Exercise diminishes the activity of acetyl-CoA carboxylase in human muscle.

Studies in rats suggest that increases in fatty acid oxidation in skeletal muscle during exercise are related to the phosphorylation and inhibition of acetyl-CoA carboxylase (ACC), and secondary to this, a decrease in the concentration of malonyl-CoA. Studies in human muscle have not revealed a consistent decrease in the concentration of malonyl-CoA during exercise; however, measurements of ACC activity have not been reported. Thus, whether the same mechanism operates in human muscle in response to physical activity remains uncertain. To investigate this question, ACC was immunoprecipitated from muscle of human volunteers and its activity assayed in the same individual at rest and after one-legged knee-extensor exercise at 60, 85, and 100% of knee extensor VO2max. ACC activity was diminished by 50-75% during exercise with the magnitude of the decrease generally paralleling exercise intensity. Treatment of the immunoprecipitated enzyme with protein phosphatase 2A restored activity to resting values, suggesting the decrease in activity was due to phosphorylation. The measurement of malonyl-CoA in the muscles revealed that its concentration is 1/10 of that in rats, and that it is diminished (12-17%) during the higher-intensity exercises. The respiratory exchange ratio increased with increasing exercise intensity from 0.84 +/- 0.02 at 60% to 0.99 0.04 at 100% VO2max. Calculated rates of whole-body fatty acid oxidation were 121 mg/min at rest and 258 +/- 35, 264 +/- 63, and 174 +/- 76 mg/min at 60, 85, and 100% VO2max, respectively. The results show that ACC activity, and to a lesser extent malonyl-CoA concentration, in human skeletal muscle decrease during exercise. Although these changes may contribute to the increases in fat oxidation from rest to exercise, they do not appear to explain the shift from mixed fuel to predominantly carbohydrate utilization when exercise intensity is increased.

Decreased insulin action on muscle glucose transport after eccentric contractions in rats.

We have recently shown that eccentric contractions (Ecc) of rat calf muscles cause muscle damage and decreased glycogen and glucose transporter GLUT-4 protein content in the white (WG) and red gastrocnemius (RG) but not in the soleus (S) (S. Asp, S. Kristiansen, and E. A. Richter. J. Appl. Physiol. 79: 1338-1345, 1995). To study whether these changes affect insulin action, hindlimbs were perfused at three different insulin concentrations (0, 200, and 20,000 microU/ml) 2 days after one-legged eccentric contractions of the calf muscles. Compared with control, basal glucose transport was slightly higher (P < 0.05) in Ecc-WG and -RG, whereas it was lower (P < 0.05) at both submaximal and maximal insulin concentrations in the Ecc-WG and at maximal concentrations in the Ecc-RG. In the Ecc-S, the glucose transport was unchanged in hindquarters perfused in the absence or presence of a submaximal stimulating concentration of insulin, whereas it was slightly (P < 0.05) higher during maximal insulin stimulation compared with control S. At the end of perfusion the glycogen concentrations were lower in both Ecc-gastrocnemius muscles compared with control muscles at all insulin concentrations. Fractional velocity of glycogen synthase increased similarly with increasing insulin concentrations in Ecc- and control WG and RG. We conclude that insulin action on glucose transport but not glycogen synthase activity is impaired in perfused muscle exposed to prior eccentric contractions.

Impaired muscle glycogen resynthesis after a marathon is not caused by decreased muscle GLUT-4 content.

