Association with sagittal alignment and osteoporosis-related fractures in outpatient women with osteoporosis.

The baseline sagittal vertical axis (SVA) and pelvic tilt (PT) are independent risk factors of osteoporosis-related fractures in women with osteoporosis. We clarified the SVA and PT to predict the incidence of osteoporosis-related fractures. PURPOSE: Sagittal alignment with osteoporosis women deteriorates with advancing age and sagittal alignment may indicate osteoporosis-related fractures in the future. However, whether the sagittal alignment predicts future osteoporosis-related fracture in patients with osteoporosis has not been clarified. We aimed to investigate the association between sagittal alignment and future osteoporosis-related fractures. METHODS: This was a retrospective cohort study. Of the 313 participants (mean follow-up period, 2.9 years), 236 were included in the analysis. At baseline, we measured bone mineral density (BMD) of the lumbar spine and the femoral neck, sagittal vertical axis (SVA), thoracic kyphosis, pelvic incidence minus lumbar lordosis, sacral slope, pelvic tilt (PT), geriatric locomotive function scale (GLFS), two-step value, and stand-up test. The information on medications and the duration of treatment were reviewed from the medical records. Additionally, participants reported their history of falls at baseline. Multiple logistic regression analysis was used to determine the association of future osteoporosis-related fracture, and adjusted Odds ratios (OR) and 95% confidence interval (CI) were calculated with all predictors as covariates. All continuous variables were calculated using standardized OR (sOR). RESULTS: Osteoporosis-related fractures occurred in 33 of 313 participants (10.5%). Multiple logistic regression analysis showed that a history of falls (OR =4.092, 95% CI: 1.029-16.265, p =0.045), SVA (sOR =4.228, 95% CI: 2.118-8.439, p <0.001), and PT (sOR =2.497, 95% CI: 1.087-5.733, p =0.031) were independent risk factors for future osteoporosis-related fractures. CONCLUSIONS: This study revealed the SVA and PT to predict osteoporosis-related fractures. TRIAL REGISTRATION NUMBER AND DATE OF REGISTRATION: UMIN000036516 (April 1, 2019).

Comparison of Near-Infrared Spectroscopy and Bioelectrical Impedance Analysis for the Assessment of Body Composition in the Frail Elderly.

BACKGROUND: Body composition is an important component of health related fitness. Near-infrared spectroscopy (NIRS) is a non-invasive, simple and rapid method of assessing body fat percentage. However, it is unknown whether NIRS can accurately estimate FFM in community-dwelling frail elderly. OBJECTIVES: This study aimed to compare NIRS with bioelectrical impedance analysis (BIA) in FFM measurement. DESIGN: Cross-sectional study. SETTING: Shizuoka, Japan. PARTICIPANTS: The study population comprised 53 community-dwelling frail elderly (15 men, 38 women; mean age 84.8±6.4 years; body mass index 19.7±3.5 kg/m2). MEASUREMENT: FFM and percentage fat mass (%FM) were estimated using a NIRS device at two sites (biceps and calf) and compared to body composition measured by BIA. Simple linear regression and Bland-Altman analyses were used to determine agreement between the methods. RESULTS: FFM determined by BIA highly correlated with that determined by NIRS at both the biceps and calf (r=0.92 for both; p<0.001). The correlation coefficients for %FM estimated by NIRS were slightly lower (r=0.70 for biceps; r=0.66 for calf). In NIRS assessments, systematic biases were found for %FM but not for FFM. CONCLUSION: NIRS has significant potential for body composition analysis. Further comparative and longitudinal studies need to be conducted using an agreed reference analysis method to find a simple and more suitable method that can be applied among the community-dwelling frail elderly.

Serum somatostatin in early-stage Parkinson's disease.

OBJECTIVE: To compare levels of plasma digestive hormones in patients with and without nausea or vomiting during initial treatment of early-stage Parkinson's disease (PD). METHODS: This was a 3-week, open-label, randomized study of treatment with an antiparkinson drug in untreated PD patients. We measured the levels of plasma digestive hormones before (baseline) and 3 weeks after administration of an antiparkinson drug. RESULTS: Mean value of serum somatostatin at baseline was significantly increased in PD patients compared with the control group (P < 0.01). Serum somatostatin levels were significantly increased after treatment in subjects who experienced nausea or vomiting (P < 0.01). However, significant increase in serum somatostatin levels after treatment was not observed in PD patients without nausea or vomitting. CONCLUSION: Serum somatostatin in early-stage PD patients before treatment was increased compared with healthy subjects. The nausea and vomiting induced by antiparkinson drugs may be related to uncontrolled somatostatin secretion through central vagus nerve dysfunction.

