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Objectives: To investigate the effects of aerobic training, resistance training, or both on abdominal subcutaneous fat (subcutaneous adipose tissue (SAT)) (deep and superficial), visceral fat (visceral adipose tissue (VAT)), apolipoproteins A-1 and B (ApoA-1, ApoB), ApoB/ApoA-1 ratio and high-sensitivity C-reactive protein (HSCRP) in post-pubertal adolescents with obesity.Participants: After a 4-week supervised moderate-intensity exercise run-in period, 304 postpubertal adolescents with overweight (body mass index (BMI) ⩾85th percentile for age and sex+diabetes risk factor) or obesity (⩾95th BMI percentile) aged 14-18 years were randomized to four groups for 22 weeks (5 months): aerobic training, resistance training, combined training or a non-exercising control.Methods: This study used a randomized controlled design. All groups received dietary counseling designed to promote healthy eating with a maximum daily energy deficit of 250 kcal. Abdominal fat (SAT and VAT) at the level of the fourth and fifth lumbar vertebrae (L4-L5) was measured by magnetic resonance imaging and ApoA-1, ApoB and HSCRP were measured after a 12-h fast at baseline and after 6 months.Results: Changes in SAT at L4-L5 were -16.2 cm(2) in aerobic (P=0.04 vs control), -22.7 cm(2) in resistance (P=0.009 vs control) and -18.7 cm(2) in combined (P=0.02 vs control). Combined training reduced ApoB levels from 0.81±0.02 to 0.78±0.02 g l(-1) (P=0.04 vs control) and ApoB/ApoA-1 ratio from 0.67±0.02 to 0.64±0.02 (P=0.02 vs control and P=0.04 vs aerobic). There were no significant differences in VAT, ApoA-1 or HSCRP levels between groups.Conclusions: Aerobic and resistance training and their combination decreased abdominal SAT in adolescents with obesity. Combined training caused greater improvements in ApoB/ApoA-1 ratio compared with aerobic training alone. [ABSTRACT FROM AUTHOR]

im/hypothesis: In people with type 2 diabetes, exercise improves glucose control (as reflected in HbA) and physical fitness, but it is not clear to what extent these exercise-induced improvements are correlated with one another. We hypothesised that reductions in HbA would be related: (1) to increases in aerobic fitness and strength respectively in patients performing aerobic training or resistance training; and (2) to changes in strength and aerobic fitness in patients performing aerobic and resistance training. Methods: We randomly allocated 251 type 2 diabetes patients to aerobic, resistance, or aerobic plus resistance training, or to a sedentary control group. Peak oxygen consumption ( $$ \mathop {V}\limits^\cdot {{\text{O}}_{\text{2 peak}}} $$), workload, treadmill time and ventilatory threshold measurements from maximal treadmill exercise testing were measured at baseline and 6 months. Muscular strength was measured as the maximum weight that could be lifted eight times on the leg press, bench press and seated row exercises. Results: With aerobic training, significant associations were found between changes in both $$ \mathop {V}\limits^\cdot {{\text{O}}_{\text{2 peak}}} $$ ( p = 0.040) and workload ( p = 0.022), and changes in HbA With combined training, improvements in $$ \mathop {V}\limits^\cdot {{\text{O}}_{\text{2 peak}}} $$ ( p = 0.008), workload ( p = 0.034) and ventilatory threshold ( p = 0.003) were significantly associated with changes in HbA Increases in strength on the seated row ( p = 0.006) and in mid-thigh muscle cross-sectional area ( p = 0.030) were significantly associated with changes in HbA after resistance exercise, whereas the association between increases in muscle cross-sectional area and HbA in participants doing aerobic plus resistance exercise ( p = 0.059) was of borderline significance. Conclusions/interpretation: There appears to be a link between changes in fitness and HbA. The improvements in cardiorespiratory fitness with aerobic training may be a better predictor of changes in HbA than improvements in strength. [ABSTRACT FROM AUTHOR]

