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Convective dissolution, one of the main mechanisms for geological storage of CO_{2}, occurs when supercritical or gas CO_{2} dissolves partially into an aqueous solution, thus triggering downward convection of the denser CO_{2}-enriched liquid. Chemical reaction in the liquid can greatly enhance the process. Here, experimental measurements of convective flow inside a cylinder filled with a sodium hydroxide (NaOH) solution show that the plume's velocity can be increased tenfold as compared to a situation with no NaOH. This tremendous effect is predicted by a model with no adjusting parameters.
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AIM: To assess the utility of dynamic chest radiography (DCR) during the preoperative evaluation of pleural adhesions. MATERIALS AND METHODS: Sequential chest radiographs of 146 patients with lung cancer were acquired during forced respiration using a DCR system. The presence of pleural adhesions and their grades were determined by retrospective surgery video assessment (absent: 121, present: 25). The maximum inspiration to expiration lung area ratio was used as an index for air intake volume. A ratio of ≥0.65 was regarded as insufficient respiration. Two radiologists assessed the images for pleural adhesions based on motion findings. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were compared for each adhesion grade and patient group (patients with sufficient/insufficient respiration). Pearson's chi-squared test compared the group. Statistical significance was set at p<0.05. RESULTS: DCR correctly identified 22/25 patients with pleural adhesions, with 20 false-positive results (sensitivity, 88%; specificity, 83.5%; PPV, 52.4%; NPV, 97.12%). Although the diagnostic performances for the various adhesion grades were similar, specificity in patients with sufficient respiration increased to 93.9% (31/33), identifying all cases except for those with loose adhesions. CONCLUSIONS: DCR images revealed restricted and/or distorted motions in lung structures and structural tension in patients with pleural adhesions. DCR could be a useful technique for routine preoperative evaluation of pleural adhesions. Further development of computerised methods can assist in the quantitative assessment of abnormal motion findings.
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Neoplasias Pulmonares , Doenças Pleurais , Humanos , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/diagnóstico por imagem , Doenças Pleurais/diagnóstico por imagem , Radiografia , Estudos Retrospectivos , Sensibilidade e Especificidade , Aderências Teciduais/diagnóstico por imagemRESUMO
BACKGROUND: MicroRNAs (miRNAs), important regulators of gene expression, have been implicated in a variety of disorders. The expression pattern of miRNAs in paediatric atopic dermatitis (AD) has not been well studied. OBJECTIVES: We sought to investigate miRNA expression profiles in different blood compartments of infants with AD. METHODS: Small RNA and analysis with the HTG EdgeSeq system were performed to identify differentially expressed miRNAs in peripheral blood mononuclear cells (PBMCs) and plasma of infants with AD vs. age-matched healthy controls, with reverse transcription quantitative real-time polymerase chain reaction (RT-qPCR) used for validation and measurement of miRNA targets. Logistic regression models with area under the receiving operating characteristic estimation was used to evaluate the diagnostic potential of chosen miRNAs for AD. RESULTS: RNA sequencing was performed to access miRNA expression profiles in paediatric AD. We identified 10 differentially expressed miRNAs in PBMCs and eight dysregulated miRNAs in plasma of infants with AD compared with controls. Upregulated miRNAs in PBMCs included miRNAs known to be involved in inflammation: miR-223-3p, miR-126-5p and miR-143-3p. Differential expression of only one miRNA, miR-451a, was observed in both PBMCs and plasma of children with AD. Dysregulation of three miRNAs (miR-451a, miR-143-3p and miR-223-3p) was validated in larger numbers of samples and miR-451a was identified as a predictive biomarker for the early diagnosis of the disease. Experimentally verified targets of miR-451a, interleukin 6 receptor (IL6R) and proteasome subunit beta type-8 (PSMB8), were increased in patients with AD, negatively correlated with miR-451a levels and upregulated following inhibition of miR-451a in PBMCs. CONCLUSIONS: In infants with AD, a distinct peripheral blood miRNA signature is seen, highlighting the systemic effects of the disease. miR-451a is uniquely expressed in different blood compartments of patients with AD and may serve as a promising novel biomarker for the early diagnosis of AD.