Our purpose was to investigate whether the slow rate of muscle glycogen resynthesis after a competitive marathon is associated with a decrease in the total muscle content of the muscle glucose transporter (GLUT-4). Seven well-trained marathon runners participated in the study, and muscle biopsies were obtained from the lateral head of the gastrocnemius muscle before, immediately after, and 1, 2, and 7 days after the marathon, as were venous blood samples. Muscle GLUT-4 content was unaltered over the experimental period. Muscle glycogen concentration was 758 +/- 53 mmol/kg dry weight before the marathon and decreased to 148 +/- 39 mmol/kg dry weight immediately afterward. Despite a carbohydrate-rich diet (containing at least 7 g carbohydrate.kg body mass-1.day-1), the muscle glycogen concentration remained 30% lower than before-race values 2 days after the race, whereas it had returned to before-race levels 7 days after the race. We conclude that the total GLUT-4 protein content is unaltered in the lateral gastrocnemius after a competitive marathon and that the slow recovery of muscle glycogen after the race apparently involves factors other than changes in the total content of this protein.

Eccentric muscle damage transiently decreases rat skeletal muscle GLUT-4 protein.

The effects of concentric and muscle-damaging eccentric contractions on muscle glucose transporter GLUT-4 content were studied in rat muscles. Rats were anesthetized, the calf muscles on one side were stimulated electrically for concentric or eccentric contractions, and bilateral calf muscles were obtained in the postexercise period. Inflammatory and phagocytic cells accumulated in the eccentric white and red gastrocnemius muscles, whereas there were only discrete changes in the eccentric soleus. Glycogen was depleted to the same extent in the white and red gastrocnemius muscles after both types of stimulation, and it remained decreased > 2 days in eccentric muscles. The total GLUT-4 protein content was decreased in the eccentric white and red gastrocnemius muscles 1 and 2 days after the eccentric stimulation, whereas the maximal activity of glycogen synthase was unaffected at these time points. In conclusion, our one-legged stimulation model caused eccentric muscle damage in the white and red gastrocnemius, whereas only minor damage was observed in the soleus muscle. In damaged muscle, muscle glycogen and GLUT-4 protein content were decreased for > 2 days. These findings may suggest (but do not prove) that decreased muscle GLUT-4 protein is involved in the delayed glycogen resynthesis after eccentric exercise.

Prior eccentric contractions impair maximal insulin action on muscle glucose uptake in the conscious rat.

Our aim was to examine the effect of prior eccentric contractions on insulin action locally in muscle in the intact conscious rat. Anesthetized rats performed one-leg eccentric contractions through the use of calf muscle electrical stimulation followed by stretch of the active muscles. Two days later, basal and euglycemic clamp studies were conducted with the rats in the awake fasted state. Muscle glucose metabolism was estimated from 2-[14C(U)]deoxy-D-glucose and D-[3-3H] glucose administration, and comparisons were made between the eccentrically stimulated and nonstimulated (control) calf muscles. At midphysiological insulin levels, effects of prior eccentric exercise on muscle glucose uptake were not statistically significant. Maximal insulin stimulation revealed reduced incremental glucose uptake above basal (P < 0.05 in the red gastrocnemius; P < 0.1 in the white gastrocnemius and soleus) and impaired net glycogen synthesis in all eccentrically stimulated muscles (P < 0.05). We conclude that prior eccentric contractions impair maximal insulin action (responsiveness) on local muscle glucose uptake and glycogen synthesis in the conscious rat.

Muscle glycogen accumulation after a marathon: roles of fiber type and pro- and macroglycogen.

Muscle glycogen remains subnormal several days after muscle damaging exercise. The aims of this study were to investigate how muscle acid-soluble macroglycogen (MG) and acid-insoluble proglycogen (PG) pools are restored after a competitive marathon and also to determine whether glycogen accumulates differently in the various muscle fiber types. Six well-trained marathon runners participated in the study, and muscle biopsies were obtained from the vastus lateralis of the quadriceps muscle before, immediately after, and 1, 2, and 7 days (days 1, 2, and 7, respectively) after the marathon. During the race, 56 +/- 3.8% of muscle glycogen was utilized, and a greater fraction of MG (72 +/- 3.7%) was utilized compared with PG (34 +/- 6.5%). On day 2, muscle glycogen and MG values remained lower than prerace values, despite a carbohydrate-rich diet, but they had both returned to prerace levels on day 7. The PG concentration was lower on day 1 compared with before the race, whereas there were no significant differences between the prerace PG concentration and the concentrations on days 2 and 7. On day 2 the glycogen concentration was particularly low in the type I fibers, indicating that local processes are important for the accumulation pattern. We conclude that a greater fraction of human muscle MG than of PG is utilized during a marathon and that accumulation of MG is particularly delayed after the prolonged exercise bout. Furthermore, factors produced locally appear important for the glycogen accumulation pattern.

