DHEA Administration Activates Transcription of Muscular Lipid Metabolic Enzymes via PPARα and PPARδ in Obese Rats.

Administration of dehydroepiandrosterone (DHEA), a precursor of sex steroid hormones, reduces total and visceral fat mass and elevates adipocytic adiponectin gene expression. The aim of this study is to investigate whether levels of peroxisome proliferator-activated receptors (PPARs) in muscle and transcription of PPAR target genes are affected by long-term DHEA administration or exercise training, and whether altered PPAR levels are associated with circulating adiponectin level in obese rats. After 14 weeks on a high-sucrose diet, obese male Wistar rats were assigned randomly to one of 3 groups: control, DHEA administration (1 mg/kg body weight), or exercise training (treadmill running for 1 h, 25 m/min, 5 days/week) for 6 weeks (n=7 for each group). Plasma DHEA and total adiponectin levels in the DHEA-treated and exercise-training groups were significantly higher than those in the obese control group. Additionally, DHEA administration and exercise training significantly increased muscular PPARα and PPARδ protein levels, with a concomitant increase in mRNA expression of 3ß-hydroxyacyl-CoA dehydrogenase and cytochrome c oxidase IV, which are target genes of PPARα and PPARδ respectively. Moreover, DHEA administration increased these protein and mRNA levels to the same degree as exercise training. Circulating adiponectin level was positively correlated with plasma DHEA and with muscle levels of PPARα and PPARδ. These results suggest that in obese rats, secretion of adiponectin due to chronic DHEA administration and exercise training may contribute to an increase in the transcription of genes encoding lipid metabolic enzymes, mediated via elevated expression of PPARα and PPARδ in muscle.

Changes of pituitary, adrenal and gonadal hormones during competition among female soccer players.

AIM: This study was intended to investigate various hormones during competition among female athletes. METHODS: Subjects were elite female soccer players (n=9). Blood samples and profiles of mood states (POMS) were obtained before (Pre), during 3 days of competition (Competition), and after competition (Post-3 days). Serum concentrations were determined for dehydroepiandrosterone sulfate (DHEAS), cortisol (C), prolactin (PRL), testosterone (T), adrenocorticotropic hormone (ACTH), luteinising hormone (LH), and follicle stimulating hormone (FSH). RESULTS: Levels of C and PRL increased significantly during competition (2nd: P<0.05; 3rd: P<0.01) compared with Pre. Levels of LH increased significantly during competition (3rd day) compared with Pre (P<0.05). Levels of DHEAS changed significantly during competition, whereas levels of T, ACTH, and FSH were unchanged during competition. The fatigue score of POMS increased significantly during competition (2nd day) compared with Pre (P<0.05). CONCLUSIONS: We demonstrated that competitive stress affected hormonal status in female athletes. These findings suggest that hormonal changes reflect physical and mental stress during competition.

Fluctuations in carotid arterial distensibility during the menstrual cycle do not influence cardiovagal baroreflex sensitivity.

AIM: Fluctuations in autonomic nervous functions throughout the menstrual cycle and the underlying mechanism concerning them are not well known. This study was designed to test the hypothesis that fluctuations in cardiovagal baroreflex sensitivity (BRS) throughout the menstrual cycles of young women are due to fluctuations in carotid arterial distensibility. METHODS: In eight eumenorrhoeic healthy young women (18-24 years), we determined the variations in the carotid arterial distensibility coefficient (DC; via simultaneous ultrasonography and applanation tonometry), cardiovagal BRS (phase IV of the Valsalva manoeuvre and the sequence method; up- or down-sequence spontaneous BRS), and serum oestradiol and progesterone concentrations at five points in the menstrual cycle (menstrual = M, follicular = F, ovulatory = O, early luteal = EL, and late luteal = LL). RESULTS: Serum oestradiol and progesterone levels were consistent with the predicted cycle phases. Carotid arterial DC fluctuated cyclically, increasing significantly from the M (52.4 +/- 4.9 x 10(-3) kPa(-1), mean +/- SE) and F (52.7 +/- 4.4) phases to the O (57.6 +/- 4.4) phase and declining sharply in the EL (46.0 +/- 4.0) and LL (45.1 +/- 3.0) phases (F = 6.37, P < 0.05). Contrary to our prediction, however, cardiovagal BRS by the Valsalva manoeuvre (P = 0.73) or sequence method (up-sequence spontaneous BRS; P = 0.84: down-sequence spontaneous BRS; P = 0.67) did not change significantly during the menstrual cycle. CONCLUSION: The results suggest that, although carotid arterial distensibility fluctuates with the changes in ovarian hormone levels that occur during the menstrual cycle, the fluctuations in carotid arterial distensibility do not influence cardiovagal BRS.

