Normal Healthy Control Subjects Research Articles

Comparison of Muscle Sympathetic Activity in Ischemic and Nonischemic Heart Failure

Background The magnitude of sympathetic activation in chronic heart failure is assumed to be independent of its cause. However, because a higher sympathetic component of heart rate variability (HRV) in patients with ischemic cardiomyopathy (ICM) has been reported, we hypothesized that patients with ICM would have a higher resting muscle sympathetic nerve activity (MSNA) than patients with nonischemic dilated cardiomyopathy (DCM). Methods and Results Resting MSNA was assessed by microneurography and HRV concurrently by coarse-graining spectral analysis in 30 treated normotensive patients with chronic heart failure (12 with ICM and 18 with DCM), matched for age and left ventricular ejection fraction, and 23 healthy normal control subjects, matched for age and blood pressure. Peak oxygen uptake was determined during graded cycling (17 W/min) to maximum effort. MSNA was significantly different between groups ( P < .001; ICM 60 ± 3; DCM 47 ± 3; control subjects 35 ± 3 bursts/min). Compared with control subjects, the total spectral power and the high-frequency component of HRV were lower in both ICM and DCM groups, but fractal and low-frequency power were lower only in the ICM group ( P < .05). Peak oxygen uptake (milliliters per kilogram of body weight per minute) was significantly less in the ICM group than in the DCM group ( P = .04) and lower in both groups than in the control subjects ( P < .001). Conclusions These observations suggest an additional ischemic stimulus to sympathetic activation in heart failure, which may impair exercise capacity reflexively.

Trichostatin A prevents the accumulation of extracellular matrix in a mouse model of bleomycin‐induced skin fibrosis

Tissue fibrosis is a hallmark compromising feature of many disorders. In this study, we investigated the antifibrogenic effects of the histone deacetylase inhibitor trichostatin A (TSA) on cytokine-driven fibrotic responses in vitro and in vivo. Skin fibroblasts from patients with systemic sclerosis (SSc) and normal healthy control subjects were stimulated with profibrotic cytokines in combination with TSA. Human Colalpha1(I) and fibronectin were measured using real-time polymerase chain reaction, and levels of soluble collagen were estimated using the SirCol collagen assay. Electromobility shift assay and confocal fluorescence microscopy were used to investigate the intracellular distribution of Smad transcription factors. For in vivo analysis, skin fibrosis was quantified by histologic assessment of mouse skin tissue in a model of bleomycin-induced fibrosis. Reductions in the cytokine-induced transcription of Colalpha1(I) and fibronectin were observed in both normal and SSc skin fibroblasts following the addition of TSA. Similarly, the expression of total collagen protein in TSA-stimulated SSc skin fibroblasts was reduced to basal levels. The mechanism of action of TSA included inhibition of the nuclear translocation and DNA binding of profibrotic Smad transcription factors. Western blot analysis revealed an up-regulation of the cell cycle inhibitor p21 by TSA, leading to reduced proliferation of fibroblasts. In addition, in bleomycin-induced fibrosis in mice, TSA prevented dermal accumulation of extracellular matrix in vivo. These findings provide novel insights into the epigenetic regulation of fibrosis. TSA and similar inhibitory compounds appear to represent early therapeutic strategies for achieving reversal of the cytokine-driven induction of matrix synthesis that leads to fibrosis.

Urinary lipocalin‐2 is associated with renal disease activity in human lupus nephritis

