Identification of an appropriate strategy to control anemia in adolescent girls of poor communities

OBJECTIVES

To obtain baseline data on hemoglobin (Hb) levels of adolescent girls belonging to the low-socio-economic groups; investigate the comparative efficacy of once 'weekly' and 'daily' administration of iron-folate tablets with respect to impact on the Hb levels; and find out the effect of added ascorbic acid supplementation on the efficacy of iron-folate administration with respect to increment in Hb levels.

DESIGN

Randomized experimental.

SETTING

Adolescent girls of poor communities in urban areas of Delhi and rural parts of Bharatpur (Rajasthan).

METHODS

The baseline investigations included measurements of height, weight, and Hb levels. The Hb levels of the participating subjects were measured again after 3 months and 6 months of supplementation.

RESULTS

61.9% of the subjects in the urban and 85.4% in the rural area were anemic. The response of Hb levels to daily iron/folate supplementation was better in comparison to once-weekly supplementation. The increment in Hb levels of subjects due to addition of vitamin C to iron/folate supplementation was more than that with supplementation of iron/folate alone.

CONCLUSIONS

Considering compliance, feasibility and cost-factors, a public-health approach consisting of once-weekly distribution of iron/folate supplementation through schools and welfare centers is better and can be recommended as an appropriate strategy for combating anemia in adolescent girls of poor communities in developing countries like India.

Flaxseed: a source of hypocholesterolemic and antiatherogenic agents

Recently there has been a moderate resurgence in the use of flaxseed food. However, the scientific basis of the benefits of flaxseed consumption and which components of flaxseed offer these beneficial effects are not known. Flaxseed contains 32-45% of its mass as oil, of which 51-55% is alpha-linolenic acid (n-3 fatty acids, omega-3 fatty acids). Flaxseed lignan (secoisolariciresinol diglucoside; SDG) is isolated from defatted flaxseed. Flaxseed has been shown to have variable effects on plasma lipids. Serum triglycerides (TG), total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) have been reported to be elevated, lowered or unchanged with flaxseed consumption in rats. In humans, flaxseed lowers serum TC and LDL-C; however, it has no effect on serum high-density lipoprotein-cholesterol (HDL-C) and TG. Flaxseed oil also lowers TG and TC in rats, but the effect is smaller than that of flaxseed. Flaxseed oil in human subjects had no effect on serum TG, TC, LDL-C or HDL-C. Flaxseed with very low alpha-linolenic acid reduced serum TC, LDL-C and the risk ratio, elevated serum TG and very low-density lipoprotein cholesterol (VLDL-C) and had no effect on serum HDL. SDG isolated from defatted flaxseed reduced serum TC, LDL-C and the TC/HDL-C risk ratio. Serum levels of HDL-C, TG and VLDL-C remained unchanged. These results suggest that the hypocholesterolemic effect of flaxseed probably resides in the non-oily part and not in the alpha-linolenic acid. Reductions in hypercholesterolemic atherosclerosis by flaxseed, flaxseed with very low alpha-linolenic acid and SDG were 46%, 69% and 73%, respectively. The antiatherogenic effect of SDG could be due to its antioxidant activity and also its lipid-lowering effect.

A conserved function for Arabidopsis SUPERMAN in regulating floral-whorl cell proliferation in rice, a monocotyledonous plant

Studies of floral organ development in two dicotyledonous plants, Arabidopsis thaliana and Antirrhinum majus, have shown that three sets of genes (A, B and C) can pattern sepals, petals, stamens and carpels [1] [2]. Mechanisms that define boundaries between these floral whorls are unclear, however. The Arabidopsis gene SUPERMAN (SUP), which encodes a putative transcription factor, maintains the boundary between stamens and carpels [3] [4] [5], possibly by regulating cell proliferation. By overexpressing SUP cDNA in rice, we examined whether its effects on whorl boundaries are conserved in a divergent monocotyledonous species. High-level ectopic SUP expression in transgenic rice resulted in juvenile death or dwarf plants with decreased axillary growth. Plants with lower levels of SUP RNA were vegetatively normal, but the flowers showed ubiquitous ventral carpel expansion. This was often coupled with reduced stamen number, or occurrence of third-whorl stamen-carpel mosaic organs. Additionally, proliferation of second-whorl ventral cells produced adventitious lodicules, and flowers lost the asymmetry that is normally inherent to this whorl. We predict that SUP is a conserved regulator of floral whorl boundaries and that it affects cell proliferation.

