Influence of conjugated linoleic acid and vitamin E on performance, energy metabolism, and change of fat depot mass in transitional dairy cows.

The objective of this experiment was to determine the effects of conjugated linoleic acid (CLA) and vitamin E as well as their interaction on performance variables and lipomobilization during late pregnancy and early lactation (wk 6 antepartum until wk 10 postpartum). For this purpose, 59 pluriparous German Holstein cows were assigned to 4 dietary groups in a 2 × 2 design with the factors CLA and vitamin E at 2 levels. For this trial, we selected cows with a high body condition score because they are more likely to mobilize fat and consequently are at a higher risk of developing ketosis. Furthermore, concentrate proportions were adjusted to provoke ketosis. Lactation performance variables were analyzed in 3 periods (d 42 antepartum until calving, 1 to 21 d in milk, 22 to 70 d in milk). Dry matter intake and net energy intake were reduced in animals receiving CLA. Milk fat content was reduced in the CLA group compared with the control group (4.83 vs. 5.46% in period 2; 3.36 vs. 4.57% in period 3). In the vitamin E and the CLA + vitamin E groups, reduction of milk fat content was observed in period 3 (3.76 vs. 4.57% compared with the control group). Milk yield was not affected by treatment. ß-Hydroxybutyrate concentrations and liver lipid contents were not influenced by CLA or vitamin E. Moreover, longitudinal changes of adipose tissue depot mass were not affected by dietary treatments. Results suggest that the effects CLA had on milk composition were compensated by an increased milk yield and a decreased dry matter intake. Reduced milk energy output in CLA-treated animals was compensated by a reduced dry matter intake. Therefore, the net energy balance was not affected by either treatment. Consequently, we found no group effect on the mobilization of adipose tissue.

[Recreational athletes and doping--a survey in 11 gyms in the area of Frankfurt/Main]. / Doping bei Freizeitsportlern--Eine Untersuchung in 11 Fitnessstudios im Raum Frankfurt am Main.

BACKGROUND: Doping no longer concerns exclusively competitive sports, but also recreational sports. METHOD: Survey of 484 recreational athletes in 11 gyms in the area of Frankfurt/Main. RESULTS: 12.9% of the men and 3.6% of the women reported to take anabolic drugs. Theyconsumed anabolic steroids (100%; 35% p.o., 71% parenterally), stimulants (14%) and growth hormone (5%). Suppliers were friends (39%), sports mates (28%), physicians (28%) and coaches (6%). The acquisition costs amounted to an average intake over 9 weeks to 175 Euro. Information about doping side effects came from literature (67%), physicians (38%), sports mates and the so-called Black Book (14% respectively), coaches, friends and Internet (5% respectively). 2% of the athletes with abuse of doping substances were smokers, 11% had a drink several times a week, 3% also consumed other drugs, 35% had consumed other drugs in the past. Abusers of doping substances primarily intended to increase muscle size (86%) and strength (61%). CONCLUSION: From a sports medical point of view it is concerning that the proportion of doping drugs prescribed by physicians has doubled in the decade after the publication of the predecessor study in Northern Germany despite optimized sports medical and legal education measures.

[Effects of headers on coagulation parameters]. / Zum Einfluss repetitiver Kopfballstossmanöver auf Parameter der Blutgerinnung.

BACKGROUND: This paper is testing the hypothesis whether headers can cause micro-traumata which can be verified in lab test. METHOD: The study examined micro-traumatic effects of headers for a sample of 22 soccer players by the means of blood tests. In the test arrangement, two probands intensively exchanged headers with a standard football (according to official regulations of the German Football Association) fora period of eight minutes.The average number of ball exchanges per series amounted to around 401 headers for each pair. The effects were measured by selected coagulation parameters. RESULTS: The results showed significant differences in the concentration of leucocytes and thrombocytes. The variance analysis of coagulation parameters revealed no significant change for fibrinogen concentration, INR and Quick. By contrast, the reduction of aPTT after the headers was significant. CONCLUSION: As for an interpretation of these results, the observed increase of the parameters may be characterised as a reaction to stress. The increase of thrombocytes could be seen as response of the corpuscular coagulation system to traumatisation. As aPTT is significantly reduced post intervention, this furthermore reflects an activation of the plasmic coagulation system induced by trauma.