Pathogenic monoclonal anti-double-stranded DNA (anti-dsDNA) antibodies up-regulate the expression of lipocalin-2 in glomerular mesangial cells. This study was undertaken to investigate whether polyclonal anti-dsDNA antibodies promote the local secretion of lipocalin-2 in the kidneys of patients with systemic lupus erythematosus (SLE), and whether urinary lipocalin-2 represents a marker of kidney involvement in SLE. Hispanic, African American, and white patients with SLE and normal healthy control subjects from affiliated hospitals of the Albert Einstein College of Medicine were recruited for this cross-sectional study. Patients were classified based on the presence of active renal disease according to the SLE Disease Activity Index (SLEDAI). Correlations of clinical and laboratory data with urinary and serum levels of lipocalin-2 were assessed. Among SLE patients, urinary lipocalin-2 levels were significantly higher in those with lupus nephritis (LN) (median 17.1 ng/mg creatinine, interquartile range [IQR] 10.3-45.4; n = 32) than in those without LN (median 11.2 ng/mg creatinine, IQR 3.1-20.3; n = 38) (P = 0.023). Compared with the values in normal controls (median 4 ng/ml, IQR 0-11.1; n = 14), urinary levels of lipocalin-2 in SLE patients were significantly higher (non-normalized median 19.3 ng/ml, IQR 8-34.2) (P = 0.004). The presence of lipocalin-2 in the urine of patients with LN correlated significantly with the renal SLEDAI score (r = 0.452, P = 0.009), but not with extrarenal disease activity. The high prevalence of LN in SLE patients and the prognostic significance of kidney disease support the need for identifying early biomarkers to assess the risk of nephritis development and for following up patients with established disease. These findings indicate that urinary lipocalin-2 is a potential marker of the presence and severity of renal involvement in adult patients with SLE.

The Coexistence of the Fibromyalgia Syndrome and the Overactive Bladder Syndrome

Objectives: Overactive bladder syndrome [OBS] and fibromyalgia syndrome [FMS] have similar etiopathological factors such as serotonine, endoteline-1, noradrenaline, etc. The aim of this study was to investigate the relation between OBS and FMS.Methods: This was a prospective study. Patients with OBS and healthy normal control subjects were included in this study. The diagnosis of FMS was based on the 1990 criteria of American College Rheumatology and the diagnosis of OBS was based on urgency and urge incontinence symptoms. All participants completed a questionnaire to gather information including demographic features, medical history such as presence of headache, poor sleep, and urological symptoms, and the Beck depression scale. Patients with OBS were divided into two subgroups according to coexistence of FMS [OBS or OBS + FMS.]Results: Forty patients with OBS and 40 healthy normal control subjects were included in this study. All of the subjects with FMS were female. The FMS was present in 30 percent of...

Gross Anatomy of the Corpus Callosum in Alzheimer’s Disease: Regions of Degeneration and Their Neuropsychological Correlates

Background/Aims: Differences in the gross shape of the corpus callosum (CC) and its subregional areas were investigated on brain MRI of patients with probable Alzheimer’s disease (AD) and age- and gender-matched healthy normal control subjects. The AD patients differed from the normal control subjects in terms of a more convex shape and a reduced area of the CC. Methods: As for the comparisons of the subregional areas of the CC, we adapted a splitting method which takes into account the modification of the global shape of the CC, and we implemented it by normalizing the CC, to avoid the bias introduced by the observed callosal shape variability. Results: The application of this method unveiled that the regional CC reductions were located in the anterior and posterior third of the CC, i.e. where small myelinated fibers are more frequent. None of the neuropsychological scores collected at the time of the MRI investigation of AD could predict a regional and/or overall callosal area reduction. The only measure that correlated with area of the isthmus of the CC was the MMSE that was administered to all participants. Conclusions: This latter result may be used as an in vivo indicator of the progress of neocortical disintegration in AD.

Fecal S100A12: A novel noninvasive marker in children with Crohnʼs disease

The calcium-binding protein S100A12 is related to calprotectin, a protein shown to be a useful marker of gut inflammation. S100A12 levels are elevated in serum and mucosa of children with inflammatory bowel disease (IBD) and may be implicated in the pathogenesis of IBD. The aims of this study were to validate an immunoassay for the detection of fecal S100A12, to assess its value as a new noninvasive marker of gut inflammation, and to investigate S100A12 levels in feces of children with IBD at diagnosis and during treatment. Feces were collected from children with active IBD at diagnosis and during treatment for IBD and from normal healthy control subjects. Fecal and serum levels of S100A12 were measured by immunoassay. A sensitivity of 96% and a specificity of 92% were observed when 10 mg/kg fecal S100A12 was used as a cutoff. S100A12 levels were evenly distributed throughout fecal samples and were stable for 7 days when stored at room temperature. Fecal S100A12 was elevated in children with IBD compared with healthy control subjects, with levels closely correlated to disease activity and other serum inflammatory markers, particularly lower gut involvement. Fecal S100A12 levels fell during therapy in children entering remission with normal C-reactive protein levels. Fecal S100A12 is a novel noninvasive marker that distinguishes children with active IBD from healthy control subjects with high sensitivity and specificity. Fecal S100A12 possesses characteristics that are desirable for a noninvasive disease marker and therefore is a suitable candidate marker for IBD. Further evaluation is required to examine this marker in additional contexts.

