IgG4-Related Pericarditis Diagnosed by Accumulated Pericardial Effusion.

IgG4-related pericarditis has rarely been reported. Here, we report a case of IgG4-related disease that presented with pericardial effusion. A 67-year-old female who presented with palpitations and chest pain was admitted because of a large amount of pericardial effusion that required drainage. The patient underwent pericardial drainage, and the symptoms were gradually alleviated. IgG4 levels were elevated in the serum and pericardial effusions. A biopsy specimen of 18F-FDG accumulated in the submandibular gland showed lymphocyte infiltration with IgG4-positive cells. The patient was diagnosed with IgG4-related pericarditis. Glucocorticoids resolved serological and imaging abnormalities. Prompt treatment improves the disease status.

A potential relation between premenstrual symptoms and subjective perception of health and stress among college students: a cross-sectional study.

BACKGROUND: A majority of women from all cultures and socioeconomic levels experience myriad symptoms known as premenstrual syndrome during the days prior to menstruation. The present study investigated commonly reported symptoms in the premenstrual phase among college students. The authors further scrutinized potential factors, including subjective perceptions of health, which may be related to the premenstrual-symptom constellation. METHODS: We conducted a cross-sectional survey, which included 200 participants (mean age: 19.8 ± 0.1 years old). The subjects completed a rating of their premenstrual experiences relative to 46 symptoms in eight categories of the self-reporting menstrual distress questionnaire (MDQ) to evaluate the prevalence and severity of premenstrual symptoms. The participants also answered a standardized health questionnaire regarding subjective perceptions of health, self-rating stress, lifestyle, and demographic variables. RESULTS: Regardless of severity, the 10 symptoms most often occurring among the participants included skin disorders, irritability, fatigue, mood swings, general aches and pains, lowered school or work performance, backache, painful breasts, weight gain, and swelling. Stepwise multiple regression analysis revealed subjective perception of health (ß = 0.28; p <  0.001) and self-rating stress (ß = 0.18; p = 0.008) as the factors most strongly related to the MDQ total scores. In addition, the 19 women who evaluated themselves as "unhealthy and stressed" had greater prevalence of severe or extremely severe physical (general aches and pains) and psychosocial symptoms (confusion, lowered school or work performance, decreased efficiency, loneliness, anxiety, restlessness, mood swings, and depression), compared to the healthy and non-stressed women. CONCLUSIONS: The present study indicates the prevalence of premenstrual symptoms, regardless of severity and number, among college students and suggests that negative subjective perceptions of health and stress may be related to the intensity of premenstrual symptomatology.

Insulin Resistance is Associated with Longitudinal Changes of Cardiac Repolarization Heterogeneity in Apparently Healthy Subjects.

INTRODUCTION: Increased heterogeneity in ventricular repolarization is a risk factor of sudden cardiac death, but its natural history is unclear. Here we examined whether insulin resistance is associated with longitudinal change in ventricular repolarization heterogeneity in apparently healthy subjects. METHODS: The study subjects were participants in health checkups in cohort 1 and cohort 2, which were followed up for 6 years and 5 years, respectively. Subjects with diabetes, cardiovascular disease, or renal disease at baseline were excluded from the analyses. As indices of insulin resistance, the homeostasis model assessment of insulin resistance (HOMA-IR) and triglyceride to HDL-cholesterol ratio (TG/HDL-C) were used in cohort 1 and cohort 2, respectively. Heterogeneity in ventricular repolarization was assessed by heart rate-corrected Tpeak-Tend interval in V5 (cTpTe), QT interval, and QT dispersion. In regression analyses, parameters with a skewed distribution were normalized by logarithmic transformation or by Box-Cox transformation. RESULTS: In longitudinal analyses, Box-Cox-transformed cTpTe at the end of follow-up was weakly correlated with log HOMA-IR at baseline in cohort 1 (n = 153, r = - 0.207, 95% CI - 0.354 to - 0.050, p = 0.010) and with log TG/HDL-C at baseline in cohort 2 (n = 738, r = - 0.098, 95% CI - 0.169 to - 0.026, p = 0.008). Multiple regression analysis showed that indices of insulin resistance, but not glycosylated hemoglobin (HbA1c) or plasma glucose, at baseline were significant explanatory variables for cTpTe at the end of follow-up. Neither QT interval nor QT dispersion was correlated with metabolic parameters. CONCLUSION: Insulin resistance may be involved in the longitudinal increase of ventricular repolarization heterogeneity in apparently healthy subjects.

