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Body mass index is a common and well-known measure in daily life. A body mass index higher than 25 is assumed to be an indicator for overweight and obesity and a high amount of total body fat. But body mass index overestimates body fat in subjects with high muscle mass and underestimates it in persons with a low lean body mass, especially in elderly and diseased persons. In the present study, we investigate the performance of the body mass index as a measure of body fatness and its ability to distinguish between well-trained and untrained subjects. Twenty-one well-trained male members of a police task force named “Cobra” and 38 non-active controls, matched by age, weight and height were participants of the study. The age range of these subjects was between 30 and 45 years. Subcutaneous adipose tissue thicknesses and body fat distributions were measured non-invasively by an optical device named the “Lipometer.” Statistics were performed with SPSS. We found that the body mass index did not show a difference between the two groups, whereas all Lipometer results were able to discriminate significantly between the trained and untrained subjects. Furthermore, the receiver operating characteristic curve analysis was calculated and all Lipometer measurements provided significant results up to a correct classification of all subjects of 86.4%, which was for the lateral thigh body site. In conclusion, the body mass index was not able to recognize the difference between trained and untrained participants, while body fat distribution measured with the Lipometer was able to distinguish more clearly the large body fat differences between these two groups. Impact statement Body mass index (BMI) is a common measure of body fatness but overestimates body fat in subjects with high muscle mass. We have developed previously a device named “Lipometer,” an alternative way to measure body fatness. We show herein that the Lipometer is able to distinguish more clearly (than the BMI) the large body fat differences between well-trained and untrained subjects. Thus, the Lipometer is superior to BMI with respect to body fat measurements.

Background: The critical role of neuro-inflammation and oxidative stress in the pathogenesis of neurodegenerative diseases such as Alzheimer's disease (AD) has become evident. Objective: The aim of this study is to assess the influence of vitamin supplementation on parameters of oxidative stress, inflammation as well as on cognition in patients with AD and mild cognitive impairment. Methods: In our study, patients with cognitive impairment and healthy controls were enrolled. All patients were intended to receive vitamin supplementation (vitamin B1, B6, B12 and folic acid) for 3 months. Mini Mental State Examination (MMSE) and laboratory markers [carbonyl proteins (CPs), malondialdehyde, tryptophan (Trp), kynurenine (Kyn), neopterin, folic acid, vitamin B12 level] were assessed for patients and controls at baseline and after 3 months. After half of the patients had been treated for 3 months, analyses were performed resulting in 3 subgroups: healthy controls without supplementation (15 subjects, 11 females), patients with vitamin supplementation (17 subjects, 10 females) and patients without vitamin supplementation (16 subjects, 9 females; baseline values prior to supplementation). Results: Age was significantly higher for the supplemented group (76.4 ± 6.7 years) compared to vitamin-naïve patients (63.3 ± 13.7 years; p < 0.01). The MMSE score was higher in the supplemented group (23.1 ± 4.8 vs. 20.3 ± 9.5) but did not reach significance. Levels of CPs were significantly higher in the vitamin-naïve patients (p < 0.05). Levels of Kyn and the Kyn/Trp ratio were significantly lower in vitamin-naïve patients compared to the supplemented group (p < 0.05). No significant difference was seen for the other markers. Conclusion: Vitamin supplementation leads to reduced levels of CPs in patients. Pearson's correlation coefficient shows a negative relation (r = -0.69) between CPs and MMSE. Future trials should assess whether CPs might be suitable markers for monitoring of demented patients.

Background Ethyl pyruvate (EP) exerts anti-inflammatory and anti-oxidative properties. The aim of our study was to investigate whether EP is capable of inhibiting the oxidation of LDL, a crucial step in atherogenesis. Additionally, we examined whether EP attenuates the cytotoxic effects of highly oxidized LDL in the human vascular endothelial cell line EA.hy926. Methods Native LDL (nLDL) was oxidized using Cu2+ ions in the presence of increasing amounts of EP. The degree of LDL oxidation was quantified by measuring lipid hydroperoxide (LPO) and malondialdehyde (MDA) concentrations, relative electrophoretic mobilities (REMs), and oxidation-specific immune epitopes. The cytotoxicity of these oxLDLs on EA.hy926 cells was assessed by measuring cell viability and superoxide levels. Furthermore, the cytotoxicity of highly oxidized LDL on EA.hy926 cells under increasing concentrations of EP in the media was assessed including measurements of high energy phosphates (ATP). Results Oxidation of nLDL using Cu2+ ions was remarkably inhibited by EP in a concentration-dependent manner, reflected by decreased levels of LPO, MDA, REM, oxidation-specific epitopes, and diminished cytotoxicity of the obtained oxLDLs in EA.hy926 cells. Furthermore, the cytotoxicity of highly oxidized LDL on EA.hy926 cells was remarkably attenuated by EP added to the media in a concentration-dependent manner reflected by a decrease in superoxide and an increase in viability and ATP levels. Conclusions EP has the potential for an anti-atherosclerotic drug by attenuating both, the oxidation of LDL and the cytotoxic effect of (already formed) oxLDL in EA.hy926 cells. Chronic administration of EP might be beneficial to impede the development of atherosclerotic lesions.

