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[A case of interstitial pneumonitis with hemoptysis, BOOP (bronchiolitis obliterans organizing pneumonia) pattern, granulomas and foreign body giant cells in lung biopsy].

A 66-year-old male presented to our hospital in January 1990 with chief complaints of hemoptysis and cough. These symptoms had developed 10 months previously and had gradually increased. Fine crepitations were audible over the right lower lung field. There were no results suggesting an inflammatory process such as leucocytosis, elevation of ESR or positive CRP reaction. Chest X-ray film on the first visit showed fine nodular shadows in the right lower lung field, and chest CT revealed fine nodular shadows and mild dilatation of the right lower lobe bronchus. Transbronchial lung biopsy specimens showed granulomas with multinucleated giant cells, alveolitis and Masson bodies. The open lung biopsy specimens showed numerous macrophages and foreign body giant cells, and extensive organizing exudates in the bronchioles and alveolar spaces. Proliferation of smooth muscle and fibrosis around the dilated bronchioles were also seen. Thus, this patient demonstrated BOOP pattern, with granulomas and foreign body giant cells. His hemoptysis appeared to have resulted from inflammation of dilated bronchioles. His symptoms and abnormal shadows on chest X-ray improved without any therapy after admission. After treatment with corticosteroid, the diffuse fine nodular shadows disappeared. There has been no recurrence of symptoms to date, although this patient has continued living in the same environment as prior to admission. BAL findings during his prolonged follow-up revealed decrease in lymphocytes and elevation of CD4/CD8 ratio. Although the presence of granulomas suggests the possibility of an allergic reaction, no antigenic material could be identified in this case.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

Hemodialysis disrupts basic sleep regulatory mechanisms: building hypotheses.

BACKGROUND: The proposition that hemodialysis may induce alterations in the sleep-wake cycle is based on two clinical observations: (a) Patients on dialysis frequently sleep during and after dialysis, and (b) the procedure often is associated with temperature elevations. A review of pertinent literature showed that sleepiness and temperature are physiologically related, and that these two variables are important indicators of sleep and circadian regulatory processes. OBJECTIVES: To describe possible associations among hemodialysis, body temperature, and sleepiness; to assist in building hypotheses; and to provide direction for future research. METHODS: Three exploratory studies were performed to investigate (a) dialysis-associated elevations in body temperature, (b) changes in body temperature patterns across the day, and (c) alterations in daytime sleepiness. RESULTS: The current study demonstrated that many patients manifest dialysis-associated episodic elevations of body temperature, changes in the circadian pattern of body temperature, and increases in daytime sleep propensity. In the context of the Two-Process Model of Sleep Regulation, these alterations provide a parsimonious explanation for the poor subjective sleep quality, prolonged sleep latency, and daytime sleepiness reported by these patients. CONCLUSIONS: These preliminary studies lead to the suggestion that hemodialysis may disrupt basic sleep regulatory mechanisms, and that further investigation in this area is warranted.

Adult↗

Identification of functioning sweat pores and visualization of skin temperature patterns in X-linked hypohidrotic ectodermal dysplasia by whole body thermography.

In this preliminary study, non-invasive infrared thermography has been used to visualize individual sweat pores and whole body skin temperature patterns in subjects with X-linked hypohidrotic ectodermal dysplasia (XHED) and normal controls. The findings in eight obligate heterozygotes and four affected males were compared to six normal female controls and to six non-manifesting females at risk for carrier status. Sweat secretion from individual pores in circumscribed areas was imaged using a high spatial resolution SPRITE infrared detector system working in the 8-14 microns band. In seven out of eight obligate heterozygotes, skin areas devoid of active sweat glands were found on the face, the hands or the trunk. Tear front movement over the cornea was also visualized and abnormal patterns were identified in obligate heterozygotes. Whole body skin temperature patterns, obtained with an Agema 780 Medical Thermovision system, identified abnormal skin temperature distributions, including characteristic aberrant "cascade" back patterns, in obligate carriers. Two out of six "at risk" females had skin temperature patterns comparable with obligate heterozygotes and we have tentatively concluded that they are carriers. Thermal imaging may be used for the examination of "at risk" non-manifesting females in families with a single affected male. The results of this study suggest that the random X-inactivation in females with XHED, as well as producing relatively large skin areas with sweat pore aplasia, is also associated with abnormal temperature patterns that are consistent with altered peripheral vascular perfusion.

Adolescent↗

Dietary patterns and changes in body mass index and waist circumference in adults.

