The Association Between Depression and Death Anxiety Among Older Adults: Moderating Effect of Ego-Integrity.

This study verifies the relationship between depression and death anxiety in older adults and the moderating effect of ego-integrity on this relationship. The survey was conducted with 236 participants aged 65 years and older through a combination of online and offline surveys. The final data were analyzed using the PROCESS macro for SPSS 2.16. The main findings of this study are as follows: First, depression in old age was positively related to anxiety about death. Second, the moderating effect of ego-integrity was observed on the relationship between depression and death anxiety. Third, on examining the moderating effect of each sub-variable of ego-integrity, the moderating effect of satisfaction with one's life was observed to be significant. Conversely, the moderating effect of attitude toward life and acceptance of old age was not significant. The results of this study are meaningful in examining the moderating effect of ego-integrity on the relationship between depression and death anxiety. Furthermore, the results of this study can provide basic data for the development and application of psychological intervention programs for older adults experiencing psychological problems due to depression and death anxiety in old age.

Influence of Health-Related Status and Social Activities on Depressive Symptoms in Korean Older Adults Who Live Alone.

The current study aimed to explore predictors of depressive symptoms in Korean older adults who live alone using data from the 2017 National Survey of Older Koreans. Participants were 2,258 adults (females, n = 1,838 [81.4%]; males, n = 420 [18.6%]) aged ≥65 years (mean = 75.9, SD = 6.8 years). Multiple hierarchical regression analysis indicated that perceived health status, instrumental activities of daily living (IADL), social gatherings, interaction frequency with children living separately, income quintile, religion, and education were significant predictors of depressive symptoms. In particular, perceived health status, IADL, and interaction frequency with children living separately were the most powerful predictors of depressive symptoms in older adults living alone. The result of the current study was to verify the relationship between social activity and depression of older adults who live alone. This study suggests that contact with children and social gatherings may help prevent depression in older adults who live alone. [Journal of Psychosocial Nursing and Mental Health Services, 59(2), 25-30.].

Effects of Hyperbaric Oxygen Therapy on Inflammation, Oxidative/Antioxidant Balance, and Muscle Damage after Acute Exercise in Normobaric, Normoxic and Hypobaric, Hypoxic Environments: A Pilot Study.

The purpose of this study was to investigate the effects of hyperbaric oxygen therapy (HBOT) on inflammation, the oxidative/antioxidant balance, and muscle damage after acute exercise in normobaric, normoxic (NN) and hypobaric, hypoxic (HH) environments. Eighteen healthy males were selected and randomly assigned to three groups: exercise in NN conditions (NN group, n = 6), HBOT treatment after exercise in NN conditions (HNN group, n = 6), and HBOT treatment after exercise in HH conditions (HHH group, n = 6). All subjects performed treadmill running for 60 min at 75-80% maximum heart rate (HRmax) exercise intensity under each condition. The HBOT treatments consisted of breathing 100% oxygen at 2.5 atmosphere absolute (ATA) for 60 min. Blood samples were collected before exercise (BE), after exercise (AE), and after HBOT (AH) to examine inflammation (fibrinogen, interleukin-6 [IL-6], and tumor necrosis factor-α (TNF-α)), the oxidative/antioxidant balance (derivatives of reactive oxygen metabolites (d-ROMs) and the biological antioxidant potential (BAP)), and muscle damage (creatine kinase (CK) and lactate dehydrogenase (LDH)). Plasma fibrinogen, serum IL-6, CK, and LDH levels were significantly increased AE compared to BE in all groups (p < 0.05). Plasma fibrinogen levels were significantly decreased AH compared to AE in all groups (p < 0.05), and the HNN group had a significantly lower AH compared to BE (p < 0.05). Serum IL-6 levels were significantly decreased AH compared to AE in the HNN and HHH groups (p < 0.05). Serum CK levels were significantly decreased AH compared to AE in the HHH group (p < 0.05). Serum LDH levels were significantly decreased AH compared to AE in the HNN and HHH groups (p < 0.05), and the NN and HNN groups had significantly higher AH serum LDH levels compared to BE (p < 0.05). These results suggest that acute exercise in both the NN and HH environments could induce temporary inflammatory responses and muscle damage, whereas HBOT treatment may be effective in alleviating exercise-induced inflammatory responses and muscle damage.

