Nitrospira-dominated biofilm within a thermal artesian spring: a case for nitrification-driven primary production in a geothermal setting.

Water chemistry, energetic modeling, and molecular analyses were combined to investigate the microbial ecology of a biofilm growing in a thermal artesian spring within Hot Springs National Park, AR. This unique fresh water spring has a low dissolved chemical load and is isolated from both light and direct terrestrial carbon input - resulting in an oligotrophic ecosystem limited for fixed carbon and electron donors. Evaluation of energy yields of lithotrophic reactions putatively linked to autotrophy identified the aerobic oxidation of methane, hydrogen, sulfide, ammonia, and nitrite as the most exergonic. Small subunit (SSU) rRNA gene libraries from biofilm revealed a low-diversity microbial assemblage populated by bacteria and archaea at a gene copy ratio of 45:1. Members of the bacterial family 'Nitrospiraceae', known for their autotrophic nitrite oxidation, dominated the bacterial SSU rRNA gene library (approximately 45%). Members of the Thaumarchaeota ThAOA/HWCGIII (>96%) and Thaumarchaeota Group I.1b (2.5%), which both contain confirmed autotrophic ammonia oxidizers, dominated the archaeal SSU rRNA library. Archaea appear to dominate among the ammonia oxidizers, as only ammonia monooxygenase subunit A (amoA) genes belonging to members of the Thaumarchaeota were detected. The geochemical, phylogenetic, and genetic data support a model that describes a novel thermophilic biofilm built largely by an autotrophic nitrifying microbial assemblage. This is also the first observation of 'Nitrospiraceae' as the dominant organisms within a geothermal environment.

Responses to arm exercise in patients with compensated heart failure.

PURPOSE: This study compares the responses of 20 male patients (mean age 51 +/- 11 years) with stable heart failure during peak and submaximal arm and leg exercise. METHODS: On day 1, subjects completed two symptom-limited graded exercise tests, one with their arms and one with their legs. On day 2, subjects performed arm only and leg only exercise at a matched power output of 30 Watts (W). Ten age-matched healthy subjects served as controls. RESULTS: During peak arm exercise power output, oxygen consumption (VO2), ventilation, and rate-pressure product were higher in healthy subjects than in patients with heart failure. However, when a subject's peak VO2 or power output during arm exercise was expressed as a percentage of that achieved during peak leg exercise, no significant differences were noted between patients with heart failure and healthy subjects. Among both groups, rate-pressure product, VO2, ventilation, the ventilatory equivalent for O2, and respiratory exchange ratio were all higher when exercising at 30 W with the arms versus 30 W with the legs. Also, in patients with heart failure heart rate was higher (+6 min-1) and stroke volume index lower (-4 mL/m2) during submaximal arm than leg exercise. CONCLUSIONS: Although peak exercise capacity (Watts, VO2) during arm exercise is lower in patients with heart failure than healthy subjects, when expressed as a percentage of peak leg capacity, the extent of the exercise intolerance they experience during arm exercise does not differ from healthy subjects.

Cardiorespiratory responses during exercise in competitive in-line skaters.

This study describes the cardiorespiratory responses of 12 male (age = 30 +/- 6 yr) competitive in-line skaters during peak and submaximal skating. We hypothesized that velocities of 22.5 and 27.4 km.h-1 would elicit heart rate (HR) and oxygen consumption (VO2) responses consistent with the American College of Sports Medicine's guidelines for developing cardiorespiratory fitness. Using a 644-m indoor cement course, subjects completed 10 trials comprised of various velocities, stroke frequencies, and body positions. At 22.5 km.h-1, HR and VO2 were 74 and 51% of peak, respectively. At 27.4 km.hr-1, HR and VO2 were 85 and 72% of peak, respectively. When compared to the College's guidelines, regression analysis revealed a leftward shift in the VO2-HR relationship, evidenced by a disproportionately higher HR at a VO2 approximating 60 vs 80% of peak. At 22.5 km.h-1 our skaters self-selected a stroke frequency which resulted in less of an increase in both HR and VO2, when compared to the imposed stroke frequencies of 50 min-1 and 70 min-1. Also, skating at 27.4 km.h-1 in the bent vs upright position resulted in less of an increase in HR and VO2. Competitive in-line skaters are capable of safely skating at velocities sufficient to stimulate an increase in cardiorespiratory fitness. These athletes select a stroke frequency and utilize a body position which results in favorable HR and VO2 responses.

