Primary reattachment of avulsed skin flaps with negative pressure wound therapy in degloving injuries of the lower extremity

Large avulsed skin flaps of the lower extremity caused by degloving injuries eventually develop skin necrosis in most cases. The current treatment option involves excision of the degloved skin and reapplication as a full- or split-thickness skin graft. We considered that reattachment of avulsed skin flaps without excision would be theoretically beneficial, since some circulation may remain around the connected pedicle and thus facilitate graft take. Furthermore, securing the skin to the original anatomic position is much easier using retained landmarks. We treated a total of 12 patients (13 cases) with degloving injuries of the lower extremity. In all cases, the avulsed skin flap was defatted and sewn back to the original position, then negative-pressure wound therapy was applied over those grafts as a bolster for approximately 7 days. Most of the avulsed skin flap took excellently, particularly close to the connected pedicle. Nine cases did not need any additional surgical procedures. Four cases required secondary skin graft for a small area of open wound due to partial necrosis of the defatted skin, as well as the raw surface left by the primary skin defect in the initial operation. Primary reattachment of the avulsed skin flaps without excision is convenient and efficient to cover the open wound over the exposed fascia and periosteum in degloving injuries. This would potentially offer a better alternative to definitive wound closure.

Direct observation of long-lived isomers in 212Bi

Long-lived isomers in (212)Bi have been studied following (238)U projectile fragmentation at 670 MeV per nucleon. The fragmentation products were injected as highly charged ions into a storage ring, giving access to masses and half-lives. While the excitation energy of the first isomer of (212)Bi was confirmed, the second isomer was observed at 1478(30) keV, in contrast to the previously accepted value of >1910 keV. It was also found to have an extended Lorentz-corrected in-ring half-life >30 min, compared to 7.0(3) min for the neutral atom. Both the energy and half-life differences can be understood as being due a substantial, though previously unrecognized, internal decay branch for neutral atoms. Earlier shell-model calculations are now found to give good agreement with the isomer excitation energy. Furthermore, these and new calculations predict the existence of states at slightly higher energy that could facilitate isomer deexcitation studies.

Significant effect of a pre-exercise high-fat meal after a 3-day high-carbohydrate diet on endurance performance

We investigated the effect of macronutrient composition of pre-exercise meals on endurance performance. Subjects consumed a high-carbohydrate diet at each meal for 3 days, followed by a high-fat meal (HFM; 1007 ± 21 kcal, 30% CHO, 55% F and 15% P) or high-carbohydrate meal (HCM; 1007 ± 21 kcal, 71% CHO, 20% F and 9% P) 4 h before exercise. Furthermore, just prior to the test, subjects in the HFM group ingested either maltodextrin jelly (M) or a placebo jelly (P), while subjects in the HCM ingested a placebo jelly. Endurance performance was measured as running time until exhaustion at a speed between lactate threshold and the onset of blood lactate accumulation. All subjects participated in each trial, randomly assigned at weekly intervals. We observed that the time until exhaustion was significantly longer in the HFM + M (p < 0.05) than in HFM + P and HCM + P conditions. Furthermore, the total amount of fat oxidation during exercise was significantly higher in HFM + M and HFM + P than in HCM + P (p < 0.05). These results suggest that ingestion of a HFM prior to exercise is more favorable for endurance performance than HCM. In addition, HFM and maltodextrin ingestion following 3 days of carbohydrate loading enhances endurance running performance.

Improvement of tardive dyskinesia and dystonia associated with aripiprazole following a switch to quetiapine: case report and review of the literature

WHAT IS KNOWN AND OBJECTIVE

Aripiprazole has a low risk of extrapyramidal symptoms. Switching to aripiprazole has been reported to improve tardive dyskinesia caused by other medications. The authors report a case and review previous reports of dystonia and dyskinesia associated with aripiprazole.

CASE SUMMARY

We present a case of a 22-year-old man with schizophrenia who experienced dyskinesia and dystonia associated with aripiprazole. Switching from olanzapine to aripiprazole resulted in worsening dyskinesia and new onset of dystonia. The patient's dyskinesia and dystonia improved after switching from aripiprazole to quetiapine therapy.

WHAT IS NEW AND CONCLUSION

There were several previous case reports on dyskinesia and dystonia associated with aripiprazole medication. The risk factors for tardive dyskinesia include older age and female sex. However, our case was a male patient who was younger compared with the previous cases and so should have been less at risk for dyskinesia in comparison with the previous cases. The effects of aripiprazole can include tardive movement disorders. Dyskinesia, dystonia and psychotic symptoms were improved with relatively small dose of quetiapine in this case. Whether some second-generation antipsychotics are more effective than others in the treatment of tardive dyskinesia remains unclear.

Long-term effects of home-based bench-stepping exercise training on healthcare expenditure for elderly Japanese

Background

We examined the long-term effects of home-based bench-stepping exercise training on total healthcare expenditure (TOHEX) and number of outpatient visits (NOVIS) in elderly adults.

Methods

A total of 189 elderly Japanese (age 73 ± 4 years) participated in this study. They were randomly assigned to either an exercise or control group. TOHEX, NOVIS, and outpatient expenditure (OPEX) were evaluated every 6 months from 1 year before the start to the end of the intervention period, as well as 1 year after the end of the intervention. The exercise group was encouraged to perform home-based bench-stepping exercise training on most, and preferably all, days of the week for 18 months.

