Successful treatment by adding duloxetine to pregabalin for peripheral neuropathy induced by paclitaxel

Although paclitaxel is a commonly used anticancer drug, peripheral neuropathy may develop as a side effect. Worsening of the symptoms with time may cause patients who receive paclitaxel to give up their chemotherapy. Duloxetine, a serotonin- and norepinephrine-reuptake inhibitor, has been used to treat peripheral neuropathic pain. We report the case of a 68-year-old man with gastric cancer, who underwent gastrectomy and then received 8 cycles of chemotherapy involving weekly administrations of paclitaxel. Under this paclitaxel treatment, he complained of severe peripheral neuropathy, leading to a diminished quality of life. Following treatment with a combination of duloxetine and pregabalin, a remission of his symptoms was achieved. Duloxetine plus pregabalin therapy may be useful for the peripheral neuropathy induced by paclitaxel.

Swollen head syndrome in broiler chickens in Japan: Its pathology, microbiology and biochemistry

Four-to-seven-week-old broilers with swollen head syndrome (SHS) from 4 different districts of Japan were examined for pathological, microbiological and biochemical findings. Periocular and mandibular subcutaneous swelling, sometimes accompanied by ocular, hepatic and cardiac lesions were observed. Histologically, diffuse fibrinopurulent inflammation with focal granulomatous lesions was characteristic of subcutaneous tissue of the head, especially periocular tissue. The air spaces of the cranial bones and middle ear showed fibrinopurulent inflammation. Upper respiratory lesions (rhinitis, sinusitis and tracheitis) were always present in chickens with SHS. The characteristic lesions of chicken colibacillosis, i.e. fibrinopurulent serositis, panophthalmitis, fibrinous thrombi in sinusoids of the liver and fibrinous exudation in the ellipsoids and lymphoid follicles of the spleen, were occasionally seen. No virological agents could be isolated. Turkey rhinotracheitis (TRT) virus gene was detected in tracheas from two flocks by reverse transcriptase polymerase chain reaction and serum antibodies against TRT virus were present. Escherichia coli and Staphylococcus aureus were isolated from subcutaneous lesions. Serum alpha(1)-acid glyco-protein, an acute phase protein, was present at high concentration in chickens with SHS. This study suggests that upper respiratory lesions induce E. coli invasion into subcutaneous connective tissue adjacent to the infraorbital sinus and nasal cavity, and SHS in this study may possibly be a local infection of E. coli in facial subcutaneous connective tissue.

Attempts to reproduce swollen head syndrome in specific pathogen-free chickens by inoculating with Escherichia coli and/or turkey rhinotracheitis virus

Attempts to reproduce swollen head syndrome (SHS) lesions were carried out in specific pathogen-free (SPF) chickens. In Experiment 1, chickens inoculated into the submucosal tissue of the nasal membrane or subcutaneous tissue of eyelids with four different strains of Escherichia coli, developed typical SHS lesions; purulent and necrotic lesions of facial subcutis (especially around their eyelids), periocular connective tissue, infraorbital sinus, air spaces, middle ears and eyeballs. The lesions elsewhere included splenic necrosis with fibrinous exudation, fibrin thrombi in hepatic sinusoids, and fibrinopurulent epicardi-tis and perihepatitis which occasionally accompanied lesions in SHS cases. In Experiment 2, SPF chickens inoculated intranasally with turkey rhinotracheitis (TRT) virus and/or E. coli showed no significant lesions in the facial skin, upper respiratory tract or other organs. However, the presence of TRT antibodies demonstrated that the virus infected the chickens. This study suggests that E. coli may play a significant role in the pathogenesis of SHS, but that the significance of TRT virus in the pathogenesis is still to be clarified.

Quantification of chicken anaemia virus by competitive polymerase chain reaction

A quantitative method for chicken anaemia virus (CAV) was developed using competitive polymerase chain reaction (PCR). Competitive template was constructed by deletion of 33 nucleotides from a wildtype DNA clone of CAV. Quantification of CAV DNA molecules by the competitive PCR was rapid and highly reproducible when compared with conventional infectivity titration methods. The ratios of the viral DNA molecules and infectivity titres in MDCC-MSB1 cells varied between 1.3 and 3.55 log(10) among several isolates, suggesting the existence of different infection efficiencies to MDCC-MSB1 cells by isolates. The competitive PCR will be useful for studying CAV infection in vivo and/or in vitro.

