How Does a 12-Week Physical Exercise Program Affect the Motor Proficiency and Cognitive Abilities of Overweight and Normal-Weight Preschool Children?

The objective of this research was to examine a 12-week exercise program and its impact on the motor proficiency and cognitive abilities of preschool children with overweight and normal weight. The study involved a total of 71 participants who were preschool children enrolled in a longitudinal study. Body mass index (BMI) was determined by measuring body height and weight, and the nutritional status of the children was assessed using the World Health Organization's (WHO) criteria. Motor proficiency encompasses both motor abilities and motor skills, and the assessment of motor abilities was conducted using subtests from the Bruininks-Oseretsky Test of Motor Proficiency (BOT-2). These subtests measured fine motor integration, manual dexterity, balance, and bilateral coordination. The evaluation of motor skills involved the utilization of the Test of Gross Motor Development (TGMD-2), which examines both locomotor skills and manipulative skills. Cognitive abilities were assessed using the School Maturity Test (TZS). All participants, regardless of weight status, took part in a 12-week physical exercise program. According to the World Health Organization's criteria, 52 children (73.2%) were categorized as having a normal weight, while 19 children (26.8%) were classified as overweight. These findings indicate that every fourth child in the study was overweight. Using a statistical analysis called SPANOVA (2 × 2, group × time), differences were observed in three out of eleven variables. Specifically, there were significant differences in two motor skill variables: manipulative skills (p = 0.006) and total movement skills (p = 0.014). Additionally, there was a significant difference in one cognitive ability variable: visual memory (p = 0.010). No significant differences were found in the remaining variables. The findings of this study aimed to contribute to the understanding of the potential benefits of regular exercise on motor and cognitive development in preschool children, specifically examining the differences between overweight and normal-weight children. By investigating these effects, the study could provide valuable insights for educators, parents, and health professionals involved in promoting the overall well-being of preschool-aged children. Regular physical exercise has been found to have positive effects on motor and cognitive abilities in both overweight and normal-weight preschool children.

Clinical findings, treatment and outcome of trapped neutrophil syndrome in Border Collies: 12 cases (2011-2022)

OBJECTIVES

This study aimed to evaluate clinical signs, diagnostic findings, treatment administered and short- (survival to 28 days) and long-term prognosis (survival >6 months) in dogs diagnosed with trapped neutrophil syndrome.

MATERIALS AND METHODS

Medical records of 12 dogs (10 Border Collies and two Border Collie Crossbreeds) homozygous for VPS13B gene mutation causing trapped neutrophil syndrome from seven veterinary institutions between January 2011 and June 2022 were evaluated retrospectively.

RESULTS

The most common clinical signs at the time of diagnosis were pyrexia, abnormal gait and gastrointestinal signs. Concurrent metaphyseal osteopathy and immune-mediated polyarthritis were common. Seven dogs had a segmented neutrophil count below, four dogs within and one dog above the analyser reference interval at presentation. Two dogs had a septic source identified and both were additionally identified to be homozygous mutant positive on DNA testing by polymerase chain reaction (PCR) for canine cyclic neutropenia. All dogs received at least one antimicrobial agent and 10 dogs received treatment with prednisone or prednisolone (median starting dose 1 mg/kg/day; range 0.5 to 2.5 mg/kg/day). Nine dogs were alive at 28 days and six dogs were alive at 6 months post-diagnosis.

CLINICAL SIGNIFICANCE

Trapped neutrophil syndrome should be suspected in young Border Collies with pyrexia, lameness and gastrointestinal signs. Neutropenia may not always be present and long-term survival is possible. A septic focus was not commonly identified in our population; however, our results suggest that if identified, testing for concurrent canine cyclic neutropenia should be considered.

Validity and reliability of the My Jump 2 app for detecting interlimb asymmetry in young female basketball players

Introduction

The aim of this study was to examine the validity and reliability of the My Jump 2 app for the assessment of interlimb jump asymmetry in young female basketball players.