Effects of detraining and retraining on muscle energy-sensing network and meteorin-like levels in obese mice.

BACKGROUND: Increased intramuscular peroxisome proliferator-activated receptor gamma coactivator-1α (PGC-1α) with exercise directly or indirectly affects other tissues, but the effector pathway of PGC-1α has not been clearly elucidated. The purpose of this study was to investigate the effect of exercise and/or dietary change on the protein levels of the soleus muscle energy-sensing network and meteorin-like (Metrnl), and additionally to analyze the detraining and retraining effects in high-fat diet (HFD)-induced obese mice. METHODS: One hundred male C57BL/6 mice were divided into normal-diet + sedentary (CO, n = 20) and HFD + sedentary (HF, n = 80) groups, and obesity was induced in the HF group through consumption of a 45% HFD for 6 weeks. The HF group was subdivided into HF only (n = 20), HF + training (HFT, n = 20), dietary change + sedentary (HFND, n = 20), and HFND + training (HFNDT, n = 20) groups, and the mice in the training groups underwent a treadmill training for 8 weeks, 5 times per week, 40 min per day. The HFT and HFNDT groups underwent 8-week training, 8-week detraining, and 4-week retraining. RESULTS: An 8-week training was effective in increasing the protein levels of soleus muscle AMP-activated protein kinase (AMPK), PGC-1α, and plasma Metrnl in the obese mice (P < 0.05). Moreover, exercise in obesity reduced body weight (P < 0.05), and exercise with dietary conversion was effective in reducing body weight (P < 0.05) and fat mass (P < 0.05) after 8-week training. 8-week detraining restored the increased protein level to the pre-exercise state, but, the previous exercise effect in body weight and fat mass (P < 0.05) of the HFNDT group remained until the end of 4-week detraining. 4-week retraining was effective in increasing the protein levels of soleus muscle AMPK, PGC-1α, blood Metrnl (P < 0.05), and reducing in body weight (P < 0.05) and fat mass (P < 0.05), when retraining with dietary change. CONCLUSIONS: The results of this study suggest that regular exercise is indispensable to reduce body weight and fat mass through upregulation of the muscle energy-sensing network and Metrnl protein levels, and retraining with dietary change is necessary to obtain the retraining effects more quickly.

Exercise training improves intramuscular triglyceride lipolysis sensitivity in high-fat diet induced obese mice.

BACKGROUND: The purpose of this study was to determine whether regular exercise training enhances intramuscular triglyceride (IMTG) lipolysis sensitivity during consumption of a continued high-fat diet by exploring changes in biochemical factors activated by IMTG lipolysis. METHODS: Male C57BL/6 mice aged 4 weeks were randomly divided into a high-fat diet group (HF) to induce obesity for 6 weeks and a control (CO) group. Thereafter, the HF group was divided into a high-fat diet group (HF) and high-fat diet + training group (HFT). The HFT group was trained on an animal treadmill 40 min/day, 5 days/week for 8 weeks. PKA, Plin5, p-Plin5, CGI-58, ATGL, and HSL were analyzed to investigate IMTG sensitivity by western blotting. RESULTS: PKA, CGI-58, and HSL protein levels in the HF group were significantly lower than those in the CO group (p < 0.05). However, PKA, CGI-58, and HSL protein levels in the HFT group were significantly higher than those in the HF group, and ATGL and p-Plin5 protein levels as well as the p-Plin5/Plin5 ratio in the HFT group were significantly higher than those in the HF group (p < 0.05). In addition, the HF group showed a significantly higher IMTG volume than the CO and HFT groups (p < 0.05). CONCLUSIONS: These results suggest that in an obese mouse model, 8 weeks of treadmill exercise contributes to decreased IMTG volume by activating lipolysis factors, such as PKA, PLIN5, CGI-58, and lipases. Therefore, regular exercise training may play an important role in obesity treatment by increasing IMTG lipolysis sensitivity.

The effects of detraining and training on adipose tissue lipid droplet in obese mice after chronic high-fat diet.