Purpose:To investigate whether a home-based resistance training (RT) program that supplied high-quality equipment and qualified exercise specialists could provide benefits to obese patients with type 2 diabetes.Methods:A total of 48 obese individuals with type 2 diabetes were randomly assigned to either an RT (n=27) or a control group (n=21). Those in the RT group received a multigym and dumbbells and performed RT 3 days per week for 16 weeks at home. A qualified exercise specialist supervised training, with supervision being gradually decreased throughout the study. Primary outcome measures included strength and hemoglobin-A1C, whereas secondary outcome measures included other cardiovascular risk markers, key social-cognitive constructs and health-related quality of life.Results:Intention-to-treat analyses indicated a significant increase in upper and lower body strength for the RT group compared with controls (20-37% mean increases in the RT group). No significant reduction in A1C levels was observed. The RT group had unchanged high-density lipoprotein cholesterol levels in comparison to declines in the control group. Significant reductions in fasting insulin, and increases in RT-related self-efficacy and intentions, were also observed in the RT group.Conclusions:Supervised home-based RT with high-quality equipment was effective for improving strength, along with other secondary outcomes in obese patients with type 2 diabetes. [ABSTRACT FROM AUTHOR]

The Diabetes Aerobic and Resistance Exercise (DARE) study showed that aerobic and resistance exercise training each improved glycaemic control and that a combination of both was superior to either type alone in patients with type 2 diabetes mellitus. Here we report effects on patient-reported health status and well-being in the DARE Trial. We randomised 218 inactive participants with type 2 diabetes mellitus in parallel to 22 weeks of aerobic exercise ( n = 51), resistance exercise ( n = 58), combined aerobic and resistance exercise ( n = 57) or no exercise (control; n = 52). Intervention allocation was managed by a central office. Outcomes included health status as assessed by the physical and mental component scores of the Medical Outcomes Trust Short-Form 36-item version (SF-36) and well-being as measured by the Well-Being Questionnaire 12-item version (WBQ-12); these were measured at the Ottawa Hospital. Using a p value of 0.0125 for statistical significance due to multiple comparisons, mixed model analyses indicated that resistance exercise led to clinically but not statistically significant improvements in the SF-36 physical component score compared with aerobic exercise (Δ = 2.7 points; p = 0.048) and control (i.e. no exercise; Δ = 3.3 points; p = 0.015). For mental component scores, there were clinically important improvements favouring no (control) compared with resistance (Δ = 7.6 points; p < 0.001) and combined (Δ = 7.2 points; p < 0.001) exercise. No effects on WBQ-12 scores were noted. Overall, 59/218 (27%) of participants included in this analysis sustained an adverse event during the course of the study, including 16 participants in the combined exercise group, 19 participants in the resistance exercise group, 16 participants in the aerobic exercise group, and eight participants in the control group. All participants were included in the intent-to-treat analyses. The trial is now closed to follow-up. Resistance exercise was better than aerobic or no exercise for improving physical health status in these patients. No exercise was superior to resistance or combined exercise for improving mental health status. Well-being was unchanged by intervention. ClinicalTrials.gov NCT00195884 This study was funded by the Canadian Institutes of Health Research (grant MCT-44155) and the Canadian Diabetes Association (The Lillian Hollefriend Grant). [ABSTRACT FROM AUTHOR]