[Analysis of sports injuries covered by German occupational accident insurance associations at a former district hospital over a period of six years]. / Analyse der berufsgenossenschaftlichen Sportunfälle eines ehemaligen Kreis- krankenhauses uber den Zeitraum von sechs Jahren.

An epidemiological analysis was carried out of 1,126 sports injuries covered by German occupational accident insurance at a small regional hospital over a period of six years, of which 86.6% were allotted to the sport at schools. The types of sport most frequently involved were general fitness sports (n = 486), soccer (n = 137), volleyball (n = 126), gymnastics (n = 125) and basketball (n = 121). In the general fitness sports (n = 228 women/girls, n = 258 men/boys), bruising injuries dominated (47%), followed by sprains (29%), mostly involving the upper extremities (53%). In soccer injuries (proportion of woman = 15%), bruising and injuries to the lower extremities ranked first. Falls (33%) and sprains (31%) were the most common gymnastics injuries. Injuries to the upper extremities were most common in volleyball and basketball with 72% and 68% respectively. The distribution of these sports injuries more or less mirrors the distribution of sports disciplines at schools and institutions like the Federal Border Police. Sporting activity here should include preventive elements such a proprioceptive training.

[A 15-year-old boy with spontaneous pain in the lower leg]. / Knacks beim Kicken. Was war die Ursache für die Spontanfraktur?

On kicking the ball during a football tournament, and with no involvement of any other player, a 15-year-old boy experienced a spontaneous fracture of the tibia with no fragment displacement. The X-ray of the region of the fracture revealed a cystic structure measuring approximately 3 cm x 2 cm x 2 cm. After eight weeks of conservative treatment, radiography showed bony consolidation of the cyst, and the patient was pain-free. The differential diagnosis must give consideration to juvenile and aneurysmal bone cysts, giant cell tumors and malignant tumors (e.g. osteosarcoma and Ewing's sarcoma).

In vivo determination of subcutaneous and abdominal adipose tissue depots in German Holstein dairy cattle.

Ultrasonography was used as a noninvasive method for quantitative estimation of the subcutaneous and abdominal adipose tissue depots in dairy cattle. The prediction model was created and validated with a total of 29 German Holstein cows; 6 were in early lactation (≤100 d in milk [DIM]) and 16 were in advanced lactation (101 to 292 DIM). Seven cows were nonpregnant and nonlactating and had been off milk for 350 to 450 d. Transcutaneous assessment of the thickness of subcutaneous and retroperitoneal adipose tissue was done at 16 sites on the body surface of all cows. After completion of the ultrasonographic measurements, the cows were slaughtered and the adipose depots were separately weighed. A stepwise multivariate regression analysis of the ultrasonographic variables was performed to estimate the slaughter weights of the different fat depots. Slaughter weights of the fat depots ranged from 5.0 to 43.0 kg for subcutaneous adipose tissue (SCAT), from 13.7 to 98.8 kg for abdominal adipose tissue (AAT), from 3.4 to 30.3 kg for retroperitoneal adipose tissue (RPAT), from 5.2 to 39.6 kg for omental adipose tissue (OMAT), and from 4.0 to 35.8 kg for mesenteric adipose tissue (MAT). The relationship between calculated amount of fat and slaughter weight of fat had coefficients of determination () and root mean square errors (kg) of 0.88 and 3.4, respectively, for SCAT; 0.94 and 6.1, respectively, for AAT; 0.94 and 1.7, respectively, for RPAT; 0.83 and 3.2, respectively, for OMAT; and 0.95 and 1.6, respectively, for MAT. The accuracy of ultrasonographic measurement of the different fat depots appears sufficient for the quantitative assessment of internal and subcutaneous fat stores in cows. This method is noninvasive and therefore allows safe and repeated monitoring of the amount of stored fat in different adipose tissue depots of German Holsteins cows.

