(GT)N dinucleotide repeat polymorphism of haem oxygenase-1 promotor region is not associated with inflammatory bowel disease risk or disease course.

Haem oxygenase-1 (HO-1) up-regulation was suggested to reduce mucosal tissue damage in inflammatory bowel disease (IBD) and an up-regulation of HO-1 expression in patients with Crohn's disease (CD) and ulcerative colitis (UC) was demonstrated. A HO-1 gene promoter microsatellite (GT)(n) dinucleotide repeat polymorphism was associated with regulation of HO-1 in response to inflammatory stimuli. We therefore hypothesized that IBD patients might segregate into phenotypes with high or low HO-1 inducibility. Ethylenediamine tetraacetic acid blood samples were obtained from 179 CD patients, 110 UC patients and 56 control patients without inflammation. Genomic DNA was purified and the 5'-flanking region of the HO-1 gene containing the (GT)(n) dinucleotide repeat was amplified. Polymerase chain reaction (PCR) products were purified and the length of the PCR fragments was analysed. The number of (GT)(n) repeats in the population studied ranged from 13 to 42. The distribution of the allele frequencies was comparable in patients and controls for both the short and the long alleles. The frequencies of short-, middle- and long-sized alleles were not changed among the groups studied. No correlation was found between IBD and microsatellite instability detected in five individals. Our data indicate that (GT)(n) dinucleotide repeats of the HO-1 promotor region have no significance for the pathophysiology and disease course of IBD.

Weight loss without losing muscle mass in pre-obese and obese subjects induced by a high-soy-protein diet.

OBJECTIVE: To determine change of weight, body composition, metabolic and hormonal parameters induced by different intervention protocols. DESIGN: Randomized, controlled study including participants exhibiting a BMI between 27.5 and 35. Three different interventions containing lifestyle education (LE-G), or a substitutional diet containing a high-soy-protein low-fat diet with (SD/PA-G) or without (SD-G) a guided physical activity program. SUBJECTS: A total of 90 subjects (mean weight 89.9 kg; mean BMI 31.5), randomly assigned to one of three treatment groups. MEASUREMENTS: Change in body weight, fat mass and lean body mass measured with the Bod Pod device at baseline, 6 weeks and 6 months; change in metabolic and hormonal parameters. RESULTS: In all, 83 subjects completed the 6-months study. BMI dropped highly significantly in all groups (LE-G: -2.2+/-1.43 kg/m(2); SD-G: -3.1+/-1.29 kg/m(2); SD/PA-G: -3.0+/-1.29 kg/m(2)). Subjects in the SD-G and in the SD/PA-G lost more weight during the 6-months study (-8.9+/-3.9; -8.9+/-3.9 kg) than did those in the LE-G (-6.2+/-4.2 kg), and had a greater decrease in fat mass (-8.8+/-4.27; -9.4+/-4.54 kg) than those in the LE-G (-6.6+/-4.59 kg). In contrast, no significant intraindividual or between-group changes in the fat-free mass were seen. In all groups, metabolic parameters showed an improvement in glycemic control and lipid profile. CONCLUSIONS: Our data suggest that a high-soy-protein and low-fat diet can improve the body composition in overweight and obese people, losing fat but preserving muscle mass.

[Imaging of myomas: is preoperative MRI usefull?]. / Imagerie des myomes: I'IRM est-elle utile en préopératoire?

Leiomyomas are the most common uterine neoplasms. Leiomyomas classified as intramural, submucosal, or subserosal are usually associated with various types of degeneration. The diagnosis and the treatment of leiomyomas vary among these subtypes of leiomyomas. Magnetic resonance imaging is the most accurate imaging technique for detection, localization, and characterization of myomas. The differential diagnosis at MR imaging includes adenomyosis and solid adnexal masses. Despite its relatively high cost, MR imaging is a very useful procedure which can assist preoperative planning.

[Menorrhagia after age 40. Contribution of ultrasonic examination]. / Les ménorragies après 40 ans. Apport des examens ultrasonores.

