Detraining Effects on Muscle Quality in Older Men with Osteosarcopenia. Follow-Up of the Randomized Controlled Franconian Osteopenia and Sarcopenia Trial (FrOST)

The present study aimed to determine the effect of detraining on muscle quality (MQ) in older men with osteosarcopenia. Forty-three community-dwelling older men (78 ± 4 years) were randomly allocated to a consistently supervised high-intensity resistance exercise training (HIRT) group (n = 21) or a control group (CG, n = 22). The HIRT scheduled a periodized single set protocol twice weekly. After the intervention, the men were subjected to six months of detraining. Muscle quality (MQ), defined as maximum isokinetic hip/leg extensor strength per unit of mid-thigh intra-fascia volume, was determined by magnetic resonance imaging (MRI) or per unit of thigh muscle mass assessed by dual-energy X-ray absorptiometry (DXA). Intention-to-treat analysis with multiple imputations was applied. We observed significant exercise effects for MQ (p = 0.001). During detraining, the HIRT group lost about one-third of the intervention-induced gain and displayed significantly (p = 0.001) higher MQ reductions compared to the CG. Nevertheless, after training and detraining, the overall intervention effect on MQ remained significant (p ≤ 0.004). In summary, six months of absence from HIRT induce a significant deleterious effect on MQ in older osteosarcopenic men. We conclude that intermitted training programs with training breaks of six months and longer should be replaced by largely continuous exercise programs, at least when addressing MQ parameters.     

Physical fitness and clustering of risk factors associated with the metabolic syndrome

PURPOSE: The purposes of this study were to 1) assess the prevalence of clustering of metabolic markers of the MS in a defined population and 2) determine the association between CRF and such clustering in a large group of adult men (N = 15,537) and women (N = 3,899). METHODS: Metabolic markers of the MS included systolic blood pressure (BP) > or = 140 mm Hg, serum triglycerides > or = 150 mg x dL(-1), fasting blood glucose > or = 110 mg x dL(-1), and elevated central adiposity (waist circumference > 100 cm). Cardiorespiratory fitness was defined as total time on a maximal treadmill exercise test. The cohort was grouped by the number of metabolic abnormalities and level of CRF. Associations between CRF and the number of metabolic abnormalities were assessed using proportional odds logit models. RESULTS: Among men, the age-adjusted cumulative odds ratio for abnormal markers of the MS was 3.0 (95% C.I. 2.7-3.4; P < 0.001) for the least-fit men when compared with moderately-fit ones, and 10.1 (95% C.I. 9.1-11.2; P < 0.001) when compared with the most-fit men. Among women, the age-adjusted cumulative odds ratio was 2.7 (95% C.I. 2.1-3.5; P < 0.001) for the least-fit women when compared with moderately-fit ones, and 4.9 (95% C.I. 3.8-6.3; P < 0.001) when compared with the most-fit women. CONCLUSIONS: These cross-sectional results suggest that low CRF is associated with an increased clustering of the metabolic abnormalities associated with the MS in both adult men and women and support the need for future prospective analyses.     

Thyroid function in prophylactic therapy with lithium (author's transl)]

In 62 out-patients under maintenance treatment with lithium, thyroid function was evaluated. 21% of the patients exhibited goiter II0; 34% showed elevated thyrotrophin (TSH) serum levels; in 42% exaggerated TSH response to intravenous thyrotrophin releasing hormone (TRH) was found.     

Quantitative and qualitative HPLC-analysis of indole alkaloids from Catharanthus roseus cell cultures.

HPLC separation conditions for the qualitative and quantitative analysis of indole alkaloids from CATHARANTHUS ROSEUS tissue cultures were discribed as well as sample preparation procedures with Extrelut and Bond Elut SCX cartridges, which allow a quicker and more effective sample clean up as the classical alkaline chloroform extraction method. The methods are suitable for very small amounts of cell material.     

Combined chemotherapy-radiotherapy study of small cell bronchial carcinoma: chemo-/radiotherapy vs radio-/chemotherapy

The authors studied the effect of a chemo-/radiotherapy or radio-/chemotherapy on 52 cases of microcellular bronchial carcinoma, classification "limited disease". The survival curves were slightly better for the patients submitted to primary chemotherapy, but the difference was not statistically significant, and the curves coincided again after 18 months. 60 to 80% of the patients had no complaints or only unimportant complaints during more than half of their survival time. In 23 patients with "extensive disease" who received only a symptomatic therapy or a combined palliative chemotherapy, chemotherapy had a slightly better effect, but this was not statistically significant.     

