A Comparison of Blood Viscosity and Hematocrit Levels between Yoga Practitioners and Sedentary Adults

International Journal of Exercise Science 12(2): 425-432, 2019. Elevations in whole blood viscosity (WBV) and hematocrit (Hct), have been linked with increased risk of cardiovascular disease (CVD). Endurance training has been demonstrated to lower WBV and Hct; however, evidence supporting the efficacy of yoga on these measures is sparse. A cross-sectional study was conducted examining WBV and Hct levels between yoga practitioners with a minimum of 3 years of consistent practice and sedentary, healthy adults. Blood samples were collected from a total of 42 participants: 23 sedentary adults and 19 regular yoga practitioners. Brachial arterial blood pressure (BP) was measured and the averages of 3 measures were reported. The yoga practitioner group had significantly lower WBV at 45 s-1 (p \u3c 0.01), 90 s-1 (p \u3c 0.01), 220 s-1 (p \u3c 0.05), and 450 s-1 (p \u3c 0.05) than sedentary participants. No significant group differences in Hct (p =0.38) were found. A tendency toward lower systolic BP (p=0.06) was observed in the yoga practitioner group; however, no significant group differences in BP were exhibited. A consistent yoga practice was associated with lower WBV, a health indicator related to CVD risk. These findings support a regular yoga practice as a valid form of exercise for improving rheological indicators of cardiovascular health

A Comparison of Blood Viscosity, Hematocrit and Blood Pressure between Yoga Practitioners and Sedentary Individuals

Elevations in whole blood viscosity (WBV) and hematocrit (Hct) have been linked with increased risk of cardiovascular disease (CVD) and coexist with elevations in systolic blood pressure (SBP). Endurance training has been demonstrated to lower WBV and Hct; however, evidence supporting the efficacy of yoga on these measures is sparse. METHODS: A cross-sectional study was conducted examining WBV, Hct and blood pressure among yoga practitioners with a minimum of 3 months of consistent practice and sedentary, healthy adults. Blood samples were collected from a total of 42 participants: 23 sedentary adults and 19 regular yoga practitioners. Brachial arterial blood pressure (BP) was measured and the averages of 3 measures were reported. RESULTS: Yoga practitioners had significantly lower WBV at 45 s-1 (p \u3c 0.01), 90 s-1 (p \u3c 0.01), 220 s-1 (p \u3c 0.05), and 450 s-1 (p \u3c 0.01) than sedentary participants. No significant group differences in Hct (p =0.38) were found. A tendency toward lower systolic BP (p=0.06) was observed in the yoga practitioner group; however, no significant group differences in BP were exhibited. CONCLUSION: A consistent yoga practice was associated with lower WBV and a trend of lower SBP, health indicators associated with CVD risk. These findings support a regular yoga practice as a valid form of exercise for improving rheological indicators of cardiovascular health

Low Flow-Mediated Constriction: Prevalence, Impact, and Physiological Determinant

Flow-mediated dilation (FMD) is a surrogate marker for endothelial function. In the FMD procedure, arterial response during cuff inflation is not taken into consideration yet studies have demonstrated vasoconstriction, vasodilation, and no change in the brachial artery during cuff inflation. The term low flow-mediated constriction (L-FMC) has been introduced to describe the vasoconstriction that occurs in some individuals during inflation of the cuff. PURPOSE: To determine 1) if brachial artery response during cuff inflation differed in a population with varied coronary artery disease (CAD) risk factor profiles, 2) the impact of this response on the subsequent calculation of FMD, and 3) the role of arterial stiffness in this variable response. METHODS: Low flow-mediated constriction (L-FMC), “traditional” FMD, and “modified” FMD that accounts for L-FMC by using inflation diameter in place of baseline diameter in calculating FMD, were studied in a total of 46 subjects. Subjects varied in age (38-62 years) and risk factor profiles for coronary artery disease. RESULTS: During cuff inflation, brachial artery responses varied widely from -5.6% (vasoconstriction) to 5.0% (vasodilation). When subjects were divided into healthy versus multiple risk factors (n=34), L-FMC and FMD were not different between the groups but modified FMD was significantly different (p=0.02). L-FMC was modestly but significantly associated with FMD (r=0.41) and positively correlated with brachial artery pulse wave velocity (r=0.30). CONCLUSION: Our results indicate that brachial artery responses to inflation of the cuff are very variable and are associated with arterial stiffness and that accounting for so-called L-FMC may provide a more comprehensive assessment of endothelial vasodilatory function

Impact of Blood Pressure Cuff Inflation Rates on Flow-Mediated Dilatation and Contralateral Arm Response

