resuscitative Endovascular Balloon Occlusion of Aorta (REBOA) versus Resuscitative thoracotomy (RT) or standard care without REBOA, to identify potential indicators of REBOA use and complications.

Method

Cochrane and PRISMA guidelines were used to perform the study. A literature search was done from 01 January 2005 to 30 June 2020 using EMBASE, MEDLINE and COCHRANE databases. Meta-analysis was conducted using a random effects model and the DerSimonian and Laird estimation method.

Results

25 studies were included in this study. The odds of in-hospital mortality of patients who underwent REBOA compared to RT was 0.18 (p &lt; 0.01). The odds of in-hospital survival of patients who underwent REBOA compared to non-REBOA was 1.28 (p = 0.62). There was a significant difference found between survivors and non-survivors in terms of their pre-REBOA systolic blood pressure (SBP) (19.26 mmHg, p &lt; 0.01), post-REBOA SBP (20.73 mmHg, p &lt; 0.01), duration of aortic occlusion (-40.57 mins, p &lt; 0.01) and ISS (-8.50, p &lt; 0.01). Common complications of REBOA included acute kidney injury, multi-organ dysfunction and thrombosis.

Conclusions

Our study demonstrated lower in-hospital mortality of REBOA versus RT. Prospective multi-centre studies are needed for further evaluation of the indications, feasibility, and complications of REBOA.

Digital Image Analysis of CD8+ and CD3+ Tumor-Infiltrating Lymphocytes in Tongue Squamous Cell Carcinoma

Purpose

The presence of CD8+ tumor-infiltrating lymphocytes (TILs) has been reported to be associated with treatment outcomes in many types of solid tumors. However, the results vary due to the various methods of visual estimation and subjective interpretation. The current study is the first to use digital image analyses to evaluate the density of CD8+/CD3+ TILs in tongue squamous cell carcinoma (TSCC).

Patients and Methods

From 2005 to 2015, a cohort of 258 TSCC patients were consecutively enrolled in this study. After immunohistochemistry on representative sections, the density of CD8+/CD3+ TILs at tumor invasive margins was evaluated by digital image analysis. The subjects were stratified by the median values of CD3+ cell density, CD8+ cell density, CD8/CD3, and scores (0, 1, and 2) to demonstrate the association with various clinicopathological manifestations.

Results

Low CD8+ TIL counts were associated with advanced tumor stages (p=0.034), and low CD8/CD3 ratios were associated with perineural invasion (p=0.043). Both parameters were also associated with increased tumor depths (p=0.034 and 0.004, respectively). Univariate analyses revealed that advanced tumor stages, perineural invasion, extranodal extension, tumor depth, lower CD8 counts, and lower scores (score 0 vs 2) were associated with poorer overall survival, and multivariate analysis further indicated that extranodal extension and low scores (score 0 vs 2) were both independent factors for overall survival (p < 0.0001 and p = 0.0369, respectively).

Conclusion

The use of digital image analysis to assess CD8+ TILs at the invasive margins provides an objective indicator of prognoses including overall survival.

Neutrophil-to-lymphocyte ratio as a predictive marker of metabolic syndrome

Neutrophil-to-lymphocyte ratio (NLR) serves as a strong prognostic indicator for patients suffering from various diseases. Neutrophil activation promotes the recruitment of a number of different cell types that are involved in acute and chronic inflammation and are associated with cancer treatment outcome. Measurement of NLR, an established inflammation marker, is cost-effective, and it is likely that NLR can be used to predict the development of metabolic syndrome (MS) at an early stage. MS scores range from 1 to 5, and an elevated MS score indicates a greater risk for MS. Monitoring NLR can prevent the risk of MS.A total of 34,013 subjects were enrolled in this study. The subjects (score 0-5) within the 6 groups were classified according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria, and all anthropometrics, laboratory biomarkers, and hematological measurements were recorded. For the 6 groups, statistical analysis and receiver operating characteristic (ROC) curves were used to identify the development of MS.Analysis of the ROC curve indicated that NLR served as a good predictor for MS. An MS score of 1 to 2 yielded an acceptable discrimination rate, and these rates were even higher for MS scores of 3 to 5 (P < .001), where the prevalence of MS was 30.8%.NLR can be used as a prognostic marker for several diseases, including those associated with MS.