Steroids for treating cerebral malaria

BACKGROUND

Cerebral malaria is associated with swelling of the brain. Corticosteroid drugs could reduce the harmful effects of this swelling, but could also suppress host immunity to infection.

OBJECTIVES

This review aimed to assess the effects of steroids in patients with cerebral malaria in relation to survival and long-term disability.

SEARCH STRATEGY

The Cochrane Controlled Trials Register, the Cochrane Infectious Diseases Group Trials Register, existing reviews, and contact with experts in the field.

SELECTION CRITERIA

Randomised controlled trials comparing steroids and no steroids in otherwise identical treatments for patients with cerebral malaria.

DATA COLLECTION AND ANALYSIS

Assessments of inclusion criteria, trial quality and data extraction were done by each author independently. The outcomes sought were death, death with life-threatening complications, other complications, and disability.

MAIN RESULTS

Two trials met the inclusion criteria. Out of a total of 143 patients, there were 30 deaths, distributed evenly between the steroid and the comparator group. The researchers reported clinical complications as the number of events in each trial arm, and did not exclude complications occurring in fatalities. This makes it difficult to interpret the reports of significantly more episodes of gastro-intestinal bleeding and seizures in the steroid group. No studies examined disability.

REVIEWER'S CONCLUSIONS

There is currently no evidence of benefit from steroids in this condition, but the small number of participants means it is difficult to exclude an effect on mortality in either direction. Data on clinical complications are difficult to assess.

Drugs for treating neurocysticercosis (tapeworm infection of the brain)

BACKGROUND

Anthelminthic drugs may shrink brain cysts in neurocysticercosis, but can also cause severe adverse effects.

OBJECTIVES

The objective of this review was to assess the effects of drug treatment in human neurocysticercosis in relation to survival, cyst persistence, subsequent seizures and hydrocephalus.

SEARCH STRATEGY

We searched the Cochrane Infectious Diseases Group trials register and Medline. We contacted researchers and experts in the field and drug manufacturers.

SELECTION CRITERIA

Randomised or quasi-randomised trials comparing a cysticidal drug with a placebo or a control group receiving symptomatic therapy, in patients with neurocystercosis.

DATA COLLECTION AND ANALYSIS

Assessment of trial quality and data extraction was done independently by two reviewers.

MAIN RESULTS

Four studies involving 305 people met the inclusion criteria. None reported on withdrawal of anticonvulsant therapy, headache relief, disability or death as outcomes. A difference just approaching significance was detected between cysticidal therapy and placebo in relation to cyst persistence up to six months (relative risk 0.83, 95% confidence interval 0.70 to 0.99). Two trials reported on seizures after one to two years follow-up and found no difference (relative risk 0.95, 95% 0.59 to 1.51). There was no difference detected for hydrocephalus (relative risk 2.19, 95% confidence interval 0.29 to 16.55).

REVIEWER'S CONCLUSIONS

There is insufficient evidence to assess whether cysticidal therapy in neurocysticerosis is associated with beneficial effects.

Steroids for treating tuberculous meningitis

BACKGROUND

Even though corticosteroids have been used alongside antituberculosis drugs for tuberculous meningitis (TBM) since the 1950s their role remains controversial. Some believe corticosteroids improve outcome while others point to the lack of supportive evidence. In patients who are immunocompromised because of HIV infection the risks and benefits of steroids are unknown.

OBJECTIVES

To assess the effects of steroids on death and disability in patients with TBM.

SEARCH STRATEGY

Electronic searching of MEDLINE, Cochrane Controlled Trials Register, and Cochrane Infectious Diseases Group Trials Register.

SELECTION CRITERIA

Randomised controlled trials of steroids in people on TB treatment for TBM.

DATA COLLECTION AND ANALYSIS

Two independent reviewers applied study selection criteria, assessed methodological quality and extracted data.

