RÉSUMÉ
Marine n-3 polyunsaturated fatty acids (PUFAs) may improve cardiovascular, renal, and mental health. No previous trial has investigated the effects of marine n-3 PUFA supplementation on quality of life (QoL) indices after renal transplant. METHODS: In this trial, 132 renal transplant recipients were randomized to receive daily either 2.6 g of marine n-3 PUFAs or an equivalent dose of olive oil (controls) on top of standard care for 44 weeks. We used a Short Form 36 (SF-36) questionnaire at baseline (8 weeks post transplant) and at the end of the study (1 year after transplant) to assess QoL. Results were expressed as net change (Δ) in SF-36 individual and composite mental and physical scores during follow-up. RESULTS: We found no improvement of Δ SF-36 individual or composite scores after marine n-3 PUFA supplementation compared with controls. In per-protocol analysis, patients who received marine n-3 PUFAs had a Δ emotional role function (mean, 17% [SD, 50%] vs mean, 3% [SD, 37%]; P = .11). In addition, plasma marine n-3 PUFA levels showed a weak but statistically significant correlation with Δ composite mental function score (r = .18; P = .04). CONCLUSION: Marine n-3 PUFA supplementation did not improve QoL after renal transplant.
Sujet(s)
Compléments alimentaires , Acides gras omega-3/administration et posologie , Transplantation rénale , Qualité de vie , Adulte , Sujet âgé , Femelle , Humains , Transplantation rénale/psychologie , Mâle , Adulte d'âge moyen , Enquêtes et questionnaires , Receveurs de transplantation/psychologieRÉSUMÉ
BACKGROUND: There are major gaps in the understanding of sexual and reproductive health in female renal transplant recipients. METHODS: In this Norwegian multicenter retrospective observational study, 118 female renal transplant recipients aged 22 to 49 years responded to a questionnaire on fertility, contraceptive use, and pregnancy. RESULTS: More than one-third (37%) of patients reported that they did not receive advice on contraceptive methods from health care personnel in the early post-transplant phase. These women used effective contraceptive methods less often. Nearly half of the patients (45%) reported that they had not received any advice on timing of conception after transplant. From 95 pregnancies after renal transplant, 52 (55%) resulted in live births. CONCLUSION: Counseling on contraceptive methods should be part of standard care in conjunction with transplantation. More than one-third of young female renal transplant recipients of reproductive age could not recall having received advice from health care personnel about contraceptive use, and nearly half of the patients did not receive preconceptional advice after transplant. Although the current study does not discriminate between lack of advice and recall bias, the findings signal the need for improved counseling on female sexual and reproductive health after renal transplant.
Sujet(s)
Contraception , Assistance , Fécondité , Transplantation rénale , Receveurs de transplantation/enseignement et éducation , Adulte , Femelle , Humains , Adulte d'âge moyen , Norvège , Grossesse , Études rétrospectives , Comportement sexuel , Jeune adulteRÉSUMÉ
BACKGROUND/OBJECTIVES: Cardiovascular (CV) disease is the leading cause of death after renal transplantation. Marine n-3 polyunsaturated fatty acids (PUFAs) exert potential cardio-protective metabolic effects and might reduce CV morbidity and mortality in renal transplant recipients (RTRs). SUBJECTS/METHODS: In this cross-sectional study of 1990 Norwegian RTRs, transplanted between 1999 and 2011, associations between plasma phospholipid marine n-3 PUFA levels and various CV risk markers at 10 weeks after transplant were evaluated. RESULTS: Higher plasma marine n-3 PUFA levels were associated with lower resting heart rate (rHR), lower fasting plasma glucose (fPG) levels, lower plasma triglyceride levels and higher plasma high-density lipoprotein (HDL) cholesterol levels. Plasma levels of eicosapentaenoic acid, but not docosahexaenoic acid, showed a positive association with plasma HDL cholesterol levels. Plasma marine n-3 PUFA levels were not associated with plasma low-density lipoprotein cholesterol levels, pulse wave velocity or systolic and diastolic blood pressure. A negative association between plasma marine n-3 PUFA levels and CV mortality was weakened by additional adjustment for plasma triglyceride levels and rHR. The ratio of n-6 to n-3 PUFAs showed similar associations with CV risk markers as absolute plasma marine n-3 PUFA levels. CONCLUSIONS: This is the first study in RTRs showing that marine n-3 PUFAs are negatively associated with rHR and fPG in addition to beneficial effects on plasma HDL cholesterol and triglyceride levels. Especially, effects on autonomic nervous function and triglyceride metabolism might contribute to explain the lower CV mortality risk with higher plasma marine n-3 PUFA levels previously shown in this cohort.
