Effects of combined endurance and strength training on muscle strength, power and hypertrophy in 40-67-year-old men

Both strength and endurance training have several positive effects on aging muscle and physical performance of middle-aged and older adults, but their combination may compromise optimal adaptation. This study examined the possible interference of combined strength and endurance training on neuromuscular performance and skeletal muscle hypertrophy in previously untrained 40-67-year-old men. Maximal strength and muscle activation in the upper and lower extremities, maximal concentric power, aerobic capacity and muscle fiber size and distribution in the vastus lateralis muscle were measured before and after a 21-week training period. Ninety-six men [mean age 56 (SD 7) years] completed high-intensity strength training (S) twice a week, endurance training (E) twice a week, combined training (SE) four times per week or served as controls (C). SE and S led to similar gains in one repetition maximum strength of the lower extremities [22 (9)% and 21 (8)%, P<0.001], whereas E and C showed minor changes. Cross-sectional area of type II muscle fibers only increased in S [26 (22)%, P=0.002], while SE showed an inconsistent, non-significant change [8 (35)%, P=0.73]. Combined training may interfere with muscle hypertrophy in aging men, despite similar gains in maximal strength between the strength and the combined training groups.

[Laryngotracheal separation as treatment for severe bronchopulmonary aspiration]

We present the case of a patient with brain stem tumour and severe chronic aspiration. The bilateral dysfunction of lower cranial nerves and the severe gastroesophageal reflux contributed to the aspirations. Despite medical treatment and cuffed tracheotomy tube, she required almost constant hospitalization for a year and a half due to respiratory infections. Laryngotracheal separation dramatically reduced the infections and improved her quality of life.

Incidence and significance of K-RAS mutation in first line treatment of colorectal cancer (cc): Experience of a single institution (Hospital Universitario Central de Asturias (HUCA))

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Background: Although the significance of K-RAS mutation and cetuximab/panitumumab has been established in first line (ASCO 08 abstract 2# and 4000#) and in previously treated patients (pts) (NEJM 2008; 359: 1757. JCO 2008; 26: 374. JCO 2008; 26: 1626), data of the significance of this mutation in relation to bevacizumab is scarcer (JNCI 2005; 97: 981). Methods: Sample tissue of alive patients diagnosed of stage IV colorectal cancer were analyzed for the presence of K-RAS mutation by PCR amplification and direct sequencing. Data regarding presence of K-RAS mutation were retrospectively analyzed in relation to clinical data. Results: From IV to XII 08 122 paraffin embedded samples were analyzed. The percentage of mutant cases were 41% (95% CI 32–51%). The most frequent mutant type was Gly12Asp (37%) followed by Gly12Val (25%) and Gly13Asp (19%). We have clinical data of 94 pts. 62 were men and 32 female. 25 pts had received previous complementary treatment; in 80 pts primary tumor was previously resected (85%); median number of affected organs was 1 (1–4); in first line 76 pts received bevacizumab and 18 did not received any biological agent. Response Rate (RR) between mutant and no mutant pts was 48% (95% CI 37–59%) vs 47.8% (95% CI 32–63%) (p=0.92). Median follow up was 15.4 months. Progression free survival was 15 months for mutant and native K-RAS. There were no differences in response or PFS in any subgroup studied. Multivariable Cox analysis did not find any significant difference between sex (p=0.78), primary resected organ (p=0.28), liver metastases (p=0.37), LDH value at diagnosis (p=0.0.43), employ of biological agents in first line (p=0.37) or mutation in K-RAS gene (p=0.68). Conclusions: The percentage of K-RAS mutants is coherent with the results of the literature; mutations Gly12Asp, Gly12Val, and Gly13Asp represents the majority of the cases (81%); no significant relation was found between responses or DFS and mutations in the gene.

No significant financial relationships to disclose.

[Functional capacity evaluation in a clinical and ambulatory setting: new challenges of accelerometry to assessment balance and muscle power in aging population]

If we consider a population of free-living individuals, who are 65 years old and even older, a substantial proportion (in the range of 6% to 25%) suffers from many of the elements of the syndrome of frailty. Although the syndrome is complex and still lacks a standard definition, there is a growing consensus about its signs and symptoms. Patients who are afflicted with frailty typically exhibit losses of muscle strength, fatigue easily, are physically inactive, with an increased risk (and fear) of falling, have undergone a recent, unintentional loss of weight, experience impaired cognition and depression, all of which is frequently complicated by a variety of coexistent illnesses. In this context, functional tests to predict disability and frailty are needed. Accelerometry offers a practical and low cost method of objectively monitoring human movements, and has particular applicability to the monitoring of disability in an aging population. Accelerometers have been used to monitor a range of different movements, including gait, sit to stand transfers and postural sway. This review focuses on methodological concepts in the evaluation of skeletal muscle function and monitoring systems (accelerometers and gyroscopes) in each of these areas. An integrated approach is described in which a combination of accelorometry and gyroscopy can be used to monitor a range of different parameters (muscle power, gait and balance) in an aging population in a clinical or out-patient setting.

