Allostatic load and frailty do not covary significantly among older residents of Greater Poland

BACKGROUND

Physiological dysregulation/allostatic load and the geriatric syndrome frailty increase with age. As a neurophysiological response system, allostasis supports survival by limiting stressor-related damage. Frailty reflects decreased strength, endurance, and physical abilities secondary to losses of muscle and bone with age. One suggestion, based on large cohort studies of person's ages 70 + years, is that frailty contributes to allostatic load at older ages. However, small community-based research has not confirmed this specific association.

METHODS

To further explore possible associations between allostatic load and frailty, we enrolled 211 residents of Greater Poland aged 55-91 years living in a small village (Nekla, N = 104) and an urban center and capital of Greater Poland (Poznan, N = 107). For each, we recorded age, self-reported sex, and residence and estimated a 10-biomarker allostatic load score (ALS) and an 8-biomarker frailty index. We anticipated the following: higher ALS and frailty among men and rural residents; for frailty but not ALS to be higher at older ages; significant associations of ALS with sex and place of residence, but not with age or frailty. The significance of observed associations was evaluated by t-tests and multivariate regression.

RESULTS

ALS did not vary significantly between men and women nor between Nekla and Poznan residents overall. However, women showed significantly higher frailty than men. Nekla men showed significantly higher ALS but not frailty, while Nekla women showed nonsignificantly higher ALS and lower frailty than Poznan. In multivariate analyses, neither age, nor sex, nor residence was associated with ALS. Conversely, age, sex, and residence, but not ALS, are associated significantly with frailty. In Nekla, both age and sex, but in Poznan only age, are associated with ALS. Among women, both age and residence, but among men, neither associated with ALS. In no case did ALS associate significantly with frailty.

CONCLUSION

In this sample, lifestyle factors associated with residence, age, and sex influence stress-related physiology, less so in women, while ALS and frailty do not covary, suggesting their underlying promoters are distinct. Similar complex associations of physiological dysregulation with frailty, age, sex, and residence likely exist within many local settings. Knowledge of this variation likely will aid in supporting health and healthcare services among seniors.

Retrograde Type A Acute Aortic Dissection With Cerebral Malperfusion Six Years After Thoracic Endovascular Aortic Repair

A 59-year-old male with prior thoracic endovascular aortic repair presented with altered mental status. Magnetic resonance imaging showed cerebral infarction, and subsequent computed tomography revealed acute type A aortic dissection and right carotid artery occlusion. He underwent total arch replacement with right carotid artery bypass. After successful intervention, he was transferred to a rehabilitation facility for further improvement.

DeBakey Type II Acute Aortic Dissection Distant From the Proximal Edge of a Stent Graft: A Case Report Nine Years After Thoracic Endovascular Aortic Repair

An 84-year-old male with a medical history notable for prior thoracic endovascular aortic repair for thoracic aneurysm nine years ago presented to the emergency department with a chief complaint of transient loss of consciousness. A brain computed tomography showed no remarkable findings. A subsequent computed tomography scan for comprehensive evaluation revealed DeBakey type II acute aortic dissection as evidenced by contrast-enhanced imaging. An intimal tear was found on the ascending aorta distant from the proximal edge of a stent graft. Due to the urgency of the situation, the patient underwent emergent ascending aortic replacement. Following the successful intervention, the patient was transferred to a specialized rehabilitation facility with the goal of facilitating further improvement in their condition.

Pulsatile thrombus evacuation from the false lumen of an occluded carotid artery in acute aortic dissection

Herein, we present a case of aortic dissection with right carotid artery occlusion that was treated successfully with thrombus evacuation from the false lumen of the occluded carotid artery during hemiarch replacement. This procedure is performed with two maneuvers: aggressive retrieval of the thrombus from the innominate artery during circulatory arrest and thrombus evacuation from the false lumen of the right common carotid artery through a right neck incision with the heart beating. In this alternative method, thrombi can be evacuated more naturally and briskly, using pulsatile flow.

Type A Acute Aortic Dissection Presenting With Arch and Abdominal Aortic Aneurysms

Herein, we present the case of an 89-year-old female who presented with acute aortic dissection involving the arch and abdominal aneurysms. Emergent total arch replacement with a frozen elephant trunk was the first-line approach taken to save the patient's life. Although prolonged mechanical ventilation necessitated a tracheostomy, subsequent endovascular aortic repair mitigated the risk of rupture in the abdominal aortic aneurysm. While managing acute aortic syndrome with multiple aneurysms poses a challenge for surgeons, a diagnosis based on computed tomography angiography and timely intervention alleviated the critical condition.

Deep Femoral Artery Aneurysm Resection and Revascularization With a Saphenous Vein

An incidental discovery was made of a right deep femoral artery aneurysm (DFAA) in a plain computed tomography (CT) scan of a 72-year-old male. Although he had been diagnosed with type B aortic dissection six years ago and was followed for 12 months in the outpatient clinic, the patient was no longer receiving regular checkups. After a thorough discussion between cardiovascular surgeons and interventional radiologists, it was decided to proceed with aneurysm resection and revascularization. The postoperative course was uneventful, and the patient was discharged home without complications.

