Pemphigus vulgaris: clinicopathologic review of 33 cases in the oral cavity

A retrospective study was conducted on all cases of pemphigus vulgaris occurring on oral mucosal surfaces in the files of the Oral Pathology Laboratory at Temple University from 1974 to 1996. A total of 35 biopsies from 33 patients were reviewed, 25 female and eight male. Patient ages ranged from 27 to 79 years; the mean age was 56.5. The most common clinical complaint was of painful ulcers that failed to resolve within several weeks. Thirty patients had no known history of pemphigus, while in three patients a history of pemphigus was known. The most common clinical impression was that of mucous membrane pemphigoid, but the differential diagnosis included other vesiculoerosive conditions.

Comparisons of cutaneous blood flow reactivity to norepinephrine and sodium nitroprusside between patients with heart transplantation and healthy subjects

Heart transplant patients are reported to have impaired regulation of the microvasculature. The purpose of this study was to investigate the cutaneous blood flow and its reactivity to sodium nitroprusside (vasodilator, Nipride 0.1%) and norepinephrine (vasoconstrictor, Levophed 0.1%) in patients after heart transplantation in comparison to normal healthy individuals. Eighteen patients after heart transplantation and 16 healthy, nonsmoking individuals served as subjects of the study. Sodium nitroprusside and norepinephrine were introduced by iontophoresis to the skin of the right and left forearms, respectively. After measuring cutaneous blood flow reactivity in the pre-exercise state by laser Doppler flowmetry, subjects were then asked to close and open their fists for 2 min. The same measurements were repeated after exercise. Comparisons between the groups were carried out by the Wilcoxan signed rank test. The Mann Whitney U-test was used for comparison between pre-exercise and post-exercise states. The results demonstrated that sodium nitroprusside significantly increased forearm cutaneous perfusion at rest but produced only a mild increase after exercise. This reactivity was significantly lower after exercise with no significant differences between groups. Norepinephrine decreased cutaneous blood flow at rest. The transplant patients were significantly less sensitive to norepinephrine before but not after exercise. The changes in norepinephrine reactivity with exercise were significantly different between groups (p < 0.05).

Energy expenditure of wheeling and walking during prosthetic rehabilitation in a woman with bilateral transfemoral amputations

OBJECTIVE

To compare the energy expenditure of locomotion by wheelchair with that required for prosthetic ambulation in a person with bilateral transfemoral (TF) amputations.

DESIGN

Observational, single patient, descriptive.

SETTING

An 80-meter long rectangular hallway in a rehabilitation unit.

PATIENT

A 41-year-old woman with bilateral TF amputations that were performed 79 days before her admission to the rehabilitation unit.

MAIN OUTCOME MEASURES

The oxygen uptake, oxygen cost, heart rate, speed, cadence, and stride length of walking measured during a 4-month course of prosthetic rehabilitation. Five locomotion conditions were evaluated: (1) wheelchair propulsion, (2) walking with short-leg prostheses (stubbies) and a walker, (3) long-leg prostheses and a walker, (4) long-leg prostheses without knee mechanism and axillary crutches, and (5) long-leg prostheses with right polycentric knee and left locked knee and axillary crutches. A portable and telemetric system was used to measure the metabolic parameters. An arm ergometry graded exercise test was performed at the end of rehabilitation.

RESULTS

Oxygen cost (range, 466%--707% of that of wheeling) and heart rate (range, 106%--116% of that of wheeling) were higher during walking with various combinations of prostheses and walking aids. The speed of prosthetic walking was only 24% to 33% of that of wheeling. Our patient preferred using a wheelchair to prosthetic walking after discharge.

CONCLUSIONS

People with bilateral TF amputations require very high cardiorespiratory endurance to fulfill the energy demand during prosthetic rehabilitation. The high energy cost of prosthetic walking will limit its application in daily activities.

