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Biomedical subjects

Mitsuo Iida

Publications and source records attributed to Mitsuo Iida.

At least 127 records · Page 7Linked to original sources

Changes in endothelium-derived hyperpolarizing factor in hypertension and ageing: response to chronic treatment with renin-angiotensin system inhibitors.

1. Endothelial function is impaired in hypertension and ageing and this may be associated with an increase in cardiovascular disease. Several clinical studies have shown that blocking the renin-angiotensin system (RAS) improves endothelial function not only in hypertensive patients, but also in normotensive patients with cardiovascular disease. 2. The aim of the present study was to test whether endothelium-derived hyperpolarizing factor (EDHF)-mediated smooth muscle hyperpolarization and relaxation are altered in hypertension and ageing and, if so, whether chronic treatment with RAS inhibitors (the angiotensin-converting enzyme inhibitor enalapril and the angiotensin AT1 receptor antagonist candesartan) would correct such changes. 3. Endothelium-derived hyperpolarizing factor-mediated responses were examined in mesenteric arteries from 12-month-old spontaneously hypertensive rats (SHR) and 3-, 6-, 12- and 24-month-old normotensive Wistar-Kyoto (WKY) rats. Furthermore, both strains were treated for 3 months with either RAS blockers or a conventional therapy with hydralazine and hydrochlorothiazide from 9 to 12 months of age. 4. In arteries of 12-month-old SHR, EDHF-mediated responses were impaired compared with age-matched WKY rats. In SHR, all antihypertensive treatments improved the impairment of EDHF-mediated responses; however, RAS inhibitors tended to improve these responses to a greater extent compared with conventional therapy with hydralazine and hydrochlorothiazide. 5. In arteries of WKY rats, EDHF-mediated responses were impaired at the age of 12 and 24 months compared with 3- and 6-month-old rats, with the response tending to be impaired to a greater extent in 24-month-old rats. 6. Three months of treatment of WKY rats, until 12 months of age, with RAS inhibitors, but not with conventional therapy with hydralazine and hydrochlorothiazide, improved the age-related impairment of EDHF-mediated responses, despite a similar reduction in blood pressure by both treatments. 7. These findings suggest that: (i) EDHF-mediated hyperpolarization and relaxation decline with hypertension and ageing in rat mesenteric arteries; (ii) antihypertensive treatment restores the impaired EDHF-mediated responses in hypertension; (iii) RAS inhibitors may be more efficacious in improving endothelial dysfunction associated with hypertension; and (iv) chronic treatment with RAS inhibitors improves the age-related impairment of EDHF-mediated responses, presumably through the blockade of RAS but not blood pressure lowering alone.

Aging↗

PPARgamma ligands attenuate mesangial contractile dysfunction in high glucose.

BACKGROUND: To elucidate the regulation of peroxisome proliferator-activated receptor gamma (PPARgamma) and its roles in mesangial cells, we examined the expression of PPARgamma1 and effects of its ligands on cell phenotypes and angiotensin II-induced contractile response in cultured rat mesangial cells under a high (20 mmol/L) glucose condition. METHODS: The effects of tumor necrosis factor alpha (TNFalpha), protein kinase C (PKC) activation, antisense DNA for PPARgamma1, PPARgamma ligands and PD98059 were examined in mesangial cells cultured in either 5 mmol/L or 20 mmol/L glucose. The expressions of PPARgamma1 protein and alpha-smooth muscle actin (alphaSMA) as a marker of phenotype of cells were determined by Western blot. The expression of PPARgamma1 mRNA was determined by a reverse transcription-polymerase chain reaction method. The reduction of cell surface area in response to angiotensin II was measured by microscope to determine cellular contraction. RESULTS: PKC activation, TNFalpha, and 20 mmol/L glucose decreased PPARgamma1 at both protein and mRNA levels, which was inhibited by PD98059, a specific inhibitor of mitogen-activated protein kinase (MAPK). Decreases of PPARgamma1 protein and contractile response and an increase of alphaSMA occurred simultaneously in the cells treated with 20 mmol/L glucose after 5 days, which were attenuated to the normal levels by PPARgamma ligands. The antisense DNA also induced the decrease of PPARgamma1 protein, contractile dysfunction, and increase of alphaSMA. CONCLUSION: MAPK suppresses PPARgamma1 at the transcriptional level, and the reduction of PPARgamma1 in cultured rat mesangial cells under the high glucose condition induces phenotypic change and loss of contractile function. PPARgamma ligands recover both reductions of PPARgamma 1 protein and contractile response.

