1
|
Abstract
OBJECTIVES To clarify whether serum creatinine to cystatin C ratio (CCR), a marker of muscle mass and muscle function may be used as a simple marker of bone property. DESIGN A cross-sectional analysis. SETTING A general population-based observation study. PARTICIPANTS 1,606 middle-aged to elderly (≥50 years, mean age: 66.9 ± 7.5 years old) men (n = 642) and post-menopausal women (n = 964). MEASUREMENT Speed of sound (SOS) at the calcaneal bone was used as a surrogate marker of bone mineral density. The cross-sectional area of the muscle at the mid-thigh was measured using computed tomography. RESULTS There was significant linear correlation between the quartiles of CCR and SOS (Q1: 1,495 ± 25, Q2: 1,499 ± 24, Q3: 1,507 ± 26, Q4: 1,511 ± 25 m/sec; P < 0.001) even in a sex-separated analysis. This association was independent of major covariates (Q1: β = -0.126, P < 0.001; Q2: β = -0.096, P = 0.001; Q3: β = -0.022; P = 0.412, Q4: reference) and the mid-thigh muscle mass, while creatinine alone or eGFR did not show clear association with SOS. CONCLUSION The CCR may be used as a simple marker of bone property independently of muscle mass in a general population with preserved renal function.
Collapse
Affiliation(s)
- Y Tabara
- Yasuharu Tabara, Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Shogoinkawara-cho, Sakyo-ku, Kyoto 606-8507, Japan, Tel: +81-75-751-4157, Fax: +81-75-751-4167, E-mail:
| | | | | | | | | |
Collapse
|
2
|
Igase M, Okada Y, Ochi M, Igase K, Ochi H, Okuyama S, Furukawa Y, Ohyagi Y. Auraptene in the Peels of Citrus Kawachiensis (Kawachibankan) Contributes to the Preservation of Cognitive Function: A Randomized, Placebo-Controlled, Double-Blind Study in Healthy Volunteers. J Prev Alzheimers Dis 2019; 5:197-201. [PMID: 29972213 DOI: 10.14283/jpad.2017.47] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Dementia, which is characterized by a progressive decline in cognitive function, is a major concern in aging societies. Although a number of treatments have been approved, an effective therapy to prevent the disorder is lacking. A supplement that improves cognitive function would benefit patients. The aim of this study was to assess whether auraptene, a citrus coumarin, has a protective effect on cognitive decline. DESIGN A randomized, placebo-controlled, double-blind study SETTING: Outpatient medical check-up program for cognitive disorders PARTICIPANTS: 84 adult volunteers (they are cognitively normal) met inclusion and exclusion criteria to participate. INTERVENTION 42 participants received auraptene enriched (containing 6.0 mg/day of auraptene) test juice, and another participants received placebo juice. MEASUREMENTS 1) Mild Cognitive Impairment (MCI) Screen using the 10-word immediate recall test. 2) The Mini-Mental State Examination (MMSE). Cognitive assessment ware carried out baseline and at 24 weeks. RESULTS Auraptene enriched test juice did not improve cognitive function after 24 weeks compared with baseline data. However, there was a significant difference in the percentage change in cognitive function between the test and placebo orange juice groups (6.3 ± 18.9 vs. -2.4 ± 14.8, P < 0.05). Multiple regression analysis demonstrated a significant independent relationship between the percentage change in the 10-word immediate recall test score and test juice consumption including baseline 10-word immediate recall test score in all subjects. CONCLUSION This is the first study to assess the effectiveness of auraptene in the prevention of cognitive decline. Our results suggest that auraptene is a safe supplement for the prevention of cognitive decline.
Collapse
Affiliation(s)
- M Igase
- Michiya Igase, MD, PhD, Department of Geriatric Medicine and Neurology, Ehime University Graduate School of Medicine, 454 Shitsukawa, Toon City, Ehime 791-0295, Japan, Phone: +81-89-960-5851, Fax: +81-89-960-5852, E-mail:
| | | | | | | | | | | | | | | |
Collapse
|
3
|
Hwang CC, Igase M, Sakurai M, Haraguchi T, Tani K, Itamoto K, Shimokawa T, Nakaichi M, Nemoto Y, Noguchi S, Coffey M, Okuda M, Mizuno T. Oncolytic reovirus therapy: Pilot study in dogs with spontaneously occurring tumours. Vet Comp Oncol 2017; 16:229-238. [PMID: 29076241 DOI: 10.1111/vco.12361] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 09/17/2017] [Accepted: 09/18/2017] [Indexed: 12/26/2022]
Abstract
Oncolytic virotherapy is a novel treatment involving replication-competent virus in the elimination of cancer. We have previously reported the oncolytic effects of reovirus in various canine cancer cell lines. This study aims to establish the safety profile of reovirus in dogs with spontaneously occurring tumours and to determine a recommended dosing regimen. Nineteen dogs with various tumours, mostly of advanced stages, were treated with reovirus, ranging from 1.0 × 108 to 5.0 × 109 TCID50 given as intratumour injection (IT) or intravenous infusion (IV) daily for up to 5 consecutive days in 1 or multiple treatment cycles. Adverse events (AEs) were graded according to the Veterinary Cooperative Oncology Group- Common Terminology Criteria for Adverse Events (VCOG-CTCAE) v1.1 guidelines. Viral shedding, neutralizing anti-reovirus antibody (NARA) production and immunohistochemical (IHC) detection of reovirus protein in the tumours were also assessed. AE was not observed in most dogs and events were limited to Grade I or II fever, vomiting, diarrhoea and inflammation of the injected tumour. No infectious virus was shed and all dogs had elevated NARA levels post-treatment. Although IHC results were only available in 6 dogs, 4 were detected positive for reovirus protein. In conclusion, reovirus is well-tolerated and can be given safely to tumour-bearing dogs according to the dosing regimen used in this study without significant concerns of viral shedding. Reovirus is also potentially effective in various types of canine tumours.
