Pathological changes of adipose tissue in secondary lymphoedema.

BACKGROUND: The pathophysiology of lymphoedema is poorly understood. Current treatment options include compression therapy, resection, liposuction and lymphatic microsurgery, but determining the optimal treatment approach for each patient remains challenging. OBJECTIVES: We characterized skin and adipose tissue alterations in the setting of secondary lymphoedema. METHODS: Morphological and histopathological evaluations were conducted for 70 specimens collected from 26 female patients with lower-extremity secondary lymphoedema following surgical intervention for gynaecological cancers. Indocyanine green lymphography was performed for each patient to assess lymphoedema severity. RESULTS: Macroscopic and ultrasound findings revealed that lymphoedema adipose tissue had larger lobules of adipose tissue, with these lobules surrounded by thick collagen fibres and interstitial lymphatic fluid. In lymphoedema specimens, adipocytes displayed hypertrophic changes and more collagen fibre deposits when examined using electron microscopy, whole-mount staining and immunohistochemistry. The number of capillary lymphatic channels was also found to be increased in the dermis of lymphoedema limbs. Crown-like structures (dead adipocytes surrounded by M1 macrophages) were less frequently seen in lymphoedema samples. Flow cytometry revealed that, among the cellular components of adipose tissue, adipose-derived stem/stromal cells and M2 macrophages were decreased in number in lymphoedema adipose tissue compared with normal controls. CONCLUSIONS: These findings suggest that long-term lymphatic volume overload can induce chronic tissue inflammation, progressive fibrosis, impaired homeostasis, altered remodelling of adipose tissue, impaired regenerative capacity and immunological dysfunction. Further elucidation of the pathophysiological mechanisms underlying lymphoedema will lead to more reliable therapeutic strategies.

Theoretical study on substituent and solvent effects for nanocubes formed with gear-shaped amphiphile molecules.

Gear-shaped amphiphile molecules (1) recently synthesized by Hiraoka et al. self-assemble into a hexameric structure, nanocubes (16), in 25% aqueous methanol due to a solvophobic effect. Here we have carried out molecular dynamic simulations to elucidate the stability of these hexameric capsules (16 and 26) in water, 25% aqueous methanol, and methanol. In all solvents, the 16 nanocubes are maintained for all trajectories. On the other hand, 26 was found to collapse for one trajectory in water and seven trajectories in 25% aqueous methanol. In a pure methanol solvent, 26 was found to collapse for all trajectories. The number of collapsed trajectories of 26 increased with the amount of methanol in the solvent. We therefore focused on the structure of the π-π stacking between pyridyl groups and the CH-π interactions between the methyl and pyridyl groups within the nanocube. Our study clearly shows the role played by the methanol solvent molecules in the assembly of the nanocube in terms of the substituent and solvent effects at the molecular level, and that these substituent and solvent effects are important for the self-assembly of the nanocubes.

Effects of dietary uridine 5'-monophosphate on immune responses in newborn calves.

When compared with normal milk, bovine colostrum contains a large amount of uridine 5'-monophosphate (UMP) and its derivatives. In the present study, we carried out 2 experiments to determine the effects of dietary UMP (2 g/d) on the immune status of newborn calves. In Exp. 1, newborn Holstein bull calves were fed milk replacer alone (control group) or milk replacer supplemented with UMP (UMP group) from d 4 to 10 after birth. The increase in interferon-gamma concentration by peripheral blood mononuclear cells (PBMC) on d 24 tended to be greater in the UMP group than in the control group (P = 0.06). The IgA concentration of the ileal mucosa was greater in the UMP group than in the control group (P < 0.05), although there was no difference between groups in the jejunal mucosa. In Exp. 2, newborn Holstein bull calves were fed milk replacer alone (control group) or milk replacer supplemented with UMP (UMP group) from d 4 to 56 after birth. The proliferation of PBMC was greater in the UMP group than in the control group on d 14, 28, and 42 (P < 0.01). The increase in interferon-gamma concentration by PBMC was greater in the UMP group than in the control group on d 28 and 42 (P < 0.05). From these results, we concluded that dietary UMP affected the immune responses of newborn calves.

Effects of rugby sevens matches on human neutrophil-related non-specific immunity.