Objective:To assess the association between fetal macrosomia and adolescent obesity.Design:Longitudinal cohort study of the association between macrosomia and adolescent obesity.Subjects:Between 1 October 2005 and 1 February 2007, a follow-up study of live-born infants born in 1993–1995 in Wuxi, a suburban area of Shanghai, was conducted. Subjects with birth weight > 4000 g were selected as the exposed. For each exposed subject, one subject with a birth weight of 2500–4000 g, matched by year of birth, sex of infant, and type of institute at birth, was chosen as non-exposed. Clinical data were collected by structured interview and physical examination. Obesity was defined as body mass index (weight (kg)/height (m2)) higher than the sex-age-specific criteria by the working group on obesity in China. Distribution of baseline characteristics and adolescent obesity rate between the exposed and non-exposed groups was compared.Results:A total of 1435 pairs of exposed and non-exposed subjects were included in the final analysis. No major difference in baseline characteristics (other than birth weight) was found between the exposed and non-exposed groups. Obesity rate was significantly higher in the exposed group (2.9%) than in the non-exposed group (1.6%). Adolescent obesity rates were 1.4, 1.9, 2.6, and 5.6%, respectively, in study subjects with a birth weight of 2500–3499, 3500–3999, 4000–4499, and 4500 g. The association between birth weight and adolescent obesity remained essentially the same when mother's demographic and anthropometric factors, breast feeding, and adolescent life-style factors were adjusted.Conclusion:Compared with infants of normal birth weight, infants with birth weight >4000 g, especially those >4500 g, are at increased risk of adolescent obesity.International Journal of Obesity (2009) 33, 923–928; doi:10.1038/ijo.2009.131; published online 30 June 2009 [ABSTRACT FROM AUTHOR]

Coexisting hypertension increases the morbidity and mortality associated with diabetes, and may be more so in less educated people. We analysed data from 49 904 Canadians 40–64 years of age who participated in the Canadian Community Health Survey, 2000–2001. Multiple classification analysis was used to adjust for covariates. Population weight and design effect of the survey were taken into account in the analysis. The association between hypertension and hospitalization varied according to diabetes and education. The adjusted difference in hospitalization incidence attributable to hypertension was significantly higher for the lower education group than the higher education group, and such a pattern tended to be more pronounced among diabetic people. The adjusted incidence difference attributable to hypertension was higher in the diabetic group (8.8, 95% confidence interval (CI): 4.6, 13.0%) than in the non-diabetic group (4.6, 95% CI: 3.6, 5.6%) for people with low education, but was similar for those with well-educated people. Possible reasons for the modifying effect of education on the relationship among hypertension, diabetes and hospitalization were discussed.Journal of Human Hypertension (2007) 21, 225–230. doi:10.1038/sj.jhh.1002131; published online 14 December 2006 [ABSTRACT FROM AUTHOR]

Aims/hypothesis: Exercise training improves glycaemic control in some but not all individuals and little research has been done regarding genetic impact on the exercise training response in type 2 diabetes. The purpose of this study was to investigate the influence of the Pro12Ala variant of the peroxisome proliferator-activated receptor (PPAR) γ2 gene on changes in fasting plasma glucose in response to exercise training. Methods: The study population comprised 139 sedentary type 2 diabetic patients (age: 54.4±7.2; HbA1c: 7.7±0.9%) who completed 3 months of supervised exercise training. The primary outcome variable in our analysis was the post-intervention change in blood glucose. Other assessments included measures of body composition, insulin sensitivity indices and maximal oxygen uptake (VO2max). Results: The frequency of the Ala allele was 8.3% and the genotypes were in Hardy-Weinberg equilibrium. At baseline, neither body composition variables (weight, BMI, waist circumference), glucose homeostasis variables (glucose, insulin, HbA1c, homeostasis model assessment method) nor VO2max were different between genotypes (wild-type: Pro12Pro n=117, Ala carriers: X12Ala n=22). The exercise-training intervention led to similar improvements in body composition and glucose homeostasis variables in both genotype groups (p<0.05). The change in fasting plasma glucose was significantly different between PPARγ2 genotypes (-1.66 mmol/l vs -0.54 mmol/l, Ala carriers and wild-type, respectively) (p=0.034 unadjusted and p=0.089 including baseline glucose) and the significant association between genotype and glucose response remained after adjusting for statistically significant predictors (age, changes in insulin and BMI [p=0.015]) and including baseline glucose, insulin and BMI (p= 0.031). Conclusions/interpretation: These data suggest that the Pro12Ala polymorphism may influence the glycaemic response to exercise in type 2 diabetes. [ABSTRACT FROM AUTHOR]

