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Purpose Immigration from a Third-World society to a Western society can be associated with higher blood pressure and salt sensitivity. We therefore tested whether immigrants from Afghanistan to Denmark compared with non-immigrant Danes exhibit a (i) higher 24-h ambulatory blood pressure (24-h ABP) and (ii) blunted renin response to a change in salt intake. Methods Twenty-four-hour ABP was measured in 40 men of Afghan (Afghans) and 40 men of Danish (Danes) origin. Each group was divided into young (20-30 years, n = 20) and middle aged (40-60 years, n = 20). A 3-day low (70 mmol per 24-h) and a 3-day high (250 mmol per 24-h) salt intake were in addition instituted in subgroups of the young groups ( n = 18). Results Young and middle-aged Afghans exhibited a lower 24-h mean arterial pressure (24-h MAP) than the same respective age groups of Danes (83 ± 1 versus 90 ± 1 mm Hg, P<0·05, and 89 ± 2 versus 100 ± 1 mm Hg, P<0·05). 24-h ABP did not change in any of the young groups during increased salt intake, whereas the Danes exhibited a greater decrease in plasma renin activity ( PRA) ( P<0·05). Plasma noradrenaline (PNA) was significantly higher among the young Afghans. Conclusions Afghan immigrants to Denmark exhibit a lower 24-h ABP than Danes. In young Afghans, PRA is less sensitive to changes in salt intake, while PNA is higher and may reflect their lower systolic blood pressure and/or arterial pulse pressure. Whether these hormonal differences can explain the lower 24-h ABP in Afghans should be further explored. [ABSTRACT FROM AUTHOR]

The article determines whether the microvascular volume (MV) of the Achilles tendon increases in patients with Achilles tendinopathy (AT) compared with healthy controls during pre-exercise rest, after acute exercise and 24 hours after exercise. The study used real-time harmonic contrast-enhanced ultrasound (CEU) measurements of the MV of the Achilles tendon taken in several volunteers. Results showed acute exercise increases MV of the Achilles tendon in healthy patients and patients with AT.

Background Real-time harmonic contrast-enhanced ultrasound ( CEU) is used in several diseases to visualize the microvascularization in various tissues, due to its high sensitivity. Aim The aim of the present study was to investigate whether CEU could be used to detect an increase in the microvascular volume ( MV) in healthy tendon tissue in response to exercise comprising a 1-h run. Methods After a bolus injection of the ultrasound contrast Sono Vue®, CEU measurements of ( MV) in the Achilles tendon were taken prior to exercise, immediately after a 1-h run, and 24 h after exercise in nine healthy young subjects (seven men and two women) mean age 31 ± 4 years. In addition, the effect of 15 min of arm cycling exercise on the flow within the Achilles tendon was tested in four athletes (mean age 33 ± 6 years) using the CEU method before and after exercise. Results The present data show a significant increase in the ( MV) of the Achilles tendon for all subjects following the run compared with before exercise. No significant change in ( MV) was seen in the Achilles tendon after 15-min arm cycling exercise ( P = 0·96). This indicates that the increase in microvascular blood volume within the Achilles tendon in response to running is a local response. Conclusion The present data reveal that real-time harmonic CEU can be used to determine the MV of healthy Achilles tendons both at rest and after 1 h of running exercise. [ABSTRACT FROM AUTHOR]

