Determining Optimal Cut-Off Value of Pancreatic-Cancer-Induced Total Cholesterol and Obesity-Related Factors for Developing Exercise Intervention: Big Data Analysis of National Health Insurance Sharing Service Data.

This study aimed to examine the effects of multiple parameters on the incidence of pancreatic cancer. We analyzed data from 1,108,369 individuals in the National Health Insurance Sharing Service Database (NHISS DB; birth to death; 2002 to 2015) and identified 2912 patients with pancreatic cancer. Body mass index, systolic/diastolic blood pressure, and fasting blood glucose and total cholesterol concentrations were lower in women with than without pancreatic cancer (p < 0.01). Fasting blood glucose and total cholesterol concentrations were significantly different between men with and without pancreatic cancer (p < 0.05). In the logistic regression analysis, the total cholesterol concentration (odds ratio (OR), 1.007; 95% confidence interval (CI), 1.005-1.010) was significantly higher in men than women with pancreatic cancer (p < 0.05). Pancreatic cancer rates were highest in men who smoked for 5-9 years or more (OR, 5.332) and in women who smoked for 10-19 years (OR, 18.330). Daily intensive exercise reduced the risk of pancreatic cancer by 56% in men (95% CI, 0.230-0.896). Receiver operating characteristic curve analysis revealed a total cholesterol concentration cut-off point of 188.50 mg/dL (p < 0.05) in men with pancreatic cancer, with a sensitivity and specificity of 53.5% and 54.6%, respectively. For women, the cut-off values for weight and gamma glutamyl transpeptidase concentration were 58.5 kg and 20.50 U/L, respectively. The sex-specific differences in patients with pancreatic cancer identified herein will aid in the development of individualized evidence-based prognostic and preventive programs for the treatment of pancreatic cancer.

High-Intensity Aerobic Exercise Suppresses Cancer Growth by Regulating Skeletal Muscle-Derived Oncogenes and Tumor Suppressors.

High-intensity aerobic exercise (90% of the maximal heart rate) can effectively suppress cancer cell proliferation in vivo. However, the molecular effects of exercise and its relevance to cancer prevention remain uninvestigated. In this study, mice with colorectal cancer were subjected to high-intensity aerobic exercise, and mRNA-seq analysis was performed on the heart, lungs, and skeletal muscle tissues to analyze the genome-wide molecular effects of exercise. The skeletal muscle-derived genes with exercise-dependent differential expression were further evaluated for their effects on colorectal cancer cell viability. Compared to the results obtained for the control groups (healthy and cancer with no exercise), the regular and high-intensity aerobic physical activity in the mice produced positive results in comprehensive parameters (i.e., food intake, weight gain, and survival rate). A heatmap of differentially expressed genes revealed markedly different gene expression patterns among the groups. RNA-seq analysis of 23,282 genes expressed in the skeletal muscle yielded several anticancer effector genes (e.g., Trim63, Fos, Col1a1, and Six2). Knockdown and overexpression of selected anticancer genes repressed CT26 murine colorectal carcinoma cell proliferation by 20% (p < 0.05). Our findings, based on the aerobic exercise cancer mouse model, suggest that high-intensity aerobic exercise results in a comprehensive change in the expression patterns of genes, particularly those that can affect cancer cell viability. Such an approach may identify key exercise-regulated genes that can help the body combat cancer.

Significant Physical and Exercise-Related Variables for Exercise-Centred Lifestyle: Big Data Analysis for Gynaecological Cancer Patients.

This study investigated the characteristics of gynaecological cancers and is aimed at identifying significant risk variables using the National Health Insurance Sharing Service database to develop practical interventions for affected patients. Data regarding patients with uterine and ovarian cancer from the National Health Insurance Sharing Service database were collected and analysed using Student's t-test, logistic regression, and receiver operating characteristic curve analyses. Student's t-test analyses revealed that age, body mass index, blood pressure, and waist variables differed significantly among patients with uterine cancer. Gamma-glutamyl transpeptidase levels were higher in patients with ovarian cancer than in patients with uterine cancer. Physical fitness function tests reflected the status of patients with cancer. Moreover, physical disability was associated with an increased incidence of ovarian cancer. Intensive exercise for 20 min more than 1 time per week must be avoided to prevent uterine cancer. Receiver operating characteristic curve analyses showed that the optimal cutoff value for one-leg standing time, a prognostic and preventive factor in ovarian cancer, was 9.50 s (sensitivity, 94.9%; specificity, 96.9%). Controlling significant variables for each gynaecological cancer type in an individualised and optimised manner is recommended, including by maintenance of an adjusted exercise-centred lifestyle.