Targeting and Immobilization of Bioactive Peptides on Dentin Matrix

The regeneration of structurally/functionally competent tooth root cementum is a critical step for the successful restoration of periodontal attachment. In this study, we tested whether a poly-glutamic acid-rich domain and glutamine-containing transglutaminase substrate can be used to target biologically active peptides to the mineralized root matrix and to bind such peptides covalently to the organic matrix. As a biologically active model molecule, the integrin-binding motif, RGD, was used. The effects of immobilization of such synthetic peptides to the dentin matrix on cementoblastic adhesion in vitro and cementogenesis in vivo were studied. In vitro, cementoblastic adhesion improved significantly when the dentin surface contained covalently bound peptides. In vivo, this bound peptide significantly increased cementum formation compared with that attained in control conditions. Transglutaminase-catalyzed covalent binding of bioactive peptides targeted to mineralized collagenous dentin matrix via the poly-glutamate domain can be readily achieved. This approach offers potential for clinical use in periodontal regeneration.

Effects of health intervention program on cardiometabolic risk profiles from health evaluation center in Asian population: a longitudinal study and propensity analysis

Background

Health intervention program (HIP) based on diet and lifestyle modifications had been shown to improve cardiovascular risks. The effects of such program on a variety of cardiometabolic outcome measures conducted in a strict analysis remained relatively unexplored.

Materials and methods

A total of 2,660 participants (mean age: 43.3 ± 10 years, 63.6 % male) underwent annual health survey from our health evaluation department. We implemented health intervention program (HIP) in which diet and lifestyle modifications including smoking cessation and advised physical activities were introduced. We further studied the effects of HIP on several cardiometabolic outcome measures including Framingham, metabolic scores and renal function in terms of Egfr with a mean follow-up period of 38.5 months. Propensity score (PS) matching (HIP vs non-HIP group) was used to avoid effects of case selection bias.

Results

Totally 1,004 (502 subjects for each group) left after PS matching protocol (both HIP and non-HIP group). The HIP group showed significant decline of waist circumference (−1.46 ± 0.61, p = 0.016), post-prandial glucose (−6.77 ± 2.06, p = 0.001), and total cholesterol level (−4.42 ± 2.15, p = 0.04), with borderline increase in eGFR (1.72 ± 0.94, p = 0.068) after an average of 1.91 ± 1.14 year follow up period. Exercise behavior significantly increased for those who received HIP when compared to the non-HIP group (44.6 vs 52.4 %, p = 0.014). PS matching and difference-in-difference (DID) analysis further confirmed the beneficial effects of ATP III reduction by HIP (−0.36 ± 0.06, p < 0.05).

Conclusion

We demonstrated in our study that several cardiometabolic profiles can be substantially improved after health intervention introduction at the health evaluation center, supporting the beneficial evidence of such health intervention programs implementation based on primary prevention view points.

Electronic supplementary material

The online version of this article (doi:10.1186/s12955-015-0325-2) contains supplementary material, which is available to authorized users.

The impact of depression and somatic symptoms on treatment outcomes in patients with chronic prostatitis/chronic pelvic pain syndrome: a preliminary study in a naturalistic treatment setting

AIM

The aim of this study was to evaluate the impact of depression and somatic symptoms on treatment outcomes in Korean male patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) attending a routine clinical practice.

METHODS

This was a 12-week prospective observational study (n = 80). The Korean version of the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) to measure the severity of CP/CPPS, the Korean version of the Patient Health Questionnaire-9 (PHQ-9) to assess depression, the Korean version of the Patient Health Questionnaire-15 (PHQ-15) to evaluate somatisation and the Korean version of the EuroQol Questionnaire-5 Dimensions (EQ-5D), specifically the EQ-5D utility index and the EQ-5D visual analogue scale (EQ-5D VAS), to assess quality of life, were utilised and given at baseline and week 12. The primary and secondary end-points in this study were changes in the NIH-CPSI total score from baseline to week 12 according to depression and somatisation.

RESULTS

The change in NIH-CPSI total score was significantly higher in those without depression than in those with depression (p = 0.003), with a magnitude of difference of 2.8. The responder rate (a ≥ 4 point decrease in NIH-CPSI total score from baseline) was significantly higher in those without depression (42.9%) than in those with depression (17.2%, p = 0.023). However, significant differences were not observed between the two groups in the other outcome measures or in all study outcomes between subjects with or without somatisation. A logistic regression analysis revealed that the presence or absence of depression may be a principal predictor of response to treatment.