Summary Purpose: Lymphoscintigraphy is currently the leading diagnostic modality of lower extremity lymphoedema but has been criticized for being unreliable. Washout rate constants have been investigated and proven to be of diagnostic value in several studies of breast-cancer-related lymphoedema; however, the applicability in lower extremity lymphoedema needs further evaluation. The aim of the study was to verify if washout of 99mTc-Human Serum Albumin (99mTc-HSA) is a reliable diagnostic tool in lower extremity lymphoedema. Methods: Twenty healthy volunteers and eight patients (11 legs) with lymphoscintigraphy verified lower extremity lymphoedema participated in the study. A depot consisting of 0·1 ml 10 MBq/ml 99mTc-HSA was injected subcutaneously into the dorsum of each foot. The depot washout rate was measured using a portable scintillation detector system and time-activity curves were generated. After 30 min of supine rest and 10 min of standardized ergometric exercise, measurements were recorded for 20 min. Following correction for physical decay of 99mTc, the depot washout rate constant was calculated using linear regression analysis. Finally depot half-life was calculated from the washout rate constant. Results: Median half-life for healthy volunteers was 9·4 h (range 2·5-28·3 h). Median half-life for lymphoedema patients was 10·7 h (range 1·5-35·1 h). No statistical significant difference could be detected between healthy volunteers and lymphoedema patients ( P = 0·78). Conclusions: The washout rate of a subcutaneous 99mTc-HSA depot is not a reliable diagnostic tool in examination of lower extremity lymphoedema. Additional examinations revealed in vivo instability of the utilized 99mTc-HSA as the likely reason. [ABSTRACT FROM AUTHOR]

Lymphoedema of the lower extremities is a chronic debilitating disease that is often underdiagnosed. Early diagnosis and treatment is paramount in reducing the risk of progression and complications. Lymphoedema has traditionally been defined as interstitial oedema and protein accumulation because of a defect in the lymphatic drainage; however, some findings suggest that the interstitial protein concentration may be low in some types of lymphoedema. Primary lymphoedema is caused by an inherent defect in the lymphatic vessels or lymph nodes. Secondary lymphoedema is caused by damages to the lymphatic system most often caused by cancer or its treatment. Many of the underlying pathophysiological mechanisms have yet to be elucidated. Many methods have been developed for examination of the lymphatic system. Lymphoscintigraphy is presently the preferred diagnostic modality. Lack of consensus regarding protocol and qualitative interpretation criteria results in a too observer dependent outcome. Methods for objectifying the scintigraphy through quantification have been criticized. Depot clearance rates are an alternative method of quantification of lymphatic drainage capacity. This method however has mostly been applied on upper extremity lymphoedema. The aim of this review is to provide a literature-based overview of the aetiology and pathophysiology of lower extremity lymphoedema and to summarize the current knowledge about lymphoscintigraphy and depot clearance techniques. The abundance of factors influencing the outcome of the examination stresses the need for consensus regarding examination protocols and interpretation. Further studies are needed to improve diagnostic performance and understanding of pathophysiological mechanisms. [ABSTRACT FROM AUTHOR]

OBJECTIVE--Glucose-dependent insulinotropic polypeptide (GIP) has been implicated in lipid metabolism in animals. In humans, however, there is no clear evidence of GIP effecting lipid metabolism. The present experiments were performed in order to elucidate the effects of GIP on regional adipose tissue metabolism. RESEARCH DESIGN AND METHODS--Eight healthy subjects were studied on four different occasions. Abdominal subcutaneous adipose tissue metabolism was assessed by measuring arterio-venous concentration differences and regional adipose tissue blood flow during GIP (1.5 pmol/kg/min) or saline infused intravenously alone or in combination with a hyperinsulinemic-hyperglycemic (HI-HG) clamp. RESULTS--During GIP and HI-HG clamp, abdominal subcutaneous adipose tissue blood flow, hydrolysis of circulating triacylglycerol (TAG) (P = 0.009), and glucose uptake (P = 0.03) increased significantly while free fatty acid (FFA) output (P = 0.04) and FFA/glycerol release ratio (P = 0.02) decreased compared with saline and HI-HG clamp. CONCLUSIONS--In conclusion, GIP in combination with hyperinsulinemia and slight hyperglycemia increased adipose tissue blood flow, glucose uptake, and FFA re-esterification, thus resulting in increased TAG deposition in abdominal subcutaneous adipose tissue. Diabetes 59:2160-2163, 2010 [ABSTRACT FROM AUTHOR]