P2-297: Heterogeneous atrophy of medial temporal lobe structures in patients with amnesic mild cognitive impairment

Recent MRI volumetric studies of Medial Temporal Lobe (MTL) in patients with amnestic MCI (aMCI) have shown that atrophy of the entorhinal cortex (ERC) could predict future conversion to Alzheimer's disease (AD). The aim of this study was to evaluate the volume of different MTL structures in aMCI patients and determine if volume loss of the subcomponents of the MTL is homogenous. We included 25 patients with aMCI (mean age = 68.5 ± 8.1, MMSE = 27.4 ± 1.4) and 27 healthy elderly normal control subjects matched for age. The MRI scans were acquired with a 1.5 T Siemens imager using an MP–RAGE sequence (TR/TE/TI: 9.7/4/250 ms, FOV 256mm*256mm, flip angle12°, matrix 230*256). Segmentation was performed according to previously developed protocols. Quantitative volumes were obtained with a manual ROI method on coronal images. We measured volumes of the ERC, the perirhinal cortex (PRC), the parahippocampal cortex, and the hippocampal formation (HP). Two independent operators (C.Y., A.S.), blinded to clinical data, obtained the ROI volumetric measurements independently. The inter–rater variability was 0.4% for the HP, 1.8% for the PRC, and 2.25% for the ERC. Statistical analyses were performed using ANCOVA. Comparing aMCI subjects to normal controls, we found a volume loss of the ERC (p<0.05), which was more important on the left side (p< 0.01). The posterior HP was also significantly atrophied in the aMCI group (p<0.05), while there was no difference for the anterior HP. Within the aMCI group, we identified two subgroups. One group had no ERC or PRC atrophy. The second group had significant ERC and PRC atrophy, which was in some cases associated with atrophy of the HP. This study confirms atrophy of the ERC in a group of patients with aMCI. Moreover, concerning the HP, the posterior part is more atrophied in patients with aMCI. Our results furthermore suggest a heterogeneity concerning rhinal cortices, with preservation in one patient subgroup and atrophy in another.

Evidence of Lower Oxidative Stress in the Air Spaces of Patients with Reversible Copd

The mechanism responsible for the reversibility of airflow limitation in stable chronic obstructive pulmonary disease (COPD) patients is unknown. The aim of this study is to assess the relationship between the reversibility of airflow limitation, the redox balance and the inflammatory cells in the sputum of patients with stable COPD. For this purpose we examined 15 normal healthy control subjects and 20 nonatopic COPD patients. The COPD patients were divided into two groups: reversible COPD (increase in FEV1> 200 ml and/or > or =12> or = after 200 microg of inhaled salbutamol) or non-reversible COPD. GSH, GSSG were measured in induced sputum and blood. Protein carbonyls were evaluated by WB in sputum and IL-4 and IL-6 and TNF-alpha in plasma and sputum. GSH oxidation and protein oxidation were lower in reversible COPD patients than in those with no reversibility. The sputum eosinophil count was significantly higher in the reversible group than in the non-reversible group, and IL-4 concentration was higher in the same patients both in sputum and in plasma. In contrast, IL-6 and TNF-alpha were increased in non-reversible COPD patients in both biological samples. We conclude that airflow reversibility in COPD patients is associated with airway oxidative stress and activation of eosinophil inflammatory pattern in sputum and blood, suggesting that these patients could respond to specific pharmacological treatment.