Actins↗

Dialysis-related hypotension as a cause of progressive frontal lobe atrophy in chronic hemodialysis patients: a 3-year prospective study.

BACKGROUND/AIM: Brain atrophy is known to develop more rapidly in hemodialysis (HD) patients than other individuals. The present study was designed to examine the role of HD-related hypotension in brain atrophy in patients on chronic HD. METHODS: By using magnetic resonance imaging, whole brain atrophy was assessed by the ventricular-brain ratio (VBR; ventricular area/whole brain area). Frontal brain atrophy was assessed by the frontal atrophy index (FAI; frontal brain area/intracranial frontal space). The number of lacunae was also counted. We studied 32 HD patients without symptomatic neurological abnormalities or diabetes mellitus: male/female ratio 19/13; mean age +/- SD 53 +/- 10 (range 28-77) years; mean HD duration +/- SD 11 +/- 6 (range 1-22) years. Magnetic resonance imagings were taken in 1995 and 1998. All dialysis-related hypotension episodes during the same period were identified from the medical records and counted. RESULTS: The VBR ranged from 8.8 to 18.7% in 1995 (12.8 +/- 2.2%) and was not different in 1998 (13.1 +/- 2.7%). However, the VBR increased by more than 5% in 14 patients, and their HD duration of 13 +/- 6 years was significantly longer than that of 18 patients with stable VBR (p < 0.05). The FAI in 1995 was 62.2 +/- 4.2% (range 55.8-71.3%) and decreased significantly to 59.7 +/- 4.7% (range 50.2-70.9%) in 1998 (p < 0.05). The change in FAI correlated significantly with both the total number of dialysis-related hypotension episodes (r = 0.45, p < 0.05) and the increase in number of lacunae (r = 0.42, p < 0.05). CONCLUSION: Our results suggest that dialysis-related hypotension plays a role in progressive frontal lobe atrophy in HD patients.

Adult↗

Association of QT interval with blood pressure in 80-year-old subjects.

Few data are available on the association between the prolonged heart rate-adjusted QT (QTc) interval and high blood pressure in elderly individuals, particularly in subjects over 80 years old. The aim of the present study was to determine the association between the QTc interval and blood pressure in 80-year-old subjects. This study was part of the 8020 Data Bank Survey, which was designed to collect the baseline data of systemic and dental health conditions in 80-year-old subjects. We studied the cross-sectional association of the QTc interval with blood pressure in 642 Japanese (257 men and 385 women), all 80 years old. Mean systolic blood pressure (SBP) rose from 146.0 mmHg in the first quartile of QTc interval to 149.1 mmHg in the second, 154.6 mmHg in the third, and 152.3 mmHg in the fourth quartile (test for trend, p=0.008). Mean diastolic blood pressure (DBP) also rose from 76.9 mmHg in the first quartile of QTc interval to 77.7 mmHg in the second, 81.8 mmHg in the third, and 79.0 mmHg in the fourth quartile (test for trend, p=0.003). We performed multiple regression analysis, controlling for factors known to influence the QTc intervals-e.g., SBP, heart rate, sex, and left ventricular hypertrophy assessed by the voltage amplitudes recorded in the precordial leads of the electrocardiogram. The association between the QTc interval and SBP was highly statistically significant in all analyses. These results show that SBP by itself may influence the QTc interval in very old subjects.

Aged↗

Relationship between electrocardiographic abnormalities and periodontal disease: the Hisayama Study.