Sujet(s)
Glycémie/métabolisme , Maladies cardiovasculaires/prévention et contrôle , Cholestérol HDL/sang , Acides gras omega-3/sang , Rythme cardiaque/effets des médicaments et des substances chimiques , Transplantation rénale/effets indésirables , Triglycéride/sang , Adulte , Pression sanguine/effets des médicaments et des substances chimiques , Maladies cardiovasculaires/sang , Maladies cardiovasculaires/étiologie , Études de cohortes , Études transversales , Régime alimentaire , Matières grasses alimentaires/sang , Matières grasses alimentaires/pharmacologie , Acides gras omega-3/pharmacologie , Femelle , Huiles de poisson/sang , Humains , Rein/chirurgie , Mâle , Adulte d'âge moyen , Norvège , Phospholipides/métabolisme , Analyse de l'onde de pouls , Facteurs de risque , Produits de la merRÉSUMÉ
OBJECTIVES: Endoplasmic reticulum (ER) stress has been implicated in both pre-eclampsia (PE) and fetal growth restriction (FGR), and is characterised by activation of three signalling branches: 1) PERK-pEIF2α, 2) ATF6 and 3) splicing of XBP1(U) into XBP1(S). To evaluate the contribution of ER stress in the pathogenesis of PE relative to FGR, we compared levels of ER stress markers in decidual tissue from pregnancies complicated by PE and/or FGR. STUDY DESIGN: Whole-genome transcriptional profiling was performed on decidual tissue from women with PE (n = 13), FGR (n = 9), PE+FGR (n = 24) and controls (n = 58), and used for pathway and targeted transcriptional analyses of ER stress markers. The expression and cellular localisation of ER stress markers was assesses by Western blot and immunofluorescence analyses. RESULTS: Increased ER stress was observed in FGR and PE+FGR, including both the PERK-pEIF2α and ATF6 signalling branches, whereas ER stress was less evident in isolated PE. However, these cases demonstrated elevated levels of XBP1(U) protein. ATF6 and XBP1 immunoreactivity was detected in most (>80%) extravillous trophoblasts, decidual cells and macrophages. No difference in the proportion of immunopositive cells or staining pattern was observed between study groups. CONCLUSIONS: Increased PERK-pEIF2α and ATF6 signalling have been associated with decreased cellular proliferation and may contribute to the impaired placental growth characterising pregnancies with FGR and PE+FGR. XBP1(U) has been proposed as a negative regulator of ER stress, and increased levels in PE may reflect a protective mechanism against the detrimental effects of ER stress.
Sujet(s)
Caduques/métabolisme , Stress du réticulum endoplasmique/physiologie , Retard de croissance intra-utérin/métabolisme , Pré-éclampsie/métabolisme , Adulte , Marqueurs biologiques/analyse , Marqueurs biologiques/métabolisme , Études cas-témoins , Caduques/anatomopathologie , Stress du réticulum endoplasmique/génétique , Femelle , Retard de croissance intra-utérin/étiologie , Retard de croissance intra-utérin/génétique , Analyse de profil d'expression de gènes , Humains , Analyse sur microréseau , Pré-éclampsie/étiologie , Pré-éclampsie/génétique , Grossesse , Complications de la grossesse/étiologie , Complications de la grossesse/génétique , Complications de la grossesse/métabolisme , Complications de la grossesse/anatomopathologie , Régulation positive/génétique , Jeune adulteRÉSUMÉ
Variation in the Storkhead box-1 (STOX1) gene has previously been associated with pre-eclampsia. In this study, we assess candidate single nucleotide polymorphisms (SNPs) in STOX1 in an independent population cohort of pre-eclamptic (n = 1.139) and non-pre-eclamptic (n = 2.269) women (the HUNT2 study). We also compare gene expression levels of STOX1 and its paralogue, Storkhead box-2 (STOX2) in decidual tissue from pregnancies complicated by pre-eclampsia and/or fetal growth restriction (FGR) (n = 40) to expression levels in decidual tissue from uncomplicated pregnancies (n = 59). We cannot confirm association of the candidate SNPs to pre-eclampsia (P > 0.05). For STOX1, no differential gene expression was observed in any of the case groups, whereas STOX2 showed significantly lower expression in deciduas from pregnancies complicated by both pre-eclampsia and FGR as compared with controls (P = 0.01). We further report a strong correlation between transcriptional alterations reported previously in choriocarcinoma cells over expressing STOX1A and alterations observed in decidual tissue of pre-eclamptic women with FGR.
