Skeletal Muscle Adaptations to Physical Training in Type II (Non-insulin-dependent) Diabetes Mellitus

Seven middle-aged men with manifest type II diabetes mellitus underwent an endurance training programme for 10–15 weeks. The maximal aerobic capacity, as well as the endurance capacity, was improved by 10% (p<0.05). The intramuscular glycogen store increased by more than 80% (p<0.05) from 350 μmol/g dw (dry weight), and the activities of citrate synthase and 3-hydroxy-acyl-CoA dehydrogenase increased by more than 50% (p<0.05) and 30% (p<0.05). The activity of glycogen synthase was decreased by approximately 20% (p<0.05), whereas lactate dehydrogenase remained unchanged. Capillaries/fibre and fibre area increased by more than 50% (p<0.05) and 30% (p<0.05) leaving the area of supply constant. Training did not influence fasting blood lipids and glucose, glycosylated hemoglobin, oral glucose tolerance, and insulin response to an oral glucose load measured 72 hours post-exercise. It is concluded that patients with manifest type II diabetes, as normoglycaemic individuals, adapt to physical training. However, no persistent effect on glucohomeostasis and lipaemia is produced by short-term training in the diabetic patients.     

Cyclic hormonal replacement therapy after the menopause: Transdermal versus oral treatment

Summary In an open, randomized, comparative, between-patient trial, 45 postmenopausal women were treated for 4 months with cyclical transdermal oestradiol 0.05 mg per day or oral conjugated equine oestrogens 0.625 mg per day, in both cases, plus, medroxyprogesterone acetate 10 mg per day on the last 8 days of each cycle. Similar relief from postmenopausal symptoms was obtained with both treatments. Post-treatment histological evaluation of the endometrium did not reveal neoplastic or hyperplastic change in any patient.Early follicular-phase plasma oestradiol levels were observed only after transdermal oestradiol. There was a significant reduction in serum total cholesterol and LDL cholesterol in both treatment groups, with no difference between treatments, whereas serum triglyceride levels were decreased only by transdermal oestradiol. Plasma calcium and phosphorus fell significantly and serum intact parathyroid hormone rose significantly, with no difference between the therapies. No significant changes were observed in clotting factors.Transdermal oestradiol appears to be an effective and safe hormonal replacement therapy, and this route of administration may be responsible for the more useful action of the drug on serum lipids and plasma oestradiol levels.     

Aptitude for physical exercise in a population of female hospital workers

Summary The aim of this study was to evaluate the level of physical capacity in a female hospital population of Paris and its suburbs. A total of 1505 women working in the selected departments filled in a questionnaire concerning their working conditions, life habits and health and also attended a medical examination. The effort test performed consisted in flexing the legs 20 times with the chest held straigt, in 40 s. The heart rates were measured for the first, the second and the third minutes of recovery (first 15 s multiplied by 4). The blood pressure was measured just after the heart rate, for the first and the third minute. Recovery indices have been constituted from the results. The respective weights of anthropometric and sociodemographic risk factors for recovery indices were studied in multiple logistic regression models. The classification enables us to consider about 25%–30% of our population as having a satisfactory physical capacity, about 26%–27% as having an acceptable capacit, and about 24%–27% as having a weak capacity. About 21% of the population presented an excessive pressure reaction and 44% a questionable pressure reaction. Our results concerning the level of physical capacity of the female nursing staff should be taken into account especially in the future planning of work loads and architectural choices, which must avoid excessive physical burdens in relation to this level. An improvement in the level of physical capacity could be envisaged as well.     

Drinking History Is Related to Persistent Blood Pressure Dysregulation in Postwithdrawal Alcoholics

We have previously demonstrated that alcoholics with transitory (< 72 hr) elevations in blood pressure (BP) during withdrawal continue to show residual cardiovascular dysregulation up to 4 weeks of abstinence. The present study replicates and extends these findings. Alcoholic inpatients were divided into three subgroups ( ns = 14) based on BP during the first 72 hr of withdrawal: transitory hypertensives (tHTs; BP > 160/95 mm Hg), transitory borderline hypertensives (tBHs; 140/90 BP < 160/95), and normotensives (NTs; all BPs < 140/90). All patients had normal resting pressures after 72 hr of withdrawal. At 3–4 weeks postadmission, the alcoholics and 14 nonalcoholic controls (CONTs) were tested at rest and during a 5-min handgrip task. The tHTs showed an exaggerated systolic and diastolic BP response to handgrip compared with NTs and CONTs, with tBHs intermediate ( ps < 0.05). Drinking history showed the tHTs had the highest reported level of alcohol consumption and severity of withdrawal symptoms ( ps < 0.05). Regression analyses indicated that consumption of hard liquor was the variable most predictive of admission BPs; further, parental history of hypertension potentiated this relationship for systolic BP. Age and consumption of nicotine and caffeine were not significant predictors of admission BP. The results suggest a persistent cardiovascular dysregulation in alcoholics showing transient hypertensive withdrawal BPs. These alcoholics may be at increased risk for future alcohol-related cardiovascular disorder.     