Effect of eccentric exercise on natural killer cell activity.

The effect of eccentric one-legged exercise on natural killer (NK) cell activity was studied in eight healthy males. To distinguish between local and systemic effects, blood samples were collected from veins in the exercising leg and resting arm. However, the results did not significantly differ between the leg and arm. To eliminate diurnal variations, the results were compared with a control group that did not exercise but had blood samples collected at the same time points. In the exercising group, plasma creatine kinase increased progressively during and up to 4 days after exercise. The percentage of CD16+ NK cells increased during exercise, which was paralleled by an increase in the NK cell activity per fixed number of blood mononuclear cells. The NK cell activity on a per NK cell basis did not change. The percentage of CD3+, CD4+, CD8+, CD19+, and CD14+ cells did not change significantly during exercise. The present study thus showed that eccentric exercise with a relatively small muscle mass (1 quadriceps femoris muscle) causes systemic effects on NK cells. It is suggested that the increase in plasma epinephrine during eccentric exercise is responsible for the observed increase in the percentage of CD16+ cells.

N-3 polyunsaturated fatty acids do not affect cytokine response to strenuous exercise.

The aim of the present study was to investigate whether fish oil supplementation was able to modulate the acute-phase response to strenuous exercise. Twenty male runners were randomized to receive supplementation (n = 10) with 6.0 g fish oil daily, containing 3.6 g n-3 polyunsaturated fatty acids (PUFA), for 6 wk or to receive no supplementation (n = 10) before participating in The Copenhagen Marathon 1998. Blood samples were collected before the race, immediately after, and 1.5 and 3 h postexercise. The fatty acid composition in blood mononuclear cells (BMNC) differed between the fish oil-supplemented and the control group, showing incorporation of n-3 PUFA and less arachidonic acid in BMNC in the supplemented group. The plasma levels of tumor necrosis factor-alpha, interleukin-6, and transforming growth factor-beta(1) peaked immediately after the run, the increase being 3-, 92-, and 1.1-fold, respectively, compared with resting samples. The level of interleukin-1 receptor antagonist peaked 1.5 h after exercise, with the increase being 87-fold. However, the cytokine levels did not differ among the two groups. Furthermore, supplementation with fish oil did not influence exercise-induced increases in leucocytes and creatine kinase. In conclusion, 6 wk of fish oil supplementation had no influence on the acute-phase response to strenuous exercise.

Patient-handling skill, back injuries, and back pain. An intervention study in nursing.

The aim of this intervention was to evaluate the effect of training on patient-handling skills and prospectively to assess the effect of skill on subsequent back pain and back injuries in nursing. Of a total of 255 nurses, 199 were assessed for their skill in patient-handling. One-half (control group) received traditional training in patient-handling, and the other half (trained group) received a curriculum of instruction totaling 40 hours. The skills of both groups were assessed on graduation. The control group was rated as less competent in patient-handling. Nurses in both groups were questioned about the prevalence of back pain and incidence of back injuries in the first year after graduation. In multiple regression analysis, the major risk indicators for back injuries were poor patient-handling skill, low numbers of repetitions in the sit-up test, and high work-load scores. High score on the hysteria scale of Middlesex Hospital Questionnaire was a risk indicator for all kinds of back pain. Though back pain was independent of patient-handling skill, those rated as "bad" or "poor" had more back injuries (24%) than those who had been rated as "good" or "excellent" (2%) (P less than 0.001), but the difference between the trained and control groups was not statistically significant. It was concluded that back injuries may be prevented by the teaching of patient-handling skills.

