Twenty-eight mild hypercholesterolemic male and female adults were orally administered psyllium seed for 3 months. After psyllium treatment, the serum total sholesterol, low-density-lipoprotein-cholesterol and atherogenic index signigicantly decreased, but levels of high-density-lipoprotein-cholesterol, triglyceride and urea nitrogen did not. To determine the parameters associated with the cholesterol-lowering effect in the subjects' backgrounds, both biochemical and hematological parameters, we statistically examined the correlation between pretreatment parameters and the absolute change of total cholesterol level. The absolute change of total cholesterol level showed a direct correlation with the triglyceride level at pretreatment (r=0.41, P=0.03) and had an inverse correlation with urea nitrogen (=-0.46, P=0.01) but not with the total cholesterol (=-0.18). The change in urea nitrogen level had an inverse correlation with the urea nitrogen level itself at pretreatment (r=-0.82, P=7×10^-8) and had a direct correlation with the triglyceride (=0.43, P=0.02). The change in triglyceride level had an inverse correlation with the urea nitrogen (=-0.48, P=0.008). Furthermore, the change in total cholesterol level had direct correlations with changes in the triglyceride (=0.56, P=0.002) and the urea nitrogen (=0.51, P=0.006), but these changes in triglyceride and urea nitrogen level did not correlate significantly. These findings suggest the close association of urea nitrogen and lipid metabolism in hyperlipidemia and psyllium seed treatment.

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Thyroid hormones play a crucial role in regulating mood and cognitive function. However, the effect of thyroid function on psychiatric symptoms remains unclear. In this study, we investigated the association between psychiatric symptoms and thyroid hormone levels in patients with depression and mania. In this retrospective cross-sectional study, we enrolled patients with depression or mania admitted to the Department of Psychiatry of the National Kohnodai Medical Center from April 2014 to March 2023. We examined the association between thyroid function at admission and psychiatric symptoms using the Global Assessment of Functioning (GAF) score. A total of 309 patients with depression (199 females, mean age = 62 ± 15 years) and 91 patients with mania (60 females, mean age = 50 ± 16 years) were included. In the depression group, the median TSH level was 1.05 μIU/mL, the median free T3 level was 2.76 pg/mL, and the median free T4 level was 0.95 ng/dL. In the mania group, the median TSH level was 1.09 μIU/mL, the median free T3 level was 3.28 pg/mL, and the median free T4 level was 1.06 ng/dL. In patients with depression, the GAF score showed a weak but significant negative correlation with the free T4

( = –0.212, p < 0.001) and with the free T3 ( = –0.253, p = 0.008). In patients with mania, the GAF score was negatively correlated with the free T4 ( = –0.225, p = 0.033) and positively correlated with the TSH ( = 0.226, p = 0.031). These findings suggest that higher thyroid hormone levels may be associated with more severe psychiatric symptoms. Our study presents possible associations between thyroid hormone levels and psychiatric symptoms.

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Serum and urinary lysozyme values were assayed in 51 patients with chronic glomerulonephritis and 10 undergoing regular hemodialysis. Renal threshold for lysozyme was in the range from 15 to 20 μ/ml, but no correlation was obtained between serum and urinary lysozyme concentrations. Significant correlations were found between serum lysozyme activities and commonly employed parameters of renal dysfunctions, such as blood urea nitrogen (=0.77), serum creatinine (=0.86), and creatinine clearance (r=-0.80). The majority of patients with markedly diminished glomerular filtration rates smaller than 20 ml/min exhibited urinary excretion of more than 3 mg of lysozyme per day and elevated serum lysozyme, while in patients with mildly to moderately impaired renal function, serum and urine lysozyme concentrations were within normal limits. Therefore, positive lysozymuria and increased serum lysozyme activity may be taken as evidence of severe renal damage, whereas the lysozyme determination may not serve as sensitive indicators in mildly to moderately injured renal diseases.

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Recently, expired gases are analyzed non-invasively for monitoring the substances in the blood. Breath ammonia has been shown to correlate with blood urea nitrogen (BUN) which are indicators of solute removal in hemodialysis. In this study, breath ammonia concentration was continuously measured using a crystal oscillator Quartz Crystal Microbalance (QCM) during the expiration of patients undergoing dialysis treatment. The results show that NH_3 decreased gradually as the treatment proceeded. A strong correlation was observed between changes in the frequency of the QCM gas sensor and both the pre-dialysis BUN (=0.71, p<0.05) and the post-dialysis BUN (=0.90, p<0.05). NH_3 was found to fall precipitously during dialysis. The differences were statistically significant. In addition, we found a statistically significant correlation between BUN and NH_3 in expired gas. These results suggest that continuous measurement of NH_3 is useful to assess the status of solute removal during hemodialysis.

