Relação entre área do braço, área do músculo, área de gordura do braço e a menarca em adolescentes do município de Botucatu

The authors show the relations among arm circumference, arm muscle and arm fat areas with or without menarche, by carrying out an anthropometric study in 717 adolescents in the municipality of Botucatu. It must be emphasized that those adolescents who had already menstruated presented significantly higher nutritional indicators than those who had not menstruated yet. There was an increase in fat tissue and lean body mass in those adolescents who had already menstruated. Body changes might be expressed by calculating muscle and arm fat areas using triceps skinfold and arm circumference.

Avaliação dos mecanismos moleculares envolvidos na instalação da resistência periférica à insulina em camundongos portadores de caquexia tumoral

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Investigação da expressão de genes do metabolismo lipídico em pacientes com Diabetes Mellitus tipo 2, Dislipidemia e Doença Periodontal Crônica

Pós-graduação em Odontologia - FOAR

Investigação da expressão de genes do metabolismo lipídico em pacientes com Diabetes Mellitus tipo 2, Dislipidemia e Doença Periodontal Crônica

Pós-graduação em Odontologia - FOAR

Kinin B1 Receptor in Adipocytes Regulates Glucose Tolerance and Predisposition to Obesity

Background: Kinins participate in the pathophysiology of obesity and type 2 diabetes by mechanisms which are not fully understood. Kinin B-1 receptor knockout mice (B-1(-/-)) are leaner and exhibit improved insulin sensitivity. Methodology/Principal Findings: Here we show that kinin B-1 receptors in adipocytes play a role in controlling whole body insulin action and glucose homeostasis. Adipocytes isolated from mouse white adipose tissue (WAT) constitutively express kinin B-1 receptors. In these cells, treatment with the B-1 receptor agonist des-Arg(9)-bradykinin improved insulin signaling, GLUT4 translocation, and glucose uptake. Adipocytes from B-1(-/-) mice showed reduced GLUT4 expression and impaired glucose uptake at both basal and insulin-stimulated states. To investigate the consequences of these phenomena to whole body metabolism, we generated mice where the expression of the kinin B-1 receptor was limited to cells of the adipose tissue (aP2-B-1/B-1(-/-)). Similarly to B-1(-/-) mice, aP2-B-1/B-1(-/-) mice were leaner than wild type controls. However, exclusive expression of the kinin B1 receptor in adipose tissue completely rescued the improved systemic insulin sensitivity phenotype of B-1(-/-) mice. Adipose tissue gene expression analysis also revealed that genes involved in insulin signaling were significantly affected by the presence of the kinin B-1 receptor in adipose tissue. In agreement, GLUT4 expression and glucose uptake were increased in fat tissue of aP2-B-1/B-1(-/-) when compared to B-1(-/-) mice. When subjected to high fat diet, aP2-B-1/B-1(-/-) mice gained more weight than B-1(-/-) littermates, becoming as obese as the wild types. Conclusions/Significance: Thus, kinin B-1 receptor participates in the modulation of insulin action in adipocytes, contributing to systemic insulin sensitivity and predisposition to obesity.

The influence of anthropometric factors on postural balance: the relationship between body composition and posturographic measurements in young adults

OBJECTIVE: The aim of the present study was to evaluate the influence of anthropometric characteristics and gender on postural balance in adults. One hundred individuals were examined (50 males, 50 females; age range 20-40 years). METHODS: The following body composition measurements were collected (using bone densitometry measurements): fat percentage (% fat), tissue (g), fat (g), lean mass (g), bone mineral content (g), and bone mineral density (g/cm(2)). In addition, the following anthropometric measurements were collected: body mass (kg), height (cm), length of the trunk-cephalic region (cm), length of the lower limbs (cm) and length of the upper limbs (cm). The following indices were calculated: body mass index (kg/m(2)), waist-hip ratio and the support base (cm 2). Also, a postural balance test was performed using posturography variables with open and closed eyes. RESULTS: The analysis revealed poor correlations between postural balance and the anthropometric variables. A multiple linear regression analysis demonstrated that the whole group (female and male) height explained 12% of the medial-lateral displacement, 10% of the speed of oscillation, and 11% of the displacement area. The length of the trunk-cephalic length explained 6% of the displacement in the anteroposterior direction. With eyes closed, the support base and height explained 18% of the medial displacement, and the lateral height explained 10% of the displacement speed and 5% of the scroll area. CONCLUSION: Measured using posturography, the postural balance was only slightly influenced by the anthropometric variables, both with open and closed eyes. Height was the anthropometric variable that most influenced postural balance, both in the whole group and separately for each gender. Postural balance was more influenced by anthropometric factors in males than females.