Background Although there is no direct evidence, it is generally believed that bed rest shifts the haemostatic system towards hypercoagulability; thus, immobilized patients are commonly treated with anticoagulants. We therefore aimed to investigate whether long-term bed rest actually leads to an elevated risk for thromboembolic events. Materials and methods Eleven healthy men were enrolled in our study (bed rest campaign in MEDES Clinique d'Investigation, Toulouse, France). Besides various standard laboratory methods, we used calibrated automated thrombography (CAT) and thrombelastometry (TEM). Activation of samples with minute amounts of relipidated tissue factor allowed sensitive detection of hyper- or hypocoagulable states. Results CAT and TEM values were not indicative of bed rest-induced hypercoagulability. On the contrary, several parameters were indicative of a tendency towards a hypocoagulable state. Peak and thrombin formation velocity (VELINDEX) were significantly decreased during bed rest compared to baseline. Coagulation times were significantly increased and alpha angles were significantly decreased, indicating attenuated clot formation. Moreover, F1 + 2 and thrombin/antithrombin complex (TAT) values were significantly decreased during bed rest, indicating suppressed coagulation activation. FVII plasma levels were also significantly decreased during the first week of bed rest. Conclusions Our data indicate that the re-ambulation period is associated with a tendency towards hypercoagulability: ttPeak and StartTail were significantly shorter, Peak and VELINDEX were significantly higher compared to baseline. Moreover, plasma levels of F1 + 2, TAT, FVII and FVIII were significantly higher compared to baseline. The results from our study suggest that bed rest by itself is not associated with hypercoagulable states in healthy subjects.

Aims: The objective of our study was to assess the effects of orthostatic challenge on the coagulation system in patients with a history of thromboembolic events and to assess how they compared with age-matched healthy subjects. Methods: Twenty-two patients with histories of ischemic stroke and 22 healthy age-matched subjects performed a sit-to-stand test. Blood was collected prior to- and at the end of- standing in the upright position for 6 minutes. Haemostatic profiling was performed by determining thrombelastometry and calibrated automated thrombogram values, indices of thrombin generation, standard coagulation times, markers of endothelial activation, plasma levels of coagulation factors and copeptin, and hematocrit. Results: Orthostatic challenge caused a significant endothelial and coagulation activation in patients (Group 1) and healthy subjects (Group 2): Plasma levels of prothrombin fragment F1+2 were increased by approximately 35% and thrombin/antithrombin-complex (TAT) increased fivefold. Several coagulation variables were significantly altered in Group 1 but not in Group 2: Coagulation times (CTs) were significantly shortened and alpha angles, peak rate of thrombin generation (VELINDEX), tissue factor (TF) and copeptin plasma levels were significantly increased (comparison between standing and baseline). Moreover, the shortening of CTs and the rise of copeptin plasma levels were significantly higher in Group 1 vs. Group 2 (comparison between groups). Conclusion: The coagulation system of patients with a history of ischemic stroke can be more easily shifted towards a hypercoagulable state than that of healthy individuals. Attentive and long-term anticoagulant treatment is essential to keep patients from recurrence of vascular events.

Skinfold Calipers are widely used to obtain subcutaneous adipose tissue thickness because of its non-invasive, simple and inexpensive technique. Nevertheless, Caliper skinfold thicknesses have the disadvantage of measuring compressed adipose tissue and double layers of skin, which might reduce the precision of these results. In contrast, the computerized optical device Lipometer was developed to permit a quick, precise and non-invasive determination of non-compressed mono layers of subcutaneous adipose tissue thickness. In the present paper we investigate the hypothesis that Caliper skinfold thicknesses are significantly different from subcutaneous adipose tissue thicknesses in mm, which can be measured by Lipometer. Caliper and Lipometer results were obtained from 371 Estonian boys aged between 9.0 and 12.8 years. Measurements were performed at six different body sites: triceps, biceps, upper back, upper abdomen, hip and front thigh. Caliper measurements were systematically higher than Lipometer results in a range between 1.2 mm (hip) and 11.08 mm (front thigh). The limits of agreement analysis provided intervals from 7.5 mm (biceps) up to 30.14 mm (front thigh). Comparing Caliper and Lipometer results very low measurement agreement was found. The two methods provided very poor interchangeability.

We investigated a polyethylene glycol non-precipitable low-density lipoprotein (LDL) subfraction targeted by IgG and the influence of statin therapy on plasma levels of these small LDL-IgG-immune complexes (LDL-IgG-IC). LDL-subfractions were isolated from 6 atherosclerotic subjects and 3 healthy individuals utilizing iodixanol density gradient ultracentrifugation. Cholesterol, apoB and malondialdehyde (MDA) levels were determined in each fraction by enzymatic testing, dissociation-enhanced lanthanide fluorescence immunoassay and high-performance liquid chromatography, respectively. The levels of LDL-IgG-IC were quantified densitometrically following lipid electrophoresis, particle size distribution was assessed with dynamic light scattering and size exclusion chromatography. The influence of simvastatin (40 mg/day for three months) on small LDL-IgG-IC levels and their distribution among LDL-subfractions (salt gradient separation) were investigated in 11 patients with confirmed coronary artery disease (CAD). We demonstrate that the investigated LDL-IgG-IC are small particles present in atherosclerotic patients and healthy subjects. In vitro assembly of LDL-IgG-IC resulted in particle density shifts indicating a composition of one single molecule of IgG per LDL particle. Normalization on cholesterol levels revealed MDA values twice as high for LDL-subfractions rich in small LDL-IgG-IC if compared to dominant LDL-subfractions. Reactivity of affinity purified small LDL-IgG-IC to monoclonal antibody OB/04 indicates a high degree of modified apoB and oxidative modification. Simvastatin therapy studied in the CAD patients significantly lowered LDL levels and to an even higher extent, small LDL-IgG-IC levels without affecting their distribution. In conclusion simvastatin lowers levels of small LDL-IgG-IC more effectively than LDL-cholesterol and LDL-apoB levels in atherosclerotic patients. This antiatherogenic effect may additionally contribute to the known beneficial effects of this drug in the treatment of atherosclerosis.