BACKGROUND: Obesity has increased > 20% in the past decade in the United States, and more than one-half of US adults are overweight or obese. OBJECTIVE: Our objective was to further elucidate the nutritional etiology of changes in body mass index (BMI; in kg/m(2)) and waist circumference by dietary intake pattern. We hypothesized that a healthy dietary pattern would lead to smaller changes in BMI and waist circumference than would other dietary patterns. DESIGN: Subjects were 459 healthy men and women participating in the ongoing Baltimore Longitudinal Study of Aging. Diet was assessed with the use of 7-d dietary records, from which 41 food groups were created and entered into a cluster analysis. RESULTS: Five dietary patterns were derived (healthy, white bread, alcohol, sweets, and meat and potatoes). The mean annual change in BMI was 0.30 +/- 0.06 for subjects in the meat-and-potatoes cluster and 0.05 +/- 0.06 for those in the healthy cluster (P < 0.01). The mean annual change in waist circumference was more than 3 times as great for subjects in the white-bread cluster (1.32 +/- 0.29 cm) as for those in the healthy cluster (0.43 +/- 0.27 cm) (P < 0.05). CONCLUSIONS: Consuming a diet high in fruit, vegetables, reduced-fat dairy, and whole grains and low in red and processed meat, fast food, and soda was associated with smaller gains in BMI and waist circumference. Because foods are not consumed in isolation, dietary pattern research based on natural eating behavior may be useful in understanding dietary causes of obesity and in helping individuals trying to control their weight.

Adult↗

Fecundability in relation to body mass and menstrual cycle patterns.

Few studies have investigated the association between body mass index and fecundability, that is, the ability to conceive in a menstrual cycle, among fertile women with normal menstrual cycle pattern. We examined the independent and combined effects of duration and regularity of the menstrual cycle, body mass index, and fecundability from records on pregnant women attending antenatal care at Odense University Hospital, Denmark, between 1972 and 1987. We included only the first birth of each woman who had planned pregnancies and no pre-pregnancy disease (N = 10,903). We estimated the fecundability odds ratio (FR) as the odds of conception in a menstrual cycle. After adjusting for confounders, the fecundability for women with a body mass index >25 kg/m2 was lower than for women with a body mass index of 20-25 kg/m2 [FR = 0.77; 95% confidence interval (CI) = 0.70-0.84]. FR was lower for women with long (>35 days) (FR = 0.74; 95% CI = 0.63-0.87) or irregular cycles (FR = 0.78; 95% CI = 0.70-0.87), even when their body mass index was within the normal range (20-25 kg/m2) and/or their cycles were regular.

Body Mass Index↗

Body density affects stroke patterns in Baikal seals.

Buoyancy is one of the primary external forces acting on air-breathing divers and it can affect their swimming energetics. Because the body composition of marine mammals (i.e. the relative amounts of lower-density lipid and higher-density lean tissue) varies individually and seasonally, their buoyancy also fluctuates widely, and individuals would be expected to adjust their stroke patterns during dives accordingly. To test this prediction, we attached acceleration data loggers to four free-ranging Baikal seals Phoca sibirica in Lake Baikal and monitored flipper stroking activity as well as swimming speed, depth and inclination of the body axis (pitch). In addition to the logger, one seal (Individual 4) was equipped with a lead weight that was jettisoned after a predetermined time period so that we had a set of observations on the same individual with different body densities. These four data sets revealed the general diving patterns of Baikal seals and also provided direct insights into the influence of buoyancy on these patterns. Seals repeatedly performed dives of a mean duration of 7.0 min (max. 15.4 min), interrupted by a mean surface duration of 1.2 min. Dive depths were 66 m on average, but varied substantially, with a maximum depth of 324 m. The seals showed different stroke patterns among individuals; some seals stroked at lower rates during descent than ascent, while the others had higher stroke rates during descent than ascent. When the lead weight was detached from Individual 4, the seal increased its stroke rate in descent by shifting swimming mode from prolonged glides to more stroke-and-glide swimming, and decreased its stroke rate in ascent by shifting from continuous stroking to stroke-and-glide swimming. We conclude that seals adopt different stroke patterns according to their individual buoyancies. We also demonstrate that the terminal speed reached by Individual 4 during prolonged glide in descent depended on its total buoyancy and pitch, with higher speeds reached in the weighted condition and at steeper pitch. A simple physical model allowed us to estimate the body density of the seal from the speed and pitch (1,027-1,046 kg m(-3), roughly corresponding to 32-41% lipid content, for the weighted condition; 1,014-1,022 kg m(-3), 43-47% lipid content, for the unweighted condition).

Acceleration↗

Body composition characteristics and fat distribution patterns in young infertile women.