BACKGROUND: It is well known that exercise promotes lipolysis by stimulating the lipid droplet (LD) signaling pathway. However, few studies have been conducted to examine the effect of detraining with high fat diet (HFD) and training effects after long-term HFD. Here, we investigated the effect of detraining and training on adipose tissue LD pathway in diet-induced obese mice after continuous HFD. METHODS: Seventy male C57BL/6 mice were randomly assigned into a Normal diet + Sedentary group (ND, n = 10) or a High-fat diet + Sedentary group (HF, n = 50); in the HF group, obesity was induced by a 45% fat chow for six weeks. For the subsequent eight weeks, the HF group was randomly subdivided into an HF (n = 30) or an HF + training group (HFT, n = 20), and the HFT group was subjected to treadmill training while on an HFD. Following this eight-week period, the HFT group stopped exercising (HFT-DT group, n = 10), and the mice in the HF group were randomly subdivided into an HF (n = 10) or an HF + training group (HF-T, n = 10). After training and detraining, abdominal visceral fat was obtained and analyzed by histological staining and western blot. RESULTS: Treadmill exercise decreased body weight and fat mass (P <0.05), and increased the levels of PKA, perilipin1, CGI-58, ATGL, and HSL (P <0.05) after eight weeks of training. Following eight weeks of detraining, the levels of PKA and HSL were decreased (P <0.05); however, exercise after chronic HFD increased the levels of PKA, perilipin1, CGI-58, ATGL, and HSL (P <0.05), and decreased body weight and fat mass (P <0.05). CONCLUSIONS: Regardless of dietary restrictions, exercise is an effective treatment for obesity, owing to the regulation of LD signaling proteins. Moreover, the effects of regular exercise after chronic HFD were similar to those of exercise in the absence of HFD. Therefore, although obesity is induced by chronic HFD, exercise without dietary change is sufficiently effective for obesity treatment regardless of the preceding HFD period.

Diet change and exercise enhance protein expression of CREB, CRTC 2 and lipolitic enzymes in adipocytes of obese mice.

BACKGROUND: The study investigated the effects of regular exercise and diet changes on the change in metabolic processes of the cAMP-Response Element-Binding Protein-Regulated Transcription Coactivator (CRTC) family and its sub-lipolysis. METHODS: Four-week-old C57/black male mice received an 8-week diet of general formula (control, CO; n = 10) or a high fat diet (HF; n = 30) to induce obesity. Thereafter, the mice received another 8-week regimen of general formula CO (n = 10) diet, continuous HF diet (n = 10), switched to general formula (diet change, DC; n = 10) or switched to general formula + exercise (diet and exercise, DE; n = 10). RESULTS: The DE group displayed significantly lower body weight, abdominal fat and lipid profiles (p < 0.05). The DE group also displayed significantly lower (35 %) CRTC 2 activity than the CO (p < 0.05). Activities of adipose triglyceride lipase (ATGL), hormone sensitive lipolitic enzyme (HSL) and monoacylglycerol lipase (MGL) were significantly higher (51 %, 38 %, 49 %) in the DE group than the HF group (p < 0.05). MGL, there were no differences between the CO group, HF group, and DC group, with the DE group (70 %) being significantly higher (p < 0.05). CONCLUSION: Change in diet in the absence of exercise was not associated with changes in adipose tissue CRTC family lipase activity, indicating that lipolysis metabolic processes are effective only when diet and exercise are carried out together.

Exercise and dietary change ameliorate high fat diet induced obesity and insulin resistance via mTOR signaling pathway.

PURPOSE: The purpose of this study was to investigate the effect of exercise and dietary change on obesity and insulin resistance and mTOR signaling protein levels in skeletal muscles of obese rats. METHODS: Sixty male Sprague-Dawley rats were divided into CO (Normal diet) and HF (High Fat diet) groups in order to induce obesity for 15 weeks. The rats were then subdivided into CO, COT (CO + Training), HF, HFT (HF + Training), HFND (Dietary change), and HFNDT (HFND + Training) groups (10 rats / group). The training groups underwent moderate-intensity treadmill exercise for 8 weeks, after which soleus muscles were excised and analyzed. Data was statistically analyzed by independent t-test and One-way ANOVA tests with a 0.05 significance level. RESULTS: Fasting blood glucose, plasma insulin, and HOMA-IR in the HF group were significantly higher, as compared with other groups (p <.05). Protein levels of insulin receptor subunit-1 (IRS-1), IRS-2, and p-Akt were significantly higher in the HFT, HFND, and HFNDT groups, as compared with HF group. In addition, the protein levels of the mammalian target of rapamycin complex 1 (mTORC1) and ribosomal S6 protein kinase 1 were significantly decreased by exercise and dietary change (p <.05). However, mTORC2 and phosphoinositide 3-kinase were significantly increased (p <.05). CONCLUSION: In summary, despite the negative impact of continuous high fat intake, regular exercise and dietary change showed a positive effect on insulin resistance and mTOR signaling protein levels.