Artificial neural network classifier for the diagnosis of Parkinson's disease using [99mTc]TRODAT-1 and SPECT

Imaging the dopaminergic neurotransmitter system with positron emission tomography (PET) or single photon emission tomography (SPECT) is a powerful tool for the diagnosis of Parkinson's disease (PD). Previous studies have indicated that human observers have a diagnostic accuracy similar to conventional ROI analysis of SPECT imaging data. Consequently, it has been hypothesized that an artificial neural network (ANN), which can mimic the pattern recognition skills of human observers, may provide similar results. A set of patients with PD, and normal healthy control subjects, were studied using the dopamine transporter tracer [99mTc]TRODAT-1 and SPECT. The sample was comprised of 81 patients (mean age ± SD: 63.4 ± 10.4 years; age range: 39.0–84.2 years) and 94 healthy controls (mean age ± SD: 61.8 ± 11.0 years; age range: 40.9–83.3 years). The images were processed to extract the striatum and the striatal pixel values were used as inputs to a three-layer ANN. The same set of data was used to both train and test the ANN, in a ‘leave one out’ procedure. The diagnostic accuracy of the ANN was higher than any previous analysis method applied to the same data (94.4% total accuracy, 97.5% specificity and 91.4% sensitivity). However, it should be stressed that, as with all applications of an ANN, it was difficult to interpret precisely what triggers in the images were being detected by the network.

Elevated Activity of Transcription Factor Nuclear Factor of Activated T-Cells 5 (NFAT5) and Diabetic Nephropathy

The expression of aldose reductase is tightly regulated by the transcription factor tonicity response element binding protein (TonEBP/NFAT5) binding to three osmotic response elements (OREs; OREA, OREB, and OREC) in the gene. The aim was to investigate the contribution of NFAT5 to the pathogenesis of diabetic nephropathy. Peripheral blood mononuclear cells (PBMCs) were isolated from the following subjects: 44 Caucasoid patients with type 1 diabetes, of whom 26 had nephropathy and 18 had no nephropathy after a diabetes duration of 20 years, and 13 normal healthy control subjects. In addition, human mesangial cells (HMCs) were isolated from the normal lobe of 10 kidneys following radical nephrectomy for renal cell carcinoma. Nuclear and cytoplasmic proteins were extracted from PBMCs and HMCs and cultured in either normal or high-glucose (31 mmol/l D-glucose) conditions for 5 days. NFAT5 binding activity was quantitated using electrophoretic mobility shift assays for each of the OREs. Western blotting was used to measure aldose reductase and sorbitol dehydrogenase protein levels. There were significant fold increases in DNA binding activities of NFAT5 to OREB (2.06 +/- 0.03 vs. 1.33 +/- 0.18, P = 0.033) and OREC (1.94 +/- 0.21 vs. 1.39 +/- 0.11, P = 0.024) in PBMCs from patients with diabetic nephropathy compared with diabetic control subjects cultured under high glucose. Aldose reductase and sorbitol dehydrogenase protein levels in the patients with diabetic nephropathy were significantly increased in PBMCs cultured in high-glucose conditions. In HMCs cultured under high glucose, there were significant increases in NFAT5 binding activities to OREA, OREB, and OREC by 1.38 +/- 0.22-, 1.84 +/- 0.44-, and 2.38 +/- 1.15-fold, respectively. Similar results were found in HMCs exposed to high glucose (aldose reductase 1.30 +/- 0.06-fold and sorbitol dehydrogenease 1.54 +/- 0.24-fold increases). Finally, the silencing of the NFAT5 gene in vitro reduced the expression of the aldose reductase gene. In conclusion, these results show that aldose reductase is upregulated by the transcriptional factor NFAT5 under high-glucose conditions in both PBMCs and HMCs.

Studies on the age dependent changes in serum adenosine deaminase activity and its changes in hepatitis

Serum Adenosine deaminase (ADA) activity in normal healthy control subjects increases upto 30 years, remains steady between 31-60 years of age and shows a steep increase in the age group of 61-70 years. This was compared with serum aspartate transaminase (AST) and alanine transaminase (ALT) activity which also showed a gradual increase upto 40 years of age and decreased thereafter. The activities of serum ADA, AST and ALT increased in patients with hepatitis of all age groups compared to their respective controls. The degree of increase in the activities of the above enzymes in hepatitis, decreased with age. The present study also shows that while studying serum ADA activity in hepatitis for diagnostic purposes, the value obtained in a particular age group should be compared with normal range of values for the respective age group only.

