Background: Although toe grip strength has been closely associated with physical performance, the association between toe grip strength and history of falls in older adults remains unclear. The purpose of our study was to investigate the associations between physical function testing, including toe grip strength and falls in the previous 12 months, in community-dwelling frail older women. Methods: Forty-eight participants aged ≥65 years who were screened by a frailty checklist were included. We compared the faller group (n=18) and non-faller group (n=30) in terms of physical function including toe grip strength, hand grip strength, five-repetition sit-to-stand test, one-leg standing duration with vision, 5-meter walk test, and timed up-and-go test, as well as history of orthopedic disease. Results: Participants in the faller group had significantly weaker left toe grip strength than those in the non-faller group (p=0.009), whereas the other physical measurements were not found to be significantly different. Regarding orthopedic disease, the faller group had a significantly higher prevalence of lumbar spine and ankle joint disease compared with the nonfaller group (p=0.025 and p=0.001, respectively). Conclusions: Left toe grip strength and lumbar spine/ankle joint disease may be the most important physical function factors for predicting falls in frail older women.

抄録全体を表示

Aims: We previously reported an inverse association between adult height and dyslipidemia in subjects with low, but not high, body mass index (BMI) by elucidating genetic influences. However, the genetic factors that are associated with short stature and dyslipidemia in subjects with a low BMI are unknown. Methods: We conducted a cross-sectional study of 877 elderly Japanese subjects aged ≥60 years who underwent a national health check-up in 2014 and 2015. We focused on single nucleotide polymorphism (SNP) rs3782886, since this variant was reported to be associated with metabolic syndrome. Short stature was defined as the lowest 20% of the height distribution (‹157.8cm for men and ‹145.0cm for women), and dyslipidemia was defined by the Japan Atherosclerosis Society (JAS) guidelines as follows: triglycerides (TG) ≥150mg/dL and/or low density lipoprotein-cholesterol (LDL) ≥140mg/dL, and/or high density lipoproteincholesterol (HDL) ‹40mg/dL, and/or lipid lowering medication use. Results: Of the study population, 62.3% were major homo, 33.0% were hetero and 4.8% minor homo. With non-minor homo (major homo and hetero) as reference groups, minor homo was significantly positively associated with short stature independent of known cardiovascular risk factors. The multivariable odds ratio (OR) and 95% confidence interval (CI) of short stature for minor homo was 2.23 (1.07, 4.67). Minor homo also showed a significant positive association with dyslipidemia in subjects with a BMI‹23kg/m2, 3.20 (1.08, 9.51), but not in those with a BMI ≥23kg/m2 ,0.77 (0.32, 1.89). Conclusion: SNP rs3782886 is associated with short stature and dyslipidemia in elderly Japanese subjects with a BMI<23kg/m2.

抄録全体を表示

VRK1 plays a pivotal role in the upregulation of cyclin D1 (also known as CCND1) by phosphorylating histone H2A (Thr120) around its promoter region. However, the pathways or proteins that regulate this activity upstream of VRK1 remain unknown. It has been confirmed that after serum stimulation VRK1 is recruited to the cyclin D1 promoter region, and phosphorylation of the neighboring histone H2A (Thr120) is elevated. To clarify the upstream signals that regulate VRK1, we knocked down mitogen-activated protein kinases (MAPKs), including ERK5, MAP3K2, ERK1/2, JNK1/2, JNK3, and p38 in HeLa cells. We found that ERK5 knockdown decreases cyclin D1 expression, and this dependence on ERK5 was confirmed with the ERK5 inhibitors, BIX02188 and XMD8-92. Knockdown of MAP3K2, which is a well-known kinase acting upstream of the MEK5-ERK5 pathway, also reduced cyclin D1 expression, signifying the importance of the MAP3K2–ERK5 axis in regulating the expression of this gene. Next, evidence from chromatin immunoprecipitation qPCR (ChIP-qPCR) assays indicated that ERK5 or MAP3K2 knockdown reduces the recruitment of VRK1 and phosphorylation of H2A (Thr120) around the cyclin D1 promoter. Moreover, public microarray analysis of HeLa cells treated with either EGF or a DNA-damaging agent showed that ERK5 and cyclin D1 expression levels were significantly correlated in both treatments. Pathway analysis using the Ingenuity database supported our experimental observation that the MAP3K2– ERK5 pathway promotes cyclin D1 expression upstream of the VRK1 phosphorylation of H2A (Thr120). Finally, we showed that H2A (Thr120) phosphorylation is correlated with cyclin D1 expression in clinical tissue analysis. These results suggest that the MAP3K2– ERK5 pathway elevates cyclin D1 expression by recruiting VRK1 and elevating H2A (Thr120) phosphorylation in the cyclin D1 promoter region, which may be involved in dysregulated cell proliferation and cancer progression.

