Effects of intensity, frequency, and time window of exercise on sleep quality among community-dwelling adults aged 65-86 years.

BACKGROUND: Although the effects of exercise training (ET) on sleep problem have been reported, the effects according to the components of exercise, including intensity, frequency, and time window, are unknown. Thus, in this study, we aimed to assess the effects of ET on sleep quality in community-dwelling older adults with sleep problems. METHODS: We evaluated individuals aged ≥65 years whose Pittsburgh sleep quality index was >5 points at baseline. The participants were allocated to either the control group or the ET group and underwent interval walking training (IWT) for 5 months. Information regarding intensity, frequency, and time window of ET were obtained using a waist-worn accelerometer. RESULTS: Overall, 63 participants (24 men [mean ± standard deviation age: 75.1 ± 4.6 years] and 39 women [74.7 ± 5.2 years]) and 65 participants (24 men [75.2 ± 4.0 years] and 41 women [73.6 ± 4.2 years]) were included in the ET and control groups, respectively. The change in Pittsburgh sleep quality index was not significantly different between the two groups for both sexes. In the ET group, women who exercised 3-8 h before bedtime, men who did ET > 8 h before bedtime and more than 1 h after waking up, and men who did ET ≥ 5.05 days/week experienced significant improvements compared to the baseline. CONCLUSIONS: IWT does not significantly improve sleep quality. To obtain improvements in sleep quality, it might be necessary to consider the time window of performing ET for both sexes and ET frequency for men.

Effects of interval-walking training on blood pressure in community-dwelling Japanese older adults.

BACKGROUND: The hypotensive effects of high-intensity interval training have been reported; however, studies on older adults are few. This study aimed to examine whether interval-walking training (IWT), a home-based program of high-intensity interval training, reduces blood pressure (BP) levels when compared with a non-intervention group in community-dwelling older adults. METHODS: An intervention study was conducted with 55 men (age, 75±5 years; IWT/control groups, N.=27/28) and 100 women (75±5 years; N.=47/53). The IWT regimen was as follows: fast (high-intensity) walking at 70-85% of the peak aerobic capacity and normal (light-intensity) walking at approximately 40% of the peak aerobic capacity for 3 min each, ≥5 times/walking day, and ≥4 days/week for 5 months. Systolic, diastolic, and mean arterial BPs (SBP, DBP, and MAP, respectively) were measured in the supine posture. RESULTS: The mean baseline SBP/DBP was 132/78 mmHg in men and 131/72 mmHg in women. Five-month changes in SBP, DBP, or MAP did not significantly differ between the IWT and control groups in either sex. The weekly fast-walking time in the IWT group was negatively correlated with changes in DBP (Spearman's ρ=-0.383, P=0.049) and MAP (ρ=-0.444, P=0.021) only in men. CONCLUSIONS: Though present findings did not indicate significant hypotensive effects of IWT in community-dwelling older adults, men with longer fast-walking times experienced greater BP decreases. Further studies with sufficient sample sizes are needed to determine the factors modulating the effects of the proposed training program.

Effect of high-intensity interval walking on microvascular endothelial function among community-dwelling older people.

AIM: To investigate the effects of high-intensity interval exercise training on microvascular endothelial function among community-dwelling older people. METHODS: We analyzed the data from a nonrandomized controlled trial. This study's participants were 48 men (aged 75 ± 5 years; exercise training group, n = 24; control group, n = 24) and 83 women (aged 75 ± 4 years; exercise training group, n = 36; control group, n = 47). The exercise training group underwent a high-intensity interval walking training for 5 months. RESULTS: In the exercise group, 100% and 91.7% of men and women, respectively, achieved brisk walking times ≥50 min/week. The change in the reactive hyperemia index significantly differed between the groups of men, whereas that in the control group was not significant; however, a significant increase was observed in the exercise training group. Among women, changes in the reactive hyperemia index were not significant in either group; however, for women in the exercise training group, these changes negatively and positively correlated with the change in body mass index (Spearman's rho = -0.342; P = 0.041) and baseline body mass index (rho = 0.362, P = 0.030), respectively. Additionally, the distribution of body mass index was broader in women than in men. CONCLUSIONS: Interval walking training increased the reactive hyperemia index in men rather than in women. A higher variation in baseline body mass index may be associated with no statistical increase in reactive hyperemia index in women. Geriatr Gerontol Int 2023; 23: 103-110.

Induction of antitumor response by in vivo allogeneic major histocompatibility complex gene transfer using electroporation.

