RESUMEN
AIM: Chitinase-3-like protein 1 (CHI3L1) is involved in tissue remodelling and inflammatory processes. Plasma levels are elevated in patients with insulin resistance and T2DM. We recently showed that CHI3L1 and its receptor protease-activated receptor 2 (PAR-2) are expressed in skeletal muscle. Activation of PAR-2 by CHI3L1 protects against TNF-α-induced inflammation and insulin resistance. However, the effect of exercise on CHI3L1 and PAR-2 signalling remains unknown. The aim of this work was to study the impact of exercise on CHI3L1 production and the effect of CHI3L1/PAR-2 signalling on skeletal muscle growth and repair. METHODS: Three human exercise studies were used to measure CHI3L1 plasma levels (n = 32). In addition, muscle and adipose tissue CHI3L1 mRNA expression was measured in response to acute and long-term exercise (n = 24). Primary human skeletal muscle cells were differentiated in vitro, and electrical pulse stimulation was applied. In addition, myoblasts were incubated with CHI3L1 protein and activation of MAP kinase signalling as well as proliferation was measured. RESULTS: Circulating CHI3L1 levels and muscle CHI3L1 mRNA were increased after acute exercise. In addition, CHI3L1 mRNA expression as well as CHI3L1 secretion was enhanced in electrically stimulated cultured myotubes. Incubation of cultured human myoblasts with CHI3L1 protein leads to a strong activation of p44/42, p38 MAPK and Akt as well as enhanced myoblast proliferation. CONCLUSION: Our findings suggest that CHI3L1 is induced by acute exercise and that CHI3L1/PAR-2 signalling activates myocyte proliferation, which is important for restructuring of skeletal muscle in the response to exercise training.
Asunto(s)
Proliferación Celular/fisiología , Proteína 1 Similar a Quitinasa-3/metabolismo , Ejercicio Físico/fisiología , Células Musculares/metabolismo , Adulto , Anciano , Humanos , Masculino , Persona de Mediana Edad , Músculo Esquelético/metabolismo , ARN Mensajero/análisis , Reacción en Cadena en Tiempo Real de la Polimerasa , Transducción de Señal/fisiología , Adulto JovenRESUMEN
OBJECTIVE: Aim of the study was to assess whether different birth management of an english and german department can influence the maternal and neonatal outcome. MATERIAL AND METHODS: The database consisted of routinely published data from 1986-95 for two clinical units in Solihull (England) and Ibbenbueren (Germany) comprising 34 820 and 9 053 deliveries respectively. In order to standardise the obstetric risk profiles the heterogeneous primary groups were subdivided into "standard primip groups". A statistical comparison using the "binomial confidence interval method" was carried out. RESULTS: In the standardised comparison induction of labour, duration of labour 1-6 hours, vaginal delivery from cephalic presentation, elective caesarean section, both for cephalic and breech presentation, transfer to the childrens hospital were less frequent in Solihull. On the other hand, Solihull showed more frequent oxytocin administration, fetal blood analysis, epidural anaesthesia, episiotomies, duration of labour > 13 hours, forceps, ventouse and emergency caesarean section deliveries from cephalic presentation, vaginal deliveries or emergency caesarean sections from breech presentation, resuscitation of the newborn using mask and/or drugs, maternal blood loss > 1 000 ml as well as abnormalities of placental separation. Despite the different management of the departments being compared no significant differences in the incidence of perinatal hypoxia as determined by Apgar scores at 5 minutes nor in the fetal mortality rate between the units could be identified. CONCLUSION: Using standardised data the quality of obstetric and perinatal care in England and Germany can be reliably compared. Different birth management does not significantly influence the neonatal outcome.
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Obstetricia/normas , Complicaciones del Embarazo/epidemiología , Resultado del Embarazo , Presentación de Nalgas , Intervalos de Confianza , Bases de Datos Factuales , Parto Obstétrico , Inglaterra , Femenino , Alemania , Humanos , Recién Nacido , Embarazo , Garantía de la Calidad de Atención de SaludRESUMEN
BACKGROUND: In German nursing insurance, the act of classifying the client into four categories of disability is based on legally defined distinct criteria. When classifying deceased persons it is often impossible to collect all the required information. PRIMARY OBJECTIVE: We aimed to determine the ability of an artificial neural network (ANN) to calculate the category of disability, to investigate the response of the ANN to input items of different nature, quantity and data quality, and to estimate the minimum number of training data required. RESEARCH DESIGN: The investigation was conducted as a retrospective observational study. METHODS AND PROCEDURES: The analysis was based on routine records of 14000 adult clients of the nursing insurance. Several ANNs were trained, varying nature, number and quality of the input items as well as the size of the training data set. Each ANN's classification competence was tested on independent validation data, judging the ANN's conformance to the result of the individual expert assessment, using kappa statistics. MAIN RESULTS: Fed with all 30 input items available, the net classified 80% of cases correctly (weighted kappa = 0.78). Using three input items, weighted kappa was 0.63. Severe misclassification (deviation by more than one category in either direction) ranged between 0.2% (all 30 input items) and 3.7% (3/30 items). The less complete the individual input items were, the less accurate was the net's estimate. A 20% rate of missing values was well tolerated. A training set comprising 500 cases was adequate. CONCLUSIONS: The input item set inherits redundancy. The ANN's ability to correctly respond to subsets of input items makes it a powerful tool in quality control. In the categorization of deceased persons when only an incomplete input item set is available, the ANN can achieve satisfactory results.
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Evaluación de la Discapacidad , Seguro por Discapacidad/clasificación , Redes Neurales de la Computación , Atención de Enfermería , Actividades Cotidianas , Adulto , Estudios de Evaluación como Asunto , Alemania , Humanos , Estudios Retrospectivos , Validación de Programas de ComputaciónRESUMEN
OBJECTIVE: In order to characterise carcinoma of the breast the determination of ploidy can be used in addition to established prognostic factors such as histology and grading. The aim of the investigation was to establish the association between histology, grading and ploidy and to indicate the prognostic and predictive value of these parameters in relation to disease free survival (DFS) and overall survival (OS). MATERIAL AND METHODS: 125 consecutive cases of primary breast carcinoma occurring between the years 1992-1995 were surveyed. The median follow up time lasted 45 months. Correlation analyses were carried out using the Chi-square test, Kaplan-Meier (univariate) and Cox (multivariate) methods. RESULTS: Histology and grading showed no correlation to ploidy but seems to be of importance for DFS in node-negative breast carcinoma. Ploidy did not influence neither DFS nor OS. Ductal histology appeared to be a useful factor in predicting the response of cases treated with an anti-oestrogen (Tamoxifen) since in this group a higher relapse rate of 25% occurred. CONCLUSIONS: Ploidy appears not to be of clinical importance.