Dynamic change in respiratory resistance during inspiratory and expiratory phases of tidal breathing in patients with chronic obstructive pulmonary disease

Yasuhiro Yamauchi1,2, Tadashi Kohyama2, Taisuke Jo2, Takahide Nagase21Division of Health Promotion Center, 2Department of Respiratory Medicine, University of Tokyo, Tokyo, JapanBackground and objective: Chronic obstructive pulmonary disease (COPD) is characterized by persistent airflow limitation consisting of airway obstruction and parenchymal emphysema, with loss of elastic recoil. The forced oscillation technique can detect impairment of lung function by measuring lung impedance during normal tidal breathing. Respiratory resistance (Rrs) in COPD has been well-studied, but the differences in Rrs in the inspiratory and expiratory phases between mild and moderate COPD remain poorly understood. Since airway obstruction in COPD is known to change dynamically during tidal breathing and might affect Rrs, the differences in Rrs during tidal breathing between mild and moderate COPD were evaluated.Methods: Mild (n = 13) and moderate (n = 13) COPD patients were recruited at Tokyo University Hospital (Tokyo, Japan). Rrs was measured using MostGraph-01 (Chest MI, Inc, Tokyo, Japan), which depicted Rrs in a frequency- and respiratory cycle-dependent manner in three-dimensional graphics. Rrs was evaluated at 4–35 Hz during tidal breathing.Results: Rrs changed dynamically during tidal breathing in COPD. The mean Rrs values were significantly greater in the moderate COPD group than in the mild group. The maximal and minimal Rrs values at higher frequencies in the respiratory cycle were significantly greater in moderate COPD. In inspiratory–expiratory breath analysis, the maximal and minimal Rrs values at 20 Hz and 35 Hz were significantly greater in the moderate group, whereas at 4 Hz they did not differ significantly between the groups.Conclusion: Rrs changed dynamically during tidal breathing in patients with COPD. The Rrs values at higher frequencies were greater in moderate COPD than in mild COPD. Rrs at higher frequencies might reflect the degree of airway obstruction in tidal breathing in patients with COPD and might be a useful marker for evaluation of airway obstruction at an early stage of COPD.Keywords: COPD, airflow limitation, respiratory resistance, forced oscillation techniqu

Age-Dependent Association Between Modifiable Risk Factors and Incident Cardiovascular Disease

BACKGROUND: There have been limited data examining the age-dependent relationship of wide-range risk factors with the incidence of each subtype of cardiovascular disease (CVD) event. We assessed age-related associations between modifiable risk factors and the incidence of CVD. METHODS AND RESULTS: We analyzed 3 027 839 participants without a CVD history enrolled in the JMDC Claims Database (mean age, 44.8±11.0 years; 57.6% men). Each participant was categorized as aged 20 to 49 years (n=2 008 559), 50 to 59 years (n=712 273), and 60 to 75 years (n=307 007). Using Cox proportional hazards models and the relative risk reduction, we identified associations between risk factors and incident CVD, consisting of myocardial infarction, angina pectoris, stroke, and heart failure (HF). We assessed whether the association of risk factors for developing CVD would be modified by age cat-egory. Over a mean follow-up of 1133 days, 6315 myocardial infarction, 56 447 angina pectoris, 28 079 stroke, and 56 369 HF events were recorded. The incidence of myocardial infarction, angina pectoris, stroke, and HF increased with age category. Hazard ratios of obesity, hypertension, and diabetes in the multivariable Cox regression analyses for myocardial infarction, angina pectoris, stroke, and HF decreased with age category. The relative risk reduction of obesity, hypertension, and diabetes for CVD events decreased with age category. For example, the relative risk reduction of hypertension for HF decreased from 59.2% in participants aged 20 to 49 years to 38.1% in those aged 60 to 75 years. CONCLUSIONS: The contribution of modifiable risk factor to the development of CVD is greater in younger compared with older individuals. Preventive efforts for risk factor modification may be more effective in younger people.</p

Impacts of Glucose-Dependent Insulinotropic Polypeptide on Orthodontic Tooth Movement-Induced Bone Remodeling

Glucose-dependent insulinotropic polypeptide (GIP) exerts extra-pancreatic effects via the GIP receptor (GIPR). Herein, we investigated the effects of GIP on force-induced bone remodeling by orthodontic tooth movement using a closed-coil spring in GIPR-lacking mice (GIPRKO) and wild-type mice (WT). Orthodontic tooth movements were performed by attaching a 10-gf nickel titanium closed-coil spring between the maxillary incisors and the left first molar. Two weeks after orthodontic tooth movement, the distance of tooth movement by coil load was significantly increased in GIPRKO by 2.0-fold compared with that in the WT. The alveolar bone in the inter-root septum from the root bifurcation to the apex of M1 decreased in both the GIPRKO and WT following orthodontic tooth movement, which was significantly lower in the GIPRKO than in the WT. The GIPRKO exhibited a significantly decreased number of trabeculae and increased trabecular separation by orthodontic tooth movement compared with the corresponding changes in the WT. Histological analyses revealed a decreased number of steady-state osteoblasts in the GIPRKO. The orthodontic tooth movement induced bone remodeling, which was demonstrated by an increase in osteoblasts and osteoclasts around the forced tooth in the WT. The GIPRKO exhibited no increase in the number of osteoblasts; however, the number of osteoclasts on the coil-loaded side was significantly increased in the GIPRKO compared with in the WT. In conclusion, our results demonstrate the impacts of GIP on the dynamics of bone remodeling. We revealed that GIP exhibits the formation of osteoblasts and the suppression of osteoclasts in force-induced bone remodeling