The Effect of Significant Exercise Modalities, Gender and Age on 9 Markers (Indicators) in NHISS Registered ACL Patients for Designing Exercise Intervention Program.

BACKGROUND: Knee disease is prevalent in the post middle-aged and associated with lower quality of life. Knee disease (i.e., anterior cruciate ligament, ACL) related injury preventive program should be supported. We examined the significant effect of different age, gender, and exercise modalities on measureable nine dependent markers in National Health Insurance Sharing Service database (NHISS DB) registered ACL patients using big data analysis. METHODS: The 1755 ACL patients from 514,866 in NHISS DB have been randomly selected by retrospective cohort study using big data from 2002 to 2013. Six independent and 9 dependent variables were used for analyzing patients with ACL injuries by T-test and Two-way analysis of variance (ANOVA). RESULTS: Mean (SD) (men vs. women) of BMI, high blood pressure (BP), serum glutamic oxaloacetic transaminase (SGOT), and total cholesterol were 24.38±2.72 vs. 24.86±3.12 (P<0.01, 95% C.I., -0.763 ∼ -0.194), 126.64±14.70 vs. 125.02±16.62 (P<0.05, 95% C.I., 0.104 ∼ 3.151), 27.63±12.18 vs. 24.27±8.48 (P<0.01, 95% C.I., 2.393 ∼ 4.331), 197.77±37.60 vs. 205.72±36.72 (P<0.01, 95% C.I., -11.533 ∼ -4.378), respectively. Age and the frequency of 20 min severe exercise per week (Move20_Freq) intensive exercise had a significant association with BMI (P<0.05). Gender and Move20_Freq had a significant association with BP (P<0.05). CONCLUSION: Age-dependent Move20_Freq is associated with BMI in ACL patients. Women with ACL have higher BMI and cholesterol levels than men. These gender-specific differences can be relieved by exercise.

Evidence-Based Optimal Cutoff Values with the Validation of Criterion-Referenced Standards for Sarcopenic Elderly Fitness Improvement.

This study provides a newly updated perspective of information on severely screened 21 previous studies of the various measurement methods for improving physical fitness and providing determined cutoff values from our reserved elderly human database. We aimed to provide scientific evidence-based information regarding physical fitness standards for developing useful prognostics, promoting and maintaining health programs for sarcopenic elderly. 21 previous studies emphasizing criterion referenced standards and receiver operator characteristic (ROC) curve analyses for improving physical fitness were screened. For predicting the prevalence of sarcopenia, the t-test, logistic regression, linear regression, ROC curve analyses, and voluntary categorizations such as the twentieth or sixtieth percentile classification were used. Based on these scientific evidences, we determined cutoff values from our reserved DB and realized that 75 years for men and 70 years for women are the transitional period during which there are large declines in muscle and fat mass (p < 0.01), which reflects physical function tests (p < 0.01) in both genders. Using the six factors with ideal cutoff thresholds, an individual exercise program can be designed for alleviating symptoms of frailty caused by sarcopenia for the elderly.

ACTN-3 Genotype, Body Composition, Fitness, and +Gz Tolerance in Senior Cadets.

BACKGROUND: This study aimed to investigate the relationships among ACTN-3, body composition, fitness, and +Gz tolerance for senior cadet training development and their safe task performance.METHODS: The subjects were all senior cadets (N = 68) at the Korea Air Force Academy. All cadets are required to pass a physical fitness test (3-km running, sit-ups, push-ups) and body composition test on a semiannual basis. Isokinetic muscle function (strength and endurance), +Gz test (+6 Gz ⋅ 30 s-1), and target gene (ACTN-3) were analyzed.RESULTS: The effects of body composition and physical fitness along with the relationship of the ACTN-3 genotype to the +6 Gz test results were determined. Consequently, no significant difference was found concerning the effect of ACTN-3 on the +6 Gz test result, body composition, and physical fitness; however, body fat (%) and isokinetic muscle strength (peak torque right leg extension and left leg flexion) showed significance between the pass and failure groups in the +Gz test.DISCUSSION: The cadets of the Korea Air Force Academy showed dominant fast genetic expression type based on their ACTN-3 genotype [RR and RX (N = 51, 75%) > XX (N = 17, 25%)]. Body fat (%) and isokinetic muscle strength (PT R EX, L FL) can be more effective predictors in the +6 Gz test for cadet training. Another speculation is that more RR- and RX-type-oriented training can promote cadets' Gz tolerance from the isokinetic factors such as high peak torque and low fatigue index.Shin S, Jee H. ACTN-3 genotype, body composition, fitness, and +Gz tolerance in senior cadets. Aerosp Med Hum Perform. 2019; 90(12):1055-1060.