MAIN RESULTS

Six trials of 595 patients met the inclusion criteria. No study described allocation concealment. Steroids were associated with fewer deaths (relative risk [RR] 0.79; 95% confidence interval [CI] 0.65 to 0.97) and a reduced incidence of death and severe residual disability (RR 0.58, 95% CI 0.38 to 0.88). Subgroup analysis suggests an effect on mortality in children (RR 0.77, 95% CI 0.62 to 0.96) but the results in a smaller number of adults are inconclusive (RR 0.96, 95% CI 0.50 to 1.84). There is little evidence that the severity of disease influences the effects of steroids on mortality.

REVIEWER'S CONCLUSIONS

Adjunctive steroids might be of benefit in patients with TBM. However, existing studies are small, and poor allocation concealment and publication bias may account for the positive results found in this review. No data are available on the use of steroids in HIV positive persons. Future placebo-controlled studies should include patients with HIV infection and should be large enough to assess both mortality and disability.

Surgery for primary supratentorial intracerebral haemorrhage

BACKGROUND

There is considerable international variation in the rate and indications of surgery for primary supratentorial intracerebral haematoma, reflecting the uncertainty about the effects of surgery.

OBJECTIVES

The objective of this review was to assess the effects of surgery plus routine medical management, compared with routine medical management alone, in patients with primary supratentorial intracerebral haematoma.

SEARCH STRATEGY

We searched the Cochrane Stroke Group trials register, Current Opinion in Neurology and Neurosurgery, and Neurosurgical Clinics of North America (1991 to July 1993) and reference lists of articles.

SELECTION CRITERIA

Randomised and quasi-randomised trials of routine medical treatment plus intracranial surgery compared with routine medical treatment, in patients with presumed or confirmed primary supratentorial intracerebral haematoma. Intracranial surgery included craniotomy, stereotactic endoscopic evacuation or stereotactic aspiration.

DATA COLLECTION AND ANALYSIS

Two reviewers independently applied the inclusion criteria, assessed trial quality and extracted the data.

MAIN RESULTS

Four trials were included. No trial had blinded outcome assessment. Craniotomy and endoscopic evacuation were analysed separately. Craniotomy showed a non-significant trend towards increased odds of death and dependency among survivors (odds ratio 1.99, 99% confidence interval 0.92 to 4. 31). The result was inconclusive in the two trials with patients confirmed as having primary supratentorial intracerebral haematoma by CT. Endoscopic evacuation was not shown to significantly decrease the odds of death and dependency among survivors in one trial involving 100 patients (odds ratio 0.45, 99% confidence interval 0. 15 to 1.33).

REVIEWER'S CONCLUSIONS

There is not enough evidence to evaluate the effect of craniotomy or stereotactic surgery, or endoscopic evacuation in patients with supratentorial intracerebral haematoma.

A role for the clathrin assembly domain of AP180 in synaptic vesicle endocytosis

We have used the squid giant synapse to determine whether clathrin assembly by AP180 is important for synaptic vesicle endocytosis. The squid homolog of AP180 encodes a 751 amino acid protein with 40% sequence identity to mouse AP180. Alignment of squid AP180 with other AP180 homologs shows that amino acid identity was highest in the N-terminal inositide-binding domain of the protein and weakest in the C-terminal clathrin assembly domain. Recombinant squid AP180 was able to assemble clathrin in vitro, suggesting a conserved three-dimensional structure that mediates clathrin assembly despite the divergent primary sequence of the C-terminal domain. Microinjection of the C-terminal domains of either mouse or squid AP180 into the giant presynaptic terminal of squid enhanced synaptic transmission. Conversely, a peptide from the C-terminal domain of squid AP180 that inhibited clathrin assembly in vitro completely blocked synaptic transmission when it was injected into the giant presynaptic terminal. This inhibitory effect occurred over a time scale of minutes when the synapse was stimulated at low (0.03 Hz), physiological rates. Electron microscopic analysis revealed several structural changes consistent with the inhibition of synaptic vesicle endocytosis; peptide-injected terminals had far fewer synaptic vesicles, were depleted of coated vesicles, and had a larger plasma membrane perimeter than terminals injected with control solutions. In addition, the remaining synaptic vesicles were significantly larger in diameter. We conclude that the clathrin assembly domain of AP180 is important for synaptic vesicle recycling at physiological rates of activity and that assembly of clathrin by AP180 is necessary for maintaining a pool of releasable synaptic vesicles.