[Stress-induced changes of attention during choking in judo]. / Stressinduzierte Aufmerksamkeitsänderungen beim Würgen im Judo.

The aim of the investigation is the registration and analysis of cognitive parameters in the alarm phase of the stress reaction during a conventional judo cross choking technique. 57 judoka (41 males, 16 females; mean age 23.1 +/- 6.7 years) underwent a standardized cross-choking maneuvre (juji-jime), which lasted for 6 - 8 s until giving up, carried out by a black belt physician. The Stroop inference test was performed before and twice after the intervention. The reading velocity of the interference task was reduced by an average of 77.4 s to a mean of 74.4 s (p < 0.01), and the number of reading errors decreased by a mean from 2.9 to 2.1 (p < 0.01), finally increasing to 2.4 s. The data show the most important improvement in performance in 25 s after choking in the male judoka. In the female judoka increasing performance started already 25 s before choking and continued 25 s after the intervention. The alarm reaction following the potential life threatening stressor with an attack upon the throat improves selective attention before (female subjects) and after choking (female and male subjects) depending on gender.

[Medical insurance focus on sports disabilities: the knee joint]. / Versicherungsmedizinischer Invaliditätsfokus durch Sportunfälle: Das Kniegelenk.

This retrospective epidemiological study analyzes the distribution of sports invalidism in Berlin and Brandenburg in a period of four years, based on the data material of the German Lloyd sports insurance company and medical expert opinions. Over 600 cases occurred in a period of four years in more than 40 types of sports disciplines; most of them were registered in soccer (57%), followed by handball (13%), volleyball (4%) and judo (4%). Most of disablements were found during competition (63%). Most of incapacities were concerned with the knee joint (48%).

[Epiphysiolysis capitis femoris caused by a repeat minor trauma]. / 14-Jähriger mit Hüftschmerz nach Bagatelltrauma. Bleiben Sie am Ball--sonst wird's kompliziert.

We discuss the case of a 14-year-old boy who, after two episodes of mild recurrent sports trauma, presented with restricted mobility of the right hip due to substantial pain. Radiography revealed an acute slipped capital femoral epiphysis affecting the right femoral head. We report on the successful emergency osteosynthesis, and follow-up. On the basis of the current literature, we also discuss the clinical course of this lesion.

Significantly lower prevalence of Helicobacter pylori in uremic patients than in patients with normal renal function.

The objective of the study was to evaluate the prevalence of Helicobacter pylori in patients with different degrees of renal function. Two hundred and twenty consecutive patients requiring gastroscopy for upper intestinal symptoms were enrolled in the study: group I (normal renal function, n = 127), group II (chronic renal failure, creatinine clearance > 5 < 90 ml/min, n = 59), and group III (hemodialysis therapy, n = 34). On endoscopy, biopsy specimens were taken for analysis of H. pylori infection by urease test and histology. The prevalence of H. pylori in patients with renal dysfunction proved to be significantly lower than that in patients with normal renal function (22.6% vs 37%, P < 0.05). The incidence of ulcer disease in patients with normal renal function was higher than that in uremic patients (14.2% vs 10.8%, not significant). These findings indicate that uremic patients seem to be partly protected against H. pylori infection.

Spectral analysis of electroencephalography changes after choking in judo (juji-jime).

