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CONTEXT: The range of shoulder rotation is associated with shoulder pain in young male and female swimmers. However, the association between shoulder pain and shoulder complex mobility of the scapulothoracic and acromioclavicular joints has not yet been examined. Moreover, shoulder pain occurs more frequently in females than in males, but only a few studies have examined the relationship between shoulder pain and sex as a risk factor. This study aims to determine the association between shoulder complex mobility and shoulder pain in young male and female swimmers. DESIGN: Prospective cohort design. METHODS: The participants were competitive swimmers (n = 76; 37 males and 39 females) with a mean age of 14 years in Japan. The shoulder rotation width, which was the index of shoulder complex mobility, shoulder internal and external rotation range, and middle finger distance of the back-scratch test were measured. An examiner regularly visited the swimming clubs to evaluate the development of shoulder pain and swimming distance. Logistic regression analysis was used to determine the physical characteristics related to the overall development of shoulder pain in both female and male swimmers. The cutoff value was calculated using receiver operating characteristic curves. RESULTS: Sixteen participants, composed of 8 males and 8 females, developed shoulder pain. The overall swimming distance of the male (odds ratio [OR]: 1.0007, P = .01) and female (OR: 1.0018, P = .02) swimmers and the shoulder rotation width of the male (OR: 1.0952, P = .04) and female (OR: 0.888, P = .03) swimmers were identified as risk factors for shoulder pain. The cutoff value for swimming distance was 6000 m. Shoulder rotation width was more than 88 cm in males and <54 cm in females. CONCLUSIONS: Hypomobility and hypermobility of the shoulder complex were identified as risk factors for shoulder pain in male and female swimmers, respectively.

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Hyponatremia is a common finding after subarachnoid hemorrhaging (SAH) and can be caused by either cerebral salt-wasting syndrome (CSWS) or syndrome of inappropriate antidiuretic hormone (SIADH). Distinguishing between these two entities can be difficult because they have similar manifestations, including hyponatremia, serum hypo-osmolality, and high urine osmolality. We herein report the case of a 60-year-old man who suffered from SAH complicated by hyponatremia. During his initial hospitalization, he was diagnosed with CSWS. He was readmitted one week later with hyponatremia and was diagnosed with SIADH. This is the first report of SAH causing CSWS followed by SIADH. These two different sources of hyponatremia require different treatments.

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AIMS: Anemia, which might contribute to pathogenesis of kidney dysfunction, is a common finding in patients with type 2 diabetes. The aim of this study was to investigate if hemoglobin concentration is associated with the degree of change in urinary albumin-creatinine ratio or the development of albuminuria in patients with type 2 diabetes. METHODS: We measured hemoglobin concentration in 470 (296 men and 174 women) consecutive type 2 diabetic patients without albuminuria. We performed a follow-up study to assess the progression or development of albuminuria, the interval of which was 3.0 years. Then we evaluated relationships between hemoglobin concentration and albuminuria, using multivariate linear regression analyses and logistic regression analyses. RESULTS: Eighty four patients developed albuminuria during follow-up duration. In multivariate analyses, hemoglobin concentration was negatively associated with a change in urinary albumin-creatinine ratio in men (ß = -0.259, P = 0.0002) and women (ß = -0.194, P = 0.030). Moreover, multivariate adjusted odds ratio associated with 1 g/L in hemoglobin for the development of albuminuria was 0.93 (95% confidence interval; 0.89-0.96) in men and 0.94 (95% confidence interval; 0.88-0.99) in women, respectively. And, multivariate analyses revealed that adjusted odds ratios for the development of albuminuria were 4.78 (95% confidence interval; 1.65-13.91) in men and 4.62 (95% confidence interval; 1.34-16.68) in women with anemia (hemoglobin < 130 g/L for men and < 120 g/L for women), which were higher than those without anemia. CONCLUSIONS: Low hemoglobin concentration could be a predictor for the progression and development of albuminuria in patients with type 2 diabetes.

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Elastic layer-structured metal organic frameworks (ELMs) having flexible two-dimensional structure show a gate phenomenon in sorption/desorption of simple gas molecules. The gate phenomenon is accompanied by expansion/shrinkage of the layers. The gas sorption/desorption is not based on a physical adsorption, but on a chemical reaction, which includes high cooperativity. The cooperative reaction could be analyzed thermodynamically. The gate phenomenon showed advantages in separation of CO2 from mixed gases and in storage of CH4 owing to easy release of absorbed molecules.