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Dermatite Atópica , MicroRNAs , Criança , Dermatite Atópica/genética , Perfilação da Expressão Gênica , Humanos , Lactente , Leucócitos Mononucleares , MicroRNAs/genética , Reação em Cadeia da Polimerase em Tempo RealRESUMO
BACKGROUND: Atopic dermatitis (AD) presents with the wide spectrum of clinical phenotypes within and between various populations. Recent study showed low frequency of filaggrin loss-of-function (FLG LOF) mutations in Croatian AD patients. At present, there are no data on biomarkers of immune response in Croatian AD patients that might be useful in the selection and monitoring of novel immune therapies. OBJECTIVES: To investigate levels of cytokines of various signature in the stratum corneum (SC) collected from lesional and non-lesional skin of AD patients and healthy controls and to evaluate their relationship with the severity of disease and skin barrier function. METHODS: SC samples were collected from 100 adult patients with moderate-to-severe AD and 50 healthy controls. The levels of 21 cytokines were measured by multiplex immunoassay. We conducted machine learning analysis to assess whether a small number of cytokine measurements can discriminate between healthy controls and AD patients and can predict AD severity (SCORAD). RESULTS: The SC levels of thirteen cytokines representing innate immunity, Th-1, Th-2 and Th-17/22 immune response showed significant differences between healthy and AD skin. Our analysis demonstrated that as few as three cytokines measured in lesional skin can discriminate healthy controls and AD with an accuracy of 99% and that the predictive models for SCORAD did not achieve a high accuracy. Cytokine levels were highly correlated with the levels of filaggrin degradation products and skin barrier function. CONCLUSIONS: Stratum corneum analysis revealed aberrant levels of cytokines representing innate immunity, Th-1-, Th-2- and Th-17/22-mediated immune response in Croatian AD patients. Increased Th-2 cytokines and their strong association with natural moisturizing factor (NMF) can explain low NMF levels despite of low frequency of FLG LOF mutations in Croatian population. Predictive models for SCORAD identified cytokines associated with SCORAD but warrants further investigation.
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Dermatite Atópica , Adulto , Biomarcadores , Epiderme , Proteínas Filagrinas , Humanos , Índice de Gravidade de Doença , Pele , Linfócitos T Auxiliares-IndutoresRESUMO
The heaviest bound isotope of boron ^{19}B has been investigated using exclusive measurements of its Coulomb dissociation, into ^{17}B and two neutrons, in collisions with Pb at 220 MeV/nucleon. Enhanced electric dipole (E1) strength is observed just above the two-neutron decay threshold with an integrated E1 strength of B(E1)=1.64±0.06(stat)±0.12(sys) e^{2} fm^{2} for relative energies below 6 MeV. This feature, known as a soft E1 excitation, provides the first firm evidence that ^{19}B has a prominent two-neutron halo. Three-body calculations that reproduce the energy spectrum indicate that the valence neutrons have a significant s-wave configuration and exhibit a dineutronlike correlation.
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BACKGROUND: Surgery is the gold standard for basal cell carcinomas (BCC). Current recommended surgical margins for BCCs are determined from studies in Caucasian populations. However, the appropriate surgical margins for BCCs in non-white races are unclear. OBJECTIVES: To investigate the accuracy of preoperative determination of clinical tumour borders and appropriate surgical margins in Japanese patients with BCC. METHODS: The maximum calculated differences in distance between the preoperatively determined surgical margins and the actual histologic tumour side margins were considered as 'accuracy gaps' of clinical tumour borders. Estimated side margin positivity rates (ESMPRs) with narrower (2 and 3 mm) surgical margins were calculated on the basis of the accuracy gaps. RESULTS: Overall, 1000 surgically excised BCCs from 980 Japanese patients were included. The most frequent histologic subtype was nodular BCC (67%). The median accuracy gap was 0.3 mm [interquartile range (IQR): -0.5 to +1 mm]. The ESMPRs with 2- and 3-mm surgical margins were 3.8% and 1.4%, respectively. Only the ESMPRs between the well-defined (n = 921) and poorly defined clinical tumour border groups (n = 79) showed statistical difference [2-mm margin: 3.1% vs. 11.7%, OR: 3.89, 95% confidential interval (CI): 1.41-10.71, P <0.01; 3-mm margin: 0.97% vs. 6.3%, OR: 6.58, 95% CI: 1.67-25.99, P <0.01]. No significant differences in ESMPRs were noted in other subgroups including risk classifications. CONCLUSIONS: The determined clinical tumour border accuracy gaps in this Japanese cohort were negligible. Dermatologic surgeons may use narrower surgical margins with acceptable margin positivity rates. The clarity of clinical tumour borders could be an appropriate guide for selection of different surgical margins in the Japanese cohort.