The effect of exercise on expression of myokine and angiogenesis mRNA in skeletal muscle of high fat diet induced obese rat.

PURPOSE: The purpose of this study was to investigate the effect of regular treadmill exercise on the mRNA expressions of myokines and angiogenesis factors in the skeletal muscle of obese rats. METHODS: Thirty two male Sprague-Dawley rats (4weeks old) were divided into the CO (control) and HF (high fat diet) groups. Obesity was induced in the HF group by consumption of 45% high-fat diet for 15 weeks. These groups were further subdivided into training groups (COT and HFT); the training groups conducted moderate intensity treadmill training for 8 weeks. Soleus muscles were excised and analyzed by real-time quantitative PCR. RESULTS: mRNA expression of myokines, such as PGC-1α, IL-6, and IL-15, in the COT and HFT groups (which conducted regular exercise), were higher as compared with the CO and HF groups (p < 0.05). Also, the levels in the HF group were significantly lower when compared with CO group (p < 0.05). Expression of angiogenesis mRNA, namely mTOR, VEGF, and FLT1, were significantly lower in the HF group, as compared to the CO group (p < 0.05). In addition, COT group had a higher expression of mTORC1, mTORC2, VEGF and FLT mRNA, than the CO group (p < 0.05); the HFT group also had higher expressions of mTOR, VEGF and FLT1 mRNA than the HF group (p < 0.05). CONCLUSION: These results indicate that mRNA expression of myokines was increased through the activity of muscle contraction, and it also promoted the mRNA expression of angiogenesis due to activation of mTOR. Thus, we conclude that not only under normal health conditions, but in obesity and excess nutritional circumstances also, regular exercise seems to act positively on the glycemic control and insulin sensitivity through the angiogenesis signaling pathway.

Effects of Supplementation with BCAA and L-glutamine on Blood Fatigue Factors and Cytokines in Juvenile Athletes Submitted to Maximal Intensity Rowing Performance.

[Purpose] This study was conducted to understand the impacts of BCAA (branched-chain amino acid) and glutamine supplementation on the degree of blood fatigue factor stimulation and cytokines along with performance of exercise at the maximal intensity. [Subjects] Five male juvenile elite rowing athletes participated in this study as the subjects; they took 3 tests and received placebo supplementation (PS), BCAA supplementation (BS), and glutamine supplementation (GS). [Methods] The exercise applied in the tests was 2,000 m of rowing at the maximal intensity using an indoor rowing machine, and blood samples were collected 3 times, while resting, at the end of exercise, and after 30 min of recovery, to analyze the blood fatigue factors (lactate, phosphorous, ammonia, creatine kinase (CK)) and blood cytokines (IL (interleukin)-6, 8, 15). [Results] The results of the analysis showed that the levels of blood phosphorous in the BS and GS groups at the recovery stage were decreased significantly compared with at the end of exercise, and the level of CK appeared lower in the GS group alone at recovery stage than at the end of exercise. The level of blood IL-15 in the PS and BS groups appeared higher at the end of exercise compared with the resting stage. [Conclusion] It seemed that glutamine supplementation had a positive effect on the decrease in fatigue factor stimulation at the recovery stage after maximal intensity exercise compared with supplementation with the placebo or BCAA. Besides, pre-exercise glutamine supplementation seemed to help enhance immune function and the defensive inflammatory reaction.

Exercise training improves cardiac autonomic nervous system activity in type 1 diabetic children.