Does Japanese Citrus Fruit Yuzu (Citrus junos Sieb. ex Tanaka) Fragrance Have Lavender-Like Therapeutic Effects That Alleviate Premenstrual Emotional Symptoms? A Single-Blind Randomized Crossover Study.

OBJECTIVE: A majority of menstruating women experience some degree of regular recurrences of diverse symptoms-commonly known as premenstrual syndrome (PMS)-during the days before menstruation. Given the multifactorial etiology of PMS, no single treatment is universally recognized as effective, and many women turn to alternative modalities, including aromatherapy. The present study investigated therapeutic effects on premenstrual symptoms using fragrance from yuzu, a Japanese citrus fruit (Citrus junos Sieb. ex Tanaka), and aromatherapy, from the perspective of autonomic nervous system function. SUBJECTS: Seventeen women in their 20s with subjective premenstrual symptoms. DESIGN: A single-blind randomized crossover study. SETTINGS/LOCATION: This study was performed at a laboratory in a university in Osaka, Japan. Subjects were examined on two separate occasions in the luteal phase. OUTCOME MEASURES: Using two aromatic stimulation sources (yuzu and lavender used as the control), this experiment measured heart rate variability (HRV) reflecting autonomic nerve activity and the Profile of Mood States (POMS) as a psychologic index before and after aromatic stimulation. RESULTS: A scant 10-min inhalation of the yuzu scent significantly decreased heart rate and increased high-frequency power of HRV, reflecting parasympathetic nerve activity, in the luteal phase. Additionally, POMS tests demonstrated that inhalation of the yuzu essential oil significantly decreased three negative subscales: tension-anxiety, anger-hostility, and fatigue-common premenstrual symptoms, together with a total mood disturbance as a global measure of affective state, as long as 35 min after the aroma stimulation. These premenstrual psychoneurophysiologic effects of yuzu fragrance did not differ from those of the effects of lavender. CONCLUSIONS: The present study indicated that short-term inhalation of yuzu fragrance could alleviate premenstrual emotional symptoms, which, at least in part, is attributable to the improvement of parasympathetic nervous system activity. This study further implies that yuzu fragrance aromatherapy might serve as an anti-PMS modality, given its comparable psychoneurophysiologic effects to those of lavender, a representative relaxing scent.

A Case of Crescentic Glomerulonephritis Complicated with Hypocomplementemic Urticarial Vasculitis Syndrome and ANCA-Associated Vasculitis.

Systemic urticaria in a 64-year-old woman was diagnosed as leukocytoclastic vasculitis by a punch biopsy of the skin. Her physical findings improved after prescription of prednisolone at a dose of 20 mg/day, but the skin rash relapsed with renal dysfunction, proteinuria, and hematuria when the dose of prednisolone was reduced over a period of 9 months to 1 mg/day. She was admitted to our institute for further examination, when urinary protein and plasma creatinine levels were 0.8 g/day and 1.7 mg/dL, respectively. Complement analysis showed that levels of total hemolytic component, component C3 fraction, and component C4 fraction were 30∼60% of normal values and the titer of anti-neutrophil cytoplasmic antibody for myeloperoxidase (MPO-ANCA) was 89 EU (normal range, <10 EU), though there were no immunologic disorders such as systemic lupus erythematosus. Cellular crescentic glomerulonephritis was observed by light microscopy, and immunofluorescent studies showed positive staining for IgG, IgM, C3, C4, and C1q. Electron microscopy showed mesangial and subendothelial deposits with circumferential mesangial interposition. She fulfilled the diagnostic criteria for hypocomplementemic urticarial vasculitis syndrome (HUV), and ANCA-associated vasculitis (AAV) was also indicated by small vessel vasculitis and positive MPO-ANCA. Steroid pulse therapy with methylprednisolone followed by oral prednisolone improved her general condition and hypocomplementemia, and MPO-ANCA became negative. HUV and AAV are distinct clinical disorders, though both affect small blood vessels. Here we report a case of AAV-complicated HUV with crescentic glomerulonephritis.

