Diffusion tensor imaging combined with T2 mapping to quantify changes in the skeletal muscle associated with training and endurance exercise in competitive triathletes.

OBJECTIVES: Diffusion tensor magnetic resonance imaging (DTI) and T2 mapping enable the detection of exercise-induced changes in the skeletal muscle microenvironment. This study prospectively quantified DTI metrics and T2 relaxation times of thigh muscles in competitive triathletes at rest and following a triathlon race in comparison with sedentary controls. METHODS: Twenty-two triathletes (males N = 16, females N = 6) and twenty-three controls (males N = 16, females N = 7) underwent magnetic resonance imaging (MRI) on a 3 T system at baseline (time point 1; 72 h at rest). Twelve triathletes (males N = 8, females N = 4) underwent a second scan (time point 2; 3 h of completing a triathlon race). The tensor eigenvalues (λ1, λ2, λ3), mean diffusivity (MD), fractional anisotropy (FA), and T2 times were compared between controls and triathletes at time point 1 and triathletes at time points 1 and 2 using independent and paired t tests. RESULTS: In comparison with the controls at time point 1, the T2 times of rectus femoris (RF, p < 0.02), adductor magnus (AM, p = 0.02), biceps femoris (BF, p < 0.001), semitendinosus (ST, p = 0.005), and semimembranosus (SM, p = 0.003) muscles were significantly increased in triathletes. At time point 2 in triathletes, the average tensor metrics (MD, λ3/ λ1) of BF, ST, and SM muscles increased (p < 0.05) and FA values in ST and SM muscles decreased (p < 0.03). T2 times were not significantly changed between both time points in triathletes. CONCLUSION: Our results indicate that this multiparametric MRI protocol allows detection and quantification of changes in the skeletal muscle microenvironment caused by endurance training and acute strenuous exercise. KEY POINTS: • Endurance training results in changes to the skeletal microstructure, which can be quantified using MRI-based diffusion tensor imaging. • The combined application of MRI diffusion tensor imaging and T2 mapping allows the differentiation of microstructural changes caused by active exercise or endurance training. • Environmental adaptations of the skeletal muscle caused by physical training are influenced by gender.

Interleukin (IL)-4, IL-10 and IL-12 profile in serum of patients with alveolar echinococcosis.

Alveolar echinococcosis (AE), caused by Echinococcus multilocularis (E.m.), provokes a characteristic immune response. Based mainly on in vitro studies, Th2 dominated immunity is associated with increased susceptibility to disease, while Th1 cell activation is assumed to induce protective immunity. We investigated serum levels of interleukin (IL)4, IL-10, and IL-12 in 40 AE patients and 20 controls to assess Th1/Th2 cell activation in vivo. Significantly higher levels of IL-10 were found in AE patients (P = 0.003) than in controls, with a tendency to higher concentrations in progressive cases. In contrast, IL-4 was only measurable in a minority of patients and controls. IL-12 levels (measured with an ELISA that detects both the p35/p40 heterodimer and free p40) were comparable between AE patients and controls and showed a similar distribution pattern to IL-10 with regard to disease progression. By using an IL-12-ELISA specific for the heterodimer, only minute amounts of IL-12 were detectable in merely a minority of samples. In conclusion, our data are suggestive of Th2 dominated immune response in AE in vivo.

[Analysis of causes of incorrect use of dose aerosols]. / Ursachenanalyse fehlerhafter Anwendung von Dosier-Aerosolen.

Preparations administered by inhalation make relatively high demands on the skill and knowledge of the patient in handling this form of application, for the effectivity of the therapy is inseparably linked to its faultless application. The present article aims at analysing possible mistakes in handling and at finding the most effective way of avoiding them. Several groups of patients with different previous knowledge were analysed in respect of handling skill and the influence of training on an improvement of the same; the patients' self-assessment was analysed by questioning them. Most mistakes are committed by patients whose only information consists of the contents of the package circular. Written instructions alone cannot convey sufficient information especially on how to synchronize the release operations. Major mistakes are insufficient expiration before application in 85.6% of the patients and lack of synchronisation in 55.9%, while the lowest rate of errors in respect of handling was seen in patients who had undergone training and instruction. Training in application associated with demonstration and subsequent exercise reduces the error ratio to a tolerable level. Pulverizers free from propelling gas and preparations applied by means of a spacer are clearly superior to others in respect of a comparatively low error rate. 99.3% of all patients believe they are correctly following the instructions, but on going into the question more deeply it becomes apparent that 37.1% of them make incorrect statements. Hence, practical training in application should get top priority in the treatment of obstructive diseases of the airways. The individual steps of inhalation technique must be explained in detail and demonstrated by means of a placebo dosage aerosol.(ABSTRACT TRUNCATED AT 250 WORDS)

Michael-type reactions of tenulin, a biologically active sesquiterpene lactone.

The antitumor pseudoguaianolide tenulin has been exposed to a wide variety of biological and model nucleophilic reagents and has been shown to react exclusively with sulfur nucleophiles in a Michael-like fashion. The biological implications of these results are discussed.