Effects of aerobic or combined aerobic resistance exercise on body composition in overweight and obese adults: gender differences. A randomized intervention study.

BACKGROUND: In the literature, it is not yet clear whether sex may affect the outcomes of exercise training in obese adults. AIM: The aim of this study was to investigate gender difference in the effects of combined aerobic resistance exercise (ARE) versus aerobic exercise (AE) alone on body composition in overweight and obese adults. DESIGN: Randomized clinical trial. SETTING: University-based outpatient clinic. POPULATION: Sixty-five healthy, untrained overweight and obese men and women METHODS: They were randomized into one of two intervention groups; AE group (N.=33) performed leg cycle exercises with increasing duration and frequency; ARE group (N.=32) performed additionally progressive weight-resistance exercises for the upper and lower parts of body. Both groups were asked not to change their diet. Body composition including percentage of fat (PF), fat mass (FM) and fat free mass (FFM) in regional and whole body was determined by dual-energy X-ray absorptiometry (DXA) at baseline and week 12. RESULTS: ARE leads to more gains on regional and whole body FFM than AE. ARE was more effective in increasing the FFM of arms, trunk and whole body and decreasing PF of trunk in men and superior on reducing FM of legs in women when comparing with AE. CONCLUSION: In order to reduce the trunk fat in men and leg fat in women, resistance exercise can be added into an aerobic training program. CLINICAL REHABILITATION IMPACT: Dissimilar results of exercises on sex obtained in our study serves as a guide for prescribing exercises in overweight and obese men and women.

Congenital lymphoedema, bronchiectasis and seizure: case report.

A 10-year-old girl with facial anomalies, mental retardation, peripheral lymphoedema, convulsions, cerebral cortical dysgenetic changes, bronchiectasis and chronic sinusitis is presented. She had features of both yellow nail syndrome and Hennekam syndrome. We think that our case might be a new congenital lymphoedema syndrome or an intermediate form between these syndromes.

Malign cystic glucagonoma presented with diabetic ketoacidosis: case report with an update.

A 44-year-old woman was diagnosed with type II diabetes in 1998 and 1 year later she developed necrolytic migratory erythema, which is a specific skin lesion of glucagonoma. During the clinical investigation, a nodular 6 cm mass in the distal pancreatic region and multiple cystic liver metastases were found. She was operated on, and glucagonoma was detected and the long-acting, repeatable, octreotide treatment was started. 3 years after resection of a pancreatic glucagonoma she presented to a hospital emergency department with diabetic ketoacidosis. Hepatic multiple cystic metastases were visualized by computed tomography. During hospitalization she developed severe pulmonary embolism and deep-venous thrombosis of the lower extremities. Indium-labeled octeotide scintigraphy showed multiple cystic lesions in the liver with additional lesions in the iliocecal region, which had not been visualized by computed tomography. Despite somatostatin therapy the tumor had expanded in the liver. Arterial chemoembolization was performed but 6 months later she died.

Validation of the Yale circumferential quantification method using 201Tl and 99mTc: a phantom study.

UNLABELLED: The Yale circumferential quantification (Yale CQ) method for quantification of SPECT images has been validated previously using empirically derived correction factors. In the present studies, the Yale CQ method was further validated using 2 SPECT gamma cameras and 2 radioisotopes. METHODS: SPECT images were acquired from cardiac phantoms with multiple fillable inserts to simulate myocardial perfusion defects of varying extents and severities. Seventy phantom configurations were created. One hundred and forty SPECT images (70 with 99mTc and 70 with 201TI) were acquired using a triple-head SPECT camera. SPECT defects were quantified using the Yale CQ method, with incorporation of 99mTc- and 201TI-derived normal databases and correction factors. RESULTS: Quantified phantom SPECT defect sizes acquired with 99mTc correlated well with actual calculated defect sizes (r = 0.96, y = 0.92x - 0.41). Bland-Altman analysis of agreement revealed strong agreement over a wide range of defect sizes, with a mean error of 1.2% and 2 SDs of 5.0%. Overall 201TI SPECT defect sizes also correlated well with actual defect sizes (r = 0.92), but there was a systematic underestimation (y = 0.72x - 0.76). Bland-Altman analysis showed underestimation over the entire range of defect sizes, with a mean error of 3.4% and 2 SDs of 7.5%. Implementation of a normal 201TI phantom database improved accuracy of quantification (r = 0.95, y = 0.87x - 1.36). The addition of 201TI-specific correction factors further improved accuracy (r= 0.94, y = 0.98x - 1.52). Reproducibility of SPECT defect sizes quantification for 99mTc using 2 gamma cameras was excellent (r = 0.98, y = 0.98x + 0.84). CONCLUSION: The Yale CQ SPECT quantification method, using the empirically derived correction factors, provides accurate and reproducible quantification of phantom defects over a wide range of defect sizes. Accurate quantification of 201TI and 99mTc SPECT defect sizes requires radiotracer-specific normal databases.

Detection of metastatic bone lesions in patients with prostate carcinoma: 99Tcm-monoclonal antibody imaging.

Bone scintigraphy has been shown to be sensitive in determining bone involvement in patients with malignancy, but it does not allow the assessment of bone marrow lesions in early disease. The aim of this study was to detect bone marrow invasion using 99Tcm-labelled monoclonal antigranulocyte antibody (AgMoAb) in patients with prostate carcinoma. We studied 56 patients whose mean (+/- S.D.) age was 67 +/- 7 years. The mean prostate-specific antigen level was 6.1 ng ml-1 (normal range 0-5 ng ml-1). Twelve patients were in stage A, 16 in stage B, 17 in stage C and 11 in stage D. Six patients had been receiving chemotherapy and four patients radiotherapy before scanning. Bone scans were obtained 2 h after the intravenous injection of 555 MBq 99Tcm-methylene diphosphonate (99Tcm-MDP). Within a week, bone marrow imaging was performed 4 and 24 h after the injection of 555 MBq 99Tcm-AgMoAb. Metastatic bone lesions were detected on the 99Tcm-MDP scans of 14/56 (25%) patients, of whom one was in stage A, two in stage B, four in stage C and seven in stage D. Hypoactive lesions in bone marrow were detected in 25/56 (45%) patients, of whom two were in stage A, five in stage B, seven in stage C and 11 in stage D. Bone marrow metastases were confirmed in six patients by computed tomography (CT) and magnetic resonance imaging (MRI) and in two patients by marrow aspiration biopsy. A false-positive immune scintigram was found in three patients previously receiving radiotherapy or chemotherapy. We suggest that 99Tcm-AgMoAb scintigraphy is a sensitive procedure for the detection of bone marrow lesions. However, the reason for false-positive and false-negative results should be considered and CT, MRI and marrow biopsy should be performed when clinically necessary.