Sujet(s)
Protéines de transport/génétique , Caduques/métabolisme , Pré-éclampsie/métabolisme , Adulte , Protéines de transport/métabolisme , Protéines de transport/physiologie , Études de cohortes , Femelle , Retard de croissance intra-utérin/génétique , Retard de croissance intra-utérin/métabolisme , Expression des gènes , Génotype , Humains , Polymorphisme de nucléotide simple , Pré-éclampsie/génétique , GrossesseRÉSUMÉ
Superficial invasion of extravillous trophoblasts (EVTs) and impaired spiral artery remodelling are characterizing phenomena in pregnancies complicated by pre-eclampsia (PE) and fetal growth restriction (FGR). However, the underlying causes remain unclear. In this study, gene expression in decidua basalis tissue from pregnancies complicated with PE and/or FGR (n = 18) and normal pregnancies (n = 17) was assessed by Affymetrix HG Focus microarray to obtain hints of mechanisms involved in the pathogenesis. A total of 200 differentially expressed transcripts were detected at a false discovery rate (FDR) Sujet(s)
Retard de croissance intra-utérin/enzymologie
, Matrix metalloproteinase 1/métabolisme
, Pré-éclampsie/enzymologie
, Trophoblastes/métabolisme
, Caduques/métabolisme
, Femelle
, Expression des gènes
, Analyse de profil d'expression de gènes
, Humains
, Grossesse
RÉSUMÉ
The hyperinsulinemic glucose clamp is generally performed for at least 120 minutes, due to assumptions of steady-state. We were interested in relationships between glucose disposal rate (GDR) and cardiovascular risk factors, rather than a standard measure of insulin sensitivity per se. Therefore, we analyzed 120-minute clamps performed on borderline hypertensive, but otherwise healthy young men (n = 19). GDR was calculated at different time points and related to baseline cardiovascular risk factors and responses to a mental stress test (MST). The 60-, 90-, and 120-minute GDR correlated significantly with serum high-density lipoprotein (HDL) cholesterol (r=.59, r=.50, and r=.53, respectively), heart rate (HR) during MST (r = -.65, r = -.64, and r = -.58, respectively) and plasma epinephrine (Epi) (r = -.55, r= -.58, and r = -.56, respectively) and norepinephrine (NE) (r = -.52, r = -.49, and r = -.48, respectively) 1 minute after announcement of the MST (all P <.05). Although not statistically significant at all time points, similar relationships were observed between GDR and resting HR, systolic blood pressure (BP) at rest and during mental stress, body mass index (BMI), serum total cholesterol (Chol), serum triglycerides (TG), and blood hemoglobin (HgB), with remarkable consistency from about 40 to 50 minutes onwards. HDL cholesterol and Epi remained independent in stepwise multiple regression analyses with the 60-, 90-, and 120-minute GDR as dependent variables (all P <.05). We suggest that 60- to 90-minute glucose clamps may provide information about the relationship between insulin sensitivity and various cardiovascular risk factors in borderline hypertensive young caucasian men.
Sujet(s)
Maladies cardiovasculaires/étiologie , Technique du clamp glycémique , Glucose/métabolisme , Hypertension artérielle/complications , Adulte , Pression sanguine , Catécholamines/sang , Rythme cardiaque , Humains , Hyperinsulinisme/physiopathologie , Hypertension artérielle/sang , Hypertension artérielle/métabolisme , Mâle , Analyse de régression , Facteurs de risque , Stress physiologique/physiopathologie , Facteurs tempsRÉSUMÉ
We compared the effects of amlodipine and verapamil slow release on autonomic responses to a 5-min mental arithmetic test (MST) in patients with mild to moderate hypertension. Twenty subjects received 8 weeks of verapamil slow release 240 mg or amlodipine 10 mg in a double-blind crossover design, both after 4 weeks' placebo. Heart rate (HR) and blood pressure (BP) were continuously monitored. Venous plasma catecholamines were analysed by a radioenzymatic assay. Baroreflex sensitivity (BRS) was estimated with the transfer function technique. Calculations of the area under the curve (AUC) were used to estimate average HR, BP and catecholamine concentrations. The reactivity to MST was estimated as percent change from the basal AUC. A paired t-test was performed. Data are means +/-SEM. Compared to verapamil, amlodipine increased average noradrenaline (NA) concentrations (245 +/- 23 vs 191 +/- 17 pg/l, respectively, p = 0.005), NA reactivity (14.0 +/- 5.5% vs -2.9 +/- 3.3, p = 0.004), average HR (65 +/- 2 vs 61 +/- 2 beats/min, p < 0.001) and HR reactivity (2.5 +/- 1.0 vs 0.1 +/- 0.9%, p = 0.056). BP did not differ significantly. BRS correlated with average and baseline HR on both medications (r = -0.53 and -0.63, p < or = 0.03). We conclude that adrenergic responses to MST are blunted on treatment with verapamil compared to amlodipine in hypertensive patients.