T-3 Rapidly Increases SLC2A4 Gene Expression and GLUT4 Trafficking to the Plasma Membrane in Skeletal Muscle of Rat and Improves Glucose Homeostasis

Background: Glucose transporter 4 (GLUT4) is highly expressed in muscle and fat tissue, where triiodothyronine (T-3) induces solute carrier family 2 facilitated glucose transporter member 4 (SLC2A4) gene transcription. T-3 was also shown to rapidly increase glucose uptake in myocytes exposed to cycloheximide, indicating that it might act nongenomically to regulate GLUT4 availability. We tested this hypothesis by evaluating, in thyroidectomized rats (Tx rats), the acute and/or chronic T-3 effects on GLUT4 mRNA expression and polyadenylation, protein content, and trafficking to the plasma membrane (PM) in skeletal muscle, as well as on blood glucose disappearance rate (kITT) after insulin administration. Methods: Rats were surgically thyroidectomized and treated with T-3 (0.3 to 100 mu g/100 g body weight) from 10 minutes to 5 days, and killed thereafter. Sham-operated (SO) rats were used as controls. Total RNA was extracted from the skeletal muscles (soleus [SOL] and extensorum digitalis longus [EDL]) and subjected to Northern blotting analysis using rat GLUT4 cDNA probe. Total protein was extracted and subjected to specific centrifugations for subcellular fractionation, and PM as well as microsomal (M) fractions were subjected to Western blotting analysis, using anti-GLUT4 antiserum as a probe. GLUT4 mRNA polyadenylation was examined by a rapid amplification of cDNA ends-poly(A) test (RACE-PAT). Results: Thyroidectomy reduced skeletal muscle GLUT4 mRNA, mRNA poly(A) tail length, protein content, and trafficking to the PM, as well as the kITT. The acute T-3 treatment rapidly (30 minutes) increased all these parameters compared with Tx rats. The 5-day T-3 treatment increased GLUT4 mRNA and protein expression, and restored GLUT4 trafficking to the PM and kITT to SO values. Conclusions: The results presented here show for the first time that, in parallel to its transcriptional action on the SLC2A4 gene, T-3 exerts a rapid post-transcriptional effect on GLUT4 mRNA polyadenylation, which might increase transcript stability and translation efficiency, leading to the increased GLUT4 content and availability to skeletal muscle, as well as on GLUT4 translocation to the PM, improving the insulin sensitivity, as shown by the kITT.

Abdominal compression: A new intraoperative maneuver to detect chyle fistulas during left neck dissections that include level IV