Confounding by variable smoking habits in different occupational groups.

Smoking habits of different occupational groups were studied in a sample of persons who participated in health screening examinations carried out by the mobile clinic of the Institute of Occupational Health (Helsinki, Finland). The sample consisted of 1 990 men and 1 044 women. The smoking habits of the study population as a whole conformed with those of the entire Finnish population. Distinct differences in smoking habits were found, however, in different occupational groups. The effect of smoking habits on tentative rate ratios of lung cancer in occupational groups were estimated with a procedure presented by Olav Axelson. The groups were selected from extreme ends of the smoking habit variable. Extreme estimates were taken to maximize the confounding effect of smoking. When occupational groups were contrasted with the general population, the confounding effect was found to be smaller than usually believed.

Mortality of 2,4-dichlorophenoxyacetic acid and 2,4,5-trichlorophenoxyacetic acid herbicide applicators in Finland: first report of an ongoing prospective cohort study.

Some recent epidemiologic studies have suggested that chlorinated phenoxy acid herbicides are human carcinogens. The mortality experience in a cohort of 1,926 men who had sprayed 2,4-dichlorophenoxyacetic acid (2,4-D) and 2,4,5-trichlorophenoxyacetic acid (2,4,5-T) during 1955-1971 has been followed prospectively from 1972 to 1980. The total phenoxy acid exposure was generally rather low because the duration of work had mostly been less than two months. In 1972-1976 mortality from all natural causes in the cohort was only 54% of the expected value (based on age-specific rates for the general population), and in the succeeding 4-a period 81% of the expected value. In the assessment of cancer, mortality allowance was made for 10- and 15-a periods of latency between the first exposure and the start of the recording of vital status during the follow-up. No increase in cancer mortality was detected, and the distribution of cancer types was unremarkable. No cases of death from lymphomas or soft tissue sarcomas were found. The study results must, however, be viewed with great caution owing to the small size of the cohort, the low past exposure, and the brief follow-up period.

Exposure-response relationship between styrene exposure and central nervous functions.

For the study of the relationship between styrene exposure and symptoms and signs of central nervous dysfunctions, 98 male workers occupationally exposed to styrene were given clinical, neurophysiological and psychological examinations; also a symptom survey was made. Urinary mandelic acid concentrations, measured once a week during five consecutive weeks, were used to express the exposure intensity. Different unexposed groups were used for reference. No exposure-response relationship was observed between symptoms of ill health and the urinary mandelic acid concentration, although the exposed group as a whole expressed significantly more symptoms than the reference group. The occurrence of abnormal electroencephalograms was about 10% in the group of workers with mandelic acid concentrations below 700 mg/l, but it was 30% among those whose mandelic acid concentration exceeded 700 mg/l, a level corresponding to the 8-h time-weighted average (TWA) of styrene exposure of about 30 ppm. With regard to psychological functions, the first change in visuomotor accuracy became discernible when the urinary mandelic acid concentration exceeded 800 mg/l. A more pronounced decrement appeared in both visuomotor accuracy and psychomotor performance when the mandelic acid concentration exceeded 1,200 mg/l, which corresponds to an 8-h TWA of styrene exposure of about 55 ppm.

Preliminary results from a cohort of workers exposed to wollastonite in a Finish limestone quarry.