AIMS: To evaluate the influences of the accumulative effect of two consecutive rugby sevens matches (Sevens) on aspects of human neutrophil-related non-specific immunity. METHODS: In seven players participating in the Japan Sevens, neutrophil reactive oxygen species (ROS) production capability and phagocytic activity were measured using flow cytometry, and serum opsonic activity (SOA) was assessed by measuring neutrophil ROS using the peak height of lucigenin-dependent chemiluminescence before and after two consecutive matches. RESULTS: ROS showed no change immediately after the first match, and had significantly (P<0.05) increased 4 h later, but showed a decrease after the second match. Phagocytic activity showed no change immediately after the first match, but had significantly (P<0.01) decreased 4 h later, and showed a further decrease after the second match, although it was not significant. SOA significantly (P<0.01) increased after the first match, and still maintained its high 4 h later, but decreased after the second match. ROS production capability, phagocytic activity and SOA significantly (P<0.01) decreased after the second match. CONCLUSIONS: When rugby players play two consecutive Sevens matches, the exercise loading is thought to be hard, similar to that experienced during a marathon race and intensive or long training in a training camp, although the expected changes were not seen after the first match. Differences between after the first and the second matches may be due to the "cumulative effect".

Effects of 5'-uridylic acid feeding on postprandial plasma concentrations of GH, insulin and metabolites in young calves.

Postprandial changes in plasma concentrations of GH, insulin, IGF-I, leptin and metabolites were compared between young Holstein bull calves fed with milk alone (control group) and with milk+5'-uridylic acid (UMP) (UMP group). UMP (2 g/day) was given with milk at 0830 h and 1530 h for 11 days from the 4th to the 14th day after birth. The perirenal fat weight was significantly lower in the UMP group than in the control group, but there was no significant difference in the weights of the liver, spleen and heart between the groups. Basal GH concentrations in the UMP group were slightly higher, but the postprandial increase in plasma insulin level and the area under the curve for insulin in the UMP group were significantly lower than those in the control group. There was no significant difference in IGF-I levels between the groups. In addition, the postprandial glucose concentrations were lower in the UMP group as reflected by the insulin level, and nonesterified fatty acid concentrations were not different. In the muscle (M. longissimus thoracis) sampled at 14 days of age, the triacylglycerol (TAG) content was significantly greater but glycogen content was significantly lower in the UMP group than in the control group. From these results, we have concluded that feeding 5'-UMP at 2 g/day for 11 days significantly alters TAG accumulation in the body and plasma concentrations of GH and insulin in young bull calves.

Position related analysis of the appearance of and relationship between post-match physical and mental fatigue in university rugby football players.

OBJECTIVE: The relationship between physical and mental fatigue in rugby players after a match was examined, taking into account the position played. METHODS: The Profile of Mood State (POMS) test, blood biochemical parameters, and serum opsonic activity were measured for 37 university rugby football players before and after a match. RESULTS: There were no differences in parameter changes except for blood urea nitrogen (a marker for protein catabolism) between the forwards and the backs. Regarding correlation between physical and mental fatigue, in forwards, changes in POMS scores showed a positive correlation with changes in the levels of enzymes of skeletal muscle origin, such as glutamate oxaloacetic transaminase (GOT) and lactate dehydrogenase (LDH), and free fatty acid (FFA) level and white blood cell count (for example, in the Total Mood Disturbance (TMD) score, Spearman's correlation coefficient was 0.417 and p<0.05 with GOT, 0.413 and p<0.05 with LDH, 0.462 and p<0.05 with FFA, and 0.442 and p<0.05 with white blood cell count). In backs, changes in the POMS scores showed a positive correlation with changes in the levels of lipid related parameters such as FFA and total cholesterol (for example, as regards the TMD score, Spearman's correlation coefficient was 0.481 and p<0.05 with FFA, and 0.550 and p<0.05 with total cholesterol), and showed a negative correlation with change in blood glucose level (TMD score, -0.517 and p<0.05). CONCLUSIONS: The different exercise loading of the position played during a rugby match may cause differences in the relationship between physical and mental fatigue.

Use of the curved linear-array echo endoscope to identify gastrorenal shunts in patients with gastric fundal varices.