Results

The exercise group showed significant increases in lactate threshold as compared with pre-intervention values. There were no significant differences in TOHEX, OPEX, or NOVIS between the exercise and control groups 1 year before the start of the intervention, and the values remained similar during the first 12 months of the intervention period. However, at 18 months, TOHEX, NOVIS, and OPEX were significantly lower in the exercise group than in the control group (TOHEX: 170 007 ± 192 072 vs. 294 705 ± 432 314 yen, P = 0.008; NOVIS: 19.2 ± 26.3 vs. 28.2 ± 32.1 days, P = 0.012; OPEX: 132 973 ± 132 016 vs. 187 799 ± 158 167 yen, P = 0.005).

Conclusions

The data indicate that a long-term home-based bench-stepping exercise program can reduce healthcare expenditure in elderly Japanese.

[Evaluation of sub-maximal aerobic capacity level determined by double product break point (DPBP) among Japanese adults]

OBJECTIVES

The purpose of this study was to determine sub-maximal aerobic capacity levels evaluated by metabolic equivalents (unit is METs) at the double product break point (DPBP) and elucidate the safe and effective average exercise intensity among Japanese adults. A total of 438 subjects (123 males and 315 females) who participated in the exercise prescription course with measurement of the DPBP during a continuous incremental exercise test with a bicycle

METHODS

ergometer were enrolled in this study. The DP (heart rate-systolic blood pressure product) featured rapid increase with increasing exercise load during the continuous incremental exercise test.

RESULTS

The metabolic equivalents at the DPBP level for males and females were 5.3+/-0.9 METs and 4.9+/-0.7 METs, respectively. Interestingly, the metabolic equivalent at the DPBP level in 87.2% of the study subjects was less than 6 METs.

CONCLUSIONS

This study indicated that some physical activities above moderate intensity, such as the stair climbing (8 METs), might be inappropriate as health promotion exercises. Thus, the upper limit of exercise intensity for health promotion was 6 METs, especially if the subject was at cardiovascular risk. In addition, it was found necessary to make synthetic judgments in consideration of heart rate and rating of perceived exertion (RPE) during exercise.

Significant lowering of plasma ghrelin but not des-acyl ghrelin in response to acute exercise in men

Ghrelin, an acylated peptide produced predominantly in the stomach, stimulates feeding and growth hormone (GH) secretion via interaction with the GH secretagogue receptor. Ghrelin molecules are present in two major endogenous forms, an acylated form (ghrelin) and a des-acylated form (des-acyl ghrelin). Recent studies indicated that aerobic exercise did not change plasma total ghrelin levels, however, dynamics of circulating ghrelin and des-acyl ghrelin during aerobic exercise remains unclear. The purpose of this study is to examine the effects of moderate intensity exercise on plasma ghrelin and des-acyl ghrelin concentrations, and to investigate the relationship between ghrelin molecules and other hormonal and metabolic parameters during exercise. Nine healthy males (25.2 ± 0.5 years) exercised for 60 min at 50% of their maximal oxygen consumptions. We measured the plasma concentrations of ghrelin, des-acyl ghrelin, GH, norepinephrine (NE), epinephrine (E), dopamine (DA), insulin, and glucose. Plasma ghrelin level significantly decreased during exercise, whereas plasma des-acyl ghrelin and total ghrelin levels did not change. Plasma NE, E, DA and GH levels were significantly increased during exercise. Plasma insulin level significantly decreased during exercise, and plasma glucose levels remained steady during exercise. NE, E, DA, and GH were correlated negatively with plasma ghrelin levels. These findings suggest that acute moderate exercise may suppress ghrelin release from the stomach, decrease ghrelin O-acyltransferase activity, and/or activate ghrelin utilization in peripheral tissues and that exercise-induced ghrelin suppression may be mediated by activated adrenergic system.

Effect of low-intensity aerobic exercise on insulin-like growth factor-I and insulin-like growth factor-binding proteins in healthy men

Increased concentrations of circulating insulin-like growth factor-I (IGF-I) or IGF-I relative to IGF-binding proteins (IGFBPs) are associated with increased risk of developing several forms of cancer. Conversely, exercise is linked with reduced risk. This study aims to investigate the effect of a low-intensity exercise program on circulating levels of IGF-I, IGFBP-1, and IGFBP-3, in previously sedentary males. Fourteen healthy men participated in cycle ergometer training at lactate threshold intensity for 60 min/day, 5 days/week for 6 weeks. After aerobic training, insulin sensitivity improved by 20%, while fasting insulin levels decreased by 13%. Simultaneously, low-intensity aerobic training decreased the circulating levels of IGF-I by 9%, while IGFBP-1 levels increased by 16%. An interesting finding was that higher pretraining level of IGF-I was associated with greater decline in IGF-I with training. Insulin-sensitizing low-intensity aerobic exercise is thus considered to be an effective method for downregulating IGF-I and upregulating IGFBP-1 levels.