PURPOSE: The present study was carried out to investigate possible electroencephalographic changes induced by choking in judo (shime-waza) by means of spectral analysis and brain mapping. METHODS: Power spectral changes in Electroencephalography (EEG) were recorded in six experienced judoka who underwent a choking trial with a "shime-waza choking" technique called juji-jime. RESULTS: A significant increase of global field power in the delta- and theta-range occurred, while physiological alpha-power decreased. These changes in the low-frequency range reached a statistically significant level within a time span up to 20 s after choking, which was performed at an average choking time of 8 s. In no case did choking provoke neuropsychological symptoms. Yet, spectral EEG-analysis revealed subclinical changes of brain function. CONCLUSIONS: Choking in judo may induce subclinical electroencephalographic perturbations. The extent and duration can be objectified by means of spectral analysis of EEG data, global field power computation, and brain-mapping representation.

Is there seasonal periodicity in the prevalence of Helicobacter pylori?

The objective of the present study was to evaluate seasonal periodicity in the prevalence of Helicobacter pylori. A prospective study was performed on 1076 consecutive patients who were investigated in our hospital over a 3-year span because of epigastric complaints. Our findings indicate a significant accumulation of positive Helicobacter pylori tests in October. Gastric acidity, gender, and age did not influence Helicobacter pylori infection significantly. There was no significant correlation between potential seasonal influence on the diagnosis of ulcer disease and the seasonal fluctuation of Helicobacter pylori infection. The seasonality was confirmed by cosinor analysis for the absolute frequencies of H. pylori infections and also for the number of cases positive for H. pylori per number of presenting patients per month. A seasonal concept of a sensitivity threshold for positive Helicobacter pylori testing is introduced, taking into account such factors as immune system, nutrition, and medication status.

Anthropometric data and acetylsalicylic acid pharmacokinetics.

The relationship between anthropometric data and pharmacokinetic characteristics of acetylsalicylic acid (ASA) after administration of a single oral dose of 500 mg ASA, an oral and intravenous dose of 500 mg D,L-lysine-mono-acetylsalicylate (Lys-ASA) and an oral dose of 1,000 mg Lys-ASA were evaluated. Individual data from an open, randomized crossover trial in 13 healthy volunteers (age 18-50 years, 6 female, 7 male, height 158-189 cm, weight 45-118 kg) were re-analyzed using a non-compartmental approach. The influence of body weight, height, body surface area and age on pharmacokinetic characteristics (Cmax, Tmax, AUClast, MRTlast, t 1/2, Cl, Vd) was assessed using the multiple regression method and pairwise multiple correlations were calculated. Multiple regression analysis showed significant multiple correlation coefficients of approximately 0.86 for Cmax (500 mg Lys-ASA i.v., 1,000 mg Lys-ASA per os and 500 mg ASA per os), Cl and AUClast (1,000 mg Lys-ASA per os). Standardized regression values (beta) reflected a major contribution for height, weight and body surface area, but age was not a relevant factor. Pairwise comparisons confirmed negative correlations between anthropometric characteristics and Cmax, AUClast and MRTlast and positive correlations between anthropometric data, Cl and Vd. In conclusion, apart from Tmax and t 1/2, all pharmacokinetic characteristics were influenced by body weight, height and body surface area. Whereas repeated administration of high doses in patients with low body weights may give rise to toxic effects, acute single dose administration would not lead to significant under-dosing in tall or stout patients.

Uniform decrease of alpha-global field power induced by intermittent photic stimulation of healthy subjects.

Nineteen-channel EEGs were recorded from the scalp surface of 30 healthy subjects (16 males and 14 females, mean age: 34 years, SD: 11.7 years) at rest and under trains of intermittent photic stimulation (IPS) at rates of 5, 10 and 20 Hz. Digitalized data were submitted to spectral analysis with fast fourier transformation providing the basis for the computation of global field power (GFP). For quantification, GFP values in the frequency ranges of 5, 10 and 20 Hz at rest were divided by the corresponding data obtained under IPS. All subjects showed a photic driving effect at each rate of stimulation. GFP data were normally distributed, whereas ratios from photic driving effect data showed no uniform behavior due to high interindividual variability. Suppression of alpha-power after IPS with 10 Hz was observed in about 70% of the volunteers. In contrast, ratios of alpha-power were unequivocal in all subjects: IPS at 20 Hz always led to a suppression of alpha-power. Dividing alpha-GFP with 20-Hz IPS by alpha-GFP at rest (R = alpha-GFP(IPS)/alpha-GFP(rest)) thus resulted in ratios lower than 1. We conclude that ratios from GFP data with 20-Hz IPS may provide a suitable paradigm for further investigations.