BACKGROUND: Recent studies have suggested a relationship between periodontitis and cardiovascular disease (CVD). This study investigated the relationship between periodontitis and electrocardiographic (ECG) abnormalities, which are known predictors of CVD. METHODS: We examined the periodontal status of 1,111 residents of Hisayama Town, Fukuoka, Japan. Nine hundred fifty-seven (957) subjects (374 males, 583 females) with > or = 10 teeth and without a medical history of CVD were included in the analysis. Probing depth (PD) and clinical attachment level (CAL) were measured on two randomly selected quadrants, one maxillary and one mandibular. A 12-lead ECG was recorded using a standard electrocardiograph. ECG abnormalities included left ventricular hypertrophy (Minnesota code 3-1) and ST depression (4-1, 2, 3). The relation of periodontal condition and ECG abnormalities was assessed with logistic regression analysis. RESULTS: Univariate analysis revealed that mean probing depth, mean attachment loss, number of teeth, and plaque index were significantly associated with ECG abnormalities, as well as with known risk factors of CVD. In multivariate analysis, the subjects with deep pockets (mean probing depth > or = 2 mm) had an increased risk for ECG abnormalities (odds ratio [OR] = 1.6; 95% confidence interval [CI] = 1.01 to 2.50) compared to the subjects with mean PD < 2 mm. Subjects with severe attachment loss (mean CAL > or = 2.5 mm) had also significant risk for ECG abnormalities (OR = 1.7; 95% CI = 1.07 to 2.67) compared to those whose mean CAL was < 2.5 mm. CONCLUSION: This study clearly shows the relationship between periodontitis and ECG abnormalities, which are important predictors of CVD.

Adult↗

Hyperhomocysteinemia and the development of chronic kidney disease in a general population: the Hisayama study.

BACKGROUND: Hyperhomocysteinemia has been linked with various atherosclerotic diseases, but has not been evaluated sufficiently as a risk factor for the development of chronic kidney disease (CKD) in the general population. METHODS: To clarify this issue, we followed up 1,477 community-dwelling individuals without CKD, aged 40 years or older, for 5 years and examined the effects of baseline serum total homocysteine (tHcy) levels on the development of CKD. RESULTS: During follow-up, 88 subjects experienced CKD. Baseline tHcy levels were greater in men than women (1.35 versus 1.04 mg/L [10.0 versus 7.7 micromol/L]; P < 0.01). Age-adjusted 5-year incidences were 2.2% in the low tertile, 5.4% in the middle tertile, and 8.6% in the high tertile of tHcy levels for men and 3.3%, 6.0%, and 6.9% for women, respectively. The difference between the low and high tertiles was statistically significant for both sexes ( P < 0.05). In multivariate analysis, these relationships remained substantially unchanged, even after adjustment for other confounding factors, such as systolic blood pressure, antihypertensive medication, hemoglobin A 1c level, total cholesterol level, high-density lipoprotein cholesterol level, habitual smoker status, regular alcohol intake, proteinuria, and baseline kidney function (odds ratio [OR] in the high tertile of tHcy levels, 2.09; 95% confidence interval [CI], 0.66 to 6.61 for men; OR, 2.86; 95% CI, 1.10 to 7.43 for women). Furthermore, baseline tHcy level showed a significantly inverse association with rate of change in kidney function during the 5 years after being adjusted for confounding factors, including baseline kidney function. CONCLUSION: Our findings suggest that elevated serum tHcy levels are a significant risk factor for the development of CKD in the general population.

Aged↗

[Behavioral situation at onset of paradoxical brain embolism due to patent foramen ovale].