Energy-dependent enhancement of the electron-coupling spectrum of the underdoped Bi2Sr2CaCu2O(8+δ) superconductor.

We have determined the electron-coupling spectrum of superconducting Bi2Sr2CaCu2O(8+δ) from high-resolution angle-resolved photoemission spectra by two deconvolution-free robust methods. As hole concentration decreases, the coupling spectral weight at low energies ≲15 meV shows a twofold and nearly band-independent enhancement, while that around ∼65 meV increases moderately, and that in ≳130 meV decreases leading to a crossover of dominant coupling excitation between them. Our results suggest the competition among multiple screening effects, and provide important clues to the source of sufficiently strong low-energy coupling, λ(LE)≈1, in an underdoped system.

Anti-inflammatory sesquiterpenes from Curcuma zedoaria.

From the methanolic extract of the rhizome of Curcuma zedoaria, we isolated anti-inflammatory sesquiterpene furanodiene (1) and furanodienone (2) along with new sesquiterpene compound 3 and known eight sesquiterpenes, zederone (4), curzerenone (5), curzeone (6), germacrone (7), 13-hydroxygermacrone (8), dehydrocurdione (9), curcumenone (10), and zedoaronediol (11). Their structures were elucidated on the basis of spectroscopic data. The anti-inflammatory effect of isolated components on 12-O-tetradecanoylphorbol-13-acetate (TPA)-induced inflammation of mouse ears were examined. Compounds 1 and 2 suppressed the TPA-induced inflammation of mouse ears by 75% and 53%, respectively, at a dose of 1.0 micromol. Their activities are comparable to that of indomethacin, the normally used anti-inflammatory agent.

Usefulness of switching to cabergoline from other dopamine agonists in patients with advanced Parkinson's disease.

Problems associated with long-term treatment of advanced Parkinson's disease (PD) include motor complications and psychotic and autonomic symptoms. We switched patients from bromocriptine (BR) or pergolide (PER) to cabergoline (CB) therapy and investigated CB's usefulness in alleviating such problems. Subjects were 30 patients (mean age 68.2 years; 13 receiving BR, 17 PER) with PD complicated by effects of long-term treatment but in whom their dose of dopamine (DA) agonist was contraindicated due to adverse reactions. Patients were switched to CB over a 2-4-week period. Hoehn-Yahr and Unified Parkinson Disease Rating Scale (UPDRS) I-IV "on" and "off" scores improved in both the BR and PER groups. CB was not discontinued due to adverse reactions in any patient. In conclusion, switching to CB is useful in patients in whom it is problematic to increase their dose of DA agonist due to motor complications or psychotic symptoms of advanced PD.

Periodic structures and diurnal variation in blood pressure and heart rate in relation to microgravity on space station MIR.

Four Russian crew members were studied on space station MIR, and blood pressure (BP) and heart rate (HR) data were continuously collected. BP and HR data were collected on earth 1 day before orbital flight to the space station, then at weeks 8, 16 and 24 during space flight, and again 1 or 2 days after returning to earth. Time serial data for BP and HR were analyzed by spectral analysis with the MemCalc system (Suwa Trust, Sapporo, Japan). Periodic structures of diurnal variation in systolic blood pressure (SBP), diastolic blood pressure (DBP) and HR were compared at 24-hour, 12-hour and 8-hour intervals, these being determined as the main periodic components for the assessment of BP and HR variability. The 24-h mean levels of SBP and HR during space flight were unchanged. Waking SBP was not different from pre-flight values. During sleep, in-flight changes in HR did not differ from pre-flight values. SBP during sleep in orbit increased to over pre-flight values. Waking DBP was reduced during flight. The SBP and HR phases over a 24-hour cycle were shortened with a more pronounced shortening in weeks 8 and 16 compared with pre-flight values, and at week 24 recovered to preflight values. The 12, 8-hour-cycle remained unchanged, and were similar to pre-flight values. At the space station, the astronauts' mission was carried out under strict control of sleeping and waking hours; therefore, their 24-hour schedule is an artificially constructed situation. Main periodicity structures were maintained by strict control of lifestyle during long-term space flight. The conclusions reached were as follows: 1) SBP levels during sleep in a space environment increased compared with those on earth; 2) the periodicity phase of BP and HR shifted toward to 24-hour cycle as a result of long-term space flight, even though these periods shortened after a few months compared with pre-space flight values.