Objective:  To measure bone mineral density in patients with diabetes mellitus and the complication Charcot osteoarthropathy (CA). Research design and methods:  A total of 49 patients with diabetes were investigated. The population consisted of patients with an acute CA ( n = 17) or chronic CA ( n = 7). Control groups consisted of diabetes patients with ( n = 9) and without neuropathy ( n = 11) and who had an amputation of the first toe ( n = 5). Values measured were bone mineral density (BMD) in lumbar spine, hip and calcaneus, using lunar DEXA scanner. The bone turnover markers CTX-1 and N-MID were measured. Results:  There were no differences in BMD measured in the spine and hip. There was an increase in the markers of bone turnover in the patients with acute CA. The BMD of the calcaneus was statistically lower in the affected foot in patients with chronic Charcot ( P < 0·01), than in the unaffected foot, but there were no statistically significant differences between the BMD of the calcaneus in the feet in the other groups. Conclusions:  From this study, we can conclude that there were no differences in BMD values in the spine and hip between groups. There were no differences between BMD of the calcaneus between groups, except that patients with chronic Charcot had a significantly lower calcaneal BMD in the affected foot than in the healthy foot. Furthermore, there was an increased bone turnover in the group with acute CA, which was not found in the other patients groups. This suggests that the Charcot foot is a rather local phenomenon, with little effect on the skeleton in general. [ABSTRACT FROM AUTHOR]

Aim: During prolonged infusion of somatostatin, there is an increase in arterial glucose concentration, and this increase persists even during prolonged exercise. The aim of the study was to measure glucose uptake in the leg muscles during infusion of the somatostatin analogue octreotide before and during leg exercise. Material and methods: Eight healthy male subjects were investigated twice in the fasting state: during 3 h infusion of octreotide [30 ng (kg min)−1] or sodium chloride with exercise at 50% of maximal VO2 in the last hour. Glucose uptake and oxygen uptake in the leg were measured using Fick’s principle by blood sampling from an artery and a femoral vein. Blood flow in the leg was measured using the indicator (indocyanine green) dilution technique. Results: After an initial decrease during rest, octreotide infusion resulted in a significant increase in arterial glucose concentrations compared to control conditions during exercise (mean ± SEM: 7·6 ± 0·6 versus 5·6 ± 0·1 mmol l−1, P<0·01). During rest, octreotide did not change the leg glucose uptake (59 ± 10 versus 55 ± 11 μmol min−1). In contrast, leg glucose uptake was significantly lower during exercise compared to control conditions (208 ± 79 versus 423 ± 87 μmol min−1, P<0·05). During exercise, leg oxygen uptake was not different in the two experiments (20·4 ± 1·3 versus 19·5 ± 1·1 μmol min−1). Conclusion: In conclusion, infusion of octreotide reduced leg glucose uptake during exercise, despite the same leg oxygen consumption and blood flow compared to control conditions. The hyperglycaemic effect of octreotide can partly be explained by the reduction in leg glucose uptake. Furthermore, the results suggest that a certain level of circulating insulin is necessary to obtain sufficient stimulation of glucose uptake in the exercising muscles. [ABSTRACT FROM AUTHOR]

In view of the emerging role, disturbances in regional blood flow rate seem to play in the pathogenesis of the metabolic syndrome; we review the concepts of the classical indicator dilution and washout techniques used for determinations of regional blood flow rate. Prerequisites, assumptions, necessary precautions for the application of these experimental techniques are emphasized. Special attention has been carried out to elucidate the consequence of a choice of indicators having a large distribution volume in the tissues. [ABSTRACT FROM AUTHOR]

In order to elucidate the circulatory and respiratory effects of a newly developed abdominal compression binder 25 healthy, normal weight subjects were studied. In supine position the central haemodynamics were measured and estimated with a Finapress device. Lower extremity venous haemodynamics were measured in supine position with venous occlusion plethysmography. In an upright-seated position arterial oxygen saturation was measured by a pulseoxymeter for 1 h before spirometry was performed with a turbine flow measurement device. All the tests were performed in a randomized order with or without the abdominal compression binder. The results show that the compression binder significantly increases the venous volume in the lower extremities as showed by a reduction in the venous capacitance in the lower extremities and a reduction in the stroke volume and cardiac output, while it does not influence the pulmonary volumes. It is concluded that the applied abdominal binder significantly affects peripheral and central haemodynamics. It should therefore be used with caution when in the supine position for longer periods, as the pooling of blood it induces in the lower extremities may have implications for the risk of deep venous thrombosis formation. [ABSTRACT FROM AUTHOR]