Comparison of region-of-interest analysis and human observers in the diagnosis of Parkinson's disease using [99mTc]TRODAT-1 and SPECT

This study determined the relative accuracy of diagnosis of Parkinson's disease (PD) using SPECT imaging data, comparing a semi-quantitative region-of-interest (ROI) approach and human observers. A set of patients with PD and normal healthy control subjects were studied using the dopamine transporter tracer [99mTc]TRODAT-1 and SPECT. The sample comprised 81 patients (mean age ± SD, 63.4 ± 10.4 years; age range, 39.0–84.2 years) and 94 healthy controls (mean age ± SD, 61.8 ± 11.0 years; age range, 40.9–83.3 years). A standardized template containing six ROIs was transposed onto subregions of the brain, and the ratio of striatal to background ROI values was used as a semi-quantitative outcome measure. All images were used in a human observer study, with four experienced investigators. The data from the observer and ROI studies were analysed using a receiver operating characteristic (ROC) analysis, where the area under the ROC curve (AUC) indicated the diagnostic accuracy. ROI analysis and human observers gave similar diagnostic performance (mean observer AUC = 0.89, best ROI AUC = 0.90). This suggested that the human observers are visually acquiring similar information from the images that are contained in the semi-quantitative striatal uptake.

Abnormally Low Antibody Markers of Elastin Synthesis in Patients with Fibromyalgia Syndrome

Background: Antibodies [Abs] to tropoelastin [elastin precursor] and alpha-elastin [elastin breakdown product] are found in serum of all human subjects and correlate with their respective serum peptide levels; however, peptide levels vary with age and some disease states. This study was undertaken to determine if serum elastin Abs reflective of elastin metabolism were altered in patients with fibromyalgia syndrome [FMS] by determining the ratio of serum anti-tropoelastin to anti-alpha-elastin Ab levels.Method: Serum samples from 20 female patients with FMS were compared with samples from 19 age-matched healthy normal control subjects for the levels of anti-elastin Abs directed against tropoelastin and alpha elastin using enzyme-linked immunosorbent assays.Results: Anti-tropoelastin Abs in the sera of patients with FMS were decreased relative to the levels measured in healthy subjects [P < 0.0002]. The ratios of anti-tropoelastin to anti-alpha-elastin Abs were 1.98 versus 1.01 for control and FMS subjects, respectively. This suggested a decrease in elastin production in patients with FMS. There were no differences in the average values of anti-alpha-elastin Abs in the FMS patients sera compared to the average value of the control samples, suggesting there was no differences in elastin destruction.Conclusions: Variations in elastin metabolism were detected in sera of patients with FMS. This suggests an altered elastin metabolism in terms of reduced elastin production in patients with FMS. The relationship between elastin metabolism and disease pathology is currently being explored.

Toll‐like receptor 3 gene polymorphisms in South African Blacks with type 1 diabetes

Type 1 diabetes is the consequence of exposure of genetically susceptible individuals to specific environmental precipitants. The innate immune system provides the initial response to exogenous antigen and links with the adaptive immune system. The aim of this study was to assess the role of polymorphisms occurring in the cytoplasmic region of toll-like receptor (TLR) 3 gene and immediate 5' sequence, in subjects of Zulu descent with type 1 diabetes in KwaZulu-Natal, South Africa. Seventy-nine subjects with type 1 diabetes and 74 healthy normal glucose tolerant gender-matched control subjects were studied. Parts of exon 4 and exon 3/intron 3 of the TLR3 gene were studied by polymerase chain reaction, direct sequencing and restriction enzyme digestion with Bts 1. Of the nine polymorphisms studied, a significant association with type 1 diabetes was found for the major allele in the 2593 C/T polymorphism and for the minor alleles in the 2642 C/A and 2690 A/G polymorphisms, which were found to be in complete linkage disequilibrium. Correction of the P-values for the number of alleles studied, however, rendered the results no longer significant. These results suggest that polymorphisms in the TLR3 gene, which is part of the innate immune system, may be associated with type 1 diabetes in this population.