Development of 3D microwave imaging reflectometry in LHD (invited)

Three-dimensional (3D) microwave imaging reflectometry has been developed in the large helical device to visualize fluctuating reflection surface which is caused by the density fluctuations. The plasma is illuminated by the probe wave with four frequencies, which correspond to four radial positions. The imaging optics makes the image of cut-off surface onto the 2D (7 × 7 channels) horn antenna mixer arrays. Multi-channel receivers have been also developed using micro-strip-line technology to handle many channels at reasonable cost. This system is first applied to observe the edge harmonic oscillation (EHO), which is an MHD mode with many harmonics that appears in the edge plasma. A narrow structure along field lines is observed during EHO.

Elevated BAFF levels in the cerebrospinal fluid of patients with neuro-Behçet's disease: BAFF is correlated with progressive dementia and psychosis

Neuro-Behçet's disease (NBD) is a serious complication of Behçet's disease. Generally, NBD patients with a chronic course are refractory to immunosuppressive treatment, resulting in the deterioration of personality. In this study, levels of B cell-activating factor belonging to the TNF family (BAFF) were measured in the cerebrospinal fluid (CSF) from 18 patients with NBD, 27 patients with epidemic aseptic meningitis (AM), 24 patients with multiple sclerosis (MS) and 34 healthy controls. BAFF levels in patients with NBD were significantly elevated compared with healthy controls, but showed no statistically significant elevation compared with either of the disease controls. In contrast, CSF IL-6 levels were slightly elevated in patients with NBD and significantly elevated in patients with AM and MS compared with healthy controls. Patients with NBD were subdivided into two groups according to their clinical course (eight patients with a slowly progressive course presenting with psychosis and dementia and 10 patients with an acute course including aseptic meningitis, brainstem involvement and myelopathy). BAFF levels were significantly increased in those with a slowly progressive course compared with those with an acute course. CSF BAFF levels did not correlate with serum BAFF levels, CSF cell counts or CSF IL-6 levels in patients with NBD. These data suggested that BAFF was produced within the central nervous system and may be associated with the development of NBD, particularly with a progressive course.

The effect of pre-operative developmental delays on the speech perception of children with cochlear implants

OBJECTIVE

The objective of this study was to evaluate the relationship between developmental delays and speech perception in pre-lingually deafened cochlear implant recipients.

METHODS

This study was a retrospective review of patient charts conducted at a tertiary referral center. Thirty-five pre-lingually deafened children underwent multichannel cochlear implantation and habilitation at the Kyoto University Hospital Department of Otolaryngology-Head and Neck Surgery. A pre-operative cognitive-adaptive developmental quotient was evaluated using the Kyoto scale of psychological development. Post-operative speech performance was evaluated with speech perception tests two years after cochlear implantation. We computed partial correlation coefficients (controlled for age at the time of implantation and the average pre-operative aided hearing level) between the cognitive-adaptive developmental quotient and speech performance.

RESULTS

A developmental delay in the cognitive-adaptive area was weakly correlated with speech perception (partial correlation coefficients for consonant-vowel syllables and phrases were 0.38 and 0.36, respectively).

CONCLUSION

A pre-operative developmental delay was only weakly associated with poor post-operative speech perception in pre-lingually deafened cochlear implant recipients.

Triglyceride-rich lipoproteins in chronic kidney disease patients undergoing maintenance haemodialysis treatment

OBJECTIVE

Plasma triglyceride (TG) levels were reported to be high in chronic kidney disease (CKD) patients undergoing haemodialysis (HD) treatment. One of the atherogenic causes of hypertriglyceridemia is the increase in TG-rich lipoprotein remnants, which are equivalent to remnant-like particle cholesterol (RLP-C). Here, we compared the plasma levels of TG, a representative indicator of TG-rich lipoproteins and RLP-C, as well as the TG/RLP-C ratio between CKD patients undergoing HD and controls, in an effort to elucidate the atherogenicity of TG-rich lipoproteins in CKD patients on HD.

MATERIALS AND METHODS

Plasma lipid and apo(lipo)protein levels and the TG/RLP-C ratio were compared between 49 CKD patients undergoing HD and 627 controls. Blood sampling for lipid and apoprotein analysis was performed in a 12-h fasting state. Controls were divided into four subgroups according to TG level (from highest to lowest). RLP-C and apo(lipo)proteins were measured using the immunoprecipitation method and turbidimetric immunoassay, respectively. In addition, a comparison between HD patients and age-, gender-, and plasma TG level-matched controls was performed.