Methods

Nine athletes (age 15 ± 0.9 years; weight 62.9 ± 5.8 kg; height 173.6 ± 6.1 cm) performed single-leg drop jumps (DJs) and both-leg drop jumps on a force plate (Kistler Quattro jump) and were simultaneously recorded on two smartphones using the My Jump 2 app. Jump height from flight time and contact time data were statistically analyzed to evaluate the validity of two different camera settings, drop jump performance, and interlimb jump asymmetry in basketball players. The testing was repeated after 1 week for test retest reliability.

Results

High test-retest reliability [intraclass correlation coefficient (ICC) > 0.88] was observed in DJ height. High correlation between the force plate and the My Jump 2 app was observed in DJ height (r = 0.99) and DJ contact time (r = 0.98). For the interlimb jump height asymmetries, mean differences were 0.6 percentages for the My Jump 2 app and the force plate, respectively (p = 0.77). Inter-device reliability revealed almost perfect correlation for the DJ height (ICC = 0.99, r = 0.98).

Conclusion

The My Jump 2 app is a valid and reliable tool to assess drop jump performance and interlimb asymmetry in young female basketball players.

The Influence of Body Composition on Sagittal Plane Posture among Elementary School-Aged Children

Proper posture, characterized by the appropriate alignment of the cervical, thoracic, and lumbar segments of the spine, enables these regions to maintain their normal curvature. Body composition is recognized as one of the factors that can influence overall postural alignment of the spine. The objective of this study was to determine the influence of the parameters of body composition on the prevalence of postural disorders in the sagittal plane. The cross-sectional study was conducted on 152 children of both genders (78 boys), at a mean age of 11 years ± 6 months. In order to evaluate postural disorders, the Formetric 4D System, a tool manufactured by Diers, Schlangenbad, Germany was used. Based on its output data, the following variables were obtained: hyperkyphosis, hyperlordosis, kypholordosis, flatback, and normal alignment of the body in the sagittal plane. The evaluation of body composition parameters was conducted using the InBody 770 device. To determine how body composition influences the postural status of the spinal column, a discriminant analysis was employed. The results showed that approximately 65.8% of children exhibit various types of postural disorders when assessing the alignment of the spine in the sagittal plane. The most prevalent disorder observed was hyperkyphosis, affecting 34.2% of the subjects, followed by kypholordosis at 16.4%. Moreover, the results demonstrated that body composition significantly influences body posture (p = 0.004). An increase in fat mass corresponds to a deviation from normal body posture, whereas an increase in the percentage of skeletal muscle mass and fat-free mass is associated with a reduction in postural abnormalities in the sagittal plane. Considering the results, it is clear that body composition parameters serve as more reliable predictors of the influence on body posture compared to simply calculating the body mass index. Furthermore, it can be concluded that there are consistent patterns of influence by specific body composition parameters, including fat mass, percentage of skeletal muscle, and fat-free mass, on body posture among children from various climates. These results underscore the significance of implementing strength exercises in children, particularly during periods of rapid growth and development, as a means of preventing and correcting postural disorders.

Association between PNPLA3[G]/I148M variant, steatosis and fibrosis stage in hepatitis C virus - genetic matters

