Many epidemiological research studies have shown that vital exhaustion and psychosocial factors are associated with the occurrence of cerebrocardiovascular disease (CCVD). Fatigue is thought to induce endothelial dysfunction and may be linked to the occurrence of CCVD; however, no studies have investigated this potential link. We studied to determine the effect of fatigue on endothelial function in healthy subjects with no traditional CCVD risk factors or potential confounding factors to be controlled. Subjects and methods: Peripheral arterial tonometry (PAT) was used to evaluate endothelial function. The influence of the following parameters on endothelial function was analyzed in 74 office workers without traditional CCVD risk factors at health checkups: endothelial function before and after work, subjective fatigue, lifestyle factors such as sleeping time, and psychosocial factors such as depression and social support. Results: Twenty-five subjects (33.8%) had low endothelial function; reactive hyperemia (RH)-PAT index 1.67, even though no abnormalities were reported in the health checkups. There was no significant difference in endothelial function before versus after labor. Of note, endothelial function was associated with the individual's level of subjective fatigue (t = 2.98, P = 0.008) and showed a daily fluctuation, sometimes to a pathological degree (1.67). Conclusion: We showed that, even in healthy people, endothelial function fluctuates diurnally, with an interaction between the individual's cognitive fatigue and the environment, sometimes to a pathological degree. Based on these findings, we suggest that endothelial function is an objective assessment tool of fatigue in healthy individuals.
Lipoma is relatively uncommon in the oral cavity. Among the intraoral regions, lipoma involving the gingiva or gingivobuccal fold is relatively infrequent. We report the case of a patient with lipoma extending superiorly from the mandibular gingivobuccal fold to the gingiva. In addition to the case report, we retrospectively reviewed 207 patients with intraoral lipoma reported in Japan from 1987 to 2004. The most frequent site of development was the buccal mucosa (40.6%), followed by the tongue (17.9%), lip (12.6%), gingiva (8.7%), oral floor (6.8%), gingivobuccal fold and palate (4.8%), and others (3.9%). Occurrence tended to be more frequent in males (57.5%) than in females (42.5%). Relative to age, frequency peaked among patients in the 7th (27.3%) and 6th decades (25.1%), respectively, followed in descending order by the 5th (14.8%) and 8th decades (13.1%). The majority of patients (86.3%) were at least 40 years. The most frequent size was 10-19 mm (37.5%), followed by 0-9 mm (27.8%) and 20-29 mm (14.6%), and tumors 30 mm or larger were relatively infrequent. Histopathological types in order of descending frequency were lipomas (69.0%), fibrolipomas (27.4%), and others (3.5%). The male:female ratio was 1.7:1 for lipoma and 1:1.6 for fibrolipoma.
Angioleiomyoma (AL) is a benign tumor derived from smooth muscle. The overwhelming majority of ALs occur in the uterus, gastrointestinal tract, or skin; AL of the oral cavity is infrequent, and AL of the tongue is particularly rare. The present report describes a case of AL of the tongue that resulted in a good outcome. We also review the literature with a special emphasis on the etiology of ALs. It is generally agreed that minor trauma, venous stasis, and hormonal changes are etiological factors for AL. The roles of estrogen and progesterone have been particularly emphasized, and the expression of progesterone receptors (PRs) and estrogen receptors (ERs) has been recently evaluated in some cases of AL. To our knowledge, the presence of PRs and ERs has only been evaluated in seven cases of AL arising in different regions of the body including the oral cavity. This is the first report to demonstrate negative expression of both receptors in an AL of the oral cavity. Further study and additional cases are needed to elucidate the influence of PRs and ERs in AL of the oral cavity.
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