Collapse
Affiliation(s)
- C C Hwang
- Laboratory of Molecular Diagnostics and Therapeutics, The United Graduate School of Veterinary Science, Yamaguchi University, Yamaguchi, Japan
| | - M Igase
- Laboratory of Molecular Diagnostics and Therapeutics, The United Graduate School of Veterinary Science, Yamaguchi University, Yamaguchi, Japan
| | - M Sakurai
- Laboratory of Veterinary Pathology, Joint Faculty of Veterinary Medicine, Yamaguchi University, Yamaguchi, Japan
| | - T Haraguchi
- Laboratory of Small Animal Clinical Science (Surgical Division), Joint Faculty of Veterinary Medicine, Yamaguchi University, Yamaguchi, Japan
| | - K Tani
- Laboratory of Veterinary Surgery, Joint Faculty of Veterinary Medicine, Yamaguchi University, Yamaguchi, Japan
| | - K Itamoto
- Laboratory of Small Animal Clinical Science (Surgical Division), Joint Faculty of Veterinary Medicine, Yamaguchi University, Yamaguchi, Japan
| | - T Shimokawa
- Laboratory of Veterinary Internal Medicine, Joint Faculty of Veterinary Medicine, Yamaguchi University, Yamaguchi, Japan
| | - M Nakaichi
- Laboratory of Veterinary Radiology, Joint Faculty of Veterinary Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Y Nemoto
- Laboratory of Molecular Diagnostics and Therapeutics, The United Graduate School of Veterinary Science, Yamaguchi University, Yamaguchi, Japan
| | - S Noguchi
- Laboratory of Molecular Diagnostics and Therapeutics, The United Graduate School of Veterinary Science, Yamaguchi University, Yamaguchi, Japan
| | - M Coffey
- Oncolytics Biotech Inc, Calgary, Canada
| | - M Okuda
- Laboratory of Veterinary Internal Medicine, Joint Faculty of Veterinary Medicine, Yamaguchi University, Yamaguchi, Japan.,Biomedical Science Center for Translational Research, The United Graduate School of Veterinary Science, Yamaguchi University, Yamaguchi, Japan
| | - T Mizuno
- Laboratory of Molecular Diagnostics and Therapeutics, The United Graduate School of Veterinary Science, Yamaguchi University, Yamaguchi, Japan.,Biomedical Science Center for Translational Research, The United Graduate School of Veterinary Science, Yamaguchi University, Yamaguchi, Japan
| |
Collapse
|
4
|
Ohyagi Y, Ohara M, Igase M, Nakamura N, Imamura T, Yanagihara Y, Kira J, Watanabe A, Fujii N. Glucose intolerance associating with cognitive impairment and brain diabetes as a therapeutic target in alzheimer’s disease. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
5
|
Tabara Y, Igase M, Miki T, Ohyagi Y, Matsuda F, Kohara K. [PP.06.12] B-TYPE NATRIURETIC PEPTIDE IS A DETERMINANT OF THE NOCTURNAL INCREASE IN BLOOD PRESSURE INDEPENDENTLY OF ARTERIAL HYPERTROPHY AND HYPOXIA. J Hypertens 2017. [DOI: 10.1097/01.hjh.0000523345.22271.62] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
6
|
Noguchi S, Shibutani S, Fukushima K, Mori T, Igase M, Mizuno T. Bosutinib, an SRC inhibitor, induces caspase-independent cell death associated with permeabilization of lysosomal membranes in melanoma cells. Vet Comp Oncol 2017; 16:69-76. [DOI: 10.1111/vco.12312] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 02/15/2017] [Accepted: 03/07/2017] [Indexed: 12/14/2022]
Affiliation(s)
- S. Noguchi
- Laboratory of Veterinary Radiology, Graduate School of Life and Environmental Sciences; Osaka Prefecture University; Osaka Japan
- Biomedical Science Center for Translational Research, The United Graduate School of Veterinary Science; Yamaguchi University; Yamaguchi Japan
| | - S. Shibutani
- Laboratory of Veterinary Hygiene, Joint Faculty of Veterinary Medicine; Yamaguchi University; Yamaguchi Japan
| | - K. Fukushima
- Laboratory of Molecular Diagnostics and Therapeutics, Joint Faculty of Veterinary Medicine; Yamaguchi University; Yamaguchi Japan
| | - T. Mori
- Laboratory of Veterinary Clinical Oncology, Faculty of Applied Biological Sciences; Gifu University; Gifu Japan
| | - M. Igase
- The United Graduate School of Veterinary Science; Yamaguchi University; Yamaguchi Japan
| | - T. Mizuno
- Biomedical Science Center for Translational Research, The United Graduate School of Veterinary Science; Yamaguchi University; Yamaguchi Japan
- Laboratory of Molecular Diagnostics and Therapeutics, Joint Faculty of Veterinary Medicine; Yamaguchi University; Yamaguchi Japan
| |
Collapse
|
7
|
Miyawaki S, Kohara K, Kido T, Tabara Y, Igase M, Miki T, Sayama K. Facial pigmentation as a biomarker of carotid atherosclerosis in middle-aged to elderly healthy Japanese subjects. Skin Res Technol 2015; 22:20-4. [DOI: 10.1111/srt.12223] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2015] [Indexed: 01/27/2023]
Affiliation(s)
- S. Miyawaki
- Department of Dermatology; Ehime University Graduate School of Medicine; Ehime Japan
| | - K. Kohara
- Department of Geriatric Medicine; Ehime University Graduate School of Medicine; Ehime Japan
| | - T. Kido
- Department of Geriatric Medicine; Ehime University Graduate School of Medicine; Ehime Japan
| | - Y. Tabara
- Center for Genomic Medicine; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - M. Igase
- Department of Geriatric Medicine; Ehime University Graduate School of Medicine; Ehime Japan
| | - T. Miki
- Department of Geriatric Medicine; Ehime University Graduate School of Medicine; Ehime Japan
| | - K. Sayama
- Department of Dermatology; Ehime University Graduate School of Medicine; Ehime Japan
| |
Collapse
|
8
|
Ema Y, Igase M, Takeda Y, Yanase T, Umeki S, Hiraoka H, Okuda M, Mizuno T. Investigation of the cytotoxic effect of flavopiridol in canine lymphoma cell lines. Vet Comp Oncol 2015; 14 Suppl 1:95-106. [DOI: 10.1111/vco.12130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 10/30/2014] [Accepted: 11/04/2014] [Indexed: 11/27/2022]
Affiliation(s)
- Y. Ema
- Laboratory of Veterinary Internal Medicine, Joint Faculty of Veterinary Medicine; Yamaguchi University; Yamaguchi Japan
| | - M. Igase
- Laboratory of Molecular Diagnostics and Therapeutics, Joint Faculty of Veterinary Medicine; Yamaguchi University; Yamaguchi Japan
| | - Y. Takeda
- Laboratory of Veterinary Internal Medicine, Joint Faculty of Veterinary Medicine; Yamaguchi University; Yamaguchi Japan
| | - T. Yanase
- Laboratory of Veterinary Internal Medicine, Joint Faculty of Veterinary Medicine; Yamaguchi University; Yamaguchi Japan
| | - S. Umeki
- Laboratory of Veterinary Internal Medicine, Joint Faculty of Veterinary Medicine; Yamaguchi University; Yamaguchi Japan
| | - H. Hiraoka
- Laboratory of Veterinary Internal Medicine, Joint Faculty of Veterinary Medicine; Yamaguchi University; Yamaguchi Japan
| | - M. Okuda
- Laboratory of Veterinary Internal Medicine, Joint Faculty of Veterinary Medicine; Yamaguchi University; Yamaguchi Japan
- Biomedical Science Center for Translational Research; The United Graduate School of Veterinary Science, Yamaguchi University; Yamaguchi Japan
| | - T. Mizuno
- Laboratory of Veterinary Internal Medicine, Joint Faculty of Veterinary Medicine; Yamaguchi University; Yamaguchi Japan
- Laboratory of Molecular Diagnostics and Therapeutics, Joint Faculty of Veterinary Medicine; Yamaguchi University; Yamaguchi Japan