There is an established correlation between the PNPLA3 rs738409 C > G single nucleotide polymorphism (SNP) and hepatic steatosis and fibrosis in hepatitis C virus (HCV) infected patients. However not all data is convergent regarding the exact impact of this SNP on the pattern of disease progression in different clinical settings. In this study, we aimed to further bridge the knowledge gap on this topic by investigating the role of the G allele in promoting steatosis, fibrosis and disease progression in relation to other metabolic and anthropometric host factors. Two hundred and fifty consecutive patients, previously diagnosed with chronic hepatitis C (CHC) underwent liver biopsy. Histology was assessed using the Metavir scoring system. Transient elastography was used for follow-up. Ninety-eight patients were genotyped for PNPLA3 rs738409 and followed up for fibrosis progression. PNPLA3 rs738409[G] allele was significantly correlated with severe steatosis (P = 0.04), severe fibrosis at the time of enrollment (P = 0.0005) and fibrosis progression with an OR of 10.31 (95% CI 1.06 - 99.59, P = 0.04), after a mean follow-up time of 62.85 (95%CI: 52.21 - 76.15) months. Severe steatosis at the time of enrollment had an OR of 11.02 (95% CI 1.48 - 82.09, P = 0.01) for the association with fibrosis progression. The HOMA-IR index was also positively correlated with severe fibrosis (P = 0.03) and fibrosis progression on univariate analysis (P = 0.02). PNPLA3 rs738409[G] allele is a reliable predictor for steatosis and fibrosis in CHC. The presence of G allele, along with severe steatosis and insulin resistance are significant predictors for fibrosis progression.

Laparoscopic Greater Curvature Plication for Morbid Obesity: Indications, Results, Perspectives

Morbid obesity is an important health problem of our century. It is managed by diet, lifestyle changes and medication and surgery. Weight-loss surgery is the most effective treatment for morbid obesity, producing durable weight loss, improvement or remission of comorbid conditions and longer life. Bariatric surgery provides the best results in up to 75% of cases of severe obesity and obesity comorbidities. In the United States, over 200 000 patients benefit every year from bariatric procedures. That means there is a continuous evolving of the bariatric surgery. Bariatric surgery is metabolic surgery because it resolves or alleviates Type2 Diabetes, hyperlipidemia and hypertension. The most employed bariatric operations are Roux -en- Y gastric by-pass, adjustable gastric banding, biliopancreatic diversion and sleeve gastrectomy, each of them having shortage of long term results and safety. In the last eight years was introduced a new bariatric procedure, the gastric plication, in an effort to obtain similar weight loss with lesser complications and costs. We present our initial experience with 30 morbid obese patients who undergone laparoscopic gastric plication in our institution. The mean % Excess Weight Loss was 50% at 6 month and 65% at 12 month with important alleviation of comorbidities. The complications rate was 6.6% for major complications (but only in the first 6 cases) and 10% for minor complications.

The utility of the predictive scores in polytrauma with abdomino-pelvic injuries: a series of 38 patients

Trauma is the principal cause of mortality among the population under 40 years. The aim of our study was to compare predictive trauma scores and demonstrate their utility in the evaluation of the quality of care in polytrauma.

MATERIAL AND METHODS

A retrospective study was performed between 2000-2011 including polytrauma patients with abdominal lesions and pelvic fracture who under went emergency laparotomy. We calculated ISS, GCS, RTS,TRISS, ASCOT trauma scores and W score for evaluation of treatment quality.

RESULTS

We obtained the necessary data to calculate the predictive scores in 38 cases. Comparing the scores of the survivals and non-survivals we noted the following regarding mortality predictive scores: GCS 13.74 vs. 6.13 (p 0.0001),ISS 28.52 vs. 35 (p=0.0169), RTS 6.96 vs. 3.07 (p 0.0001),TRISS 84.67% vs. 28.7% (p 0.0001), ASCOT 10.34% vs.64.32% (p 0.0001). The W score in TRISS and ASCOT methodology was -2.05 (p=0.7997) and -7.81 (p=0.336),respectively. There was no statistically significant difference between actual and predicted mortality, the former being 39.47%.

CONCLUSION

We did not observe differences between the two methodologies TRISS and ASCOT in mortality prediction (p=0.5401). Both of them can be used to predict polytrauma patient evolution. The W score is useful in treatment quality assessment.