Degradation products of proteins damaged by glycation, oxidation and nitration in clinical type 1 diabetes

Hyperglycaemia in diabetes is associated with increased glycation, oxidative stress and nitrosative stress. Proteins modified consequently contain glycation, oxidation and nitration adduct residues, and undergo cellular proteolysis with release of corresponding free adducts. These free adducts leak into blood plasma for eventual renal excretion. The aim of this study was to perform a comprehensive quantitative analysis of protein glycation, oxidation and nitration adduct residues in plasma protein and haemoglobin as well as of free adducts in plasma and urine to quantify increased protein damage and flux of proteolytic degradation products in diabetes. Type 1 diabetic patients (n=21) and normal healthy control subjects (n=12) were studied. Venous blood samples, with heparin anticoagulant, and 24-h urine samples were taken. Samples were analysed for protein glycation, oxidation and nitration adducts by a quantitative comprehensive screening method using liquid chromatography with triple quadrupole mass spectrometric detection. In type 1 diabetic patients, the concentrations of protein glycation, oxidation and nitration adduct residues increased up to three-fold in plasma protein and up to one-fold in haemoglobin, except for decreases in pentosidine and 3-nitrotyrosine residues in haemoglobin when compared with normal control subjects. In contrast, the concentrations of protein glycation and oxidation free adducts increased up to ten-fold in blood plasma, and urinary excretion increased up to 15-fold in diabetic patients. We conclude that there are profound increases in proteolytic products of glycated and oxidised proteins in diabetic patients, concurrent with much lower increases in protein glycation and oxidation adduct residues.

No association of anti-GM1 and anti-GAD antibodies with juvenile myoclonic epilepsy: A pilot study

The presence of anti-ganglioside (GM1) or anti-glutamic acid decarboxylase (GAD) antibodies has been reported in association with therapy-resistant epilepsy mostly of focal origin. Our aim was to detect GM1 and GAD autoantibodies in patients with juvenile myoclonic epilepsy (JME) and to evaluate their association with rarely encountered therapy-resistant cases in this idiopathic generalised epilepsy syndrome. Ninety-six consecutive JME patients and 25 healthy normal control subjects were included to the study. We investigated anti-GM1 and anti-GAD antibodies with enzyme-linked immunosorbent assay (ELISA) and radioimmunoassay (RIA), respectively. We found anti-GM1 antibodies in one of 96 (1.04%) JME patients and in one out of 25 (4%) healthy controls, without reaching a significant difference between the titres. Anti-GAD antibodies were detected in 5.8% of the patients and in 4% of the healthy controls. Both antibodies did not have any association with therapy-resistant cases and with any other relevant parameters. The results of our pilot study suggested that anti-GM1 and anti-GAD antibodies are rare and they did not associate with therapy-resistance and other parameters in JME syndrome.

Serum brain-derived neurotrophic factor (BDNF) levels in patients with panic disorder: As a biological predictor of response to group cognitive behavioral therapy

Little is known about biological predictors of treatment response in panic disorder. Our previous studies show that the brain-derived neurotrophic factor (BDNF) may play a role in the pathophysiology of major depressive disorders and eating disorders. Assuming that BDNF may be implicated in the putative common etiologies of depression and anxiety, the authors examined serum BDNF levels of the patients with panic disorder, and its correlation with therapeutic response to group cognitive behavioral therapy (CBT). Group CBT (10 consecutive 1 h weekly sessions) was administered to the patients with panic disorder after consulting the panic outpatient special service. Before treatment, serum concentrations of BDNF and total cholesterol were measured. After treatment, we defined response to therapy as a 40% reduction from baseline on Panic Disorder Severity Scale (PDSS) score as described by Barlow et al. (2000) [Barlow, D.H., Gorman, J.M., Shear, M.K., Woods, S.W., 2000. Cognitive-behavioral therapy, imipramine, or their combination for panic disorder: A randomized controlled trial. JAMA. 283, 2529–2536]. There were 26 good responders and 16 poor responders. 31 age- and sex-matched healthy normal control subjects were also recruited in this study. The serum BDNF levels of the patients with poor response (25.9 ng/ml [S.D. 8.7]) were significantly lower than those of the patients with good response (33.7 ng/ml [S.D. 7.5]). However, there were no significant differences in both groups of the patients, compared to the normal controls (29.1 ng/ml [S.D. 7.1]). No significant differences of other variables including total cholesterol levels before treatment were detected between good responders and poor responders. These results suggested that BDNF might contribute to therapeutic response of panic disorder. A potential link between an increased risk of secondary depression and BDNF remains to be investigated in the future.

