Exercise capacity independently predicts bone mineral density and proximal femoral geometry in patients with acute decompensated heart failure

Heart failure is associated with increased risk of osteoporosis. We evaluated the prevalence and predictors of osteoporosis in hospitalized patients with ADHF using quantitative computed tomography. Osteoporosis and vertebral fracture are prevalent in patients with ADHF and exercise capacity independently predicts bone mass and femoral bone geometry.

INTRODUCTION

Heart failure is associated with reduced bone mass and increased risk of osteoporotic fractures. However, the prevalence and predictors of osteoporosis in hospitalized patients with acute decompensated heart failure (ADHF) are not well understood.

METHODS

Sixty-five patients (15 postmenopausal females and 50 males) with ADHF were prospectively and consecutively enrolled. After stabilization of heart failure symptoms, quantitative computed tomography for bone mineral density (BMD) and femoral geometry as well as biochemical, echocardiographic, and cardiopulmonary exercise tests were performed.

RESULTS

Fifteen postmenopausal female showed a high prevalence of osteoporosis (40%) and vertebral fracture (53%). Among 50 male patients, 12% had osteoporosis and 32% had osteopenia, while vertebral fracture was found in 12%. Lumbar volumetric BMD (vBMD) was significantly lower in ischemic patients than non-ischemic patients (107.9 ± 47.5 vs. 145.4 ± 40.9 mg/cm(3), p = 0.005) in male. Exercise capacity, indicated by peak oxygen consumption (VO2), was significantly associated with lumbar vBMD (r = 0.576, p < 0.001) and total hip areal BMD (aBMD) (r = 0.512, p = 0.001) and cortical thickness of the femur neck (r = 0.544, p = 0.001). When controlled for age, body mass index, N-terminal proBrain natriuretic protein (NT-proBNP), etiology of heart failure, hemoglobin, and thigh circumference, multivariate regression analysis revealed peak VO2 independently predicted lumbar vBMD (β = 0.448, p = 0.031), total hip aBMD (β = 0.547, p = 0.021), and cortical thickness of the femur neck (β = 0.590, p = 0.011).

CONCLUSION

In male patients with ADHF, osteoporosis and vertebral fracture are prevalent, and exercise capacity independently predicts bone mass and geometry. Given that heart failure patients with reduced exercise capacity carry a substantial increased risk of fracture, proper osteoporosis evaluation is important in these patients.

The Effects of Cynomorium songaricum on the Reproductive Activity in Male Golden Hamsters

Cynomorium songaricum (CS) has been used in traditional Korean medicine in treating male impotence and sexual dysfunction. We investigated the effects of aqueous CS extract on the reproductive activity of golden hamsters whose spermatogenetic capacity is active in summer and inactive in winter. The animals were divided into 5 groups: long photoperiod (LP) control, short photoperiod (SP) control, and SP animals treated with low, middle, or high concentrations of CS. The animals were orally ingested with low (0.5 g/kg), middle (1.0 g/kg), or high (2.5 g/kg) concentrations of the aqueous extracts for 8 weeks on the daily basis. The control animals received the vehicle. As results, the LP control animals showed active testicular function but SP control animals displayed remarkably reduced testicular weights. The outcomes of the reproductive activity from low and middle concentrations of CS treatments were identical and marked as low dose. The consequences were a partial blocking of regressing activity by SP. On the other hand, the animals treated with high dose of CS extract showed remarkable significance in comparison to the SP control, indicative of a complete blocking effect of the CS on the regressing testes by SP. There were a dose-dependent effects of the CS on the sexual function. These results suggest that the CS extract promotes the male fertility by strengthening the spermatogenesis in the golden hamsters.

