Expression of extracellular matrix proteins nidogen-1 and legumain in endometrial carcinomas.

PURPOSE: Our purpose was to comparatively investigate the expressions of nidogen-1 (NID1) and legumain (LGMN) in patients with endometrial cancer, endometrial intraepithelial neoplasia, and proliferative endometrium. METHODS: A cross-sectional, single-center study was performed by the obstetrics and gynecology and pathology departments of our institution. The relationships between descriptive data, clinicopathologic information, and immunohistochemical expressions of NID1 and LGMN were investigated. RESULTS: The histological grades of endometrial cancers (n = 124) as classified by FIGO included 1 (41, 21.1%), 2 (48, 24.7%), and 3 (35, 18.0%). The medians and ranges of deep and superficial NID1 expressions were 50.00 (0-285) and 5.00 (0-100), respectively. The intensity of legumain expression was noted as negative (30, 24.2%), mild (16, 12.9%), moderate (27, 21.8%), or strong (51, 41.1%). Median disease-free survival and overall survival were 75.00 (range: 1 to 170) months and 77.00 (range: 1 to 170) months, respectively. Patients with more intense expression of NID1 and LGMN displayed a higher histological grade. These patients were more likely to have a positive peritoneal cytology, larger tumor size, higher tendency for myometrial or lymphovascular invasion, involvement of ovaries, cervix, omentum, as well as lymph node metastasis, and recurrence. CONCLUSION: Our data indicated that the expressions of NID1 and LGMN may have important diagnostic implications in endometrial pathologies. Further studies should be performed to understand the significance of NID1 and LGMN in the pathogenesis of endometrial tumors.

A nomogram for decision-making of completion surgery in endometrial cancer diagnosed after hysterectomy.

OBJECTIVE: Extrauterine tumor spread is one of the essential determinants of disease outcome in endometrial cancer. However; more than 30% of patients still undergo incomplete surgery at the initial attempt. Strategies regarding the management of patients with incompletely staged early-stage disease or patients with undebulked advanced-stage disease remain controversial. Depending on postoperative uterine features and findings on imaging, patients may be put on observation or receive adjuvant therapy or undergo re-staging or debulking surgery followed by adjuvant therapy. To identify patients who would most benefit from a completion surgery, either for restaging or for cytoreduction, we developed a nomogram for estimation of extrauterine disease based on findings of final hysterectomy specimen. METHODS: Data of 336 patients whose extrauterine disease status was known were analyzed. A nomogram was constructed using patient characteristics including age, grade, myometrial invasion, lymphovascular space involvement, cervical involvement, and peritoneal cytology. The nomogram was internally validated in terms of discrimination, calibration and overall performance. RESULTS: The nomogram showed good performance accuracy with an area under the receiver operating characteristic curve of 0.870, a specificity of 95.5%, and a positive predictive value of 73.9%. Decision curve analysis revealed that the use of the nomogram in decision-making for completion surgery leads to the equivalent of a net 18 true-positive results per 100 patients without an increase in the number of false-positive results. CONCLUSIONS: Estimation of extrauterine disease from final hysterectomy specimen is possible with high predictive performance using the nomogram developed. The nomogram may help clinicians in decision-making for management of incomplete surgeries.

The association between serum ghrelin levels and large-for-gestational-age fetuses in patients with gestational diabetes mellitus.

We aimed to determine the relationship between serum ghrelin levels and large-for-gestational-age (LGA) fetuses in patients with gestational diabetes mellitus (GDM). A case-control study was conducted in 32 women with GDM and LGA fetuses (GDM + LGA group), 35 women with GDM and appropriate-for-gestational-age (AGA) fetuses (GDM + AGA group), 32 women with normal glucose tolerance (NGT) and LGA fetuses (NGT + LGA group), and 31 women with NGT and AGA fetuses (NGT + AGA group). All participants were recruited at the time of GDM diagnosis between 24 and 30 weeks of pregnancy. Participants also underwent ultrasonographic examinations. Serum ghrelin levels were significantly higher in GDM + LGA and GDM + AGA groups than in the NGT + AGA group. In the univariate model, biparietal diameter, head circumference, abdominal circumference (AC), femur length and ghrelin values were significant predictors of LGA fetuses. In the multivariate model, only AC remained as a predictor of LGA fetuses.

