Physical training in obese women

Summary Peripheral adaptations to 3 months of physical endurance training without food restrictions were studied in skeletal muscles of 14, middle-aged, physically untrained, obese women.In comparison to aged-matched controls of normal weight, the obese group showed significantly lower isometric endurance. In the obese group, physical training resulted in a significant increase of maximal isometric and isokinetic strength. Isokinetic but not isometric endurance also increased after training. The isometric strength of obese women showed a positive correlation with the percentage of FTb fibres.The training (50 min/day, 3 days/w) did not result in any change in body weight, body fat, and the number and weight of fat cells. The 20% increase of after training was found to be significantly correlated with the increase in the number of capillaries around muscle fibres. The relative percentage of FTa fibres, the number of capillaries per fibre as well as the activities of citrate synthase, 3-hydroxy-acyl-CoA-dehydrogenase, and hexokinase showed a significant increase after training.The concentrations of glucose during OGTT showed a trend to decrease with a significant decrease at the end glucose curve (120-min value). The concentration of insulin and C peptide and the insulin removal did not change after training. The changes in the concentration of glucose during OGTT was significantly correlated with the increase in muscle capillarization and of dynamic endurance.     

Transcranial colour Doppler sonography in emergency management of intracerebral haemorrhage caused by an arteriovenous malformation: case report

We present a case which demonstrates the use of transcranial colour Doppler (TCCD) sonography in screening for an underlying arteriovenous malformation (AVM) in a middle-aged hypertensive patient with a spontaneous thalamic haematoma. The AVM was not detected on emergency CT but its presence, site and shape were demonstrated by TCCD, in the presence of a massive cerebral haemorrhage and acute intracranial hypertension. Received: 1 March 2000/Accepted: 17 April 2000     

Global and Local Deformation Effects of Dry Vacuum-Consolidated Triaxial Compression Tests on Sand Specimens: Making a Database Available for the Calibration and Development of Forward Models

A comprehensive experimental database containing results of a series of dry vacuum-consolidated triaxial compression tests was populated. The tests were performed on sand specimens and conducted under similar experimental conditions, in which specimens’ boundary deformation was captured using a three-dimensional digital image correlation analysis (3D-DIC). The use of a standard triaxial device along with the 3D-DIC technology allowed the specimens’ global and local boundary displacement fields to be computed from start to end of the compression phase. By repeating each test under the same experimental conditions and building the specimens using the same type of sand, the boundary deformation patterns could be identified, and the statistics associated with both global and local displacement fields could be assessed. Making this experimental database available to others should serve to calibrate as well as develop new forward models to account for effects associated with the specimens’ local displacements and material heterogeneity and include statistics to represent a specimen’s random response. Moreover, this work will serve as a basis for the statistical characterization of spatio-temporal boundary localization effects used to develop stochastic models and machine-learning models, and simulate virtual triaxial tests.     

Potential use of aldose reductase inhibitors to prevent diabetic complications

Reviewed are (1) the biochemical basis and pathophysiology of diabetic complications and (2) the structure-activity relationships, pharmacology, pharmacokinetics, clinical trials, and adverse effects of aldose reductase inhibitors (ARIs). ARIs are a new class of drugs potentially useful in preventing diabetic complications, the most widely studied of which have been cataracts and neuropathy. ARIs inhibit aldose reductase, the first, rate-limiting enzyme in the polyol metabolic pathway. In nonphysiological hyperglycemia the activity of hexokinase becomes saturated while that of aldose reductase is enhanced, resulting in intracellular accumulation of sorbitol. Because sorbitol does not readily penetrate the cell membrane it can persist within cells, which may lead to diabetic complications. ARIs are a class of structurally dissimilar compounds that include carboxylic acid derivatives, flavonoids, and spirohydantoins. The major pharmacologic action of an ARI involves competitive binding to aldose reductase and consequent blocking of sorbitol production. ARIs delay cataract formation in animals, but the role of aldose reductase in cataract formation in human diabetics has not been established. The adverse effects of ARIs include hypersensitivity reactions. Although the polyol pathway may not be solely responsible for diabetic complications, studies suggest that therapy with ARIs could be beneficial. Further research is needed to determine the long-term impact and adverse effects of ARIs in the treatment of diabetic complications.     