article Introduction: The mechanisms of restenosis, the recurrence of luminal narrowing, are complex and incompletely understood to date. Thrombin, the pivotal enzyme in haemostasis, presumably contributes to the formation of in-stent restenosis (ISR). It was therefore the aim of our study to investigate whether blood coagulation/ thrombin generation plays a critical role in the formation of ISR in peripheral artery disease patients with stent angioplasty in the superficial femoral artery. Materials and Methods: We aimed to examine in this retrospective study whether patients with high-degree reste- nosis (50-75% lumen diameter reduction, n = 20) are in a hypercoaguable state implying enhanced readiness to generate thrombin compared to patients with low-degree restenosis (b 50% lumen diameter reduction, n = 14). Results: The coagulation tests calibrated automated thrombography, activated partial thromboplastin time, plate- let aggregation, platelet adhesion, fibrinogen, and microparticles' procoagulant activity did not indicate a differ- ent coagulation status in the two patient groups. However, the thrombelastometry-derived value Coagulation Time (CT) was significantly shorter in the high-degree restenosis group (p= 0.012), indicating a hypercoagulable state of patients with high-degree restenosis. Under our experimental conditions, CTs shorter than 444.5 s iden- tify patients at high risk (sensitivity = 95%) for luminal narrowing. Conclusions: Our study supports the assumption that blood coagulation/thrombin generation plays a critical role in the development of ISR in peripheral arteries after stent insertion and that the thrombelastometry-derived CT might be a suitable value to identify peripheral artery disease patients at risk for development of high-degree in- stent restenosis in the superficial femoral artery.

Objectives The observation and research of body composition is a topic of present interest. For the assessment of health and variables influencing growth and nutrition, it is of utmost interest to focus on the population of young children. Subjects and methods The measurements of subcutaneous body fat distribution in a sample of clinically healthy children ages 0 to 7 years were examined. The optical device LIPOMETER was applied to measure the thickness of subcutaneous adipose tissue layers (in millimeters) at 15 well-defined body sites. This set of measurement points defines the subcutaneous adipose tissue topography. In the present study, subcutaneous adipose tissue topography was determined in 275 healthy children (128 girls and 147 boys) divided into 3 age groups. Results The results of the measurements are presented in 3 levels: total subcutaneous adipose tissue, 4 body regions, and 15 body sites. Our results show a clear physiological decrease in subcutaneous body fat in boys (-43.8%) and girls (-39.8%). One interesting finding was that the decrease occurs mainly in the trunk, abdomen, and lower extremities, whereas the body fat distribution of the upper extremities did not differ. Furthermore, slight subcutaneous adipose tissue topography differences between both sexes were found. Conclusions The present study provides basic documentation of subcutaneous adipose tissue topography in healthy children ages 0 to 7 years. An accurate description of subcutaneous adipose tissue topography in healthy subjects could help to characterize various diseases in relation to overnutrition and malnutrition throughout childhood.

Background: To date, only few pharmacokinetic studies on low-molecular-weight heparins (LMWHs) in neonates exist not allowing to formally assess pharmacodynamics of LMWHs in neonates. Objective: To evaluate the anticoagulant effects of the two LMWHs nadroparin and enoxaparin on endogenous formation of FXa or FIIa in cord versus adult platelet-poor plasma (PPP) and on thrombelastometry profiles in cord versus adult whole blood (WB). Unfractionated heparin (UH) was the reference antithrombotic drug. Methods: The effects of nadroparin, enoxaparin, or UH on endogenous formation of FXa or FIIa was investigated in tissue factor-activated PPP using a subsampling technique and chromogenic substrates. The anticoagulant efficacy of these drugs was also investigated in WB triggered by the physiological relevant activator collagen/endogenous thrombin using thrombelastometry. Results: The major findings are (i) nadroparin is as efficient as enoxaparin concerning inhibition of the endogenous formation of FXa and FIIa, (ii) cord PPP and WB are significantly more susceptible to the addition of LMWHs or UH than adult PPP or WB, and (iii) compared by equivalent anti-FXa activity, the anticoagulant action of UH is markedly higher than that of the LMWHs in PPP and WB of neonatal or adult origin. Conclusions: Administration of LMWHs in neonates has to be performed carefully to avoid bleeding side effects due to their high anticoagulant efficacy in cord PPP and WB.

The aim of this study was to investigate the possible relationships between adiponectin and leptin with blood lipids (CHOL, HDL-C, LDL-C, and TG) in physically active postmenopausal women. One hundred and thirty-four physically active practicing gymnastics (2–3 times per week) women between the ages of 51 to 85 years participated in this cross-sectional study. Body height, body mass, waist-to-hip circumference ratio (WHR), and BMI were used as anthropometrical parameters. Body composition parameters (fat%, fat mass, fat free mass) were measured by DXA. The fasting adiponectin, leptin, CHOL, HDL-C, LDL-C, and TG were measured. From the anthropometrical and body composition parameters, only WHR correlated significantly with adiponectin (r = −0.306). In addition, adiponectin correlated with TG (r = −0.277) and leptin (r = −0.381). Leptin was positively related to body mass (r = 0.261), and BMI (r = 0.274) from anthropometrical parameters and body fat% (r = 0.288) and fat mass (r = 0.298) from body composition variables. No relationships emerged between leptin and blood lipids. We found that there are some significant relationships between adiponectin, leptin and anthropometrical and body composition parameters in physically active postmenopausal females. From blood lipids, only TG correlated significantly with adiponectin. Am. J. Hum. Biol. 22:609–612, 2010. © 2010 Wiley-Liss, Inc.

Activation of the cellular immune system is discussed to be partly responsible in the neurodegenerative process of Parkinson's disease. We determined concentrations of neopterin, of cytokine interleukin-6, and of soluble cytokine receptors sIL-2Rα, sTNF-R75α in plasma and cerebrospinal fluid in controls and patients with vascular parkinsonism and idiopathic Parkinson's disease diagnosed according to published clinical diagnostic criteria, to examine if the cellular immune system is activated locally or peripherally or both. Our results show no activation in idiopathic Parkinson's disease and controls, but a significant increased activation in vascular parkinsonism, where concomitant signs of cerebrovascular disease are present.

