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Improving daily-life habits is considered to be effective in treating obesity. We have examined obesity in regular physical examinations in university students since 1974. In this study, the subjects were 199 students regarded as obese (Broca's index: more than 120%) and 326 non-obese students randomly selected (525 subjects in total) among students who underwent regular physical examinations at Nagoya University, Japan, between 1974 and 1978. Here we report our follow-up survey of obese university students and non-obese individuals who were students of the same university during the same period. This study was carried out for the purpose of clarifying the relationship between changes in lifestyle and body weight 20 years after graduation. Concerning eating behavior, a higher proportion of subjects cared diet intake in the current non-obese group than in the current obese group (P<0.05). The metal-time in the obese was shorter than that in the non-obese group(P<0.01). Ten percent of subjects in the obese group and 24.4% of subjects in the non-obese group selected class II (moderate) or higher as indicative of the intensity of their daily physical activity. There was a significant difference in distribution between the groups (P<0.05). In the group showing improvement in obesity over time, a higher proportion of subjects cared about diet intake than in the group with continued obesity (P<0.05). Concerning intensity of physical activity, 11.8% of subjects in the group with continued obesity selected class II (moderate) or higher, while 45.5% of subjects in the group showing improvement in obesity chose class II (moderate) or higher. A significant difference in distribution existed between the groups(P<0.01). These findings suggest that the eating... [ABSTRACT FROM AUTHOR]

Advanced glycation end products (AGEs) and their receptor (RAGE) have been shown to play a role in insulin resistance. We have previously shown that combination therapy with nateglinide (NAT) and telmisartan (TEL) improves postprandial metabolic derangements in Zucker fatty (ZF) rats, an animal model of insulin resistance with obesity. However, effects of combination therapy on insulin resistance remain unknown. We investigated here whether combination therapy with TEL and NAT could ameliorate insulin resistance in ZF rats by suppressing AGE-RAGE axis. NAT and / or TEL inhibited insulin receptor substrate-1 (IRS-1) serine phosphorylations at 307 and 636 / 639 residues in the liver of ZF rats. Further, combination therapy with NAT and TEL, but not each monotherapy alone, significantly restored the decrease in hepatic IRS-1 tyrosine phosphorylation in these animals. In addition, serum levels of AGEs, RAGE expression levels in the liver and hepatic AGE-RAGE index were decreased in NAT plus TEL-treated ZF rats. The present study suggests that combination therapy with NAT and TEL could ameliorate insulin resistance in ZF rats by suppressing the AGE-RAGE axis in the liver. [ABSTRACT FROM AUTHOR]

Background/aims: The prevalence of inflammatory bowel disease (IBD) in Japan has been increasing. We aimed to clarify the symptoms of patients with IBD in Japan using an internet-based questionnaire survey., Methods: Overall, 805 patients with IBD were asked to complete an internet-based questionnaire addressing their history of disturbances in daily activities, prevalence of fecal urgency, incontinence, and treatment preferences., Results: Responses were obtained from 447 patients with IBD (mean age: 54 years; 70% were men), comprising 363 patients with ulcerative colitis (UC), and 84 with Crohn's disease (CD). Notably, 16% of patients with UC and 35% with CD took over 1 year until the diagnosis of IBD, and 5% of patients with CD visited more than 5 medical institutions. Patients with CD were more likely to experience disturbances in their diet, work, travel, and outings than those with UC. Fecal urgency and incontinence were significantly more frequent in patients with CD than in those with UC (72% vs. 44%, and 50% vs. 26%, respectively). In contrast, 26% of the men and 37% of women with IBD had constipation. Acid reflux, sleep disorders, and depressive symptoms were present in approximately 30% of the patients. Oral administration was preferred., Conclusions: Patients with IBD in Japan experience more severe disturbances in their daily activities, and these are more severe in those with CD than those with UC. In addition to fecal urgency and incontinence, care is required for constipation, acid reflux, sleep disorders, and depressive symptoms., Competing Interests: T.M.: Lecture fee and consultant fee; EA Pharma Co., Ltd. K.I., Y.G., Y.F., T.K., H.K., Y.F., S.I., and M.U.: EA Pharma Co. Ltd., (© The Author(s) 2023. Published by Oxford University Press on behalf of Crohn's & Colitis Foundation.)