Effects of Acupuncture on Potential Along Meridians of Healthy Subjects and Patients with Gastric Disease

The purpose of this study was to investigate the differences in bio-potential in the stomach meridians of 20 normal healthy control subjects (NHC) and 20 patients with gastric disease (PGD). We measured changes in potential between ST-39 and ST-37 on the stomach meridian in response to invasive insertion of a needle at ST-36. The response patterns of NHC were regular in both the left and right meridians, whereas the response patterns of PGD were irregular. The potential of the NHC was significantly higher than that of the PGD group. The potential values in the left and right meridians of NHC were the same. However, the potential in the right meridian was significantly higher than that in the left meridian of PGD (p < 0.001). This study indicates that there may be changes in Qi or in the electrical properties of meridians according to health status, reflected in the regularity of the response to acupuncture or in the level of potential along meridians. Therefore, it may be possible to make a diagnosis from the state of a meridian by comparing levels of potential difference and its regularity.

Audio-vestibular disturbances in Behcet’s patients: report of 62 cases

This study was carried out to determine the characteristics and incidence of hearing loss and vestibular disturbance in Behcet’s syndrome with a large number of patients. Sixty-two patients with Behcet’s syndrome were included in this study, 34 men and 28 women whose mean age was 33.7 (15–60). Sixty-two healthy normal control subjects (38 male and 24 female) were included. Patient and control groups were questioned about any history of audio-vestibular disturbance and underwent physical and ENT examination and the following audiologic tests: pure tone audiometric test (0.25, 0.5, 1, 2, 4, and 6 kHz), tympanogram, speech discrimination, short increment sensitivity index, tone-decay test, auditory brainstem response. Vestibular system was evaluated by videonistagmogram and caloric test. Cranial and brainstem magnetic resonance imagine (MRI) of patients who have vestibular disturbances were practiced to examine the central nervous system. Both the patient and the control groups were tested with the HLA-B51 antigen. Pure tone audiogram showed sensory-neural hearing loss (⩾25 dB hearing level in at least two frequencies) in 20 of the 62 (32%) Behcet’s patients while the control group were normal. There was a hearing loss involving high frequencies in the audiograms of Behcet’s patients with hearing disturbances. The recruitment investigation tests and auditory brain stem response confirmed cochlear involvement in all 20 patients. Caloric stimulation tests revealed a normal vestibular function in all patient and control group. In electronystagmography, 21 (34%) patients had hypometric or hypermetric saccades and smooth pursuit tests showing that 4 (6%) patients had pathological changes while the control group was normal. HLA-B51 antigen was found positive in 15 of 20 Behcet’s patient with hearing loss. Conclusion: (1) The hearing and vestibular disturbances in Behcet’s syndrome is more prevalent than previously recognized; (2) Hearing loss in high frequencies in Behcet’s patients is an indicator of cochlear involvement in this disease; (3) There is a higher prevalence of central vestibular syndrome in Behcet’s patients than it was thought before; (4) HLA-B51 antigen may be able to be a prognostic factor for sensorineural hearing loss in Behcet’s patients.

Elevated Plasma Ghrelin Level in Underweight Patients with Chronic Obstructive Pulmonary Disease

Ghrelin, a novel growth hormone-releasing peptide, has been shown to cause a positive energy balance by reducing fat use and stimulating food intake. This study investigated whether plasma ghrelin is associated with clinical parameters in patients with chronic obstructive pulmonary disease. Plasma ghrelin was measured in 50 patients and 13 control subjects, together with anabolic and catabolic factors. Patients were divided into two groups based on body mass index: underweight patients (n = 26) or normal weight patients (n = 24). Plasma ghrelin was significantly higher in underweight patients than in normal weight patients and healthy control subjects. Circulating tumor necrosis factor-alpha, interleukin-6, and norepinephrine were significantly higher in underweight patients than in normal weight patients. Plasma ghrelin correlated negatively with body mass index and correlated positively with catabolic factors such as tumor necrosis factor-alpha and norepinephrine. In addition, plasma ghrelin correlated positively with percent predicted residual volume and residual volume-to-total lung capacity ratio. In conclusion, plasma ghrelin was elevated in underweight patients with chronic obstructive pulmonary disease, and the level was associated with a cachectic state and abnormality of pulmonary function.