Endothelin-1 and endothelin-converting enzyme-1 gene regulation by shear stress and flow-induced pressure

Hemodynamic forces have been shown to modulate the expression of endothelin (ET-1) and endothelin-converting enzyme (ECE-1) in endothelial cells. We have subjected E.A. hy 926 cells in culture to steady fluid shear stress with and without flow-induced pressure. The effect of combining these two mechanical forces on the expression of genes in the ET system was studied and the changes were compared to the mRNA levels in static culture. Analysis of total RNA by Northern blot analysis and RNAse protection showed that steady shear stress induced ET-1 gene expression three- to fourfold in this system. The same condition had little to no effect on altering expression of ECE-1 isoforms. A range of flow-induced pressure (80-160 mm Hg) was not able to further augment ET-1 or ECE-1 gene expression. Overall, with the mechanical environment studied, we have been able to detect a predominant contribution of shear stress to altering the ET-1 gene in our system. Furthermore, this induction was independent of an alteration of ECE-1 gene levels, suggesting that these two genes have a different pattern of regulation by the same stimuli in this cell type.

Model for the alignment of actin filaments in endothelial cells subjected to fluid shear stress

Cultured vascular endothelial cells undergo significant morphological changes when subjected to sustained fluid shear stress. The cells elongate and align in the direction of applied flow. Accompanying this shape change is a reorganization at the intracellular level. The cytoskeletal actin filaments reorient in the direction of the cells' long axis. How this external stimulus is transmitted to the endothelial cytoskeleton still remains unclear. In this article, we present a theoretical model accounting for the cytoskeletal reorganization under the influence of fluid shear stress. We develop a system of integro-partial-differential equations describing the dynamics of actin filaments, the actin-binding proteins, and the drift of transmembrane proteins due to the fluid shear forces applied on the plasma membrane. Numerical simulations of the equations show that under certain conditions, initially randomly oriented cytoskeletal actin filaments reorient in structures parallel to the externally applied fluid shear forces. Thus, the model suggests a mechanism by which shear forces acting on the cell membrane can be transmitted to the entire cytoskeleton via molecular interactions alone.

Synergistic effects of fluid shear stress and cyclic circumferential stretch on vascular endothelial cell morphology and cytoskeleton

The development of atherosclerosis is thought to be initiated by a dysfunctional state of the vascular endothelium. The proposal that mechanical forces play a role in the localization of this disease has led researchers to develop in vitro models to assess their effects on cultured endothelial cells. The arterial endothelium is exposed simultaneously to circumferential hoop stretch and wall shear stress, yet previous investigations have focused on the isolated effects of either cyclic stretch or shear stress. The influence of physiological levels of combined shear stress and hoop stretch on the morphology and F-actin organization of bovine aortic endothelial cells was investigated. Cells subjected for 24 hours to shear stresses higher than 2 dyne/cm2 or to hoop stretch greater than 2% elongated significantly compared with unstressed controls and oriented along the direction of flow and perpendicular to the direction of stretch. Exposure to more than 4% stretch significantly enhanced the responses to shear stress. Both shear stress and hoop stretch induced formation of stress fibers that were aligned with the cells' long axes. Simultaneous exposure to both stimuli appeared to enhance stress fiber size and alignment. These results indicate that shear stress and hoop stretch synergistically induce morphological changes in endothelial cells, which suggests that circumferential strain might modulate sensitivity of endothelial cells towards shear stress.

A device for subjecting vascular endothelial cells to both fluid shear stress and circumferential cyclic stretch

The proposal of the role of mechanical forces as a localizing factor of atherosclerosis has led many researchers to investigate their effects on vascular endothelial cells. Most previous efforts have concentrated on either the fluid shear stress, which results from the flow of blood, or the circumferential "hoop" stretch, which results from the expansion of the artery during the cardiac cycle. In fact, arterial endothelial cells are subjected to both fluid shear stress and cyclic hoop stretch in vivo. Therefore, a more complete investigation of mechanical phenomena on endothelial cell behavior should include both kinds of mechanical stimuli. This study was undertaken to design an experimental apparatus that could subject cultured vascular endothelial cells to simultaneous physiologic levels of both shear stress and cyclic hoop stretch. The experimental apparatus consists of four cylindrical elastic tubes so that the following conditions may be studied: (a) static conditions: (b) shear stress only; (c) hoop stretch only; and (d) shear stress and hoop stretch. In order to establish the functional capabilities of the apparatus, bovine pulmonary artery endothelial cells were cultured in the tubes, and their morphology and f-actin structure were observed with confocal microscopy. The cells remained healthy and attached to the walls throughout the 24 hr experiment. Preliminary results indicated that the alignment of endothelial cells subjected to shear stress was significantly enhanced by the addition of hoop strain.