Sujet(s)
Agents adrénergiques/pharmacologie , Amlodipine/pharmacologie , Antihypertenseurs/pharmacologie , Hypertension artérielle/physiopathologie , Tests d'intelligence , Vérapamil/pharmacologie , Adulte , Sujet âgé , Amlodipine/administration et posologie , Antihypertenseurs/administration et posologie , Baroréflexe/effets des médicaments et des substances chimiques , Pression sanguine/effets des médicaments et des substances chimiques , Inhibiteurs des canaux calciques/administration et posologie , Inhibiteurs des canaux calciques/pharmacologie , Catécholamines/sang , Femelle , Rythme cardiaque/effets des médicaments et des substances chimiques , Humains , Hypertension artérielle/traitement médicamenteux , Mâle , Adulte d'âge moyen , Norépinéphrine/sang , Stress psychologique , Vérapamil/administration et posologieRÉSUMÉ
We have previously shown correlations between cardiovascular risk factors such as blood pressure (BP), sympathetic nervous system activity, lipids and insulin resistance in young men with elevated screening BP. In the present study we aimed to: (1) compare the genotype distribution and allele frequencies of 11 polymorphisms in seven candidate genes for BP regulation in healthy 21-year-old Caucasian men, between 18 men with normal and 67 men with high screening BP, and (2) evaluate the effect of these polymorphisms in candidate genes on casual BP, BP responses to mental stress or catecholamines and metabolic parameters including insulin sensitivity. There were no differences in genotype distributions or allele frequencies between the subjects with normal and those with high screening BP. Insulin sensitivity was significantly higher in GG homozygotes in the G-261A polymorphism at the alpha 2A-adrenergic receptor (alpha(2A)AR) locus compared to GA heterozygotes (p = 0.007). Subjects who were homozygous both GG in the G-261A polymorphism at the alpha(2A)AR locus and GlyGly in the Arg16Gly polymorphism at the beta2-adrenergic (beta2AR) receptor loci had significantly higher insulin sensitivity and lower catecholamine levels during mental stress than subjects with other genotypes. Subjects who were II homozygous at the angiotensin converting enzyme (ACE) locus and AA homozygous at the angiotensin type I receptor (AT1R) locus had lower BP and a better lipid profile than the rest of the group. Thus, in this explorative study, we report an association between insulin sensitivity and a polymorphism at the alpha(2A)AR locus. We suggest the presence of gene-gene interactions in the renin-angiotensin system and the sympathetic nervous system.
Sujet(s)
Pression sanguine/génétique , Polymorphisme génétique , Adulte , Pression sanguine/effets des médicaments et des substances chimiques , Catécholamines/administration et posologie , Catécholamines/pharmacologie , Analyse de mutations d'ADN , Fréquence d'allèle , Génotype , Technique du clamp glycémique , Humains , Hypertension artérielle/étiologie , Hypertension artérielle/génétique , Insuline/administration et posologie , Insuline/pharmacologie , Mâle , Dépistage de masse , Système rénine-angiotensine/génétique , Stress psychologique/physiopathologie , Système nerveux sympathique/métabolismeRÉSUMÉ
The present work describes a strategy to predict the mutagenicity of very complex mixtures of polycyclic aromatic compounds (PAC) from gas chromatography-mass spectrometry (GC-MS) patterns of the mixtures, each containing 260 compounds on average. The mixtures, 13 organic extracts of exhaust particles, were characterized by full scan GC-MS. The data were resolved into peaks and spectra for individual compounds by an automated curve resolution procedure. Similarity between spectra was evaluated for peaks that appeared within a time interval of 4 min, using a similarity index of 0.8 to ascertain that the same compound was represented by the same variable name (retention time) in all samples. The resolved chromatograms were integrated, resulting in a predictor matrix of size 13 x 721, which was used as input to a multivariate regression model. Partial least-squares projections to latent structures (PLS) were used to correlate the GC-MS chromatograms to mutagenicity as measured in the Ames Salmonella assay. The best model (high r2 and Q2) was obtained with 52 variables. These variables covary with the observed mutagenicity, and may subsequently be identified chemically. Furthermore, the regression model can be used to predict mutagenicity from GC-MS chromatograms of other organic extracts.