The effect of coenzyme Q10 on venous ischemia reperfusion injury.

BACKGROUND: Coenzyme Q10 (CoQ10) is a lipid-soluble benzoquinone with antioxidant features that make it important in the treatment of ischemia reperfusion injury. In this study, we aimed to investigate the beneficial effect of CoQ10 in the treatment of venous ischemia/reperfusion injury. METHODS: Eighteen Sprague-Dawley male rats were randomly divided into two equal groups: the control group and an experimental group (n = 9 rats). The experimental group received CoQ10 orally, and the control group received a control diet for 8 wk. An inferior epigastric island flap was raised, and the inferior epigastric vein was clamped for 9 h; the flap was then reperfused. All rats were sacrificed on postoperative day 5. The flap survival rate and levels of CoQ10, malondialdehyde, glutathione, and superoxide dismutase were assessed, and flap tissues were examined under a light microscope (×200 magnification) after being stained with Hematoxylin & Eosin. RESULTS: The flap survival rate and levels of CoQ10, glutathione, and superoxide dismutase were significantly higher, but level of malondialdehyde was lower in the experimental group. The mean flap survival rates and plasma levels of CoQ10 were 51% ± 24% and 251 ± 11 ng/mL in the control group, whereas they were 88% ± 7% and 692.8 ± 79.7 ng/mL in the experimental group with statistically significant differences (P < 0.001). Polymorphonuclear leukocyte infiltration was higher, and surface epithelial integrity was more impaired in the control group. CONCLUSIONS: We concluded that CoQ10 supplementation has a beneficial effect on venous ischemia and/or reperfusion injury and improves flap survival rate.

Key and Keyhole Model for Dorsal Onlay Cartilage Grafts in Correcting Nasal Deformities.

BACKGROUND: The shaping of the cartilage and keeping it in place is very significant for patients who need nasal reconstruction with costal grafts at traumatic or secondary rhinoplasties. In this study, a template is prepared during the surgery that shows the dorsal defect in a 3-dimensional manner and acts as a guide while shaping the cartilage. METHODS: Seventeen patients who required secondary rhinoplasties because of trauma or previous operations were included in this study. The patients were operated on between the years 2009 and 2013. The mean age of the patients was 24 years (19-38 years). According to the surgical technique, bone wax was placed in a sheath prepared from the finger of a sterile nylon surgical glove before the dorsal reconstruction. It was placed to the nasal dorsum and shaped over the skin with digital maneuvers. Afterward, the bone wax was stripped off the nylon glove, and it was used as a template to shape the cartilage graft. RESULTS: No need for revision rhinoplasties was seen in any of the patients during the mean follow-up period of 19 months. The patients stated that they were satisfied by both the functional and the aesthetic results. CONCLUSIONS: The bone wax template and the defect fit in a key and keyhole fashion. It is supported by multiple points on the nasal bone and the septum. Thus, it does not slide and its warping is avoided. We think that it gives satisfactory results and it shortens the learning process.

Effect of Topical Application and/or Systemic Use of Red Ginseng Extract on Wound Healing in Rats With Experimentally Induced Diabetes.