- Biomedical Science Center for Translational Research; The United Graduate School of Veterinary Science, Yamaguchi University; Yamaguchi Japan
| |
Collapse
|
9
|
Hwang CC, Umeki S, Igase M, Coffey M, Noguchi S, Okuda M, Mizuno T. The effects of oncolytic reovirus in canine lymphoma cell lines. Vet Comp Oncol 2014; 14 Suppl 1:61-73. [DOI: 10.1111/vco.12124] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Revised: 09/11/2014] [Accepted: 09/18/2014] [Indexed: 12/19/2022]
Affiliation(s)
- C. C. Hwang
- Laboratory of Molecular Diagnostics and Therapeutics, The United Graduate School of Veterinary Science; Yamaguchi University; Yamaguchi Japan
| | - S. Umeki
- Laboratory of Molecular Diagnostics and Therapeutics, The United Graduate School of Veterinary Science; Yamaguchi University; Yamaguchi Japan
| | - M. Igase
- Laboratory of Molecular Diagnostics and Therapeutics, Joint Faculty of Veterinary Medicine; Yamaguchi University; Yamaguchi Japan
| | - M. Coffey
- Oncolytics Biotech Inc.; Calgary Alberta Canada
| | - S. Noguchi
- Laboratory of Molecular Diagnostics and Therapeutics, Joint Faculty of Veterinary Medicine; Yamaguchi University; Yamaguchi Japan
| | - M. Okuda
- Laboratory of Veterinary Internal Medicine, Joint Faculty of Veterinary Medicine; Yamaguchi University; Yamaguchi Japan
- Biomedical Science Center for Translational Research, The United Graduate School of Veterinary Science; Yamaguchi University; Yamaguchi Japan
| | - T. Mizuno
- Laboratory of Molecular Diagnostics and Therapeutics, The United Graduate School of Veterinary Science; Yamaguchi University; Yamaguchi Japan
- Laboratory of Molecular Diagnostics and Therapeutics, Joint Faculty of Veterinary Medicine; Yamaguchi University; Yamaguchi Japan
- Biomedical Science Center for Translational Research, The United Graduate School of Veterinary Science; Yamaguchi University; Yamaguchi Japan
| |
Collapse
|
10
|
Yoshino Y, Kohara K, Abe M, Ochi S, Mori Y, Yamashita K, Igase M, Tabara Y, Mori T, Miki T, Ueno S. Missense variants of the alanine: glyoxylate aminotransferase 2 gene correlated with carotid atherosclerosis in the Japanese population. J BIOL REG HOMEOS AG 2014; 28:605-614. [PMID: 25620171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Alanine:glyoxylate aminotransferase 2 (AGXT2; EC 2.6.1.44) degrades asymmetric dimethylarginine (ADMA), a competitive inhibitor of nitric oxide (NO) synthase. Increased ADMA, reduced NO, and hypertension are shown in Agxt2 knockout mice. There are four single nucleotide polymorphisms (rs37370, rs37369, rs180749, and rs16899974) with which AGXT2 activity changes in humans and may be related to vulnerability of vascular sclerosis. To examine the relationship between them, we studied the functional haplotypes of the AGXT2 gene and decided their relationship with arteriosclerotic changes via carotid intima-media thickness (carotid IMT) in Japanese subjects. Genotyping of those polymorphisms and the carotid IMT in 1,426 Japanese subjects were then evaluated. Subjects with C-A-A-A haplotype (rs37370, rs37369, rs180749, rs16899974) showed low AGXT2 activity (P<0.0001; Pearsons correlation coefficients: 0.497). The C-A-A-A haplotype was significantly associated with mean carotid IMT (P=0.049) and max carotid IMT (P=0.004). Subjects with two C-A-A-A haplotypes exhibited thicker mean carotid IMT (P=0.022) and maximum carotid IMT (P=0.001). In multiple regression analysis, subjects with two C-A-A-A haplotypes were independently and positively associated with mean carotid IMT (P=0.02) and maximum IMT (P=0.005) after correction. There was a significant correlation between the functional variants in the AGXT2 gene and carotid IMT in Japanese. The AGXT2 genotype may be an important factor underlying atherosclerosis.
Collapse
Affiliation(s)
- Y Yoshino
- Department of Neuropsychiatry, Molecule and Function, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan
| | - K Kohara
- Department of Geriatric Medicine, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan
| | - M Abe
- Department of Neuropsychiatry, Molecule and Function, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan
| | - S Ochi
- Department of Neuropsychiatry, Molecule and Function, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan
| | - Y Mori
- Department of Neuropsychiatry, Molecule and Function, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan
| | - K Yamashita
- Department of Neuropsychiatry, Molecule and Function, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan
| | - M Igase
- Department of Geriatric Medicine, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan
| | - Y Tabara
- Department of Clinical Genetics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - T Mori
- Department of Neuropsychiatry, Molecule and Function, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan
| | - T Miki
- Department of Geriatric Medicine, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan
| | - S Ueno
- Department of Neuropsychiatry, Molecule and Function, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan
| |
Collapse
|
11
|
Tabara Y, Igase M, Okada Y, Nagai T, Uetani E, Kido T, Ochi N, Takita R, Yamamoto M, Kohara K, Miki T. Association of Chr17q25 with cerebral white matter hyperintensities and cognitive impairment: the J-SHIPP study. Eur J Neurol 2012; 20:860-2. [DOI: 10.1111/j.1468-1331.2012.03879.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2012] [Accepted: 08/21/2012] [Indexed: 11/30/2022]
Affiliation(s)
| | - M. Igase
- Department of Geriatric Medicine; Ehime University Graduate School of Medicine; Toon City; Japan
| | - Y. Okada
- Department of Geriatric Medicine; Ehime University Graduate School of Medicine; Toon City; Japan
| | - T. Nagai
- Department of Geriatric Medicine; Ehime University Graduate School of Medicine; Toon City; Japan
| | - E. Uetani
- Department of Geriatric Medicine; Ehime University Graduate School of Medicine; Toon City; Japan
| | - T. Kido
- Department of Geriatric Medicine; Ehime University Graduate School of Medicine; Toon City; Japan
| | - N. Ochi
- Department of Geriatric Medicine; Ehime University Graduate School of Medicine; Toon City; Japan
| | - R. Takita
- Department of Geriatric Medicine; Ehime University Graduate School of Medicine; Toon City; Japan
| | - M. Yamamoto
- Department of Geriatric Medicine; Ehime University Graduate School of Medicine; Toon City; Japan
| | - K. Kohara
- Department of Geriatric Medicine; Ehime University Graduate School of Medicine; Toon City; Japan
| | - T. Miki
- Department of Geriatric Medicine; Ehime University Graduate School of Medicine; Toon City; Japan
| |
Collapse
|
12
|
Ochi M, Kohara K, Tabara Y, Takita R, Nagai T, Shinohara N, Okada Y, Ochi H, Igase M, Miki T. Thigh Muscle Mass Decline Was Associated Brain Small Vessel Diseases in Men; Possible Link between Sarcopenia and Dementia (P07.196). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p07.196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
13
|
