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Background: Knee osteoarthritis (KOA) is associated with reduced quality of life due to knee pain and gait disturbance. However, the evaluation of KOA is mainly based on images and patient-reported outcome measures (PROMs), which are said to be insufficient for functional evaluation. Recently, gait analysis using an accelerometer has been used for functional evaluation of KOA patients. Nevertheless, evaluation of the entire body motion is insufficient. The aim of this study was to clarify the gait characteristics of KOA patients using the distribution of scalar products and the interval time of heel contact during spontaneous walking and to compare them with healthy subjects., Methods: Participants wore a three-axis accelerometer sensor on the third lumbar vertebra and walked for 6 min on a flat path at a free walking speed. The sum of a composite vector (CV) scalar product and a histogram for distribution were used for body motion evaluation. The CV consisted of a synthesis of acceleration data from three axes. In addition to the summation of the CV, a histogram can be created to evaluate in detail the magnitude of the waves. The amount of variation was measured in the left-right and front-back directions. Variability was evaluated from the distribution of heel contact duration between both feet measured from the vertical acceleration., Results: KOA patients showed a smaller sum of CV that converged to small acceleration in the distribution when compared with healthy subjects. In the KOA group, the amount of variation in the forward and backward directions was greater than that in the forward direction. The variability of heel-ground interval time was greater in the KOA group than in healthy subjects., Conclusion: KOA patients walked with less overall body movement, with limited movable range of the knee joint and pain-avoiding motion. The gait of the KOA group was considered unstable, with long time intervals between peaks. The increase in the amount of forward variation was thought to be due to the effect of trunk forward bending during walking. The clinical relevance of this study is that it was possible to evaluate KOA patients' gait quantitatively and qualitatively., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background: Rupture of an iliac artery aneurysm is rare but could be catastrophic unless it is treated with an appropriate strategy. We reviewed our 10-year institutional experience in treating iliac artery aneurysms to elucidate the effectiveness of open surgical repair strategies for ruptured iliac artery aneurysms in terms of short- and long-term postoperative results., Methods: A total of 26 patients (men/women = 22/4), with a mean age of 72 years, underwent open repair of iliac artery aneurysm with or without rupture (unruptured/ruptured = 15/11) between January 2001 and April 2010. There was no difference in the distribution of aneurysm morphology between the unruptured and ruptured groups, and 20 (76.9%) of the 26 patients had aneurysms involving unilateral or bilateral internal iliac arteries. Long-term event-free survival rates and freedom from secondary intervention were analyzed using the Kaplan-Meier method (follow-up: 55 ± 39 and 40 ± 25 months in the unruptured and ruptured groups, respectively)., Results: There was no difference in the time of surgery between the two groups (351 ± 118 and 348 ± 152 minutes in the unruptured and ruptured groups, respectively), but the ruptured group showed greater blood loss/min (time of surgery) and transfusion volume than the unruptured group. The early postoperative mortality was 6.7% in the unruptured group and 0% in the ruptured group (p = 0.557). There was no difference in the number of postoperative morbidities between the two groups, but the ruptured group showed significantly greater C-reactive protein, lactate dehydrogenase, and total bilirubin levels than the unruptured group. The cardiovascular event-free survival rate at 5 years was 93.3% and 100.0% in the unruptured and ruptured groups, respectively. The secondary intervention-free rate at 5 years was 100.0% and 90.0% in the unruptured and ruptured groups, respectively., Conclusions: The short- and long-term postoperative mortality rates after open repair for iliac artery aneurysms were satisfactorily low and similar in unruptured and ruptured groups. This suggests that open repair strategies remain as a reliable treatment option to obtain successful postoperative results in patients with rupture of an iliac artery aneurysm., (Copyright © 2011 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved.)