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An angiotensin converting enzyme inhibitor, captopril (or SQ 14225), was administered orally to 23 hypertensive patients under a constant sodium and potassium diet. It resulted in reduction of plasma aldosterone concentration which was related significantly to the increase of serum potassium (=-0.533), but only weakly to the reduction of plasma angiotensin II (=0.474). Aldosterone level remained suppressed in the face of increased serum potassium. The effects on aldosterone level and potassium were greater in patients with high plasma renin activity than in those with low and normal plasma renin activities. They also paralleled the reduction in blood pressure. It is suggested that reduction in aldosterone level and potassium retention were caused by blockade of angiotensin II formation by captopril, but the potassium retention was additionally influenced by renal impairment.

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It is well recognized that serum creatinine level provides a quick general assessment of renal function. However, we frequently encounter elderly hypertensive patients with renal involvement whose serum creatinine levels are within normal limits. The aim of this study was thus to determine whether serum creatinine level is a sensitive indicator of renal function in elderly hypertensive patients. Study groups were classified according to age: 82 elderly patients (aged 65 yr or older) and 98 middle-aged patients (aged 40-65 yr) with essential hypertension. To assess hypertensive renal involvement, serum creatinine and serum uric acid levels were measured. We also measured the left ventricular mass (LVM) index by using echocardiography as a marker of hypertensive target organ damage. There was no age-related difference in the LVM index, but the serum creatinine level in elderly hypertensive patients was significantly lower than that in middle-aged hypertensive patients. There was no significant difference in serum uric acid level between the two groups. In addition, the LVM index was correlated with the serum uric acid (=0.46, p=0.0001) but not with the serum creatinine level in elderly hypertensive patients. In middle-aged hypertensive patients, the LVM index was related to both serum uric acid (=0.41, p=0.007) and serum creatinine (=0.43, p=0.003). In conclusion, serum creatinine level may underestimate hypertensive renal involvement in elderly hypertensive patients. In contrast, serum uric acid level may be a sensitive indicator of hypertensive target organ damage irrespective of age. (Hypertens Res 1999; 22: 297-301)

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This study assessed the biochemical status of serumα-tocopherol (Toc), retinol (Ret), and lipids in elementary school children (ages 9-12 years, 38 males and 37 females) and searched for relationships among them. No significant difference was observed between the sexes for total cholesterol (T-C) (165 and 163mg/100ml for males and females, respectively), high-density lipoprotein-cholesterol (HDL-C) (64 and 62mg/100ml), low-density lipoprotein-cholesterol (LDL-C) (101mg/100ml for both groups), or for triglycerides (TG) (79 and 77mg/100ml). Therefore, the percentage of HDL-C to T-C (39 and 38%) and the LDL-C/HDL-C ratio (1.67 and 1.68) were about the same for both sexes. Toc and Ret levels of males and females were 5.48 and 5.57μg/ml and 478 and 449ng/ml, respectively. The ratios of Toc/TG (7.50 and 7.93μg/mg) and Ret/TG (666 and 613ng/mg) also showed no significant differences. A correlation was found between the T-C level and LDL-C (r=0.85, p<0.001) and also between it and the ratio of LDL-C/HDL-C (r=0.42, p<0.001). The atherogenic index, LDL-C/HDL-C ratio, showed a negative correlation with the HDL-C (=-0.73, p<0.001). The Toc level was positively correlated with the ratio of Toc/TG (r=0.45, p<0.001), and the ratio of Toc/TG was inversely correlated with the TG (=-0.80, p<0.001). Serum Ret levels showed a positive correlation with the ratios of Ret/TG (r=0.63, p<0.001), and the Ret/TG ratio showed an inverse correlation with the TG (=-0.56, p<0.001). The ratios of Toc/TG were positively correlated with the ratios of Ret/TG (r=0.56, p<0.001), and these ratios showed a positive correlation With the HDL-C (r=0.42, p<0.001; and r=0.36, p<0.01, respectively). These results reveal that relationships among the risk factors for coronary heart disease are the same in children as in adults and that the TG levels affect the relative nutritional status of vitamins E and A in serum. Thus, the ratios of Toc/TG and Ret/TG may be useful for assessment of hyperlipidemia in children.

