Appendicular muscle mass and fasting triglycerides predict serum liver aminotransferases in young female collegiate athletes.

OBJECTIVE: We test the hypothesis that aspartate aminotransferase (AST) may be associated inversely with serum triglycerides (TG) and positively with high density lipoprotein (HDL) cholesterol in young athletes because athletes have larger amounts of muscle mass. RESEARCH DESIGN AND METHODS: Pearson's correlation coefficients were calculated between serum AST and alanine aminotransferase (ALT) and body composition identified by dual-energy X-ray absorptiometry, markers of insulin resistance, serum lipids, lipoproteins, apolipoproteins, adiponectin and leptin in 174 female collegiate athletes (18-22 years). Multivariate linear regression analyses were used to identify independent determinants of the aminotransferases. RESULTS: AST and ALT showed positive correlation with appendicular skeletal muscle mass (ASM) and height-adjusted ASM. In addition, ALT as well as AST showed inverse, not positive, association with fasting TG. Further, both AST and ALT showed positive associations with HDL cholesterol and apolipoprotein AI, a major apolipoprotein of HDL particles. Multivariate analysis revealed that height-adjusted ASM and TG (inverse) were independent determinants for AST and ALT. Further, fat mass index (inverse) and resting heart rate (inverse) predicted AST and apolipoprotein AI predicted ALT. CONCLUSIONS: In young female collegiate athletes, both serum AST and ALT showed inverse association with fasting TG and positive association with apoAI, both of which may be mediated through positive association between the aminotransferases and ASM. The association between ALT and TG is opposite in direction in young athletes (inverse) and in the general population (positive).

Increased Adipose and Muscle Insulin Sensitivity Without Changes in Serum Adiponectin in Young Female Collegiate Athletes.

BACKGROUND: Effects of endurance training on adipose insulin sensitivity in association with body composition, circulating adipokines, and markers of inflammation have been studied less in young Asian subjects. METHODS: Adipose insulin sensitivity/resistance was compared between 170 female Japanese collegiate athletes and 311 nonathletes (18-24 years), who underwent measurements of serum adipokines, markers of insulin sensitivity, inflammation, and dual-energy X-ray absorptiometry. Two separate subsamples of two groups of women underwent either a 75-gram oral glucose tolerance test or a standardized meal test, but not both. RESULTS: As compared with nonathletes, athletes, characterized by higher skeletal muscle mass and lower percentage of body fat (both P < 0.001), had lower adipose insulin resistance (IR) (a product of fasting insulin and nonesterified fatty acid (NEFA) and lower leptin/adiponectin ratio (both P < 0.001). Although athletes had lower postmeal/postglucose insulinemia (P = 0.009 and 0.01, respectively), the two groups did not differ in postmeal percentage NEFA suppression and postmeal/postglucose glycemia, suggesting increased insulin sensitivity in adipose tissue and skeletal muscle, respectively. Serum leptin (P < 0.001) and tumor necrosis factor-α (P = 0.01) were lower in athletes, whereas adiponectin and homeostasis model assessment IR did not differ. CONCLUSIONS: Endurance training was associated with increased insulin sensitivity in adipose tissue as well as skeletal muscle without changes in circulating adiponectin even in young, normal-weight Japanese women.

Resection of distal gastric tube cancer with sentinel node biopsy: a case report and review of the literature.

BACKGROUND: The frequency of gastric tube cancers has increased with advances in surgical techniques and improvement of survival rates in patients with esophageal cancer. However, a standard surgical treatment has not yet been established. Total resection of the gastric tube with lymphadenectomy has been considered a radical treatment, while repeat surgery with both laparotomy and thoracotomy has been associated with severe complications, including anastomotic leakage, recurrent nerve paralysis, bronchotracheal injury, and damage to other organs. CASE PRESENTATION: We present a successful case of a gastric tube cancer that was treated with surgical resection in combination with sentinel node biopsy. The tumor was diagnosed as a type 0-IIc lesion with ulceration, and was located proximal to the pyloric ring. Endoscopic submucosal dissection was not indicated because the primary lesion was submucosally invasive, and undifferentiated. By the dye-guided method, sentinel nodes were detected along the right gastroepiploic artery and vein. Intraoperative pathological examination revealed no metastasis of the sentinel nodes. Resection of the distal gastric tube was safely performed with a Roux-en-Y reconstruction, preserving the right gastroepiploic artery and vein and the perfusion of the proximal gastric tube. CONCLUSION: We suggest distal resection of the gastric tube with sentinel node biopsy as a novel surgical method for a cT1N0 gastric tube cancer located in the abdomen.

Relationship between peak VO2 and subcutaneous fat thickness of the thigh measured by ultrasonography.

BACKGROUND: Measured physical activity and percent body fat obtained by bioelectrical impedance analysis have been used as indicators of cardiorespiratory fitness in middle-aged women and children. However, the relationship between subcutaneous fat thickness in various regions of the thigh determined by ultrasonography and cardiorespiratory fitness has not been previously reported. METHODS: We measured subcutaneous fat thickness in the frontal, lateral, and medial regions of both thighs using ultrasonography, and also determined peak VO2 and percent body fat in 13 healthy and generally well female college students. RESULTS: There were significant negative correlations found between peak VO2 and the 3 frontal portions of the thigh, as well as the vastus lateralis (both sides), while correlations were not seen with the right and left medial regions 15 cm above the medial epicondyle. CONCLUSIONS: Our results suggest that increases in peak VO2 are reflected by decreases in subcutaneous fat thickness in the frontal and lateral regions of the thigh, but not in decreases in that in both sides of the medial region of the thigh. In addition, subcutaneous fat thickness may indicate partial or segmental activation of the frontal and lateral regions of the legs, such as that obtained by cycling. We concluded that measurement of subcutaneous fat thickness in the region above the muscle mass of the thigh such as the rectus femoris or lateral vastus using ultrasonography may reasonably represent physical activity. Further study is needed to be done with larger groups of subjects and to evaluate the effects of training on activation of regions of the thigh.

Spindle epithelial tumor with thymus-like differentiation (SETTLE) of the thyroid.

BACKGROUND: Tumors of the so-called intrathyroidal epithelial thymoma type are a rare group of thyroid neoplasm tumors. Of this type of tumor, spindle epithelial tumor with thymus like differentiation (SETTLE) has been reported only 17 times in English literature. METHODS: An 18-year-old woman was initially seen with a 6-cm left thyroid mass that was resected with a left thyroidectomy. Histopathologic features of the excised left thyroid tumor together with an immunohistochemistry and electron microscopy led us to a diagnosis of SETTLE. RESULTS: Most of the specimen was composed of highly cellular spindle cells that formed intersecting and streaming fascicles. The spindle cells showed both vimentin immunoreactivity and cytokeratin immunoreactivity but no immunoreactivity for thyroglobulin or calcitonin. Electron microscopic examination of the spindle cells demonstrated prominent cytoplasmic tonofilaments, desmosomes, and basal lamina consistent with epithelial cell origin. DNA content analysis by flow cytometry revealed DNA diploidy. CONCLUSIONS: SETTLE of thyroid gland is an extremely rare entity. A review of the literature reveals that SETTLE has distinctive morphologic features and an immunohistochemical profile.