Environmental, physical and structural characterisation of geopolymer matrixes synthesised from coal (co-)combustion fly ashes

The synthesis of geopolymer matrixes from coal (co-)combustion fly ashes as the sole source of silica and alumina has been studied in order to assess both their capacity to immobilise the potentially toxic elements contained in these coal (co-)combustion by-products and their suitability to be used as cement replacements. The geopolymerisation process has been performed using (5, 8 and 12 M) NaOH solutions as activation media and different curing time (6-48 h) and temperature (40-80 degrees C) conditions. Synthesised geopolymers have been characterised with regard to their leaching behaviour, following the DIN 38414-S4 [DIN 38414-S4, Determination of leachability by water (S4), group S: sludge and sediments. German standard methods for the examination of water, waste water and sludge. Institut für Normung, Berlin, 1984] and NEN 7375 [NEN 7375, Leaching characteristics of moulded or monolithic building and waste materials. Determination of leaching of inorganic components with the diffusion test. Netherlands Normalisation Institute, Delft, 2004] procedures, and to their structural stability by means of compressive strength measurements. In addition, geopolymer mineralogy, morphology and structure have been studied by X-ray diffraction (XRD), scanning electron microscopy (SEM) and Fourier transform infrared spectroscopy (FTIR), respectively. It was found that synthesised geopolymer matrixes were only effective in the chemical immobilisation of a number of elements of environmental concern contained in fly ashes, reducing (especially for Ba), or maintaining their leachable contents after the geopolymerisation process, but not for those elements present as oxyanions. Physical entrapment does not seem either to contribute in an important way, in general, to the immobilisation of oxyanions. The structural stability of synthesised geopolymers was mainly dependent on the glass content of fly ashes, attaining at the optimal activation conditions (12 M NaOH, 48 h, 80 degrees C) compressive strength values about 60 MPa when the fly ash glass content was higher than 90%.

Detección múltiple de SNPS relacionados con crecimiento y calidad de carne en porcino

Se describe un método basado en análisis por primer extension para genotipar simultáneamente 7 SNPs relacionados con el crecimiento y la calidad de la carne en porcino. Las muestras de ADN genómico fueron obtenidas de 193 animales pertenecientes a varias razas (54 Ibérico, 63 Duroc, 47 Large White-Landrace x Large White) y a jabalí (29). A partir de las secuencias de los genes H-FABP, MC4R y LEPR, se diseñaron 4 parejas de cebadores con el fin de amplificar las regiones del genoma porcino que contienen esos 7 SNPs. La reacción de minisecuenciación primer extension (ABI PRISM SNaPshot MultiplexTM kit. Applied Biosystem) se realizó con cebadores diseñados en las regiones flanqueantes de cada uno de los SNPs de interés. Los genotipos fueron identificados por mini-secuenciación con ABIPrism 3130 y GeneMapper 3.7 (Applied Biosystems) pudiéndose así discriminar, en una sola reacción, los diferentes alelos de los 7 SNPs de cada animal. Gracias a esta técnica han sido detectados los polimorfismos T221C y C233T del gen LEPR (Genbank AF092422), que no eran reconocibles por enzimas de restricción. Este método permite identificar los animales con genotipo más deseables para la selección.

Differences in Physical Fitness and Throwing Velocity Among Elite and Amateur Female Handball Players

This study compared physical characteristics (body height [BH], body mass [BM], body fat [BF], and fat free mass [FFM]), one repetition maximum bench press (1RM (BP)), jumping explosive power (VJ), handball throwing velocity, power-load relationship of the leg and arm extensor muscles, 5- and 15-m sprint running time, and running endurance in elite (n = 16; EF) and amateur (n = 15; AF) female handball players aged 17 - 38. Results revealed that, compared to AF, EF players presented similar values in body mass and percent body fat, but higher values (p < 0.001 - 0.05) in BH (6 %), FFM (10 %), 1RM (BP) (23 %), VJ (10 %), handball throwing velocity (11 %), power-load relationship of the arm (25 %) and leg (12 %) extensors, as well as 5- and 15-m sprint (3 - 4 %) and endurance running velocities (13 %). Univariate regression analyses showed that 1RM (BP) was associated with throwing velocity (R (2) = 0.64). The higher absolute values of maximal strength and muscle power, although explained by the differences in fat free mass, will give EF an advantage to sustain certain handball game actions. The association between 1RM (BP) and throwing velocity suggests that throwing velocity values in female handball players depend more on maximal strength than on the capacity to move low loads at high velocities, during elbow extension actions.

[Rare Diseases: chronic diseases that need a new approach]

The concept of Rare Diseases is relatively new. They are those processes "...that can be mortal or to cause a chronic weakening of the patient and who, due to its little prevalence, require combined efforts to treat them. For indicative purposes, a little prevalence is considered when is lesser than 5 cases per 10,000 people in the Community". The existence of these diseases is closely tied with orphan drugs, meaning all drugs, prosthesis, biological agents or dietetic preparations destined to the treatment of a Rare Disease. Besides, it is necessary to add two factors more: 1. The Primary Attention physicians do not feel very motivated in their knowledge and 2. These diseases need a complex sociosanitary attention, habitually more expensive than chronic diseases. By all exposed the Rare Diseases appear like a universe that requires a new sociosanitary approach from the health system.

T lymphocyte activation signals

Activation of T lymphocytes results in immediate biochemical changes including increases in intracellular calcium levels, activation of protein kinase C (PKC) and changes in tyrosine phosphorylation. In T cells recent studies have indicated that activation of the guanine nucleotide-binding proteins p21ras is mediated by PKC, which suggests that the p21ras proteins may regulate intracellular signalling events downstream of PKC. The p21ras proteins can be activated in T cells by signals generated by triggering of the T cell antigen receptor (TCR), the CD2 antigen and the interleukin 2 receptor. Experiments using a PKC pseudosubstrate inhibitor indicate that PKC does not mediate TCR-induced activation of p21ras. These results imply that an alternative signal transduction pathway not involving PKC can regulate the activity of p21ras proteins in T cells.

mTOR Inhibitors and Their Secondary Effects in Cardiac Trasplant Recipients: A Descriptive Study

BACKGROUND

Mammalian target of rapamycin (mTOR) inhibitors are relatively new drugs in the field of cardiac transplantation (HT), hence the need for further study of their secondary effects. We described the nature and incidence of secondary effects of these drugs in a group of HT recipients.

PATIENTS AND METHODS

We studied 23 HT recipients aged 52 +/- 9 years (Male: 91%, body mass index: 27 +/- 3.7, ischemic cardiopathy: 52%, dilated cardiomyopathy: 39%) who were started on an mTOR inhibitor (everolimus: 65%, sirolimus: 35%) as part of their treatment. We have described the secondary effects detected during a follow-up period of 10.7 +/- 6 months.