Influence of choking in Judo on vision in well-trained Judoka: an explorative field study.

The present study was designed to investigate the effects of a cross-choking-technique commonly used in Judo on visual acuity. In 156 Judokas, experienced in competition, visual acuity was examined before and after choking (Juji-Jime). The average age of the 46 female and 110 male subjects was 22.8 years (standard deviation 10.5 years). In all examined grades of distance (infinite, 0.55 m and 0.4 m), eye tests showed an improvement of visual acuity after choking on a highly significant scale. In quantitative terms, vision the far sight range was optimized more clearly than in the close ranges. The following mechanisms are discussed as possible causes of the present results: an increase of blinking frequency induced by stress, an optimized tear film covering the cornea, a stenopaeic gap induced by improved blinking, pupillomotor alterations and an improved cerebral processing of visual signals and information. From an evolutionary-biologic perspective, the benefit of this psychophysiological mechanism might consist in an improvement of visual acuity in moments of danger, approaching from a distance and, thus, better chances of survival.

The influence of the mode of emergency ambulance transportation on the emergency patient's outcome.

Emergency transport by an ambulance can cause considerable psychical and physical stress for patients. We determined the haemodynamic and endocrinological values of 54 healthy volunteers subjected to one high speed emergency transport and one smooth transport. There were significant differences in all measurements: heart rate (p < or = 0.001), blood pressure, cortisol (p < or = 0.01), prolactin, somatotropine and ACTH between the two modes of transportation. We hypothesize that the additional stress of high speed ambulance transport particularly in patients with acute cardiac disease may result in additional morbidity.

Longterm treatment of psoriasis using fumaric acid preparations can be associated with severe proximal tubular damage.

Fumaric acid preparations are used as longterm and effective treatment of psoriasis. Apart from gastrointestinal, dermatological and hematological side-effects, transient renal damage was observed during treatment with fumaric acid. The case of a 38 year old woman who was treated with fumaric acid (420 mg bid) for 5 years before she complained of fatigue and weakness. According to clinical laboratory she had developed severe proximal tubular damage. Hypophosphatemia, glycosuria and proteinuria persisted although medication was stopped immediately.

[Pharmacokinetics after oral and intravenous administration of d,l-monolysine acetylsalicylate and an oral dose of acetylsalicylic acid in healthy volunteers]. / Etude pharmacocinétique après administration orale et intraveineuse d'acétylsalicylate de DL-lysine et administration orale d'acide acétylsalicylique chez des volontaires sains.

We studied the ASA pharmacokinetics of single doses of 500 mg and 1000 mg of D,L-lysine-monoacetylsalicylate (Lys-ASA) administered both orally (Delgesic) and 500 mg parenterally (Aspisol) as well as 500 mg acetylsalicylate (ASA, Aspirin) in 13 healthy volunteers. Blood samples were taken before and at defined times up to 48 h after application of Lys-ASA and ASA. Analysis for ASA and its metabolite salicylic acid were performed by HPLC. All concentration versus time data were presented descriptively. As far as ASA was concerned, differences were assessed by means of ANOVA according to Friedman including post hoc Wilcoxon tests for each time point. Pharmacokinetic parameters were calculated based on a one-compartment model. The concentration vs. time curves after oral intake of 500 mg of ASA and Lys-ASA differed significantly (p < 0.001). Peak serum ASA concentrations (Cmax) were 6.8 mg/l for oral Lys-ASA and 2.7 mg/l for ASA per os. The corresponding tmax-values were 14.2 and 38.0 min. Absolute bioavailabilities for 500 mg doses were 75.4 and 63.4 pour cent, respectively. After intake of 100 mg and 1000 mg oral doses of Lys-ASA Cmax was 2.7 mg/l and 15.9 mg/l, tmax being 14.2 min for the 1000 mg dose. The shortest half-life was found after i.v. injection with 7.5 min. Metabolism was fast with maximum rise of salicylic acid concentration after injection of Lys-ASS. We conclude that concerning time dimension oral administration of Lys-ASA is almost equivalent to i.v. Lys-ASA and may be an alternative for i.v. administration in cases of acute heart attacks.