OBJECTIVE: To document body composition and fat patterning characteristics in normal and underweight infertile women. DESIGN: Status quo method. SETTING: University clinics. PATIENT(S): Fifteen amenorrheic women with anorexia nervosa, 16 women with polycystic ovary syndrome (PCO2), 10 women with primary amenorrhea and 19 healthy controls. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Determination of body mass index, body composition parameters such as fat mass, lean body mass, bone mass using dual-energy x-ray absorptiometry (DEXA), fat distribution patterns, 17beta-estradiol, FSH, LH, prolactin, progesterone, testosterone, DHEA-S, and androstenedione levels. RESULT(S): A statistically significant difference was found comparing all proband groups with healthy controls for the majority of body fat and bone mineral content parameters but not for lean body mass. Infertile women of normal weight, with PCOS, and with primary amenorrhea exhibited an extraordinarily high amount of fat tissue and a tendency toward android fat patterning. In contrast, patients with anorexia nervosa and the healthy controls showed predominantly gynoid fat patterning. According to logistic regression analyses, anorexia nervosa was characterized by reduced fat tissue and PCOS was characterized by android fat patterning and an increased fat percentage. Patients with primary amenorrhea were characterized by reduced bone mass. CONCLUSION(S): Infertile young women showed characteristic differences in body composition and fat distribution patterns when compared with healthy, fertile, age-matched counterparts.

Adipose Tissue↗

Teleost Hox code defines regional identities competent for the formation of dorsal and anal fins.

The dorsal and anal fins can vary widely in position and length along the anterior-posterior axis in teleost fishes. However, the molecular mechanisms underlying the diversification of these fins remain unknown. Here, we used genetic approaches in zebrafish and medaka, in which the relative positions of the dorsal and anal fins are opposite, to demonstrate the crucial role of hox genes in the patterning of the teleost posterior body, including the dorsal and anal fins. By the CRISPR-Cas9-induced frameshift mutations and positional cloning of spontaneous dorsalfinless medaka, we show that various hox mutants exhibit the absence of dorsal or anal fins, or a stepwise posterior extension of these fins, with vertebral abnormalities. Our results indicate that multiple hox genes, primarily from hoxc-related clusters, encompass the regions responsible for the dorsal and anal fin formation along the anterior-posterior axis. These results further suggest that shifts in the anterior boundaries of hox expression which vary among fish species, lead to diversification in the position and size of the dorsal and anal fins, similar to how modulations in Hox expression can alter the number of anatomically distinct vertebrae in tetrapods. Furthermore, we show that hox genes responsible for dorsal fin formation are different between zebrafish and medaka. Our results suggest that a novel mechanism has occurred during teleost evolution, in which the gene network responsible for fin formation might have switched to the regulation downstream of other hox genes, leading to the remarkable diversity in the dorsal fin position.

Animals↗

Insulin response during the oral glucose tolerance test: the role of age, sex, body fat and the pattern of fat distribution.

To clarify their primary roles on insulin response to oral glucose, age and sex differences in body composition should be taken into account. Oral glucose tolerance tests were performed on 472 men and 299 women of the Baltimore Longitudinal Study of Aging, ranging in age from 20 to 96 years. Subjects who were taking medications or had any diseases which could affect glucose tolerance were excluded. In addition to insulin and glucose values for the glucose tolerance test, we calculated body mass index (BMI), percentage body fat from skinfolds (% Body Fat), waist hip ratio (WHR), mean glucose level over the 2-hour test (GM), the basal insulin (IO), and the mean insulin response over the 2-hour test (IM). There was no significant sex difference in mean age, but men had significantly higher BMI (25.6 vs 24.0 kg/m2), WHR (0.93 vs 0.76), and GM (8.5 vs 7.7 mM), while % Body Fat was lower (25% vs 33%). Unadjusted IO and IM levels were significantly higher in men than in women (51 vs 44 and 303 vs 231 pM--antilogs of log-normalized values). Insulin levels, adjusted for differences in age, % Body Fat, WHR, and GM by analysis of covariance, however, showed no sex differences (49 vs 46 and 282 vs 257 pM). Adjusted insulin levels declined significantly with age; IM fell progressively from 323 pM in 20 to 39-year olds, 267 pM in 40 to 59-year, 253 pM in 60 to 79-year, and 228 pM in 80 to 96-year olds (p < 0.01). We conclude that the sex differences in insulin levels are explained by differences in body habitus and post-load glucose levels, but that insulin levels decline with age per se.

Adipose Tissue↗

Comparison of total body surface map depolarization patterns of left bundle branch block and normal axis with left bundle branch block and left-axis deviation.