Seasonal variations of serum cholesterol detected in the Bucharest Multifactorial Prevention Trial of Coronary Heart Disease. Ten years follow-up (1971-1982)

A group of 4800 men, aged fourty to sixty at entry, subjected to a multifactorial prevention trial of coronary heart disease for a ten-year period, showed spontaneous seasonal variations of serum cholesterol, characterized by increases in winter and decreases in summer. The authors discuss the relationship between the food changes and the seasonal variation of serum cholesterol values.

Biochemical changes induced by Campylobacter pylori in the gastric juice

The biochemical changes induced in the gastric juice by the presence of Campylobacter pylori (CP) were followed up in 151 patients with various gastric and duodenal diseases. The diagnosis of CP infection was made by the urease test. In the presence of CP urea decreased in the gastric juice and ammonia increased. The sialic acid, fucose and hexoses, glucide components of the mucus glycoproteins dissolved in the gastric juice, underwent no change in the presence of CP. The hexosamines in the gastric mucus increased significantly in CP patients. Urease activity is present in the gastric juice even in the absence of CP, probably due to other microorganisms present in the human stomach. This does not exclude the use of the urease test for the diagnosis of CP infection. However the test can only be used in the bioptically removed gastric mucosa samples, not in the gastric juice.

Possible correlation between the zinc and copper concentrations involved in the pathogenesis of various forms of anemia

The concentrations of three trace elements (iron, copper and zinc) involved in hematopoiesis were studied in 200 patients with iron-deficit anemia, hemolytic anemia and Biermer's anemia, in comparison with a group of normal subjects. The method used was atomic absorption spectrophotometry. The results obtained showed that in iron-deficit anemia resistant to iron therapy the copper and ceruloplasmin serum concentrations are at the lowest limit of normal. This copper deficit has a negative effect on the disease by preventing hemoglobin synthesis. In iron-deficit anemias responding to iron therapy the relatively low (about 90 gamma %) zinc values have a negative effect by blocking the iron in the iron reserve. In hemolytic anemia the very high zinc serum concentrations (over 200 gamma %) may lead to a shortening of the erythrocytes life span due to its "entatic state". In Biermer's anemia zinc by its high concentration has a positive role owing to carbonic anhydrase which eliminates more rapidly carbon dioxide from the organism.

Variations of zinc, calcium and magnesium in normal subjects and in patients with neoplasias

The serum zinc, calcium and magnesium concentration as well as the possible relationship between these elements was determined by means of atomic absorption spectrophotometry in 150 patients with prostatic, lung, liver and breast neoplasms as well as with chronic leukemia, and in 80 normal subjects. These determinations showed that zinc concentration is increased in almost all the forms of cancer except prostatic and lung cancer in which the zinc values were below the lowest normal limits. From this study it also resulted that high zinc values favour the development of cancer. The antagonic relationship between zinc and calcium or magnesium in neoplasias proves the protective role played by the latter elements in the forms of cancer in such cases.

Contributions to the study of gastric carcinogenesis

Investigations were carried out on duodeno- and jejunogastric reflux, gastric juice acidity, microbial population and the concentration of nitrites in 199 subjects. In gastric cancer patients or those with gastric ulcer, chronic atrophic gastritis, stomach resection or more seldom with removal of the gallbladder, a significant increase over normal values of the pH, duodenogastric reflux, microbial flora contamination (especially intestinal) and nitrite concentration was found. In smokers the salivary nitrite concentration was greater than in non-smokers and in direct relationship to gastric concentrations. The parallelism of these alterations suggests a causative relation between them and their presence in diseases or conditions of notorious increased incidence in gastric cancer highlights the direction to be followed in the primary prophylaxis of this disease.