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Carcinoma Basocelular , Neoplasias Cutâneas , Carcinoma Basocelular/cirurgia , Humanos , Japão , Margens de Excisão , Estudos Retrospectivos , Neoplasias Cutâneas/cirurgiaRESUMO
In ovarian cancer patients, chemotherapy can be an independent risk factor for the development of thromboembolic complications, such as venous thromboembolism (VTE). The factors and their values that lead to the development of VTE are remaining unknown in patients undergoing chemotherapy with paclitaxel and carboplatin. This study investigated serial rheological parameters (D-dimer, red blood cell count, hematocrit, and plasma viscosity) for VTE that developed following chemotherapy for ovarian cancer. Forty-eight ovarian cancer patients undergoing chemotherapy were enrolled in this study. A significant difference in the mean values of plasma viscosity and hematocrit was observed between the VTE group (n = 5) and the non-VTE group (n = 43) (P < 0.10). Univariate and multiple regression analyses by stepwise selection identified plasma viscosity as the independent variable associated with VTE development. The VTE incidence was the same as in previous reports. The results support the contention that plasma viscosity could be an index for development of VTE in ovarian cancer after chemotherapy.
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Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Neoplasias Ovarianas/terapia , Tromboembolia Venosa/epidemiologia , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Carboplatina/administração & dosagem , Quimioterapia Adjuvante , Feminino , Produtos de Degradação da Fibrina e do Fibrinogênio/metabolismo , Humanos , Incidência , Pessoa de Meia-Idade , Paclitaxel/administração & dosagem , Estudos Retrospectivos , Reologia , Fatores de Risco , Tromboembolia Venosa/induzido quimicamenteRESUMO
BACKGROUND: Biomarkers of atopic dermatitis (AD) are largely lacking, especially in infant AD. Those that have been examined to date have focused mostly on serum cytokines, with few on noninvasive biomarkers in the skin. OBJECTIVES: We aimed to explore biomarkers obtainable from noninvasive sampling of infant skin. We compared these with plasma biomarkers and structural and functional measures of the skin barrier. METHODS: We recruited 100 infants at first presentation with AD, who were treatment naive to topical or systemic anti-inflammatory therapies, and 20 healthy children. We sampled clinically unaffected skin by tape stripping the stratum corneum (SC). Multiple cytokines and chemokines and natural moisturizing factor were measured in the SC and plasma. We recorded disease severity and skin barrier function. RESULTS: Nineteen SC and 12 plasma biomarkers showed significant differences between healthy and AD skin. Some biomarkers were common to both the SC and plasma, and others were compartment specific. Identified biomarkers of AD severity included T helper 2-skewed markers [interleukin (IL)-13, CCL17, CCL22, IL-5]; markers of innate activation (IL-18, IL-1α, IL1ß, CXCL8) and angiogenesis (Flt-1, vascular endothelial growth factor); and others (soluble intercellular adhesion molecule-1, soluble vascular cell adhesion molecule-1, IL-16, IL-17A). CONCLUSIONS: We identified clinically relevant biomarkers of AD, including novel markers, easily sampled and typed in infants. These markers may provide objective assessment of disease severity and suggest new therapeutic targets, or response measurement targets for AD. Future studies will be required to determine whether these biomarkers, seen in very early AD, can predict disease outcomes or comorbidities.
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Dermatite Atópica/diagnóstico , Índice de Gravidade de Doença , Pele/patologia , Biomarcadores/análise , Estudos de Casos e Controles , Quimiocinas/análise , Quimiocinas/imunologia , Estudos de Coortes , Citocinas/análise , Citocinas/imunologia , Dermatite Atópica/sangue , Dermatite Atópica/imunologia , Feminino , Humanos , Imunidade Celular/imunologia , Imunidade Inata , Lactente , Recém-Nascido , Masculino , Neovascularização Fisiológica , Permeabilidade , Pele/imunologia , Pele/metabolismo , Linfócitos T Auxiliares-Indutores/imunologia , Perda Insensível de Água/imunologiaRESUMO
Despite advances, challenges remain for less invasive imaging of peripheral arterial occlusive disease (PAOD) using computed tomography (CT) angiography. The application of dual-energy imaging to PAOD has been reported to improve the diagnostic accuracy of this application; however, severe arteriosclerosis with heavy arterial wall calcification still hampers definitive lesion characterisation, especially in distal and smaller arteries. Recently an ultra-high resolution scanner has been introduced. In combination with advances in post-processing, such as subtraction techniques, these developments may overcome some of the current challenges and allow far more detailed characterisation of PAOD non-invasively. The aim of this review is to describe our current experience with ultra-high resolution CT in combination with subtraction and discuss the potential advantages of their application for peripheral angiography.