RESULTS

The reasons for starting the drug were renal impairment (65%), tumors (26%), and others (8%). During follow-up, 17% of patients required a dose reduction and 12% required drug withdrawal: edemas: 4%, recurrent infection: 4%, and hemolytic-uremic syndrome: 4%. Drug-attributable edemas presented in 26% of patients. Thirty nine percent suffered an infection that required hospital admission, 89% of which were lung and all bacterial two patients died due to the infection). The mean time to first infection was 5 +/- 6 months. In patients who had a treatment change due to tumors, 50% experienced improvement. We did not detect alterations in cholesterol, triglycerides, creatinine, or leukocytes. There was a nonsignificant trend toward decreased hemoglobin and platelet levels (P = .07 and P = .056, respectively).

CONCLUSIONS

Lung infection was the principal complication among our patients treated with mTOR inhibitors. A large percentage required dose reduction (17%) and even drug withdrawal (12%) due to secondary effects.

mTOR Inhibitors: Do They Help Preserve Renal Function?

BACKGROUND

Renal function deterioration is one of the main problems facing heart transplant recipients. The mammalian target of rapamycin (mTOR) inhibitors, in combination with or replacing calcineurin inhibitors, may help preserve renal function. The aim of this study was to evaluate the progression of renal function after switching the immunosuppressive regimen.

PATIENTS AND METHODS

We studied 23 heart transplant recipients (5.5 +/- 4.5 years since transplantation). An mTOR inhibitor was introduced to replace cyclosporine (everolimus, 65%; sirolimus, 35%). Patient clinical characteristics and renal function were studied after switching. The statistical analysis used Student t test for paired data.

RESULTS

The reason for the transplantation was ischemic cardiopathy (52%), dilated myocardiopathy (39%), or other causes (9%). Mean age at time of transplantation was 52 +/- 9 years. Comorbidities were as follows hypertension (43%), insulin-dependent diabetes (22%), hypercholesterolemia (39%), and ex-smokers (70%). The reason for the switch was increased creatinine (65%), appearance of tumors (26%), or others (8%). Previous creatinine level was 1.89 +/- 0.6 mg/dL with clearance of 61.7 +/- 23 mL/min and at the end of follow-up (mean follow-up, 11 +/- 6 months) creatinine level was 2.0 +/- 1.45 mg/dL with clearance of 68.3 +/- 35 mL/min, namely, no significant difference (P = .49 and P = .57, respectively). In the subgroup of patients who switched treatment due to renal dysfunction, initial creatinine level was 2.38 +/- 0.4 mg/dL with clearance of 42.3 +/- 10 mL/min and at the end of follow-up it was 2.28 +/- 0.2 mg/dL and 43.6 +/- 11 mL/min, respectively (P = .68 for creatinine and clearance).

CONCLUSIONS

The introduction of mTOR inhibitors to the immunosuppressant regimen may be useful to delay renal functional deterioration caused by calcineurin inhibitors.

Ezetimibe in Heart Transplantation: Initial Experience

Dyslipidemia is a common problem among heart transplant (HT) recipients; it is a frequent risk factor in these patients that is exacerbated by immunosuppressive drugs. Statins are effective drugs to treat dyslipidemia in HT recipients, but control is suboptimal in some patients. Ezetimibe acts through inhibition of the enterohepatic recirculation, a mechanism different from but complementary to statins. Our objective was to assess the effect of the addition of ezetimibe to statin therapy among a population of HT patients.

PATIENTS AND METHODS

We included 19 stable patients on statin therapy with suboptimal control of cholesterol. Determinations were performed at baseline on statins and at 6 months (statins + ezetimibe). The analyzed variables were total cholesterol and fractions, triglycerides, cyclosporine levels, CPK, SGOT/SGPT, and bilirubin. The statistics were Student's t test for paired samples.

RESULTS

The overall mean age was 59 +/- 9 years with 95% males and mean BMI 27.5 +/- 3.5. The time since HT was 7 +/- 3 years. The reason for HT included ischemic heart disease in 68%. Pre-HT risk factors included in arterial hypertension in 32% and insulin-dependent diabetes mellitus in 10%, Dyslipidemia occurred in 68%; hypertriglyceridemia in 16% and hyperuricemia in 21%. Immunosuppression was cyclosporine in 100% and steroids in 94%. Type of lipid-lowering agent was simvastatin in 5%; pravastatin, 32%; atorvastatin, 58%; fibrates, 10%. The ezetimibe dose was 10 mg/day in 95% of cases. When ezetimibe was added we observed differences in total cholesterol values (total cholesterol at baseline: 279 +/- 74, total cholesterol with ezetimibe: 198 +/- 47 mg/dL; P = .0001) and LDL-cholesterol values (LDL-cholesterol at baseline: 171 +/- 69, LDL-cholesterol with ezetimibe: 109 +/- 41 mg/dL; P = .001). The remaining variables did not show significant differences.

CONCLUSION

The addition of ezetimibe to statin therapy among heart transplant patients was effective to control dyslipidemia and showed an excellent safety profile.

Targeting c-Jun and JunB proteins as potential anticancer cell therapy

The activating protein-1 transcription factor, in particular the Jun proteins play critical roles in the regulation of cell proliferation and tumor progression. To study the potential clinical relevance of interfering with JunB expression, we generated retroviruses expressing short hairpin RNA. Reduction of JunB levels causes increased proliferation and tumorigenicity in wild-type murine fibroblasts, whereas in c-Jun knockout cells p53-independent cell cycle arrest and apoptosis are induced. Using melanoma-derived B16-F10 cancer cells the combination of JunB knockdown and c-Jun/JNK inactivation leads to cell cycle arrest and apoptosis-inducing factor-dependent apoptosis. Furthermore, the combined treatment extends survival of mice inoculated with the tumor cells. These results indicate that in the absence of c-Jun, JunB can act as a tumor promoter and inactivation of both, c-Jun and JunB, could provide a valuable strategy for antitumor intervention.