Nagai T, Kohara K, Tabara Y, Okada Y, Ochi M, Kido T, Uetani E, Kido M, Igase M, Miki T. Epidemiological Studies Suggest the Link between Sleep Disorders and Nonspecific Headache Including Chronic Headache (P04.255). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p04.255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
14
|
Ochi N, Kohara K, Tabara Y, Nagai T, Kido T, Uetani E, Ochi M, Igase M, Miki T. Association of central systolic blood pressure with intracerebral small vessel disease in Japanese. Am J Hypertens 2010; 23:889-94. [PMID: 20339355 DOI: 10.1038/ajh.2010.60] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Recent studies have reported the association between advanced arterial stiffness and brain small vessel diseases (SVDs). Two possible hemodynamic mechanisms, increases in central blood pressure (BP) and pulsatile flow load to the brain, have been speculated to link arterial stiffness and SVD. The carotid flow augmentation index (AI) has been proposed as an index of pulsatile flow to the brain. We compared its association with brain SVD with that of central BP in a general population. METHODS Subjects were 500 individuals free from symptomatic cardiovascular diseases with a mean age of 66.9 +/- 8.4 years. Brachial-ankle pulse wave velocity (baPWV) was measured as an index of arterial stiffness. Carotid flow AI was obtained by Doppler ultrasonography. The presence of silent cerebral lacunar infarcts (SCI) was determined as a manifestation of SVD by 3-tesla magnetic resonance imaging (MRI). Second peak radial systolic BP (SBP2) and pulse pressure (PP2) were used as estimates of central BP. RESULTS baPWV was significantly associated with radial BP2 (r = 0.55, P < 0.0001) but not with carotid flow AI (r = 0.03, P = 0.51). Radial BPs and baPWV, but not flow AI, were significantly higher in subjects with SCI. Radial SBP2 had higher odds ratio for the presence of SCI than brachial SBP, PP, and radial PP2. Logistic regression analysis showed that radial SBP2, but not flow AI, was independently related to the presence of SCI. CONCLUSION These findings indicate that the SBP2, an estimate of central SBP, is significantly associated with the presence of SVD in an apparently healthy general population.
Collapse
|
15
|
Abstract
An 82-year-old woman was diagnosed with hypertension at the age of 50 and had been treated with antihypertensive agents. Proteinuria was detected at age 60 and her renal function subsequently deteriorated. Hemodialysis was started on February 14, 2000. She fell out of the bed and hit her neck in the early morning on February 15. Neck X-ray tomography revealed Anderson type III dens fracture. Since she had several complicating conditions including angina pectoris and arrhythmia, she was treated by external fixation using a halo-vest. The neck pain improved gradually. During her clinical course, she experienced delirium due to immobilization. However, bone union was complete 5 months later. Physicians should be aware of the possibility that even minor injury can cause dens fracture in elderly patients. Conservative management of type III dense fracture should be considered for elderly patients with a compromised condition.
Collapse
Affiliation(s)
- T Nagai
- Department of Geriatric Medicine, Ehime University School of Medicine
| | | | | | | |
Collapse
|
16
|
Kido M, Igase M, Nomura T, Kohara K, Miki T. [Early treatment with non-invasive positive pressure ventilation a successful case of bulbar type amyotrophic lateral sclerosis]. Nihon Ronen Igakkai Zasshi 2001; 38:816-8. [PMID: 11774729 DOI: 10.3143/geriatrics.38.816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A 60-year-old man who has suffered dysarthria since 1999. He had noticed twitching of right upper extremity and orbicularis oris muscle since August 2000. The bulbar type of amyotrophic lateral sclerosis was diagnosed. He was admitted for evaluation of sleep disorder with respiratory distress on November 20, 2000. Arterial blood gas analysis on admission showed marked hypercapnea (PaCO2:51.6 Torr). Nocturnal hypoxia index, which was calculated using the nocturnal oximetry monitoring, was elevated. Non-invasive positive pressure ventilation started during sleep at night, although it was earlier than to start for mechanical ventilation. After one week, both hypercapnea and his nocturnal hypoxia index, together with symptoms, improved markedly. Respiratory insufficiency due to progressive fatigue of respiratory muscles, such as diaphragm and intercostal muscles, is a major cause of death in amyotrophic lateral sclerosis. In general mechanical ventilation is introduced when marked hypercapnea and dyspnea become clinically overt. However, the exact time to introduce noninvasive methods of ventilatory support for amyotrophic lateral sclerosis has not been established. Based on the observation in this patient, we would suggest that earlier introduction of non-invasive mechanical support for ventilation (nocturnal hypoxia index > 70) would be useful to improve the symptoms and to prolong the life of patients with ALS. The nocturnal hypoxia index is useful to decide the time of the introduction of non-invasive mechanical support for ventilation.
Collapse
Affiliation(s)
- M Kido
- Department of Geriatric Medicine, Ehime University School of Medicine
| | | | | | | | | |
Collapse
|
17
|
Igase M, Okura T, Nakamura M, Takata Y, Kitami Y, Hiwada K. Role of GADD153 (growth arrest- and DNA damage-inducible gene 153) in vascular smooth muscle cell apoptosis. Clin Sci (Lond) 2001; 100:275-81. [PMID: 11222113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
GADD153 (growth arrest- and DNA damage-inducible gene 153) is expressed at very low levels in growing cells, but is markedly induced in response to a variety of cellular stresses, including glucose deprivation, exposure to genotoxic agents and other growth-arresting situations. Forced expression of GADD153 induces cell cycle arrest in many types of cells. It is also reported that GADD153 is directly associated with apoptosis. Recently we have reported that platelet-derived growth factor (PDGF)-BB induces apoptosis in cultured vascular smooth muscle cells (VSMC), but only when 100% confluency is reached. These results suggested that cell-cell contact inhibition (cell growth arrest) may be a critical factor for induction of VSMC apoptosis by PDGF-BB. In the present study, we explored the role of GADD153, one of a number of growth-arrest-related gene products, in the molecular mechanisms of VSMC apoptosis in vitro and in vivo. GADD153 was markedly induced at both the mRNA and protein levels, in parallel with the induction of VSMC apoptosis, after treatment with PDGF-BB. Moreover, overexpression of GADD153 in VSMC significantly reduced cell viability and induced apoptosis. In the carotid artery balloon injury model in rats, GADD153 protein was expressed in apoptotic VSMC which were positively stained by in situ DNA labelling. These results demonstrate an important role for GADD153 in the molecular mechanisms of VSMC apoptosis.