Exercise training in a patient with congestive heart failure on continuous dobutamine.

We present a 53-yr-old man with congestive heart failure who underwent 32 wk of exercise training. The patient was on a continuous infusion of dobutamine for 10 months prior to exercise training, which was subsequently discontinued at wk 24 of exercise training. Symptom-limited graded exercise tests were performed at baseline, wk 12, wk 24, and wk 32 of exercise training. While on a continuous infusion of dobutamine, the patient's oxygen consumption and exercise duration were increased during the exercise training period. Additionally, the patient was able to maintain these changes for 8 wk while continuing to exercise after the discontinuation of the dobutamine therapy.

Cardiovascular responses to submaximal arm and leg exercise in cardiac transplant patients.

We examined whether an increase in stroke volume (SV) contributes to the increase in cardiac output that occurs when cardiac transplant patients (CT) exercise between 50% and 75% of maximum. Upright arm and leg exercise was performed by 13 CT and 10 normal controls. Cardiac output (CO2 rebreathing), expired air, and catecholamine measures were obtained at rest and at 50% and 75% of maximum. From rest to 50% of maximum both normals and CT increased heart rate (HR) and SV during arm and leg exercise. In normals, HR (arm = +17 +/- 2 min-1; leg = +21 +/- 3 min-1) was increased further at 75% of maximum but not SV (arm = 3 +/- 4 ml; leg = +2 +/- 8 ml). In CT, further increases in both HR (arm = +9 +/- 1 min-1; leg = +13 +/- 1 min-1) and SV (arm = +12 +/- 5 ml; leg = +12 +/- 3 ml) were observed at 75% of maximum. During leg exercise plasma norepinephrine was increased more in CT than in normals. Between 50% and 75% of maximum, an increase in SV is a more important mechanism for increasing cardiac output during upright arm and leg exercise in CT than in normals.

Cardiovascular responses of cardiac transplant patients to arm and leg exercise.

This investigation compares the cardiovascular responses of normal (n = 10) and cardiac transplant (n = 14) subjects to peak arm and leg exercise. It also tests the hypothesis that the higher heart rate (fc) in normal subjects during light (30 W) submaximal arm versus leg exercise is due to cardiac innervation. In cardiac transplant patients, power output, oxygen consumption (VO2), fc and rate pressure product were 54%, 28%, 7%, and 8% lower during peak arm than leg exercise, respectively. In normal subjects, power output, VO2, fc and rate pressure product were 61%, 33%, 8%, and 11% lower during peak arm than leg exercise, respectively. In cardiac transplant patients there was no significant difference in absolute fc during submaximal arm and leg exercise. In normal subjects, absolute fc during arm and leg exercise was [mean (SD)] 97 (4) beats.min-1 and 92 (4) beats.min-1, respectively (P = 0.07). Plasma noradrenaline was increased more during arm than leg exercise in both cardiac transplant and normal subjects. Maximal leg testing is useful when determining the capacity of cardiac transplant patients to perform arm work. The higher absolute fc reported by other investigators for normal subjects during submaximal arm versus leg exercise may be mediated by cardiac innervation.

Comparison of azathioprine, methotrexate, and the combination of both in the treatment of rheumatoid arthritis. A controlled clinical trial.