Flat and Uphill Climb Time Trial Performance Prediction in Elite Amateur Cyclists

The aim of this study was to determine physiological, anthropometric, biomechanical and hormonal variables related to road flat and uphill climb performance. Eighteen elite level amateur road cyclists (21.1 +/- 3.8 yrs), homogeneous with regard to time trial performance (coefficient of variation: 2.9-5.2 %), were measured for frontal area (FA), maximal strength, power, cross-sectional area of the quadriceps femoris muscle and basal serum concentrations of total testosterone (TT), free testosterone (FT) and cortisol (C). Maximal (W (max)) and submaximal workload were measured during a progressive discontinuous maximal cycling laboratory test, and two all-out time trial performance tests (duration range: 1049-1251 s) were also conducted outdoors on two separate days: a 14-km flat road (average gradient of 0.2 %) and a 6.7-km uphill climb (average gradient of 6 %). Significant negative correlations (p < 0.01-0.001) were observed between the individuals' 14-km flat time values and the individual values of W (max) (r = - 0.90) and FA (r = - 0.73). Regression analysis showed that the individual values of the 6.7-km uphill climb trial performance time correlated significantly (p < 0.05-0.001) with those of FT (r = - 0.75) and W (max) x kg (-1) (r = - 0.66). The present results suggest that flat time trial performance in highly elite amateur cyclists is mainly related to absolute maximal workload and anthropometric variables, whereas uphill climb time trial performance is associated with maximal workload normalized to body mass, as well as with an increased anabolic-androgenic activity.

Calcineurin inhibitors affect circulating regulatory T cells in stable renal transplant recipients

INTRODUCTION

Immunosuppression, although crucial for short-term management, has been described in renal transplantation to be a major hurdle for long-term graft survival. Efforts have been directed at achieving a true state of allotolerance, thereby reducing the load of immunosuppression. Recently, increased frequencies of CD4(+)CD25(high) regulatory T cells (Tregs) have been described as an additional mechanism to induce alloimmune tolerance.

MATERIALS AND METHODS

We assessed 64 renal transplant recipients with stable renal function for at least 1 year, divided into two groups: one composed of patients receiving rapamycin but not calcineurin inhibitors (CNIs), and another, of those receiving CNIs but not rapamycin.

RESULTS

We demonstrated that T cells with a regulatory phenotype were decreased in peripheral blood of renal transplant recipients under CNI therapy compared to those who were CNI-free. The Tregs in our patients showed a modest association with renal function as measured by the delta serum creatinine, which was not significant.

CONCLUSIONS

CNIs, but not rapamycin, reduce the frequencies of circulating Tregs in renal transplant recipients. The use of rapamycin might be further exploited in strategies reducing immunosuppression in renal transplantation. Furthermore, quantification of blood Tregs may be a suitable tool to identify those recipients who are candidates for reducing immunosuppression.

Pulmonary sarcoidosis in a patient with ankylosing spondylitis treated with infliximab

We present a case of a 34 year-old male diagnosed with ankylosing spondylitis. After two years of treatment with infliximab, the patient developed a clinical picture compatible with stage II thoracic sarcoidosis. These findings resulted in the interruption of infliximab therapy. The patient was not administered new treatment since respiratory function testing did not confirm harmful repercussions. After a follow-up of 1 year, the patient is asymptomatic and radiologic tests show complete resolution of pulmonary infiltrates and mediastinal and bilateral hilar lymphad- enopathy.

Exchange and correlation effects in electronic excitations of Cu(2)O

State-of-the-art theoretical methods fail in describing the optical absorption spectrum, band gap, and optical onset of Cu(2)O. We have extended a recently proposed self-consistent quasiparticle approach, based on the GW approximation, to the calculation of optical spectra, including excitonic effects. The band structure compares favorably with our present angle-resolved photoemission measurements. The excitonic effects based on these realistic band structure and screening provide a reliable optical absorption spectrum, which allows for a revised interpretation of its main structures.

Electromyostimulation and plyometric training effects on jumping and sprint time

This study compared the effects of four-week training periods of electromyostimulation (EMS), plyometric training (P), or combined EMS and P training of the knee extensor muscles on 20 m sprint time (ST), jumping ability (Squat jump [SJ] and Countermovement jump [CMJ]), maximal isometric strength (MVC), and muscle cross-sectional area (CSA). Forty subjects were randomly assigned to one of the four treatment groups: electromyostimulation (EG), plyometric (PG), combined EMG, and P (EPG), that took place 4 times per week, and a control group (CG). Subjects were tested before and after the training program, as well as once more after 2 wk of detraining. A significant improvement (p < 0.05) in ST was observed after training (2.4 %) in EG while a significant slowing (p < 0.05) was observed (- 2.3 %) in EPG. Significant increases in EPG (p < 0.05) were observed in SJ (7.5 %) and CMJ (7.3 %) after training, while no significant changes in both jumps were observed after training and detraining for EG. A significant increase (p < 0.05) in MVC was observed after training (9.1 %) and after detraining (8.1 %) in EG. A significant increase (p < 0.05) in MVC was observed after training (16.3 %) in EPG. A significant increase (p < 0.01) in CSA was observed after training in EG (9.0 %) and in EPG (7.1 %). EMS combined with plyometric training increased the jumping height and sprint run in physically active men. In addition, EMS alone or EMS combined with plyometric training leads to increase maximal strength and to some hypertrophy of trained muscles. However, EMS training alone did not result in any improvement in jumping explosive strength development or even interfered in sprint run.