Flow-mediated dilatation (FMD) is widely used as an index of nitric oxide-mediated vasodilator function, yet its methodology has not been well established. Previous research indicates that rapid inflations of a blood pressure cuff evoke systemic vasoconstriction as it was observed on non-occluded contralateral arm. This would potentially contribute to the well-known variability of FMD readings and could complicate the emerging evidence that non-occluded contralateral arm responses during the FMD procedure is associated with the presence of coronary artery disease. Purpose: To test the hypotheses that fast inflation of a blood pressure cuff could reduce FMD values and influence contralateral vasodilatory states. Method: Thirty-three apparently healthy adults (18 males and 15 females, 29±6 years) were studied in two randomized FMD trials. The blood flow-occluding cuff was inflated fast (\u3c1s with a Hokanson rapid cuff inflation\u3edevice) in one trial or slow (over a period of 10s) in the other during the FMD procedure. Arterial diameter, fingertip temperature, and infrared thermal images were obtained throughout each session. Results: FMD values were not different between the fast and slow cuff inflation trials (5.9±0.6% vs. 5.9±0.4%). There were no differences in fingertip temperature rebound between the trials (1.8±0.3 vs. 1.9±0.3oC). The infrared thermal imaging revealed greater reductions in hand and finger temperature as well as more variable responses in the contralateral arm when the cuff was inflated more rapidly. Conclusion: Rates to inflate a blood pressure cuff do not appear to affect FMD readings although a fast cuff occlusion would evoke greater neurovascular changes in the non-occluded contralateral arm

Elevated Serum C-Reactive Protein Relates to Increased Cerebral Myoinositol Levels in Middle-Aged Adults

C-reactive protein (CRP), a systemic marker of inflammation, is a risk factor for late life cognitive impairment and dementia, yet the mechanisms that link elevated CRP to cognitive decline are not fully understood. In this study we examined the relationship between CRP and markers of neuronal integrity and cerebral metabolism in middle-aged adults with intact cognitive function, using proton magnetic resonance spectrocospy. We hypothesized that increased levels of circulating CRP would correlate with changes in brain metabolites indicative of early brain vulnerability. Thirty-six individuals, aged 40 to 60, underwent neuropsychological assessment, a blood draw for CRP quantification, and 1H MRS examining N-acetyl-aspartate, myo-inositol, creatine, choline, and glutamate concentrations in occipito-parietal grey matter. Independent of age, sex and education, serum CRP was significantly related to higher cerebral myo-inositol/creatine ratio (F(4,31) = 4.74, P = 0.004), a relationship which remained unchanged after adjustment for cardiovascular risk (F(5,30) = 4.356, CRP β = 0.322, P = 0.045). Because these biomarkers are detectable in midlife they may serve as useful indicators of brain vulnerability during the preclinical period when mitigating intervention is still possible

同時性4重複癌の一例

近年,癌の診断技術の進歩や治療成績の向上に伴い重複癌の報告が増加しているが,同時性4重複癌の頻度は0.21%と稀である.超音波検査によるスクリーニングが診断に有用であった同時性4重複癌の一例を報告する.症例は69歳の男性で肝障害と高血圧で定期通院中であった.増大する無痛性頸部腫瘤を自覚し頸部超音波検査を施行し,転移性リンパ節腫大を疑い,同日に腹部超音波検査を行った.その結果,進行胃癌と進行大腸癌を疑い,消化管精査を開始した.精査の結果,中咽頭癌,食道癌,胃癌,直腸癌の同時性4重複癌であった.最も進行度の高い中咽頭癌から治療を開始し,現在外来通院中であるが,経過は良好である.1990年から2013年の間で医中誌による検索では同時性4重複癌の報告は自験例を含めて15例に過ぎない.その15例で検討を行うと男性に多く,罹患臓器は胃癌と食道(8.8%),または胃癌と直腸の重複(6.9%)と消化管領域での重複を多く認めた.重複癌の発生要因としては飲酒や喫煙などの嗜好品,遺伝的要因が報告されている.飲酒習慣については飲酒後の顔面の紅潮(フラッシャー)は発癌リスクが有意に高まるとされ,本症例でもBrinkman Index 1350,Sake Index 180と高値であり,更にフラッシャーであり複数のリスク因子を認めた.遺伝的要因については家族性大腸腺腫症やLynch症候群での多臓器癌の発症が知られているが,本症例では病理標本での検討の結果,その可能性は否定的であった.癌の治療方針決定においては,進行度の評価が重要となるため,全身のスクリーニングが必要であるが,超音波検査は非侵襲かつ放射線被曝もないことから,スクリーニングに適した検査法と考えられた.According to the recent advancement in diagnosis technique for cancers, the incidence of patients with cancer has been increasing. However, cases with synchronous quadruple cancers are rarely found. In this paper, we report a case of synchronous quadruple cancers located in the pharynx, esophagus, stomach and rectum. A 69-year-old man complained of swelling in the cervical lymph nodes, suspected to be metastasis by cervical ultrasonographic examination. Additionally, advanced gastric cancer and advanced rectal cancer were suspected via an abdominal ultrasonography (US). Thereafter, subsequent detailed examinations revealed the quadruple cancers, including advanced middle pharyngeal cancer, early-stage esophageal cancer, advanced gastric cancer and advanced rectal cancer. Chemoradiation therapy was performed for pharyngeal cancer as a neoadjuvant treatment because it was at the most advanced clinical stage. The patient had a good clinical course after the treatment. In Japan, we identified 14 case reports about synchronous quadruple cancers through the Japan Medical Abstracts Society database between the years 1990 to 2013. Summarizing all these cases, including our case, showed the following findings: male (13 cases) were predominant with a combination of gastric cancer and esophageal cancer (8.8%), or the combination of gastric cancer and rectal cancer (6.9%) were also common. Furthermore, cigarette smoking and alcohol consumption were considered the major risk factors for patients presenting with multiple cancers. Our patient was found to have both risks such as Brinkman Index 1350 and Sake Index 180. The treatment order for patients with cancer should be determined by its clinical stage. Screening examinations for checking metastasis or other organic diseases are important. Ultrasonography (US) is noninvasive and free from radiation exposure and it is a useful modality for patients with cancer