Aromatic effects of a Japanese citrus fruit-yuzu (Citrus junos Sieb. ex Tanaka)-on psychoemotional states and autonomic nervous system activity during the menstrual cycle: a single-blind randomized controlled crossover study.

BACKGROUND: Yuzu (Citrus junos Sieb. ex Tanaka), a yellow-golden colored citrus fruit, has traditionally been used to promote psychosomatic health in Japan. While the yuzu produces a distinctive, pleasing aroma of citrus and floral, the efficacy of its fragrance remains unknown. The present study investigated the soothing effects of the fragrance of yuzu essential oil from the perspective of autonomic nervous system activity, which plays a crucial role in the integrity of the mind-body connection. METHODS: Twenty one women in their 20s participated in a single-blind randomized controlled crossover study. Subjects were examined twice each in the follicular and late-luteal phases. Two kinds of aromatic stimulation (yuzu and water as a control) were used. This experiment measured heart rate variability (HRV) reflecting autonomic nervous system activity and used the Profile of Mood States (POMS) as a psychological index before and after the aromatic stimulation. RESULTS: Only a 10-min inhalation of the yuzu scent significantly decreased heart rate and increased high frequency power of HRV reflecting parasympathetic nervous system activity, regardless of menstrual phase. This significant physiological effect continued for at least 25 min. In addition, the POMS tests revealed that inhalation of the aromatic yuzu oil significantly decreased total mood disturbance, a global measure of affective state, together with two POMS subscales-tension-anxiety and fatigue, as long as 35 min after the aroma stimulation, both in the symptomatic late-luteal and non-symptomatic follicular phases. CONCLUSIONS: The present study provides the novel information that yuzu's aromatic effects could serve to alleviate negative emotional stress, which, at least in part, would contribute to the improvement of parasympathetic nervous system activity.

Effects of olfactory stimulation from the fragrance of the Japanese citrus fruit yuzu (Citrus junos Sieb. ex Tanaka) on mood states and salivary chromogranin A as an endocrinologic stress marker.

OBJECTIVE: This study investigated the soothing effects of fragrance from yuzu, a Japanese citrus fruit (Citrus junos Sieb. ex Tanaka), with salivary chromogranin A (CgA) used as an endocrinologic stress marker reflecting sympathetic nervous system activity. METHODS: Twenty healthy women (mean age, 20.5 ± 0.1 years) participated in a randomized, controlled, crossover study. Participants were examined on two separate occasions-once using the yuzu scent and once using unscented water as a control-in the follicular phase. This experiment measured salivary CgA and the Profile of Mood States (POMS) as a psychological index before and after the aromatic stimulation. RESULTS: Ten-minute inhalation of the yuzu scent significantly decreased salivary CgA. At 30 minutes after the inhalation period, the salivary CgA level further decreased. In addition, POMS revealed that inhalation of the aromatic yuzu oil significantly decreased total mood disturbance, a global measure of affective state, as well as four subscores of emotional symptoms (tension-anxiety, depression-dejection, anger-hostility, and confusion), as long as 30 minutes after the olfactory stimulation. CONCLUSIONS: Yuzu's aromatic effects may alleviate negative emotional stress, which, at least in part, would contribute to the suppression of sympathetic nervous system activity.

Does lavender aromatherapy alleviate premenstrual emotional symptoms?: a randomized crossover trial.