Wollastonite metasilicate fibers are rather similar in form, length, and diameter, but mineralogically different, to amphibole asbestos fibers. We have studied immunologic findings from 46 men exposed to wollastonite at a limestone quarry for at least 10 years. These workers showed a higher prevalence of positive serum rheumatoid factors than blood donors did. This finding resembles the one detected among asbestos workers. The group of wollastonite workers with radiological signs of pulmonary fibrosis had activities of serum angiotensin-converting enzyme that were similar to those of wollastonite workers without fibrosis. A mortality study of 238 quarry workers with 5,769 person-years was, as expected, nonpositive. It was interesting that one woman with 20 years of exposure to wollastonite and with no other known exposure to fibers revealed a malignant retroperitoneal mesenchymal tumor 30 years after the initial exposure. This kind of very rare tumor is difficult to distinguish from mesothelioma. However, this is only one case, and it is impossible to draw any definite conclusions.

Training effects on muscle glucose transport during exercise.

Muscle glucose uptake is increased during exercise compared to rest. In general, muscle glucose uptake increases with increasing exercise intensity and duration. Whereas the arterio-venous concentration difference only increases 2-4-fold during exercise compared with rest the increase in muscle perfusion in 10-20 times and therefore quantitatively very important. During exercise the surface membrane glucose transport capacity increases in skeletal muscle primarily due to an increase in surface membrane GLUT4 protein content. Endurance training decreases muscle glucose uptake during exercise at a given absolute submaximal work-load despite a large increase in muscle GLUT4 protein content. We have shown that this decrease in glucose uptake at least in part is due to a blunted exercise-induced increase in sarcolemmal glucose transport capacity secondary to a blunted increase in sarcolemmal GLUT4 transporter number. Thus, endurance training leads to a marked reduction of the fraction of muscle GLUT4 that is translocated during a given submaximal exercise bout. Whether this is true also during exercise at higher intensities remains to be seen.

Doctors' drinking habits and consumption of alcohol.

Alcohol consumption and drinking habits among Finnish doctors were studied as part of a survey of stress and burnout. A questionnaire containing 99 questions or groups of questions was sent to all 3496 practising doctors aged under 66 randomly selected from the registry of the Finnish Medical Association. Altogether 2671 doctors (76%) responded; this sample was representative of the Finnish medical profession. The average weekly consumption of alcohol during the past year and various aspects of drinking behaviour were assessed, and the presence or absence of symptoms and diseases often encountered among heavy drinkers and addicts was determined. The data were analysed separately for men and women, for those aged less than or equal to 40 and greater than 40, and for the men with high and low alcohol consumption and with high and low scores on the index of drinking habits. Selected variables related to work, stress, and coping were correlated with alcohol consumption and drinking behaviour. The median consumption of alcohol among male doctors was 4876 g (6.2 litres) and among female doctors 2226 g (2.8 litres) of absolute alcohol per person per year and was higher in those aged over 40. Beer was most commonly drunk by men and wine by women. Increased alcohol consumption was associated with older age, disappointment with career, heavy smoking, use of benzodiazepines, stress and burnout symptoms, suicidal thoughts, general dissatisfaction, and diseases related to alcohol. Drinking habits were heavier among doctors working in community health centres, those taking long sick leaves, younger doctors disappointed with their careers or the atmosphere at work, and older doctors immersed in their work. Alcohol consumption among doctors seems to be higher than that of the general population in Finland, and heavy drinking seems to be associated with stress and burnout.

Dynamic maceration of Matricaria chamomilla inflorescences: optimal conditions for flavonoids and antioxidant activity