Distal Arch Aneurysm Discovered With Dysphagia

A 64-year-old man sought medical attention from a family physician, expressing concerns about dysphagia. Recognizing the complexity of the symptoms, the family physician promptly engaged the expertise of an attending physician at a regional hospital to ensure accurate diagnosis and management. Plain computed tomography (CT) revealed a space-occupied lesion located posterior to the trachea. Although mediastinal tumor was suspected at first, contrast-enhanced CT revealed a distal arch aneurysm that compressed the esophagus. The patient underwent total arch replacement, and the postoperative course was uneventful.

An Escherichia coli-Induced Distal Arch Aneurysm Presenting With Hemoptysis

Infected thoracic aneurysms are a rare and potentially life-threatening condition that present with non-specific symptoms. We describe here a case of an 83-year-old female who presented to the emergency department with the chief complaint of vomiting blood. The patient had presented to the emergency department 40 days earlier with abdominal pain, fever, and leukocytosis. She had a medical history of traumatic liver injury resulting in bile duct stenosis, necessitating percutaneous transhepatic gallbladder drainage and subsequent bile duct-jejunal anastomosis 25 years ago. Emergency contrast-enhanced computed tomography (CT) revealed an irregular distal arch aneurysm. According to the patient's present symptoms, CT findings, and medical history, infected thoracic aneurysm was suspected. Total arch replacement was performed promptly, followed by thorough antibiotic therapy. Following successful treatment, the patient's condition stabilized, and she was transferred to a rehabilitation facility for further recovery.

Worsening Isolated Superior Mesenteric Artery Dissection on the Day After Discharge

A 59-year-old male was transported to the emergency department by ambulance with complaints of left-sided abdominal pain. Blood gas analysis revealed elevated lactate, and plain computed tomography revealed no bowel ischemic change. Contrast-enhanced computed tomography revealed isolated superior mesenteric artery dissection with mildly stenosed true lumen. The patient was treated with conservative management on admission. Staged fluid intake, oral prescriptions, and diet were commenced with attention to the symptoms. After four days of hospitalization, the patient was discharged with a stable condition. However, the patient returned to our hospital complaining of left lower back pain three hours after discharge. Contrast-enhanced computed tomography revealed an enlarged false lumen with a moderately stenosed true lumen. After a thorough discussion between vascular surgeons and interventional radiologists, conservative management was commenced on the second admission. The clinical course was uneventful, with proof of improved imaging findings.

Conservative Treatment for Isolated Superior Mesenteric Artery Dissection With Severely Narrowed True Lumen

A 59-year-old male presented to the emergency department with distressing epigastric pain after seeking medical attention at a nearby clinic three hours prior. Upon examination, the attending physician noticed edematous changes in the proximal segment of the superior mesenteric artery, and a subsequent enhanced computed tomography (CT) scan confirmed the diagnosis of an isolated dissection of the artery. Notably, the true lumen of the vessel was significantly narrowed, raising concerns for potential vascular compromise. After extensive consultation between a vascular surgeon and a radiologist, a decision was made to adopt a conservative management approach. The patient was closely monitored with meticulous bowel rest, hydration management, and carefully curated dietary modifications. Over time, subsequent CT scans revealed progressive enlargement of the true lumen, which was highly reassuring to the medical team. As a result of the expert management and diligent care provided, the patient was eventually discharged home without any adverse events or complications. This case highlights the critical role of a multidisciplinary approach in managing complex vascular pathology and underscores the importance of thoughtful clinical decision-making and meticulous monitoring in achieving favorable outcomes.

Posterior Mitral Leaflet (PML) Perforation due to Infective Endocarditis (IE) Complicated with Cerebral Infarction

A 64-year-old man on dialysis presented to the emergency department with a fever and chills. Transthoracic echocardiography (TTE) showed small vegetation on the posterior mitral leaflet (PML). Antibiotic therapy was initiated. Two weeks later, right hemiparesis occurred. MRI of the head showed occlusion of the left middle cerebral artery, which suggested an embolism derived from the vegetation. The patient was then referred to the department of cardiovascular surgery. Transesophageal echocardiography (TEE) revealed perforation of the PML and severe mitral regurgitation (MR). The patient underwent mitral valve repair. The postoperative course was uneventful, and the patient was discharged after six weeks of antibiotic treatment. A fresh autologous pericardium is the material of choice to repair the valve.

Determining Infected Aortic Aneurysm Treatment Using Focused Detection of Helicobacter cinaedi

We detected Helicobacter cinaedi in 4 of 10 patients with infected aortic aneurysms diagnosed using blood or tissue culture in Aichi, Japan, during September 2017-January 2021. Infected aortic aneurysms caused by H. cinaedi had a higher detection rate and better results after treatment than previously reported, without recurrent infection.

Viral eradication reduces both liver stiffness and steatosis in patients with chronic hepatitis C virus infection who received direct-acting anti-viral therapy

BACKGROUND

Whether direct-acting anti-viral therapy can reduce liver fibrosis and steatosis in patients with chronic hepatitis C virus (HCV) infection is unclear.

AIMS

To evaluate changes in liver stiffness and steatosis in patients with HCV who received direct-acting anti-viral therapy and achieved sustained virological response (SVR).

METHODS

A total of 198 patients infected with HCV genotype 1 or 2 who achieved SVR after direct-acting anti-viral therapy were analysed. Liver stiffness as evaluated by magnetic resonance elastography, steatosis as evaluated by magnetic resonance imaging-determined proton density fat fraction (PDFF), insulin resistance, and laboratory data were assessed before treatment (baseline) and at 24 weeks after the end of treatment (SVR24).