BACKGROUND: A majority of reproductive-age women experience a constellation of various symptoms in the premenstrual phase, commonly known as premenstrual syndrome (PMS). Despite its prevalence, however, no single treatment is universally recognized as effective, and many women turn to alternative approaches, including aromatherapy, a holistic mind and body treatment. The present study investigated the soothing effects of aromatherapy on premenstrual symptoms using lavender (Lavandula angustifolia), a relaxing essential oil, from the perspective of autonomic nervous system function. METHODS: Seventeen women (20.6 ± 0.2 years) with mild to moderate subjective premenstrual symptoms participated in a randomized crossover study. Subjects were examined on two separate occasions (aroma and control trials) in the late-luteal phases. Two kinds of aromatic stimulation (lavender and water as a control) were used. This experiment measured heart rate variability (HRV) reflecting autonomic nerve activity and the Profile of Mood States (POMS) as a psychological index before and after the aromatic stimulation. RESULTS: Only a 10-min inhalation of the lavender scent significantly increased the high frequency (HF) power reflecting parasympathetic nervous system activity in comparison with water (aroma effect: F = 4.50, p = 0.050; time effect: F = 5.59, p = 0.017; aroma x time effect: F = 3.17, p = 0.047). The rate of increase in HF power was greater at 10-15 min (p = 0.051) and 20-25 min (p = 0.023) in the lavender trial than in the control trial with water. In addition, POMS tests revealed that inhalation of the aromatic lavender oil significantly decreased two POMS subscales-depression-dejection (p = 0.045) and confusion (p = 0.049)-common premenstrual symptoms, in the late-luteal phase, as long as 35 min after the aroma stimulation. CONCLUSIONS: The present study indicated that lavender aromatherapy as a potential therapeutic modality could alleviate premenstrual emotional symptoms, which, at least in part, is attributable to the improvement of parasympathetic nervous system activity. This study further implies that HRV could evaluate the efficacy of aromatherapy using various fragrances to relieve premenstrual symptoms, and ultimately, support the mind and body health of women.

Biopsychosocial aspects of premenstrual syndrome and premenstrual dysphoric disorder.

A majority of women in their reproductive years experience a variety of symptoms premenstrually that can alter behavior and well-being and affect family, friends, and working relationships. Notwithstanding its prevalence, however, research has not yet clarified this inscrutable condition, commonly known as premenstrual syndrome (PMS) or more severe PMS, premenstrual dysphoric disorder (PMDD). This comprehensive review discusses the diagnosis, epidemiology, symptoms, etiology, and the complex web of biopsychosocial factors that attends PMS.

Increased salivary chromogranin A in women with severe negative mood states in the premenstrual phase.

The present study investigated whether salivary chromogranin A (CgA), a psychological stress marker associated with sympathetic nervous system activity, changes during the menstrual cycle in women with different degrees of premenstrual psychoemotional symptoms. Forty-five women (28.6 ± 1.3 years) with regular menstrual cycles participated in this study. Salivary CgA and cortisol were measured during the follicular and late-luteal phases. The authors used the Profile of Mood State (POMS) to assess current mood states of subjects in each menstrual phase and divided the subjects into three groups depending on increase of total mood disturbance (TMD), a global measure of affective states of POMS from the follicular to the late-luteal phase: Low (4.1 ± 0.7%), Middle (18.7 ± 1.2%) and High (51.7 ± 7.4%). Results showed no intramenstrual cycle differences in salivary CgA in the Low and Middle groups. Women in the High group, in contrast, had a significantly higher level of salivary CgA in the late-luteal phase compared to that of the follicular phase. Additionally, salivary CgA level significantly and positively correlated with TMD and four emotional subscales: tension-anxiety, depression-dejection, anger-hostility and confusion in the late-luteal phase. No intergroup or menstrual-cycle difference occurred in the salivary cortisol. This study indicates a significant late-luteal increase in salivary CgA, reflecting an increase of sympathetic nerve activity in women who experience a substantial increase (>30%) in a cluster of negative psychoemotional symptoms premenstrually. Furthermore, salivary CgA, as opposed to salivary cortisol, could serve as a reliable noninvasive biomarker to more sensitively evaluate neuropsychophysiological fluctuations during the menstrual cycle.

Autonomic nervous system activity and psychiatric severity in schizophrenia.