Background: Raised levels of C-reactive protein (CRP), a marker of low grade systemic inflammation, is common in ageing populations although the relevance of very highly elevated CRP (>10mg/L) remains unclear. We examined cross-sectional associations of very high CRP with psychosocial, behavioural, and cardiovascular risk factors., Methods: Participants were 5307 men and women from the English Longitudinal Study of Ageing, a study of community dwelling older adults (46.0% men, aged 66.5+/-10.1 years). Psychosocial (social status, marital status, depressive symptoms), behavioural (smoking, physical activity, alcohol), and cardiovascular risk factors (blood pressure, cholesterol, glycated haemoglobin, body mass index, waist) were assessed in relation to CRP., Results: A very high CRP concentration was recorded in 7.5% of the sample. After adjustments for age, sex, acute infection and chronic inflammatory conditions, very high CRP was associated with lower social position, depressive symptoms, physical inactivity, smoking, and alcohol abstinence. There was a linear trend for increased prevalence of cardiovascular risk factors across CRP categories representing low (<1mg/L), medium (1 to <3mg/L), high (3-10mg/L), and very high (>10mg/L), although little differences in risk between high and very high groups were observed., Conclusions: Very high levels of CRP in elderly participants might reflect chronic health and psychosocial adversity, independently of acute infection.

Previous psychological studies have paid extensive attention to the association between psychosocial stress and symptomatic herpes simplex virus (HSV) recurrence, but subsequent research has been conducted and conflicting findings have been published. We aimed to quantify the longitudinal association between psychosocial stress and recurrent HSV in the contemporary literature. We searched Medline; PsycINFO; Web of Science; PubMed up to March 2009, and included prospective studies that investigated associations between psychosocial stress and symptomatic HSV recurrence. Two reviewers independently extracted data on study characteristics, quality, and estimates of associations. The overall meta-analysis examining 11 articles (17 psychosocial and disease related relationships) exhibited a robust positive association between psychosocial stress and symptomatic HSV recurrence (correlation coefficient as combined effect size 0.083, 95% confidence interval 0.025-0.141, p=0.005). This finding was supported by more conservative analysis of aggregate effects and by sensitivity analysis of the methodologically strong studies. There were indications of publication bias in some analyses. Intriguingly, sensitivity analyses demonstrated that psychological distress was more strongly associated with symptomatic HSV recurrence than stress stimuli per se, and that psychosocial stress tended to be more strongly associated with oral than genital herpes recurrence. In conclusion, the current review reveals a robust relationship between psychosocial stress and symptomatic HSV recurrence, justifying further research in this field, especially clinical trials evaluating the efficacy of stress reduction interventions on HSV recurrence.

There is a growing epidemiological literature focusing on the association between psychosocial stress and human immunodeficiency virus (HIV) disease progression or acquired immunodeficiency syndrome (AIDS), but inconsistent findings have been published. We aimed to quantify the association between adverse psychosocial factors and HIV disease progression. We searched Medline; PsycINFO; Web of Science; PubMed up to 19 January 2009, and included population studies with a prospective design that investigated associations between adverse psychosocial factors and HIV disease progression or AIDS. Two reviewers independently extracted data on study characteristics, quality, and estimates of associations. The overall meta-analysis examined 36 articles including 100 psychosocial and disease related relationships. It exhibited a small, but robust positive association between adverse psychosocial factors and HIV progression (correlation coefficient as combined size effect 0.059, 95% confidence interval 0.043-0.074, p<0.001). Notably, sensitivity analyses showed that personality types or coping styles and psychological distress were more strongly associated with greater HIV disease progression than stress stimuli per se, and that all of the immunological and clinical outcome indicators (acquired immunodeficiency syndrome stage, CD4+ T-cell decline, acquired immunodeficiency syndrome diagnosis, acquired immunodeficiency syndrome mortality, and human immunodeficiency virus disease or acquired immunodeficiency syndrome symptoms) except for viral load exhibited detrimental effects by adverse psychosocial factors. In conclusion, the current review reveals a robust relationship between adverse psychosocial factors and HIV disease progression. Furthermore, there would appear to be some evidence for particular psychosocial factors to be most strongly associated with HIV disease progression.

