Effects of high-intensity training on fatty infiltration in paraspinal muscles in elderly males with osteosarcopenia - the randomized controlled FrOST study.

BACKGROUND: Osteosarcopenia is a common geriatric syndrome with an increasing prevalence with age, leading to secondary diseases and complex consequences such as falls and fractures, as well as higher mortality and frailty rates. There is a great need for prevention and treatment strategies. METHODS: In this analysis, we used magnetic resonance imaging (MRI) data from the randomised controlled FrOST trial, which enrolled community-dwelling osteosarcopenic men aged > 72 years randomly allocated to 16 months of twice-weekly high-intensity resistance training (HIRT) or a non-training control group. MR Dixon imaging was used to quantify the effects of HIRT on muscle fat infiltration in the paraspinal muscles, determined as changes in muscle tissue, fat faction and intermuscular adipose tissue (IMAT) in the erector spinae and psoas major muscles. Intention-to-treat analysis with multiple imputation was used to analyse the data set. RESULTS: After 16 months of intervention, 15 men from the HIRT and 16 men from the CG were included in the MRI analysis. In summary, no positive effects on the fat infiltration of the erector spinae and psoas major muscles were observed. CONCLUSIONS: The previously reported positive effects on lumbar spine bone mineral density (BMD) suggest that mechanotransduction induces tropic effects on bone, but that fat infiltration of the erector spinae and psoas major muscles are either irreversible or, for some unknown reason, resistant to exercise. Because of the beneficial effects on spinal BMD, HIRT is still recommended in osteosarcopenic older men, but further research is needed to confirm appropriate age-specific training exercises for the paraspinal muscles. The potential of different MRI sequences to quantify degenerative and metabolic changes in various muscle groups must be better characterized. TRIAL REGISTRATIONS: FrOST was approved by the University Ethics Committee of the Friedrich-Alexander University of Erlangen-Nürnberg (number 67_15b and 4464b) and the Federal Office for Radiation Projection (BfS, number Z 5-2,246,212 - 2017-002). Furthermore, it fully complies with the Declaration of Helsinki and is registered at ClinicalTrials.gov: NCT03453463 (05/03/2018). JAMA 310:2191-2194, 2013.

Effect of High-Intensity Resistance Training Versus Endurance Training on Irisin and Adipomyokine Levels in Healthy Individuals: An 8-Week Interventional Study.

Background: Irisin and adipomyokine are proteins secreted by the body during exercise and exhibit potential therapeutic effects for chronic disorders. Gaining insights into how high-intensity resistance training and endurance training influence irisin and adipomyokine secretion could shed light on optimizing exercise regimens for potential therapeutic applications. Such knowledge could pave the way for personalized exercise prescriptions and contribute to the development of novel treatments for chronic conditions, enhancing overall health and well-being. Objectives: To investigate the effects of high-intensity resistance training (HIRT) and endurance training on irisin and adipomyokine levels in healthy individuals. Methods: An 8-week interventional comparative study was conducted at Nimra Institute of Medical Sciences, Andhra Pradesh, India. One hundred healthy male individuals aged 21 to 35 were divided into two groups: HIRT and endurance. The HIRT group performed high-intensity resistance training, while the endurance group performed endurance training. Ethical approval was obtained, and baseline and post-intervention values of the participants were recorded and analyzed using SPSS software. Results: After 8 weeks, irisin levels were significantly elevated in the HIRT group (167.39±11.27) compared to the endurance group (155.39±11.28). A positive correlation was observed between skeletal muscle and irisin levels in both the HIRT group (χ2-16.38; p=0.04) and the endurance group (χ2-18.36; p=0.01). Additionally, TNF-α (HIRT: 81.47±4.02 and Endurance: 61.19±4.00) and interleukin-6 (IL-6) (HIRT: 46.84±4.46 and Endurance: 36.15±3.89) levels significantly increased in the HIRT group. However, there was no significant change in leptin levels in either group (HIRT: 3.75±0.58 0.58 and 4.15±0.58). Conclusion: The findings of this study indicate that HIRT is more effective in increasing irisin levels compared to endurance training. However, the notable elevation of IL-6 and TNF-α in the HIRT group raises concerns about potential chronic inflammation. To optimize outcomes, a combined approach, coupling HIRT and endurance training, may be beneficial. Additionally, the results emphasize the significance of skeletal muscle as a primary source of irisin secretion, implying that increased muscle contraction contributes to higher irisin release even in healthy individuals. These insights can guide exercise prescriptions and potentially enhance therapeutic strategies for chronic disorders.