Regulation of muscle genes by moderate exercise

Moderate-intensity exercise at the lactate threshold (LT) is considered to be a safe and effective training regimen for improving metabolic syndrome. The aim of the current study was to investigate the effects of moderate exercise performed at the LT on skeletal muscle gene expression. 6 healthy men participated in cycle ergometer training at LT, 60 min/d, 5 d/wk for 12 wks. Muscle samples were collected after 5 d of training, and then 2 d after training at wks 6 and 12. Quantitative real-time PCR analysis revealed that the expression of peroxisome proliferator activated receptor co-activated 1alpha was significantly increased at 1 h after the training session on day 5. Moreover, using serial analysis gene expression, we found that moderate training for 6 and 12 wks simultaneously induced the expression of a number of metabolic genes involved in the TCA cycle, beta-oxidation, and electron transport. Furthermore, several genes encoding antioxidant enzymes and contractile apparatus were induced. The expression levels of 233 novel transcripts were also altered in response to moderate exercise. Thus, moderate training at the LT is a sufficient stimulus to induce the expression of numerous genes implicated in the development of metabolic syndrome, transcripts involved in the contractile apparatus, and novel transcripts.

Hepatic insulin sensitivity assessed by integrated model of hepatic and peripheral glucose regulation

BACKGROUND

The integrated model of hepatic and peripheral glucose metabolism incorporates a model for liver glucose metabolism into the two-compartment minimal model framework to describe endogenous glucose kinetics during a labeled intravenous glucose tolerance test (IVGTT). This model also provides a parametric description of endogenous glucose production (EGP). The present study extended the theoretical potential of the model by defining hepatic glucose effectiveness (hS(G)(2)) as the ability of glucose per se to inhibit EGP and hepatic insulin sensitivity (hS(1)(2)) as the ability of insulin to enhance glucose suppression of EGP.

METHODS

As a retrospective data base review of our previous study, we re-analyzed time courses of exogenous and endogenous glucose concentration during [6,6-(2)H(2)]glucose-labeled IVGTT (0.3 g/kg glucose), performed in 11 exercise-trained and 12 age-matched sedentary subjects. Model parameters of the two-compartment minimal model and of liver glucose metabolism were simultaneously identified to assess insulin sensitivity specific to stimulate glucose uptake (S(1)(2*)) and that specific to inhibit EGP (hS(1)(2)). The abilities of glucose per se to stimulate its own uptake (S(G)(2*)) and to inhibit EGP (hS(G)(2)) were also estimated.

RESULTS

Parameters of the integrated model were identified in all the subjects. Hepatic insulin sensitivity consisted of about one-third of total insulin sensitivity (S(1)(2*) + hS(1)(2)). Compared with the sedentary subjects, S(1)(2*), hS(1)(2), hS(G)(2) of the trained subjects were greater.

CONCLUSIONS

Because insulin resistance in liver and peripheral tissue may play a differential role in the pathogenesis of diabetes, this analysis can serve as a simple one-step approach to obtain metabolic indexes specific to EGP suppression and stimulating glucose uptake.

Schottky mass measurement of the 208Hg isotope: implication for the proton-neutron interaction strength around doubly magic 208Pb

Time-resolved Schottky mass spectrometry has been applied to uranium projectile fragments which yielded the mass value for the 208Hg (Z=80, N=128) isotope. The mass excess value of ME=-13 265(31) keV has been obtained, which has been used to determine the proton-neutron interaction strength in 210Pb, as a double difference of atomic masses. The results show a dramatic variation of the strength for lead isotopes when crossing the N=126 neutron shell closure, thus confirming the empirical predictions that this interaction strength is sensitive to the overlap of the wave functions of the last valence neutrons and protons.

Anatomic study for pubic medullary screw insertion

PURPOSE

To study the anatomy of the pubic ramus and adjacent structures in 160 Japanese to establish a safer pubic screw fixation technique.

METHODS

80 male and 80 female Japanese aged 16 to 89 (mean, 50) years (10 persons in each decade of age) underwent 3-dimensional computed tomographic scanning of their pelvises. The angle at which the screw should be targeted, the appropriate length of the screw, the size of the canal for screw insertion, and the proximity to the bladder, iliac artery, and iliac vein were determined. Correlations between the canal diameters (of the acetabular, base, and parasymphyseal areas) and body features (age, height, and weight) were analysed.

RESULTS

In men and women respectively, the appropriate mean screw length was 124.6 and 123.8 mm; the guide wire should be targeted at a mean of 66 degrees and 67 degrees cephalad and 54.1 degrees and 55.9 degrees laterally for insertion of a retrograde pubic screw; the minimum distances from the pubis to the bladder/iliac artery/ iliac vein were 0 and 0 mm/4.9 and 4.6 mm/0.8 and 0.2 mm. In both men and women, the canal diameters at the base were positively correlated to weight. In women, the canal diameters at the parasymphyseal area were correlated to height and weight. Canal diameters at the acetabulum were not correlated to height and weight.

CONCLUSION

Pubic screw fixation may be potentially disastrous (owing to joint penetration and iliac vein injury) and should be performed with caution. When the canal diameter at the acetabulum is extremely narrow, plate fixation, computer-assisted surgery, or changing to a smaller-diameter screw is recommended.