BACKGROUND: Red ginseng (Rg) is an herbal product that has been used in traditional medicine in Asian and European countries for many years. PURPOSE: To study the effects of Rg extract on wound healing when used systemically, locally, or in combination in rats with experimentally induced diabetes. METHODS: A total of 60 rats were randomly divided into 4 groups: saline (control), local Rg (LRg), systemic Rg (SRg), and local + systemic = combined Rg (CRg). A full-thickness wound (2 cm × 1 cm) was created on the back of the rats, and treatment protocols were carried out for 14 days. Wound areas of all rats were measured on days 0 and 14. Tissue samples were taken from the wound areas for histopathologic evaluation of inflammation, epithelialization, and fibrosis. Vascular endothelial growth factor (VEGF), CD4+, and CD8+ expressions were examined by immunohistochemistry. RESULTS: Wound contraction measurements were 63.8%, 80.5%, 88.5%, and 86.6% in the control, LRg, SRg and CRg groups, respectively. Although significant differences were observed for all treated groups (LRg, SRg, and CRg) compared with the control group in terms of wound contraction, there was no difference among the treatment groups. VEGF-positive vessel/mm2 was observed 4.00 ± 0.75, 5.93 ± 0.70, 5.93 ± 1.93, and 7.93 ± 0.70 in the control, LRg, SRg and CRg groups, respectively. There was no difference between LRg and SRg in terms of VEGF expression, but there was significant difference for all other groups compared with each other. CONCLUSION: All usage methods of Rg extract increased wound contraction, and differences were observed compared with the control group. However, the authors believe that the combined usage was more effective due to higher VEGF expression levels and lower CD4+:CD8+ ratio.

Reduction mammaplasty using bipedicled dermoglandular flaps and free-nipple transplantation.

BACKGROUND: Secondary revisions due to deflation, flattening, and ptosis have been the major concerns after free-nipple breast reduction procedures. This study used a new modification of the standard technique known as the "bipedicled dermoglandular flap method" to reduce reoperation rates. METHODS: A total of 24 patients were treated with the bipedicled dermoglandular free-nipple method between the years 2004 and 2008. The mean patient age was 45.6 years, and the average body mass index (BMI) was calculated as 27.8 kg/m². In contrast to the standard technique, the superior dermoglandular flap was fixed as backfolded, whereas the inferior flap was fixed directly to the pectoralis fascia together with the superior flap with polydiaxanone sutures. An average breast tissue volume of 1,736 g was removed. RESULTS: One case of seroma and one case of partial nipple graft loss (8%) were observed in the follow-up period. The patients were followed for an average of 32.4 months. Complications such as deflation, flattening, and Regnault's mild (1st degree), moderate (2nd degree), and severe (3rd degree) ptosis were not observed. However minimal glandular ptosis was observed in four cases (16.6%). Central peripheral minimal hypopigmentation was observed in five cases. None of these complications required reoperation. CONCLUSION: Bipedicled dermaglandular flap modification of conventional free-nipple reduction mammaplasty is a new option for reducing the probable complications of the standard technique.

Occipital cortex activation studied with simultaneous recordings of functional transcranial Doppler ultrasound (fTCD) and visual evoked potential (VEP) in cognitively normal human subjects: effect of healthy aging.

We evaluated effect of aging, gender and eye (sighting) dominance on relationship between visual evoked flow response (VEFR) and visual evoked potential (VEP), which refers to neurovascular coupling. The VEFR was defined as a percentage increase of the ratio of mean blood flow velocity in the contralateral (according to the side of dominant eye processing) posterior cerebral artery P2 segment to those in ipsilateral middle cerebral artery from the baseline during half-field stimulation. Vasoneural coupling index (CI) was defined as "100 x VEFR/VEP P100 amplitude". Compared to the healthy elderly subjects (n: 19; female/male: 6/13, mean age: 69.7 +/- 7), younger participants (n: 28; female/male: 16/12; mean age: 31.1 +/- 4.7) had significantly higher VEFR for both sides: 18.9 +/- 6.7% versus 11.2 +/- 6.7%, p < 0.001 and 17.3 +/- 7.7% versus 11.8 +/- 5.5%, p: 0.007, for the hemisphere contralateral to dominant and nondominant eye (D and ND side), respectively. Albeit absence of any correlation between their latencies, VEP and VEFR amplitudes were well correlated. However, this was significant only for younger subjects and more evident in D side. The CI was higher in young subjects compared to those in old ones (6.49 +/- 2.79 versus 4.75 +/- 2.35, respectively, p = 0.007). But, this age-related trend remained as borderline when sides were analyzed individually: In the young subjects CI was 5.99 +/- 2.21 and 6.96 +/- 3.22 for D and ND sides, while those were 4.27 +/- 2.60 and 5.19 +/- 2.07 in old ones. This study confirmed diminished visual evoked flow in relation with advancing age, and suggested that "weakened" neurovascular coupling (as evidenced by a decreased VEP and VEFR correlation along with decreased CI) as one of the underlying mechanisms.