Collapse
Affiliation(s)
- M Igase
- Second Department of Internal Medicine, Ehime University School of Medicine, Onsen-gun, Ehime 791-0295, Japan
| | | | | | | | | | | |
Collapse
|
18
|
Igase M, Yamamoto Y, Kohara K, Miki T. [An autopsy case of anaplastic thyroid carcinoma that transformed from papillary carcinoma within 5 years from initial diagnosis]. Nihon Ronen Igakkai Zasshi 2000; 37:819-22. [PMID: 11215223 DOI: 10.3143/geriatrics.37.819] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
An 84-year-old man was admitted to our hospital with right shoulder pain. He had been suffering from well-differentiated papillary thyroid carcinoma since 1994, and had undergone surgery three times, including procedures due to recurrence. Since CT showed a right cervical tumor, recurrence of thyroid carcinoma was diagnosed. He died in September 1999 due to progressive respiratory failure. Autopsy was performed and pathological examination revealed the recurrent tumor and metastatic lesions had totally transformed to anaplastic thyroid carcinoma. Since anaplastic carcinoma is characterized by exceptionally rapid progression with dire prognosis, physicians should be aware of the major risk factors of anaplastic transformation in elderly males aged over 60 years old, with repeated relapses of differentiated carcinoma, and a history of tumor irradiation.
Collapse
Affiliation(s)
- M Igase
- Department of Geriatric Medicine, Ehime University School of Medicine
| | | | | | | |
Collapse
|
19
|
Matsubara M, Kohara K, Uemura K, Taguchi K, Igase M, Yamagata H, Nakura J, Miki T. [A very elderly autopsy case of cecal cancer with pulmonary lymphangitis carcinomatosa]. Nihon Ronen Igakkai Zasshi 2000; 37:561-4. [PMID: 11031830 DOI: 10.3143/geriatrics.37.561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A 91-year-old man was admitted with colliquative diarrhea, anorexia and weight loss. He had a history of healed tuberculosis, hypertension and atherosclerotic abdominal aortic aneurysms. On admission, shortness of breath without cough, exertional dyspnea, and ascites were also noticed. His chest X-ray and CT showed almost normal findings in the lung fields except for calcified old pleurisy. Since laboratory tests revealed thrombocytopenia, low fibrinogen, and increased CA19-9. DIC induced by an unknown cancer was diagnosed. He died on the eighth day due to progressive respiratory failure which did not respond to oxygen therapy. Autopsy revealed that he had a poorly differentiated adenocarcinoma in the cecum complicated with pulmonary lymphangitis carcinomatosa. Lymphangitis should be considered in the case of unexplained progressive respiratory failure developing in patient with cancer, even in the absence of X-ray findings.
Collapse
Affiliation(s)
- M Matsubara
- Department of Geriatric Medicine, Ehime University School of Medicine
| | | | | | | | | | | | | | | |
Collapse
|
20
|
Igase M, Kohara K. [Noradrenaline, adrenaline]. Nihon Rinsho 2000; 58 Suppl 1:90-3. [PMID: 11026242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Affiliation(s)
- M Igase
- Department of Geriatric Medicine, Ehime University School of Medicine
| | | |
Collapse
|
21
|
Abstract
Pressure wave reflection plays a pivotal role in the augmentation of systolic blood pressure. In the present study, the association between reflection of pressure wave and structural and functional alteration, including blood flow, in the common carotid artery was investigated in 70 hospitalized essential hypertensive patients. The reflection of pressure was estimated by the "augmentation index" of the carotid arterial pressure waveform. The carotid augmentation index was significantly related to age (r = 0.36), body height (r = -0.30), intima-media thickening (r = 0.28), number of plaques (r = 0.44), stiffness of the carotid artery (r = 0.38), diastolic carotid flow velocity (r = -0.31), and left ventricular mass index (r = 0.33). Furthermore, the reflection of arterial pressure showed a significant negative correlation with diastolic/systolic ratio of blood flow velocity in the carotid artery (r = -0.41, P = .0005). Stepwise regression analysis revealed that age and left ventricular mass index were independent determinants for the carotid augmentation index. These findings indicate that the reflection of arterial pressure is related to morphological and functional alterations of the carotid artery, including a relative reduction of diastolic blood flow.
Collapse
Affiliation(s)
- K Kohara
- Department of Geriatric Medicine, Ehime University School of Medicine, Onsen-gun, Japan
| | | | | | | |
Collapse
|
22
|
Igase M, Okura T, Kitami Y, Hiwada K. Apoptosis and Bcl-xs in the intimal thickening of balloon-injured carotid arteries. Clin Sci (Lond) 1999; 96:605-12. [PMID: 10334966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
We performed balloon injury in the rat carotid artery and identified intimal thickening after injury. Balloon-injured carotid arteries showed maximum thickness of the neointima on the 14th day before complete endothelial cell regeneration. In this lesion we identified apoptosis of vascular smooth muscle cells (VSMCs) by in situ DNA labelling and electron microscopy in the neointima on the 14th day after injury. mRNA expression levels of bcl-2, bax, bcl-x, p53 and caspase-1 were determined by the reverse transcriptase-polymerase chain reaction method both in injured and uninjured carotid arteries. Neither bcl-2 nor bcl-xl mRNA expression was detected in either injured or uninjured arteries, whereas bax and p53 mRNA expression was identified and their mRNA levels were not altered after balloon injury. In contrast, both bcl-xs and caspase-1 mRNA was detected and was markedly induced only in the injured carotid artery. Positive staining for immunoreactive Bcl-x was observed specifically in the injured arterial wall and co-localized with positive staining of nuclei identified by in situ DNA labelling. We conclude that two opposite cellular responses, VSMC proliferation and apoptosis, exist together in the neointima of the rat carotid artery after balloon injury, and selective induction of Bcl-xs expression is a key regulator of VSMC apoptosis in the process of vascular remodelling.
