Summary
Background
Increased level of hydrogen sulphide (H2S) in sputum is reported to be a new biomarker of neutrophilic airway inflammation in chronic airway disorders. However, the relationship ...between H2S and disease activity remains unclear.
Objective
We investigated whether H2S levels could vary during different conditions in asthma.
Method
H2S levels in sputum and serum were measured using a sulphide‐sensitive electrode in 47 stable asthmatic subjects (S‐BA), 21 uncontrolled asthmatic subjects (UC‐BA), 26 asthmatic subjects with acute exacerbation (AE‐BA) and 15 healthy subjects. Of these, H2S levels during stable, as well as exacerbation states, were obtained in 13 asthmatic subjects.
Results
Sputum H2S levels were significantly higher in the AE‐BA subjects compared to the UC‐BA and healthy subjects (P < .05). However, serum H2S levels in the AE‐BA subjects were lower than in the S‐BA subjects (P < .001) and similar to those in healthy subjects. Thus, the sputum‐to‐serum ratio of H2S (H2S ratio) in the AE‐BA subjects was significantly higher than in the S‐BA, UC‐BA and healthy subjects (P < .05). Among all subjects, sputum H2S levels showed a trend to decrease with FEV1 %predicted and significantly positive correlations with sputum neutrophils (%), sputum IL‐8 and serum IL‐8. A multiple linear regression analysis showed that sputum H2S was independently associated with increased sputum neutrophils (%) and decreased FEV1 %predicted (P < .05). The cut‐off level of H2S ratio to indicate an exacerbation was ≥0.34 (area under the curve; 0.88, with a sensitivity of 81.8% and specificity of 72.7%, P < .001). Furthermore, half of the asthmatic subjects with H2S ratios higher than the cut‐off level experienced asthma exacerbations over the following 3 months after enrolment.
Conclusions
The H2S ratio may provide useful information on predicting future risks of asthma exacerbation, as well as on obstructive neutrophilic airway inflammation as one of the non‐Th2 biomarkers, in asthma.
We examined whether pulse wave velocity (PWV), determined by brachial ankle arterial pressure wave measurements, using a newly developed, fully automated device could be a surrogate measure for ...carotid femoral PWV.
This device (AT-form PWV/ABI, Nippon Colin, Komaki, Japan) can simultaneously monitor bilateral brachial and ankle pressure wave forms using the volume plethysmographic method, with two optional tonometry sensors for carotid and femoral arterial wave measurements. We examined the right brachial–right ankle PWV and left carotid–left femoral PWV in 89 normotensive and untreated hypertensive patients. The brachial ankle PWV correlated well with carotid femoral PWV (
r = 0.755,
P < .00001). The Bland-Altman plots of the two variables, however, showed a significant difference exists between the two techniques over the range of measurement. The within-observer and between-observer coefficients of variation of the brachial ankle PWV were 6.5% ± 4.1% and 3.6% ± 3.9%, respectively. To determine the factors affecting brachial ankle PWV, we studied treated and untreated hypertensive patients with World Health Organization stage I (
n = 146), stage II (
n = 74), or stage III (
n = 54). In multiple regression analysis, age, brachial ankle PWV, and the presence of diabetes were significant predictors of the severity of hypertensive organ damage. Age, systolic blood pressure, and the stage of hypertensive organ damage were major determinants of brachial ankle PWV.
Although the brachial ankle PWV does not agree with the carotid femoral PWV, this parameter may yet become a new, useful measure for arterial stiffness. Further longitudinal studies are necessary to confirm the clinical significance of the brachial ankle PWV.
BACKGROUND
Increases in blood pressure were reported in overworked public workers following the Mid-Niigata earthquake. This study aimed to compare blood pressure changes between public employees and ...the general population after the Great East Japan Earthquake of March 2011.
METHODS
We analyzed 1,776 individuals from the general population and 240 public employees of the town of Watari who received medical check-ups in 2010 and from July 2011 through November 2011. Anthropometric parameters and sitting blood pressure were compared, and fasting blood samples were taken from all participants. In postdisaster measurements, the degrees of insomnia, depression, fatigue, and life disruption due to the disaster were assessed using a questionnaire. Information on the working hours of public employees was obtained from authorized sources.
RESULTS
After age-sex adjustments, the public employees showed greater increases in systolic (11.3 vs. -1.9mm Hg, P < 0.001) and diastolic (7.8 vs. 1.1mm Hg, P < 0.001) blood pressure than the general population when compared with measurements taken during the previous year. In contrast, the degrees of fatigue, depression, and life disruption were equivalent in the 2 groups. The average monthly overtime hours worked by public employees in March 2011 was 10-fold higher compared with the previous March.
CONCLUSION
Public employees showed greater and more prolonged increases in blood pressure than the general population after the Great East Japan earthquake. Thus blood pressure should be monitored after a great earthquake among public employees, and treatment should be considered if necessary.
We aimed to compare the efficacy and safety of irinotecan/S-1 (IRIS) therapy with S-1 monotherapy in patients with gemcitabine-refractory pancreatic cancer.
