Raynaud's phenomenon in vibration syndrome: the impact of cold feet on skin temperature and vasomotion of the hand after immersion in cold water

Patients with vibration syndrome, suffering from Raynaud's phenomenon, are sensitive to cold. Rewarming time, after local cooling, is delayed. The present study evaluated whether rewarming of the hand after cooling is influenced by the temperature of the feet. In five Japanese patients (former forest workers) with vibration syndrome, suffering from Raynaud's phenomenon, and in five healthy controls, temperature changes of the hand after cooling were registered under the two test situations (on different days) with the feet immersed in water of 35 degrees C or 20 degrees C, respectively. In both patients and controls (in both groups, in four of five cases) rewarming of the hand after cooling was faster when the feet were immersed in cold water, compared with when the feet were immersed in warm water. In this test situation, the systemic thermoregulative counterreaction appears to be more important for rewarming of the hand after cooling than a possible synchronous passive reaction accompanying warming of the feet. A deliberate training of the systemic counterreaction may prove beneficial for patients with Raynaud's phenomenon.

Involvement of Ras in the expression of glycolipid sulfotransferase in human renal cancer cells

Glycolipid sulfotransferase activity in a human renal cell carcinoma cell line, SMKT-R3, is enhanced by epidermal growth factor (EGF); tyrosine kinase inhibitors suppress this enhancement. To investigate the involvement of Ras in the signal transduction pathway from the EGF receptor to the expression of glycolipid sulfotransferase, we introduced v-H-ras into SMKT-R3 cells. In a quiescent state, the percent GTP bound to Ras in v-H-ras-expressing cells increased about 2.5-fold compared with control cells, suggesting that v-Ras introduced into the renal cancer cells is in an active form without EGF stimulation. Glycolipid sulfotransferase activity in v-H-ras-expressing cells was higher than in control cells. The sulfotransferase activity was affected neither by EGF nor by genistein, a tyrosine kinase inhibitor, in v-H-ras-expressing cells, whereas it was enhanced by EGF and reduced by genistein in control cells. Our observations suggest that Ras mediates the regulation pathway of glycolipid sulfotransferase activity in SMKT-R3 cells.

Physical effects of negative air ions in a wet sauna

The physical effects of negative air ions on humans were determined in an experimental sauna room equipped with an ionizer. Thirteen healthy persons took a wet sauna bath (dry bulb temperature 42 degrees C, relative humidity 100%, 10 min exposure) with or without negative air ions. The subjects were not told when they were being exposed to negative air ions. There were no differences in the moods of these persons or changes in their blood pressures between the two saunas. The surface temperatures of the foreheads, hands, and legs in the sauna with negative ions were significantly higher than those in the sauna without ions. The pulse rates and sweat produced in the sauna with ions were significantly higher than those in the sauna without ions. The results suggest that negative ions may amplify the effects on humans of the sauna.

Balneotherapy and platelet glutathione metabolism in type II diabetic patients

Effects of balneotherapy on platelet glutathione metabolism were investigated in 12 type II (non-insulin-dependent) diabetic patients. Levels of the reduced form of glutathione (GSH) on admission were well correlated with those of fasting plasma glucose (FPG; r = 0.692, P < 0.02). After 4 weeks of balneotherapy, the mean level of GSH showed no changes; however, in well-controlled patients (FPG < 150 mg/dl), the level increased (P < 0.01) and in poorly controlled patients (FPG > 150 mg/dl), the value decreased (P < 0.05). There was a negative correlation between glutathione peroxidase (GPX) activities and the levels of FPG (r = -0.430, P < 0.05). After balneotherapy, the activity increased in 5 patients, decreased in 3 patients and showed no changes (alteration within +/- 3%) in all the other patients. From these findings in diabetic patients we concluded: (1) platelet GSH synthesis appeared to be induced in response to oxidative stress; (2) lowered GPX activities indicated that the antioxidative defense system was impaired; and (3) platelet glutathione metabolism was partially improved by 4 weeks balneotherapy, an effect thought to be dependent on the control status of plasma glucose levels. It is suggested that balneotherapy is beneficial for patients whose platelet antioxidative defense system is damaged, such as those with diabetes mellitus and coronary heart disease.