Background: AJM300 is an oral, small-molecule α4-integrin antagonist. We assessed the efficacy and safety of AJM300 in patients with moderately active ulcerative colitis., Methods: This multicentre, randomised, double-blind, placebo-controlled, phase 3 study consisted of two phases: a treatment phase and an open-label re-treatment phase. The study was done at 82 hospitals and clinics in Japan. Patients with a Mayo Clinic score of 6-10, endoscopic subscore of 2 or more, rectal bleeding subscore of 1 or more, and an inadequate response or intolerance to mesalazine were enrolled. Patients were randomly allocated (1:1) via a website to either AJM300 (960 mg) or placebo by the minimisation method, which was adjusted centrally by dynamic assignment against the Mayo Clinic score (≥6 to ≤7, ≥8 to ≤10 points), any use of corticosteroid, anti-TNFα antibody, or immunosuppressants during the disease-active period (yes vs no), duration of induction therapy until randomisation (<4 weeks vs ≥4 weeks) as the minimisation factors. Patients, investigators, site staff, assessors, and the sponsor were masked to treatment assignments. The study drug was administered orally, three times daily, for 8 weeks, and continued for up to 24 weeks if endoscopic remission was not achieved or rectal bleeding did not stop. The primary endpoint was the proportion of patients with a clinical response at week 8, and was analysed in the full analysis set. Clinical response was defined as a reduction in Mayo Clinic score of 30% or more and 3 or more, a reduction in rectal bleeding score of 1 or more or rectal bleeding subscore of 1 or less, and an endoscopic subscore of 1 or less at week 8. The study is registered with ClinicalTrials.gov, NCT03531892, and is closed to recruitment., Findings: Between June 6, 2018, and July 22, 2020, 203 patients were randomly assigned to AJM300 (n=102) or placebo (n=101). At week 8, 46 (45%) patients in the AJM300 group and 21 (21%) patients in the placebo group had a clinical response (odds ratio 3·30, 95% CI 1·73-6·29; p=0·00028). During the 8-week treatment and 16-week extension treatment periods, adverse events occurred in 39 (39%) of 101 patients in the placebo group and 39 (38%) of 102 patients in the AJM300 group. We found no difference in the incidence of adverse events between groups or after repeated administration of AJM300. The most common adverse event was nasopharyngitis (11 [11%] of 101 patients in the placebo group and ten [10%] of 102 patients in the AJM300 group). The most common treatment-related adverse event was also nasopharyngitis (four [4%] of 101 patients in the placebo group and three [3%] of 102 patients in the AJM300 group). Most adverse events were mild-to-moderate in severity. No deaths were reported. A serious adverse event was reported in the AJM300 group (one patient with anal abscess), but this was judged to be unrelated to study drug., Interpretation: AJM300 was well tolerated and induced a clinical response in patients with moderately active ulcerative colitis who had an inadequate response or intolerance to mesalazine. AJM300 could be a novel induction therapy for the treatment of patients with moderately active ulcerative colitis., Funding: EA Pharma and Kissei Pharmaceutical., Translation: For the Japanese translation of the abstract see Supplementary Materials section., Competing Interests: Declaration of interests KM has received research support and lecture or consulting fees from AbbVie, EA Pharma, Mitsubishi Tanabe, Mochida, Kyorin, Kissei, JIMRO, Janssen, Pfizer, Takeda, Zeria, Gilead Sciences, Miyarisan, Nippon Kayaku, Celltrion, Eli Lilly, Bristol-Myers Squibb, and Boehringer Ingelheim. MW has received research support and lecture or consulting fees from AbbVie, EA Pharma, Mitsubishi Tanabe, Mochida, Kyorin, Kissei, JIMRO, Janssen, Pfizer, Takeda, Zeria, Gilead Sciences, Miyarisan, Nippon Kayaku, Celltrion, and Eli Lilly. TO has received research support and lecture or consulting fees from Mochida, Janssen, Mitsubishi Tanabe, Takeda, Daiichi Sankyo, Otsuka, Tsumura, Olympus Corporation, JIMRO, and Kyorin. FH has received research support and lecture or consulting fees from AbbVie, EA Pharma, Janssen, Mochida, Mitsubishi Tanabe, Takeda, AYUMI, Eisai, Otsuka, and Kissei. KW has received research support and lecture or consulting fees from Mitsubishi Tanabe, Takeda, AbbVie, EA Pharma, Kissei, Pfizer, Kyorin, Mochida, Zeria, JIMRO, Nippon Kayaku, Janssen, GlaxoSmithKline, Olympus, Sandoz, Helmsley Charitable Trust, and EP CRSU. HM has received research support and lecture or consulting fees from EA Pharma. SK has received research support and lecture or consulting fees from EA Pharma. AO and TK are employees of EA Pharma. TH has received research support and lecture or consulting fees from Aspen, EA Pharma, AbbVie, JIMRO, Zeria, Mitsubishi Tanabe, Janssen, Mochida, Takeda, Gilead Sciences, Celltrion, Ferring, Eli Lilly, Pfizer, Nichi-Iko, Bristol-Myers Squibb, and Apo Plus Station. All other authors declare no competing interests., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Background and Objectives: Carotegrast methyl, a novel prodrug, oral antagonist of α4-integrin, is in development for the treatment of active ulcerative colitis. This randomised, placebo-controlled, double-blind, crossover study evaluated the effect of food on the pharmacokinetics and pharmacodynamics as well as the safety profile after a single dose of carotegrast methyl in healthy male subjects., Methods: Subjects were randomised to receive a single dose of carotegrast methyl (240, 480 or 960 mg) or placebo in a 6:2 ratio and received the study drug under both fed and fasted conditions separated by an 8-day washout. The pharmacokinetic profiles of carotegrast methyl and its active metabolite, carotegrast, were assessed. The pharmacodynamic profile was evaluated according to a change in the peripheral lymphocyte count. Safety was monitored throughout., Results: Based on the area under the time curve from zero to the time of the last quantifiable concentration (AUC last ), food reduced systemic exposure to both carotegrast methyl and carotegrast by 21-57% and 5-29%, respectively. The fed-to-fasted ratio of least square means for the increase in the lymphocyte count was almost at unity in each dose, indicating no food effect on pharmacodynamics. The time  ≥ 90% of maximum effect was prolonged dose dependently, suggesting that a 960 mg-dose can provide a long-lasting effect. Reported adverse events were all mild., Conclusions: Despite the reduced systemic exposure to both carotegrast methyl and carotegrast, food had no effect on the increase in lymphocyte count. A single administration of carotegrast methyl up to 960 mg was found to be safe.