The aim of this study was to investigate whether subcutaneous adipose tissue topography (SAT-Top) is different in female CHD patients (n=26) and healthy controls (n=36) matched to age, body size, weight, and BMI. The thicknesses of SAT layers were measured by LIPOMETER at 15 specified body sites. To calculate the power of the different body sites to discriminate between CHD women and healthy controls, receiver operating characteristic (ROC) curve analysis was performed. For each parameter, sensitivity and specificity were calculated at different cutoff points. CHD women showed a significant decrease to 78.36% (p=0.012) at body site 11-front thigh, 73.10% (p=0.012) at 12-lateral thigh, 72.20% (p=0.009) at 13-rear thigh, 66.43% (p

The aim of this study was to examine the relationships between body fat measured by DXA and subcutaneous adipose tissue layers (SAT-layers) measured by LIPOMETER in adult males (n=28) and females (n=53). Body height and mass were measured and BMI was calculated (kg/m2). Measurements of the thicknesses of SAT-layers by LIPOMETER were performed at 15 original body sites. Body composition was measured using DXA. Total body fat % measured by DXA was highly dependent on the SAT-layers in the upper back and inner thigh in males (87.1%, R(2)x100) and the lateral chest, biceps, and calf in females (78.5%, R(2)x100). There were gender differences in trunk fat mass and right hand and leg fat mass calculation using specific SAT-layers. In conclusion, our results indicate that there are close relationships between SAT-layers and body fat measured by DXA. However, there are big differences between genders.

BACKGROUND: It is postulated that application of hyperbaric oxygenation may induce the production of radicals after HBO. Higher oxygenation and transport of oxygen increase the mitochondrial energy turnover, whereas inner mitochondrial radical formation decreases. METHODS: Several markers of oxidative stress in healthy volunteers (n = 21), including plasma carbonyl proteins (CP), malondialdehyde (MDA), oxidized LDL (oxLDL), 8-hydroxy-deoxyguanosine (8-OHdG), and erythrocyte glutathione peroxidase (GPx) activity are measured before, during, and after HBO. RESULTS: Median plasma concentrations of CP decreased significantly during HBO compared to CP levels before HBO (from 77.1 to 61.7 pmol/mg; p < 0.001) and increased again after HBO (to 78.1 pmol/mg; p = 0.035). 8-OHdG decreased significantly during HBO (8.1 ng/mL; p < 0.001) and remained constant after HBO (8.1 ng/mL) compared to "before HBO" (9.4 ng/mL). MDA increased significantly from 0.92 μM (before HBO) to 1.26 μM (during HBO, p < 0.01) and decreased again to 1.00 μM (after HBO, p = 0.023). Erythrocyte GPx activity also increased significantly during HBO (26.5 ± 14.7; p = 0.005), but not after HBO (25.6 ± 17.2 IU/mg). A negative correlation was observed between GPx and MDA only during HBO (r = -0.518; p = 0.016). CONCLUSIONS: We assume that higher oxygen consumption decreases, on the one hand, the inner mitochondrial generation of free radicals and, on the other, RONS by activation of detoxifying enzymes like GPx.

Skinfold Calipers are widely used to obtain subcutaneous adipose tissue thickness because of its non-invasive, simple and inexpensive technique. Nevertheless, Caliper skinfold thicknesses have the disadvantage of measuring compressed adipose tissue and double layers of skin, which might reduce the precision of these results. In contrast, the computerized optical device Lipometer was developed to permit a quick, precise and non-invasive determination of non-compressed mono layers of subcutaneous adipose tissue thickness. In the present paper we investigate the hypothesis that Caliper skinfold thicknesses are significantly different from subcutaneous adipose tissue thicknesses in mm, which can be measured by Lipometer. Caliper and Lipometer results were obtained from 371 Estonian boys aged between 9.0 and 12.8 years. Measurements were performed at six different body sites: triceps, biceps, upper back, upper abdomen, hip and front thigh. Caliper measurements were systematically higher than Lipometer results in a range between 1.2 mm (hip) and 11.08 mm (front thigh). Comparing Caliper and Lipometer results very low measurement agreement was found. The two methods provided very poor interchangeability.

In the context of enteral feeding in children the influence on growth and the question of fat resorption is of great interest. We, therefore, measured the thickness of subcutaneous body fat in a sample of long-term enterally fed toddlers and healthy controls. In 33 long-term enterally fed toddlers (10 girls, 23 boys) and 275 healthy controls (128 girls, 147 boys) subcutaneous body fat was measured by means) of the optical device Lipometer. All participants were divided into three age groups (infants, toddlers and children). The height (p=0. 014, -11.7 cm, -12.5%) and weight (p=0.012, -3.0 kg, -21.9%) of long-term enterally fed female toddlers were significantly lower than healthy controls, while male enterally fed toddlers had lower values in all anthropometric measures compared to healthy controls: height (p=0.003, -8.0 cm, -8.4%), weight (p0.001, -3.5 kg, -24.8%), BMI (p=0.004, -1.3 BMI), Z-score BMI (p=0.001, -1.2 Z-score BMI), upper arm circumference (p0.001, -1.6 cm, -10.1%) and waist circumference (p0.001, -6.2 cm, -12.5%). Tube fed toddlers showed a similar body fat distribution when compared to healthy controls, but demonstrated significantly lower values of anthropometric measurements. The results indicate that long-term enterally fed children have ample fat stores but lack physical development.

The new optical device, the lipometer, enables the noninvasive, quick, safe, and precise determination of the thickness of subcutaneous adipose tissue (SAT) layers at any given site of the human body. Fifteen anatomically well-defined body sites from neck to calf describe a SAT topography (SAT-Top) like an individual "fingerprint" of a subject. This SAT-Top was examined in 16 women with polycystic ovary syndrome (PCOS) and compared to the body fat distribution of 87 age-matched healthy controls and 20 type-2 diabetic women. SAT-Top differences of these three groups were described and, to render the possibility of visual comparison, the 15-dimensional body fat information was condensed to a two-dimensional factor plot by factor analysis. All PCOS patients had an android body fat distribution with significantly thinner SAT layers on the legs as compared to healthy controls. Moreover, a hierarchical cluster analysis resulted in two distinctly different groups of PCOS women, a lean (PCOSL) and an obese (PCOSO) cluster: compared to healthy women, lean PCOS patients had significantly lower total SAT development, even though height, weight, and body mass index did not deviate significantly. Especially on the legs, their SAT layers were significantly lowered, indicating a more "apple-like" fat distribution type. Obese PCOS women showed a SAT-Top pattern very similar to that of women with type-2 diabetes, although the mean age difference between these groups was more than 30 years. Compared to healthy controls, the SAT-Top of these obese PCOS patients was strongly shifted into the android direction, appearing as "super-apples" with a significantly increased upper trunk obesity to 237.8% and a significantly decreased leg SAT development to 79.8%.