Background Chyle fistulas may occur after left neck dissections that include level IV, due to injury of the thoracic duct or of 1 of its major branches. Despite being unusual, this complication carries substantial postoperative morbidity and even mortality. So far, no effective intraoperative maneuver has been reported to detect this fistula at the end of a neck dissection. In this cohort study, we sought to describe a simple new maneuver, intraoperative abdominal compression, which can effectively help to identify an open major lymphatic duct on level IV at the end of a neck dissection. Patients and Methods From March 1989 to September 2010, 206 patients underwent neck dissections involving left level IV, and underwent intraoperative abdominal compression. There were 119 men and 87 women, with ages ranging from 18 to 81 years (median, 52 years). One hundred forty-four patients had squamous cell carcinomas, 54 had thyroid carcinomas, 5 had malignant melanomas, and 3 had salivary cancers. Distribution by type of left neck dissection was: selective including levels II, III, and IV (73 cases; 35.4%), selective including levels II, III, IV, and V (55 cases; 26.6%), selective including levels I, II, III, and IV (12 cases; 5.8%), modified radical (47 cases; 22.8%), and radical (19 cases; 9.2%). In all cases, at the end of the procedure, the endotracheal tube was temporarily disconnected from the ventilator. Keeping the dissected level IV area under clear visualization, an abdominal compression was performed. At this moment, any detected lymphatic leak was carefully clamped and tied with nonabsorbable sutures. After ventilating the patient, the intraoperative abdominal compression was repeated to reassure complete occlusion of the lymphatic vessel. Results In 13 cases (6.3%), a chyle leak was detected after performing the intraoperative abdominal compression. All leaks except for 2 were successfully controlled after 1 attempt. In these 2 patients, a patch of muscle and fat tissue was applied with fibrin glue on the top. In 1 of these patients, another chyle leak in a different location was detected only at the second intraoperative abdominal compression, and was also effectively closed. Postoperatively, there were 2 (1%) chyle fistulas, both among these 13 cases, and all were successfully managed with clinical measures only. No fistulas occurred among the remaining 193 patients in whom intraoperative abdominal compression did not demonstrate lymphatic leak. Conclusion To our knowledge, this is the first description of a specific maneuver to actively detect a lymphatic fistula at the end of a left neck dissection involving level IV. In this study, intraoperative abdominal compression was able to detect an open lymphatic vessel in 6.3% of the cases, as well as to assure its effective sealing in the remaining 93.7% of the patients. Moreover, no life-threatening high-volume fistula was noted in this study. (C) 2012 Wiley Periodicals, Inc. Head Neck, 2012

Entwicklung und Tests von Algorithmen für die Impedanztomographie

Die Elektrische Impedanztomographie soll als kostengünstige und nebenwirkungsfreie Tomographiemethode in der medizinischen Diagnostik, z. B. in der Mammographie dienen. Mit der EIT läßt sich Krebsgewebe von gesundem Gewebe unterscheiden, da es eine signifikant erhöhte Leitfähigkeit aufweist. Damit kann die EIT als Ergänzung zu den klassischen Diagnoseverfahren dienen. So ist z.B. bei jungen Frauen mit einem dichteren Fettgewebe die Identifizierung eines Mammakarzinoms mit der Röntgentomographie nicht immer möglich. Ziel dieser Arbeit war es, einen Prototypen für die Impedanztomographie zu entwickeln und mögliche Anwendungen zu testen. Der Tomograph ist in Zusammenarbeit mit Dr. K.H.Georgi gebaut worden. Der Tomograph erlaubt es niederohmige, Wechselströme an Elektroden auf der Körperoberfläche einzuspeisen. Die Potentiale können an diesen Elektroden programmierbar vorgegeben werden. Weitere hochohmige Elektroden dienen zur Potentialmessung. Um den Hautwiderstand zu überbrücken, werden Wechselstromfrequenzen von 20-100 kHz eingesetzt. Mit der Möglichkeit der Messung von Strom und Potential auf unterschiedlichen Elektroden kann man das Problem des nur ungenau bekannten Hautwiderstandes umgehen. Prinzipiell ist es mit dem Mainzer EIT System möglich, 100 Messungen in der Sekunde durchzuführen. Auf der Basis von mit dem Mainzer EIT gewonnenen Daten sollten unterschiedliche Rekonstruktionsalgorithmen getestet und weiterentwickelt werden. In der Vergangenheit sind verschiedene Rekonstruktionsalgorithmen für das mathematisch schlecht gestellte EIT Problem betrachtet worden. Sie beruhen im Wesentlichen auf zwei Strategien: Die Linearisierung und iterative Lösung des Problems und Gebietserkennungsmethoden. Die iterativen Verfahren wurden von mir dahingehend modifiziert, dass Leitfähigkeitserhöhungen und Leitfähigkeitserniedrigungen gleichberechtigt behandelt werden können. Für den modifizierten Algorithmus wurden zwei verschiedene Rekonstruktionsalgorithmen programmiert und mit synthetischen Daten getestet. Zum einen die Rekonstruktion über die approximative Inverse, zum anderen eine Rekonstruktion mit einer Diskretisierung. Speziell für die Rekonstruktion mittels Diskretisierung wurde eine Methode entwickelt, mit der zusätzliche Informationen in der Rekonstruktion berücksichtigt werden können, was zu einer Verbesserung der Rekonstruktion beiträgt. Der Gebietserkennungsalgorithmus kann diese Zusatzinformationen liefern. In der Arbeit wurde ein neueres Verfahren für die Gebietserkennung derart modifiziert, dass eine Rekonstruktion auch für getrennte Strom- und Spannungselektroden möglich wurde. Mit Hilfe von Differenzdaten lassen sich ausgezeichnete Rekonstruktionen erzielen. Für die medizinischen Anwendungen sind aber Absolutmessungen nötig, d.h. ohne Leermessung. Der erwartende Effekt einer Inhomogenität in der Leitfähigkeit ist sehr klein und als Differenz zweier grosser Zahlen sehr schwierig zu bestimmen. Die entwickelten Algorithmen kommen auch gut mit Absolutdaten zurecht.