Study of the relationship between the granulocyte LDH, alkaline phosphatase and Zn at the level of the leukocyte in patients with chronic myeloid leukemia

Mixed leukocyte suspensions were prepared from heparinized blood collected from healthy subjects and from patients with chronic myeloid leukemia (CML). In all the suspensions determinations were made for: zinc, by atomic absorption; granulocyte alkaline phosphatase (GAP), using the method with p-nitrophenylphosphatase; granulocyte LDH, by means of the enzymatic autoanalyser LKD 8,600. In the patients with CML, the values of zinc and of granulocyte alkaline phosphatase activity were very low while the granulocyte LDH values were higher than normal. The chromatogram of the granulocyte LDH isoenzymes on DEAE-Sephadex A50 minicolumn (0.5 X 12 cm) showed an "alpha type abnormality" revealed by the increased activity of the isoenzymes with high electrophoretic mobility LDH2 and LDH1 specific for tissues with intense oxidative phosphorylation. In the normal subjects the chromatogram of the leukocyte LDH isoenzymes showed a type M (skeletal muscle) prevalence denoting intense anaerobic glycolysis. Therefore the low zinc concentrations (0.55 micrograms mg N2 as compared with the normal 1.24 micrograms mg N2) in these patients cause the decrease of GAP activity by the lack of zinc in the active center of the enzyme and the decrease of cellular permeability thus allowing the extracellular release of granulocyte LDH.

Alkaline phosphatase activity improved by the addition of zinc in granulocytes from leukemic subjects (in vitro study)

Granulocyte alkaline phosphatase (GAP) was extracted from the leukocyte suspensions of 15 subjects with chronic myeloid leukemia (CML), determining the Zn content by atomic absorption spectrophotometry. The purified enzymatic preparation was dialyzed against a ZnCl2 solution (.01 mg%) in TRIS-HCl 0.1 M, pH 7.5, for 48 hours. After dialysis Zn concentration and GAP activity reached normal values. This suggests that the GAP molecule isolated from CML subjects is not altered as it is able to receive at most 2 Zn moles responsible for the enzymatic function.

Gallstones--mineralogical and chemical investigations

A comparative study of the mineralogical-structural characteristics and chemical composition of gallstones was performed on stone samples removed intraoperatively from the gallbladders of 12 patients. The study included all the types of gallstones. Their chemical components determined were: bilirubin, cholesterol, phospholipids, calcium, proteins. The stones were examined physically (size, number, shape, color) and the radial or concentric disposition of the layers was estimated on cross-sections. Thin sections (2 X 10(-2)mm) were obtained and examined by polarizing microscope in order to observe the inner structural characteristics. The crystallographic analysis of all the types of stones studied is reported. In all the samples, a perfect concordance was found between the mineralogical structure and the chemical composition of the gallstones. The results obtained are valuable premises for further research in the formation of stones, since a mineralogical study offers the possibility to estimate variations of crystal aggregation, according to the local changes of the gallbladder (inflammation, bacterial growth, pH, etc.).

The relationship zinc--alkaline phosphatase activity in normal and pathologic granulocytes