Blood pressure variability during 120-day head-down bed rest in humans.

Influence of physical inactivity and microgravity to periodic structure of blood pressure was studied. Six healthy males were kept under head-down bed rest (HDBR) for 120 days. Blood pressure and heart rate (HR) were recorded by a portable sphygmomanometer and a Holter electrocardiogram, respectively. The results were analyzed by spectrum analysis. Phase, amplitude and acrophase of systolic blood pressure (SBP) by approximately 24, 12 and 8 h were measured before, 60, 120 day and after HDBR. The phase at 24, 12 and 8 h did not show significant changes during HDBR, and acrophase showed a tendency to shift to 14:00 after HDBR. Amplitude for 24 h tended to attenuate during bed rest (BR), and significantly increased after BR. The results of this study suggest that the circadian rhythm of SBP and HR were maintained by strict control of sleep, awakening and food intake in microgravity model of a long-term BR state. However, the tendency to decrease 24-h cyclic amplitude of SBP appeared to be the rhythmic modulation related to cardiovascular deconditioning.

Aspirin enhances the induction of type I allergic symptoms when combined with food and exercise in patients with food-dependent exercise-induced anaphylaxis.

We examined the effect of aspirin as a substitute for exercise in inducing urticaria/anaphylaxis in three patients with food-dependent exercise-induced anaphylaxis (FDEIA). Two of the patients had specific IgE antibodies to wheat and the other had antibodies to shrimp. Administration of aspirin before ingestion of food allergens induced urticaria in one patient and urticaria and hypotension in another, while aspirin alone or food alone elicited no response. The third patient developed urticaria only when he took all three items, i.e. aspirin, food and additional exercise, whereas provocation with any one or or two of these did not induce any symptoms. These findings suggest that aspirin upregulates type I allergic responses to food in patients with FDEIA, and further shows that aspirin synergizes with exercise to provoke symptoms of FDEIA. This is the first report of a synergistic effect of aspirin in inducing urticaria/anaphylaxis, which was confirmed using challenge tests in patients with FDEIA.

Central volume expansion is pivotal for sustained decrease in heart rate during seated to supine posture change.

During prolonged, static carotid baroreceptor stimulation by neck suction (NS) in seated humans, heart rate (HR) decreases acutely and thereafter gradually increases. This increase has been explained by carotid baroreceptor adaptation and/or buffering by aortic reflexes. During a posture change from seated to supine (Sup) with similar carotid stimulation, however, the decrease in HR is sustained. To investigate whether this discrepancy is caused by changes in central blood volume, we compared (n = 10 subjects) the effects of 10 min of seated NS (adjusted to simulate carotid stimulation of a posture change), a posture change from seated to Sup, and the same posture change with left atrial (LA) diameter maintained unchanged by lower body negative pressure (Sup + LBNP). During Sup, the prompt decreases in HR and mean arterial pressure (MAP) were sustained. HR decreased similarly within 30 s of NS (65 +/- 2 to 59 +/- 2 beats/min) and Sup + LBNP (65 +/- 2 to 58 +/- 2 beats/min) and thereafter gradually increased to values of seated. MAP decreased similarly within 5 min during Sup + LBNP and NS (by 7 +/- 1 to 9 +/- 1 mmHg) and thereafter tended to increase toward values of seated subjects. Arterial pulse pressure was increased the most by Sup, less so by Sup + LBNP, and was unchanged by NS. LA diameter was only increased by Sup. In conclusion, static carotid baroreceptor stimulation per se causes the acute (<30 s) decrease in HR during a posture change from seated to Sup, whereas the central volume expansion (increased LA diameter and/or arterial pulse pressure) is pivotal to sustain this decrease. Thus the effects of central volume expansion override adaptation of the carotid baroreceptors and/or buffering of aortic reflexes.

Mechanisms of hypotensive effects of a posture change from seated to supine in humans.