Testicular feminization: role of MRI in diagnosing this rare male pseudohermaphroditism.

PURPOSE: The purpose of our study was to assess the role of MR in the diagnosis and follow-up of patients with testicular feminization (TF). METHOD: MR scans of seven patients with TF were retrospectively reviewed. RESULTS: MR could diagnose uterus agenesis in all cases. Undescended testes were depicted within or just below the inguinal canal in four cases. They were smaller and more hypointense than those in normal males. Testes that we could not find by MR were found during surgery in two cases. They were just below the inguinal canal where we had not scanned caudally enough in one and they were too small to be detected in the other. CONCLUSION: MR can demonstrate both uterine agenesis and undescended testes in TF. The latter tend to be missed because they are small and can be anywhere in the abdomen and inguinal canal. Radiologists should perform careful MR examination to detect testes in patients suspected having TF, as these organs are more likely to undergo malignant neoplasia.

Effect of maternal exercise on fetal umbilical artery waveforms: the comparison of IUGR and AFD fetuses.

OBJECTIVE: To determine the effect of maternal exercise on the fetal blood flow of normal and growth-retarded fetuses. METHODS: The effect of maternal exercise on fetal blood flow was investigated with 24 pregnant women between 36 and 42 weeks' gestation. Seventeen pregnancies were uncomplicated (normal group) and the other 7 were complicated with growth-retarded fetuses (IUGR group). They underwent graded walking on a treadmill with an upper limit of 150 bpm for the maternal heart rate. The systolic over diastolic velocity ratio (S/D ratio) of the umbilical artery was measured before exercise, and at 3, 5, 10, and 15 minutes after exercise. RESULTS: The mean S/D ratio of the IUGR group before exercise was significantly higher than that of the normal group (p < 0.05). The S/D ratio did not change significantly after exercise, in either the normal group or the IUGR group. CONCLUSION: This study suggests that maternal exercise at this level of intensity and duration does not have any harmful effect, even on growth-retarded fetuses that might have placental dysfunctions.

Exercise at high temperature causes maternal hyperthermia and fetal anomalies in rats.

Hyperthermia is thought to be a teratogen in many animal species and also in humans. It has been reported that hyperthermia caused by sauna, hot tub, or fever during the early stages of pregnancy is related to an increased risk for neural tube defects. During exercise, especially in hot conditions, body temperature can also rise to fairly high levels. Thus, we can surmise that hyperthermia induced by exercise can also cause fetal malformation. To investigate this hypothesis, pregnant rats at 9 days of gestation were divided into four groups. In the first group, the animals were made to swim for 30 minutes in water at a temperature of 40.5 degrees C. In the second group, they were restrained and immersed in water for the same time at the same temperature. In the third group, the rats were forced to swim in water at 36.0 degrees C. The fourth group were controls. The core temperature of the rats was measured during these procedures. On the 18th gestational day, fetuses were extracted by cesarean section. The elevation of maternal core temperature was significantly greater in the first group than in the other groups. In the first group, 69% of fetuses had various external anomalies. No anomalies were found in the other groups. Our results show that exercise in hot conditions caused the elevation of core temperature and resulted in fetal anomalies in rats.

[Fetal heart rate monitoring during maternal swimming].

Fetal physiology during swimming in pregnancy has remained unclear. To assess the fetal status, the fetal heart rate (FHR) was measured during maternal swimming. We studied individually a group of seventeen women in normal pregnancy (during their third trimester, 35-38th week) who participated in a maternal swimming class. We adapted the Doppler ultra-sound transducer for underwater use and attached it to the mothers' abdomen. FHR was recorded before, during and after swimming. The group swam from 375 to 750 meters in 33 to 41 minutes. During swimming, motion artifacts interfered with the FHR signal and we were only able to detect FHR in eleven in the group. The mean FHR rose significantly during swimming in eight of eleven women compared to the FHR recorded before the exercise. The FHR pattern was reactive and baseline variability was preserved in all cases. No pathological deceleration was seen. It is concluded that maternal swimming under such class conditions is safe for the fetus.