Menorrhagia after age 40 can have functional, general, local, or organic reasons. The most frequent are: submucous myomas, adenomyosis, polyps. Submucous myomas: a transvaginal scan (TVUS) specifies the type of myoma according to its situation within the uterine cavity: intracavitary myoma or submucous. A transvaginal scan is performed to assess myomas before operative HSC. There are three criteria to check: myomas diameter must be less than 5 cm; 5 mm or more of normal myometrium should be present between myoma and external wall; the myoma must not be in contiguity with a subserosal myoma. Uterine adenomyosis is a common gynecologic condition that is characterized by the presence of heterotopic endometrial glands and stroma in the myometrium with adjacent smooth muscle hyperplasia. Pathology may be proximal or distal, focal or diffuse. Transvaginal US shows: cystic dilatation of heterotopic glands, heterogeneity of the myometrial echotexture, antero-posterior asymmetry of the uterus. TVUS has a sensitivity of 62 to 89% and a specificity of 89 to 96%. Polyps are most often hyperechoic: this makes the diagnosis more difficult in luteal phase; Power Doppler shows the vascular central pedicle. TVUS has a sensitivity of 75%. The polyps smaller than 3 mm are not visible in a reliable way without the help of a contrast media in the cavity.

Low-resolution data analysis for low-density lipoprotein particle.

The knowledge of the molecular structure of LDL, a large lipoprotein complex, is of great interest for medical investigations. Currently available LDL crystals do not diffract to high resolution and do not allow the application of standard crystallographic techniques. Additional difficulties arise because of a very dense crystal packing and the presence of several components with quite different mean densities. Several ab initio phasing methods previously reported by the authors have been successfully applied to find a crystallographic image of LDL at a resolution of 27 A. The most promising results have been obtained using direct phasing with a connectivity analysis of the electron-density maps. The current image makes it possible to discern a single particle covered by a layer of relatively high density that is asymmetrically distributed on the particle surface. It shows a partition of high and low densities inside the particle and, in particular, strips of varying density in the lipid core.

Relation of leisure-time physical activity to structural and functional arterial properties of the common carotid artery in male subjects.

The structure and function of central arteries are altered with advancing age. These changes comprise arterial dilation, intima-media thickening and increase in stiffness. Arterial wall hypertrophy and increased stiffness are associated with major cardiovascular disease. In contrast to this, physical activity has been found to be inversely related to the incidence of major cardiovascular disease and mortality in humans. However, conflicting data exist on the effect of physical activity on arterial stiffness and very little data about its association with structural arterial properties. We therefore investigated the association of the self-selected leisure-time physical activity (LTPA), assessed by a self-administered questionnaire, with the structure and function of the common carotid artery, examined with high-resolution ultrasound, in 51 male subjects aged between 16 and 78 years. We found that men with a higher level of LTPA (> 38.1 MET*h/week = H-LTPA) (metabolic equivalent value; 1 MET= energy expended by a person at rest, i.e. approximately 3.5 ml oxygen uptake/kg body mass or 1 kcal/kg per h) had a significantly lower arterial stiffness (P = 0.02) than men with lower levels ( < 38.1 MET*h/week = L-LTPA) (4.32+/-1.17 versus 5.75+/-1.21 x 10(6) cm(-2)). In multiple regression analyses, with several atherosclerotic risk factors as correlating variables with arterial stiffness, LTPA persisted as an independent predictor of arterial stiffness (adjusted R2=0.19) in addition to apolipoprotein B level (adjusted R2 = 0.33). The study could not, however, show an association of LTPA with reduced intima-media thickness (L-LTPA = 0.66+/-0.15 versus H-LTPA 0.66+/-0.14) or arterial dilation of diastolic diameter (L-LTPA = 6.34 + 0.64 versus H-LTPA 6.08+/-0.69). However, the positive association of LTPA with several parameters, which correlated inversely with intima-media thickness, may be taken as an indicator for a possible positive (not visible in an ultrasonic examination of the common carotid artery) effect of LTPA on the arterial wall structure.

[Freiburg Questionnaire of physical activity--development, evaluation and application]. / Freiburger Fragebogen zur körperlichen Aktivität--Entwicklung, Prüfung und Anwendung.

Aim of the present study was to design a questionnaire to assess health related physical activity, to validate the instrument and to apply it to a population sample. Reliability of the questionnaire was evaluated by test-retest investigations with intervals of two weeks and six months. High correlations between the repeated administrations reflect a good reliability of our instrument. Only gardening and cycling, as well as the depending basic and total activity, showed typically seasonal variations. Validity was established by correlating physical activity data with maximum oxygen uptake. Maximum oxygen uptake correlated with sport activities (partial correlation coefficient: r = 0.422, p < 0.01). Evaluated data were consistent. People rating themselves as "more active than their coevals" were indeed more active in sport (r = 0.334, p < 0.01) and total activity (r = 0.282, p < 0.05). Studying activity patterns of a population sample of adult residents of Freiburg (systematic random sampling, n = 612, 20-98 years) we found total physical activity of 9.2 hours per week (median), with activities of low to moderate intensities dominating. Age and gender are important determinants of the activity patterns. According to the recommendation of Paffenbarger (2000 kcal/week total physical activity) 40% of the residents of Freiburg did not reach the recommended energy expenditure. Compared to the recommendation of the American College of Sports Medicine (1000 kcal/week by training) 63% of the population sample were not active enough.