RESULTS

Plasma TG levels were 107 ± 70 (mean ± SD) mg/dl in HD patients and 115 ± 72 mg/dl in controls. Plasma RLP-C levels were 6.7 ± 4.5 mg/dl in HD patients and 4.6 ± 3.5 mg/dl in the controls (p < 0.0001). RLP-C levels decreased in descending order from the highest to the lowest TG group in controls. RLP-C levels were higher in HD patients than in controls with plasma TG levels of < 150 mg/dl (p < 0.0001). TG/RLP-C ratios were 19.0 ± 12.0 in HD patients and 25.9 ± 9.5 in controls (p < 0.0001). This ratio was significantly lower in HD patients than in all four TG subgroups. The comparison between HD patients and age-, gender-, plasma TG-matched controls revealed identical results.

CONCLUSION

Plasma RLP-C levels were high, and the TG/RLP-C ratio was low in CKD patients undergoing HD treatment. These findings indicate that total plasma TG-rich lipoprotein levels were not increased, but the distribution of plasma TG-rich lipoproteins were skewed towards remnant fractions in CKD patients undergoing HD treatment; these plasma TG-rich lipoproteins appear to be more atherogenic than those in controls.

Effect of the addition of beta-mercaptoethanol to a thawing solution supplemented with caffeine on the function of frozen-thawed boar sperm and on the fertility of sows after artificial insemination

We have reported that artificial insemination (AI) with frozen-thawed boar semen supplemented with caffeine increased the number of uterine sperm by inhibiting the migration of polymorphonuclear leukocytes (PMNs) into the uterine lumen, thereby improving the fertility of gilts and sows. The objective of the present study was to examine the effects of the addition of the antioxidant beta-mercaptoethanol (bME) and caffeine to the thawing solution on the function of frozen-thawed sperm, on the phagocytic activity of PMNs for sperm, and on the fertility of sows after AI. When frozen-thawed sperm were cultured in the presence of 25 or 50 μm bME, sperm capacitation and spontaneous acrosome reactions were inhibited (P < 0.01). There was no effect of bME on phagocytic activity of PMNs for sperm in vitro. When hormonally treated (400 IU of equine chorionic gonadotropin + 200 IU of human chorionic gonadotropin) weaned sows experienced a single intrauterine insemination with frozen-thawed sperm (25 × 10(8) sperm per 50 ml dose) 40 h after subsequent hCG administration, pregnancy and farrowing rates were unaffected by the addition of 50 μm bME (pregnancy rate, 20 vs 21% in controls; farrowing rate, 20 vs 21%; n = 15 and 14, respectively). However, litter size tended to be higher than in the presence of 50 μm bME compared to its absence (10.0 ± 1.0 vs 5.7 ± 1.5, respectively; P < 0.07). Thus, the addition of bME to the thawing solution containing caffeine could be of benefit for improving the function of frozen-thawed sperm without influencing the phagocytic activity of PMNs for sperm. Although there were no statistically significant effects of bME on pregnancy or farrowing rates, the litter size tended to be higher in the sows subjected to a fixed-time single AI treatment with synchronized ovulation.

Association of genetic variants for susceptibility to obesity with type 2 diabetes in Japanese individuals

AIMS/HYPOTHESIS

In populations of East Asian descent, we performed a replication study of loci previously identified in populations of European descent as being associated with obesity measures such as BMI and type 2 diabetes.

METHODS

We genotyped 14 single nucleotide polymorphisms (SNPs) from 13 candidate loci that had previously been identified by genome-wide association meta-analyses for obesity measures in Europeans. Genotyping was done in 18,264 participants from two general Japanese populations. For SNPs showing an obesity association in Japanese individuals, we further examined diabetes associations in up to 6,781 cases and 7,307 controls from a subset of the original, as well as from additional populations.

RESULTS

Significant obesity associations (p < 0.1 two-tailed, concordant direction with previous reports) were replicated for 11 SNPs from the following ten loci in Japanese participants: SEC16B, TMEM18, GNPDA2, BDNF, MTCH2, BCDIN3D-FAIM2, SH2B1-ATP2A1, FTO, MC4R and KCTD15. The strongest effect was observed at TMEM18 rs4854344 (p = 7.1 × 10(-7) for BMI). Among the 11 SNPs showing significant obesity association, six were also associated with diabetes (OR 1.05-1.17; p = 0.04-2.4 × 10(-7)) after adjustment for BMI in the Japanese. When meta-analysed with data from the previous reports, the BMI-adjusted diabetes association was found to be highly significant for the FTO locus in East Asians (OR 1.13; 95% CI 1.09-1.18; p = 7.8 × 10(-10)) with substantial inter-ethnic heterogeneity (p = 0.003).