Proprioceptive Training and Outcomes of Patients With Knee Osteoarthritis: A Meta-Analysis of Randomized Controlled Trials.

OBJECTIVE: To describe the effects of proprioceptive training on pain, stiffness, function, and functional test outcomes among patients with knee osteoarthritis (OA). DATA SOURCES: All studies completed from 1946 to 2017 were obtained from 4 databases (PubMed, MEDLINE, CINAHL, and SPORTDiscus). STUDY SELECTION: Three reviewers independently identified appropriate studies and extracted data. DATA EXTRACTION: Methodologic quality and level of evidence were assessed using the Physiotherapy Evidence Database scale and Oxford Centre for Evidence-Based Medicine guidelines. The standardized mean differences (SMDs) and 95% confidence intervals (CIs) were calculated for pain, stiffness, function, and functional test outcomes. DATA SYNTHESIS: Seven randomized controlled trials involving 558 patients with knee OA met the inclusion criteria. The selected studies had Physiotherapy Evidence Database scores of 6 to 8. All randomized controlled trials had an Oxford Centre for Evidence-Based Medicine level of evidence of 2. Meta-analysis of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale (SMD = -0.56; 95% CI = -1.06, -0.07; P = .026), function subscale (SMD = -0.40; 95% CI = -0.59, -0.21; P < .001), and non-WOMAC walking speed test (SMD = -1.07; 95% CI = -2.12, -0.01; P = .048) revealed that proprioceptive training had significant treatment effects. Proprioceptive training was not associated with reductions in WOMAC stiffness subscale scores and did not improve non-WOMAC get-up-and-go scores. CONCLUSIONS: Proprioceptive training effectively promoted pain relief and completion of functional daily activity among patients with knee OA and should be included in rehabilitation programs. Stiffness and other mobility measures were unchanged after proprioceptive training. Modified proprioceptive training programs are needed to target stiffness and improve additional physical function domains.

Gender difference in colorectal cancer indicators for exercise interventions: the National Health Insurance Sharing Service-Derived Big Data Analysis.

We aimed to examine various characterized features and effects of gender-associated different parameters including exercise on the prevalence of colorectal cancer by using data from the National Health Insurance Sharing Service Database (NHISS DB). Data from NHISS were collected on Koreans aged from 40 to 85 years and were subjected to thematic analysis. The colorectal cancer codes (C19, C20, D011, and D012) from Korean Standard Classification of Disease and Causes of Death selected a target study group, and t-test and logistic regression were used. As results, the age was higher for men who had colorectal cancer than the noncancer group; however, high and low blood pressure, hemoglobin, and age had lower values for the cancer group compared to their counterparts in women. Only total cholesterol in men and waist size in women between cancer and noncancer groups were shown to have significant differences. Serum glutamic pyruvic transaminase and alanine aminotransaminase (SGPT_ALT) showed significant differences for both sexes. In exercise-related parameter, the response number 2 (1-2 times/wk, 0.535 for odd ratio) in women and response number 3 (3-4 times/wk, 0.466 for odd ratio) in men were associated with a reduced incidence of colon cancer. There was a difference in parameters in colorectal cancer patients over 40 years old for both sexes, but not in SGPT_ALT. Regular physical activity might be one of strong factors affecting or predicting colorectal cancer incidence.

Evidence-Based Cutoff Threshold Values from Receiver Operating Characteristic Curve Analysis for Knee Osteoarthritis in the 50-Year-Old Korean Population: Analysis of Big Data from the National Health Insurance Sharing Service.

We aimed to investigate the characteristics of patients with osteoarthritis (OA), using the data of all Koreans registered in the National Health Insurance Sharing Service Database (NHISS DB), and to provide ideal alternative cutoff thresholds for alleviating OA symptoms. Patients with OA (codes M17 and M17.1-M17.9 in the Korean Standard Classification of Disease and Causes of Death) were analyzed using SAS software. Optimal cutoff thresholds were determined using receiver operating characteristic curve analysis. The 50-year age group was the most OA pathogenic group (among 40~70 years, n = 2088). All exercise types affected the change of body mass index (p < 0.05) and the sex difference in blood pressure (BP) (p < 0.01). All types of exercise positively affected the loss of waist circumference and the balance test (standing time on one leg in seconds) (p < 0.01). The cutoff threshold for the time in seconds from standing up from a chair to walking 3 m and returning to the same chair was 8.25 (80% sensitivity and 100% specificity). By using the exercise modalities, categorized multiple variables, and the cutoff threshold, an optimal alternative exercise program can be designed for alleviating OA symptoms in the 50-year age group.