BACKGROUND: Most malignancies lack tumor-associated antigens, which are recognized by T-lymphocytes through major histocompatibility complex (MHC) molecules, and seem to evade host immunological defense. In this study, we investigated whether allogeneic MHC gene transfer into the low-antigenic tumor might induce cell-mediated immunity, and provide an immunotherapeutic effect in vivo. MATERIALS AND METHODS: Mammary adenocarcinoma cells (MAT B III) originated from an F344 rat (RT1A(l)) were transfected with a plasmid DNA encoding RT1A(a) (pcMRT1A) in vitro. Cytolytic T-cell response was then evaluated using F344 splenocytes. Furthermore, pcMRT1A-liposome complex was injected into the MAT B III tumors grown in F344 rats, followed by a series of eight electrical pulses with a electroporator, every other d for total of four times. The tumor size and survival of animals were evaluated thereafter. RESULTS: The expression of RT1A(a) on the tumor cells induced cytolytic T-cell response in vitro. Intratumor injection of pcMRT1A-liposome complex followed by in vivo electroporation markedly generated biological response, including increased interferon-gamma (IFN-gamma) expression and a large number of infiltrated cells in the tumor. Inhibited tumor growth, even complete tumor regression, was observed, resulting in prolonged survival time. CONCLUSIONS: Direct transfer of allogeneic MHC gene into the tumor by in vivo electroporation could induce a cell-mediated immune response against the introduced antigens, resulting in local IFN-gamma production. This initial response may bring about the subsequent immunological response even to the unmodified tumor cells through cytokines such as IFN-gamma, resulting in the marked tumor regression.

Adenocarcinoma of the rectosigmoid colon seeding into pre-existing anal fistula.

This paper reports a rare case of rectosigmoid colon carcinoma metastasizing to anal fistula. The patient is a 57-year old man with a 7-year history of a fistula in ano. Colonoscopy revealed a rectosigmoid carcinoma. He underwent high-anterior resection. Two years and 3 months later, a subcutaneous tumor was found at the external opening of fistula. Trans perineal tumor excision plus fistulectomy was performed. Pathology revealed that the colon cancer and the perianal tumor were both moderately differentiated adenocarcinoma. Many reports support the concept of tumor cell implantation in mucosa that have been altered or denuded by various factors. Sixteen reports could be found of implantation metastasis of colorectal cancer into anal fistula. In diagnosis, it is important to differentiate implantation of colorectal cancer in anal fistula from primary anal fistular adenocarcinoma. The histology of the perianal tumor in this patient closely resembles the tumor of the colon. Furthermore, immunohistochemistry for cytokeratins 7 and 20 was performed on tissues to distinguish colorectal adenocarcinoma from anal gland carcinoma. Both colorectal cancer and perianal tumor showed CK7-/CK20+.

Decreased cell-mediated immune status in colorectal cancer patients with hepatic metastasis.

BACKGROUND/AIMS: Depression of cell-mediated immunity frequently accompanies solid tumor malignancy, and appears to be worsened as the disease progresses. In this study, we investigated cell-mediated immune status in colorectal cancer patients. METHODOLOGY: Interleukin-2 (IL-2) productivity by phytohemagglutinin (PHA)-stimulated non-adherent peripheral blood mononuclear cells (PBMC), and prostaglandin E2 (PGE2) productivity by LPS-stimulated adherent PBMC were investigated in colorectal cancer patients with hepatic metastasis (n=20) and without hepatic metastasis (n=20), and in non-malignant disease controls (n=20). Percentages of peripheral blood T-cell subsets and NK activity were also investigated. RESULTS: In the colorectal cancer patients with hepatic metastasis IL-2 productivity was significantly decreased, compared with the controls. However, the percentages of T-cell subsets and NK activity were not significantly different among the groups. Meanwhile, PGE2 productivity in the patients with hepatic metastasis was significantly increased, compared with the other groups, and was significantly correlated with the hepatic tumor load. CONCLUSIONS: Tumor-bearing state, especially metastasis to the liver, may influence immune status of the patient. For evaluating cellular immunity status, cytokine productivity by activated lymphocytes and monocytes may be a more sensitive marker rather than other conventional immunological parameters, and may also provide useful information for immune intervention in the treatment of patients from this point of view.

Circulating heat-shock protein 70 is associated with postoperative infection and organ dysfunction after liver resection.