The aim of this study was to compare the relationships between bioelectrical impedance and thicknesses of adipose tissue measured by traditional skinfold caliper (double thickness) or a LIPOMETER device (single non-compressed thickness) in 9- to 12-year-old boys ( n=52) and girls ( n=44). In total, nine skinfolds (triceps, subscapular, biceps, iliac crest, supraspinale, abdominal, front thigh, medial calf, mid-axilla) were measured. Measurement for the thickness of subcutaneous adipose tissue layers (SAT-layers) by LIPOMETER were performed at 15 body sites (neck, triceps, biceps, upper back, front chest, lateral chest, upper abdomen, lower abdomen, lower back, hip, front thigh, lateral thigh, rear thigh, inner thigh, calf). Body bioelectrical impedance was measured with a multiple-frequency impedance device Multiscan-5000 (Bodystat, UK). Impedance at 50 kHz highly correlated with body mass ( r=-0.47 in boys, r=-0.46 in girls, r=-0.47 in total group). The relationship with body height was significant only in girls ( r=-0.42). Skinfold thicknesses measured by caliper did not correlate significantly with body impedance at 50 kHz. SAT-layers measured by LIPOMETER at triceps, front thigh, lateral thigh and rear thigh sites in boys and at the lateral thigh site in girls correlated significantly with body impedance measured at 50 kHz. Stepwise multiple regression analysis indicated that the iliac crest and front thigh skinfold thicknesses measured by caliper characterized only 5.7-12.0% of the impedance at 50 kHz in the total group ( n=96). From the measured 15 SAT-layers, the most significant was the lateral thigh layer which characterized 20.0%, 11.9% and 13.6% of the impedance at 50 kHz in boys, girls and the total group, respectively. It was concluded that the influence of subcutaneous adipose tissue on body impedance is relatively low in children. However, SAT-layers have a slightly higher influence on body impedance than skinfold thicknesses measured by caliper. The sum of skinfolds or SAT-layers did not correlate significantly with body impedance in any group.

Neopterin, 7,8-dihydroneopterin and 5,6,7,8-terahydroneopterm are secreted by human macrophages after activation by interferon-γ. The biological stability of the reduced pterins is less than one hour and therefore distinctly lower than that of neopterin. Ptendme derivatives are known to act as enhancers as well as scavengers of radical mediated processes. The effects of the three pteridines were investigated on hemoglobin and myoglobin, biomolecules that generate reactive oxygen species themselves. The amounts of liberated carbon monoxide and non heme iron stemming from the cleaved porphyrin were quantified. Iron and carbon monoxide were yielded at equimolar concentrations with a con-elation coefficients greater 0.9. Dihydroneopterin and tetrahydroneopterin were assumed to reduce the heme iron in intact heme molecules creating the conditions for adducting carbon monoxide and additionally the subsequent generation of hydroxide radicals via autooxidation. The effect of neopterin under these experimental concentrations was rather weak.

Recent studies suggest that ozone is present in atherosclerotic lesions. Since these lesions are characterized by a dramatic accumulation of low-density lipoprotein (LDL), we aimed to investigate whether ozone is capable of oxidizing LDL, thereby rendering this lipoprotein atherogenic. Lipid hydroperoxide (LPO) concentrations and thiobarbituric acid reactive substances (TBARS) were measured to assess the oxidative status of the lipid part of LDL. Relative electrophoretic mobility (REM) and oxidation-specific immune epitopes were measured to assess the oxidative status of the protein part (apoB) of the LDL particle. Ozone turned out to be a potent oxidant of LDL. LPO concentrations, TBARS, REM, and oxidation-specific immune epitopes significantly increased upon ozonization. Our results suggest that ozonization of LDL may be a novel pathway which supports atherogenesis. Ozone is capable of oxidizing the lipid part of LDL, followed by immediate oxidation of the protein part of LDL, rendering the lipoprotein atherogenic.

The new optical device Lipometer allows noninvasive, quick, and safe determination of the thickness of subcutaneous adipose tissue (SAT) layers (in mm) at any site of the human body. The specification of 15 evenly distributed body sites enables the precise measurement of subcutaneous body fat distribution, so-called subcutaneous adipose tissue topography (SAT-Top). SAT-Top was measured in 980 children aged 7-19 years. In this paper we describe the degree to which SAT-Top body sites are intercorrelated. We consider whether a meaningful reduction of data is possible using factor analysis, which factors can be extracted, and how SAT-Top data of children can be added to a factor value plot, depicting the essential results of age-dependent subcutaneous fat development. SAT layers situated on the same body area provide correlation coefficients up to +r = 0.91. Two factors are extracted: factor 1, containing all upper body sites (from neck to hip); and factor 2, consisting of all leg body sites. When all 980 children are divided into three age groups in a factor value plot, the first age group (7-11 years) shows almost equal SAT-Top development in boys and girls. Afterwards, for the consecutive age groups 2 (11-15 years) and 3 (15-19 years), the age-dependent subcutaneous fat development of boys and girls progresses into nearly orthogonal directions.