RESULTS

Alanine aminotransferase and homeostatic model assessment-insulin resistance levels decreased significantly from baseline to SVR24. Conversely, platelet count, which is inversely associated with liver fibrosis, increased significantly from baseline to SVR24. In patients with high triglyceride levels (≥150 mg/dL), triglyceride levels significantly decreased from baseline to SVR24 (P = 0.004). The median (interquartile range) liver stiffness values at baseline and SVR24 were 3.10 (2.70-4.18) kPa and 2.80 (2.40-3.77) kPa respectively (P < 0.001). The PDFF values at baseline and SVR 24 were 2.4 (1.7-3.4)% and 1.9 (1.3-2.8)% respectively (P < 0.001). In addition, 68% (19/28) of patients with fatty liver at baseline (PDFF ≥5.2%; n = 28) no longer had fatty liver (PDFF <5.2%) at SVR24.

CONCLUSION

Viral eradication reduces both liver stiffness and steatosis in patients with chronic HCV who received direct-acting anti-viral therapy (UMIN000017020).

Effect of waxy barley, Kirarimochi, consumption on bowel movements of late-stage elderly residents at Roken nursing home

Background

It is very important for the late-stage elderly to have the least stressful bowel movements for maintaining a good quality of life. It is generally accepted that consuming adequate dietary fiber is a promising method for the prevention and management of stressful bowel movements such as those during constipation. Therefore, we examined the effect of long-term consumption of waxy barley, which is high in dietary fiber, on the bowel movements of the late-stage elderly living at Roken nursing home (a geriatric health services facility), Japan.

Methods

We compared the defecation and laxative administration frequencies of the subjects before and after waxy barley consumption, for which we served 28 residents a boiled mixture of rice and waxy barley (variety name, Kirarimochi) as the main meals for 5 months, from November to March. In October, all residents were served boiled rice as the main meals.

Results

The residents were categorized into “constipated” subjects and “non-constipated” subjects according to their weekly defecation frequency during October. Among the 14 residents categorized as constipated subjects, monthly number of days with defecation in November, January, and March significantly increased in comparison to monthly number of days with defecation in October. In addition, monthly number of days with laxative administration significantly decreased in December and February in comparison to monthly number of days with laxative administration in October. In contrast, the defecation and laxative administration frequencies did not change after waxy barley consumption among the 14 residents categorized as non-constipated subjects.

Conclusions

Consumption of waxy barley, Kirarimochi, for 5 months improved the bowel movements of the constipated subjects; however, the consumption had no effect on the bowel movements of the non-constipated subjects at Roken nursing home. These results indicate that consuming waxy barley, Kirarimochi, is beneficial for the management of constipation in the late-stage elderly residents at Roken nursing home.

Allostatic load differs by sex and diet, but not age in older Japanese from the Goto Islands

BACKGROUND

Lifelong exposure to stressors promotes physiological dysregulation and produces an allostatic load (AL). In European-derived samples, AL associates significantly with sex, age and health.

AIM

To assess associations of AL with age, sex, socio-demographic differences and self-reports of diet and ability to complete activities of daily living in older Japanese residing in rural Nagasaki Prefecture.

SUBJECTS AND METHODS

In 2011, 96 older residents of Nagasaki Prefecture, Japan, were assessed for components of AL. They also self-reported their age, principal life-long occupational activity, educational attainments, marital status, dietary choices and abilities to complete daily living activities.

RESULTS

Average age was 67.9 years (range = 55-89; SD = 8.65). Among these 48 men and 48 women, AL was not related significantly to age, although women showed lower AL than men. AL did not differ significantly between respondents by occupation, marital status, education or abilities to complete daily activities. Women who reported eating more green/yellow vegetables or consuming more meat had lower AL than their counterparts. Men who reported drinking more alcohol spirits had higher AL.

CONCLUSIONS

Among older Japanese residing outside a major urban area, AL varies significantly by sex, but not age, while being associated with dietary choices. Although lack of association with life ways was not expected, AL apparently assesses physiological dysregulation cross-culturally.

Ability of 18-fludeoxyglucose positron emission tomography/CT to detect incidental cancer

OBJECTIVE

To determine the prevalence and clinical features of pathologically proven incidental cancer (IC) detected by whole-body fluorine-18 fludeoxyglucose ((18)F-FDG) positron emission tomography (PET)/CT, as well as the incidence of false-positive and false-negative results.

METHODS

We retrospectively reviewed reports derived from (18)F-FDG PET/CT images of 3079 consecutive patients with known or suspected malignancies for 3 years. Discrete focal uptake indicating IC was identified from reports as well as pathological or clinical diagnoses, and the clinical courses were investigated. The false-positive result was defined as uptake indicating IC but not pathologically confirmed as malignant during follow-up. The false-negative result was defined as pathologically proven IC detected by another modality at initial clinical work-up or diagnosed during the follow-up period.

RESULTS

We found (18)F-FDG uptake indicating IC in 6.7% of all patients, and IC was pathologically proven in 2.2% of all patients. The most common sites were the colon, lung and stomach. The median survival duration of patients with IC was 42 months. The results were false positive in 4.5% of all patients, and the results were false negative in 2.3% of all patients.