Aims: AJM300 is an oral antagonist of α4-integrin that reduces inflammation by blocking leucocyte trafficking. This study aimed to investigate safety, tolerability, pharmacokinetics and pharmacodynamics of AJM300 in healthy male subjects., Methods: A total of 23 subjects were randomised to receive 240 mg (n = 6), 480 mg (n = 5), 960 mg (n = 6) of AJM300 or the corresponding placebo (n = 2 per group). The study drugs were taken orally 3 times daily after each meal on the first day followed by a 4-day washout period. Thereafter, multiple-dose administration was conducted for 6 consecutive days. The pharmacokinetic parameters of AJM300 and its active metabolite (HCA2969) were assessed, and total white blood cells and the differential cell count were used to determine the pharmacodynamic effects. Adverse events (AEs) were also monitored., Results: The plasma AJM300 and HCA2969 concentration-time curves displayed a triphasic pattern on Day 1 (single-day administration) and Day 10 (last day of multiple dosing), whereas the concentration of HCA2969 was much higher than that of AJM300. A significant but transient increase in lymphocyte count was observed after AJM300 dosing at all dosages tested compared with the placebo. The increase was sustained over a 24-h period only at the 960-mg dosage. In particular, a significant increase in the lymphocyte count compared to placebo (mean, 50.58%; 95% confidence intervals, 20.40-80.76) was observed at the first 960-mg dose on Day 10. Six (26.1%) subjects reported ≥1 AEs, all of which were mild and resolved spontaneously., Conclusion: The maximal and 24-h sustained pharmacodynamic effects were demonstrated at the 960-mg dosage after oral administration of AJM300 3 times daily for 6 days, which was also found to be safe and well tolerated., (© 2019 The Authors. British Journal of Clinical Pharmacology published by John Wiley & Sons Ltd on behalf of British Pharmacological Society.)