During prolonged adrenaline infusion, lipolysis peaks within 30 min and thereafter tends to decline, and we hypothesized that the stimulation of local adipose tissue α2-adrenergic receptors accounts for this decline. The lipolytic effect of a prolonged intravenous adrenaline infusion combined with local infusion of the α2-blocker phentolamine in superficial and deep abdominal subcutaneous adipose tissue and in preperitoneal adipose tissue was studied in seven healthy subjects. The interstitial glycerol concentration in the three adipose tissue depots was measured by the microdialysis method. Regional adipose tissue blood flow was measured by the 133Xe clearance technique. Regional glycerol output (lipolytic rate) was calculated from these measurements and simultaneous measurements of arterial glycerol concentrations. Adrenaline infusion increased lipolysis in all three depots (data previously published). Phentolamine infusion did not augment lipolysis in the subcutaneous depots while it increased the lipolytic rate in the preperitoneal depot. It is concluded that α2-adrenergic receptors do not have a significant effect on subcutaneous adipose tissue lipolysis during high circulating adrenaline concentrations, and the decrease in lipolysis in subcutaneous adipose tissue under prolonged adrenaline stimulation is thus not attributed to α2-adrenergic receptor inhibition of lipolysis. However, in the preperitoneal adipose tissue depot, α2-adrenergic receptor tone plays a role for the lipolytic rate obtained during prolonged adrenaline stimulation. [ABSTRACT FROM AUTHOR]

To determine whether blockade of the exercise-induced increase in growth hormone (GH) secretion may affect the regional lipolytic rate in the post-exercise recovery period, the aim of the present experiments was to study the effect of infusion of the somatostatin analogue octreotide on the s.c., abdominal adipose tissue metabolism, before, during and after exercise in healthy, fasting, young male subjects. The adipose tissue net releases of fatty acids and glycerol were measured by arterio-venous catherizations and simultaneous measurements of adipose tissue blood flow with the local Xe-clearance method. Nine subjects were studied during 1-h basal rest, and then during continuous octreotide infusion during 1-h rest, 1-h exercise at 50% of maximal oxygen consumption and 4-h post-exercise rest. A control study on seven subjects was performed under similar conditions but without octreotide infusion. The results show that octreotide infusion during rest increased lipolysis and fatty acid release from the abdominal, s.c. adipose tissue. The exercise-induced increase in lipolysis and fatty acid release does not seem to be affected by octreotide when compared with the control study without octreotide infusion while the post-exercise increase in lipolysis is inhibited by octreotide, suggesting that the exercise-induced increase in GH secretion plays a role for the post-exercise lipolysis in s.c., abdominal adipose tissue. [ABSTRACT FROM AUTHOR]

Background and aims: Restricted physical activity as a consequence of chronic disease or injury is a predictor of functional decline. The aim of this study was to test the hypothesis that a 6-month multidimensional training program would have sustained beneficial effects upon the physiological, functional and psychological condition of old women with a recent history of falls. Methods: Participants were 65 home-dwelling women (70-90 years) identified from hospital records as having had an accidental fall. After assessment of muscle strength, balance performance, walking speed, balance confidence, and physical activity level, the participants were randomly assigned to a control group (n=33) or a training group (n=32), who performed a multidimensional training program including moderate resistance exercise and balance exercise twice weekly for 6 months. Measurements were repeated after 6 and 12 months. Results. Six months of multidimensional training resulted in significant improvements and between-group differences in isometric knee extension strength (p<0.05), trunk extension/ flexion strength (p<0.001), habitual/maxi-real walking speed (p<0.001) and balance performance (p<0.001). At follow-up, 6 months after intervention, these improvements were preserved in the training group and there was also a significant between-group difference with regard to balance confidence. No between-group differences were found concerning number of falls or physical activity level during the one-year study period. Conclusions: A multi-dimensional training program produced significant improvements in physiological and functional risk factors for falls and disability in women aged 70-90 years with a recent history of falls. [ABSTRACT FROM AUTHOR]