The goal of this study was to determine whether there was difference in behavioral situation at onset of stroke between the patients with right-to-left shunt whose stroke was diagnosed as paradoxical brain embolism according to the new criteria proposed by Strategies against Stroke Study for Young Adults in Japan (SASSY-Japan) and whose stroke was not. Among 365 consecutive patients with possible acute ischemic stroke who underwent transesophageal echocardiography, we compared clinical profiles of the following three patient groups: patients with patent foramen ovale whose stroke was diagnosed as paradoxical brain embolism (group A), patients with patent foramen ovale whose stroke was not diagnosed as paradoxical brain embolism (group B), and patients without patent foramen ovale whose stroke was diagnosed as cardiogenic brain embolism (group C). Patent foramen ovale was present on echocardiogram in 76 of 365 patients (21%). Among them, 19 patients were classified into group A and 34 into group B. Group C was composed of 69 patients. At stroke onset, 3 patients in group A took behavior with positive Valsalva maneuver, 2 in group B, and 1 in group C. Similarly at stroke onset, 4 patients in group A just stood up from long-time sitting position, 1 in group B, and 1 in group C. In all, stroke onset following Valsalva maneuver or long-time sitting position was positive in 37% of group A, 9% of group B, and 3% of group C, and was most frequent in group A (p < 0.0001). In group A, the frequency of Valsalva maneuver or long-time sitting position at stroke onset was higher than the frequency of detection of venous thrombus (21%). The result indicates that Valsalva maneuver and long-time sitting position contribute to occurrence of paradoxical brain embolism. We think that these behavioral situations are appropriate diagnostic criteria for paradoxical brain embolism.

Aged↗

Incidence, etiology, and outcome of stroke in patients on continuous ambulatory peritoneal dialysis.

BACKGROUND: Little information exists on clinical features of stroke in patients receiving continuous ambulatory peritoneal dialysis (CAPD). The goals of this study was to clarify features of stroke in CAPD patients, to determine factors to predict onset of stroke during chronic CAPD, and to determine whether CAPD had an advantage over hemodialysis (HD) for prevention of stroke. METHODS: We determined features of stroke in 12 patients (14 attacks including 7 parenchymal and 1 subarachnoid hemorrhage and 6 infarction) among 188 consecutive patients on CAPD, and compared them with those of 137 stroke patients among 1,681 consecutive patients on hemodialysis. RESULTS: Incidence of stroke for CAPD patients (15.7 per 1,000 person-years) was high compared with that of HD patients (approximately 12) or general residents in our suburban town. Patients with stroke on CAPD were younger than those on HD (52 +/- 12 vs. 62 +/- 11 years, p = 0.008). Mean arterial pressure (MAP) of patients with stroke increased after the introduction of CAPD (p = 0.01), whereas that of patients without stroke did not change. Increase in MAP during chronic CAPD was related independently to the occurrence of total stroke or brain hemorrhage. The majority of CAPD patients with stroke (67%) were dead or dependent in the chronic stage of stroke. CONCLUSION: CAPD patients seem to have a greater risk of stroke than the general population primarily because of poor control of hypertension, presumably in part due to overhydration. CAPD does not seem to have an advantage over HD for the prevention of stroke.

Adult↗

Transoral carotid ultrasonography as a diagnostic aid in patients with severe carotid stenosis.

Evaluation of the distal portion of the extracranial internal carotid artery (ICA) is indispensable for the judgment of whether surgical treatment for high-grade carotid stenosis is preferable or not. When the ICA is occluded or severely stenosed by an organic lesion along the long segment, carotid endarterectomy (CEA) is abandoned. On the other hand, CEA may be beneficial in patients with severe carotid stenosis which is situated only in the restricted lesion of the proximal portion of the ICA. Conventional carotid ultrasonography sometimes cannot provide sufficient information due to calcified plaque and/or high position of bifurcation. Newly developed transoral carotid ultrasonography (TOCU) enables us to observe the distal extracranial ICA and distinguish the differential diagnosis. We herein report 3 cases of severe carotid stenosis in which TOCU provided the necessary information obtained neither by conventional carotid ultrasonography nor by angiogram. We concluded that TOCU provides prerequisite information in certain cases in which CEA is considered.

Aged↗

Effect of exogenous cholecystokinin on islet blood flow in anesthetized rats.