Role of less commonly agreed risk factors on disease recurrence in endometrial cancer: a propensity scorematched comparison.

OBJECTIVE: To compare the clinicopathologic features of patients with endometrial cancer (EC) with recurrent disease with a primary surgery, stage, grade, and tumor histotype-matched cohort of patients without recurrence. MATERIALS AND METHODS: Patients with EC who were surgically treated at a single tertiary care institution between 2005 and 2015 were enrolled in this study. The dataset included 381 consecutive patients with EC, of which 31 (8.1%) had disease recurrence. Data consisting of age at surgery, CA- 125 concentration at diagnosis, number of lymph nodes harvested, growth pattern of the primary tumor, location of the primary tumor within the endometrium, tumor histotype, tumor grade, disease stage, adjuvant therapy, disease recurrence, time to recurrence, CA-125 concentration at recurrence, clinical and imaging findings at recurrence, and treatment modalities used for recurrent disease were extracted from the institutional database. RESULTS: After 1-to-1 propensity-score matching of patients with and without recurrence, the clinicopathologic features of 26 patients from each group were compared. Patients with recurrent disease were found to have a significantly higher CA-125 concentration at initial diagnosis (p<0.001) and different tumor growth pattern (p=0.019) than patients without disease recurrence. The papillary growth pattern of the primary tumor was significantly associated with disease recurrence as compared with polypoid and infiltrative patterns. Omental involvement, papillary tumor growth, and advanced age were associated with increased mortality. CONCLUSION: Our results indicated that higher CA-125 concentrations at initial diagnosis and papillary growth pattern of primary tumors were found to be associated with disease recurrence.

Uterine giant cell carcinoma: a case report and review of the literature.

Endometrial carcinoma is the most common genital malignancy in women. Endometrioid type is the most common variant of endometrial carcinoma described in literature. Giant cell carcinoma is a rare, and infrequently reported variant of endometrial carcinoma. We present a 75-year-old patient admitted with vaginal bleeding. Transvaginal ultrasound revealed a 26x28 mm hypodense lesion without any adnexal pathology. The patient underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, and bilateral pelvic, and paraaortic lymph node dissection. The final histopathology report indicated a 3.8x2x9 cm giant cell carcinoma variant of endometrial carcinoma and one positive external iliac lymph node metastasis. Administration of adjuvant carboplatin and paclitaxel chemotherapy was given. As far as we know, this is the fifteenth case reported in the English literature.

Stanniocalcin-2 May Be a Potentially Valuable Prognostic Marker in Endometrial Cancer: a Preliminary Study.

In the current study, we primarily aimed to investigate stanniocalcin-2 (STC2) protein expression pattern in hysterectomy specimens from patients with endometrioid type endometrial cancer (EC) using immunohistochemistry. Secondly, in order to clarify its prognostic impact, we examined relationships of the expression levels of STC2 with clinicopathologic features and outcome of patients. Histopathology slides of 49 patients were stained with the monoclonal mouse antibody targeting STC2 protein. The expression levels of STC2 were classified based on three-tiered semiquantitative scheme: negative expression, expression level of 0; low-expression, expression level of 1+; and high-expression, expression levels of 2+ and 3+. Recurrence-free survival (RFS) was used as the primary prognostic outcome. Immunohistochemical analysis revealed that 73.5% of tissue samples exhibited positive staining with STC2. The intensity of staining with STC2 was weak in 40.8%, moderate in 22.4%, and strong in 10.2%. Thirty-eight percent of samples showed negative expression; 18.4%, low-expression (1+); and 42.8%, high-expression (2 to 3+). High-expression of STC2 was significantly associated with grade 2-3 tumors (p = 0.026) and disease recurrence (p = 0.013). Multivariate analysis revealed that both the tumor grade and STC2 were independent predictors of disease recurrence. Kaplan-Meier analyses confirmed that patients with high-expression of STC2 had a significantly poorer RFS than those with negative or low STC2 expression (p = 0.037); although overall survival did not differ with respect to expression levels of STC2 (p = 0.148). In conclusion, high-expression of STC2 is a negative prognostic factor, associated with increased risk of recurrence in endometrioid EC.