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To evaluate oxidant stress and antioxidant activity in cases of myocardial infarction (MI) with and without diabetes mellitus (DM), erythrocyte superoxide dismutase (SOD) and glutathione peroxidase (GPx) activities together with reduced glutathione (GSH) and plasma lipid peroxides (LPO) were estimated in 15 cases of MI without DM, 15 cases of MI with insulin-dependent DM (MI-IDDM), and 14 cases of MI with non-insulin-dependent DM (MI-NIDDM), as well as in 10 normal subjects as controls. SOD activity was significantly lower in both MI-IDDM and MI-NIDDM groups than in the controls. GPx activity was lower in the three MI groups than in the controls. GSH level was significantly lower in the two DM groups than in the controls. GSH level was significantly lower in MI-NIDDM than in MI-IDDM. LPO were significantly higher in the three MI groups than in the controls. LPO were significantly higher in the MI-NIDDM group than in the MI group (p<0.05), Moreover, a significant negative correlation was detected between the plasma LPO level and erythroctye GPx (=0.53) and also between the plasma LPO level and the GSH (=0.50). These results suggest that oxidative injury in cases of MI results not only from increased free radical production but also from impaired antioxidant defense mechanisms and that the oxidant injury is intensified in cases with DM. Exogenous antioxidants such as vitamins A and E, as well as selenium, may be useful for therapeutic management of these patients.

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Sixteen patients under regular hemodialysis were investigated for their serum osteocalcin (OC) BUN, creatinine, and PTH. To evaluate the effect of lα(OH) D₃ on the serum level of OC, the changes of these parameters following lα(OH)D₃ treatment for 10.2 ±;5.5 months (mean ± SD) were investigated. The mean daily dose was 0.53 ± 0.16 μg/day. OC was increased from 24.6 ± 20.4 ng/ml to 49.7 ± 42.6 ng/ml (p<0.05) after the lα(OH)D₃ treatment. The natural course of hemodialysis and/or less efficient dialysis technique were not responsible for the increase in OC because of the insignificant relation between the OC level and duration of dialysis, and insignificant changes in BUN, creatinine, and PTH levels during the treatment. Significant positive correlations were found between the daily VD dose and the increase in OC (=0.513, p<0.02), and the serum OC (=0.701, p <0.01) after the VD treatment. These data suggest that long-term treatment with lα(OH)D₃ increases the serum OC level in dialyzed patients, possibly due to improvement of the relative vitamin D deficiency in these patients, followed by an increase of OC synthesis.

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To investigate the relationship of serum and urine levels of hyaluronic acid (HA) in rheumatoid arthritis (RA) patients to aging, joint destruction and clinical parameters, we measured HA levels by HA binding protein assay in 92 patients and 128 healthy controls.
Serum and urine levels of HA in healthy controls were elevated with aging over 70 years old. Serum and urine levels of HA in RA patients were elevated compared with those in 30 to 83 years old healthy controls (P<0.001) . There was no significant correlation between serum and urine HA in RA patients (r=0.018) . Serum levels of HA in stage III and IV in Steinbrocker's classification were significantly elevated compared with those in stage I (P<0.001) . Serum levels of HA did not show a significant correlation with inflammatory markers, including ESR (r=0.194, P=0.064), CRP ( =0.202, P=0.053), WBC count (r=0.042, P=0.688) and IgG (=-0.081, P=0.445) .
These results suggest that the elevation of serum HA levels might be one of the evidences for premature senescence in RA patients.

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Aim: There have been inconsistent reports regarding the relationship between the iron status and coronary vascular diseases (CVD). Recently, low serum iron levels have been shown to be associated with mortality from CVD in women.
Methods: The relationships between the serum iron levels and traditional and nontraditional risk factors for CVD were examined in 202 community-living elderly Japanese women.
Results: The women in the lowest iron tertile had higher high-sensitivity C-reactive protein (hsCRP) and tumor necrosis factor-α (TNF-α) levels than the women in the top iron tertile (p<0.01 or less for both). In addition, the women in the lowest tertile had higher serum levels of adiponectin and copper and ratios of serum copper to zinc and lower serum levels of albumin, hemoglobin and hematocrit. Furthermore, the women in the lowest tertile had higher creatinine levels and lower eGFR values, although there were no significant differences in the prevalence of chronic kidney disease between the three tertile groups. In a multiple regression analysis including the levels of hsCRP, TNF-α, adiponectin and serum creatinine and the ratio of serum copper to zinc as independent variables, the levels of hsCRP, TNF-α and adiponectin emerged as independent determinants of the serum iron (= 0.106). In the model to which the hemoglobin level was added as an independent variable, the levels of hemoglobin, hsCRP and TNF-α emerged as independent determinants of the serum iron (= 0.192).
Conclusions: The present study demonstrated that community-living elderly Japanese women with low serum iron levels have nontraditional risk factors for CVD, including low-grade inflammation and higher levels of serum adiponectin.