The aim of the study was to elucidate whether there are sex differences of significant biological importance in the human abdominal, subcutaneous adipose tissue lipid metabolism when studied by Fick's Principle during rest and exercise in steady-state conditions. The net mobilization of fatty acids and glycerol from the abdominal, subcutaneous adipose tissue was measured by arterio-venous catheterizations and simultaneous measurements of adipose tissue blood flow with the local Xe-clearance technique in 16 healthy, young normal weight men and women during rest, during 1 h of exercise at moderate intensity, and for another 60 min during post-exercise recovery. The results show that there are not significant sex differences with respect to the steady-state fatty acid and glycerol mobilizations neither during resting condition nor during exercise. [ABSTRACT FROM AUTHOR]

Adipose tissue blood flow was measured in six healthy, non-obese subjects with the xenon wash-out technique after labelling of the tissue by either injection of 133Xe dissolved in isotonic sodium chloride (water depot) or injection of 133Xe in gas form (gas depot). The wash-out rates were registered from four depots simultaneously. Two depots were placed above the umbilicus, and two depots were placed below the umbilicus in the abdominal, subcutaneous adipose tissue. A water depot and a gas depot were placed in the two positions, respectively. It was not possible to demonstrate any difference between the wash-out rates registered from the two depot types, and it was also not possible to demonstrate any difference between the changes in wash-out rates induced by an oral glucose load. Similarly, the tissue distribution of the water and the gas depots appeared to be similar as registered by a gamma camera. It is concluded that that the two tissue labelling modes give identical results. However, there are significant regional differences in the wash-out rates of xenon from subcutaneous, abdominal adipose tissue, the wash-out rates from infraumbilical depots being about 20% lower than from the supraumbilical depots. [ABSTRACT FROM AUTHOR]

The purpose of these experiments was to measure the influence of insulin and glucagon on the splanchnic oxygen consumption. Two experiments were performed. Methods: In one experiment, the influence of hyperinsulinaemia was investigated in six healthy subjects, who were studied during a euglycaemic hyperinsulinaemic clamp. In another experiment, the influence of glucagon was investigated in seven healthy subjects, who were studied twice during a pancreatic islet clamp with either supplementation of insulin and glucagon, or of insulin alone. In both situations the measurements were performed during euglycaemia. Splanchnic oxygen consumption and net substrate balances were studied by the arterio-hepatic venous catheterisation technique and measurement of splanchnic blood flow in all experiments. Results: During the euglycaemic hyperinsulinaemic clamp, the splanchnic blood flow increased significantly and the splanchnic oxygen consumption decreased by about 20%, while the net splanchnic glucose output reversed to a net uptake. In the pancreatic islet clamp experiments there was a significant difference between the net splanchnic glucose outputs whether glucagon and insulin or only insulin was supplemented. In spite of this, the splanchnic oxygen consumption decreased by about 20% in both situations, i.e. independent of glucagon supplementation. In both experiments there was a pronounced inhibition of lipolysis, which led to decreased fatty acids availability to the liver. This resulted in a concomitant decrease in hepatic ketone body formation. This decrease could account for about 30% of the decrease in splanchnic oxygen consumption. Conclusion: The reduction in splanchnic oxygen consumption can be explained by decreased ketogenesis, decreased protein synthesis and changes in splanchnic fuel selection, while changes in the rate of gluconeogenesis does not seem to play a significant role. [ABSTRACT FROM AUTHOR]

Focuses on the lipolytic response in the subcutaneous abdominal adipose tissue in older women to endurance exercise. Importance of nonesterified fatty acids (NEFA) in regulating substrate choice in the muscle; Role of NEFA mobilization for NEFA oxidation in skeletal muscle; Association of aging with increased fat mass.