Adenoviral-mediated gene transfer of ectodysplasin-A2 results in induction of apoptosis and cell-cycle arrest in osteosarcoma cell lines

The extremely poor prognosis of patients with metastatic osteosarcoma indicates the need for novel therapeutic approaches. Ectodysplasin-A2 (EDA-A2) is a recently isolated member of the tumor necrosis factor superfamily that binds to X-linked ectodermal dysplasia receptor (XEDAR). In this report, we have analyzed the biological activity of EDA-A2 against osteosarcoma-derived cell lines. We report that XEDAR is expressed in cell lines derived from osteosarcoma and adenoviral-mediated expression of EDA-A2 in these cells results in the induction of apoptosis via caspase activation and cell-cycle arrest in the G(0)/G(1) phase. Treatment with EDA-A2 also upregulates the expression of alkaline phosphatase, a marker of osteogenic differentiation, in a caspase-dependent fashion. Collectively, our results suggest that EDA-A2 may be a promising agent for the gene therapy of osteosarcoma.

Gene expression profile of sprinter's muscle

We have characterized the global gene expression profile in left vastus lateralis muscles of sprinters and sedentary men. The gene expression profile was analyzed by using serial analysis of gene expression (SAGE) method. The abundantly expressed transcripts in the sprinter's muscle were mainly involved in contraction and energy metabolism, whereas six transcripts were corresponding to potentially novel transcripts. Thirty-eight transcripts were differentially expressed between the sprinter and sedentary individuals. Moreover, sprinters showed higher expressions of both uncharacterized and potentially novel transcripts. Sprinters also highly expressed seven transcripts, such as glycine-rich protein, myosin heavy polypeptide (MYH) 2, expressed sequence tag similar to (EST) fructose-bisphosphate aldolase 1 isoform A (ALDOA), glyceraldehyde-3-phosphate dehydrogenase and ATP synthase F0 subunit 6. On the other hand, 20 transcripts such as MYH1, tropomyosin 2 and 3, troponin C slow, C2 fast, I slow, T1 slow and T3 fast, myoglobin, creatine kinase, ALDOA, glycogen phosphorylase, cytochrome c oxidase II and III, and NADH dehydrogenase 1 and 2 showed lower expression levels in the sprinters than the sedentary controls. The current study has characterized the global gene expressions in sprinters and identified a number of transcripts that can be subjected to further mechanistic analysis.

Angiotensin I converting enzyme gene polymorphism and exercise trainability in elderly women: an electrocardiological approach

Angiotensin I converting enzyme (ACE) gene Insertion / Deletion (I/D) polymorphism is associated with exercise trainability and exercise induced left ventricular hypertrophy. However, it is unclear whether this polymorphism influences exercise trainability in the elderly, and the electrocardiological alterations by exercise training is unknown among the genotypes. We herein investigated the association between ACE gene insertion/deletion (I/D) polymorphism, exercise trainability and the electrocardiological alternations by exercise in elderly women. Eighty four elderly women participated in this study. In all subjects the leg extension power (LEP) and lactate threshold (LT) were determined in order to evaluate the muscle strength, aerobic capacity and to also select the appropriate training intensity for each individual. They performed bench step exercise training for 12 weeks. A resting electrocardiogram was recorded for the obtained QTc interval in before and after the program. The baseline of aerobic capacity was higher in I/I than that in I/D, and the QTc interval was shorter in I/I than that in I/D. All other characteristics were similar among the genotypes. The QTc interval tended to be shorten only in the D/D. Furthermore, the value of the QTc interval change showed a significant difference between the I/I and D/D genotype after the program. The LT and LEP demonstrated a similar response among the genotypes. The D allele of ACE gene I/D polymorphism may therefore play a role in the electrocardiological aspect during exercise training, however, it was not found to influence the aerobic capacity. Key pointsThe D allele of ACE gene I/D polymorphism may play a role in the electrocardiological aspects during exercise trainingACE gene I/D polymorphism was not determined the aerobic capacity and leg strength in elderly people.The ACE gene I/D polymorphism did not influence aerobic and strength trainability in elderly people.

Recurrent herpes simplex virus infection in a patient with autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy associated with L29P and IVS9-1G>C compound heterozygous autoimmune regulator gene mutations

Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) has characteristic clinical features with organ-specific autoimmune polyendocrine diseases and candidiasis, caused by the mutations of autoimmune regulator (AIRE) gene. Although almost all patients are complicated with mucocutaneous candidiasis, no apparent susceptibility to other infections has yet been reported. We herein report that a patient with APECED suffered from recurrent herpes simplex virus type 1 (HSV-1) infection after severe primary herpetic stomatitis, associated with sequential HSV-1 isolates of the same genomic profile, consistent with endogeneous recurrence. Thus, not only candidiasis but also HSV infection should receive more attention in patients with APECED, with treatment being administered accordingly.

Association between silent ST segment depression in exercise electrocardiography and insulin resistance in obese subjects

OBJECTIVES

This study was designed to clarify the association between ST segment depression in exercise electrocardiography (ECG) and insulin resistance in obese subjects.

METHODS

A multistage graded submaximal exercise stress test on the bicycle ergometer was performed under CM5-lead ECG monitoring in 114 obese subjects (39 men and 75 women, mean age 50.9 +/- 12.2 years, mean body mass index 28.6 +/- 3.1 kg/m(2)).