Treating neurocysticercosis medically: a systematic review of randomized, controlled trials

OBJECTIVE

To summarize the evidence from randomized controlled trials on the effects of cysticidal therapy used for treating human cysticercosis.

METHODS

Published and unpublished studies in any language identified through MEDLINE (1966 - June 1999) specialized databases, abstracts, proceedings and contact with experts were analysed. Those which compared, using randomized or quasi-randomized methods, any cysticidal drug with placebo or symptomatic therapy were entered in the study. Data were extracted independently by two reviewers and trial quality assessed. Meta-analysis using fixed effects models calculated provided there was no significant heterogeneity, expressed as relative risk.

RESULTS

Four trials met the inclusion criteria, treating intraparenchymatous neurocysticercosis with either albendazole or praziquantel compared to placebo or no treatment. In the two trials reporting clinical outcomes, treatment was not associated with a reduction in the risk of seizures, although numbers were small (RR 0.95, 95% CI 0.59-1.51). Four trials reported radiological outcomes, and cysticidal treatment was associated with a lower risk of cyst persistence of scans taken within six months of start of treatment (RR 0.83, 95% CI 0.70-0.99). Subsidiary analysis assuming different outcomes in patients lost to follow-up did not alter the findings of the main analysis.

CONCLUSIONS

There is insufficient evidence to determine whether cysticidal therapy is of any clinical benefit to patients with neurocysticercosis. The review does not exclude the possibility that more patients remain seizure-free when treated with cysticidal drugs. Further testing through placebo-controlled trials is required.

Intratesticular varicocele: evaluation using conventional and Doppler sonography

OBJECTIVE

The aim of this study was to describe the conventional and Doppler sonographic appearances of intratesticular varicoceles and to determine their occurrence.

SUBJECTS AND METHODS

One thousand forty men with various testicular problems were examined using conventional and Doppler sonography, and the incidence of intratesticular varicocele and other conditions was recorded. Eighteen patients with intratesticular varicoceles were further examined, allowing us to study the various sonographic and Doppler parameters of this rare entity.

RESULTS

Intratesticular varicocele was identified in 18 (1.7%) patients. The condition was bilateral in seven patients and unilateral in 11. Of 25 testes involved, 12 (48%) were right-sided and 14 (56%) were isolated without any ipsilateral extratesticular varicocele. The shape of the intratesticular varicocele was tubular in 21 cases and oval in five; one patient had both oval and tubular varicoceles. Diameters ranged from 2 to 8 mm (mean, 3.1 mm). Mean venous flow velocity was 2.8 cm/sec and had an inverse relationship to the diameter of the intratesticular varicocele.

CONCLUSION

Intratesticular varicocele is seen in fewer than 2% of the symptomatic population. The condition has a characteristic sonographic appearance of dilated tubular intratesticular veins with a proximity to the mediastinum testis. Variations from previously published reports included presentation with an oval shape, more frequent bilateral occurrence, greater number of isolated right-sided intratesticular varicoceles, and fewer associations with an extratesticular varicocele.

Protection of coronary angioplasty-induced oxidative stress by Isovue used during angioplasty

BACKGROUND

Oxygen free radicals (OFRs) have been implicated in ischemic-reperfusion cardiac injury. Use of percutaneous transluminal coronary angioplasty (PTCA) has created renewed interest in salvation of ischemic myocardium. The PTCA procedure is similar to the ischemia-reperfusion model. It is possible that OFRs are increased following PTCA. However, OFR-related cardiac complications are uncommon and the evidence for lipid peroxidation is conflicting.

PATIENTS AND METHODS

In this study the levels of plasma malondialdehyde, OFR-producing activity of polymorphonuclear leukocytes (PMNL-CL) and blood antioxidant enzymes (superoxide dismutase, catalase and glutathione peroxidase) were measured in peripheral venous blood of 50 consecutive patients with stable angina undergoing elective PTCA. The ability of Isovue (used during PTCA) and of streptokinase (used during thrombolysis) to scavenge OH in the high performance liquid chromatography method and to reduce OH-induced lipid peroxidation were also assessed. Patients were divided into three groups: group 1, single vessel PTCA; group 2, two or more vessel PTCA; and group 3, combined single and multivessel PTCA.