[Purpose] We investigated the effect exercise training has on cardiac autonomic nervous system (ANS) and cardiovascular risk profiles in children with type 1 diabetes mellitus (DM). [Subjects] Fifteen type 1 DM children (all boys; 13.0±1.0 years of age) were enrolled in the study. [Methods] The subjects received exercise training three times a week in a 12-week program. Each child was asked to walk on a treadmill to achieve an exercise intensity of VO2max 60%. ANS activity was measured by power spectral analysis of the electrocardiogram (ECG). Blood samples were obtained for serum lipid profiles. To evaluate Doppler-shifted Fourier pulsatility index (PI) analysis, a 5-MHz continuous wave Doppler (VASCULAB D10) set was used to measure forward blood flow velocity (FLOW) in the radial artery. [Results] Total and low-frequency (LF) power of heart rate variability increased significantly after exercise intervention. Total cholesterol (TC) levels were significant lower after exercise intervention. Total and high-frequency (HF) power were significantly correlated with higher TC levels, but diastolic blood pressure and HF was significantly correlated with lower TC levels. [Conclusion] Regular exercise intervention should be prescribed for children with type 1 DM.

A survey of overweight, body shape perception and eating attitude of Korean female university students.

PURPOSE: We obtained basic data on a proper weight loss training program by considering the relationship between body mass index (BMI), the perception of appearance, and eating attitudes of Korean female university students. METHODS: The survey and anthropometry for the perception of appearance and eating attitudes were conducted targeting 657 female university students located in Seoul, Busan, Ulsan, Daejeon, Chungcheongnam-do, and Gangwon-do South Korea who were not specializing in physical education. RESULTS: The underweight group accounted for 21.16% of the population, the normal weight group comprised 69.71%, the overweight group was 6.09%, and the obese group accounted for 3.04%. The satisfaction rate of appearance was 56.16%, the dissatisfaction rate was 43.84%, and normal-weight students who were dissatisfied with their own appearance comprised 48.5%. The More obese students were more dissatisfied with their appearance. As a result of investigating eating attitudes, 37.75% of all subjects had a risk for an eating disorder, and 38.6% were normal weight but showed a risk for an eating disorder. More obese (BMI) subjects were at higher risk for an eating disorder. CONCLUSION: The BMIs of the Korean female university students were lower than those of European and American Caucasian women students, but the dissatisfaction of Korean female university students with their appearances was greater than that of European and American students, indicating that more Korean female university students were suffering from an eating disorder. It is predicted that the incidence of eating disorders, such as anorexia and bulimia, will rise in Korean women if there is no accurate understanding and measure to identify the high risk group for an eating disorder.

Effects of exercise and diet change on cognition function and synaptic plasticity in high fat diet induced obese rats.

BACKGROUND: Nutritional imbalance-induced obesity causes a variety of diseases and in particular is an important cause of cognitive function decline. This study was performed on Sprague Dawley (SD) rats with 13-weeks of high fat diet-induced obesity in connection to the effects of regular exercise and dietary control for 8 weeks on the synaptic plasticity and cognitive abilities of brain. METHODS: Four weeks-old SD rats were adopted classified into normal-normal diet-sedentary (NNS, n = 8), obesity-high fat diet-sedentary (OHS, n = 8), obesity-high fat diet-training (OHT, n = 8), obesity-normal diet-sedentary (ONS, n = 8) and obesity- normal diet-training (ONT, n = 8). The exercise program consisted of a treadmill exercise administered at a speed of 8 m/min for 1-4 weeks, and 14 m/min for 5-8 weeks. The Western blot method was used to measure the expression of NGF, BDNF, p38MAPK and p-p38MAPK proteins in hippocampus of the brain, and expressions of NGF, BDNF, TrkA, TrkB, CREB and synapsin1 mRNA were analyzed through qRT-PCR. RESULTS: The results suggest cognitive function-related protein levels and mRNA expression to be significantly decreased in the hippocampus of obese rats, and synaptic plasticity as well as cognitive function signaling sub-pathway factors were also significantly decreased. In addition, 8-weeks exercises and treatment by dietary change had induced significant increase of cognitive function-related protein levels and mRNA expression as well as synaptic plasticity and cognitive function signaling sub-pathway factors in obese rats. In particular, the combined treatment had presented even more positive effect. CONCLUSIONS: Therefore, it was determined that the high fat diet-induced obesity decreases plasticity and cognitive function of the brain, but was identified as being improved by exercises and dietary changes. In particular, it is considered that regular exercise has positive effects on memory span and learning capacity unlike dietary control.