To study the relationship granulocyte alkaline phosphatase (AP)--zinc (Zn) in mixed leukocyte suspensions, the enzyme from 51 mixed leukocyte suspensions was separated and purified. In the pure extract, determinations were carried out for enzymatic activity--using the autoanalyzer LKB 8600--and for Zn content--using atomic absorption spectrophotometry. From the data obtained it resulted that, in agreement with the results in the literature Zn concentration in the mixed leukocyte suspensions from chronic myeloid leukemia, (CML) patients is about half that in the normal controls (0.65 +/- 0.15 as compared with 1.24 +/- 0.15 micrograms/mg total nitrogen). Granulocyte AP separated from normal leukocyte suspensions was found to bind about 95% of the total Zn content, i.e., 1.21 +/- 0.15 micrograms/mg total nitrogen and its enzymatic activity was about 16 U/g total nitrogen. In CML patients the enzyme bound a mean Zn concentration of 0.55 +/- 0.15 micrograms/mg total nitrogen and its mean activity was 2.25 U/g total nitrogen, i.e., about 86% of the normal values found in the controls. The enzymatic activity decreased to zero after only 20 min dialysis with 8-hydroxyquinoleine-5-sulfonic acid (8HC5S) as compared with the 60-80 min in the controls. It can be concluded that the leukemic leukocyte is unable to form the metal-enzyme complex owing to the deficit of the Zn involved in the enzymatic activity.

Pathogenetic interrelations between cholesterolosis and cholesterol gallstone disease

In order to define the relationship between cholesterolosis (COL) and cholesterol gallstone disease (CGD), risk factors were comparatively investigated in a great number of patients. Sex, age and metabolic risk factors were the same for both diseases, but gallbladder anomalies and neuroendocrine disturbances were more often associated with COL. The lipid composition of the gallbladder bile was determined in patients with COL. The bile acid decrease and the increase of cholesterol molar concentration (moles %) were found, similar to those known in CGD. The similarity of risk factors and of bile lithogenicity, as well as the frequent association of COL and CGD suggest a pathogenic relationship of both diseases. Local morphological changes in conditions of high biliary cholesterol levels may be responsible for the intraparietal precipitation of cholesterol in COL. Thus, COL seem to be a peculiar variant of CGD and its classification into the heterogeneous group of cholecystoses is at present questionable.

The Bucharest multifactorial prevention trial of coronary heart disease. General methodology and risk factor correction after five year follow-up (1971-1977)

Both the intervention and the control group included each 5000 men aged 40-60 years, randomly selected by their home address in five districts of the city of Bucharest. The intervention group underwent an "at entry" examination for risk factor detection (high serum cholesterol, high blood pressure, overweight, diabetes, minor ECG abnormalities, family history) and subsequently a five-year multifactorial intervention aimed to reduce the risk factors. Both groups were followed up in this lapse of time for major end-points: myocardial infarction, stroke, sudden death. The qualitative analysis of the results used ten evolution indices based on a quantal counting and lead to a classification of risk factors which allowed the setting up of a strategy for their correction. The quantitative analysis showed the following decreases between the first and the last examination in the intervention group: for serum cholesterol greater than or equal to 250 mg/dl -17%; for cigarettes/day greater than or equal to 15-53%; for overweight greater than or equal to 30% - 13.57%; for high blood pressure -8%; for the overall risk computed by multiple regression -33.8%.

Effect of silymarin on experimental liver lesions

The effect of Silymarin (Legalon) upon liver lesions was investigated using four experimental models: In acute galactosamine-hepatitis, Silymarin administration achieved protection of the liver structure (electron-microscopy included), liver cell glycogen, RNA and enzymatic activity, Galactosamine-depressed gluconeogenesis in the isolated perfused rat liver was significantly preserved by Silymarin treatment. In lead and cadmium poisoning the structural damage and histochemical and histoenzymatic changes were partly but significantly prevented. The complex noxious effects of Imuran overdoses were favourably influenced by Silymarin, without diminishing the cytostatic-immunosuppressive action of Imuran.