Sujet(s)
Polluants atmosphériques/effets indésirables , Polluants atmosphériques/analyse , Chromatographie gazeuse-spectrométrie de masse , Modèles théoriques , Hydrocarbures aromatiques polycycliques/effets indésirables , Hydrocarbures aromatiques polycycliques/analyse , Emissions des véhicules/analyse , Prévision , Tests de mutagénicité , Composés chimiques organiques/analyse , Analyse de régression , Salmonella/effets des médicaments et des substances chimiques , Salmonella/génétique , Sensibilité et spécificitéRÉSUMÉ
We aimed to study the glycemic response to epinephrine during hyperinsulinemia and infused epinephrine (0.03 microg/kg/min) for 30 min after 90 min of hyperinsulinemic glucose clamp in 14 borderline hypertensive young men. Plasma epinephrine was increased from 0.34 +/- 0.08 to 2.33 +/- 0.33 nmol/L while insulin and glucose infusions were kept constant with consequent changes in blood glucose. Initially (90 to 95 min), there was a decrease in blood glucose (P = .016) that correlated negatively with glucose disposal rate corrected for insulin (r = -0.55, P = .040) and positively with fasting insulin (r = 0.55). Thereafter, there was an increase in blood glucose (95 to 120 min) (P < .001) that persisted during the recovery period (120 to 140 min). The glucose increase (90 to 140 min) correlated positively with fasting insulin (r = 0.55), systolic blood pressure (r = 0.57), delta epinephrine 90 to 120 min (r = 0.59), and baseline epinephrine (r = 0.57). Blood glucose remained unchanged (P = .207) in a saline control group (n = 6) with a significant group X treatment effect versus epinephrine (P = .003). Thus, epinephrine caused a biphasic response in blood glucose during hyperinsulinemia. The initial dip in glucose was more pronounced with higher insulin sensitivity, corresponding to previous observations during mental stress test. The following increment in blood glucose was positively related to insulin, systolic blood pressure, and epinephrine levels. These data suggest that insulin may modify the glycemic response to epinephrine in a potentially favorable direction and indicate some lag time before epinephrine gains effect. Subjects who are insulin sensitive and have low blood pressure and resting epinephrine levels seem to be less prone to hyperglycemia induced by epinephrine.
Sujet(s)
Glycémie/effets des médicaments et des substances chimiques , Catécholamines/pharmacologie , Épinéphrine/pharmacologie , Hyperinsulinisme/sang , Hypertension artérielle/sang , Insuline/sang , Adolescent , Analyse de variance , Aire sous la courbe , Glycémie/métabolisme , Pression sanguine/effets des médicaments et des substances chimiques , Catécholamines/administration et posologie , Catécholamines/sang , Épinéphrine/administration et posologie , Épinéphrine/sang , Glucose/administration et posologie , Rythme cardiaque/effets des médicaments et des substances chimiques , Humains , Hypertension artérielle/physiopathologie , Insuline/administration et posologie , Mâle , Système nerveux sympathique/physiopathologieRÉSUMÉ
BACKGROUND: Measurements of PSA in serum is crucial in the diagnostic work-up of prostatic diseases. MATERIAL AND METHODS: We have studied the distribution of PSA values in an unselected population of 609 men, and the relation between PSA level and urinary symptoms, age and prostate volume. RESULTS: 87 (14%) men had a PSA concentration at or above the reference value of 4.0 ng/ml. Prostate cancer was verified in 14 (16%) of these men. The probability of having PSA equal to or above 4.0 ng/ml was 12 times greater for men with a prostate volume of 40 cm3 or less than for men with a prostate volume less than 20 cm3. Mean PSA values were higher in men with severe than with mild urinary symptoms, but symptoms were poor predictors of PSA levels. Age was not associated with an increase in PSA level independent of prostate volume. INTERPRETATION: Absence of urinary symptoms does not exclude elevated PSA values and thus not cancer. Most men with PSA equal to or above 10.0 ng/ml will have prostate cancer, but enlarged prostate without cancer can also give elevated PSA values.
Sujet(s)
Antigène spécifique de la prostate/sang , Troubles mictionnels/diagnostic , Sujet âgé , Humains , Mâle , Adulte d'âge moyen , Norvège/épidémiologie , Hyperplasie de la prostate/sang , Hyperplasie de la prostate/diagnostic , Hyperplasie de la prostate/épidémiologie , Tumeurs de la prostate/sang , Tumeurs de la prostate/diagnostic , Tumeurs de la prostate/épidémiologie , Enquêtes et questionnaires , Troubles mictionnels/sang , Troubles mictionnels/épidémiologieRÉSUMÉ
OBJECTIVE: Activation of the sympathetic nervous system may increase hematocrit (Hct), whole blood viscosity (WBV), and possibly cardiovascular risk. The aim was to study gender specific differences of mental stress on sympathetic reactivity and blood rheology. METHODS: Responses in blood pressure, heart rate (HR), Hct, WBV (Bohlin rotational viscosimeter), and plasma catecholamines to a mental arithmetic stress test (MST) were measured in male (n = 10, 23 +/- 3 years, BMI 23 +/- 2 kg/m2) and female (n = 10, 21 +/- 4 years, BMI 24 +/- 2 kg/m2) students. RESULTS: Systolic blood pressure (SBP), diastolic blood pressure (DBP), and HR increased during MST in men and women, and declined to baseline levels after 15 min of recovery. In men, plasma adrenaline increased by 217% during MST (p < 0.01, ANOVA). and plasma noradrenaline increased by 68% (p < 0.05). Hct and WBV at low shear rates (0.5 and 1.1 l/s) increased as well (p < 0.001, p < 0.05, and p < 0.05, respectively). In women, the increase in plasma adrenaline averaged 118% during MST (p < 0.05) while plasma noradrenaline (-3%, p = 0.38), Hct, and WBV at all shear rates remained unchanged. Men and women differed in A adrenaline (p < 0.05), A noradrenaline (p = 0.01), delta Hct (p < 0.05), and delta WBV (p < 0.05). A Hct tended to correlate with delta SBP (r= 0.60, p = 0.07), A DBP (r = 0.57. p = 0.09). and delta HR (r = 0.50, p = 0.14), and correlated significantly with A noradrenaline (r = 0.66, p < 0.05) in men only. Multiple regression analysis showed that gender independently explained 22% of the change in Hct during mental stress. CONCLUSION: Data suggest gender specific differences in sympathetic and hemorrheological responses to mental stress in healthy young subjects. In men, sympathetic responses were related to hemorrheological responses, but not in women. It may be speculated whether such differences in stress responses may contribute to lower cardiovascular risk in premenopausal women than in men.