BACKGROUND: Although extracellular heat-shock protein 70 (Hsp70) potentially mediates an inflammatory response, the association of circulating Hsp70 with complications after surgery is poorly understood. METHODS: Perioperative plasma concentrations of Hsp70 and interleukin-6 were measured by immunoassays in 64 consecutive patients undergoing liver resection. RESULTS: Plasma concentrations of Hsp70 and interleukin-6 showed a striking increase immediately after surgery, and on postoperative day 1. The Hsp70 levels correlated significantly with operation time, hepatic ischemia time, postoperative alanine aminotransferase levels, and maximum interleukin-6 levels (P <0.01). The Hsp70 and interleukin-6 concentrations were associated significantly with postoperative infection (P <0.05); Hsp70 concentrations and blood loss but not interleukin-6 were associated significantly with postoperative organ dysfunction (P <0.05) in multivariate analyses. CONCLUSIONS: These results suggest that circulating Hsp70 and IL-6 potentially play a pivotal role in pathophysiology of postoperative infection, and that circulating Hsp70 and blood loss may represent a prognostic marker for postoperative organ dysfunction.

Surgical treatment for extrahepatic recurrence after hepatectomy for colorectal metastases.

BACKGROUND/AIMS: Recurrence of the remnant liver or extrahepatic sites after hepatic resection for colorectal metastases is concerned as a significant prognostic factor. While regional chemotherapy may reduce recurrence of the liver, appropriate therapy for extrahepatic metastases needs to be elucidated. METHODOLOGY: We identified 207 patients undergoing hepatectomy for colorectal metastases. Patient characteristics, clinicopathological features, sites of extrahepatic recurrence, and outcome are examined. RESULTS: Recurrence of the lung, brain, bone, and other site after hepatic resection was seen in 49, 8, 8, and 12 cases, respectively. Fourteen patients underwent pulmonary resection, and three patients are alive and disease-free survival was 35, 79, and 128 months after the second resection. Overall 2- and 5-year survival was 64 and 18%. Univariate and multivariate analysis indicated that time and number of pulmonary metastases, and serum CEA levels are independent prognostic factors. Surgical resection for brain metastasis was only in one case who survived for 31 months. Other treatment such as gamma-knife may not improve outcome. CONCLUSIONS: Both hepatic and pulmonary resection for colorectal metastases could prolong survival in selected patients. Surgical indication for other extrahepatic metastases must be strictly selected, although resection of brain metastasis might lead to better outcome.

Partial splenic embolization for the treatment of hereditary spherocytosis.

OBJECTIVE: Splenectomy is the standard surgical treatment for hereditary spherocytosis, but partial splenic embolization is another potential option. We retrospectively studied the therapeutic effects of partial splenic embolization as a treatment for hereditary spherocytosis. CONCLUSION: Partial splenic embolization is a safe and effective alternative to splenectomy or partial splenectomy in the treatment of hereditary spherocytosis.

Angiopoietins and Tie-2 expression in angiogenesis and proliferation of human hepatocellular carcinoma.

Human hepatocellular carcinoma (HCC) is a hypervascular tumor but the mechanisms underlying the process of angiogenesis are not fully understood. Angiopoietins (Ang) have been recently identified as ligands for Tie-2 receptor and are thought to be important factors in vascular maturation and stability during angiogenesis. In this study, we investigated the expression of Ang-1, Ang-2, Tie-2, and vascular endothelial growth factor (VEGF) in surgically resected specimens from 46 patients with HCC to determine their potential role in tumor angiogenesis and its progression. VEGF messenger RNA (mRNA) was significantly up-regulated in HCC compared to normal liver tissue from patients with hepatic metastases. No differences were found between HCC and adjacent liver tissue. Meanwhile, Ang-2 mRNA expression in HCC was significantly increased when compared to adjacent liver tissue. On the other hand, Ang-1 and Tie-2 mRNA expression in HCC was not different from that in adjacent liver tissue. Immunohistochemical staining also showed increased Ang-2 protein in HCC. Furthermore, a high Ang-2/1 mRNA ratio in HCC was closely associated with tumor portal vein invasion, tumor diameter, and the microvessel density level as assessed by CD34 immunostaining. With regard to prognosis, the survival time for patients in the high Ang-2/1 mRNA ratio group was significantly poorer when compared with the low Ang-2/1 mRNA ratio group. In conclusion, an increased expression of Ang-2/1 in the presence of VEGF may play a critical role in promoting tumor angiogenesis and progression in human HCC.