Characterization of sports by the Vo2 dynamics of athletes in response to sinusoidal work load

The purpose of this study was to evaluate the specificity of maximal oxygen uptake (Vo_2max) and the dynamic response of oxygen uptake (Vo₂) to sinusoidal work load in distance runners and in American-football players. Sinusoidal work load during ergometer cycling was carried from 30 W to 60% to Vo_2max(60% Vo_2max) for a 2 min period. Vo₂ was measured by the breath-by-breath method. The subjects were 10 distance runners (DRs), 10 American-football players (AFPs), and 11 untrained men (UTM). Mean Vo_2max was 64.4 mL kg^-1 min^-1 in the DRs, 53.1 mL kg^-1 min^-1 in the AFPs and 47.3 mL kg^-1 min^-1 in the UTM. The fundamental amplitudes ofthe Vo₂ response, nomalized by dividing by steady state Vo₂ at 60% Vo_2max were similar in the AFPs (20.3%) and the UTM (19.5%), and both were significantly less than in the DRs (25.5%). Phase shift to work load expressed in degrees was similar in the AFPs (87.7d?) and UTM (88.0d?), but significantly greater than in the DRs (80.4d?). HR dynamics in all three groups were similar to a dynamic Vo₂ response. These findings suggest that development of the dynamic Vo₂ response and higher Vo_2max in the AFPs there is no improvement in the dynamic Vo₂ response. The results of the present study demonstrate that athletes participating in different sports have characteristic dynamic Vo₂ responses during cycling exercise.     

Risk factors for small for gestational age

BACKGROUND: The purpose of the paper was to determine the risk factors for small-for-gestational-age (SGA) infants at full term, in Japan. METHODS: The study was conducted at four hospitals and clinics in the Tokyo metropolitan area. A retrospective review of 2972 mothers and their infants born from singleton pregnancies at any time during the years 2002 and 2003 was conducted. RESULTS: Of these women, 8.4% gave birth to SGA infants. The proportion of SGA infants was significantly higher among heavy smokers (>10 cigarettes/day; 13.7%, P < 0.01). The odds ratio (OR) for SGA decreased significantly in proportion to the pregnancy body mass index (OR, 0.89; 95% confidence interval [CI]: 0.84-0.94, P < 0.001). The OR of SGA for stratified maternal weight gain was 1.79 (95%CI: 1.24-2.58, P 12 kg. CONCLUSION: The present study clearly confirms the detrimental effect of a low prepregnancy body mass index, low maternal weight gain and maternal smoking during pregnancy on the incidence of SGA infants.     

Alternating Non-Cross Resistant Chemotherapy for Small Cell Lung Cancer

After stratification for the extent of disease, previously untreatedpatients .with small cell lung cancer randomized to receivetherapy with the four-drug combination of cyclophosphamide,oncovin, nimustine hydrochloride (ACNU), and procarbazine (CONP)every four weeks (continuous regimen) or to receive CONP alternatingwith the three-drug combination of etoposide (VP-16), adriamycinand cisplatin (VAD) at four-week intervals (alternating regimen).Sixty-nine patients were entered in the study. Of 34 evaluablepatients receiving the continuous regimen, six (17.6%) achievedcomplete response (CR) and 16 (47.1%) achieved partial response(PR). Of 31 evaluable patients receiving the alternating regimen,10 (32.3%) achieved CR, and 16 (51.6%) achieved PR. There wasa tendency in favor of the alternating regimen in CR and overall response rates (0.05 < p < 0.1). There were no significantdifferences be tween the regimens in response duration or survival.The projected median survival times were 9.2 months and 9.4months for the continuous and alternating regimens, respectively.One patient receiving the continuous regimen and three receivingthe alternating regimen have been living for more than two years.The major toxicity was myelosuppression in both regimens. Onepatient died of hemorrhage due to thrombocytopenia during inductionwith CONP, and one patient died of cisplatin-induced renal failure.We conclude that alternating non-cross resistant chemotherapyleads to improved CR and response rates, but does not improvesurvival.     