Collapse
Affiliation(s)
- M Igase
- The Second Department of Internal Medicine, Ehime University School of Medicine, Onsen-gun, Ehime 791-0295, Japan
| | | | | | | |
Collapse
|
23
|
Kohara K, Igase M, Takata Y, Fukuoka T, Okura T, Kitami Y, Hiwada K. Contribution of reflection of pressure wave on central systolic blood pressure in older hypertensive patients. J Am Geriatr Soc 1999; 47:499. [PMID: 10203133 DOI: 10.1111/j.1532-5415.1999.tb07253.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
24
|
Kohara K, Zhao B, Jiang Y, Takata Y, Fukuoka T, Igase M, Miki T, Hiwada K. Relation of left ventricular hypertrophy and geometry to asymptomatic cerebrovascular damage in essential hypertension. Am J Cardiol 1999; 83:367-70. [PMID: 10072225 DOI: 10.1016/s0002-9149(98)00870-4] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Increased left ventricular (LV) mass and abnormal geometry have a powerful prognostic value for cardiovascular morbidity and mortality including stroke. However, there have been no studies on the association between LV hypertrophy and preclinical brain damage in essential hypertensive patients. In the present study, we investigated the relation between LV hypertrophy and asymptomatic cerebrovascular damage identified by magnetic resonance imaging in 150 essential hypertensive patients, with an emphasis on LV geometry. Patients were divided into the following 4 groups according to their LV mass index and relative wall thickness; normal ventricular geometry (n = 50), concentric remodeling (n = 22), eccentric hypertrophy (n = 44), and concentric LV hypertrophy (n = 34). Lacunar lesions and leukoaraiosis were evaluated. The prevalence of lacunae was significantly higher in patients with LV remodeling than in patients with normal LV (chi-square 19.6, p = 0.0002). The number of lacunae was significantly higher in patients with LV hypertrophy than in patients with normal LV or concentric remodeling (F [3,146] = 8.03, p<0.0001). The severity of leukoaraiosis was also significantly greater in patients with LV hypertrophy than in patients with a normal left ventricle (chi-square 14.5, p = 0.02). Stepwise regression analysis confirmed that LV mass index and relative wall thickness, in addition to age and systolic blood pressure, were independent predictors for asymptomatic cerebrovascular damage, even in the absence of neurologic abnormalities. In hypertensive patients, LV hypertrophy, and especially concentric LV hypertrophy, provides important prognostic information on the presence of pre-clinical brain damage.
Collapse
Affiliation(s)
- K Kohara
- Department of Geriatric Medicine, Ehime University School of Medicine, Japan.
| | | | | | | | | | | | | | | |
Collapse
|
25
|
Kohara K, Jiang Y, Igase M, Takata Y, Fukuoka T, Okura T, Kitami Y, Hiwada K. Postprandial hypotension is associated with asymptomatic cerebrovascular damage in essential hypertensive patients. Hypertension 1999; 33:565-8. [PMID: 9931166 DOI: 10.1161/01.hyp.33.1.565] [Citation(s) in RCA: 72] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
offelucidate the relationship between postprandial hypotension (PPH) and asymptomatic cerebrovascular damage, we evaluated changes in blood pressure after a meal by 24-hour blood pressure monitoring in 70 hospitalized essential hypertensive patients aged >/=50 years. They received a diet containing standard nutritional ingredients with 120 mmol (7 g) NaCl and were free from medication for at least 1 week. PPH was defined as the mean reduction of systolic blood pressure during 2 hours after a meal. Patients were divided into three groups according to mean values of PPH after 3 meals: PPH-1 (n=16, 5 mm Hg</=PPH<10 mm Hg), PPH-2 (n=18, PPH>/=10 mm Hg), and normal (n=36, PPH<5 mm Hg). As asymptomatic cerebrovascular damage, lacunae and leukoaraiosis were evaluated by magnetic resonance imaging. PPH did not correlate with daytime or nighttime blood pressure or the nondipper phenomenon; however, PPH was significantly related to asymptomatic cerebrovascular damage. The prevalence of lacunae in the normal, PPH-1, and PPH-2 groups was 44%, 69%, and 83%, respectively (chi2=8.22, P<0.05). The number of lacunae in the normal, PPH-1, and PPH-2 groups was 1.0+/-1.3, 1.3+/-1.2, and 1. 9+/-1.4, respectively (F[2,67]=3.2, P<0.05). The prevalence of advanced leukoaraiosis in the normal, PPH-1, and PPH-2 groups was 44%, 50%, and 83%, respectively (chi2=7.63, P<0.05). Severity score of leukoaraiosis in the normal, PPH-1, and PPH-2 groups was 1.5+/-0. 7, 1.7+/-0.8, and 2.1+/-0.7, respectively (F[2,67]=4.3, P<0.05). These findings indicate that elderly hypertensive patients with marked PPH should be considered to have advanced cerebrovascular damage even in the absence of abnormal neurological findings.
Collapse
Affiliation(s)
- K Kohara
- Department of Geriatric Medicine, Ehime University School of Medicine, Onsen-gun,
| | | | | | | | | | | | | | | |
Collapse
|
26
|
Okura T, Igase M, Kitami Y, Fukuoka T, Maguchi M, Kohara K, Hiwada K. Platelet-derived growth factor induces apoptosis in vascular smooth muscle cells: roles of the Bcl-2 family. Biochim Biophys Acta 1998; 1403:245-53. [PMID: 9685664 DOI: 10.1016/s0167-4889(98)00065-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Apoptosis (programmed cell death) is observed in vascular smooth muscle cells (VSMC) in atherosclerotic lesions and stenotic lesions after injury, and modulates the cellularity of these lesions. It is recognized that cell growth and apoptosis are two linked processes. Platelet-derived growth factor (PDGF) induces VSMC proliferation and migration in vitro. We studied the effect of PDGF on apoptosis in VSMC. Cultured rat VSMC were treated with PDGF-AA or PDGF-BB. PDGF-BB induced cell death in cultured VSMC in a time- and dose-dependent manner, but PDGF-AA did not. Gel electrophoresis of genomic DNA and in situ DNA labeling confirmed that the cell death induced by PDGF-BB is apoptosis. PDGF-BB treatment reduced bcl-2 mRNA and bcl-xl mRNA expression, in contrast, induced bcl-xs mRNA expression, linked with the induction of apoptosis in cultured VSMC.