Continuous measurement of blood pressure, heart rate and left ventricular performance during and after isometric exercise in head-out water immersion

Experiments were performed to determine the changes in blood pressure (BP), heart rate (HR) and left ventricular function during and after isometric knee extension during thermoneutral (35 degrees C) head-out water immersion (HWI) or in air. Seven healthy male subjects mean age 24 (SD 3) years kept their knees extended (60% maximal voluntary extension) until they reached exhaustion. The mean BP at rest was 80 (SD 10) and 78 (SD 8) mmHg [10.7 (SD 1.33) and 10.4 (SD 1.07)kPa] in air and during HWI, respectively, (NS). They increased progressively (P < 0.01) during contraction and reached maximal values of 148 (SD 22) and 143 (SD 26) mmHg [19.7 (SD 2.93) and 19.1 (SD 3.47)kPa] in air and in HWI, respectively, (NS). The mean HR at rest was 74 (SD 8) and 70 (SD 11) beats.min-1 in air and in HWI, respectively, (NS). They also increased progressively, (P < 0.01) and reached 126 (SD 14) and 118 (SD 17) beats.min-1 in air and in HWI, respectively, (NS). The changes in BP and HR during contraction in HWI tended to be smaller than those in air (NS). Left ventricular end diastolic diameters (dd) at rest in HWI were greater than those in air and were maintained at higher values during and after isometric contraction. In contrast, dd decreased during isometric contraction in air (P < 0.01). The change of left ventricular systolic diameters (ds) in HWI was no different to those in air. From these findings, isometric exercise in thermoneutral HWI would seem to be characterized by a greater dd than in air and this could be useful for patients with deconditioning effects such as orthostatic hypotension.

Elevated levels of heat-shock protein 70 (HSP70) in the mononuclear cells of patients with non-insulin-dependent diabetes mellitus

Increased free radicals and reduced levels of antioxidants have been reported in diabetes mellitus. Since heat-shock protein 70 (HSP70) is a stress-induced protein and is suggested to play a protective role against oxidative stress, we have investigated whether HSP7O acts as one of the defense systems against this stress. We separated mononuclear cells from diabetic patients (N=12) and age- and sex-matched healthy controls (N =12), and detected HSP70 by western blot analysis. The results were expressed by the ratio of the density determined by laser densitometry, to that of 10 mu g of purified HSP70. HSP70 levels in the mononuclear cells of diabetic patients (0.78 + or- 0.56) were significantly high, compared with healthy subjects (0.43 + or - 0.23) (P < 0.05). No correlation was found between HSP7O and hemoglobin A1c, fasting plasma glucose, duration of diabetes or diabetic complications except age. A negative correlation was found between HSP70 and age (r = -0.658, P < 0.05). These results suggest that HSP70 levels in the mononuclear cells are elevated reflecting increased oxidative stress in patients with diabetes.

[Study of the interrelation between variation of blood pressure and pulse rate under various respiratory conditions]

By means of non-invasive continuous blood pressure measurement (Finapres method), coefficient of variation for pulse rate (CV-PR) and coefficient of variation for blood pressure (CV-BP) under various respiratory conditions were calculated simultaneously to examine the interrelation between them. The subjects were 148 healthy normal adults and 75 patients with diabetes mellitus (DM). Both coefficients of variation for healthy normal adults showed significantly (p < 0.01) positive correlations: correlation coefficients tended to be greater during deep breathing than that during resting breathing. The case was the same for the ratio of CV-PR to CV-BP (CV-PR/CV-BP): the ratio for deep breathing was approximately 1.0. The ratio showed a significant decrease for DM patients compared with that for healthy normal group. The examination of the interrelation between these coefficients of variation under various respiratory conditions, which reflected the sensitivity of cardiovascular vagal reflex was considered to be also useful for the judgment of the degree of progress of DM-complications.

Thermal stress and diabetic complications

Activities of erythrocyte aldose reductase were compared in 34 normal subjects, 45 diabetic patients, and nine young men following immersion in water at 25, 39, and 42 degrees C. Mean basal enzyme activity was 1.11 (SEM 0.12) U/g Hb and 2.07 (SEM 0.14) U/g Hb in normal controls and diabetic patients, respectively (P < 0.0001). Activities of the enzyme showed a good correlation with hemaglobin A1 (HbA1) concentrations (P < 0.01) but not with fasting plasma glucose concentrations. After immersion at 42 degrees C for 10 min, enzyme activity was increased by 37.6% (P < 0.01); however, the activity decreased by 52.2% (P < 0.005) after immersion for 10 min at 39 degrees C and by 47.0% (P < 0.05) at 25 degrees C. These changes suggest that heat stress might aggravate diabetic complications, and body exposure to hot environmental conditions is not recommended for diabetic patients.