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Angiografia Digital/métodos , Angiografia por Tomografia Computadorizada/métodos , Doença Arterial Periférica/diagnóstico por imagem , Intensificação de Imagem Radiográfica/métodos , Arteriopatias Oclusivas/diagnóstico por imagem , HumanosRESUMO
The most neutron-rich boron isotopes ^{20}B and ^{21}B have been observed for the first time following proton removal from ^{22}N and ^{22}C at energies around 230 MeV/nucleon. Both nuclei were found to exist as resonances which were detected through their decay into ^{19}B and one or two neutrons. Two-proton removal from ^{22}N populated a prominent resonancelike structure in ^{20}B at around 2.5 MeV above the one-neutron decay threshold, which is interpreted as arising from the closely spaced 1^{-},2^{-} ground-state doublet predicted by the shell model. In the case of proton removal from ^{22}C, the ^{19}B plus one- and two-neutron channels were consistent with the population of a resonance in ^{21}B 2.47±0.19 MeV above the two-neutron decay threshold, which is found to exhibit direct two-neutron decay. The ground-state mass excesses determined for ^{20,21}B are found to be in agreement with mass surface extrapolations derived within the latest atomic-mass evaluations.
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How behavioural diversity emerged in evolution is an unexplored subject in biology. To tackle this problem, genes and circuits for a behaviour need to be determined in different species for phylogenetic comparisons. The recently developed clustered regulatory interspaced short palindromic repeats/CRISPR associated protein9 (CRISPR/Cas9) system made such a challenge possible by providing the means to induce mutations in a gene of interest in any organism. Aiming at elucidating diversification in genetic and neural networks for courtship behaviour, we attempted to generate a genetic tool kit in Drosophila subobscura, a nonmodel species distantly related to the genetic model Drosophila melanogaster. Here we report the generation of yellow (y) and white mutations with the aid of the CRISPR/Cas9 system, and the rescue of the y mutant phenotype by germline transformation of the newly established y mutant fly line with a y(+) -marked piggyBac vector. This successful mutagenesis and transformation in D. subobscura open up an avenue for comprehensive genetic analyses of higher functions in this and other nonmodel Drosophila species, representing a key step toward systematic comparisons of genes and circuitries underlying behaviour amongst species.
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Transportadores de Cassetes de Ligação de ATP/genética , Repetições Palindrômicas Curtas Agrupadas e Regularmente Espaçadas , Proteínas de Drosophila/genética , Drosophila/genética , Proteínas do Olho/genética , Técnicas de Transferência de Genes , Mutagênese , Transportadores de Cassetes de Ligação de ATP/metabolismo , Animais , Sequência de Bases , Drosophila/classificação , Drosophila/metabolismo , Proteínas de Drosophila/metabolismo , Proteínas do Olho/metabolismo , Feminino , Masculino , FenótipoRESUMO
The unbound nucleus ^{26}O has been investigated using invariant-mass spectroscopy following one-proton removal reaction from a ^{27}F beam at 201 MeV/nucleon. The decay products, ^{24}O and two neutrons, were detected in coincidence using the newly commissioned SAMURAI spectrometer at the RIKEN Radioactive Isotope Beam Factory. The ^{26}O ground-state resonance was found to lie only 18±3(stat)±4(syst) keV above threshold. In addition, a higher lying level, which is most likely the first 2^{+} state, was observed for the first time at 1.28_{-0.08}^{+0.11} MeV above threshold. Comparison with theoretical predictions suggests that three-nucleon forces, pf-shell intruder configurations, and the continuum are key elements to understanding the structure of the most neutron-rich oxygen isotopes beyond the drip line.