Collapse
Affiliation(s)
- T Okura
- Second Department of Internal Medicine, Ehime University School of Medicine, Onsen-gun, Ehime 791-0295, Japan.
| | | | | | | | | | | | | |
Collapse
|
27
|
Kitami Y, Fukuoka T, Okura T, Takata Y, Maguchi M, Igase M, Kohara K, Hiwada K. Molecular structure and function of rat platelet-derived growth factor beta-receptor gene promoter. J Hypertens 1998; 16:437-45. [PMID: 9797189 DOI: 10.1097/00004872-199816040-00005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To understand the regulatory mechanism of platelet-derived growth factor beta-receptor gene expression. METHODS A 1.7 kb genomic fragment was obtained from a rat genomic library. After we had determined an entire sequence of this fragment, transcription start sites were determined both by primer extension analysis and by riboprobe mapping. We performed a functional promoter assay by using a dual-luciferase reporter system. Progressive 5'-deletions of the fragment and site-directed mutagenesis for the CCAAT motif located at -67 or -94 were used for the assay, and their promoter activities in vascular smooth muscle cells were assessed. Gel-mobility shift analysis was also performed for the CCAAT motif at -67. Effects of the upstream sequence spanning -310 through -120 on heterologous gene promoters were also investigated. RESULTS Multiple transcription start sites were observed in the 5'-flanking region, and the 1.7 kb sequence was actually active as a functional promoter in vascular smooth muscle cells. Two important sequences responsible for the basal transcriptional activity were identified by the functional promoter assay. One was the CCAAT motif at -67 which acts as a promoter itself, and the other was the upstream region spanning -310 through -210 which positively regulates the basal promoter activity. CONCLUSION The basal promoter activity of the rat platelet-derived growth factor beta-receptor gene is mainly regulated by the interaction or coordination of two sequences, the CCAAT motif and the upstream control element.
Collapse
Affiliation(s)
- Y Kitami
- The Second Department of Internal Medicine, Ehime University School of Medicine, Japan.
| | | | | | | | | | | | | | | |
Collapse
|
28
|
Inoue K, Kitami Y, Saiki H, Igase M, Fukuoka T, Maguchi M, Okura T, Kohara K, Kodama K, Hiwada K. [An elderly patient with bleeding from the alimentary tract caused by aberrant pancreas of the small intestine]. Nihon Ronen Igakkai Zasshi 1998; 35:53-6. [PMID: 9564742 DOI: 10.3143/geriatrics.35.53] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A 71-year-old woman was admitted to hospital because of malaise and bloody stool. Laboratory findings consistently showed anemia (Hb 9.2 g/dl) and occult blood in the stool. Although barium series and endoscopy of the upper and lower intestinal tructs were carried out, there was no evidence of bleeding from the gastrointestinal tract 99mTcO4- scintigraphy, which was performed to exclude bleeding from Meckel's diverticulum, also did not locate a significant lesion. Angiographic imaging of the superior mesenteric arteries (SMA) was performed to exclude lesions such as small intestine tumors with extraluminal growth and vascular abnormalities such as A-V malformation and it revealed the round encasement of arteries in the peripheral SMA region, strongly suggestive of a small intestine tumor. Surgery was performed and an extraluminally protruding tumor was found in the small intestine. The excised tumor was 4 x 3 x 3.5 cm in size, are was diagnosed histologically as aberrant pancreas. The postoperative laboratory findings showed that the anemia had improved and occult blood was not detected in the stools. Although aberrant pancreas of the small intestine is a common benign tumor, it is a very unusual cause of bleeding from the alimentary tract.
Collapse
Affiliation(s)
- K Inoue
- Second Department of Internal Medicine, Ehime University School of Medicine
| | | | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Kohara K, Igase M, Yinong J, Fukuoka T, Maguchi M, Okura T, Kitami Y, Hiwada K. Asymptomatic cerebrovascular damages in essential hypertension in the elderly. Am J Hypertens 1997; 10:829-35. [PMID: 9270076 DOI: 10.1016/s0895-7061(97)00116-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
To investigate the underlying mechanisms of asymptomatic cerebrovascular damage, the diurnal change in blood pressure was evaluated in hypertensive patients with silent cerebral infarction (SCI). Sixty elderly hypertensive patients (age > or = 60 years) were matched with 40 middle-aged patients (age < or = 59 years) for sex and left ventricular mass index (LVMi). Lacunar lesions were evaluated by magnetic resonance imaging as SCI. The presence and the severity of SCI increased with age. In the middle-aged group, the presence of SCI was significantly related to 24-h blood pressure and LVMi evaluated by echocardiography. In elderly patients, the presence of SCI had no relationship with 24-h blood pressure or LVMi. The lowest level of nocturnal diastolic blood pressure showed a J-shaped relationship with the incidence of SCI in the elderly patients. These findings indicate that the hemodynamic characteristics underlying the development of SCI differ between middle-aged and elderly hypertensive patients. A different approach to the treatment of hypertension in the elderly appears necessary.
Collapse
Affiliation(s)
- K Kohara
- Second Department of Internal Medicine, Ehime University School of Medicine, Japan
| | | | | | | | | | | | | | | |
Collapse
|
30
|
Katayama H, Kohara K, Igase M, Maguchi M, Fukuoka T, Okura T, Kitami Y, Hiwada K. [Mollaret meningitis associated with a high level of cytokines in cerebrospinal fluid]. Nihon Ronen Igakkai Zasshi 1997; 34:65-9. [PMID: 9077108 DOI: 10.3143/geriatrics.34.65] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
A 70-year-old man was admitted to our hospital for further evaluation of recurrent fever, which had begun in October 1994. The patient had 5 to 7 days without fever, and then 2 to 3 days of fever. He had headaches during the febrile periods. On admission, he had abnormal pyramidal, extrapyramidal, and celebellar signs, and nuchal rigidity during the febrile period. However, these neurological abnormalities were completely absent during the afebrile period. Examination of cerebrospinal fluid revealed pleocytosis of mononuclear cells. During the febrile period, pleocytosis was associated with high levels of IgG, IL-6, TNF-alpha, and PGE2 in the cerebrospinal fluid. Administration of indomethacin prevented the fever, which suggests that abnormal production of cytokines in the cerebrospinal fluid contributes to fever in Mollaret meningitis.
Collapse
Affiliation(s)
- H Katayama
- Second Department of Internal Medicine, Ehime University School of Medicine
| | | | | | | | | | | | | | | |
Collapse
|
31
|
Kohara K, Igase M, Maguchi M, Fukuoka T, Kitami Y, Hiwada K. Autonomic nervous function in essential hypertension in the elderly. Evaluation by power spectral analysis of heart rate variability. Am J Hypertens 1996; 9:1084-9. [PMID: 8931833 DOI: 10.1016/0895-7061(96)00198-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Autonomic nervous function in elderly essential hypertensive patients was investigated by power spectral analysis of heart rate variability. Fifty-seven essential hypertensive patients participated in this study. They were divided into two groups: the middle-aged group (age < or = 59 years, n = 30) and the elderly group (age > or = 60 years, n = 27). All examinations were performed during hospitalization. Power spectral analysis of R-R interval was performed from Holter electrocardiogram every 10 min by the maximum entropy method to obtain the low frequency band (LFB; 0.04 to 0.15 Hz), which is an index of both sympathetic and parasympathetic nervous activity. Twenty-four-hour blood pressure measurement was performed by the cuffoscillometric method to evaluate the nocturnal decrease in blood pressure. Nondipper patients were defined as those whose nocturnal decrease in systolic blood pressure was < 10% of daytime blood pressure. Both LFB and HFB were significantly lower in elderly hypertensive patients than in middle-aged patients (P < .001 and P < .05, respectively). Elderly nondipper patients had further reduced power spectral densities throughout the day. Both LFB and HFB showed a negative correlation with age. However, the age-related decline of power densities was more prominent in dipper patients and was not statistically significant in nondipper patients. These findings indicate that the nondipper phenomenon is superimposed on age-related attenuation of autonomic nervous function in essential hypertension.