Aims/hypothesis. Low cardiorespiratory fitness is a powerful and independent predictor of mortality in people with diabetes. Several studies have examined the effects of exercise on cardiorespiratory fitness in Type 2 diabetic individuals. However, these studies had relatively small sample sizes and highly variable results. Therefore the aim of this study was to systematically review and quantify the effects of exercise on cardiorespiratory fitness in Type 2 diabetic individuals. Methods. MEDLINE, EMBASE, and four other databases were searched up to March 2002 for randomized, controlled trials evaluating effects of structured aerobic exercise interventions of 8 weeks or more on cardiorespiratory fitness in adults with Type 2 diabetes. Cardiorespiratory fitness was defined as maximal oxygen uptake (VO2max) during a maximal exercise test. Results. Seven studies, presenting data for nine randomized trials comparing exercise and control groups (overall n=266), met the inclusion criteria. Mean exercise characteristics were as follows: 3.4 sessions per week, 49 min per session for 20 weeks. Exercise intensity ranged from 50% to 75% of VO2max. There was an 11.8% increase in VO2max in the exercise group and a 1.0% decrease in the control group (post intervention standardized mean difference =0.53, p<0.003). Studies with higher exercise intensities tended to produce larger improvements in VO2max. Exercise intensity predicted post-intervention weighted mean difference in HbA1c (r=-0.91, p=0.002) to a larger extent than did exercise volume (r=-0.46, p=0.26). Conclusions/interpretation. Regular exercise has a statistically and clinically significant effect on VO2max in Type 2 diabetic individuals. Higher intensity exercise could have additional benefits on cardiorespiratory fitness and HbA1c. [ABSTRACT FROM AUTHOR]

The aim of this study was to compare the clinical usefulness of ultrasmall superparamagnetic iron oxide (USPIO) MR contrast media (Sinerem, Guerbet Laboratories, Aulnay-sous-Bois, France) with precontrast MRI in the diagnosis of metastatic lymph nodes in patients with head and neck squamous cell carcinoma, using histology as gold standard. Eighty-one previously untreated patients were enrolled in a multicenter phase-III clinical trial. All patients had a noncontrast MR, a Sinerem MR, and surgery within a period of 15 days. The MR exams were analyzed both on site and by two independent radiologists (centralized readers). Correlation between histology and imaging was done per lymph node groups, and per individual lymph nodes when the short axis was > or = 10 mm. For individual lymph nodes, Sinerem MR showed a high sensitivity (> or = 88%) and specificity (> or = 77%). For lymph node groups, the sensitivity was > or = 59% and specificity > or = 81%. False-positive results were partially due to inflammatory nodes; false-negative results from the presence of undetected micrometastases. Errors of interpretation were also related to motion and/or susceptibility artifacts and problems of zone assignment. Sinerem MR had a negative predictive value (NPV) > or = 90% and a positive predictive value (PPV) > or = 51%. The specificity and PPV of Sinerem MR were better than those of precontrast MR. Precontrast MR showed an unexpectedly high sensitivity and NPV which were not increased with Sinerem MR. The potential contribution of Sinerem MR still remains limited by technical problems regarding motion and susceptibility artifacts and spatial resolution. It is also noteworthy that logistical problems, which could reduce the practical value of Sinerem MR, will be minimized in the future since Sinerem MR alone performed as good as the combination of precontrast and Sinerem MR. [ABSTRACT FROM AUTHOR]