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Alanine aminotransferase (ALT), aspartate transaminase (AST), and glutamyl transpeptidase (GGT) were three key enzymes in the hepatic metabolism. This study aimed to investigate the effect of homocysteine (Hcy) metabolism gene polymorphisms and serum Hcy and folate level on the hepatic functions in a Chinese hypertensive population. A representative sample with 480 subjects aged 28-75 was enrolled in 2005.9-2005.12 from six hospitals in different Chinese regions. Serum ALT, AST and GGT were measured by using an automatic biochemistry analyzer. Serum Hcy was measured by high-performance liquid chromatography, and serum folate was measured by chemiluminescent immunoassay. Known genotypes were detected by PCR-RFLP methods. The results showed that the MTHFR C677T mutation was related a decreased serum AST (=−0.11, p=0.026), whereas the MTHFR A1298C mutation elevated serum AST (=0.11, p=0.032). Furthermore, multiple regression analysis showed that folate deficiency was associated with higher serum ALT (β (SE): 0.13 (0.06), p=0.031) and GGT level (β (SE): 0.18 (0.07), p=0.011). However, serum Hcy level may not affect the hepatic functions. Our data suggested that hepatic functions were affected by MTHFR gene polymorphisms and serum folate level. Further studies are needed to confirm these correlations in a larger population.

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A lead-shielding was constructed for a welltype Ge detector to utilize low-

level

r

spectrometry. Background counting rate was investigated under lead thickness of 5-25 cm. It has been confirmed that selection of low activity materials for the construction of the detector has advantage to reduce the contribution of background deu to natural radioactivities. N₂ gas was helpful to reduce the contribution of atmospheric radon daughters especially during ofd ventilation period.

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Aim: Both oxidative stress and inflammation are known to play roles in the pathogenesis of cardiovascular disease. We investigated the relations between reactive oxygen metabolites (ROMs) and various inflammatory and metabolic parameters in a Japanese population.
Methods: We analyzed 48 male and 69 female subjects, aged 25 to 65 years, who underwent an annual health checkup in our university. Serum ROM level was assayed using a free radical elective evaluator. We also measured serum concentrations of high-sensitivity C-reactive protein (hsCRP), insulin, and high molecular weight (HMW) adiponectin.
Results: Although the serum ROM level in females (347±83 Carr U) was slightly higher than in males (333±53 Carr U), this was not statistically significant. In the 48 male subjects, the ROM level negatively correlated with age (r=-0.344, p=0.0161), and positively correlated with the hsCRP (=0.306, p=0.0338). In the 69 female subjects, the ROM level negatively correlated with serum creatinine (r=-0.293, p=0.0141), and positively correlated with insulin (r=0.278, p=0.0202), the insulin resistance index (r=0.286, p=0.0170) and hsCRP levels (r=0.487, p<0.0001). Stepwise multiple regression analysis revealed that serum hsCRP, creatinine, and age were independently correlated with the serum ROMs (=0.365; F value highest for hsCRP). When the study subjects were divided into tertiles according to the ROM level, serum hsCRP was significantly different among the three groups: its level was highest in the highest tertile of ROMs (p<0.001).
Conclusion: These results suggest that the serum ROM level is closely associated with serum hsCRP in Japanese adult subjects.

