Effects of daily walking on intermuscular adipose tissue accumulation with age: a 5-year follow-up of participants in a lifestyle-based daily walking program.

PURPOSE: Intermuscular adipose tissue (IMAT) accumulates with age. However, there has been no long-term intervention study examining whether daily walking prevents or decreases the age-related IMAT accumulation. The purpose of this study was to determine effects of a long-term lifestyle-based daily walking program on age-related IMAT accumulation after a 5-year follow-up. METHODS: Using a pedometer, daily step count was evaluated for 5 years in 24 middle-aged and elderly male and female participants. Using magnetic resonance imaging, thigh muscle, thigh subcutaneous adipose tissue, IMAT, abdominal subcutaneous adipose tissue, and visceral adipose tissue were examined at baseline and after 5 years. RESULTS: After 5 years, there was no significant increase in IMAT in all participants. In addition, IMAT significantly decreased in participants with a daily step count of > 9000 (4.0 ± 2.1 vs. 3.1 ± 1.6 cm2; p < 0.05). Moreover, changes in IMAT within 5 years correlated with changes in daily step counts, even after adjusting for confounding factors (p < 0.05). CONCLUSIONS: Long-term lifestyle-based daily walking program prevented the age-related IMAT accumulation in middle-aged and elderly adults. Furthermore, increased daily walking correlated with decreased IMAT over 5 years.

Effect of bromhexine hydrochloride therapy for alcoholic chronic pancreatitis.

BACKGROUND: Abstinence is a prerequisite for the treatment of alcoholic chronic pancreatitis, but there are patients who have repeated attacks because of their inability to abstain and the consequent congestive effects of the continued alcohol intake on pancreatic juice. Bromhexine hydrochloride, a bronchial mucolytic, has an affinity for acinar cells and causes them to secrete pancreatic juice of low viscosity. METHODS: Twelve patients with alcoholic chronic pancreatitis, who were unable to abstain from drinking, were administered bromhexine hydrochloride for 6 months to assess its therapeutic efficacy. RESULTS: Of 12 patients administered bromhexine, 8 (67%) reported symptomatic improvement, and all patients showed improvement in the levels of pancreatic enzymes. Pancreatic exocrine function also tended to improve, but no improvement of pancreatic endocrine function was detected. Although none of the pancreatic stones present in some patients disappeared, a protein plug present in one patient disappeared, accompanied by improvement in the irregular outline of the lumen of the main pancreatic duct. CONCLUSION: Bromhexine hydrochloride may be a new for the morbidity of chronic pancreatitis, in which there is increased viscosity of the pancreatic juice and formation of a protein plug.

Mediastinal pancreatic pseudocyst caused by obstruction of the pancreatic duct was eliminated by bromhexine hydrochloride.

A 49-year-old man, who had a 30-year history of drinking the equivalent of 80 g of ethanol per day, underwent a detailed medical examination for cough and dyspnea. Chest-abdominal computed tomography and endoscopic retrograde pancreatography led to the diagnosis of a mediastinal pancreatic pseudocyst resulting from obstruction of the pancreatic duct by a protein plug. The pseudocyst rapidly improved with conservative treatment with camostat mesilate, H2-receptor antagonist and digestive enzymes. Although the patient abstained from alcohol for approximately 6 months, he resumed drinking, leading to recurrent attacks of pancreatitis. Bromhexine hydrochloride was then administered for 6 months, with the expectation that it would have a mucolytic effect on the pancreatic juice, resulting in improvement in the clinical symptoms, pancreatic enzymes and pancreatic exocrine function, as well as elimination of the protein plug. Bromhexine hydrochloride may be a new therapy for pathological states, such as alcoholic chronic pancreatitis, in which there is increased viscosity of the pancreatic juice because of elevated protein concentration, leading to protein plug formation and temporary blockage of the pancreatic duct.

Onset of ischemic colitis following use of electrical muscle stimulation (EMS) exercise equipment.

Our patient was a 71-year-old man who presented with lower abdominal pain, and bloody and white mucosal stools. He purchased by mail-order an electrical muscle stimulation (EMS) device, which he strapped onto his lower abdomen, and for 2 consecutive days he underwent muscle stimulation comprising 600 contractions at 2.40 mA and 1.20 V over a 10 minute period. He experienced the onset of lower abdominal pain immediately following muscle stimulation on the second day, and then passed stools containing blood and white mucus. The cause was thought to be electrical and mechanical stimulation of the lower abdomen by the EMS equipment, either inducing colonic or vascular spasm, or dislodging thrombi associated with atrial fibrillation or atherosclerosis. This is the first known report of ischemic colitis associated with the use of EMS exercise equipment. We report this case in the belief that this condition is likely to become more common with increasing use of such devices.