Chromosome changes in malignant mesothelioma

Cytogenetic study was made of mesothelioma cells from 14 patients. Metaphases were obtained from 12 tumors and revealed aneuploidy and clonal abnormalities in 9 specimens. In the two remaining cases, no metaphases were obtained. The cytogenetic abnormalities were complex, and up to 12 marker chromosomes were observed in the tumors. Rearrangements of chromosomes #1, #2, #3, #6, #9, #11, #17, and #22 were most frequently observed. Chromosome markers involved diverse bands, including several that are loci of oncogenes, fragile sites, and nonrandom rearrangements in other types of cancer. This study shows that the karyotypes of malignant mesothelioma can be analyzed by standard cytogenetic techniques. Additional studies of untreated mesothelioma may help to distinguish primary cytogenetic changes from effects of prior therapy in some of our patients.     

Endothelin receptor--a blockade decreases ventricular arrhythmias after myocardial infarction in rats

OBJECTIVE: Endothelin-1 (ET-1) production increases during acute myocardial infarction (MI) and may contribute to the genesis of ventricular tachycardia (VT) and ventricular fibrillation (VF). However, the antiarrhythmic effects of ET-1 receptor blockade, examined shortly after MI, have been debated. In the present study, we examined the effects of such treatment on VT/VF during the first 24 h post-MI. METHODS: Thirty-five Wistar rats (223+/-22 g) were randomly allocated to either the ET-1 receptor-A (ETA) antagonist BQ-123 (0.4 mg/kg, BQ-123 group, n=17), or normal saline (control group, n=18) and were subjected to coronary artery ligation. A single-lead electrocardiogram was continuously recorded for 24 h post-MI, using an implanted telemetry system, and episodes of VT/VF were analyzed. Monophasic action potential (MAP) recordings were obtained from the left (LV) and right (RV) ventricular epicardium at baseline, 5 min after treatment and 24 h post-MI. RESULTS: There were 15.94+/-19.35 episodes/h/rat of VT/VF in the control group and 1.66+/-2.22 in the BQ-123 group (p=0.010), resulting in a lower (p=0.030) arrhythmic mortality in treated animals. The mean episode duration was 7.40+/-7.16 s for the control group and 2.30+/-1.37 s for the BQ-123 group (p=0.011). The maximum decrease in VT/VF was observed during the 1st, 5th and 6th hours post-MI. In the control group, LV MAP duration increased 24 h post-MI, displaying an increased beat-to-beat variation, but remained unchanged in the BQ-123 group. CONCLUSION: Acute ETA blockade reduces the incidence of VT/V F during the first 24-h post-MI in the rat, through a decrease in the dispersion of repolarization.     

Meeting the clinical challenge of care for Jehovah's Witnesses

Quality patient care entails more than simply biomedical interventions. Respect for the wishes, values, and preferences of patients are important elements of quality care. Unique aspects of the beliefs of Jehovah's Witnesses may present physicians with ethical and clinical conflicts. Witnesses believe that allogeneic blood transfusion (ie, whole blood, red blood cells, white cells, platelets, and plasma) and preoperative autologous blood deposit (PAD) are prohibited by several Biblical passages. This article reviews the Witness position on medical care, blood components, and fractions, placing these and related interventions into categories that may help physicians to individualize clinical management plans and meet the challenge of caring for patients who are Jehovah's Witnesses. It includes an overview of cost, safety, efficacy, and medicolegal issues related to patient care using transfusion-alternative strategies.     

Hypothermia as a neuroprotective agent

Hypothermia has long been employed for therapeutic purposes but its use has been limited because of the potential life-threatening side-effects. In late eighties a neuroprotective effect of bold hypothermia was demonstrated and this implied that the method could be used more safely. It has then been shown in a lot of animal experiments that post-ischaemic mild hypothermia significantly limits damage to the brain caused by cardiac arrest. Similar results have been obtained for local brain ischaemia and for experimental head trauma. Molecular basis for this neuroprotection with mild hypothermia has been found to be complex, involving attenuation of the excitotoxic effects of glutamate and diminishing the synthesis of free radicals. In the last decade some clinical series and multicenter randomised trials have shown that mild hypothermia is safe and effective in global brain ischaemia due to cardiac arrest. Clinical data suggest also its effectiveness in ischaemic stroke though no multicenter randomised study has been published to date. At present there are conflicting results of clinical trials concerning brain injuries. Although some authors have reported up to 38% improvement in the outcome, a recently published multicenter randomised trial has failed to demonstrate any practical benefit of mild hypothermia after acute brain injury. There is however virtually no data in the literature on mild hypothermia in spinal cord injury.