CONCLUSIONS/INTERPRETATION

We confirmed that ten candidate loci are associated with obesity measures in the general Japanese populations. Six (of ten) loci exert diabetogenic effects in the Japanese, although relatively modest in size, and independently of increased adiposity.

Bone bonding bioactivity of Ti metal and Ti-Zr-Nb-Ta alloys with Ca ions incorporated on their surfaces by simple chemical and heat treatments

Ti15Zr4Nb4Ta and Ti29Nb13Ta4.6Zr, which do not contain the potentially cytotoxic elements V and Al, represent a new generation of alloys with improved corrosion resistance, mechanical properties, and cytocompatibility. Recently it has become possible for the apatite forming ability of these alloys to be ascertained by treatment with alkali, CaCl2, heat, and water (ACaHW). In order to confirm the actual in vivo bioactivity of commercially pure titanium (cp-Ti) and these alloys after subjecting them to ACaHW treatment at different temperatures, the bone bonding strength of implants made from these materials was evaluated. The failure load between implant and bone was measured for treated and untreated plates at 4, 8, 16, and 26 weeks after implantation in rabbit tibia. The untreated implants showed almost no bonding, whereas all treated implants showed successful bonding by 4 weeks, and the failure load subsequently increased with time. This suggests that a simple and economical ACaHW treatment could successfully be used to impart bone bonding bioactivity to Ti metal and Ti-Zr-Nb-Ta alloys in vivo. In particular, implants heat treated at 700 °C exhibited significantly greater bone bonding strength, as well as augmented in vitro apatite formation, in comparison with those treated at 600 °C. Thus, with this improved bioactive treatment process these advantageous Ti-Zr-Nb-Ta alloys can serve as useful candidates for orthopedic devices.

Neurological deficit after simultaneous open abdominal aortic surgery and thoracic aortic endovascular therapy

We examined a total of 12 cases; 8 cases were identified by searching the literature on Pubmed (excluding case reports published prior to 2000) and 4 cases were ones we personally encountered. We examined age, sex, history of smoking, and preoperative risk factors as preoperative factors, the access route and coverage of the descending aorta as perioperative factors, and complications and survival time as postoperative factors. Mean coverage of the thoracic aorta was 90.8 mm. In terms of perioperative deaths, 8.3% (1 patient) were due to coagulopathy. Perioperative complications occurred in 16.7% of cases (coagulopathy in 1 patient and paralysis in another). No patients experienced complications or underwent additional treatment during a mean follow-up of 22.9 months. This study suggested that simultaneous open abdominal aortic repair and thoracic aortic endovascular therapy is feasible and also involves few postoperative complications. Paraplegia and paralysis tended to occur less frequently than with two-stage surgery, but further study is needed to explain why this is true.

Quantitative analysis of masticatory activity during unilateral mastication using muscle fMRI

OBJECTIVE

Quantitative analysis of the activities of all masticatory muscles is required to elucidate the mechanism of stomatognathic dysfunction. Electromyography can be used to record the activity of masticatory muscles, but quantification of the overall activity of every masticatory muscle has not been accomplished because of methodological limitations. In this study, we used muscle functional magnetic resonance imaging for simultaneous quantification of the overall activities of the masseter, medial pterygoid and lateral pterygoid muscles during unilateral gum chewing.

METHODS

Seven healthy male volunteers participated in the study. We evaluated changes in the mean proton transverse relaxation time in the bilateral masseter, medial pterygoid and lateral pterygoid muscles before and after unilateral gum chewing, and to quantify the overall activity of these muscles simultaneously during unilateral gum chewing.

RESULTS

After 5 min of chewing, the activity of the ipsilateral masseter was highest among the six muscles, followed by the ipsilateral medial pterygoid, contralateral lateral pterygoid and contralateral masseter muscles.

CONCLUSION

These results affirm the importance of the ipsilateral masseter muscle and quantitatively demonstrate the important contribution of the ipsilateral medial pterygoid and contralateral lateral pterygoid muscles during unilateral mastication.