抄録全体を表示

Background: Age-related disruption of the microvascular endothelium exacerbates hypertension and sarcopenia. Reduced maximum voluntary tongue pressure against the palate (MTP) is known to be associated with sarcopenia. On the other hand, elevated platelet count acts as an indicator of active endothelial repair. However, no studies have reported the association between reduced MTP and platelet count in the context of hypertension status. To evaluate the association between reduced MTP and platelet count, we conducted a cross-sectional study of 1,607 elderly Japanese who had undergone an annual health check from 2015 to 2016. Methods: Since hypertension should mask the beneficial effects of endothelial repair, subjects were stratified by hypertension status. Among the present study population, 876 subjects had hypertension. Reduced tongue pressure was defined as an MTP at or under the 20th percentile of the study population ( < 23.9kPa for men and < 21.8kPa for women). Results: Independent of known cardiovascular risk factors, a significant inverse association between platelets and reduced tongue pressure was seen among non-hypertensive, but not hypertensive, subjects. The fully adjusted odds ratios (OR) and 95% confidence intervals (CI) of 1 standard deviation (SD) increment of platelet count (5.4×104/μL for men and 5.2×104 /μL for women) were 0.73 (0.60, 0.90) and 1.13 (0.94, 1.35) for non-hypertensive subjects and hypertensive subjects, respectively. Conclusions: Independent of known cardiovascular risk factors, platelet count is significantly inversely associated with reduced tongue pressure among elderly non-hypertensive Japanese subjects. This finding could be an efficient tool to clarify a part of mechanism underlying reduced tongue pressure.

抄録全体を表示

Staphylococcus aureus exotoxin toxic shock syndrome toxin-1 (TSST-1) can cause a wide spectrum of immunopathological conditions, from toxic shock syndrome (TSS), a life-threatening illness, to neonatal TSS-like exanthematous disease (NTED), a self-limited mild disease. Leukocytoclastic vasculitis, which develops in the skin, is another immunopathological condition that is commonly observed in patients with IgA vasculitis during childhood. We report the case of an infant with an NTED-like exanthematous rash and IgA vasculitis-like purpuric skin lesions that were histopathologically diagnosed as leukocytoclastic vasculitis. A blood culture yielded methicillin-sensitive Staphylococcus aureus producing TSST-1, suggesting an etiological role in the aforementioned skin lesions. (99 words)

抄録全体を表示

Persistent bile leakage from an excluded segmental bile duct after liver resection is one of the intractable complications and difficult to manage. A 79-year-old male underwent left hepatectomy for hepatolithiasis. On postoperative day (POD) 6, bile leakage developed from the drain placed on the cut surface of the liver. On POD 19, a fistulography revealed bile leakage from B7-posterior biliary branch without connection to B6-posterior biliary branch or the common bile duct. On POD 21, we confirmed no communication between the common bile duct and the B7-posterior biliary branch by endoscopic retrograde cholangiography. We diagnosed a bile leakage due to an excluded segmental bile duct after liver resection. On POD 41, we performed embolization of n-buthyl-2 cyanoacrylate (NBCA) with lipiodol via the percutaneous catheter. On the next day, the bile leakage decreased markedly. On POD 53, the drainage catheter was removed and he was discharge from hospital without any complaints or symptoms. There was no evidence of recurrent biliary leakage and symptom 8 months after the embolization. Percutaneous embolization with NBCA is a safe, feasible, and effective therapeutic strategy for an excluded bile leakage after liver resection.

抄録全体を表示