A retrogen strategy for presentation of an intracellular tumor antigen as an exogenous antigen by dendritic cells induces potent antitumor T helper and CTL responses

Induction of an effective antitumor response requires CD4+ helper T (Th) cells to recognize antigens on the same dendritic cells (DCs) that cross-present CTL antigens. Such cross-presentation is difficult to achieve by current tumor vaccine strategies. Here, we develop a novel "Retrogen" strategy for DCs to efficiently cross-present an intracellular tumor antigen, MAGE-3, to both MHC class I and MHC class II in a cognate manner. Specifically, the MAGE-3 gene was linked to a leader sequence at its NH2 terminus for secretion and to a cell-binding domain at its COOH terminus for receptor-mediated internalization. DCs transduced with the modified MAGE-3 gene produced and secreted MAGE-3 proteins, which were efficiently taken up by DCs via receptor-mediated internalization and presented as exogenous antigens to class I and class II molecules. Immunization of mice with the transduced DCs expressing the MAGE-3 fusion protein, termed "Retrogen" for its retrograde transport/internalization after secretion, efficiently induced all arms of the adaptive antitumor immune responses. Thus, this retrogen strategy of using a unifying mechanism for DCs to cross-present an intracellular tumor antigen in a cognate manner could be generally used to improve the efficacy of tumor vaccines and immunotherapies.

[Microsatellite marker analysis of a soybean recombinant inbred line NJRIKY]

The prerequisite of genomic research such as genetic mapping is construction of a suitable segregating population and its reasonable evaluation before use. A recombinant inbred line (RILs), NJRIKY, was constructed through a cross between Kefeng 1 and Nannong 1138-2. The present study was focused on evaluation of genetic structure of the RILs through the simple sequence repeats (SSRs) analysis. A total number of 138 pairs of SSRs primers covering the whole soybean genome were randomly selected for polymorphic analysis between two parents. 86 pairs of which were polymorphic and polymorphic rate is up to 62.32%. 90 polymorphic loci were found. Further analysis with polymorphic SSRs loci on the sampled lines indicated that not only segregation of most SSRs loci conformed to the ratio of 1:1, but also almost each sampled line tended to homozyge. The distribution of genotypic composition was normal. The population is ideal for genetic mapping and other genomic research.

Hazardous organic matters in municipal sewage sludge in Taiwan

Application of municipal sewage sludge to agricultural land has attracted significant attention in recent years because it conserves abundant nutrients and hydrocarbons that can be used as a soil amendment. The presence of hazardous organic matters (HOMs) in sewage sludge limits the feasibility of reuse of sewage sludge. The purpose of this study was to investigate the types and the concentrations of HOMs in municipal sewage sludge in Taiwan. An efficient SFE/GC/MS method was used to determine HOMs in sludge samples. The results indicated that di-(2-ethylhexyl) phthalate (DEHP) was persistently found in both aerobically and anaerobically digested sludges. 4-nonylphenol (4-NP) was only found in anaerobically digested sludges. Both DEHP and 4-NP have been characterized as endocrine disrupting chemicals (EDCs) or environmental endorine disruptors (EEDs). It suggested that sludges containing high levels of DEHP and 4-NP need further treatment and reduction of possible impacts on the environment before their reuse as soil fertilizers.

[QTLs mapping of some agronomic traits of soybean]

A recombinant inbred population of soybean was developed from a intraspecies cross of Kefeng1 and Nannong 1138-2. A genetic linkage group of soybean genome was constructed, which composed of 22 linkage groups, included 302 loci, covered 2,363.8 cM. The interval mapping was used to identify quantitative trait loci (QLTs) associated with ten important agronomic traits in the RIL population. The results indicated that thirty-four QTLs were detected for the ten traits associated with yield and seed quality. We conclude that QTL analysis offers a useful tool for the genetic improvement of soybean cultivars.

Disability-adjusted life years for breast cancer patients in Taiwan

BACKGROUND AND PURPOSE

The incidence and mortality of breast cancer in Taiwan have increased rapidly in the past several decades, but the societal impact of deaths and disabilities due to breast cancer has not been assessed. This study estimated the disability-adjusted life years (DALYs) for breast cancer patients during 1994, and compared the results with similar data from other areas of the world.

