Effect of serotonin on pentagastrin-stimulated gastric acid secretion and gastric antral motility in dogs with gastric fistula

The effects of exogenous serotonin on pentagastrin-stimulated gastric acid secretion and antral motility were evaluated with regard to inhibition kinetics and receptor mediation. Conscious gastric fistula dogs were used. Serotonin inhibited the acid secretion dose-dependently, whereas the antral motility was initially stimulated and thereafter inhibited. The inhibition of secretion was counteracted by different beta-adrenergic blocking drugs and methysergide, whereas the inhibition of antral motility was blocked by methysergide and indomethacin. Dose-response analysis showed inhibition of non-competitive types. This study supports the concept of differences in the regulation of gastric acid secretion and motility, but further experiments with simultaneous registration are required.     

Changes in 3-dimensional bone structure indices in hypoparathyroid patients treated with PTH(1-84): a randomized controlled study

Hypoparathyroidism (hypoPT) is characterized by a state of low bone turnover and high bone mineral density (BMD) despite conventional treatment with calcium supplements and active vitamin D analogues. To assess effects of PTH substitution therapy on 3‐dimensional bone structure, we randomized 62 patients with hypoPT into 24 weeks of treatment with either PTH(1‐84) 100 µg/day subcutaneously or similar placebo as an add‐on therapy. Micro‐computed tomography was performed on 44 iliac crest bone biopsies (23 on PTH treatment) obtained after 24 weeks of treatment. Compared with placebo, PTH caused a 27% lower trabecular thickness (p < 0.01) and 4% lower trabecular bone tissue density (p < 0.01), whereas connectivity density was 34% higher (p < 0.05). Trabecular tunneling was evident in 11 (48%) of the biopsies from the PTH group. Patients with tunneling had significantly higher levels of biochemical markers of bone resorption and formation. At cortical bone, number of Haversian canals per area was 139% higher (p = 0.01) in the PTH group, causing a tendency toward an increased cortical porosity (p = 0.09). At different subregions of the hip, areal BMD (aBMD) and volumetric BMD (vBMD), as assessed by dual‐energy X‐ray absorptiometry (DXA) and quantitative computed tomography (QCT), decreased significantly by 1% to 4% in the PTH group. However, at the lumbar spine, aBMD decreased by 1.8% (p < 0.05), whereas vBMD increased by 12.8% (p = 0.02) in the PTH compared with the placebo group. © 2012 American Society for Bone and Mineral Research.     

Prevention of hamstring strains in elite soccer: an intervention study

The purpose was to test the effect of eccentric strength training and flexibility training on the incidence of hamstring strains in soccer. Hamstring strains and player exposure were registered prospectively during four consecutive soccer seasons (1999-2002) for 17-30 elite soccer teams from Iceland and Norway. The first two seasons were used as baseline, while intervention programs consisting of warm-up stretching, flexibility and/or eccentric strength training were introduced during the 2001 and 2002 seasons. During the intervention seasons, 48% of the teams selected to use the intervention programs. There was no difference in the incidence of hamstring strains between teams that used the flexibility training program and those who did not [relative risk (RR)=1.53, P=0.22], nor was there a difference compared with the baseline data (RR=0.89, P=0.75). The incidence of hamstring strains was lower in teams who used the eccentric training program compared with teams that did not use the program (RR=0.43, P=0.01), as well as compared with baseline data for the same intervention teams (RR=0.42, P=0.009). Eccentric strength training with Nordic hamstring lowers combined with warm-up stretching appears to reduce the risk of hamstring strains, while no effect was detected from flexibility training alone. These results should be verified in randomized clinical trials.     

