The present study was conducted to examine whether gene expression of the insulin signaling pathway is activated in response to a single bout of exercise. Adult male rats underwent a single bout of treadmill exercise for 90 min at 22 m/min on a 6°C incline. The animals were sacrificed immediately after exercise or after a predetermined post-exercise recovery period of up to 48 h, and the level of mRNA in the gastrocnemius muscle was measured by the RT-PCR method. Immediately after exercise, mRNA levels of insulin signal transduction intermediates in the gastrocnemius muscle were lower in the exercise group than in the controls. Following this tendency reduction, mRNA levels of insulin receptor, IRS-1, PI 3-kinase, SH-PTP2 and Nck were higher in the exercise group than in the controls. The levels of PI 3-kinase mRNA was significantly higher in the exercise group than in the controls within 6 h after exercise, while levels of mRNA for insulin receptor, IRS-1, SH-PTP2 and Nck were significantly higher in the the exercise group than in the controls at 48 h after exercise. Gene expression of oncogenes was also affected by a single bout of exercise. Levels of c-fos and c-myc mRNA were significantly higher than in the controls immediately after exercise, while the level of c-jun mRNA was lower in the exercise group at 3 h after exercise. Thus, a single bout of exercise affects the gene expression of insulin signal transduction pathway intermediates and oncogenes in rat gastrocnemius muscle. The present findings suggest that an exercise-induced adaptive increase of skeletal muscle insulin sensitivity is a cumulative effect of a single bout of exercise on the gene expression of insulin signal transduction pathway intermediates.

INTRODUCTIONEarly detection of catheter-related candidemia is necessary to ensure that patients receive prompt and appropriate treatment. The aim of the present case-control study is to investigate the clinical features of catheter-related candidemia at disease onset, so as to determine the clinical indications for empiric antifungal therapy.

METHODSAll 41 cases of catheter-related candidemia from September 2009 to August 2011 at a teaching hospital were included in the present study. To determine the characteristics that were risk factors for developing catheter-related candidemia, we compared all cases of catheter-related candidemia with all 107 cases of catheter-related blood stream infection (CRBSI) caused by non-Candida spp.

RESULTSIn comparison with CRBSI due to non-Candida spp., the duration of catheter use was significantly longer in cases of catheter-related candidemia (13.9 ± 9.0 days vs. 23.2 ± 25.2 days). There was also a significant difference in the frequency of pre-antibiotic treatment between catheter-related candidemia and CRBSI due to non-Candida spp. (97.6% [40/41 cases] vs. 44.9% [48/107 cases]). Patients with catheter-related candidemia also had significantly more severe clinical statuses (measured using the Sepsis-related Organ Failure Assessment score) than patients with CRBSI due to non-Candida spp. (7.63 ± 3.65 vs. 5.92 ± 2.81).

CONCLUSIONWhen compared to patients with CRBSI caused by non-Candida spp., patients with catheter-related candidemia had significantly more severe clinical backgrounds, longer duration of catheter use and more frequent prior administration of antibiotic agents.

Aged ; Aged, 80 and over ; Candida ; pathogenicity ; Candidemia ; diagnosis ; Case-Control Studies ; Catheter-Related Infections ; diagnosis ; Female ; Humans ; Male ; Middle Aged

A woman in her 60s was being treated for diabetes and hypertension but had impaired activities of daily living (ADL) due to severe obesity (150 kg). She was transported to the emergency department because of disturbance of consciousness in August 201X. Imaging findings showed decreased permeability of the whole right lung field. She was intubated and started on ceftriaxone plus levofloxacin for severe infection with respiratory failure. Erysipelothrix rhusiopathiae was detected in blood cultures, leading to a diagnosis of sepsis due to a large pressure ulcer on the posterior aspect of the thigh. We switched levofloxacin to clindamycin and continued medical treatment, and she was extubated on the 10th day of illness. However, type 2 respiratory failure was prolonged because of alveolar hypoventilation due to obesity and she required noninvasive positive pressure ventilation. Also, she had difficulty getting out of bed due to obesity, disuse syndrome, and pressure ulcer. Cooperation among staff from many professions, including respiratory nursing, intensive care nursing, wound, ostomy and continence nursing, physical therapy, and nutrition management, led to improvement of ADL and weight loss (to 109 kg), allowing her to be transferred out of the intensive care unit.