Women suffering from type-2 diabetes mellitus (NIDDM) show a more android fat pattern than healthy females, but to date no exact determination of their fat distribution differences exists. Measurements at 15 specified body sites with an optical device, the LIPOMETER, provide a subcutaneous adipose tissue topography (SAT-Top) of the individual. SAT-Top of 20 female NIDDM patients and 122 healthy controls was measured. ROC curve analysis was applied to evaluate the discriminative power of each body site and to provide cutoff values. Then a classification tree by the CART algorithm was established, showing SAT-Top differences between the two groups. Best discriminating results were achieved by the neck site (ROC area index = 0.76, sensitivity = 61.3%, specificity = 77.8%), the four sites of the thigh (area indices from 0.71 to 0.76), and a linear combination of all body sites stemming from a previous factor analysis, which provides condensed information of the extremities SAT-Top (area index = 0.80, sensitivity = 80.4%, specificity = 64.6%). The results could be improved by a summary measure of "android fat pattern" (area index = 0.89, sensitivity = 73.6%, specificity =88.3%) and a proportional measure of SAT-distribution, the relative neck (area index = 0.84, sensitivity = 83.0%, specificity = 70.5%). Overall, 136 (95.8%) of the 142 subjects were correctly classified by the classification tree (sensitivity = 75%, specificity = 99.2%). Both methods show the expected increased upper trunk obesity and decreased lower body obesity of NIDDM women compared with healthy females. Am. J. Hum. Biol. 12:388-394, 2000. Copyright 2000 Wiley-Liss, Inc.

To quantify subcutaneous adipose tissue topography (SAT-Top) describing individual SAT distribution for a subject or even a group we measured subcutaneous adipose tissue thickness at 15 specified body sites of 303 healthy women aged 20-69 yrs and 20 women with proven non-insulin-dependent diabetes mellitus (NIDDM) by the optical device 'LIPOMETER'. The type of upper-body- and lower-body-fat pattern, (apples or pears), was determined by factor analysis of the data. Upper body sites were highly loaded in factor 1, whereas factor 2 included highly loaded body sites from the lower extremities. For an individual, factor 1 scoresfactor 2 scores, was described as an 'apple'-type, while factor 2factor 1 was described as a 'pear'-type. We found about 80% 'pears' and 20% 'apples' in 20-29 year olds and 20% 'pears' and 80% 'apples' in 60-69 year old women. Women with NIDDM tended to be 'super-apples'. SAT-Top provides a useful differentiation between apples and pears and we recommend this approach as a screening method.

Summary In 30 atherosclerotic patients different serum analytes and neopterin concentrations in serum and urine were determined before and after Heparin-Induced Extracorporeal LDL and Fibrinogen Precipitation therapy. Neopterin concentrations in serum of all 30 patients were increased (mean=9.18 nmol/l, SD=3.23) compared to age matched healthy people (mean=5.34 nmol/l, SD=2.70) and were significantly lowered after H.E.L.P therapy (mean=S.22 nmol/l; SD=3.22, p=0.002, t-test) . These results suggest the involvement of the cellular immune system in the occurrence of atherosclerosis. Further neopterin, the macrophagederived immune activation marker, is significantly correlated with fibrinogen (linear correlation coefficient r=0.36, p=0.05). Long-term neopterin concentrations in serum of 4 patients (three with coronary heart disease and one with Papilla edema), from the first up to the 9th, respectively 12th therapy decreased, in contrast to fibrinogen which stayed stable or even increased during long-term treatment.

The optical device LIPOMETER allows for non-invasive, quick, precise and safe determination of subcutaneous fat distribution, so-called subcutaneous adipose tissue topography (SAT-Top). In this paper, we show how the high-dimensional SAT-Top information of women with type-2 diabetes mellitus (non-insulin-dependent diabetes mellitus (NIDDM)) and a healthy control group can be analysed and represented in low-dimensional plots by applying factor analysis and special artificial neural networks. Three top-down sorted subcutaneous adipose tissue compartments are determined (upper trunk, lower trunk, legs). NIDDM women provide significantly higher upper trunk obesity and significantly lower leg obesity ('apple' type), as compared with their healthy control group. Further, we show that the results of the applied networks are very similar to the results of factor analysis.

Since the early nineties the number of scientific papers reporting on artificial neural network (ANN) applications in medicine has been quickly increasing. In the present paper, we describe in some detail the architecture of network types used most frequently in ANN applications in the broad field of laboratory medicine and clinical chemistry, present a technique-structured review about the recent ANN applications in the field, and give information about the improvements of available ANN software packages. ANN applications are divided into two main classes: supervised and unsupervised methods. Most of the described supervised applications belong to the fields of medical diagnosis (n=7) and outcome prediction (n=9). Laboratory and clinical data are presented to multilayer feed-forward ANNs which are trained by the back propagation algorithm. Results are often better than those of traditional techniques such as linear discriminant analysis, classification and regression trees (CART), Cox regression analysis, logistic regression, clinical judgement or expert systems. Unsupervised ANN applications provide the ability of reducing the dimensionality of a dataset. Low-dimensional plots can be generated and visually understood and compared. Results are very similar to that of cluster analysis and factor analysis. The ability of Kohonen's self-organizing maps to generate 2D maps of molecule surface properties was successfully applied in drug design.

Treatment of Parkinson patients with l -DOPA (3,4-dihydroxy- l -phenylalanine) leads to endproduct inhibition of tyrosine hydroxylase, the key enzyme in dopamine biosynthesis and the enzyme needing tetrahydrobiopterin and iron as cofactors. To overcome this problem an alternative treatment was investigated which attempted to stimulate endogenous dopamine biosynthesis. Incubation of rat PC 12 cells with NADH (β-nicotinamide adeninedinucleotide) leads to increased dopamine production. We investigated the possibility that this increase of dopamine biosynthesis was due to stimulation of quinonoid dihydropteridine reductase, the enzyme which recycles the inactive dihydrobiopterin to the active tetrahydrobiopterin. The experiments showed that whereas NADH is able to increase dopamine production in PC 12 cells (rat phaeochromocytoma cells, clone PC 12) up to three-fold, no influence is exerted by NADH on pteridine metabolism; neither are tetrahydrobiopterin concentrations nor the de novo-biosynthesis of pteridines from guanosine triphosphate altered by NADH. Further no influence of NADH on protein de novo synthesis of quinonoid dihydropteridine reductase was observed. However, NADH was able to directly increase the catalytic activity of this enzyme. Our results suggest that the stimulation of dopamine biosynthesis by NADH is due to more rapid regeneration of quinonoid dihydrobiopterin to tetrahydrobiopterin.