RESULTS

The results indicated that there was an increase in PMNL-CL (22% to 44%) and a decrease in plasma malondialdehyde (33% to 40%) at 60 mins following PTCA. The activity of antioxidant enzymes remained unaltered. Isovue scavenged OH in a concentration-dependent manner and was complete at a concentration below that used in patients. Streptokinase, on the other hand, was ineffective in scavenging OH.

CONCLUSIONS

These results suggest that, in spite of increased production of OFR by polymorphonuclear leukocytes and unaltered activity of antioxidant enzymes, lipid peroxidation decreased. Lack of lipid peroxidation may have been due to the OH-scavenging property of Isovue. The observed differences in OFR-related complications between PTCA and thrombolytic therapy may have been due to the antioxidant activity of Isovue.

Cyclofusion in normal and superior oblique palsy subjects

PURPOSE

To evaluate the cyclofusional status in normal and acquired superior oblique palsy subjects. To know the extent to which cyclodeviations can be tolerated asymptomatically.

METHOD

Incyclovergence and excyclovergence break points and recovery points were evaluated in 40 normal subjects and 17 cases of acquired superior oblique palsy. A Polaroid dissociation stereoprojector was used with special torsional slides at fixation distances of 1 meter and 6 meters. In addition, maximum intorsion tolerated (MIT) and maximum extorsion tolerated (MET), ie, the torsion that allowed baseline horizontal fusion, were studied. The evaluation was repeated in the palsy group 1 month after recovery, which was spontaneous in 8 cases, and after surgery in 9 cases.

RESULT

The normal values for incyclovergence and excyclovergence were in the range of 12 degrees (break point) and 8 degrees (recovery point). In the case of superior oblique palsy, only the incyclovergence recovery point was significantly diminished (p=.004), which improved after recovery to near normal values. The intorsion tolerance (MIT) and extorsion tolerance (MET) also showed deterioration in the palsy group. After recovery, the MIT normalized but the MET did not recover at 1-meter distance fixation. The maximum torsional tolerance values appear to be more critical.

CONCLUSION

The cyclofusional vergence under physiological conditions are better than reported earlier. But MIT and MET are better indicators of cyclofusional potential. These low values demand more precise alignment of the torsion in weakening or strengthening surgery of the oblique muscles.

AP180 and AP-2 interact directly in a complex that cooperatively assembles clathrin

Clathrin-coated vesicles are involved in protein and lipid trafficking between intracellular compartments in eukaryotic cells. AP-2 and AP180 are the resident coat proteins of clathrin-coated vesicles in nerve terminals, and interactions between these proteins could be important in vesicle dynamics. AP180 and AP-2 each assemble clathrin efficiently under acidic conditions, but neither protein will assemble clathrin efficiently at physiological pH. We find that there is a direct, clathrin-independent interaction between AP180 and AP-2 and that the AP180-AP-2 complex is more efficient at assembling clathrin under physiological conditions than is either protein alone. AP180 is phosphorylated in vivo, and in crude vesicle extracts its phosphorylation is enhanced by stimulation of casein kinase II, which is known to be present in coated vesicles. We find that recombinant AP180 is a substrate for casein kinase II in vitro and that its phosphorylation weakens both the binding of AP-2 by AP180 and the cooperative clathrin assembly activity of these proteins. We have localized the binding site for AP-2 to amino acids 623-680 of AP180. The AP180/AP-2 interaction can be disrupted by a recombinant AP180 fragment containing the AP-2 binding site, and this fragment also disrupts the cooperative clathrin assembly activity of the AP180-AP-2 complex. These results indicate that AP180 and AP-2 interact directly to form a complex that assembles clathrin more efficiently than either protein alone. Phosphorylation of AP180, by modulating the affinity of AP180 for AP-2, may contribute to the regulation of clathrin assembly in vivo.