RESULTS

In 27 patients showing ST segment depression at the final exercise intensities (abnormal ST), insulin resistance index by homeostasis model assessment (HOMA-IR) was higher and insulin sensitivity index was lower than in the remaining 87 patients with normal ST segment level (normal ST). The abnormal ST group showed significantly higher plasma glucose and serum insulin levels during the oral glucose tolerance test (OGTT) than the normal ST group. The abnormal ST group showed a significantly higher prevalence of hypertension, impaired glucose tolerance and metabolic syndrome than the normal ST group. Multiple logistic regression analysis showed that insulin resistance as evaluated by fasting insulin, sigma insulin during OGTT, HOMA-IR, insulin sensitivity index, the levels of uric acid, fasting glucose, systolic blood pressure and maximal oxygen uptake were independently associated with ST segment depression.

CONCLUSIONS

These results suggest that insulin resistance may involve pathological ST depression during exercise, as well as previously reported factors such as hyperglycemia, hyperuricemia, hypertension and lower aerobic capacity.

JTP-426467 acts as a selective antagonist for peroxisome proliferator-activated receptor gamma in vitro and in vivo

AIM

JTP-426467 was identified as a result of screening in search of selective antagonist for peroxisome proliferator-activated receptor gamma (PPARgamma). We examined whether JTP-426467 functioned as a PPARgamma antagonist in vitro and in vivo and investigated physiological effects of JTP-426467.

METHODS

The effect of JTP-426467 as a PPARgamma antagonist was studied in a cell-based reporter assay and an adipocyte differentiation assay. Target mRNA expression levels were determined by branched DNA (bDNA) assay. To examine the effects as a PPARgamma antagonist in vivo, a competitive study between JTP-426467 and BRL49653 (rosiglitazone), a PPARgamma agonist, was performed using KK-Ay mice. The effects of JTP-426467 alone after administration to KK-Ay mice were also explored. JTP-426467 antagonized PPARgamma activity in a reporter assay system, but not PPARalpha.

RESULTS

JTP-426467 inhibited the expression of hormone-sensitive lipase (HSL) mRNA, an adipocyte-abundant gene, but not PPARgamma itself or cyclophilin mRNA (as constitutive mRNA), and also suppressed triglyceride accumulation in differentiated stromal vascular fraction cells (SVFs). JTP-426467 antagonized PPARgamma agonistic action by BRL49653 in KK-Ay mice on high-fat diet, in terms of plasma glucose, body weight gain and interscapular brown adipose tissue (IBAT) weight. JTP-426467 alone inhibited body weight gain and decreased plasma leptin level in KK-Ay mice.

CONCLUSIONS

JTP-426467 acted as a pure and potent PPARgamma antagonist in vitro. Interestingly, JTP-426467 completely antagonized the effects of PPARgamma agonist BRL49653 in an obese diabetic model. JTP-426467 may be a useful tool for the study of PPARgamma in biological and physiological function.

Lack of modulation of Ib inhibition during antagonist contraction in spasticity

OBJECTIVE

To examine the modulation of non-reciprocal group I (Ib) inhibition during tonic contraction of antagonist muscles in patients with spasticity vs normal subjects.

METHODS

The authors studied 10 patients with spastic paraplegia due to cervical compression myelopathy and 16 age-matched normal subjects. Ib inhibition to soleus motoneurons was recorded as the change in size of the H-reflex of the soleus, evoked by conditioning stimulus to the nerve innervating the medial gastrocnemius muscle. The extent of inhibition was studied at rest and during tonic contraction of the pretibial muscles of variable strength.

RESULTS

In the resting state, the extent of inhibition in the patients did not differ from normal controls. During antagonist contraction, the extent of inhibition increased both in the normal subjects and patients. The increment was smaller in the patients, especially in those with severe spastic gait. The smaller increment in the inhibition was correlated with the time required to walk 10 m in the patients.

CONCLUSION

The authors observed a lack of modulation of Ib inhibition during tonic antagonist contraction in patients with spasticity, especially those with gait disturbance. Disturbed central modulation of non-reciprocal (Ib) interneurons may be responsible for spasticity.

Suppression of tumor growth by intra-muscular transfer of naked DNA encoding adrenomedullin antagonist

We have recently reported that the intra-tumoral injection of adrenomedullin (AM) antagonist (AMA; AM (22-52)) peptides significantly reduced the in vivo growth of a pancreatic cancer cell line in severely combined immunodeficient (SCID) mice. In the present study, we examined the effects of intra-tumoral and intra-muscular transfers of naked DNA encoding AMA on the in vivo growth of cancer cell lines. We demonstrate that these treatments induce the regression of a pancreatic cancer cell line and a breast cancer cell line inoculated in SCID mice. Furthermore, CD31-positive cells disappear completely from tumor tissues, following treatment, indicating that neo-vascularization is entirely inhibited. These results suggest that the intra-tumoral or intra-muscular transfer of naked DNA encoding AMA might be a promising alternative modality for treating human cancers.

