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PURPOSE The purpose of this study was to determine the effect of exercise types on the Wnt/BMP signaling and the response to myogenic mechanism by downhill and uphill training in the aged rat skeletal muscles. METHODS Young and old rats were randomly assigned to control groups; young (YC) and old (OC), and two types of running training groups: old downhill exercise (ODE) and old uphill exercise (OUE). Training was progressively carried out on a treadmill at a speed of 21 m/min with a slope of +10° for uphill training vs 16 m/min with a slope of -16° for downhill training: 60 min/day, 5 days/week for 8 weeks respectively. RESULTS Downhill and uphill training significantly increased the protein levels of Wnt3a, β-catenin and LEF-1 in aged rats. On the contrary, GSK3β was reduced by running training. In addition, the expression patterns of Wnt7a, Fzd7, PKC, p-AKT, and p-mTOR in extensor digitorum longus (EDL) and soleus (SOL) muscle were significantly increased in both ODE and OUE groups. Expression patterns of BMP-2, BMP-7, and p-Smad-1/5/8 in EDL and SOL muscles were significantly increased in both ODE and OUE groups. Especially, ODE group showed more increased expression pattern than OUE group. The expression patterns of MyoD, Myf5, and Myogenin were significantly increased in both DOE and OUE groups. Myf5 and Myogenin showed more increased expression pattern in ODE group than OUE group. CONCLUSIONS The downhill and uphill exercise training may play a mediating role in increasing the expression of these reduced myogenesis related factors. Furthermore, the formation process and hypertrophy of skeletal muscle weakened due to aging can be improved and maintained.

Purpose: The purpose of this study is to investigate the relative surgical risk and problems in hip hemiarthroplasty for treatment of an unstable intertrochanteric fracture in elderly patients over 80 years old. Materials and Methods: Between April 2005 and May 2010, 58 patients whose age was over 80 years were available for inclusion in this study. They were divided into two groups: group 1 included 30 patients with femoral neck fracture and group 2 included 28 patients with intertrochanteric fracture. No significant differences in average age, concomitant disease, and walking ability before development of fracture were noted between the two groups. The following factors, including interval from development of fracture to operation, operation time, amount of blood loss, start time of walking after operation, duration of hospital stay, complications, revision rate, and walking ability were compared between the two groups. Results: Operation time was an average of 85.2 minutes in group 1 and 97.5 minutes in group 2(P=0.03). The amount of bleeding was an average of 483 cc in group 1 and 695 cc in group 2(P=0.006). Similar results for walking start and recovery of walking ability after operation were observed in the two groups. No significant differences were observed in duration of hospital stay, complications, and revision rate. While 25 patients in group 1(83.3%) showed restoration of walking ability after operation to the same level of walking before injury, 19 patients in group 2(67.8%) showed restoration of walking ability postoperatively. Conclusion: Even though patients in group 2 showed a longer operation time and a higher amount of blood loss, compared with those in group 1, patients in group 2 had similar surgical risk and complications, compared with those in group 1. Therefore, primary hip hemiarthropalsty could be a good treatment option for intertrochanteric fracture in elderly. [ABSTRACT FROM AUTHOR]