Although a number of studies have investigated the effect of cholecystokinin (CCK) on pancreatic blood flow and exocrine function, few have addressed the effect of CCK on islet blood flow. Here, we studied the effect of exogenous CCK on islet blood flow in anesthetized rats. Islet blood flow was measured by the color microsphere method. Bolus intravenous administration of CCK (10 microg/kg) significantly increased pancreatic and islet blood flow in control Long-Evans Tokushima Otsuka (LETO) rats, but not in Otsuka Long-Evans Tokushima Fatty (OLETF) rats lacking CCK-A receptors. Since fractional islet blood flow expressed as a percentage of whole pancreatic blood flow was decreased after CCK administration in LETO rats, the vasodilating effect of CCK appeared to be stronger in exocrine than endocrine tissue. Although vagotomy failed to alter the CCK-induced increase in pancreatic and islet blood flow, pretreatment with nitric oxide synthase inhibitor N(G)-monomethyl-L-arginine completely prevented the increase in pancreatic and islet blood flow. Our results demonstrated that exogenous CCK is a potent vasodilator of exocrine as well as islet vasculature via CCK-A receptors, and that such action is mediated by a NO-dependent mechanism rather than by vagal mechanisms.

Anesthesia↗

Photothrombotic middle cerebral artery occlusion and reperfusion laser system in spontaneously hypertensive rats.

BACKGROUND AND PURPOSE: To establish a less invasive and reproducible focal ischemia model in the rat, we adopted a 2-laser system (ie, photothrombosis and YAG laser-induced reperfusion). METHODS: The distal middle cerebral artery (MCA) of spontaneously hypertensive rats was occluded by 568-nm krypton laser and intravenous infusion of the photosensitizing dye rose bengal and was recanalized by 355-nm ultraviolet laser irradiation. Cerebral blood flow was determined by laser-Doppler flowmetry at the penumbral cortex. Infarct volume was determined at 3 days after distal MCA occlusion. RESULTS: Brain temperature determined with infrared thermography was maintained within an acceptable range of approximately 1 degrees C upper shift of the center of brain temperature distribution during krypton or YAG laser irradiation. The average of the values (23 experiments; n=163) of coefficient of variation of infarct volume was 21+/-6%, indicating high reproducibility of this model. After distal MCA occlusion, cerebral blood flow was decreased to 32+/-16% of the control values and was increased to 98+/-21% after YAG laser-induced reperfusion. Infarct volume in these rats was 61+/-18 mm3 (coefficient of variation=30%; n=6). CONCLUSIONS: We have characterized a highly reproducible focal ischemia model utilizing a 2-laser system, one to induce thrombotic MCA occlusion and the other to facilitate reperfusion.

Animals↗

Ten-year prognosis of stroke and risk factors for death in a Japanese community: the Hisayama study.

BACKGROUND AND PURPOSE: There have been very few population-based cohort studies of long-term prognosis and risk factors for death after stroke. We examined the 10-year prognosis, causes, and risk factors of death after stroke in a Japanese cohort. METHODS: During a 26-year follow-up of a cohort of 1621 subjects > or =40 years of age, 333 subjects developed first-ever stroke and were prospectively followed up for 10 years after onset. During these 10-year follow-up periods, 268 of the 333 stroke patients died. Of those, 239 (89.2%) underwent autopsy. RESULTS: The risk of death was greatest in the first year after first-stroke onset in both sexes (men, 40.3%; women, 43.7%). Thereafter, the survival curves decreased gradually, and risk of death reached 80.7% for men and 80.2% for women by the end of the 10-year follow-up. The 30-day case fatality rate was substantially greater in patients with cerebral hemorrhage (63.3%) or subarachnoid hemorrhage (58.6%) than in patients with cerebral infarction (9.0%). The risk of dying after the first stroke was twice the risk for stroke-free subjects. The most common cause of death was the index stroke in the first year. Thereafter, the impact of the first stroke gradually decreased, while that of recurrent stroke increased. Multivariate analysis revealed that age, lower body mass index, and hemorrhagic stroke were significant risk factors for death after stroke. CONCLUSIONS: Our findings suggest that the risk of death after first-ever stroke is high, in part because of the larger proportion of hemorrhagic stroke in Japanese relative to stroke victims in Western countries.