The hypothesis tested was that the hydrostatic stimulation of carotid baroreceptors is pivotal to decrease mean arterial pressure at heart level during a posture change from seated to supine. In eight males, the cardiovascular responses to a 15-min posture change from seated to supine were compared with those of water immersion to the xiphoid process and to the neck, respectively. Left atrial diameter and cardiac output (rebreathing) increased similarly during the posture change and water immersion to the xiphoid process and further so during neck immersion. Mean arterial pressure decreased by 12 +/- 2 mmHg during the posture change, by 5 +/- 1 mmHg during xiphoid immersion, and was unchanged during neck immersion. Arterial pulse pressure increased by 12 +/- 3 mmHg during the posture change (P < 0.05) and less during xiphoid and neck immersion by 7 +/- 3 mmHg (P < 0.05). Total peripheral vascular resistance decreased similarly during the posture change and neck immersion and slightly less during xiphoid immersion (P < 0.05). In conclusion, the hydrostatic stimulation of carotid baroreceptors combined with some additional increase in arterial pulse pressure, which also stimulates aortic baroreceptors, accounts for more than half of the hypotensive response at heart level to a posture change from seated to supine.

PCR-based method for isolation and detection of Chlamydia pneumoniae DNA in cerebrospinal fluids.

Since current studies indicate the possible involvement of Chlamydia pneumoniae in the pathogenesis of multiple sclerosis (MS), demonstration of C. pneumoniae in the cerebrospinal fluid (CSF) of patients with MS is highly desirable. However, there is controversy concerning the detection of C. pneumoniae in CSFs from MS patients due to the lack of a standard protocol for extraction and detection of C. pneumoniae DNA. In this regard, we attempted to establish a highly effective extraction protocol for C. pneumoniae DNA from CSFs utilizing a commercial kit and a PCR detection method. The extraction and PCR detection protocol established in this study succeeded in detecting as few as 20 C. pneumoniae organisms in 200 microl of mock CSF. The use of this protocol to detect C. pneumoniae DNA in CSFs revealed that 68% of CSF samples obtained from patients with MS were positive (11 out of 16 samples) for chlamydia DNA. Thus, the protocol established here is sensitive enough to detect chlamydia DNA from CSFs and can be used by other laboratories for evaluation of the presence of chlamydiae in CSFs because the protocol is based on the use of a commercial kit.

Actinidic acid, a new triterpene phytoalexin from unripe kiwi fruit.

Seven phytoalexins (1-7), including a new compound, were isolated from the peel of unripe kiwi fruit (Actinidia deliciosa cv. Golden King) that had been wounded and inoculated with Colletotrichum musae. The new phytoalexin (1) was identified as 2alpha,3beta,23-trihydroxy-12,20(30)-ursadien-28-oic acid, and named actinidic acid. Phytoalexins 2-6 are known triterpenes but have not previously been described as phytoalexins. Phytoalexin 7 is the same triterpene as the phytoalexin of nectarine fruit.

An adult case of congenital external carotid-jugular arteriovenous fistula with reversible circulatory insufficiency in the cerebellum and lower brain stem.

A 27-year-old man with congenital external carotid-jugular arteriovenous fistula presented with a diminished level of consciousness and an ataxic gait. Axial fluid-attenuated inversion-recovery (FLAIR) MR imaging revealed venous congestion, a dilated right jugular vein, and an area of high signal intensity in the brain stem and cerebellum. Angiography showed a dilated right external carotid artery and jugular vein and the presence of a fistula. After coil embolization of the fistula, axial MR FLAIR images showed only a few areas of high signal intensity in the brain stem and cerebellum. The causal factor was venous congestion in the inferior petrosal sinus and basilar plexus due to high blood pressure in the jugular vein. This case is presented for its unusual clinical and radiologic findings.

Changes in the content and biosynthesis of phytoalexins in banana fruit.