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Age-related macular degeneration (AMD) is one of the most common causes of vision loss. AMD has been classified into two forms: atrophic and exudative forms. The exudative form is associated with choroidal neovascularization of the subretinal macular region, resulting in a sudden loss of central vision. However, the exact cause of AMD remains unknown. Several risk factors have been postulated, including smoking, atherosclerosis, and low levels of antioxidant enzymes. Malondialdehyde (MDA), a lipid peroxidation product, is used as a marker of oxidative stress. Paraoxonase 1 (PON1) metabolizes lipid peroxides and prevents oxidation of low-density lipoprotein. Increased levels of homocysteine may cause vascular endothelial injury by releasing free radicals. The purpose of this study is to investigate the relationships between serum PON1 activity and the serum levels of homocysteine and MDA in AMD. Forty patients with exudative-type AMD (63.3 ± 5 years) and 40 controls (61± 4 years) were assessed in a cross-sectional study. The serum PON1 activity was significantly lower in the patients with AMD than that in the controls (p < 0.001). In contrast, the serum levels of MDA and homocysteine were significantly higher in the patients than those in the controls (p < 0.001, for both). In AMD patients, significant negative correlation was found between PON1 activity and MDA ( = −0.493, p < 0.05) and between PON1 activity and homocysteine ( = −0.557, p < 0.05). Increased serum homocysteine and MDA levels may be responsible for the decreased PON1 activity in patients with AMD.

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Aims: Oxidative stress has been recently postulated to be an important factor in the pathogenesis and development of arteriosclerosis. Although urinary 8-hydroxydeoxyguanosine (8-OHdG) is clinically used as a marker of oxidative stress, its usefulness in diagnosing arteriosclerosis has not been fully examined. This study aimed to evaluate the association between urinary 8-OHdG and the cardioankle vascular index (CAVI) as a marker of arterial stiffness in hypertensive patients.
Methods: We enrolled 100 hypertensive patients (70±10 years) who had been taking antihypertensive medications for at least one year. Urinary 8-OHdG levels were measured by an immunochromatographic assay (ICR-001; Selista Inc., Tokyo, Japan). CAVIs were measured at the same visit.
Results: Urinary 8-OHdG was correlated with smoking habits (r=0.382, p<0.001) and CAVIs (r= 0.223, p= 0.026). Multiple linear regression analysis revealed two independent determinants of urinary 8-OHdG: smoking habits (β=0.501, p<0.001) and CAVI (β=0.325, p=0.001). In addition, CAVIs were correlated with age (r= 0.600, p<0.001), BMI (r=−0.348, p<0.001), systolic blood pressure (r= 0.343, p<0.001), pulse pressure (r= 0.358, p<0.001), serum creatinine (=0.408, p<0.001), urinary 8-OHdG (= 0.223, p= 0.026), and diabetes (r= 0.210, p=0.036). Multiple linear regression analysis revealed two independent determinants of CAVI: age (β= 0.568, p<0.001) and 8-OHdG (β=0.357, p<0.001).
Conclusion: Elevated CAVI is independently associated with an elevated urinary 8-OHdG level in hypertensive patients.

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Maintenance policies for armour blocks are discussed to minimize total expected maintenance cost over target horizons. The amour block facility is subject to waves which occur at a homogeneous Poisson process, deterioration of the facility's performance occurs cumulatively. The broken facility is maintained immediately as corrective maintenance. This study proposes three kinds of maintenance models; repair , block with minimal repair ,T and discrete k models. An optimal R₁^* to minimize the expected total maintenance cost in service period is discussed. Optimal time T^* and the number of corrective maintenances k^* are derived. Some numerical examples are given.

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Background: Sleep-disordered breathing (SDB) is thought to be a state of inflammation caused by hypoxic stress. Whether adaptive servo ventilation (ASV) attenuates the inflammatory response and improves the cardiac function of patients with congestive heart failure (CHF) accompanied by SDB was not been investigated. Methods and Results: Seventeen inpatients with New York Heart Association (NYHA) II or III underwent polysomnography. There was a positive correlation between the apnea hypopnea index and high-sensitivity C-reactive protein (hs-CRP) (=0.753, P=0.016). The patients were divided into ASV (n=10) and non-ASV groups (n=7), and CHF-parameters were measured before and after ASV treatment. Improvement was noted for the NYHA class in the ASV group but not in the non-ASV group. In contrast to the non-ASV group, the level of brain natriuretic peptide (BNP), ejection fraction, and hs-CRP levels in the ASV group significantly improved (BNP, 212.1±181.2 to 77.3±54.0 pg/ml [P<0.05]; ejection fraction, 43.5±6.4 to 53.3±6.1% [P=0.002]; hs-CRP, 0.85±0.58 to 0.21±0.19 mg/dl, [P=0.008]). The increase in ejection fraction was correlated with a decrease in the hs-CRP (=-0.753, P=0.001). Conclusions: Anti-inflammatory effects of ASV are important contributors for improving cardiac function in patients with CHF accompanied by SDB. (Circ J 2010; 74: 2118-2124)

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