Variation in in-patient stroke management in ten centres in different countries: the INCLEN multicentre stroke collaboration

BACKGROUND AND PURPOSE

Large within-country variations have been described in stroke management and there have been a few studies of between-country variation (in the USA and the UK). We designed a study to examine stroke management across a wide range of countries representing different stages of economic development. Large variations would suggest the need to explore methods of increasing the uptake of evidence-based stroke practice.

METHODS

Members of the International Clinical Epidemiology Network (INCLEN) from 14 centres in ten countries agreed to review the records of the last 50 patients admitted to hospital with a clinical diagnosis of stroke. Information on demographic variables, the clinical diagnosis of stroke type, investigations performed and treatments given and the discharge destination of the patient were recorded and sent to the coordinating centre in Australia for analysis.

RESULTS

There were statistically significant between-centre differences in the proportions of patients cared for by a neurologist, staying in hospital for at least ten days and having CT or MRI scans. Significant between-centre differences were also seen for treatment, for example, the use of aspirin in non-haemorrhagic stroke varied from 11 to 79%. The variation (for all interventions studied) was no longer statistically significant when examined within strata according to availability of facilities.

CONCLUSIONS

The large variation between centres in the management of stroke is largely 'explained' by the availability of resources, even for interventions that do not depend on resource availability. It will be important to develop management guidelines that reflect evidence-based practice of relevance across a range of economic settings.

Fasciolopsis buski (giant intestinal fluke)--a case report

A girl, aged 20 years presented with diarrhoea, vomiting, pain abdomen and loss of weight, the routine Stool examination revealed Fasciolopsis buski (giant intestinal fluke) in large numbers. Despite treatment with Praziquantel, she died after three days.

Surgical results and complications of mitomycin C-augmented trabeculectomy in refractory developmental glaucoma

BACKGROUND AND OBJECTIVE

To evaluate the surgical results and complications of mitomycin C-augmented trabeculectomy in refractory developmental glaucoma.

PATIENTS AND METHODS

The authors reviewed the charts of all patients of refractory developmental glaucoma who underwent mitomycin C-augmented trabeculectomy (0.4 mg/ml for 3 minutes) between September 1990 and August 1995. Thirty-eight eyes of 29 patients were included in the study; 34 eyes (89.5%) had refractory primary congenital glaucoma with documented failure of primary surgery, 2 eyes (5.3%) had Axenfeld-Rieger syndrome and 2 eyes (5.3%) had aniridia. The main outcome measures in this study were preoperative and postoperative intraocular pressures (IOPs),visual acuities, bleb characteristics, success rate, time of surgical failure, and complications.

RESULTS

The IOP (mean +/- SD) reduced from a preoperative level of 32.6 +/- 11.8 mm Hg to 12.3 +/- 7.3 mm Hg (P <0.0001) with the percentage reduction in IOP being 56%. Kaplan-Meier survival analysis showed that the success probability at 18 months was 65%, which was maintained till 30 months of follow-up. The bleb was characterized by its large, elevated, avascular, transparent appearance in all the eyes. There were no intraoperative complications. The postoperative complications included hyphema (absorbed one week) in 8 eyes (21%), uncontrolled IOP in 8 eyes (21%), shallow anterior chamber in 3 eyes (7.9%), hypotony without visual loss in one eye (2.6%) and retinal detachment in 2 eyes (5.2%) which was surgically repaired successfully. Visual acuity was maintained in all cases after surgery. None of the patients developed mitomycin-C related late bleb-leakage or endophthalmitis.

CONCLUSION

Treatment of refractory developmental glaucoma with mitomycin C-augmented trabeculectomy is effective and safe with an acceptable rate of complications.

Evaluation of thyroid hormones in chronic renal failure

When chronic renal failure becomes advanced, the serum levels of most hormones are altered because of several interplaying mechanisms. This study was carried out to evaluate the level of total thyroxine (T4), triiodothyronine (T3) and thyrotropin (TSH) in 96 clinically euthyriod patient with chronic renal failure and 25 healthy individual as control. The patients were grouped into two groups, 62 patient on conservative management and 34 patients on chronic haemodialysis. The patient of both groups showed significant decrease in total T3 and T4 level as compared to normal control. Serum TSH level were similar in both groups as well as in control and were with in normal limit except 3 patients on conservative management which showed TSH level above normal chronic haemodialysis did not have positive effect in alteration of serum T3, T4 and TSH level.