[Organ pathology causing sudden death in athletes. International study of autopsies (Germany, Austria, Switzerland)]. / Organpathologische Ursachen des akuten Sporttodes. Eine internationale Autopsiestudie (Deutschland, Osterreich, Schweiz).

BACKGROUND: Accordance of all studies concerning the distribution of causes of cardiovascular sports deaths can only be registered in the dominating role of coronary heart disease and myocardial infarction among athletes > 35 years. In North America a predominance of hypertrophic cardiomyopathy among younger sportsmen (< or = 35 years) is described. This study investigates the conditions in the German speaking countries in central Europe. PATIENTS AND METHODS: The present prospective and retrospective 1.5-year (July 1996 to December 1997) study is based on post-mortem examinations of 28 institutes of pathology and forensic medicine in Germany, Austria and German speaking Switzerland. RESULTS: Twelve out of 113 cases (10.6%) were females, their age being significantly lower (27.8 years, sd = 15.2) than the age of the males (37.5 years, sd = 16.5). Eighty sports deaths (70.8%) were caused by cardiovascular reasons, 33 sports deaths (29.2%) were traumatic in origin. The main cause of cardiovascular deaths of the older athletes (> 35 years) was the coronary heart disease (84.1%). The main reasons for cardiovascular deaths of younger athletes (< or = 35 years) were the coronary heart disease (36.1%) and myocarditis (30.6%). A case of hypertrophic cardiomyopathy was not registered. Most of sports deaths happened in soccer (28), jogging (15), walking (8), cycling (7) and skiing (7). Most of traumatic sports deaths were registered in aerial sports. Four ball players (soccer n = 3, handball n = 1) and 1 motor cyclist suffered from a thrombosis after an orthopedic injury and died due to a consecutive pulmonary embolism. CONCLUSIONS: The distribution of cardiovascular sports deaths displays astonishing regional differences. In contrast to North America anatomical-pathological studies of German speaking countries do not show any dominance of hypertrophic cardiomyopathy among younger athletes, although the pathologists in recent investigations knew the results of Maron. Possible explanations for this phenomenon might be varying selections of patients (top-performance athletes and hobby sportsmen) or a different genetical background.

[Emergency service utilization and athletic injuries--data collection from the Fulda district]. / Rettungsdiensteinsätze und Sportunfälle--eine Erhebung im Bezirk Fulda.

Throughout the period of one year all sports accidents, which implied the need of medical services (n = 59), in the district of Fulda with 195,000 inhabitants were analysed. The bulk of the accidents took place during soccer matches (37.3%). The share of women was 25.4%. A repeated trauma was registered in 69.5% of the cases. 16% of the casualties received outpatient treatment. The ambulance was already at the site of the accident in 35.6% of the cases. The greater part of the accidents happened in the afternoon (57.6%). The accident was caused due to another athlete in 44.1% of the accidents. An ambulance with a doctor on board was needed four times, because the injury demanded treatment by an internist. The principle measure of first aid, taken by the ambulance men, was the positioning of the injured limb on a splint (n = 44). The incidence of sports accidents with need for medical service is 30/100,000 inhabitants. The part of sports accidents in relation to all ambulance actions is 2.3% (internal medicine only 0.18% and surgery only 15.3%). The percentage of sports accidents demanding a doctor in relation to all rescues with the need for a doctor is 0.3%.