BACKGROUND AND STUDY AIMS: : Balloon-occluded retrograde transvenous obliteration (B-RTO) has emerged as an effective, minimally invasive treatment for fundal varices. B-RTO requires a spontaneously developed gastrorenal shunt as a pathway for the balloon catheter to reach the fundal varices. We used a curved linear-array (CLA) echo endoscope in patients with fundal varices to identify gastrorenal shunts, and compared the detection rate with the gold standard, contrast-enhanced computed tomography (CECT). PATIENTS AND METHODS: A total of 40 patients with fundal varices were examined with both CLA echo endoscopy and CECT. The CECT images were retrospectively and independently evaluated by two gastroenterologists who were unaware of the clinical details, including the results of the CLA echo endoscopy. RESULTS: CLA echo endoscopy identified gastrorenal shunts in 26/40 patients with fundal varices. It visualized the shunt in a longitudinal direction and provided images of the connections of the shunt at both ends, the fundal varices and the left renal vein/branch of the inferior adrenal vein. The kappa index for CLA echo endoscopy and CECT for the identification of gastrorenal shunt was 0.9 (95 % CI, 0.6 to 1.0). When the cutoff point for the diameter of the gastrorenal shunt detected by the CLA echo endoscope was set at equal to or greater than 5 mm, the kappa index was 1.0 (95 % CI, 0.7 to 1.0). CONCLUSIONS: These results suggest that CLA echo endoscopy can successfully identify gastrorenal shunt and provide detailed morphological information. It also efficiently identifies patients suitable for B-RTO, particularly in cases of acute bleeding. It also has considerable potential for providing detailed information with regard to the treatment of gastric varices.

Effect of incorporating low intensity exercise into the recovery period after a rugby match.

BACKGROUND: The psychological and physiological condition of athletes affect both their performance in competitions and their health. Rugby is an intense sport which appears to impose psychological and physiological stress on players. However, there have been few studies of the most appropriate resting techniques to deliver effective recovery from a match. OBJECTIVES: To compare the difference in recovery after a match using resting techniques with or without exercise. METHODS: Fifteen Japanese college rugby football players were studied. Seven performed only normal daily activities and eight performed additional low intensity exercise during the post-match rest period. Players were examined just before and immediately after the match and one and two days after the match. Blood biochemistry and two neutrophil functions, phagocytic activity and oxidative burst, were measured to assess physiological condition, and the profile of mood states (POMS) scores were examined to evaluate psychological condition. RESULTS: Immediately after the match, muscle damage, decreases in neutrophil functions, and mental fatigue were observed in both groups. Muscle damage and neutrophil functions recovered with time almost equally in the two groups, but the POMS scores were significantly decreased only in subjects in the low intensity exercise group. CONCLUSIONS: Rugby matches impose both physiological and psychological stress on players. The addition of low intensity exercise to the rest period did not adversely affect physiological recovery and had a significantly beneficial effect on psychological recovery by enhancing relaxation.

Effects of exercise on the physical condition of college rugby players during summer training camp.

OBJECTIVES: To determine the effects of exercise training on physical condition in 25 college rugby players during a summer training camp, and to compare these variables by the different players' positions. METHODS: Changes in body composition parameters and blood biochemistry were examined before and after a summer training camp. RESULTS: Body weight and percentage body fat did not change significantly during the camp. There were significant decreases in levels of serum total cholesterol, triglycerides, phosphate, uric acid, and immunoglobulin G and M. In contrast, there were significant increases in levels of serum potassium, markers of renal, hepatic, and muscular damage (BUN, GOT, GPT, LDH, CK), and complement C4. Comparison of the changes in biochemical parameters between rugby players playing in different positions showed a significant increase in serum albumin level in the forwards, and significant decreases in serum triglyceride and sodium levels in the backs. The magnitude of change in serum LDH during the camp was significantly greater (p<0.05) for the forwards than for the backs. CONCLUSIONS: These data suggest that, in rugby players attending a 20 day camp, exercise training resulted in muscular damage, loss of electrolytes due to sweating, and changes in immune function. Backs exhibited a higher rate of fat metabolism and loss of electrolytes than forwards, possibly because they did more running during the camp. In contrast, forwards experienced more physical contact, performed more physically strenuous exercise, and exhibited higher levels of muscular damage and tissue protein degradation.

Explanations for the smoking paradox in Japan.

The prevalence of cigarette smoking among Japanese men has been consistently high compared with Western males over the past 30 years. However, during the same period, the incidence of and mortality rates for lung cancer have consistently been lower in Japan than in Western countries ('Japanese smoking paradox'). The odds ratio/relative risk of cigarette smoking for lung cancer mortality/incidence relative to the same number of cigarettes smoked per capita in Japan, were apparently lower than those in Western countries. This must be the cause driving the 'Japanese smoking paradox'. Furthermore, low carcinogenic ingredients in Japanese cigarettes and a congenitally-related resistance to smoking-related lung carcinogenesis emerged as the main factors which have brought the 'Japanese smoking paradox'.

