Gradual Increase of High Mobility Group Protein B1 in the Lungs after the Onset of Acute Exacerbation of Idiopathic Pulmonary Fibrosis

The pathogenesis of acute exacerbation of idiopathic pulmonary fibrosis (IPF) remains to be elucidated. To evaluate the roles of inflammatory mediators in acute exacerbation, the concentrations of high mobility group protein B1 (HMGB1), a chief mediator of acute lung injury, and 18 inflammatory cytokines were measured in the bronchoalveolar lavage fluid, serially sampled from seven IPF patients after the onset of acute exacerbation. HMGB1 gradually increased in the alveolar fluid after the onset of acute exacerbation, in positive correlation with monocytes chemotactic protein-1 (MCP-1), a potent fibrogenic mediator. In the lung tissues of eight IPF patients autopsied after acute exacerbation, intense cytoplasmic staining for HMGB1 was observed in the alveolar epithelial cells in alveolar capillary augmented lesions, where the capillary endothelial cells remarkably reduced the expression of thrombomodulin, an intrinsic antagonist of HMGB1. These results suggest pathogenic roles for HMGB1 and MCP-1 in the late phase of acute exacerbation of IPF

Low-Intensity Resistance Training with Moderate Blood Flow Restriction Appears Safe and Increases Skeletal Muscle Strength and Size in Cardiovascular Surgery Patients:A Pilot Study

We examined the safety and the effects of low-intensity resistance training (RT) with moderate blood flow restriction (KAATSU RT) on muscle strength and size in patients early after cardiac surgery. Cardiac patients (age 69.6 +/- 12.6 years, n = 21, M = 18) were randomly assigned to the control (n = 10) and the KAATSU RT group (n = 11). All patients had received a standard aerobic cardiac rehabilitation program. The KAATSU RT group additionally executed low-intensity leg extension and leg press exercises with moderate blood flow restriction twice a week for 3 months. RT-intensity and volume were increased gradually. We evaluated the anterior mid-thigh thickness (MTH), skeletal muscle mass index (SMI), handgrip strength, knee extensor strength, and walking speed at baseline, 5-7 days after cardiac surgery, and after 3 months. A physician monitored the electrocardiogram, rate of perceived exertion, and the color of the lower limbs during KAATSU RT. Creatine phosphokinase (CPK) and D-dimer were measured at baseline and after 3 months. There were no side effects during KAATSU RT. CPK and D-dimer were normal after 3 months. MTH, SMI, walking speed, and knee extensor strength increased after 3 months with KAATSU RT compared with baseline. Relatively low vs. high physical functioning patients tended to increase physical function more after 3 months with KAATSU RT. Low-intensity KAATSU RT as an adjuvant to standard cardiac rehabilitation can safely increase skeletal muscle strength and size in cardiovascular surgery patients.</p

Seasonal shifts in the contributions of the Changjiang River and the Kuroshio Current to nitrate dynamics in the continental shelf of the northern East China Sea based on a nitrate dual isotopic composition approach

The northern East China Sea (ECS) serves as a spawning and nursery ground for many species of fish and squid. To clarify the basis of the food web in the northern ECS, we examined the nitrate (NO3) dynamics along four latitudinal transects based on stable nitrogen and oxygen isotopes of NO 3 (δ15NNO3 and δ18ONO3) and temperature-salinity dynamics in both winter (February 2009) and summer (July 2009 and July 2011). The δ15NNO3 and δ18ONO3, which were distinctly different among the potential NO3 sources, were useful for clarifying NO3 sources and its actual usage by phytoplankton. In winter, Kuroshio Subsurface Water (KSSW) and the Yellow Sea Mixed Water (YSMW) predominantly contributed to NO3 distributed in the shelf water. In the surface water of the Okinawa Trough, NO3 from the KSSW, along with a temperature increase caused by an intrusion of Kuroshio Surface Water (KSW), seemed to stimulate phytoplankton growth. In summer, Changjiang Diluted Water (CDW), Yellow Sea Cold Water Mass (YSCWM), and KSSW affected the distribution and abundance of NO 3 in the northern ECS, depending on precipitation in the Changjiang drainage basin and the development of the YSCWM in the shelf bottom water. Although isotopic fractionation during NO3 uptake by phytoplankton seemed to drastically increase δ15NNO3 and δ18ONO3 in summer, relatively light nitrate with δ15NNO3 lower than expected from this fractionation effect might be explained by contribution of atmospheric nitrogen and/or nitrification to NO3 dynamics in the surface and subsurface layers. If the latter were a dominant process, this would imply a tightly coupled nitrogen cycle in the shelf water of the northern ECS

Blood Flow Restriction Increases the Neural Activation of the Knee Extensors During Very Low-Intensity Leg Extension Exercise in Cardiovascular Patients:A Pilot Study

Blood flow restriction (BFR) has the potential to augment muscle activation, which underlies strengthening and hypertrophic effects of exercise on skeletal muscle. We quantified the effects of BFR on muscle activation in the rectus femoris (RF), the vastus lateralis (VL), and the vastus medialis (VM) in concentric and eccentric contraction phases of low-intensity (10% and 20% of one repetition maximum) leg extension in seven cardiovascular patients who performed leg extension in four conditions: at 10% and 20% intensities with and without BFR. Each condition consisted of three sets of 30 trials with 30 s of rest between sets and 5 min of rest between conditions. Electromyographic activity (EMG) from RF, VL, and VM for 30 repetitions was divided into blocks of 10 trials and averaged for each block in each muscle. At 10% intensity, BFR increased EMG of all muscles across the three blocks in both concentric and eccentric contraction phases. At 20% intensity, EMG activity in response to BFR tended to not to increase further than what it was at 10% intensity. We concluded that very low 10% intensity exercise with BFR may maximize the benefits of BFR on muscle activation and minimize exercise burden on cardiovascular patients