Total body surface maps from 15 subjects with left bundle branch block and normal axis (LBBB-NA) and 10 subjects with left bundle branch block and left axis (LBBB-LA) were analyzed and compared with maps from normal subjects. In 19 of the 25 subjects with LBBB, the timing of early upper sternal positivity was similar to that of normal subjects, indicative of timely but oppositely directed septal activation. The right ventricular breakthrough was normally located in all, but was earlier after the onset of QRS than expected in some. The initial portion of the positivity produced by left ventricular activation was located in the upper anterior chest in both LBBB-NA and LBBB-LA, but its onset was generally delayed compared with that in normal subjects, presumably because of the time taken by the right-to-left septal activation. Also, the total duration of this positivity was longer than in normal subjects and extended considerably beyond 90 msec, indicating prolonged activation of the anterior free wall of the left ventricle. In LBBB-NA, this upper anterior positivity remained anterior throughout depolarization, but in LBBB-LA it moved toward the left shoulder and the left upper back, presumably due to the posterior orientation of the terminal portion of depolarization. This terminal orientation in patients with LBBB-LA was thought to be due to the additional delay in the activation of the anterobasal portion of the left ventricle caused by selective involvement of the left anterior fascicle.

Aged↗

A caudal mRNA gradient controls posterior development in the wasp Nasonia.

One of the earliest steps of embryonic development is the establishment of polarity along the anteroposterior axis. Extensive studies of Drosophila embryonic development have elucidated mechanisms for establishing polarity, while studies with other model systems have found that many of these molecular components are conserved through evolution. One exception is Bicoid, the master organizer of anterior development in Drosophila and higher dipterans, which is not conserved. Thus, the study of anteroposterior patterning in insects that lack Bicoid can provide insight into the evolution of the diversity of body plan patterning networks. To this end, we have established the long germ parasitic wasp Nasonia vitripennis as a model for comparative studies with Drosophila. Here we report that, in Nasonia, a gradient of localized caudal mRNA directs posterior patterning, whereas, in Drosophila, the gradient of maternal Caudal protein is established through translational repression by Bicoid of homogeneous caudal mRNA. Loss of caudal function in Nasonia results in severe segmentation defects. We show that Nasonia caudal is an activator of gap gene expression that acts far towards the anterior of the embryo, placing it atop a cascade of early patterning. By contrast, activation of gap genes in flies relies on redundant functions of Bicoid and Caudal, leading to a lack of dramatic action on gap gene expression: caudal instead plays a limited role as an activator of pair-rule gene expression. These studies, together with studies in short germ insects, suggest that caudal is an ancestral master organizer of patterning, and that its role has been reduced in higher dipterans such as Drosophila.

Animals↗

Structure and spatial pattern of the sensilla of the body segments of insect larvae.

We describe the types and patterns of sensilla present on the thorax and abdomen of newly hatched larvae of representative species of several insect orders, among them Saltatoria, Mantodea, Blattaria, Heteroptera, Lepidoptera, and Diptera. Sensilla of non-Dipteran species almost exclusively comprise mechanoreceptive hairs or bristles (trichoid sensilla) of various sizes and numbers. In higher Dipterans, peg sensilla (sensilla basiconica, sensilla coeloconica) and so-called papilla sensilla predominate. The pattern of early larval sensilla falls into three main classes, which can be described as 1) fixed pattern, 2) variable pattern, and 3) variable pattern with fixed elements. In larvae exhibiting a fixed sensillum pattern (found in all Dipteran species investigated), sensilla are invariant in number; they are precisely placed in relationship to each other and typically form a single row behind the middle of each segment. A variable pattern (common in most insect groups) typically consists of several rows of relatively evenly spaced sensilla encircling the middle of each segment. In animals with a variable pattern including fixed elements, some sensilla, recognizable by their size or shape, are precisely placed, whereas other sensilla surrounding them are variable.

Animals↗

Segment polarity genes and cell patterning within the Drosophila body segment.

The formation of complex structures in any multicellular organism requires cooperative behaviour within cell populations. Genetic and molecular analysis of pattern formation in the Drosophila embryo is providing us with new insights into the cellular basis of this process, implicating a diversity of molecules, some familiar, others novel, in intercellular communication.

Animals↗

High monetary costs of dietary patterns associated with lower body mass index: a population-based study.