OBJECTIVE: To compare the relative safety and efficacy of azathioprine (AZA), methotrexate (MTX), and the combination of both in the treatment of active rheumatoid arthritis (RA). METHODS: Two hundred twelve patients with active RA were entered into a 24-week prospective, controlled, double-blind, multicenter trial and were randomly assigned to 1 of 3 treatment groups. RESULTS: One hundred fifty-eight patients finished 24 weeks of the study. There were no remissions seen but response rates were greater than 30% for all outcome measures. Combination therapy was not statistically superior to MTX therapy alone, but both combination therapy and MTX alone were superior to AZA alone when patients were analyzed by intent-to-treat and with withdrawals treated as therapy failures. If only patients who continued taking the therapy were analyzed, the mean improvement was greater for AZA therapy than for MTX, while the combination remained the most active. Adverse effects on the gastrointestinal tract and elevations of liver enzyme levels were the most frequent causes for discontinuations. CONCLUSION: Both combination therapy and MTX alone were superior to therapy with AZA alone for active RA but were not statistically different in their effect on outcome assessment.

Assessment of body composition in heart transplant patients.

Orthotopic heart transplantation (OHT) recipients often experience increased body weight (BW) following surgery. Using hydrostatic weighing (HW), this study assessed the body density (BD) and body composition of 17 white and seven black male OHT patients. It examined the cross-validity of the Jackson and Pollock seven and three site skinfold (SF) regression equations for predicting BD in these patients. We hypothesized that both prednisone (P) dose and months post-operative (MPO) would be inversely related to BD. The average of the last five of ten HW trials was used in computing BD. BW and % body fat (BF) were 88.5 +/- 17.8 kg (mean +/- SD) and 33.5 +/- 9.4%, respectively. The correlation coefficient between hydrostatically determined BD and BD determined via two of the three intercept revised Jackson and Pollock SF equations was r = 0.89, SE = 0.009. A polynomial regression model for BD using P dose and MPO provided a correlation coefficient of r = 0.71, SE = 0.015. Partial correlation techniques incorporating SF, age, MPO, and P dose indicated that neither P dose or MPO provided any significant additive effect, above SF and age, when predicting BD. We conclude that in OHT patients receiving glucocorticoids, the intercept revised Jackson and Pollock SF regression equations are generally applicable and associated with a SE of +/- 4 BF percentage points. Up to 49 months after OHT, both P dose and MPO are inversely related to BD but provide no additive value above SF for predicting BD.

Association of HLA-Dw16 with rheumatoid arthritis in Yakima Indians. Further evidence for the "shared epitope" hypothesis.

Rheumatoid arthritis (RA) is prevalent in Yakima Indians, a Native American tribe. HLA-DR4, the HLA specificity commonly associated with RA in Caucasians, is rare among the Yakima. Using a specific oligonucleotide probe that recognizes DR4 nucleotide sequences associated with RA, a rare HLA-Dw16 gene was identified in 83% of Yakima patients with RA and in 60% of Yakima control subjects. This shared sequence encodes a discrete class II epitope that is highly correlated with RA in both DR4 positive and DR4 negative individuals.

Liver histology in patients receiving low dose pulse methotrexate for the treatment of rheumatoid arthritis.

The liver histology of 52 patients treated with intermittent low dose pulse methotrexate for rheumatoid arthritis was evaluated using a modification of the Roenigk grading system. Patients studied had had an average of 3.2 years of treatment or had received 1.7 g methotrexate. No patient had cirrhosis; 15 (29%) patients had evidence of mild fibrosis. Histological abnormalities were not predicted by liver function test changes, with the exception that hypoalbuminaemia occurred in 60% of those with grade IV (modified criteria) findings. The need for liver biopsy in patients with rheumatoid arthritis treated with methotrexate before two years or 1500 mg of treatment has not been established. Whether serial liver biopsies will be needed beyond this time has yet to be determined.

Physiological responses to nine different exercise:rest protocols.