[Gene therapy in neuro-oncology]

INTRODUCTION AND DEVELOPMENT

The concept of gene therapy implies the transfer of genetic material to a cell, a tissue or an organ with the aim to cure an illness or at least to improve the clinical status of a patient. The essential components of the therapy are: a vector able to enter efficiently and selectively the target cells; and the therapeutic gene competent to cure the pathology. In cancer therapies, retroviruses are preferentially used as vectors because they only infect dividing cells. Among the most popular and successful gene therapies against cancer we find the immunotherapy, the antiangiogenic strategies, the killer-suicide genes and RNA interference against specific oncogenes.

CONCLUSIONS

Each one of these therapies have proven successful in cancer cell lines and in experimental animals where it has been shown a clear antitumoral effect in the absence of appreciable secondary effects. At present, the majority of these procedures are in clinical phases but none as yet is considered a therapeutic option.

Variations in the Frequency and Type of Infections in Heart Transplantation According to the Immunosuppression Regimen

OBJECTIVE

To evaluate the frequency of infection according to the immunosuppressive regimens used in our center.

MATERIALS AND METHODS

From 259 consecutive heart transplants we excluded pediatric cases, retransplants, combined transplants (lung and kidney) and immunosuppressive regimens with fewer than 10 cases. The six groups analyzed were: (1) OKT3 (7 days) + cyclosporine (CsA) + mycophenolate mofetil (MMF) + steroids (S); (2) OKT3 (7 days) + CsA + azathioprine (AZA) + S; (3) OKT3 (10 days) + CsA + MMF + S; (4) OKT3 (10 days) + CsA + AZA + S; (5) interleukin-2 (IL-2) antagonists + CsA + MMF + S; (6) IL-2 antagonists + tacrolimus + MMF + S. Infection was considered significant when it causal hospital admission or prolonged hospitalization.

RESULTS

With a total mean follow-up of 54 +/- 43 months, the total percentage of infection-free patients at the end of follow-up was 45.5%. Infection-free survival was lower among patients administered induction with OKT3 antibodies for 10 days, combined with cyclosporine, either with MMF (10%, group 3) or with azathioprine (27%, group 4), compared to those given IL-2 antagonists (particularly in combination with tacrolimus and MMF-69.2%, group 6).

CONCLUSIONS

The results of this study showed that infection was frequent in heart transplantation. Furthermore, induction therapy with OKT3 monoclonal antibodies was associated with an important number of infections (particularly viral infections). Comparison of the treatment groups showed that the regimen associated with fever infections included an IL-2 receptor antagonist with tacrolimus, MMF, and S.

Influence of Immunosuppression Regimen on Heart Transplantation Survival

OBJECTIVE

To perform an analysis comparing long-term survival in heart transplant (HT) patients depending on the immunosuppressive regimen.

MATERIALS AND METHODS

The study included 317 consecutive HT patients. We excluded pediatric cases, retransplants, combined transplants (lung and kidney), and immunosuppressive regimens with fewer than 10 cases. The six groups analyzed were: (1) OKT3 7 days + cyclosporine (CsA) + mycophenolate mofetil (MMF) + steroids (S); (2) OKT3 7 days + CsA + azathioprine (AZA) + S; (3) OKT3 10 days + CsA + MMF + S; (4) OKT3 10 days + CsA + AZA + S; (5) interleukin-2 (IL-2) antagonists + CsA + MMF + S; and (6) IL-2 antagonists + tacrolimus + MMF + S. Probability of survival was analyzed by Kaplan-Meier and log-rank methods.

RESULTS

The groups were heterogeneous regarding the number of patients and follow-up. The baseline characteristics were similar, although there were differences in surgery times. The survivals by groups at the end of the follow-up period were: group 1: 75.8%; group 2: 51.2%; group 3: 63.6%; group 4: 25.3%; group 5: 91.2%; and group 6: 84.6%. A major reduction in survival was observed in the groups that were given induction with OKT3 monoclonal antibodies (groups 1, 2, 3, and 4), particularly when AZA was combined in the maintenance phase (groups 2 and 4) and when the induction dose was high (10-day therapy in groups 3 and 4).

CONCLUSIONS

Our study suggested an association between the immunosuppressive regimen and the long-term survival of HT patients. The best results were obtained with an induction regimen based on IL-2 antagonists. On the basis of the survivals observed in this study, the maintenance combination we regard as "optimal" at this time is based on a combination of CsA, MMF, and steroids.

Effect of Loading on Unintentional Lifting Velocity Declines During Single Sets of Repetitions to Failure During Upper and Lower Extremity Muscle Actions

The purpose of this study was to examine the effect of different loads on repetition speed during single sets of repetitions to failure in bench press and parallel squat. Thirty-six physical active men performed 1-repetition maximum in a bench press (1 RM (BP)) and half squat position (1 RM (HS)), and performed maximal power-output continuous repetition sets randomly every 10 days until failure with a submaximal load (60 %, 65 %, 70 %, and 75 % of 1RM, respectively) during bench press and parallel squat. Average velocity of each repetition was recorded by linking a rotary encoder to the end part of the bar. The values of 1 RM (BP) and 1 RM (HS) were 91 +/- 17 and 200 +/- 20 kg, respectively. The number of repetitions performed for a given percentage of 1RM was significantly higher (p < 0.001) in half squat than in bench press performance. Average repetition velocity decreased at a greater rate in bench press than in parallel squat. The significant reductions observed in the average repetition velocity (expressed as a percentage of the average velocity achieved during the initial repetition) were observed at higher percentage of the total number of repetitions performed in parallel squat (48 - 69 %) than in bench press (34 - 40 %) actions. The major finding in this study was that, for a given muscle action (bench press or parallel squat), the pattern of reduction in the relative average velocity achieved during each repetition and the relative number of repetitions performed was the same for all percentages of 1RM tested. However, relative average velocity decreased at a greater rate in bench press than in parallel squat performance. This would indicate that in bench press the significant reductions observed in the average repetition velocity occurred when the number of repetitions was over one third (34 %) of the total number of repetitions performed, whereas in parallel squat it was nearly one half (48 %). Conceptually, this would indicate that for a given exercise (bench press or squat) and percentage of maximal dynamic strength (1RM), the pattern of velocity decrease can be predicted over a set of repetitions, so that a minimum repetition threshold to ensure maximal speed performance is determined.

