Systemic Capillary Responses to Acute Exercise in Hypertensive Seniors: Insights from a Single-Center Pilot Study.

Objective: The aim of this study was to investigate nailfold capillary parameters in community-dwelling individuals aged over 60 years who have hypertension and do not exercise regularly. Furthermore, the study examined the correlations between capillary function and other health-related indicators. DESIGN: This study was a single- center pilot trial. SETTING: The study took place in the Faculty of Health, Tsukuba University of Technology, Japan. PARTICIPANTS: Hypertensive community-dwelling elderly people took part in the study. INTERVENTION: Microcirculation was observed before and 1 min after an arm-curl exercise by means of capillary microscopy of the non-exercised limb. Additionally, we examined other health-related indicators. Methods: We measured the acute effects of reperfusion on nailfold density, flow, and diameters. Secondary outcomes included the correlations between microvascular parameters and other health-related indicators. We hypothesized that brief exercise could enhance microcirculation reperfusion and correlate with other health-related parameters. Results: There were 20 participants with a mean (SD) age of 67.1 (5.8) years. The capillary flow rate changed from 2.3 ± 6.7 to 2.7 ± 0.2 log µm/s (p < 0.01), and the capillary density changed from 0.8 ± 0.2 to 0.9 ± 0.1 log/mm (p < 0.01), which included a significant increase in the non-exercising limb. Significant correlations were observed between the nailfold capillary diameter and body fat mass, the capillary diameter and physical activity, and the capillary density and bone mineral density. Conclusions: The acute effects of exercise on high-risk elderly individuals can be safe, and even 1 of min exercise can potentially improve their nailfold capillary function, despite the brief time, compared to no exercise. The results indicate that capillaries have an impact on the function of the whole body. Thus, they may be a useful diagnostic tool for assessing nailfold capillaries.

Prevalence, morphological and electrophysiological characteristics of confluent inferior pulmonary veins in patients with atrial fibrillation.

BACKGROUND: Although the common trunk of left pulmonary veins (PVs) has been reported as a relatively popular anatomical variation of PVs, little is known about the coalescence of contralateral PVs. The present study was conducted to reveal the prevalence and electrophysiologic characteristics of the confluent inferior common PVs. METHODS AND RESULTS: Anatomical variation in the PV drainage to the left atrium (LA) was assessed using the multidetector computed tomography scan in 326 patients with atrial fibrillation (AF) who underwent the PV isolation procedure. Coalescence of inferior PVs was observed in 5 cases (1.5%). Both inferior PVs conjoined prior to the junction with the LA in 3 cases, while they coalesced at the LA junction in the other 2 cases. The arrhythmogenic activities of the confluent inferior PVs were generally low in all cases without any ectopic firings triggering the observed AF. All inferior PVs, as well as the superior PVs, were successfully isolated either en bloc at the common trunk or individually at the orifice of each PV. CONCLUSIONS: Confluent inferior PVs were present in 1.5% of cases in patients with AF who underwent the PV isolation procedure. Preoperative recognition of this venous anomaly by 3-dimensional imaging is important for smooth and safe ablation.

Clinical usefulness of diffusion-weighted imaging using low and high b-values to detect rectal cancer.

PURPOSE: The purpose of this study was to assess the potential role of diffusion-weighted imaging (DWI) using low and high b-values to detect rectal cancer. METHODS: The subjects were 15 patients diagnosed endoscopically with rectal cancer (m in 1 patient, sm in 0, mp in 3, ss in 7, se in 1, a in 3) and 20 patients diagnosed endoscopically with colon cancer and no other lesions (control group). Magnetic resonance imaging was performed using a 1.5T system. DWI was performed in the axial plane using echo planar imaging sequence (repetition time/echo time 1200/66, field of view 306x350 mm, reconstruction matrix 156x256, pixel size 2.0x1.4x8.0 mm) and acquired with 2 b-values (50 and 800 s/mm2). Low and high b-value DW images were analyzed visually. A lesion was positive by detection of a focal area of high signal in the rectum in high b-value images. The apparent diffusion coefficient (ADC) values of areas of high signal in high b-value images were calculated from the low and high b-value images. RESULTS: High b-value images enabled visualization of all 15 rectal cancers. In the control group, 13 cases were classified as negative and 7 cases as positive for rectal cancer. Sensitivity for detection of rectal cancer was 100% (15/15), and specificity was 65% (13/20). The mean ADC values in 7 patients with false-positive lesions and in 15 patients with rectal cancer were 1.374x10(-3) mm2/s (standard deviation [SD]: 0.157) and 1.194x10(-3) mm2/s (SD: 0.152), respectively (P=0.026). CONCLUSION: DWI with low and high b-values may be used to screen for rectal cancer.

[Clinical usefulness of B-flow imaging in the diagnosis of superficial soft tissue tumors].

B-flow imaging is a recently developed ultrasound technique that extends the B-mode imaging quality of blood flow, including high-frame-rate and high-spatial-resolution imaging. The purpose of the present study was to clarify the usefulness of B-flow for evaluation of the hemodynamics of superficial soft tissue tumors. All 33 cases of superficial soft tissue tumors were examined by both B-flow and Color/Power Doppler methods on the same plane. The B-flow images that were obtained were evaluated by comparison with corresponding Color/Power Doppler images. The following four items were compared and evaluated: (1) sensitivity to the detection of tumor vessels; (2) quality of background B-mode imaging; (3) frame rate; and (4) spatial resolution of tumor vessels. B-flow was somewhat inferior to Color/Power Doppler imaging in sensitivity to the detection of tumor vessels. B-flow was clearly inferior in the quality of background B-mode imaging. B-flow provided high-frame-rate imaging. The diameter of tumor vessels on B-flow imaging was clearly thinner than that on Color/Power Doppler images and appeared to indicate the true diameter of tumor vessels. By providing high-frame-rate imaging and high spatial resolution, B-flow makes it possible to clarify the precise vascular structure.