[Collagen disease and vasculitis with manic and depressive symptoms]

Collagen diseases and vasculitis diseases are known to have severe disorders in many organs. Manic and depressive symptoms are also found in these diseases as one of central nervous system disorders. They are frequently observed in systemic lupus erythematosus, primary Sjögren's syndrome and rheumatoid arthritis. It is very difficult to diagnose and treat the manic-depressive states because there are many origins that cause the psychological disorder; immunological disorders (anti-cardiolipin antibodies, anti ribosomal protein P etc.), cerebral vasculitis, thrombosis, infections, endocrinological disorders, steroid induced psychosis and so on. There are few pathogenic studies to explain the manic-depressive symptom in these diseases.

Effect of thermal stress on glutathione metabolism in human erythrocytes

This is the first experiment to investigate the effect of heat and cold stress on glutathione metabolism in human erythrocytes. We immersed men at three different water temperatures for 10 min. At 39 degrees C, no remarkable changes were observed. Levels of glutathione (GSH) decreased from 2.44 (0.14) to 1.80 (0.10) mumol.ml red blood cells-1 [mumol.ml RBC-1; mean (SEM); P < 0.0005] and those of lipid peroxides increased from 1.87 (0.03) to 2.06 (0.04) nmol.ml RBC-1 (P < 0.01) after the immersion at 42 degrees C. In contrast, levels of GSH increased from 2.46 (0.17) to 2.91 (0.17) mumol.ml RBC-1 (P < 0.05) and those of lipid peroxides did not change after the immersion at 25 degrees C. The activities of glutathione peroxidase decreased from 35.90 (1.83) to 34.33 (1.66) IU.g Hb-1 (P < 0.01) after the immersion at 42 degrees C; however, these activities did not change after the immersion at 25 degrees C. The activities of glutathione reductase (both active and inactive forms) showed no changes at any temperatures. These changes indicate that heat stress causes oxidative stress in the human body; however, cold stress is thought to augment the activity of the antioxidative defence system. It is suggested that body exposure to hot environmental conditions should not be recommended for patients suffering from a damaged antioxidative defence system.

[Abnormal amino acid metabolism in diabetes mellitus]

Abnormal amino acid metabolism is sometimes observed among patients with diabetes mellitus. Of many amino acids, alanine and branched-chain amino acids such as valine, leucine, isoleucine show characteristic changes. In diabetic ketoacidosis, plasma concentration of alanine decreases and that of branched-amino acid increases and the oxidation of branched-amino acids is enhanced. Splanchnic amino acid uptake is generally higher in diabetics and this level is partially restored by exercise. Some glycosylated proteins are used to estimate the condition of diabetes mellitus. Increment of urinary glycosylated amino acid excretion is reported in diabetics. Plasma homocysteine, reactive vascular-injuring amino acid, increases in diabetics with nephropathy. Those abnormal amino acid metabolism would be restored after good glycemic control is obtained.

Effects of simvastatin, an HMG-CoA reductase inhibitor, on plasma lipids and steroid hormones

Seven hyperlipidemic postmenopausal women received 2.5 mg of simvastatin daily for six months, 5 mg for four months, and 2.5 mg for two months. During treatment, there were significant decreases in the patients' levels of plasma total cholesterol, phospholipids, low-density lipoprotein cholesterol, apolipoprotein (apo) B, apo E, and in the ratios of low-density lipoprotein:high-density lipoprotein cholesterol and apo B:apo A-I. Levels of high-density triglycerides increased significantly. Blood pressures tended to decrease. No significant changes in the plasma levels of cortisol, adrenocorticotropic hormone, testosterone, progesterone, or plasma renin activity were noted. Plasma aldosterone levels decreased significantly after nine months of treatment, but remained within normal limits. No other treatment side effects were recorded.