Sujet(s)
Hématocrite , Numération des leucocytes , Stress psychologique/physiopathologie , Système nerveux sympathique/physiopathologie , Adulte , Épinéphrine/sang , Femelle , Hémorhéologie , Humains , Mâle , Norépinéphrine/sang , Analyse de régression , Répartition par sexe , Facteurs sexuelsRÉSUMÉ
Several studies have shown increased sympathetic activity during acute exposure to hypobaric hypoxia. In a recent field study we found reduced plasma catecholamines during the first days after a stepwise ascent to high altitude. In the present study 14 subjects were exposed to a simulated ascent in a hypobaric chamber to test the hypothesis of a temporary reduction in autonomic activity. The altitude was increased stepwise to 4500 m over 3 days. Heart rate variability (HRV) was assessed continuously in seven subjects. Baroreceptor reflex sensitivity (BRS) was determined in eight subjects with the 'Transfer Function' method at baseline, at 4500 m and after returning to baseline. Resting plasma catecholamines and cardiovascular- and plasma catecholamine- responses to cold pressor- (CPT) and mental stress-test (MST) were assessed daily in all and 12 subjects, respectively. Data are mean +/- SEM. Compared with baseline at 4500 m there were lower total power (TP) (35 457 +/- 26 302 vs. 15 001 +/- 11 176 ms2), low frequency (LF) power (3112 +/- 809 vs. 1741 +/- 604 ms2), high frequency (HF) power (1466 +/- 520 vs. 459 +/- 189 ms2) and HF normalized units (46 +/- 0.007 vs. 44 +/- 0.006%), P < or = 0.001. Baroreceptor reflex sensitivity decreased (15.6 +/- 2.1 vs. 9.5 +/- 2.6 ms mmHg(-1), P = 0.015). Resting noradrenaline (NA) decreased (522 +/- 98 vs. 357 +/- 60 pmol L(-1), P = 0.027). The increase in systolic blood pressure (SBP) and NA during mental stress was less pronounced (21 +/- 4 vs. 10 +/- 2% and 25 +/- 9 vs. -2 +/- 8%, respectively, P < 0.05). The increase in SBP during cold pressor test decreased (16 +/- 3 vs. 1 +/- 6%, P = 0.03). Diastolic blood pressure, HR and adrenaline displayed similar tendencies. We conclude that a transient reduction in parasympathetic and sympathetic activity was demonstrated during stepwise exposure to high altitude.
Sujet(s)
Mal de l'altitude/physiopathologie , Altitude , Système nerveux autonome/physiopathologie , Épinéphrine/sang , Norépinéphrine/sang , Adulte , Arginine vasopressine/sang , Chambres d'exposition à l'atmosphère , Baroréflexe/physiologie , Pression sanguine/physiologie , Dioxyde de carbone/sang , Basse température , Femelle , Rythme cardiaque/physiologie , Humains , Concentration en ions d'hydrogène , Hypoxie/physiopathologie , Mâle , Oxygène/sang , Respiration , Stress physiologique/physiopathologieRÉSUMÉ
BACKGROUND: Serum PSA has been commercially available for more than ten years, and has proved to be the most important tumour marker for prostate cancer. We review the clinical usefulness and limitations of serum PSA as a tumour marker of prostate cancer. MATERIAL AND METHODS: The international literature and medical databases were searched for studies on the contributions and limitations of PSA in clinical practice. RESULTS: Serum PSA > or = 4.0 ng/ml is commonly regarded as elevated, and give rise suspicion of prostate cancer. However, only one out of four men with serum PSA level between 4.0 ng/ml and 10.0 ng/ml has prostate cancer. The most common cause of elevated serum PSA value in this group is benign prostatic hyperplasia. In an attempt to increase the sensitivity as well as the specificity for serum PSA in the detection of prostate cancer, the serum PSA level has been combined with age of patients (age-specific serum PSA), time (PSA velocity), prostate volume (PSA density), different molecular PSA forms, like per cent of free PSA. Some of these new methods have shown promising results. INTERPRETATION: PSA is the best and most widely used tumour marker in urology. However, it is important that clinicians know the limitations of this marker.