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Receptores ErbB , Nevo , Neoplasias Cutâneas , Criança , Receptores ErbB/genética , Humanos , Masculino , Mutação/genética , Nevo/genética , Neoplasias Cutâneas/genéticaRESUMO
AIM: To assess the efficacy, safety and tolerability of different doses of tofogliflozin, a novel, highly selective sodium-glucose cotransporter 2 (SGLT2) inhibitor, in patients with type 2 diabetes mellitus (T2DM). METHODS: In a 12-week, multicentre, multinational, randomized, double-blind, parallel-group, placebo-controlled, dose-finding study, patients with inadequate glycaemic control from diet and exercise alone, or from diet and exercise plus a stable dose of metformin, were randomized to one of five doses of tofogliflozin (2.5, 5, 10, 20, or 40 mg) or placebo. The primary efficacy endpoint was absolute change at week 12 from baseline in glycated haemoglobin (HbA1c), minus the change in the placebo group. RESULTS: Statistically significant dose-dependent reductions in HbA1c were shown in all treated groups except the 2.5-mg dose group, with a maximum reduction of 0.56% (placebo-subtracted) at the 40-mg dose, along with increased urinary glucose excretion. Metformin treatment had no substantial influence on tofogliflozin efficacy. Dose-dependent reductions in fasting plasma glucose and body weight were observed, and glucose intolerance was improved, with a trend towards blood pressure reduction. Slight increases were observed for mean ketone bodies with no abnormal change in ketone body ratio. No deaths or treatment-related serious adverse events were reported. The incidence of adverse events was similar in the placebo (37.9%) to that in the tofogliflozin group (35.9-46.3%). Withdrawal because of adverse events was rare (≤2 patients per treatment group), with similar rates of withdrawal in the placebo and tofogliflozin groups. CONCLUSIONS: A once-daily dose of tofogliflozin for 12 weeks was an effective, safe and well-tolerated treatment for T2DM.
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Compostos Benzidrílicos/administração & dosagem , Peso Corporal/efeitos dos fármacos , Diabetes Mellitus Tipo 2/terapia , Glucosídeos/administração & dosagem , Hipoglicemiantes/administração & dosagem , Metformina/administração & dosagem , Adulto , Idoso , Glicemia/efeitos dos fármacos , Pressão Sanguínea/efeitos dos fármacos , Terapia Combinada , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/urina , Dieta para Diabéticos , Relação Dose-Resposta a Droga , Método Duplo-Cego , Quimioterapia Combinada , Terapia por Exercício , Jejum/sangue , Feminino , Hemoglobinas Glicadas/efeitos dos fármacos , Glicosúria/induzido quimicamente , Humanos , Cetonas/metabolismo , Masculino , Pessoa de Meia-IdadeRESUMO
The aim of this study was to determine the effect on the knee joint of the interaction between ankle muscle weakness and moderate exercise. Gastrocnemius muscle weakness was induced by intramuscular injection of botulinum toxin type A (BTX) in rats. Low-speed treadmill running (12 m/min for 60 min) was applied for 6 weeks in rats with and without BTX. Untreated animals were used as controls. After BTX injection, the gastrocnemius muscle weakness was confirmed by 3-D motion analysis in kinematic features of the hindlimb during locomotion as an increased maximal dorsiflexion angle during the stance phase. Serum biomarker analysis by enzyme-linked immunosorbent assay revealed that low-speed running decreased the catabolic effect on type II collagen. However, the inhibition of catabolism induced by running exercise was significantly counteracted by BTX injection. In addition, thinning of the cartilage layer and a reduction in the chondrocyte density was also found in the tibial plateau of the knee in the BTX-injected rats after running for 6 weeks. These data suggest that moderate exercise have a positive effect on joint homeostasis. However, ankle muscle weakness may alter the mechanical environment of the knee and impair the integrity of joint cartilage with moderate exercise.
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Debilidade Muscular/fisiopatologia , Músculo Esquelético/fisiopatologia , Condicionamento Físico Animal/fisiologia , Joelho de Quadrúpedes/fisiopatologia , Animais , Tornozelo/fisiopatologia , Fenômenos Biomecânicos , Toxinas Botulínicas Tipo A/toxicidade , Cartilagem Articular/patologia , Colágeno Tipo II/metabolismo , Debilidade Muscular/induzido quimicamente , Debilidade Muscular/metabolismo , Fármacos Neuromusculares/toxicidade , RatosRESUMO
Cross sections of 1n-removal reactions from the neutron-rich nucleus (37)Mg on C and Pb targets and the parallel momentum distributions of the (37)Mg residues from the C target have been measured at 240 MeV/nucleon. A combined analysis of these distinct nuclear- and Coulomb-dominated reaction data shows that the (37)Mg ground state has a small 1n separation energy of 0.22(-0.09)(+0.12) MeV and an appreciable p-wave neutron single-particle strength. These results confirm that (37)Mg lies near the edge of the "island of inversion" and has a sizable p-wave neutron halo component, the heaviest such system identified to date.