Visualization of signal propagation from sciatic nerve to spinal cord in canine.

The neuroelectric activity that ascends the sciatic nerve and moves to the spinal cord was visualized by measuring the magnetic compound action fields (CAFs) with a superconducting quantum interference device gradiometer. The sciatic nerve of a dog was stimulated electrically, and propagating evoked CAFs were measured non-invasively. Isomagnetic field maps were made on the basis of this data, and the signal propagation was visualized. The evoked magnetic fields presented a quadrupole consisting of two elements: depolarization and repolarization. Measuring the magnetic CAFs of the sciatic nerve on the body surface enabled us to visualize the non-invasively the signal movement continuously from the sciatic nerve to the spinal cord.

Progression of prostate cancer: diagnostic and prognostic utility of prostate-specific antigen, alpha2-macroglobulin, and their complexes.

We previously reported cases of advanced prostate cancer (PCa) in which serum alpha2-macroglobulin (alpha2M) levels were markedly decreased to less than approximately 50 mg/dl whereas serum prostate-specific antigen (PSA) levels were remarkably increased. These cases were not complicated with disseminated intravascular coagulation (DIC). In this study, we measured serum PSA and alpha2M in 108 patients with either benign prostatic hyperplasia (BPH) or PCa to elucidate the relationship between PSA, i.e. the serum protease derived from the prostatic tissue, and alpha2M, i.e. the protease inhibitor that was the most abundantly contained in serum. alpha2M was determined by ELISA, total PSA and PSA-alpha1-antichymotrypsin (PSA-ACT) by EIA, and free-PSA by RIA in 44 patients with untreated BPH and 64 patients with untreated PCa. The ready association of alpha2M and PSA was assessed using Western blotting to identify complexes of the two. Levels of total serum PSA correlated positively with those of PSA-ACT in PCa (r = 0.99, p < 0.001), and both levels increased with advancing stage of disease. In contrast, the serum-free PSA/total PSA ratio (free/total PSA) and alpha2M levels decreased as the disease progressed. However, only the free/total PSA ratio attained significant difference for localized cancer in stage T1,2 versus BPH (p < 0.05). In stage M1b PCa, in which serum PSA levels were very high, there was a negative correlation between the total PSA and alpha2M values (r = -0.57, p < 0.05). In addition, serum alpha2M levels tended to decrease with progression of PCa. Serum total PSA levels correlated tightly with serum PSA-ACT levels. It is suggested that PSA is usually complexed with ACT in the serum. Free/total PSA was useful for differential diagnosis between early cancer and BPH. Levels of serum alpha2M of less than 50 mg/dl in PCa patients may indicate a possibility of bone metastases.

Levels of alpha 2 macroglobulin can predict bone metastases in prostate cancer.

BACKGROUND: In prostate cancer, we previously reported that a marked decrease of serum alpha 2 macroglobulin (alpha 2M) to less than approximately 50 mg/dl was associated with the presence of bone metastases. In order to investigate the relationship between bone metastases and alpha 2M, we assessed these two parameters in 128 patients with prostatic diseases. MATERIALS AND METHODS: 66 patients with untreated benign prostatic hypertrophy and 62 with untreated prostate cancer were included in the study. Measurement of alpha 2M concentration was performed by Laser-Nephelometry, prostate-specific antigen (PSA) by EIA. RESULTS: The serum alpha 2M levels in prostate cancer with bone metastases showed a significantly lower level compared with the group without bone metastases (p < 0.01). Cases with serum alpha 2M levels of less than 50 mg/dl all had bone metastases. Serum alpha 2M levels were inversely related to PSA levels in stage M1b disease. CONCLUSIONS: Measurement of serum alpha 2M levels may be useful for the diagnosis and follow up of bone metastases in prostate cancer.

[Assay for determination of the serum procalcitonin level: biochemical and clinical evaluation].