Lens opacity in patients with hypercholesterolemia and ischaemic heart disease

Lens opacity studies were performed using an electronic Lens Opacity Meter (Interzeag Opacity Lensmeter 701) in a population (n = 321) with ischaemic heart disease. These patients are participating in a trial targetting at the reduction of mortality and incidence of myocardial infarction using a cholesterol-lowering drug, simvastatin. A separate study to evaluate the reliability of the method showed good reproducibility. Repeated measurements after a short time-interval (2–10 days) gave statistically lower opacity values either due to a change in lens transparency or perhaps a change in pigment and cell dispersion in the acqueous caused by repeated mydriasis. Lens opacity values showed a highly significant positive correlation to age. Serum cholesterol, systolic blood pressure and smoking habits showed no significant correlations to the levels of lens opacity when adjustments for age were made.Abbreviations HMG-CoA hydroxy-methylglutarylcoenzyme A - 4S Scandinavian Simvastatin Survival Study - LOM lens opacity meter     

桡骨头切除对肘关节稳定性影响的生物力学研究

目的：探讨桡骨头粉碎性骨折不同治疗方法对肘关节稳定性的影响。方法：将10个尸体标本，分别测定在其它组织无损伤时，肘内侧副韧带切断时，肘内侧副韧带和前臂骨间膜均切断时的力－位移曲线（纵向位移）及肘外翻角。结果：肘内侧副韧带切断时的纵向位移及肘外翻角均大于其它组织无损伤时；肘内侧副韧带和前臂骨间膜均切断时的纵向位移及肘外翻角均大于其它组织无损伤时和肘内侧副韧带切断时，两两间比较均有显著性差异（P＜0．001）。结论：在其它组织无损伤时，单纯桡骨头切除是安全的；合并肘内侧副韧带损伤时，可在有效修补韧带的同时作单纯头切除，必要时行假体置换；合并肘内侧副韧带和前臂骨间膜均损伤时，最好作假体置换。     

The effect of oral appliance therapy on blood pressure in patients with obstructive sleep apnea

The objective of the study was to investigate the effects of oral appliance (OA) therapy on ambulatory blood pressure in patients with obstructive sleep apnea (OSA). Eleven OSA patients who received OA therapy were prospectively investigated. Ambulatory blood pressure was measured for 20 h from 4:00 p.m. to 12:00 noon the next day using an ambulatory blood pressure monitor. The Respiratory Disturbance Index (RDI) was measured in the pretreatment and posttitration periods. The OA was titrated to reach a therapeutic jaw position over 2 to 8 months, and posttitration measurements were repeated. At posttitration, the RDI was significantly decreased from a mean (SD) of 24.7 (20.1) to 6.1 (4.5). Significant reductions in diastolic blood pressure (DBP) and mean arterial pressure (MAP) were found for the 20-h periods, and systolic blood pressure (SBP), DBP, and MAP while asleep. The mean values were 79.5 (5.5) to 74.6 (6.0) for DBP and 95.9 (5.4) to 91.2 (5.9) for MAP, for over a 20-h period, and 118.4 (10.0) to 113.7 (9.1) for SBP, 71.6 (8.0) to 67.2 (7.9) for DBP, and 88.4 (8.0) to 83.9 (7.5) for MAP, while asleep. This study suggests that successful OSA treatment with an OA may also be beneficial to lower blood pressure in OSA patients, as previously suggested for nasal continuous positive airway pressure therapy. This study was conducted in the Division of Orthodontics, The University of British Columbia, Canada     

股骨颈骨折后选择性血管造影评价股骨头血液循环

目的 探讨选择性血管造影检查对评价股骨颈骨折后早期股骨头血液循环损伤及影响因素的价值。方法采用选择性旋股动脉及支持带动脉造影(DSA)，对9例2～23天内单侧股骨颈骨折患者血管损伤和血液循环改变进行评价。结果髋关节囊内出血2例，骨内出血4例，下、后支持带动脉损伤和血管移位各3例。患髋牵引时，除外下支持带动脉，其他支持带动脉无显影或仅显示起始部主干，相应股骨头颈部几无灌注成像，静脉显影延迟；髋关节维持伸直内旋位或囊内注入生理盐水后造影，所有支持带动脉无明确显影或仅显示其主干，股骨头颈部无灌注、染色，静脉显影延迟。结论选择性旋股内、外侧动脉DSA技术是一项准确评价股骨颈骨折后股骨头血液循环损伤及影响因素的微创性检查方法；股骨头血液循环受髋关节体位、囊内压和牵引等因素影响；牵引可导致或加重股骨颈骨折后股骨头缺血。     

不同眩晕证型两侧脑血流速度差变化与症状的关系研究

目的:为了观察不同眩晕证型中的脑血流速度差大于正常与临床症状之间的关系。方法:应用经颅多普勒超声检查方法,观察颅底各个相对应大血管血流速度两侧差值的变化。结果:各种不同眩晕证型之间的差值有非常显著性的差异,各个指标之间均存在着不同的差异,这些差异性的变化多数与临床表现的头痛有着密切的关系。结论:使用此方法可以更早期地评价不同眩晕证型脑血管功能状态的水平,以便为临床提供可靠的诊断依据。另一方面也充分地说明了经颅多普勒超声对脑血管功能的观察是一项十分敏感的观察指标。     

原发性高血压和血液流变学异常之间的关系的研究

目的探讨原发性高血压病和血液流变学异常改变之间的关系。方法对80例高血压病人进行血液流变学观察。结果原发性高血压病组血液流变学多项指标出现异常升高,与正常对照组比较差异有显著性,其主要表现为全血粘度增高,其增高程度和血压升高程度之间呈正相关趋势。其中红细胞压积增高可能是血液粘度增高的重要因素。结论高血压病患者的血液流变学异常和血压增高程度之间有密切相关性。