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 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.

T-cell clones with L3T4-positive or Lyt-2-positive phenotypes responding to mutant MHC class II antigen and inducing graft versus host reaction.

Two types of T cell clones responding to mutant major histocompatibility class II antigen (Iabm12) were established from spleen cells of C57BL/6 mice: one was L3T4-positive and the other Lyt-2-positive. These two types of clones carried functionally different properties. Lyt-2+ clones were absolutely dependent on exogenous interleukin-2 for their proliferation, whereas some L3T4+ clones secreted interleukin-2 and proliferated autonomously. Both types of clones had cytotoxic activities to bm12 target cells, and Lyt-2+ clones showed stronger activities than L3T4+ clones. Lyt-2+ clones induced induration in situ, whereas the L3T4+ clones induced ulcerative reaction when injected intradermally into mice. Histologically, the L3T4+ clones caused necrosis of the epidermis or upperdermis, while the Lyt-2+ clones induced infiltration of small round cells through the epidermis to the subcutaneous tissues and caused thickening of the epidermis. These characteristic reactivities might be due to a difference in lymphokines produced by each type of T cell subset in response to Iabm12 antigen.

Developing rat pineal cells manifest potential of neuronal differentiation in vitro.

The pineal gland in mammals is an endocrine organ and generally does not exhibit neuronal characteristics. However, it is known that under culture conditions, cells from newborn rat pineals express properties characteristic of photoreceptors. Here, we studied the potential of rat pineal cells to differentiate into neuronal cell types using different neural markers. Three phenotype markers characteristic of nerve cells, i.e., intense GABA, neuron-specific antigen (HPC-1) and microtubule-associated protein 2 (MAP2) immunoreactivities, were detected in the pineal culture of newborn rats. Expression of the respective neuronal phenotypes appears to be controlled by different mechanisms; in the normal culture medium containing 5.4 mM KCl, numerous cells were stained intensely with anti-GABA antiserum, whereas only a few were stained intensely either with HPC-1 or MAP2 antibody. In a culture medium with a high concentration of KCl (35 mM), which may induce depolarization of nerve cells, numerous cells became strongly positive for HPC-1 or MAP2; both the cell bodies and the neuritic fibers were stained positively. Since cells intensely immunoreactive to GABA, HPC-1 or MAP2 were not found in intact pineals of the rat, the present results indicate that the neuronal potency of the rat pineal cells is expressed only in vitro and is suppressed in vivo, and that the potency is lost during postnatal development. Norepinephrine at 1 microM, which suppresses differentiation of rhodopsin immunoreactive cells, was ineffective in inducing phenotypic expression of neuronal properties in the present system, indicating that the mechanism of suppression of neuronal properties in the intact pineal may be different from the one for photoreceptors.

Are there discrete distal-proximal representations of the index finger and palm in the human somatosensory cortex? A neuromagnetic study.

OBJECTIVE: The distal-proximal representations of the finger and palm in the first somatosensory cortex (SI) were studied in humans. METHODS: Somatosensory evoked magnetic fields (SEFs) from 11 subjects were measured, following mechanical stimulation of the skin by using a 122 channel whole head SQUID system. Sensory stimulus comprising of a 10 ms vibration at the frequency of 200 Hz was delivered to 6 successive sites in 3 cm increments, along the distal-proximal direction over the volar surface of the right index finger and palm. Using a single dipole model, the sources of the magnetic fields were estimated and mapped onto magnetic resonance images of each subject. ANOVA was used for statistics. RESULTS: Source localization was determined on the main peak (M50) of the SEFs. All of the sources were located in the area 3b of SI. Contrary to the well-defined distal-proximal representations in the hand area of simian SI cortex, there was no statistically significant differences between the locations of the dipoles in human SI cortex evoked by stimulation of different sites. CONCLUSION: The result, however, should be interpreted with caution, because it cannot be denied that the spatial separation of sources in the distal-proximal somatotopy is beyond the resolving capacity of magnetoencephalography (MEG). In addition, at variance with the discrete distal-proximal gradient in the mechanoreceptor density, there was no statistically significant differences between the signal strengths of the dipoles for stimulation of the different locations.

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.

Describing head shape with surface harmonic expansions.

Surface harmonic expansions are used to represent boundaries between regions of different conductivity in the human head. This facilitates calculation of the electric potential and magnetic field generated by neural current sources using discretized integral equations.

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.

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.

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.

[Report of a case of intraosseous meningioma: a review of the literature and diagnostic value using MRI study].

A 40-year-old woman with intraosseous meningioma is reported. She was admitted because of a slowly growing, bony hard, fixed mass in the temporal area that was covered by the normal scalp. The neurological examination on admission was negative. Plain skull radiogram demonstrated an area of hyperostotic change in the temporal region. Bone-targeted CT demonstrated irregularity in the structure of the skull bone. Selective external carotid angiogram showed a homogeneous tumor stain in the region of the skull thickening. Macroscopically complete tumor resection (Simpson's grade 1) was carried out. Her postoperative course was uneventful. The skull tumor had the typical feature of meningotheliomatous meningioma. MRI showed a mass lesion of the temporal bone on T1- and T2-weighted images, and a well-enhanced mass lesion of the outer dura and outer table of the skull bone on Gd-DTPA enhanced T1 images. The findings of the preoperative MRI study using Gd-DTPA were identical with the tumor area on histological study. Therefore, MRI with Gd-DTPA enhancement was considered a useful diagnostic modality.