Beneficial Molecular Adaptations In BRCA-Mutation Carriers By Combined HIT/HIRT Intervention: Results From A Pilot Study.

: Based on growing evidence that breast cancer (BRCA) also plays a pivotal role in the regulation of skeletal muscle metabolism and the response to anti-oxidative stress, we examined the influence of regular exercise in human BRCA mutation carriers on their BRCA1 gene/protein expression and inflammatory/oxidative response. Sixteen BRCA-mutation carriers were assigned to an intervention (IG) or control group (CG). IG received a combination of high-intensity interval endurance (HIT) and strength training (HIRT) for six weeks, whereas CG received a low-intensity activity program. Before (T0) and at the end of the intervention (T1), muscle biopsy, physiological performance, blood withdrawal and anthropometry were obtained. Parameters included: Muscle BRCA1 gene/protein expression, inflammatory/oxidative stress, anti-oxidative capacity, peak oxygen capacity (VO2peak) and 1-repetition maximum (1-RM) at six different training machines. VO2peak and 1-RM of IG were increased at T1 compared to T0, whereas CG performance, physiological and molecular parameters remained unchanged. IG showed increased BRCA1 protein concentration as well as anti-oxidative capacity, whereas gene expression was unaltered. IG inflammatory and oxidative damage did not differ between time points. Combined HIT/HIRT increases aerobic and strength performance of BRCA-mutation carriers with up regulated BRCA1 protein expression and improved anti-oxidative status without showing an increased inflammatory response.

The Favorable Effects of a High-Intensity Resistance Training on Sarcopenia in Older Community-Dwelling Men with Osteosarcopenia: The Randomized Controlled FrOST Study.

PURPOSE: Sarcopenia, the loss of muscle mass combined with the loss of muscle function, has become a public health issue. There is an urgent need for interventions. The study aimed to determine the effect of high-intensity resistance training (HI-RT), a time- and cost-efficient training modality, on sarcopenia in osteosarcopenic (OS) older men. METHODS: Forty-three community-dwelling men aged ≥72 years from Northern Bavaria, Germany, with OS were randomly assigned to either an active HI-RT group (HI-RT) or an inactive control group (CG). Both received dietary protein (up to 1.5 g/kg/day in HI-RT and 1.2 g/kg/day in CG) and Vitamin-D (up to 800 IE/d) supplements. The HI-RT was applied as a consistently supervised single-set training on resistance exercise machines using intensifying strategies, with two training sessions/week, structured into three phases (ranging from 8 to 12 weeks) totaling 28 weeks. The primary study endpoint was the Sarcopenia Z-score; secondary endpoints were changes in the underlying physiological parameters, skeletal muscle mass index (SMI), handgrip-strength and gait velocity. RESULTS: The results show a significant effect of the exercise intervention on the sarcopenia Z-score in the HI-RT (p<0.001) and a significant worsening of it in the CG (p=0.012) in the intention-to-treat analysis, as well as a significant intergroup change (p<0.001). Analysis upon the underlying parameters showed a significant increase of skeletal muscle mass index (SMI) in the HI-RT group (p<0.001) and a significant intergroup difference of SMI (p<0.001) and handgrip strength (p<0.001). There were no adverse effects related to dietary supplementation or training. CONCLUSION: The results clearly confirm the favorable effects of HI-RT on sarcopenia. We conclude that HI-RT is a feasible, highly efficient and safe training modality for combating sarcopenia, also in the elderly.

Anatomy in the Third Reich - The Anatomical Institute of the Reichsuniversität Strassburg and the deliveries of dead bodies.