川崎医科大学附属病院におけるバルーン小腸内視鏡検査の現状 : 325症例の解析結果を含めて

バルーン小腸内視鏡(balloon assisted endoscopy; BAE)は,従来困難であった小腸の検査・治療に有用な検査法である.当院では,2004年にダブルバルーン小腸内視鏡(double balloon endoscopy; DBE)を導入し,2012年6月現在,234症例(延べ325症例;シングルバルーン小腸内視鏡[single balloon endoscopy; SBE]2例を含む)経験した.症例の内訳は,男性127例,女性107例で,平均年齢は62.6歳であった.主訴は,原因不明の消化管出血(obscure gastrointestinal bleeding; OGIB)症例が143例(61.1%)と最多であった.基礎疾患は心血管障害47例(20.1%)が最多で,抗血小板・抗凝固療法を施行している症例は53例(22.6%)にみられた.経口的アプローチは325症例中158例で,経肛門的アプローチは167例,経口的,経肛門的アプローチを両方施行された症例は56例あった.病変は78例(24.0%)に検出され,その内訳は,びらん及び潰瘍性病変23例(29.5%),腫瘍性病変22例(28.2%),血管性病変21例(26.9%)であった.また,外科的切除,内視鏡的止血術等の治療を58例(74.4%)に施行した.BAE により小腸疾患の診断・治療が大きく進歩した.しかしながら,一方で手技が煩雑な点,患者の身体的侵襲も少なくなく合併症を有する点が欠点として挙げられる.そのため,各種小腸疾患の診断,治療に対しては,個々の患者の状況により,BAEとカプセル内視鏡(capsule endoscopy; CA)とを使い分けていくことが重要である.Balloon assisted endoscopy (BAE) is a novel endoscopic technique developed to investigate small bowel diseases (SBDs). BAE has been installed from 2004 in Kawasaki Medical School Hospital. Since then, 234 patients (107 female, 117 male; mean age 62.6 years) with suspected or known SBDs underwent BAE, and we have performed a total of 325 consecutive BAE procedures. The most common indication for BAE was an obscure gastrointestinal bleeding. Cardiovascular disease was the most major coexisting disease (47 patients, 20.1%), and 53 patients (22.6%) were prescribed anti-platelet and/or anticoagulant therapy. One hundred and fifty eight patients were treated BAE via the oral approach, 167 patients were performed via the anal approach, and 56 patients were treated via the dual approach. The overall diagnostic yield was 24.0% (78/325 cases). Among the 78 cases, there were 23 erosions/ulcerations, 22 tumors, 21 angiovascular lesions, and other SBDs. The subsequent treatments, such as endoscopic therapy and surgical therapy were performed following the BAE procedure in 74.4% (58/78) of cases. BAE is a useful tool that not only allows diagnostic workup of SBDs, but also makes it possible to carry out therapeutic intervention. On the other hand, we should make careful decisions of indications for BAE, because it\u27s an invasive and complex procedure and the examination requires substantial time to complete