This study determined the metabolic responses to different exercise:rest protocols during circuit exercise using hydraulic resistance. In experiment 1, nine subjects underwent nine different 27 min exercise circuits. There were three variations of three exercise:rest protocols (2:1, 1:1, 1:2). The VO2 for the nine circuits averaged (mean +/- SEM) 1.94 +/- 0.03 l.min-1 (43% of treadmill VO2max), with the largest difference between the protocols being 13%. Heart rate averaged 152.2 +/- 3.1 beats.min-1, with the largest difference between the protocols being 8%. Increasing the exercise duration per minute or the number of exercise bouts per minute had minimal effects on the mean VO2 and heart rate response to hydraulic resistive exercise. In experiment 2, nine subjects underwent three different 9 min exercise circuits using exercise:rest protocols of 2:1, 1:1, and 1:2 while work and VO2 were simultaneously measured. Surprisingly, increases in work were not necessarily accompanied by corresponding increases in VO2.

Coronary risk incidence of obese adolescents: reduction by exercise plus diet intervention.

The incidence of coronary heart disease risk factors and the effects of 20 weeks of diet and exercise were studied in 36 obese adolescents. Values for the following risk factors were determined: serum triglyceride level, high-density lipoprotein-cholesterol level, total cholesterol level, systolic and diastolic BP, maximum work capacity, obesity, and presence of coronary heart disease in the family history. Of the subjects, 97% had four or more risk factors. Two subjects possessed all eight risk factors. The adolescents were randomly assigned to either a control, diet therapy and behavior change, or exercise, diet therapy, and behavior change group. From pre- to posttreatment, a 14.8% and 41.4% reduction in multiple risk was noted for the latter two groups, respectively. No significant difference between the control group and the diet and behavior change group was found. In contrast, the exercise-diet-behavior change group reduced multiple risk (P less than .01) more than either of the other groups. It was concluded that obese adolescents are at high risk for the development of coronary heart disease and that exercise in addition to moderate dietary restriction can result in the reduction of multiple coronary heart disease risk.

Resistance weight training during caloric restriction enhances lean body weight maintenance.

To assess the individual and combined effects of weight loss and weight training on body weight and body composition, 40 obese women were randomly assigned to one of four groups for an 8 wk weight-loss study. These groups were control (C); diet without exercise (DO); diet plus weight training (DPE); and weight training without diet (EO). Body weight decreased for DO (-4.47 kg) and DPE (-3.89 kg) compared with C (-0.38 kg) and EO (0.45 kg). Lean body weight (LBW) increased for EO (1.07 kg) compared with DO (-0.91 kg) and C (-0.31 kg) and for DPE (0.43 kg) compared with DO. Upper-arm muscle areas (determined by radiograph) increased for DPE (11.2 cm2) and EO (10.4 cm2) compared with C (2.7 cm2) and DO (2.1 cm2). It was concluded that weight training results in comparable gains in muscle area and strength for DPE and EO. Adding weight training exercise to a caloric restriction program results in maintenance of LBW compared with DO.

Osteoclast populations in congenital osteopetrosis: additional evidence of heterogeneity.

Osteopetrosis is a metabolic bone disease characterized by excessive accumulation of skeletal mass due to a reduction in bone resorption. The pathogenesis of osteopetrosis is reduced osteoclast function. Reports of osteoclast numbers in several mammalian mutations exhibiting osteopetrosis have shown them to be increased, decreased, or normal in numbers. The present investigation quantitated the osteoclast populations and examined the cytology of osteoclasts by light microscopy in calvarial and tibial sites in one rabbit and two mouse mutations and compared them with their normal littermates. Our observations show that osteoclast numbers are, depending on the particular mutation, increased, decreased, or comparable to those found in normal littermates. In each mutation, however, osteoclasts fail to exhibit the cytoplasmic vacuolization next to bone surfaces seen in normal osteoclasts. These data provide additional evidence of heterogeneity in the congenital mammalian osteopetrosis and suggest that these mutations may be significant sources of new information about the biology of osteoclasts.