AIMS: Schizophrenia patients have a mortality rate two to three-fold higher than that of the general population. Despite the disorder's widespread recognition, how and to what extent autonomic nervous system (ANS) activity contributes to schizophrenia remains inconclusive. The aim of the present study, therefore, was to determine the extent of ANS activity depression with respect to healthy, well-matched control subjects and the severity of psychiatric disorders as determined using the Global Assessment of Functioning (GAF) scale among schizophrenia patients with special reference to antipsychotic dose. METHODS: This study included 71 schizophrenia patients and 72 healthy controls. ANS activity was assessed by means of heart rate variability power spectral analysis. RESULTS: ANS-related spectral parameters were three-four-fold lower in the patients compared to the control group (P < 0.01). Furthermore, when the patients without cardiovascular complications were classified according to GAF score, overall ANS (P = 0.033) and parasympathetic nervous system (PNS) activity (P = 0.025) were significantly reduced in the low-GAF as compared to the high-GAF group. Partial correlation analyses demonstrated that ANS activity was significantly correlated with GAF score while statistically eliminating the effects of age, gender, body mass index, antipsychotic dose, and lipid profiles of the patient population. CONCLUSION: The significantly lower ANS activity in the low-GAF group suggests that such autonomic functional depression could be associated with the severity of schizophrenia. The present data further imply that schizophrenia patients with more depressed overall ANS and PNS activity might encounter increasing risks for cardiovascular events such as sudden death.

Thermoregulatory sympathetic nervous system activity and diet-induced waist-circumference reduction in obese Japanese women.

The present study is designed to investigate how and to what extent sympathovagal behavior in a balanced low-calorie diet relates to favorable changes of body mass, waist circumference, and/or metabolic risk factors. The study involved 28 mildly obese women without clinical complications, who underwent an 8-week calorie restriction program using a 1,200-kcal daily diet with an adequate nutrient content; including two regular meals, and one formula meal replacement. All subjects were examined before and after the dietary intervention. We measured anthropometric parameters, blood pressure, and biochemical blood profiles for lipid metabolism. Autonomic nervous system activity was evaluated by heart rate variability power spectral analysis. The dietary intervention induced moderate, but significant reduction of waist circumference (-5.3% +/- 0.8%), body fat percentage (-5.8% +/- 0.8%), and body mass (-6.6% +/- 0.5%). Linear regression analysis showed that Deltavery low frequency (VLF) power reflecting energy metabolic- and thermoregulatory sympathetic function significantly correlated to Deltawaist circumference (r = -0.53, P < 0.01), Deltabody fat percentage (r = -0.39, P < 0.05), Deltabody mass (r = -0.43, P < 0.05), DeltaHDL-cholesterol/total cholesterol ratio (HDL-C/TC) (r = 0.62, P < 0.001), and Deltanonesterified fatty acids (NEFA) (r = 0.56, P < 0.01). A stepwise multiple regression analysis additionally revealed that Deltawaist circumference (P = 0.024), DeltaHDL-C/TC (P = 0.013), and DeltaNEFA (P = 0.016) were significant and independent factors, which contributing to the variance in DeltaVLF power (r(2) = 0.61). Although causes and consequences of obesity continue to elude researchers, the present study indicates that thermoregulatory sympathetic activity relates to moderate waist-circumference reduction together with favorable changes of blood lipid profiles after short-term dietary modification in mildly obese women.

Altered autonomic nervous system activity as a potential etiological factor of premenstrual syndrome and premenstrual dysphoric disorder.

BACKGROUND: Premenstrual syndrome (PMS) encompasses a wide variety of cyclic and recurrent physical, emotional, and behavioral symptoms occurring during the late luteal phase of the menstrual cycle and abating shortly following the beginning of menses. Although PMS is widely recognized, its etiopathogenesis is not yet understood. The present study investigates whether the activity of the autonomic nervous system, which plays a vital role in orchestrating physiological homeostasis within the human body, is altered during the menstrual cycle of women with different degrees of premenstrual symptomatology. METHODS: Sixty-two women in their 20s to 40s with regular menstrual cycles participated in this study. All subjects were examined during the follicular and late luteal phases. Cycle phase was determined by the onset of menstruation and oral temperature and was verified by concentrations of ovarian hormones, estrone, and pregnanediol in a urine sample taken early in the morning. Autonomic nervous system activity was assessed by means of heart-rate variability (HRV) power spectral analysis during supine rest. The Menstrual Distress Questionnaire was used to evaluate physical, emotional, and behavioral symptoms accompanying the menstrual cycle of the subjects. The subjects were categorized in three groups, Control, PMS, and premenstrual dysphoric disorder (PMDD) groups, depending on the severity of premenstrual symptomatology. RESULTS: No intramenstrual cycle difference in any of the parameters of HRV was found in the Control group, which had no or a small increase in premenstrual symptoms. In contrast, Total power and high frequency power, which reflect overall autonomic and parasympathetic nerve activity, respectively, significantly decreased in the late luteal phase from the follicular phase in the PMS group. As for the PMDD group, which had more severe symptoms premenstrually, heart-rate fluctuation as well as all components of the power spectrum of HRV were markedly decreased regardless of the menstrual cycle compared to those of the other two groups. CONCLUSION: Several theories have been proposed to explain the underlying mechanisms of PMS with its complex web of bio-psycho-social factors. Although causes and consequences continue to elude, the present study provides intriguing and novel findings that the altered functioning of the autonomic nervous system in the late luteal phase could be associated with diverse psychosomatic and behavioral symptoms appearing premenstrually. In addition, when symptoms become more severe (as seen in women with PMDD), the sympathovagal function might be more depressed regardless of the menstrual cycle.