Relationship between the structures of fatty acid amide derivatives and their antimicrobial activities

The structure-activity relationships of derivatives of the antibiotic cerulenin were investigated by chemically modifying dodecanoic acid, its skeletal back-bone. The dimethylamide derivatives were active against both gram-positive and -negative bacteria, and fungi. Among the compounds having modified groups at positions C2 and C4, the most active were those with a carbonyl group at C4 and a double bond at C2. The dimethylamide and pyrrolidine amide derivatives of this structure type were the most active. Activity against bacteria and yeast increased with the number of carbon atoms in the skeleton, with the maximum activity being observed at C=12. No significant differences in activity against fungi were observed with change in chain length.

Long-period accelerometer monitoring shows the role of physical activity in overweight and obesity

CONTEXT

Physical activity (PA) plays an important role in obesity. A new accelerometer has been developed to assess total energy expenditure as well as PA.

OBJECTIVE

To investigate the association of PA with overweight and obesity in Japanese men and women, a large cross-sectional study was performed using a single-axis accelerometer.

DESIGN, SETTING AND PARTICIPANTS

Population-based cross-sectional study of Japanese 18-84 y of age. Height, body weight and PA were measured in 400 male and 388 female Japanese volunteers from 1999 to 2000. The outcome measurements were overweight and obesity, which are defined as a body mass index >/=25 kg/m(2). PA was measured for 1 to 4 weeks and was then categorized into three activity levels, which were defined as light, moderate and vigorous PA.

RESULTS

Prevalence of overweight and obesity was 22.3%. Number of steps and time spent in moderate and vigorous PA per day were lower in overweight and obese individuals. No difference was found in time spent in light PA. Individuals who are in the 4th and 5th quintile of moderate and vigorous PA showed a significantly lower body mass index. When odd ratios (ORs) of overweight and obesity estimated by logistic regression were used as effect measures, overweight and obesity were negatively associated with vigorous PA (ORs=0.91).

CONCLUSION

These results indicate that overweight and obese individuals have a lower step rate and are spending less time for moderate to vigorous PA. Participation in vigorous PA is an important predictor of overweight and obesity.

The use of uniaxial accelerometry for the assessment of physical-activity-related energy expenditure: a validation study against whole-body indirect calorimetry

Assessing the total energy expenditure (TEE) and the levels of physical activity in free-living conditions with non-invasive techniques remains a challenge. The purpose of the present study was to investigate the accuracy of a new uniaxial accelerometer for assessing TEE and physical-activity-related energy expenditure (PAEE) over a 24 h period in a respiratory chamber, and to establish activity levels based on the accelerometry ranges corresponding to the operationally defined metabolic equivalent (MET) categories. In study 1, measurement of the 24 h energy expenditure of seventy-nine Japanese subjects (40 (SD 12) years old) was performed in a large respiratory chamber. During the measurements, the subjects wore a uniaxial accelerometer (Lifecorder; Suzuken Co. Ltd, Nagoya, Japan) on their belt. Two moderate walking exercises of 30 min each were performed on a horizontal treadmill. In study 2, ten male subjects walked at six different speeds and ran at three different speeds on a treadmill for 4 min, with the same accelerometer. O2 consumption was measured during the last minute of each stage and was expressed in MET. The measured TEE was 8447 (SD 1337) kJ/d. The accelerometer significantly underestimated TEE and PAEE (91.9 (SD 5.4) and 92.7 (SD 17.8) % chamber value respectively); however, there was a significant correlation between the two values (r 0.928 and 0.564 respectively; P<0.001). There was a strong correlation between the activity levels and the measured MET while walking (r(2) 0.93; P<0.001). Although TEE and PAEE were systematically underestimated during the 24 h period, the accelerometer assessed energy expenditure well during both the exercise period and the non-structured activities. Individual calibration factors may help to improve the accuracy of TEE estimation, but the average calibration factor for the group is probably sufficient for epidemiological research. This method is also important for assessing the diurnal profile of physical activity.

The Physical Activity Patterns of Cardiac Rehabilitation Program Participants

PURPOSE

This investigation aimed to examine the physical activity patterns of cardiac rehabilitation program (CRP) participants.

METHODS

The investigation enrolled 53 male and 24 female CRP participants between 46 and 88 years of age. By means of a uniaxial accelerometer (Life-Corder), the amount of physical activity (in kilocalories) and the time spent in physical activity at light (<3 metabolic equivalents [METs]), moderate (3 to 6 METs), and vigorous (>6 METs) intensity were evaluated. In addition to these variables, the MET levels for the CRP and non-CRP periods were calculated.

RESULTS

The weekly amount of physical activity energy expenditure averaged 1597 +/- 846 kcal/week, and the time spent in light, moderate, and vigorous physical activity averaged, respectively, 375.5 +/- 124.5 minutes, 125.2 +/- 109.4 minutes, and 5.7 +/- 12.8 minutes per week. These levels were significantly lower on non-CRP days than on CRP days: 177 +/- 113 versus 299 +/- 161 kcal/day and, respectively, 49.3 +/- 19.3 versus 59.7 +/- 19.8 minutes, 10.5 +/- 14.6 versus 26.4 +/- 20.4 minutes, and 0.4 +/- 1.7 versus 1.4 +/- 3.0 minutes per day.

CONCLUSIONS

These results indicate that the amount of physical activity was generally adequate on CRP days, but failed to reach target levels on non-CRP days. Thus CRP participants, when it is medically appropriate, should be encouraged to incorporate lifestyle physical activity, additional exercise, or both on non-CRP days to supplement their caloric expenditure from CRP exercise sessions.