An evaluation of serum high density lipoproteins-phospholipids

Phospholipids in high density lipoproteins (HDL) is being used as a negative risk indicator of atherosclerosis. Phospholipids in HDL may not demonstrate the actual level of HDL-phospholipids when determined by the precipitation or ultracentrifugal methods, because HDL fractions contain very high density lipoproteins (VHDL) and albumin. In the present study, the true level of phospholipids in HDL was estimated using high performance liquid chromatography (HPLC), and it was compared with the level of phospholipids in HDL determined by the precipitation method. Sera from 18 healthy subjects were used as materials. In the HPLC method, the HDL fraction was extracted making sure that it contained no free albumin, which is albumin not bound to phospholipids. The HDL fraction was separated into subfractions. It was found that phospholipids in the VHDL fraction make a 20.2 +/- 7.3% (mean +/- S.D.) part of the total HDL-phospholipids. A large part of the VHDL fraction was constituted of albumin-bound phospholipids. A significant correlation was observed between HDL-phospholipids determined by the precipitation method, which contain albumin, and the actual HDL fraction phospholipids determined by HPLC, which do not contain VHDL (r = 0.903, p less than 0.01). These results suggest that HDL-phospholipids values determined by the precipitation method give useful clinical data.

[Effects of hydrostatic pressure on cardiac function in human]

Effects of hydrostatic pressure on cardiac function were measured by echocardiography and radiography. Seven normal subjects (three females and four males) aged from 21 to 45 years were performed echocardiography on long axis of the heart at standing position in air and in head-out water (36 degrees C) immersion. A same trials were done at long sitting position in four subjects (one female and three males). The measurement of cardiac functions was calculated by Pombo's method. A chest radiography of a normal male individual (45 years) was taken at the time of functional residual capacity of lung in air and in head-out water (36 degrees C) immersion. For taking the chest radiography in water and in air, a box made by wood was used. X-ray exposure was synchronized with R wave of electro-cardiogram. The end-diastolic left ventricular volume, end-systolic volume and cardiac output in water immersion were significantly increased to compare with that of in air. Mean +/- SD of these percent changes were 213 +/- 71% (p less than 0.005), 193 +/- 90% (p less than 0.05), 220 +/- 83% (p less than 0.005), respectively. A same results were obtained at long sitting position. There was no significant changes on the heart rate between in water and in air. The circumstance of the abdomen decreased significantly in water immersion in comparison to in air. The percent change was 94.4 +/- 3.1% (p less than 0.001). There was a significant correlation between percent changes of abdominal circumstance and percent changes of end-systolic left ventricular volume (r = 0.754, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Characteristics of pulmonary function in patients with diabetes mellitus

The incidence of pulmonary diseases among diabetics in Japan has been found to be more than 50% at death. This suggests the existence of some pulmonary risk factors. We analyzed pulmonary functions in 50 diabetics (31 males and 19 females) without overt lung disease, compared to 21 healthy male subjects of the same age (around 50 years old). Forced vital capacity and timed vital capacity were lower in diabetics (P less than 0.005). Diffusing capacity was also decreased in male diabetics (P less than 0.05). Among diabetics, a decrease in the diffusing capacity was dominant in patients with diabetic retinopathy, which correlated with an increasing duration of their diabetes. Analysis by the partial correlation method which accounts for the smoking index showed that standardized indices for peripheral airflow in male diabetics decreased significantly as the patient's age increased (P less than 0.005); the rate of decrement was greater than that of the control subjects. Diabetic patients showed abnormal lung function in the peripheral airways which increased with age and gas transfer was also affected by diabetic microangiopathy as well as the duration of diabetes. These changes seemed to deteriorate progressively, possibly combining and contributing to respiratory insufficiency in critical pathological conditions.

[Mechanisms of high hemoglobin A1 in alcohol drinkers]

Hemoglobin A1 (HbA1) levels were significantly higher in healthy alcohol drinkers (HbA1 = 7.50%, n = 11) than in normal non-drinkers (HbA1 = 6.62%, n = 13). Ethanol was not able to change HbA1 level when ethanol was added to human whole blood in vitro. Acetaldehyde (AcCHO), although, markedly increased it. Glucose utilization in erythrocytes was stimulated by AcCHO. While it was completely blocked by sodium fluoride in the presence of AcCHO in the incubation medium, but sodium fluoride did not affect the formation of HbA1. AcCHO formed HbA1 with human purified hemoglobin in vitro. The level of HbA1 formed by AcCHO was significantly low when purified human hemoglobin used as a substrate in comparison with the use of whole blood. AcCHO and dihydroxyacetone phosphate reacted in the presence of aldolase. The reacted product, 5-deoxy-D-xylulose-1-phosphate, increased HhA1 level of human purified hemoglobin. It is suggested, the high level of HbA1 in healthy drinkers was caused by AcCHO, the first metabolite of ethanol. AcCHO formed addicts with human hemoglobin directly, and there might be other mechanisms of HbA1 formation due to AcCHO, such as 5-deoxy-D-xylulose-1-phosphate, which is the reacted product of AcCHO.