CONCLUSION

These preliminary results indicate that depression may have a negative impact on treatment outcome and is a likely predictor of response to treatment in patients with CP/CPPS. However, additional studies with adequate power and improved design are necessary to further support the present findings.

Serine protease PRSS23 is upregulated by estrogen receptor α and associated with proliferation of breast cancer cells

Serine protease PRSS23 is a newly discovered protein that has been associated with tumor progression in various types of cancers. Interestingly, PRSS23 is coexpressed with estrogen receptor α (ERα), which is a prominent biomarker and therapeutic target for human breast cancer. Estrogen signaling through ERα is also known to affect cell proliferation, apoptosis, and survival, which promotes tumorigenesis by regulating the production of numerous downstream effector proteins.In the present study, we aimed to clarify the correlation between and functional implication of ERα and PRSS23 in breast cancer. Analysis of published breast cancer microarray datasets revealed that the gene expression correlation between ERα and PRSS23 is highly significant among all ERα-associated proteases in breast cancer. We then assessed PRSS23 expression in 56 primary breast cancer biopsies and 8 cancer cell lines. The results further confirmed the coexpression of PRSS23 and ERα and provided clinicopathological significance. In vitro assays in MCF-7 breast cancer cells demonstrated that PRSS23 expression is induced by 17β-estradiol-activated ERα through an interaction with an upstream promoter region of PRSS23 gene. In addition, PRSS23 knockdown may suppress estrogen-driven cell proliferation of MCF-7 cells.Our findings imply that PRSS23 might be a critical component of estrogen-mediated cell proliferation of ERα-positive breast cancer cells. In conclusion, the present study highlights the potential for PRSS23 to be a novel therapeutic target in breast cancer research.

The shape control of ZnO based nanostructures

Tetrapod-shape ZnO nanostructures are formed on Si substrates by vapor phase transportation method. The effects of two important growth parameters, growth temperature and VI/II ratio, are investigated. The growth temperature is varied in the range from 600 degrees C to 900 degrees C to control the vapor pressure of group II-element and the formation process of nanostructures. VI/II ratio was changed by adjusting the flux of carrier gas which affects indirectly the supplying rate of group VI-element. From the scanning electron microscopy (SEM), systematic variation of shape including cluster, rod, wire and tetrapod was observed. ZnO tetrapods, formed at 800 degrees C under the carrier gas flux of 0.5 cc/mm2 min, show considerably uniform shape with 100 nm thick and 1-1.5 microm long legs. Also stoichiometric composition (O/Zn - 1) was observed without any second phase structures. While, the decrease of growth temperature and the increase of carrier gas flux, results in the irregular shaped nanostructures with non-stoichiometric composition. The excellent luminescence properties, strong excitonic UV emission at 3.25 eV without deep level emission, indicate that the high crystalline quality tetrapod structures can be formed at the optimized growth conditions.

Growth of well-aligned ZnO nanorods using auge catalyst by vapor phase transportation

Well-aligned ZnO nanorods have been achieved using new alloy (AuGe) catalyst. Zn powder was used as a source material and it was transported in a horizontal tube furnace onto an AuGe deposited Si substrates. The structural and optical properties of ZnO nanorods were characterized by scanning electron microscopy, high resolution X-ray diffraction, and photoluminescence. ZnO nanorods grown at 650 degrees C on 53 nm thick AuGe layer show uniform shape with the length of 8 +/- 0.5 microm and the diameter of 150 +/- 5 nm. Also, the tilting angle of ZnO nanorods (+/- 5.5 degrees) is confirmed by HRXRD. High structural quality of the nanorods is conformed by the photoluminescence measurement. All samples show strong UV emission without considerable deep level emission. However, weak deep level emission appears at high (700 degrees C) temperature due to the increase of oxygen desertion.

Magnetic resonance imaging and proton magnetic resonance spectroscopy in neuro-Behçet's disease

OBJECTIVE

Neuro-Behcet's disease (NBD) is one of the most serious complications of Behcet's disease (BD). Proton magnetic resonance spectroscopy (1H MRS) has been proved to be useful in detecting neuro-metabolic abnormalities in various diseases affecting the brain. In this study, we attempted to characterize the magnetic resonance imaging (MRI) findings in Korean patients with NBD and then examined the usefulness of 1HMRS in evaluating the MRI-negative brain area of NBD patients.

METHODS

We performed brain MRI in 18 BD patients with neurologic symptoms and signs. Seven NBD patients without thalamic lesions and 8 healthy controls underwent brain 1H MRS, in which an 8 ml voxel was placed in the left thalamus and the N-acetylaspartate (NAA)/creatine (Cr) ratio was measured.