Precision spectroscopy of pionic 1s states of Sn nuclei and evidence for partial restoration of chiral symmetry in the nuclear medium

Deeply bound 1s states of pi(-) in (115,119,123)Sn were preferentially observed using the Sn(d,3He) pion-transfer reaction under the recoil-free condition. The 1s binding energies and widths were precisely determined and were used to deduce the isovector parameter of the s-wave pion-nucleus potential to be b1=-(0.115+/-0.007)m(-1)(pi). The observed enhancement of |b(1)| over the free piN value (b(free)1/b1=0.78+/-0.05) indicates a reduction of the chiral order parameter, f*pi(rho)2/f2pi approximately 0.64, at the normal nuclear density, rho=rho(0).

Effect of moderate exercise training on peripheral glucose effectiveness, insulin sensitivity, and endogenous glucose production in healthy humans estimated by a two-compartment-labeled minimal model

For examining the effects of moderate exercise training on peripheral glucose effectiveness (S(g)(2)*), insulin sensitivity (S(i)(2)*), and endogenous glucose production (EGP), seven men and one woman (24.8 +/- 1.8 years) participated in cycle ergometer training at lactate threshold intensity for 60 min/day, 5 days/week for 12 weeks. Stable-labeled frequently sampled intravenous glucose tolerance tests were performed before and 16 h and 1 week after the last training session. S(g)(2)* (pre 0.71 +/- 0.03 x 10(-2), 16 h 0.85 +/- 0.02 x 10(-2) dl. kg(-1). min(-1)) and S(i)(2)* (pre 12.6 +/- 2.6 x 10(-4), 16 h 19.7 +/- 3.3 x 10(-4) dl. kg(-1). min(-1). [ micro U/ml](-1)), analyzed using the two-compartment minimal model, were significantly elevated 16 h after the last training session. The elevated S(g)(2)* remained higher despite the cessation of exercise training for 1 week (1.00 +/- 0.03 x 10(-2) dl. kg(-1). min(-1)). EGP was suppressed within 20 min after glucose bolus, and the suppression of EGP was followed by their overshoot. The time course of EGP during the intravenous glucose tolerance test remained similar after the training period. In conclusion, moderate exercise training at lactate threshold improves not only peripheral insulin sensitivity but also peripheral glucose effectiveness with no change in the effect of glucose and/or insulin to suppress EGP in healthy humans.

The Difference between the Basal Metabolic Rate and the Sleeping Metabolic Rate in Japanese

Previous studies have demonstrated the difference between the basal metabolic rate (BMR) and the sleeping metabolic rate (SMR): however, the difference in the Japanese population has not yet been explored. This study examined the relationship between the BMR and SMR in ninety-four healthy Japanese subjects (37 males and 57 females, 39 +/- 12 y of age and 22.0 +/- 7.4% body fat) in a respiratory chamber. The SMR was significantly lower than the BMR (1416 +/- 245 vs. 1492 +/- 256 kcal/d): however, there was a highly significant correlation between the two (r = 0.867; p < 0.001). The ratio of SMR/BMR largely varied among individuals (0.95 +/-0.08, 8.4% of the coefficient of variation). The ratio was significantly lower in males than in females (0.93 +/- 0.10 vs. 0.97 +/- 0.06, p < 0.05). None of the anthropometric measures (age, weight, body mass index, body surface area or percent body fat) correlated with the ratio. These results showed that SMR was 95%, of BMR on average in a healthy Japanese group. However, when applied over a longer time period (24 h or more), the difference tends to become negligible for most analyses in a group. Although the difference between SMR and BMR will induce a 5% gap of physical activity level defined as the total energy expenditure divided by the BMR or SMR, this factor seems to have little practical importance in epidemiological research.

Serial analysis of gene expression in the skeletal muscle of endurance athletes compared to sedentary men

Physical exercise produces several adaptive changes in skeletal muscle. However, the molecular mechanisms of these effects are poorly understood. We performed serial analysis of gene expression (SAGE) to quantify the global gene expression profile in sedentary and endurance-trained muscle. A total of 10869 SAGE tags was sequenced and represented 4727 genes. The genes most expressed in muscle are mainly involved in contraction and energy metabolism. Thirty-three genes were differentially expressed between endurance athletes and sedentary individuals. Four genes such as myosin binding protein C fast-type, glycogen phosphorylase, and pyruvate kinase were expressed less in endurance athletes, whereas eight genes coding for expressed sequence tag similar to (EST) crystallin alpha B, EST myosin light chain 2, EST surfactant pulmonary-associated protein A1, EST thrombospondin, EST fructose-bisphosphate aldolase A, EST cytochrome oxidase 1, NADH dehydrogenase 3, and G8 protein were up-regulated. Most of the up-regulated tags corresponded to novel genes. On the other hand, different isoforms of fructose-bisphosphate aldolase A were also differentially expressed. The current study underlying the most highly expressed genes allows a better understanding of global muscle characteristics in normal and endurance-trained individuals. Moreover, the current data suggest novel candidate genes that may be responsible for enhanced endurance performance.

Cardiorespiratory fitness and cancer mortality in Japanese men: a prospective study

PURPOSE

Limited data are available on the relationship between cardiorespiratory fitness and cancer mortality. We evaluated the cardiorespiratory fitness and risk of cancer mortality in Japanese men.