Collapse
Affiliation(s)
- K Kohara
- 2nd Department of Internal Medicine, Ehime University School of Medicine, Japan
| | | | | | | | | | | |
Collapse
|
32
|
Ogimoto A, Kohara K, Igase M, Fukuoka T, Maguchi M, Nishida W, Kitami Y, Hiwada K. [A very old man with Crush syndrome]. Nihon Ronen Igakkai Zasshi 1996; 33:783-6. [PMID: 8958743 DOI: 10.3143/geriatrics.33.783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
A 90-year-old man fell into a marsh and was rescued 18 hours later. When he was admitted to our emergency room, physical examination revealed no remarkable findings except for many abrasions on his skin. Laboratory examination revealed a serum CPK level of 46, 904 IU/L, which had further increased to 84,678 IU/L by the following day. Oliguria developed on the second day, along with an increase in serum creatinine to 5.5 mg/dt. Hemodialysis was considered for the treatment of acute renal failure, but his renal function recovered soon by the continuation of conservative fluid therapy. Fluid therapy may be an effective and easy treatment for acute renal failure due to the crush syndrome, even in very old patients.
Collapse
Affiliation(s)
- A Ogimoto
- Second Department of Internal Medicine, Ehime University School of Medicine
| | | | | | | | | | | | | | | |
Collapse
|
33
|
Kodama K, Igase M, Kazatani Y, Matsuzaki K, Murakami E, Kokubu T. Detection of perioperative coronary vasospasm on iodine-123-MIBG, thallium-201 and iodine-123-BMIPP myocardial SPECT images. J Nucl Med 1995; 36:2050-2. [PMID: 7472596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
A 64-yr-old woman, who had no history of anginal attack, underwent cholecystectomy under general anesthesia. A few hours after successful surgery, the EKG showed T-wave inversions with QT-interval prolongations and torsades de pointes. The [123I]MIBG scintigraphic findings revealed marked denervation in the anteroseptal and inferoposterior myocardium, whereas 201TI myocardial SPECT showed only slightly reduced tracer uptake in those areas. The [123I]BMIPP scans showed abnormal fatty acid metabolism in the anteroseptal myocardium. Coronary angiogram detected no fixed stenosis, but coronary vasoconstriction in the left anterior descending artery was induced by intracoronary injection of acetylcholine. In our patient, the findings of cardiac imaging with [123I]MIBG, 201TI and [123I]BMIPP led to coronary angiography and the final diagnosis of probable perioperative coronary vasospasm.
Collapse
Affiliation(s)
- K Kodama
- Department of Internal Medicine, Kinki Central Hospital, Itami, Japan
| | | | | | | | | | | |
Collapse
|
34
|
Kodama K, Igase M, Kazatani Y, Matsuzaki K, Murakami E, Kokubu T. [Malignant fibrous histiocytoma of the chest wall in a nonagenarian]. Nihon Ronen Igakkai Zasshi 1995; 32:592-6. [PMID: 8531406 DOI: 10.3143/geriatrics.32.592] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
We report a case of malignant fibrous histiocytoma of the chest wall observed in a 94-year-old woman. She noticed appetite loss and general edema a week before admission. The patient was diagnosed as having congestive heart failure due to valvular heart disease on the basis of echocardiographic findings and became symptom-free by treatment with vasodilators and diuretics. However, chest roentgenogram disclosed a extrapleural mass in the left mid-lateral chest. About 2 months after admission, she experienced left lateral chest pain for the first time. The chest CT scan revealed a 5 x 5 x 2 cm mass, adjacent to the lateral-posterior chest wall and projecting into the thoracic cavity and rib osteolysis. Gallium-67 citrate scintigram showed abnormal isotope accumulation in the left middle chest. Biopsy was not done. The therapeutic approach was mainly pain relief, and no tumor resection, chemotherapy, or radiotherapy was performed. The mass increased in size, and increasingly extended into the thoracic cavity on follow-up CT scans. Furthermore, marked invasion of the tumor to subcutis and subscapula was found. She died of cachexia and respiratory failure 34 weeks after admission. Histologic examination revealed malignant fibrous histiocytoma.
Collapse
Affiliation(s)
- K Kodama
- Department of Internal Medicine, Kinki Central Hospital
| | | | | | | | | | | |
Collapse
|
35
|
Kodama K, Igase M, Funada J, Kazatani Y, Matsuzaki K, Murakami E, Kokubu T. Gallium-67 citrate scintigraphy in idiopathic pericarditis--report of a case. Jpn Circ J 1994; 58:298-302. [PMID: 8051789 DOI: 10.1253/jcj.58.298] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
We report a case of idiopathic pericarditis in a 71-year-old woman without a friction rub or electrocardiographic changes suggestive of pericardial inflammation. She noticed dyspnea and palpitation on exertion about 40 days before admission. After admission, pericardial effusion and inflammatory reactions, such as elevated C-reactive protein, were found. Moreover, gallium-67 citrate scintigraphy revealed abnormal isotope accumulation over the cardiac silhouette. Therefore, she was diagnosed as having "active" pericarditis. The finding with the gallium scan became negative with steroid therapy. In this case, a gallium scan was very useful in assessing and monitoring the course of pericardial inflammation.
Collapse
Affiliation(s)
- K Kodama
- Department of Internal Medicine, Kinki Central Hospital, Itami, Japan
| | | | | | | | | | | | | |
Collapse
|
36
|
Inoue Y, Igase M, Otsuka T, Yokoyama A, Kohno N, Hiwada K. [A case report of obstructive sleep apnea syndrome associated with primary aldosteronism]. Nihon Kyobu Shikkan Gakkai Zasshi 1994; 32:288-92. [PMID: 8189653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
A 60-year-old obese woman was admitted for evaluation of excessive daytime sleepiness, loud snoring, cyanosis, systemic edema, hypertension and diabetes mellitus. Laboratory examination showed severe hypoxemia, hypercapnea, metabolic alkalosis, hypokalemia and hyperaldosteronism. CT scan showed a left adrenal tumor. A diagnosis of obstructive sleep apnea syndrome associated with primary aldosteronism was established. Metabolic alkalosis, hypokalemia and sodium retention due to hyperaldosteronism were thought to be factors exacerbating her sleep apnea.
Collapse
Affiliation(s)
- Y Inoue
- Second Department of Internal Medicine, Ehime University School of Medicine, Japan
| | | | | | | | | | | |
Collapse
|