Nocturnal hypoxic stress activates invasive ability of monocytes in patients with obstructive sleep apnoea syndrome

Background and objective:   Obstructive sleep apnoea syndrome (OSAS) is known to be a risk factor for cardiovascular events. However, the precise mechanism has not been fully elucidated. OSAS-induced hypoxic stress may promote the production of inflammatory cytokines and chemokines by monocytes, which has a crucial role in the development of atherosclerosis. In addition, adhesion to the vascular endothelium and transendothelial migration of monocytes are considered to induce atherosclerosis. The aim of this study was to investigate the effects of hypoxic stress on the invasive ability of monocytes in OSAS.
Methods:   Twenty-one male patients with OSAS and 17 healthy male control subjects, who were matched for age and BMI, were enrolled. Venous blood samples were collected before and after sleep, and also after CPAP titration, for the purpose of monocyte isolation. The invasive ability of monocytes was evaluated by counting the number of invading cells using a BD BioCoat Matrigel Invasion Chamber.
Results:   The number of cells, which represents the invasive ability of monocytes, was significantly higher in patients with OSAS compared with control subjects, in the early morning ( P  < 0.001). In patients with OSAS, invasive ability in the early morning after sleep was significantly elevated as compared with that before sleep ( P  < 0.001), and was positively correlated with the oxygen desaturation index ( P  < 0.05). CPAP titration led to a decrease in the invasive ability ( P  < 0.001).
Conclusions:   These results indicate that OSAS-induced hypoxic stress activates the invasive ability of monocytes, and that the occurrence of this phenomenon during sleep may contribute to the development of atherosclerosis in OSAS.     

SUCCESSFUL SURGICAL MANAGEMENT AND LONG-TERM FOLLOW-UP OF EPIDERMOLYSIS BULLOSA

Background. Esophageal stenosis and hand deformity are serious complications of recessive dystrophic epidermolysis bullosa that influence the prognosis of patients. To control such complications we have used surgical treatments with favorable results. Additional objectives were to summarize the results of long-term follow-up. Methods. Six patients with esophageal stenosis and nine patients (13 hands) with hand deformity (contracted fingers, mitten-like deformity) were treated surgically after anemia and malnutrition were corrected by intravenous iron infusion, high-energy diet, and blood transfusion. As intubation was contraindicated, topical anesthesia was used (eg., lidocaine spray to the nasopharyngeal mucosa for esophageal dilatation and brachial block, ketamine drip, and nitrous oxide inhalation for reconstruction of contracted fingers). We established a new method for esophageal dilatation using a microvasive rigiflex balloon catheter. This catheter was advanced to the stenotic area under radiography and then expanded by injecting contrast medium into the balloon. For reconstruction of hand deformities, the epidermal glove was initially peeled off, and then the combined digits separated carefully by hand, if the release of the contracture was not sufficient, a skin incision was made avoiding injury to nerves and blood vessels. Any skin defects that appeared after the release of the contracture were covered with skin grafts taken from the abdominal wall. K-wire fixation was used to maintain the extended position of the fingers. Three weeks after the operation, the K-wires were removed and rehabilitation was commenced. Results. The esophageal stenosis was successfully dilated with the balloon catheter; in all six cases the dysphagia was relieved immediately. There was no recurrence in any of the patients on long-term follow-up. After reconstruction of the hand, daily activity improved in 12 of the 13 hands. The remaining hand was difficult to reconstruct due to severe mutilation and bone deformity. During follow-up, 6 of the 12 hands maintained successful reconstruction, whereas the remaining 6 hands showed slight to moderate recontraction of the fingers. Conclusion. Esophageal dilatation with a balloon catheter is safer and has fewer side effects compared to other surgical procedures. This method can provide favorable results and can be carried out repeatedly in a short time. Daily and social activities of patients can be improved upon reconstruction of hand deformities.