Changes in the phytoalexin content in unripe fruit of banana, Musa acuminata, were analyzed after various treatments. The results show that level of hydroxyanigorufone started to increase 1-2 day after either wounding or inoculation with conidia of Colletotrichum musae. Inoculation followed by wounding induced the formation of many other phenylphenalenones. The accumulation of hydroxyanigorufone decreased, after its transient maximum, on ripening by exposure of the wounded fruit to ethylene. The level of production of hydroxyanigorufone in ripe fruit treated by wounding and/or by inoculation was much lower than that in unripe fruit. 2-Aminooxyacetic acid, an inhibitor of phenylalanine ammonia-lyase (PAL), inhibited the accumulation of hydroxyanigorufone in wounded fruit, and the PAL activity increased after wounding and ethylene treatment, respectively. Feeding experiments with [1-(13)C] and [2-(13)C]cinnamic acids, and [2-(13)C]malonate show that two molecules of cinnamic acid and one of malonate were incorporated into each molecule of hydroxyanigorufone. The phytoalexins isolated from fruit to which deuterated hydroxyanigorufone and irenolone had been administered revealed that 2-(4'-hydroxyphenyl)-1,8-naphthalic anhydride was biosynthesized from hydroxyanigorufone rather than from irenolone.

Triterpene phytoalexins from strawberry fruit.

Strawberry cv. Houkouwase is resistant to infection by Colletotrichum fragariae. The formation of antifungal compounds was observed in unripe fruit which had been wounded and inoculated with conidia of C. musae. Three antifungal compounds were isolated and identified as euscaphic acid, tormentic acid and myrianthic acid. Myrianthic acid inhibited the growth of C. musae at 3 microg, and euscaphic and tormentic acids showed inhibitory effects at 100 microg. A quantitative analysis of their contents showed that the triterpenes increased in wounded fruit, and in wounded and inoculated fruit, but not in non-treated fruit. These findings indicate that unripe fruit of Houkouwase produced the triterpenes as phytoalexins. The triterpene phytoalexins seem to be involved in the resistance of strawberry to the fungus.

Isolation and localization of type IIb Na/Pi cotransporter in the developing rat lung.

Differential display analysis of rat lung at different developmental stages identified a fragment, HG80, which appeared on embryonic day 16.5 and thereafter. A full-length cDNA derived from a cDNA library of newborn rat lung probed with HG80 was the rat counterpart of sodium-dependent phosphate transporter type IIb and was designated rNaPi IIb. In situ hybridization showed that rNaPi IIb was expressed in type II alveolar cells, suggesting a role in the synthesis of surfactant in the alveoli. The time-dependent changes in localization of this gene in the developing lung and its possible use as a type II pneumocyte marker are discussed.

Expression of the OGG1-type 1a (nuclear form) protein in cancerous and non-cancerous human cells.

The human OGG1 gene encodes 8-hydroxyguanine DNA glycosylase. By RT-PCR analysis, five novel type 1 transcripts, in addition to eight known types (OGG1-types 1a to 1c and 2a to 2e), were identified. Among them, only the type 1a isoform contains both a nuclear localization signal and the entire DNA binding motif, suggesting the involvement of type 1a in chromosomal DNA repair. By Western blot analysis using a monoclonal antibody prepared by immunizing the whole type 1a protein, a 39 kDa type 1a protein was detected in lung cancer cell lines and peripheral lymphocytes. The type 1a protein was expressed at a similar level, irrespective of its polymorphic types characterized by distinct repair activity. By an immunocytochemical study, the majority of type 1a protein was localized in the nucleus. These results indicate that OGG1-type 1a protein is involved in the repair of 8-hydroxyguanine in chromosomal double-stranded DNA and constitutively expressed in cancerous and non-cancerous human cells.

[A case of transverse myelitis caused by primary antiphospholipid antibody syndrome].

A 14-year-old man was admitted with sudden onset of paralysis in his lower extremities paralysis and of sensory loss below Th10 level. On admission, linear high intensity signals was seen in the spinal cord from Th 8 to Th 12 level on thoracic MRI T2 weighted image. Laboratory data on admission indicated existence of lupus anticoagrant in the patient's serum. Systemic lupus erythematodes was negative in his past history. The diagnosis of transverse myelitis caused by primary antiphospholipid syndrome was made accordingly. Plasmapheresis was performed to remove the lupus anticoagrant. After plasma pheresis coagulopathy was normalized with disappearance of the lupus anticoagrant. The lesion of the spinal cord is too extensive to be caused by single obstruction of any one blood vessel branch of the spinal cord. The transverse myelitis may be aggravated by the direct invasion of the lupus anticoagrant into nervous tissue from the vasculature whose blood brain barrier had been compromised by intravascular coagulation of this substance.