August Hirt (1898-1945) was director of the Institute of Anatomy of the Reichsuniversität Strassburg from November 1941 to November 1944. During this period, he was involved in many criminal activities: mustard gas experiments on prisoners of KL Natzweiler-Struthof, creating a collection of Jewish skeletons by gassing 86 Jews from KL Auschwitz in the Struthof-Natzweiler gas chamber, and involvement in experiments on phosgene gas performed by Otto Bickenbach. Extensive literature exists on these crimes. However, there has been very little work completed on the so-called normal activity of the Institute of Anatomy of which he was head and in particular the question of deliveries of corpses. We estimate that between 244 and 724 bodies were delivered to the Anatomical Institute of the Reichsuniversität Strassburg between 1942 and 1944. In the course of our investigations, we have determined the identity of 232 corpses received between 1942 and 1944, the vast majority of Soviet prisoners of war from two hospitals for prisoners of war (Strassburg and Mutzig). Other sources of dead bodies have been found, such as hospital patients and French citizens who had been executed by shooting. Most of the corpses were used for dissection by medical students, but many anatomical preparations were also made from the bodies. The bodies were buried during and after the war, but the fate of the anatomical and histological specimens is unknown. Newly discovered archival record allowed us to identify and find three jars with tissues from the 86 gassed Jews. These pieces were in the Museum of the Institute of Forensic Medicine of Strasbourg. At this point the following proposals are made: (1) opening of the Medical Faculty of Strasbourg archives, (2) creation of an historical commission, (3) identification and publication of the complete inventory of all preparations at the Strasbourg Anatomical Museum, (4) research of the fate of the dry and wet preparations made under National Socialism, (5) verification of histological slides, embryological specimens and the tissues from the institutes already existing under National Socialism, (6) verification of the pieces of the Museum of Forensic Medicine, (7) publications of these results and information of the press and (8) creation of a memorial for the victims of the NS delivered to the Institute of Anatomy.

The Initial Case Report: Salvage Robotic Assisted Radical Prostatectomy After Heavy Ion Radiotherapy.

Salvage radical prostatectomy is one of treatments after radiation therapy to patients with prostate cancer. To date, no case of the salvage robotic assisted radical prostatectomy (RARP) following heavy ion radiotherapy (HIRT) has been published. We report on a 70-year-old man with a history of HIRT for prostate cancer in 2011. For 3 years after. HIRT, his serum PSA levels were permissible range. However, his PSA levels were increased. We had diagnosis localized prostate cancer after HIRT. We had carried out salvage RARP. Until 10 months after salvage RARP, his PSA level was not detectable.

In Vitro Replication Assay for Merkel Cell Polyomavirus (MCPyV).

Merkel cell polyomavirus (MCPyV) genomes are clonally integrated in tumor cells of ∼95% of all Merkel cell carcinoma (MCC) cases. The virus is highly prevalent; however, where the virus persists and which cell types are permissive for MCPyV replication is still unknown. As a consequence, very little information is available about the life cycle and no fully permissive in vitro replication system has been established. Recently, semi-permissive replication systems based on wild-type MCPyV genomes recovered from the skin of healthy donors or synthetic MCPyV genomes constructed from consensus sequences have been established. The transfection of this intramolecular re-circularized MCPyV DNA into some human cell lines recapitulates efficient DNA replication of the viral genome, viral gene expression as well as moderate levels of virus particle formation. However, serial transmission of infectious virus is still restricted in these cells.

August Hirt and "extraordinary opportunities for cadaver delivery" to anatomical institutes in National Socialism: a murderous change in paradigm.

German anatomical institutes always had problems obtaining sufficient cadavers for research and training. In the National Socialist (NS) period this changed. Universities could count on "extraordinary opportunities for cadaver delivery." Most frequently tacitly, many bodies were those of victims of NS crimes. Scientists increasingly exploited the exceptional political situation to systematically supplement their institutional collections. Their endeavors to fill the, in their terms, "lamentable gaps" in their collections took on truly bizarre forms. In Austria, Jewish cemeteries were plundered for racial-political expansion of anatomical collections. A change in paradigm was merely the next step: intentional murder for the benefit of NS-oriented science. In December of 1942, anatomists meeting in Tübingen discussed plans for "material acquisition." August Hirt, director of the anatomical institute at the Reichsuniversität in Strasbourg, was to develop guidelines. There was express reference to "Auftrag Beger," which had already been conceived although not yet realized: at the behest of Hirt and the SS-scientific organization, "Ahnenerbe," the anthropologists Bruno Beger and Hans Fleischhacker selected 86 Jewish prisoners in Auschwitz in June of 1943 and deported them to the concentration camp at Struthof near Natzweiler, where they were murdered. The bodies were delivered to the anatomy department in Strasbourg for preparation and used as anatomical specimens. The Reichsuniversität Strasbourg was considered a center of excellence for Nazi ideology. For modern scientists, the elucidation of these criminal acts is not exhausted in the search for an answer to the questions of perpetrator, place, modus operandi or motive. A suitable memorial to the victims must go beyond mere quantification.