Phase II open label randomized study of trabectedin (T) given as two different dosing schedules in women with platinum-sensitive, recurrent ovarian carcinoma: Preliminary results

5031

Background: Trabectedin (Yondelis, ET-743) is a marine derived compound which binds to the minor groove of DNA distorting the DNA structure and induces apoptosis and cell cycle arrest. It has shown clinical activity in soft tissue sarcoma, ovarian, prostate and breast cancer. Methods: Patients (pts) with recurrent platinum sensitive ovarian carcinoma were randomized in a multicenter, open label study to receive T as 1.5 mg/m2 over 24 h infusion (schedule A) or 1.3 mg/m2 over 3 h infusion (schedule B) both every 3 weeks. All pts received dexamethasone premedication. Primary objective is to evaluate the response rate (RECIST) and secondary objectives are response duration, CA-125 response, time to progression and safety. Results: 107 pts were enrolled in 23 centers. Demographic and disease characteristics were well balanced. Toxicity and response data on the first 99 pts are available: median age 57 (25–78) years; ECOG PS=0: 72% and =1: 28%; pts received a median of 4 cycles (range:1–19 in A, 1–13 in B). Relative dose intensity was 84% and 93% respectively. Objective responses due to investigator’s assessment were 29% (8% CR, 21% PR) with 52% SD in A and 28% (11% CR, 17% PR) with 45% SD in B, with 11 pts not yet evaluable for response. CA 125 responses ≥ 50% occurred in 23% in A and 26% in B. TTP data will be presented. Safety: 501cycles were delivered; the most common any grade drug-related AEs per patient were (A and B) fatigue (56% and 47%), nausea (63% and 70%), vomiting (56% and 45%) and constipation (25% and 30%). Consistent with previous experience, alopecia, stomatitis and neurotoxicity were uncommon and mild/moderate. Grade 3/4 fatigue occurred in 15% in A and 4% in B. Grade 3/4 lab abnormalities were non-cumulative neutropenia (50% and 32%) and reversible ALT increase (58% and 53%). G-CSF support was not routinely given. There were 4 deaths <30 days last infusion date (3 in A unrelated to study drug, one in B due to related multiorgan failure). Conclusions: This analysis suggests that both T schedules appear active with manageable toxicity. There was a trend for less neutropenia and fatigue with schedule B. On the basis of these efficacy results, no additional phase III comparisons between these 2 schedules seem warranted

[Table: see text]

RNA interference against Hec1 inhibits tumor growth in vivo

Hec1 (highly expressed in cancer) plays an important role in chromosome segregation by interacting with a subset of checkpoint proteins that survey proper chromosome alignment and bipolar spindle attachment. In order to disrupt mitotic progression of tumor cell lines, we have used retrovirus and adenovirus vectors that inhibit Hec1 synthesis. Vector-expressed short hairpin RNAs (shRNAs) caused very efficient depletion of the target protein, cellular arrest and considerable mitotic catastrophe induction 96 h post infection in human cervix-adenocarcinoma (HeLa) and glioblastoma (U-373-MG) cell lines. Furthermore, adenocarcinomas induced in the flanks of nude mice show significant reduction in size compared with control when treated with either Hec1-shRNA retroviruses or adenoviruses. These results indicate that depletion of Hec1 could be used as a new strategy to block the dividing cell, and therefore against cancer.

Epitaxy and magnetic properties of surfactant-mediated growth of bcc cobalt

High resolution core level photoemission spectroscopy, photoelectron diffraction, and x-ray magnetic circular dicroism (XMCD) have been used to characterize the structural and magnetic properties of bcc-cobalt films grown on GaAs(110) substrates by using Sb as a surfactant. We have unambiguously disentangled the surfactant role played by the Sb which improves the crystallinity and reduces the lattice distortion of the metallic films as well as changes the interdiffusion process at the interface compared to the Co/GaAs(110) system. As a consequence of these combined effects, an improvement on the magnetic response of the grown Co thin films has been observed by XMCD measurements.

Differences in Physical Fitness and Throwing Velocity Among Elite and Amateur Male Handball Players

This study compared physical characteristics (body height, body mass [BM], body fat [BF], and free fatty mass [FFM]), one repetition maximum bench-press (1RM (BP)), jumping explosive strength (VJ), handball throwing velocity, power-load relationship of the leg and arm extensor muscles, 5- and 15-m sprint running time, and running endurance in two handball male teams: elite team, one of the world's leading teams (EM, n = 15) and amateur team, playing in the Spanish National Second Division (AM, n = 15). EM had similar values in body height, BF, VJ, 5- and 15-m sprint running time and running endurance than AM. However, the EM group gave higher values in BM (95.2 +/- 13 kg vs. 82.4 +/- 10 kg, p < 0.05), FFM (81.7 +/- 9 kg vs. 72.4 +/- 7 kg, p < 0.05), 1RM (BP) (107 +/- 12 kg vs. 83 +/- 10 kg, p < 0.001), muscle power during bench-press (18 - 21 %, p < 0.05) and half squat (13 - 17 %), and throwing velocities at standing (23.8 +/- 1.9 m . s (-1) vs. 21.8 +/- 1.6 m . s (-1), p < 0.05) and 3-step running (25.3 +/- 2.2 m . s (-1) vs. 22.9 +/- 1.4 m . s (-1), p < 0.05) actions than the AM group. Significant correlations (r = 0.67 - 0.71, p < 0.05 - 0.01) were observed in EM and AM between individual values of velocity at 30 % of 1RM (BP) and individual values of ball velocity during a standing throw. Significant correlations were observed in EM, but not in AM, between the individual values of velocity during 3-step running throw and the individual values of velocity at 30 % of 1RM (BP) (r = 0.72, p < 0.05), as well as the individual values of power at 100 % of body mass during half-squat actions (r = 0.62, p < 0.05). The present results suggest that more muscular and powerful players are at an advantage in handball. The differences observed in free fatty mass could partly explain the differences observed between groups in absolute maximal strength and muscle power. In EM, higher efficiency in handball throwing velocity may be associated with both upper and lower extremity power output capabilities, whereas in AM this relationship may be different. Endurance capacity does not seem to represent a limitation for elite performance in handball.