METHODS

DALYs for breast cancer patients in Taiwan were calculated using the equation developed by Murray and Lopez. The incidence and mortality of breast cancer and the population structure were obtained from national statistics maintained by the Department of Health and the Ministry of the Interior. The age-specific mean survival time for breast cancer patients was estimated using the exponential distribution from incidence-mortality linkage of the incidence file at National Taiwan University Hospital and the National Mortality File maintained by the Department of Health.

RESULTS

There were 11,963 years of life lost (YLL) due to breast cancer during 1994, 2677 years lived with disability (YLD), and 14,640 DALYs. The YLL and DALYs per 1000 population (1.17 and 1.44) were in the middle of the world spectrum, while the YLD value per 1000 population (0.26) was closer to those of developed countries. The proportion of DALYs contributed by younger patients (< 45 years) was higher than in developed countries and similar to those in developing countries other than Sub-Saharan Africa. The DALYs per 1000 population of women younger than 45 years of age in Taiwan were also higher than those in India, China, other regions of Asia and Islands, Sub-Saharan Africa, and the Middle Eastern Crescent.

CONCLUSIONS

The disability portion (YLD) of the DALYs for breast cancer patients in Taiwan was higher than in other regions of the world. Moreover, patients younger than 45 years contributed a higher proportion of DALYs than in developed countries. The DALY value per 1000 population younger than 45 years of age was also higher than in developing countries. These results suggest that health professionals should focus more attention on programs for education, screening, and treatment of younger women.

[Cloning and characterization of CMO gene from Atriplex hortensis]

Glycine betaine is a widespread osmopretectant existed in many organisms. In higher plant, glycine betaine is synthesized via a two-sep oxidation reaction: choline-->betaine aldehyde-->glycine betaine. The first step, also the speed-limiting step, is catalyzed by choline monooxygenase(CMO). Choosing halophyte Atriplex hortensis as material, we constructed a salt stress-induced cDNA library, and isolated a 1.77 kb length cDNA clone with spinach CMO cDNA as probe. The sequencing result showed a complete Open Reading Frame encoding a 438-amino-acid polypeptide which was 81% and 72% identified to CMO sequences of spinach and sugar beet in amino acid homology respectively. Compared with the CMO from spinach and sugar beet, the AhCMO had one conserved Rieske-Type [2Fe-2S] cluster-binding region and one conserved mononuclear Fe-binding motif. The expression pattern of AhCMO under salt stress was also stuied, the transcriptional level of AhCMO raised about three folds after the plant was treated with brine for 4 days. The AhCMO was then transfered into tobacco(Nictiana tabacum var. Xanthi) with 35S promotor and seven transgenic plants were certified by northern blot, these plants displayed some salt- and drought-stress tolerance when grew well on MS medium contained 1.2% NaCl or 10% PEG while the control was stagnated under the same cndition.

[Phylogenetic analysis of interspecies in genus Glycine through SSR markers]

The genetic diversity among 11 species of genus Glycine (altogether 37 accessions) was evaluated through SSR analysis. The number of alleles in different loci ranges from 6 to 29, averaging 15.9 per locus; alleles of subgenus soja account for 71.5% of those in subgenus Glycine, and the fingerprinting among subgenus Glycine is more divergent than that of subgenus soja. Principal factor analysis shows that the first and the second principal factor can classify genus Glycine into two groups which represent subgenus Glycine and subgenus soja. The results of UPGMA indicate that G. mas, G. soja and G. gracilis in subgenus soja are different species.

3D coronary reconstruction from routine single-plane coronary angiograms: clinical validation and quantitative analysis of the right coronary artery in 100 patients

BACKGROUND

Current coronary angiographic techniques display complex three-dimensional (3D) coronary structures in two dimensions (2D). We have developed a 3D reconstruction (3DR) algorithm using standard single-plane angiographic images that allows for 3D display of coronary structures. The purpose of this study was to validate our 3DR algorithm and quantify anatomic characteristics of the right coronary artery (RCA) in vivo.

METHODS

Accuracy and reproducibility studies were performed using 3DRs of a coronary phantom and in vivo following 3DRs in 40 patients. The anatomic features of the RCA were then quantified in 100 patients.

