Ghrelin Treatment of Cachectic Patients with Chronic Obstructive Pulmonary Disease: A Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial

BACKGROUND: Pulmonary cachexia is common in advanced chronic obstructive pulmonary disease (COPD), culminating in exercise intolerance and a poor prognosis. Ghrelin is a novel growth hormone (GH)-releasing peptide with GH-independent effects. The efficacy and safety of adding ghrelin to pulmonary rehabilitation (PR) in cachectic COPD patients were investigated. METHODOLOGY/PRINCIPAL FINDINGS: In a multicenter, randomized, double-blind, placebo-controlled trial, 33 cachectic COPD patients were randomly assigned PR with intravenous ghrelin (2 µg/kg) or placebo twice daily for 3 weeks in hospital. The primary outcomes were changes in 6-min walk distance (6-MWD) and the St. George Respiratory Questionnaire (SGRQ) score. Secondary outcomes included changes in the Medical Research Council (MRC) scale, and respiratory muscle strength. At pre-treatment, serum GH levels were increased from baseline levels by a single dose of ghrelin (mean change, +46.5 ng/ml; between-group p<0.0001), the effect of which continued during the 3-week treatment. In the ghrelin group, the mean change from pre-treatment in 6-MWD was improved at Week 3 (+40 m, within-group p = 0.033) and was maintained at Week 7 (+47 m, within-group p = 0.017), although the difference between ghrelin and placebo was not significant. At Week 7, the mean changes in SGRQ symptoms (between-group p = 0.026), in MRC (between-group p = 0.030), and in maximal expiratory pressure (MEP; between-group p = 0.015) were better in the ghrelin group than in the placebo group. Additionally, repeated-measures analysis of variance (ANOVA) indicated significant time course effects of ghrelin versus placebo in SGRQ symptoms (p = 0.049) and MEP (p = 0.021). Ghrelin treatment was well tolerated. CONCLUSIONS/SIGNIFICANCE: In cachectic COPD patients, with the safety profile, ghrelin administration provided improvements in symptoms and respiratory strength, despite the lack of a significant between-group difference in 6-MWD. TRIAL REGISTRATION: UMIN Clinical Trial Registry C000000061

Recent Results from LHD Experiment with Emphasis on Relation to Theory from Experimentalist’s View

he Large Helical Device (LHD) has been extending an operational regime of net-current free plasmas towardsthe fusion relevant condition with taking advantage of a net current-free heliotron concept and employing a superconducting coil system. Heating capability has exceeded 10 MW and the central ion and electron temperatureshave reached 7 and 10 keV, respectively. The maximum value of β and pulse length have been extended to 3.2% and 150 s, respectively. Many encouraging physical findings have been obtained. Topics from recent experiments, which should be emphasized from the aspect of theoretical approaches, are reviewed. Those are (1) Prominent features in the inward shifted configuration, i.e., mitigation of an ideal interchange mode in the configuration with magnetic hill, and confinement improvement due to suppression of both anomalous and neoclassical transport, (2) Demonstration ofbifurcation of radial electric field and associated formation of an internal transport barrier, and (3) Dynamics of magnetic islands and clarification of the role of separatrix

Comparison of patellar position and moment arm between tibial plateau leveling osteotomy and cranial closing wedge ostectomy: An ex vivo study

Background: Tibial plateau leveling osteotomy (TPLO) and cranial closing wedge ostectomy (CCWO) are common treatments for cranial cruciate ligament disease. These two techniques mainly differ in whether the proximal tibial fragment contains the attachment site of the patellar ligament. Currently, there are no reports comparing how these techniques affect the patellofemoral joint. Aim: This ex vivo study aimed to compare the effects of TPLO and CCWO on the patellar position and moment arm in healthy Beagles. Methods: TPLO and CCWO were performed on each stifle in six cadavers of Beagles. Pre- and postoperative mediolateral radiographs with the stifle angle at approximately 90&#xb0; were obtained. The modified Blumensaat index (MBI), patellar ligament length to patella length ratio (PLL:PL), and patellar moment arm (PMA) were measured in each radiograph. Mixed-model multiple regression analyses for the MBI, PLL:PL, and PMA, with the surgical procedure as the independent variable, was then performed. The joint angle was included as an independent variable for MBI, and PMA. Results: The PLL:PL was decreased after TPLO. Additionally, the PLL:PL after TPLO was significantly lower than that after CCWO. The MBI decreased with flexion. Postoperative MBI values were decreased for both procedures, with lower values after CCWO than after TPLO. The PMA values decreased with flexion. Postoperative values for both procedures were decreased in the PMA, with the values being lower after CCWO than after TPLO. Conclusion: Both TPLO and CCWO affect the patellofemoral joint. Compared with TPLO, CCWO produced greater downward traction on the patella. Therefore, CCWO may be used to correct the patellar alta and treat cranial cruciate ligament disease. [Open Vet J 2023; 13(3.000): 262-269