Experimental Studies on Sideroblasts Part 3 Influences of Sera from Patients with Various Blood Diseases on the Sideroblasts of Rabbit In Vitro

By adding sera of the patients with various blood diseases along with iron to the bone-marrow tissue culture in fluid medium the author has observed direct influences of the sera on the erythrocyte series in bone marrow and studied their action from the standpoint of the iron metabolism in erythroblasts, and obtained the following results. 1. In the cases of the bone-marrow tissue culture supplemented with sera from idiopathic hypochromic anemia, Banti's disease, Hodgkin's disease and a portion of leukemias (myelogenous leukemia, acute lymphocytic leukemia) along with iron, there can be recognized no factor that affects the iron metabolism of erythroblasts and hence these sera seem to have no direct action to inhibit the bone-marrow function. 2. It has been found that there is a factor that disturbs the bonemarrow erythropoiesis in the serum of hypoplastic anemia. 3. In the sara of cancer and monocytic leukemia patients likewise there is a factor that suppresses the erythropoiesis of bone marrow. 4. It is obvious that the serum of polycythemia vera contains a factor that accelerates the erythropoiesis of bone marrow

Experimental Studies on Sideroblasts Part 1 Effects of Addition of Iron or Vitamin B(12) on Sideroblasts In Vitro of Patients with Various Blood Diseases

The author describes the results obtained in the series of tissue culture in fluid medium using the bone marrow from normal persons and patients with various blood diseases as materials supplemented with iron or vitamin B(12), in ordar to observe the alteration in the number of sideroblasts, and discusses about the iron metabolism of erythroblasts. 1 In the bone-marrow tissue culture of normal persons the iron addition to the culture slightly increases the number of sideroblasts. 2. In the cases of bone-marrow tissue culture of idiopathic hypochromic anemia, hook worm anemia, Banti's disease and malignant tumor, sidereblasts are increased considerably in proportion to the degree of iron deficiency state in these diseases by the iron addition. 3. In the cases of hypoplastic anemia and liver cirrhosis, sideroblasts are hardly or only slighly increased. 4. In the cases of leukemias the incresse in the number of sideroblasts in vitro by the addition of iron differs widely from a considerable increase to a very small incease. 5. Despite the fact that polycythemia vera shows a low rate of sideroblast appearance, there can berecognized no appreciable increase in the number of sideroblasts by the addition of iron. 6. In the cases of iron deficiency and the lowered or accelerated functions of bone-marrow, each of them reveals certain different patterns of alteration in the number of sideroblasts and to this phenomenon stainable iron of erythroblasts before addition plays an important role. 7. However, in the cases of the bone-marrow tissue culture supplemented with vitamin B(12) sideroblasts are hardly affected, and therefore, vitamin B(12) has almost no effect on the iron metabolism of erythroblasts

Experimental Studies on Sideroblasts Part 2 Effects of Iron and Cobalt on Sideroblasts In Vitro in Experimental Anemia

By adding iron or cobalt to the tissne culture in fluid medium of bone marrow from normal and various experimental anemic rabbits the author has observed the alteration in the number of sideroblasts and studied the iron metabolism of erythroblasts. The following are the results. 1. In the case of the bone-marrow tissue culture of normal rabbit supplemented with iron sideroblasts are slightly increased in number. 2. In the case of bensol or collargol anemia hardly any increase can be recognized in sideroblasts by the iron addition. 3. In the case of the rabbit irradiated with 300r. the addition of iron increases sideroblasts in number considerably. 4. In the case of hemorrhagic anemia the addition of iron markedly increases the number of sideroblasts as the iron deficiency state advances in its degree. 5. Hardly any increase in the sideroblast number can be observed in the case of phenylhydrazine anemia supplemented with iron. 6. From these alterations in siderodlasts by the effect of iron addition, it is assumed that non-hemoglobin iron in erythroblasts has an important bearing on the iron uptake of erythroblasts. 7. Cobalt has an action as to direct the iron in erythroblasts towards the heme synthesis because in the case supplemented with iron plus cobalt the increase in the number of sideroblasts is smaller than that supplemented with iron alone

Experimental Studies on Sideroblasts Part 1 Effects of Addition of Iron or Vitamin B(12) on Sideroblasts In Vitro of Patients with Various Blood Diseases