Lower peripheral circulation in eumenorrheic young women with premenstrual symptoms.

BACKGROUND: A majority of women from all cultures and socioeconomic levels experience diverse psychosomatic and behavioral symptoms premenstrually, a phenomenon commonly termed premenstrual syndrome, although symptoms and discomfort levels vary from woman to woman. The underlying pathological mechanisms of premenstrual syndrome remain unknown; however, altered function or even slight disorder of the blood circulation system, which contributes to the orchestrations of the human internal environment, could cause bio-psychological changes leading to complaints and ultimately compromising a woman's overall health. The present study, therefore, investigates to what extent and how the menstrual cyclicity of peripheral circulation is associated with premenstrual symptomatology. METHODS: Twenty-one eumenorrheic young women participated in this study. All subjects were investigated during the follicular and late luteal phases. Cycle phase was determined by the onset of menstruation and oral temperature and was verified by concentrations of ovarian hormones, estrone, and pregnanediol in a urine sample taken early in the morning. Peripheral circulation was evaluated with the Astrim (Sysmex, Kobe), a portable non-invasive monitoring device using the principle of near-infrared spectroscopy, which calculates the venous oxygenation index (VOI) based on the ratio of light absorption of oxyhemoglobin and deoxyhemoglobin, a proven reliable indicator of peripheral blood circulation. The Menstrual Distress Questionnaire was applied to measure physical, emotional, and behavioral symptoms accompanying the menstrual cycle of the subjects. RESULTS: The oral temperature and urinary ovarian hormones adjusted for creatinine significantly increased in the late luteal phase in all subjects. While 10 subjects experienced no symptoms during the menstrual cycle, 11 subjects had apparent physical and psychological discomfort in the late luteal phase. We found that VOI decreased more significantly in the late luteal phase than in the follicular phase only in women with premenstrual discomfort although the symptoms were not unbearable enough to cause the disruption of daily activities. CONCLUSION: Several models have tried to explain the etiopathogenesis of premenstrual syndrome. Although causes and consequences remain enigmatic, our data suggest that the peripheral circulation could alter in the luteal phase, which might be partly associated with premenstrual psychosomatic symptoms in eumenorrheic young women.

Body fat and blood lipids in postmenopausal women are related to resting autonomic nervous system activity.

The present study investigated the activity of the autonomic nervous system (ANS), a major influence in normal physiological function, and its association with unfavorable postmenopausal states in body composition, lipid and/or glucose metabolism, or cardiovascular profiles. Body composition, blood pressure, and blood profiles of lipid and glucose of 175 postmenopausal women were measured. Resting ANS activity was assessed by heart rate variability (HRV) power spectral analysis. To scrutinize the influence of ANS activity levels on postmenopausal obesity-related factors, we divided the subjects into a low group ( < 220 ms(2)) and a high group ( > 220 ms(2)), based on the total power of HRV. Low-frequency (P < 0.01) and high-frequency power (P < 0.01) were both significantly lower in the low group. No significant difference was found in age, age at menopause, or years after menopause between the two groups. In contrast, body mass index (P < 0.05), percentages of body fat (P < 0.01), and systolic (P < 0.01) and diastolic (P < 0.01) blood pressure were significantly greater in the low group. As to blood lipid profiles, triglycerides (P < 0.05), total cholesterol (P < 0.05), and low-density lipoprotein cholesterol (P < 0.05) were significantly higher in the low group. Our findings indicate that reduced sympatho-vagal activity is associated with higher postmenopausal body fat content, blood pressure, and blood lipid concentrations. This study further implies that such autonomic depression could be a crucial risk factor in undermining the health and, ultimately, the quality of life, of postmenopausal women.