In patients with inflammatory conditions such as infection, cytokines induce the production of C-reactive protein(CRP) and serum amyloid A protein(SAA) in hepatic cells. It has been reported that upon viral infection, the serum SAA level increases by a greater degree than the serum CRP level. Procalcitonin (PCT), the precursor of calcitonin, is a new type of inflammatory marker that is specifically induced by bacterial infection, sepsis and lethal multiple organ failure, but not by viral infection, autoimmune diseases, tumors or surgical stress. To evaluate the immunoluminometric assay(LUMI test PCT; Brahms Diagnostics, Berlin, Germany) procedure for determining the PCT level and to study the clinical significance of the serum PCT level, we determined the serum levels of PCT, CRP and SAA in patients with various inflammatory diseases and normal subjects. The serum PCT level in the normal subjects was < 0.3 ng/ml. Among the patients with inflammatory disease who had a high CRP level(CRP > 20000 micrograms/dl), the PCT level was elevated only in those patients with severe bacterial infection. These results suggest that determining the PCT level may be useful in the differential diagnosis of severe bacterial infection. The patients who had a low CRP level(CRP < 150 micrograms/dl), had a PCT level within the normal range. The patients with autoimmune disease, viral infection, and fungal infection did not have an elevated PCT level.

Postoperative changes on functional mapping of the motor cortex in patients with brachial plexus injury: comparative study of magnetoencephalography and functional magnetic resonance imaging.

Using magnetoencephalography (MEG) and functional magnetic resonance imaging (f-MRI), we investigated the areas of the cerebral cortex that were activated when patients with brachial plexus injuries performed elbow flexion, a motion re-acquired through nerve transfer surgery. In all patients, elbow flexion on the operated side and on the unaffected side led to the activation of an area in the motor cortex, with these areas being located almost symmetrically on either side of the sagittal midline. These findings suggest that the activity center for the transferred intercostal nerves shifted to the motor cortex for the elbow, from the original intercostal nerve site.

The effect of anti-platelet aggregation to prevent pressure ulcer development: a retrospective study of 132 elderly patients.

BACKGROUND: As the number of bedridden elderly patients increases, prevention of pressure ulcers is becoming a more important issue. However, an approach to this problem using medication has not been considered sufficiently in the clinical context. OBJECTIVE: To test the hypothesis that anti-platelet aggregation therapy administered to the elderly patients may be helpful in preventing pressure ulcer formation, the medical records of 132 bedridden elderly patients were analyzed. In addition, the propensity of platelets to aggregate was also measured in some of the bedridden patients. METHODS: Patients were divided into two groups, with pressure ulcers (group P, 52 patients) and without (group N, 80 patients). Subsequently, six factors defining the clinical characteristics age and gender, underlying disease, cause of being bedridden, level of consciousness, mobility and activity as defined on the Braden scale, and frequency of anti-platelet aggregation medication were investigated in groups P and N. In addition, physical findings (three factors): body mass index, blood pressure (BP), and heart rate were investigated in both groups. Furthermore, laboratory data (seven factors): total protein (TP), albumin, total cholesterol, hemoglobin (Hb), hematocrit (Hct), platelets, and platelet aggregation were compared between two groups. RESULTS: There were no significant differences in clinical characteristics between the two groups with the exception of the frequency of anti-platelet aggregation medication (23.1% of group P vs. 40.0% of group N, chi(2) = 4.06, p < 0.05). There was also no significant difference in physical findings except a difference between systolic and diastolic BP (48.4 mm Hg in group P vs. 57.1 mm Hg in group N, p < 0.01). Values of TP, albumin, Hb, and Hct in both groups were lower than the normal range, but there was no significant difference between the two groups. The platelet count was significantly greater in group P than in group N after lying supine (p < 0.03), and platelet aggregation in group P was significantly higher compared with group N (p < 0.03). CONCLUSIONS: Although our hypothesis must be tested by a randomized prospective trial, these results indicate that increased platelet aggregation is possibly associated with the development of pressure ulcers; therefore anti-platelet aggregation therapy may prevent their occurrence in bedridden elderly patients.

Effect of dietary concentration of xylitol on growth in male broiler chicks during immunological stress.

Two experiments were conducted to determine the effect of dietary xylitol concentration on growth performance, plasma (alpha1 acid glycoprotein (AGP), nitrite, and Fe concentration in male broiler chicks during immunological stress. Ten-day-old chicks were fed a corn-soybean diet containing 15% glucose and 6% xylitol or 15% xylitol with identical metabolizable energy and crude protein content for 12 d in Experiment 1. In Experiment 2, 12-d-old chicks were fed either the 15% glucose or 6% xylitol diet for 7 d. During the final 6 d of each experiment, half of the birds fed each diet were injected intraperitoneally with Escherichia coli lipopolysaccharide (LPS; 0127:B8) on Days 1, 3, and 5 and with Sephadex-G50 superfine on Days 2 and 4 to stimulate the immune system. The xylitol diets partially prevented reductions in body weight gain, feed intake, and feed efficiency caused by LPS and Sephadex injections, but the glucose diet did not. The injections of LPS and Sephadex increased plasma AGP and nitrite concentrations. Plasma AGP concentration on Days 2 and 6 in chicks fed the xylitol diets did not differ from that of chicks fed the glucose diet in both experiments. Nitric oxide production estimated by plasma nitrite concentration following immunological stress did not differ due to dietary treatments in Experiment 2. The LPS and Sephadex resulted in decreased plasma Fe concentration on Day 6 in Experiment 1 in chicks fed glucose but not xylitol. These results indicate that a beneficial effect of dietary xylitol on growth is obtained with 6% xylitol given to chicks 1 d before stimulating the immune system.