A study detection of the ROS1 gene fusion by FISH and ROS1 protein expression by IHC methods in patients with ovarian malignant or borderline serous tumors.

OBJECTIVE: ROS1 is an orphan receptor protein tyrosine kinase which is supposed to undergo genetic rearrangement in carcinogenesis. In the current study, we aimed to investigate the frequency and clinicopathologic features associated with ROS1 gene fusion and ROS1 protein expression in patients with ovarian serous carcinoma or serous borderline tumors. MATERIALS AND METHODS: Tissue samples of 102 patients with high or low grade serous carcinoma and borderline serous tumors were selected randomly from the archives of Department of Gyneco-pathology, and analyzed for ROS1 gene expression. (Fluorescence in situ hybridization (FISH) method was used to assess ROS1 gene rearrangement, while ROS1 protein expression was analyzed using immunohistochemistry. RESULTS: The study consisted of 94 cases of high-grade serous carcinoma (92.1%), 2 cases of low-grade serous carcinoma (%2) and 6 cases of serous borderline tumor (5.9%). ROS1 gene rearrangement analysis revealed that 4 patients (3.9%) were FISH-positive; whereas the immunohistochemical analysis yielded only 1 patient (0.9%) exhibiting faint positive expression of ROS1 protein. Given the low incidences of ROS1 gene rearrangement and protein expression, their relationships with clinicopathologic parameters could not be statistically analyzed. CONCLUSION: Although rare, patients with ovarian serous carcinoma or serous borderline tumor may exhibit ROS1 gene rearrangement and ROS1 protein expression. Further large-scale studies are necessary to explore the clinicopathologic significance of ROS1 gene expression in ovarian serous carcinoma.

Impact of coexistent adenomyosis on outcomes of patients with endometrioid endometrial cancer: a propensity score-matched analysis.

PURPOSE: Despite the common occurrence of adenomyosis in endometrial cancer (EC), there is a paucity and conflict in the literature regarding its impact on outcomes of patients. We sought to compare outcomes of patients with endometrioid type EC with or without adenomyosis. METHODS: A total of 314 patients were included in the analysis. Patients were divided into 2 groups according to the presence or absence of adenomyosis. Adenomyosis was identified in 79 patients (25.1%). A propensity score-matched comparison (1:1) was carried out to minimize selection biases. The propensity score was developed through multivariable logistic regression model including age, stage, and tumor grade as covariates. After performing propensity score matching, 70 patients from each group were successfully matched. Primary outcome of the study was disease-free survival (DFS), and the secondary outcomes were overall survival (OS) and disease-specific survival (DSS). RESULTS: Median follow-up time was 61 months for the adenomyosis positive group and 76 months for the adenomyosis negative group. There were no statistically significant differences in 3- and 5-year DFS, OS, and DSS rates between the 2 groups. Five-year DFS was 92% vs 88% (hazard ratio [HR] 1.54 [0.56-4.27]; p = 0.404), 5-year OS was 94% vs 92% (HR 1.60 [0.49-5.26]; p = 0.441), and 5-year DSS was 94% vs 96% (HR 2.51 [0.46-13.71]; p = 0.290) for patients with and without adenomyosis, respectively. CONCLUSIONS: Coexistent adenomyosis in EC is not a prognostic factor and does not impact survival outcomes.

Effect of strength and endurance training on cognition in older people.