Sujet(s)
Marqueurs biologiques tumoraux/sang , Antigène spécifique de la prostate/sang , Tumeurs de la prostate/diagnostic , Facteurs âges , Humains , Mâle , Tumeurs de la prostate/immunologie , Tumeurs de la prostate/thérapie , Valeurs de référence , Sensibilité et spécificitéRÉSUMÉ
In vitro rates of metabolism and Michaelis-Menten constants were determined for 25 different C6 to C10 hydrocarbons using rat liver slices in a vial head-space equilibration system. The rates of metabolism were compared with steady-state levels obtained in vivo in the same strains of rats after inhalation. Aromates were metabolized at a higher rate than naphthenes n-alkanes, isoalkanes and 1-alkenes. The aromates showed, in contrast to the other hydrocarbons investigated, increased metabolism with increasing number of carbon atoms up to C8 (o-xylene, the most extensively metabolized compound). The in vivo steady-state concentrations of the aromates in blood were inversely related to the in vitro efficiency of their metabolism. This explains the pattern of blood levels observed for the C6 to C10 aromates in the rat after inhalation, with o-xylene demonstrating the lowest concentration. In general, the extent of tissue metabolism of the investigated hydrocarbons might be of greater importance for their body distribution than their lipophilicity, especially for the highly metabolized compounds. The high in vitro intrinsic liver clearances found for the aromates indicate a flow-dependent metabolism of these hydrocarbons in vivo. The head-space liver slice equilibration system seems to work adequately for metabolic studies of hydrocarbons with different volatility and water solubility.
Sujet(s)
Hydrocarbures/métabolisme , Foie/métabolisme , Pétrole , Animaux , Biotransformation , Chromatographie en phase gazeuse , Techniques in vitro , Mâle , Rats , Rat Sprague-DawleyRÉSUMÉ
In a recent study, we could not find evidence to support the hypothesis that insulin activates the sympathetic nervous system (SNS) during a hyperinsulinemic glucose clamp procedure. Mental stress tests (MST), however, may be used to detect differences in blood pressure and SNS activity that are not present during baseline or resting conditions. In this study, we aimed to investigate the effects of hyperinsulinemia during glucose clamp on blood pressure and sympathetic responses to mental stress. Borderline hypertensive but otherwise healthy 21-year-old men (n = 18) underwent 5 min of mental arithmetic stress testing (MST-1) before and at the end of 120 min of isoglycemic hyperinsulinemic glucose clamp (MST-2) with infusion rates of glucose and insulin kept constant. Insulin concentration increased from 119 +/- 10 pmol/L to 752 +/- 65 pmol/L. We observed highly significant increases in blood pressure and heart rate in response to MST, but neither insulin nor saline solution infusions affected these responses. During MST-1, norepinephrine increased by 461 +/-165 pmol/L (mean +/- SEM) and epinephrine by 218 +/- 76 pmol/L. During MST-2 the changes were 372 +/- 112 pmol/L and 187 +/- 60 pmol/L, respectively. The norepinephrine (P = .8) and epinephrine (P = .7) responses were unchanged by insulin. Thus, there were similar increases in blood pressure, heart rate, and plasma catecholamine concentrations in arterialized venous blood in response to MST despite the infusion of insulin. A possible time effect was excluded by including a saline solution control group (n = 7) that showed almost identical results. Our results suggest that acute hyperinsulinemia during isoglycemic glucose clamp does not interfere with cardiovascular or sympathetic responses to mental stress.