Autonomic nervous system activity in the late luteal phase of eumenorrheic women with premenstrual symptomatology.

The majority of women of reproductive age experience a regular recurrence of various symptoms in the premenstrual phase. The etiopathogenesis of premenstrual symptomatology, however, remains inconclusive. The present study was proposed to evaluate whether the activity of the autonomic nervous system (ANS), which largely contributes to the relative stability of a human's internal environment, is altered during the menstrual cycle of women with premenstrual symptomatology. Thirty eumenorrheic young women participated in this study. All subjects were investigated during the follicular and late luteal phases. The ANS activity was assessed by means of heart rate variability power spectral analysis during supine rest. No intramenstrual cycle differences in the ANS activity were found in women experiencing no or small increases in premenstrual symptoms. In contrast, the sympathetic nervous system (SNS) activity significantly increased and the parasympathetic nervous system (PNS) activity apparently decreased in the late luteal phase in subjects whose premenstrual symptomatology was not unbearable, but substantially increased (> 20%) compared to the symptom-free follicular phase. The women with greater degrees of premenstrual distress possessed higher SNS activity and lower PNS activity in the late luteal phase than the women with less symptomatology. The ANS activity in the follicular phase did not differ among the subjects regardless of their premenstrual symptoms. Although causes and consequences continue to elude, the present study provides additional intriguing evidence that the altered functioning of ANS in the late luteal phase could be associated with diverse psychosomatic or behavioral symptoms appearing premenstrually.

Potential association between endogenous leptin and sympatho-vagal activities in young obese Japanese women.

Leptin is an adipocyte-derived hormone that decreases food intake and increases energy expenditure through the activation of the sympathetic nervous system (SNS). Notwithstanding recent intensive research, the underlying physiological mechanism of leptin as well as the etiology of obesity in humans remains elusive. The present study attempted to investigate the potential association between endogenous circulating leptin and sympatho-vagal activities in age- and height-matched obese and nonobese healthy young women. Plasma leptin concentrations were measured by radioimmunoassay. The autonomic nervous system activity was assessed during the resting condition by means of a recently devised power spectral analysis of heart rate variability, which serves to identify three separate frequency components, very low (VLO), low (LO), and high (HI). Plasma leptin concentrations were greater in the obese than in the control group (45.7 +/- 5.89 vs. 11.2 +/- 1.10 ng. ml(-1), P < 0.01). As to the contribution of endogenous leptin to SNS activity, both the ratios of the VLO frequency component reflecting thermoregulatory sympathetic function and the global SNS index [(VLO + LO)/HI] to plasma leptin concentration were markedly reduced in the obese compared to the control group (VLO per leptin: 5.9 +/- 1.39 vs. 37.8 +/- 8.1 ms(2). ml. ng(-1), P < 0.01; SNS index per leptin: 0.04 +/- 0.008 vs. 0.33 +/- 0.01 ml c. ng(-1), P < 0.01). Additionally, a nonlinear regression analysis revealed that these ratios exponentially decreased as a function of body fat content (VLO per leptin r(2) = 0.57, P < 0.01; SNS index per leptin r(2) = 0.53, P < 0.01). Our data suggest that reduced sympathetic responsiveness to endogenous leptin production, implying peripheral leptin resistance, might be a pathophysiological feature of obesity in otherwise healthy young women. The findings regarding the association of leptin, body fat content, and SNS activity further indicate that the 30% of total body fat, which has been used as a criterion of obesity, might be a critical point at which leptin resistance is induced.

Autonomic nervous system activity and the state and development of obesity in Japanese school children.