Intradural extramedullary spinal canal secondary neoplasms: MR findings in 30 patients.

The purpose of this study was to describe magnetic resonance findings of intradural spinal canal secondaries and to select the best way of investigating this condition. Thirty patients with a known malignancy [breast carcinoma (n = 14), lung carcinoma (n = 10), other sites (n = 6)] and unexplained neurologic signs were studied with pre- and post-contrast T1-weighted images and T2-weighted images. Cerebrospinal fluid cytology was available in 16 patients and positive in 11 patients. In all the patients, post-contrast T1-weighted images demonstrated abnormal enhanced lesions. Most of them were nodular, located on the conus medullaris and the cauda equina. Few lesions appeared at the thoracic or cervical levels, as nodular or thin areas of enhancement. Pre-contrast T1-weighted sequences failed or were equivocal to detect the lesions. Eighteen of 30 patients had cerebral metastases. Fourteen had osseous metastases. In conclusion, post-contrast T1-weighted sequence is the optimal modality for the diagnostic of intradural spinal canal metastases. Axial and coronal images may be a useful adjunct to precise anatomic changes. T1-weighted and T2-weighted sequences remain necessary when further information is expected on vertebra or soft tissue.

[Importance of increased physical activity in ambulatory cardiovascular prevention]. / Stellenwert von körperlicher Mehraktivität in der ambulanten kardiovaskulären Prävention.

Current trends in public health provided potential arguments to, first, intensify the recommendations of a physically active lifestyle in the primary prevention of atherosclerosis and, second, to prescribe a supervised outpatient exercise training program for secondary prevention of cardiovascular diseases. Regular physical exercise may positively influence cardiovascular risk factors (overweight, hypertension, hyperlipoproteinaemia, insulin resistance, hemostatic markers). Physical conditioning modifies the body composition in favor of an increased skeletal muscle mass, changes the eating habits, and other life style characteristics. The dietary modifications characterized by a low-fat, more vegetarian food supports the weight control and the adjustment of the other metabolic risk factors. All these changes are suitable to reduce the manifestation of atherosclerosis and to minimize the risk of an acute thromboembolic arterial occlusion. Physical conditioning on one's own initiative in primary prevention or an exercise training program supervised by health professionals in secondary prevention of atherosclerosis should predominantly include a low intensive aerobic endurance exercise training. Lactate concentration in capillary blood can be measured to objectify and regulate exercise intensity. The additional energy turnover should amount to a minimum of 1,000 kcal and a maximum of 3,500 kcal weekly. This energy expenditure could be realized either with an increased physical activity level in daily routine (e.g., stair climbing, go for a walk, gardening) or by a regular leisure-time physical exercise. A turnover of 300 kcal per session should be prescribed. In long-term clinical trials investigating the benefit of primary and secondary cardiovascular prevention a reduction of the cardiovascular mortality of about 20-30% has been demonstrated.

Crystallization and preliminary X-ray diffraction data of two different human low-density lipoprotein (LDL) subfractions.

Human LDL subfractions LDL-2 (d = 1.031-1.034 g/ml) and LDL-5 (d = 1.040-1.044 g/ml) were crystallized in two different crystal forms by using polyethylene glycol as a precipitant. Both fractions were from one donor. Crystals of LDL-5 were yellow, hexagonal, and showed no dichroism. Crystals of LDL-2 were of the same color, had a rodlike shape with notches at both ends, and were highly dichroitic. LDL-2 crystals diffracted to a resolution of 29 A by using synchrotron radiation. Indexing in P1 resulted in preliminary parameters for the reduced cell of a = 171 A, b = 438 A, c = 519 A, alpha = 102 degrees, beta = 99 degrees, gamma = 91. These dimensions are consistent with the size of LDL particles. Using Fourier transform infrared spectroscopy (FTIR) and agarose gel electrophoresis, we could further confirm that the crystals consist of LDL. The FTIR spectrum showed bands characteristic for lipids and protein. Dissolved crystals exhibited a mobility similar to native LDL in agarose gels and could be stained with anti-human apolipoprotein B (apoB).