CONCLUSION

(18)F-FDG PET/CT is a valuable tool for detecting IC. The rates of false-positive and false-negative results are within acceptable range.

ADVANCES IN KNOWLEDGE

This is the first report to describe the survival of patients with IC, and the detailed features of false-negative results at actual clinical settings.

Biofilm formation and resistance to benzalkonium chloride in Listeria monocytogenes isolated from a fish processing plant

Listeria monocytogenes is a foodborne pathogen that causes the potentially life-threatening illness listeriosis. Previously, a few clones of L. monocytogenes persisting in a cold-smoked fish processing plant were isolated from the plant's products continuously. To evaluate the role of biofilms in the persistence of L. monocytogenes strains specific to this plant, the abilities of the persistent strain (PS) and transient strain (TS) of L. monocytogenes found in this plant to form biofilms were compared, as was resistance to the sanitizing effects of benzalkonium chloride (BC). The PS produced more biofilm than the TS in 48 h. The half-maximal effective concentration (EC50), the BC concentration at which the ATP bioluminescence of each bacterial strain decreased by 50 % relative to its maximum activity, was about 150-fold higher in the PS than in the TS. In contrast, when these values were measured in organisms in a planktonic state, the EC50 of the PS was only 2.2-fold higher than that of the TS. Extracellular polymeric substances (EPS) were extracted from biofilms, and the glucose content of these biofilms was determined with the phenol-sulfuric acid method to estimate the quantity of EPS. The total amount of EPS in the PS biofilm was higher than that in the TS biofilm. These findings suggest that the PS produces greater amounts of biofilm and EPS than the TS, which results in greater resistance of the PS to disinfectants. The persistence of the strain in the fish processing plant might be attributable to these properties.

Effects of a late supper on digestion and the absorption of dietary carbohydrates in the following morning

Background

Our previous experiment showed that the light intensity exposed on the subjects during evening time had no effect in the following morning on the efficiency of the digestion and absorption of dietary carbohydrates ingested at a usual suppertime. People who keep late hours usually have a late suppertime; thus, we examined the effects of a late suppertime on gastrointestinal activity in the following morning in comparison to that of a usual suppertime.

Methods

Twelve female university students volunteered as paid participants. The breath hydrogen test was carried out to estimate the amount of unabsorbed dietary carbohydrates and the percentage of the total amount of dietary carbohydrates in the breakfast that were unabsorbed, as well as to estimate oro-cecal transit time. The respiratory quotient was also measured to find the ratio of carbohydrates/lipid metabolism in the post-breakfast state. Subjects’ peripheral blood glucose concentration was measured by a blood glucose meter. The subjects participated under two different experimental conditions: with a usual suppertime (having supper at 18:00) and a late suppertime (having supper at 23:00).

Results

The efficiency of the digestion and absorption of dietary carbohydrates in the breakfast under late suppertime conditions was higher than that under usual suppertime conditions. Usual or late suppertime had no effect on the ratio of carbohydrates to lipids oxidized after the subjects had breakfast. There were significant differences in the blood glucose level between the two conditions at 30, 60, 120, 150, and 180 minutes after having breakfast, whereas the mean blood glucose level under late suppertime conditions was significantly higher than under usual suppertime conditions.

Conclusions

Having a late supper showed a worse effect on postprandial serum glucose profiles the following morning. This study confirmed that keeping our usual meal timing is important for our health.

Westernization of dietary patterns among young Japanese and Polish females -- a comparison study

INTRODUCTION AND OBJECTIVE

Nowadays, the process of the westernization of eating habits is perceived to be one of the main causes of epidemics of civilization diseases, such as metabolic syndrome. The aim of the study was to assess the westernization of eating habits among 100 Japanese (aged 18-23 years) and 111 Polish female students (aged 19-25 years) of nutrition science related faculties.

MATERIALS AND METHODS

Food-frequency questionnaires were used to assess a dietary pattern during the four seasons of a one-year investigation. Data obtained in each season was pooled. The frequency of consumption of different foods (servings/week) between the two countries was compared and characterization of the dietary patterns of both studied populations was analyzed by factor analysis.

RESULTS

When food consumption between the two countries was compared, apart from total meat and meat products and high-energy drink intake, significant differences were observed in all foods and food groups. Three dietary patterns were identified in both groups. Among Japanese participants, the first pattern was 'traditional Japanese', the second 'sweets and beverages', and the third 'Western', explaining 9.0%, 8.5% and 6.4% of the total variance, respectively. Among Polish participants, the first pattern was 'prudent', the second 'Western', and the third 'sweets and alcoholic beverages', explaining 8.2%, 7.7%, 6.4% of the total variance, respectively. Although the 'Western' dietary pattern was found in both groups, there were some differences in the remaining dietary patterns between the two countries.

CONCLUSIONS

In the Japanese participants, significant cultural influences on habitual food intake could still be observed, and the extent of diet westernization seems to be smaller compared to the Polish participants.

Comparison of variations between percentage of body fat, body mass index and daily physical activity among young Japanese and Thai female students

Background

In our series of investigations concerning the causes of seasonal change in fat accumulation in young university students, we could not find any contribution of seasonal variation in the ratio of carbohydrate and fat metabolism to that of body fat percentage in Japanese and Thai participants. After our previous study, we examined the effect of daily physical activity on body fat percentage to look for the major causes of seasonal change in fat accumulation in young university students.