Age of Onset↗

Effects of carotid endarterectomy on cerebral blood flow and neuropsychological test performance in patients with high-grade carotid stenosis.

We examined the changes in cognitive function following carotid endarterectomy (CEA) in relation to the cerebral blood flow (CBF) in patients with high-grade carotid stenosis. The subjects consisted of 23 patients who underwent CEA and 17 controls matched by age and education. Single photon emission computed tomography (SPECT) and neuropsychological tests were performed 2 weeks before and 4 weeks after CEA in all patients. The preoperative CBF tests revealed a decreased vasodilatory reserve in the ipsilateral cerebral hemisphere in nine patients, which was increased after CEA. In these patients, the grade of carotid stenosis was significantly higher than in those with a normal perfusion reserve (90.2+/-8.1% vs. 78.6+/-11.3%, respectively, p<0.05). In the patient group, the postoperative scores (27.2+/-2.9) of the mini-mental state examination (MMSE) improved significantly over the preoperative ones (26.1+/-3.2, p<0.05). Moreover, the scores in the block-design test after CEA (86.8+/-19.8) were significantly higher than those before the operation (81.8+/-22.3, p<0.01). The error score in immediate retention improved from 9.0+/-3.1 to 7.7+/-4.0 following CEA (p<0.05). In the control group, none of the test scores showed significant improvement between the first and second tests. In the patients with an impaired vasodilatory reserve, the mean score of the block-design test significantly improved from 65.6+/-22.1 to 74.0+/-19.2 after CEA compared with those in patients without impairment (p<0.05). High-grade carotid stenosis was thus concluded to cause cognitive impairment due to cerebral hemodynamic failure, which is presumably reversed by CEA.

Aged↗

Trends in the incidence, mortality, and survival rate of cardiovascular disease in a Japanese community: the Hisayama study.

BACKGROUND AND PURPOSE: The slowdown of a steeply declining trend in cardiovascular mortality has been reported in Japan, but precise reasons for this trend are uncertain. METHODS: We established 3 study cohorts of Hisayama residents aged > or =40 years without a history of stroke or myocardial infarction in 1961 (1618 subjects, first cohort), 1974 (2038 subjects, second cohort), and 1988 (2637 subjects, third cohort). We followed up with each cohort for 12 years, comparing the incidence, mortality, and survival rate of cardiovascular disease. RESULTS: The age-adjusted incidence of cerebral infarction significantly declined by 37% for men and by 32% for women from the first to the second cohort. It continued to decline by 29% for men, but the decline decelerated for women in the third cohort. The incidence of cerebral hemorrhage steeply declined by 61% from the first to the second cohort in men only, while it was sustained for both sexes in the third cohort. Stroke mortality continuously declined as a result of these incidence changes and significant improvement of survival. In contrast, the incidence and mortality rate of coronary heart disease were unchanged except for the increasing incidence in the elderly. The prevalence of severe hypertension and current smoking significantly decreased, while that of glucose intolerance, hypercholesterolemia, and obesity greatly increased among the cohorts. CONCLUSIONS: Our data suggest that the decline in stroke incidence is slowing down and that the incidence of coronary heart disease has been increasing in the elderly in recent years. Insufficient control of hypertension and the increase in metabolic disorders may contribute to these trends.

Adult↗

Dilazep and fenofibric acid inhibit MCP-1 mRNA expression in glycoxidized LDL-stimulated human endothelial cells.