[Sonohysterography: a new study method of the uterine cavity: evaluation of 84 cases and comparison to hysteroscopy]. / La sonohystérographie: nouvelle méthode d'étude de la cavité utérine: évaluation sur 84 cas et comparaison à l'hystéroscopie.

Sonohysterography versus hysteroscopy: the assessment of the uterine cavity: a series of 84 cases. We study indications, advantages, limits of a technic of investigation of uterine cavity: sonohysterography. Our results show that sonohysterography is as effective as hysteroscopy in the diagnosis of intrauterine conditions. It is painless, no time consuming. There is no adverse effects and it is helpful in the diagnosis of intrauterine abnormality as a complement of transvaginal scanning.

Moderate hypothermia in patients with severe head injury: cerebral and extracerebral effects.

Cerebral and extracerebral effects of moderate hypothermia (core temperature 32.5 degrees C-33.0 degrees C) were prospectively studied in 10 patients with severe closed head injury (Glasgow Coma Scale score < 7) in the intensive care unit of a university hospital. Hypothermia was induced by cooling the patient's body surface with water-circulating blankets. Before cooling, a conventional intracranial pressure (ICP) reduction therapy was applied, which remained unchanged throughout the study. Cerebral blood flow (CBF), cerebral metabolic rates for oxygen (CMRO2) and lactate (CMRL), and ICP were simultaneously measured prior to inducing hypothermia, after obtaining hypothermia, after 24 hours of hypothermia, and after rewarming. With respect to extracerebral effects, supplemental investigations were conducted 24 and 72 hours after rewarming. The median delay between injury and induction of hypothermia was 16 hours. Hypothermia reduced CMRO2 by 45% (p < 0.01), whereas CBF did not change significantly. Before cooling, six patients had elevated CMRL indicating cerebral ischemia. Cooling normalized CMRL in all patients (p < 0.01). The intracranial hypertension present prior to cooling declined markedly during hypothermia (p < 0.01) without significant rebound effects after rewarming. Cardiac index decreased by 18% after hypothermia was reached (p < 0.05), recovered at 24 hours of hypothermia, and surpassed baseline values after rewarming. Platelet counts dropped continuously up to 24 hours after rewarming (p < 0.01). Plasma coagulation tests did not show significant worsening. Creatinine clearance decreased during cooling (p < 0.01) and recovered by 24 hours after rewarming. Twenty-four hours after cooling had begun, eight patients had elevated serum lipase activity (p < 0.01) and four of them acquired pancreatitis. Rewarming normalized both pancreatic alterations. Seven patients made a good recovery; one survived severely disabled; and two patients died. Moderate hypothermia is effective in preventing secondary brain damage while reducing cerebral ischemia. However, there are potentially hazardous side effects that require additional monitoring.

[Ultrasono-hysterography: techniques and indications]. / La sono-hystérographie: techniques et indications.

Sonohysterography consists in injecting a saline solution into the uterine cavity and performing transvaginal sonography. The purpose of this procedure is the pre-operative assessment of intracavitary anomalies, especially polyps, myoma, adhesions, congenital abnormalities such as septate uterus. Technical aspects are shown. This procedure is painless, atraumatic and no adverse effect is seen if the usual precautions before hysterography are taken. The right place of this exam is between hysterography and hysteroscopy, but more widespread use is required before a final opinion can be reached.

Relationship between obesity and concentration and composition of low-density lipoprotein subfractions in normoinsulinemic men.