[Concentrations of free form and complex form of prostate-specific antigen in serum of alpha 2 macroglobulin deficient patients with prostatic carcinoma].

Prostate-specific antigen (PSA) is present in blood in free form as well as in complex form with various protease inhibitors such as alpha 2 macroglobulin (alpha 2M) and alpha 1 antichymotrypsin (alpha 1 ACT). We had found that alpha 2M is deficient (below approximately 40 mg/dl) in some patients with prostatic carcinoma. Therefore, we investigated the levels of free and complex form of PSA in patients with prostatic disease and obtained the following results. The HPLC study showed that total (free plus complex) PSA level was much higher in the alpha 2M deficient patients with prostatic carcinoma stage D (n = 7, range 1,530-14,746 ng/ml, median value 6,800 ng/ml) than in the non-deficient patients with stage D (n = 16, range 121.6-4,210 ng/ml, median value 851 ng/ml). In the deficient patients, the complex of PSA with alpha 1 ACT increased extraordinarily while free PSA increased to only some extent. In the more severe cases of prostatic carcinoma, the ratio (complex/total PSA) was higher while the ratio (free/total PSA) was lower. The SDS-PAGE Western blotting showed that complex PSA increased extraordinarily and free PSA increased in sera of the deficient patients which was consistent with the HPLC results. Many bands appeared on the blotting at the positions smaller than alpha 2M molecule, which indicated that many fragments of alpha 2M were present in their sera. These bands were more intense than the bands with sera of controls or benign prostatic hypertrophy. The alpha 2M deficiency may be due to the rapid disappearance of the complex with PSA or any other prostate-originated proteases. The complex may undergo accelerated degradation or catabolism of alpha 2M.

[Quantitative levels of serum amyloid A protein and other proteins in cerebrospinal fluid and serum of patients with meningitis].

Serum amyloid A protein (SAA), a putative precursor of the AA protein which constitutes amyloid fibrils in secondary amyloidosis, is evaluated as a sensitive acute-phase reactant in serum. At present, SAA concentration in serum is determined by latex nephelometry, but this assay cannot detect SAA in the low concentration range lower than 10 ng/ml. We have developed a sensitive enzyme immunoassay (EIA) for determining low concentrations of SAA. The assay is reproducible, reliable and requires no pretreatment of specimen prior to assay. We measured levels of SAA by this EIA in both cerebrospinal fluid (CSF) and serum of patients with suspected meningitis, measured also levels of albumin, alpha 2 macroglobulin and C-reactive protein (CRP) to investigate if these protein levels are useful for differential diagnoses of meningitis and for indicators damage of blood-CSF barrier. The SAA reference value in CSF is 3.99 +/- 1.74 ng/ml (mean +/- SD for nonmeningitis patients). The CRP concentration in CSF in bacterial meningitis was much higher than in viral meningitis, but CRP in CSF was also high in bacterial infection other than meningitis. On the other hand, SAA concentration in CSF in these patients with any meningitis are significantly higher than the reference values of SAA (p < 0.001). However, the differences in SAA concentrations among the three types (bacterial, viral and mycotic meningitis) of meningitis were not significant.

[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.

[Quantitation and heterogeneity of serum alpha 2-macroglobulin].

alpha 2-Macroglobulin (alpha 2M) is a major protease inhibitor in human plasma. In this study, serum alpha 2M was determined by means of immunoelectrophoresis (IEP), rocket immunoelectrophoresis (R-IEP), laser nephelometry (LN) and single radial immunodiffusion (SRID) in 133 subjects. The values obtained by these methods coincided well in most specimens, but some specimens showed disagreement. The sera of alpha 2M deficiency found by IEP were analyzed by the other methods. We found that R-IEP gave the results of alpha 2M deficiency most frequently while the other methods gave the results of normal alpha 2M level for some specimens. We studied on the presumption that the phenomenon is due to heterogeneity in molecular weight of alpha 2M. After alpha 2M was purified by affinity chromatography and gel filtration chromatography, we further employed gel-filtration on a high-performance liquid chromatography (HPLC) to isolate alpha 2M with different molecular size. Two peaks of immunoreactive alpha 2M were found by the gel-filtration HPLC. When we performed IEP for both portions, the first portion with higher molecular size showed larger rate of migration than the second portion. Serum alpha 2M quantitation with SRID is not appropriate because molecular weight influences on the determination by SRID. We conclude that R-IEP is best suitable for the detection of decrease of serum alpha 2M, although this method requires expertness of manipulation.

[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.