MTHFR c.677C>T polymorphism as an independent predictor of peak bone mass in Danish men--results from the Odense Androgen Study

The MTHFR c.677C>T polymorphism has been shown to have significant effects on skeletal health in middle-aged to elderly women and men. Despite an accumulating amount of data on MTHFR genetics and the association between homocysteine levels and fracture, it remains unknown if MTHFR c.677C>T genotype affects bone mineral accretion in youth or bone loss in adulthood. The purpose of this cross-sectional study was to examine the effects of this common allelic polymorphism on peak bone mass and bone turnover. We performed MTHFR genotyping in 780 healthy Danish men, aged 20 to 29 years, participating in the Odense Androgen Study. BMD at the spine, hip and whole-body was measured using a Hologic QDR-4500 densitometer. Genotype frequencies were compatible with Hardy-Weinberg equilibrium. Spine BMD was significantly associated with genotype, with a decrease in BMD of 0.20 SD for each copy of the T-allele. Effects were independent of age, BMI, smoking and serum levels of vitamin D and IGF-I. Associations with BMD of the hip and whole body were short of statistical significance. MTHFR genotype showed no association with the bone turnover markers 1-CTP, bone specific alkaline phosphatase or osteocalcin. In conclusion, significant skeletal effects of this common polymorphism were present at the lumbar spine in men at the age of 25 years.     

A 3-Year Physical Activity Intervention Program Increases the Gain in Bone Mineral and Bone Width in Prepubertal Girls but not Boys: The Prospective Copenhagen School Child Interventions Study (CoSCIS)

The aim of this study was to evaluate the effect of increasing the amount of time spent in physical education classes on bone mineral accrual and gain in bone size in prepubertal Danish children. A total of 135 boys and 108 girls, aged 6–8 years, were included in a school-based curriculum intervention program where the usual time spent in physical education classes was doubled to four classes (180 min) per week. The control group comprised age-matched children (62 boys and 76 girls) recruited from a separate community who completed the usual Danish school curriculum of physical activity (90 min/week). Dual-energy X-ray absorptiometry was used to evaluate bone mineral content (BMC; g), bone mineral density (g/cm²), and bone width at the calcaneus and distal forearm before and after 3 years of intervention. Anthropometrics and Tanner stages were evaluated on the same occasions. General physical activity was measured with an accelerometer worn for 4 days. In girls, the intervention group had a 12.5% increase (P = 0.04) in distal forearm BMC and a 13.2% increase (P = 0.005) in distal forearm scanned area compared with girls in the control group. No differences were found between the intervention and control groups in boys. Increasing the frequency of physical education classes for prepubertal children is associated with a higher accrual of bone mineral and higher gain in bone size after 3 years in girls but not in boys.     

Gender Differences and Biomechanics in the 3000M Steeplechase Water Jump

Since 1996, women have been competing in the 3000m steeplechase race internationally. Whenever women and men both compete in similar events with different equipment (the barriers are lower for women) consideration should be given as to how techniques should be coached differently. This study investigated the differences in water-jump technique between men and women after accounting for differences in running speed and which techniques led to maintenance of race pace through the water-jump. Eighteen men and 18 women were filmed at two major track and field meets during the 2004 season. Peak Motus 8.2 was used to digitize all seven jumps from each athlete. Various characteristics of water-jump technique were measured or calculated and compared using two multiple linear regressions (one for men and one for women) to determine which characteristics led to maintaining race pace speeds through the water jump obstacle. Repeated measures ANOVA was used to determine any differences between men and women in the measured characteristics of technique.Velocity through the jump divided by race pace was predicted very well by approach velocity and landing distance for men and women. Other characteristics of the movement were non-significant. Differences between genders were found in: approach velocity, take-off distance, landing distance, push-off angle, velocity through jump, and exit velocity. Men and women steeplechasers must focus on approach velocity and landing distance to complete the water-jump close to their race pace. Coaches need to consider many characteristics of technique that differ between men and women.

Key points

• Women may need to be coached differently than men in the steeplechase water jump due to different techniques required.
• Men and women must focus on a high approach velocity to complete the steeplechase water jump successfully.
• Men and women must generate a relatively long landing distance to maintain velocity and keep from having to use extra energy exiting the water pit.
• Women''s race paces were affected more than men''s by the water jump in a negative way.

Key words: Track and field, athletics, hurdling, running, biomechanics.     