The purpose of this study was to investigate the effect of moderate strength and endurance training on cognition evaluated by event-related potentials (ERP) in older people. Thirty-six adults, aged 60-85 years, were randomly divided into three groups: sedentary control (C), strength training (ST), and endurance training (ET). Participants performed functional fitness tests and ERP data were recorded before and after nine weeks of training. Training involved three sessions per week. Functional fitness test performance improved significantly in the ST and ET groups. The latencies of the N1, N2, and P2 components and the amplitudes of the N1P2, P2N2, and N2P3 components differed significantly between groups (p < 0.05). After training, the latencies of the P2 and N2 components at the Fz and Cz sites, decreased significantly, and the amplitudes of the N1P2, P2N2, and N2P3 components at the Fz site and the N1P2 and N2P3 components at the Cz site, increased significantly in the ST group compared with the ET group. After training, the latencies of N1, N2, and P2 components shortened significantly, and the amplitudes of the N1P2, P2N2, and N2P3 components increased significantly in the ST group compared with the C group. The latencies of the N2 and P2 components shortened significantly in the ET group compared with the C group, although the amplitudes of the ERP recordings did not differ significantly between groups. These data suggest that strength training might facilitate early sensory processing and cognitive functioning in older individuals. Key PointsStrength training may have facilitating effects on early information processing and cognition in older people.It is interesting that only small improvements in functional fitness affected cognitive performance.More research is needed to determine how the different exercise regimens contribute to discrete changes in CNS functioning and how such changes affect the P3 component of the ERP.

Preexpanded perforator flaps of the dorsolateral trunk in pediatric patients.

BACKGROUND: Contractures and broad scars of the axilla, anterior chest wall, and neck have detrimental effects on functional, physical, and psychological development of children. Perforator flaps have already been shown to be reliable options for the reconstruction of contractures, but there have been no reports demonstrating the value of preexpanded perforator flaps of the dorsolateral trunk region in the treatment of extensive contractures and scars of pediatric patients. The purpose of this study was to demonstrate these techniques by a case series formed of pediatric patients with broad scars and contractures of the anterior chest wall, axilla, neck, and breasts. METHODS: Seven pediatric patients (mean age, 11.6 years) who were treated by preexpanded perforator flaps are presented. By this means, clinical experience regarding the intercostal artery perforator, thoracodorsal artery perforator, circumflex scapular artery perforator, and lumbar artery perforator flaps was shared. RESULTS: Flaps as large as 21 × 11 cm could be successfully transferred in pediatric patients. Broad scar tissues were resurfaced with broad flaps carrying similar characteristics with the uninjured anterior chest wall and neck skin in six of the authors' patients. In one patient with partial necrosis, a full-thickness skin graft was used for the residual defect. The mean duration of postoperative (after flap transfer) follow-up was 17.2 months. CONCLUSIONS: The preexpanded thoracodorsal artery perforator, intercostal artery perforator, and circumflex scapular artery perforator flaps are useful and effective reconstructive options for the treatment of scars and contractures of the anterior chest wall, axilla, neck, and breast in pediatric patients. CLINICAL QUESTION/LEVEL OF EVIDENCE: : Therapeutic, IV.

Lower eyelid reconstruction in a paediatric face: a one-stage aesthetic approach using the versatile temporoparietal fascia flap.

There are many different lower eyelid reconstruction techniques defined in the literature. Almost all of the published techniques have been described on elderly patients and use upper eyelid, periorbital or facial tissues as donor sites. However, in case of a paediatric patient or a young adult who has a crease-free and scarless face, camouflage of the facial donor-site scar is usually impossible. In order to avoid possible facial donor-site scars and upper eyelid deformities, a technique which uses the temporoparietal fascia (TPF) flap as the framework of a new eyelid was used for the reconstruction of an adolescent patient's postoncologic defect. The inner side of the flap was covered with nasal septal chondromucosal graft and the external side was covered with a retroauricular full-thickness skin graft. Eighteen months of unproblematic follow-up of this overlooked usage of the versatile TPF flap indicates that our technique has proved successful in terms of good functional and cosmetic outcome that is obtained at one stage.