Objective. Risk phenotypes for cardiovascular disease (CVD) differ markedly between countries, like the reported high difference in CVD mortality in Austria and Estonia. Hitherto, the goal of this study was to find out risk profiles in body fat distribution yet present in childhood, paving the way for later clinical end points. Methods. he subcutaneous adipose tissue (SAT) distribution patterns in 553 Austrian (A) and Estonian (E) clinically healthy normal weight boys aged 11.1 (±0.8) years were analysed. We applied the patented optical device Lipometer which determines the individual subcutaneous adipose tissue topography (SAT-Top). Results. Total body fat did not differ significantly between E and A boys. A discriminant analysis using all Lipometer data, BMI, and the total body fat (TBF) yielded 84.6% of the boys correctly classified in Estonians and Austrians by 9 body sites. A factor analysis identified the SAT distribution of E as critically similar to male adult patients with coronary heart disease (CHD). Conclusions. We show in normal weight Estonian boys a highly significant decreased fat accumulation on the lower body site compared to age matched Austrian males. This SAT-Top phenotype may play an important role for the increased cardiovascular risk seen in the Estonian population.

Background: Hashimoto's encephalopathy (HE) is a rare immune-mediated encephalopathy associated with autoimmune Hashimoto's thyroiditis. Objectives and Methods: We report on a patient with HE and significant clinical improvement correlating with an increase in cerebral blood flow demonstrated by hexamethylpropyleneamine oxime (HMPAO) single-photon emission computed tomography (SPECT). HMPAO-SPECT was performed with 740 MBq of technetium-99m-HMPAO. To demonstrate the improvement in regional cerebral blood flow, individual regions of interest were drawn around visually diminished HMPAO uptake, the lesion to reference region ratio was calculated and transverse section images and semi-quantitative measurements were performed. Results: We show a 5-year follow-up with significant clinical improvement, a 10-fold reduction in autoantibodies to thyroid peroxidase and an approximately 20% improvement in cerebral blood flow with HMPAO-SPECT. Conclusion: Adequate levothyroxine treatment achieving and maintaining euthyroidism should be considered as therapy to lower autoantibodies and improve clinical outcome in patients with Hashimoto's thyroiditis and encephalopathy.

The physiological reactions of the body in scuba diving situation can be simulated in a pressure chamber by increasing the ambient pressure. In this study the influence of a hyperbaric environment of 6 bar on the changes of the subcutaneous adipose tissue (SAT) thicknesses on different body sites in 68 voluntary men with undersea diving experience was investigated. Measurements of SAT-Topography (SAT-Top) were performed with the optical device Lipometer before and after hyperbaric exposure. We observed a significant increase of the SAT-layers of the upper body zones, upper abdomen (+24.5%), lower abdomen (+21%) and front chest (+19%) after hyperbaric exposure. This increase of volume can be assumed to the nitrogen accumulation in fat cells at increased ambient pressures. In conclusion we describe for the first time in detail the influence of a hyperbaric environment on quantitative and topographic changes of SAT.

Thrombophilic or haemorrhagic complications are possible adverse events following cardiac catheterization particularly in pediatric patients. It was therefore the aim of our study to compare the cardiac catheterization-related haemostatic changes in children with that in adults. The total of 50 patients was subdivided into Gr I (1–6 years), Gr II (7–18 years), and Gr III (19–58 years). Parameters of coagulation activation, plasma levels of various clotting factors and heparinase-modified thrombelastometry parameters were determined prior and immediately after cardiac catheterization. The haemostatic system of pediatric patients was markedly more affected by the procedure than that of adults. Levels of thrombin/antithrombin complex and prothrombin fragment 1+2 in the post-catheter plasma samples were significantly increased in Grs I and II, not in Gr III. The catheter-related decrease in fibrinogen and F II levels was higher in Gr I than in Grs II and III. F VII levels were significantly decreased in Grs I and II, not in Gr III. The catheter-related prolongation of Coagulation times was highest in Gr I, followed by Gr II and finally Gr III. A significant catheter-related decrease of maximum clot firmness was observed solely in Gr I. Our results show that cardiac catheterisation perturbs the haemostatic system of adults, and, even more pronounced, that of pediatric patients. Thus, our results indicate that children might be at a higher risk for either thrombotic complications or post-operative bleeding events than adults.

AIMS: We studied the relationship of subcutaneous adipose tissue layers (SAT-layers) measured at 15 specified body sites with leptin before and after a weight loss program for three weeks. SUBJECTS AND METHODS: In 70 obese girls, SAT-layers were measured by means of the optical device, lipometer. Fat mass (FM) was estimated by means of bioelectrical impedance. RESULTS: At the beginning of the study, all estimates of adiposity, insulin, and SAT-layers from the upper body (from 1–neck to 6–lateral chest) were correlated to leptin at a P-value of

The heparinase-modified thrombelastometry (HEPTEM) assay is a promising tool to assess the coagulation status of heparinised patients. The aim of our study was to examine the heparin neutralizing capability of the HEPTEM assay in plasma samples.In the HEPTEM assay, blood or plasma samples become activated via the intrinsic pathway in the presence of a heparin processing enzyme.We examined coagulation times (CTs) in the presence of increasing amounts (0-4 IU/mL) of heparin. We found that up to a concentration of 0.5 IU/mL, heparin is completely neutralized. However, CTs increased linearly in the presence of heparin concentrations higher than 0.5 IU/mL, indicating incomplete heparin neutralization in the standard HEPTEM assay.We provide herein a mathematical procedure to correct the misleadingly prolonged CTs (for heparin0.5 IU/mL) for the HEPTEM assay performed in plasma samples to allow better estimation of the coagulation status in patients requiring intense anticoagulation (e.g., patients undergoing cardiac surgery).