The author describes the results obtained in the series of tissue culture in fluid medium using the bone marrow from normal persons and patients with various blood diseases as materials supplemented with iron or vitamin B(12), in ordar to observe the alteration in the number of sideroblasts, and discusses about the iron metabolism of erythroblasts. 1 In the bone-marrow tissue culture of normal persons the iron addition to the culture slightly increases the number of sideroblasts. 2. In the cases of bone-marrow tissue culture of idiopathic hypochromic anemia, hook worm anemia, Banti's disease and malignant tumor, sidereblasts are increased considerably in proportion to the degree of iron deficiency state in these diseases by the iron addition. 3. In the cases of hypoplastic anemia and liver cirrhosis, sideroblasts are hardly or only slighly increased. 4. In the cases of leukemias the incresse in the number of sideroblasts in vitro by the addition of iron differs widely from a considerable increase to a very small incease. 5. Despite the fact that polycythemia vera shows a low rate of sideroblast appearance, there can berecognized no appreciable increase in the number of sideroblasts by the addition of iron. 6. In the cases of iron deficiency and the lowered or accelerated functions of bone-marrow, each of them reveals certain different patterns of alteration in the number of sideroblasts and to this phenomenon stainable iron of erythroblasts before addition plays an important role. 7. However, in the cases of the bone-marrow tissue culture supplemented with vitamin B(12) sideroblasts are hardly affected, and therefore, vitamin B(12) has almost no effect on the iron metabolism of erythroblasts

Distribution of mammals on the offshore islands of Uwajima City, Shikoku, Japan

宇和海の4つの有人島: 九島, 嘉島, 戸島, 日振島(いずれも愛媛県宇和島市)において聞き取り調査とフィールドサイン調査を実施し, 野生哺乳類の分布を調べた. その結果, 九島ではタヌキ, イタチ類(イタチあるいはチョウセンイタチ), ハクビシン, イノシシ, ニホンノウサギ, 戸島ではニホンジネズミとイノシシ, 日振島ではイタチ類とイノシシの分布情報を得た. 嘉島では野生哺乳類の分布情報が得られなかった. 日振島に低密度で分布するイタチ類は, 1960年頃にドブネズミの天敵として愛媛県本土から導入された個体群の子孫であると考えられた. 同じ頃に嘉島と戸島へ導入されたイタチ類は絶滅した可能性が高い. 九島, 戸島, 日振島のイノシシは本土から近年新たに侵入した個体群であると考えられた. これらの島嶼ではイノシシによる農作物の被害が発生していた.We investigated the mammalian fauna of the four offshore islands (Hiburijima, Tojima, Kashima, and Kushima) of Uwajima City, Shikoku, Japan. As a result, six species: dsinezumi shrew Crocidura dsinezumi, raccoon dog Nyctereutes procyonoides, weasel Mustela sp., masked palm civet Paguma larvata, wild boar Sus scrofa, and Japanese hare Lepus brachyurus, were recorded. Weasels in Hiburijima are presumably descended from the population introduced from the mainland Ehime Prefecture around 1960. On the other hand, weasels introduced to Kashima and Tojima were probably extinct. Wild boars in Hiburijima, Tojima, and Kushima are presumably an invading population from the mainland. Agricultural damage by wild boar was found in the islands

Radiological differences in computed tomography findings and texture analysis between cystic lymph node metastases of human papillomavirus-positive oropharyngeal cancer and second branchial cysts

Purpose: The study aimed to analyse radiological differences in computed tomography (CT) findings and texture analysis between cystic lymph node metastases (CNM) in human papillomavirus (HPV)-positive oropharyngeal cancer (OPC) and second branchial cleft cysts (2nd BC). Material and methods: Patients with pathological evidence of CNM-HPV-OPC and 2nd BC, who underwent contrastenhanced CT, were retrospectively evaluated. The evaluated characteristics include age, sex, and CT findings. CT findings included the maximum and minimum transverse diameters, maximum caudal diameter, thickness of the peripheral wall, presence of internal septation, presence of surrounding fat stranding, location, and 40 texture parameters. Results: A total of 13 patients had CNM-HPV-OPC (19 lesions), while 20 patients had 2nd BC (20 lesions). Patients with 2nd BC were significantly younger than those with CNM-HPV-OPC (p < 0.001). In terms of diameter, 2nd BC lesions were significantly larger than the CNM-HPV-OPC lesions (p < 0.001). CNM-HPV OPC lesions had significantly thicker walls than 2nd BC lesions (p < 0.001). CNM-HPV-OPC lesions had significantly higher association with internal septations than 2nd BC lesions (p < 0.001). Second BC lesions were significantly less common at level III than CNM-HPV-OPC lesions (p = 0.047). Among the 40 texture parameters measured, 8 had significant differences (p ≤ 0.001). Conclusions: There were significant differences in CT findings and textural parameters between CNM-HPV-OPC and 2nd BC lesions. These results may help in differentiating one from the other