Findings

In this study, we measured participants’ (young Japanese and Thai university students) daily physical activity by a uniaxial accelerometer in addition to the measurements of body fat percentage and body mass index by a bioelectrical impedance meter. We found that there was significant and moderate negative correlation between body fat percentage and daily step counts among Japanese but not Thai participants. We observed significant, moderate and positive correlations between the percentage of body fat and body mass index among Japanese and Thai participants.

Conclusions

Daily physical activity plays an important role in the seasonal variation of body fat percentage of Japanese female students. Our present study also confirmed the importance of daily physical activity for controlling body mass index and for the prevention of obesity.

A pilot study of allostatic load among elderly Japanese living on Hizen-Oshima Island

Background

Between July and September 2005, a preliminary sampling of the elderly population of Hizen-Oshima Island, Nagasaki Prefecture, Japan was conducted by the local hospital’s nursing staff.

Results

Reported here are preliminary results from this sample of 27 individuals with an average age of 71 years. Their ages ranged from 51 to 82 years, with a standard deviation (sd) of 7.4 years. In total, 33 aspects of physical and physiological variation were assessed on these 15 women and 12 men. As expected from previous studies of Japanese elders, our sample shows slightly elevated average blood pressure (142/81 mmHg, sd 16/10), but they are relatively lean (waist/hip = .9: sd 0.06) when compared to European or American standards. However, their average total cholesterol (TC = 210 mg/dl, sd = 42.8) is high compared to standards, as is their high-density lipoprotein cholesterol (HDLc = 55.4 mg/dl, sd = 15.1). Means, standard deviations (sd), ranges and upper bounds for quartile cut-points for all 10 variables used in the calculation of allostatic load (AL) were assessed. The overall average estimate for AL in this sample is 3.1 (sd = 1.58) and ranges from 1 to 7.

Conclusion

AL shows variability across men and women, has little correlation with age, and is associated with physiological variation in blood glucose, dopamine and uric acid.

Which characteristic of Natto: appearance, odor, or taste most affects preference for Natto

Background

In Japan, consumption of Natto, a fermented bean dish, is recommended because of its high quality protein, digestibility in the gut and its preventive effect on blood clot formation due to high vitamin K content. However, consumption of Natto in Kansai and the Chugoku area (the western part of Honshu) is less than that in the other areas of Japan probably because of a “food related cultural inhibition”. In this study, we determined which characteristic of Natto (appearance, odor or taste) most affect subjects’ perception of sensory attributes by observation of brain hemodynamics in relation to subjects’ preference for Natto.

Findings

In this experiment, we defined each subject’s changes in brain hemodynamics as (+) or (−) corresponding to an increase or a decrease in total hemoglobin concentration after stimuli compared to that before stimuli. As a result, there was no relation between preference for Natto and change in brain hemodynamics by the stimuli of “looking at” or “smelling”, while there was a significant relationship between preference and stimulus of “ingestion”; (+) : (−) = 21:15 in the subjects of the “favorite” group and (+):(−) = 30:7 in the subjects of the “non-favorite” group (P = 0.034).

Conclusion

This result indicated that characteristic “taste” of Natto most affects preference for Natto.

Comparison of seasonal variation in the fasting respiratory quotient of young Japanese, Polish and Thai women in relation to seasonal change in their percent body fat

Background

From the viewpoint of human physiological adaptability, we previously investigated seasonal variation in the amount of unabsorbed dietary carbohydrates from the intestine after breakfast in Japanese, Polish and Thai participants. In this investigation we found that there were significant seasonal variations in the amount of unabsorbed dietary carbohydrates in Japanese and Polish participants, while we could not find significant seasonal variation in Thai participants. These facts prompted us to examine seasonal variations in the respiratory quotient after an overnight fast (an indicator of the ratio of carbohydrate and fat oxidized after the last meal) with female university students living in Osaka (Japan), Poznan (Poland) and Chiang Mai (Thailand).

Methods

We enrolled 30, 33 and 32 paid participants in Japan, Poland and Thailand, respectively, and measurements were taken over the course of one full year. Fasting respiratory quotient was measured with the participants in their postabsorptive state (after 12 hours or more fasting before respiratory quotient measurement). Respiratory quotient measurements were carried out by means of indirect calorimetry using the mixing chamber method. The percent body fat was measured using an electric bioelectrical impedance analysis scale. Food intake of the participants in Osaka and Poznan were carried out by the Food Frequency Questionnaire method.

Results

There were different seasonal variations in the fasting respiratory quotient values in the three different populations; with a significant seasonal variation in the fasting respiratory quotient values in Japanese participants, while those in Polish and Thai participants were non-significant. We found that there were significant seasonal changes in the percent body fat in the three populations but we could not find any significant correlation between the fasting respiratory quotient values and the percent body fat.

Conclusions

There were different seasonal variations in the fasting respiratory quotient values in the three different populations. There were significant seasonal changes in the percent body fat in the three populations but no significant correlation between the fasting respiratory quotient values and the percent body fat.

A novel ring-expanded product with enhanced tyrosinase inhibitory activity from classical Fe-catalyzed oxidation of rosmarinic acid, a potent antioxidative Lamiaceae polyphenol

The iron-ion catalyzed oxidation of the ethanol solution of rosmarinic acid, a potent antioxidant polyphenol of Lamiaceae (Labiatae) plants, afforded a highly tyrosinase-inhibitory active product. The structure of the active product in the oxidation product mixture was determined using extensive NMR spectroscopy to have a novel oxygen-containing seven-membered ring system. The formation mechanism of the unique ring structure from the catechol part of the rosmarinic acid was proposed.