Simultaneous projection and detection system of four different frequencies for microwave imaging reflectometry in Large Helical Device

A simultaneous projection/detection system of four different frequencies for microwave imaging reflectometry (MIR) was developed for three-dimensional observation of electron density fluctuations in the Large Helical Device (LHD). The microwave with four frequency components at 60.410, 61.808, 63.008, and 64.610 GHz is projected in a continuous-wave mode to illuminate the target LHD plasma. A two-dimensional horn-antenna mixer array (2D HMA) receives the reflected wave from the plasma as well as the wave from the local oscillator operating at 55.800 GHz. The first intermediate frequency (IF) signals at 4.610, 6.008, 7.208, and 8.810 GHz were confirmed to be obtained by downconversion of these microwaves using the 2D HMA. Each of these first IF components is filtered from each other and downconverted again for the superheterodyne detection. It was confirmed that both the amplitudes and the phases of the detected signals reflect the fluctuations in LHD plasmas.

Development of electron cyclotron emission imaging system on Large Helical Device

A combined system of microwave imaging reflectometry and electron cyclotron emission (ECE) imaging has been developed for the Large Helical Device. This system includes a wide-band two-dimensional horn-antenna mixer array (HMA). The HMA consists of horn antennas, waveguides, mixers, and intermediate frequency circuits. The frequency response of the HMA is between 50 and 110 GHz. The ECE signal is selected using a 95 GHz local oscillator and a 93 GHz high-pass filter.

Diaphragm dysfunction with congenital cytomegalovirus infection

Congenital cytomegalovirus infection can cause a wide variety of symptoms. We report three infants with congenital cytomegalovirus infection presenting with respiratory insufficiency associated with persistent diaphragmatic dysfunction. Congenital cytomegalovirus infection should be considered in the differential diagnosis of neonatal diaphragmatic dysfunction.

Mechanisms of tumor necrosis factor-alpha-induced interleukin-6 synthesis in glioma cells

BACKGROUND

Interleukin (IL)-6 plays a pivotal role in a variety of CNS functions such as the induction and modulation of reactive astrogliosis, pathological inflammatory responses and neuroprotection. Tumor necrosis factor (TNF)-alpha induces IL-6 release from rat C6 glioma cells through the inhibitory kappa B (IkappaB)-nuclear factor kappa B (NFkappaB) pathway, p38 mitogen-activated protein (MAP) kinase and stress-activated protein kinase (SAPK)/c-Jun N-terminal kinase (JNK). The present study investigated the mechanism of TNF-alpha-induced IL-6 release in more detail than has previously been reported.

METHODS

Cultured C6 cells were stimulated by TNF-alpha. IL-6 release from the cells was measured by an enzyme-linked immunosorbent assay, and the phosphorylation of IkappaB, NFkappaB, the MAP kinase superfamily, and signal transducer and activator of transcription (STAT)3 was analyzed by Western blotting. Levels of IL-6 mRNA in cells were evaluated by real-time reverse transcription-polymerase chain reaction.

RESULTS

TNF-alpha significantly induced phosphorylation of NFkappaB at Ser 536 and Ser 468, but not at Ser 529 or Ser 276. Wedelolactone, an inhibitor of IkappaB kinase, suppressed both TNF-alpha-induced IkappaB phosphorylation and NFkappaB phosphorylation at Ser 536 and Ser 468. TNF-alpha-stimulated increases in IL-6 levels were suppressed by wedelolactone. TNF-alpha induced phosphorylation of STAT3. The Janus family of tyrosine kinase (JAK) inhibitor I, an inhibitor of JAK 1, 2 and 3, attenuated TNF-alpha-induced phosphorylation of STAT3 and significantly reduced TNF-alpha-stimulated IL-6 release. Apocynin, an inhibitor of NADPH oxidase that suppresses intracellular reactive oxygen species, significantly suppressed TNF-alpha-induced IL-6 release and mRNA expression. However, apocynin failed to affect the phosphorylation of IkappaB, NFkappaB, p38 MAP kinase, SAPK/JNK or STAT3.

CONCLUSION

These results strongly suggest that TNF-alpha induces IL-6 synthesis through the JAK/STAT3 pathway in addition to p38 MAP kinase and SAPK/JNK in C6 glioma cells, and that phosphorylation of NFkappaB at Ser 536 and Ser 468, and NADPH oxidase are involved in TNF-alpha-stimulated IL-6 synthesis.

Common variants at the GCK, GCKR, G6PC2-ABCB11 and MTNR1B loci are associated with fasting glucose in two Asian populations

AIMS/HYPOTHESIS

To test fasting glucose association at four loci recently identified or verified by genome-wide association (GWA) studies of European populations, we performed a replication study in two Asian populations.