Intestinal Anastomosis by Use of a Memory-shaped Compression Anastomosis Clip (Hand CAC 30): Early Clinical Experience.

PURPOSE: The safety and the efficacy of the compression anastomosis clip (Hand CAC 30) have been demonstrated by animal studies. This study was designed to evaluate the clinical validity of the Hand CAC 30 in enterocolic side-to-side anastomosis after colonic or enteric resections. METHODS: A non-randomized prospective data collection was performed for patients undergoing a side-to-side anastomosis using the Hand CAC 30. Eligibility criteria for the use of the Hand CAC 30 were for anastomoses between the colon and the ileum or between two small bowels. The primary short-term endpoint was the rate of anastomotic leakage. Other clinical outcomes, including intra- and postoperative complications, length of operation time and hospital stay, and the clip elimination time were recorded. RESULTS: A total of 63 patients (male, 36) underwent an enteric or right-sided colonic resection followed by a side-to-side anastomosis using the Hand CAC 30. Laparoscopic surgery was performed in 36 patients, in whom one patient who underwent a laparoscopic right hemicolectomy was converted to an open procedure (1/32, 3.1%). One patient with ascending colon cancer showed postoperative anastomotic leakage and died of co-morbid ischemic heart disease. There were no other surgical mortalities. The exact date of expulsion of the clip could not be recorded because most patients were not aware of clip elimination. No patients manifested clinical symptoms of anastomotic stricture. CONCLUSION: Short-term evaluation of the Hand CAC 30 anastomosis in patients undergoing enterocolic surgery proved it to be a safe and efficacious alternative to the standard hand-sewn or stapling technique.

Anastomosis by use of compression anastomosis ring (CAR™ 27) in laparoscopic surgery for left-sided colonic tumor.

PURPOSE: The safety and efficacy of the compression anastomosis ring (CAR™ 27) had been demonstrated by animal studies. This study was designed to evaluate clinical validity of the CAR™ 27 anastomosis in laparoscopic surgery for patients with left-sided colonic neoplasm. METHODS: Intracorporeal anastomosis using the CAR™ 27 (CAR group) was performed in 66 patients (male 35; median age, 64.5 years), and short-term results were compared with consecutive 116 patients (male 70; median age, 64 years) where the anastomosis was constructed by double stapling technique using a circular stapler for the same indications (stapled group). RESULTS: There were no statistically significant differences between the two groups in terms of gender, age, and distribution of pathologic lesion. The laparoscopic procedures, pathologic diagnosis/stage, and length of operation time and postoperative hospital stay were comparable between the two groups. Conversion rate in the CAR and stapled group was 3% and 6%, respectively. There was no surgical mortality in either group. No intraoperative complications associated with the CAR™ 27 anastomosis were encountered. One patient in the CAR group was complicated by anastomotic leakage and none in the stapled group (p = 0.36). There was intestinal obstruction in two patients, in whom one required re-operation for entrapped small bowel adhesions within pelvis. No patient in either group showed symptomatic anastomotic stricture. CONCLUSIONS: The anastomosis using the CAR™ 27 is an innovative technique. The CAR™ 27 anastomosis in patients undergoing laparoscopic colectomy for left-sided colonic tumor proved to be a safe and efficacious alternative to the standard double stapling technique.

The effects of detraining on blood adipokines and antioxidant enzyme in Korean overweight children.