Seasonal variation in amount of unabsorbed dietary carbohydrate from the intestine after breakfast in young female Thai subjects: comparison with that of Japanese subjects

Previously, using the breath hydrogen test, we investigated seasonal variations in the amount of unabsorbed dietary carbohydrate from the intestine after breakfast in female Japanese university students and young Polish subjects. In the study we found that there were significant seasonal variations in both countries with the smallest unabsorbed dietary carbohydrate in autumn and the biggest in winter. Considering the theory of human adaptation to living environments, we suggested a hypothesis that this seasonal variation in the efficiency of carbohydrate absorption in the intestine may reflect human adaptation and/or a response to seasonal change in the living environment. In order to prove this hypothesis, we carried out the same examination in Chiang Mai, Thailand, where there is different seasonal change in the living environment from that of Japan and of Poland. In this examination, we measured the amount of unabsorbed dietary carbohydrate (UDC) from the intestine after breakfast and the oro-cecal transit time (OCTT) of the breakfast in female Thai university students using the same method and experimental protocol as previously carried out with Japanese subjects. We conducted the examination in April (the hot season), in August-September (the rainy season), and in November-December (the dry season) of 2008, at the Medical School of Chiang Mai University, Chiang Mai. The results are summarized as follows: (1) there were no significant seasonal variations in the amounts of unabsorbed dietary carbohydrate from breakfast in Thai subjects; (2) there were no significant seasonal variations in the oro-cecal transit times of breakfast or a soluble indigestible trisaccharide (lactosucrose) solution in Thai subjects; (3) there were no significant differences in the oro-cecal transit times of breakfast between the two countries in any season; (4) the UDC of Thai subjects was significantly less than that of the Japanese subjects in the three seasons. These results suggest that differences in seasonal change in a living environment have different effects on seasonal variations in the efficiency of carbohydrate absorption in the intestine after breakfast.

Identification of cytotoxic dimers in oxidation product from sesamol, a potent antioxidant of sesame oil

Phytophenols of edible plants have recently attracted much attention as potent antioxidants and related bioactive substances. These antioxidative phytophenols are very oxidizable due to their chemical properties, and their oxidation products must accumulate in the oxidizing foods when they are contained as active ingredients. In this investigation, several phytophenols, which are well known as potent antioxidants in food science, were oxidized by oxygen in the presence of a catalytic amount of Ferric ion. Caffeic acid, catechin, chlorogenic acid, rosmarinic acid, and sesamol were quickly oxidized, whereas eugenol, resveratrol, rutin, and quercetin were not under the stated conditions. The oxidation product mixtures of the quickly oxidized phytophenols were next subjected to a cytotoxic assay using normal cells. Among the products, the oxidation product from sesamol showed a remarkably high cytotoxic activity. To clarify the cytotoxic principle of the oxidation products, an assay-guided fractionation and subsequent isolation of the oxidation compound of sesamol was carried out. Structure analysis of the isolated compounds revealed that they are new dimeric compounds (2-5) of sesamol. The cytotoxic activity of the dimers was evaluated from the population of dead cells by a flow cytometric analysis of rat thymocytes in the presence of 100 μM of each compound. Compound 2 showed the most potent cytotoxic activity among them. Compound 2 has a typical conjugated carbonyl moiety and the moiety possibly contributes to its high toxicity from a structure-activity point of view.

Effect of evening exposure to bright or dim light after daytime bright light on absorption of dietary carbohydrates the following morning

We had previously reported on the effect of exposure to light on the human digestive system: daytime bright light exposure has a positive effect, whereas, evening bright light exposure has a negative effect on the efficiency of dietary carbohydrate absorption from the evening meal. These results prompted us to examine whether the light intensity to which subjects are exposed in the evening affects the efficiency of dietary carbohydrate absorption the following morning. In this study, subjects were exposed to either 50 lux (dim light conditions) or 2,000 lux (bright light conditions) in the evening for 9 h (from 15:00 to 24:00) after staying under bright light in the daytime (under 2,000 lux from 07:00 to 15:00). We measured unabsorbed dietary carbohydrates using the breath-hydrogen test the morning after exposure to either bright light or dim light the previous evening. Results showed that there was no significant difference between the two conditions in the amount of breath hydrogen. This indicates that evening exposure to bright or dim light after bright light exposure in the daytime has no varying effect on digestion or absorption of dietary carbohydrates in the following morning's breakfast.