Morphologic changes in breast biopsies after duct endoscopy

Duct endoscopy is a recent technique used for a direct view of the breast ductal system. The aim of this study is to determine any morphological changes in breast tissue attributable to low-pressure irrigation with saline solution that the technique requires. A total of 26 breast biopsies from patients who underwent ductal endoscopy before surgery were compared with 26 breast specimens from the retroareolar region. Breast specimens from duct endoscopy showed more frequent epithelial detachment (73%), epithelial loss (35%), periductal clefts (77%), stromal disaggregation (46%) and displacement of epithelial cells into the stroma (27%) than the control group in which epithelial detachment was seen in 4% of patients, periductal clefts in 15%, and stromal disaggregation in 15%. Epithelial loss and epithelial displacement where not seen in the control group. Although low-pressure fluid perfusion used for duct endoscopy induced morphological changes in breast tissue, these can easily be distinguished from malignancy, and are most likely to occur as the result of duct rupture.

T-cell activation

Activation of T lymphocytes results in immediate intracellular biochemical changes, including increases in cytosolic Ca(2+) levels, stimulation of protein kinase C (PKC) and regulation of protein tyrosine kinases (PTKs). This review describes recent advances in the study of the signalling steps downstream of PKC and PTKs in T cells. A model is presented in which the GTP-binding protein p21(ras) acts as an integrator of the signal transduction pathways controlled by the T-cell antigen receptor.

Strength training effects on physical performance and serum hormones in young soccer players

To determine the effects of simultaneous explosive strength and soccer training in young men, 8 experimental (S) and 11 control (C) players, aged 17.2 (0.6) years, were tested before and after an 11-week training period with respect to the load-vertical jumping curve [loads of 0-70 kg (counter-movement jump CMJ0-70)], 5- and 15-m sprint performances, submaximal running endurance and basal serum concentrations of testosterone, free testosterone and cortisol. In the S group, the 11-week training resulted in significant increases in the low-force portion of the load-vertical jumping curve (5-14% in CMJ0-30, P<0.01) and in resting serum total testosterone concentrations (7.5%, P<0.05), whereas no changes were observed in sprint running performance, blood lactate during submaximal running, resting serum cortisol and resting serum free testosterone concentrations. In the C group, no changes were observed during the experimental period. In the S group, the changes in CMJ0 correlated ( P<0.05-0.01) with the changes in the 5-m ( r=0.86) and 15-m ( r=0.92) sprints, whereas the changes in CMJ40 correlated negatively with the changes in the testosterone:cortisol ratio ( r=-0.84, -0.92, respectively, P<0.05). These data indicate that young trained soccer players with low initial strength levels can increase explosive strength by adding low-frequency, low-intensity explosive-type strength training. The inverse correlations observed between changes in CMJ40 and changes in the testosterone:cortisol ratio suggest that a transient drop in this ratio below 45% cannot always be interpreted as a sign of overstrain or neuroendocrine dysfunction.

Exacerbated inflammatory responses in transgenic mice expressing an inhibitor of apoptosis protein (OpIAP)

Members of the inhibitor of apoptosis protein family are involved not only in suppressing apoptosis, but also in signal transduction, cell division, and are associated with some types of cancers. Here we show that transgenic expression of the inhibitor of apoptosis protein OpIAP in murine T lymphocytes leads to a significant increase in T-cell receptor-induced cell activation, proliferation and cytokine production. Transgenic T lymphocytes expressing OpIAP have a lower proliferation threshold in response to T-cell receptor stimulation. Unstimulated OpIAP transgenic T lymphocytes show elevated nuclear levels of NF-kappaB transcription factor that increase after in vivo antigen peptide treatment. OpIAP transgenic animals present an exacerbated inflammatory response in an experimental contact hypersensitivity model, suggesting increased T-cell activation in vivo. These data indicate a new role for the inhibitor of apoptosis proteins in T-lymphocyte activation and proliferation.

Neuromuscular adaptations during concurrent strength and endurance training versus strength training

The purpose of this study was to investigate effects of concurrent strength and endurance training (SE) (2 plus 2 days a week) versus strength training only (S) (2 days a week) in men [SE: n=11; 38 (5) years, S: n=16; 37 (5) years] over a training period of 21 weeks. The resistance training program addressed both maximal and explosive strength components. EMG, maximal isometric force, 1 RM strength, and rate of force development (RFD) of the leg extensors, muscle cross-sectional area (CSA) of the quadriceps femoris (QF) throughout the lengths of 4/15-12/15 (L(f)) of the femur, muscle fibre proportion and areas of types I, IIa, and IIb of the vastus lateralis (VL), and maximal oxygen uptake (VO(2max)) were evaluated. No changes occurred in strength during the 1-week control period, while after the 21-week training period increases of 21% (p<0.001) and 22% (p<0.001), and of 22% (p<0.001) and 21% (p<0.001) took place in the 1RM load and maximal isometric force in S and SE, respectively. Increases of 26% (p<0.05) and 29% (p<0.001) occurred in the maximum iEMG of the VL in S and SE, respectively. The CSA of the QF increased throughout the length of the QF (from 4/15 to 12/15 L(f)) both in S (p<0.05-0.001) and SE (p<0.01-0.001). The mean fibre areas of types I, IIa and IIb increased after the training both in S (p<0.05 and 0.01) and SE (p<0.05 and p<0.01). S showed an increase in RFD (p<0.01), while no change occurred in SE. The average iEMG of the VL during the first 500 ms of the rapid isometric action increased (p<0.05-0.001) only in S. VO(2max) increased by 18.5% (p<0.001) in SE. The present data do not support the concept of the universal nature of the interference effect in strength development and muscle hypertrophy when strength training is performed concurrently with endurance training, and the training volume is diluted by a longer period of time with a low frequency of training. However, the present results suggest that even the low-frequency concurrent strength and endurance training leads to interference in explosive strength development mediated in part by the limitations of rapid voluntary neural activation of the trained muscles.