Fibrous dysplasia is usually a slowly progressive, benign disease that develops over several years and presents with deformity or mild symptomatology. Five of 34 patients (ages 4-21 years), who were subsequently diagnosed histologically as having fibrous dysplasia of the maxillary sinus, rapidly developed soft tissue masses of the malar region over a period of less than 4 months with accompanying pain (2 patients) and nasal obstruction and exophthalmos (2 patients). Each was clinically suspected of having a sarcoma; two had been thought to have an "osteofibrosarcoma" on initial biopsy at outside hospitals. After resection, all lesions developed regrowth. At histopathologic examination, both initial and recurrent masses proved to be typical fibrous dysplasia with spicules of woven bone in cellular, sometimes vascular, fibrous tissue. No malignant degeneration was found. On conventional radiography, aggressive fibrous dysplasia produced opacification and expansion of the maxillary sinus and apparent disruption of its wall with an associated soft tissue mass. Computed tomography (CT) demonstrated voluminous heterogeneous masses with "ground glass appearance", calcifications, areas of enhancement, low attenuation, cystic areas, and a thinned, sometimes interrupted, maxillary wall. Despite the aggressive clinical course for both initial and recurrent lesions, the CT findings of a "ground glass" mass with calcifications surrounded by a maxillary sinus wall, even if incomplete, can suggest the diagnosis of aggressive fibrous dysplasia. [ABSTRACT FROM AUTHOR]

A total of 162 patients with suspected acoustic neuromas underwent MR imaging at 1.5 T. All patients were injected with Gd DTPA or DOTA. In 72 patients, uni- or bilateral acoustic neuromas were detected. 18 cases were equivocal: In 9 cases, contrast enhancement was due to other tumors (5 meningiomas, 2 metastases, 1 hemangioma). In 1 case, misinterpretation resulted from partial volume effects with the petrous bone marrow. In one patient, previously operated on, increased signal was due to postoperative fat graft. Four hypersignals were due to intracanalicular venous or meningeal enhancement. Three cases are still equivocal. Most of the diagnostic problems may be obviated by precontrast MR imaging, multidimensional 3-mm sections, and fast imaging. [ABSTRACT FROM AUTHOR]

Twenty cases of intrapetrous lesions were studied by a 1.5 T magnetic resonance (MR) unit. In all cases, comparisons were made between MR, CT and clinical findings. Our present material included 9 cholesteatomas, 1 cholesterol cyst, 3 primary epidermoid carcinomas, 2 metastatic neoplasms, 1 glomus jugulare tumor and 4 facial neurinomas. Gadolinium was injected in 7 cases and seemed to be the best method for studying the intrapetrous tumors. MR permitted accurate topographic study and assessment of tumoral extension, as well as a ready demonstration of tumor vascularity. The present findings also showed that MR is not capable of defining small bony detail or calcifications. [ABSTRACT FROM AUTHOR]

Porocarcinoma is a very rare cutaneous lesion arising from the eccrine sweat glands. We present a case of porocarcinoma located in the mastoid region, which developed multiple relapses, with intracranial extension. This is the first report of intracranial invasion. [ABSTRACT FROM AUTHOR]

Teratomas of the nasopharynx occur usually in neonates. We present a case of teratoma which was discovered in an adult, and which relapsed after 34 years. The conventional radiograms, CT, MR, and histologic appearances are described. [ABSTRACT FROM AUTHOR]

Abstract The COP9 signalosome (CSN), an eight‐subunit protein complex, is conserved in all higher eukaryotes. CSN intersects the ubiquitin–proteasome pathway, modulating signaling pathways controlling various aspects of development. We are using Drosophila as a model system to elucidate the function of this important complex. Transcriptome data were generated for four csn mutants, sampled at three developmental time points. Our results are highly reproducible, being confirmed using two different experimental setups that entail different microarrays and different controls. Our results indicate that the CSN acts as a transcriptional repressor during development of Drosophila, resulting in achronic gene expression in the csn mutants. ‘Time shift’ analysis with the publicly available Drosophila transcriptome data indicates that genes repressed by the CSN are normally induced primarily during late embryogenesis or during metamorphosis. These temporal shifts are likely due to the roles of the CSN in regulating transcription factors. A null mutation in CSN subunit 4 and hypomorphic mutations in csn5 lead to more severe defects than seen in the csn5‐null mutants strain, suggesting that CSN5 carries only some of the CSN function.