Seasonal Variation in the Amount of Dietary Carbohydrate Not Absorbed from the Intestine after Breakfast in Elderly Japanese Females

It was previously shown that there is seasonality in the amount of dietary carbohydrate not absorbed from the intestine after breakfast, the amount of carbohydrate in winter being significantly larger than that in autumn in young Japanese subjects. In order to investigate this phenomenon further, the experiment was repeated on 22 elderly Japanese female subjects (61-78 yrs of age) during the four seasons of the year. The amount of unabsorbed dietary carbohydrate by the breath hydrogen test, which measures the amount of hydrogen in exhaled air, was then estimated. A 6 g solution of lactosucrose, an indigestible trisaccharide, was used for comparison. Two groups of subjects, 16 subjects in Osaka and 6 subjects in Nagano, were studied in the summer (July to August) and autumn (October to November) of 2005 and the winter (January to February) and spring (April to May) of 2006. The following results were found using the pooled data of the total of 22 subjects. With regard to the amount of breath hydrogen excretion of the lactosucrose solution, there was no significant difference between the four seasons. There was a significant seasonal change in the efficiency of dietary carbohydrate absorption from the intestine after breakfast. The percentage of total carbohydrate that was not absorbed was lowest in the spring and highest in the winter. A comparison of the results from studies on the elderly and young subjects revealed the percentage of total carbohydrate that was not absorbed in the elderly was significantly lower than in the young in the winter, spring, and summer. These results indicate that there is seasonal variation in the efficiency of dietary carbohydrate absorption from the intestine among elderly female Japanese subjects as well as young female Japanese subjects. They also suggest that the efficiency of dietary carbohydrate absorption from the intestine after breakfast is retained in these naturally active and healthy elderly subjects.

Correlation of serum ribavirin concentration with pretreatment renal function estimates in patients with chronic hepatitis C receiving combination antiviral therapy with peginterferon and ribavirin

Serum ribavirin concentration is an important factor in antiviral therapy in combination with peginterferon (PEG-IFN) and ribavirin for patients with chronic hepatitis C in terms of both beneficial and adverse effects. We evaluated whether the serum ribavirin concentration can be predicted on the basis of renal function estimates. Serum creatinine and cystatin C concentrations were measured at the start of treatment in a total of 148 patients with chronic hepatitis C who underwent combination PEG-IFN and ribavirin therapy. Creatinine clearance (CrCl) and total clearance of ribavirin (CL/F) were calculated on the basis of the serum creatinine level. The glomerular filtration rate was calculated with two different formulae on the basis of the serum cystatin C level. These values were compared with serum ribavirin concentrations 4 weeks after the start of therapy. The cystatin C level increased with the progression of liver fibrosis, whereas the creatinine level was constant regardless of the degree of liver fibrosis. Significant correlation was not observed between the serum ribavirin concentration and serum creatinine level, cystatin C level, or calculated renal function estimates. However, significant correlation was found between the serum ribavirin concentration and CrCl and CL/F in patients who were given ribavirin >800 mg/day. Overall, renal function estimates do not correlate with the serum ribavirin concentration in Japanese patients with chronic hepatitis C who undergo combination PEG-IFN and ribavirin therapy. Serum creatinine-based renal function estimates might be predictive for the serum ribavirin concentration only in patients with a daily ribavirin intake of 800 mg or more.

Antioxidation mechanism studies of caffeic acid: identification of antioxidation products of methyl caffeate from lipid oxidation

As a part of a research project on the elucidation of the chain-breaking antioxidation mechanism of natural phenols in food components, caffeic acid, a polyphenolic acid widely distributed in edible plants, was investigated. The identification and time course analysis of the antioxidation reaction products from methyl caffeate were carried out in the ethyl linoleate oxidation system. The antioxidation reaction produced a quinone derivative of methyl caffeate as an antioxidation product during the initial stage, which was identified by (13)C NMR. The quinone, however, was not the final product, and a further reaction occurred to produce several new peroxides. The isolation and structure determination of the peroxides revealed that they had tricyclic structures, which consisted of ethyl linoleate, methyl caffeate, and molecular oxygen. On the basis of the formation pathway of these products, an antioxidation reaction mechanism of methyl caffeate, including the redox reaction of the caffeate and Diels-Alder reaction of the produced peroxides, was proposed.

Seasonal variation in amount of unabsorbed dietary carbohydrate from the intestine after breakfast in Japanese subjects

We previously showed that daytime dim-light exposure has a negative effect on the efficiency of dietary carbohydrate absorption in the evening, whereas evening-time dim-light exposure has a beneficial effect. These results suggest that seasonal changes in the environmental light may affect gastrointestinal activity, and that there might, therefore, be seasonal variation in the efficiency of dietary carbohydrate absorption from the intestine. In order to prove this hypothesis, we measured the amount of dietary carbohydrate unabsorbed from the intestine after a breakfast in healthy female Japanese subjects during the four seasons of the year. We estimated the amount of unabsorbed dietary carbohydrate by the breath hydrogen test, which measures the amount of hydrogen in exhaled air. A 6 g solution of lactosucrose, an indigestible trisaccharide, was used for comparison. Two groups of subjects, 12 subjects in Osaka and 14 subjects in Nagano, were studied in the winter (January to February), spring (April to May), summer (July to August), and autumn (October to November) of 2004. We found the following results: (1) In no season were there any significant differences between the two subgroups in the orocecal transit time of the breakfast and the lactosucrose solution. Nor were there any significant differences in the amount of unabsorbed dietary carbohydrate from the breakfast. (2) Using the pooled data of the total of 26 subjects, there was no significant seasonal variation in the orocecal transit time of the breakfast or the lactosucrose solution. (3) There was a significant seasonal variation in the amount of unabsorbed dietary carbohydrate from the breakfast. (4) The amount of unabsorbed dietary carbohydrate from the breakfast was largest in winter and smallest in autumn. Results in spring and in summer were similar and intermediate between those in winter and autumn. Post hoc multiple comparison tests showed that the amount of unabsorbed dietary carbohydrate in winter was significantly larger than in autumn. (5) In winter, the average ratio of the amount of unabsorbed dietary carbohydrate to the total amount of carbohydrate in the breakfast was about 12%; in autumn it was about 6%. These results clearly show that there is seasonal variation in the efficiency of intestinal dietary carbohydrate absorption among young female Japanese subjects.