Obesity, insulin resistance (IR) with hyperinsulinemia, and a dyslipoproteinemia characterized by reduced high-density lipoprotein 2 (HDL2) cholesterol and elevated levels of small, dense low-density lipoprotein (LDL) particles are risk factors for coronary artery disease (CAD). The impact of obesity independent of hyperinsulinemia on the concentration and composition of small, dense LDL subfractions is uncertain. The aim of this study was to investigate the relationship between obesity indices, namely body mass index (BMI), skinfold measurements (SF), and waist to hip ratio (WHR), and LDL-subfraction particle concentration and composition in 200 healthy men without evidence of IR. A precise analysis of the concentration of lipids and apolipoproteins and the composition of very-low-density lipoprotein (VLDL), intermediate-density lipoprotein (IDL), and two HDL- and six LDL-subfraction particles was obtained using the technique of density-gradient ultracentrifugation. Dividing the individuals according to BMI showed that those with a BMI greater than 27 kg/m2 had significantly lower HDL2 cholesterol and apolipoprotein (apo) A-I and higher VLDL and IDL cholesterol and apo B concentrations than those with a BMI less than 25 kg/m2. Regarding LDL particles, we found that men with a BMI above 25 kg/m2 had significantly more small, dense LDL particles (d 1.044 to 1.063 g/mL) and correspondingly fewer medium, dense LDL particles (d 1.031 to 1.037 g/mL) than leaner men; those with a BMI above 27 kg/m2 had the highest concentration of circulating small, dense LDL particles. These findings were not influenced by fasting insulin concentrations, IR, or WHR.(ABSTRACT TRUNCATED AT 250 WORDS)

[Assessment and evaluation of leisure activity of participants in heart rehabilitation groups]. / Beurteilung und Bewertung der Freizeitaktivität von Herzgruppenteilnehmern.

A self-administered questionnaire was used to assess leisure-time physical activity (LTPA) of patients participating in cardiac rehabilitation groups (CHD: n = 144, 115 male, 29 female) and an age-matched control group (CG: n = 100, 76 male, 24 female). The mean times spent on LTPA per week were 12.2 h (CHD) and 13.3 h (CG); this difference was due to the fact that participants of the cardiac rehabilitation groups were less engaged (1 h) in sports activities (12% contribution to LTPA versus 19.5%). The results show that most of the CHD patients organized in the groups achieved LTPA levels and energy turnover rates which are thought to have beneficial effects on the course of the atherosclerotic coronary disease. Participants who did not reach the critical energy turnover threshold should be paid particular attention with regard to their educational, as well as their medical needs.

ADP-induced changes in ordering of spin-labelled myosin heads in muscle fibres.

Rotational dynamics and ordering of myosin heads in glycerinated skeletal muscle fibres were studied using an isothiocyanate-based spin label attached to the fast-reacting thiol sites of myosin and were compared with data obtained for maleimide and iodoacetamide spin labels attached to the same sites. The ordering of probe molecules on the millisecond time scale in the rigor state, at sarcomere length 2.2-2.3 +/- 0.1 microns, was static. Isothiocyanate probe molecules showed greater mobility; the segment holding the label rotated in the microsecond time range. In the saturation transfer EPR time domain, MgADP did not produce a significant change in the mobility of spin labels. The spectra of isothiocyanate spin-labelled fibres were analyzed in terms of two narrow distributions with mean angles of 75 degrees and 56 degrees. In the rigor state, the fractions represented approximately 76% and 24% of the total EPR absorbance. In the presence of MgADP, the conventional EPR spectra showed large changes in the ordering of isothiocyanate probe molecules towards a new distribution, the population with a theta value of 56% increased from 24% to 71% at the expense of the 75% population with no change in the mean angles of the distributions. In the case of maleimide and iodoacetamide spin-labelled fibres, however, the effect of MgADP on the probe angular distribution was small.

Physical activity and lipoprotein lipid disorders.

Working muscle plays a central role in the control of lipid metabolism. Increased physical activity induces a number of positive changes in the metabolism of lipoproteins: serum triglycerides are lowered by the increased lipolytic activity and the production of native high density lipoprotein (HDL) particles is increased. The increased lecithin: cholesterol acyltransferase activity leads to an increased production of HDL2, which in addition is catabolised more slowly due to a decreased activity of hepatic lipase. The 3 effects explain the increased HDL levels of endurance trained individuals. These effects have been demonstrated in cross-sectional as well as longitudinal studies by different groups, and can be induced by training, independent of changes in bodyweight. The influence of endurance activity on the quality and quantity of low density lipoprotein (LDL) particles is a further reason for the antiatherogenic potential of increased physical activity. It has been shown by several groups that small dense LDL particles represent a particular risk factor for atherosclerosis. Recent studies presented strong evidence that LDL level and composition can be influenced favorably by physical activity. In addition to the direct influence of physical activity on lipids and lipoproteins, physical exercise may improve the disturbances of haemorheological factors, particularly those associated with hypertriglyceridaemia. In conclusion, there is increased evidence that physical activity is able to favourably influence all 3 components of the atherogenic lipoprotein phenotype: the HDL concentration increases, the concentration of small dense LDL decreases, and serum triglycerides are reduced.