RESULTS

Comparison of length and bifurcation angles (BA) from the phantom to the 3DRs revealed good accuracy and correlation for both (r = 0.95 and 0.93 respectively), with diameter error of < 7%. In vivo, the average root mean square (RMS) error in the spatial coordinates of the vessel centerlines was 3.12 +/- 0.77 and 3.16 +/- 0.75 mm in 20 left coronary arteries (LCA) and 20 RCAs respectively. Interobserver average RMS error was 3.47 +/- 1.96 mm and intraobserver average RMS error was 3.02 +/- 1.07 and 3.44 +/- 1.57 mm for two different operators (p = NS). The average RCA length was 10.2 +/- 1.7 cm, average radius of curvature (ROC) was 52 +/- 9 degrees, and the average 3D bifurcation angle of the posterior descending artery (PDA) from the RCA was 55 +/- 22 degrees. Foreshortening (FS) of the segments of the RCA in three 'standard' projections ranged from 0-60, 0-75, and 0-82% respectively.

CONCLUSIONS

Using our 3DR algorithm patient-specific anatomic characteristics can be accurately displayed and quantified, expanding the information that can be derived from routine coronary angiography.

The relation of serum leptin to body mass index and to serum cortisol in men with spinal cord injury

OBJECTIVE

To investigate the relations among serum leptin, body mass index (BMI), and various hormone levels in men with spinal cord injury (SCI).

DESIGN

Cross-sectional.

SETTING

University hospital that is a tertiary referral center.

PARTICIPANTS

Forty-seven men with traumatic neurologically complete SCI and 47 age- and BMI-matched male controls.

MAIN OUTCOME MEASURES

Baseline levels of various hormones were measured in subjects with SCI. Serum leptin and cortisol levels and BMI were measured in both groups.

RESULTS

Serum leptin was significantly higher in the group with SCI than in the control group. A linear relation was found between serum leptin and BMI in both groups separately. A polynomial relation was found between serum leptin level and BMI in the group with SCI. A "J" phenomenon is noted at the lowest BMI. Serum cortisol correlated significantly with serum leptin level in the group with SCI.

CONCLUSION

Sympathetic denervation, peripheral nerve palsy, recurrent infections, and possible central neurotransmitter alterations after SCI may contribute to the elevation of serum leptin level in men with SCI.

Immuno-histopathology in the diagnosis of early leprosy

The present study of 45 early leprosy cases in an endemic area in China indicates: a) Sensitivity of acid-fast bacilli (AFB) detection can be significantly improved by examining approximately 30 serial sections. AFB and/or phenolic glycolipid-I (PGL-I) were mostly detected in the infiltrates in the subepidermal zone, intraneurium, perineurium and around blood vessels. b) PGL-I antigen was positive in 10 clinically suspected, single lesion leprosy cases and AFB positive in 7 patients, AFB and/or PGL-I in nerve in 6 patients. c) Nonspecific chronic inflammation in indeterminate leprosy presented as selective perineural and/or intraneural infiltration with lymphocytes predominating. In the infiltrating mass, fragments of neural tissue were demonstrated with anti-S-100 protein staining. d) Except for 3 cases with unknown numbers of lesions, the present positive immunohistopathological findings are in direct correlation with the number of lesions at first diagnosis, namely: 41.6% (10/24) for single lesion, 66.6% (6/9) for 2 lesions, and 88.8% (8/9) for patients with > or = 3 lesions. e) Typical epithelioid or macrophage granuloma formations were not seen in early leprosy with a single lesion. In testing the immunological inclination of these patients with CD68 or tumor necrosis factor-alpha (TNF-alpha) a positive test is likely to be of prognostic value since TNF-alpha is involved in granuloma formation and nerve damage.