Continuous melatonin attenuates the regressing activities of short photoperiod in male golden hamsters

Golden hamsters reproduce in a limited time of a year. Their sexual activities are active in summer but inactive in winter during which day length does not exceed night time and environmental conditions are severe to them. The reproductive activities are determined by the length of light in a day (photoperiod). Melatonin is synthesized and secreted only at night time from the pineal gland. Duration of elevated melatonin is longer in winter than summer, resulting in gonadal regression. The present study aimed at the influences of continuous melatonin treatments impinging on the gonadal function in male golden hamsters. Animals received empty or melatonin-filled capsules for 10 weeks. They were divided into long photoperiod (LP) and short photoperiod (SP). All the animals maintained in LP (either empty or melatonin-filled capsules) showed large testes, implying that melatonin had no effects on testicular functions. Animals housed in SP displayed completely regressed testes. But animals kept in SP and implanted with melatonin capsules exhibited blockage of full regression by SP. These results suggest that constant release of melatonin prohibits the regressing influence of SP.

The Potential Regressive Role of Syzygium aromaticum on the Reproduction of Male Golden Hamsters

The flower buds of Syzygium aromaticum (clove) have been used as traditional medicine for the treatment of male sexual disorders in Asian countries. Recently, there are some reports about the effects of the clove on reproductive activities in mammals. Therefore, its effect on testicular function was examined in male golden hamsters whose reproductive activity is inhibited by photoperiod such as winter climate. The male animals were given by daily oral administrations (56 consecutive days) in three doses (4 mg, 20 mg, and 100 mg/kg BW) of the alcoholic extract of the clove. Generally lower dose (4 mg) of the extract continued to keep the reproductive activities of testes. The both middle and high doses (20 mg and 100 mg) of the extract completely inhibited the testicular activity in some animals. Taken together, these results suggest a possible biphasic action of alcoholic extract of Syzygium aromaticum flower bud on testicular function.

Differentiation of solid-type serous cystic neoplasm from neuroendocrine tumour in the pancreas: value of abdominal MRI with diffusion-weighted imaging in comparison with MDCT

AIM

To evaluate the value of abdominal MRI with diffusion-weighted (DW) imaging for differentiation of solid-type serous cystic neoplasm (SCN) from neuroendocrine tumour (NET) in the pancreas compared with that of CT.

MATERIALS AND METHODS

Ten solid-type SCNs and 15 NETs were included in the study. Qualitative and quantitative analyses were performed, and two observers independently reviewed CT and MRI images for diagnosis of solid-type SCNs. Fisher's exact test and Mann-Whitney U-test, diagnostic performance [receiver operating characteristic (ROC) curve analysis] were evaluated.

RESULTS

SCNs showed more frequently hypo-attenuation on unenhanced CT images and marked hyperintensity on T2-weighted images compared with NETs (p < 0.01). The density of the tumour on unenhanced CT images and the apparent diffusion coefficient (ADC) value of the tumour were significantly different between SCNs (mean 18.5 HU; mean 2.45 × 10(-3) mm(2)/s) and NETs (mean 39.2 HU; mean 1.51 × 10(-3) mm(2)/s; p < 0.001). In the differentiation of SCNs from NETs, diagnostic performance of MRI with DW images was significantly higher than that of CT imaging (p < 0.01).

CONCLUSION

Abdominal DW-MRI shows a higher diagnostic accuracy than abdominal CT imaging in the differentiation of solid-type SCNs from NETs.

Mapping the nonlinear dynamics of a laser diode via its terminal voltage

We show that the bifurcations between dynamical states originating in the nonlinear dynamics of an external-cavity semiconductor laser at constant current can be detected by its terminal voltage V. We experimentally vary the intensity fed back into the gain medium by the external cavity and show that the dc component V(dc) of V tracks the optical intensity-based bifurcation diagram. It is shown using computational results based upon the Lang-Kobayashi model that whereas optical intensity accesses the dynamical-state variable |E|, V is related to population-inversion carrier density N. The change in feedback strength affects N and thereby the quasi-Fermi energy level difference at the p-i-n junction band-gap of the gain medium. The change in the quasi-Fermi energy-level thereby changes the terminal voltage V. Thus V is shown to provide information on the change in the dynamical-state variable N, which complements the more conventionally probed optical intensity.