Epiploic appendagitis is a rare cause of abdominal pain. Diagnosis of epiploic appendagitis, although infrequent, is easily made with CT or ultrasonography in experienced hands. As reported in the literature, most patients with primary epiploic appendagitis are treated conservatively without surgery, with or without anti-inflammatory drugs. A small number of patients are treated with antibiotics and some patients require surgical intervention to ensure therapeutic success. Symptoms of primary epiploic appendagitis usually resolve with or without treatment within a few days. A correct diagnosis of epiploic appendagitis with imaging procedures enables conservative and successful outpatient management of the condition and avoids unnecessary surgical intervention and associated additional health-care costs. Gastroenterologists and all medical personnel should be aware of this rare disease, which mimics many other intra-abdominal acute and subacute conditions, such as diverticulitis, cholecystitis and appendicitis. This article reviews epiploic appendagitis and includes discussion of clinical findings, pathophysiology, diagnosis and therapeutic possibilities.

The question arises whether oxidative stress is connected with systemic immune activation in Alzheimer's disease (AD) and mild cognitive impairment (MCI). During immune response interferon-gamma stimulates the kynurenine (Kyn) pathway, a major route of L-tryptophan (Trp) degradation.Plasma Kyn, Trp and the Kyn to Trp ratio (Kyn/Trp), carbonyl proteins (CP) as oxidative stress parameter and homocysteine, neopterin, folate and vitamin B12 were measured from patients with AD and MCI (n = 16: 6 females and 4 males with AD, 3 females and 3 males with MCI; 63.3 +/- 13.7 years), and an age matched healthy control group (n = 15: 11 females and 4 males; 62.8 +/- 3.6 years). We correlated the oxidative stress parameter CP with the degradation of Trp creating a new quotient CP/Trp and calculated the sensitivity, specificity, and cut-off values for CP, Trp, CP/Trp, and Kyn/Trp using discriminate analysis.CP was significantly higher in AD/MCI (930 +/- 265 pmol/mg; p0.001) compared to controls (300 +/- 120 pmol/mg), Trp was significantly lower in AD/MCI (48.9 +/- 9.0 micromol/L; p0.001) than controls (65.2 +/- 10.7 micromol/L). While Kyn showed no significant difference between AD/MCI (1.72 +/- 0.56 micromol/L) and controls (1.53 +/- 0.29 micromol/L), Kyn/Trp was significantly higher in AD/MCI (35.2 +/- 8.8 micromol/mmol; p0.001) than in controls (23.7 +/- 4.2 micromol/mmol). CP/Trp ratio was more than 4 fold higher in the AD/MCI group (19.8 +/- 7.76 [(pmol/mg)/(micromol/L)]; p0.001) compared to controls (4.79 +/- 2.26 [(pmol/mg)/(micromol/L)]). Homocysteine, folate, vitamin B12, and neopterin showed no significant difference. Discriminant analysis provided CP alone as the best clinical marker with highest sensitivity and highest specificity for AD/MCI followed by the ratio of CP/Trp. ROC curve analysis provided the best result for CP/Trp.These preliminary results support the hypothesis that oxidative damage to proteins is directly connected with Trp degradation and Kyn pathway in the systemic immune activation.

Introduction Patent paraumbilical and abdominal subcutaneous veins are found frequently as collaterals in patients due to portal hypertension mainly in liver cirrhosis. Case presentation For evaluation of portal hypertension in a 72-year-old Caucasian man without liver cirrhosis, magnetic resonance imaging with gadolinium contrast-enhancement was performed and demonstrated a missing inferior vena cava. A blood return from the lower extremities was shown through enlarged collateral veins of the abdominal wall, vena azygos and hemiazygos continuation, and multiple liver veins emptying into the right cardiac atrium. We describe a rare case of abdominal subcutaneous wall veins as collaterals caused by a congenitally absent infrarenal inferior vena cava with preservation of a hypoplastic suprarenal segment. Conclusion Knowledge of these congenital variations can be of clinical importance and it is imperative for the reporting radiologist to identify these anomalies as they can have a significant impact on the clinical management of the patient.

Objective: To compare subcutaneous adipose tissue topography (SAT-top) in obese juveniles with age-matched normal-weight controls. Research Methods and Procedures: The optical device LIPOMETER (European Patent EP 0516251) enables the non-invasive, rapid, safe, and precise measurement of the thickness of subcutaneous adipose tissue. Fifteen defined body sites (1 = neck to 15 = calf) characterize the individual SAT-top like an individual fingerprint. SAT-top of 1351 juveniles (obese: 42 boys, 59 girls, normal weight: 680 boys, 570 girls) from 7 to 19 years of age were measured. For visual comparison, the 15-dimensional SAT-top information was condensed by factor analysis into a two-dimensional factor plot. Results: Both female and male obese juveniles had markedly increased adipose tissue layers at 7 = upper abdomen, 8 = lower abdomen, 5 = front chest, and 6 = lateral chest. The pubertal changes of body shape and fat distribution of the normal-weight boys and girls (boys show thinner adipose tissue layers on their legs, whereas girls had thicker adipose tissue layers at the extremities) were not seen in the obese group. Independently of age and sex, all of the obese juveniles showed a similar, more android body fat distribution with increased trunk fat. Discussion: SAT-top of the obese juveniles is similar to that of patients with type 2 diabetes, polycystic ovary syndrome, and coronary heart disease. Patients with these metabolic disorders and obese juveniles are located in the factor plot in the same area. This body shape may indicate a risk profile for developing polycystic ovary syndrome (women), type 2 diabetes, and early atherosclerosis (both sexes).