METHODS

We genotyped five common variants previously reported in Europeans: rs1799884 (GCK), rs780094 (GCKR), rs560887 (G6PC2-ABCB11) and both rs1387153 and rs10830963 (MTNR1B) in the general Japanese (n = 4,813) and Sri Lankan (n = 2,319) populations. To identify novel variants, we further examined genetic associations near each locus by using GWA scan data on 776 non-diabetic Japanese samples.

RESULTS

Fasting glucose association was replicated for the five single nucleotide polymorphisms (SNPs) at p < 0.05 (one-tailed test) in South Asians (Sri Lankan) as well as in East Asians (Japanese). In fine-mapping by GWA scan data, we identified in the G6PC2-ABCB11 region a novel SNP, rs3755157, with significant association in Japanese (p = 2.6 x 10(-8)) and Sri Lankan (p = 0.001) populations. The strength of association was more prominent at rs3755157 than that of the original SNP rs560887, with allelic heterogeneity detected between the SNPs. On analysing the cumulative effect of associated SNPs, we found the per-allele gradients (beta = 0.055 and 0.069 mmol/l in Japanese and Sri Lankans, respectively) to be almost equivalent to those reported in Europeans.

CONCLUSIONS/INTERPRETATION

Fasting glucose association at four tested loci was proven to be replicable across ethnic groups. Despite this overall consistency, ethnic diversity in the pattern and strength of linkage disequilibrium certainly exists and can help to appreciably reduce potential causal variants after GWA studies.

Amphiregulin induces proliferative activities in osseous dysplasia

Human osseous dysplasia (OD) is a benign fibro-osseous neoplasm of periodontal ligament origin in which normal bone is replaced with fibrous connective tissue containing abnormal bone or cementum. However, cellular differentiation and proliferation in OD have not been fully elucidated. In vitro culture systems have distinct advantages for analytical studies. Therefore, we established immortalized cell lines (OD-1) from OD lesions of the jaw from an individual with gnathodiaphyseal dysplasia (GDD). We hypothesized that OD-1 had a characteristic growth mechanism different from that of mineralized-associated cells such as osteoblasts. To clarify the difference of gene expression patterns between OD-1 and osteoblasts, we compared the profiles of genes expressed in the 2 cell types by microarray analysis. We identified amphiregulin to be highly expressed in OD-1 compared with osteoblasts and gingival fibroblasts. OD-1 showed proliferative activities regulated in an autocrine manner by amphiregulin, and amphiregulin may play a significant role in the proliferation of OD.

Evaluation of asymmetric dimethylarginine and homocysteine in microangiopathy-related cerebral damage

BACKGROUND

Microangiopathy-related cerebral damage (MARCD) is an entity of cerebrovascular disease based on arteriosclerosis in deep white matter, which includes lacunar infarction and white matter hyperintensity (WMH). As asymmetric dimethylarginine (ADMA), an endogenous inhibitor of the nitric oxide (NO) synthases, and homocysteine are both potential risk factors for arteriosclerosis, the plasma levels of these two substances were evaluated in individuals with MARCD.

METHODS

Consecutive participants of a health examination (401 males and 311 females) were recruited for this cross-sectional study. All participants received an magnetic resonance imaging examination, and those with either lacunar infarction or WMH (grade > or =2) were classified into MARCD (+) (N = 146). The plasma ADMA concentration was measured with high performance liquid chromatography. The total homocysteine (tHcy) concentration was measured using a commercial kit.

RESULTS

The ADMA level (P < 0.001), symmetric dimethylarginine (SDMA) level (P < 0.05) and L-arginine (Arg)/ADMA ratio (P < 0.01) differed significantly between MARCD (+) and (-) according to nonparametric Wilcoxon test, while the tHcy level did not (P = 0.37). Classic risk factors such as age, blood pressure, and the presence of hypertension differed significantly between the two groups as well. In the logistic analysis, the association of Arg/ADMA with MARCD remained significant (odds ratio and 95% confidence interval, 0.19 (0.05, 0.73), P < 0.05) even after adjusting for the effects of age and hypertension.

CONCLUSIONS

ADMA and tHcy levels were studied in 712 subjects with or without MARCD. The Arg/ADMA ratio was suggested to be an independent risk factor for MARCD. A large-scale prospective study is warranted to confirm the causal relationship between Arg/ADMA and MARCD.