Separation of creatine-kinase isoenzymes on ion-exchange mini-columns for diagnostic purposes

For diagnostic purposes, creatine-kinase (CK) isoenzymes were separated on mini-columns of DEAE Sephadex A50 from the serum of 55 patients with myocardial infarction or cerebral disturbances and from 45 normal subjects. The optimum conditions of separation were determined by separation of CK isoenzymes (CK--MM, CK--MB, CK--BB) from human organ homogenates (skeletal muscle, myocardium, brain). In the patients with myocardial infarction the CK-MB isoenzyme activity amounted to more than 6% of the total enzyme value. The chromatogram in these cases was similar to that of human myocardium homogenate. The CK-BB isoenzyme was found only in patients with severe cerebral disturbances (cerebral hemorrhage). In such cases the chromatogram was similar to that of human brain homogenate. Therefore, by associating the assay of serum CK total activity with the separation of CK isoenzymes it was proved that the CK--MB and CK--BB isoenzymes can supply a useful test in differential diagnosis.

Diagnostic value of serum bile acid determination in chronic hepatitis and liver cirrhosis

Fasting and postprandial total bile acid measurements were performed by an enzymatic method in the serum of 12 patients with chronic persistent hepatitis, 8 with chronic active hepatitis, 14 with cirrhosis and 10 with cholestatic chronic hepatitis, as well as in that of 22 normal controls. The results indicated a rise of serum bile acid concentration concomitant with the degree of morphologic liver injury. A significant rise of the fasting concentration of bile acids as compared to the control started with chronic active hepatitis. As postprandial bile acid level was significantly higher in all types of chronic hepatitis and cirrhosis and correlated significantly with most of the usual biochemical liver tests, it could be considered as a test of major diagnostic significance for chronic liver diseases.

[Improvement of the conditions of rat liver preservation by concomitant perfusion of the liver and kidney]

One of the factors limiting the duration of rat liver storage is the excessive accumulation of catabolites in the perfusion medium. In view of obtaining of an efficient depuration the authors have introduced a new circuit allowing for the concomittant perfusion of the liver and of the kidneys. The excretion effort of the kidneys is assessed by the estimation of urea nitrogen in the perfusion medium and in the urine collected over the entire duration of the experiment. The results have confirmed the good function of the system which provides possibilities for improved storage conditions of rat liver.

[The action of silymarin on Galactosamine-induced hepatitis in the rat (author's transl)]

The hepatoprotective action of Silymarin was studied in 65 male Wistar rats, prior to and following D-galactosamine intoxication. There was a marked reduction in the histological and ultrastructural changes in the nucleolus, nuclear membrane, mitochondria, granular and agranular endoplasmic reticulum and lysosomes of the liver cell and also in the Kupffer stellate cells. The reduction in glycogen and RNA loss was determined biochemically. The activities of many enzymes were kept constant (oxidoreductases, NADH2 diaphorase, G-6-phosphatase, Mg++ and K+/Na+-dependent ATPases, acid phosphatases).

Coronary heart disease and its risk factors in a group of 5,000 middle aged men in urban environment

The results obtained at entry in the subjects included in a pilot study (Institute of Internal Medicine, Bucharest) for the detection and prevention of coronary heart disease and hypertension, are presented. These data are the prevalences of the risk factors of coronary heart disease (high serum cholesterol, hypertension, smoking, overweight, diabetes, nonspecific minor ECG signs, family history), as well as the prevalences of the various forms of coronary heart disease. The study of the frequency distribution of biologic parameters likely to become risk factors showed that in middle aged subjects the upper limit of the normal should be lowered from the 95th percentile to the 76th one.

[Preservation of rat liver using prolonged perfusion with a complex solution lacking hemoglobin]

The author's aim was to investigate conservation of rat liver by continuous perfusion of the isolated organ in conditions of normal temperature, as well as in hypothermia. A complex solution was used, lacking hemoglobin. Over a period of 5 hours of conservation the authors evaluated the perfusion rate, the concentration of lactate and pyruvate in the conservation medium, while on histological preparations was investigated the formation of fibrin deposits in the intra-hepatic vessels. The results confirmed the positive effects of hypothermia, that is not due exclusively to a limiting of the metabolic necessities of the organ but also to a reduction of the fibrinogenesis and a slowing down of the formation of intra-hepatic microaggregates.