Obese people may succeed in reducing their weight temporarily, but most of them regain the lost weight within a few years. We, therefore, recommend moderate long-term changes in habit rather than a strict temporary program. The purpose of this study was to examine whether physical activity of 40 minutes, mainly walking, was effective in improving or preventing metabolic syndrome when combined with dieting. Participants, all of whom had a waist circumference >or= 85 cm (men) or >or= 90 cm (women), were assigned into one of two groups: the control group (10 men and 11 women, age: 64.2 +/- 3.4 [SD] years) and the intervention group (10 men and 12 women, age: 62.4 +/- 4.2 years). Participants (n = 22) enrolled in a 52-week program; their diets were assessed using a 3-day dietary record and daily steps were measured with a pedometer. No significant change was seen in their dietary records, but the mean number of daily steps increased from 5,806 to 8,000-9,000. In the intervention group, BMI, waist circumference, and systolic and diastolic blood pressures decreased significantly by week 12 (all p < 0.001) and remained low until week 52. In fact, no significant change was seen between weeks 12 and 52. The control group showed no significant changes in all variables. These results indicate that gentle exercise of about 40 minutes in combination with dieting is effective in preventing metabolic syndrome among a sedentary population, although its effect may be limited.

Recently, many cross-sectional studies observed that body mass index (BMI) and percentage of body fat (%BF) were inversely associated with pedometer-determined physical activities, but studies on Asian populations, including the Japanese, are sparse. Height, weight, body fat percentage (%BF, bioelectrical impedance analyzer), and waist circumference were measured on 117 women (62.8+/-4.5 years, 22.2+/-2.2 kg/m(2)) and 62 men (64.0+/-4.6 years, 23.6+/-2.5 kg/m(2)). Pearson correlations and partial correlation coefficients after controlling for age were calculated between steps/day and variables. Furthermore, participants were classified into four groups as follows: <5,000, 5,000-7,499, 7,500-9,999, and >or=10,000 steps/day, and analyzed using ANOVA across activity groups. In women, a significant correlation was found between steps/day and BMI (r=-0.217, p=0.018), %BF (r=-0.292, p=0.0014), and the relationship was still significant after controlling for age. The relationship between steps/day and waist circumference was not significant. In men, a significant relationship was not observed between steps/day and obesity indices. The correlations between steps/day and both BMI and %BF were significant in Japanese women, but weak compared with Caucasian and African-American women as reported previously. A possible cause is racial difference in degree of obesity and body shape. The effects of physical activity on body shape and composition may differ according to race.

Dyslipidemia and fatty liver are important components of the metabolic syndrome and are the factors most commonly associated with the development of nonalcoholic fatty liver disease. Delayed and excessive insulin secretion in response to food intake is a key element in the onset of these risk factors. Nateglinide (NAT) is known to restore early-phase insulin secretion. We assessed the effect of NAT on postprandial hypertriglyceridemia and fatty liver in type 2 diabetic Goto-Kakizaki (GK) rats. The GK rats fed a high-fat diet containing 30% beef tallow twice a day were administered either the vehicle alone or NAT (50 mg/kg) before each meal for 12 weeks. Delayed insulin secretion and an increase of total insulin release were caused by feeding 30% beef tallow to the rats. This diet also induced postprandial hypertriglyceridemia and increased the hepatic triglyceride content. Treatment with NAT restored early-phase insulin secretion without any increase of total insulin release and also reduced postprandial hypertriglyceridemia and the hepatic triglyceride content. There was up-regulation of the hepatic expression of peroxisome proliferators-activated receptor alpha and its downstream enzymes after 12 weeks of NAT treatment, as well as normalization of the plasma total ketone body level. Furthermore, NAT also up-regulated hepatic expression of the adiponectin receptor AdipoR2, although there was no effect on the plasma adiponectin level. These findings indicate that long-term treatment with NAT prevented the development of fatty liver through the up-regulation of hepatic lipid oxidation pathways. Restoration of early-phase insulin secretion and suppression of recurrent postprandial hypertriglyceridemia might be involved in these effects of NAT. The present results may support the use of NAT to prevent the onset and progression of the metabolic syndrome and chronic liver disease.

