Central blood pressure and pulse wave velocity in young and middle-aged Japanese adults with isolated systolic hypertension.

Isolated systolic hypertension (ISH), defined as systolic blood pressure (SBP) ≥140 mmHg and diastolic BP (DBP) <90 mmHg, is a common type of hypertension among young men. This study aimed to investigate the clinical characteristics, central blood pressure, and arterial stiffness of young and middle-aged Japanese individuals with ISH. A total of 432 male participants, aged 18-49 years, were classified into six subgroups: optimal BP (SBP <120 mmHg and DBP <80 mmHg), high-normal BP (SBP 120-129 mmHg and DBP <80 mmHg), high-BP (SBP 130-139 mmHg and/or DBP 80-89 mmHg), ISH (SBP ≥140 mmHg and DBP <90 mmHg), isolated diastolic hypertension (IDH) (SBP <140 mmHg and DBP ≥90 mmHg), and systolic and diastolic hypertension (SDH) (SBP ≥140 mmHg and DBP ≥90 mmHg). Participants with ISH had a greater body mass index (BMI) and waist circumference than the optimal BP participants but were more likely to be physically active than the IDH and SDH participants. The central SBP of the ISH subgroup was higher than that of the optimal/high-normal/high-BP subgroups and lower than that of the SDH subgroup. The carotid-femoral pulse wave velocity (cfPWV) of the ISH subgroup was higher than that of the optimal and high-normal BP subgroups and lower than that of the SDH subgroup after adjusting for age, heart rate, BMI, and physical activity. These differences disappeared after further adjustment for central mean arterial pressure. In conclusion, the central SBP of Japanese men with ISH was greater than that of Japanese men with optimal/high-normal/high-BP, but the progression of arterial stiffness was unclear.

[Impact of visceral fat measurements and a weight loss support web system on visceral fat loss in a workplace setting: insights from a JVALUE2 (Japanese study of visceral adiposity and lifestyle information; utilization and evaluation)].

OBJECTIVES: Providing different programs of occupational health services in the same company is difficult. We report the results of a parallel randomized trial for the employees of our company for visceral fat measurements and the effect of a weight loss support web system. MATERIALS AND METHODS: 181 healthy employees with BMI over 23 who volunteered to participate in this study. In a parallel randomized study, we divided them into 3 groups (A, health guidance by occupational health staff with visceral fat measurements and a weight loss support web system; B, health guidance by occupational health staff with a weight loss support web system; C, without health guidance (control)) by date of birth. To assess the effects of guidance and support, we compared each group's waist circumference (WC), weight, and BMI, before and after the guidance. We also conducted questionnaire surveys of eating behavior and life activities before and after the guidance to estimate the relationship between the intervention method used for each group and their behavioral modification. RESULTS: 150 employees (83%) finished this program. Within 3 months, reduction in the outcome measures was largest in group A, and showed significant differences from the other two groups. For many employees in group A, eating behavior factors improved markedly; however, in the control group, there were no changes in eating behavior or daily living activities. CONCLUSIONS: A parallel randomized trial involving the employees of our company was performed and we scientifically verified the effects of an occupational health programs. Objective study of occupational health activities and measures were enabled by devising methods and procedures, e.g., applying the waiting-list method for the control group. This approach will lead to appropriate selection and precise implementation of evidence-based measures in occupational health in the future.

[A case of advanced gastric cancer with lymphangitis carcinomatosa of the lung, successfully treated with paclitaxel and TS-1].

A 65-year-old man, who had been admitted to another hospital with complaints of severe cough and dyspnea, was transferred to our hospital for the further examination and therapy. The patient was diagnosed with advanced gastric cancer (type-3) with lymphangitis carcinomatosa of the lung. He was treated with combination therapy of 5-FU and cisplatin, and showed a complete response. However, because resistance was seen in the lymphangitis of the lung and the gastric lesion; and a liver metastasis was also seen, we attempted combination therapy with paclitaxel and TS-1. Sixty mg/m2/day of paclitaxel was administered intravenously on day 1 and 8, and TS-1 of 60-80 mg/m2/day was administered orally for 2 weeks followed by one drug-free week. After 2 courses of the combination therapy, the patient achieved a remarkable response in the lymphangitis carcinomatosa of the lung, but a slight response in the liver metastasis and gastric lesion.