Increased concentrations of L-lactate in the rectal lumen in patients undergoing cardiopulmonary bypass

Background. Gut ischaemia may contribute to morbidity in patientsafter cardiopulmonary bypass (CPB), but little is known aboutthe metabolic state of the large bowel in such patients. Thereforewe estimated the concentrations of L-lactate and in rectal mucosa in patients undergoing cardiac surgery withor without the use of CPB. Methods. Patients undergoing coronary artery bypass grafting(CABG) (n=12) or off-pump CABG (n=10) were subjected to equilibriumdialysis of the rectal lumen during the procedure and in thefirst 4 h afterwards. Dialysate concentrations of L-lactateand were measured using an auto-analyser and compared with values obtained in healthy subjects (n=10). Results. During CPB, a 2- to 3-fold increase in luminal concentrationsof L-lactate was observed (CABG vs off-pump CABG, P=0.05; CABGvs healthy subjects, P<0.01). The dialysate concentrationsof L-lactate were higher than the mean systemic values (luminal–arterialgradient mean (SD) 0.9 (1.0) mmol litre^–1, P<0.05),and the two values were positively correlated (P<0.05). LuminalL-lactate concentrations remained elevated 4 h after the operation.In contrast, dialysate was equally high in patient and control groups and substantially higher thanvalues observed in arterial blood. Conclusions. Uncomplicated CPB is associated with moderate butsustained increases in luminal concentrations of L-lactate inthe rectum, indicating metabolic dysfunction of the mucosa inthe large bowel. Part of this study was presented at the 27th Congress of theScandinavian Society of Anaesthesiology and Intensive Care Medicine,Helsinki, Finland, 2003.     

Three-dimensional description of ligamentous attachments around the lunate

PURPOSE: To detail the location and area of specific ligament attachments on the 3-dimensional (3-D) surface morphology of the individual carpal bones. METHODS: We describe the attachment regions of both extrinsic and intrinsic intercarpal ligaments by using a combination of detailed dissection, computed tomography imaging, and a 3-D digitization technique and provide detailed information about ligament attachments around the lunate. RESULTS: The length, width, and thickness of each ligament are described in millimeters and its area of attachment is given in square millimeters and as a percentage of the bone surface and/or total ligament attachment area. The attachment sites of the ligaments also are shown visually on 3-D images of the bones. CONCLUSIONS: This study improves the knowledge and understanding of carpal ligament anatomy, which can result in better intraoperative assessment of ligament integrity/disruption and allow more accurate and anatomic repair, reattachment, and/or reconstruction of carpal ligaments for the treatment of carpal instability.     

The patient's choice of androgen-deprivation therapy in locally advanced prostate cancer: bicalutamide, a gonadotrophin-releasing hormone analogue or orchidectomy

OBJECTIVE: To investigate patient preference for three established androgen-deprivation therapies for locally advanced prostate cancer; the patient's capacity to decide his therapy; the reasons for selecting a certain mode of therapy; and patient satisfaction with the chosen therapy 3 months after initiation. PATIENTS AND METHODS: In all, 150 patients (mean age 75 years, range 57-89) with previously untreated locally advanced prostate cancer from 13 hospitals were consecutively given the chance to choose between the antiandrogenic oral drug bicalutamide, a gonadotrophin-releasing hormone analogue (GnRH) by injection, or surgical orchidectomy. After discussing the nature of their disease the patients took home written information about prostate cancer and the three different treatment options. After 1 week they were assessed using a questionnaire for biographical data, their attitude towards the different treatment alternatives and their choice of therapy. Three months later the patients completed a questionnaire about the treatment they had undergone. RESULTS: Sixty-three patients (42%) chose bicalutamide, 51 (34%) the GnRH analogue and 36 (24%) orchidectomy; 87% of those choosing bicalutamide, 84% GnRH and 94% orchidectomy, respectively, were sure about their choice but 12%, 17% and 3% of the patients, respectively, had some difficulty in deciding. The most important reasons for the therapy chosen were avoidance of injections and surgery, and a lower risk of impotence (bicalutamide), negative attitude to surgery and tablets (GnRH), and avoidance of injections and tablets (orchidectomy). Almost all patients (98%, 98% and 97%, respectively) were satisfied with their choice after 3 months of treatment. CONCLUSION: There are three equally effective forms of androgen deprivation for locally advanced prostate cancer without known metastases. There are major differences among these treatments in the mode of application and the likelihood and impact of side-effects. When patients are fully informed and play an active role in the treatment decision they are satisfied with their decision 3 months later.