Interactions of metabolic hormones, adipose tissue and exercise

Physiological and psychological systems work together to determine energy intake and output, and thus maintain adipose tissue. In addition, adipose tissue secretes leptin and cytokines, which induces satiety and has been linked to catecholamines, cortisol, insulin, human growth hormone, thyroid hormones, gonadotropin and lipolysis. Thus, adipose tissue is acted upon by a number of physiological stimuli, including hormones, and simultaneously, is an active component in the regulation of its own lipid content. All of the hormones mentioned above are associated with each other and respond to exercise and exercise training. Thus, exercise is one of the major links between the hormonal modulators of energy intake and output. It appears that the sympathetic nervous system and the catecholamines are key components facilitating the lipolytic activity during exercise. These two neuroendocrine factors directly affect adipose metabolism and metabolic hormones that influence adipose metabolism. Acute low- and moderate-intensity exercise causes hormonal changes that facilitate lipolytic activity. Exercise training reduces these hormonal responses, but the sensitivity to these hormones increases so that lipolysis may be facilitated. Large amounts of adipose tissue blunt the metabolic hormonal responses to exercise, but the sensitivity of these hormones is increased; thus maintaining normal lipolytic activity. Although the physiological role of the endocrine system during exercise and training is significant, other training effects may have as great, or greater influence on lipolytic activity in adipose tissue.     

Apparent diffusion coefficients in spinal cord transplants and surrounding white matter correlate with degree of axonal dieback after injury in rats

BACKGROUND AND PURPOSE: Abnormal apparent diffusion coefficient (ADC) values in injured spinal cord white matter and fibroblast transplants have been shown to correspond with qualitative histologic findings of axonal loss or regeneration. We proposed that ADC values would correlate with quantitative axonal tracing in the transected rubrospinal tract (RST). METHODS: Eleven rats received right-sided lateral funiculus lesions at C3-4 (disrupting the RST) and transplantation of fibroblasts that were unmodified or modified to secrete brain-derived neurotrophic factor (BDNF). Behavioral tests measured hindlimb function at 1, 2, 4, 6, 8, 10, and 12 weeks after injury. At 12 weeks after injury, the antegrade axon tracer biotinylated dextran amine was stereotactically injected into the red nucleus to label the injured RST axons. Animals were sacrificed 2 weeks later. Diffusion-weighted MR imaging of the excised, fixed spinal cord specimens was then performed at 9.4 T. RESULTS: In white matter surrounding transplants, ADC values transverse to axons were elevated and ADC values longitudinal to axons were decreased. These ADC values were more abnormal closer to the transplant, and this correlated with decreases in numbers of labeled RST axons. ADC values in BDNF-expressing fibroblast transplants were significantly lower than those in unmodified fibroblast transplants, and these lower values correlated with decreased axonal dieback. Behaviorally, all animals showed partial recovery, but animals with BDNF-expressing fibroblast transplants had slightly improved hindlimb function compared to those with unmodified fibroblast transplants. CONCLUSION: ADC values may be able to evaluate graft function after spinal cord injury by demonstrating the degree of axonal dieback and preservation.     

Magnetization transfer micro-MR imaging of live excised lamprey spinal cord: characterization and immunohistochemical correlation

BACKGROUND AND PURPOSE: Membrane constituents may play a key role in the magnetization transfer (MT) effect. In lamprey spinal cord, axonal diameters range from <1 microm in the dorsal region to 20-40 microm in the ventral region. There is a corresponding range of axonal, and hence cell membrane, density. These characteristics permit determination of the effect of cell membrane density on MT. The purpose of this study was to characterize regional MT effects in lamprey spinal cord. METHODS: Excised spinal cords from eight sea lampreys were measured with a 9.4-T MR imaging system. MT saturation was applied for spin-echo sequences. The MT ratio (MTR) was calculated in each location (dorsal, lateral, and ventral columns). Spinal cords from five other lampreys were prepared with an antibody to lamprey glial keratin (LCM 29). The percentage of area staining with LCM29 was calculated for each location. RESULTS: Mean MTR (+/- SD) for the dorsal, lateral, and ventral columns were 62.4 +/- 4.2, 59.2 +/- 2.7, and 56.9 +/- 3.0, respectively; all differences were significant (P < .05). Mean LCM29-positive areas for the dorsal, lateral, and ventral columns were 85.1%, 69.7%, and 50.9%, respectively. MTR and percentage LCM29-positive area were significantly correlated (r(2) = 0.98). CONCLUSION: Regional differences in MT effect exist in the lamprey spinal cord. MTR is well correlated with percentage LCM29-positive area. These results support the hypothesis that membrane constituents are at least partly responsible for regional variations in MT effect.     

Early prophylactic inhaled beclomethasone in infants less than 1250 g for the prevention of chronic lung disease

OBJECTIVE:

Inflammation plays an important role in the development of chronic lung disease (CLD), which has become a major cause of morbidity in surviving infants less than 1250 g at birth. The authors hypothesized that the progression of this inflammation and, therefore, the establishment of CLD would be decreased with the use of early prophylactic inhaled corticosteroids. Short, and long term respiratory and neurodevelopmental outcomes were also examined.