We previously reported that glycoxidized low-density lipoprotein (glycoxidized LDL) enhanced monocyte chemoattractant protein-1 (MCP-1) mRNA expression through activation of nuclear factor-kappaB (NF-kappaB). Here we investigated the effects of dilazep, an anti-platelet agent, and fenofibric acid, an active metabolite of fenofibrate, on glycoxidized low-density lipoprotein-(LDL)-enhanced MCP-1 mRNA expression. Both 10 microg/ml dilazep and 100 microM fenofibric acid abrogated MCP-1 mRNA expression. ZM241385, an A2a adenosine receptor antagonist, partially inhibited the suppressive effect of dilazep. NF-kappaB activity was also suppressed by 1 microg/ml dilazep and 10 microM fenofibric acid. The antioxidative activity of these drugs on glycation to native LDL or oxidation to glycated LDL was measured using lipid peroxidation and lyso-phosphatidylcholine contents in LDL. Dilazep but not fenofibric acid exhibited antioxidative activity. Although the mechanisms of anti-atherogenic effects of the two drugs on glycoxidized LDL are different, both dilazep and fenofibric acid could potentially prevent atherosclerosis in diabetes mellitus.

Cells, Cultured↗

Age-associated prevalence and risk factors of Lewy body pathology in a general population: the Hisayama study.

In dementia with Lewy bodies (DLB), the Lewy bodies (LBs) are an essential substrate. Although LB pathology has gained increasing attention as one of the major causes of dementia, little is known about the exact prevalence of LB pathology in the general population. In addition, the pathology of Alzheimer-type dementia (ATD) is frequently associated with DLB. To investigate the prevalence of LB pathology in a community-based population and to evaluate the relationship between LB and ATD pathology, we performed an analysis of 102 consecutive autopsy cases. The survey extended over 2.5 years and autopsy rate was 70.5%. LB pathology was detected using alpha-synuclein immunohistochemistry and was assessed based on consensus guidelines for DLB. ATD pathology was evaluated by both CERAD and NIA-RI criteria. Twenty-nine subjects were clinically demented. LB pathology was present in 23 (22.5%) of 102 cases, and in 12 (41.4%) of the demented subjects. The LB score was not significantly different between DLB cases and non-demented subjects with LB pathology (nd-LB), while the Braak stages were significantly different between the two groups. Prevalence of LB pathology constantly increased with age. DLB cases accompanying severe ATD pathology showed more rapid increase of LB scores than did DLB cases without severe ATD pathology. Moreover, DLB cases with severe ATD pathology had poorer prognoses than those without severe ATD pathology. Our results suggested that aging and severe ATD pathology have a strong effect on the evolution of LB pathology.

Age of Onset↗

Prevalence and risk factors for epiretinal membranes in a Japanese population: the Hisayama study.

PURPOSE: To examine the prevalence and risk factors for epiretinal membranes (ERMs) in a sample Japanese population. METHODS: In 1998 a cross-sectional community survey was conducted among residents of Hisayama. A total of 688 men and 1087 women living in Hisayama, Japan, aged 40 years or older consented to participate in the study. Each participant underwent a comprehensive physical examination that included an ophthalmic examination. The presence of ERMs was judged from grading based on fundus examination using indirect ophthalmoscopy, slit lamp examination, and color fundus photographs. This study used non-stereoscopic 45 degrees fundus photographs to grade ERMs, whereas the other population-based studies used 30 degrees stereoscopic fundus photographs, which might explain some differences in prevalence of ERMs. Multiple logistic regression analysis was performed on the cross-sectional data to determine the risk factors for ERMs. The following ten possible risk factors were used: age; gender; hypertension; diabetes; serum cholesterol; serum HDL cholesterol; serum triglycerides; smoking habits; alcohol intake; and body mass index. RESULTS: The prevalence of ERMs was 4.0%, and increased with age. The ERMs were more prevalent in women (4.3%) than in men (3.5%). Multiple logistic regression analysis showed that age and serum cholesterol significantly associated with ERMs. CONCLUSIONS: This study suggests that ERMs are less common in the Japanese population than in similar populations in Western countries, and that hypercholesterolemia is a relevant risk factor for ERMs.

Adult↗