This study examined the effect of a 12-week non-instrumental resistance training program using body weight as a load (RT-BW) on body composition, fat distribution and metabolic profiles in elderly males and females. Healthy, non-diabetic, elderly volunteers (22 males and 30 females) aged 65-82 years were non-randomly divided into RT-BW (12 males and 20 females) and control (10 males and 10 females) groups. The RT-BW subjects were trained three times per week for 12 weeks according to a specified protocol involving a combination of upper and lower body weight and rubber tubing exercises. We evaluated body composition and fat distribution using anthropometry, dual energy X-ray absorptiometry and ultrasonography, and measured serum lipid levels and HbA(1c) at baseline and after 12 weeks of training. Changes over 12 weeks were significantly greater in the RT-BW group compared with the control group, with a decrease in waist circumference, pre-peritoneal (visceral) fat thickness and thigh fat thickness, and an increase in thigh muscle thickness. On the other hand, the changes in body weight, fat mass and fat free mass were no different between the groups. Further, there were significantly greater changes of metabolic profiles in the RT-BW group with an increase in HDL cholesterol and a decrease in triglyceride and HbA(1c). There was a significant between-group difference in diastolic blood pressure. Relatively short-term, non-instrumental resistance training using body weight as a load was effective in improving fat distribution and metabolic profiles in healthy elderly people without weight loss.

Bioelectrical impedance analysis (BIA) is commonly used to measure the percentage of body fat (%BF), but its accuracy is controversial. In addition, the equations are specific to the group for which they were established. As far as we know, there is no study examining the accuracy of BIA in Japanese middle-aged and older people. We compared %BF assessed using BIA with that of dual-energy X-ray absorptiometry (DEXA) in 102 female and 51 male local residents aged 40 to 78 y. Simple correlation coefficients were 0.79 for females and 0.69 for males, which are statistically significant (p<0.001). However, BIA tended to overestimate %BF in the lower BF group and underestimate it in the BF higher group, and only 45.1% for female and 47.1% for male subjects were measured accurately, i.e., within 10% of the measurement by DEXA. This result suggests that this model of BIA is an alternative for estimating %BF in Japanese middle-aged and older people as well as when subjects are within a normal body fat range, but greater accuracy is needed for lean and overweight subjects.

In Alzheimer disease (AD), the microtubule-associated protein tau is found hyperphosphorylated in paired helical filaments. Among many phosphorylated sites in tau, Ser-262 is the major site for abnormal phosphorylation of tau in AD brain. The kinase known to phosphorylate this particular site is MARK2, whose activation mechanism is yet to be studied. Our first finding that treatment of cells with LiCl, a selective inhibitor of another major tau kinase, glycogen synthase kinase-3beta (GSK-3beta), inhibits phosphorylation of Ser-262 of tau led us to investigate the possible involvement of GSK-3beta in MARK2 activation. In vitro kinase reaction revealed that recombinant GSK-3beta indeed phosphorylates MARK2, whereas it failed to phosphorylate Ser-262 of tau. Our further findings led us to conclude that GSK-3beta phosphorylates MARK2 on Ser-212, one of the two reported phosphorylation sites (Thr-208 and Ser-212) found in the activation loop of MARK2. Down-regulation of either GSK-3beta or MARK2 by small interfering RNAs suppressed the level of phosphorylation on Ser-262. These results, respectively, indicated that GSK-3beta is responsible for phosphorylating Ser-262 of tau through phosphorylation and activation of MARK2 and that the phosphorylation of tau at this particular site is predominantly mediated by a GSK-3beta-MARK2 pathway. These findings are of interest in the context of the pathogenesis of AD.