OBJECTIVE: The autonomic nervous system (ANS) plays an important role in regulating energy expenditure and body fat content; however, the extent to which the ANS contributes to pediatric obesity remains inconclusive. The aim of this study was to evaluate whether sympathetic and/or the parasympathetic nerve activities were altered in an obese pediatric population. We further examined a physiological association between the duration of obesity and the sympatho-vagal activities to scrutinize the nature of ANS alteration as a possible etiologic factor of childhood obesity. RESEARCH METHODS AND PROCEDURES: Forty-two obese and 42 non-obese healthy sedentary school children were carefully selected from 1080 participants initially recruited to this study. The two groups were matched in age, gender, and height. The clinical records of physical characteristics and development of the obese children were retrospectively reviewed to investigate the onset and progression of obesity. The ANS activities were assessed during a resting condition by means of heart rate variability power spectral analysis, which enables us to identify separate frequency components, i.e., total power (TP), low-frequency (LF) power, and high-frequency (HF) power. The spectral powers were then logarithmically transformed for statistical testing. RESULTS: The obese children demonstrated a significantly lower TP (6.77 +/- 0.12 vs. 7.11 +/- 0.04 ln ms(2), p < 0.05), LF power (6.16 +/- 0.12 vs. 6.42 +/- 0.05 ln ms(2), p < 0.05), and HF power (5.84 +/- 0.15 vs. 6.34 +/- 0.07 ln ms(2), p < 0.01) compared with the non-obese children. A partial correlation analysis revealed that the LF and HF powers among 42 obese children were negatively associated with the duration of obesity independent of age (LF: partial r = -0.55, p < 0.001; HF: partial r = -0.40, p < 0.01). The obese children were further subdivided into two groups based on the length of their obesity. All three spectral powers were significantly reduced in the obese group with obesity of >3 years (n = 18) compared to the group with obesity of <3 years. DISCUSSION: Our data indicate that obese children possess reduced sympathetic as well as parasympathetic nerve activities. Such autonomic depression, which is associated with the duration of obesity, could be a physiological factor promoting the state and development of obesity. These findings further imply that preventing and treating obesity beginning in the childhood years could be an urgent and crucial pediatric public health issue.

Effects of clothing pressure caused by different types of brassieres on autonomic nervous system activity evaluated by heart rate variability power spectral analysis.

The present study was designed to investigate the effects of clothing skin pressures exerted by two different types of brassieres (a conventional higher skin-pressured brassiere and a newly devised low skin-pressured brassiere) on the autonomic nervous system (ANS) activity. Six healthy young women (22.8 +/- 1.4 yrs.) with regular menstrual cycles participated in this study. The ANS activities were assessed by means of heart rate variability power spectral analysis. The skin pressures exerted by the brassieres were measured with an air-pack type contact surface pressure sensor at five different points. The total amount of clothing pressure, and the pressures at the center and the side regions of the brassieres were significantly greater in the high than in the low skin-pressured brassiere (Total 9816.1 +/- 269.0 vs. 6436.8 +/- 252.4 Pa, P < 0.01; Center 2212.1 +/- 336.3 vs. 353.8 +/- 85.8 Pa, P < 0.01; Side 2556.8 +/- 316.1 vs. 1747.2 +/- 199.2 Pa, P < 0.05). Concerning the ANS activity, the Total power, and the very low frequency (VLF) and the high frequency (HF) components were significantly decreased in the high skin-pressured brassiere than those in the low skin-pressured brassiere (Total 531.6 +/- 57.3 vs. 770.5 +/- 54.2 ms2, P < 0.01; VLF 60.7 +/- 14.6 vs. 179.2 +/- 38.1 ms2, P < 0.05; HF 209.5 +/- 33.2 vs. 283.2 +/- 61.5 ms2, P < 0.01). Our data indicate that the higher clothing pressures exerted by a conventional brassiere have a significant negative impact on the ANS activity, which is predominantly attributable to the significant decrease in the parasympathetic as well as the thermoregulatory sympathetic nerve activities. Since the ANS activity plays an important role in modulating the internal environment in the human body, excess clothing pressures caused by constricting types of foundation garments on the body would consequently undermine women's health.