Lack of accumulation of midazolam in plasma and lipoprotein fractions during intravenous lipid infusions in patients on artificial respiration

Summary Severely ill patients often require total parenteral nutrition including intravenous liqid emulsions concurrently administered with lipophilic drugs. Therefore we investigated whether therapeutic application of a mixed medium chain/long chain triglyceride infusion affects the disposition of midazolam necessary for sedation in patients on artificial respiration. The concentrations of midazolam were measured in unfractionated plasma, and in lipoprotein fractions isolated from ex vivo blood samples, including determination of triglycerides and cholesterol; the albumin level was also analysed.Midazolam in the VLDL fraction was only 0.246 g·ml^–1, whereas the total plasma concentration averaged 1.101 g·ml^–1, and the midazolam content of the LDL plus HDL fractions amounted to 1.771 g·ml^–1. Albumin in these lipoprotein fractions was just as unequally distributed. A lipid infusion resulted in a significant elevation of total triglycerides from 157 to 221 mg·dl^–1 and VLDL-triglycerides from 77 to 155 mg·dl^–1. The triglyceride content of the LDL plus HDL fraction rose from 102 to 139 mg·dl^–1. At the same time the midazolam concentration in unfractionated plasma and in the VLDL and the LDL + HDL fractions decreased to 0.899 g·ml^–1, 0.130 g·ml^–1, and 1.265 g·ml^–1, respectively. Cholesterol and albumin concentrations were not affected.The data show for the first time that a significant increase in plasma triglycerides during an intravenous lipid infusion does not result in accumulation of midazolam in lipoproteins, probably because albumin binding of the drug is very strong. The lack of midazolam trapping is important with respect to the safety of concurrent use of lipophilic drugs and intravenous lipid infusions.     

Effects of interleukin-1, tumor necrosis factor-β, and forskolin on tissue plasminogen activator activity in human osteoblastic osteosarcoma cells

Summary The effects of interleukin-1 (IL-1), forskolin, and tumor necrosis factor (TNF-) on tissue plasminogen activator (t-PA) activity were studied in the human osteoblastic osteosarcoma cell line, G292. t-PA activity was measured in the cell media using the chromogenic substrate, S-2251. After a 24 hour incubation period, IL-1 increased t-PA in a dose-dependent manner. The effect of IL-1 at 10.0 U/ml was partially inhibited in the presence of indomethacin. Forskolin (1.0 M) increased t-PA activity after 24 hours with the effects of combined treatment of IL-1 (1.0 U/ml, 10.0 U/ml) and forskolin being apparently additive in nature. TNF- (10^-8–10^-7 M) also produced increased t-PA activity in the cell medial after a 24 hour incubation period. These results suggest that the cytokines, IL-1 and TNF-, can increase t-PA activity in G292 cells and that there is both a cAMP-dependent as well as a cAMP-independent pathway involved in the regulation of this osteoblastic cell function.     

Social class and mental disorders

Summary We have ascertained the social class distribution at different care levels for a semi-rural area of southeastern Bavaria. The analysis is based on a prevalence study of psychiatric patients treated as in-and outpatients (n=3,788), a study of patients in general practices (n = 1,274) and a field study (n= 1,536). The first study is based solely on secondary statistical material (case histories); in the latter two studies, the psychiatric diagnosis was reached with the aid of the Clinical Psychiatric Interview (Goldberg et al. 1970). In classifying the psychiatric diagnoses we used the ICD (8th revision). Social class was recorded in all three samples according to the classification of Moore and Kleining (1960). During the first 6 months of 1971, psychiatric outpatients were clearly overrepresented in the lower social classes, above all in the upper working class. With the exception of the diagnoses of (pre)senile dementia and other organic mental disorders, significant class differences were found. The lower the social class, the higher the rate of inpatient treatment (6 months' treated prevalence). The rate for the lower working class was especially high. The differences in class distribution between in-and outpatients are due primarily to those patients resident on 1 January 1971, mostly chronically ill, who, to a great extent, belong to the lower class. No significant difference exists between the social class distributions of inpatient and outpatient admissions, whether first or readmissions. In contrast to those under psychiatric treatment, and with the exception of the mentally retarded, we found no significant classspecific differences for patients in general practices. The rate of mental illnesses in need of treatment in the lower lower class in the field study was clearly higher than the expected value for the general population. The high rate in Class V is due to the diagnoses of mental retardation, alcoholism and neurotic/psychosomatic illnesses.This study was funded by the German Research Foundation (Deutsche Forschungsgemeinschaft) within the research division Psychiatric Epidemiology (Sonderforschungsbereich 116, Psychiatrische Epidemiologie). Revised version of a paper presented at the 31st Congress of the Deutsche Gesellschaft für Psychologie in Mannheim, FRG, 17–21 September 1978.