BACKGROUND AND OBJECTIVES GH administration results in increased lean body mass (LBM), decreased fat mass (FM) and increased energy expenditure (EE). GH therapy may therefore have potential benefits, especially in the elderly, who are known to have decreased function of the GH/IGF-I axis. Several studies have focused on effects of GH administration in the elderly in the last decade. However, very limited information is available regarding changes in body composition and EE upon GH discontinuation in the elderly. The present study therefore investigated the effects of 12 weeks of GH administration and subsequent discontinuation on body composition, resting oxygen uptake (VO2), resting heart rate (HR) and GH related serum markers in healthy elderly men. SUBJECTS AND METHODS Sixteen healthy men [age 74 ± 1 years (mean ± SEM), height 174·2 ± 1·6 cm, body weight 80·7 ± 2·6 kg, body fat 27·5 ± 1·1%] completed the study protocol. Recombinant human GH (1·80 ± 0·24 IU/day) was administered for 12 weeks in a single-blinded, placebo-controlled design. Body composition (dual energy X-ray absorptiometry), resting VO2 (indirect calorimetry), resting HR (telemetry) and serum IGF-I, IGF-II, IGFBP-3 and acid labile subunit (ALS) were measured at baseline, after 12 weeks of GH administration and, additionally in the GH group, 1, 2, 3, 4, 5 and 9 days after GH discontinuation. RESULTS Body weight was unchanged from baseline to 12 weeks in both groups. However, GH administration caused a decrease in FM (3·4 ± 1·0 kg, P < 0·012), paralleled by a similar increase in LBM (3·2 ± 0·4 kg, P < 0·0002). Resting VO2 and resting HR increased by 31 ± 3·6% and 7·3 ± 1·9 per minute, respectively, in the GH-group, where significant increases in serum IGF-I, IGFBP-3 and ALS also were noted. None of the above parameters changed in the placebo group. Within 2–3 days after GH discontinuation, the GH related serum markers and resting HR returned to baseline levels, whereas resting VO2 remained elevated even 9 days after GH discontinuation. In addition, GH discontinuation caused a significant decrease in body weight (1·86 ± 0·35 kg), derived exclusively from a decrease in LBM (1·63 ± 0·43 kg), while the decreased FM was maintained (12 weeks: 17·93 ± 1·65 kg, +9 days: 17·74 ± 1·62 kg). CONCLUSIONS The increases in serum IGF-I, IGFBP-3, ALS and resting heart rate induced by 12 weeks of GH administration in elderly men returned to baseline levels within 2–3 days after GH discontinuation. However, resting VO2 remained elevated for a longer period. GH administration reduced fat mass but maintained body weight by increasing lean body mass. In contrast, 9 days of GH discontinuation reduced body weight exclusively by reducing lean body mass. [ABSTRACT FROM AUTHOR]

Purpose: Compare the recanalization rate of femoropopliteal occlusions between movable core wire guide (MG) and hydrophilic guidewire (HG).Methods: Conventional PTA technique was used, followed by enclosed thrombolysis. The MG was used for all patients in the first 2 years, the HG in the following 2 years. Baseline characteristics were similar for the two groups of patients.Results: Recanalization of 124 femoropopliteal occlusions was attempted. Technical success was achieved with the MG in 45 of 59 procedures; 42 procedures were clinically successful. Using the HG, technical success was achieved in 35 of 65 procedures; clinical success was achieved in 35 of 65 procedures; clinical success was achieved in 29 cases (p < 0.0048). At 1-year follow-up, 32 extremities improved after treatment with MG and 22 extremities after treatment with HG (p < 0.035).Conclusion: The results suggest that the MG should be the first choice in recanalization of femoropopliteal occlusions. [ABSTRACT FROM AUTHOR]