A tricistronic retroviral vector expressing natural antiangiogenic factors inhibits angiogenesis in vitro, but is not able to block tumor progression in vivo

Angiogenesis, the formation of new blood vessels out of pre-existing capillaries, is essential for tumor progression. Many factors have been identified that are able to inhibit angiogenesis. Here, we report the construction of a tricistronic retroviral vector encoding two inhibitors of angiogenesis expressed in mammals: the N-terminal fragment of rat prolactin (16KrPRL) and a secreted form of human platelet factor 4 (sPF4). When transduced by this retroviral vector, a rat glioblastoma cell line loses its ability of promoting endothelial cell locomotion, the initial step of angiogenesis, and the formation of an endothelial cell tube network. In spite of this encouraging in vitro result, however, the anti-angiogenic vector cannot block glioblastoma progression in animal models. These results suggest that therapeutic strategies aiming to block tumor progression through the inhibition of tumor-associated angiogenesis, should not only provide large numbers of angiogenesis inhibitors, but also target the angiogenic factors produced by tumor cells. Moreover, the data described herein may confirm recent findings from other groups which indicate that in order to successfully counteract tumor progression, drugs inhibiting new blood vessel formation should be employed in combination with traditional anti-tumor strategies, such as chemotherapy or radiotherapy.

Identification of Hake species (Merluccius Genus) using sequencing and PCR-RFLP analysis of mitochondrial DNA control region sequences

The use of DNA-based methodologies in identification of hake species belonging to the Merluccius genus was shown to be successful. A short fragment of the left hypervariable domain of the mitochondrial control region was amplified, sequenced, and digested from 11 hake species. The hake-specific PCR product, due to its limited size, was obtained in a variety of tissue samples with different levels of DNA concentration and degradation, including sterilized food products. On the basis of this phylogenetically informative 156-bp sequence were selected four restriction enzymes (ApoI, DdeI, DraIII, and MboII) that allow the hake species discrimination. Species identification by phylogenetic analysis of sequences or by PCR-RFLP methodologies is useful in a variety of scenarios including authentication of thermally processed food, detection of food components, and species determination of individuals whose morphological characters are removed.

In vivo reduction in ATP cost of contraction is not related to fatigue level in stimulated rat gastrocnemius muscle

1. We tested whether the reduction in ATP cost of contraction during in vivo stimulation of rat gastrocnemius muscle was related to fatigue level. 2. Muscles (n = 44) were electrically stimulated to perform 6 min repeated isometric contractions at different frequencies; one non-fatiguing protocol (stimulation at 0.8 Hz) and five fatiguing protocols (2, 3.2, 4, 5.2 and 7.6 Hz) were used. Anaerobic and oxidative ATP turnover rates were measured non-invasively using (31)P-magnetic resonance spectroscopy. 3. At the onset of the stimulation period, no signs of fatigue were measured in the six protocols and ATP cost of contraction did not differ significantly (P = 0.45) among protocols (mean value of 1.76 +/- 0.11 mM (N s)(-1)). 4. For the six protocols, ATP cost of contraction was significantly reduced (P < 0.05) at the end of the stimulation period when compared with the initial value. This reduction did not differ significantly (P = 0.61) among the five fatiguing protocols (averaging 35 +/- 3 % of initial value), whereas isometric force decreased significantly as stimulation frequency increased. No significant correlation (P = 0.87, r(2) = 0.01) was observed between isometric force and ATP cost of contraction at the end of the stimulation period. In addition, this reduction was significantly lower (P < 0.05) for the non-fatiguing protocol (67 +/- 9 % of initial value) when compared with the fatiguing protocols. 5. These results demonstrate that (i) the reduction in ATP cost of contraction during in vivo stimulation of rat gastrocnemius muscle is not related to the fatigue level; (ii) surprisingly, this reduction was significantly larger during the fatiguing protocols compared with the non-fatiguing protocol.

Time-dependent and indirect effect of inorganic phosphate on force production in rat gastrocnemius exercising muscle determined by 31P-MRS

The relationship of inorganic phosphate (P(i)) and its diprotonated form (H(2)PO(4)(-)) to isometric force (F) was analyzed non-invasively using 31P-magnetic resonance spectroscopy. Rat gastrocnemius muscles were electrically stimulated at six different frequencies in order to produce different levels of fatigue. A curvilinear relationship was demonstrated between force production and [P(i)] and [H(2)PO(4)(-)] accumulation. [P(i)] and [H(2)PO(4)(-)] were correlated with F at the end of the stimulation period but not when F was maximal at the early stage of the stimulation period. Interestingly, the respective [P(i)] and [H(2)PO(4)(-)] did not differ significantly between these two stages demonstrating that [P(i)] and [H(2)PO(4)(-)] cannot be considered as direct effectors of fatigue. This time-dependent and indirect effect of [P(i)] and [H(2)PO(4)(-)] on force production might be mediated by calcium ions.