[Simulation of cold acclimation by chronic treatment with noradrenaline, with special reference to metabolic responses to noradrenaline (author's transl)]

Rats treated with noradrenaline (NA) or L-dopa for 28 days were infused i.v. with NA for 30 min and changes in rectal temperature and plasma concentrations of nonesterified fatty acids (NEFA), glycerol, blood sugar, and lactate were observed. Results obtained were compared with those in cold-acclimated rats. The NA infusions caused a significant elevation of the rectal temperature in cold-acclimated and NA-treated rats, but not in L-dopa-treated ones. NA-induced increase in the plasma NEFA level was less in extent in cold-acclimated rats than in warm-adapted ones. Similar difference in the NEFA increase was observed between NA-treated and control rats. Changes in plasma glycerol level were the same in cold-acclimated and warm-adapted rats and in NA-treated and control rats. NA-induced increase in blood sugar level was less in extent in cold-acclimated and NA-treated rats as compared to the increase in respective control rats. No consistent changes were observed in blood lactate concentration. From the results it was inferred that the responses to exogenous NA in NA-treated rats, but not in L-dopa treated ones, were similar to those in cold-acclimated rats. It was thus suggested that the chronic treatment with NA may produce similar metabolic state as in cold-acclimation.

[Changes in blood constituents induced by noradrenaline infusion and acute cold exposure in rats treated chronically with noradrenaline and thyroxine (author's transl)]

Rats were treated with noradrenaline (NA), thyroxine (T4), NA plus T4, and NA plus ACTH for 28 days, and changes in rectal temperature and blood concentrations of nonesterified fatty acids (NEFA), sugar, and lactate were observed following NA infusion and acute cold exposure. Results obtained were compared with those found in cold-acclimated rats. NA infusion caused a marked elevation of the rectal temperature in cold-acclimated rats and NA plus T4-treated ones. No significant changes were observed in plasma NEFA level following NA infusion in cold-acclimated and NA-treated rats. Treatment with T4 tended to augment the lipolytic action of NA. Treatment with NA plus ACTH showed similar effect of augmented lipolysis. Changes in blood sugar level induced by NA infusion were small in cold-acclimated and NA plus T4 groups. Changes in blood lactate level were not significant in NA plus ACTH group. After acute cold exposure plasma NEFA level was low in cold-acclimated rats and high in NA plus T4-treated rats. Blood sugar level was slightly higher in cold-acclimated and NA plus T4-treated rats than in the other groups. Plasma lactate level showed relatively high values in T4 and NA plus T4 groups. It was thus suggested that metabolic patterns in cold-acclimated rats and in NA plus T4- as well as NA-treated rats were somewhat alike, but not always the same.

[Sensitivity to noradrenaline and cold tolerance of rats treated chronically with ACTH and adrenocortical hormone (author's transl)]

Rats treated with ACTH and hydrocortisone for 4 weeks were infused i.v. with noradrenaline or exposed to cold at -15 degrees C for 2 hours, and changes in the rectal temperature and plasma concentrations of NEFA, sugar, and lactate were observed. Rats received single injection of ACTH and hydrocortisone, warm- and cold-acclimated rats were used as controls. In ACTH- and hydrocortisone-treated rats, the noradrenaline infusion caused a significant elevation of the rectal temperature, but lowering of the rectal temperature induced by the acute cold exposure in these treated rats did not differ from the changes in control groups. Moreover, considerable differences were found between these treated rats and cold-acclimated ones in plasma concentrations of NEFA, sugar and lactate after noradrenaline infusion and acute cold exposure. From the results it was inferred that chronic treatment with ACTH and hydrocortisone did not produce similar adaptive metabolic alterations to those found in the course of cold acclimation.