Sujet(s)
Hyperinsulinisme/physiopathologie , Stress psychologique/physiopathologie , Système nerveux sympathique/physiopathologie , Adulte , Pression sanguine/effets des médicaments et des substances chimiques , Pression sanguine/physiologie , Catécholamines/sang , Technique du clamp glycémique , Rythme cardiaque/effets des médicaments et des substances chimiques , Rythme cardiaque/physiologie , Humains , Hypoglycémiants/pharmacologie , Insuline/pharmacologie , MâleRÉSUMÉ
This study compares (32)P-postlabeling and high-resolution gas chromatography/mass spectrometry (GC/MS) in the quantification of N7-(2-hydroxyethyl)guanine adducts (7-HEG) in DNA obtained from the same tissue samples of control rats and rats exposed to ethene. The samples were obtained from two independent studies. In one study, male Sprague-Dawley rats were exposed to 300 ppm ethene for 12 h/day for 3 days ("Euro samples"). In the other study, male F-344 rats were exposed to 3000 ppm ethene for 6 h/day for 5 days ("U.S. samples"). DNA from liver and kidney from the European study was isolated in the European laboratory, and DNA from liver and spleen from the U.S. study was isolated in the U.S. laboratory. The DNA samples were coded, divided into two portions, and exchanged between the two laboratories. All DNA samples from both laboratories were analyzed with respect to 7-HEG adducts by (32)P-postlabeling and high-resolution GC/MS in the European and U.S. laboratories, respectively. However, the U.S. samples were repurified in the European laboratory before the postlabeling analysis. The data from the Euro and the U.S. samples were therefore treated separately in the regression analysis of the (32)P-postlabeling versus GC/MS data. The slope of the regression line for the Euro samples was 1.19 (r = 0.97), implying that the GC/MS data were slightly lower than the postlabeling data (one possible outlier was excluded). The slope of the regression line for the U.S. samples was 0.61 (r = 0.94), implying that the GC/MS data were somewhat higher than the postlabeling data. The main conclusion from this study is that there is very good agreement between the (32)P-postlabeling and high-resolution GC/MS methods in quantifying 7-HEG adducts to DNA, particularly when identical DNA samples are analyzed and the RNA content is <2%. The paper also discusses the background levels of adducts, the interorgan distribution, comparison between different strains, and exposure conditions.
Sujet(s)
Adduits à l'ADN/analyse , Guanine/analogues et dérivés , Animaux , Chromatographie gazeuse-spectrométrie de masse , Guanine/analyse , Rein/composition chimique , Foie/composition chimique , Mâle , Radio-isotopes du phosphore , Rats , Rats de lignée F344 , Rat Sprague-Dawley , Analyse de régressionRÉSUMÉ
Since the late sixties, the pentagastrin test has been the standard method to examine maximal gastric acid secretion in humans. However, studies on rats and dogs have shown that maximal pentagastrin-stimulated acid secretion can be augmented by concomitant cholinergic stimulation. The aim of this study was to examine whether the combined stimulation of the vagal nerves and pentagastrin infusion could increase maximal gastric acid secretion compared with pentagastrin alone. Eight healthy medical students (seven males) were included in the study. Gastric acid secretion was determined thrice in each subject. On day one, pentagastrin (6 microg kg(-1) h(-1)) was infused. On day two, insulin-induced hypoglycaemia (plasma glucose approximately 2.3 mM during 30 min) was obtained by applying the glucose clamp technique. On day three, pentagastrin infusion and insulin induced-hypoglycaemia were combined. The combination of insulin-induced hypoglycaemia and pentagastrin infusion increased peak acid output about 20% (P = 0.018) compared with pentagastrin alone. The hypoglycaemia did not cause significant release of gastrin. It is concluded that vagal stimulation of gastric acid secretion may be safely obtained by insulin-induced hypoglycaemia when applying the glucose clamp technique. In addition, maximal pentagastrin-stimulated acid secretion does not represent the maximal acid secretory capacity in humans.
Sujet(s)
Acide gastrique/métabolisme , Pentagastrine/pharmacologie , Nerf vague/physiologie , Adulte , Animaux , Chiens , Femelle , Technique du clamp glycémique , Humains , Hypoglycémie/physiopathologie , Insuline/administration et posologie , Mâle , Pentagastrine/administration et posologie , RatsRÉSUMÉ
Detection of 7-alkylguanine DNA adducts is useful to assess human exposure to and the resulting DNA damage caused by simple alkylating agents. The background 7-methylguanine (7-MG) and 7-hydroxyethylguanine (7-HEG) adduct levels were determined in human and rat tissues, using thin-layer chromatography (TLC) combined with high pressure liquid chromatography (HPLC). In addition, these two adduct levels were also compared in various tissues between smokers and non-smokers. The results demonstrated that the background level of 7-alkylguanine adducts in WBC and lung tissues of non-smokers was 2.9 and 4.0 adducts/107 nucleotides, respectively. In smokers with lung cancers 7-MG adduct level in lung samples (6.3+/-1.9 adducts/107 nucleotides) and in bronchus samples (6.1+/-1.5 adducts/107 nucleotides) was significantly higher than that in WBC samples (3.3+/-0.9 adducts/107 nucleotides). 7-HEG adduct levels obtained from the same individuals were 0.8+/-0.3 in lung, 1.0+/-0.8 in bronchus and 0.6+/-0.2 adducts/107 nucleotides in WBC, respectively. Animal studies showed that background levels of 7-MG (2.1-2.5 adducts/107 nucleotides) in control rats were approximately 2-4-fold higher than 7-HEG levels (0.6-0.9 adducts/107 nucleotides). After a 3-day exposure to 300 ppm ethene, 7-HEG adducts accumulated to a similar extent in different tissues of rats, with the mean adduct level of 5.6-7.0 in liver, 7.4 in lymphocytes and 5.5 adducts/107 nucleotides in kidney.