In drug-naïve normotensive individuals, the effects of a lower-salt and higher-potassium diet, and IR on blood pressure, were more evident in women. These results suggest that to prevent the new onset of hypertension and its complications, the balances of a sodium restriction and an increased potassium intake are important even in normotensive individuals, independent of known risk factors for salt sensitivity, especially in women.
Psittacosis infection is usually reported in adults aged around 30 to 60 years. We report here two cases of psittacosis in an elderly couple (76 and 77 years old) who jointly ran a pet shop. Psittacosis was diagnosed from a history of exposure to birds and from serological testing for Chlamydophilia avium. CASE REPORTSCase 1. Case 1 was that of a 76-year-old Japanese man who owned a pet shop selling parrots, parakeets, and budgerigars. He was admitted to our hospital due to general malaise and fever without cough or sputum, with no past history of such symptoms. Physical examination revealed the following: height, 160 cm; weight, 45.5 kg; arterial blood pressure, 170/92 mmHg; heart rate, 90 beats/min; body temperature, 38.3°C. Coarse crepitations were not detected, and lymphadenopathy was not present. Laboratory findings showed a white blood cell count of 10.05 ϫ 10 9 /liter (neutrophils, 90.8%; lymphocytes, 5.4%). Culture examination of sputum induced by 3% saline was negative. Blood culture examinations were likewise negative. Table 1 shows antibody titers against Mycoplasma pneumoniae, Chlamydophilia avium, and Chlamydophilia pneumoniae. Blood samples were submitted for examination of serum antibody titers to two Japanese commercial laboratories, SRL (Tokyo, Japan) and BML (Tokyo, Japan), and each serum antibody titer was measured. Complement fixation (CF) antibody titers against C. avium and M. pneumoniae were measured using a CF kit (Denka Seiken Co., Tokyo, Japan) according to the manufacturer's instructions at SRL. Microimmunofluorescence (MIF) testing against C. avium and C. pneumoniae was performed by BML according to the manufacturer's instructions (9). Enzyme-linked immunosorbent assay (ELISA) against C. pneumoniae was performed at SRL using a commercial kit (Hitachi Chemical Co., Tokyo, Japan) according to the manufacturer's instructions. CF antibodies against C. avium were not found in serum from blood samples taken on admission but were present at a dilution of 1/16 in serum taken 14 days later. The serum titer detected by MIF rose more than 32-fold from Ͻ8 in 14 days. The C. pneumoniae antibody titer using ELISA rose from 0.31 to 1.18, but the titer according to MIF was not considered elevated at 64-fold. A chest X-ray revealed infiltration shadows in the left upper and right lower lung fields. Computed tomography showed air space consolidation and ground-glass attenuation in the left upper and right lower lungs (Fig. 1A). Liver dysfunction was identified as follows: glutamic oxalacetic transaminase, 243 IU/liter (normal, 0 to 42 IU/liter), glutamic pyruvic transaminase, 56 IU/liter (normal, 0 to 37 IU/liter); lactate dehydrogenase, 602 IU/liter (normal, 106 to 211 IU/liter). The patient did not consent to bronchofiberscopic examination. He was treated with intravenous minocycline and sulbactam-ampicillin until serological and bacteriological reports became available. His body temperature normalized within 72 h. On day 9, treatment was switched from intravenous to oral minocycline and sulbactam-am...
The microbicidal activity of the myeloperoxidase (MPO)-hydrogen peroxide-halide system has been implicated as the most efficient, oxygen-dependent antimicrobial component of neutrophil host defense. Unexpectedly, individuals with MPO deficiency suffer few clinical consequences. In order to understand better the clinical impact of MPO deficiency, we surveyed several clinical hematology laboratories in Japan to assess the prevalence of MPO deficiency in the general population. MPO activity was determined by flow cytometry using the Technicon H series of automated systems. We identified 26 cases of complete MPO deficiency, prevalence 1 in 57,135, and 129 cases of partial deficiency, prevalence 1 in 17,501. The distribution of complete and partial deficiencies differed among the laboratories studied.
Objective The aim of this study was to explore the relations between toe pinch force and other muscle strength parameters in male patients with type 2 diabetes mellitus. Methods A total of 40 men with type 2 diabetes (age: 53.4 ± 13.1 years, duration of diabetes: 8.5 ± 8.1 years) who needed exercise training were enrolled in this crosssectional study. We evaluated the clinical parameters and 4 muscle strength parameters, which were toe pinch force, handgrip strength, isometric knee extension force, and isometric ankle dorsiflexion force. Results The HbA1c, toe pinch force, handgrip strength, isometric knee extension force, and isometric ankle dorsiflexion force were 10.1 ± 2.4 %, 3.2 ± 1.2 kg, 37.3 ± 7.0 kg, 39.6 ± 11.4 kgf, and 17.0 ± 6.3 kgf, respectively. Toe pinch force was significantly correlated with handgrip strength (r = 0.365, p = 0.0206), isometric knee extension force (r = 0.668, p \ 0.0001), and isometric ankle dorsiflexion force (r = 0.514, p = 0.0007). All muscle strength parameters were significantly lower in patients with diabetic polyneuropathy than in those without polyneuropathy. Conclusion Although toe pinch force was significantly correlated with the other muscle strength parameters, the correlation was not so strong. However, evaluation of toe pinch force might be recommended for assessment of distal limb muscle strength in patients with type 2 diabetes.
Myeloperoxidase (MPO) catalyzes a nitration reaction to form nitrotyrosine in the presence of high nitrite, the metabolite of NO. Human leukocyte was shown to cause phenolic nitration using released MPO as a catalyst in the presence of nitrite. It opposes our previous finding that inhibition of MPO was essential for phenol nitration in human leukocyte study. To clarify the role of MPO, we utilized MPO-deficient human leukocytes and MPO-knockout mice. Even in the absence of exogenously added nitrite, high nitration product was observed in MPO-deficient leukocytes. In liver subjected to ischemia/reperfusion injury, a significantly higher amount of nitrotyrosine was produced in MPO-knockout mice than in normal mice. These results clearly demonstrate that MPO inhibits the accumulation of nitration products in vivo. Further experiments showed that MPO could degrade nitrotyrosine in the presence of glutathione. Thus, MPO-induced degradation of nitration products may cause the underestimation of the nitration product generated in vivo. We conclude that MPO may act predominantly to scavenge nitrotyrosine under physiological nitrite condition, and protect against injurious effect of nitrotyrosine.
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