The present study examined the change to clarify the effects of detraining on the concentration of lipid profiles, serum adipokines and antioxidant enzyme gene expression in Korean overweight children. The subjects were normal children (n = 19) and obese children (n = 20) who were further subdivided into the overweight training (OT) group (n = 10) and the overweight detraining (OD) group (n = 10). Maximal oxygen uptake (VO(2)max); body composition; lipid profiles (TG, TC); adipokines (adiponectin and leptin); antioxidants (blood and gene expressions SOD and GPX) were measured before, 12 weeks, and 24 weeks after the exercise program. Body mass index (BMI) and %fat were significantly higher in the OD group only. However, waist hip ration (WHR) and systolic blood pressure (SBP) were significantly decreased in the OT group. TG was significantly decreased in the OT group. There was a significant difference in TG level between the two groups. Besides, adiponectin was significantly increased in both the OT group and the OD group. Furthermore, leptin was significantly decreased in the OT group. There was a significant difference in leptin level between the two groups. In training groups, the expression of SOD was significantly increased after a 12- and 24-week period (p < 0.05). However, detraining group was significantly increased after a 12-week only (p < 0.05). In addition, GPX was significantly increased after a 24-week only in the training group (p < 0.05). Thus, detraining showed that negative effected on body composition and lipid profiles and maintained of uniform period on adipokines and antioxidant enzyme the protein and expression.

Early experience of the compression anastomosis ring (CAR™ 27) in left-sided colon resection.

AIM: To evaluate clinical validity of the compression anastomosis ring (CAR™ 27) anastomosis in left-sided colonic resection. METHODS: A non-randomized prospective data collection was performed for patients undergoing an elective left-sided colon resection, followed by an anastomosis using the CAR™ 27 between November 2009 and January 2011. Eligibility criteria of the use of the CAR™ 27 were anastomoses between the colon and at or above the intraperitoneal rectum. The primary short-term clinical endpoint, rate of anastomotic leakage, and other clinical outcomes, including intra- and postoperative complications, length of operation time and hospital stay, and the ring elimination time were evaluated. RESULTS: A total of 79 patients (male, 43; median age, 64 years) underwent an elective left-sided colon resection, followed by an anastomosis using the CAR™ 27. Colectomy was performed laparoscopically in 70 patients, in whom two patients converted to open procedure (2.9%). There was no surgical mortality. As an intraoperative complication, total disruption of the anastomosis occurred by premature enforced tension on the proximal segment of the anastomosis in one patient. The ring was removed and another new CAR™ 27 anastomosis was constructed. One patient with sigmoid colon cancer showed postoperative anastomotic leakage after 6 d postoperatively and temporary diverting ileostomy was performed. Exact date of expulsion of the ring could not be recorded because most patients were not aware that the ring had been expelled. No patients manifested clinical symptoms of anastomotic stricture. CONCLUSION: Short-term evaluation of the CAR™ 27 anastomosis in elective left colectomy suggested it to be a safe and efficacious alternative to the standard hand-sewn or stapling technique.

Adjuvant Chemotherapy Using the FOLFOX Regimen in Colon Cancer.

PURPOSE: Great progress has been made in the adjuvant treatment of colon cancer. The aim of this study was to evaluate the efficacy of postoperative adjuvant chemotherapy using the FOLFOX regimen in patients with stage III and high-risk stage II colon cancer. METHODS: Eighty-two patients who underwent a potentially curative resection for stage III or high-risk stage II colon cancer were enrolled in this retrospective study. They received FOLFOX4 or modified FOLFOX6. The primary endpoint was disease-free survival. RESULTS: During the median follow-up of 37 months (range, 21 to 61 months), 14 patients experienced disease relapse. The disease-free survival rate at 3 years was 82.9%: 84.6% for stage II and 82.6% for stage III. At the time of the analysis, 8 patients were dead from recurrence. The probability of overall survival at 5 years was 74.5%: 90% for stage II and 74.6% for stage III. Grade 3 or 4 hematologic adverse events included neutropenia (40.2%), anemia (2.4%), and thrombocytopenia (1.2%). Gastrointestinal toxicities included grade 3 or 4 nausea (4.9%) and stomatitis (2.4%). Peripheral sensory neuropathy was observed in 81.7% of the patients during treatment. Of the 11 patients (13.4%) who had grade 3 peripheral sensory neuropathy during treatment, grade 3 symptoms were persistent in 3 patients with gait disturbance at the time of analysis. No treatment-related deaths were recorded. CONCLUSION: Postoperative chemotherapy using the FOLFOX regimen, oxaliplatin in combination with 5-fluorouracil and leucovorin, is effective and tolerable in patients with stage III and high-risk stage II colon cancer.