A mini-overview of single muscle fibre mechanics: the effects of age, inactivity and exercise in animals and humans.

Many basic movements of living organisms are dependent on muscle function. Muscle function allows for the coordination and harmonious integrity of movement that is necessary for various biological processes. Gross and fine motor skills are both regulated at the micro-level (single muscle fibre level), controlled by neuronal regulation, and it is therefore important to understand muscle function at both micro- and macro-levels to understand the overall movement of living organisms. Single muscle mechanics and the cellular environment of muscles fundamentally allow for the harmonious movement of our bodies. Indeed, a clear understanding of the functionality of muscle at the micro-level is indispensable for explaining muscular function at the macro-(whole gross muscle) level. By investigating single muscle fibre mechanics, we can also learn how other factors such Ca2+ kinetics, enzyme activity and contractile proteins can contribute to muscle mechanics at the micro- and macro-levels. Further, we can also describe how aging affects the capacity of skeletal muscle cells, as well as how exercise can prevent aging-based sarcopenia and frailty. The purpose of this review is to introduce and summarise the current knowledge of single muscle fibre mechanics in light of aging and inactivity. We then describe how exercise mitigates negative muscle adaptations that occur under those circumstances. In addition, single muscle fibre mechanics in both animal and human models are discussed.

Positive Prehabilitative Effect of Intense Treadmill Exercise for Ameliorating Cancer Cachexia Symptoms in a Mouse Model.

Due to the importance of exercise in prehabilitation, we conducted this study to understand the effects of different exercise intensities on cancer-related cachexia. Forty adult male CDF1 mice were randomly divided into a non-cancer control group (N=10, NC), cancer control group (N=10, CC), cancer with moderate exercise group (N=10, ME, 70% maxHR), and cancer with intense exercise group (N=10, SE, 90% maxHR) for obtaining data such as tissue weight and body weight changes, quality of life (QoL) indicators, and levels of cytokines and a muscle homeostasis regulatory protein. We verified that mouse colonic carcinoma cancer cells metastasized based on our observation that the weight of CC group lungs was almost 87% greater than NC group lungs. Survival rates of SE, NC, ME, and CC groups were 100%, 100%, 80%, and 50%, respectively (p<0.01). Other results such as tissue and body weight changes, QoL indicators, and protein analyses also supported our hypothesis that the SE group had improved survival compared to CC and ME groups (p<0.05 and p<0.01, respectively). Our results suggest that exercise, especially intense exercise, improves QoL and survival rate and prevents muscle atrophy. These data suggest that exercise is an optimal prehabilitation choice to alleviate the negative impacts of cancer cachexia.

Size dependent classification of heat shock proteins: a mini-review.

Molecular chaperones are ubiquitous and abundant within cellular environments, functioning as a defense mechanism against outer environment. The range of molecular chaperones varies from 10 to over 100 kDa. Depending on the size, the specific locations and physiological roles of molecular chaperones vary within the cell. Multifunctionality of heat shock proteins (HSPs) expressed via various cyto-stress including heat shock have been spotlighted as a reliable prognostic target biomarker for therapeutic purpose in neuromuscular disease or cancer related studies. HSP also plays a critical role in the maintenance of proteins and cellular homeostasis in exercise-induced adaptation. Such various functions of HSPs give scientists insights into intracellular protective mechanisms in the living body thus HSPs can be target molecules to know the defense mechanism in cellular environment. Based on experimental results regarding small to large scaled HSPs, this review aims to provide updated important information regarding the modality of responses of intracellular HSPs towards extracellular stimulations. Further, the expressive mechanisms of HSPs data from tremendous in vivo and in vitro studies underlying the enhancement of the functionality of living body will be discussed.

Discrepancies between Skinned Single Muscle Fibres and Whole Thigh Muscle Function Characteristics in Young and Elderly Human Subjects.

We aimed to analyse the mechanical properties of skinned single muscle fibres derived from the vastus lateralis (VL) muscle in relation to those of the whole intact thigh muscle and to compare any difference between young and older adults. Sixteen young men (29.25 ± 4.65 years), 11 older men (71.45 ± 2.94 years), 11 young women (29.64 ± 4.88 years), and 7 older women (67.29 ± 1.70 years) were recruited. In vivo analyses were performed for mechanical properties such as isokinetic performance, isometric torque, and power. Specific force and maximum shortening velocity (Vo) were measured with single muscle fibres. Sex difference showed greater impact on the functional properties of both the whole muscle (p < 0.01) and single muscle fibres than aging (p < 0.05). Sex difference, rather than aging, yielded more remarkable differences in gross mechanical properties in the single muscle fibre study in which significant differences between young men and young women were found only in the cross-sectional area and Vo (p < 0.05). Age and sex differences reflect the mechanical properties of both single muscle fibres and whole thigh muscle, with the whole muscle yielding more prominent functional properties.