Electrothermal bipolar vessel sealer in endoscope-assisted latissumus dorsi flap harvesting.

LigaSure™ is a new bipolar vascular sealing system commonly used in various fields of surgery. However, no reports have been published about its use in plastic surgery, particularly for endoscopic flap harvesting. In this study, we present the use of LigaSure in endoscope-assisted latissimus dorsi (LD) flap harvesting for breast reconstruction. Between 2006 and 2008, 11 female patients with the mean age of 33.4 (range, 20-49 years) who had previously undergone mastectomy operations were included in the study. First stage of reconstruction was performed with the ipsilateral LD harvested by the help of LigaSure and a tissue expander placed beneath the LD and pectoralis major muscles. Secondary reconstruction was done by a definitive silicon gel-filled implant placed after an average of 6.6 months of expansion (range, 6-9 months). Data concerning the hospitalization and operation times, drainage amounts, complications, etc., were recorded. Mean follow-up was 13 months (range, 8-18 months). Mean flap harvesting time was recorded as 74.2 minutes (range, 50-125 minutes), which shortened as the surgeon got used to the procedure. Patients were hospitalized for 3-7 days, with a mean hospitalization period of 5.5 days. The total mean drainage amount postoperatively was found to be 950 mL (range, 725-975 mL), which is relatively lower than the previously reported values. LigaSure use in endoscope-assisted LD harvesting is easy, safe, and time sparing with almost no complications observed in this small initial series. Although more controlled studies with larger number of patients need to be done to verify its effectiveness in terms of hospitalization, drainage amounts, etc., it holds promise for a wide spectrum of operations in the field of plastic surgery.

Vitamin E and aerobic exercise: effects on physical performance in older adults.

BACKGROUND AND AIMS: Aerobic endurance exercise enhances antioxidant defenses and improves the physical performance of older adults. However, the combined effect on physical performance of exercise and an antioxidant such as vitamin E has not been investigated. The purpose of this study was to evaluate the effects of six months of vitamin E supplementation and supervised aerobic training on physical performance and body composition in sedentary older adults. METHODS: Fifty-seven adults, whose average age was 71.5+/-7.5 years, were randomly assigned to an exercise (E), exercise-vitamin (EV), control (C) or vitamin (V) group, and were evaluated before, halfway through, and after training. The dose of vitamin E was 900 IU/day. The training program comprised three sessions of walking exercise per week, at an intensity of 70% of heart rate reserve. RESULTS: In the E and EV groups, the training program significantly reduced (p<0.016 for each) body weight and body mass index (BMI), and improved performance in the 6- min walk, chair stand, arm curl, and back scratch tests. Performance on the 6-min walk test improved in E and EV, but decreased in the V group. Performance on the chair stand test increased in the EV and E groups, but decreased in the V and C groups. Body weight and BMI decreased more in the EV group than in the C and V groups (p<0.016). CONCLUSIONS: Six months of vitamin E supplementation has no additive effect beyond that of aerobic training on indices of physical performance and body composition in older sedentary adults.

Effects of intrathecal administration of FK506 after sciatic nerve crush injury.

Although various administration routes of FK506 have been published, intrathecal administration of FK506 has not previously been reported in the literature. A daily dose of 0.05 mg/kg of FK506 was given (a small dose compared with those reported in the available literature). The authors used this small dose to obtain lower immunosuppression and neurotoxicity, and a higher axonal regeneration rate. A total number of 40 female Wistar rats were used and randomly divided into four groups: control, sham, FK506-treated, and vehicle-treated. Sciatic nerve regeneration was evaluated by walking track analysis, an electrostimulation test, and light microscopic evaluation. There was a statistically significant difference ( P < 0.05) between FK506-treated and vehicle-treated groups at the end of 6 weeks according to both the walking track analysis and the electrostimulation test. Comparing the stimulus thresholds of the sham and FK506-treated group, no significant difference ( P > 0.05) was observed. Evaluation of the data revealed that FK506 had a beneficial effect on sciatic nerve regeneration.