Retroperitonial, teratoma as fetus in fetu--a case report

We report a rare case of Retroperitonial teratoma containing Axial Skeleton long bone. Jaw, pelvis & scapula in a 27 yrs old male. Aberration in monozygotic twinning may rarely present as Fetus in Fetu. Rarer is presentation in Adult.

Reduction of serum cholesterol and hypercholesterolemic atherosclerosis in rabbits by secoisolariciresinol diglucoside isolated from flaxseed

BACKGROUND

Secoisolariciresinol diglucoside (SDG) is a plant lignan isolated from flaxseed. Lignans are platelet-activating factor-receptor antagonists that would inhibit the production of oxygen radicals by polymorphonuclear leukocytes. SDG is an antioxidant. Antioxidants studied thus far are known to reduce hypercholesterolemic atherosclerosis. The objective of this study was to determine the effect of SDG on various blood lipid and aortic tissue oxidative stress parameters and on the development of atherosclerosis in rabbits fed a high-cholesterol diet.

METHODS AND RESULTS

Rabbits were assigned to 4 groups: group 1, control; group 2, SDG control (15 mg. kg body wt-1. d-1 PO); group 3, 1% cholesterol diet; and group 4, same as group 3 but with added SDG (15 mg. kg body wt-1. d-1 PO). Blood samples were collected before (time 0) and after 4 and 8 weeks of experimental diets for measurement of serum triglycerides, total cholesterol (TC), and LDL, HDL, and VLDL cholesterol (LDL-C, HDL-C, and VLDL-C). The aorta was removed at the end of the protocol for assessment of atherosclerotic plaques; malondialdehyde, an aortic tissue lipid peroxidation product; and aortic tissue chemiluminescence, a marker for antioxidant reserve. Serum TC, LDL-C, and the ratios LDL-C/HDL-C and TC/HDL-C increased in groups 3 and 4 compared with time 0, the increase being smaller in group 4 than in group 3. Serum HDL-C decreased in group 3 and increased in group 4 compared with time 0, but changes were lower in group 3 than in group 4. SDG reduced TC and LDL-C by 33% and 35%, respectively, at week 8 but increased HDL-C significantly, by>140%, as early as week 4. It also decreased TC/LDL-C and LDL-C/HDL-C ratios by approximately 64%. There was an increase in aortic malondialdehyde and chemiluminescence in group 3, and they were lower in group 4 than in group 3. SDG reduced hypercholesterolemic atherosclerosis by 73%.

CONCLUSIONS

These results suggest that SDG reduced hypercholesterolemic atherosclerosis and that this effect was associated with a decrease in serum cholesterol, LDL-C, and lipid peroxidation product and an increase in HDL-C and antioxidant reserve.

Angiotensin-converting-enzyme gene insertion/deletion polymorphism and response to physical training

BACKGROUND

The function of local renin-angiotensin systems in skeletal muscle and adipose tissue remains largely unknown. A polymorphism of the human angiotensin converting enzyme (ACE) gene has been identified in which the insertion (I) rather than deletion (D) allele is associated with lower ACE activity in body tissues and increased response to some aspects of physical training. We studied the association between the ACE gene insertion or deletion polymorphism and changes in body composition related to an intensive exercise programme, to investigate the metabolic effects of local human renin-angiotensin systems.

METHODS

We used three independent methods (bioimpedance, multiple skinfold-thickness assessment of whole-body composition, magnetic resonance imaging of the mid-thigh) to study changes in body composition in young male army recruits over 10 weeks of intensive physical training.

FINDINGS

Participants with the II genotype had a greater anabolic response than those with one or more D alleles for fat mass (0.55 vs -0.20 kg, p=0.04 by bioimpedance) and non-fat mass (1.31 vs -0.15 kg, p=0.01 by bioimpedance). Changes in body morphology with training measured by the other methods were also dependent on genotype.

INTERPRETATION

II genotype, as a marker of low ACE activity in body tissues, may conserve a positive energy balance during rigorous training, which suggests enhanced metabolic efficiency. This finding may explain some of the survival and functional benefits of therapy with ACE inhibitors.