The objective of the present study was to determine anti-proteinuric effect of an N-type calcium channel blocker-cilnidipine. Subjects were 43 essential or renal hypertensive subjects who had been taking calcium channel blockers other than cilnidipine for at least 6 months. All patients had proteinuria greater than 0.2 g/day in spite of fair blood pressure control (<150/90 mmHg). Calcium channel blockers in 25 patients (62+/-3 years) were switched to cilnidipine (cilnidipine group), whereas other 18 patients (58+/-3 years) continued to take originally prescribed calcium channel blockers (control group). The 24-hr urine collections were done at baseline and after 6 months of the follow-up period. Baseline characteristics including age, blood pressure levels, body mass index and creatinine clearance were similar between cilnidipine and control groups. Urinary protein excretion also was comparable between cilnidipine (0.61+/-0.10 g/day) and control (0.86+/-0.17 g/day) groups. Urinary protein significantly decreased after 6 months in cilnidipine group (- 0.21+/- 0.11 g/day, - 36%, p< 0.01), whereas it did not change in control group (+ 0.01+/- 0.15 g/day, 0.4%, ns). There were no significant changes in blood pressure, serum creatinine, creatinine clearance, estimated protein intake, and urinary salt excretion during the follow-up period in either group. The reduction of urinary protein by cilnidipine was evident in essential hypertensives (- 54+/-9%, n=18, p<0.01) but not in renal hypertensives (+10+/-35%, n=7, ns). Results suggest that cilnidipine has an anti-proteinuric effect especially in patients with essential hypertension.

A 24-h home urine collection was conducted to estimate accurate salt intake in hypertensive outpatients. Using 24-h urinary creatinine excretion as a criterion for success, urine samples were obtained from 534 hypertensive patients. The urinary salt excretion of hypertensive outpatients ranged widely from 1.5 to 23.4 g/day (mean value 9.7 +/- 3.9 g/day). Urinary salt excretion was higher in males than in females (10.6 +/- 4.0 vs. 9.2 +/- 3.7 g/day, p<0.01). Based on the questionnaires, the patients were divided into salt-conscious patients, or those who were careful to reduce their daily salt intake, and non-salt-conscious patients. It was found that urinary salt excretion was lower in the salt-conscious group than in the non-salt-conscious group (9.4 +/- 3.8 vs. 10.6 +/- 4.0 g/day, p<0.01), but that urinary salt excretion adjusted for body weight was not significantly different between the two groups (0.16 +/- 0.06 vs. 0.17 +/- 0.07 g/kg/day). Our results suggest that there was no obvious reduction in the actual salt intake in salt-conscious patients, suggesting the importance of monitoring salt intake by 24-h home urine collection and informing patients of their actual salt intake as a means of encouraging the achievement of salt restriction.

We report here a unique case of recurrent malignant hypertension after the removal of an adrenal tumor for primary aldosteronism. The patient had a history of hypertension for 15 years. In 1995, he developed drug-resistant hypertension with hyperreninemia, hyperaldosteronemia and hypokalemia. He was diagnosed as having primary aldosteronism with a right adrenal tumor. His blood pressure did not normalize and renal dysfunction continued after the adrenalectomy. Although antihypertensive treatment was continued for residual hypertension, he soon refused medication. In 1997, he developed recurrent malignant hypertension. It was considered that the different underlying mechanisms might be attributable to the two episodes of malignant hypertension in this patient.