Stress influences circulating inflammatory markers, and these effects may mediate the influence of psychosocial factors on cardiovascular risk and other conditions such as psoriasis and rheumatoid arthritis. Inflammatory responses can be investigated under controlled experimental conditions in humans, and evidence is beginning to emerge showing that circulating inflammatory factors respond to acute psychological stress under laboratory conditions. However, research published to date has varied greatly in the composition of study groups, the timing of samples, assay methods, and the type of challenge imposed. The purpose of this review is to synthesize existing data using meta-analytic techniques. Thirty studies met inclusion criteria. Results showed robust effects for increased levels of circulating IL-6 (r=0.19, p=0.001) and IL-1beta (r=0.58, p<0.001) following acute stress, and marginal effects for CRP (r=0.12, p=0.088). The effects of stress on stimulated cytokine production were less consistent. Significant variation in the inflammatory response was also related to the health status of participants and the timing of post-stress samples. A number of psychobiological mechanisms may underlie responses, including stress-induced reductions in plasma volume, upregulation of synthesis, or enlargement of the cell pool contributing to synthesis. The acute stress-induced inflammatory response may have implications for future health, and has become an important topic of psychoneuroimmunological research.

Some previous works have further expanded the 'Brain-Gut axis', that is a bi-directional interaction between the gut and brain function, into a relationship of the brain with the liver. However, all the details of such brain-liver relationship were not fully understood because appropriate animal models had not been established yet. Here we developed a novel animal model, in which hepatic blood flow of conscious mice could be measured in real-time. In addition, using this model, we also demonstrated that exposure to psychological stress considerably reduced hepatic blood flow via central CRF receptors. Thus, this new model is considered to be a useful and promising tool for elucidating the precise effects of emotional factors on liver function.

The lipoprotein lipase (LPL) catalyzed hydrolysis of plasma lipoproteins is a rate-limiting step in the lipid transport into peripheral tissues. The aim of the present study was to isolate monoclonal antibodies against chicken adipose LPL and to investigate whether chronic infusion of the LPL monoclonal antibodies inhibits adipose LPL activity and consequently reduces fat accumulation in broiler chickens. The LPL catalyzed very low density lipoprotein (VLDL) hydrolysis was completely inhibited by the addition of 100 microg/mL of monoclonal antibodies (CLP10, CLP14, CLP16) in the in vitro incubation with plasma VLDL and LPL. A single injection of CLP10 and CLP16 into chickens fed or starved for 24 h elevated plasma triacylglycerol concentrations for 24 h, whereas that of CLP14 was ineffective. Intravenous injection every other day and continuous infusion by osmotic minipump with CLP16 maintained higher plasma triacylglycerol concentration for 5 d than that of the control group and extensively reduced LPL activity in adipose tissues and abdominal fat pad weight. Lipoprotein lipase mRNA and protein levels in adipose tissue were not modified by chronic administration of anti-LPL antibody. The results indicate that chronic administration of anti-LPL antibodies is effective in retarding fatness in broiler chickens, and the antibodies are a proper subject for studies of lipoprotein metabolism.

Left ventricular systolic and diastolic performance was examined using Doppler and M-mode echocardiography in 42 patients with chronic renal failure before and after hemodialysis. Twenty patients with left ventricular hypertrophy, 22 without hypertrophy and 30 normal subjects were studied. Chronic renal failure patients showed significantly larger chamber diameters of the left ventricle, left atrium and right ventricle than did normal subjects. This group also exhibited greater fractional shortening, stroke volume and cardiac output. Before hemodialysis, patients with left ventricular hypertrophy had a significantly higher cardiac output and the greater ratio of late to early diastolic peak flow velocities (A/R) than did patients without hypertrophy. After hemodialysis, there were significant reductions in blood pressure, ventricular and atrial dimensions, stroke volume and cardiac output. The velocities of early and late diastolic left ventricular filling and the deceleration rate were also significantly reduced. The heart rate, A/R, deceleration half time, and the ratio of deceleration half time to acceleration half time (DHT/AHT) were significantly increased. The greater the amount of fluid removed, the greater the changes in the above values. Patients with left ventricular hypertrophy exhibited significant reductions in fractional shortening, ejection fraction, stroke volume and cardiac output, compared to those without hypertrophy. However, patients without hypertrophy showed more significant decrease in the acceleration half time and increase in DHT/AHT than did patients with hypertrophy. These findings demonstrated normal systolic function and impaired diastolic properties in patients with chronic renal failure, who had left ventricular hypertrophy unaccompanied by dilatation.