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BACKGROUND: It is difficult to treat patients in the advanced stages of extramammary Paget disease (EMPD) because no effective treatment has yet been established. OBJECTIVE: To describe the experience of using combination chemotherapy (FECOM) in patients with metastatic EMPD. METHODS: Since we reported a case of metastatic EMPD that responded to FECOM, we have treated further patients with metastatic EMPD using FECOM at the National Cancer Center Hospital in Japan. FECOM consists of epirubicin 40 mg m(-2) , mitomycin C 3·5 mg m(-2) and vincristine 0·7 mg m(-2) on day 1, carboplatin 300 mg m(-2) on day 2 and 5-fluorouracil 350 mg m(-2) on days 2-6. To evaluate the efficacy of this combination therapy in patients with metastatic EMPD, data regarding patients given FECOM for the first-line treatment of metastatic EMPD were extracted retrospectively. RESULTS: Seven patients were eligible for this study. A partial response was noted in four evaluable patients (100%). The other three patients were not evaluable for clinical response. One of the three unevaluable patients showed a decrease in tumour size by 100%, the other two by about 20%. The median overall survival and progression-free survival were 9·4 months (7·6-17·3) and 6·5 months (2·6-7·9), respectively. The 1-year survival rate was 43% (three of seven). Three of the seven patients (43%) had grade 3 haematological toxicities. All treatment-related toxicities were reversible and there was no febrile neutropenia or treatment-related deaths. CONCLUSION: This study suggests that the combination chemotherapy FECOM may be a treatment option for patients with metastatic EMPD.
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Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias do Ânus/tratamento farmacológico , Neoplasias dos Genitais Masculinos/tratamento farmacológico , Doença de Paget Extramamária/tratamento farmacológico , Neoplasias Vulvares/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Neoplasias do Ânus/cirurgia , Neoplasias Ósseas/secundário , Carboplatina/administração & dosagem , Terapia Combinada , Epirubicina/administração & dosagem , Feminino , Fluoruracila/administração & dosagem , Neoplasias dos Genitais Masculinos/cirurgia , Humanos , Neoplasias Hepáticas/secundário , Excisão de Linfonodo , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Mitomicina/administração & dosagem , Doença de Paget Extramamária/cirurgia , Estudos Retrospectivos , Resultado do Tratamento , Vincristina/administração & dosagem , Neoplasias Vulvares/cirurgiaRESUMO
BACKGROUND AND PURPOSE: Obesity is associated with the risk of coronary artery disease and stroke. Visceral fat plays a significant role in the atherogenic effects of obesity. Whether visceral fat accumulation, as measured by computed tomography (CT), is an independent risk factor for the presence of cerebral small vessel disease (SVD) was investigated. METHODS: This study comprised 506 Japanese subjects 35-74 years of age (mean 55.3 years) without a history of symptomatic cerebrovascular disease who underwent health screening tests, including brain magnetic resonance imaging, carotid echography and measurements of the visceral fat area (VFA) and subcutaneous fat area (SFA) on abdominal CT. Visceral fat accumulation was defined as VFA ≥ 100 cm(2) . Logistic regression analysis was performed to examine the associations between visceral fat accumulation and cerebral SVD such as white matter lesions (WMLs) and silent lacunar infarction (SLI). RESULTS: The prevalence of WMLs and SLI but not carotid plaque were significantly higher in subjects with VFA ≥ 100 cm(2) than those with VFA < 100 cm(2) . A VFA ≥ 100 cm(2) was associated with WMLs and SLI independent of age, cardiovascular risk factors and other measurements of obesity, such as waist circumference and body mass index. A large waist circumference was independently associated with SLI. SFA, the combination of VFA and SFA, and body mass index were not associated with WMLs or SLI. CONCLUSIONS: Visceral fat accumulation was independently associated with the presence of cerebral SVD in subjects without a history of symptomatic cerebrovascular disease.