RESULTS

Fourteen of 18 BD patients were diagnosed as having NBD and 12 NBD patients (86%) had brain lesions on MRI. Most lesions were of high signal intensity on T2-weighted images and located in the midbrain, pons, basal ganglia, and white matter. On 1H MRS, the thalamic area without gross abnormalities on MRI showed a significantly lower NAA/Cr ratio in NBD patients compared to healthy controls (1.07 +/- 0.08 versus 1.54 +/- 0.27, P < 0.01). In 2 NBD patients, the NAA/Cr ratios, monitored serially, were normalized along with clinical improvement 6 months after treatment with prednisolone and immune suppressive agents.

CONCLUSION

MRI is a very sensitive diagnostic method for NBD, and 1H MRS may be useful for the early detection and follow-up of MRI-negative NBD.

Nonlinear analysis of the EEG of schizophrenics with optimal embedding dimension

We estimated the correlation dimensions of EEGs in patients with schizophrenia to investigate the dynamical properties underlying the EEG. We employed a new method, proposed by Kennel et al. (Kennel MB, Brown R, Abarbanel HDI. Determining embedding dimension for phase-space reconstruction using a geometrical construction. Phys Rev A 1992;45:3403-11), to calculate the correlation dimension D2. That method determined the proper minimum embedding dimension by looking at the behaviour of nearest neighbours under a change in the embedding dimension d from d to d + 1. We demonstrated that for limited noisy data, our algorithm was strikingly faster and more accurate than previous ones. We estimated the D2 of EEGs from 16 channels in patients with schizophrenia according to DSM-IV whereas previous studies, which estimated chaoticity of EEG in schizophrenia, recorded EEG only in a limited number of channels. Schizophrenic patients had a lower correlation dimension in the left inferior frontal and anterior temporal regions compared with controls. Our finding of decreased left frontal and temporal chaotic activity in schizophrenics is in line with the findings of a hypofrontality and hypotemporality reported in previous clinical studies such as EEG, blood flow, brain MRI and positron emission tomography studies in schizophrenia. This result suggests that chaos analysis may be a useful tool in analysing EEG data to explore the brain mechanism of schizophrenia.

Reliability and validity of the cognitive impairment diagnosing instrument (CIDI) in the elderly

The reliability and validity of the Cognitive Impairment Diagnosing Instrument (CIDI) were studied in 67 nursing home elderly subjects and 251 elderly psychiatric patients. Its possible highest score is 77 and covers 10 subscales: short-term memory, long-term memory, concentration/calculation, abstract thinking, judgement, memory registration, higher cortical functions, orientation in time, orientation in place and object naming. Test-retest correlations were between 0.827 and 0.990 for the subscale scores and 0.984 for the total score. Inter-tester kappas for each item ranged from 0.200 to 1.000 with a mean of 0.698. Concordance rates were between 50.0 and 100.0% with a mean of 87.2%. Cronbach's alphas for the items of the individual subscales ranged from 0.702 to 0.915. Inter-subscale and subscale-total correlations ranged from 0.503 to 0.820 with a mean of 0.684 and from 0.721 to 0.883, respectively. Cronbach's alpha of the subscales was 0.934. Sensitivity and specificity were 93.3% and 93.8% at the cut-off point of 57.0/57.5 for dementia. Subscale and total scores were significantly different between the demented and non-demented. The total CIDI score was significantly correlated with scores of the Blessed Dementia Rating Scale and the Korean version of the Mini-Mental State Examination.

Psychological maladjustment and academic achievement: a cross-cultural study of Japanese, Chinese, and American high school students

Psychological maladjustment and its relation to academic achievement, parental expectations, and parental satisfaction were studied in a cross-national sample of 1,386 American, 1,633 Chinese, and 1,247 Japanese eleventh-grade students. 5 indices of maladjustment included measures of stress, depressed mood, academic anxiety, aggression, and somatic complaints. Asian students reported higher levels of parental expectation and lower levels of parental satisfaction concerning academic achievement than their American peers. Nevertheless, Japanese students reported less stress, depressed mood, aggression, academic anxiety, and fewer somatic complaints than did American students. Chinese students reported less stress, academic anxiety, and aggressive feelings than their American counterparts, but did report higher frequencies of depressed mood and somatic complaints. High academic achievement as assessed by a test of mathematics was generally not associated with psychological maladjustment. The only exception was in the United States, where high achievers indicated more frequent feelings of stress than did low achievers.