Patients were treated with oral S-1 ...(80-120 mg for 14 days every 4 weeks) plus intravenous irinotecan (100 mg m
on days 1 and 15 every 4 weeks; IRIS group) or oral S-1 group (80-120 mg daily for 28 days every 6 weeks). The primary endpoint was progression-free survival (PFS).
Of 137 patients enrolled, 127 were eligible for efficacy. The median PFS in the IRIS group and S-1 monotherapy group were 3.5 and 1.9 months, respectively (hazard ratio (HR)=0.77; 95% confidence interval (CI), 0.53-1.11; P=0.18), while the median overall survival (OS) were 6.8 and 5.8 months, respectively (HR=0.75; 95% CI, 0.51-1.09; P=0.13). Response rate was significantly higher in the IRIS group than in the S-1 monotherapy group (18.3% vs 6.0%, P=0.03). Grade 3 or higher neutropenia and anorexia occurred more frequently in the IRIS group.
There was a trend for better PFS and OS in the IRIS group that could be a treatment arm in the clinical trials for gemcitabine-refractory pancreatic cancer.
OBJECTIVE:In developed countries, systolic blood pressure is known to increase with age. Metabolic risks may generally worse with increasing age. But this trend may be modified by environmental ...factors which are different between gender and generation. The aim of this study was to examine the relationship between age and gender-related difference in cardio-metabolic risks and life style factors in the Japanese general population.
DESIGN AND METHOD:We studied 3628 inhabitants of Watari (mean age 63.9 yrs, 42.5% men), Miyagi prefecture, who participated in a health check-up in 2009. Anthropometry, sitting blood pressures, fasting blood samples were examined. Unhealthy dietary behaviors (night meal, late dinner, fast eating, skipping breakfast, smoking, heavy drinking, lack of regular exercise) were evaluated by standard questionnaire. Presence or absence of each behavior was scored 0 or 1 and total score was calculated as healthy life style score (range 0 to 7, higher the better). Gender difference in age-related changes in blood pressures, BMI, lipid and glucose metabolism were examined by two way ANOVA.
RESULTS:Systolic blood pressure was continuously increased from age 30 s to 70 s in both genders. Systolic blood pressure was significantly higher in men than in women in age 30 s (122.0 ± 13.9 vs. 113.3 ± 12.8 mmHg, p < 0.001) but the difference decreased with an increase in age. Similar gender interaction was observed for diastolic blood pressure, BMI, triglyceride and high density lipoprotein (all p < 0.001) but was not for HbA1c. The healthy life style score was lowest in men age 30 s (5.1 ± 1.5) and it increased with an increase in age. Women demonstrated significantly higher healthy life style score than men in all generations. The gender difference in the score was largest in age 30 s and decreased with an increase in age.
CONCLUSIONS:Cardio-metabolic risks are worse in men than in women in young generation but this gender difference diminishes with age. The gender difference in the young may be largely attributable to life style factors. Glucose metabolism may be less affected by life style than blood pressure or lipid.
Worker doses received from non-fixed surface contamination for transport of radioactive materials were evaluated for 356 nuclides in TECDOC-1449 published by the International Atomic Energy Agency ...(IAEA). In this study, a revised evaluation model for inhalation of worker was derived based on an investigation of actual conditions of transport of radioactive materials in Japan. Evaluation scenarios for the transport of a spent fuel cask and small manually handled packages were considered. Transportation workers for indoor, outdoor and in carrier task were classified in eight groups in these scenarios. Parameters of annual working time were defined for each classified work. The applicable surface contamination limits were calculated with the comparison to the current regulation and the surface contamination limits derived using TECDOC-1449. The results showed that critical pathway was inhalation for alpha emitter and a dominating worker group was a group of packages preparation and transfer workers and conveyance drivers.
The prevalence of COPD and asthma is increasing all over the world; however, their morbidities are thought to be greatly underestimated because of unawareness of patients' conditions and respiratory ...symptoms. Spirometry is useful for the early detection of COPD and asthma with airflow limitation (AL), although it is not yet widely used for screening in epidemiological and primary care settings. A simple predictive marker used in combination with spirometry for AL is expected to be established. In medical health check-ups, serum uric acid (s-UA) is measured when screening for gout and has recently been suggested to have an association with several respiratory disorders, including asthma and COPD. However, whether s-UA influences the development of AL remains unclear. Therefore, the aims of this study were to examine the relationship between AL and s-UA and to investigate s-UA as a potential auxiliary marker for predicting AL risk in medical health check-ups. A total of 8,662 subjects aged >40 years were included. They were administered a simple questionnaire and assessed using pulmonary function tests, blood pressure (BP) measurements, and blood samplings. One hundred and fifty-six subjects (1.8%) had AL, just 29% of whom had experienced respiratory symptoms. The subjects with AL had significantly higher s-UA levels compared with never-smoking subjects without AL. Forced expiratory volume in 1 second (FEV
) %predicted showed significant correlations with age, smoking index, body mass index (BMI), mean BP, white blood cells, hemoglobin A1c, s-UA, and high-density lipoprotein cholesterol. In multiple logistic regression analysis, s-UA, in addition to age, smoking index, respiratory symptoms, and BMI, was independently associated with AL. In conclusion, elevated s-UA levels, together with respiratory symptoms, high smoking index, and weight loss, may epidemiologically predict the development of AL risk.
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