ABSTRACT The aim of this paper was to study and optimize the dynamic maceration process to obtain Matricaria chamomilla L., Asteraceae, inflorescences extracts with optimum flavonoid content and antioxidant activity using a multivariate approach. Hydroalcoholic extracts were obtained by dynamic maceration in lab scale and the influence of extraction temperature, ratio of plant to solvent, ethanol strength; extraction time and stirring speed on the flavonoid content and antioxidant activity were unveiled using a fractional factorial design. The ethanol strength, ratio of plant to solvent and temperature were the three factors that influenced most the extract properties and were studied by a central composite design. Total flavonoid content and antioxidant activity were affected by the ethanol strength and ranged from 1.49 to 3.95% and 13.3 to 36.2 µg/ml, respectively. The desirability functions resulted in an optimal dynamic maceration condition using 1 h extraction at stirring speed of 900 rpm, ethanol 74.7%, temperature of 69 °C and using 36.8% of plant in solvent (w/v). Under this set of conditions, the extract had total flavonoid content of 4.11 ± 0.07%, in vitro antioxidant activity with IC50 of 18.19 µg/ml and apigenin and apigenin-7-glycoside contents of 2.0 ± 0.1 mg/g and 20.1 ± 0.9 mg/g, respectively. The results showed a low solvent consumption compared to previous works. The model was able to predict extract properties with maximum deviation of 12% and the extraction process developed herein showed to be reliable, efficient and scalable for M. chamomilla inflorescences, enriched with flavonoids, apigenin and apigenin-7-glycoside and high antioxidant activity.

Effect of prior eccentric contractions on lactate/H+ transport in rat skeletal muscle.

The effect of prior eccentric contractions on skeletal muscle lactate/H+ transport was investigated in rats. Lactate transport was measured in sarcolemmal giant vesicles obtained from soleus and red (RG) and white gastrocnemii (WG) muscles 2 days after intense eccentric contractions (ECC) and from the corresponding contralateral control (CON) muscles. The physiochemical buffer capacity was determined in the three muscle types from both ECC and CON legs. Furthermore, the effect of prior eccentric contractions on release and muscle content of lactate and H+ during and after supramaximal stimulation was examined using the perfused rat hindlimb preparation. The lactate transport rate was lower (P < 0.05) in vesicles obtained from ECC-WG (29%) and ECC-RG (13%) than in vesicles from the CON muscles. The physiochemical buffer capacity was reduced (P < 0.05) in ECC-WG (13%) and ECC-RG (9%) compared with the corresponding CON muscles. There were only marginal effects on the soleus muscle. Muscle lactate concentrations and release of lactate during recovery from intense isometric contractions were lower (P < 0.05) in ECC than in CON hindlimbs, indicating decreased anaerobic glycogenolysis. In conclusion, the sarcolemmal lactate/H+ transport capacity and the physiochemical buffer capacity were reduced in prior eccentrically stimulated WG and RG in rats, suggesting that muscle pH regulation may be impaired after unaccustomed eccentric exercise. In addition, the data indicate that the glycogenolytic potential is decreased in muscles exposed to prior eccentric contractions.

Mortality among Finnish doctors, 1953-1972.

The mortality with respect to the total population of Finnish physicians during the period 1953 to 1972 has been analysed and compared with the corresponding statistics for the general Finnish population, for Finnish foundry workers, and for American physicians. It was found that the overall mortality was lower for male physicians than that for the general population or for foundry workers, but was clearly higher than that for American physicians. Male physicians did not exhibit any major differences from the general population with regard to cardiovascular diseases and suicide, but had a lower mortality from malignant neoplasms, accidents and "other diseases" (including infectious diseases). The explanation of cancer mortality being lower than expected among male physicians was mainly to be found in a deficit in lung cancer. Although female physicians had higher life expectancy than male physicians and the female general Finnish population, they did not show any clear deficit for cancer. In respect of all specialists, surgical specialists had the lowest mortality; general practitioners had the highest mortality. Most of these variations were attributable to differences in coronary mortality, but mortality from lung cancer was also remarkably low among surgeons. Differences of a similar type were also found between occupational sub-categories; private practitioners had the highest, and research workers and central hospital physicians the lowest mortality figures. The lower cancer mortality among male physicians, as contrasted with the general population, is probably attributable to differences in smoking habits; about 22% of male physicians smoked in 1973, whereas earlier studies by others have indicated that the corresponding proportion was about 50% in the general population. In contrast, the differences in mortality between different specialist categories probably arises from other factors, since Finnish physicians reportedly display a relatively homogeneous smoking pattern.