Equestrian expertise affecting physical fitness, body compositions, lactate, heart rate and calorie consumption of elite horse riding players.

Horse riding (HR) is a sport harmonized with rider and horse. HR is renowned as an effective sport for young and old women and men. There is rare study regarding comparison between elite horse riders and amateurs. We aimed to investigate comprehensive ranges of parameters such as change of lactate, heart rate, calorie, VO2max, skeletal muscle mass, body water, body fat, etc between amateurs and professionals to emphasize HR not only as a sport training but also as a therapeutic aspect. We performed 3 experiments for comparing physical fitness, body compositions, lactate value, heart rate and calorie consumption change before and after riding between amateurs and elites. Around 3 yr riding experienced elites are preeminent at balance capability compared to 1 yr riding experienced amateurs. During 18 min horse riding, skeletal muscle mass and body fat were interestingly increased and decreased, respectively. Lactate response was more sensitive in elites rather than amateurs and its recovery was reversely reacted. Exercise intensity estimated from heart rate was significantly higher in elites (P<0.05). The similar pattern of calorie consumption during riding between amateurs and elites was shown. Horse riding possibly induces various physiological (muscle strength, balance, oxidative capability, flexibility, and metabolic control) changes within body and is thus highly recommended as combined exercise for women, children, and aged as therapeutic and leisure sport activity.

Changes in αB-crystallin, tubulin, and MHC isoforms by hindlimb unloading show different expression patterns in various hindlimb muscles.

PURPOSE: αB-crystallin is a small heat shock protein that acts as a molecular chaperone under various stress conditions. Microtubules, which consist of tubulin, are related to maintain the intracellular organelles and cellular morphology. These two proteins have been shown to be related to the properties of different types of myofibers based on their contractile properties. The response of these proteins during muscular atrophy, which induces a myofibril component change, is not clearly understood. METHODS: We performed 15 days of hindlimb unloading on rats to investigate the transitions of these proteins by analyzing their absolute quantities. Protein contents were analyzed in the soleus, plantaris, and gastrocnemius muscles of the unloading and control groups (N = 6). RESULTS: All three muscles were significantly atrophied by hindlimb unloading (P < 0.01): soleus (47.5%), plantaris (16.3%), and gastrocnemius (21.3%) compared to each control group. αB-crystallin was significantly reduced in all three examined unloaded hindlimb muscles compared to controls (P < 0.01) during the transition of the myosin heavy chain to fast twitch muscles. α-Tubulin responded only in the unloaded soleus muscle. Muscle atrophy induced the reduction of αB-crystallin and α-tubulin expressions in plantar flexor muscles with a shift to the fast muscle fiber compared to the control. CONCLUSION: The novel finding of this study is that both proteins, αB-crystallin and α-tubulin, were downregulated in slow muscles (P < 0.01); However, α-tubulin was not significantly reduced compared to the control in fast muscles (P < 0.01).

Significant roles of microtubules in mature striated muscle deduced from the correlation between tubulin and its molecular chaperone alphaB-crystallin in rat muscles.

To elucidate the significance of cytoskeletal microtubule networks in striated muscles, we analyzed correlation between the content of tubulin (building block of microtubules) and alphaB-crystallin (a molecular chaperone for tubulin) in a variety of striated muscles expressing different myosin heavy-chain (MHC) isoforms. The content of both tubulin and alphaB-crystallin was larger in MHC-I dominant soleus muscle and in MHC-alpha dominant cardiac (atrium and ventricle) muscles; intermediate in MHC-IId dominant masseter, tongue, and diaphragm muscles; and smaller in MHC-IIb dominant plantaris, gastrocnemius, psoas, extensor digitorum longus, and tibialis anterior muscles. Since the muscles of slow-type MHC (MHC-I/alpha) show the most economical features in their function and metabolism, which suit for continuous activity required to sustain posture and blood pumping, the present results afforded additional support to our hypothesis that microtubule networks transduce mechanical environmental demands to morphological and biochemical responses that eventually evolve adaptive transformation in the function and metabolism of the mature muscles. The comparison of tubulin/alphaB-crystalline ratios across the muscles of varied MHC isoforms further suggested that mechanical stress fluctuating at the rhythmic frequency of walking and breathing efficiently activates the hypothesized dynamic function of microtubules.