INTRODUCTION: Food choice is strongly influenced through economic constraints. The monetary costs for foods, especially those foods associated with a lower risk of obesity, have considerably increased during the last years. The purpose of this study was to determine the cost differences between low and high adherence to two dietary patterns which have been inversely associated with body mass index (BMI) and obesity. METHODS: The subjects were Spanish men (n=1547) and women (n=1615) aged 25-74 years who were examined in 1999-2000, in a population-based cross-sectional survey in the northeast of Spain (Girona). Dietary intake was assessed using a food frequency questionnaire. Two dietary quality indices, namely the Mediterranean Diet Score (MDS) and the Healthy Eating Index (HEI), were created. Average food prices were calculated. Anthropometric variables were measured. RESULTS: Adjusted linear regression analysis revealed that an increase in 1 Euro (1.25$) of monetary diet costs per day was associated with a change of 0.46 units (P<0.001) and 2.03 units (P<0.001) in the MDS and HEI, respectively. The magnitude of the association was similar for both scores after standardization. Subjects who closely adhered to the MDS and HEI paid daily 1.2 Euro (1.50$) (P<0.001) and 1.4 Euro (1.75$) (P<0.001) more for food consumption, respectively, than those who weakly adhered to these dietary patterns. Multiple linear regression analysis adjusted for several confounders showed an inverse association of the MDS (P=0.011) and the HEI (P<0.001) with BMI. The risk of obesity (BMI> or =30) significantly decreased across quartile distribution of MDS (P=0.004) and HEI (P=0.001). CONCLUSION: Data showed that a high adherence to the MDS and HEI, both inversely associated with BMI and obesity, led to higher monetary costs as compared to a low adherence. This might be of importance for public health policies in an effort to develop strategies to promote healthy diets preventing weight gain.

Adult↗

Influence of adiposity on tonic sympathetic support of resting metabolism in healthy adults.

BACKGROUND: beta-Adrenergic receptor sympathetic nervous system (beta-AR SNS) support of resting metabolic rate (RMR) is attenuated with older age, female sex, and a sedentary lifestyle. Total and abdominal adiposity and/or body fat pattern modulate some SNS-mediated physiological functions. OBJECTIVE: To determine if total and abdominal adiposity and/or body fat distribution are independently related to SNS support of RMR. DESIGN: Cross-sectional comparison of beta-AR SNS support of RMR. SUBJECTS: A total of 54 healthy male and female subjects aged 18-75 y. MEASUREMENTS: RMR (ventilated hood, indirect calorimetry) before (baseline) and during complete beta-AR blockade; body composition by dual energy X-ray absorptiometry. RESULTS: Forward stepwise multiple regression analysis using sex, exercise status, age group, %body fat, total adiposity, abdominal adiposity, and the ratio of abdominal adiposity to hip adiposity as variables revealed sex to be the strongest predictor, explaining 21% of the variability in beta-AR SNS support of RMR (P=0.0006). Age group explained an additional 4% and exercise status a further 4% (both P=0.10). %Body fat, total adiposity, abdominal adiposity, and the ratio of abdominal adiposity to hip adiposity did not enter the equation. CONCLUSION: Total and abdominal adiposity and body fat pattern are not independent physiological determinants of beta-AR SNS support of RMR among healthy men and women. Moreover, further support is provided for our previous finding of attenuated beta-AR SNS support of RMR with age, female sex, and sedentary lifestyle.

Abdomen↗

Predictors of residual venous obstruction after deep vein thrombosis of the lower limbs: a prospective cohort study.

INTRODUCTION: Delayed thrombus regression after deep vein thrombosis (DVT) of the lower limbs is associated with increased risk of DVT recurrence. Predictors of residual venous occlusion are unknown. We hypothesized that obesity, which causes reduced fibrinolytic activity, can predict delayed thrombus regression. MATERIALS AND METHODS: In a prospective cohort study, 98 patients with objective diagnosis of DVT underwent compression ultrasonography (CUS) after 6 and 12 months. Persistent occlusion was arbitrarily defined as a thrombus occupying, at maximal point of compressibility, more than 20% of the vein area in the absence of compression. The body mass index (BMI) and waist circumference were measured at baseline and at follow up to assess individual patterns of body fat distribution. Information on antithrombotic treatment, family history of varicose veins, cigarette smoking, concomitant disorders, the presence of known risk factors for DVT, the duration of anticoagulant treatment and the use of elastic stockings was collected. RESULTS: Post-thrombotic recanalization was documented in 34 patients (34.7%) at 6 months and in 44 patients (44.9%) at 12 months. There was no difference in the mean BMI (p=0.469 at 12 months), in the prevalence of obesity (p=0.479) and visceral pattern of body fat distribution (p=0.239) between patients who did and did not show thrombus regression. The presence of a permanent risk factor for DVT was the only predictor of delayed thrombus regression (OR 11.0, 95% CI 1.359-61.978). CONCLUSIONS: Despite consistent evidence of impaired fibrinolysis, obesity is not associated with persistent venous obstruction.

Body Mass Index↗