[Fetal hemodynamics assessed by transvaginal color flow mapping during the first and early second trimesters].

The present study has been carried out to evaluate the usefulness of transvaginal color flow mapping in the assessment of fetal hemodynamics during the first and early second trimesters. Forty normal fetuses were examined by transvaginal color flow mapping from 12 to 20 weeks of gestation. Maximum velocity in the transmitral (MVmax), transtricuspid (TVmax), transaortic (AVmax), fetal descending aorta (Vmax) and fetal internal carotid artery (ICVmax) was assessed. The systolic/diastolic ratio and pulsatility index (PI) of umbilical artery was also assessed. The detection rates for the fetal and umbilical flow velocity waveforms were 42.5%-85.0%. In particular, intracardiac blood flow velocity was easy to detect by transvaginal color flow mapping. The Vmax, ICVmax, MVmax, TVmax and AVmax increased significantly with advancing gestation in the normal fetuses. The TVmax was lower than the MVmax during the first and early second trimesters. Transvaginal color flow mapping studies can improve the understanding of the characteristics of fetal blood flow during the first and second early trimesters. Thus it seems to be useful in making an accurate antenatal diagnosis of congenital heart disease earlier.

[Effect of maternal exercise with graded treadmill on fetal heart rate].

The effect of maternal exercise on the fetal and maternal heart rate was studied in 10 normal pregnant women in their third trimester. They participated in 15 minute graded treadmill exercise. Fetal heart rate (FHR), uterine contraction, maternal blood pressure, electrocardiogram, and oxygen consumption were monitored, before, during, and after exercise. FHR could be monitored in 7 women. Maternal maximal heart rate ranged from 143 to 168 bpm which approximated 61% to 84% training intensity. FHR showed a significant rise in 4 women during exercise. Of four cases which showed more than 70% training intensity, 3 demonstrated fetal tachycardia over 160 bpm and one demonstrated fetal bradycardia under 120 bpm. The baseline fetal heart rate remained from 120 bpm to 160 bpm in cases under 70% training intensity. There was no pathological deceleration and the variability was preserved in all cases. It is suggested that maternal exercise intensity should be less than 70% of the patient's maximal capacity, which approximates maternal heart rate of about 150 bpm.

[Pulsatile release of gonadotropins in athletic women].

In athletic women menstrual disorders such as luteal insufficiency, oligomenorrhea and amenorrhea are often seen. It has been suggested that such disorders may be related to hypothalamic-pituitary axis insufficiency caused by physical activity. To investigate the mechanism by which the disorder is promoted, episodic gonadotropin secretion was studied in 10 athletic women (normal ovulatory, 5; short luteal, 5) and 6 non-athletic controls. In the early follicular phase of the menstrual cycle, blood samples were obtained through an indwelling venous catheter at 15-minute intervals for 4 hours. The concentrations of luteinizing hormone (LH) and follicle-stimulating hormones (FSH) were measured by radioimmunoassay. The mean LH and FSH concentrations in the athletic groups were lower than those in the control group. LH pulse frequencies in the short luteal group were 2.8 +/- 0.2 times/four hours (mean +/- standard error) and decreased compared with that of the control group (3.7 +/- 0.2 times/four hours; p less than 0.001). The LH pulse amplitudes of all three groups were similar. Pulsatile FSH secretion was also observed in all the women. Dynamism of FSH was the same as that of LH except for low pulse amplitude in the athletic groups. These data suggest that hypothalamic-pituitary axis insufficiency, especially of hypothalamic origin may be caused by athletic activity.

[Significance of twin to twin transfusion syndrome in the prognosis of twin pregnancies and its prenatal diagnosis by ultrasonography].

The reason why TTS worsen the prognosis of twin pregnancies was discussed with reference to case results for perinatal death, and antenatal diagnostic criteria for TTS by ultrasonography was established. Of 12 perinatal deaths in 71 twin pregnancies, eight fetuses were affected with TTS (1 acardia, 4 donors, 3 recipients). Perinatal mortality rate (39.3%), rate of preterm lobar (62.2%), rate of polyhydramnion (50.0%), mean amniotic fluid volume (3.310 ml) and cord cross section area ratio (2.38) in monochorionic discordant twins were higher than in the other three groups (monochorionic concordant twins, dichorionic discordant twins and dichorionic concordant twins). Eight fetuses among 12 monochorionic discordant twins were affected with TTS. All twins which showed a single GS in early pregnancy were monochorionic twins. Therefore TTS was considered to have a poorer prognosis than usually reported for all TTS, and to find monochorionic discordant twins with a high cord cross section area ratio must be the key in the screening of TTS. Antenatal diagnosis of TTS by ultrasonography is summarized as follows: 1) A single GS in early pregnancy. 2) Estimated body weight difference between the twins/estimated body weight of the larger twins greater than or equal to 0.2. 3) Cord cross sectional area ratio greater than or equal to 2.0.