[Calcium and blood pressure]

The regulation of blood pressure is complex with several organs being involved. Intracellular calcium plays a crucial role in the regulation of cardiovascular functions: An increased influx of calcium into the vascular smooth muscle cells leads to an augmental muscular tone and therefore to an increased vascular resistance and rise in blood pressure. Parathormone plays a permissive role since it regulates the calcium-influx into the cells and thus increases the vasoconstrictive effect. There is a positive correlation between parathormone and blood pressure, present in primary as well as secondary hyperparathyroidism. Moreover, patients with essential hypertension have high parathormone levels already before hypertension is diagnosed. A calcium-rich diet (> 1000 mg calcium daily) slightly decreases blood pressure. This positive effect is due to parathormone suppression with a subsequently decreased calcium content in the vascular smooth muscle cells. A calcium-rich diet inhibits lipogenesis in the fat tissue; thus additionally improving the cardiovascular risk profile.

Virtopsy -- noninvasive detection of occult bone lesions in postmortem MRI: additional information for traffic accident reconstruction

In traffic accidents with pedestrians, cyclists or motorcyclists, patterned impact injuries as well as marks on clothes can be matched to the injury-causing vehicle structure in order to reconstruct the accident and identify the vehicle which has hit the person. Therefore, the differentiation of the primary impact injuries from other injuries is of great importance. Impact injuries can be identified on the external injuries of the skin, the injured subcutaneous and fat tissue, as well as the fractured bones. Another sign of impact is a bone bruise. The bone bruise, or occult bone lesion, means a bleeding in the subcortical bone marrow, which is presumed to be the result of micro-fractures of the medullar trabeculae. The aim of this study was to prove that bleeding in the subcortical bone marrow of the deceased can be detected using the postmortem noninvasive magnetic resonance imaging. This is demonstrated in five accident cases, four involving pedestrians and one a cyclist, where bone bruises were detected in different bones as a sign of impact occurring in the same location as the external and soft tissue impact injuries.

Does normalized signal intensity of cervical discs on T2 weighted MRI images change in whiplash patients?

PURPOSE We tested the hypothesis that whiplash trauma leads to changes of the signal intensity of cervical discs in T2-weighted images. METHODS AND MATERIALS 50 whiplash patients (18-65 years) were examined within 48h after motor vehicle accident, and again after 3 and 6 months and compared to 50 age- and sex-matched controls. Signal intensity in ROI's of the discs at the levels C2/3 to C7/T1 and the adjacent vertebral bodies were measured on sagittal T2 weighted MR images and normalized using the average of ROI's in fat tissue. The contrast between discs and both adjacent vertebrae was calculated and disc degeneration was graded by the Pfirrmann-grading system. RESULTS Whiplash trauma did not have a significant effect on the normalized signals from discs and vertebrae, on the contrast between discs and adjacent vertebrae, or on the Pfirrmann grading. However, the contrast between discs and adjacent vertebrae and the Pfirrmann grading showed a strong correlation. In healthy volunteers, the contrast between discs and adjacent vertebrae and Pfirrmann grading increased with age and was dependent on the disc level. CONCLUSION We could not find any trauma related changes of cervical disc signal intensities. Normalized signals of discs and Pfirrmann grading changed with age and varied between disc levels with the used MR sequence.