METHODS

A total of 9039 men (19-59 yr) who were given a submaximal exercise test and a health examination between 1982 and 1988 and were followed for mortality up to 1999. Cardiorespiratory fitness was measured using a cycle ergometer test, and maximal oxygen uptake was estimated.

RESULTS

The mean follow-up period was slightly more than 16 yr, producing a total of 148,491 person-years of observation. There were 231 deaths, with 123 deaths due to cancer. Relative risk (RR) and 95% confidence interval (95%CI) for cancer mortality were obtained using the Cox proportional hazards model. Taking into consideration age, systolic blood pressure, body mass index, smoking habit, and alcohol habit and using the lowest physical fitness group as the reference, the RR (95% CI) for increasing quartiles of fitness were 0.75(0.48-1.16), 0.43(0.25-0.74) and 0.41(0.23-0.74); P < 0.001 for trend.

CONCLUSION

Low cardiorespiratory fitness is associated with cancer mortality in Japanese men.

Multivariate analysis of the prognostic determinants of the depressor response to exercise therapy in patients with essential hypertension

This study investigated the contribution of hemodynamic and humoral factors to the variation in the depressor responses to exercise therapy and the significance of the baseline values of these factors in predicting the depressor response of essential hypertensives to mild exercise therapy. Patients with mild to moderate essential hypertension (n=122, F/M: 97/25) performed a bicycle ergometer exercise at a workload equivalent to the lactate threshold for 10 weeks. In all of the patients, systolic and diastolic blood pressures (BP) significantly decreased after 1 week of exercise, continued to decrease until 4 weeks, and were stable from 4 weeks to 10 weeks. Changes in the plasma volume and humoral factors during the study did not differ significantly between responders and non-responders. A multiple logistic regression analysis showed that higher baseline mean BP (MBP) was significantly associated with a poor depressor response (odds ratio 1.84, p=0.002). A variance component analysis indicated that baseline MBP accounted for only 11.2% of the total variance of the depressor response. In conclusion, these summarized results showed that variations in the depressor response to mild exercise therapy were partly determined by baseline MBP, but not by humoral factors, suggesting the possible involvement of other factors, including genetic factors.

Relationship between exercise training-induced increase in insulin sensitivity and adiponectinemia in healthy men

Circulating concentrations of adiponectin, an adipocyte-derived protein, are increased by thiazolidinediones and by weight reduction, accompanied with improvement in insulin sensitivity. The effect of exercise training, another therapy to increase insulin sensitivity (SI), on adiponectinemia is currently unclear. The present study was undertaken to clarify whether exercise training-induced increase in SI is related to changes in adiponectinemia in healthy men. Twelve healthy non-obese men underwent ergometer training at lactate threshold (LT) intensity for 60 min/day for 5 days/week for 6 weeks. An insulin-modified intravenous glucose tolerance test was performed before and at 16 h and 1 week after the last training session to determine SI using a minimal-model approach. Serum levels of adiponectin were determined at the same time. After the exercise training, VO2max and LT were significantly increased by 7.2% and 22.3% (P<0.01), while BMI and body fat mass remained unchanged. SI was significantly increased at 16 h after the last training session (from 7.0 +/- 3.1 to 9.6 +/- 3.6 [x 10(-4) x (microU/ml)(-1) x min(-1)], P<0.01), but returned toward the basal levels at 1 week after the cessation of the training. Serum adiponectin concentrations before the training (20.9 +/- 7.4 microg/ml) were positively correlated with SI. The concentrations were slightly but significantly decreased at 16 h (17.2 +/- 6.6 microg/ml, P<0.05), and returned to the basal values at 1 week after the training. From these results, it can be concluded that exercise training-induced increase in SI is not dependent on the increase in adiponectinemia in healthy men.

Effects of low intensity aerobic training on skeletal muscle capillary and blood lipoprotein profiles

The effects of low intensity endurance training on skeletal muscle capillary density and serum lipoprotein levels were studied in 11 non-obese men (18-25 years). The subjects performed a 6-week training regimen (60 min, 5 times per week) at the lactate threshold (LT). Capillary density was determined in biopsy specimens obtained from the vastus lateralis muscle before and after the training. The number of capillaries per fiber (cap/fiber ratio) before training was 1.97 +/- 0.47, and increased to 2.49 +/- 0.69 after training (p < 0.05). The maximal oxygen uptake (VO2 max) and LT- VO2 increased significantly by 5% (p < 0.01) and 27% (p < 0.01), respectively, whereas no change was observed in body weight. Low density lipoprotein cholesterol (LDL-C) tended to decrease (p = 0.06). The change in the cap/fiber ratio correlated inversely with the change in the ratio of LDL-C to high density lipoprotein cholesterol (HDL-C) (r = -0.61, p < 0.05). It was also, positively associated with the change in HDL2-C (r = 0.82, p < 0.01) and inversely associated with the change in HDL3-C (r = -0.63, p < 0.05). The change in LT- VO2 was inversely associated with the change in LDL-C (r = -0.62, r < 0.05). These results indicate that low intensity training increases capillary density in skeletal muscle, which may explain in part the changes in the lipoprotein profiles.