Effect of naloxone on hormonal changes during exercise.

It is well established that prolactin release during exercise is one of the important factors in exercise-induced menstrual dysfunction. The purpose of this study is to clarify the mechanisms of prolactin release during exercise. Ten female athletes measured their BBT every morning. They performed incremental exercise on a cycle ergometer, with or without naloxone, on the 5th to 8th days of the follicular phase. Three minutes before the exercise, 0.4mg of naloxone was injected intravenously and a further 1.6mg/hr of naloxone was continuously infused during exercise. Blood samples were collected after 60 minutes bed rest (Rest), at the time when the heart rates reached 150 bpm (Submax), the point of exhaustion (Max) during exercise and after 60 minutes bed rest following exercise (After 1hr). The levels of prolactin in serum, dopamine, beta-endorphin. VIP and ACTH in the plasma were measured. Whereas prolactin increased significantly at Submax (p less than 0.05) and Max (p less than 0.001), the increase in prolactin was suppressed by the administration of naloxone (p less than 0.05). Dopamine showed no remarkable change during exercise, with or without naloxone. There were significant increases in beta-endorphin at Max (p less than 0.001), VIP at Submax and Max (p less than 0.001), but these increases were suppressed by the administration of naloxone (p less than 0.001). ACTH which had markedly increased at Submax (p less than 0.025) and Max (p less than 0.001) showed a slight tendency to decrease following the administration of naloxone, but there were no significant differences in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)

[Management of the goat fetus in water using membrane oxygenator by V-A bypass through the cervical vessels--comparison with the A-V bypass method through umbilical vessels].

Fourteen goat fetuses were totally sustained in water by extracorporeal perfusion using a membrane oxygenator. The two groups which underwent perfusion methods may be described as follows: One was an A-V bypass through umbilical vessels which has been reported previously, and the other was a new method, a V-A bypass through cervical vessels. Ten fetuses were perfused by an A-V bypass and the longest survival time was 9 hours. Three fetuses suddenly died shortly after perfusion was started. Four fetuses were perfused by a V-A bypass and the longest survival time was 27 hours. Cardiovascular dynamics were stable from the beginning of perfusion. Autopsy revealed hepatomegaly and bloody ascites in A-V bypassed fetuses but not in the fetuses perfused by a V-A bypass. The A-V bypass through umbilical vessels resembles physiological fetal circulation, and the cannulation technique is not difficult but it needs strict control, especially in the early stages of perfusion. A V-A bypass through cervical vessels doesn't seem to be close to a physiological perfusion for fetuses and the cannulation technique is difficult. But the cardiovascular dynamics are stable, so they are employed for clinical uses in neonatal ECMO. The V-A bypass method seems to be an adequate technique for managing extremely premature fetuses in water.

[Hormonal changes during continuous exercise in athletic women].

Recently, the number of women who participate in strenuous exercise has increased significantly. The relationship between delayed menarche and early onset of sports training, and increased incidence of menstrual dysfunction related to athletic activity had led to increased interest. Five basketball players who are among the best players in Japan were subjected to an investigation of endocrinological responses effected by 60 minutes continuous exercise cycle ergometer. The VO2max value was previously examined. Then, the level of load during exercise was established at 60% VO2max in this study. The serum level of estradiol increased significantly in the luteal phase but not so significantly in the follicular phase. Progesterone did not show a significant change during exercise. FSH increased slightly in both phases. However, LH showed a slight increase in the follicular phase and a slight decrease in the luteal phase. On the other hand, prolactin showed a continuous significant increase during exercise in both phases. These data suggested that strenuous daily training leads to a frequent significant increase in prolactin in athletic women and this frequent increase in prolactin may be one of the major factors causing menstrual dysfunction in athletic women. The specialized physician should be more concerned about the managing of athletes who are suffering from menstrual dysfunction.

[Hormonal changes during incremental exercise in athletic women].