Comparison of carbohydrate digestion between Japanese and Polish healthy subjects

We have revealed that light environment affects digestion and absorption of dietary carbohydrates in the gastrointestinal tract. This experimental result supposes that the efficiency of carbohydrate absorption may differ among people who live in different latitudes, such as Japanese and Polish people, at the same calendar season. In order to prove this hypothesis, we have been comparing the efficiency of carbohydrate absorption using the breath hydrogen test in Japan and Poland. Here, we report the comparison of the result obtained in the summer of 2004 as the following; (1) Orocecal transit time (OCTT) for indigestible trisaccharide of Japanese subjects was significantly longer than that in Poland (p = 0.043). (2) On the ingestion of minestrone, the amount of unabsorbed carbohydrate of Japanese subjects (which was estimated as trisaccharide equivalent) was significantly larger than that of Polish subjects (p = 0.006).

Endoscopic management and follow up of Dieulafoy lesion in the upper gastrointestinal tract

BACKGROUND AND STUDY AIMS

Dieulafoy's lesion is an important cause of upper gastrointestinal bleeding, and the safety and efficacy of endoscopic treatment have been widely accepted. The aim of this study was to evaluate the effectiveness of endoscopic management, including hemoclipping and injection methods, for bleeding Dieulafoy lesions in the upper gastrointestinal tract.

PATIENTS AND METHODS

Between 1995 and 2003, 61 patients with bleeding Dieulafoy lesions underwent endoscopic treatment. The available hemostatic methods were hemoclipping, hypertonic saline-epinephrine injection, and pure ethanol injection. Clinical data, endoscopic features, and treatment outcome were analyzed retrospectively.

RESULTS

Comorbid conditions were present in 39 patients (64 %). Active bleeding was noted in 20 patients (33 %). Hemoclipping was a selected treatment in 48 patients (79 %). Initial hemostasis was achieved in 61 patients (100 %). One patient had rebleeding 6 days after the initial procedure but was successfully treated endoscopically. The 30-day mortality was 0 %. During follow-up, for a mean of 47 months, 15 patients (25 %) died of causes unrelated to the Dieulafoy lesion. Two patients had recurrent bleeding due to non-Dieulafoy gastric ulcer, and responded to endoscopic therapy. We encountered no patients who required surgery.

CONCLUSIONS

Dieulafoy lesion can be successfully managed by endoscopic treatment. The long-term outcome is acceptable.

Immunohistochemical localization of hemicelluloses and pectins varies during tissue development in the bamboo culm

The distribution of hemicelluloses and pectins in bamboo internodes was studied immunocytochemistrically at various stages of development. The ultra-structures of bamboo cell walls have been reported previously at various stages. The internodes were identically classified into three developmental phases: primary wall stage (phase I), unlignified secondary wall stage (phase II) and lignified wall stage (phase III), using the same bamboo culm. (1-->3, 1-->4)-Beta-glucans were distributed in nearly all tissues in an actively elongating stage. Limited amounts of beta-glucans were deposited in primary walls and the middle lamellae, but were limited to the phloem in secondary walls. This suggests that the function of beta-glucans might be different in phloem vis-à-vis other tissues. Highly-substituted xylans were located in nearly all tissues of early phase I, but had disappeared in all tissues immediately prior to lignification. In contrast, low-branched xylan epitopes were present only in the protoxylem in phase I, but were present in all tissues immediately prior to lignification in phase II. In phase III, the epitopes were densely localized in lignified walls, suggesting that the substitution of xylans is closely related to maturation. Methyl-esterified (but not unesterified) pectins were present in all tissues of early phase I. Just before and after lignification, both types of pectins were concentrated in the phloem and protoxylem. Xyloglucans were largely distributed in the phloem and in lignified tissues, suggesting that they might be closely correlated with maturation. This represents the first account of the distribution of hemicelluloses and pectins at the tissue and ultrastructural level in bamboo internodes at various stages of development.

Effect of evening exposure to dim or bright light on the digestion of carbohydrate in the supper meal

In a previous study we found that daytime exposure to bright as compared to dim light exerted a beneficial effect on the digestion of the evening meal. This finding prompted us to examine whether the digestion of the evening meal is also affected by evening light intensity. Subjects lived in light of 200 lux during the daytime (08:00-17:00 h) and took their evening meal at 17:00 h under 20 lux (evening dim-light condition: 17:00-02:00 h) or 2000 lux (evening bright-light condition: 17:00-02:00 h) until retiring at 02:00 h. Assessment of carbohydrate digestion of the evening meal was accomplished by a breath hydrogen test that is indicative of the malabsorption of dietary carbohydrate. Hydrogen excretion in the breath in the evening under the dim-light condition was significantly less than under the bright-light condition (p < 0.05). This finding is the opposite to that obtained in previous experiments in which subjects were exposed to the different intensities of light during the daytime, and indicates that the exposure to dim light in the evening exerts a better effect on carbohydrate digestion in the evening meal than does the exposure to bright light.