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Carbon monoxide (CO), long considered a toxic gas, has recently been shown to mediate anti-inflammatory effects in various animal models. The aim of this study was to investigate whether the inhalation of CO ameliorated collagen-induced arthritis (CIA) in mice. CIA was induced in female DBA/1 mice by the injection of an anti-type II collagen antibody and lipopolysaccharide. The CO treatment group was exposed to CO gas at a concentration of 200 ppm in a closed cage starting on the day of the injection with an anti-type II collagen antibody and throughout the remaining study period. The clinical arthritis scores was examined daily for swelling of the paws as a sign of arthritis. For histopathology, the sections of the hind legs were evaluated by hematoxylin-eosin staining. Moreover, we evaluated the expression of interleukin (IL)-1beta and monocyte chemoattractant protein-1 (MCP-1) mRNA in the hind paws. Both clinical arthritis scores as well as histological findings of joint inflammation were significantly reduced in mice treated with CO gas inhalation compared to untreated mice. Further, CO significantly inhibited the increased expression of IL-1beta and MCP-1 mRNA in paws at day 3 after the induction of arthritis. In conclusion, the inhalation of CO protected mice from the synovial inflammation of CIA. Based on these data, the beneficial effects of CO in murine RA model may be attributed to its anti-inflammatory properties.

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Metallothionein (MT) is a protein that can be induced by inflammatory mediators and participates in cytoprotection. However, its role in antigen-related inflammation remains to be established. We determined whether intrinsic MT protects against antigen-related airway inflammation induced by ovalbumin (OVA) in MT-I/II null (MT [-/-]) mice and in corresponding wild-type (WT) mice. MT (-/-) mice and WT mice were intratracheally challenged with OVA (1 mug per body) biweekly four times. Twenty-four hours after the last OVA challenge, significant increases were shown in the numbers of total cells, eosinophils, and neutrophils in bronchoalveolar lavage fluid from MT (-/-) mice than in those from WT mice. The protein level of interleukin-1beta (IL-1beta) was significantly greater in MT (-/-) mice than in WT mice after OVA challenge. Immunohistochemical analysis showed that the formations of 8-oxy-deoxyguanosine and nitrotyrosine in the lung were more intense in MT (-/-) mice than in WT mice after OVA challenge. These results indicate that endogenous MT is a protective molecule against antigen-related airway inflammation induced by OVA, at least partly, via the suppression of enhanced lung expression of IL-1beta and via the antioxidative properties. Our findings suggest that MT may be a therapeutic target for the treatment of antigen-related airway inflammatory diseases such as bronchial asthma.

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To examine the changes in nutritional status during the progression of rheumatoid arthritis (RA), we studied anthropometric and biochemical variables in 97 Japanese patients with RA. Anthropometric data included body mass index (BMI), triceps skinfold thickness (TSF), and arm muscle area (AMA). Levels of albumin and cholesterol in serum, and lymphocyte count were studied as biochemical variables. The prevalence of malnutrition defined as hypoalbuminemia less than 3.4 g/dl was 24.7%, similar to the reports in other countries. Analysis of the data according to disease stage showed that malnutrition in RA was characterized by a progressive reduction in body protein. Body mass index and TSF were increased in patients with stage 1 disease, whereas serum albumin and AMA were within normal range. Stage 2 patients had normal BMI with decreased body protein, albumin, and AMA. Progression to stages 3 and 4 was associated with a stepwise decrease in AMA; serum albumin and BMI remained in the same range as stage 2. Albumin values and AMA were significantly lower in patients with poor functional class and high C-reactive protein. The characteristic progression of malnutrition in RA is attributed to excessive protein catabolism evoked by inflammatory cytokines and by disuse atrophy due to functional impairment.

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A 73-year-old woman with a three-year history of allergic rhinitis and bronchial asthma was found to have Churg-Strauss syndrome combined with fever, eosinophilia, mononeuritis multiplex, and acute coronary syndrome. After the treatment with a methylprednisolone pulse therapy and a high dose of corticosteroids were initiated, eosinophilia normalized together with decline of fever, but acute superior mesenteric artery occlusion occurred, which improved with conservative therapy. Severe stenosis of bilateral carotid arteries was found, so immunosuppressive drugs were added. In general, Churg-Strauss syndrome is a disease with vasculitis affecting small arteries, arterioles, venules, or capillaries, and cases with arteritis in large and medium-sized arteries, such as this case are rare. This suggested that in cases of Churg-Strauss syndrome of the elderly patients, physicians must be careful about involvement of larger vessels.

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It has recently been reported that not only endogenous nitric oxide (NO) but also carbon monoxide (CO) produced by heme oxygenase (HO) have many physiological functions. The objective of the present study was to determine whether endogenous NO or CO is involved in the experimental pulmonary or liver metastasis of colon cancer in mice. Intravenous or intrasplenic injection of colon 26 cells from a mouse colon adenocarcinoma cell line resulted in multiple pulmonary or liver metastases. NG-nitro-L-arginine methyl ester (L-NAME), a competitive inhibitor of NO synthase (NOS), or zinc deuteroporphyrin 2, 4-bis glycol (ZnDPBG), a competitive inhibitor of HO, was administered to the mice only on the day of tumor inoculation. We assessed the number of tumor cells 24 h later and the outcome of metastases of the target organ. In the pulmonary metastasis model, L-NAME increased both the number of tumor cells 24 h later and outcome of metastases 18 days later, but did not have a significant effect on liver metastasis. On the other hand, metastasis to the liver, but not that to the lung, increased following administration of ZnDPBG. These results suggest that the activities of NOS and HO could influence experimental metastasis in an organ-specific manner.

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