Recently, the number of women who participate in strenuous sports has increased rapidly. The evidence indicating a causal relationship between athletic activity and increased incidence of menstrual dysfunction has led to increased interest. Five basketball players who are among the top players in Japan were subjected to an investigation of the endocrinological responses effected by incremental exercise using a cycle ergometer. Serum levels of FSH and LH decreased significantly in the follicular phase, but there was no change in the luteal phase. Estradiol was seen to increase significantly in the luteal phase but no change occurred in the follicular phase. Progesterone did not show a significant change during exercise. Although TSH did not show any significant change, prolactin showed a significant increase in both phases. These results suggest that strenuous daily training leads to a frequent increase of prolactin in athletic women and this frequent increase of prolactin may be one of the major factors in causing menstrual dysfunction.

[Effect of menstrual cycle on cardiorespiratory system during incremental exercise].

According to the results of questionnaires to college athletes, they believe the follicular phase is better than luteal phase for competitive sports. However, it is not clear whether there is significant difference in athletic performance between the two phases of the menstrual cycle. The effects of the menstrual cycle on the cardiorespiratory system were investigated in exercising women who are top players of basketball in Japan. They performed incremental exercise on a cycle ergometer. During the exercise, the ECG and heart rate (HR) were monitored. The expired air was sampled continuously and expiratory gas volume/minute (VE), oxygen uptake (VO2), carbon dioxide output (VCO2), gas exchange ratio(R) and respiratory rate (Resp. E.) were measured. Blood samples were collected to measure the blood lactic acid concentration during the exercise. HR in the luteal phase is higher than in the follicular phase at rest and throughout the exercise. VE, R and Resp. R. at rest and during exercise indicated a tendency to a higher level in the follicular phase. The blood lactic acid concentration during exercise in the follicular phase indicated a tendency to increase more rapidly than in luteal phase. However, no statistical differences in the cardiorespiratory system were detected when the follicular and luteal phase were compared. These results did not indicate conclusively in which phase it is better for athletic women to take part in competitive sports.

[Menstrual characteristics in college athletes].

This study investigated the influences of endurance physical exercise on menstrual characteristics in college athletes. 311 college students at the University of Tsukuba (174: college athletes, 137: non-athletes, control students (group C) ) completed questionnaires which inquired about their menstrual history. College athletes were divided into two groups with hard physical activity (group A) and moderate physical activity (group B). The physical profile showed that group A and B had a lower total body water/body weight ratio than group C. The incidences of prolonged menstruation and hypomenorrhea of athletes were higher than those of non-athletes. There was no significant difference in the incidence of dysmenorrhea. However, the incidence of cases which required the medication to treat dysmenorrhea was lower in athletes than in non-athletes. Regarding the menstrual cycle, there was no significant difference in the incidence of oligomenorrhea and polymenorrhea in the three groups. On the other hand, the incidence of irregular menstrual cycles in group A was significantly higher than in group C. Athletes replied that the period of good physical condition during the menstrual cycles occurred in the late follicular and ovulatory phase. On the other hand, the period of bad condition was in the late luteal phase and during the menstrual period. Only 21.4% of athletes desire to regulate the menstrual cycle according to their sports schedule. The specialized physician should be more concerned either about managing the athletes who are suffering from menstrual dysfunction or about establishing a way to control the menstrual cycle.

[Delayed menarche following early onset of athletic sports training].

To investigate the effect of athletic sports training on the onset of menarche, we submitted questionnaires to college students at University of Tsukuba. 311 students (174 college athletes and 137 non-athlete control students (group C) completed the questionnaires. The college athletes were divided into hard physical activity (group A) and moderate physical activity (group B) groups. The average age was similar in each group. The physical profile showed that group A and B were significantly (p less than 0.001) taller and heavier than those of group C. There was no significant difference among the average menarcheal age of group A (12.9 +/- 1.1 years, Mean +/- S.D.), group B (12.8 +/- 1.1 years) and group C (12.6 +/- 1.0 years). However, some of athletes in group A who had begun sports training before menarche had a later menarcheal age (13.1 +/- 1.1 years, p less than 0.001), and others who had begun training after menarche had a significantly earlier menarcheal age (12.1 +/- 0.9 years, p less than 0.001) whereas in group B the average menarcheal ages of premenarche-trained (12.9 +/- 1.1 years) and postmenarcheal-trained (12.3 +/- 1.1 years) students were similar to that of group C. These data indicate that early beginning of hard athletic training delays the onset of menarche.