[Development of gamma-heavy chain disease during the course of diabetic nephropathy].

We reported a rare case of gamma-heavy chain disease. A 63-year-old man had been given a diagnosis of diabetes mellitus at the age of 30 and had received hemodialysis since the age of 55. The patient presented with swollen lymph nodes in the neck. Lymph node biopsy findings suggested immunoblastic lymphadenopathy. The patient was admitted to Kitasato University hospital. Serum protein electrophoresis showed an increase of beta-fraction peak, and immunoelectrophoresis revealed an increase of gamma-heavy chain protein. Further studies of the gamma-heavy chain protein showed that it contained three different components and that the molecular weight of the main component was 34,000 Da. The patient died on the 11th day of hospitalization. The diagnosis at autopsy was unclassified malignant lymphoma.

[Ultrastructural study on intracerebral small blood vessels and fluorescent granular perithelial (FGP) cells in experimental cerebral ischemia].

In order to clarify the sequential changes of the morphology of vascular cells and FGP cells under cerebral ischemia, 32 male Wistar rats were employed. The FGP cells in the present paper are distributed along cerebral microvessels, and markedly potent in the uptake capacity for endo- and exogenous substances under the physiological and pathological conditions. Under the anesthesia of pentobarbital, experimental animals suffered from cerebral ischemia were produced by (1) occlusion of bilateral vertebral arteries, (2) unilateral ligation of common carotid artery accompanied with occlusion of vertebral arteries and (3) temporary clipping of bilateral common carotid arteries accompanied with occlusion of vertebral arteries. On 1 to 14 days after the treatments mentioned above, the cerebral cortices of animals were examined with the electron microscope with paying special attention to morphological changes of FGP cells. From the observation, it is confirmed that: (1) after occlusion of vertebral arteries (first group of experimental animals), the FGP cells become edematous without any severe damage of cerebral neurons through 2 weeks.: (2) In case of the unilateral ligation of common carotid artery (second group of experimental animals), the FGP cells and neurons tend to degenerate at the ligated side on 14 days, but at the opposite side, the considerable vacuolation and swelling of the FGP cells are evident, without accompanying with any degeneration of neurons and FGP cells, and: (3) In the reflow experiment (third group of experimental animals), the neurons are not affective and the FGP cells show some degenerative changes on 7 days, but most of them recovered on 14 days. From these observations, it may be concluded that the morphological changes of FGP cells run parallel with the change of microenvironment surrounding neurons, and the FGP cells, in addition to astrocytes, are reliable morphological markers of cerebral edema.

[The possibility of acute inflammatory reaction affects the development of pressure ulcers in bedridden elderly patients].

To test the hypothesis that acute inflammatory reaction associates with the development of pressure ulcers in bedridden elderly patients, 40 hospitalized elderly patients suffering from bacterial pneumonia, cerebrovascular disease, and femoral bone fracture were enrolled in this study. All of them were divided into two groups with pressure ulcers (group P; 17 patients) and without one (group N; 23 patients). The blood samples were taken from them within 5 days after the patients being bedridden. Although no significant difference exist in pressure ulcer risk factors (age, gender, Braden scale, underlying diseases, blood pressure, and heart rate) between the two groups, white blood cell, plasma C-reactive protein and fibrinogen in group P increased significantly as compared with those in group N. Besides number of platelets and maximum platelet aggregation rate were significantly higher in group P than in group N. Serum albumin and hemoglobin of both groups decreased after being bedridden, especially hemoglobin in group P was significantly lower than that in group N. While the concentration of serum IL-6 did not indicate a significant difference between both the groups, serum IL-1 beta increased significantly in group P. In conclusion, we suggested that acute inflammatory reaction releasing proinflammatory cytokines affected the development of pressure ulcer in bedridden elderly patients.