Induction of vigorous helper and cytotoxic T cell as well as B cell responses by dendritic cells expressing a modified antigen targeting receptor-mediated internalization pathway

Efficient Ag presentation is essential to induce effective cellular and humoral immune responses. Thus, one central goal of current immunotherapy and vaccine development is to enhance Ag presentation to induce potent and broad immune responses. Here, a novel Ag presentation strategy is developed by transducing dendritic cells (DCs) to produce an Ag for presentation as an exogenous Ag to efficiently induce both humoral and cellular immunity. The principle of this strategy is illustrated by genetically modifying DCs to secrete a model hepatitis B virus Ag fused with a cell-binding domain and to process the fusion Ag as an exogenous Ag after receptor-mediated internalization for MHC class I and II presentation. Vigorous Ag-specific CD4(+) helper and CD8(+) cytotoxic T cell, as well as B cell, responses were induced by the transduced DCs in mouse models. Thus, this novel strategy uses a receptor-mediated internalization process to efficiently induce all arms of the adaptive immunity and may provide a powerful means to develop potent vaccines and immunotherapies.

Segmental odontomaxillary dysplasia: a case report and review of the literature

Segmental odontomaxillary dysplasia (SOD) is a rare, unilateral developmental disorder of the maxilla involving abnormal growth and maturation of the bone, lack of one or both premolars, altered primary molar structure, delayed tooth eruption, and fibrous hyperplasia of the gingiva. In this, the twenty-third reported case of SOD, the literature is reviewed, and the clinical, radiographic, and histopathologic data are described. Computed tomographic scans of this case showed that the involved segment of the maxilla extends mesiodistally from the permanent cuspid to the mesial portion of the first permanent molar, largely limited to the area of the missing premolars. However, the affected bone extends superiorly in the lateral wall of the maxilla to the zygoma and base of the orbit. This article is intended to serve as baseline data for a future article, describing the natural history and possible treatment of SOD, which remain undocumented.

[Cloning of E. coli mtl-D gene and its expression in transgenic Balizhuangyang (Populus)]

E. coli 1-phosphate mannitol dehydrogenase gene (mtl-D) was cloned using PCR method. Sequence analysis showed that the gene was the same as the published one except that codon CAT at position 416 was replaced by AAA and resulted in a Lys residue instead of His. This gene (mtl-D) was inserted in a binary vector and transformed into populas via agrobacteria. Several transgenic plants grow very well in 0.6% NaCl while controls can not survive even in 0.4% NaCl. PCR analysis and Northern blotting indicated that foreign gene was integrated into the genome of transgenic plant and transcribed successfully.

Upregulation of tyrosine kinase TKT by the Epstein-Barr virus transactivator Zta

The Zta protein is a key transactivator involved in initiating the Epstein-Barr virus (EBV) lytic cascade. In addition to transactivating many viral genes, Zta has the capacity to influence host cellular signals by binding to promoter regions or by interacting with several important cellular factors. Based on the observation that tyrosine kinases play central roles in determining the fate of cells, a kinase display assay was used to investigate whether cells expressing Zta have an altered pattern of kinase expression. The assay revealed that TRK-related tyrosine kinase (TKT) is expressed at significant levels in Zta transfectants but not in control cells. Additional evidence was obtained from Northern and Western blotting. Importantly, the upregulation of phosphorylated TKT and TKT downstream effector matrix metalloproteinase 1 in Zta transfectants hinted that TKT might initiate a signaling cascade in Zta-expressing cells. In addition, deletion analysis of the Zta protein revealed that the transactivation and dimerization domains were both essential for the upregulation of TKT transcription. Moreover, correlation of expression levels of Zta and TKT transcripts in nasopharyngeal carcinoma biopsy specimens was clearly demonstrated by quantitative PCR (Q-PCR), which provides the first evidence for an effect of Zta on cellular gene expression in vivo. These findings offer insight into the virus-cell interactions and may help us elucidate the role of EBV in tumorigenesis.