Essentials of forensic post-mortem MR imaging in adults

Post-mortem MR (PMMR) imaging is a powerful diagnostic tool with a wide scope in forensic radiology. In the past 20 years, PMMR has been used as both an adjunct and an alternative to autopsy. The role of PMMR in forensic death investigations largely depends on the rules and habits of local jurisdictions, availability of experts, financial resources, and individual case circumstances. PMMR images are affected by post-mortem changes, including position-dependent sedimentation, variable body temperature and decomposition. Investigators must be familiar with the appearance of normal findings on PMMR to distinguish them from disease or injury. Coronal whole-body images provide a comprehensive overview. Notably, short tau inversion–recovery (STIR) images enable investigators to screen for pathological fluid accumulation, to which we refer as “forensic sentinel sign”. If scan time is short, subsequent PMMR imaging may be focussed on regions with a positive forensic sentinel sign. PMMR offers excellent anatomical detail and is especially useful to visualize pathologies of the brain, heart, subcutaneous fat tissue and abdominal organs. PMMR may also be used to document skeletal injury. Cardiovascular imaging is a core area of PMMR imaging and growing evidence indicates that PMMR is able to detect ischaemic injury at an earlier stage than traditional autopsy and routine histology. The aim of this review is to present an overview of normal findings on forensic PMMR, provide general advice on the application of PMMR and summarise the current literature on PMMR imaging of the head and neck, cardiovascular system, abdomen and musculoskeletal system.

["Not to be taken lightly"].

A 78 year old patient with type 2 diabetes mellitus was hospitalized because of weakness and poor nutritional status. For several years, he suffered from an unintended weight loss and chronic, pulpy diarrhea. On examination, we found a severe loss of muscle and fat tissue as well as difficulty swallowing. An adequate nutritional therapy with combined parenteral and enteral nutrition was implemented under regular monitoring of electrolytes and volume status, under which the state of health improved noticeably, while steatorrhea improved under substitution of pancreatic enzymes.

The role of CD1d in adipogenesis

Atherosclerosis-associated coronary heart disease is the number one cause of death in the western society, and often triggered by metabolic disorders, such as hyperlipidemia, hypertension, obesity, and diabetes. The CD1 molecules are a group of evolutionarily conservative transmembrane proteins that have recently emerged as novel lipid-binding and transporting molecules. The current study was aimed at illustrating the role of CD1d in regulation of lipid metabolism and adipogenesis. In stably transfected smooth muscle cells where CD1d is overexpressed via a pCMV promoter, high levels of binding of the oxysterol 7-ketocholesterol was found. Adipogenic treatment induces the cells to transdifferentiate into an adipocyte-like morphology. This adipocyte morphology of CD1d transfected SMCs strongly resembles that of the pre-adipocytes 3T3-L1 cells grown in the same adipogenic media. Adipogenic treatment of CD1d transfected 3T3-L1 cells led to an increased accumulation of lipids compared to mock transfected cells. Induction of adipogenic gene expression and activation, such as PPARγ and lipoprotein lipase (LPL), was achieved in adipogenically treated smooth muscle cells as well as 3T3-L1 cells with overexpression of CD1d. For determination of the role of CD1d in regulation of adipogenesis, a CD1d transgenic mouse strain was created using the CD1d-smooth muscle promoter construct. Compared to wild type control mice matched in age and sex, the transgenic mice show an age-dependent increase in abdominal and visceral fat tissue. Histopathological examination demonstrated marked enlargement of adipocytes in the transgenic fat tissue which otherwise remained a normal fat tissue structure. Immunohistochemical analysis of CD1d expression in the fat tissue revealed much stronger membrane CD1d immunostaining in the transgenic tissue than the wild type fat tissue. Under normal chow diets, CD1d-transgenic mice also developed fatty livers. In conclusion, CD1d serves as a regulator of lipid metabolism, which may transducer signals from oxysterols to induce expression of genes important in lipogenesis. These experimental results point to a novel mechanism by which CD1d mediates lipid metabolism in adipose tissue and contributes to the development of obesity. ^