(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.

Structure of human low-density lipoprotein subfractions, determined by X-ray small-angle scattering.

The structure of low-density lipoprotein (LDL) particles from three different density ranges (LDL-1: d = 1.006-1.031 g/ml; LDL-3: d = 1.034-1.037 g/ml; LDL-6: d = 1.044-1.063 g/ml) was determined by X-ray small-angle scattering. By using a theoretical particle model, which accounted for the polydispersity of the samples, we were able to obtain fits of the scattering intensity that were inside the noise interval of the measured intensity. The assumption of deviations from radial symmetry is not supported by our data. This implies a spread-out conformation of the apolipoprotein B (apoB) molecule, which appears to be localized in the outer surface shell. A globular structure is not consistent with our data. Furthermore, different models exist concerning the structure of the cholesterol ester core below the phase transition temperature. The electron density data suggest an arrangement in which the steroid moieties are localized at average radii of 3.2 and 6.4 nm. Model calculations show that packing problems can only be avoided if approximately half of the acyl chains of each shell are pointing towards the center of the particle, the other half towards the surface. This arrangement of the acyl chains has never been proposed before. The LDL particles of different density classes differ mainly with respect to the size of the core but also with respect to the width of the surface shells. Model calculations show that the size of different LDL particles can be accurately predicted from the compositional data.

Influence of probucol administration on lipoprotein cholesterol and apolipoproteins in normolipemic males.

In order to interpret the known lipoprotein changes in probucol-treated patients, serum concentrations of apolipoproteins (A-I, A-II, B, C-II, C-III, E) were measured before, during and after probucol administration (2 X 500 mg p.d.), in 16 healthy males (30.3 +/- 5.6 years old). Cholesterol concentrations were determined in LDL and VLDL fractions as well as in HDL subfractions which were isolated by preparative ultracentrifugation. In addition, apolipoprotein A-I and A-II concentrations were measured in the HDL subfractions. Compared with the baseline values, significant apolipoprotein changes were found in the serum apolipoprotein A-I (151 +/- 18 to 115 +/- 31 mg/dl; P less than 0.001) and C-II levels during administration. The HDL subfraction analysis showed that the decrease of HDL-cholesterol and apolipoprotein A-I (59.9 +/- 23.5 to 34.4 +/- 16.4 mg/dl, P less than 0.001, and 65.7 +/- 49.0 to 37.5 +/- 23.5 mg/dl, P less than 0.05, respectively) was predominantly related to the HDL2b subfraction (d = 1.063-1.100 g/ml).

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.

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)

Probucol, incorporated into LDL particles in vivo, inhibits generation of lipid peroxides more effectively than endogenous antioxidants alone.

One of the first steps in lipid autoxidation leads to the generation of lipid peroxides (LPO). The time course of LPO generation during Cu++ catalyzed oxidation of LDL before and after treatment with probucol was determined in this study. Before analysis the samples had been stored for about 3 years at -20 degrees C. The results show that in LDL samples without probucol the total antioxidative potential had been depleted during the long-term storage. In contrast, LDL containing probucol showed almost no signs of lipid autoxidation. In addition, the ratio of vitamin E to cholesterol was significantly higher in serum samples containing probucol. We conclude that, in vivo, probucol is incorporated into LDL particles in concentrations high enough to inhibit even early steps of lipid autoxidation.

Apolipoprotein profile in healthy males and its relation to maximum aerobic capacity (MAC).

In order to document possible variations of apolipoproteins in relation to the maximum aerobic capacity, 36 healthy young males of different aerobic performance were examined and the serum concentrations of apolipoprotein A-I, A-II, B, C-II, C-III, E investigated. In contrast to all other lipoproteins, significant differences between the endurance-trained and control subjects could be found in the apo A-I concentrations only (1025 +/- 92 vs 1456 +/- 179 mg/l, p less than 0.001). In addition, the apolipoprotein A-II, B, C-II, C-III, E concentrations correlated neither with the maximum aerobic capacity values nor with the relative body weight of the subjects.

Distribution of lipoprotein species (LpA-I, LpA-I:A-II) in serum and HDL subfractions of untrained and trained normolipemic men.

The distribution of lipoprotein species (LpA-I, LpA-I:A-II) in serum and within HDL subfractions (HDL2b, HDL2a, HDL3) was examined in 26 sedentary and 19 endurance trained normolipemic male individuals. The concentrations of lipids and apolipoproteins in serum and HDL subfractions and the concentrations of LpA-I and LpA-I:A-II were determined. Significant differences (Mann-Whitney-U-test) were found in serum concentrations of apoB (P < 0.05), apoA-II (P < 0.01) and LpA-I:A-II (P < 0.001). In HDL3 apoA-II concentration was significantly lower in the trained group (P < 0.05) but in HDL2 subclasses the concentrations of apoA-I and apoA-II did not differ between the groups. Despite similar concentrations of the two apolipoproteins, there were difference in the distribution of lipoprotein species within HDL2 subfractions. The concentrations of LpA-I did not differ, but the concentrations of LpA-I:A-II particles were higher in the trained group. Untrained and trained had similar concentrations of apoA-II (in HDL2b) but obviously more apoA-II containing particles and this leads to the assumption that within HDL2 of endurance trained individuals LpA-I:A-II particles have a lower apoA-II content compared with particles of untrained individuals. The data emphasize, that normolipemic individuals of different maximum oxygen uptake have a different distribution and composition of lipoprotein species (LpA-I, LpA-I:A-II).

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.

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.

[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.

[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.

[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.

[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.

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.

Influence of acute maximal exercise on lecithin:cholesterol acyltransferase activity in healthy adults of differing aerobic performance.

To document the possible influence of a single episode of maximal aerobic stress on the serum lecithin:cholesterol acyltransferase (LCAT) activity in subjects with differing histories of training, two groups of healthy male adults [controls (C), n = 18, 28.6 years, SD 5.2, 50.1 ml.kg-1.min-1 maximal O2 uptake (VO2max), SD 5.3; endurance trained athletes (T), n = 18, 31.4 years, SD 8.8, 65.0 ml.kg-1.min-1 VO2max, SD 2.8] were examined in a maximal aerobic stress test. In addition to the routine assessment of lipid status, LCAT activity was measured immediately before and after exercise. At rest nearly identical LCAT activity values were found in both groups: C 64.4 nmol.ml-1.h-1, SD 16.7 vs T 65.0 nmol.ml-1.h-1, SD 20.9. The post-exercise LCAT values induced by the maximal stress test increased significantly to (C) 95.7 nmol.ml-1.h-1, SD 23.5, +48.6%, P less than 0.001; (T) 83.5 nmol.ml-1.h-1, SD 24.3, +29.1%, P less than 0.01. Neither the pre nor the postexercise individual LCAT activity values showed any significant correlation to the corresponding data on physical performance.