This study investigated the effects of intentional weight cycling in non-obese, young women (n = 5; mean age, 24.6 years; mean body mass index [BMI], 20.5 kg/m(2)). During the first 30 days, the subjects lost more than 4 kg with energy restriction alone (first diet period). In the following 14 days, they regained more than the weight they had lost by eating ad libitum (free-living period). In the subsequent 30 days, they once again lost more than 4 kg with only energy restriction (second diet period). Height, weight, waist and hip circumferences, body composition, lipid profiles, thyroid hormones, systolic and diastolic blood pressures (SBP, DBP), and resting energy expenditure (REE) were examined. Measurements were taken at the beginning of the study (day 0), at the end of each diet period (day 30 and day 74), the end of the free-living period (day 44), and on day 180. The mean change in each variable from baseline (day 0) was used and controlled for the baseline value, baseline weight, and change in weight (Delta weight). Statistical tests were performed to determine the significance of the mean changes in the variables. By day 180, there were significant decreases in the subjects' lean body mass (P <.01), serum triiodothyronine (T(3)) (P <.001), serum total thyroxine (T(4)) (P <.001), and REE (P <.001), and significant elevations of SBP (P <.05) and DBP (P <.001). The lipid profiles had not changed except for increased triglycerides (TG). These results suggest that weight cycling through energy restriction alone may have negative health consequences in non-obese, young women., (Copyright 2002 by W.B. Saunders Company)

14π-Electrocyclization across the two pentafulvenoid moieties of pentafulvene 1 occurs upon heating to provide dicyclopenta[a,d]cyclooctene 2 [Eq. (1)]. The nonalternant hydrocarbon 2 shows diatropic character and a distinctive absorption spectrum with the longest wavelength maximum at 767 nm., (© 2001 WILEY-VCH Verlag GmbH, Weinheim, Fed. Rep. of Germany.)

We report here a unique case of renovascular hypertension(RVH) showing spontaneously normalized blood pressure(BP) after progression of a stenosis of the renal arteries for 16 years. The patient was a 41-year-old man. At the age of 25, he developed drug-resistant hypertension with hypokalemia, hyperreninemia and severe stenosis of the right renal artery, and was diagnosed with RVH. He soon discontinued medication without medical advice. At age 40, he developed pons infarction and his aortography showed progression of the stenosis to the bilateral renal arteries. However, his BP along with the levels of plasma potassium and renin activity were normalized and his renal function was preserved. Renal scintigraphy revealed a significant size difference between the bilateral kidneys. We assume that the hypotrophic changes in the ischemic kidneys counterbalanced the reduction in renal blood flow.

The effect of daily walking on body fat distribution was investigated using an electronic pedometer and ultrasonography. Subjects were 77 women, aged 31 to 72 years. They were divided into four groups according to the average number of steps they walked per day (I<7,500, 7,500 ≤II<10,000, 10,000

The spectral power of heart rate variability has been shown to be negatively correlated with left ventricular mass (LVM), suggesting the contribution of left ventricular hypertrophy to autonomic dysfunction in essential hypertension. However, a simultaneous assessment of autonomic function and ambulatory blood pressure in relation to LVM has not been carried out. The objective of the present study was to elucidate the synergistic effects of ambulatory blood pressure and autonomic nerve activity on the heart. We enrolled 25 ambulant patients with untreated essential hypertension (9 men and 16 women; mean age 50.6 +/- 2.0 years). The ambulatory blood pressure and heart rate variability were simultaneously monitored every 30 min for 24 h. The spectral power of high-frequency (HF: 0.15 to 0.4 Hz) and low-frequency (LF: 0.05 to 0.15 Hz) bands were measured, and the ratio of LF to HF (LF/HF) was calculated. LF/HF and HF were used as indexes of sympathetic and parasympathetic activities, respectively. LVM was determined by echocardiography. Both the average daytime and nighttime systolic ambulatory blood pressures significantly correlated with the LVM index (r= 0.644, p< 0.001; and r= 0.428, p< 0.05; respectively), although there was no such correlation with the clinic blood pressures. In contrast, a single reading of ambulatory systolic blood pressure measured when LF/HF reached a maximum value was significantly correlated with the LVM index independently of age and sex (partial r= 0.484, p< 0.05). These results suggest that the ambulatory systolic blood pressure during increases in the activity of the sympathetic nervous system is able to infer LVM in essential hypertension.