[Study on gene-dosage effect of high level expression of the yeast glucoamylase genes]

Diploid strains homozygous for both MAT allele and STA genes (a/a, STA1/STA1 or STA2/STA2 or STA3/STA3) and diploid strains homozygous for MAT allele but intercombinative for STA genes (a/a, STA1/STA2 or STA2/STA3 or STA1/STA3) were constructed by means of the protoplast fusion or the colchicine treatment. According to glucoamylase activity in YPS medium, we studied the gene-dosage effect and their interrelation of these three polymeric genes coding for glucoamylase. The results of the glucoamylase activity determination showed that the gene-dosage effect of glucoamylase is obvious in diploid and triploid strains homozygous for both MAT allele and STA gene, such as the glucoamylase activity of a diploid strain SFY56-6 and a triploid strain SFY56-104 homozygous for both MAT allele and STA genes were respectively 2.35 and 3.18-fold as compared with that of the their parental strain IATA-Y56 that is a haploid Saccharomyces diastaticus. Moreover, the glucoamylase activity of diploid strains homozygous for MAT allele but intercombinative for STA genes also showed the combinative gene-dosage effect to a certain extent.

Iron-mediated free radical injury in ethanol-exposed mouse neural crest cells

Previous studies using cell and whole embryo cultures have shown that free radicals play an important role in the ethanol-induced death of mouse neural crest cells (NCCs; a significant cell type with respect to the genesis of alcohol-related birth defects). This investigation was spurred by reports of increased iron in ethanol-exposed fetuses and the knowledge that iron can initiate the production of reactive oxygen species. Initially, the ameliorative potential of two iron chelators, deferoxamine and phenanthroline, relative to ethanol-induced cell death was examined. Cotreatment of cultured NCCs with 100 mM ethanol and either 1 or 10 microM deferoxamine or 10, 50, or 250 microM phenanthroline significantly increased the percentage of viable cells as compared with exposure to 100 mM ethanol alone. These data indicate that iron is involved in the ethanol-induced cytotoxicity. To support this premise, the direct toxicity of iron to NCCs was also examined. As expected, loading the cells with Fe(II)/Fe(III) using 8-hydroxyquinoline as a carrier had an adverse effect on their viability as did treatment with a neurotoxin, 6-hydroxydopamine, that releases iron from ferritin storage. Cotreatment with an antioxidant, N-acetylcysteine, significantly diminished the toxicity of ethanol alone, that resulting from iron loading, as well as from the combination of ethanol exposure and iron loading. These results confirm the role of free radical-mediated damage in ethanol-induced cytotoxicity and highlight the potential role of iron relative to the genesis of alcohol-related birth defects.

Describing shape changes in the human mandible using elliptical Fourier functions

Elliptical Fourier functions (EFF) were generated for the boundary outline of the mandibular form in 24 non-orthodontic growth study subjects at 9, 11, 13, and 15 years of age. The mean residual fit (observed versus predicted points) of the mandibular form was 0.11 mm, with a range from 0.09 to 0.14 mm, suggesting an accurate fit. The mean plot for each of the four age groups was area standardized and superimposed on the centroid. Shape changes in males and females were found to be similar. No significant shape changes were found between 9 and 11 years. Shape changes were observed in the lower incisor area, the mental region, the body of the mandible, and the gonial angle area between 11 and 15 years. These changes coincided with the onset of the pubertal growth spurt.

Viability of Heterodera glycines Exposed to Fungal Filtrates

Filtrates from nematode-parasitic fungi have been reported to be toxic to plant-parasitic nematodes. Our objective was to determine the effects of fungal filtrates on second-stage juveniles and eggs of Heterodera glycines. Eleven fungal species that were isolated from cysts extracted from a soybean field in Florida were tested on J2, and five species were tested on eggs in vitro. Each fungal species was grown in Czapek-Dox broth and malt extract broth. No toxic activity was observed for fungi grown in Czapek-Dox broth. Filtrates from Paecilomyces lilacinus, Stagonospora heteroderae, Neocosmospora vasinfecta, and Fusarium solani grown in malt extract broth were toxic to J2, whereas filtrates from Exophiala pisciphila, Fusarium oxysporum, Gliocladium catenulatum, Pyrenochaeta terrestris, Verticillium chlamydosporium, and sterile fungi 1 and 2 were not toxic to J2. Filtrates of P. lilacinus, S. heteroderae, and N. vasinfecta grown in malt extract broth reduced egg viability, whereas F. oxysporum and P. terrestris filtrates had no effect on egg viability.