DESIGN:

A double-blind, randomized placebo controlled trial.

SETTING:

Level-III neonatal intensive care unit.

POPULATION STUDIED:

Sixty infants less than 1250 g at birth, diagnosed with respiratory distress syndrome and requiring ventilatory support at 72 h of age were enrolled in the study.

INTERVENTION:

Infants enrolled received either placebo or beclomethasone diproprionate by a metered dose inhaler, which was used in-line with the ventilator circuit while the infant was ventilated and then via a spacer until 28 days of age.

RESULTS:

Thirty infants were given beclomethasone and 30 were given placebo. There were two deaths in each group. Among the surviving infants, the frequency of moderate-to-severe CLD was 17% in each study group. Mean time to extubation was not different for beclomethasone compared with placebo at 16.4 and 12.5 days (P=0.12), respectively. The requirement for intravenous corticosteroids was lower in the beclomethasone-treated group (RR 0.67, 95% CI 0.43 to 1.04), although this difference was not statistically significant. The incidence of growth failure, infection and intraventricular hemmorhage did not differ between the two groups. Long term outcomes were not different with respect to the incidence of respiratory re-admissions, cerebral palsy, developmental delay, blindness or deafness.

CONCLUSIONS:

Early treatment with inhaled beclomethasone diproprionate did not reduce the incidence of CLD or decrease the duration of mechanical ventilation. The decrease in intravenous corticosteroid use was not statistically significant. Long term outcome was not affected.     

Substrate utilization and hormonal responses to moderate intensity exercise during pregnancy and after delivery

OBJECTIVE: This study was undertaken to examine substrate utilization and hormonal responses to moderate intensity exercise in the same group of women across gestation. STUDY DESIGN: Glucose, triglyceride, insulin, glucagon, cortisol, growth hormone, and blood urea nitrogen levels were measured in 12 women at rest and after exercise. Heart rate, oxygen uptake, and respiratory exchange ratio were measured at rest and during exercise. Urine urea nitrogen levels, urine volume, and creatinine levels were measured 24 hours before and after exercise. Each woman completed a 30-minute treadmill walk at 65% of her predicted maximal heart rate at the same time of day during the 22nd and 33rd weeks of gestation and at 14 weeks after delivery. RESULTS: There were no significant differences between exercise trials in oxygen uptake, respiratory exchange ratio, or heart rate. Pregnancy elevated resting triglyceride levels but lowered plasma glucose levels. Exercise during pregnancy caused a reduction in plasma glucose levels but elevated circulating triglyceride levels (P <.05). Resting levels of cortisol, growth hormone, and insulin were elevated during pregnancy compared with after delivery, but resting glucagon levels were not affected by pregnancy. Exercise caused circulating levels of cortisol, growth hormone, and glucagon to increase (P <.05). The exercise-induced change in the cortisol level was greater during pregnancy than that after delivery. The exercise-induced changes in growth hormone and glucagon levels were greatest after delivery compared with those during pregnancy (P <.05). Exercise reduced insulin levels (P <.05), with the greatest reduction at 33 weeks' gestation. There were no significant differences in urine urea nitrogen excretion as a result of exercise. CONCLUSIONS: Certain substrate and hormonal responses to exercise are altered as pregnancy progresses. Quantitatively, protein appears to be a relatively unimportant fuel during a 30-minute bout of moderate intensity exercise in this group of women evaluated during pregnancy and after delivery. Furthermore, a 30-minute bout of moderate intensity exercise would not be expected to compromise fetal amino acid availability.     

Day to day variability in the transferrin receptor/ferritin index in female athletes

OBJECTIVE: To determine the within subject (day to day) variability for variables reflecting iron status (concentrations of ferritin and soluble transferrin receptor (sTfR), and the sTfR/logFerr index) in female athletes during a training camp, and in female control subjects. RESULTS: The error for ferritin concentration was nearly twice as high in athletes as in controls, that for sTfR concentration was identical in the two groups, and that for the sTfR/logFerr index was about 50% higher in athletes than in controls. CONCLUSIONS: The within subject, day to day error for the sTfR/logFerr index computed from data recorded for untrained subjects cannot serve as a reference value for training athletes. When the sTfR/logFerr index is used to monitor iron stores in athletes, an error value of 0.20 should be used, because determination of the index after a few days of rest may not be feasible.     

Ventral hernia repair: a study of current practice

Ventral wall hernias are common; despite this, there are no guidelines on the best surgical management. The aim of this study was to examine the types of repair in use for abdominal wall hernias in the West of Scotland over a 3-month period. Data were gathered on 120 patients. There were 60 incisional, 32 umbilical, and 28 epigastric hernias. The main indication for repair was pain (78%), while 12 patients (10%), presented acutely with incarceration or strangulation. The most common method of repair was sutured (55%), followed by mesh (29%) and Mayo repair (16%). There was no correlation between use of mesh and hernia size or whether repair was for a recurrent hernia. Surgical practice varies widely in the repair of ventral wall hernias. Clinical trials are required to establish the best method of repair for this common condition. Electronic Publication