Dementia among the elderly in a rural Korean community

The age-specific prevalence of dementia, its sex difference, and the relative prevalence of important types of dementia were studied in the elderly people in a Korean rural community. A two-stage approach was employed, involving screening and clinical assessment. The prevalence among individuals aged 65 and over was found to be 10.8%, with rates of 7.2% in men and 14.5% in women. The dementia was of the Alzheimer type in 60.0% of cases, multi-infarct dementia in 12.0%, mixed dementia of Alzheimer type and multi-infarct in 10.7%, alcoholic dementia in 8.0%, and others and unclassifiable in 9.3%. The prevalence of dementia of the Alzheimer type was significantly higher in women and rapidly increased with age in both sexes. The prevalence of multi-infarct dementia was not related to sex or age. Alcoholic dementia was identified only in men. These findings indicate that the prevalence of dementia in rural Korea is similar to that reported in Western countries and that the prevalence of dementia of the Alzheimer type in rural Korea is greater than that of multi-infarct dementia.

Possible superoxide radical-induced alteration of vascular reactivity in aortas from streptozotocin-treated rats

We investigated the possible involvement of the superoxide (.O2-) radical in alterations of vascular reactivity and phosphoinositide (PI) turnover in aortas from streptozotocin (STZ)-induced diabetic (4 week) rats. STZ treatment increased the maximal contractile response of the aorta to norepinephrine (NE), phenylephrine (PE) and high K+, whereas the sensitivity remained unaltered. Ca(++)-induced contractions in the presence of maximally effective concentrations of PE and K+ were also augmented after STZ treatment. The increased maximal response was associated with both decreased endothelium-dependent relaxation and increased NE-induced PI turnover. Pyrogallol (PYR), a potent .O2- generating agent, did not affect basal tone or PI turnover but, depending on concentrations, it significantly increased or decreased both the contractile response to PE and NE-induced PI turnover in control aorta. In contrast, PYR decreased NE-induced PI turnover in diabetic aorta. The malondialdehyde content of liver, serum and aorta, and of .O2- from aorta of diabetic rats, were increased significantly. Copper catalyzed oxidation of ascorbic acid resulted in contraction followed by relaxation, depending upon the ascorbic acid concentration in both control and diabetic aorta. Pretreatment with superoxide dismutase (300 U/ml) prevented the PYR-induced potentiation of the PE contraction, but not of NE+PYR-induced PI turnover in control aorta and decreased further NE+PYR-induced PI turnover in diabetic aorta. The present findings indicate that .O2- may be responsible, at least in part, for the impaired endothelial integrity, enhanced alpha adrenergic receptor-mediated PI turnover and augmented contractility, possibly through modification of calcium channels in STZ-induced short-term (4 week) diabetic rat aorta.

Pharmacological characterization of effects of verapamil and GS 283 on isolated guinea pig and rat trachealis

The pharmacological effects of verapamil and GS 283, 1-(4'-methoxybenzyl)-6,7-dihydroxy-3,4-dihydroxyisoquinoline, were investigated using isolated rat and guinea pig trachealis. Both verapamil and GS 283 inhibited carbachol-, histamine (only guinea pig)-, and high-K(+)-induced contraction in a dose-dependent manner. GS 283 acted as a weak histamine H1 and muscarinic receptor antagonist in guinea pig and rat trachealis with respective pKB values in the range of 5.60 approximately 6.12 and 5.17 approximately 5.83. On the other hand, pyrilamine and atropine showed a typical competitive antagonism on histamine (guinea pig) and on muscarinic receptors (rat trachea) with pKB values of 9.25 +/- 0.21 and 9.37 +/- 0.32, respectively. GS 283 inhibited Ca(2+)-induced contraction on guinea pig trachealis in Ca(2+)-free media. Furthermore, very high concentrations of GS 283 and verapamil completely abolished a phasic contraction induced by carbachol in Ca(2+)-free media, suggesting that verapamil and GS 283 can enter into the cytoplasm, where they may exert secondary actions on internal sites of the muscle, such as the sarcoplasmic reticulum. It is concluded that GS 283 has a Ca2+ antagonistic action along with weak histamine and muscarinic receptor blocking activity in isolated rat and guinea pig tracheal smooth muscle and its mode of action is likely inhibition of Ca2+ influx from plasma membrane and also release from the sarcoplasmic reticulum.