[Analysis of heavy oil fractions in high-temperature coal tar by capillary gas chromatography/fourier transform infrared spectrometry]

Capillary gas chromatography-Fourier transform infrared spectrometry-gas chromatography retention indices (GC/FTIR-RI), combined with the linear relationship between retention value and boiling points for polycyclic aromatic hydrocarbons, performed the determination of the composition of heavy oil fractions in high-temperature coal tar. More than 70 and 61 compounds were separated and identified in heavy oil fractions F7(300-330 degrees C) and F8(330-360 degrees C) respectively. The results are useful in coal tar distillation processing and pollution monitoring when such compounds are present.

Tai Chi Chuan to improve muscular strength and endurance in elderly individuals: a pilot study

OBJECTIVE

To evaluate the training effect of a Tai Chi Chuan (TCC) program on knee extensor muscular strength and endurance in elderly individuals.

DESIGN

Before-after trial.

SETTING

Community setting.

PARTICIPANTS

Forty-one community dwelling subjects aged 61.1 +/- 9.8 years undertook a TCC program. Nine dropped out during the study. Pretraining and posttraining measurements were obtained from 15 men and 17 women.

INTERVENTION

Subjects participated in a 6-month TCC program. Each session consisted of 20 minutes of warm-up, 24 minutes of structured TCC training, and 10 minutes of cool-down exercises.

MAIN OUTCOME MEASURES

Peak torque of dominant and nondominant knee extensors was tested at speeds of 60 degrees , 180 degrees , and 240 degrees/sec concentrically and eccentrically. Muscular endurance of the knee extensor was tested at the speed of 180 degrees /sec.

RESULTS

In the group of men, concentric knee extensor peak torque increased by 15.1% to 20.0% and eccentric peak torque increased by 15.1% to 23.7%. The group of women also showed increases, ranging from 13.5% to 21.8% in concentric peak torque, and 18.3% to 23.8% in eccentric peak torque. In addition, the knee extensor endurance ratio increased by 9.6% to 18.8% in the men and 10.1% to 14.6% in the women.

CONCLUSION

TCC training may enhance muscular strength and endurance of knee extensors in elderly individuals.

Body composition in hemodialysis patients--is it different from that of normal subjects?

OBJECTIVE

Body composition assessment is an important method of evaluating nutritional and metabolic status in hemodialysis patients.

PATIENTS AND METHODS

To assess the body composition of hemodialysis patients, we used dual-energy X ray absorptiometry to test 40 stable chronic hemodialysis patients and 40 normal subjects. The patients were from 38 to 70 years old, and all without diabetic mellitus. Comparing with the hemodialysis patients, the normal subjects were selected on a one-to-one base with the same sex and about the same age, body weight and height.

RESULTS

The lean body mass/body weight (LBM/BW) ratio had no significant statistical difference between hemodialysis patients and normal subjects in this study (63.02 +/- 8.42% vs 64.80 +/- 7.92%, p =0.3308). The male LBM/BW ratio was higher than that of the female (71.07 +/- 4.63% vs 59.30 +/- 6.35%, p < 0.0001). According to the multiple linear regression analyses, the LBM of hemodialysis patients had positive correlation with gender (p < 0.0001), height (p = 0.0360) and weight (p < 0.0001). The total bone mineral density (BMD) of hemodialysis patients was found to be lower than that of the normal subjects (0.90 +/- 0.10 g/cm vs 0.97 +/- 0.08 g/cm, p = 0.0092). The BMD had been found to be low in the hemodialysis patients with serum intact parathyroid hormone (iPTH) > 1,700 pg/ml. The BMD had negative correlation with age in the female hemodialysis patients (r = 0.63, p = 0.0009), but no correlation in the male hemodialysis patients and in the female or male normal subjects. With the multiple linear regression analyses, the BMD of hemodialysis patients had positive correlation with weight (p = 0.0329) and negative correlation with age (p = 0.0183) and serum iPTH (p = 0.0231).

CONCLUSION

We concluded that: the LBM/BW ratio of hemodialysis patients was not different from that of normal subjects. Severe secondary hyperparathyroidism hemodialysis patients had low BMD. The BMD had negative correlation with age in the female hemodialysis patients.